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Faber T, Coffeng LE, Sheikh A, Reiss IK, Mackenbach JP, Been JV. Tobacco control policies and respiratory conditions among children presenting in primary care. NPJ Prim Care Respir Med 2024; 34:11. [PMID: 38755181 PMCID: PMC11099007 DOI: 10.1038/s41533-024-00369-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/23/2024] [Indexed: 05/18/2024] Open
Abstract
Tobacco control policies can protect child health. We hypothesised that the parallel introduction in 2008 of smoke-free restaurants and bars in the Netherlands, a tobacco tax increase and mass media campaign, would be associated with decreases in childhood wheezing/asthma, respiratory tract infections (RTIs), and otitis media with effusion (OME) presenting in primary care. We conducted an interrupted time series study using electronic medical records from the Dutch Integrated Primary Care Information database (2000-2016). We estimated step and slope changes in the incidence of each outcome with negative binomial regression analyses, adjusting for underlying time-trends, seasonality, age, sex, electronic medical record system, urbanisation, and social deprivation. Analysing 1,295,124 person-years among children aged 0-12 years, we found positive step changes immediately after the policies (incidence rate ratio (IRR): 1.07, 95% CI: 1.01-1.14 for wheezing/asthma; IRR: 1.16, 95% CI: 1.13-1.19 for RTIs; and IRR: 1.24, 95% CI: 1.14-1.36 for OME). These were followed by slope decreases for wheezing/asthma (IRR: 0.95/year, 95% CI: 0.93-0.97) and RTIs (IRR: 0.97/year, 95% CI: 0.96-0.98), but a slope increase in OME (IRR: 1.05/year, 95% CI: 1.01-1.09). We found no clear evidence of benefit of changes in tobacco control policies in the Netherlands for the outcomes of interest. Our findings need to be interpreted with caution due to substantial uncertainty in the pre-legislation outcome trends.
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Affiliation(s)
- Timor Faber
- Division of Neonatology, Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research Centre of Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK
- Health Data Research UK BREATHE Hub, Edinburgh, UK
| | - Irwin K Reiss
- Division of Neonatology, Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Johan P Mackenbach
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Jasper V Been
- Division of Neonatology, Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
- Asthma UK Centre for Applied Research Centre of Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK.
- Department of Obstetrics and Gynaecology, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
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2
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Akter S, Islam MR, Rahman MM, Rouyard T, Nsashiyi RS, Hossain F, Nakamura R. Evaluation of Population-Level Tobacco Control Interventions and Health Outcomes: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2322341. [PMID: 37418258 PMCID: PMC10329215 DOI: 10.1001/jamanetworkopen.2023.22341] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/22/2023] [Indexed: 07/08/2023] Open
Abstract
Importance Smoking causes considerable noncommunicable diseases, perinatal morbidity, and mortality. Objective To investigate the associations of population-level tobacco-control policies with health outcomes. Data Sources PubMed, EMBASE, Web of Science, Cumulated Index to Nursing and Allied Health Literature, and EconLit were searched from inception to March 2021 (updated on 1 March 2022). References were manually searched. Study Selection Studies reporting on associations of population-level tobacco control policies with health-related outcomes were included. Data were analyzed from May to July 2022. Data Extraction and Synthesis Data were extracted by 1 investigator and cross-checked by a second investigator. Analyses were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Main Outcomes and Measures The primary outcomes were respiratory system disease (RSD), cardiovascular disease (CVD), cancer, mortality, hospitalization, and health care utilization. The secondary outcomes were adverse birth outcomes, such as low birth weight and preterm birth. Random-effects meta-analysis was used to estimate pooled odds ratios (ORs) and 95% CIs. Results Of 4952 records identified, 144 population-level studies were included in the final analysis; 126 studies (87.5%) were of high or moderate quality. The most frequently reported policies were smoke-free legislation (126 studies), followed by tax or price increases (14 studies), multicomponent tobacco control programs (12 studies), and a minimum cigarette purchase age law (1 study). Smoke-free legislation was associated with decreased risk of all CVD events (OR, 0.90; 95% CI, 0.86-0.94), RSD events (OR, 0.83; 95% CI, 0.72-0.96), hospitalization due to CVD or RSD (OR, 0.91; 95% CI, 0.87-0.95), and adverse birth outcomes (OR, 0.94; 95% CI, 0.92-0.96). These associations persisted in all sensitivity and subgroup analyses, except for the country income category, for which a significant reduction was only observed in high-income countries. In meta-analysis, there was no clear association of tax or price increases with adverse health outcomes. However, for the narrative synthesis, all 8 studies reported statistically significant associations between tax increases and decreases in adverse health events. Conclusions and Relevance In this systematic review and meta-analysis, smoke-free legislation was associated with significant reductions in morbidity and mortality related to CVD, RSD, and perinatal outcomes. These findings support the need to accelerate the implementation of smoke-free laws to protect populations against smoking-related harm.
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Affiliation(s)
- Shamima Akter
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Md. Rashedul Islam
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Md. Mizanur Rahman
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Thomas Rouyard
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | | | - Fahima Hossain
- Global Public Health Research Foundation, Dhaka, Bangladesh
| | - Ryota Nakamura
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
- Graduate School of Economics, Hitotsubashi University, Tokyo, Japan
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3
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Gill I, Shah A, Lee EK, Sommer R, Ross K, Bole A, Freedman D. Community Interventions for Childhood Asthma ED Visits and Hospitalizations: A Systematic Review. Pediatrics 2022; 150:189494. [PMID: 36102121 DOI: 10.1542/peds.2021-054825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED A systematic review of interventions in community environments found significant reductions in childhood asthma exacerbations leading to emergency department visits and hospitalizations. BACKGROUND AND OBJECTIVES Structural and social determinants of childhood asthma inequities manifest within geographic communities that are often segregated. Childhood asthma disproportionately affects Black, Hispanic, and low-income populations. Community interventions have the potential to improve inequities in emergency healthcare. This systematic review was conducted to assess the effectiveness of childhood asthma community interventions and provide a conceptual model to inform implementation of future community interventions. METHODS Publications from PubMed, ScienceDirect, CINAHL, Cochrane Library, Web of Science, and hand searched references were examined from 2010 to 2021. Community intervention studies among children with asthma were included. Main outcomes were emergency department visits and hospitalizations. Community interventions exclusively focusing on schools or hospitals were excluded. Two reviewers independently assessed eligibility for final inclusion. Emergency healthcare findings were extracted in addition to co-benefits (eg, fewer missed school days and caregiver workdays). RESULTS Out of 1856 records, 26 publications met the inclusion criteria. Community interventions were categorized by care coordination (n = 8), policy and environmental changes (eg, smoke-free legislature, traffic reduction models, and green housing) (n = 8), home-based (n = 6), and community-based health services (n = 4). Selected studies indicated that community interventions significantly reduced childhood asthma emergency department visits and hospitalizations through increased caregiver self-efficacy, home environmental trigger reduction, and increased access to healthcare. Because of heterogeneity among studies, we were unable to conduct a meta-analysis. CONCLUSIONS Findings show significant associations between community interventions and the reduction of emergency healthcare, suggesting a protective effect for severe cases of childhood asthma.
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Affiliation(s)
- India Gill
- Mary Ann Swetland Center for Environmental Health, Department of Population and Quantitative Health Sciences
| | - Aashna Shah
- Mary Ann Swetland Center for Environmental Health, Department of Population and Quantitative Health Sciences.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Eun Kyung Lee
- Mary Ann Swetland Center for Environmental Health, Department of Population and Quantitative Health Sciences.,Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts
| | - Rachael Sommer
- Mary Ann Swetland Center for Environmental Health, Department of Population and Quantitative Health Sciences
| | - Kristie Ross
- Division of Pediatric Pulmonology, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, Ohio.,Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Aparna Bole
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Division of General Academic Pediatrics, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | - Darcy Freedman
- Mary Ann Swetland Center for Environmental Health, Department of Population and Quantitative Health Sciences
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Tweed EJ, Mackay DF, Boyd KA, Brown A, Byrne T, Conaglen P, Craig P, Demou E, Graham L, Leyland AH, McMeekin N, Pell JP, Sweeting H, Hunt K. Evaluation of a national smoke-free prisons policy using medication dispensing: an interrupted time-series analysis. Lancet Public Health 2021; 6:e795-e804. [PMID: 34537108 PMCID: PMC8554387 DOI: 10.1016/s2468-2667(21)00163-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Internationally, smoking prevalence among people in prison custody (ie, people on remand awaiting trial, awaiting sentencing, or serving a custodial sentence) is high. In Scotland, all prisons implemented a comprehensive smoke-free policy in 2018 after a 16-month anticipatory period. In this study, we aimed to use data on medication dispensing to assess the impact of this policy on cessation support, health outcomes, and potential unintended consequences among people in prison custody. METHODS We did an interrupted time-series analysis using dispensing data for 44 660 individuals incarcerated in 14 closed prisons in Scotland between March 30, 2014, and Nov 30, 2019. We estimated changes in dispensing rates associated with the policy announcement (July 17, 2017) and full implementation (Nov 30, 2018) using seasonal autoregressive integrated moving average models. Medication categories of primary interest were treatments for nicotine dependence (as an indicator of smoking cessation or abstinence attempts), acute smoking-associated illnesses, and mental health (antidepressants). We included antiepileptic medications as a negative control. FINDINGS A 44% step increase in dispensing of treatments for nicotine dependence was observed at implementation (2250 items per 1000 people in custody per fortnight, 95% CI 1875 to 2624) due primarily to a 42% increase in dispensing of nicotine replacement therapy (2109 items per 1000 people in custody per fortnight, 1701 to 2516). A 9% step decrease in dispensing for smoking-related illnesses was observed at implementation, largely accounted for by respiratory medications (-646 items per 1000 people in custody per fortnight, -1111 to -181). No changes associated with announcement or implementation were observed for mental health dispensing or antiepileptic medications (control). INTERPRETATION Smoke-free prison policies might improve respiratory health among people in custody and encourage smoking abstinence or cessation without apparent short-term adverse effects on mental health dispensing. FUNDING National Institute of Health Research Public Health Research programme, Scottish Government Chief Scientist Office, and UK Medical Research Council.
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Affiliation(s)
- Emily J Tweed
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Daniel F Mackay
- Department of Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kathleen A Boyd
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Ashley Brown
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Thomas Byrne
- NHS Healthcare Improvement Scotland, Glasgow, UK
| | - Philip Conaglen
- Department of Public Health and Health Policy, NHS Lothian, Edinburgh, UK
| | - Peter Craig
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Evangelia Demou
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Alastair H Leyland
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nicola McMeekin
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jill P Pell
- Department of Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Helen Sweeting
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kate Hunt
- Department of Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK; Institute for Social Marketing and Health, University of Stirling, Stirling, UK
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Stern J, Pier J, Litonjua AA. Asthma epidemiology and risk factors. Semin Immunopathol 2020; 42:5-15. [PMID: 32020334 DOI: 10.1007/s00281-020-00785-1] [Citation(s) in RCA: 228] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/15/2020] [Indexed: 12/20/2022]
Abstract
Asthma is a clinical syndrome that affects all age groups. Asthma prevalence worldwide has seen a rapid increase in the latter part of the last century. Recent data has shown that asthma prevalence has plateaued and even decreased in some areas of the world, despite continuing to increase in other areas of the world. Many risk factors have been associated with asthma and the differences in distributions of these risk factors may explain the differences in prevalence. This article will review recent trends in the prevalence of asthma and recent studies that investigate risk factors of asthma.
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Affiliation(s)
- Jessica Stern
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.,Division of Allergy and Immunology, Department of Pediatrics, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, USA
| | - Jennifer Pier
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.,Division of Allergy and Immunology, Department of Pediatrics, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, USA
| | - Augusto A Litonjua
- Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Golisano Children's Hospital, University of Rochester Medical Center, 601 Elmwood Avenue, Box 667, Rochester, NY, 14642, USA. .,Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
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6
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Rando-Matos Y, Pons-Vigués M, Rodriguez-Blanco T, Ripoll J, Llobera J, Morán J, Ballvé-Moreno JL, Violán C, Bolíbar B. Effect of comprehensive smoke-free legislation on asthma and coronary disease trends in Spanish primary care patients. Eur J Public Health 2019; 28:553-559. [PMID: 29401282 DOI: 10.1093/eurpub/cky010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background To examine the impact of comprehensive smoke-free legislation (SFL) (Law 42/2010) on the incidence and prevalence of adult asthma and coronary disease in primary health care (PHC) patients from three Spanish regions, overall and stratified by sex. Methods Longitudinal observational study conducted between 2007 and 2013 in the population over 15 years of age assigned to 66 PHC teams in Catalonia, Navarre and the Balearic Islands. Crude rates and age-standardized (truncated: asthma ≥ 16 years and coronary disease ≥ 35 years) incidence and prevalence rates using the direct method based on the European Standard Population were estimated based on data from PHC electronic health records. Joinpoint analysis was used to analyse the trends of age-standardized incidence and prevalence rates. Trends were expressed as annual percentage change and average annual percent change (AAPC). Results The standardized asthma incidence rate showed a non-significant downward trend and the standardized prevalence rates rose significantly in the three regions. Standardized coronary disease incidence and prevalence rates were considerably higher for men than for women in all regions. The standardized coronary disease incidence rates in Catalonia (AAPC: -8.00%, 95% CI: -10.46; -5.47) and Navarre (AAPC: -3.66%, 95% CI: -4.95;-2.35) showed a significant downward trend from 2007 to 2013, overall and by sex. The standardized coronary disease prevalence trend rate increased significantly in the whole period in Catalonia and the Balearic Islands, although a non-significant downward trend was observed from 2010 in Catalonia. Conclusion No changes in the trends of adult asthma and coronary disease in PHC Spanish patients were detected after the introduction of comprehensive SFL.
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Affiliation(s)
- Yolanda Rando-Matos
- Centre d'Atenció Primària (CAP) Florida Nord. Gerència d'Àmbit d'Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain.,Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Mariona Pons-Vigués
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain.,Universitat de Girona, Girona, Spain
| | - Teresa Rodriguez-Blanco
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Joana Ripoll
- Primary Care Research Unit of Mallorca, Baleares Health Services-Ibsalut, Palma, Spain.,Instituto de Investigación Sanitaria les Illes Balears (IdSBA), Hospital Universitario Son Espases, Palma, Spain
| | - Joan Llobera
- Primary Care Research Unit of Mallorca, Baleares Health Services-Ibsalut, Palma, Spain.,Instituto de Investigación Sanitaria les Illes Balears (IdSBA), Hospital Universitario Son Espases, Palma, Spain
| | - Julio Morán
- Consultorio de Barásoain (Equipo de Atención Primaria de Tafalla), Servicio Navarro de Salud, Navarra, Spain
| | - Josep Lluís Ballvé-Moreno
- Centre d'Atenció Primària (CAP) Florida Nord. Gerència d'Àmbit d'Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain.,Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Concepció Violán
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Bonaventura Bolíbar
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
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7
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Bhatta DN, Glantz S. Parental tobacco use and child death: analysis of data from demographic and health surveys from South and South East Asian countries. Int J Epidemiol 2018; 48:199-206. [DOI: 10.1093/ije/dyy209] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 12/15/2022] Open
Affiliation(s)
- Dharma N Bhatta
- Center for Tobacco Control Research and Education
- Helen Diller Family Comprehensive Cancer Center
| | - Stanton Glantz
- Center for Tobacco Control Research and Education
- Helen Diller Family Comprehensive Cancer Center
- Department of Medicine, Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
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8
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Patel M, Thai CL, Meng YY, Kuo T, Zheng H, Dietsch B, McCarthy WJ. Smoke-Free Car Legislation and Student Exposure to Smoking. Pediatrics 2018; 141:S40-S50. [PMID: 29292305 PMCID: PMC9924054 DOI: 10.1542/peds.2017-1026h] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Policies protecting children from exposure to secondhand smoke (SHS) may help prevent SHS-related negative health outcomes in children and discourage them from intending to smoke in the future. In this study, we assess the impact of California's 2007 smoke-free vehicle law on changes in middle and high school students' reported exposure to smoking in cars. Secondary aims included assessing the association of student-reported exposure to smoking in vehicles and lifetime asthma diagnosis and future intentions to smoke. METHODS Population-weighted data from the California Student Tobacco Survey and the National Youth Tobacco Survey were used to evaluate California and national trends, respectively. Weighted logistic regression models using California Student Tobacco Survey 2011 data assessed the association between the number of days of exposure to smoking in cars and student-reported lifetime asthma diagnosis as well as intention to smoke in the future. RESULTS The proportion of California students reporting exposure to smoking in cars in the last 7 days declined <1% annually from 2001 through 2005, but declined 12% annually from 2007 to 2011. National trends did not show comparable declines after 2006. Students reporting exposure to smoking in vehicles were more likely to report having ever been diagnosed with asthma and intending to smoke in the future than students who were not exposed to SHS. CONCLUSIONS These findings support the legislative intent that public policies that are designed to protect children from exposure to smoking in vehicles will yield better adolescent health outcomes and a lower risk of future adolescent cigarette smoking.
