Chinese Pediatrician Attitudes and Practices Regarding Child Exposure to Secondhand Smoke (SHS) and Clinical Efforts against SHS Exposure

This study aimed to estimate the secondhand smoke (SHS) exposure using urinary cotinine (UCo) to prove that the SHS exposure could not be properly assessed by self-reporting (SR). In total, 28,574 nonsmokers aged >19 years were selected from the Korean National Health and Nutrition Examination Survey data (2009–2018). First, changes in the annual concentration of UCo were analyzed, and the annual SHS exposure rates were measured based on SR and UCo from 2009 to 2018. Then, the average UCo concentration and UCo-measured SHS exposure rate were confirmed according to the subjects’ characteristics. Finally, factors associated with the UCo-measured SHS exposure rate were identified based on multiple regression analysis. The findings showed that the annual UCo concentrations and self-reported SHS exposure rates dropped significantly over the past decade. In contrast, the UCo-measured SHS exposure rate indicated that >80% of nonsmokers are still exposed to SHS. Moreover, we found vulnerable groups using UCo-measured SHS exposure rate. In particular, the self-reported SHS exposure at home and in workplaces and house type was highly associated with SHS exposure. Thus, these findings indicate that the actual SHS exposure could not be properly assessed by SR and should be verified using a biomarker, such as UCo. Considering that even a short-term exposure can be harmful to health, the goal of the policy should be to keep cotinine concentration as low as possible.

Download Full-text

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.

Download Full-text

Is exposure to secondhand smoke associated with current depression (PHQ-8) among never-smokers? Results from a survey among German adults

BMC Public Health ◽

10.1186/s12889-020-09970-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Fabian Erdsiek ◽

Patrick Brzoska

Keyword(s):

Secondhand Smoke ◽

Logistic Regression Model ◽

German Health ◽

Potential Association ◽

Prevalence Of Depression ◽

Patient Health ◽

Shs Exposure ◽

Interaction Term ◽

Never Smokers ◽

Exposure To Secondhand Smoke

Abstract Background Findings on the association between exposure to secondhand smoke (SHS) and depression are contradictory. Comparability of existing research is limited due to varied methods and measures. This study examines the potential association between exposure to SHS and depression and a potential moderation by sex using representative data from Germany. Methods For our study, we used data from the German Health Update (GEDA) 2014/2015 on n = 10,274 never-smokers. We calculated a logistic regression model with an interaction term for potential sex-exposure interactions. We used the self-reported duration of exposure to predict current depression of any type as defined by the Patient Health Questionnaire PHQ-8 (score ≥ 10), accounting for a large number of confounders. Results In our sample, prevalence of depression was 8.8% in women and 5.3% in men. 90.4% were never or almost never exposed to SHS, while 7.1% were exposed < 1 h per day and around 2.5% reported being exposed for ≥1 h per day. While SHS exposure for < 1 h per day was not associated with current depression (OR = 1.54; 95%-CI: 0.93–1.61), SHS exposure for at least 1 h per day was associated with increased odds for current depression (OR = 1.59; 95%-CI: 1.08–2.35). No sex-specific differences were found. Conclusions Higher levels of SHS exposure are associated with current depression, although the nature and direction of the association are still unclear. We identified no differences in the association between men and women. More studies, particularly using longitudinal data, are needed to determine the nature of the association.

Download Full-text

Characteristics of Non-Smokers’ Exposure Using Indirect Smoking Indicators and Time Activity Patterns

Sustainability ◽

10.3390/su12219099 ◽

2020 ◽

Vol 12 (21) ◽

pp. 9099

Author(s):

Byung Lyul Woo ◽

Min Kyung Lim ◽

Eun Young Park ◽

Jinhyeon Park ◽

Hyeonsu Ryu ◽

...

