Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study
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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.
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Cross-sectional observational studies evaluating the level of enforcement of school tobacco policies more consistently found links between stronger enforcement and lower rates of smoking among students.
“In contrast to studies assessing the presence of anti-tobacco policies, cross-sectional observational studies evaluating the level of enforcement of these policies more consistently found links between stronger enforcement and lower rates of smoking among students.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [452]
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The effects of clean indoor air laws: what do we know and what do we need to know?
Levy, D. T. (2003) · Health Education Research · doi:10.1093/her/cyf045 · Cited by 97 · see citing works
“Using a broader range of smoking restrictions (e.g. selfreported home restrictions) and enforcement variables, Wake®eld et al. (Wake®eld et al., 2000) found more consistent effects of clean air policies on youth quantity smoked, including relatively consistent effects for reducing progression to…”
BackgroundMethodInfluentialSocial exchange of cigarettes by youth
Forster, J. L., Chen, V., Blaine, T. M., Perry, C. L., & Toomey, T. L. (2003) · Tobacco Control · doi:10.1136/tc.12.2.148 · Cited by 98 · see citing works
Disparities in Children's Exposure to Environmental Tobacco Smoke in the United States, 2007
Singh, G. K., Siahpush, M., & Kogan, M. D. (2010) · PEDIATRICS · doi:10.1542/peds.2009-2744 · Cited by 96 · see citing works
Beyond modeling: Parenting practices, parental smoking history, and adolescent cigarette smoking
Kodl, M., & Mermelstein, R. J. (2003) · Addictive Behaviors · doi:10.1016/s0306-4603(03)00087-x · Cited by 96 · see citing works
“Recent studies have found that home smoking bans are associated with decreased rates of youth smoking (Chassin, Presson, Todd et al., 1998; Farkas, Gilpin, White, & Pierce, 2000; Wakefield et al., 2000).”
BackgroundHamilton, W. L., Biener, L., & Brennan, R. T. (2007) · Health Education Research · doi:10.1093/her/cym054 · Cited by 96 · see citing works
“There is good evidence that tobacco control policies are associated with reductions in smoking prevalence among both youth and adults [3–7].”
BackgroundWakefield, M. A., Kloska, D. D., O’Malley, P. M., Johnston, L. D., Chaloupka, F. J., Pierce, J. P., Giovino, G. A., Ruel, E. E., & Flay, B. R. (2004) · Addiction · doi:10.1111/j.1360-0443.2004.00742.x · Cited by 96 · see citing works
Self-citationEffect of local restaurant smoking regulations on progression to established smoking among youths
Siegel, M., Albers, A. B., Cheng, D. M., Biener, L., & Rigotti, N. A. (2005) · Tobacco Control · doi:10.1136/tc.2005.012302 · Cited by 96 · see citing works
Drago, G., Perrino, C., Canepari, S., Ruggieri, S., L’Abbate, L., Longo, V., Colombo, P., Frasca, D., Balzan, M. V., Cuttitta, G., et al. (2018) · Environmental Research · doi:10.1016/j.envres.2018.03.026 · Cited by 95 · see citing works
Tobacco use among students in the eight North-eastern states of India
Gupta, P. C., Sinha, D., & Pednekar, M. S. (2003) · Indian Journal of Cancer · doi:10.4103/0019-509x.13056 · Cited by 94 · see citing works
Galanti, M. R., Coppo, A., Jönsson, E., Bremberg, S. G., & Faggiano, F. (2013) · Tobacco Control · doi:10.1136/tobaccocontrol-2012-050846 · Cited by 93 · see citing works
Local Restaurant Smoking Regulations and the Adolescent Smoking Initiation Process
Siegel, M., Albers, A. B., Cheng, D. M., Hamilton, W. L., & Biener, L. (2008) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.162.5.477 · Cited by 92 · see citing works
“Existing evidence that smoke-free laws reduce youth smoking derives from cross-sectional studies.(11-16) However, the results of the first longitudinal investigation of the impact of local smokefree restaurant laws on smoking initiation were recently reported.”
