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van der Eijk Y, Woh J. Is secondhand smoke associated with mental health issues? A narrative review of the evidence and policy implications. Health Policy 2023; 136:104900. [PMID: 37651970 DOI: 10.1016/j.healthpol.2023.104900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/20/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023]
Abstract
Secondhand smoke (SHS) is a well-established cause of lung cancer, respiratory disease, heart disease and developmental issues in children, with an overwhelming evidence base spanning over four decades. In this narrative review, we describe studies which have also linked self-reported or cotinine-assessed SHS exposure in the home, workplace and other settings to mental health disorders including depression, suicide, anxiety, and psychological distress in children and adults, sleeping disorders, Attention Deficit Hyperactivity Disorder and behavioural issues in children, and dementia in older adults. In general, evidence indicates that SHS exposure is associated with these disorders in a dose-response manner, with higher odds reported in people who are exposed to SHS at high levels, frequently, and in the home environment. Most studies so far are cross-sectional albeit in large, nationally representative samples from various countries with a smaller number of longitudinal studies. More research is needed in this area to determine whether SHS is a direct cause of adverse mental health outcomes, and whether creating smokefree environments leads to improved mental wellbeing. In particular, more research is needed on the impact of smokefree home environments, an area which has received relatively little focus in smokefree interventions which generally target public places.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, MD1 Tahir Foundation Building, National University of Singapore, 12 Science Drive 2 #09-01C, 117549, Singapore.
| | - Joanne Woh
- Saw Swee Hock School of Public Health, MD1 Tahir Foundation Building, National University of Singapore, 12 Science Drive 2 #09-01C, 117549, Singapore
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Payne-Sturges DC, Taiwo TK, Ellickson K, Mullen H, Tchangalova N, Anderko L, Chen A, Swanson M. Disparities in Toxic Chemical Exposures and Associated Neurodevelopmental Outcomes: A Scoping Review and Systematic Evidence Map of the Epidemiological Literature. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:96001. [PMID: 37754677 PMCID: PMC10525348 DOI: 10.1289/ehp11750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/29/2023] [Accepted: 08/10/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Children are routinely exposed to chemicals known or suspected of harming brain development. Targeting Environmental Neuro-Development Risks (Project TENDR), an alliance of > 50 leading scientists, health professionals, and advocates, is working to protect children from these toxic chemicals and pollutants, especially the disproportionate exposures experienced by children from families with low incomes and families of color. OBJECTIVE This scoping review was initiated to map existing literature on disparities in neurodevelopmental outcomes for U.S. children from population groups who have been historically economically/socially marginalized and exposed to seven exemplar neurotoxicants: combustion-related air pollution (AP), lead (Pb), mercury (Hg), organophosphate pesticides (OPs), phthalates (Phth), polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs). METHODS Systematic literature searches for the seven exemplar chemicals, informed by the Population, Exposure, Comparator, Outcome (PECO) framework, were conducted through 18 November 2022, using PubMed, CINAHL Plus (EBSCO), GreenFILE (EBSCO), and Web of Science sources. We examined these studies regarding authors' conceptualization and operationalization of race, ethnicity, and other indicators of sociodemographic and socioeconomic disadvantage; whether studies presented data on exposure and outcome disparities and the patterns of those disparities; and the evidence of effect modification by or interaction with race and ethnicity. RESULTS Two hundred twelve individual studies met the search criteria and were reviewed, resulting in 218 studies or investigations being included in this review. AP and Pb were the most commonly studied exposures. The most frequently identified neurodevelopmental outcomes were cognitive and behavioral/psychological. Approximately a third (74 studies) reported investigations of interactions or effect modification with 69% (51 of 74 studies) reporting the presence of interactions or effect modification. However, less than half of the studies presented data on disparities in the outcome or the exposure, and fewer conducted formal tests of heterogeneity. Ninety-two percent of the 165 articles that examined race and ethnicity did not provide an explanation of their constructs for these variables, creating an incomplete picture. DISCUSSION As a whole, the studies we reviewed indicated a complex story about how racial and ethnic minority and low-income children may be disproportionately harmed by exposures to neurotoxicants, and this has implications for targeting interventions, policy change, and other necessary investments to eliminate these health disparities. We provide recommendations on improving environmental epidemiological studies on environmental health disparities. To achieve environmental justice and health equity, we recommend concomitant strategies to eradicate both neurotoxic chemical exposures and systems that perpetuate social inequities. https://doi.org/10.1289/EHP11750.
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Affiliation(s)
| | | | - Kristie Ellickson
- Minnesota Pollution Control Agency, St. Paul, Minnesota, USA
- Union of Concerned Scientists, Cambridge, Massachusetts, USA
| | - Haley Mullen
- Department of Geographical Sciences, University of Maryland, College Park, Maryland, USA
| | | | - Laura Anderko
- M. Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Aimin Chen
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Min J, Park JE, Kim SY, Kim YY, Park JH. Growing disparity in the prevalence of chronic obstructive pulmonary disease between people with and without disabilities: a Korean nationwide serial cross-sectional study. Sci Rep 2023; 13:13205. [PMID: 37580327 PMCID: PMC10425333 DOI: 10.1038/s41598-023-39319-8] [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: 08/29/2022] [Accepted: 07/23/2023] [Indexed: 08/16/2023] Open
Abstract
Few studies have examined the association between disability and chronic obstructive pulmonary disease (COPD). We compared the trends in the annual COPD prevalence between people with and without disabilities, and examined the association between disability and COPD. We linked the National Health Information Database (2008-2017) with the National Disability Registration Database, which includes more than 2 million people with disabilities every year. In the 2017 dataset, people with disabilities had a higher prevalence of COPD than those without disabilities (30.6% vs. 12.5%, P < 0.001). The age-standardized prevalence rate of COPD among people without disabilities increased from 4.2 in 2008 to 10.9% in 2017 (change of 6.7%), whereas that among those with disabilities increased from 7.0 to 17.1% (change of 10.1%). In multivariate analysis, compared to people without disabilities, those with disabilities had a higher probability of having COPD (adjusted odds ratio, 1.42; 95% confidence interval 1.42-1.43). The results of subgroup analysis by disability characteristics suggested that disabilities due to failure of an organ, such as the kidney, lung, heart, or liver, and severe disabilities were particularly vulnerable to COPD. In conclusion, people with disabilities are more likely to have COPD compared to people without disabilities. Further longitudinal studies that examine cause-and-effect relationship between disability and COPD are needed to clarify this relationship and to further investigate any potential negative effects associated with the coexistence of these conditions.
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Affiliation(s)
- Jinsoo Min
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jong Eun Park
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju, South Korea
| | - So Young Kim
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju, South Korea
- Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju, South Korea
| | - Yeon Yong Kim
- Big Data Steering Department, National Health Insurance Service, Wonju, South Korea
- Drug Evaluation Department, National Institute of Food and Drug Safety Evaluation, Cheongju, South Korea
| | - Jong Hyock Park
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju, South Korea.
- Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju, South Korea.
- Department of Medicine, College of Medicine, Chungbuk National University, Cheongju, South Korea.
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Lee S, Lee W. The association between attention deficit hyperactivity disorder (ADHD) and smoking experience or exposure to environmental tobacco smoke among children and adolescents. Tob Induc Dis 2023; 21:15. [PMID: 36762265 PMCID: PMC9885444 DOI: 10.18332/tid/157209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/01/2022] [Accepted: 12/06/2022] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Direct and indirect smoking exposure is highly related to mental health in children. This study aimed to identify the association between exposure to smoking or secondhand smoke (SHS) and attention deficit hyperactivity disorder (ADHD). METHODS We used data from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2019, including variables such as diagnosed ADHD, smoking status, SHS, and urine cotinine levels among children and adolescents. We estimated the risk of ADHD according to smoking or SHS exposure in various exposure groups using adjusted logistic or linear regression models. RESULTS Among 16434 participants, 133 children were diagnosed with ADHD (0.8%). Of these, 58 (43.6%) were aged <12 years and 75 (56.3%) were aged ≥12 years. Smoking was significantly associated with ADHD (crude odds ratio, OR=1.48; 95% CI: 1.14-3.26 and adjusted odds ratio, AOR=1.22; 95% CI: 1.02- 1.64). SHS exposure and ADHD were attenuated after adjustment (OR=2.42; 95% CI: 1.08-4.02; AOR=1.42; 95% CI: 0.86-2.64) in the logistic regression model. Smoking history was statistically associated with a younger age of ADHD diagnosis in the linear regression model. CONCLUSIONS Smoking and the amount of smoking among children and adolescents was associated with ADHD.
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Affiliation(s)
- Sunho Lee
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
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Liu B, Fang X, Strodl E, He G, Ruan Z, Wang X, Liu L, Chen W. Fetal Exposure to Air Pollution in Late Pregnancy Significantly Increases ADHD-Risk Behavior in Early Childhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710482. [PMID: 36078201 PMCID: PMC9518584 DOI: 10.3390/ijerph191710482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Air pollution nowadays has seriously threatened the health of the Chinese population, especially in the vulnerable groups of fetuses, infants and toddlers. In particular, the effects of air pollution on children's neurobehavioral development have attracted widespread attention. Moreover, the early detection of a sensitive period is very important for the precise intervention of the disease. However, such studies focusing on hyperactive behaviors and susceptible window identification are currently lacking in China. OBJECTIVES The study aims to explore the correlation between air pollution exposure and hyperactive behaviors during the early life stage and attempt to identify whether a susceptible exposure window exists that is crucial for further precise intervention. METHODS Based on the Longhua Child Cohort Study, we collected the basic information and hyperactivity index of 26,052 children using a questionnaire conducted from 2015 to 2017, and the Conners' Parent Rating Scale-revised (CPRS-48) was used to assess hyperactive behaviors. Moreover, the data of air pollution concentration (PM10, PM2.5, NO2, CO, O3 and SO2) were collected from the monitoring station between 2011 to 2017, and a land-use random forest model was used to evaluate the exposure level of each subject. Furthermore, Distributed lag non-linear models (DLNMs) were applied for statistic analysis. RESULTS The risk of child hyperactivity was found to be positively associated with early life exposure to PM10, PM2.5 and NO2. In particular, for an increase of per 10 µg/m3 in PM10, PM2.5 and NO2 exposure concentration during early life, the risk of child hyperactivity increased significantly during the seventh month of pregnancy to the fourth month after birth, with the strongest association in the ninth month of pregnancy (PM10: OR = 1.043, 95% CI: 1.016-1.071; PM2.5: OR = 1.062, 95% CI: 1.024-1.102; NO2: OR = 1.043, 95% CI: 1.016-1.071). However, no significant associations among early life exposure to CO, O3 and SO2 and child hyperactive behaviors were observed. CONCLUSIONS Early life exposure to PM10, PM2.5 and NO2 is associated with an increased risk of child ADHD-like behaviors at the age around 3 years, and the late-prenatal and early postnatal periods might be the susceptible exposure windows.
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Affiliation(s)
- Binquan Liu
- Nanjing Institute of Geography and Limnology, Chinese Academy of Sciences, Nanjing 210006, China
| | - Xinyu Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
- Department of Public Health and Health Administration, Clincial College of Anhui Medical University, Hefei 230031, China
- Anhui Province Laboratory of Inflammation and Immune Mediated Disease, Hefei 230032, China
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Guanhao He
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zengliang Ruan
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ximeng Wang
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Li Liu
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Weiqing Chen
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- Department of Information Management, Xinhua College of Sun Yat-sen University, Guangzhou 510080, China
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Gao Y, Wang T, Duan Z, Pu Y, Zhang J. The association between neurodevelopmental and behavioral problems and tobacco smoke exposure among 3-17 years old children. Front Public Health 2022; 10:881299. [PMID: 36033778 PMCID: PMC9399492 DOI: 10.3389/fpubh.2022.881299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/11/2022] [Indexed: 01/21/2023] Open
Abstract
Children being exposed to tobacco smoke can lead to poor developmental and behavioral problems. We aimed to explore the correlation between neurodevelopmental and behavioral problems (NBPs) and tobacco smoke exposure (TSE) among children aged 3-17 years. In this study, data were obtained from the 2018-2019 U.S. National Survey of Children's Health (NSCH). Children in the range of 3-17 years old were taken as the research subjects, and their parents were surveyed through questionnaires. TSE status was defined as one of three groups: no tobacco smoke exposure (no TSE), someone smoking but not inside the house (no home TSE), and someone smoking inside the house (home TSE). NBPs mainly included behavioral or conduct problems, intellectual disability, learning disability, speech or other language disorders, and developmental delay. We used the sampling weights provided by the NSCH to weight the data in order to obtain an unbiased population estimate. One-way ANOVA and Chi-square tests were performed to examine the difference of each variable. Logistic regression analysis and stratified analysis were carried out to investigate the association between NBPs and TSE. A total of 48,783 children were included in this study, with an average age of 10.1 years. In total 17.9% of all the participants were preschool children, 35.1% were school-age children, and 47.0% were school-age adolescents. More than 85.0% of children lived with no TSE. Over 90.0% of children were healthy in each NBP. Children living with home TSE and no home TSE showed significant adjusted odds ratios (aORs) compared with no TSE in four NBPs besides intellectual disability. The stratified analysis found aORs were higher for NBPs in preschool children compared to the school-age children and school-age adolescents. Male children living with home TSE showed higher aORs in moderate/severe NBP conditions. Our study indicated it is necessary to protect the health of young children from TSE by intervention measures.
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Hashemi-Aghdam MR, Shafiee G, Ebrahimi M, Ejtahed HS, Yaseri M, Motlagh ME, Qorbani M, Heshmat R, Kelishadi R. Trend of passive smoking and associated factors in Iranian children and adolescents: the CASPIAN studies. BMC Public Health 2022; 22:603. [PMID: 35351076 PMCID: PMC8962519 DOI: 10.1186/s12889-022-13045-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 03/22/2022] [Indexed: 01/19/2023] Open
Abstract
Background It is well documented that, similar to active smokers, passive smokers are also at an increased risk of developing non-communicable diseases, and it could impose high financial costs on the healthcare system. This study aimed to evaluate the trend of passive smoking and related determinants during the three phases of a school-based surveillance program. Methods This is a secondary study using the national data obtained from three phases of the surveillance program entitled The Childhood and Adolescence Surveillance and Prevention of Adult Noncommunicable Disease (CASPIAN) study, conducted from 2008 to 2014 on Iranian children and adolescents living in urban and rural areas of 30 provinces in Iran. Participants were selected by cluster multistage sampling method. Results Overall, the study participants consisted of 33,288 students (50.5% boys) with a mean (± SD) age of 12.8 ± 3.2 years. The passive smoking rate was significantly increased from 35.6% in 2008 to 43.2% in 2015 among children and adolescents. According to the multivariate logistic regression, father’s university education, mother’s employment, life satisfaction, and socioeconomic status had a protective role regarding second-hand smoke exposure. In contrast, the father’s self-employment had a positive role in increasing the rate of passive smoking. Conclusion Considering the increasing trend of passive smoking and its considerable adverse health effects, it is necessary to implement large-scale public interventions to reduce the rate and hazards of exposure to tobacco smoke.
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Lallai V, Manca L, Sherafat Y, Fowler CD. Effects of Prenatal Nicotine, THC, or Co-Exposure on Cognitive Behaviors in Adolescent Male and Female Rats. Nicotine Tob Res 2022; 24:1150-1160. [PMID: 35090174 PMCID: PMC9278841 DOI: 10.1093/ntr/ntac018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/26/2021] [Accepted: 01/26/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Although there has been a decrease in the prevalence of tobacco smoking, exposure to nicotine during pregnancy remains a substantial problem worldwide. Further, given the recent escalation in e-cigarette use and legalization of cannabis, it has become essential to understand the effects of nicotine and cannabinoid co-exposure during early developmental stages. AIMS AND METHODS We systematically examined the effects of nicotine and/or THC prenatal exposure on cognitive behaviors in male and female offspring. Dams were exposed to nicotine vape or vehicle, and oral edible THC or vehicle, throughout pregnancy. Adolescent offspring were then tested in the prepulse inhibition test, novel object recognition task, and novelty suppressed feeding task. RESULTS At birth, pups from mothers exposed to nicotine vape or oral THC exhibited reduced body weight, compared to control pups. Prenatal nicotine vape exposure resulted in a decreased baseline startle reactivity in adolescent male and female rats, and in females, enhanced sensorimotor gating in the prepulse inhibition test. Prenatal nicotine and THC co-exposure resulted in significant deficits in the prepulse inhibition test in males. Deficits in short-term memory were also found in males prenatally exposed to THC, either alone or with nicotine co-exposure, and in females exposed to THC alone. Finally, in males, a modest increase in anxiety-associated behaviors was found with THC or nicotine exposure in the latency to approach a novel palatable food. CONCLUSIONS These studies demonstrate differential effects of prenatal exposure to e-cigarette nicotine vape and/or edible THC on cognitive function, with differing effects within male and female groups. IMPLICATIONS These studies demonstrate an impact of nicotine, THC, or co-exposure during early developmental stages in utero on behavioral outcomes in adolescence. These findings have important translational implications given the continued use of nicotine and THC containing products by pregnant women worldwide, which can be applied to support healthcare and policy efforts restricting nicotine and THC use during pregnancy.
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Affiliation(s)
- Valeria Lallai
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA 92697, USA
| | - Letizia Manca
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA 92697, USA
| | - Yasmine Sherafat
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA 92697, USA
| | - Christie D Fowler
- Corresponding Author: Christie D. Fowler, PhD, Department of Neurobiology and Behavior, University of California Irvine, 1232 McGaugh Hall, Irvine, CA 92697-4550, USA. Telephone: 949-824-8363; Fax: 949-824-2447; E-mail:
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Paraje G, Valdés N. Changes in parental smoking behavior and children's health status in Chile. Prev Med 2021; 153:106792. [PMID: 34506821 DOI: 10.1016/j.ypmed.2021.106792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/26/2021] [Accepted: 09/05/2021] [Indexed: 11/18/2022]
Abstract
Studies on parental smoking behavior have mostly been conducted for developed countries and show that current parental smoking is negatively associated with children's current health. Using four waves of a Chilean longitudinal survey (Encuesta de Protección Social), we estimate probit and ordinary least squares models relating parents' self-report of their children's current health status to several covariates, including current parental smoking status and change (transitions) in parental smoking status across the waves of the survey. The data were collected in the years 2004, 2006, 2009, and 2015. The working sample includes 25,052 observations. The study revealed that parents' self-report of their children's current health status is strongly associated with current and past parental smoking status. Parents who smoke have an increased 11.17% probability of reporting that their children are in fair, poor, or very poor health status, when compared to non-smoking parents. The effect is stronger if the smoker is the mother, and it is exacerbated if she is less educated or unemployed/inactive. In addition, quitting smoking has a significant positive effect on children's reported health status, which is greater if the mother quits smoking. Cessation among mothers who are unemployed or inactive is also associated with a more positive assessment of their children's health status. The findings suggest that cessation programs may have health benefits not only for smoking parents, but also for their children. Improving coverage or establishing a national cessation program may have important present and future effects on population health and well-being.
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Affiliation(s)
- Guillermo Paraje
- Escuela de Negocios, Universidad Adolfo Ibáñez, Avenida Diagonal Las Torres 2640, Peñalolén, Santiago de Chile, Chile.
| | - Nieves Valdés
- Escuela de Negocios, Universidad Adolfo Ibáñez, Avenida Diagonal Las Torres 2640, Peñalolén, Santiago de Chile, Chile.
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Jackson DB, Testa A. Environmental Tobacco Smoke and Early Language Difficulties among U.S. Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6489. [PMID: 34208503 PMCID: PMC8296409 DOI: 10.3390/ijerph18126489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/09/2021] [Accepted: 06/12/2021] [Indexed: 11/16/2022]
Abstract
Objective: Environmental Tobacco Smoke (ETS) is a serious public health concern with the potential to interfere with various components of healthy child development. Even so, there has been limited nationally representative research investigating these connections. The current study examines the relationship between ETS and language difficulties among toddlers and preschool-aged children in the United States. Method: Data are derived from the 2018 National Survey of Children's Health and facilitate strategic comparisons between different forms of ETS-namely, children who live with family members who smoke vs. children whose family members smoke inside the housing unit. Results: The findings reveal a robust association between family members smoking inside the housing unit and both receptive and expressive language difficulties, but only among male children. After adjusting for covariates, smoking inside the housing unit is associated with a 182% increase in the rate of early composite language difficulties among male children. These associations persist even when compared to male children who live with smoking family members who do not smoke inside the housing unit. Conclusions: The findings suggest a need for interventions designed to reduce ETS in households with young children and increase targeted language skill training for vulnerable children in an effort to enhance child development and well-being. To maximize this effort, we advocate for interdisciplinary teams, including medical and public health practitioners, educators, and researchers, to work together to develop and implement evidence-based strategies to limit ETS in homes and facilitate healthy language development among young children.
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Affiliation(s)
- Dylan B. Jackson
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Alexander Testa
- Department of Criminology & Criminal Justice, University of Texas at San Antonio, San Antonio, TX 78249, USA;
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Lin LZ, Xu SL, Wu QZ, Zhou Y, Ma HM, Chen DH, Chen GB, Yu HY, Yang BY, Zeng XW, Hu LW, Dong GH. Association of Prenatal, Early Postnatal, or Current Exposure to Secondhand Smoke With Attention-Deficit/Hyperactivity Disorder Symptoms in Children. JAMA Netw Open 2021; 4:e2110931. [PMID: 34014325 PMCID: PMC8138689 DOI: 10.1001/jamanetworkopen.2021.10931] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
IMPORTANCE Few studies have investigated the association between the exposure window (prenatal, early postnatal, and current period) of secondhand smoke (SHS) and attention-deficit/hyperactivity disorder (ADHD) symptoms and subtypes in children. OBJECTIVE To evaluate the associations of prenatal, early postnatal, or current SHS exposure with ADHD symptoms and subtypes among school-aged children. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, 48 612 children aged 6 to 18 years from elementary and middle schools in Liaoning province, China, between April 2012 and January 2013 were eligible for participation. Data on SHS exposure and ADHD symptoms and subtypes for each child were collected via questionnaires administered to parents or guardians by school teachers. Data were analyzed from September 14 to December 2, 2020. MAIN OUTCOMES AND MEASURES The ADHD symptoms and subtypes (inattention, hyperactivity-impulsivity, and combined) were measured based on a validated tool developed from the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Generalized linear mixed models were evaluated to estimate the association of SHS exposure with ADHD symptoms and subtypes. RESULTS A total of 45 562 participants completed the questionnaires and were included in this study (22 905 girls [50.3%]; mean [SD] age, 11.0 [2.6] years; 2170 [4.8%] with ADHD symptoms). Compared with their unexposed counterparts, children who were ever exposed (odds ratio [OR], 1.50; 95% CI, 1.36-1.66) or always exposed to SHS (OR, 2.88; 95% CI, 2.55-3.25) from pregnancy to childhood had higher odds of having ADHD symptoms and subtypes (ORs ranged from 1.46 [95% CI, 1.31-1.62] to 2.94 [95% CI, 2.09-4.13]). Compared with their unexposed counterparts, children with SHS exposure had higher odds of having ADHD symptoms when exposed in the prenatal period (OR, 2.28; 95% CI, 2.07-2.51), early postnatal period (OR, 1.47; 95% CI, 1.29-1.68), or current period (OR, 1.20; 95% CI, 1.09-1.31). Compared with their unexposed counterparts, children whose fathers smoked 10 or more cigarettes/d on both weekdays and weekends had higher odds of having ADHD symptoms and subtypes (ORs ranged from 1.48 [95% CI, 1.28-1.70] to 2.25 [95% CI, 1.29-3.93]). CONCLUSIONS AND RELEVANCE Being exposed to SHS from pregnancy to childhood was associated with higher odds of having ADHD symptoms and subtypes among school-aged children, and the associations were somewhat stronger for SHS exposure during prenatal and early postnatal periods. Our findings highlight the important public health implications of reducing SHS exposure, which may decrease the health and economic burdens of individuals with ADHD.
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Affiliation(s)
- Li-Zi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shu-Li Xu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qi-Zhen Wu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, China
| | - Hui-Min Ma
- State Key Laboratory of Organic Geochemistry and Guangdong Key Laboratory of Environmental Protection and Resources Utilization, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou, China
| | - Duo-Hong Chen
- Department of Air Quality Forecasting and Early Warning, Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangdong Environmental Protection Key Laboratory of Atmospheric Secondary Pollution, Guangzhou, China
| | - Gong-Bo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hong-Yao Yu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Wen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li-Wen Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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12
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Merianos AL, Nabors LA, Fiser KA, Mahabee-Gittens EM. Exposure to Tobacco Smoke and Temperament among U.S. Children 0-5 Years Old. J Pediatr Psychol 2021; 46:454-464. [PMID: 33355348 PMCID: PMC8056209 DOI: 10.1093/jpepsy/jsaa123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study examined the association between tobacco smoke exposure (TSE) and temperament among children 0-5 years old overall and within age groups: 0-2 and 3-5 years. METHODS Data were obtained from the 2017-2018 NSCH (N = 14,345). TSE status was defined as whether children lived with a smoker who: does not smoke inside the home (no home TSE) or smokes inside the home (home TSE). We conducted logistic regression analyses while controlling for covariates. RESULTS Overall, 12.5% of children lived with a smoker with no home TSE and 1.1% had home TSE. Children with home TSE were at increased odds to not always: be affectionate and tender (aOR = 1.74, 95% CI = 1.18-2.58), show interest and curiosity (aOR = 1.81, 95% CI = 1.23-2.68), and smile and laugh (aOR = 1.77, 95% CI = 1.13-2.77) than those with no TSE. Among 0- to 2-year-olds, those with home TSE were more likely to not always be affectionate and tender (aOR = 1.97, 95% CI = 1.04-3.74). Among 3- to 5-year-olds, those who lived with a smoker with no home TSE were more likely to not always: bounce back quickly (aOR = 1.21, 95% CI = 1.05-1.40) and smile and laugh (aOR = 1.26, 95% CI = 1.03-1.54), and those with home TSE were more likely to not always: show interest and curiosity (aOR = 2.24, 95% CI = 1.40-3.59) and smile and laugh (aOR = 2.43, 95% CI = 1.43-4.11). CONCLUSIONS Tobacco smoke-exposed children were at increased odds of not always demonstrating positive early childhood temperament behaviors, with 3- to 5-year-olds having more pronounced odds.
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Affiliation(s)
| | | | | | - E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, College of Medicine, University of Cincinnati
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13
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Nabi-Burza E, Drehmer JE, Walters BH, Willemsen MC, Zeegers MPA, Winickoff JP. Smoking Cessation Treatment for Parents Who Dual Use E-Cigarettes and Traditional Cigarettes. J Smok Cessat 2021; 2021:6639731. [PMID: 34306227 PMCID: PMC8279196 DOI: 10.1155/2021/6639731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 02/15/2021] [Accepted: 02/25/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION An increasing number of parents use both e-cigarettes and cigarettes (dual users). Previous studies have shown that dual users may have higher rates of contemplating smoking cessation than parents who only smoke cigarettes. This study was aimed to assess the delivery of tobacco cessation treatment (prescription for nicotine replacement therapy and referral to the quitline) among parents who report being dual users vs. cigarette-only smokers. METHODS A secondary analysis of parent survey data collected between April and October 2017 at 10 pediatric primary care practices participating in a cluster-randomized controlled trial of the Clinical Effort Against Secondhand Smoke Exposure (CEASE) intervention was conducted. Parents were considered to be dual users of cigarettes and e-cigarettes if they reported smoking a cigarette, even a puff, in the past seven days and using an e-cigarette within the past 30 days. Parents were asked if they received a prescription for nicotine replacement therapy and referral to the quitline to help them quit from their child's clinician. Multivariable logistic regression examined factors (dual use, insurance status, relationship to the child, race, and education status of the parent) associated with delivery of smoking cessation treatment (receiving prescriptions and/or enrollment in quitline) to smoking parents. Further, we compared the rates of tobacco cessation treatment delivery to dual users in the usual-care control practices vs. intervention practices. RESULTS Of 1007 smokers or recent quitters surveyed in the five intervention practices, 722 parents reported current use of cigarettes-only and 111 used e-cigarettes. Of these 111 parents, 82 (73.9%) reported smoking cigarettes. Parents were more likely to report receiving any treatment if they were dual users vs. cigarette-only smokers (OR 2.43, 95% CI 1.38, 4.29). Child's insurance status, parents' sex, education, and race were not associated with parental receipt of tobacco cessation treatment in the model. No dual users in the usual-care control practices reported receiving treatment. Discussion. Dual users who visited CEASE intervention practices were more likely to receive treatment than cigarette-only smokers when treatments were discussed. An increased uptake of tobacco cessation treatments among dual users reinforces the importance of discussing treatment options with this group, while also recognizing that cigarette-only smokers may require additional intervention to increase the acceptance rate of cessation assistance. This trial is registered with ClinicalTrials.gov, Identifier: NCT01882348.
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Affiliation(s)
- Emara Nabi-Burza
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, USA
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, USA
| | - Jeremy E. Drehmer
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, USA
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, USA
| | - Bethany Hipple Walters
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, USA
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, USA
| | - M. C. Willemsen
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
- Dutch Alliance for a Smokefree Society, The Hague, NL, Netherlands
| | - Maurice P. A. Zeegers
- Nutrition and Translational Research in Metabolism (School NUTRIM), Maastricht University, Maastricht, Netherlands
- Care and Public Health Research Institute (School CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Jonathan P. Winickoff
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, USA
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Itasca, IL, USA
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14
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Prenatal alcohol and tobacco use and the risk of depression in offspring at age of 17 years: findings from the Raine Study. J Affect Disord 2021; 279:426-433. [PMID: 33120243 DOI: 10.1016/j.jad.2020.10.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/07/2020] [Accepted: 10/12/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Prenatal alcohol and tobacco exposures have been associated with adverse mental health consequences in offspring. The objective of this study was to test the associations between maternal prenatal alcohol and tobacco exposures and depressive symptoms in the offspring, adjusting for a wide range of potential confounders. METHODS We used data from 1168 mother-offspring pairs from the Raine Study based in Perth, Western Australia. Depressive symptoms at age 17 years were measured using the Beck Depression Inventory for Youth (BDI-Y). Associations between prenatal alcohol and tobacco use and the risk of depressive symptoms in offspring were estimated by risk ratios (RR) derived with multivariable log-binomial regression. RESULTS Among offspring who were assessed for depressive symptoms, 5% were born to mothers who consumed six or more standard drinks of alcohol per week during pregnancy and 20% were exposed to prenatal tobacco. After adjustment for confounders, depressive symptoms at the age of 17 years remained associated with maternal alcohol use of six or more standard drinks per week [RR 1.59 (95% CI: 1.11-2.26)] and any tobacco use [RR 1.36 (95% CI: 1.05-1.79)] during the first trimester of pregnancy. CONCLUSION Offspring exposed to prenatal alcohol and tobacco use had greater risks of depressive symptoms compared with unexposed offspring, suggesting early screening and prevention of these exposures could possibly reduce depressive symptoms in offspring.
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Hamidzadeh A, Kharatha M, Bazghaleh M, Basirinejad H, Aghdam NF, Ebrahimi H. The prevalence of attention-deficit hyperactivity disorder and its related risk factors among children at elementary school in Shahroud. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:341. [PMID: 34761027 PMCID: PMC8552256 DOI: 10.4103/jehp.jehp_46_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/17/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is one of the most common reasons for visiting psychiatrists and psychologists. This study aimed to investigate the prevalence of ADHD and its related risk factors among children at elementary schools. MATERIALS AND METHODS This cross-sectional study focused on teachers and parents of 779 elementary students who were selected through stratified cluster random sampling; Conners Parent and Teacher Questionnaires were used to collecting data. The data were analyzed by the use of descriptive statistics (frequency and percentage), independent samples t-test, Chi-square, one-way ANOVA, and linear regression. The significant level was set at 0.05. RESULTS According to teachers' responses, the prevalence of ADHD among students in elementary schools was 4.4%, whereas parents reported a prevalence of 0.5%. There was a significant relationship between childhood ADHD and marital status of parents, fathers' smoking habits, previous experience of living in rural areas, children's previous history of having diseases and using the medicine, previous history of ADHD, and psychological problems in the family. CONCLUSIONS According to the study, teachers and parents suffer from a lack of knowledge about ADHD. Thus, the educational workshops and programs should be held for teachers, parents, and counselors to inform them about the procedures for timely diagnosis and treatment of ADHD.
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Affiliation(s)
- Azam Hamidzadeh
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mehrnaz Kharatha
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Milad Bazghaleh
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hassan Basirinejad
- Department of Epidemiology, School of Epidemiology and Biostatics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Fadae Aghdam
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Ebrahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
- Address for correspondence: Dr. Hossein Ebrahimi, Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran. E-mail:
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16
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Huang A, Wu K, Cai Z, Lin Y, Zhang X, Huang Y. Association between postnatal second-hand smoke exposure and ADHD in children: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:1370-1380. [PMID: 33097989 DOI: 10.1007/s11356-020-11269-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 10/14/2020] [Indexed: 02/05/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder which is caused by the interplay of genetic and environmental risk factors such as second-hand smoke (SHS). The association between postnatal exposure to SHS and ADHD risk in children was still inconclusive. We performed a systematic review and meta-analysis to explore the definite association. We searched for relevant studies from PubMed, Embase, Ovid, and Web of Science databases up to January 2020. We used random effect models to calculate pooled odds ratio (OR) with 95% confidence interval (CI). Subgroup analyses and sensitive analyses were also performed to solve the heterogeneity. According to our inclusion criteria, 9 studies including 6 cross-sectional studies, 2 cohort studies, and 1 case-control study were included in the final analysis. Postnatal exposure to SHS increased the risk of ADHD in children (OR: 1.60; 95% CI: 1.37-1.87). Children who exposed to SHS were found a slight risk for conduct problems (OR: 1.33, 95% CI: 1.00-1.77). Among the studies which used cotinine as a biomarker for SHS exposure, a lower pooled OR (OR = 1.16, 95%CI = 1.01, 1.33) was observed between cotinine and ADHD in children. Our meta-analysis results suggested that SHS exposure may be a risk factor for ADHD. We also found that SHS exposure may be associated with some adverse behavioral outcomes. More prospective studies should be conducted to confirm the relationship between SHS exposure and ADHD in children.
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Affiliation(s)
- Anyan Huang
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China
| | - Kusheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China.
| | - Zemin Cai
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China
| | - Yuhang Lin
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China
| | - Xuanzhi Zhang
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China
| | - Yanhong Huang
- Mental Health Center, Shantou University Medical College, North Taishan Road, Shantou, 515065, Guangdong Province, China.
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Park B, Park B, Kim EJ, Kim YJ, Lee H, Ha EH, Park H. Longitudinal association between environmental tobacco smoke exposure and behavioral problems in children from ages 5 to 9. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 746:141327. [PMID: 32758989 DOI: 10.1016/j.scitotenv.2020.141327] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/01/2020] [Accepted: 07/27/2020] [Indexed: 06/11/2023]
Abstract
Few studies have assessed the cumulative effects of exposure to environmental tobacco smoke (ETS1) in relation to children's neurobehavioral problems over time. We assessed the longitudinal associations between ETS exposure at age 5 and behavioral problems at ages 5, 7, and 9 using the Ewha Birth and Growth Cohort, in Seoul, Korea. Children with available urinary cotinine levels at age 5 and one or more behavioral problem scores measured with the Korean Version of Child Behavior Checklist (CBCL2) at age 5, 7, and 9 were included in the study. Those whose mothers smoked during pregnancy were excluded, and a total of 179 children were included in the analysis. A linear mixed-model analysis using a REPEATED statement was conducted to assess whether ETS exposure was associated with the total, internalizing, and externalizing behavioral problem scores of the CBCL. The group with higher levels of cotinine showed continuously higher total and external behavioral problem scores from ages 5 to 9, which was seen after adjusting for preterm birth, father's education level, and television watching time. In addition, the difference in the total and external behavioral problem scores between the higher and lower cotinine groups at age 5 was statistically significant after a Bonferroni correction (p = 0.02 and 0.04, respectively), even though the fixed effect of cotinine level was almost but not statistically significant (p = 0.07 and 0.08, respectively). The results of this longitudinal cohort study provide evidence regarding the negative effects of ETS exposure in early childhood and their behavioral problems over time. This study supports the strengthening of anti-smoking policies used in educational interventions for parents, in order to reduce early ETS exposure in children.
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Affiliation(s)
- Bomi Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, Republic of Korea; National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Republic of Korea.
| | - Bohyun Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, Republic of Korea.
| | - Eui-Jung Kim
- Department of Psychiatry, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, Republic of Korea.
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, Republic of Korea.
| | - Hwayoung Lee
- Department of Anatomy, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, Republic of Korea.
| | - Eun-Hee Ha
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, Republic of Korea.
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, 25, Magokdong-ro 2-gil, Gangseo-gu, Seoul, Republic of Korea.
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18
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Duko B, Ayano G, Pereira G, Betts K, Alati R. Prenatal tobacco use and the risk of mood disorders in offspring: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1549-1562. [PMID: 32895729 DOI: 10.1007/s00127-020-01949-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/01/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE It is plausible that offspring born to mothers using tobacco during pregnancy may have increased risk of mood disorders (depression and bipolar disorders); however, mixed results have been reported. We conducted a systematic review and meta-analysis to investigate the magnitude and consistency of associations reported between prenatal tobacco use and mood disorders in offspring. METHODS We systematically searched EMBASE, SCOPUS, PubMed and Psych-INFO for studies on mood disorders and prenatal tobacco use. Methodological quality of studies was assessed with the revised Newcastle-Ottawa Scale. We estimated pooled relative risk (RR) with inverse variance weighted random-effects meta-analysis. We performed leave-one-out analyses, and stratified analyses by a subgroup (depression and bipolar disorder). Potential publication bias was assessed by inspection of the funnel plot and Egger's test for regression asymmetry. This study protocol was prospectively registered in PROSPERO (CRD42017060037). RESULTS Eight cohort and two case-control studies were included in the final meta-analysis. We found an increased pooled relative risk of mood disorders in offspring exposed to maternal prenatal tobacco use RRs 1.43 (95% CI 1.27-1.60) compared to no prenatal tobacco use. Similarly, the pooled relative risks of bipolar and depressive disorders in offspring were 1.44, (95% CI 1.15-1.80) and 1.44, (95% CI 1.21-1.71), respectively. Moreover, the pooled estimated risk of mood disorders was not significantly attenuated in the studies that reported sibling comparison results [RR = 1.21 (95% CI 1.04-1.41)]. CONCLUSION Taken together, there was strong evidence for a small (RR < 2) association between prenatal tobacco use and mood disorders in offspring.
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Affiliation(s)
- Bereket Duko
- School of Public Health, Curtin University, Kent Street, Bentley, WA, 6102, Australia.
| | - Getinet Ayano
- School of Public Health, Curtin University, Kent Street, Bentley, WA, 6102, Australia
| | - Gavin Pereira
- School of Public Health, Curtin University, Kent Street, Bentley, WA, 6102, Australia.,Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands, WA, 6009, Australia.,Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
| | - Kim Betts
- School of Public Health, Curtin University, Kent Street, Bentley, WA, 6102, Australia
| | - Rosa Alati
- School of Public Health, Curtin University, Kent Street, Bentley, WA, 6102, Australia.,Institute for Social Sciences Research, The University of Queensland, 80 Meier's Rd, Indooroopilly, QLD, 4068, Australia
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19
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Salem EAA, Saheen HM, Allam HK. Secondhand tobacco smoke, does it have an impact on the neurobehavioral performance of the exposed children? ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:44701-44708. [PMID: 32468375 DOI: 10.1007/s11356-020-08989-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Abstract
Secondhand tobacco smoke (SHS) is a significant public health problem for all ages worldwide. Children are more vulnerable to the health effects of SHS because of the inhalation of more air per body volume compared to adults. The study aimed to assess neurobehavioral performance among SHS exposed Egyptian basic school children (10-12 years) and its relationship with urinary cotinine levels. Multistage cluster sampling was carried out, where 181 children (80 exposed and 101 non-exposed children) were recruited. A questionnaire on SHS exposure was sent to students' parents/caregivers. Urine samples were taken for assessment of cotinine levels by enzyme immunoassay. A Neurobehavioral test battery was measured. The exposed children had significantly lower performance in tests of attention (PASAT) [5.22 ± 5.10 vs. 6.98 ± 5.87, p = 0.035], visuomotor speed (Digit Symbol and Trail making A) [41.40 ± 18.01 vs. 46.53 ± 15.89 and 107.92 ± 44.34 vs. 92.44 ± 37.09; respectively] than non-exposed subjects. The neurobehavioral effects were correlated with urinary cotinine levels among children exposed to SHS compared to unexposed children. The study revealed poor performance in neurobehavioral domains of attention and visuomotor skills among children exposed to SHS. This necessitates the implementation of antismoking media awareness programs on the harmful effects of SHS and how to protect children from it.
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Affiliation(s)
- Eman Abdel-Azeem Salem
- Public Health and Community Medicine Department, Faculty of Medicine, Menoufia University, 25 Omar Bin El Khattab Street, Dakama Village, Shebein El kom District, Menoufia Governorate, Egypt.
| | - Hala Mohammed Saheen
- Family Medicine Department, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
| | - Heba Khodary Allam
- Public Health and Community Medicine Department, Faculty of Medicine, Menoufia University, 25 Omar Bin El Khattab Street, Dakama Village, Shebein El kom District, Menoufia Governorate, Egypt
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20
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Gatzke-Kopp L, Willoughby MT, Warkentien S, Petrie D, Mills-Koonce R, Blair C. Association between environmental tobacco smoke exposure across the first four years of life and manifestation of externalizing behavior problems in school-aged children. J Child Psychol Psychiatry 2020; 61:1243-1252. [PMID: 31797389 PMCID: PMC7350288 DOI: 10.1111/jcpp.13157] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Extensive literature in human and animal models has documented an association between maternal smoking during pregnancy and externalizing behavior in offspring. It remains unclear; however, the extent to which postnatal environmental smoke exposure is associated with behavioral development, particularly for children whose mothers did not smoke during pregnancy. The present study examined whether magnitude of exposure to environmental smoke across the first four years of life demonstrated a linear association with later externalizing symptoms. METHODS Exposure was quantified through salivary cotinine measured when children were 6, 15, 24, and 48 months of age, providing a more accurate quantification of realized exposure than can be estimated from parental report of cigarettes smoked. Data were available for n = 1,096 (50% male; 44% African American) children recruited for the Family Life Project, a study of child development in areas of rural poverty. RESULTS Analyses indicate a linear association between cotinine and children's symptoms of hyperactivity and conduct problems. This association remained significant after controlling for family poverty level, parental education, parental history of ADHD, hostility, depression, caregiver IQ, and obstetric complications. Furthermore, this association was unchanged when excluding mothers who smoked during pregnancy from the model. CONCLUSIONS Findings are consistent with animal models demonstrating an effect of environmental exposure to nicotine on ongoing brain development in regions related to hyperactivity and impulsivity, and highlight the importance of mitigating children's exposure to environmental smoke, including sources that extend beyond the parents.
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Affiliation(s)
| | | | | | - Daniel Petrie
- Pennsylvania State University, University Park, PA, USA
| | | | - Clancy Blair
- New York University School of Medicine, New York, NY, USA
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21
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Rashidi M, Mohammadpoorasl A, Sahebihagh MH. Environmental Tobacco Smoke and Educational Self-Regulation and Achievement in First Grade High School Students. J Med Life 2020; 13:229-234. [PMID: 32742519 PMCID: PMC7378345 DOI: 10.25122/jml-2020-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Environmental tobacco smoke, containing many toxic gases, suggests inevitable contact of humans with the damaging factors of cigarettes. On average, approximately 40% of children, 35% of women and 32% of men worldwide are exposed to environmental tobacco smoke. This study aims at investigating the relationship between environmental tobacco smoke in adolescents and their educational self-regulation and achievement. In this study, 770 students aged between 13 and 15 were selected and studied using the multistage sampling method. The tools used in this study consisted of four questionnaires, demographic characteristics, environmental tobacco smoke, educational self-regulation, and educational achievement. The validity and reliability of tools have been approved, and the data were analyzed using SPSS v22. The results indicated a significant inverse relationship between environmental tobacco smoke and students' educational self-regulation and achievement (p-value > 0.001). Given the relationship between exposure to environmental tobacco smoke and educational self-regulation and achievement, it is essential to keep children away from tobacco smoke. Family health and education policy-makers are recommended to design and operate fundamental schemes in order to deal with environmental tobacco smoke.
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Affiliation(s)
- Mina Rashidi
- Student Research Committee, Department of Community Health Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asghar Mohammadpoorasl
- Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hasan Sahebihagh
- Tabriz Health Services Management Research Center, Department of Community Health Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
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Oh K, Xu Y, Terrizzi BF, Lanphear B, Chen A, Kalkbrenner AE, Yolton K. Associations Between Early Low-Level Tobacco Smoke Exposure and Executive Function at Age 8 Years. J Pediatr 2020; 221:174-180.e1. [PMID: 31955878 PMCID: PMC7249348 DOI: 10.1016/j.jpeds.2019.11.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/31/2019] [Accepted: 11/20/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate whether exposure to tobacco smoke during early brain development is linked with later problems in behavior and executive function. STUDY DESIGN We studied 239 children in a prospective birth cohort. We measured tobacco exposures by caregiver report and serum cotinine 3 times during pregnancy and 4 times during childhood. We used linear regression to examine the association between prenatal and childhood serum cotinine concentrations and behavior (the Behavior Assessment System for Children-2) and executive function (the Behavior Rating Inventory of Executive Function) at age 8 years while adjusting for important covariates. RESULTS Neither prenatal nor child serum cotinine were associated with behavior problems measured by the Behavior Assessment System for Children-2. On the Behavior Rating Inventory of Executive Function, prenatal and childhood exposure was associated with poorer task initiation scores (B = 0.44; 95% CI, 0.03-0.85 and B = 0.69, 95% CI, 0.06-1.32 respectively). Additionally, in a subset of 208 children with nonsmoking mothers, prenatal exposure was associated with task initiation scores (B = 1.17; 95% CI, 0.47-1.87) and additional components of the metacognition index (eg, working memory, B = 1.20; 95% CI, 0.34-2.06), but not components of the behavioral regulation index. CONCLUSIONS Tobacco exposures during pregnancy (including low-level second-hand smoke) and childhood were associated with deficits in some domains of children's executive function, especially task initiation and metacognition. These results highlight that decreasing early exposure to tobacco smoke, even second-hand exposure, may support ideal brain functioning.
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Affiliation(s)
- Karin Oh
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Cincinnati, OH
| | - Yingying Xu
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Cincinnati, OH
| | - Brandon F Terrizzi
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Cincinnati, OH.
| | - Bruce Lanphear
- British Columbia Children's Hospital Research Institute and Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada
| | - Aimin Chen
- Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Amy E Kalkbrenner
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
| | - Kimberly Yolton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Cincinnati, OH; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
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Harbin MM, Kelly AS, Dengel DR, Rudser KD, Evanoff NG, Ryder JR. Relation of secondhand smoke exposure to vascular phenotypes in children and adolescents. Pediatr Res 2020; 87:760-766. [PMID: 31645051 PMCID: PMC7082180 DOI: 10.1038/s41390-019-0627-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/11/2019] [Accepted: 09/25/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Subclinical cardiovascular risks of secondhand smoke (SHS) exposure among children and adolescents remains insufficiently described. METHODS This was a cross-sectional study of 298 children and adolescents (48.0% male, body mass index: 27.0 ± 8.9 kg/m2), including 49 self-reported cases with SHS. Arterial elasticity and stiffness (distensibility, compliance, incremental elastic modulus [IEM]) were obtained via ultrasound imaging in the abdominal aorta, brachial, and carotid arteries. A one-way analysis of variance compared differences between groups, and multiple linear regression adjusted for covariates. RESULTS SHS was associated with lower abdominal aorta diameter distensibility (aDD) (13.4 ± 3.6% vs. 16.0 ± 5.2%, p = 0.009) and abdominal aorta cross-sectional distensibility (aCSD) (28.8 ± 8.3% vs. 35.1 ± 12.2%, p = 0.009), as well as higher abdominal aorta IEM (aIEM) (1241 ± 794 vs. 935 ± 388 mmHg, p = 0.001). After adjustment for covariates, aDD (p = 0.047), aCSD (p = 0.040), and aIEM (p = 0.017) remained significant; this significance persisted with the additional adjustment of percent body fat. Measures of brachial and carotid compliance and distensibility were not associated with SHS. CONCLUSIONS SHS was associated with abdominal aorta stiffness; the majority of vascular measures within the brachial and carotid artery remained unaffected following adjustment for covariates, including hypertension and adiposity. SHS may predispose individuals to increased abdominal aorta stiffness, an artery previously reported to exhibit increased susceptibility to atherosclerosis.
