Factors Associated with Exposure to Passive Smoking among 12-18 year-old Students in Athens and Thessaloniki, Greece

IntroductIon Passive-smoking is a major, preventable cause of disease, disability and death. It is estimated that the majority of the world’s population is still living in countries not fully covered by smoke-free public health regulations and Greece is unfortunately one of them. The aim of our study, conducted in October 2014, was to provide up to date information regarding determinants of exposure to passive smoking among the student population of the two biggest Greek cities. Methods Our survey was conducted on a representative sample of middle and high school students (1803 in total, 810 boys and 992 girls), living in the two biggest cities of Greece. A questionnaire was developed to estimate the exposure of students to passive-smoking. Relative frequencies were calculated for all the questions and a Pearson χ2-test was used to evaluate the potential association of several variables with gender, age and smoking status. Logistic regression analysis were also applied to evaluate the association between social influences and the likelihood of being exposed to passive smoking. results A total of 86.7% of youth were exposed to passive-smoking during the 30 days preceding the survey. Daily exposure during the past 7 days was reported by 20.2% of the students. The highest rates of exposure were reported in cafes (61.2%), home (43.7%) and school (37.2%). Gender, age, smoking status, and the smoking habits of parents, siblings and friends, but also the sight of peers and teachers smoking inside the school campus, were significant determinants of students’ exposure to passive smoking. conclusIons Passive-smoking exposure is prevalent among the student population in Greece, despite the New Anti-Smoking Legislation that came into effect in July 2009. Our findings indicate that enforcement of the law and additional public health initiatives must be implemented. IntroductIon Exposure to passive-smoking is a major, preventable cause of disease, disability and death, with consequent huge economic costs. Undoubtedly, children and adolescents are the main victims of passive-smoking, as they are at considerable risk of developing cognitive impairment, cancer, asthma, acute lower respiratory tract infections, but also irreversibly impaired lung function. Furthermore, it is estimated that exposure to passive-smoking kills 600,000 children per year worldwide. Policies towards the prevention of exposure to passivesmoking have been implemented in many developed countries. However, it is estimated that 93% of the world’s population is still living in countries not fully covered by smoke-free public health regulations. Unfortunately, Greece is one of them. Previous studies (2004-2005) detected extremely high prevalence of exposure to passive smoking among adolescent students. In 2004-2005, nearly 9 out of 10 Greek students aged 13-15 years were exposed to passive-smoking either at home or outside. Despite the above, significant initiatives have been taken since the last epidemiological data were published. First and foremost, in May 2006, Greece ratified the WHO Framework Convention on Tobacco Control (FCTC), which was a significant motivation for many public health initiatives. The most important initiative was the new Greek Anti-smoking Legislation, which came into effect in July 2009, clearly stating that it is against the law to smoke in any indoor public places. Such important interventions have created optimism regarding the restriction and, ideally, the elimination of exposure to passive-smoking in public places. The aim of our study was to provide up-to-date information regarding exposure to passive-smoking among high school students in the two biggest Greek cities in 2014. Factors Associated with Exposure to Passive Smoking among 12-18 year-old Students in Athens and Thessaloniki, Greece Andreas s lappas1,2, Anna s tzortzi2, efstathia M Konstantinidi1,2 niki l dimou3, Panagiotis behrakis1,2 AFFIlIAtIon 1 Biomedical Research Foundation of the Academy of Athens, Greece 2 Smoking and lung cancer research center, Hellenic Cancer Society, Greece 3 Department of computer science and biomedical informatics, University of Thessaly, Greece corresPondence to Lappas A. Biomedical Research Foundation of the Academy of Athens (BRFAA), 4 Soranou Ephessiou st. 5 27, Athens, Greece, andreaslappaswork@ gmail.com KeY Words passive smoking, students, Greece Published by E.U. European Publishing on behalf of the European Network for Smoking and Tobacco Prevention (ENSP). © 20 5 Lappas A. This is an open access article distributed under the terms of the Creative Commons Attribution Non Commercial 0.4 International License. (http://creativecommons.org/licenses/by/4.0) Tob. Prev. Cessation 20 5; (November):7 http://dx.doi.org/ 0. 8332/tpc/60652