Youth exposure to in-vehicle second-hand smoke and their smoking behaviours: trends and associations in repeated national surveys (2006-2012).

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Healey, Benjamin; Hoek, Janet; Wilson, Nick; Thomson, George; Taylor, Steve; Edwards, Richard

2015-03-01

To extend the limited international evidence on youth in-vehicle second-hand smoke (SHS) exposure by examining trends in New Zealand, a country with a national smoke-free goal and indoors smoke-free environment legislation. We tracked exposure rates and explored the associations between in-vehicle SHS exposure and smoking behaviours. In-home exposure was also examined for comparative purposes. Data were collected in annual surveys of over 25 000 year 10 school students (14-15-year olds) for a 7-year period (2006-2012). Questions covered smoking behaviour, exposure to smoking and demographics. Youth SHS exposure rates in-vehicle and in-home trended down slightly over time (pvehicle in the previous week in 2012. However, marked inequalities in exposure between ethnic groups, and by school-based socioeconomic position, persisted. The strongest association with SHS exposure was parental smoking (eg, for both parents versus neither smoking in 2012: in-vehicle SHS exposure adjusted OR: 7.4; 95% CI: 6.5 to 8.4). After adjusting for seven other factors associated with initiation, logistic regression analyses revealed statistically significant associations of in-vehicle SHS exposure with susceptibility to initiation and smoking. The slow decline in SHS exposure in vehicles and the lack of progress in reducing relative inequalities is problematic. To accelerate progress, the New Zealand Government could follow the example of other jurisdictions and prohibit smoking in cars carrying children. Other major policy interventions, beside enhanced smoke-free environments, will also likely be required if New Zealand is to achieve its 2025 smoke-free nation goal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Are Canadian youth still exposed to second-hand smoke in homes and in cars?

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Barisic, A; Leatherdale, S T; Burkhalter, R; Ahmed, R

2014-07-01

The objective of this manuscript is to examine the prevalence of youth exposed to second-hand smoke (SHS) in homes and cars, changes in SHS exposure over time, and factors associated with beliefs youth hold regarding SHS exposure among a nationally representative sample of Canadian youth. Descriptive analysis of SHS exposure in homes and cars was conducted using data from the Canadian Youth Smoking Survey (2004, 2006 and 2008). Logistic regression was conducted to examine factors associated with beliefs youth had about SHS exposure in 2008. In 2008, 21.5% of youth reported being exposed to SHS in their home on a daily or almost daily basis, while 27.3% reported being exposed to SHS while riding in a car at least once in the previous week. Between 2004 and 2008, the prevalence of daily SHS exposure in the home and cars decreased by 4.7% and 18.0% respectively. Despite reductions in SHS exposure over time, a substantial number of Canadian youth continue to be exposed to SHS in homes and cars. Further effort is required to implement and evaluate policies designed to protect youth from SHS.

The association between second-hand smoke exposure and depressive symptoms among pregnant women.

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Huang, Jingya; Wen, Guoming; Yang, Weikang; Yao, Zhenjiang; Wu, Chuan'an; Ye, Xiaohua

2017-10-01

Tobacco smoking and depression are strongly associated, but the possible association between second-hand smoke (SHS) exposure and depression is unclear. This study aimed to examine the possible relation between SHS exposure and depressive symptoms among pregnant women. A cross-sectional survey was conducted in Shenzhen, China, using a multistage sampling method. The univariable and multivariable logistic regression models were used to explore the associations between SHS exposure and depressive symptoms. Among 2176 pregnant women, 10.5% and 2.0% were classified as having probable and severe depressive symptoms. Both binary and multinomial logistic regression revealed that there were significantly increased risks of severe depressive symptoms corresponding to SHS exposure in homes or regular SHS exposure in workplaces using no exposure as reference. In addition, greater frequency of SHS exposure was significantly associated with the increased risk of severe depressive symptoms. Our findings suggest that SHS exposure is positively associated with depressive symptoms in a dose-response manner among the pregnant women. Copyright © 2017 Elsevier B.V. All rights reserved.

Attitudes towards second hand smoke amongst a highly exposed workforce: survey of London casino workers.

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Pilkington, P A; Gray, S; Gilmore, A B; Daykin, N

2006-06-01

To examine knowledge, attitudes and experiences of London casino workers regarding exposure to second hand smoke (SHS) in the workplace. Postal survey of 1568 London casino workers in 25 casinos who were members of the TGWU or GMB Trade Unions. Of the workers, 559 responded to the survey (36% response), 22% of whom were current smokers. Of the respondents, 71% report being nearly always exposed to heavy levels of SHS at work, and most (65%) want all working areas in their casino to be smoke-free. The majority (78%) are bothered by SHS at work, while 91% have wanted to move away from where they are working because of it. Fifty-seven per cent believe their health has suffered as a result of SHS. Of the workers who smoke at work, 59% believe that they would try to quit smoking if no one was allowed to smoke in the casino. The majority of responders are bothered by SHS, and many are concerned about the health impacts. Most want all working areas in their casino to be smoke-free. Despite difficulties in generalizing from this limited sample, these findings add weight to the argument that the legislation on smoking in public places in England should encompass all workplaces, without exemption.

Independent and joint effects of prenatal maternal smoking and maternal exposure to second-hand smoke on the development of adolescent obesity: a longitudinal study.

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Wang, Liang; Mamudu, Hadii M; Alamian, Arsham; Anderson, James L; Brooks, Billy

2014-11-01

To examine associations of prenatal maternal smoking and second-hand smoke (SHS) exposure with the development of adolescent obesity. Longitudinal data (1991-2007) from National Institute of Child Health and Human Development Study of Early Child Care and Youth Development involving mothers that smoked and or exposed to SHS during the year before birth were analysed. Adolescent obesity in ages 12.0-15.9 years was defined as a BMI ≥ 95th percentile. Generalised estimating equations (GEE) were used for the analyses. Obesity was more prevalent among adolescents whose mothers smoked or had SHS exposure than those that did not smoke or exposed to SHS. After adjusting for maternal and child factors, GEE models showed that odds of adolescent obesity increased with prenatal maternal smoking (OR = 1.57, 95% CI = 1.03-2.39) and SHS exposure (OR = 1.53, 95% CI = 1.04-2.27). The odds for obesity increased more than two times among adolescents exposed to both maternal smoking and SHS (OR = 2.10, 95% CI = 1.24, 3.56) compared with those without exposure. Additionally, not breastfeeding, maternal obesity, and longer screen viewing hours per day were associated with increased odds of obesity. There is possibly a long-term joint effect of prenatal maternal smoke (smoking and SHS) exposure on obesity among adolescent offspring, and the effect is independent of birthweight. These findings suggest that adolescent obesity could possibly be curtailed with the development and promotion of smoking cessation programmes for families during the year before birth. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Impact of the Spanish smoking law on exposure to second-hand smoke and respiratory health in hospitality workers: a cohort study.

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Fernández, Esteve; Fu, Marcela; Pascual, José A; López, María J; Pérez-Ríos, Mónica; Schiaffino, Anna; Martínez-Sánchez, Jose M; Ariza, Carles; Saltó, Esteve; Nebot, Manel

2009-01-01

A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban. We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8%) were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, phospitality venues where smoking was totally banned. Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS or its consequences for respiratory health.

[Knowledge and attitudes towards second hand smoking among hospitality patronage in five cities in China].

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Liu, Rui-Ling; Yang, Yan; Liu, Xiu-Rong; Chang, Ai-Ling; Gong, Jie; Zhao, Bai-Fan; Liu, Tao; Jiang, Yuan; Hyland, Andrew; Li, Qiang

2008-05-01

To understand the knowledge and attitudes towards second hand smoking (SHS) among restaurant or bar patronage in five cities in China. 405 restaurants and bars were conveniently selected in 5 cities as Beijing, Wuhan, Xi'an, Kunming and Guiyang. From each of these hospitality venues, at least 3 patrons, including one smoker, one female non-smoker and one male nonsmoker were asked to answer a questionnaire on their knowledge and attitudes towards SHS and smoking policies in public places. 43.1% of the respondents had good knowledge on SHS hazards. 65% reported that those who smoked around them had never asked for their permission, and about 60% admitted that they had never asked others to stop smoking in front of them. There were almost two thirds of patrons reporting that they once felt discomfort of SHS in restaurants or bars, nearly half of whom chose to leave the venue to avoid exposure to SHS. Though majority of patrons supported '100% smoke-free hospitals, schools and public vehicles' initiations, the proportions of patrons that supporting '100% smoke-free restaurants and bars' initiations were only 30.0% and 19.8%, respectively. In Beijing, logistic regression model analyses showed that those who supporting 100% smoke-free restaurants and bars tended to be non-smokers, aged 25 years or older and to have had at least college education. Also in Beijing, those being female, having at least college education or non-smokers were more likely to choose restaurants and bars with smoking restrictions. Though knowledge on SHS hospitality patronage was still not high or popular for the public to refuse SHS exposure, banning smoking in hospitality venues was public's inclination and would become a trend in public health endeavor.

Parental smoking, exposure to secondhand smoke at home, and smoking initiation among young children.

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Wang, Man Ping; Ho, Sai Yin; Lam, Tai Hing

2011-09-01

To investigate the associations of parental smoking and secondhand smoke (SHS) exposure at home with smoking initiation among young children in Hong Kong. A prospective school-based survey of Hong Kong primary 2-4 students was conducted at baseline in 2006 and followed up in 2008. Self-administered anonymous questionnaires were used to collect information about smoking, SHS exposure at home, parental smoking, and sociodemographic characteristics. Cross-sectional and prospective associations of SHS exposure at home and parental smoking with student smoking were analyzed using logistic regression adjusting for potential confounders. Cross-sectional association between parental smoking and ever smoking was significant with adjustment of sociodemographic characteristics but became insignificant after adjusting for home SHS exposure. Home SHS exposure mediated the association between parental smoking and students smoking (p = .03). Prospectively, parental smoking was not associated with smoking initiation after adjusting for home SHS exposure. Each day increase in home SHS exposure significantly predicted 16% excess risk of smoking initiation after adjusting for parental smoking. The prospective effect of parental smoking on smoking initiation was significantly mediated by baseline home SHS exposure (p smoking initiation of young Chinese children in Hong Kong independent of parental smoking status. On the other hand, the effect of parental smoking on smoking initiation was mediated through SHS exposure at home. To prevent children from smoking as well as the harm of SHS exposure, parents and other family members should quit smoking or at least reduce smoking at home.

The Effect of a Pilot Pediatric In-Patient Department-Based Smoking Cessation Intervention on Parental Smoking and Children's Secondhand Smoke (SHS) Exposure in Guangxi, China.

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Huang, Kaiyong; Yang, Li; Winickoff, Jonathan P; Liao, Jing; Nong, Guangmin; Zhang, Zhiyong; Liang, Xia; Liang, Gang; Abdullah, Abu S

2016-11-08

Children's exposure to secondhand smoke (SHS) at home has numerous adverse health effects. This study evaluated the effects of a pediatric in-patient department-based pilot smoking cessation intervention for household members to reduce children's SHS exposure and encourage smoking cessation. A pre-post test design study was designed to assess the effectiveness of a telephone counseling intervention on household members of hospitalized children in pediatric departments. Data were collected with a standardized Chinese language questionnaire. At the three-month follow-up survey, the proportions of household members who reported adopting complete smoking restriction at home (55%), did not smoke at home at all (37%), did not allow others to smoke in the car (70%), or did not allow others to smoke around the child (57%) were significantly higher than the self-reported responses at the baseline survey. The proportions of household members who reported smoking at home (49%) and in the car (22%) were significantly lower than the baseline survey. Overall, 7% of the participants had reported quitting smoking after three months. Pediatric in-patient department-based telephone counseling for smoking cessation was found to be acceptable to Chinese parents. The intervention encouraged few parents to quit smoking, but encouraged more parents to take measures to reduce children's SHS exposure.

Second-hand smoke exposure among workers of restaurants, bars, and nightclubs in Lagos State

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Oluwakemi Ololade Odukoya

2017-01-01

Full Text Available Background: The Lagos State Regulation of Smoking Law was passed in February 2014 and stipulates the total restriction of tobacco smoking in listed public places. Workers in hospitality venues are at a high risk of exposure to second-hand smoke (SHS. Therefore, their awareness of the health risks, attitudes toward SHS and their reported levels of exposure may play a crucial role in developing an effective monitoring, implementation, and enforcement mechanism. Methods: We conducted a cross-sectional, descriptive study among workers in restaurants, bars, and nightclubs registered with the Lagos State Ministry of Tourism in the second quarter of the year 2014. We used a multistage sampling technique to select one respondent each from the 300 centers randomly selected to participate in the survey. Data were collected using a modified version of the World Health Organization Global tobacco surveillance system tools. Univariate and bivariate analysis were carried out. Exposure to SHS in the workplace and in other public places was treated as the outcome variable in the bivariate analysis. Results: Majority (75.3% of the respondents were aged between 21 and 40 years with a mean age of 27.7 + 8.6 years. Many (66% were waiters/waitresses and spent more than 8 h a day. Most (60.6% of the venues were indoor only establishments, and 26.8% had no form of smoking restrictions. Majority of the respondents were exposed to SHS at work, and this was higher in bars and nightclubs. A bivariate analysis of results showed that workers were exposed to SHS at work irrespective of workplace smoking restrictions or respondents smoking status. Conclusion: Our study demonstrates that second-hand smoke exposure is very high (65% in smokers; 65.6% in nonsmokers among workers in restaurants, bars, and nightclubs in Lagos State. We are therefore of the opinion that strict enforcement of law would ensure the protection of these workers.

The Effect of Second-Hand Smoke Exposure during Pregnancy on the Newborn Weight in Malaysia.

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Norsa'adah, Bachok; Salinah, Omar

2014-03-01

There was strong evidence from studies conducted in developed countries that second-hand smoke (SHS) exposure is detrimental to the birth weight of newborn. This study was conducted to determine the effect of exposure to SHS smoke during pregnancy on the weight of newborns. A retrospective cohort study was conducted. The exposed group consists of 209 postnatal women who experienced SHS exposure at home because of a husband or other housemate who smoked inside the house throughout the pregnancy. The non-exposed group included 211 women who did not experience SHS exposure at home or at work during pregnancy. We excluded non-Malay ethnicity, multiple births, and congenital defects. There was a significant difference in the adjusted mean birth weight between exposed infants [2893.0 g (95% confidence interval (CI): 2781.3, 3004.7)] and not exposed infants to SHS [3046.1 g (95% CI 2929.5, 3162.6) (P cigarette (P < 0.001). The incidence of low birth weight (LBW) was higher in exposed women, [10% (95% CI: 5.94, 14.06)] compared to non-exposed women [4.7% (95% CI: 1.85, 7.55)]. This study found a significant association between SHS exposure during pregnancy and decreased birth weight.

Smoking at workplace – Legislation and health aspect of exposure to second-hand tobacco smoke

Directory of Open Access Journals (Sweden)

Agnieszka Lipińska-Ojrzanowska

2015-12-01

Full Text Available Tobacco smoke contains thousands of xenobiotics harmful to human health. Their irritant, toxic and carcinogenic potential has been well documented. Passive smoking or exposure to second-hand smoke (SHS in public places, including workplace, poses major medical problems. Owing to this fact there is a strong need to raise workers’ awareness of smoking-related hazards through educational programs and to develop and implement legislation aimed at eliminating SHS exposure. This paper presents a review of reports on passive exposure to tobacco smoke and its impact on human health and also a review of binding legal regulations regarding smoking at workplace in Poland. It has been proved that exposure to tobacco smoke during pregnancy may lead to, e.g., preterm delivery and low birth weight, sudden infant death syndrome, lung function impairment, asthma and acute respiratory illnesses in the future. Exposure to tobacco smoke, only in the adult age, is also considered as an independent risk factor of cardiovascular diseases, acute and chronic respiratory diseases and cancer. Raising public awareness of tobacco smoke harmfulness should be a top priority in the field of workers’ health prevention. Occupational medicine physicians have regular contacts with occupationally active people who smoke. Thus, occupational health services have a unique opportunity to increase employees and employers’ awareness of adverse health effects of smoking and their prevention. Med Pr 2015;66(6:827–836

Bar workers' exposure to second-hand smoke: the effect of Scottish smoke-free legislation on occupational exposure.

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Semple, Sean; Maccalman, Laura; Naji, Audrey Atherton; Dempsey, Scott; Hilton, Shona; Miller, Brian G; Ayres, Jon G

2007-10-01

To examine changes in bar workers' exposure to second-hand smoke (SHS) over a 12-month period before and after the introduction of Scottish smoke-free legislation on the 26 March 2006. A total of 371 bar workers were recruited from 72 bars in three cities: Aberdeen, Glasgow, Edinburgh and small towns in two rural regions (Borders and Aberdeenshire). Prior to the introduction of the smoke-free legislation, we visited all participants in their place of work and collected saliva samples, for the measurement of cotinine, together with details on work patterns, self-reported exposure to SHS at work and non-work settings and smoking history. This was repeated 2 months post-legislation and again in the spring of 2007. In addition, we gathered full-shift personal exposure data from a small number of Aberdeen bar workers using a personal aerosol monitor for fine particulate matter (PM(2.5)) at the baseline and 2 months post-legislation visits. Data were available for 371 participants at baseline, 266 (72%) at 2 months post-legislation and 191 (51%) at the 1-year follow-up. The salivary cotinine level recorded in non-smokers fell from a geometric mean of 2.94 ng ml(-1) prior to introduction of the legislation to 0.41 ng ml(-1) at 1-year follow-up. Paired data showed a reduction in non-smokers' cotinine levels of 89% [95% confidence interval (CI) 85-92%]. For the whole cohort, the duration of workplace exposure to SHS within the last 7 days fell from 28.5 to 0.83 h, though some bar workers continued to report substantial SHS exposures at work despite the legislation. Smokers also demonstrated reductions in their salivary cotinine levels of 12% (95% CI 3-20%). This may reflect both the reduction in SHS exposure at work and falls in active cigarette smoking in this group. In a small sub-sample of bar workers, full-shift personal exposure to PM(2.5), a marker of SHS concentrations, showed average reductions of 86% between baseline and 2 months after implementation of the

Validity of self-reported exposure to second-hand smoke in hospitality venues.

Science.gov (United States)

Galán, Iñaki; Mayo, Elga; López, María J; Pérez-Ríos, Mónica; Fu, Marcela; Martínez-Sánchez, Jose M; Schiaffino, Anna; Moncada, Albert; Montes, Agustín; Nebot, Manel; Fernández, Esteve

2014-08-01

The aim was to assess the validity of self-reported exposure to second-hand smoke (SHS) in 50 hospitality venues of Madrid (Spain) in 2010, taking as a reference vapour-phase nicotine measured by active sampling. The questions posed in the questionnaire permitted distinguishing between the different levels of SHS. However, the moderate relationship found (Spearman׳s correlation=0.387, phospitality venues, based solely on self-reported information, should be used with caution. Copyright © 2014 Elsevier Inc. All rights reserved.

[Smoking at workplace - Legislation and health aspect of exposure to second-hand tobacco smoke].

Science.gov (United States)

Lipińska-Ojrzanowska, Agnieszka; Polańska, Kinga; Wiszniewska, Marta; Kleniewska, Aneta; Dörre-Kolasa, Dominika; Walusiak-Skorupa, Jolanta

2015-01-01

Tobacco smoke contains thousands of xenobiotics harmful to human health. Their irritant, toxic and carcinogenic potential has been well documented. Passive smoking or exposure to second-hand smoke (SHS) in public places, including workplace, poses major medical problems. Owing to this fact there is a strong need to raise workers' awareness of smoking-related hazards through educational programs and to develop and implement legislation aimed at eliminating SHS exposure. This paper presents a review of reports on passive exposure to tobacco smoke and its impact on human health and also a review of binding legal regulations regarding smoking at workplace in Poland. It has been proved that exposure to tobacco smoke during pregnancy may lead to, e.g., preterm delivery and low birth weight, sudden infant death syndrome, lung function impairment, asthma and acute respiratory illnesses in the future. Exposure to tobacco smoke, only in the adult age, is also considered as an independent risk factor of cardiovascular diseases, acute and chronic respiratory diseases and cancer. Raising public awareness of tobacco smoke harmfulness should be a top priority in the field of workers' health prevention. Occupational medicine physicians have regular contacts with occupationally active people who smoke. Thus, occupational health services have a unique opportunity to increase employees and employers' awareness of adverse health effects of smoking and their prevention. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

The Effect of a Pilot Pediatric In-Patient Department-Based Smoking Cessation Intervention on Parental Smoking and Children’s Secondhand Smoke (SHS Exposure in Guangxi, China

Directory of Open Access Journals (Sweden)

Kaiyong Huang

2016-11-01

Full Text Available Children’s exposure to secondhand smoke (SHS at home has numerous adverse health effects. This study evaluated the effects of a pediatric in-patient department-based pilot smoking cessation intervention for household members to reduce children’s SHS exposure and encourage smoking cessation. A pre-post test design study was designed to assess the effectiveness of a telephone counseling intervention on household members of hospitalized children in pediatric departments. Data were collected with a standardized Chinese language questionnaire. At the three-month follow-up survey, the proportions of household members who reported adopting complete smoking restriction at home (55%, did not smoke at home at all (37%, did not allow others to smoke in the car (70%, or did not allow others to smoke around the child (57% were significantly higher than the self-reported responses at the baseline survey. The proportions of household members who reported smoking at home (49% and in the car (22% were significantly lower than the baseline survey. Overall, 7% of the participants had reported quitting smoking after three months. Pediatric in-patient department-based telephone counseling for smoking cessation was found to be acceptable to Chinese parents. The intervention encouraged few parents to quit smoking, but encouraged more parents to take measures to reduce children’s SHS exposure.

Tobacco Use and Exposure to Second-Hand Smoke among Urban Residents: A Community-Based Investigation

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Zhaorui Xu

2015-08-01

Full Text Available Objectives: In 2005, China acceded to the World Health Organization Framework Convention on Tobacco Control (WHO FCTC, the foundation for the global fight against tobacco. Certain cities in China have established local regulations to control tobacco use ahead of national policy; however, without the enforcement of statutory law, some of these regulations are merely lip service. The aim of the study was to assess the effects of city policy on smoking prevalence and on second-hand smoke (SHS exposure status among non-smokers in Changchun City. Methods: A cross-sectional survey covering a multiple-stage, representative sample of the urban population aged ≥15 years was conducted between 1 Dec 2013 and 31 Jan 2014. The WHO and the US Centers for Disease Control and Prevention developed the questionnaires used, which included demographic characteristics, smoking behaviors and SHS exposure status. Results: Overall cigarette smoking prevalence was 23.5%; daily cigarette smoking prevalence was 21.2%. Smoking prevalence and cigarettes consumed per day was higher among men (p < 0.05 and those aged 45–64 years (p < 0.05. Among current smokers, 8.1% planned to quit within 12 months; 53.4% had no intention of quitting. Overall SHS exposure prevalence was 41.9% (workplace and 34.1% (at home over the previous 30 days. The weighted workplace SHS exposure prevalence increased with age. Conclusions: The high proportion of smokers with no intention of quitting and the high level of SHS exposure may constitute one of the most significant barriers to successful smoking cessation in the city. A continued drive to promote full implementation of the WHO FCTC is still needed.

Second-hand smoke exposure in 4-year-old children in Spain: Sources, associated factors and urinary cotinine.

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Aurrekoetxea, Juan José; Murcia, Mario; Rebagliato, Marisa; Guxens, Mònica; Fernández-Somoano, Ana; López, María José; Lertxundi, Aitana; Castilla, Ane Miren; Espada, Mercedes; Tardón, Adonina; Ballester, Ferran; Santa-Marina, Loreto

2016-02-01

Second-hand smoke exposure (SHS) in children remains as a major pollution problem, with important consequences for children's health. This study aimed to identify the sources of exposure to SHS among 4-year-old children, comparing self-reports to a urinary biomarker of exposure, and characterize the most important variables related to SHS exposure in this population. 4-year-old children's exposure to SHS was assessed by a parental-reported questionnaire and by urinary cotinine (UC) measurements in 1757 participants from 4 different areas of the Spanish INMA (INfancia y Medio Ambiente - Environment and Childhood) Project. The questionnaire about SHS included information about smoking habits at home by household members, and about exposure to SHS in other places including other homes, bars, restaurants or transportation. The association between quantified UC levels (>4ng/ml) and sociodemographic variables and the different sources of SHS exposure was examined using logistic regression. Based on parental reports, 21.6% of the children were exposed to SHS at home and 47.1% elsewhere; making a total 55.9% of the children exposed to SHS. In addition, 28.2% of the children whose parents reported being not regularly exposed to SHS had quantified UC values. Children from younger mothers (<34 vs. ≥39.4 y) had a higher odds of exposure to SHS [OR (95% CI): 2.28 (1.70-3.05) per year], as well as from families with a lower educational level [OR secondary: 2.12 (1.69-2.65); primary or less: 2.91 (2.19-3.88)]. The odds of quantifiable UC in children dropped after the smoking ban in public places [OR=0.59 (0.42-0.83)]. Regarding the sources of SHS exposure we observed that quantifiable UC odds was increased in children whose parents smoked at home in their presence [OR mother occasionally: 13.39 (7.03-25.50); mother often: 18.48 (8.40-40.66); father occasionally: 10.98 (6.52-18.49); father often: 11.50 (5.96-22.20)] or in children attending other confined places, mainly other

‘Only Fathers Smoking’ Contributes the Most to Socioeconomic Inequalities: Changes in Socioeconomic Inequalities in Infants’ Exposure to Second Hand Smoke over Time in Japan

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Saito, Junko; Tabuchi, Takahiro; Shibanuma, Akira; Yasuoka, Junko; Nakamura, Masakazu; Jimba, Masamine

2015-01-01

Background Exposure to second hand smoke (SHS) is one of the major causes of premature death and disease among children. While socioeconomic inequalities exist for adult smoking, such evidence is limited for SHS exposure in children. Thus, this study examined changes over time in socioeconomic inequalities in infants’ SHS exposure in Japan. Methods This is a repeated cross-sectional study of 41,833 infants born in 2001 and 32,120 infants born in 2010 in Japan from nationally representative surveys using questionnaires. The prevalence of infants’ SHS exposure was determined and related to household income and parental education level. The magnitudes of income and educational inequalities in infants’ SHS exposure were estimated in 2001 and 2010 using both absolute and relative inequality indices. Results The prevalence of SHS exposure in infants declined from 2001 to 2010. The relative index of inequality increased from 0.85 (95% confidence interval [CI], 0.80 to 0.89) to 1.47 (95% CI, 1.37 to 1.56) based on income and from 1.22 (95% CI, 1.17 to 1.26) to 2.09 (95% CI, 2.00 to 2.17) based on education. In contrast, the slope index of inequality decreased from 30.9 (95% CI, 29.3 to 32.6) to 20.1 (95% CI, 18.7 to 21.5) based on income and from 44.6 (95% CI, 43.1 to 46.2) to 28.7 (95% CI, 27.3 to 30.0) based on education. Having only a father who smoked indoors was a major contributor to absolute income inequality in infants’ SHS exposure in 2010, which increased in importance from 45.1% in 2001 to 67.0% in 2010. Conclusions The socioeconomic inequalities in infants’ second hand smoke exposure increased in relative terms but decreased in absolute terms from 2001 to 2010. Further efforts are needed to encourage parents to quit smoking and protect infants from second hand smoke exposure, especially in low socioeconomic households that include non-smoking mothers. PMID:26431400

Secondhand smoke exposure (SHS) and health-related quality of life (HRQoL) in Chinese never smokers in Hong Kong.

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Chen, Jing; Wang, Man-Ping; Wang, Xin; Viswanath, Kasisomayajula; Lam, Tai-Hing; Chan, Sophia S

2015-09-02

The evidence on the effect of secondhand smoke (SHS) on Health Related Quality of Life (HRQoL) is limited. We examined the relation between SHS and HRQoL among Chinese in Hong Kong. Adult never smokers from a probability sample of three cross-sectional waves (2010, 2012, 2013) of The Hong Kong Family and Health Information Trends Survey who completed the Cantonese-version of Short-Form 12 Health Survey Questionnaire (SF12v2) were included in the data analysis conducted in 2014. Models were used to examine associations of SHS with SF12 domains and summary scores of Physical (PCS12) and Mental Component (MCS12) with subgroups analysis by SHS locations. After adjustments, SHS was associated with lower scores on all SF12 domains except physical functioning. PCS12 (regress coefficient=-0.76, 95% CI -1.34 to -0.17) and MCS12 (regress coefficient=-1.35, 95% CI -2.06 to -0.64) were lower in those with SHS exposure than those non-exposed. Those exposed to SHS in outdoor public places had lower scores on most SF12 domains and PSC12 and MCS12. SHS exposure in one's home and workplace was associated with lower scores on role physical, body pain and role emotional while SHS exposure in friends' homes was additionally associated with lower social functioning and mental health scores. Lower MCS12 was associated with SHS exposure at all locations except one's home. Our study showed that SHS exposure, particularly in outdoor public places, was associated with decreased HRQoL. It can provide new evidence for stronger smoke-free policies on public places and promoting smoke-free homes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Impact of the Spanish smoking control law on exposure to second-hand smoke and respiratory health in hospitality workers: a cohort study

OpenAIRE

Fernández Muñoz, Esteve; Fu Balboa, Marcela; Pascual, José A.; López, María José; Pérez-Ríos, Mónica; Schiaffino, Anna; Martínez Sánchez, Jose M.; Ariza, Carles; Saltó i Cerezuela, Esteve; Nebot, Manel

2009-01-01

BACKGROUND: A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban. METHO...

Occupational exposure to second hand smoke and respiratory and sensory symptoms: A cross-sectional survey of hospital workers in Egypt

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Ghada Radwan

2014-02-01

Full Text Available Objective: Exposure to Second Hand Smoke (SHS has been associated with an increased risk of respiratory symptoms, upper and lower respiratory tract diseases and an increased risk of asthma and chronic obstructive pulmonary disease. The majority of cases of mortality and morbidity is attributable to exposure of adults to SHS and is related to cardiovascular diseases and lung cancer. In Egypt, comprehensive smoke-free laws exist, however, in many workplaces they are poorly enforced consequently exposing workers to the detrimental health hazards of SHS. We aimed at determination of workplace exposure to Second Hand Smoke (SHS and its association with respiratory and sensory irritation symptoms in hospital workers in Port-said governorate in Egypt. Material and methods: A cross-sectional face to face survey was conducted by the use of a standardised questionnaire among 415 adult hospital workers; representing 50% of all employees (81% response rate; recruited from 4 randomly selected general hospitals in Port-said governorate in Egypt. Results: All hospitals employees reported exposure to SHS - on average 1.5 (SD = 2.5 hours of exposure per day. After controlling for potential confounders, exposure to SHS at work was significantly associated with an increased risk of wheezes (OR = 1.14, p < 0.01, shortness of breath (OR = 1.17, p < 0.01, phlegm (OR = 1.23, p < 0.01, running and irritated nose (OR = 1.14, p < 0.01 as well as a sore, scratchy throat (OR = 1.23. Conclusions: These findings point out that workplace exposure to SHS is evident in hospitals in Port-said governorate and that workers are adversely affected by exposure to it at work. This underlines the importance of rigorous enforcement of smoke-free policies to protect the workers' health in Egypt.

Women exposed to second-hand smoke more at home than at workplace: An analysis of GATS Report, India, 2009-10

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Deepika Agrawal

2015-01-01

Full Text Available Background: Tobacco smoke has adverse health effects on women of the reproductive age group with serious health implications for the next generation. Objectives: This study assessed the prevalence of current active smoking, second-hand smoke (SHS exposure and the factors influencing smoke exposure in females of the reproductive age group. Materials and Methods: Data from the nationally representative Global Adult Tobacco Survey-India (GATS 2009 was analyzed for socio demographic variables, tobacco-related variables and knowledge variables. Results: 50.4% of the women in the reproductive age group had been exposed to SHS at home, though only 2.6% of the women were current active smokers. This was more than the SHS exposure at work (21.7% and elsewhere (32.6%. SHS exposure of the women at home did not vary significantly with knowledge of adverse effects of smoking but was affected by the place of dwelling as the smoke exposure was found to be more among rural women. Conclusion: SHS exposure is more prevalent than current active smoking in women of the reproductive age group and that too at home. Thus, policies need to be framed in order to curb this menace which is a vicious one as women don′t really have an alternative as far as this exposure is concerned.

Impact of the Spanish smoking law on exposure to second-hand smoke and respiratory health in hospitality workers: a cohort study.

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Esteve Fernández

Full Text Available BACKGROUND: A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS exposure and the frequency of respiratory symptoms before and one year after the ban. METHODS AND FINDING: We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8% were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, p<0.01. Cotinine concentration decreased by 27.6% (p = 0.068 among workers in venues with designated smoking areas, and by 10.7% (p = 0.475 among workers in venues where smoking was allowed. In Portugal and Andorra, no differences between cotinine concentration were found before (1.2 ng/ml and after the ban (1.2 ng/ml. In Spain, reported respiratory symptom declined significantly (by 71.9%; p<0.05 among workers in venues that became smoke-free. After adjustment for potential confounders, salivary cotinine and respiratory symptoms decreased significantly among workers in Spanish hospitality venues where smoking was totally banned. CONCLUSIONS: Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS

‘Only Fathers Smoking’ Contributes the Most to Socioeconomic Inequalities: Changes in Socioeconomic Inequalities in Infants’ Exposure to Second Hand Smoke over Time in Japan

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Saito, Junko; Tabuchi, Takahiro; Shibanuma, Akira; Yasuoka, Junko; Nakamura, Masakazu; Jimba, Masamine

2015-01-01

Background Exposure to second hand smoke (SHS) is one of the major causes of premature death and disease among children. While socioeconomic inequalities exist for adult smoking, such evidence is limited for SHS exposure in children. Thus, this study examined changes over time in socioeconomic inequalities in infants’ SHS exposure in Japan. Methods This is a repeated cross-sectional study of 41,833 infants born in 2001 and 32,120 infants born in 2010 in Japan from nationally representative su...

The UCB particle monitor: A tool for logging frequency of smoking and the intensity of second-hand smoke concentrations in the home

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Semple, Sean; Apsley, Andrew; Moir, Gill; Henderson, George; Ayres, Jon, E-mail: sean.semple@abdn.ac.u [Department of Environmental and Occupational Medicine, Liberty Safe Work Research Centre, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZP (United Kingdom)

2009-02-01

Second-hand tobacco smoke (SHS) exposure generates a large public health burden. Recent legislation has moved to prohibit smoking in public places and there are concerns that this may lead to an increase in exposures in private homes. Measurement of SHS aerosol has tended to use active pumped samples or longer-term diffusive badges. Pumped methods are noisy and poorly tolerated in home settings while diffusive badges do not provide real-time data. The UCB particle monitor (UCB-PM) is a modified smoke-alarm device capable of logging changes in airborne particulate matter over extended periods and has been used successfully to measure biomass fuel smoke concentrations in developing world settings This study has examined the use of the UCB-PM to measure SHS aerosol in both controlled laboratory conditions and a pilot field trial over a 7 day period in a smoker's home. Comparisons with a pumped sampler (TSI Sidepak Personal Aerosol Monitor) indicate good agreement over a range of exposure concentrations but there is evidence of a threshold effect at approximately 0.5 mg/m{sup 3} of fine particulate measured as PM{sub 2.5}. While this threshold effect undermines the ability of the device to provide useful data on the time-weighted average SHS concentration, the field trial indicates that that the UCB-PM has a sensitivity of about 71% and a specificity of 98%. The device has many advantages including zero noise operation, low cost and long battery life and may be a useful tool in quitting and smoke-free home intervention studies.

The TackSHS project - a collaborative H2020 project

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Esteve Fernandez

2016-03-01

Full Text Available TackSHS is a new research project funded by the European Union’s Horizon 2020 Research and Innovation Programme. It aims to improve our understanding of second-hand tobacco smoke and e-cigarette emissions and find ways of tackling the health burden caused by exposure to them. Within a fast changing environment, the project will try to elucidate the comprehensive impact that SHS and e-cigarette aerosols have on respiratory health of the European population and how health impacts vary according to socio-economic parameters with particular emphasis on specific vulnerable groups such as patients suffering from chronic lung diseases.

Do Clinicians Ask Pregnant Women about Exposures to Tobacco and Cannabis Smoking, Second-Hand-Smoke and E-Cigarettes? An Australian National Cross-Sectional Survey.

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Gould, Gillian S; Zeev, Yael Bar; Tywman, Laura; Oldmeadow, Christopher; Chiu, Simon; Clarke, Marilyn; Bonevski, Billie

2017-12-16

Clinicians often ask pregnant women about tobacco smoking, but their practices of asking about other smoking and nicotine exposures are unknown. This study analysed how often clinicians ask pregnant women about their use of e-cigarettes, cannabis, chewing tobacco, and second-hand smoke (SHS) exposure. Two cross-sectional surveys were undertaken. A random sample of 500 General Practitioner (GP) members were invited from the National Faculty of Aboriginal and Torres Strait Islander Health (NFATSIH) to complete an on-line survey, and 5571 GP and Obstetrician (OBS) members of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) were sent a paper survey by mail. Questions on frequency of asking about the exposures used Likert Scales, later dichotomized to "often-always" and "never-sometimes". Logistic regressions estimated associations between clinician type and asking about cannabis, e-cigarettes, chewing tobacco, and SHS. An adjusted model reduced potential confounders of location, guidelines, gender and population. n = 378 GPs and OBS participated (6.2% response). In total, 13-14% asked "often-always" about e-cigarettes; 58% cannabis; 38% cannabis with tobacco; 27% SHS, and 10% chewing tobacco-compared to 95% of the sample asking about cigarette smoking. After adjustment, the odds of RANZCOG GPs (OR 0.34) and OBS (OR 0.63) asking about cannabis were lower compared to NFATSIH GPs. Clinician type was non-significant for asking about e-cigarettes, chewing tobacco and SHS. Surveyed Australian GPs and obstetricians asked less frequently about e-cigarettes, chewing, SHS exposure, and cannabis, potentially missing important exposures for mother and child.

[Second-hand smoke exposure in hospitality venues in Barcelona: measurement of respirable particles].

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Villarroel, Nazmy; López, María José; Sánchez-Martínez, Francesca; Fernández, Esteve; Nebot, Manel

2011-01-01

To quantify the concentration of respirable particles equal to or smaller than 2.5μm (PM(2.5)) as a marker of second-hand smoke (SHS) exposure in a sample of hospitality venues in Barcelona 2 years after the Spanish smoking law came into effect. We performed a cross-sectional descriptive study from October to December 2007. The study population consisted of 40 hospitality venues in Barcelona selected by a random route sampling, with representation of the different types of smoking regulation included in the law (smoking allowed, smoking ban and venues with smoking areas). SHS levels were quantified by measuring PM(2.5) concentrations, which were measured using a laser photometer (Side Pack AM 510 Personal Aerosol Monitor). The measurements were carried out for 5 minutes outside the venue and for 30 minutes inside the venue. In addition, observational variables related to the characteristics of the venue and signs of tobacco consumption were recorded. The concentration of PM(2.5) in venues where smoking was still allowed was five times higher than that in venues where smoking was banned (182μg/m(3) and 34μg/m(3), respectively) and exceeded the concentration established by the US Environmental Protection Agency (EPA) as harmful (35μg/m(3)). However, in venues where smoking was banned, the concentration was lower than the EPA standard and there were no significant differences with the outdoor PM(2.5) concentration. Two years after the introduction of the Spanish smoking law, SHS exposure in venues where smoking was allowed was q still very high, representing a significant health risk for hospitality workers. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Smoke-free policies and non-smokers’ reactions to SHS exposure in small and medium enterprises

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Calliopi Sivri

2013-12-01

Full Text Available Introduction: Non-smoker employees can significantly improve the existing smoke-free policies in the workplace by asserting their right for smoke-free air and confronting smoker colleagues. The aim of the study was to assess the psychological and social drivers of non-smokers' readiness to assert their right for smoke-free air in the workplace. Materials and Methods: Twenty-six small-and-medium enterprises (SME with diverse background were randomly selected, and 284 employees agreed to participate in the study. Our study focused on the responses of 85 non-smokers (M age = 34 years, SD = 7.98, 84.2% worked in indoor offices. A cross-sectional design was used and participants completed a structured anonymous questionnaire assessing background and demographic characteristics, and psychosocial predictors of assertiveness intentions. Results: Although more than half of non-smokers reported they were often/almost always bothered by exposure to SHS, roughly one third of them reported having asked their colleagues not to smoke at work. Regression analysis showed that the effects of distal predictors (i.e. annoyance due to SHS exposure were mediated by past behaviour, attitudes (protection motivation beliefs, social norms, and self-efficacy. Conclusions: Health beliefs related to SHS exposure, and concerns about workplace health and job performance, social norms and self-efficacy can increase the assertiveness of non-smokers in workplace settings. Related campaigns should focus on communicating normative messages and self-efficacy training to empower non-smoker employees to act assertively towards protecting their smoke-free rights.

Everyday Prospective Memory and Executive Function Deficits Associated with Exposure to Second-Hand Smoke

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Thomas M. Heffernan

2013-01-01

Full Text Available This study explored whether exposure to second-hand smoke (SHS has a detrimental impact upon everyday memory in two groups of non-smokers; one which reported regular exposure to SHS and one that reported never having been exposed to SHS. Thirty-four non-smokers who reported having been regularly exposed to SHS (SHS group and 34 non-smokers who reported never having been exposed to SHS (non-SHS group were compared on self-reports of prospective memory (PM: remembering future intentions and/or activities and executive function (EF: those processes involved in attention, multitasking and decision-making. The Prospective and Retrospective Memory Questionnaire (PRMQ assessed everyday PM lapses; the Executive Function Questionnaire (EFQ assessed self-reported problems in EF; a drug-use questionnaire and a mood questionnaire were also administered. Two univariate ANCOVAs were applied to the PM and EF data, controlling for between-group differences in age, weekly alcohol use, anxiety and depression scores, and self-reported retrospective memory scores. The SHS group reported significantly more lapses on the PRMQ and more deficits on the EFQ than the non-SHS group. These findings provide new insights into PM and EF deficits associated with prolonged exposure to SHS in a group of non-smokers. Possible explanations and suggestions for future research are also considered.

Children's exposure to second-hand smoke in the home: a household survey in the North of England.

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Alwan, Nisreen; Siddiqi, Kamran; Thomson, Heather; Cameron, Ian

2010-05-01

Exposure of children to second-hand smoke (SHS) leads to increased risk of health and social problems and uptake of smoking in the future. We aimed to assess the prevalence of children's exposure to SHS in their homes, in a deprived area in the North of England and identify what people thought would help them achieve a smoke-free home (SFH). We performed a cross-sectional survey of 318 households with at least one child aged under 16 years in Beeston Hill, a deprived locality in Leeds, England in June 2008. One hundred and seventy-three households [54%, 95% confidence interval (C.I.) 49-60] had at least one smoker in the house. In 42% (95% C.I. 35-50) of these households (n = 73), smoking took place in the presence of children. The odds of allowing smoking in front of children were 2.2 (95% C.I. 1.1-4.5) times greater in households whose head had less than A-level (national exams at 18 years) or equivalent qualification than in homes with a more qualified head of household. 92% of respondents were aware that SHS has negative effects on children's health. However, 71% felt more information about health risks to children would help reduce exposure to SHS in the home. Smoking in the presence of children takes place in a relatively high proportion of households with smoker(s), despite media awareness campaigns regarding the dangers of passive smoking launched alongside the recently enforced smoke-free public and workplaces legislation. Specific promotion of SFHs is needed to protect the health of children.

Do Clinicians Ask Pregnant Women about Exposures to Tobacco and Cannabis Smoking, Second-Hand-Smoke and E-Cigarettes? An Australian National Cross-Sectional Survey

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Gillian S. Gould

2017-12-01

Full Text Available Clinicians often ask pregnant women about tobacco smoking, but their practices of asking about other smoking and nicotine exposures are unknown. This study analysed how often clinicians ask pregnant women about their use of e-cigarettes, cannabis, chewing tobacco, and second-hand smoke (SHS exposure. Two cross-sectional surveys were undertaken. A random sample of 500 General Practitioner (GP members were invited from the National Faculty of Aboriginal and Torres Strait Islander Health (NFATSIH to complete an on-line survey, and 5571 GP and Obstetrician (OBS members of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG were sent a paper survey by mail. Questions on frequency of asking about the exposures used Likert Scales, later dichotomized to “often-always” and “never-sometimes”. Logistic regressions estimated associations between clinician type and asking about cannabis, e-cigarettes, chewing tobacco, and SHS. An adjusted model reduced potential confounders of location, guidelines, gender and population. n = 378 GPs and OBS participated (6.2% response. In total, 13–14% asked “often-always” about e-cigarettes; 58% cannabis; 38% cannabis with tobacco; 27% SHS, and 10% chewing tobacco—compared to 95% of the sample asking about cigarette smoking. After adjustment, the odds of RANZCOG GPs (OR 0.34 and OBS (OR 0.63 asking about cannabis were lower compared to NFATSIH GPs. Clinician type was non-significant for asking about e-cigarettes, chewing tobacco and SHS. Surveyed Australian GPs and obstetricians asked less frequently about e-cigarettes, chewing, SHS exposure, and cannabis, potentially missing important exposures for mother and child.

Recent Contributions of Air- and Biomarkers to the Control of Secondhand Smoke (SHS): A Review

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Prignot, Jacques J.

2011-01-01

Since the publication of the US Surgeon General Reports in 1996 and 2006 and the report of the California Environmental Protection Agency in 1999, many reports have appeared on the contribution of air and biomarkers to different facets of the secondhand smoke (SHS) issue, which are the targets of this review. These recent studies have allowed earlier epidemiological surveys to be biologically validated, and their plausibility demonstrated, quantified the levels of exposure to SHS before the bans in various environments, showed the deficiencies of mechanical control methods and of partial bans and the frequently correct implementation of the efficient total bans. More stringent regulation remains necessary in the public domain (workplaces, hospitality venues, transport sector, etc.) in many countries. Personal voluntary protection efforts against SHS are also needed in the private domain (homes, private cars). The effects of SHS on the cardiovascular, respiratory and neuropsychic systems, on pregnancy and fertility, on cancers and on SHS genotoxicity are confirmed through experimental human studies and through the relationship between markers and prevalence of disease or of markers of disease risk. PMID:21556172

Recent Contributions of Air- and Biomarkers to the Control of Secondhand Smoke (SHS: A Review

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Jacques J. Prignot

2011-03-01

Full Text Available Since the publication of the US Surgeon General Reports in 1996 and 2006 and the report of the California Environmental Protection Agency in 1999, many reports have appeared on the contribution of air and biomarkers to different facets of the secondhand smoke (SHS issue, which are the targets of this review. These recent studies have allowed earlier epidemiological surveys to be biologically validated, and their plausibility demonstrated, quantified the levels of exposure to SHS before the bans in various environments, showed the deficiencies of mechanical control methods and of partial bans and the frequently correct implementation of the efficient total bans. More stringent regulation remains necessary in the public domain (workplaces, hospitality venues, transport sector, etc. in many countries. Personal voluntary protection efforts against SHS are also needed in the private domain (homes, private cars. The effects of SHS on the cardiovascular, respiratory and neuropsychic systems, on pregnancy and fertility, on cancers and on SHS genotoxicity are confirmed through experimental human studies and through the relationship between markers and prevalence of disease or of markers of disease risk.

Second-hand smoke: a neglected public health challenge.

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Singh, Rana J; Lal, Pranay G

2011-01-01

Exposure to secondhand smoke (SHS) causes an estimated 5% of the global burden of disease, slightly higher than the burden from direct use of tobacco. This review highlights the urgent need to address this ignored public health issue by presenting the evidence and impact of SHS on those exposed using global studies including those from the South-East Asia Region. The burden of morbidity from SHS exposure is higher in low-income countries in Southeast Asia region compared to the rest of the world. SHS exposure affects those most vulnerable, especially women and children. While several countries in the region have enacted legislation which offer protection to those exposed to SHS, most measures are partial and inadequate. As a result, implementation and compliance at national and sub-national level within the countries of the Southeast Asia region is variable. Governments must ensure that legislation mandates comprehensive smoke-free environments in order to provide public health benefit which offers universal protection to everyone and everywhere. Where comprehensive legislation exists, stringent implementation and enforcement, along with awareness building, education and monitoring through regular compliance studies must be done to sustain smokefree status of public places within jurisdictions.

Parents’ educational level and second-hand tobacco smoke exposure at home in a sample of Portuguese children

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Paulo D. Vitória

2017-07-01

Full Text Available Second-hand tobacco smoke (SHS exposure is a major and entirely avoidable health risk for children's health, well-being and development. The main objective of the current study was to investigate the association between parents’ educational level and children's SHS home exposure.A self-administered questionnaire was conducted within a sample of 949 students in 4th grade (mean age 9.56 ± 0.75, 53.4% male. The sample was randomly selected from all schools located at Lisbon District, Portugal.The current study confirmed that Portuguese children are exposed to unacceptable high levels of SHS at home, mainly by their parents’ smoke. Prevalence of smokers was higher amongst parents with low educational level. Children of parents with low educational level were more likely to suffer SHS exposure at home. These results confirmed the social inequalities associated with smoking, support the relevance of more research on this subject and stress the need for more interventions to control this problem. Some interventions should be specifically aimed at less educated parents, particularly at less educated mothers. Keywords: Air pollution, Health promotion, Parenting, Pediatrics, Poverty, Preventive medicine, Public health practice, Risk factors, Smoking, Tobacco

[The prevalence of exposure of children under the age of 18 to second-hand smoke inside motor vehicles].

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Pedrol, M T; Tolosana, M; Soler, M T; Taló, M; Godoy, P

2013-12-01

The objective of the study was to estimate the level of exposure of children under the age of 18 to second-hand smoke (SHS) inside motor vehicles. A prevalence study was conducted on the exposure of children under the age of 18 to SHS in motor vehicles in Lleida (Spain). The population was the users of private motor vehicles. The sample was random, and the data were collected by direct observation. The study variables were: the age and sex of the driver, whether the driver was smoking, and the presence of an exposed passenger under the age of 18. A total of 1600 vehicles were observed, 134 of which (8.4%) were carrying a child. In 8 of these 134 vehicles (6%; 95% CI: 2.5-11.0) a child was exposed to SHS. In all these cases, the driver was a male (P=0.02), and in 75% of cases he was over 40 years old. The rate of child exposure to SHS is very high. There is, therefore, a case for organising campaigns to prevent smoking tobacco inside motor vehicles in the presence of children in Spain. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Within family transmission of secondhand smoke sensitivity and smoking attitude

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David Laszlo Tarnoki

2014-11-01

Full Text Available [b]introduction and objective[/b]. The role of genetic factors in nicotine dependence is well understood, but no information is available on the inheritability of second-hand smoke (SHS exposure sensitivity and their co-variance. [b]materials and methods[/b]. 186 adult same-gender pairs of twin (146 monozygotic, 40 dizygotic; 44±17 years±SD completed a questionnaire. [b]results[/b]. The model showed a significant role of unshared environmental factors influencing the co-variance between smoking habit and SHS sensitivity (r[sub]e[/sub]=-0.191, 95% CI, -0.316 to -0.056, or the total phenotypic correlation of r[sub]ph[/sub]=-0.406, p<0.001 without evidence for genetic covariation. Age, gender and country-adjusted analysis indicated 51.5% heritability for smoking habit (95% confidence interval/CI/, 6.2 to 89.8%, 49.7% for SHS sensitivity (95%CI, 19.1–72.0%, 35.5% for general opinions on SHS exposure in restaurants/cafés (95%CI, 10.7–58.6%, and 16.9% in pubs/bars (95%CI, 0.0–49.0%. [b]conclusions[/b]. The co-variance between SHS sensitivity and smoking habits is driven mainly by the unshared environment. SHS sensitivity is moderately inheritable. The considerable influence of environmental factors on general opinions on SHS exposure in designated indoor public venues emphasizes the importance of smoking bans and health behaviour interventions at the individual level in developing an anti-smoking attitude.

Inhibition of the receptor for advanced glycation end-products (RAGE) protects from secondhand smoke (SHS)-induced intrauterine growth restriction IUGR in mice.

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Lewis, Joshua B; Mejia, Camilo; Jordan, Clinton; Monson, Troy D; Bodine, Jared S; Dunaway, Todd M; Egbert, Kaleb M; Lewis, Adam L; Wright, Tanner J; Ogden, K Connor; Broberg, Dallin S; Hall, Parker D; Nelson, Shawn M; Hirschi, Kelsey M; Reynolds, Paul R; Arroyo, Juan A

2017-12-01

Intrauterine growth restriction (IUGR) is a disease affecting 10% of all pregnancies. IUGR is associated with maternal, fetal, or placental abnormalities. Studies investigating the effects of secondhand smoke (SHS) exposure and IUGR are limited. The receptor for advanced glycation end-products (RAGE) is a pro-inflammatory transmembrane receptor increased by SHS in the placenta. We tested the hypothesis that inhibition of RAGE during SHS exposure protects from smoke-induced IUGR. C57BL/6 mice were exposed to SHS or SHS + semi-synthetic glycosaminoglycan ethers (SAGEs) known to inhibit RAGE signaling. Trophoblast cells were treated with cigarette smoke extract (CSE) with or without SAGEs in order to address the effects of RAGE inhibition during trophoblast invasion in vitro. SHS-treated mice demonstrated a significant reduction in fetal weight (7.35-fold, P ≤ 0.0001) and placental weight (1.13-fold, P ≤ 0.0001) compared with controls. Mice co-treated with SHS and SAGEs were protected from SHS-induced fetal weights decreases. SHS treatment of C57BL/6 mice activated placental extracellular signal-regulated kinase (ERK) (3.0-fold, P ≤ 0.05), JNK (2.4-fold, P ≤ 0.05) and p38 (2.1-fold, P ≤ 0.05) and the expression of inflammatory mediators including TNF-α (1.34-fold, P ≤ 0.05) and IL-1β (1.03-fold, P ≤ 0.05). SHS-mediated activation of these molecules was reduced to basal levels when SAGE was co-administered. Invasion of trophoblast cells decreased 92% (P < 0.002) when treated with CSE and CSE-mediated invasion was completely reversed by SAGEs. We conclude that RAGE inhibition protects against fetal weight loss during SHS-induced IUGR. These studies provide insight into tobacco-mediated IUGR development and clarify avenues that may be helpful in the alleviation of placental complications.

