1
|
Lim JH, Kim DB, Ko J, Joo MJ, Park EC. Association between secondhand smoke exposure and anxiety among adolescents: A nationwide cross-sectional study. Tob Induc Dis 2024; 22:TID-22-145. [PMID: 39165923 PMCID: PMC11334696 DOI: 10.18332/tid/191750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/28/2024] [Accepted: 07/31/2024] [Indexed: 08/22/2024] Open
Abstract
INTRODUCTION Adolescents are especially susceptible to the harmful effects of secondhand smoke exposure. Mental health issues may be one of these negative consequences. This study aimed to explore the association between secondhand smoke exposure and anxiety among Korean adolescents. METHODS This study used the nationwide representative cross-sectional data obtained from the 4-year (2020-2023) Korea Youth Risk Behavior Survey. In total, 214514 individuals aged 12-18 years were included in this study (109910 males and 104604 females). Secondhand smoke exposure was assessed based on responses to questions concerning the days they were exposed (at home and in public places), while anxiety levels were measured using the Generalized Anxiety Disorder 7 scale. Multivariable logistic regression analysis divided by sex was performed to explore the association (p=0.0173 for interaction by secondhand smoke exposure and sex), and adjusted odds ratios (ORs) with 95% confidence intervals (CI) were calculated. RESULTS Among the study population, 8.8% of the male and 15.6% of the female participants had anxiety. After adjusting for covariates, adolescents with secondhand smoke exposure had a higher likelihood of reporting anxiety than those without the exposure (male, OR=1.23; 95% CI: 1.16-1.29; female, OR=1.27; 95% CI: 1.21-1.33). In additional stratified analyses, this association was more prominent among those who were never smokers, were exposed for more days, and had severe levels of anxiety. CONCLUSIONS This study found that secondhand smoke exposure was associated with anxiety in adolescents; hence, proper political interventions to reduce secondhand smoke exposure may be required.
Collapse
Affiliation(s)
- Jae Hyeok Lim
- Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Dan Bi Kim
- Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Jisu Ko
- Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Min Jeong Joo
- Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine and Public Health, College of Medicine, Yonsei University, Seoul, Republic of Korea
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Tan GPP, Teo O, van der Eijk Y. Residential secondhand smoke in a densely populated urban setting: a qualitative exploration of psychosocial impacts, views and experiences. BMC Public Health 2022; 22:1168. [PMID: 35690740 PMCID: PMC9187883 DOI: 10.1186/s12889-022-13561-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/30/2022] [Indexed: 11/23/2022] Open
Abstract
Background People remain exposed to secondhand smoke, a serious health hazard, inside their home as households face challenges in setting no-smoking rules or are exposed to secondhand smoke drifting in from neighbouring homes. This study explores the psychosocial impacts, views, and experiences with residential secondhand smoke in a densely populated urban setting. Methods In-depth online or face to face interviews with 18 key informants who had been involved in public discourse, policy, advocacy or handling complaints related to residential secondhand smoke, 14 smokers, and 16 non-smokers exposed to secondhand smoke inside their home. All participants were residents of Singapore, a densely populated, multi-ethnic city-state. Interview transcripts were coded in NVivo using a deductive and inductive coding process. Findings Secondhand smoke has wide-reaching impacts on physical and psychosocial wellbeing, even if smokers tried to minimise secondhand smoke. Feelings of anxiety and stress are generally tied to feeling discomfort in one’s personal space, a perceived lack of control over the situation, resentment towards smokers, and concerns over the health effects. Family, community, and cultural dynamics add complexities to tackling the issue, especially in patriarchal households. Secondhand smoke exposure from neighbours is considered a widespread issue, exacerbated by structural factors such as building layout and the COVID-19 pandemic. Resolving the issue amicably is considered challenging due to the absence of regulations and a reluctance to stir up conflict with neighbours. While smokers took measures to reduce secondhand smoke, these were described as ineffective by other participants. Smokers appeared to have contrasting views from other participants on what it means to smoke in a socially responsible manner. Conclusion Given the wide-reaching psychosocial impacts of residential secondhand smoke, there is a case for stronger interventions, especially in densely populated urban settings where it is more difficult to avoid. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13561-7.
