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Sim B, Park MB. Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179284. [PMID: 34501873 PMCID: PMC8431172 DOI: 10.3390/ijerph18179284] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Boram Sim
- Health Insurance Review and Assessment Service (HIRA), Wonju 26465, Korea;
| | - Myung-Bae Park
- Department of Gerontology Health and Welfare, Pai Chai University, Daejeon 35345, Korea
- Correspondence: ; Tel.: +82-42-520-5037
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Tatekawa S, Shimamoto S, Miyata Y, Yoshino Y, Hirata T, Tamari K, Seo Y, Isohashi F, Yamamoto Y, Uno A, Inohara H, Ogawa K. Monitoring expiratory carbon monoxide to study the effect of complete smoking cessation on definitive radiation therapy for early stage glottic carcinoma. Acta Oncol 2021; 60:582-588. [PMID: 33406970 DOI: 10.1080/0284186x.2020.1865563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Previous studies reported that cigarette smoking during radiation therapy was associated with unfavorable outcomes in various cancers using medical interviewing or monitoring of cotinine. Here, we evaluated the effect of smoking cessation on definitive radiation therapy for early stage glottic carcinoma by monitoring expiratory carbon monoxide (CO). MATERIAL AND METHODS We enrolled 103 patients with early glottic carcinoma (T1N0/T2N0 = 79/24) who underwent conventional radiotherapy between 2005 and 2016. The median age was 70 years. Pathologically, all patients had squamous cell carcinoma. Since 2009, we confirmed smoking cessation before radiation therapy by medical interviews. Since 2014, we measured expiratory CO to strictly monitor smoking cessation. The patients were divided according to diagnosis years: 'no cessation' (2005-2008), 'incomplete cessation' (2009-2013), and 'complete cessation' (2014-2016). We retrospectively analyzed the local recurrence rate and disease-free survival (DFS). RESULTS The median follow-up period was 60.1 months (range, 1.9-110.0 months). The 2-year local recurrence rate in the 'complete cessation' group was 5.3% and tended to be lower than that in the 'incomplete cessation' group (13.7%) and 'no cessation' group (21.2%). Multivariate analysis revealed that 'no cessation' was a risk factor for DFS (hazard ratio [HR] = 4.25) and local recurrence rate (HR = 16.5, p < .05) compared to 'complete cessation.' DISCUSSION We confirmed that the 'complete cessation' group had better prognosis than the 'no cessation' group by monitoring expiratory CO during radiation therapy for early stage glottic carcinoma. Moreover, monitoring expiratory CO was easier and more suitable than conventional methods for evaluating smoking cessation because it provided real-time measurements.
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Affiliation(s)
- Shotaro Tatekawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Radiation Oncology, Osaka General Medical Center, Osaka, Japan
| | | | - Yoshiaki Miyata
- Department of Radiation Oncology, Saito Yukoukai Hospital, Osaka, Japan
| | - Yutaro Yoshino
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takero Hirata
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Keisuke Tamari
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuji Seo
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Fumiaki Isohashi
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshifumi Yamamoto
- Department of Otorhinolaryngology-Head and Neck surgery, Osaka General Medical Center, Osaka, Japan
| | - Atsuhiko Uno
- Department of Otorhinolaryngology-Head and Neck surgery, Osaka General Medical Center, Osaka, Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology-Head and Neck surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuhiko Ogawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
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You HS, Lee JW, Kim YS, Kim Y, Lee HC, Hwang JY, Yang W, Kang HT. Association between Second-hand Smoke Exposure and Urinary NNAL Level in Korean Adolescents. J Korean Med Sci 2021; 36:e82. [PMID: 33821591 PMCID: PMC8021977 DOI: 10.3346/jkms.2021.36.e82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/13/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) is a metabolite of tobacco-specific lung carcinogen that can be found in both smokers and non-smokers. Particularly, NNAL levels of children with a history of exposure to second-hand smoke (SHS) are higher than those of adults. Thus, we aimed to investigate the association between SHS exposure and urine NNAL levels in Korean adolescents. METHODS This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey VII. Overall, 648 never-smoking adolescents (425 boys and 223 girls) aged 12 to 18 were included in this study. Logistic regression analyses identified the relationship between SHS exposure and elevated urine NNAL levels. RESULTS The mean urine NNAL levels of the no exposure and exposure group in boys were 1.39 and 2.26 ng/mL, respectively, whereas they were 1.01 and 2.45 ng/mL in girls, respectively (P < 0.001). Among the adolescents exposed to SHS, the confounder-adjusted odds ratio (95% confidence intervals) for elevated urine NNAL levels according to exposure area as overall, home, and public area were 2.68 (1.58-4.53), 31.02 (9.46-101.74), and 1.89 (1.12-3.17) in boys; and 6.50 (3.22-13.11), 20.09 (7.08-57.04), and 3.94 (1.98-7.77) in girls, respectively. CONCLUSION SHS exposure was significantly associated with elevated urine NNAL levels in Korean adolescents, particularly in female adolescents and in those with home exposure. These findings remind us of the need to protect adolescents from SHS.
