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Indoor and outdoor smoking: Impact on children’s health
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
Department of Health sciences, Kristianstad University, Sweden .
2003 (English)In: European Journal of Public Health, ISSN 1101-1262 (print) 1464-360X (online), Vol. 13, no 1, 61-66 p.Article in journal (Refereed) Published
Abstract [en]

Background: Many children are exposed to ETS (environmental tobacco smoke), which has both immediate and long-term adverse health effects. The aim was to determine the prevalence and nature of smoking among parents with infants and the association of indoor or outdoor smoking with the health of their children.

Methods: Mail-questionnaire study, which was performed in a county in the south-east of Sweden, as a retrospective cross-sectional survey including 1990 children, 12–24 months old.

Results: 20% of the children had at least one smoking parent; 7% had parents who smoked indoors and 13% parents who smoked only outdoors. Indoor smoking was most prevalent among single and blue-collar working parents. In the case of smoking cessation during pregnancy, smoking was usually resumed after delivery or at the end of the breast-feeding period. Coughing more than two weeks after a URI (upper respiratory infection), wheezing without a URI as well as pooled respiratory symptoms differed significantly between children of non-smokers and indoor smokers.

Conclusion: Further research of the common belief that outdoor smoking is sufficient to protect infants from health effects due to ETS exposure is warranted.

Place, publisher, year, edition, pages
2003. Vol. 13, no 1, 61-66 p.
Keyword [en]
children, environmental tobacco smoke, health effects, smoking behaviour
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-13622DOI: 10.1093/eurpub/13.1.61OAI: diva2:21071
Available from: 2004-03-12 Created: 2004-03-12 Last updated: 2009-05-20
In thesis
1. Passive Smoking in Children: The Importance of Parents’ Smoking and Use of Protective Measures
Open this publication in new window or tab >>Passive Smoking in Children: The Importance of Parents’ Smoking and Use of Protective Measures
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Passive smoking has been recognised as a health hazard, and chidren are especially vulnerable. The general aim of this thesis was to describe and analyse the importance of parents’ smoking and smoking behaviour for children’s tobacco smoke exposure. The studies were conducted in the South-East part of Sweden and pre-school children and their parents constituted the study samples. Five studies are described in six papers. Smoking prevalence among parents (14%) and commonly used measures of protection were surveyed. An instrument designed to measure children’s tobacco smoke exposure in the home was developed and validated. It was used on 687 families with a smoking parent and a child 2½-3 years old, included in a prospective cohort study on environmental variables of importance for immun-mediated diseases ABIS (All Babies in South-East Sweden). Almost 60% of the parents stated that they always smoked outdoors with the door closed, 14% mixed this with smoking near the kitchen fan, 12% near an open door, 7% mixed all these behaviours and 8 % smoked indoors without precautions. The smoking behaviours were related to the children’s creatinine adjusted urine cotinine. All groups had significantly higher values than had children from non-smoking homes, controls. Outdoor smoking with the door closed seemed to be the best, though not a total, measure for tobacco smoke protection in the home.

Most parents were aware of the importance of protecting children from tobacco smoke exposure but all were not convinced of the increased risk for disease for exposed children. The majority of parents were not satisfied with the smoking prevention in health-care and 50% did not think that their smoking was of any concern to the child health care nurse.

Further research is warranted to describe if the difference in exposure score related to smoking behaviours is related to different prevalence of disease. Efforts are needed to convince those who still smoke indoors that tobacco smoke exposure influence children’s health and that consequent outdoor smoking with the door closed seemed to give the best protection.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2004. 80 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 831
ETS, infant, child, cotinine, smoking behaviour, protective measures, parents, home, tobacco, child health care, ABIS
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-5174 (URN)91-7373-801-8 (ISBN)
Public defence
2004-02-13, Victoriasalen, Campus US, Linköpings universitet, Linköping, 09:00 (English)
Article I: copyright (2003), with permission from Oxford University Press. On the day of the public defence the status of article III was: Submitted and the status of article VI was: Revised and resubmitted and the original title was: Attitudes to children’s tobacco smoke exposure among smoking and non-smoking parents and their opinions on how the issue is handled in health care.Available from: 2004-03-12 Created: 2004-03-12 Last updated: 2012-01-25Bibliographically approved

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