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

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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

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.

Water pipe (Shisha, Hookah, Arghile) Smoking and Secondhand Tobacco Smoke Effects on CYP1A2 and CYP2A6 Phenotypes as Measured by Caffeine Urine Test.

Science.gov (United States)

Yılmaz, Şenay Görücü; Llerena, Adrián; De Andrés, Fernando; Karakaş, Ümit; Gündoğar, Hasan; Erciyas, Kamile; Kimyon, Sabit; Mete, Alper; Güngör, Kıvanç; Özdemir, Vural

2017-03-01

Public policies to stop or reduce cigarette smoking and exposure to secondhand smoke and associated diseases have yielded successful results over the past decade. Yet, the growing worldwide popularity of another form of tobacco consumption, water pipe smoking, has received relatively less attention. To the best of our knowledge, no study to date has evaluated the effects of water pipe smoking on cytochrome P450 (CYP450) activities and drug interaction potential in humans, whereas only limited information is available on the impact of secondhand smoke on drug metabolism. In a sample of 99 healthy volunteers (28 water pipe smokers, 30 secondhand tobacco smoke exposed persons, and 41 controls), we systematically compared CYP1A2 and CYP2A6 enzyme activities in vivo using caffeine urine test. The median self-reported duration of water pipe smoking was 7.5 h/week and 3 years of exposure in total. The secondhand smoke group had a median of 14 h of self-reported weekly exposure to tobacco smoke indoor where a minimum of five cigarettes were smoked/hour for a total of 3.5 years (median). Analysis of variance did not find a significant difference in CYP1A2 and CYP2A6 activities among the three study groups (p > 0.05). Nor was there a significant association between the extent of water pipe or secondhand smoke exposure and the CYP1A2 and CYP2A6 activities (p > 0.05). Further analysis in a subsample with smoke exposure more than the median values also did not reveal a significant difference from the controls. Although we do not rule out an appreciable possible impact of water pipe smoke and secondhand smoke on in vivo activities of these two drug metabolism pathways, variability in smoke constituents from different tobacco consumption methods (e.g., water pipe) might affect drug metabolism in ways that might differ from that of cigarette smoke. Further studies in larger prospective samples are recommended to evaluate water pipe and secondhand tobacco smoke effects

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 among nonsmoking adults in two ...

African Journals Online (AJOL)

2011-06-15

Jun 15, 2011 ... population of two Nigerian cities: Enugu and Ilorin. ... Keywords: Environmental tobacco smoke, Nigeria, secondhand smoke, smoking ban, tobacco control. Résumé ..... China,[20] 68% in Seoul city of South Korea[21] and.

Secondhand tobacco smoke in public venues in three Indonesian cities

Directory of Open Access Journals (Sweden)

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

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.

Legislative smoking bans for reducing exposure to secondhand smoke and smoking prevalence: Opportunities for Georgians.

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Coughlin, Steven S; Anderson, Jennifer; Smith, Selina A

2015-01-01

Secondhand smoke, which is also referred to as environmental tobacco smoke and passive smoke, is a known human carcinogen. Secondhand smoke also causes disease and premature death in nonsmoking adults and children. We summarize studies of secondhand smoke in public places before and after smoking bans, as well as studies of cardiovascular and respiratory disease before and after such bans. To protect the public from the harmful effects of secondhand smoke, smoke-free legislation is an effective public health measure. Smoking bans in public places, which have been implemented in many jurisdictions across the U.S. and in other countries, have the potential to influence social norms and reduce smoking behavior. Through legislative smoking bans for reducing secondhand smoke exposure and smoking prevalence, opportunities exist to protect the health of Georgians and other Americans and to reduce health care costs. These opportunities include increasing the comprehensiveness of smoking bans in public places and ensuring adequate funding to quit line services.

Tobacco use and second-hand smoke exposure in young adolescents aged 12-15 years: data from 68 low-income and middle-income countries.

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Xi, Bo; Liang, Yajun; Liu, Yunxia; Yan, Yinkun; Zhao, Min; Ma, Chuanwei; Bovet, Pascal

2016-11-01

Tobacco use is an important risk factor for non-communicable diseases worldwide. However, the global extent and prevalence of tobacco use in adolescents is poorly described. Using previously collected survey data, we aimed to assess tobacco use and second-hand smoke exposure in young adolescents aged 12-15 years in 68 low-income and middle-income countries. We used data from the Global School-based Student Health Survey (2006-13) and the China Global Tobacco Youth Survey (2013), which are school-based surveys of young adolescents aged 12-15 years that assess health behaviours using a standardised, anonymous, self-reported questionnaire. We calculated the prevalence of current tobacco use and exposure to second-hand smoke in young adolescents from 68 low-income and middle-income countries that collected these data in the surveys. We used a multilevel model to estimate the association between parental tobacco use, second-hand smoke, and adolescent tobacco use, adjusting for sex, age, school, school class, country's purchasing power parity, smoking initiation age, national prevalence of tobacco use among adults, year the WHO FCTC was ratified for each country, proxy of socioeconomic status, and survey year. The mean prevalence of current tobacco use was 13·6%, ranging from 2·8% in Tajikistan to 44·7% in Samoa. In most countries, the prevalence of tobacco use was higher for boys than girls, and higher for adolescents aged 14-15 years than for those aged 12-13 years. The overall prevalence of second-hand smoke exposure was 55·9%, ranging from 16·4% in Tajikistan to 85·4% in Indonesia. Parental tobacco use (as reported by the young adolescents), especially maternal use, was associated with tobacco use in young adolescents (odds ratio 2·06, 95% CI 1·93-2·19, for maternal and 1·29, 1·23-1·35 for paternal use). Second-hand smoke exposure was also a risk factor for young adolescents' tobacco use (2·56, 2·43-2·69). However, the prevalence of tobacco use was not

Caregivers' interest in using smokeless tobacco products: Novel methods that may reduce children's exposure to secondhand smoke.

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Wagener, Theodore L; Tackett, Alayna P; Borrelli, Belinda

2016-10-01

The study examined caregivers' interest in using potentially reduced exposure tobacco products for smoking cessation, reduction, and to help them not smoke in places such as around their child, as all three methods would potentially lead to reduced secondhand smoke exposure for their children. A sample of 136 caregivers completed carbon monoxide testing to assess smoking status and a brief survey. Few caregivers had ever used potentially reduced exposure tobacco products (smoke around their child or in the home (55%). Caregivers less motivated to quit smoking and with no home smoking ban were more interested in using potentially reduced exposure tobacco products to help them quit/stay quit from smoking (p < .05). © The Author(s) 2015.

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

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Frazer, Kate; Callinan, Joanne E; McHugh, Jack; van Baarsel, Susan; Clarke, Anna; Doherty, Kirsten; Kelleher, Cecily

2016-02-04

Smoking bans have been implemented in a variety of settings, as well as being part of policy in many jurisdictions to protect the public and employees from the harmful effects of secondhand smoke (SHS). They also offer the potential to influence social norms and the smoking behaviour of those populations they affect. Since the first version of this review in 2010, more countries have introduced national smoking legislation banning indoor smoking. To assess the effects of legislative smoking bans on (1) morbidity and mortality from exposure to secondhand smoke, and (2) smoking prevalence and tobacco consumption. We searched the Cochrane Tobacco Addiction Group Specialised Register, MEDLINE, EMBASE, PsycINFO, CINAHL and reference lists of included studies. We also checked websites of various organisations. Date of most recent search; February 2015. We considered studies that reported legislative smoking bans affecting populations. The minimum standard was having an indoor smoking ban explicitly in the study and a minimum of six months follow-up for measures of smoking behaviour. Our search included a broad range of research designs including: randomized controlled trials, quasi-experimental studies (i.e. non-randomized controlled studies), controlled before-and-after studies, interrupted time series as defined by the Cochrane Effective Practice and Organisation of Care Group, and uncontrolled pre- and post-ban data. One author extracted characteristics and content of the interventions, participants, outcomes and methods of the included studies and a second author checked the details. We extracted health and smoking behaviour outcomes. We did not attempt a meta-analysis due to the heterogeneity in design and content of the studies included. We evaluated the studies using qualitative narrative synthesis. There are 77 studies included in this updated review. We retained 12 studies from the original review and identified 65 new studies. Evidence from 21 countries is

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

Secondhand tobacco exposure is associated with nonalcoholic fatty liver disease in children

International Nuclear Information System (INIS)

Lin, Connie; Rountree, Carl B.; Methratta, Sosamma; LaRusso, Salvatore; Kunselman, Allen R.; Spanier, Adam J.

2014-01-01

Background: Nonalcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in children in the United States, and prevalence rates are rising. Smoking is associated with NAFLD, but the association of secondhand smoke exposure with NAFLD is unknown. Aims: To investigate the association of secondhand tobacco exposure with NAFLD in children. Methods: We surveyed parents/guardians of 304 children aged 3–12 years who had received an abdominal ultrasound at Penn State Hershey Medical Center. The survey addressed demographics, medical history, secondhand tobacco exposure, activity level, screen viewing time and other environmental exposures. A pediatric radiologist and sonographer reviewed the ultrasounds to grade the presence of bight liver compatible with NAFLD. We conducted logistic regression analysis to assess the association of secondhand tobacco exposure and NAFLD. Results: 54% of eligible potential participants responded to the survey. Fatty liver was present in 3% of the children. Increasing child age was associated with increased odds of NAFLD (OR 1.63 95% CI 1.1, 2.4). Reported child obesity was associated with increased odds of NAFLD (OR 44.5 95% CI 5.3, 371.7). The rate of NAFLD was higher in the smoke exposed group (6.7% vs. 1.7%). For every extra pack per day smoked at home, the odds of a child having NAFLD increased 1.8 times (AOR 1.8, 95% CI 1.2, 2.8), and any exposure increased a child's odds of NAFLD four-fold (AOR 4.0, 95% CI 1.02, 15.8). Conclusion: We found an association of secondhand smoke exposure and NAFLD in children. This may represent an area for future prevention efforts. - Highlights: • We evaluated the relation of tobacco exposure with nonalcoholic fatty liver disease. • Tobacco smoke exposure was associated with nonalcoholic fatty liver disease. • Tobacco smoke exposure may be an addressable risk factor

Secondhand tobacco exposure is associated with nonalcoholic fatty liver disease in children

Energy Technology Data Exchange (ETDEWEB)

Lin, Connie [College of Medicine, Penn State University Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033-0850 (United States); Rountree, Carl B. [Department of Pediatrics, Penn State University Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033-0850 (United States); Department of Pediatrics, Bon Secour St. Mary' s Hospital, 5801 Bremo Rd, Richmond, VA 23226 (United States); Methratta, Sosamma [Department of Pediatrics, Penn State University Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033-0850 (United States); Department of Radiology, Penn State University Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033-0850 (United States); LaRusso, Salvatore [Department of Radiology, Penn State University Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033-0850 (United States); Kunselman, Allen R. [Department of Public Health Sciences, Penn State University Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033-0850 (United States); Spanier, Adam J., E-mail: aspanier@hmc.psu.edu [Department of Pediatrics, Penn State University Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033-0850 (United States); Department of Public Health Sciences, Penn State University Hershey Medical Center, 500 University Drive, PO Box 850, Hershey, PA 17033-0850 (United States)

2014-07-15

Background: Nonalcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in children in the United States, and prevalence rates are rising. Smoking is associated with NAFLD, but the association of secondhand smoke exposure with NAFLD is unknown. Aims: To investigate the association of secondhand tobacco exposure with NAFLD in children. Methods: We surveyed parents/guardians of 304 children aged 3–12 years who had received an abdominal ultrasound at Penn State Hershey Medical Center. The survey addressed demographics, medical history, secondhand tobacco exposure, activity level, screen viewing time and other environmental exposures. A pediatric radiologist and sonographer reviewed the ultrasounds to grade the presence of bight liver compatible with NAFLD. We conducted logistic regression analysis to assess the association of secondhand tobacco exposure and NAFLD. Results: 54% of eligible potential participants responded to the survey. Fatty liver was present in 3% of the children. Increasing child age was associated with increased odds of NAFLD (OR 1.63 95% CI 1.1, 2.4). Reported child obesity was associated with increased odds of NAFLD (OR 44.5 95% CI 5.3, 371.7). The rate of NAFLD was higher in the smoke exposed group (6.7% vs. 1.7%). For every extra pack per day smoked at home, the odds of a child having NAFLD increased 1.8 times (AOR 1.8, 95% CI 1.2, 2.8), and any exposure increased a child's odds of NAFLD four-fold (AOR 4.0, 95% CI 1.02, 15.8). Conclusion: We found an association of secondhand smoke exposure and NAFLD in children. This may represent an area for future prevention efforts. - Highlights: • We evaluated the relation of tobacco exposure with nonalcoholic fatty liver disease. • Tobacco smoke exposure was associated with nonalcoholic fatty liver disease. • Tobacco smoke exposure may be an addressable risk factor.

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.

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 ...

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

Science.gov (United States)

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.

Exposure to Secondhand Smoke Impairs Fracture Healing in Rats.

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Santiago, Hildemberg A R; Zamarioli, Ariane; Sousa Neto, Manoel D; Volpon, Jose B

2017-03-01

Nonsmokers may be affected by environmental tobacco smoke (secondhand smoke), but the effects of such exposure on fracture healing have not been well studied. To explore the possible effects of passive inhalation of tobacco smoke on the healing of a diaphyseal fracture in femurs of rats. We hypothesized that secondhand exposure to tobacco smoke adversely affects fracture healing. A mid-diaphyseal fracture was created in the femur of 41 female Wistar rats and fixed with an intramedullary metallic pin; 14 rats were excluded (nine for inadequate fractures and five for K wire extrusion). Tobacco exposure was provided by a smoking machine on a daily basis of four cigarettes a day. Each cigarette yielded 10 mg tar and 0.8 mg nicotine, and was puffed by alternating injections of fresh air for 30 seconds and smoke air for 15 seconds. The smoke exposure was previously adjusted to provide serum levels of cotinine similar to human secondhand tobacco exposure. Cotinine is a predominant catabolite of nicotine that is used as a biological biomarker for exposure to tobacco smoke. In one group (n = 11), the animals were intermittently exposed to tobacco smoke before sustaining the fracture but not afterward. In another group (n = 7), the exposure occurred before and after the fracture. The control group (n = 9) was sham-exposed before and after the fracture. We evaluated the specimens 28 days after bone fracture. The callus quality was measured by dual-energy x-ray absorptiometry (bone mineral density [BMD], bone mineral content [BMC], and callus area), μCT (callus volume and woven bone fraction), and mechanical bending (maximum force and stiffness). Tobacco exposure resulted in delayed bone callus formation, which is represented by decreased BMD (Control: 0.302 ± 0.008 g/cm 2 vs Preexposed: 0.199 ± 0.008 g/cm 2 and Pre- and Postexposed: 0.146 ± 0.009 g/cm 2 ; mean difference = 0.103 g/cm 2 , 95% CI, 0.094-0.112 g/cm 2 and mean difference = 0.156 g/cm 2 , 95% CI, 0.147-0.167 g

Place and Policy: Secondhand Smoke Exposure in Bars and Restaurants.

Science.gov (United States)

Buettner-Schmidt, Kelly; Boursaw, Blake; Lobo, Marie L

2018-06-04

Rural populations have been identified as having tobacco use disparities, with contributing factors including less demand for policy change than in urban areas, resulting in higher age-adjusted death rates related to tobacco use. In 2012, the rural state of North Dakota enacted a statewide comprehensive law requiring all bars and restaurants to be smoke-free. The purpose of this longitudinal study, performed in three phases, was to assess the continued effects of a statewide comprehensive smoke-free law in a primarily rural state, using a stratified random sample. Particulate matter and compliance indicators were assessed in restaurants and bars 21 months after enactment of the comprehensive law. Results were compared with the findings from the Phase 1 and Phase 2 samples, in which venues were assessed before passage of the law and approximately 3 months after enactment, respectively. The comprehensive, statewide, smoke-free law led to immediate, sustained, and substantial reductions in secondhand smoke and eliminated previous significant disparities in secondhand smoke exposure in rural communities. Although indoor smoke-free compliance with the law was generally high, compliance in required outdoor smoke-free areas was low. Compliance with signage requirements, both indoors and outdoors, was low. The comprehensive statewide smoke-free law created a just distribution of smoke-free laws statewide, resulting in increased protection of rural populations from secondhand smoke. Targeted public health interventions to address compliance may reduce secondhand smoke levels in outlier venues that continue to have high levels of secondhand smoke.

Smoking and Tobacco Use: How to Quit

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... for State Tobacco Control Programs Basic Information Health Effects Cancer Heart Disease and Stroke Chronic Obstructive Pulmonary Disease (COPD) Smoking During Pregnancy Secondhand Smoke Smokeless Products Electronic Cigarettes Youth Tobacco Prevention Tobacco ...

Physical, behavioral, and cognitive effects of prenatal tobacco and postnatal secondhand smoke exposure.

Science.gov (United States)

Zhou, Sherry; Rosenthal, David G; Sherman, Scott; Zelikoff, Judith; Gordon, Terry; Weitzman, Michael

2014-09-01

The purpose of this review is to examine the rapidly expanding literature regarding the effects of prenatal tobacco and postnatal secondhand smoke (SHS) exposure on child health and development. Mechanisms of SHS exposure are reviewed, including critical periods during which exposure to tobacco products appears to be particularly harmful to the developing fetus and child. The biological, biochemical, and neurologic effects of the small fraction of identified components of SHS are described. Research describing these adverse effects of both in utero and childhood exposure is reviewed, including findings from both animal models and humans. The following adverse physical outcomes are discussed: sudden infant death syndrome, low birth weight, decreased head circumference, respiratory infections, otitis media, asthma, childhood cancer, hearing loss, dental caries, and the metabolic syndrome. In addition, the association between the following adverse cognitive and behavioral outcomes and such exposures is described: conduct disorder, attention-deficit/hyperactivity disorder, poor academic achievement, and cognitive impairment. The evidence supporting the adverse effects of SHS exposure is extensive yet rapidly expanding due to improving technology and increased awareness of this profound public health problem. The growing use of alternative tobacco products, such as hookahs (a.k.a. waterpipes), and the scant literature on possible effects from prenatal and secondhand smoke exposure from these products are also discussed. A review of the current knowledge of this important subject has implications for future research as well as public policy and clinical practice. Published by Mosby, Inc.

Levels of Urine Cotinine from Hookah Smoking and Exposure to Hookah Tobacco Secondhand Smoke in Hookah Lounges and Homes.

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Kassem, Nada O F; Kassem, Noura O; Liles, Sandy; Jackson, Sheila R; Posis, Alexander Ivan B; Chatfield, Dale A; Hovell, Melbourne F

2018-03-01

Nicotine, an addictive drug, is present in all forms of tobacco products, including hookah tobacco, which is not yet regulated in the United States. This study aimed to investigate the uptake of nicotine in hookah smokers and non-smokers exposed to secondhand smoke (SHS) at indoor hookah social events in natural settings where hookah tobacco was smoked exclusively. We quantified cotinine, a metabolite of nicotine, in the urine of 105 hookah smokers and 103 non-smokers. Participants provided spot urine samples the morning of and the morning after attending an indoor hookah-only smoking social event at a hookah lounge or in a private home. Following a social event where exclusively hookah tobacco was smoked, urinary cotinine levels increased significantly 8.5 times (geometric mean (GM): 16.0 ng/mg to 136.1 ng/mg) among hookah smokers, and 2.5 times (GM: 0.4 ng/mg to 1.0 ng/mg) among non-smokers exposed exclusively to hookah tobacco SHS. Among hookah smokers, the highest increase in urinary cotinine levels post a hookah event was found in occasional hookah smokers in which GM levels increased significantly 31.2 times post smoking (from 2.0 ng/mg to 62.3 ng/mg). Reported reasons for preference to smoke hookah at home by hookah smokers who attended a hookah social event in a private home included recreational purposes, socializing with friends and family, 'Me' time and relaxing at home, more comfortable to smoke hookah at home, owning a hookah and hookah tobacco, eating and drinking while smoking hookah, and saving money by smoking at home and not going to hookah lounges. Hookah tobacco smoke is a source of substantial nicotine exposure. Our results call for protecting hookah smokers' and non-smokers' health by requiring accurate hookah tobacco labels, raising taxes on hookah tobacco, reducing the spread of hookah lounges, and encouraging voluntary bans on smoking hookah tobacco in private homes.

Sex, gender, and secondhand smoke policies: implications for disadvantaged women.

Science.gov (United States)

Greaves, Lorraine J; Hemsing, Natalie J

2009-08-01

Although implementation of secondhand smoke policies is increasing, little research has examined the unintended consequences of these policies for disadvantaged women. Macro-, meso-, and micro-level issues connected to secondhand smoke and women are considered to illustrate the range of ways in which sex, gender, and disadvantage affect women's exposure to secondhand smoke. A review of current literature, primarily published between 2000 and 2008, on sex- and gender-based issues related to secondhand smoke exposure and the effects of secondhand smoke policies for various subpopulations of women, including low-income girls and women, nonwhite minority women, and pregnant women, was conducted in 2008. These materials were critically analyzed using a sex and gender analysis, allowing for the drawing of inferences and reflections on the unintended effects of secondhand smoke policies on disadvantaged women. Smoke-free policies do not always have equal or even desired effects on low-income girls and women. Low-income women are more likely to be exposed to secondhand smoke, may have limited capacity to manage their exposure to secondhand smoke both at home and in the workplace, and may experience heightened stigmatization as a result of secondhand smoke policies. Various sex- and gender-related factors, such as gendered roles, unequal power differences between men and women, child-caring roles, and unequal earning power, affect exposure and responses to secondhand smoke, women's capacity to control exposure, and their responses to protective policies. In sum, a much more nuanced gender- and diversity-sensitive framework is needed to develop research and tobacco control policies that address these issues.

Tobacco use, exposure to secondhand smoke, and cessation counseling training of dental students around the world.

Science.gov (United States)

Warren, Charles W; Sinha, Dhirendra N; Lee, Juliette; Lea, Veronica; Jones, Nathan; Asma, Samira

2011-03-01

The Global Health Professions Student Survey (GHPSS) has been conducted among third-year dental students in schools in forty-four countries, the Gaza Strip/West Bank, and three cities (Baghdad, Rio de Janeiro, and Havana) (all called "sites" in this article). In more than half the sites, over 20 percent of the students currently smoked cigarettes, with males having higher rates than females in thirty sites. Over 60 percent of students reported having been exposed to secondhand smoke in public places in thirty-seven of forty-eight sites. The majority of students recognized that they are role models in society and believed they should receive training on counseling patients to quit using tobacco, but few reported receiving formal training. Tobacco control efforts must discourage tobacco use among dentists, promote smoke-free workplaces, and implement programs that train dentists in effective cessation-counseling techniques.

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.

Reduction of secondhand tobacco smoke in public places following national smoke-free legislation in Uruguay.

Science.gov (United States)

Blanco-Marquizo, Adriana; Goja, Beatriz; Peruga, Armando; Jones, Miranda R; Yuan, Jie; Samet, Jonathan M; Breysse, Patrick N; Navas-Acien, Ana

2010-06-01

Smoke-free legislation eliminating tobacco smoke in all indoor public places and workplaces is the international standard to protect all people from exposure to secondhand smoke. Uruguay was the first country in the Americas and the first middle-income country in the world to enact a comprehensive smoke-free national legislation in March 2006. To compare air nicotine concentrations measured in indoor public places and workplaces in Montevideo, Uruguay before (November 2002) and after (July 2007) the implementation of the national legislation. Air nicotine concentrations were measured for 7-14 days using the same protocol in schools, a hospital, a local government building, an airport and restaurants and bars. A total of 100 and 103 nicotine samples were available in 2002 and 2007, respectively. Median (IQR) air nicotine concentrations in the study samples were 0.75 (0.2-1.54) microg/m(3) in 2002 compared to 0.07 (0.0-0.20) microg/m(3) in 2007. The overall nicotine reduction comparing locations sampled in 2007 to those sampled in 2002 was 91% (95% CI 85% to 94%) after adjustment for differences in room volume and ventilation. The greatest nicotine reduction was observed in schools (97% reduction), followed by the airport (94% reduction), the hospital (89% reduction), the local government building (86% reduction) and restaurants/bars (81% reduction). Exposure to secondhand smoke has decreased greatly in indoor public places and workplaces in Montevideo, Uruguay, after the implementation of a comprehensive national smoke-free legislation. These findings suggest that it is possible to successfully implement smoke-free legislations in low and middle-income countries.

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

Science.gov (United States)

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.

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; 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.

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.

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

Impact of institutional smoking bans on reducing harms and secondhand smoke exposure.

Science.gov (United States)

Frazer, Kate; McHugh, Jack; Callinan, Joanne E; Kelleher, Cecily

2016-05-27

Smoking bans or restrictions can assist in eliminating nonsmokers' exposure to the dangers of secondhand smoke and can reduce tobacco consumption amongst smokers themselves. Evidence exists identifying the impact of tobacco control regulations and interventions implemented in general workplaces and at an individual level. However, it is important that we also review the evidence for smoking bans at a meso- or organisational level, to identify their impact on reducing the burden of exposure to tobacco smoke. Our review assesses evidence for meso- or organisational-level tobacco control bans or policies in a number of specialist settings, including public healthcare facilities, higher education and correctional facilities. To assess the extent to which institutional smoking bans may reduce passive smoke exposure and active smoking, and affect other health-related outcomes. We searched the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE, EMBASE, and the reference lists of identified studies. We contacted authors to identify completed or ongoing studies eligible for inclusion in this review. We also checked websites of state agencies and organisations, such as trial registries. Date of latest searches was 22nd June 2015. We considered studies that reported the effects of tobacco bans or policies, whether complete or partial, on reducing secondhand smoke exposure, tobacco consumption, smoking prevalence and other health outcomes, in public healthcare, higher educational and correctional facilities, from 2005 onwards.The minimum standard for inclusion was having a settings-level policy or ban implemented in the study, and a minimum of six months follow-up for measures of smoking behaviour. We included quasi-experimental studies (i.e. 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. Two or more review authors independently

Exposure to Secondhand Smoke Among Nonsmokers in New York City in the Context of Recent Tobacco Control Policies: Current Status, Changes Over the Past Decade, and National Comparisons.

Science.gov (United States)

Perlman, Sharon E; Chernov, Claudia; Farley, Shannon M; Greene, Carolyn M; Aldous, Kenneth M; Freeman, Amy; Rodriguez-Lopez, Jesica; Thorpe, Lorna E

2016-11-01

Exposure to secondhand smoke is hazardous and can cause cancer, coronary heart disease, and birth defects. New York City (NYC) and other jurisdictions have established smoke-free air laws in the past 10-15 years. NYC Health and Nutrition Examination Survey (HANES) 2013-2014 was a population-based survey of NYC residents, aged 20 years and older, in which biospecimens were collected and cotinine levels were measured. Secondhand smoke exposure was assessed by demographics and risk factors and compared with that from NYC HANES 2004 and national HANES. More than a third (37.1%, 95% confidence interval [CI] = 33.3%-41.2%) of nonsmoking adult New Yorkers were exposed to secondhand smoke, defined as a cotinine level of 0.05-10ng/mL. This was significantly lower than in 2004 NYC HANES, when 56.7% (95% CI = 53.6%-59.7%) of nonsmokers were exposed to secondhand smoke, but was greater than the proportion of adults exposed nationwide, as measured by national HANES (24.4%, 95% CI = 22.0%-26.9% in 2011-2012). Men, non-Hispanic blacks, adults aged 20-39, those with less education, and those living in high-poverty neighborhoods were more likely to be exposed. There has been a large decrease in secondhand smoke exposure in NYC, although disparities persist. The decrease may be the result of successful policies to limit exposure to secondhand smoke in public places and of smokers smoking fewer cigarettes per day. Yet NYC residents still experience more secondhand smoke exposure than US residents overall. Possible explanations include multiunit housing, greater population density, and pedestrian exposure. Measuring exposure to secondhand smoke can be difficult, and few studies have monitored changes over time. This study uses serum cotinine, a nicotine metabolite, from a local population-based examination survey, the NYC HANES 2013-2014, to examine exposure to secondhand smoke in an urban area that has implemented stringent antismoking laws. Comparison with NYC HANES conducted 10

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...

Setting the Record Straight: Secondhand Smoke is a Preventable Health Risk

Science.gov (United States)

This report concludes that exposure to environmental tobacco smoke (ETS), commonly known as secondhand smoke, is responsible for approximately 3,000 lung cancer deaths each year in nonsmoking adults and impairs respiratory health.

Acrolein Exposure in Hookah Smokers and Non-Smokers Exposed to Hookah Tobacco Secondhand Smoke: Implications for Regulating Hookah Tobacco Products.

Science.gov (United States)

Kassem, Nada O F; Kassem, Noura O; Liles, Sandy; Zarth, Adam T; Jackson, Sheila R; Daffa, Reem M; Chatfield, Dale A; Carmella, Steven G; Hecht, Stephen S; Hovell, Melbourne F

2018-03-06

Acrolein is a highly ciliatoxic agent, a toxic respiratory irritant, a cardiotoxicant, and a possible carcinogen present in tobacco smoke including hookah tobacco. 105 hookah smokers and 103 non-smokers attended exclusively hookah smoking social events at either a hookah lounge or private home, and provided urine samples the morning of and the morning after the event. Samples were analyzed for 3-hydroxypropylmercapturic acid (3-HPMA), a metabolite of acrolein. Geometric mean (GM) urinary 3-HPMA levels in hookah smokers and non-smokers exposed to secondhand smoke (SHS) increased significantly, 1.41 times, 95% CI = 1.15 to 1.74 and 1.39 times, 95% CI = 1.16 to 1.67, respectively, following a hookah social event. The highest increase (1.68 times, 95% CI = 1.15 to 2.45; p = 0.007) in 3-HPMA post a hookah social event was among daily hookah smokers (GM, from 1991 pmol/mg to 3348 pmol/mg). Pre-to-post event change in urinary 3-HPMA was significantly positively correlated with pre-to-post event change in urinary cotinine among hookah smokers at either location of hookah event, (ρ = 0.359, p = 0.001), and among non-smokers in hookah lounges (ρ = 0.369, p = 0.012). Hookah tobacco smoke is a source of acrolein exposure. Findings support regulating hookah tobacco products including reducing humectants and sugar additives, which are precursors of acrolein under certain pyrolysis conditions. We suggest posting health warning signs for indoor smoking in hookah lounges, and encouraging voluntary bans of smoking hookah tobacco in private homes. Our study is the first to quantify the increase in acrolein exposure in hookah smokers and non-smokers exposed to exclusively hookah tobacco SHS at hookah social events in homes or hookah lounges. Our findings provide additional support for regulating hookah tobacco product content, protecting non-smokers' health by posting health warning signs for indoor smoking in hookah lounges, and encouraging home bans on hookah tobacco smoking to

Coaching to Create a Smoke-Free Home in a Brief Secondhand Smoke Intervention

Science.gov (United States)

Escoffery, Cam; Mullen, Patricia; Genkin, Brooke; Bundy, Lucja; Owolabi, Shade; Haardörfer, Regine; Williams, Rebecca; Savas, Lara; Kegler, Michelle

2017-01-01

Few community interventions exist to reduce secondhand exposure to tobacco smoke in the home. This study presents the coaching process of a larger intervention to promote smoke-free homes across an efficacy and 2 effectiveness trials. It furthers assesses the coaching call's reach and participants' satisfaction with the call across three…

Secondhand smoke emission levels in waterpipe cafes in Doha, Qatar.