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Affiliation(s)
- Hyo Sun You
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Jae Woo Lee
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Ye Seul Kim
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Yonghwan Kim
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Hyeong Cheol Lee
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Jin Young Hwang
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Woojung Yang
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Hee Taik Kang
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Korea
- Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
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Untargeted Urinary Metabolomics and Children's Exposure to Secondhand Smoke: The Influence of Individual Differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020710. [PMID: 33467557 PMCID: PMC7830063 DOI: 10.3390/ijerph18020710] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/30/2020] [Accepted: 01/09/2021] [Indexed: 12/26/2022]
Abstract
Children’s exposure to secondhand smoke (SHS) is a severe public health problem. There is still a lack of evidence regarding panoramic changes in children’s urinary metabolites induced by their involuntary exposure to SHS, and few studies have considered individual differences. This study aims to clarify the SHS-induced changes in urinary metabolites in preschool children by using cross-sectional and longitudinal metabolomics analyses. Urinary metabolites were quantified by using untargeted ultra high-performance liquid chromatography-mass spectrometry (UPLC(c)-MS/MS). Urine cotinine-measured SHS exposure was examined to determine the exposure level. A cross-sectional study including 17 children in a low-exposure group, 17 in a medium-exposure group, and 17 in a high-exposure group was first conducted. Then, a before–after study in the cohort of children was carried out before and two months after smoking-cessation intervention for family smokers. A total of 43 metabolites were discovered to be related to SHS exposure in children in the cross-sectional analysis (false discovery rate (FDR) corrected p < 0.05, variable importance in the projection (VIP) > 1.0). Only three metabolites were confirmed to be positively associated with children’s exposure to SHS (FDR corrected p < 0.05) in a follow-up longitudinal analysis, including kynurenine, tyrosyl-tryptophan, and 1-(3-pyridinyl)-1,4-butanediol, the latter of which belongs to carbonyl compounds, peptides, and pyridines. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis indicated that 1-(3-pyridinyl)-1,4-butanediol and kynurenine were significantly enriched in xenobiotic metabolism by cytochrome P450 (p = 0.040) and tryptophan metabolism (p = 0.030), respectively. These findings provide new insights into the pathophysiological mechanism of SHS and indicate the influence of individual differences in SHS-induced changes in urinary metabolites in children.
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The association between self-reported versus nicotine metabolite-confirmed smoking status and coronary artery calcification. Coron Artery Dis 2018; 29:254-261. [DOI: 10.1097/mca.0000000000000568] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Liu W, Mumford EA. Concurrent Trajectories of Female Drinking and Smoking Behaviors Throughout Transitions to Pregnancy and Early Parenthood. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 18:416-427. [PMID: 28349236 DOI: 10.1007/s11121-017-0780-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this longitudinal study was to investigate whether there are distinct etiological processes explaining dual usage of alcohol and conventional cigarettes by mothers from preconception through the early parenting years. Data on 8800 biological mothers were drawn from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), representative of US births in 2001. A general growth mixture model (GGMM) was used to empirically identify developmental trajectories of maternal smoking and drinking over the 5-6-year study period. Six classes defined by alcohol consumption and cigarette smoking were identified. These included a nonsmoking, low probability of drinking class (41%), and two drinking classes displaying no smoking with either moderate (26%) or escalating high (8%) probability drinking. Additionally, two predominantly smoking classes were identified, one displaying temporary reduction in smoking during pregnancy and low probability of drinking (11%) and one following a trajectory of persistent heavy smoking with a declining probability of drinking (9%). The sixth class was described by temporary reduction in smoking during pregnancy with high probability of drinking (6%). Covariates differentially predicted class membership, e.g., having a high school degree but not further education predicted concurrent drinking and smoking, and breastfeeding for more than 6 months is protective against concurrent use. Prior to conception, during prenatal care, and in post-natal clinical visits, whether for personal or pediatric care, screening women of reproductive age via characteristics that predict heterogeneity in smoking and drinking trajectories may help guide prevention and treatment options.
