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Azagba S, Latham K, Shan L. Exposure to secondhand smoke in vehicles among Canadian adolescents: Years after the adoption of smoke-free car laws. Addict Behav Rep 2019; 10:100215. [PMID: 31508478 PMCID: PMC6726844 DOI: 10.1016/j.abrep.2019.100215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 11/17/2022] Open
Abstract
Exposure to secondhand smoke (SHS) can result in several adverse health consequences. SHS concentrations in vehicles can significantly exceed levels present in other enclosed spaces. Years after the adoption of smoke-free car laws, this study examined the prevalence of exposure to SHS in vehicles among adolescents. Data were utilized from the 2016-2017 Canadian Student Tobacco, Alcohol and Drugs Survey (n = 48,444). The prevalence of exposure to SHS in cars was estimated by grade level and demographic characteristics. The results showed a gradient by grade level in exposure to SHS with students in upper-grade levels reporting a higher prevalence of SHS in cars. SHS varied by province, with the lowest rate found in British Columbia (15.6%) and the highest in Saskatchewan (36.9%). The provinces with laws that extend protections to older children also had high rates of SHS exposure among students in upper-grade levels. Students exposed to SHS were more likely to engage in risky behaviors, including the use of marijuana, alcohol, cigarettes, and e-cigarettes. Despite laws prohibiting smoking in vehicles carrying children, SHS prevalence remains high. While enforcement of these laws may be challenging, persuasion campaigns highlighting that children are especially vulnerable to the health risks of SHS may be beneficial.
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Affiliation(s)
- Sunday Azagba
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States of America
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Díez-Izquierdo A, Lidón-Moyano C, Martín-Sánchez JC, Matilla-Santander N, Cassanello-Peñarroya P, Balaguer A, Martínez-Sánchez JM. Smoke-free homes and attitudes towards banning smoking in vehicles carrying children in Spain (2016). ENVIRONMENTAL RESEARCH 2017; 158:590-597. [PMID: 28715788 DOI: 10.1016/j.envres.2017.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/28/2017] [Accepted: 07/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To describe the voluntary adoption of smoke-free homes and social attitudes in Spain towards banning smoking in vehicles in which children are present. METHODS Cross-sectional study of a representative sample of the adult Spanish population age range, 18-75 years (n=1036). The field work was conducted via a computer-assisted telephone survey in March and April 2016. Survey respondents answered questions about smoking rules at home and attitudes towards a smoking ban in cars with or without children. Home smoking rules were defined as complete (smoking not allowed anywhere in the house), partial (smoking allowed in some areas inside the house) or absent (smoking allowed everywhere). RESULTS Most (83.0%) of the surveyed population had some type of smoking restriction in place at home (45.6% complete and 37.5% partial). There were significant differences between groups according to age group (the highest prevalence was 86.1% from 66 to 75 years and the lowest prevalence was 77.8% from 46 to 65 years) and smoking status (the highest prevalence was 89.4% in people who had never been smokers and the lowest prevalence was 75.0% in current smokers) with regards to the prevalence of smoke-free homes (p<0.05), with partial bans more prevalent in smoking households (49.0%). Most (61.6%) of the population favored banning smoking in cars, and 90.1% supported a ban in cars carrying minors. Attitudes towards smoking regulation in cars (with or without children) varied significantly by age group (the highest prevalence was 81.9% from 66 to 75 years and the lowest prevalence was 54.5% from 18 to 45 years) and smoking status (the highest prevalence was 71.4% in people who had never been smokers and the lowest prevalence was 46.0% in current smokers). However, no significant differences were found with regard to attitudes towards smoking regulation in cars carrying children, regardless of sex, age, social class, or smoking status. CONCLUSION Approximately half of the adult population in Spain have implemented a complete smoke-free rule at home. More than 9 out of 10 adults favor regulating smoking in cars in the presence of minors. These findings support the expansion of smoke-free regulations to include private vehicles, particularly when minors are in the car.
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Affiliation(s)
- Ana Díez-Izquierdo
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Paediatrics department, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Cristina Lidón-Moyano
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Group of Evaluation of Health Determinants and Health Policies, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Juan Carlos Martín-Sánchez
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Group of Evaluation of Health Determinants and Health Policies, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Nuria Matilla-Santander
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Group of Evaluation of Health Determinants and Health Policies, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Pia Cassanello-Peñarroya
- Paediatrics department, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Albert Balaguer
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Paediatrics department, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Jose M Martínez-Sánchez
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Group of Evaluation of Health Determinants and Health Policies, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain.
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Senthilselvan A, Niruban SJ, King M, Majaesic C, Veugelers P, Laing L, Rowe BH. Prevalence and risk factors of asthma in First Nations children living on reserves in Canada. Canadian Journal of Public Health 2016; 106:e483-8. [PMID: 26986908 DOI: 10.17269/cjph.106.5147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/08/2015] [Accepted: 09/10/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To explore the prevalence and determine the risk factors of asthma in First Nations children aged 0 to 11 years living on reserves in Canada. METHODS In this cross-sectional study, we considered the data collected as part of the First Nations Regional Health Survey involving 6,657 children living in 238 First Nations communities in the 10 Canadian provinces, the Northwest Territories and the Yukon. RESULTS The overall prevalence of asthma that has lasted or is expected to last at least six months (ever-asthma) among children living on reserves was 14.6%: a prevalence of 12.9% among 0 to 4 year olds and 15.6% among 5 to 11 year olds. The prevalence of ever-asthma was greater among boys (16.1%) than girls (13.2%). Children from homes with two or more children aged less than 11 years and those who were engaged in daily physical activities were less likely to have a report of ever-asthma. Children from high-income families and smoke-free homes were more likely to have a report of ever-asthma. The association between allergy and ever-asthma was stronger in children with low birth weight. The association between chronic ear infections and ever-asthma was stronger in girls than boys. CONCLUSIONS The overall prevalence of ever-asthma and factors associated with ever-asthma in First Nations children living on reserves were similar to those reported for off-reserve Aboriginal children and non-Aboriginal Canadian children.
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Antunes H, Precioso J, Araújo AC, Machado JC, Samorinha C, Rocha V, Gaspar Â, Becoña E, Belo-Ravara S, Vitória P, Rosas M, Fernandez E. Prevalence of secondhand smoke exposure in asthmatic children at home and in the car: A cross-sectional study. REVISTA PORTUGUESA DE PNEUMOLOGIA 2016; 22:190-5. [PMID: 26906288 DOI: 10.1016/j.rppnen.2015.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 12/18/2015] [Accepted: 12/30/2015] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To compare secondhand smoke exposure (SHSe) prevalence at home and inside the car between asthmatic and non-asthmatic Portuguese children. MATERIALS AND METHODS This is a cross-sectional study that assessed children's SHSe in a representative sample of nine Portuguese cities. A validated self-reported questionnaire was administered to a random sample of 4th grade students during the school year of 2010/2011. The asthma prevalence was defined by the answers to three questions regarding asthma symptoms, medication and inhaler use. We performed chi-square tests and analysed frequencies, contingency tables, confidence intervals, and odd-ratios. RESULTS The self-reported questionnaire was administered to 3187 students. Asthma prevalence was 14.8% (472 students). Results showed that 32.3% of non-asthmatic children and 32.4% of asthmatic children were exposed to secondhand smoke as at least one of their household members smoked at home. The prevalence of parental smoking, smoking among fathers and smoking among mothers at home was also similar in both groups (asthmatic and non-asthmatic children). SHSe inside the car was 18.6% among non-asthmatic children and 17.9% among asthmatic children. CONCLUSIONS Asthmatic and non-asthmatic children were equally exposed to secondhand smoke, because no significant differences were found between the two groups concerning the prevalence of SHSe at home and inside the car. These findings highlight the need to include SHSe brief advice in paediatric asthma management.
