Effects Of Environmental Tobacco Smoke Research Articles

Unraveling the link: environmental tobacco smoke exposure and its impact on infertility among American women (18-50 years).

The detrimental effects of environmental tobacco smoke (ETS) on women's reproductive health have been widely recognized. However, the detailed association between exposure to environmental tobacco smoke and the incidence of infertility remains under-explored. This investigation focuses on exploring this potential connection. For this analysis, we extracted data from the US National Health and Nutrition Examination Survey (NHANES) database, covering the years 2013 to 2018, focusing on individuals with recorded serum cotinine levels and infertility information. ETS exposure and fertility status were analyzed as independent and dependent variables, respectively. We applied weighted multivariate logistic regression method to evaluate the impact of ETS on infertility, including subgroup analyses for more detailed insights. The study encompassed 3,343 participants. Logistic regression analysis revealed a notable positive correlation between ETS exposure and infertility, with an odds ratio (OR) of 1.64 (95% Confidence Interval [CI]: 1.14-2.36). We observed a non-linear relationship between ETS exposure and infertility risk. Notably, infertility risk increased by 64% in serum cotinine levels above 0.136 compared to that in serum cotinine levels below 0.011. Further, subgroup analysis and interaction tests showed consistent results across different segments, underscoring the robustness of the ETS-infertility link. Our findings suggest that environmental tobacco smoke exposure may be a contributing factor to infertility. These results reinforce the recommendation for women in their reproductive years to avoid ETS exposure, especially when planning for pregnancy.

Comprehensive evaluation of smoking exposures and their interactions on DNA methylation

BackgroundSmoking impacts DNA methylation, but data are lacking on smoking-related differential methylation by sex or dietary intake, recent smoking cessation (<1 year), persistence of differential methylation from in utero smoking exposure, and effects of environmental tobacco smoke (ETS). MethodsWe meta-analysed data from up to 15,014 adults across 5 cohorts with DNA methylation measured in blood using Illumina’s EPIC array for current smoking (2,560 exposed), quit <1 year (500 exposed), in utero (286 exposed), and ETS exposure (676 exposed). We also evaluated the interaction of current smoking with sex or diet (fibre, folate, and vitamin C). FindingsUsing false discovery rate (FDR<0.05), 65,857 CpGs were differentially methylated in relation to current smoking, 4,025 with recent quitting, 594 with in utero exposure, and 6 with ETS. Most current smoking CpGs attenuated within a year of quitting. CpGs related to in utero exposure in adults were enriched for those previously observed in newborns. Differential methylation by current smoking at 4-71 CpGs may be modified by sex or dietary intake. Nearly half (35-50%) of differentially methylated CpGs on the 450K array were associated with blood gene expression. Current smoking and in utero smoking CpGs implicated 3,049 and 1,067 druggable targets, including chemotherapy drugs. InterpretationMany smoking-related methylation sites were identified with Illumina’s EPIC array. Most signals revert to levels observed in never smokers within a year of cessation. Many in utero smoking CpGs persist into adulthood. Smoking-related druggable targets may provide insights into cancer treatment response and shared mechanisms across smoking-related diseases. FundingIntramural Research Program of the National Institutes of Health, Norwegian Ministry of Health and Care Services and the Ministry of Education and Research, Chief Scientist Office of the Scottish Government Health Directorates and the Scottish Funding Council, Medical Research Council UK and the Wellcome Trust

Knowledge about the Harmful Effects of Environmental Tobacco Smoke, Perceptions toward Initiation of Smoking and Factors Influencing Smoking in Adolescents: A Cross-sectional Study.

