Department of Health Sciences, University of York, Heslington, York, UK.
Department of Economics, University of Dhaka, Social Science Building, Nilkhet, Dhaka, Bangladesh.
Nicotine Tob Res. 2019 Mar 30;21(4):416-423. doi: 10.1093/ntr/ntx248.
We report on second-hand smoke (SHS) exposure based on saliva cotinine levels among children in Bangladesh-a country with laws against smoking in public places.
A survey of primary school children from two areas of the Dhaka district was conducted in 2015. Participants completed a questionnaire and provided saliva samples for cotinine measurement to assess SHS exposure with a cut-off range of ≥0.1ng/mL.
Four hundred and eighty-one children studying in year-5 were recruited from 12 primary schools. Of these, 479 saliva samples were found sufficient for cotinine testing, of which 95% (453/479) were positive for recent SHS exposure. Geometric mean cotinine was 0.36 (95% CI = 0.32 to 0.40); 43% (208/479) of children lived with at least one smoker in the household. Only 21% (100/479) reported complete smoking restrictions for residents and visitors; 87% (419/479) also reported being recently exposed to SHS in public spaces. Living with a smoker and number of tobacco selling shops in the neighborhood had positive associations with recent SHS exposure.
Despite having a ban on smoking in public places, recent SHS exposure among children in Bangladesh remains very high. There is an urgent need to reduce exposure to SHS in Bangladeshi children.
Children bear the biggest burden of disease due to SHS exposure than any other age group. However, children living in many high-income countries have had a sharp decline in their exposure to SHS in recent years. What remains unknown is if children living in low-income countries are still exposed to SHS. Our study suggests that despite having a ban on smoking in public places, most primary school children in Dhaka, Bangladesh are still likely to be exposed to SHS.
我们报告了孟加拉国儿童的二手烟（SHS）暴露情况，该国有公共场所禁烟的法律。
2015 年在达卡区的两个地区对小学生进行了调查。参与者完成了一份问卷，并提供了唾液样本进行可替宁测量，以评估 SHS 暴露情况，其截断范围为≥0.1ng/mL。
从 12 所小学中招募了 481 名正在读五年级的儿童。其中，479 份唾液样本足以进行可替宁检测，其中 95%（453/479）最近接触过 SHS。几何平均可替宁浓度为 0.36（95%置信区间=0.32 至 0.40）；43%（208/479）的儿童与家中至少有一名吸烟者同住。只有 21%（100/479）报告完全限制居民和访客吸烟；87%（419/479）还报告最近在公共场所接触过 SHS。与家中吸烟者同住和附近烟草销售店数量与最近接触 SHS 呈正相关。
尽管孟加拉国有公共场所禁烟令，但儿童最近接触 SHS 的情况仍然很高。孟加拉国迫切需要减少儿童接触 SHS。
与任何其他年龄组相比，儿童因接触 SHS 而患病的负担最大。然而，近年来，许多高收入国家的儿童接触 SHS 的情况急剧下降。目前还不清楚的是，生活在低收入国家的儿童是否仍然接触 SHS。我们的研究表明，尽管孟加拉国有公共场所禁烟令，但达卡的大多数小学生仍有可能接触 SHS。
