Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses

OBJECTIVES Smoke-free areas have expanded and related campaigns have been implemented since 1995 in Korea. As a result, household secondhand smoke (SHS) exposure has decreased over the past 15 years. We assessed the cohort effect, the effect of a 2008 campaign on household SHS exposure, and the impa...

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Main Authors: Hana Kim, Heewon Kang, Sung-il Cho
Format: Article
Language:English
Published: Korean Society of Epidemiology 2023-12-01
Series:Epidemiology and Health
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Online Access:http://www.e-epih.org/upload/pdf/epih-46-e2024009.pdf
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author Hana Kim
Heewon Kang
Sung-il Cho
author_facet Hana Kim
Heewon Kang
Sung-il Cho
author_sort Hana Kim
collection DOAJ
description OBJECTIVES Smoke-free areas have expanded and related campaigns have been implemented since 1995 in Korea. As a result, household secondhand smoke (SHS) exposure has decreased over the past 15 years. We assessed the cohort effect, the effect of a 2008 campaign on household SHS exposure, and the impact of a complete smoking ban in public places along with increased penalties, as implemented in December 2011. METHODS Nationally representative cross-sectional 15-wave survey data of Korean adolescents were used. The 810,516 participants were classified into 6 grade groups, 15 period groups, and 20 middle school admission cohorts. An age-period-cohort analysis, conducted with the intrinsic estimator method, was used to assess the cohort effect of household SHS exposure, and interrupted-time series analyses were conducted to evaluate the effects of the smoke-free policy and the campaign. RESULTS For cohorts who entered middle school from 2002 to 2008, the risk of household SHS exposure decreased among both boys and girls. Immediately after implementation of the smoke-free policy, the prevalence of household SHS exposure by period decreased significantly for boys (coefficient, -8.96; p<0.05) and non-significantly for girls (coefficient, -6.99; p=0.07). After the campaign, there was a significant decrease in household SHS exposure by cohort among boys, both immediately and post-intervention (coefficient, -4.84; p=0.03; coefficient, -1.22; p=0.02, respectively). CONCLUSIONS A school-admission-cohort effect was found on household SHS exposure among adolescents, which was associated with the smoke-free policy and the campaign. Anti-smoking interventions should be implemented consistently and simultaneously.
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spelling doaj-art-e7b2e9ff142c4b2e99f9c6f1dc7d0df42025-08-20T02:13:26ZengKorean Society of EpidemiologyEpidemiology and Health2092-71932023-12-014610.4178/epih.e20240091472Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analysesHana Kim0Heewon Kang1Sung-il Cho2 Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea Institute of Health and Environment, Seoul National University, Seoul, Korea Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, KoreaOBJECTIVES Smoke-free areas have expanded and related campaigns have been implemented since 1995 in Korea. As a result, household secondhand smoke (SHS) exposure has decreased over the past 15 years. We assessed the cohort effect, the effect of a 2008 campaign on household SHS exposure, and the impact of a complete smoking ban in public places along with increased penalties, as implemented in December 2011. METHODS Nationally representative cross-sectional 15-wave survey data of Korean adolescents were used. The 810,516 participants were classified into 6 grade groups, 15 period groups, and 20 middle school admission cohorts. An age-period-cohort analysis, conducted with the intrinsic estimator method, was used to assess the cohort effect of household SHS exposure, and interrupted-time series analyses were conducted to evaluate the effects of the smoke-free policy and the campaign. RESULTS For cohorts who entered middle school from 2002 to 2008, the risk of household SHS exposure decreased among both boys and girls. Immediately after implementation of the smoke-free policy, the prevalence of household SHS exposure by period decreased significantly for boys (coefficient, -8.96; p<0.05) and non-significantly for girls (coefficient, -6.99; p=0.07). After the campaign, there was a significant decrease in household SHS exposure by cohort among boys, both immediately and post-intervention (coefficient, -4.84; p=0.03; coefficient, -1.22; p=0.02, respectively). CONCLUSIONS A school-admission-cohort effect was found on household SHS exposure among adolescents, which was associated with the smoke-free policy and the campaign. Anti-smoking interventions should be implemented consistently and simultaneously.http://www.e-epih.org/upload/pdf/epih-46-e2024009.pdfage-period-cohort analysisinterrupted time series analysissegmented regressionsecondhand smokingadolescents
spellingShingle Hana Kim
Heewon Kang
Sung-il Cho
Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
Epidemiology and Health
age-period-cohort analysis
interrupted time series analysis
segmented regression
secondhand smoking
adolescents
title Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
title_full Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
title_fullStr Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
title_full_unstemmed Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
title_short Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
title_sort decrease in household secondhand smoking among korean adolescents associated with smoke free policies grade period cohort and interrupted time series analyses
topic age-period-cohort analysis
interrupted time series analysis
segmented regression
secondhand smoking
adolescents
url http://www.e-epih.org/upload/pdf/epih-46-e2024009.pdf
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