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Affiliation(s)
- Minal Patel
- Cancer Prevention Fellowship Program, and .,Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Chan L. Thai
- Department of Communication, College of Arts & Sciences, Santa Clara University, Santa Clara, California
| | | | - Tony Kuo
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, California; and
| | - Hong Zheng
- Health and Human Development Program, WestEd, Los Alamitos, California
| | - Barbara Dietsch
- Health and Human Development Program, WestEd, Los Alamitos, California
| | - William J. McCarthy
- Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California
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9
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Hatoun J, Davis-Plourde K, Penti B, Cabral H, Kazis L. Tobacco Control Laws and Pediatric Asthma. Pediatrics 2018; 141:S130-S136. [PMID: 29292313 DOI: 10.1542/peds.2017-1026p] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Exposure to environmental tobacco smoke increases pediatric asthma severity. Strict, state-level tobacco control reduces smoking. The Child Asthma Call-Back Survey (Child ACBS) is a nationally representative survey of the guardians of children with asthma. The American Lung Association's annual State of Tobacco Control report grades tobacco control laws in each state including a tax grade (cigarette excise tax relative to the national mean), and a smoke-free air grade (number of locations where smoking is prohibited). METHODS We joined Child ACBS data from 2006 to 2010 with corresponding state and year tobacco grades. In the primary analysis, we investigated the effect of state tax grades on a child's asthma severity by using a logistic regression model adjusting for year. A secondary analysis assessed the impact of smoke-free air grades on in-home smoking. RESULTS Our analysis included 12 860 Child ACBS interviews from 35 states over 5 years, representing over 24 million individuals. We merged 112 unique State of Tobacco Control grades with patient data by state and year. A higher tax grade was associated with reduced severity (adjusted odds ratio = 1.40; P = .007, 95% confidence interval: 1.10-1.80). A better smoke-free air grade was not associated with decreased in-home smoking after adjusting for confounding by income and type of residence. CONCLUSIONS A stronger tobacco tax is associated with reduced asthma severity. Further study is needed to determine the effect of smoke-free air laws on in-home environmental. This work supports ongoing efforts to strengthen tobacco control through federal and state regulations.
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Affiliation(s)
- Jonathan Hatoun
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts;
| | | | - Brian Penti
- Department of Family Medicine, Boston Medical Center, Boston, Massachusetts
| | - Howard Cabral
- School of Public Health, Boston University, Boston, Massachusetts; and
| | - Lewis Kazis
- School of Public Health, Boston University, Boston, Massachusetts; and
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10
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Díez-Izquierdo A, Balaguer A, Lidón-Moyano C, Martín-Sánchez JC, Galán I, Fernández E, Martínez-Sánchez JM. Correlation between tobacco control policies and preterm births and low birth weight in Europe. ENVIRONMENTAL RESEARCH 2018; 160:547-553. [PMID: 29089104 DOI: 10.1016/j.envres.2017.10.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 10/18/2017] [Accepted: 10/19/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess the correlation between tobacco control policies- particularly smoking bans in work and public places-and the prevalence of preterm births and low birth weight in the European countries. METHODS This is an ecological study and the unit of analysis set at the country level. Tobacco control data in Europe were obtained for the years 2010 and 2013 as measured by the Tobacco Control Scale (TCS), which reflects the level of implementation of tobacco control policies. Prevalence data for preterm births and low birth weight were obtained from two sources: the European Perinatal Health Report (EPHR), which provides data for 2010, and the Eurostat data, which includes the years 2013 and 2014. We analyzed the correlation between the TCS score and the prevalence of preterm birth and low birth weight in the European countries by means of Spearman (rsp) rank-correlation coefficients and their 95% confidence intervals (95%CI). RESULTS The 2010 TCS was negatively correlated with the prevalence of preterm births before week 37 (rsp = -0.51; 95% CI: -0.77, -0.15; p = 0.006) and week 32 (rsp = -0.42; 95%CI: -0.73, -0.01; p = 0.030) and with the prevalence of the low birth weight (< 2500g, (rsp = -0.42; 95% CI: -0.66, -0.09; p = 0.028) in European countries in 2010. We found a statistically significant inverse correlation between the level of restrictions on smoking in public places and the prevalence of low birth weight (< 2500g rsp: -0.54; 95%CI: -0.72, -0.10; p = 0.017). CONCLUSION The level of smoke-free legislation in European countries correlates with lower preterm birth prevalence rates at the ecological level. Given the important negative effects of premature births for the public health system, these data support greater implementation of smoke-free policies and tend to support the implementation of tobacco control policies, but more research is needed.
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Affiliation(s)
- Ana Díez-Izquierdo
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Paediatrics Department, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Albert Balaguer
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Paediatrics Department, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Cristina Lidón-Moyano
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Juan Carlos Martín-Sánchez
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Iñaki Galán
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Spain; Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Jose M Martínez-Sánchez
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Tobacco Control Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-ICO, L'Hospitalet de Llobregat, Spain; Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Spain.
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11
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Faber T, Kumar A, Mackenbach JP, Millett C, Basu S, Sheikh A, Been JV. Effect of tobacco control policies on perinatal and child health: a systematic review and meta-analysis. Lancet Public Health 2017; 2:e420-e437. [PMID: 28944313 PMCID: PMC5592249 DOI: 10.1016/s2468-2667(17)30144-5] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Tobacco smoking and smoke exposure during pregnancy and childhood cause considerable childhood morbidity and mortality. We did a systematic review and meta-analysis to investigate whether implementation of WHO's recommended tobacco control policies (MPOWER) was of benefit to perinatal and child health. METHODS We searched 19 electronic databases, hand-searched references and citations, and consulted experts to identify studies assessing the association between implementation of MPOWER policies and child health. We did not apply any language restrictions, and searched the full time period available for each database, up to June 22, 2017. Our primary outcomes of interest were perinatal mortality, preterm birth, hospital attendance for asthma exacerbations, and hospital attendance for respiratory tract infections. Where possible and appropriate, we combined data from different studies in random-effects meta-analyses. This study is registered with PROSPERO, number CRD42015023448. FINDINGS We identified 41 eligible studies (24 from North America, 16 from Europe, and one from China) that assessed combinations of the following MPOWER policies: smoke-free legislation (n=35), tobacco taxation (n=11), and smoking cessation services (n=3). Risk of bias was low in 23 studies, moderate in 16, and high in two. Implementation of smoke-free legislation was associated with reductions in rates of preterm birth (-3·77% [95% CI -6·37 to -1·16]; ten studies, 27 530 183 individuals), rates of hospital attendance for asthma exacerbations (-9·83% [-16·62 to -3·04]; five studies, 684 826 events), and rates of hospital attendance for all respiratory tract infections (-3·45% [-4·64 to -2·25]; two studies, 1 681 020 events) and for lower respiratory tract infections (-18·48% [-32·79 to -4·17]; three studies, 887 414 events). Associations appeared to be stronger when comprehensive smoke-free laws were implemented than when partial smoke-free laws were implemented. Among two studies assessing the association between smoke-free legislation and perinatal mortality, one showed significant reductions in stillbirth and neonatal mortality but did not report the overall effect on perinatal mortality, while the other showed no change in perinatal mortality. Meta-analysis of studies on other MPOWER policies was not possible; all four studies on increasing tobacco taxation and one of two on offering disadvantaged pregnant women help to quit smoking that reported on our primary outcomes had positive findings. Assessment of publication bias was only possible for studies assessing the association between smoke-free legislation and preterm birth, showing some degree of bias. INTERPRETATION Smoke-free legislation is associated with substantial benefits to child health. The majority of studies on other MPOWER policies also indicated a positive effect. These findings provide strong support for implementation of such policies comprehensively across the world. FUNDING Chief Scientist Office Scotland, Farr Institute, Netherlands Lung Foundation, Erasmus MC.
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Affiliation(s)
- Timor Faber
- Division of Neonatology, Erasmus University Medical Centre—Sophia Children's Hospital, Rotterdam, Netherlands,Department of Paediatrics, Erasmus University Medical Centre—Sophia Children's Hospital, Rotterdam, Netherlands,Department of Public Health, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Arun Kumar
- Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Johan P Mackenbach
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Sanjay Basu
- Prevention Research Center, Stanford University, Stanford, CA, USA
| | - Aziz Sheikh
- Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK,Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jasper V Been
- Division of Neonatology, Erasmus University Medical Centre—Sophia Children's Hospital, Rotterdam, Netherlands,Department of Paediatrics, Erasmus University Medical Centre—Sophia Children's Hospital, Rotterdam, Netherlands,Department of Obstetrics and Gynaecology, Erasmus University Medical Centre—Sophia Children's Hospital, Rotterdam, Netherlands,Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK,Correspondence to: Dr Jasper V Been, Division of Neonatology, Erasmus University Medical Centre—Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, NetherlandsCorrespondence to: Dr Jasper V BeenDivision of NeonatologyErasmus University Medical Centre—Sophia Children's HospitalPO Box 2060RotterdamCB3000Netherlands
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12
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Rando-Matos Y, Pons-Vigués M, López MJ, Córdoba R, Ballve-Moreno JL, Puigdomènech-Puig E, Benito-López VE, Arias-Agudelo OL, López-Grau M, Guardia-Riera A, Trujillo JM, Martin-Cantera C. Smokefree legislation effects on respiratory and sensory disorders: A systematic review and meta-analysis. PLoS One 2017; 12:e0181035. [PMID: 28759596 PMCID: PMC5536320 DOI: 10.1371/journal.pone.0181035] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 06/26/2017] [Indexed: 11/22/2022] Open
Abstract
Aims The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose) among all populations. Materials and methods Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1) original scientific studies about smokefree legislation, 2) Data before and after legislation were collected, and 3) Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment. Results A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers). Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months). Four (50%) of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1–36%) than for asthma (5–31%). Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46%) of the studies. Conclusions Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms) and, to a lesser degree, rates of hospitalization for asthma.
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Affiliation(s)
- Yolanda Rando-Matos
- Centre d'Atenció Primària (CAP) Florida Nord. Gerència d’Àmbit d’Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
- * E-mail:
| | - Mariona Pons-Vigués
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
- Universitat de Girona, Girona, Spain
| | - María José López
- Public Health Agency of Barcelona, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Institut d'Investigació Biomèdic (IIB Sant Pau), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Rodrigo Córdoba
- Centro de Salud Universitario Delicias Sur, Servicio Aragonés de Salud (SALUD), Zaragoza, Spain
- Universidad de Zaragoza, Zaragoza, Spain
| | - José Luis Ballve-Moreno
- Centre d'Atenció Primària (CAP) Florida Nord. Gerència d’Àmbit d’Atenció Primària Metropolitana Sud, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
| | - Elisa Puigdomènech-Puig
- Agència de Qualitat i Avaluació Sanitàries, AQuAS, Generalitat de Catalunya, Barcelona, Spain
| | - Vega Estíbaliz Benito-López
- Servicio de Medicina Preventiva, Complejo Asistencial Universitario de Salamanca, Sanidad de Castilla y Leon (SACYL), Salamanca, Spain
- Grupo de investigación: Trastornos sensoriales y neuroplasticidad cerebral (UIC: 083), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Instituto de Neurociencias de Castilla y León (INCYL), Salamanca, Spain
| | - Olga Lucía Arias-Agudelo
- Centre d'Atenció Primària (CAP) San Martí de Provençals, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Mercè López-Grau
- Centre d'Atenció Primària (CAP) Passeig de Sant Joan, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Anna Guardia-Riera
- Àrea Bàsica de Salut l'Hospitalet de Llobregat 6—Sta. Eulàlia sud, Gerència d’Àmbit d’Atenció Primària Hospitalet de Llobregat, Institut Català de la Salut, Barcelona, Spain
| | | | - Carlos Martin-Cantera
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
- Centre d'Atenció Primària (CAP) Passeig de Sant Joan, Gerència d’Àmbit d’Atenció Primària Barcelona Ciutat, Institut Català de la Salut (ICS), Barcelona, Spain
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13
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Ablah E, Dong F, Konda K. Tobacco-free policies at worksites in Kansas. BMC Public Health 2017; 17:566. [PMID: 28606151 PMCID: PMC5468950 DOI: 10.1186/s12889-017-4277-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 04/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study sought to examine the relationship between tobacco-free policies at worksites to worksite demographics such as company size and geographic location. METHODS Worksites participating in a worksite wellness workshop were asked to complete a worksite wellness instrument, which provided an assessment of their wellness practices already in place in the worksite, including the degree to which tobacco-free policies were in place at the worksite. RESULTS At a bivariate level, those more likely to have tobacco-free policies included: urban employers (76.8% versus 50% rural employers, p = 0.0001); large employers (> = 250 employees) (74.3% versus 43.1% small employers (<50 employees), p = 0.0003); and schools (69.4%) and hospitals (61.5%) (versus 35.5%, agricultural/ manufacturing employers, p = 0.0125). At the multivariate level, rural employers (AOR = 0.47, 95% CI 0.23, 0.95) and small employers (AOR = 0.34, 95% CI 0.16, 0.71) had decreased odds, compared to their urban and large employer counterparts, of having tobacco-free policies. CONCLUSIONS Rural and smaller employers are less likely to have tobacco-free policies than their urban and large counterparts.
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Affiliation(s)
- Elizabeth Ablah
- University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS 67214 USA
| | - Frank Dong
- Western University of Health Sciences, 309 E 2nd Street, Pomona, CA 91766 USA
| | - Kurt Konda
- University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS 67214 USA
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14
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Smoke-free legislation and child health. NPJ Prim Care Respir Med 2016; 26:16067. [PMID: 27853176 PMCID: PMC5113157 DOI: 10.1038/npjpcrm.2016.67] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/25/2016] [Accepted: 08/02/2016] [Indexed: 11/08/2022] Open
Abstract
In this paper, we aim to present an overview of the scientific literature on the link between smoke-free legislation and early-life health outcomes. Exposure to second-hand smoke is responsible for an estimated 166 ,000 child deaths each year worldwide. To protect people from tobacco smoke, the World Health Organization recommends the implementation of comprehensive smoke-free legislation that prohibits smoking in all public indoor spaces, including workplaces, bars and restaurants. The implementation of such legislation has been found to reduce tobacco smoke exposure, encourage people to quit smoking and improve adult health outcomes. There is an increasing body of evidence that shows that children also experience health benefits after implementation of smoke-free legislation. In addition to protecting children from tobacco smoke in public, the link between smoke-free legislation and improved child health is likely to be mediated via a decline in smoking during pregnancy and reduced exposure in the home environment. Recent studies have found that the implementation of smoke-free legislation is associated with a substantial decrease in the number of perinatal deaths, preterm births and hospital attendance for respiratory tract infections and asthma in children, although such benefits are not found in each study. With over 80% of the world’s population currently unprotected by comprehensive smoke-free laws, protecting (unborn) children from the adverse impact of tobacco smoking and SHS exposure holds great potential to benefit public health and should therefore be a key priority for policymakers and health workers alike.
