Household Smoking Research Articles

Associations between Second-Hand Tobacco Smoke Exposure and Cardiorespiratory Fitness, Physical Activity, and Respiratory Health in Children.

Background: Cardiorespiratory fitness (CRF) and physical activity (PA) are associated with a plethora of positive health effects. Many UK children fail to meet the recommended level of PA, with an observed decline in CRF levels over recent decades. Second-hand tobacco smoke (SHS) is responsible for a significant proportion of the worldwide burden of disease, but little is understood regarding the impact of SHS exposure on CRF and PA in children. The aim of this study was to test the associations between SHS exposure and CRF, PA, and respiratory health in children. Method: Children (9–11 years) from UK primary schools in deprived areas participated (n = 104, 38 smoking households). Surveys determined household smoking, and exhaled carbon monoxide was used to indicate children’s recent SHS exposure. CRF (VO2peak) was assessed via maximal treadmill protocol using breath-by-breath analysis. Fractional exhaled nitric oxide and spirometry were utilised as indicators of respiratory health. Results: Linear regression models demonstrated that SHS exposure was negatively associated with allometrically scaled VO2peak (B = −3.8, p = 0.030) but not PA or respiratory health. Conclusion: The results indicate that SHS is detrimental to children’s CRF; given that approximately one-third of children are regularly exposed to SHS, this important finding has implications for both public health and the sport and exercise sciences.

Parental health risk perceptions and preventive measures related to Children\u2019s second-hand cigarette smoke exposure in Malaysia

BackgroundSecondhand smoke (SHS) exposure can affect physical development in children. An understanding of parental risk perception of SHS could guide efforts to develop measures for prevention of SHS exposure among children. This study aimed to assess parental risk perceptions of SHS and action taken by parents to minimise SHS exposure in their children.MethodsThis cross-sectional nationwide study conducted in 2018 recruited convenience sample of 289 parents with children up to age 12 at public areas. Parents were asked to rate the risk level from 1 (no risk) to 5 (extremely high risk) by looking at photographs of an adult smoking in the presence of a child in 8 different situations. The implementation of smoking restriction rules was assessed. Mean scores were calculated with higher scores representing higher risk perception of SHS to child’s health. Linear regression analysis was used to determine factors associated with the level of parental risk perception of SHS exposure to their children’s health.ResultsA total of 246 parents responded. Their mean age was 35 years (SD 6.4). The majority were mothers (75.6%), Malays (72.0%) and had tertiary education level (82.5%), and non-smoker (87.1%). The mean age of respondents’ youngest child was 3 years (SD 3.1). The risk perception level was high [mean scores: 4.11 (SD: 0.82)]. Most parents implemented household (65.0%) and car (68.3%) smoking restriction rules. Lower levels of risk perception were observed among participants who were current smokers (p < 0.001), lived with a smoker (p < 0.001), allowed household smoking with an open window (p = 0.027).ConclusionMost parents perceived that risks of SHS exposure to their children were high but only two-thirds of them had set rules prohibiting smoking. Health policymakers should pay attention to factors associated with lower risk perception among parents.Trial registrationThis study was approved by the Medical Research Ethics Committee, Ministry of Health Malaysia (Registration Number: NMRR-18-3299-44967).

Racial Differences in Food Allergy Phenotype and Health Care Utilization among Egyptian &amp; USA Patients

