Perceptions of Secondhand and Thirdhand Smoke Among Hispanic Residents of Multiunit Housing

Despite the progressive adoption of smoking bans in public spaces, children living in multi-unit housing remain at risk of exposure to secondhand smoke (SHS) and thirdhand smoke (THS). Hispanic populations in California are particularly vulnerable to the harmful effects of SHS and THS because a large proportion of Hispanics live in multi-unit housing. Three focus groups were conducted in the fall of 2012 (in Spanish and English, N = 24) to understand Hispanics’ knowledge of and experiences with SHS and THS, including barriers to avoiding smoke exposure and strategies for protecting their homes from smoke. Hispanic residents reported unpleasant experiences with SHS and THS and were generally knowledgeable about the adverse health effects, although they were not familiar with the term “thirdhand smoke.” Some participants also mentioned marijuana smoke as a potential health hazard. Hispanic cultural values made participants reluctant to confront their neighbors but also motivated them to find ways to protect their families from smoke. Potential solutions included working with the smokers to designate a smoking area and gaining support from the building owners. Broad smoking policies should be implemented to help Hispanic residents overcome cultural and social barriers to smoke free air.     

Smoke-Free Multi-unit Housing Policies Show Promise in Reducing Secondhand Smoke Exposure Among Racially and Ethnically Diverse,Low-Income Seniors

Secondhand smoke (SHS) exposure is a public health issue for residents of multi-unit housing (MUH) properties. We evaluated the impact of smoke-free policy implementation on reported SHS exposure among racially, ethnically diverse seniors living in low-income MUH properties. In Spring 2013 and Summer 2014, we surveyed residents (n = 960) at 15 MUH properties in Broward and Miami-Dade Counties, Florida. The percentage of residents reporting SHS exposure within their apartments from elsewhere in or around their building decreased from 31.1 %, before policy implementation, to 23.6 % at follow-up (p = 0.02). In multivariate analysis of non-smoking residents after policy implementation, residents who reported having one or more comorbidities were two times more likely to report SHS exposure (aOR 2.23, 95 % CI 1.12–4.40). Considering the vulnerability of low-income seniors to SHS exposure, our findings are relevant to residents, property owners/managers, and public health professionals making decisions about smoke-free policies for MUH properties in which seniors reside.     

Secondhand Smoke Exposure and Smoke-Free Policy Support Among Public Housing Authority Residents in Rural and Tribal Settings

Previous research has shown that multi-unit housing (MUH) residents are at risk of secondhand smoke (SHS) exposure, which can transfer between units. The purpose of this study was to determine SHS exposure and examine attitudes towards smoking policies among public housing authority (PHA) residents in rural and tribal settings. A self-administered questionnaire was completed by 895 adult tenants (41 % response rate) living in PHA multiunit buildings in Montana in 2013. Our primary outcome was tenant support of smoke-free policies; our secondary outcome was exacerbation of child asthma symptoms due to SHS exposure. In 2014, we used multiple logistic regression models to test associations between independent variables and outcomes of interest. The majority (80.6 %) of respondents supported having a smoke-free policy in their building, with support being significantly higher among nonsmokers [adjusted odds ratio (aOR) 4.2, 95 % confidence interval (CI) 1.5–11.6] and among residents living with children (aOR 2.9, 95 % CI 1.3–6.2). Tribal residents were as likely to support smoke-free policies as non-tribal residents (aOR 1.4; 95 % CI 0.5–4.0). Over half (56.5 %) of respondents reported SHS exposure in their home; residents in a building with no smoke-free policy in place were significantly more likely to report exposure (aOR 3.5, 95 % CI 2.2–5.5). SHS exposure was not significantly associated with asthma symptoms. There is a significant reduction in exposure to SHS in facilities with smoke-free policies and there is strong support for such policies by both tribal and non-tribal MUH residents. Opportunities exist for smoke-free policy initiatives in rural and tribal settings.     

Attitudes,Experiences, and Acceptance of Smoke-Free Policies Among US Multiunit Housing Residents

We assessed factors related to smoke-free policies among a cross-sectional, nationally representative, random-digit-dial sample (landline and cell phone) of US multiunit housing residents (n = 418). Overall, 29% reported living in smoke-free buildings, while 79% reported voluntary smoke-free home rules. Among those with smoke-free home rules, 44% reported secondhand smoke incursions in their unit. Among all respondents, 56% supported smoke-free building policy implementation. These findings suggest that smoke-free building policies are needed to protect multiunit housing residents from secondhand smoke in their homes.Secondhand smoke (SHS) contains hundreds of toxic or carcinogenic compounds and can cause significant morbidity and mortality among nonsmoking children and adults.1–3 Currently, there is a growing interest in adopting smoke-free policies in private settings, including multiunit housing (MUH). The home represents a major source of SHS exposure for many individuals,2,4–6 and MUH residents are particularly susceptible to SHS incursions from nearby units and shared areas.6–8 This cross-sectional study evaluated attitudes, experiences, and acceptance of smoke-free home rules and building policies among a nationally representative sample of US MUH residents.     

