HealthDay News — Many smoking parents expose their children to tobacco smoke in cars and few are advised by pediatricians to implement a smoke-free car policy, results of a recent study suggest.

Less than a third of parents in a trial-based survey reported having a policy of keeping the car smoke-free, Jonathan Winickoff, MD, MPH, of Massachusetts General Hospital for Children in Boston, and colleagues reported in Pediatrics. And nearly half of those who had no such policy said they smoked with their child in the car.

“Studies have shown that smoking one cigarette in a confined space such as inside a car creates unsafe levels of respiratory suspended particles,” the researchers wrote.

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Second-hand smoke exposure is known to contribute to children’s risk for cancer, lower respiratory infections, sudden infant death syndrome and ear infections, as well as worsening asthma.

Winickoff and colleagues examined the prevalence and factors associated with strictly enforced smoke-free car policies among smoking parents based on answers provided in exit interviews with smokers who served as controls as part of the larger Clinical Effort Against Secondhand Smoke Exposure, a pediatric office-based intervention trial.

Among 817 parents who smoked and had a car, 795 answered questions about their car smoking policy. Results showed 29% had a smoke-free car policy and 24% had a strictly enforced smoke-free policy.

Those with a strictly enforced policy tended to have a younger child and smoke 10 or fewer cigarettes per day. Of those without a smoke-free car policy, 48% reported that smoking occurred while children were present in the car.

Only 12% of smoking parents were advised by their pediatricians to institute a smoke-free car policy. Although about one in five parents reported having been asked about their smoking status, just 14% had been asked about whether smoking was allowed in their vehicle, and 12% were advised to have a policy of no smoking in the car.

“Childhood tobacco smoke exposure in confined spaces should be considered an intervention priority in the pediatric setting because children’s exposure to tobacco smoke is involuntary, and no one other than the child’s healthcare provider may have the opportunity to advocate for smoke-free cars,” the researchers wrote.


  1. Nabi-Burza E et al. Pediatrics 2012; DOI: 10.1542/peds.2012-0334.