The main hope of a nation lies in the proper education of its adolescents because the youths of today are the leaders of tomorrow. About 15% of children of ages 13-15 years are ingesting tobacco in certain forms and are getting addicted to tobacco. Hence, tobacco has become a burden in our society. Similarly, environmental tobacco smoking (ETS) is more dangerous than smoking and is common among young adolescents. This study is aimed to explore the knowledge about the hazards of ETS and the factors which are responsible for adolescents to initiate tobacco smoking among parents visiting the pediatric dental clinic. A cross-sectional survey on the knowledge about the harmful effects of ETS and factors influencing the initiation of tobacco use among adolescents was assessed using a self-administered questionnaire. A sample size of 400 parents of adolescents aged between 10 and 16 years visiting the pediatric clinics was included in the study; data thus obtained was subjected to statistical analysis. The effect of ETS in increasing the risk of cancer was known to be 64.4%. But the effect on premature babies was least known by 37% of the parent population, which is statistically significant. About 14% of parents perceive that children initiate smoking to experiment or relax, which is statistically significant. Parents have very little knowledge regarding the effects of ETS on children. They can be counseled regarding types of smoking and smokeless tobacco products, health hazards, the deleterious health effects of ETS, and passive smoking, particularly in children with respiratory diseases. Thimmegowda U, Kattimani S, Krishnamurthy NH. Knowledge about the Harmful Effects of Environmental Tobacco Smoke, Perceptions toward Initiation of Smoking and Factors Influencing Smoking in Adolescents: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(6):667-671.

Effective Facilitator Strategies for Supporting Primary Care Practice Change: A Mixed Methods Study.

Practice facilitation is an evidence-informed implementation strategy to support quality improvement (QI) and aid practices in aligning with best evidence. Few studies, particularly of this size and scope, identify strategies that contribute to facilitator effectiveness. We conducted a sequential mixed methods study, analyzing data from EvidenceNOW, a large-scale QI initiative. Seven regional cooperatives employed 162 facilitators to work with 1,630 small or medium-sized primary care practices. Main analyses were based on facilitators who worked with at least 4 practices. Facilitators were defined as more effective if at least 75% of their practices improved on at least 1 outcome measure-aspirin use, blood pressure control, smoking cessation counseling (ABS), or practice change capacity, measured using Change Process Capability Questionnaire-from baseline to follow-up. Facilitators were defined as less effective if less than 50% of their practices improved on these outcomes. Using an immersion crystallization and comparative approach, we analyzed observational and interview data to identify strategies associated with more effective facilitators. Practices working with more effective facilitators had a 3.6% greater change in the mean percentage of patients meeting the composite ABS measure compared with practices working with less effective facilitators (P <.001). More effective facilitators cultivated motivation by tailoring QI work and addressing resistance, guided practices to think critically, and provided accountability to support change, using these strategies in combination. They were able to describe their work in detail. In contrast, less effective facilitators seldom used these strategies and described their work in general terms. Facilitator background, experience, and work on documentation did not differentiate between more and less effective facilitators. Facilitation strategies that differentiate more and less effective facilitators have implications for enhancing facilitator development and training, and can assist all facilitators to more effectively support practice changes.

Gender differences in the association between biomarkers of environmental smoke exposure and developmental disorders in children and adolescents.

Effects of environmental tobacco smoke (ETS) exposure on children and adolescent health outcomes have been attracted more and more attention. In the present study, we seek to examine the gender-specific difference association of environmental smoke exposure biomarkers and developmental disorders in children and adolescents aged 6-15 years. US nationally representative sample collected from the National Health and Nutrition Examination Survey (NHANES) 2007-2014 was enrolled (N = 4428). Developmental disorders (DDs) are defined as a positive answer to the question, "Does your child receive special education or early intervention services?" Serum cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) were utilized as acute and chronic exposure biomarkers of ETS, respectively. Participants with serum cotinine >0.015 ng/mL were considered as with acute ETS exposure, and participants with creatinine-adjusted NNAL >0.0006 ng/mL were considered as with chronic ETS exposure. A survey logistic regression model was used to estimate the association between ETS exposure biomarkers and DDs. Additive interaction was utilized to examine the interaction of gender and biomarkers of ETS. Overall, approximately 9% of children were defined as DDs, and 65% of children had serum cotinine and urinary NNAL levels above the limit of detection. In the adjusted models, the association of ETS exposure biomarkers with DDs was only observed in girls. Girls with low cotinine levels and high urinary NNAL levels had 2.074 (95% CI: 1.012-4.247) and 1.851 (95% CI: 1.049-3.265) times higher odds of being DDs than those without ETS exposure, respectively. However, the effects of boys and NNAL exposure on DDs have additively interacted. Our findings first provided strong evidence for gender differences in the association between two tobacco metabolites and DDs in children, disclosing the public health implications and economic burdens of environmental tobacco smoke exposure.

