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Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study
Open accessAbstract
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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“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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“In addition to the details of policy content, researchers have investigated the consistency with which schools enforce policy responses (regardless of the type of sanction imposed) to student smokers and have shown this to be an important component of policy effectiveness [7,9-11].”
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“Other findings indicated, among others, that students are more likely susceptible to smoking if they have two or more close friends who smoke, attend a school with a relatively high smoking rate among the older students or a school with less (endorsed) smoking restrictions (Leatherdale et al., 2006; Wakefield et al.,…”
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“and those living and working in smoke-free environments are less likely to begin smoking than those exposed to smoke.”
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“smoking among youth [20,29,94-97].”
Strength of Tobacco Control in Rural Communities
York, N. L., Rayens, M. K., Zhang, M., Jones, L. G., Casey, B. R., & Hahn, E. J. (2010) · The Journal of Rural Health · doi:10.1111/j.1748-0361.2010.00273.x · Cited by 34
Beech, B. M., & Scarinci, I. C. (2003) · American Journal of Health Promotion · doi:10.4278/0890-1171-17.4.240 · Cited by 34
Goel, S., Sharma, D., Gupta, R., & Mahajan, V. (2017) · Tobacco Control · doi:10.1136/tobaccocontrol-2016-053559 · Cited by 33
Smokers’ Decision Making: More than Mere Risk Taking
Ert, E., Yechiam, E., & Arshavsky, O. (2013) · PLoS ONE · doi:10.1371/journal.pone.0068064 · Cited by 33
“While originally proposed to address secondary smoking hazards, this policy also reduces the immediate convenience of smoking, and it was found to decrease the rate of adolescent cigarette use [44].”
BackgroundThe relationship between local clean indoor air policies and smoking behaviours in Minnesota youth
Klein, E. G., Forster, J. L., Erickson, D. J., Lytle, L. A., & Schillo, B. (2008) · Tobacco Control · doi:10.1136/tc.2007.024307 · Cited by 32
“Cross-sectional findings at the local and state level have demonstrated a reduction in youth smoking behaviours associated with local CIA policies.(15) 25 26 Siegel and colleagues that suggest that local CIA policies may result in a reduction in youth smoking behaviours over time.”
BackgroundSmoking cessation and pregnancy
West, R. (2002) · Fetal and Maternal Medicine Review · doi:10.1017/s0965539502000335 · Cited by 32
A cross-country comparison of tobacco consumption among youths from selected South-Asian countries
Kabir, M. A., Goh, K., & Khan, M. H. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-379 · Cited by 31
“However, in accordance with some studies [4,8,24-26], the likelihood of TC increased significantly among youths who had witnessed others smoking at home and public places.”
ResultFactores predictores del inicio y consolidación del consumo de tabaco en adolescentes
Caballero-Hidalgo, A., González, B., Pinilla, J., & Pérez, P. B. (2005) · Gaceta Sanitaria · doi:10.1016/s0213-9111(05)71394-7 · Cited by 31
“No, pero lo he probado 170 (23) 231 (31) 292 (39)”
Community Readiness for Local Smoke-Free Policy Change
York, N. L., Hahn, E. J., Rayens, M. K., & Talbert, J. (2008) · American Journal of Health Promotion · doi:10.4278/ajhp.07021615 · Cited by 30
Verma, A., Clough, D., McKenna, D., Dodd, M. E., & Webb, A. K. (2001) · Journal of the Royal Society of Medicine · doi:10.1177/014107680109440s08 · Cited by 30
Lee, P., Wu, D., Lai, H., & Chu, N. (2007) · Addictive Behaviors · doi:10.1016/j.addbeh.2007.01.018 · Cited by 30
Iqbal, N., Irfan, M., Ashraf, N., Awan, S., & Khan, J. A. (2015) · BMC Research Notes · doi:10.1186/s13104-015-1455-7 · Cited by 30
“It has been shown that smoking restrictions at home not only reduce the overall exposure of tobacco, but it can also reduce the smoking practice in youth [15].”
BackgroundKang, H., & Cho, S. (2018) · Tobacco Control · doi:10.1136/tobaccocontrol-2018-054536 · Cited by 30
Youth Smoking Uptake Progress: Price and Public Policy Effects
Ross, H., Chaloupka, F. J., & Wakefield, M. A. (2003) · RePEc: Research Papers in Economics · Cited by 30
Self-citationSmoke-Free School Policy and Exposure to Secondhand Smoke: A Quasi-Experimental Analysis
Azagba, S., Kennedy, R. D., & Baskerville, N. B. (2015) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntv077 · Cited by 31
Compliance with point-of-sale tobacco control policies and student tobacco use in Mumbai, India
Mistry, R., Pednekar, M. S., McCarthy, W. J., Resnicow, K., Pimple, S. A., Hsieh, H., Mishra, G. A., & Gupta, P. C. (2018) · Tobacco Control · doi:10.1136/tobaccocontrol-2018-054290 · Cited by 29
Associations between parental smoking restrictions and adolescent smoking
Ditre, J. W., Coraggio, J. T., & Herzog, T. A. (2008) · Nicotine & Tobacco Research · doi:10.1080/14622200802087549 · Cited by 28
“For example, there is evidence that parental restrictions on smoking in the home can delay the progression of smoking behaviors among teens who are in the early phases of smoking acquisition (Wakefield et al., 2000).”
BackgroundInfluentialThe Emerging Human Right to Tobacco Control
Dresler, C. M., & Marks, S. P. (2006) · Human Rights Quarterly · doi:10.1353/hrq.2006.0032 · Cited by 28
Molyneux, A., Lewis, S., Antoniak, M. D., Hubbard, R., McNeill, A. D., Godfrey, C., Madeley, R. J., & Britton, J. R. (2002) · Tobacco Control · doi:10.1136/tc.11.3.241 · Cited by 28
What Are the Effects of Tobacco Policies on Vulnerable Populations?
Greaves, L., Johnson, J. L., Bottorff, J. L., Kirkland, S., Jategaonkar, N., McGowan, M., McCullough, L., & Battersby, L. (2006) · Canadian Journal of Public Health · doi:10.1007/bf03405610 · Cited by 41
Smoke‐free air policy: subcultural shifts and secondary health effects among club‐going young adults
Kelly, B. C. (2009) · Sociology of Health & Illness · doi:10.1111/j.1467-9566.2008.01150.x · Cited by 27
Cigarette access and pupil smoking rates: a circular relationship?
Turner, K. M. (2004) · Health Promotion International · doi:10.1093/heapro/dah404 · Cited by 27
“Children with parents who smoke are more likely to smoke than children with parents do not smoke (Wakefield et al., 2000).”
BackgroundTurner, K. M. (2004) · Health Education Research · doi:10.1093/her/cyg005 · Cited by 27
Parental Education and Family Status - Association with Children's Cigarette Smoking
Žaloudíková, I., Hrubá, D., & Samara, I. (2012) · Central European Journal of Public Health · doi:10.21101/cejph.a3652 · Cited by 27
“On the other hand, a lack of household smoking restrictions is associated with a higher degree of smoking susceptibility (13, 16, 26).”
Background
Metadata
- 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 › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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