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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:ntae130. [PMID: 38890774 DOI: 10.1093/ntr/ntae130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [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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Hashemi-Aghdam MR, Shafiee G, Ebrahimi M, Ejtahed HS, Yaseri M, Motlagh ME, Qorbani M, Heshmat R, Kelishadi R. Trend of passive smoking and associated factors in Iranian children and adolescents: the CASPIAN studies. BMC Public Health 2022; 22:603. [PMID: 35351076 PMCID: PMC8962519 DOI: 10.1186/s12889-022-13045-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 03/22/2022] [Indexed: 01/19/2023] Open
Abstract
Background It is well documented that, similar to active smokers, passive smokers are also at an increased risk of developing non-communicable diseases, and it could impose high financial costs on the healthcare system. This study aimed to evaluate the trend of passive smoking and related determinants during the three phases of a school-based surveillance program. Methods This is a secondary study using the national data obtained from three phases of the surveillance program entitled The Childhood and Adolescence Surveillance and Prevention of Adult Noncommunicable Disease (CASPIAN) study, conducted from 2008 to 2014 on Iranian children and adolescents living in urban and rural areas of 30 provinces in Iran. Participants were selected by cluster multistage sampling method. Results Overall, the study participants consisted of 33,288 students (50.5% boys) with a mean (± SD) age of 12.8 ± 3.2 years. The passive smoking rate was significantly increased from 35.6% in 2008 to 43.2% in 2015 among children and adolescents. According to the multivariate logistic regression, father’s university education, mother’s employment, life satisfaction, and socioeconomic status had a protective role regarding second-hand smoke exposure. In contrast, the father’s self-employment had a positive role in increasing the rate of passive smoking. Conclusion Considering the increasing trend of passive smoking and its considerable adverse health effects, it is necessary to implement large-scale public interventions to reduce the rate and hazards of exposure to tobacco smoke.
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Junus S, Chew CC, Sugunan P, Meor-Aziz NF, Zainal NA, Hassan HM, Abu-Mansor MA, Abu-Zamri H, Hss AS. Parental health risk perceptions and preventive measures related to Children's second-hand cigarette smoke exposure in Malaysia. BMC Public Health 2021; 21:1860. [PMID: 34654405 PMCID: PMC8518244 DOI: 10.1186/s12889-021-11825-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 09/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background Secondhand smoke (SHS) exposure can affect physical development in children. An understanding of parental risk perception of SHS could guide efforts to develop measures for prevention of SHS exposure among children. This study aimed to assess parental risk perceptions of SHS and action taken by parents to minimise SHS exposure in their children. Methods This cross-sectional nationwide study conducted in 2018 recruited convenience sample of 289 parents with children up to age 12 at public areas. Parents were asked to rate the risk level from 1 (no risk) to 5 (extremely high risk) by looking at photographs of an adult smoking in the presence of a child in 8 different situations. The implementation of smoking restriction rules was assessed. Mean scores were calculated with higher scores representing higher risk perception of SHS to child’s health. Linear regression analysis was used to determine factors associated with the level of parental risk perception of SHS exposure to their children’s health. Results A total of 246 parents responded. Their mean age was 35 years (SD 6.4). The majority were mothers (75.6%), Malays (72.0%) and had tertiary education level (82.5%), and non-smoker (87.1%). The mean age of respondents’ youngest child was 3 years (SD 3.1). The risk perception level was high [mean scores: 4.11 (SD: 0.82)]. Most parents implemented household (65.0%) and car (68.3%) smoking restriction rules. Lower levels of risk perception were observed among participants who were current smokers (p < 0.001), lived with a smoker (p < 0.001), allowed household smoking with an open window (p = 0.027). Conclusion Most parents perceived that risks of SHS exposure to their children were high but only two-thirds of them had set rules prohibiting smoking. Health policymakers should pay attention to factors associated with lower risk perception among parents. Trial registration This study was approved by the Medical Research Ethics Committee, Ministry of Health Malaysia (Registration Number: NMRR-18-3299-44967).
