1
|
Lee HS, Lee YJ, Cho JH, Park DS. Analysis of patient health questionnaire-9 (PHQ-9) based depression prevalence according to a discordance between quantitative urinary cotinine levels and self-report of second-hand smoke exposure among adults: A cross-sectional study. Heliyon 2024; 10:e32125. [PMID: 38882351 PMCID: PMC11176832 DOI: 10.1016/j.heliyon.2024.e32125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 06/18/2024] Open
Abstract
Background Second-hand smoke (SHS) exposure appears to be more common among individuals with depression. However, self-report of SHS exposure is an inaccurate classification compared to confirming SHS exposure using urinary cotinine (UC). Additionally, the dose-response relationship between depression and UC is controversial. Methods The severe stress rate and depression prevalence was estimated among 14530 Korean participants aged ≥19 years using data patient health questionnaire-9 (PHQ-9) and on UC from the Korean National Health and Nutrition Examination Survey. Measured UCs were divided into four categories: UC- (≤0.3 μg/L), UC± (0.4 μg/L-0.9 μg/L), UC+ (1.0 μg/L-11.9 μg/L), and UC++ (≥12.0 μg/L). Results About 55.0 % participants were female and participants' mean age was 51.1 years. Non-smokers were 80.3 %. Among non-smokers, non-SHS exposure participants (SR-) and SHS exposure participants (SR+) were 83.0 % and 17.0 %, respectively. When UC- was used as the reference subgroup, the UC++ subgroup showed a higher depression prevalence, whereas the UC ± subgroup showed a lower prevalence. In the same UC categories, the depression prevalence and severe stress rate were higher among females than among males. Furthermore, the SR + subgroup had a higher severe stress rate than the SR- subgroup. Conclusions Our study showed a paradoxical reduction in the depression prevalence and severe stress rate in the UC ± subgroup compared to the UC- subgroup. Additionally, the dose-response relationship between the SHS exposure biomarker and the depression prevalence was not linear. Our study indicates that an emotional stress-based model may be more appropriate for explaining the relationship between depression and SHS exposure.
Collapse
Affiliation(s)
- Hyun-Seung Lee
- Department of Laboratory Medicine and Institute of Wonkwang Medical Science, School of Medicine, Wonkwang University, Iksan, South Korea
- Wonkwang Institute of Clinical Medicine, Wonkwang University Hospital, Iksan, South Korea
| | - Young-Jin Lee
- Department of Laboratory Medicine and Institute of Wonkwang Medical Science, School of Medicine, Wonkwang University, Iksan, South Korea
| | - Ji-Hyun Cho
- Department of Laboratory Medicine and Institute of Wonkwang Medical Science, School of Medicine, Wonkwang University, Iksan, South Korea
| | - Do-Sim Park
- Department of Laboratory Medicine and Institute of Wonkwang Medical Science, School of Medicine, Wonkwang University, Iksan, South Korea
- Wonkwang Institute of Clinical Medicine, Wonkwang University Hospital, Iksan, South 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
|
Oyapero A, Erinoso O, Olatosi OO. Adolescents' exposure to secondhand smoke and its association with susceptibility to smoking and mental health in Lagos, Nigeria. Pan Afr Med J 2023; 44:202. [PMID: 37484581 PMCID: PMC10362663 DOI: 10.11604/pamj.2023.44.202.35973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 04/08/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction this study assessed the relationship between exposure to secondhand smoking (SHS) and its association with self-reported anxiety, depression and susceptibility to smoking among adolescents in Lagos, Nigeria. Methods depression among study subjects was determined using the Patient Health Questionnaire-9 (PHQ-9) while the Generalized Anxiety Disorder - 7 (GAD-7) was used to determine anxiety levels. Susceptibility to smoking cigarettes was also determined while the Statistical Package for the Social Science (SPSS) 26.0 software was used for data analysis. Significant associations were determined at P-values <0.05. Results of the 300 adolescents surveyed (mean age 12.9±1.43), 7.6 % were regularly exposed to SHS, of which 3.0% were daily exposed to SHS indoors. In multivariable analyses, indoor SHS exposure for ≥ 1 hour daily was associated with increased odds for susceptibility to smoking (AOR=3.793; 95%-CI: 0.98-14.60; p= 0.052) and increased odds for depression (AOR=1.303; 95%-CI: 0.84-2.01; p= 0.228) and slightly reduced odds for anxiety (AOR=0.952; 95%-CI: 0.62-1.47; p=0.822). Conclusion secondhand smoking exposure was associated with higher odds of susceptibility to smoking cigarettes and depression among adolescents exposed to SHS, especially among females living in cramped accommodations. Further validation of these findings should however be determined by cohort study designs.
