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Research paper
Children's exposure to secondhand smoke at home before and after smoke-free legislation in Taiwan
  1. Ying-Ting Wang1,
  2. Yi-Wen Tsai1,
  3. Tzu-I Tsai2,
  4. Po-Yin Chang3
  1. 1 Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan
  2. 2 Department of Nursing, National Yang-Ming University, Taipei, Taiwan
  3. 3 Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA
  1. Correspondence to Dr Po-Yin Chang, Department of Medicine, Stanford University, School of Medicine, S-025, 300 Pasteur Drive, Stanford, CA 94304, USA; poyin{at}stanford.edu

Abstract

Introduction In January 2009, Taiwan broadened smoke-free legislation, requiring mass transportation systems, indoor public areas and indoor workplaces with 3 or more people, to become smoke-free. We investigated the secondhand smoke (SHS) exposure at home for children aged 3–11 years in Taiwan before and after the implantation of the legislation.

Methods We studied 7911 children from the 2005, 2009 and 2013 National Health Interview Surveys (cross-sectional, nationally representative household surveys). Logistic regression modelling estimated adjusted ORs (AOR) and 95% CIs for children's SHS exposure at home in 2009 and 2013 (2005 as reference) for the overall sample and for each category of household socioeconomic status (SES) and household composition.

Results Prevalence of children SHS exposure at home decreased from 51% (2005) to 32% (2009) and 28% (2013). Compared to 2005, children in 2009 and 2013 had lower likelihoods of SHS exposure at home with AOR of 0.45 (95% CI 0.41 to 0.51) and 0.41 (95% CI 0.36 to 0.46), respectively. All children had reduced SHS exposure at home after the legislation, irrespective of household SES and compositions. Low household income, low parental education level, living with grandparents or living with other adults was individually associated with increased SHS exposure.

Discussion The proportion of children exposed to SHS at home in Taiwan declined substantially from 2005 to 2009 after smoke-free legislation, and fell further by 2013, irrespective of SES and household compositions. Still, inequality in SHS exposure at home by SES and household composition warrants future research.

  • Secondhand smoke
  • Public policy
  • Disparities

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/tobaccocontrol-2016-053039

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    Footnotes

    • Contributors All authors conceived the study, contributed to drafts and approved of the final version of the paper. Y-TW wrote the introduction section and revised the manuscript. Y-WT undertook the data analysis and completed the method section. T-IT wrote the discussion section. P-YC led the study design, completed the result section and revised the manuscript.

    • Funding National Yang-Ming University received research funding from the tobacco health and welfare surcharges by the Health Promotion Administration for the project titled ‘International Collaborative Project for the Evaluation of Medical Services for Smoking Cessation’ (G1031227-105).

    • Disclaimer The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the funding agency.

    • Competing interests None declared.

    • Ethics approval The study was approved by the Institutional Review Board (IRB) of National Yang-Ming University (YM104027E). Informed consent form was waived.

    • Provenance and peer review Not commissioned; externally peer reviewed.