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Agbaria N, Finkelstein A, Zwas DR, Daoud N. Perceptions of Barriers and Facilitators to Reducing Exposure to Secondhand Smoke in the Home: A Qualitative Study With Palestinian-Arab Women in Israel. Nicotine Tob Res 2024:ntad257. [PMID: 38217542 DOI: 10.1093/ntr/ntad257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Smoking is a collective and complex problem in the Palestinian-Arab community in Israel, where women and children are particularly vulnerable to exposure to secondhand smoke (SHS), especially in the home. AIMS AND METHODS We undertook this study to better understand women's experiences with SHS exposure in the home and to identify pathways for intervention. Using the grounded theory approach, seven focus groups were conducted with 66 women in different localities across Israel. Purposive and snowball sampling techniques were applied to recruit women who have currently or previously been exposed to smoking in the home. Focus groups were audio-recorded and transcribed verbatim, and data were then coded and analyzed using the constant comparison analysis method to identify emergent themes and subthemes. RESULTS Three core themes emerged from the discussions. These include women's perceptions of smoking among men and exposure to SHS in the home, the implications of smoking on spousal and social relationships, and the women's experiences in coping with this situation and their suggestions for interventions. We identified additional sub-themes, including the consequences to women's and children's health, as well as the complex interaction between smoking in the home and women's social position, agency, and home ownership. CONCLUSIONS Women exposed to SHS in the home experience consequences that affect their health and their spousal and social relationships. They also face several personal and societal challenges in tackling this issue. Culturally tailored interventions targeting both communities and households can raise awareness and impact smoking behaviors in the home. IMPLICATIONS The findings of this study demonstrate the far-reaching consequences of SHS exposure in the home among women who are exposed. The findings contribute to our understanding of smoking contingencies among men and smoking behaviors in the home. This study lays the groundwork for future community and household-based research and interventions. We suggest several critical junctures that may increase response to smoking cessation interventions and to reduce smoking in the home, such as at the time of marriage when the home policy is set, and the adverse effects of exposure on children and other family members, especially those with illness.
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Affiliation(s)
- Nisreen Agbaria
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Hospital, Jerusalem, Israel
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Adi Finkelstein
- Department of Nursing, Faculty of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel
| | - Donna R Zwas
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Hospital, Jerusalem, Israel
| | - Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
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Rosen LJ, Zucker DM, Gravely S, Bitan M, Rule AM, Myers V. Tobacco Smoke Exposure According to Location of Home Smoking in Israel: Findings from the Project Zero Exposure Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3523. [PMID: 36834219 PMCID: PMC9965201 DOI: 10.3390/ijerph20043523] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
Young children are particularly vulnerable to harms from tobacco smoke exposure (TSE). This study aimed to compare TSE: (1) between children who live in smoking families and those who do not; and (2) among children who live in smoking households with varying smoking locations. The data came from two studies that were conducted concurrently in Israel (2016-2018). Study 1: a randomized controlled trial of smoking families (n = 159); Study 2: a cohort study of TSE among children in non-smoking families (n = 20). Hair samples were collected from one child in each household. Baseline hair nicotine data were analyzed for 141 children in Study 1 and 17 children in Study 2. Using a logistic regression analysis (exposed vs. not exposed as per laboratory determination) and a linear regression (log hair nicotine), we compared TSE between: (1) children in Study 1 vs. Study 2; (2) children in families with different smoking locations in Study 1: balcony; garden, yard, or other place outside of the home; or inside the home (designated smoking areas within the home (DSAs) or anywhere). A higher proportion of children living in smoking households were measurably exposed to tobacco smoke (68.8%) compared to children living in non-smoking households (35.3%, p = 0.006). Among children from smoking families, 75.0% of those whose parents smoked in the house were exposed, while 61.8% of children whose parents restricted smoking to the porch (n = 55) were exposed, and 71.4% of those whose parents smoked outside the home (including gardens and yards) (n = 42) were exposed. In univariable and multivariable models, smoking location was not significantly associated with exposure. The majority of children in smoking families were measurably exposed to TSE, even if smoking was restricted to designated areas in the home, balconies, orgarden/yard/other outdoor areas. Reducing population smoking rates, particularly among parents, restricting smoking to at least 10 meters from homes and children, and denormalizing smoking around others are recommended to reduce population-level child TSE and tobacco-attributable disease and death.
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Affiliation(s)
- Laura J. Rosen
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - David M. Zucker
- Department of Statistics and Data Science, Hebrew University, Jerusalem 9190501, Israel
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Michal Bitan
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Computer Science, College of Management Academic Studies, Rishon LeTsiyon 7579806, Israel
| | - Ana M. Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Vicki Myers
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 5262100, Israel
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Gunay F, Cullas Ilarslan NE, Bakar-Ates F, Deniz K, Kadioglu YK, Kiran S, Bakirarar B, Cobanoglu N. Evaluation of hair cotinine and toxic metal levels in children who were exposed to tobacco smoke. Pediatr Pulmonol 2020; 55:1012-1019. [PMID: 32068966 DOI: 10.1002/ppul.24692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/03/2020] [Indexed: 11/11/2022]
Abstract
Tobacco or tobacco products (TTP) are harmful because they contain nicotine and some heavy metals. In this study, it was aimed to evaluate whether the responses of parents to questionnaires were compatible with the hair cotinine levels of their children, and to investigate whether exposure to environmental tobacco smoke (ETS) and living conditions increased the levels of cotinine, lead (Pb), arsenic (As), and cadmium (Cd) in the hair samples of the children. Questionnaires were administered to the parents questioning household consumption of TTP and living conditions. Children were grouped as "exposed to ETS" (E-ETS) and "not exposed to ETS" (NE-ETS). This grouping was performed through a questionnaire-based evaluation, and a hair cotinine cut-off value-based evaluation. According to the questionnaire-based evaluation, there were no significant differences in hair Pb, As, and Cd levels between the groups (P-values: .337, .994, and .825, respectively). The hair cotinine of the E-ETS group was higher (0.24 ± 0.21 vs 0.22 ± 0.15 ng/mg), but the difference was not statistically significant (P = .317). According to the cotinine evaluation, cotinine, Pb, and As levels were statistically higher in the E-ETS group (P < .001, <.001, and .036, respectively), but there was no statistical difference between the groups in terms of Cd levels (P = .238). Our results showed that exposure to ETS increased the levels of cotinine, Pb, and As in the hair samples of children, and the questionnaire responses of the parents about their smoking habits might not be compatible with the hair cotinine levels of the children.
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Affiliation(s)
- Fatih Gunay
- Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | | | - Filiz Bakar-Ates
- Department of Biochemistry, Ankara University Faculty of Pharmacy, Ankara, Turkey
| | - Kiymet Deniz
- Department of Geological Engineering, Ankara University Faculty of Engineering, Ankara, Turkey
| | - Yusuf Kagan Kadioglu
- Department of Geological Engineering, Ankara University Faculty of Engineering, Ankara, Turkey
| | - Sibel Kiran
- Institute of Public Health, Hacettepe University, Ankara, Turkey
| | - Batuhan Bakirarar
- Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey
| | - Nazan Cobanoglu
- Division of Pediatric Pulmonology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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Leung LT, Ho SY, Wang MP, Lam TH. Secondhand Smoke From Multiple Sources, Thirdhand Smoke and Respiratory Symptoms in Hong Kong Adolescents. Nicotine Tob Res 2019; 20:192-198. [PMID: 27807126 DOI: 10.1093/ntr/ntw302] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 11/01/2016] [Indexed: 12/28/2022]
Abstract
Introduction Reports on involuntary tobacco smoke exposure in children have focused mostly on secondhand smoke (SHS) from smoking inside the home. We studied the separate and combined prevalence of SHS exposure from multiple sources and thirdhand smoke (THS) and the associations with respiratory symptoms in Hong Kong adolescents. Methods In 2010-2011, 61 810 Secondary 1 (US Grade 7) to seven students reported their smoking status, respiratory symptoms, and exposure to four sources of tobacco smoke in the past 7 days. Weighted prevalence of exposure was calculated. Associations with respiratory symptoms were analyzed in 50 762 never smokers using logistic regression. Results Tobacco smoke exposure at home was 23.2% considering SHS exposure from inside the home, but increased to 33.2% including SHS from neighbors and 36.2% further including THS. Including SHS outside home (55.3%), 63.3% of adolescents were exposed to SHS anywhere or THS at home. In never smokers, SHS from each source and THS at home were linearly associated with respiratory symptoms. Exposure to more sources yielded stronger associations with respiratory symptoms (p for trend<.001). The adjusted odds ratios (95% CI) were 1.04 (0.97-1.11), 1.12 (1.03-1.22), 1.40 (1.26-1.56) and 1.99 (1.74-2.28) for 1, 2, 3, and 4 sources, respectively. Conclusions Although Hong Kong's smoking prevalence is among the lowest in the developed world, over 60% of its adolescents were involuntarily exposed to tobacco smoke from one or more sources with a linear association with respiratory symptoms in never smokers. More stringent policies are needed to protect adolescents from tobacco smoke. Implications In a high-density urban setting, involuntary exposure to tobacco smoke in adolescents can be much higher than the smoking prevalence of the general population, especially if SHS exposure from multiple sources and THS are also considered. Such exposures have important health implications as demonstrated by their linear associations with respiratory symptoms. Tobacco control measures effective in reducing smoking prevalence may have little effect in reducing adolescent exposure to tobacco smoke, especially in the private home, in which other public health strategies are urgently needed.
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Affiliation(s)
- Lok Tung Leung
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Pattemore PK, Silvers KM, Frampton CM, Wickens K, Ingham T, Fishwick D, Crane J, Town GI, Epton MJ. Hair nicotine at 15 months old, tobacco exposure and wheeze or asthma from 15 months to 6 years old. Pediatr Pulmonol 2018; 53:443-451. [PMID: 29210195 DOI: 10.1002/ppul.23903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 10/06/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate the relationship between hair nicotine levels at 15 months of age and prior parent-reported smoking exposure, and the risk of wheezing and current asthma from 15 months to 6 years of age. STUDY DESIGN We measured hair nicotine levels at 15 months of age in 376 of 535 infants enrolled in a prospective birth cohort in Christchurch, New Zealand. We obtained detailed information from parents about smoking exposure during pregnancy and in the home at 3 and 15 months of age. Data for demographics, wheezing, and asthma were obtained from yearly questionnaires up to age 6 years. We assessed hair nicotine levels in relation to reported smoke exposure in pregnancy and up to age 15 months, and the association between high levels of hair nicotine and annual reports of current wheeze and current asthma using multiple logistic regression. RESULTS Hair nicotine increased with numbers of smokers and daily cigarettes smoked at home, and was also strongly associated with smoking in pregnancy. High level of hair nicotine was associated with increased risk of wheeze (Odds ratio 2.30, P = 0.001) and, though not significant, of current asthma (Odds ratio 2.02, P = 0.056) at 15 months of age, after controlling for socio-economic status, ethnicity, body mass index, respiratory infections in the first 3 months of life, and duration of exclusive breastfeeding. At older ages the associations were non-significant. CONCLUSION In children aged 15 months hair nicotine level was related to smoking exposure, and was associated with increased risk of wheeze and asthma.
