Changes in child exposure to environmental tobacco smoke (CHETS) study after implementation of smoke-free legislation in Scotland: national cross sectional survey

doi:10.1136/bmj.39311.550197.AE

BMJ 2007;335:545 (15 September), doi:10.1136/bmj.39311.550197.AE (published 9 September 2007)

Research

Changes in child exposure to environmental tobacco smoke (CHETS) study after implementation of smoke-free legislation in Scotland: national cross sectional survey

Patricia C Akhtar, research fellow¹, Dorothy B Currie, senior statistician¹, Candace E Currie, director¹, Sally J Haw, principal public health adviser²

¹ Child and Adolescent Health Research Unit (CAHRU), University of Edinburgh, Edinburgh EH8 8AQ, ² NHS Health Scotland, Edinburgh EH12 5EZ

Correspondence to: P C Akhtar patricia.akhtar{at}ed.ac.uk

Objective To detect any change in exposure to secondhand smokeamong primary schoolchildren after implementation of smoke-freelegislation in Scotland in March 2006.

Design Comparison of nationally representative, cross sectional,class based surveys carried out in the same schools before andafter legislation.

Setting Scotland.

Participants 2559 primary schoolchildren (primary 7; mean age11.4 years) surveyed in January 2006 (before smoke-free legislation)and 2424 in January 2007 (after legislation).

Outcome measures Salivary cotinine concentrations, reports ofparental smoking, and exposure to tobacco smoke in public andprivate places before and after legislation.

Results The geometric mean salivary cotinine concentration innon-smoking children fell from 0.36 (95% confidence interval0.32 to 0.40) ng/ml to 0.22 (0.19 to 0.25) ng/ml after the introductionof smoke-free legislation in Scotland—a 39% reduction.The extent of the fall in cotinine concentration varied accordingto the number of parent figures in the home who smoked but wasstatistically significant only among pupils living in householdsin which neither parent figure smoked (51% fall, from 0.14 (0.13to 0.16) ng/ml to 0.07 (0.06 to 0.08) ng/ml) and among pupilsliving in households in which only the father figure smoked(44% fall, from 0.57 (0.47 to 0.70) ng/ml to 0.32 (0.25 to 0.42)ng/ml). Little change occurred in reported exposure to secondhandsmoke in pupils' own homes or in cars, but a small decreasein exposure in other people's homes was reported. Pupils reportedlower exposure in cafes and restaurants and in public transportafter legislation.

Conclusions The Scottish smoke-free legislation has reducedexposure to secondhand smoke among young people in Scotland,particularly among groups with lower exposure in the home. Wefound no evidence of increased secondhand smoke exposure inyoung people associated with displacement of parental smokinginto the home. The Scottish smoke-free legislation has thushad a positive short term impact on young people's health, butfurther efforts are needed to promote both smoke-free homesand smoking cessation.

The future of smoke-free legislation: Simon Chapman
BMJ 2007 335: 521-522. [Extract] [Full Text] [PDF]

Changes in exposure of adult non-smokers to secondhand smoke after implementation of smoke-free legislation in Scotland: national cross sectional survey: Sally J Haw and Laurence Gruer
BMJ 2007 335: 549. [Abstract] [Full Text] [PDF]

Legislation for smoke-free workplaces and health of bar workers in Ireland: before and after study: Shane Allwright, Gillian Paul, Birgit Greiner, Bernie J Mullally, Lisa Pursell, Alan Kelly, Brendan Bonner, Maureen D'Eath, Bill McConnell, James P McLaughlin, Diarmuid O'Donovan, Eamon O'Kane, and Ivan J Perry
BMJ 2005 331: 1117. [Abstract] [Full Text] [PDF]

WHO takes up issue of child abuse: Sophie Arie
BMJ 2005 331: 129. [Extract] [Full Text]

Children's exposure to passive smoking in England since the 1980s: cotinine evidence from population surveys: Martin J Jarvis, Eileen Goddard, Vanessa Higgins, Colin Feyerabend, Andrew Bryant, and Derek G Cook
BMJ 2000 321: 343-345. [Abstract] [Full Text] [PDF]

Passive exposure to tobacco smoke in children aged 5-7 years: individual, family, and community factors: G D Cook, P H Whincup, M J Jarvis, D P Strachan, O Papacosta, and A Bryant
BMJ 1994 308: 384-389. [Abstract] [Full Text]

This article has been cited by other articles:

Wimbush, E., Young, I., Robertson, G. (2007). Developing effective policy and practice for health promotion in Scotland. Promotion & Education 14: 228-232 [Abstract]
Chapman, S. (2007). The future of smoke-free legislation. BMJ 335: 521-522 [Full text]
Haw, S. J, Gruer, L. (2007). Changes in exposure of adult non-smokers to secondhand smoke after implementation of smoke-free legislation in Scotland: national cross sectional survey. BMJ 335: 549-549 [Abstract] [Full text]