Association between second-hand smoke exposure and respiratory symptoms among teenagers attending school in Soshanguve, South Africa

Second-hand smoke (SHS) is a major risk factor for respiratory symptoms and conditions in children. Despite tobacco control laws in South Africa, exposure persists. This study investigated the association between second-hand smoke exposure and respiratory symptoms among teenagers attending school in Soshanguve, Gauteng Province. A cross-sectional survey was conducted among 2885 schoolchildren aged 12–15 years using the modified validated ISAAC questionnaire. Associations between SHS exposure and respiratory symptoms were analysed using chi-square tests and multiple logistic regression at p ≤ 0.05. SHS exposure was significantly associated with ever wheeze (in cars/transport > 20 days: OR 1.84; 95% CI: 1.17–2.90), current wheeze (home > 20 days: OR 2.34; 95% CI: 1.41–3.91), and asthma (school > 20 days: OR 1.69; 95% CI: 1.20–2.57). Rhinitis was linked to maternal smoking (OR 1.44; 95% CI: 1.09–1.89) and SHS at home > 20 days (OR 1.51; 95% CI: 1.12–2.07). SHS exposure significantly increases the risk of respiratory symptoms and conditions among teenagers in Soshanguve. Strengthened enforcement of smoke-free policies is crucial to protect children’s respiratory health.