title: Household secondhand smoke exposure of elementary schoolchildren in Southern Taiwan and factors associated with their confidence in avoiding exposure: a cross-sectional study.
abstract: 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.
authors.affiliation: Department of Public Health, Fu-Jen Catholic University, Sinjhuang District, New Taipei City, Taiwan.
authors.forename: Hsiao-Ling
authors.initials: HL
authors.lastname: Huang
authors.forename: Yea-Yin
authors.initials: YY
authors.lastname: Yen
authors.forename: Pi-Li
authors.initials: PL
authors.lastname: Lin
authors.forename: Chin-Hsuan
authors.initials: CH
authors.lastname: Chiu
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Hsu
authors.forename: Ted
authors.initials: T
authors.lastname: Chen
authors.forename: Chih-Yang
authors.initials: CY
authors.lastname: Hu
authors.forename: Ya-Ying
authors.initials: YY
authors.lastname: Lin
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Lee
authors.forename: Fu-Li
authors.initials: FL
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D012044:Regression Analysis; D020377:Self Efficacy; D013334:Students / Q000523:psychology*; D013624:Taiwan; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution