1Department of Alcohol, Drugs and Addiction, National Institute for Health and Welfare, Helsinki, Finland.
Scand J Public Health. 2014 Mar;42(2):184-93. doi: 10.1177/1403494813514301. Epub 2013 Dec 10.
Socioeconomic differences in children's exposure to environmental tobacco smoke (ETS) in favour of those with higher positions are known, but research is scarce on whether differences have persisted when smoking restrictions have been tightened. We examined socioeconomic differences in adolescents' ETS exposure from 1991 to 2009 in Finland where the tobacco law has gradually restricted smoking of population.
National cross-sectional surveys (1991-2009) in 12-18-year-olds (N=72,726, response rate 77-56%). An outcome measure was self-reported exposure to ETS (≥ 1 hour/day). Parents' socioeconomic and adolescent's individual social position (school performance/career) were used as independent variables. Across four time periods, associations were studied by logistic regression.
Over the study period 1991-2009, the proportion of adolescents exposed to ETS decreased from 17% to 6% (p ≤ 0.001). There were large and persistent differences between socioeconomic and parents' smoking groups. The decrease occurred in all groups but was smaller among 16-18-year-olds whose father had a low education. A steeper decline occurred among 16-18-year-olds who were not in school or were in vocational school with poor school performance compared with those with more advanced educational career. Compared with other subgroups, the decline in ETS exposure was greater among those whose parents were smokers.
Adolescents' ETS exposure remarkably decreased over time, when tobacco control measures were tightened, particularly among children of smoking parents. Socioeconomic differences persisted although diminishing differences were observed between educational groups at age 16-18.
已知儿童接触环境烟草烟雾（ETS）的社会经济差异有利于那些地位较高的人，但关于在吸烟限制收紧的情况下，这些差异是否仍然存在的研究却很少。我们研究了芬兰在逐步限制人群吸烟的情况下，青少年在 1991 年至 2009 年期间接触 ETS 的社会经济差异，因为在芬兰，吸烟法律逐渐限制了吸烟行为。
对 12-18 岁的青少年进行了全国性的横断面调查（1991-2009 年；N=72726，响应率为 77-56%）。将自我报告的 ETS 暴露（≥1 小时/天）作为因变量。父母的社会经济地位和青少年的个体社会地位（学习成绩/职业）作为自变量。在四个时间段内，采用逻辑回归分析了这些关联。
在 1991-2009 年的研究期间，接触 ETS 的青少年比例从 17%降至 6%（p≤0.001）。在社会经济和父母吸烟群体之间存在很大且持续的差异。这种下降发生在所有群体中，但在父亲受教育程度较低的 16-18 岁青少年中，降幅较小。与那些没有上学或在职业学校就读、学习成绩较差的青少年相比，16-18 岁没有上学或在职业学校就读的青少年下降更为明显。与其他亚组相比，父母吸烟的青少年 ETS 暴露下降更为明显。
随着控烟措施的加强，青少年接触 ETS 的情况在过去的时间里显著减少，尤其是在吸烟父母的孩子中。尽管在 16-18 岁的青少年中，不同教育群体之间的差异有所缩小，但社会经济差异仍然存在。
