Indoor Smoking Research Articles

Prevalence of Asthma and Its Associating Environmental Factors among 6-12-Year-Old Schoolchildren in a Metropolitan Environment-A Cross-Sectional, Questionnaire-Based Study.

We aimed to evaluate the prevalence of asthma and its associating environmental factors within a 6–12-year-old population. A cross-sectional, questionnaire-based study was conducted in primary schools located in the capital of Hungary; 3836 eligible parent-reported questionnaires were evaluated. Besides the International Study of Asthma and Allergies in Childhood (ISAAC) phase three core questions for asthma, the survey also assessed various potential risk factors. We introduced the umbrella term cumulative asthma as the union of physician-diagnosed asthma and current wheezing to estimate the lifetime prevalence of asthma. Current wheezing and physician-diagnosed asthma showed a frequency of 9.5% and 6.3%, respectively. They contributed to a cumulative asthma prevalence of 12.6% among the sampled population, with a girl-boy percentage of 37.4% to 62.6%. Air-pollution and weedy areas were associated with greater risk for asthma, while a suburban residence showed lesser odds. Indoor smoking, visible mold, and keeping a dog were defined as risk factors for asthma, while the presence of plants in the bedroom and pet rodents were associated with lower odds ratios. The consumption of fast food, beverages containing additives and margarine were significantly higher in asthmatics, while we found frequent sport activity and cereal intake associated with lower odds ratios for asthma. In this urban environment, we identified an increased asthma prevalence compared to some previously published studies, but the cross-sectional design and the different methodology did not permit us to draw timeframe-dependent conclusions.

Social Predictors of Continued and Indoor Smoking Among Partners of Non-smoking Pregnant Women: The TMM BirThree Cohort Study.

BackgroundSecondhand smoke (SHS) from partners is a major source of exposure for non-smoking women. However, epidemiological studies have rarely examined social factors associated with continued and indoor smoking among pregnant women’s partners.MethodsWe analyzed data on 6,091 partners of non-smoking pregnant women in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Partners’ age, education, income, workplace SHS exposure (almost never or sometimes, almost every day), and pregnant women’s smoking history (never, quit before pregnancy awareness, quit after pregnancy awareness) were used as social factors. Multiple logistic regression analyses were conducted to examine the associations of social factors with partners’ continued smoking and indoor smoking.ResultsAmong 2,432 smoking partners, 2,237 continued to smoke after pregnancy awareness. Workplace SHS exposure was associated with increased risk of partners’ continued smoking: the odds ratio of workplace SHS exposure almost every day compared with almost never or sometimes was 2.08 (95% confidence interval, 1.52–2.83). Women’s quitting smoking after—but not before—pregnancy awareness was associated with decreased risk of partners’ continued smoking: the odds ratio of women’s quitting after pregnancy awareness compared with never smoking was 0.57 (95% confidence interval, 0.40–0.80). About one-third of partners who continued to smoke did so indoors. Older age, lower education, workplace SHS exposure, and women’s quitting smoking after pregnancy awareness were associated with increased risk of partners’ indoor smoking.ConclusionsWorkplace SHS exposure and pregnant women’s smoking history were associated with continued smoking and indoor smoking among partners of non-smoking pregnant women.

Indoor sources strongly contribute to exposure of Chinese urban residents to PM2.5 and NO2

Ambient fine particulate matter (diameters <2.5 µm; PM2.5) and nitrogen dioxide (NO2) pollution are responsible for substantial health burdens in China, contributing to a considerable proportion of global mortality. Simultaneously, the proportion of indoor smoking and cooking-induced PM2.5 and NO2 pollution lacks robust exposure assessment findings. Rapid poverty alleviation and urbanization affect the proportion of indoor vs outdoor sources of PM2.5 and NO2 exposures in China. The current understanding of air pollution and health lacks an understanding of source-specific air pollution exposure. Thus, we developed a model to estimate human exposure to pollutants originating indoors and outdoors. We found indoor sources strongly contribute to total PM2.5 and NO2 exposure in urban China and are comparable to outdoor sources. Cooking contributes 28.6 μg m−3 PM2.5 and 10.8 μg m−3 NO2 on average to the air people breathe, and so did smoking contributing 14.2 μg m−3 PM2.5 and 0.6 μg m−3 NO2, respectively. The results give us a clearer understanding of exposure to PM2.5 and NO2 from indoor and outdoor sources. Pollutant control policies on ambient exposure levels without addressing indoor air pollution in China are insufficient given our estimated exposure levels.

