巴伐利亚州禁烟令对儿童接触二手烟的影响及对父母吸烟习惯的改变——一项多时间横断面研究。
Change in exposure of children to second-hand smoke with impact on children's health and change in parental smoking habits after smoking ban in Bavaria - a multiple cross-sectional study.
机构信息
Institute for Medical Information Processing, Biometry and Epidemiology - IBE, LMU Munich, Munich, Germany.
Pettenkofer School of Public Health, Munich, Germany.
出版信息
BMC Public Health. 2021 Nov 20;21(1):2134. doi: 10.1186/s12889-021-12130-8.
BACKGROUND
Concerns about smoking displacement from public places to private amenities aroused following smoking ban implementation in Bavaria in 2008. We analysed children's exposure to second-hand smoke (SHS) before and after the ban, its effect on children's health and prevalence of active smoking in adults.
METHODS
Six cross-sectional surveys (n = 32,443) on pre-school children in Bavaria were analysed, two surveys before the smoking ban in years 2004 and 2005 (S1 and S2) and four after the ban in 2008, 2012, 2014 and 2016 (S4, S6, S7 and S8). Using multivariable logistic regression, we analysed change in children's intra- and extrauterine SHS exposure and its adverse health effects (Asthma, wheezing, bronchitis and neurodermatitis) as well as change in parental active smoking.
RESULTS
The response rates were 78% for S1, 73% for S2, 61% for S4, 62% for S6, 56% for S7 and 54% for S8. Odds of parents never smoked at home in presence of children increased significantly from before to after the ban with odds ratios (OR) 1.17 (CI 1.01-1.35), 1.65 (CI 1.39-1.95), 2.85 (CI 2.32-3.51), 2.24 (CI 1.84-2.72) and 3.66 (CI 2.89-4.63) for S2, S4, S6, S7 and S8, respectively with S1 as reference. Compared to S4, odds of parents who were not actively smoking is significantly higher in S7 (OR = 1.13 (CI 1.03-1.24)) and S8 (OR = 1.24 (CI 1.13-1.36)). The odds of mothers who never smoked during pregnancy increased over time with OR = 1.22 (CI 1.06-1.40) for S2 and 1.57 (CI 1.33-1.86) for S8 compared to S1. Adverse health effects related to children's exposure to SHS are significantly less in S8 compared to S1.
CONCLUSION
After 11 years of smoking ban in Bavaria, smoking displacement to homes was disproved. Exposure of children to SHS intrauterine and at home is decreasing. Number of parents who are not actively smoking is increasing over time. Prevalence of health problems in children related to exposure to SHS is decreasing.
背景
2008 年巴伐利亚州实施禁烟令后，人们开始担心吸烟行为会从公共场所转移到私人场所。我们分析了禁烟令实施前后儿童接触二手烟（SHS）的情况，及其对儿童健康的影响和成年人中主动吸烟的流行情况。
方法
我们分析了巴伐利亚州学龄前儿童的 6 项横断面调查（n=32443），其中 2 项调查在 2004 年和 2005 年禁烟令实施前进行（S1 和 S2），4 项在 2008 年、2012 年、2014 年和 2016 年禁烟令实施后进行（S4、S6、S7 和 S8）。我们采用多变量逻辑回归分析了儿童宫内和宫内 SHS 暴露的变化及其不良健康影响（哮喘、喘息、支气管炎和特应性皮炎），以及父母主动吸烟的变化。
结果
S1 的应答率为 78%，S2 为 73%，S4 为 61%，S6 为 62%，S7 为 56%，S8 为 54%。与禁令实施前相比，在家中有儿童时父母从不吸烟的几率显著增加，OR 值分别为 1.17（CI 1.01-1.35）、1.65（CI 1.39-1.95）、2.85（CI 2.32-3.51）、2.24（CI 1.84-2.72）和 3.66（CI 2.89-4.63），S1 为参考。与 S4 相比，S7（OR=1.13（CI 1.03-1.24））和 S8（OR=1.24（CI 1.13-1.36））中不主动吸烟的父母的几率明显更高。随着时间的推移，母亲在怀孕期间从不吸烟的几率也有所增加，S2 的 OR 值为 1.22（CI 1.06-1.40），S8 的 OR 值为 1.57（CI 1.33-1.86），与 S1 相比。与 S1 相比，S8 儿童接触 SHS 导致的健康问题明显减少。
结论
巴伐利亚州禁烟令实施 11 年后，证明了吸烟向家庭转移的说法是没有依据的。儿童宫内和家庭内接触 SHS 的情况正在减少。不主动吸烟的父母数量随着时间的推移而增加。与 SHS 接触相关的儿童健康问题的发生率正在下降。
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