Reduce Tobacco Smoking Research Articles

Decreasing trend in passive tobacco smoke exposure and association with asthma in U.S. children

In this study, we assessed trends of serum cotinine levels over time among US children ages 3–11 years and compared the risk of asthma in groups exposed to passive tobacco smoke. We utilized National Health and Nutrition Examination Survey (NHANES) data collected from 2003 to 2014 (n = 8064). Serum cotinine level, household smoker status, asthma status, and sociodemographic information were extracted for multiple regression analyses. The adjusted biannual change in log (cotinine) in comparison to earlier NHANES survey cycles was − 0.196 (p < 0.001) overall, − 0.055 (p = 0.089) among children with household smoker(s), and − 0.129 (p < 0.001) among children without. The proportion of children living with household smokers decreased from 24.9% in the 2003–2004 cycle to 11.4% in the 2013–2014 cycle. The adjusted odds ratios (ORs) for asthma were 1.34 (95% confidence interval (CI): 1.00–1.80; 2nd tertile vs 1st tertile) and 1.69 (95%CI: 1.25–2.29; 3rd tertile vs1st tertile), respectively. Highly exposed asthmatic children, in the 3rd cotinine tertile (>0.13 ng/mL), were primarily Non-Hispanic Black (61.0%) and whose family incomes were below poverty guidelines. Overall results reveal passive smoke exposure level among children ages 3–11 in the US decreased over the study period. Nevertheless, higher exposure to passive smoke is still associated with higher odds of childhood asthma. Targeted smoking cessation interventions in clinical practices are needed to reduce tobacco smoke exposure and related asthma risk in children, particularly in low-income and minority groups.

Self-Reported Environmental Tobacco Smoke Exposure and Avoidance Compared with Cotinine Confirmed Tobacco Smoke Exposure among Pregnant Women and Their Infants

Background: Exposure to environmental tobacco smoke (ETS) presents substantial health risks for pregnant women and newborn infants. Measurements of ETS include invasive and expensive biochemical tests, as well as less invasive and lower-cost, self-reported exposure and avoidance measures. Better understanding of self-report measures will help to select ETS assessments for evaluation. Methods: This analysis was conducted within the context of a tailored video intervention to reduce tobacco smoking and ETS exposure during pregnancy and after delivery in the control group sample of 147 nonsmoking women. Measurements of salivary cotinine concentration, self-reported ETS exposure, and avoidance behaviors were captured at 32 weeks’ gestation and 6 months postpartum. Results: Salivary cotinine concentration was significantly related to ETS avoidance among pregnant nonsmokers at 32 weeks’ gestation, but not ETS exposure. At 6 months postpartum, both the reported ETS exposure of the infant and maternal avoidance behaviors to reduce her infant’s exposure were associated with the infant’s salivary cotinine concentration. At 32 weeks’ gestation and 6 months postpartum, avoidance behaviors decreased as exposure increased. Discussion: This study suggests that for nonsmoking women during pregnancy, reports of tobacco smoke avoidance are more valid than reports of exposure. After delivery, self-reported ETS exposure or avoidance are associated with each other and the biochemical measurement of salivary cotinine. These results provide researchers and clinicians with evidence to support the inclusion of avoidance behaviors in the selection of ETS measures.

Reducing tobacco smoke exposure for vulnerable groups: hospital settings and teachable moments.

Reducing tobacco smoke exposure for vulnerable groups: hospital settings and teachable moments.

Motivation and main flavour of use, use with nicotine and dual use of electronic cigarettes in Barcelona, Spain: a cross-sectional study

ObjectiveThis study seeks to describe current e-cigarette users’ patterns of use including primary motivation for use, dual use, use with nicotine and principal flavour used, according to individuals’ sociodemographic characteristics...

The Effect of Treatment with Guanfacine, an Alpha2 Adrenergic Agonist, on Dopaminergic Tone in Tobacco Smokers: An [11C]FLB457 PET Study.

