不同家庭控烟方式对婴幼儿可替宁水平和急性呼吸道感染的影响

目的研究不同家庭控烟方式对婴幼儿可替宁水平和急性呼吸道感染(ARI)的影响。方法选择300名居家婴幼儿为研究对象,根据家庭控烟方式分为严格控烟组97人、部分控烟组88人和未控烟组115人,测量尿可替宁水平,并进行为期1年的前瞻性随访,记录随访期间ARI发生情况。结果严格控烟组可替宁的平均水平为(0.45±0.21)μg/L,明显低于部分控烟组(1.01±0.49)μg/L和未控烟组(1.16±0.48)μg/L(P0.05),但部分控烟组与未控烟组比较差异无统计学意义(P0.05)。严格控烟组下呼吸道感染发生率为18.75%,明显低于部分控烟组的32.18%和未控烟组的37.72%(P0.05);上呼吸道感染次数、下呼吸道感染次数在三组间分别作比较,差异均有统计学意义(P0.01)。严格控烟组发生上、下呼吸道感染的比例明显低于部分控烟组和未控烟组(P0.05),但部分控烟组与未控烟组的上、下呼吸道感染的发生比例比较,差异均无统计学意义(P0.05)。结论室内严格禁烟有助于减少婴幼儿被动吸烟和ARI的发生。     

大连市部分饭店工作人员二手烟暴露水平的研究

目的:了解大连市部分饭店工作人员二手烟暴露的水平,为控烟工作提供参考。方法:选取大连市区20家饭店,采集并检测不吸烟工作人员尿液中尼古丁和可替宁的含量及头发中的尼古丁含量。结果:不吸烟工作人员尿液中尼古丁的检出率为32.00%,可替宁的检出率为24.00%;头发中尼古丁检出率较高为96.00%。结论:大连市部分饭店工作人员二手烟暴露的情况不容乐观。     

学校与家庭控烟对中学生家庭二手烟暴露的联合作用

观察学校与家庭控烟对中学生的联合作用,探讨其对降低中学生家庭二手烟暴露的有效性,以期为中学生控烟工作提供新思路.方法 采用分层整群随机抽样的方法,在北京市东城区抽取4所中学的所有初一和高一学生共2 125名开展问卷调查.调查内容包括中学生个人基本信息,中学生家庭、学校和周围社会控烟环境情况及中学生控烟相关知识、态度和行为等.结果 北京市东城区中学生的家庭二手烟暴露率为33.41%.在校园内见过“明确禁烟标识”的学生中,家里有限制吸烟规定的暴露率(4.92%)低于家里没有规定的学生(58.94%) (x2=452.57,P<0.01).Logistic回归分析结果显示,父母至少一方吸烟与学生家庭二手烟暴露呈正相关(OR=22.88,P<0.05);有家庭限制吸烟规定分别与见过校园内禁烟标识(OR=0.08)、在学校接受过控烟宣教(OR=0.08)对中学生的家庭二手烟暴露存在联合作用.结论 学校与家庭的联合控烟措施能有效降低中学生家庭二手烟暴露率,较二者单独控烟作用更优.     

兵团石河子教师吸烟现况及知识态度调查

目的了解兵团石河子教师吸烟现况,掌握其控烟知识、态度,为制定干预措施提供依据。方法采取简单随机抽样方法抽取3所学校教师349名,采用面对面问卷调查。结果教师吸烟率13.48%,男性（34.85%）高于女性（0.46%）;25岁以下年龄组吸烟率显著高于其他年龄组（P〈0.01）;成功戒烟者20.34%;有吸烟行为者人均每天吸烟11.8支;控烟教学活动小学及中学显著好于大学（P〈0.01）;上班吸烟场所以办公室最多;对吸烟与被动吸烟危害常见知识知晓率差别不大;对在家庭、医院及学校禁烟的态度支持率小学及中学显著高于大学。结论对教师特别是年轻教师要加大控烟健康教育力度,制定严格的校园禁烟制度,提高教师控烟责任感,杜绝烟草对学生的危害。     