Collapse
Affiliation(s)
- Grace Ping Ping Tan
- Saw Swee Hock School of Public Health, National University of Singapore, MD1 Tahir Foundation Building 12 Science Drive 2 #09-01C, 117549, Singapore, Singapore
| | - Odelia Teo
- Saw Swee Hock School of Public Health, National University of Singapore, MD1 Tahir Foundation Building 12 Science Drive 2 #09-01C, 117549, Singapore, Singapore
| | - Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore, MD1 Tahir Foundation Building 12 Science Drive 2 #09-01C, 117549, Singapore, Singapore.
| |
Collapse
|
4
|
Luk TT, Hsieh CJ, Leung WC, Leung KY, Cheung KW, Kwa C, Siong KH, Tang KK, Lee KW, Li WHC, Lam TH, Wang MP. Brief cessation advice, nicotine replacement therapy sampling and active referral (BANSAR) for smoking expectant fathers: Study protocol for a multicentre, pragmatic randomised controlled trial. Contemp Clin Trials 2020; 93:106006. [PMID: 32320843 DOI: 10.1016/j.cct.2020.106006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/11/2020] [Accepted: 04/13/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Pregnancy presents a teachable moment to engage male smokers whose partners are pregnant in smoking cessation. Evidence on how to approach and help these smokers quit smoking in antenatal settings has remained scarce. This paper presents the rationale and study design of a trial which aims to evaluate the effectiveness of a brief intervention model for promoting smoking cessation in expectant fathers. METHODS BANSAR is a pragmatic randomised controlled trial conducted in antenatal clinic in seven public hospitals in Hong Kong, China. An estimated 1148 fathers who smoke at least one cigarette daily and whose partners are pregnant and non-smoking will be randomised (1:1) to receive brief advice combined with 1-week sample of nicotine replacement therapy (NRT) and active referral to smoking cessation services, or brief advice only (usual care). Outcome will be assessed at 3 and 6 months after treatment initiation. The primary outcome is carbon monoxide-verified (<4 part per million) abstinence at 6 months post-treatment initiation. Secondary outcomes include self-reported 7-day point-prevalence abstinence and 24-week continuous abstinence, use of smoking cessation service and NRT and quit attempt, and smoking reduction, change in nicotine dependence and intention to quit in continuing smokers. COMMENT This trial will provide real-world evidence on the effectiveness of a combined brief intervention model for smoking cessation in expectant fathers, an understudied population. The findings may be particularly relevant to low and middle-income countries, where male-to-female smoking ratios and birth rates tend to be higher than higher-income countries. TRIAL REGISTRATION ClinicalTrials.gov, number NCT03671707.
Collapse
Affiliation(s)
- Tzu Tsun Luk
- School of Nursing, The University of Hong Kong, Hong Kong
| | - Chi Ju Hsieh
- School of Nursing, The University of Hong Kong, Hong Kong
| | - Wing-Cheong Leung
- Department of Obstetrics & Gynecology, Kwong Wah Hospital, Hong Kong
| | - Kwok-Yin Leung
- Department of Obstetrics & Gynecology, Queen Elizabeth Hospital, Hong Kong
| | - Ka Wang Cheung
- Department of Obstetrics & Gynecology, Queen Mary Hospital, Hong Kong
| | - Carina Kwa
- Department of Obstetrics & Gynecology, United Christian Hospital, Hong Kong
| | - Kar-Hung Siong
- Department of Obstetrics & Gynecology, Tuen Mun Hospital, Hong Kong
| | - Kwok-Keung Tang
- Department of Obstetrics & Gynecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - Kai-Wan Lee
- Department of Obstetrics & Gynecology, Princess Margaret Hospital, Hong Kong
| | | | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong.
| |
Collapse
|
5
|
Adolescent Smoking in Hong Kong: Prevalence, Psychosocial Correlates, and Prevention. J Adolesc Health 2019; 64:S19-S27. [PMID: 31122545 DOI: 10.1016/j.jadohealth.2019.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 11/24/2022]
Abstract
Preventing adolescent smoking is important as smoking is typically initiated by young people. This article reviews the prevalence, psychosocial correlates, and prevention of smoking in Hong Kong adolescents. The past 30-day smoking prevalence in adolescents decreased from 9.6% in 2003 to 2.5% in 2017. Tobacco advertisements, parental and best friends smoking, nonintact families, poor family relationships, lower socioeconomic status, being a new immigrant, poor knowledge of smoking-related harm, positive attitudes toward smoking, overestimation of peer smoking, and depressive symptoms were positively associated with smoking outcomes, whereas positive youth development, authoritative mother and permissive father, family functioning, school competence, and stronger tobacco industry denormalization beliefs were protective against smoking. Along with tobacco tax increase, ban on tobacco advertisements, smoke-free law and pictorial warnings, educational efforts through theater performances, social norms campaigns, and positive adolescent training programs have been conducted to prevent adolescent smoking. To achieve the ultimate goal of tobacco endgame, further tax increase, plain packaging, banning point-of-sale display of tobacco products, smoke-free area extension, and raising minimum age of purchase should be implemented. The government proposed law to ban e-cigarettes, and heated tobacco products should be passed soon to protect children and adolescents from using these products.