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Affiliation(s)
- Philip K Pattemore
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Karen M Silvers
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Chris M Frampton
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Kristin Wickens
- Wellington Asthma Research Group, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Tristram Ingham
- Wellington Asthma Research Group, Department of Medicine, University of Otago, Wellington, New Zealand
| | - David Fishwick
- Centre for Workplace Health and the University of Sheffield, Sheffield, UK
| | - Julian Crane
- Wellington Asthma Research Group, Department of Medicine, University of Otago, Wellington, New Zealand
| | - G Ian Town
- University of Canterbury, Christchurch, New Zealand
| | - Michael J Epton
- Department of Medicine, University of Otago, Christchurch, New Zealand.,Canterbury Respiratory Research Group, Christchurch Hospital, Christchurch, New Zealand
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Higher hair nicotine level in children compared to mother living with smoking father in Malaysia. Environ Health Prev Med 2016; 21:572-578. [PMID: 27770244 DOI: 10.1007/s12199-016-0584-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 10/13/2016] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The objectives of this study are to determine parental and children's hair nicotine levels, their relationships as well as to investigate the association of smoking status of the fathers with mothers' and children's hair nicotine. METHODS A cross-sectional study design was conducted among 124 families who were participants of the Universiti Sains Malaysia Pregnancy Cohort Study. Both parents with their 2 years old children joined this study. A total of 92 hair samples of fathers, 124 hair samples of mothers and 111 hair samples of children were collected and analyzed by gas chromatography-mass spectrometry. RESULTS Of total, 52.4 % of the fathers reported smoking. None of the mothers were smokers. Hair nicotine levels of fathers were found to be significantly correlated with mothers (r = 0.233, p = 0.026) and children (r = 0.508, p < 0.001). Children living with smoking fathers had significantly higher median hair nicotine level compared to the children of non-smoking fathers (6.08 vs 0.22 ng/mg, p = 0.046). However, this association was not seen in the mothers. Quantile regression showed significant association between fathers' and children's hair nicotine. CONCLUSION There is a positive relationship between fathers' hair nicotine with mother's and children's hair nicotine. Living with smoking fathers can contribute to higher hair nicotine levels in children but not in mothers.
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Kleinjan M, Engels RCME, DiFranza JR. Parental smoke exposure and the development of nicotine craving in adolescent novice smokers: the roles of DRD2, DRD4, and OPRM1 genotypes. BMC Pulm Med 2015; 15:115. [PMID: 26449981 PMCID: PMC4599744 DOI: 10.1186/s12890-015-0114-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 09/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Among adolescent novice smokers, craving is often the first, and is the most reported, symptom of nicotine dependence. Until now, little has been known about the development of craving symptoms in novice smokers. The aim of this study was to identify specific genetic (i.e., DRD2 Taq1A, DRD4 48 bp VNTR, and OPRM1 A118G polymorphisms) and environmental mechanisms that underlie the emergence of both cue-induced and cognitive craving among adolescent novice smokers. METHOD A five-wave longitudinal, genetically-informed survey study was conducted with intervals of four months. The sample included 376 early adolescent smokers (12-13 years of age at baseline). Self-report questionnaires were completed regarding smoking behavior, observed parental smoking behavior, and both cue-induced and cognitive craving. RESULTS Data were analyzed with a latent growth curve approach. For both cue-induced and cognitive craving, significant interaction effects were found for DRD2 Taq1A with parental smoke exposure. A1-allele carriers did not seem to be influenced by the environment with regard to craving development. Adolescents who are homozygous for the A2-allele and who are more exposed to parental smoking experience the highest levels of both types of craving over time. No significant interaction effects were found between parental smoke exposure and DRD4 48 bp VNTR or OPRM1 A118G. CONCLUSIONS Previous studies identified DRD2 Taq1A A1-allele carriers as vulnerable to developing nicotine dependence. However, this study showed that parental smoking increased the chances of developing dependence more rapidly for early adolescents who are considered to be less sensitive to the rewarding effects of nicotine according to their DRD2 Taq1A genotype. It is thus especially important that these young people not be exposed to smoking in their social environment.
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Affiliation(s)
- Marloes Kleinjan
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Da Costakade 45, 3521 VS, Utrecht, The Netherlands.
| | - Rutger C M E Engels
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Da Costakade 45, 3521 VS, Utrecht, The Netherlands.
- Behavioural Science Institute, Radboud University Nijmegen, Montessorilaan 3, 6525 HR, Nijmegen, The Netherlands.
| | - Joseph R DiFranza
- University of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA, 01655, USA.
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Transgenerational exposure to environmental tobacco smoke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:7261-74. [PMID: 25032741 PMCID: PMC4113874 DOI: 10.3390/ijerph110707261] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/07/2014] [Accepted: 07/08/2014] [Indexed: 11/17/2022]
Abstract
Traditionally, nicotine from second hand smoke (SHS), active or passive, has been considered the most prevalent substance of abuse used during pregnancy in industrialized countries. Exposure to environmental tobacco smoke (ETS) is associated with a variety of health effects, including lung cancer and cardiovascular diseases. Tobacco is also a major burden to people who do not smoke. As developing individuals, newborns and children are particularly vulnerable to the negative effects of SHS. In particular, prenatal ETS has adverse consequences during the entire childhood causing an increased risk of abortion, low birth weight, prematurity and/or nicotine withdrawal syndrome. Over the last years, a decreasing trend in smoking habits during pregnancy has occurred, along with the implementation of laws requiring smoke free public and working places. The decrease in the incidence of prenatal tobacco exposure has usually been assessed using maternal questionnaires. In order to diminish bias in self-reporting, objective biomarkers have been developed to evaluate this exposure. The measurement of nicotine and its main metabolite, cotinine, in non-conventional matrices such as cord blood, breast milk, hair or meconium can be used as a non-invasive measurement of prenatal SMS in newborns. The aim of this review is to highlight the prevalence of ETS (prenatal and postnatal) using biomarkers in non-conventional matrices before and after the implementation of smoke free policies and health effects related to this exposure during foetal and/or postnatal life.
