Adult Exposure Study (Health Education Population Survey - HEPS)
This study, conducted by NHS Health Scotland and British Market Research Bureau Social Research (BMRB), uses the Health Education Population Survey (HEPS) - an annual survey - to collect the data.
Principal Investigator: Sally Haw
Study Aims
- To determine if there was a measurable change in adult non-smokers' exposure to second-hand smoke (SHS) in public and private places post-implementation of smoke-free legislation in Scotland.
- To assess whether any overall changes in SHS exposure were related to changes in exposure in public or private spaces.
- To determine if there was any evidence of displacement of smoking from public places into the home.
Study Design
- Repeat cross-sectional household survey of nationally representative samples of 1800 adults (ages 16-74 years) pre-legislation and 1800 adults post-legislation.
- Data were collected by trained interviewers using computer assisted personal interviewing (CAPI).
- Samples of saliva were also collected for testing for cotinine - a biomarker of second-hand smoke (SHS) exposure in non-smokers.
- Main outcome measures included: salivary cotinine concentrations; self-reported exposure to tobacco smoke in public and private places; and self-reported smoking restrictions in homes and cars.
Research Instruments and Protocols
- HEPS Final Pre-legislation questionnaire
- HEPS Final Post-legislation questionnaire
- Protocol for saliva collection
Main Outcomes
- Geometric mean cotinine concentrations in adult non-smokers fell by 39% from 0.43 ng/ml at baseline to 0.26 ng/ml post-legislation.
- The reduction in mean cotinine was greatest in non-smokers from non-smoking households (49%). Among non-smokers from smoking households the reduction was much smaller (16%) and did not reach statistical significance.
- Pre-legislation, levels of exposure to SHS amongst non-smokers living in smoking households was 2.6 times higher than among non-smokers living in non-smoking households. Post-legislation the difference in SHS exposure between non-smokers living in non-smoking and smoking households was 4.5 times higher.
- Reduction in SHS exposure was reported in public places (pubs, other workplaces and public transport) but not in cars and homes, but there was no evidence of a displacement of smoking from public places into the home.
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