Tobacco advertising and oral health among never smokers: the mediating role of secondhand smoke exposure.

IF 0.9 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Community dental health Pub Date : 2024-05-31 DOI:10.1922/CDH_00053Oliveira05

L M Oliveira, T R Pelissari

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Abstract

Objective: To determine whether the association between tobacco advertising (TA) exposure and poor self-rated oral health (SROH) is mediated through secondhand smoke (SHS) exposure in Brazilian adults who have never smoked.

Methods: Secondary cross-sectional analysis of The Brazilian National Health Survey 2019 data. The daily, weekly, or monthly exposure to SHS at home or at work was set as the mediator. Mediation analysis within a counterfactual approach used adjusted binary logistic regressions for both poor SROH and SHS exposure, to estimate the natural direct effect (NDE), natural indirect effect (NIE) through SHS exposure, and marginal total effect (MTE) of TA exposure on poor SROH. To assess the robustness of the results, we calculated the E-value for the MTE.

Results: The sample comprised 53,295 never smoker adults. The MTE of TA exposure on poor SROH was 1.09 (1.03, 1.16), with the indirect effect through SHS exposure responsible for only 16.6% of the total (NIE: 1.01 [1.01, 1.02] and NDE: 1.08 [1.02, 1.14]). An effect of 1.42 would be required for an unmeasured confounder to explain away the association between TA and SROH.

Conclusion: More individuals exposed to TA have poor SROH than those unexposed, with secondhand smoke exposure explaining only a small portion of this effect. Upstream tobacco policies should consider oral health outcomes.

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烟草广告与从不吸烟者的口腔健康：二手烟暴露的中介作用。

目的确定在从未吸烟的巴西成年人中，烟草广告（TA）暴露与自评口腔健康不良（SROH）之间的关联是否通过二手烟（SHS）暴露来调节：对2019年巴西全国健康调查数据进行二级横断面分析。将每天、每周或每月在家中或工作场所接触的SHS设定为中介因素。在反事实方法中进行中介分析时，对不良SROH和SHS暴露进行调整后的二元逻辑回归，以估计TA暴露对不良SROH的自然直接效应（NDE）、通过SHS暴露产生的自然间接效应（NIE）和边际总效应（MTE）。为了评估结果的稳健性，我们计算了 MTE 的 E 值：样本包括 53,295 名从不吸烟的成年人。TA 暴露对不良 SROH 的 MTE 为 1.09 (1.03, 1.16)，通过 SHS 暴露产生的间接效应仅占总效应的 16.6%（NIE：1.01 [1.01, 1.02]；NDE：1.08 [1.02, 1.14]）。如果要解释TA与SROH之间的关系，需要1.42的影响，而这是一个未测量的混杂因素：结论：与未暴露于烟草暴露的人相比，更多暴露于烟草暴露的人的口腔健康状况较差，而二手烟暴露只能解释这种影响的一小部分。上游烟草政策应考虑口腔健康结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Community dental health 医学-牙科与口腔外科

CiteScore

2.20

自引率

11.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal is concerned with dental public health and related subjects. Dental public health is the science and the art of preventing oral disease, promoting oral health, and improving the quality of life through the organised efforts of society. The discipline covers a wide range and includes such topics as: -oral epidemiology- oral health services research- preventive dentistry - especially in relation to communities- oral health education and promotion- clinical research - with particular emphasis on the care of special groups- behavioural sciences related to dentistry- decision theory- quality of life- risk analysis- ethics and oral health economics- quality assessment. The journal publishes scientific articles on the relevant fields, review articles, discussion papers, news items, and editorials. It is of interest to dentists working in dental public health and to other professionals concerned with disease prevention, health service planning, and health promotion throughout the world. In the case of epidemiology of oral diseases the Journal prioritises national studies unless local studies have major methodological innovations or information of particular interest.