Active smoking, secondhand smoke exposure and serum cotinine levels among Cheyenne River Sioux communities in context of a Tribal Public Health Policy

IntroductionAmerican Indians and Alaska Natives face disproportionately high rates of smoking and secondhand smoke (SHS) exposure. The Cheyenne River Sioux Tribe (CRST) is among the few Tribal Nations controlling commercial tobacco exposures in public and work places. We had an opportunity to explore effects of the new commercial tobacco-free policy (implemented in 2015) in an environmental health study (2014–2016) that collected information about commercial tobacco use and SHS prevalence and examined predictor variables of serum cotinine concentrations.MethodsSelf-reported survey data were used in quantile regression statistical modelling to explore changes in cotinine levels, based on smoking status, smokeless tobacco consumption and SHS exposure.ResultsFrom enrolled 225 adults, 51% (N=114) were current smokers. Among 88 non-tobacco users, 35 (40%) reported current SHS exposure. Significant differences in cotinine median concentrations were found among participants with and without current SHS exposure. Extremely high cotinine concentrations (~100 times larger than the median) were detected in some non-tobacco users. After implementing the new smoke-free air Tribal policy, cotinine decreased in participants with intermediate (3–15 ng/mL, non-tobacco users with SHS exposure) and high (>15 ng/mL, mainly tobacco users) cotinine levels showing association with an abatement of opportunities for SHS exposure. Significant predictors of cotinine levels were sampling year, current smoking and tobacco chewing. No gender differences were observed in cotinine.ConclusionsOur results show decrease in cotinine concentrations in CRST participants since implementation of their ‘Smoke-Free Clean Air Act’ in 2015.

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Estimation of lifetime cumulative mortality risk of lung cancer by smoking status in Japan

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa094 ◽

2020 ◽

Vol 50 (10) ◽

pp. 1218-1224

Author(s):

Megumi Hori ◽

Eiko Saito ◽

Kota Katanoda ◽

Shoichiro Tsugane

Keyword(s):

Lung Cancer ◽

Life Table ◽

Mortality Risk ◽

Secondhand Smoke ◽

Smoking Status ◽

Cumulative Risk ◽

Cumulative Mortality ◽

Shs Exposure ◽

Estimated Risk ◽

Exposure To Secondhand Smoke

Abstract The main objective of this study was to estimate the cumulative mortality risk for lung cancer according to smoking status and exposure to secondhand smoke (SHS) in Japan. We applied a life-table method to estimate the cumulative risk. Estimated lifetime cumulative risk for 20-year-old non-smokers, former, and current smokers was 3.2%, 7.6%, and 14.9% for men and 1.9%, 5.6%, and 7.2% for women, respectively. For males, the estimated risk was 3.2% for non-smokers not exposed to SHS and 4.1% for non-smokers exposed to SHS. For females, the estimated risk was 1.9% for non-smokers not exposed to SHS and 2.4% for non-smokers exposed to SHS. Lifetime cumulative mortality risk differed greatly according to smoking status. Moreover, SHS exposure resulted in observable differences in lifetime mortality risk. This study may be useful for the development of tailored prevention programs.

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Serum cotinine and adverse cardiovascular outcomes: a cross-sectional secondary analysis of the nuMoM2b Heart Health Study

American Journal of Perinatology ◽

10.1055/a-1580-3155 ◽

2021 ◽

Author(s):

Lauren Theilen ◽

Rebecca McNeil ◽

Shannon Hunter ◽

William Grobman ◽

Colette Parker ◽

...

Keyword(s):

