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Critselis E, Panagiotakos D. Impact of Electronic Cigarette use on Cardiovascular Health: Current Evidence, Causal Pathways, and Public Health Implications. Angiology 2024; 75:417-424. [PMID: 36913951 DOI: 10.1177/00033197231161905] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Electronic cigarette (e-cigarette) use is increasing in Europe and the USA. While mounting evidence exists regarding an array of associated adverse health effects, to date limited evidence exists regarding the health effects of e-cigarette use on cardiovascular (CV) disease (CVD). The present review summarizes the effects of e-cigarette use on CV health. A search strategy of in vivo experimental, observational studies (including population-based cohort studies), and interventional studies was conducted in PubMed, MEDLINE, and Web of Science (April 1, 2009-April 1, 2022). The main findings revealed that the influence of e-cigarette on health are attributed mainly to the individual and interactive effects of flavors and additives used in e-cigarette fluids, along with the extended heating. The above collectively stimulate prolonged sympathoexcitatory CV autonomic effects, such as increased heart rate and diastolic blood pressure (BP), as well as decreased oxygen saturation. Hence, e-cigarette users are at increased risk of developing atherosclerosis, hypertension, arrhythmia, myocardial infarction, and heart failure. Such risks are anticipated to increase, especially among the young who are increasingly adopting e-cigarette use particularly with flavored additives. Further investigations are urgently needed to evaluate the long-term effects of e-cigarette use, particularly among susceptible population groups such as youth.
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Affiliation(s)
- Elena Critselis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
- Faculty of Health, University of Canberra, Canberra, Australia
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2
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Ji S, Liu Z, Liu P. Effects of the grade/price and thickness of cigarette on the PM2.5 concentration of smoke. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27610-0. [PMID: 37204582 DOI: 10.1007/s11356-023-27610-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 05/09/2023] [Indexed: 05/20/2023]
Abstract
In an attempt to promote sales of high-grade/price and slim cigarettes with lower tar and nicotine content, the State Tobacco Monopoly Administration (STMA) also known as the China National Tobacco Corporation (CNTC), whose monopoly controls all aspects of tobacco production, marketing, and distribution in China, have advertised them as safe cigarettes that cause less tobacco smoke pollution (TSP). However, cigarette smoke contains thousands of harmful components, and the effects of only tar and nicotine cannot be used to represent TSP. This study aimed to evaluate the impact of cigarette grade/price and size on TSP by measuring PM2.5 concentrations for three different grades/prices and two sizes of popular cigarettes in China. The results showed that cigarette grade/price did not significantly affect PM2.5 levels in regular (R) or slim (S) cigarettes in either sidestream or mainstream smoke. However, cigarette size had a significant effect on PM2.5 levels, with R cigarette PM2.5 being 116% higher than S cigarette PM2.5 in sidestream smoke. In mainstream smoke, this difference decreased to 31%, although R-cigarette PM2.5 levels remained higher. While S cigarette PM2.5 levels were lower than those of R cigarettes, this did not necessarily mean that S cigarettes were less harmful. The harmfulness of smoke is not only manifested in PM2.5 but also in other particulate matter such as PM10 and PM1.0. At the same time, it is also affected by smoking habits. Therefore, further experiments are required to evaluate the potential harmfulness of S cigarettes.
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Affiliation(s)
- Shengzhe Ji
- College of Plant Protection, Shandong Agricultural University, No. 61 Daizong Street, Taian, 271018, Shandong Province, Taian, China
| | - Zhen Liu
- Taian City Central Hospital, Taian 271000, Shandong Province, Taian, China
| | - Peng Liu
- College of Plant Protection, Shandong Agricultural University, No. 61 Daizong Street, Taian, 271018, Shandong Province, Taian, China.
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Ostrowska A, Jankowski M, Pinkas J. Public support for car smoking bans in Poland: a 2022 national cross-sectional survey. BMJ Open 2022; 12:e066247. [PMID: 36216427 PMCID: PMC9557322 DOI: 10.1136/bmjopen-2022-066247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE The objectives of this study were to assess the prevalence of self-reported secondhand smoke exposure in cars among adults in Poland and to characterise public attitudes towards the implementation of the ban on smoking in cars with children. DESIGN Cross-sectional survey was carried out between 4 March 2022 and 7 March 2022 on a national sample of 1090 adult Polish residents. The questionnaire included 12 closed questions on smoking behaviours, secondhand smoke exposure as well as attitudes towards different smoke-free laws. PARTICIPANTS Data were obtained from 1090 individuals, aged 18-84 years, 52.6% were females. RESULTS Almost every fifth respondent (17.7%) declared secondhand smoke exposure in cars in the past 30 days (31.8% of smokers and 12.0% of non-smokers; p<0.001). Lack of the implementation of smoke-free home rules (aOR 2.92, 95% CI 1.99 to 4.29; p<0.001), age 18-29 years (aOR 2.06; 95% CI 1.16 to 3.67; p=0.01), current smoking (aOR 1.99, 95% CI 1.37 to 2.90; p<0.001) as well as bad financial situation (aOR 1.60, 95% CI 1.02 to 2.48; p=0.04) were significantly associated with the higher risk of secondhand smoke exposure in cars. Out of all respondents, 84.2% supported the implementation of the ban on smoking in cars with children. Out of 12 different sociodemographic factors, only the female gender (aOR 1.94, 95% CI 1.37 to 2.74) and being non-smokers (aOR 1.70. 95% CI 1.20 to 2.41; p=0.003) were significantly associated with the higher odds of supporting the implementation of the ban on smoking in cars with children. CONCLUSIONS This study showed high public support for the implementation of the ban on smoking in cars with children. Social support for smoke-free environments in Poland should be used by public health specialists and policy-makers to strengthen the national tobacco control act.
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Affiliation(s)
- Aurelia Ostrowska
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Mateusz Jankowski
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland
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Taha MN, Al-Ghumgham Z, Ali N, Al-Rifai RH, Elbarazi I, Al-Maskari F, El-Shahawy O, Ahmed LA, Loney T. Tobacco Use and Exposure to Environmental Tobacco Smoke amongst Pregnant Women in the United Arab Emirates: The Mutaba'ah Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127498. [PMID: 35742747 PMCID: PMC9224424 DOI: 10.3390/ijerph19127498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/10/2022]
Abstract
Self-reported tobacco use is high in the male adult Emirati population (males ~36% vs. females ~3%); however, there are minimal data on tobacco use or exposure to environmental tobacco smoke (ETS) during pregnancy in the United Arab Emirates (UAE). This study investigated the prevalence of, and factors associated with, tobacco use and exposure to environmental tobacco smoke (ETS) amongst pregnant women in the UAE. Baseline cross-sectional data were analysed from the Mutaba’ah Study. Expectant mothers completed a self-administered questionnaire collecting sociodemographic information, maternal tobacco use, and ETS exposure during antenatal visits at three hospitals in Al Ain (UAE; May 2017–February 2021). Amongst 8586 women included in the study, self-reported tobacco use during pregnancy was low (0.7%), paternal tobacco use was high (37.9%), and a third (34.8%) of expectant mothers were exposed to ETS (28.0% at home only). Pregnant women who were employed (adjusted odds ratio (aOR): 1.35, 95% confidence interval (CI): 1.19–1.52), with childbirth anxiety (aOR 1.21, 95% CI 1.08–1.36), and with an increased number of adults living in the same household (aOR 1.02 95% CI 1.01–1.03) were independently more likely to be exposed to ETS. Pregnant women with higher education levels (aOR 0.84, 95% CI 0.75–0.94) and higher gravidity (aOR 0.95, 95% CI 0.92–0.99) were less likely to be exposed to ETS. Public health efforts targeting smoking cessation amongst husbands and promoting smoke-free homes are warranted to help reduce prenatal ETS exposure in the UAE.
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Affiliation(s)
- Mohammed Nagdi Taha
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates; (M.N.T.); (Z.A.-G.)
| | - Zaki Al-Ghumgham
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates; (M.N.T.); (Z.A.-G.)
| | - Nasloon Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
| | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates
| | - Omar El-Shahawy
- Tobacco, Alcohol and Drug Use Section, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA;
- Division of Global Health, New York University School of Global Public Health, New York, NY 10003, USA
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (N.A.); (R.H.A.-R.); (I.E.); (F.A.-M.); (L.A.A.)
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates; (M.N.T.); (Z.A.-G.)
- Correspondence: ; Tel.: +971-43-838-737
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Chan Sun M, Beeharry Panray UD, Cheeneebash J, Gunesh R. Need for sensitization on serious threats of second-hand smoke: Findings from a national study in Mauritius, a small island developing state in the Indian Ocean. Prev Med Rep 2022; 25:101667. [PMID: 35127351 PMCID: PMC8800046 DOI: 10.1016/j.pmedr.2021.101667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/08/2021] [Accepted: 12/12/2021] [Indexed: 11/28/2022] Open
Abstract
This study had the following objectives: To assess the level of knowledge of Mauritians aged ≥ 20 years on the health effects of Second Hand Smoke (SHS), to investigate their behaviour when exposed to SHS and to look for any association between SHS-related knowledge and behaviour towards exposure. A national cross-sectional online survey was conducted. With the total population of Mauritians above the age of 20 years being 941,719, the calculated sample size was 400. A validated questionnaire was used to collect data among respondents from all 9 districts of the island of Mauritius, with representative district-wise samples. Data analysis was carried out using SPSS version 19.0. Considering the findings of the study, there were 408 respondents: Two-thirds of participants showed good knowledge of the harmful effects of SHS. Participants were aware of the link of SHS to respiratory diseases, nonetheless, they were not aware of its causes for non-respiratory diseases. One out of four participants (25.5%) were not aware that maternal passive smoking causes preterm delivery. More than one-third of the participants (37.3%) did not know that passive smoking causes sudden infant death syndrome. Inadequate levels of knowledge were also revealed by authors in other developing countries. We thus recommend bold sensitization campaigns about the serious threats of SHS. We highlight the pertinence of longitudinal cohort studies with assessment of SHS-related knowledge/behaviour before and after health education campaigns, in Mauritius and other developing countries.
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Affiliation(s)
- Marie Chan Sun
- Faculty of Medicine and Health Sciences, University of Mauritius, Mauritius
- Corresponding author.
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Aggarwal P, Sharma T, Singh M. Second hand smoke exposure in pregnant women in Dehradun, Uttarakhand: A cross sectional study. J Family Med Prim Care 2022; 11:667-671. [PMID: 35360800 PMCID: PMC8963620 DOI: 10.4103/jfmpc.jfmpc_1607_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/02/2021] [Accepted: 12/09/2021] [Indexed: 12/03/2022] Open
Abstract
Aim: The aim of this study was to estimate the percentage and sources of secondhand smoke (SHS) exposure among non-smoking pregnant women. It was a cross-sectional study conducted among the non-smoking pregnant women registered at the primary health center (PHC) under the All India Institute of Medical Science (AIIMS), Rishikesh. Materials and Methods: All registered pregnant women at sub-center in the field practice area (Raiwala) of the Department of Community and Family Medicine, AIIMS Rishikesh were recruited in the study. In this study, a questionnaire was used for measuring the exposure of SHS. Mean and standard deviation (SD), median, minimum, and maximum were used for continuous variables. A Chi-square test was used to compare the association of categorical variables. Results: Out of the total participants, 62% were exposed to SHS. 33% of participants were exposed to SHS at home only, 24% at public places only, and 5% were the ones exposed both at home and public places. More than half (69%) of the participants were having inadequate knowledge about the harms caused by SHS. Conclusions: More than half of the participants were exposed to SHS. Inadequate knowledge among the participants about adverse effects of SHS exposure and insufficient practices and action were observed.
