The European Journal of Public Health Advance Access originally published online on November 25, 2008
The European Journal of Public Health 2009 19(1):52-58; doi:10.1093/eurpub/ckn114
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Social inequalities |
Socioeconomic determinants of children's environmental tobacco smoke exposure and family's home smoking policy
Gabriele Bolte, Hermann Fromme and for the GME Study Group*Department of Environmental Health, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany
Correspondence: Gabriele Bolte, Department of Environmental Health, Bavarian Health and Food Safety Authority, Veterinaerstr. 2, 85764 Oberschleissheim, Germany, tel: +49-89-31560159, fax: +49-89-31560835, e-mail: gabriele.bolte{at}lgl.bayern.de
Received July 22, 2008 , accepted October 17, 2008
Background: Few studies have analysed the impact of different socioeconomic indicators on the prevalence of children's environmental tobacco smoke (ETS) exposure at several indoor environments and on family's home smoking policy. Methods: Data on 12 422 pre-school children (48% female) from two cross-sectional surveys conducted during 2004–06 in Germany were analysed. Exposure assessment was based on parental report. Independent effects of socioeconomic indicators were determined by mutually adjustment in logistic regression analyses. Results: Low parental education, unemployment, low household equivalent income, non-German nationality, single-parent family and family size were independently associated with children's ETS exposure at home and in cars. The strongest associations were observed for low parental education [at home: adjusted odds ratio (OR) 3.94; 95% confidence interval (CI) 3.46–4.49; in cars: 5.00; 3.84–6.50]. Indicators of material living conditions (relative poverty: 0.48; 0.39–0.57, parental unemployment: 0.55; 0.46–0.65), as well as single-parent family, non-German nationality and family size, but not parental education, were independently associated with ETS exposure at hospitality venues. Smoking households with low parental education, unemployment, poverty, single-parent family and non-German nationality were less likely to have the rule of exclusively smoking on the balcony or terrace. Low parental education and unemployment were negatively associated with no smoking in presence of the child in households with smoking inside the flat. Conclusion: Several dimensions of socioeconomic position have to be considered in explanations of social inequalities in children's ETS exposure and family's home smoking policy as well as in development of targeted interventions.
Keywords: children, education, income, passive smoking, single parent
*The members of the GME Study Group are listed in the Appendix.
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