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15
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Prevalence of asthma symptoms in Golestan schoolchildren aged 6-7 and 13-14 years in Northeast Iran. Front Med 2016; 10:345-50. [PMID: 27527365 DOI: 10.1007/s11684-016-0462-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
Abstract
Asthma is the most common chronic disease among children, and its incidences are often imminent among elementary schoolchildren. This study aimed to examine the prevalence of asthma symptoms in Golestan schoolchildren aged 6-7 and 13-14 years in Northeast Iran. The prevalence rate was compared according to age group (aged 6-7 years vs. aged 13-14 years) and gender (male vs. female). In this cross-sectional study, 1706 Iranian schoolchildren aged 6-7 and 13-14 years in Golestan Province were enrolled. Participants completed questionnaires between February and July 2014. Asthma symptoms were assessed using the questionnaire of the International Study of Asthma and Allergies in Childhood protocol in Persian. The logistic regression model was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the asthma symptoms for each of the gender and age groups. The prevalence rates of "current asthma" symptoms and "asthma ever" in all the children were estimated as 9.5% and 7.5%, respectively. The prevalence of asthma ("asthma ever" and "wheezing in the past 12 months") in junior high schoolchildren (aged 13-14 years) is higher than that in elementary schoolchildren (aged 6-7 years) (P < 0.05). The prevalence of the severity of wheezing in girls is lower than that in boys (OR = 1.7, 95%CI = 1.06-2.96, P = 0.02). Asthma is still a major public health problem. This study shows that the prevalence of the asthma symptoms in boys is lower than that in girls in both age groups, and the severity of asthma in girls is higher than that in boys aged 13-14 years.
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16
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Seaweed (Eucheuma cottonii) reduced inflammation, mucin synthesis, eosinophil infiltration and MMP-9 expressions in asthma-induced rats compared to Loratadine. J Funct Foods 2015. [DOI: 10.1016/j.jff.2015.10.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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17
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Been JV, Szatkowski L, van Staa TP, Leufkens HG, van Schayck OC, Sheikh A, de Vries F, Souverein P. Smoke-free legislation and the incidence of paediatric respiratory infections and wheezing/asthma: interrupted time series analyses in the four UK nations. Sci Rep 2015; 5:15246. [PMID: 26463498 PMCID: PMC4604467 DOI: 10.1038/srep15246] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 09/17/2015] [Indexed: 11/15/2022] Open
Abstract
We investigated the association between introduction of smoke-free legislation in the UK (March 2006 for Scotland, April 2007 for Wales and Northern Ireland, and July 2007 for England) and the incidence of respiratory diseases among children. We extracted monthly counts of new diagnoses of wheezing/asthma and RTIs among children aged 0–12 years from all general practices in the Clinical Practice Research Datalink during 1997–2012. Interrupted time series analyses were performed using generalised additive mixed models, adjusting for underlying incidence trends, population size changes, seasonal factors, and pandemic influenza, as appropriate. 366,642 new wheezing/asthma diagnoses and 4,324,789 RTIs were observed over 9,536,003 patient-years. There was no statistically significant change in the incidence of wheezing/asthma after introduction of smoke-free legislation in England (incidence rate ratio (IRR) 0.94, 95% CI 0.81–1.09) or any other UK country (Scotland: IRR 0.99, 95% CI 0.83–1.19; Wales: IRR 1.09, 95% CI 0.89–1.35; Northern Ireland: IRR 0.96, 95% CI 0.76–1.22). Similarly no statistically significant changes in RTI incidence were demonstrated (England: IRR 0.95, 95% CI 0.86–1.06; Scotland: IRR 0.96, 95% CI 0.83–1.11; Wales: IRR 0.97, 95% CI 0.86–1.09; Northern Ireland: IRR 0.90, 95% CI 0.79–1.03). There were no demonstrable reductions in the incidence of paediatric wheezing/asthma or RTIs following introduction of smoke-free legislation in the UK.
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Affiliation(s)
- Jasper V Been
- Division of Neonatology, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, Netherlands.,Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom.,Department of Paediatrics, Maastricht University Medical Centre, Maastricht, Netherlands.,School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Lisa Szatkowski
- UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Division of Epidemiology and Public Health, Nottingham City Hospital, Nottingham, United Kingdom
| | - Tjeerd-Pieter van Staa
- London School of Hygiene and Tropical Medicine, London, United Kingdom.,Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Hubert G Leufkens
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Onno C van Schayck
- Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom.,School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Aziz Sheikh
- Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom.,School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Netherlands.,Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital/Harvard Medical School, Boston, USA
| | - Frank de Vries
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands.,Department of Clinical Pharmacy &Toxicology, Maastricht University Medical Centre, Maastricht, the Netherlands.,MRC Epidemiology Lifecourse Unit, Southampton General Hospital, Southampton, United Kingdom
| | - Patrick Souverein
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
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18
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Fedele DA, Tooley E, Busch A, McQuaid EL, Hammond SK, Borrelli B. Comparison of secondhand smoke exposure in minority and nonminority children with asthma. Health Psychol 2015; 35:115-22. [PMID: 26237117 DOI: 10.1037/hea0000220] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study determined if secondhand smoke (SHS) exposure is related to asthma-related functional morbidity by examining racial/ethnic differences in non-Latino White (NLW), African American, and Latino families and whether racial/ethnic SHS exposure differences across families persist when accounting for smoking factors. METHODS Participants were 305 caregiver smokers of children with asthma. Two passive dosimeters measured secondhand smoke: one in the home and one worn by the child. RESULTS Higher SHS exposure was related to greater asthma-related functional morbidity. African Americans had higher levels of home SHS exposure than did Latinos (p = .003) or NLWs (p = .021). SHS exposure as assessed by the child-worn dosimeter did not differ across race/ethnicity. African American families were less likely to report a household smoking ban (46.4%) compared to Latinos (79.2%) and NLWs (67.9%; p < .05). African Americans were less likely to report having two or more smokers in the home (37.2%) compared to NLWs (53.6%; p < .05). NLWs reported the highest number of cigarettes smoked daily (Mdn = 15.00) compared to Latinos (Mdn = 10.00; p = .001) and African Americans (Mdn = 10.00; p < .001). SHS home exposure levels were regressed on race/ethnicity and relevant covariates. Household smoking ban (p < .001) and only one smoker in the home (p = .005) were associated with lower levels of SHS in the home; race/ethnicity was not significant. CONCLUSIONS Differences in SHS exposure across race/ethnicity exist among children with asthma, possibly due to differential presence of a household smoking ban and number of smokers in the home.
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Affiliation(s)
- David A Fedele
- Department of Clinical & Health Psychology, University of Florida
| | - Erin Tooley
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Andrew Busch
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | - Elizabeth L McQuaid
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
| | | | - Belinda Borrelli
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
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19
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Lin HC, Park JY, Seo DC. Comprehensive US Statewide Smoke-Free Indoor Air Legislation and Secondhand Smoke Exposure, Asthma Prevalence, and Related Doctor Visits: 2007-2011. Am J Public Health 2015; 105:1617-22. [PMID: 26066917 PMCID: PMC4504278 DOI: 10.2105/ajph.2015.302596] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated the impact of comprehensive statewide smoke-free indoor air laws on secondhand smoke (SHS) exposure, asthma prevalence, and asthma-related doctor visits. METHODS We used the 2007-2011 Behavioral Risk Factor Surveillance System data sets. We employed a paired t test to determine whether comprehensive statewide smoke-free indoor air laws reduced SHS exposure. We performed weighted logistic and Poisson regressions to obtain likelihood of reporting asthma symptoms and incidence rate ratio (IRR) of doctor visits owing to severe asthma symptoms. RESULTS After such laws were enacted, people in states with comprehensive smoke-free indoor air laws had a lower level of SHS exposure (P < .01), decreased odds of reporting current asthma symptoms (adjusted odds ratio [AOR] = 0.57; 95% confidence interval [CI] = 0.51, 0.63), and a decreased frequency of doctor's visits owing to severe asthma symptoms (IRR = 0.80; 95% CI = 0.69, 0.92) than did their counterparts in fully adjusted models. CONCLUSIONS Comprehensive statewide smoke-free indoor air laws appear to be effective in reducing SHS exposure and improving asthma outcomes. Regulations requiring smoke-free indoor environments and public areas are beneficial, and smoke-free indoor air laws should be enforced in all states.
