Indoor Smoking Research Articles

Lady health workers smoking cessation initiative in rural Pakistan

Abstract Background In Pakistan, tobacco smoking and indoor smoke from cooking fires pose significant health risks. Lady Health Workers (LHWs) play a crucial role in improving healthcare access, particularly in rural areas. This study aimed to explore the practicality of training LHWs to deliver health education aimed at reducing household exposure to tobacco smoke and indoor biomass smoke, while also documenting baseline exposure levels and assessing the immediate impact on household awareness and intentions to reduce exposure. The Program Over 170 LHWs were trained and equipped with health education resources to raise awareness about the risks of tobacco and biomass smoke exposure. The training was designed to be integrated into their routine duties. Results Over 24 weeks, the program was delivered to 25,760 households in Gujranwala district. Approximately half of these households had at least one person who smoked, with 90% smoking indoors. Many (85%) households used indoor cooking fires. Only 24% of household head-women were aware of the health risks associated with indoor smoke exposure. Awareness of less harmful alternatives to smoking was low. Most households had someone who wanted to stop smoking and 51 women and 146 men agreed to try a tobacco harm reduction (THR) product. Primary health units’ staff appreciated the project, especially the training provided. They believed the program could be sustainable, and LHWs expressed interest in continuing it. Conclusion The study demonstrated the practicality of training LHWs to deliver health education on reducing tobacco and biomass smoke exposure in rural settings. The program effectively raised awareness and showed potential for sustainable integration into existing healthcare structures, highlighting the value of community-centric approaches in low-resource settings.

Protocol for a cluster randomised controlled trial to evaluate effectiveness of a self-help group intervention to encourage smoke-free homes in slums of Kochi(Kochi Intervention for tobacco smoke free homes-KIFT)

Background Exposure to second hand smoke (SHS) is a cause for heart disease and lung cancer among non- smokers. This cluster randomized control trial will evaluate the effectiveness of a tobacco smoke free home intervention in reducing exposure to second hand smoke. Protocol The intervention will be conducted among 30 clusters in urban and peri-urban areas of Kochi, India. The sample size is 300 per arm and 15 clusters to detect a minimal difference of 0.03ng/ml in cotinine levels between groups, at 80% power with a two-sided alfa of 0.05 considering variable cluster size. A baseline survey will be undertaken to identify smokers. Data related to smoking, indoor smoking, nicotine dependence, blood pressure (BP) of smokers, morbidity experienced, and lung volume Fev1/Fev6 of smokers will be measured. Urine cotinine, morbidity, BP of spouse and child will be assessed. Air quality monitors measuring PM2.5 will be placed in homes. Trained self-help group women and frontline health workers will implement the intervention. The intervention will consist of monthly home visits to educate the smoker on the harms of second-hand smoke using 3 A’s. The circle of influencers around the smoking men will also be contacted by the members of self-help group to provide support to stop smoking within homes and to quit. They will then organize two-three meetings of community leaders and heads of women’s groups, present data on harms of SHS, and explain the rationale for establishing smoke free homes in their community for a duration of six months. After the intervention a post assessment will be conducted and this will be repeated after six months. Ethics and dissemination The trial protocol was approved by the Institutional Ethical Committee of Amrita Institute of Medical Sciences. Results will be submitted to open access peer reviewed journals and shared with other stakeholders. Trial registration CTRI/2021/06/034478

Energy retrofits: Factors affecting a just transition to better indoor air quality