Abstract Introduction This research is to answer the question of whether socio-economic class and the environmental factors associated with it has an impact on the presentation of food allergy (FA) in the Egyptian population, including serum IgE, sensitization to different foods and the impact on the family. Methods The study was conducted over 50 patients diagnosed with IgE-mediated FA aged less than 12 years, All patients were subjected to FA-related QOL Questionnaire. The study investigated age, gender, duration of pregnancy, mode of delivery, birth place, parental education, annual household income and household size as proxy sociodemographic variables. Results Low SES as regard low household income, small household size, more crowded household and low level of parental education, showed an impact on FA; Milk was the most common food allergen (60%) with late self-reporting FA cases; In contrast to high SES patients showed higher household income, bigger household size with less crowded household and higher level of parental education; Egg was the most common food allergen (56%) with earlier self-reporting of FA. With no significant deference as regard to sex preference (Male predominance), childhood infections, pre-natal &amp; first year antibiotics use, pets in the house, household smoking, symptoms of FA, number &amp; severity of reactions, history of anaphylaxis, number of ER visits &amp; hospitalization and history of associated allergies. Conclusion SES is a proxy measure for lifestyle features and characteristics including dietary habits, allergen exposure and other environmental factors and it is an important risk factor for atopic dermatitis, rhinitis and food allergy.

Effect of second-hand smoke on systemic, oral and psychological health of primary school children in Western Uttar Pradesh: a biochemical analysis.

Secondhand smoke (SHS) exposure causes several systemic problems like asthma, dental problems like caries and effects overall wellbeing. This study was conducted to study the impact of SHS on primary school children by associating it with dental caries, cotinine level, asthma severity and overall wellbeing. A case control study was conducted amongst 200 children (9-15 years old) that came to the Dental College in Muradnagar-Ghaziabad, India. Children who lived in smoking households were identified as SHS subjects-100 children and those who lived in nonsmoking households were identified as control group-100 children. Parents completed questionnaire regarding their smoking status. In children's questionnaire severity of asthma was determined by using expert panel report (EPR3), dental caries was recorded by dmft Index and psychological assessment of children was done using WHO-5 Wellbeing Index. Collection of unstimulated saliva of children was done in sterile plastic tubes and cotinine level was measured using Enzyme-Linked-Immunosorbent Assay (ELISA). Students' t-test and One-Way Analysis of Variance (ANOVA) were used to analyze data. Mean number of children suffering from asthma was higher in SHS subjects in comparison to control group i.e. 348.9±166.509 and 247.3±15.86 respectively. dmft and WHO wellbeing scores increased as level of cotinine increased. Mean cotinine level was higher in SHS subjects than control group i.e. 348.9±166.509 and 247.3±15.86 respectively. SHS has an adverse impact on young children reflected by poor dmft scores and psychological wellbeing, increased cotinine levels and asthma severity in comparison to control group.

S1416 Medicaid Expansion Is Associated with Decreased Gastric Cancer Incidence

Introduction: Individuals in Medicaid expanded states have increased access to treatment for medical conditions and other health care resources, including preventive healthcare. Esophageal and gastric cancer are associated with several modifiable risk factors (i.e. smoking, drinking, obesity, Helicobacter pylori infection). The impact of Medicaid expansion on gastric and esophageal cancer incidence and mortality remains uninvestigated. Methods: We evaluated the association between Medicaid expansion and gastric and esophageal cancer incidence and mortality in adults aged 25-64. This study employed an observational design using a difference-in-differences method with state level data from 31 states (given the availability of complete data), from 2010 – 2017. Annual, age-adjusted gastric and esophageal incidence and mortality rates, from the CDC Wonder Database, were analyzed and were accounted for by ICD-O-3 and ICD-10, respectively. Rates were adjusted for gender, race, poverty, median household income, unemployment, insurance, smoking, alcohol consumption, diabetes mellitus, obesity, and number of physicians per 100,000 population. Results: In expansion states, median (IQR) gastric cancer incidence was unchanged: from 4.6 (4.2-5.2) to 4.6 (4.1-5.4) per 100,000 population from the pre-expansion to post-expansion period. There was an increase in median (IQR) gastric cancer incidence among non-expansion states, from 4.6 (4.2-5.0) to 4.8 (4.3-5.1) per 100,000 from pre- to post-expansion. There was no considerable change in gastric cancer mortality and esophageal cancer incidence and mortality pre- and post- expansion. Adjusted analyses demonstrate that expansion states had significantly fewer new cases of gastric cancer: -1.6 (95% CI: 0.2-3.5; P = .08) per 1,000,000 persons per year. No significant association was seen between Medicaid expansion and gastric cancer mortality (0.46 [95% CI: -0.08-0.17; P = .46]) and esophageal cancer incidence (0.8 [95% CI: -0.08- 0.24; P = .33]) and mortality (1.0 [95% CI: -0.06-0.26; P = 0.21]) in multivariable analyses. Annual adjusted medians for gastric and esophageal cancer mortality and incidence are shown in Figure 1. Conclusion: States that adopted Medicaid expansion saw a decrease in gastric cancer incidence among adults aged 25-64 when compared to states that did not expand Medicaid. Though several factors may influence gastric cancer incidence, this association is important to consider during health policy negotiations.Figure 1.: Annual distribution of age-adjusted gastric and esophageal cancer incidence and mortality rates pre- and post- Medicaid expansion.Table 1.: Comparison of sociodemographic and clinical characteristics of Expansion Vs Non-Expansion States based on 2010 data.