Towards estimating the burden of disease attributable to second-hand smoke exposure in Polish children

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Dorota Jarosińska

2014-02-01

Full Text Available Objectives: To estimate the burden of disease attributable to second-hand smoke (SHS exposure in Polish children in terms of the number of deaths and disability adjusted life years (DALYs due to lower respiratory infections (LRI, otitis media (OM, asthma, low birth weight (LBW and sudden infant death syndrome (SIDS. Materials and Methods: Estimates of SHS exposure in children and in pregnant women as well as information concerning maternal smoking were derived from a national survey, the Global Youth Tobacco Survey, and the Global Adult Tobacco Survey in Poland. Mortality data (LRI, OM, asthma, and SIDS, the number of cases (LBW, and population data were obtained from national statistics (year 2010, and DALYs came from the WHO (year 2004. The burden of disease due to SHS was calculated by multiplying the total burden of a specific health outcome (deaths or DALYs by a population attributable fraction. Results: Using two estimates of SHS exposure in children: 48% and 60%, at least 12 and 14 deaths from LRI in children aged up to 2 years were attributed to SHS, for the two exposure scenarios, respectively. The highest burden of DALYs was for asthma in children aged up to 15 years: 2412, and 2970 DALYs, for the two exposure scenarios, respectively. For LRI, 419 and 500 DALYs, and for OM, 61 and 77 DALYs were attributed to SHS, for the two exposure scenarios, respectively. Between 13% and 27% of SIDS cases and between 3% and 16% of the cases of LBW at term were attributed to SHS exposure. Conclusions: This study provides a conservative estimate of the public health impact of SHS exposure on Polish children. Lack of comprehensive, up to date health data concerning children, as well as lack of measures that would best reflect actual SHS exposure are major limitations of the study, likely to underestimate the burden of disease.

The impact of multiple interventions to reduce household exposure to second-hand tobacco smoke among women: a cluster randomized controlled trial in Kalutara district, Sri Lanka

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A. M. A. A. P. Alagiyawanna

2017-10-01

Full Text Available Abstract Background Second-hand smoke (SHS in households remains a serious public health problem in Sri Lanka, partly due to a lack of voluntary prohibitions of tobacco smoking inside houses. Women are especially at risk of being exposed. Effective community based interventions to reduce the SHS in households targeting women is scarce. The objective of this study was to examine the impact of a multi-component intervention on household SHS exposure among Sri Lankan women. Methods Thirty clusters of 25 women (aged 18–65 from 750 households were randomized into the intervention and control groups. Women in the intervention group were exposed to activities which focused on improving knowledge on the health effects of SHS, attitudes towards SHS exposure, right to a smoke-free living and women empowerment against smoking. The duration of the intervention was six months. The comparison group received no intervention. The primary outcome of interest was self-reported SHS exposure in the household within 7 days prior to data collection. The secondary outcomes were exposure in the past 30 days, knowledge of the health risks of exposure, attitudes towards exposure, right to smoke-free living, women empowerment against smoking, and smoking inside the homes. Results Final assessment was in 329 (89.6% in the intervention group and 309 (85.8% in the comparison group. Following the intervention, significantly lower proportion of women in the intervention group as compared to the control group reported SHS exposure in their households within 7-days (9.2% vs. 15.3%, p = 0.02 and 30-days (13.6% vs. 21.6%, p = 0.008 prior to the post survey. As compared to the control group, significantly higher median scores were observed in the intervention group on the knowledge of the health risks of exposure to SHS (p < 0.001, attitudes on exposure to SHS (p = 0.004, right to smoke free living (p = 0.001 and women empowerment (p < 0.001. Conclusion Multi

Policies on smoking in the casino workplace and their impact on smoking behavior among employees: Case study of casino workers in Macao

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Chan, S. H.; Pilkington, P.; Wan, Y. K. P.; Faculty of Business Administration, University of Macao; Institute for Sustainability, Health and Environment, UWE

2012-01-01

Exposure to second hand smoke (SHS) is a major health concern, contributing to a range of adverse health effects. Workers in the hospitality industry are often exposed to increased levels of SHS in the workplace, and casino workers in particular have been shown to be exposed to high levels of SHS. During the past decade, authorities worldwide have introduced smoke-free legislation in enclosed public places, primarily to protect workers from the harmful effects of SHS. Importantly, implementat...

Knowledge and opinion about smoke-free laws and second-hand smoke among hospitality venue managers in Gujarat and Andhra Pradesh, India.

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Gupta, Vinay K; Arora, Monika; Sharma, Indrani; Nazar, Gaurang P; Modi, Bhavesh; Singh, Deepti; Millett, Christopher; Reddy, K Srinath

2013-01-01

India's Smoke-Free Law (SFL) was implemented in 2004 and reinforced on 2nd October 2008. This research attempts to understand the knowledge and opinion of hospitality venue (HV) managers about second-hand smoke (SHS) and SFL as well as self-reported compliance with SFL in two Indian states. A survey was conducted among 804 randomly sampled HVs from project STEPS (Strengthening of tobacco control efforts through innovative partnerships and strategies) in Gujarat and Andhra Pradesh, India. Four hundred and three HVs from two districts in Gujarat and 401 HVs from six districts in Andhra Pradesh were selected. The owner, manager or supervisor of each HV was interviewed using a pre-tested structured interview schedule. Association of opinion scales with respondents' background characteristics was assessed through the analysis of variance (ANOVA) method. Out of the 403 respondents in Gujarat and 401 in Andhra Pradesh, 56.1% and 84.3% had knowledge about SFL respectively. Compliance of HVs with SFL was 21.8% in Gujarat and 31.2% in Andhra Pradesh as reported by the managers. Knowledge about SHS was noted among 39.7% of respondents in Gujarat and 25.4% in Andhra Pradesh. Bivariate results indicated that more educated HV managers showed higher support for smoke-free public places (P < 0.001) and were more concerned about the health effects of SHS exposure (P = 0.002). Complete self-reported compliance with, and knowledge of SFL as well as SHS was not found in Gujarat and Andhra Pradesh. The education level of HV managers is an important determinant to ensure compliance with SFL in public places.

Trends in Second-Hand Tobacco Smoke Exposure Levels at Home among Viet Nam School Children Aged 13-15 and Associated Factors.

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Lam, Nguyen Tuan; Nga, Pham Thi Quynh; Minh, Hoang Van; Giang, Kim Bao; Hai, Phan Thi; Huyen, Doan Thu; Linh, Nguyen Thuy; Van, Duong Khanh; Khue, Luong Ngoc

2016-01-01

Second-hand tobacco smoke (SHS) exposure at home, especially among children, is a serious issue in Viet Nam. During the past decade, much effort has been taken for tobacco control in the country, including various prgorammes aiming to reduce SHS exposure among adults and children. This article analysed trends and factors associated with SHS exposure at home among school children aged 13-15 in Viet Nam, using the Global Youth Tobacco Surveys conducted in 2007 and 2014. Descriptive and inferential statistical methods with logistic regression were applied. Overall, there was a significant reduction in the level of exposure, from 58.5% (95%CI: 57.6-59.3) in 2007 to 47.1% (95%CI: 45.4-48.8) in 2014. Of the associated factors, having one or both parents smoking was significantly associated with the highest odds of SHS exposure at home (OR=5.0; 95%CI: 4.2-6.1). Conversely, having a mother with a college or higher education level was found to be a protective factor (OR=0.5; 95%CI: 0.3-0.8).

Potential pathways by which maternal second-hand smoke exposure during pregnancy causes full-term low birth weight.

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Niu, Zhongzheng; Xie, Chuanbo; Wen, Xiaozhong; Tian, Fuying; Yuan, Shixin; Jia, Deqin; Chen, Wei-Qing

2016-04-29

It is well documented that maternal exposure to second-hand smoke (SHS) during pregnancy causes low birth weight (LBW), but its mechanism remains unknown. This study explored the potential pathways. We enrolled 195 pregnant women who delivered full-term LBW newborns, and 195 who delivered full-term normal birth weight newborns as the controls. After controlling for maternal age, education level, family income, pre-pregnant body mass index, newborn gender and gestational age, logistic regression analysis revealed that LBW was significantly and positively associated with maternal exposure to SHS during pregnancy, lower placental weight, TNF-α and IL-1β, and that SHS exposure was significantly associated with lower placental weight, TNF-α and IL-1β. Structural equation modelling identified two plausible pathways by which maternal exposure to SHS during pregnancy might cause LBW. First, SHS exposure induced the elevation of TNF-α, which might directly increase the risk of LBW by transmission across the placenta. Second, SHS exposure first increased maternal secretion of IL-1β and TNF-α, which then triggered the secretion of VCAM-1; both TNF-α and VCAM-1 were significantly associated with lower placental weight, thus increasing the risk of LBW. In conclusion, maternal exposure to SHS during pregnancy may lead to LBW through the potential pathways of maternal inflammation and lower placental weight.

Health Impact Assessment for Second-Hand Smoke Exposure in Germany—Quantifying Estimates for Ischaemic Heart Diseases, COPD, and Stroke

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Florian Fischer

2016-02-01

Full Text Available Evidence of the adverse health effects attributable to second-hand smoke (SHS exposure is available. This study aims to quantify the impact of SHS exposure on ischaemic heart diseases (IHD, chronic obstructive pulmonary diseases (COPD, and stroke in Germany. Therefore, this study estimated and forecasted the morbidity for the three outcomes in the German population. Furthermore, a health impact assessment was performed using DYNAMO-HIA, which is a generic software tool applying a Markov model. Overall 687,254 IHD cases, 231,973 COPD cases, and 288,015 stroke cases were estimated to be attributable to SHS exposure in Germany for 2014. Under the assumption that the population prevalence of these diseases and the prevalence of SHS exposure remain constant, the total number of cases will increase due to demographic aging. Assuming a total eradication of SHS exposure beginning in 2014 leads to an estimated reduction of 50% in cases, compared to the reference scenario in 2040 for all three diseases. The results highlight the relevance of SHS exposure because it affects several chronic disease conditions and has a major impact on the population’s health. Therefore, public health campaigns to protect non-smokers are urgently needed.

Impact of a smoking ban in hospitality venues on second hand smoke exposure: a comparison of exposure assessment methods.

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Rajkumar, Sarah; Huynh, Cong Khanh; Bauer, Georg F; Hoffmann, Susanne; Röösli, Martin

2013-06-04

In May 2010, Switzerland introduced a heterogeneous smoking ban in the hospitality sector. While the law leaves room for exceptions in some cantons, it is comprehensive in others. This longitudinal study uses different measurement methods to examine airborne nicotine levels in hospitality venues and the level of personal exposure of non-smoking hospitality workers before and after implementation of the law. Personal exposure to second hand smoke (SHS) was measured by three different methods. We compared a passive sampler called MoNIC (Monitor of NICotine) badge, to salivary cotinine and nicotine concentration as well as questionnaire data. Badges allowed the number of passively smoked cigarettes to be estimated. They were placed at the venues as well as distributed to the participants for personal measurements. To assess personal exposure at work, a time-weighted average of the workplace badge measurements was calculated. Prior to the ban, smoke-exposed hospitality venues yielded a mean badge value of 4.48 (95%-CI: 3.7 to 5.25; n = 214) cigarette equivalents/day. At follow-up, measurements in venues that had implemented a smoking ban significantly declined to an average of 0.31 (0.17 to 0.45; n = 37) (p = 0.001). Personal badge measurements also significantly decreased from an average of 2.18 (1.31-3.05 n = 53) to 0.25 (0.13-0.36; n = 41) (p = 0.001). Spearman rank correlations between badge exposure measures and salivary measures were small to moderate (0.3 at maximum). Nicotine levels significantly decreased in all types of hospitality venues after implementation of the smoking ban. In-depth analyses demonstrated that a time-weighted average of the workplace badge measurements represented typical personal SHS exposure at work more reliably than personal exposure measures such as salivary cotinine and nicotine.

Second-hand smoke exposure in homes and in cars among Canadian youth: current prevalence, beliefs about exposure, and changes between 2004 and 2006.

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Leatherdale, Scott T; Ahmed, Rashid

2009-08-01

The present study examines second-hand smoke (SHS) exposure and the beliefs youth have about being exposed to SHS in their home and in cars and explores changes in exposure and beliefs over time. Nationally representative data from the 2006 Youth Smoking Survey (YSS) were used to examine youth exposure to smoking and beliefs about smoking in the home and car among 71,003 Canadian youth in grades 5-12. Gender-specific logistic regression models were conducted to examine if being exposed to smoking at home or in the car were associated with the beliefs youth have about either smoking around kids at home or smoking around kids in cars. In 2006, 22.1% of youth in grades 5-12 were exposed to smoking in their home on a daily or almost daily basis and 28.1% were exposed to smoking while riding in a car at least once in the previous week. The majority of youth reported that they do not think smoking should be allowed around kids at home (88.3%) or in cars (88.4%). Youth exposed to smoking in the home or in cars reported missing substantially more days of school in the previous month because of their health. Among both male and female youth, being an ever smoker, living in a house where someone smokes inside daily, and having ridden in a car with someone who was smoking cigarettes in the past seven days were all associated with being more likely to report that smoking should not be allowed around kids at home or in cars. Compared to their male counterparts, female youth with at least one parent who smokes were more likely to report that smoking should not be allowed around kids at home or in cars. As rates of SHS exposure in the home and car decreased between 2004 and 2006, the prevalence of youth who reported that they do not think smoking should be allowed around kids at home or in cars also decreased over the same period of time. These results highlight that Canadian youth are frequently exposed to SHS in their homes and in cars despite the fact that the vast majority of

Exposure to secondhand smoke and associated factors among non-smoking pregnant women with smoking husbands in Sichuan province, China.

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Yang, Lian; Tong, Elisa K; Mao, Zhengzhong; Hu, Teh-wei

2010-01-01

Secondhand smoke (SHS) exposure harms pregnant women and the fetus. China has the world's largest number of smokers and a high male smoking prevalence rate. To compare exposure to SHS among rural and urban Chinese non-smoking pregnant women with smoking husbands, and analyze factors associated with the level of SHS exposure and hair nicotine concentration. Sichuan province, China. In all 1,181 non-smoking pregnant women with smoking husbands recruited from eight district/county Women and Children's hospitals. The women completed a questionnaire in April and May 2008. Based on systematic sampling, 186 pregnant women were selected for sampling the nicotine concentration in their hair. Ordinal logistic regression analysis was conducted to examine correlates with self-reported SHS exposure (total and at home); linear regression was conducted for the sub-sample of hair nicotine concentrations. Secondhand smoking exposure rates, hair nicotine levels. About 75.1% of the non-smoking pregnant women with smoking husbands reported regular SHS exposure. The major source of exposure was through their husband. In the multivariate analysis, the risk of greater SHS exposure (total and at home) and hair nicotine concentration was increased for women who were rural, had a husband with greater cigarette consumption, less knowledge about SHS, less negative attitudes about SHS, and no smoke-free home rules. The high prevalence rate of SHS exposure suggests that it is important for non-smoking pregnant women, especially rural women, to establish smoke-free home rules and increase knowledge and negative attitudes towards SHS.

Exposure to tobacco smoke among adults in Bangladesh.

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Palipudi, Krishna Mohan; Sinha, Dhirendra N; Choudhury, Sohel; Mustafa, Zaman; Andes, Linda; Asma, Samira

2011-01-01

To examine exposure to second-hand smoke (SHS) at home, in workplace, and in various public places in Bangladesh. Data from 2009 Global Adult Tobacco Survey (GATS) conducted in Bangladesh was analyzed. The data consists of 9,629 respondents from a nationally representative multi-stage probability sample of adults aged 15 years and above. Exposure to second-hand smoke was defined as respondents who reported being exposed to tobacco smoke in the following locations: Indoor workplaces, homes, government building or office, health care facilities, public transportation, schools, universities, restaurants, and cafes, coffee shops or tea houses. Exposure to tobacco smoke in these places was examined by gender across various socioeconomic and demographic sub-groups that include age, residence, education and wealth index using SPSS 17.0 for complex samples. The study shows high prevalence of SHS exposure at home and in workplace and in public places. Exposure to SHS among adults was reported high at home (54.9%) (male-58.2% and female-51.7%), in workplace (63%) (male-67.8% and female-30.4%), and in any public place (57.8%) (male-90.4% and female-25.1%) 30 days preceding the survey. Among the public places examined exposure was low in the educational institutions (schools-4.3%) and health care facilities (5.8%); however, exposure was high in public transportation (26.3%), and restaurants (27.6%). SHS exposure levels at home, in workplace and public places were varied widely across various socioeconomic and demographic sub-groups. Exposure was reported high in settings having partial ban as compared to settings having a complete ban. Following the WHO FCTC and MPOWER measures, strengthening smoke-free legislation may further the efforts in Bangladesh towards creating and enforcing 100% smoke-free areas and educating the public about the dangers of SHS. Combining these efforts can have a complementary effect on protecting the people from hazardous effect of SHS as well as

Second-hand smoke exposure and the factors associated with avoidance behavior among the mothers of pre-school children: a school-based cross-sectional study

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Lin Wei-Ting

2010-10-01

Full Text Available Abstract Background Second-hand Smoke (SHS exposure is a significant public health problem that may be responsible for serious health hazards for child. This study aimed to examine the exposure status of SHS and the factors associated with SHS avoidance behavior among the mothers of pre-school children. Methods A cross-sectional study was used to obtain a sample of the mothers of pre-school children (n = 1,020 in 30 registered kindergartens in eastern Taiwan. Overall, 919 (a response rate of 90% completed the questionnaires. Regression models were used to identify factors with respect to the avoidance behavior of SHS. Results The prevalence of exposure to SHS was 70% and 50% for the mothers and their children, respectively. After adjusting for other variables, mothers who were current smokers (β = -0.260, p Conclusions The high prevalence rate of exposure to SHS for mothers and their children suggests that a well-designed future intervention program should be implemented in regard to pre-school children's mothers in order to prevent these mothers and their children from SHS exposure hazards, more particularly, to strengthen the knowledge base, to enhance self-efficacy and to foster a more positive attitude toward the avoidance of SHS in the mothers.

Counseling parents to quit smoking.

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Sheahan, Sharon L; Free, Teresa A

2005-01-01

It is estimated that 20%-50% of adult smokers reside with children, and the majority of these smokers (70%) continue to smoke inside their homes despite the adverse health effects of second hand smoke (SHS) for their children (Centers for Disease Control and Prevention, 1997). Smoking is more prevalent among parents with lower incomes and less education (U.S. Surgeon General's Report, 2002a). Young persons, ages 20-40 in the family child-rearing stage, are more likely to be smokers. However, they usually have less time and financial resources for quitting smoking. To prevent the adverse health effects of SHS for children, pediatric nurses must provide parents with accurate information on affordable smoking cessation education resources. Evidenced-based smoking cessation guidelines, the cost and efficacy of prescription and over-the-counter (OTC) pharmacological aids, and essential counseling tips for parents are reviewed.

Secondhand Smoke Exposure and Smoking Behavior Among Young Adult Bar Patrons

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Kalkhoran, Sara; Neilands, Torsten B.

2013-01-01

Objectives. We described frequency of secondhand smoke (SHS) exposure among young adults patronizing bars and associations between SHS exposure, attitudes, and smoking behavior. Methods. We collected cross-sectional surveys from randomized time–location samples of bar patrons aged 18 to 26 years in San Diego, California, and Oklahoma City and Tulsa, Oklahoma, in 2010 to 2011. Multivariate logistic regression evaluated associations between SHS exposure, attitudes about dangers of SHS, susceptibility to smoking initiation among nonsmokers, and quit attempts among current smokers. Results. More than 80% of respondents reported past 7-day exposure to any SHS, and more than 70% reported exposure at a bar. Current smokers reported more SHS exposure in cars and their own homes than did nonsmokers. Among nonsmokers, SHS exposure was associated with susceptibility to initiation, but those who believed that SHS exposure is harmful were less susceptible. Belief that SHS is dangerous was associated with quit attempts among smokers. Conclusions. Smoke-free environments and education about the harms of SHS may decrease tobacco use among young adults who frequent bars, where they are heavily exposed to SHS. PMID:24028259

Pregnant women and children's exposure to tobacco and solid fuel smoke in southwestern India.

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Kelly, Patricia J; Goudar, Shivaprasad S; Chakraborty, Hrishikesh; Moore, Janet; Derman, Richard; Kodkany, Bhala; Bellad, Mrutyunjaya; Naik, Vijjaya A; Angolkar, Mubashir; Bloch, Michele

2011-07-01

To examine factors associated with smoke exposure among pregnant women in rural India. We conducted a survey of exposure to second-hand smoke (SHS) and solid fuel smoke (SFS) among 736 pregnant women. Odds ratios (OR) and 95% confidence intervals (CI) were computed using logistic regression models to assess the relationship between demographic variables and exposure to SHS and to SFS. While few respondents smoked cigarettes, 19.9% of women and 27.8% of children were frequently or always exposed to SHS, and 43.5% were at high and 46.7% at medium risk for SFE. Low educational levels and illiteracy were associated with exposure. Smoke exposure is a serious health risk for many poor women and children in India.

Changes in and Factors Affecting Second-hand Smoke Exposure in Nonsmoking Korean Americans in California: A Panel Study

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Hyeongsu Kim, MD, PhD

2014-12-01

Conclusions: We showed that SHS exposure increased among Korean American nonsmokers in California, and the most important variables explaining the change in SHS exposure involved smoking among others with whom the subject is associated. These findings could be used as objective evidence for developing public health policies to reduce SHS exposure.

Toward smoke-free homes: A community-based study on initiatives of rural Indian women.

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Mittal, Srabani; Das, Samiran

2011-05-01

Since the home is the primary source of exposure of children to second-hand smoke (SHS), measures to restrict smoking at home should be introduced to protect children from its adverse health consequences. Objectives of the study were to assess the level of awareness of rural Indian women on the health impacts of SHS on children and to look into the strategies they used to reduce children's exposure to SHS at home. A community-based cross-sectional study was conducted among 438 rural women using a survey questionnaire. Information on socio-demographic characteristics, knowledge on specific health effects of SHS on children, and attitude toward having a smoke-free home were collected. The perceived reasons that made it difficult to have smoke-free homes were also explored. A total of 75.8% of women agreed that SHS was a serious health risk for children. Knowledge on health impacts of SHS on children identified asthma as the most common problem. Smoking by husbands (89.7%) was the major source of exposure to SHS at home. While 67.6% of women reported having taken measures to limit SHS exposure in their homes, only 12.8% of them had tried to introduce a complete ban on smoking at home. On a five-point evaluation scale, 73.3% of the women indicated a failure of their initiatives to have smoke-free homes. Women's initiatives to introduce restrictions on smoking at home had very limited success and did not produce an appreciable change in smoking behavior at home. Lack of empowerment of women in rural India probably rendered the interventional measures ineffective.

Toward smoke-free homes: A community-based study on initiatives of rural Indian women

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Srabani Mittal

2011-01-01

Full Text Available Context: Since the home is the primary source of exposure of children to second-hand smoke (SHS, measures to restrict smoking at home should be introduced to protect children from its adverse health consequences. Aims: Objectives of the study were to assess the level of awareness of rural Indian women on the health impacts of SHS on children and to look into the strategies they used to reduce children′s exposure to SHS at home. Materials and Methods: A community-based cross-sectional study was conducted among 438 rural women using a survey questionnaire. Information on socio-demographic characteristics, knowledge on specific health effects of SHS on children, and attitude toward having a smoke-free home were collected. The perceived reasons that made it difficult to have smoke-free homes were also explored. Results: A total of 75.8% of women agreed that SHS was a serious health risk for children. Knowledge on health impacts of SHS on children identified asthma as the most common problem. Smoking by husbands (89.7% was the major source of exposure to SHS at home. While 67.6% of women reported having taken measures to limit SHS exposure in their homes, only 12.8% of them had tried to introduce a complete ban on smoking at home. On a five-point evaluation scale, 73.3% of the women indicated a failure of their initiatives to have smoke-free homes. Conclusions: Women′s initiatives to introduce restrictions on smoking at home had very limited success and did not produce an appreciable change in smoking behavior at home. Lack of empowerment of women in rural India probably rendered the interventional measures ineffective.

Predictors of children's secondhand smoke exposure at home: a systematic review and narrative synthesis of the evidence.

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Sophie Orton

Full Text Available Children's exposure to secondhand smoke (SHS has been causally linked to a number of childhood morbidities and mortalities. Over 50% of UK children whose parents are smokers are regularly exposed to SHS at home. No previous review has identified the factors associated with children's SHS exposure in the home.To identify by systematic review, the factors which are associated with children's SHS exposure in the home, determined by parent or child reports and/or biochemically validated measures including cotinine, carbon monoxide or home air particulate matter.Electronic searches of MEDLINE, EMBASE, PsychINFO, CINAHL and Web of Knowledge to July 2014, and hand searches of reference lists from publications included in the review were conducted.Forty one studies were included in the review. Parental smoking, low socioeconomic status and being less educated were all frequently and consistently found to be independently associated with children's SHS exposure in the home. Children whose parents held more negative attitudes towards SHS were less likely to be exposed. Associations were strongest for parental cigarette smoking status; compared to children of non-smokers, those whose mothers or both parents smoked were between two and 13 times more likely to be exposed to SHS.Multiple factors are associated with child SHS exposure in the home; the best way to reduce child SHS exposure in the home is for smoking parents to quit. If parents are unable or unwilling to stop smoking, they should instigate smoke-free homes. Interventions targeted towards the socially disadvantaged parents aiming to change attitudes to smoking in the presence of children and providing practical support to help parents smoke outside the home may be beneficial.

Effectiveness of a smoke-free policy in lowering secondhand smoke concentrations in offices in China.

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Gan, Quan; Hammond, S Katharine; Jiang, Yuan; Yang, Yan; Hu, Teh-Wei

2008-05-01

To examine the secondhand smoke (SHS) exposure level in Chinese office buildings and to evaluate the effectiveness of a smoke-free policy in reducing SHS exposure. Survey of smoking policies and measurement of SHS level in 14 office buildings from 10 provinces in China. Smoking in the building significantly elevated the SHS concentrations both in offices with at least one smoker and in offices with no smokers. In one building that recently adopted a smoke-free policy, the nicotine concentrations decreased significantly after the policy was enacted. Enactment of a smoking policy was effective in reducing SHS exposure in the buildings. Nonsmoking office workers in China were exposed to significant levels of SHS at work; both the central and local governments should realize the need to legislate against workplace smoking.

Secondhand smoke and smoking restrictions in casinos: a review of the evidence.

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Babb, Stephen; McNeil, Carrie; Kruger, Judy; Tynan, Michael A

2015-01-01

There is no safe level of secondhand smoke (SHS) exposure. Most US casinos continue to allow smoking, thus exposing workers and patrons to the hazards of SHS. This paper reviews the scientific literature on air quality, SHS exposure, health effects and economic outcomes related to SHS and smoking restrictions in casinos, as well as on smoking prevalence among casino patrons and problem gamblers. Peer reviewed studies published from January 1998 to March 2011. Evidence from air quality, biomarker and survey studies indicates that smoking in casinos is a significant public health problem. Workers and patrons in casinos that allow smoking are exposed to high levels of SHS, as documented by elevated levels of SHS constituents in the air of casinos and by elevated levels of tobacco-specific biomarkers in non-smokers' blood, urine and saliva. Partial smoking restrictions in casinos do not effectively protect non-smokers from SHS. Findings suggest that the smoking prevalence of casino patrons is comparable with that of the general public, although this prevalence may be higher among problem gamblers. Few studies have examined the economic impact of smoke-free policies in casinos, and the results of these studies are mixed. Employees and patrons are exposed to SHS in casinos, posing a significant, preventable risk to their health. Policies completely prohibiting smoking in casinos would be expected to greatly reduce or eliminate SHS exposure in casinos, thereby protecting the health of casino workers and patrons. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Effect of Exposure to Second-Hand Smoke on the Quality of Life: A Nationwide Population-Based Study from South Korea.

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Yeon Wook Kim

Full Text Available Although exposure to second-hand smoke (SHS has been associated with various medical conditions, only limited data are available on its association with health-related quality of life (HRQOL, particularly data obtained with the EQ-5D or EQ visual analogue scale (VAS.This cross-sectional study evaluated 10,532 adult never-smokers who participated in the fifth Korea National Health and Nutrition Examination Survey. By using linear regression models to adjust for possible confounders and incorporating survey weights in analyses, the association between exposure to SHS and HRQOL-measured with the EQ-5D index and the EQ-VAS score-was evaluated. Data were further stratified by the amount of exposure time.After weighted analysis and adjustment, exposure to SHS was significantly associated with lower measures on the EQ-5D index (β = -0.007, P = 0.005 and EQ-VAS score (β = -1.936, P < 0.001. When comparing the unexposed group with the groups exposed <2h/day and ≥2h/day, exposure to a longer duration of SHS was significantly associated with lower scores on the EQ-5D index and the EQ-VAS score.In conclusion, exposure to SHS was associated with reduced HRQOL measured by the EQ-5D index and EQ-VAS score, revealing a dose-response relationship.

Secondhand smoke exposure and susceptibility to initiating cigarette smoking among never-smoking students in selected African countries: Findings from the Global Youth Tobacco Survey.

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Lee, Kyung A; Palipudi, Krishna M; English, Lorna M; Ramanandraibe, Nivo; Asma, Samira

2016-10-01

Exposure to secondhand smoke (SHS) causes premature death and illness in non-smokers. We examined SHS exposure at home and in public places, as well as susceptibility to initiate cigarette smoking among never cigarette smokers. We used 2006-2011 Global Youth Tobacco Survey (GYTS) data from 29 African countries (56,967 students). GYTS is a nationally representative, self-administered school-based survey, conducted among students aged 13-15years. Prevalence ratio, estimates and 95% confidence intervals were computed for SHS exposure in the homes and public places separately. The two-sample t-test was used to assess the difference in susceptibility to smoking by SHS exposure among never-smoking students (α=0.05). Among never-smoking students, exposure to SHS at home ranged from 12.7% (Cape Verde) to 44.0% (Senegal). The prevalence ratio (PR) comparing susceptibility to smoking initiation among never smokers exposed to SHS at home to those who were not exposed at home ranged from 1.2 to 2.6. Exposure to SHS in public places ranged from 23.9% (Cape Verde) to 80.4% (Mali). Of the countries being studied, 8 countries showed a significant difference in susceptibility to smoking initiation among never smokers exposed to SHS in public places compared to those not exposed in public places. (PR ranged from 0.5-3.5). In many African countries in the study, a substantial proportion of students who never smoked are exposed to SHS at home and in public places. Majority of never smokers who were exposed to SHS at home and in public places had a higher prevalence of susceptibility to initiate smoking than those that were not exposed to SHS at home and in public places. Adoption and enforcement of smoke-free policies in public places and smoke-free rules at home could substantially contribute to reducing SHS exposure in many of these countries. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of the Spanish smoking laws on tobacco consumption and secondhand smoke exposure: A longitudinal population study.

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Lidón-Moyano, Cristina; Fu, Marcela; Ballbè, Montse; Martín-Sánchez, Juan Carlos; Matilla-Santander, Nuria; Martínez, Cristina; Fernández, Esteve; Martínez-Sánchez, Jose M

2017-12-01

In Spain, two smoke-free laws have been passed after the approval of the WHO-FCTC. This study assesses the impact of these Spanish smoking legislations on the active and passive smoking through a population cohort in Barcelona (Spain). This is a longitudinal study before and after the implementation of two national smoking bans in Spain in a representative sample (n=1245) of adults (≥16years old) from Barcelona (Spain) surveyed in 2004-2005 and followed-up in 2013-2014. The final sample analyzed was 736 individuals. Both questionnaires (before and after the two laws) included the same variables about active and passive smoking. We calculated the prevalence and the prevalence ratio (PR, with their 95% confidence intervals, 95% CI) of smoking cigarettes and hand-rolled tobacco and also the prevalence of exposure to secondhand smoke (SHS) at home, work, public transport, leisure time and at any setting after vs. before Spanish legislations. After the implementation of the two Spanish smoke-free bans, a significant decrease was observed in the smoking prevalence (from 34.5% to 26.1%, PR=0.76, psmoke-free legislations in Spain is related to a reduction in smoking prevalence and SHS exposure. However, the smoking of other tobacco products, particularly hand-rolled tobacco, has increased among young population. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment of prenatal exposure to tobacco smoke by cotinine in cord blood for the evaluation of smoking control policies in Spain

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2012-01-01

Background Over the last few years a decreasing trend in smoking has occurred not only in the general population but also during pregnancy. Several countries have implemented laws requiring all enclosed workplace and public places to be free of second hand smoke (SHS). In Spain, legislation to reduce SHS was implemented in 2005. The present study examines the possible effect of this legislation on prenatal SHS exposure. Methods Mothers and newborns were recruited from 3 independent studies performed in Hospital del Mar (Barcelona) and approved by the local Ethics Committee: 415 participated in a study in 1996-1998, 283 in 2002-2004 and 207 in 2008. A standard questionnaire, including neonatal and sociodemographic variables,tobacco use and exposure during pregnancy, was completed at delivery for all the participants in the three study groups. Fetal exposure to tobacco was studied by measuring cotinine in cord blood by radioimmunoassay (RIA). Results 32.8% of the pregnant women reported to smoke during pregnancy in 1996-1998, 25.9% in 2002-2004 and 34.1% in 2008. In the most recent group, the percentage of no prenatal SHS exposure (cord blood cotinine 0.2-1 ng/mL) showed an increase compared to the previous groups while the percentages of both: low (1.1-14 ng/mL) and very high (> 100 ng/mL) prenatal SHS exposure showed a decrease. Discussion The results of the three study periods (1996-2008) demonstrated a significant increase in the percentage of newborns free from SHS exposure and a decrease in the percentage of newborns exposed to SHS during pregnancy, especially at the very high levels of exposure. A significant maternal smoking habit was noted in this geographical area with particular emphasis on immigrant pregnant smoking women. Conclusions Our study indicates that there is a significant maternal smoking habit in this geographical area. Our recommendation is that campaigns against smoking should be directed more specifically towards pregnant women with

Assessment of prenatal exposure to tobacco smoke by cotinine in cord blood for the evaluation of smoking control policies in Spain.

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Puig, Carme; Vall, Oriol; García-Algar, Oscar; Papaseit, Esther; Pichini, Simona; Saltó, Esteve; Villalbí, Joan R

2012-04-05

Over the last few years a decreasing trend in smoking has occurred not only in the general population but also during pregnancy. Several countries have implemented laws requiring all enclosed workplace and public places to be free of second hand smoke (SHS). In Spain, legislation to reduce SHS was implemented in 2005. The present study examines the possible effect of this legislation on prenatal SHS exposure. Mothers and newborns were recruited from 3 independent studies performed in Hospital del Mar (Barcelona) and approved by the local Ethics Committee: 415 participated in a study in 1996-1998, 283 in 2002-2004 and 207 in 2008. A standard questionnaire, including neonatal and sociodemographic variables,tobacco use and exposure during pregnancy, was completed at delivery for all the participants in the three study groups. Fetal exposure to tobacco was studied by measuring cotinine in cord blood by radioimmunoassay (RIA). 32.8% of the pregnant women reported to smoke during pregnancy in 1996-1998, 25.9% in 2002-2004 and 34.1% in 2008. In the most recent group, the percentage of no prenatal SHS exposure (cord blood cotinine 0.2-1 ng/mL) showed an increase compared to the previous groups while the percentages of both: low (1.1-14 ng/mL) and very high (> 100 ng/mL) prenatal SHS exposure showed a decrease. The results of the three study periods (1996-2008) demonstrated a significant increase in the percentage of newborns free from SHS exposure and a decrease in the percentage of newborns exposed to SHS during pregnancy, especially at the very high levels of exposure. A significant maternal smoking habit was noted in this geographical area with particular emphasis on immigrant pregnant smoking women. Our study indicates that there is a significant maternal smoking habit in this geographical area. Our recommendation is that campaigns against smoking should be directed more specifically towards pregnant women with particular emphasis on non-native pregnant smokers due to

Airborne Nicotine, Secondhand Smoke, and Precursors to Adolescent Smoking.

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McGrath, Jennifer J; Racicot, Simon; Okoli, Chizimuzo T C; Hammond, S Katharine; O'Loughlin, Jennifer

2018-01-01

Secondhand smoke (SHS) directly increases exposure to airborne nicotine, tobacco's main psychoactive substance. When exposed to SHS, nonsmokers inhale 60% to 80% of airborne nicotine, absorb concentrations similar to those absorbed by smokers, and display high levels of nicotine biomarkers. Social modeling, or observing other smokers, is a well-established predictor of smoking during adolescence. Observing smokers also leads to increased pharmacological exposure to airborne nicotine via SHS. The objective of this study is to investigate whether greater exposure to airborne nicotine via SHS increases the risk for smoking initiation precursors among never-smoking adolescents. Secondary students ( N = 406; never-smokers: n = 338, 53% girls, mean age = 12.9, SD = 0.4) participated in the AdoQuest II longitudinal cohort. They answered questionnaires about social exposure to smoking (parents, siblings, peers) and known smoking precursors (eg, expected benefits and/or costs, SHS aversion, smoking susceptibility, and nicotine dependence symptoms). Saliva and hair samples were collected to derive biomarkers of cotinine and nicotine. Adolescents wore a passive monitor for 1 week to measure airborne nicotine. Higher airborne nicotine was significantly associated with greater expected benefits ( R 2 = 0.024) and lower expected costs ( R 2 = 0.014). Higher social exposure was significantly associated with more temptation to try smoking ( R 2 = 0.025), lower aversion to SHS ( R 2 = 0.038), and greater smoking susceptibility ( R 2 = 0.071). Greater social exposure was significantly associated with more nicotine dependence symptoms; this relation worsened with higher nicotine exposure (cotinine R 2 = 0.096; airborne nicotine R 2 = 0.088). Airborne nicotine exposure via SHS is a plausible risk factor for smoking initiation during adolescence. Public health implications include limiting airborne nicotine through smoking bans in homes and cars, in addition to stringent restrictions

The economic burden of smoking and secondhand smoke exposure in rural South-West China.

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Cai, Le; Cui, Wenlong; He, Jianhui; Wu, Xinan

2014-06-01

To estimate the direct and indirect costs of chronic diseases attributed to smoking and exposure to secondhand smoke (SHS) in a given year (2011) in rural southwest China. A prevalence-based, disease-specific attributable-risk approach was used to estimate the economic burden of chronic diseases attributable to both smoking and exposure to secondhand smoke (SHS). A cross-sectional questionnaire survey of 17 158 consenting adults aged ≥18 years was used to derive prevalence of smoking and exposure to SHS, as well as direct and indirect costs of chronic diseases. In the study population, the prevalence rates of smoking and exposure to SHS are 73.1 and 38.2% for males and 1.4 and 43.4% for females, respectively. The total costs of illness are $25.85 million for COPD, $18.80 million for asthma, $37.25 million for CHD, $17.91 million for stroke, $264.35 million for hypertension and $17.11 million for peptic ulcer. The estimated costs attributable to smoking and exposure to SHS are $95.51 million and $79.35 million, accounting for 7.15 and 5.94% of local healthcare costs, respectively. Of the total costs of tobacco, direct costs and indirect costs are $94.66 million and $0.85 million for smoking, and $78.22 million and $1.36 million for exposure to SHS. Smoking contributes more cost of illness than exposure to SHS in men, whereas exposure to SHS contributes more cost of illness than smoking in women. Smoking and exposure to SHS produce substantial economic burden as well as have a considerable public health impact in rural southwest China.

Disparities in exposure to tobacco smoke pollution at Romanian worksites

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Dorota Kaleta

2015-12-01

Full Text Available [b]Introduction[/b]. Differences in the risk of being exposed to second-hand smoke (SHS in the workplace may occur not only between countries, but also within a country among socio-economic groups. [b]Objectives. [/b]The aim of the study was to examine the associations of exposure to SHS at worksites with selected factors in non-smoking Romanian employees. [b]Material and Methods[/b]. Data on exposure to SHS at worksites and other characteristics of respondents came from the Global Adult Tobacco Survey (GATS. GATS is a nationally representative household survey of adults 15 years of age or older, using a standard protocol. [b]Results[/b]. Among 4,517 respondents who completed the questionnaire there were 1,333 subjects, including 859 non-smokers who worked in an indoor area outside the home. The prevalence of exposure to SHS was 31.2% among non-smoking male and 23.9% among non-smoking female employees (p<0.05. Employees with primary education had odds of exposure to SHS at work nearly twice as high, compared to the respondents having high education attainment (OR=1.9; 95% CI: 1.2–2.9. Moreover, exposure to SHS at worksites was significantly associated with a low level of support for tobacco control policies among workers (OR = 1.8; 95% CI: 1.2–2.8. [b]Conclusions[/b]. In spite of the increasing presence of smoking bans in public and workplaces, enforcement still seems to be unsuccessful in the occupational space in Romania. In order to reduce SHS exposure in workplaces, strengthening support for tobacco control policies is essential.

Exposure to secondhand smoke and voluntary adoption of smoke-free home and car rules among non-smoking South African adults.

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Ayo-Yusuf, Olalekan A; Olufajo, Olubode; Agaku, Israel T

2014-06-10

Secondhand smoke (SHS) exposure is a well-established health hazard. To determine the effectiveness of existing smoke-free policies and adoption of smoke-free rules in South Africa, we assessed exposure to SHS from several sources among non-smoking adults during 2010. Data were analyzed for 3,094 adults aged ≥16 years who participated in the 2010 South African Social Attitudes Survey. Descriptive statistics and multivariate analyses were used to assess presence of smoke-free rules among all South Africans, and prevalence and correlates of SHS exposure at work, at home, and at hospitality venues among non-smokers. Overall, 70.6% of all South African adults had 100% smoke-free rules in their private cars, 62.5% in their homes, while 63.9% worked in places with 100% smoke-free policies. Overall, 55.9% of all non-smokers reported exposure to SHS from at least one source (i.e., in the home, workplace or at a hospitality venue). By specific source of exposure, 18.4% reported being exposed to SHS at work, 25.2% at home, 33.4% in a restaurant, and 32.7% at a bar. Presence of work bans on indoor smoking conferred lower likelihood of SHS exposure at work among non-smokers (adjusted odds ratio [aOR] = 0.23; 95% CI: 0.09-0.60). Similarly, smoke-free home rules decreased the odds of being exposed to SHS at home among non-smokers (aOR =0.16; 95% CI: 0.09-0.30). Over half of South African adults reported SHS exposure in the home or at public places such as the workplace and at hospitality venues. This underscores the need for comprehensive smoke-free laws that prohibit smoking in all public indoor areas without exemptions.

Workplace exposure to secondhand smoke among non-smoking hospitality employees.

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Lawhorn, Nikki A; Lirette, David K; Klink, Jenna L; Hu, Chih-Yang; Contreras, Cassandra; Ajori Bryant, Ty-Runet Pinkney; Brown, Lisanne F; Diaz, James H

2013-02-01

This article examines salivary cotinine concentrations to characterize secondhand smoke (SHS) exposure among non-smoking hospitality employees (bar and casino employees and musicians who perform in bars) who are exposed to SHS in the workplace. A pre-post test study design was implemented to assess SHS exposure in the workplace. The convenience sample of 41 non-smoking hospitality employees included 10 controls (non-smoking hospitality employees not exposed to SHS in the workplace). The findings demonstrate that post-shift saliva cotinine levels of hospitality employees who are exposed to SHS in the workplace are significantly higher than controls who work in smoke-free venues. Findings also suggested a statistically significant increase between pre- and post-shift saliva cotinine levels of hospitality employees who are exposed in the workplace. No statistically significant difference was noted across labor categories, suggesting that all exposed employees are at increased risk. The study results indicate that non-smoking hospitality employees exposed to SHS in the workplace have significantly higher cotinine concentration levels compared with their counterparts who work in smoke-free venues. Findings from other studies suggest that these increased cotinine levels are harmful to health. Given the potential impact on the health of exposed employees, this study further supports the efforts of tobacco prevention and control programs in advocating for comprehensive smoke-free air policies to protect bar and casino employees.

Secondhand smoke exposure and other correlates of susceptibility to smoking: a propensity score matching approach.

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McIntire, Russell K; Nelson, Ashlyn A; Macy, Jonathan T; Seo, Dong-Chul; Kolbe, Lloyd J

2015-09-01

Secondhand smoke (SHS) exposure is responsible for numerous diseases of the lungs and other bodily systems among children. In addition to the adverse health effects of SHS exposure, studies show that children exposed to SHS are more likely to smoke in adolescence. Susceptibility to smoking is a measure used to identify adolescent never-smokers who are at risk for smoking. Limited research has been conducted on the influence of SHS on susceptibility to smoking. The purpose of this study was to determine a robust measure of the strength of correlation between SHS exposure and susceptibility to smoking among never-smoking U.S. adolescents. This study used data from the 2009 National Youth Tobacco Survey to identify predictors of susceptibility to smoking in the full (pre-match) sample of adolescents and a smaller (post-match) sample created by propensity score matching. Results showed a significant association between SHS exposure and susceptibility to smoking among never-smoking adolescents in the pre-match (OR=1.47) and post-match (OR=1.52) samples. The odds ratio increase after matching suggests that the strength of the relationship was underestimated in the pre-match sample. Other significant correlates of susceptibility to smoking identified include: gender, race/ethnicity, personal income, smoke-free home rules, number of smoking friends, perception of SHS harm, perceived benefits of smoking, and exposure to pro-tobacco media messages. The use of propensity score matching procedures reduced bias in the post-match sample, and provided a more robust estimate of the influence of SHS exposure on susceptibility to smoking, compared to the pre-match sample estimates. Copyright © 2015 Elsevier Ltd. All rights reserved.

Support for smoke-free policies in the Cyprus hospitality industry.

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Lazuras, Lambros; Savva, Christos S; Talias, Michael A; Soteriades, Elpidoforos S

2015-12-01

The present study used attitudinal and behavioural indicators to measure support for smoke-free policies among employers and employees in the hospitality industry in Cyprus. A representative sample of 600 participants (95 % response rate) completed anonymous structured questionnaires on demographic variables, smoking status, exposure to second-hand smoke at work and related health beliefs, social norms, and smoke-free policy support. Participants were predominantly males (68.3 %), with a mean age of 40 years (SD = 12.69), and 39.7 % were employers/owners of the hospitality venue. Analysis of variance showed that employers and smokers were less supportive of smoke-free policies, as compared to employees and non-smokers. Linear regression models showed that attitudes towards smoke-free policy were predicted by smoking status, SHS exposure and related health beliefs, and social norm variables. Logistic regression analysis showed that willingness to confront a policy violator was predicted by SHS exposure, perceived prevalence of smoker clients, and smoke-free policy attitudes. SHS exposure and related health beliefs, and normative factors should be targeted by interventions aiming to promote policy support in the hospitality industry in Cyprus.

Secondhand smoke exposure among never-smoking youth in 168 countries.

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Veeranki, Sreenivas P; Mamudu, Hadii M; Zheng, Shimin; John, Rijo M; Cao, Yan; Kioko, David; Anderson, James; Ouma, Ahmed E O

2015-02-01

To estimate the prevalence of secondhand smoke (SHS) exposure among never-smoking adolescents and identify key factors associated with such exposure. Data were obtained from nationally representative Global Youth Tobacco Surveys conducted in 168 countries during 1999-2008. SHS exposure was ascertained in relation to the location-exposure inside home, outside home, and both inside and outside home, respectively. Independent variables included parental and/or peer smoking, knowledge about smoke harm, attitudes toward smoking ban, age, sex, and World Health Organization region. Simple and multiple logistic regression analyses were conducted. Of 356,414 never-smoking adolescents included in the study, 30.4%, 44.2%, and 23.2% were exposed to SHS inside home, outside home, and both, respectively. Parental smoking, peer smoking, knowledge about smoke harm, and positive attitudes toward smoke ban were significantly associated with increased odds of SHS exposure. Approximately 14% of adolescents had both smoking parents and peers. Compared with never-smoking adolescents who did not have both smoking parents and peers, those who had both smoking parents and peers had 19 (adjusted odds ratio [aOR], 19.0; 95% confidence interval [CI], 16.86-21.41), eight (aOR, 7.71; 95% CI, 7.05-8.43), and 23 times (aOR, 23.16; 95% CI, 20.74-25.87) higher odds of exposure to SHS inside, outside, and both inside and outcome home, respectively. Approximately one third and two fifths of never-smoking adolescents were exposed to SHS inside or outside home, and smoking parents and/or peers are the key factors. Study findings highlight the need to develop and implement comprehensive smoke-free policies consistent with the World Health Organization Framework Convention on Tobacco Control. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Smoke-Free School Policy and Exposure to Secondhand Smoke: A Quasi-Experimental Analysis.

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Azagba, Sunday; Kennedy, Ryan David; Baskerville, Neill Bruce

2016-02-01

Tobacco control prevention efforts are important to protect people from exposure to dangerous tobacco smoke, support cessation, and reduce tobacco-use initiation. While smoke-free laws have been a widespread tobacco control strategy, little work has been done to examine the impact of smoke-free school policies. The objective of this study is to evaluate the impact of provincial smoke-free school ground policies on youth-reported exposure to secondhand smoke (SHS) on school property. This study used a nationally representative sample of 20 388 youth aged 15-18 from the 2005-2012 Canadian Tobacco Use Monitoring Survey. A quasi-experimental design was used to evaluate the impact of smoke-free school policies on SHS exposure. Approximately over half (52%) of respondents reported SHS exposure on a school property in the past month. Smoke-free school policy had a statistically significant effect on SHS exposure. Specifically, the adoption of smoke-free school reduced the probability of SHS exposure by about 8 percentage points. Respondents who were smokers were more likely to report being exposed to SHS than nonsmokers. Likewise, those living in urban areas had higher probability of being exposed to SHS than those living in rural parts of Canada. Reported exposure to tobacco smoke did decrease after the introduction of smoke-free ground policies; however, almost half of high-school aged youth report exposure in the last month. Across Canada, provincial health authorities as well as school administers may need to assess the implementation of these smoke-free policies and improve enforcement strategies to further reduce exposure to dangerous SHS. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

Secondhand Smoke Exposure, Indoor Smoking Bans and Smoking-Related Knowledge in China

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Yue Jin

2014-12-01

Full Text Available Although previous studies have provided strong evidence that Chinese individuals are exposed to secondhand smoke (SHS and lack knowledge of its harmful effects, there has not been an in-depth exploration of the variability in exposure and knowledge by geographic region, occupation, and socioeconomic status. The objectives of this study were to examine: (1 the demographic factors associated with the level of knowledge of the harmful effects of smoking; (2 the factors related to implementation of in-home and workplace smoking bans; and (3 geographic differences in being exposed to SHS in government buildings, healthcare facilities, restaurants, public transportations, and schools. We used data from the 2010 Global Adult Tobacco Survey-China. Chi-square tests were used for statistical analysis. The results suggested that among Chinese citizens age 15 years and older, there is poor knowledge of the harmful effects of tobacco, and knowledge varies with region and socioeconomic status. Over three-quarters of the households had no smoking restrictions, and a large percentage of workers reported working in places with no smoking ban. In public places, exposure to SHS was high, particularly in rural areas and in the Southwest. These results suggest Chinese individuals are not well informed of smoking and SHS associated risks and are regularly exposed to SHS at home, work and public places.

Validity of self-reported intensity of exposure to second-hand smoke at home against environmental and personal markers.

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Martínez-Sánchez, José M; González-Marrón, Adrián; Martín-Sánchez, Juan Carlos; Sureda, Xisca; Fu, Marcela; Pérez-Ortuño, Raúl; Lidón-Moyano, Cristina; Galán, Iñaki; Pascual, José Antonio; Fernández, Esteve

2017-11-02

The objective of this study was to assess the validity of two questions about the perception of intensity of exposure to secondhand smoke (SHS) at home using as a reference environmental markers (airborne nicotine and benzene) and biomarkers of exposure (cotinine in saliva and urine). This was a cross-sectional study in a convenience sample of 49 non-smoking volunteers. We found a high correlation between self-reported SHS exposure and airborne nicotine (r sp =0.806, p0.05). In conclusion, the significant correlation of the two questions proposed with environmental markers and personal markers indicates their potential validity to assess exposure to SHS at home. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Five-year trends of second-hand smoke exposure in Greece: a comparison between complete, partial, and prelegislation levels.

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Vardavas, Constantine I; Anagnostopoulos, Nektarios; Patelarou, Evridiki; Minas, Markos; Nakou, Chrysanthi; Dramba, Vassiliki; Giourgouli, Gianna; Bagkeris, Emmanouil; Gourgoulianis, Konstantinos; Pattaka, Paraskevi; Antoniadis, Antonis; Lionis, Christos; Bertic, Monique; Dockery, Douglas; Connolly, Gregory N; Behrakis, Panagiotis K

2012-12-01

Our aim was to assess second-hand smoke (SHS) exposure in hospitality venues after the smoke-free legislation implemented in September 2010 in Greece and to compare with when a partial ban was in place and in 2006 when no ban was in place. Hospitality venues were prospectively assessed for their indoor concentrations of particulate matter (PM(2.5)) during the partial ban phase (n=149) and the complete ban phase (n=120, 80% followed up), while overall and matched by venue comparisons were also performed (no ban vs. partial ban vs. complete ban). Comparisons with previously collected data in 2006 when no ban was in place also was performed. Indoor air levels of PM(2.5) attributable to SHS dropped following the transition from a partial to a complete ban by 34% (137 μg/m(3) vs. 90 μg/m(3), p=0.003). This drop was larger in bars (from 195 μg/m(3) to 121 μg/m(3)), than in cafes (124 μg/m(3) vs. 87 μg/m(3)) or restaurants (42 μg/m(3) vs. 39 μg/m(3)). PM(2.5) concentrations between 2006 (no ban) and the partial ban of 2010 were also found to decrease by 94 μg/m(3); however, among matched venues, the levels of indoor air pollution were not found to change significantly (218 μg/m(3) vs. 178 μg/m(3), p=0.58). Comparing the 2010 complete ban results (n=120) with previously collected data from 2006 when no ban was in place (n=43), overall PM(2.5) concentrations were found to fall from 268 μg/m(3) to 89 μg/m(3), while a matched analysis found a significant reduction in PM(2.5) concentrations (249 μg/m(3) vs. 46 μg/m(3), p=0.011). The complete ban of smoking in hospitality venues in Greece led to a reduction in SHS exposure, in comparison to when the partial ban or no ban was in place; however, exposure to SHS was not eliminated indicating the need for stronger enforcement.