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Affiliation(s)
- H Antunes
- Pediatric Department, Hospital de Braga, Braga, Portugal
| | - J Precioso
- Institute of Education, University of Minho, Braga, Portugal.
| | - A C Araújo
- Institute of Education, University of Minho, Braga, Portugal
| | - J C Machado
- Institute of Social Sciences, University of Minho, Braga, Portugal
| | - C Samorinha
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - V Rocha
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Â Gaspar
- Immunoallergy Department, CUF-Descobertas Hospital, Lisbon, Portugal
| | - E Becoña
- Unidade de Tabaquismo, Santiago de Compostela University, Spain
| | - S Belo-Ravara
- Preventive Medicine, Faculty of Health Sciences, Beira Interior University, Covilhã, Portugal
| | - P Vitória
- Preventive Medicine, Faculty of Health Sciences, Beira Interior University, Covilhã, Portugal
| | - M Rosas
- Division of Health Promotion, Town Hall, Viana do Castelo, Portugal
| | - E Fernandez
- Catalan Oncology Institute, Barcelona, Spain
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Fedele DA, Tooley E, Busch A, McQuaid EL, Hammond SK, Borrelli B. Comparison of secondhand smoke exposure in minority and nonminority children with asthma. Health Psychol 2015; 35:115-22. [PMID: 26237117 DOI: 10.1037/hea0000220] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study determined if secondhand smoke (SHS) exposure is related to asthma-related functional morbidity by examining racial/ethnic differences in non-Latino White (NLW), African American, and Latino families and whether racial/ethnic SHS exposure differences across families persist when accounting for smoking factors. METHODS Participants were 305 caregiver smokers of children with asthma. Two passive dosimeters measured secondhand smoke: one in the home and one worn by the child. RESULTS Higher SHS exposure was related to greater asthma-related functional morbidity. African Americans had higher levels of home SHS exposure than did Latinos (p = .003) or NLWs (p = .021). SHS exposure as assessed by the child-worn dosimeter did not differ across race/ethnicity. African American families were less likely to report a household smoking ban (46.4%) compared to Latinos (79.2%) and NLWs (67.9%; p < .05). African Americans were less likely to report having two or more smokers in the home (37.2%) compared to NLWs (53.6%; p < .05). NLWs reported the highest number of cigarettes smoked daily (Mdn = 15.00) compared to Latinos (Mdn = 10.00; p = .001) and African Americans (Mdn = 10.00; p < .001). SHS home exposure levels were regressed on race/ethnicity and relevant covariates. Household smoking ban (p < .001) and only one smoker in the home (p = .005) were associated with lower levels of SHS in the home; race/ethnicity was not significant. CONCLUSIONS Differences in SHS exposure across race/ethnicity exist among children with asthma, possibly due to differential presence of a household smoking ban and number of smokers in the home.
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Affiliation(s)
- David A Fedele
- Department of Clinical & Health Psychology, University of Florida
| | - Erin Tooley
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Andrew Busch
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Elizabeth L McQuaid
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | | | - Belinda Borrelli
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
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Streja L, Crespi CM, Bastani R, Wong GC, Jones CA, Bernert JT, Tashkin D, Hammond SK, Berman BA. Can a minimal intervention reduce secondhand smoke exposure among children with asthma from low income minority families? Results of a randomized trial. J Immigr Minor Health 2015; 16:256-64. [PMID: 22945813 DOI: 10.1007/s10903-012-9713-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We report on the results of a low-intensity behavioral intervention to reduce second hand smoke (SHS) exposure of children with asthma from low income minority households in Los Angeles, California. In this study, 242 child/adult dyads were randomized to a behavioral intervention (video, workbook, minimal counseling) or control condition (brochure). Main outcome measures included child's urine cotinine and parental reports of child's hours of SHS exposure and number of household cigarettes smoked. Implementation of household bans was also considered. No differences in outcomes were detected between intervention and control groups at follow-up. Limitations included high attrition and low rates of collection of objective measures (few children with urine cotinine samples). There continues to be a need for effective culturally and linguistically appropriate strategies that support reduction of household SHS exposure among children with asthma in low income, minority households.
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Affiliation(s)
- Leanne Streja
- Division of Cancer Prevention and Control Research and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA,
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Yücel U, Ocek ZA, Ciçeklioğlu M. Evaluation of an intensive intervention programme to protect children aged 1-5 years from environmental tobacco smoke exposure at home in Turkey. HEALTH EDUCATION RESEARCH 2014; 29:442-455. [PMID: 24718082 DOI: 10.1093/her/cyu005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of this randomized-controlled trial was to evaluate the effectiveness of an intensive intervention to reduce children's environmental tobacco smoke (ETS) exposure at their home compared with a minimal intervention. The target population of the study was the mothers of children aged 1-5 who lived in the Cengizhan district of Izmir in Turkey, who smoked and/or whose spouses smoked. It was found that at least one parent of a total of 182 children smoked and 80 of these mothers were taken into stratified sampling based on the number of the smoking parents. Mothers were visited at their homes. During the initial visit, they were educated and urine samples were taken from their children. Following this initial visit, mothers were randomized to the intensive intervention (n = 38) or the minimal intervention group (n = 40). The levels of cotinine in the intensive intervention (P = 0.000) and minimal intervention (P = 0.000) groups in the final follow-up were significantly lower than the initial levels. The proportion of mothers reporting a complete smoking ban at home in the final follow-up was higher in the intensive intervention group than the minimal intervention group (P = 0.000). The education provided during the home visits and the reporting of the urinary cotinine levels of the children were effective in lowering the children's exposure to ETS at their home.
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Affiliation(s)
- U Yücel
- Department of Midwifery, Ege University Izmir Atatürk School of Health, Izmir 35100, Turkey and Faculty of Medicine, Department of Public Health, Ege University, Izmir 35100, Turkey
| | - Z A Ocek
- Department of Midwifery, Ege University Izmir Atatürk School of Health, Izmir 35100, Turkey and Faculty of Medicine, Department of Public Health, Ege University, Izmir 35100, Turkey
| | - M Ciçeklioğlu
- Department of Midwifery, Ege University Izmir Atatürk School of Health, Izmir 35100, Turkey and Faculty of Medicine, Department of Public Health, Ege University, Izmir 35100, Turkey
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Home smoking policies in urban households with children and smokers. Prev Med 2014; 62:30-4. [PMID: 24370456 DOI: 10.1016/j.ypmed.2013.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 12/11/2013] [Accepted: 12/14/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVE We identified household, child, and demographic characteristics associated with not having a smoking ban and having a rule about smoking in the presence of children in an urban population. METHOD We conducted a cross-sectional random digit dial telephone survey (n=456) of Philadelphia parents in June 2012. RESULTS Forty-eight percent of homes reported a full smoking ban. In homes that allowed smoking, over half allowed smoking in front of children. Cigarettes smoked in the home decreased as the restrictiveness of the bans increased. Multinomial logistic regression analyses showed that compared to having a full ban, banning smoking only in the presence of children was associated with being African-American, having a child >5 years old, and having an asthma-free child. These characteristics, as well as having both parents as smokers and not having an outdoor space, were also associated with not having any restrictions. CONCLUSION It is possible that households attempt to reduce home smoking by limiting smoking in the presence of children. Health communication messages should be used to inform families about the lingering effects of SHS in the home even when smoking does not occur in the presence of a child.