Metabolic Syndrome ◽

Smoking Status ◽

Cardiovascular Outcomes ◽

Reproductive Age ◽

Self Report ◽

Health Study ◽

Chronic Hypertension ◽

Heart Health ◽

Serum Cotinine ◽

Cross Sectional

Objective: Women with adverse pregnancy outcomes (APOs) have increased risks for cardiovascular disease. Smoking is a source of confounding that may be difficult to assess by self-report. We aimed to estimate odds of cardiovascular outcomes by smoking status using serum cotinine versus self-report and to assess whether the association between APOs and cardiovascular outcomes varies by smoking status. Study Design: We conducted a cross-sectional study of the nuMoM2b Heart Health Study wherein women attended an in-person visit 2-7 years following their first pregnancy. The exposure was smoking status, determined by self-report and by serum cotinine levels. Outcomes included incident chronic hypertension, metabolic syndrome, and dyslipidemia. Multivariable logistic regression estimated odds ratios for each outcome by smoking status. Results: Of the 4,392 women with serum cotinine measured, 3,610 were categorized as nonsmokers, 62 as having secondhand smoke exposure, and 720 as smokers. After adjustment for APOs, smoking defined by serum cotinine levels was associated with metabolic syndrome (adjusted odds ratio (aOR) 1.52, 95% confidence interval (CI) 1.21, 1.91) and dyslipidemia (aOR 1.28, 95% CI 1.01, 1.62). When stratified by nicotine exposure, nonsmokers with an APO in their index pregnancy had higher odds of stage 1 (aOR 1.64, 95% CI 1.32, 2.03) and stage 2 hypertension (aOR 2.92, 95% CI 2.17, 3.93), metabolic syndrome (aOR 1.76, 95% CI 1.42, 2.18), and dyslipidemia (aOR 1.55, 95% CI 1.25, 1.91) relative to women with no APO. Similar findings were obtained using self-report to define smoking exposure. Conclusion: Smoking and APOs are independently associated with subsequent cardiovascular outcomes in reproductive-age women. Smoking is associated with metabolic syndrome and dyslipidemia, whether smoking status is obtained by serum cotinine or self-report. Among nonsmokers, a history of APO is associated with hypertension, metabolic syndrome, and dyslipidemia compared to women without APOs.

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Abstract 15034: Exposure to Secondhand Smoke is Associated With Increased Left Ventricular Mass

Circulation ◽

10.1161/circ.142.suppl_3.15034 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Travis M Skipina ◽

Bharathi Upadhya ◽

Elsayed Z Soliman

Keyword(s):

Secondhand Smoke ◽

Left Ventricular ◽

Nhanes Iii ◽

P Value ◽

Response Relationship ◽

Dose Response Relationship ◽

Serum Cotinine ◽

Lv Mass ◽

Shs Exposure ◽

Exposure To Secondhand Smoke

Background: Exposure to secondhand smoke (SHS), or passive smoking, has been associated with chronic hypertension. However, little is known about the relationship between SHS and left ventricular (LV) hypertrophy, the most common complication of hypertension and a manifestation of cardiac end-organ damage. Hypothesis: SHS exposure is independently associated with LV mass. Methods: This analysis included 4,982 non-smoker participants (age 60.8±13.6 years, 57.8% women, 77.7% whites) from the Third National Health and Nutrition Examination (NHANES-III). Non-smoking was defined by self-report and serum cotinine ≤ 10 ng/dL, a biomarker for tobacco exposure. SHS was defined as serum cotinine level >1 ng/dL. LV mass was estimated using an electrocardiographic model developed and applied in NHANES-III then validated in the Cardiovascular Health Study. Multivariable linear regression was used to examine the cross-sectional association between SHS exposure (vs. no exposure) with estimated LV mass. In similar models, we also examined the associations of LV mass across quartiles of serum cotinine (reference group, 1 st quartile) and in subgroups stratified by race, sex, and hypertension status. Results: About 9.8% (n=489) of the participants were exposed to SHS. Exposure to SHS was associated with an estimated 2.9 gram increase in LV mass, with a dose-response relationship between higher serum cotinine and LV mass ( Table ). These results were consistent in men and women (interaction p-value= 0.31), whites and non-whites (interaction p-value= 0.21), and those with and without hypertension (interaction p-value= 0.88) Conclusion: In a racially diverse sample of non-smokers, SHS is associated with increased LV mass with a dose-response relationship between level of exposure and LV mass. These findings underscore the harmful effect of passive smoking on the cardiovascular system and highlight the need for more restrictions on smoking in public areas.

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Biomarker evaluation of Greek adolescents’ exposure to secondhand smoke

Human & Experimental Toxicology ◽

10.1177/0960327109354941 ◽

2009 ◽

Vol 29 (6) ◽

pp. 459-466 ◽

Cited By ~ 8

Author(s):

CI Vardavas ◽

MN Tzatzarakis ◽

M. Plada ◽

AM Tsatsakis ◽

A. Papadaki ◽

...

