Prevalence Of Secondhand Smoke Exposure Research Articles

Assessing second-hand smoke exposure among non-smoking youth in India: Insights from GATS I & II.

Background & objectives This study aimed to compare the prevalence and identify the patterns of second-hand smoke (SHS) exposure among non-smoking Indian youth (ages 15-24 and 25-29 yr) in various settings-homes, workplaces, public places, and a combination of these locations-based on sociodemographic factors and knowledge about the health implications of smoking. The purpose of the study was to identify the factors influencing SHS exposure in India between the Global Adult Tobacco Survey (GATS) I and II. Methods Secondary data analysis was conducted utilising GATS I and II data to analyse the prevalence and patterns of SHS exposure at home, workplace, public place and all the places combined among non-smoking youths aged 15-29 yr. The study sample included 20,604 and 20,927 individuals for GATS I and II, respectively. The predictor variables included the sociodemographic variables and the knowledge regarding the ill effects of smoking. Weighted prevalence was calculated using survey weights, and multivariate logistic regression analyses were utilised to examine the adjusted relationships between SHS exposure and predictors. Results Between GATS I and II, there was a notable decline in the weighted prevalence of SHS exposure at home and in public places among non-smoking youth aged 15-29 yr. The study also indicates an increase in workplace SHS exposure between the two rounds of GATS among non-smoking youth who had knowledge about the ill effects of SHS exposure on health. Multivariate regression analyses revealed significant associations between SHS exposure and gender, education level, employment status, place of residence, and wealth index, affecting exposure in one or more locations. Interpretation & conclusions Our secondary analysis of GATS data from 2009-10 to 2016-17 reveals a decline in SHS exposure at home and public places but an increase in workplaces among non-smoking youth. Factors like female gender, higher education, and wealth were linked to lower SHS exposure, while rural residence and self-employment indicated higher risks. These findings underscore the need for targeted, community-based interventions and stricter enforcement of anti-tobacco laws to protect non-smoking youth in India.

Cotinine-measured secondhand smoke exposure among federal housing assistance recipients without active tobacco or nicotine in the United States: NHANES, 2007-2018.

The prevalence of cigarette smoking is high among U.S. Department of Housing and Urban Development (HUD) assistance recipients, putting others at risk for secondhand smoke (SHS) exposure. We evaluated the burden of SHS exposure among HUD-assisted children, adolescents, and adults. Using 2007-2018 National Health and Nutrition Examination Survey (NHANES) data linked with HUD administrative data, we assessed SHS exposure prevalence, defined using serum cotinine, among non-tobacco, non-nicotine-using, HUD-assisted children and adolescents (ages 3-17 years, n=955) and adults (ages ≥18 years, n=878) and among low-income, HUD-unassisted children and adolescents (n=5,788) and adults (n=8,027). Time trends were evaluated. Unadjusted and adjusted multivariable logistic regression models were created to assess SHS exposure by HUD assistance status. The prevalence of SHS exposure during 2015-2018 was 73.2% [95% CI: 63.2%-81.7%] among HUD-assisted children and adolescents and 50.1% [40.1%-60.1%] among HUD-assisted adults. Decreases in SHS exposure among HUD-assisted individuals from 2007-2010 through 2015-2018 were significant only for ages 12-17 years (78.6% [68.0%-87.0%] to 64.3% [52.5%-74.9%]; P=0.04). Among low-income individuals, SHS exposure was higher during 2007-2018 among HUD-assisted than HUD-unassisted children and adolescents (Odds Ratio: 3.39 [2.58-4.47]) and adults (2.11 [1.66-2.68]). Results remained significant after adjusting for social, demographic, and housing characteristics. HUD-assisted children, adolescents, and adults had higher exposure to SHS than those not receiving HUD assistance. SHS exposure among HUD-assisted individuals was high for all years studied, compared to published estimates for the general U.S. population, but did decrease among children and adolescents ages 12-17 years. This study is the first to provide biomarker-derived prevalence estimates of SHS exposure among recipients of HUD assistance within a nationally representative sample of the United States. The findings suggest that HUD-assisted children, adolescents, and adults are an at-risk population for SHS exposure, independent of known confounding social and demographic factors.

