Effects Of Environmental Tobacco Smoke Research Articles

The effect of environmental tobacco smoke on the dose requirements of rocuronium in children.

Smoking affects the pharmacodynamic and pharmacokinetic behaviour of several drugs. The aim of this study was to evaluate the effects of environmental tobacco smoke on onset and recovery time after single dose rocuronium in children. Forty children between 4 and 10 years were enrolled into the study. Children who have no familial smoking history were included in the first group whereas passive smokers included in the second group. Sevoflurane in 50% O2 and 50% N2O was used for induction of anaesthesia. Evoked adductor pollicis electromyography was used to monitor neuromuscular block. The T95 and T25 values were recorded. The T95 values (+/-sd) for rocuronium were 110.1 +/- 39.3 s and 79.3 +/- 35.6 s for group 1 and group 2, respectively (P < 0.05). The T25 value of group 2 was 40.1 +/- 10.6 min and compared with group 1 values (30.85 +/- 7.02 min) it was significantly longer (P < 0.01). This study shows that passive smoking children consume less rocuronium than nonsmokers during similar anaesthesia. We think that a history of passive smoking must also be taken into consideration during preoperative evaluation of paediatric patients.

Environmental tobacco smoke effects on cysteinyl leukotrienes in respiratory syncytial virus bronchiolitis

Rationale Infants exposed to environmental tobacco smoke (ETS) have more severe respiratory syncytial virus (RSV) bronchiolitis. RSV bronchiolitis is associated with elevated cysteinyl leukotrienes and ETS exposure is associated with a Th2 phenotype, which may ultimately result in a greater production of cysteinyl leukotrienes. Cysteinyl leukotrienes can produce bronchoconstriction, edema, and mucus secretion, hallmarks of bronchiolitis. We hypothesized that infants hospitalized with RSV bronchiolitis who were exposed to ETS would have higher cysteinyl leukotrienes in their urine. Methods Urine was collected from infants ≤24 months of age admitted with RSV bronchiolitis. Patients were excluded if they had asthma, chronic lung or heart disease, or immunodeficiency. The urine was analyzed with an enzyme immunoassay for leukotriene E4 (LTE4), liquid chromatography with tandem mass spectophotometry for cotinine, a metabolite of nicotine, and colorometric technique for creatinine. Results None of the caretakers reported that the infant was exposed to smoke in the home. However, 6 of 23 infants had a urinary cotinine/creatinine ratio of >30ng/mg indicating exposure to ETS. LTE4 was 134% higher in infants exposed to ETS (P=0.005, single factor ANOVA). Among the infants exposed to ETS, cotinine/creatinine ratio correlated with LTE4 ( r 2=0.82, P=0.01). Conclusions ETS exposure may worsen RSV bronchiolitis by enhancing production of cysteinyl leukotrienes.

The effect of environmental tobacco smoke on eczema and allergic sensitization in children.

The negative impact of environmental tobacco smoke (ETS) on airway diseases in children is well known. Whether there is an effect on atopic eczema is not clear. To determine the impact of ETS on atopic eczema, allergic sensitization and allergic airway diseases in 1669 school beginners. The prevalence of atopy-related health outcomes was assessed by questionnaire, dermatological examination, skin prick testing and specific immunoglobulin E measurement. Exposure assessments were based on measurement of cotinine [expressed as cotinine to creatine ratio (CCR)] in spot urine samples (n = 1220) together with questionnaire and interview data on smoking behaviour of the parents. In the total study group, prevalence of atopic eczema diagnosed on examination was significantly associated with urinary CCR values. The odds ratio (OR) and 95% confidence interval (CI), calculated for an increase of 100 ng mg-1 CCR was 1.97 (95% CI 1.23-3.16). The prevalence of skin manifestations according to questionnaire data as well as a history of asthma, wheezing, and hay fever were positively although not significantly associated with ETS exposure. When genetically predisposed children (defined by the presence of parental atopy) were compared with children whose parents had no atopy, the ORs of allergic outcome variables were generally higher in the first group. In the group of predisposed children, significant associations with urinary CCR were found for allergic sensitization against house dust mites as measured by skin prick test (OR 3.10, 95% CI 1.63-5.90). Children are at a higher risk of developing an atopic eczema when exposed to ETS and genetically predisposed children are at higher risk of developing a sensitization against house dust mites.

