Changes in Prevalence of Childhood Exposure to Secondhand Smoke in India: A Secondary Analysis of GATS Survey (2009-2017).

Background: Children are susceptible to early life inequalities stemming from their limited control over their environment and their physical incapability to handle the health and developmental consequences of smoke exposure. Additionally, their lack of awareness regarding the detrimental effects of secondhand smoke (SHS) exposure on their well-being emphasizes the crucial need to comprehend the extent of SHS exposure among the younger population.

Objective: The study aims to analyze the magnitude and factors influencing SHS exposure among children under 15 years, along with the shifts in SHS exposure in India and its states between 2009-10 and 2016-17.

Methods: The study utilized two rounds of the nationally representative cross-sectional Global Adult Tobacco Survey (GATS) conducted in 2009-10 and 2016-17, respectively. The study included a total of 47,494 households with 108,814 children under 15 years of age for GATS1 and 46,874 households with 1,000,167 children under 15 years of age for GATS2. Bivariate analysis and Multivariable logistic regression was employed.

Results: Forty-five percent of children experienced SHS exposure at home. Although most states saw a reduction in exposure rates, Jammu and Kashmir, Punjab, and Tamil Nadu  exhibited increases between 2009-10 and 2016-17. Multivariate analysis revealed that children from the North-Eastern (OR = 6.51, CI = (5.93-7.15)) and North (OR = 7.51, CI = 6.88-8.19)) regions, rural areas (OR = 1.45, CI = (1.37-1.52)), Scheduled Tribes (OR = 1.76, CI = (1.63-1.90)),  and those with household adults lacking knowledge of SHS's harmful health effects on children (OR = 1.15, CI = (1.04-1.27)) were more likely to be exposed to SHS at home.

Conclusion: India has made strides in reducing child SHS exposure, yet challenges persist in rural and impoverished homes. Comprehensive tobacco control measures can break the cycle of poverty driven by smoking-related expenses, fostering a tobacco-free generation.