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Saffari A, Daher N, Ruprecht A, De Marco C, Pozzi P, Boffi R, Hamad SH, Shafer MM, Schauer JJ, Westerdahl D, Sioutas C. Particulate metals and organic compounds from electronic and tobacco-containing cigarettes: comparison of emission rates and secondhand exposure. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2014; 16:2259-67. [PMID: 25180481 DOI: 10.1039/c4em00415a] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In recent years, electronic cigarettes have gained increasing popularity as alternatives to normal (tobacco-containing) cigarettes. In the present study, particles generated by e-cigarettes and normal cigarettes have been analyzed and the degree of exposure to different chemical agents and their emission rates were quantified. Despite the 10-fold decrease in the total exposure to particulate elements in e-cigarettes compared to normal cigarettes, specific metals (e.g. Ni and Ag) still displayed a higher emission rate from e-cigarettes. Further analysis indicated that the contribution of e-liquid to the emission of these metals is rather minimal, implying that they likely originate from other components of the e-cigarette device or other indoor sources. Organic species had lower emission rates during e-cigarette consumption compared to normal cigarettes. Of particular note was the non-detectable emission of polycyclic aromatic hydrocarbons (PAHs) from e-cigarettes, while substantial emission of these species was observed from normal cigarettes. Overall, with the exception of Ni, Zn, and Ag, the consumption of e-cigarettes resulted in a remarkable decrease in secondhand exposure to all metals and organic compounds. Implementing quality control protocols on the manufacture of e-cigarettes would further minimize the emission of metals from these devices and improve their safety and associated health effects.
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Affiliation(s)
- Arian Saffari
- University of Southern California, Department of Civil and Environmental Engineering, Los Angeles, CA, USA.
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Kim S, Jung A. Optimum cutoff value of urinary cotinine distinguishing South Korean adult smokers from nonsmokers using data from the KNHANES (2008-2010). Nicotine Tob Res 2013; 15:1608-16. [PMID: 23509092 DOI: 10.1093/ntr/ntt027] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Cutoff values for distinguishing smokers from nonsmokers have generally been derived from studies in White populations. Even though recent population-based studies have demonstrated that cutoff values can differ by race and ethnicity, few studies have explored cutoff values among Asian populations. We established the cutoff values for urinary cotinine and cotinine:creatinine ratio (CCR) using a nationally representative South Korean adult population sample. METHODS Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2010 with pooled sampling weights. Adult participants (n = 11,629) aged ≥19 were included. Optimal cutoff values were determined by performing receiver operating characteristic curve analysis. RESULTS The optimum cutoff values for urinary cotinine and CCR for Korean adults were found to be 164ng/mL and 1122ng/mg, respectively. The application of these urinary cotinine and CCR cutoff values for the female subpopulations aged 19-34, 35-54, and ≥55 years provided sensitivities ranging from 87.1% to 93.8% and from 82.9% to 94.9%, respectively, while maintaining specificity of ≥92%. For the 3 male age-based subpopulations, we obtained sensitivities and specificities for cotinine ranging from 93.1% to 94.5% and from 92.8% to 97.0%, respectively, and for CCR ranging from 90.0% to 96.9% and from 92.2% to 96.8%, respectively. CONCLUSIONS Our cutoff values should allow researchers conducting environmental epidemiological or clinical studies in South Korea to distinguish adult smokers from nonsmokers effectively. However, different values may be applicable for subpopulations with different smoking prevalence rates or higher exposure levels to secondhand smoke.
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Affiliation(s)
- Sungroul Kim
- Department of Environmental Health Sciences, Soonchunhyang University, Asan, South Korea.
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Rashid H, Booy R. Passive smoking, invasive meningococcal disease and preventive measures: a commentary. BMC Med 2012; 10:160. [PMID: 23228079 PMCID: PMC3568012 DOI: 10.1186/1741-7015-10-160] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 12/10/2012] [Indexed: 11/12/2022] Open
Abstract
Active smoking is a recognized risk factor of various infectious diseases. In a systematic review published in BMC Public Health, Murray et al. demonstrated that exposure to passive smoking significantly increased the risk of meningococcal disease among children. Their review especially highlights that the risk remains high even if the exposure occurs during pregnancy or after birth, although the authors could not disentangle the independent effects of smoking during pregnancy from those in the postnatal period. How passive smoking increases the risk of childhood meningococcal disease is not precisely known. Both exposure to 'smoke', or 'smokers' (who are highly susceptible to pharyngeal carriage of meningococci) are postulated mechanisms, but unfortunately very few studies have examined the risk of exposure by considering these two variables separately, and this therefore remains a research priority. Quitting may well be the mainstay of preventing tobacco-related hazards but the available global data suggest that most smokers are reluctant to quit. Among other interventions, immunizing children with a meningococcal conjugate vaccine could, theoretically, reduce the risk of meningococcal disease among children and their smoker household contacts through herd immunity. See related article http://www.biomedcentral.com/1471-2458/12/1062
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Affiliation(s)
- Harunor Rashid
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead and The University of Sydney, New South Wales, Australia
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Chiang HC, Huang YK, Chen PF, Chang CC, Wang CJ, Lin P, Lee HL. 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone is correlated with 8-hydroxy-2'-deoxyguanosine in humans after exposure to environmental tobacco smoke. THE SCIENCE OF THE TOTAL ENVIRONMENT 2012; 414:134-139. [PMID: 22138374 DOI: 10.1016/j.scitotenv.2011.11.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 11/14/2011] [Accepted: 11/14/2011] [Indexed: 05/31/2023]
Abstract
Cigarette smoking and exposure to environmental tobacco smoke (ETS) are important risk factors for many cancers. However, exposure doses have usually not been quantitatively assessed in human studies. In humans 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronate conjugate (defined as total NNAL) are the major metabolites of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone, a cigarette-specific carcinogen. Although animal studies have shown that exposure to cigarette smoke increases tissue oxidative DNA damage, the relationship between cigarette smoke and 8-hydroxydeoxyguanosine (8-OHdG) is not consistent in human studies. In the present study, we have developed a simple, sensitive, and robust LC-MS/MS method for quantifying total NNAL and 8-OHdG concentrations in human plasma. We quantified total NNAL and 8-OHdG in plasma as well as 8-OHdG in urine of 121 healthy male subjects. Total NNAL levels were significantly higher in ever-smokers than in never-smokers. Furthermore, total NNAL levels in plasma were increased with numbers of cigarettes smoked per day in ever-smokers. It suggests that total NNAL in plasma is a good biomarker for cigarette smoke exposure. After stratifying by smoking status and adjusting for age, ETS exposure and occupation category, total NNAL was associated with plasma and urinary 8-OHdG in never-smokers, but not in ever-smokers. Since total NNAL levels in nonsmokers represented the ETS exposure, it appears that 8-OHdG levels are dose-dependently correlated with their ETS exposure dose. Furthermore, this correlation supports the hypothesis that oxidative DNA damage is one of major adverse effects induced by ETS exposure in humans.
