{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:22:20Z","timestamp":1765887740543,"version":"build-2065373602"},"reference-count":56,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2015,11,13]],"date-time":"2015-11-13T00:00:00Z","timestamp":1447372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hong Kong Council on Smoking and Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Tobacco use adversely affects many aspects of well-being and is disliked by  non-smokers. However, its association with family happiness is unknown. We investigated the associations of family unhappiness with smoking in family members and secondhand smoke (SHS) exposure at home in Hong Kong children. In a school-based survey in 2012\u20132013,  1238 primary school students (mean age 8.5 years, standard deviation 0.9; 42.6% boys) reported family smoking, SHS exposure at home and whether their families had any unpleasant experience caused by smoking or SHS in the past 30 days (tobacco-related unpleasant experience), and rated the overall level of happiness in their families (family unhappiness). Multivariable logistic regression was used to study the associations of tobacco-related unpleasant experience and family unhappiness with family smoking and SHS exposure at home. Tobacco-related unpleasant experience and family unhappiness were reported by 27.5% and 16.5% of students. Unpleasant experience was more strongly associated with family smoking than SHS exposure at home. Family unhappiness was associated with both family smoking (odds ratio 2.37; 95% confidence interval 1.51\u20133.71) and SHS exposure at home (1.82; 1.39\u20132.40). These results suggest a previously neglected possible impact of tobacco use on family happiness.<\/jats:p>","DOI":"10.3390\/ijerph121114557","type":"journal-article","created":{"date-parts":[[2015,11,16]],"date-time":"2015-11-16T05:40:47Z","timestamp":1447652447000},"page":"14557-14570","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Family Smoking, Exposure to Secondhand Smoke at Home and Family Unhappiness in Children"],"prefix":"10.3390","volume":"12","author":[{"given":"Jian","family":"Chen","sequence":"first","affiliation":[{"name":"School of Public Health, University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sai","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wing","family":"Au","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4000-2388","authenticated-orcid":false,"given":"Man","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tai","family":"Lam","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2015,11,13]]},"reference":[{"key":"ref_1","unstructured":"US Department of Health and Human Services The Health Consequences of Smoking\u201450 years of Progress: A report of the Surgeon General, Available online: http:\/\/www.surgeongeneral.gov\/library\/reports\/50-years-of-progress\/full-report.pdf."},{"key":"ref_2","unstructured":"US Department of Health and Human Services The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK44324\/pdf\/Bookshelf_NBK44324.pdf."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1007\/BF02883426","article-title":"Cigarette smoking predicts development of depressive symptoms among US adolescents","volume":"19","author":"Choi","year":"1997","journal-title":"Ann. Behav. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.jpsychires.2010.06.006","article-title":"Tobacco smoking as a risk factor for depression. A 26-year population-based follow-up study","volume":"45","author":"Flachs","year":"2011","journal-title":"J. Psychiatr. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1017\/S0033291706009639","article-title":"Smoking behaviour as a predictor of depression among Finnish men and women: A prospective cohort study of adult twins","volume":"37","author":"Korhonen","year":"2007","journal-title":"Psychol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/j.1600-0447.1994.tb05796.x","article-title":"Physical activity and personal characteristics associated with depression and suicide in American college men","volume":"89","author":"Paffenbarger","year":"1994","journal-title":"Acta. Psychiatr. Scand."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1093\/aje\/kwi219","article-title":"Effect of smoking on depressive symptomatology: A reexamination of data from the National Longitudinal Study of Adolescent Health","volume":"162","author":"Duncan","year":"2005","journal-title":"Am. J. Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1192\/bjp.bp.107.046706","article-title":"Tobacco smoking as a risk factor for major depressive disorder: Population-based study","volume":"193","author":"Pasco","year":"2008","journal-title":"Br. J. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1111\/j.1360-0443.2005.01092.x","article-title":"Depressive symptoms and smoking among Hong Kong Chinese adolescents","volume":"100","author":"Lam","year":"2005","journal-title":"Addiction"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1111\/j.1360-0443.2007.01885.x","article-title":"Smoking is associated with first-ever incidence of mental disorders: A prospective population-based study","volume":"102","author":"Cuijpers","year":"2007","journal-title":"Addiction"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1192\/bjp.bp.106.022558","article-title":"Risk factors for common mental disorders in women Population-based longitudinal study","volume":"189","author":"Patel","year":"2006","journal-title":"Br. J. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"87","DOI":"10.4088\/JCP.v68n0112","article-title":"Smoking as a risk factor for mental health disturbances after a disaster: A prospective comparative study","volume":"68","author":"Grievink","year":"2007","journal-title":"J. Clin. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1001\/archpsyc.60.7.692","article-title":"Smoking increases the risk of panic: Findings from a prospective community study","volume":"60","author":"Isensee","year":"2003","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.drugalcdep.2004.06.004","article-title":"Smoking, nicotine dependence and psychiatric comorbidity\u2014A population-based study including smoking cessation after three years","volume":"76","author":"John","year":"2004","journal-title":"Drug Alcohol Depend."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2348","DOI":"10.1001\/jama.284.18.2348","article-title":"Association between cigarette smoking and anxiety disorders during adolescence and early adulthood","volume":"284","author":"Johnson","year":"2000","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1002\/brb3.137","article-title":"How cigarette smoking may increase the risk of anxiety symptoms and anxiety disorders: A critical review of biological pathways","volume":"3","author":"Moylan","year":"2013","journal-title":"Brain Behav."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/hrp_8.3.99","article-title":"Biological aspects of the link between smoking and depression","volume":"8","author":"Quattrocki","year":"2000","journal-title":"Harv. Rev. Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1038\/379733a0","article-title":"Inhibition of monoamine oxidase B in the brains of smokers","volume":"379","author":"Fowler","year":"1996","journal-title":"Nature"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/S0887-6185(02)00222-0","article-title":"The impact of smoking on panic disorder: An initial investigation of a pathoplastic relationship","volume":"17","author":"Zvolensky","year":"2003","journal-title":"J. Anxiety Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1038\/npp.2008.220","article-title":"Nicotine exposure during adolescence induces a depression-like state in adulthood","volume":"34","author":"Iniguez","year":"2009","journal-title":"Neuropsychopharmacology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.ypmed.2008.01.024","article-title":"Active and passive smoking and depression among Japanese workers","volume":"46","author":"Nakata","year":"2008","journal-title":"Prev. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1001\/archpediatrics.2010.243","article-title":"Objectively measured secondhand smoke exposure and mental health in children: Evidence from the Scottish Health Survey","volume":"165","author":"Hamer","year":"2011","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1001\/archpediatrics.2011.30","article-title":"Secondhand smoke exposure and mental health among children and adolescents","volume":"165","author":"Bandiera","year":"2011","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1097\/PSY.0b013e3181c6c8b5","article-title":"Secondhand smoke exposure and depressive symptoms","volume":"72","author":"Bandiera","year":"2010","journal-title":"Psychosom Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1136\/tobaccocontrol-2012-050548","article-title":"Second-hand smoke exposure and psychological distress in adolescents. A population-based study","volume":"23","year":"2014","journal-title":"Tob. Control"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1001\/archgenpsychiatry.2010.76","article-title":"Objectively assessed secondhand smoke exposure and mental health in adults: Cross-sectional and prospective evidence from the Scottish Health Survey","volume":"67","author":"Hamer","year":"2010","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.jad.2014.07.014","article-title":"Secondhand smoke exposure across the life course and the risk of adult-onset depression and anxiety disorder","volume":"168","author":"Taha","year":"2014","journal-title":"J. Affect. Disord."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1093\/ntr\/ntp031","article-title":"Do ex-smokers report feeling happier following cessation? Evidence from a cross-sectional survey","volume":"11","author":"Shahab","year":"2009","journal-title":"Nicotine Tob. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.drugalcdep.2011.08.011","article-title":"Differences in happiness between smokers, ex-smokers and never smokers: Cross-sectional findings from a national household survey","volume":"121","author":"Shahab","year":"2012","journal-title":"Drug Alcohol Depend."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1136\/tobaccocontrol-2014-052092","article-title":"Smoking status, nicotine dependence and happiness in nine countries of the former Soviet Union","volume":"24","author":"Stickley","year":"2015","journal-title":"Tob. Control"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1111\/add.12531","article-title":"Ex-smokers are happier than current smokers among Chinese adults in Hong Kong","volume":"109","author":"Wang","year":"2014","journal-title":"Addiction"},{"key":"ref_32","unstructured":"Drehmer, J.E., Hipple, B., Ossip, D.J., Nabi-Burza, E., and Winickoff, J.P. (2015). A Cross-Sectional Study of Happiness and Smoking Cessation Among Parents. J Smok Cessat, Available online: http:\/\/journals.cambridge.org\/download.php?file=%2F289_D0EB4E16008FE04EBB9CF838A27055F8_journals__JSC_S1834261215000067a.pdf&cover=Y&code=070ae8ef0fc96cd88a9e7b504bdd5319."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Piqueras, J.A., Kuhne, W., Vera-Villarroel, P., van Straten, A., and Cuijpers, P. (2011). Happiness and health behaviours in Chilean college students: A cross-sectional survey. BMC Public Health, 11.","DOI":"10.1186\/1471-2458-11-443"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"255","DOI":"10.3233\/WOR-2009-0873","article-title":"Lifestyle determinants of depressive feeling and a feeling of unhappiness among workers: A study in Japan","volume":"33","author":"Kawada","year":"2008","journal-title":"Work"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.jadohealth.2010.06.016","article-title":"Sensitivity to secondhand smoke exposure predicts smoking susceptibility in 8\u201313-year-old never smokers","volume":"48","author":"Wahlgren","year":"2011","journal-title":"J. Adolesc. Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1177\/001789698904800402","article-title":"Clean-air kids or ashtray kids-children\u2019s views about other people smoking","volume":"48","author":"Michell","year":"1989","journal-title":"Health Educ. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1080\/10410230903104939","article-title":"The utility of anger in promoting clean indoor air policies","volume":"24","author":"Quick","year":"2009","journal-title":"Health Commun."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1136\/tc.2009.031161","article-title":"Can you please put it out? Predicting non-smokers\u2019 assertiveness intentions at work","volume":"19","author":"Aspropoulos","year":"2010","journal-title":"Tob. Control"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.adolescence.2013.09.006","article-title":"Happiness and health behaviour in Iranian adolescent girls","volume":"36","author":"Fararouei","year":"2013","journal-title":"J. Adolesc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1093\/her\/cyh027","article-title":"\u2018Stop it, it\u2019s bad for you and me\u2019: Experiences of and views on passive smoking among primary-school children in Liverpool","volume":"20","author":"Woods","year":"2005","journal-title":"Health Educ. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1111\/add.12435","article-title":"Children\u2019s resistance to parents\u2019 smoking in the home and car: A qualitative study","volume":"109","author":"Amos","year":"2014","journal-title":"Addiction"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1097\/01.NMC.0000269568.17432.72","article-title":"Family attitudes about tobacco smoke exposure of young children at home","volume":"32","author":"Yousey","year":"2007","journal-title":"MCN Am. J. Matern. Child. Nurs."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1111\/j.174-1617.1977.tb01321.x","article-title":"Family structure, family happiness, and their effect on college students\u2019 personal and social adjustment","volume":"15","author":"Raschke","year":"1977","journal-title":"Fam. Court. Rev."},{"key":"ref_44","unstructured":"Urban Expansion Project 11th Annual Demographia International Housing Affordability Survey, 2015. Available online: http:\/\/www.demographia.com\/dhi.pdf."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1093\/pan\/mpl013","article-title":"Matching as nonparametric preprocessing for reducing model dependence in parametric causal inference","volume":"15","author":"Ho","year":"2007","journal-title":"Polit. Anal."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/pan\/mpr013","article-title":"Causal inference without balance checking: Coarsened exact matching","volume":"20","author":"Iacus","year":"2012","journal-title":"Polit. Anal."},{"key":"ref_47","unstructured":"Hong Kong Council on Smoking and Health Living Smoke-Free, Annual Report 2012\u20132013. Available online: http:\/\/www.smokefree.hk\/UserFiles\/resources\/about_us\/annual_reports\/COSH_Annual_Report_2012_2013.pdf."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1136\/tc.2008.026955","article-title":"The impact of smoking and quitting on household expenditure patterns and medical care costs in China","volume":"18","author":"Xin","year":"2009","journal-title":"Tob. Control"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1016\/j.socscimed.2007.11.020","article-title":"Crowding out effect of tobacco expenditure and its implications on household resource allocation in India","volume":"66","author":"John","year":"2008","journal-title":"Soc. Sci. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1016\/j.socscimed.2005.07.032","article-title":"The impact of tobacco expenditure on household consumption patterns in rural China","volume":"62","author":"Wang","year":"2006","journal-title":"Soc. Sci. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1136\/tc.2003.004770","article-title":"Is household smoking status associated with expenditure on food at restaurants, alcohol, gambling and insurance? Results from the 1998\u201399 Household Expenditure Survey, Australia","volume":"13","author":"Siahpush","year":"2004","journal-title":"Tob. Control"},{"key":"ref_52","unstructured":"Information Service Department of HKSAR Hong Kong: Fact Sheets, Available online: http:\/\/www.gov.hk\/en\/about\/abouthk\/factsheets\/docs\/population.pdf."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1093\/heapro\/dan028","article-title":"Employees\u2019 job satisfaction after the introduction of a total smoke-ban in bars and restaurants in Norway","volume":"23","author":"Hetland","year":"2008","journal-title":"Health Promot. Int."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1136\/tc.2009.032003","article-title":"Comprehensive smoke-free legislation and displacement of smoking into the homes of young children in Hong Kong","volume":"19","author":"Ho","year":"2010","journal-title":"Tob. Control"},{"key":"ref_55","unstructured":"Chen, J.J., Ho, S.Y., Wang, M.P., and Lam, T.H. Reactions to Thirdhand Smoke are associated with Openness to Smoking in Young never Smoking Children. Available online: http:\/\/link.springer.com\/article\/10.1007%2Fs10900-015-0115-0."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Protano, C., and Vitali, M. (2011). The new danger of thirdhand smoke: Why passive smoking does not stop at secondhand smoke. Environ. Health Perspect., 119.","DOI":"10.1289\/ehp.1103956"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/12\/11\/14557\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T20:52:03Z","timestamp":1760215923000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/12\/11\/14557"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11,13]]},"references-count":56,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2015,11]]}},"alternative-id":["ijerph121114557"],"URL":"https:\/\/doi.org\/10.3390\/ijerph121114557","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2015,11,13]]}}}