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Home- and Car-Based Rules in Foster Care Settings to Reduce Exposure to Secondhand Smoke: Before and after Romanian National Clean Air Legislation

1
Department of Implementation Science, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, USA
2
Department of Hygiene, University of Medicine and Pharmacy Targu Mures, Targu Mures 540139, Romania
3
Department of Obstetrics, Gynecology and Reproductive Biology Michigan State University, East Lansing, MI 48824, USA
4
Institute of Public Health, Semmelweis University, Budapest 1088, Hungary
5
Department of General Directorate of Social Assistance and Child Protection of Mures County, Targu Mures 540139, Romania
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(8), 1631; https://doi.org/10.3390/ijerph15081631
Received: 29 June 2018 / Revised: 29 July 2018 / Accepted: 31 July 2018 / Published: 2 August 2018
(This article belongs to the Section Global Health)
Background: To evaluate changes in smoke free rules in the foster care system after the implementation of the Romanian national clean air law. Methods: A repeated cross-sectional, self-administered questionnaire among foster care employees (n = 599) was conducted in 58 foster care homes during 2014 (n = 295) and 51 homes during 2016 (n = 304). We estimated the absolute difference in the proportion of employees who stated that smoke free rules existed before and after national clean air legislation. Results: There was an absolute increase in 4 of 5 smoke free measures after the law: bans on non-cigarette tobacco products (n = 169 to 206, +10.6%), non-smoking on premises for adults (n = 142 to 202, +18.3%), and for children (n = 201 to 239, +10.3%), and no smoking in cars to transport children (n = 194 to 227, +9%). There was a significant increase in the perception of outdoor bans that prohibit employees from smoking on foster care home premises (AOR 2.24, 95% CI 1.14–4.38). The increase in the perception of indoor smoking bans did not change. Conclusion: The national law may have had a spillover influence by strengthening smoke free rules in unregulated spaces. Nonetheless, foster care home rules could be further enhanced, particularly in cars that transport children. View Full-Text
Keywords: secondhand smoke; low- and middle-income countries; LMIC; vulnerable populations; foster care; orphanage; policy secondhand smoke; low- and middle-income countries; LMIC; vulnerable populations; foster care; orphanage; policy
MDPI and ACS Style

Foley, K.; Ferencz, L.; Meghea, C.; Abram, Z.; Pénzes, M.; Fogarasi-Grenczer, A.; Balazs, P.; Schmidt, L. Home- and Car-Based Rules in Foster Care Settings to Reduce Exposure to Secondhand Smoke: Before and after Romanian National Clean Air Legislation. Int. J. Environ. Res. Public Health 2018, 15, 1631.

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