An Evaluation of Mi Familia No Fuma: Family Cohesion and Impact on Secondhand Smoking

By Law, Jon; Kelly, Michael et al. | American Journal of Health Education, September-October 2010 | Go to article overview

An Evaluation of Mi Familia No Fuma: Family Cohesion and Impact on Secondhand Smoking


Law, Jon, Kelly, Michael, Garcia, Pema, Taylor, Thom, American Journal of Health Education


BACKGROUND

Secondhand smoke (SHS) can cause disease and premature death in individuals who do not smoke. (1,2) Children exposed to SHS are at increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, ear problems and more severe asthma. (1) Exposure of adults to SHS has immediate, adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer. (1,3)

Whereas a downward trend in SHS exposure emerged in the 1990s, approximately 60% of nonsmokers in the U.S. continue to have biologic evidence of SHS. (1,3-4) About 22% of U.S. children (ages 3-11 years of age) are exposed to SHS in their homes. (1) Across all groups, the percentage of nonsmokers with detectable serum cotinine was highest for those aged 4-11 years and 12-19 years. (4) Whereas SHS exposure is estimated to be higher among non-Hispanic blacks, National Health and Nutrition Examination Surveys (NHANES) report that at least 40% of all ethnic groups, including Mexican Americans, have detectable serum cotinine. (4)

Consistent with efforts to reduce smoking prevalence, SHS exposure prevention is recognized to be most effective when "clinical, regulatory, economic and social strategies" are implemented simultaneously. (5) At the state level, components of a comprehensive initiative may include: clean indoor air ordinances, smoking cessation programming, counter advertising, and excise taxes. (5) The Centers for Disease Control and Prevention (CDC) also recommend implementation of community-based programs to influence the knowledge, attitudes and practices of tobacco users and nonusers. (5)

The home smoking ban is a specific strategy that has been demonstrated to reduce risk of SHS exposure within Mexican and Mexican-descent households, including households with residents that smoke. (6) Evidence suggests that income, education and the presence of smokers in a household have an inverse relationship with the presence of home smoking rules. (7) Among one sample of U.S. and Mexican-born Hispanics, U.S. born mothers were less likely than their Mexican born peers to have a complete smoking ban in their household. (8)

PURPOSE

This evaluation study is an analysis of one permutation of Mi Familia, No Fuma (MFNF). MFNF is an approach designed by the Texas Department of State Health Services (TX DSHS) to decrease exposure to secondhand smoke (SHS) and consequently reduce smoking related disease among the Hispanic/Latino population in Texas. The design of the MFNF utilizes the construct "family cohesion," the influence that the Hispanic family can have on its members to influence smoking behaviors. TX DSHS has operationalized this approach through a range of media: Spanish-language television commercials, billboards, in-store posters, theatre slides, transit ads, brochures, Quit Line cards, and other printed materials that educate Hispanic families about tobacco prevention. (9) In the permutation evaluated, the Colonias Program of the Center for Housing and Urban Development (CHUD) at Texas A&M University, a community-based unit of the university, utilized the one-year home smoking ban and family picture as an intervention to decrease exposure to SHS in E1 Paso County, Texas. The intent of the evaluation is to identify relationships between MFNF, the family cohesion construct, and participants', both smokers and non-smokers, intent to allow smoking in the home.

METHODS

Program Design

In various community settings (health fairs, community meetings, parent/teacher nights at schools, etc), CHUD hosts booths at which its personnel share health education materials and discuss the dangers of smoking tobacco and SHS with attendees who visit the table. Attendees are invited to sign a family pledge that they will not allow SHS in their home during the next year. If the family is willing to take the pledge, CHUD personnel take a Polaroid picture of the family. …

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