Smoking Ban Research Articles

Long-Term Follow-up Study of Hospitalizations for Acute Coronary Syndrome in Kobe-City and Other Districts Under the Hyogo Smoking Ban Legislation - A Nationwide Database Study.

Hyogo Prefecture has managed smoking ban legislation with partial restrictions in public places (Hyogo-L) since 2013. Previous studies have reported a significant decrease in admissions for acute coronary syndrome (ACS) in Kobe-city, but not in other districts of Hyogo Prefecture in the 2 years after Hyogo-L. The aim of the present study was to define the long-term effect of Hyogo-L. The JROAD-DPC dataset was used to collect information on the number of hospitalizations for ACS in Hyogo Prefecture, and in Osaka-city without smoking ban legislation, from April 2013 to March 2020. Poisson regression analysis was performed to calculate incident rate ratios (IRRs) and 95% confidence intervals (CIs). ACS records of 3,101 in Kobe-city, 11,375 in areas of Hyogo Prefecture other than Kobe-city and 11,079 in Osaka-city were collected for admissions. The incidence of ACS reduced significantly over time in Kobe-city [IRR (95% CI); 0.96 (0.94-0.97)], but did not reduce in the others. The decrease in Kobe-city was observed in ACS patients without smoking, hypertension, and hyperlipidemia, but not in those with such risk factors. The long-term ACS reduction or non-reduction under Hyogo-L was determined at the initial period and the same scenario continued, supporting the importance of legislation and compliance with the smoking ban. The lowering effect was remarkable in ACS patients without risk factors such as non-smoking.

Trends in acute hospital smoking prevalence and support of campus ban in Dublin, Ireland (1997-2018)

Abstract Background St Vincent's University Hospital (SVUH), a major hospital in Dublin, Ireland pioneered a hospital smoke-free campus policy in 2009; pre/post this intervention it conducted periodic surveys of patients, staff & visitors for smoking prevalence and policy attitudes. As rates of smoking decline nationally in Ireland, it is important to monitor trends for at-risk groups, including lower socioeconomic status (SES). Methods Repeat questionnaires were administered by census surveys of inpatients, quota or random sub-sample surveys of staff, and quota surveys with outpatients and visitors between 1997 and 2018. As a proxy for social deprivation, the rate of inpatients eligible by income for the state-funded General Medical Services (GMS) card was assessed. Chi square test for trend and SPSS v.27 were used for analysis. Results Support for and awareness of the campus smoking ban increased steadily; post ban agreement varied by smoking status (64.7% smokers, 89.7% ex-smokers; 92.5% non-smokers, p = 0.002). Smoking rates declined in all groups but significantly in outpatients (19.5% vs. 10%; p < 0.01), visitors (27.4% vs 9.5%; p < 0.0001) and staff (30.0% vs 10.8%; p < 0.0001). Rates of inpatient GMS entitlement was high at 54.2% average, compared with national rates of approximately 30% in 2021. Rates of smoking were non-significantly higher in GMS entitled inpatients (33.2% vs 26.8%; p = 0.09) across all survey periods. Conclusions While hospital smoking prevalence has decreased and campus ban support persists, the campus is not immune to challenges in keeping it smoke-free. There are many socioeconomically deprived patients who smoke; this in part may reflect a private hospital on the same campus where affluent smokers are more likely to attend. Recent national initiatives for free nicotine replacement therapy and targeted smoking cessation courses in deprived areas work to address inequalities. We are not aware of similar studies in a hospital population over 25 years. Key messages • Periodic hospital smoking surveys show trends in prevalence which mirror the falling national trends in Ireland. • Socioeconomic differences persist in smoking rates among hospital patients.

