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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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“Previously, implementation of community-level comprehensive tobacco control strategies has been recommended to reduce youth smoking.(29) 30 The cross-sectional results show that increases in student-reported community support for tobacco control were significantly associated with a lower smoking index.”
BackgroundSmoking-Cessation Strategies for American Indians
Fu, S. S., Burgess, D. J., van Ryn, M., Rhodes, K., Widome, R., Ricards, J., Noorbaloochi, S., Clothier, B. A., Su, J., & Joseph, A. M. (2010) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2010.08.012 · Cited by 15
Getting a Puff: A Social Learning Test of Adolescents Smoking
Monroe, J. (2004) · Journal of Child & Adolescent Substance Abuse · doi:10.1300/j029v13n03_04 · Cited by 15
“Wakefield et al. (2000) found that enforced smoking restrictions, alone, in the home, and public places like a school served as protective fibers against adolescents smoking.”
BackgroundBritton, J. R., Jarvis, M. J., McNeill, A. D., Bates, C., Cuthbertson, L., & Godfrey, C. (2001) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.164.1.2010034 · Cited by 15
Smoke-free schools? Results of a secondary school smoking policies survey 2002.
Darling, H., & Reeder, A. I. (2003) · PubMed · Cited by 15
Use of four major tobacco control interventions in New Zealand: a review.
Wilson, N., Thomson, G., & Edwards, R. (2008) · PubMed · Cited by 15
Strong smoker interest in ‘setting an example to children’ by quitting: national survey data
Thomson, G., Wilson, N., Weerasekera, D., & Edwards, R. (2010) · Australian and New Zealand Journal of Public Health · doi:10.1111/j.1753-6405.2010.00638.x · Cited by 14
“Other research has associated decreased public and private indoor smoking with decreased risks of starting smoking.(2,3)”
BackgroundEvolution of the association between parental and child smoking in Finland between 1977 and 2005
Rainio, S. U., Rimpelä, A., Luukkaala, T. H., & Rimpelä, M. (2008) · Preventive Medicine · doi:10.1016/j.ypmed.2008.01.011 · Cited by 14
“…modeling, parenting style, parental attitudes toward smoking, and home smoking restrictions are important mediating family factors between parents' and their child's smoking (Wakefield et al., 2000; Proescholdbell et al., 2000; Sargent and Dalton, 2001; Jackson, 2002; Kodl and Mermelstein, 2004).”
BackgroundHemsing, N., Greaves, L., Poole, N., & Bottorff, J. L. (2012) · Journal of Environmental and Public Health · doi:10.1155/2012/907832 · Cited by 14
Home smoking policies in urban households with children and smokers
Bleakley, A., Hennessy, M. H., Mallya, G. G., & Römer, D. (2013) · Preventive Medicine · doi:10.1016/j.ypmed.2013.12.015 · Cited by 14
“However, partial smoking bans which allow household smoking in certain rooms or under certain circumstances are not as effective as full bans in reducing children's exposure to SHS (Wakefield et al., 2000a).”
BackgroundPadilla, M., Berg, C. J., Schauer, G. L., Lang, D. L., & Kegler, M. C. (2014) · Health Education Research · doi:10.1093/her/cyu051 · Cited by 14
“Other consistent predictors of household smoking bans include the presence of children, the presence of a non-smoking adult in the home and friends and family members who smoke [18–20, 22–27].”
BackgroundThe Effect of Household Smoking Bans on Household Smoking
Hennessy, M. H., Bleakley, A., Mallya, G. G., & Römer, D. (2014) · American Journal of Public Health · doi:10.2105/ajph.2013.301634 · Cited by 14
Alinia, T., Sadeghi, M., Mohammad-Shafiee, G., Naji, M., Roohafza, H., Heidari, K., & Omidi, R. (2014) · International Journal of Preventive Medicine · doi:10.4103/2008-7802.157677 · Cited by 14
Smoke-Free Homes and Youth Smoking Behavior in Italy: Findings From the SIDRIAT Longitudinal Study
Gorini, G., Carreras, G., Cortini, B., Verdi, S., Petronio, M. G., Sestini, P., & Chellini, E. (2016) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntw149 · Cited by 14
The Association Between School Tobacco Control Policies and Youth Smoking Behavior
Jayawardhana, J., Bolton, H. E., & Gaughan, M. (2019) · International Journal of Behavioral Medicine · doi:10.1007/s12529-019-09825-z · Cited by 14
Tobacco-Free Ambassador Partnership: Empowering Youth Advocates in Appalachian Communities
Ickes, M. J., Sampson, S. O., Parsons, J., Rayens, M. K., Xiao, M., Fisher, A., Mundy, M., & Hahn, E. J. (2020) · Health Promotion Practice · doi:10.1177/1524839919880563 · Cited by 14
Li, D.-M., Shi, H., Xie, Z.-D., Rahman, I., McIntosh, S., Bansal-Travers, M., Winickoff, J., Drehmer, J. E., & Ossip, D. (2020) · Preventive Medicine · doi:10.1016/j.ypmed.2020.106215 · Cited by 14
Martínez, J. A., Amaya, W., Campillo, H. A., Campo, A., & Díaz‐Martínez, L. A. (2005) · Biomédica · doi:10.7705/biomedica.v25i4.1378 · Cited by 14
“Finalmente, para hacer viable este proceso es fundamental la adopción de políticas de salud pública que hagan efectivas las medidas que protegen a los no fumadores, la restricción de la publicidad en algunos lugares y horarios y el aumento de los impuestos a los cigarrillos (60).”
BackgroundKabir, Z., Alpert, H. R., Goodman, P. G., Haw, S., Behm, I., Connolly, G. N., Gupta, P. C., & Clancy, L. (2010) · Pediatric Health · doi:10.2217/phe.10.41 · Cited by 13
“One well-conducted intervention trial in Australia also reported similar findings among low-income families [28], while ethnic studies showed similar results across multiple ethnic groups [31,46], as well as in children who were asthmatics [27,43].”
BackgroundResultSecondhand Smoke Exposure in a Rural High School
Lee, K., Hahn, E. J., Riker, C. A., Hoehne, A., White, A., Greenwell, D., & Thompson, D. (2007) · The Journal of School Nursing · doi:10.1177/10598405070230040701 · Cited by 13
“The development, implementation, and strong enforcement of tobacco-free policies in schools may result in lower rates of smoking among adolescents (Charlton & While, 1994; Pentz et al., 1989; Wakefield et al., 2000).”
BackgroundLeiva, A., Estela, A., Torrent, M., Calafat, A., Bennasar‐Veny, M., & Yáñez, A. M. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-373 · Cited by 13
Children's exposure to secondhand smoke at home before and after smoke-free legislation in Taiwan
Wang, Y.-T., Tsai, Y., Tsai, T.-I., & Chang, P.-Y. (2016) · Tobacco Control · doi:10.1136/tobaccocontrol-2016-053039 · Cited by 13
Jóvenes y tabaco: prevalencia, patrón y actitud ante el consumo de tabaco
García, M., García, R. R., Martín, D. P., Mezquita, M. Á. H., Ferrero, M. B., & Díaz, A. A. (2004) · Anales de Pediatría · doi:10.1016/s1695-4033(04)78303-4 · Cited by 13
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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