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Lu R, Qin Y, Xie C, Tan X, Zhu T, Tan J, Wang S, Liang J, Qin Z, Pan R, Pei P, Sun D, Su L, Lan J. Secondhand smoke exposure can increase the risk of first ischemic stroke: A 10.7-year prospective cohort study in China. Ann Epidemiol 2024; 92:25-34. [PMID: 38367798 DOI: 10.1016/j.annepidem.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 02/19/2024]
Abstract
INTRODUCTION Passive smoking is considered a major public health issue in China. Prospective evidence regarding the link between secondhand smoke (SHS) and ischemic stroke in China is scarce. METHODS The China Kadoorie Biobank (CKB) study in Liuzhou City recruited 50,174 participants during 2004-2008. Of these 30,456 never-smokers were included in our study. The median follow-up period was 10.7 years. The incidence of ischemic stroke was obtained through the China Disease Surveillance Points (DSP) system and the Health Insurance (HI) database. Cox proportional risk models were used to evaluate the association between SHS exposure and ischemic stroke. RESULTS During 320,678 person-years of follow-up, there were 2059 patients with ischemic stroke observed and the incidence of ischemic stroke was 6.42 per thousand person-years. Participants exposed to SHS daily faced a 21 % higher risk of ischemic stroke (HR = 1.21, 95 %CI: 1.09-1.34) compared to those exposed to SHS less than once a week. Subgroup analyses revealed that daily SHS exposure was linked to heightened risk of ischemic stroke among women, non-employed, and non-weekly tea drinkers. CONCLUSIONS Daily SHS exposure was associated with higher risks of ischemic stroke. Proactive tobacco control strategies are necessary to decrease the risk of ischemic stroke in never smokers.
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Affiliation(s)
- Rumei Lu
- School of Public Health, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, China
| | - Yulu Qin
- Liuzhou Center for Disease Prevention and Control, Liuzhou, Guangxi Zhuang Autonomous Region 545007, China
| | - Changping Xie
- Liuzhou Center for Disease Prevention and Control, Liuzhou, Guangxi Zhuang Autonomous Region 545007, China
| | - Xiaoping Tan
- Liuzhou Center for Disease Prevention and Control, Liuzhou, Guangxi Zhuang Autonomous Region 545007, China
| | - Tingping Zhu
- Liuzhou Center for Disease Prevention and Control, Liuzhou, Guangxi Zhuang Autonomous Region 545007, China
| | - Jinxue Tan
- Liuzhou Center for Disease Prevention and Control, Liuzhou, Guangxi Zhuang Autonomous Region 545007, China
| | - Sisi Wang
- Liuzhou Center for Disease Prevention and Control, Liuzhou, Guangxi Zhuang Autonomous Region 545007, China
| | - Jiajia Liang
- Liuzhou Center for Disease Prevention and Control, Liuzhou, Guangxi Zhuang Autonomous Region 545007, China
| | - Zhongshu Qin
- Liuzhou Center for Disease Prevention and Control, Liuzhou, Guangxi Zhuang Autonomous Region 545007, China
| | - Rong Pan
- Liuzhou Center for Disease Prevention and Control, Liuzhou, Guangxi Zhuang Autonomous Region 545007, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
| | - Dianjianyi Sun
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China; Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Li Su
- School of Public Health, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, China.
| | - Jian Lan
- Liuzhou Center for Disease Prevention and Control, Liuzhou, Guangxi Zhuang Autonomous Region 545007, China.
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Okekunle AP, Asowata OJ, Danladi DK, Ogunjuyigbe AS, Akpa OM. Association of second-hand smoking with sleep quality among adults in Ibadan, Nigeria: a cross-sectional evaluation of data from the COMBAT-CVDs study. Int Arch Occup Environ Health 2024; 97:279-289. [PMID: 38252129 DOI: 10.1007/s00420-023-02042-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/12/2023] [Indexed: 01/23/2024]
Abstract
PURPOSE Sleep quality (SQ) is essential in the overall well-being and quality of life, but little is known about the association of secondhand smoking (SHS) with SQ. This study assessed the relationship between SHS and SQ among adults who had never smoked in Ibadan, Nigeria. METHODS We identified 3193 respondents who had never smoked or used any form of tobacco product in the Community-based Investigation of the Risk Factors for Cardiovascular Diseases in the Ibadan and suburbs (COMBAT-CVDs) study. SHS was self-reported, SQ assessed using a sleep quality scale, and SQ scores were classified by the quartile distributions of SQ scores in this sample as good (< 7), moderate (7-13), fair (14-20), and poor (≥ 21), and logistic regression models were used to estimate the multivariable-adjusted odds ratio and 95% confidence interval (CI) of the association between SHS and SQ in a two-sided test at P < 0.05. RESULTS The mean (SD) of age in this sample was 34.8 ± 15.1 years; 1621 (50.8%) were females, and 848 (26.6%) experienced SHS. The multivariable-adjusted odds by categories of SQ scores (using good SQ as reference) in the light of SHS were OR: 1.64 (95%CI 1.28, 2.12) for moderate SQ, OR: 1.88 (95%CI 1.46, 2.42) for fair SQ and OR: 2.14 (95%CI 1.66, 2.75) for poor SQ; P < 0.0001 after adjusting for relevant covariates. The sex- and age groups- stratified analyses revealed similar trends. CONCLUSION SHS is associated with higher odds of poor SQ in this study. Culturally relevant interventions for mitigating exposure to SHS might improve SQ and overall quality of life, particularly among vulnerable populations.
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Affiliation(s)
- Akinkunmi Paul Okekunle
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, 200284, Nigeria
- The Postgraduate College, University of Ibadan, Ibadan, 200284, Nigeria
- Research Institute of Human Ecology, Seoul National University, Seoul, 08826, Republic of Korea
| | - Osahon Jeffery Asowata
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, 200284, Nigeria
| | - David Kadan Danladi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, 200284, Nigeria
| | - Ayodeji Samson Ogunjuyigbe
- The Postgraduate College, University of Ibadan, Ibadan, 200284, Nigeria
- Department of Electrical and Electronic Engineering, Faculty of Technology, University of Ibadan, Ibadan, 200284, Nigeria
| | - Onoja Matthew Akpa
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, 200284, Nigeria.
- The Postgraduate College, University of Ibadan, Ibadan, 200284, Nigeria.
- Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, 200284, Nigeria.
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, USA.
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