Exposure to Tobacco Retail Outlets and Smoking Initiation among New York City Adolescents

This study was designed to estimate the relationship between exposure to tobacco retail outlets and smoking initiation in a racially diverse urban setting. Using data from the 2011 NYC Youth Risk Behavior Survey, multivariable logistic regression analyses were conducted to estimate the exposure–initiation relationship and test for effect modification, while controlling for covariates. The predicted probability of smoking initiation from the multivariable model increased from 7.7 % for zero times a week exposed to tobacco retailers to 16.0 % for exposure seven times or more per week. The odds of initiation were significantly higher among adolescents exposed to tobacco retail outlets two times or more a week compared with those exposed less often (AOR = 1.41; 95 % CI: 1.08, 1.84). Risk-taking behavior modified the relationship between exposure and initiation, with the odds of initiation highest among those low in risk-taking (AOR = 1.78; 95 % CI: 1.14, 1.56). These results are consistent with past research, showing that frequent exposure to tobacco marketing in retail settings is associated with increased odds of initiation. Reducing exposure to tobacco retail marketing could play an important role in curtailing smoking among adolescents, especially those less prone to risk-taking.     

Prevalence and Predictors of Environmental Tobacco Smoke Exposure among Adolescents in Cambodia

Objective:

To estimate the prevalence and predictors of environmental tobacco smoke (ETS) exposure among nonsmoking adolescents in Cambodia.

Materials and Methods:

Analysis of data from the Global Youth Tobacco Survey (GYTS) conducted in 2003 in Cambodia. Data were analysed to obtain the prevalence of ETS exposure at home and elsewhere by age and gender. Logistic regression analysis was conducted to assess the association between ETS and gender, age, smoking status of parents and friends.

Results:

67.1% (64.0, 70.0) males and 67.4% (64.2, 70.5) females reported being exposed to ETS either at home or elsewhere. Adolescents who had one or both smoking parents had a more than three times the odds of ETS exposure at home (OR = 3.71; 95% CI (3.02, 4.57)). Those who had smoking friends were more likely to be exposed to ETS both at home and outside home (OR = 1.74; 95% CI (1.36, 2.24)). The overall proportion of adolescents exposed to ETS outside home was higher than those exposed at home (P < 0.001), suggesting that exposure in public areas was the main form of ETS among adolescents in Cambodia.

Conclusions:

Exposure to ETS is high among adolescent in Cambodia, which indicates an urgent need for specific measures, policies and regulations to protect nonsmoker Cambodian adolescents both within and outside home.     

Environmental tobacco smoke and canine urinary cotinine level

Epidemiologic studies of companion animals such as dogs have been established as models for the relationship between exposure to environmental tobacco smoke (ETS) and cancer risk in humans. While results from these studies are provocative, pet owner report of a dog's ETS exposure has not yet been validated. We have evaluated the relationship between dog owner's report of household smoking by questionnaire and dog's urinary cotinine level. Between January and October 2005, dog owners presenting their pet for non-emergency veterinary care at the Foster Hospital for Small Animals at Cummings School of Veterinary Medicine, Tufts University, were asked to complete a 10-page questionnaire measuring exposure to household ETS in the previous 24 h and other factors. A free-catch urine sample was also collected from dogs. Urinary cotinine level was assayed for 63 dogs, including 30 whose owners reported household smoking and 33 unexposed dogs matched on age and month of enrollment. Urinary cotinine level was significantly higher in dogs exposed to household smoking in the 24 h before urine collection compared to unexposed dogs (14.6 ng/ml vs. 7.4 ng/ml; P=0.02). After adjustment for other factors, cotinine level increased linearly with number of cigarettes smoked by all household members (P=0.004). Other canine characteristics including age, body composition and nose length were also associated with cotinine level. Findings from our study suggest that household smoking levels as assessed by questionnaire are significantly associated with canine cotinine levels.     

Smoking among American adolescents: a risk and protective factor analysis

Cigarette smoking remains a substantial threat to the current and future health of America's youth. The purpose of this study was to identify the risk and protective factors for cigarette smoking among US adolescents. Data from the National Longitudinal Study of Adolescent Health was used, comparing the responses of all non-smokers at Time 1 for their ability to predict the likelihood of smoking at Time 2, one year later. Data was stratified into four gender by grade group cohorts. Cross-cutting risk factors for smoking among all four cohorts were: using alcohol, marijuana, and other illicit drugs; violence involvement; having had sex; having friends who smoke and learning problems. Having a higher grade point average and family connectedness were protective across all cohorts. Other gender and grade group specific risk and protective factors were identified. The estimated probability of initiating smoking decreased by 19.2% to 54.1% both in situations of high and low risk as the number of protective factors present increased. Of the factors that predict or protect against smoking some are influential across all gender and grade group cohorts studied, while others are specific to gender and developmental stage. Prevention efforts that target both the reduction of risk factors and enhancement of protective factors at the individual, family, peer group and community are likely to reduce the likelihood of smoking initiation.     