In Utero Exposure to Smoking and Alcohol, and Passive Smoking during Childhood: Effect on the Retinal Nerve Fibre Layer in Young Adulthood

ABSTRACT Purpose In utero exposure to cigarette smoke has been suggested to result in thinner retinal nerve fibre layer (RNFL). However, the potential cofounding effects of in utero alcohol exposure and passive smoking during childhood had not been considered. We explored RNFL thickness in young adults in relation to these early life factors. Methods In 1989–1991, pregnant women completed questionnaires on their current smoking and alcohol drinking patterns. Following the birth of their offspring, information on household smokers was obtained between the 1- and 13-year follow-ups. At the 20-year follow-up, these offspring underwent an eye examination including optical coherence tomography imaging of the RNFL. Results Participants (n = 1,287) were 19–22 years old at time of eye examination. Most participants (77%) had no in utero exposure to cigarette smoke; 1.3% were initially exposed but not after 18 weeks’ gestation, while 21% had continual in utero smoking exposure. Half of the mothers never consumed alcohol or only consumed alcohol once during their pregnancies. After correcting for potential confounders, including in utero alcohel exposure and childhood passive smoking, participants who had continued in utero exposure to >10 cigarettes/day and ≤10 cigarettes/day had thinner RNFLs by 6.6 (95% confidence interval [CI] = 4.4–8.7) and 3.7 µm (95%[CI] = 2.3–5.5), respectively, than those with no exposure (p < .001). In utero alcohol exposure and childhood passive smoking were not significantly associated with RNFL thickness after accounting for in utero exposure to smoking. Conclusions In utero exposure to cigarette smoke is associated with thinner RFNL in young adulthood, independent of other early life environmental factors.

Sociodemographic and Clinical Predictors of Prescription Opioid Use in a Longitudinal Community-Based Cohort Study of Middle-Aged and Older Adults.

ObjectivesIdentifying factors associated with opioid use in middle-aged and older adults is a fundamental step in the mitigation of potentially unnecessary opioid consumption and opioid-related harms.MethodsUsing longitudinal data on a community-based cohort of adults aged 50–90 years residing in Johnston County, North Carolina, we examined sociodemographic and clinical factors in non-opioid users (n = 786) at baseline (2006–2010) as predictors of opioid use at follow-up (2013–2015). Variables included age, sex, race, obesity, educational attainment, employment status, household poverty rate, marital status, depressive symptoms, social support, pain catastrophizing, pain sensitivity, insurance status, polypharmacy, and smoking status.ResultsAt follow-up, 13% of participants were using prescription opioids. In the multivariable model, high pain catastrophizing (adjusted odds ratio; 95% confidence interval = 2.14; 1.33–3.46), polypharmacy (2.08; 1.23–3.53), and history of depressive symptoms (2.00; 1.19–3.38) were independent markers of opioid use.DiscussionFindings support the assessment of these modifiable factors during clinical encounters in patients ≥ 50 years old with chronic pain.