Formation of cluster mode particles (1–3 nm) in preschools

This study is the first study that reports the cluster particle (1–3 nm) formation (CPF) in two modern preschools located in Nur-Sultan city of Kazakhstan from October 28 to November 27, 2019. The average particle number concentration and mode diameter values during major CPF events in Preschool I and Preschool II were found to be 1.90 × 106 (SD 6.43 × 106) particles/cm3 and 1.60 (SD 0.85) nm, and 1.11 × 109 (SD 5.46 × 109) particles/cm3 and 2.16 (SD 1.47) nm, respectively. The ultraviolet PM concentration reached as high as 7 μg/m3 in one of the measurement days. The estimated emission rate in Preschool I for CPF events was 9.57 × 109 (SD 1.92 × 109) particles/min. For Preschool II, the emission rate was 7.25 × 109 (SD 12.4 × 109) particles/min. We identified primary cluster particles (CPs) emitted directly from the sources such as candle burning, and secondary CPs formed as a result of the oxidation of indoor VOCs or smoking VOCs. The secondary CPs are likely to be SOA. Indoor VOCs were mainly emitted during cleaning activities as well as during painting and gluing. Indoor VOCs are the controlling factors in the CPF events. Changes in the training and cleaning programs may result in significant reductions in the exposure of the children to CPs.

Lung Health in the Solomon Islands: A Mixed Methods Study.

Background and ObjectivesDespite a population of 600,000 people from 900 islands, there is little published data on the prevalence of lung disease in the Solomon Islands. We sought to 1) estimate the prevalence of obstructive lung disease (OLD) in Gizo, Solomon Islands, 2) identify risk factors for respiratory disease in this population and 3) review current management practices for respiratory disease through an audit of local emergency department (ED) presentations.MethodsA two-part mixed methods study was performed between March and May 2019; the first was a population-based, cross-sectional study conducted in Gizo, Solomon Islands, with a random sample undergoing questionnaires and spirometry. The second was an audit of Gizo Hospital ED records to assess presentation numbers, diagnoses and outcomes.ResultsA total of 104 patients were randomly selected for spirometry. The mean age was 46.9 years. Current smoking rates were high (24.0% overall, 43.3% age < 40, 16.2% age ≥ 40) as was regular (>10h/week) exposure to indoor/enclosed wood fire ovens (51.5%). The prevalence of COPD was 3.2% overall. A further 9.7% of participants demonstrated significant bronchodilator responsiveness suggestive of possible asthma. Most patients seen in ED presented with a respiratory condition or fever/viral illness, but spirometry was not available. Only four outpatients were prescribed salbutamol and two patients inhaled corticosteroid.ConclusionThere appears to be a high burden of obstructive lung disease in the Solomon Islands with high smoking rates, indoor smoke exposure and bronchodilator responsiveness. Respiratory symptoms are common amongst hospital ED presentations; however, inhaled asthma treatments are infrequently prescribed to outpatients.

Household Air Pollution and Respiratory Health in Rural Crete, Greece: A Cross-Sectional FRESH AIR Study