The association between secondhand smoke exposure and overweight/obesity among children and adolescents

This study aimed to investigate the association between secondhand smoke exposure in different places and overweight/obesity among children and adolescents. Children and adolescents aged 7 to 18 years old in Hunan Province were recruited for questionnaire surveys and physical examinations using a multi-stage stratified cluster sampling method. Secondhand smoke exposure was evaluated according to the answer to the question, "Has someone smoked in front of you in the last 7 days?". Overweight and obesity were determined using BMI-for-age and BMI-for-sex according to the national standard WS/T586-2018. Multivariate logistic regression was used to explore the association between secondhand smoke exposure in different places and overweight/obesity among children and adolescents. A total of 187 863 participants were included in this study, with a prevalence of overweight and obesity of 28.4%. The prevalence of secondhand smoke exposure at home, school and other public places was 25.5%, 12.6% and 32.3%, respectively. Children and adolescents with secondhand smoke exposure at home, school and other public places had a higher prevalence of overweight and obesity than those without exposure. After adjusting for confounding factors, secondhand smoke exposure was positively associated with overweight and obesity among children and adolescents, and exposure at home showed the closest association (OR=1.091; 95%CI: 1.066-1.117). In conclusion, secondhand smoke exposure, especially at home, significantly increases the risk of overweight and obesity among children and adolescents. Comprehensive strategies should be implemented to avoid secondhand smoke exposure and protect children and adolescents from overweight and obesity.

Increasing Trends of Household Secondhand Smoke Exposure and Widening Socioeconomic Disparities in Hong Kong Adolescents, 2010-2020.

The aim of this study is to assess 10-year trends (2010-2020) in household secondhand smoke exposure in Hong Kong adolescents from inside their own homes and from their neighbors and analyze changes by SES. Data from the 2010-2020 School-based Smoking Survey among students (total responses were 228,623) were analyzed in 2023. Weighted prevalence and temporal trends of secondhand smoke exposure were calculated across years. Prevalence differences and prevalence ratios were used to assess SES disparities. Poisson regression models with robust SEs were used for trend analysis. From 2010 to 2020, the prevalence of secondhand smoke exposure from inside students' homes and from their neighbors increased by 26.8% (from 23.5% to 29.8%) and 142.3% (from 16.8% to 40.7%), respectively. Any household secondhand smoke exposure from these sources increased from 33.2% to 58.5%. The prevalence of home secondhand smoke exposure was significantly higher in 2018 and 2020 than in 2010. Neighbor secondhand smoke exposure showed a continuous upward trend throughout the period. Students with lower parental education levels and from poorer families were more exposed, with disparities by parental education widening in 2018. Household secondhand smoke exposure in Hong Kong adolescents has increased in recent years, with persistent socioeconomic disparities and a widening in 2018. Targeted policies, such as home smoking bans, are needed to protect adolescents from secondhand smoke exposure and reduce socioeconomic disparities.

ASSESSMENT OF PASSIVE SMOKING EXPOSURE AMONG PREGNANT WOMEN

Secondhand smoke (SHS) exposure poses significant health risks to both mothers and fetuses during pregnancy. Despite global efforts to reduce smoking in public and private spaces, SHS exposure remains prevalent, particularly in low- and middle-income countries. Objective: The study aimed to assess the extent of passive smoking exposure among pregnant women in various settings, including their homes, workplaces, and public spaces, and to examine the frequency and potential health risks associated with SHS exposure during pregnancy. Methods: This cross-sectional study was conducted among 150 pregnant women attending a tertiary care hospital in Pakistan between January and June 2024. Data were collected using a structured questionnaire that captured demographic information and SHS exposure across different environments, including home, workplace, and public spaces. Descriptive statistics, including frequencies and percentages, were used to summarize the data. Results: Among the participants, 60.7% reported SHS exposure at home, with 30% experiencing SHS exposure 6-10 times weekly. Additionally, 61.3% of the women reported exposure at work, with 52.7% exposed 11-15 times monthly. Public spaces also contributed to significant SHS exposure, with 86% of participants affected. Notably, 37.3% of women reported spending 15-30 minutes daily inside a car with someone smoking. Demographically, most participants were aged 25-28 years (46.7%) and had a matric-level education (36.0%). Conclusion: This study reveals a high prevalence of SHS exposure among pregnant women, particularly at home, work, and public places. The findings underscore the urgent need for public health interventions, such as stricter smoke-free policies and public awareness campaigns, to reduce SHS exposure and safeguard maternal and fetal health.

