Association between exposure to tobacco information through mass media, smoking households and secondhand smoke exposure in adolescents: Survey data from South Korea

INTRODUCTION: To explore the current situation of exposure of Korean adolescents to secondhand smoke (SHS) in households our study aimed to determine the relationship between family member smoking status, exposure to tobacco information through mass media, and household SHS exposure. METHODS: The present study uses pooled data from the Korean adolescent health behavior online survey conducted in 2015, 2018 and 2021, with 157944 participants. The regression models were used to explore the association between the smoking status of households, and exposure to tobacco information through mass media, and household SHS exposure in adolescents, controlling for potential confounding factors. RESULTS: SHS exposure duration of Korean adolescents in households was 0.88 days per week. The households with smokers including the father (β=1.087; 95% CI: 1.0-1.126), mother (β=1.461; 95% CI: 1.379- 1.543), siblings (β=0.545; 95% CI: 0.493-0.597), grandparents (β=0.224; 95% CI: 0.174-0.272), and other relatives (β=0.170; 95% CI: 0.126-0.214), showed a positive association with SHS exposure in adolescents within the household. At the same time, information about anti-smoking ads on television (β= -0.042; 95% CI: -0.069 - -0.015) and public transportation (β= -0.031; 95% CI: -0.054 - -0.010), showed a negative association with SHS exposure in adolescents. However, broadcasts, online, and newspaper non-smoking ads were not associated with SHS exposure (p>0.05). In addition, regression models revealed that exposure to cigarette advertising in magazines (β=0.131; 95% CI: 0.097-0.166), networks (β=0.151; 95% CI: 0.127-0.175), convenience stores (β=0.061; 95% CI: 0.035-0.087), and supermarkets (β=0.133; 95% CI: 0.108-0.158) is associated with SHS exposure in adolescents. Finally, our study showed stronger ties between SHS exposure, family smoking, and tobacco ads in girls. The link between maternal smoking, supermarket ads, and adolescent SHS exposure intensified in 2021 compared to 2015. CONCLUSIONS: Family and media were identified as potential factors associated with SHS exposure in adolescents. Therefore, publicity and education regarding household SHS hazards, and smoking bans in media, can be helpful in protecting adolescents from SHS.