Breathing polluted air is a risk to respiratory conditions. During the Greek financial crisis, the use of household fireplaces/wood stoves shifted from mostly decorative to actual domestic heating, resulting in increased indoor smoke production. We aimed to evaluate household air pollution (HAP), fuel use and respiratory symptoms in rural Crete, Greece. PM2.5 and CO were measured in 32 purposively selected rural households (cross-sectional study) at periods reflecting lesser (baseline) versus extensive (follow-up) heating. Clinical outcomes were assessed using questionnaires. Mean PM2.5 were not significantly different between measurements (36.34 µg/m3 vs. 54.38 µg/m3, p = 0.60) but exceeded the WHO air quality guidelines. Mean and maximal CO levels were below the WHO cut-offs (0.56 ppm vs. 0.34 ppm, p = 0.414 and 26.1 ppm vs. 9.72 ppm, p = 0.007, respectively). In total, 90.6% of households were using wood stoves or fireplaces for heating, but half also owned clean fuel devices. The differences between devices that were owned versus those that were used were attributed to financial reasons. In both cases, the most frequent respiratory symptoms were phlegm (27.3% vs. 15.2%; p = 0.34) and cough (24.2% vs. 12.1%; p = 0.22). Our findings demonstrate the magnitude of HAP and confirm the return to harmful practices during Greece’s austerity. Upon validation, these results can support strategies for fighting fuel poverty, empowering communities and strengthening local health systems.

Research and Design of Distributed Fire Alarm System of Indoor Internet of Things Based on LoRa

In order to comprehensively improve the sensitivity of fire warning and effectively shorten the warning time, this paper proposes and implements an indoor distributed fire alarm system based on low power wide area network. The system is mainly composed of three parts: a multisensor acquisition node based on LoRa technology, a distributed edge gateway, and a remote user monitoring system. The multisensor collection node obtains environmental parameters such as indoor temperature, smoke concentration, and air quality and then transmits the sensing data to edge gateway by LoRa after preprocessing. The edge gateway is based on an embedded Linux platform and is deployed in distributed state to collect and store data from multiple collection nodes. Besides, edge gateway forwards valid data to the remote user monitoring system by standard MQTT protocol. The user monitoring system displays current deployment area parameters to users in real time and provides early warning prompts based on relevant preset indicators to help the administrator make more accurate decisions on corresponding measures. The system has been deployed and tested in Nanjing Institute of Technology. By sensor calibration experiments, LoRa communication experiments, and system tests in different environments, the experimental results show that the average received signal strength in a small interference space is -104.12 dBm, and the average received signal strength in a noisy signal environment is -57.5 dBm. By setting the optimal transmitting power for each distance, the packet receiving rate can reach more than 95%, and the alarm accuracy can reach 100% under premise of ensuring the lowest power consumption. Finally, this paper conducts a comprehensive performance analysis on the wireless communication performance of environmental collection nodes, multisensor data fusion algorithm, distributed LoRa edge gateway deployment performance, and remote system early warning accuracy.

Current status and intention to change indoor smoking rules by enforcing smoke-free legislation in Japan

Objective In Japan, the revised Health Promotion Act and the Tokyo Metropolitan Ordinance to Prevent Exposure to Second-hand Smoke have been in place since April 1, 2020. However, regional differences in the prohibition of smoking in restaurants have raised concerns that some restaurants are not regulated by the smoke-free legislation. In addition, outdoor smoking rules have been in place in municipalities prior to the smoke-free legislation, so smoking outside restaurants may occur, and this may obstruct progress in the prohibition of smoking. In this study, we examined the indoor smoking rules before and after the enforcement of the smoke-free legislation, as well as what influenced the changes in these rules.Methods We conducted a self-administered questionnaire survey in 6,000 restaurants in Tokyo, Osaka, and Aomori prefectures from February to March 2020. We examined the indoor smoking rules before and after the enforcement of the smoke-free legislation and calculated the proportion of change by categorizing the indoor smoking rules into "smoking prohibited," "smoking permitted in separate area," and "smoking permitted."Results Of the 879 restaurants that responded, 603 indicated that they were not regulated by the smoke-free legislations. The percentage of restaurants that switched from "smoking permitted in separate area" and "smoking permitted" to "smoking prohibited" was 5.2% (3/58) in Tokyo, 23.1% (31/134) in Osaka, and 17.2% (57/326) in Aomori. In addition, when we included restaurants that were already "smoking prohibited" before the enforcement and did not plan to change the rules after the enforcement, the percentage was 46.6% (55/118) in Tokyo, 49.6% (113/228) in Osaka, and 48.6% (125/257) in Aomori.Conclusion In total, 17.6% (91/518) of the restaurants that were not regulated by the smoke-free legislations would plan to change their indoor smoking rules from "smoking permitted in separate area" and "smoking permitted" to "smoking prohibited." There is a concern regarding the reduction in customers and sales due to the prohibition of smoking, and the existence of outdoor smoking rules prior to the smoke-free legislation may obstruct progress in the prohibition of smoking. It will be important to examine changes in the number of customers and sales resulting from changes to the indoor smoking rules to deal with smokers when smoking is prohibited, and to improve environments set as public smoking spaces in Japan.

