Sociodemographic Differences in Secondhand Smoke Exposure in the United States

2020 ◽  
Vol 47 (4) ◽  
pp. 602-610 ◽  
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.

Nursing Research in Community-Based Approaches to Reduce Exposure to Secondhand Smoke

2009 ◽  
Vol 27 (1) ◽  
pp. 365-391 ◽  
Author(s):  
Ellen J. Hahn ◽  
Kristin B. Ashford ◽  
Chizimuzo T. C. Okoli ◽  
Mary Kay Rayens ◽  
S. Lee Ridner ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Indoor Air ◽  
Secondhand Smoke ◽  
The United States ◽  
Population Based ◽  
Emergency Department Visits ◽  
Nursing Research ◽  
Smoke Free Policy ◽  
Shs Exposure ◽  
Race Ethnicity

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.

scholarly journals Comparison of social inequality in HPV vaccination among teenagers with parental reports and healthcare providers’ records in the 2019 National Immunization Survey-Teen.

2021 ◽  
Author(s):  
Bongkyoo Choi ◽  
Sol Seo Choi
Keyword(s):  
United States ◽  
Social Inequality ◽  
Family Income ◽  
Information Source ◽  
Hpv Vaccination ◽  
The United States ◽  
Poverty Level ◽  
National Immunization ◽  
Parental Reports ◽  
National Immunization Survey

Background: Relatively little is known and inconclusive about social inequality in human papillomavirus (HPV) vaccination among teenagers in the United States. This study aims to investigate whether there is a social disparity in HPV vaccination among teenagers and if so, whether it can differ by the source of teen vaccination information (parental reports and provider records). 
Methods: We used the data from the 2019 National Immunization Survey-Teen (NIS-Teen; 42,668 teenagers, aged 13-17) including parental reported vaccination status. Among them, 18,877 teenagers had adequate provider reported vaccination records. Two socioeconomic status (SES) measures were used: mother’s education and annual family income. Multivariate logistic analyses were conducted. 
Results: False negatives of parental reports against provider records were more than two times higher (p < 0.001) in low SES teens than in high SES teens. In both SES measures, the proportion of HPV unvaccinated teenagers were lowest in the highest SES level in analyses with parental reports. However, it was the opposite in analyses with provider records. Interestingly, regardless of vaccination information source, the HPV unvaccinated rate was highest in the middle SES teens (>12 years, non-college graduates; and above poverty level, but not > $75K). 
Conclusion: A significant social inequality in HPV vaccination among teenagers exists in the United States. The pattern of social inequality in HPV vaccination can be distorted when only parent reported vaccination information is used.

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

2019 ◽  
pp. tobaccocontrol-2019-055056
Author(s):  
Elena R. O'Donald ◽  
Curtis P. Miller ◽  
Rae O'Leary ◽  
Jennifer Ong ◽  
Bernadette Pacheco ◽  
...  
Keyword(s):  
American Indians ◽  
Secondhand Smoke ◽  
Smoking Status ◽  
Statistical Modelling ◽  
Tobacco Consumption ◽  
Health Study ◽  
Serum Cotinine ◽  
Free Air ◽  
Shs Exposure ◽  
Cheyenne River

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.

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

Circulation ◽  
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.

Biomarker evaluation of Greek adolescents’ exposure to secondhand smoke

2009 ◽  
Vol 29 (6) ◽  
pp. 459-466 ◽  
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.

scholarly journals Trends in Cancer Diseases Prevalence by Different Socioeconomic Strata in the United States

2021 ◽  
Author(s):  
Mingsi Wang ◽  
Yi Ma ◽  
Liangru Zhou ◽  
Yi Cheng ◽  
Yue Li ◽  
...  
Keyword(s):  
United States ◽  
Low Income ◽  
Family Income ◽  
Temporal Trends ◽  
The United States ◽  
High Income ◽  
Poverty Level ◽  
Middle Income ◽  
Socioeconomic Strata ◽  
Cancer Diseases

Abstract Background Income disparity among different socioeconomic strata in the United States has widened sharply in recent decades. Take into account the well-established link between income and health, this widening income gap may provide insight into the dynamics of the cancer disease burden in American adults. Assess the temporal trends of the 20-year predicted absolute cancer risk in American adults at different socioeconomic classes. Methods The cross-sectional analyses were carried out using data from adults aged 20 to 85 years between the 1999 and 2018 NHANES. Socioeconomic status was divided into three groups based on the family income to poverty ratio (PIR): high income (PIR ≥ 4), middle income (> 1 and <4), or at or below the federal poverty level (≤ 1). Results The analysis included 49 720 participants. The prevalence of lung cancer was lower in high-income participants than in middle-income participants (0.15% [n= 19] vs 0.35% [n= 92], p <0.001). For the low-income stratum, the prevalence of breast cancer was 1.12% [n = 117], but the number of adults in the middle (1.48% [n = 391], p = 0.009) and high-income levels (1.71% [n = 219], p <0.001) has increased. Conclusions The study found that the prevalence of cancer diseases was increasingly different among participants of different socioeconomic classes of NHANES from 1999 to 2018. Further research is required on the dynamics and health impact of income inequality, as well as public health policies and efforts to reduce these inequalities.

