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Gupta A, Bansal A, Dixit P, Kumar KA. The crossroads of work and home: linkages between smoke-free policies at work and household environments. BMC Public Health 2024; 24:1127. [PMID: 38654247 DOI: 10.1186/s12889-024-18658-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/18/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Tobacco use causes over eight million global deaths annually, with seven million directly attributed to tobacco use and 1.2 million to second hand smoke (SHS). Smoke-free environments are crucial to counter SHS. Although India banned smoking in public places in 2008, SHS exposure remains high. Studies have noted that limiting smoking in workplaces, restaurants, etc., helps to reduce overall smoking and reduce SHS exposure. Under this background, the study explores the linkages between smoke-free workplaces and living in smoke-free homes in India. METHODS The two rounds of the GATS India (2009-10 and 2016-17) have been used for the study. The study focuses on male tobacco smokers working indoors or outdoors or both indoors and outdoors. The sample for the study was 2,969 for GATS 1 and 2,801 for GATS 2. Dependent variables include living in a smoke-free home, while the independent variables were adherence to a smoke-free office policy and socio-demographic variables. The two rounds of the GATS data were pooled for analysis. Statistical analysis involves bivariate and multivariate analysis. RESULTS Findings reveal that 41% of respondents worked in smoke-free workplaces in GATS 2. Nationally, smoke-free homes increased from 35% in 2009-2010 to 44% in 2016-17. Individuals with smoke-free workplaces were more likely to have smoke-free homes. The Southern region consistently exhibited the highest proportion of smoke-free homes. Urban areas and higher education correlated with increased smoke-free homes. Logistic regression analysis confirmed that workplace smoke-free status is a significant predictor of smoke-free homes. In GATS 2, respondents aged 30 years and above were less likely to have smoke-free homes, while education and Southern region residence positively influenced smoke-free homes. CONCLUSIONS The correlation between smoke-free workplaces and smoke-free homes is linked to stringent workplace no-smoking policies, potentially deterring individuals from smoking at home. Opportunities exist for the expansion and stringent implementation of the smoke-free policies among Indian working adults, leveraging the workplace as a key setting for evidence-based tobacco control. The study highlights positive trends in India's smoke-free homes, crediting workplace policies. Effective policies, education, and regional strategies can advance smoke-free homes, stressing the pivotal role of workplace policies and advocating broader implementation.
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Affiliation(s)
- Amrita Gupta
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India.
| | - Anjali Bansal
- International Institute for Population Sciences, Mumbai, India
| | - Priyanka Dixit
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
| | - K Anil Kumar
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
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2
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Su WC, Juan HL, Lee JI, Huang SP, Chen SC, Geng JH. Secondhand smoke increases the risk of developing chronic obstructive pulmonary disease. Sci Rep 2024; 14:7481. [PMID: 38553570 PMCID: PMC10980762 DOI: 10.1038/s41598-024-58038-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024] Open
Abstract
Smoking is the most important risk factor for chronic obstructive pulmonary disease (COPD), however evidence from large-scale studies on whether secondhand smoke (SHS) increases the risk of COPD is still lacking. We conducted this large longitudinal study to investigate the association between SHS and the development of COPD. This is a longitudinal study. Data on 6519 subjects who were never-smokers, had no history of COPD, and had complete lung function records were extracted from the Taiwan Biobank. They were divided into two groups according to SHS exposure: no exposure and exposure groups. Data were collected when participants enrolled in the study and during regular follow-up. Cox proportional hazards regression models were used to estimate the relative risk (RR) and 95% confidence interval (CI) for the association between SHS and the risk of developing COPD. At 48 months of follow-up, 260 (4%) participants in the no exposure group and 34 (7%) participants in the exposure group developed COPD. The RR of incident COPD development was significantly higher in the exposure group than that in the no exposure group after adjusting for confounders (RR = 1.49; 95% CI 1.04 to 2.14; P value = 0.031). There is a dose-response relationship between the duration of exposure to SHS and the risk of incident COPD, which demonstrates that an additional hour of exposure to SHS per week was associated with a 1.03-fold increased likelihood of developing COPD after adjusting for confounders (RR = 1.03; 95% CI 1.00 to 1.05; P value = 0.027). SHS exposure contributes to the development of COPD. This finding can help raise awareness of the harms of SHS and provide a reference for formulating anti-smoking policies.
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Affiliation(s)
- Wen-Chi Su
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Huai-Lei Juan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jia-In Lee
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Pin Huang
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Medical Science and Technology, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jiun-Hung Geng
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, No. 482, Shanming Rd, Xiaogang District, Kaohsiung City, 812, Taiwan.
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Lin L, Yi X, Liu H, Meng R, Li S, Liu X, Yang J, Xu Y, Li C, Wang Y, Xiao N, Li H, Liu Z, Xiang Z, Shu W, Guan WJ, Zheng XY, Sun J, Wang Z. The airway microbiome mediates the interaction between environmental exposure and respiratory health in humans. Nat Med 2023:10.1038/s41591-023-02424-2. [PMID: 37349537 DOI: 10.1038/s41591-023-02424-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/26/2023] [Indexed: 06/24/2023]
Abstract
Exposure to environmental pollution influences respiratory health. The role of the airway microbial ecosystem underlying the interaction of exposure and respiratory health remains unclear. Here, through a province-wide chronic obstructive pulmonary disease surveillance program, we conducted a population-based survey of bacterial (n = 1,651) and fungal (n = 719) taxa and metagenomes (n = 1,128) from induced sputum of 1,651 household members in Guangdong, China. We found that cigarette smoking and higher PM2.5 concentration were associated with lung function impairment through the mediation of bacterial and fungal communities, respectively, and that exposure was associated with an enhanced inter-kingdom microbial interaction resembling the pattern seen in chronic obstructive pulmonary disease. Enrichment of Neisseria was associated with a 2.25-fold increased risk of high respiratory symptom burden, coupled with an elevation in Aspergillus, in association with occupational pollution. We developed an individualized microbiome-based health index, which covaried with exposure, respiratory symptoms and diseases, with potential generalizability to global datasets. Our results may inform environmental risk prevention and guide interventions that harness airway microbiome.
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Affiliation(s)
- Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
| | - Xinzhu Yi
- Institute of Ecological Sciences, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Haiyue Liu
- Xiamen Key Laboratory of Genetic Testing, Department of Laboratory Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Saiqiang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaomin Liu
- Institute of Ecological Sciences, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Junhao Yang
- Institute of Ecological Sciences, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Yanjun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Chuan Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Ye Wang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Ni Xiao
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Huimin Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zuheng Liu
- Xiamen Key Laboratory of Cardiac Electrophysiology, Department of Cardiology, Xiamen Institute of Cardiovascular Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Zhiming Xiang
- Department of Radiology, Panyu Central Hospital, Guangzhou, China
| | - Wensheng Shu
- Institute of Ecological Sciences, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
- Department of Thoracic Surgery, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Xue-Yan Zheng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
| | - Jiufeng Sun
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
| | - Zhang Wang
- Institute of Ecological Sciences, School of Life Sciences, South China Normal University, Guangzhou, China.
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Strassmann A, Çolak Y, Serra-Burriel M, Nordestgaard BG, Turk A, Afzal S, Puhan MA. Nationwide indoor smoking ban and impact on smoking behaviour and lung function: a two-population natural experiment. Thorax 2023; 78:144-150. [PMID: 35277448 PMCID: PMC9872239 DOI: 10.1136/thoraxjnl-2021-218436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/10/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Many countries have implemented indoor smoking bans over the past two decades. Although smoking bans have been shown to reduce cardiovascular outcomes, little is known about their impact on respiratory health. This study investigated the impact of a nationwide indoor smoking ban on smoking behaviour and lung function. METHODS We used repeated cross-sectional data from two large cohorts of the general population comprising 31 807 Swiss and 62 093 Danish adults. We compared associations between smoking ban and smoking prevalence and prebronchodilator lung function trends in Denmark (indoor smoking ban introduced in 2007) and Switzerland (indoor smoking ban introduced in 2010) from 2005 to 2010 using a quasi-experimental study design. We performed difference-in-difference analyses with linear regression models adjusted for age, sex, weight and height. RESULTS Denmark had a stronger decrease in active smokers compared with Switzerland. Also, forced expiratory volume in the first second was higher in Danish adults than in Swiss adults: 26 mL (95% CI 2.4 to 49) 1 year, 88 mL (65 to 112) 2 years, and 74 mL (51 to 98) 3 years after smoking ban implementation. Correspondingly, forced vital capacity was higher in Danish adults compared with Swiss adults (80 mL (50 to 109) after 1 year and 126 mL (97 to 155) after two and 3 years). Improvements were observed in both never-smokers and ever-smokers, most pronounced in ever-smokers. CONCLUSIONS Nationwide indoor smoking ban is associated with less smoking and improved lung function in the general population. Implementing an indoor smoking ban can improve lung function by influencing smoking behaviour and reducing secondhand smoke.
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Affiliation(s)
- Alexandra Strassmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Yunus Çolak
- Department of Respiratory Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Miquel Serra-Burriel
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Børge G Nordestgaard
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | | | - Shoaib Afzal
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Uddin MN, Emran TB. Prevention of Progression and Remission in Public Health Sectors: Bangladesh Perspectives. ATLANTIS HIGHLIGHTS IN CHEMISTRY AND PHARMACEUTICAL SCIENCES 2023:131-150. [DOI: 10.2991/978-94-6463-130-2_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Wu Y, Wang Z, Zheng Y, Wang M, Wang S, Wang J, Wu J, Wu T, Chang C, Hu Y. Trends in Hospital Admissions for Chronic Obstructive Pulmonary Diseases After Comprehensive Tobacco Control Policies in Beijing, China. Nicotine Tob Res 2022; 24:1978-1984. [PMID: 35808957 DOI: 10.1093/ntr/ntac137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/12/2022] [Accepted: 05/30/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Only a few studies have examined the effectiveness of tobacco control policies on respiratory conditions, and the results were less consistent. The 2015 Beijing tobacco control policy package incorporating all six components of MPOWER has been implemented since Jun 2015. The present study aimed to evaluate the impact of a comprehensive tobacco control policy package on hospital admissions for chronic obstructive pulmonary disease (COPD) in Beijing, China. AIMS AND METHODS An interrupted time-series study was conducted based on the hospital admission information for about 18 million residents, who were covered by the Beijing Medical Claim Data for Employees from January 2013 to June 2017. The average percentage change of COPD hospital admission rates and reductions in hospital admission numbers were estimated by segmented Poisson regression models. RESULTS There were 54 040 COPD hospital admissions with a crude rate of 67.2 per 100 000 residents during the observational period. After the implementation of the policy package, the hospital admission rates of COPD were reduced by -14.7% (95%CI: -17.8%, -11.5%) immediately. The secular trend was slowed down by -3.0% (95% CI: -5.6%, -0.4%) annually. A total of 5 581 reductions in COPD hospital admissions were estimated during the 25 months post-law period, accounting for 17.5% (95% CI: 12.5%, 22.5%) of overall COPD hospital admissions. More reductions were shown in males and those aged over 65 years old. CONCLUSIONS The results indicated significant protections against hospitalization of COPD after the 2015 Beijing comprehensive tobacco control policy package. The results provide support for public health benefits for respiratory conditions from WHO-recommended tobacco control measures. IMPLICATIONS Only a few studies have examined the effectiveness of tobacco control policies on respiratory conditions, and the results were less consistent. Based on medical records for about 18 million residents, this study showed an association between comprehensive tobacco control policies and significant reductions of hospital admissions for chronic obstructive pulmonary disease. The results provide support for public health benefits for respiratory conditions from WHO-recommended tobacco control measures.
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Affiliation(s)
- Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Zijing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
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7
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Hasina SN, Livana PH, Ainiyah N, Firdaus F, Wardani EM, Putri RA, Umamah F. Exposure to Cigarette Smoke and Daily Physical Activity Associated with Asthma. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Asthmatic sufferers complain of sudden relapse when performing daily activities. exposure to cigarette smoke makes asthmatics where the longer the exposure is experienced by the patient, the more frequent asthma exacerbations are experienced. For people with asthma, avoiding excessive physical activity and exposure to cigarette smoke is very necessary to prevent recurrence of symptoms. So it is necessary to control the level of asthma, which is influenced by factors that trigger asthma recurrence.
