Assessing second-hand smoke exposure among non-smoking youth in India: Insights from GATS I & II

Background & objectives This study aimed to compare the prevalence and identify the patterns of second-hand smoke (SHS) exposure among non-smoking Indian youth (ages 15-24 and 25-29 yr) in various settings-homes, workplaces, public places, and a combination of these locations-based on sociodemographic factors and knowledge about the health implications of smoking. The purpose of the study was to identify the factors influencing SHS exposure in India between the Global Adult Tobacco Survey (GATS) I and II. Methods Secondary data analysis was conducted utilising GATS I and II data to analyse the prevalence and patterns of SHS exposure at home, workplace, public place and all the places combined among non-smoking youths aged 15-29 yr. The study sample included 20,604 and 20,927 individuals for GATS I and II, respectively. The predictor variables included the sociodemographic variables and the knowledge regarding the ill effects of smoking. Weighted prevalence was calculated using survey weights, and multivariate logistic regression analyses were utilised to examine the adjusted relationships between SHS exposure and predictors. Results Between GATS I and II, there was a notable decline in the weighted prevalence of SHS exposure at home and in public places among non-smoking youth aged 15-29 yr. The study also indicates an increase in workplace SHS exposure between the two rounds of GATS among non-smoking youth who had knowledge about the ill effects of SHS exposure on health. Multivariate regression analyses revealed significant associations between SHS exposure and gender, education level, employment status, place of residence, and wealth index, affecting exposure in one or more locations. Interpretation & conclusions Our secondary analysis of GATS data from 2009-10 to 2016-17 reveals a decline in SHS exposure at home and public places but an increase in workplaces among non-smoking youth. Factors like female gender, higher education, and wealth were linked to lower SHS exposure, while rural residence and self-employment indicated higher risks. These findings underscore the need for targeted, community-based interventions and stricter enforcement of anti-tobacco laws to protect non-smoking youth in India.