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Siddiqi K, Welch C, Huque R, Iqbal R, Kanaan M, Mishu MP, Khokhar MA, Semple S. The Effect of Adult Smoking Behavior on Children's Exposure to Secondhand Smoke. An Analysis Based on Salivary Cotinine Levels Among Children in Dhaka and Karachi. Nicotine Tob Res 2024; 26:1512-1520. [PMID: 38890774 PMCID: PMC11494616 DOI: 10.1093/ntr/ntae130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/17/2024] [Accepted: 05/27/2024] [Indexed: 06/20/2024]
Abstract
INTRODUCTION Exposure to secondhand smoke (SHS) risks children's health. However, biomarkers are rarely used to study SHS exposure among children in low- and middle-income countries. AIMS AND METHODS We analyzed cross-sectional data collected between March and November 2022 for a cluster-randomized controlled trial investigating a Smoke-Free Intervention in 2769 children aged 9-15 in 74 schools (34 in Dhaka, Bangladesh, and 40 in Karachi, Pakistan). Children's saliva was tested for the concentration of cotinine-a highly sensitive and specific biomarker for SHS exposure. Based on their reports, children's homes were categorized as Nonsmoking Homes (NSH) when residents were nonsmokers; Smoke-free Homes (SFH) when residents and visitors smoked outdoors only; and Smoke-permitted Homes (SPH) when either residents or visitors smoked indoors. We compared cotinine concentrations across these home types and the two cities using a proportional odds model. RESULTS Overall, 95.7% of children (92% in Dhaka; and 99.4% in Karachi) had cotinine levels between 0.1 and 12 ng/mL, indicating SHS exposure. Median cotinine levels were higher in Karachi (0.58 ng/mL, IQR 0.37 to 0.93) than in Dhaka (0.27 ng/mL, IQR 0.16 to 0.49). Median cotinine concentration was also higher among children living in SPH than those in either NSH or SFH; with absolute differences of approximately 0.1-0.3 and 0.05 ng/mL, respectively. CONCLUSIONS The level of SHS exposure in Dhaka and Karachi indicates widespread and unrestricted smoking. Smoking restrictions in households and enforcement of smoking bans are urgently needed. IMPLICATIONS The high levels of SHS exposure in children living in SFH suggest parental behavior to hide their smoking and/or exposure in private vehicles or public spaces. It is important to advocate for SFH and cars to protect children from SHS exposure. However, these initiatives alone may not be enough. There is a need to enforce smoking bans in enclosed public places and transportation, as well as extend these bans to playgrounds, parks, fairgrounds, and other public spaces that children frequently visit. It is essential to complement smoking restrictions with tobacco cessation advice and support in these settings.
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Affiliation(s)
- Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, University of York, York, UK
| | - Charlie Welch
- Department of Health Sciences, University of York, York, UK
| | | | - Romania Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Mona Kanaan
- Department of Health Sciences, University of York, York, UK
| | - Masuma Pervin Mishu
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
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Matt GE, Greiner L, Record RA, Wipfli H, Long J, Dodder NG, Hoh E, Lopez Galvez N, Novotny TE, Quintana PJE, Destaillats H, Tang X, Snijders AM, Mao JH, Hang B, Schick S, Jacob P, Talbot P, Mahabee-Gittens EM, Merianos AL, Northrup TF, Gundel L, Benowitz NL. Policy-relevant differences between secondhand and thirdhand smoke: strengthening protections from involuntary exposure to tobacco smoke pollutants. Tob Control 2024; 33:798-806. [PMID: 37263783 PMCID: PMC11503167 DOI: 10.1136/tc-2023-057971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/16/2023] [Indexed: 06/03/2023]
Abstract
Starting in the 1970s, individuals, businesses and the public have increasingly benefited from policies prohibiting smoking indoors, saving thousands of lives and billions of dollars in healthcare expenditures. Smokefree policies to protect against secondhand smoke exposure, however, do not fully protect the public from the persistent and toxic chemical residues from tobacco smoke (also known as thirdhand smoke) that linger in indoor environments for years after smoking stops. Nor do these policies address the economic costs that individuals, businesses and the public bear in their attempts to remediate this toxic residue. We discuss policy-relevant differences between secondhand smoke and thirdhand smoke exposure: persistent pollutant reservoirs, pollutant transport, routes of exposure, the time gap between initial cause and effect, and remediation and disposal. We examine four policy considerations to better protect the public from involuntary exposure to tobacco smoke pollutants from all sources. We call for (a) redefining smokefree as free of tobacco smoke pollutants from secondhand and thirdhand smoke; (b) eliminating exemptions to comprehensive smoking bans; (c) identifying indoor environments with significant thirdhand smoke reservoirs; and (d) remediating thirdhand smoke. We use the case of California as an example of how secondhand smoke-protective laws may be strengthened to encompass thirdhand smoke protections. The health risks and economic costs of thirdhand smoke require that smokefree policies, environmental protections, real estate and rental disclosure policies, tenant protections, and consumer protection laws be strengthened to ensure that the public is fully protected from and informed about the risks of thirdhand smoke exposure.
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Affiliation(s)
- Georg E Matt
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Lydia Greiner
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Rachael A Record
- School of Communication, San Diego State University, San Diego, CA, USA
| | - Heather Wipfli
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jamie Long
- Public Health Law Center, Mitchell Hamline School of Law, University of Minnesota, St Paul, MN, USA
| | - Nathan G Dodder
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Eunha Hoh
- School of Public Health, San Diego State University, San Diego, CA, USA
| | | | - Thomas E Novotny
- School of Public Health, San Diego State University, San Diego, CA, USA
| | | | - Hugo Destaillats
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Xiaochen Tang
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Antoine M Snijders
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Jian-Hua Mao
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Bo Hang
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Suzaynn Schick
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Peyton Jacob
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Prue Talbot
- Department of Molecular, Cell, and Systems Biology, University of California Riverside, Riverside, CA, USA
| | - E Melinda Mahabee-Gittens
- Department of Pediatrics, Division of Emergency Medicine Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Thomas F Northrup
- Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
| | - Lara Gundel
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Neal L Benowitz
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
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Luo Y, Zhang L, Lu Y, Lin X, Weng Z, Xu Y. Association Between the Serum Copper Levels and Environmental Tobacco Exposure on the Risk of Overweight and Obesity in Children: a Study Based on the National Health and Nutrition Examination Survey. Biol Trace Elem Res 2024; 202:4440-4449. [PMID: 38158458 DOI: 10.1007/s12011-023-04037-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
This study was to assess the individual effects of serum copper levels and environmental tobacco exposure and their joint effects on the risk of overweight and obesity among children and adolescents of 6 to 19 year olds. We analyzed cross-sectional data from 1849 children and adolescents participating in the National Health and Nutrition Examination Survey (NHANES) collected between 2011 and 2016. Environmental tobacco exposure was determined by cotinine levels. The serum copper level was divided into < median group and ≥ median groups according to the median of 109.81 µg/dL. The outcome was overweight/obese in children and adolescents. Weighted multinomial multivariate logistic regression models were used to assess the association of serum copper and cotinine levels, with the risk of overweight/obesity, and the joint effects on the risk of overweight and obesity among children and adolescents. The subgroup analyses based on age, gender, and household smoking status were conducted. Among 1849 children and adolescents, 332 children and adolescents had overweight BMI, and 450 children and adolescents had obese BMI. Higher serum copper levels were associated with the risk of obesity in children and adolescents (odds ratio (OR) 2.96, 95% confidence interval (CI) 1.39-6.31, P = 0.006). A positive association between increasing levels of cotinine levels and the risk of overweight (OR 1.83, 95% CI 1.16-2.87, P = 0.010) and obesity (OR 2.56, 95% CI 1.03-6.40, P = 0.044) in children and adolescents was observed. A remarkable association was found between higher serum copper in combination with higher cotinine levels and the risk of overweight (OR 3.23, 95% CI 1.19-8.83, P = 0.023) and obesity (OR 8.76, 95% CI 2.14-35.87, P = 0.003) in children and adolescents. The subgroup analyses revealed positive associations between high serum copper levels in combination with high cotinine levels and overweight and obesity in children and adolescents aged ≥ 12 years, of female sex, and without smoking family members. There may exist a joint effect of serum copper levels and environmental tobacco exposure on overweight/obesity among children and adolescents. These findings offer an insight that early weight control and reduction of tobacco exposure and the detection of serum copper levels may be important in reducing the risk of obesity in children.
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Affiliation(s)
- Yujun Luo
- Department of Pediatrics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, People's Republic of China
- Xiaorong Luo's Renowned Expert Inheritance Studio, 3Rd Floor, East District, Guangdong Provincial Hospital of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, Guangdong Province, 510120, People's Republic of China
| | - Linzhu Zhang
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, 510405, People's Republic of China
| | - Yanting Lu
- The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, 510405, People's Republic of China
| | - Xiaohong Lin
- Department of Pediatrics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, People's Republic of China
- Xiaorong Luo's Renowned Expert Inheritance Studio, 3Rd Floor, East District, Guangdong Provincial Hospital of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, Guangdong Province, 510120, People's Republic of China
| | - Zelin Weng
- Department of Pediatrics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, People's Republic of China.
- Xiaorong Luo's Renowned Expert Inheritance Studio, 3Rd Floor, East District, Guangdong Provincial Hospital of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, Guangdong Province, 510120, People's Republic of China.
| | - Youjia Xu
- Department of Pediatrics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, People's Republic of China.
- Xiaorong Luo's Renowned Expert Inheritance Studio, 3Rd Floor, East District, Guangdong Provincial Hospital of Chinese Medicine, No.111, Dade Road, Yuexiu District, Guangzhou, Guangdong Province, 510120, People's Republic of China.
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Baker E, Harris WT, Guimbellot JS, Bliton K, Rowe SM, Raju SV, Oates GR. Association between biomarkers of tobacco smoke exposure and clinical efficacy of ivacaftor in the G551D observational trial (GOAL). J Cyst Fibros 2024; 23:959-966. [PMID: 39033068 PMCID: PMC11410542 DOI: 10.1016/j.jcf.2024.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 06/15/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Acrolein, an aldehyde in smoke from tobacco products, inhibits CFTR function in vitro. Ivacaftor is an FDA-approved potentiator that improves mutant CFTR function. This human clinical study investigated the relationship between two urinary markers of tobacco smoke exposure - the acrolein metabolite 3-HPMA and the nicotine metabolite NNAL - and sweat chloride response to ivacaftor in the G551D Observational Trial (GOAL). METHODS 3-HPMA (low: <50th centile; moderate: 50-75th centile; high: >75th centile) and NNAL (detectable/undetectable) in GOAL samples was quantified with LC-MS/MS. Self-report of tobacco smoke exposure (Y/N) served as a subjective measure. Change in sweat chloride from pre- to 6 months post-ivacaftor treatment (ΔSC) was the primary CFTR-dependent readout. RESULTS The sample included 151 individuals, mean age 20.7 (SD 11.4) years, range 6-59 years. Smoke exposure prevalence was 15 % per self-reports but 27 % based on detectable NNAL. 3-HPMA was increased in those reporting tobacco smoke exposure (607 vs 354 ng/ml, p = 0.008), with a higher proportion of smoke-exposed in the high- vs low-acrolein group (31 % vs 9 %, p=0.040). Compared to low-acrolein counterparts, high-acrolein participants experienced less decrease in sweat chloride (-35.2 vs -48.2 mmol/L; p = 0.020) and had higher sweat chloride values (50.6 vs 37.6 mmol/L; p = 0.020) 6 months post-ivacaftor. The odds of ivacaftor-mediated potentiation to near normative CFTR function (defined as SC6mo <40 mmol/L) was more than twice as high in the low-acrolein cohort (OR: 2.51, p = 0.026). CONCLUSIONS Increased urinary 3-HPMA, an acrolein metabolite of tobacco smoke, is associated with a diminished sweat chloride response to ivacaftor potentiation of CFTR function.
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Affiliation(s)
- Elizabeth Baker
- Medicine University of Alabama at Birmingham 1808 7th Ave S, BDB 853 Birmingham, AL 35233 United States
| | - William T Harris
- Medicine University of Alabama at Birmingham 1808 7th Ave S, BDB 853 Birmingham, AL 35233 United States
| | - Jennifer S Guimbellot
- Medicine University of Alabama at Birmingham 1808 7th Ave S, BDB 853 Birmingham, AL 35233 United States; The University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kyle Bliton
- Medicine University of Alabama at Birmingham 1808 7th Ave S, BDB 853 Birmingham, AL 35233 United States
| | - Steven M Rowe
- Medicine University of Alabama at Birmingham 1808 7th Ave S, BDB 853 Birmingham, AL 35233 United States
| | - S Vamsee Raju
- Medicine University of Alabama at Birmingham 1808 7th Ave S, BDB 853 Birmingham, AL 35233 United States
| | - Gabriela R Oates
- Medicine University of Alabama at Birmingham 1808 7th Ave S, BDB 853 Birmingham, AL 35233 United States.
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Qadri S, Maia ACRG, Ali HEA, Alarabi AB, Alshbool FZ, Khasawneh FT. Sex-Dependent Occlusive Cardiovascular Disease Effects of Short-Term Thirdhand Smoke Exposure. Nicotine Tob Res 2024; 26:1225-1233. [PMID: 38520288 PMCID: PMC11339167 DOI: 10.1093/ntr/ntae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 02/06/2024] [Accepted: 03/13/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Thirdhand smoke (THS) is associated with many public health and disease concerns, such as respiratory illness, cancer, lipidemia, and cardiovascular disease (CVD). We have previously shown that a moderate to long-term exposure to THS increases the risk of thrombosis. However, whether short-term exposure to THS would produce any effects remains to be discovered. Therefore, this study investigated the impact of 1-month THS exposure on platelet function, in vivo and in vitro, and on cytokine response, in a sex-dependent manner. AIMS AND METHODS Secondhand smoke or clean air (CA) exposed upholstery materials for 1 week were kept in cages housed with 5-6 mice, and the procedure was repeated for 4 weeks. These THS-exposed mice were evaluated for thrombogenesis and platelet function assays. In addition, cytokines expression was evaluated from pooled serum. RESULTS Compared to the CA group, THS exposure significantly shortened the tail bleeding time and carotid artery thrombus formation. Moreover, the female mice appeared more sensitive to THS exposure than males. Furthermore, platelet aggregation, dense granule secretion, and P-selectin activation markers were significantly elevated due to THS exposure. In addition, high-throughput screening showed at least 30 cytokines differentially modulated by THS in females relative to 26 in male mice. CONCLUSIONS Collectively, these results demonstrate that 1 month of THS exposure represents a high health risk, in part, by triggering a prothrombotic phenotype that appears to be more significant in females, who are at a much higher risk for occlusive CVD. Additionally, changes in cytokine levels mediate some of the THS-induced occlusive effects. IMPLICATIONS This study revealed that THS exposure for 1 month is detrimental to the cardiovascular health of both sexes; however, females could be more aggressively affected than males. In addition, interleukins and chemokines could be critical factors for initiating prothrombotic activity due to THS exposure.
