Environmental Smoke Research Articles

Associations of multiple risk factors with prenatal depression and anxiety: Evidence from the Tianjin Birth Cohort (TJBC) study

BackgroundAntenatal mental disorders are associated with maternal and fetal adverse events. Previous studies have been focused on the postpartum period, rather than pregnancy, yet the association of risk factors with prenatal depression and anxiety through pregnancy has been rarely reported. This study aimed to identify the risk factors of prenatal depression and anxiety, and access their potential roles in developing mental disorders during pregnancy. MethodsThis is a prospective study in 6470 participants from the Tianjin Birth Cohort in China (TJBC). The degree of prenatal depression and anxiety was evaluated using a questionnaire of Self-Rating Depression scale (SDS) and Self-Rating Anxiety Scale (SAS), which was given to pregnant women at 15–27 (Stage-2), and 28–41 (Stage-3) gestational weeks. The questionnaire also collected demographic, personal, and lifestyle information. The association of different factors with SDS/SAS score was examined by logistic regression analysis. ResultsWe observed an overall depression rate of 12.4 % and an overall anxiety rate of 7.7 % during pregnancy in the TJBC. In the Stage-2, the depression rate was 14.5 % and the anxiety rate was 9.5 %. In the Stage-3, the depression rate dropped to 9.7 % while the anxiety rate dropped to 5.3 %. With univariate analysis, we found that age, education, social support, marriage satisfaction, secondhand smoke (SHS), sleeping time and stress were common factors of prenatal mental health. Working status, family income, gravidity, smoking, electronic using, recreational activities were associated with depression risk, whereas BMI, disease history, changing eating habits, and feeding animal were associated with anxiety risk. Using logistic regression, we found that low education level, low social support, low marriage satisfaction, thyroid disfunction, Stage-2(second trimester), and stress were related to prenatal mental health. ConclusionThe prevalence anxiety and depression in Tianjin is normal as national level. Age appropriateness, a good education level, sufficient social support, marital satisfaction, normal thyroid function, and absence of stress are associated with relieving depression and anxiety during gestation. However, due to individual difference, expectant mothers should seek professional support and guidance to address their mental health needs during gestation.

Smoke-free legislation impact on the hospitality sector in the Republic of Georgia

IntroductionComprehensive smoke-free (SF) policies reduce secondhand smoke exposure and improve population-level health outcomes. However, some decision-makers heed the tobacco industry’s argument that SF policies negatively impact the hospitality sector. This...

Evaluation of environmental emissions from glo heated tobacco products and combustible Cigarettes

Compared to cigarette smoke, heated tobacco product (HTP) aerosol contains significantly fewer and lower levels of harmful and potentially harmful constituents (HPHCs). However, the impact on environmental air is relatively unexplored. Therefore, this study compared levels of secondhand aerosol (SHA) constituents in air following glo HTP use with secondhand smoke (SHS) constituents following cigarette smoking in an environmental test chamber (ETC). Extracted ETC air samples following product use sessions were analyzed for 27 SHS/SHA constituents, including HPHCs. The use of glo HTPs resulted in significantly lower SHA HPHC levels in the ETC air relative to SHS HPHC levels from cigarette smoking. Some aerosol constituents (benzene, CO, formaldehyde, nicotine, respirable suspended particles, toluene, ethylbenzene, fine particulate matter, m- and p-cresol, o-cresol, pyridine, styrene, and ultraviolet particulate matter) were either below the limit of detection in ETC air or at significantly low levels following glo HTP use relative to cigarette smoking. Mean concentrations of the assessed constituents were at least 90 % lower following use of glo HTPs compared to smoking combustible cigarettes. These results suggest that glo HTP use would not contribute significantly to indoor air contamination and would reduce non-user exposure to HPHCs and other harmful constituents relative to combustible cigarettes. Such reductions in non-user exposure should be considered when assessing the tobacco harm reduction potential of glo HTPs.

A Multi-Omics Study of Epigenetic Changes in Type II Alveolar Cells of A/J Mice Exposed to Environmental Tobacco Smoke.

Lung cancer remains a major contributor to cancer fatalities, with cigarette smoking known to be responsible for up to 80% of cases. Based on the ability of cigarette smoke to induce inflammation in the lungs and increased lung cancer incidence in smokers with inflammatory conditions such as COPD, we hypothesized that inflammation plays an important role in the carcinogenicity of cigarette smoke. To test this hypothesis, we performed multi-omic analyses of Type II pneumocytes of A/J mice exposed to cigarette smoke for various time periods. We found that cigarette smoke exposure resulted in significant changes in DNA methylation and hydroxymethylation, gene expression patterns, and protein abundance that were partially reversible and contributed to an inflammatory and potentially oncogenic phenotype.

