영·유아 간접흡연, 피해인지 교육 및 금연교육현황

박애경(Aekyung Park) 중앙대학교 한국교육문제연구소 2013 한국교육문제연구 Vol.31 No.4

본 연구는 영유아의 간접흡연노출현황, 간접흡연에 따른 피해인지교육 및 금연교육현황을 조사하기 위해 수 원시 거주 영유아 약 2500명의 부모를 대상으로 설문지를 배포하여 실시되었고 결과는 다음과 같다. 첫째, 수원시 거주 영유아를 대상으로 한 결과 영유아의 간접흡연 노출현황은 가족 중 흡연자기 있음이 55.7% 이상으로 나타나 과반수 이상의 영유아들이 간접흡연에 노출된 것으로 나타난다. 따라서 영유아 간접흡연의  주요 제공자이면서 동시에 예방자가 되는 부모변인을 고려하여 부모에게 간접흡연의 피해 교육을 필수적으로  실시하여야 할 것으로 사료된다. 둘째, 간접흡연에 대한 피해인지와 금연교육 여부를 조사한 결과 영유아의 간접흡연 피해에 대한 부모의 인지 여부와 영아의 인지여부를 나누어 조사한 결과, 부모의 간접흡연 피해인지에 대해 안다고 응답한 비율이  97.86%로 매우 높게 나타남으로 부모들의 간접흡연 피해인지 지식정도가 높음이 나타났다. 한편, 영유아의  피해인지 여부를 아는가에 대한 비율은 33.94%가 안다, 66.06%가 모른다고 응답함으로써 영유아들의 간접흡 연피해 인지에 대한 지식이 매우 낮음을 나타내고 있다. 또한, 자녀에 대한 금연교육 지도여부에서는 없다가  81.84%로 1780명이 자녀에게 금연교육에 대해 지도하지 않는 것으로 나타났다. 단지, 18.16%인 395명만이 자 녀에게 금연교육을 하고 있는 것으로 조사되었다. 영유아의 간접흡연의 노출비율이 조사대상 과반수 이상을  차지할 정도로 높고, 피해인지여부측면에서는 부모는 높은 수치를 나타냈으나 정작 영유아의 피해인지는 낮 게 나타났다. 또한 영유아의 연령이 낮을수록 흡연시 동석비율이 높다는 것, 따라서 간접흡연의 피해가 어릴 수록 높다는 감안할 때 보다 어린 시기부터 금연교육 및 피해인지교육과 함께 부모교육도 지속적으로 실시해 야 할 것으로 사료된다. 이상의 연구결과는 영·유아 금연교육을 위한 프로그램 개발의 기초자료로 활용할 수  있다. The purposes of the study were to investigate how many young children were exposed to secondhand  smoke, what levels of damage recognition of secondhand smoke parents and their children had, and what  levels of prevention of smoking education the parents gave their children. Subjects were 2,500 parents of  2- to 5-year-old children in Suwon city. A survey was used to collect the data and Chi-square was utilized  to analyze them. The results are as follows: 1) exposure of young children to secondhand smoke was up  to 55.7%; 2) parents showed a higher level of recognition (97.86%) toward children’s exposure to  secondhand smoke, and young children showed low levels of recognition (33.94%) toward exposure to  secondhand smoke; 3) parents showed low levels of smoke prevention education toward exposure to  secondhand smoke for their children; 4) the Youngthong-gu region had higher exposure of children’s  secondhand smoke than other regions; 5) children’s age, the type of daycare centers and attending time  of daycare, and children’s presence during smoking were correlated with secondhand smoke. The results  of the study suggest the following. The majority of young children were exposed to secondhand smoke.  While the rate of parents’ damage recognition was high, the rate of young children’s damage recognition  was low. In addition, the rate of younger children’s presence during smoking was higher than the rate of  older children’s. This means that younger children suffer more from secondhand smoke than older  children do. Therefore, smoking prevention and damage recognition education for young children should  be implemented in early childhood. Parents should also continue to support this education for their  children. As stated above, these results of the study, as fundamental data, may be applied to develop  smoking prevention programs for young children.