Keyword(s):

Secondhand Smoke ◽

Healthy Lifestyle ◽

Gas Chromatography Mass Spectrometry ◽

Serum Cotinine ◽

Public Places ◽

School Based ◽

Shs Exposure ◽

Almost All ◽

Biomarker Evaluation ◽

Exposure To Secondhand Smoke

Exposure to secondhand smoke (SHS) is a significant threat to public health, and represents a danger for both the development and health status of children and adolescents. Taking the above into account, our aim was to quantify Greek adolescents’ exposure to SHS using serum cotinine levels. During 2006, 341 adolescents aged 13-17 were randomly selected from high schools in Heraklion and agreed to participate as part of the European Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Blood samples were drawn from a random sample of 106 adolescents, while serum cotinine/nicotine concentrations were measured by Gas Chromatography—Mass Spectrometry (GC-MS). The mean levels of serum cotinine and nicotine were calculated at 1.60 ± 2.18 ng/mL and 4.48 ± 4.00 ng/mL, respectively, while 97.7% of the non-smoker adolescents were found to have measureable levels of serum cotinine indicating exposure to SHS. The analysis revealed that their paternal (p = .001) and maternal smoking habits (p = .018) as also the existence of a younger brother or sister (p = .008) were the main modifiers of SHS exposure during adolescence. Conclusively, almost all of the measured Greek adolescents were exposed to SHS, even when their parents were non-smokers. This finding indicates the need for both community and school-based educational programmes as also the implementation of a comprehensive ban on smoking in public places.

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The prevalence of secondhand smoke exposure and related factors among schoolchildren in Northeast Thailand

F1000Research ◽

10.12688/f1000research.26039.1 ◽

2020 ◽

Vol 9 ◽

pp. 1158

Author(s):

Nirun Intarut ◽

Piyalak Pukdeesamai

Keyword(s):

Depressive Symptoms ◽

Secondhand Smoke ◽

Tobacco Consumption ◽

Cross Sectional Study ◽

Chi Square ◽

Related Factors ◽

Cross Sectional ◽

Depression Status ◽

Chi Square Test ◽

Shs Exposure

Background: The prevalence of tobacco consumption in Thailand has gradually declined; however, the prevalence of exposure to secondhand smoke (SHS) is still high. The objective of this study is to estimate the prevalence of SHS exposure and examine the association between exposure to SHS and depressive symptoms among schoolchildren, and test for moderation by the number of smokers in household. Methods: We conducted a cross-sectional study of 1105 schoolchildren. Socioeconomics factors, depressive symptoms and exposure to SHS variables were collected. We used the chi-square test for testing the factors associated to SHS exposure. In addition, we used the Mantel Haenszel test for testing interaction effect of depression to SHS exposure by the number of smokers in home. Multiple logistic regression was used to test the factors related to SHS exposure adjusted for confounders. Results: The prevalence of exposure to SHS was 58.2% (95%CI: 55.2, 61.1). The schoolchildren with abnormal depression status were 1.8 times more likely to have been exposed to SHS (95%CI: 1.3, 2.5). In addition, the number of smokers in the home did not modify the association between exposure to SHS and depressive symptoms (P: 0.964). Conclusions: An association between exposure to SHS and depressive in schoolchildren was observed, but this relationship was not affected by the number of smokers in children’s homes.

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Secondhand smoke (SHS) exposure before and after the implementation of the Tobacco Free Cities (TFC) initiative in five Chinese cities: a pooled cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-044570 ◽

2020 ◽

Vol 10 (12) ◽

pp. e044570

Author(s):

Zongshuan Duan ◽

Yu Wang ◽

Jidong Huang ◽

Pamela B Redmon ◽

Michael P Eriksen

Keyword(s):

