On average, seven out of ten European households are smoke-free, according to a survey published in ERJ Open Research. However, not all countries are the same, and some are better than others at protecting children and adults from second-hand smoke at home.
England scored the highest out of the 12 countries included in the survey, with more than eight in ten homes being smoke-free, followed by Ireland, Latvia, and Italy. Romania, Bulgaria, and Spain allow smoke in more than four in ten homes, and Greece came out bottom, allowing smoke in more than five out of ten houses.
The authors recognise that the proportion of smoke-free homes is growing but claim that progress is too slow. More work is needed to protect children and adults from the health effects of second-hand smoke at home.
“Exposure to second-hand tobacco smoke, in any setting, is harmful to both adults and children. Since 2004, many European countries have introduced smoke-free regulations in public places. However, private settings, particularly homes, remain common sites for smoking and tobacco smoke exposure. With this research, we wanted to examine the home smoking rules across the general population in Europe. Although some national surveys have taken place, there has been no multi-country survey in Europe since 2010,” said Olena Tigova from the Tobacco Control Unit of the Catalan Institute of Oncology, Barcelona, Spain.
The team surveyed around 1,000 people in each of the 12 countries participating in the research (11,734 people in total). Participants were selected to represent the population of each country and interviewed face-to-face in 2017-18. All participants were asked if they were allowed to smoke inside their homes and, if so, if there were restrictions on smoking indoors.
The results showed that about 70% of all participants interviewed don’t allow smoking in their homes. A further 18% said they have strict rules but are not entirely smoke-free. Surprisingly, about 13% of participants don’t allow those living in the house to smoke, but visitors are free to do so.
The proportion of smoke-free homes according to the country was:
- England 84.5%
- Ireland 79.4%
- Latvia 78.9%
- Italy 75.8%
- Germany 75.0%
- Portugal 74.0%
- Poland 69.6%
- France 65.1%
- Spain 57.6%
- Bulgaria 56.6%
- Romania 55.2%
- Greece 44.4%
“Countries in Northern Europe have more smoke-free homes, while Eastern Europe and less affluent countries have more homes with partial smoking rules, allowing smoking in specific areas or on certain occasions,” said Tigova.
The researchers also examined other factors that influence rules on smoking in the home. Independently of country, the survey showed that women, older people, people with a higher level of education, and those living with children are more likely to have smoke-free homes.
“Our findings suggest that smoke-free homes are gradually increasing in Europe by about 1% each year. However, at this slow rate, it could take another 30 years for all homes in Europe to be smoke-free. To speed things up, stronger tobacco control measures are essential. Expanding smoke-free laws in workplaces, public spaces, and some private areas like cars, combined with new strategies to reduce smoking at home, will help make more European homes smoke-free sooner,” added Tigova.
To continue assessing the situation, the team wants to broaden their study and examine vaping behaviors in European homes and exposure to second-hand smoke and vape fumes in cars. They are also evaluating ways to encourage people to make their homes and cars smoke-free.
“While it’s good to see that more homes are becoming smoke-free, this survey reveals that there are countries that are lagging far behind and that progress is too slow,” said Dr. Filippos Filippidis, Chair of the European Respiratory Society Tobacco Control Committee, a reader in public health at Imperial College London, UK, and was not involved in the research. “Across Europe, millions of people still smoke, and millions more are exposed to second-hand smoke. Making our homes smoke-free protects children and adults from second-hand smoke, and it can help smokers cut down or quit, too. The cost of smoking in Europe, both to the public purse and to public health, is too high. We need comprehensive smoke-free laws and freely available support to help people quit.”
Tigova O, Stovall C, Castellani Y et al. (2024) Prevalence and determinants of smoke-free homes in 12 European countries: the TackSHS Survey. ERJ Open Research 2024 00950-2024; DOI: https://doi.org/10.1183/23120541.00950-2024