간접흡연과 비만간의 관계 분석

김지훈 ( Ji Hoon Kim ),정완교 ( Wan Kyo Chung ) 한국보건경제정책학회(구 한국보건경제학회) 2014 보건경제와 정책연구 Vol.20 No.3

본 연구에서는 2005년 국민건강영양조사를 이용하여 흡연보다 내생성의 문제가 작은 간접흡연이 비만에 미치는 영향을 분석하였다. 직장 및 가정내의 간접흡연에 노출되는 시간이 체질량 및 허리둘레로 측정된 비만에 미치는 영향을 분석한 결과 간접흡연이 증가할수록 비만이 증가하였다. 한편 2003년에 도입된 직장 내 흡연규제가 간접흡연을 특히 직장내 간접흡연을 통계적으로 유의하게 줄였다. 이는 금연정책이 흡연뿐만 아니라 간접흡연을 줄인다는 매우 유의미한 결과이다. 한편, 간접흡연이 흡연에 비해 작지만 내생성의 문제를 가지고 있을 수 있어 이러한 내생성의 문제를 통제하기 위해 직장내 흡연규제를 도구변수로 사용하여 분석한 결과 간접흡연과 비만은 통계적으로 유의한 관계를 보이지 않았다. 더불어, 선택편의 혹은 건강편의에 따른 문제를 줄이기 위해 65세 미만을 분석대상으로 한정하여 분석하여도, 개인의 일일 에너지의 섭취량을 추가적으로 통제하고 분석하여도 동일한 결과를 얻었다. 금연정책이 흡연뿐만 아니라 간접흡연을 줄이고, 줄어든 간접흡연이 비만에 통계적으로 유의한 영향을 보이지 않았다는 이러한 결과는 금연정책의 비용으로 비만이 중요하게 고려될 필요가 없다는 주요한 시사점을 제시한다. Presently, there is a growing concern on smoking and obesity as global health risks. Both are responsible for worsening individual health, growing medical cost and productivity-decline related social cost. Recently, few research have paid attention on the inverse relationship between declining smoking rate and increasing obesity rate. This paper uses 2005 Korea National Health and Nutrition Examination Survey to study the relationship between secondhand smoking and obesity. Secondhand smoking is studied because it is important itself and less likely to be subject to endogeneity problem than smoking. The results show that secondhand smoking is positively related to obesity measured by BMI and waist circumference, contrary to the expectation that smoking helps to control weight. In addition, smoking regulation is introduced at working places in 2003 and its effect is found to have reduced secondhand smoking. Therefore, smoking regulation is shown to be effective in reducing not only smoking but also secondhand smoking. Driven by this effect of smoking regulation, this paper use smoking regulation as an IV for secondhand smoking and find statistically insignificant relationship between secondhand smoking and obesity. This result is robust to the selected sample analysis of people aged 64 and under to reduce selective bias due to the fact that the old are more likely to unhealthy and lean and (secondhand) smokers are more likely to die earlier.

The effects of secondhand smoke on chronic obstructive pulmonary disease in nonsmoking Korean adults

( Woong Jun Kim ),( June Seok Song ),( Dong Won Park ),( Hyun Jung Kwak ),( Ji Yong Moon ),( Sang Heon Kim ),( Jang Won Sohn ),( Ho Joo Yoon ),( Dong Ho Shin ),( Sung Soo Park ),( Tae Hyung Kim ) 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.5

Background/Aims: Smoking is widely acknowledged as the single most importantrisk factor for chronic obstructive pulmonary disease (COPD). However, therisk of COPD in nonsmokers exposed to secondhand smoke remains controversial. In this study, we investigated the association of secondhand smoke exposurewith COPD prevalence in nonsmokers who reported never smoking. Methods: This study was based on data obtained from the Korean NationalHealth and Nutrition Examination Surveys (KNHANES) conducted from 2008 to2010. Using nationwide stratified random sampling, 8,596 participants aged ≥ 40years of age with available spirometry results were recruited. After selecting participantswho never smoked, the duration of exposure to secondhand smoke wasassessed based on the KNHANES questionnaire. Results: The prevalence of COPD was 6.67% in participants who never smoked. We divided the participants who had never smoked into those with or withoutexposure to secondhand smoke. The group exposed to secondhand smoke wasyounger with less history of asthma and tuberculosis, higher income, and highereducational status. Multivariate logistic regression analysis determined that secondhandsmoke did not increase the prevalence of COPD. Conclusions: There was no significant difference in the prevalence of COPD betweenparticipants who had never smoked with or without exposure to secondhandsmoke in our study. Thus, secondhand smoke may not be an important riskfactor for the development of COPD in patients who have never smoked.

