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Effect of strategies to reduce exposure of infants to environmental tobacco smoke in the home: cross sectional survey

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7409.257 (Published 31 July 2003) Cite this as: BMJ 2003;327:257
  1. Clare Blackburn, senior lecturer (c.m.blackburn{at}warwick.ac.uk)1,
  2. Nick Spencer, professor of child health1,
  3. Sheila Bonas, lecturer in health psychology2,
  4. Christine Coe, research fellow1,
  5. Alan Dolan, lecturer1,
  6. Rob Moy, senior lecturer in community paediatrics3
  1. 1School of Health and Social Studies, University of Warwick, Coventry CV4 7AL
  2. 2Department of Epidemiology and Public Health, University of Leicester, Leicester LE1 6TP
  3. 3Institute of Child Health, Birmingham Children's Hospital, Birmingham
  1. Correspondence to: C Blackburn
  • Accepted 9 May 2003

Abstract

Objective To examine parents' reported knowledge and use of harm reduction strategies to protect their infants from exposure to tobacco smoke in the home, and the relation between reported use of strategies and urinary cotinine to creatinine ratios in the infants.

Design Cross sectional survey.

Settings Coventry and Birmingham.

Main outcome measures Parents' reported knowledge and use of harm reduction strategies and urinary cotinine to creatinine ratios in their infants.

Participants 314 smoking households with infants.

Results 86% of parents (264/307) believed that environmental tobacco smoke is harmful, 90% (281/314) believed that infants can be protected from it in the home, and 10% (32/314) were either unaware of measures or reported using none. 65% of parents (205/314) reported using two or more measures, but only 18% (58/314) reported not allowing smoking in the home. No difference was found in mean log e transformed urinary cotinine to creatinine ratio in infants from households that used no measures compared with households that used less strict measures. Mean log cotinine to creatinine ratios were significantly different in households banning smoking in the home compared with those using less strict or no measures. Banning smoking in the home was independently associated with a significant reduction in urinary cotinine to creatinine ratio by a factor of 2.6 (1.6 to 4.2) after adjustment for average household cigarette consumption, tenure, and overcrowding.

Conclusions Less than a fifth of parents in smoking households ban smoking in the home. Banning smoking was associated with a small but significant reduction in urinary cotinine to creatinine ratio in infants, whereas less strict measures compared with no measures had no effect on the infants' exposure to environmental tobacco smoke.

Footnotes

  • Contributors CB and NS as principal investigators had primary responsibility for the study design, project management, and planning of the analysis. They were assisted by CC and RM. SB and AD supervised the data collection, data entry, and interviewers. CB, NS, and SB created the variables and carried out the data analysis. CB and NS wrote the paper with comments from SB, CC, AD, and RM. CB and NS will act as guarantors for the paper.

  • Funding NS, CB, CC, and RM were supported by the Foundation for the Study of Infant Deaths (grant No 266).

  • Competing interests None declared.

  • Ethical approval This study was approved by the Coventry and south Birmingham research ethics committees.

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