The Role of Active and Passive Smoking in Chronic Obstructive Pulmonary Disease and Systemic Inflammation: A 12-year Prospective Study in China.

There is no consensus on the cause and effect of systemic chronic inflammation (SCI) regarding chronic obstructive pulmonary disease (COPD). The impact of second-hand smoke (SHS) on COPD has reached inconsistent conclusions. The China Kadoorie Biobank cohort was followed up from the 2004-08 baseline survey to 31 December 2018. Among the selected 445,523 participants in the final analysis, Cox and linear regressions were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of tobacco exposure with COPD risk and baseline levels of log-transformed inflammatory factors [βs (95% CIs)], respectively. Participants were followed up for a median of 12.1 years and 11,825 incident COPD events were documented. Ever-smokers were associated with a higher risk of COPD than non-smokers with non-weekly SHS exposure. A younger age to start smoking, a greater amount of daily tobacco consumption, and deeper inhalation were associated with increased risk of COPD and correlated with elevated levels of plasma high-sensitivity C-reactive protein (hs-CRP, all Ptrend < 0.001) even two years before COPD onset. Among former smokers, COPD risk declined with longer smoking cessation (Ptrend < 0.001) and those quitting smoking for over ten years presented no difference in COPD risk and hs-CRP level from non-smokers [HR (95% CI) = 1.05 (0.89, 1.25), β (95% CI) = 0.17 (- 0.09, 0.43)]. Among non-smokers, weekly SHS exposure was associated with a slightly higher COPD risk [HR (95% CI) = 1.06 (1.01, 1.12)]. Incremental exposure to tobacco smoke was related to elevated SCI level before COPD onset, then an increase in COPD susceptibility. Quitting smoking as early as possible is suggested as a practical approach to reducing COPD risk in smokers. Given the high prevalence of both COPD and SHS exposure, the risk associated with SHS exposure deserves attention.

O13 ASSOCIATION OF SECONDHAND SMOKE EXPOSURE IN RELATION TO HYPERTENSION TREATMENT STATUS WITH STROKE OCCURRENCE IN GHANA AND NIGERIA

Background and objective: It is unclear whether secondhand smoke exposure (SHSE) in hypertensive states with a disproportionate gap in hypertension treatment status is fuelling the epidemic of stroke in sub-Saharan Africa. This study, therefore, assessed the association of SHSE in relation to hypertension treatment status with stroke occurrence among West Africans. Methods: The Stroke Investigative Research and Educational Network (SIREN) is a case-control study across 16 study sites in Ghana and Nigeria. Cases were acute stroke (n =3684) with age- and sex-matched stroke-free controls (n =3684). Hypertension definition was based on standard guidelines, and SHSE was based on self-reported exposure to smoke from a burning cigarette or exhaled from a smoker in any indoor area. We evaluated the associations of untreated hypertension, treated but uncontrolled hypertension, and controlled hypertension at BP of &lt;140/90 mmHg with odds of stroke occurrence. Multivariable-adjusted logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of the risk of stroke by hypertension treatment and SHSE status. Results: Overall, mean age was 59.0±14.9 years, and 54.2% were male. Among stroke cases, the prevalence of SHSE was 352 (20.7%), and the frequencies of no hypertension, untreated hypertension, treated but uncontrolled hypertension, and controlled hypertension were 4.0%, 47.7%, 37.1%, and 9.2%. The aOR and PAR (95% CI) for untreated hypertension were 6.58 (5.15-8.41) and 35.4% (33.4-37.4); treated but uncontrolled hypertension was 9.95 (7.60-13.02) and 35.9% (34.2-37.5); and controlled hypertension was 5.37 (3.90-7.41) and 8.5% (7.6-9.5) respectively. The aOR (95% CI) of stroke, given exposure to secondhand smoke, was 1.15 (0.94-1.41), while among untreated hypertensives and treated but uncontrolled hypertensives was 1.54 (0.99-2.37) and 1.15 (0.48-1.46) respectively. Conclusion: SHSE with hypertension significantly aggravated the odds of stroke occurrence, particularly when hypertension is untreated. Implementing targeted multi-sectoral interventions that advocate for clean air and aggressive hypertension treatment can potentially reduce the escalating burden of stroke in Africa.

