Household Smoking Research Articles

Individual and environmental factors associated with successful aging among Korean older adults: Multilevel analysis of cross-sectional nationwide survey data

PurposeThe importance of environmental influences on successful aging has recently been emphasized. However, existing studies that investigated environmental factors related to successful aging in older adults did not apply multi-level analysis while simultaneously examining individual and environmental factors related to successful aging. Therefore, this study aimed to determine the level of successful aging in older adults and the individual and environmental factors related to successful aging. Materials and methodsData from a nationwide survey were used. The study comprised a cross-sectional sample of 73,942 community-dwelling adults aged ≥65 years with individual-level data drawn from the 2019 Korea Community Health Survey. Community-level data of 255 local administrative districts (cities or counties) were extracted from the Community Health Determinant Database from 2017 to 2019. These data were merged and used in multi-level logistic regression analyses. ResultsGenerally, 27.1% of the participants achieved successful aging. Individual factors including sex, age, marital status, education level, job, monthly household income, smoking, physical activity, and body mass index were significantly associated with successful aging. Four environmental factors, urban residential area, social network, satisfaction with living environment, and air quality, were positively associated with successful aging at the community level; among them, high satisfaction with living environment (OR = 6.06, 95% CI: 2.43–15.12) was the most strongly associated factor with successful aging. ConclusionsThe findings suggest that environmental factors are essential for successful aging among older adults in addition to individual factors. Therefore, multiple strategies considering individual and environmental factors are needed to improve successful aging.

Association between cooking fuel and chronic diseases among Chinese housewives from 2015 to 2017

To analyze the association between the use of different household cooking fuels(including solid fuels and clean fuels) and hypertension, stroke, chronic obstructive pulmonary disease, and asthma among Chinese housewives. 15616 housewives aged over 18 years were selected from China Nutrition and Health Surveillance 2015-2017, and their basic information investigation, physical examination and laboratory examination were carried out. Using multiple adjustment logistic regression analysis to compare the risk of using clean fuels and solid fuels in hypertension, stroke, chronic obstructive pulmonary disease and asthma. And living areas(urban or rural) were used as stratified factors for stratified logistic regression analysis. Among 15616 Chinese housewives, 9539(61.08%) used clean cooking fuels and 6077(38.92%) used solid cooking fuels at that time. There were significant differences in the composition of urban and rural areas, age groups, body mass index, education level, household annual income, smoking and drinking, second-hand smoke exposure level and whether to participate in physical examination within one year. After multivariable adjustment, using solid cooking fuels increased the risk of hypertension(OR=1.14, 95% CI 1.05-1.23), stroke(OR=1.44, 95% CI 1.18-1.75), chronic obstructive pulmonary disease(OR=1.20, 95% CI 1.03-1.40) and asthma(OR 1.33, 95% CI 1.09-1.63). After stratified by urban and rural areas, the result showed that using solid cooking fuels among rural housewives significantly increased the risk of the above four diseases(hypertension: OR=1.11, 95% CI 1.01-1.22; stroke: OR=1.49, 95% CI 1.17-1.91; chronic obstructive pulmonary disease: OR=1.20, 95% CI 1.00-1.42; asthma: OR=1.40, 95% CI 1.09-1.79). While in urban housewives, except that using solid cooking fuels might increase the risk of hypertension, the risk of stroke, chronic obstructive pulmonary disease and asthma has not increased significantly, but there was still an increasing tendencies(hypertension: OR=1.18, 95% CI 1.02-1.36; stroke: OR=1.37, 95% CI 0.99-1.90; chronic obstructive pulmonary disease: OR=1.20, 95% CI 0.89-1.60; asthma: OR=1.20, 95% CI 0.82-1.74). The use of solid cooking fuels is a risk factor for Chinese housewives in hypertension, stroke, chronic obstructive pulmonary disease, and asthma, and is more significant among rural housewives.

