Global association of secondhand smoke exposure locations and smoking behaviour among adolescents in 99 countries

Seohyun Hong; Yejun Son; Hyeri Lee; Soeun Kim; Hyeon jin Kim; Hyesu Jo; Jaeyu Park; Kyeongmin Lee; Hayeon Lee; Elena Dragioti; Guillaume Fond; Laurent Boyer; Guillermo f. López sánchez; Mark a. Tully; Masoud Rahmati; Lee Smith; Sunyoung Kim; Selin Woo; Dong keon Yon

doi:10.1111/apa.17319

Global association of secondhand smoke exposure locations and smoking behaviour among adolescents in 99 countries

Seohyun Hong
, Yejun Son
, Hyeri Lee
, Soeun Kim
, Hyeon jin Kim
, Hyesu Jo
, Jaeyu Park
, Kyeongmin Lee
, Hayeon Lee
, Elena Dragioti
, Guillaume Fond
, Laurent Boyer
, Guillermo f. López sánchez
, Mark a. Tully
, Masoud Rahmati
, Lee Smith
, Sunyoung Kim
, Selin Woo
, Dong keon Yon

Aix Marseille Universite

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

168 Downloads (Pure)

Abstract

Aim
This study classified 99 countries into four income groups and then analysed the impact of secondhand smoke (SHS) exposure at home, in public places and at school, on current cigarette smoking prevalence.

Methods
We utilised data from the WHO Global Youth Tobacco Survey and a meta-analysis was conducted to evaluate the prevalence and weighted odds ratios (wORs) of adolescent smoking behaviour and SHS exposure locations.

Results
Both smoking behaviours increased with higher national income levels. Smoking behaviours in high and upper-middle-income countries (HICs and UMICs) exhibited an association with SHS exposure in public places (HIC: wOR, 3.50 [95% CI, 2.85–4.31]; UMIC: wOR, 2.90 [2.60–3.23]) compared to home. Low- and lower-middle-income countries (LICs and LMICs) showed an association with SHS exposure in the home (LIC: wOR, 5.33 [3.59–7.93]; LMIC: wOR, 2.71 [2.33–3.17]) than public places. The association between current cigarette smoking and SHS exposure at home increased with lower income levels, while anticipated future use of any form of tobacco with SHS exposure in public places rose in lower income countries.

Conclusions
Targeted interventions based on income levels are essential, emphasising home strategies in lower income countries and public place efforts in higher income countries.

Original language	English
Pages (from-to)	2048-2060
Number of pages	13
Journal	Acta Paediatrica
Volume	113
Issue number	9
Early online date	11 Jun 2024
DOIs	https://doi.org/10.1111/apa.17319
Publication status	Published (in print/issue) - 30 Sept 2025

Bibliographical note

Publisher Copyright:
© 2024 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Data Availability Statement

Data are available on reasonable request. Study protocol, statistical code: available from DKY (email: [email protected]). Data set: available from the World Health Organisation and the US Centers for Disease Control and Prevention through a data use agreement.

Funding

This research was supported by grants from the National Research Foundation of Korea (NRF) funded by the Korea government (MSIT; RS\u20132023\u201300248157). The funders had no role in study design, data collection, data analysis, data interpretation or writing of the report.

Funder number
RS–2023–00248157

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 10 Reduced Inequalities

Keywords

Adolescents
GYTS
smoking
secondhand smoke
WHO
adolescents
Prevalence
Global Health
Humans
Male
Smoking/epidemiology
Adolescent
Tobacco Smoke Pollution/statistics & numerical data
Female
Developing Countries
Adolescent Behavior