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Affiliation(s)
- Hung-Che Chiang
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Zhunan, Miaoli County, Taiwan, ROC
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Brčić Karačonji I, Zimić L, Brajenović N, Skender L. Optimisation of a solid-phase microextraction method for the analysis of nicotine in hair. J Sep Sci 2011; 34:2726-31. [DOI: 10.1002/jssc.201100109] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 06/17/2011] [Accepted: 06/25/2011] [Indexed: 11/09/2022]
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Daly JB, Wiggers JH, Burrows S, Freund M. Household smoking behaviours and exposure to environmental tobacco smoke among infants: are current strategies effectively protecting our young? Aust N Z J Public Health 2010; 34:269-73. [PMID: 20618268 DOI: 10.1111/j.1753-6405.2010.00525.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine the prevalence of infant exposure to environmental tobacco smoke (ETS) among infants attending child health clinics in regional NSW; the association between such exposure and household smoking behaviours; and the factors associated with smoking restrictions in households with infants. METHODS Parents completed a computer-based questionnaire and infant urine samples were collected. Information was obtained regarding the smoking behaviours of household members and samples were analysed for cotinine. RESULTS Twenty seven per cent of infants had detectable levels of cotinine. Infant ETS exposure was significantly associated with the smoking status of household members, absence of complete smoking bans in smoking households and having more than one smoker in the home. Smoking households were significantly less likely to have a complete smoking ban in place. CONCLUSIONS This study suggests that a significant proportion of the population group most vulnerable to ETS were exposed. IMPLICATIONS Future efforts to reduce children's exposure to ETS need to target cessation by smoking parents, and smoking bans in households of infants where parents are smokers if desired reductions in childhood ETS-related illness are to be realised.
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Affiliation(s)
- Justine B Daly
- Hunter New England Population Health, New South Wales; The University of Newcastle, New South Wales
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15
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Kim S, Wipfli H, Navas-Acien A, Dominici F, Avila-Tang E, Onicescu G, Breysse P, Samet JM. Determinants of Hair Nicotine Concentrations in Nonsmoking Women and Children: A Multicountry Study of Secondhand Smoke Exposure in Homes. Cancer Epidemiol Biomarkers Prev 2009; 18:3407-14. [DOI: 10.1158/1055-9965.epi-09-0337] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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16
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Preschool children and their mothers are more exposed to paternal smoking at home than school children and their mothers. Clin Chim Acta 2009; 411:72-6. [PMID: 19833114 DOI: 10.1016/j.cca.2009.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Revised: 10/03/2009] [Accepted: 10/05/2009] [Indexed: 11/21/2022]
Abstract
BACKGROUND Exposure to secondhand smoke (SHS) is a major risk to human health, and the home is the greatest single source of SHS in children. Here, the authors assessed SHS exposure of children and mothers by paternal smoking at home, and investigated how different this exposure is according to smoking location and children's age. METHODS Two hundred-five families were enrolled in this study as trios of fathers, mothers, and children. Nicotine concentrations in hair were measured using liquid chromatography-tandem mass spectrometry to determine long-term exposure to SHS. RESULTS Differences between the smoker group and nonsmoker group in nicotine levels were statistically significant in both children and their mothers. However, difference between the indoor-smoker group and outdoor-smoker group was marginally significant in children and was not significant in their mothers. In the indoor-smoker group, preschool children and their mothers had nicotine concentrations about twice as high as school children and their mothers, respectively. In the outdoor-smoker group, however, differences between two age groups in nicotine levels were significant in preschool children, but not their mothers. CONCLUSION These findings indicate that paternal smoking at home leads to significant exposure to SHS in their children and spouses, which is not completely prevented by smoking outside. Especially, preschool children and their mothers appear to be most at risk for SHS exposure among nonsmoking household members.
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17
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Biological matrices for the evaluation of exposure to environmental tobacco smoke during prenatal life and childhood. Anal Bioanal Chem 2009; 396:379-99. [DOI: 10.1007/s00216-009-2831-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Revised: 04/26/2009] [Accepted: 04/30/2009] [Indexed: 10/20/2022]
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18
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Lee HL, Hsueh YM, Chung CJ, Pu YS, Chang LW, Hsieh DPH, Liou SH, Lin P. Correlation between the Urine Profile of 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanone Metabolites and N7-Methylguanine in Urothelial Carcinoma Patients. Cancer Epidemiol Biomarkers Prev 2008; 17:3390-5. [DOI: 10.1158/1055-9965.epi-08-0761] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Rumchev K, Jamrozik K, Stick S, Spickett J. How free of tobacco smoke are 'smoke-free' homes? INDOOR AIR 2008; 18:202-208. [PMID: 18336533 DOI: 10.1111/j.1600-0668.2008.00517.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
UNLABELLED The risks of exposure to environmental tobacco smoke (ETS) are well established and 'harm reduction' strategies such as smoking outside to protect infants and children from exposure to ETS have been advocated for some time. The aim of this study was to assess the validity of self-reported smoking levels in residential settings. The participants were families (n = 92) randomly selected from lower socioeconomic areas of Perth, Western Australia. Each household was monitored for vapor phase nicotine and particulates with an aerodynamic diameter of < or = 10 microm (PM(10)). Of the 42% (39) households who reported that someone smoked cigarettes at home, only four (4%) said that smoking occurred inside the house. There was a 'moderate' agreement between parental-reported tobacco smoking and levels of nicotine (kappa = 0.55, P < 0.01). There were significant differences in the median levels of air nicotine (P < 0.01) and PM(10) (P < 0.05) between households in which smoking was reported as only occurring outside, and the smoke-free households. PRACTICAL IMPLICATIONS The study outcome suggests that a strategy based on the separation of children and smoking activity is inadequate to protect the former from ETS at home, and that health professionals should give parents unambiguous advice to give up smoking in order to make their homes a completely smoke-free environment.
