Health Effects Of Secondhand Smoke Exposure Research Articles

High‐Fat Diet and Environmentally Relevant Secondhand Smoke Co‐exposure and Cardiovascular Regulation in Mice

BACKGROUNDOver the past few decades, cardiovascular disease incidence significantly decreased by 27%. Paradoxically, the number of deaths from cardiovascular diseases increased by 42% over the same period, owing to population growth and longevity. Consequently, cardiovascular diseases remain the leading cause of global death. Cardiovascular diseases are complex, multifactorial diseases that cannot be ascribed to a single factor. High‐fat diet (HFD) and secondhand smoke (SHS) are two preventable risk factors for the development of cardiovascular diseases. Studies have shown that SHS exposure is associated with poor dietary habits, suggesting the importance of potential confounding diet effects on health effects of SHS exposure. We previously showed that, in mice, environmentally relevant SHS exposure resulted in 10% decrease in baroreflex sensitivity (BRS) and 13% decrease in measures of heart rate variability (HRV). Here, we sought to characterize how HFD interplay with SHS in inducing cardiovascular dysfunction.METHODSMale C57BL/6J mice (11 wk) implanted with BP/ECG telemetry devices were fed with either normal diet (ND, 13.6 kcal% fat) or HFD (60 kcal% fat) and exposed to either filtered air (FA) or SHS (3 mg/m3, 6 hr/d, 5 d/wk) for 11 weeks. 36‐hr continuous BP/ECG recordings were performed. Data were divided into three 12‐hour periods: the first dark cycle (dark 1) immediately after the last day of exposure, and the following light and dark (dark 2) cycles. Spontaneous baroreflex sensitivity (BRS) was determined with the sequence method. Standard time domain heart rate variability (HRV) parameters were obtained from normal‐to‐normal R‐R intervals.RESULTSHFD‐fed mice had significantly greater weight gain than ND‐fed group (+15.3 g and +2.8 g over 11 weeks, HFD and ND, respectively). SHS exposure had no effect on body weight. Compared to ND mice, HFD mice had significantly higher BP (~6.5 mmHg), HR (~98 bpm), and lower BRS (~15% decrease) in the light cycle. Furthermore, HFD significantly reduced overall and short‐term HRV (36% and 47% reduction for SDNN and rMSSD, respectively, p < 0.05) across all three light cycles. The reduction in HRV is unlikely due to a higher HR in HFD mice because normalizing the HRV measures to baseline R‐R intervals did not change the results. SHS exposure did not pose additional effects on these HFD‐induced changes. While HFD alone did not affect BP variability, co‐exposure of SHS and HFD significantly increased BP variability during the first dark cycle (16.8%, 15.6%, and 17.3% higher than HFD+FA group, for systolic, diastolic, and mean BP variability, respectively, p < 0.05), suggesting a co‐exposure‐induced BP dysregulation.CONCLUSIONSThis study emphasizes the importance of accounting for differences in diet when studying the cardiovascular effects of SHS.

Secondhand smoke exposure for different education levels: findings from a large, nationally representative survey in Turkey

ObjectivesThe aim of this study is to determine the factors that influence individuals’ exposure to tobacco smoke in Turkey according to their education level.DesignSecondary data analysis.ParticipantsAltogether, 17 084 individuals aged...

Effects of Secondhand Smoke Exposure on Hearing and Auditory Evoked Potentials, ABR and AMLR in Young Adults.