Assessment of prenatal exposure to tobacco smoke by cotinine in cord blood for the evaluation of smoking control policies in Spain

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Puig Carme

2012-04-01

Full Text Available Abstract Background Over the last few years a decreasing trend in smoking has occurred not only in the general population but also during pregnancy. Several countries have implemented laws requiring all enclosed workplace and public places to be free of second hand smoke (SHS. In Spain, legislation to reduce SHS was implemented in 2005. The present study examines the possible effect of this legislation on prenatal SHS exposure. Methods Mothers and newborns were recruited from 3 independent studies performed in Hospital del Mar (Barcelona and approved by the local Ethics Committee: 415 participated in a study in 1996-1998, 283 in 2002-2004 and 207 in 2008. A standard questionnaire, including neonatal and sociodemographic variables,tobacco use and exposure during pregnancy, was completed at delivery for all the participants in the three study groups. Fetal exposure to tobacco was studied by measuring cotinine in cord blood by radioimmunoassay (RIA. Results 32.8% of the pregnant women reported to smoke during pregnancy in 1996-1998, 25.9% in 2002-2004 and 34.1% in 2008. In the most recent group, the percentage of no prenatal SHS exposure (cord blood cotinine 0.2-1 ng/mL showed an increase compared to the previous groups while the percentages of both: low (1.1-14 ng/mL and very high (> 100 ng/mL prenatal SHS exposure showed a decrease. Discussion The results of the three study periods (1996-2008 demonstrated a significant increase in the percentage of newborns free from SHS exposure and a decrease in the percentage of newborns exposed to SHS during pregnancy, especially at the very high levels of exposure. A significant maternal smoking habit was noted in this geographical area with particular emphasis on immigrant pregnant smoking women. Conclusions Our study indicates that there is a significant maternal smoking habit in this geographical area. Our recommendation is that campaigns against smoking should be directed more specifically towards

Impacto de la Ley 28/2005 de medidas sanitarias frente al tabaquismo en la prevalencia de la exposición al humo ambiental del tabaco en Barcelona Impact of the 28/2005 Spanish smoking law on second-hand smoke exposure in Barcelona

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Sandra Manzanares-Laya

2011-12-01

Full Text Available Objetivo: Evaluar el impacto de la Ley 28/2005 de medidas sanitarias frente al tabaquismo en la prevalencia de la exposición al humo ambiental del tabaco (HAT en Barcelona. Métodos: Estudio de evaluación antes-después mediante comparación de dos encuestas transversales. Las fuentes de datos fueron las Encuestas de Salud de Barcelona de 2000 y 2006. Se analizó la prevalencia de exposición al HAT en población adulta no fumadora según el ámbito de exposición (hogar, trabajo y tiempo libre y las variables sociodemográficas. Resultados: La exposición al HAT en no fumadores en el hogar y el trabajo disminuyó significativamente (p Objective: To assess the impact of the 28/2005 Spanish smoking law on exposure to second-hand smoke (SHS in Barcelona. Methods: We performed a pre-post evaluation study. Two cross-sectional surveys were compared. Data were obtained from the Barcelona Health Surveys of 2000 and 2006. The prevalence of SHS exposure among non-smoking adults was analyzed by setting (home, workplace and leisure time and sociodemographic variables. Results: SHS exposure in non-smokers significantly decreased between 2000 and 2006 (p <0.01. Odds ratios adjusted by sex, age and social class were 0.7 (95% CI: 0.6-0.8 for home and 0.2 (95% CI: 0.2-0.3 for workplace exposure in 2006 compared with 2000. In both settings, the decrease in exposure was greater in the higher social classes. After the implementation of the law, almost 50% of the population remained exposed to SHS during leisure time, younger people being the most exposed (83.5%. Conclusion: After the implementation of the law, the prevalence of SHS exposure in non-smokers in Barcelona decreased significantly in workplaces and in the home. Nevertheless, nearly half of the population remained exposed to SHS during leisure time.

Smoke-Free Homes and Home Exposure to Secondhand Smoke in Shanghai, China

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Pinpin Zheng

2014-11-01

Full Text Available Few studies have examined home exposure to secondhand smoke (SHS in China. This study aimed to document: (1 the prevalence and correlates of exposure to SHS in homes (in adult non-smokers in Shanghai, and (2 enforcement of rules, harm reduction behaviors, and self-efficacy for maintaining smoke-free homes in Shanghai. A total of 500 participants were recruited using a multistage proportional random sampling design in an urban and suburban district to complete a survey. Among the total 355 nonsmokers, 127 (35.8% participants reported being exposed to SHS in the past 7 days. Participants living with smokers in the home, with no smoking restriction at home, and having children younger than 18 were more likely to be exposed to SHS at home. Higher self-efficacy in maintaining a smoke-free home was negatively associated with home SHS exposure. Having visitors who smoke was the greatest policy enforcement challenge. Ineffective measures such as opening windows were more commonly used in homes with partial bans. Educational initiatives to protect against SHS exposure in the home should promote smoke-free homes, address challenges to implementing such policies, and address misconceptions regarding the effectiveness of supposed harm reduction behaviors.

SHS-desintegration

International Nuclear Information System (INIS)

Merzhanov, A.G.; Stolin, A.M.; Majzeliya, A.V.

1995-01-01

A possibility of hot disintegration of SHS product is demonstrated using titanium carbide production as an example. It is shown that SHS-disintegration features a higher yield of small fractions. It is possible to decrease significant by the capacity of disintegrators using the SHS disintegration technique proposed in this paper and to enhance the degree of powder dispersion. 5 refs.; 2 figs.; 1 tab

Prevalence of invehicle smoking and secondhand smoke exposure in Uruguay.

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Llambi, Laura; Barros, Mary; Parodi, Carolina; Pippo, Antonella; Nunez, Virginia; Colomar, Mercedes; Ciganda, Alvaro; Cavalleri, Fiorella; Goyeneche, Juan J; Aleman, Alicia

2018-01-19

Protection from secondhand smoke (SHS) is one of the fundamental principles of the WHO Framework Convention for Tobacco Control. Objective data on SHS exposure in vehicles in South America is scarce. This study aimed to estimate prevalence of smoking inside vehicles. The point prevalence of smoking in vehicles was observed, and a method for estimating smoking prevalence was piloted. We observed 10 011 vehicles. In 219 (2.2%; 95% CI 1.91 to 2.49) of them, smoking was observed, and in 29.2% of these, another person was exposed to SHS. According to the 'expansion factor' we constructed, direct observation detected one of six to one to nine vehicles in which smoking occurred. The observed prevalence of smoking in vehicles (2.2%) could reflect a real prevalence between 12% and 19%. In 29.2% (95% CI 23.6 to 35.5) and 4.6% (95% CI 2.2 to 8.3) of vehicles in which smoking was observed, another adult or a child, respectively, was exposed to SHS. Smoking was estimated to occur in 12%-19% of vehicles, with involuntary exposure in one of three of vehicles observed. These data underscore a need for new public policies to eliminate SHS in vehicles to protect public health. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Tobacco toxins deposited on surfaces (third hand smoke) impair wound healing.

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Dhall, Sandeep; Alamat, Raquelle; Castro, Anthony; Sarker, Altaf H; Mao, Jian-Hua; Chan, Alex; Hang, Bo; Martins-Green, Manuela

2016-07-01

Third hand smoke (THS) is the accumulation of second hand smoke (SHS) toxins on surfaces in homes, cars, clothing and hair of smokers. It is known that 88M US nonsmokers ≥3 years old living in homes of smokers are exposed to THS toxicants and show blood cotinine levels of ≥0.05 ng/ml, indicating that the toxins are circulating in their circulatory systems. The goal of the present study is to investigate the mechanisms by which THS causes impaired wound healing. We show that mice living under conditions that mimic THS exposure in humans display delayed wound closure, impaired collagen deposition, altered inflammatory response, decreased angiogenesis, microvessels with fibrin cuffs and a highly proteolytic wound environment. Moreover, THS-exposed mouse wounds have high levels of oxidative stress and significantly lower levels of antioxidant activity leading to molecular damage, including protein nitration, lipid peroxidation and DNA damage that contribute to tissue dysfunction. Furthermore, we show that elastase is elevated, suggesting that elastin is degraded and the plasticity of the wound tissue is decreased. Taken together, our results lead us to conclude that THS toxicants delay and impair wound healing by disrupting the sequential processes that lead to normal healing. In addition, the lack of elastin results in loss of wound plasticity, which may be responsible for reopening of wounds. © 2016 The Author(s). published by Portland Press Limited on behalf of the Biochemical Society.

Smoking, secondhand smoke, and cotinine levels in a subset of EPIC cohort

NARCIS (Netherlands)

Baltar, V.T.; Xun, W.W.; Chuang, S.C.; Relton, C.; Ueland, P.M.; Vollset, S.E.; Midttun, O.; Johansson, M.; Slimani, N.; Jenab, M.; Boshuizen, H.C.

2011-01-01

Background: Several countries are discussing new legislation regarding the ban on smoking in public places, based on the growing evidence of the hazards of secondhand smoke (SHS) exposure. The objective of the present study is to quantitatively assess the relationship between smoking, SHS, and serum

Smoking, Secondhand Smoke, and Cotinine Levels in a Subset of EPIC Cohort

NARCIS (Netherlands)

Baltar, Valeria Troncoso; Xun, Wei W.; Chuang, Shu-Chun; Relton, Caroline; Ueland, Per Magne; Vollset, Stein Emil; Midttun, Oivind; Johansson, Mattias; Slimani, Nadia; Jenab, Mazda; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Kaaks, Rudolf; Rohrmann, Sabine; Boeing, Heiner; Weikert, Cornelia; Bueno-de-Mesquita, H. Bas; Boshuizen, Hendriek C.; van Gils, Carla H.; Peeters, Petra H. M.; Agudo, Antonio; Barricarte, Aurelio; Navarro, Carmen; Rodriguez, Laudina; Huerta Castano, Jose Maria; Larranaga, Nerea; Sanchez Perez, Maria Jose; Khaw, Kay-Tee; Wareham, Nick; Allen, Naomi E.; Crowe, Francesca; Gallo, Valentina; Norat, Teresa; Tagliabue, Giovanna; Masala, Giovanna; Panico, Salvatore; Sacerdote, Carlota; Tumino, Rosario; Trichopoulou, Antonia; Lagiou, Pagona; Bamia, Christina; Rasmuson, Torgny; Hallmans, Goran; Roswall, Nina; Tjonneland, Anne; Riboli, Elio; Brennan, Paul; Vineis, Paolo

Background: Several countries are discussing new legislation regarding the ban on smoking in public places, based on the growing evidence of the hazards of secondhand smoke (SHS) exposure. The objective of the present study is to quantitatively assess the relationship between smoking, SHS, and serum

Family Smoking, Exposure to Secondhand Smoke at Home and Family Unhappiness in Children

Directory of Open Access Journals (Sweden)

Jian Jiu Chen

2015-11-01

Full Text Available Tobacco use adversely affects many aspects of well-being and is disliked by non-smokers. However, its association with family happiness is unknown. We investigated the associations of family unhappiness with smoking in family members and secondhand smoke (SHS exposure at home in Hong Kong children. In a school-based survey in 2012–2013, 1238 primary school students (mean age 8.5 years, standard deviation 0.9; 42.6% boys reported family smoking, SHS exposure at home and whether their families had any unpleasant experience caused by smoking or SHS in the past 30 days (tobacco-related unpleasant experience, and rated the overall level of happiness in their families (family unhappiness. Multivariable logistic regression was used to study the associations of tobacco-related unpleasant experience and family unhappiness with family smoking and SHS exposure at home. Tobacco-related unpleasant experience and family unhappiness were reported by 27.5% and 16.5% of students. Unpleasant experience was more strongly associated with family smoking than SHS exposure at home. Family unhappiness was associated with both family smoking (odds ratio 2.37; 95% confidence interval 1.51–3.71 and SHS exposure at home (1.82; 1.39–2.40. These results suggest a previously neglected possible impact of tobacco use on family happiness.

Clear Skies and Grey Areas: Flight Attendants’ Secondhand Smoke Exposure and Attitudes toward Smoke-Free Policy 25 Years since Smoking was Banned on Airplanes

Directory of Open Access Journals (Sweden)

Frances A. Stillman

2015-06-01

Full Text Available Our objective was to provide descriptive data on flight attendant secondhand smoke (SHS exposure in the work environment, and to examine attitudes toward SHS exposure, personal health, and smoke-free policy in the workplace and public places. Flight attendants completed a web-based survey of self-reported SHS exposure and air quality in the work environment. We assessed the frequency and duration of SHS exposure in distinct areas of the workplace, attitudes toward SHS exposure and its health effects, and attitudes toward smoke-free policy in the workplace as well as general public places. A total of 723 flight attendants participated in the survey, and 591 responded to all survey questions. The mean level of exposure per flight attendant over the past month was 249 min. The majority of participants reported being exposed to SHS always/often in outdoor areas of an airport (57.7%. Participants who worked before the in-flight smoking ban (n = 240 were more likely to support further smoking policies in airports compared to participants who were employed after the ban (n = 346 (76.7% versus 60.4%, p-value < 0.01. Flight attendants are still being exposed to SHS in the workplace, sometimes at concerning levels during the non-flight portions of their travel. Flight attendants favor smoke-free policies and want to see further restrictions in airports and public places.

A quantitative content analysis of UK newsprint coverage of proposed legislation to prohibit smoking in private vehicles carrying children.

Science.gov (United States)

Patterson, Chris; Semple, Sean; Wood, Karen; Duffy, Sheila; Hilton, Shona

2015-08-08

Mass media representations of health issues influence public perceptions of those issues. Despite legislation prohibiting smoking in public spaces, second-hand smoke (SHS) remains a health risk in the United Kingdom (UK). Further legislation might further limit children's exposure to SHS by prohibiting smoking in private vehicles carrying children. This research was designed to determine how UK national newspapers represented the debate around proposed legislation to prohibit smoking in private vehicles carrying children. Quantitative analysis of the manifest content of 422 articles about children and SHS published in UK and Scottish newspapers between 1st January 2003 and 16th February 2014. Researchers developed a coding frame incorporating emergent themes from the data. Each article was double-coded. The frequency of relevant articles rose and fell in line with policy debate events. Children were frequently characterised as victims of SHS, and SHS was associated with various health risks. Articles discussing legislation targeting SHS in private vehicles carrying children presented supportive arguments significantly more frequently than unsupportive arguments. The relatively positive representation of legislation prohibiting smoking in vehicles carrying children is favourable to policy advocates, and potentially indicative of likely public acceptance of legislation. Our findings support two lessons that public health advocates may consider: the utility of presenting children as a vulnerable target population, and the possibility of late surges in critical arguments preceding policy events.

Secondhand Smoke Exposure Reduced the Compensatory Effects of IGF-I Growth Signaling in the Aging Rat Hearts.

Science.gov (United States)

Wu, Jia-Ping; Hsieh, Dennis Jine-Yuan; Kuo, Wei-Wen; Han, Chien-Kuo; Pai, Peiying; Yeh, Yu-Lan; Lin, Chien-Chung; Padma, V Vijaya; Day, Cecilia Hsuan; Huang, Chih-Yang

2015-01-01

Secondhand smoke (SHS) exposure is associated with increased risk of cardiovascular disease. Aging is a physiological process that involves progressive impairment of normal heart functions due to increased vulnerability to damage. This study examines secondhand smoke exposure in aging rats to determine the age-related death-survival balance. Rats were placed into a SHS exposure chamber and exposed to smog. Old age male Sprague-Dawley rats were exposed to 10 cigarettes for 30 min, day and night, continuing for one week. After 4 weeks the rats underwent morphological and functional studies. Left ventricular sections were stained with hematoxylin-eosin for histopathological examination. TUNEL detected apoptosis cells and protein expression related death and survival pathway were analyzed using western blot. Death receptor-dependent apoptosis upregulation pathways and the mitochondria apoptosis proteins were apparent in young SHS exposure and old age rats. These biological markers were enhanced in aging SHS-exposed rats. The survival pathway was found to exhibit compensation only in young SHS-exposed rats, but not in the aging rats. Further decrease in the activity of this pathway was observed in aging SHS-exposed rats. TUNEL apoptotic positive cells were increased in young SHS-exposed rats, and in aging rats with or without SHS-exposure. Aging reduces IGF-I compensated signaling with accelerated cardiac apoptotic effects from second-hand smoke.

Tobacco smoke induced COPD/emphysema in the animal model – are we all on the same page?

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Maike eLeberl

2013-05-01

Full Text Available Chronic Obstructive Pulmonary Disease (COPD is one of the foremost causes of death worldwide. It is primarily caused by tobacco smoke, making it an easily preventable disease, but facilitated by genetic α-1 antitrypsin deficiency. In addition to active smokers, health problems also occur in people involuntarily exposed to second hand smoke (SHS. Currently, the relationship between SHS and COPD is not well established. Knowledge of pathogenic mechanisms is limited, thereby halting the advancement of new treatments for this socially and economically detrimental disease. Here, we attempt to summarize tobacco smoke studies undertaken in animal models, applying both mainstream (direct, nose only and side stream (indirect, whole body smoke exposures. This overview of 155 studies compares cellular and molecular mechanisms as well as proteolytic, inflammatory, and vasoreactive responses underlying COPD development. This is a difficult task, as listing of exposure parameters is limited for most experiments. We show that both mainstream and SHS studies largely present similar inflammatory cell populations dominated by macrophages as well as elevated chemokine/cytokine levels, such as TNF-α. Additionally, SHS, like mainstream smoke, has been shown to cause vascular remodeling and neutrophil elastase-mediated proteolytic matrix breakdown with failure to repair. Disease mechanisms and therapeutic interventions appear to coincide in both exposure scenarios. One of the more widely applied interventions, the anti-oxidant therapy, is successful for both mainstream and SHS. The comparison of direct with indirect smoke exposure studies in this review emphasizes that, even though there are many overlapping pathways, it is not conclusive that SHS is using exactly the same mechanisms as direct smoke in COPD pathogenesis, but should be considered a preventable health risk. Some characteristics and therapeutic alternatives uniquely exist in SHS-related COPD.

Clear Skies and Grey Areas: Flight Attendants' Secondhand Smoke Exposure and Attitudes toward Smoke-Free Policy 25 Years since Smoking was Banned on Airplanes.

Science.gov (United States)

Stillman, Frances A; Soong, Andrea; Zheng, Laura Y; Navas-Acien, Ana

2015-06-04

Our objective was to provide descriptive data on flight attendant secondhand smoke (SHS) exposure in the work environment, and to examine attitudes toward SHS exposure, personal health, and smoke-free policy in the workplace and public places. Flight attendants completed a web-based survey of self-reported SHS exposure and air quality in the work environment. We assessed the frequency and duration of SHS exposure in distinct areas of the workplace, attitudes toward SHS exposure and its health effects, and attitudes toward smoke-free policy in the workplace as well as general public places. A total of 723 flight attendants participated in the survey, and 591 responded to all survey questions. The mean level of exposure per flight attendant over the past month was 249 min. The majority of participants reported being exposed to SHS always/often in outdoor areas of an airport (57.7%). Participants who worked before the in-flight smoking ban (n=240) were more likely to support further smoking policies in airports compared to participants who were employed after the ban (n=346) (76.7% versus 60.4%, p-valuesmoke-free policies and want to see further restrictions in airports and public places.

Developing a smoke free homes initiative in Kerala, India.

Science.gov (United States)

Nichter, Mimi; Padmajam, Sreedevi; Nichter, Mark; Sairu, P; Aswathy, S; Mini, G K; Bindu, V C; Pradeepkumar, A S; Thankappan, K R

2015-05-10

Results of the Global Adult Tobacco Survey in Kerala, India found that 42 % of adults were exposed to second hand smoke (SHS) inside the home. Formative research carried out in rural Kerala suggests that exposure may be much higher. Numerous studies have called for research and intervention on SHS exposure among women and children as an important component of maternal and child health activities. Community-based participatory research was carried out in Kerala. First, a survey was conducted to assess prevalence of SHS exposure in households. Next, a proof of concept study was conducted to develop and test the feasibility of a community-wide smoke free homes initiative. Educational materials were developed and pretested in focus groups. After feasibility was established, pilot studies were implemented in two other communities. Post intervention, surveys were conducted as a means of assessing changes in community support. At baseline, between 70 and 80 % of male smokers regularly smoked inside the home. Over 80 % of women had asked their husband not to do so. Most women felt powerless to change their husband's behavior. When women were asked about supporting a smoke free homes intervention, 88 % expressed support for the idea, but many expressed doubt that their husbands would comply. Educational meetings were held to discuss the harms of second hand smoke. Community leaders signed a declaration that their community was part of the smoke free homes initiative. Six months post intervention a survey was conducted in these communities; between 34 and 59 % of men who smoked no longer smoked in their home. The smoke free homes initiative is based on the principle of collective efficacy. Recognizing the difficulty for individual women to effect change in their household, the movement establishes a smoke free community mandate. Based on evaluation data from two pilot studies, we can project that between a 30 and 60 % reduction of smoking in the home may be achieved, the

The impact of smoke-free legislation on reducing exposure to secondhand smoke: differences across gender and socioeconomic groups.

Science.gov (United States)

Tsai, Yi-Wen; Chang, Li-Chuan; Sung, Hai-Yen; Hu, Teh-Wei; Chiou, Shu-Ti

2015-01-01

On 11 January 2009, Taiwan expanded its smoke-free legislation to all indoor public places and workplaces. This study examined the impact of this policy on secondhand smoke (SHS) exposure in adult non-smokers, across gender and socioeconomic status groups (SES). An annual sample of about 13,000-14,000 non-smokers was drawn from cross-sectional nationwide data of Taiwan Adult Tobacco Behavior Surveys during 2005-2011. Logistic regressions were used to analyse the aggregate data to estimate the association between the 2009 smoke-free legislation and SHS exposures in homes and workplaces. Interaction terms were used to examine the impact of the 2009 smoke-free policy on reducing differences in SHS exposure across gender, education and income groups. The 2009 policy reduced the odds of SHS exposure in homes in 2009 (OR=0.76, 95% CI 0.68 to 0.84) and in workplaces (year 2009: OR=0.49, 95% CI 0.39 to 0.62; year 2010: OR=0.79, 95% CI 0.66 to 0.95). The model with interaction terms showed that men were more likely than women to be exposed to workplace SHS (OR=2.02, 95% CI 1.80 to 2.27) but were less likely to be exposed to home SHS (OR=0.79, 95% CI 0.73 to 0.86). SHS exposure in homes was significantly related to lower socioeconomic status, but the 2009 smoke-free policy reduced the difference in SHS exposure across education levels. The 2009 smoke-free policy reduced the SHS exposure for non-smokers. However, this impact on home SHS did not persist after 2009, and the effect of protection was unequal across gender and SES groups. Thus, further enforcement of smoking restrictions would be needed to reduce the risk of SHS exposure and improve protection against SHS risk among parts of the population with lower socioeconomic status. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Secondhand smoke exposure in young people and parental rules against smoking at home and in the car.

Science.gov (United States)

Cartmell, Kathleen B; Miner, Christine; Carpenter, Matthew J; Vitoc, Camelia S; Biggers, Sharon; Onicescu, Georgiana; Hill, Elizabeth G; Nickerson, Brenda C; Alberg, Anthony J

2011-01-01

Secondhand smoke (SHS) exposure is an important cause of morbidity in children. We assessed the impact of family rules about smoking in the home and car on SHS exposure prevalence in students in grades six to 12. We studied never-smoking young people (n = 1,698) in the random sample cross-sectional South Carolina Youth Tobacco Survey, a 2006 survey of middle and high school students in South Carolina. Overall, 40% of the students reported SHS exposure in either the home or car in the past week; among these, 85% reported exposure in cars. Subsequent analyses focused on students who lived with a smoker (n = 602). Compared with those whose families prohibited smoking in the home or car, SHS exposure prevalence was 30% (p car) and 36% (p car, and 55% (p car that were adhered to, SHS exposure prevalence was significantly higher (p cars were much less likely to report SHS exposure. Parents would be wise to endorse and enforce strong smoke-free policies for both homes and cars.

Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption.

LENUS (Irish Health Repository)

Callinan, Joanne E

2010-01-01

BACKGROUND: Smoking bans have been implemented in a variety of settings, as well as being part of policy in many jurisdictions to protect the public and employees from the harmful effects of secondhand smoke (SHS). They also offer the potential to influence social norms and smoking behaviour of those populations they affect. OBJECTIVES: To assess the extent to which legislation-based smoking bans or restrictions reduce exposure to SHS, help people who smoke to reduce tobacco consumption or lower smoking prevalence and affect the health of those in areas which have a ban or restriction in place. SEARCH STRATEGY: We searched the Cochrane Tobacco Addiction Group Specialised Register, MEDLINE, EMBASE, PsycINFO, CINAHL, Conference Paper Index, and reference lists and bibliographies of included studies. We also checked websites of various organisations. Date of most recent search; July 1st 2009. SELECTION CRITERIA: We considered studies that reported legislative smoking bans and restrictions affecting populations. The minimum standard was having a ban explicitly in the study and a minimum of six months follow-up for measures of smoking behaviour. We included randomized controlled trials, quasi-experimental studies (i.e. non-randomized controlled studies), controlled before and after studies, interrupted-time series as defined by the Cochrane Effective Practice and Organization of Care Group, and uncontrolled pre- and post-ban data. DATA COLLECTION AND ANALYSIS: Characteristics and content of the interventions, participants, outcomes and methods of the included studies were extracted by one author and checked by a second. Because of heterogeneity in the design and content of the studies, we did not attempt a meta-analysis. We evaluated the studies using qualitative narrative synthesis. MAIN RESULTS: There were 50 studies included in this review. Thirty-one studies reported exposure to secondhand smoke (SHS) with 19 studies measuring it using biomarkers. There was

Knowledge of the health consequences of tobacco smoking: a cross-sectional survey of Vietnamese adults

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Dao Thi Minh An

2013-01-01

Full Text Available Background: Although substantial efforts have been made to curtail smoking in Vietnam, the 2010 Global Adult Tobacco Survey (GATS revealed that the proportion of male adults currently smoking remains high at 47.4%. Objectives: To determine the level of, and characteristics associated with, knowledge of the health consequences of smoking among Vietnamese adults. Design: GATS 2010 was designed to survey a nationally representative sample of Vietnamese men and women aged 15 and older drawn from 11,142 households using a two-stage sampling design. Descriptive statistics were calculated and multivariate logistic regression was used to examine associations between postulated exposure factors (age, education, access to information, ethnic group etc. and knowledge on health risks. Results: General knowledge on the health risks of active smoking (AS and exposure to second hand smoke (SHS was good (90% and 83%, respectively. However, knowledge on specific diseases related to tobacco smoking (stroke, heart attack, and lung cancer appeared to be lower (51.5%. Non-smokers had a significantly higher likelihood of demonstrating better knowledge on health risks related to AS (OR 1.6 and SHS (OR 1.7 than smokers. Adults with secondary education, college education or above also had significantly higher levels knowledge of AS/SHS health risks than those with primary education (AS: ORs 1.6, 1.7, and 1.9, respectively, and SHS: ORs 2.4, 3.9, and 5.7 respectively. Increasing age was positively associated with knowledge of the health consequences of SHS, and access to information was significantly associated with knowledge of AS/SHS health risks (ORs 2.3 and 1.9 respectively. Otherwise, non-Kinh ethnic groups had significantly less knowledge on health risks of AS/SHS than Kinh ethnic groups. Conclusions: It may be necessary to target tobacco prevention programs to specific subgroups including current smokers, adults with low education, non-Kinh ethnics in order to

Smokers’ compliance with smoke-free policies, and non-smokers’ assertiveness for smoke-free air in the workplace: a study from the Balkans.

Science.gov (United States)

Lazuras, Lambros; Zlatev, Martin; Rodafinos, Angelos; Eiser, J Richard

2012-10-01

Identify the psychosocial variables that predict smokers’ compliance with smoke-free policies at work, and non-smokers’ assertiveness for smoke-free rights in Greek and Bulgarian workplaces. Data were collected from employees in Greece and Bulgaria. The main outcome measures were smokers’ compliance with smoke-free policies, and non-smokers’ assertiveness intentions. Demographic variables, tobacco use and dependence, as well as beliefs about second-hand smoke (SHS) exposure and smoking at work were also assessed. Regression analyses showed that smokers’ compliance with smoke-free policies was predicted by age, perceived health risks of smoking, and beliefs related to the benefits of smoking at work. Non-smokers’ assertiveness was predicted by annoyance from exposure to SHS at work, and assertiveness-related social cognitions (e.g., attitudes, social norms, and self-efficacy). Interventions to promote support for tobacco control policies at work in Greece and Bulgaria may benefit from targeting smokers’ beliefs about the actual effects of tobacco use on health and job performance. Accordingly, efforts to promote non-smokers assertiveness should build stronger assertiveness-related attitudes, convey anti-smoking normative messages, and strengthen self-efficacy skills.

Exposure to secondhand smoke and voluntary adoption of smoke-free home and car rules among non-smoking South African adults

OpenAIRE

Ayo-Yusuf, Olalekan A; Olufajo, Olubode; Agaku, Israel T

2014-01-01

Background: Secondhand smoke (SHS) exposure is a well-established health hazard. To determine the effectiveness of existing smoke-free policies and adoption of smoke-free rules in South Africa, we assessed exposure to SHS from several sources among non-smoking adults during 2010. Methods: Data were analyzed for 3,094 adults aged ≥16 years who participated in the 2010 South African Social Attitudes Survey. Descriptive statistics and multivariate analyses were used to assess presence of smoke-f...

Pulmonary effects of active smoking and secondhand smoke exposure among adolescent students in Juárez, Mexico.

Science.gov (United States)

Bird, Yelena; Staines-Orozco, Hugo

2016-01-01

Youth smoking trends among Latin American countries, including Mexico, are on the rise. Notably, although the high prevalence of smoking in teens has been well documented in the literature, few studies have evaluated the impact of smoking and secondhand smoke (SHS) exposure on their respiratory system. To investigate the effects of smoking and SHS exposure on the respiratory health and lung function among eighth-grade students in Juárez, Mexico. A cross-sectional study was undertaken on a sample of convenience. The study outcomes centered on evaluating 300 students' lung function by spirometry (forced expiratory volume in 1 second [FEV1], forced expiratory volume in 1 second/forced vital capacity ratio [FEV1/FVC], and forced mid-expiratory flow rate [FEF25%-75%]) and their respiratory health (smoking behavior and SHS exposure) by their self-reported responses to a standardized respiratory questionnaire. The study outcomes were compared among three distinct groups: 1) nonsmokers/nonexposed to SHS; 2) nonsmokers/exposed to SHS; and 3) smokers. The majority of the study participants were 14 years old (85%), females (54%), who attended eighth grade in a public school setting (56%). Approximately, half reported being of low socioeconomic status (49%) and nonsmokers/exposed to SHS (49%). The lung function parameters of smokers were found to be lower (FEV1 =62.88±10.25; FEV1/FVC =83.50±14.15; and FEF25%-75% =66.35±12.55) than those recorded for the nonsmokers/exposed to SHS (FEV1 =69.41±11.35; FEV1/FVC =88.75±15.75; and FEF25%-75% =78.90±14.65) and significantly reduced when compared to the nonsmokers/nonexposed to SHS (FEV1 =79.14±13.61; FEV1/FVC =94.88±21.88; and FEF25%-75% =87.36±17.02) (P<0.001). Similarly, respiratory complaints were more prevalent among smokers and those exposed to SHS when compared to nonsmokers/nonexposed to SHS. Our findings suggest that initiation of cigarette smoking and, to a lesser extent, exposure to SHS in adolescence leads to

Challenges in Creating Evidence in Environmental Health Risk Assessments: The Example of Second-Hand Smoke

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Florian Fischer

2016-01-01

Full Text Available Public health interventions are directed to influence the (state of a risk factor, either by behavioral or environmental changes. Therefore, environmental health risk assessments are highly relevant for public health decision making and policy development. The credibility of an environmental health risk assessment depends, to a large extent, on the strength of the scientific evidence on which it is based. In this article, the main challenges for assessing the impact of a potential adverse health effect from an environmental pollutant are described. Second-hand smoke (SHS was chosen to illustrate the current state of evidence. The assessment of the impact of potential adverse health effects from environmental risk factors is dependent on several issues, such as the hypothesized health outcome, the nature of the exposure, the dose-response-relationship and the variability and susceptibility of the exposed population. The example of SHS exposure highlights the need for evidence-based public health. Several challenges in terms of study design, assessment methods, as well as data analysis and synthesis with respect to the stratification of results, and consideration of bias and confounding exist. Future research needs to take into account which methods and techniques will be used to generate evidence for population-level decisions.

Secondhand smoke exposure of children at home and prevalence of parental smoking following implementation of the new tobacco control law in Macao.

Science.gov (United States)

Zheng, Z L; Deng, H Y; Wu, C P; Lam, W L; Kuok, W S; Liang, W J; Wang, H L

2017-03-01

To investigate secondhand smoke exposure (SHS) of children at home and the prevalence of parental smoking after implementation of the new tobacco control law in Macao. This study explored whether the smoking ban in public places in Macao has decreased the prevalence of smoking or led to increased SHS exposure of children at home. As smokers cannot smoke in public places any more, they may smoke at home more frequently; a displacement effect of smoke-free legislation. Cross-sectional survey. This study surveyed 337 fathers and 538 mothers. Questions from a subset of key questions from the Global Adult Tobacco Survey (2nd edition) were applied to assess the SHS exposure of children and the prevalence of parental smoking since the smoking ban. A classification tree analysis was used to analyse the factors increasing SHS exposure of children. The prevalence of SHS exposure in children at home was 41.3%. The prevalence rates of paternal and maternal smoking were 43.7% and 3.8%, respectively. Compared with data reported by the Health Bureau of Macao SAR in 2011, the prevalence of parental smoking and the prevalence of SHS exposure of children at home have not decreased since the smoking ban. Analysis of the factors increasing the prevalence of SHS exposure of children indicated that fathers with an education level below high school were more likely to contribute to this increase, compared with fathers with a high school education or more (48.2% vs 32.4%, respectively). In addition, fathers represented the majority of smokers at home, accounting for 92.0% of 415 smoking parents. The prevalence of paternal smoking (82.0%) in the group of children with SHS exposure was much higher than that in the unexposed group (16.7%, Chi-squared test = 367.199, P = 0.000). The SHS exposure of children increased consistently with the decrease in paternal education level. This was consistent with the increasing prevalence of paternal smoking as paternal education level decreased. SHS

Promoting smoke-free homes: a novel behavioral intervention using real-time audio-visual feedback on airborne particle levels.

Directory of Open Access Journals (Sweden)

Neil E Klepeis

Full Text Available Interventions are needed to protect the health of children who live with smokers. We pilot-tested a real-time intervention for promoting behavior change in homes that reduces second hand tobacco smoke (SHS levels. The intervention uses a monitor and feedback system to provide immediate auditory and visual signals triggered at defined thresholds of fine particle concentration. Dynamic graphs of real-time particle levels are also shown on a computer screen. We experimentally evaluated the system, field-tested it in homes with smokers, and conducted focus groups to obtain general opinions. Laboratory tests of the monitor demonstrated SHS sensitivity, stability, precision equivalent to at least 1 µg/m(3, and low noise. A linear relationship (R(2 = 0.98 was observed between the monitor and average SHS mass concentrations up to 150 µg/m(3. Focus groups and interviews with intervention participants showed in-home use to be acceptable and feasible. The intervention was evaluated in 3 homes with combined baseline and intervention periods lasting 9 to 15 full days. Two families modified their behavior by opening windows or doors, smoking outdoors, or smoking less. We observed evidence of lower SHS levels in these homes. The remaining household voiced reluctance to changing their smoking activity and did not exhibit lower SHS levels in main smoking areas or clear behavior change; however, family members expressed receptivity to smoking outdoors. This study established the feasibility of the real-time intervention, laying the groundwork for controlled trials with larger sample sizes. Visual and auditory cues may prompt family members to take immediate action to reduce SHS levels. Dynamic graphs of SHS levels may help families make decisions about specific mitigation approaches.

Asthma diagnosis in a child and cessation of smoking in the child's home : the PIAMA birth cohort

NARCIS (Netherlands)

Wijga, Alet H; Schipper, Maarten; Brunekreef, Bert; Koppelman, Gerard H; Gehring, Ulrike

Second hand smoke (SHS) exposure is associated with increased incidence and severity of childhood asthma. We investigated whether, in turn, asthma diagnosis in a child is associated with cessation of smoking exposure in the child's home. In the PIAMA birth cohort (n=3963), parents reported on

Asthma diagnosis in a child and cessation of smoking in the child's home : the PIAMA birth cohort

NARCIS (Netherlands)

Wijga, Alet H.; Schipper, Maarten; Brunekreef, Bert; Koppelman, Gerard H.; Gehring, Ulrike

2017-01-01

Second hand smoke (SHS) exposure is associated with increased incidence and severity of childhood asthma. We investigated whether, in turn, asthma diagnosis in a child is associated with cessation of smoking exposure in the child's home. In the PIAMA birth cohort (n = 3963), parents reported on

Second Hand Smoke Exposure and Excess Heart Disease and Lung Cancer Mortality among Hospital Staff in Crete, Greece: A Case Study

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Anthony Kafatos

2008-09-01

Full Text Available Exposure to secondhand smoke (SHS is a serious threat to public health, and a significant cause of lung cancer and heart disease among non-smokers. Even though Greek hospitals have been declared smoke free since 2002, smoking is still evident. Keeping the above into account, the aim of this study was to quantify the levels of exposure to environmental tobacco smoke and to estimate the attributed lifetime excess heart disease and lung cancer deaths per 1000 of the hospital staff, in a large Greek public hospital. Environmental airborne respirable suspended particles (RSP of PM2.5 were performed and the personnel’s excess mortality risk was estimated using risk prediction formulas. Excluding the intensive care unit and the operating theatres, all wards and clinics were polluted with environmental tobacco smoke. Mean SHS-RSP measurements ranged from 11 to 1461 μg/m3 depending on the area. Open wards averaged 84 μg/m3 and the managing wards averaged 164 μg/m3 thus giving an excess lung cancer and heart disease of 1.12 (range 0.23-1.88 and 11.2 (range 2.3–18.8 personnel in wards and 2.35 (range 0.55-12.2 and 23.5 (range 5.5–122 of the managing staff per 1000 over a 40-year lifespan, respectively. Conclusively, SHS exposure in hospitals in Greece is prevalent and taking into account the excess heart disease and lung cancer mortality risk as also the immediate adverse health effects of SHS exposure, it is clear that proper implementation and enforcement of the legislation that bans smoking in hospitals is imperative to protect the health of patients and staff alike.

Secondhand Smoke Exposure Among Nonsmoking Adolescents in West Africa

Science.gov (United States)

Veeranki, Sreenivas P.; Kioko, David M.; Ogwell Ouma, Ahmed E.

2015-01-01

Objectives. We estimated the prevalence and determinants of secondhand smoke (SHS) exposure among nonsmoking adolescents in 9 West African countries. Methods. We conducted a pooled analysis with nationally representative 2006 to 2009 Global Youth Tobacco Survey data. We used descriptive statistics to determine the prevalence of SHS exposure and inferential statistics using a multivariable logistic regression model to determine factors associated with SHS exposure. We investigated average marginal effect results that show the probability of SHS exposure, adjusting for all other attributes. Results. SHS exposure inside the home ranged from 13.0% to 45.0%; SHS exposure outside the home ranged from 24.7% to 80.1%. Parental or peer smoking behaviors were significantly associated with higher probability of SHS exposure in all 9 countries. Knowledge of smoking harm, support for smoking bans, exposure to antismoking media messages, and receptivity of school tobacco education were significantly associated with higher SHS exposure in most countries. Conclusions. West African policymakers should adopt policies consistent with Article 8 of the World Health Organization Framework Convention on Tobacco Control and its guidelines and public health education to promote smoke-free households. PMID:26180960

Secondhand tobacco smoke exposure in selected public places (PM2.5 and air nicotine) and non-smoking employees (hair nicotine) in Ghana.

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Agbenyikey, Wilfred; Wellington, Edith; Gyapong, John; Travers, Mark J; Breysse, Patrick N; McCarty, Kathleen M; Navas-Acien, Ana

2011-03-01

Secondhand tobacco smoke (SHS) exposure is a global public health problem. Ghana currently has no legislation to prevent smoking in public places. To provide data on SHS levels in hospitality venues in Ghana the authors measured (1) airborne particulate matter working in smoking venues (median 2.49 [0.46-6.84] ng/mg) compared to those working in non-smoking venues (median 0.16 [0.08-0.79]ng/mg). Hair nicotine concentrations correlated with self-reported hours of SHS exposure (r=0.35), indoor air PM(2.5) concentrations (r=0.47) and air nicotine concentrations (r=0.63). SHS levels were unacceptably high in public places in Ghana where smoking is allowed, despite a relatively low-smoking prevalence in the country. This is one of the first studies to ascertain SHS and hair nicotine in Africa. Levels were comparable to those measured in American, Asian and European countries without or before smoking bans. Implementing a comprehensive smoke-free legislation that protects workers and customers from exposure to secondhand smoke is urgently needed in Ghana.

Second hand smoke exposure and the risk of invasive meningococcal disease in children: systematic review and meta-analysis

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Murray Rachael L

2012-12-01

Full Text Available Abstract Background Invasive meningococcal disease remains an important cause of serious morbidity and mortality in children and young people. There is a growing body of literature to suggest that exposure to passive smoke may play a role in the development of the disease, therefore we have performed a systematic review to provide a comprehensive estimate of the magnitude of this effect for smoking by any household member, by individual family members, and of maternal smoking before and after birth. Methods Four databases (Medline, Embase, PsychINFO and CAB Abstracts database were searched to identify studies (to June 2012 and reference lists scanned for further studies. Titles, abstracts and full texts were checked for eligibility independently by two authors. Quality of included studies was assessed using the Newcastle-Ottawa Scale. Pooled odds ratios (OR with 95% confidence intervals (CI were estimated using random effect models, with heterogeneity quantified using I2. Results We identified 18 studies which assessed the effects of SHS on the risk of invasive meningococcal disease in children. SHS in the home doubled the risk of invasive meningococcal disease (OR 2.18, 95% CI 1.63 to 2.92, I2 = 72%, with some evidence of an exposure-response gradient. The strongest effect was seen in children under 5 years (OR 2.48, 95% CI 1.51 to 4.09, I2 = 47%. Maternal smoking significantly increased the risk of invasive meningococcal disease by 3 times during pregnancy (OR 2.93, 95% CI 1.52-5.66 and by 2 times after birth (OR 2.26, 95% CI 1.54-3.31. Conclusions SHS exposure, and particularly passive foetal exposure to maternal smoking during pregnancy, significantly increases the risk of childhood invasive meningococcal disease. It is likely that an extra 630 cases of invasive meningococcal disease annually in children under 16 are directly attributable to SHS exposure in UK homes.

Pulmonary effects of active smoking and secondhand smoke exposure among adolescent students in Juárez, Mexico

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Bird Y

2016-06-01

Full Text Available Yelena Bird,1 Hugo Staines-Orozco2 1School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada; 2Institute of Biomedical Sciences, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del PRONAF y Calle Estocolmo, Ciudad Juárez, Chihuahua, Mexico Background: Youth smoking trends among Latin American countries, including Mexico, are on the rise. Notably, although the high prevalence of smoking in teens has been well documented in the literature, few studies have evaluated the impact of smoking and secondhand smoke (SHS exposure on their respiratory system.  Objective: To investigate the effects of smoking and SHS exposure on the respiratory health and lung function among eighth-grade students in Juárez, Mexico. Methods: A cross-sectional study was undertaken on a sample of convenience. The study outcomes centered on evaluating 300 students’ lung function by spirometry (forced expiratory volume in 1 second [FEV1], forced expiratory volume in 1 second/forced vital capacity ratio [FEV1/FVC], and forced mid-expiratory flow rate [FEF25%–75%] and their respiratory health (smoking behavior and SHS exposure by their self-reported responses to a standardized respiratory questionnaire. The study outcomes were compared among three distinct groups: 1 nonsmokers/nonexposed to SHS; 2 nonsmokers/exposed to SHS; and 3 smokers. Results: The majority of the study participants were 14 years old (85%, females (54%, who attended eighth grade in a public school setting (56%. Approximately, half reported being of low socioeconomic status (49% and nonsmokers/exposed to SHS (49%. The lung function parameters of smokers were found to be lower (FEV1 =62.88±10.25; FEV1/FVC =83.50±14.15; and FEF25%–75% =66.35±12.55 than those recorded for the nonsmokers/exposed to SHS (FEV1 =69.41±11.35; FEV1/FVC =88.75±15.75; and FEF25%–75% =78.90±14.65 and significantly reduced when compared to the nonsmokers/nonexposed to SHS (FEV1 =79.14±13

Secondhand smoke in outdoor settings: smokers’ consumption, non-smokers’ perceptions, and attitudes towards smoke-free legislation in Spain

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Sureda, Xisca; Fernández, Esteve; Martínez-Sánchez, Jose M; Fu, Marcela; López, María J; Martínez, Cristina; Saltó, Esteve

2015-01-01

Objective To describe where smokers smoke outdoors, where non-smokers are exposed outdoors to secondhand smoke (SHS), and attitudes towards smoke-free outdoor areas after the implementation of national smoke-free legislation. Design This cross-sectional study was conducted between June 2011 and March 2012 (n=1307 participants). Setting Barcelona, Spain. Participants Representative, random sample of the adult (≥16 years) population. Primary and secondary outcomes Proportion of smoking and prevalence of exposure to SHS in the various settings according to type of enclosure. Percentages of support for outdoor smoke-free policies according to smoking status. Results Smokers reported smoking outdoors most in bars and restaurants (54.8%), followed by outdoor places at work (46.8%). According to non-smokers, outdoor SHS exposure was highest at home (42.5%) and in bars and restaurants (33.5%). Among non-smoking adult students, 90% claimed exposure to SHS on university campuses. There was great support for banning smoking in the majority of outdoor areas, which was stronger among non-smokers than smokers. Over 70% of participants supported smoke-free playgrounds, school and high school courtyards, and the grounds of healthcare centres. Conclusions Extending smoking bans to selected outdoor settings should be considered in further tobacco control interventions to protect non-smokers from SHS exposure and to establish a positive model for youth. The majority of public support for some outdoor smoke-free areas suggests that it is feasible to extend smoking bans to additional outdoor settings. PMID:25854974

Insufficient smoking restrictions in restaurants around junior high schools in Japan.

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Kotani, Kazuhiko; Osaki, Yoneatsu; Kurozawa, Youichi; Kishimoto, Takuji

2006-12-01

Controls for second hand smoke (SHS) and adolescent smoking have been still sociomedical concerns in Japan. Restaurant smoking restrictions are associated with community social norms affecting adolescent smoking behavior, and the status in areas around Junior high schools (JHSs) in the community could be a sign of community practices on regulating SHS for adolescents. To examine whether restaurant smoking restrictions are seen especially in areas around JHSs in Japan, a survey using the direct inspection of a total of 163 restaurants (64 restaurants within and 99 outside a 1-km radius from the nearest JHSs) was conducted in May 2003 in Yonago city, Japan. We assessed smoking restriction status in each restaurant and classified them into 2 groups according to the distance from the nearest JHSs. There were only 2 (3.1%) restaurants with 100% non-smoking and 11 (17.2%) with some partial restrictions among the restaurants within a 1-km radius of JHSs. There were 1 (1.0%) restaurant with 100% non-smoking, 3 (3.0%) with complete non-smoking sections and 17 (17.2%) with some partial restrictions among the restaurants outside a 1-km radius of JHSs. Among restaurants with some partial restrictions, restriction methods were considered insufficient. The smoking restriction status was not significantly different between the restaurant groups within and outside a 1-km radius of JHSs. These results suggest that the public awareness of and attitude toward adolescent smoking problems remains low in Japan. Further SHS control actions for adolescents are needed in Japan.

Secondhand Smoke Exposure 7 Years After an Indoor Smoke-Free Law.

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St Claire, Ann W; Amato, Michael S; Boyle, Raymond G; Rode, Peter; Kinney, Ann M

2018-01-01

To examine locations of secondhand smoke (SHS) exposure among nonsmokers, 7 years after a statewide smoke-free policy. Data collected via statewide, random digit dial telephone survey. Response rates were 64.7% for landline and 73.5% for cell phone. Minnesota, 2014. Representative sample of 7887 nonsmoking adults. Self-reported locations of SHS exposure and opinions on smoke-free restrictions. Descriptive statistics and logistic regression. A total of 35.5% of nonsmokers reported SHS exposure in the past 7 days. The greatest proportion of exposure occurred in community settings (31.7%) followed by cars (6.9%) and in the home (3.2%). Young adults were more likely to be exposed in a home or car than older adults. Nonsmokers living with a smoker were 39.6 (20.6-75.8) times more likely to be exposed to SHS in their home and 5.3 (4.1-6.8) times more likely to be exposed in a car, compared to those who did not live with a smoker. SHS exposure continues after comprehensive smoke-free policies restricted it from public places. Disparities in exposure rates exist for those who live with a smoker, are young, and have low incomes. Findings suggest the need for additional policies that will have the greatest public health benefit.

Smoke-Free Rules and Secondhand Smoke Exposure in Homes and Vehicles Among US Adults, 2009–2010

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Dube, Shanta R.; Homa, David M.

2013-01-01

Introduction An increasing number of US states and localities have implemented comprehensive policies prohibiting tobacco smoking in all indoor areas of public places and worksites. However, private settings such as homes and vehicles remain a major source of exposure to secondhand smoke (SHS) for many people. This study assessed the prevalence and correlates of voluntary smoke-free rules and SHS exposure in homes and vehicles among US adults. Methods We obtained data from the 2009–2010 National Adult Tobacco Survey, a landline and cellular-telephone survey of adults aged 18 years or older residing in the 50 US states or the District of Columbia. We calculated national and state estimates of smoke-free rules and past-7-day SHS exposure in homes and vehicles and examined national estimates by sex, age, race/ethnicity, and education. Results The national prevalence of voluntary smoke-free home rules was 81.1% (state range, 67.9%–92.9%), and the prevalence of household smoke-free vehicle rules was 73.6% (state range, 58.6%–85.8%). Among nonsmokers, the prevalence of SHS exposure was 6.0% in homes (state range, 2.4%–13.0%) and 9.2% in vehicles (state range, 4.8%–13.7%). SHS exposure among nonsmokers was greatest among men, younger adults, non-Hispanic blacks, and those with a lower level of education. Conclusion Most US adults report having voluntary smoke-free home and vehicle rules; however, millions of people remain exposed to SHS in these environments. Disparities in exposure also exist among certain states and subpopulations. Efforts are needed to warn about the dangers of SHS and to promote voluntary smoke-free home and vehicle rules. PMID:23680508

The effect of workplace smoking bans on heart rate variability and pulse wave velocity of non-smoking hospitality workers.

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Rajkumar, Sarah; Schmidt-Trucksäss, Arno; Wellenius, Gregory A; Bauer, Georg F; Huynh, Cong Khanh; Moeller, Alexander; Röösli, Martin

2014-08-01

To investigate the effect of a change in second-hand smoke (SHS) exposure on heart rate variability (HRV) and pulse wave velocity (PWV), this study utilized a quasi-experimental setting when a smoking ban was introduced. HRV, a quantitative marker of autonomic activity of the nervous system, and PWV, a marker of arterial stiffness, were measured in 55 non-smoking hospitality workers before and 3-12 months after a smoking ban and compared to a control group that did not experience an exposure change. SHS exposure was determined with a nicotine-specific badge and expressed as inhaled cigarette equivalents per day (CE/d). PWV and HRV parameters significantly changed in a dose-dependent manner in the intervention group as compared to the control group. A one CE/d decrease was associated with a 2.3% (95% CI 0.2-4.4; p = 0.031) higher root mean square of successive differences (RMSSD), a 5.7% (95% CI 0.9-10.2; p = 0.02) higher high-frequency component and a 0.72% (95% CI 0.40-1.05; p < 0.001) lower PWV. PWV and HRV significantly improved after introducing smoke-free workplaces indicating a decreased cardiovascular risk.

Relationship of secondhand smoke exposure with sociodemographic factors and smoke-free legislation in the European Union.