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Affiliation(s)
- K Rumchev
- School of Public Health, Curtin University of Technology, Perth, Western Australia, Australia.
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20
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Stepanov I, Hecht SS, Lindgren B, Jacob P, Wilson M, Benowitz NL. Relationship of human toenail nicotine, cotinine, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol to levels of these biomarkers in plasma and urine. Cancer Epidemiol Biomarkers Prev 2007; 16:1382-6. [PMID: 17627002 DOI: 10.1158/1055-9965.epi-07-0145] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Recently, we developed sensitive and quantitative methods for analysis of the biomarkers of tobacco smoke exposure nicotine, cotinine, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in human toenails. In this study, we further evaluated the newly developed toenail biomarkers by investigating their relationship to demographic factors, reported exposure, plasma nicotine, cotinine, and trans-3'-hydroxycotinine, and urinary NNAL. Toenails of 105 smokers, mean age 38.9 years (range, 19-68), were analyzed. Fifty-five (53.4%) were male, with approximately equal numbers of Whites and African-Americans. The average number of cigarettes smoked per day was 18 (range, 5-50). There was no effect of age or gender on the toenail biomarkers. Toenail NNAL was higher in White than in African-American participants (P = 0.019). Toenail nicotine and toenail cotinine correlated significantly with cigarettes smoked per day (r = 0.24; P = 0.015 and r = 0.26; P = 0.009, respectively). Toenail nicotine correlated with plasma nicotine (r = 0.39; P < 0.001); toenail cotinine correlated with plasma cotinine (r = 0.45; P < 0.001) and plasma trans-3'-hydroxycotinine (r = 0.30; P = 0.008); and toenail NNAL correlated with urine NNAL (r = 0.53; P = 0.005). The results of this study provide essential validation data for the use of toenail biomarkers in investigations of the role of chronic tobacco smoke exposure in human cancer.
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Affiliation(s)
- Irina Stepanov
- The Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA.
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Yang J, Hu Y, Cai JB, Zhu XL, Su QD, Hu YQ, Liang FX. Selective hair analysis of nicotine by molecular imprinted solid-phase extraction: An application for evaluating tobacco smoke exposure. Food Chem Toxicol 2007; 45:896-903. [PMID: 17222493 DOI: 10.1016/j.fct.2006.11.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2005] [Revised: 05/18/2006] [Accepted: 11/20/2006] [Indexed: 10/23/2022]
Abstract
A method using a molecularly imprinted polymer (MIP) as the selective sorbent for solid-phase extraction (SPE) has been developed. Its application to the assay of hairy nicotine level among smokers and non-smokers with high-performance liquid chromatography (HPLC) and evaluation of exposures to the environmental tobacco smoke (ETS) were validated. The MIP was synthesized using nicotine as the template molecule and methacrylic acid (MAA) as the functional monomer. This MIP-SPE method provided inherent selectivity and a sensitive response to nicotine with a detection limit of 0.2 ng/ml hair at a signal-to-noise ratio of 3:1 and the limit of quantification was 0.5 ng/ml. The linearity was assessed in the range of 0.5-80 ng/ml hair, with a coefficient (r(2)) greater than 0.987. The amounts of nicotine determined in smokers and non-smokers hair were in the range of 5.1-69.5 ng/mg hair and 0.50-9.3 ng/mg hair, respectively. The reported measures of ETS exposure were significantly associated with hairy nicotine levels. This assay of nicotine in hair using MISPE provided a very selective and reliable method for the evaluation of the exposure to tobacco smoke.
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Affiliation(s)
- J Yang
- Department of Chemistry, University of Science and Technology of China, Hefei 230026, PR China
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Stepanov I, Feuer R, Jensen J, Hatsukami D, Hecht SS. Mass spectrometric quantitation of nicotine, cotinine, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol in human toenails. Cancer Epidemiol Biomarkers Prev 2007; 15:2378-83. [PMID: 17164359 DOI: 10.1158/1055-9965.epi-06-0265] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Numerous studies have quantified total cotinine (the sum of cotinine and cotinine-N-glucuronide) and total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol [NNAL; the sum of NNAL and its O- and N-glucuronides (NNAL-Glucs)] in the urine and blood of smokers, smokeless tobacco users, and nonsmokers exposed to environmental tobacco smoke. Analysis of hair and nails has several advantages over blood and urine testing, such as accumulation of xenobiotics during long-term exposure, ease of collection, and indefinite stability of samples. We developed sensitive methods for quantitation of nicotine, cotinine, and NNAL in human toenails. Nicotine and cotinine were analyzed by gas chromatography-mass spectrometry-selected ion monitoring. NNAL was assayed using liquid chromatography-electrospray ionization-tandem mass spectrometry-selected reaction monitoring. The detection limits of the methods were 0.01 ng/mg toenail for nicotine, 0.012 ng/mg toenail for cotinine, and 0.02 pg/mg toenail for NNAL. In 35 smokers, the mean nicotine level was 5.9 +/- 5.6 ng/mg toenail, mean cotinine was 1.6 +/- 1.3 ng/mg toenail, and mean NNAL was 0.41 +/- 0.67 pg/mg toenail. Samples collected from six nonsmokers were negative for NNAL. In smokers, NNAL correlated with cotinine (r = 0.77; P < 0.0001). The results of this study for the first time show the presence of cotinine and NNAL in human toenails. These sensitive and quantitative methods should be useful in epidemiologic studies of the role of chronic tobacco smoke exposure, including environmental tobacco smoke exposure, in human cancer.
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Affiliation(s)
- Irina Stepanov
- The Cancer Center, University of Minnesota, Mayo Mail Code 806, 420 Delaware Street Southeast, Minneapolis, MN 55455, USA.