Science.gov (United States)

Al Mulla, Ahmad; Fanous, Nadia; Seidenberg, Andrew B; Rees, Vaughan W

2015-10-01

Exposure to the emissions of a tobacco waterpipe is associated with increased health risks among its users as well as those exposed to its secondhand smoke. Waterpipe use is an emerging concern to the tobacco control community, particularly among countries of the Eastern Mediterranean Region. In 2002, Qatar adopted legislation that prohibited cigarette smoking inside public venues, but exempted tobacco waterpipe smoking. To inform the development and enforcement of effective policy, the impact of cigarette and waterpipe use on indoor air quality was monitored in waterpipe cafes in Doha, Qatar. Particulate matter (PM2.5) levels were measured inside and outside of a sample of 40 waterpipe cafes and 16 smoke-free venues in Doha, Qatar between July and October 2012. In addition, the number of waterpipes being smoked and the number of cigarette smokers were counted within each venue. Non-paired and paired sample t tests were used to assess differences in mean PM2.5 measurements between venue type (waterpipe vs smoke-free) and environment (indoor vs outdoor). The mean PM2.5 level inside waterpipe venues (476 μg/m(3)) was significantly higher than the mean PM2.5 level inside smoke-free venues (17 μg/m(3); pQatar, potentially endangering the health of employees and patrons. To protect the public from the dangers of secondhand tobacco smoke, and to change social norms around tobacco use, smoke-free policies that apply to all forms of combusted tobacco products, including the waterpipe, are needed. 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 in waterpipe tobacco venues in Istanbul, Moscow, and Cairo.

Science.gov (United States)

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.

Clearing the Air: Smoke-Free Housing Policies, Smoking, and Secondhand Smoke Exposure Among Affordable Housing Residents in Minnesota, 2014-2015.

Science.gov (United States)

Kingsbury, John H; Reckinger, Dawn

2016-08-18

During the past 30 years, local and state tobacco use control laws in the United States have helped reduce smoking prevalence and exposure to secondhand smoke, but progress among low socioeconomic populations has been slow. Implementing smoke-free housing policies in affordable housing may help address this issue. The purpose of our study was to assess how such policies affect smoking rates and exposure to secondhand smoke among residents of affordable housing. We conducted a pretest-posttest longitudinal study of 180 residents from 8 affordable housing properties in Minnesota. Participating properties agreed to adopt a smoke-free housing policy covering indoor grounds, and 3 of these properties also prohibited smoking on all outdoor grounds. Policies were implemented with assistance from local public health departments and the Statewide Health Improvement Program. Participants completed surveys one month before policy implementation and 6 months postimplementation. Surveys assessed smoking, quit attempts, and indoor and outdoor secondhand smoke exposure. Results indicated a significant reduction in nonsmokers' indoor exposure to secondhand smoke (F1,144 = 22.69, P exposure to secondhand smoke from Time 1 (pretest) to Time 2 (posttest) (F1,140 = 2.17, P = .14). However, when examining sites that only prohibited smoking indoors, we observed an increase in outdoor secondhand smoke exposure that approached significance (F1,118 = 3.76, P = .055). Results showed no change in quit attempts over time, but 77% of residents who smoked at pretest reported reducing the amount that they smoked at posttest, and an additional 5% reported that they had quit. Smoke-free housing policies may be an effective strategy to reduce exposure to indoor secondhand exposure and promote decreased cigarette smoking among residents of affordable housing.

Occupational secondhand smoke is the main determinant of hair nicotine concentrations in bar and restaurant workers

Science.gov (United States)

Iglesias, Verónica; Erazo, Marcia; Droppelmann, Andrea; Steenland, Kyle; Aceituno, Paulina; Orellana, Cecilia; Acuña, Marisol; Peruga, Armando; Breysse, Patrick N.; Navas-Acien, Ana

2015-01-01

Objective To evaluate the relative contribution of occupational vs. non-occupational secondhand tobacco smoke exposure to overall hair nicotine concentrations in non-smoking bar and restaurant employees. Method We recruited 76 non-smoking employees from venues that allowed smoking (n = 9), had mixed policies (smoking and non-smoking areas, n = 13) or were smoke-free (n = 2) between April and August 2008 in Santiago, Chile. Employees used personal air nicotine samplers during working and non-working hours for a 24-h period to assess occupational vs. non-occupational secondhand tobacco smoke exposure and hair nicotine concentrations to assess overall secondhand tobacco smoke exposure. Results Median hair nicotine concentrations were 1.5 ng/mg, interquartile range (IQR) 0.7 to 5.2 ng/mg. Time weighted average personal air nicotine concentrations were higher during working hours (median 9.7, IQR 3.3-25.4 μg/m3) compared to non-working hours (1.7, 1.0-3.1 μg/m3). Hair nicotine concentration was best predicted by personal air nicotine concentration at working hours. After adjustment, a 2-fold increase in personal air nicotine concentration in working hours was associated with a 42% increase in hair nicotine concentration (95% confidence interval 14-70%). Hair nicotine concentration was not associated with personal air nicotine concentration during non-working hours (non-occupational exposure). Conclusions Personal air nicotine concentration at working hours was the major determinant of hair nicotine concentrations in non-smoking employees from Santiago, Chile. Secondhand tobacco smoke exposure during working hours is a health hazard for hospitality employees working in venues where smoking is allowed. PMID:24813578

Clearing the Air: Smoke-Free Housing Policies, Smoking, and Secondhand Smoke Exposure Among Affordable Housing Residents in Minnesota, 2014–2015

Science.gov (United States)

Reckinger, Dawn

2016-01-01

Introduction During the past 30 years, local and state tobacco use control laws in the United States have helped reduce smoking prevalence and exposure to secondhand smoke, but progress among low socioeconomic populations has been slow. Implementing smoke-free housing policies in affordable housing may help address this issue. The purpose of our study was to assess how such policies affect smoking rates and exposure to secondhand smoke among residents of affordable housing. Methods We conducted a pretest–posttest longitudinal study of 180 residents from 8 affordable housing properties in Minnesota. Participating properties agreed to adopt a smoke-free housing policy covering indoor grounds, and 3 of these properties also prohibited smoking on all outdoor grounds. Policies were implemented with assistance from local public health departments and the Statewide Health Improvement Program. Participants completed surveys one month before policy implementation and 6 months postimplementation. Surveys assessed smoking, quit attempts, and indoor and outdoor secondhand smoke exposure. Results Results indicated a significant reduction in nonsmokers’ indoor exposure to secondhand smoke (F 1,144 = 22.69, P secondhand smoke from Time 1 (pretest) to Time 2 (posttest) (F 1,140 = 2.17, P = .14). However, when examining sites that only prohibited smoking indoors, we observed an increase in outdoor secondhand smoke exposure that approached significance (F 1,118 = 3.76, P = .055). Results showed no change in quit attempts over time, but 77% of residents who smoked at pretest reported reducing the amount that they smoked at posttest, and an additional 5% reported that they had quit. Conclusions Smoke-free housing policies may be an effective strategy to reduce exposure to indoor secondhand exposure and promote decreased cigarette smoking among residents of affordable housing. PMID:27536903

Secondhand Smoke

Science.gov (United States)

... to not allow smoking indoors. Separating smokers from non-smokers (like “no smoking” sections in restaurants)‚ cleaning the air‚ and airing out buildings does not get rid of secondhand smoke. Other Ways Smoking Affects Others Smoking affects the people in your life ...

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.

Science.gov (United States)

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.

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

Directory of Open Access Journals (Sweden)

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

Vital Signs-Secondhand Smoke

Centers for Disease Control (CDC) Podcasts

This podcast is based on the February 2015 CDC Vital Signs report. Secondhand smoke kills more than 400 infants and 41,000 adult nonsmokers every year. Learn what can be done to prevent secondhand smoke exposure.

Gender differences in first and secondhand smoke exposure, spirometric lung function and cardiometabolic health in the old order Amish: A novel population without female smoking.

Science.gov (United States)

Reed, Robert M; Dransfield, Mark T; Eberlein, Michael; Miller, Michael; Netzer, Giora; Pavlovich, Mary; Pollin, Toni I; Scharf, Steven M; Shuldiner, Alan R; Sin, Don; Mitchell, Braxton D

2017-01-01

Due to their relatively homogeneous lifestyle and living environment, the Amish offer a novel opportunity to study the health associations of tobacco smoke exposure, particularly secondhand smoke. We hypothesized that secondhand smoke exposure is associated with worse pulmonary and cardiometabolic health. We examined cross-sectional data on 3568 Amish study participants, including tobacco use and secondhand smoke exposure from family members included in the study. Thirty-four percent of Amish men reported ever smoking. Of this proportion, 64% used cigars, 46% cigarettes, and 21% pipes. Less than 1% of women reported ever smoking. Smoking was associated with lower spirometric lung function, higher body mass index, lower HDL cholesterol, higher heart rate, lower ankle-brachial index, and larger aortic diameter in men. A greater number of sources of secondhand smoke exposure (defined from the total of spouses, parents, and siblings who smoke) was associated with higher body mass index (p = 0.03) and with higher fasting glucose in men (p = 0.01), but not in women (p = 0.007 for sex*secondhand smoke interaction). Secondhand smoke exposure was also associated with reduced HDL cholesterol only in women (p = 0.002) and a lower heart rate only in men (p = 0.006). Smoking habits among the Old Order Amish are notable for the absence of female participation and a high proportion of cigar and pipe use. Smoking is associated with decreased spirometric indices of lung function and increased cardiovascular risk in this population and secondhand smoke exposure is associated with a greater burden of risk factors for cardiovascular disease. Sex differences in correlations could reflect differences in exposure patterns, mechanisms, or susceptibilities.

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.

Public Place Smoke-Free Regulations, Secondhand Smoke Exposure and Related Beliefs, Awareness, Attitudes, and Practices among Chinese Urban Residents

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Dan Wu

2013-06-01

Full Text Available Objective: To evaluate the association between smoke-free regulations in public places and secondhand smoke exposure and related beliefs, awareness, attitudes, and behavior among urban residents in China. Methods: We selected one city (Hangzhou as the intervention city and another (Jiaxing as the comparison. A structured self-administered questionnaire was used for data collection, and implemented at two time points across a 20-month interval. Both unadjusted and adjusted logistic methods were considered in analyses. Multiple regression procedures were performed in examining variation between final and baseline measures. Results: Smoke-free regulations in the intervention city were associated with a significant decline in personal secondhand smoke exposure in government buildings, buses or taxis, and restaurants, but there was no change in such exposure in healthcare facilities and schools. In terms of personal smoking beliefs, awareness, attitudes, and practices, the only significant change was in giving quitting advice to proximal family members. Conclusions: There was a statistically significant association between implementation of smoke-free regulations in a city and inhibition of secondhand tobacco smoking exposure in public places. However, any such impact was limited. Effective tobacco control in China will require a combination of strong public health education and enforcement of regulations.

Secondhand Smoke PSA (:60)

Centers for Disease Control (CDC) Podcasts

This 60 second public service announcement is based on the February 2015 CDC Vital Signs report. Secondhand smoke kills more than 400 infants and 41,000 adult nonsmokers every year. Learn what can be done to prevent secondhand smoke exposure.

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.

Science.gov (United States)

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.

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...

Active smoking and exposure to secondhand smoke and their relationship to depressive symptoms in the Korea national health and nutrition examination survey (KNHANES).

Science.gov (United States)

Jung, Sun Jae; Shin, Aesun; Kang, Daehee

2015-10-14

The relationship between tobacco smoking, including secondhand smoking, and depression has been assessed. The purpose of this study was to evaluate the association between secondhand smoking among current, former and never smokers and depressive symptoms. For secondhand smoking, gender differences and sources of exposure were examined. Data from 34,693 participants from the fourth and fifth Korean Health and Nutritional Examination Survey (2007-2012) were analyzed in 2014. Self-reported exposure to active (current, former or never) and secondhand smoking and depressive symptoms experienced during the past year were analyzed using logistic regression. The dose-response relationship between duration of secondhand smoke exposure and depression was assessed with stratification by gender and sources of exposure (at home only, at the workplace only or both). Regardless of their smoking status, all women who had secondhand smoke exposure at home reported more depressive symptoms than non-smoking women without any exposure to secondhand cigarette smoking (OR 1.43, 95 % CI 1.04-1.96 for current smokers; OR 2.32, 95 % CI 1.04-5.16 for former smokers; OR 1.25, 95 % CI 1.08-1.43 for never smokers). There was also a significant dose-response pattern (p-trend secondhand smoke exposure at home among women. No significant association was found between smoking and depressive symptoms in men. There was a significant association between secondhand smoke exposure at home and depressive symptoms in women. Secondhand smoke exposure at home was associated with depressive symptoms in a dose-response manner.

[Secondhand smoke in hospitality venues. Exposure, body burden, economic and health aspects in conjunction with smoking bans].

Science.gov (United States)

Fromme, H; Kuhn, J; Bolte, G

2009-04-01

Secondhand smoke was classified by national and international organisations as a known cause of cancer in humans and has many adverse health effects, especially cardiovascular diseases and lung tumours. Global studies have clearly shown that hospitality venues have the highest levels of indoor air pollution containing different substances that are clearly carcinogenic--such as tobacco-related chemicals--compared with other, smoke-free indoor spaces. Data from the human biomonitoring of non-smoking employees in the food service industry confirm this high exposure level. Non-smokers exposed to secondhand smoke in these environments are at increased risk for adverse health effects. The consistent protection of non-smokers in public places such as restaurants and bars through a smoking ban results in a significant reduction of the pollutants in the air (mostly > 90%) and clearly reduces the internal body burden for users and employees. Furthermore, health complaints by non-smoking employees are reduced and the higher risk for lung tumours of employees in the food service industry compared with the general population can be effectively reduced as well. According to current standards of knowledge, other measures such as spatial separation of smoking areas or the use of mechanical venting systems do not achieve a comparably high and effective pollutant reduction under field conditions. Studies concerning the economic effects of prohibiting smoking in public places conducted in various countries have shown that beverage-focused gastronomic enterprises experience a short-term down trend but that food-focused gastronomic enterprises do not experience any negative or even positive effects. The positive effects of a ban on smoking in public places on the general population are a decline in cigarette consumption and the reduction of secondhand smoke exposure by non-smokers. Smoking bans in hospitality venues are not necessarily linked with a shift of the tobacco consumption to

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.

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

Science.gov (United States)

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…

"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.

Determinants of exposure to second-hand tobacco smoke (SHS) among current non-smoking in-school adolescents (aged 11-18 years) in South Africa: results from the 2008 GYTS study.

Science.gov (United States)

Peltzer, Karl

2011-09-01

The aim of this study was to estimate the prevalence and identify correlates of second-hand tobacco smoke (SHS) among 6,412 current non-smoking school-going adolescents (aged 11 to 18 years) in South Africa. A cross-sectional study was carried out in 2008 in South Africa within the framework of the Global Youth Tobacco Survey. Overall, 25.7% of students were exposed to SHS at home, 34.2% outside of the home and 18.3% were exposed to SHS at home and outside of the home. Parental and close friends smoking status, allowing someone to smoke around you and perception that passive smoking was harmful were significant determinants of adolescent's exposure to both SHS at home and outside of the home. Identified factors can inform the implementation of public health interventions in order to reduce passive smoking among adolescents.

Major depression and secondhand smoke exposure.

Science.gov (United States)

Patten, Scott B; Williams, Jeanne V A; Lavorato, Dina H; Woolf, Benjamin; Wang, Jian Li; Bulloch, Andrew G M; Sajobi, Tolulope

2018-01-01

Epidemiological studies have consistently linked smoking to poor mental health. Among non-smokers, some studies have also reported associations between secondhand smoke exposure and psychological symptoms. However, an association between secondhand smoke exposure and depressive disorders has not been well established. This analysis used cross-sectional data from a series of 10 population surveys conducted in Canada between 2003 and 2013. The surveys targeted the Canadian household population, included a brief structured interview for past year major depressive episode (MDE) and included items assessing secondhand smoke exposure. We used two-stage individual-level random-effects meta-regression to synthesize results from these surveys. Over the study interval, about 20% of non-smokers reported substantial exposure to secondhand smoke. In this group, the pooled annual prevalence of MDE was 6.1% (95% CI 5.3-6.9) compared to 4.0% (95% CI 3.7-4.3) in non-smokers without secondhand smoke exposure. The crude odds ratio was 1.5 (95% CI 1.4-1.7). With adjustment for a set of potential confounding variables the odds ratio was unchanged, 1.4 (95% CI 1.2 - 1.6). These results provide additional support for public health measures aimed at reducing secondhand smoke exposure. A causal connection between secondhand smoke exposure and MDEs cannot be confirmed due to the cross-sectional nature of the data. Longitudinal studies are needed to establish temporal sequencing. Copyright © 2017 Elsevier B.V. All rights reserved.

Changes in Secondhand Smoke Exposure After Smoke-Free Legislation (Spain, 2006-2011).

Science.gov (United States)

Fernández, Esteve; Fu, Marcela; Pérez-Ríos, Mónica; Schiaffino, Anna; Sureda, Xisca; López, María J

2017-11-01

In 2011, the Spanish partial smoke-free legislation was extended to affect all enclosed settings, including hospitality venues and selected outdoor areas. This study evaluated the change in self-reported exposure to secondhand smoke among the adult, nonsmoking population. Two cross-sectional surveys were conducted on nationally representative samples of the adult (≥18 years) nonsmoking Spanish population. One was conducted in 2006 (6 months after the first ban) and the other in 2011, 6 months after the new ban was implemented. We assessed the prevalence and 95% confidence interval (CI) of self-reported exposure to secondhand smoke in various settings, and the corresponding adjusted prevalence ratios (PR) and 95% CIs. Overall, the self-reported exposure to secondhand smoke fell from 71.9% (95% CI: 70.1%-73.7%) in 2006 to 45.2% (95% CI: 43.1%-47.3%) in 2011 (PR = 0.43; 95% CI: 0.39-0.47). Specifically, self-reported exposure significantly decreased from 29.2% to 12.7% (PR = 0.36; 95% CI: 0.31-0.42) in the home, from 35.0% to 13.0% (PR = 0.40; 95% CI: 0.33-0.49) at work/education venues, from 56.2% to 32.2% (PR = 0.44; 95% CI: 0.39-0.48) during leisure time (mainly hospitality venues, but also venues other than work/education venues and home), and from 40.6% to 12.7% (PR = 0.24; 95% CI: 0.21-0.29) in transportation vehicles/stations. The prevalence of secondhand smoke exposure among nonsmokers decreased after implementation of a comprehensive smoke-free legislation in Spain. In addition to the expected reduction in exposure during leisure time, we observed reductions in settings that were not subject to the new legislation, such as homes, outdoor bus stops, and train stations. Exposure to secondhand smoke in selected outdoor settings may be further reduced by extending smoke-free legislation. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e

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

Science.gov (United States)

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.

Vital Signs-Secondhand Smoke

Centers for Disease Control (CDC) Podcasts

2015-02-03

This podcast is based on the February 2015 CDC Vital Signs report. Secondhand smoke kills more than 400 infants and 41,000 adult nonsmokers every year. Learn what can be done to prevent secondhand smoke exposure.  Created: 2/3/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 2/3/2015.

Indoor secondhand tobacco smoke and risk of under-five mortality in 23 sub-Saharan Africa countries: A population based study and meta-analysis.

Science.gov (United States)

Owili, Patrick Opiyo; Muga, Miriam Adoyo; Pan, Wen-Chi; Kuo, Hsien-Wen

2017-01-01

Inhalation of secondhand smoke from tobacco results in serious health outcomes among under-five children, and yet, few studies have assessed its effect on under-five mortality. We investigated the association between frequency of exposure to household tobacco smoke and risk of under-five mortality in sub-Saharan Africa (SSA). Demographic Health Survey data of under-five children from 23 SSA countries (n = 787,484) were used. Cox proportional hazard models described the association between exposure to tobacco smoke and the risk of under-five mortality in each country, with age as the time-to-event indicator. Meta-analysis was used to investigate the overall effect of tobacco smoke in SSA. The association between tobacco smoke exposure and the risk of under-five mortality attenuated in eight countries (Burkina Faso, Benin, Congo, Gabon, Guinea, Liberia, Togo, and Zambia) after adjustment, while the hazard ratios (HR) of daily exposure to tobacco smoke in Kenya (HR = 1.40; 95% CI, 1.16-1.70) and Namibia (HR = 1.40; 1.07-1.83) grew. The children in rural areas in SSA were 1.08 (95% CI, 1.04-1.13) times more likely to die than their urban peers. In general, the exposure to household tobacco smoke was associated with an increased risk of under-five mortality in SSA (HR = 1.09; 95% CI, 1.06-1.13). This study provided evidence of a positive association between exposure to household tobacco smoke and risk of under-five mortality in SSA. Policymakers in low- and middle-income countries, where tobacco control as a child health issue is relatively neglected, should integrate tobacco control measures with other child health promotion policies.

How do policy advisors and practitioners prioritise the protection of children from secondhand smoke exposure in a country with advanced tobacco control policy?

Science.gov (United States)

Ritchie, Deborah Doreen; Amos, Amanda; Shaw, April; O'Donnell, Rachel; Semple, Sean; Turner, Steve; Martin, Claudia

2015-01-01

The aim is to extend understanding of the policy and practice discourses that inform the development of national tobacco control policy to protect children from secondhand smoke exposure (SHSE) in the home, particularly in a country with successful implementation of smoke-free public places legislation. The Scottish experience will contribute to the tobacco control community, particularly those countries at a similar level of tobacco control, as normalising discourses about protecting children from SHSE are becoming more widespread. Case study design using qualitative interviews and focus groups (FGs) with policy makers, health and childcare practitioners during which they were presented with the findings of the Reducing Families' Exposure to Secondhand Smoke (REFRESH) intervention and discussed the implications for their policy and practice priorities. Scotland, UK PARTICIPANTS: Qualitative interviews and FGs were conducted with 30 policy makers and practitioners who were purposively recruited. Participants accepted the harm of SHSE to children; however, action is limited by political expedience due to-the perception of a shift of the public health priority from smoking to alcohol, current financial constraints, more immediate child protection concerns and continuing unresolved ethical arguments. In a country, such as Scotland, with advanced tobacco control strategies, there continue to be challenges to policy and practice development in the more contentious arena of the home. Children's SHSE in their homes is unequivocally accepted as an important health priority, but it is not currently perceived to be a top public health priority in Scotland. 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 PSA (:60)

Centers for Disease Control (CDC) Podcasts

2015-02-03

This 60 second public service announcement is based on the February 2015 CDC Vital Signs report. Secondhand smoke kills more than 400 infants and 41,000 adult nonsmokers every year. Learn what can be done to prevent secondhand smoke exposure.  Created: 2/3/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 2/3/2015.

Infertility, Pregnancy Loss and Adverse Birth Outcomes in Relation to Maternal Secondhand Tobacco Smoke Exposure

Science.gov (United States)

Meeker, John D.; Benedict, Merle D.

2013-01-01

A substantial proportion of the etiology involved in female infertility and adverse pregnancy outcomes remains idiopathic. Recent scientific research has suggested a role for environmental factors in these conditions. Secondhand tobacco smoke (STS) contains a number of known or suspected reproductive toxins, and human exposure to STS is prevalent worldwide. Robust evidence exists for the toxic effects of active smoking on fertility and pregnancy, but studies of passive exposure are much more limited in number. While the association between maternal STS exposure and declined birth weight has been fairly well-documented, only recently have epidemiologic studies begun to provide suggestive evidence for delayed conception, altered menstrual cycling, early pregnancy loss (e.g. spontaneous abortion), preterm delivery, and congenital malformations in relation to STS exposure. There is also new evidence that developmental exposures to tobacco smoke may be associated with reproductive effects in adulthood. To date, most studies have estimated maternal STS exposure through self-report even though exposure biomarkers are less prone to error and recall bias. In addition to utilizing biomarkers of STS exposure, future studies should aim to identify vital windows of STS exposure, important environmental co-exposures, individual susceptibility factors, and specific STS constituents associated with female infertility and adverse pregnancy outcomes. The role of paternal exposures/factors should also be investigated. PMID:23888128

3 Very Real Dangers of Secondhand Smoke

Science.gov (United States)

Secondhand smoke is the combination of smoke from the burning end of a cigarette and the smoke breathed out by the smoker. When you stand near a smoker or go to a restaurant or home where smoking is allowed, you breathe secondhand smoke.

Environmental monitoring of secondhand smoke exposure

Science.gov (United States)

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

International law, national policies and youth smoking: an examination of the Framework Convention on Tobacco Control

Directory of Open Access Journals (Sweden)

G Emmanuel Guindon

2018-03-01

Full Text Available Background The Framework Convention on Tobacco Control (FCTC addresses a wide range of issues including protection from exposure to secondhand smoke and advertising, promotion and sponsorship. The FCTC represents a minimum set of tobacco control policies, although the treaty explicitly encourages countries to go above and beyond these measures. Despite its lack of mandatory provisions. FCTC ratification and its timing may be good proxy for a country's commitment to tobacco control. Our first objective is to assess the impact of the FCTC on global youth tobacco use. Our second objective is to explore two areas that are amenable to policy change: secondhand smoke and advertising. Methods We used pooled repeated-cross-sectional data from youth surveys conducted between 1999 and 2015 in more than 150 low- and middle-income countries and multilevel analyses to account for the nesting of students in schools and schools in countries. First, we examined the association between three outcome variables (smoking susceptibility, defined as the absence of a firm decision not to smoke, current smoking defined as 30-day smoking prevalence and a five-point scale of smoking uptake and various indicators of the FCTC implementation. Second, we examined the association between exposure to secondhand smoke and advertising and indicators of the FCTC implementation. Results We found considerable heterogeneity in the association between different measures of youth smoking and indicators of the FCTC implementation. On the whole, we found clearer associations between exposure to secondhand smoke and advertising and indicators of the FCTC implementation. Conclusions A number of studies have examined changes in the implementation of tobacco control measures since the ratification of the FCTC but few studies have examined the effect of the FCTC on tobacco use; fewer still have used pre- and post-FCTC data. More research that use such data is needed.

Determinants of Exposure to Second-Hand Tobacco Smoke (SHS among Current Non-Smoking In-School Adolescents (aged 11–18 years in South Africa: Results from the 2008 GYTS Study

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Karl Peltzer

2011-08-01

Full Text Available The aim of this study was to estimate the prevalence and identify correlates of second-hand tobacco smoke (SHS among 6,412 current non-smoking school-going adolescents (aged 11 to 18 years in South Africa. A cross-sectional study was carried out in 2008 in South Africa within the framework of the Global Youth Tobacco Survey. Overall, 25.7% of students were exposed to SHS at home, 34.2% outside of the home and 18.3% were exposed to SHS at home and outside of the home. Parental and close friends smoking status, allowing someone to smoke around you and perception that passive smoking was harmful were significant determinants of adolescent’s exposure to both SHS at home and outside of the home. Identified factors can inform the implementation of public health interventions in order to reduce passive smoking among adolescents.

Indoor secondhand tobacco smoke and risk of under-five mortality in 23 sub-Saharan Africa countries: A population based study and meta-analysis

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Owili, Patrick Opiyo; Muga, Miriam Adoyo; Pan, Wen-Chi

2017-01-01

Background Inhalation of secondhand smoke from tobacco results in serious health outcomes among under-five children, and yet, few studies have assessed its effect on under-five mortality. We investigated the association between frequency of exposure to household tobacco smoke and risk of under-five mortality in sub-Saharan Africa (SSA). Methods Demographic Health Survey data of under-five children from 23 SSA countries (n = 787,484) were used. Cox proportional hazard models described the association between exposure to tobacco smoke and the risk of under-five mortality in each country, with age as the time-to-event indicator. Meta-analysis was used to investigate the overall effect of tobacco smoke in SSA. Results The association between tobacco smoke exposure and the risk of under-five mortality attenuated in eight countries (Burkina Faso, Benin, Congo, Gabon, Guinea, Liberia, Togo, and Zambia) after adjustment, while the hazard ratios (HR) of daily exposure to tobacco smoke in Kenya (HR = 1.40; 95% CI, 1.16–1.70) and Namibia (HR = 1.40; 1.07–1.83) grew. The children in rural areas in SSA were 1.08 (95% CI, 1.04–1.13) times more likely to die than their urban peers. In general, the exposure to household tobacco smoke was associated with an increased risk of under-five mortality in SSA (HR = 1.09; 95% CI, 1.06–1.13). Conclusions This study provided evidence of a positive association between exposure to household tobacco smoke and risk of under-five mortality in SSA. Policymakers in low- and middle-income countries, where tobacco control as a child health issue is relatively neglected, should integrate tobacco control measures with other child health promotion policies. PMID:28542166

Indoor secondhand tobacco smoke and risk of under-five mortality in 23 sub-Saharan Africa countries: A population based study and meta-analysis.

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Patrick Opiyo Owili

Full Text Available Inhalation of secondhand smoke from tobacco results in serious health outcomes among under-five children, and yet, few studies have assessed its effect on under-five mortality. We investigated the association between frequency of exposure to household tobacco smoke and risk of under-five mortality in sub-Saharan Africa (SSA.Demographic Health Survey data of under-five children from 23 SSA countries (n = 787,484 were used. Cox proportional hazard models described the association between exposure to tobacco smoke and the risk of under-five mortality in each country, with age as the time-to-event indicator. Meta-analysis was used to investigate the overall effect of tobacco smoke in SSA.The association between tobacco smoke exposure and the risk of under-five mortality attenuated in eight countries (Burkina Faso, Benin, Congo, Gabon, Guinea, Liberia, Togo, and Zambia after adjustment, while the hazard ratios (HR of daily exposure to tobacco smoke in Kenya (HR = 1.40; 95% CI, 1.16-1.70 and Namibia (HR = 1.40; 1.07-1.83 grew. The children in rural areas in SSA were 1.08 (95% CI, 1.04-1.13 times more likely to die than their urban peers. In general, the exposure to household tobacco smoke was associated with an increased risk of under-five mortality in SSA (HR = 1.09; 95% CI, 1.06-1.13.This study provided evidence of a positive association between exposure to household tobacco smoke and risk of under-five mortality in SSA. Policymakers in low- and middle-income countries, where tobacco control as a child health issue is relatively neglected, should integrate tobacco control measures with other child health promotion policies.

