What's Thirdhand Smoke? Assessment of a Community's Readiness for 100% Smoke-Free Scent-Free Childcare Center Policy

Issue: Over a 18-month period staff of the Lexington-Fayette County Hlth. Dept. (LFCHD) delivered a continuing education unit to childcare centers (CCC's) about effects of tobacco use in their workplace and on child health.  They observed that CCC workers and leadership consistently showed no knowledge about thirdhand smoke (THS), or about how exposure during childcare endangered the health of infants and young children. LFCHD staff began to pursue the goal of reducing childhood exposure to THS by providing information and advocacy for THS and adoption of model tobacco policy to CCC's.  

Description: This pilot identified community readiness for 100% smoke-free scent-free (SF-SF) policy for CCC’s in Fayette County, KY by: 1) assessing CCC’s tobacco policies and parents’ readiness to financially support them; 2) increasing knowledge of THS in CCC's; 3) initiating dialogue about 100% SF-SF policy with CCC directors; and 4) providing recognition for CCC’s that adopted model policies. Model policy stipulated that no smoking is allowed on CCC’s property, employees may not report for work in clothes smelling of smoke or strong scent used to mask smoke, may not leave the property or go to their vehicles during breaks to smoke, and there are no specified smoking areas.

Lessons Learned: Enforcement and definition of scent-free were primary concerns over policy change.  THS training was welcomed in CCC's that had smoke-free campuses, but received a lukewarm reception in others. Staff members who smoked felt they were being targeted unfairly, and about half doubted the validity of information.

Recommendations: Methods to increase participation from diverse CCC's are needed. A collaborative effort led by CCC workers, directors, parents, and community stakeholders in child health offers the most promise for policy change.  The fact that childcare workers tend to have low wages needs to be explored because it affects their smoking risk and openess to cessation.