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      Exposure to environmental tobacco smoke among South Korean adults: a cross-sectional study of the 2005 Korea National Health and Nutrition Examination Survey

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      Environmental Health
      BioMed Central

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          Abstract

          Background

          Studies have identified that environmental tobacco smoke exposure is associated with sociodemographic factors such as age, sex, and socioeconomic status, but few studies have been conducted in South Korea. In this study, the authors investigated the extent of environmental tobacco smoke exposure and factors related in a nationally representative sample of Korean adults.

          Methods

          The data of 7,801 adults aged 19 years and over collected during the 2005 Korea National Health and Nutrition Examination Survey were analyzed. Information on smoking habits and exposure to environmental tobacco smoke was obtained by self-reports using a standardized questionnaire. Risks of environmental tobacco smoke exposure conferred by sociodemographic variables and behavioral risk factors were evaluated using logistic regression methods.

          Results

          Overall, 36.1% of nonsmokers (defined as those not currently smoking) and 50.1% of current smokers were found to be exposed to environmental tobacco smoke either at work or at home. Among the nonsmokers, women were more likely to be exposed to environmental tobacco smoke at home (OR = 5.22, 95%CI, 4.08-6.67). Furthermore, an inverse relationship was found between education level and the risk of environmental tobacco smoke exposure at home (OR = 1.73, 95%CI, 1.38-2.17 for those with a high school education; OR = 2.30, 95%CI, 1.68-3.16 for those with a middle school education; and OR = 2.58, 95%CI, 1.85-3.59 for those with less than an elementary school education vs. those with a college education or more). In addition, those with office, sales service, or manual labor jobs were found to be at significantly higher risk of environmental tobacco smoke exposure at work than those with professional, administrative, or managerial jobs. Also, the risk of environmental tobacco smoke exposure in the workplace was significantly higher for alcohol drinkers than non-drinkers (OR = 1.23, 95%CI, 1.07-1.47). After adjusting for age, sex and education, it was found that those exposed to environmental tobacco smoke at home were more likely to have been admitted to hospital during the previous year (OR 1.29, 95%CI, 1.002-1.66).

          Conclusions

          In this study of Korean adults, exposure to environmental tobacco smoke at home or work was found to be affected by sex, age, marital status, educational level, and type of occupation. Accordingly, these factors should be given appropriate consideration by those developing policies or interventions designed to control exposure to environmental tobacco smoke.

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          Most cited references24

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          Smoking behaviour in Taiwan, 2001.

          To examine smoking behaviours in Taiwan and compare those behaviours to those in the USA. Using the National Health Interview Survey (NHIS) of Taiwan (2001), a survey of over 20 000 participants, frequencies were calculated for smoking, ex-smoking, quantity smoked, and exposure to environmental tobacco smoke (ETS). Breakdowns by age, sex, and socioeconomic status were also calculated. The ratio of male to female smoking rates was 10.9 to 1 among adults (46.8%/4.3%), but 3.6 to 1 among underage teenagers (14.3%/4.0%). The proportion of underage to adult smokers was three times higher for girls than for boys. Smoking prevalence substantially increased during and after high school years, and peaked in those aged 30-39 years. Smoking rates of high school age adolescents increased more than threefold if they did not attend school or if they finished their education after high school. Low income and less educated smokers smoked at nearly twice the rate of high income and better educated smokers. The smoker/ex-smoker ratio was close to 7. Male daily smokers smoked on average 17 cigarettes/day, and females, 11. Half of the total population, especially infants and women of childbearing age, were exposed to ETS at home. Taiwan has particularly high male smoking prevalence and much lower female prevalence. The low female prevalence is likely to increase if the current sex ratio of smoking by underage youth continues. The low quit rate among males, the high ETS exposure of females and young children at home, and the sharp increase in smoking rates when students leave school, are of particular concern. These observations on smoking behaviour can provide valuable insights to assist policymakers and health educators in formulating strategies and allocating resources in tobacco control.
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            Cigarette smoking and exposure to environmental tobacco smoke in China: the international collaborative study of cardiovascular disease in Asia.

            We estimated the prevalence of cigarette smoking and the extent of environmental tobacco smoke exposure (ETS) in the general population in China. A cross-sectional survey was conducted on a nationally representative sample of 15540 Chinese adults aged 35-74 years in 2000-2001. Information on cigarette smoking was obtained by trained interviewers using a standard questionnaire. The prevalence of current cigarette smoking was much higher among men (60.2%) than among women (6.9%). Among nonsmokers, 12.1% of men and 51.3% of women reported exposure to ETS at home, and 26.7% of men and 26.2% of women reported exposure to ETS in their workplaces. On the basis of our findings, 147358000 Chinese men and 15895000 Chinese women aged 35-74 years were current cigarette smokers, 8658000 men and 108402000 women were exposed to ETS at home, and 19072000 men and 55372000 women were exposed to ETS in their workplaces. The high prevalence of cigarette smoking and environmental tobacco smoke exposure in the Chinese population indicates an urgent need for smoking prevention and cessation efforts.
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              A questionnaire for assessing environmental tobacco smoke exposure.

              Exposure to environmental tobacco smoke (ETS) has been associated with adverse health consequences. In this study, the association between self-reported ETS exposure and serum cotinine levels was examined. As part of the population-based Epidemiology of Hearing Loss Study in Beaver Dam, WI, self-reported data on ETS were obtained at the 5-year follow-up examination (1998-2000; n = 2800). Serum cotinine levels were obtained on 643 of these participants (53-75 years old). Serum cotinine levels increased with reported number of hours of recent ETS exposure. Most (95.3%) participants who reported being smokers had serum cotinine levels >15 ng/mL, compared with only 2.7% of nonsmokers. Usual ETS exposure among nonsmokers was assessed with a brief questionnaire quantifying exposure at work, at home, and in social settings, and then classified into three levels of exposure. Those reporting little or no exposure had a geometric mean cotinine level of 0.06 ng/mL (95% confidence interval (CI): 0.05, 0.07), compared with 0.14 (95% CI: 0.09, 0.22) and 0.63 (95% CI: 0.36, 1.10) for those reporting moderate and high ETS exposure, respectively (F-test for trend: P < 0.001). These results suggest that the questionnaire can be used to distinguish relative levels of exposure to ETS.
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                Author and article information

                Journal
                Environ Health
                Environmental Health
                BioMed Central
                1476-069X
                2011
                3 April 2011
                : 10
                : 29
                Affiliations
                [1 ]Department of Preventive Medicine and Medical Research Institute, School of Medicine, Ewha Womans University, 911-1 Mok-6-dong, Yangcheon-gu, Seoul, Korea
                Article
                1476-069X-10-29
                10.1186/1476-069X-10-29
                3076229
                21457578
                650b2411-e6f6-40a5-af6d-e6f57f4d042c
                Copyright ©2011 Lee and Ha; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 October 2010
                : 3 April 2011
                Categories
                Research

                Public health
                Public health

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