부모가 지각한 영유아의 특성별 간접흡연 피해 인지 및 금연교육현황

박애경 한국보육학회 2010 한국보육학회지 Vol.10 No.1

Subjects were 2,500 parents of 2-,3-,4- and 5-year-old day care children. Statistical technique was chi-square test. Major findings were 1) that parents showed a higher level of recognition toward preschoolers' exposure to secondhand smoke. Preschoolers showed a low levels of recognition toward exposure to secondhand smoke. Parents showed a low levels of smoke prevention education toward exposure to secondhand smoke. 2) In parent's recognition about secondhand smoke, Parents's age, education and income were not founded to be correlated. 3) In preschoolers's recognition about secondhand smoke, parents's age and education showed a higher levels of preschoolers' recognition toward exposure to secondhand smoke and showed greater degree of smoke prevention education. This results suggest that a smoking prevention program specific for young children is necessary to prevent early onset of smoking. This results also can be applied to the instruction-learning method for young children. 본 연구는 2세-5세 영유아를 둔 부모를 대상으로 가정에서의 간접흡연의 피해인지와 금연교육현황을 조사하기 위해 실시되었다. 간접흡연 피해인지는 부모의 인지와 부모가 지각한 영유아의 인지로 나누어 조사되었다. 수원시 거주 영유아부모 약 2500명을 대상으로 하였고 연구결과는 다음과 같다. 첫째, 간접흡연에 대한 부모의 인지수준은 높은 반면, 부모가 지각한 영유아의 인지수준은 매우 낮게 나타났다. 또한 금연교육 실시여부도 낮게 조사되었다. 둘째, 부모의 간접흡연피해인지수준에서는, 부모의 연령, 교육정도 및 소득과는 관련성이 없는 것으로 조사되었다. 셋째, 부모가 지각한 영유아의 간접흡연피해인지 수준과 금연교육 실시여부면에서는, 부모의 연령과 교육정도와 상관이 있는 것으로 나타났다. 즉, 연령이 높을수록, 교육정도가 높을수록 영유아의 피해인지가 높았고, 금연교육을 많이 하는 것으로 나타났다. 본 연구의 결과는 영유아를 위한 특별한 간접흡연피해인지교육을 포함한 금연교육이 부모와 영유아를 대상으로 적극적으로 실시되어야 함을 제안하고 있다.

우리나라 금연구역 정책의 성과와 과제

김현숙 대한금연학회 2022 대한금연학회지 Vol.13 No.4

The policy of smoking ban has been implemented in South Korea for >25 years. Despite the prevalence of cigarette use, the relationship between secondhand nicotine exposure and smoking ban policy remains poorly understood. This study aimed to investigate the achievements and emerging challenges of the smoking ban policy in South Korea by identifying its effects and suggesting its future direction in this country. Based on the WHO FCTC Article 8 guideline, this study evaluated the implementation and expansion of smoking ban policies, focusing on outdoor and indoor policies in South Korea and other countries. Results suggest that the smoking ban policy should be extended and strengthened in indoor and outdoor areas. The relative protective zone at school should be smoke-free to prevent secondhand smoke exposure among adolescents. However, the policy allows smoking in apartments, outdoor workplaces, night clubs, and individual cars. The implementation and effectiveness of the smoking ban policy should be monitored and evaluated. For preventing secondhand smoking, education and campaigns for people must be provided. The social support system is essential for establishing and maintaining smoking ban policies. In conclusion, the effects of the smoking ban policy are evident in indoor and outdoor places in South Korea, however, the partial smoking ban policy does not completely prohibit secondhand smoking. Complete smoking ban should be established in all indoor spaces and further expanded in outdoor spaces to protect people from secondhand smoke exposure.

청소년의 간접흡연이 정신건강에 미치는 영향

권민,이진화,현숙정 한국학교보건학회 2020 韓國學校保健學會誌 Vol.33 No.1

Purpose: The purpose of this study was to investigate the effects of secondhand smoke on depression and suicidal ideation in adolescents. Methods: The study used the raw data of the Korea Youth Risk Behavior Web-based Survey (2018). Age, academic achievement, living with family, economic status, and stress were adjusted and the relationship between secondhand smoke and depression and suicidal thoughts was analyzed by gender. Results: The results showed that secondhand smoke had a significant effect on mental health of adolescents. Male students who experienced secondhand smoke at school and at public places had 1.41 times and 1.37 times higher depression rates, respectively. Female students who experienced secondhand smoke at home, school, and public places had 1.27 times, 1.35 times, and 1.39 times higher depression rates, respectively. Suicidal thoughts were 1.17 times and 1.22 times higher among male students who experienced secondhand smoke at school and at public places. Female students who experienced secondhand smoke at home, school, and public places had 1.12 times, 1.08 times, and 1.21 times more suicidal thoughts. Conclusion: Secondhand smoke has a significant effect on adolescent depression and suicidal thoughts. Therefore, efforts should be made to have institutional changes and increased awareness across the country, such as homes, schools, and communities, to prevent exposure to secondhand smoke.