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Affiliation(s)
- Weiwei Liu
- NORC at the University of Chicago, 4350 E-West Hwy, 8th Floor, Bethesda, MD, 20910, USA.
| | - Elizabeth A Mumford
- NORC at the University of Chicago, 4350 E-West Hwy, 8th Floor, Bethesda, MD, 20910, USA
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Ino T, Kurosawa K. Screening for secondhand smoke in schoolchildren in Japan. Pediatr Int 2015; 57:961-7. [PMID: 25808130 DOI: 10.1111/ped.12630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 02/03/2015] [Accepted: 02/19/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is no systematic screening for secondhand smoke exposure in children. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Toshihiro Ino
- Gunma Paz College, Faculty of Health Science, Takasaki, Gunma.,Ino Clinic, Kumagaya, Saitama, Japan
| | - Kazuo Kurosawa
- Gunma Paz College, Faculty of Health Science, Takasaki, Gunma
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Pérez-Ortuño R, Martínez-Sánchez JM, Fernández E, Pascual JA. High-throughput wide dynamic range procedure for the simultaneous quantification of nicotine and cotinine in multiple biological matrices using hydrophilic interaction liquid chromatography-tandem mass spectrometry. Anal Bioanal Chem 2015; 407:8463-73. [DOI: 10.1007/s00216-015-8993-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/21/2015] [Accepted: 08/19/2015] [Indexed: 10/23/2022]
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Abstract
BACKGROUND Persistent maternal smoking during pregnancy, reduction or cessation during pregnancy, and smoking initiation or resumption postpartum impel further research to understand these behavioral patterns and opportunities for intervention. OBJECTIVES We investigated heterogenous longitudinal patterns of smoking quantity to determine if these patterns vary across three maternal age groups, and whether the influence of individual and contextual risk factors varies by maternal age. METHODS Separate general growth mixture models were estimated for mothers ages 15-25, 26-35, and 36+, allowing different empirical patterns of an ordinal measure of smoking behavior at six time points, from preconception through child entry to kindergarten. RESULTS We identify five classes for mothers ages 15-25, four classes for ages 26-35, and three classes for ages 36+. Each age group presents classes of nonsmokers and persistent heavy smokers. Intermediate to these ends of the spectrum, each age group exhibited its own smoking classes characterized by the extent of pregnancy smoking reductions and postpartum behavior. In all three age groups, class membership can be distinguished by individual sociodemographic and behavioral characteristics. Co-resident smokers predicted nearly all smoking classifications across age groups, and selected neighborhood characteristics predicted classification of younger (15-25) and older (36+) mothers. CONCLUSIONS The design, timing, and delivery of smoking prevention and cessation services, for women seeking to become pregnant and for women presenting for prenatal or pediatric care, are best guided by individual characteristics, particularly maternal age, preconception alcohol consumption, and postpartum depression, but neighborhood characteristics merit further attention for mothers at different ages.
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Jeong BY, Lim MK, Yun EH, Oh JK, Park EY, Lee DH. Tolerance for and potential indicators of second-hand smoke exposure among nonsmokers: a comparison of self-reported and cotinine verified second-hand smoke exposure based on nationally representative data. Prev Med 2014; 67:280-7. [PMID: 25019959 DOI: 10.1016/j.ypmed.2014.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 06/03/2014] [Accepted: 07/03/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE We assessed the extent to which self-reported exposure to SHS underestimates the actual exposure to SHS and what factors are associated with a tolerance for SHS exposure in the Korean setting where the smoke-free policy is incomplete. METHODS Information on socio-demographic characteristics, alcohol drinking and smoking was collected for 7948 nonsmokers aged ≥ 19 years from the fourth Korea National Health and Nutrition Examination Survey, 2008-2009. Self-reported and cotinine verified SHS exposures were compared. Potential factors associated with cotinine verified but not self-reported SHS exposures were assessed using a logistic regression model. RESULTS Self-reported SHS exposure significantly underestimated the actual SHS exposure as determined by cotinine verification (kappa coefficient: 0.1066). At younger age, frequent alcohol drinking in females and a longer smoking duration in males were positively associated with cotinine verified exposure but not with the self-reported SHS exposure; they were also positively associated with cotinine verified exposure irrespective of self-reported SHS exposure. CONCLUSIONS Our findings show a tolerance for smoking in Korea. The current partial ban on smoking does not fully protect people from exposure to SHS. Smoking should be banned in all public places. In addition, efforts to de-normalize smoking in the Korean culture need to be strengthened.
