Non-smoking Households Research Articles

A participatory study of indoor environment quality in homes of children and youth in Kanehsatake First Nation

Indoor air quality is an important determinant for the health of children and youth, but the conditions within Indigenous communities are understudied. We collaborated with Kanehsatake First Nation in Quebec, Canada, to address this gap using a community-based participatory research approach. Levels of key indoor air indicators, including particulate matter (PM2.5), CO2, and relative humidity, were measured in 31 randomly selected households between June 2021 and January 2022. Questionnaires were administered remotely to collect information on housing conditions. Excessive humidity was common, with 52% of households having a relative humidity above 55%. The mean PM2.5 concentration was 21.0 (standard deviation 38.5) µg/m3, with higher mean levels observed in smoking compared to non-smoking households (36.1 µg/m3 and 10.1 µg/m3, respectively). The mean CO2 level in participating households was 881 ppm (standard deviation 256), with 30% (n = 9) of homes exceeding 1000 ppm. Flooding rates were high, with 55% of households reporting at least one past flood. One-third of houses were inadequately ventilated relative to occupancy, and over one-quarter reported needing major repairs. The results indicate the value and importance of characterizing the indoor environment in First Nations households and the viability of data collection through community-based participatory research in environmental health research.

Factors associated with terminated pregnancies in Sri Lanka: A case study of the Sri Lankan Demographic and health survey (DHS) 2016.

Pregnancy termination is considered to have adverse effects on women's health and to have created financial, economic, and social problems in their lives. This study aimed to identify factors associated with pregnancy termination in Sri Lanka. The study used 2016 Sri Lanka Demographic and Health Survey (DHS) data of 16,323 ever-married women aged 15-49, who were clustered in selected enumerated areas. A binary logistic random intercept multilevel model was fitted to find the association between pregnancy termination and the predictor variables in this study. The overall pregnancy termination rate among Sri Lankan women was 16.14%. Increasing age of women was found to be associated with increasing odds of pregnancy termination. Women who were overweight or obese had higher odds of pregnancy termination, with 14% and 36%, respectively, compared to women with a normal weight. With increasing parity, the likelihood of pregnancy termination decreased. Women who used contraceptives had a 24% higher likelihood of pregnancy termination than those who refrained from using them. Cohabiting women had a 57% higher chance of pregnancy termination. Working women had 15% higher odds than unemployed women. Women who experienced domestic violence had a 14% higher odds of pregnancy termination than those who did not. Women from the Northern, Eastern, and North Central provinces had a lower likelihood of pregnancy termination compared to those from the Western province. Women in the urban sector were more likely to terminate their pregnancy than those in the estate sector. Further, women residing in households where indoor smoking was permitted had a 13% greater chance of ending their pregnancy compared to non-smoking households. The study highlights the importance of restructuring education related to health and well-being, family planning, and work-life balancing for both women and their partners, and developing and implementing or strengthening policies and laws related to mitigating pregnancy termination including domestic violence for women.

Traffic-related air pollution, chronic stress, and changes in exhaled nitric oxide and lung function among a panel of children with asthma living in an underresourced community

We examined associations between short-term exposure to traffic-related air pollutants (TRAP) and airway inflammation and lung function in children with asthma, and whether these associations are modified by chronic psychological stress. Residents of underresourced port-adjacent communities in New Jersey were concerned about the cumulative impacts of exposure to TRAP, particularly diesel-engine truck emissions, and stress on exacerbation of asthma among children. Children with asthma aged 9–14 (n = 35) were recruited from non-smoking households. We measured each participant's (1) continuous personal exposure to black carbon (BC, a surrogate of TRAP) at 1-min intervals, (2) 24-h integrated personal exposure to nitrogen dioxide (NO2), (3) daily fractional exhaled nitric oxide (FeNO), and (4) lung function for up to 30 consecutive days. Personal BC was recorded by micro-aethalometers. We measured daily FeNO using the NIOX MINO, forced expiratory volume in one second (FEV1), and forced vital capacity (FVC) using Easy One Frontline spirometers. Chronic stress was measured with the UCLA Life Stress Interview for Children. The association was examined using linear mixed-effect models. In the fully adjusted model, an interquartile range (IQR) increase in BC at lag 0–6 h before the FeNO measurement was associated with 8 % (95 % CI: 3 % - 12 %) increase in FeNO, whereas an IQR increase in BC at lag 7–12 h and lag 0–24 h were associated with 6 % (95 % CI: 2 % - 11 %) and 7 % (2 % - 12 %) FeNO increases, respectively. There were no significant lung function changes per IQR increase in BC. No interactions were observed between chronic stress and BC on FeNO. Chronic stress was negatively associated with individual average FeNO levels. Our findings suggest that higher levels of BC exposure within the prior 24 h increased airway inflammation levels in children with asthma, with the strongest effect observed within the first 6 h.