Prenatal Secondhand Smoke Exposure: Correlation Between Nicotine in Umbilical Cord Blood and Neonatal Anthropometry

Mery Ramadani,Budi Utomo,Hartono Gunardi,Endang L Achadi 질병관리본부 2019 Osong Public Health and Research Persptectives Vol.10 No.4

Objectives: Nicotine narrows uterine blood vessels reducing the flow of oxygen and nutrients to the developing fetus. This study examined the effects of fetal exposure to secondhand smoke on neonatal anthropometry. Methods: This cross sectional study recruited 128 pregnant women in the third trimester of single pregnancies who had no chronic illness, were not active or ex-smokers, and who were willing to participate in the study. Pregnant women who were exposed to secondhand smoke had umbilical cord blood nicotine concentrations of ≥ 1 ng/mL. Neonatal anthropometry was assessed according to the newborn birth weight and length. The independent t-test was used to determine the neonatal difference in mean birth weight and length between the women who were exposed to secondhand smoke, and those who were not exposed. A multiple linear regression analysis was employed to assess the effect of secondhand smoke exposure on birth weight and birth length, controlling for potential confounding variables (weight gain during pregnancy, body mass index, parity, maternal age, and maternal hemoglobin). Results: There were 35 women exposed to secondhand smoke (nicotine ≥ 1 ng/mL). Neonate birth weight and birth length were lower among mothers who were exposed to secondhand smoke. However, only neonate birth weight was significantly reduced by exposure to secondhand smoke (p = 0.005). The mean birth weight of these neonates was 2,916.5 g ± 327.3 g which was 205.6 g less than in unexposed fetuses. Conclusion: Exposure of mothers to secondhand smoke during pregnancy reduces fetal development and neonatal weight.

우리나라 비흡연청소년의 간접흡연이 치은 통증 및 출혈에 미치는 영향

최미진 ( Mi Jin Choi ),김소영 ( So Yeong Kim ),장혜영 ( Hye Young Jang ) 대한예방치과·구강보건학회 2021 大韓口腔保健學會誌 Vol.45 No.3

Objectives: This study aimed to identifying the relationship between exposure to secondhand smoking and oral diseases in adolescents, based on the web-based youth health risk behavior survey from 2020. Methods: Among the 54,948 adolescent respondents to the 16th youth health risk behavior survey in 2020, this study included a total of 48,867 non-smoking adolescent participants who had never used regular cigarettes, vapes, or e-cigarettes. Analysis of the complex sample survey data was performed by applying weights according to the complex sample provided by the Korea Disease Control and Prevention Agency. Cross-tabulation analysis by complex sampling using the Rao- Scott chi-square test and complex-sample t-test was then performed to identify the relationship between subject characteristics and gingival pain and bleeding prevalence. Finally, a binary logistic regression analysis was performed to determine the effects of secondhand smoking on symptoms of gingival pain and bleeding in non-smoking adolescents. Data were analyzed using SPSS 26.0 version, and the statistical significance level was defined as P<0.05. Results: Among the participants, periodontal disease symptoms were reported 1.201 times (95% confidence interval [CI]: 1.101-1.310) more often in those with exposure to secondhand smoking exposure at home and 1.281 times (95% CI: 1.173-1.398) more often in those with exposure to secondhand smoking in public places than in those who did not report exposure to secondhand smoking. Conclusions: The study results suggest that exposure to secondhand smoking increases the risk of gingival pain and bleeding in non-smoking South Korean adolescents and is a risk factor for periodontal diseases.

