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17 million) currently use e-cigarettes (CDC NHIS, 2023) 1.63 million US middle and high school students currently vape down from 5+ million at the 2019 peak (CDC NYTS, 2024) $45.7 billion global vaping market size in 2025 (Grand View Research, 2025) 129 million estimated adult vapers worldwide (GSTHR, 2025) 2,807 EVALI hospitalizations in the US caused by vitamin E acetate in illicit THC cartridges (CDC, 2020) 46 countries have entirely banned the sale of e-cigarettes worldwide (GGTC, 2025) 1

Therefore, this study aimed to explore the association between secondhand smoke exposure and anxiety among Korean adolescents, utilizing nationwide cross-sectional data spanning 4 years, including the post-COVID-19 era