[Passive smoking in childhood]

[Exposure to environmental tobacco smoke at home increases the need for medical attention for respiratory diseases in childhood]

OBJECTIVES

Children are highly vulnerable to damage from passive smoking as they are unable to avoid environmental tobacco, if present. Some reports have suggested that domestic exposure to environmental tobacco smoke can increase respiratory diseases in children. The aim of this study was to assess whether domestic passive smoking is associated with new respiratory events.

METHODS

A descriptive, retrospective study was performed of 410 children aged less than 14 years old. The variables studied were: a) smokers in the household, b) the number of cigarettes smoked per day, c) school attendance, d) the number of siblings, e) previous respiratory diseases among parents and siblings, f) maternal smoking in pregnancy, and g) the number of respiratory events recorded in the previous year. Univariate, bivariate and multivariate analyses were performed.

RESULTS

A total of 50.2 % of the children cohabited with smokers at home. The mean number of upper respiratory tract events per child living in environments free of tobacco smoke was 2.53 versus 3.52 when one of the household members smoked. For respiratory disease as a whole, an inverse association with age was found [OR = 0.83; (95 % CI: 0.76-0.90)] and a direct association was found with maternal smoking [OR = 4.56 (95 % CI; 1.84-11.34)]. With upper respiratory tract disease, the OR was 1.4 if the mother smoked 11-20 cigarettes/day, and was 1.9 if the number of cigarettes was > 20. With lower respiratory diseases, the odds ratio was 3.48 (95 % CI; 2.07-6.06) if the mother smoked.

CONCLUSIONS

Fifty percent of the children studied were exposed to environmental tobacco smoke in the home. Younger children were at higher risk. The major risk factor for respiratory disease was maternal smoking and the risk increased with the number of cigarettes smoked. Health education is essential to protect children from tobacco smoke exposure.

[Tobacco use among young people in informal education settings: a survey of behaviors and opinions]

OBJECTIVES

To obtain information about the tobacco use of young people in an informal educational setting. To analyze the profile of the young smoker and the associated social and health factors, and to discover the opinion of tobacco held by smokers and non-smokers. POPULATION AND METHODS An anonymous, self-administered, personal questionnaire was completed by volunteers aged 14 to 26 years old taking part in the activities of 3 youth centers. The questionnaire included items about the subjects' smoking habits, their awareness of the harmful effects of cigarette smoking and knowledge of tobacco cessation techniques. The survey also covered the health and social profile of young smokers.

RESULTS

A total of 84 completed questionnaires were received (40 males and 44 females). The mean age of the sample was 18.3 years. Of the total, 15.4% had never smoked, 44% described themselves as smokers, and 16.6% as ex-smokers. Of the smokers, 40% smoked up to 10 cigarettes/day and 60% between 11 and 20. The age of initiation or experimentation was 13.1 years, and that of the onset of regular or daily use, 14.6 years. Only 23.5% of the smokers expressed a desire to stop smoking, and 50% had never tried to quit. Tobacco use was associated with weekend alcohol consumption in 59% of the smokers. None of the respondents were aware of the tobacco cessation aids and therapies available.

CONCLUSIONS

According to the data collected by way of these questionnaires, a high percentage of the young people who participate in these leisure activities are smokers. They report a very early age of initiation and an accurate understanding of the serious consequences of tobacco use. Their lack of awareness about the available aids for tobacco cessation is a cause for concern, and the number of smokers who expressed a desire to quit was minimal. A disturbing increase in the association between alcohol and tobacco consumption was observed.

[Individually tailored medical counseling for pregnant smokers]

OBJECTIVES

To identify the characteristics of smoking addiction in a group of pregnant women, to evaluate the efficacy of medical counseling tailored to the patient's stage in the cessation process and to examine factors that might affect the ability of a woman to quit smoking during pregnancy.

PATIENTS AND METHODS

One hundred sixteen women (mean age 29.71 5.44 years; range 15-41) were referred by obstetricians to a respiratory medicine specialist if they continued smoking after being advised to quit. The information each woman received was appropriate to her stage in the cessation process and covered the risks that smoking posed for her child and the benefits that would come from quitting. Each woman was provided with guidelines for quitting and helped to choose the first day to start the cessation process. The women received follow-up counseling sessions after the first and third months.

RESULTS

Twenty-seven women (23.3%) quit smoking, 18 (15.52%) advanced a stage in the cessation process and 30 (25.86%) smoked less. Overall, the program benefited 60 women (51.7%) who quit smoking, reduced the number of cigarettes they smoked or progressed to a new stage.

CONCLUSIONS

The results reveal that most pregnant smokers need the intervention of specialists with knowledge of smoking addiction to facilitate the cessation process.