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Affiliation(s)
- Hsien-Chang Lin
- Hsien-Chang Lin and Ji-Yeun Park are with the Department of Applied Health Science, Indiana University School of Public Health, Bloomington. Dong-Chul Seo is with the Department of Health Education and Management, College of Health Sciences, Ewha Womans University, Seoul, South Korea
| | - Ji-Yeun Park
- Hsien-Chang Lin and Ji-Yeun Park are with the Department of Applied Health Science, Indiana University School of Public Health, Bloomington. Dong-Chul Seo is with the Department of Health Education and Management, College of Health Sciences, Ewha Womans University, Seoul, South Korea
| | - Dong-Chul Seo
- Hsien-Chang Lin and Ji-Yeun Park are with the Department of Applied Health Science, Indiana University School of Public Health, Bloomington. Dong-Chul Seo is with the Department of Health Education and Management, College of Health Sciences, Ewha Womans University, Seoul, South Korea
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Croghan IT, Ebbert JO, Hays JT, Schroeder DR, Chamberlain AM, Roger VL, Hurt RD. Impact of a countywide smoke-free workplace law on emergency department visits for respiratory diseases: a retrospective cohort study. BMC Pulm Med 2015; 15:6. [PMID: 25608660 PMCID: PMC4417313 DOI: 10.1186/1471-2466-15-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 01/12/2015] [Indexed: 11/18/2022] Open
Abstract
Background With the goal of reducing exposure to secondhand smoke, the state of Minnesota (MN), enacted a smoke-free law (i.e., Freedom to Breathe Act) in all workplaces, restaurants, and bars in 2007. This retrospective cohort study analyzes emergency department (ED) visits in Olmsted County, MN, for chronic obstructive pulmonary disease (COPD) and asthma over a five-year period to assess changes after enactment of the smoke-free law. Methods We calculated the rates of ED visits in Olmsted County, MN, with a primary diagnosis of COPD and asthma in the five-year period from January 1, 2005 to December 31, 2009. Analyses were performed using segmented Poisson regression to assess whether ED visit rates declined following enactment of the smoke free law after adjusting for potential underlying temporal trends in ED visit rates during this time period. Results Using segmented Poisson regression analyses, a significant reduction was detected in asthma-related ED visits (RR 0.814, p < 0.001) but not for COPD-related ED visits following the enactment of the smoke-free law. The reduction in asthma related ED visits was observed in both adults (RR 0.840, p = 0.015) and children (RR 0.751, p = 0.015). Conclusions In Olmsted County, MN, asthma-related ED visits declined significantly after enactment of a smoke-free law. These results add to the body of literature supporting community health benefits of smoke-free policies in public environments and their potential to reduce health care costs.
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Affiliation(s)
- Ivana T Croghan
- Nicotine Research Program, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. .,Clinical Research Office, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Jon O Ebbert
- Nicotine Research Program, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. .,Clinical Research Office, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA. .,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
| | - J Taylor Hays
- Nicotine Research Program, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Darrell R Schroeder
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Alanna M Chamberlain
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Véronique L Roger
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA. .,Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. .,Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Richard D Hurt
- Nicotine Research Program, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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Hahn EJ, Rayens MK, Adkins S, Begley K, York N. A controlled community-based trial to promote smoke-free policy in rural communities. J Rural Health 2014; 31:76-88. [PMID: 25182714 DOI: 10.1111/jrh.12087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Rural, tobacco-growing areas are disproportionately affected by tobacco use, secondhand smoke, and weak tobacco control policies. The purpose was to test the effects of a stage-specific, tailored policy-focused intervention on readiness for smoke-free policy, and policy outcomes in rural underserved communities. METHODS A controlled community-based trial including 37 rural counties. Data were collected annually with community advocates (n = 330) and elected officials (n = 158) in 19 intervention counties and 18 comparison counties over 5 years (average response rate = 68%). Intervention communities received policy development strategies from community advisors tailored to their stage of readiness and designed to build capacity, build demand, and translate and disseminate science. Policy outcomes were tracked over 5 years. FINDINGS Communities receiving the stage-specific, tailored intervention had higher overall community readiness scores and better policy outcomes than the comparison counties, controlling for county-level smoking rate, population size, and education. Nearly one-third of the intervention counties adopted smoke-free laws covering restaurants, bars, and all workplaces compared to none of the comparison counties. CONCLUSIONS The stage-specific, tailored policy-focused intervention acted as a value-added resource to local smoke-free campaigns by promoting readiness for policy, as well as actual policy change in rural communities. Although actual policy change and percent covered by the policies were modest, these areas need additional resources and efforts to build capacity, build demand, and translate and disseminate science in order to accelerate smoke-free policy change and reduce the enormous toll from tobacco in these high-risk communities.
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Affiliation(s)
- Ellen J Hahn
- University of Kentucky College of Nursing, Tobacco Policy Research Program, Kentucky Center for Smoke-Free Policy, Lexington, Kentucky
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22
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Mamudu HM, Dadkar S, Veeranki SP, He Y, Barnes R, Glantz SA. Multiple streams approach to tobacco control policymaking in a tobacco-growing state. J Community Health 2014; 39:633-45. [PMID: 24370600 PMCID: PMC4074267 DOI: 10.1007/s10900-013-9814-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Smokefree policies (SFPs) have diffused throughout the US and worldwide. However, the development of SFPs in the difficult policy environment of tobacco-producing states and economies worldwide has not been well-explored. In 2007, Tennessee, the third largest tobacco producer in the US, enacted the Non-Smoker Protection Act (NSPA). This study utilizes the multiple streams model to provide understanding of why and how this policy was developed by triangulating interviews with key stakeholders and legislative debates with archival documents. In June 2006, the Governor unexpectedly announced support for SFP, which created a window of opportunity for policy change. The Campaign for Healthy and Responsible Tennessee, a health coalition, seized this opportunity and worked with the administration and the Tennessee Restaurant Association to negotiate a comprehensive SFP, however, a weaker bill was used by the legislative leadership to develop the NSPA. Although the Governor and the Tennessee Restaurant Association's support generated an environment for 100% SFP, health groups did not fully capitalize on this environmental change and settled for a weak policy with several exemptions. This study suggests the importance for proponents of policy change to understand changes in their environment and be willing and able to capitalize on these changes.
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Affiliation(s)
- Hadii M Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, S. Dossett Drive, Lamb Hall, P.O. Box 70264, Johnson City, TN, 37614, USA,
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Been JV, Nurmatov UB, Cox B, Nawrot TS, van Schayck CP, Sheikh A. Effect of smoke-free legislation on perinatal and child health: a systematic review and meta-analysis. Lancet 2014; 383:1549-60. [PMID: 24680633 DOI: 10.1016/s0140-6736(14)60082-9] [Citation(s) in RCA: 191] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Smoke-free legislation has the potential to reduce the substantive disease burden associated with second-hand smoke exposure, particularly in children. We investigated the effect of smoke-free legislation on perinatal and child health. METHODS We searched 14 online databases from January, 1975 to May, 2013, with no language restrictions, for published studies, and the WHO International Clinical Trials Registry Platform for unpublished studies. Citations and reference lists of articles of interest were screened and an international expert panel was contacted to identify additional studies. We included studies undertaken with designs approved by the Cochrane Effective Practice and Organisation of Care that reported associations between smoking bans in workplaces, public places, or both, and one or more predefined early-life health indicator. The primary outcomes were preterm birth, low birthweight, and hospital attendances for asthma. Effect estimates were pooled with random-effects meta-analysis. This study is registered with PROSPERO, number CRD42013003522. FINDINGS We identified 11 eligible studies (published 2008-13), involving more than 2·5 million births and 247,168 asthma exacerbations. All studies used interrupted time-series designs. Five North American studies described local bans and six European studies described national bans. Risk of bias was high for one study, moderate for six studies, and low for four studies. Smoke-free legislation was associated with reductions in preterm birth (four studies, 1,366,862 individuals; -10·4% [95% CI -18·8 to -2·0]; p=0·016) and hospital attendances for asthma (three studies, 225,753 events: -10·1% [95% CI -15·2 to -5·0]; p=0·0001). No significant effect on low birthweight was identified (six studies, >1·9 million individuals: -1·7% [95% CI -5·1 to 1·6]; p=0·31). INTERPRETATION Smoke-free legislation is associated with substantial reductions in preterm births and hospital attendance for asthma. Together with the health benefits in adults, this study provides strong support for WHO recommendations to create smoke-free environments. FUNDING Thrasher Fund, Lung Foundation Netherlands, International Paediatric Research Foundation, Maastricht University, Commonwealth Fund.