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Kim HL, Chung J, Kim KJ, Kim HJ, Seo WW, Jeon KH, Cho I, Park JJ, Lee MH, Suh J, Lim SY, Choi S, Kim SH. Lifestyle Modification in the Management of Metabolic Syndrome: Statement From Korean Society of CardioMetabolic Syndrome (KSCMS). Korean Circ J 2022; 52:93-109. [PMID: 35128848 PMCID: PMC8819565 DOI: 10.4070/kcj.2021.0328] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/08/2021] [Accepted: 12/01/2021] [Indexed: 11/11/2022] Open
Abstract
Metabolic syndrome (MetS) is highly prevalent and is associated with worse cardiovascular outcome. Lifestyle modification is the most effective way to reduce the incidence of cardiovascular complications caused by MetS. Here, we would like to review the effects and specific methods of the 6 lifestyle modifications (weight control, smoking cessation, alcohol drinking in moderation, diet control, exercise and physical activity, and cognitive behavioral therapy) and control of blood pressure, dyslipidemia, and blood sugar based on evidence in the management of MetS. With the recent rapid increase in obesity worldwide, metabolic syndrome (MetS) has gained significant importance. MetS is a cluster of obesity-related cardiovascular risk factors including abdominal obesity, atherogenic dyslipidemia, high blood pressure and impaired glucose tolerance. MetS is highly prevalent and strongly associated with an increased risk of developing diabetes and cardiovascular disease, putting a great burden on human society. Therefore, it is very important to reduce MetS risk, which can improve patients’ cardiovascular prognosis. The primary and most effective strategy to control each component of MetS is lifestyle change such as losing body weight, keeping regular exercise, adopting a healthy diet, quitting smoking and alcohol drinking in moderation. Many studies have shown that lifestyle modification has improved all components of MetS, and reduces the incidence of diabetes and cardiovascular disease. Here, the Korean Society of CardioMetabolic Syndrome has summarized specific and practical methods of lifestyle modification in the management of MetS in the healthcare field.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jaehoon Chung
- Division of Cardiology, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Kyung-Jin Kim
- Division of Cardiology, Department of Internal Medicine, Ewha Womans University Medical Center, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyun-Jin Kim
- Department of Cardiology in Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Won-Woo Seo
- Division of Cardiology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Ki-Hyun Jeon
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Iksung Cho
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Joo Park
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min-Ho Lee
- Division of Cardiology, Department of Internal Medicine, Soon Chun Hyang University Seoul Hospital, Seoul, Korea
| | - Jon Suh
- Division of Cardiology, Department of Internal Medicine, Soon Chun Hyang Bucheon Hospital, Soon Chun Hyang University College of Medicine, Bucheon, Korea
| | - Sang-Yup Lim
- Departments of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Seonghoon Choi
- Division of Cardiology, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
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Kataoka H, Kaji S, Moai M. Risk Assessment of Passive Smoking Based on Analysis of Hair Nicotine and Cotinine as Exposure Biomarkers by In-Tube Solid-Phase Microextraction Coupled On-Line to LC-MS/MS. Molecules 2021; 26:molecules26237356. [PMID: 34885941 PMCID: PMC8659248 DOI: 10.3390/molecules26237356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022] Open
Abstract
Passive smoking due to environmental tobacco smoke is a serious public health concern because it increases the risk of lung cancer and cardiovascular disease. However, the current status and effect of passive smoking in various lifestyles are not fully understood. In this study, we measured hair nicotine and cotinine levels as exposure biomarkers in non-smokers and assessed the risk from the actual situation of passive smoking in different lifestyle environments. Nicotine and cotinine contents in hair samples of 110 non-smoker subjects were measured by in-tube solid-phase microextraction with on-line coupling to liquid chromatography-tandem mass spectrometry, and self-reported lifestyle questionnaires were completed by the subjects. Nicotine and cotinine were detected at concentrations of 1.38 ng mg−1 and 12.8 pg mg−1 respectively in the hair of non-smokers, with levels significantly higher in subjects who reported being sensitive to tobacco smoke exposure. These levels were also affected by type of food intake and cooking method. Nicotine and cotinine in hair are useful biomarkers for assessing the effects of passive smoking on long-term exposure to environmental tobacco smoke, and our analytical methods can measure these exposure levels in people who are unaware of passive smoking. The results of this study suggest that the environment and places of tobacco smoke exposure and the lifestyle behaviors therein are important for the health effects of passive smoking.
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Paraje G, Valdés N. Changes in parental smoking behavior and children's health status in Chile. Prev Med 2021; 153:106792. [PMID: 34506821 DOI: 10.1016/j.ypmed.2021.106792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/26/2021] [Accepted: 09/05/2021] [Indexed: 11/18/2022]
Abstract
Studies on parental smoking behavior have mostly been conducted for developed countries and show that current parental smoking is negatively associated with children's current health. Using four waves of a Chilean longitudinal survey (Encuesta de Protección Social), we estimate probit and ordinary least squares models relating parents' self-report of their children's current health status to several covariates, including current parental smoking status and change (transitions) in parental smoking status across the waves of the survey. The data were collected in the years 2004, 2006, 2009, and 2015. The working sample includes 25,052 observations. The study revealed that parents' self-report of their children's current health status is strongly associated with current and past parental smoking status. Parents who smoke have an increased 11.17% probability of reporting that their children are in fair, poor, or very poor health status, when compared to non-smoking parents. The effect is stronger if the smoker is the mother, and it is exacerbated if she is less educated or unemployed/inactive. In addition, quitting smoking has a significant positive effect on children's reported health status, which is greater if the mother quits smoking. Cessation among mothers who are unemployed or inactive is also associated with a more positive assessment of their children's health status. The findings suggest that cessation programs may have health benefits not only for smoking parents, but also for their children. Improving coverage or establishing a national cessation program may have important present and future effects on population health and well-being.
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Affiliation(s)
- Guillermo Paraje
- Escuela de Negocios, Universidad Adolfo Ibáñez, Avenida Diagonal Las Torres 2640, Peñalolén, Santiago de Chile, Chile.
| | - Nieves Valdés
- Escuela de Negocios, Universidad Adolfo Ibáñez, Avenida Diagonal Las Torres 2640, Peñalolén, Santiago de Chile, Chile.
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Wang K, Wang Y, Zhao R, Gong L, Wang L, He Q, Chen L, Qin J. Relationship between childhood secondhand smoke exposure and the occurrence of hyperlipidaemia and coronary heart disease among Chinese non-smoking women: a cross-sectional study. BMJ Open 2021; 11:e048590. [PMID: 34226229 PMCID: PMC8258554 DOI: 10.1136/bmjopen-2020-048590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the influence of secondhand smoke (SHS) exposure during childhood on type 2 diabetes mellitus, hypertension, hyperlipidaemia and coronary heart disease among Chinese non-smoking women. METHODS In this cross-sectional study, the SHS exposure data in childhood were obtained using a questionnaire survey. Self-reported childhood SHS exposure was defined as the presence of at least one parent who smoked during childhood. RESULTS Of the 6522 eligible participants, 2120 Chinese women who had never smoked were assessed. The prevalence of SHS exposure in the entire population was 28.1% (596). SHS exposure during childhood was not significant for the standard risk factors of type 2 diabetes mellitus (p=0.628) and hypertension (p=0.691). However, SHS was positively associated with hyperlipidaemia (p=0.037) after adjusting for age, obesity, education status, physical activity, alcohol consumption, current SHS exposure status, diabetes mellitus and hypertension. In addition, childhood SHS increased the occurrence of coronary heart disease (p=0.045) among non-smokers after further adjusting for hyperlipidaemia. CONCLUSION SHS exposure during childhood is associated with prevalent hyperlipidaemia and coronary heart disease in adulthood among non-smoking Chinese women.
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Affiliation(s)
- Kewei Wang
- Department of Endocrinology, Shandong University Qilu Hospital, Jinan, Shandong, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province medicine & health, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Yuanqi Wang
- Department of Endocrinology, Shandong University Qilu Hospital, Jinan, Shandong, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province medicine & health, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Ruxing Zhao
- Department of Endocrinology, Shandong University Qilu Hospital, Jinan, Shandong, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province medicine & health, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Lei Gong
- Department of Endocrinology, Shandong University Qilu Hospital, Jinan, Shandong, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province medicine & health, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Lingshu Wang
- Department of Endocrinology, Shandong University Qilu Hospital, Jinan, Shandong, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province medicine & health, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Qin He
- Department of Endocrinology, Shandong University Qilu Hospital, Jinan, Shandong, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province medicine & health, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Li Chen
- Department of Endocrinology, Shandong University Qilu Hospital, Jinan, Shandong, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province medicine & health, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Jun Qin
- Department of Endocrinology, Shandong University Qilu Hospital, Jinan, Shandong, China
- Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China
- Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province medicine & health, Jinan, China
- Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
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Liu J, Ghastine L, Um P, Rovit E, Wu T. Environmental exposures and sleep outcomes: A review of evidence, potential mechanisms, and implications. ENVIRONMENTAL RESEARCH 2021; 196:110406. [PMID: 33130170 PMCID: PMC8081760 DOI: 10.1016/j.envres.2020.110406] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 06/02/2023]
Abstract
Environmental exposures and poor sleep outcomes are known to have consequential effects on human health. This integrative review first seeks to present and synthesize existing literature investigating the relationship between exposure to various environmental factors and sleep health. We then present potential mechanisms of action as well as implications for policy and future research for each environmental exposure. Broadly, although studies are still emerging, empirical evidence has begun to show a positive association between adverse effects of heavy metal, noise pollution, light pollution, second-hand smoke, and air pollution exposures and various sleep problems. Specifically, these negative sleep outcomes range from subjective sleep manifestations, such as general sleep quality, sleep duration, daytime dysfunction, and daytime sleepiness, as well as objective sleep measures, including difficulties with sleep onset and maintenance, sleep stage or circadian rhythm interference, sleep arousal, REM activity, and sleep disordered breathing. However, the association between light exposure and sleep is less clear. Potential toxicological mechanisms are thought to include the direct effect of various environmental toxicants on the nervous, respiratory, and cardiovascular systems, oxidative stress, and inflammation. Nevertheless, future research is required to tease out the exact pathways of action to explain the associations between each environmental factor and sleep, to inform possible therapies to negate the detrimental effects, and to increase efforts in decreasing exposure to these harmful environmental factors to improve health.