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Filippidis, Filippos T; Agaku, Israel T; Girvalaki, Charis; Jiménez-Ruiz, Carlos; Ward, Brian; Gratziou, Christina; Vardavas, Constantine I

2016-04-01

To explore whether exposure to secondhand smoke (SHS) among non-smokers in the European Union (EU) showed any association with sociodemographic factors and/or the extent of national tobacco control policies. A secondary analysis was performed on data from 26 751 individuals ≥15 years old from 27 EU member states (EU MS), collected during the 2012 Special Eurobarometer survey (wave 77.1). Respondents were asked whether they had been exposed to SHS in eating or drinking establishments during the past 6 months, and/or in their workplace. Data on smoke-free policies were extracted from the European Tobacco Control Status Report and the European Tobacco Control Scale (TCS) in 2013. In total, 29.0% of non-smoking participants reported being exposed to SHS in indoor areas. Males (vs. females) as well as individuals with difficulties to pay bills (vs. those with no difficulties), had significantly greater odds of being exposed to SHS in bars, restaurants and workplaces. For every unit increase of a country's score on the Smoke-free Component of the TCS (indicating greater adherence to smoke-free legislations) the odds ratio of reporting exposure to SHS was 0.82 in bars, 0.85 in restaurants and 0.94 in workplaces. Differences in exposure to SHS clearly exist between and within EU MS, despite the fact that they all have signed the Framework Convention on Tobacco Control, with the burden found to disproportionally affect younger people and individuals with financial difficulties. Moreover, enforcement of smoke-free legislation was inversely associated with SHS exposure, highlighting the importance of enforcing comprehensive smoking bans. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Changes in child exposure to secondhand smoke after implementation of smoke-free legislation in Wales: a repeated cross-sectional study

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Holliday Jo

2009-01-01

Full Text Available Abstract Background Smoke-free legislation was introduced in Wales in April 2007. In response to concerns regarding potential displacement of smoking into the home following legislation, this study assessed changes in secondhand smoke (SHS exposure amongst non-smoking children. Methods Approximately 1,750 year 6 (aged 10-11 children from 75 Welsh primary schools were included in cross-sectional surveys immediately pre-legislation and one year later. Participants completed self-report questionnaires and provided saliva samples for cotinine assay. Regression analyses assessed the impact of legislation on children's SHS exposure at the population level, and amongst subgroups defined by parental figures who smoke within the home. Results Geometric mean salivary cotinine concentrations were 0.17 ng/ml (95% CI 0.15,0.20 pre-legislation and 0.15 ng/ml (95% CI 0.13,0.17, post-legislation, although this change was not statistically significant. Significant movement was however observed from the middle (0.10-0.50 ng/ml to lower tertile, though not from the higher end (>0.51 ng/ml to the middle. Reported exposure to SHS was greatest within the home. Home-based exposure did not change significantly post-legislation. Reported exposure in cafés or restaurants, buses and trains, and indoor leisure facilities fell significantly. The proportion of children reporting that parent figures smoked in the home declined (P = 0.03, with children with no parent figures who smoke in the home significantly more likely to provide saliva with cotinine concentrations of <0.10 ng/ml post-legislation. Amongst children with no parent figures who smoke in the home, the likelihood of 'not knowing' or 'never' being in a place where people were smoking increased post-legislation. Conclusion Smoke-free legislation in Wales did not increase SHS exposure in homes of children aged 10-11. Reported SHS exposure in public places fell significantly. The home remained the main source of

Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: a cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban.

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Ravara, Sofia B; Calheiros, Jose M; Aguiar, Pedro; Barata, Luis Taborda

2011-09-23

Several studies have investigated attitudes to and compliance with smoking bans, but few have been conducted in healthcare settings and none in such a setting in Portugal. Portugal is of particular interest because the current ban is not in line with World Health Organization recommendations for a "100% smoke-free" policy. In November 2007, a Portuguese teaching-hospital surveyed smoking behaviour and tobacco control (TC) attitudes before the national ban came into force in January 2008. Questionnaire-based cross-sectional study, including all eligible staff. 52.9% of the 1, 112 staff; mean age 38.3 ± 9.9 years; 65.9% females. Smoking behaviour and TC attitudes and beliefs were the main outcomes. Bivariable analyses were conducted using chi-squared and MacNemar tests to compare categorical variables and Mann-Whitney tests to compare medians. Multilogistic regression (MLR) was performed to identify factors associated with smoking status and TC attitudes. Smoking prevalence was 40.5% (95% CI: 33.6-47.4) in males, 23.5% (95% CI: 19.2-27.8) in females (p smoking bans, even among smokers, despite the fact that 70.3% of the smokers smoked on the premises and 76% of staff reported being frequently exposed to second-hand smoke (SHS). In addition 42.8% reported that SHS was unpleasant and 28.3% admitted complaining. MLR showed that smoking behaviour was the most important predictor of TC attitudes. Smoking prevalence was high, especially among the lower socio-economic groups. The findings showed a very high level of support for smoking bans, despite the pro-smoking environment. Most staff reported passive behaviour, despite high SHS exposure. This and the high smoking prevalence may contribute to low compliance with the ban and low participation on smoking cessation activities. Smoking behaviour had greater influence in TC attitudes than health professionals' education. Our study is the first in Portugal to identify potential predictors of non-compliance with the partial

Factors associated with secondhand smoke incursion into the homes of non-smoking residents in a multi-unit housing complex: a cross-sectional study in Seoul, Korea

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Jeonghoon Kim

2017-09-01

Full Text Available Abstract Background In a multi-unit housing (MUH complex, secondhand smoke (SHS can pass from one living space to another. The aim of this study was to determine the prevalence of SHS incursion, and to establish the relationship between SHS incursion and socio-demographic and built environmental factors in MUH in Korea. Methods A population-based sample of 2600 residents (aged ≥19 years living in MUH from across the city of Seoul, Korea, was obtained through a web-based selection panel. The residents completed a questionnaire detailing socio-demographic factors, smoking status, frequency of SHS incursion, and built environmental factors. The presence of a personal smoke-free home rule was determined by residents declaring that no one smoked inside the home. Results Of the 2600 participants, non-smoking residents who lived in homes with a personal smoke-free rule were selected for further analysis (n = 1784. In the previous 12 months, 74.7% of residents had experienced SHS incursion ≥1 times. A multivariate ordinal logistic regression analysis indicated that residents who spent more time at home, lived with children, supported the implementation of smoke-free regulations in MUH, lived in small homes, lived in homes with natural ventilation provided by opening a front door or the windows and front door, and lived in homes with more frequent natural ventilation were more likely to report SHS incursion into their homes. Conclusions The majority of the non-smoking residents experienced SHS incursion, even with a personal smoke-free rule in their homes. A smoke-free policy in MUH is needed to protect residents from SHS exposure when they are at home.

Exposure to tobacco secondhand smoke and its associated factors among non-smoking adults in smoking-restricted and non-restricted areas: findings from a nationwide study in Malaysia.

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Lim, Kuang Hock; Teh, Chien Huey; Nik Mohamed, Mohamad Haniki; Pan, Sayan; Ling, Miaw Yn; Mohd Yusoff, Muhammad Fadhli; Hassan, Noraryana; Baharom, Nizam; Dawam, Netty Darwina; Ismail, Norliana; Ghazali, Sumarni Mohd; Cheong, Kee Chee; Chong, Kar Hon; Lim, Hui Li

2018-01-08

Secondhand smoke (SHS) has been associated with increased morbidity and mortality. Therefore, the aims of the paper are to assess SHS exposure among non-smoking adults in Malaysia attending various smoking-restricted and non-restricted public areas according to the Control of Tobacco Product Regulations (CTPR) as well as its relationship with various sociodemographic variables. Data were extracted from a cross-sectional study, the Global Adults Tobacco Survey (GATS) 2011 which involved 3269 non-smokers in Malaysia. Data was obtained through face-to-face interviews using a validated pre-tested questionnaire. Factors associated with exposure to SHS were identified via multivariable analysis. The study revealed that almost two-thirds of respondents were exposed to SHS in at least one public area in the past 1 month, with a significantly higher exposure among males (70.6%), those with higher educational attainment (81.4%) and higher income (quintile 1%-73.9%). Besides, the exposure to SHS was almost four times higher in non-restricted areas compared with restricted areas under the CTPR (81.9% vs 22.9). Multivariable analysis revealed that males and younger adults at non-restricted areas were more likely to be exposed to SHS while no significant associated factors of SHS exposure was observed in restricted areas. The study revealed the prevalence of SHS exposure was higher among Malaysian adults. Although smoke-free laws offer protection to non-smokers from exposure to SHS, enforcement activities in restricted areas should be enhanced to ensure strict public abidance. In addition, legislation of restricted areas should also be extended to greatly reduce the SHS exposure among non-smokers in Malaysia. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Secondhand smoke in outdoor settings: smokers' consumption, non-smokers' perceptions, and attitudes towards smoke-free legislation in Spain.

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Sureda, Xisca; Fernández, Esteve; Martínez-Sánchez, Jose M; Fu, Marcela; López, María J; Martínez, Cristina; Saltó, Esteve

2015-04-08

To describe where smokers smoke outdoors, where non-smokers are exposed outdoors to secondhand smoke (SHS), and attitudes towards smoke-free outdoor areas after the implementation of national smoke-free legislation. This cross-sectional study was conducted between June 2011 and March 2012 (n=1307 participants). Barcelona, Spain. Representative, random sample of the adult (≥16 years) population. Proportion of smoking and prevalence of exposure to SHS in the various settings according to type of enclosure. Percentages of support for outdoor smoke-free policies according to smoking status. Smokers reported smoking outdoors most in bars and restaurants (54.8%), followed by outdoor places at work (46.8%). According to non-smokers, outdoor SHS exposure was highest at home (42.5%) and in bars and restaurants (33.5%). Among non-smoking adult students, 90% claimed exposure to SHS on university campuses. There was great support for banning smoking in the majority of outdoor areas, which was stronger among non-smokers than smokers. Over 70% of participants supported smoke-free playgrounds, school and high school courtyards, and the grounds of healthcare centres. Extending smoking bans to selected outdoor settings should be considered in further tobacco control interventions to protect non-smokers from SHS exposure and to establish a positive model for youth. The majority of public support for some outdoor smoke-free areas suggests that it is feasible to extend smoking bans to additional outdoor settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Smoking in the home after childbirth: prevalence, determinants and the relationship to smoking in pregnancy

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Orton, Sophie

2016-01-01

Childhood secondhand smoke (SHS) exposure causes substantial ill health and mortality, and poses a significant economic and social burden. This thesis aimed to explore the prevalence and determinants of smoking in the home after childbirth, and to understand the experience and attitudes of mothers who stop smoking during pregnancy but relapse soon after delivery.\\ud \\ud \\ud In study one, the factors associated with child SHS exposure in the home were systematically reviewed. Parental smoking,...

Secondhand Smoke Exposure and Smoke-free Policy in Philadelphia Public Housing.

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Klassen, Ann C; Lee, Nora L; Pankiewicz, Aaron; Ward, Rikki; Shuster, Michelle; Ogbenna, Bethany Townsend; Wade, Anita; Boamah, Maxwell; Osayameh, Olufunlayo; Rule, Ana M; Szymkowiak, Dorota; Coffman, Ryan; Bragg, Virginius; Mallya, Giridhar

2017-04-01

Multi-unit housing environments remain significant sources of secondhand smoke (SHS) exposure, especially for vulnerable populations in subsidized housing. In Philadelphia, the largest US housing authority to implement smoke-free policies, we measured baseline resident smoking-related behaviors and attitudes, and longitudinal exposures to airborne nicotine, during policy development and implementation. In 4 communities, we collected data in 2013, 2014, and 2016, before and after introduction of comprehensive smoke-free policies, interviewing persons in 172 households, and monitoring air-borne nicotine in non-smoking homes and public areas. Average nicotine level differences across years were estimated with multi-level models. Fifty-six percent of respondents smoked. Only 37% of households were smoke-free, with another 41% restricting smoking by area or time of day. The number of locations with detectable nicotine did not differ before and after policy implementation, with approximately 20% of non-smoking homes and 70%-80% of public areas having detectable nicotine. However, public area nicotine levels were lower in 2016, after policy implementation, than in 2013 and 2014 (-0.19 μg/m 3 , p = .03). Findings suggest that initial policy implementation was associated with reduced SHS exposure in Philadelphia. As HUD strengthens smoke-free policies, SHS monitoring can be useful to educate stakeholders and build support for policy enforcement.

Statistika i karakter spoljne trgovine Kraljevine SHS 1919-1929.

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Ivan M. Becić

2015-08-01

Full Text Available Active trade balance was one of the most important factors of financial policy of the Kingdom of Serbs Croats and Slovenes. It was supposed to contribute to the stability of the domestic currency. This intention could not be achived until 1924 since the recovery of the economy of the Kingdom from the great casualties and material hardship in the First World War. In following years, the foreign trade balance was active, except in exceptional drought years of 1927 and 1928. The main items of export were agricultural products alongside with raw materials and semi-finished products. On the other hand, the main items of imports were manufactured goods, materials for the textile industry, different machinery and tools. Great importance for the import into the Kingdom of SHS were on its neighbours. In 1929 they accounted around 38.2% of import, while as the destination of the Yugoslav exports were absolutely dominant with 69.16%. The discrepancy between foreign trade and foreign policy of the Kingdom of SHS was obvious. Although the main Yugoslav ally at the time, France has participated in trade with only a few percent. It was similar practice with another Great War ally: Great Britain. Wider economic relations with Czechoslovakia were hindered by lack of Czech interest to purchase goods from the Kingdom of SHS. On the other hand, the most important partners were Italy, which showed huge belligerence against new Yugoslavian state, and have a strained political relations with Kingdom of SHS throughout the 1920s and Austria and Germany, both bitter enemies form the First World War.

The impact of SHS exposure on health status and exacerbations among patients with COPD

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Mark D Eisner

2009-05-01

Full Text Available Mark D Eisner1,3, Carlos Iribarren3, Edward H Yelin2, Stephen Sidney3, Patricia P Katz2, Gabriela Sanchez3, Paul D Blanc11Division of Occupational and Environmental Medicine and Division of Pulmonary and Critical Care Medicine; 2Institute for Health Policy Studies, Department of Medicine, University of California, San Francisco, CA, USA; 3Division of Research, Kaiser Permanente, Oakland, CA, USAAbstract: Secondhand smoke (SHS is a major contributor to indoor air pollution. Because it contains respiratory irritants, it may adversely influence the clinical course of persons with chronic obstructive pulmonary disease (COPD. We used data from nonsmoking members of the FLOW cohort of COPD (n = 809 to elucidate the impact of SHS exposure on health status and exacerbations (requiring emergency department visits or hospitalization. SHS exposure was measured by a validated survey instrument (hours of exposure during the past week. Physical health status was measured by the SF-12 Physical Component Summary Score and disease-specific health-related quality of life (HRQL by the Airways Questionnaire 20-R. Health care utilization for COPD was determined from Kaiser Permanente Northern California computerized databases. Compared to no SHS exposure, higher level SHS exposure was associated with poorer physical health status (mean score decrement −1.78 points; 95% confidence interval [CI] −3.48 to −0.074 points after controlling for potential confounders. Higher level SHS exposure was also related to poorer disease-specific HRQL (mean score increment 0.63; 95% CI 0.016 to 1.25 and less distance walked during the Six-Minute Walk test (mean decrement −50 feet; 95% CI −102 to 1.9. Both lower level and higher level SHS exposure was related to increased risk of emergency department (ED visits (hazard ratio [HR] 1.40; 95% CI 0.96 to 2.05 and HR 1.41; 95% CI 0.94 to 2.13. Lower level and higher level SHS exposure were associated with a greater risk of

Smoking behaviour, involuntary smoking, attitudes towards smoke-free legislations, and tobacco control activities in the European Union.

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Jose M Martínez-Sánchez

Full Text Available BACKGROUND: The six most important cost-effective policies on tobacco control can be measured by the Tobacco Control Scale (TCS. The objective of our study was to describe the correlation between the TCS and smoking prevalence, self-reported exposure to secondhand smoke (SHS and attitudes towards smoking restrictions in the 27 countries of the European Union (EU27. METHODS/PRINCIPAL FINDINGS: Ecologic study in the EU27. We used data from the TCS in 2007 and from the Eurobarometer on Tobacco Survey in 2008. We analysed the relations between the TCS and prevalence of smoking, self-reported exposure to SHS (home and work, and attitudes towards smoking bans by means of scatter plots and Spearman rank-correlation coefficients (r(sp. Among the EU27, smoking prevalence varied from 22.6% in Slovenia to 42.1% in Greece. Austria was the country with the lowest TCS score (35 and the UK had the highest one (93. The correlation between smoking prevalence and TCS score was negative (r(sp = -0.42, p = 0.03 and the correlation between TCS score and support to smoking bans in all workplaces was positive (r(sp = 0.47, p = 0.01 in restaurants; r(sp = 0.5, p = 0.008 in bars, pubs, and clubs; and r(sp = 0.31, p = 0.12 in other indoor workplaces. The correlation between TCS score and self-reported exposure to SHS was negative, but statistically non-significant. CONCLUSIONS/SIGNIFICANCE: Countries with a higher score in the TCS have higher support towards smoking bans in all workplaces (including restaurants, bars, pubs and clubs, and other indoor workplaces. TCS scores were strongly, but not statistically, associated with a lower prevalence of smokers and a lower self-reported exposure to SHS.

After the smoke has cleared: evaluation of the impact of a new national smoke-free law in New Zealand.

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Edwards, R; Thomson, G; Wilson, N; Waa, A; Bullen, C; O'Dea, D; Gifford, H; Glover, M; Laugesen, M; Woodward, A

2008-02-01

The New Zealand 2003 Smoke-free Environments Amendment Act (SEAA) extended existing restrictions on smoking in office and retail workplaces by introducing smoking bans in bars, casinos, members' clubs, restaurants and nearly all other workplaces from 10 December 2004. To evaluate the implementation and outcomes of aspects of the SEAA relating to smoke-free indoor workplaces and public places, excluding schools and early learning centres. Data were gathered on public and stakeholder attitudes and support for smoke-free policies; dissemination of information, enforcement activities and compliance; exposure to secondhand smoke (SHS) in the workplace; changes in health outcomes linked to SHS exposure; exposure to SHS in homes; smoking prevalence and smoking related behaviours; and economic impacts. Surveys suggested growing majority support for the SEAA and its underlying principles among the public and bar managers. There was evidence of high compliance in bars and pubs, where most enforcement problems were expected. Self reported data suggested that SHS exposure in the workplace, the primary objective of the SEAA, decreased significantly from around 20% in 2003, to 8% in 2006. Air quality improved greatly in hospitality venues. Reported SHS exposure in homes also reduced significantly. There was no clear evidence of a short term effect on health or on adult smoking prevalence, although calls to the smoking cessation quitline increased despite reduced expenditure on smoking cessation advertising. Available data suggested a broadly neutral economic impact, including in the tourist and hospitality sectors. The effects of the legislation change were favourable from a public health perspective. Areas for further investigation and possible regulation were identified such as SHS related pollution in semi-enclosed outdoor areas. The study adds to a growing body of literature documenting the positive impact of comprehensive smoke-free legislation. The scientific and public

Excessive Exposure to Secondhand Tobacco Smoke among Hospitality Workers in Kyrgyzstan

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Ana Navas-Acien

2010-03-01

Full Text Available The aim of this study was to assess the levels of secondhand smoke (SHS exposure of men and women in public places in Kyrgyzstan. This cross-sectional study involved 10 bars and restaurants in Bishkek the capital city of Kyrgyzstan. Smoking was allowed in all establishments. Median (interquartile range air nicotine concentrations were 6.82 (2.89, 8.86 μg/m3. Employees were asked about their smoking history and exposure to SHS at work. Employees were exposed to SHS for mean (SD 13.5 (3.6 hours a day and 5.8 (1.4 days a week. Women were exposed to more hours of SHS at work compared to men. Hospitality workers are exposed to excessive amounts of SHS from customers. Legislation to ban smoking in public places including bars and restaurants is urgently needed to protect workers and patrons from the harmful effects of SHS.

Excessive Exposure to Secondhand Tobacco Smoke among Hospitality Workers in Kyrgyzstan

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Vinnikov, Denis; Brimkulov, Nurlan; Shahrir, Shahida; Breysse, Patrick; Navas-Acien, Ana

2010-01-01

The aim of this study was to assess the levels of secondhand smoke (SHS) exposure of men and women in public places in Kyrgyzstan. This cross-sectional study involved 10 bars and restaurants in Bishkek the capital city of Kyrgyzstan. Smoking was allowed in all establishments. Median (interquartile range) air nicotine concentrations were 6.82 (2.89, 8.86) μg/m3. Employees were asked about their smoking history and exposure to SHS at work. Employees were exposed to SHS for mean (SD) 13.5 (3.6) hours a day and 5.8 (1.4) days a week. Women were exposed to more hours of SHS at work compared to men. Hospitality workers are exposed to excessive amounts of SHS from customers. Legislation to ban smoking in public places including bars and restaurants is urgently needed to protect workers and patrons from the harmful effects of SHS. PMID:20617012

Smoke-Free Rules and Secondhand Smoke Exposure in Vehicles among U.S. Adults-National Adult Tobacco Survey, 2009-2010 and 2013-2014.

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Kruger, Judy; Jama, Amal; Kegler, Michelle; Baker Holmes, Carissa; Hu, Sean; King, Brian

2016-10-26

In the United States (U.S.), secondhand smoke (SHS) exposure causes more than 41,000 deaths among nonsmoking adults annually. Adoption of smoke-free laws in public areas has increased, but private settings such as vehicles remain a source of SHS exposure. This study assessed change in voluntary smoke-free vehicle rules and SHS exposure in personal vehicles among U.S. adults between two periods, 2009-2010 and 2013-2014, using data from the National Adult Tobacco Survey (NATS). NATS is a national landline and cellular telephone survey of non-institutionalized adults aged ≥18 years in the 50 U.S. states and the District of Columbia. We assessed percentage change in the prevalence of smoke-free vehicle rules among all adults and SHS exposure in vehicles among nonsmoking adults, overall, by sociodemographic factors (sex, age, race/ethnicity, education, marital status, annual household income, U.S. region), and by cigarette smoking status. During 2009-2010 to 2013-2014, the percentage of adults with a 100% smoke-free vehicle rule increased from 73.6% to 79.5% (% change = +8.0%; p exposure in vehicles in the previous 7 days decreased from 9.2% to 8.2% (% change = -10.9%; p Smoke-free rules in private settings such as vehicles, in coordination with comprehensive smoke-free policies in indoor public settings, can help reduce SHS exposure and promote smoke-free norms.

Secondhand Smoke Exposure and Smoke-Free Policy Support Among Public Housing Authority Residents in Rural and Tribal Settings.

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Schmidt, Lisa M; Reidmohr, Alison A; Helgerson, Steven D; Harwell, Todd S

2016-12-01

Previous research has shown that multi-unit housing (MUH) residents are at risk of secondhand smoke (SHS) exposure, which can transfer between units. The purpose of this study was to determine SHS exposure and examine attitudes towards smoking policies among public housing authority (PHA) residents in rural and tribal settings. A self-administered questionnaire was completed by 895 adult tenants (41 % response rate) living in PHA multiunit buildings in Montana in 2013. Our primary outcome was tenant support of smoke-free policies; our secondary outcome was exacerbation of child asthma symptoms due to SHS exposure. In 2014, we used multiple logistic regression models to test associations between independent variables and outcomes of interest. The majority (80.6 %) of respondents supported having a smoke-free policy in their building, with support being significantly higher among nonsmokers [adjusted odds ratio (aOR) 4.2, 95 % confidence interval (CI) 1.5-11.6] and among residents living with children (aOR 2.9, 95 % CI 1.3-6.2). Tribal residents were as likely to support smoke-free policies as non-tribal residents (aOR 1.4; 95 % CI 0.5-4.0). Over half (56.5 %) of respondents reported SHS exposure in their home; residents in a building with no smoke-free policy in place were significantly more likely to report exposure (aOR 3.5, 95 % CI 2.2-5.5). SHS exposure was not significantly associated with asthma symptoms. There is a significant reduction in exposure to SHS in facilities with smoke-free policies and there is strong support for such policies by both tribal and non-tribal MUH residents. Opportunities exist for smoke-free policy initiatives in rural and tribal settings.

Children's exposure to secondhand smoke at home before and after smoke-free legislation in Taiwan.

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Wang, Ying-Ting; Tsai, Yi-Wen; Tsai, Tzu-I; Chang, Po-Yin

2017-11-01

In January 2009, Taiwan broadened smoke-free legislation, requiring mass transportation systems, indoor public areas and indoor workplaces with 3 or more people, to become smoke-free. We investigated the secondhand smoke (SHS) exposure at home for children aged 3-11 years in Taiwan before and after the implantation of the legislation. We studied 7911 children from the 2005, 2009 and 2013 National Health Interview Surveys (cross-sectional, nationally representative household surveys). Logistic regression modelling estimated adjusted ORs (AOR) and 95% CIs for children's SHS exposure at home in 2009 and 2013 (2005 as reference) for the overall sample and for each category of household socioeconomic status (SES) and household composition. Prevalence of children SHS exposure at home decreased from 51% (2005) to 32% (2009) and 28% (2013). Compared to 2005, children in 2009 and 2013 had lower likelihoods of SHS exposure at home with AOR of 0.45 (95% CI 0.41 to 0.51) and 0.41 (95% CI 0.36 to 0.46), respectively. All children had reduced SHS exposure at home after the legislation, irrespective of household SES and compositions. Low household income, low parental education level, living with grandparents or living with other adults was individually associated with increased SHS exposure. The proportion of children exposed to SHS at home in Taiwan declined substantially from 2005 to 2009 after smoke-free legislation, and fell further by 2013, irrespective of SES and household compositions. Still, inequality in SHS exposure at home by SES and household composition warrants future research. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Attitudes and experiences with secondhand smoke and smoke-free policies among subsidised and market-rate multiunit housing residents living in six diverse communities in the USA.

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Gentzke, Andrea S; Hyland, Andrew; Kiviniemi, Marc; Travers, Mark J

2018-03-01

Given that higher smoking rates persist among lower socioeconomic populations, multiunit housing (MUH) environments may result in higher secondhand smoke (SHS) exposures among subsidised MUH residents. This cross-sectional assessment compares experiences with SHS and smoke-free policies among subsidised and market-rate MUH residents living in six US communities. MUH residents (n=1565) were surveyed regarding their smoke-free rules (home and building), SHS exposures and preferences towards smoke-free policies. Binary logistic regression identified predictors of each outcome, focusing on differences by subsidised housing status (subsidised vs market rate). Among residents enforcing smoke-free home rules (76%, overall), 50% reported SHS incursions into their unit. Only 23% reported living in a smoke-free building; 56% of those living in smoking-allowable buildings reported preferences towards smoke-free building policies. Among market-rate housing residents, smoke-free home (OR=4.18) and building (OR=2.26) rules were significantly higher when children were present. Smoke-free building rules reduced the odds of SHS incursions among market-rate housing residents (OR=0.50), but no association was observed among subsidised housing residents. Non-smoking subsidised housing residents exhibited stronger preferences for smoke-free policies compared with those in market-rate housing. Smoke-free home rules may not protect MUH residents from SHS exposures, particularly in subsidised MUH. Although strong preferences towards smoke-free policies were present overall, subsidised MUH residents may have fewer alternative smoke-free housing options available. Therefore, all publicly funded housing should be smoke free to protect these vulnerable populations. However, continued efforts to encourage privately owned MUH operators to adopt smoke-free policies are also necessary. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights

Association of prenatal exposure to maternal smoking and postnatal exposure to household smoking with dental caries in 3-year-old Japanese children.

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Tanaka, Keiko; Miyake, Yoshihiro; Nagata, Chisato; Furukawa, Shinya; Arakawa, Masashi

2015-11-01

Epidemiological studies of the association between smoking exposure and dental caries are limited. The purpose of this cross-sectional study was to examine the association between prenatal and postnatal secondhand smoke (SHS) exposure and the prevalence of dental caries in primary dentition in young Japanese children. Study subjects were 6412 children aged 3 years. Information on exposure to maternal smoking during pregnancy and postnatal SHS exposure at home was collected via parent questionnaire. Children were classified as having dental caries if one or more primary teeth had decayed or had been filled. Compared with never smoking during pregnancy, maternal smoking in the first trimester of pregnancy was significantly associated with an increased prevalence of dental caries in children (adjusted odds ratio=1.37, 95% confidence interval: 1.03-1.80). Postnatal SHS exposure was also positively associated with dental caries, with a significant positive exposure-response relationship. Compared with children not exposed to prenatal maternal smoking or postnatal SHS at home, those exposed to both prenatal and postnatal smoking had higher odds of dental caries (adjusted odds ratio=1.62, 95% confidence interval: 1.23-2.11). Our findings suggest that maternal smoking during pregnancy and postnatal SHS exposure may be associated with an increased prevalence of dental caries in primary dentition. Copyright © 2015. Published by Elsevier Inc.

Secondhand smoke is associated with heavy metal concentrations in children.

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Li, Li; Guo, Li; Chen, Xingjie; Xiang, Mingli; Yang, Fang; Ren, Jing-Chao; Zhang, Guang-Hui

2018-02-01

Secondhand smoke (SHS) has adverse effects on health, particularly for children. Our purpose was to analyze the correlation between SHS exposure and heavy metal concentrations in children. The investigation was conducted in Xinxiang County, Henan Province, China, from August 2015 to December 2015. In total, 821 students (433 boys and 388 girls) were recruited, and the contents of heavy metals in their hair-including chromium, manganese, nickel, arsenic, lead, and cadmium-were detected by ICP-MS. The children's parents were informed, and a questionnaire was conducted, which included questions about smoking habits and demographic characteristics. Our results indicate that all parent smokers are fathers, 48.9% of fathers who are smokers, but 25.2% of fathers smoke in front of their children. The levels of chromium (median girls vs boys, μg/g) (2.36 vs 2.06, p secondhand smoking (SHS) exposure was inquired by face-to-face investigation of their parents. We illustrated that children exposed to SHS have increased lead and cadmium accumulations in the body. What is Known: • Secondhand smoke (SHS) has adverse effects on health, particularly for children. • There might be correlation between SHS exposure and heavy metal concentrations in children. What is New: • The levels of chromium, nickel, arsenic, and lead in girls were significantly higher than in boys. • SHS exposure in children was correlated with increasing levels of lead and cadmium in their hair because of exposure to SHS.

Exposure to secondhand smoke from neighbours and respiratory symptoms in never-smoking adolescents in Hong Kong: a cross-sectional study.

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Leung, Lok Tung; Ho, Sai Yin; Wang, Man Ping; Lo, Wing Sze; Lam, Tai Hing

2015-11-04

To investigate secondhand smoke (SHS) exposure at home from neighbours in Hong Kong adolescents and its association with respiratory symptoms in never-smokers. A cross-sectional study. 79 randomly selected secondary schools in Hong Kong. 61,810 secondary 1 (USA grade 7) to 7 students, in which 50,762 never-smokers were identified and included in the analysis of the association between SHS exposure at home from neighbours and respiratory symptoms. Smoking status, family smoking status, SHS exposure at home from inside the home and from neighbours in the past 7 days, respiratory symptoms and sociodemographic characteristics were reported. Adjusted ORs (AORs) of respiratory symptoms for SHS exposure from the 2 sources in never-smokers were calculated using logistic regression. In all students, 33.2% were exposed to SHS at home, including 16.2% from inside the home only, 10.0% from neighbours only and 7.0% from both. The prevalence of SHS exposure from neighbours was 17.1%, including 13.5% for 1-4 days/week and 3.6% for 5-7 days/week. In never-smokers (n=50,762), respiratory symptoms were significantly associated with SHS exposure from neighbours with AORs (95% CI) of 1.29 (1.20 to 1.39) for any exposure (pexposure at home from any source, the AORs were 1.16 (1.07 to 1.25) for SHS from inside the home only (pexposure at home from neighbours was prevalent in Hong Kong adolescents, and was associated with respiratory symptoms in never-smokers. SHS exposure at home may be underestimated by ignoring the neighbouring source. Smoke-free housing policy is needed to protect children and adolescents from harms of SHS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A Casino goes smoke free: a longitudinal study of secondhand and thirdhand smoke pollution and exposure.

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Matt, Georg E; Quintana, Penelope J E; Hoh, Eunha; Zakarian, Joy M; Chowdhury, Zohir; Hovell, Melbourne F; Jacob, Peyton; Watanabe, Kayo; Theweny, Teaba S; Flores, Victoria; Nguyen, Anh; Dhaliwal, Narinder; Hayward, Gary

2018-02-08

Secondhand smoke (SHS) in US casinos is common, but little is known about the residue of tobacco smoke pollutants left behind in dust and on surfaces, commonly referred to as thirdhand smoke (THS). We examined SHS and THS pollution and exposure before and during a casino smoking ban and after smoking resumed. A casino was visited nine times over a 15-month period to collect dust, surface and air samples in eight locations. Finger wipe and urine samples were collected from non-smoking confederates before and after a 4-hour casino visit. Samples were analysed for markers of SHS and THS pollution and exposure. Exceptionally high levels of THS were found in dust and on surfaces. Although the smoking ban led to immediate improvements in air quality, surface nicotine levels were unchanged and remained very high for the first month of the smoking ban. Surface nicotine decreased by 90% after 1 month (Pcasino creates deep THS reservoirs that persist for months after a smoking ban. A complete smoking ban immediately improves air quality and significantly reduces exposure to SHS and THS. However, THS reservoirs contribute to continued low-level exposure to toxicants. To accelerate the effect of smoking bans, remediation efforts should address specific THS reservoirs, which may require intensive cleaning as well as replacement of carpets, furniture and building materials. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Workplace smoking restrictions in China: results from a six county survey.

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Ma, Jiemin; Apelberg, Benjamin J; Avila-Tang, Erika; Yang, Gonghuan; Ma, Shaojun; Samet, Jonathan M; Stillman, Frances A

2010-10-01

To determine the coverage of smoking restriction policies in indoor workplaces in China and to assess the relationships between these restrictive policies and secondhand smoke (SHS) exposure and smoking behaviours. A cross-sectional household survey was conducted in six counties in Sichuan, Jiangxi and Henan provinces in 2004. Using a standardised questionnaire, information on demographic characteristics, knowledge, attitudes and behaviours related to smoking and SHS exposure was collected through face-to-face interviews by trained local investigators among 12 036 respondents. Of respondents, 2698 individuals worked mainly indoors and were included in data analysis. Only 28.5% of respondents reported that indoor workplaces had a smoke-free policy. Even when respondents reported smoke-free policies, 41.1% smokers reported that they were non-compliant with policies and smoked at work. In addition, 32.0% of non-smokers reported being exposed to SHS at work despite smoke-free policies. Non-smokers who reported no smoking restriction policies were 3.7 times more likely to be exposed to SHS than those working in smoke-free workplaces (adjusted OR 3.7, 95% CI 1.3 to 10.1). On average, respondents complying with smoke-free policies smoked 3.8 fewer cigarettes than those reporting no policies in their workplaces at a marginally non-significant level (p=0.06) (adjusted mean difference -3.8, 95% CI -8.0 to 0.5). In China, few workplaces have implemented policies to restrict smoking, and, even in workplaces that have policies, workers report exposure to SHS while at their places of employment. Many workers report a lack of compliance with smoke-free policies. China needs better implementation of SHS policies to promote compliance. Working to improve implementation of smoke-free policies would promote cessation since Chinese smokers who were compliant with these efforts reported smoking fewer cigarettes per day.

Lawsuits and secondhand smoke.

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Sweda, E L

2004-03-01

This paper describes secondhand smoke (SHS) litigation over the past quarter century where non-smoking litigants have prevailed and attempts to decipher trends in the law that may impact the course of future cases. Since the early 1980s, the author has sought and examined legal cases in which SHS exposure is an important factor. Law library searches using the official reporter system (for example, Shimp v. New Jersey Bell Telephone Co., 368 A.2d 408) have more recently been combined with computerised online searches using LexisNexis and Westlaw. The author has learned of other cases through personal correspondence and from articles in newspapers. Over 420 cases involving exposure to SHS were identified. Each case was reviewed and summarised. Since 1976, the year of the first reported SHS lawsuit, this type of litigation has increased both in number and in scope with increasing success. While it is common for initial cases to lose in a new area where the law eventually evolves, litigants and their lawyers who later bring similar cases can learn from those previous, unsuccessful cases. It is now apparent that the judicial branch has begun to recognise the need to protect the public-especially some of the most vulnerable members of our society-from the serious threat to their health that is exposure to SHS. Successful cases brought on behalf of individuals exposed to SHS produce an additional benefit for the public health by both paving the way for other non-smoking litigants to succeed in their cases and persuading business owners and others voluntarily to make their facilities 100% smoke-free.

"These Things Don't Happen in Greece": A Qualitative Study of Greek Young People's Attitudes to Smoking, Secondhand Smoke and the Smokefree Legislation

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Tamvakas, Ioannis; Amos, Amanda

2010-01-01

Greece has the highest smoking prevalence in the European Union, with adolescents having high levels of exposure to secondhand smoke (SHS). In July 2009, national smokefree legislation was implemented in Greece. This study explored Greek young people's attitudes to smoking, SHS and the impending legislation. Semi-structured qualitative interviews…

Transgenerational Exposure to Environmental Tobacco Smoke

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Xavier Joya

2014-07-01

Full Text Available Traditionally, nicotine from second hand smoke (SHS, active or passive, has been considered the most prevalent substance of abuse used during pregnancy in industrialized countries. Exposure to environmental tobacco smoke (ETS is associated with a variety of health effects, including lung cancer and cardiovascular diseases. Tobacco is also a major burden to people who do not smoke. As developing individuals, newborns and children are particularly vulnerable to the negative effects of SHS. In particular, prenatal ETS has adverse consequences during the entire childhood causing an increased risk of abortion, low birth weight, prematurity and/or nicotine withdrawal syndrome. Over the last years, a decreasing trend in smoking habits during pregnancy has occurred, along with the implementation of laws requiring smoke free public and working places. The decrease in the incidence of prenatal tobacco exposure has usually been assessed using maternal questionnaires. In order to diminish bias in self-reporting, objective biomarkers have been developed to evaluate this exposure. The measurement of nicotine and its main metabolite, cotinine, in non-conventional matrices such as cord blood, breast milk, hair or meconium can be used as a non-invasive measurement of prenatal SMS in newborns. The aim of this review is to highlight the prevalence of ETS (prenatal and postnatal using biomarkers in non-conventional matrices before and after the implementation of smoke free policies and health effects related to this exposure during foetal and/or postnatal life.

Directly measured secondhand smoke exposure and COPD health outcomes

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Balmes John

2006-06-01

Full Text Available Abstract Background Although personal cigarette smoking is the most important cause and modulator of chronic obstructive pulmonary disease (COPD, secondhand smoke (SHS exposure could influence the course of the disease. Despite the importance of this question, the impact of SHS exposure on COPD health outcomes remains unknown. Methods We used data from two waves of a population-based multiwave U.S. cohort study of adults with COPD. 77 non-smoking respondents with a diagnosis of COPD completed direct SHS monitoring based on urine cotinine and a personal badge that measures nicotine. We evaluated the longitudinal impact of SHS exposure on validated measures of COPD severity, physical health status, quality of life (QOL, and dyspnea measured at one year follow-up. Results The highest level of SHS exposure, as measured by urine cotinine, was cross-sectionally associated with poorer COPD severity (mean score increment 4.7 pts; 95% CI 0.6 to 8.9 and dyspnea (1.0 pts; 95% CI 0.4 to 1.7 after controlling for covariates. In longitudinal analysis, the highest level of baseline cotinine was associated with worse COPD severity (4.7 points; 95% CI -0.1 to 9.4; p = 0.054, disease-specific QOL (2.9 pts; -0.16 to 5.9; p = 0.063, and dyspnea (0.9 pts; 95% CI 0.2 to 1.6 pts; p Conclusion Directly measured SHS exposure appears to adversely influence health outcomes in COPD, independent of personal smoking. Because SHS is a modifiable risk factor, clinicians should assess SHS exposure in their patients and counsel its avoidance. In public health terms, the effects of SHS exposure on this vulnerable subpopulation provide a further rationale for laws prohibiting public smoking.

Impact of the 2011 Spanish smoking ban in hospitality venues: indoor secondhand smoke exposure and influence of outdoor smoking.

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López, María J; Fernández, Esteve; Pérez-Rios, Mónica; Martínez-Sánchez, Jose M; Schiaffino, Anna; Galán, Iñaki; Moncada, Albert; Fu, Marcela; Montes, Agustín; Saltó, Esteve; Nebot, Manel

2013-05-01

The Spanish tobacco control law of 2006 was modified in January 2011, banning smoking in all hospitality venues. The objective of the study was to assess the impact of the 2011 Spanish smoking ban on secondhand smoke (SHS) exposure in hospitality venues, and to analyze the potential impact of outdoor smokers close to entrances on indoor SHS levels after the law came into force. Before-and-after evaluation study with repeated measures. The study was carried out in three regions of Spain (Catalonia, Galicia, and Madrid) and included a random sample of 178 hospitality venues. We measured vapor-phase nicotine and particulate matter 2.5 micrometers or less in diameter (PM2.5) as SHS markers at baseline (November-December 2010) and at follow-up (April-June 2011). We also recorded tobacco consumption variables such as the presence of butts, ashtrays, and smokers. In the posttest assessment, we also recorded the number of outdoor smokers close to the entrance. A total of 351 nicotine and 160 PM2.5 measurements were taken. Both nicotine and PM2.5 concentrations decreased by more than 90% (nicotine from 5.73 to 0.57 µg/m(3), PM2.5 from 233.38 to 18.82 µg/m(3)). After the law came into force, both nicotine and PM2.5 concentrations were significantly higher in venues with outdoor smokers close to the entrance than in those without outdoor smokers. All the observational tobacco consumption variables significantly decreased (p hospitality venues dramatically decreased after the 2011 Spanish smoking ban. SHS from outdoor smokers close to entrances seems to drift inside venues. Smoking control legislation should consider outdoor restrictions to ensure complete protection against SHS.

Factors associated with secondhand tobacco smoke in the home: an exploratory cross-sectional study among women in Aleta Wondo, Ethiopia.

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Petersen, Anne Berit; Thompson, Lisa M; Dadi, Gezahegn Bekele; Tolcha, Alemu; Cataldo, Janine K

2016-08-31

In Ethiopia, female smoking rates are currently low (1 %). However, because of male smoking rates (overall 7.7 % and up to 27 % depending on region), women and children's risk of second hand smoke (SHS) exposure is a pressing concern. In order to develop effective public health interventions that prevent the uptake and exposure to smoking, thereby averting the projected increase in tobacco-induced disease, an understanding of Ethiopian women's practices regarding tobacco is needed. The purpose of this study was to explore Ethiopian women's tobacco use and prevalence of SHS exposure, and to identify covariates associated with SHS exposure. We conducted an exploratory cross-sectional study in Southern Ethiopia between August and October 2014, and systematically sampled households in Aleta Wondo town and surrounding districts. Trained interviewers verbally administered surveys to women 18-55 years of age. Descriptive statistics and multiple logistic regression analyses were performed. None of the 353 participants reported current tobacco use and less than 1 % reported ever use, however, 11 % reported ever use of the stimulant leaf khat. Twenty-seven women (7.6 %) reported living with a tobacco user, however, twice that number (14.4 %) overall, and 22 % of urban participants reported that smoking occurred daily in their home. When controlling for other factors, living with a tobacco user (OR = 9.91, 95 % CI [3.32, 29.59]), allowing smoking in the home (OR = 5.67, 95 % CI [2.51, 12.79]), place of residence (OR = 2.74, 95 % CI [1.11, 6.74)]), and exposure to point-of-sale advertising within the last 30 days (OR = 2.87, 95 % CI [1.26, 6.54]) contributed significantly to a model predicting the likelihood of reporting daily occurrence of smoking/SHS in the home. While few women reported having ever used tobacco, one in seven women in this study reported that smoking/SHS occurred daily in their homes. Therefore SHS exposure is a potential health

Secondhand tobacco smoke exposure among adolescents in an Ethiopian school

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Sabit Abazinab Ababulgu

2016-05-01

Full Text Available Tobacco use is responsible for 6 million deaths globally per year, of which 600,000 deaths are due to secondhand smoke (SHS mainly among women and children. This study aims to determine the prevalence of SHS exposure among school-going adolescents and highlights the essential determinants in developing successful strategies to prevent adverse health effects in Ethiopia. The analysis is based on a school based cross sectional study where 1673 students with 98.2% of response rate from grade 9-12, aged 13-19 were included. Data was collected by a self-administered questionnaire that is adapted from the global youth tobacco survey questionnaire. Proportions and 95% confidence intervals were obtained as estimates of prevalence. Bivariate and multivariate analyses were made using logistic regression on SPSS version 20.0 software in order to predict factors associated with SHS exposure. About 17% of adolescents were exposed to tobacco smoke in their home, whereas more than half (60.8% of adolescents were exposed to tobacco smoke in public places. In multivariate analysis, sex, parent smoking, peer smoking, and absence of discussion in the classroom about dangers of smoking were seen significantly associated with SHS exposure. The prevalence of SHS exposure among adolescents in Ethiopia is highest. Moreover, exposure to SHS in public places is much higher than at home.

Determinants of self-reported smoking and misclassification during pregnancy, and analysis of optimal cut-off points for urinary cotinine: a cross-sectional study.

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Aurrekoetxea, Juan J; Murcia, Mario; Rebagliato, Marisa; López, María José; Castilla, Ane Miren; Santa-Marina, Loreto; Guxens, Mónica; Fernández-Somoano, Ana; Espada, Mercedes; Lertxundi, Aitana; Tardón, Adonina; Ballester, Ferran

2013-01-24

To estimate the prevalence and factors associated with smoking and misclassification in pregnant women from INMA (INfancia y Medio Ambiente, Environment and Childhood) project, Spain, and to assess the optimal cut-offs for urinary cotinine (UC) that best distinguish daily and occasional smokers with varying levels of second-hand smoke (SHS) exposure. We used logistic regression models to study the relationship between sociodemographic variables and self-reported smoking and misclassification (self-reported non-smokers with UC >50 ng/ml). Receiver operating characteristic (ROC) curves were used to calculate the optimal cut-off point for discriminating smokers. The cut-offs were also calculated after stratification among non-smokers by the number of sources of SHS exposure. The cut-off points used to discriminate smoking status were the level of UC given by Youden's index and for 50 and 100 ng/ml for daily smokers, or 25 and 50 ng/ml for occasional smokers. At the third trimester of pregnancy, 2263 pregnant women of the INMA Project were interviewed between 2004 and 2008 and a urine sample was collected. Prevalence of self-reported smokers at the third trimester of pregnancy was 18.5%, and another 3.9% misreported their smoking status. Variables associated with self-reported smoking and misreporting were similar, including born in Europe, educational level and exposure to SHS. The optimal cut-off was 82 ng/ml (95% CI 42 to 133), sensitivity 95.2% and specificity 96.6%. The area under the ROC curve was 0.986 (95% CI 0.982 to 0.990). The cut-offs varied according to the SHS exposure level being 42 (95% CI 27 to 57), 82 (95% CI 46 to 136) and 106 ng/ml (95% CI 58 to 227) for not being SHS exposed, exposed to one, and to two or more sources of SHS, respectively. The optimal cut-off for discriminating occasional smokers from non-smokers was 27 ng/ml (95% CI 11 to 43). Prevalence of smoking during pregnancy in Spain remains high. UC is a reliable biomarker for classifying

Determinants of self-reported smoking and misclassification during pregnancy, and analysis of optimal cut-off points for urinary cotinine: a cross-sectional study

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Aurrekoetxea, Juan J; Murcia, Mario; Rebagliato, Marisa; López, María José; Castilla, Ane Miren; Santa-Marina, Loreto; Guxens, Mónica; Fernández-Somoano, Ana; Espada, Mercedes; Lertxundi, Aitana; Tardón, Adonina; Ballester, Ferran

2013-01-01

Objectives To estimate the prevalence and factors associated with smoking and misclassification in pregnant women from INMA (INfancia y Medio Ambiente, Environment and Childhood) project, Spain, and to assess the optimal cut-offs for urinary cotinine (UC) that best distinguish daily and occasional smokers with varying levels of second-hand smoke (SHS) exposure. Design We used logistic regression models to study the relationship between sociodemographic variables and self-reported smoking and misclassification (self-reported non-smokers with UC >50 ng/ml). Receiver operating characteristic (ROC) curves were used to calculate the optimal cut-off point for discriminating smokers. The cut-offs were also calculated after stratification among non-smokers by the number of sources of SHS exposure. The cut-off points used to discriminate smoking status were the level of UC given by Youden's index and for 50 and 100 ng/ml for daily smokers, or 25 and 50 ng/ml for occasional smokers. Participants At the third trimester of pregnancy, 2263 pregnant women of the INMA Project were interviewed between 2004 and 2008 and a urine sample was collected. Results Prevalence of self-reported smokers at the third trimester of pregnancy was 18.5%, and another 3.9% misreported their smoking status. Variables associated with self-reported smoking and misreporting were similar, including born in Europe, educational level and exposure to SHS. The optimal cut-off was 82 ng/ml (95% CI 42 to 133), sensitivity 95.2% and specificity 96.6%. The area under the ROC curve was 0.986 (95% CI 0.982 to 0.990). The cut-offs varied according to the SHS exposure level being 42 (95% CI 27 to 57), 82 (95% CI 46 to 136) and 106 ng/ml (95% CI 58 to 227) for not being SHS exposed, exposed to one, and to two or more sources of SHS, respectively. The optimal cut-off for discriminating occasional smokers from non-smokers was 27 ng/ml (95% CI 11 to 43). Conclusions Prevalence of smoking during pregnancy in

Measuring Secondhand Smoke in Muscat, Oman

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Jawad A. Al-Lawati

2015-05-01

Full Text Available Objectives: This study aimed to measure exposure to secondhand smoke (SHS and assess venue compliance with the municipal Law against smoking indoors in public places in Muscat, Oman. Methods: Following the selection of 30 public indoor venues within the Muscat governorate, the concentration of suspended SHS particulate matter (PM2.5 in the venues’ indoor air was measured throughout July and August 2010. Results: Almost all of the venues were found to be compliant with the smoke-free municipal, with the exception of a café that served waterpipes for smoking indoors. The concentration of PM2.5 in this venue showed an average level of 256 μg/m3 which was 64 times the level of that found in the non-smoking venues. Conclusion: Aside from one café, the majority of the assessed indoor public venues abided by the smoke-free municipal law. However, the enforcement of policies banning smoking in indoor public recreational venues should be re-examined in order to protect member of the public in Oman from exposure to SHS.

Characterization of urinary cotinine in non-smoking residents in smoke-free homes in the Korean National Environmental Health Survey (KoNEHS

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Jeonghoon Kim

2016-07-01

Full Text Available Abstract Background The objectives of this study were to determine urinary cotinine concentrations in non-smoking residents of smoke-free homes and to establish the relationship of urinary cotinine with housing type and other socio-demographic and secondhand smoke (SHS exposure factors. Methods We used data from the Korean National Environmental Health Survey I (2009–2011. The study included 814 non-smoking adult residents living in apartments, attached, and detached housing. Residents who lived with smokers were excluded. Urinary cotinine concentration was used as a biomarker for SHS exposure. The factors associated with urinary cotinine levels in non-smoking residents were determined using multivariate regression analysis. Results Urinary cotinine was detected in 88 % of the 814 non-smoking residents of smoke-free homes. The urinary cotinine concentrations of residents living in attached [1.18 ng/mg creatinine (Cr] and detached housing (1.23 ng/mg Cr were significantly higher than those of residents who lived in apartments (0.69 ng/mg Cr. Urinary cotinine concentrations were significantly higher in residents who were men, those with a household income ≤1000 USD/month, those who were former smokers with >1 year and ≤1 year of not smoking, and those who experienced SHS odor every day. In the multivariate regression analysis, housing type, sex, former smoking status, and frequency of experiencing SHS odor were associated with urinary cotinine concentrations (R 2 = 0.14. Conclusions The majority of non-smoking residents of smoke-free homes had detectable urinary cotinine. Housing type, sex, former smoking status, and frequency of experiencing SHS odor were predictors for urinary cotinine concentrations in the study participants.

Smoke-Free Rules and Secondhand Smoke Exposure in Vehicles among U.S. Adults—National Adult Tobacco Survey, 2009–2010 and 2013–2014

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Kruger, Judy; Jama, Amal; Kegler, Michelle; Baker Holmes, Carissa; Hu, Sean; King, Brian

2016-01-01

In the United States (U.S.), secondhand smoke (SHS) exposure causes more than 41,000 deaths among nonsmoking adults annually. Adoption of smoke-free laws in public areas has increased, but private settings such as vehicles remain a source of SHS exposure. This study assessed change in voluntary smoke-free vehicle rules and SHS exposure in personal vehicles among U.S. adults between two periods, 2009–2010 and 2013–2014, using data from the National Adult Tobacco Survey (NATS). NATS is a national landline and cellular telephone survey of non-institutionalized adults aged ≥18 years in the 50 U.S. states and the District of Columbia. We assessed percentage change in the prevalence of smoke-free vehicle rules among all adults and SHS exposure in vehicles among nonsmoking adults, overall, by sociodemographic factors (sex, age, race/ethnicity, education, marital status, annual household income, U.S. region), and by cigarette smoking status. During 2009–2010 to 2013–2014, the percentage of adults with a 100% smoke-free vehicle rule increased from 73.6% to 79.5% (% change = +8.0%; p exposure in vehicles in the previous 7 days decreased from 9.2% to 8.2% (% change = −10.9%; p Smoke-free rules in private settings such as vehicles, in coordination with comprehensive smoke-free policies in indoor public settings, can help reduce SHS exposure and promote smoke-free norms. PMID:27792208

Disparity and Trends in Secondhand Smoke Exposure among Japanese Employees, Particularly Smokers vs. Non-Smokers.

