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Kim S, Oh J, Yun B, Cho A, Sim J, Yoon JH. Secondhand Smoke in the Workplace Is Associated With Depression in Korean Workers. Front Public Health 2022; 10:802083. [PMID: 35558545 PMCID: PMC9087188 DOI: 10.3389/fpubh.2022.802083] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Smoking negatively affects health, and previous studies argue that secondhand smoke (SHS) has a significantly negative health effect. We investigated whether SHS in the workplace influences workers' depression. Methods Three years of data (2014, 2016, and 2018) from the Korean National Health and Nutrition Examination Survey were analyzed. Participants who were not current smokers were classified into the occupational SHS exposed and non-exposed groups. Multivariate logistic regression was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) by adjusting various covariates. Stratified analysis with variables, such as year, sex, occupational classification, average working hours, was additionally performed. Results The crude ORs of depression was 1.51 (95% CI: 1.27–1.80), and the fully adjusted OR with all the covariates was 1.57 (95% CI: 1.30–1.88). This indicated a significant relationship between occupational SHS and depression. The ORs increased every 2 years: 1.07 (95% CI: 0.79–1.44) in 2014, 1.88 (95% CI: 1.34–2.64) in 2016, and 2.07 (95% CI: 1.43–2.99) in year 2018. Stratification analysis also showed a significant association between SHS and depression among those in the prolonged work hours group and male employees, as well as blue- and white-collar workers. Conclusion SHS in the workplace was significantly associated with workers' depression. Our study provides insights into the impact of exposure to SHS for workers and provides a basis for further research and policy-making in this field.
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Affiliation(s)
- Seunghan Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Juyeon Oh
- Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea
| | - Byungyoon Yun
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Ara Cho
- Department of Occupational Health, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Juho Sim
- Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
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Alkan Ö, Ünver Ş. Secondhand smoke exposure for different education levels: findings from a large, nationally representative survey in Turkey. BMJ Open 2022; 12:e057360. [PMID: 35177464 PMCID: PMC8860053 DOI: 10.1136/bmjopen-2021-057360] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/28/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The aim of this study is to determine the factors that influence individuals' exposure to tobacco smoke in Turkey according to their education level. DESIGN Secondary data analysis. PARTICIPANTS Altogether, 17 084 individuals aged 15 and over were included in this study. SETTINGS Data set of the Turkey Health Survey in 2019. METHODS Binary logistic regression analysis was used to determine the factors associated with individuals' exposure to tobacco smoke. PRIMARY AND SECONDARY OUTCOME MEASURES The variables age, gender, marital status, general health status, employment status, receipt of psychosocial support and tobacco use were found to be correlated with exposure to tobacco smoke. RESULTS The study determined that individuals who are illiterate/unschooled were exposed to tobacco smoke at a rate of 32.61%, primary school graduates at a rate of 34.32%, primary education graduates at a rate of 41.75%, high school graduates at a rate of 41.04% and university graduates at a rate of 40.34%. CONCLUSION As a result of the study, it is emphasised that men, young individuals, individuals with moderate and very good general health status, those who use tobacco, those who are unemployed and those who receive psychosocial support should be targeted. In addition, appropriate strategies for reducing secondhand smoke (SHS) exposure should be developed, taking into account public health strategies for increasing awareness of the adverse health effects of SHS exposure and the determinants of tobacco exposure according to the study.
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Affiliation(s)
- Ömer Alkan
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Turkey
| | - Şeyda Ünver
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Turkey
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3
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Okekunle AP, Asowata JO, Adedokun B, Akpa OM. Secondhand smoke exposure and dyslipidemia among non-smoking adults in the United States. INDOOR AIR 2022; 32:e12914. [PMID: 34331323 DOI: 10.1111/ina.12914] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/11/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
Dyslipidemia is a major public health challenge worldwide and whether secondhand smoke exposure (SHSE) is associated with dyslipidemia is yet to be understood. This study evaluated the relationship between SHSE and odds of dyslipidemia among adults in the United States. We identified 3064 adults who had never smoked in the 2015-2016 National Health and Nutrition Examination Survey and estimated the odds ratio and 95% confidence interval for the relationship between SHSE and odds of dyslipidemia using a multivariable adjusted-logistic regression at a two-sided p < 0.05. Overall, the mean age of respondents was 46.4 ± 18.0 years, 59.6% had dyslipidemia and 36.2% had SHSE. The odds of dyslipidemia among individuals with SHSE were 1.148 (1.147, 1.149) in the overall sample, 1.214 (1.214, 1.215) among women and 1.165 (1.163, 1.167) among men. The odds trended similarly independent of age groups: 1.130 (1.129, 1.131) for young adults (<60 years) and 1.304 (1.300, 1.308) for old adults (≥60 years). SHSE was associated with higher odds of dyslipidemia with higher odds among women and old adults. Primary intervention(s) targeted at reducing SHSE may show benefits in reducing the odds of dyslipidemia, and longitudinal studies would be necessary to clarify the association between SHSE and dyslipidemia.
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Affiliation(s)
- Akinkunmi Paul Okekunle
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- The Postgraduate College, University of Ibadan, Ibadan, Nigeria
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
- Research Institute of Human Ecology, Seoul National University, Seoul, Korea
| | - Jeffery Osahon Asowata
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Babatunde Adedokun
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, University of Chicago, Chicago, IL, US
| | - Onoja Matthew Akpa
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, Nigeria
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4
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Abbasi-Kangevari M, Masinaei M, Fattahi N, Rahimi Y, Rezaei N, Azadnajafabad S, Ghanbari A, Fakhimi R, Jourahmad Z, Ghamari SH, Malekpour MR, Ahmadi N, Hajebi A, Jafar-pour H, Farzadfar F. Current Inequities in Smoking Prevalence on District Level in Iran: A Systematic Analysis on the STEPS Survey. J Res Health Sci 2021; 22:e00540. [PMID: 36511256 PMCID: PMC9315459 DOI: 10.34172/jrhs.2022.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/28/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The prevalence of tobacco smoking and its burden on societies is not homogenous at the national and district levels. This nationwide study aimed to investigate current inequalities in the prevalence of smoking at the district level and the association of smoking behaviors with gender, wealth, education, and urbanization in Iran. STUDY DESIGN A cross-sectional study. METHODS This study was conducted by analyzing the data of the STEPS survey 2016 with 30 541 participants. The small-area estimation method using the Bayesian spatial hierarchical multilevel regression model was employed to generate district-level prevalence of all types of smoking by gender. The inequalities between the groups by wealth, education, and urbanization were investigated via concentration index. RESULTS The prevalence rates of current daily cigarette smoking were found to be at the range of 4.6-40.9 and 0-4.5 among men and women, respectively. Current daily cigarette smoking was higher in men than in women: 19.0 (95% CI: 9.5-28.7) vs 0.7 (95% CI: 0-6.9). Women with lower wealth, education, or urbanization were more likely to smoke tobacco or be exposed to secondhand smoking. On the other hand, men with higher wealth or education indices were more likely to smoke tobacco. Men with lower wealth, education, or urbanization were more likely to be exposed to secondhand smoking. CONCLUSION The smoking behavior varied significantly at the district level in Iran. Gender, wealth, education, and urbanization were determinants of smoking prevalence.