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Affiliation(s)
- Shahnaz Qadri
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Ana Carolina R G Maia
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Hamdy E A Ali
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Ahmed B Alarabi
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Fatima Z Alshbool
- Department of Pharmacy Practice, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
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Merianos AL, Matt GE, Stone TM, Jandarov RA, Hoh E, Dodder NG, Quintana PJE, Lopez-Galvez N, Stone L, Mahabee-Gittens EM. Contamination of surfaces in children's homes with nicotine and the potent carcinogenic tobacco-specific nitrosamine NNK. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024; 34:727-734. [PMID: 38104233 DOI: 10.1038/s41370-023-00629-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Tobacco smoke exposure (TSE) through secondhand and thirdhand smoke is a modifiable risk factor that contributes to childhood morbidity. Limited research has assessed surface TSE pollution in children's environments as a potential source of thirdhand smoke exposure, and none have examined levels of the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) on surfaces. OBJECTIVE This study measured surface NNK and nicotine in children's homes and associations with sociodemographics and parent-reported TSE behaviors. We assessed correlations of surface NNK and nicotine with dust NNK, dust nicotine, and child cotinine. METHODS Home surface wipe NNK and nicotine data from 84 children who lived with smokers were analyzed. Tobit and simple linear regression analyses were conducted to assess associations of surface NNK and nicotine with child characteristics. Spearman's (ρ) correlations assessed the strength of associations between environmental markers and child cotinine. RESULTS Nearly half (48.8%) of children's home surfaces had detectable NNK and 100% had detectable nicotine. The respective geometric means (GMs) of surface NNK and nicotine loadings were 14.0 ng/m2 and 16.4 µg/m2. Surface NNK positively correlated with surface nicotine (ρ = 0.54, p < 0.001) and dust NNK (ρ = 0.30, p = 0.020). Surface nicotine positively correlated with dust NNK (ρ = 0.42, p < 0.001) and dust nicotine (ρ = 0.24, p = 0.041). Children with household incomes ≤$15,000 had higher surface NNK levels (GM = 18.7 ng/m2, p = 0.017) compared to children with household incomes >$15,000 (GM = 7.1 ng/m2). Children with no home smoking bans had higher surface NNK (GM = 18.1 ng/m2, p = 0.020) and surface nicotine (GM = 17.7 µg/m2, p = 0.019) levels compared to children with smoking bans (GM = 7.5 ng/m2, 4.8 µg/m2, respectively). IMPACT Although nicotine on surfaces is an established marker of thirdhand smoke pollution, other thirdhand smoke contaminants have not been measured on surfaces in the homes of children living with smokers. We provide evidence that the potent carcinogenic tobacco-specific nitrosamine NNK was detectable on surfaces in nearly half of children's homes, and nicotine was detectable on all surfaces. Surface NNK was positively correlated with surface nicotine and dust NNK. Detectable surface NNK levels were found in homes with indoor smoking bans, indicating the role of NNK as a persistent thirdhand smoke pollutant accumulating on surfaces as well as in dust.
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Affiliation(s)
- Ashley L Merianos
- University of Cincinnati, School of Human Services, PO Box 210068, Cincinnati, OH, 45221-0068, USA.
| | - Georg E Matt
- Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4611, USA
| | - Timothy M Stone
- Department of Environmental and Public Health Sciences, Division of Biostatistics and Bioinformatics, University of Cincinnati, College of Medicine, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA
| | - Roman A Jandarov
- Department of Environmental and Public Health Sciences, Division of Biostatistics and Bioinformatics, University of Cincinnati, College of Medicine, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA
| | - Eunha Hoh
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Nathan G Dodder
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Penelope J E Quintana
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Nicolas Lopez-Galvez
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Lara Stone
- Cincinnati Children's Hospital Medical Center, Division of Emergency Medicine, University of Cincinnati, College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA
| | - E Melinda Mahabee-Gittens
- Cincinnati Children's Hospital Medical Center, Division of Emergency Medicine, University of Cincinnati, College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA
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Yildirim-Ozturk EN, Uyar M, Ozturk M. Determining the prevalence of people's knowledge that third-hand smoke is harmful to health: A meta-analysis study. Public Health Nurs 2024; 41:836-844. [PMID: 38591176 DOI: 10.1111/phn.13313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/24/2024] [Accepted: 03/20/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Although the health effects of first-hand smoke and second-hand smoke are well known, third-hand smoke (THS) is a relatively new concept. We estimated the prevalence of people's knowledge that THS is harmful to health, including for some subgroups, in a meta-analysis. METHODS We searched PubMed, Web of Science, Scopus, EBSCO Host, ProQuest, and YOKTEZ databases for the prevalence of people's knowledge that THS is harmful to health using specified search words. A total of 12 publications (n = 8549 people) were included in the meta-analysis. The random effect model was used for meta-analysis, and Cochran's Q test and I2 values were used to determine heterogeneity. Subgroup analyzes and meta-regression were also performed. RESULTS The prevalence of people's knowledge that THS is harmful was 80.1%. The prevalence of people's knowledge that THS is harmful for children was 82%, and the prevalence of people's knowledge that THS is harmful for adults was 70.4%. For health professionals, the prevalence of people's knowledge that THS is harmful for children was 89.8%, the highest prevalence value calculated in this meta-analysis. Cochran's Q test and I2 values indicated that the included studies were heterogeneous. CONCLUSIONS In this meta-analysis, the overall prevalence of people's knowledge that THS is harmful was 80.1%, but large variations were found between samples.
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Affiliation(s)
- Elif Nur Yildirim-Ozturk
- Public Health Department-Epidemiology Section, Faculty of Medicine, Ankara University, Mamak, Ankara, Turkey
| | - Mehmet Uyar
- Public Health Department, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey
| | - Mustafa Ozturk
- Emergency Service, Ankara Pursaklar State Hospital, Pursaklar, Ankara, Turkey
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Özcan G, Kaygı Tartıcı E, Çelik B. Thirdhand Smoke Exposure Ignored by Pediatricians: A Cross-sectional Study. Turk Arch Pediatr 2024; 59:312-317. [PMID: 39140649 PMCID: PMC11181161 DOI: 10.5152/turkarchpediatr.2024.23277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/18/2024] [Indexed: 08/15/2024]
Abstract
Thirdhand smoke (THS) is defined as the harmful substances in cigarette smoke that are absorbed into objects, people, and surfaces after smoking. This study aimed to determine the level of awareness of pediatricians working in a tertiary healthcare institution about THS exposure. In this cross-sectional study, participants were asked to fill out an information form in which we questioned the participant's age, sex, occupation in the institution, the exposure of pediatric patients to cigarette smoke during daily healthcare, tobacco product use status, smoking status in their home and car, behavior in case of smoking in closed areas where smoking is prohibited, and whether they knew the term of THS. Also, the Turkish version of The Beliefs About Third-Hand Smoke was used. Eighty-one participants, with a mean age of 34.2 ± 7.6 years, were included in the study. Fifty-six (69.1%) participants said they had never used tobacco products. Participants who had never used tobacco products (P = .005), never allowed smoking in their homes (P = .017) and cars (P = .001), had heard the definition of THS before (P = .013), and thought they knew it (P = .005) had higher total scale scores. There was no significant difference between the THS awareness levels of pediatricians who questioned children's exposure to cigarette smoke in their daily practice and those who did not (P = .491). Determining the awareness levels of pediatricians about THS will be an important step in preventing THS exposure in children.
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Affiliation(s)
- Gizem Özcan
- Division of Pediatric Pulmonology, Department of Pediatrics, Kayseri City Hospital, Kayseri, Türkiye
| | | | - Binnaz Çelik
- Department of Pediatrics, Kayseri City Hospital, Kayseri, Türkiye
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Barchard KA, Russell JA. Distorted correlations among censored data: causes, effects, and correction. Behav Res Methods 2024; 56:1207-1228. [PMID: 38129736 PMCID: PMC10991075 DOI: 10.3758/s13428-023-02086-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 12/23/2023]
Abstract
Data censoring occurs when researchers do not know precise values of data points (e.g., age is 55+ or concentration ≤ .001). Censoring is frequent within psychology but typically unrecognized outside of longitudinal studies. We describe five circumstances when censoring may occur, demonstrate censoring distorts correlations, and discuss how censoring can create spurious factors. Next, we explain how to use R package lava to calculate maximum likelihood estimates (Holst and Budtz-Jørgensen Computational Statistics, 28(4), 1385-1452, 2013) of correlations between uncensored variables based upon censored variables. Previous research demonstrated these estimates were more accurate than Muthén's (1984) estimate for one particular model, but no research has systematically examined their accuracy. We therefore conducted a simulation study exploring the effects of the correlation, sample size, and censoring on point and interval estimates of correlations. Based upon 80 cells in which low values of normally distributed variables were censored, we recommend the constrained regression model with Wald confidence intervals. These methods were precise and unbiased unless both variables had 70% censoring and the correlation was large and negative (e.g., -.9), in which case estimates were closer to -1 than they should be. Opposite results would occur if low values of one variable and high values of the other were censored: Estimates would be precise and unbiased unless censoring was extreme and correlations were large and positive. To estimate large correlations accurately, we recommend researchers reduce censoring by using longer longitudinal studies, using scales with more response options, and matching measures to populations to reduce floor and ceiling effects.
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Affiliation(s)
- Kimberly A Barchard
- Department of Psychology, University of Nevada, Las Vegas, 4505 Maryland Parkway, Las Vegas, NV, 89154-5030, USA.
| | - James A Russell
- Department of Psychology and Neuroscience, Boston College, Chestnut Hill, MA, 02467, USA
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Richardot WH, Hamzai L, Ghukasyan T, Dodder NG, Quintana PJ, Matt GE, Sant KE, Lopez-Galvez N, Hoh E. Novel chemical contaminants associated with thirdhand smoke in settled house dust. CHEMOSPHERE 2024; 352:141138. [PMID: 38272136 DOI: 10.1016/j.chemosphere.2024.141138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/27/2024]
Abstract
Thirdhand smoke (THS) is the persistent and toxic residue from tobacco smoke in indoor environments. A comprehensive understanding of the chemical constituents of THS is necessary to assess the risks of long-term exposure and to establish reliable THS tracers. The objective of this study was to investigate compounds associated with THS through nontargeted analysis (NTA) of settled house dust samples from smokers' and non-smokers' homes, using comprehensive two-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GC×GC/TOF-MS). Compounds that were either only present in dust from smokers' homes or that had significantly larger abundance than in non-smokers' homes were termed qualified compounds. We identified 140 qualified compounds, and of these, 42 compounds were tentatively identified by searching matching mass spectra in NIST electron impact (EI) mass spectral library including 20 compounds confirmed with their authentic standards. Among the 42 compounds, 26 compounds were statistically more abundant (p < 0.10) in dust from homes of smokers; seven were tobacco-specific compounds, two of which (nornicotyrine, 3-ethenylpyridine) have not been reported before in house dust. Two compounds, tris (2-chloroethyl) phosphate (a toxic compound used as a flame retardant and reported in tobacco) and propanoic acid, 2-methyl-, 1-(1,1-dimethylethyl)-2-methyl-1,3-propanediyl ester (highly abundant and reported in exhaled air of smokers), were found in dust from all smokers' homes and in zero non-smokers' homes, making these potential THS tracers, possibly associated with recent smoking. Benzyl methyl ketone was significantly higher in dust in smokers' homes, and was previously reported not as a product of tobacco but rather as a form of methamphetamine. This compound was recently reported in mainstream tobacco smoke condensate through NTA as well. These identified potential tracers and chemical components of THS in this study can be further investigated for use in developing THS contamination and exposure assessments.
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Affiliation(s)
- William H Richardot
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182-4162, USA; San Diego State University Research Foundation, 5250 Campanile Dr., San Diego, CA, 92182, USA
| | - Laila Hamzai
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182-4162, USA
| | - Tigran Ghukasyan
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182-4162, USA
| | - Nathan G Dodder
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182-4162, USA; San Diego State University Research Foundation, 5250 Campanile Dr., San Diego, CA, 92182, USA
| | - Penelope Je Quintana
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182-4162, USA
| | - Georg E Matt
- Department of Psychology, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182-4611, USA
| | - Karilyn E Sant
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182-4162, USA
| | - Nicolas Lopez-Galvez
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182-4162, USA; San Diego State University Research Foundation, 5250 Campanile Dr., San Diego, CA, 92182, USA
| | - Eunha Hoh
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182-4162, USA.
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Sargin F, Buldu E. Turkish Pediatrician Beliefs About Third-hand Smoking. J Pediatr Health Care 2024; 38:97-104. [PMID: 37831029 DOI: 10.1016/j.pedhc.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/30/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION Although third-hand smoke (THS) is a relatively new concept, it emerges as an important health problem. This study evaluated the beliefs of Turkish Pediatricians about THS. METHOD The survey, designed to be self-filled by pediatricians, provided information on demographic data, lifestyle factors, and beliefs about THS. Participant beliefs about THS were evaluated using the Beliefs About Third-Hand Smoke scale. This study was conducted by applying a web-based survey to pediatricians in Turkey. RESULTS The Beliefs About Third-Hand Smoke scale scores were lower in participants who were male (odds ratio [OR] = 1.479; 95% confidence interval [CI], 0.246-0.526; p < .001), have children (OR = 0.656; 95% CI, 0.156-0.665; p = .002), widowed/separated (OR = 0.498; 95% CI, -1.072 to -0.360; p < .001), a smoker (OR = 0.586; 95% CI, -0.711 to -0.355; p < .001), worked in State Hospital (OR = 0.574; 95% CI, -0.768 to -0.423; p < .001), and specialists (OR = 0.621; 95% CI, -0.608 to -0.207; p < .001). DISCUSSION This study showed that pediatricians who were male, widowed/separated, a smoker, with children, working in a State Hospital, and specialists had less belief in the side effects of THS.
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Berman T, Rorman E, Groisman L, Keinan-Boker L, Shimony T, Barnett-Itzhaki Z. Association between parental smoking and child exposure to environmental tobacco smoke in Israel. Isr J Health Policy Res 2023; 12:37. [PMID: 38115120 PMCID: PMC10731699 DOI: 10.1186/s13584-023-00585-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/19/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Environmental tobacco smoke (ETS) exposure in children can cause delayed lung development and lifelong cardiovascular damage. The aim of this study was to measure ETS exposure in children in Israel in 2020-2021 using urinary cotinine (UC) measurements and to assess correlates of ETS exposure, including parental smoking. METHODS In the framework of the National Human Biomonitoring Program, spot urine samples and questionnaire data were collected from 166 children aged 4-12 years, during the years 2020-2021. We collected urine samples in 233 adults, 69 of whom were parents of children included in the study. Parents of participating children were asked about parental smoking, child's exposure to ETS and smoking policy at home. Cotinine and creatinine were measured in urine. Creatinine-adjusted and unadjusted urine cotinine (UC) geometric means were calculated. Associations between potential correlates and UC concentrations were analyzed in univariate and multivariate analyses. For 69 child-parent pairs, correlation between child and parental UC was analyzed. RESULTS Based on urinary cotinine measurement, 65.2% of children of smokers are exposed to ETS, compared to 20.7% of children in non-smoking families. Greater numbers of smokers living in the home (beta = 1.27, p < 0.01), and low maternal education (beta = - 2.32, p < 0.01) were associated with higher levels of UC in a multivariate analysis. Spearman correlations showed a positive moderate correlation between UC in 69 child-parent pairs (r = 0.52, p < 0.01). CONCLUSIONS In order to reduce child exposure to ETS, smoking parents should be urgently targeted for smoking cessation and smoke-free home interventions. Further interventions are needed to protect all children from ETS.
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Affiliation(s)
- Tamar Berman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Efrat Rorman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
| | - Luda Groisman
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Tal Shimony
- Israel Center for Disease Control, Israel Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, 39 Yirmiyahu Street, Jerusalem, Israel.
- Faculty of Engineering, Ruppin Academic Center, Emek Hefer, Israel.
- Research Group in Environmental and Social Sustainability, Ruppin Academic Center, Emek Hefer, Israel.
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13
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Murphy J, Tharumakunarajah R, Holden KA, King C, Lee AR, Rose K, Hawcutt DB, Sinha IP. Impact of indoor environment on children's pulmonary health. Expert Rev Respir Med 2023; 17:1249-1259. [PMID: 38240133 DOI: 10.1080/17476348.2024.2307561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
INTRODUCTION A child's living environment has a significant impact on their respiratory health, with exposure to poor indoor air quality (IAQ) contributing to potentially lifelong respiratory morbidity. These effects occur throughout childhood, from the antenatal period through to adolescence. Children are particularly susceptible to the effects of environmental insults, and children living in socioeconomic deprivation globally are more likely to breathe air both indoors and outdoors, which poses an acute and long-term risk to their health. Adult respiratory health is, at least in part, determined by exposures and respiratory system development in childhood, starting in utero. AREAS COVERED This narrative review will discuss, from a global perspective, what contributes to poor IAQ in the child's home and school environment and the impact that indoor air pollution exposure has on respiratory health throughout the different stages of childhood. EXPERT OPINION All children have the right to a living and educational environment without the threat of pollution affecting their health. Action is needed at multiple levels to address this pressing issue to improve lifelong respiratory health. Such action should incorporate a child's rights-based approach, empowering children, and their families, to have access to clean air to breathe in their living environment.