A Qualitative Study of Unfairness and Distrust in Smoke-free Housing.

Objectives: Whereas smoke-free housing (SFH) has the potential to protect residents from tobacco smoke, evidence suggests that SFH could lead to increased indoor smoking. In this study, we examine how perceptions of a residential smoking ban could be related to non-compliance. Methods: We conducted 8 focus group interviews of low-income housing residents living in Norfolk, Virginia (N=53). Interviews were semi-structured and based on a list of guided questions related to SFH compliance, developed in partnership with a standing community advisory board comprised of low-income housing residents. Results: Several themes emerged, including pervasive non-compliance, perceived unfairness and shame, barriers to compliance, and distrust of the housing authority. Smokers reported behavior primarily motivated by punishment avoidance, rather than out of any perceived obligation to comply with the ban. Conclusions: Results led us to consider Procedural Justice Theory as a conceptual framework, in which compliance is directly related to perceptions about the legitimacy of a rule or authority. When compliance is low due to a lack of perceived legitimacy, SFH should be adapted to promote changes in smoking behavior. We offer specific theory-supported adaptations to SFH focused on trust-building and improving perceived fairness.

Assessing BTEX concentrations emitted by hookah smoke in indoor air of residential buildings: health risk assessment for children

Hookah smoke is one of the major indoor sources of Volatile Organic Compounds (VOCs), including Benzene, Toluene, Ethylbenzene, and Xylenes (BTEX). The present study aimed to investigate potential exposure to BTEX compounds among primary school children whose parents smoked hookah at home. BTEX concentrations in indoor air were measured in 60 residential buildings of Khesht, southwestern Iran (case = 30 and control = 30). Target compounds were sampled by charcoal tubes, and the samples were then analyzed by GC-FID. Monte Carlo simulation was used to assess the carcinogenic and non-carcinogenic risks of BTX exposure for the children aged 7-13years. The concentrations of benzene (7.19 ± 3.09 vs. 0.82 ± 0.5μg/m3), toluene (1.62 ± 0.69 vs. 0.3 ± 0.22μg/m3), and xylenes (2.9 ± 1.66 vs. 0.31 ± 0.22μg/m3) were considerably higher in the indoor air of the case houses compared with the control houses (p < 0.05). The Incremental Lifetime Cancer Risk (ILCR) of benzene for non-smoking and smoking houses were estimated 1.8 × 10-6 and 15 × 10-6, respectively, exceeding the recommendations of the World Health Organization (WHO) and the Environmental Protection Agency (EPA) (1 × 10-6). Moreover, Hazard Quotients (HQs) of all BTX compounds were < 1. The indoor benzene concentration was significantly influenced by the floor at which families lived and type of the kitchen. In order to prevent children's exposure to BTX emitted by hookah, banning indoor smoking is the only way to eliminate these compounds in the indoor air.

