Ma Chuanwei, Heiland Emerald G, Li Zilin, Zhao Min, Liang Yajun, Xi Bo
Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden.
Lancet Glob Health. 2021 Dec;9(12):e1667-e1678. doi: 10.1016/S2214-109X(21)00365-X. Epub 2021 Sep 24.
Secondhand smoke exposure can cause morbidity and premature mortality. However, the global prevalence of, and trends in, secondhand smoke exposure among adolescents are poorly documented. We aimed to assess the prevalence of, and trends in, secondhand smoke exposure among adolescents from 1999 to 2018.
We did an analysis of the most recent data from the Global Youth Tobacco Survey (GYTS), a nationally representative, self-administered, school-based cross-sectional survey of tobacco use and related factors among adolescents aged 12-16 years worldwide. Data from 142 countries and territories that had done a GYTS between 2010 and 2018, comprising 711 366 participants, were used to assess the prevalence of secondhand smoke exposure. Data from 131 countries and territories that had done two or more surveys between 1999 and 2018, comprising 1 405 458 participants, were used to assess trends in secondhand smoke exposure. The frequency of secondhand smoke exposure at home, in public places, or in any place was defined as follows, based on students' responses: 1 or more days, 3 or more days, 5 or more days, or daily during the past 7 days.
Based on the most recent surveys done in 142 countries between Jan 1, 2010, and Dec 31, 2018, the global prevalence of secondhand smoke exposure in any place was 62·9% (95% CI 61·7-64·1) on 1 or more days, 51·0% (49·8-52·1) on 3 or more days, 40·1% (38·9-41·2) on 5 or more days, and 32·5% (31·5-33·6) daily during the past 7 days. The prevalence of secondhand smoke exposure at home was 33·1% (95% CI 32·1-34·1) on 1 or more days, 20·1% (19·3-20·9) on 3 or more days, 14·9% (14·2-15·7) on 5 or more days, and 12·3% (11·7-13·0) daily during the past 7 days; and in public places the prevalence of secondhand smoke exposure was 57·6% (56·4-58·8) on 1 or more days, 43·4% (42·2-44·6) on 3 or more days, 30·3% (29·2-31·5) on 5 or more days, and 23·5% (22·5-24·5) daily during the past 7 days. Between Jan 1, 1999, and Dec 31, 2018, the prevalence of secondhand smoke exposure (on ≥1 day during the past 7 days) in any place decreased in 57 (43·5%) of 131 countries, increased in 27 (20·6%), and remained unchanged in 47 (35·9%). Although the prevalence of secondhand smoke exposure at home decreased in 86 (65·6%) countries, the prevalence in public places did not change in 46 (35·1%) countries and increased in 40 (30·5%).
Secondhand smoke exposure among adolescents remains a serious public health challenge worldwide. Although the prevalence of secondhand smoke exposure at home decreased in most countries, the prevalence in public places increased or remained unchanged in most countries between 1999 and 2018. These findings emphasise the need to strengthen smoke-free policies, especially in public places.
Youth Team of Humanistic and Social Science of Shandong University, Jinan, China.
For the Chinese translation of the abstract see Supplementary Materials section.
接触二手烟会导致发病和过早死亡。然而，全球青少年二手烟接触的流行情况及趋势鲜有文献记载。我们旨在评估1999年至2018年期间青少年二手烟接触的流行情况及趋势。
我们对全球青少年烟草调查（GYTS）的最新数据进行了分析，这是一项具有全国代表性的、由青少年自行填写的、基于学校的横断面调查，调查对象为全球12至16岁青少年的烟草使用及相关因素。来自142个国家和地区的数据（这些国家和地区在2010年至2018年期间开展了GYTS，共711366名参与者）用于评估二手烟接触的流行情况。来自131个国家和地区的数据（这些国家和地区在1999年至2018年期间开展了两次或更多次调查，共1405458名参与者）用于评估二手烟接触的趋势。根据学生的回答，将在家中、公共场所或任何地方接触二手烟的频率定义如下：过去7天内1天或更多天、3天或更多天、5天或更多天、或每天。
基于2010年1月1日至2018年12月31日期间在142个国家进行的最新调查，在任何地方二手烟接触的全球流行率为：过去7天内1天或更多天为62.9%（95%CI 61.7 - 64.1），3天或更多天为51.0%（49.8 - 52.1），5天或更多天为40.1%（38.9 - 41.2），过去7天内每天为32.5%（31.5 - 33.6）。在家中二手烟接触的流行率为：过去7天内1天或更多天为33.1%（95%CI 32.1 - 34.1），3天或更多天为20.1%（19.3 - 20.9），5天或更多天为14.9%（14.2 - 15.7），过去7天内每天为12.3%（11.7 - 13.0）；在公共场所二手烟接触的流行率为：过去7天内1天或更多天为57.6%（56.4 - 58.8），3天或更多天为43.4%（42.2 - 44.6），5天或更多天为30.3%（29.2 - 31.5），过去7天内每天为23.5%（22.5 - 24.5）。在1999年1月1日至2018年12月31日期间，131个国家中有57个（43.5%）国家在任何地方二手烟接触的流行率（过去7天内≥1天）下降，27个（20.6%）国家上升，47个（35.9%）国家保持不变。虽然86个（65.6%）国家在家中二手烟接触的流行率下降，但46个（35.1%）国家在公共场所的流行率没有变化，40个（30.5%）国家上升。
青少年二手烟接触在全球范围内仍然是一项严峻的公共卫生挑战。虽然大多数国家在家中二手烟接触的流行率下降，但在1999年至2018年期间，大多数国家在公共场所的流行率上升或保持不变。这些发现强调了加强无烟政策的必要性，尤其是在公共场所。
中国济南山东大学人文社会科学青年团队。
中文翻译摘要见补充材料部分。