Second-hand smoke and fine particulate matter exposures among multi-unit housing residents in Singapore: A pilot study

Globally, approximately 1.2 million deaths among non-smokers are attributed to second-hand smoke (SHS) per year. Multi-unit housing is becoming the common type of residential dwelling in developed cities and the issue of neighbour SHS is of rising concern especially as ‘Work From Home’ became the norm during and post COVID-19 pandemic. The objective of this pilot study is to measure and compare the air quality of households that are exposed to SHS and unexposed households among smoking and non-smoking households in Singapore. A total of 27 households were recruited from April to August 2021. Households were categorized into smoking households with neighbour SHS, smoking households without neighbour SHS, non-smoking households with neighbour SHS, and non-smoking household without neighbour SHS. Air quality of the households was measured using calibrated particulate matter (PM2.5) sensors for 7–16 days. Socio-demographic information and self-reported respiratory health were collected. Regression models were used to identify predictors associated with household PM2.5 concentrations and respiratory health. Mean PM2.5 concentration was significantly higher among non-smoking households with neighbour SHS (n = 5, mean = 22.2, IQR = 12.7) than in non-smoking household without neighbour SHS (n = 2, mean = 4.1, IQR = 5.8). Smoking activity at enclosed areas in homes had the lowest PM2.5 concentration (n = 7 mean = 15.9, IQR = 11.0) among the three smoking locations. Exposure to higher household PM2.5 concentration was found to be associated with poorer respiratory health. A ‘smoke-free residential building’ policy is recommended to tackle the issue of rising neighbour SHS complaints and health concerns in densely populated multi-unit housing in Singapore. Public education campaigns should encourage smokers to smoke away from the home to minimize SHS exposure in household members.

Long-Term Trends in Secondhand Smoke Exposure in High-Rise Housing Serving Low-Income Residents in New York City: Three-Year Evaluation of a Federal Smoking Ban in Public Housing, 2018-2021.

In July 2018, the U.S. Department of Housing and Urban Development passed a rule requiring public housing authorities to implement smoke-free housing (SFH) policies. We measured secondhand smoke (SHS) exposure immediately before, and repeatedly up to 36 months post-SFH policy implementation in a purposeful sample of 21 New York City (NYC) high-rise buildings (>15 floors): 10 NYC Housing Authority (NYCHA) buildings subject to the policy and 11 privately managed buildings in which most residents received housing vouchers (herein "Section 8"). We invited participants from nonsmoking households (NYCHA n = 157, Section-8 n = 118) to enroll in a longitudinal air monitoring study, measuring (1) nicotine concentration with passive, bisulfate-coated filters, and (2) particulate matter (PM2.5) with low-cost particle sensors. We also measured nicotine concentrations and counted cigarette butts in common areas (n = 91 stairwells and hallways). We repeated air monitoring sessions in households and common areas every 6 months, totaling six post-policy sessions. After 3 years, we observed larger declines in nicotine concentration in NYCHA hallways than in Section-8, [difference-in-difference (DID) = -1.92 µg/m3 (95% CI -2.98, -0.87), p = .001]. In stairwells, nicotine concentration declines were larger in NYCHA buildings, but the differences were not statistically significant [DID= -1.10 µg/m3 (95% CI -2.40, 0.18), p = .089]. In households, there was no differential change in nicotine concentration (p = .093) or in PM2.5 levels (p = .385). Nicotine concentration reductions in NYCHA common areas over 3 years may be attributable to the SFH policy, reflecting its gradual implementation over this time. Continued air monitoring over multiple years has demonstrated that SHS exposure may be declining more rapidly in NYCHA common areas as a result of SFH policy adherence. This may have positive implications for improved health outcomes among those living in public housing, but additional tracking of air quality and studies of health outcomes are needed. Ongoing efforts by NYCHA to integrate the SFH policy into wider healthier-homes initiatives may increase policy compliance.