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Murphy-Hoefer R, Madden P, Maines D, Coles C. Prevalence of smoke-free car and home rules in Maine before and after passage of a smoke-free vehicle law, 2007-2010. Prev Chronic Dis 2014; 11:130132. [PMID: 24433624 PMCID: PMC3899850 DOI: 10.5888/pcd11.130132] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION This is the first study to examine the prevalence of self-reported smoke-free rules for private cars and homes before and after the passage of a smoke-free vehicle law. METHODS Data were examined for 13,461 Maine adults aged 18 or older who participated in the Behavioral Risk Factor Surveillance System, a state-based telephone survey covering health topics. Self-reported smoke-free car and home rules, smoking behavior, and demographic variables of age, sex, education, income, and children in household were analyzed for prevalence before and after the state's smoke-free vehicle law was passed. RESULTS Prevalence of smoke-free car and home rules was significantly higher after Maine's smoke-free vehicle law was passed in the state (P = .004 for car rules and P = .009 for home rules). Variations in smoking rules differed by smoking and demographic variables. People with household incomes of less than $20,000 saw an increase of 14.3% in smoke-free car rules; overall, those with annual incomes of less than $20,000 and those with less than a high school education reported a lower prevalence of smoke-free car rules both before and after the law was passed than did people with higher incomes and higher education levels. The prevalence of smoke-free home rules after the law was implemented was higher among those with 4 or more years of college education than among those with lower levels of education (P = .02). CONCLUSION The prevalence of smoke-free car and home rules among Maine adults was significantly higher after the passage of a statewide smoke-free vehicle law. This apparent change in smoke-free rule prevalence may be indicative of changing social norms related to the unacceptability of secondhand smoke exposure.
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Affiliation(s)
- Rebecca Murphy-Hoefer
- School of Community and Population Health, University of New England, 716 Stevens Ave, Portland, ME 04103. E-mail:
| | | | - Dorean Maines
- Partnership for a Tobacco-Free Maine, Augusta, Maine
| | - Carol Coles
- Partnership for a Tobacco-Free Maine, Augusta, Maine
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Ossip DJ, Chang Y, Nabi-Burza E, Drehmer J, Finch S, Hipple B, Rigotti NA, Klein JD, Winickoff JP. Strict smoke-free home policies among smoking parents in pediatric settings. Acad Pediatr 2013; 13:517-23. [PMID: 24238677 PMCID: PMC4046861 DOI: 10.1016/j.acap.2013.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 05/27/2013] [Accepted: 06/10/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine strict smoke-free home policies among smoking parents assessed in pediatric offices. METHODS We analyzed baseline parental survey data from 10 control practices in a national trial of pediatric office-based tobacco control interventions (Clinical Effort Against Secondhand Smoke Exposure, CEASE). We used logistic regression models with generalized estimating equations to examine factors associated with strict smoke-free home policies. RESULTS Subjects were 952 parents who were current smokers. Just over half (54.3%) reported strict smoke-free home policies. Few reported being asked (19.9%) or advised (17.1%) regarding policies by pediatricians. Factors associated with higher odds of policies were child 5 years or younger (adjusted odds ratio [aOR] 2.43, 95% confidence interval [CI] 1.53, 3.86), nonblack race/ethnicity (aORs 2.17-2.60, 95% CIs 1.25-5.00), non-Medicaid (HMO/private (aOR 1.84, 95% CI 1.31, 2.58); self-pay/other aOR 1.76, 95% CI 1.12, 2.78); well-child versus sick child visit (aOR 1.61, 95% CI 1.11, 2.34), fewer than 10 cigarettes per day (aOR 1.80, 95% CI 1.31, 2.47), no other home smokers (aOR 1.68, 95% CI 1.26, 2.25), only father smoking (aOR 1.73, 95% CI 1.06, 2.83), and strict smoke-free car policy (aOR 3.51, 95% CI 2.19, 5.64). CONCLUSIONS Nearly half of smoking parents did not have strict smoke-free home policies. Parents were less likely to report policies if they were heavier smokers, black, living with other smokers, or attending a sick child visit; if they did not have a young child or smoke-free car policy; if they had a child on Medicaid; and if anyone other than only the father smoked. Few pediatricians addressed or recommended strict smoke-free home policies in an office visit. The pediatric office encounter represents a currently missed opportunity to intervene regarding smoke-free homes, particularly for high-risk groups.
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Affiliation(s)
- Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY.
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Hood NE, Wewers ME, Ferketich AK, Klein EG, Pirie P. Predictors of Voluntary Home-Smoking Restrictions and Associations with an Objective Measure of In-Home Smoking among Subsidized Housing Tenants. Am J Health Promot 2013; 28:97-104. [DOI: 10.4278/ajhp.120816-quan-399] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. Examine predictors of voluntary home-smoking restrictions (HSRs) and associations with an objective measure of in-home smoking. Design. Cross-sectional. Setting. Publicly subsidized multiunit housing units managed by private company in Columbus, Ohio, without a smoke-free housing policy. Subjects. Probability sample of primary leaseholders (N = 301, 64% response rate). Measures. Self-reported knowledge, attitudes, and behaviors collected during face-to-face survey in fall 2011, including individual (e.g., knowledge of health effects), social (e.g., number of friends who smoke), and environmental (e.g., safety) factors hypothesized to be related to having HSRs. Surface nicotine concentration (μg/m2) based on samples collected from wood surface in respondents' living rooms (n = 279). Analysis. Multiple linear and logistic regression were used to identify factors associated with having HSRs and with indoor surface nicotine concentrations. Results. Fewer than one-third (29.2%) of tenants had complete HSRs, while more than half (55.8%) had partial restrictions. Several individual and social factors, but no environmental/community factors, were associated with having HSRs. Type of HSRs (p < .001) and smoking status (p < .001) were independently associated with mean surface nicotine concentrations. Conclusion. Few subsidized housing tenants voluntarily limit in-home smoking. Partial restrictions could be considered as a harm reduction strategy but may be less effective among smokers. Strategies to change social norms are also needed to modify in-home smoking behavior among subsidized housing tenants.
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Abstract
PURPOSE Pregnant women with asthma have many concerns about their respiratory health, as well as the health of their baby. A woman's respiratory system experiences many physiological changes during pregnancy and when a diagnosis of asthma is present, the clinical effect of pregnancy on asthma is variable. Regardless of disease years, when asthma patients become pregnant, both patients and healthcare providers want to know how pregnancy affects asthma and how asthma may affect pregnancy outcomes. This article will review how to optimally manage asthma during pregnancy using an evidence-based approach that recognizes the patient's changing needs. DATA SOURCES Literature collected from sources identified through searches of PubMed and CINAHL covering the periods from 1996 to 2012. CONCLUSION With the implementation of evidence-based management and treatment, pregnant patients who have asthma can be positioned to better control their symptoms and avoid unwanted complications that may affect the health of their baby. IMPLICATIONS FOR PRACTICE Pregnant patients with asthma may be cared for in a variety of healthcare settings ranging from primary care to specialty care to the emergency department. Consequently, it is imperative that healthcare providers across the array of clinical venues be proficient on how to optimize the asthma outcomes of their pregnant patients.
