Brown, A

English

Nottingham Trent Institutional Repository (IRep)

Commentary on Sims et al. (2012):A timely response to the impact ofsmoke-free public places on the most exposed childrenIt is now well established that legislation prohibitingsmoking in public places is effective in reducing second-hand smoke (SHS) exposure [1–3]. Nonetheless, in theface of arguments that introducing smoke-free publicplaces would increase smoking in the home, Sims et al.[4] provide timely evidence that smoke-free legislationdoes not displace adult smoking to the home, but ratherreduces SHS exposure among most at risk children, i.e.those with smoking parents or living in homes allow-ing smoking. These findings dispute the arguments andinform health advocates and policymakers about theunintended health benefits of protecting non-smokers,especially children exposed to second-hand smoke in thehome [5]. Given that the main source of SHS exposureamong children is domestic [6,7], the reported declinesreflect changing social norms around smoking [8],perhaps derived from voluntary family-based restrictionsby adults to promote health in children [6].Children are particularly vulnerable to SHS exposure,as even modest levels of exposure have been associatedwith respiratory abnormalities and other adverse healtheffects [9,10]. As adolescents observe smoking in thedomestic setting, they tend more towards seeing smokingas normal adult behaviour, and attribute favourableoutcome expectations over time with repeated exposure[8,11]. Research has shown that adolescent adoption ofsmoking is related to perceptions of significant others,such as parental smoking behaviour, as well as societalnorms of smoking [12,13]. In an environment where anon-smoking directive, e.g. smoke-free homes or cars, isenacted children will possibly perceive smoking as asocially unacceptable behaviour, and may be less likely totake up smoking [14]. However, despite reported declinesin SHS exposure by the authors, the high levels of chil-dren’s exposure in England (approximately half livingin homes allowing smoking and a third with smokingparents) may send an unequivocal message to youthsthat smoking is still a normative behaviour, and mightsensitize them to start smoking.Sims et al.’s work therefore underlines the importanceof continuing to undertake interventions and legislatedpolicies to make smoke-free environments, especially inhomes and cars, the societal norm. Such efforts shouldinclude community-level campaigns and programmes toraise awareness of the damaging effects of SHS exposureand support adults, particularly those living in smokinghomes, to enforce smoke-free policies voluntarily in theirhomes and cars. The balance of evidence from severalstudies suggests strongly that the primary objective ofreducing second-hand smoke exposure has beenachieved, particularly among non-smokers in work-places and the hospitality industry [15–17]. Nonetheless,to the extent that smoking in domestic settings remainsevident in several jurisdictions [1], there is the need toencourage governments to enact policies that will makesmoke-free homes the accepted norm.Further research is therefore required to inform futuresmoke-free policy development by exploring how thesevoluntary and legislated policies are implemented, andhow they work to impact upon young children living insmoking and non-smoking households. Finally, as studieson the long-term effect of smoke-free policies on chil-dren’s second-hand smoke exposure are mixed, moreresearch is needed to examine population-level changesin SHS exposure in the long term among these groups, aswell as whether there are any significant changes in theirhealth after enactment of smoke-free legislation.Declaration of interestsNone.Keywords Children, legislation, second-hand smoke,smoke-free, smoking norms, youth smoking.ABRAHAM BROWNCentre for Tobacco Control Research, UK Centre for TobaccoControl Studies, Institute for Social Marketing, Universityof Stirling, Stirling FK9 4LA, UK.E-mail: a.k.brown@stir.ac.ukReferences1. Callinan J. E., Clarke A., Doherty K., Kelleher C. Legislativesmoking bans for reducing secondhand smoke exposure,smoking prevalence and tobacco consumption. CochraneDatabase Syst Rev 2010; 4. CD005992. doi: 10.1002/14651858.2. Akhtar P. C., Haw S. J., Levin K. A., Currie D. B., Zachary R.,Currie C. E. Socioeconomic differences in second-handsmoke exposure among children in Scotland after introduc-tion of the smoke-free legislation. J Epidemiol CommunHealth 2010; 64: 341–6.3. Allwright S., Paul G., Greiner B., Mullally B. J., Pursell L.,Kelly A. et al. Legislation for smoke-free workplaces andhealth of bar workers in Ireland: before and after study.BMJ2005; 331: 1117–20.4. Sims M., Bauld L., Gilmore A. England’s legislation onsmoking in indoor public places and work-places: impact onthe most exposed children. Addiction 2012; 107: 2009–16.5. Akhtar P. C., Currie D. B., Currie C. E., Haw S. J. Changes inChild Exposure to Environmental Tobacco Smoke (CHETS)COMMENTARYbs_bs_banner© 2012 The Author, Addiction © 2012 Society for the Study of Addiction Addiction, 107, 2017–2018study after implementation of smoke-free legislation inScotland: national cross sectional survey. BMJ 2007; 335:545–9.6. O’Dowd A. Smoking ban in public places also cuts smokingat home. BMJ 2005; 331: 129.7. Jarvis M. J., Mindell J., Gilmore A., Feyerbrand C., West R.Smoke-free homes in England: prevalence, trends and vali-dation by cotinine in children. Tob Control 2009; 18: 491–5.8. Moore G. F., Holliday J. C., Moore L. A. R. Socioeconomicpatterning in changes in child exposure to secondhandsmoke after implementation of smoke-free legislation inWales. Nicotine Tob Res 2011; 13: 903–10.9. Pattenden S., Antova T., Neuberger M., Nikiforov B., DeSario M., Grize L. et al. Parental smoking and children’srespiratory health: independent effects of prenatal and post-natal exposure. Tob Control 2006; 15: 294–301.10. Vork K. L., Broadwin R. L., Blaisdell R. J. Developing asthmain childhood from exposure to secondhand tobacco smoke:insights from a meta-regression. Environ Health Perspect2007; 115: 1394–400.11. Alesci N. L., Forster J. L., Blaine T. Smoking visibility, per-ceived acceptability, and frequency in various locationsamong youth and adults. Prev Med 2003; 36: 272–81.12. Wiium N., Torsheim T., Wold B. Normative processes andadolescents’ smoking behaviour in Norway: a multilevelanalysis. Soc Sci Med 2006; 62: 1810–8.13. Cialdini R. B., Trost M. R. Social influence: social norms,conformity, and compliance. In: Gilbert D. T., Fiske S. T.,Lindzey G., editors. The Handbook of Social Psychology.Boston: McGraw-Hill; 1998, p. 151–92.14. Wakefield M. A., Chaloupka F. J., Kaufman N. T., OrleansC. T., Barker D. C., Ruel E. E. Effect of restrictions at home,at school, and in public places on teenage smoking: crosssectional study. BMJ 2000; 321: 333–7.15. Semple S., Creely K. S., Naji A., Miller B. J., Ayres J. G.Secondhand smoke levels in Scottish pubs: the effectof the smoke-free legislation. Tob Control 2007; 16: 127–32.16. Pickett M., Schober S. E., Brody D. J., Curtin L. R., GiovinoG. A. Smoke-free laws and secondhand smoke exposure inUS non-smoking adults, 1999–2002. Tob Control 2006; 15:302–7.17. Abrams S. M., Mahoney M. C., Hyland A., Cummings K. M.,Davis W., Song L. Early evidence on the effectiveness ofclean indoor air legislation in New York State. Am J PublicHealth 2006; 96: 296–8.2018 Commentary© 2012 The Author, Addiction © 2012 Society for the Study of Addiction Addiction, 107, 2017–2018