Spatial distribution, driving factors and health risks of fine particle-bound polycyclic aromatic hydrocarbons (PAHs) from indoors and outdoors in Hefei, China

Atmospheric particulate matter, especially in urban and industrial environments, can act as a source of different organic pollutants that can pose significant health impacts to residents. However, the pollution status and transport mechanisms of fine particle-bound polycyclic aromatic hydrocarbons (PAHs) in indoor and outdoor environments are uncertain. This study aimed to determine the spatial distribution and morphological characteristics of fine particle-bound PAHs and analyze the factors (source contributions and backward trajectories) that influence their concentrations. The results showed that mean concentrations of 16 PAHs were higher in indoor dust as compared to outdoor dust. In addition, the lowest concentrations of the 16 PAHs were found on the 11-20th floor, with smoking households > nonsmoking households (except Nap, Acy, and Ace). The 2–3 ring PAHs were more prominent in households with cooking activities. The particle size distribution showed that most of the particles were <62 μm in diameter, indicating that the indoor particles were smaller in size. Furthermore, the range of δ13C values in the outdoor dust (−30.17 ~ −28.63 ‰) samples was significantly lower than in indoor dust (−28.29 ~ −22.53 ‰). The results based on diagnostic ratios, positive matrix factorization (PMF) analysis and backward trajectory model analysis suggested that the sources of PAHs in indoor and outdoor dust were mixed, originated both locally and from neighboring provinces transported over long distances, especially concentrated in the Yangtze River Delta area. Finally, carcinogenic risk values for indoor dust were greater than those for outdoor dust. Therefore, it is recommended that local governments and industries with high PAH emissions should implement proper protocols to monitor and minimize the pollution levels of PAHs in the urban industrial environment in order to mitigate their health risks.

Implementing the Federal Smoke-Free Public Housing Policy in New York City: Understanding Challenges and Opportunities for Improving Policy Impact.

In 2018, the U.S. Department of Housing and Urban Development required public housing authorities to implement a smoke-free housing (SFH) policy that included individual apartments. We analyzed the policy implementation process in the New York City Public Housing Authority (NYCHA). From June–November 2019, we conducted 9 focus groups with 64 NYCHA residents (smokers and nonsmokers), 8 key informant interviews with NYCHA staff and resident association leaders, and repeated surveys with a cohort of 130 nonsmoking households pre- and 12-month post policy. One year post policy implementation, participants reported widespread smoking violations and multi-level factors impeding policy implementation. These included the shared belief among residents and staff that the policy overreached by “telling people what to do in their own apartments”. This hindered compliance and enforcement efforts. Inconsistent enforcement of illegal marijuana use, staff smoking violations, and a lack of accountability for other pressing housing issues created the perception that smokers were being unfairly targeted, as did the lack of smoking cessation resources. Resident support for the policy remained unchanged but satisfaction with enforcement declined (60.1% vs. 48.8%, p = 0.047). We identified multilevel contextual factors that are influencing SFH policy implementation. Findings can inform the design of strategies to optimize policy implementation.

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.

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.

Smoke-Free Home Rules and Association with Child Secondhand Smoke Exposure among Mother-Child Dyad Relationships.

