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Bakchi J, Rasel RA, Shammi KF, Ferdous S, Sultana S, Rabeya MR. Effect of housing construction material on childhood acute respiratory infection: a hospital based case control study in Bangladesh. Sci Rep 2024; 14:8163. [PMID: 38589435 PMCID: PMC11001851 DOI: 10.1038/s41598-024-57820-6] [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: 12/17/2023] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
Despite several studies conducted to investigate housing factors, the effects of housing construction materials on childhood ARI symptoms in Bangladesh remain unclear. Hence, the study aimed to measure such a correlation among children under the age of five. A hospital-based case-control study was conducted, involving 221 cases and 221 controls from January to April 2023. Bivariate and multivariate binary logistic regression was performed to measure the degree of correlation between housing construction materials and childhood ARI symptoms. Households composed of natural floor materials had 2.7 times (95% confidence interval 1.27-5.57) and households composed of natural roof materials had 1.8 times (95% confidence interval 1.01-3.11) higher adjusted odds of having under-five children with ARI symptoms than household composed of the finished floor and finished roof materials respectively. Households with natural wall type were found protective against ARI symptoms with adjusted indoor air pollution determinants. The study indicates that poor housing construction materials are associated with an increased risk of developing ARI symptoms among under-five children in Bangladesh. National policy regarding replacing poor housing materials with concrete, increasing livelihood opportunities, and behavioral strategies programs encouraging to choice of quality housing construction materials could eliminate a fraction of the ARI burden.
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Affiliation(s)
- Jhantu Bakchi
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh.
| | - Rosul Ahmed Rasel
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Khandokar Farmina Shammi
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Sumaiya Ferdous
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Shamima Sultana
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
| | - Mst Rokshana Rabeya
- Department of Public Health Nutrition, School of Science, Primeasia University, Dhaka-1213, Bangladesh
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Lim CCW, Rutherford B, Gartner C, McClure-Thomas C, Foo S, Su FY, Scheurer R, Sebayang S, Chan G, Stjepanović D, Fausiah F, Farassania G, Leung J. A systematic review of second-hand smoking mass media campaigns (2002-2022). BMC Public Health 2024; 24:693. [PMID: 38438990 PMCID: PMC10913644 DOI: 10.1186/s12889-024-18222-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Second-hand smoking (SHS) increases the risk of chronic disease in adults and poses a serious health threat to children. Mass media campaigns are instrumental in raising awareness and reducing SHS exposure. There is a need to identify recent SHS mass media campaigns and assess their sustainability in terms of knowledge, attitudes, and behavioural changes. This systematic review summarises the characteristics and outcomes of mass media campaigns on SHS prevention. METHODS PubMed, Embase, Web of Science, and grey literature were searched in November 2022 for SHS campaigns implemented between 2016 and 2022. The eligibility criteria included campaigns on the dangers or effects of SHS with any target group, dissemination medium, study design, or language. The database search identified 1,413 peer-reviewed titles, of which 82 full-texts were screened, with 14 meeting the eligibility criteria. The grey literature search identified 9,807 sources, of which 61 were included. We extracted data on the campaign characteristics, metrics, and smoking-related outcomes. The JBI critical appraisal tool was used to assess the risk of bias of the included studies. RESULTS We found 73 SHS campaigns conducted between 2002 and 2022, across 50 countries. The campaigns reached 378 million people. The reported recall rates range from 8 to 76%. Of the 11 studies that reported smoking-related outcomes, 10 reported increased knowledge in understanding SHS risks (73-85%), five reported an increased prevalence of smoke-free homes, and two reported an increase in number of participants persuading others to quit smoking. Two studies reported a decrease in overall smoking, whereas three studies observed a reduction in smoking in the presence of children. CONCLUSION The available data provide some support for the effectiveness of SHS campaigns in reducing smoking behaviours in homes and around children. However, the certainty of evidence was low due to the lack of a control group and the substantial heterogeneity in the outcomes assessed. Future campaigns need comprehensive evaluation and reporting to reduce publication bias.
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Affiliation(s)
- Carmen C W Lim
- National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, 4072, St Lucia, QLD, Australia.
- School of Psychology, The University of Queensland, Brisbane, Australia.
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Australia.
| | - Brienna Rutherford
- National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, 4072, St Lucia, QLD, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Coral Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Caitlin McClure-Thomas
- National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, 4072, St Lucia, QLD, Australia
| | - Shaun Foo
- National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, 4072, St Lucia, QLD, Australia
| | - Fang-Yi Su
- National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, 4072, St Lucia, QLD, Australia
| | - Roman Scheurer
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia
| | - Susy Sebayang
- School of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Gary Chan
- National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, 4072, St Lucia, QLD, Australia
| | - Daniel Stjepanović
- National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, 4072, St Lucia, QLD, Australia
| | - Fitri Fausiah
- School of Psychology, Universitas Indonesia, Depok, Indonesia
| | - Ghea Farassania
- School of Psychology, Universitas Indonesia, Depok, Indonesia
| | - Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, 4072, St Lucia, QLD, Australia
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Agbaria N, Finkelstein A, Zwas DR, Daoud N. Perceptions of Barriers and Facilitators to Reducing Exposure to Secondhand Smoke in the Home: A Qualitative Study With Palestinian-Arab Women in Israel. Nicotine Tob Res 2024:ntad257. [PMID: 38217542 DOI: 10.1093/ntr/ntad257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Smoking is a collective and complex problem in the Palestinian-Arab community in Israel, where women and children are particularly vulnerable to exposure to secondhand smoke (SHS), especially in the home. AIMS AND METHODS We undertook this study to better understand women's experiences with SHS exposure in the home and to identify pathways for intervention. Using the grounded theory approach, seven focus groups were conducted with 66 women in different localities across Israel. Purposive and snowball sampling techniques were applied to recruit women who have currently or previously been exposed to smoking in the home. Focus groups were audio-recorded and transcribed verbatim, and data were then coded and analyzed using the constant comparison analysis method to identify emergent themes and subthemes. RESULTS Three core themes emerged from the discussions. These include women's perceptions of smoking among men and exposure to SHS in the home, the implications of smoking on spousal and social relationships, and the women's experiences in coping with this situation and their suggestions for interventions. We identified additional sub-themes, including the consequences to women's and children's health, as well as the complex interaction between smoking in the home and women's social position, agency, and home ownership. CONCLUSIONS Women exposed to SHS in the home experience consequences that affect their health and their spousal and social relationships. They also face several personal and societal challenges in tackling this issue. Culturally tailored interventions targeting both communities and households can raise awareness and impact smoking behaviors in the home. IMPLICATIONS The findings of this study demonstrate the far-reaching consequences of SHS exposure in the home among women who are exposed. The findings contribute to our understanding of smoking contingencies among men and smoking behaviors in the home. This study lays the groundwork for future community and household-based research and interventions. We suggest several critical junctures that may increase response to smoking cessation interventions and to reduce smoking in the home, such as at the time of marriage when the home policy is set, and the adverse effects of exposure on children and other family members, especially those with illness.
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Affiliation(s)
- Nisreen Agbaria
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Hospital, Jerusalem, Israel
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Adi Finkelstein
- Department of Nursing, Faculty of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - Donna R Zwas
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Hospital, Jerusalem, Israel
| | - Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
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Flor LS, Anderson JA, Ahmad N, Aravkin A, Carr S, Dai X, Gil GF, Hay SI, Malloy MJ, McLaughlin SA, Mullany EC, Murray CJL, O'Connell EM, Okereke C, Sorensen RJD, Whisnant J, Zheng P, Gakidou E. Health effects associated with exposure to secondhand smoke: a Burden of Proof study. Nat Med 2024; 30:149-167. [PMID: 38195750 PMCID: PMC10803272 DOI: 10.1038/s41591-023-02743-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/28/2023] [Indexed: 01/11/2024]
Abstract
Despite a gradual decline in smoking rates over time, exposure to secondhand smoke (SHS) continues to cause harm to nonsmokers, who are disproportionately children and women living in low- and middle-income countries. We comprehensively reviewed the literature published by July 2022 concerning the adverse impacts of SHS exposure on nine health outcomes. Following, we quantified each exposure-response association accounting for various sources of uncertainty and evaluated the strength of the evidence supporting our analyses using the Burden of Proof Risk Function methodology. We found all nine health outcomes to be associated with SHS exposure. We conservatively estimated that SHS increases the risk of ischemic heart disease, stroke, type 2 diabetes and lung cancer by at least around 8%, 5%, 1% and 1%, respectively, with the evidence supporting these harmful associations rated as weak (two stars). The evidence supporting the harmful associations between SHS and otitis media, asthma, lower respiratory infections, breast cancer and chronic obstructive pulmonary disease was weaker (one star). Despite the weak underlying evidence for these associations, our results reinforce the harmful effects of SHS on health and the need to prioritize advancing efforts to reduce active and passive smoking through a combination of public health policies and education initiatives.
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Affiliation(s)
- Luisa S Flor
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Jason A Anderson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Noah Ahmad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aleksandr Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Sinclair Carr
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Gabriela F Gil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Matthew J Malloy
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Susan A McLaughlin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erin M O'Connell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chukwuma Okereke
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Reed J D Sorensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Joanna Whisnant
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Tripathy JP. Second Hand Smoke Exposure among Children in Indian Homes: Findings from the Global Adult Tobacco Survey. Behav Med 2024; 50:75-81. [PMID: 36259371 DOI: 10.1080/08964289.2022.2105795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 11/02/2022]
Abstract
Children are vulnerable to second hand smoke (SHS) exposure because of limited control over their indoor environment, especially at homes. This study determines the magnitude, patterns and determinants of SHS exposure in the home among children in India. Data collected under the Global Adult Tobacco Survey (GATS) data, a household survey of adults ≥15 years of age during 2016-2017 conducted in India were analyzed to estimate the proportion of children exposed to SHS in their homes. GATS estimates and national census population projections for 2020 were also used to estimate the number of children exposed to SHS in the homes. Nearly half (46.5%) of the children <15 years of age were exposed to SHS in their homes in India which extrapolates to nearly an estimated 170 million. Children living in rural households, north-east and central regions and households with an adult smoker were more likely to be exposed to SHS. SHS exposure among children in home is high in India which calls for adoption of voluntary smoke-free homes initiative and promoting cessation among smokers.
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Affiliation(s)
- Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
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van der Eijk Y, Woh J. Is secondhand smoke associated with mental health issues? A narrative review of the evidence and policy implications. Health Policy 2023; 136:104900. [PMID: 37651970 DOI: 10.1016/j.healthpol.2023.104900] [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: 02/20/2023] [Revised: 07/20/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023]
Abstract
Secondhand smoke (SHS) is a well-established cause of lung cancer, respiratory disease, heart disease and developmental issues in children, with an overwhelming evidence base spanning over four decades. In this narrative review, we describe studies which have also linked self-reported or cotinine-assessed SHS exposure in the home, workplace and other settings to mental health disorders including depression, suicide, anxiety, and psychological distress in children and adults, sleeping disorders, Attention Deficit Hyperactivity Disorder and behavioural issues in children, and dementia in older adults. In general, evidence indicates that SHS exposure is associated with these disorders in a dose-response manner, with higher odds reported in people who are exposed to SHS at high levels, frequently, and in the home environment. Most studies so far are cross-sectional albeit in large, nationally representative samples from various countries with a smaller number of longitudinal studies. More research is needed in this area to determine whether SHS is a direct cause of adverse mental health outcomes, and whether creating smokefree environments leads to improved mental wellbeing. In particular, more research is needed on the impact of smokefree home environments, an area which has received relatively little focus in smokefree interventions which generally target public places.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, MD1 Tahir Foundation Building, National University of Singapore, 12 Science Drive 2 #09-01C, 117549, Singapore.
| | - Joanne Woh
- Saw Swee Hock School of Public Health, MD1 Tahir Foundation Building, National University of Singapore, 12 Science Drive 2 #09-01C, 117549, Singapore
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Reynolds AM, Spaeth AM, Hale L, Williamson AA, LeBourgeois MK, Wong SD, Hartstein LE, Levenson JC, Kwon M, Hart CN, Greer A, Richardson CE, Gradisar M, Clementi MA, Simon SL, Reuter-Yuill LM, Picchietti DL, Wild S, Tarokh L, Sexton-Radek K, Malow BA, Lenker KP, Calhoun SL, Johnson DA, Lewin D, Carskadon MA. Pediatric sleep: current knowledge, gaps, and opportunities for the future. Sleep 2023; 46:zsad060. [PMID: 36881684 PMCID: PMC10334737 DOI: 10.1093/sleep/zsad060] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/19/2023] [Indexed: 03/09/2023] Open
Abstract
This White Paper addresses the current gaps in knowledge, as well as opportunities for future studies in pediatric sleep. The Sleep Research Society's Pipeline Development Committee assembled a panel of experts tasked to provide information to those interested in learning more about the field of pediatric sleep, including trainees. We cover the scope of pediatric sleep, including epidemiological studies and the development of sleep and circadian rhythms in early childhood and adolescence. Additionally, we discuss current knowledge of insufficient sleep and circadian disruption, addressing the neuropsychological impact (affective functioning) and cardiometabolic consequences. A significant portion of this White Paper explores pediatric sleep disorders (including circadian rhythm disorders, insomnia, restless leg and periodic limb movement disorder, narcolepsy, and sleep apnea), as well as sleep and neurodevelopment disorders (e.g. autism and attention deficit hyperactivity disorder). Finally, we end with a discussion on sleep and public health policy. Although we have made strides in our knowledge of pediatric sleep, it is imperative that we address the gaps to the best of our knowledge and the pitfalls of our methodologies. For example, more work needs to be done to assess pediatric sleep using objective methodologies (i.e. actigraphy and polysomnography), to explore sleep disparities, to improve accessibility to evidence-based treatments, and to identify potential risks and protective markers of disorders in children. Expanding trainee exposure to pediatric sleep and elucidating future directions for study will significantly improve the future of the field.