In comparison with other European countries, Ireland has a disproportionately high number of poorly performing energy-inefficient buildings. Consequently, Ireland has one of the most ambitious energy retrofit programmes in Europe. The aim of this study was to evaluate the impact of deep energy renovation measures i.e. (replacement of heating system and upgrade to building envelope) on indoor air quality, thermal comfort and ventilation in a sample of primarily social housing in Ireland. A mixed methods approach including measurement of indoor air quality and a thermal comfort questionnaire survey was employed. Indoor concentration measurements of PM2.5, carbon dioxide, formaldehyde, and radon along with measurements of air temperature and relative humidity were made (N=14). Occupants (n=56) completed a thermal comfort questionnaire survey pre- and post-retrofit. Data collection ran from autumn 2020 until autumn 2023.Thermal comfort improved post-retrofit along with occupant satisfaction with the indoor thermal environment and heating-systems. Post-retrofit, higher bedroom CO2, and higher PM2.5 concentrations were recorded in both living areas and bedrooms. Occupant behaviours e.g. blocking wall vents were significant predictors of poorer ventilation while smoking indoors was related to higher concentrations of PM2.5. In general, homes that had mechanical ventilation systems installed were better ventilated. Underventilation, as indicated by visible condensation or mould was observed in half of the social homes surveyed and reported by questionnaire respondents (26 %). Tailored communications to occupants regarding the important role of ventilation and indoor air quality is required as part of retrofit to optimise impacts on IEQ.

Impacts of revised smoke-free regulations under the 2020 Japan Health Promotion Act on cigarette smoking and heated tobacco product use in indoor public places and homes: findings from 2018 to 2021 International Tobacco Control (ITC) Japan Surveys

BackgroundIn April 2020, Japan’s revised Health Promotion Act (HPA) banned cigarette smoking and heated tobacco products (HTP) use in indoor public places but exempted small establishments and permitted smoking-designated/HTP-designated rooms....

Prevalence and predictors of indoor secondhand tobacco smoke exposure among Senegalese household population

ABSTRACT Indoor secondhand tobacco smoke (SHS) exposure imposes substantial health risks among all household members, including children. Earlier studies reported high tobacco use in West African country Senegal. Despite the high health risks, no recent study has presented the situation of indoor SHS exposure in Senegal. Using cross-sectional design, we assessed the prevalence and predictors of indoor SHS exposure in Senegal. We used recent demographic and health survey (DHS) 2023 data of 75,080 household members of all ages. Analyzing these data, the prevalence of indoor SHS was assessed, and binomial logistic regression was used to identify predictors of indoor SHS exposure. The prevalence of indoor SHS exposure in Senegal was 24% (95% CI 23.5–24.2). Females, compared to males, were less likely to get indoor SHS exposure (aOR 0.9; 95% CI 0.8–0.9). Compared to the urban population, rural residents were less likely to get indoor SHS exposure (aOR 0.8; 95% CI 0.7–0.8). Individuals lived in households where members experienced shock events (aOR 1.2; 95% CI 1.1–1.2) and had members with psychological issues (aOR 1.5; 95% CI 1.4–1.6) were more susceptible to indoor SHS exposure. We conclude that indoor SHS exposure is high, particularly among Senegalese males, urban residents, and the poorest wealth quintiles. Additionally, susceptibility to indoor SHS increases with the presence of stressors like past adverse shock events and mental health issues. Both of these stressors encourage indoor smoking and intensify the risk of indoor SHS exposure among all household members. Community-based interventions providing behavior change communication on quitting tobacco and preventing indoor smoking are recommended.

Ambient smoke exposure and indoor air quality in eastern Massachusetts during the 2023 wildfire season

