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Kibria MG, Hossain A, Islam T, Islam KR, Mahmud HMM, Nabi MH, Hawlader MDH. Secondhand smoke exposure and associated factors among city residents living in multiunit housing in Bangladesh. PLoS One 2023; 18:e0291746. [PMID: 37733729 PMCID: PMC10513191 DOI: 10.1371/journal.pone.0291746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 09/05/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Secondhand smoke (SHS) poses a high health risk to those living in multiunit housing (MUH) since it can easily spread from unit to unit and throughout the building's communal areas. MUH residents in Bangladesh are particularly vulnerable to SHS due to the absence of smoking restrictions within a housing complex. Therefore, this study aimed to assess the prevalence of SHS exposure and its associated factors among MUH residents living in seven divisional cities of Bangladesh- Dhaka, Chattogram, Rajshahi, Khulna, Sylhet, Barishal, and Rangpur. METHODS From April 2019 to November 2019, a cross-sectional survey was conducted with 616 MUH residents aged 18 or older who had been residing in MUH for at least two years in the seven divisional cities of Bangladesh. A multivariable logistic regression model was performed to determine the associated factors of SHS exposure. RESULTS In MUH complexes, more than half (54.9%) of the 616 respondents were exposed to SHS. The key factors positively associated with SHS exposure were females (aOR: 1.8, 95% CI:1.236-2.681), residents with a low monthly family income (aOR: 1.9, 95% CI: 1.162-3.220), those whose family members smoked (aOR: 2.4, 95% CI: 1.537-3.746), and Dhaka city residents (aOR: 1.9, 95% CI: 1.013-3.440). CONCLUSIONS This study revealed a high prevalence of SHS exposure among Bangladeshi MUH residents. Therefore, a smoking ban is needed in and around MUH complexes to protect non-smoking residents from SHS exposure.
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Affiliation(s)
- Md. Golam Kibria
- Department of Research, Centre for Development Action, Dhaka, Bangladesh
| | - Ahmed Hossain
- Health Services Administrations, College of Health Sciences, University of Sharjah, Sharjah, UAE
| | - Taslima Islam
- Department of Research, Centre for Development Action, Dhaka, Bangladesh
- Department of Monitoring, Evaluation and Learning, Social Development Foundation, Dhaka, Bangladesh
| | - Kazi Rakibul Islam
- Department of Public Health, Northern University Bangladesh, Dhaka, Bangladesh
| | - H. M. Miraz Mahmud
- Department of Research & Evaluation, Bangladesh Center for Communication Programs, Dhaka, Bangladesh
| | | | - Mohammad Delwer Hossain Hawlader
- Department of Research, Centre for Development Action, Dhaka, Bangladesh
- Department of Public Health, North South University, Dhaka, Bangladesh
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Li L, Xu G, Li J, Wang Y, Bian G. Association between secondhand smoke exposure and negative emotions among 12-15-year-old non-smoking adolescents from 63 low- and middle-income countries. J Affect Disord 2023; 325:297-305. [PMID: 36586618 DOI: 10.1016/j.jad.2022.12.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/14/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Secondhand smoke (SHS) exposure is associated with negative emotions in adolescents, but the association between SHS exposure and negative emotions has been understudied, especially in low- and middle-income countries. Hence, we studied the association between SHS exposure and negative emotions among 12-15-year-old non-smoking adolescents from 63 low- and middle-income countries (LMICs). METHODS We calculated the pooled prevalence of SHS exposure, loneliness, and anxiety in 12-15-year-old non-smoking adolescents. Multivariable logistic regression was used to evaluate country-specific associations between SHS exposure and negative emotions, after adjusting for important confounders. Meta-analyses were performed to evaluate the overall, regional, and country-income level pooled associations. RESULTS Of the adolescents included in the analysis, 34.88 % had less than daily SHS exposure and 13.41 % were exposed to SHS daily. The overall prevalence of loneliness and anxiety in the adolescents was 10.51 % and 8.95 %, respectively. Exposure to SHS in the past 7 days was associated with loneliness and anxiety, with odds ratios (95 % confidence intervals) of 1.15 (1.09-1.21) and 1.24 (1.17-1.31), respectively. These positive associations were observed in girls, but not in boys. In addition, there was a positive dose-response relationship between the day of exposure to SHS and loneliness and anxiety. LIMITATIONS The GSHS data were obtained from a self-report questionnaire and the participants were only adolescents in school. CONCLUSIONS Our study revealed a positive association between SHS exposure and negative emotions among non-smoking adolescents from LMICs.