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Sørensen M, Bisgaard H, Stage M, Loft S. Biomarkers of exposure to environmental tobacco smoke in infants. Biomarkers 2007; 12:38-46. [PMID: 17438652 DOI: 10.1080/13547500600943148] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Non-invasive biomonitoring of exposure to environmental tobacco smoke (ETS) by means of hair is attractive in children, although systematic evaluation is required in infants. The objective was to compare nicotine and cotinine concentrations in hair and plasma and parentally reported exposure to ETS in a birth cohort of 411 infants. Plasma was collected from 356 six-month-old infants and hair samples were collected from 368 one-year-old infants. Concentrations of nicotine and cotinine were measured by an optimized gas chromatography-mass spectrometry (GC/MS)-based method requiring 4 mg hair or 200 microl plasma. Information was obtained on the number of days with ETS exposure during the first year of life, the smoking habits of the parents, and the number of cigarettes smoked per day in the home. All three parentally reported indices of ETS exposure were significantly associated with the biomarkers, with clear dose response relationships. There was a significant association between days with ETS exposure and nicotine in hair at relatively low exposure levels (10-99 days per year), whereas the other biomarkers only showed significant increases at higher exposure levels. In conclusion, nicotine in hair appears to be the biomarker most strongly associated with parental reports on exposure to ETS in infants.
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Affiliation(s)
- M Sørensen
- Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
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24
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Thomson G, Wilson N, Howden-Chapman P. Population level policy options for increasing the prevalence of smokefree homes. J Epidemiol Community Health 2006; 60:298-304. [PMID: 16537345 PMCID: PMC2577370 DOI: 10.1136/jech.2005.038091] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To identify and evaluate the options for population level government policies to increase the prevalence of homes free of secondhand smoke. METHODS The literature was searched for population level policy options and evidence on them. Three criteria were used to evaluate the policy options: effectiveness, the reductions on inequalities in secondhand smoke exposure, and cost effectiveness. The setting was four developed, English speaking jurisdictions: Britain, USA, Australia, and New Zealand. RESULTS Evidence from all four countries shows some association between relatively comprehensive tobacco control programmes and lower prevalence levels of smoking in homes. The evidence of the effect of such programmes on inequalities in smokefree home prevalence is limited. No published evidence was found of the cost effectiveness of the programmes in achieving changes in smokefree homes. Within comprehensive programmes, there is some indirect evidence that some mass media campaigns could increase the prevalence of smokefree homes. Structural options that have potential to support smokefree homes include smokefree places legislation, and laws for the protection of children. CONCLUSION The available evidence to date suggests that comprehensive tobacco control programmes (to reduce the prevalence of smoking in the total population) are likely to be the most effective and sustainable option for increasing the prevalence of smokefree homes.
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Affiliation(s)
- George Thomson
- Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington South, New Zealand.
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25
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Ryu HJ, Seong MW, Nam MH, Kong SY, Lee DH. Simultaneous and sensitive measurement of nicotine and cotinine in small amounts of human hair using liquid chromatography/tandem mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2006; 20:2781-2. [PMID: 16921558 DOI: 10.1002/rcm.2659] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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Spencer N, Blackburn C, Bonas S, Coe C, Dolan A. Parent reported home smoking bans and toddler (18-30 month) smoke exposure: a cross-sectional survey. Arch Dis Child 2005; 90:670-4. [PMID: 15970606 PMCID: PMC1720498 DOI: 10.1136/adc.2004.054684] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIMS To study the relation between the use of parent reported home smoking bans and smoke exposure among children aged 18-30 months. METHODS A total of 309 smoking households with children aged 18-30 months, who were part of the Coventry Cohort study, consented to participate in this cross-sectional survey. RESULTS Although parents in almost 88% of smoking households reported using harm reduction strategies to protect their toddlers from smoke exposure, only 13.9% reported smoking bans in the house. Mean log urinary cotinine:creatinine ratio was significantly lower for those children whose parents reported no smoking in the house (1.11, 95% CI 0.64 to 1.49) compared with none/less strict strategies (1.87, 95% CI 1.64 to 2.10). In linear regression models fitted on log cotinine:creatinine ratio, no smoking in the house was independently associated with a significant reduction in cotinine:creatinine ratio (B = -0.55, 95% CI -0.89 to -0.20) after adjusting for mother's and partner's average daily cigarette consumption, housing tenure, and overcrowding. The final model accounted for 44.3% of the variance. CONCLUSIONS Not smoking in the house was associated with a reduction in mean urinary cotinine:creatinine ratio in children aged 18-30 months; the relation persisted after adjustment for levels of mother's and partner's daily cigarette consumption and sociodemographic factors. Results suggest that home smoking bans in this age group have a small but significant effect on smoke exposure independent of levels of parental tobacco consumption.
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Affiliation(s)
- N Spencer
- School of Health and Social Studies, University of Warwick, UK.
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Wilson SE, Kahn RS, Khoury J, Lanphear BP. Racial differences in exposure to environmental tobacco smoke among children. ENVIRONMENTAL HEALTH PERSPECTIVES 2005; 113:362-7. [PMID: 15743729 PMCID: PMC1253766 DOI: 10.1289/ehp.7379] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2004] [Accepted: 12/09/2004] [Indexed: 05/24/2023]
Abstract
Exposure to environmental tobacco smoke (ETS) is a major cause of morbidity and mortality among U.S. children. Despite African-American children's having a lower reported exposure to tobacco compared to whites, they suffer disproportionately from tobacco-related illnesses and have higher levels of serum cotinine than white children. The goal of this study was to test whether African-American children have higher levels of serum and hair cotinine, after accounting for ETS exposure and various housing characteristics. We investigated the level of cotinine in both hair and serum in a sample of 222 children with asthma. Using a previously validated survey for adult smokers, we assessed each child's exposure to ETS. We collected detailed information on the primary residence, including home volume, ventilation, and overall home configuration. Despite a lower reported ETS exposure, African-American children had higher mean levels of serum cotinine (1.41 ng/mL vs. 0.97 ng/mL; p = 0.03) and hair cotinine (0.25 ng/mg vs. 0.07 ng/mg; p < 0.001) compared with white children. After adjusting for ETS exposure, housing size, and other demographic characteristics, serum and hair cotinine levels remained significantly higher in African-American children (ss = 0.34, p = 0.03) than in white children (ss = 1.06, p < 0.001). Housing volume was significantly associated with both serum and hair cotinine but did not fully explain the race difference. Our results demonstrate that, despite a lower reported exposure to ETS, African-American children with asthma had significantly higher levels of both serum and hair cotinine than did white children. Identifying causes and consequences of increased cotinine may help explain the striking differences in tobacco-related illnesses.