Collapse
|
6
|
Luk TT, Wang MP, Leung LT, Chen J, Wu Y, Lam TH, Ho SY. Perceived family relationship quality and use of poly-tobacco products during early and late adolescence. Addict Behav 2018; 85:38-42. [PMID: 29843039 DOI: 10.1016/j.addbeh.2018.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/15/2018] [Accepted: 05/15/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The role of family relationship in adolescent use of emerging tobacco products, which have become increasingly popular, is unknown. We examined the associations of perceived family relationship quality with current use of poly-tobacco products including cigarettes, electronic cigarettes (e-cigarettes), waterpipe and smokeless tobacco in adolescents. METHODS Data from a representative sample of 42,250 US grade 7-12 equivalent students (mean ± SD age 14.6 ± 1.9 years; 51.3% boys) from 75 randomly selected secondary schools in Hong Kong (2012-13) were analysed. Logistic regressions yielded adjusted odds ratios (AORs) for current (past 30-day) use of cigarettes, e-cigarettes, waterpipe, smokeless tobacco and poly-tobacco (≥2 products) in relation to perceived family relationship quality, adjusted for age, sex, perceived family affluence, parental education, family structure, parental and sibling smoking and secondhand smoke exposure at home. Subgroup analyses were conducted to compare the associations in early (aged ≤14 years) versus late (>14) adolescents. RESULTS The odds of current use increased with worse perceived family relationship quality with AORs (95% confidence interval) of up to 2.92 (2.32-3.68) for cigarettes, 7.28 (4.71-11.2) for e-cigarettes, 5.04 (3.44-7.40) for waterpipe, 8.09 (4.87-13.4) for smokeless tobacco and 5.25 (3.45-8.01) for poly-tobacco products use (all P for trend <.001). The associations for all tobacco use outcomes were stronger in early than late adolescents (all P for interaction <.001). CONCLUSIONS Dose-response relationships were found between negatively perceived family relationship quality and current poly- and individual tobacco product use by Hong Kong Chinese secondary students. The associations were stronger for alternative tobacco products and in early adolescents.
Collapse
Affiliation(s)
- Tzu Tsun Luk
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Lok Tung Leung
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Jianjiu Chen
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Yongda Wu
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region
| |
Collapse
|
7
|
Jalali-Farahani S, Amiri P, Khalili-Chelik A, Karimi M, Azizi F. Association between Smoking and Perceived Social Support among Tehranian Adults: Tehran Lipid and Glucose Study. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2018. [DOI: 10.21859/jech.5.2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
8
|
Affiliation(s)
- Ruth E Malone
- Department of Social and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Joshua S Yang
- Department of Health Science, College of Health and Human Development, California State University, Fullerton, California, USA
| |
Collapse
|
9
|
Parental smoking, rejection of parental smoking, and smoking susceptibility and behaviors in Hong Kong adolescents. Addict Behav 2018; 82:19-22. [PMID: 29477902 DOI: 10.1016/j.addbeh.2018.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/08/2018] [Accepted: 02/12/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION We explored the role of rejection of parental smoking in the association between parental smoking and smoking in adolescents. METHODS In 2010-11 cross-sectional survey, 61,810 Hong Kong secondary school students (mean age 14.6 years, 50.5% boys) reported their smoking (never, not susceptible; never, susceptible; ever, not current; current), paternal and maternal smoking, and whether they accepted paternal and maternal smoking (acceptance/rejection). We used multinomial logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of students' smoking in relation to acceptance and rejection of parental smoking, compared with no parental smoking. RESULTS The OR (95% CI) of "never, susceptible", "ever, not current", and "current", compared with "never, not susceptible", in relation to acceptance of paternal smoking was 1.81 (1.67-1.96), 2.46 (2.25-2.69), and 2.79 (2.51-3.10), respectively. The corresponding ORs for rejection were 0.70 (0.64-0.76), 1.23 (1.13-1.35), and 0.47 (0.40-0.56). The OR (95% CI) of "never, susceptible", "ever, not current", and "current", compared with "never, not susceptible", in relation to acceptance of maternal smoking was 2.05 (1.80-2.33), 2.57 (2.29-2.88), and 6.33 (5.39-7.44), respectively. The corresponding ORs for rejection were 0.85 (0.69-1.05), 1.59 (1.39-1.81), and 2.14 (1.71-2.68). No overlapping was observed between the 95% CIs for acceptance and rejection of paternal or maternal smoking. CONCLUSIONS While adolescent smoking was associated with parental smoking, especially in those who accepted parental smoking, the association was attenuated or reversed in those who rejected parental smoking.