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Affiliation(s)
- Suria Junus
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Jalan Raja Ashman Shah, 30450, Ipoh, Perak, Malaysia
| | - Chii-Chii Chew
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Jalan Raja Ashman Shah, 30450, Ipoh, Perak, Malaysia.
| | - Pravin Sugunan
- Paediatric Department, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Perak, Malaysia
| | - Nurul-Fazlin Meor-Aziz
- Institute of Training Ministry of Health, Ministry of Health, Ulu Kinta, Perak, Malaysia
| | - Nurul Ain Zainal
- Institute of Training Ministry of Health, Ministry of Health, Ulu Kinta, Perak, Malaysia
| | - Husna Mat Hassan
- Institute of Training Ministry of Health, Ministry of Health, Ulu Kinta, Perak, Malaysia
| | | | - Hazirah Abu-Zamri
- Institute of Training Ministry of Health, Ministry of Health, Ulu Kinta, Perak, Malaysia
| | - Amar-Singh Hss
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Jalan Raja Ashman Shah, 30450, Ipoh, Perak, Malaysia.,Paediatric Department, Hospital Raja Permaisuri Bainun, Ministry of Health, Ipoh, Perak, Malaysia
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Lim KH, Ghazali SM, Lim HL, Cheong YL, Kee CC, Heng PP, Tiunh TY, Mat Hashim MH, Lim JH. Prevalence and factors related to secondhand smoke exposure among secondary school-going adolescents in Malaysia: Findings from Malaysia Global Health School Survey 2012 and 2017. Tob Induc Dis 2021; 19:50. [PMID: 34177412 PMCID: PMC8204740 DOI: 10.18332/tid/136029] [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: 01/27/2021] [Revised: 03/15/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Secondhand (SHS) smoke exposure has caused various health problems. Therefore, continuous monitoring of SHS exposure is important to determine the efficacy of various anti-tobacco measure implemented. The study aims to compare the prevalence and factor(s) associated with SHS exposure among secondary school-going adolescents in Malaysia during 2012 and 2017. METHODS We derived data from the Global School Health Survey (GSHS) 2012 and GSHS 2017, which was carried out in Malaysia using multistage sampling to select representative samples of secondary school-going adolescents. Both surveys used similar questionnaires to measure SHS exposure. Descriptive and multivariate logistic regression was used to determine the prevalence and factors associated with SHS exposure. RESULTS Approximately four in ten respondents were exposed to SHS in the past week in both surveys (41.5% in GSHS 2012 and 42.0% in GSHS 2017, respectively). Both surveys revealed a significantly higher SHS exposure among respondents who smoked than among non-smokers and higher among males compared to females. The likelihood of SHS exposure in both surveys was also similar, with a higher likelihood of SHS exposure among smoking adolescents and non-smoking adolescents who had at least one smoking parent/guardian, regardless of their own smoking status. Male adolescents had a higher risk of SHS exposure compared to their female counterparts. Meanwhile, SHS risk also increased with age, regardless of smoking status. CONCLUSIONS Our findings suggested that there were no changes in the prevalence of SHS exposure and recorded only a slight change in the factors associated with exposure to SHS among school-going adolescents in Malaysia between the years 2012 and 2017. A more pro-active, extensive and comprehensive programme should be implemented to address the problem of SHS exposure. Parents should be advised to stop smoking or abstain from smoking in the presence of their children, and smoking cessation interventions are necessary for smoking adolescents and their parents.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Biostatistics and Data Raspatory Sector, National Institutes of Health, Shah Alam, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Tsye Yih Tiunh
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Jia Hui Lim
- Department of Pharmacy and Pharmaceutical Sciences, Monash University Malaysia, Subang Jaya, Malaysia
