Social inequalities in secondhand smoke exposure in children in Spain
Maria J López 1, 2, 3  
Teresa Arechavala 1, 3
Xavier Continente 1, 2, 4
Mónica Pérez-Ríos 2, 6, 7
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Evaluation and Intervention Methods Service, Agència de Salut Pública de Barcelona, Barcelona, Spain
CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
Universitat Pompeu Fabra (UPF), Department of Experimental and Health Science, Barcelona, Spain
Institut d’Investigació Biomèdica Sant Pau (IIB St. Pau), Barcelona, Spain
Direcció General de Planificació en Salut, Departament de Salut Generalitat de Catalunya, Barcelona, Spain
Epidemiology Unit, Galician Directorate for Public Health, Galician Health Authority, Xunta de Galicia, Santiago de Compostela, Spain
Department of Preventive Medicine and Public Health, School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
Cancer Prevention and Control Group, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d’Oncologia (ICO), Barcelona, Spain
Department of Clinical Sciences, School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
Maria J López   

Evaluation and Intervention Methods Service, Agència de Salut Pública de Barcelona, Barcelona, Spain
Publish date: 2018-04-18
Tob. Induc. Dis. 2018;16(April):14
Children are particularly vulnerable to the health effects of secondhand smoke (SHS). The objectives of this study are to describe SHS exposure of children younger than 12 years in Spain and to identify potential social inequalities associated with SHS exposure.

Material and Methods:
A cross-sectional study was conducted in a representative sample of the population younger than 12 years in Spain. A computerassisted telephone interview was conducted with parents or legal guardians in 2016, to assess the children’s SHS exposure at home, in the car, at school and at the nursery gates, in public transport, and during leisure time. The socio-demographic variables included were the child’s age and sex, the highest educational attainment at home, and occupational social class. Prevalence and 95% confidence intervals were calculated for SHS exposure in each setting and for overall exposure.

In all, 71.8% of the children were exposed to SHS: 25.8% were exposed at home, 4.6% in the car, 8.2% in public transport, 31.9% at outdoor nursery or school gates, and 48% during leisure time. The higher the educational attainment at home, the lower the exposure (38.8% for primary school or lower, 28.7% for secondary school and 20.8% university level). The more deprived the social class, the higher the exposure (21.7% class I-II, 23.4% class III-IV and 31.1% class V-VII). SHS exposure in cars and overall exposure also decreased with higher educational achievement.

In Spain, a large proportion of children are still exposed to SHS. Furthermore, there are clear social inequalities. To reduce SHS exposure, there is an urgent need for evidence-based interventions with an equity perspective.

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