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Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study.

ABSTRACT: 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.

SUBMITTER: Wakefield MA

PROVIDER: S-EPMC27448 | biostudies-literature | 2000 Aug

REPOSITORIES: biostudies-literature

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Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study.

Wakefield M A MA Chaloupka F J FJ Kaufman N J NJ Orleans C T CT Barker D C DC Ruel E E EE

BMJ (Clinical research ed.) 20000801 7257

<h4>Objective</h4>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.<h4>Design</h4>Cross sectional survey with merged records of extent of restrictions on smoking in public places.<h4>Setting</h4>United States.<h4>Participants</h4>17 287 high school students.<h4>Main outcome measures</h4>Five point scale of smoking uptake; 30 day smoking prevalence.<h4>Results</h4>More restr ...[more]

PMID: 10926588

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Project description:Smoke-free legislation has been a great success for tobacco control but its impact on smoking uptake remains under-explored. We investigated if trends in smoking uptake amongst adolescents differed before and after the introduction of smoke-free legislation in the United Kingdom.Prevalence estimates for regular smoking were obtained from representative school-based surveys for the four countries of the United Kingdom. Post-intervention status was represented using a dummy variable and to allow for a change in trend, the number of years since implementation was included. To estimate the association between smoke-free legislation and adolescent smoking, the percentage of regular smokers was modeled using linear regression adjusted for trends over time and country. All models were stratified by age (13 and 15 years) and sex.For 15-year-old girls, the implementation of smoke-free legislation in the United Kingdom was associated with a 4.3% reduction in the prevalence of regular smoking (P = .029). In addition, regular smoking fell by an additional 1.5% per annum post-legislation in this group (P = .005). Among 13-year-old girls, there was a reduction of 2.8% in regular smoking (P = .051), with no evidence of a change in trend post-legislation. Smaller and nonsignificant reductions in regular smoking were observed for 15- and 13-year-old boys (P = .175 and P = .113, respectively).Smoke-free legislation may help reduce smoking uptake amongst teenagers, with stronger evidence for an association seen in females. Further research that analyses longitudinal data across more countries is required.Previous research has established that smoke-free legislation has led to many improvements in population health, including reductions in heart attack, stroke, and asthma. However, the impacts of smoke-free legislation on the rates of smoking amongst children have been less investigated. Analysis of repeated cross-sectional surveys across the four countries of the United Kingdom shows smoke-free legislation may be associated with a reduction in regular smoking among school-aged children. If this association is causal, comprehensive smoke-free legislation could help prevent future generations from taking up smoking.

Project description:OBJECTIVES:To explore the prevalence, perpetrator characteristics and the correlates of child abuse in Kathmandu, Nepal. METHODS:For this cross-sectional study, we translated the internationally validated questionnaire developed by the International Society for Prevention of Child Abuse and Neglect, Child Abuse Screening Tool-Child Home into Nepali. We added questions on descriptive information about students and their family to the questionnaire. We recruited students from 20 schools selected randomly-2 from each of the 10 electoral constituencies of Kathmandu district. In each school, we administered the questionnaires to the students in a classroom selected randomly. To assess the correlates, we ran multilevel multivariable logistic regression models, stratified by schools. RESULTS:Among the 962 students, 88.88% had experience of at least one form of abuse throughout their lifetime. Psychological abuse was the most prevalent form of abuse (previous year: 75.19%; lifetime: 76.15%) followed by physical abuse, exposure to violence, neglect and sexual abuse. Adults were the most common perpetrators of child abuse (37.55%). The correlates identified in this study mostly aligned with the global literature on correlates of abuse. Female students were more likely to report neglect (previous year: adjusted OR (AOR) 1.50, 95%?CI 1.10 to 2.04; lifetime: AOR 1.49, 95%?CI 1.10 to 2.02), but no gender difference was observed with other forms of abuse. Students living with a single parent had a greater likelihood of exposure to violence (previous year: AOR 2.55, 95%?CI 1.31 to 4.94; lifetime: AOR 2.77, 95%?CI 1.39 to 5.53), neglect (previous year: AOR 2.01, 95%?CI 1.10 to 3.69; lifetime: AOR 2.08, 95%?CI 1.14 to 3.81) and sexual abuse (previous year: AOR 3.03, 95%?CI 1.45 to 6.37; lifetime: AOR 2.49, 95%?CI 1.21 to 5.14). CONCLUSIONS:Over 88% of students reported experiencing child abuse in the home in one or more forms throughout their lifetime. Delineating the reasons for the high burden and its implications are important topics for future research.

Dataset Information

Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study.

Publications

Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study.

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