Tattan-Birch Harry, Jarvis Martin J
Department of Behavioural Science & Health, University College London, London, UK.
Lancet Reg Health Eur. 2022 Feb 3;15:100315. doi: 10.1016/j.lanepe.2022.100315. eCollection 2022 Apr.
We aimed to investigate trends in children's exposure to second-hand tobacco smoke in England from 1998 to 2018.
We used twenty-one years of data from the Health Survey for England, a yearly repeated cross-sectional population study. A total of 49,460 children participated between 1998 and 2018, of whom 17,463 were biochemically confirmed non-smokers aged 4-15. We examined changes in (i) the proportion of children living in reported smoke-free homes and (ii) second-hand smoke uptake, measured quantitatively using saliva cotinine concentration.
The percentage of children living in a home reported to be smoke-free increased from 63.0% (95% CI 60.5%-65.2%) in 1998 to 93.3% (91.8%-94.6%) in 2018. This increase was most pronounced among children with a smoker parent, rising from 17.1% (14.7%-19.8%) to 75.9% (70.8%-80.4%). Segmented regression showed that the rate of adoption of smoke-free homes accelerated leading up to the 2007 ban on smoking in public places, growing most rapidly in the four years after its entry into law. Between 1998 and 2018, there was a ten-fold decline in geometric mean cotinine among non-smoking children, from 0.50 ng/ml (0.46-0.56) to 0.05 ng/ml (0.04-0.06). A total of 65.0% (61.2%-68.6%) of children had undetectable cotinine in 2018, up from 14.3% (12.7%-16.0%) in 1998. Children living in rented accommodation were more exposed than those from owner-occupied households, but they experienced similar relative declines across years.
Cotinine data show that children's exposure to second-hand smoke has fallen by some 90% since 1998, with an apparent acceleration in adoption of smoke-free homes since the 2007 ban on smoking in public places. A norm has emerged that sees smoking in the home as inappropriate, almost universally where parents are non-smokers, but also increasingly among smoking parents.
Public Health England, now the Office for Health Improvement and Disparities, and Cancer Research UK.
我们旨在调查1998年至2018年英格兰儿童接触二手烟的趋势。
我们使用了来自英格兰健康调查的21年数据，这是一项每年重复进行的横断面人群研究。1998年至2018年间共有49460名儿童参与，其中17463名是经生化确认的4至15岁非吸烟者。我们研究了以下方面的变化：（i）居住在报告为无烟家庭的儿童比例；（ii）二手烟摄入量，通过唾液可替宁浓度进行定量测量。
报告居住在无烟家庭的儿童比例从1998年的63.0%（95%置信区间60.5%-65.2%）增至2018年的93.3%（91.8%-94.6%）。这种增长在有吸烟父母的儿童中最为明显，从17.1%（14.7%-19.8%）升至75.9%（70.8%-80.4%）。分段回归显示，在2007年公共场所禁烟令颁布之前，无烟家庭的采用率加速上升，在该法令生效后的四年中增长最为迅速。1998年至2018年间，非吸烟儿童的可替宁几何平均值下降了十倍，从0.50纳克/毫升（0.46-0.56）降至0.05纳克/毫升（0.04-0.06）。2018年，共有65.0%（61.2%-68.6%）的儿童可替宁检测不到，高于1998年的14.3%（12.7%-16.0%）。居住在出租房的儿童比自有住房家庭的儿童接触二手烟更多，但多年来他们的相对下降情况相似。
可替宁数据表明，自1998年以来，儿童接触二手烟的情况下降了约90%，自2007年公共场所禁烟令颁布以来，无烟家庭的采用率明显加速上升。一种规范已经形成，即认为在家中吸烟是不合适的，在父母不吸烟的情况下几乎普遍如此，在吸烟父母中也越来越普遍。
英国公共卫生署（现更名为健康改善与差异办公室）和英国癌症研究中心。