662Factors associated with smoking continuation and indoor smoking among pregnant women’s partners

Abstract Background Secondhand smoke by partners is a major source of exposure for non-smoking women. However, factors associated with smoking continuation and indoor smoking among pregnant women’s partners remain unknown. Methods We used data from 6348 partners of non-smoking pregnant women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan from 2013 to 2017. Partners’ age, educational attainment, equivalent household income, and pregnant women’s smoking history (never, quitting before pregnancy awareness, quitting after pregnancy awareness) were used as explanatory variables. Multivariate logistic regression analyses were conducted to examine the associations between these variables and smoking continuation/indoor smoking of partners. Results Among 6348 partners, 2506 partners had been smokers at pregnancy awareness. Among them, the prevalence of smoking continuation after pregnancy awareness was 92.0%. Partners whose wives had quitted smoking after pregnancy awareness were less likely to continue smoking than partners whose wives had never smoked; the odds ratio was 0.57 (95% confidence interval, 0.41–0.80). Among partners who continued smoking, the prevalence of indoor smoking was 30.7%. Partners with ≤high school education were more likely to smoke indoors than partners with ≥university education; the odds ratio was 1.60 (95% confidence interval, 1.23–2.07). Conclusions Women’s smoking cessation after pregnancy awareness was associated with decreased risk of partners’ smoking continuation, and lower level of partners’ education was associated with increased risk of partners’ indoor smoking. Key messages Interventions for both women and their partners may be effective in reducing secondhand smoke exposure during pregnancy.

Tobacco control policies and smoking cessation treatment utilization: A moderated mediation analysis.

BackgroundTobacco policies, including clean indoor air laws and cigarette taxes, increase smoking cessation in part by stimulating the use of cessation treatments. We explored whether the associations between tobacco policies and treatment use varies across sociodemographic groups.MethodsWe used data from 62,165 U.S. adult participants in the 2003 and 2010/11 Tobacco Use Supplement to the Current Population Survey (TUS-CPS) who reported smoking cigarettes during the past-year. We built on prior structural equation models used to quantify the degree to which smoking cessation treatment use (prescription medications, nicotine replacement therapy, counseling/support groups, quitlines, and internet resources) mediated the association between clean indoor air laws, cigarette excise taxes, and recent smoking cessation. In the current study, we added selected moderators to each model to investigate whether associations between tobacco polices and smoking cessation treatment use varied by sex, race/ethnicity, education, income, and health insurance status.ResultsAssociations between clean indoor air laws and the use of prescription medication and nicotine replacement therapies varied significantly between racial/ethnic, age, and education groups in 2003. However, none of these moderation effects remained significant in 2010/11. Higher cigarette excise taxes in 2010/2011 were associated with higher odds of using counseling among older adults and higher odds of using prescription medications among younger adults. No other moderator reached statistical significance. Smoking cessation treatments did not mediate the effect of taxes on smoking cessation in 2003 and were not included in these analyses.ConclusionsSociodemographic differences in associations between clean indoor air laws and smoking cessation treatment use have decreased from 2003 to 2010/11. In most cases, policies appear to stimulate smoking cessation treatment use similarly across varied sociodemographic groups.

PM2.5 exposure close to marijuana smoking and vaping: A case study in residential indoor and outdoor settings

We conducted 35 experiments for spatial measurement of marijuana aerosols in a current smoker's residential spaces. Fine particulate matter (PM2.5) concentrations were measured every second at 1, 2, and 3 m horizontal distances from the smoker who performed prescribed 5-min smoking and vaping activities. In each experiment, five SidePak monitors measured PM2.5 concentrations at five different angles facing the front of the smoker, representing the worst-case exposures. We studied the effect of distance from the smoker for two marijuana sources – smoking a marijuana cigarette, or joint, and vaping a liquid-cartridge vaping pen. Experiments were conducted in the family room indoors and in the backyard outdoors where the smoker normally consumes marijuana. Indoor marijuana vaping had higher average exposures (5-min PM2.5) at 1 m distance than indoor marijuana smoking, but the levels from indoor vaping decreased more rapidly with distance (e.g., 77% reduction for vaping versus 33% for smoking from 1 to 2 m). Smoking and vaping in the outdoor environment reduce the average exposures down to <5% of the indoor levels at each distance. Cumulative frequency distributions of the 1-s PM2.5 concentrations revealed the frequencies of exceeding any selected transient peak exposure limit at a given distance. The frequency of exceedance decreased more quickly with distance for vaping than for smoking. Smoking and vaping outdoors made the transient peak exposures close to the source much less frequent than smoking and vaping indoors (e.g., <1% exceeded 1000 μg/m3 outdoors versus >20% indoors at 1 m). Plotting the frequency of exceedance versus distance could offer additional guidance for a recommended minimum distance from a marijuana source.

