Survey of 12 European countries reveals the best and worst for smoke-free homes

Seven out of 10 homes in Europe are smoke-free, according to a major survey published in ERJ Open Research. However, some countries have come further than others in protecting children and adults from second-hand tobacco smoke in the home.

Greece came out bottom of the 12 countries in the survey, with smoking allowed in more than half of homes. In Romania, Bulgaria and Spain, more than four in 10 homes allow smoking to take place. England scored the highest out of the 12, with more than eight in 10 homes smoke-free, with Ireland, Latvia and Italy following next.

The researchers say that the proportion of smoke-free homes is growing but progress is too slow, and more work is needed to protect children and adults from the health effects of breathing second-hand smoke in the home.

The study’s author is Olena Tigova from the Tobacco Control Unit of the Catalan Institute of Oncology, Barcelona, Spain. She said, “Exposure to second-hand tobacco smoke, in any setting, is harmful to both adults and children. Since 2004, many European countries have introduced smoke-free regulations in public places.

“However, private settings, particularly homes, remain common sites for smoking and tobacco-smoke exposure. With this research, we wanted to examine the home smoking rules across the general population in Europe. Although some national surveys have taken place, there has been no multi-country survey in Europe since 2010.”

Around 1,000 people were surveyed in each of the 12 countries taking part in the research (11,734 people in total). These people were carefully selected to represent the population of each country and were interviewed face-to-face in 2017–18. They were asked whether smoking was allowed anywhere inside their homes and, if so, whether there were any restrictions on smoking indoors.

The survey showed that around 70% of all people interviewed do not allow smoking anywhere in their homes. A further 18% said they have some rules but are not completely smoke-free. Surprisingly, about 13% of homes where there are no smokers living in the house still allow visitors to smoke.

The proportion of smoke-free homes according to country from highest to lowest was:

1. England 84.5%
2. Ireland 79.4%
3. Latvia 78.9%
4. Italy 75.8%
5. Germany 75.0%
6. Portugal 74.0%
7. Poland 69.6%
8. France 65.1%
9. Spain 57.6%
10. Bulgaria 56.6%
11. Romania 55.2%
12. Greece 44.4%

“Countries in Northern Europe have more smoke-free homes, while Eastern Europe and less affluent countries have more homes with partial smoking rules, allowing smoking in specific areas or on certain occasions,” Olena Tigova said.

The researchers also looked at other factors that seem to influence rules on smoking in the home. They found that women, older people, people with a higher level of education and those living with children are more likely to have smoke-free homes.

Tigova added, “Our findings suggest that smoke-free homes are gradually increasing in Europe by about 1% each year. However, at this slow rate, it could take another 30 years for all homes in Europe to be smoke-free.

“To speed things up, stronger tobacco control measures are essential. Expanding smoke-free laws in workplaces, public spaces, and some private areas like cars, combined with new strategies to reduce smoking at home, will help make more European homes smoke-free sooner.”

The researchers plan to broaden their study to examine levels of vaping in European homes and exposure to second-hand smoke and vape fumes in cars. They are also studying how best to encourage people to make their homes smoke-free.

Dr. Filippos Filippidis is Chair of the European Respiratory Society Tobacco Control Committee, a reader in public health at Imperial College London, UK, and was not involved in the research. He said, “While it’s good to see that more homes are becoming smoke-free, this survey reveals that there are countries that are lagging far behind, and that progress is too slow.

“Across Europe, millions of people still smoke and millions more are exposed to second-hand smoke. Making our homes smoke-free protects children and adults from second-hand smoke and it can help smokers to cut down or quit too.

“The cost of smoking in Europe, both to the public purse and to public health, is too high. We need comprehensive smoke-free laws and freely available support to help people quit.”

Provided by
European Respiratory Society