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Affiliation(s)
- Lian Li
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Guodong Xu
- Precaution ang Health Care Section, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Jincheng Li
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China
| | - Yucheng Wang
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
| | - Guolin Bian
- Ningbo Kangning Hospital, Ningbo, Zhejiang, China.
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ÖKSÜZ A, KUTLU R, REİSLİ İ, KILINC İ. İdrar kotinin ve kotinin/kreatinin oranının çevresel tütün dumanı maruziyetinin bir biyolojik belirteci olarak kullanımı. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1087781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: Exposure to Environmental Tobacco Smoke (ETS) remains a worldwide public health problem. The purpose of this study was to investigate the relationship between parents' smoking habits at home and children's exposure to environmental tobacco smoke by measuring urinary cotinine levels and urine cotinine/creatinine ratios in children.
Materials and Methods: This case-control typed analytical study was conducted with 357 children in the 0-18 age group. The case group consisted of 180 children exposed to environmental cigarette smoke. As the control group, it consisted of 177 healthy children and non-smoking in their family. The levels of cotinine and creatinine in spot urinary were analyzed in both groups.
Results: The urinary cotinine level of the children was found to be statistically higher in those whose parents were smokers, female gender, fathers with a low educational level, and those with 3 or fewer rooms in the house. The urinary cotinine/creatinine ratio of the children was found to be statistically higher in those whose parents were smokers (15.91 pg/mg (1.54-147.54) vs 7.90 pg/mg (1.29-68.52)), female gender (13.19 pg/mg (1.79-115.07) vs 10.45 pg/mg (1.29-147.54)). Urinary cotinine levels in the ETS exposed group were affected 1042 times more than in the ETS unexposed group [OR:1042,462, 95% CI (139.821.839-7772.246)].
Conclusion: In the present study, urinary cotinine levels were found to be higher in children exposed to tobacco smoke than in children not exposed to tobacco smoke. In the light of these results, urinary cotinine can be used as a biomarker to evaluate exposure to ETS in children. Educating parents is essential to raising their awareness of exposure to ETS and teaching the right behaviors to protect children's health, especially in the home environment.
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Affiliation(s)
| | - Ruhuşen KUTLU
- Necmettin Erbakan University Meram Medical Faculty Department of Family Medicine
| | - İsmail REİSLİ
- Necmettin Erbakan University Meram Medical Faculty Department of Pediatric Alergy and Immunology
| | - İbrahim KILINC
- Necmettin Erbakan University Meram Medical Faculty Department of Biochemistry
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Shehab K, Ziyab AH. Beliefs of parents in Kuwait about thirdhand smoke and its relation to home smoking rules: A cross-sectional study. Tob Induc Dis 2021; 19:66. [PMID: 34531710 PMCID: PMC8404267 DOI: 10.18332/tid/140090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/06/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Thirdhand smoke (THS) is the toxic residue of tobacco smoke that persists long after tobacco smoking on the clothing and hair of smokers and in the surrounding environment. This study aimed to assess parents' beliefs about THS in terms of harm and persistence in the environment and evaluate associations between parents' THS beliefs and home smoking rules. METHODS A sample of parents living in Kuwait were enrolled in a cross-sectional study. Parents reported home smoking rules (strict, partial, and no, home smoking ban) and completed the 9-item Beliefs About ThirdHand Smoke (BATHS) scale that assessed parents' overall, health, and persistence beliefs about THS. Associations between the quartiles of THS overall, health, and persistence beliefs scores and home smoking rules were evaluated using a modified Poisson regression, and adjusted prevalence ratios (APR) and 95% confidence intervals (CI) were estimated. RESULTS In total, 536 parents (404 females) were enrolled in the study, with 42.0% (n=225) and 43.6% (n=234) reporting a strict or partial home smoking ban, respectively. The prevalence of a strict home smoking ban was higher among never smokers than among ever smokers (49.1% vs 25.2%, p<0.001). The majority of participants indicated that THS exposure harms the health of children (67.2%) and adults (60.6%) and THS residue could remain for days in the environment (58.9%). The prevalence of a strict home smoking ban increased as THS overall (APRQ4 vs Q1 = 1.48; 95% CI: 1.12-1.96), health (APRQ4 vs Q1 = 1.22; 1.02-1.45), and persistence (APRQ4 vs Q1 = 1.55; 1.17-2.05) beliefs scores increased. CONCLUSIONS Parents' harm and persistence beliefs about THS were associated with enforcing a strict home smoking ban, which provides a safer environment for children and non-smokers. Therefore, tobacco prevention programs need to incorporate educational messages about the harm of THS in an attempt to promote smoke-free homes.