Second Hand Tobacco Smoke Exposure among Adults in an Urbanized Village in Delhi

Background: India contributes to the maximum of the world’s health burdens attributable to tobacco use. Exposure to secondhand smoke (SHS) is also associated with adverse health effects, causing 1.2 million deaths worldwide each year. In Delhi, 28.0% had SHS exposure at public places. About one-fifth experienced exposure to SHS at workplace. This study aimed to determine the prevalence of SHS exposure among adults in an urbanized village in Delhi. Materials and Method: It was a community-based cross-sectional house-to-house survey conducted between January 2020 and June 2021 in Aliganj, an urbanized village in Delhi. A total of 490 residents ≥15 years were included using simple random sampling. The interview was conducted by the primary author using the Global Adult Tobacco Survey (GATS). Each subject enrolled in the study was explicitly informed of the purpose of the study by the investigator and provided written informed consent before enrolment. Data were checked for errors, entered in Microsoft Excel, and analyzed in Statistical Package for the Social Sciences (SPSS). Results: Of the 490 participants, 14.7% were exposed to SHS in their house and 16.1% were exposed to SHS outside the house in the last 1 month. The majority (85.3%) believed secondhand smoking is harmful, 6.5% disagreed, and the rest were unaware. Conclusion: Though most participants knew that exposure to SHS can cause serious illness, further awareness sessions need to be conducted to improve knowledge and understanding and reduce exposure to secondhand tobacco smoke in homes. Strict adherence to no-smoking policies should be implemented as per law to reduce exposure to SHS in public areas.

Tobacco exposure and alcohol drinking prevalence and associations with hypertension in rural southwest China: A cross-sectional study.

This study examined the prevalence of tobacco exposure and drinking and ascertained the relationships between tobacco exposure, alcohol drinking, concurrent smoking and drinking, and hypertension in rural southwestern China. Data were collected from a cross-sectional health interview and examination survey, which included 7572 adults aged ≥35 years, in rural China. Participant demographic characteristics, smoking habits, exposure to secondhand smoke (SHS), and alcohol drinking habits were obtained using a standard questionnaire. Blood pressure (BP), height, weight, and waist circumference were measured for each participant. The overall prevalence of smoking, SHS exposure, drinking, concurrent smoking and drinking, concurrent exposure to SHS and drinking, and hypertension was 37.7%, 27.4%, 16.2%, 12.6%, 1.6%, and 41.3%, respectively. Males had a significantly higher prevalence of smoking (74.1% vs 2.2%, p<0.01), drinking (31.1% vs 1.7%, p<0.01), and concurrent smoking and drinking than females (25.3% vs 0.3%, p<0.01). However, females had a higher prevalence of SHS exposure than males (30.2% vs 20.6%, p<0.01). Ethnic minorities had a higher prevalence of SHS exposure, drinking, and concurrent smoking and drinking, than Han participants (p<0.01). Participants with a higher education level had a higher prevalence of smoking, drinking, and concurrent smoking and drinking than their counterparts (p<0.01). In contrast, participants with a lower education level had a higher prevalence of SHS exposure than their counterparts (p<0.01). Multivariate logistic regression analysis found that smokers (AOR=1.31; 95% CI: 1.13-1.51), individuals exposed to SHS (AOR=1.24; 95% CI: 1.11-1.43), drinkers (AOR=1.31; 95%: CI: 1.15-1.50), and concurrent smokers and drinkers (AOR=1.45; 95% CI: 1.25-1.67) all had a higher probability of having hypertension (p<0.01). Additionally, concurrent smoking and drinking had the strongest association with the prevalence of hypertension (AOR=1.45; 95% CI: 1.25-1.67; p<0.01). Socioeconomic factors play an important role in influencing the prevalence of smoking, exposure to SHS, and drinking in rural southwest China. Interventions to prevent and reduce hypertension should, in particular, focus on smokers, individuals exposed to SHS, drinkers, and, in particular, concurrent smokers and drinkers.

Prevalence of Second Hand Smoke Exposure and Measures to Overcome: A Cross Sectional Study among Youth in Urban Hyderabad.

