Effect of restrictions on smoking at home, at school, and in public placeson teenage smoking: cross sectional study

Objective To determine the relation between extent of restrictions on smoki ng at home, at school, and in public places and smoking uptake and smoking prevalence among school students, Design Cross sectional survey with merged records of extent of restrictions on smoking in public places. Setting United States. Participants 17 287 high school students, Main outcome measures Five point scale of smoking uptake; 30 day smoking pr evalence, Results More restrictive arrangements on smoking at home were associated wi th a greater likelihood of being in an earlier stage of smoking uptake (P < 0.05) and a lower 30 day prevalence (odds ratio 0.79 (95% confidence inter val 0.67 to 0.91), P < 0.001). These findings applied even when parents wer e smokers. More pervasive restrictions on smoking in public places were ass ociated with a higher probability of being in a earlier stage of smoking up take (P < 0.05) and lower 30 day prevalence (0.91 (0.83 to 0.99), P = 0.03) . School smoking bans were related to a greater likelihood of being in an e arlier stage of smoking uptake (0.89 (0.85 to 0.99), P < 0.05) and lower pr evalence (0.86 (0.77 to 0.91), P< 0.001) only when the ban was strongly enf orced, as measured by instances when teenagers perceived that most or ail s tudents obeyed the rule. Conclusions These findings suggest that restrictions on smoking at home, mo re extensive bans on smoking in public places, and enforced bans on smoking at school may reduce teenage smoking.