International Healthcare Center, Asan Medical Center, Seoul, Republic of Korea.
Division of Cancer Prevention, National Cancer Control Research Institute, National Cancer Center, Gyeonggi-do, Republic of Korea.
Nicotine Tob Res. 2021 Aug 18;23(9):1518-1526. doi: 10.1093/ntr/ntab051.
The expansion of smoke-free policies has reduced the prevalence of second-hand smoke (SHS) exposure; however, declines differ according to socioeconomic positions. We evaluated the trends in socioeconomic inequalities related to SHS exposure in nonsmoking Korean adults from 2008 to 2018.
We analyzed 30,027 nonsmoking adults from the Korea National Health and Nutrition Examination Survey 2008 to 2018. We evaluated trends in urine cotinine levels, self-reported prevalence of SHS exposure at workplaces and homes, and people exhibiting nonmeasurable urine cotinine levels between 2008 and 2018. To evaluate the yearly decline differences of urine cotinine levels according to socioeconomic positions, we calculated the interaction effects of year and education, household incomes, and occupation from linear regression analysis.
In the last 11 years, the geometric means of urine cotinine levels decreased from 3.53 (95% CI 2.96-4.19) ng/mL to 0.60 (0.57-0.64) ng/mL in males, and from 2.36 (2.03-2.73) ng/mL to 0.53 (0.51-0.56) ng/mL in females. The prevalence of SHS exposure at workplaces and homes also declined. In the multivariate model, the interaction effects between education and years were significant; therefore, indicating a substantial yearly decline of urine cotinine levels in higher educated individuals. The interaction effects between household incomes and years were only significant among males; the interaction effects between occupations and years were not significant.
SHS exposure in nonsmoking Korean adults has consistently decreased; however, socioeconomic inequalities related to SHS exposure by education level have widened. Policies targeting socioeconomically disadvantaged populations should be implemented to decrease the disparities of SHS exposure.
Along with tobacco control policies, the prevalence of self-reported and urinary cotinine verified SHS exposure has decreased in the last 11 years. In contrast, the socioeconomic inequalities related to SHS exposure by education level have increased over time. This study emphasizes the need for implementing tobacco control policies to reduce disparities of SHS exposure.
随着无烟政策的扩大，二手烟（SHS）暴露的流行率有所降低；然而，下降情况因社会经济地位而异。我们评估了 2008 年至 2018 年期间，非吸烟韩国成年人中与 SHS 暴露相关的社会经济不平等趋势。
我们分析了 2008 年至 2018 年韩国国家健康与营养调查中的 30027 名非吸烟成年人。我们评估了 2008 年至 2018 年期间尿液可替宁水平、工作场所和家庭中自我报告的 SHS 暴露率以及尿液可替宁水平无法测量的人群的趋势。为了评估根据社会经济地位，尿液可替宁水平的逐年下降差异，我们从线性回归分析中计算了年份与教育、家庭收入和职业之间的交互效应。
在过去的 11 年中，男性尿液可替宁水平的几何平均值从 3.53（95%CI 2.96-4.19）ng/mL 下降到 0.60（0.57-0.64）ng/mL，女性从 2.36（2.03-2.73）ng/mL 下降到 0.53（0.51-0.56）ng/mL。工作场所和家庭中的 SHS 暴露率也有所下降。在多变量模型中，教育与年份之间的交互作用显著；因此，这表明受过高等教育的个体尿液可替宁水平的年下降幅度较大。家庭收入与年份之间的交互作用仅在男性中显著；职业与年份之间的交互作用不显著。
非吸烟韩国成年人的 SHS 暴露率持续下降；然而，与教育水平相关的 SHS 暴露的社会经济不平等现象有所扩大。应该实施针对社会经济弱势群体的政策，以减少 SHS 暴露的差异。
随着控烟政策的实施，过去 11 年来，自我报告和尿液可替宁验证的 SHS 暴露率有所下降。相反，与教育水平相关的 SHS 暴露的社会经济不平等程度随时间而增加。本研究强调了实施控烟政策以减少 SHS 暴露差异的必要性。