Smoke-free home rules restrict smoking in the home, but biomarkers of secondhand smoke exposure are needed to help understand the association between smoke-free homes and child secondhand smoke exposure. Participants (n = 346) were majority Black/African American mother–child dyads from a longitudinal study in North Carolina. Mothers completed questionnaires on household smoking behaviors and rules, and child saliva samples were assayed for secondhand smoke exposure. Regression models used smoke-free home rules to predict child risk for secondhand smoke exposure. Children in households with smoke-free home rules had less salivary cotinine and risk for secondhand smoke exposure. After controlling for smokers in the household, home smoking rules were not a significant predictor of secondhand smoke exposure. Compared to children in households with no smokers, children in households with at least one smoker but a non-smoking mother (OR 5.35, 95% CI: 2.22, 13.17) and households with at least one smoker including a smoking mother (OR 13.73, 95% CI: 6.06, 33.28) had greater risk for secondhand smoke exposure. Results suggest smoke-free home rules are not sufficient to fully protect children from secondhand smoke exposure, especially in homes with smokers. Future research should focus on how household members who smoke can facilitate the prevention of child secondhand smoke exposure.

The utility of household Grocery Purchase Quality Index scores as an individual diet quality metric.

The Grocery Purchase Quality Index (GPQI) reflects concordance between household grocery purchases and US dietary recommendations. However, it is unclear whether GPQI scores calculated from partial purchasing records reflect individual-level diet quality. This secondary analysis of a 9-month randomised controlled trial examined concordance between the GPQI (range 0-75, scaled to 100) calculated from 3 months of loyalty-card linked partial (≥50 %) household grocery purchasing data and individual-level Healthy Eating Index (HEI) scores at baseline and 3 months calculated from FFQ (n 209). Concordance was assessed with overall and demographic-stratified partially adjusted correlations; covariate-adjusted percentage score differences, cross-classification and weighted κ coefficients assessed concordance across GPQI tertiles (T). Participants were middle aged (55·4 (13·9) years), female (90·3 %), from non-smoking households (96·4 %) and without children (70·7 %). Mean GPQI (54·8 (9·1) %) scores were lower than HEI scores (baseline: 73·2 (9·1) %, 3 months: 72·4 (9·4) %) and moderately correlated (baseline r 0·41 v. 3 months r 0·31, P < 0·001). Correlations were stronger among participants with ≤ bachelor's degree, obesity and children. Scores showed moderate agreement (κ = 0·25); concordance was highest in T3. Participants with high (T3) v. low (T1) GPQI scores had 7·3-10·6 higher odds of having HEI scores >80 % at both time points. Household-level GPQI was moderately correlated with self-reported intake, indicating their promise for evaluating diet quality. Partial purchasing data appear to moderately reflect individual diet quality and may be useful in interventions monitoring changes in diet quality.

Evaluation of Secondhand Smoke Exposure in New York City Public Housing After Implementation of the 2018 Federal Smoke-Free Housing Policy

Secondhand smoke (SHS) exposure is associated with many health conditions in children and adults. Millions of individuals in the US are currently exposed to SHS in their homes. To investigate whether a federal ban on smoking in public housing settings was associated with a decrease in indoor SHS levels in New York City public housing developments 12 months after the policy's implementation. This cohort study tracked indoor air quality longitudinally from April 2018 to September 2019 and used difference-in-differences analysis to examine SHS exposure before vs after implementation of the 2018 federal smoke-free housing (SFH) policy in 10 New York City Housing Authority (NYCHA) buildings vs 11 matched low-income buildings not subject to the SFH policy (ie, Section 8 buildings). Federal SFH policy implementation, beginning July 30, 2018. Comparison of nicotine concentration levels from passive, bisulfate-coated filters before vs 12 months after implementation of the federal SFH policy. Secondary outcomes included changes in particulate matter less than 2.5 μm in diameter, measured with low-cost particle monitors, and counts of cigarette butts in common areas. Air quality was measured repeatedly in a total of 153 NYCHA and 110 Section 8 nonsmoking households as well as in 91 stairwells and hallways. Before the SFH policy implementation, air nicotine was detectable in 19 of 20 stairwells (95.0%) in NYCHA buildings and 15 of 19 stairwells (78.9%) in Section 8 buildings (P = .19) and in 17 of 19 hallways (89.5%) in NYCHA buildings and 14 of 23 hallways (60.9%) in Section 8 buildings (P = .004). Nicotine was detected less frequently inside nonsmoking apartments overall (26 of 263 [9.9%]) but more frequently in NYCHA apartments (20 of 153 [13.1%]) than in Section 8 apartments (6 of 110 [5.5%]) (P = .04). One year after policy implementation, there was no differential change over time in nicotine concentrations measured in stairwells (DID, 0.03 μg/m3; 95% CI, -0.99 to 1.06 μg/m3) or inside nonsmoking households (DID, -0.04 μg/m3; 95% CI, -0.24 to 0.15 μg/m3). Larger decreases in nicotine concentration were found in NYCHA hallways than in Section 8 hallways (DID, -0.43 μg/m3; 95% CI, -1.26 to 0.40 μg/m3). The findings suggest that there was no differential change in SHS in NYCHA buildings 12 months after SFH policy implementation. Additional support may be needed to ensure adherence to SFH policies.

