Abstract
BackroundMeta-analysis of the impact of public smoking bans on children’s exposure to secondhand smoke (SHS) exposure at home.MethodsThe electronic databases of PubMed, Web of Science, PsycINFo, ASSIA, CINAHL were searched. German public health journals not captured by these databases and grey literature were considered in addition.Studies were included when they reported children’s SHS exposure at home in relation to smoke-free legislation by measuring exposure before and after the introduction of a public smoking ban. Studies had to provide results on exposure prevalences of children aged below 18 years. Language of publications was restricted to German and English.Details of the included studies (n = 15) were extracted by one author and checked for accuracy by a second author. Given the exposure prevalences before and after the introduction of a smoke-free legislation, a random-effects meta-analysis of relative risks (RR) was conducted. Results were presented in a forest plot.ResultsMeta-analysis showed that the overall effect was a decreased exposure to SHS in the children’s homes after introduction of a public smoking ban (RR = 0.72; 95% CI = 0.62–0.83). Only two of the 15 studies indicated an increased exposure. Sensitivity analyses considering the type of smoke-free legislation, children’s age group and study quality did not substantially alter the result.ConclusionThe assumption of a displacement of smoking into homes with children due to smoke-free legislation in public places could not be confirmed. Additional research is needed to analyse long-term trends.
Highlights
Secondhand smoke (SHS) is known to consist of several harmful substances relevant for health [1]
If several articles had been published based on the same data of a single study, these articles were considered as one study
The present meta-analysis shows that up to now there is no indication of displacement of smoking into homes after the introduction of smoke-free legislations
Summary
Secondhand smoke (SHS) is known to consist of several harmful substances relevant for health [1]. FCTC article 8 comprises smoke-free legislation in terms of smoking bans at public places aiming to reduce exposure to secondhand smoke among non-smokers [8]. With the introduction of public smoking bans in enclosed spaces of hospitality venues and further workplaces, the so-called displacement hypothesis has been put forward. This proposes that smoke-free laws may result in a displacement from smoking in public to smoking at home [9, 10]. If proven, this would contradict one of the main aims of public smoking bans, as it would have a deleterious effect on health especially for children with smoking parents and/or family members. Children living with an adult smoker are up to twice as likely to take up smoking themselves [11, 12]
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