Household secondhand smoke exposure of elementary schoolchildren in Southern Taiwan and factors associated with their confidence in avoiding exposure: a cross-sectional study

BMC Public Health

Fu-Li Chen⁶  Chien-Hung Lee¹  Ya-Ying Lin⁴  Chih-Yang Hu⁷  Ted Chen⁵  Chih-Cheng Hsu²  Chin-Hsuan Chiu³  Pi-Li Lin⁸  Yea-Yin Yen³  Hsiao-Ling Huang³ 

[1] Department of Public Health, College of Health Science, Kaohsiung Medical University. 100 Shih-Chuan 1st Road, Kaohsiung City 80708, Taiwan;Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes. No. 35, Keyan Road, Zhunan Town, Miaoli County 350, Taiwan;Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University. 100 Shih-Chuan 1st Road, Kaohsiung City 80708, Taiwan;Department of Physical Therapy, Shu Zen College of Medicine and Management. No. 452, Huanqiu Rd., Luzhu District, Kaohsiung City 82144, Taiwan;Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA;Department of Public Health, Fu-Jen Catholic University. 510 Jhongjheng Rd., Sinjhuang District, New Taipei City 24205, Taiwan;School of Public Health, Health Sciences Center, Louisiana State University, New Orleans, LA 70112, USA;Department of Nursing, Meiho University. 23, Pingguang Rd., Neipu Town, Pintung County 91202, Taiwan

关键词: Secondhand smoke;    Children;   

Others  :  1163934
DOI  :  10.1186/1471-2458-12-40

 received in 2011-08-29, accepted in 2012-01-17,  发布年份 2012

【 摘 要 】

Background

Exposure 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.

Methods

In 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.

Results

Over 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).

Conclusions

The 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.

【 授权许可】

   
2012 Huang et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Lee CH, Ko YC, Goggins W, Huang JJ, Huang MS, Kao EL, Wang HZ: Lifetime environmental exposure to tobacco smoke and primary lung cancer of non-smoking Taiwanese women. Int J Epidemiol 2000, 29(2):224-231.
• [2]He J, Vupputuri S, Allen K, Prerost MR, Hughes J, Whelton PK: Passive smoking and the risk of coronary heart disease--a meta-analysis of epidemiologic studies. N Engl J Med 1999, 340(12):920-926.
• [3]Cook DG, Strachan DP: Health effects of passive smoking. 3. Parental smoking and prevalence of respiratory symptoms and asthma in school age children. Thorax 1997, 52(12):1081-1094.
• [4]Moritsugu KP: The 2006 Report of the Surgeon General: the health consequences of involuntary exposure to tobacco smoke. Am J Prev Med 2007, 32(6):542-543.
• [5]Mannino DM, Siegel M, Husten C, Rose D, Etzel R: Environmental tobacco smoke exposure and health effects in children: results from the 1991 National Health Interview Survey. Tob Control 1996, 5(1):13-18.
• [6]BHP: Taiwanese Adult Smoking Behavior Telephone Survey. Taipei, Taiwan: Bureau of Health Promotion (BHP), Department of Health, the Executive Yuan; 2009.
• [7]BHP: Global Youth Tobacco Survey (GYTS). Taipei, Taiwan: Bureau of Health Promotion, Department of Health, the Executive Yuan; 2008.
• [8]Huang CM, Yen YY, Chen FL, Hsu CC, Lee CH, Lin Y, Huang HL: School-level policy for tobacco control and individual-level characteristics in relation to cigarette smoking among children: a multilevel study of elementary schools in Pingtung County. Taiwan J Public Health 2010, 29(2):145-158.
• [9]Huang HL, Chen FL, Hsu CC, Yen YY, Chen T, Huang CM, Shi HY, Hu CY, Lee CH: A multilevel-based study of school policy for tobacco control in relation to cigarette smoking among children in elementary schools: gender differences. Health Educ Res 2010, 25(3):451-463.
• [10]Wang WL, Herting JR, Tung YY: Adolescents' avoidance of secondhand smoke exposure: model testing. West J Nurs Res 2008, 30(7):836-851.
• [11]Lin PL, Huang HL, Lu KY, Chen T, Lin WT, Lee CH, Hsu HM: Second-hand smoke exposure and the factors associated with avoidance behavior among the mothers of pre-school children: a school-based cross-sectional study. BMC Publ Health 2010, 10:606. BioMed Central Full Text
• [12]Li MF, Wang RH: Factors related to avoidance of environmental tobacco smoke among adolescents in southern Taiwan. J Nurs Res 2006, 14(2):103-112.
• [13]Chen YH, Chen PL, Huang WG, Chiou HY, Hsu CY, Chao KY: Association between social climate for smoking and youth smoking behaviors in Taiwan: an ecological study. Int J Nurs Stud 2010, 47(10):1253-1261.
• [14]Yen LL, Chen L, Lee SH, Hsiao C, Pan LY: Child and adolescent behaviour in long-term evolution (CABLE): a school-based health lifestyle study. Promot Educ 2002, (Suppl 1):33-40.
• [15]Huang HL, Hsu CC, Magnus JH, Chen FL, Rice J, Lee CH, Yen YY, Chen T: Perceived smoking prevalence at school-level and children's smoking initiation: a multi-level analysis of a cross-sectional data in Taiwan. Health Policy 2008, 86:(2-3):213-221.
• [16]Huang HL, Chen T, Chen FL, Magnus J, Rice J, Yen YY, Hsu CC: A study of smoking disparity and factors associated with children smoking behavior in the mountain and city schools in Taiwan. J Sch Health 2009, 79(2):67-73.
• [17]Huang HL, Lee CH, Yen YY, Chen T, Chen FL, Ho PS, Lai TC, Tsai WL, Hsu CC: School-level contextual factors associated with betel quid chewing among schoolchildren in Taiwan. Community Dent Oral Epidemiol 2009, 37(1):58-67.
• [18]Soliman S, Pollack HA, Warner KE: Decrease in the prevalence of environmental tobacco smoke exposure in the home during the 1990s in families with children. Am J Public Health 2004, 94(2):314-320.
• [19]Akhtar PC, Haw SJ, Currie DB, Zachary R, Currie CE: Smoking restrictions in the home and secondhand smoke exposure among primary schoolchildren before and after introduction of the Scottish smoke-free legislation. Tob Control 2009, 18(5):409-415.
• [20]Kurtz ME, Kurtz JC, Johnson SM, Beverly EE: Exposure to environmental tobacco smoke--perceptions of African American children and adolescents. Prev Med 1996, 25(3):286-292.
• [21]Ajzen I: The theory of planned behavior. Organ Behav Hum Decis Process 1991, 50(2):179-211.
• [22]Ausems M, Mesters I, van Breukelen G, De Vries H: Do Dutch 11-12 years olds who never smoke, smoke experimentally or smoke regularly have different demographic backgrounds and perceptions of smoking? Eur J Public Health 2003, 13(2):160-167.