Possible Association between Passive Smoking and Lower Exhaled Nitric Oxide in Asthmatic Children

In adults, both active and passive smoking reduce levels of exhaled nitric oxide (eNO); however, to date, passive exposure to environmental tobacco smoke (ETS) has not been shown to affect eNO in children. The authors recruited 174 asthmatic children (96 male, 78 female) and 79 nonasthmatic controls (46 male, 33 female) from a group of children aged 5 to 14 yr who attended a children's hospital for an outpatient visit or elective surgery. Each subject's exposure to ETS was ascertained by questionnaire, and their eNO levels were measured. Asthmatic children had higher eNO levels (ppb) than nonasthmatic children (p = 0.04), and asthmatic children exposed to ETS had significantly lower eNO levels than unexposed children (p = 0.005). Exposure to ETS did not alter eNO levels in nonasthmatic children (p = 0.4). Results of the study suggest that ETS exposure is associated with lower eNO levels among childhood asthmatics. Consequently, ETS exposure may need to be considered when physicians interpret eNO levels in asthmatic children. Further study of the effects of ETS on eNO levels is recommended.     

Smoking is an occupational hazard

BACKGROUND: Even though the prevalence of tobacco smoking has declined in the general population and among white-collar workers, the prevalence of tobacco smoking among blue-collar workers remains unacceptably high. Blue-collar workers experience greater exposure to workplace toxins which can add to, or even multiply, their risk of adverse health effects from tobacco smoking. Among blue-collar workers, workers in the restaurant, bar, and gaming industries are exposed to much higher levels of environmental tobacco smoke (ETS) than are office workers, and are at increased risk of cancer and cardiovascular diseases even if they are non-smokers themselves. METHODS: The literature on health risks, and the disparity between white and blue collar workers in smoking prevalence, and the literature on various tobacco control strategies provide the sources on which this review is based. CONCLUSIONS: Over the past 20 years, the accumulating scientific evidence about smoking as an occupational hazard has prompted the implementation of various educational, economic, and legal tobacco control strategies.     

某有色金属冶炼厂造成的环境污染对青少年健康的影响

有色金属冶炼厂造成的环境污染区内．青少年头发及尿中的铅（Pb）、砷（As）、镉（Cd）的含量显高于对照区，两者间的差异具有高度显著性（P＜0．01），其中铅是主要的重金属危险因素．同时，环境污染使青少年的非特异也免疫功能降低．     

上海市某区部分餐厅环境烟草烟雾浓度调查

[目的]对上海市某区8家餐厅的环境烟草烟雾浓度在《上海市公共场所控制吸烟条例》(简称《控烟条例》)实施前后进行比较,旨在评价《控烟条例》在餐厅的实施效果,为该条例今后的进一步修订提供参考. [方法]采用目的抽样方法,在2008年4月《控烟条例》实施前和2010年12月《控烟条例》实施后选取8家餐厅分别进行基线调查和随访监测,采用AM510个体气溶胶监测仪检测空气中细颗粒物(PM2.5)浓度以代表环境烟草烟雾污染状况. [结果]《控烟条例》实施前后餐厅室内PM2.5浓度分别为147.76、125.15μg/m3,室内PM2.5浓度峰值分别为363.20、272.00μg/m3.《控烟条例》实施前后餐厅室内外PM2.5浓度差值分别为80.44、70.53μg/m3,差异无统计学意义(P＞0.05). [结论]《控烟条例》实施前后,餐厅室内PM2.5浓度没有明显变化.部分餐厅大厅内尚无有效控烟措施,环境烟草烟雾暴露问题比较严重,必须采取严格有效禁烟措施减少环境中因吸烟所致的烟雾污染.     

青少年吸烟发生机制与对策

我国是一个有3亿多烟民的吸烟大国,控制吸烟、减少由于吸烟对人们健康的危害是现代社会和人们共同关心的问题。中小学校是开展青少年反吸烟教育的主要场所,为了加强青少年控烟工作,本文着重描述青少年吸烟的危害及发生机制,并制订对策。     

Estimation of the diesel exhaust exposures of railroad workers: I. Current exposures

As a part of a series of epidemiological studies of railroad workers, measurements were made to characterize workers' exposures to diesel exhaust. Since diesel exhaust is not a single compound, an exposure marker was sought. The personal exposures to respirable particulate matter (RPM) of over 530 workers in 39 common jobs were measured in four U.S. railroads over a three-year period. Significant amounts of cigarette smoke (20–90%) were found in many of these samples. Therefore, the respirable particulate concentration, adjusted to remove the fraction of cigarette smoke (ARP), was chosen as a marker of diesel exhaust exposures. The geometric mean exposures to ARP ranged from 17 μg/m³ for clerks to 134 μg/m³ for locomotive shop workers. Significant interrailroad variations were observed in some job groups indicating that the different facilities, equipment, and work practices found among the railroads can affect a worker's exposure to diesel exhaust. Climate was also found to have a significant effect on exposure in some job groups.     