Access to Document

10.1111/apa.17319

Acta AAMAuthor Accepted Manuscript, 547 KB

https://onlinelibrary.wiley.com/doi/10.1111/apa.17319

Cite this

Hong, S., Son, Y., Lee, H., Kim, S., Kim, H. J., Jo, H., Park, J., Lee, K., Lee, H., Dragioti, E., Fond, G., Boyer, L., López sánchez, G. F., Tully, M. A., Rahmati, M., Smith, L., Kim, S., Woo, S., & Yon, D. K. (2025). Global association of secondhand smoke exposure locations and smoking behaviour among adolescents in 99 countries. Acta Paediatrica, 113(9), 2048-2060. https://doi.org/10.1111/apa.17319

@article{cf3962fc9dcb4652a0fb9c6902e8633a,

title = "Global association of secondhand smoke exposure locations and smoking behaviour among adolescents in 99 countries",

abstract = "Aim This study classified 99 countries into four income groups and then analysed the impact of secondhand smoke (SHS) exposure at home, in public places and at school, on current cigarette smoking prevalence. Methods We utilised data from the WHO Global Youth Tobacco Survey and a meta-analysis was conducted to evaluate the prevalence and weighted odds ratios (wORs) of adolescent smoking behaviour and SHS exposure locations. Results Both smoking behaviours increased with higher national income levels. Smoking behaviours in high and upper-middle-income countries (HICs and UMICs) exhibited an association with SHS exposure in public places (HIC: wOR, 3.50 [95\% CI, 2.85–4.31]; UMIC: wOR, 2.90 [2.60–3.23]) compared to home. Low- and lower-middle-income countries (LICs and LMICs) showed an association with SHS exposure in the home (LIC: wOR, 5.33 [3.59–7.93]; LMIC: wOR, 2.71 [2.33–3.17]) than public places. The association between current cigarette smoking and SHS exposure at home increased with lower income levels, while anticipated future use of any form of tobacco with SHS exposure in public places rose in lower income countries. Conclusions Targeted interventions based on income levels are essential, emphasising home strategies in lower income countries and public place efforts in higher income countries.",

keywords = "Adolescents, GYTS, smoking, secondhand smoke, WHO, adolescents, Prevalence, Global Health, Humans, Male, Smoking/epidemiology, Adolescent, Tobacco Smoke Pollution/statistics \& numerical data, Female, Developing Countries, Adolescent Behavior",

author = "Seohyun Hong and Yejun Son and Hyeri Lee and Soeun Kim and Kim, \{Hyeon jin\} and Hyesu Jo and Jaeyu Park and Kyeongmin Lee and Hayeon Lee and Elena Dragioti and Guillaume Fond and Laurent Boyer and L{\'o}pez s{\'a}nchez, \{Guillermo f.\} and Tully, \{Mark a.\} and Masoud Rahmati and Lee Smith and Sunyoung Kim and Selin Woo and Yon, \{Dong keon\}",

note = "Publisher Copyright: {\textcopyright} 2024 Foundation Acta Paediatrica. Published by John Wiley \& Sons Ltd.",

year = "2025",

month = sep,

day = "30",

doi = "10.1111/apa.17319",

language = "English",

volume = "113",

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}

Hong, S, Son, Y, Lee, H, Kim, S, Kim, HJ, Jo, H, Park, J, Lee, K, Lee, H, Dragioti, E, Fond, G, Boyer, L, López sánchez, GF, Tully, MA, Rahmati, M, Smith, L, Kim, S, Woo, S & Yon, DK 2025, 'Global association of secondhand smoke exposure locations and smoking behaviour among adolescents in 99 countries', Acta Paediatrica, vol. 113, no. 9, pp. 2048-2060. https://doi.org/10.1111/apa.17319

TY - JOUR

T1 - Global association of secondhand smoke exposure locations and smoking behaviour among adolescents in 99 countries

AU - Hong, Seohyun

AU - Son, Yejun

AU - Lee, Hyeri

AU - Kim, Soeun

AU - Kim, Hyeon jin

AU - Jo, Hyesu

AU - Park, Jaeyu

AU - Lee, Kyeongmin

AU - Lee, Hayeon

AU - Dragioti, Elena

AU - Fond, Guillaume

AU - Boyer, Laurent

AU - López sánchez, Guillermo f.

