A Qualitative Study Exploring Facilitators and Barriers to Implementing Smoke-free Homes in Georgia

Abstract

Background: Georgia is a middle-income country with high male smoking rates and recently implemented public smoke-free policies. In contexts like Georgia, smoke-free homes (SFHs) can play crucial roles in reducing secondhand smoke exposure and use prevalence. Objectives: This study examined barriers and facilitators to SFHs among Georgian adults. Methods: In February-March 2024, focus groups were conducted separately with smoking and nonsmoking adults in 2 rural communities (n=25; Mage=42.92, 52.0% female, 48.0% married). Data were examined using thematic analysis. Results: Smoking participants (n=13) were primarily (84.6%) male; nonsmoking participants (n=12) were primarily (91.7%) female. Despite 72.2% reporting complete SFH restrictions, several exceptions and implementation challenges were noted. Smoking was commonly allowed for certain people (e.g., guests) or rooms/spaces (e.g., kitchen, balcony). Salient challenges included prevalent male smoking, difficulty changing behavior (smoking in general and smoking in the home), noncompliance, and accommodating guests, older extended family members, and important traditions and celebrations. However, important SFH motives were the health of non-smokers, particularly children, and serving as good role models for children. Conclusions: Effective SFH interventions for Georgian households must address specific characteristics (e.g., high male smoking rates, hospitality, accommodating important traditions) and may serve as models for other countries with similar characteristics.