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Affiliation(s)
- Michelle M Harbin
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN, 55455, USA.
| | - Aaron S Kelly
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, 55455, USA
- Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Donald R Dengel
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN, 55455, USA
- Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Kyle D Rudser
- Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, MN, 55455, USA
- Division of Biostatistics, School of Public Health and Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Nicholas G Evanoff
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, MN, 55455, USA
- Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Justin R Ryder
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, 55455, USA
- Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, MN, 55455, USA
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Carreras G, Lugo A, Gallus S, Cortini B, Fernández E, López MJ, Soriano JB, López-Nicolás A, Semple S, Gorini G. Burden of disease attributable to second-hand smoke exposure: A systematic review. Prev Med 2019; 129:105833. [PMID: 31505203 DOI: 10.1016/j.ypmed.2019.105833] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/30/2019] [Accepted: 09/05/2019] [Indexed: 10/26/2022]
Abstract
Our aim was to provide a systematic review of studies on the burden of disease due to second-hand smoke (SHS) exposure, reviewing methods, exposure assessment, diseases causally linked to SHS, health outcomes, and estimates available to date. A literature review of studies on the burden of disease from SHS exposure, available in PubMed and SCOPUS, published 2007-2018 in English language, was carried out following the PRISMA recommendations. Overall, 588 studies were first identified, and 94 were eligible. Seventy-two studies were included in the systematic review. Most of them were based on the comparative risk assessment approach, assessing SHS exposure using mainly surveys on exposure at home/workplaces. Diseases more frequently studied were: lung cancer, ischemic heart disease, stroke, chronic obstructive pulmonary disease, asthma and breast cancer in adults; lower respiratory tract infection, otitis media, asthma, sudden infant death syndrome and low birth weight in children. The SHS exposure assessment and the reported population attributable fractions (PAF) were largely heterogeneous. As an example, the PAF from lung cancer varied between 0.6% and 20.5%. Moreover, PAF were estimated applying relative risks and SHS exposures with no consistent definitions or with different age classes. The research gap on the SHS exposure burden is shrinking. However, estimates are not yet available for a number of countries, particularly the Middle Eastern and African countries, and not all diseases with the strongest evidence of causation, such as sudden infant death syndrome, have been explored. Moreover, in some cases the applied methodology revealed relatively low quality of data.
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Affiliation(s)
- Giulia Carreras
- Oncologic Network, Prevention and Research Institute (ISPRO), via Cosimo il Vecchio 2, 50139 Florence, Italy.
| | - Alessandra Lugo
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS (IRFMN), Via La Masa 19, 20156 Milan, Italy
| | - Silvano Gallus
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS (IRFMN), Via La Masa 19, 20156 Milan, Italy
| | - Barbara Cortini
- Oncologic Network, Prevention and Research Institute (ISPRO), via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Esteve Fernández
- Catalan Institute of Oncology (ICO), Granvia de L'Hospitalet, 199-203, PC 08908 L'Hospitalet de Llobregat, Spain; Bellvitge Biomedical Research Institute (IDIBELL), Granvia de L'Hospitalet, 199, PC 08908 L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Campus de Bellvitge, School of Medicine and Health Sciences, University of Barcelona, Feixa Llarga, s/n, PC 08907 L'Hospitalet de Llobregat, Spain
| | - Maria José López
- Public Health Agency of Barcelona (ASPB). Pl. Lesseps, 1, PC 08023 Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0. PC 28029, Madrid, Spain; Institut d'Investigació Biomèdica de Sant Pau (IIB Sant Pau), Sant Antoni Maria Claret, 167, PC 08025 Barcelona, Spain
| | - Joan B Soriano
- Hospital Universitario La Princesa (IISP), Diego de León, 62 1st floor, PC 28006 Madrid, Spain
| | - Angel López-Nicolás
- Polytechnic University of Cartagena (UPCT), Plaza Cronista Isidoro Valverde, s/n, PC 30202 Cartagena, Spain
| | - Sean Semple
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, Scotland, UK
| | - Giuseppe Gorini
- Oncologic Network, Prevention and Research Institute (ISPRO), via Cosimo il Vecchio 2, 50139 Florence, Italy
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Gonzalez-Sicilia D, Derevensky JL, Pagani LS. Two Lifestyle Risks Intertwined: Parental Smoking Predicts Child Gambling Behavior at Age 12 Years. Am J Lifestyle Med 2019; 14:89-96. [PMID: 31903088 DOI: 10.1177/1559827618824286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Parental smoking can create a toxic environment for child development. A parental smoking lifestyle can predispose children to executive deficits, influencing precocious risk activities. Using a prospective birth cohort design, we examine the association between 2 lifestyle factors by estimating the relative contribution of long-term parental household smoking in predicting subsequent precocious child gambling behavior. METHOD Parents reported on the amount of household smoke exposure from ages 1.5 to 7.5 years for children from the Quebec Longitudinal Study of Child Development. The main outcome measure was children's self-report of gambling behavior (at age 12 years). RESULTS Sixty percent of parents reported that their children were never exposed to secondhand smoke in the home, while 27% and 13% reported transient and continuous levels of secondhand smoke, respectively. Overall, 16% of children reported gambling participation. When compared with never-exposed children, children exposed to secondhand smoke had 18% more chances of having participated in gambling at age 12 years (odds ratio = 1.18; 95% CI = 1.080-1.293). These results are adjusted for competing explanations and possible individual and family confounders. CONCLUSIONS Higher levels of early childhood household smoke exposure are associated with greater odds of reporting gambling participation at age 12 years, which is more than several years before it is normative youthful behavior. By connecting the neurotoxic influence of one lifestyle factor on another, we show a nontrivial link between 2 public health issues (smoke exposure and precocious gambling) associated with considerable individual and societal costs that are amenable to community information campaigns.
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Affiliation(s)
- Daniela Gonzalez-Sicilia
- Université de Montréal, École de Psychoéducation, Montréal, Quebec, Canada (DG-S, LSP).,INRS-Institut Armand-Frappier, Laval, Quebec, Canada (DG-S).,International Centre for Youth Gambling Problems and High Risk Behaviors, McGill University, Montreal, Quebec, Canada (JLD).,Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada (LSP)
| | - Jeffrey L Derevensky
- Université de Montréal, École de Psychoéducation, Montréal, Quebec, Canada (DG-S, LSP).,INRS-Institut Armand-Frappier, Laval, Quebec, Canada (DG-S).,International Centre for Youth Gambling Problems and High Risk Behaviors, McGill University, Montreal, Quebec, Canada (JLD).,Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada (LSP)
| | - Linda S Pagani
- Université de Montréal, École de Psychoéducation, Montréal, Quebec, Canada (DG-S, LSP).,INRS-Institut Armand-Frappier, Laval, Quebec, Canada (DG-S).,International Centre for Youth Gambling Problems and High Risk Behaviors, McGill University, Montreal, Quebec, Canada (JLD).,Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada (LSP)
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26
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Cho HJ. Environmental Tobacco Smoke Can Be an Important Risk Factor for Children's Behavioral Problems, and Policies to Reduce Exposure Are Urgently Required. J Korean Med Sci 2018; 33:e244. [PMID: 30181733 PMCID: PMC6115695 DOI: 10.3346/jkms.2018.33.e244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hong-Jun Cho
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Arrhenius B, Gyllenberg D, Chudal R, Lehti V, Sucksdorff M, Sourander O, Virtanen JP, Torsti J, Sourander A. Social risk factors for speech, scholastic and coordination disorders: a nationwide register-based study. BMC Public Health 2018; 18:739. [PMID: 29902994 PMCID: PMC6002992 DOI: 10.1186/s12889-018-5650-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 05/31/2018] [Indexed: 01/24/2023] Open
Abstract
Background Broadly defined learning and coordination disorders (LCDs) are common in the population and have previously been associated with familial social risk factors and male sex. However, comprehensive nationwide studies of these risk factors in LCD subgroups are lacking. Our objective was to assess different LCDs in relation to sex and maternal education, marital status and socioeconomic status based on occupation. Methods We conducted a nationwide register-based study. The following diagnoses were identified from the Finnish Hospital Discharge Register (FHDR) according to the ICD-10 (n = 28,192): speech disorders (F80), scholastic disorders (F81), motor and coordination disorders (F82) and mixed developmental disorder (F83). To study cumulative incidence and male: female ratios of service use of LCDs, we used a cohort design among all Finnish children born singleton 1996–2007 (n = 690,654); to study social risk factors, we used a nested case-control design with extensive register data on both cases and matched controls (n = 106,616). Results The cumulative incidence was 4.7% for any LCD by age 15 and the changes in cumulative incidence over time were minor. The male: female ratios were 2.2–3.0 across LCD subgroups. Learning and coordination disorders were more common in households with lower maternal education, socioeconomic status based on occupation and among children with single mothers at the time of birth; the odds ratios (OR) for any LCD were 1.2–1.9 across risk factors. The odds for LCD diagnosis increased linearly with the number of social risk factors, except for coordination disorder. The effect size of three risk factors was highest in the group with mixed or multiple LCDs; OR 3.76 (95% CI 3.31–4.28). Conclusions Multiple social risk factors increase the odds for multiple, more comprehensive learning difficulties. The findings have implications for service planning, as early identification and interventions of learning and coordination disorders might reduce related long-term social adversities. Electronic supplementary material The online version of this article (10.1186/s12889-018-5650-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bianca Arrhenius
- Child and Youth Health Services, City of Helsinki, Helsinki, Finland. .,Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland.
| | - David Gyllenberg
- National Institute for Health and Welfare, Helsinki, Finland.,Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Roshan Chudal
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Venla Lehti
- Department of Psychiatry, University of Helsinki, Helsinki, Finland.,Helsinki University Hospital, Helsinki, Finland.,Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Minna Sucksdorff
- Department of Pediatrics, Turku University Hospital, Turku, Finland.,Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Ona Sourander
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Juha-Pekka Virtanen
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
| | - Jutta Torsti
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland.,Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori, 20014, Turku, Finland
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Al-Hamdan AZ, Preetha PP, Albashaireh RN, Al-Hamdan MZ, Crosson WL. Investigating the effects of environmental factors on autism spectrum disorder in the USA using remotely sensed data. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:7924-7936. [PMID: 29299867 DOI: 10.1007/s11356-017-1114-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 12/20/2017] [Indexed: 06/07/2023]
Abstract
This study aimed to assess the association between exposures to outdoor environmental factors and autism spectrum disorder (ASD) prevalence in a diverse and spatially distributed population of 8-year-old children from the USA (n = 2,097,188) using the air quality index (AQI) of the US Environmental Protection Agency as well as satellite-derived data of PM2.5 concentrations, sunlight, and maximum heat index. Multivariable logistic regression analyses were performed to determine whether the unhealthy AQI, PM2.5, sunlight, and maximum heat index were related to the odds of ASD prevalence based on gender and race and taking into consideration the confounding factors of smoking and socioeconomic status. The logistic regression odds ratios for ASD per 10% increase in the unhealthy AQI were greater than 1 for all categories, indicating that unhealthy AQI is related to the odds of ASD prevalence. The odds ratio of ASD due to the exposure to the unhealthy AQI was higher for Asians (OR = 2.96, 95% CI = 1.11-7.88) than that for Hispanics (OR = 1.308, 95% CI = 0.607-2.820), and it was higher for Blacks (OR = 1.398, 95% CI = 0.827-2.364) than that for Whites (OR = 1.219, 95% CI = 0.760-1.954). The odds ratio of ASD due to the unhealthy AQI was slightly higher for males (OR = 1.123, 95% CI = 0.771-1.635) than that for females (OR = 1.117, 95% CI = 0.789-1.581). The effects of the unhealthy environmental exposures on the odds ratios of ASD of this study were inconclusive (i.e., statically insignificant; p value > 0.05) for all categories except for Asians. The odds ratios of ASD for Asians were increased by 5, 12, and 14% with increased levels of the environmental exposures of 10 μg/m3 of PM2.5, 1000 kJ/m2 of sunlight, and 1 °F of maximum heat index, respectively. The odds ratios of ASD prevalence for all categories, except for Asians, were increased with the inclusion of the smoking covariate, reflecting the effect of smoking on ASD prevalence besides the unhealthy environmental factors.