Intrauterine Device Training,Attitudes, and Practices Among U.S. Health Care Providers: Findings from a Nationwide Survey

BackgroundProvider training in intrauterine device (IUD) procedures is a key strategy for improving evidence-based IUD care. We examined the influence of IUD training on IUD attitudes and practices among U.S. family planning providers.MethodsIn 2019, we conducted a cross-sectional survey of U.S. family planning providers. We performed logistic regression to examine associations between training in routine IUD placement and specific IUD safety attitudes, confidence performing IUD procedures, and specific IUD practices.ResultsAmong 1,063 physicians and advanced practice clinicians, 85.1% reported training in routine IUD placement. Overall, IUD training was associated with accurately stating IUDs are safe for queried groups, including patients immediately postpartum (prevalence ratio [PR] 4.22; 95% confidence interval [CI] 1.29–13.85). Trained providers reported higher confidence in routine IUD placement for parous (PR 7.71; 95% CI 1.31–45.3) and nulliparous (PR 7.12; 95% CI 1.17–43.5) women and in IUD removal (PR 2.06; 95% CI 1.12–3.81). Among providers with IUDs available onsite, IUD training was associated with frequent same-day IUD provision for adults (PR 7.32; 95% CI 2.16–24.79) and adolescents (PR 7.63; 95% CI 2.22–26.24). Trained providers were also less likely to routinely use misoprostol before IUD placement for nulliparous (PR 0.19; 95% CI 0.11–0.33) and parous women (PR 0.07; 95% CI 0.03–0.16).ConclusionTraining in routine IUD placement was associated with evidence-based IUD safety attitudes, confidence in performing IUD procedures, and clinical practices aligned with Centers for Disease Control and Prevention contraception guidance. Expanding IUD training might increase evidence-based care and patient access to the full range of contraception, including IUDs.     

Association of Campus Tobacco Policies With Secondhand Smoke Exposure,Intention to Smoke on Campus,and Attitudes About Outdoor Smoking Restrictions

College campus tobacco-free policies are an emerging trend. Between September 2013 and May 2014, we surveyed 1309 college students at 8 public 4-year institutions across California with a range of policies (smoke-free indoors only, designated outdoor smoking areas, smoke-free, and tobacco-free).Stronger policies were associated with fewer students reporting exposure to secondhand smoke or seeing someone smoke on campus. On tobacco-free college campuses, fewer students smoked and reported intention to smoke on campus. Strong majorities of students supported outdoor smoking restrictions across all policy types.Comprehensive tobacco-free policies are effective in reducing exposure to smoking and intention to smoke on campus.Exposure to tobacco smoke harms nearly every organ of the body.1 Young adults smoke at rates higher than any other age group,2 likely in part because the tobacco industry aggressively markets to young adults3 as the youngest age group that they can legally target. Between 2001 and 2011, undergraduate enrollment increased 32% from 13.7 million to 18.1 million, with 42% of young adults (aged 18–24 years) attending a 2- or 4-year college or university. The National Center for Educational Statistics projects that this trend will continue, with a 13% increase in enrollment of students aged 24 years and younger from 2011 to 2021.4 Colleges are rapidly adopting a range of policies on tobacco, including tobacco-free policies that prohibit tobacco use on the entire grounds for students, faculty, staff, and visitors.Smoke-free college campus policies have been associated with a drop in student smoking rates.5 On North Carolina college campuses, as tobacco policy strength increased (none, designated areas, or tobacco-free), less cigarette butt litter was found on the ground outside building entrances.6 As tobacco control advocates shift focus to promoting comprehensive tobacco-free policies, a more nuanced understanding of the benefits of these policies is necessary.Previous research has indicated that college smoke-free policies lead to a reduction in student smoking rates,5 and strength of policy is linked to cigarette butt litter on college campuses.6 The purpose of this study was to examine the relationship between the strength of the tobacco policy and exposure to secondhand smoke, seeing someone smoking, and intention to smoke on campus. We studied a range of policies on 8 public 4-year colleges and universities in California and found that the stronger the policy provisions, the lower the reported exposure to secondhand smoke, and seeing someone smoking. In addition, students on the tobacco-free campuses reported the lowest intention to smoke on campus in the next 6 months.     

