Social determinants of smoking among parents with infants.
To estimate the smoking prevalence among parents of infants and examine these parents' socio-demographic characteristics. The sample of all parents of infants (669 mother-father pairs, 90 single parents) was derived from the 1995 Australian Health Survey. Data were collected by face-to-face interview in the respondent's home. Socio-demographic measures include parent's age, family structure, age-left-school, highest post-school qualification, occupation, and family income. The overall rate of smoking among parents was 28.9% (mothers 24.7%, fathers 33.7%). The lowest rate was observed among mothers with a post-school tertiary qualification (7.6%) and the highest among fathers aged 18-24 (49.0%). In 15.4% of two-parent families both parents smoked, but this rate differed markedly by family income (9.9% vs. 29.7% for high and low-income families respectively). Multiple logistic regression showed that parents who smoked were more likely to be young, minimally educated, employed in blue-collar occupations, and resident in low-income families. Infants in this sample who were exposed to parental smoking were likely to be at increased risk of experiencing higher mortality and morbidity for childhood conditions related to passive smoking; more likely to experience adverse health consequences in adulthood; and may themselves take up smoking in later life. The study results pose serious challenges to our tobacco control efforts and health interventions more generally. No single policy or strategy can adequately address the problem of parental smoking. We need macro/upstream approaches that deal with the degree of social and economic inequality in society, as well as more intermediate approaches that intervene at the level of communities, families and individuals.