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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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“Issues that may be examined include the criteria for inclusion in analyses, the definitions of exposures or outcomes [122], which confounding variables merit adjustment, the handling of missing data [120,123], possible selection bias or bias from inaccurate or inconsistent measurement of exposure, disease and other va…”
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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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