Association between Self-Reported Survey Measures and Biomarkers of Second-Hand Tobacco Smoke Exposure in Non-Smoking Pregnant Women

Second-hand tobacco smoke (SHS) causes adverse health outcomes in adults. Further studies are needed to evaluate psychosocial SHS exposure measures in comparison to SHS exposure biomarkers, particularly in pregnant women. This study aimed to compare self-reported SHS exposure to urinary cotinine levels in pregnant women. A cross-sectional correlation design was conducted using a convenience sample of 70 non-smoking pregnant women. Measures included self-reported questionnaires and laboratory confirmation of cotinine levels in the urinary samples. Multiple regression analysis was used to assess the correlation after controlling for potential confounding variables. The average level of urinary cotinine among non-smoking pregnant women was 6.77 ng/mL. Medium-strength correlations were found among psychosocial SHS exposure measures and urine cotinine levels. Questions regarding ‘instances of smoking in front of the individual’ and ‘subjective perceived frequency of SHS exposure in past 7 days’ are feasible items for pregnant women in clinics (particularly the first question). Hence, we suggest that these simple questions should be used to assist pregnant women in reducing the harm associated with SHS exposure.

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

BMJ Open ◽

10.1136/bmjopen-2017-017811 ◽

2017 ◽

Vol 7 (10) ◽

pp. e017811 ◽

Cited By ~ 1

Author(s):

Javiera Parro ◽

Paulina Aceituno ◽

Andrea Droppelmann ◽

Sthepanie Mesías ◽

Claudio Muñoz ◽

...

Keyword(s):

Pulmonary Function ◽

Cross Sectional Study ◽

Tobacco Smoke Exposure ◽

Cumulative Exposure ◽

Outcome Variable ◽

Linear Regression Models ◽

Cross Sectional ◽

Urine Cotinine ◽

Secondhand Tobacco Smoke ◽

Shs Exposure

IntroductionThe workplace remains a significant source of secondhand smoke (SHS) exposure. This pollutant is known to be associated with respiratory and cardiovascular problems, but its effects on specific pulmonary function parameters remain largely unexplored. The objectives of this study were to measure SHS exposure among non-smoking employees of bar and restaurants in Santiago, Chile and to evaluate the effects of such exposure on pulmonary function.MethodsCross-sectional design. The study sample included non-smoking workers from 57 restaurants and bars in Santiago, Chile. The outcome variable was pulmonary function and the exposure variables were urine cotinine concentration, a biomarker for current SHS exposure, and years of SHS exposure in the workplace as proxy of chronic exposure. Personal and occupational variables were also recorded. Data analysis was performed using linear regression models adjusted by confounders.ResultsThe median age of the workers was 35 years and the median employment duration at the analysed venues was 1 year. Workers in smoking facilities reported greater SHS exposure (36 hours per week) than workers in smoke-free locations (4 hours per week). Urine cotinine levels were inversely correlated with forced vital capacity, but the finding was not statistically significant (β=−0.0002; 95% CI −0.007 to 0.006). Years of exposure to SHS showed to be significantly associated with forced expiratory flow25/75(β=−0.006; 95% CI −0.010 to −0.0004).ConclusionThese findings suggest that cumulative exposure to SHS at work may contribute to deterioration of pulmonary function in non-smoking employees.

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Measuring Tobacco Smoke Exposure Among Smoking and Nonsmoking Bar and Restaurant Workers

Biological Research For Nursing ◽

10.1177/1099800407300852 ◽

2007 ◽

Vol 9 (1) ◽

pp. 81-89 ◽

Cited By ~ 17

Author(s):

Chizimuzo T. C. Okoli ◽

Lynne A. Hall ◽

Mary Kay Rayens ◽

Ellen J. Hahn

Keyword(s):

Tobacco Smoke ◽

High Performance ◽

Hospitality Industry ◽

Cross Sectional Study ◽

Reversed Phase ◽

Smoke Exposure ◽

Tobacco Smoke Exposure ◽

Cross Sectional ◽

Hair Samples ◽

Shs Exposure

Purpose: This study assesses the validity of hair nicotine as a biomarker for secondhand smoke (SHS) exposure. Although most biomarkers of tobacco-smoke exposure have a relatively short half-life, hair nicotine can measure several months of cumulative SHS exposure. Design: A cross-sectional study of hospitality-industry workers. Method: Hair samples were obtained from 207 bar and restaurant workers and analyzed by the reversed-phase high-performance liquid chromatography with electrochemical detection (HPLC-ECD) method. Self-reported tobacco use and sources of SHS exposure were assessed. Findings: Higher hair-nicotine levels were associated with more cigarettes smoked per day among smokers and a greater number of SHS-exposure sources among nonsmokers. Number of SHS exposure sources, gender, number of cigarettes smoked per day, and type of establishment predicted hair-nicotine levels. Discussion: Hair nicotine is a valid measure of SHS exposure. It may be used as an alternative biomarker to measure longer term SHS exposure.

