Center for Tobacco Control Research and Education

Objectives - To determine the relationship between extent of restrictions on smoking at home, at school and in public places, and smoking uptake, smoking prevalence and monthly cigarette consumption by 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 prevalence; monthly cigarette consumption among current smokers.

Results – More restrictive arrangements on smoking at home were associated with a greater likelihood of being in an earlier stage of smoking uptake (p<.05), lower 30-day prevalence (p<.001) and reduced monthly cigarette consumption (p<.001). These findings applied even where parents were smokers. More pervasive restrictions on smoking in public places were associated with a higher probability of being in a earlier stage of smoking uptake (p<.05), lower 30-day prevalence (p<.05), but not reduced consumption. School smoking bans were only related to a greater likelihood of being in an earlier stage of smoking uptake (p<.05), lower prevalence (p<.001) and reduced consumption (p<.006), when the ban was strongly enforced, as measured by instances when teenagers perceived that most or all students obeyed the rule.

Conclusions - These findings suggest that restrictions on smoking at home, more extensive bans on smoking in public places and enforced bans on smoking at school may reduce teenage smoking.