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Affiliation(s)
- Mohsen Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Mohsen Abbasi-Kangevari and Masoud Masinaei are co-first authors
| | - Masoud Masinaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Mohsen Abbasi-Kangevari and Masoud Masinaei are co-first authors
| | - Nima Fattahi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yekta Rahimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghanbari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roozbe Fakhimi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Zahra Jourahmad
- Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - AmirAli Hajebi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Jafar-pour
- Medical Student, Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: Farshad Farzadfar (MD, MPH, MHS, DSc), Tel/Fax: +98 21 88631293, E-mail:
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5
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Okekunle AP, Asowata JO, Lee JE, Akpa OM. Association of Environmental tobacco smoke exposure with depression among non-smoking adults. BMC Public Health 2021; 21:1755. [PMID: 34565350 PMCID: PMC8474776 DOI: 10.1186/s12889-021-11780-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 09/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background Depression is a psychological dysfunction that impairs health and quality of life. However, whether environmental tobacco smoke exposure (ETSE) is associated with depression is poorly understood. This study was designed to evaluate the association of ETSE with depression among non-smoking adults in the United States. Method Using the 2015–2016 United States National Health and Nutrition Examination Survey (NHANES), we identified 2623 adults (females – 64.2%, males – 35.8%) who had never smoked and applied multivariable adjusted-logistic regression to determine the adjusted odds ratio (aOR) and 95% confidence interval (CI) at P < 0.05 for the association of ETSE with depression adjusting for relevant confounders. Results Mean age of respondents was 46.5 ± 17.9 years, 23.5% reported ETSE, and 4.7% reported depression. Also, aORs for the association of ETSE with depression were 1.992 (1.987, 1.997) among females and 0.674 (0.670, 0.677) among males. When we examined the association by age groups, the aORs were 1.792 (1.787, 1.796) among young adults (< 60 years) and 1.146 (1.140, 1.152) among older adults (≥60 years). Conclusions We found that ETSE was associated with higher odds of depression among females but not among males.
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Affiliation(s)
- Akinkunmi Paul Okekunle
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Post Office200284 PMB, Ibadan, UI, 900001, Nigeria. .,The Postgraduate College, University of Ibadan, Ibadan, 200284, Nigeria. .,Department of Food and Nutrition, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, IL, 08826, South Korea. .,Research Institute of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, IL, 08826, South Korea.
| | - Jeffery Osahon Asowata
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Post Office200284 PMB, Ibadan, UI, 900001, Nigeria
| | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, IL, 08826, South Korea.,Research Institute of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, IL, 08826, South Korea
| | - Onoja Matthew Akpa
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Post Office200284 PMB, Ibadan, UI, 900001, Nigeria. .,Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, 200284, Nigeria. .,Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, 200284, Nigeria.
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6
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Dadipoor S, Nejatizade AA, Farshidi H, Gharibzade A, Aghamolaei T, Ghanbarnejad A. Determinants of environmental tobacco smoke at work and at home: analysis of baseline data from the Kong Cohort Study, Southern Iran. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1967480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sakineh Dadipoor
- Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Abdul Azim Nejatizade
- Department of Medical Genetics, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hossein Farshidi
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Abdullah Gharibzade
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Amin Ghanbarnejad
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Sharma D, Panigrahi A. Second-hand smoke exposure and its determinants among nonsmoking adolescents residing in slum areas of Bhubaneswar, India. Indian J Cancer 2021; 58:402-408. [PMID: 33402582 DOI: 10.4103/ijc.ijc_265_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Second-hand exposure (SHS) is a significant public health problem and accounts for over 600,000 deaths among non smokers worldwide every year. The study aimed to estimate the prevalence and determinants of SHS exposure among nonsmoking adolescents residing in slum areas of Bhubaneswar, India. Methods Multistage cluster random sampling was used to select 259 nonsmoking adolescents from eleven slum areas. We used descriptive statistics to determine the prevalence of SHS exposure and inferential statistics using multivariable logistic regression model to identify factors associated with SHS exposure. Results Of the 259 adolescent participants, 67 (25.9%) were exposed to SHS inside home and 97 (37.5%) were exposed outside home. About 47.5% adolescents were exposed to anti-smoking media messages and 22.8% were unaware of the harmful effects of exposure to SHS. SHS exposure inside home was associated with smokeless tobacco use (adjusted odds ratio [aOR]: 10.64; 95% confidence interval (CI): 2.57-43.48), illiteracy of father (aOR: 5.40; 95% CI: 1.51-19.32), non-exposure to antismoking media messages (aOR: 3.53; 95% CI: 1.06-11.72), and absence of knowledge regarding harmful effects of SHS (aOR: 3.72; 95% CI: 1.15-12.05). Also, variables like male gender (aOR: 10.31; 95% CI: 4.50-23.81), smokeless tobacco use (aOR: 2.43; 95% CI: 1.05-5.65), illiteracy of father (aOR: 4.58; 95% CI: 1.23-17.14), and non-exposure to antismoking media messages (aOR: 4.04; 95% CI: 1.49-10.89) had increased SHS exposure outside home. Conclusion The findings underscore the urgent need to implement comprehensive smoke-free policies to reduce SHS exposure among slum adolescents.
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Affiliation(s)
- Dheeraj Sharma
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology University, Bhubaneswar, Odisha, India
| | - Ansuman Panigrahi
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology University, Bhubaneswar, Odisha, India
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Akpa OM, Okekunle AP, Asowata JO, Adedokun B. Passive smoking exposure and the risk of hypertension among non-smoking adults: the 2015-2016 NHANES data. Clin Hypertens 2021; 27:1. [PMID: 33384019 PMCID: PMC7775627 DOI: 10.1186/s40885-020-00159-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/03/2020] [Indexed: 01/14/2023] Open
Abstract
Background Hypertension is a major public health problem and a prominent risk factor for cardiovascular diseases. However, whether passive smoking exposure (PSE) is associated with the risk of hypertension is scarcely understood. This study assessed the association between PSE and the risk of hypertension among adults (≥18 years) in the United States of America. Methods Three thousand and sixty-seven adults were identified from the 2015–2016 National Health and Nutrition Examination Survey and the association between PSE and hypertension (adjusting for relevant confounders) was examined using multivariable adjusted-logistic regression analysis at P < 0.05. Results Mean age of respondents was 46.5 ± 17.9 years. Overall, 23.7% of respondents reported PSE and 32.6% were hypertensives (of which only 14.3% were aware of their hypertensive state) Also, adjusted odds of hypertension for participants with PSE was 1.038 (1.037, 1.040), P < 0.0001, in the overall population. Also, PSE aggravated odds of hypertension among young adults – < 60 years (aOR: 1.095, 95CI%: 1.094 to 1.097), P < 0.0001, and old adults – ≥60 years (aOR: 1.110, 95% CI: 1.108 to 1.113), P < 0.0001. Similarly, PSE was associated with increased odds of hypertension among women (aOR: 1.240, 95% CI: 1.238 to 1.242), P < 0.0001 but not among men (aOR: 0.755, 95% CI: 0.754 to 0.757), P < 0.0001. Conclusions PSE was independently associated with the risk of hypertension particularly among women, young and old adults. A multi-ethnic longitudinal cohort may help ascertain causality and provide more evidence for appropriate interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s40885-020-00159-7.
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Affiliation(s)
- Onoja Matthew Akpa
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, PMB 900001 UI Post Office, Ibadan, 200284, Nigeria. .,Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, 200284, Nigeria. .,Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, 200284, Nigeria.
| | - Akinkunmi Paul Okekunle
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, PMB 900001 UI Post Office, Ibadan, 200284, Nigeria. .,The Postgraduate College, University of Ibadan, PMB 900001, Ibadan, Nigeria. .,Nutritional Epidemiology Lab, Department of Food and Nutrition, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, IL, 08826, Korea. .,Research Institute of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, IL, 08826, Korea.
| | - Jeffery Osahon Asowata
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, PMB 900001 UI Post Office, Ibadan, 200284, Nigeria
| | - Babatunde Adedokun
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, University of Chicago, Chicago, IL, 60637, USA
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9
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Kashani H, Nakhjirgan P, Hassanvand MS, Shamsipour M, Yunesian M, Farzadfar F, Naddafi K, Mesdaghinia A. Subnational exposure to secondhand smoke in Iran from 1990 to 2013: a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:2608-2625. [PMID: 33140301 DOI: 10.1007/s11356-020-11199-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
Every year, almost eight million people die from tobacco-related diseases, among which around 1.2 million die from secondhand smoke (SHS) exposure. Generally, it is estimated that SHS constituents generated in the interval between puffs are approximately 3 times more toxic than those produced at the moment of puffing. There is no risk-free level of SHS exposure, and even brief exposure can be harmful to health. The aim of this study was to assess SHS exposure and its trend in the different provinces of Iran from 1990 to 2013. To collect available data on SHS exposure, a systematic review was performed. We searched international and national databases using a combination of Medical Subject Headings (MeSH) and relevant text words in the titles, abstracts, and/or keywords. Also, the data in national surveys were gathered. The frequency of exposure in different provinces as well as age, sex, and rural/urban areas were extracted. Afterwards, modeling was done to estimate SHS exposure from the smoking data. According to our findings, SHS exposure was more prevalent among young people. Moreover, this exposure was greater in rural areas as compared to urban areas. A national study on 13-15-year-old individuals showed the highest exposure occurred outdoors. In addition, a declining trend was observed on SHS exposure over time. It seems that attention to the importance of SHS exposure in researches in Iran dates back to 2001, and gradually, especially in recent years, further studies have been conducted on SHS exposure.
