Brief report
Exposure to Environmental Tobacco Smoke in the Nonsmoking Population of Cambodia

https://doi.org/10.1016/j.amepre.2007.09.018Get rights and content

Objective

To estimate the extent of environmental tobacco smoke (ETS) exposure among nonsmokers in the adult population of Cambodia.

Methods

A cross-sectional survey was conducted on a nationally representative sample of 13,988 Cambodian adults in 2005. Information on smoking and exposure to ETS was obtained by trained interviewers using a standard questionnaire.

Results

Overall, 37.4% of the 10,263 nonsmoking responders, or an estimated 1,629,700 nonsmoking Cambodians, were exposed to ETS. One third of pregnant women (31.4%) were exposed to ETS at home. In both unadjusted and adjusted models, men were less likely to be exposed to ETS at home (OR=0.34; 95% CI=0.29–0.41) and more likely to be exposed to ETS at work and in public places (OR=3.08; 95% CI=2.14–4.43 and OR=2.17; 95% CI=1.82–2.59, respectively). Education was inversely related to ETS exposure at home (OR=0.51; 95% CI=0.27–0.96 for 10 years of education vs 5 years or less). Legislators, senior officials, and managers were less likely to be exposed to ETS at home than professionals (OR=0.13; 95% CI=0.04–0.46), but more likely to be exposed at work or in public places. Rural residence was associated with higher ETS exposure in the home (OR=2.52; 95% CI=1.71–3.71) and lower ETS exposure at work (OR=0.42; 95% CI=0.24–0.76) compared to urban residence.

Conclusions

The high prevalence of ETS exposure among adult Cambodians indicates an urgent need for specific measures such as public awareness campaigns, policies, and regulations to protect nonsmokers in Cambodia.

Introduction

Cambodia has one of the highest male smoking rates in the world.1, 2 Such high prevalence and the increasing incidence of tobacco smoking among women and youth raise serious concerns about the public health impact of both tobacco use and the escalating exposure to environmental tobacco smoke (ETS).3, 4

Exposure to ETS is one of the major preventable causes of death among children worldwide.5 While the Global Youth Tobacco Survey (GYTS) Collaborative Group has estimated the prevalence of ETS exposure among teenagers in most countries,6 there are few studies on ETS exposure among adults. The primary aim of this study was to determine the levels of self-reported ETS exposure among Cambodian nonsmoking adults. The secondary aim was to characterize ETS exposure among Cambodian nonsmoking adults.

Section snippets

Study Population and Questionnaire

A multistage stratified sampling method was used to randomly select 13,988 adults (aged 18 years or older) from all provinces in 2005, using the most recent census (1998) as a sampling frame. The questionnaire included items on demographics, ETS exposure, tobacco use, age at initiation, reasons for starting to smoke, knowledge and attitudes about smoking cessation, anthropometrics, diet, current health, women’s health, and media exposure.

Statistical Methods

The prevalence and mean levels were weighted based on the

Results

The mean age of the nonsmoking 10,263 study participants was 37.3 years (SD=15.2 years). Most study participants were women (70.6%), were Khmer by ethnicity (96.2%), had 5 years of education or less (66.7%), and were skilled agricultural and fishery workers by occupation (53.5%). Overall, 37.4% of the subjects were exposed to ETS. The home represented the most common source of ETS exposure (10.3% for men, 23.7% for women, and 31.4% for pregnant women). Table 1 presents selected characteristics

Discussion

This study indicates that 37.4%, or an estimated 1,629,700 Cambodian nonsmoking adults, were exposed to ETS. The ETS prevalence in Cambodia, while slightly lower, is similar to that found among nonsmoking Chinese (41.4%).7 Men were less likely to be exposed to ETS at home than women while being much more likely to be exposed to ETS at work and in public places. Similar patterns also were reported in China7 and Spain,8 suggesting that nonsmoking men are less likely to have smoking spouses than

Conclusion

The high prevalence of ETS exposure among Cambodian adults at home as well as in the workplace and public areas, indicates an urgent need for specific measures, such as public awareness campaigns, policies, and regulations, to protect the general nonsmoking population. These findings have major public health implications for Cambodia and other countries in the Western Pacific Region (WPR) whose populations have similar ethnic composition.

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