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Liu TY, Qiu DC, Song F, Chen T. Trends in Socio-economic Inequality in Smoking Among Middle-aged and Older Adults in China: Evidence From the 2011 and 2018 China Health and Retirement Longitudinal Study. Nicotine Tob Res 2023; 25:50-57. [PMID: 35764073 DOI: 10.1093/ntr/ntac158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 05/25/2022] [Accepted: 06/27/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Socio-economic inequalities in smoking and related health problems are a public health concern worldwide. To support the development of effective tobacco control policies, this study examines trends in smoking rates according to socio-economic status (SES) in China. AIMS AND METHODS We analyzed data from repeated cross-sectional China Health and Retirement Longitudinal Study (CHARLS) on adults aged ≥45 years for the years 2011 and 2018, which involved 16 471 participants in 2011 and 19 367 in 2018. We then estimated the SES of individuals based on four types of wealth-related variables, namely, education, occupation, household characteristics, and durable consumer goods. Principal-component analysis was conducted to measure SES, and the Erreygers normalised concentration index (ECI) was used to calculate socio-economic inequality in current smoking by gender, age, and region. RESULTS The overall ECI (95% confidence interval) for women was -0.042 (-0.054 to -0.031) and -0.038 (-0.047 to -0.029) for 2011 and 2018, respectively. The ECI (95% confidence interval) for men was -0.077 (-0.101 to -0.050) and -0.019 (-0.042 to 0.005) for 2011 and 2018, respectively. The inequality in smoking by SES for adults aged < 60 years in the Northeast region increased during 2011-2018, from -0.069 (-0.144 to 0.006) to -0.119 (-0.199 to -0.038) for women and from 0.009 (-0.115 to 0.132) to -0.164 (-0.296 to -0.032) for men. CONCLUSIONS smoking inequality by socio-economic among adults aged ≥45 years declined in recent years in China. However, smoking inequality by SES increased in other population groups. IMPLICATIONS Our research indicated that socio-economic inequality of current smoking among residents aged 45 years and older declined in 2018 when compared with 2011 numbers, particularly for men aged ≥ 60 years. Women in the Northeast region displayed more significant smoking inequality by SES than women in other regions did. During the study period, there was an increase in inequality in smoking by SES for adults aged < 60 years in the Northeast region. Thus, tobacco control policies and interventions should be targeted at high-risk subpopulations with lower SES, particularly in Northeast China.
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Affiliation(s)
- Tai-Yi Liu
- School of Public Health, Hubei Provincial Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - De-Chao Qiu
- Jintang First People's Hospital, West China Hospital Sichuan University Jingtang Hospital, Jingtang, China
| | - Fujian Song
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Ting Chen
- School of Public Health, Hubei Provincial Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
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Wang J, Zhang S. Passive smoking may be associated with bleeding of cerebral arteriovenous malformation in non-smoking women: a retrospective analysis. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:557-562. [PMID: 35946710 PMCID: PMC9387183 DOI: 10.1590/0004-282x-anp-2021-0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/01/2021] [Accepted: 08/27/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Smoking has been considered to be a risk factor for cardiovascular disease, cancer, depression and other diseases in previous reports, and active smoking is considered to be a risk factor for hemorrhagic stroke. In addition, a retrospective study showed that male smokers were at increased risk of bleeding from arteriovenous malformation (AVM), compared with non-smokers. However, the effect of passive smoking on rupturing of cerebral AVM in non-smoking women has not been addressed. OBJECTIVE This study aimed to assess the impact of tobacco exposure on AVM bleeding risk in non-smoking women. METHODS A total of 393 non-smoking women diagnosed with AVM were included. They were divided into a bleeding group (205 women) and a non-bleeding group (188 women). We conducted univariate and multivariate analysis on these two groups. In univariate analysis, risk factors that might be related to AVM bleeding were analyzed. In multivariate analysis, the relationship between passive smoking and AVM rupture was analyzed by correcting confounding factors. RESULTS Multivariate analysis showed that the proportion of passive smoking was statistically different between the bleeding group and the non-bleeding group (OR = 1.609; CI = 1.031-2.509; p = 0.036). CONCLUSION Passive smoking may increase the risk of AVM bleeding in non-smoking women. This increased risk may be related to the inflammatory response, vascular wall damage, hemodynamic disorders, changes in atherosclerosis and changes in gene expression caused by passive smoking.