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Affiliation(s)
- Homa Kashani
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, No. 1547, North Kargar Ave, Tehran, 1417993359, Iran.
| | - Pegah Nakhjirgan
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, No. 1547, North Kargar Ave, Tehran, 1417993359, Iran
| | - Masud Yunesian
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, No. 1547, North Kargar Ave, Tehran, 1417993359, Iran
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology & Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Mesdaghinia
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Water Quality Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
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10
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Tripathy JP. Secondhand smoke exposure at home and public places among smokers and non-smokers in India: findings from the Global Adult Tobacco Survey 2016-17. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:6033-6041. [PMID: 31865581 DOI: 10.1007/s11356-019-07341-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 12/09/2019] [Indexed: 06/10/2023]
Abstract
Secondhand smoke (SHS) accounts for 0.9 million deaths and 24 million disability adjusted life years (DALYs) annually. Nearly 30% of adults in India are exposed to SHS in India. To reduce SHS exposure, India enacted a smoke-free law in 2003 under which smoking in public places is banned. However, the compliance to this law has been variable in several assessments in the country. A better understanding of the nature and extent of SHS exposure can help inform better implementation of national smoke-free policies. The Global Adult Tobacco Survey (GATS) India 2016-17 collects information on the self-reported prevalence of SHS exposure in homes, workplaces, government buildings, restaurants, public transportation and health care facilities among adults (> 15 years of age).The present study utilized the GATS India 2016-17 dataset to provide estimates of SHS exposure among adults in India in homes, workplace and other public places, across gender and age groups and among the overall population and non-smokers. Weighted analysis was carried out. In the overall population, exposure to SHS in the home was 29.2%, more among young females. In workplaces, exposure to SHS was 29.2% overall, significantly higher among males (32.5%) compared to females (17.8%). In public buildings such as health care facilities and government offices, SHS exposure was less with 15.6% and 21.2% respectively. SHS exposure was high in restaurants with 39.3% overall, significantly higher among males (43.2%) compared to females (22.2%). Similar results were also seen among non-smokers. A large proportion of adults in India, both smokers and non-smokers are exposed to SHS in their homes, workplaces and other public places, especially restaurants, workplaces and public transportation. Females are more exposed to SHS at home, whereas males are more exposed in public places including workplaces. High SHS exposure among youths is also a concern. Stricter enforcement of legislation is required to ensure 100% smoke-free homes, public places and workplaces and reduce SHS exposure.
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Affiliation(s)
- Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India.
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11
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The exposure level of environmental harmful substances related to the secondhand smoke in Korean non-smoker adults: data from the second Korean National Environmental Health Survey (KoNEHS 2012-2014): a cross-sectional study. Ann Occup Environ Med 2019; 31:e30. [PMID: 31737285 PMCID: PMC6850792 DOI: 10.35371/aoem.2019.31.e30] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 09/23/2019] [Indexed: 11/20/2022] Open
Abstract
Background We aimed to find the exposure level of environmental harmful substances related to the secondhand smoke (SHS) using a nationally representative data of the general population in Korea. Methods Total 3,533 people were included in this study. We compared the proportion exceeding 95 percentile of the concentrations of harmful substances by sex according to SHS exposure. 16 kinds of substances related to tobacco smoke were analyzed including heavy metals, polycyclic aromatic hydrocarbons, volatile organic compounds, and environmental phenol. For 16 kinds of substances, the odds ratios (ORs) for exceeding 95 percentile of each harmful substance were calculated by multiple logistic regression according to SHS exposure. Age, education level, marital status, body mass index, drinking, and exercise were adjusted as covariates. Cotinine level was additionally adjusted to increase reliability of our results. Results SHS was associated with high exposure of mercury, methylhippuric acid, fluorene, and cotinine. In women, SHS was associated with mercury, methylhippuric acid, fluorene, and cotinine, while in men, it was associated with cotinine. After adjusting covariates, ORs of blood mercury, methylhippuric acid and hydroxyfluorene in the exposed gruop were greater than that in the non-exposed group. Especially in female, methylhippuric acid and hydroxyfluorene showed consistent result. Conclusions Our finding demonstrates that SHS is related to several harmful substances. Therefore, to reduce the health effects of SHS, it is necessary to educate and publicize the risk of SHS. Future studies are necessary to more accurately analyze factors such as exposure frequency, time, and pathway of SHS.
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12
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Lee Y, Lee KS. Factors Related to Smoking Status Among Young Adults: An Analysis of Younger and Older Young Adults in Korea. J Prev Med Public Health 2019; 52:92-100. [PMID: 30971075 PMCID: PMC6459759 DOI: 10.3961/jpmph.18.201] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 01/14/2019] [Indexed: 01/20/2023] Open
Abstract
Objectives Young adulthood represents a critical developmental period during which the use of tobacco may begin or cease. Furthermore, differences in smoking behaviors between younger (aged 18-24 years) and older (aged 25-34 years) young adults may exist. This study aimed to characterize patterns related to current smoking in younger and older young adults. Methods This study used data acquired from the Sixth Korea National Health and Nutrition Examination Survey conducted from 2013 to 2014. A total of 2069 subjects were categorized as younger (712 subjects) and older (1357 subjects) young adults. The chi-square test was used to assess the relationships between smoking status and socio-demographic, health-related, and smoking-related factors. Multivariable logistic regression models were constructed to assess the factors affecting current smoking in these age groups. Results The current smoking prevalence was 18.3% among the younger young adults and 26.0% among the older young adults. Sex, education level, occupation, perceived health status, alcohol consumption, and electronic cigarette use were related to current smoking in both age groups. Secondhand smoke exposure at home and stress levels showed significant relationships with smoking in younger and older young adults, respectively. Conclusions Strong correlations were found between the observed variables and smoking behaviors among young adults. Determining the factors affecting smoking and designing interventions based on these factors are essential for smoking cessation in young adults.
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Affiliation(s)
- Yeji Lee
- Graduate School of Public Health, The Catholic University of Korea, Seoul, Korea
| | - Kang-Sook Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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13
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Female non-smokers' environmental tobacco smoking exposure by public transportation mode. Ann Occup Environ Med 2018; 30:24. [PMID: 29713477 PMCID: PMC5907694 DOI: 10.1186/s40557-018-0239-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/12/2018] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to analyze environmental tobacco smoking exposure in female nonsmokers by public transportation mode using representative data of Koreans. Methods Data from the Second Korean National Environmental Health Survey (2012–2014) were analyzed. Urine cotinine was analyzed by public transport behavior, secondhand smoke exposure, socioeconomic factors, and health-related factors. Participants were 1322 adult females; those with the top 75% urine cotinine concentrations were assigned to the high exposure group. A logistic regression analysis was performed considering appropriate weights and stratification according to the sample design of the Second Korean National Environmental Health Survey. Results The geometric mean of urine cotinine concentrations differed according to public transportation modes: subway (1.66 μg/g creatinine) bus (1.77 μg/g creatinine), and taxi (1.94 μg/g creatinine). The odds ratio [OR] was calculated for the high exposure group. The OR of the taxi (2.39; 95% confidence interval, 1.00–5.69) was statistically significantly higher than the subway value (reference), and marginally significant after adjusted with life style, sociodemographic factors and involuntary smoking frequency (2.42, 95% confidence interval, 0.97–6.04). Conclusions The odds ratio of passengers who mainly used taxis was marginally significantly higher than those of passengers who used subways and buses after adjusted with life style and sociodemographic factors. Implementation of supplementary measures and further studies on exposure to environmental tobacco smoking in taxis are warranted.