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Tabuchi, Takahiro; Colwell, Brian

2016-01-01

Monitoring disparities in secondhand smoke (SHS) exposure is important for tailoring smoke-free policies to the needs of different groups. We examined disparity and trends in SHS exposure among both nonsmokers and smokers at Japanese workplaces between 2002 and 2012. A total of 32,940 employees in nationally representative, population-based, repeated cross-sectional surveys in 2002, 2007 and 2012 in Japan was analyzed. Adjusted rate ratios for workplace SHS exposure from other people ("everyday" and "everyday or sometimes") were calculated according to covariates, using log-binomial regression models with survey weights. In this survey, employees who do not smoke at workplace are defined as workplace-nonsmokers; and those smoke at workplace are used as workplace-smokers. SHS exposure for smokers does not involve their own SHS. While everyday SHS exposure prevalence in workplace-nonsmokers decreased markedly (33.2% to 11.4%), that in workplace-smokers decreased only slightly (63.3% to 55.6%). Workplace-smokers were significantly more likely to report everyday SHS exposure than workplace-nonsmokers, and the degree of association increased over time: compared with the nonsmokers (reference), covariates-adjusted rate ratio (95% confidence interval) for the smokers increased from 1.70 (1.62-1.77) in 2002 to 4.16 (3.79-4.56) in 2012. Similar results were observed for everyday or sometimes SHS exposure. Compared with complete workplace smoking bans, partial and no bans were consistently and significantly associated with high SHS exposure among both nonsmokers and smokers. We also observed disparities in SHS exposure by employee characteristics, such as age group and worksite scale. Although overall SHS exposure decreased among Japanese employees between 2002 and 2012, the SHS exposure disparity between nonsmokers and smokers widened. Because smokers reported more frequent SHS exposure than nonsmokers, subsequent mortality due to SHS exposure may be higher in smokers than

Secondhand smoke exposure and serum cotinine levels among current smokers in the USA.

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Lindsay, Ryan P; Tsoh, Janice Y; Sung, Hai-Yen; Max, Wendy

2016-03-01

Secondhand smoke (SHS) likely provides additional exposure to nicotine and toxins for smokers, but has been understudied. Our objective was to determine whether SHS exposure among smokers yields detectable differences in cotinine levels compared with unexposed smokers at the population level. Using the US National Health and Nutrition Examination Survey (NHANES) for the years 1999-2012, we compared serum cotinine levels of 4547 current adult cigarette smokers stratified by self-reported SHS exposure sources (home and/or work) and smoking intensity. A weighted multivariable linear regression model determined the association between SHS exposure and cotinine levels among smokers. Smokers with SHS exposure at home (43.8%) had higher cotinine levels (β=0.483, p≤0.001) compared with those with no SHS exposure at home after controlling for the number of cigarettes smoked per day and number of days smoked in the previous 5 days, survey year, age, gender and education. Smokers with SHS exposure at work (20.0%) did not have significantly higher cotinine levels after adjustment. The adjusted geometric mean cotinine levels of light smokers (1-9 cigarettes per day) with no SHS exposure, exposure at work only, home only, and both home and work were 52.0, 62.7, 67.2, 74.4 ng/mL, respectively, compared with 219.4, 220.9, 255.2, 250.5 ng/mL among moderate/heavy smokers (≥10 cigarettes per day). Smokers living in residences where others smoke inside the home had significantly higher cotinine levels than smokers reporting no SHS exposure, regardless of individual smoking intensity. Future research should target the role that SHS exposure may have in nicotine dependence, cessation outcomes and other health impacts among smokers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Secondhand tobacco smoke exposure and pulmonary function: a cross-sectional study among non-smoking employees of bar and restaurants in Santiago, Chile.

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Parro, Javiera; Aceituno, Paulina; Droppelmann, Andrea; Mesías, Sthepanie; Muñoz, Claudio; Marchetti, Nella; Iglesias, Verónica

2017-10-06

The workplace remains a significant source of secondhand smoke (SHS) exposure. This pollutant is known to be associated with respiratory and cardiovascular problems, but its effects on specific pulmonary function parameters remain largely unexplored. The objectives of this study were to measure SHS exposure among non-smoking employees of bar and restaurants in Santiago, Chile and to evaluate the effects of such exposure on pulmonary function. Cross-sectional design. The study sample included non-smoking workers from 57 restaurants and bars in Santiago, Chile. The outcome variable was pulmonary function and the exposure variables were urine cotinine concentration, a biomarker for current SHS exposure, and years of SHS exposure in the workplace as proxy of chronic exposure. Personal and occupational variables were also recorded. Data analysis was performed using linear regression models adjusted by confounders. The median age of the workers was 35 years and the median employment duration at the analysed venues was 1 year. Workers in smoking facilities reported greater SHS exposure (36 hours per week) than workers in smoke-free locations (4 hours per week). Urine cotinine levels were inversely correlated with forced vital capacity, but the finding was not statistically significant (β=-0.0002; 95% CI -0.007 to 0.006). Years of exposure to SHS showed to be significantly associated with forced expiratory flow 25/75 (β=-0.006; 95% CI -0.010 to -0.0004). These findings suggest that cumulative exposure to SHS at work may contribute to deterioration of pulmonary function in non-smoking employees. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

One Minute of Marijuana Secondhand Smoke Exposure Substantially Impairs Vascular Endothelial Function.

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Wang, Xiaoyin; Derakhshandeh, Ronak; Liu, Jiangtao; Narayan, Shilpa; Nabavizadeh, Pooneh; Le, Stephenie; Danforth, Olivia M; Pinnamaneni, Kranthi; Rodriguez, Hilda J; Luu, Emmy; Sievers, Richard E; Schick, Suzaynn F; Glantz, Stanton A; Springer, Matthew L

2016-07-27

Despite public awareness that tobacco secondhand smoke (SHS) is harmful, many people still assume that marijuana SHS is benign. Debates about whether smoke-free laws should include marijuana are becoming increasingly widespread as marijuana is legalized and the cannabis industry grows. Lack of evidence for marijuana SHS causing acute cardiovascular harm is frequently mistaken for evidence that it is harmless, despite chemical and physical similarity between marijuana and tobacco smoke. We investigated whether brief exposure to marijuana SHS causes acute vascular endothelial dysfunction. We measured endothelial function as femoral artery flow-mediated dilation (FMD) in rats before and after exposure to marijuana SHS at levels similar to real-world tobacco SHS conditions. One minute of exposure to marijuana SHS impaired FMD to a comparable extent as impairment from equal concentrations of tobacco SHS, but recovery was considerably slower for marijuana. Exposure to marijuana SHS directly caused cannabinoid-independent vasodilation that subsided within 25 minutes, whereas FMD remained impaired for at least 90 minutes. Impairment occurred even when marijuana lacked cannabinoids and rolling paper was omitted. Endothelium-independent vasodilation by nitroglycerin administration was not impaired. FMD was not impaired by exposure to chamber air. One minute of exposure to marijuana SHS substantially impairs endothelial function in rats for at least 90 minutes, considerably longer than comparable impairment by tobacco SHS. Impairment of FMD does not require cannabinoids, nicotine, or rolling paper smoke. Our findings in rats suggest that SHS can exert similar adverse cardiovascular effects regardless of whether it is from tobacco or marijuana. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Socioeconomic disparities in secondhand smoke exposure among US never-smoking adults: the National Health and Nutrition Examination Survey 1988-2010.

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Gan, Wen Qi; Mannino, David M; Jemal, Ahmedin

2015-11-01

Secondhand smoke (SHS) is a leading preventable cause of illness, disability and mortality. There is a lack of quantitative analyses on socioeconomic disparities in SHS; especially, it is not known how socioeconomic disparities have changed in the past two decades in the USA. To examine socioeconomic disparities and long-term temporal trends in SHS exposure among US never-smoking adults aged ≥20 years. 15 376 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2010 were included in the analysis of socioeconomic disparities; additional 8195 participants from NHANES III 1988-1994 were included in the temporal trend analysis. SHS exposure was assessed using self-reported exposure in the home and workplace as well as using serum cotinine concentrations ≥0.05 ng/mL. Individual socioeconomic status (SES) was assessed using poverty-to-income ratio. During the period 1999-2010, 6% and 14% of participants reported SHS exposure in the home and workplace, respectively; 40% had serum cotinine-indicated SHS exposure. Individual SES was strongly associated with SHS exposure in a dose-response fashion; participants in the lowest SES group were 2-3 times more likely to be exposed to SHS compared with those in the highest SES group. During the period 1988-2010, the prevalence declined over 60% for the three types of SHS exposure. However, for cotinine-indicated exposure, the magnitudes of the declines were smaller for lower SES groups compared with higher SES groups, leading to widening socioeconomic disparities in SHS exposure. SHS exposure is still widespread among US never-smoking adults, and socioeconomic disparities for cotinine-indicated exposure have substantially increased in the past two decades. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Impact of the Spanish smoking law on exposure to secondhand smoke in offices and hospitality venues: before-and-after study.

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Nebot, Manel; López, Maria J; Ariza, Carles; Pérez-Ríos, Mónica; Fu, Marcela; Schiaffino, Anna; Muñoz, Gloria; Saltó, Esteve; Fernández, Esteve

2009-03-01

A smoking law was passed by the Spanish Parliament in December 2005 and was enforced by 1 January 2006. The law bans smoking in all indoor workplaces but only in some hospitality venues, because owners are allowed to establish a smoking zone (venues>100 m2) or to allow smoking without restrictions (venueshospitality venues. The study design is a before-and-after evaluation. We studied workplaces and hospitality venues from eight different regions of Spain. We took repeated samples of vapor-phase nicotine concentration in 398 premises, including private offices (162), public administration offices (90), university premises (43), bars and restaurants (79), and discotheques and pubs (24). In the follow-up period, SHS levels were markedly reduced in indoor offices. The median decrease in nicotine concentration ranged from 60.0% in public premises to 97.4% in private areas. Nicotine concentrations were also markedly reduced in bars and restaurants that became smoke-free (96.7%) and in the no-smoking zones of venues with separate spaces for smokers (88.9%). We found no significant changes in smoking zones or in premises allowing smoking, including discotheques and pubs. Overall, this study shows the positive impact of the law on reducing SHS in indoor workplaces. However, SHS was substantially reduced only in bars and restaurants that became smoke-free. Most hospitality workers continue to be exposed to very high levels of SHS. Therefore, a 100% smoke-free policy for all hospitality venues is required.

Secondhand smoke exposure among Hispanics/Latinos living in multiunit housing: exploring barriers to new policies.

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Baezconde-Garbanati, Lourdes A; Weich-Reushé, Kimberly; Espinoza, Lilia; Portugal, Cecilia; Barahona, Rosa; Garbanati, James; Seedat, Faatima; Unger, Jennifer B

2011-01-01

Despite a high prevalence of voluntary home smoking bans and laws protecting Californians from exposure to secondhand smoke (SHS) in the workplace, many Hispanic/Latino (H/L) residents of multiunit housing (MUH) are potentially exposed to SHS from neighboring apartments. An advocacy/policy intervention was implemented to reduce tobacco-related health disparities by encouraging H/L living in MUH to implement voluntary policies that reduce exposure to SHS. This article presents findings from qualitative and quantitative data collected during development of the intervention, as well as preliminary results of the intervention. MUH residents in Southern California participated in focus groups (n = 48), door-to-door surveys (n = 142), and a telephone survey (n = 409). Exposure to SHS, attitudes toward SHS, and attitudes toward policies restricting SHS in MUH were assessed. H/L MUH residents reported high levels of exposure to SHS and little ability to protect themselves and their families from SHS. Respondents expressed positive attitudes toward adopting antismoking policies in MUH, but they also feared retaliation by smokers. The cultural values of familismo, respeto, simpatía, and personalismo influenced their motivation to protect their families from SHS as well as their reluctance to ask their neighbors to refrain from smoking. Nonsmokers were more likely to favor complete indoor and outdoor smoking bans in MUH, whereas smokers were more likely to favor separate smoking areas. The Regale Salud advocacy/policy intervention, implemented to reduce SHS exposure, prompted the passage of seven voluntary policies in apartment complexes in Southern California to prevent smoking in MUH. H/L in California support voluntary policies, local ordinances, and state laws that prevent exposure to SHS in MUH, especially those that are consistent with H/L cultural values and norms for interpersonal communication.

Prenatal Secondhand Smoke Exposure and Infant Birth Weight in China

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Adolfo Correa

2012-09-01

Full Text Available Epidemiologic evidence provides some support for a causal association between maternal secondhand smoke (SHS exposure during pregnancy and reduction in infant birth weight. The purpose of this cross-sectional study is to examine the magnitude of this association in China, where both prevalence and dose of SHS exposure are thought to be higher than in U.S. populations. Women who gave birth in Beijing and Changchun September 2000–November 2001 were interviewed to quantify self-reported prenatal SHS exposure. Their medical records were reviewed for data on pregnancy complications and birth outcomes. Non-smoking women who delivered term babies (≥37 weeks gestation were included in the study (N = 2,770. Nearly a quarter of the women (24% reported daily SHS exposure, 47% reported no prenatal exposure, and 75% denied any SHS exposure from the husband smoking at home. Overall, no deficit in mean birth weight was observed with exposure from all sources of SHS combined (+11 grams, 95% CI: +2, +21. Infants had higher mean birth weights among the exposed than the unexposed for all measures of SHS exposure. Future studies on SHS exposure and infant birth weight in China should emphasize more objective measures of exposure to quantify and account for any exposure misclassification.

Perceptions of Secondhand and Thirdhand Smoke Among Hispanic Residents of Multiunit Housing.

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Rendón, Angélica Delgado; Unger, Jennifer B; Cruz, Tess; Soto, Daniel W; Baezconde-Garbanati, Lourdes

2017-02-01

Despite the progressive adoption of smoking bans in public spaces, children living in multi-unit housing remain at risk of exposure to secondhand smoke (SHS) and thirdhand smoke (THS). Hispanic populations in California are particularly vulnerable to the harmful effects of SHS and THS because a large proportion of Hispanics live in multi-unit housing. Three focus groups were conducted in the fall of 2012 (in Spanish and English, N = 24) to understand Hispanics' knowledge of and experiences with SHS and THS, including barriers to avoiding smoke exposure and strategies for protecting their homes from smoke. Hispanic residents reported unpleasant experiences with SHS and THS and were generally knowledgeable about the adverse health effects, although they were not familiar with the term "thirdhand smoke." Some participants also mentioned marijuana smoke as a potential health hazard. Hispanic cultural values made participants reluctant to confront their neighbors but also motivated them to find ways to protect their families from smoke. Potential solutions included working with the smokers to designate a smoking area and gaining support from the building owners. Broad smoking policies should be implemented to help Hispanic residents overcome cultural and social barriers to smoke free air.

Tobacco smoke exposure in public places and workplaces after smoke-free policy implementation: a longitudinal analysis of smoker cohorts in Mexico and Uruguay

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Thrasher, James F.; Nayeli Abad-Vivero, Erika; Sebrié, Ernesto M.; Barrientos-Gutierrez, Tonatiuh; Boado, Marcelo; Yong, Hua Hie; Arillo-Santillán, Edna; Bianco, Eduardo

2013-01-01

Objective: To determine the prevalence, correlates and changes in secondhand smoke (SHS) exposure over the period after comprehensive smoke-free policy implementation in two Latin American countries. Methods: Data were analysed from population-based representative samples of adult smokers and recent quitters from the 2008 and 2010 waves of the International Tobacco Control Policy Evaluation Survey in Mexico (n = 1766 and 1840, respectively) and Uruguay (n = 1379 and 1411, respectively). Prevalence of SHS exposure was estimated for regulated venues, and generalized estimating equations were used to determine correlates of SHS exposure. Results: Workplace SHS exposure in the last month was similar within and across countries (range: Mexico 20–25%; Uruguay 14–29%). At the most recent restaurant visit, SHS exposure was lower where comprehensive smoke-free policies were implemented (range: Uruguay 6–9%; Mexico City 5–7%) compared with Mexican cities with weaker policies, where exposure remained higher but decreased over time (32–17%). At the most recent bar visit, SHS exposure was common (range: Uruguay 8–36%; Mexico City 23–31%), although highest in jurisdictions with weaker policies (range in other Mexican cities: 74–86%). In Uruguay, males were more likely than females to be exposed to SHS across venues, as were younger compared with older smokers in Mexico. Conclusions: Comprehensive smoke-free policies are more effective than weaker policies, although compliance in Mexico and Uruguay is not as high as desired. PMID:23172895

Secondhand smoke exposure in cars among middle and high school students--United States, 2000-2009.

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King, Brian A; Dube, Shanta R; Tynan, Michael A

2012-03-01

Exposure to secondhand smoke (SHS) from cigarettes poses a significant health risk to nonsmokers. Among youth, the home is the primary source of SHS. However, little is known about youth exposure to SHS in other nonpublic areas, particularly motor vehicles. Data were obtained from the 2000, 2002, 2004, 2006, and 2009 waves of the National Youth Tobacco Survey, a nationally representative survey of US students in grades 6 to 12. Trends in SHS exposure in a car were assessed across survey years by school level, gender, and race/ethnicity by using binary logistic regression. From 2000 to 2009, the prevalence of SHS exposure in cars declined significantly among both nonsmokers (39.0%-22.8%; trend P race/ethnicity subgroups. SHS exposure in cars decreased significantly among US middle and high school students from 2000 to 2009. Nevertheless, in 2009, over one-fifth of nonsmoking students were exposed to SHS in cars. Jurisdictions should expand comprehensive smoke-free policies that prohibit smoking in worksites and public places to also prohibit smoking in motor vehicles occupied by youth.

Secondhand smoke exposure levels in outdoor hospitality venues: a qualitative and quantitative review of the research literature.

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Licht, Andrea S; Hyland, Andrew; Travers, Mark J; Chapman, Simon

2013-05-01

This paper considers the evidence on whether outdoor secondhand smoke (SHS) is present in hospitality venues at high levels enough to potentially pose health risks, particularly among employees. Searches in PubMed and Web of Science included combinations of environmental tobacco smoke, secondhand smoke, or passive smoke AND outdoor, yielding 217 and 5,199 results, respectively through June, 2012. Sixteen studies were selected that reported measuring any outdoor SHS exposures (particulate matter (PM) or other SHS indicators). The SHS measurement methods were assessed for inclusion of extraneous variables that may affect levels or the corroboration of measurements with known standards. The magnitude of SHS exposure (PM2.5) depends on the number of smokers present, measurement proximity, outdoor enclosures, and wind. Annual excess PM2.5 exposure of full-time waitstaff at outdoor smoking environments could average 4.0 to 12.2 μg/m3 under variable smoking conditions. Although highly transitory, outdoor SHS exposures could occasionally exceed annual ambient air quality exposure guidelines. Personal monitoring studies of waitstaff are warranted to corroborate these modeled estimates.

Validity of self-reported adult secondhand smoke exposure.

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Prochaska, Judith J; Grossman, William; Young-Wolff, Kelly C; Benowitz, Neal L

2015-01-01

Exposure of adults to secondhand smoke (SHS) has immediate adverse effects on the cardiovascular system and causes coronary heart disease. The current study evaluated brief self-report screening measures for accurately identifying adult cardiology patients with clinically significant levels of SHS exposure in need of intervention. A cross-sectional study conducted in a university-affiliated cardiology clinic and cardiology inpatient service. Participants were 118 non-smoking patients (59% male, mean age=63.6 years, SD=16.8) seeking cardiology services. Serum cotinine levels and self-reported SHS exposure in the past 24 h and 7 days on 13 adult secondhand exposure to smoke (ASHES) items. A single item assessment of SHS exposure in one's own home in the past 7 days was significantly correlated with serum cotinine levels (r=0.41, p85% and correct classification rates >85% at cotinine cut-off points of >0.215 and >0.80 ng/mL. The item outperformed multi-item scales, an assessment of home smoking rules, and SHS exposure assessed in other residential areas, automobiles and public settings. The sample was less accurate at self-reporting lower levels of SHS exposure (cotinine 0.05-0.215 ng/mL). The single item ASHES-7d Home screener is brief, assesses recent SHS exposure over a week's time, and yielded the optimal balance of sensitivity and specificity. The current findings support use of the ASHES-7d Home screener to detect SHS exposure and can be easily incorporated into assessment of other major vital signs in cardiology. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Association between current asthma and secondhand smoke exposure in vehicles among adults living in four US states.

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Nguyen, Kimberly H; King, Brian A; Dube, Shanta R

2015-07-01

Many states have implemented laws prohibiting tobacco smoking in indoor public places. However, private settings remain a major source of secondhand smoke (SHS) exposure for many people. We assessed the association between current asthma and SHS exposure in vehicles among adult never-smokers in Indiana, Kentucky, Louisiana and Mississippi. Data came from the 2011 Behavioral Risk Factor Surveillance System, a state-based telephone survey of US adults aged ≥18 years. Analyses were restricted to states (n=4) that administered an optional SHS module. Prevalence of self-reported asthma and past 7-day SHS exposure in vehicles was calculated by demographics, voluntary smoke-free vehicle rules and SHS exposure in homes, public places and workplaces. Logistic regression was used to assess the adjusted association between asthma and SHS exposure in vehicles. Among 17 863 never-smoking adults, 7.4% reported having current asthma, whereas 12.3% reported past 7-day SHS exposure in vehicles. Among adults with asthma, SHS exposure in vehicles was lower among those with voluntary smoke-free rules compared with those without voluntary smoke-free rules (9.5% vs 56.7%, psmoke-free rules in vehicles, especially among adults with asthma. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Nursing research in community-based approaches to reduce exposure to secondhand smoke.

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Hahn, Ellen J; Ashford, Kristin B; Okoli, Chizimuzo T C; Rayens, Mary Kay; Ridner, S Lee; York, Nancy L

2009-01-01

Secondhand smoke (SHS) is the third leading cause of preventable death in the United States and a major source of indoor air pollution, accounting for an estimated 53,000 deaths per year among nonsmokers. Secondhand smoke exposure varies by gender, race/ethnicity, and socioeconomic status. The most effective public health intervention to reduce SHS exposure is to implement and enforce smoke-free workplace policies that protect entire populations including all workers regardless of occupation, race/ethnicity, gender, age, and socioeconomic status. This chapter summarizes community and population-based nursing research to reduce SHS exposure. Most of the nursing research in this area has been policy outcome studies, documenting improvement in indoor air quality, worker's health, public opinion, and reduction in Emergency Department visits for asthma, acute myocardial infarction among women, and adult smoking prevalence. These findings suggest a differential health effect by strength of law. Further, smoke-free laws do not harm business or employee turnover, nor are revenues from charitable gaming affected. Additionally, smoke-free laws may eventually have a positive effect on cessation among adults. There is emerging nursing science exploring the link between SHS exposure to nicotine and tobacco dependence, suggesting one reason that SHS reduction is a quit smoking strategy. Other nursing research studies address community readiness for smoke-free policy, and examine factors that build capacity for smoke-free policy. Emerging trends in the field include tobacco free health care and college campuses. A growing body of nursing research provides an excellent opportunity to conduct and participate in community and population-based research to reduce SHS exposure for both vulnerable populations and society at large.

Factors associated with secondhand tobacco smoke in the home: an exploratory cross-sectional study among women in Aleta Wondo, Ethiopia

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Anne Berit Petersen

2016-08-01

Full Text Available Abstract Background In Ethiopia, female smoking rates are currently low (1 %. However, because of male smoking rates (overall 7.7 % and up to 27 % depending on region, women and children’s risk of second hand smoke (SHS exposure is a pressing concern. In order to develop effective public health interventions that prevent the uptake and exposure to smoking, thereby averting the projected increase in tobacco-induced disease, an understanding of Ethiopian women’s practices regarding tobacco is needed. The purpose of this study was to explore Ethiopian women’s tobacco use and prevalence of SHS exposure, and to identify covariates associated with SHS exposure. Methods We conducted an exploratory cross-sectional study in Southern Ethiopia between August and October 2014, and systematically sampled households in Aleta Wondo town and surrounding districts. Trained interviewers verbally administered surveys to women 18–55 years of age. Descriptive statistics and multiple logistic regression analyses were performed. Results None of the 353 participants reported current tobacco use and less than 1 % reported ever use, however, 11 % reported ever use of the stimulant leaf khat. Twenty-seven women (7.6 % reported living with a tobacco user, however, twice that number (14.4 % overall, and 22 % of urban participants reported that smoking occurred daily in their home. When controlling for other factors, living with a tobacco user (OR = 9.91, 95 % CI [3.32, 29.59], allowing smoking in the home (OR = 5.67, 95 % CI [2.51, 12.79], place of residence (OR = 2.74, 95 % CI [1.11, 6.74], and exposure to point-of-sale advertising within the last 30 days (OR = 2.87, 95 % CI [1.26, 6.54] contributed significantly to a model predicting the likelihood of reporting daily occurrence of smoking/SHS in the home. Conclusions While few women reported having ever used tobacco, one in seven women in this study reported that smoking/SHS occurred

Smoke-free policies and the social acceptability of smoking in Uruguay and Mexico: findings from the International Tobacco Control Policy Evaluation Project.

Science.gov (United States)

Thrasher, James F; Boado, Marcelo; Sebrié, Ernesto M; Bianco, Eduardo

2009-06-01

Little research has been conducted to determine the psychosocial and behavioral impacts of smoke-free policies in middle-income countries. Cross-sectional data were analyzed from the 2006 waves of the International Tobacco Control Policy Evaluation. Survey comparing adult smokers in Mexico (n = 1,080), where smoke-free legislation at that time was weak, and Uruguay (n = 1,002), where comprehensive smoke-free legislation was implemented. Analyses aimed to determine whether exposure to smoke-free policies and perceived antismoking social norms were associated with smokers' receiving cues about the bothersome nature of secondhand smoke (SHS), with smokers' reactance against such cues, and with smokers' level of support for smoke-free policies in different venues. In bivariate analyses, Uruguayan smokers were more likely than Mexican smokers to experience verbal anti-SHS cues, lower reactance against anti-SHS cues, stronger antismoking societal norms, and stronger support for 100% smoke-free policies in enclosed workplaces, restaurants, and bars. In multivariate models for both countries, the strength of voluntary smoke-free policies at home was independently associated with support for smoke-free policies across all venues queried, except for in bars among Uruguayans. Perceived strength of familial antismoking norms was consistently associated with all indicators of the social acceptability of smoking in Uruguay but only with the frequency of receiving anti-SHS verbal cues in Mexico. These results are generally consistent with previous research indicating that comprehensive smoke-free policies are likely to increase the social unacceptability of smoking and that resistance against such policies is likely to diminish once such policies are in place.

Secondhand Smoke Exposure in Cars Among Middle and High School Students—United States, 2000–2009

Science.gov (United States)

King, Brian A.; Dube, Shanta R.; Tynan, Michael A.

2015-01-01

OBJECTIVE Exposure to secondhand smoke (SHS) from cigarettes poses a significant health risk to nonsmokers. Among youth, the home is the primary source of SHS. However, little is known about youth exposure to SHS in other nonpublic areas, particularly motor vehicles. METHODS Data were obtained from the 2000, 2002, 2004, 2006, and 2009 waves of the National Youth Tobacco Survey, a nationally representative survey of US students in grades 6 to 12. Trends in SHS exposure in a car were assessed across survey years by school level, gender, and race/ethnicity by using binary logistic regression. RESULTS From 2000 to 2009, the prevalence of SHS exposure in cars declined significantly among both nonsmokers (39.0%–22.8%; trend P race/ethnicity subgroups. CONCLUSIONS SHS exposure in cars decreased significantly among US middle and high school students from 2000 to 2009. Nevertheless, in 2009, over one-fifth of nonsmoking students were exposed to SHS in cars. Jurisdictions should expand comprehensive smoke-free policies that prohibit smoking in worksites and public places to also prohibit smoking in motor vehicles occupied by youth. PMID:22311992

Reshuffling and Relocating: The Gendered and Income-Related Differential Effects of Restricting Smoking Locations

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Natalie Hemsing

2012-01-01

Full Text Available This study investigates secondhand smoke (SHS exposure and management in the context of smoking location restrictions, for nonsmokers, former, and current smokers. A purposive sample of 47 low income and non-low-income men and women of varied smoking statuses was recruited to participate in a telephone interview or a focus group. Amidst general approval of increased restrictions there were gendered patterns of SHS exposure and management, and effects of SHS policies that reflect power, control, and social roles that need to be considered as policies are developed, implemented and monitored. The experience of smoking restrictions and the management of SHS is influenced by the social context (relationship with a partner, family member, or stranger, the space of exposure (public or private, worksite, the social location of individuals involved (gender, income, and differential tolerance to SHS. This confluence of factors creates differing unintended and unexpected consequences to the social and physical situations of male and female smokers, nonsmokers, and former smokers. These factors deserve further study, in the interests of informing the development of future interventions and policies restricting SHS.

Brief Counseling on Secondhand Smoke Exposure in Pregnant Women in Argentina and Uruguay

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Alicia Alemán

2016-12-01

Full Text Available Argentina and Uruguay have a high prevalence of smoking during pregnancy, as well as of secondhand smoke (SHS exposure. In this secondary analysis of a trial to implement brief smoking cessation counseling during antenatal care in Argentina and Uruguay, we aim to evaluate the effects of the intervention on the rates of self-reported SHS exposure at home and at work, and on attitudes recalled by non-smoker women enrolled in the intervention group compared with the control group. We randomly assigned (1:1 20 antenatal care clusters in Argentina and Uruguay to receive a multifaceted intervention to implement brief smoking cessation counseling, which also included questions and counseling regarding SHS exposure, or to receive the standard of care. There was not a statistically significant difference between groups of the intervention’s effect (reduction of exposure to SHS on any of the three exposure outcome measures (exposure at home, work or other indoor areas or on the attitudes of women regarding exposure (avoiding breathing SHS and having rooms where smoking is forbidden. This analysis shows that we should not expect reductions in SHS exposure with this modest intervention alone. To achieve such reductions, strategies engaging partners and other household members may be more effective.

Brief Counseling on Secondhand Smoke Exposure in Pregnant Women in Argentina and Uruguay.

Science.gov (United States)

Alemán, Alicia; Morello, Paola; Colomar, Mercedes; Llambi, Laura; Berrueta, Mabel; Gibbons, Luz; Buekens, Pierre; Althabe, Fernando

2016-12-29

Argentina and Uruguay have a high prevalence of smoking during pregnancy, as well as of secondhand smoke (SHS) exposure. In this secondary analysis of a trial to implement brief smoking cessation counseling during antenatal care in Argentina and Uruguay, we aim to evaluate the effects of the intervention on the rates of self-reported SHS exposure at home and at work, and on attitudes recalled by non-smoker women enrolled in the intervention group compared with the control group. We randomly assigned (1:1) 20 antenatal care clusters in Argentina and Uruguay to receive a multifaceted intervention to implement brief smoking cessation counseling, which also included questions and counseling regarding SHS exposure, or to receive the standard of care. There was not a statistically significant difference between groups of the intervention's effect (reduction of exposure to SHS) on any of the three exposure outcome measures (exposure at home, work or other indoor areas) or on the attitudes of women regarding exposure (avoiding breathing SHS and having rooms where smoking is forbidden). This analysis shows that we should not expect reductions in SHS exposure with this modest intervention alone. To achieve such reductions, strategies engaging partners and other household members may be more effective.

A survey of schoolchildren's exposure to secondhand smoke in Malaysia

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Turner Stephen W

2011-08-01

Full Text Available Abstract Background There is a lack of data describing the exposure of Malaysian schoolchildren to Secondhand Smoke (SHS. The aim of this study is to identify factors influencing schoolchildren's exposures to SHS in Malaysia. Method This cross-sectional study was carried out to measure salivary cotinine concentrations among 1064 schoolchildren (10-11 years attending 24 schools in Malaysia following recent partial smoke-free restrictions. Parents completed questionnaires and schoolchildren provided saliva samples for cotinine assay. Results The geometric mean (GM salivary cotinine concentrations for 947 non-smoking schoolchildren stratified by household residents' smoking behaviour were: for children living with non-smoking parents 0.32 ng/ml (95% CI 0.28-0.37 (n = 446; for children living with a smoker father 0.65 ng/ml (95% CI 0.57-0.72 (n = 432; for children living with two smoking parents 1.12 ng/ml (95% CI 0.29-4.40 (n = 3; for children who live with an extended family member who smokes 0.62 ng/ml (95% CI 0.42-0.89 (n = 33 and for children living with two smokers (father and extended family member 0.71 ng/ml (95% CI 0.40-0.97 (n = 44. Parental-reported SHS exposures showed poor agreement with children's self-reported SHS exposures. Multiple linear regression demonstrated that cotinine levels were positively associated with living with one or more smokers, urban residence, occupation of father (Armed forces, parental-reported exposure to SHS and education of the father (Diploma/Technical certificate. Conclusions This is the first study to characterise exposures to SHS using salivary cotinine concentrations among schoolchildren in Malaysia and also the first study documenting SHS exposure using salivary cotinine as a biomarker in a South-East Asian population of schoolchildren. Compared to other populations of similarly aged schoolchildren, Malaysian children have higher salivary cotinine concentrations. The partial nature of smoke

Predictors of Childhood Exposure to Parental Secondhand Smoke in the House and Family Car

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Vassiliki Mantziou

2009-02-01

Full Text Available Childhood exposure to secondhand smoke (SHS is a serious threat to public health and can be influenced by parental lifestyle habits and beliefs. Taking the above into account we aimed at locating predictors of parental induced exposure to SHS in the house and family car among 614 children who visited the emergency department of two large pediatric hospitals in Athens, Greece. The multivariate analysis revealed that the factors found to mediate household exposure to paternal SHS were the number of cigarettes smoked per day (O.R 1.13, p<0.001 while, having a non-smoking spouse had a protective effect (O.R 0.44, p=0.026. Maternally induced household SHS exposure was related to cigarette consumption. For both parents, child exposure to SHS in the family car was related to higher numbers of cigarettes smoked (p<0.001, and for fathers was also more often found in larger families. Additionally, lower educated fathers were more likely to have a spouse that exposes their children to SHS inside the family car (O.R 1.38 95%C.I: 1.04-1.84, p=0.026. Conclusively, efforts must be made to educate parents on the effects of home and household car exposure to SHS, where smoke free legislation may be difficult to apply.

Economic costs attributable to smoking in Hong Kong in 2011: a possible increase from 1998.

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Chen, Jing; McGhee, Sarah; Lam, Tai Hing

2017-11-15

Reduction in smoking prevalence does not necessarily reduce the costs of smoking as evidence shows in developed countries. We provide up-to-date estimates for direct and indirect costs attributable to smoking in Hong Kong in 2011 and compare with our 1998 estimates. We took a societal perspective to include lives and life years lost, health care costs and time lost from work in the costing. We followed guidelines on estimating costs of active smoking for those aged 35 years or above (35+) and costs due to SHS exposure for 35+, infants aged 12 months and under and children aged 15 and below. All costs are in US$. We estimated that 6154 deaths among 35+ in Hong Kong in 2011 were attributable to active smoking, an increase of 10% from 1998. Besides, 672 deaths were attributable to SHS exposure, i.e. 10% of the total 6826 smoking-attributable deaths. The estimate of productive life lost due to deaths from active smoking by those aged under 65 years in 2011 was $166 million, an increase of about 4% over the estimate in 1998. Our conservative estimate of the annual tobacco-related disease cost in 2011 was $716 million which accounted for 0.3% of GDP. If we added the value of attributable lives lost, the annual cost would be $4.7 billion. Despite the reduction in smoking prevalence, smoking-attributable disease still imposes a substantial economic burden on Hong Kong society. These findings support more stringent and effective tobacco control legislation, polices and measures. Current evidence shows reduction in smoking prevalence does not necessarily reduce the economic costs of smoking. Most studies in developed countries employed a societal perspective, including costs of productivity loss and indirect costs, but not all studies estimated costs associated with second-hand smoking (SHS). The present study estimated the total costs of smoking in Hong Kong including direct and indirect costs attributable to active smoking and to SHS exposure. Our study confirms the

Tobacco smoking and hand eczema - is there an association?

DEFF Research Database (Denmark)

Sørensen, Jennifer A; Clemmensen, Kim K; Nixon, Rosemary L

2015-01-01

than for population-based studies. No studies reported tobacco to be a clear protective factor for hand eczema. Two of five studies regarding severity found a positive association between smoking and hand eczema severity. CONCLUSION: Overall, the data indicate that smoking may cause an increased...... eczema, as well as severity, may be important....

Two-year impact of the Spanish smoking law on exposure to secondhand smoke: evidence of the failure of the 'Spanish model'.

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López, Maria J; Nebot, Manel; Schiaffino, Anna; Pérez-Ríos, Mónica; Fu, Marcela; Ariza, Carles; Muñoz, Gloria; Fernández, Esteve

2012-07-01

Studies evaluating the long-term impact of smoking laws on secondhand smoke (SHS) exposure using airborne markers are scarce. This study aimed to assess the long-term impact of the Spanish smoking law on SHS levels, using a specific and objective marker. Follow-up study, measuring vapour-phase nicotine levels before the implementation of the law and 6, 12 and 24 months after the initial assessment. A total of 443 samples were taken at baseline in eight different regions in offices in the public administration, private sector, universities and hospitality venues. Two years after the law was implemented, the nicotine concentration decreased by a minimum of 60% in public administration, university and private sector offices, as well as in venues where smoking was totally banned. However, nicotine levels significantly increased by 40% in hospitality venues allowing smoking. No significant differences were found in hospitality venues with areas for smokers and non-smokers or in pubs and discotheques. Two years after the smoking law came into force, levels of SHS exposure in the workplace were significantly lower than before the law was implemented. Importantly, however, SHS levels were even higher than before the law was implemented in venues still allowing smoking. The data obtained in this study clearly show that the 'Spanish model' is not protecting the health of hospitality workers and that a complete ban is required. Furthermore, this study highlights the importance of long-term monitoring of compliance with smoking laws over time.

Exposure to secondhand smoke in terraces and other outdoor areas of hospitality venues in eight European countries.

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López, Maria J; Fernández, Esteve; Gorini, Giuseppe; Moshammer, Hanns; Polanska, Kinga; Clancy, Luke; Dautzenberg, Bertrand; Delrieu, Agnes; Invernizzi, Giovanni; Muñoz, Glòria; Precioso, Jose; Ruprecht, Ario; Stansty, Peter; Hanke, Wojciech; Nebot, Manel

2012-01-01

Outdoor secondhand smoke (SHS) concentrations are usually lower than indoor concentrations, yet some studies have shown that outdoor SHS levels could be comparable to indoor levels under specific conditions. The main objectives of this study were to assess levels of SHS exposure in terraces and other outdoor areas of hospitality venues and to evaluate their potential displacement to adjacent indoor areas. Nicotine and respirable particles (PM2.5) were measured in outdoor and indoor areas of hospitality venues of 8 European countries. Hospitality venues of the study included night bars, restaurants and bars. The fieldwork was carried out between March 2009 and March 2011. We gathered 170 nicotine and 142 PM2.5 measurements during the study. The median indoor SHS concentration was significantly higher in venues where smoking was allowed (nicotine 3.69 µg/m3, PM2.5: 120.51 µg/m3) than in those where smoking was banned (nicotine: 0.48 µg/m3, PM2.5: 36.90 µg/m3). The median outdoor nicotine concentration was higher in places where indoor smoking was banned (1.56 µg/m3) than in venues where smoking was allowed (0.31 µg/m3). Among the different types of outdoor areas, the highest median outdoor SHS levels (nicotine: 4.23 µg/m3, PM2.5: 43.64 µg/m3) were found in the semi-closed outdoor areas of venues where indoor smoking was banned. Banning indoor smoking seems to displace SHS exposure to adjacent outdoor areas. Furthermore, indoor settings where smoking is banned but which have a semi-closed outdoor area have higher levels of SHS than those with open outdoor areas, possibly indicating that SHS also drifts from outdoors to indoors. Current legislation restricting indoor SHS levels seems to be insufficient to protect hospitality workers--and patrons--from SHS exposure. Tobacco-free legislation should take these results into account and consider restrictions in the terraces of some hospitality venues to ensure effective protection.

One Minute of Marijuana Secondhand Smoke Exposure Substantially Impairs Vascular Endothelial Function

OpenAIRE

Wang, X; Derakhshandeh, R; Liu, J; Narayan, S; Nabavizadeh, P; Le, S; Danforth, OM; Pinnamaneni, K; Rodriguez, HJ; Luu, E; Sievers, RE; Schick, SF; Glantz, SA; Springer, ML

2016-01-01

Background Despite public awareness that tobacco secondhand smoke (SHS) is harmful, many people still assume that marijuana SHS is benign. Debates about whether smoke?free laws should include marijuana are becoming increasingly widespread as marijuana is legalized and the cannabis industry grows. Lack of evidence for marijuana SHS causing acute cardiovascular harm is frequently mistaken for evidence that it is harmless, despite chemical and physical similarity between marijuana and tobacco sm...

Original Research Article Second-Hand Smoke in a University

African Journals Online (AJOL)

Erah

staff and students concerning tobacco policies at a university campus in a ... to smoking and exposure to second-hand smoke on campus. A. 3-wave e-mailing was used to send the questionnaire. Results: ... smoke free policies on university campuses in North America. ... reported that cigarette smoking among fulltime.

Secondhand smoke exposure in hospitality venues in Europe.

Science.gov (United States)

Lopez, Maria J; Nebot, Manel; Albertini, Marco; Birkui, Pierre; Centrich, Francesc; Chudzikova, Monika; Georgouli, Maria; Gorini, Giuseppe; Moshammer, Hanns; Mulcahy, Maurice; Pilali, Maria; Serrahima, Eulalia; Tutka, Piotr; Fernandez, Esteve

2008-11-01

Although in the last few years some European countries have implemented smoking bans in hospitality venues, the levels of secondhand smoke (SHS) in this occupational sector could still be extremely high in most countries. The aim of this study was to assess exposure to SHS in hospitality venues in 10 European cities. We included 167 hospitality venues (58 discotheques and pubs, 82 restaurants and cafeterias, and 27 fast-food restaurants) in this cross-sectional study. We carried out fieldwork in 10 European cities: Vienna (Austria), Paris (France), Athens (Greece), Florence and Belluno (Italy), Galway (Ireland), Barcelona (Spain), Warsaw and Lublin (Poland), and Bratislava (Slovak Republic). We measured vapor-phase nicotine as an SHS marker. We analyzed 504 samples and found nicotine in most samples (97.4%). We found the highest median concentrations in discos/pubs [32.99 microg/m(3); interquartile range (IQR), 8.06-66.84 microg/m(3)] and lower median concentrations in restaurants/cafeterias (2.09 microg/m(3); IQR, 0.49-6.73 microg/m(3)) and fast-food restaurants (0.31 microg/m(3); IQR, 0.11-1.30 microg/m(3)) (p Hospitality venues from European cities without smoking regulations have very high levels of SHS exposure. Monitoring of SHS on a regular basis as well as a total smoking ban in hospitality sector would be needed.

Exposure to second-hand smoke and the risk of tuberculosis in children and adults: a systematic review and meta-analysis of 18 observational studies.

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Jayadeep Patra

2015-06-01

Full Text Available According to WHO Global Health Estimates, tuberculosis (TB is among the top ten causes of global mortality and ranks second after cardiovascular disease in most high-burden regions. In this systematic review and meta-analysis, we investigated the role of second-hand smoke (SHS exposure as a risk factor for TB among children and adults.We performed a systematic literature search of PubMed, Embase, Scopus, Web of Science, and Google Scholar up to August 31, 2014. Our a priori inclusion criteria encompassed only original studies where latent TB infection (LTBI and active TB disease were diagnosed microbiologically, clinically, histologically, or radiologically. Effect estimates were pooled using fixed- and random-effects models. We identified 18 eligible studies, with 30,757 children and 44,432 adult non-smokers, containing SHS exposure and TB outcome data for inclusion in the meta-analysis. Twelve studies assessed children and eight studies assessed adult non-smokers; two studies assessed both populations. Summary relative risk (RR of LTBI associated with SHS exposure in children was similar to the overall effect size, with high heterogeneity (pooled RR 1.64, 95% CI 1.00-2.83. Children showed a more than 3-fold increased risk of SHS-associated active TB (pooled RR 3.41, 95% CI 1.81-6.45, which was higher than the risk in adults exposed to SHS (summary RR 1.32, 95% CI 1.04-1.68. Positive and significant exposure-response relationships were observed among children under 5 y (RR 5.88, 95% CI 2.09-16.54, children exposed to SHS through any parent (RR 4.20, 95% CI 1.92-9.20, and children living under the most crowded household conditions (RR 5.53, 95% CI 2.36-12.98. Associations for LTBI and active TB disease remained significant after adjustment for age, biomass fuel (BMF use, and presence of a TB patient in the household, although the meta-analysis was limited to a subset of studies that adjusted for these variables. There was a loss of association

The Living Tomorrow Project: how Philip Morris has used a Belgian tourist attraction to promote ventilation approaches to the control of second hand smoke

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Pilkington, P; Gilmore, A

2004-01-01

Study objective: To examine the involvement of Philip Morris in Living Tomorrow 2 and determine the rationale behind its involvement. Design: Research was conducted through a web based search of internal tobacco industry documents made publicly available through litigation. Main results: For approximately €1 000 000 Philip Morris (now Altria) became a co-initiator of Living Tomorrow 2, a tourist complex in Belgium that aims to demonstrate how we will be living in the future. In addition to promoting the company and its grocery products, Philip Morris is using the complex and its website to promote ventilation as a means of accommodating smokers and non-smokers in the indoor environment. Particular emphasis was placed on the bar and restaurant areas. Despite the rationale for its involvement, Philip Morris fails to acknowledge its role as a cigarette manufacturer. As a form of corporate sponsorship Philip Morris thought its involvement could evade any European tobacco advertising ban. Conclusions: Philip Morris is using a tourist attraction to promote its views on control of second hand smoke (SHS) and accommodation of smokers and non-smokers in the indoor environment. However, ventilation does not deal with the health effects of SHS. Policymakers must be cognisant of the devious tactics the industry employs to promote its own agenda, especially in relation to indoor air quality and smoking in public places. Tobacco control legislation should be continually modified and strengthened in response to the changing activities of the tobacco industry as it strives to evade existing legislation and deter the advent of new legislation. PMID:15564621

Secondhand smoke exposure among non smoking adults in two ...

African Journals Online (AJOL)

Background: Tobacco control policy can only succeed if the burdens of smoking are known. The objective of this study was to determine the prevalence and correlates of secondhand smoke (SHS) exposure among nonsmoking adults in two Nigerian cities. Materials and Methods: We carried out a cross-sectional study from ...

Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke — United States, 1999–2012

Science.gov (United States)

Homa, David M.; Neff, Linda J.; King, Brian A.; Caraballo, Ralph S.; Bunnell, Rebecca E.; Babb, Stephen D.; Garrett, Bridgette E.; Sosnoff, Connie S.; Wang, Lanqing

2015-01-01

Background Exposure to secondhand smoke (SHS) from burning tobacco causes disease and death in nonsmoking children and adults. No risk-free level of SHS exposure exists. Methods National Health and Nutrition Examination Survey (NHANES) data from 1999–2012 were used to examine SHS exposure among the nonsmoking population aged ≥3 years. SHS exposure among nonsmokers was defined as a serum cotinine level (a metabolite of nicotine) of 0.05–10 ng/mL. SHS exposure was assessed overall and by age, sex, race/ethnicity, poverty level, education, and whether the respondent owned or rented their housing. Results Prevalence of SHS exposure in nonsmokers declined from 52.5% during 1999–2000 to 25.3% during 2011–2012. During this period, declines were observed for all population subgroups, but disparities exist. During 2011–2012, SHS was highest among: children aged 3–11 years (40.6%), non-Hispanic blacks (46.8%), persons living below the poverty level (43.2%), and persons living in rental housing (36.8%). Among children aged 3–11 years, 67.9% of non-Hispanic blacks were exposed to SHS compared with 37.2% of non-Hispanic whites and 29.9% of Mexican Americans. Conclusion Overall, SHS exposure in the United States has been reduced by half since 1999–2000. However, 58 million persons were still exposed to SHS during 2011–2012, and exposure remains higher among children, non-Hispanic blacks, those living in poverty, and those who rent their housing. Implications for Public Health Practice Eliminating smoking in indoor spaces fully protects nonsmokers from SHS exposure; separating smokers from nonsmokers, cleaning the air and ventilating buildings cannot completely eliminate exposure. Continued efforts to promote implementation of comprehensive statewide laws prohibiting smoking in workplaces and public places, smoke-free policies in multiunit housing, and voluntary smoke-free home and vehicle rules are critical to protect nonsmokers from this preventable health

Exposure to secondhand smoke among adults - Philippines, 2009.

Science.gov (United States)

Baquilod, Marina M; Segarra, Agnes B; Barcenas, Glen; Mercado, Susan P; Rarick, James; Palipudi, Krishna Mohan; Asma, Samira; Andes, Linda J; Talley, Brandon

2016-06-01

We assessed the differences in exposure to secondhand smoke (SHS) among adults at home, in indoor workplaces, and in various public places in the Philippines across various socio-demographic groups. Data from the Global Adult Tobacco Survey conducted in 2009 in the Philippines were used. The data consist of survey answers from 9705 respondents from a nationally representative, multistage probability sample of adults aged 15 years or older. We considered that respondents were exposed to SHS if during the previous 30 days they reported that they lived in a home, worked in a building, or visited a public place where people smoked. The public places included in our analysis were indoor workplaces, public transportation vehicles, restaurants, government buildings or offices, and healthcare facilities. The differences in various socioeconomic and demographic groups' exposure to SHS in these places were also examined. Of respondents who reported working indoors, 36.8% were exposed to SHS. Men (43.3% [95% CI 39.7-46.9]) were more likely than women (28.8% [95% CI 25.4-32.4]) to be exposed to SHS (p exposure for those who visited public buildings was 33.6% in restaurants, 25.5% in government buildings or offices, and 7.6% in healthcare facilities. Despite a national law passed and several local government ordinances that have promulgated smoke-free workplaces, schools, government offices, and healthcare facilities, our findings show that a large proportion of adults were exposed to SHS at work and in public places, which offers opportunities to strengthen and improve enforcement of the smoke-free initiatives and ordinances in the Philippines. © The Author(s) 2013.

Secondhand tobacco smoke in public venues in three Indonesian cities

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M. J. Byron

2013-12-01

Full Text Available Background: The aim of this study was to measure secondhand tobacco (including kretek smoke (SHS concentrations in public places in Jakarta, Bogor, and Palembang before laws banning smoking in public spaces went into effect.Methods: Particulate matter (PM2.5 was measured in 15 hospitals, 15 government offices, 30 restaurants, and 26 entertainment venues throughout the three cities. Also, in Jakarta, vapor-phase nicotine was measured in 5 schools, 5 hospitals, 5 government offices, 9 restaurants, and 10 entertainment venues. Data were analyzed descriptively. Differences by city and venue characteristics were analyzed by Student’s t-test, ANOVA, and Bonferroni pairwise statistical tests.Results: Geometric mean PM2.5 levels were highest in entertainment venues (96 μg/m3, followed by restaurants (78 μg/m3, government offices (57 μg/m3, and hospitals (46 μg/m3. Air nicotine levels in Jakarta were highest in designated smoking areas (4.71 μg/m3 and designated non-smoking areas (1.55 μg/m3 of entertainment venues. These were followed by government offices (0.30 μg/m3, designated smoking areas (0.24 μg/m3 and designated non-smoking areas (0.19 μg/m3 of restaurants, hospitals (0.01 μg/m3, and schools (0.01 μg/m3.Conclusion: SHS was detected in all venues in the three cities in Indonesia. High levels of air nicotine were found in non-smoking areas of restaurants and entertainment venues, indicating that designated smoking areas are not an effective solution to eliminate SHS. There is no safe level of SHS exposure and thus SHS in these venues increases the risk of adverse health effects among children and adults. These findings support the need for 100% smoke-free laws covering all public venues in these and other Indonesian cities. (Med J Indones. 2013;22:232-7. doi: 10.13181/mji.v22i4.606 Keywords: Cigarettes, kretek, protection, protect, secondhand smoke, smoke-free policy, tobacco

Secondhand smoke in psychiatric units: patient and staff misperceptions.

Science.gov (United States)

Ballbè, Montse; Sureda, Xisca; Martínez-Sánchez, Jose M; Fu, Marcela; Saltó, Esteve; Gual, Antoni; Fernández, Esteve

2015-10-01

Mental health units have usually been exempted from complete smoke-free policies. The aim of this study was to compare the self-reported level of exposure to secondhand smoke (SHS) of patients and staff in psychiatric units to objective measures, and examine preference for different types of smoking bans. Cross-sectional survey about ban preferences and self-reported exposure to SHS by means of a self-administered questionnaire administered to patients and staff from 65 inpatient psychiatric units in Catalonia (95.5% of all units). We measured air concentrations of particulate matter ≤ 2.5 μm (PM2.5 in µg/m(3)) as a marker of SHS in these units. 600 patients and 575 professionals completed the questionnaire. 78.7% of them were objectively exposed to SHS (PM2.5>10 μm/m(3)) but 56.9% of patients and 33.6% of staff believed they were not exposed at all and 41.6% of patients and 28.4% of staff believed the environment was not at all unhealthy. Nurses had a higher smoking prevalence than psychiatrists (35.8% vs 17.2%; psmoke-free bans. It is particularly noteworthy that less that one-third of mental health staff supported smoke-free units, suggesting an urgent need for further education about the harmful health effects of SHS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Correlations of indoor second-hand smoking, household smoking rules, regional deprivation and children mental health: Scottish Health Survey, 2013.

Science.gov (United States)

Shiue, Ivy

2015-07-01

It has been known that second-hand smoking and deprivation could cluster together affecting child health. However, little is known on the role of household smoking rules. Therefore, it was aimed to study the relationships among indoor second-hand smoking, household smoking rules, deprivation level and children mental health in a country-wide and population-based setting. Data was retrieved from and analysed in Scottish Health Survey, 2013. Information on demographics, indoor second-hand smoking status, household smoking rules, deprivation level and child mental health by Strengths and Difficulties Questionnaire was obtained by household interview through parents. Statistical analysis included chi-square test and survey-weighted logistic regression modelling. Of 1019 children aged 4-12, 17.9% (n = 182) lived in the 15% most deprivation areas. Deprived areas tended to be where indoor smoking occurred (p Scottish children are greater Glasgow, Ayrshire & Arran and Forth Valley while the top three sub-regions of exposure to the indoor second-hand smoking are Fife, Forth Valley and Ayrshire & Arran. The top three sub-regions with indoor smoking allowed are greater Glasgow, Western Isles and Borders. Children emotional and behavioural problems were reduced when the strict household smoking rules (not allowed or outdoor areas) applied. One in six Scottish children lived in the 15% most deprivation areas and exposed to indoor second-hand smoking that could have led to emotional and behavioural problems. Public health programs promoting strict household smoking rules should be encouraged in order to optimise children mental health.