Population health is impacted by environmental secondhand smoke (SHS) exposure. Although the negative health effects of SHS exposure include respiratory problems in children (nonsmokers) as seen in cigarette smokers, other health impacts such as sensory function are not assumed to be the same for both passive nonsmokers and smokers. However, hearing loss was recently reported in adolescents and aging adults with SHS exposure, suggesting that SHS might impact auditory function similarly to cigarette smoking. Specific effects of SHS exposure on the central auditory system have not been fully described. To measure auditory function via pure-tone audiometry and evoked potentials in young nonsmoking adults aged 18-23 yr who reported exposure to environmental SHS. Participants were selected for the SHS-exposed (SHS-E) group first, followed by age and gender matched individuals for the SHS-unexposed (SHS-U) group. Self-reported nonsmoker status was confirmed by biochemical analysis of urine for cotinine level. Potential participants (N = 208) completed a questionnaire about health, smoking history, SHS exposure, and hearing ability. Individuals with any neurological conditions, alcohol/drug dependencies, excessive noise exposure, using certain medications, or current smokers were excluded. Twenty-two nonsmokers in excellent health consented to participate. Participants in the SHS-E group reported SHS exposure in home, work, or social settings for an extensive time period. Participants in the SHS-U group did not live with smokers and reported no SHS exposure, medication use, tinnitus, or any chemical exposures. Statistical analysis was conducted on data from 20 participants, 10 per group with a mean age of 20 yr. Participants underwent auditory procedures in one session in an IAC sound-treated room, including otoscopy, tympanometry, pure-tone threshold evaluation, auditory brainstem response per ear, and a three-channel auditory middle latency response in the right ear. The primary study outcomes were hearing thresholds measured (dB HL) at five frequencies, and evoked potential wave latencies (I, III, V, Na, Pa, Nb, Pb) and amplitudes (V-I, Na-Pa, Pa-Nb, Nb-Pb). It was hypothesized that SHS-exposed individuals would have poorer hearing sensitivity (threshold >25 dB HL) and abnormal central auditory function (longer latencies; smaller amplitudes) based on evoked potentials. Statistical analyses focused on identification of group differences in hearing and central auditory function. All participants had normal hearing sensitivity (thresholds ≤25 dB HL) with no significant group differences. The V/I amplitude ratio in the right ear was significantly decreased in SHS-exposed individuals (p < 0.05). Auditory brainstem response latencies were not significantly different between participant groups or ears. Wave Pb latency was significantly increased in SHS-exposed individuals (p < 0.01). Auditory middle latency response relative amplitudes were significantly different from each other at every electrode site (Cz, Fz, C4) but not between groups. Overall, the Na-Pa complex was highest in amplitude at all three electrode sites. This preliminary study indicated toxic effects of SHS exposure by evoked potentials with decreased V/I amplitude ratio and longer (delayed) Pb latency in young adults. Further studies should corroborate these findings to facilitate clinical recommendations.

Secondhand smoke exposure and other correlates of susceptibility to smoking: A propensity score matching approach

Secondhand smoke (SHS) exposure is responsible for numerous diseases of the lungs and other bodily systems among children. In addition to the adverse health effects of SHS exposure, studies show that children exposed to SHS are more likely to smoke in adolescence. Susceptibility to smoking is a measure used to identify adolescent never-smokers who are at risk for smoking. Limited research has been conducted on the influence of SHS on susceptibility to smoking. The purpose of this study was to determine a robust measure of the strength of correlation between SHS exposure and susceptibility to smoking among never-smoking U.S. adolescents. This study used data from the 2009 National Youth Tobacco Survey to identify predictors of susceptibility to smoking in the full (pre-match) sample of adolescents and a smaller (post-match) sample created by propensity score matching. Results showed a significant association between SHS exposure and susceptibility to smoking among never-smoking adolescents in the pre-match (OR=1.47) and post-match (OR=1.52) samples. The odds ratio increase after matching suggests that the strength of the relationship was underestimated in the pre-match sample. Other significant correlates of susceptibility to smoking identified include: gender, race/ethnicity, personal income, smoke-free home rules, number of smoking friends, perception of SHS harm, perceived benefits of smoking, and exposure to pro-tobacco media messages. The use of propensity score matching procedures reduced bias in the post-match sample, and provided a more robust estimate of the influence of SHS exposure on susceptibility to smoking, compared to the pre-match sample estimates.