Effects of cigarette price increase on fresh food expenditures of low-income South Korean households that spend relatively more on cigarettes

On January 1, 2015, the cigarette tax in South Korea increased sharply. In this study, we analyzed how the fresh food expenditures of low-income smoking households that spend relatively more on cigarettes changed between 2014 and 2015 compared to their demographically comparable non-smoking counterparts. We conducted the analysis using a difference-in-differences analysis from which we derived expenditure differences between smoking households and non-smoking households and then examined whether the differences increased from 2014 to 2015. In deriving the differences, we utilized the nearest-matching method to ensure that, besides smoking status, the socio-demographics of the two groups were matched. We used data from the Household Income and Expenditure Survey of South Korea. The analysis showed that smoking households spent less on fruits and vegetables than non-smoking households and that this difference increased after the tax increase. The change was more remarkable in the poorest households that spent relatively more on cigarettes. This suggests that cigarette expenditures have a crowding out effect on fresh food expenditures for smoking households, with a significantly larger effect for households in the poorest group that spend more on cigarettes.

Influence of household smoking habits on inhalation bioaccessibility of trace elements and light rare earth elements in Canadian house dust

In this study, total concentration and inhalation bioaccessibility (dissolution in simulated biological solution) of trace elements (TE) and rare earth elements (REE) were assessed in PM10 from Canadian house dust samples with smoking (n = 25) and non-smoking (n = 25) status. Compared to the natural background concentrations in Canadian soils, median Zn, Pb, Cd and Cu concentrations in PM10 were 10–23 fold higher, while median La, Ce and Pr concentrations were 1.6–2.4 fold higher. Mann-Whitney tests (α = 0.05) indicated no difference between the median TE concentrations based on the smoking status of the household; however, median REE concentrations were significantly higher in the PM10 of smoking households. Additionally, Cd and Ni were positively correlated (Spearman r, p < 0.05) to La, Ce and Nd in smoking households, suggesting that tobacco combustion may have contributed REE in the PM10 of these households. Median inhalation-ingestion bioaccessibility assay outcomes of arsenic (As) and lead (Pb) was higher in the non-smoking households when compared to smoking households (Mann Whitney test, α = 0.05), suggesting that tobacco combustion products may be associated with less soluble species of As and Pb. Although REE bioaccessibility was negligible in simulated lung epithelial fluid regardless of the smoking status of the household, bioaccessibility in the lung-gastric phase was 23.6–27.6% in the smoking household and 34.7–36.7% in the non-smoking households, indicating a significantly lower REE dissolution in PM10 of smoking households. In contrast, between 17 and 21.9% bioaccessibility of REE was observed when artificial lysosomal fluid was used, where the outcome was not significantly affected by the smoking status. This study indicates that despite a higher median REE concentration in the PM10 of smoking households, inhalation bioaccessibility may be significantly influenced by the mineralogy.

Secondhand smoke exposure in public and private high-rise multiunit housing serving low-income residents in New York City prior to federal smoking ban in public housing, 2018