Collapse
|
10
|
Bang I, Jeong YJ, Park YY, Moon NY, Lee J, Jeon TH. Secondhand Smoking Is Associated with Poor Mental Health in Korean Adolescents. TOHOKU J EXP MED 2018; 242:317-326. [PMID: 28867706 DOI: 10.1620/tjem.242.317] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In Korea, the prevalence of depression is increasing in adolescents and the most common cause of death of adolescents has been reported as suicide. At a time of increasing predicament of mental health of adolescents, there are few studies on whether secondhand smoking is associated with mental health in adolescents. The objective of this study was to determine whether exposure to secondhand smoke is associated with mental health-related variables, such as depression, stress, and suicide, in Korean adolescents. Data from the eleventh Korea youth risk behavior web-based survey, a nationally representative survey of 62,708 participants (30,964 males and 31,744 females), were analyzed. For students of aged 12 to 18 years, extensive data including secondhand smoking, mental health, sociodemographic variables, and physical health were collected. Chi-square analysis, multiple logistic regression analysis and ordered logistic regression analysis were performed to estimate the association and dose-response relation between secondhand smoking and mental health. Compared with the non-exposed group, the odds ratios (OR) of depression, stress, suicidal ideation, suicidal planning and suicidal attempt in the secondhand smoking exposed group were 1.339, 1.192, 1.303, 1.437 and 1.505, respectively (all P < 0.001). When subjects were classified into two secondhand smoke exposure groups, with increasing secondhand smoking experience, higher was the OR for each mental health related variable, in a dose-response relation. Our findings suggest that secondhand smoking is associated with poor mental health such as depression, stress, and suicide, showing a dose-response relation in Korean adolescents.
Collapse
Affiliation(s)
- Inho Bang
- Department of Family Medicine, Veterans Health Service Medical Center
| | - Young-Jin Jeong
- Department of Family Medicine, Veterans Health Service Medical Center
| | - Young-Yoon Park
- Department of Family Medicine, Veterans Health Service Medical Center
| | - Na-Yeon Moon
- Department of Family Medicine, Veterans Health Service Medical Center
| | - Junyong Lee
- Department of Family Medicine, Veterans Health Service Medical Center
| | - Tae-Hee Jeon
- Department of Family Medicine, Veterans Health Service Medical Center
| |
Collapse
|
11
|
Chen J, Ho SY, Leung LT, Wang MP, Lam TH. Associations of unhappiness with sociodemographic factors and unhealthy behaviours in Chinese adolescents. Eur J Public Health 2018; 27:518-524. [PMID: 28430967 DOI: 10.1093/eurpub/ckx015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Evidence on the effects of lack of physical exercise, alcohol drinking and smoking on happiness is limited and inconsistent. We examined the associations of unhappiness with sociodemographic factors and these unhealthy behaviours in Chinese adolescents. In a school-based survey in 2012-13 in Hong Kong, 45 857 secondary school students (mean age 14.8 years, 54.0% boys) reported their happiness level (not happy at all/not very happy/happy/very happy), frequency of physical exercise, alcohol drinking status, smoking status and sociodemographic factors. A main and a sensitivity analysis examined the associations of unhappiness with the study factors, treating unhappiness as a binary (combining 'not happy at all' and 'not very happy') and a four-level ordered variable, respectively. The main and the sensitivity analysis both showed that unhappiness was associated with older age, very poor families, non-intact families, more co-residing smokers, lack of physical exercise and alcohol drinking; current smokers were unhappier than never and ex-smokers; unhappiness also increased significantly with the number of unhealthy behaviours ( P for trend < 0.001). In Chinese adolescents, unhappiness levels were higher in those who had a very poor family, a non-intact family and more co-residing smokers, and in those who were physically inactive, drank alcohol and smoked.