The healthcare costs of secondhand smoke exposure in rural China

ObjectiveThe goal of this study was to assess the healthcare costs attributable to secondhand smoke (SHS) exposure among non-smoking adults (age ≥19) in rural China.MethodsWe analysed data from the 2011...

Knowledge and opinion about smoke-free laws and second-hand smoke among hospitality venue managers in Gujarat and Andhra Pradesh, India.

India's Smoke-Free Law (SFL) was implemented in 2004 and reinforced on 2nd October 2008. This research attempts to understand the knowledge and opinion of hospitality venue (HV) managers about second-hand smoke (SHS) and SFL as well as self-reported compliance with SFL in two Indian states. A survey was conducted among 804 randomly sampled HVs from project STEPS (Strengthening of tobacco control efforts through innovative partnerships and strategies) in Gujarat and Andhra Pradesh, India. Four hundred and three HVs from two districts in Gujarat and 401 HVs from six districts in Andhra Pradesh were selected. The owner, manager or supervisor of each HV was interviewed using a pre-tested structured interview schedule. Association of opinion scales with respondents' background characteristics was assessed through the analysis of variance (ANOVA) method. Out of the 403 respondents in Gujarat and 401 in Andhra Pradesh, 56.1% and 84.3% had knowledge about SFL respectively. Compliance of HVs with SFL was 21.8% in Gujarat and 31.2% in Andhra Pradesh as reported by the managers. Knowledge about SHS was noted among 39.7% of respondents in Gujarat and 25.4% in Andhra Pradesh. Bivariate results indicated that more educated HV managers showed higher support for smoke-free public places (P < 0.001) and were more concerned about the health effects of SHS exposure (P = 0.002). Complete self-reported compliance with, and knowledge of SFL as well as SHS was not found in Gujarat and Andhra Pradesh. The education level of HV managers is an important determinant to ensure compliance with SFL in public places.

Can nutrition lessen the effects of secondhand smoke exposure among children?

Reducing harm from secondhand smoke (SHS) exposure is especially critical for children. Current strategies aimed at reducing SHS exposure in workplaces and public spaces have been successful in reducing adult exposure, yet infants and children, who are greatly susceptible to the adverse health effects of SHS exposure, continue to be among the most exposed in the USA. Novel strategies are needed that can work in combination with those aimed at removing SHS exposure from children, our single highest priority. The overall aim of this monograph is to demonstrate how nutrition has the potential to ameliorate adverse SHS-related outcomes in children. This aim is accomplished by providing evidence for the following: susceptibility to SHS exposure is greatest during critical windows of lung and immune system development; dietary factors act on SHS mechanisms and have the potential to reduce the risk of related adverse outcomes; the key mechanisms of adverse SHS-related outcomes include reduced nutrient status, oxidative stress, compromised immune function, and chronic inflammation; identification of nutrition-related interventions for SHS-exposed populations is a timely issue and requires future research. Our primary aim should be to eliminate SHS exposure. Until infants and children are no longer exposed to SHS, however, we propose investigating nutrition-focused interventions as a method to reduce the risk of SHS-related health outcomes for infants and children.