广西小学儿童二手烟暴露及相关致癌物质摄入情况分析

目的了解广西小学儿童二手烟暴露及相关致癌物质摄入情况,为进一步采取控烟措施提供参考。方法在广西南宁市选择3所小学开展调查。根据家长自述的儿童可能二手烟暴露情况分成A、 B、 C、 D组,每组50户。对各调查户中的在校儿童进行问卷调查和尿液检测,分析体内可替宁、 4-(甲基亚硝胺)-1-(3-吡啶)-1-丁醇(NNAL)总量摄入情况及其影响因素。结果共调查205名儿童,尿液可替宁和NNAL总量浓度的中位数分别为1.50 ng/mL和0.005 pmol/mL,检出率分别为96.10%和62.93%。4组儿童中NNAL总量检出率差异有统计意义(X~2=8.68, P0.05),最高为B组(父亲或母亲吸烟但从不在家里吸烟,其他家庭成员也从不在家里吸烟),检出率为76.92%,最低为C组(父母亲及其他家庭成员均不吸烟,但儿童经常暴露在户外二手烟环境中),检出率为53.06%。4组儿童中可替宁和NNAL总量检出浓度平均值差异均有统计学意义(P0.05),可替宁检出浓度中位数B组最高,为2.20 ng/mL, NNAL总量检出浓度A组(父亲或母亲吸烟且经常在家里吸烟)最高,其浓度中位数为0.011 pmol/mL。农村儿童可替宁检出率高于城市儿童(X~2=9.27, P0.01),检出率为100.00%;农村儿童可替宁检出浓度略高于城市(P0.05),中位数为1.80 ng/mL。不同房屋性质的儿童NNAL总量检出率差异有统计学意义(X~2=12.91, P0.01),其他类型住房的儿童检出率最高(100.00%);不同房屋性质的儿童中可替宁和NNAL总量检出浓度平均值差异均有统计学意义(P均0.05)。调查儿童尿液可替宁、 NNAL总量水平之间存在正相关(r=0.898, P0.001)。多重响应变量分析结果显示,各选项响应值位于0.98%～78.54%之间,在地点选项中可替宁和NNAL总量检出情况最多的选项均为学校。结论受调查的儿童大部分已暴露于二手烟环境中,应尽快出台公共场所禁烟措施,加快立法进程,加强民众的健康教育,提倡健康的生活方式,有效减少二手烟的危害。     

大连市区部分公共场所环境烟草烟雾暴露水平的研究

目的了解大连市内部分公共场所环境烟草烟雾的暴露水平,为控烟工作提供参考。方法选取大连市区29家公共场所,悬挂被动式尼古丁采样器采集环境空气中尼古丁并进行实验室检测,同时采集检测不吸烟工作人员尿液中尼古丁和可替宁的含量及头发中的尼古丁含量。结果 63份空气中尼古丁检出浓度为0.35μg/m3~3.18μg/m3,检出率为71.43%,各场所空气中尼古丁的检出率差异无统计学意义;290份尿液中尼古丁的检出率为32.33%,可替宁的检出率为29.33%;290份头发中尼古丁检出率较高,在95.00%~100.00%之间,不同场所工作人员头发中尼古丁检出率差异无统计学意义。结论大连市区公共场所环境烟草烟雾的暴露不容乐观。     

咸宁城区被动吸烟人群尿中可替宁和3-羟基可替宁的检测

目的探讨咸宁城区被动吸烟人群被动吸烟量与尿中可替宁、3-羟基可替宁浓度的关系,准确评价被动吸烟人群烟草暴露水平,为政府制定控烟政策提供科学依据。方法根据被动吸烟指数等级分为3组,1～9、10～19和≥20支/天,采集咸宁城区被动吸烟人群尿样共120份(每组40份),另外,采集咸宁市疾病预防控制中心工作人员中本人不吸烟,且最近3个月无烟草暴露史的40人作为空白对照,对其工作生活环境等情况进行问卷调查。利用气相色谱-质谱检测法测定尿中2种尼古丁的代谢产物可替宁、3-羟基可替宁的含量,并对结果进行统计分析。结果被动吸烟量与尿液中的可替宁和3-羟基可替宁浓度均呈正相关(r=0.872、0.745,均P<0.01)。随着被动吸烟量的增加,尿液中可替宁、3-羟基可替宁含量均升高。结论被动吸烟可以增加尿液中可替宁、3-羟基可替宁的含量,可替宁和3-羟基可替宁可以作为反映被动吸烟人群烟草暴露水平较好的标志物。     

