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Trends in the Socioeconomic Inequalities Related to Second-Hand Smoke Exposure as Verified by Urine Cotinine Levels Among Nonsmoking Adults: Korea National Health and Nutrition Examination Survey 2008?2018

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Abstract
Introduction
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.

Methods
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.

Results
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.

Conclusions
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.

Implications
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.
Author(s)
강서영임민경조홍준
Issued Date
2021
Type
Article
Keyword
AdultCotinine* / analysisFemaleHumansMaleNutrition SurveysOccupationsRepublic of Korea / epidemiologyTobacco Smoke Pollution* / analysis
DOI
10.1093/ntr/ntab051
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7722
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2505364471&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Trends%20in%20the%20Socioeconomic%20Inequalities%20Related%20to%20Second-Hand%20Smoke%20Exposure%20as%20Verified%20by%20Urine%20Cotinine%20Levels%20Among%20Nonsmoking%20Adults:%20Korea%20National%20Health%20and%20Nutrition%20Examination%20Survey%202008%3F2018&offset=0&pcAvailability=true
Publisher
NICOTINE & TOBACCO RESEARCH
Location
영국
Language
영어
ISSN
1462-2203
Citation Volume
23
Citation Number
9
Citation Start Page
1518
Citation End Page
1526
Appears in Collections:
Medicine > Medicine
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