Distinguishing pulmonary rehabilitation from chest physiotherapy in the African context

Chronic respiratory diseases (CRDs) are highly prevalent in low- and middle-income countries. In Africa, the burden of CRDs is set to worsen due to an increase in smoking prevalence and household air pollution. Chest physiotherapy (CP) and pulmonary rehabilitation (PR) are used to manage CRDs in Africa, but distinguishing between these terms is not clear common among health-care professionals (HCPs) and patients. Here, we provide clarity on the differences between PR and CP to facilitate a greater understanding of PR and remove barriers to research and implementation of PR across Africa. CP is a treatment aimed at clearing secretions within airways of the lungs, while PR, through exercise training, education and self-management, treats extrapulmonary or systemic impairments. We know that there is a need for PR among people living with CRDs in Africa. However, health professionals’ knowledge and training in PR remains insufficient. To implement PR services for people with CRDs in Africa, a strong understanding of what PR is, and its evidence base are needed. The development of PR in Africa will start by filling the gaps in knowledge, awareness, advocacy, and training.

Associations of Education and Income with Secondhand Smoke Exposure Among Non-smoking Pregnant Women in Japan: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

There is accumulating evidence that lower socioeconomic groups are more exposed to secondhand smoke (SHS) than higher ones in the general population. The objective of the study was to examine the associations of education and income with SHS exposure among non-smoking pregnant women in Japan. We analyzed data from 11,615 non-smoking pregnant women in Japan who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017. SHS exposure was defined as indoor exposure to someone else's cigarette smoke ≥ 1day/week during pregnancy. Multiple logistic regression analyses were conducted to examine whether pregnant women's educational attainment or equivalent household income was associated with SHS exposure, adjusting for covariates. Stratified analyses by work status were also conducted. The prevalence of SHS exposure during pregnancy was 32.6%; 27.6% among non-working women and 35.8% among working women. Lower educational attainment was associated with an increased risk of SHS exposure; the odds ratio of high school education or lower compared with university education or higher was 1.87 (95% confidence interval, 1.66-2.10). Lower equivalent household income was associated with an increased risk of SHS exposure; the odds ratio of the lowest compared with the highest level of income was 1.53 (95% confidence interval, 1.35-1.74). These associations did not differ between non-working women and working women. Associations of education and income with SHS exposure imply that educational interventions and financial incentives are needed for pregnant women and their household smokers.

Prevalence and intensity of cigarette smoking in Iranian households: measurement of socioeconomic inequality

ABSTRACT Background Cigarette smoking is one of the most important behavioral risk factors for chronic diseases. This study aimed to investigate socioeconomic inequalities in cigarette smoking (CS) among Iranian households. Methods Concentration index (C) was calculated to measure socioeconomic inequality in smoking and number of smoked cigarettes per month among households using data from the income-expenditure survey of the statistical center of Iran (SCI) in 2017. To identify the contribution of socioeconomic and demographic variables to the measured socioeconomic inequality, the C index was decomposed using Wagstaff method. Results The results indicated that 19.89% (N = 7547) of the households were smoking cigarettes with an average number of 87.91 (SD = 235.22) per month. The C index was −0.009 for smoking households (95% CI = −0.023, 0.006) and 0.004 (95% CI = −0.011, 0.019) for the number of cigarettes smoked per month and were not statistically significant. Most of provinces had pro-rich inequality in prevalence and intensity of CS. The province of residence had the highest contribution to inequality in smoking (66.82%) followed by SES and age of the household head. Conclusions The study concluded that the prevalence and intensity of cigarette smoking were more concentrated among low-SES groups. The strategies to control CS should be modified based on the province of residence, and socioeconomic inequalities in CS among households.

Associations of household tobacco smoking status with childhood temperament among U.S. preschool-aged children

