Who lives in the same households as smokers? Evidence from a full household survey in Ningbo, China Open Access

Xiong, Wei (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/pz50gw28m?locale=en


Background. Secondhand smoke (SHS) exposure in the home is a major cause of ill-health, especially among those exposed to SHS due to living with smokers. Evaluations of nicotine concentrations and individual surveys are the two commonly used methods to estimate exposure to SHS at home.

Objective. Conduct a survey to describe the characteristics of all household members of a random sample of households to estimate the prevalence of SHS at home and identify the specific characteristics of households with smokers.

Methods. A sample of 1120 households from Ningbo, China was selected using a multi-stage stratified sampling method. Demographic information and smoking status of all residents in each selected household was obtained and the prevalence of SHS exposure among those who live in these homes was estimated. Conditional logistic regression models were used to examine the association between household characteristics (number of adult males and females, number of children, income level, etc) and SHS exposure status.

Results. Among the 1120 surveyed households, 566 (50.5%) had one current smoker and 72 (6.4%) had two or more current smokers; 706 of the 720 identified smokers (98.1%) were male. Overall, 57.5% of non-smoking women, 64.1% of non-smoking children under 18, and 63.2% of non-smoking children under 7 were exposed to SHS in home. Among the 638 households with current smokers, 569 (89.2%) of them also had non-smoking females, 246 (38.6%) of them had non-smoking children under 18, and 98 (15.4%) of them had non-smoking children under 7. Households with smokers were not different from households without smokers in terms of income and wealth, the presence of children in the home or the mean age of the adults in the home. Smoking households had more male household members than non-smoking households; after controlling for the number of males, non-smoking households had longer mean years of education among adult residents.

Conclusion. SHS exposure in the homes of women and children in urban China is a major public health problem that exists in almost all types of households. It indicates that a comprehensive tobacco control program targeted on household exposure to SHS is urgently needed.

Table of Contents

Chapter 1: Introduction...1
Chapter 2: Literature Review...3

2.1. Secondhand smoking (SHS)...3
2.2. Health effects of SHS...3

2.2.1. Adverse health effects of SHS exposure on women...5
2.2.2. Adverse health effects of SHS exposure on children...5

2.3. Development effects of SHS...6
2.4. Measurement of SHS...7
2.5. Global epidemic of SHS...9

2.5.1. Global efforts of SHS exposure prevention...11
2.5.2. Context of SHS control in China...11

2.6. SHS at home...13
2.7. SHS at home in China...14
2.8. Rationale for this study...15

Chapter 3: Manuscript...16

Authors' contribution...16
Cover page...17

*Figure 1...29
*Table 1...30
*Table 2...31
*Table 3...32
*Table 4...33


Chapter 4: Conclusion and Recommendation...35

4.1. Strengthen smoke-free regulations in public places...36
4.2. Support community-based interventions in achieving smoke-free homes...37
4.3. Improve smoking cessation services...39
4.4. Monitor and evaluate new policies...40


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