Search results

BACKGROUND: We aimed to investigate trends in children's exposure to second-hand tobacco smoke in England from 1998 to 2018. METHODS: 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. FINDINGS: 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. INTERPRETATION: 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. FUNDING: Public Health England, now the Office for Health Improvement and Disparities, and Cancer Research UK.

International audience ; Objective: To examine the impact of the ban on smoking in enclosed public places implemented in England in July 2007 on children's exposure to secondhand tobacco smoke. Design: Repeated cross-sectional surveys of the general population in England. Setting: The Health Survey for England Participants: Confirmed non-smoking children aged 4-15 with measured saliva cotinine participating in surveys from 1998 to 2008, a total of 10,825 children across years. Main outcome measures: The proportion of children living in homes reported to be smoke free; the proportion of children with undetectable concentrations of cotinine; geometric mean cotinine as an objective indicator of overall exposure. Results: Significantly more children with smoking parents lived in smoke-free homes in 2008 (48.1%, 95%CI 43.0-53.1) than in either 2006 (35.5%, 95% CI 29.7-41.7) or the first 6 months of 2007, immediately before the ban came into effect (30.5%, 95% CI 19.7-43.9). A total of 41.1% (95% CI 38.9-43.4) of children had undetectable cotinine in 2008, up from 34.0 % (95% CI 30.8-37.3) in 2006. Geometric mean cotinine in all children combined was 0.21ng/ml (95% CI .20-.23) in 2008, slightly lower than in 2006, 0.24ng/ml (95% CI .21-.26). Conclusions: Predictions that the2007 legislative ban on smoking in enclosed public places would adversely affect children's exposure to tobacco smoke were not confirmed. While overall exposure in children has not been greatly affected by the ban, the trend towards the adoption of smoke-free homes by parents who themselves smoke has received fresh impetus.

International audience ; Background Passive smoking is a serious health risk in non-smokers. The strength of tobacco control policies of the EU countries vary. This study aimed to investigate the relationship between second-hand smoke exposure, as assessed by exhaled carbon monoxide (eCO), and the strength of national tobacco control policies, in non-smokers in the EU. Methods Data were provided from the EU campaign "HELP: for a life without tobacco" during national events settled in the 27 EU countries in 2006-2007. Individual information on age, gender, and eCO were obtained from 58,919 self-reported non-smokers. The strength of national tobacco control policies was scored by the Tobacco Control Scale (TCS). The relationship between eCO and TCS score was investigated using both an ecological and a multilevel approaches. Results Both analyses reported a significant linear decrease in eCO per unit increase in TCS score, with a smaller estimation resulting from the multilevel analysis (ß = -0.03 ppm, 95% CI: – 0.04-0.02 vs. 0.05 (0.02-0.08)). Conclusion Our study confirms, in a large European non-smoker population, the relevance of strong anti-smoking policies in reducing exposure to passive smoking. Our findings give further reason to encourage European countries to strengthen their tobacco control policies to protect non-smokers from second-hand smoke.

International audience ; Background Passive smoking is a serious health risk in non-smokers. The strength of tobacco control policies of the EU countries vary. This study aimed to investigate the relationship between second-hand smoke exposure, as assessed by exhaled carbon monoxide (eCO), and the strength of national tobacco control policies, in non-smokers in the EU. Methods Data were provided from the EU campaign "HELP: for a life without tobacco" during national events settled in the 27 EU countries in 2006-2007. Individual information on age, gender, and eCO were obtained from 58,919 self-reported non-smokers. The strength of national tobacco control policies was scored by the Tobacco Control Scale (TCS). The relationship between eCO and TCS score was investigated using both an ecological and a multilevel approaches. Results Both analyses reported a significant linear decrease in eCO per unit increase in TCS score, with a smaller estimation resulting from the multilevel analysis (ß = -0.03 ppm, 95% CI: – 0.04-0.02 vs. 0.05 (0.02-0.08)). Conclusion Our study confirms, in a large European non-smoker population, the relevance of strong anti-smoking policies in reducing exposure to passive smoking. Our findings give further reason to encourage European countries to strengthen their tobacco control policies to protect non-smokers from second-hand smoke.

International audience ; Background Passive smoking is a serious health risk in non-smokers. The strength of tobacco control policies of the EU countries vary. This study aimed to investigate the relationship between second-hand smoke exposure, as assessed by exhaled carbon monoxide (eCO), and the strength of national tobacco control policies, in non-smokers in the EU. Methods Data were provided from the EU campaign "HELP: for a life without tobacco" during national events settled in the 27 EU countries in 2006-2007. Individual information on age, gender, and eCO were obtained from 58,919 self-reported non-smokers. The strength of national tobacco control policies was scored by the Tobacco Control Scale (TCS). The relationship between eCO and TCS score was investigated using both an ecological and a multilevel approaches. Results Both analyses reported a significant linear decrease in eCO per unit increase in TCS score, with a smaller estimation resulting from the multilevel analysis (ß = -0.03 ppm, 95% CI: – 0.04-0.02 vs. 0.05 (0.02-0.08)). Conclusion Our study confirms, in a large European non-smoker population, the relevance of strong anti-smoking policies in reducing exposure to passive smoking. Our findings give further reason to encourage European countries to strengthen their tobacco control policies to protect non-smokers from second-hand smoke.

