Association between Secondhand Smoke and Health-related Quality of Life in Middle-aged Korean Adults

Sang-Yun Kang; Young Hye Cho; Dong-Wook Jeong; Sang-Yeoup Lee; Yun Jin Kim; Jeong Gyu Lee; Hyun-Ju Lim

doi:10.15384/kjhp.2015.15.4.185

Korean J Health Promot > Volume 15(4); 2015 > Article

Kang, Cho, Jeong, Lee, Kim, Lee, and Lim: Association between Secondhand Smoke and Health-related Quality of Life in Middle-aged Korean Adults

Original Article

Korean Journal of Health Promotion 2015;15(4):185-193.

Published online: December 19, 2015

DOI: https://doi.org/10.15384/kjhp.2015.15.4.185

Association between Secondhand Smoke and Health-related Quality of Life in Middle-aged Korean Adults

Sang-Yun Kang¹, Young Hye Cho¹, Dong-Wook Jeong¹, Sang-Yeoup Lee^1,³, Yun Jin Kim², Jeong Gyu Lee², Hyun-Ju Lim¹

¹Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea

²Department of Family Medicine, Pusan National University Hospital, Busan, Korea

³Medical Education Unit and Medical Research Institute Pusan National University School of Medicine, Yangsan, Korea

￭ Corresponding author：Young Hye Cho, MD Department of Family Medicine, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea
Tel: +82-55-360-2018, Fax: +82-55-360-2019 E-mail: younghye82@naver.com

Received August 06, 2015 Accepted October 12, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background

The relationship between secondhand smoke and health-related quality of life is still unclear. The aim of this study was to investigate the association between secondhand smoke and health-related quality of life (HRQoL) in middle-aged Korean adults.

Methods

Data from 583 men and 3,869 women aged 40 to 64 years who participated in the fifth Korea National Health and Nutrition Examination Survey in 2010 to 2012 were evaluated. All of them are non-smokers or have smoked less than 5 packs of cigarettes for their whole life. Secondhand smoke exposed at home and workplace was assessed by using a questionnaire and HRQoL was assessed by EuroQoL five dimensions (EQ-5D). The association of secondhand smoke and HRQoL was analyzed by logistic regression analysis.

Results

Low HRQoL was associated with sex, age, body mass index, education level, family income level, occupation status, underlying diseases and secondhand smoke exposure. After adjustment for variables, secondhand smoke exposure at home was positively associated with the anxiety/depression dimension of EQ-5D (Odds ratio: 1.49, 95% Confidence interval: 1.02-2.18).

Conclusions

Secondhand smoke exposure at home is associated with anxiety and depression dimensions of EQ-5D in middle-aged Korean adults.

Keywords: Tobacco smoke pollution, Quality of life, Anxiety, Depression

Table 1.

General characteristics of the study participants according to secondhand smoke exposure^a

	Secondhand smoke exposure				P^b
	No exposure	Home alone	Work alone	Both	P^b
Sex					<0.001
Male	309 (13.0)	5 (2.3)	259 (34.5)	10 (5.4)
Female	2,691 (87.0)	374 (97.7)	590 (65.5)	214 (94.6)
Age, y	50.72±0.164	50.02±0.441	49.67±0.281	48.85±0.423	<0.001
Body mass index, kg/m²	23.89±0.079	23.82±0.205	24.03±0.126	24.64±0.256	0.034
Educational level					<0.001
Elementary school	704 (21.6)	104 (23.7)	175 (17.7)	47 (17.6)
Middle school	470 (15.8)	57 (13.1)	152 (19.1)	46 (21.1)
High school	1,070 (36.4)	156 (48.0)	316 (39.8)	100 (47.8)
University above	754 (26.1)	62 (15.3)	206 (23.4)	31 (13.4)
Monthly income					0.191
Low	330 (11.3)	39 (9.9)	75 (8.8)	21 (7.5)
Middle-low	738 (27.5)	105 (31.3)	225 (26.5)	49 (23.8)
Middle-high	833 (28.2)	116 (31.6)	248 (30.2)	64 (28.4)
High	1,065 (33.1)	115 (27.2)	297 (34.5)	85 (40.3)
Occupation					<0.001
No	1,449 (44.4)	192 (47.8)	16 (1.8)	5 (2.0)
Yes	1,548 (55.6)	187 (52.2)	832 (98.2)	219 (98.0)
Underlying disease					0.005
No	1,634 (57.3)	185 (51.5)	513 (61.4)	138 (66.8)
Yes	1,365 (42.7)	194 (48.5)	336 (38.6)	86 (33.2)

^a Values are presented as N (%) or mean±SE unless otherwise indicated.

