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 Lee1,3, Yun Jin Kim2, Jeong Gyu Lee2, Hyun-Ju Lim1
- Received August 06, 2015 Accepted October 12, 2015
- 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.
Table 1.
General characteristics of the study participants according to secondhand smoke exposurea
| Secondhand smoke exposure | Pb | ||||
|---|---|---|---|---|---|
| No exposure | Home alone | Work alone | Both | ||
| 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) | |
Table 2.
Comparison of EQ-5D according to secondhand smoke exposurea
| Secondhand smoke exposure | Pb | ||||
|---|---|---|---|---|---|
| No exposure | Only at Home | Only at Work | At Both | ||
| 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) | |
Table 3.
Simple logistic regression of the association between SHS and EQ-5Da
| 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 |
Table 4.
Multiple logistic regression of the association SHS and EQ-5Da
| 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 |
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