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Affiliation(s)
- Kawthar Shehab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
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Mpousiou D, Soteriades ES, Patrinos S, Sakkas N, Karakatsani A, Karathanasi A, Gratziou C, Katsaounou PA. Could adolescents be the vehicle that transfers a no-smoking rule from school to home? Tob Prev Cessat 2021; 7:52. [PMID: 34307967 PMCID: PMC8283973 DOI: 10.18332/tpc/137482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Banning smoking at home, schools, children's playgrounds and indoor environments, constitutes an integral part of tobacco control efforts to prevent uptake of smoking among young teenagers. We aimed at exploring the role of teenagers as facilitators of change in enforcing a home no-smoking rule following school-based anti-tobacco programs and examining the effect of home no-smoking rule on teenagers' intention to smoke. METHODS A school-based intervention-control study was implemented during the 2016-2017 academic year among middle-school students in Athens, Greece. The experiential learning intervention was delivered using an interdisciplinary approach, bridging excerpts from ancient classical Greek myths and ancient classical literature, with their decoded archetypal symbols applied in a smoking and tobacco control paradigm. An anonymous selfadministered questionnaire was used at baseline, and at follow-up at 3 months to evaluate program effectiveness. A chi-squared test was used for categorical variables and a t-test for continuous variables. Cohen's distance (d) was employed to examine the intervention effect size. A two-tailed p≤0.05 was considered statistically significant using IBM SPSS V.22. RESULTS In all, 351 students participated. At baseline, 47.5% in the intervention group reported a home no-smoking rule and 86% indicated being unlikely to smoke, these increased to 61.3% (p=0.016) and 98.2% (p<0.001) at followup, respectively. Cohen's d value was calculated to estimate the effect size of intervention. A large effect size of intervention was found in the intervention group (d=1.24), whilst d=0.19 in the control group. CONCLUSIONS Our study showed that our intervention led to the increase of no-smoking rules at home and to a negative intention towards smoking of adolescents. Consequently, we provide evidence that students are effective vehicles for carrying anti-smoking messages to their home environment including the no-smoking rule. Additionally, we confirmed previous reports that home no-smoking rule is associated with a negative intention to smoke and risk of smoking.