Biological evidence for the acute health effects of secondhand smoke exposure

A vast number of studies on the unfavorable effects of secondhand smoke (SHS) exist within the international literature, the majority of which evaluate longitudinal epidemiological data. Although limited, the experimental studies that assess the acute and short-term effects of exposure to SHS are also increasing in number. They include cellular, animal, and human studies that indicate a number of pathophysiological mechanisms through which the deleterious effects of SHS may arise. This current review evaluates the existing biological evidence regarding the acute health effects of SHS exposure. Analyses on the inhaled toxicants and the carcinogenicity of SHS are included as well as in-depth discussions on the evidence for acute SHS-induced respiratory, cardiovascular, metabolic, endocrine and immune effects, and SHS-induced influences on oxygen delivery and exercise. The influence of the length of exposure and the duration of the observed effects is also described. Moreover, recent findings regarding the underlying pathophysiological mechanisms related to SHS are depicted so as to generate models that describe the SHS-induced effects on different systems within the human body. Based on the presented biological evidence, it is concluded that brief, acute, transient exposures to SHS may cause significant adverse effects on several systems of the human body and represent a significant and acute health hazard. Future research directions in this area include research on the concentrations of tobacco smoke constituents in the alveolar milieu following SHS exposure, individual susceptibility to SHS, as well as the effects of SHS on neurobehavioral activity, brain cell development, synaptic development, and function.

Second Hand Smoke Exposure and Excess Heart Disease and Lung Cancer Mortality among Hospital Staff in Crete, Greece: A Case Study

Exposure to secondhand smoke (SHS) is a serious threat to public health, and a significant cause of lung cancer and heart disease among non-smokers. Even though Greek hospitals have been declared smoke free since 2002, smoking is still evident. Keeping the above into account, the aim of this study was to quantify the levels of exposure to environmental tobacco smoke and to estimate the attributed lifetime excess heart disease and lung cancer deaths per 1000 of the hospital staff, in a large Greek public hospital. Environmental airborne respirable suspended particles (RSP) of PM2.5 were performed and the personnel's excess mortality risk was estimated using risk prediction formulas. Excluding the intensive care unit and the operating theatres, all wards and clinics were polluted with environmental tobacco smoke. Mean SHS-RSP measurements ranged from 11 to 1461 microg/m3 depending on the area. Open wards averaged 84 microg/m3 and the managing wards averaged 164 microg/m3 thus giving an excess lung cancer and heart disease of 1.12 (range 0.23-1.88) and 11.2 (range 2.3-18.8) personnel in wards and 2.35 (range 0.55-12.2) and 23.5 (range 5.5-122) of the managing staff per 1000 over a 40-year lifespan, respectively. Conclusively, SHS exposure in hospitals in Greece is prevalent and taking into account the excess heart disease and lung cancer mortality risk as also the immediate adverse health effects of SHS exposure, it is clear that proper implementation and enforcement of the legislation that bans smoking in hospitals is imperative to protect the health of patients and staff alike.

Second Hand Smoke Exposure and Excess Heart Disease and Lung Cancer Mortality among Hospital Staff in Crete, Greece: A Case Study

Exposure to secondhand smoke (SHS) is a serious threat to public health, and a significant cause of lung cancer and heart disease among non-smokers. Even though Greek hospitals have been declared smoke free since 2002, smoking is still evident. Keeping the above into account, the aim of this study was to quantify the levels of exposure to environmental tobacco smoke and to estimate the attributed lifetime excess heart disease and lung cancer deaths per 1000 of the hospital staff, in a large Greek public hospital. Environmental airborne respirable suspended particles (RSP) of PM2.5 were performed and the personnel’s excess mortality risk was estimated using risk prediction formulas. Excluding the intensive care unit and the operating theatres, all wards and clinics were polluted with environmental tobacco smoke. Mean SHS-RSP measurements ranged from 11 to 1461 μg/m3 depending on the area. Open wards averaged 84 μg/m3 and the managing wards averaged 164 μg/m3 thus giving an excess lung cancer and heart disease of 1.12 (range 0.23-1.88) and 11.2 (range 2.3–18.8) personnel in wards and 2.35 (range 0.55-12.2) and 23.5 (range 5.5–122) of the managing staff per 1000 over a 40-year lifespan, respectively. Conclusively, SHS exposure in hospitals in Greece is prevalent and taking into account the excess heart disease and lung cancer mortality risk as also the immediate adverse health effects of SHS exposure, it is clear that proper implementation and enforcement of the legislation that bans smoking in hospitals is imperative to protect the health of patients and staff alike.