Collapse
Affiliation(s)
- Afolabi Oyapero
- Department of Preventive Dentistry, Lagos State University College of Medicine, Lagos, Nigeria
| | - Olufemi Erinoso
- Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Olubukola Olamide Olatosi
- Department of Child Dental Health, Faculty of Dental Sciences, College of Medicine University of Lagos, Lagos, Nigeria
| |
Collapse
|
4
|
Farooqui M, Shoaib S, Afaq H, Quadri S, Zaina F, Baig A, Liaquat A, Sarwar Z, Zafar A, Younus S. Bidirectionality of smoking and depression in adolescents: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 45:e20210429. [PMID: 35738567 PMCID: PMC10416256 DOI: 10.47626/2237-6089-2021-0429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/08/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Recently, evidence has been accumulating that both smoking and mental health disorders are continuously increasing among adolescents. This systematic review elucidates the research into evidence of the direction of the association and risk factors influencing the relationship between smoking and depression. We also highlight recent studies on the effects of electronic cigarettes and developments on the association between depression and smoking. METHODS A literature search was conducted on databases including PubMed, Ovid Medline, EMBASE, and PsycINFO and in relevant neurology and psychiatry journals. Terms used for electronic searches included smoking, tobacco, cigarettes; depression; adolescent, youth; direction. Relevant information was then utilized to synthesize findings on the association between smoking and depression among adolescent population. RESULTS The initial database searches yielded 2,738 related articles. After screening and cross-referencing, duplicate articles, articles published in languages other than English, and studies on animals, social and lifestyle factors, mood disorders, and substance use were excluded. Of these, a total of 122 publications only focusing on smoking and depression in the adolescent population were selected for synthesis in this qualitative systemic review. These include 110 original research articles, eight meta-analyses and reviews, and four reports and websites. CONCLUSION The relationship between smoking and depression in the literature does not reflect the cause-effect relationship. The lack of evidence on the direction of the association may reflect futile study designs, confounding factors and/or use of indirect measures of depression and quantification of smoking. Future prospective randomized studies should target elucidation of the causal association.
Collapse
Affiliation(s)
- Mudassir Farooqui
- Department of NeurologyUniversity of IowaHospitals and ClinicsIowa CityIAUSA Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
| | - Samra Shoaib
- Department of PsychiatryNassau UniversityMedical CenterEast MeadowNYUSA Department of Psychiatry, Nassau University Medical Center, East Meadow, NY, USA.
| | - Humera Afaq
- Department of Public HealthNational UniversitySan DiegoCAUSA Department of Public Health, National University, San Diego, CA, USA.
| | - Syed Quadri
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Fatima Zaina
- Department of PulmonologyZiauddin University and HospitalKarachiPakistan Department of Pulmonology, Ziauddin University and Hospital, Karachi, Pakistan.
| | - Aqsa Baig
- Liaquat National HospitalMedical CollegeKarachiPakistan Liaquat National Hospital & Medical College, Karachi, Pakistan.
| | - Ayesha Liaquat
- Karachi Medical and Dental CollegeKarachiPakistan Karachi Medical and Dental College, Karachi, Pakistan.
