Child & Adolescent Health Research Unit (CAHRU), University of Edinburgh, St Leonard's Land, Holyrood Road, Edinburgh, EH8 8AQ, UK.
J Epidemiol Community Health. 2010 Apr;64(4):341-6. doi: 10.1136/jech.2008.084178. Epub 2009 Aug 13.
To examine the impact of the Scottish smoke-free legislation on social inequalities in secondhand smoke (SHS) exposure among primary school children.
Comparison of nationally representative, cross-sectional, class-based surveys carried out in the same schools before and after legislation. Participants were 2532 primary school children (primary 7; aged around 11 y) surveyed in January 2006 (before legislation) and 2389 in January 2007 (after legislation). Outcome measures were salivary cotinine concentrations, self-reported family socioeconomic classification (family SEC) and family affluence scale (FAS).
After adjusting for number of smoking parents, mean cotinine concentration varied significantly across both family SEC and FAS groups, and increased significantly stepwise from high to low family SEC/FAS. Mean cotinine fell in all family SEC/FAS groups after legislation. The relative drop in mean cotinine was equal across all family SEC/FAS groups. Adding an interaction term between survey-year and family SEC/FAS to the model showed an increase in inequalities over time, but was only significant at the 93% level using FAS and 73% using family SEC.
Inequalities in SHS exposure exist among 11-year-old children in Scotland. Smoke-free legislation has reduced exposure to SHS among all children. Although the greatest absolute reduction in cotinine is observed in the lowest SEC/FAS group, cotinine levels remain highest for this group and there is a suggestion of possible increases in inequalities, which may warrant longer-term monitoring.
研究苏格兰无烟立法对小学生二手烟（SHS）暴露的社会不平等的影响。
在同一所学校中，对立法前后进行基于班级的全国代表性横断面调查，比较分析。参与者为 2532 名小学生（7 年级；年龄约为 11 岁），于 2006 年 1 月（立法前）和 2007 年 1 月（立法后）进行调查。结果测量为唾液可替宁浓度、自我报告的家庭社会经济分类（家庭 SEC）和家庭富裕量表（FAS）。
在调整了父母吸烟人数后，可替宁浓度在家庭 SEC 和 FAS 两组中差异显著，且随着家庭 SEC/FAS 从高到低呈阶梯式显著增加。立法后，所有家庭 SEC/FAS 组的可替宁浓度均下降。所有家庭 SEC/FAS 组的可替宁浓度平均下降幅度相等。在模型中添加调查年份和家庭 SEC/FAS 之间的交互项，显示不平等程度随时间增加，但仅在使用 FAS 时在 93%的水平和使用家庭 SEC 时在 73%的水平上具有统计学意义。
苏格兰 11 岁儿童中存在 SHS 暴露的不平等现象。无烟立法降低了所有儿童对 SHS 的暴露。虽然在最低 SEC/FAS 组中观察到可替宁的绝对减少量最大，但该组的可替宁水平仍然最高，且不平等程度可能有所增加，这可能需要进行更长期的监测。