Cancer Knowledge and Related Practices: Results from the National Adolescent Student Health Survey

The National Adolescent Student Health Survey (NASHS) provides information on student knowledge, attitudes, and self-reported practices of eighth and 10th grade students in eight health areas. Data from the NASHS were reviewed relative to cancer risk factors, specifically, smoking, smokeless tobacco use, and nutrition. About 21% of 10th grade students reported smoking and a large percentage of both eighth and 10th grade students reported eating foods high in fat. The data indicate youth may be at increased risk for cancer and that much of that risk can be reduced by eliminating smoking and lowering dietary fat.     

Physical Activity Practices,Policies and Environments in Washington State Child Care Settings: Results of a Statewide Survey

Maternal and Child Health Journal - Objectives Child care is an important setting for the promotion of physical activity (PA) in early childhood. The purpose of this study was to examine the...     

Secondhand Smoke Exposure and Urine Cotinine Concentrations by Occupation among Korean Workers: Results from the 2008 Korea National Survey for Environmental Pollutants in the Human Body

This study aimed to estimate the status of secondhand smoke (SHS) exposure through urine cotinine analysis among nonsmoking workers in Korea and to analyze factors affecting urine cotinine concentrations. Data were based on “The 2008 Korea National Survey for Environmental Pollutants in the Human Body,” a cross-sectional study of the National Institute of Environmental Research of Korea. We selected 1448 nonsmoking adult workers from 200 localities to participate in this survey. Urine cotinine concentrations were analyzed using a gas chromatograph-mass selective detector. We calculated separate covariate-adjusted geometric means for socio-demographic variables for males, females, and total subjects by analysis of covariance (ANCOVA). Statistical analyses were performed using SPSS version 18.0 (SPSS Inc., Chicago, Ill.). The prevalence of self-reported exposure to SHS was 36.9%. The geometric mean (95% confidence interval) of urine cotinine concentrations among all participants was 16.50 (14.48–18.80) μg/L. Gender, living area, education, and SHS exposure showed significant differences in urine cotinine concentrations. The urine cotinine concentrations of farmworkers and blue-collar workers such as skilled agricultural, forestry, and fishery workers, and elementary occupations were higher than those of white-collar workers such as clerical support workers, technicians, and associate professionals. Such a high proportion of the population having high urine cotinine levels indicates widespread exposure to SHS among nonsmoking workers in Korea. Furthermore, the urine cotinine levels among nonsmoking workers exposed to SHS varied by occupation. The measured urine cotinine concentration is suggested to be a valuable indication of SHS exposure in Korea.     

Vicarious Exposure to Terrorist Attacks and Substance Use: Results from an Urban Household Survey

This study investigated the impact of the 9/11 attacks on substance use in Chicago, Illinois. The study design was a cross-sectional, audio-computer-assisted self-interview survey conducted in 2001 and 2002. Biological samples were also collected for toxicological analyses. Using a multistage area probability design, residents between the ages of 18 and 40 years were randomly selected. Compared to pre-9/11 interviewees, post-9/11 interviewees showed significantly less self-reported marijuana use, marijuana use per test results, and cocaine use per test results. Law enforcement and social–structural explanations for the findings are discussed. Lippert and Fendrich are with the Center for Addiction and Behavioral Health Research, Milwaukee, WI, USA; Fendrich is with the Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Johnson is with the Survey Research Laboratory, University of Illinois-Chicago, Chicago, IL, USA.     

武汉地区高校本科生生殖健康知识、态度、行为现况调查

目的：了解武汉地区高校本科生生殖健康知识、态度、行为现状,为进行生殖健康干预提供科学依据。方法：采用分层随机整群抽样的方法,对武汉地区4类高校的本科生进行不记名问卷调查。结果：共调查8997名,其中男生4963名,女生4034名。被调查者对口服避孕药和紧急避孕相关知识了解最少,对受孕条件和艾滋病的传播途径认知较好;医学生认知水平高于其他3类院校学生（P=0.000）;90%以上被调查者认为有必要了解避孕知识和性知识;42.9%的学生对＂性解放＂持否定态度,68.2%认为贞操对男女都很重要;10.0%的调查对象曾经有过性行为,且第一次性行为时采取避孕措施的占57.4%,大学生使用过的避孕方法主要是安全套（85.6%）、安全期避孕（45.9%）、体外射精（39.2%）、口服避孕药（33.3%）。调查对象意外妊娠发生率为25.7%。文体艺术类院校学生性行为发生率（14.7%）和意外妊娠率（43.6%）均为四类院校中最高。结论：武汉地区在校大学生生殖健康的认知水平较低,性态度较宽容,普遍对生殖健康知识有需求,需要进行系统全面的生殖健康教育。     