Aim: The purpose of the study was to determine the relationship between daily physical activity and exposure to cigarette smoke on asthma recurrence in asthmatic patients
Methods: This type of research uses observational analytic using a cross sectional approach. Sampling in this study using purposive sampling obtained the number of respondents 358 with a vulnerable age of 18-45 years. This research was conducted for 6 months. The measuring instrument for exposure to cigarette smoke uses a questionnaire containing the categories of exposure to cigarette smoke less than 1 hour, exposure to cigarette smoke 1-4 hours and exposure to cigarette smoke more than 4 hours. Physical activity measurement tool using the International Physical Activity Questionnaire (IPAQ). Asthma recurrence was measured by using a questionnaire that refers to the Asthma Control Test (ACT). The research procedure was carried out by researchers by ensuring that respondents were in good health and signed the informed consent provided. Data analysis using Chi-Square test.
Result: The results of the Chi Square test with a significance value of = 0.05, p value = 0.000, which means p < then there is a relationship between daily physical activity and exposure to cigarette smoke on asthma recurrence in asthmatic patients.
Conclusions: There is a relationship between exposure to cigarette smoke and daily physical activity on asthma relapse in asthmatic patients. It is expected that asthmatics should avoid triggering factors for asthma relapse to achieve controlled asthma levels.
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Farley SM, Jasek J, Debchoudhury I, Van Beck K, Talati A, Perlman SE, Thorpe LE. Housing type and secondhand tobacco smoke exposure among non-smoking New York City adults, 2004 and 2013–14. Prev Med Rep 2022; 27:101805. [PMID: 35656213 PMCID: PMC9152802 DOI: 10.1016/j.pmedr.2022.101805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/09/2022] [Accepted: 04/18/2022] [Indexed: 11/27/2022] Open
Abstract
Assessed association between housing type and cotinine level among non-smokers. Secondhand smoke exposure among New York City non-smokers has declined overtime. Odds of elevated cotinine doubled when living in multiunit housing in 2013/14.
Secondhand tobacco smoke (SHS) exposure has declined due to smoking reductions, expanding workplace and public smoke-free air laws, and smoke-free housing policy promotion. Population-based studies examining objective SHS exposure biomarkers have documented reductions over time, however non-smoking urban adults are more likely to have elevated cotinine (a metabolite of nicotine) compared with national averages. Evidence suggests residential housing type may impact urban SHS exposure risk. Direct associations between multiunit housing (MUH) and elevated cotinine have been identified among children but not yet examined among adults. We used data from the cross-sectional 2004 and 2013/14 New York City Health and Nutrition Examination Surveys to investigate associations between MUH (single-family versus 2; 3–99; and 100 + units) and likelihood of elevated serum cotinine among nonsmoking adults (2004: n = 1324; 2013/14: n = 946), adjusting for socio-demographics (sex, age, race/ethnicity, education, income) and self-reported SHS exposure variables. Combined and single-year adjusted multivariable regressions were conducted. Elevated cotinine was defined as a serum level of ≥ 0.05 ng/ml. Combined year adjusted multivariable regression analyses found no difference in elevated cotinine by housing type among non-smoking adults. By survey year, elevated cotinine did not vary by housing type in 2004, while non-smoking adults in 3–99 unit buildings were twice as likely to have elevated cotinine compared with single family residents in 2013/14 (adjusted Odds Ratio = 2.55 (1.13, 5.79)). While SHS exposure has declined, relative burden may be increasing among MUH residents. In urban settings with extensive MUH, attention to housing-based policies and programmatic interventions is critical to reducing SHS exposure.
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Affiliation(s)
- Shannon M. Farley
- New York City Department of Health and Mental Hygiene, New York, NY, USA
- Corresponding author at: Bureau of Chronic Disease Prevention and Tobacco Control, New York City Department of Health and Mental Hygiene, 42-09 28th St, Long Island City, NY 11101, USA.
| | - John Jasek
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | | | - Kellie Van Beck
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Achala Talati
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Sharon E. Perlman
- New York City Department of Health and Mental Hygiene, New York, NY, USA
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Shang X, Scott D, Chan RK, Zhang L, He M. Association of Pulmonary Function With Cognitive Decline in Older Adults: A Nationwide Longitudinal Study in China. J Gerontol A Biol Sci Med Sci 2021; 76:1423-1430. [PMID: 33824989 DOI: 10.1093/gerona/glab096] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Indexed: 11/12/2022] Open
Abstract
This study aimed to examine whether pulmonary function and cognition are independently associated at multiple time points. We included 8264 participants (49.9% women) aged 50-94 years at baseline from the China Health and Retirement Longitudinal Study in our analysis. Participants were enrolled in 2011 and followed up in 2013 and 2015. Cognitive function was assessed through a face-to-face interview in each survey. Pulmonary function was assessed via peak expiratory flow. Pulmonary function and cognitive function decreased significantly with age in both genders. Individuals in quintile 5 of pulmonary function had a relative increase in immediate memory (β [95% CI]: 0.19 [0.09, 0.30]) and delayed memory (0.16 [0.04, 0.28]) during follow-up compared with those in quintile 1. In the repeated-measures analysis, each standard deviation increment of pulmonary function was associated with a 0.44 (95% CI: 0.34, 0.53), 0.12 (0.09, 0.15), 0.12 (0.08, 0.16), 0.08 (0.06, 0.11), and 0.10 (0.07, 0.14) higher increase in global cognitive score, immediate memory, delayed memory, orientation, and subtraction calculation, respectively. The inverse association between pulmonary function and cognitive decline during follow-up was more evident in women (p for interaction = .0333), low-educated individuals (p for interaction = .0002), or never smokers (p for interaction = .0412). In conclusion, higher baseline pulmonary function was independently associated with a lower rate of cognitive decline in older adults. The positive association between pulmonary function and cognition was stronger in women, lower-educated individuals, or never smokers.
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Affiliation(s)
- Xianwen Shang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | | | - Lei Zhang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.,China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health, Science Center, Xi'an, Shaanxi, China
| | - Mingguang He
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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10
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Aherrera A, Aravindakshan A, Jarmul S, Olmedo P, Chen R, Cohen JE, Navas-Acien A, Rule AM. E-cigarette use behaviors and device characteristics of daily exclusive e-cigarette users in Maryland: Implications for product toxicity. Tob Induc Dis 2020; 18:93. [PMID: 33209101 PMCID: PMC7668279 DOI: 10.18332/tid/128319] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/13/2020] [Accepted: 10/09/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Few studies to date have characterized daily exclusive e-cigarette users, device characteristics, and use behaviors. This study describes daily e-cigarette user characteristics, and assesses the association between user behaviors and demographics. METHODS From 2015–2017, 100 daily exclusive e-cigarette users and 50 non-users were recruited in Maryland, USA. Sociodemographic characteristics, health status, e-cigarette/tobacco use behaviors, device characteristics, and reasons for e-cigarette use were collected by interview. Chi-squared tests (categorical variables), Student’s t-test (continuous variables), and linear regressions were used to assess relationships between variables. RESULTS Most daily exclusive e-cigarette users were men, White, former smokers, used MODs/tanks, and vaped on average 365 puffs/day (SD: 720). A third of users first vaped within 5 minutes of waking in the morning, and 56% vaped throughout the day. E-liquid consumption ranged from 5–240 mL/week (median: 32.5), with nicotine concentration 0–24 mg/mL (median: 3). E-cigarette users were more likely to report wheezing/whistling and hypertension than controls, although the finding was not statistically significant after adjustment. Less than half planned to quit vaping. CONCLUSIONS Daily e-cigarette users between 2015–2017 most commonly vaped MOD/tank devices. Being male and of lower education was associated with higher usage. Daily users with no intention to quit may be at risk for increased exposure to emissions from e-cigarettes that include inorganic (metals) and organic (e.g. acrolein, formaldehyde) compounds with known toxic effects, particularly to the lung. Further research is needed to characterize the long-term health effects of daily e-cigarette use.
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Affiliation(s)
- Angela Aherrera
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.,Division of Pediatric Pulmonary Medicine, Johns Hopkins School of Medicine, Baltimore, United States
| | - Atul Aravindakshan
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Stephanie Jarmul
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.,Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Pablo Olmedo
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.,Department of Environmental Health Sciences, Columbia University, New York, United States.,Department of Legal Medicine, Toxicology and Physical Anthropology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Rui Chen
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Ana Navas-Acien
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.,Department of Environmental Health Sciences, Columbia University, New York, United States
| | - Ana M Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
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11
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Abstract
Air pollution is a grave risk to human health that affects nearly everyone in the world and nearly every organ in the body. Fortunately, it is largely a preventable risk. Reducing pollution at its source can have a rapid and substantial impact on health. Within a few weeks, respiratory and irritation symptoms, such as shortness of breath, cough, phlegm, and sore throat, disappear; school absenteeism, clinic visits, hospitalizations, premature births, cardiovascular illness and death, and all-cause mortality decrease significantly. The interventions are cost-effective. Reducing factors causing air pollution and climate change have strong cobenefits. Although regions with high air pollution have the greatest potential for health benefits, health improvements continue to be associated with pollution decreases even below international standards. The large response to and short time needed for benefits of these interventions emphasize the urgency of improving global air quality and the importance of increasing efforts to reduce pollution at local levels.
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12
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Zheng XY, Li ZL, Li C, Guan WJ, Li LX, Xu YJ. Effects of cigarette smoking and biomass fuel on lung function and respiratory symptoms in middle-aged adults and the elderly in Guangdong province, China: A cross-sectional study. INDOOR AIR 2020; 30:860-871. [PMID: 32249960 DOI: 10.1111/ina.12671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 06/11/2023]
Abstract
We sought to investigate the association between active cigarette smoking (ex- and current smokers) with or without exposure to biomass fuels and respiratory symptoms/lung function in middle-aged adults and the elderly. In the chronic obstructive pulmonary disease surveillance conducted in six cities of Guangdong province, China, we surveyed 1986 residents aged 40-93 years. We recorded respiratory symptoms, smoking status, use of biomass fuel, and other covariates by using a structured questionnaire. All models were adjusted for second-hand smoking. Active smoking with or without exposure to biomass fuels was significantly associated with wheezing, chronic cough, and phlegm (all P < .05). Active smoking alone with or without exposure to biomass fuels was associated with 2.5% and 0.6% reduction in the mean forced vital capacity predicted, 6.8% and 4.2% reduction in the mean forced expiratory volume in one second predicted, and 9.0% and 4.7% reduction in the mean maximal mid-expiratory flow predicted compared with the exposure to neither smoking nor biomass fuels, respectively. However, exposure to biomass fuel alone was associated with neither greater lung function impairment nor respiratory symptoms except for chronic cough. Efforts should be made to protect home owners and their family from adverse effects of indoor air pollution.
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Affiliation(s)
- Xue-Yan Zheng
- Institute of Non-Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangdong, China
| | - Zhang-Long Li
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Chuan Li
- Institute of Non-Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangdong, China
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Li-Xia Li
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yan-Jun Xu
- Institute of Non-Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangdong, China
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13
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Exposure to Environmental Tobacco Smoke (ETS) among Employees of Hospitality Venues in the Light of Changes in Anti-Tobacco Legislation in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103691. [PMID: 32456242 PMCID: PMC7277566 DOI: 10.3390/ijerph17103691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 11/16/2022]
Abstract
Introduction: Numerous studies conducted in Europe and worldwide have indicated that employees of hospitality venues are the most exposed professional group to environmental tobacco smoke (ETS) in the workplace. The purpose of this study was to assess the exposure of employees of hospitality venues to ETS in the light of changes in anti-tobacco legislation in Poland. Materials and methods: The study consisted of two stages. The first stage was conducted in 2010, while the second in 2015. The study was conducted among employees of 300 randomly selected hospitality venues in the city of Łódź (Poland). In total, 2607 questionnaires were analysed. The study used two survey questionnaires created and recommended by the Institute for Global Tobacco Control to study exposure to ETS. Statistical analysis was made with Statistica 13.1 PL (StatSoft, Poland). Results: In the group of all nonsmoking employees, individuals exposed to ETS at work in 2010 accounted for 72.6%; while in 2015 it was 51.8%. Factors affecting exposure to ETS in the workplace included, among others: age, marital status, education, position held, presence of a smoking room on the premises, and noncompliance with the provisions of the anti-tobacco laws. Conclusions: The prevalence of tobacco smoking among employees of hospitality venues decreased in 2010–2015, however, it remained high. More than half of nonsmoking employees were exposed to ETS at work.