Guanfacine, a noradrenergic alpha2a agonist, reduced tobacco smoking in a 4-week trial and in animal models has been shown to reduce cortical dopamine release, which is critically involved in the reinforcing effect of tobacco smoking. We measured amphetamine-induced extrastriatal dopamine release before and after treatment with guanfacine with [11C]FLB457, a dopamine D2/D3 receptor radiotracer, and positron emission tomography (PET). Sixteen tobacco smokers had one set of [11C]FLB457 PET scans on the same day, one before and one at 2.5-3 h after amphetamine (0.4-0.5 mg/kg, PO). A subset (n=12) then underwent guanfacine treatment (3 mg/day for 3 weeks) and the set of scans were repeated. [11C]FLB457-binding potential (BPND) was measured pre- and post amphetamine in extrastriatal brain regions. The fractional change in BPND after vs before amphetamine (Δ BPND) is an indirect measure of DA release and was compared between the untreated and guanfacine-treated conditions. Guanfacine treatment attenuated amphetamine-induced DA release; however, the change was due to a global 8% decrease in baseline BPND from the untreated to the guanfacine-treated condition. Chronic guanfacine treatment reduced [11C]FLB457 BPND in tobacco smokers, suggesting an increase in dopaminergic tone. Guanfacine-induced normalization of dopamine signaling may be an important mesocortical mechanism contributing to its ability to aid in tobacco smoking cessation.

New laws to reduce tobacco smoking changed attitudes to the problem, but not the percentage of smokers.

The epidemic of tobacco smoking remains one of the most important challenges in public health. It is associated with premature death. For this reason, the Act of 9 November 1995 on the Protection of Public Health against the Effects of Use of Tobacco and Tobacco Products, as amended on 15 November 2010, implemented significant additional restrictions on smoking in public places. The objective of this study is evaluation of the impact of smoking regulations on social behaviour and attitude to the legal forms of tobacco control, due to the new smoke-free policy. A secondary statistical analysis of third party data was used in the study. The material was obtained from the Public Opinion Research Centre. Polls are conducted among representative samples of about 1,000 adult inhabitants of Poland. The studies on cigarette smoking were carried out in 3 editions (2010, 2011, 2012). The collected data on tobacco smoking before and after implementation of the Act show that the number of smokers remained at a comparable level - about 30% (p=0.891). Between 2010-2012, an increase was observed in the percentage of people supporting the smoking ban in public places. The total number of people who definitely or rather supported the smoking ban increased from 75.6% in 2010 to 85.0% in 2012 (p<0.001). The restrictive smoking ban in public places implemented in 2010 did not have an impact on the number of smokers in the studied time interval, although an increase in the number of people supporting the smoking ban in public places was observed.

The use of planned behavior theory in predicting cigarette smoking among Waterpipe smokers

sBackgroundWaterpipe and cigarette smoking have been found to be associated with each other as cigarette smokers were more likely to be waterpipe users than non-cigarette smokers. Also, waterpipe smokers were likely to be former daily cigarette users. The aim of this study is to examine the likelihood of waterpipe use leading to cigarette use among current waterpipe users using theory of planned behavior.MethodsFour hundred six current waterpipe smokers who initially had started tobacco use with the waterpipe were recruited from 15 waterpipe lounges in 2015. From a total of 70 waterpipe lounges in Riyadh, the 15 waterpipe lounges were selected randomly and participants were also selected randomly inside each waterpipe lounge based on the table or section number. The survey was developed using the Qualtrics Online Survey Software and participants completed a survey using iPad tablets.ResultsCigarette smoking and intention to smoke cigarettes were predicted by attitude and perceived behavioral control. There was no direct effect of subjective norm on the cigarette use behavior, yet subjective norm had a statistically significant indirect effect on intentions through attitude and perceived behavioral control.ConclusionsThe findings of this study could be useful in prevention/intervention programs aimed at reducing tobacco smoking behaviors among waterpipe users. Intervention programs might be directed at the attitude and perceived behavioral control by targeting underlying behavioral and control beliefs. The theory of planned behavior provided solid explanations of intention to use cigarettes among waterpipe smokers.