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Affiliation(s)
| | - Andrea M Spaeth
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, USA
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Ariel A Williamson
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Monique K LeBourgeois
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Sachi D Wong
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Lauren E Hartstein
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Jessica C Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Misol Kwon
- Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, PA, USA
| | - Chantelle N Hart
- The Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
- The Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ashley Greer
- The Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Cele E Richardson
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | | | - Michelle A Clementi
- Clinical Sciences, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Stacey L Simon
- Clinical Sciences, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lilith M Reuter-Yuill
- Comprehensive Speech and Therapy Center, Western Michigan University, Kalamazoo, MI, USA
| | - Daniel L Picchietti
- University of Illinois School of Medicine, Carle Illinois College of Medicine, Carle Foundation Hospital, and University of Illinois School of Medicine, Urbana, IL, USA
| | - Salome Wild
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Leila Tarokh
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | | | - Beth A Malow
- Departments of Neurology and Pediatrics, Burry Chair in Cognitive Childhood Development, Vanderbilt University Medical Center, Nashville, TN, USA
- Sleep Disorders Division, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kristina P Lenker
- Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Susan L Calhoun
- Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Daniel Lewin
- Department of Pulmonary and Sleep Medicine, Children’s National Hospital, Washington, DC, USA
| | - Mary A Carskadon
- Bradley Hospital Sleep Lab, Warren Alpert Medical School, Brown University, Providence, RI, USA
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Das S, Kumar A, Tripathy SK, Malik A. Secondhand smoke among children: Time to act on pitfalls. Indian J Public Health 2023; 67:493-494. [PMID: 37929403 DOI: 10.4103/ijph.ijph_226_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Affiliation(s)
- Sarthak Das
- Associate Professor, Department of Pediatrics, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - Abhishek Kumar
- Senior Resident, Department of Pediatrics, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - Saroj Kumar Tripathy
- Associate Professor, Department of Pediatrics, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - Archana Malik
- Assistant Professor, Department of Pulmonology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
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Mbulo L, Palipudi K, Smith T, Owusu D, Williams F, Dean AK, Mamudu HM. Secondhand Smoke Exposure Inside the Home Among Adults in Eight Countries in Sub-Saharan Africa: Global Adult Tobacco Survey, 2012-2018. Nicotine Tob Res 2023; 25:828-837. [PMID: 36272102 PMCID: PMC10032190 DOI: 10.1093/ntr/ntac247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 10/06/2022] [Accepted: 10/21/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Secondhand tobacco smoke (SHS) exposure causes diseases and death in adults and children. Evidence indicates that most SHS exposures occur at home and in the workplace. Therefore, home is a major place where adults and children can be effectively protected from SHS. This study examined the magnitude of SHS exposure at home and associated factors in eight sub-Saharan African countries. AIMS AND METHODS We analyzed 2012-2018 Global Adult Tobacco Survey data for Botswana, Cameroon, Ethiopia, Kenya, Nigeria, Senegal, Tanzania, and Uganda. We computed prevalence estimates of self-reported monthly SHS exposure at home reported as anyone smoking inside their home daily, weekly, or monthly. We calculated SHS exposure at home prevalence and applied multivariable logistic regression models to identify related factors. RESULTS Overall median prevalence of SHS exposure at home was 13.8% in the eight countries; ranging from 6.6% (95% CI: 5.7%, 7.6%) in Nigeria to 21.6% (95% CI: 19.4%, 24.0%) in Senegal. In multivariable analysis across the countries, SHS exposure at home was associated with living with a smoker, ranging from an adjusted odds ratio (AOR) of 4.6 (95% CI: 3.6, 5.8) in Botswana to 27.6 (95% CI: 20.1, 37.8) in Nigeria. SHS exposure at home was significantly associated with lower education attainment (Kenya and Ethiopia), and lower wealth index (Uganda, Senegal, and Botswana). CONCLUSIONS SHS exposure in homes was associated with the presence of a smoker in the home and lower socioeconomic status.
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Affiliation(s)
- Lazarous Mbulo
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Krishna Palipudi
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tenecia Smith
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Daniel Owusu
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Anna K Dean
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Noninfectious Diseases Program, CDC Foundation, Atlanta, GA, USA
| | - Hadii M Mamudu
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
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10
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Association between passive smoking and the risk of rheumatoid arthritis: a systematic review and meta-analysis. Clin Rheumatol 2023; 42:663-672. [PMID: 36369402 DOI: 10.1007/s10067-022-06433-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/14/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022]
Abstract
In order to provide a basis for the prevention of RA, this systematic review and meta-analysis evaluated the association between passive smoking and the risk of developing RA. We searched electronic databases, including PubMed, Cochrane Central Register of Controlled Trials, Web of Science, and Embase, for published literature from the establishment to March 2022. Then we included subject-related cohort studies and case-control studies, and two researchers independently screened and extracted relevant data. Finally, we performed a meta-analysis, cumulative meta-analysis, and dose-response meta-analysis using the Stata software and evaluated the included literature for the level of evidence. This meta-analysis included three case-control and three cohort studies. There was only a small amount of statistical heterogeneity among the studies (I2 = 34.9%). According to the study results, the risk of RA was 12% higher in passive smokers than in unexposed individuals. In subgroup analysis, a 12% increase in the prevalence of RA was observed in those exposed to passive smoking in adulthood. The developing RA rate was 34% higher in individuals exposed to passive smoking during childhood than in unexposed individuals. As time progressed and with the inclusion of extensive sample studies in the cumulative meta-analysis, the precision of the overall incidence effect values gradually increased. A dose-response meta-analysis showed no statistical significance that the risk of RA increased with the number of passive smoking years. Passive smoking may relate to the risk of RA, especially in childhood exposures.
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Rosen LJ, Zucker DM, Gravely S, Bitan M, Rule AM, Myers V. Tobacco Smoke Exposure According to Location of Home Smoking in Israel: Findings from the Project Zero Exposure Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3523. [PMID: 36834219 PMCID: PMC9965201 DOI: 10.3390/ijerph20043523] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
Young children are particularly vulnerable to harms from tobacco smoke exposure (TSE). This study aimed to compare TSE: (1) between children who live in smoking families and those who do not; and (2) among children who live in smoking households with varying smoking locations. The data came from two studies that were conducted concurrently in Israel (2016-2018). Study 1: a randomized controlled trial of smoking families (n = 159); Study 2: a cohort study of TSE among children in non-smoking families (n = 20). Hair samples were collected from one child in each household. Baseline hair nicotine data were analyzed for 141 children in Study 1 and 17 children in Study 2. Using a logistic regression analysis (exposed vs. not exposed as per laboratory determination) and a linear regression (log hair nicotine), we compared TSE between: (1) children in Study 1 vs. Study 2; (2) children in families with different smoking locations in Study 1: balcony; garden, yard, or other place outside of the home; or inside the home (designated smoking areas within the home (DSAs) or anywhere). A higher proportion of children living in smoking households were measurably exposed to tobacco smoke (68.8%) compared to children living in non-smoking households (35.3%, p = 0.006). Among children from smoking families, 75.0% of those whose parents smoked in the house were exposed, while 61.8% of children whose parents restricted smoking to the porch (n = 55) were exposed, and 71.4% of those whose parents smoked outside the home (including gardens and yards) (n = 42) were exposed. In univariable and multivariable models, smoking location was not significantly associated with exposure. The majority of children in smoking families were measurably exposed to TSE, even if smoking was restricted to designated areas in the home, balconies, orgarden/yard/other outdoor areas. Reducing population smoking rates, particularly among parents, restricting smoking to at least 10 meters from homes and children, and denormalizing smoking around others are recommended to reduce population-level child TSE and tobacco-attributable disease and death.
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Affiliation(s)
- Laura J. Rosen
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - David M. Zucker
- Department of Statistics and Data Science, Hebrew University, Jerusalem 9190501, Israel
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Michal Bitan
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Computer Science, College of Management Academic Studies, Rishon LeTsiyon 7579806, Israel
| | - Ana M. Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Vicki Myers
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 5262100, Israel
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12
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Advocacy for Global Tobacco Control and Child Health. Pediatr Clin North Am 2023; 70:117-135. [PMID: 36402463 DOI: 10.1016/j.pcl.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Tobacco and secondhand smoke remain leading threats to public health. Evidence since the 1950s has shown that the tobacco industry has acted in bad faith to deceive the public about the health effects of smoking. They have specifically targeted vulnerable populations including children and adolescents with various-and often misleading-marketing efforts and promotions. The increased popularity and weak regulation of electronic cigarettes have created a new generation of smokers who mistakenly believe they are "safer" from harm. Continued research, advocacy, and government action are needed to protect public health. Public health advocates must know the evidence, build coalitions, and prepare for industry countermeasures. Persistence is key, but public health efforts have successfully decreased tobacco-related deaths.
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Kress AC, Mbulo L, Stadnik C, Hemedez-Gonzalez R, Twentyman E, Dorotheo EU, Pan L. Decrease in Secondhand Smoke Exposure in Work and Public Places among Adults in the Philippines: An Analysis of the Global Adult Tobacco Survey, 2009 and 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1077. [PMID: 36673832 PMCID: PMC9859332 DOI: 10.3390/ijerph20021077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
The implementation of several tobacco control policies in the Philippines may have contributed to a decrease in secondhand smoke (SHS) exposure. We examined changes in SHS exposure at work and in public places between 2009 and 2015 among adults aged ≥15 years and interpreted these results within the tobacco policy landscape in the Philippines. We analyzed the Philippines Global Adult Tobacco Survey 2009 and 2015 data. We examined marginal effects in logistic regression to get the adjusted prevalence of SHS exposure at five work and public places, controlling for selected characteristics. We calculated adjusted prevalence ratios and adjusted prevalence differences between 2009 and 2015. Adjusted prevalence of SHS exposure decreased from 2009 to 2015 by 19% (5.7 percentage points) at work, 45% (11.2 percentage points) in government buildings, 48% (3.2 percentage points) in healthcare facilities, 29% (8.2 percentage points) in restaurants, and 33% (19.9 percentage points) on public transportation. Although the prevalence of SHS exposure at work and in public places decreased significantly between 2009 and 2015, a substantial proportion of adults remain exposed to SHS. This study highlights the importance of continued implementation, enforcement, monitoring, and evaluation of tobacco control and prevention measures in the Philippines.