Developing asthma in childhood from exposure to secondhand tobacco smoke: insights from a meta-regression. Environ Health Perspect

Early evidence on the effectiveness of clean indoor air legislation in New York State.

Effect of restrictions at home, at school, and in public places on teenage smoking: cross sectional study. BMJ

Nicotine Tob Res

Normative processes and adolescents’ smoking behaviour in Norway: a multilevel analysis. Soc Sci Med

Parental smoking and children’s respiratory health: independent effects of prenatal and postnatal exposure. Tob Control

Secondhand smoke levels in Scottish pubs: the effect of the smoke-free legislation. Tob Control

Smoke-free laws and secondhand smoke exposure in US non-smoking adults, 1999–2002. Tob Control

Smoking visibility, perceived acceptability, and frequency in various locations among youth and adults. Prev Med

Social influence: social norms, conformity, and compliance.

Commentary on Sims et al. (2012): A timely response to the impact of smoke-free public places on the most exposed children

Abraham Brown

Crossref

Addiction

Commentary on Sims<i>et al</i>. (2012): A timely response to the impact of smoke-free public places on the most exposed children

Commentary on Sims et al. (2012): A timely response to the impact of smoke-free public places on the most exposed children

Abstract

Similar works

Full text

Available Versions

Nottingham Trent Institutional Repository (IRep)

Crossref