Secondhand Smoke Exposure Among Nonsmoking Adolescents in West Africa

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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

Second-hand smoke in indoor hospitality venues in Pakistan.

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Zaidi, S M A; Moin, O; Khan, J A

2011-07-01

Second-hand smoke (SHS) constitutes a significant public health threat in countries with a high smoking prevalence. However, data assessing the quality of indoor air at public venues in Pakistan are limited. To measure mean concentrations of PM(2.5) (particulate matter ≤2.5 microns in diameter), a sensitive indicator of SHS, in hospitality venues in Pakistan. Data were collected discreetly from 39 indoor venues such as cafes, restaurants and shisha (water-pipe) bars from three major cities in Pakistan. Data were recorded using a portable air quality monitoring device. The overall mean PM(2.5) value for the visited venues was 846 μg/m(3) (95%CI 484-1205). The mean PM(2.5) value was 101 μg/m(3) (95%CI 69-135 μg/m(3)) for non-smoking venues, 689 μg/m(3) (95%CI 241-1138) for cigarette smoking venues and 1745 μg/m(3) (95%CI 925-2565) for shisha smoking venues. The significant levels of SHS recorded in this study, in particular from shisha smoking venues, could represent a major public health burden in Pakistan. Appropriate legislation needs to be enforced to protect the health of those exposed to the hazards of second-hand tobacco smoke.

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.

Second-hand smoke exposure in outdoor hospitality venues: Smoking visibility and assessment of airborne markers.

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Sureda, Xisca; Bilal, Usama; Fernández, Esteve; Valiente, Roberto; Escobar, Francisco J; Navas-Acien, Ana; Franco, Manuel

2018-08-01

After the implementation of smoke-free policies in indoor hospitality venues (including bars, cafeterias, restaurants, and pubs), smokers may have been displaced to their outdoor areas. We aimed to study smoking visibility and second-hand smoke exposure in outdoor hospitality venues. We collected information on signs of tobacco consumption on entrances and terraces of hospitality venues in 2016 in the city of Madrid, Spain. We further measured airborne nicotine concentrations and particulate matter of less than 2.5 µm in diameter (PM2.5) in terraces with monitors by active sampling during 30 min. We calculated the medians and the interquartile ranges (IQR) of nicotine and PM2.5 concentrations, and fitted multivariate models to characterize their determinants. We found 202 hospitality venues between May and September (summer), and 83 between October and December 2016 (fall) that were opened at the time of observation. We found signs of tobacco consumption on 78.2% of the outdoor main entrances and on 95.1% of outdoor terraces. We measured nicotine and PM2.5 concentrations in 92 outdoor terraces (out of the 123 terraces observed). Overall median nicotine concentration was 0.42 (IQR: 0.14-1.59) μg/m 3 , and overall PM2.5 concentration was 10.40 (IQR: 6.76-15.47) μg/m 3 (statistically significantly higher than the background levels). Multivariable analyses showed that nicotine and PM2.5 concentrations increased when the terraces were completely closed, and when tobacco smell was noticed. Nicotine concentrations increased with the presence of cigarette butts, and when there were more than eight lit cigarettes at a time. Outdoor hospitality venues are areas where non-smokers, both employees and patrons, continue to be exposed to second-hand smoke. These spaces should be further studied and considered in future tobacco control interventions. Copyright © 2018 Elsevier Inc. All rights reserved.

Smokers' Willingness to Protect Children from Secondhand Smoke

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King, Keith A.; Vidourek, Rebecca A.; Creighton, Stephanie; Vogel, Stephanie

2003-01-01

Objectives: To examine the effectiveness of a secondhand smoke media campaign on adult smokers' willingness to protect children from secondhand smoke. Methods: Following a series of community awareness ads, a random sample of 390 adult smokers was surveyed via telephone regarding their perceptions of secondhand smoke. Results: Seeing or hearing…

Study of secondhand smoke exposure in St. Louis City and County suggests need for comprehensive smoke-free Missouri law adoption.

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Moreland-Russell, Sarah; Cyr, Julianne; Benson, Peter; Colditz, Graham; Pulley, Deren; Barnoya, Joaquin

2012-01-01

This cross-sectional study provides information about secondhand smoke exposure across the St. Louis metro area and perceptions and attitudes about tobacco and health within the local hospitality industry. Results from this study support the need for passage and implementation of comprehensive smoke-free laws throughout Missouri, particularly in St. Louis City and County where efforts to pass comprehensive smoke-free laws have been unsuccessful.

Sociodemographic Characteristics and Secondhand Smoke Exposure among Women

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Baheiraei, Azam; Nedjat, Saharnaz; Rahimi Foroushani, Abbas

2013-01-01

Background Exposure to secondhand cigarette smoke is an important health hazard. This study was designed to assess the sociodemographic risk factors related to women's exposure to secondhand smoke. Materials and Methods A case-control analysis of data collected as part of a prospective cohort study was conducted. Participants were 340 female Tehran residents exposed to cigarette smoke. Women consented to participate in this study and completed a questionnaire containing socio-demographic characteristics, household characteristics and smoking status at home through a face-to-face interview. Factors related to women's exposure to secondhand smoke were assessed using the multivariate logistic regression model. Results The final multivariate logistic regression model showed that lower levels of education (p = 0.002) and social class (p = 0.03) increase the risk of exposure to secondhand smoke in women. Conclusion These results support the effect of women's educational level and social class on their exposure to secondhand smoke. PMID:25191461

Secondhand smoke exposure and endothelial stress in children and adolescents.

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Groner, Judith A; Huang, Hong; Nagaraja, Haikady; Kuck, Jennifer; Bauer, John Anthony

2015-01-01

Links between secondhand smoke exposure and cardiovascular disease in adults are well established. Little is known about the impact of this exposure on cardiovascular status during childhood. The purpose of this study was to investigate relationships between secondhand smoke exposure in children and adolescents and cardiovascular disease risk--systemic inflammation, endothelial stress, and endothelial repair. A total of 145 subjects, aged 9 to 18 years, were studied. Tobacco smoke exposure was determined by hair nicotine level. Cardiovascular risk was assessed by markers of systemic inflammation (C-reactive protein [CRP] and adiponectin); by soluble intercellular adhesion molecule 1 (s-ICAM1), which measures endothelial activation after surface vascular injury; and by endothelial repair. This was measured by prevalence of endothelial progenitor cells (EPCs), which are bone marrow-derived cells that home preferentially to sites of vascular damage. Hair nicotine was directly correlated with s-ICAM1 (r = 0.4090, P Secondhand smoke exposure during childhood and adolescence is detrimental to vascular health because s-ICAM1 is a marker for endothelial activation and stress after vascular surface injury, and EPCs contribute to vascular repair. The fact that body mass index is also a factor in the model predicting s-ICAM1 is concerning, in that 2 risk factors may both contribute to endothelial stress. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Is there an impact of public smoking bans on self-reported smoking status and exposure to secondhand smoke?

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Naiman, Alisa B; Glazier, Richard H; Moineddin, Rahim

2011-01-01

Abstract Background Implementation of smoke free policies has potentially substantial effects on health by reducing secondhand smoke exposure. However little is known about whether the introduction of anti-smoking legislation translates into decreased secondhand smoke exposure. We examined whether smoking bans impact rates of secondhand smoke exposure in public places and rates of complete workplace smoking restriction. Methods Canadian Community Health Survey was used to obtain secondhand sm...

Secondhand smoke exposure during pregnancy and infantile neurodevelopment.

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Lee, Bo-Eun; Hong, Yun-Chul; Park, Hyesook; Ha, Mina; Kim, Ja Hyeong; Chang, Namsoo; Roh, Young-Man; Kim, Boong-Nyun; Kim, Yeni; Oh, Se-young; Kim, Young Ju; Ha, Eun-Hee

2011-05-01

During prenatal development, the nervous system may be more susceptible to environmental toxicants, such as secondhand smoke. The authors assessed the effects of prenatal and postnatal secondhand smoke exposure on the neurodevelopment of 6-month infants. The subjects were 414 mother and infant pairs with no medical problems, taken from the Mothers' and Children's Environmental Health study. Prenatal and postnatal exposures to secondhand smoke were determined using maternal self-reports. Examiners, unaware of exposure history, assessed the infants at 6 months of age using the Bayley Scales of Infant Development. Bayley scores were compared for secondhand smoke exposed and unexposed groups after adjusting for potential confounders. Multiple logistic regression analysis was carried out to estimate the risk of developmental delay posed by SHS exposure. The multivariate model included residential area, maternal age, pre-pregnancy body mass index, education, income, infant sex, parity, birth weight, and type of feeding. After adjusting for covariates, secondhand smoke exposure during pregnancy was found to be related to a decrease in mental developmental index score, but not to a decrease in psychomotor developmental index score. In addition, secondhand smoke exposure during pregnancy was found to increase the risk of developmental delay (mental developmental index score ≤85) at 6 months. This study suggests that the infants of non-smoking women exposed to secondhand smoke are at risk of neurodevelopmental delay. Copyright © 2011 Elsevier Inc. All rights reserved.

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.

Factors associated with secondhand smoke exposure prevalence and secondhand smoke level of children living with parental smokers: a cross sectional study.

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Ulbricht, Sabina; Unger, Friederike; Groß, Stefan; Nauck, Matthias; Meyer, Christian; John, Ulrich

2015-06-01

Factors that might account for the probability of children being exposed to secondhand smoke compared to those who are unexposed and characteristics associated with the urinary cotinine level (UCL) of those who are exposed were investigated. All households in a German region with a child aged 3 years or younger (n = 3,570) were invited to participate in a study that tested the efficacy of an intervention for reducing secondhand smoke exposure. In 1,282 households, at least one parent reported daily smoking. Among these, 915 (71.3%) participated in the study. For data analyses, we used a two-part model. Characteristics of the households associated with SHSE of the youngest child were analyzed, as well as characteristics associated with UCL among those exposed. Exposure to secondhand smoke was defined using a UCL ≥ 10 ng/ml. Secondhand smoke exposure was detected in 57.1% of the samples. Nursery attendance was associated with secondhand smoke exposure, in addition to the number of smokers living in the household, extent of home smoking ban and parental education. Among children exposed, nursery attendance, season of urine collection and age of the child were associated with UCL. Consideration of seasonal smoking behavior and a child's age at the time of intervention may increase attention to the adverse health effects of secondhand smoke exposure.

Environmental secondhand smoke exposure and policy assessment at five venues in Zhejiang Province, China.

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Xu, Yue; Wu, QingQing; Xu, ShuiYang; Xu, JinHang; Wan, Xia; Guo, YuJie

2014-11-01

The objective of this study was to assess environmental secondhand smoke exposure and tobacco control policy at 5 venues. A cross-sectional study was conducted involving 134 settings and 2727 adults in Zhejiang, China. The results show that the proportions of venues that had complete smoking ban were as follows: health administrative organizations (71.9%), hospitals (70.0%), schools (66.7%), public transportation vehicles (24.0%), and government agencies (11.8%). The proportions of venues where smoking was noticed were as follows: public transportation vehicles (88.0%), government agencies (47.1%), hospitals (46.7%), health administrative organizations (40.6%), and schools (30.0%). Venues with completely indoor smoking ban were 5 times more likely to be smoke-free at the time of survey than other venues without smoking ban (odds ratio = 5.39, 95% confidence interval = 1.92-15.14). It indicated that implementation of indoor smoking ban can reduce indoor secondhand smoke exposure. © 2013 APJPH.

Risks of tobacco

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Secondhand smoke - risks; Cigarette smoking - risks; Smoking and smokeless tobacco - risks; Nicotine - risks ... tobacco that are known to cause cancer. HEALTH RISKS OF SMOKING OR USING SMOKELESS TOBACCO Knowing the ...

Prevalence of Exposure to Secondhand Smoke among Higher Secondary School Students in Ernakulam District, Kerala, Southern India.

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Rakesh, P S; Lalu, Jishnu Satheesh; Leelamoni, K

2017-01-01

The association between secondhand smoke and health outcomes, such as frequent respiratory infections, ischemic heart disease, lung cancer, asthma, and stroke, has long been established. The study aimed to estimate the prevalence of secondhand smoking exposure among higher secondary school students in Ernakulam district, Kerala, Southern India. A structured questionnaire was administered to all students from four randomly selected higher secondary schools in Ernakulam district. Descriptive statistics was done using frequencies and percentages. Univariate and multivariate analyses were done for factors associated with household exposure to tobacco smoke generating odds ratios (ORs) and 95% confidence intervals (CIs). A total of 629 students participated in the study. The prevalence of ever smokers was 11.9% and of current smokers was 5.2%. Among the study participants, 23.2% were exposed to secondhand smoking from a family member and 18.8% from friends. Lower educational status of father was associated with the household exposure to secondhand smoke (adjusted OR 4.51 [95% CI 1.66-12.22]). More than half of the study participants (56.3%) reported that they were exposed to cigarette smoke in past 1 week in a public place and 10.2% in closed public places. Nearly one-third of the students reported that they have seen somebody smoking inside school campus in the past 30 days. Exposure to secondhand smoke at home, schools, and public places was higher among the late adolescent higher secondary school students in Ernakulam district. The findings underscore the urgent need for increased efforts to implement the strategies to reduce secondhand smoke exposure among adolescents.

Exposure to secondhand tobacco smoke and lung cancer by histological type: a pooled analysis of the International Lung Cancer Consortium (ILCCO)

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Kim, Claire H; Lee, Yuan-Chin Amy; Hung, Rayjean J; McNallan, Sheila R; Cote, Michele L; Lim, Wei-Yen; Chang, Shen-Chih; Kim, Jin Hee; Ugolini, Donatella; Chen, Ying; Liloglou, Triantafillos; Andrew, Angeline S; Onega, Tracy; Duell, Eric J; Field, John K; Lazarus, Philip; Le Marchand, Loic; Neri, Monica; Vineis, Paolo; Kiyohara, Chikako; Hong, Yun-Chul; Morgenstern, Hal; Matsuo, Keitaro; Tajima, Kazuo; Christiani, David C; McLaughlin, John R; Bencko, Vladimir; Holcatova, Ivana; Boffetta, Paolo; Brennan, Paul; Fabianova, Eleonora; Foretova, Lenka; Janout, Vladimir; Lissowska, Jolanta; Mates, Dana; Rudnai, Peter; Szeszenia-Dabrowska, Neonila; Mukeria, Anush; Zaridze, David; Seow, Adeline; Schwartz, Ann G; Yang, Ping; Zhang, Zuo-Feng

2014-01-01

While the association between exposure to secondhand smoke and lung cancer risk is well established, few studies with sufficient power have examined the association by histological type. In this study, we evaluated the secondhand smoke-lung cancer relationship by histological type based on pooled data from 18 case-control studies in the International Lung Cancer Consortium (ILCCO), including 2,504 cases and 7,276 controls who were never smokers and 10,184 cases and 7,176 controls who were ever smokers. We used multivariable logistic regression, adjusting for age, sex, race/ethnicity, smoking status, pack-years of smoking, and study. Among never smokers, the odds ratios (OR) comparing those ever exposed to secondhand smoke with those never exposed were 1.31 (95% CI: 1.17–1.45) for all histological types combined, 1.26 (95% CI: 1.10–1.44) for adenocarcinoma, 1.41 (95% CI: 0.99–1.99) for squamous cell carcinoma, 1.48 (95% CI: 0.89–2.45) for large cell lung cancer, and 3.09 (95% CI: 1.62–5.89) for small cell lung cancer. The estimated association with secondhand smoke exposure was greater for small cell lung cancer than for non-small cell lung cancers (OR=2.11, 95% CI: 1.11–4.04). This analysis is the largest to date investigating the relation between exposure to secondhand smoke and lung cancer. Our study provides more precise estimates of the impact of secondhand smoke on the major histological types of lung cancer, indicates the association with secondhand smoke is stronger for small cell lung cancer than for the other histological types, and suggests the importance of intervention against exposure to secondhand smoke in lung cancer prevention. PMID:24615328

Exposure to secondhand tobacco smoke and lung cancer by histological type: a pooled analysis of the International Lung Cancer Consortium (ILCCO).

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Kim, Claire H; Lee, Yuan-Chin Amy; Hung, Rayjean J; McNallan, Sheila R; Cote, Michele L; Lim, Wei-Yen; Chang, Shen-Chih; Kim, Jin Hee; Ugolini, Donatella; Chen, Ying; Liloglou, Triantafillos; Andrew, Angeline S; Onega, Tracy; Duell, Eric J; Field, John K; Lazarus, Philip; Le Marchand, Loic; Neri, Monica; Vineis, Paolo; Kiyohara, Chikako; Hong, Yun-Chul; Morgenstern, Hal; Matsuo, Keitaro; Tajima, Kazuo; Christiani, David C; McLaughlin, John R; Bencko, Vladimir; Holcatova, Ivana; Boffetta, Paolo; Brennan, Paul; Fabianova, Eleonora; Foretova, Lenka; Janout, Vladimir; Lissowska, Jolanta; Mates, Dana; Rudnai, Peter; Szeszenia-Dabrowska, Neonila; Mukeria, Anush; Zaridze, David; Seow, Adeline; Schwartz, Ann G; Yang, Ping; Zhang, Zuo-Feng

2014-10-15

While the association between exposure to secondhand smoke and lung cancer risk is well established, few studies with sufficient power have examined the association by histological type. In this study, we evaluated the secondhand smoke-lung cancer relationship by histological type based on pooled data from 18 case-control studies in the International Lung Cancer Consortium (ILCCO), including 2,504 cases and 7,276 control who were never smokers and 10,184 cases and 7,176 controls who were ever smokers. We used multivariable logistic regression, adjusting for age, sex, race/ethnicity, smoking status, pack-years of smoking, and study. Among never smokers, the odds ratios (OR) comparing those ever exposed to secondhand smoke with those never exposed were 1.31 (95% CI: 1.17-1.45) for all histological types combined, 1.26 (95% CI: 1.10-1.44) for adenocarcinoma, 1.41 (95% CI: 0.99-1.99) for squamous cell carcinoma, 1.48 (95% CI: 0.89-2.45) for large cell lung cancer, and 3.09 (95% CI: 1.62-5.89) for small cell lung cancer. The estimated association with secondhand smoke exposure was greater for small cell lung cancer than for nonsmall cell lung cancers (OR=2.11, 95% CI: 1.11-4.04). This analysis is the largest to date investigating the relation between exposure to secondhand smoke and lung cancer. Our study provides more precise estimates of the impact of secondhand smoke on the major histological types of lung cancer, indicates the association with secondhand smoke is stronger for small cell lung cancer than for the other histological types, and suggests the importance of intervention against exposure to secondhand smoke in lung cancer prevention. © 2014 UICC.

Tobacco Use, Exposure to Secondhand Smoke, and Training on Cessation Counseling Among Nursing Students: Cross-Country Data from the Global Health Professions Student Survey (GHPSS, 2005–2009

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Nathan R. Jones

2009-09-01

Full Text Available The Nursing Global Health Professions Student Survey (GHPSS has been conducted in schools in 39 countries and the Gaza Strip/West Bank (identified as “sites” for the remainder of this paper. In half the sites, over 20% of the students currently smoked cigarettes, with males having higher rates than females in 22 sites. Over 60% of students reported having been exposed to secondhand smoke in public places in 23 of 39 sites. The majority of students recognized that they are role models in society, believed they should receive training on counseling patients to quit using tobacco, but few reported receiving any formal training. Tobacco control efforts must discourage tobacco use among health professionals, promote smoke free workplaces, and implement programs that train health professionals in effective cessation-counseling techniques.

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).

Is there an impact of public smoking bans on self-reported smoking status and exposure to secondhand smoke?

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Glazier Richard H

2011-03-01

Full Text Available Abstract Background Implementation of smoke free policies has potentially substantial effects on health by reducing secondhand smoke exposure. However little is known about whether the introduction of anti-smoking legislation translates into decreased secondhand smoke exposure. We examined whether smoking bans impact rates of secondhand smoke exposure in public places and rates of complete workplace smoking restriction. Methods Canadian Community Health Survey was used to obtain secondhand smoking exposure rates in 15 Ontario municipalities. Data analysis included descriptive summaries and 95% confidence intervals were calculated and compared across groups Results Across all studied municipalities, secondhand smoke exposure in public places decreased by 4.7% and workplace exposure decreased by 2.3% between the 2003 and 2005 survey years. The only jurisdiction to implement a full ban from no previous ban was also the only setting that experienced significant decreases in both individual exposure to secondhand smoke in a public place (-17.3%, 95% CI -22.8, -11.8 and workplace exposure (-18.1%, 95% CI -24.9, -11.3. Exposures in vehicles and homes declined in almost all settings over time. Conclusions Implementation of a full smoking ban was associated with the largest decreases in secondhand smoke exposure while partial bans and changes in existing bans had inconsistent effects. In addition to decreasing exposure in public places as would be expected from legislation, bans may have additional benefits by decreasing rates of current smokers and decreasing exposures to secondhand smoke in private settings.

Is there an impact of public smoking bans on self-reported smoking status and exposure to secondhand smoke?

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Naiman, Alisa B; Glazier, Richard H; Moineddin, Rahim

2011-03-03

Implementation of smoke free policies has potentially substantial effects on health by reducing secondhand smoke exposure. However little is known about whether the introduction of anti-smoking legislation translates into decreased secondhand smoke exposure. We examined whether smoking bans impact rates of secondhand smoke exposure in public places and rates of complete workplace smoking restriction. Canadian Community Health Survey was used to obtain secondhand smoking exposure rates in 15 Ontario municipalities. Data analysis included descriptive summaries and 95% confidence intervals were calculated and compared across groups Across all studied municipalities, secondhand smoke exposure in public places decreased by 4.7% and workplace exposure decreased by 2.3% between the 2003 and 2005 survey years. The only jurisdiction to implement a full ban from no previous ban was also the only setting that experienced significant decreases in both individual exposure to secondhand smoke in a public place (-17.3%, 95% CI -22.8, -11.8) and workplace exposure (-18.1%, 95% CI -24.9, -11.3). Exposures in vehicles and homes declined in almost all settings over time. Implementation of a full smoking ban was associated with the largest decreases in secondhand smoke exposure while partial bans and changes in existing bans had inconsistent effects. In addition to decreasing exposure in public places as would be expected from legislation, bans may have additional benefits by decreasing rates of current smokers and decreasing exposures to secondhand smoke in private settings.

Associations between maternal periconceptional exposure to secondhand tobacco smoke and major birth defects.

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Hoyt, Adrienne T; Canfield, Mark A; Romitti, Paul A; Botto, Lorenzo D; Anderka, Marlene T; Krikov, Sergey V; Tarpey, Morgan K; Feldkamp, Marcia L

2016-11-01

While associations between secondhand smoke and a few birth defects (namely, oral clefts and neural tube defects) have been noted in the scientific literature, to our knowledge, there is no single or comprehensive source of population-based information on its associations with a range of birth defects among nonsmoking mothers. We utilized data from the National Birth Defects Prevention Study, a large population-based multisite case-control study, to examine associations between maternal reports of periconceptional exposure to secondhand smoke in the household or workplace/school and major birth defects. The multisite National Birth Defects Prevention Study is the largest case-control study of birth defects to date in the United States. We selected cases from birth defect groups having >100 total cases, as well as all nonmalformed controls (10,200), from delivery years 1997 through 2009; 44 birth defects were examined. After excluding cases and controls from multiple births and whose mothers reported active smoking or pregestational diabetes, we analyzed data on periconceptional secondhand smoke exposure-encompassing the period 1 month prior to conception through the first trimester. For the birth defect craniosynostosis, we additionally examined the effect of exposure in the second and third trimesters as well due to the potential sensitivity to teratogens for this defect throughout pregnancy. Covariates included in all final models of birth defects with ≥5 exposed mothers were study site, previous live births, time between estimated date of delivery and interview date, maternal age at estimated date of delivery, race/ethnicity, education, body mass index, nativity, household income divided by number of people supported by this income, periconceptional alcohol consumption, and folic acid supplementation. For each birth defect examined, we used logistic regression analyses to estimate both crude and adjusted odds ratios and 95% confidence intervals for both

Secondary organic aerosol formation from ozone-initiated reactions with nicotine and secondhand tobacco smoke

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Sleiman, Mohamad; Destaillats, Hugo; Smith, Jared D.; Liu, Chen-Lin; Ahmed, Musahid; Wilson, Kevin R.; Gundel, Lara A.

2010-11-01

We used controlled laboratory experiments to evaluate the aerosol-forming potential of ozone reactions with nicotine and secondhand smoke. Special attention was devoted to real-time monitoring of the particle size distribution and chemical composition of SOA as they are believed to be key factors determining the toxicity of SOA. The experimental approach was based on using a vacuum ultraviolet photon ionization time-of-flight aerosol mass spectrometer (VUV-AMS), a scanning mobility particle sizer (SMPS) and off-line thermal desorption coupled to mass spectrometry (TD-GC-MS) for gas-phase byproducts analysis. Results showed that exposure of SHS to ozone induced the formation of ultrafine particles (smoke that is associated with the formation of ultrafine particles (UFP) through oxidative aging of secondhand smoke. The significance of this chemistry for indoor exposure and health effects is highlighted.

Detection of nicotine as an indicator of tobacco smoke by direct analysis in real time (DART) tandem mass spectrometry

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Kuki, Ákos; Nagy, Lajos; Nagy, Tibor; Zsuga, Miklós; Kéki, Sándor

2015-01-01

The residual tobacco smoke contamination (thirdhand smoke, THS) on the clothes of a smoker was examined by direct analysis in real time (DART) mass spectrometry. DART-MS enabled sensitive and selective analysis of nicotine as the indicator of tobacco smoke pollution. Tandem mass spectrometric (MS/MS) experiments were also performed to confirm the identification of nicotine. Transferred thirdhand smoke originated from the fingers of a smoker onto other objects was also detected by DART mass spectrometry. DART-MS/MS was utilized for monitoring the secondhand tobacco smoke (SHS) in the air of the laboratory using nicotine as an indicator. To the best of our knowledge, this is the first report on the application of DART-MS and DART-MS/MS to the detection of thirdhand smoke and to the monitoring of secondhand smoke.

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.

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.

Detecting biomarkers of secondhand marijuana smoke in young children.

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Wilson, Karen M; Torok, Michelle R; Wei, Binnian; Wang, Lanqing; Robinson, Michelle; Sosnoff, Connie S; Blount, Benjamin C

2017-04-01

The impact of secondhand marijuana smoke exposure on children is unknown. New methods allow detection of secondhand marijuana smoke in children. We studied children ages 1 mo to 2 y hospitalized with bronchiolitis in Colorado from 2013 to 2015. Parents completed a survey, and urine samples were analyzed for cotinine using LC/MS/MS (limits of detection 0.03 ng/ml) and marijuana metabolites including COOH-THC (limits of detection 0.015 ng/ml). A total of 43 subjects had urine samples available for analysis. Most (77%) of the subjects were male, and 52% were less than 1 y of age. COOH-THC was detectable in 16% of the samples analyzed (THC+); the range in COOH-THC concentration was 0.03-1.5 ng/ml. Two subjects had levels >1 ng/ml. Exposure did not differ by gender or age. Non-white children had more exposure than white children (44 vs. 9%; P 2.0 ng/ml were THC+, compared with 7% of those with lower cotinine (P marijuana smoke can be detected in children; in this cohort, 16% were exposed. Detectable COOH-THC is more common in children with tobacco smoke exposure. More research is needed to assess the health impacts of marijuana smoke exposure on children and inform public health policy.

Prevalence of exposure to secondhand smoke among higher secondary school students in Ernakulam District, Kerala, Southern India

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P S Rakesh

2017-01-01

Full Text Available Introduction: The association between secondhand smoke and health outcomes, such as frequent respiratory infections, ischemic heart disease, lung cancer, asthma, and stroke, has long been established. The study aimed to estimate the prevalence of secondhand smoking exposure among higher secondary school students in Ernakulam district, Kerala, Southern India. Materials and Methods: A structured questionnaire was administered to all students from four randomly selected higher secondary schools in Ernakulam district. Descriptive statistics was done using frequencies and percentages. Univariate and multivariate analyses were done for factors associated with household exposure to tobacco smoke generating odds ratios (ORs and 95% confidence intervals (CIs. Results: A total of 629 students participated in the study. The prevalence of ever smokers was 11.9% and of current smokers was 5.2%. Among the study participants, 23.2% were exposed to secondhand smoking from a family member and 18.8% from friends. Lower educational status of father was associated with the household exposure to secondhand smoke (adjusted OR 4.51 [95% CI 1.66–12.22]. More than half of the study participants (56.3% reported that they were exposed to cigarette smoke in past 1 week in a public place and 10.2% in closed public places. Nearly one-third of the students reported that they have seen somebody smoking inside school campus in the past 30 days. Conclusion: Exposure to secondhand smoke at home, schools, and public places was higher among the late adolescent higher secondary school students in Ernakulam district. The findings underscore the urgent need for increased efforts to implement the strategies to reduce secondhand smoke exposure among adolescents.

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

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.

Health, Secondhand Smoke Exposure, and Smoking Behavior Impacts of No-Smoking Policies in Public Housing, Colorado, 2014-2015.

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Young, Walter; Karp, Shelley; Bialick, Peter; Liverance, Cindy; Seder, Ashley; Berg, Erica; Karp, Liberty

2016-10-20

Exposure to secondhand smoke is problematic for residents living in multiunit housing, as the smoke migrates through shared ventilation systems, unsealed cracks, and door spaces. The objective of our research was to assess resident exposure to secondhand smoke, support for no-smoking policies, and the health impacts of no-smoking policies in multiunit housing. Surveys of 312 heads of households who resided in 1 of 3 multiunit buildings managed by a Colorado public housing authority were administered before and after implementation of a no-smoking policy that prohibited smoking in all resident apartments and all indoor common areas. A matched-pairs analysis of initial surveys and 15-month post-policy implementation surveys for 115 respondents was conducted. Decreases were found in the number and percentage of smokers who smoked every day and the number of cigarettes smoked per day, and 30% had quit smoking 15 months after policy implementation. The percentage of residents who smelled secondhand smoke indoors declined significantly. A significant decrease in breathing problems was found after policy implementation. Although decreases were found in the incidence of asthma attacks, emphysema/chronic obstructive pulmonary disease, eye irritation, colds, nasal congestion, and ear/sinus infections, these decreases were not significant. Consistent findings across nearly all variables tested suggest that no-smoking policies reduce resident exposure to secondhand smoke, lower the incidence of secondhand smoke-associated breathing problems, decrease daily smoking and cigarette consumption, encourage smoking cessation, and increase quit attempts. If implemented in all multiunit housing, these policies could reduce exposure to secondhand smoke and health problems associated with secondhand smoke, promote smoking cessation, and reduce cigarette consumption.

