Secondhand Smoke Exposure among 3.2 Billion Children in 20 Countries

INTRODUCTION:  Exposure to secondhand smoke (SHS) can cause diseases and deaths among children. Although countries have made efforts to restrict smoking in public places, the home remains a place where many children particularly those in low socio-economic status, may be exposed to SHS. Children may be more vulnerable to SHS since they have little control over their indoor environments, which increases the risk for potential health problems. This study examined Global Adult Tobacco Survey (GATS) to estimate the number of children exposed to SHS in homes in low and middle-income countries.

METHODS:  We analyzed GATS data for 20 low and middle-income countries (Argentina, Bangladesh, China, Egypt, India, Indonesia, Malaysia, Mexico, Nigeria, Panama, Philippines, Poland, Qatar, Romania, Russia, Thailand, Turkey, Ukraine, Uruguay, and Viet Nam). Using questions about household members and exposure to SHS in homes, we estimated the number of children exposed to SHS in homes. Weighted country data was used to calculate prevalence estimates with 95% confidence intervals taking into account the complex sample design.

RESULTS:  More than 1.5 billion children (48.7 percent of all children) under age 15 were exposed to SHS in homes in the 20 low and middle-income countries.. SHS exposure among children varied widely from 4.5% in Panama to 79.0% in India. The percent of children living with at least one adult smoker exposed to SHS ranged from 36.1% in Egypt to 90.8% in Mexico. Although Panama had the lowest exposure percentages, about three in four of children living with at least one smoker in the countries were exposed to SHS in homes.

CONCLUSIONS:  

Given the dangers of exposure to SHS to children, there is an urgent need to address smoking among adults and to promote widespread implementation of smoke-free rules in homes among low and middle-income countries.