1
|
Cham B, Mdege ND, Bauld L, Britton J, D’Alessandro U. Exposure to Second-Hand Smoke in Public Places and Barriers to the Implementation of Smoke-Free Regulations in The Gambia: A Population-Based Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6263. [PMID: 34207895 PMCID: PMC8296069 DOI: 10.3390/ijerph18126263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/14/2021] [Accepted: 04/23/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Second-hand smoke is associated with more than 1.2 million deaths per year among non-smokers. Smoking in public places is prohibited in The Gambia but there is no information on the level of exposure to second-hand smoke among adolescents and adults 15-64 years. The aim of this study was to assess the level and predictors of exposure to second-hand smoke in public places and compliance with smoke-free regulations in The Gambia. METHODS A population-based survey was conducted in an established Health and Demographic Surveillance System (HDSS). A total of 4547 participants (15-64 years) from households within the Farafenni HDSS were interviewed at their homes but only 3343 were included in our analysis. Factors associated with exposure to second-hand smoke in public places were assessed by three different multivariable regression models. RESULTS Exposure to tobacco smoke in public places was high (66.1%), and higher in men (79.9%) than women (58.7%). Besides being male, less education, lower household income, urban residence and not aware of smoke-free regulations were strongly associated with exposure to second-hand smoke. CONCLUSION Despite existing smoke-free regulations, reported exposure to second-hand smoke remains high in public places in The Gambia. The Ministry of Health should continue to strengthen their advocacy and sensitization programs to ensure smoke-free regulations are fully implemented. Some population subgroups are at a higher risk of exposure and could be targeted by interventions; and settings where these subgroups are exposed should be targeted by enforcement efforts.
Collapse
Affiliation(s)
- Bai Cham
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Atlantic Road, Fajara, P.O. Box 273 Banjul, The Gambia;
| | | | - Linda Bauld
- Usher Institute and SPECTRUM Consortium, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh EH 8 9AG, UK;
| | - John Britton
- UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham NG5 1PB, UK;
| | - Umberto D’Alessandro
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Atlantic Road, Fajara, P.O. Box 273 Banjul, The Gambia;
| |
Collapse
|
2
|
Association Between the Location of Secondhand Smoke Exposure and Depressive Symptoms among South Korean Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145116. [PMID: 32679863 PMCID: PMC7400535 DOI: 10.3390/ijerph17145116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/09/2020] [Accepted: 07/11/2020] [Indexed: 12/27/2022]
Abstract
The incidence of depression among adolescents has gradually increased, leading to adult psychological outcomes and suicide. Although the rate of secondhand smoke exposure (SHSE) has recently decreased, SHSE remains high in children. We aimed to determine the association between depressive symptoms in adolescents and the locations of SHSE using an extensive population survey. Using data from the 14th Korea Youth Risk Behavior Web-based Survey, we assessed self-reported data of depressive symptoms and SHSE among non-smokers. SHSE locations were classified into four groups: only at school, only at home, at both school and home, and other places. Multiple logistic regression analysis was performed to identify the associations between SHSE locations and depressive symptoms. The relationship between SHSE and depressive symptoms was the highest in the “SHSE at home and school” group (boys: odds ratio [OR] = 1.61, 95% confidence interval [CI] = 1.44–1.80; girls: OR = 1.72, 95% CI = 1.54–1.91), followed by the “school” (boys: OR = 1.53, 95% CI = 1.39–1.67; girls: OR = 1.36, 95% CI = 1.25–1.48) and “home” groups (boys: OR = 1.23, 95% CI = 1.12–1.35; girls: OR = 1.30, 95% CI = 1.20–1.40). These results emphasize the importance of stricter smoking regulations not only in public places, but also in households. Adolescents and their families should be educated on the dangers of smoking and the effects of SHSE on mental health.
