Stierman Bryan, Helms Garrison Veronica, Brody Debra J, Bachand Jacqueline V
Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, United States.
U.S. Department of Housing and Urban Development, Office of Policy Development and Research, Washington, DC, United States.
Nicotine Tob Res. 2025 Jan 13. doi: 10.1093/ntr/ntaf006.
The prevalence of cigarette smoking is high among U.S. Department of Housing and Urban Development (HUD) assistance recipients, putting others at risk for secondhand smoke (SHS) exposure. We evaluated the burden of SHS exposure among HUD-assisted children, adolescents, and adults.
Using 2007-2018 National Health and Nutrition Examination Survey (NHANES) data linked with HUD administrative data, we assessed SHS exposure prevalence, defined using serum cotinine, among non-tobacco, non-nicotine-using, HUD-assisted children and adolescents (ages 3-17 years, n=955) and adults (ages ≥18 years, n=878) and among low-income, HUD-unassisted children and adolescents (n=5,788) and adults (n=8,027). Time trends were evaluated. Unadjusted and adjusted multivariable logistic regression models were created to assess SHS exposure by HUD assistance status.
The prevalence of SHS exposure during 2015-2018 was 73.2% [95% CI: 63.2%-81.7%] among HUD-assisted children and adolescents and 50.1% [40.1%-60.1%] among HUD-assisted adults. Decreases in SHS exposure among HUD-assisted individuals from 2007-2010 through 2015-2018 were significant only for ages 12-17 years (78.6% [68.0%-87.0%] to 64.3% [52.5%-74.9%]; P=0.04). Among low-income individuals, SHS exposure was higher during 2007-2018 among HUD-assisted than HUD-unassisted children and adolescents (Odds Ratio: 3.39 [2.58-4.47]) and adults (2.11 [1.66-2.68]). Results remained significant after adjusting for social, demographic, and housing characteristics.
HUD-assisted children, adolescents, and adults had higher exposure to SHS than those not receiving HUD assistance. SHS exposure among HUD-assisted individuals was high for all years studied, compared to published estimates for the general U.S. population, but did decrease among children and adolescents ages 12-17 years.
This study is the first to provide biomarker-derived prevalence estimates of SHS exposure among recipients of HUD assistance within a nationally representative sample of the United States. The findings suggest that HUD-assisted children, adolescents, and adults are an at-risk population for SHS exposure, independent of known confounding social and demographic factors.
在美国住房和城市发展部（HUD）援助接受者中，吸烟率很高，这使其他人面临二手烟暴露的风险。我们评估了接受HUD援助的儿童、青少年和成年人中二手烟暴露的负担。
利用2007 - 2018年国家健康和营养检查调查（NHANES）数据与HUD行政数据相链接，我们评估了非吸烟、非使用尼古丁的接受HUD援助的儿童和青少年（3 - 17岁，n = 955）、成年人（≥18岁，n = 878）以及低收入、未接受HUD援助的儿童和青少年（n = 5788）和成年人（n = 8027）中二手烟暴露的患病率，二手烟暴露患病率采用血清可替宁来定义。评估了时间趋势。创建了未调整和调整后的多变量逻辑回归模型，以按HUD援助状况评估二手烟暴露情况。
2015 - 2018年期间，接受HUD援助的儿童和青少年中二手烟暴露患病率为73.2% [95%置信区间：63.2% - 81.7%]，接受HUD援助的成年人中为50.1% [40.1% - 60.1%]。从2007 - 2010年到2015 - 2018年，接受HUD援助的个体中二手烟暴露的减少仅在12 - 17岁年龄段有显著意义（从78.6% [68.0% - 87.0%]降至64.3% [52.5% - 74.9%]；P = 0.04）。在低收入个体中，2007 - 2018年期间，接受HUD援助的儿童和青少年（优势比：3.39 [2.58 - 4.47]）和成年人（2.11 [1.66 - 2.68]）的二手烟暴露高于未接受HUD援助的人群。在对社会、人口和住房特征进行调整后，结果仍然显著。
接受HUD援助的儿童、青少年和成年人比未接受HUD援助的人有更高的二手烟暴露。与美国总体人群的已发表估计相比，在所有研究年份中，接受HUD援助的个体中的二手烟暴露都很高，但在12 - 17岁的儿童和青少年中确实有所下降。
本研究首次在美国具有全国代表性的样本中，提供了基于生物标志物得出的HUD援助接受者中二手烟暴露患病率估计值。研究结果表明，接受HUD援助的儿童、青少年和成年人是二手烟暴露的高危人群，独立于已知的混杂社会和人口因素。