Opportunities and challenges in studying air pollution and pregnancy loss

BACKGROUND AND AIM: Pregnancy loss is common (spontaneous abortion/miscarriage: 30%, stillbirth: 1%) but its cause is largely unknown. Air pollution has a wide range of reproductive health effects but its effects on pregnancy loss is unclear. We summarize current epidemiologic research and highlight key challenges and opportunities for future research on this important but understudied topic. METHODS: A comprehensive literature review of original epidemiologic studies (before March 2021) on ambient air pollutants and pregnancy loss at all gestational age (i.e., miscarriage, spontaneous abortion, stillbirth) was performed. We excluded studies that a) did not focus on specific outdoor pollutants (i.e., indoor smoke) or b) assessed occupational exposures. RESULTS:Thirty-five (n=35) epidemiologic studies were identified, most of which were conducted in the US (35%), China (17%), and Iran (11%); and estimated air pollution exposures using fixed air stations near maternal residence (66%). The majority of the studies evaluated stillbirths ≥20 weeks (n=19). Pollutants including SO2, PM10, and PM2.5, CO, NO2, and O3 are positively associated with both spontaneous abortion/miscarriage and stillbirth. Critical windows of exposure are unclear but both acute (prior week) and chronic exposures (average over the gestational length and trimester specific) have been suggested. Major challenges include a) lack of personal exposure or data on residential mobility/daily activities, b) exclusion of early losses in retrospective data, c) small clinical samples seeking infertility treatment, d) inconsistent definition of the outcome, e) lack of information on time of event, and f) confounding. CONCLUSIONS:There is growing evidence suggesting that exposures to ambient air pollution, even in areas with moderate concentrations, may increase the risk of pregnancy loss. While awaiting larger preconception studies to address current challenges and further understand mechanisms of effects, it is prudent to minimize exposures among pregnant women and those trying to conceive. KEYWORDS: air pollution, pregnancy loss, pregnancy outcomes, stillbirth, spontaneous abortion

Critical windows of perinatal particulate matter (PM2.5) exposure and preadolescent kidney function

BACKGROUND AND AIM: Air pollution exposure, especially particulate matter ≤ 2.5 μm in diameter (PM2.5), is associated with poorer kidney function in adults and children. Perinatal exposure may occur during susceptible periods of nephron development. We aimed to examine perinatal windows of susceptibility to PM2.5 exposure on preadolescent kidney function parameters and blood pressure (BP). METHODS: We used distributed lag nonlinear models (DLNMs) to examine time-varying associations between early life daily PM2.5 exposure (periconceptional through 1 year of life) and kidney parameters as well as BP in preadolescent children aged 8 to 9 years. Participants included 427 mother-child dyads enrolled in the PROGRESS birth cohort study based in Mexico City. Daily PM2.5 exposure was estimated at each participant’s residence using a validated satellite-based spatio-temporal model. Kidney function parameters included estimated glomerular filtration rate (eGFR), serum cystatin C, blood urea nitrogen (BUN), and BP. Models were adjusted for child’s age, sex and body mass index (BMI) z-score, as well as maternal education, indoor smoking report, seasonality and average first year of life PM2.5 exposure. RESULTS:Average perinatal PM2.5 was 22.7 µg/m3 and ranged 16.4-29.3 µg/m3. Early pregnancy PM2.5 exposures were associated with hyperfiltration in preadolescence. Specifically, we found that PM2.5 exposure between weeks 1 to 18 of gestation was associated with increased preadolescent eGFR. A constant 5 µg/m3 increase in PM2.5 sustained throughout this window would predict a cumulative increase in eGFR of 4.44 mL/min (95%CI: 1.37, 7.52). Additionally, late pregnancy levels of PM2.5 were associated with elevated BUN. In a stratified analysis, an association between PM2.5 and higher systolic BP was evident among boys but not girls. CONCLUSIONS:We identified perinatal windows of susceptibility to PM2.5 exposure with preadolescent kidney function parameters. Follow-up investigating PM2.5 exposure with peripubertal kidney function trajectories and risk of kidney disease in adulthood will be critical. KEYWORDS: particulate matter, kidney function, Cardiovascular diseases, Children's environmental health, environmental epidemiology,

Emerging Indoor Air Laws for Onsite Cannabis Consumption Businesses in the U.S.