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Assessing secondhand and thirdhand tobacco smoke exposure in Canadian infants using questionnaires, biomarkers, and machine learning

Journal of Exposure Science & Environmental Epidemiology ◽

10.1038/s41370-021-00350-4 ◽

2021 ◽

Author(s):

Jaclyn Parks ◽

Kathleen E. McLean ◽

Lawrence McCandless ◽

Russell J. de Souza ◽

Jeffrey R. Brook ◽

...

Keyword(s):

Machine Learning ◽

Tobacco Smoke ◽

Smoke Exposure ◽

Tobacco Smoke Exposure ◽

Linear Regression Models ◽

Thirdhand Smoke ◽

Urinary Cotinine ◽

Smoking Exposure ◽

Shs Exposure ◽

Technological Improvements

Abstract Background As smoking prevalence has decreased in Canada, particularly during pregnancy and around children, and technological improvements have lowered detection limits, the use of traditional tobacco smoke biomarkers in infant populations requires re-evaluation. Objective We evaluated concentrations of urinary nicotine biomarkers, cotinine and trans-3’-hydroxycotinine (3HC), and questionnaire responses. We used machine learning and prediction modeling to understand sources of tobacco smoke exposure for infants from the CHILD Cohort Study. Methods Multivariable linear regression models, chosen through a combination of conceptual and data-driven strategies including random forest regression, assessed the ability of questionnaires to predict variation in urinary cotinine and 3HC concentrations of 2017 3-month-old infants. Results Although only 2% of mothers reported smoking prior to and throughout their pregnancy, cotinine and 3HC were detected in 76 and 89% of the infants’ urine (n = 2017). Questionnaire-based models explained 31 and 41% of the variance in cotinine and 3HC levels, respectively. Observed concentrations suggest 0.25 and 0.50 ng/mL as cut-points in cotinine and 3HC to characterize SHS exposure. This cut-point suggests that 23.5% of infants had moderate or regular smoke exposure. Significance Though most people make efforts to reduce exposure to their infants, parents do not appear to consider the pervasiveness and persistence of secondhand and thirdhand smoke. More than half of the variation in urinary cotinine and 3HC in infants could not be predicted with modeling. The pervasiveness of thirdhand smoke, the potential for dermal and oral routes of nicotine exposure, along with changes in public perceptions of smoking exposure and risk warrant further exploration.

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The importance of socioeconomic position in smoking, cessation and environmental tobacco smoke exposure during pregnancy

Scientific Reports ◽

10.1038/s41598-020-72298-8 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Joana Madureira ◽

Alexandra Camelo ◽

Ana Inês Silva ◽

Ana Teresa Reis ◽

Filipa Esteves ◽

...

Keyword(s):

Smoking Cessation ◽

Pregnant Women ◽

Environmental Tobacco Smoke ◽

Tobacco Smoke ◽

Socioeconomic Position ◽

Smoking Prevalence ◽

Disease Onset ◽

Tobacco Smoke Exposure ◽

Cross Sectional ◽

Exposure During Pregnancy

Abstract Tobacco is still a leading cause of premature death and morbidity. Particular attention has been given to pregnant women due to the scientific evidence on the importance of early life exposures for disease onset later in life. The purpose of this study was to assess smoking prevalence, smoking cessation rate and environmental tobacco smoke (ETS) exposure, and the role of socioeconomic position (SEP) on these behaviors among pregnant women. Cross-sectional data of 619 pregnant women, aged between 18 and 46 years, from Porto Metropolitan Area, Portugal, on current smoking, ETS exposure and SEP indicators was collected, face-to-face, using a questionnaire filled in during a personal interview at the postpartum hospital stay. The smoking prevalence, and ETS exposure among non-smokers before pregnancy was 27.6% and 57.4%, respectively. 4.1% of the participants reported to have stopped smoking before pregnancy, whereas about 41% quitted along pregnancy, resulting in a smoking prevalence at birth of 14.6%. Exposure to ETS also decreased throughout pregnancy to 49.8% at birth. Lower educational level was significantly associated with both higher smoking prevalence and exposure to ETS and lower smoking cessation. This study demonstrates that smoking and ETS exposure during pregnancy remains high, and that there are still significant socioeconomic inequalities in smoking; thus tobacco-focused preventive interventions need to be reinforced.

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Urinary cotinine assessment of maternal smoking and environmental tobacco smoke exposure status and its associations with perinatal outcomes: A cross-sectional birth study

Environmental Research ◽

10.1016/j.envres.2021.111827 ◽

2021 ◽

pp. 111827

Author(s):

Ana Inês Silva ◽

Alexandra Camelo ◽

Joana Madureira ◽

Ana Teresa Reis ◽

Ana Paula Machado ◽

...

