Dose⁻Response Relationships between Second-Hand Smoke Exposure and Depressive Symptoms among Adolescents in Guangzhou, China.

Jingya Huang,Wei Huang,Guocong Liu,Dan Guo,Bin Xu,Xiaohua Ye,Ting Jiang

doi:10.3390/ijerph15050985

Abstract

There has been little focus on the possible association between second-hand smoke (SHS) exposure and depressive symptoms among adolescents. Thus, this study aimed to explore the dose–response relationships between SHS exposure and depressive symptoms among adolescents and differentiate these associations in setting-specific exposure and severity-specific outcomes. A cross-sectional study was conducted using a stratified cluster sampling method to obtain a representative sample of high school students in Guangzhou, China. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Univariable and multivariable logistic regression models were used to explore the potential associations between SHS exposure and depressive symptoms. Among 3575 nonsmoking students, 29.6% were classified as having probable depressive symptoms and 9.6% had severe depressive symptoms. There were monotonically increasing dose–response relationships between setting-specific (public places, homes, or indoor/outdoor campuses) SHS exposure and severity-specific (probable or severe) depressive symptoms. When examining these relations by source of exposure, we also observed similar dose–response relationships for SHS exposure in campuses from smoking teachers and from smoking classmates. Our findings suggest that regular SHS exposure is associated with a significant, dose-dependent increase in risk of depressive symptoms among adolescents, and highlight the need for smoke-free environments to protect the health of adolescents.

Highlights

The Centers for Disease Control and Prevention reported that there is no risk-free level of second-hand smoke (SHS) exposure [1]
Our findings suggest that regular SHS exposure is associated with a significant, dose-dependent increase in risk of depressive symptoms among adolescents, and highlight the need for smoke-free environments to protect the health of adolescents
We found that there were monotonically increasing frequency–risk relationships between setting-specific SHS exposure and severity-specific depressive symptoms

Summary

Introduction

The Centers for Disease Control and Prevention reported that there is no risk-free level of second-hand smoke (SHS) exposure [1]. The latest retrospective analysis of the worldwide burden of disease attributable to SHS exposure indicated that 40% of nonsmoking children are exposed to SHS [2]. In China, 740 million (including 180 million children) nonsmokers are exposed to SHS [3]. Global youth tobacco surveillance reported that nearly half of adolescents are exposed to SHS in homes (42.5%) or in public places (55.1%) [4]. It is conceivable that nonsmokers exposed to a high level of SHS may experience depression as a result. Growing evidence suggests that SHS may be associated with

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