title: Closing the knowledge gap in secondhand smoke exposure among children: employment of a five-minute household survey in China.
abstract: OBJECTIVE
  The 2010 Global Burden of Disease study unexpectedly reports no health burden associated with secondhand smoke (SHS) exposure in children 5-17 years of age. One possible reason for this error is that children under 13 years of age are not considered in standard community surveys of SHS exposure. This study aims to use a 5-min household survey to estimate the prevalence of SHS exposure among children in urban and rural China.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A multi-stage stratified sample of 1120 urban and rural households with 3073 residents from the Ningbo, China, was identified and one adult member from each household was administered a brief survey about the demographic characteristics and smoking status of all household residents.
  
  
  RESULTS
  Adjusting for the sampling design and clustering within households, 63% of children less than 7 years of age, 53% of the children 7-12 years of age, and 54% of the children 13-17 years of age were living in households with daily smokers. Controlling for the number of male residents, significantly more households with daily smokers were located in rural areas (p < 0.001) and the average education level of adults in households with daily smokers was significantly lower than that among adults in households without daily smokers (p = 0.007).
  
  
  CONCLUSIONS
  The heavy household exposure of children in China to SHS is an unrecognized public health problem that demands urgent policy and programmatic responses. The brief household survey developed for this study is an easy method for monitoring the prevalence of SHS exposure of children over time that could be useful in community-based tobacco control initiatives.
authors.affiliation: Suicide Research and Prevention Centre, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: W
authors.initials: W
authors.lastname: Xiong
authors.affiliation: Suicide Research and Prevention Centre, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Departments of Psychiatry and Global Health, Emory University, Atlanta, GA, USA. Electronic address: mphillipschina@outlook.com.
authors.forename: M R
authors.initials: MR
authors.lastname: Phillips
authors.affiliation: Suicide Research and Prevention Centre, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Centre for the Study and Prevention of Suicide, University of Rochester Medical Centre, Rochester, NY, USA.
authors.forename: Y Q
authors.initials: YQ
authors.lastname: Xu
authors.affiliation: Ningbo Municipal Centre for Disease Control and Prevention, Ningbo, Zhejiang, China.
authors.forename: X H
authors.initials: XH
authors.lastname: Wang
authors.affiliation: Ningbo Municipal Centre for Disease Control and Prevention, Ningbo, Zhejiang, China.
authors.forename: H
authors.initials: H
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D012424:Rural Population / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology*; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Children; Community screening; Low- and middle-income countries; Secondhand smoke; Surveillance and monitoring