Care for Their Air: Promoting Smoke-Free Homes and Cars for Head Start Families

The Office of Head Start and the Indoor Environments Division of the U.S. Environmental Protection Agency are partnering to improve the overall health of Head Start children. The partnership aims to reduce young children's exposure to secondhand smoke and other asthma triggers. The goal of the partnership is not to get parents to stop smoking. Rather, the purpose of the toolkit is for Head Start staff to use the information as a means to educate parents of the many ways to enhance their children's health. Note: This resource is under review.

The Facts about Secondhand Smoke
What You Can Do!
Secondhand Smoke a.k.a. Environmental Tobacco Smoke (ETS)
Smoke-Free Homes
Take the Smoke-Free Pledge
Changing Health Behaviors
Resources to Get Started on Implementing a Smoke-Free Homes Program
Asthma Resources
Related Performance Standards
Head Start Collaboration Offices  

The Facts about Secondhand Smoke

  • Currently it is estimated that 22% of children are exposed to secondhand smoke. Despite increased awareness of the risks, children continue to show toxin levels nearly twice those of adult non-smokers. This is true for many reasons: children are still developing physically; they have higher breathing rates than adults; and have little control over their indoor environments.
  • Children who receive high doses of secondhand smoke, such as children whose mother smokes, run the greatest risk of damaging health effects.
  • Smoking around a pregnant woman can cause her child to have low birth weight.
  • It is estimated that exposure to secondhand smoke kills 430 newborns from Sudden Infant Death Syndrome (SIDS) each year.
  • Exposure to secondhand smoke slows down the growth of children's developing lungs.
  • Children's exposure to secondhand smoke is responsible for: (1) between 150,000 and 300,000 lower respiratory tract infections for children under 18 months of age. These infections account for 7,500-15,000 hospitalizations a year; and, (2) an increase in the number of asthma attacks and severity of symptoms in 200,000 to one million children with asthma.
  • The only way to protect others from exposure to secondhand smoke is to eliminate smoking in indoor spaces. Separation, cleaning or ventilation cannot eliminate exposure!

What You Can Do!

  • Do not allow smoking in your home or car.
  • If you smoke, choose to smoke outside. Moving to another room or opening a window is not enough to protect your child.

Secondhand Smoke a.k.a. Environmental Tobacco Smoke

Secondhand smoke is a mixture of the smoke given off by the burning end of a cigarette, pipe, or cigar, and the smoke exhaled by smokers. It is also called environmental tobacco smoke (ETS). Exposure to ETS is sometimes called involuntary or passive smoking. Secondhand smoke contains more than 4,000 substances, several of which are known to cause cancer in humans or animals.

Secondhand smoke causes serious health risks in children. Learn more about this and the science behind the risks.

Smoking is the single greatest avoidable cause of disease and death. Learn what the Surgeon General says about involuntary exposure to tobacco smoke in the report, The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.

Flyer: How Secondhand Smoke Affects You and Your Child

Smoke-Free Homes

Smoke-Free Homes is a comprehensive, national effort to reduce children's secondhand smoke exposure focused on harm reduction and improving the health of children. To learn more about this, go to:

Take the Smoke-Free Home Pledge/ Prometa no fumar en su hogar

The first step in protecting children's health through reducing their exposure to environmental tobacco smoke is to take the Smoke-Free Pledge. The EPA has materials and information to support those who take the pledge (available in both English and Spanish).

Learn more about what some communities are doing to support "Smoke-Free Homes."

Tips and tools for "Promoting Smoke-Free Homes for Head Start Families"

Changing Health Behaviors

These tips sheets offer guidance to Head Start families and staff to promote smoke-free environments for children.

Care for Their Air: For Families

Care for Their Air: For Family Service Workers

Care for Their Air: For Health Managers

Care for Their Air: For Health Service Advisory Committees

Care for Their Air: For Home Visitors

Care for Their Air: For Program Directors

Care for Their Air: For Teachers

Enhancing Health in the Head Start Workplace: Training Guides for the Head Start Learning Community Module 3: Making Changes in Behavior for Better Health

Resources to Get Started on Implementing a Smoke-Free Homes Program

The EPA has developed tools and educational resources to get you started. Continue to make a positive change in children's lives with these materials.

A one-stop resource for getting started is "The Smoke-Free Homes Community Action Kit" available on CD-ROM or online. The kit includes:

Steps for getting your program started

  • Ideas for outreach activities
  • Tips for promoting your program
  • Resources available at no cost to your program
  • Contact and reference information [PDF, 000KB]

Beyond the Brochure—Alternative Approaches to Effective Heath Communication [PDF, 000KB]

Flyer: "I have taken the Pledge! Now what?"

Asthma Resources

A variety of resources are available to provide information about asthma symptoms, prevention and treatment strategies.

Various tools and forms are available to: (1) assist in collecting an accurate asthma history based on symptoms both at home and at school; (2) facilitate communication between school personnel and pediatricians; (3) assist in providing parents and schools information about a child's medication program; and, (4) provide guidance as to what to do when a child's asthma worsens.

"Help Your Child Gain Control over Asthma" with a guide developed by the CDC and EPA to assist parents in controlling their child's asthma. [PDF, 000KB]

"Dusty the Asthma Goldfish" is designed for children a little older; but, could be useful for families with older children who have asthma.

English version [PDF, 000KB]

Spanish version [PDF, 000KB]

"Clear Your Home of Asthma Triggers" using a check-list provided by the EPA on ways to remove dust mites, molds, pests and pet dander from the home. [PDF, 000KB]

Did you know that things in the bath, blankets, or stuffed animals can trigger an asthma attack? Learn what you can do to prevent asthma attacks.

Get involved in the fight against asthma! Each year, in the month of May, EPA joins international, national and local Asthma Awareness Month activities to increase public understanding of asthma and environmental asthma triggers.

Related Performance Standards

Family Partnerships


/hslc/standards/hspps/1304/1304.40 Family partnerships..htm

Community Partnership


/hslc/standards/hspps/1304/1304.41 Community partnerships..htm


1304.20(a)(1)(i) and 1304.20(b)(1)

/hslc/standards/hspps/1304/1304.20 Child health and developmental services..htm

The Head Start State Collaboration Offices

The Head Start State Collaboration Offices play an important role in building partnerships at the state and local levels to ensure Head Start's participation in systems integration strategies. Head Start and Early Head Start staff, Head Start Training and Technical Assistance (T/TA) providers, early child care and education professionals, policymakers, as well as state and local organizations can benefit from the resources developed by and for the State Collaboration Offices. The Head Start State Collaboration Offices ensure the coordination of services to include: health care, welfare, child care, education, community service activities, family literacy, services to homeless families, and activities related to children with disabilities.

/hslc/hsd/SCO/SCO.pdf [PDF, 42.7KB]

Care for Their Air: Promoting Smoke-Free Homes and Cars for Head Start Families. HHS/ACF/OHS. 2007. English.

Last Reviewed: August 2015

Last Updated: November 14, 2016