Maternal Smoking During Pregnancy Affects Adult Onset of Asthma in Offspring: A Follow Up From Birth to Age 46 Years

Previous evidence has revealed an effect of environmental tobacco smoke (ETS) exposure on the development of childhood asthma. However, few studies have investigated the link between prenatal ETS exposure and adult-onset asthma. Therefore, in this study, we aim to determine if an association exists between adult-onset asthma and prenatal ETS exposure. Genetic predisposition to the development of asthma was also examined in conjunction with prenatal ETS exposure.This study was comprised of mothers and their offspring who were included in the Northern Finland Birth Cohort in 1966, a total of 12053 births. Data were collected from 7148 subjects, and 5491 met the inclusion criteria. The final study population consisted of 5200 subjects.Analysis was conducted on maternal smoking status in the last 3 months of pregnancy, and asthma status was conducted at 31 and 46 years of age (n = 5200). Questionnaire data were collected from subjects at 31 and 46 years of age regarding history of asthma or wheeze to determine incident asthma between 31 and 46 years. Information regarding maternal smoking status was gathered at clinical visits via questionnaire at 6- and 7-months’ gestation. Association between the development of asthma and maternal smoking (1 or more cigarette/pipe per day) was analyzed via Pearson’s χ2 test. Maternal smoking and associated changes in forced expiratory volume in 1 second (FEV1) and the FEV1 to forced vital capacity ratio were examined by using linear regression. Binary logistic regression was used to evaluate the relationship between maternal smoking status, adult-onset asthma, and single-nucleotide polymorphisms (SNPs). Linear regression controlled for covariates including maternal education and parental asthma as well as offspring smoking status, education, ponderal index, parity, and Apgar score at first minute.Maternal smoking during the last 3 months of pregnancy was associated with an increased risk for the development of asthma in offspring between 31 and 46 years of age, and reduced offspring FEV1 to forced vital capacity ratio at 31 years of age. This association was more prominent in individuals with haplotype rs11702779-AA and with the subgroup that reported previous wheeze. No association was found between maternal smoking during the last 3 months of pregnancy and offspring FEV1 at 31 years.Gestational smoke exposure is associated with increased incidence of adult-onset asthma and reduced pulmonary function in adult offspring.The results of this study are consistent with previous research revealing an association between gestational maternal smoke exposure and the subsequent development of asthma in offspring. This reveals susceptibility of the developing airway to maternal ETS exposure and the importance of smoking cessation during pregnancy. A limitation of this study is the inability to distinguish the role of prenatal maternal smoke exposure from maternal smoking in the home during the postnatal period.

COTININE LEVEL AS A BIOCHEMICAL INDICATOR OF THE TOXIC EFFECTS OF PASSIVE SMOKING EXPOSURE ON INFANTS’ ANTHROPOMETRIC MEASURES