^b Calculated by chi-square test/t-test.

Table 2.

Comparison of EQ-5D according to secondhand smoke exposure^a

	Secondhand smoke exposure				P^b
	No exposure	Only at Home	Only at Work	At Both	P^b
Mobility					0.298
No	2,686 (90.6)	335 (89.1)	785 (93.0)	204 (91.7)
Some	312 (9.4)	43 (10.6)	63 (6.9)	20 (8.3)
Extreme problems	2 (0.0)	1 (0.3)	1 (0.1)	0 (0.0)
Self-care					0.459
No	2,953 (98.5)	374 (99.4)	841 (98.9)	219 (98.5)
Some	47 (1.5)	4 (0.5)	7 (1.0)	5 (1.5)
Extreme problems	0 (0.0)	1 (0.1)	1 (0.1)	0 (0.0)
Usual activities					0.172
No	2,868 (95.8)	367 (97.4)	824 (97.4)	216 (97.0)
Some	129 (4.1)	11 (2.3)	23 (2.4)	8 (3.0)
Extreme problems	3 (0.1)	1 (0.2)	2 (0.2)	0 (0.0)
Pain/discomfort					0.399
No	2,382 (80.3)	291 (79.3)	694 (81.8)	174 (80.5)
Some	598 (19.2)	83 (19.5)	145 (17.2)	49 (19.3)
Extreme problems	20 (0.5)	5 (1.2)	10 (1.0)	1 (0.2)
Depression/anxiety					0.023
No	2,692 (90.3)	318 (85.2)	774 (91.1)	198 (87.8)
Some	296 (9.3)	57 (13.3)	73 (8.8)	25 (11.8)
Extreme problems	12 (0.4)	4 (1.5)	2 (0.2)	1 (0.3)

Abbreviations: EQ-5D, EuroQoL five dimensions.

^a Values are presented as N (%) unless otherwise indicated.

^b Calculated by chi-square test.

Table 3.

Simple logistic regression of the association between SHS and EQ-5D^a

	EQ-5D
	Mobility	Self-care	Usual activities	Pain/discomfort	Anxiety/depression
SHS exposure
No	1	1	1	1	1
Home alone	1.18 (0.80-1.74)	0.41 (0.13-1.23)	0.60 (0.33-1.58)	1.07 (0.78-1.44)	1.61 (1.12-2.32)^b
Work alone	0.72 (0.50-1.04)	0.72 (0.29-1.76)	0.61 (0.36-1.03)	0.91 (0.71-1.16)	0.91 (0.67-1.23)
Both	0.87 (0.50-1.50)	1.01 (0.34-3.03)	0.72 (0.33-1.58)	0.99 (0.68-1.45)	1.28 (0.77-2.15)
Sex
Male	1	1	1	1	1
Female	2.40 (1.50-3.83)^c	1.72 (0.55-5.40)	2.23 (1.07-4.65)^*	2.00 (1.45-2.75)^c	1.82 (1.19-2.80)^b
Age, y	1.12 (1.10-1.14)^c	1.11 (1.08-1.15)^c	1.09 (1.06-1.12)^c	1.04 (1.03-1.06)^c	1.03 (1.02-1.05)^c
BMI, kg/m²	1.10 (1.07-1.14)^c	1.08 (0.97-1.20)	1.08 (1.02-1.14)^b	1.03 (0.10-1.05)	1.00 (0.96- 1.04)
Educational level
Elementary school	7.43 (4.94-11.19)^c	7.99 (2.91-21.89)^c	5.18 (2.67-10.04)^c	1.97 (1.54-2.52)^c	2.13 (1.50-3.02)^c
Middle school	3.69 (2.38-5.72)^c	6.12 (2.05-18.29)^c	3.20 (1.59-6.46)^b	1.46 (1.11-1.92)^c	1.54 (1.04-2.28)^b
High school	1.35 (0.85-2.15)	2.30 (0.75-7.10)	1.48 (0.70-3.09)	0.87 (0.67-1.14)	1.45 (1.01-2.07)
University above	1	1	1	1	1
Monthly income
Low	3.30 (2.33-4.69)^c	3.80 (1.49-9.73)^c	3.86 (2.32-6.41)^c	1.79 (1.31-2.44)^c	2.00 (1.35-2.96)^b
Middle-low	1.72 (1.27-2.32)^c	1.01 (0.41-2.48)	1.29 (0.79-2.12)	1.25 (0.10-1.57)	1.25 (0.92-1.71)
Middle-high	1.33 (0.96-1.84)	1.85 (0.87-3.94)	1.32 (0.81-2.16)	1.15 (0.90-1.45)	0.85 (0.62-1.16)
High	1	1	1	1	1
Occupation
No	1.51 (1.18-1.92)^b	1.71 (0.98-2.98)	1.28 (0.91-1.81)	1.22 (1.02-1.46)^b	1.18 (0.92-1.51)
Yes	1	1	1	1	1
Underlying disease
No	1	1	1	1	1
Yes	3.62 (2.72-4.81)^c	5.70 (2.72-11.96)^c	4.18 (2.72-6.43)^c	2.35 (1.94-2.83)^c	3.27 (2.52-4.24)^c