Association between serum cotinine levels and urinary incontinence in adults in the United States: a population-based cross-sectional analysis

Environmental tobacco smoke (ETS) exposure has been shown to be associated with a variety of diseases, but evidence regarding the association between it and urinary incontinence (UI) is limited. Cotinine, a metabolite of nicotine in the human body, can more accurately quantify the level of human exposure to tobacco smoke. The study utilized data from seven survey cycles (2007-March 2020 Pre-pandemic) of the National Health and Nutrition Examination Survey (NHANES) program. Weighted multivariable logistic regression analysis, subgroup analysis, interaction tests, smooth curve fitting, and threshold effect models were used to analyze the relationship between serum cotinine and UI. Additionally, a 1:1 nearest neighbor propensity score matching (PSM) method was employed to minimize the impact of confounding factors. Before and after PSM, serum cotinine levels were higher in individuals with UI than those without (P < 0.05). Both before and after PSM, UI was positively correlated with serum cotinine levels, with a significantly increased risk of urinary incontinence when serum cotinine levels were in the Q3 range (before PSM: OR = 1.89, 95% CI = 1.59–2.24; after PSM: OR = 1.60, 95% CI = 1.28-2.00). Smooth curve fitting before and after PSM showed an approximate J-shaped non-linear dose-response relationship between log-transformed serum cotinine levels and UI. This study indicates that among American adults, there is a positive relationship between serum cotinine levels and UI, which is also significant in self-reported non-smoking populations. Therefore, reducing exposure to environmental tobacco smoke (e.g., avoiding second-hand smoke) in work and daily life may help alleviate the occurrence of UI, and serum cotinine levels have the potential to be a tool for predicting the degree of risk of developing UI.

Expansion of Smoke-Free Laws in Public Places and Support for Smoke-Free in Malaysia: Findings from the 2020 ITC Malaysia Survey.

Smoke-free laws (SFL) are more effective with public support. This study investigated the smoking prevalence, public perceptions of smoking rules, and support for comprehensive SFL among 1047 people who smoke (PWS) and 206 people who do not smoke (PNS) aged ≥18 in the 2020 International Tobacco Control Malaysia Survey. Smoking prevalence was highest in nighttime entertainment venues (85.7%), non-air-conditioned eateries (49.7%), and indoor workplaces (34.6%). Respondents reported that smoking was banned in most indoor workplaces (81.7% PNS, 69.2% PWS), air-conditioned eateries (84.7% PNS, 75.7% PWS), and non-air-conditioned eateries (81.2% PNS, 78.7% PWS), but much less so in nighttime entertainment venues (30.1% PNS, 24.6% PWS). Support for comprehensive SFL in public venues was highest among PNS (≥84.9%) but still substantial among PWS (≥49.9%). PWS under 40, Malay, married, and aware of smoking rules supported SFL more. Robust SFL enforcement is essential in Malaysia to reduce secondhand smoke exposure in public places.

Exploring the role of inhaled corticosteroid/betamethasone for managing recurrent respiratory illness in infants and young children

Background: Recurrent respiratory illnesses (RRIs) are frequent respiratory tract infections, particularly common in fall-winter and during seasonal changes. RRIs primarily affect children aged 2-7 years and the elderly, with respiratory viruses causing about 80% of cases. They interfere significantly with children's well-being and incur substantial medical and social costs. The study aim was to assess the effectiveness of inhaled corticosteroids (ICS) in infants and young children with recurrent respiratory symptoms. Methods: This prospective observational study took place over one year at the department of pediatrics, Cox’s Bazar medical college, Bangladesh, from June 1, 2014, to May 31, 2015. Results: The study involved 210 children with recurrent respiratory symptoms, mostly males (57.62%) and predominantly aged 1-3 years (55.71%). Atopy was present in 16.67%, and eczema in 30.48%. Only 2.38% of mothers smoked during pregnancy, and 20.48% of children were exposed to passive smoke. Salbutamol use was high (80.48%), and 32.86% used ICS. Symptoms ranged from mild (13.81%) to severe (23.81%). After six months, daytime cough reduced from 52.38% to 1.43%, and nighttime cough from 66.19% to 0%. Symptom-free days increased, and hospital admissions decreased from 90.95% to 9.05%. Common adverse events included worsening symptoms (13.81%) and fever (13.33%). Conclusions: Inhaled corticosteroid/betamethasone therapy significantly improved symptoms in infants and young children with RRIs over six months, reducing coughing, wheezing, shortness of breath, and hospital admissions, while increasing symptom-free days. Adverse events were mild and infrequent, suggesting ICS is effective and safe. Further research is needed to optimize treatment.