Background: Fetuses, infants and children seem to be the most susceptible populations to the harmful effects of Environmental Tobacco Smoke (ETS). Significant maternal and fetal exposure to ETS inside the home may affect fetal and child health. The aim of the study was to evaluate the toxic effects of perinatal exposure to Second-Hand Smoke (SHS) on the infant’s anthropometric measures and nutritional status and assess the benefit of using serum cotinine level in early childhood as a measurable indicator to such toxic perinatal exposure. Subjects & Methods: an observational cross-sectional study including the mothers and their children (less than two years) attend Monfallout’s Family Medicine Center from the period of October 2017 to October 2018. The questionnaire and serum cotinine of the infants were investigated along with the most important SHS determinants (socio-demographic and environmental). Results: The study included 400 mothers with their infants. The commonest site of SHS exposure was the home and the husband was the main responsible source. SHS infants were classified according to their serum cotinine level as active smokers (14.44%), non-smokers exposed to SHS (75.56%), and non-smokers not exposed (10%). There was a highly statistically significant difference between median birth weight, median birth length of regularly exposed babies to smoking and median birth weight, median birth length of non-exposed babies. There was a dose-dependent decrease in weight and length of babies at birth, as well as associated with reduced weight, length and hemoglobin level in different stages later on in their life with an increase in serum cotinine level. Conclusion: Regular Prenatal and postnatal ETS lead to a dose-dependent decrease in weight and length of babies at birth and later on at early childhood stages. Mothers should take adequate precautions to avoid exposure to such SHS hazards as they and their children may be more susceptible to a series of negative health effects most mothers with their children were regularly exposed to SHS in various places during daily life especially at home and the main source of smoking was husband smoking.

Effect of Environmental Tobacco Smoke on Children's Anxiety and Behavior in Dental Clinics, Jeddah, Saudi Arabia: A Cross-Sectional Study.

Background: Environmental tobacco smoke (ETS) has been linked to behavioral problems, but no study has assessed its relationship with dental anxiety. Therefore, this study’s goal is to assess the relation between ETS and both behavioral problems and dental anxiety among children. Methods: The study sample was collected from two centres in Jeddah from October 2019 to January 2020. Inclusion criteria included healthy 5–16-year-old children having their first dental visit with no emergency complaint. The questionnaire including general information, ETS exposure, the child’s anxiety using the Abeer Children Dental Anxiety Scale (ACDAS) and dental behavior using the Frankl Behavioral Rating Scale. Results: Of 500 children, 337 (67.4% response rate) responded to the questionnaire, among whom 201 (59.6%) had been exposed to passive smoking compared to 136 (40.4%) who had not. Exposed children had a statistically significantly greater tendency to develop anxiety (p = 0.002) and demonstrate uncooperative behavior (p = 0.006). Generalized linear mode and binary regression analyses suggested that ETS has a statistically significant effect on children’s dental anxiety and behavior (p < 0.05). Conclusions: Children exposed to ETS demonstrated statistically significantly higher anxiety levels and uncooperative behavior in the dental clinic compared to those who were not exposed.

Examining electronic nicotine delivery system use and perception of use among college students with and without asthma across the South

Background The effects of environmental tobacco smoke is a risk factor for everyone, but more so for individuals living with asthma. Most studies have focused on youth and young adults as the vulnerable population affected by secondhand smoke with policies related to secondhand smoke enacted to lessen such exposure given the known negative health effects. Most individuals are aware that secondhand exposure to tobacco smoke is not healthy, yet there is a shortage of literature on the secondhand vapor associated with electronic nicotine delivery systems (ENDS). Suggestions for nicotine, metals, and carcinogens in secondhand vapor are beginning to emerge in the literature but are still not common knowledge to the public. This study aims to look at the demographic differences among young adults (college students) with asthma and non-asthma concerning ENDS use. A secondary aim will also look at the difference in perceived health status and perception of harm in the relationship between asthma and ENDS use in these two populations. Methods: A cross-sectional online survey was designed and disseminated to two independent southeastern colleges. The survey was prepared following a comprehensive review of the literature by a group of experts focused on ENDS usage. The survey examined self-reported usage of and perceptions of ENDS within college students with and without asthma. Results: Approximately 50% of college-age students' perceived ENDS vapor as less harmful than traditional cigarette smoke. Around 24% of the students stated they use ENDS daily with over 50% of these students utilizing ENDS in the past 30 days. Asthma was a significant predictor in reporting lower perceived health status than students without asthma and perceived health status was a significant predictor of reporting fewer ever use of ENDS. Higher than the national average, 19% of students self-identified with an asthma diagnosis, and the use of ENDS was 20% in students without asthma and 27% in students with asthma. Conclusions: There are limited studies on perceptions related to ENDS and exposures in college students with and without asthma. Since 2007, various alternative forms of ENDS devices have been marketed. ENDS have gained popularity with young adults and college-age students, while rates of traditional cigarette usage have declined. College students report less perceived harm with ENDS over traditional cigarettes, yet studies acknowledge the high levels of the addictive substance nicotine. Of great concern is the lack of knowledge that college students have regarding nicotine based on their perceptions and the increasing use of these devices in those individuals with underlying respiratory conditions.