Global burden of lower respiratory infections attributable to secondhand smoke among children under 5 years of age, 2010–2019: a systematic analysis of the global burden of disease study 2019

BackgroundEpidemiological trends of lower respiratory infections (LRIs) attributable to secondhand smoke (SHS) among children under 5 years since smoking bans have been increasingly applied globally remain unclear. Here, we aimed to estimate the spatiotemporal trends of the global, regional, and national burden of LRIs attributable to SHS among children under 5 years old between 2010 and 2019.MethodsData on the deaths, and disability adjusted life years (DALYs) of the disease burden was retrieved from the Global Burden of Disease (GBD) 2019 for 204 countries and territories between 2010 and 2019. The rates per 100,000 population, along with 95% uncertainty intervals, as well as population-attributable fraction (PAF) was presented for each estimate.ResultsIn 2019, an estimated 6.94% (3.80–10.12%) of under-5 LRIs deaths were attributable to SHS globally, with an under-5 mortality rate of 7.02 per 100,000, a decrease of 5.77% since 2010. Similarly, 6.95% (3.81–10.13%) of LRIs DALYs were due to SHS among children under 5 years, with a rate in under-5s of 619.36 DALYs per 100,000, and also a 5.77% decrease since 2010. Azerbaijan, Turkmenistan, and Papua New Guinea showed the highest under-5 mortality and DALYs burden rates of LRIs attributable to SHS in 2019. In contrast, the PAF was stagnant over the past ten years and there is even a year-on-year upward trend in South Asia. Nationally, in 2019, Bosnia and Herzegovina, Armenia, and Montenegro showed the highest PAFSHS of LRIs burden among children under 5 years of age. In addition, the burden was heavier in children under 1 year of age and was significantly negatively associated with sociodemographic index.ConclusionsSHS remains a risk factor that cannot be ignored for LRIs burden worldwide. Hence, governments and health systems should continue to take steps to reduce SHS pollution among young children to mitigate this burden.

Assessing the Policy of Non-Smoking Areas in Schools in Indonesia: A Mixed Methods Study.

Regulations in the form of Regional Regulations on Non-Smoking Areas are efforts to prevent smoking in schools. We will show qualitatively and quantitatively whether the policy can control smoke-free schools since 2015 in Muaro Jambi Regency. However, the implementation is still not optimal, even almost not implemented following the mandate of government regulation Number 109 of 2012 and regional regulation Number 5 of 2018. This study aims to evaluate the implementation of the smoke-free area policy in schools in Muaro Jambi Regency. Research using mixed method study employing quantitative through distribution survey of smoke-free zones and qualitative by interviewing 31 schools of informants and observing 499 points of educational institutions. Selection of informants by considering the criteria of adequacy and suitability of data analysis with content analysis. The cause of the non-implementation of the smoke-free area policy is the lack of socialization of local regulations. The regulation of non-smoking area bylaws has not been made, implementing rules with the decree of the law. Schools do not run areas without cigarettes because they do not fully understand the rules, namely that they are not allowed to smoke in all school environments and health facilities. Oversight of the no-smoking area policy has not been carried out due to the lack of policy support from policymakers and sources of funds for monitoring the no-smoking area. No smoking area policy is meaningless if there is neglect in its implementation so that it does not impact the compliance of smoking behavior following the No Smoking Area policy. The need for the commitment of school leaders in implementing and operational rules from the regional regulations in the implementation of smoke-free areas.

Nicotine as an Environmental Toxin: Implications for Children's Health

Despite significant declines in population smoking rates and effective policies to ban smoking in public places, environmental exposure to nicotine remains prevalent among children. Environmental smoke exposure affects children's respiratory, immune, and metabolic health but is also implicated in children's cognitive and behavioral development. Nicotine's chemical properties mimic naturally occurring chemicals in the brain. When nicotine is present during brain development (prenatally through the first five years of life), it alters developmental processes that affect systems involved in cognitive control, impulsivity, and sensitivity to rewarding substances, increasing risks for obesity. Because nicotine is the specific toxin underlying these outcomes, vaping is unlikely to be a safer alternative. Given the rise in vaping among young adults generally, and pregnant women specifically, this exposure represents a public health concern that warrants additional attention. Policies including modernized public health messaging and routine screening could reduce children's inadvertent exposure.