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Ellis-Suriani Z, Norsa'adah B, Othman A, Siti-Azrin AH. Association between secondhand smoke exposure at home and cognitive performance among rural primary school children in Malaysia. Tob Induc Dis 2021; 19:27. [PMID: 33867904 PMCID: PMC8049107 DOI: 10.18332/tid/133638] [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: 10/07/2020] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Secondhand smoke (SHS) exposure is linked to a series of serious health problems. Children may be particularly vulnerable to the effects of SHS exposure at home. This study aimed to determine the association between SHS exposure at home and cognitive performance in school children. METHODS A multistage sampling was performed across rural primary schools in Kuala Krai, Kelantan, Malaysia. Data were collected using self-administered questionnaires and the children aged 10-11 years (n=312) were subjected to cognitive tests including digit span, letter-number sequencing, coding, and symbol search. Cognitive performance was tested using subscales derived from the Wechsler Intelligence Scale for Children. RESULTS The prevalence of SHS exposure at home was 55.8%, where 11.9% of children lived with one smoker, while 43.9% of children lived with ≥2 smokers. There was a significant difference in the mean score of the combined cognitive tests between SHS-exposed and non-exposed children after adjustment for sex, parental educational level, family income and academic performance [Pillai's Trace=0.084, F statistic (df)=6.803 (4302), p<0.001]. CONCLUSIONS More than half of the primary school children in rural Kuala Krai were exposed to SHS from at least one smoker at home. There was a significant association between SHS exposure at home and cognitive performance.
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Affiliation(s)
- Zulkarnain Ellis-Suriani
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Bachok Norsa'adah
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Azizah Othman
- Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Ab Hamid Siti-Azrin
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
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Mohd Radzi NA, Saub R, Mohd Yusof ZY, Dahlui M, Sujak SL. Nicotine Dependence among Adolescents Single and Dual Cigarette Users. CHILDREN-BASEL 2021; 8:children8020144. [PMID: 33672960 PMCID: PMC7918536 DOI: 10.3390/children8020144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 11/16/2022]
Abstract
The prevalence of concurrent use of combustible and electronic cigarettes (dual-use) is on the rise among Malaysian adolescents. This study compares nicotine dependence among exclusive cigarette users, e-cigarette users, and dual adolescent users. A total of 227 adolescent smokers completed a self-administrated questionnaire with items based on Hooked on Nicotine Checklist (HONC) incorporated. Endorsement of at least one HONC item indicates nicotine dependence. Exhaled carbon monoxide readings and salivary cotinine data were also collected. Over half (52.9%) of the participants were exclusive e-cigarette users (EC). The prevalence of exclusive conventional cigarette smokers (CC) and dual users was 11.9% and 35.2%, respectively. Adolescents who have mothers with secondary school education were more likely to become addicted to nicotine (Adjusted Odd Ratio (aOR) = 2.72; 95% CI = 1.17–6.32). Adolescents’ “mother’s education” level predicted nicotine dependence. This highlighted the need to target families within the identified demography with a more supportive anti-tobacco program.
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Affiliation(s)
- Nawwal Alwani Mohd Radzi
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (N.A.M.R.); (Z.Y.M.Y.)
- Centre of Population Oral Health and Clinical Prevention Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor 47000, Malaysia
| | - Roslan Saub
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (N.A.M.R.); (Z.Y.M.Y.)
- Correspondence:
| | - Zamros Yuzadi Mohd Yusof
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (N.A.M.R.); (Z.Y.M.Y.)
