Abstract
BackgroundExposure to second hand smoke (SHS) is one of the major causes of premature death and disease among children. While socioeconomic inequalities exist for adult smoking, such evidence is limited for SHS exposure in children. Thus, this study examined changes over time in socioeconomic inequalities in infants’ SHS exposure in Japan.MethodsThis is a repeated cross-sectional study of 41,833 infants born in 2001 and 32,120 infants born in 2010 in Japan from nationally representative surveys using questionnaires. The prevalence of infants’ SHS exposure was determined and related to household income and parental education level. The magnitudes of income and educational inequalities in infants’ SHS exposure were estimated in 2001 and 2010 using both absolute and relative inequality indices.ResultsThe prevalence of SHS exposure in infants declined from 2001 to 2010. The relative index of inequality increased from 0.85 (95% confidence interval [CI], 0.80 to 0.89) to 1.47 (95% CI, 1.37 to 1.56) based on income and from 1.22 (95% CI, 1.17 to 1.26) to 2.09 (95% CI, 2.00 to 2.17) based on education. In contrast, the slope index of inequality decreased from 30.9 (95% CI, 29.3 to 32.6) to 20.1 (95% CI, 18.7 to 21.5) based on income and from 44.6 (95% CI, 43.1 to 46.2) to 28.7 (95% CI, 27.3 to 30.0) based on education. Having only a father who smoked indoors was a major contributor to absolute income inequality in infants’ SHS exposure in 2010, which increased in importance from 45.1% in 2001 to 67.0% in 2010.ConclusionsThe socioeconomic inequalities in infants’ second hand smoke exposure increased in relative terms but decreased in absolute terms from 2001 to 2010. Further efforts are needed to encourage parents to quit smoking and protect infants from second hand smoke exposure, especially in low socioeconomic households that include non-smoking mothers.
Highlights
Exposure to second hand smoke (SHS) is one of the major causes of premature death and disease among children[1]
The relative index of inequality increased from 0.85 (95% confidence interval [confidence intervals (CIs)], 0.80 to 0.89) to 1.47 based on income and from 1.22 to 2.09 based on education
Social inequalities in the prevalence of adult smoking are widening in some European countries[9], there are limited studies focusing on the changes in SHS exposure inequalities in children over time
Summary
Exposure to second hand smoke (SHS) is one of the major causes of premature death and disease among children[1]. The majority of SHS exposure in children occurs in homes or cars because their parents smoke, and 40% of children worldwide are regularly exposed to SHS indoors[2]. An ideal solution to protect children from exposure to SHS is parents’ cessation of smoking, this is often not achievable[3,4]. Social inequalities in the prevalence of adult smoking are widening in some European countries[9], there are limited studies focusing on the changes in SHS exposure inequalities in children over time. Examining which combinations of parental indoor smoking drive inequalities the most would help to prioritize tobacco control policies or interventions to reduce children’s SHS exposure. While socioeconomic inequalities exist for adult smoking, such evidence is limited for SHS exposure in children. This study examined changes over time in socioeconomic inequalities in infants’ SHS exposure in Japan
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