Format
Scientific article
Publication Date
Published by / Citation
Yoshioka T, Shinozaki T, Hori A, et alAssociation between exposure to secondhand aerosol from heated tobacco products and respiratory symptoms among current non-smokers in Japan: a cross-sectional studyBMJ Open 2023;13:e065322. doi: 10.1136/bmjopen-2022-065322
Original Language

English

Country
Japan
Keywords
heated tobacco products
tobacco
exposure to secondhand aerosol
secondhand smoke
respiratory symptoms

Association between exposure to secondhand aerosol from heated tobacco products and respiratory symptoms among current non-smokers in Japan: a cross-sectional study

Abstract

Objectives To investigate the association between secondhand-aerosol exposure from heated tobacco products (HTPs) and respiratory symptoms among current non-smokers.

Design Cross-sectional study.

Setting Internet survey conducted between 8 and 26 February 2021 in Japan.

Participants Non-smoking respondents at the survey aged 15–80 years.

Exposure Self-reported secondhand-aerosol exposure.

Primary and secondary outcomes We defined asthma/asthma-like symptoms as a primary outcome and persistent cough as a secondary outcome. We examined the association between secondhand-aerosol exposure from HTPs and respiratory symptoms (asthma attacks/asthma-like symptoms and persistent cough). The prevalence ratio (PR) and 95% CI were calculated by using weighted, multivariable ‘modified’ Poisson regression models.

Results Of the 18 839 current non-smokers, 9.8% (95% CI 8.2% to 11.7%) and 16.7% (95% CI 14.8% to 18.9%) of those who were exposed to secondhand aerosols reported asthma attacks/asthma-like symptoms and persistent cough, whereas 4.5% (95% CI 3.9% to 5.2%) and 9.6% (95% CI 8.4% to 11.0%) of those who were not, respectively. Secondhand-aerosol exposure was associated with respiratory symptoms (asthma attacks/asthma-like symptoms: PR 1.49, 95% CI 1.21 to 1.85; persistent cough: PR 1.44, 95% CI 1.21 to 1.72) after adjusting for covariates.

Conclusion Secondhand-aerosol exposure from HTPs was associated with both asthma attacks/asthma-like symptoms and persistent cough. These results provide policymakers with meaningful information in the regulation of HTP use for the protection of current non-smokers.

 

Strengths and limitations of this study

  • This study used large-scale internet survey data with sampling weights from a nationally representative survey in Japan.

  • This study focused on current non-smokers that are the most important population for tobacco control policy but are currently underexamined.

  • There may be some differences between respondents and the general population.

  • There may also be measurement errors because all variables were based on self-reported questionnaires.