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Affiliation(s)
- Alissa C. Kress
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Lazarous Mbulo
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Carlen Stadnik
- Oak Ridge Institute for Science and Education, Oak Ridge, TN 37830, USA
| | | | - Evelyn Twentyman
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | | | - Liping Pan
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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Huang L, Cao Y, Zhang Z, Zhang Y, Kuang M, Luo Y, Zhang L. Status and correlates of children's exposure to secondhand smoke at home: A survey in Chongqing, China. Tob Induc Dis 2023; 21:38. [PMID: 36923486 PMCID: PMC10009880 DOI: 10.18332/tid/159802] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/27/2022] [Accepted: 01/25/2023] [Indexed: 03/14/2023] Open
Abstract
INTRODUCTION The home is the primary source of children's exposure to secondhand smoke. This study investigated the status and influencing factors of child exposure to secondhand smoke at home when people smoke in the household. METHODS Participants with at least one child living in their household from 10 communities in Chongqing were recruited and provided a self-administered questionnaire using a multistage proportional random sampling design from June to August 2021. The chi-squared test and binary logistic regression analyses were used to identify influencing factors. RESULTS The questionnaire completed by 1345 families showed that 631 (46.9%) families lived with smokers in their household, and 509 (80.7%) of those families reported that smoking occurred within the home while the children were present. Binary logistic regression analyses demonstrated that the time between waking up and household smokers having the first cigarette of the day (OR=0.44; 95% CI: 0.22-0.85), changes to smoking habits and behaviors within the last six months (OR=1.76; 95% CI: 1.06-2.90), attitudes towards tobacco control in the household (OR=2.91; 95% CI: 1.72-4.92), self-efficacy in maintaining a smoke-free home (OR=2.27; 95% CI: 1.36-3.79), having rules to maintain a smoke-free home (OR=3.25; 95% CI: 1.68-6.29), and the status of providing cigarettes to guests at home (OR=11.0; 95% CI: 1.33-90.8) were associated with exposure to SHS. CONCLUSIONS Education focusing on the impact of smoking on children's health should be encouraged. Smoke-free homes should be established, and smoking restrictions in the household should be enacted. Therefore, information about the available tobacco-control services should be given to family members and be used properly. It is an effective way to decrease the risk of at-home exposure to SHS for children, to overcome any obstacles in tobacco control.
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Affiliation(s)
- Longxian Huang
- Respiratory Medicine Department, The First Branch of the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Yang Cao
- Health Center of Bafu Town, Bafu Town, People's Republic of China
| | - Zhiyong Zhang
- Integrated Traditional Chinese Medicine and Western Medicine Department, Healthcare Center, Jinlong Town, Chongqing, People's Republic of China
| | - Ya Zhang
- Nursing Department, Shiqiaopu Street Healthcare Center, Chongqing, People's Republic of China
| | - Mei Kuang
- Nursing Department, Township Hospital, Jinfeng Town, People's Republic of China
| | - Yetao Luo
- Clinical Epidemiology and Biostatistics Department, Children's Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Li Zhang
- College of Nursing, Chongqing Medical University, Chongqing, People's Republic of China
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Asyary A, Veruswati M. Smoking Behavior and Cigarette Expenditure in a Household: Evidence for Smoke-Free Houses Initiation in Indonesia. Int J Prev Med 2023; 14:7. [PMID: 36942034 PMCID: PMC10023842 DOI: 10.4103/ijpvm.ijpvm_113_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 06/18/2021] [Indexed: 01/26/2023] Open
Abstract
Background The household is considered as a private area that is untouched tobacco control policies in developing countries, especially in Indonesia, which has not ratified the Framework Convention on Tobacco Control (FCTC) treaty. Objectives This study aims to identify smoking behavior and expenditure on cigarettes in the household, which are part of the initiation of a policy including a smoke-free home, so it assumes that the home is a public domain in Tegal Regency, Central Java Province, Indonesia. Methods This research is an observational study with a quantitative descriptive design. A total of 225 subjects in the seven regions designated as smoke-free areas were all selected as samples in this study and were willing to be the subject of research. Results The results found that 76.1% of smokers smoked with their nuclear family (wife/children/husband) present. Smoking behavior with the nuclear family inside the home (39.13%) and outside the home (36.96%) was more common than not smoking with the nuclear family. Expenditure for cigarettes per month was one-third of household revenue (IDR 607,521.74) based on the regency minimum wage (UMR) set by the local government. Conclusions The study concludes that smokers who smoke with family still lack knowledge on smoking's impact on health and household economics. The smoke-free regulation that is initiated should include households as a parameter.
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Affiliation(s)
- Al Asyary
- Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
- Center for Educational and Community Services, Faculty of Public Health, Universitas Indonesia (P3M FKM-UI), Depok, Indonesia
- Address for correspondence: Dr. Al Asyary, Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, C Building 2nd Floor, Kampus FKM-UI, Depok - 16424, Indonesia. E-mail:
| | - Meita Veruswati
- Center for Educational and Community Services, Faculty of Public Health, Universitas Indonesia (P3M FKM-UI), Depok, Indonesia
- PhD Program in Business and Management, Management and Science University (MSU), Selangor Darul Ehsan, Malaysia
- Department of Public Health Science, Faculty of Health Sciences, Universitas Muhammadiyah Prof. Dr. HAMKA (UHAMKA), Jakarta, Indonesia
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Xiao H, Li M, Li A, Amaerjiang N, Zunong J, Vermund SH, Pérez-Escamilla R, Song M, Hu Y, Jiang G. Passive Smoking Exposure Modifies Cardiovascular Structure and Function: Beijing Child Growth and Health Cohort (PROC) Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:14585-14593. [PMID: 36094430 DOI: 10.1021/acs.est.2c00991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Passive smoking exposure in children is prevalent worldwide and exposes children to respiratory and systemic toxins. In this study, we enrolled 568 children to study how secondhand smoke (SHS) might affect children's cardiovascular health in China. The measurement of nicotine and its metabolites in urine showed that 78.9% of children were exposed to SHS. Children exposed to SHS had greater interventricular septum thickness (p = 0.005) and left ventricular mass index (p = 0.008) than nonexposed children. Urinary norcotinine levels were associated with increased ascending aorta diameter (β = 0.10, 95%CI 0.02-0.17) and decreased left ventricular end systolic diameter (β = -0.10, 95%CI -0.19 to -0.01). The effects of SHS exposure on cardiovascular function: norcotinine levels associated with lower left ventricular mass index (β = -0.32, 95%CI -0.59 to -0.05), left ventricular end diastolic volume index (β = -0.43, 95%CI -0.85 to -0.02), and left ventricular end systolic volume index (β = -0.20, 95%CI -0.37 to -0.03). Moreover, there no no significant associations of nicotine, cotinine, and trans-3'-hydroxycotinine with cardiovascular health. Overall, SHS exposure in children remains prevalent in Beijing and may affect children's cardiovascular development, in both structure and function. It suggests that stricter and practical measures are needed toward the elimination of tobacco use in children's environments.
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Affiliation(s)
- Huidi Xiao
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Menglong Li
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Aijing Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
- University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Nubiya Amaerjiang
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Jiawulan Zunong
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Sten H Vermund
- Yale School of Public Health, Yale University, New Haven, Connecticut 06510-3201, United States
| | - Rafael Pérez-Escamilla
- Yale School of Public Health, Yale University, New Haven, Connecticut 06510-3201, United States
| | - Maoyong Song
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
- University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Yifei Hu
- Department of Child, Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Science, Beijing 100085, People's Republic of China
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Štěpánek L, Ševčíková J, Horáková D, Patel MS, Durďáková R. Public Health Burden of Secondhand Smoking: Case Reports of Lung Cancer and a Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13152. [PMID: 36293731 PMCID: PMC9603183 DOI: 10.3390/ijerph192013152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Secondhand smoke (SHS), composed of mainstream and sidestream smoke, is a known human carcinogen. It contains a variety of harmful substances at even higher concentrations than mainstream smoke itself, which is inhaled during firsthand smoking. Exposure to SHS, affecting more than a third of the worldwide population, increases the likelihood of lung cancer by roughly 30%, with specific contributions depending on the histological type of cancer. This study aimed to present the harmful potential of SHS through case reports and describe the burden of SHS via a literature review. From a collection of lung cancer case reports occurring in never smokers from the Olomouc district over the last 10 years, 2 cases with no risk factors for lung cancer except for significant exposure to SHS were identified. Both cases were of young women who lived in households where their parents smoked during childhood. They suffered from rarer histological types of lung cancer in which the association with SHS has not yet been analyzed. As the literature confirms, SHS has the most adverse effects in individuals exposed during childhood. It is necessary to both take measures to reduce the prevalence of SHS, especially among children in households and pay due attention to the smoking history of patients, including current and previous exposure to SHS, when obtaining anamnestic data. Furthermore, the effect of SHS on rarer histological types of lung cancer should be studied.
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Secondhand smoke exposure among never-smoking adolescents in Wuhan, China. Sci Rep 2022; 12:14209. [PMID: 35988001 PMCID: PMC9392782 DOI: 10.1038/s41598-022-18612-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/16/2022] [Indexed: 01/01/2023] Open
Abstract
Without smoke-free legislation in Wuhan, China, we investigated secondhand smoke (SHS) exposure at home, school, and public places for never-smoking school-going adolescents in 2019. A cross-sectional study was carried out within the Global Youth Tobacco Survey (GYTS) framework. Weighted univariate, bivariate and multivariable analyses were conducted. The prevalence of SHS exposure among never-smoking adolescents at home, school and public places was 25.7%, 31.9% and 48.9%, respectively. Multivariable logistic regression analysis showed that parents smoking, peers smoking and observing teachers smoking in school were all significantly related to a higher probability of SHS exposure at home, school, and public places. Never-smoking adolescents who had smoking parents had 14 times (adjusted odds ratio [aOR], 14.00; 95% confidence interval [CI], 11.37–17.24) higher odds of SHS exposure at home; Never-smoking adolescents who observed teachers smoking in school had about 10 (aOR = 9.76; 95% CI = 7.13–13.36) and four times (aOR = 3.55; 95% CI = 2.77–4.55) higher odds of SHS exposure in school and public places, respectively. Adopting comprehensive smoke-free legislation in public places and smoke-free home rules and implementing and supervising smoke-free school policies may further reduce SHS exposure among adolescents.
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Kellar I, Al Azdi Z, Jackson C, Huque R, Mdege ND, Siddiqi K. Muslim Communities Learning About Second-hand Smoke in Bangladesh (MCLASS II): a combined evidence and theory-based plus partnership intervention development approach. Pilot Feasibility Stud 2022; 8:136. [PMID: 35780245 PMCID: PMC9250240 DOI: 10.1186/s40814-022-01100-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Deaths from second-hand smoke (SHS) exposure are increasing, but there is not sufficient evidence to recommend a particular SHS intervention or intervention development approach. Despite the available guidance on intervention reporting, and on the role and nature of pilot and feasibility studies, partial reporting of SHS interventions is common. The decision-making whilst developing such interventions is often under-reported. This paper describes the processes and decisions employed during transitioning from the aim of adapting an existing mosque-based intervention focused on public health messages, to the development of the content of novel community-based Smoke-Free Home (SFH) intervention. The intervention aims to promote smoke-free homes to reduce non-smokers’ exposure to SHS in the home via faith-based messages. Methods The development of the SFH intervention had four sequential phases: in-depth interviews with adults in households in Dhaka, identification of an intervention programme theory and content with Islamic scholars from the Bangladesh Islamic Foundation (BIF), user testing of candidate intervention content with adults, and iterative intervention development workshops with Imams and khatibs who trained at the BIF. Results It was judged inappropriately to take an intervention adaptation approach. Following the identification of an intervention programme theory and collaborating with stakeholders in an iterative and collaborative process to identify barriers, six potentially modifiable constructs were identified. These were targeted with a series of behaviour change techniques operationalised as Quranic verses with associated health messages to be used as the basis for Khutbahs. Following iterative user testing, acceptable intervention content was generated. Conclusion The potential of this community-based intervention to reduce SHS exposure at home and improve lung health among non-smokers in Bangladesh is the result of an iterative and collaborative process. It is the result of the integration of behaviour change evidence and theory and community stakeholder contributions to the production of the intervention content. This novel combination of intervention development frameworks demonstrates a flexible approach that could provide insights for intervention development in related contexts. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01100-5.