ABSTRACT Widespread North American wildfires in 2023 led to exposure to ambient wildfire smoke outside of traditionally wildfire-prone regions. The objective was to evaluate levels of indoor air pollutants in relation to ambient wildfire smoke exposure in eastern Massachusetts. Using a real-time multipollutant sensor system in five Boston area households, this study assessed indoor fine particulate matter (PM2.5), nitrogen dioxide (NO2), and total volatile organic compound concentrations (TVOC) two days before and during days of hazardous wildfire smoke exposure (smoke days). The relationship between ambient PM2.5 from regulatory monitors and indoor PM2.5 before and during smoke days was investigated by mixed effects linear regression. During smoke days and the preceding non-smoke days, median indoor PM2.5 was 9.9 µg/m3 and 3.5 µg/m3 (p < 0.001), respectively; median NO2 was 20.5 ppb and 18.4 ppb (p = 0.11); median TVOC was 6,715 µg/m3 and 5,361 µg/m3 (p = 0.35). A 1% increase in ambient PM2.5 was associated with a 0.93% increase in indoor PM2.5 on smoke days (95% CI, 0.54%–1.32%) and a 0.34% increase on non-smoke days (95% CI, 0.17%–0.66%), though interaction testing of smoke day status was not statistically significant (p = 0.14). In Northeastern US homes, indoor PM2.5 increased significantly during ambient wildfire smoke exposure, which may reflect increased infiltration and increased indoor particle-generating activities during smoke days. Implications: This study reports on household exposure to wildfire smoke in eastern Massachusetts, finding that indoor PM2.5 more than doubled compared to preceding non-smoke days, while indoor NO2 and TVOC did not significantly rise. Though the generalizability of this study is limited by the small number of homes studied, the findings suggest that more investigation is needed to understand indoor air pollution during future wildfire smoke exposure in regions not traditionally wildfire-prone and to inform mitigation efforts.

The Association Between The Physical Condition of the House and the Smoking Habits of Residents with the Incidence of Pneumonia In Children Under Five Years

Pneumonia is leading cause of death worldwide, with a prevalence of 44%, and is second leading cause of death among under-fives in Indonesia, at 15.5%. Pneumonia is caused by viruses and bacteria that are associated with physical conditions, air quality, and smoking habits in house. This study aimed to determine association between physical house conditions and smoking habits with incidence of pneumonia in children under five years in Cengkareng Health Center working area. This study was a case-control design analytic observational study. Population involved chindren under five aged 12-59 months with a sample of 43 cases and 43 controls calculated using Lemeshow’s formula, taken using purposive sampling technique. Independent variables included floor and wall types, ventilation, occupancy density, temperature, humidity, light intensity, PM10 and PM2.5 levels, and smoking habits. Dependent varariable are incident of pneumonia. Data were collected through observation, sanitarian kits, and questionnaires. Data were analyzed using chi-square and logistic regression with 95% CI and alpha 0.05. The results showed that PM2.5 levels (p=0.010, OR=3.290, 95% CI=1.323-8.181) and indoor smoking (p=0.044, OR=2.758, 95% CI=1.027-7.410) were most significant factors associated with pneumonia. This study recommends optimizing educational programs regarding PM2.5 exposure and smoking habits to improve healthy living practices and reduce risk of pneumonia

Support for regulating smoking in private and public places by adults who currently smoke and recently quit smoking in Spain.

While indoor smoking restrictions are common, outdoor restrictions are still rare. We explored opinions and support for regulating smoking in different indoor and outdoor environments among adults who smoke and those who recently quit smoking, in Spain. The 2021 ITC EUREST-PLUS Spain Survey is a cross-sectional study conducted among a nationally representative sample of 1006 adults aged ≥18 years who smoked cigarettes (n=867) or had recently quit smoking (n=139). Using Poisson regression with robust variance, we estimated adjusted prevalence and prevalence ratios of favorable opinions on regulating smoking in different indoor and outdoor environments and support for regulation in unregulated outdoor environments, by sociodemographic and smoking-related characteristics. There were highly favorable opinions for regulating smoking in places with minors (>95% in primary and secondary playgrounds, and cars with pre-school children and minors) and outdoor transportation (60-80%). There were less favorable opinions for regulating smoking in outdoor terraces of bars/pubs and restaurants (15-20%). Support for further total outdoor regulations on smoking was moderate for markets/shopping centers, public building entrances and swimming pools (40-60%), and low for restaurants/bars/pubs (29.2%). Having quit smoking, having no significant others who smoke and/or believing that cigarette smoke is harmful to others, were factors positively associated with favorable opinions and support for regulating smoking. The settings in Spain with the most favorable opinions for regulation among adults who smoke and have recently quit smoking are places with minors, private cars with others and outdoor areas of public transportation, while the settings with the least favorable opinions were outdoor terraces of bars, pubs, and restaurants. Support for further total outdoor smoking bans is generally moderate, but low for restaurants, bars, and pubs. Overall, these findings suggest the feasibility of extending smoke-free policies to other public and private settings to protect others from tobacco smoke exposure.