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14
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Sun LY, Park JH. Second-hand smoke prevalence in 252 regions of South Korea in three exposure locations. Jpn J Nurs Sci 2018; 15:210-217. [PMID: 29314668 DOI: 10.1111/jjns.12196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 07/08/2017] [Accepted: 08/10/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE The association between regional contextual factors and second-hand smoke (SHS) prevalence is important, but is unclear. This study investigated the changes of SHS prevalence from 2011 to 2013 and explored the correlations of SHS prevalence and regional contextual factors by exposure location. METHODS The data were obtained from the 2011 and 2013 Korean Community Health Survey and the Development of Health Indicators for Community Health Ranking report. A t-test was used to examine and compare the SHS prevalence in 2011 and 2013 by exposure location (home, workplace, and public places). A correlation analysis and linear regression were used to investigate the impacts of the regional variables on SHS prevalence by location. RESULTS The prevalence of SHS in all three locations had a decreased trend overall, but remained high in public locales. There were clear differences in the prevalence of SHS and its change by region between 2011 and 2013. The SHS prevalence in the workplace and public places had increased in the high social and economic characteristic regions, compared to the other regions in 2 years. The SHS had an increased trend in regions featuring a high level of socioeconomic development. It was observed that regional factors affecting SHS prevalence differed in the three locations. CONCLUSION The differences and changes of regional SHS prevalence by location were influenced by specific social contextual factors of the particular region. Local government initiatives regarding special SHS protective measures or tailored regulations, according to specific regional status and location, are recommended, with attention to high socioeconomic regions in particular.
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Affiliation(s)
- Li-Yuan Sun
- Health Science Center School of Nursing, Shenzhen University, Shenzhen, China
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, South Korea
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15
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Nguyen M, Nishi N, Kadota A, Okuda N, Arima H, Fujiyoshi A, Nakano Y, Ohkubo T, Ueshima H, Okayama A, Miura K. Passive Smoking at Home by Socioeconomic Factors in a Japanese Population: NIPPON DATA2010. J Epidemiol 2018; 28 Suppl 3:S40-S45. [PMID: 29503385 PMCID: PMC5825692 DOI: 10.2188/jea.je20170243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 10/02/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Long-term passive exposure to cigarette smoke has been reported to affect the health of non-smokers. This study aims to investigate the relationships among socioeconomic factors and passive smoking at home in the non-current smokers of a representative sample from a general Japanese population. METHODS Data are from NIPPON DATA2010. Among 2,891 participants, 2,288 non-current smokers (1,763 never smokers and 525 past smokers) were analyzed in the present study. Cross-sectional analyses were performed on the relationships among socioeconomic factors and passive smoking at home (several times a week or more) in men and women separately. Socioeconomic factors were employment, length of education, marital status, and equivalent household expenditure. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a multivariable logistic regression model. RESULTS The multivariable-adjusted model showed that employed women had a higher risk of passive smoking than unemployed women (OR 1.44; 95% CI, 1.06-1.96). Women with 9 years or less of education had a higher risk of passive smoking at home than women with 13 years and more of education (OR 2.37; 95% CI, 1.49-3.78). Single women had a lower risk of passive smoking at home (OR 0.53; 95% CI, 0.37-0.77) than married women. No significant associations were observed in men. CONCLUSIONS An employed status, lower education, and being single were associated with passive smoking at home in the non-current smoking women of a representative Japanese population.
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Affiliation(s)
- Minh Nguyen
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Aya Kadota
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Yasutaka Nakano
- Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Hirotsugu Ueshima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan
- Department of Public Health, Shiga University of Medical Science, Shiga, Japan
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Reddy MM, Kanungo S, Kar SS. Correlates of secondhand smoke exposure among nonsmoking youth (15-24 years) in India: Secondary analysis from Global Adult Tobacco Survey, 2009-10. J Family Med Prim Care 2018; 7:111-117. [PMID: 29915743 PMCID: PMC5958551 DOI: 10.4103/jfmpc.jfmpc_409_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction: Nonsmoking youth form a high-risk group and are at increased risk of ill-effects caused due to secondhand smoke (SHS). The objective is to determine the prevalence and correlates of SHS exposure among the nonsmoking youth in India from global adult tobacco survey (GATS), 2009–10. Methods: Secondary data analysis of GATS, 2009–10 was done to find the correlates of SHS at three different settings – house, workplace - indoor, and public place. All the sociodemographic variables were tested for association with SHS exposure using multivariate analysis. Prevalence ratio with 95% confidence interval [CI] was used to report the risk. Results: The prevalence of SHS was 48.6% (95% CI: 47.7%–49.5%) at house, 25.5% (95% CI: 23.5%–27.6%) at workplace - indoors, and 42.7% (95% CI: 41.7%–43.7%) at public places. SHS exposure among females was found to be higher at house; youth living in rural area were found at increased risk to SHS at both household and public places; and inverse relationship was seen between SHS exposure and education level at both household and workplace - indoors. Overall, the study showed that smokeless tobacco users were at increased risk of SHS exposure at all the three settings. Conclusion: Being female, living in rural area, lower education status, lower socioeconomic status, and use of smokeless tobacco were found to be associated with SHS exposure among nonsmoking youth in India.
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Affiliation(s)
- Mahendra M Reddy
- Department of Community Medicine, Sri Devaraj Urs Medical College, Kolar, Karnataka, India
| | - Srikanta Kanungo
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Saw A, Tang H, Tsoh JY, Chen MS, Tong EK. Non-smoker assertive behaviour against smoke exposure: Chinese and Korean American non-smokers. Drug Alcohol Rev 2017; 36:779-787. [PMID: 28439993 PMCID: PMC5656557 DOI: 10.1111/dar.12557] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 03/03/2017] [Accepted: 03/16/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Non-smokers' assertive behaviour towards smokers by asking them not to smoke is important in promoting smoke-free environments. Korean and Chinese Americans come from countries where most women are non-smokers and assertive behaviour may not be prevalent but may increase after migration because of social-ecological factors. This study assessed the extent to which Korean and Chinese American non-smokers ask someone not to smoke and associated factors. DESIGN AND METHODS The 2003 California Chinese American and Korean American Tobacco Use Surveys were analysed. Multivariate logistic regression analyses examined factors related to non-smoker self-reports that they asked someone not to smoke within the past year. RESULTS About 40% reported past-year assertive behaviour against smoking, with higher rates among Koreans than Chinese (60.4% vs. 34.5%), those living with smokers (63.5%), ever exposed with a smoke-free home rule (62.3%), recently exposed at work without a smoke-free work policy (67.6%) and regularly exposed at other locations (52.3%). In combined multivariate analyses of both ethnic groups, assertive behaviour was associated with individual factors (single vs. married; tobacco exposure knowledge), family factors (living with smokers, exposed at home despite a smoke-free rule), community factors (exposed at work with no smoke-free policy, exposed at other locations) and cultural factors (Korean vs. Chinese ethnicity; lower acculturation). DISCUSSION AND CONCLUSIONS Chinese and Korean American non-smokers report assertive behaviour against smoking, which is associated with social-ecological factors. Results help identify target groups and strategies for future intervention, including the need to implement or enforce smoke-free environments and promote empowerment. [Saw A, Tang H, Tsoh JY, Chen MS Jr, Tong EK. Non-smoker assertive behaviour against smoke exposure: Chinese and Korean American non-smokers.