Secondhand cannabis smoke, like secondhand tobacco smoke, creates unhealthy indoor air quality. Ventilation and engineering techniques cannot reduce this pollution to healthy levels, and complete smoke-free policies are the only way to provide healthy indoor environments. Even so, multiple state and local governments have begun to allow indoor smoking of cannabis in businesses. A systematic search of Lexis Advance, NewsBank, and government websites for U.S. state and local laws passed between November 6, 2012 and June 10, 2020 that permit and regulate onsite cannabis consumption businesses was conducted in February-July 2020. In total, 6 of 11 states and the District of Columbia that legalized adult-use cannabis as of June 10, 2020 allowed onsite consumption and ≥56 localities within these 6 states allowed onsite cannabis consumption. Only 9% (5/56) of localities ban indoor smoking in these businesses; 23% (13/56) require indoor smoking to occur in physically isolated rooms. Other common local legal requirements address onsite odor control, ventilation/filtration, and building location. The majority of the localities that allow onsite cannabis consumption do not explicitly prohibit smoking or vaping inside. Policymakers should be made aware that ventilation and other engineering interventions cannot fully protect workers and patrons. Health authorities and local leaders should educate policymakers on the science of secondhand smoke remediation and advocate for the same standards for secondhand cannabis smoking and vaping that apply to tobacco, particularly because other modes of cannabis administration do not pollute the air.

Research on Hengqin Model of Ecological Protection and Enterprise Compliance Development in Tobacco Control Cities

Objectives: Analyze the situation of tobacco control in Chinese cities and the development of Hengqin enterprises and the implementation of national tobacco control policies, to provide the theoretical reference for tobacco control, ecological protection and enterprise compliance development in Hengqin city. Methods: Make statistics on the tobacco control policies and the effects of Chinese cities, and analyze the behavioral role of enterprises in the ecological construction of tobacco control cities. Results: Although most cities support indoor smoking prohibition in various public places, the awareness rate of smoking prohibition regulations in public places is low. Relevant departments need to take more targeted publicity and education measures to increase the awareness rate and implementation effect of tobacco control policies and regulations, which is not only conducive to the ecological environment protection of tobacco control cities, but also conducive to the compliance development of enterprises. Conclusion: It is necessary that the healthy development of ecological protection in Chinese cities be combined with tobacco control policies, laws and regulations; Enterprises shall play an important guiding role, with the full participation of stakeholders at the planning level, to optimize the design of tobacco control policies; The implementation level shall strengthen the protection of minors and play the role of various policy tools.

Surveillance of the Incidence and Mortality of Oral and Pharyngeal, Esophageal, and Lung Cancer in Nevada: Potential Implications of the Nevada Indoor Clean Air Act.

