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. 2015 Oct 2;10(10):e0139512.
doi: 10.1371/journal.pone.0139512. eCollection 2015.

'Only Fathers Smoking' Contributes the Most to Socioeconomic Inequalities: Changes in Socioeconomic Inequalities in Infants' Exposure to Second Hand Smoke over Time in Japan

Junko Saito  1 , Takahiro Tabuchi  2 , Akira Shibanuma  1 , Junko Yasuoka  1 , Masakazu Nakamura  3 , Masamine Jimba  1
Affiliations

'Only Fathers Smoking' Contributes the Most to Socioeconomic Inequalities: Changes in Socioeconomic Inequalities in Infants' Exposure to Second Hand Smoke over Time in Japan

Junko Saito et al. PLoS One. .

Abstract

Background: Exposure to second hand smoke (SHS) is one of the major causes of premature death and disease among children. While socioeconomic inequalities exist for adult smoking, such evidence is limited for SHS exposure in children. Thus, this study examined changes over time in socioeconomic inequalities in infants' SHS exposure in Japan.

Methods: This is a repeated cross-sectional study of 41,833 infants born in 2001 and 32,120 infants born in 2010 in Japan from nationally representative surveys using questionnaires. The prevalence of infants' SHS exposure was determined and related to household income and parental education level. The magnitudes of income and educational inequalities in infants' SHS exposure were estimated in 2001 and 2010 using both absolute and relative inequality indices.

Results: The prevalence of SHS exposure in infants declined from 2001 to 2010. The relative index of inequality increased from 0.85 (95% confidence interval [CI], 0.80 to 0.89) to 1.47 (95% CI, 1.37 to 1.56) based on income and from 1.22 (95% CI, 1.17 to 1.26) to 2.09 (95% CI, 2.00 to 2.17) based on education. In contrast, the slope index of inequality decreased from 30.9 (95% CI, 29.3 to 32.6) to 20.1 (95% CI, 18.7 to 21.5) based on income and from 44.6 (95% CI, 43.1 to 46.2) to 28.7 (95% CI, 27.3 to 30.0) based on education. Having only a father who smoked indoors was a major contributor to absolute income inequality in infants' SHS exposure in 2010, which increased in importance from 45.1% in 2001 to 67.0% in 2010.

Conclusions: The socioeconomic inequalities in infants' second hand smoke exposure increased in relative terms but decreased in absolute terms from 2001 to 2010. Further efforts are needed to encourage parents to quit smoking and protect infants from second hand smoke exposure, especially in low socioeconomic households that include non-smoking mothers.

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Conflict of interest statement

Competing Interests: The authors have read the journal’s policy and have the following competing interests: Dr. Nakamura received a Medical Education grant from Pfizer Japan Inc., for the smoking cessation training program development and dissemination project (J-STOP) as a member of Japan Medical-Dental Association for Tobacco Control. All other authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Contributions of parental indoor smoking behaviour to absolute income inequality in SHS exposure in infants.
The total bar represents the total absolute income inequality (SII) in each survey year, and each component represents the SII of each parental indoor smoking behaviour.
Fig 2
Fig 2. Prevalence of parental smoking and indoor smoking according to the income level by both parents smoking and only father smoking.
The prevalence is presented in Table 4. The total bar represents the parental smoking in each survey year, and each coloured bar, dark gray and light gray, represents the parental indoor smoking (SHS exposure in infants) and outdoor smoking, respectively.
See this image and copyright information in PMC

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