Exposure to second-hand smoke and direct healthcare costs in children – results from two German birth cohorts, GINIplus and LISAplus

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Batscheider Ariane

2012-10-01

Full Text Available Abstract Background Although the negative health consequences of the exposure to second hand tobacco smoke during childhood are already known, evidence on the economic consequences is still rare. The aim of this study was to estimate excess healthcare costs of exposure to tobacco smoke in German children. Methods The study is based on data from two birth cohort studies of 3,518 children aged 9-11 years with information on healthcare utilisation and tobacco smoke exposure: the GINIplus study (German Infant Study On The Influence Of Nutrition Intervention Plus Environmental And Genetic Influences On Allergy Development and the LISAplus study (Influence of Life-Style Factors On The Development Of The Immune System And Allergies In East And West Germany Plus The Influence Of Traffic Emissions And Genetics. Direct medical costs were estimated using a bottom-up approach (base year 2007. We investigated the impact of tobacco smoke exposure in different environments on the main components of direct healthcare costs using descriptive analysis and a multivariate two-step regression analysis. Results Descriptive analysis showed that average annual medical costs (physician visits, physical therapy and hospital treatment were considerably higher for children exposed to second-hand tobacco smoke at home (indoors or on patio/balcony compared with those who were not exposed. Regression analysis confirmed these descriptive trends: the odds of positive costs and the amount of total costs are significantly elevated for children exposed to tobacco smoke at home after adjusting for confounding variables. Combining the two steps of the regression model shows smoking attributable total costs per child exposed at home of €87 [10–165] (patio/balcony and €144 [6–305] (indoors compared to those with no exposure. Children not exposed at home but in other places showed only a small, but not significant, difference in total costs compared to those with no exposure

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

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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 ...

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

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.

Tobacco

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... Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn ... as smuggling, illicit manufacturing and counterfeiting. The tobacco industry and others often argue that high tobacco product ...

Policy support, norms, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico city.

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Thrasher, James F; Pérez-Hernández, Rosaura; Swayampakala, Kamala; Arillo-Santillán, Edna; Bottai, Matteo

2010-09-01

We assessed attitudes and beliefs about smoke-free laws, compliance, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico City. Trends and odds of change in attitudes and beliefs were analyzed across 3 representative surveys of Mexico City inhabitants: before implementation of the policy (n=800), 4 months after implementation (n=961), and 8 months after implementation (n=761). Results indicated high and increasing support for 100% smoke-free policies, although support did not increase for smoke-free bars. Agreement that such policies improved health and reinforced rights was high before policy implementation and increased thereafter. Social unacceptability of smoking increased substantially, although 25% of nonsmokers and 50% of smokers agreed with smokers' rights to smoke in public places at the final survey wave. Secondhand smoke exposure declined generally as well as in venues covered by the law, although compliance was incomplete, especially in bars. Comprehensive smoke-free legislation in Mexico City has been relatively successful, with changes in perceptions and behavior consistent with those revealed by studies conducted in high-income countries. Normative changes may prime populations for additional tobacco control interventions.

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

A population study on the time trend of cigarette smoking, cessation, and exposure to secondhand smoking from 2001 to 2013 in Taiwan

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Chi-Yung Chiang

2016-11-01

Full Text Available Abstract Background In 2001, the National Health Interview Survey (NHIS commenced in Taiwan. This survey, conducted on a sample of the whole Taiwanese population, is nationally representative and has a high response rate (>80 %. As a result, the four already completed surveys from 2001 to 2013 can be used to investigate the time trend of smoking prevalence, the rate of cessation, and exposure to secondhand smoking. Methods There were 72918 adults combined from the 2001, 2005, 2009 and 2013 National Health Interview Surveys (NHIS. Smoking status, exposure to secondhand smoking, and smoking cessation were asked, as well as demographic characteristics and other variables. Statistical analyses with sampling weights were carried out using SAS and SUDAAN. Results In males, the prevalence of smoking significantly decreased (rates in 4 surveys were 44.4 %, 44.6 %, 38.9 %, and 34.2 %, respectively. Since 2005 the rate of smoking cessation increased significantly (p = 0.033. The odd ratio (OR exposure of secondhand among non-smokes (OR in 2009 and 2013 were 0.96 (CI = 0.85–1.08 and 0.78 (CI = 0.70–0.88 comparing to 2005. In females, the prevalence of smoking was stable over time. The rate of smoking cessation only appeared significantly high in the older age group. The OR for exposure to secondhand smoking were 0.81 (CI = 0.74–0.89 and 0.68 (CI = 0.62–0.74, for 2009 and 2013 comparing to 2005, respectively. Conclusion Early anti-smoking legislation in Taiwan might have raised the awareness of the harm of smoking. However, the implementation of the Tobacco Hazards Prevention Act (THPA in 2009 had great contribution to the reduction of smoking rate, especially in males.

Tobacco and Pregnancy

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This paper will review the epidemiology of the impact of cigarette smoking and other forms of tobacco exposure on human development. Sources of exposure described include cigarettes and other forms of smoked tobacco, secondhand (environmental) tobacco smoke, several forms of smok...

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.

Tobacco industry use of corporate social responsibility tactics as a sword and a shield on secondhand smoke issues.

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Friedman, Lissy C

2009-01-01

The tobacco industry has used corporate social responsibility tactics to improve its corporate image with the public, press, and regulators who increasingly have grown to view it as a merchant of death. There is, however, an intractable problem that corporate social responsibility efforts can mask but not resolve: the tobacco industry's products are lethal when used as directed, and no amount of corporate social responsibility activity can reconcile that fundamental contradiction with ethical corporate citizenship. This study's focus is to better understand the tobacco industry's corporate social responsibility efforts and to assess whether there has been any substantive change in the way it does business with regard to the issue of exposure to secondhand smoke. The results show that the industry has made no substantial changes and in fact has continued with business as usual. Although many of the tobacco companies' tactics traditionally had been defensive, they strove for a way to change to a more offensive strategy. Almost without exception, however, their desire to appear to be good corporate citizens clashed with their aversion to further regulation and jeopardizing their legal position, perhaps an irreconcilable conflict. Despite the switch to offense, in 2006 a federal judge found the companies guilty of racketeering.

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.

Exposure to secondhand smoke and risk of tuberculosis: prospective cohort study.

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Lin, Hsien-Ho; Chiang, Yi-Ting; Chuang, Jen-Hsiang; Yang, Shiang-Lin; Chang, Hsing-Yi; Ezzati, Majid; Murray, Megan

2013-01-01

Prospective evidence on the association between secondhand-smoke exposure and tuberculosis is limited. We included 23,827 never smokers from two rounds (2001 and 2005) of Taiwan National Health Interview Survey. Information on exposure to secondhand smoke at home as well as other sociodemographic and behavioral factors was collected through in-person interview. The participants were prospectively followed for incidence of tuberculosis through cross-matching the survey database to the national tuberculosis registry of Taiwan. A total of 85 cases of active tuberculosis were identified after a median follow-up of 7.0 years. The prevalence of exposure to secondhand smoke at home was 41.8% in the study population. In the multivariable Cox proportional hazards analysis, secondhand smoke was not associated with active tuberculosis (adjusted hazard ratio [HR], 1.03; 95% CI, 0.64 to 1.64). In the subgroup analysis, the association between secondhand smoke and tuberculosis decreased with increasing age; the adjusted HR for those = 18 and = 40 and = 60 years old was 8.48 (0.77 to 93.56), 2.29 (0.75 to 7.01), 1.33 (0.58 to 3.01), and 0.66 (0.35 to 1.23) respectively. Results from extensive sensitivity analyses suggested that potential misclassification of secondhand-smoke exposure would not substantially affect the observed associations. The results from this prospective cohort study did not support an overall association between secondhand smoke and tuberculosis. However, the finding that adolescents might be particularly susceptible to secondhand smoke's effect warrants further investigation.

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

Science.gov (United States)

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.

Avoiding Secondhand Smoke (A Cup of Health with CDC)

Centers for Disease Control (CDC) Podcasts

2015-02-19

Exposure to secondhand smoke causes serious health problems in both children and adult nonsmokers. In this podcast, Dr. David Homa discusses health hazards posed by exposure to secondhand smoke. .  Created: 2/19/2015 by MMWR.   Date Released: 2/19/2015.

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

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

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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.…

Tobacco industry consumer research on socially acceptable cigarettes.

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Ling, P M; Glantz, S A

2005-10-01

To describe tobacco industry consumer research to inform the development of more "socially acceptable" cigarette products since the 1970s. Analysis of previously secret tobacco industry documents. 28 projects to develop more socially acceptable cigarettes were identified from Philip Morris, RJ Reynolds, British American Tobacco, and Lorillard tobacco companies. Consumer research and concept testing consistently demonstrated that many smokers feel strong social pressure not to smoke, and this pressure increased with exposure to smoking restrictions. Tobacco companies attempted to develop more socially acceptable cigarettes with less visible sidestream smoke or less odour. When presented in theory, these product concepts were very attractive to important segments of the smoking population. However, almost every product developed was unacceptable in actual product tests or test markets. Smokers reported the complete elimination of secondhand smoke was necessary to satisfy non-smokers. Smokers have also been generally unwilling to sacrifice their own smoking satisfaction for the benefit of others. Many smokers prefer smoke-free environments to cigarettes that produce less secondhand smoke. Concerns about secondhand smoke and clean indoor air policies have a powerful effect on the social acceptability of smoking. Historically, the tobacco industry has been unable to counter these effects by developing more socially acceptable cigarettes. These data suggest that educating smokers about the health dangers of secondhand smoke and promoting clean indoor air policies has been difficult for the tobacco industry to counter with new products, and that every effort should be made to pursue these strategies.

Secondhand Exposure to Vapors From Electronic Cigarettes

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Czogala, Jan; Fidelus, Bartlomiej; Zielinska-Danch, Wioleta; Travers, Mark J.; Sobczak, Andrzej

2014-01-01

Introduction: Electronic cigarettes (e-cigarettes) are designed to generate inhalable nicotine aerosol (vapor). When an e-cigarette user takes a puff, the nicotine solution is heated and the vapor is taken into lungs. Although no sidestream vapor is generated between puffs, some of the mainstream vapor is exhaled by e-cigarette user. The aim of this study was to evaluate the secondhand exposure to nicotine and other tobacco-related toxicants from e-cigarettes. Materials and Methods: We measured selected airborne markers of secondhand exposure: nicotine, aerosol particles (PM2.5), carbon monoxide, and volatile organic compounds (VOCs) in an exposure chamber. We generated e-cigarette vapor from 3 various brands of e-cigarette using a smoking machine and controlled exposure conditions. We also compared secondhand exposure with e-cigarette vapor and tobacco smoke generated by 5 dual users. Results: The study showed that e-cigarettes are a source of secondhand exposure to nicotine but not to combustion toxicants. The air concentrations of nicotine emitted by various brands of e-cigarettes ranged from 0.82 to 6.23 µg/m3. The average concentration of nicotine resulting from smoking tobacco cigarettes was 10 times higher than from e-cigarettes (31.60±6.91 vs. 3.32±2.49 µg/m3, respectively; p = .0081). Conclusions: Using an e-cigarette in indoor environments may involuntarily expose nonusers to nicotine but not to toxic tobacco-specific combustion products. More research is needed to evaluate health consequences of secondhand exposure to nicotine, especially among vulnerable populations, including children, pregnant women, and people with cardiovascular conditions. PMID:24336346

Inequities in workplace secondhand smoke exposure among nonsmoking women of reproductive age.

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Johnson, Candice Y; Luckhaupt, Sara E; Lawson, Christina C

2015-07-01

We characterized workplace secondhand smoke exposure among nonsmoking women of reproductive age as a proxy for workplace secondhand smoke exposure during pregnancy. We included nonsmoking women aged 18 to 44 years employed during the past 12 months who participated in the 2010 National Health Interview Survey. We estimated the prevalence of workplace secondhand smoke exposure and its associations with sociodemographic and workplace characteristics. Nine percent of women reported workplace secondhand smoke exposure. Prevalence decreased with increasing age, education, and earnings. Workplace secondhand smoke exposure was associated with chemical exposure (prevalence odds ratio [POR] = 3.3; 95% confidence interval [CI] = 2.3, 4.7); being threatened, bullied, or harassed (POR = 3.2; 95% CI = 2.1, 5.1); vapors, gas, dust, or fume exposure (POR = 3.1; 95% CI = 2.3, 4.4); and worrying about unemployment (POR = 3.0; 95% CI = 1.8, 5.2), among other things. Comprehensive smoke-free laws covering all workers could eliminate inequities in workplace secondhand smoke exposure, including during pregnancy.

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

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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

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.

The effects of secondhand smoke on chronic obstructive pulmonary disease in nonsmoking Korean adults.

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Kim, Woong Jun; Song, June Seok; Park, Dong Won; Kwak, Hyun Jung; Moon, Ji-Yong; Kim, Sang-Heon; Sohn, Jang Won; Yoon, Ho Joo; Shin, Dong Ho; Park, Sung Soo; Kim, Tae-Hyung

2014-09-01

Smoking is widely acknowledged as the single most important risk factor for chronic obstructive pulmonary disease (COPD). However, the risk of COPD in nonsmokers exposed to secondhand smoke remains controversial. In this study, we investigated the association of secondhand smoke exposure with COPD prevalence in nonsmokers who reported never smoking. This study was based on data obtained from the Korean National Health and Nutrition Examination Surveys (KNHANES) conducted from 2008 to 2010. Using nationwide stratified random sampling, 8,596 participants aged ≥ 40 years of age with available spirometry results were recruited. After selecting participants who never smoked, the duration of exposure to secondhand smoke was assessed based on the KNHANES questionnaire. The prevalence of COPD was 6.67% in participants who never smoked. We divided the participants who had never smoked into those with or without exposure to secondhand smoke. The group exposed to secondhand smoke was younger with less history of asthma and tuberculosis, higher income, and higher educational status. Multivariate logistic regression analysis determined that secondhand smoke did not increase the prevalence of COPD. There was no significant difference in the prevalence of COPD between participants who had never smoked with or without exposure to secondhand smoke in our study. Thus, secondhand smoke may not be an important risk factor for the development of COPD in patients who have never smoked.

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

Science.gov (United States)

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

Demographic and geographic differences in exposure to secondhand smoke in Missouri workplaces, 2007-2008.

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Harris, Jenine K; Geremakis, Caroline; Moreland-Russell, Sarah; Carothers, Bobbi J; Kariuki, Barbara; Shelton, Sarah C; Kuhlenbeck, Matthew

2011-11-01

African Americans, Hispanics, service and blue-collar workers, and residents of rural areas are among those facing higher rates of workplace secondhand smoke exposure in states without smokefree workplace laws. Consequently, these groups also experience more negative health effects resulting from secondhand smoke exposure. The objective of this study was to examine disparities in workplace secondhand smoke exposure in a state without a comprehensive statewide smokefree workplace law and to use this information in considering a statewide law. We developed a logistic multilevel model by using data from a 2007-2008 county-level study to account for individual and county-level differences in workplace secondhand smoke exposure. We included sex, age, race, annual income, education level, smoking status, and rural or urban residence as predictors of workplace secondhand smoke exposure. Factors significantly associated with increased exposure to workplace secondhand smoke were male sex, lower education levels, lower income, living in a small rural or isolated area, and current smoking. For example, although the overall rate of workplace exposure in Missouri is 11.5%, our model predicts that among young white men with low incomes and limited education living in small rural areas, 40% of nonsmokers and 56% of smokers may be exposed to secondhand smoke at work. Significant disparities exist in workplace secondhand smoke exposure across Missouri. A statewide smokefree workplace law would protect all citizens from workplace secondhand smoke exposure.

Current smoking and secondhand smoke exposure and depression among Korean adolescents: analysis of a national cross-sectional survey.

Science.gov (United States)

Lee, Kyung-Jae

2014-02-06

To examine the association between cigarette smoke exposure and depression among Korean adolescents using the seventh Korea Youth Risk Behavior Web-based Survey (KYRBWS). Cross-sectional study. A nationally representative sample of middle and high school students across South Korea. 75 643 eligible participants across the country. Current smoking, secondhand smoke exposure and depression. Data were analysed from a nationally representative survey of 75 643 participants (37 873 men and 37 770 women). Data were gathered on extensive information including current smoking, secondhand smoke exposure and depression in adolescence. Multiple logistic regression analysis was used to estimate the association between current smoking, secondhand smoke exposure and depression in Korean adolescents. Among those who had never smoked, secondhand smoke exposure was positively associated with depression in male and female adolescents in a dose-response relation (OR 1.27, OR 1.52 in males; OR 1.25, OR 1.72 in females). Similar associations were observed among currently smoking men and women in a dose-response manner (OR 1.29, OR 1.55 in males; OR 1.22, OR 1.41 in females). These significant trends were consistently observed even after adjustments. We suggested that current smoking and secondhand smoke exposure were positively associated with depression in male and female adolescents. Efforts to encourage no smoking and no secondhand smoke exposure will be established for adolescents.

Using tobacco-industry marketing research to design more effective tobacco-control campaigns.

Science.gov (United States)

Ling, Pamela M; Glantz, Stanton A

2002-06-12

To improve tobacco-control efforts by applying tobacco-industry marketing research and strategies to clinical and public health smoking interventions, we analyzed previously secret tobacco-industry marketing documents. In contrast to public health, the tobacco industry divides markets and defines targets according to consumer attitudes, aspirations, activities, and lifestyles. Tobacco marketing targets smokers of all ages; young adults are particularly important. During the 1980s, cost affected increasing numbers of young and older smokers. During the 1990s, eroding social acceptability of smoking emerged as a major threat, largely from increasing awareness of the dangers of secondhand smoke among nonsmokers and smokers. Physicians and public health professionals should use tobacco-industry psychographic approaches to design more relevant tobacco-control interventions. Efforts to counter tobacco marketing campaigns should include people of all ages, particularly young adults, rather than concentrating on teens and young children. Many young smokers are cost sensitive. Tobacco-control messages emphasizing the dangers of secondhand smoke to smokers and nonsmokers undermine the social acceptability of smoking.

Secondhand smoke exposure induces acutely airway acidification and oxidative stress.

Science.gov (United States)

Kostikas, Konstantinos; Minas, Markos; Nikolaou, Eftychia; Papaioannou, Andriana I; Liakos, Panagiotis; Gougoura, Sofia; Gourgoulianis, Konstantinos I; Dinas, Petros C; Metsios, Giorgos S; Jamurtas, Athanasios Z; Flouris, Andreas D; Koutedakis, Yiannis

2013-02-01

Previous studies have shown that secondhand smoke induces lung function impairment and increases proinflammatory cytokines. The aim of the present study was to evaluate the acute effects of secondhand smoke on airway acidification and airway oxidative stress in never-smokers. In a randomized controlled cross-over trial, 18 young healthy never-smokers were assessed at baseline and 0, 30, 60, 120, 180 and 240 min after one-hour secondhand smoke exposure at bar/restaurant levels. Exhaled NO and CO measurements, exhaled breath condensate collection (for pH, H(2)O(2) and NO(2)(-)/NO(3)(-) measurements) and spirometry were performed at all time-points. Secondhand smoke exposure induced increases in serum cotinine and exhaled CO that persisted until 240 min. Exhaled breath condensate pH decreased immediately after exposure (p secondhand smoke induced airway acidification and increased airway oxidative stress, accompanied by significant impairment of lung function. Despite the reversal in EBC pH and lung function, airway oxidative stress remained increased 4 h after the exposure. Clinical trial registration number (EudraCT): 2009-013545-28. Copyright © 2012 Elsevier Ltd. All rights reserved.

Smoke-Free Workplaces Are Associated with Protection from Second-Hand Smoke at Homes in Nigeria: Evidence for Population-Level Decisions

Directory of Open Access Journals (Sweden)

Dorota Kaleta

2015-01-01

Full Text Available The evidence suggests that smoke-free workplace policies may change social norms towards exposing others to second-hand smoke at home. The aim of the study was to assess whether being employed in a smoke-free workplace (SFWP is associated with living in a smoke-free home (SFH. We used the data from the Global Adult Tobacco Survey conducted in Nigeria in 2012, in which 9,765 individuals were interviewed including 1,856 persons who worked indoors. The percentage of Nigerians employed in SFWP that reported living in a SFH was higher compared to those employed in a workplace where smoking occurred (95% versus 73%. Working in a SFWP was associated with a significantly higher likelihood of living in a SFH (OR = 5.3; p<0.001. Urban inhabitants indicated more frequently that they lived in SFH compared to rural residents (OR = 2.0; p=0.006. The odds of living in a SFH were significantly higher among nonsmokers and nonsmokeless tobacco users compared to smokers and smokeless tobacco users (OR = 28.8; p<0.001; OR = 7.0; p<0.001. These findings support the need for implementation of comprehensive smoke-free policies in Nigeria that result in substantial health benefits.

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

Science.gov (United States)

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.

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.

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

Science.gov (United States)

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.

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.

Science.gov (United States)

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 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.

Case-control study of tobacco smoke exposure and breast cancer risk in Delaware

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Hathcock H Leroy

2008-06-01

Full Text Available Abstract Background Tobacco smoke exposure may be associated with increased breast cancer risk, although the evidence supporting the association is inconclusive. We conducted a case-control study in Delaware, incorporating detailed exposure assessment for active and secondhand smoke at home and in the workplace. Methods Primary invasive breast cancer cases diagnosed among female Delaware residents, ages 40–79, in 2000–2002 were identified through the Delaware cancer registry (n = 287. Delaware drivers license and Health Care Finance Administration records were used to select age frequency-matched controls for women Results A statistically significant increased risk of breast cancer was observed for ever having smoked cigarettes (odds ratio = 1.43, 95% confidence interval = 1.03–1.99. However, there was no evidence of a dose-response relationship between breast cancer risk and total years smoked, cigarettes per day, or pack-years. Neither residential nor workplace secondhand smoke exposure was associated with breast cancer. Recalculations of active smoking risks using a purely unexposed reference group of women who were not exposed to active or secondhand smoking did not indicate increased risks of breast cancer. Conclusion These findings do not support an association between smoking and breast cancer.

The effects of secondhand smoke on postoperative pain and fentanyl consumption.

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Aydogan, Mustafa Said; Ozturk, Erdogan; Erdogan, Mehmet Ali; Yucel, Aytac; Durmus, Mahmut; Ersoy, Mehmet Ozcan; Colak, Cemil

2013-08-01

Although the need for increased postoperative analgesia in smokers has been described, the effect of secondhand smoke on postoperative analgesia requirements has not been studied. We examined the effects of secondhand smoke on fentanyl consumption and postoperative pain. In this study, 101 patients (American Society of Anesthesiology physical status I and II) who underwent abdominal hysterectomy were divided into 3 groups according to history of exposure to cigarette smoke as per medical records which was retrospectively confirmed by measurement of serum cotinine: smokers (n = 28), nonsmokers (n = 31), and secondhand smokers (n = 32). All patients received propofol-remifentanil total intravenous anesthesia and used fentanyl patient controlled analgesia for postoperative pain. The fentanyl consumption visual analogue scale-pain intensity (VAS-PI) score and side effects were recorded in the postanesthesia care unit (PACU) and at 2, 4, 6, and 24 h after surgery. Fentanyl consumption at all the evaluation time points was significantly higher in secondhand smokers than in nonsmokers (P secondhand smokers was lower than that in smokers in the PACU and at 24 h (P secondhand smokers than in nonsmokers (P effects such as nausea, vomiting, and dizziness (P > 0.05). Secondhand smoking was associated with increased postoperative fentanyl consumption, and increased VAS-PI scores. These findings may be beneficial for managing postoperative pain in secondhand smokers.

Second-hand smoke in Italy.

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Gallus, S

2015-12-01

Second-hand smoke (SHS) has been classified as carcinogenic to humans by the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO) [IARC, 2004]. Of the 5.7 million deaths attributable each year to tobacco smoking, more than 600,000 (i.e., around 1% of all deaths worldwide) refer to subjects who never smoked and that prematurely die due to their lifetime exposure to SHS [WHO, 2012]. Italy has been one of the pioneering countries - and the first large country worldwide - to enact a comprehensive smoke-free legislation in 2005. The law, introduced in order to reduce SHS exposure, banned smoking in indoor public places, including restaurants and bars, and in all workplaces [Gallus et al., 2006]. This legislation has had an undisputed success from a public health perspective: it was widely supported and strongly observed, restaurant and bar owners did not experience any dreaded decline in their business, and tobacco smoking (and its detrimental health effects) substantially decreased [Gallus et al., 2006; Gorini et al., 2007]. More importantly, the regulation has been effective in dramatically reducing SHS exposure [Gorini et al., 2007; Martinez-Sanchez et al., 2012]. Most high- income countries followed Italy in the adoption of similar comprehensive smoking ban legislations over the last decade [IARC, 2009]. These regulations and the information campaigns conducted for their enforcement had also the effect to increase the social unacceptability of SHS and consequently the adoption of voluntary home smoking bans [Ferketich et al., 2014; Martinez-Sanchez et al., 2014]. This notwithstanding, in 2010 specific Italian subpopulations were still frequently exposed to SHS, both in public and private places. In particular, 54% of the young (i.e., age 15-24 years) were still exposed to SHS in any settings, 27% in private houses, and 33% in private cars [Martinez-Sanchez et al., 2012]. The relatively high SHS exposure in private cars is of

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

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.

Secondhand Smoking Is Associated with Poor Mental Health in Korean Adolescents.

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Bang, Inho; Jeong, Young-Jin; Park, Young-Yoon; Moon, Na-Yeon; Lee, Junyong; Jeon, Tae-Hee

2017-08-01

In Korea, the prevalence of depression is increasing in adolescents and the most common cause of death of adolescents has been reported as suicide. At a time of increasing predicament of mental health of adolescents, there are few studies on whether secondhand smoking is associated with mental health in adolescents. The objective of this study was to determine whether exposure to secondhand smoke is associated with mental health-related variables, such as depression, stress, and suicide, in Korean adolescents. Data from the eleventh Korea youth risk behavior web-based survey, a nationally representative survey of 62,708 participants (30,964 males and 31,744 females), were analyzed. For students of aged 12 to 18 years, extensive data including secondhand smoking, mental health, sociodemographic variables, and physical health were collected. Chi-square analysis, multiple logistic regression analysis and ordered logistic regression analysis were performed to estimate the association and dose-response relation between secondhand smoking and mental health. Compared with the non-exposed group, the odds ratios (OR) of depression, stress, suicidal ideation, suicidal planning and suicidal attempt in the secondhand smoking exposed group were 1.339, 1.192, 1.303, 1.437 and 1.505, respectively (all P mental health related variable, in a dose-response relation. Our findings suggest that secondhand smoking is associated with poor mental health such as depression, stress, and suicide, showing a dose-response relation in Korean adolescents.

Secondhand smoke and asthma: what are the effects on healthcare utilization among children?

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Jin, Yue; Seiber, Eric E; Ferketich, Amy K

2013-08-01

This study aims to examine the associations between asthma, secondhand smoke exposure and healthcare utilization in a nationally representative sample of children. Data from 5686 children aged 0-11 years were analyzed. Healthcare utilization, asthma diagnosis and demographic information came from the 2001 and 2006 Medical Expenditure Panel Surveys. Secondhand smoke exposure was measured during the 2000 and 2005 National Health Interview Surveys. Multivariable regression models were used to determine the association between secondhand smoke exposure, asthma diagnosis and healthcare utilization (hospitalizations, emergency department visits, outpatient visits and prescription medication use). Asthma modified the relationship between secondhand smoke exposure and hospitalizations, as exposure more than doubled the odds of hospitalization among children with asthma but had no effect on children without asthma. Secondhand smoke exposure increased the odds by 37% of emergency room visits (PSecondhand smoke exposure was associated with a greater utilization of hospitals and emergency departments, and the effect on hospitalizations was most pronounced among children with asthma. Reducing secondhand smoke exposure would help to reduce the burden on the healthcare system, especially among children with asthma. Copyright © 2013 Elsevier Inc. All rights reserved.

Italy and Austria before and after study: second-hand smoke exposure in hospitality premises before and after 2 years from the introduction of the Italian smoking ban.

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Gorini, G; Moshammer, H; Sbrogiò, L; Gasparrini, A; Nebot, M; Neuberger, M; Tamang, E; Lopez, M J; Galeone, D; Serrahima, E

2008-08-01

The aim of this paper was to compare nicotine concentration in 28 hospitality premises (HPs) in Florence and Belluno, Italy, where a smoking ban was introduced in 2005, and in 19 HPs in Vienna, Austria, where no anti-smoking law entered into force up to now. Airborne nicotine concentrations were measured in the same HPs in winter 2002 or 2004 (pre-ban measurements) and winter 2007 (post-ban measurements). In Florence and Belluno, medians decreased significantly (P hospitality workers of 11.81 and 14.67 per 10,000, respectively. Lifetime excess lung cancer mortality risks for bar and disco-pub workers were 10-20 times higher than that calculated for restaurant workers, both in Italy and Austria. In winter 2007, it dropped to 0.01 per 10,000 in Italy, whereas in Austria it remained at the same levels. The drop of second-hand smoke exposure indicates a substantial improvement in air quality in Italian HPs even after 2 years from the ban. The nation-wide smoking ban introduced in Italy on January 10, 2005, resulted in a drop in second-hand smoke exposure in hospitality premises, whereas in Austria, where there is no similar nation-wide smoking ban, the exposure to second-hand smoke in hospitality premises remains high. Given that second-hand smoke is considered a group 1 carcinogen according to the International Agency for Research on Cancer classification, the World Health Organization Framework Convention on Tobacco Control strongly recommends the implementation of nation-wide smoke-free policies in order to improve the indoor air quality of hospitality premises and workplaces. Results from our study strongly supports this recommendation.

Up in Smoke: The Effects of Secondhand Smoke on Children's Health.

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Marx, Joe

1993-01-01

Environmental or second-hand smoke can have serious effects on children. Many smokers are more likely to consider quitting if they know they are causing harm to their children and families. Physicians must take the time to point out the dangers of passive smoking to parents who smoke. (SM)

Health Harms from Secondhand Smoke

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... those who live in rental housing. 3 For workers, exposure is relatively higher in service and blue-collar occupations than in white- collar occupations. 4 The report found that, “today, the adverse health effects of exposure to secondhand smoke are well understood, ...

Secondhand smoke and incidence of dental caries in deciduous teeth among children in Japan: population based retrospective cohort study.

