Smoke-free homes in England: Prevalence, trends and validation by cotinine in children

Reference:

Jarvis, M. J., Mindell, J., Gilmore, A., Feyerabend, C. and West, R., 2009. Smoke-free homes in England: Prevalence, trends and validation by cotinine in children. Tobacco Control, 18 (6), pp. 491-495.

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Official URL:

http://dx.doi.org/10.1136/tc.2009.031328

Abstract

Objective: To examine the prevalence of smoke-free homes in England between 1996 and 2007 and their impact on children’s exposure to secondhand smoke. Design: A series of annual cross-sectional surveys: the Health Survey for England. Setting and participants: Nationally representative samples of non-smoking children aged 4-15 (N=13,365) and their parents interviewed in the home. Main outcome measures: Cotinine measured in saliva. Smoke-free homes defined by ‘no’ response to “Does anyone smoke inside this house/flat on most days?” Self-reported smoking status of parents and self-reported and cotinine validated smoking status in children. Results: The proportion of homes where one parent was a smoker that were smoke-free increased from 21% in 1996 to 37% in 2007, and where both parents were smokers from 6% to 21%. The overwhelming majority of homes with non-smoking parents were smoke-free (95% in 1996; 99% in 2007). For children with non-smoking parents and living in a smoke-free home the geometric mean cotinine across all years was 0.22ng/ml, For children with one smoking parent geometric mean cotinines were 0.37 ng/ml when the home was smoke-free and 1.67ng/ml when there was smoking in the home; and for those with two smoking parents, 0.71ng/ml and 2.46ng/ml. There were strong trends across years for declines in cotinine concentrations in children in smoke-free homes for both children of smokers and non-smokers. Conclusion: There has been a marked secular trend towards smoke-free homes, even when parents themselves are smokers. Living in a smoke-free home offers children a considerable, but not complete, degree of protection against exposure to parental smoking.

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