| | - Zoona Sarwar
- Department of SurgeryUniversity of OklahomaOklahoma CityOKUSA Department of Surgery, University of Oklahoma, Oklahoma City, OK, USA.
| | - Atif Zafar
- Department of NeurologyUniversity of TorontoTorontoONCanada Department of Neurology, University of Toronto, Toronto, ON, Canada.
| | - Sana Younus
- Menninger Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonTXUSA Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| |
Collapse
|
5
|
Christian F, Kim Y. Association Between Place of Secondhand Smoke Exposure and Depression Among Nonsmoking Children and Adolescents: A Systematic Review. Asia Pac J Public Health 2022; 34:616-626. [PMID: 35596574 DOI: 10.1177/10105395221099418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Secondhand smoke (SHS) exposure patterns of children and adolescents are different from those of adults because children and adolescents spend a majority of their time in the home and school. It was aimed to conduct a systematic review of the published literature regarding the association between depression and the place of SHS exposure among children and adolescents. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines, PubMed, ScienceDirect, and Cochrane Library databases were used for the literature review. The studies were screened and selected by two independent reviewers based on the inclusion criteria. All eight studies included in the systematic review measured SHS exposure in participants' own homes. Two studies measured SHS exposure at school and one study in cars. The majority of the studies showed a positive association between depression and SHS exposure in both private and public places among nonsmoking children and adolescents. Also, they concluded a dose-response relationship between SHS exposure and depression. Health practitioners would be encouraged to work with stakeholders to create smoke-free policies in both private and public places to avoid the adverse effects of SHS exposure.
Collapse
Affiliation(s)
| | - Yeonsoo Kim
- Central Michigan University, Mount Pleasant, MI, USA
| |
Collapse
|
6
|
Remes O, Mendes JF, Templeton P. Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature. Brain Sci 2021; 11:1633. [PMID: 34942936 PMCID: PMC8699555 DOI: 10.3390/brainsci11121633] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Depression is one of the leading causes of disability, and, if left unmanaged, it can increase the risk for suicide. The evidence base on the determinants of depression is fragmented, which makes the interpretation of the results across studies difficult. The objective of this study is to conduct a thorough synthesis of the literature assessing the biological, psychological, and social determinants of depression in order to piece together the puzzle of the key factors that are related to this condition. Titles and abstracts published between 2017 and 2020 were identified in PubMed, as well as Medline, Scopus, and PsycInfo. Key words relating to biological, social, and psychological determinants as well as depression were applied to the databases, and the screening and data charting of the documents took place. We included 470 documents in this literature review. The findings showed that there are a plethora of risk and protective factors (relating to biological, psychological, and social determinants) that are related to depression; these determinants are interlinked and influence depression outcomes through a web of causation. In this paper, we describe and present the vast, fragmented, and complex literature related to this topic. This review may be used to guide practice, public health efforts, policy, and research related to mental health and, specifically, depression.
Collapse
Affiliation(s)
- Olivia Remes
- Institute for Manufacturing, University of Cambridge, Cambridge CB3 0FS, UK
| | | | - Peter Templeton
- IfM Engage Limited, Institute for Manufacturing, University of Cambridge, Cambridge CB3 0FS, UK;
- The William Templeton Foundation for Young People’s Mental Health (YPMH), Cambridge CB2 0AH, UK
| |
Collapse
|
7
|
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: 4] [Impact Index Per Article: 1.3] [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.
Collapse
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.