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Affiliation(s)
- Jiao Wang
- Beijing Jingmei Group General Hospital, Department of Emergency, Beijing, China
| | - Shuai Zhang
- Beijing Jingmei Group General Hospital, Department of Neurosurgery, Beijing, China
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Alkan Ö, Ünver Ş. Secondhand smoke exposure for different education levels: findings from a large, nationally representative survey in Turkey. BMJ Open 2022; 12:e057360. [PMID: 35177464 PMCID: PMC8860053 DOI: 10.1136/bmjopen-2021-057360] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/28/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The aim of this study is to determine the factors that influence individuals' exposure to tobacco smoke in Turkey according to their education level. DESIGN Secondary data analysis. PARTICIPANTS Altogether, 17 084 individuals aged 15 and over were included in this study. SETTINGS Data set of the Turkey Health Survey in 2019. METHODS Binary logistic regression analysis was used to determine the factors associated with individuals' exposure to tobacco smoke. PRIMARY AND SECONDARY OUTCOME MEASURES The variables age, gender, marital status, general health status, employment status, receipt of psychosocial support and tobacco use were found to be correlated with exposure to tobacco smoke. RESULTS The study determined that individuals who are illiterate/unschooled were exposed to tobacco smoke at a rate of 32.61%, primary school graduates at a rate of 34.32%, primary education graduates at a rate of 41.75%, high school graduates at a rate of 41.04% and university graduates at a rate of 40.34%. CONCLUSION As a result of the study, it is emphasised that men, young individuals, individuals with moderate and very good general health status, those who use tobacco, those who are unemployed and those who receive psychosocial support should be targeted. In addition, appropriate strategies for reducing secondhand smoke (SHS) exposure should be developed, taking into account public health strategies for increasing awareness of the adverse health effects of SHS exposure and the determinants of tobacco exposure according to the study.
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Affiliation(s)
- Ömer Alkan
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Turkey
| | - Şeyda Ünver
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Turkey
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Abbasi-Kangevari M, Masinaei M, Fattahi N, Rahimi Y, Rezaei N, Azadnajafabad S, Ghanbari A, Fakhimi R, Jourahmad Z, Ghamari SH, Malekpour MR, Ahmadi N, Hajebi A, Jafar-pour H, Farzadfar F. Current Inequities in Smoking Prevalence on District Level in Iran: A Systematic Analysis on the STEPS Survey. J Res Health Sci 2021; 22:e00540. [PMID: 36511256 PMCID: PMC9315459 DOI: 10.34172/jrhs.2022.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/28/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The prevalence of tobacco smoking and its burden on societies is not homogenous at the national and district levels. This nationwide study aimed to investigate current inequalities in the prevalence of smoking at the district level and the association of smoking behaviors with gender, wealth, education, and urbanization in Iran. STUDY DESIGN A cross-sectional study. METHODS This study was conducted by analyzing the data of the STEPS survey 2016 with 30 541 participants. The small-area estimation method using the Bayesian spatial hierarchical multilevel regression model was employed to generate district-level prevalence of all types of smoking by gender. The inequalities between the groups by wealth, education, and urbanization were investigated via concentration index. RESULTS The prevalence rates of current daily cigarette smoking were found to be at the range of 4.6-40.9 and 0-4.5 among men and women, respectively. Current daily cigarette smoking was higher in men than in women: 19.0 (95% CI: 9.5-28.7) vs 0.7 (95% CI: 0-6.9). Women with lower wealth, education, or urbanization were more likely to smoke tobacco or be exposed to secondhand smoking. On the other hand, men with higher wealth or education indices were more likely to smoke tobacco. Men with lower wealth, education, or urbanization were more likely to be exposed to secondhand smoking. CONCLUSION The smoking behavior varied significantly at the district level in Iran. Gender, wealth, education, and urbanization were determinants of smoking prevalence.