BACKGROUND: A number of treatments can help smokers make a successful quit attempt, but many initially successful quitters relapse over time. Several interventions have been proposed to help prevent relapse. OBJECTIVES: To assess whether specific interventions for relapse prevention reduce the proportion of recent quitters who return to smoking. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group trials register, clinicaltrials.gov, and the ICTRP in February 2018 for studies mentioning relapse prevention or maintenance in their title, abstracts, or keywords. SELECTION CRITERIA: Randomised or quasi‐randomised controlled trials of relapse prevention interventions with a minimum follow‐up of six months. We included smokers who quit on their own, were undergoing enforced abstinence, or were participating in treatment programmes. We included studies that compared relapse prevention interventions with a no intervention control, or that compared a cessation programme with additional relapse prevention components with a cessation programme alone. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: We included 77 studies (67,285 participants), 15 of which are new to this update. We judged 21 studies to be at high risk of bias, 51 to be at unclear risk of bias, and five studies to be at low risk of bias. Forty‐eight studies included abstainers, and 29 studies helped people to quit and then tested treatments to prevent relapse. Twenty‐six studies focused on special populations who were abstinent because of pregnancy (18 studies), hospital admission (five studies), or military service (three studies). Most studies used behavioural interventions that tried to teach people skills to cope with the urge to smoke, or followed up with additional support. Some studies tested extended pharmacotherapy. We focused on results from those studies that randomised abstainers, as these are the best test of relapse prevention interventions. Of the 12 analyses we conducted ...

BACKGROUND: On 1 July 2007, smokefree legislation was implemented in England, which made virtually all enclosed public places and workplaces smokefree. OBJECTIVES: We examined trends in and predictors of secondhand smoke exposure among nonsmoking adults to determine whether exposure changed after the introduction of smokefree legislation and whether these changes varied by socioeconomic status (SES) and by household smoking status. METHODS: We analyzed salivary cotinine data from the Health Survey for England that were collected in 7 of 11 annual surveys undertaken between 1998 and 2008. We conducted multivariate regression analyses to examine secondhand smoke exposure as measured by the proportion of nonsmokers with undetectable levels of cotinine and by geometric mean cotinine. RESULTS: Secondhand smoke exposure was higher among those exposed at home and among lower-SES groups. Exposure declined markedly from 1998 to 2008 (the proportion of participants with undetectable cotinine was 2.9 times higher in the last 6 months of 2008 compared with the first 6 months of 1998 and geometric mean cotinine declined by 80%). We observed a significant fall in exposure after legislation was introduced--the odds of having undetectable cotinine were 1.5 times higher [95% confidence interval (CI): 1.3, 1.8] and geometric mean cotinine fell by 27% (95% CI: 17%, 36%) after adjusting for the prelegislative trend and potential confounders. Significant reductions were not, however, seen in those living in lower-social class households or homes where smoking occurs inside on most days. CONCLUSIONS: We found that the impact of England's smokefree legislation on secondhand smoke exposure was above and beyond the underlying long-term decline in secondhand smoke exposure and demonstrates the positive effect of the legislation. Nevertheless, some population subgroups appear not to have benefitted significantly from the legislation. This finding suggests that these groups should receive more support to reduce their exposure.

BACKGROUND: A number of treatments can help smokers make a successful quit attempt, but many initially successful quitters relapse over time. Several interventions have been proposed to help prevent relapse. OBJECTIVES: To assess whether specific interventions for relapse prevention reduce the proportion of recent quitters who return to smoking. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group trials register, clinicaltrials.gov, and the ICTRP in May 2019 for studies mentioning relapse prevention or maintenance in their title, abstracts, or keywords. SELECTION CRITERIA: Randomised or quasi‐randomised controlled trials of relapse prevention interventions with a minimum follow‐up of six months. We included smokers who quit on their own, were undergoing enforced abstinence, or were participating in treatment programmes. We included studies that compared relapse prevention interventions with a no intervention control, or that compared a cessation programme with additional relapse prevention components with a cessation programme alone. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: We included 81 studies (69,094 participants), five of which are new to this update. We judged 22 studies to be at high risk of bias, 53 to be at unclear risk of bias, and six studies to be at low risk of bias. Fifty studies included abstainers, and 30 studies helped people to quit and then tested treatments to prevent relapse. Twenty‐eight studies focused on special populations who were abstinent because of pregnancy (19 studies), hospital admission (six studies), or military service (three studies). Most studies used behavioural interventions that tried to teach people skills to cope with the urge to smoke, or followed up with additional support. Some studies tested extended pharmacotherapy. We focused on results from those studies that randomised abstainers, as these are the best test of relapse prevention interventions. Of the 12 analyses we conducted in ...