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Affiliation(s)
- Karen Rance
- Allergy Partners of Central Indiana, Indianapolis, Indiana
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Kit BK, Simon AE, Brody DJ, Akinbami LJ. US prevalence and trends in tobacco smoke exposure among children and adolescents with asthma. Pediatrics 2013; 131:407-14. [PMID: 23400612 DOI: 10.1542/peds.2012-2328] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine exposure to tobacco smoke products (TSPs), environmental tobacco smoke (ETS), and in-home smoke among youth with asthma in the United States. METHODS Nationally representative, cross-sectional data from 2250 youth aged 4 to 19 years with current asthma in the 1988-1994, 1999-2004, and 2005-2010 National Health and Nutrition Examination Survey (NHANES) were analyzed. Outcomes were use of TSPs (serum cotinine level >10 ng/mL or self-reported recent use of cigarettes, cigars, or pipes) and, among non-TSP users, ETS exposure (serum cotinine ≥0.05 ng/mL) and in-home smoke exposure (reported). Multiple logistic regression analyses assessed the associations between the outcomes and age, gender, race/ethnicity, and family income. RESULTS Among adolescents (aged 12-19 years) with asthma in 2005-2010, 17.3% reported TSP use. Among youth (aged 4-19 years) with asthma who did not use TSPs, 53.2% were exposed to ETS and 17.6% had in-home smoke exposure. Among low-income youth, 70.1% and 28.1% had exposure to ETS and in-home smoke, respectively. After controlling for sociodemographic factors, higher prevalence of exposure to ETS and in-home smoke persisted among low-income youth. Between 1988-1994 and 2005-2010, there was a decline in ETS and in-home smoke exposure (both P < .001). CONCLUSIONS ETS exposure among youth with asthma declined between 1988-1994 and 2005-2010, but a majority remained exposed in 2005-2010, with higher exposure among low-income youth. More than 1 in 6 youth with asthma in 2005-2010 were exposed to in-home smoke and a similar portion of adolescents used TSPs.
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Affiliation(s)
- Brian K Kit
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.
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Gupta RS, Lau CH, Springston EE, Warren CM, Mears CJ, Dunford CM, Sharp LK, Holl JL. Perceived Factors Affecting Asthma Among Adolescents. ACTA ACUST UNITED AC 2013. [DOI: 10.1177/2150129712472342] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To describe the development, implementation, and findings of a participatory media-based asthma afterschool program. Methods: A pilot study was conducted during the 2010/2011 school year in an inner-city Chicago high school with high asthma rates and poor asthma morbidity. Students met after school twice a week over 10 weeks. Students were given basic training in research and media production using photovoice participatory research technique and were instructed to identify personally relevant factors affecting asthma through photography and journaling. Students’ journal entries and photographs were qualitatively coded. Relative frequencies of codes were calculated to determine common themes among identified factors. Students worked with a videographer to compile their findings into informational videos, which were used to educate peers and community members about asthma. Results: Fifteen students aged 13 to 18 attended a mean of 11 sessions (out of 20). One hundred eighty photographs (mean = 12 per student) and 112 journal entries (mean = 7.5 per student) were reviewed, with 4 predominant positive and negative factors identified. Reported factors influencing students’ health and asthma included social support (22% of student photos and journal entries), neighborhood environment (17%), and lifestyle (28%), in addition to well-established asthma factors (43%). Conclusions: Results from the Student Asthma Research Team pilot demonstrate that adolescent students, given appropriate instruction and opportunity, are able to identify factors affecting their asthma. Interventions engaging adolescents via self-directed identification and participatory media production techniques hold promise as vehicles for enabling students to own and share health-related experiences through research and peer/community outreach.
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Affiliation(s)
- Ruchi S. Gupta
- Northwestern University Feinberg School of Medicine (RSG, EES, CMW, JLH), Chicago, Illinois
- Smith Child Health Research Program, Ann & Robert H. Lurie Children’s Hospital of Chicago (RSG, CHL), Chicago, Illinois
- Uplift School-Based Health Center, Chicago Public Schools (CJM), Chicago, Illinois
- Department of Anthropology, The Field Museum (CMD), Chicago, Illinois
- Lookingglass Theatre Company (CMD), Chicago, Illinois
| | - Claudia H. Lau
- Northwestern University Feinberg School of Medicine (RSG, EES, CMW, JLH), Chicago, Illinois
- Smith Child Health Research Program, Ann & Robert H. Lurie Children’s Hospital of Chicago (RSG, CHL), Chicago, Illinois
- Uplift School-Based Health Center, Chicago Public Schools (CJM), Chicago, Illinois
- Department of Anthropology, The Field Museum (CMD), Chicago, Illinois
- Lookingglass Theatre Company (CMD), Chicago, Illinois
| | - Elizabeth E. Springston
- Northwestern University Feinberg School of Medicine (RSG, EES, CMW, JLH), Chicago, Illinois
- Smith Child Health Research Program, Ann & Robert H. Lurie Children’s Hospital of Chicago (RSG, CHL), Chicago, Illinois
- Uplift School-Based Health Center, Chicago Public Schools (CJM), Chicago, Illinois
- Department of Anthropology, The Field Museum (CMD), Chicago, Illinois
- Lookingglass Theatre Company (CMD), Chicago, Illinois
| | - Christopher M. Warren
- Northwestern University Feinberg School of Medicine (RSG, EES, CMW, JLH), Chicago, Illinois
- Smith Child Health Research Program, Ann & Robert H. Lurie Children’s Hospital of Chicago (RSG, CHL), Chicago, Illinois
- Uplift School-Based Health Center, Chicago Public Schools (CJM), Chicago, Illinois
- Department of Anthropology, The Field Museum (CMD), Chicago, Illinois
- Lookingglass Theatre Company (CMD), Chicago, Illinois
| | - Cynthia J. Mears
- Northwestern University Feinberg School of Medicine (RSG, EES, CMW, JLH), Chicago, Illinois
- Smith Child Health Research Program, Ann & Robert H. Lurie Children’s Hospital of Chicago (RSG, CHL), Chicago, Illinois
- Uplift School-Based Health Center, Chicago Public Schools (CJM), Chicago, Illinois
- Department of Anthropology, The Field Museum (CMD), Chicago, Illinois
- Lookingglass Theatre Company (CMD), Chicago, Illinois
| | - Christine M. Dunford
- Northwestern University Feinberg School of Medicine (RSG, EES, CMW, JLH), Chicago, Illinois
- Smith Child Health Research Program, Ann & Robert H. Lurie Children’s Hospital of Chicago (RSG, CHL), Chicago, Illinois
- Uplift School-Based Health Center, Chicago Public Schools (CJM), Chicago, Illinois
- Department of Anthropology, The Field Museum (CMD), Chicago, Illinois
- Lookingglass Theatre Company (CMD), Chicago, Illinois
| | - Lisa K. Sharp
- Northwestern University Feinberg School of Medicine (RSG, EES, CMW, JLH), Chicago, Illinois
- Smith Child Health Research Program, Ann & Robert H. Lurie Children’s Hospital of Chicago (RSG, CHL), Chicago, Illinois
- Uplift School-Based Health Center, Chicago Public Schools (CJM), Chicago, Illinois
- Department of Anthropology, The Field Museum (CMD), Chicago, Illinois
- Lookingglass Theatre Company (CMD), Chicago, Illinois
| | - Jane L. Holl
- Northwestern University Feinberg School of Medicine (RSG, EES, CMW, JLH), Chicago, Illinois
- Smith Child Health Research Program, Ann & Robert H. Lurie Children’s Hospital of Chicago (RSG, CHL), Chicago, Illinois
- Uplift School-Based Health Center, Chicago Public Schools (CJM), Chicago, Illinois
- Department of Anthropology, The Field Museum (CMD), Chicago, Illinois
- Lookingglass Theatre Company (CMD), Chicago, Illinois
