Cardiff Institute of Society and Health, School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff CF10 3BD, United Kingdom.
Nicotine Tob Res. 2011 Oct;13(10):903-10. doi: 10.1093/ntr/ntr093. Epub 2011 May 12.
Secondhand smoke (SHS) exposure is higher among children from lower socioeconomic status (SES) households. Legislation banning smoking in public places has been linked with reduced SHS exposure in children. However, socioeconomic patterning in responses to legislation has been little explored.
A total of 3,083 children aged 10-11 years, within 75 Welsh primary schools, completed questionnaires either before legislation or 1 year later. Saliva samples were provided by 2,787 of these children for cotinine assay. Regression analyses assessed socioeconomic differences in SHS exposure, and associations of legislation with exposure among children from low, medium, and high SES households. Changes in parental smoking in the home, car-based exposure, and perceived norms were assessed.
SHS exposure was highest among children from lower SES households. The likelihood of providing a sample containing an undetectable level of cotinine increased significantly after legislation among children from high [relative risk ratio (RRR) = 1.44, 95% CI = 1.04-2.00] and medium SES households (RRR = 1.66, 95% CI = 1.20-2.30), while exposure among children from lower SES households remained unchanged. Parental smoking in the home, car-based SHS exposure, and perceived smoking prevalence were highest among children from low SES households. Parental smoking in the home and children's estimates of adult smoking prevalence declined only among children from higher SES households.
Post-legislation reductions in SHS exposure were limited to children from higher SES households. Children from lower SES households continue to have high levels of exposure, particularly in homes and cars, and to perceive that smoking is the norm among adults.
二手烟（SHS）暴露在社会经济地位（SES）较低的家庭的儿童中更高。公共场所禁止吸烟的立法与儿童 SHS 暴露减少有关。然而，对于立法的社会经济模式的研究还很少。
共有 3083 名 10-11 岁的儿童在威尔士的 75 所小学完成了问卷，要么在立法之前，要么在 1 年之后。这些儿童中有 2787 人提供了唾液样本进行可替宁检测。回归分析评估了 SHS 暴露的社会经济差异，以及立法对 SES 家庭中低、中、高收入儿童暴露的影响。还评估了家庭中父母吸烟、车内暴露和感知规范的变化。
来自 SES 较低家庭的儿童 SHS 暴露最高。立法后，高 SES [相对风险比（RRR）=1.44，95%置信区间（CI）=1.04-2.00]和中 SES [RRR=1.66，95% CI = 1.20-2.30]家庭的儿童提供的样本中可替宁含量无法检测到的可能性显著增加，而 SES 较低家庭的儿童暴露则保持不变。家庭中父母吸烟、车内 SHS 暴露和感知吸烟率在 SES 较低的家庭中最高。只有 SES 较高家庭的儿童的家庭吸烟和儿童对成人吸烟率的估计才会下降。
立法后 SHS 暴露的减少仅限于 SES 较高的家庭。SES 较低的家庭的儿童仍然暴露在高水平的环境中，尤其是在家里和汽车里，并且认为吸烟是成年人的常态。
