young people’s exposure to and perceptions of smoking in cars and associated harms in the uk laura...
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Young people’s exposure to and perceptions of
smoking in cars and associated harms in the UK
Laura Jones, Crawford Moodie, Anne-Marie MacKintosh and Linda BauldUKNSCC London 27th June 2013
Introduction Source of secondhand smoke (SHS) exposure SHS particulate level (PM2.5) much greater in cars
than other spaces No legislation around smoking in private vehicles
in the UK 76% of UK adults (including 54% of daily
smokers) support a ban on smoking in cars carrying children under 18 years
86% of 8-15 year olds want the government to stop people smoking in cars carrying children
Populus Survey 2009; YouGov 2009
Prevalence of exposure in the UK 15% of UK adult smokers report smoking in
cars when travelling with children (ITC 2007/8) 15% of Irish 13-14 year olds self-reported
exposure to SHS in cars (2007) 35% of English 8-13 year olds self-reported
their parent/s smoked in the car with them (2009)
51% of English 8-15 years olds self-reported being in a car with a smoker (BLF 2011)
Populus Survey 2009; Kabir et al 2009; European Commission 2007; Jarrold et al 2011
Health risks
General SHS exposure risks well established Some evidence for specific risks from exposure
in cars– allergic & respiratory symptoms– persistent wheeze– hay fever symptoms – symptoms of nicotine dependence (at
adolescence)– early initiation of smoking
Sly et al 2007; Kabir et al 2009; Belanger et al 2008 ; Glover et al 2011
Youth views on smoking in cars 1009 English 8-13 year olds
– 76% worried that their parents smoking in the car was damaging to their own health
– When travelling with smokers 73% don’t like it and wished their parents
would stop 31% would ask the smoker to stop 24% were too embarrassed to say
anything 9% were too scared to say anything
Populus Survey 2009; Jarrold et al 2011
Aim To explore UK
adolescents’ perceptions of smoking in cars and awareness of the potential harms associated with such exposure
Wave 6 Youth Tobacco Policy Survey
11-16 year olds from UK households
Face to face interviews & self-complete questionnaire
Sample
Measures Smoking status Age; sex; social
grade; smoking by parents, siblings and friends
Frequency of exposure
Tolerance Perceived risk of
harm Support for a ban
Descriptive data weighted for age, gender & social grade
Bivariate analysis (chi square)
Logistic regression
Analysis
Sample characteristics
Total n = 1373 51% 11-13 years/ 49% 14-16 years 50% female 66% low SES (C2DE) Smoking status
– 9% regular smoker– 17% occasional/tried/used to smoke
Smoking network– 46% had one or more parent that smokes– 22% had siblings that smoke– 46% had friends that smoke
Frequency of exposure
Total% (n)
Regular smokers
% (n)
Occasional smokers
% (n)
Never smokers
% (n)Chi2 test
Never 53 (719) 19 (23) 40 (93) 59 (601)
<0.001
Once a week or less
30 (413) 42 (51) 33 (77) 28 (285)
More than once a week
17 (234) 39 (47) 26 (60) 12 (126)
Exposed vs. never exposed
Adjusted OR (95% CI) pParental SmokingNeither ref <0.001Either or both 4.93 (3.80, 6.38) <0.001Not sure/not stated/no mum/dad 1.52 (0.93, 2.48) 0.09Sibling SmokingNone/no siblings/not stated ref 0.008Any siblings smoke 1.55 (1.12, 2.15)Close Friends SmokingNone/not stated ref <0.001Any smoke 1.67 (1.26, 2.20)Smoking statusRegular smoker ref 0.04Occasional/used to/tried 0.56 (0.32, 1.00) 0.05Never smoker 0.48 (0.28, 0.85) 0.01Social GradeABC1 ref 0.02C2DE 1.35 (1.05, 1.74)
Adjusted for all other variables in the model
Tolerance of exposure
Total% (n)
Regular smokers
% (n)
Occasional smokers
% (n)
Never smokers
% (n)Chi2 test