청소년의 흡연 경험과 관련요인 분석: 가족구조, 가정 내 간접흡연 경험, 친한 친구 흡연 중심으로

조규희,목형균 사단법인 대한보건협회 2019 대한보건연구 Vol.45 No.3

Background: Adolescence life-style affects adulthood health behaviors. Unhealthy behaviors such as smoking tend to be learned from surrounding people like family members or friends. Also, environmental risk factors for smoking such as secondhand smoke at home or peer smoking would have negative effects on healthy behaviors. Objective: The purpose of this study was to examine association among family structure, environmental risk factors and adolescent smoking experiences. Method: This study used data from the 2018 Korea Youth Risk Behavior Web-based Survey. We analyzed 60,040 participants. Study variables included family structure, secondhand smoke at home, peer smoking and life time smoking experience. For this study, descriptive analysis, Chi-square test, and multivariate logistic regression analysis were performed. Results: Among boys, family structure (living with both parents reference groug vs. step parents: OR: 1.60, 95% CI: 1.04-2.50), secondhand smoke at home (No reference group vs. Yes: OR: 1.29, 95% CI: 1.19-1.38), and peer smoking (No reference group vs. Yes: OR: 3.60, 95% CI: 3.32-3.80) were associated with lifetime smoking experience. Among girls, family structure (living with both parents reference group vs living without both parents: OR: 1.60, 95% CI: 1.10-2.24), secondhand smoke at home (No reference group vs Yes: OR: 1.28, 95% CI: 1.15-1.42), and peer smoking (No reference group vs Yes: OR: 6.60, 95% CI: 5.87-7.43) were associated with lifetime smoking experience. Conclusion: Study variables would be a risk factor of adolescent smoking. Health promotion programs should be concerned about these findings. 연구배경: 청소년기의 건강행태는 성인기의 건강생활습관에 영향을 미친다. 흡연과 같은 불건강행태는 가족구성원, 친구, 선생님 등 주변관계에서 습득될 수 있다. 가정 내 간접흡연 경험, 친한 친구의 흡연과 같은 환경적 요인이 주된 흡연 건강위험요인 중 하나이다. 연구목적: 가족구조, 가정 내 간접흡연 경험, 친한 친구의 흡연, 청소년 흡연 경험 간의 관련성을 파악하고자한다. 연구방법: 연구자료는 제14차(2018년) 청소년 건강행태조사를 활용하였다. 연구대상자는 총 60,040명 이었으며, 연구변수로 가족구조, 가정 내 간접흡연 경험, 친한 친구 흡연 여부, 평생 흡연 경험을 사용하였다. 흡연경험과 관련요인을 분석하기 위해 빈도분석, 교차분석, 다중로지스틱회귀분석을 실시하였다. 연구결과: 남학생의 경우, 계부모와 거주하는 경우가 양부모와 거주하는 경우에 비해 교차비가 높았으며(교차비: 1.61, 신뢰구간: 1.04, 2.47), 가정 내 간접흡연 경험이 있는 경우가 흡연 가능성이 높았고(교차비: 1.28, 신뢰구간: 1.19, 1.38), 친한 친구가 흡연하는 경우 교차비가 높았다(교차비: 3.59, 신뢰구간: 3.32, 3.89). 여학생의 경우, 부모와 함께 거주하지 않은 경우가 그렇지 않은 경우에 비해 교차비가 높았고(교차비: 1.57, 신뢰구간: 1.11, 2.24), 가정 내 간접흡연 경험이 있으면 흡연 가능성이 높았으며(교차비: 1.28, 신뢰구간: 1.15, 1.42), 친한 친구 중에 흡연하는 친구가 있으면 교차비가 높았다(교차비: 6.61, 신뢰구간: 5.87, 7.43). 결론: 양부모와 거주하지 않고, 가정 내 간접흡연자가 있고, 친한 친구가 흡연을 하면 그렇지 않은 경우에 비해 흡연을 할 가능성이 높았다. 건강증진프로그램과 금연프로그램을 개발할 때 환경적 요인들을 고려하여 기획해야한다.

Secondhand Smoking Among Children in Rural Households: A Community Based Cross-Sectional Study in Bangladesh

Robin Rishad Choudhury,Noosorn Narongsak,Alif Sheikh Mohammad 질병관리본부 2020 Osong Public Health and Research Persptectives Vol.11 No.4

Objectives This study aimed to determine the factors associated with reducing exposure to secondhand smoke among children in households of rural Bangladesh. Methods A cross-sectional study of 410 smokers and non-smokers, in 6 villages of Munshigonj district was conducted. Data were collected randomly using a self-administrative questionnaire. Differences between variables were assessed using Chi-square or Fisher’s exact test (as appropriate). Univariate and multivariate logistic regression models were used to investigate associations. All results were presented as unadjusted and adjusted odds ratios with a 95% confidence interval. The level of statistical significance was reached when p < 0.05. Results A smoker in the household was determined to be a risk factor associated with exposure of other household members to secondhand smoke (p < 0.001). Higher education, strict implementation of household smoke-free rules, a higher influence of social norms and culture, as well as moderate knowledge on exposure to secondhand smoke were considered as preventive factors associated with exposure of others in the home to secondhand smoke. Conclusion Exposure to secondhand smoke is an extensive and preventable risk factor for children, and reducing exposure to secondhand smoke will have a largely positive effect in the community. An effective public health intervention model may reduce secondhand smoking.