BackgroundThis study investigated the association between household tobacco smoking status and temperament among U.S. 3–5-year-olds. MethodsA secondary analysis of 2019–2020 National Survey of Children's Health data (N = 11,100) was conducted. Temperament dimensions of effortful control (characterized by attention focusing), negative affectivity (characterized by anger and soothability), and surgency (characterized by activity level and shyness) were assessed. Weighted ordinal regression models were conducted while adjusting for child and family covariates. ResultsApproximately 13 % of children lived with smokers. Compared to children who did not live with smokers, children living with smokers displayed behaviors of poorer effortful control and were more likely to be easily distracted (AOR = 1.59, 95%CI = 1.24–2.04) and less likely to keep working on tasks until finished (AOR = 0.56, 95%CI = 0.44–0.71). Children living with smokers displayed behaviors of greater negative affectivity and were at increased odds of being angry or anxious when transitioning between activities (AOR = 1.50, 95%CI = 1.13–1.98) and losing their temper when things did not go their way (AOR = 1.53, 95%CI = 1.20–1.96), and were at decreased odds of calming down quickly when excited (AOR = 0.54, 95%CI = 0.42–0.70). Children living with smokers displayed behaviors of poorer surgency and were less likely to play well with others (AOR = 0.58, 95%CI = 0.45–0.76) and sit still compared to same-aged children (AOR = 0.56, 95%CI = 0.44–0.71). LimitationsThe NSCH uses a cross-sectional survey design; longitudinal associations and objective measures could not be assessed. However, the NSCH is nationally representative and results are generalizable to U.S. 3–5-year-olds. ConclusionsFindings suggest household tobacco smoking influences temperament in early childhood. Results signify the need to promote household tobacco cessation.

Preventive medicine in pediatric cardiology practice.

The objective of the study was to assess contemporary practice patterns of pediatric cardiologists with respect to cholesterol disorders and smoking-related illness. We sent 2 anonymous surveys to the members of the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery and the Pediheart online community. The surveys addressed training in and management of cholesterol disorders and smoking-related illness. There were 97 responses to the cholesterol disorders survey. A total of 51.6% reported little or no formal training on cholesterol disorders. A total of 56.4% underestimated the prevalence of familial hypercholesterolemia by at least twofold. A total of 54.7% were at least somewhat comfortable prescribing statins. In 5 clinical vignettes, respondents frequently gave clinical recommendations in line with the 2019 American Heart Association guidelines although both undertreatment and overtreatment were recommended. There were 90 responses to the survey on smoking-related illness. Little or no formal training in nicotine addiction (52.3%) or smoking cessation (60.5%) was reported by respondents. Respondents screened for tobacco use in less than a one-third of hospitalizations and less than two-thirds of outpatient clinic visits. Screening for exposure to secondhand smoke was even less common. Twenty-seven percent of respondents never recommend a household smoking ban for their patients. A total of 83.3% were uncomfortable prescribing medications for their patients for smoking cessation, and 65.5% rarely or never refer patients for smoking cessation assistance. Although positioned to address the childhood origins of adult heart disease, those cardiologists surveyed placed a limited emphasis on cholesterol disorders and smoking-related disease in their clinical practice.

Distinguishing Exposure to Secondhand and Thirdhand Tobacco Smoke among U.S. Children Using Machine Learning: NHANES 2013-2016.

While the thirdhand smoke (THS) residue from tobacco smoke has been recognized as a distinct public health hazard, there are currently no gold standard biomarkers to differentiate THS from secondhand smoke (SHS) exposure. This study used machine learning algorithms to assess which combinations of biomarkers and reported tobacco smoke exposure measures best differentiate children into three groups: no/minimal tobacco smoke exposure (NEG); predominant THS exposure (TEG); and mixed SHS and THS exposure (MEG). Participants were 4485 nonsmoking 3-17-year-olds from the National Health and Nutrition Examination Survey 2013-2016. We fitted and tested random forest models, and the majority (76%) of children were classified in NEG, 16% were classified in TEG, and 8% were classified in MEG. The final classification model based on reported exposure, biomarker, and biomarker ratio variables had a prediction accuracy of 95%. This final model had prediction accuracies of 100% for NEG, 88% for TEG, followed by 71% for MEG. The most important predictors were the reported number of household smokers, serum cotinine, serum hydroxycotinine, and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL). In the absence of validated biomarkers specific to THS, comprehensive biomarker and questionnaire data for tobacco smoke exposure can distinguish children exposed to SHS and THS with high accuracy.

