Brys Z, Pénzes M, Békés V, Albert F. (2025) Gendered educational disparities and in-home smoking and use of electronic tobacco/nicotine devices among cohabiting couples: findings from a Hungarian cross-sectional survey. Tobacco Control. (IF:4.7, D1), https://doi.org/10.1136/tc-2025-059333

Abstract

Background: Smoke-free and aerosol-free households (SAFHs) reduce exposure to secondhand smoke and aerosol and support prevention and cessation efforts. However, SAFHs are less common in disadvantaged households, where women often initiate but lack the bargaining power to enforce bans. This power disparity is influenced by education. Our study examines the relationship between educational disparities and in-home smoking and in-home use of electronic devices for tobacco or nicotine aerosol delivery (EDTNAD) among couples.

Method: A cross-sectional, online survey was conducted among Hungarian adults from 15 November 2022 to 26 November 2022. Cohabiting couples (n=623) with no other adults in the households were included. Respondents provided information about themselves and their romantic partners. Self-reported permission for in-home smoking and in-home EDTNAD use, sociodemographic variables and tobacco/nicotine use were assessed. Couples were the unit of analysis, and data were analysed using z-tests, cross-tabulation and binomial Least Absolute Shrinkage and Selection Operator regression.

Results: Allowing in-home smoking was negatively correlated with both partners having a secondary or higher education (SoHE) and with female-only SoHE, but not with male-only SoHE couples. Allowing in-home smoking and in-home EDTNAD use were both positively correlated with financial deprivation and negatively correlated with the presence of minors. Male partners' smoking and EDTNAD use showed consistently stronger effects than female partners' status.

Conclusions: Allowing in-home smoking and in-home EDTNAD use is more prevalent in disadvantaged communities. The correlation between women's educational advantage (relative to their male partners) and in-home smoking suggests increased bargaining power to establish smoke-free homes. Our findings underscore the importance of gender-sensitive approaches in interventions aimed at promoting SAFH.