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Affiliation(s)
- Mohsen Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Mohsen Abbasi-Kangevari and Masoud Masinaei are co-first authors
| | - Masoud Masinaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Mohsen Abbasi-Kangevari and Masoud Masinaei are co-first authors
| | - Nima Fattahi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yekta Rahimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghanbari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roozbe Fakhimi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Zahra Jourahmad
- Isfahan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - AmirAli Hajebi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Jafar-pour
- Medical Student, Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: Farshad Farzadfar (MD, MPH, MHS, DSc), Tel/Fax: +98 21 88631293, E-mail:
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Zhang Q, Zeng G, Wang X, Wu KH. Associations of exposure to secondhand smoke with hypertension risk and blood pressure values in adults. Environ Health Prev Med 2021; 26:86. [PMID: 34488622 PMCID: PMC8422707 DOI: 10.1186/s12199-021-01009-0] [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: 06/08/2021] [Accepted: 08/21/2021] [Indexed: 12/19/2022] Open
Abstract
Background The effects of environmental chemical exposure on blood pressure (BP) have been confirmed, but the association between exposure to secondhand smoke (SHS) and hypertension risk and BP in the general population remains unknown. Methods Cross-sectional associations between SHS exposure and hypertension risk and BP values were evaluated using data for subjects who participated in the National Health and Nutrition Examination Survey (NHANES), 1999–2016. Logistic regression and linear regression were performed after adjusting for age, sex, race, alcohol consumption, poverty-to-income ratio (PIR), body mass index (BMI), estimated glomerular filtration rate, physical activity, diabetes, cardiovascular disease, and NHANES cycle. Restricted cubic spline models were created to display the potential nonlinear association between SHS and BP levels. Results Higher risk of hypertension was found at the highest SHS concentrations (OR = 1.13, 95% CI 1.04, 1.24, P for trend = 0.007). Additionally, SHS exposure had a strong positive association with systolic blood pressure (SBP) but was negatively associated with diastolic blood pressure (DBP). Furthermore, the nonlinear model result showed a significant association between SHS and SBP (P = 0.017); however, the nonlinear model result was not significant for SHS or DBP. Conclusions Our results suggest a potential association between high SHS exposure and the risk of hypertension. Further research is needed to elucidate the underlying mechanisms. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-01009-0.
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Affiliation(s)
- Qi Zhang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Guowei Zeng
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China
| | - Xiaowei Wang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Kai-Hong Wu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China.
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Affiliation(s)
- Ömer Alkan
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Turkey
| | - Şeyda Ünver
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Turkey
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7
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Kashani H, Nakhjirgan P, Hassanvand MS, Shamsipour M, Yunesian M, Farzadfar F, Naddafi K, Mesdaghinia A. Subnational exposure to secondhand smoke in Iran from 1990 to 2013: a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:2608-2625. [PMID: 33140301 DOI: 10.1007/s11356-020-11199-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
Every year, almost eight million people die from tobacco-related diseases, among which around 1.2 million die from secondhand smoke (SHS) exposure. Generally, it is estimated that SHS constituents generated in the interval between puffs are approximately 3 times more toxic than those produced at the moment of puffing. There is no risk-free level of SHS exposure, and even brief exposure can be harmful to health. The aim of this study was to assess SHS exposure and its trend in the different provinces of Iran from 1990 to 2013. To collect available data on SHS exposure, a systematic review was performed. We searched international and national databases using a combination of Medical Subject Headings (MeSH) and relevant text words in the titles, abstracts, and/or keywords. Also, the data in national surveys were gathered. The frequency of exposure in different provinces as well as age, sex, and rural/urban areas were extracted. Afterwards, modeling was done to estimate SHS exposure from the smoking data. According to our findings, SHS exposure was more prevalent among young people. Moreover, this exposure was greater in rural areas as compared to urban areas. A national study on 13-15-year-old individuals showed the highest exposure occurred outdoors. In addition, a declining trend was observed on SHS exposure over time. It seems that attention to the importance of SHS exposure in researches in Iran dates back to 2001, and gradually, especially in recent years, further studies have been conducted on SHS exposure.