BackgroundTobacco remains the leading cause of preventable death in the United States, with 41,000 deaths attributable to secondhand smoke (SHS) exposure. On July 30, 2018, the U.S. Department of Housing and Urban Development passed a rule requiring public housing authorities to implement smoke-free housing (SFH) policies. ObjectivesPrior to SFH policy implementation, we measured self-reported and objective SHS incursions in a purposeful sample of 21 high-rise buildings (>15 floors) in New York City (NYC): 10 public housing and 11 private sector buildings where most residents receive federal housing subsidies (herein ‘Section 8’ buildings). MethodsWe conducted a baseline telephone survey targeting all residents living on the 3rd floor or higher of selected buildings: NYC Housing Authority (NYCHA) residents were surveyed in April-July 2018 (n = 559), and residents in ‘Section 8’ buildings in August-November 2018 (n = 471). We invited non-smoking household participants to enroll into a longitudinal air monitoring study to track SHS exposure using: (1) nicotine concentration from passive, bisulfate-coated nicotine filters and (2) particulate matter (PM2.5) from low-cost particle monitors. SHS was measured for 7-days in non-smoking households (NYCHA n = 157, Section 8 n = 118 households) and in building common areas (n = 91 hallways and stairwells). ResultsSmoking prevalence among residents in the 21 buildings was 15.5%. Two-thirds of residents reported seeing people smoke in common areas in the past year (67%) and 60% reported smelling smoke in their apartments coming from elsewhere. Most stairwells (88%) and hallways (74%) had detectable nicotine levels, but nicotine was detected in only 9.9% of non-smoking apartments. Substantial variation in nicotine and PM2.5 was observed between and within buildings; on average nicotine concentrations were higher in NYCHA apartments and hallways than in Section 8 buildings (p < 0.05), and NYCHA residents reported seeing smokers in common areas more frequently. ConclusionsSFH policies may help in successfully reducing SHS exposure in public housing, but widespread pre-policy incursions suggest achieving SFH will be challenging.

Husband’s smoking behaviors associated with women’s depression in China: the importance of a smoke-free household

ABSTRACTBackground: Passive smoking is a significant public health problem worldwide. The aim of this study was to examine the association between passive smoking and women’s depression.Methods: Data for this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS), and panel data analysis was applied. Data from a total of 10,498 Chinese women were selected for analysis, including 2,919 who were interviewed in 2011, 3,490 in 2013, and 4,089 in 2015.Results: Passive smoking was found to be significantly associated with depression. Compared with those living in nonsmoking households, women who had lived with a smoking husband for over 20 years had significantly more depressive symptoms. In addition, compared with individuals with lower educational levels, and residing in nonsmoking households, those with more education were less likely to develop depression, although exposed to smoking.Conclusions: The results suggest that passive smoking within households is a risk factor for depression among Chinese women. Smoke-free policies should be promoted, to help push forward tobacco control in China. Provision of more educational opportunities for Chinese women should also be promoted, as these will also help to protect them against the negative effects brought on by passive smoking.Abbreviations: CHARLS: China health and retirement longitudinal study; CES-D: center for epidemiological studies depression Scale; SES: socio-economic status

Household Smoking Status and Heavy Metal Concentrations in Toenails of Children.

There is limited evidence on the distribution of heavy metals and its association with secondhand smoking (SHS) within Pacific Island children living in New Zealand. Certain heavy metals such as cadmium (Cd), lead (Pb), and aluminum (Al) bioaccumulates in the body and can deteriorate health in both children and adults. Others, such as chromium (Cr) and nickel (Ni) in trace amounts are necessary but become toxic at high levels. Exposure routes of these elements include food, water, and air. The purpose of this study was to identify the distribution of toxic metal concentrations and its possible correlation with SHS within the Pacific Island children. A sub-sample of children within Pacific Island families longitudinal study, at the nine-year phase, who were living in the New Zealand city of Auckland were invited to participate, (n = 278). Toenails were used as a biomarker to determine Cr, Pb, Cd, Cu, Ni, and Al concentration using inductively coupled plasma mass spectrometry. Reliable and validated questionnaires were used for demographics, lifestyle, and health outcome variables. Significant differences between household smoking status and ethnicity, as well as parents’ marital status, were observed (p < 0.05). There was no statistical difference in heavy metal concentrations in smoking versus non-smoking households. However, Cr, Pb, Cd, Cu, and Ni concentrations were all higher than the required optimal health value in both groups. A high concentration of heavy metals was observed in these children that exceeded the value required for optimal health, although no significant difference in heavy metals with regards to secondhand smoking was observed. SHS was associated with children’s ethnicity and parental marital status, but not with household income levels or maternal education.

