Zheng Z L, Deng H Y, Wu C P, Lam W L, Kuok W S, Liang W J, Wang H L
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
Public Health. 2017 Mar;144:57-63. doi: 10.1016/j.puhe.2016.11.018. Epub 2017 Jan 4.
To investigate secondhand smoke exposure (SHS) of children at home and the prevalence of parental smoking after implementation of the new tobacco control law in Macao. This study explored whether the smoking ban in public places in Macao has decreased the prevalence of smoking or led to increased SHS exposure of children at home. As smokers cannot smoke in public places any more, they may smoke at home more frequently; a displacement effect of smoke-free legislation.
Cross-sectional survey.
This study surveyed 337 fathers and 538 mothers. Questions from a subset of key questions from the Global Adult Tobacco Survey (2nd edition) were applied to assess the SHS exposure of children and the prevalence of parental smoking since the smoking ban. A classification tree analysis was used to analyse the factors increasing SHS exposure of children.
The prevalence of SHS exposure in children at home was 41.3%. The prevalence rates of paternal and maternal smoking were 43.7% and 3.8%, respectively. Compared with data reported by the Health Bureau of Macao SAR in 2011, the prevalence of parental smoking and the prevalence of SHS exposure of children at home have not decreased since the smoking ban. Analysis of the factors increasing the prevalence of SHS exposure of children indicated that fathers with an education level below high school were more likely to contribute to this increase, compared with fathers with a high school education or more (48.2% vs 32.4%, respectively). In addition, fathers represented the majority of smokers at home, accounting for 92.0% of 415 smoking parents. The prevalence of paternal smoking (82.0%) in the group of children with SHS exposure was much higher than that in the unexposed group (16.7%, Chi-squared test = 367.199, P = 0.000). The SHS exposure of children increased consistently with the decrease in paternal education level. This was consistent with the increasing prevalence of paternal smoking as paternal education level decreased. SHS exposure was most common among children whose fathers had an education level below high school and whose mothers were aged ≤29 years (75.0%).
This study did not find any decline in the prevalence of parental smoking after the smoking ban. These parents were more likely to smoke at home after the ban, leading to more frequent SHS exposure for their children.
调查澳门实施新控烟法后儿童在家中的二手烟暴露情况以及父母吸烟率。本研究探讨澳门公共场所禁烟是否降低了吸烟率或导致儿童在家中二手烟暴露增加。由于吸烟者不能再在公共场所吸烟，他们可能会更频繁地在家中吸烟；这是无烟立法的替代效应。
横断面调查。
本研究调查了337名父亲和538名母亲。应用全球成人烟草调查（第2版）中的部分关键问题来评估自禁烟以来儿童的二手烟暴露情况和父母吸烟率。采用分类树分析来分析增加儿童二手烟暴露的因素。
儿童在家中二手烟暴露率为41.3%。父亲和母亲的吸烟率分别为43.7%和3.8%。与澳门特别行政区卫生局2011年报告的数据相比，自禁烟以来，父母吸烟率和儿童在家中二手烟暴露率均未下降。对增加儿童二手烟暴露率的因素分析表明，与高中及以上学历的父亲相比，高中以下学历的父亲更有可能导致这种增加（分别为48.2%和32.4%）。此外，父亲占家中吸烟者的大多数，占415名吸烟父母的92.0%。二手烟暴露儿童组中父亲的吸烟率（82.0%）远高于未暴露组（16.7%，卡方检验=367.199，P=0.000）。儿童二手烟暴露随着父亲教育水平的降低而持续增加。这与随着父亲教育水平降低父亲吸烟率上升一致。二手烟暴露在父亲学历低于高中且母亲年龄≤29岁的儿童中最为常见（75.0%）。
本研究未发现禁烟后父母吸烟率有任何下降。这些父母在禁烟后更有可能在家中吸烟，导致其子女二手烟暴露更频繁。