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14
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Shahmanesh M, Harling G, Coltart CEM, Bailey H, King C, Gibbs J, Seeley J, Phillips A, Sabin CA, Aldridge RW, Sonnenberg P, Hart G, Rowson M, Pillay D, Johnson AM, Abubakar I, Field N. From the micro to the macro to improve health: microorganism ecology and society in teaching infectious disease epidemiology. THE LANCET. INFECTIOUS DISEASES 2020; 20:e142-e147. [PMID: 32386611 PMCID: PMC7252039 DOI: 10.1016/s1473-3099(20)30136-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 02/14/2020] [Accepted: 02/18/2020] [Indexed: 12/21/2022]
Abstract
Chronic and emerging infectious diseases and antimicrobial resistance remain a substantial global health threat. Microbiota are increasingly recognised to play an important role in health. Infections also have a profound effect beyond health, especially on global and local economies. To maximise health improvements, the field of infectious disease epidemiology needs to derive learning from ecology and traditional epidemiology. New methodologies and tools are transforming understanding of these systems, from a better understanding of socioeconomic, environmental, and cultural drivers of infection, to improved methods to detect microorganisms, describe the immunome, and understand the role of human microbiota. However, exploiting the potential of novel methods to improve global health remains elusive. We argue that to exploit these advances a shift is required in the teaching of infectious disease epidemiology to ensure that students are well versed in a breadth of disciplines, while maintaining core epidemiological skills. We discuss the following key points using a series of teaching vignettes: (1) integrated training in classic and novel techniques is needed to develop future scientists and professionals who can work from the micro (interactions between pathogens, their cohabiting microbiota, and the host at a molecular and cellular level), with the meso (the affected communities), and to the macro (wider contextual drivers of disease); (2) teach students to use a team-science multidisciplinary approach to effectively integrate biological, clinical, epidemiological, and social tools into public health; and (3) develop the intellectual skills to critically engage with emerging technologies and resolve evolving ethical dilemmas. Finally, students should appreciate that the voices of communities affected by infection need to be kept at the heart of their work.
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Affiliation(s)
- Maryam Shahmanesh
- Institute for Global Health, University College London, London, UK; Africa Health Research Institute, Durban, South Africa.
| | - Guy Harling
- Institute for Global Health, University College London, London, UK; Africa Health Research Institute, Durban, South Africa; MRC/Wits-Agincourt Unit, University of the Witwatersrand, Johannesburg, South Africa; Harvard Centre for Population and Development Studies, Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | - Heather Bailey
- Institute for Global Health, University College London, London, UK
| | - Carina King
- Institute for Global Health, University College London, London, UK; Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Janet Seeley
- Africa Health Research Institute, Durban, South Africa; London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Phillips
- Institute for Global Health, University College London, London, UK
| | - Caroline A Sabin
- Institute for Global Health, University College London, London, UK
| | - Robert W Aldridge
- Institute of Health Informatics, University College London, London, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Graham Hart
- Institute for Global Health, University College London, London, UK
| | - Mike Rowson
- Institute for Global Health, University College London, London, UK
| | - Deenan Pillay
- Division of infection and immunity, University College London, London, UK; Africa Health Research Institute, Durban, South Africa
| | - Anne M Johnson
- Institute for Global Health, University College London, London, UK
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
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15
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Smoking ban in a psychiatry department: Are nonsmoking employees less exposed to environmental tobacco smoke? Eur Psychiatry 2020; 24:529-32. [DOI: 10.1016/j.eurpsy.2009.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2008] [Revised: 04/07/2009] [Accepted: 04/07/2009] [Indexed: 11/18/2022] Open
Abstract
AbstractStaff members of psychiatric facilities are at high risk of secondhand smoking. Smoking exposure was assessed in 41 nonsmoking employees of a psychiatry department before and after a ban. Subjective exposure measures decreased in 76% of the subjects. Salivary cotinine decreased in the subsample of seven subjects with high pre-ban levels (32 ±8 vs 40 ± 17 ng/ml, p = .045).
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16
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Impact of the 2005 and 2010 Spanish smoking laws on hospital admissions for tobacco-related diseases in Valencia, Spain. Public Health 2020; 180:29-37. [DOI: 10.1016/j.puhe.2019.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 10/07/2019] [Accepted: 10/27/2019] [Indexed: 11/18/2022]
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17
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Use of Heated Tobacco Products within Indoor Spaces: Findings from the 2018 ITC Japan Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234862. [PMID: 31816848 PMCID: PMC6926830 DOI: 10.3390/ijerph16234862] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/21/2019] [Accepted: 12/01/2019] [Indexed: 11/16/2022]
Abstract
Although heated tobacco products (HTPs) have become increasingly popular in Japan, little is known about whether these emerging tobacco products are being used within indoor public spaces. Nationally representative data were obtained prior to implementation of a comprehensive smoke-free law in Japan as part of Wave 1 of the International Tobacco Control Japan Survey (February-March 2018). We estimated the weighted prevalence of HTP use within indoor public spaces among tobacco users and compared these to estimates for combustible cigarettes (CCs). Overall, 15.6% of current tobacco users in Japan declared that they used HTPs within indoor public spaces. Any HTP use within indoor public spaces was significantly lower than any CC use (80.1% vs. 96.7%). Dual HTP + CC users reported using CCs more frequently than using HTPs within indoor public spaces (97.7% vs. 76.0%). In conclusion, HTP use is less common than CC use within indoor public spaces. Findings of this study can inform the development of targeted smoke-free policies to benefit public health.
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18
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Moon KA, Rule AM, Magid HS, Ferguson JM, Susan J, Sun Z, Torrey C, Abubaker S, Levshin V, Çarkoglu A, Radwan GN, El-Rabbat M, Cohen JE, Strickland P, Breysse PN, Navas-Acien A. Biomarkers of Secondhand Smoke Exposure in Waterpipe Tobacco Venue Employees in Istanbul, Moscow, and Cairo. Nicotine Tob Res 2019; 20:482-491. [PMID: 28582531 DOI: 10.1093/ntr/ntx125] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 05/30/2017] [Indexed: 11/12/2022]
Abstract
Background Most smoke-free legislation to reduce secondhand smoke (SHS) exposure exempts waterpipe (hookah) smoking venues. Few studies have examined SHS exposure in waterpipe venues and their employees. Methods We surveyed 276 employees of 46 waterpipe tobacco venues in Istanbul, Moscow, and Cairo. We interviewed venue managers and employees and collected biological samples from employees to measure exhaled carbon monoxide (CO), hair nicotine, saliva cotinine, urine cotinine, urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and urine 1-hydroxypyrene glucuronide (1-OHPG). We estimated adjusted geometric mean ratios (GMR) of each SHS biomarker by employee characteristics and indoor air SHS measures. Results There were 73 nonsmoking employees and 203 current smokers of cigarettes or waterpipe. In nonsmokers, the median (interquartile) range concentrations of SHS biomarkers were 1.1 (0.2, 40.9) µg/g creatinine urine cotinine, 5.5 (2, 15) ng/mL saliva cotinine, 0.95 (0.36, 5.02) ng/mg hair nicotine, 1.48 (0.98, 3.97) pg/mg creatinine urine NNAL, 0.54 (0.25, 0.97) pmol/mg creatinine urine 1-OHPG, and 1.67 (1.33, 2.33) ppm exhaled CO. An 8-hour increase in work hours was associated with higher urine cotinine (GMR: 1.68, 95% CI: 1.20, 2.37) and hair nicotine (GMR: 1.22, 95% CI: 1.05, 1.43). Lighting waterpipes was associated with higher saliva cotinine (GMR: 2.83, 95% CI: 1.05, 7.62). Conclusions Nonsmoking employees of waterpipe tobacco venues were exposed to high levels of SHS, including measurable levels of carcinogenic biomarkers (tobacco-specific nitrosamines and PAHs). Implications Smoke-free regulation should be extended to waterpipe venues to protect nonsmoking employees and patrons from the adverse health effects of SHS.
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Affiliation(s)
- Katherine A Moon
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Ana M Rule
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Hoda S Magid
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Jacqueline M Ferguson
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Jolie Susan
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Zhuolu Sun
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Christine Torrey
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Salahaddin Abubaker
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | | | - Asli Çarkoglu
- Department of Psychology, Kadir Has University, Istanbul, Turkey
| | - Ghada Nasr Radwan
- Department of Public Health, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha El-Rabbat
- Department of Psychology, Kadir Has University, Istanbul, Turkey
- Department of Public Health, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Paul Strickland
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Patrick N Breysse
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Ana Navas-Acien
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
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19
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The effect of carvacrol on inflammatory mediators and respiratory symptoms in veterans exposed to sulfur mustard, a randomized, placebo-controlled trial. Respir Med 2019; 150:21-29. [DOI: 10.1016/j.rmed.2019.01.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 01/19/2019] [Accepted: 01/27/2019] [Indexed: 01/22/2023]
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20
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Ioachimescu OC, Desai NS. Nonallergic Triggers and Comorbidities in Asthma Exacerbations and Disease Severity. Clin Chest Med 2018; 40:71-85. [PMID: 30691718 DOI: 10.1016/j.ccm.2018.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Asthma triggers are exogenous or endogenous factors that could worsen asthma acutely to cause an exacerbation, or perpetuate chronic symptoms and airflow limitation. Because it is well known that recent asthma exacerbations and poor symptom control are strong predictors of future disease activity, it is not surprising that the number of (allergic or nonallergic) asthma triggers in the environment correlates with the disease-related quality of life. There is a need to identify and avoid specific triggers as the centerpiece of disease management, especially in those with heightened sensitivity to certain factors.
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Affiliation(s)
- Octavian C Ioachimescu
- Pulmonary, Critical Care and Sleep Medicine, Emory University, Atlanta VA Medical Center, Atlanta, GA, USA
| | - Nikita S Desai
- Pulmonary and Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA.
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21
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Fernandes AGO, de Souza-Machado C, Pinheiro GP, de Oliva ST, Mota RCL, de Lima VB, Cruz CS, Chatkin JM, Cruz ÁA. Dual exposure to smoking and household air pollution is associated with an increased risk of severe asthma in adults in Brazil. Clin Transl Allergy 2018; 8:48. [PMID: 30555680 PMCID: PMC6287342 DOI: 10.1186/s13601-018-0235-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/16/2018] [Indexed: 11/10/2022] Open
Abstract
Background The relationship between smoking, household pollution, dual exposure and severity of asthma in adults has not been sufficiently studied. We examined and compared the effects of cigarette smoking, domestic wood burning pollution and dual exposure (tobacco and wood burning) upon asthma severity in adults. Methods This was a cross-sectional study performed with 452 individuals with mild to moderate asthma and 544 patients with severe asthma (previously untreated). Smoking and exposure to wood smoke were identified and quantified through questionnaires to evaluate current and/or previous exposure; objective determination of cigarette exposure was obtained through the measurement of urinary cotinine. Asthma control was evaluated through Asthma Control Questionnaire; and severity was classified according to the Global Initiative for Asthma criteria. Subjects were grouped according to exposure type into 4 groups: smokers, household pollution, dual-exposure and no-exposure. Chi square, Mann-Whitney, and Kruskal-Wallis tests were used for comparisons between groups. Results Out of 996 included individuals, 78 (7.8%) were exposed to cigarette smoking alone, 358 (35.9%) to household pollution alone, 155 (15.6%) to the two exposures combined and 405 (40.7%) were not exposed. Compared to unexposed individuals, exposure to household pollution resulted in poorer asthma control, higher proportion of severe asthma, and worse indicators of lung function. The double-exposed individuals were worse off in all the evaluated parameters, and they were significantly worse than subjects with single exposure to household air pollution in relation to asthma severity and lung function. These subjects were predominantly females, older, with longer residence time in rural areas, lower income and lower schooling levels. Multivariate analysis showed that exposure to household pollution and double exposure were predictive factors associated with lack of control and increased severity of asthma. Conclusions Exposure to household pollution is associated with poorer control, greater severity, and poorer pulmonary function; double-exposed individuals have a greater risk of severe asthma and decreased lung function than those exposed only to household pollution.