Reviews of national and state-specific cancer registries have revealed differences in rates of oral, esophageal, and lung cancer incidence and mortality that have implications for public health research and policy. Many significant associations between these types of cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans—including the Nevada Clean Indoor Air Act (NCIAA) of 2006 (and subsequent modification in 2011). Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of oral and pharyngeal, esophageal, and lung cancer incidence and mortality in Nevada. Methods: Cancer incidence and mortality rate data were obtained from the National Cancer Institute (NCI) Division of Cancer Control and Population Sciences (DCCPS) Surveillance, Epidemiology and End Results (SEER) program. Most recently available rate changes in cancer incidence and mortality for Nevada included the years 2012–2016 and are age-adjusted to the year 2000 standard US population. This analysis revealed that the overall rates of incidence and mortality from these types of cancer in Nevada differs from that observed in the overall US population. For example, although the incidence rate of oral cancer is decreasing in the US overall (0.9%), it is stable in Nevada (0.0%). However, the incidence and mortality rates from esophageal cancer are also decreasing in the US (−1.1%, −1.2%, respectively), and are declining more rapidly in Nevada (−1.5%, −1.9%, respectively). Similarly, the incidence and mortality rates from lung are cancer are declining in the US (−2.5%, −2.4%, respectively) and are also declining more rapidly in Nevada (−3.2%, −3.1%, respectively). Analysis of previous epidemiologic data from Nevada (1999–2003) revealed the highest annual percent change (APC) in oral cancer incidence in the US was observed in Nevada (+4.6%), which corresponded with the highest APC in oral cancer mortality (+4.6%). Subsequent studies regarding reduced rates of cigarette use due to smoking restrictions and bans have suggested that follow up studies may reveal changes in the incidence and mortality rates of oral and other related cancers. This study analysis revealed that oral cancer incidence rates are no longer increasing in Nevada and that mortality rates have started to decline, although not as rapidly as the overall national rates. However, rapid decreases in both the incidence and mortality from esophageal and lung cancer were observed in Nevada, which strongly suggest the corresponding changes in oral cancer may be part of a larger epidemiologic shift resulting from improved public health policies that include indoor smoking restrictions and bans.

Household and behavioral determinants of indoor PM2.5 in a rural solid fuel burning Native American community.

Indoor and outdoor concentrations of PM2.5 were measured for 24h during heating and non-heating seasons in a rural solid fuel burning Native American community. Household building characteristics were collected during the initial home sampling visit using technician walkthrough questionnaires, and behavioral factors were collected through questionnaires by interviewers. To identify seasonal behavioral factors and household characteristics associated with indoor PM2.5 , data were analyzed separately by heating and non-heating seasons using multivariable regression. Concentrations of PM2.5 were significantly higher during the heating season (indoor: 36.2μg/m3 ; outdoor: 22.1μg/m3 ) compared with the non-heating season (indoor: 14.6μg/m3 ; outdoor: 9.3μg/m3 ). Heating season indoor PM2.5 was strongly associated with heating fuel type, housing type, indoor pests, use of a climate control unit, number of interior doors, and indoor relative humidity. During the non-heating season, different behavioral and household characteristics were associated with indoor PM2.5 concentrations (indoor smoking and/or burning incense, opening doors and windows, area of surrounding environment, building size and height, and outdoor PM2.5 ). Homes heated with coal and/or wood, or a combination of coal and/or wood with electricity and/or natural gas had elevated indoor PM2.5 concentrations that exceeded both the EPA ambient standard (35μg/m3 ) and the WHO guideline (25μg/m3 ).

Household personal Health Description During The Pandemic of Covid-19 In Kabawo, Muna District

PHBS is all personal health behavior because of personal awareness so that the family and all its members are able to help themselves in the health sector and get an active role in community activities (Kemenkes RI, 2016). This research contains quantitative research using descriptive methods. The population of this research is housewives in Kabawo District. From the survey data, the number of RTs in Kabawo District spread over 10 villages 1 Kelurahan is 2899 families. With up to 91 families. The method used is Random Sampling / Probability Sampling. Where the techniques and samples that researchers use are random, regardless of the sample on the basis of strata or social status of any way by lot. The result of this study obtained during the covid-19 pandemic, delivery assistance by health workers was 92,3%, Exclusive breastfeeding was 87,9%, The use of healthy latrines was 84,6%, Entirely using clean water was 100%. Washing hands using clean water and soap was 91,2%, Weighing babies and toddlers was 95,6%, Eradicating mosquito larvae was 65.9%, Consuming fruits and vegetables was 98.9%, physical activity was 98.9%, 68,1% were still smoking indoors. Health workers are expected to always improve community health services, especially regarding PHBS activities and families are expected to always increase knowledge so that they are able to carry out daily PHBS