Environmental tobacco smoke and adult-onset asthma: a population-based incident case-control study.

The authors assessed the effects of environmental tobacco smoke (ETS) on the development of asthma in adults. In the Pirkanmaa district of South Finland, all 21- to 63-year-old adults with new cases of asthma diagnosed during a 2.5-year period (n = 521 case patients, out of 441 000 inhabitants) and a random sample of control subjects from the source population (932 control subjects) participated in a population-based incident case-control study. Risk of asthma was related to workplace ETS exposure (adjusted odds ratio [OR] = 2.16; 95% confidence interval [CI] = 1.26, 3.72) and home exposure (OR = 4.77; 95% CI = 1.29, 17.7) in the past year. Cumulative ETS exposure over a lifetime at work and at home increased the risk. This study indicates for the first time that both cumulative lifetime and recent ETS exposures increase the risk of adult-onset asthma.

Environmental tobacco smoke and ischemic heart disease

Cohort and case control studies show a 30% excess risk of ischemic heart disease in nonsmokers whose spouses smoke compared with that in nonsmokers whose spouses do not smoke. There is a nonlinear dose-response; the excess risk from actively smoking 20 cigarettes/day is only 80%. Large cohort studies of active smoking support the nonliner dose-response (the excess risk in smokers of 5 cigarettes/day is about 50%). Animal studies show a pronounced vascular effect of environmental tobacco smoke. In experimental studies passive and active smoking have similar effects on platelet aggregation. The collective evidence supports a significant effect of low dose tobacco smoke exposure in causing ischaemic heart disease.

Effects of the GSTM1 and GSTT1 polymorphisms on the relationship between maternal exposure to environmental tobacco smoke and neonatal birth weight.

The purpose of the investigation was to determine whether genetic polymorphisms in enzymes that metabolize exogenous chemicals modulate the effects of environmental tobacco smoke (ETS) exposure on birth weight. A survey was conducted from 2000 to 2001 among 266 pregnant women who were hospitalized for delivery and on their singleton live births. We determined maternal GSTM1 and GSTT1 polymorphisms by polymerase chain reaction and measured the urinary cotinine of pregnant women at delivery by radioimmunoassay. Birth weight was found to decrease significantly with increasing concentrations of maternal urinary cotinine (P < 0.05). The interactive effect of exposure to ETS and the presence of the GSTT1 polymorphism was found to be significant by multivariate analysis (P < 0.01), whereas the interactive effect of exposure to ETS and the presence of GSTM1 polymorphism did not reach statistical significance (P = 0.21). A combination of the GSTM1-null and the GSTT1 null-genotypes was found to exacerbate the effect of maternal exposure to ETS on birth weight more than the presence of either genotype alone. Our data indicate that maternal exposure to ETS negatively affects neonatal birth weight, and the adverse effect of maternal exposure to ETS on neonatal birth weight could be modified by the maternal metabolic genotypes, GSTM1 and GSTT1.

Environmental Tobacco Smoke Effects on the Primary Lipids of Lung Surfactant

The effects of environmental tobacco smoke (ETS) on lung surfactant are difficult to determine from analysis of human and animal lung lavage due to large variations in surfactant recovery, a lack of uniformity of smoke exposure, and the difficulties inherent in analyzing milligram quantities of a multicomponent biological material. An alternative is to examine specific components of lung surfactant in a Langmuir trough with a subphase conditioned by exposure to known quantities of ETS. Pressure−area isotherms and fluorescence microscopy measurements reveal that both the minimum surface tension and respreading of model lung surfactant monolayers and the morphology of the condensed phases at high lateral pressures are changed on subphases exposed to ETS. ETS alters the distribution and fraction of crystalline lipid domains in the monolayer, which are correlated with the minimum surface tension and monolayer viscosity in pristine lung surfactant monolayers. The minimum surface tension of the dominant lipid s...

