Research paper
CC-BY-NC 4.0

Factors Associated with Exposure to Passive Smoking among 12-18 year-old Students in Athens and Thessaloniki, Greece

Andreas S Lappas 1, 2  ,  
Niki Dimou 3,  
Biomedical Research Foundation of the Academy of Athens, Greece
Smoking and Lung Cancer Research Centre, Hellenic Cancer Society, Greece
Department of Computer Science and Biomedical Informatics, University of Thessaly, Greece
Tob. Prev. Cessation 2015;1(November):7
Publish date: 2015-11-28
Passive-smoking is a major, preventable cause of disease, disability and death. It is estimated that the majority of the world’s population is still living in countries not fully covered by smoke-free public health regulations and Greece is unfortunately one of them. The aim of our study, conducted in October 2014, was to provide up to date information regarding determinants of exposure to passive smoking among the student population of the two biggest Greek cities.

Our survey was conducted on a representative sample of middle and high school students (1803 in total, 810 boys and 992 girls), living in the two biggest cities of Greece. A questionnaire was developed to estimate the exposure of students to passive-smoking. Relative frequencies were calculated for all the questions and a Pearson χ2-test was used to evaluate the potential association of several variables with gender, age and smoking status. Logistic regression analysis were also applied to evaluate the association between social influences and the likelihood of being exposed to passive smoking.

A total of 86.7% of youth were exposed to passive-smoking during the 30 days preceding the survey. Daily exposure during the past 7 days was reported by 20.2% of the students. The highest rates of exposure were reported in cafes (61.2%), home (43.7%) and school (37.2%). Gender, age, smoking status, and the smoking habits of parents, siblings and friends, but also the sight of peers and teachers smoking inside the school campus, were significant determinants of students’ exposure to passive smoking.

Passive-smoking exposure is prevalent among the student population in Greece, despite the New Anti-Smoking Legislation that came into effect in July 2009. Our findings indicate that enforcement of the law and additional public health initiatives must be implemented.

Andreas S Lappas   
Biomedical Research Foundation of the Academy of Athens (BRFAA), 4 Soranou Ephessiou st. 115 27, Athens, Greece
1. World Health Organization report on tobacco epidemic 2013, Geneva, Switzerland. Available from: (accessed 27 Oct 2015).
2. Heffernan TM, O’Neill O. Exposure to second-hand smoke damages everyday prospective memory. Addiction 2012; 108:420-426. doi: 10.1111/j.1360-0443.2012.04056.x.
3. Boffetta P, Trédaniel J, Greco A. Risk of Childhood Cancer and Adult Lung Cancer after Childhood Exposure to Passive Smoke: A Meta-Analysis. Environmental Health Perspectives 2000; 108:73-82. doi: 10.1289/ehp.0010873.
4. Besaratinia A, Pfeifer GP. Second-hand smoke and human lung cancer. Lancet Oncol. 2008; 9:657-666. doi: 10.1016/S1470-2045(08)70172-4.
5. Cook DG, Strachan DP. Health effects of passive smoking, 10: Summary effects of parental smoking on the respiratory health of children and implications for research. Thorax 1999; 54:357-366. doi: 10.1136/thx.54.4.357.
6. Öberg M, Jaakkola MS, Woodward A, Peruga A, Prüss-Ustün A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet 2011; 377(9760):139-146. doi: 10.1016/S0140-6736(10)61388-8.
7. Kyrlesi A, Sotiriades ES, Warren CW, Kremastinou J, Papastergiou P, Jones NR, Hadjichristodoulou C. Tobacco use among students aged 13-15 years in Greece: the GYTS project. BMC Public Health 2007;7:3. doi: 10.1186/1471-2458-7-3.
8. Rachiotis G, Siziya S, Muula AS, Rudatsikira E, Papastergiou P, Hadjichristodoulou C. Determinants of exposure to Environmental Tobacco Smoke (ETS) among non smoking adolescents (aged 11-17) in Greece: results from the 2004-2005 GYTS Study. Int J Environ Res Public Health 2010; 7(1):284-290. doi: 10.3390/ijerph7010284.
9. Global Youth Tobacco Survey (GYTS) – World Health Organization. Available from: (accessed 27 Oct 2015).
10. Vardavas C, Klimopoulos A, Liozidou A, Behrakis P. Questionnaire design for the epidemiological study: “I learn the truth; I say no to cigarette”. Biomedical Research Foundation of the Academy of Athens. Technical Report; October 2013: report number 1.2.
11. Preston AM, Rodriguez C, Rivera CE, Sahai H. Determinants of environmental tobacco smoke in a population of Puerto Rican children. Nicotine Tob Res 2001; 3:61-70. doi: 10.1080/14622200123793.
12. Li MF, Wang RH. Factors related to avoidance of environmental tobacco smoke among adolescents in Taiwan. J Nurs Res 2006; 16:103-112. doi: 10.1097/01.jnr.0000387568.41941.f0
13. Rudatsikira E, Siziya S, Dondog J, Muula AS. Prevalence and Correlates of environmental tobacco smoke exposure among adolescents in Mongolia. Indian J Paediatr 2007; 74:1089-1093. doi: 10.1007/s12098-007-0203-y.