Prevalence of smoking restrictions and child exposure to secondhand smoke in cars and homes: a repeated cross-sectional survey of children aged 10–11 years in Wales

Abstract

ObjectiveSmall increases in smoking restrictions in cars and homes were reported after legislation prohibiting smoking in public places. Few studies examine whether these changes continued in the longer term. This study examines changes in restrictions on smoking in cars and homes, and child exposure to secondhand smoke (SHS) in these locations, since 2008 postlegislation surveys in Wales.SettingState-maintained primary schools in Wales (n=75).ParticipantsChildren aged 10–11 years (year 6) completed CHETS (CHild exposure to Environmental Tobacco Smoke) Wales surveys in 2007 (n=1612) and 2008 (n=1605). A replication survey (CHETS Wales 2) was conducted in 2014, including 1601 children.Primary outcome variableChildren's reports of whether smoking was allowed in their car or home and exposure to SHS in a car or home the previous day.ResultsThe percentage of children who reported that smoking was allowed in their family vehicle fell from 18% to 9% in 2014 (OR=0.42; 95% CI 0.33 to 0.54). The percentage living in homes where smoking was allowed decreased from 37% to 26% (OR=0.30; 95% CI 0.20 to 0.43). Among children with a parent who smoked, one in five and one in two continued to report that smoking was allowed in their car and home. The percentage reporting SHS exposure in a car (OR=0.52; 95% CI 0.38 to 0.72) or home (OR=0.44; 95% CI 0.36 to 0.53) the previous day also fell. Children from poorer families remained less likely to report smoking restrictions.ConclusionsSmoking in cars and homes has continued to decline. Substantial numbers of children continue to report that smoking is allowed in cars and homes, particularly children from poorer families. A growing number of countries have legislated, or plan to legislate, banning smoking in cars carrying children. Attention is needed to the impact of legislation on child health and health inequalities, and reducing smoking in homes.

Associations of Socioeconomic Status, Parental Smoking and Parental E-Cigarette Use with 10–11-Year-Old Children’s Perceptions of Tobacco Cigarettes and E-Cigarettes: Cross Sectional Analysis of the CHETS Wales 3 Survey

“…While smoking rates have declined at the population level, parental smoking continues to be highly concentrated in more deprived families [4,5]. In the present study, half of children from the poorest families reported that a parent figure smoked, three times as many as for children from the most affluent families.…”

“…Smoking rates have declined substantially in recent years [2], with progressively comprehensive tobacco control strategies acting to de-normalise smoking [3]. However, many parents continue to smoke, with parental smoking particularly common among less affluent families [4]. Given the strong intergenerational transmission of both socioeconomic status and smoking [5], smoking remains a major contributor to the intergenerational reproduction of health inequalities [6].…”

“…However, as New Zealand is a context of strict regulation of e-cigarettes and interviews were conducted early in their emergence, transferability to the present day in the UK is questionable. In countries such as the UK, today's primary school-aged children are the first cohort to have been born following smoke-free legislation, and to have grown up in an environment of substantially reduced tobacco smoking in the presence of children [4,[38][39][40]. They are also the first generation for whom e-cigarettes have been a significant presence throughout their lives [41].…”

The socioeconomic gradient of secondhand smoke exposure in children: evidence from 26 low-income and middle-income countries

“…Recently, Moore et al 73 found that legislation disallowing smoking in public places did not appear to influence social inequalities in ESHS in Wales. A study from Taiwan,62 however, indicated that the expansion of smoke-free legislation reduced inequalities in ESHS across educational but not income groups.…”

It comes and goes in waves

“…The UK and parts of the USA, Canada and Australia have recently implemented smoking bans for cars that carry children. Research has shown that secondhand smoke exposure in cars can still be substantial, in particular among low SES families, but that it decreased after the implementation of such bans (Elton-Marshall, Leatherdale, Driezen, Azagba, & Burkhalter, 2015;Moore et al, 2015). Smoking in restaurants and workplaces is already prohibited in the Netherlands, but our results imply that designated smoking rooms could be also banned in such environments.…”