Attitudes to Smoking on Submarines: Results of a Questionnaire Study

An anonymous survey to assess the attitudes to smoking of men serving on two Trident Nuclear submarines was conducted by questionnaire. A total of 244 questionnaires were completed, representing 87% of the two crews. Thirty-two percent of respondents declared themselves to be smokers, 69% were nonsmokers, and of these, 31% were ex-smokers. Attitudes of all respondents to an enforced ban of smoking on submarines indicated that 55% felt that it would be justifiable, 46% felt that it would be unfair, 42% felt that it was uncalled for, 46% thought that it would be illegal, and 47% thought that a ban was about time. The separate opinions of smokers and nonsmokers were polarized, whereas the overall results indicate indifferent attitudes of crew members. Further research into the atmospheric effects of environmental tobacco smoke on a submarine is required.

Validation of a Five-Question Survey to Assess a Child's Exposure to Environmental Tobacco Smoke

PURPOSE: To study the potentially adverse health effects of environmental tobacco smoke (ETS) exposure in young children, a short five-question survey was developed to identify routine exposure to ETS in a large epidemiological study. METHODS: The survey is administered to parents of a healthy cohort of children starting at age 3 months. To validate the survey, urinary cotinine levels were measured on 50 children from this cohort who were selected based on ETS exposure as reported in the survey: 24 with no exposure and 26 with exposure. Cotinine was adjusted for creatinine. RESULTS: Overall, children with some form of reported ETS exposure had urinary cotinine levels 7.5 times higher than those who were not exposed. Analysis of variance shows that mean levels of log transformed cotinine in children whose parent(s) smoke in the home, parent(s) who smoke but not in the home, and non-smoking parents are 137.13, 75.60, and 43.28 respectively ( p = 0.0009), indicating decreasing levels of cotinine as reported exposure decreases. Using a cut-point of 30ng/mg of cotinine to differentiate unexposed and exposed to ETS, we found 80% agreement with our survey. A Spearman's ranked correlation coefficient of 0.62 indicates a direct relationship between cotinine and an ETS exposure intensity score ( p < 0.0001). CONCLUSIONS: These results suggest that the 5-question survey reflects the child's exposure to passive smoke and that the survey is sensitive to varying levels of exposure.

Smoking in parents of children with asthma and bronchiolitis in a pediatric emergency department.

To determine smoking habits, levels of nicotine-addiction, readiness to quit, and beliefs about the effects of environmental tobacco smoke (ETS) of parents of children with bronchiolitis and asthma who present to a children's emergency department (ED). This was a cross-sectional prevalence study of parents or legal guardians of children with asthma or bronchiolitis presenting to a pediatric ED. Two hundred forty-nine parents/legal guardians comprised the study group. The mean age (+/-SD) was 30.0 (+/-8.9) years; 88% were female; 51% were nonwhite; 37% were educated beyond high school. The self-reported smoking prevalence was 41% (95% CI = 32-51). Smoking prevalence among parents of wheezing children varied according to education, income, and race, but not according to gender, age, or employment status. Of the 102 smokers in the sample, 84 (82.4%, 95% CI = 73-88) reported that they wanted to quit; 78 (76.5%, 95% CI = 68-84) stated that they wanted to quit within the next month. Forty-nine percent (95% CI = 39-59) scored above 4 on the Fagerstrom Test for Nicotine Dependence and were considered nicotine-dependent. The majority of smokers admitted to smoking around their children (66.7%, 95% CI = 57-75). Many parents knew that ETS might contribute to the development of the following illnesses: colds/upper respiratory tract infections - 77.5%, otitis media - 68.6%, pneumonia - 50%, wheezing/asthma attacks - 86.3%, and SIDS - 31.4%. The prevalence of smoking and nicotine addiction among parents of children with asthma or bronchiolitis who bring their children to a pediatric ED is high. Many parents have some knowledge about the effects of ETS, and the majority would like to quit. Future studies to help determine the best way to deliver advice to parents on ETS exposure reduction and smoking cessation are warranted.