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Affiliation(s)
- Ashraf Z Al-Hamdan
- Department of Civil and Environmental Engineering, University of Alabama in Huntsville, 301 Sparkman Drive, Huntsville, AL, 35899, USA.
| | - Pooja P Preetha
- Department of Civil and Environmental Engineering, University of Alabama in Huntsville, 301 Sparkman Drive, Huntsville, AL, 35899, USA
| | - Reem N Albashaireh
- Department of Mathematics, Alabama Agricultural and Mechanical University, Normal, AL, 35762, USA
| | - Mohammad Z Al-Hamdan
- Universities Space Research Association, NASA Marshall Space Flight Center, National Space Science and Technology Center, 320 Sparkman Drive, Huntsville, AL, 35805, USA
| | - William L Crosson
- Universities Space Research Association, NASA Marshall Space Flight Center, National Space Science and Technology Center, 320 Sparkman Drive, Huntsville, AL, 35805, USA
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Lim KH, Teh CH, Nik Mohamed MH, Pan S, Ling MY, Mohd Yusoff MF, Hassan N, Baharom N, Dawam ND, Ismail N, Ghazali SM, Cheong KC, Chong KH, Lim HL. Exposure to tobacco secondhand smoke and its associated factors among non-smoking adults in smoking-restricted and non-restricted areas: findings from a nationwide study in Malaysia. BMJ Open 2018; 8:e017203. [PMID: 29317411 PMCID: PMC5780697 DOI: 10.1136/bmjopen-2017-017203] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Secondhand smoke (SHS) has been associated with increased morbidity and mortality. Therefore, the aims of the paper are to assess SHS exposure among non-smoking adults in Malaysia attending various smoking-restricted and non-restricted public areas according to the Control of Tobacco Product Regulations (CTPR) as well as its relationship with various sociodemographic variables. DESIGN Data were extracted from a cross-sectional study, the Global Adults Tobacco Survey (GATS) 2011 which involved 3269 non-smokers in Malaysia. Data was obtained through face-to-face interviews using a validated pre-tested questionnaire. Factors associated with exposure to SHS were identified via multivariable analysis. RESULTS The study revealed that almost two-thirds of respondents were exposed to SHS in at least one public area in the past 1 month, with a significantly higher exposure among males (70.6%), those with higher educational attainment (81.4%) and higher income (quintile 1%-73.9%). Besides, the exposure to SHS was almost four times higher in non-restricted areas compared with restricted areas under the CTPR (81.9% vs 22.9). Multivariable analysis revealed that males and younger adults at non-restricted areas were more likely to be exposed to SHS while no significant associated factors of SHS exposure was observed in restricted areas. CONCLUSIONS The study revealed the prevalence of SHS exposure was higher among Malaysian adults. Although smoke-free laws offer protection to non-smokers from exposure to SHS, enforcement activities in restricted areas should be enhanced to ensure strict public abidance. In addition, legislation of restricted areas should also be extended to greatly reduce the SHS exposure among non-smokers in Malaysia.
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Affiliation(s)
| | | | | | - Sayan Pan
- Institute of Public Health, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Miaw Yn Ling
- Institute of Public Health, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | | | - Noraryana Hassan
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Nizam Baharom
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - Norliana Ismail
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | | | | | - Kar Hon Chong
- Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang, Malaysia
| | - Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang, Malaysia
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30
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McGrath JJ, Racicot S, Okoli CTC, Hammond SK, O'Loughlin J. Airborne Nicotine, Secondhand Smoke, and Precursors to Adolescent Smoking. Pediatrics 2018; 141:S63-S74. [PMID: 29292307 DOI: 10.1542/peds.2017-1026j] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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 AND OBJECTIVES Secondhand smoke (SHS) directly increases exposure to airborne nicotine, tobacco's main psychoactive substance. When exposed to SHS, nonsmokers inhale 60% to 80% of airborne nicotine, absorb concentrations similar to those absorbed by smokers, and display high levels of nicotine biomarkers. Social modeling, or observing other smokers, is a well-established predictor of smoking during adolescence. Observing smokers also leads to increased pharmacological exposure to airborne nicotine via SHS. The objective of this study is to investigate whether greater exposure to airborne nicotine via SHS increases the risk for smoking initiation precursors among never-smoking adolescents. METHODS Secondary students (N = 406; never-smokers: n = 338, 53% girls, mean age = 12.9, SD = 0.4) participated in the AdoQuest II longitudinal cohort. They answered questionnaires about social exposure to smoking (parents, siblings, peers) and known smoking precursors (eg, expected benefits and/or costs, SHS aversion, smoking susceptibility, and nicotine dependence symptoms). Saliva and hair samples were collected to derive biomarkers of cotinine and nicotine. Adolescents wore a passive monitor for 1 week to measure airborne nicotine. RESULTS Higher airborne nicotine was significantly associated with greater expected benefits (R2 = 0.024) and lower expected costs (R2 = 0.014). Higher social exposure was significantly associated with more temptation to try smoking (R2 = 0.025), lower aversion to SHS (R2 = 0.038), and greater smoking susceptibility (R2 = 0.071). Greater social exposure was significantly associated with more nicotine dependence symptoms; this relation worsened with higher nicotine exposure (cotinine R2 = 0.096; airborne nicotine R2 = 0.088). CONCLUSIONS Airborne nicotine exposure via SHS is a plausible risk factor for smoking initiation during adolescence. Public health implications include limiting airborne nicotine through smoking bans in homes and cars, in addition to stringent restrictions for e-cigarettes.
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Affiliation(s)
- Jennifer J McGrath
- Department of Psychology, Concordia University, Montréal, Quebec, Canada;
| | | | | | - S Katharine Hammond
- Environmental Health Sciences Division, University of California Berkeley, Berkeley, California; and
| | - Jennifer O'Loughlin
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
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31
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Gorzkowski JA, Klein JD. The Role of Secondhand Smoke Research in Protecting Nonsmokers. Pediatrics 2018; 141:S6-S9. [PMID: 29292301 DOI: 10.1542/peds.2017-1026d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
In this commentary, we explore the role of tobacco and SHS research in protecting children and families from tobacco use and exposure.
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Affiliation(s)
- Julie A Gorzkowski
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and
| | - Jonathan D Klein
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois; and.,Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
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32
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Tobacco Use and Women's Health. Nurs Womens Health 2017; 21:406-408. [PMID: 28987214 DOI: 10.1016/s1751-4851(17)30267-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Torok M, Winickoff J, McMillen R, Klein J, Wilson K. Prevalence and location of tobacco smoke exposure outside the home in adults and children in the United States. Public Health 2017; 151:149-159. [DOI: 10.1016/j.puhe.2017.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/06/2017] [Accepted: 07/09/2017] [Indexed: 12/01/2022]
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Vesterinen HM, Morello-Frosch R, Sen S, Zeise L, Woodruff TJ. Cumulative effects of prenatal-exposure to exogenous chemicals and psychosocial stress on fetal growth: Systematic-review of the human and animal evidence. PLoS One 2017; 12:e0176331. [PMID: 28700705 PMCID: PMC5507491 DOI: 10.1371/journal.pone.0176331] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/14/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Adverse effects of prenatal stress or environmental chemical exposures on fetal growth are well described, yet their combined effect remains unclear. OBJECTIVES To conduct a systematic review on the combined impact and interaction of prenatal exposure to stress and chemicals on developmental outcomes. METHODS We used the first three steps of the Navigation Guide systematic review. We wrote a protocol, performed a robust literature search to identify relevant animal and human studies and extracted data on developmental outcomes. For the most common outcome (fetal growth), we evaluated risk of bias, calculated effect sizes for main effects of individual and combined exposures, and performed a random effects meta-analysis of those studies reporting on odds of low birthweight (LBW) by smoking and socioeconomic status (SES). RESULTS We identified 17 human- and 22 animal-studies of combined chemical and stress exposures and fetal growth. Human studies tended to have a lower risk of bias across nine domains. Generally, we found stronger effects for chemicals than stress, and these exposures were associated with reduced fetal growth in the low-stress group and the association was often greater in high stress groups, with limited evidence of effect modification. We found smoking associated with significantly increased odds of LBW, with a greater effect for high stress (low SES; OR 4.75 (2.46-9.16)) compared to low stress (high SES; OR 1.95 (95% CI 1.53-2.48)). Animal studies generally had a high risk of bias with no significant combined effect or effect modification. CONCLUSIONS We found that despite concern for the combined effects of environmental chemicals and stress, this is still an under-studied topic, though limited available human studies indicate chemical exposures exert stronger effects than stress, and this effect is generally larger in the presence of stress.
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Affiliation(s)
- Hanna M. Vesterinen
- Program on Reproductive Health and the Environment, University of California, San Francisco, United States of America
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, United States of America
| | - Saunak Sen
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, United States of America
| | - Lauren Zeise
- California Environmental Protection Agency Office of Environmental Health Hazard Assessment, Oakland, United States of America
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, University of California, San Francisco, United States of America
- * E-mail:
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Pagani LS, Lévesque-Seck F, Archambault I, Janosz M. Prospective longitudinal associations between household smoke exposure in early childhood and antisocial behavior at age 12. INDOOR AIR 2017; 27:622-630. [PMID: 27868232 DOI: 10.1111/ina.12353] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 10/21/2016] [Indexed: 06/06/2023]
Abstract
Young children exert little control over household tobacco smoke exposure, which is considered a developmental neurotoxicant. Using the Quebec Longitudinal Study birth cohort, we examine prospective associations between early childhood smoke exposure and later antisocial behavior. Parents of 1035 children reported on the presence of household smokers at seven follow-ups from ages 1.5 to 7.5. At age 12, children self-reported on five aspects of early antisocial dispositions. After adjusting for confounders, every standard deviation increase in household smoke exposure was prospectively associated with a 19% standard deviation unit increase in conduct problems (β=0.07; 95% confidence interval [CI] from 0.04 to 0.09), a 11% standard deviation unit increase in proactive aggression (β=0.04; 95% CI from 0.01 to 0.07), a 13% standard deviation unit increase in reactive aggression (β=0.07; 95% CI from 0.03 to 0.12), a 14% standard deviation unit increase in school indiscipline (β=0.13; 95% CI from 0.05 to 0.20), and a 10% standard deviation unit increase in dropout risk (β=0.07; 95% CI from 0.01 to 0.12). These long-term findings warrant fostering parental awareness of developmental risks by policy-makers/health practitioners. School curricula can equally integrate these ideas into their curriculum.