Collapse
|
3
|
Jacob L, Smith L, Jackson SE, Haro JM, Shin JI, Koyanagi A. Secondhand Smoking and Depressive Symptoms Among In-School Adolescents. Am J Prev Med 2020; 58:613-621. [PMID: 32059988 DOI: 10.1016/j.amepre.2019.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Smoking has been linked with depressive symptoms in adolescents, but data on secondhand smoking and depressive symptoms in low- and middle-income countries are scarce. Thus, this study analyzes the association between secondhand smoking and depressive symptoms among in-school adolescents from 22 low- and middle-income countries. METHODS Data from the 2003-2008 Global School-Based Student Health Survey were analyzed in June 2019. Data on past-week exposure to secondhand smoke and past-year depressive symptoms were collected. The association between secondhand smoke and depressive symptoms was studied using multivariable logistic regressions and meta-analyses. RESULTS The sample consisted of 37,505 adolescents aged 12-15 years who never smoked. The prevalence of depressive symptoms increased from 23.0% in adolescents with no secondhand smoking to 28.9% in those with secondhand smoking every day in the past week. After adjusting for sex, age, food insecurity, and country, there was a dose-response relationship between secondhand smoking and depressive symptoms in the overall sample (0 days: reference; 1-2 days: OR=1.06, 95% CI=0.95, 1.18; 3-6 days: OR=1.38, 95% CI=1.20, 1.58; 7 days: OR=1.63, 95% CI=1.44, 1.86). The country-wise analysis showed that secondhand smoking on at least 3 days (versus <3 days) in the past week was associated with a 1.48-fold increase in the odds of depressive symptoms (95% CI=1.39, 1.59), with a low level of between-country heterogeneity (I2=4.2%). CONCLUSIONS There was a positive association between secondhand smoking and depressive symptoms among in-school adolescents from low- and middle-income countries. Further research should investigate causality and assess whether prevention of exposure to secondhand smoke can have a positive effect on the mental well-being of adolescents.
Collapse
Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain.
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; ICREA, Barcelona, Spain
| |
Collapse
|
4
|
Nan X, Lu H, Wu J, Xue M, Guo W, Wang X. Prevalence, knowledge and education level associated with secondhand smoke exposure among never-smoking women in Inner Mongolia, Northern China. Tob Induc Dis 2020; 18:35. [PMID: 32382257 PMCID: PMC7199659 DOI: 10.18332/tid/119162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/12/2020] [Accepted: 03/17/2020] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Currently, 40.7% of women in China are exposed daily to secondhand smoke (SHS); however, research on SHS exposure among women in Inner Mongolia is limited. We aimed to investigate the prevalence of SHS exposure, knowledge about the harms of smoking and SHS, and the association between sociodemographic factors and SHS exposure among never-smoking women in Inner Mongolia, Northern China. METHODS This study was based on a survey of chronic disease and nutrition conducted among Chinese adults in Inner Mongolia during 2015, a cross-sectional study with multi-stage stratified cluster sampling. A total 2293 never-smoking women aged ≥18 years were included in the study. Face-to-face interviews were used to collect data of sociodemographic characteristics, SHS exposure, and related knowledge. Questionnaires were administered by trained investigators, and the reliability and validity of the questionnaires were high. We performed descriptive analysis and logistic regression. All analyses were performed by IBM SPSS Statistics version 19.0. RESULTS Of the total, 69% of young women in Inner Mongolia in 2015 reported that they were exposed to SHS, the highest rate in comparison with older and middle-aged women. A total 49.90% of young women reported being exposed to SHS every day. Respondents had insufficient knowledge regarding smoking and SHS exposure. Compared with older never-smoking women, their young counterparts had a higher risk of SHS exposure, with an odds ratio of 2.143 (95% CI: 1.647–2.787). Education level and ethnicity were also significantly associated with SHS exposure. CONCLUSIONS This study showed that the highest rates of SHS exposure were among young never-smoking women in Inner Mongolia, and women with high education levels were less likely to be exposed to SHS. Improved public health information is needed that prioritizes SHS exposure among young women in Inner Mongolia. Health education regarding SHS exposure should be widely implemented throughout communities in this region.