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Affiliation(s)
- Andréia Guedes Oliva Fernandes
- 1Programa para o Controle da Asma na Bahia (ProAR) e Programa de Pós-graduação em Medicina e Saúde, Centro de Saúde Carlos Gomes, Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Rua Carlos Gomes 270, 7° andar, Salvador, Bahia 40060-330 Brazil
| | - Carolina de Souza-Machado
- 2Programa para o Controle da Asma na Bahia (ProAR) e Programa de Pós-graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Escola de Enfermagem da Universidade Federal da Bahia, UFBA, Rua Dr Augusto Vianna. 2 andar. Campus Canela, Salvador, Bahia 40110-060 Brazil
| | - Gabriela Pimentel Pinheiro
- 1Programa para o Controle da Asma na Bahia (ProAR) e Programa de Pós-graduação em Medicina e Saúde, Centro de Saúde Carlos Gomes, Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Rua Carlos Gomes 270, 7° andar, Salvador, Bahia 40060-330 Brazil
| | - Sergio Telles de Oliva
- 3Laboratório de Química Analítica Ambiental, Departamento de Química Analítica, Instituto de Química, Universidade Federal da Bahia, Brazil, Rua Barão de Jeremoabo, 147. Campus de Ondina, Salvador, Bahia 40170-115 Brazil
| | - Raquel Cristina Lins Mota
- 4Serviço de Endoscopia Digestiva do Hospital das Clínicas de Universidade de São Paulo, PAMB, Prédio dos Ambulatórios, Av. Dr. Enéas Carvalho de Aguiar, 155 - 6°. Andar, Sala 3, São Paulo, SP CEP 05403-900 Brazil
| | - Valmar Bião de Lima
- 5Programa para o Controle da Asma na Bahia (ProAR), UFBA - Centro de Saúde Carlos Gomes, Rua Carlos Gomes 270, 7° andar, Salvador, Bahia 40060-330 Brazil
| | - Constança Sampaio Cruz
- Programa de Pós-Graduação em Medicina e Saúde Humana. Escola Bahiana de Medicina e Saúde Pública (EBMSP), Obras Sociais Irmã Dulce. Hospital Santo Antônio - Avenida Bonfim, 161 Largo de Roma, Salvador, Bahia 40420-415 Brazil
| | - José Miguel Chatkin
- 7Escola de Medicina da Pontifícia, Universidade Católica do Rio Grande do Sul, Brazil, Av. Ipiranga, 6690, Porto Alegre, Rio Grande do Sul 90610-000 Brazil
| | - Álvaro A Cruz
- 5Programa para o Controle da Asma na Bahia (ProAR), UFBA - Centro de Saúde Carlos Gomes, Rua Carlos Gomes 270, 7° andar, Salvador, Bahia 40060-330 Brazil
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Wang Z, Wang L, Tapa S, Pinkerton KE, Chen CY, Ripplinger CM. Exposure to Secondhand Smoke and Arrhythmogenic Cardiac Alternans in a Mouse Model. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:127001. [PMID: 30675795 PMCID: PMC6371715 DOI: 10.1289/ehp3664] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 11/02/2018] [Accepted: 11/07/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Epidemiological evidence suggests that a majority of deaths attributed to secondhand smoke (SHS) exposure are cardiovascular related. However, to our knowledge, the impact of SHS on cardiac electrophysiology, [Formula: see text] handling, and arrhythmia risk has not been studied. OBJECTIVES The purpose of this study was to investigate the impact of an environmentally relevant concentration of SHS on cardiac electrophysiology and indicators of arrhythmia. METHODS Male C57BL/6 mice were exposed to SHS [total suspended particles (THS): [Formula: see text], nicotine: [Formula: see text], carbon monoxide: [Formula: see text], or filtered air (FA) for 4, 8, or 12 wk ([Formula: see text]]. Hearts were excised and Langendorff perfused for dual optical mapping with voltage- and [Formula: see text]-sensitive dyes. RESULTS At slow pacing rates, SHS exposure did not alter baseline electrophysiological parameters. With increasing pacing frequency, action potential duration (APD), and intracellular [Formula: see text] alternans magnitude progressively increased in all groups. At 4 and 8 wk, there were no statistical differences in APD or [Formula: see text] alternans magnitude between SHS and FA groups. At 12 wk, both APD and [Formula: see text] alternans magnitude were significantly increased in the SHS compared to FA group ([Formula: see text]). SHS exposure did not impact the time constant of [Formula: see text] transient decay ([Formula: see text]) at any exposure time point. At 12 wk exposure, the recovery of [Formula: see text] transient amplitude with premature stimuli was slightly (but nonsignificantly) delayed in SHS compared to FA hearts, suggesting that [Formula: see text] release via ryanodine receptors may be impaired. CONCLUSIONS In male mice, chronic exposure to SHS at levels relevant to social situations in humans increased their susceptibility to cardiac alternans, a known precursor to ventricular arrhythmia. https://doi.org/10.1289/EHP3664.
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Affiliation(s)
- Zhen Wang
- Department of Pharmacology, University of California, Davis, Davis, California, USA
| | - Lianguo Wang
- Department of Pharmacology, University of California, Davis, Davis, California, USA
| | - Srinivas Tapa
- Department of Pharmacology, University of California, Davis, Davis, California, USA
| | - Kent E Pinkerton
- Center for Health and the Environment, University of California, Davis, Davis, California, USA
| | - Chao-Yin Chen
- Department of Pharmacology, University of California, Davis, Davis, California, USA
| | - Crystal M Ripplinger
- Department of Pharmacology, University of California, Davis, Davis, California, USA
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Hajdu T, Hajdu G. Smoking ban and health at birth: Evidence from Hungary. ECONOMICS AND HUMAN BIOLOGY 2018; 30:37-47. [PMID: 29908431 DOI: 10.1016/j.ehb.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 04/20/2018] [Accepted: 05/31/2018] [Indexed: 06/08/2023]
Abstract
In 2012, smoking restrictions were extended to hospitality venues in Hungary. Women working in bars and restaurants were primarily affected by the intervention. In this research, we analyze the effect of this smoking ban on the outcomes of their pregnancies. Using individual live birth, fetal loss, and infant mortality registry data, we examine the probability of live birth, indicators of health at birth, and the probability of death in the first year of life. We apply a difference-in-differences framework and show that the smoking ban has improved health at birth. We observed birth weight to increase by 56 g (95% CI: 4.2 to 106.8) and gestation length by 0.19 weeks (95% CI: 0.02 to 0.36). Due to the ban, the probability of being born with very low and low birth weight has decreased by 1.2 and 2.2 percentage points, respectively (95% CI: -0.2 to -2.2 and 0.06 to -4.4), and we see a 0.9 percentage points reduction in the chance of being born very preterm (95% CI: -0.03 to -1.9). We also observe a decrease in the probability of being born with a low Ponderal index (decrease of 4.1 percentage points, 95% CI: -0.7 to -7.5). Performing a series of robustness and placebo tests, we provide evidence that supports the causal interpretation of our results. We also show that the ban was more beneficial for newborns of parents with low educational attainment and at the bottom of the fetal health endowment distribution.
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Affiliation(s)
- Tamás Hajdu
- Institute of Economics, Centre for Economic and Regional Studies, Hungarian Academy of Sciences, Tóth Kálmán u. 4., 1097 Budapest, Hungary.
| | - Gábor Hajdu
- Institute for Sociology, Centre for Social Sciences, Hungarian Academy of Sciences, Tóth Kálmán u. 4., 1097 Budapest, Hungary; MTA-ELTE Peripato Comparative Social Dynamics Research Group, Pázmány Péter sétány 1/A, 1117 Budapest, Hungary.
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Kelly BC, Vuolo M, Frizzell LC, Hernandez EM. Denormalization, smoke-free air policy, and tobacco use among young adults. Soc Sci Med 2018; 211:70-77. [DOI: 10.1016/j.socscimed.2018.05.051] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/21/2018] [Accepted: 05/30/2018] [Indexed: 10/14/2022]
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Khavjou OA, Honeycutt AA, Yarnoff B, Bradley C, Soler R, Orenstein D. Costs of community-based interventions from the Community Transformation Grants. Prev Med 2018; 112:138-144. [PMID: 29678616 DOI: 10.1016/j.ypmed.2018.04.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 04/03/2018] [Accepted: 04/16/2018] [Indexed: 11/29/2022]
Abstract
Limited data are available on the costs of evidence-based community-wide prevention programs. The objective of this study was to estimate the per-person costs of strategies that support policy, systems, and environmental changes implemented under the Community Transformation Grants (CTG) program. We collected cost data from 29 CTG awardees and estimated program costs as spending on labor; consultants; materials, travel, and services; overhead activities; partners; and the value of in-kind contributions. We estimated costs per person reached for 20 strategies. We assessed how per-person costs varied with the number of people reached. Data were collected in 2012-2015, and the analysis was conducted in 2015-2016. Two of the tobacco-free living strategies cost less than $1.20 per person and reached over 6 million people each. Four of the healthy eating strategies cost less than $1.00 per person, and one of them reached over 6.5 million people. One of the active living strategies cost $2.20 per person and reached over 7 million people. Three of the clinical and community preventive services strategies cost less than $2.30 per person, and one of them reached almost 2 million people. Across all 20 strategies combined, an increase of 10,000 people in the number of people reached was associated with a $0.22 reduction in the per-person cost. Results demonstrate that interventions, such as tobacco-free indoor policies, which have been shown to improve health outcomes have relatively low per-person costs and are able to reach a large number of people.
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Affiliation(s)
- Olga A Khavjou
- RTI International, Research Triangle Park, NC, United States.
| | | | | | | | - Robin Soler
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Diane Orenstein
- Centers for Disease Control and Prevention, Atlanta, GA, United States
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Abstract
Tobacco use and exposure to tobacco smoke remain major but avoidable causes of premature mortality and disease worldwide. Although the age-standardized prevalence of daily smoking has declined for both men and women in many countries, the number of smokers continues to increase because of global population growth. Although cigarettes are the most commonly used tobacco product, the tobacco epidemic has become tremendously complex with the emergence and popularity of alternative products such as waterpipes and electronic cigarettes (also known as e-cigarettes). Exposure sciences play a major role in characterizing the tobacco epidemic as well as in the promotion, enactment, and implementation of tobacco control initiatives including legislation and voluntary measures in countries worldwide. We reviewed several studies in Latin America and other regions, showing how high-quality exposure assessment has contributed to smoke-free policies. Although there are many toxicants in tobacco products, metals could be playing an important role in tobacco-related disease. Tobacco plants accumulate cadmium and lead from soil. In e-cigarettes, a metallic coil heats the e-liquid to produce the aerosol that is inhaled by the vaper, and studies have found high aerosol levels of nickel, chromium, lead, and zinc. Despite many tobacco control successes, including the enactment of the Framework Convention on Tobacco Control, which has been ratified by 181 countries, tobacco control faces many challenges globally. Given the continuing increase in the number of smokers worldwide and the rapid emergence of new tobacco products, additional creative efforts are needed to achieve a smoke-free world, help smokers to quit, and protect youth from initiating tobacco use.