Residential green space structures and mortality in an elderly prospective longitudinal cohort in China

Greenness is beneficial to health and is associated with lower mortality. Many studies used the normalized difference vegetation index (NDVI) to measure greenness. However, NDVI cannot be used to indicate landscape type. To go beyond NDVI, we aim to study the association between greenness structures and all-cause mortality of older adults using the 2008–2014 waves of Chinese Longitudinal Healthy Longevity Survey. We calculated landscape indices to quantify three greenspace structure characteristics: area-edge, shape, and proximity. The health outcome was all-cause mortality. We used the Cox-proportional hazards model, adjusted for the study entrant year, age, sex, activities of daily living (ADL), marital status, geographic region, urban or rural residential location, literacy, annual household income, smoking, alcohol and exercise status, biodiversity, numbers of hosts for zoonosis, contemporaneous NDVI, annual average temperature, and 3 year average PM2.5. Among 12 999 individuals (average age at baseline 87.2 years, 5502 males), we observed 7589 deaths between 2008 and 2014. We did not find a consistent dose-response relationship between greenspace structures and all-cause mortality. However, there were some signals of associations. Compared with individuals living in the lowest quartile of the number of patches, the adjusted-hazard ratio (95% CI) of those in the highest quartile was 0.85 (0.80–0.92). In stratified analyses, the largest patch index and perimeter-area ratio had protective effects on males, individuals aged <90, those free of ADL disability, and with higher income. The protective influence of greenspace structures was not as evident compared to NDVI.

Predictors of Smoking Resumption After Acute Coronary Syndrome: A Prospective Study in Western Iran

Background: Despite the health benefits of smoking cessation on patients with cardiovascular diseases (CVDs), some resume smoking even after their discharge from hospital with acute coronary syndrome (ACS). Objectives: This study aimed to determine the predictors of smoking resumption after ACS in western Iran. Patients and Methods: This prospective cohort study was performed on 175 patients admitted to the Imam Ali Cardiovascular Center, Kermanshah, Iran, with a diagnosis of ACS from January 2018 to December 2018. Data were collected by a trained interviewer using a checklist developed based on the study objectives. Differences between groups were evaluated by independent t-test, chi-square, and Fisher’s exact tests. The relationship between smoking resumption and predicting variables was assessed using univariate and multivariate logistic regression models (Forward LR). Results: All participants were male with a mean age of 56.30 ± 8.91 (mean ± SD) years. Three months post-discharge, 137 (78.3%) patients quit smoking, and 38 (21.7%) patients resumed it. The patients who resumed smoking were more likely to be divorced (20.6% vs. 0.7%), unemployed or retired (73.7% vs. 63.5%), have smokers in household (86.8% vs. 50.4%), and have history of depression (52.7% vs. 20.4%) (P-values &lt; 0.05). The independent predictors of smoking resumption were divorce (OR 4.2, 95% CI: 1.31 - 19.01), having smokers in household (OR 12.08, 95% CI: 3.45 - 40.81), and history of depression (OR 12.16, 95% CI: 3.68 - 39.04). Conclusions: Divorce, having smokers in household, and history of depression were identified as the independent predictors of smoking resumption in ACS patients. Those who have these characteristics should be viewed as having a high risk of smoking relapse and be provided with more support to quit smoking.