Teen Perceptions of Facilitator Characteristics in a School-Based Smoking Cessation Program

Background: Facilitators are often responsible for the implementation of public health programs, yet little is known about how they influence outcomes. Not‐On‐Tobacco (N‐O‐T) is a youth smoking‐cessation program implemented by trained facilitators. The purpose of this study was to investigate teens’ perceptions of facilitator characteristics and the relationship between those perceptions and program outcomes. Methods: Data were collected from N‐O‐T participants aged 14 to 19 who completed a survey about perceptions of facilitator characteristics that were linked to program outcomes 3 months post‐baseline (n = 769). Eight facilitator characteristics were ordered, based on importance to participants. Chi‐square tests measured differences in perceptions of facilitator characteristics according to race and sex, and an aggregate facilitator favorability score was created and analyzed in relation to program outcomes (smoking reduction or cessation vs increase/no change). Logistic regression was used to analyze facilitator characteristics’ relationship to outcomes, controlling for race and sex. Results: Participants rated facilitator characteristics of trustworthy, cares about students, and confidential as most important. Girls consistently ranked facilitator characteristics as more important than did boys. There were few significant differences based on race, except that white students rated nonjudgmental to be more important than did nonwhite students. There were no significant findings from the logistic regression, but there was a significant relationship between the aggregate facilitator favorability score and favorable changes in smoking outcomes (reduction or cessation). Conclusions: This study provides insights into the facilitator characteristics that are important to teen participants. It demonstrates that teens’ overall perceptions of facilitators contribute to their perception of how the program contributes to their success and program outcomes.     

Prenatal and Postnatal Tobacco Exposure and Behavioral Problems in 10-Year-Old Children: Results from the GINI-plus Prospective Birth Cohort Study

Background

Prenatal and postnatal tobacco exposure have been reported to be associated with behavioral problems. However, the magnitude of the association with tobacco exposure at specific periods of exposure is unclear.

Objective

We assessed the relative risk of behavioral problems in children who had been exposed to tobacco smoke in utero and postnatally.

Methods

We analyzed data from a prospective birth cohort study in two cities in Germany: the German Infant Nutrition Intervention. Our sample included 5,991 children born between 1995 and 1998 as well as their parents. We measured behavioral problems using the Strength and Difficulties Questionnaire (SDQ) at follow-up 10 years after birth. According to prespecified SDQ cutoff values, children were classified as “normal,” “borderline,” or “abnormal” according to the subscales “emotional symptoms,” “conduct problems,” “hyperactivity/inattention,” “peer-relationship problems,” and a total difficulties score. Smoke exposure and further covariates were assessed using parent questionnaires.

Results

Compared with children not exposed to tobacco smoke, children exposed both pre- and postnatally to tobacco smoke had twice the estimated risk [95% confidence interval (CI), 1.4–3.1] of being classified as abnormal according to the total difficulties score of the SDQ at 10 years of age. Children who were only prenatally exposed had a 90% higher relative risk (95% CI, 0.9–4.0), whereas children who were only postnatally exposed had a 30% higher relative risk (95% CI, 0.9–1.9). These results could not be explained by confounding by parental education, father’s employment, child’s time spent in front of computer or television screen, being a single father or mother, or mother’s age.

Conclusions

Prenatal exposure to tobacco smoke is associated with behavioral problems in school-age children. Although our findings do not preclude the influence of postnatal exposure, prenatal exposure seems to be more important.     

Effectiveness of Clean Indoor Air Ordinances in Controlling Environmental Tobacco Smoke in Restaurants

Clean indoor air (CIA) ordinances in Toledo, Ohio, and Bowling Green, Ohio, regulate smoking in restaurants to protect patrons and employees. Yet complete protection is questionable because the ordinances allow for smoking in certain dining sections. Two restaurants were studied in each city, one smoking and one nonsmoking. Levels of contaminants related to environmental tobacco smoke (ETS)—determined by personal and area air monitoring—in the nonsmoking restaurants were comparable to levels in a control environment. However, levels of ETS-related contaminants in the smoking restaurants, including designated nonsmoking sections, were significantly higher than levels in the control environment. ETS-related contamination of the nonsmoking sections in the smoking restaurants is attributable to direct openings between the smoking and nonsmoking sections. Reasonable protection of employees and patrons against ETS-related contaminants requires strict enforcement of CIA ordinances. Full protection is achievable only with 100% smoke-free policies.     