Tobacco smoking: Health impact, prevalence, correlates and interventions

Background and objectives: Despite reductions in prevalence in recent years, tobacco smoking remains one of the main preventable causes of ill-health and premature death worldwide. This paper reviews the extent and nature of harms caused by smoking, the benefits of stopping, patterns of smoking, psychological, pharmacological and social factors that contribute to uptake and maintenance of smoking, the effectiveness of population and individual level interventions aimed at combatting tobacco smoking, and the effectiveness of methods used to reduce the harm caused by continued use of tobacco or nicotine in some form.Results and conclusions: Smoking behaviour is maintained primarily by the positive and negative reinforcing properties of nicotine delivered rapidly in a way that is affordable and palatable, with the negative health consequences mostly being sufficiently uncertain and distant in time not to create sufficient immediate concern to deter the behaviour. Raising immediate concerns about smoking by tax increases, social marketing and brief advice from health professionals can increase the rate at which smokers try to stop. Providing behavioural and pharmacological support can improve the rate at which those quit attempts succeed. Implementing national programmes containing these components are effective in reducing tobacco smoking prevalence and reducing smoking-related death and disease.

Quit Tobacco: Are We Prepared?

Background: The pattern of tobacco consumption survey among the students in a private dental college in Mangalore helps us to assess the awareness and pattern of tobacco consumption among the dental students and also to assess the preparedness for tobacco control among the future health care professionals in India. Aim: To study the awareness and pattern of tobacco use among undergraduate dental students of a private dental College, at Dakshina Kannada, Karnataka. Materials and Methods: A Cross-sectional study was conducted among 100 dental students using a predesigned and pretested, semi-structured self-administered anonymous questionnaire. Data was analyzed by Microsoft excel and SPSS v 16.Statistical analysis comprised calculating proportion and the chi-square (χ2) test with Yates correction. Results: Among 100 participants, of which 52 students were males and 48 females, out of which 49% believed that the minimum number of cigarettes a person can smoke without causing harm to one’s health. About 89% of the students believe that it is the doctor’s duty to advice patients not to smoke or chew tobacco. 81% believe that health professional intervention would help the patient quit the habit. Conclusion: Awareness about harmful effects of tobacco abuse was good and the students feel that tobacco cessation modules should be incorporated in the dental curriculum. Given their important future role as exemplars, more effective measures to help reduce tobacco smoking among dental students are clearly needed worldwide.

Smoke-free legislation and child health.

In this paper, we aim to present an overview of the scientific literature on the link between smoke-free legislation and early-life health outcomes. Exposure to second-hand smoke is responsible for an estimated 166 ,000 child deaths each year worldwide. To protect people from tobacco smoke, the World Health Organization recommends the implementation of comprehensive smoke-free legislation that prohibits smoking in all public indoor spaces, including workplaces, bars and restaurants. The implementation of such legislation has been found to reduce tobacco smoke exposure, encourage people to quit smoking and improve adult health outcomes. There is an increasing body of evidence that shows that children also experience health benefits after implementation of smoke-free legislation. In addition to protecting children from tobacco smoke in public, the link between smoke-free legislation and improved child health is likely to be mediated via a decline in smoking during pregnancy and reduced exposure in the home environment. Recent studies have found that the implementation of smoke-free legislation is associated with a substantial decrease in the number of perinatal deaths, preterm births and hospital attendance for respiratory tract infections and asthma in children, although such benefits are not found in each study. With over 80% of the world’s population currently unprotected by comprehensive smoke-free laws, protecting (unborn) children from the adverse impact of tobacco smoking and SHS exposure holds great potential to benefit public health and should therefore be a key priority for policymakers and health workers alike.

