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The hazard of secondhand smoke (SHS) is of particular concern inside vehicles, even with windows open.1-3 This is due to the confined space and the particular effects on children.4,5 Exposure to smoking in vehicles may also increase the risk of smoking initiation by children, due to the normalisation of smoking.6-8 While the exposure rates of children to smoking in vehicles have decreased in some jurisdictions, there is still significant exposure in others.9,10
Legislation has been used to increase the proportion of smokefree vehicles in parts of a few countries, including jurisdictions (cities, states, provinces) in: the United States, Canada, Australia and Ireland,11,12 but the large majority of jurisdictions have been unable to consider or pass legislation.
There has been almost no evaluation of the impact of smokefree vehicle laws. A South Australian study found an increase in the proportion of cars with children that were reported to be smokefree, from 69% in 2005 to 82% in 2008.13 A Canadian study found smokefree car laws there reduced SHS exposure among youth by about a quarter within the first year after the law's implementation.12
Internationally, there have been a limited number of studies where the prevalence of smoking in cars was observed. A 2008 study (5928 vehicles observed) in Italy found point prevalence of smoking in vehicles of 6.9%, and of 0.1% for smoking with children.14 In a 2011 study in Barcelona (2442 vehicles), 5.5% of vehicles had smoking and 0.2% had smoking and children.15 A 2012 study (2230 cars observed) in Ireland found a point prevalence of smoking in cars of 1.39%, and this varied by car value.16
In New Zealand, a 2012 observation study (2857 cars) in Auckland found a point prevalence of 5.7% of smoking in cars, and 2.2% with smoking with children in cars. This study also found that in Manurewa (a relative socioeconomically deprived suburb), the respective results were 13% and 6.4%.17
In 2005 and 2011 we investigated the different point prevalences of smoking in vehicles in two suburbs in the Wellington urban area, New Zealand, and the proportion of vehicles with smokers and others.18,19 The 2011 study also measured the point prevalence of smoking in vehicles with those who appeared to be aged 12 and under. That study reported that in...