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Affiliation(s)
- Bo Yoon Jeong
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Min Kyung Lim
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea; Graduate School of Cancer Science & Policy, National Cancer Center, Goyang, Republic of Korea.
| | - E Hwa Yun
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Jin-Kyoung Oh
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Eun Young Park
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Do-Hoon Lee
- National Cancer Center Hospital, National Cancer Center, Goyang, Republic of Korea
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Kalliola S, Pelkonen AS, Malmberg LP, Sarna S, Hämäläinen M, Mononen I, Mäkelä MJ. Maternal smoking affects lung function and airway inflammation in young children with multiple-trigger wheeze. J Allergy Clin Immunol 2013; 131:730-5. [PMID: 23380219 DOI: 10.1016/j.jaci.2013.01.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 01/11/2013] [Accepted: 01/11/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Exposure to tobacco smoke is a well-known risk factor for childhood asthma and reduced lung function, but the effect on airway inflammation in preschool-aged children is unclear. OBJECTIVE To examine the effect of parental smoking on lung function and fractional concentration of exhaled nitric oxide (Feno) in relation to both parental reports and children's urine cotinine concentrations in preschool-aged children with multiple-trigger wheeze. METHODS A total of 105 3- to 7-year-old children with multiple-trigger wheeze and lung function abnormalities were recruited. Lung function was assessed by impulse oscillometry, and Feno measurements were performed. Exposure to tobacco smoke was determined by parental reports and measurement of children's urinary cotinine concentrations. RESULTS Forty-three percent of the children were exposed to environmental tobacco smoke according to parental reports. The Feno level was significantly higher in children with a smoking mother (n = 27) than in children with a nonsmoking mother (23.4 vs 12.5 ppb, P = .006). The Feno level expressed as z score and the cotinine level correlated significantly (P = .03). Respiratory resistance at 5 Hz was higher in children exposed to maternal smoking than in others (0.99 vs 0.88 kPas/L, P = .005). Urinary cotinine concentrations reflected well parental reports on their daily smoking and increased relative to the number of cigarettes smoked in the family (P < .01). Atopy was found in 75% of the children, but it was not associated with the Feno value (P = .65). CONCLUSION Maternal smoking was associated with increased Feno value and poorer lung function in steroid-naive preschool children with multiple-trigger wheeze. Larger controlled trials are needed to generalize the results.
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Affiliation(s)
- Satu Kalliola
- Department of Allergy, Helsinki University Central Hospital, Helsinki, Finland.
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Biologic mechanisms of environmental tobacco smoke in children with poorly controlled asthma: results from a multicenter clinical trial. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2013; 1:172-80. [PMID: 24565456 DOI: 10.1016/j.jaip.2012.11.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 11/16/2012] [Accepted: 11/16/2012] [Indexed: 01/06/2023]
Abstract
BACKGROUND Environmental tobacco smoke (ETS) negatively affects children with asthma. The prevalence of ETS exposure among children with poor asthma control may be changing. Importantly, the mechanisms by which ETS worsens asthma control are poorly understood. OBJECTIVE We describe how ETS affects gastroesophageal reflux (GER), respiratory infections, and leukotriene production among children with poor asthma control. METHODS We analyzed data from 306 children between 6 and 17 years of age with poorly controlled asthma enrolled in a 6-month clinical trial. We evaluated prevalence and determinants of ETS exposure by interview, questionnaire, and urinary cotinine and the association of ETS exposure on leukotriene production, respiratory infections, GER, lung function, and asthma control. We used multivariable linear, logistic, and Poisson regressions to assess outcomes. RESULTS ETS prevalence estimates ranged from 6% to 30%. Children with domestic indoor exposure had worse asthma control (c-Asthma Control Test, 17.8 vs 21.5; P = .04), worse FEV1 % predicted (84.1 vs 90.7; P = .02), and a trend for increased mean urinary leukotriene E4. ETS from any setting was associated with increased symptomatic respiratory infections (adjusted incidence rate ratio: 1.30; P = .02). However, children exposed to ETS did not have symptoms or pH probe results, suggestive of heightened GER. CONCLUSIONS Domestic smoking exposure was associated with both higher rates of symptomatic respiratory infection and poorer asthma control despite generally intensive controller therapy. ETS exposure is common among asthmatic children with poor control and may worsen asthma control by promoting respiratory infections. Further investigation is required to elucidate ETS mechanisms in poor asthma control.