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Affiliation(s)
- Dimitra Mpousiou
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Thoracic Society, Athens, Greece
| | - Elpidoforos S. Soteriades
- Hellenic Thoracic Society, Athens, Greece
- Healthcare Management Program, School of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, United States
| | | | - Nickolaos Sakkas
- Department of Physiotherapy, School of Bioscience, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Anna Karakatsani
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Thoracic Society, Athens, Greece
- 2nd Pulmonary Medicine Department, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Areti Karathanasi
- Institute of Educational Policy, Ministry of Education and Religious Affairs, Athens, Greece
| | - Chrstina Gratziou
- Evgenidion Clinic Agia Trias S. A., National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi A. Katsaounou
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Thoracic Society, Athens, Greece
- First Intensive Care Unit, Department of Pulmonary Medicine, Evaggelismos General Hospital, Athens, Greece
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Lim KH, Ghazali SM, Lim HL, Cheong YL, Kee CC, Heng PP, Tiunh TY, Mat Hashim MH, Lim JH. Prevalence and factors related to secondhand smoke exposure among secondary school-going adolescents in Malaysia: Findings from Malaysia Global Health School Survey 2012 and 2017. Tob Induc Dis 2021; 19:50. [PMID: 34177412 PMCID: PMC8204740 DOI: 10.18332/tid/136029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/15/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Secondhand (SHS) smoke exposure has caused various health problems. Therefore, continuous monitoring of SHS exposure is important to determine the efficacy of various anti-tobacco measure implemented. The study aims to compare the prevalence and factor(s) associated with SHS exposure among secondary school-going adolescents in Malaysia during 2012 and 2017. METHODS We derived data from the Global School Health Survey (GSHS) 2012 and GSHS 2017, which was carried out in Malaysia using multistage sampling to select representative samples of secondary school-going adolescents. Both surveys used similar questionnaires to measure SHS exposure. Descriptive and multivariate logistic regression was used to determine the prevalence and factors associated with SHS exposure. RESULTS Approximately four in ten respondents were exposed to SHS in the past week in both surveys (41.5% in GSHS 2012 and 42.0% in GSHS 2017, respectively). Both surveys revealed a significantly higher SHS exposure among respondents who smoked than among non-smokers and higher among males compared to females. The likelihood of SHS exposure in both surveys was also similar, with a higher likelihood of SHS exposure among smoking adolescents and non-smoking adolescents who had at least one smoking parent/guardian, regardless of their own smoking status. Male adolescents had a higher risk of SHS exposure compared to their female counterparts. Meanwhile, SHS risk also increased with age, regardless of smoking status. CONCLUSIONS Our findings suggested that there were no changes in the prevalence of SHS exposure and recorded only a slight change in the factors associated with exposure to SHS among school-going adolescents in Malaysia between the years 2012 and 2017. A more pro-active, extensive and comprehensive programme should be implemented to address the problem of SHS exposure. Parents should be advised to stop smoking or abstain from smoking in the presence of their children, and smoking cessation interventions are necessary for smoking adolescents and their parents.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Biostatistics and Data Raspatory Sector, National Institutes of Health, Shah Alam, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Tsye Yih Tiunh
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Jia Hui Lim
- Department of Pharmacy and Pharmaceutical Sciences, Monash University Malaysia, Subang Jaya, Malaysia
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Chen MY. The Negative Impact of Parental Smoking on Adolescents' Health-Promoting Behaviors: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052514. [PMID: 33802561 PMCID: PMC7967525 DOI: 10.3390/ijerph18052514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 11/16/2022]
Abstract
The literature has indicated that adolescents’ exposure to secondhand smoke (SHS) and having smoking parents were positively associated with current tobacco smoking. Few studies have explored the association between parental smoking and adolescent’s health-promoting behaviors. This study aimed to examine the prevalence of SHS and the relationship between parental smoking at home and adolescent’s health-promoting behaviors in rural areas. Methods: A school-based and cross-sectional study was conducted from March to December 2019 in western coastal Yunlin County, Taiwan. A total of 1227 adolescents, including 51% boys, anonymously participated in this study. Three parental smoking situations and eight questions of adolescents’ habits extracted from previous studies were applied. A linear regression model was used to analyze the factors associated with adopting health-promoting behaviors. Results: More than half (67.7%) of adolescents experienced parental smoking at home, 90.2% reported their family smoked around them, and 48.8% of participants “sometimes” or “never” avoided SHS. Many participants showed a low frequency of water (49.6%), vegetable (49.1%), and fruit (63.2%) intake, using dental floss (84.7%), and regular exercise (60.6%). The determinants of adolescents’ health-promoting scores were highly associated with avoidance of SHS, less associated with parental smoking, and parents smoking at home and around adolescents. Conclusion: The findings showed that in the rural area, a high prevalence of parental smoking at home and parental smoking around adolescents was noted. It is an important issue that parental smoking was negatively associated with adolescent’s health-promoting behaviors.
