Prevention

Smoking habits and passive smoking among children and young people

Smoking in childhood and at a young age and exposure of children and young people to tobacco smoke need special attention.

Passive smoking prevalence of children at a kindergarten was examined first in 1999 by the Institute of the National Public Health and Medical Officer Service in the Capital¹. According to results, 39.6% of kindergarteners in the capital are passive smokers and 50.5% of families have a smoking member. In 29.7% of smoking families, people smoke regularly in the presence of their little children and in 47.8% of them they smoke occasionally.

The same research was conducted in 2009².  Although, prevalence of passive smoking among children has fallen with 10% in ten years, 29% of children at Budapest kindergartens are still passive smokers. In smoking families with members smoking in the presence of children, 23.7% of children are exposed to tobacco smoke from 1-5 cigarettes, 42.4% from 6-10 cigarettes, 22% from 11-20 cigarettes and 11.9% from 21 or more cigarettes.

In 41% of families, there is a smoker. People smoke regularly in the presence of children in 21.5% of families and occasionally in 50.5% of families.

Children should have the chance to take part in programmes against passive smoking even in this early age, according to recommendations of the researchers.

The research project, called Global Youth Tobacco Survey (GYTS)  focusing on smoking habits and attitudes of young people aged 13-15 in many countries, was conducted in 2003 and 2008 in Hungary, as well. The Hungarian survey provides data on the frequency of using cigarettes and other tobacco products and gives information about the five significant features of tobacco consumption, which are as follows: accessibility and price, passive smoking, cessation, media and advertisement, school syllabus. These results can be utilised well in a comprehensive Hungarian tobacco control programme.

Based on 2008 data, more than half of the students (57.9%) have already tried smoking in Hungary (boys: 56.5%; girls: 58.4%) and 18% of ever smokers initiated smoking before the age of 10. Approximately, one quarter of students are smokers, i.e. they smoked in the last 30 days.

Nevertheless, partly due to the smoking prevention programmes implemented widely in the last years, 2008 data compared to 2003 show a decrease, i.e. an improving tendency in almost all of the figures, except the use of other tobacco products than cigarettes. Unfortunately, the use of other tobacco products (apart from cigarettes) shows a steep increase and has doubled among respondents (from 5.5% to 13.8% in total, from 8.2% to 16.8% among boys and from 3% to 10.3% among girls). 

The prevalence of those who have ever smoked cigarettes (even one or two puffs only) has significantly decreased among boys from 67.1% to 56.5%, just as there is a significant decrease overall of never smokers’ likeliness to initiate smoking in the next year (from 23.9% to 18.6%).

Approximately half of the students (50.7%) have at least one smoker parent and nearly a quarter of the respondents (22.2%) is surrounded with smoker best friends.

87.9% of never smoker students are exposed to smoke in public places, which may indicate that almost 8 in 10 students support the total ban of smoking in public places.

More than half of current smokers (52%) and a greater part of never smokers (66.2%) believe that the smoking of others (environmental tobacco smoke) is harmful to health.

In general, a greater proportion of current smokers (90%) are exposed to tobacco smoke in their homes, compared to never smokers (70%). Besides, a greater proportion of both never smoker (80.7%) and current smoker (95.9%) students in villages are exposed to environmental tobacco smoke in all categories, compared to their peers in the city region (including Budapest, as well).

There are no significant differences in environmental (passive) smoking categories according to gender. There are significant differences in smoking habits of smoker and non-smoker students’ parents: the prevalence of those who smoke at home is more than double among the parents of smoker students, compared to the parents of non-smoker students. This difference is three- or fourfold between brothers and sisters, especially in the countryside.

More than one third of never smoker students (34.8%) and more than half of current smokers (56.8%) have a father or foster-father who smokes at home. These rates are lower in mothers: 27.3% among never smokers and 50.4% among current smokers. The prevalence of current smokers exposed to smoke from their mother (63.5%) is higher in villages than in towns of the countryside (47.5%). Similar tendencies are shown in 2003 data, moreover, all figures of environmental (passive) smoking in 2008 show some improvement. In addition, the support of smoking ban at public places is significantly higher in 2008 (76.9%, compared to 69.7% in 2003), even among boys (77.4%, compared to 70.6% in 2003). More than threefold of current smoker students (43.8%) have (a) brother(s)/sister(s) smoking at home, compared to never smokers (13.9%). The difference is even more striking regarding best friends: the prevalence of current smokers whose best friend smokes in their presence (50.3%) is five times higher than of never smokers (9.1%).

Informing the public and form their opinion is essential in smoking cessation. Effective and comprehensive educational and public awareness raising programmes should be made widely accessible. It is recommended to address the following topics with special attention: advantages of smoke-free lifestyle, health risks of tobacco consumption and exposure to tobacco smoke, protection of non-smokers, signs of addiction, methods of cessation, help possibilities, important information about tobacco products and tobacco industry, information about adverse economic and environmental consequences of tobacco products manufacturing and tobacco consumption. Important target groups of campaigns can be health care workers, community workers, social workers, media experts, teachers, political and economic decision makers, leaders.

Besides campaigns, availability of smoking prevention and cessation programmes in settings should be ongoing. These programmes, partly based on skills development, provide an instant and practical knowledge base for participants, in addition to forming the opinion of the population, in order to make their everyday life more health conscious and improve the quality of it.

Conclusions

Positive changes in figures of smoking and passive smoking among youth have two reasons. The first reason is the enactment of the Act XLII of 1999 on the Protection of Non-Smokers and Certain Regulations on the Consumption and Distribution of Tobacco Products.  The successful implementation of national smoking prevention activities is the second reason. By all means, these favourable tendencies prove the efficiency of the kindergarten and school smoking prevention programmes and the various prevention activities coordinated by the National Public Health and Medical Officer Service and the health visitors in the last twenty years in Hungary.

1. Végh E., Kiss É., Ferenczi L., Pintér M. Budapesti óvodások passzív dohányzási prevalenciája. Egészségnevelés, 2000/4., 2000 (Smoking Prevalence of Pupils at Budapest Kindergartens. Health Education 2000/4, 2000)

2. Dr. Erzsébet Végh, Györgyné Jacsó, dr. Mária Gálné Seres: Budapesti óvodások passzív dohányzási prevalenciája 2009. Konferencia előadás: XVII. Primer Prevenciós Fórum, 2010. május 20., Budapest (Smoking Prevalence of Pupils at Budapest Kindergartens2009. Conference presentation, XVII. Primer PreventionForum, 20th May 2010).

3. Demjén T., Kiss J., Lőrik E., Bőti E., Papp N., Kelemen A. (2008): Nemzetközi Ifjúsági Dohányzásfelmérés, Zárótanulmány, Országos Egészségfejlesztési Intézet, 2008 (Global Youth Tobacco Survey. Final report . National Institute for Health Development, 2008) [ http://mek.oszk.hu/07900/07959/index.phtml (Magyar Elektronikus Könyvtár – Hungarian Electronic Library)]