Knowledge, attitudes and behaviours of caregivers regarding children's exposure to environmental tobacco smoke among Arabic and Vietnamese-speaking communities in Sydney, Australia

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Abstract
Objective. The aim of this study was to inform the design of a culturally appropriate health communication campaign addressing exposure of young children to Environmental Tobacco Smoke (ETS) in homes and cars, targeted at caregivers of children aged 0–6 years in the Arabic and Vietnamese-speaking communities in Sydney, Australia. Design. Nine focus groups (five Arabic and four Vietnamese) were conducted by qualified bilingual facilitators, recorded, transcribed, then translated and analysed qualitatively. Results. Results revealed concerning levels of knowledge, attitudes and behaviours regarding children's exposure to ETS. A poor understanding existed regarding what constituted passive smoking and the severity and extent of harm that ETS has on children. Smoking attitudes and behaviours described were not always consistent with the concern expressed about children's vulnerability to smoke. Initial changes in smoking patterns at home since the arrival of children were not always sustained. Despite awareness of the harm caused by smoking in the presence of their children, some caregivers continued to smoke in closed environments. Others felt it was sufficient protection to smoke in another room, with doors and/or windows open or by ensuring that visible smoke did not reach the child directly, whilst some smoked in the home or car only when children were not present. Smoking attitudes and behaviours in the presence of children were influenced by cultural and social norms associated with smoking. The desire to be sociable and hospitable often superseded concerns for children's health. Conclusion. The findings suggest that an effective communication campaign focusing on ETS and children in the Arabic and Vietnamese-speaking communities in Sydney should attempt to address knowledge deficits regarding ETS, as well as tackling entrenched culturally related attitudes and behaviours associated with smoking which are strongly linked to sociability and hospitality.

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