Before and after study designs.

Legislation to prohibit smoking in most enclosed public places was implemented in Scotland in March 2006. It has been suggested that an unintended consequence of such legislation is the displacement of adult smoking from public places into the home. Researchers investigated whether exposure to secondhand smoke in primary schoolchildren changed after the implementation of the legislation. A before and after study design was used. Participants were children in their final year of primary school, aged 10-11 years at the start of the school year. Two representative class based surveys of children were undertaken in the same schools one year apart, with one before the legislation and the other after. The surveys included different children. Of 170 schools approached, 116 agreed to take part in the study before the legislation (January 2006) and 111 of these schools also participated in the follow-up survey (January 2007). Each school selected one class to participate in each survey. A total of 2559 primary schoolchildren were surveyed in January 2006 and a further 2424 children in January 2007. The outcomemeasures included salivary cotinine concentrations and reported exposure to parental smoking in the home or car. The researchers found that salivary cotinine concentrations were significantly lower after the legislation. Reports of exposure to parental smoking did not differ significantly before and after the legislation. It was concluded that the legislation reduced exposure to secondhand smoke in schoolchildren and that there was no evidence of displacement of parental smoking from public places into the home or car. The legislation had a positive short term impact on schoolchildren’s health. Which of the following statements, if any, are true? a) The before and after study is experimental by design