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Affiliation(s)
- Jared Murphy
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | | | - Karl A Holden
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- Lab to Life Child Health Data Centre, Alder Hey Children's Hospital, Liverpool, UK
| | - Charlotte King
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - Alice R Lee
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- Lab to Life Child Health Data Centre, Alder Hey Children's Hospital, Liverpool, UK
| | - Katie Rose
- Department of Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Daniel B Hawcutt
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- NIHR Alder Hey Clinical Research Facility, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Ian P Sinha
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
- Department of Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
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Rogers GP, Twum F, Zhang J, Wei Y. Covariation between serum cotinine and blood lead levels among US pediatric populations: Trends from 1999 to 2018. J Trace Elem Med Biol 2023; 80:127283. [PMID: 37586164 DOI: 10.1016/j.jtemb.2023.127283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Tobacco smoke, including both active and passive smoke, can be an important source of lead exposure. However, the relationship between passive tobacco smoke exposure (PTSE) and blood lead levels (BLL), especially in vulnerable populations, needs to be further explored. The present study was to assess the covariation between serum cotinine, a measure of PTSE, and BLL in a pediatric population during 1999-2018. METHODS Data on 21,817 children, aged 3-19 years, was extracted from the biennial nationally representative surveys. The trends of the prevalence of lead exposure (BLL ≥ 3.5 µg/dL) and PTSE (cotinine ≥ 1 ng/mL but < 10 ng/mL) were determined, and the covariation between BLL and cotinine was assessed. The population attributable fraction (PAF) of PTSE to the BLL was proxied using the partial R2 of the hierarchical linear regression. The association between PTSE and lead exposure was estimated using multivariate logistic regression. RESULTS A parallel decreasing trend in the prevalence of lead exposure and PTSE was observed. Similarly, the means of both BLL and cotinine declined simultaneously. Overall, the PAF from PTSE towards blood lead was 7 %, doubling the PAF from race/ethnicity and family income combined. Stratified by race/ethnicity, PAF from PTSE was 8 % in Blacks and Whites and 4 % for Hispanics. The odds ratio of PTSE with lead exposure was 2.45 (95 % CI, 1.75, 3.44), 2.00 (1.21, 3.33), and 1.16 (0.64, 2.13) for Black, White, and Hispanic children, respectively. Cotinine mean remained two times higher in Blacks than non-Black children at the end of the study period. CONCLUSION Serum cotinine and BLL may have a significant association in children that persists even as both have been steadily declining in recent years. The contribution from PTSE to blood lead variations could be greater than that from socioeconomic factors. Further reducing lead exposure might be achieved by eliminating PTSE, particularly for the Black pediatric population.
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Affiliation(s)
| | - Felix Twum
- School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Jian Zhang
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA.
| | - Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, USA.
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15
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Matt GE, Merianos AL, Stone L, Wullenweber C, Quintana PJE, Hoh E, Dodder NG, Lopez Galvez N, Mahabee-Gittens EM. Changes and stability of hand nicotine levels in children of smokers: Associations with urinary biomarkers, reported child tobacco smoke exposure, and home smoking bans. ENVIRONMENT INTERNATIONAL 2023; 181:108239. [PMID: 37852151 DOI: 10.1016/j.envint.2023.108239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/13/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Exposure to thirdhand smoke (THS) residue takes place through inhalation, ingestion, and dermal transfer. Hand nicotine levels have been proposed to measure THS pollution in the environment of children, but little is known about its variability and stability over time and correlates of change. OBJECTIVES The goal was to determine the stability of hand nicotine in comparison to urinary biomarkers and to explore factors that influence changes in hand nicotine. METHODS Data were collected from 0 to 11-year-old children (Mean age = 5.9) who lived with ≥1 tobacco smokers (N = 129). At a 6-week interval, we collected repeated measures of hand nicotine, four urinary biomarkers (cotinine, trans-3'-hydroxycotinine, nicotelline N-oxides, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol), and parent-reported child tobacco smoke exposure (TSE). Dependent sample t-tests, correlations, and multivariable regression analyses were conducted to examine the changes in child TSE. RESULTS Hand nicotine levels (r = 0.63, p < 0.001) showed similar correlations between repeated measures to urinary biomarkers (r = 0.58-0.71; p < 0.001). Different from urinary biomarkers, mean hand nicotine levels increased over time (t(113) = 3.37, p < 0.001) being significantly higher in children from homes without smoking bans at Time 2 (p = 0.016) compared to Time 1 (p = 0.003). Changes in hand nicotine correlated with changes in cotinine and trans-3'-hydroxycotinine (r = 0.30 and r = 0.19, respectively, p < 0.05). Children with home smoking bans at Time 1 and 2 showed significantly lower hand nicotine levels compared to children without home smoking bans. DISCUSSION Findings indicate that hand nicotine levels provide additional insights into children's exposure to tobacco smoke pollutants than reported child TSE and urinary biomarkers. Changes in hand nicotine levels show that consistent home smoking bans in homes of children of smokers can lower THS exposure. Hand nicotine levels may be influenced by the environmental settings in which they are collected.
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Affiliation(s)
- Georg E Matt
- Department of Psychology, San Diego State University, San Diego, CA, USA.
| | - Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, USA
| | - Chase Wullenweber
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, USA
| | | | - Eunha Hoh
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Nathan G Dodder
- School of Public Health, San Diego State University, San Diego, CA, USA; San Diego State University Research Foundation, San Diego, CA, USA
| | | | - E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Roseren C, Binck S, Faÿs F, Ruiz-Castell M, Samouda H, Appenzeller BMR. Environmental tobacco smoke at home and in public places prior to smoking ban enforcement: Assessment by hair analysis in a population of young adult students. Drug Test Anal 2023; 15:962-970. [PMID: 36562126 DOI: 10.1002/dta.3429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/25/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
Despite inititatives to reduce tobacco consumption, smoking remains a primary cause of death for both smokers and nonsmokers exposed to environmental tobacco smoke (ETS). The characteristics of some specific groups can make them more exposed to ETS or limit the benefit of prevention measures. This study investigated determinants of ETS in a population of young adult students, considered at higher risk of exposure due to their specific lifestyle. This cross-sectional study involved 90 students aged 20 ± 1.7 years, from the University of Luxembourg, prior to the smoking ban enforcement in public places in the country. Participants reported their tobacco consumption and exposure to ETS at home and/or in public places, and provided a hair sample analyzed for nicotine and cotinine. Nicotine and cotinine were significantly higher in smokers than in nonsmokers' hair in general (median: 2.6 vs. 0.9 ng/mg and 87.1 vs. 22.5 pg/mg respectively). However, nonsmokers exposed to ETS at home and in public places had comparable concentrations to smokers (nic = 2.2 ng/mg; cot = 56.2 pg/mg), whereas unexposed nonsmokers presented significantly lower values (nic = 0.4 ng/mg, cot = 8.5 pg/mg). Nonsmokers exposed to ETS only at home presented higher values than nonsmokers only exposed in public places (nic: 1.3 vs. 0.8 ng/mg, cot: 70.4 vs. 15.0 pg/mg). The study shows the widespread exposure to ETS in this population, the importance of exposure assessment, and the relevance of hair analysis for this purpose. Results suggest that ETS can lead to equivalent exposure to active smoking and that exposure at home can highly contribute to ETS, which is not solved by smoking ban in public places.
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Affiliation(s)
- Claire Roseren
- Human Biomonitoring Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Sylvia Binck
- Human Biomonitoring Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - François Faÿs
- Human Biomonitoring Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Competence Centre for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Maria Ruiz-Castell
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Hanen Samouda
- Nutrition and Health Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Brice M R Appenzeller
- Human Biomonitoring Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
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Intarut N, Thronsao M, Pukdeesamai P. Promoting Smoke-Free Environments: The Impact of Thirdhand Smoke Awareness on Smoking Bans at Home. Asian Pac J Cancer Prev 2023; 24:2917-2921. [PMID: 37642082 PMCID: PMC10685245 DOI: 10.31557/apjcp.2023.24.8.2917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE A creating smoke-free home is a way to protect a vulnerable group from being exposed to secondhand smoke in the home, such as children, infants, and non-smokers. Studies reported an intervention for promoting a smoke-free home by using secondhand smoke messages and smoking cessation messages. However, the thirdhand smoke (THS) message has rarely been found. Therefore, this study aimed to explore the prevalence and correlations of smoking bans in homes. METHODS Secondary data from a community-based cross-sectional design survey was used for this study. Smoking ban status was defined as a smoking ban or no smoking ban. We used multiple logistic regression to test the association between factors and smoking ban status. An adjusted odd ratio and 95% confidence interval were reported. RESULTS Of the 882 participants included in this analysis, 38.66% (95%CI: 35.43, 41.97) had a smoking ban at home. A multiple logistic regression analysis showed that participants who believe that secondhand or THS harms children had a greater correlation with developing a smoking ban in the home compared with those who did not believe (odd ratio: 3.94, 95% confidence interval: 2.35, 6.60 and odd ratio:4.22, 95% confidence interval:2.6, 6.86, respectively). CONCLUSION This study found that the belief that thirdhand smoke and secondhand smoke exposure harm children. The smoke-free home message's relevance to the harms of thirdhand smoke exposure should be adapted to be promoted, especially in homes.
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Affiliation(s)
- Nirun Intarut
- Health Systems Science Division, Faculty of Medicine, Mahasarakham University, Muang, Maha Sarakham, Thailand.
| | - Maitree Thronsao
- Faculty of Medicine, Mahasarakham University, Muang, Maha Sarakham, Thailand.
| | - Piyalak Pukdeesamai
- Maha Sarakham Provincial Public Health Office. Maha Sarakham province. Thailand.
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Arfaeinia H, Ghaemi M, Jahantigh A, Soleimani F, Hashemi H. Secondhand and thirdhand smoke: a review on chemical contents, exposure routes, and protective strategies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-28128-1. [PMID: 37306877 DOI: 10.1007/s11356-023-28128-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/01/2023] [Indexed: 06/13/2023]
Abstract
Secondhand smoke (SHS: a mixture of sidestream and mainstream smoke) and thirdhand smoke (THS: made up of the pollutants that settle indoors after smoking in closed environments) are a significant public health concern. SHS and THS contain various chemicals which can be released into the air or settle on surfaces. At present, the hazards of SHS and THS are not as well documented. In this review, we describe the chemical contents of THS and SHS, exposure routes, vulnerable groups, health effects, and protective strategies. The literature search was conducted for published papers on September 2022 in Scopus, Web of Science, PubMed, and Google Scholar databases. This review could provide a comprehensive understanding of the chemical contents of THS and SHS, exposure routes, vulnerable groups, health effects, protective strategies, and future researches on environmental tobacco smoke.
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Affiliation(s)
- Hossein Arfaeinia
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Maryam Ghaemi
- Iranian National Institute for Oceanography and Atmospheric Science, No. 3, Etemadzadeh St., Fatemi Ave, Tehran, 1411813389, Iran
| | - Anis Jahantigh
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farshid Soleimani
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Hassan Hashemi
- Research Center for Health Sciences, Institute of Health, Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Record RA, Greiner LH, Wipfli H, Strickland J, Owens J, Pugel J, Matt GE. Evaluation of a Social Media Campaign Designed to Increase Awareness of Thirdhand Smoke among California Adults. HEALTH COMMUNICATION 2023; 38:437-446. [PMID: 34320896 DOI: 10.1080/10410236.2021.1954760] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Despite a growing body of research outlining the harms of thirdhand smoke (THS), the public remains generally unaware of risks and exposure routes. This project built on past tobacco prevention campaigns and the tenants of McGuire's input-output model to implement and evaluate a seven-month Facebook-disseminated campaign seeking to improve THS awareness among California adults (n = 1087). Multilinear regression showed that THS-related knowledge (χ2[6] = 19.31, p < .01), attitude (χ2[6] = 13.88, p < .05), and efficacy (χ2[6] = 13.81, p < .05) significantly increased by the campaign's end, with messages highlighting children's health (r = .110, p < .05), pets (r = .145, p < .01), and dust reservoirs (r = .144, p < .01) as the most persuasive. Path analysis modeling found campaign recall to be associated with changes in knowledge (β = .161, p < .01), which predicated attitude change (β = .614, p < .001) and, in turn, behavior change (β = .149, p < .05). Findings suggest social media campaigns should continue to educate diverse populations about new tobacco risks and that tobacco control advocates should consider integrating educational THS messages.
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Affiliation(s)
| | | | - Heather Wipfli
- Keck School of Medicine, University of Southern California
| | | | - James Owens
- School of Communication, San Diego State University
| | - Jessica Pugel
- Department of Psychology, San Diego State University
| | - Georg E Matt
- Department of Psychology, San Diego State University
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Rosen LJ, Zucker DM, Gravely S, Bitan M, Rule AM, Myers V. Tobacco Smoke Exposure According to Location of Home Smoking in Israel: Findings from the Project Zero Exposure Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3523. [PMID: 36834219 PMCID: PMC9965201 DOI: 10.3390/ijerph20043523] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
Young children are particularly vulnerable to harms from tobacco smoke exposure (TSE). This study aimed to compare TSE: (1) between children who live in smoking families and those who do not; and (2) among children who live in smoking households with varying smoking locations. The data came from two studies that were conducted concurrently in Israel (2016-2018). Study 1: a randomized controlled trial of smoking families (n = 159); Study 2: a cohort study of TSE among children in non-smoking families (n = 20). Hair samples were collected from one child in each household. Baseline hair nicotine data were analyzed for 141 children in Study 1 and 17 children in Study 2. Using a logistic regression analysis (exposed vs. not exposed as per laboratory determination) and a linear regression (log hair nicotine), we compared TSE between: (1) children in Study 1 vs. Study 2; (2) children in families with different smoking locations in Study 1: balcony; garden, yard, or other place outside of the home; or inside the home (designated smoking areas within the home (DSAs) or anywhere). A higher proportion of children living in smoking households were measurably exposed to tobacco smoke (68.8%) compared to children living in non-smoking households (35.3%, p = 0.006). Among children from smoking families, 75.0% of those whose parents smoked in the house were exposed, while 61.8% of children whose parents restricted smoking to the porch (n = 55) were exposed, and 71.4% of those whose parents smoked outside the home (including gardens and yards) (n = 42) were exposed. In univariable and multivariable models, smoking location was not significantly associated with exposure. The majority of children in smoking families were measurably exposed to TSE, even if smoking was restricted to designated areas in the home, balconies, orgarden/yard/other outdoor areas. Reducing population smoking rates, particularly among parents, restricting smoking to at least 10 meters from homes and children, and denormalizing smoking around others are recommended to reduce population-level child TSE and tobacco-attributable disease and death.