An Image Restoration Method for Improving Matching Robustness of Indoor Smoke Scene

An Image Restoration Method for Improving Matching Robustness of Indoor Smoke Scene

Phase distribution and probabilistic risk assessment of polycyclic aromatic hydrocarbons in indoor air of coffee shops at Zahedan, Iran

Polycyclic aromatic hydrocarbons (PAHs) are a class of hydrocarbons, some of which are established human carcinogens. Human exposure to these chemicals is complex and originates from both indoor and outdoor sources. This study measured the concentration of PAHs in the gaseous and particulate phases during the cold months of 2022 using XAD-2 sorbent tubes and Polytetrafluoroethylene (PTFE) filters in the indoor air of coffee shops in Zahedan, Iran (n = 23). The average concentrations of particulate-bound PAHs and gaseous PAHs were 13,411.86 ± 6517.24 ng/m³ and 6432.76 ± 4311.72 ng/m³, respectively. Source apportionment analyses indicated that the primary sources of PAHs in coffee shops were fossil fuel combustion and environmental tobacco smoke (ETS), commonly referred to as second and third-hand smoke. The lifetime cancer risk (LTCR) of inhaled PAHs was calculated using the Monte Carlo simulation method. The mean LTCR for adults and children from inhaling these substances were 9.43 × 10-6 ± 5.06 × 10-6 and 5.34 × 10-6 ± 2.87 × 10-6, respectively. The hazard quotient (HQ) of PAHs exceeded 1. These findings highlight the need to reduce PAHs exposure in public spaces through proper health warning labels and regulated indoor smoking policies.

Promising microRNAs in pre-diagnostic serum associated with lung cancer up to eight years before diagnosis: a HUNT study

IntroductionBlood biomarkers for early detection of lung cancer (LC) are in demand. There are few studies of the full microRNome in serum of asymptomatic subjects that later develop LC. Here we searched for novel microRNA biomarkers in blood from non-cancer, ever-smokers populations up to eight years before diagnosis.MethodsSerum samples from 98,737 subjects from two prospective population studies, HUNT2 and HUNT3, were considered initially. Inclusion criteria for cases were: ever-smokers; no known cancer at study entrance; 0–8 years from blood sampling to LC diagnosis. Each future LC case had one control matched to sex, age at study entrance, pack-years, smoking cessation time, and similar HUNT Lung Cancer Model risk score. A total of 240 and 72 serum samples were included in the discovery (HUNT2) and validation (HUNT3) datasets, respectively, and analysed by next-generation sequencing. The validated serum microRNAs were also tested in two pre-diagnostic plasma datasets from the prospective population studies NOWAC (n = 266) and NSHDS (n = 258). A new model adding clinical variables was also developed and validated.ResultsFifteen unique microRNAs were discovered and validated in the pre-diagnostic serum datasets when all cases were contrasted against all controls, all with AUC > 0.60. In combination as a 15-microRNAs signature, the AUC reached 0.708 (discovery) and 0.703 (validation). A non-small cell lung cancer signature of six microRNAs showed AUC 0.777 (discovery) and 0.806 (validation). Combined with clinical variables of the HUNT Lung Cancer Model (age, gender, pack-years, daily cough parts of the year, hours of indoor smoke exposure, quit time in years, number of cigarettes daily, body mass index (BMI)) the AUC reached 0.790 (discovery) and 0.833 (validation). These results could not be validated in the plasma samples.ConclusionThere were a few significantly differential expressed microRNAs in serum up to eight years before diagnosis. These promising microRNAs alone, in concert, or combined with clinical variables have the potential to serve as early diagnostic LC biomarkers. Plasma is not suitable for this analysis. Further validation in larger prospective serum datasets is needed.