BackgroundTeen Smokers Reach Their Mid Twenties
Patton, G. C., Coffey, C., Carlin, J. B., Sawyer, S. M., & Wakefield, M. A. (2006) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2005.11.027 · Cited by 90 · see citing works
Self-citationKasza, K. A., Edwards, K. C., Tang, Z., Stanton, C. A., Sharma, E., Halenar, M. J., Taylor, K. A., Donaldson, E. A., Hull, L. C., Bansal‐Travers, M., et al. (2020) · Tobacco Control · doi:10.1136/tobaccocontrol-2019-055255 · Cited by 85 · see citing works
Effects of a Smoke-Free Law on Hair Nicotine and Respiratory Symptoms of Restaurant and Bar Workers
Hahn, E. J., Rayens, M. K., York, N., Okoli, C. T. C., Zhang, M., Dignan, M., & Al‐Delaimy, W. K. (2006) · Journal of Occupational and Environmental Medicine · doi:10.1097/01.jom.0000215709.09305.01 · Cited by 85 · see citing works
The Effect of Smoke-Free Homes on Smoking Behavior in the U.S.
Messer, K. S., Mills, A. L., White, M. M., & Pierce, J. P. (2008) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2008.05.023 · Cited by 82 · see citing works
O'Connor, A. M. C., Sargeant, J. M., Dohoo, I. R., Erb, H. N., Cevallos, M., Egger, M., Ersbøll, A. K., Martin, S. W., Nielsen, L. R., Pearl, D. L., et al. (2016) · Journal of Veterinary Internal Medicine · doi:10.1111/jvim.14592 · Cited by 87 · see citing works
“, 2006), which confounding variables merit adjustment, the handling of missing data (Wakefield et al., 2000; Dunn et al., 2001), possible selection bias or bias from inaccurate or inconsistent measurement of exposure, disease and other variables, and specific analysis choices, such as the treatment of quantitative var…”
BackgroundMakadia, L. D., Roper, P. J., Andrews, J. O., & Tingen, M. S. (2017) · Current Allergy and Asthma Reports · doi:10.1007/s11882-017-0723-0 · Cited by 82 · see citing works
The association between home smoking restrictions and youth smoking behaviour: a review
Emory, K., Saquib, N., Gilpin, E. A., & Pierce, J. P. (2010) · Tobacco Control · doi:10.1136/tc.2010.035998 · Cited by 80 · see citing works
Greaves, L., & Jategaonkar, N. (2006) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2005.045393 · Cited by 80 · see citing works
“68 In the only study identified that examined gender differences among adolescents, Proescholdbell e t 67 report that permissive home smoking policies are more strongly related to regular smoking for girls than for boys.”
BackgroundAlbers, A. B., Biener, L., Siegel, M., Cheng, D. M., & Rigotti, N. A. (2008) · American Journal of Public Health · doi:10.2105/ajph.2007.129320 · Cited by 79 · see citing works
Regulation of Smoking in Public Housing
Winickoff, J. P., Gottlieb, M. A., & Mello, M. M. (2010) · New England Journal of Medicine · doi:10.1056/nejmhle1000941 · Cited by 78 · see citing works
Trotter, L., Wakefield, M. A., & Borland, R. (2002) · Tobacco Control · doi:10.1136/tc.11.4.300 · Cited by 77 · see citing works
Self-citationFerrence, R. G. (2010) · BMJ · doi:10.1136/bmj.c1680 · Cited by 78 · see citing works
“With increasingly comprehensive restrictions in public spaces, both indoors and out, we are beginning to tackle protection in children’s home environments—homes, multi-unit dwellings, and family vehicles. The arguments for increasing protection for children in these spaces are strong. The home is the major source of e…”
BackgroundSchreuders, M., Nuyts, P. A. W., van den Putte, B., & Kunst, A. E. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.04.031 · Cited by 77 · see citing works
“…STPs are associated with increased chances to start smoking occasionally (Murnaghan et al., 2008, 2009b) and transition into an established/ regular smoker (Wake fi eld et al., 2000), which is particularly the case for adolescents who are also exposed to family smoking (Wiium and Wold, 2006).”
Impact of home smoking rules on smoking patterns among adolescents and young adults.