Collapse
Affiliation(s)
- Xi Nan
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, China.,Contributed equally
| | - Haiwen Lu
- Department of Medical Imaging, Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Medical University, Hohhot, China.,Contributed equally
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mingming Xue
- School of Basic Medical Science, Inner Mongolia Medical University, Hohhot, China
| | - Weidong Guo
- Department of Disease Prevention and Control, Health Commission of Inner Mongolia Autonomous Region, Hohhot, China
| | - Xuemei Wang
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, China.,Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| |
Collapse
|
5
|
Cho HJ. Environmental Tobacco Smoke Can Be an Important Risk Factor for Children's Behavioral Problems, and Policies to Reduce Exposure Are Urgently Required. J Korean Med Sci 2018; 33:e244. [PMID: 30181733 PMCID: PMC6115695 DOI: 10.3346/jkms.2018.33.e244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hong-Jun Cho
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
6
|
Matsuyama Y, Aida J, Tsuboya T, Koyama S, Sato Y, Hozawa A, Osaka K. Social Inequalities in Secondhand Smoke Among Japanese Non-smokers: A Cross-Sectional Study. J Epidemiol 2017; 28:133-139. [PMID: 29093356 PMCID: PMC5821690 DOI: 10.2188/jea.je20160184] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Secondhand smoke (SHS) causes many deaths. Inequalities in SHS have been reported in several countries; however, the evidence in Asian countries is scarce. We aimed to investigate the association between socioeconomic status (SES) and SHS at home and the workplace/school among non-smoking Japanese adults. METHODS Cross-sectional data from the Miyagi Prefectural Health Survey 2014 were analyzed. Self-reported questionnaires were randomly distributed to residents ≥20 years of age and 2,443 (92.8%) responded. The data of the 1,738 and 1,003 respondents were included to the analyses for SHS in the past month at home and at the workplace/school, respectively. Ordered logistic regression models considering possible confounders, including knowledge of the adverse health effects of tobacco, were applied. RESULTS The prevalence of SHS at home and the workplace/school was 19.0% and 39.0%, respectively. Compared with ≥13 years of education, odds ratios (ORs) and 95% confidence intervals (CIs) for SHS at home were 1.94 (95% CI, 1.42-2.64) for 10-12 years and 3.00 (95% CI, 1.95-4.60) for ≤9 years; those for SHS at the workplace/school were 1.80 (95% CI, 1.36-2.39) and 3.82 (95% CI, 2.29-6.36), respectively. Knowledge of the adverse health effects of tobacco was significantly associated with lower SHS at home (OR 0.95; 95% CI, 0.91-0.98) but it was not associated with SHS at the workplace/school (OR 1.02; 95% CI, 0.98-1.06). CONCLUSIONS Social inequalities in SHS existed among Japanese non-smoking adults. Knowledge about tobacco was negatively associated with SHS at home but not at workplace/school.
Collapse
Affiliation(s)
- Yusuke Matsuyama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Toru Tsuboya
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Shihoko Koyama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Yukihiro Sato
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry
| |
Collapse
|
7
|
Milcarz K, Bak-Romaniszyn L, Kaleta D. Environmental Tobacco Smoke Exposure and Smoke-Free Rules in Homes among Socially-Disadvantaged Populations in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E447. [PMID: 28430128 PMCID: PMC5409647 DOI: 10.3390/ijerph14040447] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/05/2017] [Accepted: 04/19/2017] [Indexed: 11/17/2022]
Abstract
This study aims to examine the prevalence of exposure to environmental tobacco smoke (ETS) in homes among socially-disadvantaged populations in Poland, along with the prevalence and correlates of voluntary implementation of smoke-free home rules. Data concerning 1617 respondents from a cross-sectional study completed in the Piotrkowski District were used, which was part of the "Reducing Social Inequalities in Health" program. Overall, 19.4% of the respondents declared exposure to ETS at home. In the non-smokers group, 15.5%, including 6.6% males and 18.3% females, were exposed to ETS in their place of residence (p < 0.0001). Complete smoke-free rules were adopted by 22.1% of the study participants. Two factors, smoker status and lack of ETS-associated health risk awareness, were found to be significantly associated with no adoption of total smoking bans at home. Socially-disadvantaged non-smokers, especially females from rural areas in Poland, still constitute a large population exposed to ETS in their homes-a challenge from the perspective of public health. Focused efforts are required to address social norms around exposing others to ETS.
