title: Association of second-hand smoke exposure at home with psychological distress in the Spanish adult population.
abstract: BACKGROUND
  Second-hand smoke (SHS) exposure has been associated with increased risks of respiratory and heart diseases. However, little is known about the potential effects of SHS on psychological distress. The aim of this study is to examine the association of SHS exposure at home with psychological distress in Spain.
  
  
  METHODS
  A cross-sectional survey about SHS exposure, socio-demographic and health related variables, and psychological distress, measured with the 12-item version of the General Health Questionnaire (GHQ-12) with a cut-off score ≥ 3, was conducted from 2011-2012 among a representative sample of the adult population (aged ≥ 15 years) of Spain. From the total sample (n = 21,007), we used the subsample of never-smokers (n = 11,214). We computed the odds ratios (OR) and their 95% confidence intervals (95% CI) for scoring ≥ 3 on the GHQ by means of unconditional multiple logistic regression models adjusted for sex and age.
  
  
  RESULTS
  In the subsample, 9.7% (n = 1,090) responded that they were exposed to SHS at home. The prevalence of subjects scoring ≥ 3 on the GHQ was higher for the sample exposed to SHS (22.7%) than for the non-exposed sample (18.9%; OR: 1.39; CI: 1.19-1.62). This association was also present when stratified for sex, age, marital status, socio-economic status, perceived general health, presence of any chronic disease, and alcohol intake.
  
  
  CONCLUSIONS
  Exposure to SHS at home is associated with psychological distress. Further investigation is necessary to determine if this association is causal. Avoiding SHS exposure at home could have beneficial effects on psychological distress.
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet de Llobregat, 199-203, L'Hospitalet de Llobregat 08908, Barcelona, Spain; Catalan Network of Smoke-free Hospitals, Av. Granvia de l'Hospitalet de Llobregat, 199-203, L'Hospitalet de Llobregat 08908, Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Av. Granvia de l'Hospitalet de Llobregat, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona - IDIBAPS, C. Villarroel 170, 08036 Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa Llarga s/n, 08907 Barcelona, Spain. Electronic address: mballbe@iconcologia.net.
authors.forename: Montse
authors.initials: M
authors.lastname: Ballbè
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet de Llobregat, 199-203, L'Hospitalet de Llobregat 08908, Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Av. Granvia de l'Hospitalet de Llobregat, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Medicine and Health Sciences School, Universitat Internacional de Catalunya, C. Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Martínez-Sánchez
authors.affiliation: Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona - IDIBAPS, C. Villarroel 170, 08036 Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Gual
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet de Llobregat, 199-203, L'Hospitalet de Llobregat 08908, Barcelona, Spain; Catalan Network of Smoke-free Hospitals, Av. Granvia de l'Hospitalet de Llobregat, 199-203, L'Hospitalet de Llobregat 08908, Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Av. Granvia de l'Hospitalet de Llobregat, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Medicine and Health Sciences School, Universitat Internacional de Catalunya, C. Josep Trueta s/n, 08195 Sant Cugat del Vallès, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Martínez
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet de Llobregat, 199-203, L'Hospitalet de Llobregat 08908, Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Av. Granvia de l'Hospitalet de Llobregat, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa Llarga s/n, 08907 Barcelona, Spain.
authors.forename: Marcela
authors.initials: M
authors.lastname: Fu
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet de Llobregat, 199-203, L'Hospitalet de Llobregat 08908, Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Av. Granvia de l'Hospitalet de Llobregat, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa Llarga s/n, 08907 Barcelona, Spain.
authors.forename: Xisca
authors.initials: X
authors.lastname: Sureda
authors.affiliation: University of Miami, Miller School of Medicine, Department of Public Health Sciences, 1600 NW 10th Ave 1140, Miami, FL 33136, USA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Padrón-Monedero
authors.affiliation: National Centre for Epidemiology, Instituto de Salud Carlos III, C. Monforte de Lemos, 5, Pabellón 12, 28029 Madrid, Spain.
authors.forename: Iñaki
authors.initials: I
authors.lastname: Galán
authors.affiliation: Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet de Llobregat, 199-203, L'Hospitalet de Llobregat 08908, Barcelona, Spain; Catalan Network of Smoke-free Hospitals, Av. Granvia de l'Hospitalet de Llobregat, 199-203, L'Hospitalet de Llobregat 08908, Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, Av. Granvia de l'Hospitalet de Llobregat, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, C. Feixa Llarga s/n, 08907 Barcelona, Spain.
authors.forename: Esteve
authors.initials: E
authors.lastname: Fernández
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Adult; Mental health; Spain; Tobacco smoke pollution