9A.8 Single parents

Last update: May 2022

Suggested citation: Hanley-Jones, S, Greenhalgh, EM, & Scollo, MM. 9.A.8 Single parents. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2022. Available from: http://www.tobaccoinaustralia.org.au/chapter-9-disadvantage/in-depth/9a8_single-parents

 

Single parents, in particular single mothers, and their children are one of the most disadvantaged groups in many countries,1 suffering from ill-health and poverty more so than other family structures.2-5 In 2019, single parents with dependent children made up 6.6% of household types in Australia,6 with single mother families making up the vast majority (81.8%) of one parent families.7

9A.8.1 Trends in the prevalence of smoking

The prevalence of smoking in single-parent households is significantly higher than among those with two parents, see Table 9A.8.1 below. In 2019, the Australian National Drug Strategy Household Survey reported current smoking prevalence in single-parent households with dependent children was 29.9%, more than double the prevalence in coupled households with dependent children (12.2%). Single-parent households also reported higher consumption, with an average of 101 cigarettes smoked per week, compared to an average of 83 cigarettes per week in coupled households with children.8

Table 9A.8.1
Tobacco use by parents with dependent children, 2010 to 2019 (col per cent)

Source: National Drug Strategy Household Survey 2019, Priority population groups chapter, Supplementary data tables: Table 8.21

 

9A.8.2 Contribution of smoking to health outcomes and social inequality

Smoking not only affects the single parent’s health but also that of the child(ren), who are disproportionately exposed to secondhand smoke (See Chapter 4, Section 4.17  Health effects of secondhand smoke for infants and children). Single parenthood is associated with younger age, and in 2019, 32.7% of young Australian mothers under the age of 20 smoked during their pregnancy.9 Smoking in pregnancy causes restricted growth and low birthweight in the infant, leading to poor health outcomes through childhood and adult life (See Chapter 3, Section 3.8 Child health and maternal smoking before and after birth, and  3.7 Pregnancy and smoking). Living in a single-parent home is a significant risk factor for environmental tobacco smoke exposure. A 2020 study found that single parents, after taking into account various indicators of economic disadvantage, were approximately 40% less likely to live in smokefree homes than other daily smokers.10 Children of lone parents who smoke are also much more likely than children in two-parent families (and children of lone parents who do not smoke) to begin smoking as teenagers,11-13 leading to multiple generations of health and social disadvantage.

9A.8.3 Explanations for higher smoking prevalence

The strong relationship between single motherhood and smoking can be partly explained by low socioeconomic status (SES), younger age, living alone,14 poor mental health, higher proportion of friends who smoke, and earlier smoking initiation;15 however, Australian research has also shown that being a single mother is independently associated with a greater likelihood of smoking.15

Explanations for why single parents are less likely to implement smokefree homes for their children include, higher stress levels related to lone parenting, conflicts with the former partner, difficulty coping with the challenges of implementing smokefree rules, social isolation and loneliness. Some single parents may also believe that leaving a child unattended or bringing the child outside each time they smoke is worse than exposing them to secondhand smoke in the home. Moreover, without a supportive partner, single parents may be reluctant to insist that friends and family members refrain from smoking in their home. Some single parents may only smoke in the home when their children are away with their shared custody parent. While this may protect against secondhand smoke, it does not prevent exposure to thirdhand smoke.10

9A.8.4 Interventions for reducing smoking

A 2021 study investigating smoking cessation among South Korean single mothers found that continuous, customised smoking cessation counselling sessions were effective in increasing long-term smoking cessation.16 The 2021 study found several short-term factors involved in successful quitting, including: refraining from drinking alcohol, monitoring of exhaled carbon monoxide (CO) levels and experiencing a pregnancy. The authors noted that fifty percent of the single mothers participating in the study were adolescent mothers who smoked. It is likely that counselling needs to be tailored for adolescent mothers. The most important factor in the short-term and long-term smoking cessation for single mothers, however, was the number of customised smoking cessation counselling sessions received. The study found that as the number of counselling sessions increased, participants were 1.91 times more likely to maintain smoking cessation in the short-term and 9.16 times more likely to maintain smoking cessation in the long-term. Continuous counselling, the authors say, should focus on the psychological, social, and economic stress experienced by single mothers in the pregnancy and parenting process, and should actively utilise mothers’ internal strengths and social support to enable realistic countermeasures to smoking. For a discussion of cessation interventions for pregnant women, see Section 7.11.

Improving the mental health and social environment of single mothers could also help reduce their high smoking prevalence.14,15


 

References

1.  Jun H and Acevedo-Garcia D. The effect of single motherhood on smoking by socioeconomic status and race/ethnicity. Social Science & Medicine, 2007; 65(4):653–66. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17493724

2.  Graham H. When life's a drag: Women, smoking and disadvantage,  Department of Health, Editor London, UK: HMSO; 1993.  Available from: https://archive.org/details/whenlifesdragwom0000grah.

3.  Dorsett R and Marsh A, The Health Trap: Poverty, Smoking and Lone Parenthood.  London: Policy Studies Institute; 1998. Available from: http://www.psi.org.uk/site/publication_detail/1286.

4.  Australian Bureau of Statistics. 1370.0 - Measures of Australia's progress, 2010. ABS, 2010. Available from: https://www.abs.gov.au/ausstats/abs@.nsf/lookup/by%20subject/1370.0~2010~Main%20Features~Home%20page%20(1)

5.  Rahkonen O, Laaksonsen M, and Karvonen S. The contribution of lone parenthood and economic difficulties to smoking. Social Science & Medicine, 2005; 61:211–6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15847973

6.  Wilkins R, Vera-Toscano E, Botha F, and Dahmann S. The household, income and labour dynamics in Australia survey: Selected findings from Waves 1 to 19. Melbourne Institute: Applied Economic & Social Research, the University of Melbourne 2021. Available from: https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0009/3963249/HILDA-Statistical-Report-2021.pdf.

7.  Australian Bureau of Statistics. Labour force status of families.  2021. Available from: https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-status-families/latest-release.

8.  Australian Institute of Health and Welfare. Data tables: National Drug Strategy Household Survey 2019 - 8. Priority population groups supplementary tables. Canberra: AIHW, 2020. Available from: https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/data.

9.  Australian Institute of Health and Welfare. Australia's mothers and babies: Data table 2.3. Canberra: AIHW, 2019. Available from: https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies/data.

10. Montreuil A, Wellman RJ, and O'Loughlin JL. Single-parent status and smoke-free home rules among daily smokers. Canadian Journal of Public Health, 2019. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31858438

11. White V and Hayman J. Smoking behaviours of Australian secondary school students in 2002. National Drug Strategy monograph series no. 54, Canberra: Australian Government Department of Health and Ageing, 2004. Available from: http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/publishing.nsf/content/mono54.

12. White V and Hayman J. Smoking behaviours of Australian secondary students in 2005. National Drug Strategy monograph series no. 59, Canberra: Drug Strategy Branch, Australian Government Department of Health and Ageing, 2006. Available from: http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/publishing.nsf/Content/mono59.

13. Francesconi M, Jenkins S, and Siedler T. The effect of lone motherhood on the smoking behavior of young adults. Health Economics, 2010; 19(11):1377–84. Available from: http://onlinelibrary.wiley.com/doi/10.1002/hec.1555/pdf

14. Siahpush M, Borland R, and Scollo M. Prevalence and socio-economic correlates of smoking among lone mothers in Australia. Australian and New Zealand Journal of Public Health, 2002; 26(2):132–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12054331

15. Siahpush M. Why is lone motherhood so strongly associated with smoking in Australia? Australian and New Zealand Journal of Public Health, 2004; 28(1):37–42. Available from: https://europepmc.org/article/MED/15108745

16. Lee MJ and Lee KS. Maintenance of smoking cessation in Korean single mothers. BMC Womens Health, 2021; 21(1):292. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34372838