SMOKING IN CHILD FAMILY DAY-CARE HOMES - POLICIES AND PRACTICE IN NEW-SOUTH-WALES

Objectives: To provide estimates of the numbers of New South Wales chi ldren in Family Day Care who may be exposed to environmental tobacco s moke while attending day care; to describe existing smoking policies; and to analyse these policies with the aim of providing guidelines for smoking policy in Family Day Care. Setting: All 109 Family Day Care s chemes in NSW. Method: Scheme coordinators were sent a questionnaire r egarding the proportion of carers who smoked while caring for children ; the nature, enforcement and experience of smoking policies; and barr iers to implementation of a no-smoking policy. Results: A mean of 10% of Family Day Care caregivers were reported to smoke while caring for children (range, 0-60%). An estimated 2045 children were potentially e xposed to environmental tobacco smoke in the 86 schemes which provided this information. Thirty-five per cent of schemes had formal no-smoki ng policies. A range of advantages, disadvantages and perceived practi cal and legal barriers to implementation of a no-smoking policy in Fam ily Day Care were described. Forty-four per cent of schemes with no-sm oking policies reported no implementation problems. Conclusions: There is considerable potential for exposure of children to environmental t obacco smoke in Family Day Care homes. There is legal support for Fami ly Day Care caregivers not to expose children under their care to envi ronmental tobacco smoke. A formal (and enforced) no-smoking policy sho uld exist in every Family Day Care scheme, and a ''top-down'' directiv e is most likely to be successful. The issue of other smokers in the c aregiver's household needs to be specifically addressed in any such di rective.