Conley Thomson Carey, Siegel Michael, Winickoff Jonathan, Biener Lois, Rigotti Nancy A
Tobacco Research and Treatment Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Prev Med. 2005 Aug;41(2):349-56. doi: 10.1016/j.ypmed.2004.12.003.
Household smoking bans might decrease the visibility of cigarette smoking and communicate nonsmoking social norms and parental attitudes to youths, which may serve as mediators to reduce smoking initiation. Whether they have these effects even if parents smoke or do not otherwise communicate strong disapproval of smoking to their children is not clear. We tested these hypotheses in multi-level analyses.
A telephone survey of a random sample of 3831 Massachusetts adolescents (12-17 years) assessed respondents' perceptions of smoking prevalence and attitudes about the social acceptability of smoking in their community. The association of these outcomes with the presence of a smoking ban in the youths' home was tested in multivariate analyses that adjusted for town-level clustering and individual and environmental characteristics.
A household smoking ban was reported by 71% of all youths and 49% of youths who lived with smokers. In multivariate models, youths who had a household smoking ban were more likely to perceive a lower adult smoking prevalence (OR 2.1; 95% CI 1.7-2.5; P < 0.001), greater adult disapproval of adult smoking (OR 2.0; 1.5-2.6; P < 0.001) and of teen smoking (OR 1.5; 95% CI 1.2-1.9; P = 0.001).
Among adolescents, a household smoking ban was associated with a lower perceived prevalence of adult smoking in their communities and more negative attitudes about the social acceptability of smoking, two factors that affect the likelihood of smoking initiation. Household smoking bans had these effects even in the presence of two parental factors known to encourage adolescent smoking initiation (parental smoking and lack of perceived parental disapproval of youth tobacco use). This provides an additional rationale for promoting household smoking bans to parents.
家庭吸烟禁令可能会降低吸烟的可见度，并向青少年传达不吸烟的社会规范和父母的态度，这可能作为减少吸烟起始的中介因素。即使父母吸烟或未向子女明确表达对吸烟的强烈反对，家庭吸烟禁令是否仍有这些效果尚不清楚。我们在多层次分析中检验了这些假设。
对马萨诸塞州3831名青少年（12 - 17岁）进行随机抽样的电话调查，评估受访者对吸烟流行率的看法以及对其社区中吸烟社会可接受性的态度。在多变量分析中检验这些结果与青少年家中存在吸烟禁令之间的关联，并对城镇层面的聚类以及个体和环境特征进行了调整。
所有青少年中有71%报告家中有吸烟禁令，与吸烟者同住的青少年中有49%报告家中有吸烟禁令。在多变量模型中，家中有吸烟禁令的青少年更有可能认为成年人吸烟流行率较低（比值比[OR] 2.1；95%置信区间[CI] 1.7 - 2.5；P < 0.001），成年人对吸烟更加反对（OR 2.0；1.5 - 2.6；P < 0.001）以及对青少年吸烟更加反对（OR 1.5；95% CI 1.2 - 1.9；P = 0.001）。
在青少年中，家庭吸烟禁令与他们社区中成年人吸烟流行率较低以及对吸烟社会可接受性更负面的态度相关，这两个因素会影响吸烟起始的可能性。即使存在已知会鼓励青少年吸烟起始的两个父母因素（父母吸烟以及未察觉到父母对青少年烟草使用的反对），家庭吸烟禁令仍有这些效果。这为向父母推广家庭吸烟禁令提供了额外的理论依据。