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Affiliation(s)
- Laura J. Rosen
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - David M. Zucker
- Department of Statistics and Data Science, Hebrew University, Jerusalem 9190501, Israel
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Michal Bitan
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Department of Computer Science, College of Management Academic Studies, Rishon LeTsiyon 7579806, Israel
| | - Ana M. Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Vicki Myers
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 5262100, Israel
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21
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Henderson E, Rodriguez Guerrero LA, Continente X, Fernández E, Tigova O, Cortés-Francisco N, Semple S, Dobson R, Tzortzi A, Vyzikidou VK, Gorini G, Geshanova G, Mons U, Przewozniak K, Precioso J, Brad R, López MJ. Measurement of airborne nicotine, as a marker of secondhand smoke exposure, in homes with residents who smoke in 9 European countries. ENVIRONMENTAL RESEARCH 2023; 219:115118. [PMID: 36566961 DOI: 10.1016/j.envres.2022.115118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Smoke-free policies are effective in preventing secondhand smoke (SHS) exposure, but their adoption at home remains largely voluntary. This study aimed to quantify SHS exposure in homes with residents who smoke in Europe according to households' characteristics, tobacco consumption habits, and national contextual factors. METHODS Cross-sectional study (March 2017-September 2018) based on measurements of air nicotine inside 162 homes with residents who smoke from nine European countries. We installed passive samplers for seven consecutive days to monitor nicotine concentrations. Through self-administered questionnaires, we collected sociodemographic information and the number of individuals who smoke, smoking rules, frequency, location, and quantity of tobacco use in households. Country-level factors included the overall score in the Tobacco Control Scale 2016, the smoking prevalence, and self-reported SHS exposure prevalence. Nicotine concentrations were analyzed as continuous and dichotomous variables, categorized based on the limit of quantification of 0.02 μg/m3. RESULTS Overall, median nicotine concentration was 0.85 μg/m3 (interquartile range (IQR):0.15-4.42), and there was nicotine presence in 93% of homes. Participants reported that smoking was not permitted in approximately 20% of households, 40% had two or more residents who smoked, and in 79% residents had smoked inside during the week of sampling. We found higher nicotine concentrations in homes: with smell of tobacco smoke inside (1.45 μg/m3 IQR: 0.32-6.34), where smoking was allowed (1.60 μg/m3 IQR: 0.68-7.63), with two or more residents who smoked (2.42 μg/m3 IQR: 0.58-11.0), with more than 40 cigarettes smoked (2.92 μg/m3 IQR: 0.97-10.61), and where two or more residents smoked inside (4.02 μg/m3 IQR: 1.58-11.74). Household nicotine concentrations were significantly higher in countries with higher national smoking prevalence and self-reported SHS exposure prevalence (p < 0.05). CONCLUSIONS SHS concentrations in homes with individuals who smoke were approximately twenty times higher in homes that allowed smoking compared to those reporting smoke-free household rules. Evidence-based interventions promoting smoke-free homes should be implemented in combination with strengthening other MPOWER measures.
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Affiliation(s)
- Elisabet Henderson
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain
| | | | - Xavier Continente
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Center for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
| | - Esteve Fernández
- Institut Català d'Oncologia, Av. Granvia de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Spain; Institut d'Investigació Biomèdica de Bellvitge, Av. Granvia de l'Hospitalet 199, 08908, L'Hospitalet de Llobregat, Spain; Universitat de Barcelona, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Spain; Center for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain
| | - Olena Tigova
- Institut Català d'Oncologia, Av. Granvia de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Spain; Institut d'Investigació Biomèdica de Bellvitge, Av. Granvia de l'Hospitalet 199, 08908, L'Hospitalet de Llobregat, Spain; Universitat de Barcelona, Feixa Llarga, s/n, 08907, L'Hospitalet de Llobregat, Spain; Center for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain
| | - Nuria Cortés-Francisco
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain
| | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | - Ruaraidh Dobson
- Institute for Social Marketing and Health, University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | - Anna Tzortzi
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou str., Athens, 10557, Greece
| | - Vergina K Vyzikidou
- George D. Behrakis Research Lab, Hellenic Cancer Society, 17B Ipitou str., Athens, 10557, Greece
| | - Giuseppe Gorini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica (ISPRO), Via Cosimo il Vecchio, 2, 50139, Florence, Italy
| | - Gergana Geshanova
- Smoke-free Life Coalition, Slivnitsa Blvd, 257, 1202, Sofia, Bulgaria
| | - Ute Mons
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50923, Cologne, Germany; Cancer Prevention Unit & WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Im Neuenheimer Feld, 280, 69120, Heidelberg, Germany
| | - Krzysztof Przewozniak
- Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena, 5, 02-781, Warsaw, Poland; The Foundation Smart Health - Health in 3D, Makolągwy 24, 02-811, Warsaw, Poland; Collegium Civitas, 1 Defilad Square, 00-901, Warsaw, Poland
| | - José Precioso
- Research Center in Child Studies, University of Minho, 4710-057, Braga, Portugal
| | - Ramona Brad
- Healthy Romania Generation 2035 Association, Bucharest, Romania
| | - Maria J López
- Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Center for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 282029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain; Universitat Pompeu Fabra, Departament de Ciències Experimentals i de la Salut (DCEXS), Doctor Aiguader, 88, 08003, Barcelona, Spain.
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Merianos AL, Mahabee-Gittens EM, Stone TM, Jandarov RA, Wang L, Bhandari D, Blount BC, Matt GE. Distinguishing Exposure to Secondhand and Thirdhand Tobacco Smoke among U.S. Children Using Machine Learning: NHANES 2013-2016. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:2042-2053. [PMID: 36705578 PMCID: PMC10230650 DOI: 10.1021/acs.est.2c08121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
While the thirdhand smoke (THS) residue from tobacco smoke has been recognized as a distinct public health hazard, there are currently no gold standard biomarkers to differentiate THS from secondhand smoke (SHS) exposure. This study used machine learning algorithms to assess which combinations of biomarkers and reported tobacco smoke exposure measures best differentiate children into three groups: no/minimal tobacco smoke exposure (NEG); predominant THS exposure (TEG); and mixed SHS and THS exposure (MEG). Participants were 4485 nonsmoking 3-17-year-olds from the National Health and Nutrition Examination Survey 2013-2016. We fitted and tested random forest models, and the majority (76%) of children were classified in NEG, 16% were classified in TEG, and 8% were classified in MEG. The final classification model based on reported exposure, biomarker, and biomarker ratio variables had a prediction accuracy of 95%. This final model had prediction accuracies of 100% for NEG, 88% for TEG, followed by 71% for MEG. The most important predictors were the reported number of household smokers, serum cotinine, serum hydroxycotinine, and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL). In the absence of validated biomarkers specific to THS, comprehensive biomarker and questionnaire data for tobacco smoke exposure can distinguish children exposed to SHS and THS with high accuracy.
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Affiliation(s)
- Ashley L. Merianos
- School of Human Services, University of Cincinnati, P.O. Box 210068, Cincinnati OH, 45221, USA
| | - E. Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC 2008, Cincinnati, OH, 45229, USA
| | - Timothy M. Stone
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Kettering Lab Building, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA
| | - Roman A. Jandarov
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Kettering Lab Building, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA
| | - Lanqing Wang
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Deepak Bhandari
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Benjamin C. Blount
- Tobacco and Volatiles Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Georg E. Matt
- Department of Psychology, College of Sciences, San Diego State University, 9245 Sky Park Court, Suite 225, San Diego, CA, 92123, USA
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23
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Ballbè M, Fu M, Masana G, Pérez-Ortuño R, Gual A, Gil F, Olmedo P, García-Algar Ó, Pascual JA, Fernández E. Passive exposure to electronic cigarette aerosol in pregnancy: A case study of a family. ENVIRONMENTAL RESEARCH 2023; 216:114490. [PMID: 36220444 DOI: 10.1016/j.envres.2022.114490] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/20/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Passive exposure to the aerosols of electronic cigarettes (e-cigarettes) has been little studied. We assessed this exposure in late pregnancy in a woman and her 3-year-old child, exposed through e-cigarette use by another household member. METHODS This prospective longitudinal case study involved a family unit consisting of an e-cigarette user, a pregnant woman who delivered an infant during the study, and the couple's older 3-year-old son. At 31, 36, and 40 weeks of the pregnancy, we measured biomarkers (nicotine metabolites, tobacco-specific nitrosamines, propanediols, glycerol, and metals) in the urine and hair of all three participants and in the saliva of the adults, in cord blood at delivery, and in the breast milk at the postpartum period. RESULTS Samples from the e-cigarette user showed quantifiable concentrations of all analytes assessed (maximum urinary cotinine concentration, 4.9 ng/mL). Among samples taken from the mother, nicotine and its metabolites were found mainly in urine and also in saliva and hair, but not in cord blood. During the postpartum period, we found cotinine concentrations of 2.2 ng/mL in the mother's urine and 0.22 ng/mL in breast milk; 1,2-propanediol was generally detected in urine and saliva, but not in cord blood or breast milk. The maximum urinary cotinine concentration in the 3-year-old child was 2.6 ng/mL and propanediols also were detected in his urine. Nitrosamines were not detected in samples taken from the mother or the 3-year-old. Metals found in the refill liquid were detected at low levels in both the mother and the 3-year-old. CONCLUSIONS We detected low but not negligible concentrations of e-cigarette-related analytes (including cord blood and breast milk) in an exposed pregnant non-user and in a 3-year-old child also living in the home. Passive exposure to e-cigarette aerosols cannot be disregarded and should be assessed in larger observational studies.
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Affiliation(s)
- Montse Ballbè
- Tobacco Control Unit, Cancer Control and Prevention Program, WHO Collaborating Center for Tobacco Control, Institut Català d'Oncologia (ICO), Av. Gran Via de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Av. Gran Via de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat (Barcelona), Spain; CIBER of Respirarory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Addictions Unit, Psychiatry Department, Institute of Neurosciences, Hospital Clínic de Barcelona, C. Villarroel 170, 08036, Barcelona, Spain.
| | - Marcela Fu
- Tobacco Control Unit, Cancer Control and Prevention Program, WHO Collaborating Center for Tobacco Control, Institut Català d'Oncologia (ICO), Av. Gran Via de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Av. Gran Via de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat (Barcelona), Spain; CIBER of Respirarory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; School of Medicine and Health Sciences, Universitat de Barcelona, C. Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat (Barcelona), Spain.
| | - Guillem Masana
- Barcelona Clinic Schizophrenia Unit, Department of Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic de Barcelona, C. Villarroel 170, 08036, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBER of Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Raúl Pérez-Ortuño
- Group of Integrative Pharmacology and Systems Neuroscience, Neurosciences Programme, IMIM (Hospital del Mar Medical Research Institute), Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain.
| | - Antoni Gual
- Grup de Recerca en Addiccions Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Fernando Gil
- Department of Legal Medicine and Toxicology, School of Medicine, Universidad de Granada, Granada, Spain.
| | - Pablo Olmedo
- Department of Legal Medicine and Toxicology, School of Medicine, Universidad de Granada, Granada, Spain.
| | - Óscar García-Algar
- Neonatology Unit, ICGON, Hospital Clínic-Maternitat, BCNatal, Barcelona, Spain.
| | - Jose Antonio Pascual
- Group of Integrative Pharmacology and Systems Neuroscience, Neurosciences Programme, IMIM (Hospital del Mar Medical Research Institute), Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain; Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona Biomedical Research Park, Barcelona, Spain.
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Program, WHO Collaborating Center for Tobacco Control, Institut Català d'Oncologia (ICO), Av. Gran Via de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat (Barcelona), Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Av. Gran Via de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat (Barcelona), Spain; CIBER of Respirarory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; School of Medicine and Health Sciences, Universitat de Barcelona, C. Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat (Barcelona), Spain.
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24
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Northrup TF, Stotts AL, Suchting R, Khan AM, Klawans MR, Green C, Hoh E, Hovell MF, Matt GE, Quintana PJE. Handwashing Results in Incomplete Nicotine Removal from Fingers of Individuals who Smoke: A Randomized Controlled Experiment. Am J Perinatol 2022; 39:1634-1642. [PMID: 34634832 DOI: 10.1055/s-0041-1736287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Tobacco residue, also known as third-hand smoke (THS), contains toxicants and lingers in dust and on surfaces and clothes. THS also remains on hands of individuals who smoke, with potential transfer to infants during visitation while infants are hospitalized in neonatal intensive care units (NICUs), raising concerns (e.g., hindered respiratory development) for vulnerable infants. Previously unexplored, this study tested handwashing (HW) and sanitization efficacy for finger-nicotine removal in a sample of adults who smoked and were visiting infants in an NICU. STUDY DESIGN A cross-sectional sample was recruited to complete an interview, carbon monoxide breath samples, and three nicotine wipes of separate fingers (thumb, index, and middle). Eligible participants (n = 14) reported current smoking (verified with breath samples) and were randomly assigned to 30 seconds of HW (n = 7) or alcohol-based sanitization (n = 7), with the order of finger wipes both counterbalanced and randomly assigned. After randomization, the first finger was wiped for nicotine. Participants then washed or sanitized their hands and finger two was wiped 5 minutes later. An interview assessing tobacco/nicotine use and exposure was then administered, followed by a second breath sample and the final finger wipe (40-60 minutes after washing/sanitizing). RESULTS Generalized linear mixed models found that HW was more effective than sanitizer for nicotine removal but failed to completely remove nicotine. CONCLUSIONS Without proper protections (e.g., wearing gloves and gowns), NICU visitors who smoke may inadvertently expose infants to THS. Research on cleaning protocols are needed to protect vulnerable medical populations from THS and associated risks. KEY POINTS · NICU infants may be exposed to THS via visitors.. · THS is not eliminated by HW or sanitizing.. · THS removal protections for NICU infants are needed..
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas
| | - Angela L Stotts
- Department of Family and Community Medicine, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, Houston, Texas
| | - Amir M Khan
- Department of Pediatrics, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas
| | - Michelle R Klawans
- Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas
| | - Charles Green
- Department of Pediatrics, Center for Clinical Research and Evidence-Based Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, Texas
| | - Eunha Hoh
- Division of Environmental Health, School of Public Health, San Diego State University, San Diego, California
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, California
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, California
| | - Penelope J E Quintana
- Division of Environmental Health, School of Public Health, San Diego State University, San Diego, California
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25
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Willemse E, Walters BH, Springvloet L, Bommelé J, Willemsen MC. “If the social circle is engaged, more pregnant women will successfully quit smoking”: a qualitative study of the experiences of midwives in the Netherlands with smoking cessation care. BMC Health Serv Res 2022; 22:1106. [PMID: 36045362 PMCID: PMC9429426 DOI: 10.1186/s12913-022-08472-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background If smoking is common within a pregnant woman’s social circle, she is more likely to smoke and her chances of succeeding in quitting smoking are reduced. It is therefore important to encourage smoking cessation in a pregnant woman’s social circle. Midwives are ideally positioned to help pregnant women and members of their social circle quit smoking but there is currently little knowledge about if and how midwives approach smoking cessation with pregnant women’s social circles. Methods In 2017 and 2018, semi-structured interviews were conducted with 14 birth care providers in the Netherlands. Interviews were inductively coded; data were analyzed thematically. Results In the interviews, midwives reported that they don’t commonly provide smoking cessation support to members of pregnant women’s social circles. The respondents noted that they primarily focused on mothers and weren’t always convinced that advising the partners, family, and friends of pregnant women to quit smoking was their responsibility. Data from the interviews revealed that barriers to giving advice to the social circle included a lack of a trusting relationship with the social circle, concerns about raising the topic and giving unwanted advice on cessation to members of the social circle and a lack of opportunity to discuss smoking. Conclusions Midwives in the Netherlands were reluctant to actively provide smoking cessation advice to the social circle of pregnant women. To overcome barriers to addressing cessation to the social circle, educational programs or new modules for existing programs could be used to improve skills related to discussing smoking. Clear guidelines and protocols on the role of midwives in providing cessation support to the social circle could help midwives overcome ambivalence that they might have. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08472-7.