Exposure to toxic chemical elements among people living with HIV/AIDS in Northern Tanzania

Environmental exposure to toxic chemicals including cadmium (Cd), lead (Pb), and mercury (Hg), are known risk factors for cardiovascular (CVD) and kidney disease. In people living with HIV (PLWH), CVD and kidney disease are the leading cause of death. Neither traditional risk factors nor markers of HIV infection fully explain such an increased risk. It is of paramount importance to establish the epidemiology of toxic chemicals exposure in PLWH, to inform screening and prevention interventions in this vulnerable population. This cross-sectional study compares toxic chemical levels (T-Cd, T-Pb, and T-Hg) among PLWH and HIV-uninfected adults in Northwestern Tanzania. A total of 495 PLWH and 505 HIV-uninfected subjects were analyzed. Spearman's rank correlations were used to examine the relationship between toxic chemical elements by HIV status. Linear regression models were used to determine the association between exposures and outcomes of interest among study participants. In both PLWH and HIV-uninfected adults, blood T-Cd, T-Pb, and T-Hg levels were frequently found at levels above the reference value of 5, 50, and 20 μg/L, respectively. Overall, factors associated with blood toxic chemical levels included vegetable servings per week, obesity, untreated water sources, use of alcohol, and HIV. Among PLWH, weekly vegetable intake provided a protective effect against T-Cd (Coeff = −0.03, 95%CI = −0.06, −0.01) and T-Pb (Coeff = −0.05, 95%CI = −0.09, −0.01) exposure among PLWH. Alcohol intake (Coeff = 0.10, 95%CI = 0.06, 0.13), obesity (Coeff = 0.08, 95%CI = 0.02, 0.13), longer duration to indoor smoke exposure (Coeff = 0.003, 95%CI = 0.001, 0.004), and HIV infection (Coeff = 0.11, 95%CI = 0.07, 0.15) were associated with increased individuals blood T-Hg levels. Individuals in northwestern Tanzania, including PLWH, have high blood levels for T-Cd, T-Pb, and T-Hg. Factors associated with higher blood levels include water sources, obesity, use of alcohol, exposure to indoor smoke, and HIV infection.

Secondhand Nicotine Absorption From E-Cigarette Vapor vs Tobacco Smoke in Children

ImportanceWith the prevalence of e-cigarette use (vaping) increasing worldwide, there are concerns about children’s exposure to secondhand vapor.ObjectiveTo compare nicotine absorption among children who are (1) exposed to secondhand tobacco smoke only or (2) exposed to secondhand vapor only with (3) those exposed to neither.Design, Setting, and ParticipantsThe US Continuous National Health and Nutrition Examination Survey (NHANES) is a repeat cross-sectional survey. Participants are interviewed in their homes and, several days after, visit a mobile examination center to provide biological specimens. This study uses data from a nationally representative sample of US households from 2017 to 2020. Participants were children aged 3 to 11 years with serum cotinine levels incompatible with current firsthand nicotine use (ie, <15 μg/L). The final analysis was conducted on January 9, 2024.ExposuresReported exposure to secondhand smoke or vapor indoors in the past 7 days (only secondhand smoke, only secondhand vapor, or neither). Covariates included age, sex, ethnicity, family income, body weight, and height.Main Outcomes and MeasuresThe primary outcome was serum cotinine concentration, an objective biomarker of nicotine absorption. Geometric mean cotinine levels and 95% CIs were calculated using log-normal tobit regression, accounting for the complex survey design and weights.ResultsThe mean (SD) age of the 1777 children surveyed was 7.4 (2.6) years, 882 (49.6%) were female, and 531 (29.9%) had family incomes below the poverty level. Nicotine absorption, as indexed by serum cotinine level, was highest among children only exposed to secondhand smoke (0.494 μg/L μg/L; 95% CI, 0.386-0.633 μg/L), followed by those exposed only to secondhand vapor (0.081 μg/L; 95% CI, 0.048-0.137 μg/L), equating to 83.6% (95% CI, 71.5%-90.5%; P < .001) lower nicotine absorption. Among children with no reported secondhand exposure, the geometric mean cotinine level was 0.016 μg/L (95% CI, 0.013-0.021 μg/L), or 96.7% (95% CI, 95.6%-97.6%; P < .001) lower than for those with exposure to secondhand smoke. Results were similar after covariate adjustment.Conclusions and RelevanceIn this cross-sectional study of US children, nicotine absorption was much lower in children who were exposed to secondhand vapor vs secondhand smoke, but higher than in those exposed to neither. These findings suggest that switching from smoking to vaping indoors may substantially reduce, but not eliminate, children’s secondhand exposure to nicotine and other noxious substances.