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Affiliation(s)
- Ian Kellar
- School of Psychology, Faculty of Medicine & Health, University of Leeds, Leeds, LS2 9JT, UK.
| | - Zunayed Al Azdi
- ARK Foundation, Suite C-3, C-4, House number 06, Road 109, Dhaka, 1212, Bangladesh
| | - Cath Jackson
- Valid Research Ltd., Sandown House, Sandbeck Way, Wetherby, LS22 7DN, UK.,Department of Health Sciences, Faculty of Sciences, University of York, York, YO10 5DD, UK
| | - Rumana Huque
- ARK Foundation, Suite C-3, C-4, House number 06, Road 109, Dhaka, 1212, Bangladesh.,Department of Economics, Dhaka University, Dhaka, Bangladesh
| | - Noreen Dadirai Mdege
- Department of Health Sciences, Faculty of Sciences, University of York, York, YO10 5DD, UK
| | - Kamran Siddiqi
- Department of Health Sciences, Faculty of Sciences, University of York, York, YO10 5DD, UK.,Hull York Medical School, University of York, Heslington, York, YO10 5DD, UK
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Taha MN, Al-Ghumgham Z, Ali N, Al-Rifai RH, Elbarazi I, Al-Maskari F, El-Shahawy O, Ahmed LA, Loney T. Tobacco Use and Exposure to Environmental Tobacco Smoke amongst Pregnant Women in the United Arab Emirates: The Mutaba'ah Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127498. [PMID: 35742747 PMCID: PMC9224424 DOI: 10.3390/ijerph19127498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/10/2022]
Abstract
Self-reported tobacco use is high in the male adult Emirati population (males ~36% vs. females ~3%); however, there are minimal data on tobacco use or exposure to environmental tobacco smoke (ETS) during pregnancy in the United Arab Emirates (UAE). This study investigated the prevalence of, and factors associated with, tobacco use and exposure to environmental tobacco smoke (ETS) amongst pregnant women in the UAE. Baseline cross-sectional data were analysed from the Mutaba’ah Study. Expectant mothers completed a self-administered questionnaire collecting sociodemographic information, maternal tobacco use, and ETS exposure during antenatal visits at three hospitals in Al Ain (UAE; May 2017–February 2021). Amongst 8586 women included in the study, self-reported tobacco use during pregnancy was low (0.7%), paternal tobacco use was high (37.9%), and a third (34.8%) of expectant mothers were exposed to ETS (28.0% at home only). Pregnant women who were employed (adjusted odds ratio (aOR): 1.35, 95% confidence interval (CI): 1.19–1.52), with childbirth anxiety (aOR 1.21, 95% CI 1.08–1.36), and with an increased number of adults living in the same household (aOR 1.02 95% CI 1.01–1.03) were independently more likely to be exposed to ETS. Pregnant women with higher education levels (aOR 0.84, 95% CI 0.75–0.94) and higher gravidity (aOR 0.95, 95% CI 0.92–0.99) were less likely to be exposed to ETS. Public health efforts targeting smoking cessation amongst husbands and promoting smoke-free homes are warranted to help reduce prenatal ETS exposure in the UAE.
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Affiliation(s)
- Mohammed Nagdi Taha
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates; (M.N.T.); (Z.A.-G.)
| | - Zaki Al-Ghumgham
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates; (M.N.T.); (Z.A.-G.)
| | - Nasloon Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
| | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates
| | - Omar El-Shahawy
- Tobacco, Alcohol and Drug Use Section, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA;
- Division of Global Health, New York University School of Global Public Health, New York, NY 10003, USA
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates; (M.N.T.); (Z.A.-G.)
- Correspondence: ; Tel.: +971-43-838-737
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21
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Boey CPH, Quaye SED, Cook AR, Seow WJ, van der Eijk Y. Secondhand smoke in the densely populated urban setting: A cross-sectional survey of exposure, knowledge, attitudes, and respiratory symptoms. INDOOR AIR 2022; 32:e13069. [PMID: 35762238 DOI: 10.1111/ina.13069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/10/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Secondhand smoke (SHS) remains a common health threat in densely populated, urban settings. We estimated the prevalence of exposure and associated respiratory symptoms, knowledge, attitudes, and behaviors in a multi-ethnic, weighted sample of Singapore residents using a cross-sectional survey of 1806 adults. We weighted data to match the national population in terms of gender, ethnicity, and education level and analyzed data using descriptive statistics, bivariate analyses, multiple linear and logistic regressions, and a multinomial logistic regression model. About 88% of respondents reported regular SHS exposure. Nearly 57% reported exposure to neighbors' SHS at home. Respiratory symptoms were reported by 32.5% and significantly associated with exposure to daily (AOR = 2.63, 95% CI = 1.62-4.36), non-daily (AOR = 1.75, 95% CI = 1.14-2.77), and neighbors' (AOR = 1.37, 95% CI = 1.07-1.76) SHS. More knowledge of SHS was associated with male gender (β = 0.28, p = 0.0009) and higher household income (linear trend; p = 0.0400). More negative attitudes to SHS were associated with older age (linear trend; p < 0.0001). Engaging in behaviors to avoid SHS was associated with a more negative attitude to SHS (AOR = 1.09-1.23). SHS exposure is common in Singapore's densely populated setting and associated with respiratory symptoms, even if exposure is non-daily or from neighboring homes.
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Affiliation(s)
- Clement Peng Hee Boey
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Sharon Esi Duoduwa Quaye
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Wei Jie Seow
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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22
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Gerlach G, Braun M, Dröge J, Groneberg DA. Do Budget Cigarettes Emit More Particles? An Aerosol Spectrometric Comparison of Particulate Matter Concentrations between Private-Label Cigarettes and More Expensive Brand-Name Cigarettes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5920. [PMID: 35627457 PMCID: PMC9141942 DOI: 10.3390/ijerph19105920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 02/01/2023]
Abstract
Private-label cigarettes are cigarettes that belong to the retailer itself. Private-label cigarettes from discounters or supermarkets are cheaper than brand-name cigarettes, and their lower price has allowed them to garner an ever-increasing share of the tobacco product market, especially among lower socioeconomic groups. Particulate matter (PM), a considerable component of air pollution, is a substantial health-damaging factor. Smoking is the primary source of PM in smokers’ homes. In a 2.88 m3 measuring chamber, the PM emission fractions PM10, PM2.5, and PM1 from three private-label cigarette brands and three brand-name cigarette brands with identical nicotine, tar, and carbon monoxide content were measured and compared to those of a reference cigarette by laser aerosol spectroscopy. All cigarette brands emitted PM in health-threatening quantities. The measurement results ranged from 1394 µg/m3 to 1686 µg/m3 PM10, 1392 µg/m3 to 1682 µg/m3 PM2.5, and 1355 µg/m3 to 1634 µg/m3 PM1, respectively. Only one private-label brand differed significantly (p < 0.001) from the other cigarette brands, which were tested with slightly lower PM levels. All other brands differed only marginally (not significant, p > 0.05) from one another. Significant (p < 0.05) negative correlations between private-label and brand-name cigarettes were found for PM10, PM2.5, and PM1 when accounting for tobacco filling densities, and for PM1 when accounting for filter lengths. The especially health-hazardous fraction PM1 accounted for the largest proportion of PM emissions from the cigarettes tested. The results of this study suggest that- cheaper tobacco products are as harmful as more expensive ones, at least regarding PM emissions. This highlights the importance of anti-smoking campaigns, especially for lower socioeconomic groups, where smoking is more widespread. Governments should reduce the price gap between cheap and more expensive tobacco products by implementing specific tobacco taxes. In such a case, at increasing prices of tobacco products, a downward shift to private-label cigarettes would probably decrease.
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Affiliation(s)
| | - Markus Braun
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany; (G.G.); (J.D.); (D.A.G.)
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Caron KT, Zhu W, Bernert JT, Wang L, Blount BC, Dortch K, Hunter RE, Harmon T, Akins JR, Tsai J, Homa DM, Pirkle JL, Sosnoff CS. Geometric Mean Serum Cotinine Concentrations Confirm a Continued Decline in Secondhand Smoke Exposure among U.S. Nonsmokers-NHANES 2003 to 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105862. [PMID: 35627398 PMCID: PMC9140715 DOI: 10.3390/ijerph19105862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/16/2022]
Abstract
The objective of this study was to examine long-term trends in serum cotinine (COT) concentrations, as a measure of secondhand smoke (SHS) exposure, in U.S. nonsmokers using data from the National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2018. We analyzed NHANES serum COT results from 8 continuous NHANES 2 year cycles from 2003 to 2018 using a liquid chromatography−tandem mass spectrometry assay that has been maintained continuously at the Centers for Disease Control and Prevention (CDC) since 1992. Serum COT concentrations (based on the geometric means) among nonsmokers in the U.S. decreased by an average of 11.0% (95% confidence interval (CI) [8.8%, 13.1%]; p < 0.0001) every 2 year cycle. From 2003 to 2018, serum COT concentrations in U.S. nonsmokers declined by 55.0%, from 0.065 ng/mL in 2003−2004 to 0.029 ng/mL in 2017−2018 (p < 0.0001). Significant decreases in serum COT concentrations were observed in all demographic groups. While disparities between these groups seems to be shrinking over time, several previously observed disparities in SHS exposure remain in 2017−2018. Serum COT concentrations of the non-Hispanic Black population remained higher than those of non-Hispanic Whites and Mexican Americans (p < 0.0001). Additionally, serum COT concentrations were significantly higher for children aged 3−5 years than other age groups (p ≤ 0.0002), and men continued to have significantly higher serum COT concentrations than women (p = 0.0384). While there is no safe level of exposure to SHS, the decrease in serum COT concentrations in the U.S. population as well as across demographic groupings represents a positive public health outcome and supports the importance of comprehensive smoke-free laws and policies for workplaces, public places, homes, and vehicles to protect nonsmokers from SHS exposure.
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Affiliation(s)
- Kevin T. Caron
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.Z.); (J.T.B.); (L.W.); (B.C.B.); (K.D.); (R.E.H.); (T.H.); (J.R.A.); (J.L.P.); (C.S.S.)
- Correspondence: ; Tel.: +1-(770)-488-7648
| | - Wanzhe Zhu
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.Z.); (J.T.B.); (L.W.); (B.C.B.); (K.D.); (R.E.H.); (T.H.); (J.R.A.); (J.L.P.); (C.S.S.)
| | - John T. Bernert
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.Z.); (J.T.B.); (L.W.); (B.C.B.); (K.D.); (R.E.H.); (T.H.); (J.R.A.); (J.L.P.); (C.S.S.)
| | - Lanqing Wang
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.Z.); (J.T.B.); (L.W.); (B.C.B.); (K.D.); (R.E.H.); (T.H.); (J.R.A.); (J.L.P.); (C.S.S.)
| | - Benjamin C. Blount
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.Z.); (J.T.B.); (L.W.); (B.C.B.); (K.D.); (R.E.H.); (T.H.); (J.R.A.); (J.L.P.); (C.S.S.)
| | - Kristin Dortch
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.Z.); (J.T.B.); (L.W.); (B.C.B.); (K.D.); (R.E.H.); (T.H.); (J.R.A.); (J.L.P.); (C.S.S.)
| | - Ronald E. Hunter
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.Z.); (J.T.B.); (L.W.); (B.C.B.); (K.D.); (R.E.H.); (T.H.); (J.R.A.); (J.L.P.); (C.S.S.)
| | - Tia Harmon
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.Z.); (J.T.B.); (L.W.); (B.C.B.); (K.D.); (R.E.H.); (T.H.); (J.R.A.); (J.L.P.); (C.S.S.)
| | - J. Ricky Akins
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.Z.); (J.T.B.); (L.W.); (B.C.B.); (K.D.); (R.E.H.); (T.H.); (J.R.A.); (J.L.P.); (C.S.S.)
| | - James Tsai
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (J.T.); (D.M.H.)
| | - David M. Homa
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (J.T.); (D.M.H.)
| | - James L. Pirkle
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.Z.); (J.T.B.); (L.W.); (B.C.B.); (K.D.); (R.E.H.); (T.H.); (J.R.A.); (J.L.P.); (C.S.S.)
| | - Connie S. Sosnoff
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (W.Z.); (J.T.B.); (L.W.); (B.C.B.); (K.D.); (R.E.H.); (T.H.); (J.R.A.); (J.L.P.); (C.S.S.)