The attitudes of occupational health personnel to smoking at work

Attitudes of occupational health care professionals toward smoking and their activity to address smoking issues were investigated by a questionnaire survey. Data were also collected on employees' exposure to environmental tobacco smoke and on smoking policies that existed in workplaces. Questionnaires were mailed to all occupational health care centers (n = 1,004) in Finland. The prevalence of daily smokers was 9.6% among physicians and 3.6% among nurses; 15% and 11%, respectively, smoked occasionally. Smoking restrictions were enforced in more than 70% of all workplaces, but only 3.6% of them had a total smoking ban. Nonsmoking professionals were in favor of smoke-free workplaces and smoking restrictions significantly more often than their smoking colleagues. Nonsmokers also regarded smoking as a serious problem to the organizational climate of workplaces. Almost half of nonsmoking respondents, but only 11% of daily smokers, would totally ban smoking in workplaces. Although the personal smoking status of the respondent had a strong effect on attitudes to smoking regulations, it did not have a clear influence on interest in discussing smoking issues when seeing patients. Nurses were more active in addressing smoking issues than physicians. Occupational health professionals of large companies reported stricter smoking policies at work than those who represented small enterprises. Am. J. Ind. Med. 34:73–78, 1998. © 1998 Wiley-Liss, Inc.     

Environmental tobacco smoke interference in the assessment of the health impact of a municipal waste incinerator on children through urinary thioether assay

The urinary elimination of thioethers urinary thioethers (UT) was studied in 83 schoolchildren living in two different areas of the city of Mataró, with special attention paid to the influence of a waste incinerator and of the smoking habits of their parents. The mean UT values were 8.79+/-3.23 and 7.52+/-3.23 mmol/mol creatinine in the area close to the incinerator (A1) and in the area far away from it (A2) respectively (statistically n.s.). Children exposed to environmental tobacco smoke (ETS) at home presented increased levels of UT (8.60+/-3.11 vs 5.93+/-3.22 mmol/mol creatinine; P=0.002). Considering the two exposures together (waste incinerator and ETS), no differences were found between the two areas studied (A1 and A2) in non-exposed (ETS) children, whereas slight differences were found when comparing highest ETS exposed children from the two areas (10. 18+/-2.70 vs 8.00+/-3.42 mmol/mol creatinine; P=0.04). Exposure to ETS could affect health more than pollutants from a waste incinerator and may interfere with non-selective assays such as urinary thioethers.     

Environmental justice at school: understanding research, policy, and practice to improve our children's health

BACKGROUND: No overarching federal agencies or policies are responsible for ensuring environmental health at schools in the United States, potentially allowing many inequities for low‐income and minority communities to persist. This article examines emergent research, policy, and practice‐based efforts that may be used to identify and address environmental justice at school. METHODS: A brief literature review was conducted to understand (1) major mental, behavioral, and physical outcomes associated with environmental risk for school‐aged children and (2) current research methods for assessing these relationships. Documents prepared by government agencies, school districts, and advocacy groups were also collected and synthesized to improve understanding of the state of planning and policies for maintaining or improving school environments. RESULTS: Environmental risk can manifest in diverse ways such as mold, poor air quality, poor community design, or contaminated playgrounds. Deeply rooted in national and state structures of school funding and planning, such risks can lead to outcomes including respiratory illness, poor performance in school, and reduced levels of physical activity. With growing attention to these concerns, methods for measuring environmental risks and underlying disparities have advanced tremendously in the last few decades, yet development of innovative research approaches may be necessary to further advance and evaluate appropriate interventions. CONCLUSIONS: Environmental injustice is generally unacknowledged during decision‐making in US school districts. Continued dialogue reflective of translatable science is necessary to support school districts with limited funding in ensuring safe, healthy environments for learning.     

Children's Exposure to Environmental Tobacco Smoke in the Home: Comparison of Urine Cotinine and Parental Reports

The authors examined the relationship between parent-reported estimates of children's exposure to environmental tobacco smoke (ETS) in the home and children's urinary cotinine levels. Data were collected from a largely ethnic minority, low-income, urban sample of households in which a child had asthma and at least 1 household member smoked. Information about level of household smoking restriction, parental smoking status, and number of cigarettes smoked per day accounted for approximately 45% of the variance in cotinine concentration. Detailed information about the duration of household smoking or children's ETS exposure added no additional significant information. Questionnaires eliciting detailed information about smoking habits and children's ETS exposure may be no better at predicting children's urinary cotinine levels than simpler surveys that inquire about smoking restrictions in the home, parental smoking status, and number of cigarettes smoked at home per day.