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Affiliation(s)
- Jianghong Liu
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA.
| | - Lea Ghastine
- Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA
| | - Phoebe Um
- Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA
| | - Elizabeth Rovit
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Tina Wu
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA
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12
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Miguel JP, Dias ADC, Bettini NR, Sousa SABAD, Durão MPL, Oliveira LVDC, Monedeiro F, Ramalho LNZ, Branco LGS, Sabino JPJ, Durand MDT. Cigarette smoke exposure causes systemic and autonomic cardiocirculatory changes in rats depending on the daily exposure dose. Life Sci 2021; 277:119498. [PMID: 33864817 DOI: 10.1016/j.lfs.2021.119498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 11/15/2022]
Abstract
AIMS To evaluate the systemic changes and autonomic cardiocirculatory control of awaken rats chronically exposed to the cigarette smoke (CS) of 1 or 2 cigarettes/day. MAIN METHODS Rats were exposed to clean air (control) or cigarette smoke of 1 (CS1) or 2 (CS2) cigarettes/animal/day for 30 days. Then, arterial pressure (AP) and heart rate (HR) were recorded in conscious rats to assess spontaneous baroreflex sensitivity and HR and AP variabilities. Evoked baroreflex and cardiac autonomic tone were evaluated by vasoactive drugs and autonomic blockers, respectively. In another group, ventilatory and cardiovascular parameters were recorded under hypoxia and hypercapnia stimulus. At the end of protocols, heart, lung, kidneys and liver were collected for histological analysis. KEY FINDINGS Rats exposed to CS showed morphological changes, being more evident in the CS2 group. Also, less weight gain and cardiac hypertrophy were prominent in CS2 rats. Basal AP and HR, spontaneous baroreflex sensitivity and cardiovascular variabilities were similar among groups. CS exposure progressively blunted the bradycardia response to phenylephrine (-2.2 ± 0.1 vs. -1.7 ± 0.2 vs. -1.5 ± 0.2) while the tachycardia response to sodium nitroprusside was slightly increased compared to control. Vagal tone was not affected by CS, but CS2 rats exhibited higher sympathetic tone (-25 ± 4 vs. -28 ± 4 vs. -56 ± 9) and lower intrinsic HR (411 ± 4 vs. 420 ± 8 vs. 390 ± 6). Exposure to CS of 2 cigarettes also exacerbated the reflex cardiovascular and ventilatory responses to hypoxia and hypercapnia. SIGNIFICANCE CS exposure for 30 days promoted systemic changes and autonomic cardiocirculatory dysfunction in rats depending on the daily exposure dose.
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Affiliation(s)
- João Paulo Miguel
- Medical School, University of Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | | | | | | | | | - Lucas Vaz de Castro Oliveira
- Department of Biophysics and Physiology, Postgraduate Program in Pharmaceutical Sciences, Federal University of Piaui, Teresina, PI, Brazil
| | - Fernanda Monedeiro
- Department of Chemistry, Physiology and Basic Pathology, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Luiz Guilherme S Branco
- Department of Morphology, Physiology and Basic Pathology, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - João Paulo Jacob Sabino
- Department of Biophysics and Physiology, Postgraduate Program in Pharmaceutical Sciences, Federal University of Piaui, Teresina, PI, Brazil
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13
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Sheridan P, Trinidad D, McMenamin S, Pierce JP, Benmarhnia T. Evaluating the impact of the California 1995 smoke-free workplace law on population smoking prevalence using a synthetic control method. Prev Med Rep 2020; 19:101164. [PMID: 32775177 PMCID: PMC7394745 DOI: 10.1016/j.pmedr.2020.101164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/01/2020] [Accepted: 07/04/2020] [Indexed: 12/02/2022] Open
Abstract
The objective of this study is to assess the impact of the California 1995 Smoke-Free Workplace Act (SFWA) on cigarette smoking prevalence in the population. We used survey responses related to cigarette smoking from the Behavioral Risk Factor Surveillance System (BRFSS) from 1990 to 2000. We utilize a synthetic control method which creates a weighted combination of control states to produce a single ‘synthetic’ control group to best approximate the counterfactual trend in California in the absence of the SFWA. Variables known to be associated with smoking were included to weight each state in the pre-intervention period as medians by state and included: distribution of race/ethnicity (White, Black, Asian, Hispanic), sex (Male/Female), marital status (married/unmarried), high school education (yes/no) and employment status (yes/no). We find evidence that there was a small decrease in population smoking prevalence in California in the year immediately following the SFWA, but this effect was not sustained beyond 1995. We hypothesize that one potential explanation for the lack of prolonged impact on population smoking prevalence is that there are sustained effects from the passage of 1989 California Proposition 99, which enacted an excise tax on tobacco products. Understanding how workplace smoking ban legislation affects population smoking behaviors is necessary to better inform policy development in other states and counties and to improve existing policies. Future work should consider the impact of smoking legislation impacts subgroups of the population by socioeconomic status, occupation or race/ethnicity.
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Affiliation(s)
- Paige Sheridan
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States.,Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, 5200 Campanile Drive, San Diego, CA 92182, United States
| | - Dennis Trinidad
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Sara McMenamin
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - John P Pierce
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States.,Scripps Institute of Oceanography, University of California San Diego, 8622 Kennel Way, La Jolla, CA 92037, United States
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14
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Ishizaki A, Kataoka H. A sensitive method for the determination of tobacco-specific nitrosamines in mainstream and sidestream smokes of combustion cigarettes and heated tobacco products by online in-tube solid-phase microextraction coupled with liquid chromatography-tandem mass spectrometry. Anal Chim Acta 2019; 1075:98-105. [DOI: 10.1016/j.aca.2019.04.073] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/21/2019] [Accepted: 04/30/2019] [Indexed: 12/14/2022]
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15
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Gao M, Li Y, Wang F, Zhang S, Qu Z, Wan X, Wang X, Yang J, Tian D, Zhang W. The effect of smoke-free legislation on the mortality rate of acute myocardial infarction: a meta-analysis. BMC Public Health 2019; 19:1269. [PMID: 31533693 PMCID: PMC6749716 DOI: 10.1186/s12889-019-7408-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/31/2019] [Indexed: 12/29/2022] Open
Abstract
Background Several studies have demonstrated that smoke-free legislation is associated with a reduced risk of mortality from acute myocardial infarction (AMI). This study aimed to examine and quantify the potential effect of smoke-free legislation on AMI mortality rate in different countries. Methods Studies were identified using a systematic search of the scientific literature from electronic databases, including PubMed, Web of Science, ScienceDirect, Embase, Google Scholar, and China National Knowledge Infrastructure (CNKI), from their inception through September 30, 2017. A random effects model was employed to estimate the overall effects of smoke-free legislation on the AMI mortality rate. Subgroup analysis was performed to explore the possible causes of heterogeneity in risk estimates based on sex and age. The results of meta-analysis after excluding the studies with a high risk of bias were reported in this study. Results A total of 10 eligible studies with 16 estimates of effect size were included in this meta-analysis. Significant heterogeneity in the risk estimates was identified (overall I2 = 94.6%, p < 0.001). Therefore, a random effects model was utilized to estimate the overall effect of smoke-free legislation. There was an 8% decline in AMI mortality after introducing smoke-free legislation (RR = 0.92, 95% confidence interval (CI): 0.90–0.94). The results of subgroup analyses showed that smoke-free legislation was significantly associated with lower rates of mortality for the following 5 diagnostic subgroups: smoke-free in workplaces, restaurants and bars (RR = 0.92, 95% CI: 0.90–0.95), smaller sample size (RR = 0.92, 95% CI: 0.89–0.95), study location in Europe (RR = 0.90, 95% CI: 0.85–0.94), regional study area (RR = 0.92, 95% CI: 0.89–0.94), and no previous local smoke-free legislation (RR = 0.91, 95% CI: 0.90–0.93). However, there was not much difference in AMI mortality rates after the legislation between the longer (RR = 0.92, 95% CI: 0.86–0.98) and shorter follow-up duration subgroups (RR = 0.92, 95% CI: 0.89–0.94). Conclusion Smoke-free legislation could significantly reduce the AMI mortality rate by 8%. The reduction in the AMI mortality rate was more significant in studies with more comprehensive laws, without prior smoke-free bans, with a smaller sample size, at the regional level, and with a location in Europe. Electronic supplementary material The online version of this article (10.1186/s12889-019-7408-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Min Gao
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China
| | - Yanyu Li
- School of Humanities and Social Sciences, North China Electric Power University, Baoding, 071000, China
| | - Fugang Wang
- People's Bank of China Jinan Branch, Jinan, 250021, China
| | - Shengfa Zhang
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China
| | - Zhiyong Qu
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China
| | - Xia Wan
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China
| | - Xiaohua Wang
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China
| | - Jie Yang
- Tobacco control office, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Donghua Tian
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China
| | - Weijun Zhang
- School of Social Development and Public Policy (SSDPP), Beijing Normal University, 19, XinjiekouWai Street, Beijing, 100875, China.
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16
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Hui-Fang L, Cai L, Wang XM, Golden AR. Ethnic disparities in prevalence and clustering of cardiovascular disease risk factors in rural Southwest China. BMC Cardiovasc Disord 2019; 19:200. [PMID: 31426745 PMCID: PMC6701110 DOI: 10.1186/s12872-019-1185-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 08/14/2019] [Indexed: 01/19/2023] Open
Abstract
Background This study examines how prevalence and clustering of cardiovascular disease (CVD) risk factors differ by ethnicity and socioeconomic status (SES) among rural southwest Chinese adults. Methods A cross-sectional survey of 7027 adults aged ≥35 years of Han and four ethnic minority group descent (Na Xi, Li Shu, Dai, and Jing Po) was used to derive prevalence of tobacco smoking and exposure to secondhand smoke (SHS) as well as alcohol consumption and physical activity data. Anthropometric measurements were also taken, including height, weight, and waist and hip circumference, as well as blood pressure (BP) and fasting blood glucose (FBG) measurements. Results Current smoking and drinking status were the top two CVD risk factors in the study population. Dai ethnic minority participants had the highest prevalence of hypertension, obesity, and central obesity, whereas Jing Po ethnic minority participants had the highest prevalence of current smoking status, SHS exposure, and current drinking status (P < 0.01). Han participants had the highest prevalence of diabetes and physical inactivity (P < 0.01). 11.1% of all participants did not have any of the studied CVD risk factors, while 68.6% of Han, 60.2% of Na Xi, 50.7% of Li Shu, 82.2% of Dai, and 73.0% of Jing Po participants had clustering of two or more CVD risk factors. Prevalence of CVD risk factor clusters increased with age (P < 0.01). Males and individuals with lower education levels and lower annual household income were more likely to have CVD risk factors than their counterparts (P < 0.01). Conclusion Clustering of CVD risk factors is common in rural southwest China. Ethnicity and individual SES significantly impact prevalence of CVD risk factors and their clustering.