Dislike 73 (991) 13 (16) 59 (137) 84 (837)
<0.001Indifferent 11 (154) 22 (27) 18 (42) 9 (84)
Don’t mind 15 (204) 65 (80) 23 (52) 7 (72)
Dislike vs. don’t mind/indifferent
Adjusted for all other variables in the model
Adjusted OR (95% CI) PSmoking status Regular smoker ref <0.001Occasional/used to/tried 7.20 (3.85, 13.48) <0.001Never smoker 21.71 (11.85, 39.76) <0.001Frequency of being exposed to smoking in cars
More than once a week ref <0.001Once a week or less 1.29 (0.88, 1.89) 0.20Never 4.13 (2.78, 6.12) <0.001Gender Male ref 0.36Female 1.15 (0.85, 1.54) Social Grade ABC1 ref 0.09C2DE 0.77 (0.57, 1.04) Age Later adolescence (14 to 16 years) ref 0.003Early adolescence (11 to 13 years) 1.60 (1.17, 2.19)
Perceived risk of harm
Total% (n)
Regular smokers
% (n)
Occasional smokers
% (n)
Never smokers
% (n)Chi2 test
Great deal harm/risk
86 (1125) 59 (73) 81 (179) 91 (871)
<0.001Moderate 11 (137) 26 (32) 14 (32) 8 (72)
Little or no harm/risk 3 (43) 15 (19) 5 (11) 1 (13)
Composite harm score based on four items: (1) Perceived effect on health of non-smokers(2) Perceived effect on health from breathing others smoke in the
car (windows closed)(3) Perceived effect on health from breathing others smoke in the
car (windows open)(4) Extent to which smoking in cars increases the risk
of having a road accident
Harmful vs. not harmful/indifferent
Adjusted for all other variables in the model
Adjusted OR (95% CI) PSmoking status Regular smoker ref <0.001Occasional/used to/tried 1.83 (1.08, 3.10) 0.03Never smoker 3.27 (1.99, 5.37) <0.001Frequency of being exposed to smoking in cars
More than once a week ref <0.001Once a week or less 1.12 (0.73, 1.72) 0.60Never 3.49 (2.16, 5.62) <0.001Gender Male ref 0.02Female 1.53 (1.08, 2.17) Social Grade ABC1 ref 0.09C2DE 0.72 (0.50, 1.05) Age Later adolescence (14 to 16 years) ref 0.001Early adolescence (11 to 13 years) 2.01 (1.35, 2.98)
Support for a banTotal% (n)
Regular smokers
% (n)
Occasional smokers
% (n)
Never smokers
% (n)Chi2 test
Complete ban on smoking in all cars
Support 69 (926) 19 (23) 57 (130) 78 (771)
<0.001indifferent 15 (200) 23 (29) 19 (44) 13 (127)
Do not support 16 (218) 58 (72) 24 (55) 9 (90)
Complete ban on smoking in cars carrying children < 16 years
Support 84 (1146) 52 (64) 74 (172) 91 (907)
<0.001Indifferent 8 (109) 20 (25) 13 (29) 5 (53)
Do not support 8 (105) 27 (33) 13 (30) 4 (42)
Supportive of ban vs. not supportive/indifferent
Adjusted for all other variables in the model
Adjusted OR (95% CI) PSmoking status Regular smoker ref <0.001Occasional/used to/tried 2.78 (1.08, 3.10) 0.03Never smoker 6.92 (4.30, 11.15) <0.001Frequency of being exposed to smoking in cars
More than once a week ref <0.001Once a week or less 1.22 (0.82, 1.82) 0.33Never 3.19 (2.11, 4.84) <0.001Gender Male ref 0.01Female 1.51 (1.10, 2.06) Social Grade ABC1 ref 0.47C2DE 0.89 (0.64, 1.23) Age Later adolescence (14 to 16 years) ref 0.001Early adolescence (11 to 13 years) 1.78 (1.27, 2.51)
Results summary 47% of UK adolescents reported being
exposed to smoking in cars 73% disliked travelling with smokers 86% perceived exposure to be harmful 84% support a ban on smoking in cars
carrying children < 16 years
Discussion Adolescent smoking status significantly
influenced likelihood of exposure, perceived risk of harm and support for a ban– Encircled by a social network of smokers– Social acceptability of smoking in cars may
be increased– Conditioned to social norm of smoking
therefore perceive less harm
Summary
Many UK adolescents report exposure Health risks well established Adolescents’ oppose exposure in cars,
perceive it to be harmful and support a ban
Need for further consideration to be given to legislative options