In India, the prevalence of secondhand smoke (SHS) exposure is 29.5% in general and 11.2% at home. The youth may expose themselves to SHS without knowing the risk factors and consequences involved. This study is intended to determine the prevalence of SHS exposure and the measures adopted by the youth to avoid exposure. A cross-sectional study was conducted among 338 youth in an urban area in Hyderabad. A modified Global Youth Tobacco Survey questionnaire was used for data collection on SHS exposure and avoidance. The total prevalence of SHS exposure was 35.21%. The mean days of SHS exposure/week were 1.419 (standard deviation -1.806) days. Belonging to the age group 18-21 years, and male gender were significant predictors of SHS exposure. Education of the head of family was a significant predictor of SHS avoidance behavior. Creating awareness among young adults regarding the deleterious effects and preventive strategies of SHS exposure, thereby making them responsible for the health of their family can be a protective long-term strategy.

Changes in prevalence and socioeconomic inequalities in secondhand smoke exposure in Spanish children, 2016-2019.

Children are vulnerable to secondhand smoke (SHS) exposure, especially those with lower socioeconomic status. This study assesses the changes in prevalence and socioeconomic inequalities in SHS exposure in children younger than 12 years old in Spain between 2016 and 2019. We conducted two cross-sectional studies among representative samples of households with children aged <12 years in Spain, in 2016 (n=2411) and 2019 (n=2412). Families were interviewed to assess children's SHS exposure in private settings and outdoor public venues and their adoption of home and car smoke-free rules. We used the education level of the home main earner as a proxy for socioeconomic position. Changes over time in the prevalence and socioeconomic inequalities of SHS exposure and smoke-free rules were estimated through adjusted Poisson regression models with robust variance according to sociodemographic covariates (adjusted prevalence ratios, APRs). In 2019, 70.5% of children were exposed to SHS in Spain. No changes between 2016 and 2019 were found for overall SHS exposure, exposure at home, and at school entrances. SHS exposure increased at public transport stations (APR=1.24; 95% CI: 1.03-1.49) and outdoor hospitality venues (APR=1.17; 95% CI: 1.07-1.29) while it decreased in cars (APR=0.74; 95% CI: 0.56-0.98) and parks (APR=0.87; 95% CI: 0.77-0.98). Households with lower education level had higher prevalence of SHS exposure at home in 2019 compared with those with university studies (primary: APR=1.30; 95% CI: 1.11-1.51; secondary: APR=1.12; 95% CI: 1.00-1.25) and were less likely to adopt home indoor smoke-free rules (primary: APR=0.88; 95% CI: 0.79-0.99; secondary: APR=0.95; 95% CI: 0.89-1.02). Socioeconomic inequalities in SHS exposure at home persisted between 2016 and 2019 (p>0.05), while decreased in smoke-free rules in cars (p=0.039). Reported SHS exposure among children in Spain remained high between 2016 and 2019. Inequalities persisted at home, highlighting the need for measures to reduce such exposure with an equity perspective.

Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses.

Smoke-free areas have expanded and related campaigns have been implemented since 1995 in Korea. As a result, household secondhand smoke (SHS) exposure has decreased over the past 15 years. We assessed the cohort effect, the effect of a 2008 campaign on household SHS exposure, and the impact of a complete smoking ban in public places along with increased penalties, as implemented in December 2011. Nationally representative cross-sectional 15-wave survey data of Korean adolescents were used. The 810,516 participants were classified into 6 grade groups, 15 period groups, and 20 middle school admission cohorts. An age-period-cohort analysis, conducted with the intrinsic estimator method, was used to assess the cohort effect of household SHS exposure, and interrupted-time series analyses were conducted to evaluate the effects of the smoke-free policy and the campaign. For cohorts who entered middle school from 2002 to 2008, the risk of household SHS exposure decreased among both boys and girls. Immediately after implementation of the smoke-free policy, the prevalence of household SHS exposure by period decreased significantly for boys (coefficient, -8.96; p<0.05) and non-significantly for girls (coefficient, -6.99; p=0.07). After the campaign, there was a significant decrease in household SHS exposure by cohort among boys, both immediately and post-intervention (coefficient, -4.84; p=0.03; coefficient, -1.22; p=0.02, respectively). A school-admission-cohort effect was found on household SHS exposure among adolescents, which was associated with the smoke-free policy and the campaign. Anti-smoking interventions should be implemented consistently and simultaneously.