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Affiliation(s)
- L S Pagani
- School of Psycho-Education, Université de Montréal, Montréal, QC, Canada
- Sainte-Justine's Hospital Research Center (Brain Diseases Division), Université de Montréal, Montréal, QC, Canada
- School Environment Research Group, Université de Montréal, Montréal, QC, Canada
| | - F Lévesque-Seck
- School of Psycho-Education, Université de Montréal, Montréal, QC, Canada
- Sainte-Justine's Hospital Research Center (Brain Diseases Division), Université de Montréal, Montréal, QC, Canada
- School Environment Research Group, Université de Montréal, Montréal, QC, Canada
| | - I Archambault
- School of Psycho-Education, Université de Montréal, Montréal, QC, Canada
- School Environment Research Group, Université de Montréal, Montréal, QC, Canada
| | - M Janosz
- School of Psycho-Education, Université de Montréal, Montréal, QC, Canada
- School Environment Research Group, Université de Montréal, Montréal, QC, Canada
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Joo H, Lim MH, Ha M, Kwon HJ, Yoo SJ, Choi KH, Paik KC. Secondhand Smoke Exposure and Low Blood Lead Levels in Association With Attention-Deficit Hyperactivity Disorder and Its Symptom Domain in Children: A Community-Based Case-Control Study. Nicotine Tob Res 2017; 19:94-101. [PMID: 27613950 PMCID: PMC5157713 DOI: 10.1093/ntr/ntw152] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/02/2016] [Indexed: 11/14/2022]
Abstract
AIM Secondhand smoke (SHS) is a major indoor pollutant. We examined the possible association between exposure to both SHS and low levels of lead and attention-deficit-hyperactivity disorder (ADHD) and its symptom domain in children. METHODS This case-control study was based on the results of a community survey using the ADHD rating scale conducted in 49 elementary schools. Both cases and control subjects were confirmed by a child psychiatrist. Each case was matched with one control subject according to gender, school, and grade in school. Using a multivariate conditional logistic regression model, we analyzed 214 case-control pairs of children who ranged in age from 6 to 10 years. Urine and blood levels of cotinine and of lead were determined, and information pertaining to SHS exposure was obtained by means of a questionnaire. RESULTS Exposure to low levels of lead (geometric mean = 1.65 µg/dL) was related to ADHD, particularly inattention (odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.07-2.59), whereas SHS exposure was associated mainly with hyperactivity/impulsivity (OR = 3.85, 95% CI = 1.55-9.56). In the pathway from blood lead to hyperactivity/impulsivity, children's SHS exposure mediated and indirectly accounted for about 73% of this relationship. The combined exposure to lead and SHS synergistically increased the risk of ADHD, evident as both inattention and hyperactivity/impulsivity. CONCLUSION SHS, which is associated with hyperactivity/impulsivity in particular, combined with exposure to low blood levels of lead synergistically increased the risk of ADHD. Therefore, the exposure of children to both SHS and lead needs to be reduced. IMPLICATIONS Although exposure to low levels of lead has been shown to be associated with ADHD, there is little evidence of symptom domain specificity. In our study, low blood lead levels were related to inattention. In addition, prenatal or postnatal exposure to SHS increased the risk of ADHD, particularly hyperactivity/impulsivity. Combined exposure to lead and SHS synergistically increased the risk for both these ADHD symptom domains. To protect children from environmental risk factors related to ADHD, it is necessary to further reduce children's exposure to SHS and lead, even in those with low blood lead levels.
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Affiliation(s)
- Hyunjoo Joo
- Department of Public Health, Graduate School of Dankook University, Cheonan, Chungnam, Republic of Korea
| | - Myung-Ho Lim
- Department of Psychology, Dankook University College of Public Service, Cheonan, Republic of Korea
- Environmental Health Center, Dankook University Medical Center, Cheonan, Republic of Korea
| | - Mina Ha
- Environmental Health Center, Dankook University Medical Center, Cheonan, Republic of Korea;
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Ho-Jang Kwon
- Environmental Health Center, Dankook University Medical Center, Cheonan, Republic of Korea
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Seung Jin Yoo
- Environmental Health Center, Dankook University Medical Center, Cheonan, Republic of Korea
| | - Kyung-Hwa Choi
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Ki-Chung Paik
- Environmental Health Center, Dankook University Medical Center, Cheonan, Republic of Korea
- Department of Psychiatry, Dankook University College of Medicine, Cheonan, Republic of Korea
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Figueiró LR, Ziulkoski AL, Dantas DCM. Thirdhand smoke: when the danger is more than you can see or smell. CAD SAUDE PUBLICA 2016; 32:e00032216. [PMID: 27925021 DOI: 10.1590/0102-311x00032216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 08/24/2016] [Indexed: 11/21/2022] Open
Abstract
Recent discussion has focused on another form of exposure to tobacco - thirdhand smoke (THS) - consisting of residual pollutants from cigarette smoke that remain in environments. The main concern with THS is based on the presence and persistence of many toxic compounds, some specific nitrosamines from tobacco that have carcinogenic activity. Little is known about THS, and few people are aware of its existence and potential health repercussions, thus highlighting the need to shed light on the subject and incorporate it into the public health debate, as was done with passive smoking several years ago. THS is a form of passive smoking, together with secondary or involuntary exposure to cigarette smoke. Recentemente, passou a ser discutida mais uma forma de exposição ao tabaco - thirdhand smoke (THS) - que consiste nos poluentes residuais da fumaça de cigarro que permanecem nos ambientes. A principal preocupação com o THS é embasada na presença e longa persistência de muitos compostos tóxicos, algumas nitrosaminas específicas do tabaco que têm atividade carcinogênica. Além de se saber pouco sobre o THS, poucos sabem de sua existência e preocupante repercussão na saúde. Coloca-se em destaque a necessidade de trazê-lo à luz e incluí-lo nas discussões, assim como foi feito com o tabagismo passivo alguns anos atrás, até mesmo porque o THS se caracteriza como uma forma de tabagismo passivo junto à exposição secundária ou involuntária da fumaça de cigarro.
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Steinberger J, Daniels SR, Hagberg N, Isasi CR, Kelly AS, Lloyd-Jones D, Pate RR, Pratt C, Shay CM, Towbin JA, Urbina E, Van Horn LV, Zachariah JP. Cardiovascular Health Promotion in Children: Challenges and Opportunities for 2020 and Beyond: A Scientific Statement From the American Heart Association. Circulation 2016; 134:e236-55. [PMID: 27515136 DOI: 10.1161/cir.0000000000000441] [Citation(s) in RCA: 180] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This document provides a pediatric-focused companion to "Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction: The American Heart Association's Strategic Impact Goal Through 2020 and Beyond," focused on cardiovascular health promotion and disease reduction in adults and children. The principles detailed in the document reflect the American Heart Association's new dynamic and proactive goal to promote cardiovascular health throughout the life course. The primary focus is on adult cardiovascular health and disease prevention, but critical to achievement of this goal is maintenance of ideal cardiovascular health from birth through childhood to young adulthood and beyond. Emphasis is placed on the fundamental principles and metrics that define cardiovascular health in children for the clinical or research setting, and a balanced and critical appraisal of the strengths and weaknesses of the cardiovascular health construct in children and adolescents is provided. Specifically, this document discusses 2 important factors: the promotion of ideal cardiovascular health in all children and the improvement of cardiovascular health metric scores in children currently classified as having poor or intermediate cardiovascular health. Other topics include the current status of cardiovascular health in US children, opportunities for the refinement of health metrics, improvement of health metric scores, and possibilities for promoting ideal cardiovascular health. Importantly, concerns about the suitability of using single thresholds to identify elevated cardiovascular risk throughout the childhood years and the limits of our current knowledge are noted, and suggestions for future directions and research are provided.
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Pagani LS, Fitzpatrick C. Early Childhood Household Smoke Exposure Predicts Less Task-Oriented Classroom Behavior at Age 10. HEALTH EDUCATION & BEHAVIOR 2016; 43:584-91. [DOI: 10.1177/1090198115614317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Secondhand tobacco smoke is considered a developmental neurotoxicant especially given underdeveloped vital systems in young children. An ecological test of its negative influence on brain development can be made by examining the prospective association between early childhood household smoke exposure and later classroom behavior. Using a longitudinal birth cohort, we examined the unique contribution of household tobacco smoke exposure to children’s subsequent classroom engagement at age 10. From child ages 1.5 to 7 years, parents of 2,055 participants from the Quebec Longitudinal Study of Child Development reported on household smoking by themselves and other home occupants. At age 10, fourth-grade teachers reported on the child’s classroom engagement. In terms of prevalence, 58% of parents reported that their children were never exposed to smoke in the home, while 34% and 8% of children were exposed to transient and continuous household smoke, respectively. Compared with never exposed children, those who were exposed to transient and continuous household smoke scored 13% and 9% of a standard deviation lower on classroom engagement in fourth grade, standardized B = −.128 (95% confidence interval = −.186, −.069) and standardized B = −.093 (95% confidence interval = −.144, −.043), respectively. Compared with their never exposed peers, children exposed to transient and continuous early childhood household smoke showed proportionately less classroom engagement, which reflects task-orientation, following directions, and working well autonomously and with others. This predisposition poses risks for high school dropout, which from a population health perspective is closely linked with at-risk lifestyle habits and unhealthy outcomes.
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Affiliation(s)
| | - Caroline Fitzpatrick
- Concordia University, Montréal, Québec, Canada
- Université Ste-Anne, Halifax, Nova Scotia, Canada
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Dolan CV, Geels L, Vink JM, van Beijsterveldt CEM, Neale MC, Bartels M, Boomsma DI. Testing Causal Effects of Maternal Smoking During Pregnancy on Offspring's Externalizing and Internalizing Behavior. Behav Genet 2016; 46:378-88. [PMID: 26324285 PMCID: PMC4826626 DOI: 10.1007/s10519-015-9738-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 08/18/2015] [Indexed: 12/31/2022]
Abstract
Maternal smoking during pregnancy (SDP) is associated with increased risk of externalizing and internalizing behaviors in offspring. Two explanations (not mutually exclusive) for this association are direct causal effects of maternal SDP and the effects of genetic and environmental factors common to parents and offspring which increase smoking as well as problem behaviors. Here, we examined the associations between parental SDP and mother rated offspring externalizing and internalizing behaviors (rated by the Child Behavior Checklist/2-3) at age three in a population-based sample of Dutch twins (N = 15,228 pairs). First, as a greater effect of maternal than of paternal SDP is consistent with a causal effect of maternal SDP, we compared the effects of maternal and paternal SDP. Second, as a beneficial effect of quitting smoking before pregnancy is consistent with the causal effect, we compared the effects of SDP in mothers who quit smoking before pregnancy, and mothers who continued to smoke during pregnancy. All mothers were established smokers before their pregnancy. The results indicated a greater effect of maternal SDP, compared to paternal SDP, for externalizing, aggression, overactive and withdrawn behavior. Quitting smoking was associated with less externalizing, overactive behavior, aggression, and oppositional behavior, but had no effect on internalizing, anxious depression, or withdrawn behavior. We conclude that these results are consistent with a causal, but small, effect of smoking on externalizing problems at age 3. The results do not support a causal effect of maternal SDP on internalizing behaviors.
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Affiliation(s)
- C V Dolan
- Department of Biological Psychology, Netherlands Twin Register, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
| | - L Geels
- Department of Biological Psychology, Netherlands Twin Register, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
| | - J M Vink
- Department of Biological Psychology, Netherlands Twin Register, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - C E M van Beijsterveldt
- Department of Biological Psychology, Netherlands Twin Register, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
| | - M C Neale
- Department of Biological Psychology, Netherlands Twin Register, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - M Bartels
- Department of Biological Psychology, Netherlands Twin Register, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, Netherlands Twin Register, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
- EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
- Neuroscience Campus Amsterdam, Amsterdam, The Netherlands.
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Jorge JG, Botelho C, Silva AMC, Moi GP. Influence of passive smoking on learning in elementary school. J Pediatr (Rio J) 2016; 92:260-7. [PMID: 26859248 DOI: 10.1016/j.jped.2015.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 08/13/2015] [Accepted: 08/26/2015] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To analyze the association between household smoking and the development of learning in elementary schoolchildren. METHODS Cross-sectional study with 785 students from the 2nd to the 5th year of elementary school. Students were evaluated by the School Literacy Screening Protocol to identify the presence of learning disabilities. Mothers/guardians were interviewed at home through a validated questionnaire. Descriptive and bivariate analysis, as well as multivariate Poisson regression, were performed. RESULTS In the final model, the variables associated with learning difficulties were current smoking at the household in the presence of the child (PR=6.10, 95% CI: 4.56 to 8.16), maternal passive smoking during pregnancy (PR=1.46, 95% CI: 1.07 to 2.01), students attending the 2nd and 3rd years of Elementary School (PR=1.44, 95% CI: 1.10 to 1.90), and being children of mothers with only elementary level education (PR=1.36, 95% CI: 1.04 to 1.79). CONCLUSION The study demonstrated an association between passive exposure to tobacco smoke and learning difficulties at school.