Exposure to Secondhand Smoke at Home and Psychological Distress among College Students in China: The Role of Parental Attachment

ABSTRACT This study examined the link between home SHS exposure and psychological distress among college students in China. Between July and September of 2020, 18–25-year-old students in three Chinese universities were invited to complete an online survey. Data from 872 respondents (mean age = 20.28) were analyzed. Psychological distress was assessed by the 10-item Kessler Scale. Home SHS exposure was assessed by the presence of smoking household members, hours of exposure, and exposure to the number of cigarettes smoked. Maternal and paternal attachment were assessed by the Inventory of Parent and Peer Attachment. Pairwise comparisons of sample characteristics were performed across never-smokers, triers (smoked one or two puffs), and smokers. Generalized linear regression models were constructed to assess the association. More smokers were exposed to home SHS or engaged in ever alcohol and other drug use than never-smokers. In never-smokers, exposure for <1 h/day or ≥3 h/day, or to 6–10 cigarettes/day was associated with increased psychological distress, but they were nullified after adjusting for parental attachment. In smokers, exposure to 6–10 cigarettes/day was associated with decreased psychological distress even after adjusting for parental attachment. Home SHS exposure is a risk factor for psychological wellbeing in never-smokers, the association with smokers warrants further study.

Predictors of COVID-19 in an outpatient fever clinic.

BackgroundThe objective of this study was to identify clinical risk factors for COVID-19 in a German outpatient fever clinic that allow distinction of SARS-CoV-2 infected patients from other patients with flu-like symptoms.MethodsThis is a retrospective, single-centre cohort study. Patients were included visiting the fever clinic from 4th of April 2020 to 15th of May 2020. Symptoms, comorbidities, and socio-demographic factors were recorded in a standardized fashion. Multivariate logistic regression was used to identify risk factors of COVID-19, on the bases of those a model discrimination was assessed using area under the receiver operation curves (AUROC).ResultsThe final analysis included 930 patients, of which 74 (8%) had COVID-19. Anosmia (OR 10.71; CI 6.07–18.9) and ageusia (OR 9.3; CI 5.36–16.12) were strongly associated with COVID-19. High-risk exposure (OR 12.20; CI 6.80–21.90), especially in the same household (OR 4.14; CI 1.28–13.33), was also correlated; the more household members, especially with flu-like symptoms, the higher the risk of COVID-19. Working in an essential workplace was also associated with COVID-19 (OR 2.35; CI 1.40–3.96), whereas smoking was inversely correlated (OR 0.19; CI 0.08–0.44). A model that considered risk factors like anosmia, ageusia, concomitant of symptomatic household members and smoking well discriminated COVID-19 patients from other patients with flu-like symptoms (AUROC 0.84).ConclusionsWe report a set of four readily available clinical parameters that allow the identification of high-risk individuals of COVID-19. Our study will not replace molecular testing but will help guide containment efforts while waiting for test results.

Negative impact of the COVID-19 state of emergency on breast cancer screening participation in Japan.

BackgroundIn response to the Coronavirus-19 (COVID-19) pandemic, the Japanese government declared a state of emergency in Saitama, Chiba, Tokyo, Kanagawa, Osaka, Hyogo and Fukuoka prefectures on April 7, 2020; this was extended to the remaining prefectures on April 16, 2020. The state of emergency was lifted on May 25, 2020. Although it was known that breast cancer screening was postponed or canceled during this period, the actual extent of postponement or cancellation has not been clarified.MethodsWe investigated postponement or cancellation of breast cancer screening between April and May 2020 using a cross-sectional, web-based, self-reported questionnaire survey. In addition, we examined the association between socioeconomic and health-related factors and postponement or cancellation by multivariable log-binominal regression.ResultsAmong 1874 women aged 30–79 years who had scheduled breast cancer screening during the study period, 493 women (26.3%) postponed or canceled screening. While women aged 30–39 years and 70–79 years postponed or canceled less frequently than women aged 40–49 years (prevalence ratio = 0.62 and 0.56, respectively), there was no significant difference between age groups in the women aged 40–69 years. Postponement or cancellation was more frequent in five prefectures, where the state of emergency was declared early (prevalence ratio = 1.25). Employment status, annual household income, family structure, academic background, smoking status, and fear of COVID-19 were not associated with postponement or cancellation.ConclusionAlthough care should be taken with the interpretation of these findings due to possible biases, they suggest that the postponement or cancellation of breast cancer screening might be due more to facility suspension than to individual factors. It is necessary to explore the ideal way of encouraging breast cancer screening uptake, in an environment of coexistence with COVID-19.