Exposure to secondhand smoke at work: a survey of members of the Australian Liquor, Hospitality and Miscellaneous Workers Union.

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Cameron, Melissa; Wakefield, Melanie; Trotter, Lisa; Inglis, Graeme

2003-10-01

To measure workers' attitudes towards and experiences of exposure to secondhand smoke (SHS) in the workplace. A stratified random sample of members from the Victorian Branch of the Australian Liquor, Hospitality and Miscellaneous Workers Union (LHMU) was interviewed by telephone in September 2001. Of the 1,078 respondents surveyed (77% response rate), hospitality workers comprised 49% of the sample, while the remainder comprised community services, property services and manufacturing workers. Overall, 54% of union members were employed in workplaces that did not completely ban smoking and 34% reported being exposed to SHS during their typical working day. Workplaces with total smoking bans had a high level of compliance with these restrictions, with no workers in these settings indicating exposure to SHS at work. Compared with other workers, hospitality workers reported working in environments that had more permissive smoking policies. Consistent with this, 56% of hospitality workers said they were exposed to SHS during a typical day at work compared with 11% of other workers. Overall, 79% of workers expressed concern about exposure to SHS, including 66% of smokers. Compared with other workers, hospitality workers reported a higher level of concern about exposure to SHS at work. These findings provide evidence that many workers, and especially those employed in the hospitality sector, are exposed to SHS during their working day and are concerned about the effects of such exposure on their health. These findings indicate that workplace smoke-free policies are effective in reducing worker exposure to SHS and demonstrate support for the extension of smoke-free policies to hospitality workplaces.

Association between exposure to secondhand smoke during pregnancy and low birthweight: a narrative review.

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Hawsawi, Abdulrhman M; Bryant, Lawrence O; Goodfellow, Lynda T

2015-01-01

Exposure to secondhand smoke (SHS) during pregnancy may have adverse effects on the mother and infant. This study investigates the association of maternal exposure to SHS with low birthweight (LBW) in infants. Smoking during pregnancy has been linked to multiple complications for both mother and infant. To examine association of LBW and environmental tobacco smoke exposure during pregnancy, we reviewed 20 articles. Articles were accessed using the following electronic databases: CINAHL Plus with full text (EBSCO), PubMed, Embase, and MEDLINE. The findings of this review revealed that maternal exposure to environmental smoke is correlated with LBW in infants as well as numerous other adverse effects. The majority of the studies found negative consequences of SHS on the birthweight of infants born to nonsmoking women. Thus, this review helps to confirm the association between maternal exposure to SHS and LBW in infants. Copyright © 2015 by Daedalus Enterprises.

Cardiovascular Consequences of Childhood Secondhand Tobacco Smoke Exposure: Prevailing Evidence, Burden, and Racial and Socioeconomic Disparities: A Scientific Statement From the American Heart Association.

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Raghuveer, Geetha; White, David A; Hayman, Laura L; Woo, Jessica G; Villafane, Juan; Celermajer, David; Ward, Kenneth D; de Ferranti, Sarah D; Zachariah, Justin

2016-10-18

Although public health programs have led to a substantial decrease in the prevalence of tobacco smoking, the adverse health effects of tobacco smoke exposure are by no means a thing of the past. In the United States, 4 of 10 school-aged children and 1 of 3 adolescents are involuntarily exposed to secondhand tobacco smoke (SHS), with children of minority ethnic backgrounds and those living in low-socioeconomic-status households being disproportionately affected (68% and 43%, respectively). Children are particularly vulnerable, with little control over home and social environment, and lack the understanding, agency, and ability to avoid SHS exposure on their own volition; they also have physiological or behavioral characteristics that render them especially susceptible to effects of SHS. Side-stream smoke (the smoke emanating from the burning end of the cigarette), a major component of SHS, contains a higher concentration of some toxins than mainstream smoke (inhaled by the smoker directly), making SHS potentially as dangerous as or even more dangerous than direct smoking. Compelling animal and human evidence shows that SHS exposure during childhood is detrimental to arterial function and structure, resulting in premature atherosclerosis and its cardiovascular consequences. Childhood SHS exposure is also related to impaired cardiac autonomic function and changes in heart rate variability. In addition, childhood SHS exposure is associated with clustering of cardiometabolic risk factors such as obesity, dyslipidemia, and insulin resistance. Individualized interventions to reduce childhood exposure to SHS are shown to be at least modestly effective, as are broader-based policy initiatives such as community smoking bans and increased taxation. The purpose of this statement is to summarize the available evidence on the cardiovascular health consequences of childhood SHS exposure; this will support ongoing efforts to further reduce and eliminate SHS exposure in this

Commonly used air filters fail to eliminate secondhand smoke induced oxidative stress and inflammatory responses.

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Muthumalage, Thivanka; Pritsos, Karen; Hunter, Kenneth; Pritsos, Chris

2017-07-01

Secondhand smoke (SHS) causes approximately 50,000 deaths per year. Despite all the health warnings, smoking is still allowed indoors in many states exposing both workers and patrons to SHS on a daily basis. The opponents of smoking bans suggest that present day air filtration systems remove the health hazards of exposure to SHS. In this study, using an acute SHS exposure model, we looked at the impact of commonly used air filters (MERV-8 pleated and MERV-8 pleated activated charcoal) on SHS by assessing the inflammatory response and the oxidative stress response in C57BL/6 mice. In order to assess the inflammatory response, we looked at the tumor necrosis factor alpha (TNF-α) cytokine production by alveolar macrophages (AMs), and for the oxidative response, we quantified the products of lipid peroxidation and the total glutathione (tGSH) production in lung homogenates. Our results showed that SHS caused significant immune and oxidative stress responses. The tested filters resulted in only a modest alleviation of inflammatory and oxidative responses due to SHS exposure. Our data show that these air filters cannot eliminate the risk of SHS exposure and that a short-term exposure to SHS is sufficient to alter the inflammatory cytokine response and to initiate a complex oxidative stress response. Our results are consistent with the statement made by the Surgeon General's reports that there is no risk free level of exposure to SHS.

Ashtrays and signage as determinants of a smoke-free legislation's success.

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Vardavas, Constantine I; Agaku, Israel; Patelarou, Evridiki; Anagnostopoulos, Nektarios; Nakou, Chrysanthi; Dramba, Vassiliki; Giourgouli, Gianna; Argyropoulou, Paraskevi; Antoniadis, Antonis; Gourgoulianis, Konstantinos; Ourda, Despoina; Lazuras, Lambros; Bertic, Monique; Lionis, Christos; Connolly, Gregory; Behrakis, Panagiotis

2013-01-01

Successful smoke-free legislation is dependent on political will, enforcement and societal support. We report the success and pitfalls of a non-enforced nationwide smoke-free legislation in Greece, as well as ways in which compliance and enforcement-related factors, including ashtrays and signage, may impact indoor secondhand smoke (SHS) concentrations. A follow-up study of venues (n=150, at baseline, n=75 at 2-year follow-up) in Greece assessed indoor particulate matter with a diameter less than 2.5 micrometers (PM 2.5 ) concentrations attributable to SHS smoke every six months for two years (n=455 venue/measurements). Following the implementation of the 2010 smoke-free legislation, mean PM2.5 concentrations attributable to SHS fell from 175.3 µg/m(3) pre-ban to 84.52 µg/m(3) immediately post-ban, increasing over subsequent waves (103.8 µg/m(3) and 158.2 µg/m(3) respectively). Controlling for potential influential factors such as ventilation, time of day, day of week, city and venue type, all post-ban measurements were still lower than during the pre-ban period (Wave 2 beta: -118.7, Wave 3 beta: -87.6, and Wave 4 beta: -69.9). Outdoor or indoor signage banning smoking was not found to affect SHS concentrations (beta: -10.9, p=0.667 and beta: -18.1, p=0.464 respectively). However, ashtray or ashtray equivalents were strong determinants of the existence of indoor SHS (beta: +67 µg/m(3), p=0.017). While the public may be supportive of smoke-free legislation, adherence may decline rapidly if enforcement is limited or nonexistent. Moreover, enforcement agencies should also focus on the comprehensive removal of ashtray equivalents that could act as cues for smoking within a venue.

Ashtrays and signage as determinants of a smoke-free legislation's success.

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Constantine I Vardavas

Full Text Available INTRODUCTION: Successful smoke-free legislation is dependent on political will, enforcement and societal support. We report the success and pitfalls of a non-enforced nationwide smoke-free legislation in Greece, as well as ways in which compliance and enforcement-related factors, including ashtrays and signage, may impact indoor secondhand smoke (SHS concentrations. METHODS: A follow-up study of venues (n=150, at baseline, n=75 at 2-year follow-up in Greece assessed indoor particulate matter with a diameter less than 2.5 micrometers (PM 2.5 concentrations attributable to SHS smoke every six months for two years (n=455 venue/measurements. RESULTS: Following the implementation of the 2010 smoke-free legislation, mean PM2.5 concentrations attributable to SHS fell from 175.3 µg/m(3 pre-ban to 84.52 µg/m(3 immediately post-ban, increasing over subsequent waves (103.8 µg/m(3 and 158.2 µg/m(3 respectively. Controlling for potential influential factors such as ventilation, time of day, day of week, city and venue type, all post-ban measurements were still lower than during the pre-ban period (Wave 2 beta: -118.7, Wave 3 beta: -87.6, and Wave 4 beta: -69.9. Outdoor or indoor signage banning smoking was not found to affect SHS concentrations (beta: -10.9, p=0.667 and beta: -18.1, p=0.464 respectively. However, ashtray or ashtray equivalents were strong determinants of the existence of indoor SHS (beta: +67 µg/m(3, p=0.017. CONCLUSIONS: While the public may be supportive of smoke-free legislation, adherence may decline rapidly if enforcement is limited or nonexistent. Moreover, enforcement agencies should also focus on the comprehensive removal of ashtray equivalents that could act as cues for smoking within a venue.

The effects of second-hand smoke on biological processes important in atherogenesis

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Schneider Matthias

2007-01-01

Full Text Available Abstract Background Atherosclerosis is the leading cause of death in western societies and cigarette smoke is among the factors that strongly contribute to the development of this disease. The early events in atherogenesis are stimulated on the one hand by cytokines that chemoattract leukocytes and on the other hand by decrease in circulating molecules that protect endothelial cells (ECs from injury. Here we focus our studies on the effects of "second-hand" smoke on atherogenesis. Methods To perform these studies, a smoking system that closely simulates exposure of humans to second-hand smoke was developed and a mouse model system transgenic for human apoB100 was used. These mice have moderate lipid levels that closely mimic human conditions that lead to atherosclerotic plaque formation. Results "Second-hand" cigarette smoke decreases plasma high density lipoprotein levels in the blood and also decreases the ratios between high density lipoprotein and low density lipoprotein, high density lipoprotein and triglyceride, and high density lipoprotein and total cholesterol. This change in lipid profiles causes not only more lipid accumulation in the aorta but also lipid deposition in many of the smaller vessels of the heart and in hepatocytes. In addition, mice exposed to smoke have increased levels of Monocyte Chemoattractant Protein–1 in circulation and in the heart/aorta tissue, have increased macrophages in the arterial walls, and have decreased levels of adiponectin, an EC-protective protein. Also, cytokine arrays revealed that mice exposed to smoke do not undergo the switch from the pro-inflammatory cytokine profile (that develops when the mice are initially exposed to second-hand smoke to the adaptive response. Furthermore, triglyceride levels increase significantly in the liver of smoke-exposed mice. Conclusion Long-term exposure to "second-hand" smoke creates a state of permanent inflammation and an imbalance in the lipid profile that

Prevalence and Determinants of Secondhand Smoke Exposure Among Middle and High School Students.

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Agaku, Israel T; Singh, Tushar; Rolle, Italia; Olalekan, Ayo-Yusuf; King, Brian A

2016-02-01

Secondhand smoke (SHS) causes disease and death among nonsmokers. Private settings are major sources of exposure for children. We assessed prevalence and determinants of self-reported SHS exposure in homes and vehicles, as well as school, work, and indoor/outdoor public areas, among US students in grades 6 through 12. Data were from the 2013 National Youth Tobacco Survey (n = 18 406). Self-reported SHS exposure within the past 7 days was assessed overall and by extent of smoke-free home and vehicle rules among never users of 10 tobacco product types. Descriptive statistics were used to compare estimates, and adjusted prevalence ratios were calculated to assess determinants of SHS exposure. Among never tobacco users, 48.0% reported SHS exposure in 1 or more locations, including 15.5% in the home, 14.7% in a vehicle, 16.8% at school, 27.1% at work, and 35.2% in an indoor/outdoor public area. Home exposure was 8.5%, 55.3%, and 79.4% among never tobacco users with complete, partial, or no smoke-free home rules, respectively (P exposure was 7.1%, 44.8%, and 70.2% among never tobacco users with complete, partial, or no smoke-free vehicle rules, respectively (P exposure included current tobacco use, truant behavior, and having tobacco using household members/friends Approximately half of US students in grades 6 through 12 reported exposure to SHS in 2013. Smoke-free home and vehicle rules, coupled with intensified implementation and enforcement of comprehensive smoke-free laws, could help protect youth from this preventable health hazard. Copyright © 2016 by the American Academy of Pediatrics.

Modeling residential exposure to secondhand tobacco smoke

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Klepeis, Neil E.; Nazaroff, William W.

We apply a simulation model to explore the effect of a house's multicompartment character on a nonsmoker's inhalation exposure to secondhand tobacco smoke (SHS). The model tracks the minute-by-minute movement of people and pollutants among multiple zones of a residence and generates SHS pollutant profiles for each room in response to room-specific smoking patterns. In applying the model, we consider SHS emissions of airborne particles, nicotine, and carbon monoxide in two hypothetical houses, one with a typical four-room layout and one dominated by a single large space. We use scripted patterns of room-to-room occupant movement and a cohort of 5000 activity patterns sampled from a US nationwide survey. The results for scripted and cohort simulation trials indicate that the multicompartment nature of homes, manifested as inter-room differences in pollutant levels and the movement of people among zones, can cause substantial variation in nonsmoker SHS exposure.

Knowledge, Attitudes, and Behavior in Avoiding Secondhand Smoke Exposure Among Non-Smoking Employed Women with Higher Education in Jordan

OpenAIRE

Gharaibeh, Huda; Haddad, Linda; Alzyoud, Sukaina; El-Shahawy, Omar; Baker, Nesrin Abu; Umlauf, Mary

2011-01-01

Secondhand smoke (SHS) exposure is a serious public health threat worldwide; in the developing world there are less serious efforts towards controlling women’s and children’s exposure to SHS. Knowledge, attitudes and avoidance practices among Jordanian women have never been thoroughly studied. The purpose of this study was to assess the knowledge, attitudes, and avoidance behavior towards SHS exposure among employed Jordanian women with higher education. Methods: A survey was conducted among ...

Social disparities in parental smoking and young children's exposure to secondhand smoke at home: a time-trend analysis of repeated cross-sectional data from the German KiGGS study between 2003-2006 and 2009-2012.

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Kuntz, Benjamin; Lampert, Thomas

2016-06-08

Children who are exposed to secondhand smoke (SHS) have an increased risk of a wide range of health problems and illnesses. Smoke-free legislation aims to improve indoor air quality and in this way protect the health of people who do not smoke. This paper examines trends in SHS exposure at home among children in Germany since the introduction of smoking bans in public places. Special focus is placed on the importance of the family of origin's socioeconomic status (SES) and on parental smoking behaviour. The analyses are based on two waves of the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS)-one of which was conducted immediately before the introduction of central smoke-free legislation in the 2003-2006 period, the other approximately 6 years later from 2009 to 2012. A comparison is made between the answers given by the parents of children aged between 0 to 6 (KiGGS baseline study, n = 6680; KiGGS Wave 1, n = 4455). Domestic SHS exposure is covered in the parent interviews by asking whether anyone is allowed to smoke at home in the presence of their child. Parental smoking behaviour is determined separately for mothers and fathers. SES is determined on the basis of the parents' education, occupational status and income. The percentage of 0- to 6-year-old children exposed to SHS in the parental home fell from 23.9 to 6.6 % in the period from 2003-2006 to 2009-2012. At the same time, the percentage of children with at least one parent who smokes decreased from 49.8 to 41.8 %. While relative social inequalities in parental smoking behaviour have tended to increase over time, inequalities in domestic SHS exposure have persisted. Children whose parents smoke and children from low-SES families are still most likely to be exposed to tobacco smoke. In both study periods and after statistical adjustment for parental smoking behaviour, children with a low SES had a 6.6-fold higher risk for SHS exposure in the parental home

[Effects of tobacco habit, second-hand smoking and smoking cessation during pregnancy on newborn's health].

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Ribot, Blanca; Isern, Rosanna; Hernández-Martínez, Carmen; Canals, Josefa; Aranda, Núria; Arija, Victoria

2014-07-22

Tobacco during pregnancy affects the health of the newborn. The aim was to assess the effect of maternal exposure to active and passive tobacco and of smoking cessation on the risk of preterm deliveries and birth weight, taking into account other risk factors. Longitudinal study conducted in 282 healthy pregnant women. General, obstetrical and hematological data were collected as it was the smoking habit during pregnancy. Pregnant women were classified as "exposed to smoke" (active smoker and passive smoker) and "unexposed to smoke" (non-smokers and women who quitted smoking during pregnancy). A percentage of 59.2 were non-smokers, 18.4% active smokers, 8.5% second-hand smokers and 13.8% had stopped smoking. Unexposed pregnant women who stopped smoking had the same risk of premature deliveries and children with similar birth weight as non-smoker women. Active and second-hand smokers were at higher risk of preterm deliveries than non-smokers (odds ratio [OR] 6.5, 95% confidence interval [95% CI] 1.4-30.8 and OR 6.2, 95% CI 1.0-38.9, respectively); however, higher levels of hemoglobin in the 1st and 3rd trimester exerted a protective effect (OR 0.9, 95% CI 0.8-0.9). Active and second-hand smokers had babies weighing less than non-smokers (around 129 and 178g less, respectively). Active or passive exposure to smoke during pregnancy and lower hemoglobin levels are associated with an increased risk of premature deliveries and lower birth weight. Stopping smoking during pregnancy prevents these detrimental effects. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Secondhand Tobacco Smoke Exposure and Susceptibility to Smoking, Perceived Addiction, and Psychobehavioral Symptoms among College Students

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Okoli, Chizimuzo T. C.; Rayens, Mary Kay; Wiggins, Amanda T.; Ickes, Melinda J.; Butler, Karen M.; Hahn, Ellen J.

2016-01-01

Objective: To examine the association of secondhand smoke (SHS) exposure with susceptibility to smoking, perceived addiction, and psychobehavioral effects of exposure among never- and ever-smoking college students. Participants: Participants were 665 college students at a large, southeastern university in the United States. Methods: This study is…

Effects of a smoke-free law on hair nicotine and respiratory symptoms of restaurant and bar workers.

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Hahn, Ellen J; Rayens, Mary Kay; York, Nancy; Okoli, Chizimuzo T C; Zhang, Mei; Dignan, Mark; Al-Delaimy, Wael K

2006-09-01

Bar and restaurant workers' exposure to secondhand smoke (SHS) was compared before and 3 and 6 months after implementation of a smoke-free ordinance. Hair nicotine, self-reported exposure to SHS, and respiratory symptoms were assessed on 105 smoking and nonsmoking workers from randomly selected establishments in Lexington, Kentucky. Thirty-eight percent were current smokers with more than half smoking 10 or fewer cigarettes per day. Workers provided a hair sample at baseline and at the 3-month interview. There was a significant decline in hair nicotine 3 months postlaw when controlling for cigarettes smoked per day. Bar workers showed a significantly larger decline in hair nicotine compared with restaurant workers. The only significant decline in SHS exposure was in the workplace and other public places. Regardless of smoking status, respiratory symptoms declined significantly postlaw. Hospitality workers demonstrated significant declines in hair nicotine and respiratory symptoms after the law. Comprehensive smoke-free laws can provide the greatest protection to bar workers who are the most vulnerable to SHS exposure at work.

Effect of Perinatal secondhand tobacco smoke exposure on in vivo and intrinsic airway structure/function in non-human primates

International Nuclear Information System (INIS)

Joad, Jesse P.; Kott, Kayleen S.; Bric, John M.; Peake, Janice L.; Pinkerton, Kent E.

2009-01-01

Infants exposed to second hand smoke (SHS) experience more problems with wheezing. This study was designed to determine if perinatal SHS exposure increases intrinsic and/or in vivo airway responsiveness to methacholine and whether potential structural/cellular alterations in the airway might explain the change in responsiveness. Pregnant rhesus monkeys were exposed to filtered air (FA) or SHS (1 mg/m 3 total suspended particulates) for 6 h/day, 5 days/week starting at 50 days gestational age. The mother/infant pairs continued the SHS exposures postnatally. At 3 months of age each infant: 1) had in vivo lung function measurements in response to inhaled methacholine, or 2) the right accessory lobe filled with agarose, precision-cut to 600 μm slices, and bathed in increasing concentrations of methacholine. The lumenal area of the central airway was determined using videomicrometry followed by fixation and histology with morphometry. In vivo tests showed that perinatal SHS increases baseline respiratory rate and decreases responsiveness to methacholine. Perinatal SHS did not alter intrinsic airway responsiveness in the bronchi. However in respiratory bronchioles, SHS exposure increased airway responsiveness at lower methacholine concentrations but decreased it at higher concentrations. Perinatal SHS did not change eosinophil profiles, epithelial volume, smooth muscle volume, or mucin volume. However it did increase the number of alveolar attachments in bronchi and respiratory bronchioles. In general, as mucin increased, airway responsiveness decreased. We conclude that perinatal SHS exposure alters in vivo and intrinsic airway responsiveness, and alveolar attachments

Social disparities in parental smoking and young children’s exposure to secondhand smoke at home: a time-trend analysis of repeated cross-sectional data from the German KiGGS study between 2003-2006 and 2009-2012

Directory of Open Access Journals (Sweden)

Benjamin Kuntz

2016-06-01

Full Text Available Abstract Background Children who are exposed to secondhand smoke (SHS have an increased risk of a wide range of health problems and illnesses. Smoke-free legislation aims to improve indoor air quality and in this way protect the health of people who do not smoke. This paper examines trends in SHS exposure at home among children in Germany since the introduction of smoking bans in public places. Special focus is placed on the importance of the family of origin’s socioeconomic status (SES and on parental smoking behaviour. Methods The analyses are based on two waves of the “German Health Interview and Examination Survey for Children and Adolescents” (KiGGS—one of which was conducted immediately before the introduction of central smoke-free legislation in the 2003-2006 period, the other approximately 6 years later from 2009 to 2012. A comparison is made between the answers given by the parents of children aged between 0 to 6 (KiGGS baseline study, n = 6680; KiGGS Wave 1, n = 4455. Domestic SHS exposure is covered in the parent interviews by asking whether anyone is allowed to smoke at home in the presence of their child. Parental smoking behaviour is determined separately for mothers and fathers. SES is determined on the basis of the parents’ education, occupational status and income. Results The percentage of 0- to 6-year-old children exposed to SHS in the parental home fell from 23.9 to 6.6 % in the period from 2003-2006 to 2009-2012. At the same time, the percentage of children with at least one parent who smokes decreased from 49.8 to 41.8 %. While relative social inequalities in parental smoking behaviour have tended to increase over time, inequalities in domestic SHS exposure have persisted. Children whose parents smoke and children from low-SES families are still most likely to be exposed to tobacco smoke. In both study periods and after statistical adjustment for parental smoking behaviour, children with a low SES had a

Exposure to and attitudes regarding secondhand smoke among secondary students in Taiwan.

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Chen, Ping-Ling; Weigang Huang; Chuang, Yi-Li; Warren, Charles W; Jones, Nathan R; Lee, Juliette; Asma, Samira

2009-07-01

The 2003 School Health Act of Taiwan stipulated that school campuses of senior high and below should be smoke free, but data from the Global Youth Tobacco Survey show that the majority of students are exposed to smoke in public and at home. More than 50% of nonsmokers indicated that they had been exposed to secondhand smoke (SHS) in public places, with the exposure rate as high as 90% among smokers. More than 40% of junior and senior high school students were exposed to SHS at home. Support for banning smoking in public places ranged from almost 60% to almost 80%. More than 60% of current smokers and almost 90% of never smokers think that smoke from others is harmful to them. With a clear body of evidence detailing the harmful effects, reduction and eventual elimination of exposure to SHS should be the goal of the tobacco control community.

Sex and Age Differences in Exposure to Secondhand Smoke at Home among Korean Adolescents: A Nationally Representative Survey

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Jun Hyun Hwang

2016-02-01

Full Text Available The authors assessed sex and age differences in secondhand smoke (SHS exposure among vulnerable adolescent populations. Data from the 2013 Korea Youth Risk Behavior Web-based Survey of 64,499 non-smokers aged 13–18 years were analyzed using multiple logistic regression. Girls were exposed 1.26 times (95% confidence interval, 1.21–1.32 more to home SHS than boys, and the younger adolescents were more likely to be exposed to home SHS than were the older, regardless of sex (p < 0.001. Younger girls living with or without current smokers and the younger boys living with current smokers were more likely to be exposed to SHS at home, when the data were stratified according to current household member smoking, which was one of the main risk factors for SHS exposure at home. Girls living with current smokers were more likely to be exposed to SHS at home than boys regardless age. Girls and younger adolescents, populations vulnerable to smoke exposure, were more likely to be exposed to SHS at home, even though they should be more protected. It is necessary to improve home SHS awareness, especially among these vulnerable populations.

Secondhand smoke exposure is associated with smoke-free laws but not urban/rural status.

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Lee, Kiyoung; Hwang, Yunhyung; Hahn, Ellen J; Bratset, Hilarie; Robertson, Heather; Rayens, Mary Kay

2015-05-01

The objective was to determine secondhand smoke (SHS) exposure with and without smoke-free laws in urban and rural communities. The research hypothesis was that SHS exposure in public places could be improved by smoke-free law regardless of urban and rural status. Indoor air quality in hospitality venues was assessed in 53 communities (16 urban and 37 rural) before smoke-free laws; 12 communities passed smoke-free laws during the study period. Real-time measurements of particulate matter with 2.5 µm aerodynamic diameter or smaller (PM2.5) were taken 657 times from 586 distinct venues; about 71 venues had both pre- and post-law measurements. Predictors of log-transformed PM2.5 level were determined using multilevel modeling. With covariates of county-level percent minority population, percent with at least high school education, adult smoking rate, and venue-level smoker density, indoor air quality was associated with smoke-free policy status and venue type and their interaction. The geometric means for restaurants, bars, and other public places in communities without smoke-free policies were 22, 63, and 25 times higher than in those with smoke-free laws, respectively. Indoor air quality was not associated with urban status of venue, and none of the interactions involving urban status were significant. SHS exposure in public places did not differ by urban/rural status. Indoor air quality was associated with smoke-free law status and venue type. This study analyzed 657 measurements of indoor PM2.5 level in 53 communities in Kentucky, USA. Although indoor air quality in public places was associated with smoke-free policy status and venue type, it did not differ by urban and rural status. The finding supports the idea that population in rural communities can be protected with smoke-free policy. Therefore, it is critical to implement smoke-free policy in rural communities as well as urban areas.

Ashtrays and Signage as Determinants of a Smoke-Free Legislation’s Success

Science.gov (United States)

Vardavas, Constantine I.; Agaku, Israel; Patelarou, Evridiki; Anagnostopoulos, Nektarios; Nakou, Chrysanthi; Dramba, Vassiliki; Giourgouli, Gianna; Argyropoulou, Paraskevi; Antoniadis, Antonis; Gourgoulianis, Konstantinos; Ourda, Despoina; Lazuras, Lambros; Bertic, Monique; Lionis, Christos; Connolly, Gregory; Behrakis, Panagiotis

2013-01-01

Introduction Successful smoke-free legislation is dependent on political will, enforcement and societal support. We report the success and pitfalls of a non-enforced nationwide smoke-free legislation in Greece, as well as ways in which compliance and enforcement-related factors, including ashtrays and signage, may impact indoor secondhand smoke (SHS) concentrations. Methods A follow-up study of venues (n = 150, at baseline, n = 75 at 2-year follow-up) in Greece assessed indoor particulate matter with a diameter less than 2.5 micrometers (PM2.5) concentrations attributable to SHS smoke every six months for two years (n = 455 venue/measurements). Results Following the implementation of the 2010 smoke-free legislation, mean PM2.5 concentrations attributable to SHS fell from 175.3 µg/m3 pre-ban to 84.52 µg/m3 immediately post-ban, increasing over subsequent waves (103.8 µg/m3 and 158.2 µg/m3 respectively). Controlling for potential influential factors such as ventilation, time of day, day of week, city and venue type, all post-ban measurements were still lower than during the pre-ban period (Wave 2 beta: −118.7, Wave 3 beta: −87.6, and Wave 4 beta: −69.9). Outdoor or indoor signage banning smoking was not found to affect SHS concentrations (beta: −10.9, p = 0.667 and beta: −18.1, p = 0.464 respectively). However, ashtray or ashtray equivalents were strong determinants of the existence of indoor SHS (beta: +67 µg/m3, p = 0.017). Conclusions While the public may be supportive of smoke-free legislation, adherence may decline rapidly if enforcement is limited or nonexistent. Moreover, enforcement agencies should also focus on the comprehensive removal of ashtray equivalents that could act as cues for smoking within a venue. PMID:24023795

Air pollution in Boston bars before and after a smoking ban

Directory of Open Access Journals (Sweden)

Hyde James N

2006-10-01

Full Text Available Abstract Background We quantified the air quality benefits of a smoke-free workplace law in Boston Massachusetts, U.S.A., by measuring air pollution from secondhand smoke (SHS in 7 pubs before and after the law, comparing actual ventilation practices to engineering society (ASHRAE recommendations, and assessing SHS levels using health and comfort indices. Methods We performed real-time measurements of respirable particle (RSP air pollution and particulate polycyclic aromatic hydrocarbons (PPAH, in 7 pubs and outdoors in a model-based design yielding air exchange rates for RSP removal. We also assessed ventilation rates from carbon dioxide concentrations. We compared RSP air pollution to the federal Air Quality Index (AQI and the National Ambient Air Quality Standard (NAAQS to assess health risks, and assessed odor and irritation levels using published SHS-RSP thresholds. Results Pre-smoking-ban RSP levels in 6 pubs (one pub with a non-SHS air quality problem was excluded averaged 179 μg/m3, 23 times higher than post-ban levels, which averaged 7.7 μg/m3, exceeding the NAAQS for fine particle pollution (PM2.5 by nearly 4-fold. Pre-smoking ban levels of fine particle air pollution in all 7 of the pubs were in the Unhealthy to Hazardous range of the AQI. In the same 6 pubs, pre-ban indoor carcinogenic PPAH averaged 61.7 ng/m3, nearly 10 times higher than post-ban levels of 6.32 ng/m3. Post-ban particulate air pollution levels were in the Good AQI range, except for 1 venue with a defective gas-fired deep-fat fryer, while post-ban carcinogen levels in all 7 pubs were lower than outdoors. Conclusion During smoking, although pub ventilation rates per occupant were within ASHRAE design parameters for the control of carbon dioxide levels for the number of occupants present, they failed to control SHS carcinogens or RSP. Nonsmokers' SHS odor and irritation sensory thresholds were massively exceeded. Post-ban air pollution measurements showed 90% to 95

Air pollution in Boston bars before and after a smoking ban.

Science.gov (United States)

Repace, James L; Hyde, James N; Brugge, Doug

2006-10-27

We quantified the air quality benefits of a smoke-free workplace law in Boston Massachusetts, U.S.A., by measuring air pollution from secondhand smoke (SHS) in 7 pubs before and after the law, comparing actual ventilation practices to engineering society (ASHRAE) recommendations, and assessing SHS levels using health and comfort indices. We performed real-time measurements of respirable particle (RSP) air pollution and particulate polycyclic aromatic hydrocarbons (PPAH), in 7 pubs and outdoors in a model-based design yielding air exchange rates for RSP removal. We also assessed ventilation rates from carbon dioxide concentrations. We compared RSP air pollution to the federal Air Quality Index (AQI) and the National Ambient Air Quality Standard (NAAQS) to assess health risks, and assessed odor and irritation levels using published SHS-RSP thresholds. Pre-smoking-ban RSP levels in 6 pubs (one pub with a non-SHS air quality problem was excluded) averaged 179 microg/m3, 23 times higher than post-ban levels, which averaged 7.7 microg/m3, exceeding the NAAQS for fine particle pollution (PM2.5) by nearly 4-fold. Pre-smoking ban levels of fine particle air pollution in all 7 of the pubs were in the Unhealthy to Hazardous range of the AQI. In the same 6 pubs, pre-ban indoor carcinogenic PPAH averaged 61.7 ng/m3, nearly 10 times higher than post-ban levels of 6.32 ng/m3. Post-ban particulate air pollution levels were in the Good AQI range, except for 1 venue with a defective gas-fired deep-fat fryer, while post-ban carcinogen levels in all 7 pubs were lower than outdoors. During smoking, although pub ventilation rates per occupant were within ASHRAE design parameters for the control of carbon dioxide levels for the number of occupants present, they failed to control SHS carcinogens or RSP. Nonsmokers' SHS odor and irritation sensory thresholds were massively exceeded. Post-ban air pollution measurements showed 90% to 95% reductions in PPAH and RSP respectively, differing

Affecting Factors of Secondhand Smoke Exposure in Korea: Focused on Different Exposure Locations.

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Sun, Li Yuan; Cheong, Hae Kwan; Lee, Eun Whan; Kang, Kyeong Jin; Park, Jae Hyun

2016-09-01

Exposure to secondhand smoke (SHS) not only can cause serious illness, but is also an economic and social burden. Contextual and individual factors of non-smoker exposure to SHS depend on location. However, studies focusing on this subject are lacking. In this study, we described and compared the factors related to SHS exposure according to location in Korea. Regarding individual factors related to SHS exposure, a common individual variable model and location-specific variable model was used to evaluate SHS exposure at home/work/public locations based on sex. In common individual variables, such as age, and smoking status showed different relationships with SHS exposure in different locations. Among home-related variables, housing type and family with a single father and unmarried children showed the strongest positive relationships with SHS exposure in both males and females. In the workplace, service and sales workers, blue-collar workers, and manual laborers showed the strongest positive association with SHS exposure in males and females. For multilevel analysis in public places, only SHS exposure in females was positively related with cancer screening rate. Exposure to SHS in public places showed a positive relationship with drinking rate and single-parent family in males and females. The problem of SHS embodies social policies and interactions between individuals and social contextual factors. Policy makers should consider the contextual factors of specific locations and regional and individual context, along with differences between males and females, to develop effective strategies for reducing SHS exposure.

The healthcare costs of secondhand smoke exposure in rural China.

Science.gov (United States)

Yao, Tingting; Sung, Hai-Yen; Mao, Zhengzhong; Hu, Teh-wei; Max, Wendy

2015-10-01

The goal of this study was to assess the healthcare costs attributable to secondhand smoke (SHS) exposure among non-smoking adults (age ≥ 19) in rural China. We analysed data from the 2011 National Rural Household Survey which was conducted among adults in five provinces and one municipality in China (N=12,397). Respondents reported their smoking status, health conditions and healthcare expenditures. Relative risks were obtained from published sources. Healthcare costs included annual outpatient and inpatient hospitalisation expenditures for five SHS-related diseases: asthma, breast cancer (female only), heart disease, lung cancer and tuberculosis. SHS-attributable healthcare costs were estimated using a prevalence-based annual cost approach. The total healthcare costs of SHS exposure in rural China amounted to $1.2 billion in 2011, including $559 million for outpatient visits and $612.4 million for inpatient hospitalisations. The healthcare costs for women and men were $877.1 million and $294.3 million, respectively. Heart disease was the most costly condition for both women ($701.7 million) and men ($180.6 million). The total healthcare costs of SHS exposure in rural China accounted to 0.3% of China's national healthcare expenditures in 2011. Over one-fifth of the total healthcare costs of SHS exposure in rural China were paid by health insurance. The out-of-pocket expenditures per person accounted for almost half (47%) of their daily income. The adverse health effects of SHS exposure result in a large economic burden in China. Tobacco control policies that reduce SHS exposure could have an impact on reducing healthcare costs in China. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Smoking-related knowledge, attitudes, and behaviours among Alaska Native people: a population-based study

Directory of Open Access Journals (Sweden)

Kristen Rohde

2013-08-01

Full Text Available Background. Several studies have shown that Alaska Native people have higher smoking prevalence than non-Natives. However, no population-based studies have explored whether smoking-related knowledge, attitudes, and behaviours also differ among Alaska Native people and non-Natives. Objective. We compared current smoking prevalence and smoking-related knowledge, attitudes, and behaviour of Alaska Native adults living in the state of Alaska with non-Natives. Methods. We used Alaska Behavioral Risk Factor Surveillance System data for 1996 to 2010 to compare smoking prevalence, consumption, and cessation- and second-hand smoke-related knowledge, attitudes, and behaviours among self-identified Alaska Native people and non-Natives. Results. Current smoking prevalence was 41% (95% CI: 37.9%–44.4% among Alaska Native people compared with 17.1% (95% CI: 15.9%–18.4% among non-Natives. Among current every day smokers, Alaska Natives were much more likely to smoke less than 10 cigarettes per day (OR=5.0, 95% CI: 2.6–9.6 than non-Natives. Compared with non-Native smokers, Alaska Native smokers were as likely to have made a past year quit attempt (OR=1.4, 95% CI: 0.9–2.1, but the attempt was less likely to be successful (OR=0.5, 95% CI: 0.2–0.9. Among current smokers, Alaska Natives were more likely to believe second-hand smoke (SHS was very harmful (OR=4.5, 95% CI: 2.8–7.2, to believe that smoking should not be allowed in indoor work areas (OR=1.9, 95% CI: 1.1–3.1 or in restaurants (OR=4.2, 95% CI: 2.5–6.9, to have a home smoking ban (OR=2.5, 95% CI: 1.6–3.9, and to have no home exposure to SHS in the past 30 days (OR=2.3, 95% CI: 1.5–3.6 than non-Natives. Conclusion. Although a disparity in current smoking exists, Alaska Native people have smoking-related knowledge, attitudes, and behaviours that are encouraging for reducing the burden of smoking in this population. Programs should support efforts to promote cessation, prevent relapse

Smoking-related knowledge, attitudes, and behaviors among Alaska Native people: a population-based study.

Science.gov (United States)

Rohde, Kristen; Boles, Myde; Bushore, Chris J; Pizacani, Barbara A; Maher, Julie E; Peterson, Erin

2013-01-01

Several studies have shown that Alaska Native people have higher smoking prevalence than non-Natives. However, no population-based studies have explored whether smoking-related knowledge, attitudes, and behaviors also differ among Alaska Native people and non-Natives. We compared current smoking prevalence and smoking-related knowledge, attitudes, and behavior of Alaska Native adults living in the state of Alaska with non-Natives. We used Alaska Behavioral Risk Factor Surveillance System data for 1996 to 2010 to compare smoking prevalence, consumption, and cessation- and second-hand smoke-related knowledge, attitudes, and behaviors among self-identified Alaska Native people and non-Natives. Current smoking prevalence was 41% (95% CI: 37.9%-44.4%) among Alaska Native people compared with 17.1% (95% CI: 15.9%-18.4%) among non-Natives. Among current every day smokers, Alaska Natives were much more likely to smoke less than 10 cigarettes per day (OR = 5.0, 95% CI: 2.6-9.6) than non-Natives. Compared with non-Native smokers, Alaska Native smokers were as likely to have made a past year quit attempt (OR = 1.4, 95% CI: 0.9-2.1), but the attempt was less likely to be successful (OR = 0.5, 95% CI: 0.2-0.9). Among current smokers, Alaska Natives were more likely to believe second-hand smoke (SHS) was very harmful (OR = 4.5, 95% CI: 2.8-7.2), to believe that smoking should not be allowed in indoor work areas (OR = 1.9, 95% CI: 1.1-3.1) or in restaurants (OR = 4.2, 95% CI: 2.5-6.9), to have a home smoking ban (OR = 2.5, 95% CI: 1.6-3.9), and to have no home exposure to SHS in the past 30 days (OR = 2.3, 95% CI: 1.5-3.6) than non-Natives. Although a disparity in current smoking exists, Alaska Native people have smoking-related knowledge, attitudes, and behaviors that are encouraging for reducing the burden of smoking in this population. Programs should support efforts to promote cessation, prevent relapse, and establish smoke-free environments.

The efficacy of different models of smoke-free laws in reducing exposure to second-hand smoke: a multi-country comparison.

Science.gov (United States)

Ward, Mark; Currie, Laura M; Kabir, Zubair; Clancy, Luke

2013-05-01

Exposure to second-hand tobacco smoke is a serious public health concern and while all EU Member States have enacted some form of regulation aimed at limiting exposure, the scope of these regulations vary widely and many countries have failed to enact comprehensive legislation creating smoke-free workplaces and indoor public places. To gauge the effectiveness of different smoke-free models we compared fine particles from second-hand smoke in hospitality venues before and after the implementation of smoking bans in France, Greece, Ireland, Italy, Portugal, Turkey, and Scotland. Data on PM2.5 fine particle concentration levels were recorded in 338 hospitality venues across these countries before and after the implementation of smoke-free legislation. Changes in mean PM2.5 concentrations during the period from pre- to post-legislation were then compared across countries. While a reduction in PM2.5 was observed in all countries, those who had enacted and enforced more fully comprehensive smoke-free legislation experienced the greatest reduction in second-hand tobacco smoke. Comprehensive smoke-free laws are more effective than partial laws in reducing exposure to second-hand tobacco smoke. Also, any law, regardless of scope must be actively enforced in order to have the desired impact. There is continued need for surveillance of smoke-free efforts in all countries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Secondhand smoke concentrations in hospitality venues in the Pacific Basin: findings from American Samoa, Commonwealth of the Northern Mariana Islands, and Guam.

Science.gov (United States)

King, Brian A; Dube, Shanta R; Ko, Jean Y

2011-01-01

Secondhand smoke (SHS) from burning tobacco products causes disease and premature death among nonsmokers. Although the number of laws prohibiting smoking in indoor public places continues to increase, millions of nonsmokers in the United States (US) and its territories remain exposed to SHS. This study assessed indoor air pollution from SHS in hospitality venues in three US Pacific Basin territories. Air monitors were used to assess PM2.5, an environmental marker for SHS, in 19 smoke-permitted and 18 smoke- free bars and restaurants in American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), and Guam. Observational logs were used to record smoking and other sources of air pollution. Differences in average PM2.5 concentrations were determined using bivariate statistics. The average PM2.5 level in venues where smoking was always permitted [arithmetic mean (AM)=299.98 μg/m3; geometric mean (GM)=200.39 μg/ m3] was significantly higher (p<0.001) than smoke-free venues [AM=8.33 μg/m3; GM=6.14 μg/m3]. In venues where smoking was allowed only during certain times, the average level outside these times [AM=42.10 μg/m3; GM=41.87 μg/m3] was also significantly higher (p<0.001) than smoke-free venues. Employees and patrons of smoke-permitted bars and restaurants are exposed to dangerous levels of air pollution from SHS, even during periods when active smoking is not occurring. Prohibiting smoking in all public indoor areas, irrespective of the venue type or time of day, is the only way to fully protect nonsmokers from SHS exposure in these environments.

"Efforts to Reprioritise the Agenda" in China: British American Tobacco's Efforts to Influence Public Policy on Secondhand Smoke in China.

Directory of Open Access Journals (Sweden)

Monique E Muggli

2008-12-01

Full Text Available Each year, 540 million Chinese are exposed to secondhand smoke (SHS, resulting in more than 100,000 deaths. Smoke-free policies have been demonstrated to decrease overall cigarette consumption, encourage smokers to quit, and protect the health of nonsmokers. However, restrictions on smoking in China remain limited and ineffective. Internal tobacco industry documents show that transnational tobacco companies (TTCs have pursued a multifaceted strategy for undermining the adoption of restrictions on smoking in many countries.To understand company activities in China related to SHS, we analyzed British American Tobacco's (BAT's internal corporate documents produced in response to litigation against the major cigarette manufacturers to understand company activities in China related to SHS. BAT has carried out an extensive strategy to undermine the health policy agenda on SHS in China by attempting to divert public attention from SHS issues towards liver disease prevention, pushing the so-called "resocialisation of smoking" accommodation principles, and providing "training" for industry, public officials, and the media based on BAT's corporate agenda that SHS is an insignificant contributor to the larger issue of air pollution.The public health community in China should be aware of the tactics previously used by TTCs, including efforts by the tobacco industry to co-opt prominent Chinese benevolent organizations, when seeking to enact stronger restrictions on smoking in public places.

"Efforts to Reprioritise the Agenda" in China: British American Tobacco's Efforts to Influence Public Policy on Secondhand Smoke in China.

Science.gov (United States)

Muggli, Monique E; Lee, Kelley; Gan, Quan; Ebbert, Jon O; Hurt, Richard D

2008-12-23

Each year, 540 million Chinese are exposed to secondhand smoke (SHS), resulting in more than 100,000 deaths. Smoke-free policies have been demonstrated to decrease overall cigarette consumption, encourage smokers to quit, and protect the health of nonsmokers. However, restrictions on smoking in China remain limited and ineffective. Internal tobacco industry documents show that transnational tobacco companies (TTCs) have pursued a multifaceted strategy for undermining the adoption of restrictions on smoking in many countries. To understand company activities in China related to SHS, we analyzed British American Tobacco's (BAT's) internal corporate documents produced in response to litigation against the major cigarette manufacturers to understand company activities in China related to SHS. BAT has carried out an extensive strategy to undermine the health policy agenda on SHS in China by attempting to divert public attention from SHS issues towards liver disease prevention, pushing the so-called "resocialisation of smoking" accommodation principles, and providing "training" for industry, public officials, and the media based on BAT's corporate agenda that SHS is an insignificant contributor to the larger issue of air pollution. The public health community in China should be aware of the tactics previously used by TTCs, including efforts by the tobacco industry to co-opt prominent Chinese benevolent organizations, when seeking to enact stronger restrictions on smoking in public places.

"I Was a Full Time Proper Smoker": A Qualitative Exploration of Smoking in the Home after Childbirth among Women Who Relapse Postpartum.

Directory of Open Access Journals (Sweden)

Sophie Orton

Full Text Available Many women stop smoking during pregnancy but relapse shortly afterwards, potentially putting their infants at risk of secondhand smoke (SHS exposure. Women who were able to stop during pregnancy may be a motivated group, receptive to making behaviour changes postpartum to protect their infant from SHS exposure. Understanding more about their experiences of relapse, and if this influences home smoking behaviours and children's exposure to SHS in the home may help to inform intervention development to prevent infant SHS exposure.Guided by interpretative phenomenological methodology we conducted and analysed nine semi-structured interviews with women who quit smoking during pregnancy, but relapsed ≤3 months postpartum.Central to mothers' accounts of their smoking behaviours during pregnancy and postpartum was their desire to be a 'responsible mother'. Mothers described using strategies to protect their infant from SHS exposure, and held strong negative attitudes towards other smoking parents. After relapsing, mothers appeared to reposition themselves as 'social' or 'occasional' smokers rather than 'regular' smokers.Findings suggest that interventions to prevent/reduce infants' home SHS exposure should build on mothers' intentions to be responsible parents. As mothers who relapse principally view themselves as 'social' or 'occasional' smokers, interventions that are highlighted as relevant for women with these types of smoking patterns may be more likely to be responded to, and, ultimately, be effective.

"I Was a Full Time Proper Smoker": A Qualitative Exploration of Smoking in the Home after Childbirth among Women Who Relapse Postpartum.

Science.gov (United States)

Orton, Sophie; Coleman, Tim; Lewis, Sarah; Cooper, Sue; Jones, Laura L

2016-01-01

Many women stop smoking during pregnancy but relapse shortly afterwards, potentially putting their infants at risk of secondhand smoke (SHS) exposure. Women who were able to stop during pregnancy may be a motivated group, receptive to making behaviour changes postpartum to protect their infant from SHS exposure. Understanding more about their experiences of relapse, and if this influences home smoking behaviours and children's exposure to SHS in the home may help to inform intervention development to prevent infant SHS exposure. Guided by interpretative phenomenological methodology we conducted and analysed nine semi-structured interviews with women who quit smoking during pregnancy, but relapsed ≤3 months postpartum. Central to mothers' accounts of their smoking behaviours during pregnancy and postpartum was their desire to be a 'responsible mother'. Mothers described using strategies to protect their infant from SHS exposure, and held strong negative attitudes towards other smoking parents. After relapsing, mothers appeared to reposition themselves as 'social' or 'occasional' smokers rather than 'regular' smokers. Findings suggest that interventions to prevent/reduce infants' home SHS exposure should build on mothers' intentions to be responsible parents. As mothers who relapse principally view themselves as 'social' or 'occasional' smokers, interventions that are highlighted as relevant for women with these types of smoking patterns may be more likely to be responded to, and, ultimately, be effective.

Acute secondhand smoke-induced pulmonary inflammation is diminished in RAGE knockout mice.

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Wood, Tyler T; Winden, Duane R; Marlor, Derek R; Wright, Alex J; Jones, Cameron M; Chavarria, Michael; Rogers, Geraldine D; Reynolds, Paul R

2014-11-15

The receptor for advanced glycation end-products (RAGE) has increasingly been demonstrated to be an important modulator of inflammation in cases of pulmonary disease. Published reports involving tobacco smoke exposure have demonstrated increased expression of RAGE, its participation in proinflammatory signaling, and its role in irreversible pulmonary remodeling. The current research evaluated the in vivo effects of short-term secondhand smoke (SHS) exposure in RAGE knockout and control mice compared with identical animals exposed to room air only. Quantitative PCR, immunoblotting, and immunohistochemistry revealed elevated RAGE expression in controls after 4 wk of SHS exposure and an anticipated absence of RAGE expression in RAGE knockout mice regardless of smoke exposure. Ras activation, NF-κB activity, and cytokine elaboration were assessed to characterize the molecular basis of SHS-induced inflammation in the mouse lung. Furthermore, bronchoalveolar lavage fluid was procured from RAGE knockout and control animals for the assessment of inflammatory cells and molecules. As a general theme, inflammation coincident with leukocyte recruitment was induced by SHS exposure and significantly influenced by the availability of RAGE. These data reveal captivating information suggesting a role for RAGE signaling in lungs exposed to SHS. However, ongoing research is still warranted to fully explain roles for RAGE and other receptors in cells coping with involuntary smoke exposure for prolonged periods of time. Copyright © 2014 the American Physiological Society.

Should we bother with second-hand smoke exposure if smoking is on track?

DEFF Research Database (Denmark)

Adám, Balázs

2014-01-01

The recognition of the serious health-damaging effects of tobacco smoke exposure has initiated several preventive programmes on the national and international levels worldwide. In the last decade, a considerable decrease in the prevalence of active smoking was observed in Denmark, changing...... the country from a poor to a favourable position in comparison to other EU countries. However, second-hand tobacco smoke exposure, especially in homes, still ranks Denmark among the problematic countries in Europe. This poorly recognised and studied discrepancy calls for further research and effective...

Prevalence and Associated Factors of Secondhand Smoke Exposure among Internal Chinese Migrant Women of Reproductive Age: Evidence from China's Labor-Force Dynamic Survey.

Science.gov (United States)

Gong, Xiao; Luo, Xiaofeng; Ling, Li

2016-04-01

Secondhand smoke (SHS) is a major risk factor for poor health outcomes among women in China, where proportionately few women smoke. This is especially the case as it pertains to women's reproductive health, specifically migrant women who are exposed to SHS more than the population at large. There are several factors which may increase migrant women's risk of SHS exposure. This paper aims to investigate the prevalence and associated factors of SHS exposure among internal Chinese migrant women of reproductive age. The data used were derived from the 2014 Chinese Labor Dynamic Survey, a national representative panel survey. The age-adjusted rate of SHS exposure of women of reproductive age with migration experience was of 43.46% (95% CI: 40.73%-46.40%), higher than those without migration experience (35.28% (95% CI: 33.66%-36.97%)). Multivariate analysis showed that participants with a marital status of "Widowed" had statistically lower exposure rates, while those with a status of "Cohabitation" had statistically higher exposure. Those with an undergraduate degree or above had statistically lower SHS exposure. Those with increasing levels of social support, and those who currently smoke or drink alcohol, had statistically higher SHS exposure. Participants' different work-places had an effect on their SHS exposure, with outdoor workers statistically more exposed. Our findings suggest that urgent tobacco control measures should be taken to reduce smoking prevalence and SHS exposure. Specific attention should be paid to protecting migrant women of reproductive age from SHS.

Assessing the Exposure and Health Risks of Secondhand Smoke in Restaurants and Bars by Workers and Patrons & Evaluating the Efficacy of Different Smoking Policies in Beijing Restaurants and Bars

OpenAIRE

Liu, Ruiling

2012-01-01

Exposure to secondhand smoke (SHS) is harmful and hazardous to the health of the general public. A large body of research has been conducted in this topic, and great efforts have been made to prevent people from being exposed to SHS. Legislation on restricting smoking in workplaces and many public places has also been increasing. However, tobacco industries have been fighting against smoking bans in restaurants and bars with multiple strategies, which has led to the current situation that smo...

Evaluating the efficacy of different smoking policies in restaurants and bars in Beijing, China: a four-year follow-up study.