Environmental tobacco smoke and health in the elderly

The aims of this article are to synthesize the evidence on health effects of environmental tobacco smoke (ETS) in the elderly and to discuss questions for future research. Health effects are divided into aetiological and prognostic studies. There is convincing evidence that ETS causes lung cancer and coronary heart disease, both of which are diseases of the elderly. Several cross-sectional studies show increased occurrence of chronic respiratory symptoms and deficits in ventilatory lung function in relation to ETS exposure at home and/or at work. A limited number of studies have found significant relations between ETS exposure and asthma, chronic obstructive pulmonary disease (COPD), pneumococcal infections and stroke in the elderly. Longitudinal studies are needed before any definite conclusions can be made concerning ETS and noncarcinogenic respiratory diseases in the elderly. The potential role of environmental tobacco smoke exposure as a prognostic factor determining development of a pre-existing respiratory or heart disease is an important new area for research.

Morbidade respiratória em crianças fumantes passivas

Objetivo: Avaliar a prevalência de morbidade respiratória entre crianças expostas ao fumo passivo e determinar os efeitos do fumo ambiental no sistema respiratório inferior e superior dessas crianças, na cidade de Fortaleza, Ceará, Brasil. Casuística e método: Este é um estudo censitário do tipo transversal em 1.104 crianças menores de cinco anos. Dados sobre os sintomas respiratórios e as doenças dessas crianças, o histórico familiar de doenças respiratórias, os hábitos tabagísticos dos membros da casa e as condições habitacionais foram avaliados através de um questionário aplicado junto aos pais. Resultados: Das 1.104 crianças, 558 eram do sexo masculino e 546 do feminino. A morbidade respiratória foi maior entre as crianças expostas ao fumo ambiental do que entre as não expostas (82% vs. 74%). Em relação ao trato respiratório inferior as queixas mais comuns foram sibilância (57,7%; OR = 1,32; IC 95%: 1,04-1,68), dispnéia (43,8%; OR = 1,56; IC 95%: 1,22-1,99), asma, bronquite ou pneumonia (29,4%; OR = 1,31; IC 95%: 1,13-1,88). Quanto ao trato respiratório superior, a queixa mais comum foi de rinite em 38,1% dos casos (OR = 1,46; IC 95%: 1,00-1,71).A análise de regressão logística mostrou que as queixas referentes ao trato respiratório inferior se associaram com tabagismo materno (OR = 2,02; IC 95% 1,12-3,66); tabagismo paterno(OR = 1,99; IC 95%: 1,16-3,40); mofo (OR = 1,55; IC 95%: 1,14-2,13) e antecedentes de doenças respiratórias (OR = 1,72; IC 95%: 1,26-2,35). As doenças do trato respiratório superior associaram-se com antecedentes de doenças respiratórias (OR = 1,44; IC 95%: 1,13-1,85) e tabagismo materno (OR = 1,54; IC 95%: 1,01-2,35). Conclusão: A exposição de crianças ao fumo ambiental é um fator de associação para a morbidade do trato respiratório superior e inferior entre menores de cinco anos.

The effects of environmental tobacco smoke on children: Information and implications for PNPs

Although much information is available about the harmful effects of smoking and exposure to environmental tobacco smoke (ETS), many children are in contact with ETS in their home every day. Health effects related to ETS vary from minor nasal irritation to an increased susceptibility to sudden infant death syndrome. ETS can also cause future health problems as exposed children become adults. Assessment of ETS exposure is an essential component of a patient's health history, and parents should be educated about the harmful effects of ETS and how to protect young children from it. Strategies for prevention of ETS exposure must be pursued to ensure improved health outcomes for all children. J Pediatr Health Care. (2001). 15, 280-286.