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Affiliation(s)
- Homa Kashani
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, No. 1547, North Kargar Ave, Tehran, 1417993359, Iran.
| | - Pegah Nakhjirgan
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, No. 1547, North Kargar Ave, Tehran, 1417993359, Iran
| | - Masud Yunesian
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, No. 1547, North Kargar Ave, Tehran, 1417993359, Iran
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology & Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Mesdaghinia
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Water Quality Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
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Mengzi S, Min W, Chong S, Pingping Z, Yaogai L, Liyuan P, Shuo L, Yan Y, Lina J. The cut-off value of impaired fasting glucose should be lower: Based on the associations of fasting blood glucose with blood lipids. Prim Care Diabetes 2020; 14:147-153. [PMID: 31405610 DOI: 10.1016/j.pcd.2019.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 07/05/2019] [Accepted: 07/16/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The previous study served impaired fasting glucose (IFG), a pre-diabetic state which was much greater than that of diabetic patients, have reached no consensus on its cut-off value. In this study, we aimed to explore the cut-off value of IFG via the associations of blood lipids with fasting plasma glucose (FPG). DESIGN A cross-sectional study in Jilin province, China, 2012. SAMPLE 13,093 participants aged 18-79 years in Jilin province were involved in the study. The Lamba-Mu-Sigma (LMS) method and generalized additive model (GAM) were used to explore the associations of different levels of FPG and blood lipids. RESULTS The distributions of FPG, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-c) were significantly different by gender (p<0.01). In general, both LMS and GAM results showed that the TG and HDL-c curves had a steeper tendency when the FPG was greater than 6.0mmol/L. CONCLUSION FPG was positively associated with TG while negatively associated with HDL-c, and the associations were stronger in females. The cut-off value of IFG was suggested to be 6.0mmol/L.
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Affiliation(s)
- Sun Mengzi
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Wang Min
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Sun Chong
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Zheng Pingping
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Lv Yaogai
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Pu Liyuan
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Li Shuo
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Yao Yan
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China.
| | - Jin Lina
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China.
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Nurhasana R, Ratih SP, Djaja K, Hartono RK, Dartanto T. Passive Smokers' Support for Stronger Tobacco Control in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1942. [PMID: 32188091 PMCID: PMC7142641 DOI: 10.3390/ijerph17061942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 11/16/2022]
Abstract
Secondhand smoke exposure in Indonesia is high, especially compared to other Southeast Asian countries. Passive smoking leads to negative impacts on health and socio-economic well-being. Therefore, increasing the price of cigarettes and, thereby, increasing barriers to access to cigarettes could be an effective way to reduce smoking prevalence and protect people from second-hand smoke. This study aims to assess passive smokers' support for cigarette price increases in Indonesia. We perform a quantitative analysis with a cross-sectional design. The data were obtained through phone-based interviews of 1000 respondents aged 18 and older in Indonesia. Only 596 nonsmokers were included to be further analyzed in this study. This study found that 44.1% respondents have at least one family member who smokes. We considered the respondents' age, gender, education level, employment, and the number of people living in the respondent's household that are exposed to passive smoking. Our results demonstrate that passive smokers support stronger tobacco control such as increasing cigarette prices, regulating smoking behavior using a religious approach (Fatwa), and applying more effective pictorial health warnings.
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Affiliation(s)
- Renny Nurhasana
- Urban Studies Program, School of Strategic and Global Studies, Universitas Indonesia, Jakarta 10430, Indonesia; (R.N.); (K.D.)
- Center for Social Security Studies, Universitas Indonesia, Jakarta 10320, Indonesia
| | - Suci Puspita Ratih
- Department of Public Health, Faculty of Sports Science, Universitas Negeri Malang, Malang 65145, Indonesia
| | - Komara Djaja
- Urban Studies Program, School of Strategic and Global Studies, Universitas Indonesia, Jakarta 10430, Indonesia; (R.N.); (K.D.)