北京市中式餐馆室内控烟管理规定遵守情况调查

目的了解北京市中式餐馆室内控烟管理规定遵守情况,为评估《北京市控制吸烟条例》实施后餐馆控烟效果提供基线数据。方法 2014年11—12月该研究采用分层多阶段抽样的方法抽取320家中式餐馆,调查员以顾客身份对其中314家餐馆的控烟环境、吸烟现象、服务员烟草相关知识态度行为进行暗访观察和询问。使用SPSS 12.0软件进行构成比、χ2检验等统计分析。结果 314家餐馆中,83家(26.4%)餐馆执行控烟管理规定在室内划定了吸烟区或者规定室内全面禁烟;占观察总数的26.4%;全面禁烟餐馆69家(22.0%);部分禁烟餐馆14家(4.4%);未禁烟餐馆231家(73.6%)。35家(11.1%)在入口处设置了禁烟标识/提示,128家(40.8%)在餐厅大堂设置了禁烟标识/提示。152家餐馆大堂或卫生间出现吸烟现象,占观察总数的48.4%。全面禁烟餐馆在禁烟标识张贴、大堂吸烟现象发生率、服务员烟草相关知识知晓率等方面均好于未禁烟餐馆,差异具有统计学意义(P0.05)。结论调查期间北京市中式餐馆执行控烟管理规定的比例较低,禁烟标识张贴不充足,禁烟环境营造不够。餐馆室内吸烟现象比例较高,实行全面禁烟餐馆的控烟效果好于无禁烟规定的餐馆。     

尿液和头发及唾液中尼古丁及其代谢物可替宁的气相色谱-质谱同时测定法

目的 建立利用气相色谱-质谱(GC-MS)法同时测定人体尿液、头发、唾液中尼古丁及其代谢物可替宁的方法.方法 将样品(消解完全的头发、尿液、唾液)经NaOH碱化后用三氯甲烷萃取,气相色谱分离,质谱检测采用选择离子扫描,并以二苯胺作为内标物进行定量.尿液中尼古丁和可替宁的浓度用尿肌酐校正.结果 该方法的尼古丁和可替宁的检...     

台州市农村家庭内吸烟对儿童二手烟暴露的影响

【目的】分析浙江省台州市农村地区的家庭内吸烟情况及对儿童二手烟暴露的影响,为制定降低儿童二手烟暴露的干预措施提供帮助。【方法】2018年5月—2019年11月,选取台州临海市和路桥区的418户吸烟家庭,采用面对面询问的方式进行调查,并检测儿童尿样的可替宁含量。采用核密度估计进行曲线拟合,Wilcoxon秩和检验和卡方检验进行比较。【结果】家庭内吸烟者的年龄呈双峰分布,较小年龄群体以父母为主,较大年龄群体以祖父、外祖父等其他亲属为主;父母组的开始吸烟年龄小于其他亲属组,而其他亲属组的平均每日吸烟支数则大于父母组(P0.05);父母组家里有吸烟规定、同意在有孩子的室内不应吸烟的比例高于其他亲属组(P0.001);父母组听说过三手烟和电子烟的比例均高于其他亲属组(P0.001);父母组和其他亲属组的儿童尿可替宁检出率分别为91.05%和86.96%,父母组儿童的尿可替宁值高于其他亲属组(P=0.049)。【结论】当家庭内吸烟者为父母时,儿童的二手烟暴露程度更高。为减少儿童二手烟暴露,应进一步重视对父母吸烟者的家庭内控烟教育。     

Parental smoking and passive smoking in infants: fathers matter too

This study examines mothers' and fathers' smoking patterns in different kinds of smoking households, and assesses their relative contribution to infants' exposure to environmental tobacco smoke. It uses data from a cross-sectional survey of 314 smoking households (infants: mean age 10 weeks) in Coventry and Birmingham, England, examining reported tobacco consumption and objective measures of exposure: the study infant's urinary cotinine:creatinine ratios and their mother's salivary cotinine. The study shows that both mothers' and fathers' tobacco smoke make substantial contributions to infant exposure to tobacco smoke. Households were more likely to contain a smoking father than mother, with over two-thirds of households including a smoking father. In households where both parents smoke, fathers' tobacco consumption was found to be significantly higher than in households where only the father smokes. This suggests that the interaction between parents needs to be considered rather than focusing on mothers' or fathers' smoking behaviour in isolation. The implications for health promotion programmes are discussed, particularly the need to place more emphasis on tackling fathers' smoking. Currently, fathers' smoking receives far less research or health promotion attention than mothers' smoking. Protecting infants from fathers' as well as mothers' smoking is key to reducing environmental tobacco exposure in early infancy, when the risk of Sudden Infant Death is highest.     