scholarly journals Ever Use of E-Cigarettes Among Adults in the United States: A Cross-Sectional Study of Sociodemographic Factors

2019 ◽  
Vol 56 ◽  
pp. 004695801986447 ◽  
Author(s):  
Sericea Stallings-Smith ◽  
Taylor Ballantyne
Keyword(s):  
United States ◽  
High School ◽  
Mexican Americans ◽  
The United States ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Cigarette Use ◽  
Poverty Level ◽  
Cross Sectional ◽  
Nationally Representative

E-cigarette use among adolescents is well-documented, but less is known about adult users of e-cigarettes. The purpose of this study was to examine associations between sociodemographic factors and e-cigarette use in a nationally representative sample of adults in the United States. Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) for years 2015-2016 were analyzed to assess e-cigarette use among 5989 adults aged ≥18 years. Multivariable logistic regression was conducted to examine associations between the sociodemographic exposures of age, sex, race, marital status, education level, employment status, and poverty-income ratio and the outcome of e-cigarette use. The weighted prevalence of ever use of e-cigarettes was 20%. Compared with adults aged ≥55 years, odds of e-cigarette use were 4.77 times (95% confidence interval [CI] = 3.63-6.27) higher among ages 18 to 34 years and 2.16 times (95% CI = 1.49-3.14) higher among ages 35 to 54 years. Higher odds of e-cigarette use were observed among widowed/divorced/separated participants compared with those who were married/living with a partner, among participants with less than high school (odds ratio [OR] = 1.47; 95% CI = 1.08-2.00) or high school/general educational development (GED) education (OR=1.41; 95% CI = 1.12-1.77) compared with those with college degrees/some college, and among those with incomes below the poverty level (OR=1.31; 95% CI = 1.01-1.69) compared with above the poverty level. For non-smokers of conventional cigarettes, higher odds of e-cigarette use were observed among males compared with females, Mexican Americans/Other Hispanics compared with non-Hispanic whites, and non-working participants compared with those who were working. Overall findings indicate that individuals who are widowed/divorced/separated, individuals with lower education, and with incomes below the poverty level are likely to report ever use of e-cigarettes. As increasing evidence demonstrates negative health consequences, e-cigarette initiation may ultimately contribute to additional smoking-related health inequalities even among non-smokers of conventional cigarettes.

scholarly journals Healthy People 2020: Social Determinants of Cigarette Smoking and Electronic Cigarette Smoking among Youth in the United States 2010–2018

2020 ◽  
Vol 17 (20) ◽  
pp. 7503
Author(s):  
Gang Wang ◽  
Liyun Wu
Keyword(s):  
United States ◽  
Young People ◽  
Cigarette Smoking ◽  
Social Determinants ◽  
The United States ◽  
Healthy People ◽  
Socioeconomic Disparities ◽  
Cigarette Use ◽  
Poverty Level ◽  
Healthy People 2020

The purpose of this study was to determine social determinants of cigarette smoking and ever using electronic cigarettes (e-cigarettes) among young adults aged 18 to 25 years in the United States between 2010 and 2018. Using secondary data from National Health Interview Surveys (NHIS) across the 2010, 2014, and 2018 survey years, this study analyzed the prevalence rates of cigarette smoking and ever using e-cigarettes between 2010 and 2018, demographic and socioeconomic disparities in smoking, and the relationship between previous e-cigarette use and current smoking. First, the past decade witnessed a notable decline in conventional cigarette smoking and a sharp increase in e-cigarette use among youth. These trends were consistent regardless of socioeconomic status. Second, demographic and socioeconomic disparities persisted in cigarette smoking. Non-Hispanic white male youth were more likely to become smokers as they grew older. Young people with lower educational attainment, living below the U.S. federal poverty level, and having a poor physical health status had a higher smoking prevalence. Third, previous e-cigarette use was more likely to relate to subsequent cigarette use among young people. To achieve the Healthy People 2020 objectives, tobacco control programs and interventions need to be more specific in higher prevalence groups and service providers should not assume that there is a one-size-fits-all model for youth.

