Has childhood smoking reduced following smoke-free public places legislation? A segmented regression analysis of cross-sectional UK school-based surveys

Katikireddi, S. , Der, G. , Roberts, C. and Haw, S. (2016) Has childhood smoking reduced following smoke-free public places legislation? A segmented regression analysis of cross-sectional UK school-based surveys. Nicotine and Tobacco Research, 18(7), pp. 1670-1674. (doi: 10.1093/ntr/ntw018) (PMID:26911840) (PMCID:PMC4902887)

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Introduction: Smoke-free legislation has been a great success for tobacco control but its impact on smoking uptake remains under-explored. We investigated if trends in smoking uptake amongst adolescents differed before and after the introduction of smoke-free legislation in the United Kingdom. Methods: Prevalence estimates for regular smoking were obtained from representative school-based surveys for the four countries of the United Kingdom. Post-intervention status was represented using a dummy variable and to allow for a change in trend, the number of years since implementation was included. To estimate the association between smoke-free legislation and adolescent smoking, the percentage of regular smokers was modeled using linear regression adjusted for trends over time and country. All models were stratified by age (13 and 15 years) and sex. Results: For 15-year-old girls, the implementation of smoke-free legislation in the United Kingdom was associated with a 4.3% reduction in the prevalence of regular smoking (P = .029). In addition, regular smoking fell by an additional 1.5% per annum post-legislation in this group (P = .005). Among 13-year-old girls, there was a reduction of 2.8% in regular smoking (P = .051), with no evidence of a change in trend post-legislation. Smaller and nonsignificant reductions in regular smoking were observed for 15- and 13-year-old boys (P = .175 and P = .113, respectively). Conclusions: Smoke-free legislation may help reduce smoking uptake amongst teenagers, with stronger evidence for an association seen in females. Further research that analyses longitudinal data across more countries is required. Implications: Previous research has established that smoke-free legislation has led to many improvements in population health, including reductions in heart attack, stroke, and asthma. However, the impacts of smoke-free legislation on the rates of smoking amongst children have been less investigated. Analysis of repeated cross-sectional surveys across the four countries of the United Kingdom shows smoke-free legislation may be associated with a reduction in regular smoking among school-aged children. If this association is causal, comprehensive smoke-free legislation could help prevent future generations from taking up smoking.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Katikireddi, Professor Vittal and Der, Mr Geoffrey
Authors: Katikireddi, S., Der, G., Roberts, C., and Haw, S.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Nicotine and Tobacco Research
Publisher:Oxford University Press
ISSN (Online):1469-994X
Published Online:24 February 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in Nicotine and Tobacco Research 18(7):1670-1674
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
656601Measuring Health, Variations in Health and Determinants of HealthAlastair LeylandMedical Research Council (MRC)MC_UU_12017/5IHW - MRC/CSO SPHU
656591Evaluating the Health Effects of Social InterventionsMatthew EganMedical Research Council (MRC)MC_UU_12017/4IHW - MRC/CSO SPHU