Keyword(s):

Environmental Tobacco Smoke ◽

Tobacco Smoke ◽

Maternal Smoking ◽

Perinatal Outcomes ◽

Environmental Tobacco Smoke Exposure ◽

Smoke Exposure ◽

Tobacco Smoke Exposure ◽

Cross Sectional ◽

Urinary Cotinine

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Tobacco Smoke Exposure and Urinary Cadmium in Women from Northern Mexico

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312581 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12581

Author(s):

Ángel Mérida-Ortega ◽

Lizbeth López-Carrillo ◽

Karla Rangel-Moreno ◽

Natalia Ramirez ◽

Stephen J. Rothenberg

Keyword(s):

Tobacco Smoke ◽

Inductively Coupled Plasma ◽

Body Burden ◽

Smoke Exposure ◽

Tobacco Smoke Exposure ◽

Cross Sectional ◽

Northern Mexico ◽

Inductively Coupled ◽

Shs Exposure ◽

Sectional Analysis

Cadmium (Cd), a carcinogenic metal also related to reproductive and cardiovascular diseases, is contained in tobacco and elevated concentrations of it in humans have been consistently associated with first-hand tobacco smoke; however, there is scarce and inconclusive evidence of the relationship between Cd and secondhand smoke (SHS) exposure. Our aim was to evaluate the association between exposure to tobacco, both active and SHS, with urinary Cd concentrations in Mexican women. In a cross-sectional analysis that included 998 women living in northern Mexico, we measured the concentration of creatinine-adjusted urinary Cd (µg-cadmium/g-creatinine) using inductively coupled plasma triple quadrupole (ICP-QQQ) in tandem mass spectrometry mode (MS/MS). We gathered tobacco smoking information through an in-person interview and formed seven groups: non-smokers without SHS exposure; non-smokers with SHS exposure; ex-smokers without SHS exposure <1 year of quitting; ex-smokers without SHS exposure ≥1 year of quitting, ex-smokers with SHS exposure <1 year of quitting; ex-smokers with SHS exposure ≥1 year of quitting and current smokers. The interview also yielded sociodemographic characteristics. We used linear multivariable regression models to estimate the association between Cd concentrations and tobacco smoke exposure. Compared to non-smokers without SHS exposure, we found higher Cd concentrations in ex-smokers with SHS exposure <1 year of quitting and current smokers (adjusted geometric means 0.51 vs. 1.01 and 0.69 µg-cadmium/g-creatinine, respectively). Our results do not support a conclusion that SHS exposure is a source of Cd body burden.

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Maternal tobacco smoke exposure and determination of the optimal urinary cotinine cut-off values: a cross-sectional birth study

Toxicology Letters ◽

10.1016/s0378-4274(21)00590-7 ◽

2021 ◽

Vol 350 ◽

pp. S147-S148

Author(s):

A.I. Silva ◽

A. Camelo ◽

J. Madureira ◽

A.T. Reis ◽

F.B. Jr ◽

...

Keyword(s):

Tobacco Smoke ◽

Smoke Exposure ◽

Tobacco Smoke Exposure ◽

Cross Sectional ◽

Urinary Cotinine

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Secondhand tobacco smoke exposure among adolescents in an Ethiopian school

Healthcare in Low-resource Settings ◽

10.4081/hls.2016.5584 ◽

2016 ◽

Vol 4 (1) ◽

Cited By ~ 3

Author(s):

Sabit Abazinab Ababulgu ◽

Nebiyu Dereje ◽

Abiot Girma

Keyword(s):

Tobacco Smoke ◽

Cross Sectional Study ◽

Tobacco Smoke Exposure ◽

Global Youth Tobacco Survey ◽

Cross Sectional ◽

Public Places ◽

Adverse Health Effects ◽

School Based ◽

Secondhand Tobacco Smoke ◽

Shs Exposure

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.

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Inadequate Gestational Weight Gain and Exposure to Second-Hand Smoke during Pregnancy Increase the Risk of Low Birth Weight: A Cross-Sectional Study among Full-Term Infants

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031068 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1068

Author(s):

Muliana Edi ◽

Yit Chin ◽

Fui Woon ◽

Geeta Appannah ◽

Poh Lim ◽

...

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Pregnant Women ◽

Medical Records ◽

Cross Sectional Study ◽

Second Hand Smoke ◽

Sectional Study ◽

Cross Sectional ◽

Shs Exposure ◽

At Home

Despite the advancement of the healthcare system, low birth weight (LBW) remains as one of the leading causes of under-five mortality. This cross-sectional study aimed to determine the prevalence of LBW and its associated factors among 483 third trimester pregnant women recruited from six selected public health clinics in the Federal Territory of Kuala Lumpur and the state of Selangor, Malaysia. Pregnant women were interviewed for information on socio-demographic characteristics, smoking behaviour, and second-hand smoke (SHS) exposure at home and in the workplace. Information on the obstetrical history and prenatal care visits history were retrieved from the maternal medical records, while infant’s birth outcomes were retrieved from infant medical records. The prevalence of LBW (<2.5 kg) in infants was 10.4%, with a mean birth weight of 3.0 [standard deviation (SD) 0.4] kg. Results from the multivariable logistic regression model showed that inadequate weight gained during pregnancy [odds ratio (OR) = 2.41, 95% confidence interval (CI) = 1.18–4.90] and exposure to SHS at home (OR = 1.92, 95% CI = 1.03–3.55) were significantly associated with LBW. In conclusion, pregnant women should monitor their rate of weight gain throughout pregnancy and avoid SHS exposure at home to reduce the risk of delivering LBW infants.

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