Determinants of children's exposure to environmental tobacco smoke (ETS): a study in Southern Germany

Maternal smoking has been repeatedly found to be the most important determinant of children's exposure to environmental tobacco smoke (ETS). Here, we further investigated predictors for the urinary cotinine/creatinine ratio (CCR, ng/mg) in 1220 preschool children for the year 1996. Children from smoking homes (35.1%) had significantly higher CCR than children from nonsmoking homes (mean: 55.5 vs. 14.9 ng/mg). The level of education of the parents was a strong predictor for CCRs even after adjusting for number of cigarettes smoked, maternal smoking and dwelling space. Additionally, dwelling space was inversely related to children's urinary cotinine level. The CCR- levels in children investigated in 1996 and 1998 were significantly correlated (Pearson's r=0.67). The parents of 806 children agreed for a visit to their homes. In 79 of the 536 (14.7%) of the self-reported, nonsmoking households, smoking was admitted during the visit. The mean urinary CCR of these children was 25.2 ng/mg. We conclude that in addition to parental smoking behaviour, other variables such as dwelling space and social and educational status predict the children's exposure to ETS. Our data also revealed that a considerable percentage of parents denied the ETS exposure of their children at home.     

Newborn infant urinary cotinine and birth outcomes in the Jerusalem Environment Mother and Child Cohort Study

BackgroundEnvironmental tobacco smoke (ETS) exposure during pregnancy can cause preterm delivery and childhood cancer. The aim of this study was to measure ETS exposure in pregnant women and in newborn infants in Israel using urinary cotinine measurements, to assess predictors of ETS exposure in these vulnerable groups, and to assess associations with birth effects (birth weight, birth length, head circumference) in newborn infants.MethodsWe analyzed urinary cotinine and creatinine in 265 non-smoking pregnant women and 97 newborns, and analyzed associations with self-reported exposure to ETS, paternal smoking, sociodemographic variables and with birth outcomes (birth weight, birth length, head circumference).Results37.7% of pregnant women and 29.0% of infants had urinary cotinine concentrations above the level of quantification (LOQ) of 1 μg/L, whereas 63.8% and 50.5%, respectively, had urinary cotinine concentrations above the level of detection (LOD) of 0.5 μg/L. Median unadjusted and creatinine adjusted urinary concentrations of cotinine in pregnant women were 0.7 μg/L, and 0.9 μg/g creatinine, respectively, and in newborn infants were 0.5 μg/L, and 1.3 μg/g creatinine, respectively. We did not find an association between maternal and infant urinary cotinine level. Maternal (but not infant) urinary cotinine was significantly associated with paternal smoking (p < 0.05). Infant (but not maternal) cotinine above the LOQ was negatively associated with birth weight (p < 0.05).ConclusionsIn this high socioeconomic cohort, almost a third of newborn infants born to non-smoking mothers had quantifiable levels of urinary cotinine. This is the first study showing that newborns with quantifiable urinary cotinine levels have lower birth weight.     

Tobacco smoke exposure at one month of age and subsequent risk of SIDS--a prospective study

The aim of this investigation was to identify the sources of postnatal exposure to tobacco smoke at 1 month of age and to examine their relation to sudden infant death syndrome (SIDS). The Tasmanian Infant Health Survey was a prospective cohort study undertaken from 1988 to 1995. It involved 9,826 infants (89% of eligible infants) at higher risk of SIDS. Subsequently 53 eligible infants died of SIDS. Hospital interviews were available on 51 and home interviews on 35 SIDS infants. Urinary cotinine assays were conducted using gas-liquid chromatography (n = 100). Within a predictive model that explained 63% of urinary cotinine variance, the strongest predictor of cotinine and also of SIDS was maternal smoking, though the effects of prenatal and postnatal smoking could not be separated. However, for particular smoking-related behaviors, there was a discordance between prediction of cotinine concentration and prediction of risk of SIDS. If smoking mothers did not smoke in the room with the baby, the cotinine level in the infant's urine was reduced by a little more than a half (p = 0.009), but this was not associated with a reduction in SIDS risk (odds ratio = 1.09, 95% confidence interval 0.47-2.55). Similarly, the presence of other adult resident smokers was associated with a 63% increase in urinary cotinine (p = 0.047) but not with increased SIDS risk (odds ratio = 0.69, 95% confidence interval 0.34-1.40). However, the study lacked the power to detect modest effects, that is, those altering risk less than twofold.     

Household smoking behaviours and exposure to environmental tobacco smoke among infants: are current strategies effectively protecting our young?