| | - Maznah Dahlui
- Centre of Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Sharol Lail Sujak
- Negeri Sembilan Oral Health Division, Ministry of Health Malaysia, Seremban, Negeri Sembilan 73000, Malaysia;
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Ghazali SM, Huey TC, Cheong KC, Li LH, Fadhli M, Yusoff M, Yusoff AF, Hock LK. Prevalence and factors associated with secondhand smoke exposure among Malaysian adolescents. Tob Induc Dis 2019; 17:22. [PMID: 31582933 PMCID: PMC6751970 DOI: 10.18332/tid/102728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/19/2018] [Accepted: 01/09/2019] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Exposure to secondhand smoke (SHS) has been proven to be detrimental to health. However, there is little information on SHS exposure among Malaysian adolescents. This study aims to assess the magnitude of and factors associated with SHS exposure among school-going adolescents in Malaysia. METHODS We performed secondary analysis on data from 25461 respondents of the Global School Health Survey in Malaysia. Descriptive analyses and multivariable logistic regression were performed to determine factors associated with SHS exposure. RESULTS Respondents were adolescents of mean age 14.84 (SD=1.45) years, 50.2% of which were male and 49.8% female. Approximately four in ten respondents were exposed to SHS in the past week (41.5%). SHS exposure was significantly higher among respondents who smoked than among non-smokers (85.8% vs 35.7%, p<0.001). The likelihood of exposure to SHS was higher among smoking adolescents (Adjusted OR=1.66, 95% CI: 1.07-2.56) and non-smoking adolescents (AOR=3.15, 95% CI: 1.48-4.71) who had at least one smoking parent/guardian regardless of their own smoking status. Male adolescents had higher risk of SHS exposure compared to their female counterparts (current smoker AOR=1.66, 95% CI: 1.07-2.56; non-smoker AOR=1.50, 95% CI: 1.12-2.00) and increased with age, regardless of their smoking status. CONCLUSIONS Our findings suggest that prevalence of exposure to SHS among school-going adolescents in Malaysia is high. Parents should be advised to stop smoking or abstain from smoking in the presence of their children. Education programmes are recommended to increase awareness on avoidance of SHS as well as smoking cessation interventions for both adolescents and their parents.
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Affiliation(s)
- Sumarni Mohd Ghazali
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Teh Chien Huey
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Kee Chee Cheong
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Lim Hui Li
- Hospital Sultan Haji Ahmad Shah, Ministry of Health, Temerloh, Malaysia
| | - Muhammad Fadhli
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
- Hospital Sultan Haji Ahmad Shah, Ministry of Health, Temerloh, Malaysia
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Mohd Yusoff
- Institute for Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Ahmad Faudzi Yusoff
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Lim Kuang Hock
- Epidemiology & Biostatistics Unit, Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
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Lim HL, Teh CH, Kee CC, Mohd Ghazali S, Pan SA, Lim KH. Exposure to second-hand smoke among secondary school-going adolescents: Findings from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study. PROCEEDINGS OF SINGAPORE HEALTHCARE 2019. [DOI: 10.1177/2010105818789961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Exposure to second-hand smoke (SHS) is one of the main causes of morbidity and it has been proven to be associated with an increased likelihood of smoking initiation among adolescents. Nonetheless, evidence on SHS exposure among Malaysian adolescents is scarce. Therefore, this article aims to demonstrate the magnitude and factors associated with SHS exposure among school-going adolescents in selected secondary schools in Peninsular Malaysia. Methods: Data were derived from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study conducted in 2013. A total of 2599 adolescent were recruited into the study using a two-stage proportionate-to-size sampling method. Data were obtained from self-administered questionnaires. Descriptive analysis and multivariable logistic regression were performed to determine the risk factors/predictors associated with SHS. Results: More than half of the respondents had been exposed to SHS during the last one week (56.4%), and SHS exposure was significantly higher among respondents who smoked (94.0% vs. 49.9%, p <0.001). Multivariable analysis revealed that the likelihood of exposure to SHS was higher among those who smoked (adjusted odds ratio (aOR) 12.90, 95% confidence interval (CI): 8.01–20.4), had at least one parent/guardian who smoked (aOR 5.49, 95% CI: 4.41–6.94) and adolescents of Malay descent (aOR 2.10, 95% CI: 1.68–2.63). Conclusion: Our findings suggested that the effectiveness of anti-smoking measures implemented in recent years to protect adolescents from the health risks of passive smoking were less evident. Therefore, educational and awareness programmes that emphasize the negative health impacts of SHS exposure on Malaysian adolescents, particularly when among smoking adults, should be intensified to help in preventing adoption of smoking behaviours among adolescents.