FMCW Laser Fuze Structure with Multi-Channel Beam Based on 3D Particle Collision Scattering Model under Smoke Interference.

In the environment of smoke and suspended particles, the accurate detection of targets is one of the difficulties for frequency-modulated continuous-wave (FMCW) laser fuzes to work properly in harsh conditions. To weaken and eliminate the significant influence caused by the interaction of different systems in the photon transmission process and the smoke particle environment, it is necessary to increase the amplitude of the target echo signal to improve the signal-to-noise ratio (SNR), which contributes to enhancing the detection performance of the laser fuze for the ground target in the smoke. Under these conditions, the particle transmission of photons in the smoke environment is studied from the perspective of three-dimentional (3D) collisions between photons and smoke particles, and the modeling and Unity3D simulation of FMCW laser echo signal based on 3D particle collision is conducted. On this basis, a laser fuze structure based on multiple channel beam emission is designed for the combined effect of particle features from different systems and its impact on the target characteristics is researched. Simulation results show that the multiple channel laser emission enhances the laser target echo signal amplitude and also improves the anti-interference ability against the combined effects of multiple particle features compared with the single channel. Through the validation based on the laser prototype with four-channel beam emitting, the above conclusions are supported by the experimental results. Therefore, this study not only reveals the laser target properties under the 3D particle collision perspective, but also reflects the reasonableness and effectiveness of utilizing the target characteristics in the 3D particle collision mode to enhance the detection performance of FMCW laser fuze in the smoke.

Health Effects of Passive Smoking and Socio-Demographic Factors among Tobacco Users: A Retrospective Study

Health Effects of Passive Smoking and Socio-Demographic Factors among Tobacco Users: A Retrospective Study

Association between secondhand smoke exposure and anxiety among adolescents: A nationwide cross-sectional study.

Adolescents are especially susceptible to the harmful effects of secondhand smoke exposure. Mental health issues may be one of these negative consequences. This study aimed to explore the association between secondhand smoke exposure and anxiety among Korean adolescents. This study used the nationwide representative cross-sectional data obtained from the 4-year (2020-2023) Korea Youth Risk Behavior Survey. In total, 214514 individuals aged 12-18 years were included in this study (109910 males and 104604 females). Secondhand smoke exposure was assessed based on responses to questions concerning the days they were exposed (at home and in public places), while anxiety levels were measured using the Generalized Anxiety Disorder 7 scale. Multivariable logistic regression analysis divided by sex was performed to explore the association (p=0.0173 for interaction by secondhand smoke exposure and sex), and adjusted odds ratios (ORs) with 95% confidence intervals (CI) were calculated. Among the study population, 8.8% of the male and 15.6% of the female participants had anxiety. After adjusting for covariates, adolescents with secondhand smoke exposure had a higher likelihood of reporting anxiety than those without the exposure (male, OR=1.23; 95% CI: 1.16-1.29; female, OR=1.27; 95% CI: 1.21-1.33). In additional stratified analyses, this association was more prominent among those who were never smokers, were exposed for more days, and had severe levels of anxiety. This study found that secondhand smoke exposure was associated with anxiety in adolescents; hence, proper political interventions to reduce secondhand smoke exposure may be required.

"Why should care workers be any different from prison workers?" A qualitative study of second-hand smoke exposure during home-care visits and potential measures to eliminate exposure.

Despite world-leading measures in place to protect employees from second-hand smoke exposure in workplaces in the United Kingdom, workers who deliver health and social care in private homes remain unprotected legally in this setting from second-hand smoke exposure (SHS). Fourteen individuals took part in either an in-depth telephone interview (n = 11) or an online focus group discussion (n = 3), including home-care workers (n = 5) and managers (n = 5) based in Lanarkshire (Scotland) and local/national policy makers (n = 4). Participants were asked about the extent to which exposure to SHS is an issue during home visits and possible additional measures that could be put in place to eliminate exposure. Participants highlighted the difficulties in balancing the provision of care in a person's own home with the right of workers to be able to breathe clean air and be protected from SHS. Current strategies to reduce staff exposure to SHS during home visits were often reported as inadequate with SHS not a hazard considered by managers beyond protecting pregnant staff or those with pre-existing respiratory conditions such as asthma. Simple respiratory protective equipment (as used during the COVID-19 pandemic) was rightly identified as being ineffective. Methods such as nicotine replacement therapy and e-cigarettes were identified as potential ways to help people who smoke achieve temporary asbstinence prior to a home visit. Implementing appropriate and proportionate measures to protect home-care workers from the harms posed by SHS should be a priority to help protect the health of this often overlooked occupational group.