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Blaakman S, Tremblay PJ, Halterman JS, Fagnano M, Borrelli B. Implementation of a community-based secondhand smoke reduction intervention for caregivers of urban children with asthma: process evaluation, successes and challenges. HEALTH EDUCATION RESEARCH 2013; 28:141-52. [PMID: 22717938 PMCID: PMC3549585 DOI: 10.1093/her/cys070] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 04/27/2012] [Indexed: 05/24/2023]
Abstract
Many children, including those with asthma, remain exposed to secondhand smoke. This manuscript evaluates the process of implementing a secondhand smoke reduction counseling intervention using motivational interviewing (MI) for caregivers of urban children with asthma, including reach, dose delivered, dose received and fidelity. Challenges, strategies and successes in applying MI are highlighted. Data for 140 children (3-10 years) enrolled in the School Based Asthma Therapy trial, randomized to the treatment condition and living with one or more smoker, were analyzed. Summary statistics describe the sample, process measures related to intervention implementation, and primary caregiver (PCG) satisfaction with the intervention. The full intervention was completed by 79% of PCGs, but only 17% of other smoking caregivers. Nearly all (98%) PCGs were satisfied with the care study nurses provided and felt the program might be helpful to others. Despite challenges, this intervention was feasible and well received reaching caregivers who were not actively seeking treatment for smoking cessation or secondhand smoke reduction. Anticipating the strategies required to implement such an intervention may help promote participant engagement and retention to enhance the program's ultimate success.
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Affiliation(s)
- Susan Blaakman
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children’s Hospital at Strong, Box 777, 601 Elmwood Avenue, Rochester, NY 14642, USA, University of Rochester School of Nursing, Box SON, Helen Wood Hall, Rochester, NY 14642, USA and Center for Behavioral and Preventive Medicine, The Miriam Hospital and Brown University School of Medicine, Coro Building, Suite 500, One Hoppin Street, Providence, RI 02903 USA
| | - Paul J. Tremblay
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children’s Hospital at Strong, Box 777, 601 Elmwood Avenue, Rochester, NY 14642, USA, University of Rochester School of Nursing, Box SON, Helen Wood Hall, Rochester, NY 14642, USA and Center for Behavioral and Preventive Medicine, The Miriam Hospital and Brown University School of Medicine, Coro Building, Suite 500, One Hoppin Street, Providence, RI 02903 USA
| | - Jill S. Halterman
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children’s Hospital at Strong, Box 777, 601 Elmwood Avenue, Rochester, NY 14642, USA, University of Rochester School of Nursing, Box SON, Helen Wood Hall, Rochester, NY 14642, USA and Center for Behavioral and Preventive Medicine, The Miriam Hospital and Brown University School of Medicine, Coro Building, Suite 500, One Hoppin Street, Providence, RI 02903 USA
| | - Maria Fagnano
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children’s Hospital at Strong, Box 777, 601 Elmwood Avenue, Rochester, NY 14642, USA, University of Rochester School of Nursing, Box SON, Helen Wood Hall, Rochester, NY 14642, USA and Center for Behavioral and Preventive Medicine, The Miriam Hospital and Brown University School of Medicine, Coro Building, Suite 500, One Hoppin Street, Providence, RI 02903 USA
| | - Belinda Borrelli
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children’s Hospital at Strong, Box 777, 601 Elmwood Avenue, Rochester, NY 14642, USA, University of Rochester School of Nursing, Box SON, Helen Wood Hall, Rochester, NY 14642, USA and Center for Behavioral and Preventive Medicine, The Miriam Hospital and Brown University School of Medicine, Coro Building, Suite 500, One Hoppin Street, Providence, RI 02903 USA
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Chen X, Stanton B, Hopper J, Khankari N. Sources, locations, and predictors of environmental tobacco smoke exposure among young children from inner-city families. J Pediatr Health Care 2011; 25:365-72. [PMID: 22018427 DOI: 10.1016/j.pedhc.2010.04.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Accepted: 04/27/2010] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The purpose of this study was to determine the levels, sources, and locations of and influential factors for exposure to environmental tobacco smoke (ETS) among pediatric patients from inner-city families. METHOD Descriptive and associative analysis of ETS exposure in children 6 to 10 years of age was performed with survey data collected at Children's Hospital of Michigan through mothers' report and children's urine cotinine. RESULTS The sample included 397 participants, 82.4% of whom were African American. Urine cotinine levels were correlated with reported ETS exposure and 71% of children with urine cotinine levels > 10 ng/mL. The mean duration of ETS exposure was 14.3 minutes (SD = 11.0) in the past week and 58.9 minutes (SD = 50.8) in the past month. Smoking parents (∼30%), grandparents (∼30%), and non-family members (∼28%) were the major ETS sources, and relatives' homes (∼40%), the children's own homes (∼24%), automobiles (∼15%), and friends' homes (∼11%) were the main ETS locations. Child ETS exposure was inversely correlated with having a non-single mother, maternal education, income, use of prenatal preventive care, and satisfactory parenting. DISCUSSION ETS exposure in inner-city children was prevalent. Findings of this study may aid pediatric practitioners and public health workers in providing targeted interventions.
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Affiliation(s)
- Xinguang Chen
- Department of Pediatrics, Prevention Research Center, Wayne State University, Detroit, MI 48201, USA
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17
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Samir S, Colin Y, Thomas S. Impact of environmental tobacco smoke on children admitted with status asthmaticus in the pediatric intensive care unit. Pediatr Pulmonol 2011; 46:224-9. [PMID: 20963783 DOI: 10.1002/ppul.21355] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2010] [Revised: 08/03/2010] [Accepted: 08/04/2010] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Environmental tobacco smoke (ETS) and allergens are risk factors in children with critical status asthmaticus. Genetic studies support that ETS-associated asthma is a special inflammatory entity, causing significant number of hospital admissions and relapses. Accordingly, the course and outcome of patients with ETS-induced status asthmaticus might also be different. HYPOTHESIS We hypothesized that the progression, course, and outcome of patients with ETS-induced status asthmaticus would be worse than those of patients without ETS exposure. METHODS Medical records of children who were admitted to the Pediatric Intensive Care Unit (PICU) with the diagnosis of asthma at the Children's Hospital of Winnipeg, Manitoba, over 10 years were audited after Institutional Review Board (IRB) approval. Two hundred thirty records were reviewed. We extracted data including demographics and analyzed the patient's deterioration defined as clinical asthma score (CAS) drift between the ED and PICU. We computed the treatment response, expressed as length of stay (LOS) in the PICU and in hospital. The risk factors were stratified as none, ETS exposure, allergies, and ETS with allergies. RESULTS There were 55 (25%) patients with no risk factors, 66 (30%) with ETS exposure only, 46 (21%) with allergies only, and 53 (24%) with both. There was a 25% decrease in CAS deterioration when patients were exposed to ETS (P < 0.05). For patients with or without allergies but with exposure to ETS, both the PICU and overall hospital LOS were ∼15% longer (P < 0.05) than for those not exposed to ETS. Stratifying for gender and race in multivariate analysis did not alter the results. CONCLUSIONS Patients with ETS-associated critical status asthmaticus deteriorate and recover slower than non-ETS-exposed patients.