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Affiliation(s)
- Li Hui-Fang
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China.,The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Le Cai
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China.
| | - Xu-Ming Wang
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China.,The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Allison Rabkin Golden
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China
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17
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Critselis E, Panagiotakos DB, Georgousopoulou EN, Katsaounou P, Chrysohoou C, Pitsavos C. Exposure to second hand smoke and 10-year (2002-2012) incidence of cardiovascular disease in never smokers: The ATTICA cohort study. Int J Cardiol 2019; 295:29-35. [PMID: 31375335 DOI: 10.1016/j.ijcard.2019.07.065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/17/2019] [Accepted: 07/22/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Despite WHO Framework Convention of Tobacco Control (FCTC) adoption, effective implementation of national smoking bans remains pending in several countries. This study quantified the association of second hand smoke (SHS) exposure and 10-year cardiovascular disease (CVD) among never smokers in such settings. METHODS In 2001-2002, a sample of 1514 males and 1528 females (range: 18-89 years old) were randomly selected in Greece. Frequency and duration of SHS exposure (i.e. exposure extending >30 min/day) within the home and/or workplace were assessed by interview. Following a 10-year follow-up period (2002-2012), incidence of non-fatal and fatal CVD (ICD-10) was evaluated among n = 2020 participants. The analytic study sample consisted of all never smokers (n = 910). RESULTS Despite national smoking ban implementation (2009), 44.6% (n = 406) of never smokers reported SHS exposure. While SHS exposed never smokers exhibited a more favorable profile of CVD-related risk factors at baseline, they subsequently developed similar 10-year CVD incidence rates, at a younger mean age (p = 0.001), than their non-exposed counterparts. Following adjustment for several lifestyle and clinical factors, SHS exposed never smokers exhibited a two-fold elevated 10-year CVD risk (adj. HR: 2.04, 95% CI: 1.43-2.92), particularly among women (adj. HR: 2.45, 95% CI: 1.45-4.06). SHS exposure accounted for 32% excess Population Attributable Risk (PAR) for 10-year CVD events in never smokers, with highest rates (PAR: 52%) being among those exposed in the workplace. CONCLUSION The prevention of SHS associated CVD and related healthcare costs mandates additional strategies for securing the effective implementation of comprehensive WHO FCTC based national smoking bans.
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Affiliation(s)
- Elena Critselis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; University of Canberra, Faculty of Health, Canberra, Australia; University of La Trobe, College of Science, Health & Engineering, Melbourne, Australia.
| | - Ekavi N Georgousopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; University of Canberra, Faculty of Health, Canberra, Australia; University of Notre Dame Australia, Medical School, Sydney, Australia
| | - Paraskevi Katsaounou
- Pulmonary and Critical Care Department, First ICU, School of Medicine, University of Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
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18
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Pistilli M, Howard VJ, Safford MM, Lee BK, Lovasi GS, Cushman M, Malek AM, McClure LA. Association of secondhand tobacco smoke exposure during childhood on adult cardiovascular disease risk among never-smokers. Ann Epidemiol 2019; 32:28-34.e1. [PMID: 30799203 PMCID: PMC6441374 DOI: 10.1016/j.annepidem.2019.01.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/11/2018] [Accepted: 01/25/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE Adult secondhand tobacco smoke (SHS) exposure is related to stroke and coronary heart disease (CHD) risk, but long-term effects are less clear. We evaluated whether childhood SHS exposure affects subsequent stroke or CHD risk among adult black and white never-smokers followed for stroke and CHD. METHODS In this prospective cohort study, inverse probability weights were calculated to correct for bias due to attrition and survey nonresponse. Cox proportional hazards models were used to assess hazard ratios and 95% confidence intervals for stroke or CHD, separately, by number of childhood household smokers. RESULTS Of 13,142 eligible participants, 6136 had childhood SHS exposure assessed. Baseline mean (SD) age was 63.5 (9.0), 65% were female, 30% black, 46% reported 0 childhood household smokers, 36% reported 1, and 18% reported 2+. In 60,649 person-years, 174 strokes were observed (2.9% of participants), and in 45,195 person-years, 114 CHD events were observed (2.1% of participants). The weighted and adjusted hazard ratios (95% confidence intervals) of stroke for 2+ versus 0 childhood household smokers was 1.66 (1.29-2.13) and was 1.15 (0.82-1.59) for CHD. CONCLUSIONS We observed a significant association between childhood SHS exposure and stroke, but not CHD, after age 45 years and adjusting for missing information.
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Affiliation(s)
- Maxwell Pistilli
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama, Birmingham
| | - Monika M Safford
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Brian K Lee
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Gina S Lovasi
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Mary Cushman
- Department of Medicine, College of Medicine, University of Vermont, Burlington
| | - Angela M Malek
- Department of Public Health Sciences, Medical University of South Carolina, Charleston
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA.
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19
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Darville A, Hahn EJ. E-cigarettes and Atherosclerotic Cardiovascular Disease: What Clinicians and Researchers Need to Know. Curr Atheroscler Rep 2019; 21:15. [PMID: 30877398 DOI: 10.1007/s11883-019-0777-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW Electronic cigarettes, commonly known as electronic nicotine delivery systems (ENDS), e-cigarettes, or vapes, are growing in use and popularity. E-cigarettes are not one distinct type of product. These devices have evolved from the initial "cigarette-alike" designs to larger tank-style devices and most recently, smaller "mod-pods" that can be easily hidden. E-cigarettes can deliver nicotine at levels similar to conventional cigarettes. RECENT FINDINGS As with conventional cigarettes, e-cigarettes expose users to chemicals and particulates that affect many biological systems including the heart, lungs, and circulation. Most e-cigarettes contain and emit potentially toxic but highly variable substances. Only by using them in total abstinence from combustible tobacco products can users reduce (not eliminate) their exposure to these harmful chemicals. However, most adults smoking e-cigarettes are dual users, meaning they smoke both conventional and e-cigarettes. This review of the current cardiovascular-specific literature related to e-cigarette use explores what is known (and unknown) about the short- and long-term effects of using these devices. Specifically, the effects of nicotine, oxidizing agents, and particulates in e-cigarettes are examined in the context of cardiovascular and lung health. The goal is to assist clinicians when discussing e-cigarettes with their patients and to help them analyze the impact of use on cardiovascular health. Recommendations are provided related to clinical treatment and research to address gaps in the literature.
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Affiliation(s)
- Audrey Darville
- Tobacco Prevention and Treatment Division, BREATHE, College of Nursing, University of Kentucky, 2265 Harrodsburg Road, Suite 202, Lexington, KY, 40504, USA.
| | - Ellen J Hahn
- BREATHE, College of Nursing, University of Kentucky, 2265 Harrodsburg Road, Suite 202, Lexington, KY, 40504, USA
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20
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Sun R, Mendez D. Initiation versus Cessation Control Policies: Deriving Optimal Resource Allocation Strategies to Decrease Smoking Prevalence Under a Fixed Budget. MDM Policy Pract 2019; 4:2381468319832036. [PMID: 30859127 PMCID: PMC6402062 DOI: 10.1177/2381468319832036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 11/30/2018] [Indexed: 11/17/2022] Open
Abstract
Background. Over several decades the tobacco control community has recommended and implemented smoking initiation and cessation interventions to reduce the smoking toll. It is necessary to study the combined effect of these interventions to allocate resources optimally. However, there is a paucity of studies that address the right combination of initiation and cessation policies over time to reduce smoking prevalence. Objective. To derive optimal trajectories of initiation and cessation interventions that minimize overall smoking prevalence over a specified period while satisfying a budget constraint. Methods. Using an established dynamic model of smoking prevalence, we employ an optimal control formulation to minimize overall smoking prevalence within a specified time period. The budget constraint is handled through an iterative application of a penalty function on above-budget expenditures. We further derive the optimal cost ratio of initiation versus cessation programs over time. To parameterize our model, we use results from two empirical interventions. The demographic data are from the National Health Interview Survey in the United States. Results. For our example, our results show that the optimal cost ratio (initiation over cessation) starts around 2.02 and gradually increases to 5.28 in 30 years. Smoking prevalence decreases significantly compared with the status quo, 8.54% in 30 years with no interventions versus the estimated 6.43% with interventions. In addition, the optimal units of initiation and cessation interventions increase over time. Conclusions. Our model provides a general framework to incorporate policy details in determining the optimal mix of smoking interventions.
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Affiliation(s)
- Ruoyan Sun
- Department of Health Management and Policy, University of Michigan Ann Arbor, Ann Arbor, Michigan
| | - David Mendez
- Department of Health Management and Policy, University of Michigan Ann Arbor, Ann Arbor, Michigan
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21
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Semple S, Turner S, O'Donnell R, Adams L, Henderson T, Mitchell S, Lyttle S, Amos A. Using air-quality feedback to encourage disadvantaged parents to create a smoke-free home: Results from a randomised controlled trial. ENVIRONMENT INTERNATIONAL 2018; 120:104-110. [PMID: 30076982 DOI: 10.1016/j.envint.2018.07.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/25/2018] [Accepted: 07/26/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To determine if low-cost air-quality monitors providing personalised feedback of household second-hand smoke (SHS) concentrations plus standard health service advice on SHS were more effective than standard advice in helping parents protect their child from SHS. DESIGN A randomised controlled trial of a personalised intervention delivered to disadvantaged mothers who were exposed to SHS at home. Changes in household concentrations of fine Particulate Matter (PM2.5) were the primary outcome. METHODS Air-quality monitors measured household PM2.5 concentrations over approximately 6 days at baseline and at one-month and six-months post-intervention. Data on smoking and smoking-rules were gathered. Participants were randomised to either Group A (standard health service advice on SHS) or Group B (standard advice plus personalised air-quality feedback). Group B participants received personalised air-quality feedback after the baseline measurement and at 1-month. Both groups received air-quality feedback at 6-months. RESULTS 120 mothers were recruited of whom 117 were randomised. Follow up was completed after 1-month in 102 and at 6-months in 78 participants. There was no statistically significant reduction in PM2.5 concentrations by either intervention type at 1-month or 6-months, nor significant differences between the two groups at 1-month (p = 0.76) and 6-month follow-up (p = 0.16). CONCLUSIONS Neither standard advice nor standard advice plus personalised air-quality feedback were effective in reducing PM2.5 concentrations in deprived households where smoking occurred. Finding ways of identifying homes where air-quality feedback can be a useful tool to change household smoking behaviour is important to ensure resources are targeted successfully.
