# Secondhand smoke exposure and sleep disturbances among Korean adolescents: A nationally representative cross-sectional study

## TL;DR

Exposure to secondhand smoke is linked to shorter sleep durations in Korean adolescents, with the effect influenced by tobacco use.

## Contribution

This study provides novel evidence on the association between secondhand smoke exposure and sleep disturbances in adolescents, using a large national dataset.

## Key findings

- Each additional day of SHS exposure was associated with reduced weekly, weekday, and weekend sleep duration.
- Tobacco use significantly moderated the relationship between SHS exposure and sleep duration.
- The association between SHS and sleep deprivation remained significant after adjusting for multiple variables.

## Abstract

Inadequate sleep duration among adolescents is increasingly recognized as a significant public health concern, with potential associations with various environmental exposures. This study investigates the association between secondhand smoke (SHS) exposure and sleep duration in Korean adolescents.

This study employed a pooled cross-sectional design using data from the nationally representative Korea Youth Risk Behavior Web-based Survey from 2021 to 2024 (n=195664). This study analyzed self-reported sleep duration (hours/minutes) from the Korea Youth Risk Behavior Web-based Survey (KYRBS). Ordinary least squares regression models were used to analyze the association between SHS exposure days and sleep duration, adjusting for individual, school, and family-level control variables. The moderating effect of tobacco use was examined through interaction terms.

SHS exposure demonstrated a significant negative association with adolescent sleep duration. After full adjustment for control variables, each additional day of SHS exposure was associated with a reduction in weekly average sleep duration (β= -0.027; 95% CI: -0.029 – -0.024, p<0.01), weekday sleep duration (β= -0.030; 95% CI: -0.03 – -0.028, p<0.01), and weekend sleep duration (β= -0.018; 95% CI: -0.023 – -0.013, p<0.01). Tobacco use significantly moderated this relationship, with the interaction term showing positive coefficients across all sleep duration models.

SHS exposure significantly associated with sleep deprivation among Korean adolescents, with this association being influenced by individual tobacco use habits.