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24
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Braun M, Klingelhöfer D, Dröge J, Groneberg DA. Very high particulate matter levels by cigarettes from Bangladesh and especially Nepal. Nicotine Tob Res 2022; 24:1517-1518. [PMID: 35417555 DOI: 10.1093/ntr/ntac100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Markus Braun
- Institute of Occupational Medicine, Social Medicine, and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main
| | - Doris Klingelhöfer
- Institute of Occupational Medicine, Social Medicine, and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main
| | - Janis Dröge
- Institute of Occupational Medicine, Social Medicine, and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine, and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main
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25
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Braun M, Marsidi LL, Klingelhöfer D, Groneberg DA. Kretek Cigarettes and Particulate Matter Emissions-An Aerosol Spectrometric Study on Typical Indonesian Brands Flavored With Cloves. Nicotine Tob Res 2022; 24:778-784. [PMID: 34633042 DOI: 10.1093/ntr/ntab209] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/08/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION In Indonesia, smoking is widespread. The same applies to second-hand smoke (SHS) exposure. More than 90% of Indonesian smokers smoke clove cigarettes, so-called Kreteks. They often contain more tar and nicotine than conventional cigarettes, but little is known about particulate matter (PM) emissions. In smokers' homes, SHS is the main source of PM that is hazardous to health. This study presents data of PM emissions from Kreteks. METHODS SHS was generated in a closed 2.88 m³ measuring chamber. PM fractions (PM10, PM2.5, PM1) of three popular Kretek brands (two king-sized and one slim-sized) in comparison to conventional cigarettes and a reference cigarette were measured by laser aerosol spectroscopy in real-time. RESULTS The king-sized Kreteks reached PM10 and PM2.5 mean concentrations of up to about 3000 µg/m³, and PM1 mean concentrations of up to about 2700 µg/m³. Consequently, these Kreteks emitted up to about 100% more PM10 and PM2.5, respectively 84% more PM1 than the reference cigarette, and up to about 260% more PM10 and PM2.5, respectively 234% more PM1 than the other investigated cigarettes. CONCLUSIONS PM emissions from Kreteks can be very high. The Indonesian public should be informed and warned about it, considering the high prevalence of smoking and SHS exposure, in particular. The Indonesian tobacco control regulation is limited, and it is overdue to start with a serious and effective tobacco control policy. PM declaration to government authorities could be useful in smoking prevention and tobacco control. IMPLICATIONS Research data are limited for Kretek cigarettes, including data on particulate matter (PM). The clove buds in Kretek cigarettes are for flavoring the smoke and shall soften the smoke feeling. That makes them very popular in Indonesia, in particular. The declaration of PM data of Kreteks and other tobacco products can play a key role in a more effective tobacco policy to reduce consumption of tobacco products, not only in Indonesia. To provide data on PM emissions, this study ascertained PM amounts in passive smoke from Indonesian Kreteks.
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Affiliation(s)
- Markus Braun
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Laura Lian Marsidi
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Doris Klingelhöfer
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
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26
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Semple S, Dobson R, O'Donnell R, Zainal Abidin E, Tigova O, Okello G, Fernández E. Smoke-free spaces: a decade of progress, a need for more? Tob Control 2022; 31:250-256. [PMID: 35241597 DOI: 10.1136/tobaccocontrol-2021-056556] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/03/2021] [Indexed: 12/28/2022]
Abstract
Adoption of smoke-free measures has been one of the central elements of tobacco control activity over the past 30 years. The past decade has seen an increasing number of countries and proportion of the global population covered by smoke-free policies to some extent. Despite reductions in global smoking prevalence, population growth means that the number of non-smokers exposed to the harms caused by secondhand smoke remains high. Smoke-free policy measures have been shown to be useful in protecting non-smokers from secondhand smoke, and can additionally increase cessation and reduce smoking initiation. Policies tend to be aimed primarily at enclosed public or workplace settings with very few countries attempting to control exposure in private or semiprivate spaces such as homes and cars, and, as a result, children may be benefiting less from smoke-free measures than adults. Compliance with legislation also varies by country and there is a need for education and empowerment together with guidance and changing social norms to help deliver the full benefits that smoke-free spaces can bring. Restrictions and policies on use of electronic cigarettes (e-cigarettes) in smoke-free settings require more research to determine the benefits and implications of bystanders' exposure to secondhand e-cigarette aerosol, dual use and smoking cessation.
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Affiliation(s)
- Sean Semple
- Institute of Social Marketing and Health, University of Stirling, Stirling, UK
| | - Ruaraidh Dobson
- Institute of Social Marketing and Health, University of Stirling, Stirling, UK
| | - Rachel O'Donnell
- Institute of Social Marketing and Health, University of Stirling, Stirling, UK
| | - Emilia Zainal Abidin
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Olena Tigova
- Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Gabriel Okello
- African Centre for Clean Air, Kampala, Uganda.,Cambridge Institute for Sustainability Leadership, University of Cambridge, Cambridge, UK.,AirQo, College of Computing and Information Sciences, Makerere University, Kampala, Uganda
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology - ICO, WHO Collaborating Centre for Tobacco Control, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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27
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Bellettiere J, Liles S, Posis AIB, Anuskiewicz B, Tripathi O, Nguyen B, Chavez P, Zhu SH, Park JY, Winstock A, Ferris J. In-home cannabis smoking more prevalent than in-home tobacco smoking among 2019 Global Drug Survey respondents. Addict Behav 2022; 125:107130. [PMID: 34674905 DOI: 10.1016/j.addbeh.2021.107130] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/11/2021] [Accepted: 09/29/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE OF THE RESEARCH Early evidence from studies of home smoking policies suggests that in-home cannabis smoking is more often allowed than in-home tobacco smoking, but there are not yet data on whether cannabis is more often smoked in the home compared to tobacco, or whether in-home cannabis and tobacco smoking differs by usage status. Using cross-sectional data from over 100,000 sentinel drug users from 17 countries, we compared cannabis and tobacco smoking in the homes of Global Drug Survey 2019 respondents who currently used cannabis only, tobacco only, both tobacco and cannabis, or neither. PRINCIPAL RESULTS Complete data on cannabis and tobacco use and in-home smoking were available for 107,272 adults (average age = 30 ± 12, 34% women, countries with the three highest response rates; Germany = 32%, USA = 10%, New Zealand = 9%). In total, 53.6% and 50.6% of respondents reported past-year cannabis and tobacco smoking in their home respectively. Stratifying respondents into current cannabis-only users, tobacco-only users, dual users, and non-users, past-year in-home cannabis smoking was more prevalent (78.8%) among cannabis-only users than was in-home tobacco smoking (67.9%) among tobacco-only users. Among dual users, past-year in-home cannabis smoking (82.8%; 95%CI = 80%-86%) was higher than in-home tobacco smoking (75.9%; 95%CI = 69%-81%; p < 0.001). In-home cannabis and tobacco smoking was similar among non-users (20.2% and 20.5%, respectively). MAJOR CONCLUSIONS Past-year in-home cannabis smoking was more prevalent than tobacco smoking in the homes of participants who used cannabis and/or tobacco, supporting our speculation that in-home cannabis smoking might be more socially acceptable than in-home tobacco smoking.
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Sathish T, Teo KK, Britz-McKibbin P, Gill B, Islam S, Paré G, Rangarajan S, Duong M, Lanas F, Lopez-Jaramillo P, Mony PK, Pinnaka L, Kutty VR, Orlandini A, Avezum A, Wielgosz A, Poirier P, Alhabib KF, Temizhan A, Chifamba J, Yeates K, Kruger IM, Khatib R, Yusuf R, Rosengren A, Zatonska K, Iqbal R, Lui W, Lang X, Li S, Hu B, Dans AL, Yusufali AH, Bahonar A, O’Donnell MJ, McKee M, Yusuf S. Variations in risks from smoking between high-income, middle-income, and low-income countries: an analysis of data from 179 000 participants from 63 countries. THE LANCET GLOBAL HEALTH 2022; 10:e216-e226. [DOI: 10.1016/s2214-109x(21)00509-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/09/2021] [Accepted: 10/18/2021] [Indexed: 12/11/2022] Open
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Singh PK, Sinha P, Singh N, Singh L, Singh S. Does secondhand smoke exposure increase the risk of acute respiratory infections among children aged 0-59 months in households that use clean cooking fuel? A cross-sectional study based on 601 509 households in India. INDOOR AIR 2022; 32:e12980. [PMID: 35014716 DOI: 10.1111/ina.12980] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 12/21/2021] [Accepted: 12/27/2021] [Indexed: 06/14/2023]
Abstract
This study examines whether exposure to secondhand smoke (SHS) increases the risk of acute respiratory infections (ARI) among children aged 0-59 months. Study utilized nationally representative data from National Family Health Survey (2015-2016), which adopted two-stage stratified random sampling. Four mutually exclusive groups based on the type of cooking fuel usage and SHS exposure were created. Descriptive statistics and multivariate logistics regression analysis were applied. At the national level, 10.5% prevalence of ARI was reported during 2015-2016. About 47.9% (95%CI 47.7-48.2) of households was exposed to SHS and used solid biomass fuel for cooking. Nearly, 20.7% of households with clean fuel usage was exposed to SHS. Regression analysis suggests that the likelihood of ARI among children who were living in households with solid biomass fuel usage and exposed to SHS was 11% (95%CI 1.06-1.17) greater than children living in households with clean fuel usage with no SHS exposure. Moreover, our results further revealed that the odds of ARI among children living in households with clean fuel but exposed to SHS were 19% (95%CI 1.13-1.25) higher than the children living in the household with no SHS exposure and clean fuel use. Children living in households exposed to SHS are at higher risk of ARI.
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Affiliation(s)
- Prashant Kumar Singh
- Division of Preventive Oncology and Population Health, ICMR - National Institute of Cancer Prevention and Research, Noida, India
- WHO FCTC Knowledge Hub on Smokeless Tobacco, ICMR-National Institute of Cancer Prevention and Research, Noida, India
| | - Pallavi Sinha
- Division of Preventive Oncology and Population Health, ICMR - National Institute of Cancer Prevention and Research, Noida, India
| | - Nishikant Singh
- Division of Preventive Oncology and Population Health, ICMR - National Institute of Cancer Prevention and Research, Noida, India
| | - Lucky Singh
- ICMR - National Institute of Medical Statistics, New Delhi, India
| | - Shalini Singh
- WHO FCTC Knowledge Hub on Smokeless Tobacco, ICMR-National Institute of Cancer Prevention and Research, Noida, India
- ICMR - National Institute of Cancer Prevention and Research, Noida, India
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Fagbule O, Uti OG, Sofola O, Ayo-Yusuf OA. DENTISTS IN AFRICA SHOULD COMMIT TO IDENTIFYING AND ASSISTING PATIENTS EXPOSED TO SECONDHAND TOBACCO SMOKE. Ann Ib Postgrad Med 2021; 19:161-164. [PMID: 36159035 PMCID: PMC9484314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- O.F. Fagbule
- Department of Periodontology and Community Dentistry, University College Hospital (UCH) and College of Medicine, University of Ibadan (COMUI), Nigeria
| | - OG. Uti
- Department of Preventive Dentistry, Lagos University Teaching Hospital (LUTH) and College of Medicine, University of Lagos (CMUL), Nigeria
| | - O Sofola
- Department of Preventive Dentistry, Lagos University Teaching Hospital (LUTH) and College of Medicine, University of Lagos (CMUL), Nigeria
| | - OA. Ayo-Yusuf
- School of Health Systems and Public Health, University of Pretoria, South Africa
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31
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Wu H, Sun J, Xi B. Parental tobacco and indoor secondhand smoking exposure and the risk of offspring under-five mortality in low- and middle-income countries. INDOOR AIR 2021; 31:2188-2199. [PMID: 34181764 DOI: 10.1111/ina.12897] [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: 04/07/2021] [Revised: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
Children are vulnerable to exposure of secondhand smoking (SHS) which is a major preventable cause of disease and death. This study aimed to investigate the association between parental tobacco use or SHS exposure, respectively, and under-five mortality. Data were obtained from the nationally representative and population-based Demographic and Health Surveys in low- and middle-income countries (LMICs) between 2000 and 2018. Cox proportional hazard regression models with complex survey design were conducted to examine the adjusted associations between parental smoking and SHS exposure and child under-five mortality. In the pooled analysis of parental smoking, 437 322 children were included. Compared with children whose parents are not smoking, those whose father or both parents smoked any form of tobacco had higher risks of mortality (hazard ratio [HR] = 1.08, 95% confidence interval [CI] = 1.03-1.13; HR = 1.18, 95% CI = 1.06-1.32, respectively). In addition, parental using smokeless tobacco, smoking tobacco, and using smokeless tobacco and smoking tobacco simultaneously was significantly associated with child under-five mortality (HR = 1.07, 95% CI = 1.01-1.12; HR = 1.12, 95%CI = 1.04-1.21; and HR = 1.17, 95%CI = 1.06-1.30, respectively). In the pooled analysis of SHS exposure, 605 442 children were included, and weekly and daily SHS exposure were significantly associated with child under-five mortality (HR = 1.11, 95% CI = 1.03-1.20, and HR = 1.10, 95% CI = 1.06-1.15, respectively). The results were robust in most stratification analyses and sensitivity analyses. Parental tobacco use and indoor SHS exposure were associated with increased risk of under-five mortality in LMICs. Comprehensive tobacco control programs should be considered by policymakers in LMICs to promote smoke-free environments for children.