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Affiliation(s)
- Anne Saw
- Department of Psychology, DePaul University, Chicago, USA
| | - Hao Tang
- Genetic Disease Screening Program, California Department of Public Health, Richmond, USA
| | - Janice Y. Tsoh
- Department of Psychiatry, University of California, San Francisco, USA
| | - Moon S. Chen
- Department of Internal Medicine, University of California Davis, Sacramento, USA
| | - Elisa K. Tong
- Department of Internal Medicine, University of California Davis, Sacramento, USA
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Kwak J, Jeong H, Chun S, Bahk JH, Park M, Byun Y, Lee J, Yim HW. Effectiveness of government anti-smoking policy on non-smoking youth in Korea: a 4-year trend analysis of national survey data. BMJ Open 2017; 7:e013984. [PMID: 28706085 PMCID: PMC5577913 DOI: 10.1136/bmjopen-2016-013984] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Since the Health Promotion Act was introduced in Korea in 1995, anti-smoking policies and regulations have undergone numerous revisions, and non-smoking areas have gradually been expanded. The purpose of this study was to examine the impact of a partial legislative ban on adolescent exposure to secondhand smoke using objective urinary cotinine levels in a nationwide representative sample. METHODS Urine cotinine levels were measured in the Korea National Health and Nutrition Examination Survey from 2008 to 2011. This study was a trend analysis of 4 years of national survey data from 2197 Korean youth aged 10-18 years. Among non-smokers, the 75th percentile urinary cotinine level was estimated. We also considered the number of household smokers. RESULTS The 75th percentile urine cotinine level of non-smokers showed a significant decreasing trend from 2008 to 2011, from 15.47 to 5.37 ng/mL, respectively. Urine cotinine did not decline significantly in non-smokers living with smokers during the study period. The results did not show a statistically significant reduction in smoking rate in adolescents from 2008 to 2011, although there was a trend towards a decrease (p=0.081). CONCLUSIONS Based on urine cotinine levels, government-initiated anti-smoking policies have only been effective among highly exposed non-smoking adolescents during the study period. Further study needs to evaluate whether or not the legislative ban affects domestic smoking exposure.
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Affiliation(s)
- Jueun Kwak
- Catholic Medical Center, Seoul, Republic of Korea
| | - Hyunsuk Jeong
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sungha Chun
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji Hoon Bahk
- Catholic Medical Center, Seoul, Republic of Korea
| | - Misun Park
- Clinical Research Coordinating Center, Catholic Medical Center, Republic of Korea
| | | | - Jina Lee
- Catholic Medical Center, Seoul, Republic of Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Clinical Research Coordinating Center, Catholic Medical Center, Republic of Korea
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Zahra A, Cheong HK, Lee EW, Park JH. Burden of Disease Attributable to Secondhand Smoking in Korea. Asia Pac J Public Health 2016; 28:737-750. [DOI: 10.1177/1010539516667779] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to estimate the burden of disease (BOD) due to secondhand smoking (SHS) in Korea. SHS-related diseases were selected via systematic review. Population attributable fraction (PAF) was calculated by using standard formula. Disability adjusted life years (DALYs) were estimated using Statistical Office and Health Insurance data. SHS burden was calculated by multiplying nonsmoker’s BOD with the PAF of SHS. Total BOD due to SHS was 44 143 DALYs with 57% from males and 43% from females. The highest percentage of SHS burden was due to stroke. BOD was highest in the 50s age group in both genders. Years of life lost contributed major part of BOD due to all diseases. SHS burden in Korea in 2013 was the highest among the high-income Asia Pacific group countries. Effective intervention policies with more focus on vulnerable groups like adults in their 50s should be implemented to control SHS-related burden.
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Affiliation(s)
- Aqeela Zahra
- Sungkyunkwan University, Jangan-gu, Suwon, South Korea
| | | | - Eun-Whan Lee
- Gyeonggi Research Institute, Jangan-gu, Suwon, South Korea
| | - Jae-Hyun Park
- Sungkyunkwan University, Jangan-gu, Suwon, South Korea
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20
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Sun LY, Cheong HK, Lee EW, Kang KJ, Park JH. Affecting Factors of Secondhand Smoke Exposure in Korea: Focused on Different Exposure Locations. J Korean Med Sci 2016; 31:1362-72. [PMID: 27510378 PMCID: PMC4974176 DOI: 10.3346/jkms.2016.31.9.1362] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 06/03/2016] [Indexed: 11/24/2022] Open
Abstract
Exposure to secondhand smoke (SHS) not only can cause serious illness, but is also an economic and social burden. Contextual and individual factors of non-smoker exposure to SHS depend on location. However, studies focusing on this subject are lacking. In this study, we described and compared the factors related to SHS exposure according to location in Korea. Regarding individual factors related to SHS exposure, a common individual variable model and location-specific variable model was used to evaluate SHS exposure at home/work/public locations based on sex. In common individual variables, such as age, and smoking status showed different relationships with SHS exposure in different locations. Among home-related variables, housing type and family with a single father and unmarried children showed the strongest positive relationships with SHS exposure in both males and females. In the workplace, service and sales workers, blue-collar workers, and manual laborers showed the strongest positive association with SHS exposure in males and females. For multilevel analysis in public places, only SHS exposure in females was positively related with cancer screening rate. Exposure to SHS in public places showed a positive relationship with drinking rate and single-parent family in males and females. The problem of SHS embodies social policies and interactions between individuals and social contextual factors. Policy makers should consider the contextual factors of specific locations and regional and individual context, along with differences between males and females, to develop effective strategies for reducing SHS exposure.
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Affiliation(s)
- Li Yuan Sun
- Department of Nursing, School of Medicine, Shenzhen University, Shenzhen, Guangdong, China
| | - Hae Kwan Cheong
- Department of Social and Preventive Medicine, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Korea
| | | | - Kyeong Jin Kang
- Department of Social and Preventive Medicine, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Jae Hyun Park
- Department of Social and Preventive Medicine, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Korea.
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Lee E, Lee SH, Kwon JW, Kim Y, Cho HJ, Yang SI, Jung YH, Kim HY, Seo JH, Kim BJ, Kim HB, Lee SY, Kwon HJ, Hong SJ. A rhinitis phenotype associated with increased development of bronchial hyperresponsiveness and asthma in children. Ann Allergy Asthma Immunol 2016; 117:21-28.e1. [PMID: 27184199 DOI: 10.1016/j.anai.2016.04.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 04/13/2016] [Accepted: 04/18/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) has a wide range of clinical features and may be accompanied by comorbid allergic diseases. OBJECTIVE To identify rhinitis phenotypes in school aged children and to predict the prognosis for developing bronchial hyperresponsiveness (BHR) and asthma. METHODS This prospective follow-up study involved schoolchildren from the Children's Health and Environment Research cohort with current rhinitis, which was defined based on parental-reported, physician-diagnosed rhinitis and symptoms of rhinitis in the previous 12 months. All participants were followed up at 2 and 4 years later. Rhinitis clusters were identified by latent class analysis that used demographic, clinical, and environmental variables. RESULTS In 512 eligible children (age range, 6-8 years), 4 rhinitis phenotypes were identified: cluster 1 (25% of children) was associated with nonatopy and a low socioeconomic status; cluster 2 (36%) was associated with a high-atopic burden but normal lung function; cluster 3 (22%) was associated with a high-atopic burden and impaired lung function; and cluster 4 (17%) was associated with low atopy and a high socioeconomic status. Cluster 3 was associated with the highest total serum IgE levels and blood eosinophil percentages at enrollment and the highest incidence of new cases of BHR (P = .04) and asthma symptoms (P = .005) during follow-up. CONCLUSION The rhinitis cluster of schoolchildren with atopy and impaired lung function is associated with allergic march. This identification of distinct rhinitis phenotypes in affected children may help to prevent allergic march in children with rhinitis.