Association of anaemia with indoor air pollution among older Indian adult population: multilevel modelling analysis of nationally representative cross-sectional study

IntroductionAnaemia is a disease of public health importance with multi-causal pathways. Previous literature suggests the role of indoor air pollution (IAP) on haemoglobin levels, but this has been studied less due to logistic constraints. A high proportion of the population in developing countries, including India, still depends on unclean fuel, which exacerbates IAP. The objective was to study the association between anaemia and IAP among the older Indian adult population (≥ 45 years) as per gender.MethodsOur study analysed the nationally representative dataset of the Longitudinal Ageing Study in India (LASI 2017–18, Wave-1). We have documented the association of anaemia (outcome variable) with IAP (explanatory variable). To reduce the confounding effects of demographic and socioeconomic; health related and behavioural covariates; propensity score matching (PSM) was conducted. Nested multilevel regression modelling was conducted. States and union territories were categorised cross tabulated as low, middle and high as per anaemia and IAP exposure. P value < 0.05 was considered statistically significant. SATA version 17 was used for analysis.ResultsMore than half (52.52%) of the participants were exposed to IAP (male (53.55%) > female (51.63%)). The odds of having anaemia was significantly 1.19 times higher (AOR 1.19 (1.09–1.31)) among participants using unclean/ solid fuel. The adjusted odds were significantly higher among participants exposed to pollution-generating sources (AOR 1.30; 1.18–1.43), and household indoor smoking (AOR 1.17 (1.07–1.29). The odds of having anaemia were significantly higher (AOR 1.26; 1.15–1.38) among participants exposed to IAP, which was higher in males (AOR 1.36; 1.15–1.61) than females (AOR 1.21; 1.08–1.35). Empowered Action Group (EAG) states like Uttar Pradesh, Chhattisgarh, Madhya Pradesh, Bihar had both high anaemia and IAP exposure.ConclusionThis study established the positive association of anaemia with indoor air pollution among older Indian adults through a nationally representative large dataset. The association was higher among men. Further research is recommended to understand detailed causation and to establish temporality. It is a high time to implement positive intervention nationally to decrease solid/ unclean fuel usage, vulnerable ventilation, indoor smoking, IAP and health hazards associated with these with more focused actions towards EAG states.

Coverage of Indoor Smoking and Vaping Restrictions in the U.S., 1990–2021

Secondhand smoke exposure increases the risk of premature death and disease in children and non-smoking adults. As a result, many US states and local jurisdictions have enacted comprehensive indoor smoking restrictions (ISR). Indoor vaping restrictions (IVR) have also been adopted to protect against exposure to secondhand e-cigarette aerosol. This study aimed to quantify state and national US coverage of policies restricting indoor cigarette and e-cigarette use over time. Data from the American Nonsmokers Rights' Foundation on US ISR from 1990 to 2021 and IVR from 2006 to 2021 were analyzed. Combining these data with 2015 US Census population estimates, the percentage of state and national residents covered by partial and comprehensive restrictions in bars, restaurants, and workplaces, were calculated (analysis in 2023-2024) over time. Between 1990-2021, national coverage of comprehensive ISR increased for bars (0% to 67.3%), restaurants (0% to 78.2%), and workplaces (0% to 77.5%). Partial ISR coverage decreased for bars (14.8% to 13.9%), restaurants (40.2% to 15.4%) and workplaces (40.2% to 22.5%). From 2006 to 2021, comprehensive IVR coverage increased for bars (0% to 43.5%), restaurants (0% to 51.5%), and workplaces (0% to 53.2%). Despite these increases in coverage, by the end of 2021, <50% of the population was protected by comprehensive ISR for bars, restaurants, and workplaces in 19, 12, and 14 states, respectively. The percentage of the US population protected by ISR and IVR has increased over time. However, gaps in coverage remain, which may contribute to disparities in tobacco-related disease and death.