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Affiliation(s)
- Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Jalan Maran, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | | | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
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Mohamed NN, Loy SL, Lim PY, Al Mamun A, Jan Mohamed HJ. Early life secondhand smoke exposure assessed by hair nicotine biomarker may reduce children's neurodevelopment at 2years of age. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 610-611:147-153. [PMID: 28803192 DOI: 10.1016/j.scitotenv.2017.08.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 08/03/2017] [Accepted: 08/03/2017] [Indexed: 06/07/2023]
Abstract
Exposure to secondhand smoke (SHS) can affect fetal brain development as well as subsequent neurodevelopment. This study aimed to determine the association between prenatal and postnatal SHS exposure with children's neurodevelopment at 2years of age. Among 107 mother-child pairs from a Malaysia prospective cohort, prenatal and postnatal SHS exposure was determined based on maternal and child hair nicotine concentrations. Multiple linear regressions were used to determine the association between prenatal and postnatal levels of nicotine in maternal and children's' hair with children's neurodevelopment. After adjustment for confounders, prenatal nicotine concentration levels were negatively associated with communication (β=-2.059; p=0.015) and fine motor skills (β=-2.120; p=0.002) while postnatal nicotine concentration levels were inversely associated with fine motors (β=-0.124; p=0.004) and problem solving skills (β=-0.117; p=0.013). In conclusion, this study suggests that early life exposure to SHS may affect children's neurodevelopment.
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Affiliation(s)
- Nur Nadia Mohamed
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - See Ling Loy
- Department of Reproductive Medicine, KK Research Centre, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899 Singapore, Singapore
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Abdullah Al Mamun
- Institute for Social Science Research, The University of Queensland, Long Pocket Precinct, 80 Meiers Rd, Indooroopilly, QLD 4068, Australia
| | - Hamid Jan Jan Mohamed
- Nutrition and Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
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Higher hair nicotine level in children compared to mother living with smoking father in Malaysia. Environ Health Prev Med 2016; 21:572-578. [PMID: 27770244 DOI: 10.1007/s12199-016-0584-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 10/13/2016] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The objectives of this study are to determine parental and children's hair nicotine levels, their relationships as well as to investigate the association of smoking status of the fathers with mothers' and children's hair nicotine. METHODS A cross-sectional study design was conducted among 124 families who were participants of the Universiti Sains Malaysia Pregnancy Cohort Study. Both parents with their 2 years old children joined this study. A total of 92 hair samples of fathers, 124 hair samples of mothers and 111 hair samples of children were collected and analyzed by gas chromatography-mass spectrometry. RESULTS Of total, 52.4 % of the fathers reported smoking. None of the mothers were smokers. Hair nicotine levels of fathers were found to be significantly correlated with mothers (r = 0.233, p = 0.026) and children (r = 0.508, p < 0.001). Children living with smoking fathers had significantly higher median hair nicotine level compared to the children of non-smoking fathers (6.08 vs 0.22 ng/mg, p = 0.046). However, this association was not seen in the mothers. Quantile regression showed significant association between fathers' and children's hair nicotine. CONCLUSION There is a positive relationship between fathers' hair nicotine with mother's and children's hair nicotine. Living with smoking fathers can contribute to higher hair nicotine levels in children but not in mothers.