Effect of environmental tobacco smoke on COX-2 and SHP-2 expression in a periodontitis rat model.

ObjectivesTo investigate the effects of environmental tobacco smoke (ETS) on the inflammatory process of periodontitis by evaluating bone loss and the expression of cyclooxygenase‐2 (COX‐2) and Src homology phosphotyrosine phosphatase 2 (SHP‐2).Materials and MethodsEighty 6‐month‐old male SD rats were randomized into four groups (10 rats/group/per time point): (a) normal group, (b) ETS group, (c) ligature‐induced periodontitis group, and (d) ligature‐induced periodontitis + ETS group. After treatment with ligature and/or ETS for 8 and 12 weeks, the levels of alveolar bone resorption and the expressions of COX‐2 and SHP‐2 in periodontal tissue were analyzed using histology and immunohistochemistry.ResultsThe ligature‐induced periodontitis group displayed increased bone resorption and elevated expression of COX‐2 and SHP‐2 in periodontal tissues compared to the normal and ETS groups at 8 and 12 weeks. Furthermore, bone resorption and COX‐2 and SHP‐2 levels in the ligature‐induced periodontitis + ETS group were significantly increased compared to those in the normal and ligature‐induced periodontitis groups at both 8 and 12 weeks.ConclusionEnvironmental tobacco smoke increased alveolar bone loss in periodontitis with enhanced expression of COX‐2 and SHP‐2 in periodontal tissues. Further investigation is needed to explore the role of COX‐2 and SHP‐2 in ETS‐associated periodontitis.

Effectiveness of ongoing face-to-face anti-tobacco intervention in children with asthma.

Background: Interventions to help parents quit smoking may yield important benefits for children with asthma. Children's exposure to environmental tobacco smoke can be measured by reporting of an adult in the household and testing the child's biomarker, e.g., cotinine. Objective: The aim of the study was to assess the effectiveness of "face-to-face" intervention carried out since 2016 in families with children diagnosed with asthma 3 years after beginning the anti-tobacco intervention. Methods: This study was a follow-up to an interventional study that assessed the effectiveness of direct patient education versus educational leaflets alone about parental tobacco smoking. The patients with asthma (ages 4-17 years) enrolled in our original intervention study conducted in 2016 were under the care of the allergy outpatient clinic. The active group was individually educated about the harmful effects of environmental tobacco smoke on their children. The control group included patients and parents, among whom only leaflets were distributed. After 3 years of ongoing intervention, in patients from both groups, exposure to tobacco smoking was evaluated with a questionnaire addressed to parents and/or caregivers and measurement of cotinine in children's urine. The forced expiratory volume in the first second of expiration and fractional exhaled nitric oxide levels were measured. Results: Seventy participants completed the study: 37 in the active group and 33 in the control group. In the active group, 27% of the parents quit smoking entirely compared with 9.4% of parents in the control group. In the group of active intervention, a significant decrease in the cotinine level (p < 0 .001) and the number of cigarettes smoked daily were observed (p < 0.001) 3 years after the active intervention compared with values right after the intervention. In the control group, there were no significant changes in the above-mentioned parameters. Conclusion: "Face-to-face" intervention among families with smokers were effective and lowered cotinine levels in children with asthma and the number of cigarettes smoked assessed 3 years after the intervention.