Availability and Attitudes Toward Correctional Psychiatry Training: Results of a National Survey of Training Directors

An online survey was developed and administered to estimate how often psychiatry residents train at correctional facilities and to explore the residency directors’ attitudes towards this training. The survey contained two factual and eight opinion questions assessing their experiences with and attitudes toward resident training in correctional facilities, and allowed for free responses. Ninety-five people participated out of 492 for a response rate of 20%. Thirty percent of responders make a correctional rotation mandatory and another 25% offer it as an elective. Approximately one-third (36%) of responders have worked at a correctional facility themselves. Opinions towards correctional psychiatry were mostly positive with the exception of various logistical difficulties being mentioned in free responses. These provisional findings should generate interest in this area as providing more resident rotations at correctional facilities may increase access to care of this patient population and provide residents valuable training opportunities.     

Differences in Fruit and Vegetable Intake among Hispanic Subgroups in California: Results from the 2005 California Health Interview Survey

Objective

To compare total fruit and vegetable intake in cup equivalents and its individual components among Hispanic subgroups in California.

Methods

Data are from the adult portion of the 2005 California Health Interview Survey. Hispanic/Latino subjects (n=7,954) were grouped into six subcategories (Mexican, Central American, Caribbean, Spanish American, South American, and >1 group). Total fruit and vegetable intake in cup equivalents was estimated from frequency responses about seven food categories. Both t test and χ² test were used to assess differences in sociodemographic characteristics across Hispanic subgroups. Multivariate linear regressions using SUDAAN software (Survey Data Analysis, version 9.0.1, 2005, Research Triangle Institute, Research Triangle Park, NC) were conducted to obtain means of total fruit and vegetable intake in cup equivalents and its components by Hispanic subgroups controlling for confounders.

Results

Hispanic subgroups did not differ in their intake of total fruit and vegetable intake in cup equivalents (mean 3.4 c and 2.9 c for men and women, respectively). Small but significant differences (P<0.01) were found across Hispanic subgroups in individual fruit and vegetable components (green salad [women only], cooked dried beans and nonfried white potatoes) after adjusting for potential sociodemographic and acculturation confounders.

Conclusions

Fruit and vegetable intake by Hispanic respondents did not meet the national recommendation, although their reported intake is higher compared to other race/ethnicity groups. The public health message remains the same: Increase fruit and vegetable intake. Examination of intake for subgroups of Hispanics may enhance the utility of dietary information for surveillance, program and message design, and intervention and evaluation.     

The Association Between Apartment Layout and Depressive Symptomology among Hispanic/Latino Residents in Low-Income Housing: the AHOME Study

In this study of low-income Hispanic/Latino adults living in 291 individual apartments in the Bronx, New York, the apartment layout was significantly associated with the odds of depressive symptomology. Women living in apartments in which the most central rooms were the living, dining, or kitchen (i.e., rooms commonly used for communal activities) were less likely to have depressive symptomology (OR = 0.44, 95% CI = 0.22–0.86) than women in apartments where the central rooms were lobbies or corridors, adjusting for demographics, health conditions, and housing and neighborhood characteristics. No statistically significant association was observed in men. We present the logic underlying the use of layout variables in this study and discuss the implications it may have for understanding the role of the home environment on psychological distress among inhabitants. The results of this study show how space syntax analysis can be used to better understanding disparities in the risk of depression and offer an additional opportunity for public health stakeholders to identify those most at risk for depression.     

Blood levels of lead, cadmium, and mercury in the Korean population: Results from the Second Korean National Human Exposure and Bio-monitoring Examination

In Korea, there have been a number of efforts to measure levels of exposure to environmental pollutants among the population. This paper focuses on investigating the distribution of, extent of, and factors influencing the blood levels of lead, cadmium, and mercury in the Korean population, working from data obtained from the Second Korean National Human Exposure and Bio-monitoring Examination. To that end, blood metal concentrations were analyzed from a total of 2369 participants who were 18 years of age and older. The geometric mean concentrations and their 95% confidence intervals of metals in blood were found to be lead, 1.72 μg/dL (95% CI, 1.68-1.76); cadmium, 1.02 μg/L (95% CI, 1.00-1.05); and mercury, 3.80 μg/L (95% CI, 3.66-3.93). Regression analyses indicate that the levels of metals in the blood are mainly influenced by gender, age, and the education levels of the participants. Current smoking status is also found to be a significant factor for increasing both lead and cadmium levels. Although our study, as the first nationwide survey of exposure to environmental pollutants in Korea, has value on its own, it should be expanded and extended in order to provide information on environmental exposure pathways and to watch for changes in the level of exposure to environmental pollutants among the population.