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Al-Zalabani AH, Amer SM, Kasim KA, Alqabshawi RI, Abdallah AR. Second-Hand Smoking among Intermediate and Secondary School Students in Madinah, Saudi Arabia. BIOMED RESEARCH INTERNATIONAL 2015; 2015:672393. [PMID: 26273638 PMCID: PMC4529938 DOI: 10.1155/2015/672393] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 04/17/2015] [Accepted: 04/24/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Second-hand smoke (SHS) is an important public health problem worldwide. The study aimed to estimate the prevalence of SHS exposure and its associated risk factors among intermediate and secondary school students. METHODS A cross-sectional study was conducted in 2013 among 3400 students from 34 intermediate and secondary schools in Madinah City, Saudi Arabia. Data about sociodemographic and smoking-related factors and SHS exposure were collected using a self-administered questionnaire. RESULTS Of the 3210 students analyzed, the prevalence of SHS exposure was 32.7% 49.3%, and 25% inside, outside, and both inside and outside the home, respectively. The highest risk of SHS exposure was associated with the adolescent's smoking status, parental smoking, close friends smoking, and family structure. The risk was markedly increased in association with parental smoking for exposure inside the home (OR = 6.49; 95% CI = 5.44-7.73) and with close friends smoking for exposure outside the home (OR = 4.16; 95% CI = 3.54-4.77). The risk of SHS, however, was lower among adolescents having knowledge about smoking and highly educated parents. CONCLUSION The study revealed a considerably high prevalence of SHS both inside and outside the home among adolescents. Knowledge and beliefs about SHS exposure are the main preventable approach.
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Affiliation(s)
- Abdulmohsen H. Al-Zalabani
- Family and Community Medicine Department, College of Medicine, Taibah University, Madinah 41541, Saudi Arabia
| | - Soliman M. Amer
- Family and Community Medicine Department, College of Medicine, Taibah University, Madinah 41541, Saudi Arabia
- Department of Public Health and Community Medicine, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Khaled A. Kasim
- Family and Community Medicine Department, College of Medicine, Taibah University, Madinah 41541, Saudi Arabia
- Public Health and Community Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Reem I. Alqabshawi
- Family and Community Medicine Department, College of Medicine, Taibah University, Madinah 41541, Saudi Arabia
| | - Ayat R. Abdallah
- Environmental Health of the Liver Department, National Liver Institute, Menoufia University, Shibin Al Kawm, Egypt
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Huque R, Dogar O, Cameron I, Thomson H, Amos A, Siddiqi K. Children Learning About Second-Hand Smoking: A Feasibility Cluster Randomized Controlled Trial. Nicotine Tob Res 2015; 17:1465-72. [PMID: 25634936 DOI: 10.1093/ntr/ntv015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 01/13/2015] [Indexed: 11/13/2022]
Abstract
BACKGROUND Exposure to second-hand smoke is a threat to children's health. We developed a school-based smoke-free intervention (SFI) to support families in implementing smoke-free homes in Bangladesh, and gathered preliminary evidence of its effectiveness. METHODS A feasibility cluster randomized controlled trial of SFI was conducted in 24 schools in Mirpur, an urban area within Dhaka. Using simple stratified randomization, schools were allocated to: Arm A (SFI only), Arm B (SFI plus reminders), and Arm C (the control group). A total of 781 year-5 children (10-12 years old) in the consenting schools, participated in the study. Outcomes including "smoke-free homes" and "social visibility" that is, not smoking in front of children at home were assessed through questionnaire-based children's surveys, administered by researchers, at baseline and at weeks 1, 12, 27, and 52 in all arms. RESULTS "Smoke-free homes" were significantly higher in Arm A (odds ratio [OR] = 4.8; 95% CI = 2.6-9.0) and in Arm B (OR = 3.9; 95% CI = 2.0-7.5) than in Arm C, when controlled for the baseline levels, at year 1. Similarly, "social visibility" was significantly reduced in Arm A (OR = 5.8; 95% CI = 2.8-11.7) and in Arm B (OR = 7.2; 95% CI = 3.3-15.9) than Arm C, when controlled for the baseline levels, at year 1. We observed an increasing trend (Cochrane Armitage test statistic [Z] = 3.8; p < .0001) in homes becoming smoke-free with increasing intensity of the intervention (control < Arm A < Arm B), and a decreasing trend (Z = -5.13; p < .0001) in social visibility at homes. CONCLUSION SFI has the potential to encourage children to negotiate a smoke-free environment in their homes.