Impact of smoking cessation on household food security

Smokers can spend a substantial amount on cigarettes, potentially constraining their ability to purchase food. We tested the association of smoking cessation and household food security. Using the Current Population Survey (2001-2019), we longitudinally linked the Tobacco Use Supplement and the Food Security Supplement (n=71,278). Among adult smokers (n=13,144), we used modified Poisson regression to model household food insecurity as a function of quit status (continuing smokers vs. recent quitters), adjusting for sex, age, household size, children in the household, and other household smokers. We also used multinomial logistic regression to examine more detailed food security status (high, marginal, low, very low). The adjusted probability of household food insecurity at follow-up was 11% (95% CI: 8.7%-13%) for recent quitters and 20% (95% CI: 19%-21%) for continuing smokers. Continuing smokers had a lower adjusted probability of high food security (69% vs. 80%) and a higher adjusted probability of marginal (11% vs. 9.8%), low (12% vs. 7%), and very low food security (7.8% vs. 3.6%) compared to recent quitters. Cigarette cessation is associated with a lower risk of household food insecurity. Therefore, promoting tobacco cessation alongside food assistance and poverty reduction policies may help alleviate food insecurity.

Perfluoroalkyl Substance Serum Concentrations and Cholesterol Absorption-Inhibiting Medication Ezetimibe.

Per- and polyfluoroalkyl substances (PFAS) are human-made compounds with a widespread presence in human blood and other organs. PFAS have been associated with multiple health effects, including higher serum cholesterol and LDL cholesterol. Potential population differences in serum PFAS attributable to ezetimibe, a medication that inhibits cholesterol absorption, are of interest for several reasons. The "C8" Health Project survey data from six contaminated water districts in the mid-Ohio Valley of the United States provide a wide enough range of serum PFAS and a sufficient number of ezetimibe takers to explore this topic. A total of 44,126 adult participants of the C8 Health Survey were included in the community-based study. The status of taking (1075) or non-taking of ezetimibe, alone or in combination with another lipid-lowering agent, was acquired. The geometric mean serum concentrations of the four most commonly detected serum PFAS were compared based on the status of ezetimibe use. There is no significant difference in serum concentrations of perfluorohexanesulfonic acid (PFHxS), perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), and perfluorononanoic acid (PFNA) between ezetimibe users and non-users after adjustment for age, sex, body mass index, estimated glomerular filtration rate (eGFR), cigarette smoking, education, and average household income. The sterol absorption-inhibiting medication ezetimibe does not appear to affect serum PFAS concentrations. We sought but did not find direct evidence that ezetimibe could inhibit PFAS uptake nor inferential evidence that inter-individual differences in sterol absorption could provide a confounding factor explanation for the association of serum total- and LDL-cholesterol with serum PFAS.

Socioecological Predictors of Change in Adolescent Tobacco Use Across Waves 1–4 of the Population Assessment of Tobacco and Health Study

BackgroundDespite decreases in adolescents' cigarette use over the past decade, overall rates of adolescent tobacco use have increased. Research examining adolescents' changes across a range of tobacco products reflective of the current market, as well as multilevel predictors of use trajectories is needed. MethodsData derive from Waves 1–4 (W1-4; 2013–2018) of the Population Assessment of Tobacco and Health (PATH) study. Participants included 975 adolescents who used ≥1 tobacco product (cigarettes, electronic cigarettes [ECIGs], traditional cigars, cigarillos, filtered cigars, snus, smokeless tobacco [SLT], hookah) at any wave (W1 Mage = 13.29 [0.86], 54.2% male; 54.5% White, 25.9% Hispanic). ResultsUtilizing latent growth curve modeling (separate models per product), adolescents displayed increases in their past 30-day use of all tobacco products from W1-4. Greater W1 use was predicted by identifying as non-Hispanic (cigarettes); lower parent education (SLT); greater externalizing problems (cigarillos); greater motives (all products except cigarillos); greater youth-reported household smoking rules (cigarillos); and greater isolation (ECIGs). More use across time (i.e., higher slope) was predicted by older age (cigarettes); identifying as male (ECIGs, SLT), Black (vs. White; cigarillos), White (vs. Black, Hispanic; ECIGs, SLT); fewer externalizing problems (SLT); fewer motives (ECIGs); fewer youth-reported rules (cigarillos, SLT); and greater geographic isolation (cigarettes, SLT). DiscussionAlthough some individual-level factors (i.e., motives, externalizing problems) predicted greater W1 use (i.e., intercept) only, interpersonal- (parent rules) and community-level (geographic isolation) factors were associated with changes in use over time (i.e., slope). Intervention efforts may address such factors to reduce adolescents' escalations in use.