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Tanaka, Shiro; Shinzawa, Maki; Tokumasu, Hironobu; Seto, Kahori; Tanaka, Sachiko; Kawakami, Koji

2015-10-21

Does maternal smoking during pregnancy and exposure of infants to tobacco smoke at age 4 months increase the risk of caries in deciduous teeth? Population based retrospective cohort study of 76 920 children born between 2004 and 2010 in Kobe City, Japan who received municipal health check-ups at birth, 4, 9, and 18 months, and 3 years and had information on household smoking status at age 4 months and records of dental examinations at age 18 months and 3 years. Smoking during pregnancy and exposure of infants to secondhand smoke at age 4 months was assessed by standardised parent reported questionnaires. The main outcome measure was the incidence of caries in deciduous teeth, defined as at least one decayed, missing, or filled tooth assessed by qualified dentists without radiographs. Cox regression was used to estimate hazard ratios of exposure to secondhand smoke compared with having no smoker in the family after propensity score adjustment for clinical and lifestyle characteristics. Prevalence of household smoking among the 76 920 children was 55.3% (n=42 525), and 6.8% (n=5268) had evidence of exposure to tobacco smoke. A total of 12 729 incidents of dental caries were observed and most were decayed teeth (3 year follow-up rate 91.9%). The risk of caries at age 3 years was 14.0% (no smoker in family), 20.0% (smoking in household but without evidence of exposure to tobacco smoke), and 27.6% (exposure to tobacco smoke). The propensity score adjusted hazard ratios of the two exposure groups compared with having no smoker in the family were 1.46 (95% confidence interval 1.40 to 1.52) and 2.14 (1.99 to 2.29), respectively. The propensity score adjusted hazard ratio between maternal smoking during pregnancy and having no smoker in the family was 1.10 (0.97 to 1.25). Exposure to tobacco smoke at 4 months of age was associated with an approximately twofold increased risk of caries, and the risk of caries was also increased among those exposed to household

The determinants of quitting or reducing smoking due to the tobacco tax increase

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Tigova, Olena

2011-05-01

Full Text Available BACKGROUND. Ukraine has adopted State targeted social program for reducing the harmful effects of tobacco on public health in Ukraine till 2012. One of the measures to be implemented is increasing excise tax on tobacco products; therefore, a highly important question is which groups of population are likely to benefit from tax increase through quitting or reducing smoking.METHODS. Data used for analysis were collected in a nationally representative survey of Ukrainian population conducted in 2010. An outcome measure was the anticipated keeping smoking versus quitting (reducing smoking due to tobacco tax increase. Independent variables included socio-demographic characteristics, experience of quitting smoking, exposure to different tobacco control measures, exposure to tobacco advertizing. Binary logistic regression was used to measure associations.RESULTS. Respondents were more likely to expect to keep smoking after the tobacco tax increase if they were dependent on tobacco (odds ratio 2.57, not interested in quitting, not in favor of tobacco tax increase, and exposed to tobacco advertising on TV and cigarette promotions. Respondents were more likely to expect to reduce or quit smoking if they had higher wealth status (OR=0.55, were aware of tobacco health hazard (OR=0.09, had earlier attempts of quitting smoking, were not exposed to secondhand smoke, observed tobacco-related information on television (OR=0.7 and in newspapers (OR=0.45, and observed advertizing of tobacco on radio (OR=0.33 and in public transport (OR=0.25.CONCLUSIONS. Several aspects are important while implementing taxation policy. It is more likely to result in quitting or reducing smoking among those who are less dependent, have tried quitting smoking earlier, and have higher wealth level. Concurrent smoke-free policies and awareness campaigns may potentiate the effect of taxation policies and are recommended to be developed further.

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.

Secondhand smoke and adverse fetal outcomes in nonsmoking pregnant women: a meta-analysis.

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Leonardi-Bee, Jo; Britton, John; Venn, Andrea

2011-04-01

To determine the risk of adverse fetal outcomes of secondhand smoke exposure in nonsmoking pregnant women. This was a systematic review and meta-analysis in accordance with Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. We searched Medline and Embase (to March 2009) and reference lists for eligible studies; no language restrictions were imposed. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by using random-effect models. Our search was for epidemiologic studies of maternal exposure to secondhand smoke during pregnancy in nonsmoking pregnant women. The main outcome measures were spontaneous abortion, perinatal and neonatal death, stillbirth, and congenital malformations. We identified 19 studies that assessed the effects of secondhand smoke exposure in nonsmoking pregnant women. We found no evidence of a statistically significant effect of secondhand smoke exposure on the risk of spontaneous abortion (OR: 1.17 [95% CI: 0.88-1.54]; 6 studies). However, secondhand smoke exposure significantly increased the risk of stillbirth (OR: 1.23 [95% CI: 1.09-1.38]; 4 studies) and congenital malformation (OR: 1.13 [95% CI: 1.01-1.26]; 7 studies), although none of the associations with specific congenital abnormalities were individually significant. Secondhand smoke exposure had no significant effect on perinatal or neonatal death. Pregnant women who are exposed to secondhand smoke are estimated to be 23% more likely to experience stillbirth and 13% more likely give birth to a child with a congenital malformation. Because the timing and mechanism of this effect is not clear, it is important to prevent secondhand smoke exposure in women before and during pregnancy.

Tobacco and Pregnancy: Overview of exposures and effects

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This opening paper will review the epidemiology of the impact of cigarette smoking and other forms of tobacco exposure on human development. Sources of exposure described include cigarettes and other forms of smoked tobacco, secondhand (environmental) tobacco smoke, several forms...

Smoking, exposure to secondhand smoke, and smoking restrictions in Tijuana, Mexico Tabaquismo, exposición a humo ajeno y medidas restrictivas contra el tabaquismo en Tijuana, México

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Ana P. Martínez-Donate

2005-12-01

Full Text Available OBJECTIVE: To estimate the prevalence of tobacco use, exposure to secondhand smoke, and smoking restrictions in the home and workplace among residents of Tijuana, one of Mexico's largest cities. METHODS: This cross-sectional household survey was conducted in Tijuana, Baja California, Mexico, during 2003 and 2004. A population-based sample of 400 Tijuana adult residents responded to a tobacco survey, and 397 of the surveys were analyzed. RESULTS: About 22.9% (95% confidence interval (CI: 18.7%-27.1% of Tijuana adults reported current smoking, and 53.9% (95% CI: 48.8%-58.9% reported chronic exposure to secondhand smoke. Approximately 44.4% (95% CI: 37.9%-50.9% of Tijuana adults had a nonsmoking policy in their workplace, while 65.8% (95% CI: 61.0%-70.6% of Tijuana households were smoke-free. CONCLUSIONS: The results underline the need for increased tobacco control efforts, particularly stricter enforcement of existing passive smoking regulations, in order to expand protection from secondhand smoke from private settings to public ones and to curb the tobacco epidemic in Tijuana and elsewhere in Mexico.OBJETIVO: Calcular la prevalencia del consumo de tabaco, de la exposición a humo ajeno o ambiental y de la existencia de medidas restrictivas contra el tabaquismo en el hogar y en el lugar de trabajo entre residentes de Tijuana, una de las ciudades más grandes de México. MÉTODOS: Esta encuesta domiciliaria transversal se llevó a cabo en Tijuana, Baja California, México, durante 2003 y 2004. Una muestra poblacional de 400 adultos residentes de Tijuana respondió a una encuesta sobre el tabaquismo y 397 de las encuestas se sometieron a análisis. RESULTADOS: Cerca de 22,9% (intervalo de confianza de 95% [IC95%]: 18,7% a 27,1% de los adultos residentes de Tijuana declararon que fumaban en el momento de la encuesta y 53,9% (IC95%: 48,8% a 58,9% declararon estar expuestos crónicamente a humo ajeno o ambiental. Alrededor de 44,4% (IC95%: 37,9% a 50

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

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

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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.

Protecting workers from secondhand smoke in North Carolina.

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Plescia, Marcus; Malek, Sally Herndon; Shopland, Donald R; Anderson, Christy M; Burns, David M

2005-01-01

Exposure to job-related secondhand smoke represents a significant, but entirely preventable occupational health risk to non-smoking workers. This article examines trends in smoke-free workplace policies in North Carolina. We also examine whether workers comply with such policies. Data from the Census Bureau's Current Population Survey were analyzed from 1992 through 2002. Trends for North Carolina workers are compared with workers nationally and trends are presented by age, race, gender, and type of worker. North Carolina ranks 35th in the proportion of its workforce reporting a smoke-free place of employment. The proportion of workers reporting such a policy doubled between 1992 and 2002. Females were more likely to reporta smoke-free work environment (72.0%, CI +/- 2.6) than males (61.2%, CI +/- 4.6%). Blue-collar (55.6%, CI +/- 5.5) and service workers (61.2%, CI +/- 8.4), especially males, were less likely to report a smoke-free worksite than white-collar workers (73.4%, CI +/- 2.6). Compliance with a smoke-free policy does not appear to be an issue, only 3.2% of workers statewide reported someone had violated their company's nonsmoking policy While some progress has been made in North Carolina to protect workers from secondhand smoke, significant disparities exist. Smoke-free policies can make a significant difference in reducing exposure to airborne toxins and their associated diseases, and these protective public health policies have not been shown to reduce business revenues. Much has been done to assure the health and safety of workers through public health policy However, opportunities to protect North Carolina workers from the health effects of secondhand smoke are limited by a preemptive state law.

Tobacco industry sociological programs to influence public beliefs about smoking.

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Landman, Anne; Cortese, Daniel K; Glantz, Stanton

2008-02-01

The multinational tobacco companies responded to arguments about the social costs of smoking and hazards of secondhand smoke by quietly implementing the Social Costs/Social Values project (1979-1989), which relied upon the knowledge and authoritative power of social scientists to construct an alternate cultural repertoire of smoking. Social scientists created and disseminated non-health based, pro-tobacco arguments without fully acknowledging their relationship with the industry. After the US Surgeon General concluded that nicotine was addictive in 1988, the industry responded by forming "Associates for Research in the Science of Enjoyment" (c.1988-1999), whose members toured the world promoting the health benefits of the use of legal substances, including tobacco, for stress relief and relaxation, without acknowledging the industry's role. In this paper we draw on previously secret tobacco industry documents, now available on the Internet to show how both of these programs utilized academic sociologists, political scientists, anthropologists, psychologists, philosophers and economists, and allowed the industry to develop and widely disseminate friendly research through credible channels. Strategies included creating favorable surveys and opinions, infusing them into the lay press and media through press releases, articles and conferences, publishing, promoting and disseminating books, commissioning and placing favorable book reviews, providing media training for book authors and organizing media tours. These programs allowed the tobacco industry to affect public and academic discourse on the social acceptability of smoking.

Changing conclusions on secondhand smoke in a sudden infant death syndrome review funded by the tobacco industry.

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Tong, Elisa K; England, Lucinda; Glantz, Stanton A

2005-03-01

Prenatal and postnatal exposure to tobacco smoke adversely affects maternal and child health. Secondhand smoke (SHS) has been linked causally with sudden infant death syndrome (SIDS) in major health reports. In 1992, the US Environmental Protection Agency (EPA) first noted an association between SHS and SIDS, and both prenatal exposure and postnatal SHS exposure were listed as independent risk factors for SIDS in a 1997 California EPA report (republished in 1999 by the National Cancer Institute) and a 2004 US Surgeon General report. The tobacco industry has used scientific consultants to attack the evidence that SHS causes disease, most often lung cancer. Little is known about the industry's strategies to contest the evidence on maternal and child health. In 2001, a review was published on SIDS that acknowledged funding from the Philip Morris (PM) tobacco company. Tobacco industry documents related to this review were examined to identify the company's influence on the content and conclusions of this review. Tobacco industry documents include 40 million pages of internal memos and reports made available to the public as a result of litigation settlements against the tobacco industry in the United States. Between November 2003 and January 2004, we searched tobacco industry document Internet sites from the University of California Legacy Tobacco Documents Library and the Tobacco Documents Online website. Key terms included "SIDS" and names of key persons. Two authors conducted independent searches with similar key terms, reviewed the documents, and agreed on relevancy through consensus. Thirty documents were identified as relevant. Two drafts (an early version and a final version) of an industry-funded review article on SIDS were identified, and 2 authors independently compared these drafts with the final publication. Formal comments by PM executives made in response to the first draft were also reviewed. We used Science Citation Index in July 2004 to determine

A Tobacco Cessation Intervention with Rural, Medically Underserved, Blue-collar Employees: A Quasiexperimental Study

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Telisa Stewart

2016-12-01

Conclusion: Participants at the intervention worksite increased their knowledge regarding the dangers of tobacco use and secondhand smoke exposure. Among current tobacco users, the intervention appeared to increase family rules regarding secondhand smoke exposure in their homes and vehicles.

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.

Lung injury induced by secondhand smoke exposure detected with hyperpolarized helium-3 diffusion MR.

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Wang, Chengbo; Mugler, John P; de Lange, Eduard E; Patrie, James T; Mata, Jaime F; Altes, Talissa A

2014-01-01

To determine whether helium-3 diffusion MR can detect the changes in the lungs of healthy nonsmoking individuals who were regularly exposed to secondhand smoke. Three groups were studied (age: 59 ± 9 years): 23 smokers, 37 exposure-to-secondhand-smoke subjects, and 29 control subjects. We measured helium-3 diffusion values at diffusion times from 0.23 to 1.97 s. One-way analysis of variance revealed that the mean area under the helium-3 diffusion curves (ADC AUC) of the smokers was significantly elevated compared with the controls and to the exposure-to-secondhand-smoke subjects (P exposure-to-secondhand-smoke subjects and that of the controls was found (P = 0.115). However, application of a receiver operator characteristic-derived rule to classify subjects as either a "control" or a "smoker," based on ADC AUC, revealed that 30% (11/37) of the exposure-to-secondhand subjects were classified as "smokers" indicating an elevation of the ADC AUC. Using helium-3 diffusion MR, elevated ADC values were detected in 30% of nonsmoking healthy subjects who had been regularly exposed to secondhand smoke, supporting the concept that, in susceptible individuals, secondhand smoke causes mild lung damage. Copyright © 2013 Wiley Periodicals, Inc.

"Accommodating" smoke-free policies: tobacco industry's Courtesy of Choice programme in Latin America.

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Sebrié, Ernesto M; Glantz, Stanton A

2007-10-01

To understand the implementation and effects of the Courtesy of Choice programme designed to "accommodate" smokers as an alternative to smoke-free policies developed by Philip Morris International (PMI) and supported by RJ Reynolds (RJR) and British American Tobacco (BAT) since the mid-1990s in Latin America. Analysis of internal tobacco industry documents, BAT "social reports", news reports and tobacco control legislation. Since the mid-1990s, PMI, BAT and RJR promoted Accommodation Programs to maintain the social acceptability of smoking. As in other parts of the world, multinational tobacco companies partnered with third party allies from the hospitality industry in Latin America. The campaign was extended from the hospitality industry (bars, restaurants and hotels) to other venues such as workplaces and airport lounges. A local public relations agency, as well as a network of engineers and other experts in ventilation systems, was hired to promote the tobacco industry's programme. The most important outcome of these campaigns in several countries was the prevention of meaningful smoke-free policies, both in public places and in workplaces. Courtesy of Choice remains an effective public relations campaign to undermine smoke-free policies in Latin America. The tobacco companies' accommodation campaign undermines the implementation of measures to protect people from second-hand smoke called for by the World Health Organization Framework Convention on Tobacco Control, perpetuating the exposure to tobacco smoke in indoor enclosed environments.

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.

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

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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...

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.

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

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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.

Radiation in Tobacco | RadTown USA | US EPA

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2017-08-07

Tobacco used to make cigarettes and other tobacco products contains small amounts of radioactive materials. Stay away from secondhand smoke. Remember, smoking makes radon exposure more likely to cause cancer.

Smoking Behavior, Attitudes of Second-Hand Smoke, and No-Smoking Policies on a University Campus

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Polacek, Georgia N. L. Johnston; Atkins, Janet L.

2008-01-01

Smoking, when condoned as socially acceptable, overtly establishes such behavior as normal and risk-free. Scientific evidence verifies that cigarette smoking pervasively damages the body, causes early death, costs billions of dollars annually in medical care for smokers, and poses serious health risks to nonsmokers exposed to secondhand smoke. Yet…

Demographic and Geographic Differences in Exposure to Secondhand Smoke in Missouri Workplaces, 2007-2008

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Harris, Jenine K.; Geremakis, Caroline; Moreland-Russell, Sarah; Carothers, Bobbi J.; Shelton, Sarah C.; Kariuki, Barbara; Kuhlenbeck, Matthew

2011-01-01

Introduction African Americans, Hispanics, service and blue-collar workers, and residents of rural areas are among those facing higher rates of workplace secondhand smoke exposure in states without smokefree workplace laws. Consequently, these groups also experience more negative health effects resulting from secondhand smoke exposure. The objective of this study was to examine disparities in workplace secondhand smoke exposure in a state without a comprehensive statewide smokefree workplace ...

GENOTOXICITY OF TOBACCO SMOKE AND TOBACCO SMOKE CONDENSATE: A REVIEW

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Genotoxicity of Tobacco Smoke and Tobacco Smoke Condensate: A ReviewAbstractThis report reviews the literature on the genotoxicity of main-stream tobacco smoke and cigarette smoke condensate (CSC) published since 1985. CSC is genotoxic in nearly all systems in which it h...

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

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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.

A longitudinal study on the effects of maternal smoking and secondhand smoke exposure during pregnancy on neonatal neurobehavior.

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Hernández-Martínez, Carmen; Arija Val, Victoria; Escribano Subías, Joaquín; Canals Sans, Josefa

2012-06-01

Maternal smoking during pregnancy is one of the most modifiable causes of morbidity and mortality for both pregnant women and their fetuses. The long-term effects of prenatal exposure to smoke on child behavior and development have been the subject of more extensive research than have the short-term effects. Therefore, the aim of this work is to examine the effects of smoke exposure during pregnancy on neonatal behavior, including in our study a group of mothers exposed to secondhand smoke. The behavior of 282 healthy full-term newborns was assessed using the Neonatal Behavior Assessment Scale (NBAS) at 48-72 h of life. Sixty-two mothers smoked during pregnancy (no mother smoked more than 15 cig/day) and 17 were exposed to secondhand smoke. After adjusting for socio-demographic and obstetric factors, both newborns whose mothers smoked and those whose mothers were exposed to secondhand smoke showed significantly lower scores in the habituation cluster than non-smoking mothers. Exposure to secondhand smoke was also related to lower motor system cluster scores as well as some supplementary items and the newborns of smoking mothers showed significantly lower scores in the state regulation cluster and in some items of the state organization cluster than the newborns of non-smoking mothers. We conclude that active and passive smoking during pregnancy affects several aspects of neurobehavioral development, regardless of socio-demographic, obstetric and pediatric factors. Copyright © 2011 Elsevier Ltd. All rights reserved.

Effects of Secondhand Smoke Exposure on the Health and Development of African American Premature Infants

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Brooks, Jada; Holditch-Davis, Diane; Weaver, Mark A.; Miles, Margaret Shandor; Engelke, Stephen C.

2011-01-01

Objective. To explore the effects of secondhand smoke exposure on growth, health-related illness, and child development in rural African American premature infants through 24 months corrected age. Method. 171 premature infants (72 boys, 99 girls) of African American mothers with a mean birthweight of 1114 grams. Mothers reported on household smoking and infant health at 2, 6, 12, 18, and 24 months corrected age. Infant growth was measured at 6, 12, 18, and 24 months, and developmental assessments were conducted at 12 and 24 months. Results. Thirty percent of infants were exposed to secondhand smoke within their first 2 years of life. Secondhand smoke exposure was associated with poorer growth of head circumference and the development of otitis media at 2 months corrected age. Height, weight, wheezing, and child development were not related to secondhand smoke exposure. Conclusion. Exposure to secondhand smoke may negatively impact health of rural African American premature infants. Interventions targeted at reducing exposure could potentially improve infant outcomes. PMID:22295181

Increasing the Resolution of Chronic Obstructive Pulmonary Disease Definition. Lessons from a Cohort with Remote but Extensive Exposure to Secondhand Tobacco Smoke.

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Arjomandi, Mehrdad; Zeng, Siyang; Blanc, Paul D; Gold, Warren M

2018-04-01

The Global Initiative for Chronic Obstructive Lung Disease criteria require a ratio of forced expiratory volume in 1 second (FEV 1 ) to forced vital capacity (FVC) (FEV 1 /FVC) of less than 0.70 for the diagnosis of chronic obstructive pulmonary disease, whereas other criteria emphasize a lower limit of normal approach. However, the use of Global Initiative for Chronic Obstructive Lung Disease (or lower limit of normal) criteria may result in classification of many smokers with respiratory morbidities as not having chronic obstructive pulmonary disease. Additional accuracy in defining chronic obstructive pulmonary disease could improve its management. To determine whether in a cohort with remote but longstanding exposure to secondhand tobacco smoke, air trapping as measured by ratio of residual volume to total lung capacity (RV/TLC) can identify a subgroup at risk for respiratory morbidity among those without chronic obstructive pulmonary disease defined by Global Initiative for Chronic Obstructive Lung Disease (or lower limit of normal) criteria. We performed an observational study of symptoms and lung function in a cohort of 256 subjects with a history of extensive occupational exposure to secondhand tobacco smoke but with preserved spirometry (FEV 1 /FVC and FEV 1  ≥ lower limit of normal). We elicited symptom prevalence by structured questionnaire, and estimated the correlations between plethysmography-measured RV/TLC and spirometry-measured FEV 1 /FVC and FEV 1 . In subgroups of the cohort, we examined the association of maximum oxygen consumption ([Formula: see text]o 2 max) on exercise testing with RV/TLC (n = 179), dynamic hyperinflation (exercise-induced changes in fraction of tidal breathing that is flow-limited on expiration [percentage of expiratory flow limitation, %EFL] and end-expiratory lung volume) (n = 32), and radiographic gas trapping (percent low attenuation area in -860 to -950 Hounsfield units at end-expiration on computerized

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.

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.

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

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.

Secondhand Smoke Is an Important Modifiable Risk Factor in Sickle Cell Disease: A Review of the Current Literature and Areas for Future Research

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S. Christy Sadreameli

2016-11-01

Full Text Available Sickle cell disease (SCD is an autosomal recessive hemoglobinopathy that causes significant morbidity and mortality related to chronic hemolytic anemia, vaso-occlusion, and resultant end-organ damage. Tobacco smoke exposure (TSE through secondhand smoke exposure in people with SCD of all ages and through primary smoking in adolescents and adults is associated with significantly increased morbidity, with increased rates of emergency department visits and hospitalizations for painful vaso-occlusive crises and acute chest syndrome (ACS. Secondhand smoke is also associated with pulmonary function abnormalities in children with SCD who are already at risk for pulmonary function abnormalities on the basis of SCD. TSE is emerging as one of the few modifiable risk factors of SCD. This review discusses the current state of the evidence with respect to TSE and SCD morbidity, discusses potential mechanisms, and highlights current gaps in the evidence and future research directions.

Indoor air quality due to secondhand smoke: Signals from selected hospitality locations in rural and urban areas of Bangalore and Dharwad districts in Karnataka, India.

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Travers, Mark J; Nayak, Nayanatara S; Annigeri, Vinod B; Billava, N Narayan

2015-01-01

Tobacco smoke has compounds that are known as human carcinogens. With every breath of secondhand smoke we inhale thousands of chemicals. The Government of India in the interest of public health has enacted the Cigarette and Other Tobacco Products Act (COTPA), 2003, which bans smoking in all the public places including hotels and restaurants. The purpose of this study was to observe and record air pollution in smoke free and smoke observed locations and thereby find out whether the owners/managers of hotels, restaurants, and bars comply with rules of COTPA. The objectives of the study were to measure and compare the level of particulate air pollution from secondhand smoke (PM2.5) in smoking and nonsmoking venues. The study was conducted from September 2009 to March 2010 in Karnataka, India following a nonrandom sample of 79 locations, which included restaurants, bars, cafes, hotels, and tea stalls in two districts. The concentration of PM2.5 was measured using a TSI SidePak AM510 Personal Aerosol Monitor. In Karnataka out of the 79 hospitality locations, smoking was observed in 58% places and only 28% had displayed the required "No Smoking" signage. Places where indoor smoking was observed had high levels of air pollution with average 135 PM2.5, which were 3.1 times higher than the average 43 PM2.5 in smoke-free locations and 14 times higher than the World Health Organization (WHO) target air quality guideline for PM2.5. The average PM2.5 levels in different locations ranged from 11 to 417 μg/m(3) and was lower in the case of apparently compliant designated smoking area (DSR). The patrons and the workers in the hospitality sector continue to be exposed to secondhand smoke despite the enactment of COTPA, which bans smoking in public places. This situation demands stringent measures for effective implementation of the Smoke Free Act and negative response to smoking among civil society.

Effect of smoke-free patio policy of restaurants and bars on exposure to second-hand smoke.

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Azagba, Sunday

2015-07-01

While there is increasing support for restricting smoking in restaurant and bar patios, there is limited evidence on the effectiveness of this policy. This study examined the effect of smoke-free patio policy of restaurants and bars on adult second-hand smoke (SHS) exposure. Data were drawn from the 2005-2012 Canadian Tobacco Use Monitoring Survey (n=89,743), a repeated cross-sectional survey of youth and adult. Regression analysis, a quasi-experimental design was used to examine the effect of provincial smoke-free patio policy on self-reported exposure to SHS. Analyses suggest that exposure to SHS on patios of bars and restaurants declined following the adoption of provincial smoke-free patio policy. Relative to pre-policy SHS exposure, regression results showed a reduction in the probability of SHS exposure of up to 25% in Alberta. Similarly, in Nova Scotia, the probability of SHS exposure declined by up to 21%. Analyses stratified by smoking status found similar significant effect on both smokers and non-smokers. Findings suggest that provincial patio smoking ban on bars and restaurants had the intended effect of protecting non-smokers from SHS exposure. This study is consistent with a large body of evidence showing that a strong smoke-free legislation is an effective public health measure. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Protecting children and families from tobacco and tobacco-related NCDs in the Western Pacific: good practice examples from Malaysia, Philippines and Singapore.

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David, A M; Mercado, S P; Klein, J D; Kaundan, M s/o K; Koong, H N; Garcia, E

2017-09-01

Non-communicable diseases (NCDs) are generally considered diseases of adulthood, but NCD risk factors like tobacco use often are taken up during childhood and adolescence, and second-hand smoke exposure affects child survival and development. At a regional meeting of the Asia Pacific Child and Family Health Alliance for Tobacco Control, members reviewed existing good practices of child-focused tobacco control approaches using health promotion strategies. These interventions were implemented nationally in Malaysia, the Philippines and Singapore. Three good practice national examples were identified that focused on creating supportive tobacco-free environments and upgrading cessation skills among paediatricians. These country examples highlight strategic areas to protect children and families from the harms of tobacco, as part of NCD prevention and control. Training paediatricians in brief cessation advice has enabled them to address tobacco-using parents. Fully enforcing smoke-free public areas has led to an increase in smoke-free homes. The Tobacco Free Generation is a tobacco control 'endgame' strategy that taps into a social movement to deglamorize tobacco use and empower youth born in and after year 2000 to reject tobacco and nicotine addiction. Tobacco control is pivotal in the fight against NCDs; health promotion strategies to protect children and youth from tobacco have a critical role to play in NCD prevention and control. Frontline health workers, including primary care paediatricians, need to step up and actively advocate for full implementation of the WHO Framework Convention on Tobacco Control, including tobacco tax increases and smoke-free areas, while monitoring patients and their parents for tobacco use and second-hand smoke exposure, preventing adolescent smoking uptake, and offering cessation support. A life-course approach incorporating child-focused efforts to prevent initiation of smoking and second-hand smoke exposure with measures promoting

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

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

Kids Safe and Smokefree (KiSS): a randomized controlled trial of a multilevel intervention to reduce secondhand tobacco smoke exposure in children.

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Lepore, Stephen J; Winickoff, Jonathan P; Moughan, Beth; Bryant-Stephens, Tyra C; Taylor, Daniel R; Fleece, David; Davey, Adam; Nair, Uma S; Godfrey, Melissa; Collins, Bradley N

2013-08-30

Secondhand smoke exposure (SHSe) harms children's health, yet effective interventions to reduce child SHSe in the home and car have proven difficult to operationalize in pediatric practice. A multilevel intervention combining pediatric healthcare providers' advice with behavioral counseling and navigation to pharmacological cessation aids may improve SHSe control in pediatric populations. This trial uses a randomized, two-group design with three measurement periods: pre-intervention, end of treatment and 12-month follow-up. Smoking parents of children parents about child SHSe, advise about SHSe harms, and refer smokers to cessation resources. After receiving clinic intervention, eligible parents are randomized to receive: (a) a 3-month telephone-based behavioral counseling intervention designed to promote reduction in child SHSe, parent smoking cessation, and navigation to access nicotine replacement therapy or cessation medication or (b) an attention control nutrition education intervention. Healthcare providers and assessors are blind to group assignment. Cotinine is used to bioverify child SHSe (primary outcome) and parent quit status. This study tests an innovative multilevel approach to reducing child SHSe. The approach is sustainable, because clinics can easily integrate the tobacco intervention prompts related to "ask, advise, and refer" guidelines into electronic health records and refer smokers to free evidence-based behavioral counseling interventions, such as state quitlines. NCT01745393 (clinicaltrials.gov).

E-Cigarette as a Harm Reduction Approach among Tobacco Smoking Khat Chewers: A Promising Bullet of Multiple Gains.

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Kassim, Saba; Farsalinos, Konstantinos E

2016-02-19

Khat chewing/use, a green leaf with amphetamine-like effects is socially integrated in the Middle East and Africa. Khat chewing is often associated with tobacco smoking and occurs in closed places, such as a family home setting where the smoke-free laws cannot be implemented. Tobacco cigarette smoking among khat chewers is a significant concern, but there is also second-hand exposure to smoke at home or in places where khat users gather. Evidence suggests that e-cigarettes represent a significantly less harmful form of nicotine intake. Evaluating the effects of e-cigarettes among khat chewers could be important in understanding the impact of e-cigarettes as a harm reduction approach, with the potential to reduce the health risk associated with smoking.

E-Cigarette as a Harm Reduction Approach among Tobacco Smoking Khat Chewers: A Promising Bullet of Multiple Gains

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Saba Kassim

2016-02-01

Full Text Available Khat chewing/use, a green leaf with amphetamine-like effects is socially integrated in the Middle East and Africa. Khat chewing is often associated with tobacco smoking and occurs in closed places, such as a family home setting where the smoke-free laws cannot be implemented. Tobacco cigarette smoking among khat chewers is a significant concern, but there is also second-hand exposure to smoke at home or in places where khat users gather. Evidence suggests that e-cigarettes represent a significantly less harmful form of nicotine intake. Evaluating the effects of e-cigarettes among khat chewers could be important in understanding the impact of e-cigarettes as a harm reduction approach, with the potential to reduce the health risk associated with smoking.

Screening for secondhand smoke in schoolchildren in Japan.