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Affiliation(s)
- Eun Lee
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Si Hyeon Lee
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yeongho Kim
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Hyun-Ju Cho
- Department of Pediatrics, Childhood Asthma and Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Song-I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Young-Ho Jung
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Dankook University College of Medicine, Seoul, Korea
| | - Byoung-Ju Kim
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Hyo Bin Kim
- Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - So Yeon Lee
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma and Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Li Z, Yao Y, Yu Y, Shi J, Liu Y, Tao Y, Kou C, Zhang H, Han W, Yin Y, Jiang L, Li B. Prevalence and Associated Factors of Passive Smoking among Women in Jilin Province, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:13970-80. [PMID: 26529002 PMCID: PMC4661627 DOI: 10.3390/ijerph121113970] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 10/27/2015] [Accepted: 10/28/2015] [Indexed: 11/17/2022]
Abstract
Background: The present study aimed to investigate the prevalence and associated socio-demographic factors of passive smoking among women in Jilin Province, China. Methods: A cross-sectional study was conducted in 2012, using a self-reported questionnaire interview. A representative sample of 9788 non-smoking women aged 18–79 years was collected in Jilin Province of China by a multistage stratified random cluster sampling design. Descriptive data analysis and 95% confidence intervals (CI) of prevalence/frequency were conducted. Multivariable logistic regressions were used to examine the associated socio-demographic factors of passive smoking. Results: The overall prevalence of passive smoking among non-smoking women in Jilin Province was 60.6% (95% CI: 59.3–61.8), 58.3% (95% CI: 56.7–59.9) from urban areas, and 63.4% (95% CI: 61.6–65.3) from rural areas. Twenty-six percent (95% CI: 24.9–27.1) of the non-smoking women reported daily passive smoking, of which 42.9% (95% CI: 41.6–44.1) reported passive smoking at home, and 5.1% (95% CI: 4.5–5.7) reported passive smoking in restaurants. Women in urban areas were less likely to be passive smokers than those in rural ones (OR-Odds Ratio: 0.825, 95% CI: 0.729–0.935), elderly women were less likely to be passive smokers than younger women (55–64 years OR: 0.481, 95% CI: 0.342–0.674; 65–79 years OR: 0.351, 95% CI: 0.241–0.511). Seperated/divorced women were less likely to be passive smokers (OR: 0.701, 95% CI: 0.500–0.982), and widowed women (OR: 0.564, 95%CI: 0.440–0.722), as the married were the reference group. Retired women second-hand smoked due to environmental causes significantly less than manual workers (OR: 0.810, 95% CI: 0.708–0.928). Women with a monthly family income of more than 5000 RMB were less likely to be passive smokers than those with an income less than 500 RMB (OR: 0.615, 95% CI: 0.432–0.876). Conclusions: The prevalence of passive smoking is lower than that reported in 2010 Global Adult Tobacco Survey (GATS) China, but passive smoking is still prevalent and has been an acute public health problem among non-smoking women in Jilin Province, China. Our findings suggest an urgent need for tobacco control and the efforts of public health should be both comprehensive and focus on high-risk populations in Jilin Province, China.
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Affiliation(s)
- Zhijun Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Yan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Jieping Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Yawen Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Yuchun Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Huiping Zhang
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT 06511, USA.
| | - Weiqing Han
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Yutian Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Lingling Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
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Ham Y, Oh HY, Seo SS, Kim MK. Association between Health Behaviors and a Family History of Cancer among Korean Women. Cancer Res Treat 2015; 48:806-14. [PMID: 26511810 PMCID: PMC4843757 DOI: 10.4143/crt.2015.083] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 09/05/2015] [Indexed: 12/27/2022] Open
Abstract
Purpose The aim of this study was to examine the health-related behaviors related to a family history of cancer (FHCA) among Korean women underwent cancer screening. Materials and Methods A total of 8,956 women who underwent cancer screenings during 2001-2011 at the National Cancer Center, Korea, were analyzed. The association between health-related behaviors and a FHCA were assessed using multivariate logistic regression. Results Compared to women with no FHCA, women with FHCA were more likely to smoke (adjusted odds ratio [aOR], 1.32; 95% confidence interval [CI], 1.06 to 1.65), to be exposed to passive smoking (aOR, 1.21; 95% CI, 1.15 to 1.65), and less likely to engage in regular exercise (aOR, 1.20; 95% CI, 1.01 to 1.41). Combined effects of selected health behaviors for FHCA were significant, although no statistically significant interactions were observed between selected health behaviors. Compared to women with no FHCA, women with FHCA were more likely to simultaneously smoke and be exposed to passive smoking (aOR, 1.65; 95% CI, 1.17 to 2.31) and to simultaneously smoke and be physically inactive (aOR, 1.62; 95% CI, 1.00 to 2.64). Conclusion The study found that women with a FHCA exhibited unhealthy behaviors compared to women without FHCA. Higher emphasis on lifestyle modifications using a new standardized tool is strongly recommended for those with a FHCA, as well as individuals who are at high risk, together with their family members.
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Affiliation(s)
- Youngsun Ham
- Berlin School of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Hea Young Oh
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Goyang, Korea
| | - Sang-Soo Seo
- Center for Uterine Cancer, National Cancer Center, Goyang, Korea
| | - Mi Kyung Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Goyang, Korea
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KIM HC, LAMICHHANE DK, JUNG DY, KIM HR, CHOI EH, OH SS, KANG HT, RHEE KY, CHANG SJ. Association of active and passive smoking with occupational injury in manual workers: a cross-sectional study of the 2011 Korean working conditions survey. INDUSTRIAL HEALTH 2015; 53:445-453. [PMID: 26051290 PMCID: PMC4591137 DOI: 10.2486/indhealth.2015-0011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 05/21/2015] [Indexed: 06/04/2023]
Abstract
This study was conducted to investigate the relationship of active and passive smoking with occupational injury among manual workers. Data from the 2011 Korean Working Conditions Survey were analyzed for 12,507 manual workers aged ≥15 yr. Overall, 60.4% of men and 5.8% of women were current smokers. The prevalence of injury was higher among never smokers who were exposed to secondhand smoke (SHS) (7.7% in men and 8.1% in women) than current smokers (4.2% in men and 4.1% in women). After controlling for potential confounders, in men, compared to those who never smoked and were not exposed to SHS, people who never smoked and were exposed to SHS (adjusted odds ratio (aOR)=3.7, 2.2-6.4) and current smokers (aOR=2.5, 1.6-3.8) were more likely to experience injury. Among women, the aORs of occupational injury were 8.4 (4.2-16.7) for never smoking women with occasional exposure to SHS and 3.5 (95% CI: 1.4-8.7) for current smokers, in comparison to never smoking women who were never exposed to SHS at work (reference group). The present study suggests that exposure to SHS is a possible risk factor of occupational injury for never smoking men and women.
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Affiliation(s)
- Hwan-Cheol KIM
- Department of Occupational and Environmental Medicine, School
of Medicine, Inha University, Republic of Korea
| | - Dirga Kumar LAMICHHANE
- Department of Social and Preventive Medicine, School of
Medicine, Inha University, Republic of Korea
| | - Dal-Young JUNG
- Department of Social and Preventive Medicine, School of
Medicine, Inha University, Republic of Korea
| | - Hyoung-Ryoul KIM
- Department of Occupational and Environmental Medicine,
College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Eun-Hee CHOI
- Institute of Lifestyle Medicine, Wonju College of Medicine,
Yonsei University, Republic of Korea
| | - Sung-Soo OH
- Department of Preventive Medicine and Institute of
Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University,
Republic of Korea
| | - Hee-Tae KANG
- Department of Preventive Medicine and Institute of
Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University,
Republic of Korea
| | - Kyung-Yong RHEE
- Occupational Safety and Health Research Institute, KOSHA,
Republic of Korea
| | - Sei-Jin CHANG
- Department of Preventive Medicine and Institute of
Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University,
Republic of Korea
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Kang SY, Cho YH, Jeong DW, Lee SY, Kim YJ, Lee JG, Lim HJ. Association between Secondhand Smoke and Health-related Quality of Life in Middle-aged Korean Adults. KOREAN JOURNAL OF HEALTH PROMOTION 2015; 15:185. [DOI: 10.15384/kjhp.2015.15.4.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2024]
Affiliation(s)
- Sang-Yun Kang
- Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Young Hye Cho
- Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Dong-Wook Jeong
- Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Sang-Yeoup Lee
- Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
- Medical Education Unit and Medical Research Institute Pusan National University School of Medicine, Yangsan, Korea
| | - Yun Jin Kim
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea
| | - Jeong Gyu Lee
- Department of Family Medicine, Pusan National University Hospital, Busan, Korea
| | - Hyun-Ju Lim
- Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
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Jeong BY, Lim MK, Yun EH, Oh JK, Park EY, Lee DH. Tolerance for and potential indicators of second-hand smoke exposure among nonsmokers: a comparison of self-reported and cotinine verified second-hand smoke exposure based on nationally representative data. Prev Med 2014; 67:280-7. [PMID: 25019959 DOI: 10.1016/j.ypmed.2014.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 06/03/2014] [Accepted: 07/03/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE We assessed the extent to which self-reported exposure to SHS underestimates the actual exposure to SHS and what factors are associated with a tolerance for SHS exposure in the Korean setting where the smoke-free policy is incomplete. METHODS Information on socio-demographic characteristics, alcohol drinking and smoking was collected for 7948 nonsmokers aged ≥ 19 years from the fourth Korea National Health and Nutrition Examination Survey, 2008-2009. Self-reported and cotinine verified SHS exposures were compared. Potential factors associated with cotinine verified but not self-reported SHS exposures were assessed using a logistic regression model. RESULTS Self-reported SHS exposure significantly underestimated the actual SHS exposure as determined by cotinine verification (kappa coefficient: 0.1066). At younger age, frequent alcohol drinking in females and a longer smoking duration in males were positively associated with cotinine verified exposure but not with the self-reported SHS exposure; they were also positively associated with cotinine verified exposure irrespective of self-reported SHS exposure. CONCLUSIONS Our findings show a tolerance for smoking in Korea. The current partial ban on smoking does not fully protect people from exposure to SHS. Smoking should be banned in all public places. In addition, efforts to de-normalize smoking in the Korean culture need to be strengthened.
