Adult smoking as a proxy for environmental tobacco smoke exposure among children — Comparing the impact of the level of information in Estonia, Finland and Latvia

ObjectiveInternational comparability of environmental tobacco smoke (ETS) exposure levels is difficult. This study assesses whether estimating children's exposure from information on adult smoking and exposure to ETS makes international comparisons more reliable.MethodsThe exposure among children was estimated using three different combinations (models) based on different sets of information on adult smoking, household composition or adult exposure to ETS at home in three cross-sectional nationally representative samples drawn from data sets from Estonia (n = 2650), Finland (n = 2829) and Latvia (n = 5440) in the years 2002 and 2004. The first two models were based on adult smoking and the third also included ETS exposure.ResultsThe parental smoking rate was similar to the general smoking prevalence. ETS exposure in non-smoking parents ranged from 22% in Finland to 60% in Latvia. All models gave rather comparative ranges except in Latvia, where the proportion of children with exposure varied from 67% with the simplest model to 81% with the most complex one.ConclusionsAdult exposure at home or adult smoking prevalence, preferably among people with children, could be used as a proxy for children's exposure to ETS. It is recommended that population questionnaires include detailed information on exposure and household composition.