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Ino, Toshihiro; Kurosawa, Kazuo

2015-10-01

There is no systematic screening for secondhand smoke exposure in children. In 2002, we began a secondhand smoke screening (SSS) program for grade 4 elementary schoolchildren with the cooperation of public administration. The SSS program consisted of urinary cotinine measurement in children and a questionnaire survey of their parents. More than 1200 schoolchildren were enrolled in this program annually. The level of urinary cotinine in 30% of the children was >5 ng/mL, whereas in half of them it was undetectable. The major risk factor affecting cotinine level was mother's smoking. Average cotinine was significantly high in children who had a history of "short stature", "decayed tooth and/or periodontal disease," and "frequent stridor". In addition, the highest level of cotinine was detected in children whose father and/or mother smoked in the living room and the lowest level of cotinine was detected in children whose father and/or mother smoked on the veranda or outside the door. These levels, however, were two-fivefold higher than in children whose parents did not smoke. On follow-up questionnaire survey 4 years after initial SSS, significant elevated motivation for smoking cessation was noted. The SSS program is a very simple mass screen that can be done using only a urine test and is very effective for motivating parents to stop smoking with regard to cost benefit. © 2015 Japan Pediatric Society.

Second hand tobacco smoke adversely affects the bone of immature rats

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Rodrigo César Rosa

Full Text Available OBJECTIVES: To evaluate the influence of secondhand cigarette smoke exposure on longitudinal growth of the tibia of growing rats and some parameters of bone quality. METHODS: Forty female rats were randomly divided into four groups: control: rats were sham exposed; 30 days: rats were exposed to tobacco smoke for 30 days; 45 days: rats were exposed to tobacco smoke for 45 days; and 60 days: rats were exposed to tobacco smoke for 60 days. Blood samples were collected to evaluate the levels of cotinine and alkaline phosphatase. Both tibias were dissected and weighed; the lengths were measured, and the bones were then stored in a freezer for analysis of bone mineral content and mechanical resistance (maximal load and stiffness. RESULTS: Exposure of rats to tobacco smoke significantly compromised bone health, suggesting that the harmful effects may be time dependent. Harmful effects on bone growth were detected and were more pronounced at 60-day follow-ups with a 41.8% reduction in alkaline phosphatase levels (p<0.01 and a decrease of 11.25% in tibia length (p<0.001. Furthermore, a 41.5% decrease in bone mineral density was observed (p<0.001, leading to a 42.8% reduction in maximum strength (p<0.001 and a 56.7% reduction in stiffness (p<0.001. CONCLUSION: Second hand cigarette smoke exposure in rats affected bones that were weaker, deforming them and making them osteopenic. Additionally, the long bone was shorter, suggesting interference with growth. Such events seem to be related to time of exposure.

Epidemiology of exposure to secondhand smoke from cigarettes among innocent never smoked adult nigerians in a resource-poor environment of a primary care clinic in Southeastern Nigeria

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Gabriel Uche Pascal Iloh

2017-01-01

Full Text Available Background: Exposure to secondhand smoke from cigarettes is a public health hazard that is increasing globally and emerging in resource-poor nations where the health effects of secondhand smoke are less publicized in biomedical literatures, electronic and print media. As the global prevalence of cigarette smoking increases so does the health hazards and harm associated with secondhand smoke increases with implication for family and community health. Aim: The study was aimed at describing the epidemiology of exposure to secondhand smoke from cigarettes among innocent never smoked adult Nigerians in a primary care clinic of a tertiary hospital in Nigeria. Materials and Methods: A cross-sectional descriptive hospital-based study was carried out on 500 adult Nigerian patients in a primary care clinic in Nigeria. Data were collected using pretested, structured, and interviewer-administered questionnaire containing information on relevant epidemiological variables. Exposure to secondhand smoke was defined as exposure to cigarette smoke in a never smoked adult in the previous 1 year. Results: The prevalence of exposure to secondhand smoke was 45.0%. Exposures occur predominantly among males (56.4%, middle-aged adults (44.0%, outside home environment (72.0, during the daytime (63.6%, and dry season (58.7%. The persons involved in the smoking were principally friends and passersby (65.8%. Exposure to secondhand smoke was associated with age (middle-aged adults (P = 0.036 and male gender (P = 0.02. Conclusion: This study has demonstrated the variable epidemiology of exposure to secondhand smoke. Tackling relevant epidemiological factors that predispose to exposure to secondhand smoke through programs and policies will facilitate appropriate public health action to safeguard the health of never smoked individuals.

The effects of secondhand smoke on chronic obstructive pulmonary disease in nonsmoking Korean adults

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Kim, Woong Jun; Song, June Seok; Park, Dong Won; Kwak, Hyun Jung; Moon, Ji-Yong; Kim, Sang-Heon; Sohn, Jang Won; Yoon, Ho Joo; Shin, Dong Ho; Park, Sung Soo; Kim, Tae-Hyung

2014-01-01

Background/Aims Smoking is widely acknowledged as the single most important risk factor for chronic obstructive pulmonary disease (COPD). However, the risk of COPD in nonsmokers exposed to secondhand smoke remains controversial. In this study, we investigated the association of secondhand smoke exposure with COPD prevalence in nonsmokers who reported never smoking. Methods This study was based on data obtained from the Korean National Health and Nutrition Examination Surveys (KNHANES) conduct...

Secondhand Smoke Exposure and Preclinical Markers of Cardiovascular Risk in Toddlers.

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Groner, Judith A; Huang, Hong; Joshi, Mandar S; Eastman, Nicholas; Nicholson, Lisa; Bauer, John Anthony

2017-10-01

To investigate relationships between secondhand smoke exposure in young children and several preclinical markers of cardiovascular risk that have been established as relevant to adult populations. There were 139 children, 2-5 years of age, enrolled in a cross-sectional study. Secondhand smoke exposure was objectively determined by hair nicotine level; a comprehensive panel of clinical markers (morning blood pressure, fasting glucose and insulin, lipid profiles, inflammation) and research markers (markers of oxidation, endothelial stress, and endothelial repair) of cardiovascular risk status were assessed. Univariate and multivariate linear regression were used to evaluate relationships between secondhand smoke exposure and cardiovascular risk markers. Hair nicotine levels were correlated directly with blood pressure and serum C-reactive protein, and inversely correlated with serum high-density lipoprotein cholesterol and endothelial cell progenitor cell prevalence. In multivariate analyses, these relationships remained when controlled for age, sex, body mass index z-score, maternal education, and method of payment. Additionally, in multivariate analyses, hair nicotine level was significantly negatively correlated with total antioxidant capacity. These results support the view that secondhand smoke exposure in the very young has a detectable relationship with several markers of cardiovascular risk, long before the emergence of clinical disease. Further studies to define mechanisms and strategies to prevent and mitigate these risks early in life are warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

The road to effective tobacco control in China.

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Yang, Gonghuan; Wang, Yu; Wu, Yiqun; Yang, Jie; Wan, Xia

2015-03-14

The non-communicable disease burden in China is enormous, with tobacco use a leading risk factor for the major non-communicable diseases. The prevalence of tobacco use in men is one of the highest in the world, with more than 300 million smokers and 740 million non-smokers exposed to second-hand smoke. In the past decade public awareness of the health hazards of tobacco use and exposure to second-hand smoke has grown, social customs and habits have changed, aggressive tactics used by the tobacco industry have been revealed, and serious tobacco control policies have been actively promoted. In 2014, national legislators in China began actively considering national bans on smoking in public and work places and tobacco advertising. However, tobacco control in China has remained particularly difficult because of interference by the tobacco industry. Changes to the interministerial coordinating mechanism for implementation of the WHO Framework Convention on Tobacco Control are now crucial. Progress towards a tobacco-free world will be dependent on more rapid action in China. Copyright © 2015 Elsevier Ltd. All rights reserved.

Geographical Inequality in Tobacco Control in China: Multilevel Evidence From 98 058 Participants.

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Astell-Burt, Thomas; Zhang, Mei; Feng, Xiaoqi; Wang, Limin; Li, Yichong; Page, Andrew; Zhou, Maigeng; Wang, Linhong

2018-05-03

We investigated the spatial patterning and correlates of tobacco smoking, exposure to secondhand smoke, smoking in public places, workplace smoking prohibition, pro- and counter-tobacco advertisements in mainland China. Choropleth maps and multilevel models were used to assess geographical variation and correlates of the aforementioned outcome variables for 98 058 participants across 31 provinces of China in 2010. Current tobacco smoking prevalence was higher in the central provinces for men and in the north eastern provinces and Tibet for women. Secondhand smoke was higher for both genders in Qinghai and Hunan provinces. Workplace tobacco restrictions was higher in the north and east, whereas smoking in public places was more common in the west, central, and far northeast. Protobacco advertising was observed in public places more often by men (18.5%) than women (13.1%). Men (35.5%) were also more likely to sight counter-tobacco advertising in public places than women (30.1%). Awareness of workplace tobacco restrictions was more common in affluent urban areas. Lower awareness of workplace tobacco restrictions was in less affluent urban and rural areas. Sightings of tobacco smoking in public places was highest in restaurants (80.4% for men, 75.0% for women) and also commonly reported in less affluent urban and rural areas. Exposure to secondhand smoke was lower among women (but not men) where workplace tobacco restrictions was more common and higher regardless of gender in areas where smoking in public places was more commonly observed. Geographical and gender-sensitive targeting of tobacco prevention and control initiatives are warranted. This study demonstrates spatial patterning of China's 300 million smokers across the country that are different for men and women. Many of the factors that influence tobacco use, such as pro- and counter-advertising, also vary geographically. Workplace smoking restrictions are more commonly reported among individuals with higher

Pregnancy, maternal tobacco smoking and early age leukemia in Brazil

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Sergio eKoifman

2012-11-01

Full Text Available Background: Cigarette smoking has been associated with acute myeloid leukemia but hypothesis on the association between maternal smoking during pregnancy and childhood leukemia is unclear. Objectives: To investigate the association between maternal exposure to tobacco smoking during pregnancy and early age (< 2 yr. leukemia (EAL. Methods: A hospital-based multicenter case-control study aiming to explore EAL risk factors was carried out in Brazil during 1999-2007. Data were collected by direct interview with the biological mothers using a standardized questionnaire. The present study included 675 children, being 193 acute lymphoblastic leukemia (ALL, 59 acute myeloid leukemia (AML, and 423 controls, being the latter age frequency matched and paired by area of residence with the cases. Unconditional logistic regression was performed, and odds ratios (OR on the association between tobacco smoking (3 months before pregnancy, during pregnancy, and 3 months after delivery and EAL were ascertained after adjustment for selected variables (maternal age at birth and education, birth weight, infant skin color, and oral contraceptives use during pregnancy.Results: Smoking was reported by 17.5% of case mothers and 20.6% of controls´. Among women who reported to have smoked 20 or more cigarettes during the index pregnancy, an adjusted OR = 5.28 (95% C.I. 1.40-19.95 for ALL was observed. Heavy smoking during breastfeeding yielded an adjusted risk estimate for ALL, OR = 7.78 (95% C.I. 1.33-45.5. No dose-response effect was observed according to smoking exposure during pregnancy and EAL. An association between secondhand smoking during pregnancy or breastfeeding was not observed. Conclusion: An association between maternal smoking and AAL in the offspring was restricted to women who have reported an intense exposure to tobacco smoke during pregnancy and breastfeeding.

A DRD1 polymorphism predisposes to lung cancer among those exposed to secondhand smoke during childhood.

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Robles, Ana I; Yang, Ping; Jen, Jin; McClary, Andrew C; Calhoun, Kara; Bowman, Elise D; Vähäkangas, Kirsi; Greathouse, K Leigh; Wang, Yi; Olivo-Marston, Susan; Wenzlaff, Angela S; Deng, Bo; Schwartz, Ann G; Ryan, Bríd M

2014-12-01

Lung cancer has a familial component which suggests a genetic contribution to its etiology. Given the strong evidence linking smoking with lung cancer, we studied miRNA-related loci in genes associated with smoking behavior. CHRNA, CHRNB gene families, CYP2A6, and DRD1 (dopamine receptor D1) were mined for SNPs that fell within the seed region of miRNA binding sites and then tested for associations with risk in a three-stage validation approach. A 3'UTR (untranslated region) SNP in DRD1 was associated with a lower risk of lung cancer among individuals exposed to secondhand smoke during childhood [OR, 0.69; 95% confidence interval (CI), 0.60-0.79; P secondhand smoke and heterogeneity between individuals in regard to their susceptibility to the effects of secondhand smoke, our data show an interaction between an SNP in the 3'UTR of DRD1 and exposure to secondhand smoke during childhood. Further work is needed to explore the mechanistic underpinnings of this SNP and the nature of the interaction between DRD1 and exposure to secondhand smoke during childhood. ©2014 American Association for Cancer Research.

Secondhand smoke risk in infants discharged from an NICU: potential for significant health disparities?

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Stotts, Angela L; Evans, Patricia W; Green, Charles E; Northrup, Thomas F; Dodrill, Carrie L; Fox, Jeffery M; Tyson, Jon E; Hovell, Melbourne F

2011-11-01

Secondhand smoke exposure (SHSe) threatens fragile infants discharged from a neonatal intensive care unit (NICU). Smoking practices were examined in families with a high respiratory risk infant (born at very low birth weight; ventilated > 12 hr) in a Houston, Texas, NICU. Socioeconomic status, race, and mental health status were hypothesized to be related to SHSe and household smoking bans. Data were collected as part of The Baby's Breath Project, a hospital-based SHSe intervention trial targeting parents with a high-risk infant in the NICU who reported a smoker in the household (N = 99). Measures of sociodemographics, smoking, home and car smoking bans, and depression were collected. Overall, 26% of all families with a high-risk infant in the NICU reported a household smoker. Almost half of the families with a smoker reported an annual income of less than $25,000. 46.2% of families reported having a total smoking ban in place in both their homes and cars. Only 27.8% families earning less than $25,000 reported having a total smoking ban in place relative to almost 60% of families earning more (p < .01). African American and Caucasian families were less likely to have a smoking ban compared with Hispanics (p < .05). Mothers who reported no smoking ban were more depressed than those who had a household smoking ban (p < .02). The most disadvantaged families were least likely to have protective health behaviors in place to reduce SHSe and, consequently, are most at-risk for tobacco exposure and subsequent tobacco-related health disparities. Innovative SHSe interventions for this vulnerable population are sorely needed.

Changes in hospitality workers' exposure to secondhand smoke following the implementation of New York's smoke-free law

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Farrelly, M; Nonnemaker, J; Chou, R; Hyland, A; Peterson, K; Bauer, U

2005-01-01

Objective: To assess the impact on hospitality workers' exposure to secondhand smoke of New York's smoke-free law that prohibits smoking in all places of employment, including restaurants, bars, and bowling facilities.

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.

Second-Hand Smoke Increases Bronchial Hyperreactivity and Eosinophilia in a Murine Model of Allergic Aspergillosis

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Brian W. P. Seymour

2003-01-01

Full Text Available Involuntary inhalation of tobacco smoke has been shown to aggravate the allergic response. Antibodies to fungal antigens such as Aspergillus fumigatus (Af cause an allergic lung disease in humans. This study was carried out to determine the effect of environmental tobacco smoke (ETS on a murine model of allergic bronchopulmonary aspergillosis (ABPA. BALB/c mice were exposed to aged and diluted sidestream cigarette smoke to simulate 'second-hand smoke'. The concentration was consistent with that achieved in enclosed public areas or households where multiple people smoke. During exposure, mice were sensitized to Af antigen intranasally. Mice that were sensitized to Af antigen and exposed to ETS developed significantly greater airway hyperreactivity than did mice similarly sensitized to Af but housed in ambient air. The effective concentration of aerosolized acetylcholine needed to double pulmonary flow resistance was significantly lower in Af + ETS mice compared to the Af + AIR mice. Immunological data that supports this exacerbation of airway hyperresponsiveness being mediated by an enhanced type 1 hypersensitivity response include: eosinophilia in peripheral blood and lung sections. All Af sensitized mice produced elevated levels of IL4, IL5 and IL10 but no IFN-γ indicating a polarized Th2 response. Thus, ETS can cause exacerbation of asthma in ABPA as demonstrated by functional airway hyperresponsiveness and elevated levels of blood eosinophilia.

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

[Response of the tobacco industry to the creation of smoke-free environments in Brazil].

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Bialous, Stella Aguinaga; Presman, Sabrina; Gigliotti, Analice; Muggli, Monique; Hurt, Richard

2010-04-01

To document the response of the tobacco industry to the regulation of smoking in public places in Brazil starting in 1996. The Legacy Tobacco Documents Library (legacy.library.ucsf.edu/) and the British American Tobacco (BAT) Company Documents (bat.library.ucsf.edu/) were searched. The following key words were used: Brasil/Brazil; Souza Cruz; fumo passivo, tabagismo passivo/passive smoking; fumo de segunda mão/secondhand smoking; convivência em harmonia/courtesy of choice; along with the names of institutions, politicians, and individuals associated with tobacco control. We also searched the websites of cigarette manufacturers and hospitality industry organizations and businesses, news websites, and online newspapers and magazines. The search was limited to the period from 1995 to 2005. The text of the first law restricting smoking in Brazil (no. 9 294, of 1996) benefited the industry by stating that smokers and nonsmokers could share the same space provided that specific areas were designated as smoking and nonsmoking. As in other countries, the tobacco industry established partnerships with hotel, bar, and restaurant associations to prevent the passing of laws creating 100% smoke-free environments, as recommended by the World Health Organization. However, local state and city laws in major cities and states (such as Rio de Janeiro and São Paulo) have been successful in ensuring the creation of 100% smoke-free places. It is essential that Brazil recognize the damage caused by smoking and revise its federal law regulating smoking in closed environments. The knowledge concerning the strategies employed by the industry may be useful for politicians and health care professionals to prepare arguments opposing measures that can be detrimental to public health.

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.

Smoking and Passive Smoking

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Russell V. Luepker, MD, MS

2016-09-01

Full Text Available Objective: To review the literature on associations between cardiovascular diseases and tobacco use, including recent trends in smoking behaviors and clinical approaches for cessation of smoking. Methods: A literature review of recent scientific findings for smoking and cardiovascular diseases and recommendations for obtaining cessation. Results: Tobacco smoking is causally related to cardiovascular disease, with nearly a half million deaths annually attributed to cigarette smoking in the United States. The human, economic, medical, and indirect costs are enormous. Secondhand smoke as inhaled from the environment also plays an important role in the genesis of cardiovascular diseases. A recent trend in the use of e-cigarettes is noted particularly among youth. For children, prevention is the best strategy. For adult smokers, behavioral treatments, self-help approaches, and pharmacologic therapies are readily available. Clinicians can have a significant impact on patients’ smoking habits. Adding to individual strategies, regulatory community and public health approaches provide the potential for eliminating the use of tobacco. Conclusion: Tobacco smoke causes cardiovascular morbidity and death. Clinicians can play a role in preventing smoking and promoting cessation.

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.

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.

An Evaluation of Mi Familia No Fuma: Family Cohesion and Impact on Secondhand Smoking

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Law, Jon; Kelly, Michael; Garcia, Pema; Taylor, Thom

2010-01-01

Background: Family cohesion may be a factor to prevent exposure of Hispanics in United States to secondhand smoke. Purpose: The purpose of this study was to evaluate one permutation of Mi Familia No Fuma (MFNF) and its resulting outputs or proximal client outcomes. Methods: MFNF is an approach to secondhand smoke prevention, using family cohesion…

The impact of tobacco control policies in Albania.

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Zaloshnja, Eduard; Ross, Hana; Levy, David T

2010-12-01

To assess the impact of a tobacco control law adopted in Albania in 2007 and to estimate the share of illicit cigarettes on the market. Comparative analysis of two waves of a nationally representative household survey, one conducted before the new law went into effect and the other after 2 years. Official sales data were contrasted with the consumption estimate based on the survey. Smoking prevalence, quit attempts, exposure to cigarette advertising, exposure to second-hand smoke, total cigarette consumption, share of illicit packs among packs possessed by smokers. Despite the adoption of strong smoke-free policies and adverting restrictions, smoking prevalence in Albania has risen. The increase in prevalence has been driven by higher smoking rates among females (18.9% in 2007 vs 29.3% in 2009) and young adults (23.2% in 2007 vs 38.5% in 2009 among 18-19 year olds). Self-reported exposure to second-hand smoke and cigarette advertising have been reduced since 2007. The majority of respondents are still exposed to second-hand smoke and more than half are exposed to tobacco advertising. Nevertheless, there are signs that the consumption of illicit cigarettes is declining. The impacts of smoke-free policies and an advertising ban have been limited due to lack of enforcement and failure to adopt a comprehensive set of tobacco control measures. These measures should include sizeable and regular tobacco tax increases in excess of the general level of inflation and income growth. The decline in the share of illicit cigarettes should improve the effectiveness of the cigarette tax policy.

Exposure to secondhand smoke among adults - Philippines, 2009.

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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.

Smoking bans and the secondhand smoking problem: an economic analysis.

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Hofmann, Annette; Nell, Martin

2012-06-01

Smoking bans are gaining widespread support in the European Union and other countries. The vast majority of these bans are partial bans given that smoking is still permitted in certain places. This article investigates the role of partial smoking bans in coping with externalities caused by the secondhand smoking problem. Although it is widely known that Pigouvian taxation is superior to a perfect ban, this result does not necessarily carry over to a partial ban because taxes cannot (easily) be differentiated according to location. We show that under an easy and intuitive condition, (1) enacting a partial smoking ban alone always improves social welfare (a) in an unregulated society and (b) even in a regulated society if externalities can be eliminated, and (2) it is ensured that a combination of Pigouvian tax and a partial smoking ban leads to a higher social optimum than implementing corrective Pigouvian taxation alone.

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.

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.

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

Impact of the Spanish smoke-free legislation on adult, non-smoker exposure to secondhand smoke: cross-sectional surveys before (2004) and after (2012) legislation.

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Sureda, Xisca; Martínez-Sánchez, Jose M; Fu, Marcela; Pérez-Ortuño, Raúl; Martínez, Cristina; Carabasa, Esther; López, María J; Saltó, Esteve; Pascual, José A; Fernández, Esteve

2014-01-01

In 2006, Spain implemented a national smoke-free legislation that prohibited smoking in enclosed public places and workplaces (except in hospitality venues). In 2011, it was extended to all hospitality venues and selected outdoor areas (hospital campuses, educational centers, and playgrounds). The objective of the study is to evaluate changes in exposure to secondhand smoke among the adult non-smoking population before the first law (2004-05) and after the second law (2011-12). Repeated cross-sectional survey (2004-2005 and 2011-2012) of a representative sample of the adult (≥ 16 years) non-smoking population in Barcelona, Spain. We assess self-reported exposure to secondhand smoke (at home, the workplace, during leisure time, and in public/private transportation vehicles) and salivary cotinine concentration. Overall, the self-reported exposure to secondhand smoke fell from 75.7% (95%CI: 72.6 to 78.8) in 2004-05 to 56.7% (95%CI: 53.4 to 60.0) in 2011-12. Self-reported exposure decreased from 32.5% to 27.6% (-15.1%, p<0.05) in the home, from 42.9% to 37.5% (-12.6%, p=0.11) at work/education venues, from 61.3% to 38.9% (-36.5%, p<0.001) during leisure time, and from 12.3% to 3.7% (-69.9%, p<0.001) in public transportation vehicles. Overall, the geometric mean of the salivary cotinine concentration in adult non-smokers fell by 87.2%, from 0.93 ng/mL at baseline to 0.12 ng/mL after legislation (p<0.001). Secondhand smoke exposure among non-smokers, assessed both by self-reported exposure and salivary cotinine concentration, decreased after the implementation of a stepwise, comprehensive smoke-free legislation. There was a high reduction in secondhand smoke exposure during leisure time and no displacement of secondhand smoke exposure at home.

Correlates of exposure to secondhand smoke (SHS) at home among non-smoking adults in Bangladesh: findings from the ITC Bangladesh survey.

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Abdullah, Abu S; Driezen, Pete; Sansone, Genevieve; Nargis, Nigar; Hussain, Ghulam Akm; Quah, Anne Ck; Fong, Geoffrey T

2014-07-16

Exposure to secondhand smoke (SHS) is a serious global public health problem. Understanding the correlates of SHS exposure could guide the development of evidence based SHS exposure reduction interventions. The purpose of this study is to describe the pattern of and factors associated with SHS exposure among non-smoking adults in Bangladesh. Data come from adult non-smokers who participated in the second wave (2010) of the International Tobacco Control Policy (ITC) Evaluation Bangladesh Survey conducted in all six administrative divisions of Bangladesh. A structured questionnaire gathered information on participants' demographic characteristics, pattern of SHS exposure, SHS knowledge, and attitudes towards tobacco control. Exposure to SHS at home was defined as non-smokers who lived with at least one smoker in their household and who reported having no home smoking ban. The data were analyzed using chi-square tests and logistic regression procedures. The SHS exposure rate at home among the participants (N=2813) was 43%. Several sociodemographic and attitudinal factors were associated with SHS exposure. Logistic regression analyses identified eight predictors of SHS exposure: being female (OR=2.35), being aged 15-24 (OR=2.17), being recruited from Dhaka slums (OR=5.19) or non-tribal/non-border areas outside Dhaka (OR=2.19) or tribal/border area (OR=4.36), having lower education (1-8 years: OR=2.45; illiterate: OR=3.00, having higher monthly household income (5000 to non-smoking Bangladeshi adults are exposed to SHS at home. The findings suggest the need for comprehensive tobacco control measures that would improve public understanding about health hazards of SHS exposure at home and encourage educational initiatives to promote smoke-free homes. Interventions should deliver targeted messages to reach those in the low socioeconomic status group.

Parental tobacco smoke exposure: Epigenetics and the ...

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Epigenetic programming is an important mechanism underlying the Developmental Origins of Health and Disease (DOHaD). Much of the research in this area has focused on maternal nutrition. Parental smoking has emerged as a prime example of how exposure to environmental toxicants during the preconceptional and in utero periods can have long-term effects on offspring health, and the role of the epigenome in these effects. Maternal smoking and exposure to second-hand smoke during pregnancy result in lower birth weight of offspring, and there is now clear evidence that these offspring are at elevated risk for overweight/obesity, type-2 diabetes, respiratory effects during adolescence and adulthood, and may be programmed for increased risk of nicotine addiction. Epigenetic analyses of placenta, cord blood and offspring buccal cells have consistently revealed altered DNA methylation of genes involved in developmental processes and xenobiotic metabolism, and these epigenetic changes are persistent. Animal studies with cigarette smoke and nicotine support these findings. Paternal preconceptional smoking has been positively related to childhood cancers, potentially linked to changes in the sperm epigenome. Germ cell specification and preimplantation development are periods of widespread erasure and reprogramming of DNA methylation, and as such are likely to be sensitive periods for environmental effects on the epigenome. Exposure to tobacco smoke during gametogenesis and in

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.

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.

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

Respiratory Health Effects of Passive Smoking

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This report concludes that exposure to environmental tobacco smoke (ETS), commonly known as secondhand smoke, is responsible for approximately 3,000 lung cancer deaths each year in nonsmoking adults and impairs respiratory health.

How many deaths will it take? A death from asthma associated with work-related environmental tobacco smoke.

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Stanbury, Martha; Chester, Debra; Hanna, Elizabeth A; Rosenman, Kenneth D

2008-02-01

Despite epidemiologic, experimental and observational data on the association of environmental tobacco smoke (ETS) and adverse health effects, bar and restaurant workers remain exposed to ETS in the majority of states and countries. Three public health surveillance systems were used to identify and conduct a follow-up investigation of a reported acute asthma death of a young waitress in a bar. The waitress collapsed at the bar where she worked and was declared dead shortly thereafter. Evaluation of the circumstances of her death and her medical history concluded that her death was from acute asthma due to environmental tobacco smoke at work. This is the first reported acute asthma death associated with work-related ETS. Recent studies of asthma among bar and restaurant workers before and after smoking bans support this association. This death dramatizes the need to enact legal protections for workers in the hospitality industry from secondhand smoke.

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 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.

Changes in hospitality workers' exposure to secondhand smoke following the implementation of New York's smoke-free law.

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Farrelly, M C; Nonnemaker, J M; Chou, R; Hyland, A; Peterson, K K; Bauer, U E

2005-08-01

To assess the impact on hospitality workers' exposure to secondhand smoke of New York's smoke-free law that prohibits smoking in all places of employment, including restaurants, bars, and bowling facilities. Pre-post longitudinal follow up design. Restaurants, bars, and bowling facilities in New York State. At baseline, 104 non-smoking workers in restaurants, bars, and bowling facilities were recruited with newspaper ads, flyers, and radio announcements. Of these, 68 completed a telephone survey and provided at least one saliva cotinine specimen at baseline. At three, six, and 12 month follow up studies, 47, 38, and 32 workers from the baseline sample of 68 completed a telephone survey and provided at least one saliva cotinine specimen. The smoke-free law went into effect 24 July 2003. Self reported sensory and respiratory symptoms and exposure to secondhand smoke; self administered saliva cotinine specimens. Analyses were limited to subjects in all four study periods who completed a telephone survey and provided at least one saliva cotinine specimen. All analyses were limited to participants who completed both an interview and a saliva specimen for all waves of data collection (n = 30) and who had cotinine concentrations hospitality jobs decreased from 12.1 hours (95% confidence interval (CI) 8.0 to 16.3 hours) to 0.2 hours (95% CI -0.1 to 0.5 hours) (p law had its intended effect of protecting hospitality workers from exposure to secondhand smoke within three months of implementation. One year after implementation, the results suggest continued compliance with the law.

Impact of the Spanish smoke-free legislation on adult, non-smoker exposure to secondhand smoke: cross-sectional surveys before (2004 and after (2012 legislation.

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Xisca Sureda

Full Text Available BACKGROUND: In 2006, Spain implemented a national smoke-free legislation that prohibited smoking in enclosed public places and workplaces (except in hospitality venues. In 2011, it was extended to all hospitality venues and selected outdoor areas (hospital campuses, educational centers, and playgrounds. The objective of the study is to evaluate changes in exposure to secondhand smoke among the adult non-smoking population before the first law (2004-05 and after the second law (2011-12. METHODS: Repeated cross-sectional survey (2004-2005 and 2011-2012 of a representative sample of the adult (≥ 16 years non-smoking population in Barcelona, Spain. We assess self-reported exposure to secondhand smoke (at home, the workplace, during leisure time, and in public/private transportation vehicles and salivary cotinine concentration. RESULTS: Overall, the self-reported exposure to secondhand smoke fell from 75.7% (95%CI: 72.6 to 78.8 in 2004-05 to 56.7% (95%CI: 53.4 to 60.0 in 2011-12. Self-reported exposure decreased from 32.5% to 27.6% (-15.1%, p<0.05 in the home, from 42.9% to 37.5% (-12.6%, p=0.11 at work/education venues, from 61.3% to 38.9% (-36.5%, p<0.001 during leisure time, and from 12.3% to 3.7% (-69.9%, p<0.001 in public transportation vehicles. Overall, the geometric mean of the salivary cotinine concentration in adult non-smokers fell by 87.2%, from 0.93 ng/mL at baseline to 0.12 ng/mL after legislation (p<0.001. CONCLUSIONS: Secondhand smoke exposure among non-smokers, assessed both by self-reported exposure and salivary cotinine concentration, decreased after the implementation of a stepwise, comprehensive smoke-free legislation. There was a high reduction in secondhand smoke exposure during leisure time and no displacement of secondhand smoke exposure at home.

