Objective
Children are vulnerable to secondhand smoke (SHS) exposure because of limited control over their indoor environment. Homes remain the major place where children may be exposed to SHS. Our study examines the magnitude, patterns and determinants of SHS exposure in the home among children in 21 low- and middle-income countries.
Methods
Global Adult Tobacco Survey (GATS) data, a household survey of adults 15 years of age or older. Data collected during 2009–2013 were analyzed to estimate the proportion of children exposed to SHS in the home. GATS estimates and 2012 United Nations population projections for 2015 were also used to estimate the number of children exposed to SHS in the home.
Results
The proportion of children younger than 15 years of age exposed to SHS in the home ranged from 4.5% (Panama) to 79.0% (Indonesia). Of the approximately one billion children younger than 15 years of age living in the 21 countries under study, an estimated 507.74 million were exposed to SHS in the home. China, India, Bangladesh, Indonesia and the Philippines accounted for almost 84.6% of the children exposed to SHS. The prevalence of SHS exposure was higher in countries with higher adult smoking rates and was also higher rural areas than in urban areas in most countries.
Conclusions
A large number of children were exposed to SHS in the home. Encouraging voluntary smoke-free rules in homes and cessation in adults have the potential to reduce SHS exposure among children and prevent SHS-related diseases and deaths.
BACKGROUND: Using the Chinese version of the Global School‐based Health Survey (GSHS), this article describes the prevalence of being bullied among a nationally representative sample of Chinese students in grades 6‐10 and explores the relationships between being bullied and selected indicators of psychosocial adjustment.
METHODS: A total of 9015 students in middle schools in Beijing, Hangzhou, Wuhan, and Urumqi completed the Chinese version of the GSHS. Researchers analyzed the results from 2 questions about the frequency and form of being bullied and 11 questions about psychosocial adjustment. Descriptive statistics and logistic regression were used in the analysis.
RESULTS: About 25.7% of middle school students reported being bullied on 1 or more of the past 30 days. Rates of being bullied were similar for males and females, but the forms of being bullied were different. Being bullied was significantly lower in Beijing than in the other 3 cities. There were significant psychosocial differences between students who had been bullied and students who had not been bullied. Students who had been involved in a physical fight, often felt lonely, or had considered suicide in the past 30 days were more likely to report being bullied. Students who thought that other students in their school were often kind and helpful, who felt parents often understood their troubles, or who were taught in school how to handle stress were less likely to report being bullied.
Conclusions: Being bullied is not uncommon in Chinese middle schools. Chinese schools typically place great emphasis on academic achievement, perhaps at the expense of the social climate of the school. Results indicated schools could implement changes to the school climate to reduce the likelihood of students' being bullied.
Introduction
Increases in electronic cigarette (e-cigarette) awareness and current use have been documented in high income countries but less is known about middle and low income countries.
Methods
Nationally representative household survey data from the first four Global Adult Tobacco Surveys to assess e-cigarettes were analyzed, including Indonesia (2011), Malaysia (2011), Qatar (2013), and Greece (2013). Correlates of e-cigarette awareness and current use were calculated. Sample sizes for Greece and Qatar allowed for further analysis of e-cigarette users.
Results
Awareness of e-cigarettes was 10.9% in Indonesia, 21.0% in Malaysia, 49.0% in Qatar, and 88.5% in Greece. In all four countries, awareness was higher among male, younger, more educated, and wealthier respondents. Current e-cigarette use among those aware of e-cigarettes was 3.9% in Malaysia, 2.5% in Indonesia, 2.2% in Greece and 1.8% in Qatar. Across these four countries, an estimated 818 500 people are currently using e-cigarettes. Among current e-cigarette users, 64.4% in Greece and 84.1% in Qatar also smoked cigarettes, and, 10.6% in Greece and 6.0% in Qatar were never-smokers.
Conclusions
E-cigarette awareness and use was evident in all four countries. Ongoing surveillance and monitoring of awareness and use of e-cigarettes in these and other countries could help inform tobacco control policies and public health interventions. Future surveillance should monitor use of e-cigarettes among current smokers and uptake among never-smokers and relapsing former smokers.
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