Parental socioeconomic and lifestyle determinants of children’s secondhand smoke exposure in Hungary: analysis of European Health Interview Survey 2019 data

Abstract

Background Secondhand smoke (SHS) exposure remains a major public health concern, particularly for children who are highly vulnerable to the harmful effects of tobacco smoke. Despite comprehensive smoke-free policies in Hungary, children may still be exposed to SHS in private environments such as homes and outdoor settings. This study aimed to examine the prevalence and determinants of children’s exposure to SHS in Hungary. Methods This cross-sectional study used nationally representative data from the European Health Interview Survey (EHIS) 2019 conducted in Hungary. Of 964 eligible parents living with at least one child aged 0–15 years, 191 with missing outcome or covariate data were excluded, yielding a final analytic sample of 773 parents. Children’s exposure was assessed from parental reports of exposure to conventional cigarette smoke and/or e-cigarette aerosol during the previous week. Three outcome variables were analyzed: indoor exposure, outdoor exposure, and overall exposure. Associations between parental demographic, socioeconomic, health, and lifestyle factors and children’s exposure were examined using Pearson’s chi-square tests and weighted multivariable logistic regression models. Results Among the respondents, 8.8% reported indoor SHS exposure and 17.1% reported outdoor exposure among children, while 21.5% reported overall SHS exposure. Children’s exposure to SHS was significantly associated with several parental characteristics. Lower household income, non-registered marital status, poorer parental oral health, and active smoking were associated with higher odds of indoor SHS exposure. Outdoor exposure was associated with urbanization, poorer oral health, and parental smoking. Overall SHS exposure was higher among children of parents with lower income, non-registered marital status, poorer oral health, poorer mental health, and active smoking status. Conclusion A considerable proportion of children in Hungary remain exposed to SHS. Socioeconomic disadvantage, parental smoking, and parental health status are important determinants of children’s SHS exposure. Targeted public health interventions focusing on smoking cessation and promoting smoke-free home environments are essential to reduce children’s exposure to SHS.