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.

Risk profiling of tobacco epidemic and estimated number of smokers living in China: a cross-sectional study based on PBICR

BackgroundEvidence on the prevalence of smoking in China remains insufficient, with most previous studies focusing on a single region. However, smoking prevalence exhibits significant inequalities across the entire country. This study aimed to evaluate the risk of tobacco prevalence across the country, taking into account spatial inequalities.MethodsThe data used in this study were collected in 23 provinces, 5 autonomous regions, and 4 municipalities directly under the central government in 2022. Large population survey data were used, and a Bayesian geostatistical model was employed to investigate smoking prevalence rates across multiple spatial domains.FindingsSignificant spatial variations were observed in smokers and exposure to secondhand smoke across China. Higher levels of smokers and secondhand smoke exposure were observed in western and northeastern regions. Additionally, the autonomous region of Tibet, Shanghai municipality, and Yunnan province had the highest prevalence of smokers, while Tibet, Qinghai province, and Yunnan province had the highest prevalence of exposure to secondhand smoke.ConclusionWe have developed a model-based, high-resolution nationwide assessment of smoking risks and employed rigorous Bayesian geostatistical models to help visualize smoking prevalence predictions. These prediction maps provide estimates of the geographical distribution of smoking, which will serve as strong evidence for the formulation and implementation of smoking cessation policies.HighlightsOur study investigated the prevalence of smokers and exposure to secondhand smoke in different spatial areas of China and explored various factors influencing the smoking prevalence. For the first time, our study applied Bayesian geostatistical modeling to generate a risk prediction map of smoking prevalence, which provides a more intuitive and clear understanding of the spatial disparities in smoking prevalence across different geographical regions, economic levels, and development status. We found significant spatial variations in smokers and secondhand smoke exposure in China, with higher rates in the western and northeastern regions.

Environmental Tobacco Smoke Exposure and Perinatal Health Outcomes in the United Arab Emirates: Interim Analysis from The Mutaba’ah Study

Environmental Tobacco Smoke Exposure and Perinatal Health Outcomes in the United Arab Emirates: Interim Analysis from The Mutaba’ah Study

Evolution and characteristics of studies estimating attributable mortality to second-hand smoke: a systematic review

Evolution and characteristics of studies estimating attributable mortality to second-hand smoke: a systematic review

Correcting misperceptions about very low nicotine cigarettes for cigarette-only smokers, dual/poly smokers, other tobacco users, and non-tobacco users

BackgroundThe U.S. Food and Drug Administration authorized the sale and marketing of two very low nicotine cigarettes (VLNC) as modified risk tobacco products. The misperception that VLNC are healthier than regular cigarettes is common. This study explores effective message strategies to inform the public about health risks associated with VLNC use, encourage cigarette smokers to try VLNC, and prevent other tobacco users and non-users from product initiation. MethodsFollowing the Reasoned Action approach, a VLNC educational message was developed based on the salient beliefs associated with behavioral intention. The message was tested in an online survey conducted in 2018, where 410 participants were randomly assigned to one of the two message conditions (no-message, VLNC message). Message effects were assessed across four tobacco-use groups (non-tobacco users, cigarette-only smokers, cigarette dual/poly smokers, other tobacco users). ResultsCompared to the no-message control, the VLNC message condition showed lower nicotine risk perception for all participants, lower misbelief in VLNC safety for non-users and cigarette-only smokers, higher belief in VLNC carcinogenicity for other tobacco users, stronger belief in second-hand smoke harm for cigarette dual/poly smokers and other tobacco users, and higher VLNC intention for cigarette-only smokers. ConclusionsDifferent messages are needed for different types of tobacco users. Both cigarette smokers and other tobacco users could benefit from messages that acknowledge the non-addictiveness but emphasize the health risks of VLNC. Regulators could consider making physical harm statements a requirement for VLNC packaging and marketing. New strategies need to be explored to inform cigarette dual/poly smokers.

