Evidence-based practices are effective in increasing smoke-free home rules among Black women who smoke.

Background: Few studies have tested the effects of evidence-based practices on increasing smoke-free rules in the homes of Black and/or African American women who smoke cigarettes and/or little cigars or cigarillos and live in rural, low-resource communities. This paper presents findings from a randomized controlled trial that tested an intervention to increase the implementation of comprehensive (cigarettes, cigars, electronic cigarettes [e-cigarettes], hookah, IQOS, pipes) and tobacco product-specific smoke-free home rules at 12-month follow-up among this group.

Methods: Participants (n = 184) received motivational counseling delivered by community health workers, carbon monoxide biofeedback, and culturally relevant health education materials at 1, 3, and 6 months (intervention) or education materials only (control). We examined changes in (1) comprehensive and (2) tobacco product-specific smoke-free home rules between baseline and 12-month follow-up by study arm using binary and multinomial logistic regression with a generalized estimating equation approach (using 2-sided statistical significance tests).

Results: Over time, no difference in the implementation of comprehensive smoke-free home rules was observed by study arm. The intervention group had nearly 4 times higher odds of having a complete ban on cigarette smoking and statistically significantly higher odds of having a complete ban on e-cigarette use in the home compared with the control group.

Conclusions: Motivational counseling delivered by a community health worker and culturally relevant health educational materials were effective in increasing cigarette and e-cigarette smoke-free home rules among Black and/or African American women who smoke and reside in rural, low-resource communities. Our approach can inform future interventions that seek to address secondhand smoke exposure among disadvantaged groups (# NCT03476837).