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Gaceta Sanitaria

Print version ISSN 0213-9111


LLETJOS, Paula et al. Association between exposure to second-hand smoke and health status in children. Gac Sanit [online]. 2020, vol.34, n.4, pp.363-369.  Epub Feb 15, 2021. ISSN 0213-9111.


This study aimed to estimate the association between second-hand smoke (SHS) exposure in children and asthma, wheezing and perceived health.


A cross-sectional study based on a telephone survey was performed on a representative sample of 2411 children under 12 years old in Spain. Exposure to SHS in private and public settings, and the prevalence of asthma, wheezing and perceived poor health were described. The association between health indicators and SHS exposure was analyzed using multivariate Poisson regression models with robust variance according to age and educational level.


The prevalence of SHS exposure in children was 29.2% in private settings and 42.5% in public settings. There was no association between SHS exposure and asthma, wheezing and perceived poor health in children ≤5 years. In children aged 6-11 years with parents with primary/secondary education, presenting asthma (adjusted prevalence ratio [aPR]: 2.1; 95% confidence interval [95%CI]: 1.2-3.8) and worse perceived health (aPR: 1.6; 95%CI: 1.1-2.1) were positively associated with SHS exposure in private settings. In children with parents with university studies, a negative association between SHS exposure and asthma (aPR: .3; 95%CI: 0.1-0.7) and wheezing (aPR: 0.3; 95%CI: 0.1-0.8) was observed.


There are differences in the association between SHS exposure and asthma, wheezing and poor perceived health according to educational level. Interventions with an equity perspective aimed at reducing SHS exposure in childhood should be implemented.

Keywords : Tobacco smoke pollution; Asthma; Respiratory sounds; Children; Socioeconomic factors; Equity.

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