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Affiliation(s)
- Sean Semple
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, United Kingdom.
| | - Stephen Turner
- Respiratory Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Rachel O'Donnell
- RCO Consulting, 1 Thorters Place, Edinburgh, Scotland, United Kingdom
| | - Lynn Adams
- Tobacco Control, NHS Lanarkshire, Hamilton, Scotland, United Kingdom
| | - Tracy Henderson
- Tobacco Control, NHS Lanarkshire, Hamilton, Scotland, United Kingdom
| | - Shirley Mitchell
- Tobacco Control, NHS Lanarkshire, Hamilton, Scotland, United Kingdom
| | - Susan Lyttle
- Tobacco Control, NHS Lanarkshire, Hamilton, Scotland, United Kingdom
| | - Amanda Amos
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, United Kingdom
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Lack of association between passive smoking and blood pressure, lipids, and fasting glucose. J Hypertens 2018; 35:1952-1954. [PMID: 28858196 DOI: 10.1097/hjh.0000000000001467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Merianos AL, Jandarov RA, Mahabee-Gittens EM. Adolescent Tobacco Smoke Exposure, Respiratory Symptoms, and Emergency Department Use. Pediatrics 2018; 142:e20180266. [PMID: 30082449 PMCID: PMC6317548 DOI: 10.1542/peds.2018-0266] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Our objective was to examine the relationship between distinct tobacco smoke exposure (TSE) measures and TSE-related symptoms and emergency department (ED) and/or urgent care (UC) use among nonsmoking adolescents without asthma diagnoses. METHODS We performed a secondary analysis of 7389 adolescents who completed the Population Assessment of Tobacco and Health Study wave 2. Logistic regression and Poisson regression models were built. RESULTS Adolescents with TSE were at increased risk of reporting: shortness of breath, finding it hard to exercise, wheezing during or after exercise, and dry cough at night. Adolescents who lived with a smoker and had home TSE were at increased odds of reporting wheezing or whistling in the chest, and only adolescents with home TSE were at increased risk of reporting wheezing that disturbed sleep. Adolescents with TSE were less likely to report very good or excellent overall health and physical health but were more likely to report they sometimes, often, or very often missed school because of illness. Participants who lived with a smoker and had TSE ≥1 hour were more likely to have had an ED and/or UC visit. Participants with any TSE were at increased risk of having a higher number of ED and/or UC visits. CONCLUSIONS Different TSE measures uniquely increased the risk of TSE-related symptoms, but any TSE increased the risk of having a higher number of ED and/or UC visits. The providers at these high-volume settings should offer interventions to adolescents who are exposed to tobacco smoke and their families to decrease these symptoms and related morbidity.
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Affiliation(s)
- Ashley L Merianos
- College of Education, Criminal Justice, and Human Services, School of Human Services, University of Cincinnati, Cincinnati, Ohio
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Lennon RP, Claussen KA, Kuersteiner KA. State of the Heart: An Overview of the Disease Burden of Cardiovascular Disease from an Epidemiologic Perspective. Prim Care 2018; 45:1-15. [PMID: 29406937 DOI: 10.1016/j.pop.2017.11.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cardiovascular diseases are prevalent worldwide and have significant impact on morbidity, mortality, and overall health care costs. Common risk factors include obesity, hypertension, hyperlipidemia, diabetes mellitus, chronic kidney disease, and smoking. Both modifiable and nonmodifiable risks should be accounted for when evaluating and managing patients with cardiovascular diseases. The complex nature of cardiovascular disease is not fully understood. Therefore, primary care physicians must balance what is known, what is suspected, and each patient's individual preferences to create an optimal treatment plan.
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Analysis of nicotine and cotinine in hair by on-line in-tube solid-phase microextraction coupled with liquid chromatography-tandem mass spectrometry as biomarkers of exposure to tobacco smoke. J Pharm Biomed Anal 2018; 156:272-277. [DOI: 10.1016/j.jpba.2018.04.032] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 04/21/2018] [Accepted: 04/22/2018] [Indexed: 12/13/2022]
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Jain RB. Rates of exposure to environmental tobacco smoke from various indoor environments among US children and nonsmoker adolescents and adults. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:17002-17011. [PMID: 29627962 DOI: 10.1007/s11356-018-1891-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 03/27/2018] [Indexed: 06/08/2023]
Abstract
Data from National Health and Nutrition Examination Survey for 2013-2014 were used to compute rates of exposure (ROE) to environmental tobacco smoke (ETS) from various indoor environments among US children and nonsmoking adolescents and adults. In a typical week in USA, 473,000 infants (ROE, 11%), 3.36 million children aged 1-5 years (ROE, 16.4%), and 4.59 million children aged 6-11 years (ROE, 18.6%) are exposed to ETS from indoor environments only. ROE among children was found to be highest by inhaling tobacco smoke inside home, riding in a car, and when visiting other people's homes. In a typical week, 4.1 million nonsmoking adolescents (ROE, 29.2%) were being exposed to ETS. For every one adolescent smoker, 2.4 nonsmoker adolescents were being subjected to ETS exposure. Both non-Hispanic White (NHW) and non-Hispanic Black (NHB) nonsmoking adolescents had higher ROE (p < 0.01) than Hispanics (HISP) and non-Hispanic Asians (NHAS). Also, in a typical week, 16.8 million nonsmoking adults (ROE, 29.2%) were being exposed to ETS. For every adult smoker, 0.7 nonsmoker adult was subjected to ETS exposure. Both NHW and NHB nonsmoking adults had higher ROE (p < 0.01) than HISP and NHAS and males had higher ROE than females (p < 0.01).
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Benedikter BJ, Wouters EFM, Savelkoul PHM, Rohde GGU, Stassen FRM. Extracellular vesicles released in response to respiratory exposures: implications for chronic disease. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2018; 21:142-160. [PMID: 29714636 DOI: 10.1080/10937404.2018.1466380] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Extracellular vesicles (EV) are secreted signaling entities that enhance various pathological processes when released in response to cellular stresses. Respiratory exposures such as cigarette smoke and air pollution exert cellular stresses and are associated with an increased risk of several chronic diseases. The aim of this review was to examine the evidence that modifications in EV contribute to respiratory exposure-associated diseases. Publications were searched using PubMed and Google Scholar with the search terms (cigarette smoke OR tobacco smoke OR air pollution OR particulate matter) AND (extracellular vesicles OR exosomes OR microvesicles OR microparticles OR ectosomes). All original research articles were included and reviewed. Fifty articles were identified, most of which investigated the effect of respiratory exposures on EV release in vitro (25) and/or on circulating EV in human plasma (24). The majority of studies based their main observations on the relatively insensitive scatter-based flow cytometry of EV (29). EV induced by respiratory exposures were found to modulate inflammation (19), thrombosis (13), endothelial dysfunction (11), tissue remodeling (6), and angiogenesis (3). By influencing these processes, EV may play a key role in the development of cardiovascular diseases and chronic obstructive pulmonary disease and possibly lung cancer and allergic asthma. The current findings warrant additional research with improved methodologies to evaluate the contribution of respiratory exposure-induced EV to disease etiology, as well as their potential as biomarkers of exposure or risk and as novel targets for preventive or therapeutic strategies.
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Affiliation(s)
- Birke J Benedikter
- a Department of Medical Microbiology , NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center , Maastricht , The Netherlands
- b Department of Respiratory Medicine , NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Emiel F M Wouters
- b Department of Respiratory Medicine , NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Paul H M Savelkoul
- a Department of Medical Microbiology , NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center , Maastricht , The Netherlands
- c Department of Medical Microbiology & Infection Control , VU University Medical Center , Amsterdam , The Netherlands
| | - Gernot G U Rohde
- d Medical clinic I, Department of Respiratory Medicine , Goethe University Hospital , Frankfurt/Main , Germany
| | - Frank R M Stassen
- a Department of Medical Microbiology , NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center , Maastricht , The Netherlands
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Abstract
Supplemental Digital Content is available in the text Objective: Secondhand smoke exposure (SHSE) in nonsmokers has been associated with premature cardiovascular mortality and ischemic heart disease. We conducted a cross-sectional, population-based study evaluating the relationship between SHSE, measured by subjective and objective methods, and conventional cardiovascular risks such as blood pressure, lipid profiles, and fasting glucose. Methods: We extracted information on 7376 healthy adults who had never smoked, for whom there were available urine cotinine levels, from the Korea National Health and Nutrition Examination Survey 2008–2011. SHSE was defined using self-report questionnaires and urine cotinine levels. The main outcomes included SBP and DBP, serum lipid profiles, and fasting glucose. Results: The mean age of the study population was 45.4 ± 0.4 years and 75.2% were women. Self-reported SHSE had no significant association with study outcomes except for DBP, which had marginally positive relationships (P = 0.060). Unadjusted analysis showed higher cotinine levels were associated with lower SBP, total cholesterol, LDL cholesterol, and triglyceride. All associations lost statistical significance after multivariable adjustment. Fasting glucose had a positive relationship with urine cotinine in quartiles but not with logarithm-transformed cotinine. Conclusion: Although SHSE is associated with increased risk of cardiovascular mortality and morbidity, we did not find any consistent relationship among SHSE and blood pressure, lipid, or fasting glucose levels in this cross-sectional study. Using objective measurements of urine cotinine did not alter this relationship. Further long-term prospective studies are needed to evaluate the effect of SHSE as a cardiovascular risk factor.
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Wei Y, Lai B, Liu H, Li Y, Zhen W, Fu L. Effect of cigarette smoke extract and nicotine on the expression of thrombomodulin and endothelial protein C receptor in cultured human umbilical vein endothelial cells. Mol Med Rep 2017; 17:1724-1730. [PMID: 29257196 PMCID: PMC5780117 DOI: 10.3892/mmr.2017.8070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 09/28/2017] [Indexed: 01/15/2023] Open
Abstract
The present study investigated the influence of cigarette smoke extract (CSE) and nicotine on the expression of thrombomodulin (TM) and endothelial protein C receptor (EPCR) in human umbilical vein endothelial cells (HUVECs). Smoking is associated with intravascular thrombosis. As a vital anticoagulation cofactor, TM is located on the endothelial cell surface and regulates intravascular coagulation by binding to thrombin, hence activating protein C. Activated protein C is a natural anticoagulant that interacts with EPCR to enhance the function of anticoagulation system. The effects of CSE (0.5–5%) and nicotine (10-3-10-9 mol/l) on the expression of TM and EPCR in HUVECs were observed. Reverse transcription-quantitative polymerase chain reaction and flow cytometric analysis techniques were used for detecting TM and EPCR mRNA and protein expression levels, respectively. After 6-h exposure, TM protein and mRNA expression levels decreased in a dose-dependent manner. Stimulation with 5% CSE for 0, 6, 10, 12 and 24 h led to a decrease in the levels of TM mRNA and protein over time, which reached a peak at 12 h. The levels were significantly reduced compared with the control group (P<0.001). However, CSE had no effect on EPCR. Furthermore, nicotine had no influence on TM and EPCR. In conclusion, the present study supports a novel molecular mechanism of cigarette smoking-associated thrombosis by the decreased expression of TM. Further studies are required to identify specific components in CSE responsible for decreasing TM expression and its associated consequences.
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Affiliation(s)
- Yujie Wei
- Institute of Cardiology, the General Hospital of Chinese People's Armed Police Forces, Beijing 100039, P.R. China
| | - Bin Lai
- Department of Emergency, the General Hospital of Chinese People's Armed Police Forces, Beijing 100039, P.R. China
| | - Huiliang Liu
- Institute of Cardiology, the General Hospital of Chinese People's Armed Police Forces, Beijing 100039, P.R. China
| | - Yi Li
- Institute of Cardiology, the General Hospital of Chinese People's Armed Police Forces, Beijing 100039, P.R. China
| | - Wang Zhen
- Institute of Cardiology, the General Hospital of Chinese People's Armed Police Forces, Beijing 100039, P.R. China
| | - Ling Fu
- Institute of Biotechnology, Academy of Military Medical Sciences, Beijing 100071, P.R. China
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Lee PN, Forey BA, Hamling JS, Thornton AJ. Environmental tobacco smoke exposure and heart disease: A systematic review. World J Meta-Anal 2017; 5:14-40. [DOI: 10.13105/wjma.v5.i2.14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 01/10/2017] [Accepted: 03/02/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To review evidence relating passive smoking to heart disease risk in never smokers.
METHODS Epidemiological studies were identified providing estimates of relative risk (RR) of ischaemic heart disease and 95%CI for never smokers for various indices of exposure to environmental tobacco smoke (ETS). “Never smokers” could include those with a minimal smoking experience. The database set up included the RRs and other study details. Unadjusted and confounder-adjusted RRs were entered, derived where necessary using standard methods. The fixed-effect and random-effects meta-analyses conducted for each exposure index included tests for heterogeneity and publication bias. For the main index (ever smoking by the spouse or nearest equivalent, and preferring adjusted to unadjusted data), analyses investigated variation in the RR by sex, continent, period of publication, number of cases, study design, extent of confounder adjustment, availability of dose-response results and biomarker data, use of proxy respondents, definitions of exposure and of never smoker, and aspects of disease definition. Sensitivity analyses were also run, preferring current to ever smoking, or unadjusted to adjusted estimates, or excluding certain studies.
RESULTS Fifty-eight studies were identified, 20 in North America, 19 in Europe, 11 in Asia, seven in other countries, and one in 52 countries. Twenty-six were prospective, 22 case-control and 10 cross-sectional. Thirteen included 100 cases or fewer, and 11 more than 1000. For the main index, 75 heterogeneous (P < 0.001) RR estimates gave a combined random-effects RR of 1.18 (95%CI: 1.12-1.24), which was little affected by preferring unadjusted to adjusted RRs, or RRs for current ETS exposure to those for ever exposure. Estimates for each level of each factor considered consistently exceeded 1.00. However, univariate analyses revealed significant (P < 0.001) variation for some factors. Thus RRs were lower for males, and in North American, larger and prospective studies, and also where the RR was for spousal smoking, fatal cases, or specifically for IHD. For case-control studies RRs were lower if hospital/diseased controls were used. RRs were higher when diagnosis was based on medical data rather than death certificates or self-report, and where the never smoker definition allowed subjects to smoke products other than cigarettes or have a limited smoking history. The association with spousal smoking specifically (1.06, 1.01-1.12, n = 34) was less clear in analyses restricted to married subjects (1.03, 0.99-1.07, n = 23). In stepwise regression analyses only those associations with source of diagnosis, study size, and whether the spouse was the index, were independently predictive (at P < 0.05) of heart disease risk. A significant association was also evident with household exposure (1.19, 1.13-1.25, n = 37). For those 23 studies providing dose-response results for spouse or household exposure, 11 showed a significant (P < 0.05) positive trend including the unexposed group, and two excluding it. Based on fewer studies, a positive, but non-significant (P > 0.05) association was found for workplace exposure (RR = 1.08, 95%CI: 0.99-1.19), childhood exposure (1.12, 0.95-1.31), and biomarker based exposure indices (1.15, 0.94-1.40). However, there was a significant association with total exposure (1.23, 1.12-1.35). Some significant positive dose-response trends were also seen for these exposure indices, particularly total exposure, with no significant negative trends seen. The evidence suffers from various weaknesses and biases. Publication bias may explain the large RR (1.66, 1.30-2.11) for the main exposure index for smaller studies (1-99 cases), while recall bias may explain the higher RRs seen in case-control and cross-sectional than in prospective studies. Some bias may also derive from including occasional smokers among the “never smokers”, and from misreporting smoking status. Errors in determining ETS exposure, and failing to update exposure data in long term prospective studies, also contribute to the uncertainty. The tendency for RRs to increase as more factors are adjusted for, argues against the association being due to uncontrolled confounding.
CONCLUSION The increased risk and dose-response for various exposure indices suggests ETS slightly increases heart disease risk. However heterogeneity, study limitations and possible biases preclude definitive conclusions.
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Abstract
Little is known about long-term care workers’ cardiovascular disease (CVD) risk. Thus, the authors used baseline objective and subjective data from 98 long-term care staff participating in a worksite health promotion study to provide a comprehensive CVD assessment. The median age of the sample was 32 years ( SD = 13.38). Nine (12.2%) participants smoked and 27 (37.0%) participants reported exposure to secondhand smoke. The average nightly hours of sleep was 6.5 ( SD = 1.18), with 24 (32%) participants reporting sleeping at least fairly bad. Sixty-eight participants (73.1%) were overweight or obese. The median aerobic activity was 0 ( SD = 18.56). Participants ate on average 27 ( SD = 17.34) servings of high fatty and/or salty foods per week. Although blood pressure and cholesterol levels were within normal limits, this population demonstrated poor behavioral CVD risk factors. Given this finding and the young age of the sample, these workers may be ideal candidates for health promotion efforts before health risk factors are present.
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Zhang Y, Zhang W, Edvinsson L, Xu CB. Lipid-soluble Cigarette Smoke Particles Induced Vascular Endothelin Type A Receptor Up-Regulation through Activation of ERK1/2 Signal Pathways. Basic Clin Pharmacol Toxicol 2017; 120:327-334. [DOI: 10.1111/bcpt.12688] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 10/07/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Yaping Zhang
- Shaanxi Key Laboratory of Ischemic Cardiovascular Disease; Institute of Basic and Translational Medicine; Xi'an Medical University; Xi'an China
| | - Wei Zhang
- Division of Experimental Vascular Research; Institute of Clinical Science in Lund; Lund University; Lund Sweden
- Xiamen Institute of Cardiovascular Diseases; The First Affiliated Hospital of Xiamen University; Xiamen China
| | - Lars Edvinsson
- Division of Experimental Vascular Research; Institute of Clinical Science in Lund; Lund University; Lund Sweden
| | - Cang-Bao Xu
- Shaanxi Key Laboratory of Ischemic Cardiovascular Disease; Institute of Basic and Translational Medicine; Xi'an Medical University; Xi'an China
- Division of Experimental Vascular Research; Institute of Clinical Science in Lund; Lund University; Lund Sweden
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Affiliation(s)
- Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, 3508TD Utrecht, Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
| | - Barbara Hoffmann
- Institute of Occupational and Social Medicine, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
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Abstract
With one-fifth of the world's total population, China's prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. Understanding China's current cardiovascular epidemic requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The latter have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the healthcare system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that 4 priorities should be taken: pursue multisectorial government and nongovernment strategies targeting the underlying causes of CVD (the whole-of-government and whole-of-society policy); give priority to prevention; reform the healthcare system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the 4 priorities, the pandemic of CVD and other major noncommunicable diseases in China will be reversed and the global sustainable development goal achieved.
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Affiliation(s)
- Yangfeng Wu
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.).
| | - Emelia J Benjamin
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.)
| | - Stephen MacMahon
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.)
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Sipilä JOT, Gunn JM, Kauko T, Rautava P, Kytö V. Association of restaurant smoking ban and the incidence of acute myocardial infarction in Finland. BMJ Open 2016; 6:e009320. [PMID: 26826146 PMCID: PMC4735218 DOI: 10.1136/bmjopen-2015-009320] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To describe the changes in nationwide acute myocardial infarction (AMI) incidence following the implementation of a law banning smoking indoors in restaurants on 1 June 2007. METHODS Retrospective registry study of all hospitalisations for AMI in Finland. All 34,887 hospitalisations for AMI between 1 June 2005 and 31 May 2009 were identified from the Care Register for Health Care (CRHC) and statistics for tobacco consumption were obtained from the National Institute for Health and Welfare. Comorbidities for individual hospitalisations were searched from the CRHC. RESULTS The incidence rate of AMI was reduced by 6.3% (95% CI 4.1% to 8.6%; p<0.0001) in the latter half of the study period following the smoking ban when adjusted for age, gender and overall population prevalence of smoking. Short-term incidence of AMI (6-month prior vs 6 months after the smoking ban) was also reduced (4.5%, 95% CI 0.2% to 9.0%; p=0.0399) and was largest in the working middle-aged group (40-50 years) but observed also in the oldest age group (>70 years). The incidence rates declined similarly for men and women. CONCLUSIONS Banning indoor tobacco smoking in restaurants was associated with a mild additional reduction in AMI incidence on a nationwide level in Finland.
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Affiliation(s)
- Jussi Olli Tapani Sipilä
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland Department of Neurology, University of Turku, Turku, Finland Neurology Clinic, North Karelia Central Hospital, Joensuu, Finland
| | - Jarmo Mikael Gunn
- Heart Center, Turku University Hospital, Turku, Finland Department of Surgery, Faculty of Medicine, University of Turku, Turku, Finland
| | - Tommi Kauko
- Department of Biostatistics, Faculty of Medicine, University of Turku, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, Faculty of Medicine, University of Turku, Turku, Finland
| | - Ville Kytö
- Heart Center, Turku University Hospital, Turku, Finland Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Castaldelli-Maia JM, Ventriglio A, Bhugra D. Tobacco smoking: From 'glamour' to 'stigma'. A comprehensive review. Psychiatry Clin Neurosci 2016; 70:24-33. [PMID: 26449875 DOI: 10.1111/pcn.12365] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2015] [Indexed: 01/08/2023]
Abstract
In this narrative review, we explore the history of tobacco smoking, its associations and portrayal of its use with luxury and glamour in the past, and intriguingly, its subsequent transformation into a mass consumption industrialized product encouraged by advertising and film. Then, we describe the next phase where tobacco in parts of the world has become an unwanted product. However, the number of smokers is still increasing, especially in new markets, and increasingly younger individuals are being attracted to it, despite the well-known health consequences of tobacco use. We also explore current smoking behaviors, looking at trends in the prevalence of consumption throughout the world, discrimination against smokers, light and/or intermittent smokers, and the electronic cigarette (e-cigarette). We place these changes in the context of neuroscience, which may help explain why the cognitive effects of smoking can be important reinforcers for its consumption despite strong anti-smoking pressure in Western countries.
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Affiliation(s)
- João Mauricio Castaldelli-Maia
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,Department of Neuroscience, Medical School, ABC Foundation, Santo André, Brazil
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Fischer F, Kraemer A. Meta-analysis of the association between second-hand smoke exposure and ischaemic heart diseases, COPD and stroke. BMC Public Health 2015; 15:1202. [PMID: 26627181 PMCID: PMC4667413 DOI: 10.1186/s12889-015-2489-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/12/2015] [Indexed: 02/07/2023] Open
Abstract
Background Second-hand smoke (SHS) is the most important contaminant of indoor air in first world countries. The risks associated with SHS exposure are highly relevant, because many people are regularly, and usually involuntarily, exposed to SHS. This study aims to quantify the effects of SHS exposure. Therefore, its impact on ischaemic heart diseases (IHD), chronic obstructive pulmonary diseases (COPD) and stroke will be considered. Methods A systematic literature review was conducted to identify articles dealing with the association between SHS and the three outcomes IHD, COPD and stroke. Overall, 24 articles were included in a meta-analysis using a random effects model. Effect sizes stratified for sex and for both sexes combined were calculated. Results The synthesis of primary studies revealed significant effect sizes for the association between SHS exposure and all three outcomes. The highest RR for both sexes combined was found for COPD (RR = 1.66, 95 % CI: 1.38–2.00). The RR for both sexes combined was 1.35 (95 % CI: 1.22–1.50) for stroke and 1.27 (95 % CI: 1.10–1.48) for IHD. The risks were higher in women than in men for all three outcomes. Conclusions This is the first study to calculate effect sizes for the association between SHS exposure and the disease outcomes IHD, COPD, and stroke at once. Overall, the effect sizes are comparable with previous findings in meta-analyses and therefore assumed to be reliable. The results indicate the high relevance of public health campaigns and legislation to protect non-smokers from the adverse health effects attributable to SHS exposure. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2489-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Florian Fischer
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, P.O. Box 100 131, 33501, Bielefeld, Germany.
| | - Alexander Kraemer
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, P.O. Box 100 131, 33501, Bielefeld, Germany.
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Notara V, Panagiotakos DB, Kouroupi S, Stergiouli I, Kogias Y, Stravopodis P, Papanagnou G, Zombolos S, Mantas Y, Antonoulas A, Pitsavos C. Smoking determines the 10-year (2004-2014) prognosis in patients with Acute Coronary Syndrome: the GREECS observational study. Tob Induc Dis 2015; 13:38. [PMID: 26609288 PMCID: PMC4658767 DOI: 10.1186/s12971-015-0063-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 11/16/2015] [Indexed: 11/16/2022] Open
Abstract
Background Smoking has long been positively associated with the development and progression of coronary heart disease. However, longitudinal cohort studies evaluating smoking habits among cardiac patients as well as the role of socio-demographic factors determining such behaviours are scarce and have been focused on primary care practice. Thus the aim of the present work was to examine the association of active smoking and behaviours and exposure to second-hand smoke, with the 10-year Acute Coronary Syndrome (ACS) prognosis, among cardiovascular patients. Methods From October 2003 to September 2004, a sample of six Greek hospitals was selected and almost allconsecutive 2172 ACS patients were enrolled. In 2013–14, the 10-year follow-up was performed in 1918 participants (11 % loss to follow-up). Smoking habits at the time of entry to the study, as well as during the follow-up period were studied using a standard questionnaire. Results Patients who had >60 pack-years of smoking had 57.8 % higher ACS mortality and 24.6 % higher risk for any ACS event. Nested model, adjusted only for age and sex, revealed that for every 30 pack-years of smoking increase, the associated ACS risk increased by 13 % (95 % CI 1.03, 1.30, p = 0.001). When further adjusted analysis, including several potential confounders, was applied the tested relationship was still significant (95 %CI 1.03, 1.30, p = 0.09). Accordingly, the risk for fatal ACS events increased by 8 % for every 30 pack-years of smoking increase (95 % CI 1.03, 1.63, p = 0.06). Moreover, 52 % of the patients reported being exposed to secondhand smoke and when further adjustments were made, it was revealed that they had 33 % (95 % CI 1.12, 1.60, p = 0.01) higher risk of having recurrent ACS events. Conclusions Active smoking and second-hand smoke among cardiac patients still represent a substantial clinical burden. Thus, smoking cessation policies should be incorporated into the long-term therapeutic management.
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Affiliation(s)
- Venetia Notara
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 46 Paleon Polemiston St. 166 74, Glyfada, Athens Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 46 Paleon Polemiston St. 166 74, Glyfada, Athens Greece
| | - Semina Kouroupi
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 46 Paleon Polemiston St. 166 74, Glyfada, Athens Greece
| | | | - Yannis Kogias
- Cardiology Clinic, General Hospital of Karditsa, Karditsa, Greece
| | - Petros Stravopodis
- Cardiology Clinic, General Hospital of Zakynthos Island, Zakynthos, Greece
| | | | - Spyros Zombolos
- Cardiology Clinic, General Hospital of Kalamata, Kalamata, Greece
| | - Yannis Mantas
- Cardiology Clinic, General Hospital of Chalkida, Chalkida, Greece
| | | | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
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Mamudu HM, Veeranki SP, John RM, Kioko DM, Ogwell Ouma AE. Secondhand Smoke Exposure Among Nonsmoking Adolescents in West Africa. Am J Public Health 2015; 105:1823-30. [PMID: 26180960 PMCID: PMC4539798 DOI: 10.2105/ajph.2015.302661] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES We estimated the prevalence and determinants of secondhand smoke (SHS) exposure among nonsmoking adolescents in 9 West African countries. METHODS We conducted a pooled analysis with nationally representative 2006 to 2009 Global Youth Tobacco Survey data. We used descriptive statistics to determine the prevalence of SHS exposure and inferential statistics using a multivariable logistic regression model to determine factors associated with SHS exposure. We investigated average marginal effect results that show the probability of SHS exposure, adjusting for all other attributes. RESULTS SHS exposure inside the home ranged from 13.0% to 45.0%; SHS exposure outside the home ranged from 24.7% to 80.1%. Parental or peer smoking behaviors were significantly associated with higher probability of SHS exposure in all 9 countries. Knowledge of smoking harm, support for smoking bans, exposure to antismoking media messages, and receptivity of school tobacco education were significantly associated with higher SHS exposure in most countries. CONCLUSIONS West African policymakers should adopt policies consistent with Article 8 of the World Health Organization Framework Convention on Tobacco Control and its guidelines and public health education to promote smoke-free households.
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Affiliation(s)
- Hadii M Mamudu
- Hadii M. Mamudu and David M. Kioko are with the Department of Health Services Management and Policy, East Tennessee State University, Johnson City. Sreenivas P. Veeranki is with the Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston. Rijo M. John is with the Indian Institute of Technology, Jodhpur, India. Ahmed E. Ogwell Ouma is with the Regional Tobacco Control Advisor, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Sreenivas P Veeranki
- Hadii M. Mamudu and David M. Kioko are with the Department of Health Services Management and Policy, East Tennessee State University, Johnson City. Sreenivas P. Veeranki is with the Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston. Rijo M. John is with the Indian Institute of Technology, Jodhpur, India. Ahmed E. Ogwell Ouma is with the Regional Tobacco Control Advisor, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Rijo M John
- Hadii M. Mamudu and David M. Kioko are with the Department of Health Services Management and Policy, East Tennessee State University, Johnson City. Sreenivas P. Veeranki is with the Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston. Rijo M. John is with the Indian Institute of Technology, Jodhpur, India. Ahmed E. Ogwell Ouma is with the Regional Tobacco Control Advisor, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - David M Kioko
- Hadii M. Mamudu and David M. Kioko are with the Department of Health Services Management and Policy, East Tennessee State University, Johnson City. Sreenivas P. Veeranki is with the Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston. Rijo M. John is with the Indian Institute of Technology, Jodhpur, India. Ahmed E. Ogwell Ouma is with the Regional Tobacco Control Advisor, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Ahmed E Ogwell Ouma
- Hadii M. Mamudu and David M. Kioko are with the Department of Health Services Management and Policy, East Tennessee State University, Johnson City. Sreenivas P. Veeranki is with the Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston. Rijo M. John is with the Indian Institute of Technology, Jodhpur, India. Ahmed E. Ogwell Ouma is with the Regional Tobacco Control Advisor, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
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Jain RB. Exposure to second hand smoke at home and work among nonsmokers. CHEMOSPHERE 2015; 135:225-232. [PMID: 25965001 DOI: 10.1016/j.chemosphere.2015.04.057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 03/24/2015] [Accepted: 04/22/2015] [Indexed: 06/04/2023]
Abstract
Exposure to second hand smoke (SHS) is associated with adverse health effects. This study was undertaken to assess comparative levels of exposure to SHS at home and work among nonsmokers aged ⩾12 years. Data from National Health Examination Survey for 1999-2010 were analyzed to estimate exposure to SHS. Total number of subjects included in the study was 24,791. Those who self-reported not having used any tobacco products during the last five days were considered nonsmokers for the purpose of this study. Serum cotinine levels were used as the outcome variable to indicate the level of exposure to SHS. Adjusted serum cotinine levels for those with no exposure to SHS, exposure to SHS at work only, exposure to SHS at home only, and exposure to SHS at home and work were 0.047 (0.044-0.050)n g/mL, 0.055 (0.047-0.064) ng/mL, 0.522 (0.401-0.678) ng/mL, and 0.485 (0.280-0.0840) ng/mL respectively. Public efforts to reduce exposure to SHS at home should be strengthened.
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Affiliation(s)
- Ram B Jain
- 33 Woodbury Lane, Sanford, NC 27332, USA.
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Lv X, Sun J, Bi Y, Xu M, Lu J, Zhao L, Xu Y. Risk of all-cause mortality and cardiovascular disease associated with secondhand smoke exposure: a systematic review and meta-analysis. Int J Cardiol 2015; 199:106-15. [PMID: 26188829 DOI: 10.1016/j.ijcard.2015.07.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 05/13/2015] [Accepted: 07/03/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Emerging studies have assessed the association between secondhand smoke (SHS) exposure and cardiovascular disease (CVD) as well as all-cause mortality. However, findings were not consistent due to the heterogeneity of study characteristics. METHODS PubMed and Embase were searched through May 2014 for prospective cohort and case-control studies investigating the associations of SHS exposure in never smokers with all-cause mortality and the risk of CVD. The main analysis was performed in studies using self-reported SHS exposure and secondary analysis was performed in studies using objectively measured SHS exposure. Summary estimates were calculated using random-effects models. RESULTS Twenty-three prospective and 17 case-control studies were included. The pooled relative risks (RR) for never smokers exposed to SHS in comparison with those unexposed were 1.18 [95% confidence interval (CI): 1.10-1.27] for all-cause mortality (12 studies), and 1.23 (1.16-1.31) for CVD (38 studies). The association of SHS exposure with CVD was markedly stronger among studies conducted in China (RR=1.65, 95% CI 1.27-2.13) than that in the US (RR=1.09, 95% CI 1.03-1.16). Studies using objectively measured SHS exposure demonstrated a slightly higher risk for CVD compared with those using self-reported SHS exposure. CONCLUSIONS Exposure to SHS significantly increased the risk for all-cause mortality and CVD. The risk associated with SHS exposure was large in China while the risk was only modest in the US. Studies using objectively measured SHS exposure may yield a higher risk of CVD than those using self-reported SHS exposure.
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Affiliation(s)
- Xiaofei Lv
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Jichao Sun
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China; Laboratory of Endocrine and Metabolic Diseases, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, and Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Min Xu
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Liebin Zhao
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
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[Evolution since 2002 of the management of patients with ST elevated acute coronary syndrome (STEMI) in Île-de-France. E-MUST survey]. Presse Med 2015; 44:e273-81. [PMID: 25960444 DOI: 10.1016/j.lpm.2015.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 11/21/2014] [Accepted: 01/12/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION ST-segment-elevation acute myocardial infarction (STEMI) is a therapeutic emergency. Early reperfusion is the key to successful reperfusion. Guidelines recommend organizing regional networks. In France, this starts with a call to a medical dispatch center, the SAMU-centre 15. The aim of this study was to evaluate regional STEMI management using data collected from 2002 to 2010. METHODS Observational, prospective, multicenter survey. STEMI patient with chest pain lasting for less than 24hours managed by 40 mobile emergency and resuscitation service (SMUR) and 8 emergency medical system (SAMU) from the Greater Paris Area (Île-de-France) were analyzed. Demographic data, cardiovascular risk factors, infarction location, decision of reperfusion and delays were collected. The rate of coronary reperfusion was chosen as the primary endpoint. RESULTS Eleven thousand five hundred and eighty-eight patients enrolled from 2002 to 2010 were analyzed. Median age was 59.9 (51.0 to 72.9) years; 9080 (78.5%) were men. The number of patients included decreased from 1376 in 2002 to 1119 in 2010. Reperfusion was achieved by fibrinolysis in 2644 (23%) cases and primary angioplasty in 7999 (69%) cases. The rate of decision of coronary reperfusion significantly increased from 86.7% in 2002 to 94.8% in 2010 (P<0.0001). Interaction between the increasing decision of reperfusion and all factors studied (demographics, cardiovascular risk factors, infarct location and delays) was significant only for family history of coronary artery disease (P=0.03). In-hospital mortality was 2.8% (321 cases). CONCLUSION The number of patients with STEMI managed by the SAMU declined slightly over the past decade. The rate of decision of reperfusion progressively increased up to 95%. Entrance into the network by the SAMU-centre 15 is a guarantee of a wide and early access to the coronary reperfusion.
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O'Brien E, Spiess PC, Habibovic A, Hristova M, Bauer RA, Randall MJ, Poynter ME, van der Vliet A. Inhalation of the reactive aldehyde acrolein promotes antigen sensitization to ovalbumin and enhances neutrophilic inflammation. J Immunotoxicol 2015; 13:191-7. [PMID: 25875327 DOI: 10.3109/1547691x.2015.1033571] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Acrolein (ACR), an α,β-unsaturated aldehyde and a major component of tobacco smoke, is a highly reactive electrophilic respiratory irritant implicated in asthma pathogenesis and severity. However, few studies have directly investigated the influence of ACR exposure on allergen sensitization and pulmonary inflammation. The present study was designed to examine the impact of ACR inhalation on allergic sensitization to the inhaled antigen ovalbumin (OVA), as well as pulmonary inflammation during subsequent OVA challenge. Adult male C57BL/6 mice were exposed to inhaled OVA (1%, 30 min/day, 4 days/week) and/or ACR (5 ppm, 4 h/day, 4 days/week) over 2 weeks and subsequently challenged with aerosolized OVA (1%, 30 min/day) over three consecutive days. Serum anti-OVA IgG1 levels were increased significantly in animals exposed to both OVA and ACR, compared to animals exposed to either OVA or ACR alone. In addition, differential cell counts and histological analysis revealed an increase in BAL neutrophils in animals exposed to both OVA and ACR. However, exposure to both OVA and ACR did not influence mRNA expression of the cytokines il5, il10, il13 or tnfa, but significantly increased mRNA expression of ccl20. Moreover, ACR exposure enhanced lung mRNA levels of il17f and tgfb1, suggesting development of enhanced inhalation tolerance to OVA. Overall, the findings indicate that ACR inhalation can promote airway-mediated sensitization to otherwise innocuous inhaled antigens, such as OVA, but also enhances immune tolerance, thereby favoring neutrophilic airway inflammation.
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Affiliation(s)
| | | | | | | | | | | | - Matthew E Poynter
- b Department of Medicine , College of Medicine, University of Vermont , Burlington , VT , USA
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Delgado G, Siekmeier R, Krämer BK, März W, Kleber ME. Cotinine as a marker for risk prediction in the Ludwigshafen Risk and Cardiovascular Health Study. Respir Physiol Neurobiol 2015; 209:17-22. [DOI: 10.1016/j.resp.2014.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 01/29/2023]
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Pan A, Clark ML, Ang LW, Yu MC, Yuan JM, Koh WP. Incense use and cardiovascular mortality among Chinese in Singapore: the Singapore Chinese Health Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:1279-84. [PMID: 25127437 PMCID: PMC4256695 DOI: 10.1289/ehp.1307662] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 08/13/2014] [Indexed: 05/16/2023]
Abstract
BACKGROUND Incense burning is common in many parts of the world. Although it is perceived that particulate matter from incense smoke is deleterious to health, there is no epidemiologic evidence linking domestic exposure to cardiovascular mortality. OBJECTIVE We examined the association between exposure to incense burning and cardiovascular mortality in the Singapore Chinese Health Study. METHODS We enrolled a total of 63,257 Singapore Chinese 45-74 years of age during 1993-1998. All participants were interviewed in person to collect information about lifestyle behaviors, including the practice of burning incense at home. We identified cardiovascular deaths via record linkage with the nationwide death registry through 31 December 2011. RESULTS In this cohort, 76.9% were current incense users, and most of the current users (89.9%) had burned incense daily for ≥ 20 years. Relative to noncurrent users, current users had a 12% higher risk of cardiovascular mortality [multivariable adjusted hazard ratio (HR) = 1.12; 95% CI: 1.04, 1.20]. The HR was 1.19 (95% CI: 1.03, 1.37) for mortality due to stroke and 1.10 (95% CI: 1.00, 1.21) for mortality due to coronary heart disease. The association between current incense use and cardiovascular mortality appeared to be limited to participants without a history of cardiovascular disease at baseline (HR = 1.16; 95% CI: 1.07, 1.26) but not linked to those with a history (HR = 1.00; 95% CI: 0.86, 1.17). In addition, the association was stronger in never-smokers (HR = 1.12; 95% CI: 1.02, 1.23) and former smokers (HR = 1.19; 95% CI: 1.00, 1.42) than in current smokers (HR = 1.05; 95% CI: 0.91, 1.22). CONCLUSIONS Long-term exposure to incense burning in the home environment was associated with an increased risk of cardiovascular mortality in the study population.
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Affiliation(s)
- An Pan
- Saw Swee Hock School of Public Health, and
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Saleheen D, Zhao W, Rasheed A. Epidemiology and public health policy of tobacco use and cardiovascular disorders in low- and middle-income countries. Arterioscler Thromb Vasc Biol 2014; 34:1811-9. [PMID: 25035346 DOI: 10.1161/atvbaha.114.303826] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
All forms of tobacco lead to an increased risk of cardiovascular disorders. During the past few decades, the number of people who consume tobacco has increased worldwide because of an overall increase in the global population. It is estimated that close to 80% of the >1.3 billion people who smoke tobacco in the world are in low- and middle-income countries. Smokeless forms of tobacco are also widely consumed in low- and middle-income countries, including chewable and snuffed forms. Lack of targeted and effective strategies to control tobacco consumption contributes to a large burden of cardiovascular disorders in low- and middle-income countries, where cardiovascular disorders have become the leading cause of morbidity and mortality. In this review, we evaluate the epidemiology of tobacco use in low- and middle-income countries and assess the public health policies needed to control tobacco use in such regions for the prevention of cardiovascular disorders and other tobacco-related morbidities and mortality.
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Affiliation(s)
- Danish Saleheen
- From the Department of Biostatistics and Epidemiology (D.S.) and Division of Translational Medicine and Human Genetics, Perelman School of Medicine (D.S., W.Z.), University of Pennsylvania, Philadelphia; and Center for Non-Communicable Diseases, Karachi, Pakistan (D.S., A.R.).
| | - Wei Zhao
- From the Department of Biostatistics and Epidemiology (D.S.) and Division of Translational Medicine and Human Genetics, Perelman School of Medicine (D.S., W.Z.), University of Pennsylvania, Philadelphia; and Center for Non-Communicable Diseases, Karachi, Pakistan (D.S., A.R.)
| | - Asif Rasheed
- From the Department of Biostatistics and Epidemiology (D.S.) and Division of Translational Medicine and Human Genetics, Perelman School of Medicine (D.S., W.Z.), University of Pennsylvania, Philadelphia; and Center for Non-Communicable Diseases, Karachi, Pakistan (D.S., A.R.)
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Fischer F, Minnwegen M, Kaneider U, Kraemer A, Khan MMH. Prevalence and determinants of secondhand smoke exposure among women in Bangladesh, 2011. Nicotine Tob Res 2014; 17:58-65. [PMID: 25125322 DOI: 10.1093/ntr/ntu129] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND OBJECTIVES The population of Bangladesh is highly susceptible to secondhand smoke (SHS) exposure due to high smoking rates and low awareness about the harmful effects of SHS. This study aims to determine the prevalence of SHS exposure and highlight the essential determinants in developing successful strategies to prevent adverse health effects in Bangladesh. METHODS The analysis is based on the Bangladesh Demographic Health Survey 2011, in which 17,749 women in the reproductive age group (12-49 years) were included. The information regarding SHS exposure at home was derived from the question: "How often does anyone smoke inside your house?" The variable was recoded into 3 groups: daily exposure, low exposure (exposed weekly, monthly, or less than monthly), and no SHS exposure. We performed descriptive and bivariable analyses and multinomial logistic regression. RESULTS A total of 46.7% of the women reported high exposure to SHS at home. According to the multinomial logistic regression model, relatively lower education and lower wealth index were significantly associated with daily SHS exposure at home. The exposure differed significantly between the divisions of Bangladesh. Having children at home (vs. not) and being Islamic (compared to other religious affiliations) were protective factors. CONCLUSIONS The study indicates that women from socioeconomically disadvantaged households are more likely to experience daily exposure to SHS at home. Therefore, especially these groups have to be targeted to reduce tobacco consumption. In addition to aspects of legislation, future strategies need to focus educational aspects to improve the population's health status in Bangladesh.
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Affiliation(s)
- Florian Fischer
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, Germany
| | - Martina Minnwegen
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, Germany
| | - Ulrike Kaneider
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, Germany
| | - Alexander Kraemer
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, Germany
| | - Md Mobarak Hossain Khan
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, Germany
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Zhu B, Wu X, Wang X, Zheng Q, Sun G. The Association Between Passive Smoking and Type 2 Diabetes. Asia Pac J Public Health 2014; 26:226-37. [PMID: 24824522 DOI: 10.1177/1010539514531041] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The number of people with diabetes has been exponentially increasing. A number of reports in the literature have suggested that exposure to passive smoke may play a key role in the development of diabetes; however, the association has not been jointly summarized yet. In this meta-analysis, 2 databases were searched to identify studies, and the references of these studies were scanned for further studies. Fourteen studies on the relationship between passive smoking and diabetes were included. After all the studies were pooled, the results showed that passive smoking was significantly associated with an increased risk of type 2 diabetes in a random model. The subgroup analysis results were consistent with overall results regardless of type of study design, age, gender, adjustment of dependent variables, area, or study quality. Sensitivity analysis indicated that the overall results were reliable. There was no publication bias observed in the selected studies.
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Affiliation(s)
- Bo Zhu
- China Medical University, Shenyang, China
- Liaoning Academy of Safety Science, Shenyang, China
| | - Xiaomei Wu
- The First Hospital of China Medical University, Shenyang, China
| | - Xin Wang
- Liaoning Academy of Safety Science, Shenyang, China
| | | | - Guifan Sun
- China Medical University, Shenyang, China
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