Association Between Second-Hand Smoke Exposure and Respiratory Symptoms Among the General Population of Non-smoker Adults in Saudi Arabia: A Cross-Sectional Study.

Second-hand smoke (SHS) exposure is associated with respiratory symptoms such as cough, dyspnea, and wheezing. However, data on this association in Saudi Arabia is limited. The objective of this study is to investigate the prevalence of SHS exposure and its association with respiratory symptoms amongnon-smoker adults in Saudi Arabia. Data collection was carried out over the course of two months by distributing an online questionnaire among adults living in Saudi Arabia. The survey consisted of questions assessing sociodemographic factors, SHS exposure, and the presence of respiratory symptoms. Statistical analysis was performed using IBMSPSSStatistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States). Data was considered significant if p<0.05. The questionnaire was completed by 1360 participants. Most were females (n=845, 72.1%)and individuals aged 18 to 30 years (n=838, 71.5%). From the analyzed records, 67.3% (n=789) reported SHS exposure. Amongthem, 40.3% (n=472) reported SHS exposure from household sources, 32.6% (n=382) from work colleagues, and 30.5% (n=357) from friends. The majority (n=306, 76.9%) of those exposed at home reported daily SHS exposure. The main source of home exposure was male family members, particularly the father (n=201, 42.6%). The majority (n=985, 84.0%) of participants reported not having any kindof mold or damage at their place of residence. Individuals with SHS exposure were more likely to report asthma (p=0.043), chest whistling or wheezing (p=0.021), chronic cough (p<0.001), productive cough (p<0.001), and nasal symptoms without a cold (p<0.001). These individuals also demonstrated a higher average symptomscore than those not exposed to SHS. Conclusion: The study reveals that a significant percentage of the Saudi population is exposed to SHS daily, mainly from household sources, especially male family members. A significant association was found between SHS exposure and the presence of respiratory symptoms. Public awareness regarding the prevalence and dangers of SHS exposure is essential in order to alleviate the impact of SHS on the health of the general Saudi population. Additionally, further research is required in this field and demographic group to develop appropriate interventions.

Secondhand Smoke Exposure and Smoking Prevalence Among Adolescents

Secondhand smoke is a substantial risk factor for youth health globally, including in Japan, where tobacco control policies should be reassessed. To assess trends in the prevalence of secondhand smoke exposure among Japanese adolescents from 2008 to 2017 and to examine the association between its frequency and smoking during the study period. This study comprised a nationally representative, self-administered, school-based, cross-sectional survey focusing on tobacco and alcohol use and related factors among students in grades 7 to 12 (ages 12-18 years) in Japan. This random sampling survey used single-stage cluster sampling. Using the national school directory, junior and senior high schools throughout Japan were randomly extracted from each regional block. All students enrolled in the sampled schools were included as participants, and school-based surveys were completed in 2008, 2012, and 2017. Data analysis was performed from January 1 to March 15, 2023. Prevalence of secondhand smoke exposure among adolescents in Japan from 2008 to 2017 and changes in the association between secondhand smoke exposure frequency and prevalence of smoking were examined using multiple logistic regression analysis. Data were analyzed for 95 680 adolescents in 2008 (50.7% boys), 100 050 in 2012 (51.6% boys), and 64 152 in 2017 (53.9% boys). At baseline, 42.0%, 38.5%, and 34.6% of the participants were junior high school students in 2008, 2012, and 2017, respectively. Based on the 2008 surveys, 51.0% of adolescents in grades 7 to 12 were exposed to secondhand smoke in any place (≥1 day during the past 7 days), 37.2% were exposed at home, and 36.5% were exposed in public places. In 2017, 36.3% of participants were exposed to secondhand smoke in any place, 23.8% were exposed at home, and 27.0% were exposed in public places. An association between secondhand smoke exposure frequency and prevalence of smoking was observed consistently regardless of survey year, location, or pattern of exposure (adjusted odds ratios ranged from 2.29 [95% CI, 1.81-2.91] for 1-2 days at home to 11.15 [95% CI, 8.50-14.62] for 7 days in public places). Stratified analysis by higher education intention indicated that the prevalence of smoking and secondhand smoke exposure decreased but remained higher among adolescents who did not intend to pursue higher education. The association between secondhand smoke and smoking did not differ substantially between groups. In this cross-sectional study, the prevalence of secondhand smoke exposure among adolescents in Japan decreased but remained at high levels overall. There may not be a hazard-free threshold for smoking. Enhancing comprehensive tobacco control strategies is Japan's first step toward achieving smoke-free environments to protect youths. Implementation and verification of the effectiveness of smoke-free legislation should be considered.