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Affiliation(s)
- Jasper V Been
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Netherlands; Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK; Department of Paediatrics, Maastricht University Medical Centre, Maastricht, Netherlands.
| | - Ulugbek B Nurmatov
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
| | - Bianca Cox
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium; Department of Public Health, University of Leuven, Leuven, Belgium
| | - Constant P van Schayck
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Netherlands; Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, Netherlands; Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK; Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
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Nguyen KH, King BA, Dube SR. Association between current asthma and secondhand smoke exposure in vehicles among adults living in four US states. Tob Control 2014; 24:376-81. [PMID: 24794714 DOI: 10.1136/tobaccocontrol-2013-051526] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 04/02/2014] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Many states have implemented laws prohibiting tobacco smoking in indoor public places. However, private settings remain a major source of secondhand smoke (SHS) exposure for many people. We assessed the association between current asthma and SHS exposure in vehicles among adult never-smokers in Indiana, Kentucky, Louisiana and Mississippi. METHODS Data came from the 2011 Behavioral Risk Factor Surveillance System, a state-based telephone survey of US adults aged ≥18 years. Analyses were restricted to states (n=4) that administered an optional SHS module. Prevalence of self-reported asthma and past 7-day SHS exposure in vehicles was calculated by demographics, voluntary smoke-free vehicle rules and SHS exposure in homes, public places and workplaces. Logistic regression was used to assess the adjusted association between asthma and SHS exposure in vehicles. RESULTS Among 17 863 never-smoking adults, 7.4% reported having current asthma, whereas 12.3% reported past 7-day SHS exposure in vehicles. Among adults with asthma, SHS exposure in vehicles was lower among those with voluntary smoke-free rules compared with those without voluntary smoke-free rules (9.5% vs 56.7%, p<0.0001). Following adjustment, adults exposed to SHS in a vehicle had a higher odds of having current asthma compared with unexposed adults (OR=2.01, 95% CI 1.18 to 3.40). CONCLUSIONS Never-smoking adults recently exposed to SHS in a vehicle had higher odds of having current asthma compared with unexposed adults. Efforts are warranted to warn about the dangers of SHS and to encourage voluntary smoke-free rules in vehicles, especially among adults with asthma.
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Affiliation(s)
- Kimberly H Nguyen
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shanta R Dube
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Georgia, USA
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Butler KM, Rayens MK, Ashford K, Adkins S, Gombeski B, Britt J, Hahn EJ. Smoke-free homes, strength of smoke-free law, and children in the home. Nicotine Tob Res 2013; 16:485-90. [PMID: 24302637 DOI: 10.1093/ntr/ntt191] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Secondhand smoke (SHS) is a leading cause of childhood illness and premature death, especially in rural areas. The study examined the relationship of having a smoke-free home, strength of smoke-free law (SFL) in the county of residence, having one or more minor children in the home, rural/urban location, and demographics. METHODS An Internet-based panel survey was administered to Kentucky residents from 2007 to 2012. Sample size ranged from 400 to 513 per year; N = 2,653 total. Most were female, aged 35-54, had at least some college education, and lived in a smoke-free home. Almost half lived in a county with a comprehensive SFL; 14% lived in a county with a moderate or weak law. RESULTS Multivariate logistic regression revealed that the significant predictors of a smoke-free home included having education beyond high school, being a nonsmoker, living in an urban county, and having a year of participation in the survey. Controlling for smoking status and other personal characteristics, those who responded to the survey in the last 2 years of administration were more likely to have a smoke-free home compared to the reference year of 2007. Respondents living in urban counties were nearly 2 times more likely to report a smoke-free home than rural dwellers. CONCLUSIONS Smoke-free homes in urban areas, where SFLs may be the norm, may be more typical than in rural communities. Public awareness campaigns and education about the benefits of smoke-free homes is needed, especially in rural areas, targeting smokers, those with less education, and those with children living in the home.
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Affiliation(s)
- Karen M Butler
- Tobacco Policy Research Program, College of Nursing, University of Kentucky, Lexington, KY
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Sims M, Maxwell R, Gilmore A. Short-term impact of the smokefree legislation in England on emergency hospital admissions for asthma among adults: a population-based study. Thorax 2013; 68:619-24. [DOI: 10.1136/thoraxjnl-2012-202841] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Antó JM. Recent advances in the epidemiologic investigation of risk factors for asthma: a review of the 2011 literature. Curr Allergy Asthma Rep 2013; 12:192-200. [PMID: 22422360 DOI: 10.1007/s11882-012-0254-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The present review aims to identify and summarize epidemiologic investigations published during 2011 on the environmental risk factors for asthma. Potentially eligible papers were identified by a MEDLINE search. In total, 1,130 items were retrieved. Based on a broad definition of environment, the following topics were included: obesity, diet, vitamin D, air pollution, farming environment, and social factors. Some of the more relevant contributions included evidence that 1) obesity precedes asthma, 2) fruit consumption is longitudinally associated with a lower risk of asthma and atopy, 3) a comprehensive statewide smoking ban was followed by a reduction in hospital admissions for asthma, 4) asthma is one of the diseases showing the largest burdens due to environmental tobacco smoke, 5) traffic-related urban air pollution is associated with bronchial inflammation as measured by fractional exhaled nitric oxide and uncontrolled asthma, 6) aeroallergens and desert dust may contribute to the short-term effects of air pollution and asthma, and 7) maternal exposure to air pollution before and during pregnancy may alter the immune competence in offspring.
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Affiliation(s)
- Josep M Antó
- Centre for Research in Environmental Epidemiology, Barcelona Biomedical Research Park, Spain.
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Gonzalez M, Sanders-Jackson A, Song AV, Cheng KW, Glantz SA. Strong smoke-free law coverage in the United States by race/ethnicity: 2000-2009. Am J Public Health 2013; 103:e62-6. [PMID: 23488507 DOI: 10.2105/ajph.2012.301045] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We determined whether racial/ethnic disparities existed in coverage by type of 100% smoke-free private workplace, restaurant, and bar laws from 2000 to 2009. METHODS We combined US census population data and the American Nonsmokers' Rights Foundation US Tobacco Control Database to calculate the percentage of individuals in counties covered by each type of law by race/ethnicity from 2000 to 2009. RESULTS More of the US Hispanic and Asian populations were covered by 100% smoke-free restaurant and bar laws than non-Hispanic White and non-Hispanic Black populations. Asian coverage by smoke-free bars laws increased from 36% to 75%, and Hispanic coverage increased from 31% to 62%, compared with 6% to 41% for non-Hispanic Blacks and 8% to 49% for non-Hispanic Whites. CONCLUSIONS Hispanics and Asians benefited more from the rapid spread of smoke-free law coverage, whereas non-Hispanic Blacks benefited less. These ethnic disparities suggest a likely effect of geographic region and may provide a basis for more effective, community-based, and tailored policy-related interventions, particularly regarding areas with high concentrations of non-Hispanic Blacks.
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Affiliation(s)
- Mariaelena Gonzalez
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390, USA
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Sun protection, probiotics and parental smoking cessation. Curr Opin Pediatr 2012; 24:746-52. [PMID: 23080131 DOI: 10.1097/mop.0b013e32835a1ae1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW This article addresses three areas where new research demonstrates the potential to impact the health of children and adolescents: sun protection, probiotic use, and parental smoking cessation. RECENT FINDINGS Skin cancer rates are rising, and sun exposure in childhood and exposure to tanning beds are important preventable risk factors. Research on the use of probiotics to treat a variety of intestinal and nonintestinal diseases is expanding. By counseling parents about smoking cessation, pediatricians can assist in decreasing childhood exposure to harmful second-hand and third-hand smoke. SUMMARY New research on probiotic use in children shows its potential in prevention and treatment of common childhood illnesses. By finding ways to educate patients and parents on the dangers of ultraviolet radiation and smoke exposure, pediatricians can improve both short-term and long-term health of their patients.