Science.gov (United States)

Liu, Ruiling; Jiang, Yuan; Travers, Mark J; Li, Qiang; Hammond, S Katharine

2014-01-01

In 2006, the World Health Organization Framework Convention on Tobacco Control became effective in mainland China. In 2007, advocacy on voluntary smoking bans in restaurants was initiated in Beijing, and in 2008 the Beijing government implemented a smoking regulation, requiring big restaurants to prohibit or restrict smoking. To evaluate the efficacy of different smoking policies adopted by Beijing restaurants and bars from 2006 to 2010. The study conducted field observations of patron smoking behavior and monitored fine particulate matter from secondhand smoke (SHS PM) from 91, 85, 94 and 79 Beijing restaurants and bars in 2006, 2007, 2008 and 2010, respectively, during peak-patronage times, with overlaps of venues during each two years. Area nicotine sampling during peak patronage times and servers' personal nicotine sampling during their working shifts were also conducted in 2010. Smoking was nominally prohibited or restricted in 18% of restaurants and bars monitored in 2006, in 11% of venues in 2007, in 83% of venues in 2008, and in 69% of venues in 2010. However, smoking was observed in more than 40% of the nominal nonsmoking venues/sections in 2008 and 2010. The median of observed patron active smoker density (ASD) was 0.24, 0.27, 0.00 and 0.10 active smokers per 100 m3 in 2006, 2007, 2008 and 2010, respectively. The median of SHS PM concentrations was 53, 83, 18 and 27 μg/m3, respectively. In 2010, both the median SHS PM and air nicotine concentrations in designated nonsmoking sections were about 40% of those in designated smoking sections, according to simultaneous sampling in both sections. Servers' personal exposure to air nicotine was quite similar in venues with different nominal smoking policies. In the 15 venues followed from 2006 to 2010, SHS PM concentrations changed randomly from 2006 to 2007, decreased in most venues in 2008, and then increased to some extent in 2010. Voluntary smoking policy is rarely adopted and cannot protect people from SHS

Creating Effective Media Messaging for Rural Smoke-free Policy.

Science.gov (United States)

Riker, Carol A; Butler, Karen M; Ricks, JaNelle M; Record, Rachael A; Begley, Kathy; Anderson, Debra Gay; Hahn, Ellen J

2015-01-01

Objectives were to (1) explore perceived effectiveness of existing smoke-free print advertisements in rural communities and (2) generate message content, characteristics, and media delivery channels that resonate with residents. Qualitative methods design. Thirty-nine rural adults recruited by community partners. Content analysis of findings from individuals in four focus groups who participated in general discussion and reviewed eight print ads related to secondhand smoke (SHS) and smoke-free policy. Six content themes were identified: smoking/SHS dangers, worker health, analogies, economic impact, rights, and nostalgia. Seven message characteristics were recognized: short/to the point, large enough to read, graphic images, poignant stories, statistics/charts/graphs, message sender, and messages targeting different groups. Four media delivery channels were considered most effective: local media, technology, billboard messages, and print materials. Seeking input from key informants is essential to reaching rural residents. Use of analogies in media messaging is a distinct contribution to the literature on effective smoke-free campaigns. Other findings support previous studies of effective messaging and delivery channels. Further research is needed to examine effectiveness of themes related to message content in smoke-free ads and delivery strategies. Effective media messaging can lead to policy change in rural communities to reduce exposure to SHS. © 2015 Wiley Periodicals, Inc.

?I Was a Full Time Proper Smoker?: A Qualitative Exploration of Smoking in the Home after Childbirth among Women Who Relapse Postpartum

OpenAIRE

Orton, Sophie; Coleman, Tim; Lewis, Sarah; Cooper, Sue; Jones, Laura L.

2016-01-01

Background: \\ud Many women stop smoking during pregnancy but relapse shortly afterwards, potentially putting their infants at risk of secondhand smoke (SHS) exposure. Women who were able to stop during pregnancy may be a motivated group, receptive to making behaviour changes postpartum to protect their infant from SHS exposure. Understanding more about their experiences of relapse, and if this influences home smoking behaviours and children’s exposure to SHS in the home may help to inform int...

Recall and Effectiveness of Messages Promoting Smoke-Free Policies in Rural Communities

Science.gov (United States)

Butler, Karen M.; Wiggins, Amanda T.; Kostygina, Ganna; Langley, Ronald E.; Hahn, Ellen J.

2016-01-01

Abstract Introduction: Low-cost media campaigns increase demand for smoke-free policies in underserved rural areas. The study examined the impact of loss- and gain-framed smoke-free print ads on recall and perceived effectiveness in rural communities, controlling for personal characteristics. Methods: Following 6- to 9-month print media campaigns in three rural counties, recall and perceived effectiveness of loss-framed (ie, targeting dangers of secondhand smoke [SHS]) and gain-framed (ie, highlighting positive aspects of smoke-free air) ads were assessed using random-digit-dial phone surveys. Respondents were asked if they remembered each ad, whether they liked it, whether they were prompted to contact a smoke-free coalition, whether the ad made them think, and whether it prompted emotion. Mixed modeling assessed whether personal factors predicted ad recall or perceived effectiveness. Results: Loss-framed ads were less likely to be recalled but more likely to prompt emotion. For ads of both frame types, females reported greater recall and perceived effectiveness than males. Those with less education reported higher perceived effectiveness of the ads but lower recall. Nonsmokers were more likely than smokers to perceive the ads as effective. Knowledge of SHS risk and support for smoke-free workplaces were positively associated with recall and effectiveness. Conclusions: Ad recall and perceived effectiveness were associated with framing and demographic and personal characteristics. Smoke-free efforts in rural areas may be bolstered by continuing to promote benefits of smoke-free workplace policies and educate on SHS risks. Rural areas may need to provide a combination of ad types and framing strategies to appeal to a wide audience. Implications: Rural communities are disproportionately affected by SHS and less likely to be protected by smoke-free policies. This study adds evidence-based guidance for tailoring rural smoke-free media campaigns using different framing

A systematic review of secondhand smoke exposure in a car: Attributable changes in atmospheric and biological markers.

Science.gov (United States)

Raoof, Sana A; Agaku, Israel T; Vardavas, Constantine I

2015-05-01

Exposure to secondhand smoke (SHS) has been linked to disease, disability, and premature death. While several countries have enacted smoke-free legislations, exposure to SHS may still occur in unregulated private environments, such as in the family car. We performed a systematic review of peer-reviewed literature in PubMed and Web of Science up to May 2013. Articles were selected if they provided a quantitative measure of SHS exposure (biological or atmospheric markers); the study was conducted inside a car; and the assessed exposure was attributable to cigarette combustion. From 202 articles identified, 12 met the inclusion criteria. Among all studies that assessed smoking in cars with at least one window partially open, the particulate matter 2.5 μm or less in diameter (PM2.5) concentrations ranged from 47 μg/m(3) to 12,150 μg/m(3). For studies with all windows closed, PM2.5 ranged from 203.6 μg/m(3) to 13,150 μg/m(3). SHS concentration in a car was mediated by air-conditioning status, extent of airflow, and driving speed. Smoking in cars leads to extremely high exposure to SHS and increased concentration of atmospheric markers of exposure-even in the presence of air-conditioning or increased airflow from open windows. This clearly shows that the only way to protect nonsmokers, especially children, from SHS within cars is by eliminating tobacco smoking. © The Author(s) 2015.

Knowledge, attitudes, and behavior in avoiding secondhand smoke exposure among non-smoking employed women with higher education in Jordan.

Science.gov (United States)

Gharaibeh, Huda; Haddad, Linda; Alzyoud, Sukaina; El-Shahawy, Omar; Baker, Nesrin Abu; Umlauf, Mary

2011-11-01

Secondhand smoke (SHS) exposure is a serious public health threat worldwide; in the developing world there are less serious efforts towards controlling women's and children's exposure to SHS. Knowledge, attitudes and avoidance practices among Jordanian women have never been thoroughly studied. The purpose of this study was to assess the knowledge, attitudes, and avoidance behavior towards SHS exposure among employed Jordanian women with higher education. A survey was conducted among employed Jordanian women at two universities. A total of 209 women were included in the analysis. Two questionnaires regarding SHS exposure were used to measure knowledge, attitudes and avoidance practices. Most respondents were regularly exposed to SHS in various locations during daily life, even though they were very knowledgeable about the dangers of SHS exposure for women and children. However, the subject's attitudes and avoidance behavior did not reflect the level of knowledge about SHS risks. The results suggests there is a large discrepancy between SHS exposure, knowledge, attitudes and avoidance behavior among highly educated Jordanian women that is likely influenced by culture and traditional gender roles. Public health initiatives are needed in Jordan to address public policy, institutional practices and to empowerment of women to reduce SHS exposure.

Trends in adult exposure to secondhand smoke in vehicles: Findings from the 2009-2012 Canadian Tobacco Use Monitoring Survey.

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Azagba, Sunday

2015-10-01

A growing number of jurisdictions have implemented smoke-free vehicles when children are present due to the substantial health effects of secondhand smoke (SHS). Prior studies on the prevalence of SHS exposure in vehicles have mainly focused on adolescents. This study examined the prevalence and socio-demographic correlates of SHS exposure in vehicles among Canadian adults. A repeated cross-sectional data on youth and adult data were drawn from the 2009-2012 Canadian Tobacco Use Monitoring Survey (n=58, 195). Multivariable logistic regression analysis was used to examine the socio-demographic correlates of exposure to SHS in vehicles. Overall, 19% in 2009 and 18% in 2012 of adults reported SHS exposure in vehicles in the past month. Disparities in the SHS exposure prevalence were observed, with a higher SHS exposure among current smokers, former smokers, males, younger adults, living in a household with smoking-related exposure, and those with less education. The multivariable analyses showed significant associations between socio-demographic characteristics and SHS exposure. Higher odds SHS exposure was found for those younger (aged 20-24, OR=16.27, CI=11.09-23.88; 25-44, OR=6.12, CI=4.14-9.06; 45-64, OR=2.79, CI=1.95-4.02) compared to those aged 65 and over. Likewise, those with less education had greater odds of SHS exposure. Findings suggest that adults SHS exposure is high, especially for young adults and those with less education. Adult passengers may need protection from SHS given that no level of SHS exposure is safe. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Secondhand Smoke Concentrations in Hospitality Venues in the Pacific Basin: Findings from American Samoa, Commonwealth of the Northern Mariana Islands, and Guam

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King, Brian A; Dube, Shanta R; Ko, Jean Y

2015-01-01

Introduction Secondhand smoke (SHS) from burning tobacco products causes disease and premature death among nonsmokers. Although the number of laws prohibiting smoking in indoor public places continues to increase, millions of nonsmokers in the United States (US) and its territories remain exposed to SHS. This study assessed indoor air pollution from SHS in hospitality venues in three US Pacific Basin territories. Methods Air monitors were used to assess PM2.5, an environmental marker for SHS, in 19 smoke-permitted and 18 smoke-free bars and restaurants in American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), and Guam. Observational logs were used to record smoking and other sources of air pollution. Differences in average PM2.5 concentrations were determined using bivariate statistics. Results The average PM2.5 level in venues where smoking was always permitted [arithmetic mean (AM)=299.98 μg/m3; geometric mean (GM)=200.39 μg/m3] was significantly higher (p<0.001) than smoke-free venues [AM=8.33 μg/m3; GM=6.14 μg/m3]. In venues where smoking was allowed only during certain times, the average level outside these times [AM=42.10 μg/m3; GM=41.87 μg/m3] was also significantly higher (p<0.001) than smoke-free venues. Conclusions Employees and patrons of smoke-permitted bars and restaurants are exposed to dangerous levels of air pollution from SHS, even during periods when active smoking is not occurring. Prohibiting smoking in all public indoor areas, irrespective of the venue type or time of day, is the only way to fully protect nonsmokers from SHS exposure in these environments. PMID:22393958

OpenSHS: Open Smart Home Simulator

Directory of Open Access Journals (Sweden)

Nasser Alshammari

2017-05-01

Full Text Available This paper develops a new hybrid, open-source, cross-platform 3D smart home simulator, OpenSHS, for dataset generation. OpenSHS offers an opportunity for researchers in the field of the Internet of Things (IoT and machine learning to test and evaluate their models. Following a hybrid approach, OpenSHS combines advantages from both interactive and model-based approaches. This approach reduces the time and efforts required to generate simulated smart home datasets. We have designed a replication algorithm for extending and expanding a dataset. A small sample dataset produced, by OpenSHS, can be extended without affecting the logical order of the events. The replication provides a solution for generating large representative smart home datasets. We have built an extensible library of smart devices that facilitates the simulation of current and future smart home environments. Our tool divides the dataset generation process into three distinct phases: first design: the researcher designs the initial virtual environment by building the home, importing smart devices and creating contexts; second, simulation: the participant simulates his/her context-specific events; and third, aggregation: the researcher applies the replication algorithm to generate the final dataset. We conducted a study to assess the ease of use of our tool on the System Usability Scale (SUS.

OpenSHS: Open Smart Home Simulator.

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Alshammari, Nasser; Alshammari, Talal; Sedky, Mohamed; Champion, Justin; Bauer, Carolin

2017-05-02

This paper develops a new hybrid, open-source, cross-platform 3D smart home simulator, OpenSHS, for dataset generation. OpenSHS offers an opportunity for researchers in the field of the Internet of Things (IoT) and machine learning to test and evaluate their models. Following a hybrid approach, OpenSHS combines advantages from both interactive and model-based approaches. This approach reduces the time and efforts required to generate simulated smart home datasets. We have designed a replication algorithm for extending and expanding a dataset. A small sample dataset produced, by OpenSHS, can be extended without affecting the logical order of the events. The replication provides a solution for generating large representative smart home datasets. We have built an extensible library of smart devices that facilitates the simulation of current and future smart home environments. Our tool divides the dataset generation process into three distinct phases: first design: the researcher designs the initial virtual environment by building the home, importing smart devices and creating contexts; second, simulation: the participant simulates his/her context-specific events; and third, aggregation: the researcher applies the replication algorithm to generate the final dataset. We conducted a study to assess the ease of use of our tool on the System Usability Scale (SUS).

Secondhand smoke exposure at home among middle and high school students in the United States - does the type of tobacco product matter?

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Fischer, Florian; Kraemer, Alexander

2017-01-19

A decline in the prevalence of secondhand smoke (SHS) exposure has been observed in the United States of America (USA) during the past few decades. Nevertheless, nearly half of non-smoking students are still exposed to SHS. This paper aims to describe the factors associated with SHS exposure stratified by type of exposure (overall, cigarettes and electronic cigarettes). The analysis is based on secondary data taken from the National Youth Tobacco Survey 2014. Overall, 22,007 middle and high school students from the USA are included in the sample. Descriptive and bivariate statistics as well as binary logistic regression models were performed. Overall, 44.5% (n=9,798) of the study participants declared themselves to be exposed to SHS, 29.1% (n=6,394) declared to be exposed to SHS caused by cigarette smoke and 9.4% (n=2,067) claimed that a person who lives with them uses electronic cigarettes. There is a considerable overlap between the two types of SHS exposure, because 74.9% (n=1,548) of students declaring that a person within their household uses electronic cigarettes also declare a person in the household smoking cigarettes. The strengths of association between independent variables and SHS exposure differs by type of exposure and also by smoking status of respondents. Although only small differences are obvious in the factors associated with SHS exposure stratified by the type of tobacco product, there are still some variations which should be considered in policy making to allow for a targeted approach in prevention campaigns or legislation.

State smoking restrictions for private-sector worksites, restaurants, and bars--United States, 2004 and 2007.

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2008-05-23

Secondhand smoke (SHS) contains more than 50 carcinogens and causes heart disease and lung cancer in nonsmoking adults. Eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from SHS exposure. Smoking restrictions limit smoking to certain areas within a venue; smoke-free policies prohibit smoking within the entire venue. A Healthy People 2010 objective (27-13) calls for establishing laws in all 50 states and the District of Columbia (DC) that make indoor public places and worksites completely smoke-free. To assess progress toward meeting this objective, CDC reviewed the status of state laws restricting smoking in effect as of December 31, 2007, updating a 2005 study that reported on such laws as of December 31, 2004. This report summarizes the changes in state smoking restrictions for private-sector worksites, restaurants, and bars that occurred from 2004 to 2007. The findings indicated a substantial increase in the number and restrictiveness of state laws regulating smoking in these three settings, providing nonsmokers with increased protection from the health risks posed by SHS. If current trends continue, achieving the national health objective by 2010 might be possible.

Sex and Age Differences in Exposure to Secondhand Smoke at Home among Korean Adolescents: A Nationally Representative Survey.

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Hwang, Jun Hyun; Park, Soon-Woo

2016-02-19

The authors assessed sex and age differences in secondhand smoke (SHS) exposure among vulnerable adolescent populations. Data from the 2013 Korea Youth Risk Behavior Web-based Survey of 64,499 non-smokers aged 13-18 years were analyzed using multiple logistic regression. Girls were exposed 1.26 times (95% confidence interval, 1.21-1.32) more to home SHS than boys, and the younger adolescents were more likely to be exposed to home SHS than were the older, regardless of sex (p exposure at home. Girls living with current smokers were more likely to be exposed to SHS at home than boys regardless age. Girls and younger adolescents, populations vulnerable to smoke exposure, were more likely to be exposed to SHS at home, even though they should be more protected. It is necessary to improve home SHS awareness, especially among these vulnerable populations.

“I Was a Full Time Proper Smoker”: A Qualitative Exploration of Smoking in the Home after Childbirth among Women Who Relapse Postpartum

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Coleman, Tim; Lewis, Sarah; Cooper, Sue

2016-01-01

Background Many women stop smoking during pregnancy but relapse shortly afterwards, potentially putting their infants at risk of secondhand smoke (SHS) exposure. Women who were able to stop during pregnancy may be a motivated group, receptive to making behaviour changes postpartum to protect their infant from SHS exposure. Understanding more about their experiences of relapse, and if this influences home smoking behaviours and children’s exposure to SHS in the home may help to inform intervention development to prevent infant SHS exposure. Methods Guided by interpretative phenomenological methodology we conducted and analysed nine semi-structured interviews with women who quit smoking during pregnancy, but relapsed ≤3 months postpartum. Findings Central to mothers’ accounts of their smoking behaviours during pregnancy and postpartum was their desire to be a ‘responsible mother’. Mothers described using strategies to protect their infant from SHS exposure, and held strong negative attitudes towards other smoking parents. After relapsing, mothers appeared to reposition themselves as ‘social’ or ‘occasional’ smokers rather than ‘regular’ smokers. Conclusions Findings suggest that interventions to prevent/reduce infants' home SHS exposure should build on mothers' intentions to be responsible parents. As mothers who relapse principally view themselves as ‘social’ or ‘occasional’ smokers, interventions that are highlighted as relevant for women with these types of smoking patterns may be more likely to be responded to, and, ultimately, be effective. PMID:27308829

Secondhand Smoke Exposure Among Young Adult Sexual Minority Bar and Nightclub Patrons

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Fallin, Amanda; Neilands, Torsten B.; Jordan, Jeffrey W.

2014-01-01

Objectives. We compared exposure to secondhand smoke (SHS) and attitudes toward smoke-free bar and nightclub policies among patrons of lesbian, gay, bisexual, and transgender (LGBT) and non-LGBT bars and nightclubs. Methods. We conducted randomized time–location sampling surveys of young adults (aged 21–30 years) in 7 LGBT (n = 1113 patrons) and 12 non-LGBT (n = 1068 patrons) venues in Las Vegas, Nevada, in 2011, as part of a cross-sectional study of a social branding intervention to promote a tobacco-free lifestyle and environment in bars and nightclubs. Results. Compared with non-LGBT bars and nightclubs, patrons of LGBT venues had 38% higher adjusted odds of having been exposed to SHS in a bar or nightclub in the past 7 days but were no less likely to support smoke-free policies and intended to go out at least as frequently if a smoke-free bar and nightclub law was passed. Conclusions. The policy environment in LGBT bars and nightclubs appears favorable for the enactment of smoke-free policies, which would protect patrons from SHS and promote a smoke-free social norm. PMID:24328626

Knowledge, Attitudes, and Behavior in Avoiding Secondhand Smoke Exposure Among Non-Smoking Employed Women with Higher Education in Jordan

Directory of Open Access Journals (Sweden)

Mary Umlauf

2011-11-01

Full Text Available Secondhand smoke (SHS exposure is a serious public health threat worldwide; in the developing world there are less serious efforts towards controlling women’s and children’s exposure to SHS. Knowledge, attitudes and avoidance practices among Jordanian women have never been thoroughly studied. The purpose of this study was to assess the knowledge, attitudes, and avoidance behavior towards SHS exposure among employed Jordanian women with higher education. Methods: A survey was conducted among employed Jordanian women at two universities. A total of 209 women were included in the analysis. Two questionnaires regarding SHS exposure were used to measure knowledge, attitudes and avoidance practices. Results: Most respondents were regularly exposed to SHS in various locations during daily life, even though they were very knowledgeable about the dangers of SHS exposure for women and children. However, the subject’s attitudes and avoidance behavior did not reflect the level of knowledge about SHS risks. The results suggests there is a large discrepancy between SHS exposure, knowledge, attitudes and avoidance behavior among highly educated Jordanian women that is likely influenced by culture and traditional gender roles. Public health initiatives are needed in Jordan to address public policy, institutional practices and to empowerment of women to reduce SHS exposure.

Risks for heart disease and lung cancer from passive smoking by workers in the catering industry.

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Hedley, Anthony J; McGhee, Sarah M; Repace, James L; Wong, Lai-Chin; Yu, Marcus Y S; Wong, Tze-Wai; Lam, Tai-Hing

2006-04-01

Workers in the catering industry are at greater risk of exposure to secondhand smoke (SHS) when smoke-free workplace policies are not in force. We determined the exposure of catering workers to SHS in Hong Kong and their risk of death from heart disease and lung cancer. Nonsmoking catering workers were provided with screening at their workplaces and at a central clinic. Participants reported workplace, home, and leisure time exposure to SHS. Urinary cotinine was estimated by enzyme immunoassay. Catering facilities were classified into three types: nonsmoking, partially restricted smoking (with nonsmoking areas), and unrestricted smoking. Mean urinary cotinine levels ranged from 3.3 ng/ml in a control group of 16 university staff through 6.4 ng/ml (nonsmoking), 6.1 ng/ml (partially restricted), and 15.9 ng/ml (unrestricted smoking) in 104 workers who had no exposures outside of work. Workers in nonsmoking facilities had exposures to other smoking staff. We modeled workers' mortality risks using average cotinine levels, estimates of workplace respirable particulates, risk data for cancer and heart disease from cohort studies, and national (US) and regional (Hong Kong) mortality for heart disease and lung cancer. We estimated that deaths in the Hong Kong catering workforce of 200,000 occur at the rate of 150 per year for a 40-year working-lifetime exposure to SHS. When compared with the current outdoor air quality standards for particulates in Hong Kong, 30% of workers exceeded the 24-h and 98% exceeded the annual air quality objectives due to workplace SHS exposures.

Secondhand tobacco smoke exposure and heart rate variability and inflammation among non-smoking construction workers: a repeated measures study.

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Zhang, Jinming; Fang, Shona C; Mittleman, Murray A; Christiani, David C; Cavallari, Jennifer M

2013-10-02

Although it has been well recognized that exposure to secondhand tobacco smoke (SHS) is associated with cardiovascular mortality, the mechanisms and time course by which SHS exposure may lead to cardiovascular effects are still being explored. Non-smoking workers were recruited from a local union and monitored inside a union hall while exposed to SHS over approximately 6 hours. Participants were fitted with a continuous electrocardiographic monitor upon enrollment which was removed at the end of a 24-hr monitoring period. A repeated measures study design was used where resting ECGs and blood samples were taken from individuals before SHS exposure (baseline), immediately following SHS exposure (post) and the morning following SHS exposure (next-morning).Inflammatory markers, including high sensitivity C-reactive protein (CRP) and white blood cell count (WBC) were analyzed. Heart rate variability (HRV) was analyzed from the ECG recordings in time (SDNN, rMSSD) and frequency (LF, HF) domain parameters over 5-minute periods. SHS exposure was quantified using a personal fine particulate matter (PM2.5) monitor.Linear mixed effects regression models were used to examine within-person changes in inflammatory and HRV parameters across the 3 time periods. Exposure-response relationships with PM2.5 were examined using mixed effects models. All models were adjusted for age, BMI and circadian variation. A total of 32 male non-smokers were monitored between June 2010 and June 2012. The mean PM2.5 from SHS exposure was 132 μg/m3. Immediately following SHS exposure, a 100 μg/m3 increase in PM2.5 was associated with declines in HRV (7.8% [standard error (SE) =3%] SDNN, 8.0% (SE = 3.9%) rMSSD, 17.2% (SE = 6.3%) LF, 29.0% (SE = 10.1%) HF) and increases in WBC count 0.42 (SE = 0.14) k/μl. Eighteen hours following SHS exposure, a 100 μg/m3 increase in PM2.5 was associated with 24.2% higher CRP levels. Our study suggest that short-term SHS exposure is associated

Recall and Effectiveness of Messages Promoting Smoke-Free Policies in Rural Communities.

Science.gov (United States)

Rayens, Mary Kay; Butler, Karen M; Wiggins, Amanda T; Kostygina, Ganna; Langley, Ronald E; Hahn, Ellen J

2016-05-01

Low-cost media campaigns increase demand for smoke-free policies in underserved rural areas. The study examined the impact of loss- and gain-framed smoke-free print ads on recall and perceived effectiveness in rural communities, controlling for personal characteristics. Following 6- to 9-month print media campaigns in three rural counties, recall and perceived effectiveness of loss-framed (ie, targeting dangers of secondhand smoke [SHS]) and gain-framed (ie, highlighting positive aspects of smoke-free air) ads were assessed using random-digit-dial phone surveys. Respondents were asked if they remembered each ad, whether they liked it, whether they were prompted to contact a smoke-free coalition, whether the ad made them think, and whether it prompted emotion. Mixed modeling assessed whether personal factors predicted ad recall or perceived effectiveness. Loss-framed ads were less likely to be recalled but more likely to prompt emotion. For ads of both frame types, females reported greater recall and perceived effectiveness than males. Those with less education reported higher perceived effectiveness of the ads but lower recall. Nonsmokers were more likely than smokers to perceive the ads as effective. Knowledge of SHS risk and support for smoke-free workplaces were positively associated with recall and effectiveness. Ad recall and perceived effectiveness were associated with framing and demographic and personal characteristics. Smoke-free efforts in rural areas may be bolstered by continuing to promote benefits of smoke-free workplace policies and educate on SHS risks. Rural areas may need to provide a combination of ad types and framing strategies to appeal to a wide audience. Rural communities are disproportionately affected by SHS and less likely to be protected by smoke-free policies. This study adds evidence-based guidance for tailoring rural smoke-free media campaigns using different framing: gain-framed messages (ie, benefits of smoke-free environments) to

Mitigating residential exposure to secondhand tobacco smoke

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Klepeis, Neil E.; Nazaroff, William W.

In a companion paper, we used a simulation model to explore secondhand tobacco smoke (SHS) exposures for typical conditions in residences. In the current paper, we extend this analysis to evaluate the effectiveness of physical mitigation approaches in reducing nonsmokers' exposure to airborne SHS particulate matter in a hypothetical 6-zone house. Measures investigated included closing doors or opening windows in response to smoking activity, modifying location patterns to segregate the nonsmoker and the active smoker, and operating particle filtration devices. We first performed 24 scripted simulation trials using hypothetical patterns of occupant location. We then performed cohort simulation trials across 25 mitigation scenarios using over 1000 pairs of nonsmoker and smoker time-location patterns that were selected from a survey of human activity patterns in US homes. We limited cohort pairs to cases where more than 10 cigarettes were smoked indoors at home each day and the nonsmoker was at home for more than two thirds of the day. We evaluated the effectiveness of each mitigation approach by examining its impact on the simulated frequency distribution of residential SHS particle exposure. The two most effective strategies were the isolation of the smoker in a closed room with an open window, and a ban on smoking whenever the nonsmoker was at home. The use of open windows to supply local or cross ventilation, or the operation of portable filtration devices in smoking rooms, provided moderate exposure reductions. Closed doors, by themselves, were not effective.

Decreased activation of placental mTOR family members is associated with the induction of intrauterine growth restriction by secondhand smoke in the mouse.

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Mejia, Camilo; Lewis, Josh; Jordan, Clinton; Mejia, Juan; Ogden, Connor; Monson, Troy; Winden, Duane; Watson, Marc; Reynolds, Paul R; Arroyo, Juan A

2017-02-01

Cigarette smoke is known to be a risk for the development of intrauterine growth restriction (IUGR). Our objective was to assess the effects of secondhand smoke (SHS) during pregnancy and to what extent it regulates the activation of mTOR family members and murine trophoblast invasion. Mice were treated to SHS for 4 days. Placental and fetal weights were recorded at the time of necropsy. Immunohistochemistry was used to determine the level of placental trophoblast invasion. Western blots were utilized to assess the activation of caspase 3, XIAP, mTOR, p70 and 4EBP1 in treated and control placental lysates. As compared to controls, treated animals showed: (1) decreased placental (1.4-fold) and fetal (2.3-fold) weights (p smoke extract (CSE). Similar to primary smoking, SHS may induce IUGR via decreased activation of the mTOR family of proteins in the placenta. Increased activation of the placental XIAP protein could be a survival mechanism for abnormal trophoblast cells during SHS exposure. Further, CSE reduced trophoblast invasion, suggesting a direct causative effect of smoke on susceptible trophoblast cells involved in IUGR progression. These results provide important insight into the physiological consequences of SHS exposure and smoke-mediated placental disease.

Secondhand smoke induces hepatic apoptosis and fibrosis in hamster fetus.

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Huang, Chien-Wei; Horng, Chi-Ting; Huang, Chih-Yang; Cho, Ta-Hsiung; Tsai, Yi-Chang; Chen, Li-Jeng; Hsu, Tsai-Ching; Tzang, Bor-Show

2016-09-01

Secondhand smoke (SHS) is an important health issue worldwide. Inhaling SHS during pregnancy could cause abnormalities in the internal tissues of newborns, which may then impair fetal development and even cause severe intrauterine damage and perinatal death. However, the understanding of cytopathic mechanisms of SHS by maternal passive smoking on fetus liver during pregnancy is still limited. This study analyzed the effects of high-dose SHS (SHSH) on fetus liver using a maternal passive smoking animal model. Experiments showed that hepatic matrix metalloproteinase-9 activity and terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling-positive cells were significantly increased in livers from fetuses of hamsters treated with SHSH. Similarly, expressions of both extrinsic and intrinsic apoptotic molecules were significantly higher in livers from fetuses of hamsters exposed to SHSH. Additionally, significantly increased inflammatory proteins, including transforming growth factor β, inducible nitric oxide synthase, and interleukin 1β, and fibrotic signaling molecules, including phosphorylated Smad2/3, SP1, and α-smooth muscle actin, were observed in the fetus livers from hamsters treated with SHSH. This study revealed that SHSH not only increased apoptosis through intrinsic and extrinsic pathways in the livers of fetuses from hamsters exposed to SHSH but also augmented hepatic fibrosis via Smad2/3 signaling. © The Author(s) 2015.

Portuguese children's exposure to second-hand tobacco smoke in the family car.

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Vitória, Paulo D; Machado, José Cunha; Ravara, Sofia B; Araújo, Ana Carolina; Samorinha, Catarina; Antunes, Henedina; Rosas, Manuel; Becoña, Elisardo; Precioso, José

2015-01-01

To assess the prevalence of children's exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. In 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N=3187, mean age 9.5 ± 0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. Of the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Children's exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (psmoking parents were 5.44 times more likely to be exposed. Children's exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Secondhand smoke exposure at home among one billion children in 21 countries: findings from the Global Adult Tobacco Survey (GATS).

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Mbulo, Lazarous; Palipudi, Krishna Mohan; Andes, Linda; Morton, Jeremy; Bashir, Rizwan; Fouad, Heba; Ramanandraibe, Nivo; Caixeta, Roberta; Dias, Rula Cavaco; Wijnhoven, Trudy M A; Kashiwabara, Mina; Sinha, Dhirendra N; Tursan d'Espaignet, Edouard

2016-12-01

Children are vulnerable to secondhand smoke (SHS) exposure because of limited control over their indoor environment. Homes remain the major place where children may be exposed to SHS. Our study examines the magnitude, patterns and determinants of SHS exposure in the home among children in 21 countries (19 low-income and middle-income countries and 2 high-income countries). Global Adult Tobacco Survey (GATS) data, a household survey of people 15 years of age or older. Data collected during 2009-2013 were analysed to estimate the proportion of children exposed to SHS in the home. GATS estimates and 2012 United Nations population projections for 2015 were also used to estimate the number of children exposed to SHS in the home. The proportion of children younger than 15 years of age exposed to SHS in the home ranged from 4.5% (Panama) to 79.0% (Indonesia). Of the approximately one billion children younger than 15 years of age living in the 21 countries under study, an estimated 507.74 million were exposed to SHS in the home. China, India, Bangladesh, Indonesia and the Philippines accounted for almost 84.6% of the children exposed to SHS. The prevalence of SHS exposure was higher in countries with higher adult smoking rates and was also higher in rural areas than in urban areas, in most countries. A large number of children were exposed to SHS in the home. Encouraging of voluntary smoke-free rules in homes and cessation in adults has the potential to reduce SHS exposure among children and prevent SHS-related diseases and deaths. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Knowledge and attitude toward smoke-free legislation and second-hand smoking exposure among workers in indoor bars, beer parlors and discotheques in Osun State of Nigeria.

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Onigbogi, Olanrewaju Olusola; Odukoya, Oluwakemi; Onigbogi, Modupe; Sekoni, Oluwakemi

2015-04-01

One of the requirements of the Osun State smoke-free legislation is to ensure smoke-free enclosed and partially enclosed workplaces. This survey was conducted to assess the knowledge and attitude of workers in indoor bars, beer parlors and discotheques to smoke-free legislation in general and the Osun State smoke-free law in particular. A convenience sampling of 36 hospitality centers was conducted. Interviewer-administered questionnaires were used to elicit responses about the objectives from non-smoking workers. The questionnaires had sections on knowledge of the Osun State smoke-free law, attitude toward the law and smoke-free legislation in general and exposure to second-hand tobacco smoke by the workers. Questions were also asked about the second-hand tobacco smoking status of these workers. The data were analyzed using SPSS version 15.0. We had 154 participants recruited into the study. There were 75 males (48.0%) and 79 females (52.0%). On the overall, respondents had a good knowledge of the effects of second-hand smoke on health (70.2%) with 75.0% of them being aware of the general smoke-free law and 67.3% being aware of the Osun State smoke-free law although none of them had ever seen a copy of the law. A high proportion (60.0%) was in support of the Osun smoke-free law although all of them think that the implementation of the law could reduce patronage and jeopardize their income. Attitude toward second-hand smoking was generally positive with 72.0% of them having no tolerance for second-hand tobacco smoke in their homes. Most participants (95.5%) had been exposed to tobacco smoke in the workplace within the past week. Despite the high level of awareness of the respondents about the dangers of second hand smoke and their positive attitude to smoke-free laws, nearly all were constantly being exposed to second hand smoke at work. This calls for policy level interventions to improve the implementation of the smoke-free law.

Implementation of smoke-free legislation in Malaysia: are adolescents protected from respiratory health effects?

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Zulkifli, Aziemah; Abidin, Najihah Zainol; Abidin, Emilia Zainal; Hashim, Zailina; Rahman, Anita Abd; Rasdi, Irniza; Syed Ismail, Sharifah Norkhadijah; Semple, Sean

2014-01-01

This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation. A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire. The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8). Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.

Assessment of risk for asthma initiation and cancer and heart disease deaths among patrons and servers due to secondhand smoke exposure in restaurants and bars

Science.gov (United States)

Liu, Ruiling; Bohac, David L; Gundel, Lara A; Hewett, Martha J; Apte, Michael G; Hammond, S Katharine

2014-01-01

Background Despite efforts to reduce exposure to secondhand smoke (SHS), only 5% of the world's population enjoy smoke-free restaurants and bars. Methods Lifetime excess risk (LER) of cancer death, ischaemic heart disease (IHD) death and asthma initiation among non-smoking restaurant and bar servers and patrons in Minnesota and the US were estimated using weighted field measurements of SHS constituents in Minnesota, existing data on tobacco use and multiple dose-response models. Results A continuous approach estimated a LER of lung cancer death (LCD) of 18×10−6(95% CI 13 to 23×10−6) for patrons visiting only designated non-smoking sections, 80×10−6(95% CI 66 to 95×10−6) for patrons visiting only smoking venues/sections and 802×10−6(95% CI 658 to 936×10−6) for servers in smoking-permitted venues. An attributable-risk (exposed/non-exposed) approach estimated a similar LER of LCD, a LER of IHD death about 10−2 for non-smokers with average SHS exposure from all sources and a LER of asthma initiation about 5% for servers with SHS exposure at work only. These risks correspond to 214 LCDs and 3001 IHD deaths among the general non-smoking population and 1420 new asthma cases among non-smoking servers in the US each year due to SHS exposure in restaurants and bars alone. Conclusions Health risks for patrons and servers from SHS exposure in restaurants and bars alone are well above the acceptable level. Restaurants and bars should be a priority for governments’ effort to create smoke-free environments and should not be exempt from smoking bans. PMID:23407112

Modeling flight attendants' exposure to secondhand smoke in commercial aircraft: historical trends from 1955 to 1989.

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Liu, Ruiling; Dix-Cooper, Linda; Hammond, S Katharine

2015-01-01

Flight attendants were exposed to elevated levels of secondhand smoke (SHS) in commercial aircraft when smoking was allowed on planes. During flight attendants' working years, their occupational SHS exposure was influenced by various factors, including the prevalence of active smokers on planes, fliers' smoking behaviors, airplane flight load factors, and ventilation systems. These factors have likely changed over the past six decades and would affect SHS concentrations in commercial aircraft. However, changes in flight attendants' exposure to SHS have not been examined in the literature. This study estimates the magnitude of the changes and the historic trends of flight attendants' SHS exposure in U.S. domestic commercial aircraft by integrating historical changes of contributing factors. Mass balance models were developed and evaluated to estimate flight attendants' exposure to SHS in passenger cabins, as indicated by two commonly used tracers (airborne nicotine and particulate matter (PM)). Monte Carlo simulations integrating historical trends and distributions of influence factors were used to simulate 10,000 flight attendants' exposure to SHS on commercial flights from 1955 to 1989. These models indicate that annual mean SHS PM concentrations to which flight attendants were exposed in passenger cabins steadily decreased from approximately 265 μg/m(3) in 1955 and 1960 to 93 μg/m(3) by 1989, and airborne nicotine exposure among flight attendants also decreased from 11.1 μg/m(3) in 1955 to 6.5 μg/m(3) in 1989. Using duration of employment as an indicator of flight attendants' cumulative occupational exposure to SHS in epidemiological studies would inaccurately assess their lifetime exposures and thus bias the relationship between the exposure and health effects. This historical trend should be considered in future epidemiological studies.

The impact of second-hand tobacco smoke exposure on pregnancy outcomes, infant health, and the threat of third-hand smoke exposure to our environment and to our children.

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Merritt, T Allen; Mazela, Jan; Adamczak, Aleksandra; Merritt, Travis

2012-01-01

Smoking during pregnancy is associated with various adverse effects on pregnancy and fetal development, carries a lot of serious complications such as spontaneous abortion, placental abruption, and reduced birth weight of the newborn. Children of smoking mothers have an increased risk of premature birth, low birth weight, sudden infant death syndrome and respiratory diseases during infancy. Smoking also causes long-term risk of maternal health problems such as: heart disease, cancer, emphysema, chronic obstructive pulmonary disease and higher mortality rate. Because women are more likely to quit smoking during pregnancy than at any other time, there are attempts to increase motivation and help them to stop smoking at the procreative phase of their life. The article describes interventions that are carried out in Loma Linda, where the educational program "When You Smoke Your Baby Smokes" reminds parents about the health effects of smoking during pregnancy and harmful impact on child's health caused by second-hand smoke. Another threat to health and environment of our children, is the nicotine coming from indirect exposure to tobacco smoke. Residual nicotine that persists in high concentrations on the interior surfaces, including clothing, is forming in the reaction of nitric acid carcinogenic compounds of specific nitrosamines. In addition, ozone and related atmospheric oxidants react with nicotine smoke or smoke coming from the second-hand smoke, giving the smallest particles with high risk of asthma. Efforts towards reducing exposure to tobacco smoke coming from the passive and indirect smoking should be placed at a high priority throughout the European Union.

Factors associated with secondhand smoke exposure in different settings: Results from the German Health Update (GEDA) 2012.

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Fischer, Florian; Kraemer, Alexander

2016-04-14

The ubiquity of secondhand smoke (SHS) exposure at home or in private establishments, workplaces and public areas poses several challenges for the reduction of SHS exposure. This study aimed to describe the prevalence of SHS exposure in Germany and key factors associated with exposure. Results were also differentiated by place of exposure. A secondary data analysis based on the public use file of the German Health Update 2012 was conducted (n = 13,933). Only non-smokers were included in the analysis. In a multivariable logistic regression model the factors associated with SHS exposure were calculated. In addition, a further set of multivariable logistic regressions were calculated for factors associated with the place of SHS exposure (workplace, at home, bars/discotheques, restaurants, at the house of a friend). More than a quarter of non-smoking study participants were exposed to SHS. The main area of exposure was the workplace (40.9 %). The multivariable logistic regression indicated young age as the most important factor associated with SHS exposure. The odds for SHS exposure was higher in men than in women. The likelihood of SHS exposure decreased with higher education. SHS exposure and the associated factors varied between different places of exposure. Despite several actions to protect non-smokers which were implemented in Germany during the past years, SHS exposure still remains a relevant risk factor at a population level. According to the results of this study, particularly the workplace and other public places such as bars and discotheques have to be taken into account for the development of strategies to reduce SHS exposure.

Knowledge and Attitude toward Smoke-Free Legislation and Second-Hand Smoking Exposure among Workers in Indoor Bars, Beer Parlors and Discotheques in Osun State of Nigeria

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Olanrewaju Olusola Onigbogi

2015-04-01

Full Text Available Background One of the requirements of the Osun State smoke-free legislation is to ensure smoke-free enclosed and partially enclosed workplaces. This survey was conducted to assess the knowledge and attitude of workers in indoor bars, beer parlors and discotheques to smoke-free legislation in general and the Osun State smoke-free law in particular. Methods A convenience sampling of 36 hospitality centers was conducted. Interviewer-administered questionnaires were used to elicit responses about the objectives from non-smoking workers. The questionnaires had sections on knowledge of the Osun State smoke-free law, attitude toward the law and smoke-free legislation in general and exposure to second-hand tobacco smoke by the workers. Questions were also asked about the secondhand tobacco smoking status of these workers. The data were analyzed using SPSS version 15.0. Results We had 154 participants recruited into the study. There were 75 males (48.0% and 79 females (52.0%. On the overall, respondents had a good knowledge of the effects of second-hand smoke on health (70.2% with 75.0% of them being aware of the general smoke-free law and 67.3% being aware of the Osun State smoke-free law although none of them had ever seen a copy of the law. A high proportion (60.0% was in support of the Osun smoke-free law although all of them think that the implementation of the law could reduce patronage and jeopardize their income. Attitude toward second-hand smoking was generally positive with 72.0% of them having no tolerance for second-hand tobacco smoke in their homes. Most participants (95.5% had been exposed to tobacco smoke in the workplace within the past week. Conclusion Despite the high level of awareness of the respondents about the dangers of second hand smoke and their positive attitude to smoke-free laws, nearly all were constantly being exposed to second hand smoke at work. This calls for policy level interventions to improve the implementation of

Portuguese children's exposure to second-hand tobacco smoke in the family car

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Paulo D. Vitória

2015-03-01

Conclusions: Children's exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard.

Political dynamics promoting the incremental regulation of secondhand smoke: a case study of New South Wales, Australia

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Chapman Simon

2006-07-01

Full Text Available Abstract Background The history of governmental responses to the accumulation of scientific evidence about the harms of secondhand smoke (SHS presents an intriguing case study of incremental public health policy development. Australia has long been considered a world-leader in progressive tobacco control policies, but in the last decade has fallen behind other jurisdictions in introducing SHS legislation that protects all workers. Bars, clubs and pubs remain the only public indoor spaces where smoking is legally permitted, despite SHS exposure in the hospitality industry being higher and affecting more people than in any other setting after domestic exposure. This paper examines the political dynamics that have shaped this incremental approach to SHS. Methods In-depth interviews with 21 key stakeholders in the state of New South Wales (NSW, including politicians, their advisors, health officials and tobacco control advocates, were conducted and subjected to thematic content analysis. Interviewees' comments provided insights into the dynamics surrounding the debates and outcomes of SHS legislative attempts and the current political environment, and about how to progress SHS legislation. Results SHS restrictions have been delayed by several broad factors: the influence of industry groups successfully opposing regulation; issue wear-out; and political perceptions that there is not a salient constituency demanding that smoking be banned in bars and clubs. Interviewees also provided suggestions of strategies that advocates might utilise to best overcome the current political inertia of incremental compromises and achieve timely comprehensive smoking bans. Conclusion Advocates concerned to shorten the duration of incremental endgames must continue to insist that governments address SHS fundamentally as a health issue rather than making political concessions to industry groups, and should broaden and amplify community voices calling on governments to

Scientific Evidence Supporting Policy Change: A Study on Secondhand Smoke Exposure in Non-smoking Areas of PC Rooms in Korea.

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Hong, Soon-Yeol; Lim, Min Kyung; Yun, E Hwa; Park, Eun Young; Jeong, Bo Yoon; Yang, Wonho; Lee, Do-Hoon

2016-04-01

The objective of this study was to measure secondhand smoke (SHS) exposure in personal computer (PC) rooms with the purpose of determining the strength of scientific evidence supporting the legislative ban on smoking in PC rooms located in the Republic of Korea. From June to September 2012, particulate matter (PM2.5) and air nicotine concentration (ANC) were measured in the smoking and non-smoking areas of PC rooms in Goyang City, Korea. In 28 randomly sampled PC rooms, field investigators completed an observational questionnaire on building characteristics, smoking policies, and evidence of smoking. The geometric means (GM) of PM2.5 and ANC in smoking and non-smoking areas were compared. Evidence of smoking was identified in both the smoking and non-smoking areas of all PC rooms. The GMs of PM2.5 and ANC in both areas were high and did not differ significantly (174.77 μg/m(3) and 48.95 μg/m(3) in smoking areas; 93.38 μg/m(3) and 41.30 μg/m(3) in non-smoking areas). Overall PM2.5 concentrations were 5.5-fold higher than those listed in the World Health Organization guidelines. This study supported previous reports that a partial smoking ban did not protect individuals from SHS exposure. Furthermore, the results from our study suggest how research can support policy. Countries in which smoke-free policies are not yet comprehensive may find our results useful.

Smoke-free restaurants in Shanghai: should it be mandatory and is it acceptable?

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Zheng, Pinpin; Fu, Hua; Li, Guangyao

2009-02-01

This study aims to describe secondhand smoke (SHS) exposure in restaurants in Shanghai and to explore the impact on the health of restaurant workers. Attitude to smoke-free restaurants among restaurant workers and customers was also determined in this study. A random sample of 242 workers, 284 customers, and 46 restaurant owners participated in face-to-face questionnaire interviews. A total of 219 (90.7%) restaurant workers surveyed were found to be exposed to SHS during working hours with 24.2+/-18.6h of exposure on average per week. Exposure time each week was significantly associated with the symptoms of dyspnea and irritated eyes. Among the customers surveyed 73.9% supported the concept of a 100% smoke-free law in restaurants and 49.6% expressed that they would be more likely to eat in restaurants if smoking was banned in restaurants. And 58.6% of the restaurant owners surveyed regarded smoke-free laws banning smoking in restaurant as feasible and 56.5% estimated such bans would decrease the profit. Both restaurant workers and customers are substantially exposed to SHS. Although some restaurant owners are concerned about a decrease in profits, the fear of losing business is not supported by the response among customers. Therefore, introducing a law-banning smoking in restaurants appears to be feasible and acceptable in Shanghai.

Cigarette smoke toxins deposited on surfaces: implications for human health.

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Manuela Martins-Green

Full Text Available Cigarette smoking remains a significant health threat for smokers and nonsmokers alike. Secondhand smoke (SHS is intrinsically more toxic than directly inhaled smoke. Recently, a new threat has been discovered - Thirdhand smoke (THS - the accumulation of SHS on surfaces that ages with time, becoming progressively more toxic. THS is a potential health threat to children, spouses of smokers and workers in environments where smoking is or has been allowed. The goal of this study is to investigate the effects of THS on liver, lung, skin healing, and behavior, using an animal model exposed to THS under conditions that mimic exposure of humans. THS-exposed mice show alterations in multiple organ systems and excrete levels of NNAL (a tobacco-specific carcinogen biomarker similar to those found in children exposed to SHS (and consequently to THS. In liver, THS leads to increased lipid levels and non-alcoholic fatty liver disease, a precursor to cirrhosis and cancer and a potential contributor to cardiovascular disease. In lung, THS stimulates excess collagen production and high levels of inflammatory cytokines, suggesting propensity for fibrosis with implications for inflammation-induced diseases such as chronic obstructive pulmonary disease and asthma. In wounded skin, healing in THS-exposed mice has many characteristics of the poor healing of surgical incisions observed in human smokers. Lastly, behavioral tests show that THS-exposed mice become hyperactive. The latter data, combined with emerging associated behavioral problems in children exposed to SHS/THS, suggest that, with prolonged exposure, they may be at significant risk for developing more severe neurological disorders. These results provide a basis for studies on the toxic effects of THS in humans and inform potential regulatory policies to prevent involuntary exposure to THS.

A Comparison of Survey Measures and Biomarkers of Secondhand Tobacco Smoke Exposure among Nonsmokers.

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Okoli, Chizimuzo

2016-01-01

Secondhand tobacco smoke (SHS) exposure causes several adverse physical health outcomes. Conceptual differences in survey measures of 'psychosocial' (SHS exposure from smokers in an individual's life) and 'physical' (environments where an individual is exposed to SHS) SHS exposure exist. Few studies have examined the association between psychosocial and physical SHS exposures measures in comparison to biomarkers of SHS exposure. A secondary analysis of cross-sectional data was examined among a convenience sample of 20 adults. Data included survey items on SHS exposure and hair nicotine and saliva cotinine levels. Spearman analysis was used to assess correlations among variables. Medium and strong correlations were found among SHS exposure measures with the exception of saliva cotinine levels. Strong correlations were found among and between psychosocial and physical SHS exposure measures. Hair nicotine levels had medium strength associations with only perceived frequency of SHS exposure. As psychosocial measures of exposure were associated with biomarkers, such measures (particularly perceived frequency of SHS exposure) should be added to surveys in addition to physical SHS exposure measures to enhance accuracy of SHS measurement. Future explorations with robust sample sizes should further examine the strength of relationship between psychosocial and physical SHS exposure measures. © 2015 Wiley Periodicals, Inc.

Protecting the world from secondhand tobacco smoke exposure: where do we stand and where do we go from here?

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Barnoya, Joaquin; Navas-Acien, Ana

2013-04-01

Article 8 of the Framework Convention on Tobacco Control mandates all signatory countries to "protect citizens from exposure to tobacco smoke in workplaces, public transport and indoor public places." Even though there has been great progress in the implementation of Article 8, still most of the world population remains exposed to secondhand smoke (SHS). In this article, we sought to summarize the research that supports Article 8, where do we stand, and current research gaps and future directions. Secondhand smoke is an established cause of heart disease and several types of cancer. Additional research is needed to reach final conclusions for diseases where evidence is only suggestive of causality. The only solution to SHS exposure in public places is banning smoking indoors. Research on the gaming industry and nightclubs, particularly in developing countries, needs to be disseminated to support their inclusion in smoke-free laws. Aside from indoor bans, additional research is needed for outdoor and multiunit housing bans and in support of measures that protect children and other vulnerable populations. The impact of smoke-free laws on other health outcomes, besides heart disease and respiratory outcomes, is another area where further research is needed. Thirdhand smoke assessment and health effects are also likely to be a topic of further research. As new tobacco products emerge, evaluating SHS exposure and effects will be vital. Furthering research in support of Article 8 can contribute to reach the final goal of protecting everyone from SHS exposure.

Health effects of exposure to second- and third-hand marijuana smoke: a systematic review.

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Holitzki, Hannah; Dowsett, Laura E; Spackman, Eldon; Noseworthy, Tom; Clement, Fiona

2017-11-24

Recreational marijuana has been legalized in 11 jurisdictions; Canada will legalize marijuana by July 2018. With this changing landscape, there is a need to understand the public health risks associated with marijuana to support patient-care provider conversations, harm-reduction measures and evidence-informed policy. The objective of this work was to summarize the health effects of exposure to second- and third-hand marijuana smoke. In this systematic review, we searched 6 databases from inception to October 2017. Abstract and full-text review was conducted in duplicate. Studies were included if they were human, in vivo or in vitro studies with more than 1 case reported in English or French, and reported original, quantitative data. Three outcomes were extracted: 1) cannabinoids and cannabinoid metabolites in bodily fluids, 2) self-reported psychoactive effects and 3) eye irritation and discomfort. Of the 1701 abstracts identified, 60 proceeded to full-text review; the final data set contained 15 articles. All of the included studies were of good to poor quality as assessed with the Downs and Black checklist. There is evidence of a direct relation between the tetrahydrocannabinol content of marijuana and effects on those passively exposed. This relation is mediated by several environmental factors including the amount of smoke, ventilation, air volume, number of marijuana cigarettes lit and number of smokers present. No evidence was identified assessing exposure to third-hand marijuana smoke or the health effects of long-term exposure. Exposure to second-hand marijuana smoke leads to cannabinoid metabolites in bodily fluids, and people experience psychoactive effects after such exposure. Alignment of tobacco and marijuana smoking bylaws may result in the most effective public policies. More research is required to understand the impact of exposure to third-hand smoke and the health effects of long-term exposure to second-hand smoke. Copyright 2017, Joule Inc. or

Smoke-Free Public Policies and Voluntary Policies in Personal Settings in Tbilisi, Georgia: A Qualitative Study.

