Social and Environmental Determinants of Secondhand Smoke Exposure and Physical and Mental Health among Immigrant-Origin Youths in Korea

Secondhand smoke is understudied among immigrants in Korea. We examined the impact of smoking rates in the parents' countries of origin on secondhand smoke exposure at home and adolescents' physical and mental health, focusing on immigrant-origin status. Further, we explored the social and environmental determinants of secondhan smoke exposure. Data from the 2021 Korea Youth Risk Behavior Web-based Survey involving 38,690 middle and high school students were used. The relationships between tobacco smoking rates in parents' countries of origin, secondhand smoke exposure, and adolescents' physical and mental health were assessed using multivariable linear regression and generalized structural equation modeling. Immigrant-origin youths reported significantly higher secondhand smoke exposure (M = 1.09, SD = 2.08) than non-immigrant youths (M = 0.85, SD = 1.89, p < 0.001), which directly correlated with their poor physical and mental health. Smoking rates in fathers' countries of origin showed significant indirect effects on physical (β=-0.326) and mental health (anxiety: β = 3.906; distress: β = 0.723, and depression: OR = 1.436) via fathers' smoking behaviors. Adolescents with low subjective socioeconomic status, low academic achievement, and residing outside the Seoul metropolitan area were more vulnerable to physical and mental health problems. Therefore, culturally informed and sex-specific interventions are required to improve the well-being of vulnerable adolescents from immigrant families.