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Affiliation(s)
| | - Clóvis Botelho
- School of Medicine, Universidade Federal de Mato Grosso (UFMT), Cuiabá, MT, Brazil
| | | | - Gisele Pedroso Moi
- Centro Universitário de Várzea Grande (UNIVAG), Várzea Grande, MT, Brazil
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Influence of passive smoking on learning in elementary school. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2016. [DOI: 10.1016/j.jpedp.2016.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Emerson E, Hatton C, Robertson J, Baines S. Exposure to second hand tobacco smoke at home and child smoking at age 11 among British children with and without intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:274-281. [PMID: 26635126 DOI: 10.1111/jir.12247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 10/16/2015] [Accepted: 10/28/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND The exposure of children to second hand tobacco smoke (SHS) is a well-established risk factor for a range of adverse health conditions in childhood and later life. Little is known about the extent to which children with intellectual disability (ID) may be exposed to SHS. Our aim in this study was to estimate the risk of childhood exposure to SHS and early experience of smoking among children with and without ID in a nationally representative cohort of British children. METHOD Secondary analysis of data extracted from the UK's Millennium Cohort Study, a nationally representative sample of over 18,000 UK children born 2000-2002. RESULTS Children with ID are significantly more likely than their peers to be exposed to SHS and to have themselves experimented with smoking by age 11. Controlling for between-group differences in socio-economic position eliminated the increased risk of exposure to SHS and significantly attenuated, but did not eliminate, increased risk of experimenting with smoking by age 11. CONCLUSIONS Levels of exposure to SHS among children with ID are typical of those of families of children without ID living in similar socio-economic circumstances. The results lend no support to the hypothesis that increased rates of parental smoking may be associated with any additional 'burden of care' experienced by parents of children with ID. Nevertheless, it will be important to ensure that evidence-based interventions to reduce exposure to SHS are tailored to the specific needs of families supporting children with ID (e.g. through the provision of disability-friendly child care arrangements).
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, University of Sydney, New South Wales, Australia
- Centre for Disability Research, Lancaster University, UK
| | - C Hatton
- Centre for Disability Research, Lancaster University, UK
| | - J Robertson
- Centre for Disability Research, Lancaster University, UK
| | - S Baines
- Centre for Disability Research, Lancaster University, UK
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Leung LT, Ho SY, Wang MP, Lo WS, Lam TH. Exposure to secondhand smoke from neighbours and respiratory symptoms in never-smoking adolescents in Hong Kong: a cross-sectional study. BMJ Open 2015; 5:e008607. [PMID: 26537497 PMCID: PMC4636600 DOI: 10.1136/bmjopen-2015-008607] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 07/04/2015] [Accepted: 07/31/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To investigate secondhand smoke (SHS) exposure at home from neighbours in Hong Kong adolescents and its association with respiratory symptoms in never-smokers. DESIGN A cross-sectional study. SETTING 79 randomly selected secondary schools in Hong Kong. PARTICIPANTS 61,810 secondary 1 (USA grade 7) to 7 students, in which 50,762 never-smokers were identified and included in the analysis of the association between SHS exposure at home from neighbours and respiratory symptoms. MAIN OUTCOME MEASURES Smoking status, family smoking status, SHS exposure at home from inside the home and from neighbours in the past 7 days, respiratory symptoms and sociodemographic characteristics were reported. Adjusted ORs (AORs) of respiratory symptoms for SHS exposure from the 2 sources in never-smokers were calculated using logistic regression. RESULTS In all students, 33.2% were exposed to SHS at home, including 16.2% from inside the home only, 10.0% from neighbours only and 7.0% from both. The prevalence of SHS exposure from neighbours was 17.1%, including 13.5% for 1-4 days/week and 3.6% for 5-7 days/week. In never-smokers (n=50,762), respiratory symptoms were significantly associated with SHS exposure from neighbours with AORs (95% CI) of 1.29 (1.20 to 1.39) for any exposure (p<0.001), 1.21 (1.12 to 1.31) for 1-4 days/week (p<0.001) and 1.63 (1.44 to 1.86) for 5-7 days/week (p<0.001) (P for trend <0.001). Compared with no SHS exposure at home from any source, the AORs were 1.16 (1.07 to 1.25) for SHS from inside the home only (p<0.001), 1.20 (1.11 to 1.31) from neighbours only (p<0.001), and 1.74 (1.56 to 1.94) from both (p<0.001). CONCLUSIONS SHS exposure at home from neighbours was prevalent in Hong Kong adolescents, and was associated with respiratory symptoms in never-smokers. SHS exposure at home may be underestimated by ignoring the neighbouring source. Smoke-free housing policy is needed to protect children and adolescents from harms of SHS.
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Affiliation(s)
- Lok Tung Leung
- School of Public Health, The University of Hong Kong, Hong Kong
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong
| | - Wing Sze Lo
- School of Public Health, The University of Hong Kong, Hong Kong
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong
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Farber HJ, Nelson KE, Groner JA, Walley SC. Public Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke. Pediatrics 2015; 136:998-1007. [PMID: 26504133 DOI: 10.1542/peds.2015-3109] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Tobacco use and tobacco smoke exposure are among the most important health threats to children, adolescents, and adults. There is no safe level of tobacco smoke exposure. The developing brains of children and adolescents are particularly vulnerable to the development of tobacco and nicotine dependence. Tobacco is unique among consumer products in that it causes disease and death when used exactly as intended. Tobacco continues to be heavily promoted to children and young adults. Flavored and alternative tobacco products, including little cigars, chewing tobacco, and electronic nicotine delivery systems are gaining popularity among youth. This statement describes important evidence-based public policy actions that, when implemented, will reduce tobacco product use and tobacco smoke exposure among youth and, by doing so, improve the health of children and young adults.
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Farber HJ, Walley SC, Groner JA, Nelson KE. Clinical Practice Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke. Pediatrics 2015; 136:1008-17. [PMID: 26504137 DOI: 10.1542/peds.2015-3108] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Tobacco dependence starts in childhood. Tobacco exposure of children is common and causes illness and premature death in children and adults, with adverse effects starting in the womb. There is no safe level of tobacco smoke exposure. Pediatricians should screen for use of tobacco and other nicotine delivery devices and provide anticipatory guidance to prevent smoking initiation and reduce tobacco smoke exposure. Pediatricians need to be aware of the different nicotine delivery systems marketed and available.Parents and caregivers are important sources of children's tobacco smoke exposure. Because tobacco dependence is a severe addiction, to protect children's health, caregiver tobacco dependence treatment should be offered or referral for treatment should be provided (such as referral to the national smoker's quitline at 1-800-QUIT-NOW). If the source of tobacco exposure cannot be eliminated, counseling about reducing exposure to children should be provided.Health care delivery systems should facilitate the effective prevention, identification, and treatment of tobacco dependence in children and adolescents, their parents, and other caregivers. Health care facilities should protect children from tobacco smoke exposure and tobacco promotion. Tobacco dependence prevention and treatment should be part of medical education, with knowledge assessed as part of board certification examinations.
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Abstract
This technical report serves to provide the evidence base for the American Academy of Pediatrics' policy statements "Clinical Practice Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke" and "Public Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke." Tobacco use and involuntary exposure are major preventable causes of morbidity and premature mortality in adults and children. Tobacco dependence almost always starts in childhood or adolescence. Electronic nicotine delivery systems are rapidly gaining popularity among youth, and their significant harms are being documented. In utero tobacco smoke exposure, in addition to increasing the risk of preterm birth, low birth weight, stillbirth, placental abruption, and sudden infant death, has been found to increase the risk of obesity and neurodevelopmental disorders. Actions by pediatricians can help to reduce children's risk of developing tobacco dependence and reduce children's involuntary tobacco smoke exposure. Public policy actions to protect children from tobacco are essential to reduce the toll that the tobacco epidemic takes on our children.
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Leung CY, Leung GM, Schooling CM. Early second-hand smoke exposure and child and adolescent mental health: evidence from Hong Kong's 'Children of 1997' birth cohort. Addiction 2015; 110:1811-24. [PMID: 26119482 DOI: 10.1111/add.13033] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 03/27/2015] [Accepted: 06/22/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Second-hand smoke (SHS) exposure is associated negatively with childhood behavioural problems in western settings. In a developed non-western setting, we estimated the associations of early SHS exposure during the prenatal and postnatal periods with several aspects of adolescent mental health. DESIGN Multivariable linear regression was used to estimate the adjusted associations of pre- and postnatal SHS exposure with adolescent mental health. SETTING Hong Kong. PARTICIPANTS Population-representative "Children of 1997" birth cohort. Behavioural problems at ~11 years were available for 5598, self-esteem at ~11 years for 6937 and depressive symptoms at ~13 years for 5797. MEASUREMENTS SHS was categorized as no SHS exposure, occasional prenatal SHS exposure from non-parental sources, daily prenatal SHS exposure from non-parental sources, postnatal SHS exposure from non-parental sources, prenatal and postnatal SHS exposure from non-parental sources, occasional paternal smoking, daily paternal smoking and any maternal smoking. Behavioural problems were assessed from parent-reported Rutter score, self-esteem from self-reported Culture-Free Self-Esteem Inventory score and depressive symptoms from self-reported Patient Health Questionnaire-9 score. FINDINGS Prenatal SHS exposure from non-parental sources was associated with behavioural problems at ~11 years (1.24, 95% confidence interval 0.20-2.28) adjusted for sex, age of assessment, survey mode (for depressive symptoms only), socio-economic position (SEP), mother's birthplace, gestational age and parity; paternal smoking and maternal smoking were associated with more mental health problems but also with lower SEP. CONCLUSIONS In Hong Kong, prenatal second-hand tobacco smoke exposure appears to be a risk factor for behavioural problems at age 11 years independent of socio-economic position.
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Affiliation(s)
- Cherry Y Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,CUNY School of Public Health and Hunter College, New York, USA
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Chen J, Wang MP, Wang X, Viswanath K, Lam TH, Chan SS. Secondhand smoke exposure (SHS) and health-related quality of life (HRQoL) in Chinese never smokers in Hong Kong. BMJ Open 2015; 5:e007694. [PMID: 26338682 PMCID: PMC4563261 DOI: 10.1136/bmjopen-2015-007694] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The evidence on the effect of secondhand smoke (SHS) on Health Related Quality of Life (HRQoL) is limited. We examined the relation between SHS and HRQoL among Chinese in Hong Kong. METHODS Adult never smokers from a probability sample of three cross-sectional waves (2010, 2012, 2013) of The Hong Kong Family and Health Information Trends Survey who completed the Cantonese-version of Short-Form 12 Health Survey Questionnaire (SF12v2) were included in the data analysis conducted in 2014. Models were used to examine associations of SHS with SF12 domains and summary scores of Physical (PCS12) and Mental Component (MCS12) with subgroups analysis by SHS locations. RESULTS After adjustments, SHS was associated with lower scores on all SF12 domains except physical functioning. PCS12 (regress coefficient=-0.76, 95% CI -1.34 to -0.17) and MCS12 (regress coefficient=-1.35, 95% CI -2.06 to -0.64) were lower in those with SHS exposure than those non-exposed. Those exposed to SHS in outdoor public places had lower scores on most SF12 domains and PSC12 and MCS12. SHS exposure in one's home and workplace was associated with lower scores on role physical, body pain and role emotional while SHS exposure in friends' homes was additionally associated with lower social functioning and mental health scores. Lower MCS12 was associated with SHS exposure at all locations except one's home. CONCLUSIONS Our study showed that SHS exposure, particularly in outdoor public places, was associated with decreased HRQoL. It can provide new evidence for stronger smoke-free policies on public places and promoting smoke-free homes.
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Affiliation(s)
- Jing Chen
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - Man-Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - Xin Wang
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Kasisomayajula Viswanath
- Center for Community-Based Research, Dana-Farber Cancer Institute/Department of Social and behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Sophia S Chan
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
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