Social Inequalities in Secondhand Smoke Among Japanese Non-smokers: A Cross-Sectional Study

BACKGROUND Secondhand smoke (SHS) causes many deaths. Inequalities in SHS have been reported in several countries; however, the evidence in Asian countries is scarce. We aimed to investigate the association between socioeconomic status (SES) and SHS at home and the workplace/school among non-smoking Japanese adults. METHODS Cross-sectional data from the Miyagi Prefectural Health Survey 2014 were analyzed. Self-reported questionnaires were randomly distributed to residents ≥20 years of age and 2,443 (92.8%) responded. The data of the 1,738 and 1,003 respondents were included to the analyses for SHS in the past month at home and at the workplace/school, respectively. Ordered logistic regression models considering possible confounders, including knowledge of the adverse health effects of tobacco, were applied. RESULTS The prevalence of SHS at home and the workplace/school was 19.0% and 39.0%, respectively. Compared with ≥13 years of education, odds ratios (ORs) and 95% confidence intervals (CIs) for SHS at home were 1.94 (95% CI, 1.42-2.64) for 10-12 years and 3.00 (95% CI, 1.95-4.60) for ≤9 years; those for SHS at the workplace/school were 1.80 (95% CI, 1.36-2.39) and 3.82 (95% CI, 2.29-6.36), respectively. Knowledge of the adverse health effects of tobacco was significantly associated with lower SHS at home (OR 0.95; 95% CI, 0.91-0.98) but it was not associated with SHS at the workplace/school (OR 1.02; 95% CI, 0.98-1.06). CONCLUSIONS Social inequalities in SHS existed among Japanese non-smoking adults. Knowledge about tobacco was negatively associated with SHS at home but not at workplace/school.