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Berg, Carla J; Smith, Samantha A; Bascombe, Ta Misha; Maglakelidze, Nino; Starua, Lela; Topuridze, Marina

2016-01-25

Georgia has limited tobacco control policies, particularly in the area of smoke-free public policies, which may influence the adoption of smoke-free home rules. We qualitatively examined knowledge about and reactions to public and personal smoke-free policies among Tbilisi residents. In Spring 2014, we conducted six focus groups among 47 total participants--two among male smokers, one among male nonsmokers, two among female smokers, and one among female nonsmokers. Our sample was 48.9% male and 70.2% past 30-day smokers. Most believed that SHS was dangerous, with particular concern regarding the impact of SHS on children and pregnant women. Many had misconceptions about how to protect others from SHS and the effectiveness of some approaches. Many indicated that they had some type of home rules, but few reported a complete ban on smoking in the home. Even when some restrictions were in place, they rarely were effective or enforced. Common concerns about the partial smoke-free public policy in Georgia included its economic impact, perceived discrimination among smokers, and the policy being against the Georgian culture. These concerns were heightened when participants were asked about the possible implementation of a complete smoke-free policy. Educational programs are needed to promote smoke-free policies in Georgia.

Association between secondhand smoke exposure at home and cigarette gifting and sharing in Zhejiang, China: a repeat cross-sectional study.

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Xu, Yue; Xu, ShuiYang; Wu, QingQing; Guo, YuJie

2016-03-03

The aims of the current study were to assess the prevalence of household cigarette gifting and sharing, and to evaluate the relationship between secondhand smoke (SHS) exposure, and cigarette gifting and sharing, in Zhejiang, China. A repeat cross-sectional design. 10 sites in 5 cities in Zhejiang, China. Two surveys were conducted with adults in Zhejiang, China, in 2010 (N=2112) and 2012 (N=2279), respectively. At both waves, the same questionnaire was used; respondents were asked questions on residence, number of family smokers, indoor smoking rules, household income and cigarette gifting and sharing. The findings revealed that more than half of respondents' families (54.50% in 2010, 52.79% in 2012) reported exposure to SHS. Many families (54.73% in 2010, 47.04% in 2012) shared cigarettes with others, and a minority (14.91% in 2010, 14.17% in 2012) reported their family giving cigarettes as a gift. There was a significant decrease in cigarette sharing from 2010 to 2012, irrespective of household with SHS exposure status; and the cigarette gifting was significantly decreased in household without SHS exposure. Compared to households without SHS exposure, the prevalence of cigarette gifting and sharing in households with SHS exposure was more obvious. Encouraging and promoting a smoke-free household environment is necessary to change public smoking customs in Zhejiang, China. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The Prevalence of Exposure to Workplace Secondhand Smoke in the United States: 2010 to 2015.

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Dai, Hongying; Hao, Jianqiang

2017-11-01

To compare changes in exposure to workplace secondhand smoke (SHS) by industry of employment and occupation from 2010 to 2015. Data were collected from 2010 and 2015 National Health Interview Survey. Weighted estimates of the prevalence of exposure to workplace SHS among currently working nonsmokers in 2010 (n = 12 627) and 2015 (n = 16 399) were compared. The prevalence of exposure to workplace SHS among currently working nonsmokers was 10.0% in 2015 and 9.5% in 2010. Exposure to workplace SHS is disproportionally high among male workers, young workers, non-Hispanic blacks, Hispanics, workers with low education and low income, and workers residing in the Southern United States. Tobacco control policies have effectively reduced exposure to workplace SHS in a few white-collar and service job categories but blue-collar workers remain to have a high prevalence of exposure to workplace SHS. From 2010 to 2015, "transportation and warehousing industries" had the largest increase in SHS exposure (13.3%-21.5%, p value = .004) and "arts, entertainment, and recreation industries" had the largest decline in prevalence of exposure to SHS (20.1%-11.5%, p value = .01). In the multivariate analysis, workers with service (aOR = 1.4, p workplace SHS than those with white-collar occupations. Disparities of SHS exposure by industry, occupation, and social demographic class continue to exist. Blue-collar workers, especially those working in "transportation and construction industries," along with young workers and workers in high risk social classes are priority groups for future workplace SHS prevention. An estimated 12.6 million working nonsmokers were regularly exposed to SHS at work in 2015. We compared the changes in prevalence of exposure to workplace SHS from 2010 to 2015 by social demographic class, industry of employment and occupation. Our findings could help inform the policymakers and health practitioners to establish stronger smoke-free air laws and conduct education

Environmental monitoring of secondhand smoke exposure

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Apelberg, Benjamin J; Hepp, Lisa M; Avila-Tang, Erika; Gundel, Lara; Hammond, S Katharine; Hovell, Melbourne F; Hyland, Andrew; Klepeis, Neil E; Madsen, Camille C; Navas-Acien, Ana; Repace, James; Samet, Jonathan M

2013-01-01

The complex composition of secondhand smoke (SHS) provides a range of constituents that can be measured in environmental samples (air, dust and on surfaces) and therefore used to assess non-smokers' exposure to tobacco smoke. Monitoring SHS exposure (SHSe) in indoor environments provides useful information on the extent and consequences of SHSe, implementing and evaluating tobacco control programmes and behavioural interventions, and estimating overall burden of disease caused by SHSe. The most widely used markers have been vapour-phase nicotine and respirable particulate matter (PM). Numerous other environmental analytes of SHS have been measured in the air including carbon monoxide, 3-ethenylpyridine, polycyclic aromatic hydrocarbons, tobacco-specific nitrosamines, nitrogen oxides, aldehydes and volatile organic compounds, as well as nicotine in dust and on surfaces. The measurement of nicotine in the air has the advantage of reflecting the presence of tobacco smoke. While PM measurements are not as specific, they can be taken continuously, allowing for assessment of exposure and its variation over time. In general, when nicotine and PM are measured in the same setting using a common sampling period, an increase in nicotine concentration of 1 μg/m3 corresponds to an average increase of 10 μg/m3 of PM. This topic assessment presents a comprehensive summary of SHSe monitoring approaches using environmental markers and discusses the strengths and weaknesses of these methods and approaches. PMID:22949497

Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries.

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Oberg, Mattias; Jaakkola, Maritta S; Woodward, Alistair; Peruga, Armando; Prüss-Ustün, Annette

2011-01-08

Exposure to second-hand smoke is common in many countries but the magnitude of the problem worldwide is poorly described. We aimed to estimate the worldwide exposure to second-hand smoke and its burden of disease in children and adult non-smokers in 2004. The burden of disease from second-hand smoke was estimated as deaths and disability-adjusted life-years (DALYs) for children and adult non-smokers. The calculations were based on disease-specific relative risk estimates and area-specific estimates of the proportion of people exposed to second-hand smoke, by comparative risk assessment methods, with data from 192 countries during 2004. Worldwide, 40% of children, 33% of male non-smokers, and 35% of female non-smokers were exposed to second-hand smoke in 2004. This exposure was estimated to have caused 379,000 deaths from ischaemic heart disease, 165,000 from lower respiratory infections, 36,900 from asthma, and 21,400 from lung cancer. 603,000 deaths were attributable to second-hand smoke in 2004, which was about 1·0% of worldwide mortality. 47% of deaths from second-hand smoke occurred in women, 28% in children, and 26% in men. DALYs lost because of exposure to second-hand smoke amounted to 10·9 million, which was about 0·7% of total worldwide burden of diseases in DALYs in 2004. 61% of DALYs were in children. The largest disease burdens were from lower respiratory infections in children younger than 5 years (5,939,000), ischaemic heart disease in adults (2,836,000), and asthma in adults (1,246,000) and children (651,000). These estimates of worldwide burden of disease attributable to second-hand smoke suggest that substantial health gains could be made by extending effective public health and clinical interventions to reduce passive smoking worldwide. Swedish National Board of Health and Welfare and Bloomberg Philanthropies. Copyright © 2011 Elsevier Ltd. All rights reserved.

Correlates of Smoke-Free Home Policies in Shanghai, China

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Pinpin Zheng

2014-01-01

Full Text Available Background. Approximately 63.7% of nonsmokers in China are exposed to secondhand smoke (SHS in their homes. The current study documents the prevalence and correlates of smoke-free home policies in Shanghai, as well as reasons for implementing such a policy and places where smoking is most commonly allowed. Methods. We conducted in-person surveys of 500 participants using a multistage proportional random sampling design in an urban and suburban district. Results. Overall, 35.3% had a smoke-free home policy. In the logistic regression, having higher income, not having smokers in the home, having children in the home, having fewer friends/relatives who permit smoking at home, and not being a current smoker were correlates of having a smoke-free home policy P<0.05. Concern about the health impact of SHS was reportedly the most important reason for establishing a smoke-free home. Among participants with no or partial bans, the most common places where smoking was allowed included the living room (64.2%, kitchen (46.1%, and bathroom (33.8%. Conclusions. Smoke-free home policies were in place for a minority of households surveyed. Establishing such a policy was influenced by personal smoking behavior and social factors. These findings suggest an urgent need to promote smoke-free home policies through tobacco control programs.

Solar Home System (SHS) in rural Bangladesh: Ornamentation or fact of development?

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Rahman, Syed M.; Ahmad, Mokbul M.

2013-01-01

Energy requirement has been growing every day due to higher population growth, and consequently higher consumption. About one third of rural households of Bangladesh are connected to the grid. To meet the gap, solar energy has been treated as a feasible option for people in rural areas where grid connections are not available. A good number of organizations have been working together to provide Solar Home System (SHS) in rural Bangladesh. There is little evidence that supply of small scale energy supports significant rural development. This paper aims at understanding how increased energy access through SHS in rural Bangladesh contributes towards rural development. Recent published literatures on SHS in Bangladesh have been studied to get insight into the technical, financial, and operational as well as economic and social issues. Later the findings have been critically analyzed with respect to selected indicators of rural development. The study identified that increased access to energy through SHS in rural Bangladesh provides mostly recreational and leisure benefits with the so called ‘social status’; income generation is negligible while support for education is average. - Highlights: • No specific proof is there to conclude that SHS has contributed to development. • SHS's contribution to income generation and employment is not significant. • SHS is mostly used for entertainment and to uplift the so called ‘social status’

Deaths From Secondhand Smoke Exposure in the United States: Economic Implications

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Sung, Hai-Yen; Shi, Yanling

2012-01-01

Objectives. We estimated the number of deaths attributable to secondhand smoke (SHS), years of potential life lost (YPLL), and value of lost productivity for different US racial/ethnic groups in 2006. Methods. We determined the number of SHS–related deaths among nonsmokers from 2 adult and 4 infant conditions using an epidemiological approach. We estimated adult SHS exposure using detectable serum cotinine. For each death, we determined the YPLL and the value of lost productivity. Results. SHS exposure resulted in more than 42 000 deaths: more than 41 000 adults and nearly 900 infants. Blacks accounted for 13% of all deaths but 24% to 36% of infant deaths. SHS–attributable deaths resulted in a loss of nearly 600 000 YPLL and $6.6 billion of lost productivity, or $158 000 per death. The value of lost productivity per death was highest among Blacks ($238 000) and Hispanics ($193 000). Conclusions. The economic toll of SHS exposure is substantial, with communities of color having the greatest losses. Interventions need to be designed to reduce the health and economic burden of smoking on smokers and nonsmokers alike and on particularly vulnerable groups. PMID:22994180

‘Excuse me, sir. Please don’t smoke here’. A qualitative study of social enforcement of smoke-free policies in Indonesia

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Kaufman, Michelle R; Merritt, Alice Payne; Rimbatmaja, Risang; Cohen, Joanna E

2015-01-01

Objective District policies were recently put into place in Indonesia prohibiting smoking in public spaces. This study sought to (1) assess participants’ general knowledge of secondhand smoke (SHS) dangers; (2) assess participants’ awareness of and specific knowledge of smoke-free (SF) policies; and (3) assess the extent to which such policies are socially enforced and gather examples of successful social enforcement. Methods Qualitative in-depth interviews and focus group discussions were conducted in Bogor and Palembang cities with both community members and key informants such as government officials, non-government agency staff, religious leaders and health workers. Results Participants in both Palembang and Bogor find SF policy important. Although there was awareness of SHS dangers and SF policies, accurate knowledge of the dangers and an in-depth understanding of the policies varied. There was a high level of support for the SF policies in both cities among both smokers and non-smokers. Many participants did have experience asking a smoker not to smoke in an area where it was restricted, even if their comfort in doing so varied. There was, however, a higher level of comfort in telling smokers to stop or to move away from pregnant women and children. Hesitation to socially enforce the policies was especially present when asking men of status and/or community leaders to stop smoking, but overall participants felt they could comfortably ask someone to obey the law. Conclusion Palembang and Bogor may be evolving towards creating social norms in support of prohibiting smoking in public spaces. If provided with more support from government and law officials, such as government officials themselves promoting the policies and demonstrating compliance, and renewed efforts to promote and enforce policies in general were made, Indonesians in these cities may feel more confident protecting non-smokers from SHS. PMID:25244917

Protecting the World From Secondhand Tobacco Smoke Exposure: Where Do We Stand and Where Do We Go From Here?

Science.gov (United States)

Barnoya, Joaquin

2013-01-01

Introduction: Article 8 of the Framework Convention on Tobacco Control mandates all signatory countries to “protect citizens from exposure to tobacco smoke in workplaces, public transport and indoor public places.” Even though there has been great progress in the implementation of Article 8, still most of the world population remains exposed to secondhand smoke (SHS). In this article, we sought to summarize the research that supports Article 8, where do we stand, and current research gaps and future directions. Discussion: Secondhand smoke is an established cause of heart disease and several types of cancer. Additional research is needed to reach final conclusions for diseases where evidence is only suggestive of causality. The only solution to SHS exposure in public places is banning smoking indoors. Research on the gaming industry and nightclubs, particularly in developing countries, needs to be disseminated to support their inclusion in smoke-free laws. Aside from indoor bans, additional research is needed for outdoor and multiunit housing bans and in support of measures that protect children and other vulnerable populations. The impact of smoke-free laws on other health outcomes, besides heart disease and respiratory outcomes, is another area where further research is needed. Thirdhand smoke assessment and health effects are also likely to be a topic of further research. As new tobacco products emerge, evaluating SHS exposure and effects will be vital. Conclusions: Furthering research in support of Article 8 can contribute to reach the final goal of protecting everyone from SHS exposure. PMID:23072872

Smoking and Secondhand Smoke Exposure at Home Were Associated with Poor Perceived Family Well-Being: Findings of FAMILY Project.

Directory of Open Access Journals (Sweden)

Xin Wang

Full Text Available To investigate the associations of cigarette smoking and secondhand (SHS exposure at home with family well-being among Chinese adults in Hong Kong.Telephone surveys were conducted among 3043 randomly selected adults (response rate 70% in 2010 and 2012 to monitor family health information and tobacco use in Hong Kong. Family well-being was measured using three questions of perceived family harmony, happiness and health (3Hs with responses ranging from 0-10 and a higher score indicating better family well-being. Smoking status, nicotine dependence, quitting behaviours and SHS exposure at home were recorded. Multiple linear regressions were used to calculate β-coefficients for individual family 3Hs component and an overall composite score representing family well-being.Compared with never smokers, current smokers reported lower levels of family harmony (adjusted β = -0.15, 95% CI: -0.35 to -0.10, happiness (adjusted β = -0.12, 95% CI: -0.28 to -0.02, health (adjusted β = -0.15, 95% CI: -0.30 to -0.03 and overall family well-being (adjusted β = -0.17, 95% CI: -0.32 to -0.06. Quit attempt and intention to quit were not associated with family well-being. SHS exposure at home was associated with lower levels of family harmony (adjusted β = -0.17, 95% CI: -0.30 to -0.07, happiness (adjusted β = -0.19, 95% CI: -0.32 to -0.08, health (adjusted β = -0.13, 95% CI: -0.26 to -0.03 and family well-being (adjusted β = -0.19, 95% CI: -0.32 to -0.09.Smoking and SHS exposure at home were associated with the lower levels of perceived family well-being. Prospective studies are needed to confirm the results.

Clearing the air: improving smoke-free policy compliance at the national oncology hospital in Armenia.

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Movsisyan, Narine K; Petrosyan, Varduhi; Harutyunyan, Arusyak; Petrosyan, Diana; Stillman, Frances

2014-12-13

Smoke-free policies shown to reduce population exposure to secondhand smoke (SHS) are the norm in hospitals in many countries around the world. Armenia, a transition economy in the South Caucasus, has one of the highest male smoking rates in the European region. Although smoking in healthcare facilities has been banned since 2005, compliance with this ban has been poor due to lack of implementation and enforcement mechanisms and social acceptability of smoking. The study aimed to develop and test a model intervention to address the lack of compliance with the de jure smoking ban. The national oncology hospital was chosen as the intervention site. This study used employee surveys and objective measurements of respirable particles (PM2.5) and air nicotine as markers of indoor air pollution before and after the intervention. The intervention developed in partnership with the hospital staff included an awareness campaign on SHS hazards, creation of no-smoking environment and building institutional capacity through training of nursing personnel on basics of tobacco control. The survey analysis included paired t-test and McNemar's test. The log-transformed air nicotine and PM2.5 data were analyzed using paired t-test. The survey showed significant improvement in the perceived quality of indoor air, reduced worksite exposure to SHS and increased employees' awareness of the smoke-free policy. The number of employees reporting compliance with the hospital smoke-free policy increased from 36.0% to 71.9% (p Armenia that have failed to implement the adopted smoke-free policies.

Carcinogen derived biomarkers: applications in studies of human exposure to secondhand tobacco smoke

OpenAIRE

Hecht, S

2004-01-01

Objective: To review the literature on carcinogen derived biomarkers of exposure to secondhand tobacco smoke (SHS). These biomarkers are specifically related to known carcinogens in tobacco smoke and include urinary metabolites, DNA adducts, and blood protein adducts.

Compliance to the smoke-free law in Guatemala 5-years after implementation.

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Barnoya, Joaquín; Monzon, Jose C; Briz, Paulina; Navas-Acien, Ana

2016-04-12

Smoke-free environments decrease smoking prevalence and consequently the incidence of heart disease and lung cancer. Due to issues related to poor enforcement, scant data is currently available from low/middle income countries on the long-term compliance to smoke-free laws. In 2006, high levels of secondhand smoke (SHS) were found in bars and restaurants in Guatemala City. Six months after a smoking ban was implemented in 2009, levels significantly decreased. However, in 2010, poor law compliance was observed. Therefore, we sought to assess long-term compliance to the ban using SHS measurements. In 2014 we assessed SHS exposure using airborne nicotine monitors in bars (n = 9) and restaurants (n = 12) for 7 days using the same protocol as in 2006 and in 2009. Nicotine was measured using gas-chromatography (μg/m(3)) and compared to levels pre- (2006) and post-ban (2009). Employees responded to a survey about SHS exposure, perceived economic impact of the ban and customers' electronic cigarette use. In addition, we estimated the fines that could have been collected for each law infringement. Most (71 %) venues still have a smoking section, violating the law. The percentage of samples with detectable nicotine concentrations was 100, 85 and 43 % in 2006, 2009 and 2014, respectively. In bars, median (25(th) and 75(th) percentiles) nicotine concentrations were 4.58 μg/m(3) (1.71, 6.45) in 2006, 0.28 (0.17, 0.66) in 2009, and 0.59 (0.01, 1.45) in 2014. In restaurants, the corresponding medians were 0.58 μg/m(3) (0.44, 0.71), 0.04 (0.01, 0.11), and 0.01 (0.01, 0.09). Support for the law continues to be high (88 %) among bar and restaurant employees. Most employees report no economic impact of the law and that a high proportion of customers (78 %) use e-cigarettes. A total of US$50,012 could have been collected in fines. Long-term compliance to the smoking ban in Guatemala is decreasing. Additional research that evaluates the determinants of non

The effects of MEK1/2 inhibition on cigarette smoke exposure-induced ET receptor upregulation in rat cerebral arteries

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Cao, Lei [Division of Experimental Vascular Research, Institute of Clinical Sciences in Lund, Lund University (Sweden); Department of Pharmacology, School of Basic Medical Sciences, Xi' an Jiaotong University Health Science Center, Xi' an, Shaanxi (China); Ping, Na-Na; Cao, Yong-Xiao [Department of Pharmacology, School of Basic Medical Sciences, Xi' an Jiaotong University Health Science Center, Xi' an, Shaanxi (China); Li, Wei, E-mail: 13572512207@163.com [Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi' an Jiaotong University, Xi' an, Shaanxi (China); Cai, Yan [Department of Pharmacology, School of Basic Medical Sciences, Xi' an Jiaotong University Health Science Center, Xi' an, Shaanxi (China); Warfvinge, Karin; Edvinsson, Lars [Division of Experimental Vascular Research, Institute of Clinical Sciences in Lund, Lund University (Sweden)

2016-08-01

Cigarette smoking, a major stroke risk factor, upregulates endothelin receptors in cerebral arteries. The present study examined the effects of MEK1/2 pathway inhibition on cigarette smoke exposure-induced ET receptor upregulation. Rats were exposed to the secondhand smoke (SHS) for 8 weeks followed by intraperitoneal injection of MEK1/2 inhibitor, U0126 for another 4 weeks. The urine cotinine levels were assessed with high-performance liquid chromatography. Contractile responses of isolated cerebral arteries were recorded by a sensitive wire myograph. The mRNA and protein expression levels of receptor and MEK/ERK1/2 pathway molecules were examined by real-time PCR and Western blotting, respectively. Cerebral artery receptor localization was determined with immunohistochemistry. The results showed the urine cotinine levels from SHS exposure group were significantly higher than those from the fresh group. In addition, the MEK1/2 inhibitor, U0126 significantly reduced SHS exposure-increased ET{sub A} receptor mRNA and protein levels as well as contractile responses mediated by ET{sub A} receptors. The immunoreactivity of increased ET{sub A} receptor expression was primarily cytoplasmic in smooth muscle cells. In contrast, ET{sub B} receptor was noted in endothelial cells. However, the SHS-induced decrease in endothelium-dependent relaxation was unchanged after U0126 treatment. Furthermore, SHS increased the phosphorylation of MEK1/2 and ERK1/2 protein in cerebral arteries. By using U0126 could inhibit the phosphorylated ERK1/2 protein but not MEK1/2. Taken together, our data show that treatment with MEK1/2 pathway inhibitor offsets SHS exposure-induced ET{sub A} receptor upregulation in rat cerebral arteries. - Highlights: • Cigarette smoke exposure induces ET{sub A} receptor upregulation in rat cerebral arteries. • U0126 can alleviate the receptor upregulation. • The mechanism relies on MEK/ERK1/2 pathway activation. • We may provide a new target for the

The effects of MEK1/2 inhibition on cigarette smoke exposure-induced ET receptor upregulation in rat cerebral arteries

International Nuclear Information System (INIS)

Cao, Lei; Ping, Na-Na; Cao, Yong-Xiao; Li, Wei; Cai, Yan; Warfvinge, Karin; Edvinsson, Lars

2016-01-01

Cigarette smoking, a major stroke risk factor, upregulates endothelin receptors in cerebral arteries. The present study examined the effects of MEK1/2 pathway inhibition on cigarette smoke exposure-induced ET receptor upregulation. Rats were exposed to the secondhand smoke (SHS) for 8 weeks followed by intraperitoneal injection of MEK1/2 inhibitor, U0126 for another 4 weeks. The urine cotinine levels were assessed with high-performance liquid chromatography. Contractile responses of isolated cerebral arteries were recorded by a sensitive wire myograph. The mRNA and protein expression levels of receptor and MEK/ERK1/2 pathway molecules were examined by real-time PCR and Western blotting, respectively. Cerebral artery receptor localization was determined with immunohistochemistry. The results showed the urine cotinine levels from SHS exposure group were significantly higher than those from the fresh group. In addition, the MEK1/2 inhibitor, U0126 significantly reduced SHS exposure-increased ET A receptor mRNA and protein levels as well as contractile responses mediated by ET A receptors. The immunoreactivity of increased ET A receptor expression was primarily cytoplasmic in smooth muscle cells. In contrast, ET B receptor was noted in endothelial cells. However, the SHS-induced decrease in endothelium-dependent relaxation was unchanged after U0126 treatment. Furthermore, SHS increased the phosphorylation of MEK1/2 and ERK1/2 protein in cerebral arteries. By using U0126 could inhibit the phosphorylated ERK1/2 protein but not MEK1/2. Taken together, our data show that treatment with MEK1/2 pathway inhibitor offsets SHS exposure-induced ET A receptor upregulation in rat cerebral arteries. - Highlights: • Cigarette smoke exposure induces ET A receptor upregulation in rat cerebral arteries. • U0126 can alleviate the receptor upregulation. • The mechanism relies on MEK/ERK1/2 pathway activation. • We may provide a new target for the treatment of SHS

The influence of newspaper coverage and a media campaign on smokers' support for smoke-free bars and restaurants and on secondhand smoke harm awareness: findings from the International Tobacco Control (ITC) Netherlands Survey

NARCIS (Netherlands)

Nagelhout, G.E.; van den Putte, B.; de Vries, H.; Crone, M.; Fong, G.T.; Willemsen, M.C.

2012-01-01

Objective: To assess the influence of newspaper coverage and a media campaign about Dutch smoke-free legislation on smokers' support for smoke-free bars and restaurants and on secondhand smoke (SHS) harm awareness. Design and main outcome measures: A content analysis was conducted of 1041 newspaper

Secondhand smoke exposure within semi-open air cafes and tobacco specific 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) concentrations among nonsmoking employees.

Science.gov (United States)

Vardavas, Constantine I; Karabela, Maria; Agaku, Israel T; Matsunaga, Yuko; Myridakis, Antonis; Kouvarakis, Antonis; Stephanou, Euripides G; Lymperi, Maria; Behrakis, Panagiotis K

2014-10-01

Secondhand smoke (SHS) is a defined occupational hazard. The association though between SHS exposure in semi-open air venues and tobacco specific carcinogen uptake is an area of debate. A cross sectional survey of 49 semi-open air cafes in Athens, Greece was performed during the summer of 2008, prior to the adoption of the national smoke free legislation. All venues had at least 1 entire wall open to allow for free air exchange. Indoor concentrations of particulate matter smaller than 2.5 microns (PM2.5) attributable to SHS were assessed during a work shift, while 1 non-smoking employee responsible for indoor and outdoor table service from each venue provided a post work shift urine sample for analysis of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL). Post work shift NNAL concentrations were correlated with work shift PM2.5 concentrations attributable to SHS (r = 0.376, p = 0.0076). Urinary NNAL concentrations among employees increased by 9.5%, per 10 μg/m(3) increase in PM2.5 concentrations attributable to SHS after controlling for the time of day and day of week. These results indicate that the commonly proposed practice of maintaining open sliding walls as a means of free air exchange does not lead to the elimination of employee exposure to tobacco specific carcinogens attributable to workplace SHS.

Support for smoke-free policies among smokers and non-smokers in six cities in China: ITC China Survey.

Science.gov (United States)

Li, Q; Hyland, A; O'Connor, R; Zhao, G; Du, L; Li, X; Fong, G T

2010-10-01

To examine levels of support for comprehensive smoke-free policies in six large Chinese cities. Data from Wave 1 of the International Tobacco Control (ITC) China Survey (April-August 2006) were analysed. The ITC China Survey employed a multistage sampling design in Beijing, Shenyang, Shanghai, Changsha, Guangzhou and Yinchuan (none of which has comprehensive smoke-free policies in place). Face-to-face interviews were conducted with 4815 smokers and 1270 non-smokers. Multivariate logistic regression models were used to identify factors associated with support for comprehensive smoke-free policies. About one in two Chinese urban smokers and four in five non-smokers believed that secondhand smoke (SHS) causes lung cancer. The majority of respondents supported comprehensive smoke-free policies in hospitals, schools and public transport vehicles while support for smoke-free workplaces, restaurants and bars was lower. Levels of support were generally comparable between smokers and non-smokers. Support for comprehensive smoke-free policies was positively associated with knowledge about the harm of SHS. Respondents who worked in a smoke-free worksite or who frequented smoke-free indoor entertainment places were more likely to support comprehensive smoking restriction in bars and restaurants. Considerable support for smoke-free policies exists in these six large cities in China. Greater public education about the dangers of SHS may further increase support. Experiencing the benefits of smoke-free indoor entertainment places and/or workplaces increases support for these policies and suggests that some initial smoke-free policy implementation may hasten the diffusion of these public health policies.

Ambient Air Pollution by Second Hand Tobacco Smoke in Public ...

African Journals Online (AJOL)

2.5) pollution has been studied and established. People who are often exposed to pollutants by inhaling second-hand tobacco smoke are at risk of adverse health consequences such as heart disease and stroke, increased risk of sudden infant ...

Prevalence of second-hand smoke exposure after introduction of the Italian smoking ban: the Florence and Belluno survey.

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Gorini, Giuseppe; Gasparrini, Antonio; Tamang, Elizabeth; Nebot, Manel; Lopez, Maria José; Albertini, Marco; Marcolina, Daniela; Fernandez, Esteve

2008-01-01

A law banning smoking in enclosed public places was implemented in Italy on January 10, 2005. The aim of this paper is to present a cross-sectional survey on two representative samples of non-smokers of two Italian towns (Florence and Belluno), conducted one year after the introduction of the ban, in order to assess prevalence of second-hand smoke exposure, to record the attitudes towards the ban, and the perception about its compliance in a representative sample of non-smokers. Computer-assisted telephone interviews were carried out in March 2006, from a random sample of households from telephone registries. Respondents were 402 non-smokers from Belluno and 1,073 from Florence. About 12% of Florentines and 7% of Belluno respondents were exposed at home; 39% and 19%, respectively, at work; 10% and 5% in hospitality venues; 20% and 10% in cars. The smoke-free law was almost universally supported (about 98%) even if a smaller proportion of people (about 90%) had the perception that the ban was observed. Second-hand smoke exposure at home and in hospitality premises has dropped to hospitality venues.

Disparities and trends in indoor exposure to secondhand smoke among U.S. adolescents: 2000-2009.

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Israel T Agaku

Full Text Available INTRODUCTION: Secondhand smoke (SHS exposure causes disease and death among nonsmokers. With a plethora of smoke-free legislation implemented and a steady decrease in cigarette consumption noted over the past decade in the U.S., this study assessed trends in indoor SHS exposure among U.S. adolescents in grades 6-12 during 2000-2009. METHODS: Data were obtained from the 2000-2009 National Youth Tobacco Survey - a national survey of U.S. middle and high school students. SHS exposure within an indoor area within the past seven days was self-reported. Trends in indoor SHS exposure during 2000-2009 were assessed overall and by socio-demographic characteristics, using the Wald's test in a binary logistic regression. Within-group comparisons were performed using chi-squared statistics (p<0.05. RESULTS: The proportion of U.S. middle and high school students who were exposed to indoor SHS declined from 65.5% in 2000 to 40.5% in 2009 (p<0.05 for linear trend. Significant declines were also observed across all population subgroups. Between 2000 and 2009, prevalence of indoor SHS exposure declined significantly among both middle (58.5% to 34.3% and high school (71.5% to 45.4% students. Prevalence of indoor SHS exposure was significantly higher among girls (44.0% in 2009 compared to boys (37.2% in 2009 during each survey year. Similarly, prevalence of indoor SHS exposure during 2000-2009 was highest among non-Hispanic whites (44.2% in 2009 and lowest among non-Hispanic Asians (30.2% in 2009. During each survey year, prevalence was highest among the oldest age group (≥18 years and lowest among the youngest (9-11 years. Also, prevalence was significantly higher among current cigarette smokers (83.8% in 2009 compared to nonsmokers (34.0% in 2009. CONCLUSION: Significant declines in indoor SHS exposure among U.S. middle and high school students occurred during 2000-2009. While the results are encouraging, additional efforts are needed to further reduce youth

Association between passive smoking and mental distress in adult never-smokers: a cross-sectional study.

Science.gov (United States)

Wang, Rui; Zhang, Peng; Lv, Xin; Gao, Chunshi; Song, Yuanyuan; Li, Zhijun; Yu, Yaqin; Li, Bo

2016-07-29

Many studies have suggested exposure to secondhand smoke (SHS) is a risk factor for various somatic diseases, but only few studies based on small sample size or specific groups have explored the association between passive smoking and mental distress. We performed this study to examine the relationship between passive smoking and mental distress in adult never-smokers of north-east China. Multistage, stratified random cluster sampling design was used in this cross-sectional study in 2012. A total of 12 978 never-smokers from Jilin, north-east China, were included. Data on passive smoking and baseline characteristics were collected by face-to-face interviews. The 12-item General Health Questionnaire (GHQ-12) was used to measure mental health status. Rao-Scott χ(2) tests were used to compare the prevalence between different groups; multivariable logistic regression was used to assess the association between passive smoking and mental distress, and Spearman rank analysis was employed to assess the correlation between passive smoking and GHQ-12 scores. The estimated prevalence of mental distress among never-smokers in Jilin province is 24.5%, and the estimated prevalence of passive smoking among the mental distressing group is 65.0%. After adjusting for gender, age, region, body mass index (BMI), occupation, marriage, education, drinking status and family monthly income per capita, passive smoking conferred a risk for mental distress (adjusted OR=1.26, 95% CI 1.13 to 1.40). A high proportion of adults, especially women, were passive smokers at home, but for men, passive smoking was more common at workplace. The more frequently participants exposed to SHS, the higher GHQ-12 scores they got. Passive smoking is an important risk factor for mental distress in never-smokers of Jilin province, which reminds Chinese government of increasing the awareness of public health and take measure to prevent SHS, especially with regard to SHS exposure at home and workplace

Prevalence of smoking restrictions and child exposure to secondhand smoke in cars and homes: a repeated cross-sectional survey of children aged 10-11 years in Wales.

Science.gov (United States)

Moore, Graham F; Moore, Laurence; Littlecott, Hannah J; Ahmed, Nilufar; Lewis, Sophia; Sulley, Gillian; Jones, Elen; Holliday, Jo

2015-01-30

Small increases in smoking restrictions in cars and homes were reported after legislation prohibiting smoking in public places. Few studies examine whether these changes continued in the longer term. This study examines changes in restrictions on smoking in cars and homes, and child exposure to secondhand smoke (SHS) in these locations, since 2008 postlegislation surveys in Wales. State-maintained primary schools in Wales (n=75). Children aged 10-11 years (year 6) completed CHETS (CHild exposure to Environmental Tobacco Smoke) Wales surveys in 2007 (n=1612) and 2008 (n=1605). A replication survey (CHETS Wales 2) was conducted in 2014, including 1601 children. Children's reports of whether smoking was allowed in their car or home and exposure to SHS in a car or home the previous day. The percentage of children who reported that smoking was allowed in their family vehicle fell from 18% to 9% in 2014 (OR=0.42; 95% CI 0.33 to 0.54). The percentage living in homes where smoking was allowed decreased from 37% to 26% (OR=0.30; 95% CI 0.20 to 0.43). Among children with a parent who smoked, one in five and one in two continued to report that smoking was allowed in their car and home. The percentage reporting SHS exposure in a car (OR=0.52; 95% CI 0.38 to 0.72) or home (OR=0.44; 95% CI 0.36 to 0.53) the previous day also fell. Children from poorer families remained less likely to report smoking restrictions. Smoking in cars and homes has continued to decline. Substantial numbers of children continue to report that smoking is allowed in cars and homes, particularly children from poorer families. A growing number of countries have legislated, or plan to legislate, banning smoking in cars carrying children. Attention is needed to the impact of legislation on child health and health inequalities, and reducing smoking in homes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Assessment of Secondhand Smoke Exposure at School among U.S. Middle and High School Students

Science.gov (United States)

Olufajo, Olubode Ademola; Agaku, Israel Terungwa

2015-01-01

To obtain nationally representative estimates of the prevalence of secondhand smoke (SHS) exposure at U.S. schools, we assessed the prevalence and correlates of SHS exposure at school among U.S. middle and high school students using data from the 2011 National Youth Tobacco Survey comprising of 18,866 students spread across all the U.S. states.…

Association between respiratory tract diseases and secondhand smoke exposure among never smoking flight attendants: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Murawski Judith

2007-09-01

Full Text Available Abstract Background Little is known about long-term adverse health consequences experienced by flight attendants exposed to secondhand smoke (SHS during the time smoking was allowed on airplanes. We undertook this study to evaluate the association between accumulated flight time in smoky airplane cabins and respiratory tract diseases in a cohort of never smoking flight attendants. Methods We conducted a mailed survey in a cohort of flight attendants. Of 15,000 mailed questionnaires, 2053 (14% were completed and returned. We excluded respondents with a personal history of smoking (n = 748 and non smokers with a history of respiratory tract diseases before the age of 18 years (n = 298. The remaining 1007 respondents form the study sample. Results The overall study sample was predominantly white (86% and female (89%, with a mean age of 54 years. Overall, 69.7% of the respondents were diagnosed with at least one respiratory tract disease. Among these respondents, 43.4% reported a diagnosis of sinusitis, 40.3% allergies, 30.8% bronchitis, 23.2% middle ear infections, 13.6% asthma, 13.4% hay fever, 12.5% pneumonia, and 2.0% chronic obstructive pulmonary disease. More hours in a smoky cabin were observed to be significantly associated with sinusitis (OR = 1.21; p = 0.024, middle ear infections (OR = 1.30; p = 0.006, and asthma (OR = 1.26; p = 0.042. Conclusion We observed a significant association between hours of smoky cabin exposure and self-reported reported sinusitis, middle ear infections, and asthma. Our findings suggest a dose-response between duration of SHS exposure and diseases of the respiratory tract. Our findings add additional evidence to the growing body of knowledge supporting the need for widespread implementation of clean indoor air policies to decrease the risk of adverse health consequences experienced by never smokers exposed to SHS.

'Excuse me, sir. Please don't smoke here'. A qualitative study of social enforcement of smoke-free policies in Indonesia.

Science.gov (United States)

Kaufman, Michelle R; Merritt, Alice Payne; Rimbatmaja, Risang; Cohen, Joanna E

2015-10-01

District policies were recently put into place in Indonesia prohibiting smoking in public spaces. This study sought to (1) assess participants' general knowledge of secondhand smoke (SHS) dangers; (2) assess participants' awareness of and specific knowledge of smoke-free (SF) policies; and (3) assess the extent to which such policies are socially enforced and gather examples of successful social enforcement. Qualitative in-depth interviews and focus group discussions were conducted in Bogor and Palembang cities with both community members and key informants such as government officials, non-government agency staff, religious leaders and health workers. Participants in both Palembang and Bogor find SF policy important. Although there was awareness of SHS dangers and SF policies, accurate knowledge of the dangers and an in-depth understanding of the policies varied. There was a high level of support for the SF policies in both cities among both smokers and non-smokers. Many participants did have experience asking a smoker not to smoke in an area where it was restricted, even if their comfort in doing so varied. There was, however, a higher level of comfort in telling smokers to stop or to move away from pregnant women and children. Hesitation to socially enforce the policies was especially present when asking men of status and/or community leaders to stop smoking, but overall participants felt they could comfortably ask someone to obey the law. Palembang and Bogor may be evolving towards creating social norms in support of prohibiting smoking in public spaces. If provided with more support from government and law officials, such as government officials themselves promoting the policies and demonstrating compliance, and renewed efforts to promote and enforce policies in general were made, Indonesians in these cities may feel more confident protecting non-smokers from SHS. Published by Oxford University Press in association with The London School of Hygiene and

Smoking Policy Change Within Permanent Supportive Housing.

Science.gov (United States)

Petersen, Anne Berit; Stewart, Holly C; Walters, Jon; Vijayaraghavan, Maya

2018-04-01

Smoke-free policies effectively reduce secondhand smoke (SHS) exposure among non-smokers, and reduce consumption, encourage quit attempts, and minimize relapse to smoking among smokers. Such policies are uncommon in permanent supportive housing (PSH) for formerly homeless individuals. In this study, we collaborated with a PSH provider in San Diego, California to assess a smoke-free policy that restricted indoor smoking. Between August and November 2015, residents completed a pre-policy questionnaire on attitudes toward smoke-free policies and exposure to secondhand smoke, and then 7-9 months after policy implementation residents were re-surveyed. At follow-up, there was a 59.7% reduction in indoor smoking. The proportion of residents who identified as current smokers reduced by 13% (95% CI: -38, 10.2). The proportion of residents who reported never smelling SHS indoors (apartment 24.2%, 95% CI: 4.2, 44.1; shared areas 17.2%, 95% CI: 1.7, 32.7); in outdoor areas next to the living unit (porches or patio 56.7%, 95% CI: 40.7, 72.8); and in other outdoor areas (parking lot 28.6%, 95% CI: 8.3, 48.9) was lower post-policy compared with pre-policy. Overall, resident support increased by 18.7%; however, the greatest increase in support occurred among current smokers (from 14.8 to 37.5%). Fewer current smokers reported that the policy would enable cessation at post-policy compared to pre-policy. Our findings demonstrate the feasibility of implementing smoke-free policies in PSH for formerly homeless adults. However, policy alone appears insufficient to trigger change in smoking behavior, highlighting the need for additional cessation resources to facilitate quitting.

Using E-Cigarettes in the Home to Reduce Smoking and Secondhand Smoke: Disadvantaged Parents' Accounts

Science.gov (United States)

Rowa-Dewar, Neneh; Rooke, Catriona; Amos, Amanda

2017-01-01

Electronic cigarettes (e-cigarettes) are subject to considerable public health debate. Most public health experts agree that for smokers who find it particularly challenging to quit, e-cigarettes may reduce harm. E-cigarette use in the home may also reduce children's secondhand smoke (SHS) exposure, although e-cigarette vapour may pose risks. This…

Exposure to secondhand smoke and risk of peripheral arterial disease in southern Chinese non-smokers: The Guangzhou Biobank Cohort Study-Cardiovascular Disease Sub-cohort.

Science.gov (United States)

Lu, Liya; Jiang, Chaoqiang; Mackay, Danny F; Pell, Jill P; Cheng, Kar Keung; Lam, Tai Hing; Thomas, G Neil

2017-06-01

Objectives We studied the association between secondhand smoke (SHS) exposure and peripheral arterial disease (PAD) in Chinese non-smokers. Methods We conducted a cross-sectional study using baseline data from the Guangzhou Biobank Cohort Study: Cardiovascular Disease Sub-cohort Study (GBCS-CVD). Guangzhou residents aged ≥ 50 years were recruited between 2003 and 2008. Baseline data included measurement of ankle brachial pressure index (ABPI) and self-reported smoking status and SHS exposure. Univariate and multivariate logistic regression analyses were used to analyze the association between SHS and PAD (defined as ABPI Exposure to SHS at home of ≥25 h per week was reported by 16.7% of PAD cases compared with 3.8% of those without PAD (χ2 test, p = 0.003). After adjustment for potential confounders, exposure to ≥25 h per week at home was still associated with PAD (adjusted OR 7.86, 95% CI 2.00-30.95, p = 0.003), with suggestion of a dose-response relationship. Conclusions Our results extend the US Surgeon General's 2006 report that SHS exposure is an independent risk factor for PAD. National smoke-free legislation is needed to protect all people from exposure.

Secondhand smoke in waterpipe tobacco venues in Istanbul, Moscow, and Cairo.

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Moon, Katherine A; Magid, Hoda; Torrey, Christine; Rule, Ana M; Ferguson, Jacqueline; Susan, Jolie; Sun, Zhuolu; Abubaker, Salahaddin; Levshin, Vladimir; Çarkoğlu, Aslı; Radwan, Ghada Nasr; El-Rabbat, Maha; Cohen, Joanna; Strickland, Paul; Navas-Acien, Ana; Breysse, Patrick N

2015-10-01

The prevalence of waterpipe tobacco smoking has risen in recent decades. Controlled studies suggest that waterpipe secondhand smoke (SHS) contains similar or greater quantities of toxicants than cigarette SHS, which causes significant morbidity and mortality. Few studies have examined SHS from waterpipe tobacco in real-world settings. The purpose of this study was to quantify SHS exposure levels and describe the characteristics of waterpipe tobacco venues. In 2012-2014, we conducted cross-sectional surveys of 46 waterpipe tobacco venues (9 in Istanbul, 17 in Moscow, and 20 in Cairo). We administered venue questionnaires, conducted venue observations, and sampled indoor air particulate matter (PM2.5) (N=35), carbon monoxide (CO) (N=23), particle-bound polycyclic aromatic hydrocarbons (p-PAHs) (N=31), 4-methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) (N=43), and air nicotine (N=46). Venue characteristics and SHS concentrations were highly variable within and between cities. Overall, we observed a mean (standard deviation (SD)) of 5 (5) waterpipe smokers and 5 (3) cigarette smokers per venue. The overall median (25th percentile, 75th percentile) of venue mean air concentrations was 136 (82, 213) µg/m(3) for PM2.5, 3.9 (1.7, 22) ppm for CO, 68 (33, 121) ng/m(3) for p-PAHs, 1.0 (0.5, 1.9) ng/m(3) for NNK, and 5.3 (0.7, 14) µg/m(3) for nicotine. PM2.5, CO, and p-PAHs concentrations were generally higher in venues with more waterpipe smokers and cigarette smokers, although associations were not statistically significant. High concentrations of SHS constituents known to cause health effects indicate that indoor air quality in waterpipe tobacco venues may adversely affect the health of employees and customers. Copyright © 2015 Elsevier Inc. All rights reserved.

Lifetime secondhand smoke exposure and childhood and adolescent asthma: findings from the PIAMA cohort.

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Milanzi, Edith B; Brunekreef, Bert; Koppelman, Gerard H; Wijga, Alet H; van Rossem, Lenie; Vonk, Judith M; Smit, Henriëtte A; Gehring, Ulrike

2017-02-23

Secondhand smoke (SHS) exposure is a modifiable risk factor associated with childhood asthma. Associations with adolescent asthma and the relevance of the timing and patterns of exposure are unclear. Knowledge of critical windows of exposure is important for targeted interventions. We used data until age 17 from 1454 children of the Dutch population-based PIAMA birth cohort. Residential SHS exposure was assessed through parental questionnaires completed at ages 3 months, 1-8 (yearly), 11, 14, and 17 years. Lifetime exposure was determined as; a) time window-specific exposure (prenatal, infancy, preschool, primary school, and secondary school); b) lifetime cumulative exposure; c) longitudinal exposure patterns using latent class growth modeling (LCGM). Generalized estimation equations and logistic regression were used to analyze associations between exposure and asthma at ages 4 to 17 years, adjusting for potential confounders. With all three methods, we consistently found no association between SHS exposure and asthma at ages 4 to 17 years e.g. adjusted overall odds ratio (95% confidence interval) 0.67 (0.41-1.12), 1.00 (0.66-1.51) and 0.67 (0.41-1.11) for prenatal maternal active smoking, infancy, and preschool school time window exposures, respectively. We assessed lifetime SHS exposure using different methods. Different timing and patterns of SHS exposure were not associated with an increased risk of asthma in childhood and adolescence in our study. More longitudinal studies could investigate effects of lifetime SHS exposure on asthma in adolescence and later life.

[Secondhand smoke exposure at home and leisure time according to the day of the week (working and non-working day) in Barcelona].

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Martínez-Sánchez, José M; Fu, Marcela; Schiaffino, Anna; Sureda, Xisca; Saltó, Esteve; Moncada, Albert; Ariza, Carles; Nebot, Manel; Pascual, José A; Fernández, Esteve

2012-01-01

The objective of this study is to describe the differences in the exposure to secondhand smoke (SHS) at home and at leisure time according to the day of the week (working and non-working day) which exposure occurs in Barcelona. We carried out a cross-sectional study of a representative sample of adult (>16 years) non-smokers in Barcelona before the Spanish smoking law came into effect (years 2004-2005). We studied the prevalence of exposure to SHS at home and leisure time by means of a questionnaire and a biomarker (salivary cotinine). The questionnaire included questions on exposure to SHS on working days and nonworking days. The prevalence of exposure to SHS at home was 27.4% (6.8% exposed only on working days, 5.7% exposed only on non-working days, and 14.9% exposed on both working and non-working days). The prevalence of exposure to SHS at leisure time was 61.3% (10.7% exposed only on working days, 13.6% exposed only on non-working days, and 37.0% exposed on both working and non-working days). The exposure to SHS only on non-working days at leisure time decreases with age (χ(2) of trend = 183.7; phome on working and non-working days showed higher levels of salivary cotinine concentration, regardless of sex, age group, and educational level. In conclusion, the exposure to SHS occurs mainly during leisure time. Questions on SHS exposure according to working and non-working days allow to characterizing the exposure to SHS, especially when the exposure occurs at leisure time.

Compliance to the smoke-free law in Guatemala 5-years after implementation

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Joaquín Barnoya

2016-04-01

Full Text Available Abstract Background Smoke-free environments decrease smoking prevalence and consequently the incidence of heart disease and lung cancer. Due to issues related to poor enforcement, scant data is currently available from low/middle income countries on the long-term compliance to smoke-free laws. In 2006, high levels of secondhand smoke (SHS were found in bars and restaurants in Guatemala City. Six months after a smoking ban was implemented in 2009, levels significantly decreased. However, in 2010, poor law compliance was observed. Therefore, we sought to assess long-term compliance to the ban using SHS measurements. Methods In 2014 we assessed SHS exposure using airborne nicotine monitors in bars (n = 9 and restaurants (n = 12 for 7 days using the same protocol as in 2006 and in 2009. Nicotine was measured using gas-chromatography (μg/m3 and compared to levels pre- (2006 and post-ban (2009. Employees responded to a survey about SHS exposure, perceived economic impact of the ban and customers’ electronic cigarette use. In addition, we estimated the fines that could have been collected for each law infringement. Results Most (71 % venues still have a smoking section, violating the law. The percentage of samples with detectable nicotine concentrations was 100, 85 and 43 % in 2006, 2009 and 2014, respectively. In bars, median (25th and 75th percentiles nicotine concentrations were 4.58 μg/m3 (1.71, 6.45 in 2006, 0.28 (0.17, 0.66 in 2009, and 0.59 (0.01, 1.45 in 2014. In restaurants, the corresponding medians were 0.58 μg/m3 (0.44, 0.71, 0.04 (0.01, 0.11, and 0.01 (0.01, 0.09. Support for the law continues to be high (88 % among bar and restaurant employees. Most employees report no economic impact of the law and that a high proportion of customers (78 % use e-cigarettes. A total of US$50,012 could have been collected in fines. Conclusions Long-term compliance to the smoking ban in Guatemala is decreasing. Additional research that

Assessment of secondhand smoke in international airports in Thailand, 2013.

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Kungskulniti, Nipapun; Charoenca, Naowarut; Peesing, Jintana; Trangwatana, Songwut; Hamann, Stephen; Pitayarangsarit, Siriwan; Chitanondh, Hatai

2015-11-01

To assess secondhand smoke (SHS) exposure in Thai international airports using a fine particulate indicator, particulate matter ≤2.5 μm (PM2.5), and to compare with 2012 exposure findings in international airports in the USA. Smoking rooms in the four largest international airports that serve the most travellers and with the most operating designated smoking rooms (DSRs) were monitored using PM2.5 monitoring equipment following an approved research protocol for assessing fine particle pollution from tobacco smoke. Monitoring was conducted inside and just outside DSRs and throughout the airport terminals in all four airports. Altogether 104 samples were taken to assess SHS exposure in four airports. Simultaneous samples were taken multiple times in a total of 11 DSRs available for sampling in the research period. Levels of PM2.5 in DSRs were extremely high in all four airports and were more dangerous inside DSRs than in the US airports (overall mean=532.5 vs 188.7 µg/m(3)), higher outside DSRs than in the US airports (overall mean=50.1 vs 43.7 µg/m(3)), and at comparable levels with the US airports in the terminals away from DSRs (overall mean=13.8 vs 11.5 µg/m(3). Findings show that travellers and employees in or near DSRs in the airports assessed in Thailand are being exposed to even higher levels of SHS than in US airports that still have DSRs. Extremely high levels of SHS in and adjacent to DSR show that these rooms are not providing safe air quality for employees and travellers. These high levels of exposure are above those levels reported in US airports and show the need for remedial action to ensure safe air quality in international airports in Thailand. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Lessons from an evaluation of a provincial-level smoking control policy in Shanghai, China.

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Li, Xiang; Gao, Junling; Zhang, Zhixing; Wei, Minqi; Zheng, Pinpin; Nehl, Eric J; Wong, Frank Y; Berg, Carla J

2013-01-01

The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS), respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls). A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. Six months after implementation, 82% of the participants agreed that "legislation is enforced most of the time". The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%), with less compliance in hotels and shopping malls (about 70%). Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10%) and high in hotels and shopping malls (40% and above). The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes) among employees decreased from 83% to 67%. Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future.

Preparation of Al-Ti-B grain refiner by SHS technology

International Nuclear Information System (INIS)

Nikitin, V.I.; Wanqi, J.I.E.; Kandalova, E.G.; Makarenko, A.G.; Yong, L.

2000-01-01

Since the discovery of the grain refinement effect of aluminum by titanium, especially with the existence of B or C in 1950, grain refiners are widely accepted in industry for microstructure control of aluminum alloys. Research on this topic is to obtain the highest grain refinement efficiency with the lowest possible addition of master alloy. It is widely accepted that the morphology and size of TiAl 3 particles, which are known as heterogeneous nucleation centers, are important factors deterring the grain refinement efficiency. Fine TiAl 3 particles are favorable. The grain refinement process shows a heredity phenomenon, which means that structural information from initial materials transfers through a melt to the final product. It is important to find the connection between microstructural parameters of the master alloy and the final product. To improve the quality of Al-Ti-B master alloys for the use as a grain refiner, a new method based on SHS (self-propagating high-temperature synthesis) technology has been developed in Samara State Technical University to produce the master alloys. SHS, as a new method for preparation of materials, was first utilized by Merzhanov in 1967. This method uses the energy from highly exothermic reactions to sustain the chemical reaction in a combustion wave. The advantages of SHS include simplicity, low energy requirement, and higher product purity. Because SHS reactions can take place between elemental reactants, it is easy to control product composition. The purposes of this investigation were to fabricate an SHS Al-5%Ti-1%B master alloy, to analyze its structure and to test its grain refining performance