Analisa Kebijakan Peraturan Perundang-Undangan Kawasan Tanpa Rokok di Masjid Al-Ikhlas Jebres Surakarta

Smoking is still a problem in Indonesia to fulfill the human rights of the Indonesian people in the form of a healthy and clean environment. As a form of the seriousness of the Surakarta City government to answer environmental and health problems caused by smoking, the Surakarta City government issued Regional Regulation Number 9 of 2019 concerning Smokefree Areas. The regulation states that there are 7 (seven) places that are included in the category of Non-Smoking Areas, and one of them is a place of worship. Al-Ikhlas Mosque Jebres Surakarta is one of the non-smoking areas in the form of Muslim places of worship in the city of Surakarta. The purpose of writing this article is to find out the implementation of the non-smoking area policy at the Al-Ikhlas Jebres Surakarta Mosque. The research method used is descriptive normative -doctrinal legal research. The data used are primary legal materials, and secondary legal materials using analysis techniques in the form of the syllogism deduction method. The results showed that the implementation of the no-smoking area at the Al-Ikhlas Mosque in Jebres Surakarta has not been running as it should and the local regulations regarding the No-Smoking Area have not been able to function as an instrument to minimize violations of the smoking ban at the Al-Ikhlas Mosque in Surakarta. Therefore, the results of this study will provide input to the Surakarta city government as a policy maker to improve the Surakarta City Regional Regulation Number 9 of 2019 concerning Smokefree Areas so that the regional regulation can become an instrument in minimizing violations of the smoking ban at the Al-Ikhlas Surakarta Mosque.

Factors Related to the Implementation of Regional Regulation Number 3 of 2019 Concerning Non-Smoking Areas in the Capital of Konawe Islands Regency

Introduction: The implementation of Regional Regulation Number 3 of 2019 concerning Non-Smoking Areas in the Konawe Islands Regency has not been maximized. There are still many people who smoke in areas that are included in non-smoking areas. The problems in this study are factors of knowledge, attitudes, facilities, and infrastructure and the provision of sanctions related to the application of the Non-Smoking Areas Regional Regulation.
 Method: This research is analytical research with a cross-sectional study approach. The sample of this study was 91 respondents obtained by the Lemeshow formula, data analysis with the Chi-Square test, at a confidence level of 95% (α = 0.05).
 Result: The results of this study concluded that there is a strong relationship between attitudes and the application of Non-Smoking Areas Bylaws (p = 0.409), there is a very strong relationship between facilities and infrastructure and the application of Non-Smoking Areas Bylaws (p = 0.505), there is a moderate relationship between sanctions and the application of the Non-Smoking Areas Bylaw (p = 0.279).
 Conclusion: More active efforts are needed to socialize, supervise, and enforce the Non-Smoking Areas Bylaws so that the public can know about the implementation of the Non-Smoking Areas Bylaws and make a Regent's Regulation on the implementation of the Non-Smoking Areas Regional Regulation as a technical guide in the implementation of the Non-Smoking Areas Regional Regulation in Konawe Islands Regency.

Changes and stability of hand nicotine levels in children of smokers: Associations with urinary biomarkers, reported child tobacco smoke exposure, and home smoking bans

