title: Smoke-Free School Policy and Exposure to Secondhand Smoke: A Quasi-Experimental Analysis.
abstract: BACKGROUND
  Tobacco control prevention efforts are important to protect people from exposure to dangerous tobacco smoke, support cessation, and reduce tobacco-use initiation. While smoke-free laws have been a widespread tobacco control strategy, little work has been done to examine the impact of smoke-free school policies. The objective of this study is to evaluate the impact of provincial smoke-free school ground policies on youth-reported exposure to secondhand smoke (SHS) on school property.
  
  
  METHODS
  This study used a nationally representative sample of 20 388 youth aged 15-18 from the 2005-2012 Canadian Tobacco Use Monitoring Survey. A quasi-experimental design was used to evaluate the impact of smoke-free school policies on SHS exposure.
  
  
  RESULTS
  Approximately over half (52%) of respondents reported SHS exposure on a school property in the past month. Smoke-free school policy had a statistically significant effect on SHS exposure. Specifically, the adoption of smoke-free school reduced the probability of SHS exposure by about 8 percentage points. Respondents who were smokers were more likely to report being exposed to SHS than nonsmokers. Likewise, those living in urban areas had higher probability of being exposed to SHS than those living in rural parts of Canada.
  
  
  CONCLUSIONS
  Reported exposure to tobacco smoke did decrease after the introduction of smoke-free ground policies; however, almost half of high-school aged youth report exposure in the last month. Across Canada, provincial health authorities as well as school administers may need to assess the implementation of these smoke-free policies and improve enforcement strategies to further reduce exposure to dangerous SHS.
authors.affiliation: Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada; sazagba@uwaterloo.ca.
authors.forename: Sunday
authors.initials: S
authors.lastname: Azagba
authors.affiliation: Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Canada; Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Ryan David
authors.initials: RD
authors.lastname: Kennedy
authors.affiliation: Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada;
authors.forename: Neill Bruce
authors.initials: NB
authors.lastname: Baskerville
mesh_terms: D000293:Adolescent; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D012574:Schools / Q000331:legislation & jurisprudence*; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence*; D012907:Smoking / Q000453:epidemiology / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence* / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution
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