Impact of Comprehensive Smoking Bans on the Health of Infants and Children

As evidence of the negative effects of environmental tobacco smoke (ETS) has mounted, an increasingly popular public policy response has been to impose restrictions on smoking through 100% smoke-free bans (comprehensive smoking bans). Yet sparse information exists regarding the impact these smoking bans at the state and local levels have on the health of children and infants. A rationale for expansion of smoke-free laws implicitly presumes that potential public health gains from reducing adult cigarette consumption and declines in adult ETS exposure extend to children. However, if smokers compensate by shifting their consumption of cigarettes from public venues that impose a comprehensive smoking ban to smoking at home, then these policies may have a harmful effect on children and infants. This study provides estimates of how comprehensive smoking bans impact the venue of smoking, and the health of children and infants. Using models that exploit state- and county-level changes to smoking ban legislation over time, estimates suggest that smoking bans have improved the health of both infants and children, mainly through implementation of more comprehensive bans. Further, we find no evidence of displacement among smokers (both smokers with and without children in the household), and actually find that the bans had a positive spillover effect in terms of reducing smoking inside the home – an effect which may further explain the improvement in infant and children’s health. Our effect magnitudes imply that expanding comprehensive coverage from 60% (current level) to 100% of the population can prevent between approximately 1,110 – 1,750 low birthweight births among low-educated mothers, resulting in economic cost savings of about $71 – $111 million annually. Health improvements among older children add to these economic benefits.

Suppressive effect of environmental tobacco smoke on murine Th2 cell-mediated nasal eosinophilic inflammation.

BackgroundEnvironmental tobacco smoke (ETS) exposure is recognized as a risk factor for the development of various respiratory diseases.ObjectiveIn this study, the effect of ETS on allergen-immunized and allergen-specific Th2 cell-transferred murine eosinophilic inflammation models and that of cigarette smoke extract (CSE) and nicotine on allergen-induced Th2 cell proliferation and interleukin (IL)-4 production were investigated.MethodsOvalbumin (OVA)-immunized and OVA-specific Th2 cell-transferred BALB/c mice were exposed to ETS and were challenged with OVA. Then, the number of inflammatory cells in the nasal mucosa and nasal hyperresponsiveness (NHR) were assessed. The effects of CSE and nicotine on the allergen-induced proliferative response of and IL-4 production by Th2 cells were determined in vitro.ResultsIn OVA-immunized and Th2 cell-transferred mice, allergen-induced NHR and nasal eosinophil infiltration were significantly suppressed by ETS exposure, whereas the accumulation of neutrophils was rather enhanced. Allergen-specific Th2 cell proliferation and IL-4 production were inhibited by coculture with CSE. The same effects were induced by nicotine, though the effect on proliferation was relatively weak.ConclusionRegardless of its harmful effect, ETS suppresses NHR, probably through the inhibition of Th2 cell responses.

Pattern and correlates of tobacco use among school personnel from a rural area in Kashmir, India

Background: Tobacco -free schools and non smoking school personnel set a positive environment for the younger genration. Aim: The aim of this study was to assess the patterns and correlates of tobacco use among school personnel in a rural area in Kashmir. Methodology: This school-based cross-sectional study was conducted from April 2018 to November 2018 in 50 government high schools. The study population comprised all the school personnel (teaching as well as nonteaching) of the selected schools. An anonymous pretested self-administered questionnaire (Global School Personnel Survey) was used for the collection of data. All data were analyzed using SPSS version 20.0 to demonstrate frequencies, cross-tabulation obtained from Chi-square tests. Multivariate analysis was done to predict factors associated with tobacco control. A significance level of < 0.05 was considered for statistical analysis. Results: Majority of the school personnel (68.3%) were smoking cigarettes on a daily basis (P < 0.001). Current bidi and hookah use was significantly higher among females than males (5.5% vs. 3.9%, P < 0.001). About 93.8% of the school health personnel strongly perceived the need for an anti-tobacco training (P = 0.151). Multivariate regression analysis predicted a positive association between the position in the school, age, and knowledge concerning harmful effects of environmental tobacco smoke (P < 0.001). School personnel with primary responsibility of teaching about health predicted a higher need for specific anti-tobacco training (P < 0.001). The smokers less strongly perceived the need for nonclassroom anti-tobacco activities (P = 0.000). Conclusions: The present study reports a high level of tobacco consumption among the school personnel and paucity of tobacco control school policies. Moreover, smokers felt a lesser need for tobacco control training among school personnel. These findings underscore the importance of support for tobacco control regulations and training in educational units.

Breast-Feeding Protects Children from Adverse Effects of Environmental Tobacco Smoke.

In a cross-sectional study on 433 schoolchildren (aged 6–9 years) from 9 schools in Austria, we observed associations between housing factors like passive smoking and lung function as well as improved lung function in children who had been breast-fed. The latter findings urged the question of whether the protective effects of breast-feeding act on environmental stressors or if they act independently. Therefore, the effect of passive smoking on lung function was stratified by breast-feeding. The detrimental effects of passive smoking were significant but restricted to the group of 53 children without breast-feeding. Breast-feeding counteracts the effect of environmental stressors on the growing respiratory organs.

Impact of Comprehensive Smoking Bans on the Health of Infants and Children: Evidence from the U.S

As evidence of the negative effects of environmental tobacco smoke (ETS) has mounted, an increasingly popular public policy response has been to impose restrictions on smoking through 100% smoke-free bans (comprehensive smoking bans). Yet sparse information exists regarding the impact these smoking bans at the state and local levels have on the health of children and infants. A rationale for expansion of smoke-free laws implicitly presumes that potential public health gains from reducing adult cigarette consumption and declines in adult ETS exposure extend to children. However, if smokers compensate by shifting their consumption of cigarettes from public venues that impose a comprehensive smoking ban to smoking at home, then these policies may have a harmful effect on children and infants. This study provides estimates of how comprehensive smoking bans impact the venue of smoking, and the health of children and infants. Using models that exploit state- and county-level changes to smoking ban legislation over time, estimates suggest that smoking bans have improved the health of both infants and children, mainly through implementation of more comprehensive bans. Further, we find no evidence of displacement among smokers (both smokers with and without children in the household), and actually find that the bans had a positive spillover effect in terms of reducing smoking inside the home – an effect which may further explain the improvement in infant and children's health. Our effect magnitudes imply that expanding comprehensive coverage from 60% (current level) to 100% of the population can prevent between approximately 1,110 – 1,750 low birthweight births among low-educated mothers, resulting in economic cost savings of about $71 – $111 million annually. Health improvements among older children add to these economic benefits.

Tobacco Health Risk Awareness among Socially Disadvantaged People-A Crucial Tool for Smoking Cessation.

The goal of this cross-sectional survey was to assess the level of knowledge on harmful effects of environmental tobacco smoke (ETS) exposure and active smoking among socially-disadvantaged people in Poland. The study was conducted among 1817 respondents aged 18–59 years, who used aid services from local social care institutions in Piotrkowski district. Majority of the participants were aware of the fact that smoking may cause serious diseases and lung cancer (92%). However, those percentages were lower for awareness of ETS and health risk (69.4%) and for awareness of smoking/ETS-associated risk of stroke and heart attack (57%, 68%). The male respondents and smokers had much higher odds of lacking knowledge that smoking causes serious diseases and lung cancer compared to the females (OR = 1.47 and OR = 1.86; p < 0.05) and non-smokers (OR = 2.35 and OR = 2.31; p < 0.001). In addition, those with temporary jobs and the unemployed had a higher risk of lack of knowledge on smoking and lung cancer risk (OR = 2.14 and OR = 1.66; p < 0.05) as well as ETS and the risk of stroke (OR = 1.52 and OR = 1.51; p < 0.05) as compared to those with permanent jobs. The smokers who were aware of four health consequences of smoking indicated an intention to quit smoking within the next month more frequently when compared to those who did not have the knowledge on all of the analyzed harmful effects of tobacco use (19.7% vs. 13.1%; p < 0.05). There is a need to improve knowledge on the dangers associated with active and passive smoking among socially disadvantaged populations.

Effects of environmental tobacco smoke on the oral health of preschool children.

