Prevalence and socioeconomic inequalities in indoor exposure to secondhand smoke at home among children 0-5years in Ghana

Passive Smoking Exposure Modifies Cardiovascular Structure and Function: Beijing Child Growth and Health Cohort (PROC) Study

Passive smoking exposure in children is prevalent worldwide and exposes children to respiratory and systemic toxins. In this study, we enrolled 568 children to study how secondhand smoke (SHS) might affect children's cardiovascular health in China. The measurement of nicotine and its metabolites in urine showed that 78.9% of children were exposed to SHS. Children exposed to SHS had greater interventricular septum thickness (p = 0.005) and left ventricular mass index (p = 0.008) than nonexposed children. Urinary norcotinine levels were associated with increased ascending aorta diameter (β = 0.10, 95%CI 0.02-0.17) and decreased left ventricular end systolic diameter (β = -0.10, 95%CI -0.19 to -0.01). The effects of SHS exposure on cardiovascular function: norcotinine levels associated with lower left ventricular mass index (β = -0.32, 95%CI -0.59 to -0.05), left ventricular end diastolic volume index (β = -0.43, 95%CI -0.85 to -0.02), and left ventricular end systolic volume index (β = -0.20, 95%CI -0.37 to -0.03). Moreover, there no no significant associations of nicotine, cotinine, and trans-3'-hydroxycotinine with cardiovascular health. Overall, SHS exposure in children remains prevalent in Beijing and may affect children's cardiovascular development, in both structure and function. It suggests that stricter and practical measures are needed toward the elimination of tobacco use in children's environments.

Association Between Place of Secondhand Smoke Exposure and Depression Among Nonsmoking Children and Adolescents: A Systematic Review

Secondhand smoke (SHS) exposure patterns of children and adolescents are different from those of adults because children and adolescents spend a majority of their time in the home and school. It was aimed to conduct a systematic review of the published literature regarding the association between depression and the place of SHS exposure among children and adolescents. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines, PubMed, ScienceDirect, and Cochrane Library databases were used for the literature review. The studies were screened and selected by two independent reviewers based on the inclusion criteria. All eight studies included in the systematic review measured SHS exposure in participants' own homes. Two studies measured SHS exposure at school and one study in cars. The majority of the studies showed a positive association between depression and SHS exposure in both private and public places among nonsmoking children and adolescents. Also, they concluded a dose-response relationship between SHS exposure and depression. Health practitioners would be encouraged to work with stakeholders to create smoke-free policies in both private and public places to avoid the adverse effects of SHS exposure.

Respiratory Symptoms and Urinary Cotinine Levels in Pre-school Children Exposed to Environmental Tobacco Smoke

Objective: Preschool children exposed to environmental tobacco smoke (ETS) are at risk of developing adverse respiratory health effects. The present study aimed to investigate the relationship between the effects of cigarette-smoking caregivers on respiratory symptoms and urinary cotinine (UC) levels in children. Methods: A cross-sectional study consisting of 543 children (aged between 5 and 6 years) from 5 kindergartens in central China was conducted using a structured questionnaire. We also analyzed UC levels to investigate the relationship between respiratory symptoms and ETS exposure. We further performed logistic regression analyses to establish the relationship between respiratory symptoms (coughing, rhinorrhea, and sneezing) and UC levels. Results: A total of 71 (13.08%) children had a history of hospital admission with respiratory illnesses including bronchitis and pneumonia over the last 6 months. In addition, 102 (18.78%) children presented coughing symptoms, 114 (20.99%) experienced rhinorrhea and 79 (14.55%) presented sneezing symptoms over the last 6 months. After adjusting the confounders, odds ratio (OR) indicated that the number of cigarettes smoked by a caregiver was associated with coughing (OR = 11.02; 95% CI, 3.72-33.66), rhinorrhea (OR = 41.83; 95% CI, 5.58-313.05) and sneezing (OR = 4.71; 95% CI, 1.33-16.48). Furthermore, UC levels in children with coughing, rhinorrhea and sneezing were significantly higher than in children without respiratory symptoms (P = 0.002, P < 0.001, P < 0.001, respectively). Conclusions: This study reveals that children exposed to ETS have higher levels of UC. Compared with caregiver who non-smoked live with children, smoked cigarettes were highly risk of developing respiratory illnesses in children. Notably, the higher the UC levels the greater the respiratory risk. Our results also signify that UC can be used as an indicator of ETS exposure to inform caregivers of the associated risks, and inform efforts to reduce related effects.

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

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.

Exposure to secondhand smoke in hospitality settings in Ghana: Evidence of changes since implementation of smoke-free legislation

INTRODUCTION

Ghana has a partial smoking ban with smoking allowed in designated smoking areas. Studies evaluating smoke-free laws are scarce in Sub-Saharan Africa. Evaluation of smoke-free laws is an effective means of measuring progress towards a smoke-free society. This study assessed the level of compliance to the provisions of the current smoke-free policy using air quality measurements for fine particulate matter (PM_2.5) in hospitality venues in Ghana.

METHODS

This was a cross-sectional observational study conducted in 2019 using a structured observational checklist complemented with air quality measurements using Dylos monitors across 152 randomly selected hospitality venues in three large cities in Ghana.

RESULTS

Smoking was observed in a third of the venues visited. The median indoor PM_2.5 concentration was 14.6 μg/m³ (range: 5.2-349). PM_2.5 concentrations were higher in venues where smoking was observed (28.3 μg/m³) compared to venues where smoking was not observed (12.3 μg/m³) (p<0.001). Hospitality locations in Accra, Ghana's capital city, had the lowest compliance levels (59.5%) and poorer air quality compared to the cities of Kumasi and Tamale.

CONCLUSIONS

The study shows that while smoking and SHS exposure continues in a substantial number of hospitality venues, there is a marked improvement in PM_2.5 concentrations compared to earlier studies in Ghana. There is still a considerable way to go to increase compliance with the law. Efforts are needed to develop an action plan to build upon recent progress in providing smoke-free public spaces in Ghana.