| | - Risky Kusuma Hartono
- Department of Public Health, Sekolah Tinggi Ilmu Kesehatan Indonesia Maju, Jakarta 12630, Indonesia;
| | - Teguh Dartanto
- Department of Economics, Faculty of Economics and Business, Universitas Indonesia, Depok 16424, Indonesia;
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Shi J, Bai Y, Qiu S, Li Y, Kou C, Tao Y, Zhen Q, Gu Y, Yu Y, Zhang K, Cheng Y, Liu Y. Classified status of smoking and quitting has different associations with dyslipidemia in residents in northeast China. Clin Chim Acta 2018; 486:209-213. [DOI: 10.1016/j.cca.2018.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 07/20/2018] [Accepted: 08/01/2018] [Indexed: 12/11/2022]
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11
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Carroll X, Liang X, Zhang W, Zhang W, Liu G, Turner N, Leeper-Woodford S. Socioeconomic, environmental and lifestyle factors associated with gestational diabetes mellitus: A matched case-control study in Beijing, China. Sci Rep 2018; 8:8103. [PMID: 29802340 PMCID: PMC5970220 DOI: 10.1038/s41598-018-26412-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/10/2018] [Indexed: 12/19/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is a common health problem during pregnancy and its prevalence is increasing globally, especially in China. The aim of this study was to investigate socioeconomic, environmental and lifestyle factors associated with GDM in Chinese women. A matched pair case-control study was conducted with 276 GDM women and 276 non-GDM women in two hospitals in Beijing, China. Matched factors include age and pre-pregnancy body mass index (BMI). GDM subjects were defined based on the International Association of Diabetes Study Group criteria for GDM. A conditional logistic regression model with backward stepwise selection was performed to predict the odds ratio (OR) for associated factors of GDM. The analyses of data show that passive smoking at home (OR = 1.52, p = 0.027), passive smoking in the workplace (OR = 1.71, p = 0.01), and family history of diabetes in first degree relatives (OR = 3.07, p = 0.004), were significant factors associated with GDM in Chinese women. These findings may be utilized as suggestions to decrease the incidence of GDM in Chinese women by improving the national tobacco control policy and introducing public health interventions to focus on the social environment of pregnant women in China.
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Affiliation(s)
- Xianming Carroll
- Department of Community Medicine, Mercer University School of Medicine, Macon, USA
| | - Xianhong Liang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. .,China National Clinical Research Center for Neurological Diseases, Beijing, China.
| | - Wenyan Zhang
- Department of Obstetrics and Gynecology, Beijing Chaoyang District Hospital of Maternal and Child Health, Beijing, China
| | - Wenjing Zhang
- Department of Obstetrics, Beijing Chuiyangliu Hospital, Beijing, China
| | - Gaifen Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Nannette Turner
- Department of Public Health, Mercer University College of Health Professions, Atlanta, USA
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Anstey KJ, Chen R. Invited Commentary: Secondhand Smoke-an Underrecognized Risk Factor for Cognitive Decline. Am J Epidemiol 2018; 187:919-921. [PMID: 29370342 DOI: 10.1093/aje/kwx378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 10/31/2017] [Indexed: 01/01/2023] Open
Abstract
Pan et al. (Am J Epidemiol. 2018;187(5):911-918) reported findings that exposure to secondhand smoke (SHS) was associated with cognitive decline over the course of 2 years among middle-aged and older Chinese women who never smoked, and they also reported a dose-response relationship. SHS exposure affects vulnerable people disproportionately because they have less control or choice over their living and working environment. Smoking is an established risk factor for dementia, but recent evidence reports on dementia-risk increase have not included SHS. Many epidemiologic studies collect data on smoking but not SHS exposure. SHS may be one of the most prevalent and modifiable risk factors for cognitive decline and therefore represents a major potential target for reduction of dementia risk. Given the high prevalence of smoking in China and other parts of the world, there is an urgent need to raise awareness of SHS reduction as part of global and national strategies to reduce cognitive decline and dementia and to introduce legislation that protects nonsmokers and vulnerable children and adults from SHS.