This study investigated the association between the prevalence of oral health problems (caries, gingivitis, mucosal pigmentation and enamel defects in one to 5 year-old children exposed and not exposed to environmental tobacco smoke before and/or after birth. Exposure to environmental tobacco smoke (ETS) in childhood may have significant health effects. A structured questionnaire was used to collect data on a child's current and previous illnesses, oral health behaviours, dietary habits, parental smoking behaviours and parents' dental history. The intraoral examination recorded dental caries (dmfs), enamel defects, gingival health, melanin pigmentation and soft tissue health. Stimulated saliva was collected. Total sIgA levels were quantified using indirect competitive ELISA with a SalimetricsTM kit. The 44 children (aged 15-69months) recruited were divided into two groups: ETS and non-ETS (control). There were 22 children in each: 16 who were exposed to ETS during and after gestation were identified as the ETSB subgroup. Participants exposed to ETS were more likely to have had upper respiratory tract and middle ear infections during the neonatal period and had higher mean dmft, mean dmfs, mean percent of surfaces with demarcated opacities and mean GI than the non-ETS participants. The children exposed to ETS before and after birth had the highest occurrence of enamel opacities showed a higher risk for dental caries even though more children in this group used the recommended fluoride toothpaste (1000ppm fluoride). Mothers who smoked either never breastfed their children or breastfed their children for less than the recommended period of 6 months. Children exposed to ETS were shown to have higher mean total sIgA (μg/ml) than the children in the control group. Associations between ETS exposure before and after gestation and oral health, including salivary changes in young children were shown in the present study. Dental health professionals should include a question about household smoking in children's dental histories, which would allow opportunities to discuss the impact of smoking on child oral health. Longitudinal oral health studies should include a history of maternal smoking during pregnancy and afterwards.

Cardiovascular effects of linalyl acetate in acute nicotine exposure

BackgroudSmoking is a risk factor for cardiovascular diseases as well as pulmonary dysfunction. In particular, adolescent smoking has been reported to have a higher latent risk for cardiovascular disease. Despite the risk to and vulnerability of adolescents to smoking, the mechanisms underlying the effects of acute nicotine exposure on adolescents remain unknown. This study therefore evaluated the mechanism underlying the effects of linalyl acetate on cardiovascular changes in adolescent rats with acute nicotine exposure.MethodsParameters analyzed included heart rate (HR), systolic blood pressure, lactate dehydrogenase (LDH) activity, vascular contractility, and nitric oxide levels.ResultsCompared with nicotine alone, those treated with nicotine plus 10 mg/kg (p = 0.036) and 100 mg/kg (p = 0.023) linalyl acetate showed significant reductions in HR. Moreover, the addition of 1 mg/kg (p = 0.011), 10 mg/kg (p = 0.010), and 100 mg/kg (p = 0.011) linalyl acetate to nicotine resulted in significantly lower LDH activity. Nicotine also showed a slight relaxation effect, followed by a sustained recontraction phase, whereas nicotine plus linalyl acetate or nifedipine showed a constant relaxation effect on contraction of mouse aorta (p < 0.001). Furthermore, nicotine-induced increases in nitrite levels were decreased by treatment with linalyl acetate (p < 0.001).ConclusionsTaken together, our findings suggest that linalyl acetate treatment resulted in recovery of cell damage and cardiovascular changes caused by acute nicotine-induced cardiovascular disruption. Our evaluation of the influence of acute nicotine provides potential insights into the effects of environmental tobacco smoke and suggests linalyl acetate as an available mitigating agent.

A Bayesian approach to the g-formula.

Epidemiologists often wish to estimate quantities that are easy to communicate and correspond to the results of realistic public health interventions. Methods from causal inference can answer these questions. We adopt the language of potential outcomes under Rubin's original Bayesian framework and show that the parametric g-formula is easily amenable to a Bayesian approach. We show that the frequentist properties of the Bayesian g-formula suggest it improves the accuracy of estimates of causal effects in small samples or when data are sparse. We demonstrate an approach to estimate the effect of environmental tobacco smoke on body mass index among children aged 4-9 years who were enrolled in a longitudinal birth cohort in New York, USA. We provide an algorithm and supply SAS and Stan code that can be adopted to implement this computational approach more generally.