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Affiliation(s)
- Mei-Yen Chen
- Department of Nursing, Chang Gung University of Science and Technology, Putz City, Chiayi County 61363, Taiwan; ; Tel.: +886-(5)-3628800 (ext. 2301); Fax: +886-(5)-3628866
- School of Nursing, Chang Gung University, Taoyuan 333, Taiwan
- Department of Cardiology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
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Alali WQ, Longenecker JC, Alwotyan R, AlKandari H, Al-Mulla F, Al Duwairi Q. Prevalence of smoking in the Kuwaiti adult population in 2014: a cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:10053-10067. [PMID: 33161520 PMCID: PMC7648895 DOI: 10.1007/s11356-020-11464-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/28/2020] [Indexed: 05/06/2023]
Abstract
The study objective was to assess tobacco smoking prevalence in Kuwaiti adults in relation to sociodemographic characteristics. A cross-sectional study survey was conducted in 2014 on 3917 Kuwaiti citizens (18-69 years) following the World Health Organization (WHO) STEPwise Approach to Surveillance (STEPS) methodology. The study assessed prevalence of self-reported ever-smoking or currently smoking tobacco products and exposure to secondhand smoke in relation to demographic and smoking-related characteristics. The prevalence of "ever smoker" in men and women was 49.9% and 4.4%, respectively, whereas the prevalence of "current smoker" was 39.2% and 3.3%, respectively. Sex (adjusted OR [AOR], 19.2 [95% confidence interval (CI) 13.0-28.3], male versus female) was significantly associated with current smoking. Among daily smokers, 87.1% used manufactured cigarettes. The average daily number of manufactured cigarettes for men and women was 21.8 and 13.0, respectively. Mean age at smoking initiation was 17.5 years (95% CI 17.2-17.9). The prevalence of secondhand smoke at home and work was 38.6% and 29.9%, respectively. Half of Kuwaiti men have smoked at some point in their life with most of these being current smokers. Secondhand smoke is a common exposure at home and work, posing serious health risks to the population.
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Affiliation(s)
- Walid Q Alali
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Kuwait University, Safat, Kuwait.
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait.
| | - Joseph C Longenecker
- Faculty of Medicine and Faculty of Public Health, Kuwait University, Safat, Kuwait
| | - Rehab Alwotyan
- Primary Health Care Department, Ministry of Health, Kuwait City, Kuwait
| | - Hessa AlKandari
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Ministry of Health, Kuwait City, Kuwait
| | - Fahd Al-Mulla
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Qais Al Duwairi
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
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Esmaeil A, Alshammasi A, Almutairi W, Alnajem A, Alroumi D, Ali M, Redha A, Alhussaini M, Ziyab AH. Patterns of electronic cigarette, conventional cigarette, and hookah use and related passive exposure among adolescents in Kuwait: A cross-sectional study. Tob Induc Dis 2020; 18:59. [PMID: 32765199 PMCID: PMC7398596 DOI: 10.18332/tid/123499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Use of tobacco products among adolescents is a major global public health concern. Given the changing landscape of tobacco product use and the lack of epidemiologic data to inform tobacco prevention and control strategies in Kuwait, this study sought to estimate the prevalence and patterns of electronic cigarette (e-cigarette), conventional cigarette, and hookah use among adolescents in Kuwait. Moreover, exposure to secondhand smoke (SHS) and secondhand aerosol (SHA) from e-cigarettes was assessed. METHODS This cross-sectional study enrolled high school students (n=1565; 16–19 years) across Kuwait. Current (past 30-day) use of e-cigarettes, conventional cigarettes, and hookah were assessed through self-reported data. Additionally, current (past 7-day) exposure to SHS and SHA in households and public places were ascertained. Associations were evaluated using Poisson regression, and adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) were estimated. RESULTS Overall, 26.4% (402/1525), 25.1% (383/1525), and 20.9% (318/1525) of the study participants were current e-cigarette users, conventional cigarette smokers, and hookah smokers, respectively. Current use of any tobacco product was reported by 35.1% (535/1525) of the total study participants. The prevalence of concurrent triple use of ‘e-cigarettes, conventional cigarettes, and hookah’ was estimated to be 12.8% (195/1525). Also, among the study participants, 41.9% (619/1479) were exposed to household SHS, 32.0% (469/1465) were exposed to household SHA, and 62.2% (916/1472) were exposed to SHS and/or SHA in public places. Male adolescents were more likely than females to be current e-cigarette users (APR=5.19; 95% CI: 4.09–6.57), conventional cigarette smokers (APR=5.42; 95% CI: 4.26–6.90), and hookah smokers (APR=3.43; 95% CI: 2.72– 4.32). CONCLUSIONS A substantial proportion of adolescents in Kuwait are currently using tobacco products and being exposed to SHS/SHA. The findings emphasize the need to continue monitoring all forms of tobacco product use among adolescents and to strengthen tobacco prevention and control programs.
