Abstract
BackgroundExposure to household Secondhand Smoke (SHS) poses a major health threat to children after an indoor smoking ban was imposed in Taiwan. This study aimed to assess the household SHS exposure in elementary school children in southern Taiwan and the factors associated with their avoidance of SHS exposure before and after the implementation of Taiwan's new Tobacco Hazards Prevention Act in 2009.MethodsIn this cross-sectional school-based study, data on household SHS exposure, avoidance of SHS and related variables was obtained from the 2008 and 2009 Control of School-aged Children Smoking Study Survey. A random sample of 52 elementary schools was included. A total of 4450 3-6 graders (aged 8-13) completed the questionnaire. Regression models analyzed factors of children's self-confidence to avoid household SHS exposure.ResultsOver 50% of children were found to have lived with a family member who smoked in front of them after the new law enacted, and 35% of them were exposed to household SHS more than 4 days a week. Having a positive attitude toward smoking (β = -0.05 to -0.06) and high household SHS exposure (β = -0.34 to -0.47) were significantly associated with a lower avoidance of SHS exposure. Comparing to girls, boys had lower scores in their knowledge of tobacco hazards; and this factor was significantly related to their SHS avoidance (β = 0.13-0.14).ConclusionsThe intervention program should enhance school children do actively avoid exposure to SHS in home settings, and more importantly, provide tobacco hazard knowledge to male students to avoid exposure to household SHS for themselves. The results also provide further evidence that Tobacco Hazards Prevention Act should perhaps be extended to the family environment in order to protect children from the hazards of household SHS exposure.
Highlights
Exposure to household Secondhand Smoke (SHS) poses a major health threat to children after an indoor smoking ban was imposed in Taiwan
High household SHS exposure The results indicate that after the new Taiwan Tobacco Hazards Prevention Act was implemented, a significant number of schoolchildren still lived with family member who smokes in front of them and were subjected to household SHS exposure
This has led to the conclusion that the majority of the SHS exposure in children occurs at the home setting
Summary
Exposure to household Secondhand Smoke (SHS) poses a major health threat to children after an indoor smoking ban was imposed in Taiwan. According to the survey on smoking behavior conducted by the Taiwanese Bureau of Health Promotion, 46.8% of junior high school students self-reported having SHS exposure at home over the past 7 days [7]. The aforementioned findings indicate that younger non-smokers are more vulnerable to SHS exposure at home. Another recent study in Taiwan [8,9] found that 67.5% of the children have family members smoking at home and that 53.9% of them smoked in front of these elementary students
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