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Tan CE, Glantz SA. Association between smoke-free legislation and hospitalizations for cardiac, cerebrovascular, and respiratory diseases: a meta-analysis. Circulation 2012; 126:2177-83. [PMID: 23109514 PMCID: PMC3501404 DOI: 10.1161/circulationaha.112.121301] [Citation(s) in RCA: 215] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Secondhand smoke causes cardiovascular and respiratory disease. Smoke-free legislation is associated with a lower risk of hospitalization and death from these diseases. METHODS AND RESULTS Random-effects meta-analysis was conducted by law comprehensiveness to determine the relationship between smoke-free legislation and hospital admission or death from cardiac, cerebrovascular, and respiratory diseases. Studies were identified by using a systematic search for studies published before November 30, 2011 with the use of the Science Citation Index, Google Scholar, PubMed, and Embase and references in identified articles. Change in hospital admissions (or deaths) in the presence of a smoke-free law, duration of follow-up, and law comprehensiveness (workplaces only; workplaces and restaurants; or workplaces, restaurants, and bars) were recorded. Forty-five studies of 33 smoke-free laws with median follow-up of 24 months (range, 2-57 months) were included. Comprehensive smoke-free legislation was associated with significantly lower rates of hospital admissions (or deaths) for all 4 diagnostic groups: coronary events (relative risk, 0.848; 95% confidence interval 0.816-0.881), other heart disease (relative risk, 0.610; 95% confidence interval, 0.440-0.847), cerebrovascular accidents (relative risk, 0.840; 95% confidence interval, 0.753-0.936), and respiratory disease (relative risk, 0.760; 95% confidence interval, 0.682-0.846). The difference in risk following comprehensive smoke-free laws does not change with longer follow-up. More comprehensive laws were associated with larger changes in risk. CONCLUSIONS Smoke-free legislation was associated with a lower risk of smoking-related cardiac, cerebrovascular, and respiratory diseases, with more comprehensive laws associated with greater changes in risk.
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Affiliation(s)
- Crystal E. Tan
- Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Stanton A. Glantz
- Center for Tobacco Control Research and Education, University of California, San Francisco
- Department of Medicine, University of California, San Francisco
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Current world literature. Curr Opin Allergy Clin Immunol 2012; 12:211-7. [PMID: 22382450 DOI: 10.1097/aci.0b013e3283520fda] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vázquez-Rodríguez CF, Vázquez-Nava F, Vázquez-Rodríguez EM, Morales-Romero J, Iribar-Ibabe MC, Peinado-Herreros J. Smoking in Non-Student Mexican Adolescents With Asthma. Relation With Family Structure, Educational Level, Parental Approval of Smoking, Parents Who Smoke, and Smoking Friends. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.arbr.2011.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Vázquez-Rodríguez CF, Vázquez-Nava F, Vázquez-Rodríguez EM, Morales-Romero J, Iribar-Ibabe MC, Peinado-Herreros J. Smoking in non-student Mexican adolescents with asthma: relation with family structure, educational level, parental approval of smoking, parents who smoke, and smoking friends. Arch Bronconeumol 2011; 48:37-42. [PMID: 22113156 DOI: 10.1016/j.arbres.2011.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Revised: 07/28/2011] [Accepted: 09/10/2011] [Indexed: 10/15/2022]
Abstract
INTRODUCTION The association between some factors of the familial and social environment with smoking in non-student adolescents with asthma has not been explored. The aim of the study was to determine the association between family structure, educational level, parental approval of smoking, parents who smoke, and smoking friends with smoking in non-student adolescents with asthma. SUBJECTS AND METHODS In a cross-sectional study, data were obtained by means of a structured questionnaire applied to 4,778 non-student adolescents aged 13-18 years. Diagnosis of asthma was performed using a questionnaire based on the International Study of Asthma and Allergy in Childhood questionnaire. The smoking habit was determined by application of a self-administered questionnaire. Odds ratios (OR) were determined for smoking using logistic regression. RESULTS From the total sample, asthma prevalence was 6.6% and of active smoking, 34.2%. Age at initiation of asthma symptoms was 5.15±3.52 years, and that of active smoking was 13.65±2.07 years. Percentage of non-intact family (40.1 vs. 32.7%) was greater in the group of adolescents with asthma. Logistic regression models show that parental approval of smoking (adjusted OR=5.57; 95% confidence interval=2.48-12.51) and smoking friends (adjusted OR=2.92; 95% confidence interval=1.04-8.19) are associated with smoking in non-student adolescents with asthma. CONCLUSION In this study, parental approval of smoking and having friends who smoke appear to be associated with smoking among non-student adolescents with asthma.
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Affiliation(s)
- Carlos F Vázquez-Rodríguez
- Departamento de Investigación, Universidad Autónoma de Tampico de Tamaulipas, Centro Universitario, Tampico-Ciudad Madero, Tamp, México
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Abidin EZ, Semple S, Omar A, Rahman HA, Turner SW, Ayres JG. A survey of schoolchildren's exposure to secondhand smoke in Malaysia. BMC Public Health 2011; 11:634. [PMID: 21824403 PMCID: PMC3162528 DOI: 10.1186/1471-2458-11-634] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 08/08/2011] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND There is a lack of data describing the exposure of Malaysian schoolchildren to Secondhand Smoke (SHS). The aim of this study is to identify factors influencing schoolchildren's exposures to SHS in Malaysia. METHOD This cross-sectional study was carried out to measure salivary cotinine concentrations among 1064 schoolchildren (10-11 years) attending 24 schools in Malaysia following recent partial smoke-free restrictions. Parents completed questionnaires and schoolchildren provided saliva samples for cotinine assay. RESULTS The geometric mean (GM) salivary cotinine concentrations for 947 non-smoking schoolchildren stratified by household residents' smoking behaviour were: for children living with non-smoking parents 0.32 ng/ml (95% CI 0.28-0.37) (n = 446); for children living with a smoker father 0.65 ng/ml (95% CI 0.57-0.72) (n = 432); for children living with two smoking parents 1.12 ng/ml (95% CI 0.29-4.40) (n = 3); for children who live with an extended family member who smokes 0.62 ng/ml (95% CI 0.42-0.89) (n = 33) and for children living with two smokers (father and extended family member) 0.71 ng/ml (95% CI 0.40-0.97) (n = 44). Parental-reported SHS exposures showed poor agreement with children's self-reported SHS exposures. Multiple linear regression demonstrated that cotinine levels were positively associated with living with one or more smokers, urban residence, occupation of father (Armed forces), parental-reported exposure to SHS and education of the father (Diploma/Technical certificate). CONCLUSIONS This is the first study to characterise exposures to SHS using salivary cotinine concentrations among schoolchildren in Malaysia and also the first study documenting SHS exposure using salivary cotinine as a biomarker in a South-East Asian population of schoolchildren. Compared to other populations of similarly aged schoolchildren, Malaysian children have higher salivary cotinine concentrations. The partial nature of smoke-free restrictions in Malaysia is likely to contribute to these findings. Enforcement of existing legislation to reduce exposure in public place settings and interventions to reduce exposure at home, especially to implement effective home smoking restriction practices are required.
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Affiliation(s)
- Emilia Zainal Abidin
- Scottish Centre for Indoor Air, Environmental & Occupational Medicine, Population Health, Division of Applied Health Sciences, School of Medicine and Dentistry, Polwarth Building, Foresterhill, University of Aberdeen, AB25 2ZD Aberdeen, UK
| | - Sean Semple
- Scottish Centre for Indoor Air, Environmental & Occupational Medicine, Population Health, Division of Applied Health Sciences, School of Medicine and Dentistry, Polwarth Building, Foresterhill, University of Aberdeen, AB25 2ZD Aberdeen, UK
| | - Affandi Omar
- Biochemistry Unit, Specialised Diagnostic Unit, Institute of Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Hejar A Rahman
- Department of Community Health, Faculty of Medicine and Health Science, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Stephen W Turner
- Child Health, University of Aberdeen, Royal Aberdeen Children's Hospital, Aberdeen AB25 2ZG Scotland UK
| | - Jon G Ayres
- Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston Birmingham, B15 2TT, UK
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