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Affiliation(s)
- Rumana Huque
- Department of Economics, University of Dhaka, Dhaka, Bangladesh;
| | - Omara Dogar
- Department of Health Sciences, University of York, York, UK
| | | | - Heather Thomson
- Office of the Director of Public Health, Leeds City Council, Leeds, UK
| | - Amanda Amos
- Centre for Population Health Sciences Medical School, University of Edinburgh, Edinburgh, UK
| | - Kamran Siddiqi
- Department of Health Sciences/Hull York Medical School, University of York, York, UK
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Relationship between caregivers' smoking at home and urinary levels of cotinine in children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:12499-513. [PMID: 25469922 PMCID: PMC4276627 DOI: 10.3390/ijerph111212499] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 11/24/2014] [Accepted: 11/25/2014] [Indexed: 11/17/2022]
Abstract
Objective: To assess the impact of different smoking behaviors of caregivers on environmental tobacco smoke (ETS) exposure in children aged 5–6 years in Changsha, China. Methods: We conducted a cross-sectional, random digit-dial telephone survey of caregivers (n = 543) between August and October 2013. Caregivers’ smoking behaviors were collected by a questionnaire. Exposure assessment was based upon determination of urinary cotinine levels in children employing gas chromatography–triple quadrupole mass spectrometry (GC-MS/MS). Results: In children not living with a smoker, children living with one smoker, and children living with more than one smoker at home, median urinary cotinine concentrations (ng/mL) were 0.72, 2.97, and 4.46, respectively. For children living with one smoker, median urinary cotinine levels of children exposed to ETS were associated with caregiver smoking behaviors, i.e., if a caregiver consumed more cigarettes (>20 compared with ≤10; 7.73 versus 2.29 ng/mL, respectively). Conclusions: The magnitude of ETS exposure in children is correlated with the smoking behaviors of the caregiver. Counseling for smoking cessation and educational interventions are needed urgently for smoking caregivers to increase their awareness about ETS exposure and to encourage smoking cessation at home or to take precautions to protect children’s health.
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Predictors of children's secondhand smoke exposure at home: a systematic review and narrative synthesis of the evidence. PLoS One 2014; 9:e112690. [PMID: 25397875 PMCID: PMC4232519 DOI: 10.1371/journal.pone.0112690] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/10/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Children's exposure to secondhand smoke (SHS) has been causally linked to a number of childhood morbidities and mortalities. Over 50% of UK children whose parents are smokers are regularly exposed to SHS at home. No previous review has identified the factors associated with children's SHS exposure in the home. AIM To identify by systematic review, the factors which are associated with children's SHS exposure in the home, determined by parent or child reports and/or biochemically validated measures including cotinine, carbon monoxide or home air particulate matter. METHODS Electronic searches of MEDLINE, EMBASE, PsychINFO, CINAHL and Web of Knowledge to July 2014, and hand searches of reference lists from publications included in the review were conducted. FINDINGS Forty one studies were included in the review. Parental smoking, low socioeconomic status and being less educated were all frequently and consistently found to be independently associated with children's SHS exposure in the home. Children whose parents held more negative attitudes towards SHS were less likely to be exposed. Associations were strongest for parental cigarette smoking status; compared to children of non-smokers, those whose mothers or both parents smoked were between two and 13 times more likely to be exposed to SHS. CONCLUSION Multiple factors are associated with child SHS exposure in the home; the best way to reduce child SHS exposure in the home is for smoking parents to quit. If parents are unable or unwilling to stop smoking, they should instigate smoke-free homes. Interventions targeted towards the socially disadvantaged parents aiming to change attitudes to smoking in the presence of children and providing practical support to help parents smoke outside the home may be beneficial.
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Loy SL, Jan Mohamed HJ. Associations Between Prenatal Nicotine Exposure, Oxidative Stress, and Postpartum Visceral Fat. Women Health 2014; 54:145-60. [DOI: 10.1080/03630242.2013.870632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Semple S, Apsley A, MacCalman L. An inexpensive particle monitor for smoker behaviour modification in homes. Tob Control 2012; 22:295-8. [DOI: 10.1136/tobaccocontrol-2011-050401] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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