scholarly journals Home Tobacco Use Policies and Exposure to Secondhand Tobacco Smoke: Findings from Waves 1 through 4 of the Population Assessment of Tobacco and Health (PATH) Study

2021 ◽  
Vol 18 (18) ◽  
pp. 9719
Author(s):  
Cheryl Rivard ◽  
Anthony Brown ◽  
Karin Kasza ◽  
Maansi Bansal-Travers ◽  
Andrew Hyland
Keyword(s):  
Tobacco Use ◽  
Tobacco Smoke ◽  
Secondhand Smoke ◽  
The United States ◽  
Smoke Exposure ◽  
Tobacco Smoke Exposure ◽  
Protective Measure ◽  
Poverty Level ◽  
Population Assessment ◽  
Secondhand Tobacco Smoke

Background: The 2006 Surgeon General’s Report recommended the elimination of smoking in homes as an effective protective measure against the harmful effects of secondhand tobacco smoke exposure. This study aims to examine trends in the prevalence and levels of the adoption of home tobacco use policies specifically for cigarettes, e-cigarettes, smokeless tobacco, and the relationships between home tobacco use policies and self-reported exposure to secondhand tobacco smoke. Methods: This study utilizes data from Wave 1 (2013–2014) through Wave 4 (2016–2018) of the Population Assessment of Tobacco and Health (PATH) Study, a large prospective cohort study of youths and adults in the United States which collected information about both smoke-free and tobacco-free home policies. We present the weighted, population-based, self-reported prevalence of home tobacco use policies overall and by product, and the average number of self-reported hours of secondhand smoke (SHS) exposure by levels of home tobacco policy and by survey wave. In addition, we examine the characteristics of those who adopted (by yes or no) a home tobacco use ban between survey waves. Results: We found a high prevalence of completely tobacco-free home policies (69.5%). However, 10.6% of adults allow the use of any type of tobacco product inside their homes, and 19.8% have a policy allowing the use of some types of tobacco products and banning the use of others. Adults with a complete tobacco use ban inside their homes were more likely to be nonusers of tobacco (79.9%); living with children in the home (71.8%); at or above the poverty level (70.8%); non-white (76.0%); Hispanic (82.7%); and aged 45 or older (71.9%). The adoption of 100% tobacco-free home policies is associated with a 64% decrease in secondhand smoke exposure among youths and a 69% decrease in exposure among adults. Conclusions: Most US adults have implemented tobacco-free home policies; however, there is still exposure to SHS in the home, for both adults and children, particularly in the homes of tobacco users. Additional research should investigate tobacco-free home policies for different types of products and what effect they have on future tobacco use behaviors.

scholarly journals Social Deprivation and Secondhand Smoke Exposure Among Urban Male Residents: A Nationwide Study of China

2020 ◽  
Author(s):  
Yixin Yang ◽  
Xiaozhao Yousef Yang ◽  
Tingzhong Yang ◽  
Wenjiong He ◽  
Sihui Peng ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Secondhand Smoke ◽  
Family Income ◽  
Social Deprivation ◽  
Independent Effect ◽  
Multilevel Logistic Regression ◽  
Exposure Control ◽  
Cross Sectional ◽  
Targeted Interventions ◽  
Shs Exposure

Abstract IntroductionSocial deprivation is a known determinant of health and related behaviors. Many studies have linked socioeconomic status to secondhand smoke (SHS) exposure. However, no studies have examined the relationship between social deprivation and SHS exposure. This study examined whether social deprivation has any independent effect on SHS exposure at both individual and regional levels among Chinese residents.MethodsA cross-sectional multistage sampling design was utilized to interview subjects from 6 selected cities in China. A standardized questionnaire was used to tap demographic characteristics, social deprivation and SHS exposure. Multilevel logistic regression models were used to assess the association between social deprivation and SHS exposure.Results5,782 valid questionnaires were collected in this study. Of 2,930 non-smokers, the SHS exposure prevalence was 21.9% (95% CI 19.5, 24.30). Multilevel logistic regression showed a negative association between family income, regional GDP and SHS exposure, and positive associations between social deprivation and SHS exposure, respectively. ConclusionsFindings support the central proposition that social deprivation influences SHS exposure messages. Our research underscores the importance of reducing health inequality in controlling SHS exposure. ImplicationsThe information from this study should be helpful when considering effective SHS exposure control policies and interventions among urban residents in China. Targeted interventions for SHS exposure should help reduce health inequities across social class. With this in mind, SHS exposure control for socially deprived groups should be paid attention.

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