Association of particulate air pollution and secondhand smoke on endothelium-dependent brachial artery dilation in healthy children

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Mohammad Hashemi

2012-01-01

Full Text Available Background: This study aimed to determine the association of particulate matters with endothelial function, measured by flow mediated dilation (FMD of brachial artery, in children with or without exposure to secondhand smoke. Methods: This cross-sectional study was conducted from January to March 2011 in Isfahan, which is the second large and air-polluted city in Iran. The areas of the city with lowest and highest air pollution were determined, and in each area, 25 prepubescent boys with or without exposure to daily tobacco smoke in home were selected, i.e. 100 children were studied in total. Results: FMD was significantly smaller in those living in high-polluted area and those exposed to secondhand smoke. Multiple linear regression analysis, adjusted for age and body mass index, showed that both passive smoking status and living area in terms of particulate air pollution were effective determinants of the brachial artery diameter. The standardized coefficient of passive smoking status was –0.36 (SD = 0.09, P < 0.0001 showing negative association with percent increase in FMD. Likewise, the percent increase in brachial artery diameter was lower in passive smoker children. Similar relationship was documented for PM 10 concentration with a regression coefficient of –0.32 (SD = 0.04, P < 0.0001. Without considering passive smoking variable, PM 10 concentration has significant independent effect on FMD level. Conclusion: Our findings provide evidence on the association of environmental factors on endothelial dysfunction from early life. Studying such associations among healthy children may help identify the underlying mechanisms. The clinical implications of environmental factors on early stages of atherosclerosis should be confirmed in longitudinal studies.

Smoke-Free Policies in New Zealand Public Tertiary Education Institutions

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Robertson, Lindsay A.; Marsh, L.

2015-01-01

The Framework Convention on Tobacco Control mandates the creation of smoke-free environments to protect non-smokers from second-hand smoke and reduce demand for tobacco. We aimed to examine the extent and nature of smoke-free campus policies at tertiary education institutions throughout New Zealand, and examine the policy development process.…

Turning free speech into corporate speech: Philip Morris' efforts to influence U.S. and European journalists regarding the U.S. EPA report on secondhand smoke.

Science.gov (United States)

Muggli, Monique E; Hurt, Richard D; Becker, Lee B

2004-09-01

Previously secret internal tobacco company documents show that the tobacco industry launched an extensive multifaceted effort to influence the scientific debate about the harmful effects of secondhand smoke. Integral to the industry's campaign was an effort to derail the Environmental Protection Agency's (EPA) risk assessment on environmental tobacco smoke (ETS) by recruiting a network of journalists to generate news articles supporting the industry's position and pushing its public relations messages regarding the ETS issue. Searches of previously secret internal tobacco industry records were conducted online and at the Minnesota Tobacco Document Depository. In addition, searches on the World Wide Web were conducted for each National Journalism Center alumnus. Lexis-Nexis was used to locate news stories written by the journalists cited in this paper. Philip Morris turned to its public relations firm Burson Marsteller to "build considerable reasonable doubt em leader particularly among consumers" about the "scientific weaknesses" of the EPA report. A Washington, DC, media and political consultant Richard Hines was a key player in carrying out Burson Marsteller's media recommendations of "EPA bashing" for Philip Morris. In March 1993, Philip Morris' vice president of corporate affairs policy and administration reported to Steve Parrish, vice president and general counsel of Philip Morris, that their consultant was "responsible for a number of articles that have appeared in em leader major news publications regarding EPA and ETS." In addition to placing favorable stories in the press through its consultant, Philip Morris sought to expand its journalist network by financially supporting a U.S. school of journalism; the National Journalism Center (NJC). Philip Morris gleaned "about 15 years worth of journalists at print and visual media throughout the country em leader to get across [its] side of the story" resulting in "numerous pieces consistent with our point of

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

Health warnings on tobacco packaging in Italy: do they describe all possible smoking-related conditions?

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Vittoria Colamesta

2014-06-01

Full Text Available This report aims to evaluate the adherence between the health warnings on tobacco products in Italy and the smoking-related conditions known in the scientific literature. The Legislative Decree 2003 and 2012 established the general and the additional warnings on tobacco packaging. Regarding the smoking-related conditions, the health damages presented in the Centers for Disease Control and Prevention (CDC report are reported. Also a narrative review was performed. Respiratory and cardiovascular diseases, adverse reproductive outcomes and childhood neurobehavioral disorders are well reported in the textual health warning. Also there is at least one message indicating that the exposure of secondhand smoke is harmful. Conversely, several smoking-related cancers and other adverse health effects (diabetes, hip fractures, low bone density in postmenopausal women, rheumatoid arthritis, mental decline, acne and allergy, etc are not considered. The health warnings represent an important mean for communicating that may change smokers’ attitudes and behaviours, therefore, it’s important to implement them, also considering the introduction of graphical warnings, to maintain their effectiveness over time.

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.

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

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.

Smoked marijuana effects on tobacco cigarette smoking behavior.

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Kelly, T H; Foltin, R W; Rose, A J; Fischman, M W; Brady, J V

1990-03-01

The effects of marijuana smoke exposure on several measures of tobacco cigarette smoking behavior were examined. Eight healthy adult male volunteers, who smoked both tobacco and marijuana cigarettes, participated in residential studies, lasting 10 to 15 days, designed to measure the effects of marijuana smoke exposure on a range of behavioral variables. Tobacco cigarettes were available throughout the day (9:00 A.M. until midnight). Each day was divided into a private period (9:00 A.M. to 5:00 P.M.), during which subjects were socially isolated, and a social period (5:00 P.M. to midnight), during which subjects could interact. Under blind conditions, subjects smoked placebo and active marijuana cigarettes (0%, 1.3%, 2.3%, or 2.7% delta 9-tetrahydrocannabinol) four times daily (9:45 A.M., 1:30 P.M., 5:00 P.M. and 8:30 P.M.). Each subject was exposed to both placebo and one active dose over 2- to 5-consecutive-day intervals, and dose conditions (i.e., placebo or active) alternated throughout the study. Active marijuana smoking significantly decreased the number of daily tobacco smoking bouts, increased inter-bout intervals and decreased inter-puff intervals. Marijuana decreased the number of tobacco smoking bouts by delaying the initiation of tobacco cigarette smoking immediately after marijuana smoking, whereas decreases in inter-puff intervals were unrelated to the time of marijuana smoking. No consistent interactions between marijuana effects and social or private periods (i.e., time of day) were observed.

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

2014-01-01

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...

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/.

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.

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.

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.

Socioeconomic Differences in Exposure to Tobacco Smoke Pollution (TSP in Bangladeshi Households with Children: Findings from the International Tobacco Control (ITC Bangladesh Survey

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Geoffrey T. Fong

2011-03-01

Full Text Available This study assessed the pattern of exposure to tobacco smoke pollution (TSP; also known as, secondhand smoke in Bangladeshi households with children and examined the variations in household smoking restrictions and perception of risk for children’s exposure to TSP by socioeconomic status. We interviewed 1,947 respondents from Bangladeshi households with children from the first wave (2009 of the International Tobacco Control (ITC Bangladesh Survey. 43.5% of the respondents had complete smoking restrictions at home and 39.7% were very or extremely concerned about TSP risk to children’s health. Participants with lower level of education were significantly less likely to be concerned about the risk of TSP exposure to children’s health and less likely to adopt complete smoking restrictions at home. Logistic regression revealed that the predictors of concern for TSP exposure risk were educational attainment of 1 to 8 years (OR = 1.94 or 9 years or more (OR = 4.07 and being a smoker (OR = 0.24. The predictors of having complete household smoking restrictions were: urban residence (OR = 1.64, attaining education of 9 years or more (OR = 1.94, being a smoker (OR = 0.40 and being concerned about TSP exposure risk to children (OR = 3.25. The findings show that a high proportion of adults with children at home smoke tobacco at home and their perceptions of risk about TSP exposure to children’s health were low. These behaviours were more prevalent among rural smokers who were illiterate. There is a need for targeted intervention, customized for low educated public, on TSP risk to children’s health and tobacco control policy with specific focus on smoke-free home.

A prospective cohort study of biomarkers of prenatal tobacco smoke exposure: the correlation between serum and meconium and their association with infant birth weight

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Braun Joe M

2010-08-01

Full Text Available Abstract Background The evaluation of infant meconium as a cumulative matrix of prenatal toxicant exposure requires comparison to established biomarkers of prenatal exposure. Methods We calculated the frequency of detection and concentration of tobacco smoke metabolites measured in meconium (nicotine, cotinine, and trans-3'-hydroxycotinine concentrations and three serial serum cotinine concentrations taken during the latter two-thirds of pregnancy among 337 mother-infant dyads. We estimated the duration and intensity of prenatal tobacco smoke exposure using serial serum cotinine concentrations and calculated geometric mean meconium tobacco smoke metabolite concentrations according to prenatal exposure. We also compared the estimated associations between these prenatal biomarkers and infant birth weight using linear regression. Results We detected nicotine (80%, cotinine (69%, and trans-3'-hydroxycotinine (57% in most meconium samples. Meconium tobacco smoke metabolite concentrations were positively associated with serum cotinine concentrations and increased with the number of serum cotinine measurements consistent with secondhand or active tobacco smoke exposure. Like serum cotinine, meconium tobacco smoke metabolites were inversely associated with birth weight. Conclusions Meconium is a useful biological matrix for measuring prenatal tobacco smoke exposure and could be used in epidemiological studies that enroll women and infants at birth. Meconium holds promise as a biological matrix for measuring the intensity and duration of environmental toxicant exposure and future studies should validate the utility of meconium using other environmental toxicants.

Prevalence and correlates of tobacco use among school-going adolescents in Madagascar

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Sreenivas P. Veeranki

2015-09-01

Approximately 19% (30.7% males; 10.2% females of adolescents currently smoke cigarettes, and 7% (8.5% males and 5.8% females currently use non-cigarette tobacco products. Regardless of sex, peer smoking behavior was significantly associated with increased tobacco use among adolescents. In addition, exposures to tobacco industry promotions, secondhand smoke (SHS and anti-smoking media messages were associated with tobacco use. The strong gender gap in the use of non-cigarette tobacco products, and the role of peer smoking and industry promotions in adolescent females’ tobacco use should be of major advocacy and policy concern. A comprehensive tobacco control program integrating parental and peer education, creating social norms, and ban on promotions is necessary to reduce adolescents’ tobacco use.

How the tobacco industry responded to an influential study of the health effects of secondhand smoke

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Hong, Mi-Kyung; Bero, Lisa A

2002-01-01

In 1981 an influential Japanese study showed an association between passive smoking and lung cancer. This article documents the tobacco industry's attempts to refute this study by producing a credible alternative study.

CDC Vital Signs: Tobacco Use and Secondhand Smoke

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... on youth access to tobacco products and tobacco marketing to youth, and closely follow them. Check the ... Director for Communications (OADC) Email Recommend Tweet YouTube Instagram Listen Watch RSS ABOUT About CDC Jobs Funding ...

Global and Regional Patterns of Tobacco Smoking and Tobacco Control Policies.

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Islami, Farhad; Stoklosa, Michal; Drope, Jeffrey; Jemal, Ahmedin

2015-08-01

Tobacco smoking is a major worldwide cause of morbidity and mortality from various diseases, including urologic diseases. We reviewed, at global and regional levels, the prevalence and trends of tobacco smoking and legislative and regulatory efforts around tobacco control. We also provided information about electronic cigarette (e-cigarette) use. We used several sources to present the most up-to-date information from national surveys, including the Global Adult Tobacco Survey, the Global Tobacco Control Report, and the Global Youth Tobacco Survey. Smoking prevalence has been decreasing globally, although trends in smoking vary substantially across countries and by gender. Among men, smoking prevalence in most high-income countries started to decrease in the mid-1990s, followed after a few decades by generally smaller decreases in some low- and middle-income countries (LMICs). However, there has been no change, or there has even been an increase, in smoking prevalence in many other LMICs. Countries with the highest male smoking prevalence are located in East Asia, Southeast Asia, and Eastern Europe. Similar to men, smoking prevalence for women has been decreasing in most high-income countries and some LMICs, although the decrease began later and was slower than that for men. Except in a few countries, smoking is much less common for women than for men. Most countries with the highest smoking prevalence in women are in Europe. Countries that have implemented the best practices for tobacco control, including monitoring, smoke-free policies, cessation programs, health warnings, advertising bans, and taxation, have been able to reduce smoking rates and related harms. E-cigarette use has rapidly increased since its introduction to the market. Health care providers should advise smoking patients about quitting smoking. Countries must improve the implementation and enforcement of tobacco control policies. Particular attention should be paid to preventing an increase in

Tobacco advertising, environmental smoking bans, and smoking in Chinese urban areas.

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Yang, Tingzhong; Rockett, Ian R H; Li, Mu; Xu, Xiaochao; Gu, Yaming

2012-07-01

To evaluate whether cigarette smoking in Chinese urban areas was respectively associated with exposure to tobacco advertising and smoking bans in households, workplaces, and public places. Participants were 4735 urban residents aged 15 years and older, who were identified through multi-stage quota-sampling conducted in six Chinese cities. Data were collected on individual sociodemographics and smoking status, and regional tobacco control measures. The sample was characterized in terms of smoking prevalence, and multilevel logistic models were employed to analyze the association between smoking and tobacco advertising and environmental smoking restrictions, respectively. Smoking prevalence was 30%. Multilevel logistic regression analysis showed that smoking was positively associated with exposure to tobacco advertising, and negatively associated with workplace and household smoking bans. The association of smoking with both tobacco advertising and environmental smoking bans further justifies implementation of comprehensive smoking interventions and tobacco control programs in China. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The role of reported tobacco-specific media exposure on adult attitudes towards proposed policies to limit the portrayal of smoking in movies.

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Blake, Kelly D; Viswanath, K; Blendon, Robert J; Vallone, Donna

2010-06-01

To assess the relative, independent contribution of reported tobacco-specific media exposure (pro-tobacco advertising, anti-tobacco advertising, and news coverage of tobacco issues) to US adults' support for policy efforts that aim to regulate the portrayal of smoking in movies. Using the American Legacy Foundation's 2003 American Smoking and Health Survey (ASHES-2), multivariable logistic regression was used to model the predicted probability that US adults support movie-specific tobacco control policies, by reported exposure to tobacco-specific media messages, controlling for smoking status, education, income, race/ethnicity, age, sex, knowledge of the negative effects of tobacco and state. Across most outcome variables under study, findings reveal that reported exposure to tobacco-specific media messages is associated with adult attitudes towards movie-specific policy measures. Most exposure to tobacco information in the media (with the exception of pro-tobacco advertising on the internet) contributes independently to the prediction of adult support for movie-specific policies. The direction of effect follows an expected pattern, with reported exposure to anti-tobacco advertising and news coverage of tobacco predicting supportive attitudes towards movie policies, and reported exposure to pro-tobacco advertising lessening support for some movie policies, though the medium of delivery makes a difference. Media campaigns to prevent tobacco use and exposure to secondhand smoke have had value beyond the intended impact of single-issue campaigns; exposure to anti-tobacco campaigns and public dialogue about the dangers of tobacco seem also to be associated with shaping perceptions of the social world related to norms about tobacco, and ideas about regulating the portrayal of smoking in movies.

New report highlights epidemic of tobacco and global health inequalities

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A new set of 11 global health studies calls attention to the burden of tobacco-related inequalities in low- and middle-income countries and finds that socioeconomic inequalities are associated with increased tobacco use, second-hand smoke exposure and tob

Socioeconomic status and tobacco consumption among adolescents: a multilevel analysis of Argentina's Global Youth Tobacco Survey.

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Linetzky, Bruno; Mejia, Raul; Ferrante, Daniel; De Maio, Fernando G; Diez Roux, Ana V

2012-09-01

The relationship between poverty and tobacco consumption among adolescents has not been extensively studied, and what evidence exists has come almost entirely from developed countries. Moreover, the impact of contextual factors--such as school-level poverty--remains unclear. We obtained information about smoking behavior from the Global Youth Tobacco Survey in Argentina in 2007. School-level characteristics were derived by matching schools to census areas from the 2001 Census. Additional school-level information was obtained from the Ministry of Education. Random intercept models were used to evaluate the associations of school-level variables (poverty in the census area of the school, school receipt of social assistance, and public or private status) with current smoking, intention to quit, secondhand smoke exposure outside the home, support for smoke-free laws, purchase of single cigarettes among smokers, and susceptibility to smoking in 5 years among nonsmokers. After controlling for age and sex, students attending schools receiving social assistance were more likely to smoke (odds ratio [OR] 1.35, 95% CI 1.02-1.80) and to purchase loose cigarettes (OR 1.66, 95% CI 1.08-2.54), whereas school poverty was significantly associated with secondhand smoke exposure (OR 1.27, 95% CI 1.04-1.58). This study shows that an association exists between unfavorable contextual school characteristics and tobacco consumption and related measures among youth in Argentina. Efforts to prevent smoking may need to address the school-level factors that place youth at higher risk.

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.

Effects of tobacco exposure on perinatal suicidal ideation, depression, and anxiety.

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Weng, Shu-Chuan; Huang, Jian-Pei; Huang, Ya-Li; Lee, Tony Szu-Hsien; Chen, Yi-Hua

2016-07-22

Previous studies have stressed the importance of tobacco exposure for the mood disorders of depression and anxiety. Although a few studies have focused on perinatal women, none have specifically considered the effects of smoking and secondhand smoke exposure on perinatal suicidal ideation. Thus, this study aimed to investigate the relationships of smoking/secondhand smoke exposure status with suicidal ideation, depression, and anxiety from the first trimester to the first month post partum. This cross-sectional study based on self-reported data was conducted at five hospitals in Taipei, Taiwan from July 2011 to June 2014. The questionnaire inquired about women's pregnancy history, sociodemographic information, and pre-pregnancy smoking and secondhand smoke exposure status, and assessed their suicidal ideation, depression, and anxiety symptoms. Logistic regression models were used for analysis. In the 3867 women in the study, secondhand smoke exposure was positively associated with perinatal depression and suicidal ideation. Compared with women without perinatal secondhand smoke exposure, women exposed to secondhand smoke independently exhibited higher risks for suicidal ideation during the second trimester (odds ratio (OR) = 7.63; 95 % confidence interval (CI) = 3.25-17.93) and third trimester (OR = 4.03; 95 % CI = 1.76-9.23). Women exposed to secondhand smoke had an increased risk of depression, especially those aged 26-35 years (OR = 1.71; 95 % CI = 1.27-2.29). Secondhand smoke exposure also considerably contributes to adverse mental health for women in perinatal periods, especially for the severe outcome of suicidal ideation. Our results strongly support the importance of propagating smoke-free environments to protect the health of perinatal women.

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.

[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.

Awareness of health effects of exposure to secondhand smoke from cigarettes: A cross-sectional study of never-smoked adult primary care patients in Eastern Nigeria.

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Pascal Iloh, Gabriel Uche; Collins, Peace Ifeoma

2017-01-01

Cigarette smoking whether actively or passively is a growing public health problem. Despite the wealth of information on the hazards of active cigarette smoking, awareness of the health effects of passive smoking on human population is often neglected in Nigeria. The study was aimed at describing the awareness of health effects of exposure to secondhand smoke from cigarettes among never-smoked adult primary care patients in Eastern Nigeria. A hospital-based study carried out on a cross-section of 500 adult patients in a primary care clinic in Nigeria. Data were collected using pretested, structured, and interviewer-administered questionnaire. Exposure to secondhand smoke was defined as exposure to cigarette smoke in a never-smoked adult patient in the previous 1 year. Data were analyzed using Statistical Package for Social Sciences version 21 for the calculation of percentages for categorical variables. Bivariate analysis involving Chi-square test was used to test for significance of association between categorical variables at P effects of secondhand smoke on adults, children, and pregnant women was 95.6%, 92.8%, and 65.2%, respectively. The most common specific health effects the respondents were aware for adults, children, and obstetric population were lung cancer (95.6%), precipitation of asthmatic condition (92.8%), and delivery of small babies (65.2%), respectively. The predominant source of awareness of information was radio (93.6%). Awareness of general health effects of exposure to secondhand smoke on adults ( P = 0.041), children ( P = 0.031), and obstetrics population ( P = 0.02) was significantly associated with exposure status. The most common health effects of secondhand smoke the respondents had highest awareness were lung cancer, precipitation of asthmatic attacks, and delivery of small babies in adults, children, and obstetric population, respectively. Awareness of general health effects on adults, children, and obstetrics population was

Environmental determinants of smoking behaviors: The role of policy and environmental interventions in preventing smoking initiation and supporting cessation.

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Calo, William A; Krasny, Sarah E

2013-12-01

Tobacco control strategies have contributed to substantial declines in smoking in the United States. However, smoking still remains the single largest preventable cause of disease and premature deaths in the country. Despite the continuing challenges of implementing tobacco control strategies and the pervasive influence of the tobacco industry to undermine such strategies, there are now unprecedented opportunities to prevent smoking initiation, facilitate cessation, and protect nonsmokers from secondhand smoke. In this paper, we briefly review the most recent literature discussing key strategies that have proven effective in tobacco control including regulations on sales and marketing of tobacco products, taxation, and smoke-free legislation. We focused on these three tobacco control strategies because of their potential to positively influence the environment of both minors and adults regardless of their smoking status. Although research has identified significant individual and social predictors of tobacco use, environmental influences are also important risk factors for tobacco use.

Female non-smokers' environmental tobacco smoking exposure by public transportation mode.

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Kim, Seyoung; Park, Jin-Soo; Park, Minkyu; Kim, Yeji; Lim, Sinye; Lee, Hye-Eun

2018-01-01

This study aimed to analyze environmental tobacco smoking exposure in female nonsmokers by public transportation mode using representative data of Koreans. Data from the Second Korean National Environmental Health Survey (2012-2014) were analyzed. Urine cotinine was analyzed by public transport behavior, secondhand smoke exposure, socioeconomic factors, and health-related factors. Participants were 1322 adult females; those with the top 75% urine cotinine concentrations were assigned to the high exposure group. A logistic regression analysis was performed considering appropriate weights and stratification according to the sample design of the Second Korean National Environmental Health Survey. The geometric mean of urine cotinine concentrations differed according to public transportation modes: subway (1.66 μg/g creatinine) bus (1.77 μg/g creatinine), and taxi (1.94 μg/g creatinine). The odds ratio [OR] was calculated for the high exposure group. The OR of the taxi (2.39; 95% confidence interval, 1.00-5.69) was statistically significantly higher than the subway value (reference), and marginally significant after adjusted with life style, sociodemographic factors and involuntary smoking frequency (2.42, 95% confidence interval, 0.97-6.04). The odds ratio of passengers who mainly used taxis was marginally significantly higher than those of passengers who used subways and buses after adjusted with life style and sociodemographic factors. Implementation of supplementary measures and further studies on exposure to environmental tobacco smoking in taxis are warranted.

[Perception of parents about second hand smoke on the health of their children: an ethnographic study].

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de Carvalho Ribeiro, Fabiane Alves; de Moraes, Micaele Kedma Ribeiro; de Morais Caixeta, Joyce Cristina; da Silva, Jullieth Nadja; Lima, Amanda Sanches; Parreira, Samara Lamounier Santana; Fernandes, Viviane Lemos Silva

2015-12-01

To analyze the perception of parents about secondhand smoking in their children's health. Ethnographic qualitative and quantitative study. We sought the point of view and understanding of the parents that were active smokers in relation to environmental tobacco smoke (ETS) and secondhand smoking. Mothers and fathers who are active smokers and that live with their children from seven different public schools in the city of Anápolis, Midwest Brazil, were interviewed in the first semester of in a reserved room in the schools. A descriptive and qualitative analysis was carried out through the ethnography. 58 parents with an average time of smoking of 15.3 years and an average quantity of cigarettes smoked per day of 2 were interviewed. Among them, 59% didn't know what ETS was, and 60% stated knowing what a secondhand smoker was. However, when questioned about their children as secondhand smokers, 52% didn't consider them to be. Some parents knew some of the effects of secondhand smoking in the health of their children. However, the majority (52%) of them did not believe that their children would suffer any respiratory impairment or did not know about these impairments. Children were exposed to Environmental Tobacco Pollution in their residence if one considers parental duration of smoking and average of cigarettes smoked per day. There was a lack of knowledge of the parents about ETS, secondhand smoking and the evils that cigarettes could cause in the health of their children. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Perception of parents about second hand smoke on the health of their children: an ethnographic study

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Fabiane Alves de Carvalho Ribeiro

2015-12-01

Full Text Available Objective: To analyze the perception of parents about secondhand smoking in their children's health. Methods: Ethnographic qualitative and quantitative study. We sought the point of view and understanding of the parents who were active smokers in relation to environmental tobacco smoke (ETS and secondhand smoking. Mothers and fathers who are active smokers and that live with their children from seven different public schools in the city of Anápolis, Midwest Brazil, were interviewed in the first semester of in a reserved room in the schools. A descriptive and qualitative analysis was carried out through the ethnography. Results: 58 parents with an average time of smoking of 15.3 years and an average quantity of cigarettes smoked per day of 2 were interviewed. Among them, 59% did not know what ETS was, and 60% stated knowing what a secondhand smoker was. However, when questioned about their children as secondhand smokers, 52% did not consider them to be. Some parents knew some of the effects of secondhand smoking in the health of their children. However, the majority (52% of them did not believe that their children would suffer any respiratory impairment or did not know about these impairments. Conclusions: Children were exposed to environmental tobacco pollution in their residence if one considers parental duration of smoking and average of cigarettes smoked per day. There was a lack of knowledge of the parents about ETS, secondhand smoking and the evils that cigarettes could cause in the health of their children.

Secondhand Smoke Exposure Reduction Intervention in Chinese Households of Young Children: A Randomized Controlled Trial.

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Abdullah, Abu S; Hua, Fu; Khan, Hafiz; Xia, Xiao; Bing, Qi; Tarang, Kheradia; Winickoff, Jonathan P

2015-01-01

To assess whether a theory-based, community health worker-delivered intervention for household smokers will lead to reduced secondhand smoke exposure to children in Chinese families. Smoking parents or caregivers who had a child aged 5 years or younger at home were randomized to the intervention group (n = 164) to receive smoking hygiene intervention or to the comparison group (n = 154). The intervention was delivered by trained community health workers. Outcomes were assessed at 2- and 6- month follow-up. Of the 318 families randomized, 98 (60%) of 164 intervention group and 82 (53%) of 154 of controls completed 6-month follow-up assessment. At the 6-month follow-up, 62% of intervention and 45% of comparison group households adopted complete smoking restrictions at home (P = .022); total exposure (mean number of cigarettes per week ± standard deviation) from all smokers at home in the past 7 days was significantly lower among children in the intervention (3.29 ± 9.06) than the comparison (7.41 ± 14.63) group (P = .021); and mean urine cotinine level (ng/mL) was significantly lower in the intervention (0.030 ± .065) than the comparison (0.087 ± .027) group, P exposure to secondhand smoke. These findings have implications for the development of primary health care-based secondhand smoke exposure reduction and family oriented smoking cessation interventions as China moves toward a smoke-free society. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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.

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

Secondhand smoke exposure and risk of lung cancer in Japan: a systematic review and meta-analysis of epidemiologic studies.

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Hori, Megumi; Tanaka, Hirokazu; Wakai, Kenji; Sasazuki, Shizuka; Katanoda, Kota

2016-10-01

Systematic evaluation of the association between secondhand smoke exposure and lung cancer in Japan has yet to be conducted. Here, we performed a systematic review and meta-analysis of the relationship between secondhand smoke and lung cancer in Japanese non-smokers. Relevant studies were collected from the MEDLINE and Ichushi Web databases using a combination of search terms and Medical Subject Headings. Eligible studies were identified, and relative risks or odds ratios were extracted to calculate pooled risk estimates. This procedure was performed independently by at least two authors. Stratified analyses were carried out according to study design, publication year, and whether or not potential confounding variables were accounted for. The presence of publication bias was assessed via funnel plots. We identified four cohort studies and five case-control studies. Quantitative synthesis was conducted only for secondhand smoke exposure in the home during adulthood. Of the 12 populations included in meta-analysis, positive secondhand smoke exposure-lung cancer associations were observed in 11, whereas an inverse association was found in the remaining 1. The pooled relative risk of lung cancer associated with secondhand smoke exposure was 1.28 (95% confidence interval: 1.10-1.48). We found no evidence of publication bias, and a significant association remained even when potentially missing studies were included (pooled relative risk: 1.26; 95% confidence interval: 1.09-1.46). The results were stable across different subgroup analyses, including by study design, publication year, and when adjusting for confounding variables. Secondhand smoke exposure in the home during adulthood results in a statistically significant increase in the risk of lung cancer. © The Author 2016. Published by Oxford University Press.

Effects of tobacco exposure on perinatal suicidal ideation, depression, and anxiety

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Shu-Chuan Weng

2016-07-01

Full Text Available Abstract Background Previous studies have stressed the importance of tobacco exposure for the mood disorders of depression and anxiety. Although a few studies have focused on perinatal women, none have specifically considered the effects of smoking and secondhand smoke exposure on perinatal suicidal ideation. Thus, this study aimed to investigate the relationships of smoking/secondhand smoke exposure status with suicidal ideation, depression, and anxiety from the first trimester to the first month post partum. Methods This cross-sectional study based on self-reported data was conducted at five hospitals in Taipei, Taiwan from July 2011 to June 2014. The questionnaire inquired about women’s pregnancy history, sociodemographic information, and pre-pregnancy smoking and secondhand smoke exposure status, and assessed their suicidal ideation, depression, and anxiety symptoms. Logistic regression models were used for analysis. Results In the 3867 women in the study, secondhand smoke exposure was positively associated with perinatal depression and suicidal ideation. Compared with women without perinatal secondhand smoke exposure, women exposed to secondhand smoke independently exhibited higher risks for suicidal ideation during the second trimester (odds ratio (OR = 7.63; 95 % confidence interval (CI = 3.25–17.93 and third trimester (OR = 4.03; 95 % CI = 1.76–9.23. Women exposed to secondhand smoke had an increased risk of depression, especially those aged 26–35 years (OR = 1.71; 95 % CI = 1.27–2.29. Conclusions Secondhand smoke exposure also considerably contributes to adverse mental health for women in perinatal periods, especially for the severe outcome of suicidal ideation. Our results strongly support the importance of propagating smoke-free environments to protect the health of perinatal women.