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Affiliation(s)
- Han Wu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jiahong Sun
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Scheffers-van Schayck T, Hipple Walters B, Otten R, Kleinjan M. Implementation of a proactive referral tool for child healthcare professionals to encourage and facilitate parental smoking cessation in the Netherlands: a mixed-methods study. BMC Health Serv Res 2021; 21:973. [PMID: 34530809 PMCID: PMC8444610 DOI: 10.1186/s12913-021-06969-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 08/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background Recently, the parent-tailored telephone based smoking cessation counseling program ‘Smoke-free Parents’ was shown to be effective in helping parents to quit smoking. To implement this program in child healthcare settings in the Netherlands, the research team developed a proactive referral tool to refer parents to Smoke-free Parents. The aim of the present implementation study was to explore the facilitators, barriers, and suggestions for improvement in the implementation of this referral tool. Methods Child healthcare professionals (N = 68) were recruited via multiple strategies (e.g., social media, mailings, and word of mouth among healthcare professionals) and invited to complete two online (quantitative and qualitative) questionnaires and to participate in a telephone semi-structured qualitative interview between April 2017 and February 2019. In total, 65 child healthcare professionals were included in the analyses. After inductive coding, thematic analyses were performed on the qualitative data. Descriptive analyses were performed on the quantitative data. Results The data from both questionnaires and the telephone interview revealed that the majority of the child healthcare professionals (92.3 % female; average years of working as a healthcare professional: 23.0) found the Smoke-free Parents referral tool accessible and convenient to use. Yet there were several barriers that limited their use of the tool. The data revealed that one of the main barriers that healthcare professionals experienced was parental resistance to smoking cessation assistance. In addition, healthcare professionals noted that they experienced tension when motivating parents to quit smoking, as they were not the parent’s, but the child’s healthcare provider. Additionally, healthcare professionals reported being concerned about the lack of information about the costs of Smoke-free Parents, which limited professionals referring parents to the service. Conclusions Although healthcare professionals reported rather positive experiences with the Smoke-free Parents referral tool, the use of the tool was limited due to barriers. To increase the impact of the Smoke-free Parents telephone-based smoking cessation counseling program via child healthcare settings, it is important to overcome these barriers. Suggestions for improvement in the implementation of the referral tool in child healthcare settings are discussed.
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Affiliation(s)
- Tessa Scheffers-van Schayck
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 735, 3500 AS, Utrecht, the Netherlands. .,Department of Interdisciplinary Social Science, Utrecht University, P.O. Box 80125, 3584 CS, Utrecht, the Netherlands.
| | - Bethany Hipple Walters
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 735, 3500 AS, Utrecht, the Netherlands.,Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, USA
| | - Roy Otten
- Clinical Developmental Psychology, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, The Netherlands
| | - Marloes Kleinjan
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 735, 3500 AS, Utrecht, the Netherlands.,Department of Interdisciplinary Social Science, Utrecht University, P.O. Box 80125, 3584 CS, Utrecht, the Netherlands
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Childhood and Adulthood Passive Smoking and Nonalcoholic Fatty Liver in Midlife: A 31-year Cohort Study. Am J Gastroenterol 2021; 116:1256-1263. [PMID: 33481379 DOI: 10.14309/ajg.0000000000001141] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/22/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Identifying early life risk factors remains key to the prevention of nonalcoholic fatty liver (hereinafter "fatty liver") in adulthood. However, the longitudinal association of childhood passive smoking with adult fatty liver is not studied. We examined the association of childhood and adulthood passive smoking with fatty liver in midlife. METHODS This was a 31-year prospective cohort study of 1,315 participants. Information on childhood passive smoking (parental smoking) was collected in 1980 (aged 3-18 years) and 1983 and adulthood passive smoking in 2001, 2007, and 2011. Fatty liver was determined by ultrasound in 2011 (aged 34-49 years). RESULTS The prevalence of fatty liver was 16.3%. Both childhood and adulthood passive smoking were associated with higher risk of fatty liver, adjusting for potential confounders such as age, sex, childhood socioeconomic status, and adulthood physical activity and alcohol consumption (relative risk = 1.41, 95% confidence interval: 1.01-1.97 for childhood; 1.35, 1.01-1.82 for adulthood). Individuals with persistent exposure to passive smoking between childhood and adulthood had the highest risk (relative risk = 1.99, 95% confidence interval: 1.14-3.45) compared with those without passive smoking in either childhood or adulthood. DISCUSSION Passive smoking in both child and adult lives are associated with increased risk of adult fatty liver, suggesting that the prevention of passive smoking should start as early as possible and maintain throughout lifetime.
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Fallavollita WL, Do EK, Schechter JC, Kollins SH, Zheng J(J, Qin J, Maguire RL, Hoyo C, Murphy SK, Fuemmeler BF. Smoke-Free Home Rules and Association with Child Secondhand Smoke Exposure among Mother-Child Dyad Relationships. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5256. [PMID: 34069235 PMCID: PMC8157188 DOI: 10.3390/ijerph18105256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/05/2021] [Accepted: 05/09/2021] [Indexed: 01/22/2023]
Abstract
Smoke-free home rules restrict smoking in the home, but biomarkers of secondhand smoke exposure are needed to help understand the association between smoke-free homes and child secondhand smoke exposure. Participants (n = 346) were majority Black/African American mother-child dyads from a longitudinal study in North Carolina. Mothers completed questionnaires on household smoking behaviors and rules, and child saliva samples were assayed for secondhand smoke exposure. Regression models used smoke-free home rules to predict child risk for secondhand smoke exposure. Children in households with smoke-free home rules had less salivary cotinine and risk for secondhand smoke exposure. After controlling for smokers in the household, home smoking rules were not a significant predictor of secondhand smoke exposure. Compared to children in households with no smokers, children in households with at least one smoker but a non-smoking mother (OR 5.35, 95% CI: 2.22, 13.17) and households with at least one smoker including a smoking mother (OR 13.73, 95% CI: 6.06, 33.28) had greater risk for secondhand smoke exposure. Results suggest smoke-free home rules are not sufficient to fully protect children from secondhand smoke exposure, especially in homes with smokers. Future research should focus on how household members who smoke can facilitate the prevention of child secondhand smoke exposure.
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Affiliation(s)
- Westley L. Fallavollita
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
| | - Elizabeth K. Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Julia C. Schechter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27701, USA; (J.C.S.); (S.H.K.)
| | - Scott H. Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27701, USA; (J.C.S.); (S.H.K.)
| | - Junfeng (Jim) Zheng
- Nicholas School of the Environment and Global Health Institute, Duke University, Durham, NC 27708, USA;
| | - Jian Qin
- School of Public Health, Guangxi Medical University, Nanning 530021, China;
| | - Rachel L. Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA; (R.L.M.); (C.H.)
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA; (R.L.M.); (C.H.)
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Bernard F. Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23284, USA
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Affiliation(s)
- Marita Hefler
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Chris Bostic
- Action on Smoking and Health, Washington, District of Columbia, USA
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Maharani DA, Nadira KV, Setiawati F, El Tantawi M. Intention to provide tobacco cessation counseling among Indonesian dental students and association with the theory of planned behavior. BMC Oral Health 2021; 21:23. [PMID: 33413333 PMCID: PMC7790038 DOI: 10.1186/s12903-020-01348-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 11/22/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Use of tobacco is a serious public health problem in Indonesia that requires a multidisciplinary approach by healthcare providers to address it. The study assessed the intentions of undergraduate students in dental schools to provide tobacco cessation counseling (TCC) and their association with the constructs of the theory of planned behavior (TPB). METHODS A cross sectional study was conducted in October 2019 using an electronic survey for dental students in Indonesian dental schools (n = 30). The survey assessed schools and students' characteristics and eleven statements assessed their perspectives toward TCC based on the TPB using a 5-point Likert scale. Principal component analysis (PCA) was used to identify components within the items of perspective. Multilevel linear regression analysis was used to assess the association between intention to provide TCC and the constructs of the TPB as identified in the perspectives' items using TPB controlling for confounders. RESULTS About 1288 students participated from 30 dental schools, 83.3% females with mean age = 21.5 years with average intention to provide TCC = 4.3 out of 5. They had above average positive attitude about provision of TCC being the dentist's role (mean = 3.8 out of 5). PCA identified two components: confidence in their own abilities and perception of favorable environment with average scores = 3.2 and 2.7 out of 5. Intention to provide TCC was significantly associated with more positive attitude recognizing TCC as a dentist's role (B = 0.10, P < 0.0001), greater confidence in skills to provide TCC (B = 0.17, P < 0.0001) and less perception of favorable environment supportive off providing TCC (B = - 0.20, P < 0.0001). CONCLUSIONS Indonesian dental students' intention to provide TCC can be explained by the constructs of the TPB. Development of dental curricula promoting professional responsibility toward TCC should be given attention. Improving students' attitude and confidence potentially may support their patients' efforts to quit smoking.
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Affiliation(s)
- Diah Ayu Maharani
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, Jalan Salemba No. 4, Jakarta, 10430, Indonesia.
| | - Kiarra Vashti Nadira
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, Jalan Salemba No. 4, Jakarta, 10430, Indonesia
| | - Febriana Setiawati
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, Jalan Salemba No. 4, Jakarta, 10430, Indonesia
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Scheffers-van Schayck T, Mujcic A, Otten R, Engels R, Kleinjan M. The Effectiveness of Smoking Cessation Interventions Tailored to Smoking Parents of Children Aged 0–18 Years: A Meta-Analysis. Eur Addict Res 2021; 27:278-293. [PMID: 33311028 PMCID: PMC8315688 DOI: 10.1159/000511145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 07/03/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION A meta-analysis was conducted to examine the effectiveness of smoking cessation interventions tailored to parents of children aged 0-18 years. METHODS A systematic search was carried out in PsycInfo, Embase, and PubMed in March 2020. A manual search of the reference lists of the included studies and systematic reviews related to the topic was also performed. Two authors independently screened the studies based on the following inclusion criteria: (1) effect studies with control groups that examine smoking cessation interventions tailored to parents of children (0-18 years), and (2) full-text original articles written in English and published between January 1990 and February 2020. In total, 18 studies were included in the analyses. The TiDieR checklist and the Cochrane Risk of Bias Tool 2.0 were used to extract data and to assess the risk of bias. Consensus among authors was reached at each stage. RESULTS Random-effects meta-analyses were performed. With a total number of 8,560 parents, the pooled relative risk was 1.62 (95% CI 1.38-1.90; p < 0.00001), showing a modest effect of the interventions on smoking cessation. Overall, 13.1% of the parents in the intervention conditions reported abstinence versus 8.4% of the parents in the control conditions. DISCUSSION/CONCLUSION Smoking cessation interventions tailored to parents are modestly effective. To increase the effectiveness and the impact of these interventions in terms of controlling tobacco use and public health, it is crucial for further research to explore how these interventions can be improved.
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Affiliation(s)
- Tessa Scheffers-van Schayck
- Epidemiology and Research Support, Trimbos Institute − Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands,*Tessa Scheffers-van Schayck, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Epidemiology and Research Support, Da Costakade 45, NL–3521 VS Utrecht (The Netherlands),
| | - Ajla Mujcic
- Drugs Monitoring and Policy, Trimbos Institute − Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands,Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Roy Otten
- Research and Development, Pluryn, Nijmegen, The Netherlands,Department of Psychology, ASU REACH Institute, Arizona State University, Tempe, Arizona, USA,Developmental Psychopathology, Radboud University, Nijmegen, The Netherlands
| | - Rutger Engels
- Executive Board, Erasmus University, Rotterdam, The Netherlands
| | - Marloes Kleinjan
- Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, The Netherlands,Youth, Trimbos Institute − Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
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Duan Z, Wang Y, Huang J, Redmon PB, Eriksen MP. Secondhand smoke (SHS) exposure before and after the implementation of the Tobacco Free Cities (TFC) initiative in five Chinese cities: a pooled cross-sectional study. BMJ Open 2020; 10:e044570. [PMID: 33376183 PMCID: PMC7778775 DOI: 10.1136/bmjopen-2020-044570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To assess the levels of secondhand smoke (SHS) exposure before and after the implementation of the Tobacco Free Cities (TFC) initiative. DESIGN City-wide representative, cross-sectional surveys (Tobacco Questions for Surveys, TQS) were conducted in each participating city before and after the implementation of TFC. SETTING Five large Chinese cities (Chengdu, Chongqing, Wuhan, Xiamen and Xi'an) participated in the TFC initiative. PARTICIPANTS A total of 10 184 adults participated in the 2015 TQS survey, and 10 233 adults participated in the 2018 TQS survey, respectively. INTERVENTIONS The TFC initiative, which included targeted media campaigns, educational programmes, implementing city-wide smoke-free policies and providing cessation interventions, was implemented in these five cities between 2015 and 2018. MAIN OUTCOME Self-reported past 30-day (P30D) SHS exposure in indoor workplaces, restaurants and homes. DATA ANALYSIS The pre-TFC and post-TFC SHS exposure levels were compared among all residents and among certain population subgroups. Multivariate logistic regressions were used to estimate the adjusted associations between P30D SHS exposure and individual characteristics. RESULTS Across all five cities, the overall rate of self-reported P30D SHS exposure declined in indoor workplaces (from 49.6% (95% CI: 46.4% to 52.8%) to 41.2% (95% CI: 37.7% to 44.7%)), restaurants (from 72.4% (95% CI: 69.8% to 74.9%) to 61.7% (95% CI: 58.7% to 64.7%)) and homes (from 39.8% (95% CI: 36.9% to 42.7%) to 34.7% (95% CI: 31.5% to 37.8%)) from 2015 to 2018. These declines were statistically significant after controlling for individual characteristics. The P30D SHS exposure was associated with sex, age, education level, occupation and current smoking status. The associations varied by venues. CONCLUSIONS Our analysis showed that compared with the nationwide SHS exposure levels reported in concurrent national surveys, the declines in P30D SHS exposure in five Chinese cities that implemented the TFC initiative were larger in indoor workplaces and restaurants. Our findings suggest that the TFC initiative was effective in reducing SHS exposure in Chinese cities.