BackgroundExposure to thirdhand smoke (THS) residue takes place through inhalation, ingestion, and dermal transfer. Hand nicotine levels have been proposed to measure THS pollution in the environment of children, but little is known about its variability and stability over time and correlates of change. ObjectivesThe goal was to determine the stability of hand nicotine in comparison to urinary biomarkers and to explore factors that influence changes in hand nicotine. MethodsData were collected from 0 to 11-year-old children (Mean age = 5.9) who lived with ≥1 tobacco smokers (N = 129). At a 6-week interval, we collected repeated measures of hand nicotine, four urinary biomarkers (cotinine, trans-3′-hydroxycotinine, nicotelline N-oxides, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol), and parent-reported child tobacco smoke exposure (TSE). Dependent sample t-tests, correlations, and multivariable regression analyses were conducted to examine the changes in child TSE. ResultsHand nicotine levels (r = 0.63, p < 0.001) showed similar correlations between repeated measures to urinary biomarkers (r = 0.58–0.71; p < 0.001). Different from urinary biomarkers, mean hand nicotine levels increased over time (t(113) = 3.37, p < 0.001) being significantly higher in children from homes without smoking bans at Time 2 (p = 0.016) compared to Time 1 (p = 0.003). Changes in hand nicotine correlated with changes in cotinine and trans-3′-hydroxycotinine (r = 0.30 and r = 0.19, respectively, p < 0.05). Children with home smoking bans at Time 1 and 2 showed significantly lower hand nicotine levels compared to children without home smoking bans. DiscussionFindings indicate that hand nicotine levels provide additional insights into children’s exposure to tobacco smoke pollutants than reported child TSE and urinary biomarkers. Changes in hand nicotine levels show that consistent home smoking bans in homes of children of smokers can lower THS exposure. Hand nicotine levels may be influenced by the environmental settings in which they are collected.

Secondhand smoke exposure and associated factors among city residents living in multiunit housing in Bangladesh.

Secondhand smoke (SHS) poses a high health risk to those living in multiunit housing (MUH) since it can easily spread from unit to unit and throughout the building's communal areas. MUH residents in Bangladesh are particularly vulnerable to SHS due to the absence of smoking restrictions within a housing complex. Therefore, this study aimed to assess the prevalence of SHS exposure and its associated factors among MUH residents living in seven divisional cities of Bangladesh- Dhaka, Chattogram, Rajshahi, Khulna, Sylhet, Barishal, and Rangpur. From April 2019 to November 2019, a cross-sectional survey was conducted with 616 MUH residents aged 18 or older who had been residing in MUH for at least two years in the seven divisional cities of Bangladesh. A multivariable logistic regression model was performed to determine the associated factors of SHS exposure. In MUH complexes, more than half (54.9%) of the 616 respondents were exposed to SHS. The key factors positively associated with SHS exposure were females (aOR: 1.8, 95% CI:1.236-2.681), residents with a low monthly family income (aOR: 1.9, 95% CI: 1.162-3.220), those whose family members smoked (aOR: 2.4, 95% CI: 1.537-3.746), and Dhaka city residents (aOR: 1.9, 95% CI: 1.013-3.440). This study revealed a high prevalence of SHS exposure among Bangladeshi MUH residents. Therefore, a smoking ban is needed in and around MUH complexes to protect non-smoking residents from SHS exposure.

MEROKOK DALAM KAMPUS: ANCAMAN DAN KESALAHAN

Higher education institution is one of the smoking ban places listed in Regulation 11(1) of the Control of Tobacco Product Regulations 2004. The ban is reasonable as higher education institutions are places to acquire knowledge so the environment must be kept clean and healthy. The objective of this article is to discuss the offence of smoking on campus which can pose a direct health threat to smokers and passive smokers too. In addition, the practice of smoking from the point of view of Islam is also investigated. This study employs qualitative methods through library based and descriptive research. It is found that there are risks and negative effects when the respective parties do not observe the smoking ban. Among them, the air quality on campus becomes unhealthy thus posing a health threat to smokers and the individuals nearby. At the higher education institution level, actions such as fines or compounds can be implemented as stipulated in the rules and guidelines of the institution. This study validates the notion of smoking prohibition in Islam. Therefore, it is proposed that efforts to enforce the law can be improved, and strict action should be implemented and imposed on smokers who smoke on higher education premises.

Child Morbidity in Eastern Indonesia: Does Education and Smoking Behavior of Parents Influence it?

