Effect of restrictions on smoking at home, at school and in public places on teenage smoking: cross-sectional study
Children's exposure to passive smoking in England since the 1980s: cotinine evidence from population surveys
Effect of counselling mothers on their children's exposure to environmental tobacco smoke: randomised controlled trial
Protecting children from passive smoking
Three papers in this week's BMJ support a comprehensive approach to protect children from environmental tobacco smoke and prevent them from becoming established smokers.
Jarvis and colleagues find that exposure to passive smoking among 11-15 year old children in England has almost halved since the late 1980s, partly due to a fall in the percentage of parents who smoke, and also to reduced smoking in public places. Similarly, Wakefield and colleagues report that bans on smoking at home - as well as bans in public places and enforced school smoking bans - may reduce teenage smoking in the United States. They suggest that one explanation for this may be that exposure to environmental tobacco smoke during childhood may make children more inclined to take up active smoking in their teenage years "by reducing the noxious deterrence of the first cigarette."
Finally, Hovell and colleagues find that behavioural counselling for mothers in California was effective in reducing young children's exposure to tobacco smoke at home - illustrating the potential of techniques that impact directly on smoking parents. This view is reiterated in an accompanying editorial by Ferrence and Ashley, who suggest that shifting public attitudes towards smoking at home in the presence of children means that the climate is now right for behavioural interventions aimed at parents. It is clear, however, that no one strategy will work alone, they say. In addition to increasing smoking restrictions in public places and workplaces, price increases, reduced availability of tobacco products, and mass media interventions, are also crucial if we are to protect children's health and prevent their recruitment to smoking in adolescence.
Contacts:
Martin Jarvis, ICRF Health Behaviour Unit, University College London, UK Email: martin.jarvis@ucl.ac.uk
Melanie Wakefield, Health Research and Policy Centres, University of Illinois, Chicago, USA Email: melaniew@uic.edu
Melbourne Hovell, Centre for Behavioural Epidemiology and Community Health, San Diego State University, California, USA Email: behepi@rohan.sdsu.edu
Roberta Ferrence / Mary Jane Ashley, Ontario Tobacco Research Unit, Toronto, Canada Email: roberta.ferrence@utoronto.ca