AU - Tully, Mark a.

AU - Rahmati, Masoud

AU - Smith, Lee

AU - Kim, Sunyoung

AU - Woo, Selin

AU - Yon, Dong keon

PY - 2025/9/30

Y1 - 2025/9/30

N2 - Aim This study classified 99 countries into four income groups and then analysed the impact of secondhand smoke (SHS) exposure at home, in public places and at school, on current cigarette smoking prevalence. Methods We utilised data from the WHO Global Youth Tobacco Survey and a meta-analysis was conducted to evaluate the prevalence and weighted odds ratios (wORs) of adolescent smoking behaviour and SHS exposure locations. Results Both smoking behaviours increased with higher national income levels. Smoking behaviours in high and upper-middle-income countries (HICs and UMICs) exhibited an association with SHS exposure in public places (HIC: wOR, 3.50 [95% CI, 2.85–4.31]; UMIC: wOR, 2.90 [2.60–3.23]) compared to home. Low- and lower-middle-income countries (LICs and LMICs) showed an association with SHS exposure in the home (LIC: wOR, 5.33 [3.59–7.93]; LMIC: wOR, 2.71 [2.33–3.17]) than public places. The association between current cigarette smoking and SHS exposure at home increased with lower income levels, while anticipated future use of any form of tobacco with SHS exposure in public places rose in lower income countries. Conclusions Targeted interventions based on income levels are essential, emphasising home strategies in lower income countries and public place efforts in higher income countries.

AB - Aim This study classified 99 countries into four income groups and then analysed the impact of secondhand smoke (SHS) exposure at home, in public places and at school, on current cigarette smoking prevalence. Methods We utilised data from the WHO Global Youth Tobacco Survey and a meta-analysis was conducted to evaluate the prevalence and weighted odds ratios (wORs) of adolescent smoking behaviour and SHS exposure locations. Results Both smoking behaviours increased with higher national income levels. Smoking behaviours in high and upper-middle-income countries (HICs and UMICs) exhibited an association with SHS exposure in public places (HIC: wOR, 3.50 [95% CI, 2.85–4.31]; UMIC: wOR, 2.90 [2.60–3.23]) compared to home. Low- and lower-middle-income countries (LICs and LMICs) showed an association with SHS exposure in the home (LIC: wOR, 5.33 [3.59–7.93]; LMIC: wOR, 2.71 [2.33–3.17]) than public places. The association between current cigarette smoking and SHS exposure at home increased with lower income levels, while anticipated future use of any form of tobacco with SHS exposure in public places rose in lower income countries. Conclusions Targeted interventions based on income levels are essential, emphasising home strategies in lower income countries and public place efforts in higher income countries.

KW - Adolescents

KW - GYTS

KW - smoking

KW - secondhand smoke

KW - WHO

KW - adolescents

KW - Prevalence

KW - Global Health

KW - Humans

KW - Male

KW - Smoking/epidemiology

KW - Adolescent

KW - Tobacco Smoke Pollution/statistics & numerical data

KW - Female

KW - Developing Countries

KW - Adolescent Behavior

UR - https://www.scopus.com/pages/publications/85195603311

UR - https://pure.ulster.ac.uk/en/publications/cf3962fc-9dcb-4652-a0fb-9c6902e8633a

U2 - 10.1111/apa.17319

DO - 10.1111/apa.17319

M3 - Article

C2 - 38859709

SN - 0803-5253

VL - 113

SP - 2048

EP - 2060

JO - Acta Paediatrica

JF - Acta Paediatrica

IS - 9

ER -

Global association of secondhand smoke exposure locations and smoking behaviour among adolescents in 99 countries

Abstract

Bibliographical note

Data Availability Statement

Funding

UN SDGs

Keywords

Access to Document

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Cite this