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Affiliation(s)
- Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, College of Medicine and Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Ruoling Chen
- Centre for Health and Social Care Improvement, Faculty of Education, Health, and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
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Tan T, Shi L, Chen X, Cai Y. Changes in the smoking behavior of pregnant women andtheir family members during pregnancy: A cross-sectional study in China. Tob Induc Dis 2018; 16:12. [PMID: 31516412 PMCID: PMC6659502 DOI: 10.18332/tid/85493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/06/2018] [Accepted: 02/19/2018] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Studies regarding the changes in smoking behavior of pregnant women have been mostly conducted in high income countries but rarely in China. This study thus focused on investigating the changes in smoking behavior among pregnant women and their family members in China, both before and during pregnancy. METHODS A cross-sectional study was carried out at nine Women and Children’s Hospitals in Shanghai, China, in 2014. A total of 2831 gestational households were recruited. The chi-squared test, paired sample t-test and logistical regression analysis were used during statistical analysis. RESULTS The prevalence of smoking for all household members significantly declined during pregnancy: 76.2% of the pregnant women, 19.2% of their husbands and 14.0% of other family members quit smoking entirely. The average daily cigarette consumption rate decreased from 5.9 to 0.9 among pregnant women, 11.4 to 9.5 for husbands, and 11.4 to 9.5 for other family members (paired sample t-test, p<0.001). The likelihood that husbands continued smoking during pregnancy was significantly lower for those with a shorter history of smoking, had a lower daily cigarette consumption rate and a household registration in Shanghai. CONCLUSIONS The prevalence of smoking among pregnant women, husbands and other family members significantly declines during pregnancy. Thus, pregnancy is most likely a key period in which to provide families with health education regarding the effects of smoking, both during the pregnancy period and in general. Intervention programs designed to reduce smoking among husbands during pregnancy should focus on those with a long history of smoking, a high rate of daily cigarette consumption, and those with household registration not in Shanghai.
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Affiliation(s)
- Tianyu Tan
- School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Lili Shi
- Xinhua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Xiaowen Chen
- Children's Hospital of Fudan University, Shanghai, China
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
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14
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Yu W, Hu B, Shi X, Cao Z, Ren M, He Z, Lin J, Deng H, Hu R. Nicotine inhibits osteogenic differentiation of human periodontal ligament cells under cyclic tensile stress through canonical Wnt pathway and α7 nicotinic acetylcholine receptor. J Periodontal Res 2018; 53:555-564. [PMID: 29603740 DOI: 10.1111/jre.12545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Nicotine, the main psychoactive component of tobacco, affects cell metabolism, proliferation, adhesion and, importantly, the osteogenic differentiation of fibroblasts. Approximately 15% of all orthodontic patients are adults among who one-fifth are smokers. Hence, it is necessary to have insight into the effects of nicotine on the osteogenic differentiation of hPDLCs during orthodontic tooth movement. This study aimed to investigate the effects and mechanisms of nicotine on the osteogenic differentiation of human periodontal ligament cells (hPDLCs) under the application of cyclic tensile stress. MATERIAL AND METHODS hPDLCs were obtained from donor third molars. The hPDLCs were treated with nicotine and/or cyclic tensile stress that was applied with a cell stress plus unit. The effect of nicotine on cell viability was analyzed using the MTT assay. The osteogenic differentiation of hPDLCs was detected by alkaline phosphatase staining, Alizarin Red S staining, quantitative real-time polymerase chain reaction and western blotting. RESULTS In combination with cyclic tensile stress, nicotine prevented the tensile stress-induced increase in alkaline phosphatase activity, formation of mineralization nodules and the upregulation of mRNA and protein expression of Runt-related transcription factor 2, transcription factor Sp7 and collagen type I; however, canonical Wnt pathway was activated. Furthermore, the addition of Dickkopf-related protein 1 and α-bungarotoxin counteracted the negative effect of nicotine and rescued the osteogenic differentiation of hPDLCs, respectively. CONCLUSION These results indicate that nicotine prevents the increased osteogenic potential of hPDLCs induced by cyclic tensile stress by binding to an α7 nicotinic acetylcholine receptor and activating the canonical Wnt pathway.
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Affiliation(s)
- W Yu
- Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - B Hu
- Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - X Shi
- Department of Periodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Z Cao
- Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - M Ren
- Department of Periodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Z He
- Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - J Lin
- Department of Periodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - H Deng
- Department of Periodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - R Hu
- Department of Orthodontics, School of Stomatology, Wenzhou Medical University, Wenzhou, China
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15
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Association of Education and Smoking Status on Risk of Diabetes Mellitus: A Population-Based Nationwide Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017. [PMID: 28629199 PMCID: PMC5486341 DOI: 10.3390/ijerph14060655] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations (p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS.