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Wu JX, Lau ATY, Xu YM. Indoor Secondary Pollutants Cannot Be Ignored: Third-Hand Smoke. TOXICS 2022; 10:363. [PMID: 35878269 PMCID: PMC9316611 DOI: 10.3390/toxics10070363] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 02/05/2023]
Abstract
Smoking has been recognized by the World Health Organization (WHO) as the fifth highest threat to humanity. Smoking, a leading disease promoter, is a major risk factor for non-communicable diseases (NCDs) such as cancer, cardiovascular disease, diabetes, and chronic respiratory diseases. NCDs account for 63% of all deaths worldwide. Passive smoking is also a health risk. Globally, more than a third of all people are regularly exposed to harmful smoke. Air pollution is a common global problem in which pollutants emitted into the atmosphere undergo a series of physical or chemical reactions to produce various oxidation products, which are often referred to as secondary pollutants. Secondary pollutants include ozone (O3), sulfur trioxide (SO3), nitrogen dioxide (NO2), and respirable particulate matter (PM). It is worth mentioning that third-hand smoke (THS), formed by the reaction of nicotine with second-hand smoke (SHS) caused by indoor O3 or nitrous acid (HONO), is a major indoor secondary pollutant that cannot be ignored. As a form of indoor air pollution that is relatively difficult to avoid, THS exists in any corner of the environment where smokers live. In this paper, we summarize the important research progress on the main components, detection, and toxicity of THS and look forward to future research directions. Scientific understanding of THS and its hazards will facilitate smoking bans in indoor and public places and raise public concern for how to prevent and remove THS.
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Affiliation(s)
- Jia-Xun Wu
- Laboratory of Cancer Biology and Epigenetics, Department of Cell Biology and Genetics, Shantou University Medical College, Shantou 515041, China
| | | | - Yan-Ming Xu
- Laboratory of Cancer Biology and Epigenetics, Department of Cell Biology and Genetics, Shantou University Medical College, Shantou 515041, China
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27
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Zhang C, Lam K, Hicks P, Hicks M, Brennan L, Buka I, Hicks A. Unintentional Tobacco Smoke Exposure in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127076. [PMID: 35742325 PMCID: PMC9222355 DOI: 10.3390/ijerph19127076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Abstract
Secondhand smoke (SHS) exposure increases the prevalence and severity of sinopulmonary diseases in children. The primary source of SHS exposure in children is through adults who live in the same house; however, the level of exposure may vary based on the adult smoking habits at home. This prospective cross-sectional study in Alberta, Canada, investigated the relationship between self-reported caregiver smoking, location, outdoor temperature and children’s’ urine cotinine: creatinine ratio (CCR), a marker of nicotine metabolism. Participants aged 0−9 were recruited from the Child Health Clinics at the Misericordia Community Hospital in Edmonton, Alberta, from 8 January to 24 February 2016 and 30 June to 18 August 2016. Participant CCR levels were compared to caregiver-reported smoking location and environmental factors such as temperature and season. Of the 233 participants who reported smoking status, 21% reported smoking, in keeping with local smoking rates. More participants smoked indoors during the winter than the summer; however, some families limited indoor smoking to a garage. Of the 133 parent−child dyads who provided smoking information and a child urine sample, 18 had an elevated cotinine:creatinine ratio, suggestive of significant tobacco smoke exposure, 15 of whom were from homes that reported smoking. Age < 1 year and number of cigarettes smoked in the home weekly were risks for significant exposure while season, outdoor temperature and smoking location in the home did not reach significance. Smokers should be counseled to protect children, particularly infants, from exposure by limiting the number of cigarettes smoked and isolating smoking to outside the home. Segregated areas such as a garage may provide a useful harm mitigation strategy for indoor smokers, provided the garage does not share ventilation or is not in close proximity to high-traffic areas of the home.
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Affiliation(s)
- Caseng Zhang
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 3L8, Canada;
| | - Kaden Lam
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Patrick Hicks
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada;
| | - Matt Hicks
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2H9, Canada; (M.H.); (L.B.); (I.B.)
| | - Lesley Brennan
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2H9, Canada; (M.H.); (L.B.); (I.B.)
| | - Irena Buka
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2H9, Canada; (M.H.); (L.B.); (I.B.)
| | - Anne Hicks
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2H9, Canada; (M.H.); (L.B.); (I.B.)
- Correspondence: ; Tel.: +1-780-248-5650
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Neshteruk CD, Norman K, Armstrong SC, Cholera R, D'Agostino E, Skinner AC. Association between parenthood and cardiovascular disease risk: Analysis from NHANES 2011-2016. Prev Med Rep 2022; 27:101820. [PMID: 35656211 PMCID: PMC9152778 DOI: 10.1016/j.pmedr.2022.101820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/31/2022] [Accepted: 04/30/2022] [Indexed: 01/14/2023] Open
Abstract
The objective of this study was to examine the association between parenthood and cardiovascular disease (CVD) risk factors among a nationally representative sample of United States adults. A cross sectional analysis was conducted with adults aged 20-59 years from the National Health and Nutrition Examination Survey 2011-2016. Adults were classified as parents and non-parents based on the presence of children birth-17 years in the home. CVD risk factors assessed included: physical inactivity, obesity, blood pressure, HDL cholesterol, glycohemoglobin, and smoking status. Multivariable logistic regression models stratified by sex were used to examine the association between parenthood and each risk factor. 10,908 adults (5,329 [49%] male, weighted mean age 39.6 years) were included. In adjusted analyses, fathers had greater odds of obesity (OR: 1.22; 95% CI: 1.04-1.42) and lower odds of being a current smoker (OR: 0.82; 95% CI: 0.68-0.98) compared to non-fathers. Mothers had greater odds of physical inactivity (OR: 1.27; 95% CI: 1.03-1.56) and low HDL cholesterol (OR: 1.24; 95% CI: 1.06-1.45), and lower odds of being a current smoker (OR: 0.78; 95% CI: 0.63-0.96) compared to non-mothers. Parents with younger children in the household tended to have greater odds of CVD risk factors compared to non-parents. No clear patterns emerged in CVD factor risk based on the number of children in the household. Parents are at greater risk for several modifiable CVD risk factors. This illustrates the importance of including parental health promotion in settings that serve children and implementing policies that support parental health and wellbeing.
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Affiliation(s)
- Cody D. Neshteruk
- Department of Population Health Sciences, Duke University Medical School, Durham, NC, United States
| | - Katherine Norman
- Department of Population Health Sciences, Duke University Medical School, Durham, NC, United States
| | - Sarah C. Armstrong
- Department of Population Health Sciences, Duke University Medical School, Durham, NC, United States
- Duke Clinical Research Institute, Duke University, Durham, NC, United States
- Department of Pediatrics, Duke University Medical School, Durham, NC, United States
| | - Rushina Cholera
- Department of Pediatrics, Duke University Medical School, Durham, NC, United States
- National Clinician Scholars Program, United States
- Duke Margolis Center for Health Policy, Duke University, Durham, NC, United States
| | - Emily D'Agostino
- Department of Population Health Sciences, Duke University Medical School, Durham, NC, United States
- Department of Orthopaedic Surgery, Duke University Medical School, Durham, NC, United States
| | - Asheley C. Skinner
- Department of Population Health Sciences, Duke University Medical School, Durham, NC, United States
- Duke Clinical Research Institute, Duke University, Durham, NC, United States
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Nicotine Affects Multiple Biological Processes in EpiDermTM Organotypic Tissues and Keratinocyte Monolayers. ATMOSPHERE 2022. [DOI: 10.3390/atmos13050810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Dermal exposure to nicotine is common due to the widespread use of tobacco products. Here, we assessed the effects of nicotine at concentrations found in thirdhand smoke (THS) contaminated environments and electronic cigarette (EC) spills or leaks on a 3D human skin model (EpiDermTM) and on submerged keratinocyte cultures. Air liquid interface treatment of EpiDermTM with 10 or 400 μg/mL of nicotine for 24 h followed by proteomics analysis showed altered pathways related to inflammation, protein synthesis, cell–cell adhesion, apoptosis, and mitochondrial function. Submerged cultured keratinocytes were used to validate the proteomics data and further characterize the response of skin cells to nicotine. Mitochondrial phenotype changed from networked to punctate in keratinocytes treated with 10 or 400 μg/mL of nicotine for 48 h and 24 h, respectively. After 72 h, all concentrations of nicotine caused a significant decrease in the networked phenotype. In Western blots, keratinocytes exposed to 400 μg/mL of nicotine had a significant decrease in mitofusin 2, while mitofusin 1 decreased after 72 h. The shift from networked to punctate mitochondria correlated with a decrease in mitofusin 1/2, a protein needed to establish and maintain the networked phenotype. Mitochondrial changes were reversible after a 24 h recovery period. Peroxisomes exposed to 400 μg/mL of nicotine for 24 h became enlarged and were fewer in number. Nicotine concentrations in THS and EC spills altered the proteome profile in EpiDermTM and damaged organelles including mitochondria and peroxisomes, which are involved in ROS homeostasis. These changes may exacerbate skin infections, inhibit wound healing, and cause oxidative damage to cells in the skin.
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Sarker AH, Hang B. Tobacco-specific nitrosamine 1-(N-methyl-N-nitrosamino)-1-(3-pyridinyl)-4-butanal (NNA) causes DNA damage and impaired replication/transcription in human lung cells. PLoS One 2022; 17:e0267839. [PMID: 35576221 PMCID: PMC9109921 DOI: 10.1371/journal.pone.0267839] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/14/2022] [Indexed: 01/25/2023] Open
Abstract
Thirdhand smoke (THS) is a newly described health hazard composed of toxicants, mutagens and carcinogens, including nicotine-derived tobacco specific nitrosamines (TSNAs), one of which is 1-(N-methyl-N-nitrosamino)-1-(3-pyridinyl)-4-butanal (NNA). Although TSNAs are generally potent carcinogens, the risk of NNA, which is specific to THS, is poorly understood. We recently reported that THS exposure-induced adverse impact on DNA replication and transcription with implications in the development of cancer and other diseases. Here, we investigated the role of NNA in THS exposure-induced harmful effects on fundamental cellular processes. We exposed cultured human lung epithelial BEAS-2B cells to NNA. The formation of DNA base damages was assessed by Long Amplicon QPCR (LA-QPCR); DNA double-strand breaks (DSBs) and NNA effects on replication and transcription by immunofluorescence (IF); and genomic instability by micronuclei (MN) formation. We found increased accumulation of oxidative DNA damage and DSBs as well as activation of DNA damage response pathway, after exposure of cells to NNA. Impaired S phase progression was also evident. Consistent with these results, we found increased MN formation, a marker of genomic instability, in NNA-exposed cells. Furthermore, ongoing RNA synthesis was significantly reduced by NNA exposure, however, RNA synthesis resumed fully after a 24h recovery period only in wild-type cells but not in those deficient in transcription-coupled nucleotide excision repair (TC-NER). Importantly, these cellular effects are common with the THS-exposure induced effects. Our findings suggest that NNA in THS could be a contributing factor for THS exposure-induced adverse health effect.
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Affiliation(s)
- Altaf H. Sarker
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, United States of America
| | - Bo Hang
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, United States of America
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Collins BN, Lepore SJ, Egleston BL. Multilevel Intervention for Low-Income Maternal Smokers in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Am J Public Health 2022; 112:472-481. [PMID: 35196033 PMCID: PMC8887159 DOI: 10.2105/ajph.2021.306601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 12/30/2022]
Abstract
Objectives. To test the efficacy of Babies Living Safe and Smokefree (BLiSS), a multilevel intervention initiated in a citywide safety net health system to improve low-income maternal smokers' abstinence and reduce child tobacco smoke exposure. Methods. This randomized controlled trial in Philadelphia, Pennsylvania (2015-2020), recruited low-income maternal smokers who received a brief smoking intervention (Ask, Advise, Refer [AAR]) from nutrition professionals in the Special Supplemental Nutrition Program for Women, Infants, and Children before randomization to (1) a multilevel intervention (AAR + multimodal behavioral intervention [MBI]; n = 199) or (2) an attention control intervention (AAR + control; n = 197). Results. AAR + MBI mothers had significantly higher 12-month bioverified abstinence rates than did AAR + control mothers (odds ratio [OR] = 9.55; 95% confidence interval [CI] = 1.54, 59.30; P = .015). There were significant effects of time (b = -0.15; SE = 0.04; P < .001) and condition by time (b = -0.19; SE = 0.06; P < .001) on reported child exposure favoring AAR + MBI, but no group difference in child cotinine. Presence of other residential smokers was related to higher exposure. Higher baseline nicotine dependence was related to higher child exposure and lower abstinence likelihood at follow-up. Conclusions. The multilevel BLiSS intervention was acceptable and efficacious in a population that experiences elevated challenges with cessation. Public Health Implications. BLiSS is a translatable intervention model that can successfully improve efforts to address the persistent tobacco-related burdens in low-income communities. Trial Registration. Clinical Trials.gov identifier: NCT02602288. (Am J Public Health. 2022;112(3):472-481. https://doi.org/10.2105/AJPH.2021.306601).
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Affiliation(s)
- Bradley N Collins
- Bradley N. Collins and Stephen J. Lepore are with the Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA. Brian L. Egleston is with the Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Philadelphia, PA
| | - Stephen J Lepore
- Bradley N. Collins and Stephen J. Lepore are with the Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA. Brian L. Egleston is with the Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Philadelphia, PA
| | - Brian L Egleston
- Bradley N. Collins and Stephen J. Lepore are with the Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA. Brian L. Egleston is with the Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Philadelphia, PA
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Parks J, McLean KE, McCandless L, de Souza RJ, Brook JR, Scott J, Turvey SE, Mandhane PJ, Becker AB, Azad MB, Moraes TJ, Lefebvre DL, Sears MR, Subbarao P, Takaro TK. Assessing secondhand and thirdhand tobacco smoke exposure in Canadian infants using questionnaires, biomarkers, and machine learning. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:112-123. [PMID: 34175887 PMCID: PMC8770125 DOI: 10.1038/s41370-021-00350-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 06/02/2023]
Abstract
BACKGROUND As smoking prevalence has decreased in Canada, particularly during pregnancy and around children, and technological improvements have lowered detection limits, the use of traditional tobacco smoke biomarkers in infant populations requires re-evaluation. OBJECTIVE We evaluated concentrations of urinary nicotine biomarkers, cotinine and trans-3'-hydroxycotinine (3HC), and questionnaire responses. We used machine learning and prediction modeling to understand sources of tobacco smoke exposure for infants from the CHILD Cohort Study. METHODS Multivariable linear regression models, chosen through a combination of conceptual and data-driven strategies including random forest regression, assessed the ability of questionnaires to predict variation in urinary cotinine and 3HC concentrations of 2017 3-month-old infants. RESULTS Although only 2% of mothers reported smoking prior to and throughout their pregnancy, cotinine and 3HC were detected in 76 and 89% of the infants' urine (n = 2017). Questionnaire-based models explained 31 and 41% of the variance in cotinine and 3HC levels, respectively. Observed concentrations suggest 0.25 and 0.50 ng/mL as cut-points in cotinine and 3HC to characterize SHS exposure. This cut-point suggests that 23.5% of infants had moderate or regular smoke exposure. SIGNIFICANCE Though most people make efforts to reduce exposure to their infants, parents do not appear to consider the pervasiveness and persistence of secondhand and thirdhand smoke. More than half of the variation in urinary cotinine and 3HC in infants could not be predicted with modeling. The pervasiveness of thirdhand smoke, the potential for dermal and oral routes of nicotine exposure, along with changes in public perceptions of smoking exposure and risk warrant further exploration.
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Affiliation(s)
- Jaclyn Parks
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | | | | | - Russell J de Souza
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Jeffrey R Brook
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - James Scott
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Stuart E Turvey
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Piush J Mandhane
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Allan B Becker
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Meghan B Azad
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Theo J Moraes
- Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Diana L Lefebvre
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Malcolm R Sears
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Padmaja Subbarao
- Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Tim K Takaro
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
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Murphy CM, Micalizzi L, Sokolovsky AW, Borrelli B, Jennings EG, Lee CS, Parker DR, Risica PM. Motivational interviewing telephone counseling to increase postpartum maintenance of abstinence from tobacco. J Subst Abuse Treat 2022; 132:108419. [PMID: 34098201 PMCID: PMC8531179 DOI: 10.1016/j.jsat.2021.108419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/08/2021] [Accepted: 04/15/2021] [Indexed: 01/03/2023]
Abstract
Although many women quit smoking while pregnant, rates of relapse after delivery are high. We examined the effectiveness of motivational interviewing (MI) in maintaining postpartum abstinence from smoking among pregnant women who recently quit smoking (N = 382), randomized to receive five brief MI phone counseling calls or to a prenatal and postpartum care as usual control condition. Relapse to smoking was assessed at 3, 6, and 12 months postpartum based on self-report and urine cotinine. Cox regressions compared conditions on relapse outcomes and hazard ratio of total number of MI calls was examined to probe dose-response effects. Results revealed no difference in the hazard ratio of relapse between treatment condition and no dose-response effect of total number of MI calls. Phone counseling in the prenatal and postpartum period did not facilitate maintenance of abstinence among new mothers. Considerations for future intervention development studies on relapse prevention during the postpartum period are discussed.