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Affiliation(s)
- Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
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Demou E, Bhaskar A, Xu T, Mackay DF, Hunt K. Health, lifestyle and employment beyond state-pension age. BMC Public Health 2017; 17:971. [PMID: 29262819 PMCID: PMC5738753 DOI: 10.1186/s12889-017-4957-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 11/28/2017] [Indexed: 11/30/2022] Open
Abstract
Background The factors influencing one’s choice to retire vary, with financial and health considerations being some of the main factors impacting or associated with people’s timing of retirement. The aim of the study is to investigate the differences in current health and health-related behaviours, such as smoking, drinking and exercising, between people who kept on working beyond state-pension age and those who retired before or at state-pension age. Methods Data from six waves (2003, 2008–2012) of the Scottish Health Survey (SHeS) are used. Descriptive analyses were used to characterise the population. Multivariate logistic regression was undertaken to analyse the relationship between retirement groups and gender, age, deprivation, marital status, housing tenure, general health, longstanding illness, cigarette smoking status, amount of exercise and mental health, using Stata. Results Reporting poor self-rated health or having a long-standing illness was associated with increased odds of retiring before state pension age (SPA) in groups with a medium deprivation profile in almost all the survey years. For the least deprived there was little evidence of an association between poor health and extended-working-life, while significant associations were observed for the most deprived. An increasing trend was observed for both genders in the number of people extending their working life. Similar associations between reporting poorer self-rated health and extended working lives were observed for men and women. Distinct gender differences were observed for the associations with reporting poor mental health and no exercise. In the adjusted models, both were significantly associated with retiring at or before SPA in almost every year for women, whereas no significant associations were observed (except in 1 year) for men. Conclusions This study shows an increasing trend in the number of people extending their working lives and demonstrates significant associations between health and lifestyle behaviours and employment status past SPA. The results suggest that good health – both physically and mentally – along with either a need or a want to stay in employment could be important reasons for continuing to work beyond SPA. Electronic supplementary material The online version of this article (10.1186/s12889-017-4957-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK.
| | - Abita Bhaskar
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK
| | - Taoye Xu
- Public Health, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Daniel F Mackay
- Public Health, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Kate Hunt
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK
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Morrison D, Mair FS, Yardley L, Kirby S, Thomas M. Living with asthma and chronic obstructive airways disease: Using technology to support self-management - An overview. Chron Respir Dis 2017; 14:407-419. [PMID: 27512084 PMCID: PMC5729728 DOI: 10.1177/1479972316660977] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Long-term respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common, and cause high levels of morbidity and mortality. Supporting self-management is advocated for both asthma and increasingly so for COPD, and there is growing interest in the potential role of a range of new technologies, such as smartphone apps, the web or telehealth to facilitate and promote self-management in these conditions. Treatment goals for both asthma and COPD include aiming to control symptoms, maintain activities, achieve the best possible quality of life and minimize risks of exacerbation. To do this, health professionals should be (a) helping patients to recognize deteriorating symptoms and act appropriately; (b) promoting adherence to maintenance therapy; (c) promoting a regular review where triggers can be established, and strategies for managing such triggers discussed; and (d) promoting healthy lifestyles and positive self-management of symptoms. In particular, low uptake of asthma action plans is a modifiable contributor to morbidity and possibly also to mortality in those with asthma and should be addressed as a priority. Using technology to support self-management is an evolving strategy that shows promise. This review provides an overview of self-management support and discusses how newer technologies may help patients and health professionals to meet key treatment goals.
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Affiliation(s)
- Deborah Morrison
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frances S Mair
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Lucy Yardley
- Department of Psychology, University of Southampton, Highfield, Southampton, UK
| | - Sarah Kirby
- Department of Psychology, University of Southampton, Highfield, Southampton, UK
| | - Mike Thomas
- Primary Care Research, Aldermoor Health Centre, University of Southampton, Aldermoor Close, Southampton, UK
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Rando-Matos Y, Pons-Vigués M, López MJ, Córdoba R, Ballve-Moreno JL, Puigdomènech-Puig E, Benito-López VE, Arias-Agudelo OL, López-Grau M, Guardia-Riera A, Trujillo JM, Martin-Cantera C. Smokefree legislation effects on respiratory and sensory disorders: A systematic review and meta-analysis. PLoS One 2017; 12:e0181035. [PMID: 28759596 PMCID: PMC5536320 DOI: 10.1371/journal.pone.0181035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 06/26/2017] [Indexed: 11/22/2022] Open
Abstract
Aims The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose) among all populations. Materials and methods Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1) original scientific studies about smokefree legislation, 2) Data before and after legislation were collected, and 3) Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment. Results A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers). Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months). Four (50%) of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1–36%) than for asthma (5–31%). Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46%) of the studies. Conclusions Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms) and, to a lesser degree, rates of hospitalization for asthma.
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Affiliation(s)
- Yolanda Rando-Matos
- Centre d'Atenció Primària (CAP) Florida Nord. Gerència d’Àmbit d’Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
- * E-mail:
| | - Mariona Pons-Vigués
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
- Universitat de Girona, Girona, Spain
| | - María José López
- Public Health Agency of Barcelona, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Institut d'Investigació Biomèdic (IIB Sant Pau), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Rodrigo Córdoba
- Centro de Salud Universitario Delicias Sur, Servicio Aragonés de Salud (SALUD), Zaragoza, Spain
- Universidad de Zaragoza, Zaragoza, Spain
| | - José Luis Ballve-Moreno
- Centre d'Atenció Primària (CAP) Florida Nord. Gerència d’Àmbit d’Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
| | - Elisa Puigdomènech-Puig
- Agència de Qualitat i Avaluació Sanitàries, AQuAS, Generalitat de Catalunya, Barcelona, Spain
| | - Vega Estíbaliz Benito-López
- Servicio de Medicina Preventiva, Complejo Asistencial Universitario de Salamanca, Sanidad de Castilla y Leon (SACYL), Salamanca, Spain
- Grupo de investigación: Trastornos sensoriales y neuroplasticidad cerebral (UIC: 083), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Instituto de Neurociencias de Castilla y León (INCYL), Salamanca, Spain
| | - Olga Lucía Arias-Agudelo
- Centre d'Atenció Primària (CAP) San Martí de Provençals, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Mercè López-Grau
- Centre d'Atenció Primària (CAP) Passeig de Sant Joan, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Anna Guardia-Riera
- Àrea Bàsica de Salut l'Hospitalet de Llobregat 6—Sta. Eulàlia sud, Gerència d’Àmbit d’Atenció Primària Hospitalet de Llobregat, Institut Català de la Salut, Barcelona, Spain
| | | | - Carlos Martin-Cantera
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
- Centre d'Atenció Primària (CAP) Passeig de Sant Joan, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut (ICS), Barcelona, Spain
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Changes in hospitalizations for chronic respiratory diseases after two successive smoking bans in Spain. PLoS One 2017; 12:e0177979. [PMID: 28542337 PMCID: PMC5443522 DOI: 10.1371/journal.pone.0177979] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 05/05/2017] [Indexed: 11/21/2022] Open
Abstract
Background Existing evidence on the effects of smoke-free policies on respiratory diseases is scarce and inconclusive. Spain enacted two consecutive smoke-free regulations: a partial ban in 2006 and a comprehensive ban in 2011. We estimated their impact on hospital admissions via emergency departments for chronic obstructive pulmonary disease (COPD) and asthma. Methods Data for COPD (ICD-9 490–492, 494–496) came from 2003–2012 hospital admission records from the fourteen largest provinces of Spain and from five provinces for asthma (ICD-9 493). We estimated changes in hospital admission rates within provinces using Poisson additive models adjusted for long-term linear trends and seasonality, day of the week, temperature, influenza, acute respiratory infections, and pollen counts (asthma models). We estimated immediate and gradual effects through segmented-linear models. The coefficients within each province were combined through random-effects multivariate meta-analytic models. Results The partial ban was associated with a strong significant pooled immediate decline in COPD-related admission rates (14.7%, 95%CI: 5.0, 23.4), sustained over time with a one-year decrease of 13.6% (95%CI: 2.9, 23.1). The association was consistent across age and sex groups but stronger in less economically developed Spanish provinces. Asthma-related admission rates decreased by 7.4% (95%CI: 0.2, 14.2) immediately after the comprehensive ban was implemented, although the one-year decrease was sustained only among men (9.9%, 95%CI: 3.9, 15.6). Conclusions The partial ban was associated with an immediate and sustained strong decline in COPD-related admissions, especially in less economically developed provinces. The comprehensive ban was related to an immediate decrease in asthma, sustained for the medium-term only among men.
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Plausible Roles for RAGE in Conditions Exacerbated by Direct and Indirect (Secondhand) Smoke Exposure. Int J Mol Sci 2017; 18:ijms18030652. [PMID: 28304347 PMCID: PMC5372664 DOI: 10.3390/ijms18030652] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/07/2017] [Accepted: 03/14/2017] [Indexed: 02/07/2023] Open
Abstract
Approximately 1 billion people smoke worldwide, and the burden placed on society by primary and secondhand smokers is expected to increase. Smoking is the leading risk factor for myriad health complications stemming from diverse pathogenic programs. First- and second-hand cigarette smoke contains thousands of constituents, including several carcinogens and cytotoxic chemicals that orchestrate chronic inflammatory responses and destructive remodeling events. In the current review, we outline details related to compromised pulmonary and systemic conditions related to smoke exposure. Specifically, data are discussed relative to impaired lung physiology, cancer mechanisms, maternal-fetal complications, cardiometabolic, and joint disorders in the context of smoke exposure exacerbations. As a general unifying mechanism, the receptor for advanced glycation end-products (RAGE) and its signaling axis is increasingly considered central to smoke-related pathogenesis. RAGE is a multi-ligand cell surface receptor whose expression increases following cigarette smoke exposure. RAGE signaling participates in the underpinning of inflammatory mechanisms mediated by requisite cytokines, chemokines, and remodeling enzymes. Understanding the biological contributions of RAGE during cigarette smoke-induced inflammation may provide critically important insight into the pathology of lung disease and systemic complications that combine during the demise of those exposed.
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Kuehnle D, Wunder C. The Effects of Smoking Bans on Self-Assessed Health: Evidence from Germany. HEALTH ECONOMICS 2017; 26:321-337. [PMID: 26749275 DOI: 10.1002/hec.3310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 11/09/2015] [Accepted: 12/01/2015] [Indexed: 06/05/2023]
Abstract
We examine the effects of smoking bans on self-assessed health in Germany taking into account heterogeneities by smoking status, gender and age. We exploit regional variation in the dates of enactment and dates of enforcement across German federal states. Using data from the German Socio-Economic Panel, our difference-in-differences estimates show that non-smokers' health improves, whereas smokers report no or even adverse health effects in response to bans. We find statistically significant health improvements especially for non-smokers living in households with at least one smoker. Non smokers' health improvements materialise largely with the enactment of smoking bans. Copyright © 2016 John Wiley & Sons, Ltd.
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Wang Z, DiDonato JA, Buffa J, Comhair SA, Aronica MA, Dweik RA, Lee NA, Lee JJ, Thomassen MJ, Kavuru M, Erzurum SC, Hazen SL. Eosinophil Peroxidase Catalyzed Protein Carbamylation Participates in Asthma. J Biol Chem 2016; 291:22118-22135. [PMID: 27587397 DOI: 10.1074/jbc.m116.750034] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Indexed: 12/21/2022] Open
Abstract
The biochemical mechanisms through which eosinophils contribute to asthma pathogenesis are unclear. Here we show eosinophil peroxidase (EPO), an abundant granule protein released by activated eosinophils, contributes to characteristic asthma-related phenotypes through oxidative posttranslational modification (PTM) of proteins in asthmatic airways through a process called carbamylation. Using a combination of studies we now show EPO uses plasma levels of the pseudohalide thiocyanate (SCN-) as substrate to catalyze protein carbamylation, as monitored by PTM of protein lysine residues into Nϵ-carbamyllysine (homocitrulline), and contributes to the pathophysiological sequelae of eosinophil activation. Studies using EPO-deficient mice confirm EPO serves as a major enzymatic source for protein carbamylation during eosinophilic inflammatory models, including aeroallergen challenge. Clinical studies similarly revealed significant enrichment in carbamylation of airway proteins recovered from atopic asthmatics versus healthy controls in response to segmental allergen challenge. Protein-bound homocitrulline is shown to be co-localized with EPO within human asthmatic airways. Moreover, pathophysiologically relevant levels of carbamylated protein either incubated with cultured human airway epithelial cells in vitro, or provided as an aerosolized exposure in non-sensitized mice, induced multiple asthma-associated phenotypes including induction of mucin, Th2 cytokines, IFNγ, TGFβ, and epithelial cell apoptosis. Studies with scavenger receptor-A1 null mice reveal reduced IL-13 generation following exposure to aerosolized carbamylated protein, but no changes in other asthma-related phenotypes. In summary, EPO-mediated protein carbamylation is promoted during allergen-induced asthma exacerbation, and can both modulate immune responses and trigger a cascade of many of the inflammatory signals present in asthma.