Abbreviations: SHS, secondhand smoke; EQ-5D, EuroQoL five dimensions; BMI, body mass index.

^a Values are presented as Odds ratio (95% confidence interval) and calculated by simple logistic regression analysis.

^b P＜0.05

^c P＜0.001.

Table 4.

Multiple logistic regression of the association SHS and EQ-5D^a

	EQ-5D
	Mobility	Self-care	Usual activities	Pain/discomfort	Anxiety/depression
SHS exposure
No	1	1	1	1	1
Home alone	1.10 (0.71-1.71)	0.38 (0.12-1.18)	0.55 (0.27-1.10)	1.02 (0.75-1.39)	1.49 (1.02-2.18)^b
Work alone	0.96 (0.64-1.43)	1.02 (0.38-2.75)	0.70 (0.39-1.26)	1.12 (0.86-1.46)	1.04 (0.74-1.45)
Both	1.22 (0.68-2.19)	1.62 (0.51-5.09)	0.72 (0.30-1.74)	1.20 (0.80-1.80)	1.52 (0.90-2.58)
Sex
Male	1	1	1	1	1
Female	1.44 (0.86-2.42)	0.91 (0.29-2.83)	1.46 (0.68-3.13)	1.72 (1.24-2.39)^b	1.31 (0.80-2.15)
Age, y	1.05 (1.03-1.08)^c	1.04 (0.99-1.09)	1.03 (0.99-1.06)	1.02 (1.00-1.03)^b	1.00 (0.98-1.02)
BMI, kg/m²	1.06 (1.02-1.11)^b	1.03 (0.91-1.16)	1.04 (0.98-1.10)	1.00 (0.97-1.04)	0.97 (0.93-1.01)
Educational level
Elementary school	2.84 (1.74-4.65)^c	3.61 (1.04-12.60)^b	2.15 (0.99-4.63)	1.10 (0.80-1.51)	1.22 (0.79-1.88)
Middle school	1.98 (1.23-3.20)^b	3.68 (1.02-13.33)^b	1.86 (0.88-3.94)	1.00 (0.75-1.35)	1.11 (0.74-1.67)
High school	1.04 (0.63-1.72)	2.07 (0.57-7.49)	1.12 (0.52-2.43)	0.70 (0.53-0.93)^b	1.21 (0.83-1.75)
University above	1	1	1	1	1
Monthly income
Low	1.51 (1.02-2.24)^b	1.79 (0.64-4.99)	2.07 (1.14-3.74)^b	1.31 (0.93-1.86)	1.56 (1.01-2.40)^b
Middle-low	1.22 (0.88-1.69)	0.70 (0.27-1.75)	0.95 (0.54-1.70)	1.13 (0.89-1.44)	1.08 (0.78-1.50)
Middle-high	1.14 (0.81-1.60)	1.59 (0.75-3.36)	1.15 (0.68-1.96)	1.10 (0.86-1.41)	0.80 (0.58-1.10)
High	1	1	1	1	1
Occupation
No	1.28 (0.96-1.70)	1.62 (0.84-3.13)	0.96 (0.64-1.44)	1.08 (0.88-1.33)	1.04 (0.79-1.36)
Yes	1	1	1	1	1
Underlying disease
No	1	1	1	1	1
Yes	2.07 (1.53-2.81)^c	3.61 (1.65-7.89)^b	2.85 (1.85-4.41)^c	1.92 (1.56-2.35)^c	3.09 (2.33-4.09)^c

Abbreviations: SHS, secondhand smoke; EQ-5D, EuroQoL five dimensions; BMI, body mass index.

^a Values are presented as Odds ratio (95% confidence interval) and calculated by multiple logistic regression analysis.

^b P＜0.05

^c P＜0.001

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