Introduction:
Smoke- and aerosol-free households are key elements of anti-tobacco socialization. They are essential to reduce secondhand exposure from cigarette smoke and from aerosol of e-cigarettes and heated tobacco products. This study aimed to explore the association between indoor smoke- and aerosol-free household rules, tobacco use and/or electronic nicotine or tobacco delivery systems (ENTDS; e-cigarette and/or heated tobacco product) use, and sociodemographic variables among Hungarian couples.

Material and Methods:
A cross-sectional online survey was conducted among Hungarian adults in November, 2022. Respondents were asked about their own and their partner tobacco use habits (single user: one member-, dual user: both members of the couples use tobacco/nicotine product). Self-reported indoor smoking and/or ENDTS use ban, and sociodemographic variables were involved. Using couples as the unit of analysis, Z-test, Cohen’s h, cross tabulation statistics with 95% confidence interval, and binomial LASSO regression were applied.

Results:
Couples reported indoor smoking ban with significantly higher rate than indoor ENDTS use ban (80.1% vs 75.1%, respectively, p=0.03, h=0.12). Indoor smoking ban was reported by 73.1% of single-smoker couples and 44.4% of dual-smoker couples (p<0,001, h=0.6). In contrast, 34.3% of single-ENTDS user couples and 19.2% of dual-ENTDS user couples reported indoor ENDTS use ban (p=0,01, h=0.3). Tobacco use was negatively associated with smoke-free and aerosol-free households. Better financial status, higher education and number of minors living in the household were positively associated with indoor smoking ban, although none of these sociodemographic variables were associated with ENDTS use ban.

Conclusions:
Our results highlight the importance of communicating the potential health harms of all range of tobacco and nicotine products. Smoke- and aerosol-free policies shall be promoted to all tobacco users to protect the health of non-users, especially minors.