Serum α-Carotene, but Not Other Antioxidants, Is Positively Associated with Muscle Strength in Older Adults: NHANES 2001-2002.

Aging is associated with an increased reactive oxygen species that can decrease muscle strength. Thus, antioxidant substances could be positively associated with muscle strength in older adults. To investigate the association between serum antioxidants and muscle strength in older adults. A cross-sectional study evaluating 1172 individuals (627 men and 545 women), aged 50 to 85 years from NHANES 2001-2002, was performed. Carotenoids (α-carotene, trans-β-carotene, cis-β-carotene, β-cryptoxanthin, lutein/zeaxanthin combination, trans-lycopene), vitamin E, and retinol were analyzed via the high-performance liquid chromatography method. Muscle strength was evaluated by the isokinetic knee extension test. Linear regression was performed to evaluate the association between tertiles of serum antioxidant levels and strength, adjusted for confounders (energy and protein intake, body mass index, sex, age, C-reactive protein, uric acid, race/ethnicity, marital status, annual household income, educational level, physical activity, smoking, hypertension, arthritis, and diabetes). Alpha-carotene levels (p-trend = 0.027) were positively associated with muscle strength. However, serum vitamin E, trans-β-carotene, cis-β-carotene, β-cryptoxanthin, carotenoids, and retinol levels were not associated with strength. Serum α-carotene, but not other antioxidants, was positively associated with muscle strength in older adults.

Household Composition and Smoking Behavior in a Prospective Longitudinal Australian Cohort.

This study estimates the extent to which individuals' smoking cessation and relapse patterns are associated with the smoking behavior of their household members. Longitudinal data on household members' smoking behavior was sourced from a representative sample of 12 723 Australians who ever reported smoking between 2001 and 2019. Controlling for a rich set of confounders, multivariate regression analyses were used to predict the likelihood of smoking cessation and relapse given other household members' smoking status and their relationship type. The models were then used to forecast smoking prevalence over 10 years across different household types. Individuals living with a smoking spouse were less likely to quit (OR 0.77 [95% CI 0.72;0.83]) and more likely to relapse (OR 1.47 [95% CI 1.28;1.69]) compared to those living with nonsmoking spouses. Subsequently, the proportion of smokers living with other smoking household members increased by 15% between 2011 and 2019. A 10-year forecast using the smoking cessation and relapse models predicts that, on average, smokers living with nonsmokers will reduce by 43%, while those living alone or with a smoking partner will only reduce by 26% and 28% respectively. Over time, those who are still smoking are more likely to live with other smokers. Therefore, the current cohort of smokers is increasingly less likely to quit and more likely to relapse. Smoking projection models that fail to account for this dynamic risk may overstate the downstream health benefits and health cost savings. Interventions that encourage smoking cessation at the household level, particularly for spouses, may assist individuals to quit and abstain from smoking. The current and future paradigm shift in the smoking environment suggests that smoking cessation and relapse prevention policies should consider household structure. Policies designed to affect smoking at the household level are likely to be particularly effective. When estimating the long-term benefits of current smoking policies intrahousehold smoking behavior needs to be considered.

Personal monitoring of fine particulate matter (PM2.5) exposure in mothers and young children in a South African birth cohort study – A pilot study

