Parent reported home smoking bans and toddler (18-30 month) smoke exposure: a cross-sectional survey

Abstract

Aims: To study the relation between the use of parent reported home smoking bans and smoke exposure among children aged 18-30 months. Methods: A total of 309 smoking households with children aged 18-30 months, who were part of the Coventry Cohort study, consented to participate in this cross-sectional survey. Results: Although parents in almost 88% of smoking households reported using harm reduction strategies to protect their toddlers from smoke exposure, only 13.9% reported smoking bans in the house. Mean log urinary cotinine:creatinine ratio was significantly lower for those children whose parents reported no smoking in the house (1.11, 95% CI 0.64 to 1.49) compared with none/less strict strategies (1.87, 95% CI 1.64 to 2.10). In linear regression models fitted on log cotinine:creatinine ratio, no smoking in the house was independently associated with a significant reduction in cotinine:creatinine ratio (B = 20.55, 95% CI 20.89 to 20.20) after adjusting for mother's and partner's average daily cigarette consumption, housing tenure, and overcrowding. The final model accounted for 44.3% of the variance. Conclusions: Not smoking in the house was associated with a reduction in mean urinary cotinine:creatinine ratio in children aged 18-30 months; the relation persisted after adjustment for levels of mother's and partner's daily cigarette consumption and sociodemographic factors. Results suggest that home smoking bans in this age group have a small but significant effect on smoke exposure independent of levels of parental tobacco consumption. P assive inhalation by young children of environmental tobacco smoke (ETS) is associated with an increased risk of a range of adverse outcomes.1-3 The WHO report estimates that globally 700 million children, half the world's children, breathe air polluted by tobacco smoke and that ETS is causally related to increased risks of respiratory infections in the first years of life, chronic respiratory illness in school aged children, middle ear disease, and sudden infant death. 3ETS has also been associated with learning difficulties, behaviour problems, and language difficulties in childhood although further work is needed to clarify whether these associations are causal or related to the social patterning of smoking. 3In addition to the health impact, the economic burden is considerable: the estimated annual cost of ETS in the first year of life in Hong Kong was over 2.1 million US dollars. 4 Smoking cessation by parents of young children might be expected to reduce these risks but parental smoking habits during and after pregnancy appear resistant to health education messages to stop smoking. 5 An alternative approach might be to encourage parents and other household members who feel unable to stop smoking in the short term to change their smoking habits by avoiding smoking in the presence of their children. Observational studies of smoking bans within the home suggest that these may be effective in reducing children's exposure to ETS. In a previous paper on the effects of harm r...

A Randomized Trial of Parental Behavioral Counseling and Cotinine Feedback for Lowering Environmental Tobacco Smoke Exposure in Children With Asthma

“…The benefi t of establishing a smoke-free-home policy has been demonstrated previously. [21][22][23] Although not defi nitive, the present fi nding with regard to parental behavioral change should be confi rmed in future research, including in larger studies of children at high risk.…”

Family Beliefs and Behaviors About Smoking and Young Children’s Secondhand Smoke Exposure

“…4 "Home smoking bans" (HSBs) reduce SHSe [10][11][12][13] yet are less common among Black families and those with lower socio-economic status, 8,[13][14][15] further escalating health risks among low-income minority children.…”

Smoking on Both Sides of the Pacific: Home Smoking Restrictions and Secondhand Smoke Exposure Among Korean Adults and Children in Seoul and California

“…Research among diverse populations documents a consistent association between harsher home smoking restrictions and lower SHSe (Martinez-Donate, Johnson-Kozlow, Hovell, & Gonzalez Perez, 2009;Pizacani et al, 2003), particularly among children (Spencer, Blackburn, Bonas, Coe, & Dolan, 2005); this relationship appears to hold for Koreans and Korean Americans (Hughes, Corcos, Hofstetter, Hovell, & Irvin, 2008). However, the relative effectiveness of home smoking restrictions may be contingent on the social structures they are embedded in, the moderating ecologic deduction.…”