Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional studyBMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7257.333 (Published 05 August 2000) Cite this as: BMJ 2000;321:333
- Melanie A Wakefield (), visiting research scientista,
- Frank J Chaloupka, professorb,
- Nancy J Kaufman, senior vice presidentc,
- C Tracy Orleans, senior scientistc,
- Dianne C Barker, principald,
- Erin E Ruel, research assistanta
- a Health Research and Policy Centers, University of Illinois at Chicago, 850 West Jackson Boulevard, Chicago, IL 60607, USA
- b Department of Economics, University of Illinois at Chicago
- c Robert Wood Johnson Foundation, PO Box 2316, Princeton, NJ 08543, USA
- d Barker Bi-Coastal Health Consultants, 3556 Elm Drive, Calabasas, CA 91302, USA
- Correspondence to: M A Wakefield
- Accepted 9 June 2000
Objective: To determine the relation between extent of restrictions on smoking at home, at school, and in public places and smoking uptake and smoking prevalence among school students.
Design: Cross sectional survey with merged records of extent of restrictions on smoking in public places.
Setting: United States.
Participants: 17 287 high school students.
Main outcome measures: Five point scale of smoking uptake; 30 day smoking prevalence.
Results: More restrictive arrangements on smoking at home were associated with a greater likelihood of being in an earlier stage of smoking uptake (P<0.05) and a lower 30 day prevalence (odds ratio 0.79 (95% confidence interval 0.67 to 0.91), P<0.001). These findings applied even when parents were smokers. More pervasive restrictions on smoking in public places were associated with a higher probability of being in a earlier stage of smoking uptake (P<0.05) and lower 30 day prevalence (0.91 (0.83 to 0.99), P=0.03). School smoking bans were related to a greater likelihood of being in an earlier stage of smoking uptake (0.89 (0.85 to 0.99), P<0.05) and lower prevalence (0.86 (0.77 to 0.94), P<0.001) only when the ban was strongly enforced, as measured by instances when teenagers perceived that most or all students obeyed the rule.
Conclusions: These findings suggest that restrictions on smoking at home, more extensive bans on smoking in public places, and enforced bans on smoking at school may reduce teenage smoking.
Funding Supported by grants from Robert Wood Johnson Foundation to the National Bureau of Economic Research (the impact of environmental factors on youth and young adult tobacco use) and the University of Illinois at Chicago (ImpacTeen—a policy research partnership to reduce youth substance use).
Competing interests None declared.
This article is part of the BMJ's randomised controlled trial of open peer review. Documentation relating to the editorial decision making process is available on the BMJ's website