Air pollution is a recognized risk factor for impaired lung health and increased morbidity and mortality globally. Fine particulate matter (PM2.5) has been linked to respiratory illness, but assessing personal PM2.5 exposure remains difficult, especially in children. The MicroPEM™ and Enhanced Children's MicroPEM™ (ECM) are personal fine particulate matter exposure monitors that have not been well-evaluated for young children. We aimed to assess compliance and acceptability of these monitors and to investigate risk factors associated with fine particulate matter in mother-child pairs. MethodsMother-child pairs, enrolled in a South African birth cohort, the Drakenstein Child Health Study, were recruited. A MicroPEM (mother) and ECM (child), issued to each participant and worn over 24 h, quantified PM2.5 exposure. Home environment, wearability, and wearing compliance were assessed. Linear regression identified associations between variables characterising the home environment and PM2.5 levels. ResultsFrom August to November 2016, 86 mothers and 75 children (age 1–4 years) had results. Fossil fuels were used in 21% of homes; maternal smoking (37%) and exposure to household tobacco smoke (89%) was high. Waking wearing compliance of the devices was 59% in children and 56% in mothers. PM2.5 exposures were above the World Health Organization recommend 24-h interim target (IT-4 25 μg/m3) in 38/75 (51%) children, and in 44/86 (51%) mothers. Winter, smoking and public transport were associated with higher concentrations of PM2.5 in mothers. Whereas, for the children higher concentrations of PM2.5 were associated with winter and two or more household smokers; while lower concentrations were associated with age, weight-for-age z-score and households that had fewer than two basic dimensions. Wearability for children was reported as “very easy” in the majority (n = 54, 63%) with similar acceptability in mothers (n = 55, 64%). ConclusionThe MicroPEM and ECM provide wearable low-burden personal exposure monitoring tools for women and children with reasonable rates of acceptability. High exposure to fine particulate matter in children is concerning; strategies to minimise exposure need to be strengthened.

Sex differences in the association between smoking exposure and prevalence of wheeze and asthma in 3-year-old children

Objective We examined independent and joint associations between prenatal and postnatal smoking exposure and the prevalence of wheeze and asthma among 3-year-old Japanese children. Sex differences were also investigated. Methods Smoking exposure, allergic symptoms, and potential confounding factor data were collected using a self-administered questionnaire. Wheeze was defined on the basis of the International Study of Asthma and Allergies in Childhood criteria. Physician-diagnosed asthma was considered to be present if a physician had diagnosed the child with asthma any time before the survey was administered. Results There were 6402 pediatric participants in this study. Maternal smoking throughout pregnancy and household smoking exposure during the first year of life were associated with an increased prevalence of wheeze among girls but not boys (adjusted odds ratio (OR) [95% CI] = 2.00 [1.13–3.42] and 1.34 [1.07–1.68], respectively). Girls exposed to both prenatal maternal smoking and postnatal household smoking exposure had a significantly higher prevalence of wheeze and physician-diagnosed asthma compared with girls without these exposures (adjusted OR [95% CI] = 2.06 [1.39–3.01] and 1.86 [1.01–3.26], respectively). No association was observed between perinatal smoking exposure and the prevalence of wheeze or asthma among boys. Significant interactions between sex and smoking exposure affecting wheeze and asthma were also found (p for interaction = 0.0003 and 0.01, respectively). Conclusion We found a positive association between perinatal smoking exposure and the prevalence of wheeze and asthma only among girls. Effects of perinatal smoking exposure on wheeze and asthma might be sex specific. Further research is required.

Association of handgrip strength with all-cause mortality: a nationally longitudinal cohort study in China.

Handgrip strength is considered a vital and reliable measure of comprehensive physical assessments, whereas the association of handgrip strength with overall mortality risk among Chinese adults was less studied. We prospectively investigated the association between handgrip strength and all-cause mortality among Chinese middle-aged and older people based on data from the China Health and Retirement Longitudinal Study (CHARLS).3 DESIGN: Longitudinal cohort study. Grip strength was assessed for both hands by a dynamometer. Odds ratios (ORs)4 and 95 % confidence intervals (CIs)5 were estimated applying logistic regression models with adjustments for age, body mass index, ethnicity, education level, annual household income, marital status, drinking, smoking, physical activity, and medical insurance among men and women. Deaths were ascertained by each follow-up survey in which the household member who lived with the participants were inquired. Over an average follow-up period of approximately 8 years among the screened 11,618 participants ≥45 years old, 1290 deaths were documented. The age range was 45-93 for men and 45-96 for women. Greater handgrip strength was associated with a lower overall mortality risk, with adjusted ORs (comparing with extreme tertiles) of 0.47 (95 % CI: 0.35-0.64; P-trend<0.001) in men and 0.51 (95 % CI: 0.24-1.08; P-trend = 0.059) in women. Such inverse association seemed stronger among younger men (OR = 0.29, 95 % CI: 0.18-0.45), compared with the older men (OR = 0.49, 95 % CI: 0.33-0.73; P-interaction = 0.023). Handgrip strength was inversely associated with all-cause mortality risk, especially among the younger men. Further investigations are warranted to elucidate the underlying mechanism.