Development of the “Digihet” Multimedia Education Program to Improve Health Quality in the Setara Community Group

The digital divide and low health quality are challenges faced by the Setara South Sempaja community group. The impact of flooding is a health problem frequently experienced by this community group. The Technology and Health Education Program (Digihet) is designed to address this issue by providing education on the use of digital technology and clean and healthy living patterns to vulnerable groups affected by health problems. This study aims to develop and evaluate the effectiveness of the Digihet program in improving digital literacy, specifically in clean and healthy living patterns, and the quality of life of the community. The Digihet program is developed using multimedia development techniques, starting from the concept design stage to distribution. The Digihet program teaches about 10 clean and healthy living skills for households, including childbirth assisted by healthcare professionals, exclusive breastfeeding for babies, weighing babies and toddlers, using clean water, washing hands with clean water and soap, using healthy latrines, eradicating mosquito larvae at home, eating fruits and vegetables every day, engaging in physical activity every day, and not smoking indoors. Data were collected through beta testing, and the research results showed that the Digihet program is effective in increasing digital literacy in forming clean and healthy living patterns. The results of this study are expected to serve as a basis for developing multimedia health education programs and contribute to enhancing the understanding of the relationship between digital literacy, public health, and information technology in the context of household health quality.

IMPACTS OF TOBACCO USE AND EXPOSURE TO TOBACCO SMOKE ON HEALTH, SOCIETY, ECONOMY, AND ENVIRONMENT

Smoking represents a significant global public health challenge and is the primary preventable cause of disease and death. This problem is accentuated by the fact that a substantial 80% of adult smokers worldwide come from low- or middle-income countries. The aim of this paper is twofold: first, to highlight the health impacts associated with tobacco use, and second, to delineate the indirect damage caused to the environment during the life cycle of tobacco products - from production and distribution to consumption and waste generation. The reluctance of some countries to take decisive action, together with intense pressure from tobacco corporations, is hindering progress towards reducing the number of adult smokers and curbing tobacco use among minors. State interventions, supported by strict laws, are necessary to enforce the ban on indoor smoking, the ban on the sale of tobacco to minors, and the establishment of permanent interstate cooperation in the fight against cigarette smuggling. Educational initiatives aimed at raising awareness of the dangers of smoking and tobacco consumption are key to fostering a smoke-free culture. A strong media campaign, supported by state measures, could contribute to faster and more comprehensive targeting of target groups, especially younger age categories.

Early and late onset childhood eczema: Role of preconceptional, pre-natal and post-natal environmental exposures

BackgroundDespite mounting evidence linking indoor and outdoor environments to eczema, the role of indoor and outdoor environmental pollutant(s) exposure during critical time window(s) on eczema remains unknown. ObjectiveTo investigate the correlations between childhood eczema and itchy rashes and exposure to outdoor air pollution and the home environment. MethodsA combined cross-sectional and retrospective cohort study of 8689 kindergarten students was conducted. We collected information about each child's health outcomes and home environment, as well as calculated individual exposure to air pollutants. Multiple logistic regression models were used to investigate the links between indoor and outdoor environments and childhood eczema and itchy rashes. ResultsChildhood ever doctor-diagnosed eczema (DDE) was linked to NO2, CO, PM2.5, PM2.5-10 and PM10 exposure during the preconceptional, pregnant, and postnatal periods, with ORs (95 % CI) ranging from 1.06 (1.00–1.13) to 1.21 (1.08–1.37). Ever doctor-diagnosed itchy rash (DDIR) was associated with SO2, CO, PM2.5, PM2.5-10 and PM10 exposure during preconceptional and postnatal periods, with ORs (95 % CI) ranging from 1.11 (1.02–1.20) to 1.31 (1.13–1.52). Preconceptional outdoor air pollution was associated with a higher risk of ever, early, and late DDE and DDIR. Indoor smoke, renovation, and dampness were all associated with DDE and DDIR. Postnatal exposure to plants has been linked to both ever and early DDE. There was no link between indoor environments and late DDE. Furthermore, pregnancy has been identified as a critical indoor exposure time window for DDE and DDIR. ConclusionsEarly-life exposure to outdoor air pollutants and indoor environments, particularly before birth, played important roles in childhood eczema.