Parental Report of Indoor Air Pollution Is Associated with Respiratory Morbidities in Bronchopulmonary Dysplasia

To determine the association between indoor air pollution and respiratory morbidities in children with bronchopulmonary dysplasia (BPD) recruited from the multicenter BPD Collaborative. A cross-sectional study was performed among participants <3years old in the BPD Collaborative Outpatient Registry. Indoor air pollution was defined as any reported exposure to tobacco or marijuana smoke, electronic cigarette emissions, gas stoves, and/or wood stoves. Clinical data included acute care use and chronic respiratory symptoms in the past 4weeks. A total of 1011 participants born at a mean gestational age of 26.4±2.2weeks were included. Most (66.6%) had severe BPD. More than 40% of participants were exposed to ≥1 source of indoor air pollution. The odds of reporting an emergency department visit (OR, 1.7; 95% CI, 1.18-2.45), antibiotic use (OR, 1.9; 95% CI, 1.12-3.21), or a systemic steroid course (OR, 2.18; 95% CI, 1.24-3.84) were significantly higher in participants reporting exposure to secondhand smoke (SHS) compared with those without SHS exposure. Participants reporting exposure to air pollution (not including SHS) also had a significantly greater odds (OR, 1.48; 95% CI, 1.08-2.03) of antibiotic use as well. Indoor air pollution exposure (including SHS) was not associated with chronic respiratory symptoms or rescue medication use. Exposure to indoor air pollution, especially SHS, was associated with acute respiratory morbidities, including emergency department visits, antibiotics for respiratory illnesses, and systemic steroid use.

Understandability of passive smoking prevention leaflets in Japan

PurposeThere are few studies in Japan evaluating informational materials about passive smoking prevention with respect to health literacy. This study applied a range of health literacy assessment tools to assess the understandability of public-sector leaflets about passive smoking prevention.MethodsWe collected 26 anti-passive smoking leaflets published online by Japanese prefectural governments. We used three internationally recognized health literacy assessment tools to evaluate their understandability: the Clear Communication Index (CCI), the Suitability Assessment of Materials (SAM), and the Patient Education Materials Assessment Tool (PEMAT, further divided into scales for understandability and actionability).ResultsAlthough none of the assessed materials met the CCI's scoring threshold for “easy to understand,” the highest-scoring leaflet, which received a top-two ranking in three of the four scales (excluding the PEMAT understandability scale), was characterized by its conciseness and its easy-to-understand structure, including the use of checklists and flowcharts to engage reader interest. There was a significant correlation between CCI and SAM, and between SAM and the PEMAT understandability scale. However, the PEMAT actionability scale did not significantly associate with the other assessment scales.ConclusionsThe understandability of written informational materials about passive smoking prevention in Japan could be improved by referring to multiple assessment scales.

Effects of indoor environments and outdoor air pollutants in residential areas on acute exacerbation in patients with severe asthma

ABSTRACT This study aimed to determine the effects of indoor environment (IE) and outdoor air pollutants (OAPs) in residential areas on acute exacerbation (AE) in patients with severe asthma. A total of 115 participants were recruited. To characterize IE, we used structured questionnaires and estimated OAP concentrations using a land-use regression model. Participants who were exposed to passive smoking and lived in houses where the kitchen and living room were not separated showed a significantly higher rate of AE (p = 0.014 and 0.0016, respectively). The mean concentration of PM2.5 in residential areas during the last 3 years was significantly higher in participants with AE than that in those without AE (19.8 ± 3.1 vs. 21.0 ± 2.5 µg/m3, p = 0.033). Moreover, the serum level of 8-hydroxy-2′-deoxyguanosine significantly increased in participants with AE compared to those without AE (56.9 ± 30.0 vs. 94.7 ± 44.5 ng/mL, p = 0.0047) suggesting enhanced oxidative stress in those with AE.

The salivary metabolome of children and parental caregivers in a large-scale family environment study

Human metabolism is complex, and is impacted by genetics, cohabitation, diet, health, and environmental inputs. As such, we applied untargeted LC-MS metabolomics to 1425 saliva samples from a diverse group of elementary school-aged children and their caregivers collected during the Family Life Project, of which 1344 were paired into caregiver/child dyads. We compared metabolomes within and between homes, performed population-wide “metabotype” analyses, and measured associations between metabolites and salivary biomeasures of inflammation, antioxidant potential, environmental tobacco smoke (ETS) exposure, metabolic regulation, and heavy metals. Children and caregivers had similar salivary metabolomes, and dyad explained most metabolomic variation. Our data clustered into two groups, indicating that “metabotypes” exist across large populations. Lastly, several metabolites—putative oxidative damage-associated or pathological markers—were correlated with the above-mentioned salivary biomeasures and heavy metals. Implications of the family environment’s effects on metabolomic variation at population, dyadic, and individual levels for human health are discussed.