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Affiliation(s)
- Ali Esmaeil
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | | | - Waad Almutairi
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | | | - Dalal Alroumi
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Mohamad Ali
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Abdullah Redha
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | | | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
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Booalayan H, Abdualrasool M, Al-Shanfari S, Boujarwa A, Al-Mukaimi A, Alkandery O, Akhtar S. Exposure to environmental tobacco smoke and prevalence of asthma among adolescents in a middle eastern country. BMC Public Health 2020; 20:1210. [PMID: 32770990 PMCID: PMC7414674 DOI: 10.1186/s12889-020-09245-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 07/12/2020] [Indexed: 02/01/2023] Open
Abstract
Background There is increasing evidence linking environmental tobacco smoke (ETS) exposure at homes to the development of asthma among adolescents. Few studies have addressed this issue in the Middle Eastern countries including Kuwait. Therefore, this cross-sectional study assessed the prevalence of ETS exposure at home, prevalence of asthma and other respiratory conditions and examined the ETS exposure at home and personal tobacco smoking as risk factors for self-reported asthma among high-school students in Kuwait. Methods In this cross-sectional study, we enrolled participants from nine high-schools of Hawally Governorate of Kuwait during October 2015. We adapted a previously validated self-administered questionnaire for data collection. Prevalence of self-reported asthma and ETS exposure (≥ 1 smoker at home vs. none) were computed. The association between exposures of interest and self-reported asthma status was examined using a multivariable log-binomial regression model. Results Of 800 enrolled participants, 746 (92.2%) consented and completed the questionnaire. The participants with mean (SD) age of 16.8 (0.68) years were predominantly Kuwaiti (74.8%) and female (50.1%). The prevalence of ETS exposure at home and personal current smoking was 54 and 12.4% respectively. Self-reported asthma prevalence was 20.5%. Furthermore, the prevalence of physician-diagnosed asthma, wheezing during the last 12 months and wheezing ‘ever’ was 16.4, 20.1 and 26.2%, respectively. Fitted multivariable log-binomial regression model revealed that compared with the non-asthmatic, participants with self-reported asthma tended to be current smokers (adjusted prevalence ratio (adjusted PR) = 1.82; 95% CI: 1.30–2.56; p = 0.001) or have had ETS exposure at home (adjusted PR = 1.64; 95% CI: 1.21–2.23; p = 0.002). Conclusions We recorded a high prevalence of ETS exposure at home, high prevalence of self-reported asthma and identified ETS exposure at home and being a current smoker as strong risk factors for self-reported asthma among adolescents. Voluntary household smoking bans may substantially minimize the ETS exposure among adolescents. Additionally, such restriction may inculcate an antismoking attitude and prevent smoking initiation among adolescents. Such efforts may bring about reduction in ETS exposure and associated asthma risk and other smoking-related morbidities in this and other similar settings.
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Affiliation(s)
- Hussain Booalayan
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Mosa Abdualrasool
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Saad Al-Shanfari
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Abdulwahab Boujarwa
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Abdullah Al-Mukaimi
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Omar Alkandery
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait
| | - Saeed Akhtar
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, PO Box 24923, 13110, Safat, Kuwait.
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