The association between sleep disturbance and second-hand smoke exposure: a large-scale, nationwide, cross-sectional study of adolescents in Japan

Abstract Objective This study investigated the association between secondhand-smoke (SHS) exposure and sleep disturbance symptoms. Methods This study was a cross-sectional survey of junior and senior high school students throughout Japan. A total of 85,931 adolescents responded, and 84,988 questionnaires were included in the analysis. Results Adolescents who had never smoked accounted for 88.0% of respondents; among that group 39.1% reported having been exposed to SHS over the previous week. The results of multiple logistic regression analyses indicated that the adjusted odds ratios for insomnia symptoms such as difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS) and early morning awakening (EMA), as well as sleep disturbance symptoms such as subjectively insufficient sleep and short sleep duration ( Conclusions The present study has revealed that SHS exposure is associated with sleep disturbance. Thus, in addition to smoking cessation programs, it is also necessary to endorse measures to protect adolescents from SHS exposure in order to promote good sleep in this population.