Determinants and Follow-up of Lung Function Data from a Predominantly First Nations Cohort of Adults Referred to Specialist Respiratory Outreach Clinics in Regional and Remote Queensland.

Northern Territory (NT)-based clinical service data suggest substantial lung function impairment amongst First Nations adults as young as 18-40years. Our objectives were to describe the burden of disease and lung function of adults living in regional-remote Queensland, identify determinants of lung function, and evaluate the impact of a specialist respiratory outreach service on lung function. Retrospective 8-year cohort study (February 2012-March 2020) of 1113 First Nations Australian adults (and 648 non-First Nations adults) referred to respiratory outreach clinics in regional-remote Queensland. In the combined cohort, the forced expiratory volume in 1s (FEV1) was clinically abnormal for 54% of First Nations patients (51% of non-First Nations patients), forced vital capacity (FVC) for 46% (36%), FEV1/FVC% for 30% (36%), and gas diffusing capacity (DLCO) for 44% (37%). A respiratory diagnosis was assigned by a respiratory physician in 78% of First Nations (76% non-First Nations) patients. Smoking, household smoke exposure, underweight BMI, and respiratory disease were associated with reduced lung function. In the 40% of patients (709/1765) followed up, FEV1 and FVC significantly improved (mean change: zFEV1 = 0.15 [95% CI 0.10-0.20]; zFVC = 0.25 [0.20, 0.31]), and FEV1/FVC% significantly reduced (mean = - 0.10 [95%CI - 0.07 to - 0.03]), with no significant change in DLCO. Patients with COPD had lower FEV1 improvement, whilst underweight and obese patients had lower FVC improvement. Regional-remote First Nations adult Queenslanders have higher lung function than previously reported, with no lung function decline observed at follow-up visit, including for those with respiratory disease.

Comorbidities associated with cervical spine degenerative disc disease

Determining important links between medical comorbidities and cervical spine degenerative disc disease (DDD) will help elucidate pathomechanisms of disc degeneration. Electronic medical records and magnetic resonance imaging were retrospectively reviewed to evaluate 799 patients assessed for cervical spine pathology. Bivariate analysis identified older age, diabetes, ASA class, cancer, COPD, depression, hypertension, hypothyroidism, Medicare status, peripheral vascular disease, history of previous cervical spine surgery, smoking, and lower median household income as having strong associations with increased cumulative grade of cervical spine DDD. This study provides evidence suggesting aging and accumulation of medical comorbidities influence severity of cervical spine DDD.

Children of Smoking and Non-Smoking Households' Perceptions of Physical Activity, Cardiorespiratory Fitness, and Exercise.

Previous research has shown secondhand tobacco smoke to be detrimental to children’s health. This qualitative study aimed to explore children from low socioeconomic status (SES) families and their reasons for being physically active, attitudes towards physical activity (PA), fitness and exercise, perceived barriers and facilitators to PA, self-perceptions of fitness and physical ability, and how these differ for children from smoking and non-smoking households. A total of 38 children (9–11 years; 50% female; 42% smoking households) from the deprived areas of North West England participated in focus groups (n = 8), which were analysed by utilizing thematic analysis. The findings support hypothesised mediators of PA in children including self-efficacy, enjoyment, perceived benefit, and social support. Fewer than a quarter of all children were aware of the PA guidelines with varying explanations, while the majority of children perceived their own fitness to be high. Variances also emerged between important barriers (e.g., sedentary behaviour and environmental factors) and facilitators (e.g., psychological factors and PA opportunity) for children from smoking and non-smoking households. This unique study provided a voice to children from low SES and smoking households and these child perspectives could be used to create relevant and effective strategies for interventions to improve PA, fitness, and health.

Childhood food insecurity and incident asthma: A population-based cohort study of children in Ontario, Canada.