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Affiliation(s)
- Zeneng Wang
- From the Departments of Cellular and Molecular Medicine
| | | | | | | | | | | | - Nancy A Lee
- the Department of Biochemistry and Molecular Biology, Mayo Clinic, Scottsdale, Arizona 85259
| | - James J Lee
- the Department of Biochemistry and Molecular Biology, Mayo Clinic, Scottsdale, Arizona 85259
| | - Mary Jane Thomassen
- the Division of Pulmonary, Critical Care & Sleep Medicine, East Carolina University, Greenville, North Carolina 27834, and
| | - Mani Kavuru
- the Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania 19107
| | | | - Stanley L Hazen
- From the Departments of Cellular and Molecular Medicine, Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195,
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Patterson C, Hilton S, Weishaar H. Who thinks what about e-cigarette regulation? A content analysis of UK newspapers. Addiction 2016; 111:1267-74. [PMID: 26802534 PMCID: PMC4982091 DOI: 10.1111/add.13320] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/25/2015] [Accepted: 01/20/2016] [Indexed: 12/01/2022]
Abstract
AIMS To establish how frequently different types of stakeholders were cited in the UK media debate about e-cigarette regulation, their stances towards different forms of e-cigarette regulation, and what rationales they employed in justifying those stances. METHODS Quantitative and qualitative content analyses of 104 articles about e-cigarette regulation published in eight UK and three Scottish national newspapers between 1 January 2013 and 31 December 2014. RESULTS Reporting on e-cigarette regulation grew significantly (P < 0.001) throughout the sample period. Governments and regulatory bodies were the most frequently cited stakeholders and uniformly supported regulation, while other stakeholders did not always support regulation. Arguments for e-cigarette regulation greatly outnumbered arguments against regulation. Regulating purchasing age, restricting marketing and regulating e-cigarettes as medicine were broadly supported, while stakeholders disagreed about prohibiting e-cigarette use in enclosed public spaces. In rationalizing their stances, supporters of regulation cited child protection and concerns about the safety of e-cigarette products, while opponents highlighted the potential of e-cigarettes in tobacco cessation and questioned the evidence base associating e-cigarette use with health harms. CONCLUSIONS In the UK between 2013 and 2014, governments and tobacco control advocates frequently commented on e-cigarettes in UK-wide and Scottish national newspapers. Almost all commentators supported e-cigarette regulation, but there was disagreement about whether e-cigarette use should be allowed in enclosed public spaces. This appeared to be linked to whether commentators emphasized the harms of vapour and concerns about renormalizing smoking or emphasized the role of e-cigarettes as a smoking cessation aid.
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Affiliation(s)
- Chris Patterson
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Heide Weishaar
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
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Frazer K, Callinan JE, McHugh J, van Baarsel S, Clarke A, Doherty K, Kelleher C. Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database Syst Rev 2016; 2:CD005992. [PMID: 26842828 PMCID: PMC6486282 DOI: 10.1002/14651858.cd005992.pub3] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Smoking bans have been implemented in a variety of settings, as well as being part of policy in many jurisdictions to protect the public and employees from the harmful effects of secondhand smoke (SHS). They also offer the potential to influence social norms and the smoking behaviour of those populations they affect. Since the first version of this review in 2010, more countries have introduced national smoking legislation banning indoor smoking. OBJECTIVES To assess the effects of legislative smoking bans on (1) morbidity and mortality from exposure to secondhand smoke, and (2) smoking prevalence and tobacco consumption. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialised Register, MEDLINE, EMBASE, PsycINFO, CINAHL and reference lists of included studies. We also checked websites of various organisations. Date of most recent search; February 2015. SELECTION CRITERIA We considered studies that reported legislative smoking bans affecting populations. The minimum standard was having an indoor smoking ban explicitly in the study and a minimum of six months follow-up for measures of smoking behaviour. Our search included a broad range of research designs including: randomized controlled trials, quasi-experimental studies (i.e. non-randomized controlled studies), controlled before-and-after studies, interrupted time series as defined by the Cochrane Effective Practice and Organisation of Care Group, and uncontrolled pre- and post-ban data. DATA COLLECTION AND ANALYSIS One author extracted characteristics and content of the interventions, participants, outcomes and methods of the included studies and a second author checked the details. We extracted health and smoking behaviour outcomes. We did not attempt a meta-analysis due to the heterogeneity in design and content of the studies included. We evaluated the studies using qualitative narrative synthesis. MAIN RESULTS There are 77 studies included in this updated review. We retained 12 studies from the original review and identified 65 new studies. Evidence from 21 countries is provided in this update, an increase of eight countries from the original review. The nature of the intervention precludes randomized controlled trials. Thirty-six studies used an interrupted time series study design, 23 studies use a controlled before-and-after design and 18 studies are before-and-after studies with no control group; six of these studies use a cohort design. Seventy-two studies reported health outcomes, including cardiovascular (44), respiratory (21), and perinatal outcomes (7). Eleven studies reported national mortality rates for smoking-related diseases. A number of the studies report multiple health outcomes. There is consistent evidence of a positive impact of national smoking bans on improving cardiovascular health outcomes, and reducing mortality for associated smoking-related illnesses. Effects on respiratory and perinatal health were less consistent. We found 24 studies evaluating the impact of national smoke-free legislation on smoking behaviour. Evidence of an impact of legislative bans on smoking prevalence and tobacco consumption is inconsistent, with some studies not detecting additional long-term change in existing trends in prevalence. AUTHORS' CONCLUSIONS Since the first version of this review was published, the current evidence provides more robust support for the previous conclusions that the introduction of a legislative smoking ban does lead to improved health outcomes through reduction in SHS for countries and their populations. The clearest evidence is observed in reduced admissions for acute coronary syndrome. There is evidence of reduced mortality from smoking-related illnesses at a national level. There is inconsistent evidence of an impact on respiratory and perinatal health outcomes, and on smoking prevalence and tobacco consumption.
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Affiliation(s)
- Kate Frazer
- University College DublinSchool of Nursing, Midwifery & Health SystemsHealth Sciences CentreBelfieldDublin 4Ireland
| | - Joanne E Callinan
- Milford Care CentreLibrary & Information Service, Education, Research & Quality DepartmentPlassey Park RoadCastletroyLimerickIreland000
| | - Jack McHugh
- University College DublinSchool of Public Health, Physiotherapy and Sports ScienceBelfieldDublin 4Ireland
| | - Susan van Baarsel
- University College DublinSchool of Medicine and Medical ScienceDublinIreland
| | - Anna Clarke
- National Immunisation OfficeManor StreetDublin 7Ireland
| | - Kirsten Doherty
- Education and Research CentreDepartment of Preventive Medicine and Health PromotionSt Vincent's University HospitalElm ParkDublin 4Ireland
| | - Cecily Kelleher
- University College DublinSchool of Public Health, Physiotherapy and Sports ScienceBelfieldDublin 4Ireland
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Vuolo M, Kelly BC, Kadowaki J. Independent and Interactive Effects of Smoking Bans and Tobacco Taxes on a Cohort of US Young Adults. Am J Public Health 2016; 106:374-80. [PMID: 26691133 PMCID: PMC4758814 DOI: 10.2105/ajph.2015.302968] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the mutual effects of smoking bans and taxes on smoking among a longitudinal cohort of young adults. METHODS We combined a repository of US tobacco policies at the state and local level with the nationally representative geocoded National Longitudinal Survey of Youth 1997 (2004-2011) from ages 19 to 31 years and Census data, to examine the impact of tobacco policies on any current and daily pack smoking. The analytic sample amounts to 19,668 observations among 4341 individuals within 487 cities. RESULTS For current smoking, we found significant effects for comprehensive smoking bans, but not excise taxes. We also found an interaction effect, with bans being most effective in locales with no or low taxes. For daily pack smoking, we found significant effects for taxes, but limited support for bans. CONCLUSIONS Social smoking among young adults is primarily inhibited by smoking bans, but excise taxes only deter such smoking in the absence of a ban. Heavy smokers are primarily deterred by taxes. Although both policies have an impact on young adult smoking behaviors, their dual presence does not intensify each policy's efficacy.
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Affiliation(s)
- Mike Vuolo
- Mike Vuolo is with the Department of Sociology, The Ohio State University, Columbus, OH. Brian C. Kelly and Joy Kadowaki are with the Department of Sociology, Purdue University, West Lafayette, IN
| | - Brian C Kelly
- Mike Vuolo is with the Department of Sociology, The Ohio State University, Columbus, OH. Brian C. Kelly and Joy Kadowaki are with the Department of Sociology, Purdue University, West Lafayette, IN
| | - Joy Kadowaki
- Mike Vuolo is with the Department of Sociology, The Ohio State University, Columbus, OH. Brian C. Kelly and Joy Kadowaki are with the Department of Sociology, Purdue University, West Lafayette, IN
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Al Mulla A, Fanous N, Seidenberg AB, Rees VW. Secondhand smoke emission levels in waterpipe cafes in Doha, Qatar. Tob Control 2015; 24:e227-31. [PMID: 25352562 DOI: 10.1136/tobaccocontrol-2014-051717] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 10/08/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND Exposure to the emissions of a tobacco waterpipe is associated with increased health risks among its users as well as those exposed to its secondhand smoke. Waterpipe use is an emerging concern to the tobacco control community, particularly among countries of the Eastern Mediterranean Region. In 2002, Qatar adopted legislation that prohibited cigarette smoking inside public venues, but exempted tobacco waterpipe smoking. To inform the development and enforcement of effective policy, the impact of cigarette and waterpipe use on indoor air quality was monitored in waterpipe cafes in Doha, Qatar. METHODS Particulate matter (PM2.5) levels were measured inside and outside of a sample of 40 waterpipe cafes and 16 smoke-free venues in Doha, Qatar between July and October 2012. In addition, the number of waterpipes being smoked and the number of cigarette smokers were counted within each venue. Non-paired and paired sample t tests were used to assess differences in mean PM2.5 measurements between venue type (waterpipe vs smoke-free) and environment (indoor vs outdoor). RESULTS The mean PM2.5 level inside waterpipe venues (476 μg/m(3)) was significantly higher than the mean PM2.5 level inside smoke-free venues (17 μg/m(3); p<0.001), and significantly higher than the mean PM2.5 level found immediately outside waterpipe venues (35 μg/m(3); p<0.001). In smoke-free venues, the outside mean PM2.5 level (30 μg/m(3)) did not differ significantly from the mean PM2.5 inside levels inside these venues (p=0.121). CONCLUSIONS Elevated levels of particulate pollution were found in waterpipe cafes in Doha, Qatar, potentially endangering the health of employees and patrons. To protect the public from the dangers of secondhand tobacco smoke, and to change social norms around tobacco use, smoke-free policies that apply to all forms of combusted tobacco products, including the waterpipe, are needed.
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Affiliation(s)
- Ahmad Al Mulla
- Tobacco Control Unit, Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Nadia Fanous
- Tobacco Control Unit, Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Andrew B Seidenberg
- Department of Social & Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, USA
| | - Vaughan W Rees
- Department of Social & Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, USA
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Henneberger PK, Liang X, Lillienberg L, Dahlman-Höglund A, Torén K, Andersson E. Occupational exposures associated with severe exacerbation of asthma. Int J Tuberc Lung Dis 2015; 19:244-50. [PMID: 25574926 DOI: 10.5588/ijtld.14.0132] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The exacerbation of asthma by workplace conditions is common, but little is known about which agents pose a risk. OBJECTIVE We used data from an existing survey of adults with asthma to identify occupational exposures associated with severe exacerbation of asthma. DESIGN Questionnaires were completed by 557 working adults with asthma. Severe exacerbation of asthma in the past 12 months was defined as asthma-related hospitalization, or reports of both unplanned asthma care and treatment with a short course of oral corticosteroids. Occupational exposures for the same time period were assessed using an asthma-specific job exposure matrix. We modeled severe exacerbation to yield prevalence ratios (PRs) for exposures while controlling for potential confounders. RESULTS A total of 164 participants (29%) were positive for severe exacerbation, and 227 (40.8%) were assessed as being exposed to asthma agents at work. Elevated PRs were observed for several specific agents, notably the irritant subcategories of environmental tobacco smoke (PR 1.84, 95%CI 1.34-2.51) among all participants, inorganic dusts (PR 2.53, 95%CI 1.37-4.67) among men, and the low molecular weight subcategory of other highly reactive agents (PR 1.97, 95%CI 1.08-3.60) among women. CONCLUSION Among working adults with asthma, severe exacerbation was associated with several occupational agents.