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Affiliation(s)
- Bo Yoon Jeong
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Min Kyung Lim
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea; Graduate School of Cancer Science & Policy, National Cancer Center, Goyang, Republic of Korea.
| | - E Hwa Yun
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Jin-Kyoung Oh
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Eun Young Park
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Do-Hoon Lee
- National Cancer Center Hospital, National Cancer Center, Goyang, Republic of Korea
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Park EY, Lim MK, Yang W, Yun EH, Oh JK, Jeong BY, Hong SY, Lee DH, Tamplin S. Policy effects of secondhand smoke exposure in public places in the Republic of Korea: evidence from PM2.5 levels and air nicotine concentrations. Asian Pac J Cancer Prev 2014; 14:7725-30. [PMID: 24460359 DOI: 10.7314/apjcp.2013.14.12.7725] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate secondhand smoke (SHS) exposure inside selected public places to provide basic data for the development and promotion of smoke-free policies. METHODS Between March and May 2009, an SHS exposure survey was conducted. PM2.5 levels and air nicotine concentrations were measured in hospitals (n=5), government buildings (4), restaurants (10) and entertainment venues (10) in Seoul, Republic of Korea, using a common protocol. Field researchers completed an observational questionnaire to document evidence of active smoking (the smell of cigarette smoke, presence of cigarette butts and witnessing people smoking) and administered a questionnaire regarding building characteristics and smoking policy. RESULTS Indoor PM2.5 levels and air nicotine concentrations were relatively higher in monitoring sites where smoking is not prohibited by law. Entertainment venues had the highest values of PM2.5(μg/m3) and air nicotine concentration(μg/m3), which were 7.6 and 67.9 fold higher than those of hospitals, respectively, where the values were the lowest. When evidence of active smoking was present, the mean PM2.5 level was 104.9 μg/m3, i.e., more than 4-fold the level determined by the World Health Organization for 24-hr exposure (25 μg/m3). Mean indoor air nicotine concentration at monitoring sites with evidence of active smoking was 59-fold higher than at sites without this evidence (2.94 μg/m3 vs. 0.05 μg/m3). The results were similar at all specific monitoring sites except restaurants, where mean indoor PM2.5 levels did not differ at sites with and without active smoking evidence and indoor air nicotine concentrations were higher in sites without evidence of smoking. CONCLUSION Nicotine was detected in most of our monitoring sites, including those where smoking is prohibited by law, such as hospitals, demonstrating that enforcement and compliance with current smoke-free policies in Korea is not adequate to protect against SHS exposure.
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Affiliation(s)
- Eun Young Park
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea E-mail :
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Wei X, Zhang Z, Song X, Xu Y, Wu W, Lao X, Ma W. Household smoking restrictions related to secondhand smoke exposure in Guangdong, China: a population representative survey. Nicotine Tob Res 2013; 16:390-6. [PMID: 24130143 DOI: 10.1093/ntr/ntt162] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION China has a higher household secondhand smoke exposure rate than other countries. This study aims to estimate the prevalence rate of households implementing smoking bans in Guangdong and to identify factors correlated with household smoking bans. METHODS A cross-sectional, stratified random cluster sampling survey was conducted in Guangdong in 2010. A total of 2,114 adults aged 15 and older completed the face-to-face interviews with a response rate of 70%. The survey employed an adapted and validated questionnaire from the China Global Adult Tobacco Survey. Household smoking policy was divided into 3 groups: full ban, partial ban, and no ban. A multiple logistic regression model was employed to explore factors related to a full household smoking ban. RESULTS The survey found 14.2% of respondents reported a full ban, 23.6% reported a partial ban, and 62.2% reported no ban of smoking at home. Current smoking status was the strongest predictor for less restrictive household smoking policies (odds ratio [OR] = 4.9, 95% CI = 2.634-8.999). Our study suggested that people with a high level of education were more likely to implement a full household smoking ban (OR = 4.4, 95% CI = 2.388-8.178). Additionally, urban residents were significantly more likely to report a full household smoking ban than rural residents (OR = 1.67, 95% CI = 1.202-2.322). CONCLUSIONS Household smoking bans were not sufficiently established in Guangdong, China. Intensified efforts were called to promote home smoking bans, especially for those with a lower education level, with lower income, and living in rural areas.
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Affiliation(s)
- Xiaolin Wei
- School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
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Cai L, Wu X, Goyal A, Han Y, Cui W, He J, Xiao X, Zhao K, Jiao F, Song Y. Multilevel analysis of the determinants of smoking and second-hand smoke exposure in a tobacco-cultivating rural area of southwest China. Tob Control 2013; 22 Suppl 2:ii16-20. [PMID: 23708268 PMCID: PMC3756459 DOI: 10.1136/tobaccocontrol-2012-050850] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Accepted: 03/07/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To examine contextual and individual demographical predictors of smoking and exposure to second-hand smoke (SHS) in a tobacco-cultivating rural area of southwest China. METHODS A cross-sectional survey of 4070 consenting individuals aged 18 years or more was conducted in 2010. Information on demographical characteristics, tobacco smoking status and SHS exposure were obtained by a standard questionnaire. Multilevel logistic regression was used to model the variation in prevalence of smoking and SHS exposure. RESULTS In the study population, the prevalence rates of smoking and exposure to SHS were 63.5% and 74.7% for men, and 0.6% and 71.2% for women, respectively. Men were more likely to use tobacco than women: OR 8.27, 95% CI (4.83 to 10.97). Age was inversely associated with the probability of tobacco use (OR 0.98, 95% CI 0.97 to 0.99), and exposure to SHS (OR 0.97, 95% CI 0.96 to 0.99). Individual educational level was inversely associated with smoking, but showed no association with exposure to SHS. Adults who did not grow tobacco were less likely to consume tobacco (OR 0.75, 95% CI 0.57 to 0.99) and to be exposed to SHS (OR 0.76, 95% CI 0.58 to 0.99). Living in a high-income community was associated with a low rate of current smoking (OR 0.66, 95% CI 0.57 to 0.77) and SHS exposure (OR 0.58, 95% CI 0.52 to 0.65). CONCLUSIONS Future interventions to reduce smoking and exposure to SHS in China should focus more on tobacco farmers, less-educated individuals and on poor rural communities.
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Affiliation(s)
- Le Cai
- School of Public Health, Kunming Medical University, Kunming, China.
