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Recent trends in children's exposure to second‐hand smoke in England: cotinine evidence from the Health Survey for England
Author(s) -
Jarvis Martin J.,
Feyerabend Colin
Publication year - 2015
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12962
Subject(s) - cotinine , medicine , confidence interval , demography , secondhand smoke , tobacco smoke , population , smoke , new england , cross sectional study , environmental health , pediatrics , nicotine , geography , psychiatry , pathology , sociology , politics , meteorology , political science , law
Aims To examine changes in children's exposure to second‐hand tobacco smoke in England since 1998. Design Repeated cross‐sectional surveys of the general population in England. Setting The Health Survey for England. Participants A total of 37 038 children participating in surveys from 1998 to 2012, 13 327 of whom were aged 4–15 years, had available cotinine and were confirmed non‐smokers. Measurements The proportion of children with smoking parents; the proportion of children living in homes reported to be smoke‐free; the proportion of children with undetectable concentrations of cotinine; linear and quadratic trend estimates of geometric mean cotinine across years. Findings By 2012, 87.3% of children lived in a home that was smoke‐free {97.2% [95% confidence interval (CI) = 95.9–98.1] when parents were non‐smokers, 61.3% (95% CI = 55.5–66.8) when one or both parents smoked}. A total of 68.6% (95% CI = 64.3–72.6%) of children had undetectable cotinine in 2012, up from 14.3% (95% CI = 12.7–16.0%) in 1998. There was a highly significant linear trend across years (with a small but significant quadratic term) to declining geometric mean cotinine in all children from 0.52 ng/ml (95% CI = 0.48–0.57) in 1998 to 0.11 ng/ml (95% CI = 0.10–0.12) in 2012. Children from routine/manual backgrounds were more exposed, but experienced similar gains across years to those from non‐manual backgrounds. Conclusions In England, children's exposure to second‐hand smoke has declined by 79% since 1998, with continuing progress since smoke‐free legislation in 2007. An emerging social norm in England has led to the adoption of smoke‐free homes not only when parents are non‐smokers, but also when they smoke.