Child health is important, as it contributes to the child’s future. Indonesia was ranked second after India as a country with the highest tuberculosis (TB) cases. Well-educated parents must care for their children and maintain their health. At the same time, provinces in Eastern Indonesia have the lowest percentage of non-smoking areas (KTR) implementation. In this study, we analyzed the level of morbidity that focuses on respiratory disease, namely coughing and breathlessness in children. In addition, this study also analyzed the education and parents’ smoking behavior focused in Eastern Indonesia. The study analyzes child morbidity according to several affecting factors. Data used were cross-section data collected from secondary data from Indonesia Family Life Survey East (IFLS-East) in 2012. By applying the logistic regression analysis by logit and probit analysis, we figured out that parents’ education, children’s age, health service availability, and domicile area significantly influenced child morbidity. Fathers’ education played a crucial role, as the higher their education, the lower their children’s morbidity. Besides, we also found out that parents’ smoking habits, child immunization status, sex, and health insurance ownership did not significantly influence child morbidity. Fulfillment of educational aspects is required to the maximum until reaching adulthood, especially for unmarried individuals. Apart from that, parents of smokers and non-smokers need to be educated effectively on the dangers of smoking in order to create a healthy environment and the importance of tobacco or cigarette control policies in the Eastern part of Indonesia.

Household vaping bans and youth e-cigarette use.

The aims of this study were to measure whether household bans on vaping were associated with lower odds of youth past-month vaping when compared with (1) otherwise similar youth whose households did not have a vaping ban (using coarsened exact matching); and (2) themselves in waves when their household did not have a ban (using hybrid panel models). We used the same analytical strategies to examine cross-sectional associations between household smoking bans and adolescents' past-month cigarette smoking. This was a longitudinal study using data from a nationally representative sample of youth (age 12-17 years) in the Population Assessment of Tobacco and Health Study. United States of America. A total of 16 214 adolescents followed over 48 103 total observations (approximately three waves). Measurements comprised youth past-month e-cigarette and cigarette use and parent-reported household bans on vaping and smoking. Potential confounders were prior adolescent smoking, vaping, and other nicotine product use; parent current smoking, vaping, and other nicotine use; adolescent peer e-cigarette/cigarette use; parental monitoring; and demographic characteristics. Before matching, smoking bans were associated with 46% lower odds of youth smoking [odds ratio (OR) = 0.54; 95% confidence interval (CI) = 0.41-0.70] and vaping bans with 37% lower odds of youth e-cigarette use (OR = 0.63; 95% CI = 0.50-0.80). However, households with and without bans differed significantly on all confounders before matching. After matching, household vaping bans were associated with 56% lower odds of youth vaping (OR = 0.44; 95% CI = 0.33-0.58). Results from hybrid panel models also revealed 37% lower odds of vaping in waves when youth lived in a vape-free household compared to waves when they did not (OR = 0.63; 95% CI = 0.50-0.78). Associations between smoking bans and youth smoking were not statistically significant after matching or when using hybrid panel models. Household vaping bans appear to be associated with lower odds of past-month vaping among US adolescents, compared with similar youth whose households did not have a ban and to themselves in waves when their households did not have a ban.

Evidence from a Smoking Management Service in a University Teaching Hospital in Dublin, Ireland monitored by repeat surveys, 1997–2022

St Vincent’s University Hospital (SVUH) has a comprehensive smoking management programme and since 1997 has conducted periodic surveys of inpatients, outpatients, staff and visitors to establish prevalence of smoking and associated attitudes towards the hospital’s smoke-free campus policy pioneered in 2009. We report trends and describe also the online community stop smoking course (SSC) developed more recently in response to COVID-19. A questionnaire examining attitudes and smoking status was administered by census surveys of inpatients, quota or random sub-sample surveys of staff, and quota surveys with outpatients and visitors in the time period of 1997–2018. Chi square test for trend was used. Smoking rates declined in all groups but significantly so in outpatients (19.5% vs. 10%; p < 0.01), visitors (27.4% vs. 9.5%; p < 0.0001) and staff (30.0% vs. 10.8%; p < 0.0001). Use of E-Cigarettes was low in all cohorts. Rates of smoking were borderline higher in inpatients eligible by income for state-funded General Medical Services (33.2% vs 26.8%, p = 0.099). Support for and awareness of the ban increased over time. Demographic and quit data was compared between participants of in-person or online SSC. The online courses were successful with a maintenance of quit rates (End of Course: 54.7% vs. 55.0%, 1 Month: 50.4% vs. 54.0%, 3 Month: 19.8% vs. 22.5%). While the hospital community’s smoking prevalence has decreased over time and attitudes to the smoking ban have been increasingly positive, the campus is not without difficulties in keeping it smoke-free. We continue to advocate for hospital staff support in enacting this flagship initiative.

Obedience Dan Attitude of Hospital Employees on Non-Smoking Area Policy in Jombang

Introduction: Hospital employees are expected to be role models for the surrounding community in obeying the Non-Smoking Area (NSA) policy. However, in reality, only some of the hospital employees in Jombang obey it. Cigarette ashes are still found in many hospitals' hidden corners. This study aims to analyze the attitude and obedience of hospital employees in Jombang to ward NSA policy in hospitals. Method: This research is an analytic descriptive with a cross-sectional study approach. Random sampling collected data using a Google form questionnaire on 56 male employees. Analysis was conducted by counting the frequency distribution of employees' NSA policy comprehension variable, the dangers of smoking variable, the attitudes toward smoking variable, and the last obedience towards NSA variable. Result: It showed that 92.9% of employees are aware of NSA policy, 98.2% are aware of the dangers of smoking, yet 19.6% of the employees are smokers, and 100% of the smoking employees have ever smoked in a hospital. PR univariate calculations show that comprehension of the danger of smoking has NSA policy has risked the dangers of smoking 2.7 times in the hospital. Meanwhile, employees' comprehension of NSA policy is a risk factor. The employees who understand NSA policy have the risk of 2,889 times smoking in the hospital. Conclusion: Employees are aware of NSA policy and the dangers of smoking to their health. Nevertheless, some employees smoke in the hospital due to addiction. Efforts have been made. Include: increasing education, monitoring from colleagues, and CCTV monitoring in locations frequently used by smoke.

Smoking Cessation Behavior in Children: What is the Role of Parents and Peers?

Background: Pangarengan District is one of the areas in Sampang Regency with a fairly high number of child smokers, namely the age of 14 years as much as 26.6% and 11 years old as much as 15.4%, among elementary schools as much as 24.3%. Aims: The purpose of this study was to analyze the form of social support from parents and peers on smoking behavior in children in Pangarengan District, Sampang Regency. Method: This research is qualitative research with a phenomenological approach. There are 15 informants consisting of 5 main informants and 10 additional informants. Determination of informants used a purposive technique. Data collection techniques in this study were in-depth interviews, observation, and documentation. Data analysis used thematic content analysis. Credibility tests used source triangulation and technical triangulation. Results: Based on the results of the study, all informants received emotional support in the form of smoking bans, attention, care, and advice. Informants get instrumental support in the form of suggestions, input, and appeals to reduce cigarette consumption. In addition, the informants received support in the form of positive enthusiasm and encouragement to stop smoking, as well as gifts promised by their parents. Informants also received information support about the dangers of smoking and diseases made worse by smoking. Conclusion: The conclusion of this study is that all informants have received social support from their parents and peer groups. This study is expected to change smoking behavior in children by reducing cigarette consumption.

Trends in smoking-related diseases by socioeconomic position following a national smoking ban in 2007: a nationwide study in the Danish population

BackgroundNational comprehensive smoke-free legislation has been found to decrease the incidence of several smoking-related diseases. In 2007, Denmark introduced a national smoking ban, which banned smoking indoor in workplaces and public places, although only partial restrictions were applied in certain settings. We examined the impact of the smoking ban on smoking-related diseases and whether this differed across socioeconomic groups.MethodsInterrupted time series analyses of nationwide register data were performed using Poisson regression models to examine the differential impact of the smoking ban on monthly incidence rates of acute myocardial infarction, chronic obstructive pulmonary disease, and smoking-related cancers from 2002 to 2015. Immediate changes in incidence rates after the smoking ban and long-term changes in disease trends were estimated by comparing data from the pre- and post-ban period. Models were stratified by socioeconomic position.ResultsOverall, we found neither immediate changes in rates of acute myocardial infarction, chronic obstructive pulmonary disease, and smoking-related cancers following the smoking ban nor long-term post-ban changes in disease trends as compared to before the ban. Results did not differ across socioeconomic groups. A pronounced socioeconomic gradient in incidence rates was observed for all outcomes both before and after the smoking ban.ConclusionThe national smoking ban was not associated with a lower incidence of smoking-related diseases in the post-ban period compared to pre-ban levels and no differences between socioeconomic groups were observed. Future tobacco control in Denmark should consider which measures most effectively target the low socioeconomic groups to decrease the current strong socioeconomic inequality in health.

Breast Refusal and Maternal and Perinatal Risk Factors in the Newborn Period From a Single Center in Şanlıurfa

The many benefits of breastfeeding for both the mother and infant are well known. Therefore, the conditions that influence breastfeeding are important. Therefore, we investigated the frequency of breast refusal in the newborn period and the associated maternal perinatal risk factors at an Şan Med Hospital in Şanlurfa. A total of 407 mother-infant pairs fulfilling the study’s inclusion criteria were enrolled. The percentage of breast refusal in infants was higher in young maternal and paternal age (&lt;25 years), being the first child, and active or passive smoking exposure of the mother during pregnancy. The percentage of breast rejection was lower when the baby started to be breastfed within the first hour of birth. The percentages of infants experiencing breast rejection were found to be significantly higher in the absence of skin-to-skin contact following delivery and in the presence of prelactal feeding at the first 3 days than in their counterparts. The rate of breast rejection was found to be higher in infants fed with mixed or formula compared with infants fed only breast milk during the last 24 h. Multiple logistic regression analysis determined that the risk of breast rejection was higher in maternal smoking/exposure during pregnancy [adjusted odds ratio (aOR): 3.19, 95% confidence interval (CI): 1.01-10.06] and delayed initiation of breastfeeding after the first hour (aOR: 3.45, 95% CI: 1.09-11.0). Being in a smoke-free environment for pregnant women should be supported by an indoor smoking ban, and early initiation of breastfeeding in the first hour after birth should be encouraged.

Breast Refusal and Maternal and Perinatal Risk Factors in the Newborn Period From a Single Center in Şanlıurfa

The many benefits of breastfeeding for both the mother and infant are well known. Therefore, the conditions that influence breastfeeding are important. Therefore, we investigated the frequency of breast refusal in the newborn period and the associated maternal perinatal risk factors at an Şan Med Hospital in Şanlurfa. A total of 407 mother-infant pairs fulfilling the study’s inclusion criteria were enrolled. The percentage of breast refusal in infants was higher in young maternal and paternal age (&lt;25 years), being the first child, and active or passive smoking exposure of the mother during pregnancy. The percentage of breast rejection was lower when the baby started to be breastfed within the first hour of birth. The percentages of infants experiencing breast rejection were found to be significantly higher in the absence of skin-to-skin contact following delivery and in the presence of prelactal feeding at the first 3 days than in their counterparts. The rate of breast rejection was found to be higher in infants fed with mixed or formula compared with infants fed only breast milk during the last 24 h. Multiple logistic regression analysis determined that the risk of breast rejection was higher in maternal smoking/exposure during pregnancy [adjusted odds ratio (aOR): 3.19, 95% confidence interval (CI): 1.01-10.06] and delayed initiation of breastfeeding after the first hour (aOR: 3.45, 95% CI: 1.09-11.0). Being in a smoke-free environment for pregnant women should be supported by an indoor smoking ban, and early initiation of breastfeeding in the first hour after birth should be encouraged.

A randomized control trial to support smoke-free policy compliance in public housing

BackgroundSmoke-free housing policies in multiunit housing are increasingly widespread interventions to reduce smoking and secondhand smoke exposure. Little research has identified factors that impede compliance with smoke-free housing policies in low-income multiunit housing and test corresponding solutions.MethodsWe are using an experimental design to test two compliance support interventions: (A) a “compliance through reduction (via relocation and reduction in personal smoking) and cessation” intervention targets households with smokers and involves support to shift smoking practices to areas beyond the apartment or building setting, reduce personal smoking, and deliver in-residence smoking cessation support services via trained peer educators and (B) a “compliance through resident endorsement” intervention involving voluntary adoption of smoke-free living environments through personal pledges, visible door markers, and/or via social media. We will compare randomly sampled participants in buildings that receive A or B or A plus B to the NYCHA standard approach.DiscussionThis RCT addresses key gaps in knowledge and capitalizes on key scientific opportunities by (1) leveraging the federal mandate to ban smoking in a public housing system of more than sufficient size to conduct an adequately powered RCT; (2) expanding our understanding of smoke-free policy compliance beyond policy implementation by testing two novel treatments: (a) in-residence smoking cessation and (b) resident endorsement, while (3) addressing population and location-specific tobacco-related disparities. At the conclusion of the study, this RCT will have leveraged a monumental policy shift affecting nearly half a million NYC public housing residents, many of whom disproportionately experience chronic illness and are more likely to smoke and be exposed to secondhand smoke than other city residents. This first-ever RCT will test the effects of much-needed compliance strategies on resident smoking behavior and secondhand smoke exposure in multiunit housing.Trial registrationClinical Trials Registered, NCT05016505. Registered on August 23, 2021.

Interaction between Serum Cotinine and Magnesium Intake with Childhood Asthma: A Cross-Sectional Study

Introduction: Serum cotinine and magnesium intake are often associated with childhood asthma. This study evaluated the interaction between serum cotinine and magnesium intake and childhood asthma. Methods: This cross-sectional study included 14,159 subjects from the National Health and Nutrition Examination Survey 2005–2018. Serum cotinine levels were classified according to the lower quartile: ≤0.2089 ng/mL as low level and >0.2089 ng/mL as high level. Magnesium intake was categorized as high (>98 mg/1,000 kcal) or low level (≤98 mg/1,000 kcal) based on the upper quartile. Weighted logistic regression analyses were adopted to analyze the association between cotinine, magnesium intake, and childhood asthma. Additionally, the combined effect of cotinine and magnesium intake on childhood asthma risk was examined. The stratified analyses were based on gender, body mass index, and family history of asthma to further examine the relationship between cotinine, magnesium intake, and childhood asthma. Results: The prevalence of asthma was approximately 17.56%. Compared to low-level cotinine, high-level cotinine was associated with asthma (odds ratio [OR] = 1.25, 95% confidence interval (CI): 1.04–1.50). Low-level magnesium intake was related to asthma compared with high-level magnesium intake (OR = 1.21, 95% CI: 1.04–1.40). Using interaction analysis, we also found that the combined effect of cotinine and magnesium intake was associated with childhood asthma risk, and the interaction between high-level cotinine and low-level magnesium intake was associated with the highest risk of childhood asthma (OR = 1.35, 95% CI: 1.04–1.74). Additionally, this interaction was also found in males, overweight/non-overweight, and those with family history of asthma. Conclusion: There was an interaction between serum cotinine and magnesium intake on childhood asthma. The results suggested that implementing smoking bans in certain settings (e.g., communities, schools) and promoting the consumption of magnesium-rich foods may be effective strategies for preventing childhood asthma.