What is the Current Picture of Secondhand Smoke Exposure among Never-smoker Adolescents in Indonesia?

Introduction:Although Indonesia is not a signatory to the World Health Organization Framework Convention on Tobacco Control, 84% of local governments have adopted Smoke-Free Areas (SFAs) as a national policy. This study examines exposure to secondhand smoke (SHS) in adolescents who have never smoked after 8 years of SFA implementation.Methods:We used data from the 2019 Global Youth Tobacco Survey and a cross-sectional research design to find 6121 students from 148 schools in 30 provinces in Indonesia who met the research inclusion criteria. To identify risk factors regarding SHS exposure, multivariable logistic regression analysis was performed.Results:Although the local government had adopted an SFA policy, 61.1% of adolescents aged 11–17 years, especially middle and high school students, have relatively high exposure to SHS. School environments had the highest prevalence of SHS exposure (50.5%), followed by public places (49.9%) and at home (46.2%). A significant risk factor for exposure to SHS in the school environment is observed in teachers smoking inside school buildings (odds ratio [OR] =4.32, 95% confidence interval [CI]: 3.81–4.89); exposure to SHS at home and in public place (OR = 3.29, 95% CI: 2.93–3.70), and exposure to tobacco advertising, promotion, and sponsorship on offline and online media (OR = 2.07, 95% CI: 1.70–2.52).Conclusion:SFA policies must be evaluated and strengthened before they can be implemented to reduce smoking-related illnesses and economic losses. In addition, it is important to educate families and society about implementing SFA in school environments, public places, and at home.

Secondhand smoke exposure and associated factors among city residents living in multiunit housing in Bangladesh.

Secondhand smoke (SHS) poses a high health risk to those living in multiunit housing (MUH) since it can easily spread from unit to unit and throughout the building's communal areas. MUH residents in Bangladesh are particularly vulnerable to SHS due to the absence of smoking restrictions within a housing complex. Therefore, this study aimed to assess the prevalence of SHS exposure and its associated factors among MUH residents living in seven divisional cities of Bangladesh- Dhaka, Chattogram, Rajshahi, Khulna, Sylhet, Barishal, and Rangpur. From April 2019 to November 2019, a cross-sectional survey was conducted with 616 MUH residents aged 18 or older who had been residing in MUH for at least two years in the seven divisional cities of Bangladesh. A multivariable logistic regression model was performed to determine the associated factors of SHS exposure. In MUH complexes, more than half (54.9%) of the 616 respondents were exposed to SHS. The key factors positively associated with SHS exposure were females (aOR: 1.8, 95% CI:1.236-2.681), residents with a low monthly family income (aOR: 1.9, 95% CI: 1.162-3.220), those whose family members smoked (aOR: 2.4, 95% CI: 1.537-3.746), and Dhaka city residents (aOR: 1.9, 95% CI: 1.013-3.440). This study revealed a high prevalence of SHS exposure among Bangladeshi MUH residents. Therefore, a smoking ban is needed in and around MUH complexes to protect non-smoking residents from SHS exposure.

40737 The Prevalence of Secondhand Smoke Exposure in Hidradenitis Suppurativa

40737 The Prevalence of Secondhand Smoke Exposure in Hidradenitis Suppurativa

Prevalence of Underreported Nicotine Exposure Among US Nonsmoking Adults: A Comparison of Self-Reported Exposure and Serum Cotinine Levels From NHANES 2013-2020.