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Affiliation(s)
- Stephen E Wilson
- Division of General Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
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Matt GE, Quintana PJE, Hovell MF, Bernert JT, Song S, Novianti N, Juarez T, Floro J, Gehrman C, Garcia M, Larson S. Households contaminated by environmental tobacco smoke: sources of infant exposures. Tob Control 2004; 13:29-37. [PMID: 14985592 PMCID: PMC1747815 DOI: 10.1136/tc.2003.003889] [Citation(s) in RCA: 287] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To examine (1) whether dust and surfaces in households of smokers are contaminated with environmental tobacco smoke (ETS); (2) whether smoking parents can protect their infants by smoking outside and away from the infant; and (3) whether contaminated dust, surfaces, and air contribute to ETS exposure in infants. DESIGN Quasi-experiment comparing three types of households with infants: (1) non-smokers who believe they have protected their children from ETS; (2) smokers who believe they have protected their children from ETS; (3) smokers who expose their children to ETS. SETTING Homes of smokers and non-smokers. PARTICIPANTS Smoking and non-smoking mothers and their infants < or = 1 year. MAIN OUTCOME MEASURES ETS contamination as measured by nicotine in household dust, indoor air, and household surfaces. ETS exposure as measured by cotinine levels in infant urine. RESULTS ETS contamination and ETS exposure were 5-7 times higher in households of smokers trying to protect their infants by smoking outdoors than in households of non-smokers. ETS contamination and exposure were 3-8 times higher in households of smokers who exposed their infants to ETS by smoking indoors than in households of smokers trying to protect their children by smoking outdoors. CONCLUSIONS Dust and surfaces in homes of smokers are contaminated with ETS. Infants of smokers are at risk of ETS exposure in their homes through dust, surfaces, and air. Smoking outside the home and away from the infant reduces but does not completely protect a smoker's home from ETS contamination and a smoker's infant from ETS exposure.
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Affiliation(s)
- G E Matt
- Department of Psychology, San Diego State University, San Diego, California 92182-4611, USA.
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Chetiyanukornkul T, Toriba A, Kizu R, Kimura K, Hayakawa K. Hair analysis of nicotine and cotinine for evaluating tobacco smoke exposure by liquid chromatography-mass spectrometry. Biomed Chromatogr 2004; 18:655-61. [PMID: 15386502 DOI: 10.1002/bmc.369] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A simple liquid chromatography-electrospray ionization mass spectrometry (LC-ESI-MS) method for the determination of nicotine and cotinine in human hair was established. In the procedure, a hair sample (10 mg) was washed with dichloromethane and digested in 2.5 M sodium hydroxide. The digest was extracted with dichloromethane and then 25 mM hydrochloric acid in methanol was added to the extract, to prevent loss of analytes. The solution was evaporated and redissolved in the mobile phase, methanol/10 mM ammonium acetate (30/70, v/v). A 20 microL aliquot of redissolved solution was subjected to analysis. Nicotine and cotinine in human hair were quantified by using deuterated analytes as internal standards. The quantification limits were 8 microg/L for nicotine and 0.9 microg/L for cotinine. The proposed method was applied to measure the concentrations of nicotine and cotinine in hair of smokers and non-smokers to evaluate their self-reported smoking and exposure to environmental tobacco smoke. In both cases, the method provided good selectivity, accuracy and precision.
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Affiliation(s)
- Thaneeya Chetiyanukornkul
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan
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den Exter Blokland EAW, Engels RCME, Hale WW, Meeus W, Willemsen MC. Lifetime parental smoking history and cessation and early adolescent smoking behavior. Prev Med 2004; 38:359-68. [PMID: 14766120 DOI: 10.1016/j.ypmed.2003.11.008] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Associations are examined between parental smoking and smoking onset by their children. Smoking parents are more likely to have children who start smoking in their teenage years; however, less is known about whether parental quitting is related to adolescent smoking. METHODS A cross-sectional national sample of 2,206 adolescents, ages 10-14 years, living in two-parent households were interviewed for the DEFACTO annual report on Dutch youth smoking behavior. Adolescent smokers reported that they have tried smoking, even one puff. Respondents indicated whether their parents were never, former, or current smokers, and provided, in the case a parent had quit, their age at that time. RESULTS Logistic regression analyses revealed that likelihood increased gradually: adolescents with both parents being current smokers were four times more likely to be a smoker compared to adolescents with parents who had never smoked. Additionally, within the group of adolescents whose parents quit smoking, the findings demonstrated that the earlier the parents stopped smoking in the life of their offspring, the less likely their children were to start smoking in adolescence. CONCLUSIONS Parental smoking history is associated with smoking initiation in early adolescence. Parental cessation at an early age of their offspring reduces the likelihood of adolescent smoking initiation. Preventive efforts, therefore, should focus on the benefits of parental cessation as early as possible.
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Abstract
This article provides an overview of the hair nicotine biomarker for assessment of exposure to tobacco smoke, with emphasis on environmental tobacco smoke (ETS). Measurement of nicotine in hair can be an informative tool for research looking at ETS and related illnesses. There are still unresolved issues in relation to this biomarker such as influence of hair treatment, hair colour, and growth rate on nicotine levels in hair, which need to be addressed in order to further refine this biomarker for exposure assessment. Nevertheless, hair nicotine promises to be a valid and reliable measure of longer term exposure that can be readily applied in epidemiological studies of exposure to tobacco smoke, and more specifically ETS, and its risk to health.
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Affiliation(s)
- W K Al-Delaimy
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
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