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Affiliation(s)
- P K Henneberger
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - X Liang
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - L Lillienberg
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - A Dahlman-Höglund
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - K Torén
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - E Andersson
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
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Shamo F, Wilson T, Kiley J, Repace J. Assessing the effect of Michigan's smoke-free law on air quality inside restaurants and casinos: a before-and-after observational study. BMJ Open 2015; 5:e007530. [PMID: 26185176 PMCID: PMC4513515 DOI: 10.1136/bmjopen-2014-007530] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the effect of Michigan's smoke-free air (SFA) law on the air quality inside selected restaurants and casinos. The hypothesis of the study: if the SFA law is effectively implemented in restaurants and casinos, there will be a significant reduction in the particulate matter PM2.5 measured in the same establishments after the law is implemented. SETTING Prelaw and postlaw design study. PARTICIPANTS 78 restaurants in 14 Michigan cities from six major regions of the state, and three Detroit casinos. METHODS We monitored the real-time PM2.5 in 78 restaurants and three Detroit casinos before the SFA law, and again monitored the same restaurants and casinos after implementation of the law, which was enacted on 1 May 2010. PRIMARY AND SECONDARY OUTCOME MEASURES Concentration measurements of secondhand smoke (SHS) fine particles (PM2.5) were compared in each restaurant in the prelaw period to measurements of PM2.5 in the same restaurants during the postlaw period. A second comparison was made for PM2.5 levels in three Detroit casinos prelaw and postlaw; these casinos were exempted from the SFA law. RESULTS Prelaw data indicated that 85% of the restaurants had poor to hazardous air quality, with the average venue having 'unhealthy' air according to Michigan's Air Quality Index for PM2.5. Postlaw, air quality in 93% of the restaurants improved to 'good'. The differences were statistically significant (p<0.0001). By comparison, the three casinos measured had 'unhealthy' air both before and after the law. CONCLUSIONS The significant air quality improvement in the Michigan restaurants after implementation of the SFA law indicates that the law was very effective in reducing exposure to SHS. Since the Detroit casinos were exempted from the law, the air quality was unchanged, and remained unhealthy in both prelaw and postlaw periods.
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Affiliation(s)
- Farid Shamo
- The Michigan Department of Community Health, Division of Chronic Diseases, Lansing, Michigan, USA
| | - Teri Wilson
- The Michigan Department of Community Health, Division of Chronic Diseases, Lansing, Michigan, USA
| | - Janet Kiley
- The Michigan Department of Community Health, Division of Chronic Diseases, Lansing, Michigan, USA
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Shargorodsky J, Garcia-Esquinas E, Galán I, Navas-Acien A, Lin SY. Allergic Sensitization, Rhinitis and Tobacco Smoke Exposure in US Adults. PLoS One 2015; 10:e0131957. [PMID: 26172447 PMCID: PMC4501790 DOI: 10.1371/journal.pone.0131957] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 06/08/2015] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Tobacco exposure has been linked with sinonasal pathology and may be associated with allergic sensitization. This study evaluates the association between exposure to active smoking or secondhand smoke (SHS) and the prevalence of rhinitis and allergic sensitization in the US adult population. METHODS Cross-sectional study in 4,339 adults aged 20-85 in the National Health and Nutrition Examination Survey, 2005-2006. Never smoking was defined as reported lifetime smoking less than 100 cigarettes and serum cotinine levels <10ng/ml, while active smoking was defined as self-reported smoking or serum cotinine concentrations > 10 ng/mL. Self-reported rhinitis was based on symptoms during the past 12 months, and allergen sensitization was defined as a positive response to any of the 19 specific IgE antigens tested. RESULTS Almost half of the population (43%) had detectable levels of IgE specific to at least one inhaled allergen and 32% reported a history of rhinitis. After multivariate adjustment, there was a statistically significant association between the highest serum cotinine tertile and rhinitis in active smokers (OR 1.42; 95%CI 1.00-2.00). The association between active smoking and rhinitis was stronger in individuals without allergic sensitization (OR 2.47; 95%CI 1.44-4.23). There was a statistically significant association between increasing cotinine tertiles and decreased odds of inhaled allergen sensitization (p-trend <.01). CONCLUSION Tobacco smoke exposure was associated with increased prevalence of rhinitis symptoms, but not with allergic sensitization. The results indicate that the relationship between tobacco smoke exposure and sinonasal pathology in adults may be independent of allergic sensitization.
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Affiliation(s)
- Josef Shargorodsky
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Coastal Ear Nose and Throat, Neptune, New Jersey, United States of America
| | - Esther Garcia-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Ciber of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Iñaki Galán
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States of America
| | - Sandra Y. Lin
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Kalkhoran S, Sebrié EM, Sandoya E, Glantz SA. Effect of Uruguay's National 100% Smokefree Law on Emergency Visits for Bronchospasm. Am J Prev Med 2015; 49:85-8. [PMID: 25997906 PMCID: PMC4476915 DOI: 10.1016/j.amepre.2014.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/08/2014] [Accepted: 12/12/2014] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Implementation of smokefree laws is followed by drops in hospital admissions for cardiovascular diseases and asthma. The impact of smokefree laws on use of non-hospital medical services has not been assessed. The purpose of this study is to evaluate the impact of Uruguay's national 100% smokefree legislation on non-hospital emergency care visits, hospitalizations for bronchospasm, and bronchodilator use. METHODS The monthly number of non-hospital emergency care visits and hospitalizations for bronchospasm, as well as monthly puffs of bronchodilators (total and per person), from 3 years prior to the adoption of the 100% smokefree policy on March 1, 2006, through 5 years after the policy were assessed using interrupted time series negative binomial regression. Data analysis was conducted in 2014. RESULTS The incidence of non-hospital emergency visits for bronchospasm decreased by 15% (incidence rate ratio [IRR]=0.85, 95% CI=0.76, 0.94) following implementation of the law. Hospitalizations for bronchospasm did not change significantly (IRR=0.89, 95% CI=0.66, 1.21). Total monthly puffs of salbutamol and ipratropium administered in the non-hospital emergency setting decreased by 224 (95% CI=-372, -76) and 179 (95% CI=-340, -18.6), respectively, from means of 1,222 and 1,007 before the law. CONCLUSIONS Uruguay's 100% smokefree law was followed by fewer emergency visits for bronchospasm and less need for treatment, supporting adoption of such policies in low- and middle-income countries to reduce the disease burden and healthcare costs associated with smoking.
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Affiliation(s)
- Sara Kalkhoran
- Department of Medicine, Cardiovascular Research Institute, University of California San Francisco, San Francisco, California
| | - Ernesto M Sebrié
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York
| | - Edgardo Sandoya
- CIET, Centro para la Investigación de la Epidemia de Tabaquismo, Montevideo; CLAEH Medical School, Maldonado, Uruguay
| | - Stanton A Glantz
- Department of Medicine, Cardiovascular Research Institute, University of California San Francisco, San Francisco, California; Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California San Francisco, San Francisco, California.
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Effect of a smoking ban on respiratory health in nonsmoking hospitality workers: a prospective cohort study. J Occup Environ Med 2015; 56:e86-91. [PMID: 25285840 DOI: 10.1097/jom.0000000000000262] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to examine the effect of a smoking ban on lung function, fractional exhaled nitric oxide, and respiratory symptoms in nonsmoking hospitality workers. METHODS Secondhand smoke exposure at the workplace, spirometry, and fractional exhaled nitric oxide were measured in 92 nonsmoking hospitality workers before as well as twice after a smoking ban. RESULTS At baseline, secondhand smoke-exposed hospitality workers had lung function values significantly below the population average. After the smoking ban, the covariate-adjusted odds ratio for cough was 0.59 (95% confidence interval, 0.36 to 0.93) and for chronic bronchitis 0.75 (95% confidence interval, 0.55 to 1.02) compared with the preban period. CONCLUSIONS The below-average lung function before the smoking ban indicates chronic damages from long-term exposure. Respiratory symptoms such as cough decreased within 12 months after the ban.
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Zulkifli A, Abidin NZ, Abidin EZ, Hashim Z, Rahman AA, Rasdi I, Syed Ismail SN, Semple S. Implementation of smoke-free legislation in Malaysia: are adolescents protected from respiratory health effects? Asian Pac J Cancer Prev 2015; 15:4815-21. [PMID: 24998546 DOI: 10.7314/apjcp.2014.15.12.4815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation. MATERIALS AND METHODS A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire. RESULTS The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8). CONCLUSIONS Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.
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Affiliation(s)
- Aziemah Zulkifli
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia E-mail :
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Kim J, Kwon HJ, Lee K, Lee DH, Paek Y, Kim SS, Hong S, Lim W, Heo JH, Kim K. Air Quality, Biomarker Levels, and Health Effects on Staff in Korean Restaurants and Pubs Before and After a Smoking Ban. Nicotine Tob Res 2015; 17:1337-46. [PMID: 25649052 DOI: 10.1093/ntr/ntv012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 01/13/2015] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The Korean government implemented a smoking ban at square floor area of ≥150 m(2), rather than <150 m(2), restaurants and pubs from July 2013. This study examined the effects of the smoking regulations in restaurants and pubs in terms of the air quality, biomarker levels and health effects on staff. METHODS Particulate matter smaller than 2.5 µm (PM2.5) was measured in 146 facilities before and 1 month after the ban. The urinary cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1- butanol (NNAL) levels were measured in 101 staff members at 77 facilities before and 1 month after the ban. We also measured self-reported respiratory and sensory symptoms on both phases. RESULTS Of the 146 facilities, 121 facilities were included in the PM2.5 analysis. In ≥150 m(2) pubs, the indoor PM2.5 concentration was significantly reduced after the ban (p < .05). While the urinary cotinine concentrations of the staff in all facilities were not changed after the ban, the total NNAL concentrations of the staff in ≥150 m(2) pubs were significantly reduced after the ban (p < .05). The health effects on staff show that only sensory symptoms significantly improved in ≥150 m(2) facilities after the ban (p < .05). CONCLUSIONS The smoking ban significantly reduced the levels of PM2.5 and total NNAL concentrations in ≥150 m(2) pubs and improved sensory health among staff in ≥150 m(2) facilities. The results of this study can be useful in supporting an expansion of the smoking ban in all indoor places, including <150 m(2) restaurants and pubs.
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Affiliation(s)
- Jeonghoon Kim
- Department of Environmental Health Research, Seoul Medical Center, Seoul, Republic of Korea; Department of Environmental Health, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Chungnam, Republic of Korea;
| | - Kiyoung Lee
- Department of Environmental Health, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea; Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Do-Hoon Lee
- Department of Laboratory Medicine, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Yujin Paek
- Department of Family Medicine, Health Promotion Center, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-do, Republic of Korea
| | | | - Soyoung Hong
- Department of Environmental Health Research, Seoul Medical Center, Seoul, Republic of Korea; Department of Public Health Nutrition, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Wanryung Lim
- Department of Environmental Health Research, Seoul Medical Center, Seoul, Republic of Korea
| | - Jae-Hyeok Heo
- Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea
| | - Kyoosang Kim
- Department of Environmental Health Research, Seoul Medical Center, Seoul, Republic of Korea
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Snyder K, Vick JH, King BA. Smoke-free multiunit housing: a review of the scientific literature. Tob Control 2015; 25:9-20. [PMID: 25566811 DOI: 10.1136/tobaccocontrol-2014-051849] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 12/16/2014] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Multiunit housing (MUH) residents are susceptible to secondhand smoke (SHS) exposure, which can transfer between living units. This review summarises existing scientific literature relevant to smoke-free MUH, discusses knowledge gaps and provides recommendations for future research to inform public health action. DATA SOURCES We conducted a systematic search of peer-reviewed articles using three databases: EBSCOhost CINAHL, PubMed and Web of Science. STUDY SELECTION Article titles, abstracts and text were reviewed to ascertain three inclusion criteria: (1) English language; (2) conducted in the USA; (3) reported on baseline data, development, implementation or evaluation of smoke-free MUH. DATA EXTRACTION We used a multistep process to identify eligible articles: (1) two reviewers separately evaluated article titles; (2) two reviewers separately evaluated abstracts and (3) one reviewer read each article and determined inclusion eligibility. DATA SYNTHESIS We identified and included 35 articles published during 2001-2014, grouped based on broad themes: MUH resident (n=16); MUH operator (n=6); environmental monitoring and biomarkers (n=9); economic (n=2); legal (n=3); and implementation process and policy impact (n=8). Studies with multiple themes were included in all relevant groups. CONCLUSIONS Existing literature has focused on self-reported, cross-sectional studies of MUH residents and operators; some studies of environmental markers, biomarkers and economic indicators have also been conducted. Future research on smoke-free MUH policy compliance and enforcement, and on the impact of these policies on smoking behaviours and health outcomes, could further inform public health planning, policy and practice. Despite these gaps, the current literature provides sufficient evidence for action to eliminate SHS exposure in MUH.