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Affiliation(s)
- Cara M Murphy
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA; Center for Alcohol and Addiction Studies, Brown School of Public Health, Providence, RI, USA
| | - Lauren Micalizzi
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA; Center for Alcohol and Addiction Studies, Brown School of Public Health, Providence, RI, USA
| | - Alexander W Sokolovsky
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA; Center for Alcohol and Addiction Studies, Brown School of Public Health, Providence, RI, USA
| | - Belinda Borrelli
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA; Center for Behavioral Science Research, Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Ernestine G Jennings
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA; Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, RI, USA
| | - Christina S Lee
- Department of Clinical Practice, Boston University School of Social Work, Boston, MA, USA
| | - Donna R Parker
- Department of Epidemiology, Brown School of Public Health, Providence, RI, USA
| | - Patricia Markham Risica
- Center for Health Promotion and Health Equity, Brown School of Public Health, Providence, RI, USA; Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA; Department of Epidemiology, Brown School of Public Health, Providence, RI, USA.
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Inoue Y, Zaitsu T, Akiko O, Ishimaru M, Taira K, Takahashi H, Aida J, Tamiya N. Association between exposure to secondhand smoking at home and tooth loss in Japan: A cross-sectional analysis of data from the 2016 National Health and Nutrition Survey. Tob Induc Dis 2021; 19:96. [PMID: 34963776 PMCID: PMC8656347 DOI: 10.18332/tid/143177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Tooth loss affects oral health and physical and social functions. With widespread population aging, its prevalence is increasing. Secondhand smoking is a risk factor for oral diseases; however, in Japan, there are currently no regulations restricting exposure to secondhand smoke at home. This cross-sectional study examined the association between secondhand smoking at home and tooth loss among Japanese adults. METHODS The study examined secondary data from the 2016 National Health and Nutrition Survey, Japan. The self-reported responses of 18812 non-smokers aged ≥20 years were analyzed. The association between exposure to secondhand smoke at home and number of teeth was examined through multiple linear regression with multiple imputation. To obtain a more normal distribution, logarithmic transformation was applied to the number of teeth that deviated substantially from a normal distribution. Adjustments were made for sex, age, occupation, household size, dental check-up within the past year, and exposure to secondhand smoke outside the home. RESULTS Overall, 8.4% of the respondents were exposed to secondhand smoking at home almost every day; this percentage was larger among younger respondents, who also had more teeth than the older respondents. Although the univariate linear regression did not show a positive association between exposure to secondhand smoke and tooth loss, the multivariate-adjusted analysis revealed that respondents who were exposed to secondhand smoke at home almost every day had fewer teeth (β= -0.04; 95% CI: -0.07 – -0.01). CONCLUSIONS The present results suggest that exposure to secondhand smoke at home increases the risk of tooth loss.
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Affiliation(s)
- Yuko Inoue
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Zaitsu
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Oshiro Akiko
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Miho Ishimaru
- Department of Health Services Research, School of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kento Taira
- Department of Health Services Research, School of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nanako Tamiya
- Department of Health Services Research, School of Medicine, University of Tsukuba, Tsukuba, Japan
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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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Kelley ST, Liu W, Quintana PJ, Hoh E, Dodder NG, Mahabee-Gittens EM, Padilla S, Ogden S, Frenzel S, Sisk-Hackworth L, Matt GE. Altered microbiomes in thirdhand smoke-exposed children and their home environments. Pediatr Res 2021; 90:1153-1160. [PMID: 33654287 PMCID: PMC8410873 DOI: 10.1038/s41390-021-01400-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/29/2020] [Accepted: 01/06/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Tobacco smoke contains numerous toxic chemicals that accumulate in indoor environments creating thirdhand smoke (THS). We investigated if THS-polluted homes differed in children's human and built-environment microbiomes as compared to THS-free homes. METHODS Participants were n = 19 THS-exposed children and n = 10 unexposed children (≤5 years) and their caregivers. Environmental and biological samples were analyzed for THS pollutants and exposure. Swab samples were collected from the built-environment (floor, table, armrest, bed frame) and child (finger, nose, mouth, and ear canal), and 16S ribosomal RNA genes were analyzed for bacterial taxa using high-throughput DNA sequencing. RESULTS Phylogenetic α-diversity was significantly higher for the built-environment microbiomes in THS-polluted homes compared to THS-free homes (p < 0.014). Log2-fold comparison found differences between THS-polluted and THS-free homes for specific genera in samples from the built-environment (e.g., Acinetobacter, Bradyrhizobium, Corynebacterium, Gemella, Neisseria, Staphylococcus, Streptococcus, and Veillonella) and in samples from children (esp. Corynebacterium, Gemella, Lautropia, Neisseria, Rothia, Staphylococcus, and Veillonella). CONCLUSION When exposed to THS, indoor and children microbiomes are altered in an environment-specific manner. Changes are similar to those reported in previous studies for smokers and secondhand smoke-exposed persons. THS-induced changes in child and built-environmental microbiomes may play a role in clinical outcomes in children. IMPACT Despite smoking bans, children can be exposed to tobacco smoke residue (i.e., thirdhand smoke) that lingers on surfaces and in settled house dust. Thirdhand smoke exposure is associated with changes in the microbiomes of the home environment and of the children living in these homes. Thirdhand smoke is associated with increased phylogenetic diversity of the home environment and changes in the abundances of several genera of the child microbiome known to be affected by active smoking and secondhand smoke (e.g., Corynebacterium, Staphylococcus, Streptococcus). Thirdhand smoke exposure by itself may induce alterations in the microbiome that play a role in childhood pathologies.
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Affiliation(s)
| | - William Liu
- San Diego State University, San Diego CA, USA
| | | | - Eunha Hoh
- San Diego State University, San Diego CA, USA
| | | | - E. Melinda Mahabee-Gittens
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, U.S.A
| | | | - Shawn Ogden
- San Diego State University, San Diego CA, USA
| | - Sia Frenzel
- San Diego State University, San Diego CA, USA
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Goodwin RD, Kim JH, Cheslack-Postava K, Weinberger AH, Wu M, Wyka K, Kattan M. Trends in cannabis use among adults with children in the home in the United States, 2004-2017: impact of state-level legalization for recreational and medical use. Addiction 2021; 116:2770-2778. [PMID: 33730400 DOI: 10.1111/add.15472] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/01/2020] [Accepted: 02/24/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Cannabis use among parents may be increasing with legalization, but perception of associated risk has declined. The study investigated the association between cannabis legalization and cannabis use among adults with children in the home over time in the United States (US). DESIGN A difference-in-difference approach was applied to public and restricted-use data from the 2004-2017 National Survey on Drug Use and Health (NSDUH), an annual cross-sectional survey. SETTING A representative sample of the United States. PARTICIPANTS/CASES Respondents ages 18+ with children living in the home drawn from the NSDUH (n = 287,624), which is administered to non-institutionalized civilians in the 50 states and District of Columbia. MEASUREMENTS Exposures were year and state-level cannabis policy in state of residence annually. Outcomes were past-30-day cannabis use and daily cannabis use. Sociodemographic variables included age, gender, marital status, annual family income, race/ethnicity, educational attainment, and strength of state-level tobacco control. FINDINGS In 2017, past-month cannabis use (11.9%, 9.3%, and 6.1%) and daily cannabis use (4.2%, 3.2%, and 2.3%) were more common in states with recreational marijuana laws (RML), followed by states with medical marijuana laws (MML) and without legal cannabis use, respectively. RML and MML were associated with significantly higher prevalence of past-month cannabis use (adjusted odds ratio [AOR] = 1.28, 95% confidence interval [CI] = 1.12-1.46; AOR = 1.12, 95% CI = 1.03-1.22) and daily cannabis use (AOR = 1.25, 95% CI = 1.03-1.51; AOR = 1.16, 95% CI = 1.02-1.32), respectively. The impact of MML was particularly salient among adults ages 50+ and the highest income and education subgroups. CONCLUSIONS Among adults with children living in the home, cannabis use appears to be more common in US states with legalized cannabis use compared with states with no legal cannabis use. Recreational legalization appears to increase use among adults with children in the home broadly across nearly all sociodemographic groups, whereas the effect of legalization for medical use is heterogeneous by age and socioeconomic status.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - June H Kim
- Institute for Implementation Science in Population Health, The City University of New York, New York, NY, USA
| | | | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Melody Wu
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Katarzyna Wyka
- Center for Systems and Community Design, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
| | - Meyer Kattan
- Department of Pediatrics, New York-Presbyterian/Columbia University Medical Center, New York, NY, USA.,Division of Pediatric Pulmonology, New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, USA
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38
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Wei CF, Lin CC, Tsai MS, Guo YL, Lin SJ, Liao HF, Hsieh WS, Chen MH, Chen PC. Associations Between Infant Developmental Delays and Secondhand Smoke Exposure Modified by Maternal Prepregnancy Overweight and Obesity Status. Nicotine Tob Res 2021; 23:1475-1483. [PMID: 33556174 DOI: 10.1093/ntr/ntab024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/03/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Secondhand smoke exposure during pregnancy has long been associated with adverse health outcomes in children, but only a few studies have examined its effect modifiers. In this study, we applied effect modification analysis for maternal prepregnancy weight status on detrimental neurodevelopmental effect of secondhand smoke exposure during pregnancy and infancy in a nationwide representative population. AIMS AND METHODS Term singleton mother-infant pairs with nonsmoking mothers were included for main analysis (N = 15 987) from the Taiwan Birth Cohort Study (TBCS), and were further matched with propensity score (n = 5434). We extracted secondhand smoke exposure during pregnancy and infancy, and eight neurodevelopmental milestones from the responses in the baseline visit at 6 months, and 18-month follow-up of TBCS. The associations between secondhand smoke exposure and neurodevelopmental achievement were analyzed with multivariable logistic regression and Cox model. Propensity score weighting and matching were applied for high-versus-low analysis, and relative excess risk due to interaction were used to estimate effect modification. RESULTS Higher secondhand smoke exposure was associated with increased likelihood of delayed milestone achievement across gross motor, fine motor, language-related, and social-related domains. The associations in fine motor domains remained observable in propensity score-weighted and -matched models. We identified additive interaction with self-reported maternal overweight and obesity status before pregnancy in milestone development for walking with support, scribbling, and waving goodbye. CONCLUSIONS Secondhand smoke exposure during pregnancy and infancy were associated with delayed neurodevelopmental milestone achievement at 18 months, and the associations were modified by maternal prepregnancy overweight and obesity status. IMPLICATIONS The study results suggested the association between maternal secondhand smoke exposure during pregnancy and infancy and delayed fine motor and language-related milestone achievement at 18 months in multivariable, propensity score weighting, and matching populations. The results of positive effect modifications for maternal prepregnancy overweight and obesity status suggested the importance of concurrent interventions on smoke-free environment and maternal health during pregnancy.
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Affiliation(s)
- Chih-Fu Wei
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan.,Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Ching-Chun Lin
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Meng-Shan Tsai
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Yueliang Leon Guo
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan.,Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Shio-Jean Lin
- Department of Pediatrics, Chi Mei Medical Center, Tainan, Taiwan
| | - Hua-Fang Liao
- School and Graduate Institute of Physical Therapy, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wu-Shiun Hsieh
- Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan.,Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Mei-Huei Chen
- Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Pau-Chung Chen
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan.,Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.,National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.,Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan.,Innovation and Policy Center for Population Health and Sustainable Environment, National Taiwan University College of Public Health, Taipei, Taiwan
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39
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Northrup TF, Stotts AL, Suchting R, Matt GE, Quintana PJE, Khan AM, Green C, Klawans MR, Johnson M, Benowitz N, Jacob P, Hoh E, Hovell MF, Stewart CJ. Thirdhand smoke associations with the gut microbiomes of infants admitted to a neonatal intensive care unit: An observational study. ENVIRONMENTAL RESEARCH 2021; 197:111180. [PMID: 33865820 PMCID: PMC8187318 DOI: 10.1016/j.envres.2021.111180] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Microbiome differences have been found in adults who smoke cigarettes compared to non-smoking adults, but the impact of thirdhand smoke (THS; post-combustion tobacco residue) on hospitalized infants' rapidly developing gut microbiomes is unexplored. Our aim was to explore gut microbiome differences in infants admitted to a neonatal ICU (NICU) with varying THS-related exposure. METHODS Forty-three mother-infant dyads (household member[s] smoke cigarettes, n = 32; no household smoking, n = 11) consented to a carbon monoxide-breath sample, bedside furniture nicotine wipes, infant-urine samples (for cotinine [nicotine's primary metabolite] assays), and stool collection (for 16S rRNA V4 gene sequencing). Negative binomial regression modeled relative abundances of 8 bacterial genera with THS exposure-related variables (i.e., household cigarette use, surface nicotine, and infant urine cotinine), controlling for gestational age, postnatal age, antibiotic use, and breastmilk feeding. Microbiome-diversity outcomes were modeled similarly. Bayesian posterior probabilities (PP) ≥75.0% were considered meaningful. RESULTS A majority of infants (78%) were born pre-term. Infants from non-smoking homes and/or with lower NICU-furniture surface nicotine had greater microbiome alpha-diversity compared to infants from smoking households (PP ≥ 75.0%). Associations (with PP ≥ 75.0%) of selected bacterial genera with urine cotinine, surface nicotine, and/or household cigarette use were evidenced for 7 (of 8) modeled genera. For example, lower Bifidobacterium relative abundance associated with greater furniture nicotine (IRR<0.01 [<0.01, 64.02]; PP = 87.1%), urine cotinine (IRR = 0.08 [<0.01,2.84]; PP = 86.9%), and household smoking (IRR<0.01 [<0.01, 7.38]; PP = 96.0%; FDR p < 0.05). CONCLUSIONS THS-related exposure was associated with microbiome differences in NICU-admitted infants. Additional research on effects of tobacco-related exposures on healthy infant gut-microbiome development is warranted.
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, The University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, 6431 Fannin, JJL 324, Houston, TX, 77030, USA.
| | - Angela L Stotts
- Department of Family and Community Medicine, Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, 6431 Fannin, JJL 324, Houston, TX, 77030, USA.
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, 1941 East Road, Houston, TX, 77030, USA.
| | - Georg E Matt
- Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4611, USA.
| | - Penelope J E Quintana
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA.
| | - Amir M Khan
- Department of Pediatrics, UTHealth, McGovern Medical School, 6431 Fannin, MSB 3.236, Houston, TX, 77030, USA.
| | - Charles Green
- Department of Pediatrics, Center for Clinical Research and Evidence-Based Medicine, UTHealth, McGovern Medical School, 6431 Fannin, MSB 2.106, Houston, TX, 77030, USA.
| | - Michelle R Klawans
- Department of Family and Community Medicine, UTHealth, McGovern Medical School, 6431 Fannin, JJL 324, Houston, TX, 77030, USA.
| | - Mary Johnson
- Department of Pediatrics, UTHealth, McGovern Medical School, 6431 Fannin, MSB 3.244, Houston, TX, 77030, USA.
| | - Neal Benowitz
- Department of Medicine, University of California San Francisco, 1001 Potrero Ave, SFGH 30, San Francisco, CA, 94143, USA.
| | - Peyton Jacob
- Departments of Medicine and Psychiatry, University of California San Francisco, Division of Cardiology, Clinical Pharmacology Program, San Francisco General Hospital Medical Center, Box 1220, San Francisco, CA, 94143-1220, USA.
| | - Eunha Hoh
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA.
