title: England's legislation on smoking in indoor public places and work-places: impact on the most exposed children.
abstract: OBJECTIVE
  To examine whether English legislation to make virtually all indoor public places and work-places smoke-free on 1 July 2007 displaced smoking into the home and hence increased the proportion of children exposed to levels of second-hand smoke known to be detrimental to health.
  
  
  METHODS
  Repeated cross-sectional study with data from 10 annual surveys undertaken from 1996 to 2008.
  
  
  METHODS
  England.
  
  
  METHODS
  Nationally representative samples of non-smoking children aged 4-15 years old living in private households.
  
  
  METHODS
  Salivary cotinine, parental smoking status, whether smoking is allowed within the house, socio-demographic variables.
  
  
  RESULTS
  The proportion of children exposed to damaging levels of second-hand smoke (defined as those with cotinine levels >1.7 ng/ml) has fallen over time, from 23.5% in 1996 to 12.6% in 2008. The legislation was not associated with further changes in the proportion of children above this threshold-the odds of having cotinine >1.7 ng/ml did not change after adjustment for the pre-legislative trend and confounders (odds ratio: 1.0, 95% confidence interval: 0.78, 1.4). Non-significant associations were also found when examining children by parental or household smoking status.
  
  
  CONCLUSIONS
  Legislation to prohibit smoking in indoor public places and work-places does not increase the proportion of children exposed to damaging levels of second-hand smoke. Even in a country with a strong tobacco control climate, a significant proportion of children remain highly exposed to second-hand smoke and future policies need to include interventions to reduce exposure among these children.
authors.affiliation: Department for Health, University of Bath, Bath, UK. m.sims@bath.ac.uk
authors.forename: Michelle
authors.initials: M
authors.lastname: Sims
authors.forename: Linda
authors.initials: L
authors.lastname: Bauld
authors.forename: Anna
authors.initials: A
authors.lastname: Gilmore
mesh_terms: D000293:Adolescent; D016902:Air Pollution, Indoor / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D002648:Child; D002669:Child Welfare / Q000331:legislation & jurisprudence*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004739:England; D004781:Environmental Exposure / Q000706:statistics & numerical data; D005260:Female; D006798:Housing / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011633:Public Facilities / Q000331:legislation & jurisprudence*; D012907:Smoking / Q000331:legislation & jurisprudence*; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D017132:Workplace / Q000331:legislation & jurisprudence*
chemical_list: D014028:Tobacco Smoke Pollution