Clark, P. I., Schooley, M., Pierce, B., Schulman, J., Hartman, A. M., & Schmitt, C. L. (2006) · PubMed · Cited by 75 · see citing works
Jones, S. E., Fisher, C. J., Greene, B. Z., Hertz, M. F., & Pritzl, J. (2007) · Journal of School Health · doi:10.1111/j.1746-1561.2007.00233.x · Cited by 75 · see citing works
Lovato, C. Y., Zeisser, C., Campbell, H. S., Watts, A. W., Halpin, P., Thompson, M., Eyles, J., Adlaf, E., & Brown, K. S. (2010) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2010.08.019 · Cited by 71 · see citing works
The Relationship Between School Policies and Youth Tobacco Use*
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“23; t[16,330] = 10.”
Leatherdale, S. T., & Manske, S. (2005) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-05-0065 · Cited by 72 · see citing works
“The second is school smoking restrictions (11-15).”
BackgroundResultInfluentialProtection from exposure to second-hand tobacco smoke : policy recommendations
Initiative, T. F., & Lam, T. (2007) · The HKU Scholars Hub (University of Hong Kong) · Cited by 72 · see citing works
Sims, M., Tomkins, S., Judge, K., Taylor, G. T., Jarvis, M. J., & Gilmore, A. (2010) · Addiction · doi:10.1111/j.1360-0443.2009.02805.x · Cited by 71 · see citing works
Kegler, M. C., & Malcoe, L. H. (2002) · Preventive Medicine · doi:10.1006/pmed.2002.1091 · Cited by 71 · see citing works
Parental Smoking, Exposure to Secondhand Smoke at Home, and Smoking Initiation Among Young Children
Wang, M. P., Ho, S. Y., & Lam, T. (2011) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntr083 · Cited by 71 · see citing works
Albers, A. B., Siegel, M., Cheng, D. M., Biener, L., & Rigotti, N. A. (2004) · Tobacco Control · doi:10.1136/tc.2003.007336 · Cited by 71 · see citing works
Patnode, C. D., O'Connor, E., Whitlock, E. P., Perdue, L. A., Soh, C., & Hollis, J. (2013) · Annals of Internal Medicine · doi:10.7326/0003-4819-158-4-201302190-00580 · Cited by 70 · see citing works
“Research has shown, however, that having a strict smoke-free policy in the home is associated with fewer young persons smoking than in households with unrestricted or partial policies (that is, for only certain members of the household) (40, 41).”
BackgroundSzabo, E., WHITE, V. M., & Hayman, J. (2006) · Addictive Behaviors · doi:10.1016/j.addbeh.2006.02.025 · Cited by 70 · see citing works
WHITE, V. M., Warne, C. D., Spittal, M. J., Durkin, S. J., Purcell, K., & Wakefield, M. A. (2011) · Addiction · doi:10.1111/j.1360-0443.2011.03429.x · Cited by 69 · see citing works
Self-citationA mixed ordinal location scale model for analysis of ecological momentary assessment (EMA) data
Demirtaş, H., Hedeker, D., & Mermelstein, R. J. (2009) · Statistics and Its Interface · doi:10.4310/sii.2009.v2.n4.a1 · Cited by 69 · see citing works
“Statistics and Its Interface Volume 2 (2009) 391–401”
BackgroundSusceptibility of youth to tobacco: a social ecological framework for prevention
Corbett, K. K. (2001) · Respiration Physiology · doi:10.1016/s0034-5687(01)00269-9 · Cited by 67 · see citing works
“Bans in public places have been found to reduce smoking initiation; bans in workplaces where youth work have been less well explored (Farkas et al., 2000; Wakefield et al., 2000).”
BackgroundLeatherdale, S. T., CAMERON, R., BROWN, K., & MCDONALD, P. (2004) · Preventive Medicine · doi:10.1016/j.ypmed.2004.09.033 · Cited by 67 · see citing works
“prevalence of smokers at their school [12], and live in a home with no smoking restrictions [ 13 ].”
BackgroundPopulation level policy options for increasing the prevalence of smokefree homes
Thomson, G., Wilson, N., & Howden-Chapman, P. (2006) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2005.038091 · Cited by 67 · see citing works
Recent trends in home and work smoking bans
Levy, D. T., Romano, E. O., & Mumford, E. A. (2004) · Tobacco Control · doi:10.1136/tc.2003.006056 · Cited by 67 · see citing works
The Relationship between Socioeconomic Status, Ethnicity, and Cigarette Smoking in Urban Adolescents
Scarinci, I. C., Robinson, L. A., Alfano, C. M., Zbikowski, S. M., & Klesges, R. C. (2002) · Preventive Medicine · doi:10.1006/pmed.2001.0967 · Cited by 67 · see citing works
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“Studies have shown that school tobacco policies are effective only if they are strongly enforced [3, 4].”
BackgroundKasza, K. A., Edwards, K. C., Tang, Z., Stanton, C. A., Sharma, E., Halenar, M. J., Taylor, K. A., Donaldson, E. A., Hull, L. C., Day, H., et al. (2020) · Tobacco Control · doi:10.1136/tobaccocontrol-2020-055671 · Cited by 66 · see citing works
Sabiston, C. M., Lovato, C. Y., Ahmed, R., Pullman, A. W., Hadd, V., Campbell, H. S., Nykiforuk, C., & Brown, K. S. (2009) · Journal of Youth and Adolescence · doi:10.1007/s10964-009-9422-z · Cited by 65 · see citing works
“Schools that have smoke-free environments have lower smoking rates and less overall consumption of cigarettes than schools with minimal tobacco guidelines (Pentz et al. 1997; Wakefield et al. 2000).”
BackgroundResultInfluentialApplication of a rating system to state clean indoor air laws (USA)
Chriqui, J. F., Frosh, M. M., Brownson, R. C., Shelton, D. M., Sciandra, R. C., Hobart, R. L., Fisher, P. H., el Arculli, R., & Alciati, M. H. (2002) · Tobacco Control · doi:10.1136/tc.11.1.26 · Cited by 66 · see citing works
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Tobacco control policy and adolescent cigarette smoking status in the United States
Botello-Harbaum, M., Haynie, D. L., Iannotti, R. J., Wang, J., Gase, L. N., & Simons‐Morton, B. G. (2009) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntp081 · Cited by 64 · see citing works
“Nevertheless, research has documented the effect of tobacco control laws on cigarette smoking uptake among youth ( Wakefield et al., 2000 ).”
BackgroundCarlsen, K. C. L., & Carlsen, K. (2001) · Current Opinion in Allergy and Clinical Immunology · doi:10.1097/00130832-200104000-00004 · Cited by 64 · see citing works
A Qualitative Study of How Families Decide to Adopt Household Smoking Restrictions
Kegler, M. C., Escoffery, C., Groff, A. A., Butler, S., & Foreman, A. (2007) · Family & Community Health · doi:10.1097/01.fch.0000290545.56199.c9 · Cited by 61 · see citing works
- Authors
- Wakefield, M. A.
- Affiliations
- University of Illinois Chicago (US)
- Corresponding author
- Wakefield, M. A
- ORCID
- Wakefield, M. A
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2000-08-05
- Volume
- 321
- Issue
- 7257
- Pages
- 333-337
- ISSN
- 0959-8138 (ISSN-L)
- PMC
- PMC27448
- OpenAlex
- W1968649612
- Cited by
- 504
- References
- 46
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 2 · 2022: 6 · 2021: 15 · 2020: 15 · 2019: 13 · 2018: 18 · 2017: 17 · 2016: 16 · 2015: 12 · 2014: 20 · 2013: 23 · 2012: 23
- FWCI
- 14.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- adolescent smoking, smoking restrictions, smoking bans, school smoking bans, household smoking, smoking in public places, smoking prevalence, smoking uptake, parental smoking, adolescents
- MeSH terms
- Smoking Prevention, Adolescent, Cross-Sectional Studies, Female, Humans, Male, Motivation, Social Control Policies, Public Health, School Health Services, Smoking, Social Control, Informal, Social Environment, Tobacco Smoke Pollution, United States, Prevalence
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