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 102, Mail Box 102, San Diego, CA, 92123-4388, USA.
| | - Christopher J Stewart
- Translational and Clinical Research Institute, Newcastle University, Medical School, Framlington Place, Newcastle, NE2 4HH, UK.
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Fallavollita WL, Do EK, Schechter JC, Kollins SH, Zheng J(J, Qin J, Maguire RL, Hoyo C, Murphy SK, Fuemmeler BF. Smoke-Free Home Rules and Association with Child Secondhand Smoke Exposure among Mother-Child Dyad Relationships. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5256. [PMID: 34069235 PMCID: PMC8157188 DOI: 10.3390/ijerph18105256] [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] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/05/2021] [Accepted: 05/09/2021] [Indexed: 01/22/2023]
Abstract
Smoke-free home rules restrict smoking in the home, but biomarkers of secondhand smoke exposure are needed to help understand the association between smoke-free homes and child secondhand smoke exposure. Participants (n = 346) were majority Black/African American mother-child dyads from a longitudinal study in North Carolina. Mothers completed questionnaires on household smoking behaviors and rules, and child saliva samples were assayed for secondhand smoke exposure. Regression models used smoke-free home rules to predict child risk for secondhand smoke exposure. Children in households with smoke-free home rules had less salivary cotinine and risk for secondhand smoke exposure. After controlling for smokers in the household, home smoking rules were not a significant predictor of secondhand smoke exposure. Compared to children in households with no smokers, children in households with at least one smoker but a non-smoking mother (OR 5.35, 95% CI: 2.22, 13.17) and households with at least one smoker including a smoking mother (OR 13.73, 95% CI: 6.06, 33.28) had greater risk for secondhand smoke exposure. Results suggest smoke-free home rules are not sufficient to fully protect children from secondhand smoke exposure, especially in homes with smokers. Future research should focus on how household members who smoke can facilitate the prevention of child secondhand smoke exposure.
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Affiliation(s)
- Westley L. Fallavollita
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
| | - Elizabeth K. Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Julia C. Schechter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27701, USA; (J.C.S.); (S.H.K.)
| | - Scott H. Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27701, USA; (J.C.S.); (S.H.K.)
| | - Junfeng (Jim) Zheng
- Nicholas School of the Environment and Global Health Institute, Duke University, Durham, NC 27708, USA;
| | - Jian Qin
- School of Public Health, Guangxi Medical University, Nanning 530021, China;
| | - Rachel L. Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA; (R.L.M.); (C.H.)
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Cathrine Hoyo
- Department of Biological Sciences, North Carolina State University, Raleigh, NC 27695, USA; (R.L.M.); (C.H.)
| | - Susan K. Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Bernard F. Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA 23284, USA; (W.L.F.); (E.K.D.)
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23284, USA
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41
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Park MB, Ranabhat CL. Effect of parental smoking on their children's urine cotinine level in Korea: A population-based study. PLoS One 2021; 16:e0248013. [PMID: 33857161 PMCID: PMC8049314 DOI: 10.1371/journal.pone.0248013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Children may be exposed to tobacco products in multiple ways if their parents smoke. The risks of exposure to secondhand smoke (SHS) are well known. This study aimed to investigate the association between parental smoking and the children's cotinine level in relation to restricting home smoking, in Korea. METHODS Using the Korea National Health and Nutrition Health Examination Survey data from 2014 to 2017, we analyzed urine cotinine data of parents and their non-smoking children (n = 1,403), in whose homes parents prohibited smoking. We performed linear regression analysis by adjusting age, sex, house type, and household income to determine if parent smoking was related to the urine cotinine concentration of their children. In addition, analysis of covariance and Tukey's post-hoc tests were performed according to parent smoking pattern. FINDING Children's urine cotinine concentrations were positively associated with those of their parents. Children of smoking parents had a significantly higher urine cotinine concentration than that in the group where both parents are non-smokers (diff = 0.933, P < .0001); mothers-only smoker group (diff = 0.511, P = 0.042); and fathers-only smoker group (diff = 0.712, P < .0001). In the fathers-only smoker group, the urine cotinine concentration was significantly higher than that in the group where both parents were non-smoker (diff = 0.221, P < .0001), but not significantly different compared to the mothers-only smoker group (diff = - -0.201, P = 0.388). Children living in apartments were more likely to be exposed to smoking substances. CONCLUSION This study showed a correlation between parents' and children's urine cotinine concentrations, supporting the occurrence of home smoking exposure due to the parents' smoking habit in Korea. Although avoiding indoor home smoking can decrease the children's exposure to tobacco, there is a need to identify other ways of smoking exposure and ensure appropriate monitoring and enforcement of banning smoking in the home.
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Affiliation(s)
- Myung-Bae Park
- Department of Gerontology Health and Welfare, Pai Chai University, Daejeon, Republic of Korea
| | - Chhabi Lal Ranabhat
- Department of Gerontology Health and Welfare, Pai Chai University, Daejeon, Republic of Korea
- Global Center for Research and Development (GCRD), Kathmandu, Nepal
- Manmohan Memorial Institute of Health Science, Kathmandu, Nepal
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42
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Northrup TF, Stotts AL, Suchting R, Khan AM, Green C, Klawans MR, Quintana PJE, Hoh E, Hovell MF, Matt GE. Thirdhand Smoke Contamination and Infant Nicotine Exposure in a Neonatal Intensive Care Unit: An Observational Study. Nicotine Tob Res 2021; 23:373-382. [PMID: 32866238 DOI: 10.1093/ntr/ntaa167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/26/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Thirdhand smoke (THS) is ultrafine particulate matter and residue resulting from tobacco combustion, with implications for health-related harm (eg, impaired wound healing), particularly among hospitalized infants. Project aims were to characterize nicotine (THS proxy) transported on neonatal intensive care unit (NICU) visitors and deposited on bedside furniture, as well as infant exposure. METHODS Cross-sectional data were collected from participants in a metropolitan NICU. Participants completed a survey and carbon monoxide breath sample, and 41.9% (n = 88) of participants (n = 210) were randomly selected for finger-nicotine wipes during a study phase when all bedside visitors were screened for nicotine use and finger-nicotine levels. During an overlapping study phase, 80 mother-infant dyads consented to bedside furniture-nicotine wipes and an infant urine sample (for cotinine analyses). RESULTS Most nonstaff visitors' fingers had nicotine above the limit of quantification (>LOQ; 61.9%). Almost all bedside furniture surfaces (93.8%) and infant cotinine measures (93.6%) had values >LOQ, regardless of household nicotine use. Participants who reported using (or lived with others who used) nicotine had greater furniture-nicotine contamination (Mdn = 0.6 [interquartile range, IQR = 0.2-1.6] µg/m2) and higher infant cotinine (Mdn = 0.09 [IQR = 0.04-0.25] ng/mL) compared to participants who reported no household-member nicotine use (Mdn = 0.5 [IQR = 0.2-0.7] µg/m2; Mdn = 0.04 [IQR = 0.03-0.07] ng/mL, respectively). Bayesian univariate regressions supported hypotheses that increased nicotine use/exposure correlated with greater nicotine contamination (on fingers/furniture) and infant THS exposure. CONCLUSIONS Potential furniture-contamination pathways and infant-exposure routes (eg, dermal) during NICU hospitalization were identified, despite hospital prohibitions on tobacco/nicotine use. This work highlights the surreptitious spread of nicotine and potential THS-related health risks to vulnerable infants during critical stages of development. IMPLICATIONS THS contamination is underexplored in medical settings. Infants who were cared for in the NICU are vulnerable to health risks from THS exposure. This study demonstrated that 62% of nonstaff NICU visitors transport nicotine on their fingers to the NICU. Over 90% of NICU (bedside) furniture was contaminated with nicotine, regardless of visitors' reported household-member nicotine use or nonuse. Over 90% of infants had detectable levels of urinary cotinine during NICU hospitalizations. Results justify further research to better protect infants from unintended THS exposure while hospitalized.
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Affiliation(s)
- Thomas F Northrup
- Department of Family and Community Medicine, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX
| | - Angela L Stotts
- Department of Family and Community Medicine, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX.,Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, Houston, TX
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, Houston, TX
| | - Amir M Khan
- Department of Pediatrics, UTHealth, McGovern Medical School, Houston, TX
| | - Charles Green
- Department of Pediatrics, UTHealth, McGovern Medical School, Houston, TX.,Center for Clinical Research and Evidence-Based Medicine, UTHealth, McGovern Medical School, Houston, TX
| | - Michelle R Klawans
- Department of Family and Community Medicine, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX
| | | | - Eunha Hoh
- School of Public Health, San Diego State University, San Diego, CA
| | - Melbourne F Hovell
- Center for Behavioral Epidemiology and Community Health, School of Public Health, San Diego State University, San Diego, CA
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego, CA
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Pozuelos GL, Jacob P, Schick SF, Omaiye EE, Talbot P. Adhesion and Removal of Thirdhand Smoke from Indoor Fabrics: A Method for Rapid Assessment and Identification of Chemical Repositories. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3592. [PMID: 33808392 PMCID: PMC8037229 DOI: 10.3390/ijerph18073592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 01/23/2023]
Abstract
Thirdhand smoke (THS) is an environmental contaminant that may cause adverse health effects in smokers and nonsmokers. Currently, time-consuming analytical methods are necessary to assess chemicals in THS repositories, like upholstered furniture and clothing. Our goal was to develop a rapid, accessible method that can be used to measure THS contamination in common household fabrics and to evaluate remediation. Cotton, terry cloth, polyester, and wool were exposed to THS for various times in a controlled laboratory environment and then extracted in various media at room temperature or 60 °C to develop an autofluorescent method to quantify THS. Concentrations of nicotine and related alkaloids in the extracts were determined using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and high-performance liquid chromatography (HPLC). The autofluorescence of extracts was proportional to the time and amount of THS exposure received by cotton and terry cloth. Extracts of polyester and wool did not show autofluorescence unless heat was applied during extraction. Nicotine, nicotine alkaloids, and TSNA concentrations were higher in THS extracts from cotton and terry cloth than extracts of polyester and wool carpet, in agreement with the autofluorescence data. For fabrics spiked with 10 mg of nicotine, extraction efficiency was much higher from terry cloth (7 mg) than polyester (0.11 mg). In high relative humidity, nicotine recovery from both cotton and polyester was 80% (~8 mg). Our results provide a simple, rapid method to assess THS contaminants in household fabrics and further show that THS extraction is influenced by fabric type, heat, and humidity. Thus, remediation of THS environments may need to vary depending on the fabric reservoirs being treated. Understanding the dynamics of THS in fabrics can help set up appropriate remediation policies to protect humans from exposure.
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Affiliation(s)
- Giovanna L. Pozuelos
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA 92521, USA; (G.L.P.); (E.E.O.)
| | - Peyton Jacob
- Department of Medicine, Division of Cardiology, Clinical Pharmacology Program, University of California San Francisco, San Francisco, CA 94110, USA;
| | - Suzaynn F. Schick
- Department of Medicine, Division of Occupational and Environmental Medicine, University of California San Francisco, San Francisco, CA 94110, USA;
| | - Esther E. Omaiye
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA 92521, USA; (G.L.P.); (E.E.O.)
| | - Prue Talbot
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA 92521, USA; (G.L.P.); (E.E.O.)
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Quintana PJE, Lopez-Galvez N, Dodder NG, Hoh E, Matt GE, Zakarian JM, Vyas M, Chu L, Akins B, Padilla S, Anderson KA, Hovell MF. Nicotine, Cotinine, and Tobacco-Specific Nitrosamines Measured in Children's Silicone Wristbands in Relation to Secondhand Smoke and E-cigarette Vapor Exposure. Nicotine Tob Res 2021; 23:592-599. [PMID: 33009807 PMCID: PMC8248526 DOI: 10.1093/ntr/ntaa140] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/28/2020] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Simple silicone wristbands (WB) hold promise for exposure assessment in children. We previously reported strong correlations between nicotine in WB worn by children and urinary cotinine (UC). Here, we investigated differences in WB chemical concentrations among children exposed to secondhand smoke from conventional cigarettes (CC) or secondhand vapor from electronic cigarettes (EC), and children living with nonusers of either product (NS). METHODS Children (n = 53) wore three WB and a passive nicotine air sampler for 7 days and one WB for 2 days, and gave a urine sample on day 7. Caregivers reported daily exposures during the 7-day period. We determined nicotine, cotinine, and tobacco-specific nitrosamines (TSNAs) concentrations in WB, nicotine in air samplers, and UC through isotope-dilution liquid chromatography with triple-quadrupole mass spectrometry. RESULTS Nicotine and cotinine levels in WB in children differentiated between groups of children recruited into NS, EC exposed, and CC exposed groups in a similar manner to UC. WB levels were significantly higher in the CC group (WB nicotine median 233.8 ng/g silicone, UC median 3.6 ng/mL, n = 15) than the EC group (WB nicotine median: 28.9 ng/g, UC 0.5 ng/mL, n = 19), and both CC and EC group levels were higher than the NS group (WB nicotine median: 3.7 ng/g, UC 0.1 ng/mL, n = 19). TSNAs, including the known carcinogen NNK, were detected in 39% of WB. CONCLUSIONS Silicone WB show promise for sensitive detection of exposure to tobacco-related contaminants from traditional and electronic cigarettes and have potential for tobacco control efforts. IMPLICATIONS Silicone WB worn by children can absorb nicotine, cotinine, and tobacco-specific nitrosamines, and amounts of these compounds are closely related to the child's urinary cotinine. Levels of tobacco-specific compounds in the silicone WB can distinguish patterns of children's exposure to secondhand smoke and e-cigarette vapor. Silicone WB are simple to use and acceptable to children and, therefore, may be useful for tobacco control activities such as parental awareness and behavior change, and effects of smoke-free policy implementation.
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Affiliation(s)
| | - Nicolas Lopez-Galvez
- San Diego State University Research Foundation, San Diego State
University, San Diego, CA
| | - Nathan G Dodder
- San Diego State University Research Foundation, San Diego State
University, San Diego, CA
| | - Eunha Hoh
- School of Public Health, San Diego State University, San Diego,
CA
| | - Georg E Matt
- Department of Psychology, San Diego State University, San Diego,
CA
| | - Joy M Zakarian
- San Diego State University Research Foundation, San Diego State
University, San Diego, CA
| | - Mansi Vyas
- School of Public Health, San Diego State University, San Diego,
CA
| | - Linda Chu
- School of Public Health, San Diego State University, San Diego,
CA
| | - Brittany Akins
- School of Public Health, San Diego State University, San Diego,
CA
| | - Samuel Padilla
- San Diego State University Research Foundation, San Diego State
University, San Diego, CA
| | - Kim A Anderson
- Environmental and Molecular Toxicology, Oregon State University College of
Agricultural Sciences, Corvallis, OR
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Matt GE, Quintana PJE, Hoh E, Zakarian JM, Dodder NG, Record RA, Hovell MF, Mahabee-Gittens EM, Padilla S, Markman L, Watanabe K, Novotny TE. Remediating Thirdhand Smoke Pollution in Multiunit Housing: Temporary Reductions and the Challenges of Persistent Reservoirs. Nicotine Tob Res 2021; 23:364-372. [PMID: 32803265 PMCID: PMC7822102 DOI: 10.1093/ntr/ntaa151] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/11/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Toxic tobacco smoke residue, also known as thirdhand smoke (THS), can persist in indoor environments long after tobacco has been smoked. This study examined the effects of different cleaning methods on nicotine in dust and on surfaces. AIMS AND METHODS Participants had strict indoor home smoking bans and were randomly assigned to: dry/damp cleaning followed by wet cleaning 1 month later (N = 10), wet cleaning followed by dry/damp cleaning (N = 10) 1 month later, and dry/damp and wet cleaning applied the same day (N = 28). Nicotine on surfaces and in dust served as markers of THS and were measured before, immediately after, and 3 months after the cleaning, using liquid chromatography with triple quadrupole mass spectrometry (LC-MS/MS). RESULTS Over a 4-month period prior to cleaning, surface nicotine levels remained unchanged (GeoMean change: -11% to +8%; repeated measures r = .94; p < .001). Used separately, dry/damp and wet cleaning methods showed limited benefits. When applied in combination, however, we observed significantly reduced nicotine on surfaces and in dust. Compared with baseline, GeoMean surface nicotine was 43% lower immediately after (z = -3.73, p < .001) and 53% lower 3 months later (z = -3.96, p < .001). GeoMean dust nicotine loading declined by 60% immediately after (z = -3.55, p < .001) and then increased 3 months later to precleaning levels (z = -1.18, p = .237). CONCLUSIONS Cleaning interventions reduced but did not permanently remove nicotine in dust and on surfaces. Cleaning efforts for THS need to address persistent pollutant reservoirs and replenishment of reservoirs from new tobacco smoke intrusion. THS contamination in low-income homes may contribute to health disparities, particularly in children. IMPLICATIONS Administered sequentially or simultaneously, the tested cleaning protocols reduced nicotine on surfaces by ~50% immediately after and 3 months after the cleaning. Nicotine dust loading was reduced by ~60% immediately after cleaning, but it then rebounded to precleaning levels 3 months later. Cleaning protocols were unable to completely remove THS, and pollutants in dust were replenished from remaining pollutant reservoirs or new secondhand smoke intrusion. To achieve better outcomes, cleaning protocols should be systematically repeated to remove newly accumulated pollutants. New secondhand smoke intrusions need to be prevented, and remaining THS reservoirs should be identified, cleaned, or removed to prevent pollutants from these reservoirs to accumulate in dust and on surfaces.