Secondhand Smoke ◽

Smoking Status ◽

Cross Sectional Study ◽

Individual Characteristics ◽

Cross Sectional ◽

Media Campaigns ◽

Chinese Cities ◽

Before And After ◽

Shs Exposure ◽

Exposure Levels

ObjectivesTo assess the levels of secondhand smoke (SHS) exposure before and after the implementation of the Tobacco Free Cities (TFC) initiative.DesignCity-wide representative, cross-sectional surveys (Tobacco Questions for Surveys, TQS) were conducted in each participating city before and after the implementation of TFC.SettingFive large Chinese cities (Chengdu, Chongqing, Wuhan, Xiamen and Xi’an) participated in the TFC initiative.ParticipantsA total of 10 184 adults participated in the 2015 TQS survey, and 10 233 adults participated in the 2018 TQS survey, respectively.InterventionsThe TFC initiative, which included targeted media campaigns, educational programmes, implementing city-wide smoke-free policies and providing cessation interventions, was implemented in these five cities between 2015 and 2018.Main outcomeSelf-reported past 30-day (P30D) SHS exposure in indoor workplaces, restaurants and homes.Data analysisThe pre-TFC and post-TFC SHS exposure levels were compared among all residents and among certain population subgroups. Multivariate logistic regressions were used to estimate the adjusted associations between P30D SHS exposure and individual characteristics.ResultsAcross all five cities, the overall rate of self-reported P30D SHS exposure declined in indoor workplaces (from 49.6% (95% CI: 46.4% to 52.8%) to 41.2% (95% CI: 37.7% to 44.7%)), restaurants (from 72.4% (95% CI: 69.8% to 74.9%) to 61.7% (95% CI: 58.7% to 64.7%)) and homes (from 39.8% (95% CI: 36.9% to 42.7%) to 34.7% (95% CI: 31.5% to 37.8%)) from 2015 to 2018. These declines were statistically significant after controlling for individual characteristics. The P30D SHS exposure was associated with sex, age, education level, occupation and current smoking status. The associations varied by venues.ConclusionsOur analysis showed that compared with the nationwide SHS exposure levels reported in concurrent national surveys, the declines in P30D SHS exposure in five Chinese cities that implemented the TFC initiative were larger in indoor workplaces and restaurants. Our findings suggest that the TFC initiative was effective in reducing SHS exposure in Chinese cities.

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Sociodemographic Differences in Secondhand Smoke Exposure in the United States

Health Education & Behavior ◽

10.1177/1090198120925414 ◽

2020 ◽

Vol 47 (4) ◽

pp. 602-610 ◽

Cited By ~ 1

Author(s):

Sunday Azagba ◽

Keely Latham ◽

Lingpeng Shan

Keyword(s):

Confidence Interval ◽

Secondhand Smoke ◽

Mexican Americans ◽

Family Income ◽

The United States ◽

Socioeconomic Disparities ◽

Sociodemographic Characteristics ◽

Poverty Level ◽

Serum Cotinine ◽

Shs Exposure

Background. Socioeconomic disparities in secondhand smoke (SHS) exposure exist among nonsmokers. The present study examined the prevalence and socioeconomic disparities of both objective and self-reported measures of SHS exposure in various indoor environments among U.S. nonsmokers. Method. Data were drawn from the 2013–2014 and 2015–2016 National Health and Nutrition Examination Survey. The prevalence of objective measures of SHS (nonsmokers with serum cotinine levels of 0.05–10 ng/mL) and the self-reported SHS exposure status in restaurants, cars, and homes other than their own were examined for the overall population as well as by sociodemographic characteristics. Multivariable logistic regression analyses were used to assess the association between sociodemographic characteristics and SHS exposure measures. Results. The prevalence of self-reported SHS exposure in restaurants, cars, and homes other than one’s own decreased significantly between 2013–2014 and 2015–2016. We found higher odds of the objective measure of SHS exposure among non-Hispanic Blacks (a OR 2.07, 95% confidence interval [1.93, 2.81]) and males (a OR 1.12, confidence interval [1.05, 1.18]), while lower odds were found among Mexican Americans, other Hispanics, and those who had family income greater or equal to the poverty level. Compared to non-Hispanic Whites, the non-Hispanic Black group had higher odds of SHS exposure in restaurants and homes other than their own. Age was positively associated with self-reported SHS exposure measures but not the objective SHS measure. However, age was negatively associated with SHS measures in the adult sample (aged ≥ 20 years). Conclusions. Findings suggest that although SHS exposure may be decreasing in specific at-risk populations, socioeconomic disparities still exist.

