Association between Second-hand Smoke and Generalized Anxiety Disorder in Korean Adolescents: Based on the 17th Korea Youth Risk Behavior Survey

Abstract

Objectives: The purpose of this study was to investigate the association between secondhand smoke exposure at home, school, and public places and Generalized Anxiety Disorder (GAD) among Korean adolescents, and to determine whether the risk of GAD increases as the frequency of exposure to secondhand smoke increases. Methods: This cross-sectional study is based on the 17th Korean Youth Risk Behavior Survey (2021), Out of the 54,848 students who participated in the survey, 5,975 current smokers were excluded, leaving the final analysis subject as 48,873 non-smokers. Rao-Scott chi-square analysis was done to examine the difference between general characteristics depending on the GAD levels of the subject and to investigate the association between second-hand smoke exposure and GAD. Multivariate logistic regression analysis was performed to investigate the effect of exposure to secondhand smoke in adolescents on GAD. Results: With all the confounding factors adjusted (Model IV), the risk of high GAD when exposed to secondhand smoke at home was 1.08 times higher for 1-3 days compared to “none” and 1.17 times higher when exposed to more than 4 days. In public places, the risk increased by 1.10 times and 1.49 times, when exposure was 1-3 days and more than 4 days respectively. At school, the risk increased by 1.34 times when exposed to 1-3 days, and 1.40 times when exposed to more than 4 days. Conclusions: Based on the results of this study, public awareness of secondhand smoke should be improved, health policies should be developed to prevent exposure to secondhand smoke among adolescents.