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Affiliation(s)
- Shah Samir
- Department of Pediatrics, University of Tennessee, Memphis, Tennessee
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18
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Fagnano M, Bayer AL, Isensee CA, Hernandez T, Halterman JS. Nocturnal asthma symptoms and poor sleep quality among urban school children with asthma. Acad Pediatr 2011; 11:493-9. [PMID: 21816697 PMCID: PMC3481184 DOI: 10.1016/j.acap.2011.05.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 05/13/2011] [Accepted: 05/16/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to describe nocturnal asthma symptoms among urban children with asthma and assess the burden of sleep difficulties between children with varying levels of nocturnal symptoms. METHODS We analyzed baseline data from 287 urban children with persistent asthma (aged 4-10 years) enrolled in the School-Based Asthma Therapy trial; Rochester, New York. Caregivers reported on nocturnal asthma symptoms (number of nights/2 weeks with wheezing or coughing), parent quality of life (Juniper's Pediatric Asthma Caregivers Quality of Life Questionnaire), and sleep quality by using the validated Children's Sleep Habits Questionnaire. We used bivariate and multivariate statistics to compare nocturnal asthma symptoms with sleep quality/quantity and quality of life. RESULTS Most children (mean age, 7.5 years) were black (62%); 74% had Medicaid. Forty-one percent of children had intermittent nocturnal asthma symptoms, 23% mild persistent, and 36% moderate to severe. Children's average total sleep quality score was 51 (range, 33-99) which is above the clinically significant cutoff of 41, indicating pervasive sleep disturbances among this population. Sleep scores were worse for children with more nocturnal asthma symptoms compared with those with milder symptoms on total score, as well as several subscales, including night wakings, parasomnias, and sleep disordered breathing (all P < .03). Parents of children with more nocturnal asthma symptoms reported their child having fewer nights with enough sleep in the past week (P = .018) and worse parent quality of life (P < .001). CONCLUSIONS Nocturnal asthma symptoms are prevalent in this population and are associated with poor sleep quality and worse parent quality of life. These findings have potential implications for understanding the disease burden of pediatric asthma.
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Affiliation(s)
- Maria Fagnano
- Department of Pediatrics and the Strong Children's Research Center, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
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19
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Halterman JS, Conn KM, Hernandez T, Tanski SE. Parent knowledge, attitudes, and household practices regarding SHS exposure: a case-control study of urban children with and without asthma. Clin Pediatr (Phila) 2010; 49:782-9. [PMID: 20522612 DOI: 10.1177/0009922810368290] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Impoverished children suffer disproportionately from asthma and are more likely than other children to be exposed to secondhand smoke (SHS). We conducted a case-control study to describe and compare knowledge, attitudes, and household practices regarding SHS exposure among parents of young urban children with and without asthma (response rate, 76%). Overall, 39% of children lived with > or =1 smoker (cases, 36%; controls, 43%). The majority of parents (78%) felt that cigarette smoking is very dangerous and agreed that smoke harms the health of children (97%). Cases were more likely than controls to report that smoking in a car affects children's health (54% vs 42%) and that smoking in front of children is never allowed in their home (88% vs 79%). Additionally, more cases reported a home smoking ban (81% vs 70%). Our findings suggest that parents of children with asthma have somewhat better knowledge, attitudes, and practices regarding SHS; however, gaps remain, and many urban children continue to be exposed.
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Affiliation(s)
- Jill S Halterman
- University of Rochester School of Medicine, Golisano Children's Hospital at Strong Memorial Hospital, 601 Elmwood Avenue, Rochester, NY 14642, USA.
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20
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Halterman JS, Borrelli B, Conn KM, Tremblay P, Blaakman S. Motivation to quit smoking among parents of urban children with asthma. PATIENT EDUCATION AND COUNSELING 2010; 79:152-155. [PMID: 19796913 PMCID: PMC2856779 DOI: 10.1016/j.pec.2009.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 08/27/2009] [Accepted: 09/03/2009] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To identify factors associated with motivation to quit smoking among parents of urban children with asthma. METHODS We analyzed data from parents who smoke and had a child enrolled in the School-Based Asthma Therapy (SBAT) trial. We assessed asthma symptoms, children's cotinine, and parent smoking behaviors. Motivation to quit smoking was assessed by a 10-point continuous measure (1, not at all motivated; 10, very motivated). RESULTS 209 parents smoked (39% of sample), and children's mean cotinine was 2.48 ng/ml. Motivation to quit was on average 6.9, and 47% of parents scored >or=8 on the scale. Parents who believed their child's asthma was not under good control, and parents who strongly agreed their child's asthma symptoms would decrease if they stop smoking had higher motivation to quit compared to their counterparts (p<.05). In a multivariate analysis, parents who believed their child's asthma was not under control had more than twice the odds of reporting high motivation to quit. CONCLUSION Parents' perception of the risks of smoking to their child with asthma is associated with motivation to quit. PRACTICE IMPLICATIONS Raising awareness about the effect of smoking and quitting on children's asthma might increase motivation to quit among parents.
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Affiliation(s)
- Jill S Halterman
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children's Hospital at Strong, Rochester, NY 14642, USA.
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21
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Myung SK, McDonnell DD, Kazinets G, Seo HG, Moskowitz JM. Relationships between household smoking restrictions and intention to quit smoking among Korean American male smokers in California. J Korean Med Sci 2010; 25:245-50. [PMID: 20119578 PMCID: PMC2811292 DOI: 10.3346/jkms.2010.25.2.245] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Accepted: 04/30/2009] [Indexed: 12/02/2022] Open
Abstract
This cross-sectional study examined the relationships between household smoking restrictions and intentions to quit smoking among Korean American male smokers in California. We used data from the California Korean American Tobacco Use Survey (CKATUS), which was conducted in 2004 using computer-assisted telephone interviewing. Among the 2,545 respondents who participated in the CKATUS, the 387 male smokers who answered a question assessing their intention to quit smoking were included in the final analyses. In univariable analyses, smokers who reported having household smoking restrictions were more likely to intend to quit smoking as compared with those who did not (P<0.01). Other independent correlates of having an intention to quit smoking were being less than 50 yr of age, having spent more than 50% of one's life in the US, being assimilated, and having other smokers in the household. In a multiple logistic regression analysis, the significant correlates of having an intention to quit smoking were household smoking restrictions (complete or partial restriction vs. no restriction on smoking; odds ratio, 2.54; 95% confidence interval, 1.22-5.28) and absence of other smokers in the household. In conclusion, smoking restrictions in the household are associated with an intention to quit smoking among Korean American male smokers in California.
