title: Private space second-hand smoke exposure and the mental health of non-smokers: a cross-sectional analysis of Canadian adults.
abstract: BACKGROUND
  The aim of this paper was to examine the association between exposure to second-hand smoke (SHS) among non-smokers, in the home and the vehicle, and poor mental health outcomes (mood disorder, anxiety disorder, poor/fair mental health, and high stress).
  
  
  METHODS
  Data were drawn from the 2010 Canadian Community Health Survey, a representative sample of 62,909 Canadians 12years and older. Measures of SHS exposure are drawn from self-reported daily or near daily exposure in the home or in the vehicle. Mental health indicators include self-reported diagnosed mood and anxiety disorders, and self-report measures of overall mental health and experiences of stress. Associations between SHS exposure and poor mental health among non-smokers were examined in a series of logistic regression models. Additional analyses stratified on respondent's smoking status, physical health, and gender.
  
  
  RESULTS
  Analyses revealed that SHS exposure among non-smokers was associated with increased anxiety disorders, poor/fair mental health, and high stress, with no association to mood disorders. Stratified analyses demonstrated that associations between SHS and poor mental health are contextualized by respondent's gender, physical health, and smoking status.
  
  
  CONCLUSIONS
  Beyond changes to physical health, SHS exposure in private spaces was negatively associated with the mental health of non-smokers. Public health efforts to reduce SHS exposure in private spaces are warranted. Findings also reveal additional targets for decreasing and eliminating the societal burden of mental health disorders. Further research is needed to examine causality and to explore associations between SHS exposure and specific mental health outcomes.
authors.affiliation: Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia, Canada B3H 1V7. Mark.Asbridge@dal.ca
authors.forename: Mark
authors.initials: M
authors.lastname: Asbridge
authors.forename: Kristen
authors.initials: K
authors.lastname: Ralph
authors.forename: Sherry
authors.initials: S
authors.lastname: Stewart
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016902:Air Pollution, Indoor / Q000009:adverse effects; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology*; D001336:Automobiles / Q000706:statistics & numerical data; D002170:Canada / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology*; D012931:Social Environment; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution