Risk Of Secondhand Smoke Exposure Research Articles

The Effect of a Zero Tolerance Program Applied to Parents of Children at High Risk of Secondhand Smoke Exposure on the Child’s Urine Cotinine Level According to Exposure Feedback: A Study Protocol for a Randomized Controlled Tria

The Effect of a Zero Tolerance Program Applied to Parents of Children at High Risk of Secondhand Smoke Exposure on the Child’s Urine Cotinine Level According to Exposure Feedback: A Study Protocol for a Randomized Controlled Tria

Second-hand smoke exposure and cervical cancer: a systematic review and meta-analysis.

The association between second-hand smoke (SHS) exposure and cervical cancer (CC) risk is still unclear. The aim of this study is to provide an accurate and updated estimate of this association. Through an original methodology to identify original publications, we conducted a systematic review and meta-analysis of all epidemiological studies published up to October 2022 evaluating the association between SHS exposure and CC risk among female non-smokers. Meta-analytic estimates were obtained using random-effects models and dose-response relationships were derived using log-linear functions. Out of 25 eligible studies, 21 were included in the meta-analysis, providing a pooled relative risk (RR) of cervical intraepithelial neoplasia (CIN) of grade 2 or higher of 1.52 (95% confidence interval, CI 1.30-1.78, 21 studies) for overall SHS exposure versus non-exposure. When restricting the analysis to invasive CC, the pooled RR was 1.42 (95% CI 1.17-1.71, 13 studies), whereas the pooled RR for CIN was 1.50 (95% CI 1.22-1.84, 6 studies). Analyzing RR by setting or source of SHS exposure resulted in significant associations with CC risk for SHS exposure at home (RR for CIN2+ 1.49, 95% CI 1.21-1.84, 14 studies), in non-specified settings (RR for CIN2+ 1.64, 95% CI 1.20-2.23, 8 studies) and from partner (RR for CIN2+ 1.55, 95% CI 1.25-1.94, 10 studies). The risk of CIN2+ significantly increased linearly with the intensity and pack-years of SHS exposure. This comprehensive review and meta-analysis confirmed the association of SHS exposure with CC, further suggesting the need to raise concern about SHS exposure in the population.

Public support for car smoking bans in Poland: a 2022 national cross-sectional survey

ObjectiveThe objectives of this study were to assess the prevalence of self-reported secondhand smoke exposure in cars among adults in Poland and to characterise public attitudes towards the implementation of...

Child marriage and exposure to secondhand smoke among women of childbearing age: evidence from a nationally representative study in India

ABSTRACT Women in low-and-middle income countries (LMICs) are disproportionately exposed to secondhand smoke (SHS), particularly in the home environment. Girls married before the age of 18 are more likely to remain at home and may be at higher risk of SHS exposure. This paper investigates whether women who were married as child brides had a higher risk of SHS exposure than their peers who were married as adults in India, where both burden of smoking and child marriage are critical public health concerns. Data were obtained from the 2015–2016 wave of the nationally representative India National Family Health Survey and included 306,788 married women ages 18 to 35 years. We estimated bivariate and multivariate logistic regressions to obtain odds ratios in favor of SHS exposure. The prevalence of SHS exposure for those who were married as adults was 50.3% while that was 55.2% for those who were married before age 18. After controlling for sociodemographic characteristics, the adjusted odds of SHS exposure for those who were married as child were 1.06 (95% CI: 1.03, 1.09) times that of those who were married as adults. Findings of this study inform policies for coordinated efforts to eliminate child marriage and strengthen tobacco control.

What Helps and What Hinders the Creation of a Smoke-free Home: A Qualitative Study of Fathers in Scotland.

IntroductionFew studies have explored fathers’ views and experiences of creating a smoke-free home, with interventions largely targeting mothers. This study aimed to identify barriers and facilitators to fathers creating a smoke-free home, to inform future intervention development.MethodsEighteen fathers who were smokers and lived in Scotland were recruited from Dads’ community groups, Early Years Centres and through social media advertising. Semi-structured interviews explored their views and experiences of creating a smoke-free home. A theory-informed thematic analysis using the COM-B model highlighted ways in which capability, opportunity, and motivations shaped fathers’ home smoking behaviors. ResultsSeveral fathers understood the health risks of second-hand smoke exposure through public health messaging associated with recent smoke-free legislation prohibiting smoking in cars carrying children. Limited understanding of effective exposure reduction strategies and personal mental health challenges reduced some fathers’ ability to create a smoke-free home. Fathers were keen to maintain their smoke-free home rules, and their motivations for this largely centered on their perceived role as protector of their children, and their desire to be a good role model.ConclusionsFathers’ abilities to create a smoke-free home are shaped by a range of capabilities, opportunities, and motivations, some of which relate to their role as a father. Establishing a fuller understanding of the contextual and gender-specific factors that shape fathers’ views on smoking in the home will facilitate the development of interventions and initiatives that fathers can identify and engage with, for the broader benefit of families and to improve gender equity and health.ImplicationsOur findings can inform future development of father-centered and household-level smoke-free home interventions. They identify fathers’ views and experiences and help reframe smoking in the home as a gendered family-wide issue, which is important in building consensus on how best to support parents to create a smoke-free home. Our findings highlight the need for additional research to develop understanding of the ways in which gender-related aspects of family structures, heterosexual relationships, and child living arrangements influence home smoking rules and how to tailor interventions accordingly.

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.

An examination of social and environmental determinants of secondhand smoke exposure among non-smoking adolescents

INTRODUCTIONAdolescents are at increased risk of secondhand smoke exposure (SHS) due to the limited control that they have over social and physical environments. Yet, knowledge regarding determinants of SHS among non-smoking adolescents is limited. This study identifies social and environmental factors associated with SHS among non-smoking adolescents.METHODSTo be included, parents and adolescents (aged 11–17 years) of the Adolescents, Place, and Behavior Study had to have completed surveys between March 2019 and May 2020. Adolescents had to have not reported smoking within the past 30 days and provided a saliva sample assayed for cotinine (≤3 ng/mL). A series of stepwise linear regression models were fit to the data to identify social and environmental determinants of SHS, using log-transformed salivary cotinine.RESULTSOf the 105 adolescent and parent dyads included, 90.3% were African American, 26.9% of parents reported smoking, 33.3% resided in multi-unit housing, and 67.7% lived in homes where smoking was not permitted. Significant associations were found between parent tobacco use (β=2.56, SE=0.98, p=0.0082) and residing in multi-unit housing (β=1.72, SE=0.86, p=0.0460) with increased log-transformed cotinine levels among non-smoking adolescents. Adolescent age, gender, and race/ ethnicity, parental education, peer tobacco use, the number of adults and children in the home, average number of days of self-reported SHS within public spaces outside of the home, and home smoking policies were not significantly associated with cotinine.CONCLUSIONSResults emphasize the importance of reducing secondhand smoke exposure by reducing parental smoking and altering exposures within social and home environments. Parental tobacco use and residential setting should be considered when developing interventions to reduce secondhand smoke exposure among non-smoking adolescents.

Identifying the Best Questions for Rapid Screening of Secondhand Smoke Exposure Among Children.

Many children suffer from secondhand smoke exposure (SHSe), which leads to a variety of negative health consequences. However, there is no consensus on how clinicians can best query parents for possible SHSe among children. We employed a data-driven approach to create an efficient screening tool for clinicians to quickly and correctly identify children at risk for SHSe. Survey data from mothers and biospecimens from children were ascertained from the Neurodevelopment and Improving Children's Health following Environmental Tobacco Smoke Exposure (NICHES) study. Included were mothers and their children whose saliva were assayed for cotinine (n = 351 pairs, mean child age = 5.6 years). Elastic net regression predicting SHSe, as indicated from cotinine concentration, was conducted on available smoking-related questions and cross-validated with 2015-2016 National Health and Nutrition Examination Survey (NHANES) data to select the most predictive items of SHSe among children (n = 1670, mean child age = 8.4 years). Answering positively to at least one of the two final items ("During the past 30 days, did you smoke cigarettes at all?" and "Has anyone, including yourself, smoked tobacco in your home in the past 7 days?") showed area under the curve = .82, and good specificity (.88) and sensitivity (.74). These results were validated with similar items in the nationally representative NHANES sample, area under the curve = .82, specificity = .78, and sensitivity = .77. Our data-driven approach identified and validated two items that may be useful as a screening tool for a speedy and accurate assessment of SHSe among children. The current study used a rigorous data-driven approach to identify questions that could reliably predict SHSe among children. Using saliva cotinine concentration levels as a gold standard for determining SHSe, our analysis employing elastic net regression identified two questions that served as good classifier for distinguishing children who might be at risk for SHSe. The two items that we validated in the current study can be readily used by clinicians, such as pediatricians, as part of screening procedures to quickly identify whether children might be at risk for SHSe.

Smoking Prevalence and Secondhand Smoke Exposure during Pregnancy and Postpartum-Establishing Risks to Health and Human Rights before Developing a Tailored Programme for Smoking Cessation.

Both smoking during pregnancy and secondhand smoke exposure are associated with reduced health outcomes. However, limited consistent evidence exists of risks of secondhand smoke exposure in pregnancy. Currently, inadequate smoking cessation services exist in Irish maternity hospitals. To identify the number of pregnant women smoking during pregnancy and to identify their exposure to secondhand smoke, we conducted a cross-sectional observational pilot study in one regional maternity hospital in Ireland in July/August 2018. Respondents were (1) women attending antenatal clinics and (2) postpartum women before discharge. Variables measured included smoking status of pregnant women and partner status, demographic variables, secondhand smoke exposure, and support for hospital smoke-free policy and development of smoking cessation services. The overall response rate was 42.2% in this study. The response rate was 56.5% (111/196) from postnatal wards and 37.3% (215/577) from antenatal clinics. Over 40% of respondents reported they had smoked during their lifetime. The majority of women (70%) reported quitting smoking before their pregnancy. Few women were active smokers. Almost 40% reported exposure to tobacco smoke in the previous week (38.5%); 16.9% reported living with a smoker, a critical factor in increased risk (Odds Ratio (OR) 3.89, 95% CI = 1.86–8.15, p < 0.001). Approximately 10% of postnatal mothers reported that their newborn would travel home with a smoker. Support for a no-smoking hospital policy was very high as was support for the development of cessation services. No documentation of secondhand smoke exposure for pregnant women or newborns is sought or recorded routinely in the hospital. A systems approach to develop smoking cessation programmes in maternity care should include screening and documenting of secondhand smoke exposure risks for women during pregnancy, and for their newborns at discharge, to improve health outcomes and protect human rights.

Acculturation and Exposure to Secondhand Smoke in the Home Among Vietnamese Immigrants in Metropolitan Atlanta.

This study represents the first effort to examine associations between various measures of acculturation and past 30-day secondhand smoke (SHS) exposure among Vietnamese-Americans in metro-Atlanta, one of the areas with the highest number of Vietnamese-Americans in the U.S. Survey data of 96 Vietnamese-American nonsmoking adults attending health fairs/programs hosted by community-based organizations (2017-2018) were analyzed. Acculturation-related predictors included Vancouver Acculturation Index, language fluency, years in the U.S., and area-level proportion of Asian residents. The sample was an average 37.49years old and 65.3% female; the average number of years in the U.S. was 18.17years. Past 30-day SHS exposure was reported by 21.9%. In multiple logistic regressions, the only variable associated with SHS exposure was the number of years living in the U.S. [OR = 0.91, CI = (0.85-0.99), p = 0.02]. Newly-immigrated Vietnamese-Americans have increased SHS exposure risk. Education about smoke-free policies and harmful effects of SHS may benefit this population.

A protocol for measuring the impact of a smoke-free housing policy on indoor tobacco smoke exposure

BackgroundTobacco remains a leading cause of preventable death in the U.S., responsible for more than 440,000 deaths each year. Approximately 10% of these deaths are attributable to exposure of non-smokers to secondhand smoke (SHS). Residents living in public multi-unit housing (MUH) are at excess risk for SHS exposure compared to the general population. On November 30, 2016, the U.S. Department of Housing and Urban Development (HUD) passed a rule requiring all public housing agencies to implement smoke-free housing (SFH) policies in their housing developments by July 30, 2018.MethodsAs part of a larger natural experiment study, we designed a protocol to evaluate indoor SHS levels before and after policy implementation through collection of repeat indoor air samples in non-smoking apartments and common areas of select high-rise NYCHA buildings subject to the HUD SFH rule, and also from socio-demographically matched private-sector high-rise control buildings not subject to the rule. A baseline telephone survey was conducted in all selected buildings to facilitate rapid recruitment into the longitudinal study and assess smoking prevalence, behaviors, and attitudes regarding the SFH policy prior to implementation. Data collection began in early 2018 and will continue through 2021.DiscussionThe baseline survey was completed by 559 NYCHA residents and 471 comparison building residents (response rates, 35, and 32%, respectively). Smoking prevalence was comparable between study arms (15.7% among NYCHA residents and 15.2% among comparison residents). The majority of residents reported supporting a building-wide smoke-free policy (63.0 and 59.9%, respectively). We enrolled 157 NYCHA and 118 comparison non-smoking households into the longitudinal air monitoring study and performed air monitoring in common areas. Follow up surveys and air monitoring in participant households occur every 6 months for 2.5 years. Capitalizing on the opportunity of this federal policy rollout, the large and diverse public housing population in NYC, and robust municipal data sources, this study offers a unique opportunity to evaluate the policy’s direct impacts on SHS exposure. Methods in this protocol can inform similar SFH policy evaluations elsewhere.

Abstract P113: Predictors and Correlates of Secondhand Smoke in Work Environments Among Rural and Urban American Indians

Objective: In 2010 nearly 60% of American Indian (AI) adults in Minnesota reported they currently used cigarettes, a prevalence 3.5 times greater than the general population in that region. Here, we aim to describe the prevalence of secondhand smoke exposure and its correlates among Upper Midwest AIs in their homes and at work. Methods: Between 2010 and 2012 the American Indian Community Tobacco Project (AICTP) administered the Adult Tobacco Survey in collaboration with seven reservations and three urban communities in Minnesota. Eligible participants (n=2926) answered questions regarding exposure to secondhand smoke. Results: A third [33% (347 of 1059), 95% CI (30-36%)] of AIs reported being exposed to smoke in their workplace (compared to the 9% of the general Minnesota population). Half of males [50% (155 of 365), 95% CI (42-58%)] were exposed to secondhand smoke in the workplace, whereas only 27% [188 of 686, 95% CI (26-33%)] of females were exposed to secondhand smoke in the work environment. Of those who work on the reservation, 42% [237 of 570, 95% CI (36-48%)] of AI’s were exposed to secondhand smoke at their workplace. Within AI’s who have never smoked 25% [34 of 134, 95% CI (21-41%)] were still exposed to secondhand smoke within the workplace. Among AI’s who reported smoking policies in the workplace 30% [205 of 671, 95% CI (26-38%)] were exposed to secondhand smoke within the workplace, and 27% [158 of 578, 95% CI (20-30%)] of AI’s who stated their workplace was always enforced were still exposed to secondhand smoke in the workplace. A third [37% (120 of 321), 95% CI (35-54%)] of those who reported not having a workplace policy were exposed to secondhand smoke, demonstrating the need for policy development regarding smoking in the workplace. Conclusions: In conclusion, although strong policy protects most Minnesotans from secondhand smoke in workplaces, these policies do not seem to be benefitting AIs in the state. Discovery of who is at greatest risk for secondhand smoke exposure can inform future interventions and inform future policy optimization and protection.

Income Inequality and US Children's Secondhand Smoke Exposure: Distinct Associations by Race-Ethnicity.

Prior studies have found considerable racial and ethnic disparities in secondhand smoke (SHS) exposure. Although a number of individual-level determinants of this disparity have been identified, contextual determinants of racial and ethnic disparities in SHS exposure remain unexamined. The objective of this study was to examine disparities in serum cotinine in relation to area-level income inequality among 14 649 children from the National Health and Nutrition Examination Survey. We fit log-normal regression models to examine disparities in serum cotinine in relation to Metropolitan Statistical Areas level income inequality among 14 649 nonsmoking children aged 3-15 from the National Health and Nutrition Examination Survey (1999-2012). Non-Hispanic black children had significantly lower serum cotinine than non-Hispanic white children (-0.26; 95% CI: -0.38, -0.15) in low income inequality areas, but this difference was attenuated in areas with high income inequality (0.01; 95% CI: -0.16, 0.18). Serum cotinine declined for non-Hispanic white and Mexican American children with increasing income inequality. Serum cotinine did not change as a function of the level of income inequality among non-Hispanic black children. We have found evidence of differential associations between SHS exposure and income inequality by race and ethnicity. Further examination of environments which engender SHS exposure among children across various racial/ethnic subgroups can foster a better understanding of how area-level income inequality relates to health outcomes such as levels of SHS exposure and how those associations differ by race/ethnicity. In the United States, the association between children's risk of SHS exposure and income inequality is modified by race/ethnicity in a manner that is inconsistent with theories of income inequality. In overall analysis this association appears to be as predicted by theory. However, race-specific analyses reveal that higher levels of income inequality are associated with lower levels of SHS exposure among white children, while levels of SHS exposure among non-Hispanic black children are largely invariant to area-level income inequality. Future examination of the link between income inequality and smoking-related health outcomes should consider differential associations across racial and ethnic subpopulations.

Environmental Tobacco Smoke: Public Perception of Risks of Exposing Children to Second- and Third-Hand Tobacco Smoke

IntroductionExtensive evidence exists regarding health risks posed by children's exposure to second-hand smoke, and there is increasing evidence concerning the risks of third-hand smoke. This evidence is most meaningful if the public is aware of these risks and can help curb childhood exposure. MethodsParticipants were selected at an academic medical center and asked to complete a survey. Responses were compared based on respondents' smoking status and the presence or absence of children in their homes. ResultsA total of 310 adults responded. Nonsmokers and respondents living with children were more likely to see smoking in the home as affecting all the queried health problems (p < .05). Knowledge of the risks of second-hand smoke exposure is limited, and very few respondents perceived risk from third-hand smoke exposure. DiscussionThe widespread lack of awareness of the risks associated with environmental tobacco smoke must be addressed to curb childhood exposure.

Evaluation of secondhand smoke exposure in taxi cabs in Turkey

Introduction: In 2008, Turkey passed its smoke-free legislation prohibiting smoking in public spaces. However, this legislation does not extend to motor vehicles. This poses significant health risks to secondhand smoke exposure (SHS), especially to non-smokers. Our objective was to identify taxi drivers’ attitudes and behaviors in order to assess tobacco consumption and SHS in taxicabs. Methods: From December 2012 to July 2013, we conducted a cross-sectional observational study across 12 cities in Turkey. A systematic sample of 356 taxi commercial vehicles was selected. During trips to and from study venues, fieldworkers observed smoking exposure in taxicabs, such as the presence of cigarette butts or cigarette packs, and interviewed taxicab drivers on their smoking status and smoking policy. Results: 65% (232) of taxi drivers were current smokers. A majority of these current smokers also reported always (14%) and sometimes (29%) smoking inside the taxi. Overall, 62% of drivers allow passengers to smoke inside the taxi and 45% smoke when customers are inside the taxi. Less than 1% of smokers reported being fined by police because of smoking inside their taxi. Conclusions: This study highlights the need to promote public health awareness about the risks of secondhand smoke exposure, especially in motor vehicles. Efforts should be taken to inform the public about the potential health hazards of secondhand smoke exposure in motor vehicles, even under optimal ventilation conditions.

Prevalence and Associated Factors of Secondhand Smoke Exposure among Internal Chinese Migrant Women of Reproductive Age: Evidence from China's Labor-Force Dynamic Survey.

Secondhand smoke (SHS) is a major risk factor for poor health outcomes among women in China, where proportionately few women smoke. This is especially the case as it pertains to women’s reproductive health, specifically migrant women who are exposed to SHS more than the population at large. There are several factors which may increase migrant women’s risk of SHS exposure. This paper aims to investigate the prevalence and associated factors of SHS exposure among internal Chinese migrant women of reproductive age. The data used were derived from the 2014 Chinese Labor Dynamic Survey, a national representative panel survey. The age-adjusted rate of SHS exposure of women of reproductive age with migration experience was of 43.46% (95% CI: 40.73%–46.40%), higher than those without migration experience (35.28% (95% CI: 33.66%–36.97%)). Multivariate analysis showed that participants with a marital status of “Widowed” had statistically lower exposure rates, while those with a status of “Cohabitation” had statistically higher exposure. Those with an undergraduate degree or above had statistically lower SHS exposure. Those with increasing levels of social support, and those who currently smoke or drink alcohol, had statistically higher SHS exposure. Participants’ different work-places had an effect on their SHS exposure, with outdoor workers statistically more exposed. Our findings suggest that urgent tobacco control measures should be taken to reduce smoking prevalence and SHS exposure. Specific attention should be paid to protecting migrant women of reproductive age from SHS.

Trends in children's exposure to second-hand smoke in the INMA-Granada cohort: An evaluation of the Spanish anti-smoking law

The smoke-free legislation implemented in Spain in 2006 imposed a partial ban on smoking in public and work places, but the result did not meet expectations. Therefore, a more restrictive anti-smoking law was passed five years later in 2011 prohibiting smoking in all public places, on public transport, and the workplace. With the objective of assessing the impact of the latter anti-smoking legislation on children's exposure to second-hand smoke (SHS), we assessed parent’s smoking habits and children’s urine cotinine (UC) concentrations in 118 boys before (2005–2006) and after (2011–2012) the introduction of this law. Repeated cross-sectional follow-ups of the “Environment and Childhood Research Network” (INMA-Granada), a Spanish population-based birth cohort study, at 4–5 years old (2005–2006) and 10–11 years old (2011–2012), were designed. Data were gathered by ad-hoc questionnaire, and median UC levels recorded as an objective indicator of overall SHS exposure. Multivariable logistic regression was used to examine the association between parent’s smoking habits at home and SHS exposure, among other potential predictors. An increase was observed in the prevalence of families with at least one smoker (39.0% vs. 50.8%) and in the prevalence of smoking mothers (20.3% vs. 29.7%) and fathers (33.9% vs. 39.0%). Median UC concentration was 8.0ng/mL (interquartile range [IQR]: 2.0–21.8) before legislation onset and 8.7ng/mL (IQR: 2.0–24.3) afterwards. In the multivariable analysis, the smoking status of parents and smoking habits at home were statistically associated with the risk of SHS exposure and with UC concentrations in children. These findings indicate that the recent prohibition of smoking in enclosed public and workplaces in Spain has not been accompanied by a decline in the exposure to SHS among children, who continue to be adversely affected. There is a need to target smoking at home in order to avoid future adverse health effects in a population that has no choice in the acceptance or not of SHS exposure-derived risk.

Second-Hand Smoking among Intermediate and Secondary School Students in Madinah, Saudi Arabia

Background and objectives. Second-hand smoke (SHS) is an important public health problem worldwide. The study aimed to estimate the prevalence of SHS exposure and its associated risk factors among intermediate and secondary school students. Methods. A cross-sectional study was conducted in 2013 among 3400 students from 34 intermediate and secondary schools in Madinah City, Saudi Arabia. Data about sociodemographic and smoking-related factors and SHS exposure were collected using a self-administered questionnaire. Results. Of the 3210 students analyzed, the prevalence of SHS exposure was 32.7% 49.3%, and 25% inside, outside, and both inside and outside the home, respectively. The highest risk of SHS exposure was associated with the adolescent's smoking status, parental smoking, close friends smoking, and family structure. The risk was markedly increased in association with parental smoking for exposure inside the home (OR = 6.49; 95% CI = 5.44–7.73) and with close friends smoking for exposure outside the home (OR = 4.16; 95% CI = 3.54–4.77). The risk of SHS, however, was lower among adolescents having knowledge about smoking and highly educated parents. Conclusion. The study revealed a considerably high prevalence of SHS both inside and outside the home among adolescents. Knowledge and beliefs about SHS exposure are the main preventable approach.

Nonverbal Reasoning in Preschool Children: Investigating the Putative Risk of Secondhand Smoke Exposure and Attention-Deficit/Hyperactivity Disorder as a Mediator.

Exposure to secondhand smoke (SHS) has been found to be associated with cognitive deficits in children. However, relatively little is known about the relationship between SHS exposure, cognitive deficits, and smoking-related psychopathology, specifically attention-deficit/hyperactivity disorder (ADHD) and externalizing disorders such as conduct disorder (CD) and oppositional defiant disorder (ODD) in preschool children. Children (n = 54) between the ages of 4 and 6 years from a comprehensive, longitudinal study of preschool emotional development were included in this study. Each child's primary caregiver completed questionnaires and interviews related to childhood psychopathology. SHS exposure was estimated with the use of saliva cotinine values. After adjustment for sociodemographic factors (e.g., age, gender, an income-to-needs ratio) and for ADHD, CD, and ODD symptoms, exposure to SHS was found to be negatively associated with preschool children's nonverbal reasoning skills. Exposure to SHS continued to be negatively associated with nonverbal reasoning skills after adjustment for maternal education, maternal smoking during pregnancy, and maternal reports of exposure to SHS during pregnancy in separate models. Children who grow up in an environment with adults who smoke are vulnerable to several social and environmental risk factors. The findings of this study suggest that exposure to SHS during early childhood should also be considered as a potential variable in the risk trajectory and as a marker of other associated risks when formulating public health intervention and prevention strategies.

Assessment of secondhand smoke exposure at school among U.S. Middle and high school students.

To obtain nationally representative estimates of the prevalence of secondhand smoke (SHS) exposure at U.S. schools, we assessed the prevalence and correlates of SHS exposure at school among U.S. middle and high school students using data from the 2011 National Youth Tobacco Survey comprising of 18,866 students spread across all the U.S. states. Overall prevalence of SHS exposure at school was 25.7% (95% CI: [23.6%, 27.8%]). Multivariate logistic regression indicated that having ≥1 smoker friends (adjusted Odds Ratio [aOR] = 2.92; p < .001); being a smoker (aOR = 2.75; p < .001); and being aged 13-16 years, or ≥17 years (vs. 9-12 years) significantly increased the likelihood of SHS exposure. Understanding the health risks of SHS exposure alone did not seem to play a significant role in reducing exposure (aOR = .89; p = .342). These findings show there are significant levels of SHS exposure among students at U.S. middle and high schools, and sustained multipronged efforts are needed to reduce youth SHS exposure.