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Secondhand smoke is associated with poor sleep quality in self-reported never-smokers of Northwest China: a cross-sectional study

  • Epidemiology • Original Article
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Abstract

Objective

To investigate the relationship between secondhand smoke (SHS) exposure and sleep quality in never-smokers of Northwest China.

Methods

Never-smoking adults (≥ 15 years) from Xinjiang, Northwest China, were included in this cross-sectional survey between April and October 2019. SHS exposure in never-smokers was estimated using a structured questionnaire. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI), with PSQI score > 5 classified as poor sleep quality. Association of SHS exposure and frequency and duration of SHS exposure with poor sleep quality were analyzed by using a multivariate logistic regression after adjusting for potential confounding factors, including stratification by sex.

Results

The mean age of participants was 48.0 years, and 77% were females. Of 21,198 never-smokers, 13% (n = 2703) reported SHS exposure and 35% (n = 7390) reported poor sleep quality. In multivariate logistic regression analysis, a significant association was observed between SHS exposure and poor sleep quality (adjusted odds ratio (OR), 1.36; 95% confidence interval (CI) 1.24–1.48). Subgroup analysis showed a negative association of SHS exposure with sleep quality in both sexes. However, a significant dose–response relationship of frequency and duration of SHS exposure per week with poor sleep quality was observed only in females. Consistent results were also observed in the aged ≥ 18 years.

Conclusion

Exposure to SHS is associated with poor sleep quality in never-smoking adults of Northwest China. A dose–response relationship between SHS exposure and poor sleep quality is found in women. Avoiding SHS exposure may have beneficial effects on sleep quality, especially for females.

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Availability of data and material

Materials included in the manuscript, excluding the relevant raw data, will be made freely available to any researchers who wish to use them for noncommercial purposes while preserving any necessary confidentiality and anonymity.

Code availability

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Acknowledgements

We thank all the individuals who participated in the present study. We thank the Ministry of Science and Technology of the People’s Republic of China and the Department of Science and Technology of Xinjiang Uygur Autonomous Region of China for funding the project.

Funding

This work was supported by a grant from the national key research and development plan projects (2018YFC1311503) and the Department of Science and Technology of Xinjiang Uygur Autonomous Region of China (2017B03015).

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Authors and Affiliations

  1. Hypertension Center of People’s Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, National Health Committee Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Hypertension Research Laboratory Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases China, No. 91 Tianchi Road, Xinjiang, 830001, Urumqi, China

    Lin Wang, Mulalibieke Heizhati, Mei Li, Zhongrong Wang, Zhikang Yang, Reyila Abudereyimu, Wenbo Yang, Ling Yao & Nanfang Li

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  1. Lin Wang
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Contributions

NL, LW, and MH was involved in the study design. NL, LW, MH, ML, ZY, ZW, RA, WY, and LY participated in the data collection. LW and MH designed the survey and performed the statistical analysis. LW drafted the manuscript. MH critically revised the manuscript. NL, ML, ZY, ZW, RA, WY, and LY gave important suggestions and did significant changes. All authors reviewed and approved the final version of the paper.

Corresponding author

Correspondence to Nanfang Li.

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Ethics approval was obtained from the Ethics Review Committee of People’s Hospital of Xinjiang Uygur Autonomous Region.

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All subjects signed the informed consent.

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All authors agree with the publication.

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The authors declare no competing interests.

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Comment

The authors are commended for undertaking a study on the effects of second hand smoking in a population that includes adolescents through adults over 60 years and more importantly, that the study was undertaken on a population living in a less developed region where there is generally poor health awareness. Such populations are often ignored in health research. The outcomes identified that in women there was a dose response relationship between exposure to second hand smoke and poor sleep quality for those who were exposed but never smoked. The results highlight the important need for equity for all through education on improving health awareness about smoking cessation. a

Margot Skinner

Dunedin, New Zealand

Lin Wang and Mulalibieke Heizhati contributed equally to this work and are the co-first authors.

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Wang, L., Heizhati, M., Li, M. et al. Secondhand smoke is associated with poor sleep quality in self-reported never-smokers of Northwest China: a cross-sectional study. Sleep Breath 26, 1417–1426 (2022). https://doi.org/10.1007/s11325-021-02505-x

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