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Jung S, Lee IS, Kim SB, Moon CS, Jung JY, Kang YA, Park MS, Kim YS, Kim SK, Chang J, Kim EY. Urine Cotinine for Assessing Tobacco Smoke Exposure in Korean: Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES). Tuberc Respir Dis (Seoul) 2012; 73:210-8. [PMID: 23166556 PMCID: PMC3492421 DOI: 10.4046/trd.2012.73.4.210] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 09/03/2012] [Accepted: 09/26/2012] [Indexed: 11/24/2022] Open
Abstract
Background The level of urine cotinine is an indicator of tobacco smoke exposure. The purpose of this study is to investigate urine cotinine for the purpose of assessing the smoking status of Korean smokers and non-smokers exposed to tobacco smoke. Methods The subjects were identified from the 2007-2009 and the 2010 data sets of the Korea National Health and Nutrition Examination Survey (KNHANES). They were assigned as non-smokers, current smokers and ex-smokers. Non-smokers were also divided into three subset groups according to the duration of smoke exposure. Each group was stratified by gender prior to analysis. Results The median value of urine cotinine in the male current smokers was 1,221.93 ng/mL which was the highest among all groups. The difference between levels of urine cotinine for male and the female groups was statistically significant (p<0.01). In the female group, passive smoke exposure groups reported higher urine cotinine levels than non-exposure groups (p=0.01). The cutoff point for the discrimination of current smokers from non-smokers was 95.6 ng/mL in males and 96.8 ng/mL in females. The sensitivity and specificity were 95.2% and 97.1%, respectively, in males, 96.1% and 96.5% in females. However, the determination of urine cotinine level was not useful in distinguishing between passive smoke exposure groups and non-exposure groups. Conclusion Urine cotinine concentration is a useful biomarker for discriminating non-smokers from current smokers. However, careful interpretation is necessary for assessing passive smoke exposure by urine cotinine concentration.
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Affiliation(s)
- Sungmo Jung
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Kim EK, Choo J. Secondhand tobacco smoke exposure and associated factors among college students on campus and in the home: a preliminary study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:212-22. [PMID: 22470288 PMCID: PMC3315076 DOI: 10.3390/ijerph9010212] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/04/2012] [Accepted: 01/11/2012] [Indexed: 11/22/2022]
Abstract
To explore the prevalence of secondhand tobacco smoke (SHS) exposure of college students at two locations, i.e., on campus and in the home, and to identify factors associated with SHS exposure at each location, a preliminary cross-sectional study was conducted on 1754 nonsmoking students from two universities in Korea. In total, 83.1% were exposed to SHS at least once a week on campus or at home; the average SHS exposure was 3.4 times per week. Specifically, 79.7% and 23.5% were exposed to SHS on campus and in the home, respectively. On campus, SHS exposure was significantly more prevalent in freshmen and sophomore students. In the home, SHS exposure was significantly more prevalent among females, those with smokers in their families, and those who rated their health as poor. SHS exposure was common among nonsmoking college students, with more than two-thirds exposed on campus. The prevalence of SHS exposure was greater on campus than in the home; the factors associated with SHS exposure were location-specific.
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Affiliation(s)
- Eun-Kyung Kim
- Department of Nursing, Suwon Science College, San 9-10, Botong-ri, Jeongnam-myun, Hwaseong City, Geonggi-do 445-742, Korea;
| | - Jina Choo
- College of Nursing, Korea University, Anam-dong, Seongbuk-gu, Seoul 136-705, Korea
- Author to whom correspondence should be addressed; ; Tel.: +1-82-3290-4925; Fax: +1-82-928-9107
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