Wakefield M, Banham D, Martin J, Ruffin R, McCaul K, Badcock N
Health Research and Policy Centers, University of Illinois at Chicago, Illinois 60607, USA.
Am J Prev Med. 2000 Oct;19(3):188-92. doi: 10.1016/s0749-3797(00)00197-5.
The purpose of this study was to determine the extent to which various levels of restrictions on smoking in the home may be associated with children's exposure to environmental tobacco smoke (ETS).
The methodology consisted of a cross-sectional survey involving 249 children with asthma aged 1 to 11 attending hospital outpatient clinics, with at least one parent who smoked, linked to the child's urinary cotinine to creatinine ratios (CCR).
After adjustment for child's age, mother's smoking status, and total parental daily cigarette consumption, a total ban was associated with significantly lower urinary CCR levels (7.6 nmol/mmol) than bans with exceptions or limited smoking in the home. Where exceptions to bans were made (14.9 nmol/mmol), children's urinary CCR levels were no different from homes in which smoking was allowed in rooms the child rarely frequented (14.1 nmol/mmol). These two intermediate levels of restriction were in turn associated with significantly lower CCR levels than unrestricted smoking in the home (26.0 nmol/mmol).
Making exceptions to bans on smoking at home measurably undermines the protective effect of a ban. However, making some exceptions to a ban and limiting smoking to rooms where the child rarely goes may result in reduced exposure to ETS, compared with unrestricted smoking.
本研究旨在确定家庭中不同程度的吸烟限制与儿童接触环境烟草烟雾（ETS）之间的关联程度。
该方法包括一项横断面调查，涉及249名年龄在1至11岁的哮喘儿童，他们在医院门诊就诊，至少有一位家长吸烟，并将其与儿童尿中可替宁与肌酐比值（CCR）相关联。
在对儿童年龄、母亲吸烟状况和父母每日吸烟总量进行调整后，全面禁烟与显著较低的尿CCR水平（7.6纳摩尔/毫摩尔）相关，而有例外情况的禁烟或家中有限制吸烟的情况则不然。在有禁烟例外情况的家庭中（14.9纳摩尔/毫摩尔），儿童尿CCR水平与允许在儿童很少光顾的房间吸烟的家庭（14.1纳摩尔/毫摩尔）没有差异。这两种中间限制水平又与家中无限制吸烟（26.0纳摩尔/毫摩尔）相比，CCR水平显著降低相关。
在家中吸烟禁令设置例外情况会显著削弱禁令的保护作用。然而，与无限制吸烟相比，对禁令设置一些例外情况并将吸烟限制在儿童很少去的房间，可能会减少接触环境烟草烟雾的机会。