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Affiliation(s)
- Georg E Matt
- Department of Psychology, San Diego State University, San Diego, CA
| | | | - Eunha Hoh
- School of Public Health, San Diego State University, San Diego, CA
| | - Joy M Zakarian
- San Diego State University Research Foundation, San Diego, CA
| | - Nathan G Dodder
- San Diego State University Research Foundation, San Diego, CA
| | - Rachael A Record
- School of Communication, San Diego State University, San Diego, CA
| | | | - E Melinda Mahabee-Gittens
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Samuel Padilla
- San Diego State University Research Foundation, San Diego, CA
| | - Laura Markman
- School of Public Health, San Diego State University, San Diego, CA
| | - Kayo Watanabe
- School of Public Health, San Diego State University, San Diego, CA
| | - Thomas E Novotny
- School of Public Health, San Diego State University, San Diego, CA
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Son Y, Giovenco DP, Delnevo C, Khlystov A, Samburova V, Meng Q. Indoor Air Quality and Passive E-cigarette Aerosol Exposures in Vape-Shops. Nicotine Tob Res 2021; 22:1772-1779. [PMID: 32445475 DOI: 10.1093/ntr/ntaa094] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 05/18/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Direct emissions of nicotine and harmful chemicals from electronic cigarettes (e-cigarettes) have been intensively studied, but secondhand and thirdhand e-cigarette aerosol (THA) exposures in indoor environments are understudied. AIMS AND METHODS Indoor CO2, NO2, particulate matter (PM2.5), aldehydes, and airborne nicotine were measured in five vape-shops to assess secondhand exposures. Nicotine and tobacco-specific nitrosamines were measured on vape-shop surfaces and materials (glass, paper, clothing, rubber, and fur ball) placed in the vape-shops (14 days) to study thirdhand exposures. RESULTS Airborne PM2.5, formaldehyde, acetaldehyde, and nicotine concentrations during shop opening hours were 21, 3.3, 4.0, and 3.8 times higher than the levels during shop closing hours, respectively. PM2.5 concentrations were correlated with the number of e-cigarette users present in vape-shops (ρ = 0.366-0.761, p < .001). Surface nicotine, 4-(N-methyl-N-nitrosamino)-4-(3-pyridyl)butanal (NNA), and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) were also detected at levels of 223.6 ± 313.2 µg/m2, 4.78 ± 11.8 ng/m2, and 44.8 ± 102.3 ng/m2, respectively. Substantial amounts of nicotine (up to 2073 µg/m2) deposited on the materials placed within the vape-shops, and NNA (up to 474.4 ng/m2) and NNK (up to 184.0 ng/m2) were also formed on these materials. The deposited nicotine concentrations were strongly correlated with the median number of active vapers present in a vape-shop per hour (ρ = 0.894-0.949, p = .04-.051). NNK levels on the material surfaces were significantly associated with surface nicotine levels (ρ=0.645, p = .037). CONCLUSIONS Indoor vaping leads to secondhand and THA exposures. Thirdhand exposures induced by e-cigarette vaping are comparable or higher than that induced by cigarette smoking. Long-term studies in various microenvironments are needed to improve our understanding of secondhand and THA exposures. IMPLICATIONS This study adds new convincing evidence that e-cigarette vaping can cause secondhand and THA exposures. Our findings can inform Occupational Safety and Health Administration, state authorities, and other government agencies regarding indoor air policies related to e-cigarette use, particularly in vape-shops. There is an urgent need to ensure that vape-shops maintain suitable ventilation systems and cleaning practices to protect customers, employees, and bystanders. Our study also demonstrates that nicotine can deposit or be adsorbed on baby's clothes and toys, and that tobacco-specific nitrosamines can form and retain on baby's clothes, highlighting children's exposure to environmental e-cigarette aerosol and THA at home is of a particular concern.
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Affiliation(s)
- Yeongkwon Son
- Department of Environmental and Occupational Health, School of Public Health, Rutgers University, Piscataway, NJ.,Division of Atmospheric Sciences, Desert Research Institute, Reno, NV
| | - Daniel P Giovenco
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Cristine Delnevo
- Center for Tobacco Studies, School of Public Health, Rutgers University, Piscataway, NJ.,Cancer Prevention and Control Research Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Andrey Khlystov
- Division of Atmospheric Sciences, Desert Research Institute, Reno, NV
| | - Vera Samburova
- Division of Atmospheric Sciences, Desert Research Institute, Reno, NV
| | - Qingyu Meng
- Department of Environmental and Occupational Health, School of Public Health, Rutgers University, Piscataway, NJ.,Center for Tobacco Studies, School of Public Health, Rutgers University, Piscataway, NJ
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Wilson KM, Moss A, Lowary M, Gambino J, Klein JD, Kerby GS, Hovell M, Winickoff JP. Smoking Behaviors Among Tobacco-Using Parents of Hospitalized Children and Association With Child Cotinine Level. Hosp Pediatr 2021; 11:17-24. [PMID: 33272923 PMCID: PMC7769203 DOI: 10.1542/hpeds.2020-0122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Understanding patterns of parental tobacco use and their association with child exposure can help us target interventions more appropriately. We aimed to examine the association between parental smoking practices and cotinine levels of hospitalized children. METHODS This is a secondary analysis of data collected from parents of hospitalized children, recruited for a cessation intervention randomized controlled trial. Smoking parents were identified by using a medical record screening question. Parent-reported demographics and smoking habits were compared to child urine cotinine by using geometric means and log-transformed cotinine levels in multivariable linear regression analyses. RESULTS A total of 213 patients had complete baseline parent-interview and urine cotinine data. The median age was 4 (interquartile range: 1-9); 57% were boys; 56% were white, 12% were Black, and 23% were multiracial; 36% identified as Hispanic. Most families (54%) had 1 smoker in the home; 36% had 2, and 9% had ≥3. Many (77%) reported having a ban on smoking in the home, and 86% reported smoking only outside. The geometric mean cotinine level of the cohort was 0.98 ng/mL. Higher cotinine levels were associated with more smokers in the home (ratio of 2.99) and smoking inside the house (ratio of 4.11). CONCLUSIONS Having more smokers in the home and parents who smoke inside are associated with increased smoke exposure; however, even children whose families who smoke only outside the home have significant levels of cotinine, a marker for toxin exposure.
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Affiliation(s)
- Karen M Wilson
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, New York;
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois
| | - Angela Moss
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | | | - Jonathan D Klein
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Gwendolyn S Kerby
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Melbourne Hovell
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, College of Health and Human Sciences, San Diego State University, San Diego, California
| | - Jonathan P Winickoff
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois
- Department of Pediatrics, Massachusetts General Hospital for Children, Harvard Medical School, Harvard Universty, Boston, Massachusetts
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Nadhiroh SR, Djokosujono K, Utari DM, Hasugian AR. Questionnaire-Based Environmental Tobacco Smoke Exposure and Hair Nicotine Levels in 6-month-old Infants: A Validation Study in Indonesia. Glob Pediatr Health 2020; 7:2333794X20969287. [PMID: 33195749 PMCID: PMC7605031 DOI: 10.1177/2333794x20969287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/28/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives. Using hair nicotine as the gold standard, this study aimed to establish cutoff points and validate the questionnaire-based environmental tobacco smoke (ETS) exposure and ETS statuses of Indonesian infants. Methods. A cross-sectional study design was conducted among families who were participants of the Peer Health Cohort Study in Jakarta, Indonesia. Households with 6-month-old infants joined this study. The presence and amount of ETS exposure were assessed by both questionnaire and hair sampling for nicotine determination. Head hair samples were collected from 102 infants and measured by optimized gas chromatography-mass spectrometry (GC/MS). Infants were grouped as ETS-exposed if they lived with at least 1 smoker at home. We used the receiver operating characteristic (ROC) curve to assess the sensitivity and specificity of cutoff values of hair nicotine. Results. There were 78 (76.5%) infants exposed to ETS based on the questionnaire. The nicotine concentrations in hair were significantly higher in infants with ETS exposure than in those without ETS exposure (P < .001). The area under the curve for nicotine was 0.774. A hair nicotine cutoff value of 2.37 ng/mg, with a sensitivity of 67.95% and specificity of 83.33%, was identified as the optimal cutoff value for separating exposed from non-exposed to ETS in infants. Conclusion. The hair nicotine value of infants aged 6 months is useful in confirming the questionnaire on smoking in the household and exposure to ETS. Moreover, it also could be used to distinguish ETS-exposed from non-ETS-exposed infants.
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Affiliation(s)
| | | | | | - Armedy Ronny Hasugian
- National Institutes of Health Research and Development, Ministry of Health, Jakarta, Indonesia
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Oates GR, Harris WT, Gutierrez HH, Mims C, Rutland SB, Ott C, Niranjan SJ, Scarinci IC, Walley SC. Tobacco smoke exposure in pediatric cystic fibrosis: A qualitative study of clinician and caregiver perspectives on smoking cessation. Pediatr Pulmonol 2020; 55:2330-2340. [PMID: 32511883 PMCID: PMC7686064 DOI: 10.1002/ppul.24879] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Tobacco smoke exposure has negative impacts on the lung health of children with cystic fibrosis (CF), yet evidence-based strategies for smoking cessation have not been tested with or tailored to CF caregivers. This qualitative study identified barriers and facilitators of smoking cessation in this population and outlined potential interventional approaches. METHODS We conducted semi-structured interviews with CF familial caregivers who were current or former smokers, and with members of the CF care team. We asked about experiences, practices, and prerequisites for a successful program. Interviews were recorded, transcribed verbatim, and coded by two investigators. Analysis used a thematic approach guided by the PRECEDE model, which identifies predisposing (intrapersonal), reinforcing (interpersonal), and enabling (structural) factors relevant to health behaviors and programs. RESULTS Seventeen interviews were conducted-eight with familial caregivers and nine with CF team members. Whereas caregivers provided greater insight into internal difficulties and motivators to quit smoking, clinicians offered more extensive input on barriers and solutions related to the clinical environment. Based on study recommendations, a successful tobacco cessation program should include (a) family education about the harms of smoke exposure for children with CF; (b) screening for exposure, ideally with biochemical verification; (c) access to trained tobacco counselors; (d) affordable pharmacotherapy; and (e) outpatient follow-up of those undergoing tobacco treatment. CONCLUSION This qualitative study revealed intrapersonal, interpersonal, and structural barriers to eliminating tobacco smoke exposure in children with CF, outlined opportunities to address these barriers, and made recommendations for a comprehensive tobacco cessation strategy.
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Affiliation(s)
- Gabriela R Oates
- Pediatric Pulmonary and Sleep Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - William T Harris
- Pediatric Pulmonary and Sleep Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Hector H Gutierrez
- Pediatric Pulmonary and Sleep Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Cathy Mims
- Children's of Alabama, Birmingham, Alabama
| | - Sarah B Rutland
- Pediatric Pulmonary and Sleep Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Corilyn Ott
- Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
| | - Soumya J Niranjan
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama
| | - Isabel C Scarinci
- Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Susan C Walley
- Pediatric Hospital Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Effectiveness of a video-based smoking cessation intervention focusing on maternal and child health in promoting quitting among expectant fathers in China: A randomized controlled trial. PLoS Med 2020; 17:e1003355. [PMID: 32991589 PMCID: PMC7523971 DOI: 10.1371/journal.pmed.1003355] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 08/26/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Secondhand smoke can cause adverse pregnancy outcomes, yet there is a lack of effective smoking cessation interventions targeted at expectant fathers. We examined the effectiveness of a video-based smoking cessation intervention focusing on maternal and child health in promoting quitting among expectant fathers. METHODS AND FINDINGS A single-blind, 3-arm, randomized controlled trial was conducted at the obstetrics registration centers of 3 tertiary public hospitals in 3 major cities (Guangzhou, Shenzhen, and Foshan) in China. Smoking expectant fathers who registered with their pregnant partners were invited to participate in this study. Between 14 August 2017 to 28 February 2018, 1,023 participants were randomized to a video (n = 333), text (n = 322), or control (n = 368) group. The video and text groups received videos or text messages on the risks of smoking for maternal and child health via instant messaging. The control group received a leaflet with information on smoking cessation. Follow-up visits were conducted at 1 week and at 1, 3, and 6 months. The primary outcome, by intention to treat (ITT), was validated abstinence from smoking at the 6-month follow-up. The secondary outcomes included 7-day point prevalence of abstinence (PPA) and level of readiness to quit at each follow-up. The mean age of participants was 32 years, and about half of them were first-time expectant fathers. About two-thirds of participants had completed tertiary education. The response rate was 79.7% (815 of 1,023) at 6 months. The video and text groups had higher rates of validated abstinence than the control group (video group: 22.5% [75 of 333], P < 0.001; text group: 14.9% [48 of 322], P = 0.02; control group: 9.2% [34 of 368]) with adjusted odds ratios (ORs) of 2.80 (95% confidence interval [CI]: 1.79-4.37, P < 0.001) in the video group and 1.70 (95% CI: 1.06-2.74, P = 0.03) in the text group. The video and text groups differed in the rates of validated abstinence (22.5% versus 14.9%, P = 0.008; adjusted OR: 1.64, 95% CI: 1.10-2.46, P = 0.02). The video and text groups had higher rates of 7-day PPA than the control group at 6 months (video group: 24.6% [82 of 333] versus 11.4% [42 of 368], P < 0.001; text group: 17.4% [56 of 333] versus 11.4% [42 of 368], P = 0.02). The video and text groups also differed in the rates of 7-day PPA (24.6% versus 17.4%, P = 0.02). Excluding the quitters, the video and text groups had higher levels of readiness to quit than the control group at 6 months (video group: 43.5% [109 of 251] versus 31.6% [103 of 326], P = 0.002; text group: 40.6% [108 of 266] versus 31.6% [103 of 326], P = 0.01), No such difference was detected between the video and text groups (43.5% versus 40.6%, P = 0.29). The study was limited in that the long-term effectiveness of the intervention is uncertain. CONCLUSIONS This smoking cessation intervention for expectant fathers that focused on explaining the ramifications of smoking on maternal and child health was effective and feasible in promoting quitting, and video messages were more effective than texts in delivering the information. TRIAL REGISTRATION ClinicalTrials.gov: NCT03236025.
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