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Affiliation(s)
- Seung-Kwon Myung
- Smoking Cessation Clinic, Center for Cancer Prevention and Detection, National Cancer Center & Division of Cancer Prevention, National Cancer Control Research Institute, National Cancer Center, Goyang, Korea
- Center for Family and Community Health, School of Public Health, University of California, Berkeley, Berkeley, USA
| | - Diana D. McDonnell
- Center for Family and Community Health, School of Public Health, University of California, Berkeley, Berkeley, USA
| | - Gene Kazinets
- Center for Family and Community Health, School of Public Health, University of California, Berkeley, Berkeley, USA
| | - Hong Gwan Seo
- Smoking Cessation Clinic, Center for Cancer Prevention and Detection, National Cancer Center & Division of Cancer Prevention, National Cancer Control Research Institute, National Cancer Center, Goyang, Korea
| | - Joel M. Moskowitz
- Center for Family and Community Health, School of Public Health, University of California, Berkeley, Berkeley, USA
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22
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Hagen EW, Sadek-Badawi M, Palta M. Daycare attendance and risk for respiratory morbidity among young very low birth weight children. Pediatr Pulmonol 2009; 44:1093-9. [PMID: 19824048 PMCID: PMC2783181 DOI: 10.1002/ppul.21104] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Daycare attendance and very low birth weight (VLBW, < or =1,500 g) are associated with respiratory morbidity during childhood. The objective of this study was to evaluate whether daycare attendance is associated with even higher risk for respiratory problems among VLBW children. We hypothesized that VLBW children attending daycare, in a private home or daycare center, are at higher risk for respiratory problems than VLBW children not attending daycare. We also investigated whether the effect of daycare is independent or synergistic with respiratory risk resulting from being VLBW, as indicated by having bronchopulmonary dysplasia (BPD) as a neonate. We conducted a prospective study of VLBW children followed from birth to age 2-3 (N = 715). Logistic regression was used to evaluate the relationship between daycare attendance and respiratory problems, adjusting for known neonatal risk factors for poor respiratory outcomes. Attending daycare in either a private home or in a daycare center was significantly associated with higher risk of lower respiratory infections than never attending. Attending a daycare center was also associated with higher risk for wheezy chest, cough without a cold, and respiratory medication use. While having BPD was associated with increased risk for respiratory problems, daycare attendance and BPD were not found to be synergistic risk factors for respiratory problems among VLBW children, but acted independently to increase risk. This implies that the increase in risk for respiratory problems associated with daycare attendance may be similar among VLBW children and those of normal birth weight.
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Affiliation(s)
- Erika W Hagen
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin 53726, USA.
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Abstract
Smoking during pregnancy and exposure to environmental tobacco smoke have harmful and sometimes devastating effects on the health of the newborn. Although interventions for smoking cessation during pregnancy demonstrate effectiveness for increasing smoking abstinence, the majority of women relapse in the postpartum period. However, modifying contributing factors for relapse may improve the success of sustained abstinence. Many parents are eager to quit smoking and willing to participate in smoking cessation interventions. Through a population-based approach to healthcare, neonatal nurses are in an ideal position to prevent relapse and to promote smoking abstinence; they can coordinate and lead efforts for establishing smoking cessation strategies that integrate obstetric, newborn, and pediatric services.
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Martinez-Donate AP, Johnson-Kozlow M, Hovell MF, Gonzalez Perez GJ. Home smoking bans and secondhand smoke exposure in Mexico and the US. Prev Med 2009; 48:207-12. [PMID: 19150456 DOI: 10.1016/j.ypmed.2008.12.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 12/06/2008] [Accepted: 12/09/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study examines the association between home smoking ban status and home secondhand smoke exposure (SHSE) among Mexican-descent adults and children in three cities representing different levels of exposure to the California Tobacco Control Program. METHOD From 2003-2004, a cross-sectional tobacco survey was conducted with a population-based sample of Mexican-descent adults in San Diego, California (N=1103) and Mexican adults in Tijuana (N=398) and Guadalajara (N=400), Mexico. RESULTS After adjustment for demographic, behavioral, cultural, and contextual covariates, a complete home smoking ban was associated with Mexican American and Mexican adults and children being less likely to experience SHSE in the home compared to their counterparts with partial or no smoking restrictions. The association was significant across the three survey sites, but stronger in San Diego than in any of the two Mexican cities. CONCLUSION Home smoking bans reduce the risk of home SHSE among Mexican Americans and Mexicans, regardless of the smoking status of the household residents and other individual and environmental variables. Even if household residents continue smoking and communitywide tobacco control efforts are suboptimal, the promotion of home smoking bans can protect adults and children from home SHSE.
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Affiliation(s)
- Ana P Martinez-Donate
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St., 605 WARF, Madison, WI 53703-2397, USA.
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Binns HJ, O'Neil J, Benuck I, Ariza AJ. Influences on parents' decisions for home and automobile smoking bans in households with smokers. PATIENT EDUCATION AND COUNSELING 2009; 74:272-276. [PMID: 18938054 DOI: 10.1016/j.pec.2008.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2008] [Revised: 08/29/2008] [Accepted: 09/07/2008] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To understand clinician influence on use of home and automobile smoking bans in homes of children living with a smoker. METHODS Parents were surveyed on tobacco use, smoking bans, demographics and opinions about tobacco, including harm from environmental tobacco smoke (ETS). Responses from 463 diverse households with smokers were analyzed. RESULTS 42% of respondents smoked; 50% had a home smoking ban and 58% an automobile smoking ban. Nonsmokers living with a smoker, those who strongly agreed in ETS harm, and those having a child < or = 5 years more often had a home smoking ban. Those recalling their child's doctor ever asking the respondent about their smoking status and African American respondents less frequently had a home ban. Automobile smoking bans were more often held by those with strong agreement in ETS harm and less often found in families having a child receiving Medicaid/uninsured. CONCLUSIONS Having a strong perception of harm from ETS exposure was associated with having smoking bans. Aspects of health encounters not measured by this study may be negatively influencing adoption of home smoking bans or lead to recall bias. PRACTICE IMPLICATIONS Clinicians should examine the strength, focus, and response to their messages to parents about tobacco.
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Affiliation(s)
- Helen J Binns
- Department of Pediatrics, Children's Memorial Hospital, Chicago, IL 60614, United States.