| |
Collapse
|
8
|
Intarut N, Pukdeesamai P. The prevalence of secondhand smoke exposure and related factors among schoolchildren in Northeast Thailand. F1000Res 2020; 9:1158. [PMID: 33145013 PMCID: PMC7590888 DOI: 10.12688/f1000research.26039.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2020] [Indexed: 11/29/2022] Open
Abstract
Background: The prevalence of tobacco consumption in Thailand has gradually declined; however, the prevalence of exposure to secondhand smoke (SHS) is still high. The objective of this study is to estimate the prevalence of SHS exposure and examine the association between exposure to SHS and depressive symptoms among schoolchildren, and test for moderation by the number of smokers in household. Methods: We conducted a cross-sectional study of 1105 schoolchildren. Socioeconomics factors, depressive symptoms and exposure to SHS variables were collected. We used the chi-square test for testing the factors associated to SHS exposure. In addition, we used the Mantel Haenszel test for testing interaction effect of depression to SHS exposure by the number of smokers in home. Multiple logistic regression was used to test the factors related to SHS exposure adjusted for confounders. Results: The prevalence of exposure to SHS was 58.2% (95%CI: 55.2, 61.1). The schoolchildren with abnormal depression status were 1.8 times more likely to have been exposed to SHS (95%CI: 1.3, 2.5). In addition, the number of smokers in the home did not modify the association between exposure to SHS and depressive symptoms (P: 0.964). Conclusions: An association between exposure to SHS and depressive in schoolchildren was observed, but this relationship was not affected by the number of smokers in children’s homes.
Collapse
Affiliation(s)
- Nirun Intarut
- Health System Science Unit, Faculty of Medicine, Masarakham University, Mueng, Mahasarakham, 44000, Thailand
| | | |
Collapse
|
9
|
Kim B, Kim HR. Associations Between Secondhand Smoke and Mental Health in Korean Adolescents. Asia Pac J Public Health 2020; 32:406-413. [PMID: 32929992 DOI: 10.1177/1010539520957846] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study assessed secondhand smoke exposure among nonsmokers and examined its association with mental health in Korean adolescents. We used the 14th Korea Youth Risk Behavior Survey in 2018 to extract data and analyzed 60 040 adolescents through three secondhand smoke exposure categories: home, school, and public places. Mental health included stress, insufficient sleep, depressive symptoms, and suicidal ideation. Secondhand smoke exposure was reported at 23.0% for home, 20.0% for school, and 51.4% for public places. Secondhand smoke exposures were associated with stress insufficient sleep, depressive symptoms, and suicidal ideation. Furthermore, in the stratified analysis, secondhand smoke exposure was related to poor mental health in both nonsmokers and smokers. Based on the results, we concluded that Korean adolescents may experience poor mental health symptoms from being exposed to secondhand smoke.
Collapse
Affiliation(s)
- Boyoung Kim
- Gyeongsang National University, Gyeongnam, South Korea
| | | |
Collapse
|
10
|
Lim KH, Lim HL, Ghazali SM, Kee CC, Teh CH, Gill BS, Taib MZ, Heng PP, Lim JH. Malaysian adolescents' exposure to secondhand smoke in the car of their parents/guardians: A nationwide cross-sectional school-based study. Tob Induc Dis 2020; 18:53. [PMID: 32565765 PMCID: PMC7299278 DOI: 10.18332/tid/122586] [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: 02/17/2020] [Revised: 04/28/2020] [Accepted: 05/19/2020] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION We investigated the prevalence of children's exposure to secondhand smoke (SHS) in the car of their parents/guardians and the associated factors. METHODS A self-administered validated questionnaire was used to obtain data from the nationally representative samples of school-going adolescents aged 11-19 years in Malaysia. Prevalence rates were computed and chi-squared tests and multiple logistic regression were conducted. RESULTS Of the participants, 23.3% reported exposure to SHS at least once in the car of their parents/guardians during the last 7 days before the survey. The prevalence and likelihood of SHS exposure were significantly higher in Malays, descendants of natives of Sabah and Sarawak, schools in rural areas, females, and current smokers. However, age group and knowledge on the harmful effects of SHS were not significant after adjusting for confounding effects. CONCLUSIONS A substantial proportion of school-going adolescents were exposed to secondhand smoke in the car of their parents/guardians. This highlights the need for effective tobacco control measures to include health promotion and smoke-free car regulations to be introduced to prevent severe health hazards and to reduce smoking initiation among non-smoking adolescents.