Associations Between Sub-Clinical Markers of Cardiometabolic Risk and Exposure to Residential Indoor Air Pollutants in Healthy Adults in Perth, Western Australia: A Study Protocol.

Background: A growing body of epidemiological and clinical evidence has implicated air pollution as an emerging risk factor for cardiometabolic disease. Whilst individuals spend up to two-thirds of daily time in their domestic residential environment, very few studies have been designed to objectively measure the sub-clinical markers of cardiometabolic risk with exposure to domestic indoor air pollutants. This cross-sectional study aims to investigate associations between the components of domestic indoor air quality and selected sub-clinical cardiometabolic risk factors in a cohort of healthy adults living in Perth, Western Australia. Methods: One hundred and eleven non-smoking adults (65% female) living in non-smoking households who were aged between 35–69 years were recruited for the project. Study subjects were invited to participate in all sections of the study, which included: Domestic indoor air monitoring along with the concurrent 24 h ambulatory monitoring of peripheral and central blood pressure and measures of central hemodynamic indices, standardized questionnaires on aspects relating to current health status and the domestic environment, a 24 h time-activity diary during the monitoring period, and clinic-based health assessment involving collection of blood and urine biomarkers for lipid and glucose profiles, as well as measures of renal function and an analysis of central pulse wave and pulse wave velocity. Results: This study provides a standardized approach to the study of sub-clinical cardiometabolic health effects that are related to the exposure to indoor air pollution. Conclusion: The findings of this study may provide direction for future research that will further contribute to our understanding of the relationship that exists between indoor air pollution and sub-clinical markers of cardiometabolic risk.

Setting the standard: The acceptability of kitchen ventilation for the English housing stock

Exposure to particulate matter with diameter ≤2.5 μm (PM2.5) is associated with an elevated risk of adverse health effects and cooking is a primary source of PM2.5 in non-smoking households. Therefore, it is important to investigate PM2.5 concentrations that might be found in domestic kitchens, and the appropriate ventilation mechanisms to reduce them.Uncertainty in daily mean PM2.5 concentrations in English kitchens is predicted using a statistical model and stochastic simulation. A worst-case heating season scenario is considered where 3 meals are cooked per day and fresh air is provided by infiltration and fans.The model predicts that >98% of English houses are too airtight to dilute PM2.5 emissions solely by infiltration so that daily mean concentrations in kitchens are below the WHO guideline of 25 μg/m3. Therefore, controlled ventilation is required in all kitchens. Ventilation strategies prescribed by English Building Regulations and ASHRAE 62.2 are found to be adequate for <12% and 75% of houses, respectively, when applied during cooking. Continuing to ventilate for a further 10 minutes has a significant effect when using an intermittent strategy, increasing the centiles of compliant houses to 46% and >98%, respectively. A cooker hood is the most effective ventilation strategy when used during cooking plus 10 minutes. Standards should be amended to incorporate required combinations of airflow rates and capture efficiencies. A hood with a capture efficiency of 50% requires airflow rates of 52 l/s and 90 l/s for PM2.5 concentrations to remain below WHO guidelines in 75% and 98% of houses, respectively.

The effect of tobacco expenditure on expenditure shares in South African households: A genetic matching approach.

This paper examines whether tobacco expenditure leads to the crowding out or crowding in of different expenditure items in South Africa. We apply genetic matching to expenditure quartiles of the 2010/2011 South African Income and Expenditure Survey. Genetic matching is a more appealing approach for dealing with the endogeneity of tobacco expenditure that often plagues studies using systems of demand equations. Further, genetic matching provides transparent measures of covariate balance giving the analyst objective means of assessing match success. We find that the poorest tobacco consuming households in South Africa consistently allocate smaller budget shares towards food items than non-smoking households. Specifically, we find that dairy, fruits, nuts and oils are displaced in favour of tobacco expenditure in the two poorest quartiles. Unsurprisingly, food items are never displaced for households in the top two quartiles, given these households’ greater access to resources. Like other studies in the literature, we find that tobacco expenditure consistently crowds-in alcohol across all quartiles confirming the strong complementarities between the two.