The effects of environmental tobacco smoke on children: Information and implications for PNPs

Although much information is available about the harmful effects of smoking and exposure to environmental tobacco smoke (ETS), many children are in contact with ETS in their home every day. Health effects related to ETS vary from minor nasal irritation to an increased susceptibility to sudden infant death syndrome. ETS can also cause future health problems as exposed children become adults. Assessment of ETS exposure is an essential component of a patient's health history, and parents should be educated about the harmful effects of ETS and how to protect young children from it. Strategies for prevention of ETS exposure must be pursued to ensure improved health outcomes for all children. J Pediatr Health Care. (2001). 15, 280-286.

The effects of environmental tobacco smoke on health services utilization in the first eighteen months of life.

To examine the effects of environmental tobacco smoke (ETS) on health services use in Chinese infants with nonsmoking mothers. Prospective, population-based birth cohort. General population of Hong Kong in 1997-1998. A total of 8327 parent-infant pairs who were followed up for 18 months. Doctor consultations and hospitalizations. Results. After adjusting for the age, education level, and employment status of mothers-as well as infants' birth weight, method of delivery, breastfeeding status, and birth order-ETS exposure through the mother in utero was positively associated with higher consultation (adjusted odds ratio [OR]: 1.26; 95% confidence interval [CI]: 1.14, 1.39) and hospitalization (OR: 1.18; 95% CI: 1.05, 1.31) use in infants with nonsmoking mothers attributable to any illness. In addition, postnatal exposure to ETS at home was linked to higher rates of hospitalizations for any illness compared with nonexposed infants (OR: 1.12; 95% CI: 1.00, 1.25), although the relationship did not hold for outpatient consultation visits. The OR for higher hospital use in infants exposed to 2 or more smokers at home was 1.30 (95% CI: 1.08, 1.58). The use of tobacco products by household members, even among nonsmoking mothers, has an enormous adverse impact on the health of children, as well as increases health services use and cost. The present data support the revision of public policy to reflect an evidence-based approach to the promotion of smoking cessation in all household members during and after pregnancy. environmental tobacco smoke, health services, infants.

Sources of information on the health effects of environmental tobacco smoke among African-American children and adolescents.

To determine the common sources of information regarding the effects of smoking on health and their relationship to knowledge, attitudes, and preventative efforts regarding exposure to environmental tobacco smoke (ETS) among urban African-American children and adolescents. All students who were enrolled in Grades 5-12 in an urban public school district located in the greater metropolitan area of Detroit, Michigan were surveyed using a structured, written questionnaire that assessed sources of information on the health effects of smoking, as well as knowledge, attitudes, and preventive efforts with respect to exposure to ETS. The primary analytic procedures utilized in the study were correlation analysis and analysis of variance. The African-American students surveyed in this study received information regarding the health effects of smoking from many sources, most notably television, family, and teachers. Second, students who received information on the effects of smoking on health from family and external sources (teacher, parent's friend, and religious leader) had higher overall knowledge, attitude, and preventive efforts scores than students who received information from other sources (friends, electronic media, and printed media). Finally, family influence was greater when parents were not smokers, and influenced elementary students more than middle school or high school students. The active involvement of teachers, religious leaders, parents, and other influential adults should be elicited in tobacco education and prevention efforts to maximize their effectiveness.

A rapid appraisal method for reviewing the effectiveness of workplace smoking policies in large and medium sized organisations.

Workplace smoking policies have been developed in response to growing scientific evidence about the harmful effects of environmental tobacco smoke (ETS), increasing opposition from non-smokers, concern over escalating costs of health damage and productivity losses, and the emergence of relevant laws and codes of good practice. Much has been written on the development and implementation of workplace smoking policies, but little about their evaluation. This paper describes a rapid appraisal method for the evaluation of workplace smoking policies. The four-stage process involves rapid, focused consultation with policy makers in the workplace, appropriate risk assessment, rapid consultation with those affected by the policy and focused feedback of results for planning and ongoing monitoring. In the pilot site the existing health and safety committee members were effective informants for the identification of key issues in smoking policy. The risk assessment phase was incorporated into the main appraisal which involved a canvass of staff and others on ETS issues identified by the informants. In the final stage of the process the health and safety committee proved to be both responsive to identified need, and proactive in facilitating ongoing review of the smoking policy. It therefore proved possible to develop the rapid appraisal process for administration in a limited time frame, three months for the whole process, with the rapid canvass element being achieved within one week.