Keyword(s):

Exposure Time ◽

Secondhand Smoke ◽

Activity Patterns ◽

Time Activity ◽

Spatial Characteristics ◽

Exposure Biomarkers ◽

Shs Exposure ◽

Temporal And Spatial ◽

Temporal And Spatial Characteristics ◽

Exposure To Secondhand Smoke

Since the global enforcement of smoke-free policies, indoor smoking has decreased significantly, and the characteristics of non-smokers’ exposure to secondhand smoke (SHS) has changed. The purpose of this study was to assess the temporal and spatial characteristics of SHS exposure in non-smokers by combining questionnaires and biomarkers with time activity patterns. To assess SHS exposure, biomarkers such as cotinine and 4-(methylnitrosamino)-1-3-(pyridyl)-1-butanol (NNAL) in urine and nicotine in hair were collected from 100 non-smokers in Seoul. Questionnaires about SHS exposure and time activity patterns were also obtained from the participants. The analysis of biomarker samples indicated that about 10% of participants were exposed to SHS when compared with the criteria from previous studies. However, 97% of the participants reported that they were exposed to SHS at least once weekly. The participants were most exposed to SHS in the outdoor microenvironment, where they spent approximately 1.2 h daily. There was a significant correlation between the participants’ time spent outdoors and self-reported SHS exposure time (r2 = 0.935). In this study, a methodology using time activity patterns to assess temporal and spatial characteristics of SHS exposure was suggested. The results of this study may help develop policies for managing SHS exposure, considering the time activity patterns.

Download Full-text

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.

Download Full-text

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

BMC Public Health ◽

10.1186/1471-2458-9-430 ◽

2009 ◽

Vol 9 (1) ◽

Cited By ~ 51

Author(s):

Jo C Holliday ◽

Graham F Moore ◽

Laurence AR Moore

Keyword(s):

Secondhand Smoke ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Child Exposure ◽

Exposure To Secondhand Smoke

Download Full-text

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.

Download Full-text

Abstract P220: Exposure to Secondhand Smoke and the Risk of Stroke

Circulation ◽

10.1161/circ.129.suppl_1.p220 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Angela M Malek ◽

Leslie A McClure ◽

Mary Cushman ◽

Daniel T Lackland

Keyword(s):

African American ◽

Secondhand Smoke ◽

Hemorrhagic Stroke ◽

African American Men ◽

Health Concern ◽

White Blood Count ◽

Inflammation Markers ◽

Increased Risk ◽

Shs Exposure ◽

Exposure To Secondhand Smoke

Background: Stroke is a leading cause of death worldwide, and is a major public health concern in terms of morbidity, mortality, economic costs, and loss of productivity. While exposure to secondhand smoke (SHS) is a risk factor for cardiovascular disease, associations of SHS with risk of stroke have been inconsistent. Hypothesis: We investigated the hypotheses that SHS exposure is associated with increased incidence of stroke and stroke subtypes (ischemic stroke and hemorrhagic stroke) among non-smokers, including never and former smokers. Methods: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study enrolled a U.S. population sample of 30,239 Caucasian and African-American men and women aged >=45 years in 2003-7 and is following them for stroke outcomes. We calculated the hazard ratio (HR) of stroke among non-smokers with SHS exposure using Cox proportional hazard models. Results: The cohort, without prevalent smoking, stroke and TIA (n=21,743), included 62% Caucasians and 38% African-Americans, with 55% females. Twenty-three percent reported SHS exposure the year prior to enrollment, and these individuals were more likely to be younger, African-American, male (all p<0.001), and have higher C-reactive protein (CRP) and white blood count (WBC) (p<0.05) compared to those not exposed. SHS exposure was associated with a 31% increased risk of any stroke event after adjustment for demographic, socioeconomic, and behavioral factors (Table 1). The association was seen only in ischemic, but not hemorrhagic stroke. Associations were slightly diminished after adjusting for traditional stroke risk factors, and markedly attenuated to the null after further addition of inflammation markers. Conclusions: SHS exposure was not related to stroke after accounting for inflammation markers. Further research is needed to confirm these findings.

Download Full-text