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Social and Behavioural Research in Cancer Group, Department of Preventive and Social Medicine, University of Otago, New Zealand Children in households that permit indoor smoking are exposed to the harmful effects of secondhand smoke (SHS).1 In addition, exposed children may be at greater risk of becoming smokers through a variety of mechanisms; for example, there is a moderately strong link between parental and youth smoking.2,3 In this communication we report the relation between home SHS exposure, from all sources, and the prevalence of youth daily smoking. We have already repor ted the smoking policies of schools attended by secondary students participating in the 2002 Youth Lifestyle Study (YLS).4 Using multi-stage cluster sampling, 141 eligible schools from six geographical regions were randomly selected and 82 ag reed to participate (response rate 58.2%). School classes were randomly selected, producing 3,434 students (mean age 15.0 years), 51.7% male and 15.4% self-identified Maori. Probability weights were assigned at the individual student level. In Table 1 we present odds ratios for daily smoking according to home SHS exposure. Students whose response to the question âHow often do you smoke now?â was âat least once a dayâ were classif ied as âdaily smokersâ (12.7%). SHS exposure was measured by responses to the question âDuring the past seven days, on how many days have people smoked around you in your own homeâ. Overall, 43.8% reported SHS exposure at home, 17.7% on all seven da ys. Univariable logistic regression models demonstrated a clear dose-response effect (see Table 1). No interaction effects were found between SHS and sex, ethnicity (Maori vs. non-Maori), and school year. There was no evidence that exposure to SHS differed by age, sex or ethnicity. Study limitations include the cross-sectional design and inability to identify precisely who, in the household, smoked. Neverthe- Table 1: Odds ratios for daily smoking by exposure to SHS at home. Frequency of SHS exposure at home No exposure 1-2 days 3-4 days 5-6 days 7 days p<0.001 at each level. Odds ratio for daily smoking 95% CI 2.22-4.11 2.59-6.01 2.66-8.54 5.11-8.79 ALAND JOURNAL OF PUBLIC HEALTH Letters less, any SHS exposure was associated with a threefold increase in daily smoking among youth, a pattern confirmed by the doseresponse effect. Reducing adult smoking has the potential to decrease youth smoking.5 Children whose parents quit smoking are less likely to be daily smokers.6 As SHS exposure at home appears to be a significant risk factor for youth smoking, future research should examine the role of permissive home environments and the contributions made by different household members. The Health Sponsorship Councilâ (HSC) YLS 2002 received s support from the New Zealand Ministry of Health, Cancer Society of New Zealand, Quit Group, and Social & Behavioural Research in Cancer Group. The research was completed while Helen Darling was the recipient of postgraduate scholarships from the HSC and Univer sity of Otago. Dr Reeder received support from the Cancer Society of New Zealand grant to the Social & Behavioural Research in Cancer Group, University of Otago.
Australian and New Zealand Journal of Public Health – Wiley
Published: Dec 1, 2003
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