Collapse
Affiliation(s)
- Kuang H. Lim
- Special Resource Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Hui L. Lim
- Oncology Department, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Sumarni M. Ghazali
- Special Resource Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Chee C. Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | - Chien H. Teh
- Special Resource Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Balvinder S. Gill
- Special Resource Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Mohd Z. Taib
- Special Resource Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Pei P. Heng
- Special Resource Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Jia H. Lim
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
| |
Collapse
|
11
|
Jacob L, Smith L, Jackson SE, Haro JM, Shin JI, Koyanagi A. Secondhand Smoking and Depressive Symptoms Among In-School Adolescents. Am J Prev Med 2020; 58:613-621. [PMID: 32059988 DOI: 10.1016/j.amepre.2019.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Smoking has been linked with depressive symptoms in adolescents, but data on secondhand smoking and depressive symptoms in low- and middle-income countries are scarce. Thus, this study analyzes the association between secondhand smoking and depressive symptoms among in-school adolescents from 22 low- and middle-income countries. METHODS Data from the 2003-2008 Global School-Based Student Health Survey were analyzed in June 2019. Data on past-week exposure to secondhand smoke and past-year depressive symptoms were collected. The association between secondhand smoke and depressive symptoms was studied using multivariable logistic regressions and meta-analyses. RESULTS The sample consisted of 37,505 adolescents aged 12-15 years who never smoked. The prevalence of depressive symptoms increased from 23.0% in adolescents with no secondhand smoking to 28.9% in those with secondhand smoking every day in the past week. After adjusting for sex, age, food insecurity, and country, there was a dose-response relationship between secondhand smoking and depressive symptoms in the overall sample (0 days: reference; 1-2 days: OR=1.06, 95% CI=0.95, 1.18; 3-6 days: OR=1.38, 95% CI=1.20, 1.58; 7 days: OR=1.63, 95% CI=1.44, 1.86). The country-wise analysis showed that secondhand smoking on at least 3 days (versus <3 days) in the past week was associated with a 1.48-fold increase in the odds of depressive symptoms (95% CI=1.39, 1.59), with a low level of between-country heterogeneity (I2=4.2%). CONCLUSIONS There was a positive association between secondhand smoking and depressive symptoms among in-school adolescents from low- and middle-income countries. Further research should investigate causality and assess whether prevention of exposure to secondhand smoke can have a positive effect on the mental well-being of adolescents.
Collapse
Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain.
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; ICREA, Barcelona, Spain
| |
Collapse
|
12
|
Azagba S, Latham K, Shan L. Exposure to secondhand smoke in vehicles among Canadian adolescents: Years after the adoption of smoke-free car laws. Addict Behav Rep 2019; 10:100215. [PMID: 31508478 PMCID: PMC6726844 DOI: 10.1016/j.abrep.2019.100215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 11/17/2022] Open
Abstract
Exposure to secondhand smoke (SHS) can result in several adverse health consequences. SHS concentrations in vehicles can significantly exceed levels present in other enclosed spaces. Years after the adoption of smoke-free car laws, this study examined the prevalence of exposure to SHS in vehicles among adolescents. Data were utilized from the 2016-2017 Canadian Student Tobacco, Alcohol and Drugs Survey (n = 48,444). The prevalence of exposure to SHS in cars was estimated by grade level and demographic characteristics. The results showed a gradient by grade level in exposure to SHS with students in upper-grade levels reporting a higher prevalence of SHS in cars. SHS varied by province, with the lowest rate found in British Columbia (15.6%) and the highest in Saskatchewan (36.9%). The provinces with laws that extend protections to older children also had high rates of SHS exposure among students in upper-grade levels. Students exposed to SHS were more likely to engage in risky behaviors, including the use of marijuana, alcohol, cigarettes, and e-cigarettes. Despite laws prohibiting smoking in vehicles carrying children, SHS prevalence remains high. While enforcement of these laws may be challenging, persuasion campaigns highlighting that children are especially vulnerable to the health risks of SHS may be beneficial.