An Intelligent Approach to Reducing Tobacco Smoking among Adolescents: Health Risk Expert Approach

Tobacco smoking causes health challenges both nationally and internationally, and there is need to reduce tobacco consumption. To achieve this, the researchers used Case Based Reasoning (CBR) methodology and Nearest Neighbour (NN) similarity technique in developing a web-based expert system to assist in reducing the rate of tobacco consumption among adolescents. In the cause of the research, 20 related diseases to tobacco smoking were identified and stored in the knowledge based; these data were used to test 3 new cases and their inherent individual level associated to it. The new cases are tuberculosis, laryngeal cancer (throat cancer), and asthma with highest risk values of 1.0, 0.8, and 0.9 respectively. The results provided a procedure to assist adolescents (smokers) minimize tobacco consumption. The system also offers some home remedies to help them deal with nicotine withdrawal syndrome. Therefore, adolescents are advised to quit smoking in order to avoid serious health problems in the future.

Prevalence of tobacco smoking and KAP about smoking among medical students in a private college in Central Kerala

Background: Smoking is a leading cause of preventable death, killing more than 5 million yearly. Smoking among health care personnel such as medical students is an important public health issue. This study was done to understand and in future find effective measures to reduce tobacco smoking among medical students. Objectives: To find the prevalence and to assess knowledge, attitude and practice of tobacco smoking among students of a Private Medical College in Central Kerala. Material and Methods: Cross-sectional study, using pretested, anonymous questionnaire, was conducted in a private medical college in central Kerala and proportions, test of significance like χ2and t test were used. Results: Out of 342 students, 26 (7.6%) were smokers; Males 25 (21.0%, out of 119), females 1 (0.44% out of 223), 72 (21.1%) had ever smoked; of which 60 were males (50.42%) and 12 (5.38%) were females; 82 (24%) had family members who smoked; 196 (57.3%) had relatives who smoked; and 184 (53.8%) had a smoker in their friend circle. 68.4% of students do not like to socialize or engage in activities with smokers. 17 (53.2% of smokers) want to quit smoking; 17 (51.5% of smokers) claimed to have a relapse. Conclusions: Smokers are predominantly more between 21-26 years of age. Most of students started the habit of smoking between 16-20 years of age, therefore it is necessary to bring positive behavioral changes through adoption of comprehensive awareness programs on harmful effects of smoking among adolescent school going children.

Prevalence of tobacco smoking and KAP about smoking among medical students in a private college in Central Kerala

Background: Smoking is a leading cause of preventable death, killing more than 5 million yearly. Smoking among health care personnel such as medical students is an important public health issue. This study was done to understand and in future find effective measures to reduce tobacco smoking among medical students. Objectives: To find the prevalence and to assess knowledge, attitude and practice of tobacco smoking among students of a Private Medical College in Central Kerala. Material and Methods: Cross-sectional study, using pretested, anonymous questionnaire, was conducted in a private medical college in central Kerala and proportions, test of significance like χ2and t test were used. Results: Out of 342 students, 26 (7.6%) were smokers; Males 25 (21.0%, out of 119), females 1 (0.44% out of 223), 72 (21.1%) had ever smoked; of which 60 were males (50.42%) and 12 (5.38%) were females; 82 (24%) had family members who smoked; 196 (57.3%) had relatives who smoked; and 184 (53.8%) had a smoker in their friend circle. 68.4% of students do not like to socialize or engage in activities with smokers. 17 (53.2% of smokers) want to quit smoking; 17 (51.5% of smokers) claimed to have a relapse. Conclusions: Smokers are predominantly more between 21-26 years of age. Most of students started the habit of smoking between 16-20 years of age, therefore it is necessary to bring positive behavioral changes through adoption of comprehensive awareness programs on harmful effects of smoking among adolescent school going children.

Antenatal and early life tobacco smoke exposure in an African birth cohort study.