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Wang R, Zhang P, Lv X, Gao C, Song Y, Li Z, Yu Y, Li B. Association between passive smoking and mental distress in adult never-smokers: a cross-sectional study. BMJ Open 2016; 6:e011671. [PMID: 27473950 PMCID: PMC4985981 DOI: 10.1136/bmjopen-2016-011671] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Many studies have suggested exposure to secondhand smoke (SHS) is a risk factor for various somatic diseases, but only few studies based on small sample size or specific groups have explored the association between passive smoking and mental distress. We performed this study to examine the relationship between passive smoking and mental distress in adult never-smokers of north-east China. METHODS Multistage, stratified random cluster sampling design was used in this cross-sectional study in 2012. A total of 12 978 never-smokers from Jilin, north-east China, were included. Data on passive smoking and baseline characteristics were collected by face-to-face interviews. The 12-item General Health Questionnaire (GHQ-12) was used to measure mental health status. Rao-Scott χ(2) tests were used to compare the prevalence between different groups; multivariable logistic regression was used to assess the association between passive smoking and mental distress, and Spearman rank analysis was employed to assess the correlation between passive smoking and GHQ-12 scores. RESULTS The estimated prevalence of mental distress among never-smokers in Jilin province is 24.5%, and the estimated prevalence of passive smoking among the mental distressing group is 65.0%. After adjusting for gender, age, region, body mass index (BMI), occupation, marriage, education, drinking status and family monthly income per capita, passive smoking conferred a risk for mental distress (adjusted OR=1.26, 95% CI 1.13 to 1.40). A high proportion of adults, especially women, were passive smokers at home, but for men, passive smoking was more common at workplace. The more frequently participants exposed to SHS, the higher GHQ-12 scores they got. CONCLUSIONS Passive smoking is an important risk factor for mental distress in never-smokers of Jilin province, which reminds Chinese government of increasing the awareness of public health and take measure to prevent SHS, especially with regard to SHS exposure at home and workplace.
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Affiliation(s)
- Rui Wang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Jilin, China
| | - Peng Zhang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Jilin, China
| | - Xin Lv
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Jilin, China
| | - Chunshi Gao
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Jilin, China
| | - Yuanyuan Song
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Jilin, China
| | - Zhijun Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Jilin, China
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Jilin, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Jilin, China
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Prevalence and Associated Factors of Secondhand Smoke Exposure among Internal Chinese Migrant Women of Reproductive Age: Evidence from China's Labor-Force Dynamic Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:371. [PMID: 27043604 PMCID: PMC4847033 DOI: 10.3390/ijerph13040371] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 03/06/2016] [Accepted: 03/23/2016] [Indexed: 11/17/2022]
Abstract
Secondhand smoke (SHS) is a major risk factor for poor health outcomes among women in China, where proportionately few women smoke. This is especially the case as it pertains to women’s reproductive health, specifically migrant women who are exposed to SHS more than the population at large. There are several factors which may increase migrant women’s risk of SHS exposure. This paper aims to investigate the prevalence and associated factors of SHS exposure among internal Chinese migrant women of reproductive age. The data used were derived from the 2014 Chinese Labor Dynamic Survey, a national representative panel survey. The age-adjusted rate of SHS exposure of women of reproductive age with migration experience was of 43.46% (95% CI: 40.73%–46.40%), higher than those without migration experience (35.28% (95% CI: 33.66%–36.97%)). Multivariate analysis showed that participants with a marital status of “Widowed” had statistically lower exposure rates, while those with a status of “Cohabitation” had statistically higher exposure. Those with an undergraduate degree or above had statistically lower SHS exposure. Those with increasing levels of social support, and those who currently smoke or drink alcohol, had statistically higher SHS exposure. Participants’ different work-places had an effect on their SHS exposure, with outdoor workers statistically more exposed. Our findings suggest that urgent tobacco control measures should be taken to reduce smoking prevalence and SHS exposure. Specific attention should be paid to protecting migrant women of reproductive age from SHS.
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