Association of e-Cigarette Exposure with Pediatric Otitis Media Recurrence.

Otitis media (OM) is a common inflammatory disease spectrum in children and a leading cause of pediatric physician visits, antibiotic prescriptions and surgery. Tobacco exposure is associated with increased risk of OM recurrence, chronicity and surgeries. Tobacco products have changed dramatically in recent years with the advent of electronic cigarettes (e-cigarettes). While users frequently perceive vape as less harmful than traditional cigarettes, burgeoning evidence supports its contribution to respiratory pathologies. The consequences of secondhand exposure, particularly among children, are understudied. The aim of this study was to examine the association of e-cigarette emissions (EE) with OM recurrence and surgeries in the US. Questionnaire data regarding ear infections and tobacco exposure was gathered for all pediatric respondents of the National Health and Nutrition Examination Survey (NHANES) 2017 to 2018. Weighted analyzes and logistic regression models were used to assess associations. Data was available for 2022 participants (aged 6-17); all were included for analyzes. Tobacco exposure was observed in 42%; 9% were exposed to EE. EE contributed to risk of ≥3 ear infections (OR = 1.61, 95% CI 1.01-2.58, P = .047). After adjustment for significant covariates (race and asthma), the association fell below significance (P = .081). No other significant associations were observed between ear infections, or tympanostomy tube insertion and exposure variables (EE, gestational or other household exposure). Exposure to EE may confer greater risk of pediatric OM than previously identified factors such as household smoke, or gestational exposure. Further investigation of EE and its health implications in children is warranted. IV.

Family matters: the influence of partner and familial encouragement on home and car smoking bans

Background: Secondhand smoke exposure (SHSe) poses health risks to neonatal intensive care unit (NICU) infants after they are discharged; these risks can be mitigated by the implementation of parent-enforced total home and car smoking bans. Understanding the influence that various family members have on household smoking policies may inform interventions to reduce SHSe among vulnerable infants.Methods: In a cross-sectional, secondary analysis of data collected between 2013 and 2015, mothers of NICU infants who reported smoking or living with a smoker (N=242) were asked about whether members of 9 separate relationship types (e.g., partner, mother, father) encouraged or discouraged smoking in the home and car. The influence of perceived encouragement from each relationship type on the odds of having a total smoking ban in place was estimated.Results: Participants reported that partners (47%) and siblings (32%) were most likely to encourage smoking in the home/car. In a multivariate model, both partner (p=0.0002) and sibling (p=0.004) encouragement of indoor smoking decreased the likelihood of having a total smoking home and car ban in place.Conclusions: Family members have significant influence on SHSe reduction practices. Innovative family-based interventions may be needed in order to reduce SHSe in this particularly vulnerable group of infants.

Factors Related to Oversleeping in Korean Young Adults, with a Focus on Sociodemographic Factors.

Young adults the year after high school experience changes in lifestyle and circumstances and tend to experience more oversleeping. However, there are few studies on oversleeping in young adults. This study aims to identify the sociodemographic factors related to oversleeping among young adults in Korea using nationally representative data. This study analyzed self-reported and cross-sectional data in 2016 from a sample of 1876 participants from the Korean Children and Youth Panel Survey, which included respondents one year after high school graduation. Oversleeping was defined as sleeping 9 or more hours a day on average. Logistic regression models were analyzed to test a multivariate association between independent sociodemographic variables and oversleeping. Over one-tenth of young adults reported oversleeping. Oversleeping was associated with household income (OR = 0.99, p = 0.011) and smoking (OR = 1.52, p = 0.041). In addition, when compared to non-working college students, college students who were working (OR = 2.58, p = 0.021), non-students who were working (OR = 1.68, p = 0.048), and non-students who were not working (OR = 3.07, p < 0.001) were more likely to report oversleeping. Oversleeping among young adults was associated with major sociodemographic factors including household income (−), smoking (+), and academic and working status (+). These findings suggest the significant role of sociodemographic factors as predictors of oversleeping and emphasize the importance of examining various factors to achieve a better understanding of oversleeping in young adults.

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

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