Collapse
Affiliation(s)
- Jianjiu Chen
- School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Sai Yin Ho
- School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Lok Tung Leung
- School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| |
Collapse
|
12
|
Lamichhane DK, Kim HC, Choi CM, Shin MH, Shim YM, Leem JH, Ryu JS, Nam HS, Park SM. Lung Cancer Risk and Residential Exposure to Air Pollution: A Korean Population-Based Case-Control Study. Yonsei Med J 2017; 58:1111-1118. [PMID: 29047234 PMCID: PMC5653475 DOI: 10.3349/ymj.2017.58.6.1111] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/10/2017] [Accepted: 07/24/2017] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To investigate the association between long-term exposure to ambient air pollution and lung cancer incidence in Koreans. MATERIALS AND METHODS This was a population-based case-control study covering 908 lung cancer patients and 908 controls selected from a random sample of people within each Korean province and matched according to age, sex, and smoking status. We developed land-use regression models to estimate annual residential exposure to particulate matter (PM₁₀) and nitrogen dioxide (NO₂) over a 20-year exposure period. Logistic regression was used to estimate odds ratios (ORs) and their corresponding 95% confidence intervals (CI). RESULTS Increases in lung cancer incidence (expressed as adjusted OR) were 1.09 (95% CI: 0.96-1.23) with a ten-unit increase in PM₁₀ (μg/m³) and 1.10 (95% CI: 1.00-1.22) with a ten-unit increase in NO₂ (ppb). Tendencies for stronger associations between air pollution and lung cancer incidence were noted among never smokers, among those with low fruit consumption, and among those with a higher education level. Air pollution was more strongly associated with squamous cell and small cell carcinomas than with adenocarcinoma of the lung. CONCLUSION This study provides evidence that PM10 and NO₂ contribute to lung cancer incidence in Korea.
Collapse
Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hwan Cheol Kim
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Korea.
| | - Chang Min Choi
- Department of Pulmonary and Critical Care Medicine, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Myung Hee Shin
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Young Mog Shim
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Han Leem
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Korea
| | - Jeong Seon Ryu
- Center for Lung Cancer, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Hae Seong Nam
- Center for Lung Cancer, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Sung Min Park
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| |
Collapse
|
13
|
Luk TT, Wang MP, Leung LT, Wu Y, Chen J, Lam TH, Ho SY. Associations of perceived interparental relationship, family harmony and family happiness with smoking intention in never-smoking Chinese children and adolescents: a cross-sectional study. BMJ Open 2017; 7:e017523. [PMID: 28988179 PMCID: PMC5640025 DOI: 10.1136/bmjopen-2017-017523] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To examine the associations of perceived interparental relationship, family harmony and family happiness with smoking intention in never-smoking Chinese children and adolescents in Hong Kong. DESIGN, SETTINGS AND PARTICIPANTS Cross-sectional surveys of 15 753 primary (grades 4-6) and 38 398 secondary (grades 7-12) never-smoking students from 71 to 75 randomly selected primary and secondary schools in Hong Kong, 2012-2013. MEASUREMENTS Outcome variable was smoking intention which denoted any affirmative response to smoke within the coming year or when a cigarette was offered by a good friend. Exposure variables were perceived interparental relationship and family harmony each measured on a five-point scale from 'very good' to 'very bad' and perceived family happiness on a four-point scale from 'very happy' to 'not happy at all'. Potential confounders included age, sex, family structure, perceived family affluence, parental smoking and sibling smoking. RESULTS In primary students, the adjusted ORs (AORs) (95% CI) of smoking intention generally increased with more negative perception of the family relationship: up to 3.67 (1.91 to 7.05) for interparental relationship, 7.71 (4.38 to 13.6) for family harmony and 5.40 (3.41 to 8.55) for family happiness. For secondary students, the corresponding AORs (95% CI) were 2.15 (1.64 to 2.82) for interparental relationship, 2.98 (2.31 to 3.84) for family harmony and 2.61 (1.80 to 3.79) for family happiness. All p for trend <0.001. CONCLUSIONS More negatively perceived interparental relationship, family harmony and family happiness were associated with higher odds of smoking intention with dose-response relationships in never-smoking Chinese children and adolescents in Hong Kong. Children's perception of their family relationship may be an important intervening point for preventing youth from initiating smoking.
Collapse
Affiliation(s)
- Tzu Tsun Luk
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Lok Tung Leung
- School of Public Health, The University of Hong Kong, Hong kong, China
| | - Yongda Wu
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Jianjiu Chen
- School of Public Health, The University of Hong Kong, Hong kong, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong kong, China
| | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong kong, China
| |
Collapse
|