Collapse
Affiliation(s)
- Katarzyna Milcarz
- Department of Tobacco Control, Preventive Medicine Department, Medical University of Lodz, 90-752 Lodz, Poland.
| | - Leokadia Bak-Romaniszyn
- Department of Nutrition in Digestive Tract Diseases, Medical University of Lodz, 93-338 Lodz, Poland.
| | - Dorota Kaleta
- Department of Tobacco Control, Preventive Medicine Department, Medical University of Lodz, 90-752 Lodz, Poland.
| |
Collapse
|
8
|
Nam GE, Hwang BE, Lee YC, Paik JS, Yang SW, Chun YH, Han K, Park YG, Park SH. Lower urinary cotinine level is associated with a trend toward more myopic refractive errors in Korean adolescents. Eye (Lond) 2017; 31:1060-1067. [PMID: 28282063 DOI: 10.1038/eye.2017.36] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/06/2017] [Indexed: 11/09/2022] Open
Abstract
PurposeTo investigate the association between urinary cotinine levels as an objective biological marker for exposure to nicotine and refractive status.Patients and methodsThis cross-sectional study analyzed data from the Korea National Health and Nutrition Examination Survey between 2008 and 2011. A total of 1139 Korean adolescents aged 12-18 years were enrolled. Urinary cotinine concentrations and other potential risk factors for myopia were examined. Correlation analyses and multivariate regression analysis were performed to investigate the association between urinary cotinine level and refractive error.ResultsSpherical equivalent correlated significantly with urinary cotinine concentration (r=0.104, P=0.011). Lower urinary cotinine level was associated with a trend toward more myopic refractive errors (P for trend=0.003). After adjusting for age, sex, area of residence, physical activity, serum 25-hydroxyvitamin D level, parental income level, and receipt of basic livelihood security, subjects with a low urinary cotinine level had a significantly increased risk of myopia <-0.5 D (odds ratio (OR) 1.95, 95% confidence interval (CI) 1.18-3.21), <-3.0 D (OR 2.03, 95% CI 1.29-3.2), and <-6.0 D (OR 2.2, 95% CI, 1.15-4.23) when compared with subjects with a high urinary cotinine level. As urinary cotinine level decreased, the risks of myopia <-0.5 D, <-3.0 D, and <-6.0 D increased significantly (P for trend <0.05).ConclusionA trend toward less myopic refractive error was observed among Korean adolescents with higher urinary cotinine levels. This result provides the epidemiologic evidence implying nicotine as a potential modulator related with refractive development. Further studies with full consideration for myopia-associated risk factors are required to yield clear answers on the direct effect of smoking to the refractive status.
Collapse
Affiliation(s)
- G E Nam
- Department of Family Medicine, Sahmyook Medical Center, Seoul, Republic of Korea
| | - B E Hwang
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y-C Lee
- Department of Ophthalmology and Visual Science, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J-S Paik
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S-W Yang
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y-H Chun
- Department of Pediatrics, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K Han
- Department of Biostatistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y G Park
- Department of Biostatistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - S H Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | |
Collapse
|
9
|
Fischer F, Kraemer A. Factors associated with secondhand smoke exposure in different settings: Results from the German Health Update (GEDA) 2012. BMC Public Health 2016; 16:327. [PMID: 27080515 PMCID: PMC4832471 DOI: 10.1186/s12889-016-3007-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The ubiquity of secondhand smoke (SHS) exposure at home or in private establishments, workplaces and public areas poses several challenges for the reduction of SHS exposure. This study aimed to describe the prevalence of SHS exposure in Germany and key factors associated with exposure. Results were also differentiated by place of exposure. METHODS A secondary data analysis based on the public use file of the German Health Update 2012 was conducted (n = 13,933). Only non-smokers were included in the analysis. In a multivariable logistic regression model the factors associated with SHS exposure were calculated. In addition, a further set of multivariable logistic regressions were calculated for factors associated with the place of SHS exposure (workplace, at home, bars/discotheques, restaurants, at the house of a friend). RESULTS More than a quarter of non-smoking study participants were exposed to SHS. The main area of exposure was the workplace (40.9 %). The multivariable logistic regression indicated young age as the most important factor associated with SHS exposure. The odds for SHS exposure was higher in men than in women. The likelihood of SHS exposure decreased with higher education. SHS exposure and the associated factors varied between different places of exposure. CONCLUSIONS Despite several actions to protect non-smokers which were implemented in Germany during the past years, SHS exposure still remains a relevant risk factor at a population level. According to the results of this study, particularly the workplace and other public places such as bars and discotheques have to be taken into account for the development of strategies to reduce SHS exposure.
Collapse
Affiliation(s)
- Florian Fischer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, P.O. Box 100 131, 33501, Bielefeld, Germany.
| | - Alexander Kraemer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, P.O. Box 100 131, 33501, Bielefeld, Germany
| |
Collapse
|