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Affiliation(s)
- Kimberly Snyder
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Janice Hassett Vick
- Public Health and Survey Research Division, ICF International, Atlanta, Georgia, USA
| | - Brian A King
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Five-year lung function observations and associations with a smoking ban among healthy miners at high altitude (4000 m). J Occup Environ Med 2014; 55:1421-5. [PMID: 24270292 DOI: 10.1097/jom.0b013e3182a641e7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the annual lung function decline associated with the reduction of secondhand smoke exposure in a high-altitude industrial workforce. METHODS We performed pulmonary function tests annually among 109 high-altitude gold-mine workers over 5 years of follow-up. The first 3 years included greater likelihood of exposure to secondhand smoke exposure before the initiation of extensive smoking restrictions that came into force in the last 2 years of observation. RESULTS In repeated measures modeling, taking into account the time elapsed in relation to the smoking ban, there was a 115 ± 9 (standard error) mL per annum decline in lung function before the ban, but a 178 ± 20 (standard error) mL per annum increase afterward (P < 0.001, both slopes). CONCLUSION Institution of a workplace smoking ban at high altitude may be beneficial in terms of lung function decline.
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Weinberger AH, Pilver CE, Mazure CM, McKee SA. Stability of smoking status in the US population: a longitudinal investigation. Addiction 2014; 109:1541-53. [PMID: 24916157 PMCID: PMC4127136 DOI: 10.1111/add.12647] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/04/2013] [Accepted: 05/29/2014] [Indexed: 01/16/2023]
Abstract
AIMS To determine smoking transitions in a representative sample of US adults. DESIGN Longitudinal study using data from the National Epidemiologic Survey on Alcohol and Related Conditions (wave 1, 2001-02; wave 2, 2004-05). SETTING The general US adult population. PARTICIPANTS A total of 33 309 adults (53.6% female) classified as wave 1 current daily, current non-daily, former daily, former non-daily or never smokers. MEASUREMENTS Smoking transitions were determined from waves 1 and 2 data. FINDINGS Smoking status remained stable for the majority of current daily (79.8%), former daily (95.8%), former non-daily (96.3%) and never (97.1%) smokers. Among current non-daily smokers, 54.5% quit smoking while 22.5% increased to daily smoking. Current daily smokers who were older [30-44, odds ratio (OR) = 0.62; 95% confidence interval (CI) = 0.49-0.78; 45+, OR = 0.75; 95% CI = 0.61-0.93] and unmarried (OR = 0.80, 95% CI = 0.66-0.96) were less likely to report smoking cessation. Current daily smokers who were Hispanic (OR = 2.15, 95% CI = 1.65-2.81) and college educated (OR = 1.27, 95% CI = 1.05-1.53) were more likely to report smoking cessation. Relapse in former daily smokers was greater in women (OR = 1.44, 95% CI = 1.01-2.06) and lower in older adults (OR = 0.44; 95% CI = 0.27-0.74). Smoking initiation occurred less in women (OR = 0.65; 95% CI = 0.49-0.87) and Hispanic adults (OR = 0.57; 95% CI = 0.36-0.91) and more in unmarried adults (OR = 1.84; 95% CI = 1.37-2.47) and adults with less education (OR = 1.63; 95% CI = 1.09-2.44). CONCLUSIONS From 2001 to 2005, smoking status was extremely stable in the US population. Specific gender, race and educational groups need increased prevention and intervention efforts.
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Affiliation(s)
- Andrea H. Weinberger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519 USA,Women’s Health Research at Yale, Yale University School of Medicine, CT,Cancer Prevention and Control Research Program, Yale Cancer Center, New Haven, CT 06520 USA
| | - Corey E. Pilver
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT 06520 USA
| | - Carolyn M. Mazure
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519 USA,Women’s Health Research at Yale, Yale University School of Medicine, CT
| | - Sherry A. McKee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519 USA,Women’s Health Research at Yale, Yale University School of Medicine, CT,Cancer Prevention and Control Research Program, Yale Cancer Center, New Haven, CT 06520 USA
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Iglesias V, Erazo M, Droppelmann A, Steenland K, Aceituno P, Orellana C, Acuña M, Peruga A, Breysse PN, Navas-Acien A. Occupational secondhand smoke is the main determinant of hair nicotine concentrations in bar and restaurant workers. ENVIRONMENTAL RESEARCH 2014; 132:206-211. [PMID: 24813578 PMCID: PMC4351991 DOI: 10.1016/j.envres.2014.03.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 03/21/2014] [Accepted: 03/31/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To evaluate the relative contribution of occupational vs. non-occupational secondhand tobacco smoke exposure to overall hair nicotine concentrations in non-smoking bar and restaurant employees. METHOD We recruited 76 non-smoking employees from venues that allowed smoking (n=9), had mixed policies (smoking and non-smoking areas, n=13) or were smoke-free (n=2) between April and August 2008 in Santiago, Chile. Employees used personal air nicotine samplers during working and non-working hours for a 24-h period to assess occupational vs. non-occupational secondhand tobacco smoke exposure and hair nicotine concentrations to assess overall secondhand tobacco smoke exposure. RESULTS Median hair nicotine concentrations were 1.5 ng/mg, interquartile range (IQR) 0.7 to 5.2 ng/mg. Time weighted average personal air nicotine concentrations were higher during working hours (median 9.7, IQR 3.3-25.4 µg/m(3)) compared to non-working hours (1.7, 1.0-3.1 µg/m(3)). Hair nicotine concentration was best predicted by personal air nicotine concentration at working hours. After adjustment, a 2-fold increase in personal air nicotine concentration in working hours was associated with a 42% increase in hair nicotine concentration (95% confidence interval 14-70%). Hair nicotine concentration was not associated with personal air nicotine concentration during non-working hours (non-occupational exposure). CONCLUSIONS Personal air nicotine concentration at working hours was the major determinant of hair nicotine concentrations in non-smoking employees from Santiago, Chile. Secondhand tobacco smoke exposure during working hours is a health hazard for hospitality employees working in venues where smoking is allowed.
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Affiliation(s)
- Verónica Iglesias
- School of Public Health, Faculty of Medicine, University of Chile, Chile.
| | | | | | - Kyle Steenland
- Environmental and Occupational Health Department, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Paulina Aceituno
- School of Public Health, Faculty of Medicine, University of Chile, Chile
| | - Cecilia Orellana
- School of Public Health, Faculty of Medicine, University of Chile, Chile
| | | | - Armando Peruga
- National Capacity Building Unit, Tobacco Control Program, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland
| | - Patrick N Breysse
- Departments of Environmental Health Sciences and Epidemiology, and Institute for Global Tobacco Control, Johns Hopkins University, Bloomberg School of Public Health, USA
| | - Ana Navas-Acien
- Departments of Environmental Health Sciences and Epidemiology, and Institute for Global Tobacco Control, Johns Hopkins University, Bloomberg School of Public Health, USA
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An official American Thoracic Society proceedings: work-related asthma and airway diseases. Presentations and discussion from the Fourth Jack Pepys Workshop on Asthma in the Workplace. Ann Am Thorac Soc 2014; 10:S17-24. [PMID: 23952871 DOI: 10.1513/annalsats.201305-119st] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Work-related asthma is a common occupational lung disease. The scope of the Fourth Jack Pepys Workshop that was held in May 2010 went beyond asthma to include discussion of other occupational airway diseases, in particular occupationally related chronic obstructive pulmonary disease (COPD) and bronchiolitis. Aspects explored included public health considerations, environmental aspects, outcome after diagnosis, prevention and surveillance, and other work-related obstructive airway diseases. Consistent methods are needed to accurately estimate the comparative burden of occupation-related airway diseases among different countries. Challenges to accomplishing this include variability in health care delivery, compensation systems, cultural contexts, and social structures. These factors can affect disease estimates, while heterogeneity in occupations and workplace exposures can affect the underlying true prevalence of morbidity. Consideration of the working environment included discussion of practical methods of limiting exposure to respiratory sensitizers, methods to predict new sensitizers before introduction into workplaces, the role of legislated exposure limits, and models to estimate relative validity of various ameliorative measures when complete avoidance of the sensitizer is not feasible. Other strategies discussed included medical surveillance measures and education, especially for young individuals with asthma and new workers about to enter the workforce. Medical outcomes after development of sensitizer-induced occupational asthma are best following earlier diagnosis and removal from further exposure, but a subset may be able to continue working safely provided that exposure is reduced under close follow-up monitoring. It was recognized that occupationally related COPD is common but underappreciated, deserving further study and prevention efforts.
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Humair JP, Garin N, Gerstel E, Carballo S, Carballo D, Keller PF, Guessous I. Acute respiratory and cardiovascular admissions after a public smoking ban in Geneva, Switzerland. PLoS One 2014; 9:e90417. [PMID: 24599156 PMCID: PMC3944023 DOI: 10.1371/journal.pone.0090417] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 01/30/2014] [Indexed: 11/18/2022] Open
Abstract
Background Many countries have introduced legislations for public smoking bans to reduce the harmful effects of exposure to tobacco smoke. Smoking bans cause significant reductions in admissions for acute coronary syndromes but their impact on respiratory diseases is unclear. In Geneva, Switzerland, two popular votes led to a stepwise implementation of a state smoking ban in public places, with a temporary suspension. This study evaluated the effect of this smoking ban on hospitalisations for acute respiratory and cardiovascular diseases. Methods This before and after intervention study was conducted at the University Hospitals of Geneva, Switzerland, across 4 periods with different smoking legislations. It included 5,345 patients with a first hospitalisation for acute coronary syndrome, ischemic stroke, acute exacerbation of chronic obstructive pulmonary disease, pneumonia and acute asthma. The main outcomes were the incidence rate ratios (IRR) of admissions for each diagnosis after the final ban compared to the pre-ban period and adjusted for age, gender, season, influenza epidemic and secular trend. Results Hospitalisations for acute exacerbation of chronic obstructive pulmonary disease significantly decreased over the 4 periods and were lowest after the final ban (IRR = 0.54 [95%CI: 0.42–0.68]). We observed a trend in reduced admissions for acute coronary syndromes (IRR = 0.90 [95%CI: 0.80–1.00]). Admissions for ischemic stroke, asthma and pneumonia did not significantly change. Conclusions A legislative smoking ban was followed by a strong decrease in hospitalisations for acute exacerbation of chronic obstructive pulmonary disease and a trend for reduced admissions for acute coronary syndrome. Smoking bans are likely to be very beneficial for patients with chronic obstructive pulmonary disease.
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Affiliation(s)
- Jean-Paul Humair
- Division of Primary Care Medicine, University Hospitals of Geneva, Geneva, Switzerland
- * E-mail:
| | - Nicolas Garin
- Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland
- Division of Internal Medicine, Chablais Regional Hospital, Monthey, Switzerland
| | - Eric Gerstel
- Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland
- Division of Ambulatory Care and Emergency Medicine, Clinique La Colline, Geneva, Switzerland
| | - Sebastian Carballo
- Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - David Carballo
- Division of Cardiology, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Idris Guessous
- Unit of Population Epidemiology, Division of Primary Care Medicine, University Hospitals of Geneva, Geneva, Switzerland
- Community Prevention Unit, Lausanne University Hospital, Lausanne, Switzerland
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