Smoky homes: Gender, socioeconomic and housing disparities in second hand tobacco smoke (SHS) exposure in a large population-based Australian cohort

Objective: Although research suggests that socioeconomic status (SES) will be related to housing type with regard to second-hand smoke (SHS) exposure, there has been no comprehensive examination of these relationships. This study aimed to explore associations between SHS exposure a) at home and b) at other places, and a number of SES, housing, and health factors. Method: Data were drawn from the 45 and Up Study, a large cohort study with 266,848 adults in New South Wales, Australia, of which 160,824 participants aged 45-65. years were included in this study. Associations between socio-demographic characteristics, smoking status, housing-type, SES, and exposure to SHS were explored initially using Chi-square tests. Ordinal logistic models were created with increasing exposure to SHS at home and at other places. Results: When measuring SHS exposure at home, being female (odds ratio (OR) = 1.2, 95% confidence interval (CI) = 1.2, 1.3); being of lower age (45-49. years vs 60-64. years, OR = 1.4, 95%CI = 1.3, 1.5), being a current smoker of over 20 cigarettes per day (vs never smoked, OR = 10.2, 95%CI = 9.4,11); living in other types of dwelling compared to living at home (OR = 1.3, 95%CI = 1.1, 1.4), living with a partner (vs being single OR = 2.3, 95%CI = 2.1, 2.5), and low SES measures were associated with increased exposure. Increasing SHS exposure at other places was also related to low SES measures, however unlike SHS exposure at home, SHS exposure at other places was associated with being male (OR = 1.5, 95%CI = 1.5, 1.6); and greater paid hours of work (OR = 1.3, 95%CI = 1.2, 1.3). Conclusion: Improved monitoring of SHS exposure in high risk environments is required. Tailoring SHS messages to environments may also be required, for example to women living in units, apartments and mobile homes and males in lower income workplaces.