Objective: To determine the prevalence of infant exposure to environmental tobacco smoke (ETS) among infants attending child health clinics in regional NSW; the association between such exposure and household smoking behaviours; and the factors associated with smoking restrictions in households with infants. Methods: Parents completed a computer‐based questionnaire and infant urine samples were collected. Information was obtained regarding the smoking behaviours of household members and samples were analysed for cotinine. Results: Twenty seven per cent of infants had detectable levels of cotinine. Infant ETS exposure was significantly associated with the smoking status of household members, absence of complete smoking bans in smoking households and having more than one smoker in the home. Smoking households were significantly less likely to have a complete smoking ban in place. Conclusions: This study suggests that a significant proportion of the population group most vulnerable to ETS were exposed. Implications: Future efforts to reduce children's exposure to ETS need to target cessation by smoking parents, and smoking bans in households of infants where parents are smokers if desired reductions in childhood ETS‐related illness are to be realised.     

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.     

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.     

A passive smoking screening program for children

BACKGROUND: There has been no report to date on mass screening of passive smoking in children using biomarkers. METHOD: To identify children exposed to actual environmental tobacco smoke (ETS), 261 children were divided into the following 3 groups: (A) both parents smoke; (B) one parent smokes; and (C) no parent smokes. Child urinary cotinine measurement and a parent questionnaire were obtained. RESULTS: Urinary cotinine was positive (>10 ng/ml) in 92 (35.2%) of the 261 children. Of the 92 children, 29 were classified into group A, 47 into group B, and 16 into group C. The percentages of children who tested positive for urinary cotinine in groups A, B, and C were 56.9%, 31.1%, and 27.1%, respectively. However, in group B, the percentage of children who tested positive for urinary cotinine was significantly higher if only the mother smoked (47.1%) than if only the father smoked (29.1%) (P<0.05). The mean+SD urinary cotinine level in group A was 12.9+/-6.5 ng/ml, and that in group B was 10.4+/-3.8 ng/ml if the mother smoked and 5.4+/-2.6 ng/ml if the father smoked. CONCLUSIONS: This smoking screening program may be useful in identifying children with actual ETS exposure and motivating their parents to either quit smoking or modify their smoking behavior around children.     

Exposure of young infants to environmental tobacco smoke: breast-feeding among smoking mothers.

OBJECTIVES: This study examined the degree to which breast-feeding and cigarette smoking by mothers and smoking by other household members contribute to the exposure of infants to the products of tobacco smoke. METHODS: The subjects were 330 mother-infant pairs derived from a cohort of 1000 pairs enrolled in a longitudinal study of the pulmonary effects of prenatal and postnatal smoking. The main outcome measure was corrected urinary cotinine levels. RESULTS: Urinary cotinine levels were 10-fold higher in breast-fed infants of smoking mothers than among bottle-fed infants of smoking mothers. Among infants of nonsmoking mothers, urine cotinine levels were significantly increased in infants living in homes with other smokers; in this group there was no significant difference between bottle-fed and breast-fed infants. Infants whose mothers smoked in the same room as the infant had only nonsignificant increases in cotinine levels compared with infants whose mothers restricted their smoking to other rooms. CONCLUSIONS: Breast-fed infants of smoking mothers have urine cotinine levels 10-fold higher than bottle-fed infants whose mothers smoke, suggesting that breast-feeding, rather than direct inhalation of environmental tobacco smoke, is the primary determinant of cotinine levels in infants whose mothers smoke.     

Parental home smoking policies: the protective effect of having a young child in the household

ObjectiveTo examine selected social determinants of a home smoking policy among US households with children and whether these associations vary by the presence of a smoker and children's ages.MethodsIn the 2006/2007 US Tobacco Use Supplement to the Current Population Survey there were 30,874 parents with 0–17-year-olds.Results83.9% of parents reported that no one was allowed to smoke inside the home. However, a no smoking policy varied by the presence of a smoker (93.6% of non-smoking households; 55.8% of smoking households) and children's ages (87.1% of parents with any 0–5-year-olds; 82.1% with 6–17-year-olds only; 79.2% with 14–17-year-olds only). In smoking and non-smoking households, parents of 6–17-year-olds were 25%–46% less likely to have a no smoking policy than parents of younger children. Among smoking households, Hispanic and Asian parents were over twice as likely to not allow smoking inside the home as white parents, while Black parents were half as likely. Parents from more disadvantaged circumstances were less likely to have a no smoking policy.ConclusionsParents of 6–17-year-olds are less likely to have a no smoking policy than parents of younger children. Parents with children of all ages should enact a smoking policy that promotes a smoke-free home.