Collapse
Affiliation(s)
- Sunday Azagba
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States of America
| | | | | |
Collapse
|
13
|
Relationship Between Secondhand Smoke Exposure and Depressive Symptoms: A Systematic Review and Dose⁻Response Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081356. [PMID: 30991759 PMCID: PMC6518001 DOI: 10.3390/ijerph16081356] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/10/2019] [Accepted: 04/10/2019] [Indexed: 12/29/2022]
Abstract
Previous studies have suggested an association between secondhand smoke (SHS) exposure and risk of depressive symptoms. However, it remains unclear whether there is a dose-response relationship. The effect estimates were pooled using fixed-effect or random-effect models based on homogeneity analysis. The dose-response meta-analysis was performed by linear and non-linear regression. Subgroup analyses were conducted to explore the possible sources of heterogeneity. Twenty-four studies were included in this meta-analysis. SHS exposure was significantly associated with increased odds of depressive symptoms (odds ratio (OR) = 1.32, 95% confidence interval (CI) 1.25-1.39). For SHS exposure expressed as an ordinal variable, the dose-response meta-analysis revealed a monotonically increasing relationship between SHS exposure and depressive symptoms. A similar dose-response relationship was observed for SHS exposure expressed as a continuous variable (OR = 1.57, 95% CI = 1.26-1.87). Our findings suggest that SHS exposure is associated with increasing odds of depressive symptoms in a dose-response manner.
Collapse
|
14
|
Ye X, Huang J, Xia L, Xu X, Gong X, Xu Y. Setting-Specific and Symptom-Specific Association between Secondhand Smoke Exposure and Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071249. [PMID: 30965596 PMCID: PMC6479476 DOI: 10.3390/ijerph16071249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/04/2019] [Accepted: 04/04/2019] [Indexed: 11/16/2022]
Abstract
Few studies have focused on the potential relationship between secondhand smoke (SHS) exposure and depressive symptoms. This study aimed to explore the potential association between SHS exposure and depressive symptoms and differentiate this association in setting-specific exposure and symptom-specific outcomes. A cross-sectional study was conducted in Guangdong province of China from September to December 2010 using a multistage sampling method to randomly sample adults aged 18 years and older. SHS exposure was defined as inhalation by non-smokers of the smoke exhaled from smokers for at least 1 day a week in the past 30 days. Depressive symptoms were measured using the nine-item Patient Health Questionnaire. The zero-inflate negative binomial regression models were used to explore the associations between SHS exposure and depressive symptoms. A total of 2771 non-smokers were included in this study, with mean age of 49.6 ± 14.0 years and 70.3% of females. The prevalence of depressive symptoms was significantly higher in participants with SHS exposure than in those without exposure (incidence rate ratio (IRR) = 1.32, 95% confidence interval (CI) 1.16⁻1.51), and there were similar positive associations for SHS exposure in medical facilities (IRR = 1.37, 95% CI 1.17⁻1.61) and in schools (IRR = 1.46, 95% CI 1.20⁻1.77). Notably, there was a monotonically increasing dose-response relationship between frequency of SHS exposure and depressive symptoms. When differentiating this relationship by the dimensions of depressive symptoms, there were similar dose-response relationships for cognitive-affective and somatic symptoms. When differentiating this relationship by sex, only females showed a significant dose-response relationship. Our findings suggest dose-response relationships between SHS exposure and depressive symptoms in sex-specific and symptom-specific manners. Future longitudinal studies are needed to establish the biological mechanisms of the impact of SHS exposure.
Collapse
Affiliation(s)
- Xiaohua Ye
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China.
| | - Jingya Huang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China.
| | - Liang Xia
- Institute of Chronic Noncommunicable Disease and Control, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Xiaojun Xu
- Institute of Chronic Noncommunicable Disease and Control, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| | - Xiao Gong
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China.
| | - Yanjun Xu
- Institute of Chronic Noncommunicable Disease and Control, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
| |
Collapse
|