Conclusion: Indications for effectiveness
Smith et al. (2002) showed a 58% reduction in cigarette lighter fires caused by children younger than age 5 as a result of the standard requiring child resistant lighters. The authors use several procedures to correct for potential factors that could explain the decrease (besides the changed design of cigarette lighters) and also argument why the reduction in fires is likely attributable to the new product design of cigarette lighters.
Mackay et al. (2006) state that product modification, specifically child resistant cigarette lighters, are primary prevention strategies where the technologies have been developed, tested and found to be effective and which would prevent many fires from starting if adopted. In the U.S.A., fire deaths associated with cigarette lighters dropped 43% with the adoption of child resistant designs.
Note: MacKay et al. (2006) do not explicitly focus on the child resistant cigarette lighters, but on product modification that prevent burns in general; child resistant cigarette lighters are just one of the possible products. The specific claims they make on child resistant cigarette lighters are mainly based on the work of Viscusi and Cavallo (1994) and on the comments made on this topic by the Harborview Injury Prevention & Research Center. However, these comments of the Harborview Injury Prevention & Research Center are also mainly based on the work of Viscusi and Cavallo (1994). The link to the review of the Harborview Injury Prevention & Research Center is: http://depts.washington.edu/hiprc/practices/index.html.
Viscusi and Cavallo (1994) did not mainly focus on the effects of the introduction of child resistant cigarette lighters on the reduction of fire-related injuries of children, but on the possible negative effects of introducing a product that seems safe. That is, that parents become more lax in handling lighters and allowing for greater access to children. Overall, the findings suggest that lighters with child-resistant features cause parents to take less precaution measures. Therefore, fire safety should remain a continuing concern. However, on balance the safety improvements made possible by this lighter safety device far outweigh the effect of diminished care.
Recommendations (for research & practice)
Suggestions for practice/policy:
- Regulations requiring product modifications and their enforcement will increase availability of safe products.
- Parental knowledge and modified product availability, accessibility, cost and ease of use will impact their uptake.
- The standard is not a substitute for parental supervision. While the standard can increase the time needed for a child to operate the lighter, it may not prevent some children from operating the lighters with enough practice.
- Continuing media campaigns are needed to inform caregivers that some young children, and most older children, can still operate (child resistant) cigarette lighters.
- Given the similarity of the hazard and performance requirements, educational materials/lighter safety campaigns addressing child play fires should specifically include multipurpose lighters since it may not be evident to parents that multipurpose lighters pose the same hazard.
Review Date: 22/03/2011
Articles (reviews) and reports were included that were published between 1980 and 2010, in English and Dutch. The outcomes of the study were reviewed by the Dutch Consumer Safety Institute.
Strategy: An online literature search was performed by a researcher of the Consumer Safety Institute and after this a more thorough search was performed by the documentation centre of CSI (Catalog CenV, Pubmed, Injury lit, Google, Websites, 'Grey' literature). Results of each search were compared on differences and potential missed studies were added. First the titles and then abstracts were scanned in order to include relevant studies. In the case of insufficient information obtained from abstracts the full text articles were obtained. Relevant articles were scrutinized and background documents were created. In addition, relevant references of included articles were checked on new and relevant articles (i.e., snowball search).
The outcomes of the study were reviewed by an expert in the field of child safety in the winter of 2010.
Child Safety Good Practice Guide : good investments in unintential child injury prevention and safety promotion (version 1)
M. MacKay, J. Vincenten, M. Brussoni, L. Towner ...[et al.] (2006)
Study of the effectiveness of the US safety standard for child resistant cigarette lighters (version 1.0)
L.E. Smith, M.A. Greene, H.A. Singh (2002)
The effect of product safety regulation on safety precautions (version 1.1)
W. Kip Viscusi, Gerald O. Cavallo (1994)