Exposure to tobacco smoke in African infants has not been well studied, despite the high burden of childhood respiratory disease in these communities. To investigate the prevalence of antenatal and early life tobacco smoke exposure and associations with infant birth outcomes in an African birth cohort, the Drakenstein Child Health Study. Self-report questionnaires assessing maternal and household smoking were administered. Maternal and infant urine cotinine testing was conducted antenatally, at birth and at 6-10 weeks of life to measure tobacco smoke exposure. Multivariate regression models explored the associations between exposure to smoke and infant birth outcomes. Of 789 pregnant women included, 250 (32%) were active smokers on cotinine testing. At birth and at 6-10 weeks of life, respectively 135/241 (56%) and 154/291 (53%) infants had urine cotinine levels indicating tobacco smoke exposure. Household smoking was prevalent and was associated with positive infant cotinine test results. Antenatal maternal smoking was associated with decreased infant birthweight-for-age Z-score (0.3, 95%CI 0.1-0.5). Antenatal and early life tobacco smoke exposure is highly prevalent in this community, and may impact on birth outcomes and subsequent child health. Smoking cessation interventions are urgently needed to reduce tobacco smoke exposure in African communities.

Interventions by Health Care Professionals Who Provide Routine Child Health Care to Reduce Tobacco Smoke Exposure in Children: A Review and Meta-analysis.

Reducing child exposure to tobacco smoke is a public health priority. Guidelines recommend that health care professionals in child health settings should address tobacco smoke exposure (TSE) in children. To determine the effectiveness of interventions delivered by health care professionals who provide routine child health care in reducing TSE in children. A secondary analysis of 57 trials included in a 2014 Cochrane review and a subsequent extended search was performed. Controlled trials (published through June 2015) of interventions that focused on reducing child TSE, with no restrictions placed on who delivered the interventions, were identified. Secondary data extraction was performed in August 2015. Controlled trials of routine child health care delivered by health care professionals (physicians, nurses, medical assistants, health educators, and dieticians) that addressed the outcomes of interest (TSE reduction in children and parental smoking behaviors) were eligible for inclusion in this review and meta-analysis. Study details and quality characteristics were independently extracted by 2 authors. If outcome measures were sufficiently similar, meta-analysis was performed using the random-effects model by DerSimonian and Laird. Otherwise, the results were described narratively. The primary outcome measure was reduction in child TSE. Secondary outcomes of interest were parental smoking cessation, parental smoking reduction, and maternal postpartum smoking relapse prevention. Sixteen studies met the selection criteria. Narrative analysis of the 6 trials that measured child TSE indicated no intervention effects relative to comparison groups. Similarly, meta-analysis of 9 trials that measured parental smoking cessation demonstrated no overall intervention effect (n = 6399) (risk ratio 1.05; 95% CI, 0.74-1.50; P = .78). Meta-analysis of the 3 trials that measured maternal postpartum smoking relapse prevention demonstrated a significant overall intervention effect (n = 1293) (risk ratio 1.53; 95% CI, 1.10-2.14; P = .01). High levels of study heterogeneity likely resulted from variability in outcome measures, length of follow up, intervention strategies, and unknown intervention fidelity. Interventions delivered by health care professionals who provide routine child health care may be effective in preventing maternal smoking relapse. Further research is required to improve the effectiveness of such interventions in reducing child TSE and increasing parental smoking cessation. The findings of this meta-analysis have policy and practice implications relating to interventions by routine pediatric health care professionals that aim to reduce child exposure to tobacco smoke.

Effectiveness of Interventions to Reduce Tobacco Smoke Pollution in Homes: A Systematic Review and Meta-Analysis.