Secondhand smoke (SHS) poses a significant health risk. However, individuals who do not smoke may be unaware of their exposure, thereby failing to take protective actions promptly. We assessed the prevalence of underreported nicotine exposure in a nationally representative sample of US nonsmoking adults using data from the US National Health and Examination Survey. Individuals with underreported nicotine exposure were defined as those who reported no exposure to all tobacco products (traditional tobacco, nicotine replacements, and e-cigarettes) or SHS, yet had detectable levels of serum cotinine (>0.015 ng/mL). We fitted logistic regression models to determine sociodemographic and chronic condition factors associated with underreported nicotine exposure. Our analysis included 13 503 adults aged 18 years and older. Between 2013 and 2020, the prevalence of self-reported SHS exposure, serum cotinine-assessed nicotine exposure, and underreported nicotine exposure among US nonsmokers were 22.0%, 51.2%, and 34.6%, respectively. Remarkably, 67.6% with detectable serum cotinine reported no SHS exposure. Males, non-Hispanic blacks, individuals of other races (including Asian Americans, Native Americans, and Pacific Islanders), and those without cardiovascular diseases were more likely to underreport nicotine exposure than their counterparts. The median serum cotinine value was higher in respondents who reported SHS exposure (0.107 ng/mL) than in those who reported no exposure (0.035 ng/mL). We estimate that approximately 56 million US residents had underreported nicotine exposure. Over a third of US nonsmokers underreport their nicotine exposure, underlining the urgent need for comprehensive public awareness campaigns and interventions. Further research into sociodemographic determinants influencing this underreporting is needed. Understanding the extent of underreported nicotine exposure is crucial for developing effective public health strategies and interventions. It is imperative to bolster public consciousness about the risks associated with SHS. Additionally, surveillance tools should also incorporate measures of exposure to outdoor SHS and e-cigarette vapor to enhance the quality of data monitoring. Findings from this study can guide tobacco control initiatives and inform smoke-free air legislation.

Trends and factors associated with secondhand smoke exposure among US cancer survivors, 2013-2020.

Secondhand smoke (SHS) poses a significant public health threat. Cancer survivors are at a greater risk of adverse health outcomes from SHS because of its association with poor prognosis and other downstream clinical events. A nationally representative sample of US adults aged 20years and older was analyzed from the National Health and Nutrition Examination Survey between 2013 and 2020. Data on indoor SHS exposure were reported by 16,778 adults who were not currently smoking (1775 cancer survivors; 15,003 individuals without a cancer history). The weighted prevalence of SHS exposure was estimated and compared across sociodemographic and health-related characteristics. Multivariable logistic regression models were fitted to identify correlates of SHS exposure. Of the 1775 nonsmoking cancer survivors (mean age, 64.9years; 57.0% female; 84.4% non-Hispanic Whites), 15.8% reported SHS exposure. No significant change in trends of SHS exposure was observed during the study period. The prevalence of SHS exposure was higher in cancer survivors who were younger, racial minorities, and had a household income below 130% of the federal poverty level. After adjustment for multiple correlates, age below 40 years, low income, smoking history, and diagnosis within 2 years were associated with SHS exposure. Cancer survivors were most likely to report that SHS exposure occurred at home or in a car. The prevalence of SHS exposure among cancer survivors remained steady in the past decade. However, disparities exist in SHS exposure among cancer survivors across sociodemographic characteristics and smoking status. Smoking cessation programs should be promoted among caregivers and families of cancer survivors.

Prevalence of Secondhand Smoke and Its Associated Factors Among Pregnant Women Attending Antenatal Care at a Hospital in Yangon Region, Myanmar.

Smokers are not the only ones who suffer the effects of tobacco; those around them are also harmed, particularly vulnerable groups such as pregnant women. This study aimed to describe the prevalence of secondhand smoke (SHS) among pregnant women and the factors associated with SHS exposure. This study was a cross-sectional descriptive study conducted at Central Women's Hospital in the Yangon Region in 2022. The prevalence of SHS exposure was described, and multivariate analyses were conducted to determine the associated factors. Out of 407 participants, the prevalence of SHS exposure was 65.4%. Education level, religion, smoking rules at home, visiting public places, and avoidance of SHS during pregnancy were significantly associated with SHS exposure. The findings highlighted the need for community guidance programs, policies, and interventions to establish smoke-free environments. It is also important to conduct behavioral interventions for smokers, especially to avoid SHS for pregnant women.