Household Power Dynamics in Smoke- and Aerosol-Free Home Interventions

Introduction: Voluntary household bans on tobacco and nicotine use are effective in preventing uptake and in reducing exposure to secondhand smoke and aerosol. However, barriers to ban adoption persist, especially in disadvantaged households and with the rise of new tobacco and nicotine products. Areas covered: This perspective article first briefly discusses the psychosocial embeddedness of tobacco and nicotine use, the role of voluntary household bans in prevention, barriers to their adoption, and existing individual-centered interventions promoting smoke- and aerosol-free homes. Expert opinion: Tobacco and nicotine use are embedded in relational psychosocial processes. We argue that household bans typically emerge through negotiation among household members with divergent health behaviors, beliefs, and decision-making power and are implemented in a dynamic interpersonal system. Thus, a key element of successful implementation of household bans is likely the consideration of household power dynamics. Conclusions: Extending the focus from the individual to the household-level is likely to help inform future research as well as the development of smoke- and aerosol-free home interventions. In particular, greater attention to gendered household power relations and the inclusion of smoking male partners may represent promising directions for future interventions