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Affiliation(s)
- Zongshuan Duan
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Yu Wang
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Pamela B Redmon
- Global Health Institute, Emory University, Atlanta, Georgia, USA
| | - Michael P Eriksen
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
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Mamudu HM, Owusu D, Asare B, Williams F, Asare M, Oke A, Poole A, Osedeme F, Ouma OAE. Support for smoke-free public places among adults in four countries in sub-Saharan Africa. Nicotine Tob Res 2020; 22:2141-2148. [PMID: 31927591 DOI: 10.1093/ntr/ntaa008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 01/08/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION There is no known safe level of secondhand smoke exposure; yet, less than 30% of the global population is covered by comprehensive smoke-free policies as of 2016 and there are few smoke-free policies in sub-Saharan Africa (SSA). This study examines the support for smoke-free public places in SSA and delineates their correlates. METHODS Data collected through the Global Adult Tobacco Survey (2012-2017) were analyzed using SAS for descriptive and multivariable analyses, with a significance level set at p < .05. RESULTS No SSA country had comprehensive smoke-free policies, defined as a prohibition of smoking in eight public places. In the four countries whose Global Adult Tobacco Survey data were analyzed (Nigeria, Cameroon, Kenya, and Uganda), support for the prohibition of smoking in public places was over 90% in all eight public places except bars. Support for smoking prohibition in bars was 65.8%, 81.1%, 81.4%, and 91.0% in Nigeria, Cameroon, Kenya, and Uganda, respectively. Factors associated with support for smoke-free bars differed across the four countries, but in all countries, current smokers had decreased odds of support for smoke-free bars. Knowledge of secondhand smoke harm and living in smoke-free homes were associated with increased odds of support for smoke-free bars in all countries except Kenya. CONCLUSION The high support for smoke-free public places should inform the efforts of the public health community and policymakers in these four SSA countries toward meeting their obligations of Article 8 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). IMPLICATIONS Much of the population in SSA is not protected by comprehensive smoke-free policies. It was found that the overwhelming majority of adults in four large countries in SSA support the prohibition of smoking in public places and that knowledge of the health dangers of smoking and exposure to secondhand smoke and home smoking rules increased support for the prohibition. High support for the prohibition of smoking in these four SSA countries suggests tobacco control proponents should advocate for comprehensive smoke-free policies.
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Affiliation(s)
- Hadii M Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Daniel Owusu
- Tobacco Center of Regulatory Science (GSU TCORS), Georgia State University, Atlanta, GA
| | | | - Faustine Williams
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Matthew Asare
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX
| | - Adekunle Oke
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Amy Poole
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Fenose Osedeme
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Ogwell A E Ouma
- Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
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Zhang H, Yu L, Wang Q, Tao Y, Li J, Sun T, Zhang Y, Zhang H. In utero and postnatal exposure to environmental tobacco smoke, blood pressure, and hypertension in children: the Seven Northeastern Cities study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:618-629. [PMID: 31140839 DOI: 10.1080/09603123.2019.1612043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/22/2019] [Indexed: 06/09/2023]
Abstract
To evaluate the association of environmental tobacco smoke (ETS) exposure with hypertension and blood pressure (BP) in children, a sample of 9,354 children, aged 5-17 years, was studied from seven northeastern cities of China in 2012-2013. The results showesd that significant associations were observed for hypertension with ETS exposure in utero [odds ratio (OR) 1.36, 95% confidence interval (CI) 1.18-1.57], with current major ETS exposure from fathers (1.38, 1.21-1.57) or anyone (1.26, 1.12-1.42), and with intensity of ETS exposure greater than 1 cigarette per day (ORs ranged from 1.20 to 1.35). For SBP, significant associations were only observed in children with major ETS exposure from father and with cigarettes smoking >10/day. When stratified by sex, more significant associations were found in girls than in boys. In conclusion, prenatal and postnatal ETS exposure was significantly associated with increased odds of hypertension in children, especially in girls.
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Affiliation(s)
- Haishan Zhang
- Department of Cardiology, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Lujiao Yu
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Qi Wang
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Ye Tao
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Jing Li
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Tingting Sun
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
| | - Yousheng Zhang
- General Hospital of Northern Theater Command, Liaoning Provincial Military Clinic , Shenyang, China
| | - Haiyan Zhang
- Department of Geriatrics, the First Affiliated Hospital of China Medical University , Shenyang, China
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Nadhiroh SR, Djokosujono K, Utari DM, Hasugian AR. Questionnaire-Based Environmental Tobacco Smoke Exposure and Hair Nicotine Levels in 6-month-old Infants: A Validation Study in Indonesia. Glob Pediatr Health 2020; 7:2333794X20969287. [PMID: 33195749 PMCID: PMC7605031 DOI: 10.1177/2333794x20969287] [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: 06/13/2020] [Revised: 08/28/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives. Using hair nicotine as the gold standard, this study aimed to establish cutoff points and validate the questionnaire-based environmental tobacco smoke (ETS) exposure and ETS statuses of Indonesian infants. Methods. A cross-sectional study design was conducted among families who were participants of the Peer Health Cohort Study in Jakarta, Indonesia. Households with 6-month-old infants joined this study. The presence and amount of ETS exposure were assessed by both questionnaire and hair sampling for nicotine determination. Head hair samples were collected from 102 infants and measured by optimized gas chromatography-mass spectrometry (GC/MS). Infants were grouped as ETS-exposed if they lived with at least 1 smoker at home. We used the receiver operating characteristic (ROC) curve to assess the sensitivity and specificity of cutoff values of hair nicotine. Results. There were 78 (76.5%) infants exposed to ETS based on the questionnaire. The nicotine concentrations in hair were significantly higher in infants with ETS exposure than in those without ETS exposure (P < .001). The area under the curve for nicotine was 0.774. A hair nicotine cutoff value of 2.37 ng/mg, with a sensitivity of 67.95% and specificity of 83.33%, was identified as the optimal cutoff value for separating exposed from non-exposed to ETS in infants. Conclusion. The hair nicotine value of infants aged 6 months is useful in confirming the questionnaire on smoking in the household and exposure to ETS. Moreover, it also could be used to distinguish ETS-exposed from non-ETS-exposed infants.
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Affiliation(s)
| | | | | | - Armedy Ronny Hasugian
- National Institutes of Health Research and Development, Ministry of Health, Jakarta, Indonesia
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Ahluwalia IB, Wilson K, Gorzkowski J. Protecting Youth From Tobacco Around the Globe: Evidence to Practice. Pediatrics 2020; 146:peds.2020-1585. [PMID: 32873720 PMCID: PMC9070114 DOI: 10.1542/peds.2020-1585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/07/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Indu B. Ahluwalia
- Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Karen Wilson
- Jack and Lucy Clark Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
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Robin RC, Noosorn N, Alif SM. Secondhand Smoking Among Children in Rural Households: A Community Based Cross-Sectional Study in Bangladesh. Osong Public Health Res Perspect 2020; 11:201-208. [PMID: 32864311 PMCID: PMC7442452 DOI: 10.24171/j.phrp.2020.11.4.09] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives This study aimed to determine the factors associated with reducing exposure to secondhand smoke among children in households of rural Bangladesh. Methods A cross-sectional study of 410 smokers and non-smokers, in 6 villages of Munshigonj district was conducted. Data were collected randomly using a self-administrative questionnaire. Differences between variables were assessed using Chi-square or Fisher's exact test (as appropriate). Univariate and multivariate logistic regression models were used to investigate associations. All results were presented as unadjusted and adjusted odds ratios with a 95% confidence interval. The level of statistical significance was reached when p < 0.05. Results A smoker in the household was determined to be a risk factor associated with exposure of other household members to secondhand smoke (p < 0.001). Higher education, strict implementation of household smoke-free rules, a higher influence of social norms and culture, as well as moderate knowledge on exposure to secondhand smoke were considered as preventive factors associated with exposure of others in the home to secondhand smoke. Conclusion Exposure to secondhand smoke is an extensive and preventable risk factor for children, and reducing exposure to secondhand smoke will have a largely positive effect in the community. An effective public health intervention model may reduce secondhand smoking.
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Affiliation(s)
- Rishad Choudhury Robin
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Narongsak Noosorn
- Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Sheikh Mohammad Alif
- epartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Household Exposure to Secondhand Smoke among Chinese Children: Status, Determinants, and Co-Exposures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155524. [PMID: 32751695 PMCID: PMC7432650 DOI: 10.3390/ijerph17155524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 11/17/2022]
Abstract
Smoking prevalence stays high among adults in China, which also makes children exposed to secondhand smoke (SHS) in their households. This study aimed to investigate the status of SHS exposure among Chinese children, identify the influencing factors, and determine "co-exposure" to tobacco and other smokes in households. A total of 41,439 children aged 6-17 years were recruited from 30 provinces in Mainland China through the first Chinese Environmental Exposure-Related Human Activity Model Survey for Children (CEERHAPS-C). Information regarding children's demographics, socioeconomic status, and exposures to SHS and solid fuel smoke (SFS) in households was collected using a comprehensive questionnaire. Factors that affected exposures to household smokes were identified using multivariable logistic regressions. The overall prevalence of household SHS exposure was 41.7%, and the average duration was 14.7 ± 14.6 min/day among the exposed participants. Prevalence of household SHS exposure increased among children in older age groups and with parents in lower education levels. Among SHS-exposed children, 34% had co-exposure to SFS, and they had a significantly higher risk of co-exposure than non-SHS exposed children (odds ratio = 1.12, 95% confidence interval: 1.061, 1.162). The prevalence of household SHS exposure remains high among school-age children, suggesting the need to develop and implement smoking-free home programs.
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Xu SL, Liu AP, Wu QZ, Marks T, He ZZ, Qian Z, McMillin SE, Sun J, Appleton AA, Bloom MS, Lin S, Yu HY, Zhou Y, Liu RQ, Feng D, Hu LW, Yang BY, Zeng XW, Sun X, Dong GH. Pet ownership in utero and in childhood decreases the effects of environmental tobacco smoke exposure on hypertension in children: A large population based cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 715:136859. [PMID: 32014767 DOI: 10.1016/j.scitotenv.2020.136859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/30/2019] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Little is known about whether exposure to pets influences the association between hypertension and environmental tobacco smoke (ETS). The current study aims to examine the interaction of pet ownership on ETS exposure and the development of hypertension in children. METHODS From 2012 to 2013, a total of 9354 children, 5 to 17 years of age, were recruited from 62 schools in seven northeastern cities. BP in children was measured and hypertension was defined as an average diastolic blood pressure (DBP) or systolic blood pressure (SBP) at or above the 95th percentile for that child's age, sex, and height. Pet ownership in three different time periods (in utero, past 2 years, and currently) and ETS exposure data were collected from parents via a questionnaire. Two-level regressions were used for the data analyses. RESULTS The data show consistent, significant interactions between exposure to pets and effects from ETS. Children who were not exposed to pets experienced stronger effects from ETS on hypertension when compared to those exposed to pets, and the protective effect of pet ownership became stronger with a greater number of pets in the home. Exposure to in utero ETS was associated with hypertension [adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI): 1.13-1.54] only for those children without pet exposure in utero but not for those with pets (aOR = 0.75; 95% CI: 0.49-1.15) (pinteraction < 0.05). Moreover, household dog ownership was related to significantly lower effects of current ETS on hypertension (aOR = 0.80, 95% CI: 0.61-1.05) compared with children without dogs (aOR = 1.26, 95% CI: 1.11-1.44) (pinteraction = 0.001). Interaction associations between ETS and pet ownership were more robust for girls than for boys and for younger than older children. CONCLUSION This study indicates an inverse relationship between pet ownership and ETS, potentially pointing to pet ownership as protecting against the development of hypertension in children.