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Effectiveness of Interventions to Reduce Exposure to Parental Secondhand Smoke at Home among Children in China: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16010107 ◽

2019 ◽

Vol 16 (1) ◽

pp. 107 ◽

Cited By ~ 3

Author(s):

Yan Hua Zhou ◽

Yim Wah Mak ◽

Grace W. K. Ho

Keyword(s):

Secondhand Smoke ◽

Tobacco Consumption ◽

Text Messages ◽

Family Interactions ◽

Positive Effects ◽

Quit Smoking ◽

Shs Exposure ◽

Exposure To Secondhand Smoke ◽

At Home

There are health consequences to exposure to secondhand smoke (SHS). About two-thirds of children in China live with at least one person, usually a parent, who smokes at home. However, none of the reviews of interventions for reducing SHS have targeted children in China. The purpose of this study was to review the effectiveness of interventions for reducing parental SHS exposure at home among children in China. We searched various electronic databases for English and Chinese publications appearing between 1997 and 2017. Thirteen relevant studies were identified. Common strategies used in intervention groups were non-pharmacological approaches such as counseling plus self-help materials, and attempting to persuade fathers to quit smoking. Family interactions and follow-up sessions providing counseling or using text messages could be helpful to successful quitting. Several encouraging results were observed, including lower cotinine levels in children (n = 2), reduced tobacco consumption (n = 5), and increased quit rates (n = 6) among parents. However, the positive effects were not sustained 3~6 months after the interventions. Self-reported quitting without bio-chemical validation was the most common outcome measure. A study design using biochemical validations, a longer follow-up period, and targeting all people living with children in the same household is recommended.

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Testing effects of awareness of statewide smoke-free air law and risk perception on smoking behaviors

Health Education ◽

10.1108/he-09-2020-0088 ◽

2021 ◽

Vol 121 (2) ◽

pp. 189-199

Author(s):

YoungJu Shin ◽

Nicole L. Johnson

Keyword(s):

Secondhand Smoke ◽

Risk Perceptions ◽

Smoking Status ◽

Negative Attitude ◽

The State ◽

State Law ◽

Current Smoking Status ◽

Content Type ◽

Free Air ◽

Smoking Behaviors

PurposeTo reduce the smoking rates and alleviate societal problems associated with smoking, health administrators and policy makers have attempted to promote and implement statewide smoking free policy. The present study examined how adults' awareness of and attitude toward the smoke-free air law, their perceived risks of secondhand smoke and current smoking status were associated with smoking attitude and behaviors.Design/methodology/approachAs part of the Indiana Adult Tobacco Survey, 2,027 respondents participated in cross-sectional telephone surveys. A series of independent sample t-test and binary logistic regression analyses were performed.FindingsAwareness of the state law was inversely related to negative attitude toward smoking behaviors. Individuals who reported favorable attitude toward the state smoke-free air law and higher risk perceptions of secondhand smoke showed negative attitude toward smoking behaviors. Non-smokers and former smokers were significantly different from current smokers with regard to attitude toward smoking. Negative attitude was significantly related to intention to quit smoking. Awareness of the state law, perceived risk and current smoking status were key determinants for anti-smoking attitude and behavior.Originality/valueFindings highlight the importance of effective dissemination of the state law and recommend a strategic intervention design that invokes risk perceptions of secondhand smoke.

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Effect of secondhand smoke exposure on lung function among non-smoking population

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20193256 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1116

Author(s):

Aravind C. ◽

Ragul B. ◽

Monisha .

Keyword(s):

Lung Function ◽

Secondhand Smoke ◽

Smoking Status ◽

Cross Sectional Study ◽

Exposed Group ◽

Analysis Of Covariance ◽

Cross Sectional ◽

Urinary Cotinine ◽

Significant Difference ◽

Shs Exposure

Background: Secondhand Smoke (SHS) exposure is known to be associated with various cardiovascular and respiratory problems but its effect on pulmonary function remains unexplored. This study was done to evaluate the effect of Secondhand Smoke (SHS) exposure on lung function among non-smoking population.Methods: This cross-sectional study was conducted in Bahour, Pondicherry from 2017-2018. 350 participants, age 40 year and older, with no respiratory symptoms or prior lung diseases were included in this study. Both self-reported history and measurement of urinary cotinine level were used to evaluate the smoking status. Spirometry data, including FVC and FEV1 were used to assess lung function. Diverse variables between groups were compared using T- test and Chi-square test. Analysis of covariance (ANCOVA) adjusted for age, height, alcohol consumption, and level of exercise was used to see any statistical differences in lung function parameters between non-SHS exposed and SHS-exposed groups.Results: Among 350 non-smokers, 120 were SHS-exposed. The urinary cotinine levels clearly distinguished SHS exposure, and the mean urinary cotinine levels were 7±0.3 and 11±0.4 in non-SHS exposed group vs SHS-exposed group, respectively. However, both groups had no significant difference in lung function and was found normal.Conclusions: SHS exposure urinary cotinine is a valuable marker.

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