Measuring and modeling of residential black carbon concentrations in two megacities, China

Indoor exposure to black carbon (BC) may differ greatly from ambient concentrations measured at stationary monitoring stations. This study characterized the variation between measured indoor and outdoor levels of BC and developed models to predict BC exposures within residences. Indoor and outdoor PM2.5 filter samples were collected for five consecutive days from 66 residences in Beijing (BJ) and Nanjing (NJ), China, across two seasons. City-specific indoor BC models were developed using liner mixed effect models and assessed by R2 and root mean square error (RMSE). The mean (SD) of indoor BC concentrations in BJ and NJ were 3.0 μg/m3 (0.6 μg/m3) and 3.2 μg/m3 (0.5 μg/m3), respectively. Both the indoor and outdoor BC concentrations were significantly higher during heating season than non-heating season. In general, indoor levels of BC were strongly associated with outdoor measurements (BJ: rs = 0.74, p < 0.001; NJ: rs = 0.76, p < 0.001), but were often lower. The critical determinants influencing indoor BC exposures varied by city, including outdoor BC concentration, window opening time, presence of indoor smoking, and the volume of the room where the indoor monitor was placed. The final models accounted for 66.4%–86.5 % (RMSE: 0.070–0.106) of the variance in residential-indoor BC exposures. By incorporating the key BC exposure determinants identified here, this modelling approach can improve the estimates of BC exposure and better link BC exposure to health risk assessment.

Are People More Likely to Vape or Smoke Indoors? A Population Survey of Adults in England.

Increasingly, people smoke cigarettes outdoors and avoid exposing bystanders to harm. People may not have the same motivation to vape outdoors since e-cigarettes, unlike cigarettes, do not create side stream emissions and exhaled aerosol contains fewer toxicants than secondhand smoke. This study aims to estimate the prevalence and correlates of vaping and smoking indoors among adults in England. Data came from the Health Survey for England 2019, a cross-sectional household survey. Adults who vape or smoke (N = 1530) were asked whether they had vaped or smoked indoors inside the home, car, or other places within the past 7 days. Logistic regression was used to estimate prevalence and key correlates of indoor use, including age, sex, presence of adults/children in home, housing tenure, and nicotine dependence. People who exclusively vaped were much more likely to use their product indoors than those who exclusively smoked (87.0% vs. 52.0%; odds ratio [OR] = 6.16, 95% confidence interval [CI] = 4.09 to 9.28). Similarly, people who dual used had higher odds of vaping than smoking indoors (62.1% vs. 44.3%; OR = 3.76, 95% CI = 2.06 to 6.84). The preference for vaping over smoking indoors was found across different locations, including at home and in cars. Those who were older, highly dependent on nicotine, and lived alone were most prone to use any product indoors. While housing tenure was not strongly associated with vaping indoors, those living in social housing were much more likely to smoke indoors than homeowners. Adults in England are much more likely to vape than smoke indoors. Age, nicotine dependence, and living alone are strongly associated with both behaviors. Our results show that people have a strong preference for vaping over smoking indoors, including in the home. Given the high prevalence of vaping indoors, policy makers, landlords, and businesses must weigh up the ethics, benefits, and harms of extending smoke-free laws to include e-cigarettes.