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Affiliation(s)
- Shu-Li Xu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ai-Ping Liu
- Department of Clinical Laboratory, Shiyan Prevention and Health Care Center of Baoan, Shenzhen 518101, China
| | - Qi-Zhen Wu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Tia Marks
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Zhi-Zhou He
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Jia Sun
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Allison A Appleton
- Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Michael S Bloom
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY 12144, USA; Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Shao Lin
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA; Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Hong-Yao Yu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yang Zhou
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ru-Qing Liu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Dan Feng
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Li-Wen Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiao-Wen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiao Sun
- Department of Internal Medicine, Shenyang Women's and Children's Hospital, Shenyang 110011, China.
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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Bundy ŁT, Haardörfer R, Kegler MC, Owolabi S, Berg CJ, Escoffery C, Thompson T, Mullen PD, Williams R, Hovell M, Kahl T, Harvey D, Price A, House D, Booker BW, Kreuter MW. Disseminating a Smoke-free Homes Program to Low Socioeconomic Status Households in the United States Through 2-1-1: Results of a National Impact Evaluation. Nicotine Tob Res 2020; 22:498-505. [PMID: 30517679 PMCID: PMC7368345 DOI: 10.1093/ntr/nty256] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/29/2018] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Given homes are now a primary source of secondhand smoke (SHS) exposure in the United States, research-tested interventions that promote smoke-free homes should be evaluated in real-world settings to build the evidence base for dissemination. This study describes outcome evaluation results from a dissemination and implementation study of a research-tested program to increase smoke-free home rules through US 2-1-1 helplines. METHODS Five 2-1-1 organizations, chosen through a competitive application process, were awarded grants of up to $70 000. 2-1-1 staff recruited participants, delivered the intervention, and evaluated the program. 2-1-1 clients who were recruited into the program allowed smoking in the home, lived in households with both a smoker and a nonsmoker or child, spoke English, and were at least 18 years old. Self-reported outcomes were assessed using a pre-post design, with follow-up at 2 months post baseline. RESULTS A total of 2345 households (335-605 per 2-1-1 center) were enrolled by 2-1-1 staff. Most participants were female (82%) and smokers (76%), and half were African American (54%). Overall, 40.1% (n = 940) reported creating a full household smoking ban. Among the nonsmoking adults reached at follow-up (n = 389), days of SHS exposure in the past week decreased from 4.9 (SD = 2.52) to 1.2 (SD = 2.20). Among the 1148 smokers reached for follow-up, 211 people quit, an absolute reduction in smoking of 18.4% (p < .0001), with no differences by gender. CONCLUSIONS Among those reached for 2-month follow-up, the proportion who reported establishing a smoke-free home was comparable to or higher than smoke-free home rates in the prior controlled research studies. IMPLICATIONS Dissemination of this brief research-tested intervention via a national grants program with support from university staff to five 2-1-1 centers increased home smoking bans, decreased SHS exposure, and increased cessation rates. Although the program delivery capacity demonstrated by these competitively selected 2-1-1s may not generalize to the broader 2-1-1 network in the United States, or social service agencies outside of the United States, partnering with 2-1-1s may be a promising avenue for large-scale dissemination of this smoke-free homes program and other public health programs to low socioeconomic status populations in the United States.
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Affiliation(s)
- Łucja T Bundy
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Shadé Owolabi
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Tess Thompson
- George Warren Brown School of Social Work, Washington University, St. Louis, MO
| | | | | | - Mel Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA
| | | | | | | | | | | | - Matthew W Kreuter
- George Warren Brown School of Social Work, Washington University, St. Louis, MO
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Siddiqi K, Huque R, Kanaan M, Ahmed F, Ferdous T, Shah S, Jackson C, Parrott S, Ahluwalia JS, Sheikh A. Children Learning About Secondhand Smoke (CLASS II): A Pilot Cluster Randomized Controlled Trial. Nicotine Tob Res 2020; 21:670-677. [PMID: 29771390 PMCID: PMC6468126 DOI: 10.1093/ntr/nty090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 05/15/2018] [Indexed: 02/02/2023]
Abstract
Introduction Children exposed to secondhand smoke (SHS) are at increased risk of respiratory illnesses. We piloted a Smoke Free Intervention (SFI) and trial methods before investigating its effectiveness and cost-effectiveness in primary school children. Methods In a pilot cluster randomized controlled trial in Bangladesh, primary schools were allocated to usual education (control) or SFI, using minimization. Year-5 children were recruited. Masking treatment allocation was not possible. Delivered by schoolteachers, SFI consisted of two 45-min and four 15-min educational sessions. Our primary outcome was SHS exposure at two months post randomization, verified by children’s salivary cotinine. The trial is registered at ISRCTN.com; ISRCTN68690577. Results Between April 1, 2015 and June 30, 2015, we recruited 12 schools. Of the 484 children present in Year-5, 481 consented. Six schools were allocated to both SFI (n = 245) and to usual education only (n = 236). Of them, 450 children (SFI = 229; control = 221) who had cotinine levels indicative of SHS exposure were followed-up. All schools were retained, 91% children (208/229) in SFI and 88% (194/221) in the control arm completed primary outcome assessment. Their mean cotinine at the cluster level was 0.53 ng/ml (SD 0.36) in SFI and 1.84 ng/ml (SD 1.49) in the control arm—a mean difference of −1.31 ng/ml (95% CI = −2.86 to 0.24). Conclusion It was feasible to recruit, randomize, and retain primary schools and children in our trial. Our study, though not powered to detect differences in mean cotinine between the two arms, provides estimates to inform the likely effect size for future trials. Implications In countries with high smoking prevalence, children remain at risk of many conditions due to secondhand smoke exposure. There is little empirical evidence on the effectiveness and cost-effectiveness of interventions that can reduce their exposure to secondhand smoke at homes. CLASS II trial found that a school-based intervention (SFI) has the potential to reduce children’s exposure to SHS—an approach that has been rarely used, but has considerable merit in school-based contexts. CLASS II trial provides key information to conduct a future definitive trial in this area of public health, which despite its importance has so far received little attention.
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Affiliation(s)
- Kamran Siddiqi
- Department of Health Sciences, University of York Seebohm Rowntree Building, Heslighton, York, UK
| | - Rumana Huque
- Department of Economics, University of Dhaka Social Science Building, Dhaka, Bangladesh
| | - Mona Kanaan
- Department of Health Sciences, University of York Seebohm Rowntree Building, Heslighton, York, UK
| | | | | | - Sarwat Shah
- Department of Health Sciences, University of York ARRC Building, University of York, Heslington, York, UK
| | - Cath Jackson
- Department of Health Sciences, University of York ARRC Building, University of York, Heslington, York, UK
| | - Steve Parrott
- Department of Health Sciences, University of York ARRC Building, University of York, Heslington, York, UK
| | | | - Aziz Sheikh
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh Teviot Place, Edinburgh, UK
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Yousuf H, Hofstra M, Tijssen J, Leenen B, Lindemans JW, van Rossum A, Narula J, Hofstra L. Estimated Worldwide Mortality Attributed to Secondhand Tobacco Smoke Exposure, 1990-2016. JAMA Netw Open 2020; 3:e201177. [PMID: 32181828 PMCID: PMC7078760 DOI: 10.1001/jamanetworkopen.2020.1177] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE The World Health Organization estimates that the 1 billion individuals who smoke worldwide contribute to the 880 000 secondhand smoke (SHS)-related deaths among individuals who do not smoke each year. A better understanding of the scale of harm of SHS to those who do not smoke could increase awareness of the consequences of smoking and help to design measures to protect individuals who do not smoke, especially children. OBJECTIVE To calculate the number of individuals who smoke associated with the death of 1 individual who died of SHS exposure both on a global scale and in various World Bank regions. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional epidemiologic assessment, data from Our World in Data were used to tabulate the number of individuals who smoke in each country and number of premature deaths related to SHS in that country from 1990 to 2016. The mean number of cigarettes consumed in all countries was also included in analyses. Data were collected for the following World Bank regions: North America, Latin America and the Caribbean, Europe and Central Asia, the Middle East and North Africa, sub-Saharan Africa, South Asia, and East Asia and the Pacific from 1990 and 2016. Statistical analysis was conducted in July 2019. EXPOSURE Secondhand smoke. MAIN OUTCOMES AND MEASURES The pack-year index, calculated as the number of pack-years associated with the death of 1 individual who does not smoke but was exposed to SHS, and the SHS index, calculated as the number of individuals who smoked for 24 years (ie, the mean duration of smoking) associated with the death of 1 individual who does not smoke. RESULTS Globally, the SHS index changed favorably, from 31.3 (95% CI, 30.6-32.0) individuals who smoked associated with the death of 1 individual who did not smoke in 1990 to 52.3 (95% CI, 51.2-53.5) individuals who smoked in 2016. There was a wide regional variation in the 2016 secondhand smoke index, from 42.6 (95% CI, 41.6-43.5) individuals who smoked in the Middle East and North Africa to 85.7 (95% CI, 83.8-87.7) individuals who smoked in North America. Worldwide, the pack-year index also changed favorably from 751.9 (95% CI, 736.3-770.7) pack-years associated with 1 death in 1990 to 1255.9 (95% CI, 1227.2-1284.4) pack-years in 2016. CONCLUSIONS AND RELEVANCE In this study, the substantial disparity among regions in both the SHS index and pack-year index reflected large differences in the scale of the harm of SHS on those who do not smoke. This information may help local policy makers implement measures to better protect those who do not smoke and increase public engagement. Although the number of pack-years and the number of individuals who smoke associated with the death of 1 individual who did not smoke favorably changed over the study period, as of 2016, 52.3 individuals who smoked were associated with the death of 1 individual who did not smoke.
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Affiliation(s)
- Hamza Yousuf
- Department of Cardiology, VU University Medical Center, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | | | - Jan Tijssen
- Department of Cardiology, Amsterdam Medical Center, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | | | | | - Albert van Rossum
- Department of Cardiology, VU University Medical Center, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Jagat Narula
- Department of Cardiology, Mount Sinai Hospital, New York City, New York
| | - Leonard Hofstra
- Department of Cardiology, VU University Medical Center, Amsterdam University Medical Center, Amsterdam, the Netherlands
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Secondhand tobacco smoke exposure of infants at home: A population based cross-sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Phetphum C, Noosorn N. Prevalence of secondhand smoke exposure at home and associated factors among middle school students in Northern Thailand. Tob Induc Dis 2020; 18:11. [PMID: 32165877 PMCID: PMC7057047 DOI: 10.18332/tid/117733] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/30/2020] [Accepted: 02/01/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION One-third of youths in Thailand will be exposed to secondhand smoke (SHS) from family members who are smokers. This research aims to study the prevalence of and factors associated with SHS exposure at home among middle school students in Northern Thailand. METHODS This study used a cross-sectional survey. The sample was 780 middle school students in Northern Thailand. A self-administered questionnaire was used for data collection and analyses were performed using a chi-squared test and multiple logistic regression. RESULTS Of the respondents, 46.8% reported that they had been exposed to SHS at home. The main SHS sources were from fathers (45.4%), relatives (24.1%), siblings (12.4%), mothers (3.3%), and neighbours and guests (14.8%). The factors associated with SHS exposure at home included: household members who were smokers (OR=7.43; 95% CI: 5.17–10.68; p<0.001), home without a smoke-free rule (OR=3.40; 95% CI: 1.85–6.24; p<0.001), household members who were alcohol drinkers (OR=2.29; 95% CI: 1.59–3.30; p<0.001), and living in homes with ≤3 rooms (OR=1.79; 95% CI: 1.21–2.63; p=0.003). CONCLUSIONS Thai student’s exposure to SHS at home is high, especially when household members smoke and they live in a home without a smoke-free rule. Our findings highlight the need for policies and interventions to establish smoke-free homes.
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Affiliation(s)
- Chakkraphan Phetphum
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Narongsak Noosorn
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
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