Introduction: Smoke-free homes can help protect children from tobacco smoke exposure (TSE). The objective of this study was to conduct a meta-analysis to quantify effects of interventions on changes in tobacco smoke pollution in the home, as measured by air nicotine and particulate matter (PM). Methods: We searched MEDLINE, PubMed, Web of Science, PsycINFO, and Embase. We included controlled trials of interventions which aimed to help parents protect children from tobacco smoke exposure. Two reviewers identified relevant studies, and three reviewers extracted data. Results: Seven studies were identified. Interventions improved tobacco smoke air pollution in homes as assessed by nicotine or PM. (6 studies, N = 681, p = 0.02). Analyses of air nicotine and PM separately also showed some benefit (Air nicotine: 4 studies, N = 421, p = 0.08; PM: 3 studies, N = 340, p = 0.02). Despite improvements, tobacco smoke pollution was present in homes in all studies at follow-up. Conclusions: Interventions designed to protect children from tobacco smoke are effective in reducing tobacco smoke pollution (as assessed by air nicotine or PM) in homes, but contamination remains. The persistence of significant pollution levels in homes after individual level intervention may signal the need for other population and regulatory measures to help reduce and eliminate childhood tobacco smoke exposure.

Vaping cannabis (marijuana) has the potential to reduce tobacco smoking in cannabis users

Vaping cannabis (marijuana) has the potential to reduce tobacco smoking in cannabis users

Clinical Practice Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke

Tobacco dependence starts in childhood. Tobacco exposure of children is common and causes illness and premature death in children and adults, with adverse effects starting in the womb. There is no safe level of tobacco smoke exposure. Pediatricians should screen for use of tobacco and other nicotine delivery devices and provide anticipatory guidance to prevent smoking initiation and reduce tobacco smoke exposure. Pediatricians need to be aware of the different nicotine delivery systems marketed and available.Parents and caregivers are important sources of children's tobacco smoke exposure. Because tobacco dependence is a severe addiction, to protect children's health, caregiver tobacco dependence treatment should be offered or referral for treatment should be provided (such as referral to the national smoker's quitline at 1-800-QUIT-NOW). If the source of tobacco exposure cannot be eliminated, counseling about reducing exposure to children should be provided.Health care delivery systems should facilitate the effective prevention, identification, and treatment of tobacco dependence in children and adolescents, their parents, and other caregivers. Health care facilities should protect children from tobacco smoke exposure and tobacco promotion. Tobacco dependence prevention and treatment should be part of medical education, with knowledge assessed as part of board certification examinations.

Smoking is a major preventable risk factor for multiple sclerosis

Background: Both smoking and exposure to passive smoking have repeatedly been associated with increased multiple sclerosis (MS) risk, but have never before been studied together. We assessed the public health impact of these factors. Methods: In a Swedish population-based case-control study (2455 cases, 5336 controls), we calculated odds ratios of developing MS associated with different categories of tobacco smoke exposure, together with 95% confidence intervals, by using logistic regression. The excess proportion of cases attributable to smoking and passive smoking was calculated as a percentage. Results: Both smoking and exposure to passive smoking contribute to MS risk in a dose-dependent manner. At the population level, 20.4% of all cases were attributable to smoke exposure. Among subjects carrying the genetic risk factor HLA-DRB1*15 but lacking HLA-A*02, 41% of the MS cases were attributable to smoking. Conclusions: From a public health perspective, the impact of smoking and passive smoking on MS risk is considerable. Preventive measures in order to reduce tobacco smoke exposure are, therefore, essential. In particular, individuals with a history of MS in the family should be informed regarding the impact of smoking on the risk of MS, and the importance of preventing their children from being exposed to passive smoke.

Smoking among undergraduate university students

Smoking is one of the major Public Health problems worldwide. To study the frequency of tobacco smoking among undergraduate students of a Chilean university. An opinion survey was sent by e-mail to all undergraduate students of a university, registering gender, age, study years, study area, smoking behavior, motivation (reason for smoking), intention to quit and tobacco law perception. 1,008 (57% females) out of 11,679 surveys were answered back. Prevalence of active smoking among respondents was 36%, without association with gender, age or years of study. However, students from scientific areas had a lower prevalence. Seventy seven percent of smokers manifested the intention to quit the habit or have started quitting already. Ninety six percent were acquainted with the tobacco law and by 73% agreed with it. Smoking is highly prevalent among university students. It is necessary to develop strategies for smoking cessation within universities that may prevent or reduce tobacco smoking among students.