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Kim KH, Lee CM, Park SM, Cho B, Chang Y, Park SG, Lee K. Secondhand smoke exposure and osteoporosis in never-smoking postmenopausal women: the Fourth Korea National Health and Nutrition Examination Survey. Osteoporos Int 2013; 24:523-32. [PMID: 22532000 DOI: 10.1007/s00198-012-1987-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 03/26/2012] [Indexed: 11/30/2022]
Abstract
SUMMARY The association between secondhand smoke (SHS) exposure and lumbar and femoral neck osteoporosis was assessed in postmenopausal never-smoking Korean women. The presence of family members who actively smoked was associated with femoral neck osteoporosis. The number of cigarettes consumed by cohabitant smokers was positively associated with lumbar and femoral neck osteoporosis. INTRODUCTION This study aimed to assess the association between SHS and postmenopausal osteoporosis. METHODS Of 2,067 postmenopausal women (age, ≥55 years) participating in the Fourth Korea National Health and Nutrition Examination Survey, 925 never-smokers identified through interviews and urinary cotinine level verification were enrolled. Cross-sectional relationships between self-reported SHS exposure and osteoporosis of the lumbar vertebrae and femoral neck (defined using the World Health Organization T-score criteria) were investigated by bone densitometry. RESULTS Participants having actively smoking family members showed increased adjusted odds ratio (aOR) for femoral neck osteoporosis compared with participants not exposed to SHS (aOR, 3.68; 95 % confidence interval [CI], 1.23-10.92). Participants whose cohabitant smokers consumed any number of cigarettes per day showed increased occurrences for lumbar and femoral neck osteoporosis compared with the nonexposed group. Participants whose cohabitant smokers consumed ≥20 cigarettes/day showed increased aORs for lumbar (aOR, 5.40; 95 % CI, 1.04-28.04) and femoral neck (aOR, 4.35; 95 % CI, 1.07-17.68) osteoporosis compared with participants not exposed to SHS. CONCLUSIONS In postmenopausal never-smoking Korean women, exposure to SHS was positively associated with osteoporosis. This finding further emphasizes a need to identify vulnerable groups exposed to SHS to increase bone health.
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Affiliation(s)
- K H Kim
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Cai L, Wu X, Goyal A, Han Y, Cui W, Xiao X, He J, Zhao K, Song Y, Jiao F. Patterns and socioeconomic influences of tobacco exposure in tobacco cultivating rural areas of Yunnan Province, China. BMC Public Health 2012; 12:842. [PMID: 23035644 PMCID: PMC3515419 DOI: 10.1186/1471-2458-12-842] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 10/02/2012] [Indexed: 01/20/2023] Open
Abstract
Background This study describes the patterns and socioeconomic influences of tobacco use among adults in tobacco-cultivating regions of rural southwest China. Methods A cross-sectional survey was conducted in 8681 adults aged ≥18 years in rural areas of Yunnan Province, China from 2010 to 2011. A standardized questionnaire was administered to obtain data about participants’ demographic characteristics, individual socioeconomic status, ethnicity, self-reported smoking habits, and exposure to secondhand smoke (SHS). The socioeconomic predictors of current smoking, nicotine addiction, and SHS exposure were analyzed using multivariate logistic regression. Results The prevalence rates of tobacco use were much higher in men compared with women (current smoking 68.5% vs. 1.3%; and nicotine dependence 85.2% vs. 72.7%). However, the rate of SHS exposure was higher in women compared with men (76.6% vs. 70.5%). Tobacco farmers had higher prevalence rates of current smoking, nicotine dependence, and SHS exposure compared with participants not engaged in tobacco farming (P<0.01). Most tobacco users (84.5%) reported initiating smoking during adolescence. A total of 81.1% of smokers smoked in public places, and 77.6% smoked in workplaces. Individuals belonging to an ethnic minority had a lower probability of SHS exposure and nicotine dependence. Individual educational level was found to be inversely associated with the prevalence of current smoking, exposure to SHS, and nicotine dependence. Higher annual household income was associated with a greater risk of nicotine dependence. Conclusions This study suggests that tobacco control efforts in rural southwest China must be tailored to address tobacco-cultivating status and socioeconomic factors.
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Affiliation(s)
- Le Cai
- Cheng Gong New City, School of Public Health, Kunming Medical University, Kunming, China.
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Allem JP, Ayers JW, Unger JB, Vollinger RE, Latkin C, Juon HS, Park HR, Paik HY, Hofstetter CR, Hovell MF. The environment modifies the relationship between social networks and secondhand smoke exposure among Korean nonsmokers in Seoul and California. Asia Pac J Public Health 2012; 27:NP437-47. [PMID: 23000798 DOI: 10.1177/1010539512459750] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study compared risks of secondhand smoke exposure (SHSe) among Korean nonsmokers in Seoul, South Korea and California, United States. Social networks were hypothesized to contain more smokers in Seoul than in California, and smokers were hypothesized to produce more secondhand smoke in Seoul than California, as Seoul's policies and norms are less restrictive. Telephone interviews were conducted with Korean adults in Seoul (N = 500) and California (N = 2830). In all, 69% (95% confidence interval [CI] = 64-74) of Koreans and 31% (95% CI = 29-33) of Korean Americans reported any SHSe. A total of 44% (95% CI = 40-47) of Korean family members smoked versus 29% (95% CI = 28-30) of Korean American family members (t = 7.84, P < .01). A 25% to 75% increase in the proportion of family members that smoked corresponded with a 13% (95% CI = 5-21) higher probability of any SHSe among Koreans compared with 6% (95% CI = 2-10) among Korean Americans. Network interventions in combination with policies and/or health campaigns may help reduce SHSe globally.
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Affiliation(s)
- Jon-Patrick Allem
- University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - John W Ayers
- Children's Hospital Informatics Program at the Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA
| | - Jennifer B Unger
- University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Robert E Vollinger
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Carl Latkin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hee-Soon Juon
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Yi O, Kwon HJ, Kim H, Ha M, Hong SJ, Hong YC, Leem JH, Sakong J, Lee CG, Kim SY, Kang D. Effect of environmental tobacco smoke on atopic dermatitis among children in Korea. ENVIRONMENTAL RESEARCH 2012; 113:40-45. [PMID: 22264877 DOI: 10.1016/j.envres.2011.12.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 12/29/2011] [Accepted: 12/30/2011] [Indexed: 05/31/2023]
Abstract
The prevalence of atopic dermatitis is increasing in many countries. Several factors are known to be associated with childhood atopic dermatitis. Environmental tobacco smoke (ETS) is one of the most common indoor pollutants, and children are more vulnerable to ETS exposure than adults are. In this study, the possible association of ETS with atopic dermatitis was evaluated in 7030 individuals aged 6-13 years who participated in the Children's Health and Environment Research study. In addition, predictive factors, such as the allergic history of the parents, children's immunoglobulin E levels and children's history of rhinitis and its association with dermatitis, were assessed. After adjustment for possible confounding variables, atopic dermatitis was found to be highly correlated with ETS, especially among children whose mothers had smoked during pregnancy and/or in the first year after birth (OR=2.06, 95% CI: 1.01-4.22). In conclusion, our results show that childhood exposure to ETS is a major risk factor for atopic dermatitis.
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Affiliation(s)
- Okhee Yi
- Department of Preventive Medicine, Dankook University College of Medicine, San 29 Anseo-dong, Cheonan, Chungnam 330-714, Republic of Korea
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Yi O, Kwon HJ, Kim D, Kim H, Ha M, Hong SJ, Hong YC, Leem JH, Sakong J, Lee CG, Kim SY, Kang D. Association between environmental tobacco smoke exposure of children and parental socioeconomic status: a cross-sectional study in Korea. Nicotine Tob Res 2011; 14:607-15. [PMID: 22193578 DOI: 10.1093/ntr/ntr259] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION It has been reported that most environmental tobacco smoke (ETS) exposure of children occurs at home, and lower parental socioeconomic status (SES) increases the risk of this exposure. We estimated the independent and interactive effects of parental SES and residential area SES on ETS exposure of children at home. METHODS We evaluated whether ETS exposure was associated with parental SES by entering data from 7,059 school-aged children in Korea into fixed effects models. The empirical model, including the interaction variable of the level of deprivation of each residential area, was fitted with parental SES. RESULTS After adjustment for possible confounding variables, low paternal education (odds ratio [OR], 1.81; 95% CI, 1.30-2.54) and highly deprived areas (OR, 1.34; 95% CI, 1.06-1.69) were significantly associated with the ETS exposure of children, especially among children whose fathers had <12 years of education and lived in the most deprived area (OR, 2.04; 95% CI, 1.04-4.02). CONCLUSIONS Our findings suggest that the SES of residential areas may influence the ETS exposure of children directly, as well as interactively with parental SES, in Korea. Findings from this study will help inform policy decision makers that intervention to promote smoking cessation should consider not only the SES of individuals but also that of residential areas.
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Affiliation(s)
- Okhee Yi
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
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