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26
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Halterman JS, Borrelli B, Tremblay P, Conn KM, Fagnano M, Montes G, Hernandez T. Screening for environmental tobacco smoke exposure among inner-city children with asthma. Pediatrics 2008; 122:1277-83. [PMID: 19047246 PMCID: PMC2597221 DOI: 10.1542/peds.2008-0104] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The goals were (1) to develop an index measure of environmental tobacco smoke based on parent self-report of smoking behaviors and (2) to determine whether the index score was associated with children's present and future cotinine levels. METHODS Data were drawn from a community intervention for inner-city children with persistent asthma (N=226; response rate: 72%). Measures of child salivary cotinine levels and parent self-reported environmental tobacco smoke-related behaviors were obtained at baseline and 7 to 9 months later. To develop the index score, we used a 15-fold cross-validation method, with 70% of our data, that considered combinations of smoke exposure variables and controlled for demographic features. We chose the most parsimonious model that minimized the mean square predictive error. The resulting index score included primary caregiver smoking and home smoking ban status. We validated our model with the remaining 30% of the data. Analysis of variance and multivariate analyses were used to determine the association of the index score with children's cotinine levels. RESULTS Fifty-four percent of children with asthma lived with >or=1 smoker, and 51% of caregivers reported a complete home smoking ban. The children's mean baseline cotinine level was 1.55 ng/mL (range: 0.0-21.3 ng/mL). Children's baseline and follow-up cotinine levels increased as scores on the index measure increased. In a linear regression, the index score was significantly positively associated with children's cotinine measurements at baseline and 7 to 9 months later. CONCLUSION An index measure with combined information regarding primary caregiver smoking and household smoking restrictions helped to identify children with asthma with the greatest exposure to environmental tobacco smoke and could predict which children would have elevated cotinine levels 7 to 9 months later.
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Affiliation(s)
- Jill S Halterman
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Box 777, Strong Memorial Hospital, 601 Elmwood Ave, Rochester, NY 14642, USA.
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Matt GE, Romero R, Ma DS, Quintana PJ, Hovell MF, Donohue M, Messer K, Salem S, Aguilar M, Boland J, Cullimore J, Crane M, Junker J, Tassinario P, Timmermann V, Wong K, Chatfield D. Tobacco use and asking prices of used cars: prevalence, costs, and new opportunities for changing smoking behavior. Tob Induc Dis 2008; 4:2. [PMID: 18822157 PMCID: PMC2547891 DOI: 10.1186/1617-9625-4-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2008] [Accepted: 07/31/2008] [Indexed: 11/26/2022] Open
Abstract
Secondhand smoke (SHS) causes premature death and disease in children and adults, and the scientific evidence indicates that there is no risk-free level of exposure to SHS. Smoking tobacco in a car can pollute the microenvironment of the car with residual SHS, leaving telltale signs to potential buyers (e.g., odor, used ash tray). This study examined (a) the proportion of used cars sold in the private party market that may be polluted with tobacco smoke and (b) whether asking prices of smoker and nonsmoker cars differed for cars of otherwise equivalent value. A random sample of 1,642 private party sellers were interviewed by telephone, and content analyses of print advertisements were conducted. Findings indicate that 22% of used cars were advertised by smokers or had been smoked in during the previous year. Among nonsmokers, 94% did not allow smoking in their car during the past year. Only 33% of smokers had the same restrictions. The smoking status of the seller and tobacco use in the car were significantly (p < .01) associated with the asking price independent of a car's Kelley Blue Book value (KBB). Used nonsmoker cars were offered at a considerable premium above their KBB value (>11%) and above comparable smoker cars (7–9%). These findings suggest that community preferences are affecting the value of smoke-free cars. New directions for research, tobacco control policies, and health education are discussed to further reduce smoking behavior, to help consumers make informed purchasing decisions, and to protect nonsmokers from SHS exposure.
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Affiliation(s)
- Georg E Matt
- Department of Psychology, San Diego State University, San Diego, USA.
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Wipfli H, Avila-Tang E, Navas-Acien A, Kim S, Onicescu G, Yuan J, Breysse P, Samet JM. Secondhand smoke exposure among women and children: evidence from 31 countries. Am J Public Health 2008; 98:672-9. [PMID: 18309121 DOI: 10.2105/ajph.2007.126631] [Citation(s) in RCA: 145] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to describe the range of exposure to secondhand smoke (SHS) among women and children living with smokers around the world and generate locally relevant data to motivate the development of tobacco control policies and interventions in developing countries. METHODS In 2006, we conducted a cross-sectional exposure survey to measure air nicotine concentrations in households and hair nicotine concentrations among nonsmoking women and children in convenience samples of 40 households in 31 countries. RESULTS Median air nicotine concentration was 17 times higher in households with smokers (0.18 mug/m(3)) compared with households without smokers (0.01 mug/m(3)). Air nicotine and hair nicotine concentrations in women and children increased with the number of smokers in the household. The dose-response relationship was steeper among children. Air nicotine concentrations increased an estimated 12.9 times (95% confidence interval=9.4, 17.6) in households allowing smoking inside compared with those prohibiting smoking inside. CONCLUSIONS Our results indicate that women and children living with smokers are at increased risk of premature death and disease from exposure to SHS. Interventions to protect women and children from household SHS need to be strengthened.
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Affiliation(s)
- Heather Wipfli
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, W6027, Baltimore, MD 21205, USA.
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Halterman JS, Fagnano M, Conn KM, Lynch KA, DelBalso MA, Chin NP. Barriers to reducing ETS in the homes of inner-city children with asthma. J Asthma 2007; 44:83-8. [PMID: 17454320 DOI: 10.1080/02770900601180545] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study assessed knowledge regarding the harm of environmental tobacco smoke (ETS) exposure and barriers to reducing ETS from the point-of-view of urban parents of asthmatic children. We conducted in-depth interviews with 15 mothers of children with asthma. All parents had good knowledge regarding the harmful effects of ETS. While all children of smoking parents were exposed to ETS, parents described using various strategies to keep ETS away from children. Many parents experienced significant stress in their lives and used smoking to relieve their stress. Barriers to a smoke-free home included stress, addiction, and the use of ineffective strategies to reduce ETS exposure.
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Affiliation(s)
- Jill S Halterman
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry and the Strong Children's Research Center, Rochester, New York 14642, USA.
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Rees VW, Connolly GN. Measuring air quality to protect children from secondhand smoke in cars. Am J Prev Med 2006; 31:363-8. [PMID: 17046406 DOI: 10.1016/j.amepre.2006.07.021] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Revised: 05/17/2006] [Accepted: 07/07/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND Secondhand tobacco smoke (SHS) is a major, preventable contributor to acute and chronic adverse health outcomes that affect children disproportionately. The predominant source of SHS among children is domestic exposure, and while up to two thirds of U.S. households have car smoking bans, an unacceptable number of children remain vulnerable. To help promote more effective protection through legislation, health communication strategies, or behavioral interventions, data demonstrating the adverse effect of SHS on air quality in cars are needed. METHODS Secondhand tobacco smoke in a motor vehicle under actual driving conditions was monitored by measuring respirable suspended particles (RSPs) of less than 2.5 microns in diameter, and carbon monoxide. Forty-five driving trials were conducted, using teams of volunteer drivers and smokers recruited from the general community. Three smoking conditions (nonsmoking baseline, active smoking, and immediate post-smoking period, each 5 minutes) were crossed with two ventilation conditions (windows open, closed) in a 3 x 2 within-sessions factorial design. RESULTS The highest mean observed RSP level was 271 mug/m(3), which is unsafe, particularly for children. Peak RSP levels were considerably higher. RSPs and carbon monoxide increased significantly from baseline after smoking, and these increases were greatest during the closed ventilation condition, compared with open ventilation. CONCLUSIONS Private passenger cars are a domestic environment with the potential to yield unsafe levels of SHS contaminants. These data may assist policymakers and health advocates to promote protective strategies to ensure smoke-free domestic environments for children.
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Affiliation(s)
- Vaughan W Rees
- Harvard School of Public Health, Division of Public Health Practice, Boston, Massachusetts 02115, USA.
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