Childhood food insecurity has been associated with prevalent asthma in cross-sectional studies. Little is known about the relationship between food insecurity and incident asthma. We used administrative databases linked with the Canadian Community Health Survey, to conduct a retrospective cohort study of children <18 years in Ontario, Canada. Children without a previous diagnosis of asthma who had a household response to the Household Food Security Survey Module (HFSSM) were followed until March 31, 2018 for new asthma diagnoses using a validated administrative coding algorithm. We used multivariable Cox proportional hazard models to examine the association between food insecurity and incident asthma, and adjusted models sequentially for clinical and clinical/socioeconomic risk factors. As additional analyses, we examined associations by HFSSM respondent type, severity of food insecurity, and age of asthma diagnosis. Moreover, we assessed for interaction between food security and child's sex, household smoking status, and maternal asthma on the risk of incident asthma. Among the 27,746 included children, 5.1% lived in food insecure households. Over a median of 8.34 years, the incidence of asthma was 7.33/1000 person-years (PY) among food insecure children and 5.91/1000 PY among food secure children (unadjusted hazard ratio [HR] 1.24, 95% CI 1.00 to 1.54, p = 0.051). In adjusted analyses associations were similar (HR 1.16, 95% CI 0.91 to 1.47, p = 0.24 adjusted for clinical risk factors, HR 1.24, 95% CI 0.97 to 1.60, p = 0.09 adjusted for clinical/socioeconomic factors). Associations did not qualitatively change by HFSSM respondent type, severity of food insecurity, and age of asthma diagnosis. There was no evidence of interaction in our models. Food insecure children have numerous medical and social challenges. However, in this large population-based study, we did not observe that childhood food insecurity was associated with an increased risk of incident asthma when adjusted for important clinical and socioeconomic confounders.

Factors Related to a Smoke-free Home Status: A Parental Report.

Purpose:The household smoking ban is one potential strategy for reducing exposure to second-hand smoke at home. There is little information about whether concurrent alcohol and tobacco use are related to a smoking ban at home. This study aimed to examine the association between concurrent alcohol and tobacco use with the household smoking ban strategy as reported by the parents of schoolchildren. Methods:We used data from a cross-sectional study that surveyed schoolchildren at 9 schools (grades 6 to 8). A self-administered questionnaire was sent out to the parents of 1,335 schoolchildren. Household smoking ban status was reported by the parents. We used multiple logistics regression to investigate the association between the household smoking ban and alcohol and tobacco use adjusted for potential confounders.Results:The prevalence of a no-smoking ban in households was 51% (95% confidence interval: 48.4%, 53.8%). After adjusting for the number of smokers in a home and perceptions about the harm of exposure to second-hand smoke, the multiple logistics regression results showed that concurrent alcohol and tobacco use in the households (OR = 2.31; 95% CI: 1.66, 3.20) had a higher risk of a no-smoking ban. Conclusions:Our findings showed that concurrent alcohol and tobacco use was associated with a smoking ban status in households. A no-alcohol-drinking-at-home campaign should be adopted and promoted for increasing the rate of smoke-free homes.

'I Was Smoking a Lot More during Lockdown Because I Can': A Qualitative Study of How UK Smokers Responded to the Covid-19 Lockdown.

This study explored how Covid-19 lockdown restrictions affected people’s daily smoking routines and behaviours, including adherence and modifications to pre-established smoking restrictions in the home. Semi-structured telephone interviews were conducted with smokers and non-smokers from smoking households 19 to 27 weeks after the first full UK lockdown ended in May 2020. A non-probability purposive sample representing 25 adults aged 21 or over living in households with at least 1 smoker were recruited to the study. A quota sampling strategy was used, according to age, gender, smoking status, family status, household composition, householder access to outdoor space, and change to work-life status. Most participants found lockdown increased the amount of time spent at home, where stresses associated with confinement, curtailment of social routines, removal of barriers and distractions to smoking due to home working, and feelings of boredom all contributed to increased smoking. Fewer factors were identified as reducing smoking during lockdown. Prominent examples included disruption to habitual smoking patterns and distraction from smoking associated with spending more time doing outdoor activities. Pressures placed on physical space and lack of privacy due to the confinement at home were responsible for displacement of smoking within the home, leading to breaking of smoke-free rules and family tensions, and in some cases to greater awareness amongst parents that their children smoked. Changes in daily routines associated with lockdown affected and displaced smoking behaviour both positively and negatively. Health improvement interventions could seek to harness positive changes in smoking associated with any future lockdown approaches. New home-working norms highlight the need for employers to support staff to reduce their smoking and to remain smoke-free.

