1. Exposure of minority ethnic groups to second-hand smoke, in England Sarwat Shah Team: Kamran Siddiqi, Amanda Amos, Helen Tilbrook, Aziz Sheikh, Caroline Fairhurst Funding: Medical Research Council

2. Outline Background to research Where are we now? Gaps Our approach Findings Conclusions

3. SHS- Background to research 1% GBD Cardiovascular Lung diseases 600000 deaths Middle ear infections Asthma ALRI

4. Where we are now?

5. Gaps 2 Million children in the UK are routinely exposed to SHS

6. Why are we conducting this research? Significant health inequalities – minority ethnic groups South Asians - high susceptibility to cardiovascular diseases Higher levels of smoking among Bangladeshi- and Pakistani- origin men compared with national average (Sprotson and Mindell 2004) 51% households with at least one smoker (Alwan et al)

7. Our approach- Smoke free homes Modalities Target Output

9. Imam guide - the delivery

10. MCLASS-pilot cluster Control Group (N = 7) Do not deliver ‘Smoke Free Homes’ Cluster Randomisation (Minimisation) Intervention Group (N = 7) Deliver ‘Smoke Free Homes’ Participants (households) recruited Participants (households) approached, eligibility assessed Household follow up data collection (Questionnaire and saliva sample collection) Household baseline data collection (Questionnaire and saliva sample collection) Clusters recruited (min N = 14)

11. Data collection Type of households Households with at least one child resident Adult only Study participants Household survey – Lead adult Saliva sample – Non smoking adult OR – Child

12. Data collection Outcome Salivary cotinine – Exposed to SHS= 0.1- 12ng/ml – Unexposed= <0.1 ng/ml

13. Findings Households recruited= 209 Saliva samples=89% (187/209) Exposed to SHS=61% (114/187:95% CI 54-68)

14. Findings

15. Mediators/moderators

16. characteristics of person giving saliva sample

17. Characteristics of smoker

18. Conclusions Exposure of ethnic minorities to SHS is high 85% children living with a smoker are exposed as compared to 35% (whose parents are smokers) in general population