Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.
Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
Eur J Public Health. 2019 Aug 1;29(4):772-778. doi: 10.1093/eurpub/ckz027.
Exposure to second-hand smoke (SHS) is a preventable cause of disease and disability that can effectively be tackled by tobacco legislation. The aim of the study was to analyse the trends of SHS exposure and its sociodemographic patterning during 1996-2016 in the context of tobacco policy changes in Estonia.
Nationally representative data from biennial health surveys in 1996-2016 (n = 14 629) were used to present prevalence ratios for SHS exposure among non-smokers in Estonia. Joinpoint regression and multivariable logistic regression were used to study the sociodemographic and socio-economic differences in SHS exposure and its changes during the period.
Exposure to SHS among non-smoking men and women has declined 3.6 and 5 times, respectively, during 1996-2016. While the rate of change was constant among men throughout the period, the decline in SHS exposure among women became significantly faster after 2006 compared with the previous period. However, 15.6% [95% confidence interval (CI) 13.1-18.3%] of men and 8.8% (95% CI 7.1-10.6%) of women were still exposed to SHS in 2016 with higher odds found for younger age groups, non-Estonians and those with lower education and income.
The consistently declining prevalence of SHS exposure among non-smoking population can be at least partially attributed to implementation of tobacco legislations in 2000s. However, the existing sociodemographic and socio-economic differences in SHS exposure require further attention as those in more vulnerable positions are also more exposed to SHS-related health harms.
接触二手烟（SHS）是一种可预防的疾病和残疾的原因，可以通过烟草立法有效地解决。本研究的目的是分析在爱沙尼亚烟草政策变化的背景下，1996-2016 年 SHS 暴露及其社会人口统计学模式的趋势。
利用 1996-2016 年两年一次的全国健康调查（n=14629）的代表性数据，报告爱沙尼亚非吸烟者接触 SHS 的流行率比值。使用 Joinpoint 回归和多变量逻辑回归研究 SHS 暴露及其在该期间变化的社会人口统计学和社会经济差异。
1996-2016 年，男性和女性非吸烟者接触 SHS 的比例分别下降了 3.6 倍和 5 倍。虽然男性在整个期间的变化率保持不变，但与前一时期相比，女性接触 SHS 的下降速度在 2006 年后明显加快。然而，2016 年仍有 15.6%（95%置信区间 13.1-18.3%）的男性和 8.8%（95%置信区间 7.1-10.6%）的女性接触 SHS，年龄较小、非爱沙尼亚人、教育程度和收入较低的人群接触 SHS 的几率更高。
在 21 世纪初实施烟草立法后，非吸烟人群中 SHS 暴露的流行率持续下降。然而，由于社会人口统计学和社会经济方面的差异仍然存在，因此需要进一步关注 SHS 暴露问题，因为处于更弱势地位的人群更容易受到与 SHS 相关的健康危害。