Non-nutritive suck and airborne metal exposures among Puerto Rican infants

Air pollution has been shown to impact multiple measures of neurodevelopment in young children. Its effects on particularly vulnerable populations, such as ethnic minorities, however, is less studied. To address this gap in the literature, we assess the associations between infant non-nutritive suck (NNS), an early indicator of central nervous system integrity, and air pollution exposures in Puerto Rico.Among infants aged 0–3 months enrolled in the Center for Research on Early Childhood Exposure and Development (CRECE) cohort from 2017 to 2019, we examined associations between exposure to fine particulate matter (PM2.5) and its components on infant NNS in Puerto Rico. NNS was assessed using a pacifier attached to a pressure transducer, allowing for real-time visualization of NNS amplitude, frequency, duration, cycles/burst, cycles/min and bursts/min. These data were linked to 9-month average prenatal concentrations of PM2.5 and components, measured at three community monitoring sites. We used linear regression to examine the PM2.5-NNS association in single pollutant models, controlling for infant sex, maternal age, gestational age, and season of birth in base and additionally for household smoke exposure, age at testing, and NNS duration in full models.Among 198 infants, the average NNS amplitude and burst duration was 17.1 cmH2O and 6.1 s, respectively. Decreased NNS amplitude was consistently and significantly associated with 9-month average exposure to sulfur (−1.026 ± 0.507), zinc (−1.091 ± 0.503), copper (−1.096 ± 0.535) vanadium (−1.157 ± 0.537), and nickel (−1.530 ± 0.501). Decrements in NNS frequency were associated with sulfur exposure (0.036 ± 0.018), but not other examined PM components. Our findings provide new evidence that prenatal maternal exposure to specific PM components are associated with impaired neurodevelopment in Puerto Rican infants soon after birth.

Factors Associated With Quitting Smoking During Pregnancy Among Women Veterans.

Little is known about the rates of smoking among pregnant veterans. Our objective was to examine rates of smoking during pregnancy and factors associated with quitting smoking during pregnancy. We used data from a cohort study of pregnant veterans from 15 Veterans Health Administration facilities nationwide. Veterans who reported smoking during pregnancy were included in this analysis. Poisson regression models were used to estimate the relative risk (RR) of quitting smoking during pregnancy. Overall, 133 veterans reported smoking during pregnancy. Among this group of women who smoked, the average age was 31.6years, 20% were Black, and 14% were Hispanic/Latino. More than one-half of women (65%) who reported smoking at the start of pregnancy quit smoking during pregnancy. Multivariable models, adjusted for history of deployment and age, indicated that prenatal care initiation at 12 or fewer weeks compared with more than 13weeks (relative risk [RR], 2.06; 95% confidence interval [CI], 1.18-3.58), living without household smokers compared with any household smokers (RR, 1.58; 95% CI, 1.14-2.17), and first pregnancy (RR, 1.51; 95% CI, 1.17-1.95) were significant predictors of quitting versus persistent smoking during pregnancy. Women veterans who quit smoking may be different than those who continue to smoke during pregnancy. Establishing prenatal care early in pregnancy, which likely includes counseling about smoking cessation, seems to be an important factor in quitting. Those for whom it is not a first pregnancy and who live with other smokers may especially benefit from such counseling.