Prevalence of secondhand smoke exposure in asthmatic children at home and in the car: A cross-sectional study

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H. Antunes

2016-07-01

Full Text Available Objective: To compare secondhand smoke exposure (SHSe prevalence at home and inside the car between asthmatic and non-asthmatic Portuguese children. Materials and methods: This is a cross-sectional study that assessed children's SHSe in a representative sample of nine Portuguese cities. A validated self-reported questionnaire was administered to a random sample of 4th grade students during the school year of 2010/2011. The asthma prevalence was defined by the answers to three questions regarding asthma symptoms, medication and inhaler use. We performed chi-square tests and analysed frequencies, contingency tables, confidence intervals, and odd-ratios. Results: The self-reported questionnaire was administered to 3187 students. Asthma prevalence was 14.8% (472 students. Results showed that 32.3% of non-asthmatic children and 32.4% of asthmatic children were exposed to secondhand smoke as at least one of their household members smoked at home. The prevalence of parental smoking, smoking among fathers and smoking among mothers at home was also similar in both groups (asthmatic and non-asthmatic children. SHSe inside the car was 18.6% among non-asthmatic children and 17.9% among asthmatic children. Conclusions: Asthmatic and non-asthmatic children were equally exposed to secondhand smoke, because no significant differences were found between the two groups concerning the prevalence of SHSe at home and inside the car. These findings highlight the need to include SHSe brief advice in paediatric asthma management. Keywords: Secondhand smoke, Children, Asthma

Tobacco smoking and aortic aneurysm

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Sode, Birgitte F; Nordestgaard, Børge; Grønbæk, Morten

2013-01-01

BACKGROUND: We determined the predictive power of tobacco smoking on aortic aneurysm as opposed to other risk factors in the general population. METHODS: We recorded tobacco smoking and other risk factors at baseline, and assessed hospitalization and death from aortic aneurysm in 15,072 individuals...... aneurysm in males and females consuming above 20g tobacco daily was 3.5% and 1.3%, among those >60years with plasma cholesterol >5mmol/L and a systolic blood pressure >140mmHg. CONCLUSIONS: Tobacco smoking is the most important predictor of future aortic aneurysm outcomes in the general population...

It is time to regulate carcinogenic tobacco-specific nitrosamines in cigarette tobacco

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Hecht, Stephen S.

2014-01-01

The Family Smoking Prevention and Tobacco Control Act gives the Food and Drug Administration power to regulate tobacco products. This commentary calls for immediate regulation of the carcinogenic tobacco-specific nitrosamines 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and N’-nitrosonornicotine (NNN) in cigarette tobacco as a logical path to cancer prevention. NNK and NNN, powerful carcinogens in laboratory animals, have been evaluated as “carcinogenic to humans” by the International Agency for Research on Cancer. NNK and NNN are present in the tobacco of virtually all marketed cigarettes; levels in cigarette smoke are directly proportional to the amounts in tobacco. The NNK metabolite NNAL, itself a strong carcinogen, is present in the urine of smokers and non-smokers exposed to secondhand smoke. Some of the highest levels of NNK and NNN are found in U.S. products. It is well established that factors such as choice of tobacco blend, agricultural conditions, and processing methods influence levels of NNK and NNN in cigarette tobacco and cigarette smoke. Therefore, it is time to control these factors and produce cigarettes with 100 ppb or less each of NNK and NNN in tobacco, which would result in an approximate 15-20 fold reduction of these carcinogens in the mainstream smoke of popular cigarettes sold in the United States. PMID:24806664

The Tobacco Use Epidemic - What You Need to Know PSA (:60)

Centers for Disease Control (CDC) Podcasts

This PSA is based on the September, 2010 CDC Vital Signs report which indicates that, despite the dangers of tobacco use, about 46.6 million adults in the U.S. smoke, and 88 million nonsmokers are exposed to secondhand smoke.

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.

Non-Smoker Exposure to Secondhand Cannabis Smoke II: Effect of Room Ventilation on the Physiological, Subjective, and Behavioral/Cognitive Effects

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Herrmann, Evan S.; Cone, Edward J; Mitchell, John M.; Bigelow, George E.; LoDico, Charles; Flegel, Ron; Vandrey, Ryan

2015-01-01

Introduction Cannabis is the most widely used illicit drug. Many individuals are incidentally exposed to secondhand cannabis smoke, but little is known about the effects of this exposure. This report examines the physiological, subjective, and behavioral/cognitive effects of secondhand cannabis exposure, and the influence of room ventilation on these effects. Methods Non-cannabis-using individuals were exposed to secondhand cannabis smoke from six individuals smoking cannabis (11.3% THC) ad libitum in a specially constructed chamber for one hour. Chamber ventilation was experimentally manipulated so that participants were exposed under unventilated conditions or with ventilation at a rate of 11 air exchanges/hour. Physiological, subjective and behavioral/cognitive measures of cannabis exposure assessed after exposure sessions were compared to baseline measures. Results Exposure to secondhand cannabis smoke under unventilated conditions produced detectable cannabinoid levels in blood and urine, minor increases in heart rate, mild to moderate self-reported sedative drug effects, and impaired performance on the Digit Symbol Substitution Task (DSST). One urine specimen tested positive at using a 50 ng/mL cut-off and several specimens were positive at 20 ng/mL. Exposure under ventilated conditions resulted in much lower blood cannabinoid levels, and did not produce sedative drug effects, impairments in performance, or positive urine screen results. Conclusions Room ventilation has a pronounced effect on exposure to secondhand cannabis smoke. Under extreme, unventilated conditions, secondhand cannabis smoke exposure can produce detectable levels of THC in blood and urine, minor physiological and subjective drug effects, and minor impairment on a task requiring psychomotor ability and working memory. PMID:25957157

Young adult social smokers: their co-use of tobacco and alcohol, tobacco-related attitudes, and quitting efforts.

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Jiang, Nan; Lee, Youn O; Ling, Pamela M

2014-12-01

Young adults frequently report social smoking. This study examined the relationship between different social smoking definitions and the co-use of cigarettes and alcohol, tobacco-related attitudes, and quitting efforts. Cross-sectional data were collected at bars using randomized time location sampling among young adults aged 21-26 in San Diego, California from 2010 to 2011 (73% response rate). Multivariable logistic regression examined if current smoking and quit attempts were associated with tobacco-related attitudes, and whether social smoking self-identification or behavior was associated with cigarette-and-alcohol co-use, tobacco-related attitudes, quit attempts, or quitline use. Among 537 current smokers, 80% self-identified and 49% behaved as social smokers. Social smoking self-identification was positively associated with cigarette-and-alcohol co-use, and quit attempts. Social smoking behavior was negatively associated with tobacco marketing receptivity, quit attempts, and quitline use. Tobacco-related attitudes were associated with smoking but did not generally differ by social smoking status. Identification and behavior as a social smoker have opposing associations with co-use of cigarettes and alcohol and quit attempts. Tobacco cessation programs for self-identified social smokers should address co-use. Interventions denormalizing the tobacco industry or emphasizing the health effects of temporary smoking and secondhand smoke may address smoking among young adult bar patrons regardless of social smoking status. Copyright © 2014 Elsevier Inc. All rights reserved.

Reducing domestic exposure to environmental tobacco smoke: a review of attitudes and behaviours.

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Green, E; Courage, C; Rushton, L

2003-03-01

This paper reviews research on attitudes and behaviours towards environmental tobacco smoke (ETS), with a special focus on child health and the indoor environment. Research needs and ways forward to encourage reductions in domestic ETS levels are discussed. Published material was identified through online literature searches (Medline, Toxline, Cancerlit, Biosis, Embase, Enviroline, Sociological Abstracts, Social Science Citation Index, Academic Index and Psychinfo). The literature search strategy employed search terms such as "passive smoking" or "environmental tobacco smoke" with "attitude" or "awareness" and other synonyms. Additional publications were identified by citation chasing and expert advice. Focusing on the UK, studies that provided survey-derived data about attitudes and behaviours in relation to ETS exposure in the indoor environment were selected for review. Published studies from other countries were also included when they provided information pertinent to this review. Most people are aware of the health risks associated with ETS exposure, and there is a high level of support for smoking restrictions in public places to protect non-smokers from ETS. However, although there is concern among both non-smoking and smoking parents about children and second-hand smoke, many people allow children to be exposed to ETS in the home. The review suggests that traditional health promotion campaigns have had only limited success in encouraging ETS risk reduction measures in the home. Because ETS is a public health priority, particularly in relation to child health, the barriers to the uptake of such measures need to be explored in detail to inform the future promotion of reductions in domestic levels of ETS.

Job strain and tobacco smoking

DEFF Research Database (Denmark)

Heikkilä, Katriina; Nyberg, Solja T; Fransson, Eleonor I

2012-01-01

Tobacco smoking is a major contributor to the public health burden and healthcare costs worldwide, but the determinants of smoking behaviours are poorly understood. We conducted a large individual-participant meta-analysis to examine the extent to which work-related stress, operationalised as job...... strain, is associated with tobacco smoking in working adults....

Second-hand smoking and carboxyhemoglobin levels in children: a prospective observational study.

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Yee, Branden E; Ahmed, Mohammed I; Brugge, Doug; Farrell, Maureen; Lozada, Gustavo; Idupaganthi, Raghu; Schumann, Roman

2010-01-01

To establish baseline noninvasive carboxyhemoglobin (COHb) levels in children and determine the influence of exposure to environmental sources of carbon monoxide (CO), especially environmental tobacco smoke, on such levels. Second-hand smoking may be a risk factor for adverse outcomes following anesthesia and surgery in children (1) and may potentially be preventable. Parents and their children between the ages of 1-12 were enrolled on the day of elective surgery. The preoperative COHb levels of the children were assessed noninvasively using a CO-Oximeter (Radical-7 Rainbow SET Pulse CO-Oximeter; Masimo, Irvine, CA, USA). The parents were asked to complete an environmental air-quality questionnaire. The COHb levels were tabulated and correlated with responses to the survey in aggregate analysis. Statistical analyses were performed using the nonparametric Mann-Whitney and Kruskal-Wallis tests. P < 0.05 was statistically significant. Two hundred children with their parents were enrolled. Children exposed to parental smoking had higher COHb levels than the children of nonsmoking controls. Higher COHb values were seen in the youngest children, ages 1-2, exposed to parental cigarette smoke. However, these trends did not reach statistical significance, and confidence intervals were wide. This study revealed interesting trends of COHb levels in children presenting for anesthesia and surgery. However, the COHb levels measured in our patients were close to the error margin of the device used in our study. An expected improvement in measurement technology may allow screening children for potential pulmonary perioperative risk factors in the future.

Plausible Roles for RAGE in Conditions Exacerbated by Direct and Indirect (Secondhand) Smoke Exposure.

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Lewis, Joshua B; Hirschi, Kelsey M; Arroyo, Juan A; Bikman, Benjamin T; Kooyman, David L; Reynolds, Paul R

2017-03-17

Approximately 1 billion people smoke worldwide, and the burden placed on society by primary and secondhand smokers is expected to increase. Smoking is the leading risk factor for myriad health complications stemming from diverse pathogenic programs. First- and second-hand cigarette smoke contains thousands of constituents, including several carcinogens and cytotoxic chemicals that orchestrate chronic inflammatory responses and destructive remodeling events. In the current review, we outline details related to compromised pulmonary and systemic conditions related to smoke exposure. Specifically, data are discussed relative to impaired lung physiology, cancer mechanisms, maternal-fetal complications, cardiometabolic, and joint disorders in the context of smoke exposure exacerbations. As a general unifying mechanism, the receptor for advanced glycation end-products (RAGE) and its signaling axis is increasingly considered central to smoke-related pathogenesis. RAGE is a multi-ligand cell surface receptor whose expression increases following cigarette smoke exposure. RAGE signaling participates in the underpinning of inflammatory mechanisms mediated by requisite cytokines, chemokines, and remodeling enzymes. Understanding the biological contributions of RAGE during cigarette smoke-induced inflammation may provide critically important insight into the pathology of lung disease and systemic complications that combine during the demise of those exposed.

Patterns and socioeconomic influences of tobacco exposure in tobacco cultivating rural areas of Yunnan Province, China

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Cai Le

2012-10-01

Full Text Available Abstract Background This study describes the patterns and socioeconomic influences of tobacco use among adults in tobacco-cultivating regions of rural southwest China. Methods A cross-sectional survey was conducted in 8681 adults aged ≥18 years in rural areas of Yunnan Province, China from 2010 to 2011. A standardized questionnaire was administered to obtain data about participants’ demographic characteristics, individual socioeconomic status, ethnicity, self-reported smoking habits, and exposure to secondhand smoke (SHS. The socioeconomic predictors of current smoking, nicotine addiction, and SHS exposure were analyzed using multivariate logistic regression. Results The prevalence rates of tobacco use were much higher in men compared with women (current smoking 68.5% vs. 1.3%; and nicotine dependence 85.2% vs. 72.7%. However, the rate of SHS exposure was higher in women compared with men (76.6% vs. 70.5%. Tobacco farmers had higher prevalence rates of current smoking, nicotine dependence, and SHS exposure compared with participants not engaged in tobacco farming (P Conclusions This study suggests that tobacco control efforts in rural southwest China must be tailored to address tobacco-cultivating status and socioeconomic factors.

Recent trends in children's exposure to second-hand smoke in England: cotinine evidence from the Health Survey for England.

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Jarvis, Martin J; Feyerabend, Colin

2015-09-01

To examine changes in children's exposure to second-hand tobacco smoke in England since 1998. Repeated cross-sectional surveys of the general population in England. The Health Survey for England. A total of 37 038 children participating in surveys from 1998 to 2012, 13 327 of whom were aged 4-15 years, had available cotinine and were confirmed non-smokers. The proportion of children with smoking parents; the proportion of children living in homes reported to be smoke-free; the proportion of children with undetectable concentrations of cotinine; linear and quadratic trend estimates of geometric mean cotinine across years. By 2012, 87.3% of children lived in a home that was smoke-free {97.2% [95% confidence interval (CI) = 95.9-98.1] when parents were non-smokers, 61.3% (95% CI = 55.5-66.8) when one or both parents smoked}. A total of 68.6% (95% CI = 64.3-72.6%) of children had undetectable cotinine in 2012, up from 14.3% (95% CI = 12.7-16.0%) in 1998. There was a highly significant linear trend across years (with a small but significant quadratic term) to declining geometric mean cotinine in all children from 0.52 ng/ml (95% CI = 0.48-0.57) in 1998 to 0.11 ng/ml (95% CI = 0.10-0.12) in 2012. Children from routine/manual backgrounds were more exposed, but experienced similar gains across years to those from non-manual backgrounds. In England, children's exposure to second-hand smoke has declined by 79% since 1998, with continuing progress since smoke-free legislation in 2007. An emerging social norm in England has led to the adoption of smoke-free homes not only when parents are non-smokers, but also when they smoke. © 2015 Society for the Study of Addiction.

Validity of self-reported adult secondhand smoke exposure.

Science.gov (United States)

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.

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.

The Tobacco Use Epidemic – What You Need to Know

Centers for Disease Control (CDC) Podcasts

This podcast is based on the September, 2010 CDC Vital Signs report which indicates that, despite the dangers of tobacco use, about 46.6 million adults in the U.S. smoke, and 88 million nonsmokers are exposed to secondhand smoke.

Effects of tobacco control policies on smoking prevalence and tobacco-attributable deaths in Mexico: the SimSmoke model

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Luz Myriam Reynales-Shigematsu

Full Text Available OBJECTIVE: To examine how policies adopted in Mexico in response to the Framework Convention on Tobacco Control affected smoking prevalence and smoking-attributable deaths. METHODS: The SimSmoke simulation model of tobacco control policy is applied to Mexico. This discrete time, first-order Markov model uses data on population size, smoking rates and tobacco control policy for Mexico. It assesses, individually and jointly, the effects of seven types of policies: cigarette taxes, smoke-free air laws, mass media campaigns, advertising bans, warning labels, cessation treatment, and youth tobacco access policies. RESULTS: The Mexico SimSmoke model estimates that smoking rates have been reduced by about 30% as a result of policies implemented since 2002, and that the number of smoking-attributable deaths will have been reduced by about 826 000 by 2053. Increases in cigarette prices are responsible for over 60% of the reductions, but health warnings, smoke-free air laws, marketing restrictions and cessation treatments also play important roles. CONCLUSIONS: Mexico has shown steady progress towards reducing smoking prevalence in a short period of time, as have other Latin American countries, such as Brazil, Panama and Uruguay. Tobacco control policies play an important role in continued efforts to reduce tobacco use and associated deaths in Mexico.

Non-smoker exposure to secondhand cannabis smoke II: Effect of room ventilation on the physiological, subjective, and behavioral/cognitive effects.

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Herrmann, Evan S; Cone, Edward J; Mitchell, John M; Bigelow, George E; LoDico, Charles; Flegel, Ron; Vandrey, Ryan

2015-06-01

Cannabis is the most widely used illicit drug. Many individuals are incidentally exposed to secondhand cannabis smoke, but little is known about the effects of this exposure. This report examines the physiological, subjective, and behavioral/cognitive effects of secondhand cannabis exposure, and the influence of room ventilation on these effects. Non-cannabis-using individuals were exposed to secondhand cannabis smoke from six individuals smoking cannabis (11.3% THC) ad libitum in a specially constructed chamber for 1h. Chamber ventilation was experimentally manipulated so that participants were exposed under unventilated conditions or with ventilation at a rate of 11 air exchanges/h. Physiological, subjective and behavioral/cognitive measures of cannabis exposure assessed after exposure sessions were compared to baseline measures. Exposure to secondhand cannabis smoke under unventilated conditions produced detectable cannabinoid levels in blood and urine, minor increases in heart rate, mild to moderate self-reported sedative drug effects, and impaired performance on the digit symbol substitution task (DSST). One urine specimen tested positive at using a 50 ng/ml cut-off and several specimens were positive at 20 ng/ml. Exposure under ventilated conditions resulted in much lower blood cannabinoid levels, and did not produce sedative drug effects, impairments in performance, or positive urine screen results. Room ventilation has a pronounced effect on exposure to secondhand cannabis smoke. Under extreme, unventilated conditions, secondhand cannabis smoke exposure can produce detectable levels of THC in blood and urine, minor physiological and subjective drug effects, and minor impairment on a task requiring psychomotor ability and working memory. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Secondhand smoke in cars: assessing children's potential exposure during typical journey conditions.

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Semple, Sean; Apsley, Andrew; Galea, Karen S; MacCalman, Laura; Friel, Brenda; Snelgrove, Vicki

2012-11-01

To measure levels of fine particulate matter in the rear passenger area of cars where smoking does and does not take place during typical real-life car journeys. Fine particulate matter (PM(2.5)) was used as a marker of secondhand smoke and was measured and logged every minute of each car journey undertaken by smoking and non-smoking study participants. The monitoring instrument was located at breathing zone height in the rear seating area of each car. Participants were asked to carry out their normal driving and smoking behaviours over a 3-day period. 17 subjects (14 smokers) completed a total of 104 journeys (63 smoking journeys). Journeys averaged 27 min (range 5-70 min). PM(2.5) levels averaged 85 and 7.4 μg/m(3) during smoking and non-smoking car journeys, respectively. During smoking journeys, peak PM(2.5) concentrations averaged 385 μg/m(3), with one journey measuring over 880 μg/m(3). PM(2.5) concentrations were strongly linked to rate of smoking (cigarettes per minute). Use of forced ventilation and opening of car windows were very common during smoking journeys, but PM(2.5) concentrations were still found to exceed WHO indoor air quality guidance (25 μg/m(3)) at some point in the measurement period during all smoking journeys. PM(2.5) concentrations in cars where smoking takes place are high and greatly exceed international indoor air quality guidance values. Children exposed to these levels of fine particulate are likely to suffer ill-health effects. There are increasing numbers of countries legislating against smoking in cars and such measures may be appropriate to prevent the exposure of children to these high levels of secondhand smoke.

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

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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…

Developmental exposure to second-hand smoke increases adult atherogenesis and alters mitochondrial DNA copy number and deletions in apoE(-/- mice.

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Jessica L Fetterman

Full Text Available Cardiovascular disease is a major cause of morbidity and mortality in the United States. While many studies have focused upon the effects of adult second-hand smoke exposure on cardiovascular disease development, disease development occurs over decades and is likely influenced by childhood exposure. The impacts of in utero versus neonatal second-hand smoke exposure on adult atherosclerotic disease development are not known. The objective of the current study was to determine the effects of in utero versus neonatal exposure to a low dose (1 mg/m(3 total suspended particulate of second-hand smoke on adult atherosclerotic lesion development using the apolipoprotein E null mouse model. Consequently, apolipoprotein E null mice were exposed to either filtered air or second-hand smoke: (i in utero from gestation days 1-19, or (ii from birth until 3 weeks of age (neonatal. Subsequently, all animals were exposed to filtered air and sacrificed at 12-14 weeks of age. Oil red-O staining of whole aortas, measures of mitochondrial damage, and oxidative stress were performed. Results show that both in utero and neonatal second-hand smoke exposure significantly increased adult atherogenesis in mice compared to filtered air controls. These changes were associated with changes in aconitase and mitochondrial superoxide dismutase activities consistent with increased oxidative stress in the aorta, changes in mitochondrial DNA copy number and deletion levels. These studies show that in utero or neonatal exposure to second-hand smoke significantly influences adult atherosclerotic lesion development and results in significant alterations to the mitochondrion and its genome that may contribute to atherogenesis.

Developmental exposure to second-hand smoke increases adult atherogenesis and alters mitochondrial DNA copy number and deletions in apoE(-/-) mice.

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Fetterman, Jessica L; Pompilius, Melissa; Westbrook, David G; Uyeminami, Dale; Brown, Jamelle; Pinkerton, Kent E; Ballinger, Scott W

2013-01-01

Cardiovascular disease is a major cause of morbidity and mortality in the United States. While many studies have focused upon the effects of adult second-hand smoke exposure on cardiovascular disease development, disease development occurs over decades and is likely influenced by childhood exposure. The impacts of in utero versus neonatal second-hand smoke exposure on adult atherosclerotic disease development are not known. The objective of the current study was to determine the effects of in utero versus neonatal exposure to a low dose (1 mg/m(3) total suspended particulate) of second-hand smoke on adult atherosclerotic lesion development using the apolipoprotein E null mouse model. Consequently, apolipoprotein E null mice were exposed to either filtered air or second-hand smoke: (i) in utero from gestation days 1-19, or (ii) from birth until 3 weeks of age (neonatal). Subsequently, all animals were exposed to filtered air and sacrificed at 12-14 weeks of age. Oil red-O staining of whole aortas, measures of mitochondrial damage, and oxidative stress were performed. Results show that both in utero and neonatal second-hand smoke exposure significantly increased adult atherogenesis in mice compared to filtered air controls. These changes were associated with changes in aconitase and mitochondrial superoxide dismutase activities consistent with increased oxidative stress in the aorta, changes in mitochondrial DNA copy number and deletion levels. These studies show that in utero or neonatal exposure to second-hand smoke significantly influences adult atherosclerotic lesion development and results in significant alterations to the mitochondrion and its genome that may contribute to atherogenesis.

Implementation of a Community-Based Secondhand Smoke Reduction Intervention for Caregivers of Urban Children with Asthma: Process Evaluation, Successes and Challenges

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Blaakman, Susan; Tremblay, Paul J.; Halterman, Jill S.; Fagnano, Maria; Borrelli, Belinda

2013-01-01

Many children, including those with asthma, remain exposed to secondhand smoke. This manuscript evaluates the process of implementing a secondhand smoke reduction counseling intervention using motivational interviewing (MI) for caregivers of urban children with asthma, including reach, dose delivered, dose received and fidelity. Challenges,…

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.

Consumo y exposición al humo de tabaco en mujeres embarazadas de Ecuador Smoking and exposure to tobacco smoke among pregnant women in Ecuador

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Fernando A. Poletta

2010-01-01

pregnancy. Of the respondents, 12.9% were frequently or always exposed to secondhand smoke indoors. Having more education (11 or more years, being in the middle or upper socioeconomic classes, being Caucasian, and it being considered acceptable for women in the community to smoke were significantly and directly associated with cigarette smoking (P < 0.001. Overall, 12.9% of women were being exposed to secondhand smoke and this was significantly associated with being single and cohabiting with smokers or employees connected to the tobacco industry (P < 0.001. CONCLUSIONS: Specific measures must be designed and implemented to not only encourage smoking cessation during pregnancy, but also to prevent women of reproductive age from taking up smoking and to limit smoking in the home environment.

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.

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.

Cannabis and tobacco smoke are not equally carcinogenic

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Melamede Robert

2005-10-01

Full Text Available Abstract More people are using the cannabis plant as modern basic and clinical science reaffirms and extends its medicinal uses. Concomitantly, concern and opposition to smoked medicine has occurred, in part due to the known carcinogenic consequences of smoking tobacco. Are these reactions justified? While chemically very similar, there are fundamental differences in the pharmacological properties between cannabis and tobacco smoke. Cannabis smoke contains cannabinoids whereas tobacco smoke contains nicotine. Available scientific data, that examines the carcinogenic properties of inhaling smoke and its biological consequences, suggests reasons why tobacco smoke, but not cannabis smoke, may result in lung cancer.

Public support for smoke-free policies in Jordan, a high tobacco burden country with weak implementation of policies: Status, opportunities, and challenges.

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Obeidat, Nour A; Ayub, Hiba S; Bader, Rasha K; Shtaiwi, Aisha S; Shihab, Rawan A; Habashneh, Malek A; Hawari, Feras I

2016-12-01

Several Eastern Mediterranean (EM) countries, including Jordan, suffer from high smoking prevalence but weak implementation of smoking bans (SB). Public support (PS) influences successful implementation of SB, but little is known about PS for SB in EM countries with weak SB implementation. We conducted a cross-sectional survey measuring knowledge and perceptions of a large purposive sample of the Jordanian public regarding tobacco harms and anti-tobacco laws. Among 1169 respondents, 46% of whom used tobacco, PS for SB varied from 98% to 39% based on venue, being highest for health facilities and lowest for coffee shops. In venues with relatively lower PS (restaurants, coffee shops), lower educational groups, older age groups, nonsmokers, and those who had more knowledge regarding tobacco and secondhand smoke harms were significantly more likely to support SB than the highest educational group, the youngest age group, smokers, and those who had less knowledge (respectively). Our results suggest that aggressive promotion of SB is needed in countries like Jordan (where smoking is increasing), tailored to venue and specific sociodemographic characteristics of the public accessing these venues, particularly restaurants and coffee shops. Multifaceted health messages that enhance public knowledge can be of benefit in improving PS for SB.

Awareness of health effects of exposure to secondhand smoke from cigarettes: A cross-sectional study of never-smoked adult primary care patients in Eastern Nigeria

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Pascal Iloh, Gabriel Uche; Collins, Peace Ifeoma

2017-01-01

Background: Cigarette smoking whether actively or passively is a growing public health problem. Despite the wealth of information on the hazards of active cigarette smoking, awareness of the health effects of passive smoking on human population is often neglected in Nigeria. Aim: The study was aimed at describing the awareness of health effects of exposure to secondhand smoke from cigarettes among never-smoked adult primary care patients in Eastern Nigeria. Materials and Methods: A hospital-based study carried out on a cross-section of 500 adult patients in a primary care clinic in Nigeria. Data were collected using pretested, structured, and interviewer-administered questionnaire. Exposure to secondhand smoke was defined as exposure to cigarette smoke in a never-smoked adult patient in the previous 1 year. Data were analyzed using Statistical Package for Social Sciences version 21 for the calculation of percentages for categorical variables. Bivariate analysis involving Chi-square test was used to test for significance of association between categorical variables at P < 0.05. Results: The age of the respondents ranged from 18 to 74 years, with a mean age of 36 ± 12.4 years. There were 180 (36.0%) males with 320 (64%) females, with a sex ratio of 1.8. Awareness of general health effects of secondhand smoke on adults, children, and pregnant women was 95.6%, 92.8%, and 65.2%, respectively. The most common specific health effects the respondents were aware for adults, children, and obstetric population were lung cancer (95.6%), precipitation of asthmatic condition (92.8%), and delivery of small babies (65.2%), respectively. The predominant source of awareness of information was radio (93.6%). Awareness of general health effects of exposure to secondhand smoke on adults (P = 0.041), children (P = 0.031), and obstetrics population (P = 0.02) was significantly associated with exposure status. Conclusion: The most common health effects of secondhand smoke the respondents

Assessment of the carcinogenic N-nitrosodiethanolamine in tobacco products and tobacco smoke

International Nuclear Information System (INIS)

Brunnemann, K.D.; Hoffmann, D.

1981-01-01

A simple, reproducible gas chromatography-thermal energy analyzer (g.c.-TEA) method has been developed for the analysis of N-nitrosodiethanolamine (NDELA) in tobacco and tobacco smoke. The extract of tobacco or the trapped particulates of tobacco smoke are chromatographed on silica gel. The NDELA containing fractions are concentrated, silylated and analyzed with a modified g.c.-TEA system. [/sup 14/C]NDELA serves as internal standard for the quantitative analysis. Experimental cigarettes made from tobaccos which were treated with the sucker growth inhibitor maleic hydrazidediethanolamine (MH-DELA) contained 115--420 p.p.b. of NDELA and their smoke contained 20--290 ng/cigarette, whereas hand-suckered tobacco and its smoke were free of NDELA. The tobacco of US smoking products contained 115--420 p.p.b. of NDELA and the mainstream smoke from such products yielded 10--68 ng/cigar or cigarette. NDELA levels in chewing tobacco ranged from 220--280 p.p.b. and in two commercial snuff products were 3,200 and 6,800 p.p.b. Although the five analyzed MH-DELA preparations contained between 0.6--1.9 p.p.m. NDELA it is evident that the major portion of NDELA in tobacco is formed from the DELA residue during the tobacco processing. Based on bioassay data from various laboratories which have shown that NDELA is a relatively strong carcinogen and based on the results of this study the use of MH-DELA for the cultivation of tobacco is questioned

The healthcare costs of secondhand smoke exposure in rural China.

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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.

Tribal casinos in California: the last vestige of indoor smoking

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2012-01-01

Background High levels of airborne particles from secondhand smoke have been reported in California Indian casinos. Yet, little is known regarding the smoking status of casino patrons, their avoidance of secondhand smoke while visiting, and their views on a hypothetical smoking ban. Methods Predictors of visiting an Indian casino were assessed among participants of the 2008 California Tobacco Survey (n = 10, 397). Exposure to and avoidance of secondhand smoke were subsequently analyzed among a subset of participants who had visited a casino in the year prior to the survey (n = 3, 361). Results Ethnic minorities, older individuals, current smokers and residents of sparsely populated regions of California were more likely than other demographic groups to visit a tribal casino. Avoidance of secondhand smoke was more frequent among the never smokers than former and current smokers, particularly those who last visited a casino lacking physical separation between non-smoking and smoking sections. The never smokers versus current smokers disproportionately expressed a willingness to extend their stay and visit again if smoking were prohibited. Conclusions If casinos became smoke free, then it is anticipated that they would be visited by a significantly larger number of Californians, including both patrons and those who otherwise would not have visited a casino. PMID:22364487