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Keywords:

  • Children;
  • cotinine;
  • intervention;
  • passive smoke;
  • smoking ban;
  • Smokefree;
  • second-hand smoke

Abstract

Aims

To examine whether English legislation to make virtually all indoor public places and work-places smoke-free on 1 July 2007 displaced smoking into the home and hence increased the proportion of children exposed to levels of second-hand smoke known to be detrimental to health.

Design

Repeated cross-sectional study with data from 10 annual surveys undertaken from 1996 to 2008.

Setting

England.

Participants

Nationally representative samples of non-smoking children aged 4–15 years old living in private households.

Measurements

Salivary cotinine, parental smoking status, whether smoking is allowed within the house, socio-demographic variables.

Findings

The proportion of children exposed to damaging levels of second-hand smoke (defined as those with cotinine levels >1.7 ng/ml) has fallen over time, from 23.5% in 1996 to 12.6% in 2008. The legislation was not associated with further changes in the proportion of children above this threshold—the odds of having cotinine >1.7 ng/ml did not change after adjustment for the pre-legislative trend and confounders (odds ratio: 1.0, 95% confidence interval: 0.78, 1.4). Non-significant associations were also found when examining children by parental or household smoking status.

Conclusions

Legislation to prohibit smoking in indoor public places and work-places does not increase the proportion of children exposed to damaging levels of second-hand smoke. Even in a country with a strong tobacco control climate, a significant proportion of children remain highly exposed to second-hand smoke and future policies need to include interventions to reduce exposure among these children.