The pediatrician's role in reducing tobacco exposure in children.

Pediatricians have a unique and important role to play in the prevention and treatment of childhood and adolescent tobacco use, the protection of patients from the harmful effects of environmental tobacco smoke, and the encouragement of smoking cessation among parents. However, because recent research indicates that physician training in tobacco dependence is woefully weak and lacks a model for training, this article constructs a useful approach to this problem. A comprehensive review of the literature served as the basis for the development of a new model for pediatrician training in tobacco dependence. A comprehensive model is presented for training pediatricians in the areas of reducing infant and child exposure to environmental tobacco smoke, preventing youth smoking initiation, and providing smoking cessation assistance for adolescents and parents. Pediatricians have been called on to play an active role in the antitobacco arena. Because of their unique opportunity to interact with children, adolescents, and parents, pediatricians can and should be antitobacco interventionists. For this to occur, however, additional guidance should be provided to pediatricians during their training to better prepare them to carry out effective assessment and intervention practices. smoking initiation, smoking prevention, smoking cessation, environmental tobacco smoke, pediatricians.

Effect of environmental tobacco smoke on intracellular free calcium of boar sperm incubated in seminal plasma

The extractable-respirable particulate of environmental tobacco smoke (ERP-ETS) was collected and tested for its effect on the intracellular free Ca 2+ concentration, [Ca 2+] i, in boar sperm incubated in seminal plasma in vitro. The intracellular free Ca 2+ level is reportedly closely related to in sperm capacitation and acrosome reaction, which must take place to confer upon sperm the full fertilizing potential. In the absence of ERP-ETS [Ca 2+] i in the boar sperm increased dramatically from initially 75 nM to about 248 nM after a 5-h incubation in seminal plasma. However, such an increase was virtually inhibited by ERP-ETS at a concentration of 10 μg/ml, without any significant reduction of the sperm motility and viability. We conclude that application of ERP-ETS negatively affected the [Ca 2+] i of boar sperm in vitro.

Respiratory effects of environmental tobacco smoke in a panel study of asthmatic and symptomatic children.

The effect of environmental tobacco smoke (ETS) on respiratory health was investigated among 7- to 12-yr-old children with asthmatic (n = 74) or cough (n = 95) symptoms. For 3 mo the children measured their peak expiratory flow rate (PEFR) every morning and evening, and kept a daily diary of respiratory symptoms. They also noted daily whether they had used respiratory medication and whether someone had smoked inside their home. Eleven percent of the asthmatic children and 14% of the children with cough had exposure to ETS at home during the study. In multiple regression and analyses controlling for potential confounders, any exposure to ETS during the study was associated with a reduction of 42 L/min (95% confidence interval [CI]: 10 to 74 L/min) in morning and 41 L/min (95% CI: 8 to 74 L/min) in evening PEFR among asthmatic children. Among these children, a dose-dependent increase in the effect of ETS was also seen. Daily variation in ETS exposure was only weakly (-9.2 L/min; 95% CI: 2.9 to 21.2 L/min) associated with PEFR, but the previous day's ETS exposure was a risk factor for bronchodilator use (relative risk [RR]: 10.3; 95% CI: 1.3 to 83.7), as well as for cough (RR: 12.4; 95% CI: 2.4 to 63.3) and phlegm production (RR: 7. 8; 95% CI: 1.4 to 41.7), on any given day. Among children with cough only, there was only a weak suggestion of any possible ETS effect. In conclusion, we found that exposure to ETS was associated with a decline in peak flow and increases in respiratory symptoms and use of bronchodilator drugs among asthmatic children.