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Environmental Tobacco Smoke (environmental + tobacco_smoke)
Terms modified by Environmental Tobacco Smoke Selected AbstractsRural-Urban Differences in the Social Climate Surrounding Environmental Tobacco Smoke: A Report From the 2002 Social Climate Survey of Tobacco ControlTHE JOURNAL OF RURAL HEALTH, Issue 1 2004Robert McMillen PhD ABSTRACT: Context: Although previous research has found smoking rates to be higher among residents of rural areas, few studies have investigated rural-urban differences in exposure to environmental tobacco smoke (ETS). Objective: This study contrasted the social climate surrounding ETS among Americans who resided in 5 levels of county urbanization. Design: Data were collected via telephone interviews administered to a representative sample of 3,009 civilian, noninstitutionalized adults over age 18 in the United States. Households were selected using random digit dialing procedures. Findings: Compared to residents of urban counties, rural residents reported fewer restrictions on smoking in the presence of children and lower incidences of smoking bans in households, family automobiles, work areas, convenience stores, fast-food restaurants, and restaurants. Interestingly, when rural-urban variations in knowledge and attitudes about ETS were examined, the magnitude of rural-urban differences was smaller or nonexistent for these indicators. Moreover, logistic regression models indicated that none of these rural-urban differences in knowledge and attitudes persisted after statistically controlling for region, smoking status, gender, race, age, and education factors. This suggests that the observed rural-urban differences in ETS bans could not be explained adequately by rural-urban differences in knowledge and attitudes about the dangers of ETS. Conclusions: The policy implications of this research point to a greater need in rural America for programs focusing on the restriction and elimination of ETS. They also suggest that programs focusing only on influencing the levels of ETS knowledge and attitudes among the general population may not be adequate in producing the desired change. [source] Environmental tobacco smoke in homes, motor vehicles and licensed premises: community attitudes and practicesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2002Raoul A. Walsh Objective: To assess community knowledge, attitudes and practices in relation to environmental tobacco smoke (ETS) especially in homes, private motor vehicles and licensed premises, and to document levels of support for further government legislation. Methods: 656 persons aged 18 years and over, a sub-sample in a computer-assisted telephone survey of 2,087 randomly selected respondents across NSW, answered 12 ETS-specific questions The whole sample was asked demographic, smoking status and household membership questions. The overall response rate was 61.4% (consent rate 75.4%). Results: Overall, 32.8% (95% CI 27.8,37.8) of children aged 0,4 years in the households surveyed were reported to live with at least one smoker. Agreement about ETS hazards was lowest in relation to child ear problems (31.2%) and sudden infant death syndrome (50.6%). Complete bans on smoking were reported in 69.9% of homes and 77.1% of private motor vehicles The percentages favouring total bans in homes (p<0.001) and private motor vehicles (p<0.001) were significantly lower among smokers than non-smokers. Overall, 55.8% supported legislation to ban smoking in private vehicles carrying children. The majority support restrictions on smoking in non-eating areas of licensed clubs (88.7%) and hotels (84.8%). Overall, the data indicate a ban on smoking in licensed premises is likely to increase business. Conclusion: Smoking is banned in most NSW homes and private motor vehicles Acceptance of ETS risks is high but there are important knowledge gaps. Considerable support exists for further government regulation of ETS. Media campaigns are likely to reinforce a public environment already receptive of the need for more government ETS restrictions. [source] Changes in environmental tobacco smoke (ETS) exposure over a 20-year period: cross-sectional and longitudinal analysesADDICTION, Issue 3 2009Barbara J. Jefferis ABSTRACT Aims To examine long-term changes in environmental tobacco smoke (ETS) exposure in British men between 1978 and 2000, using serum cotinine. Design Prospective cohort: British Regional Heart Study. Setting General practices in 24 towns in England, Wales and Scotland. Participants Non-smoking men: 2125 studied at baseline [questionnaire (Q1): 1978,80, aged 40,59 years], 3046 studied 20 years later (Q20: 1998,2000, aged 60,79 years) and 1208 studied at both times. Non-smokers were men reporting no current smoking with cotinine < 15 ng/ml at Q1 and/or Q20. Measurements Serum cotinine to assess ETS exposure. Findings In cross-sectional analysis, geometric mean cotinine level declined from 1.36 ng/ml [95% confidence interval (CI): 1.31, 1.42] at Q1 to 0.19 ng/ml (95% CI: 0.18, 0.19) at Q20. The prevalence of cotinine levels , 0.7 ng/ml [associated with low coronary heart disease (CHD) risk] rose from 27.1% at Q1 to 83.3% at Q20. Manual social class and northern region of residence were associated with higher mean cotinine levels both at Q1 and Q20; older age was associated with lower cotinine level at Q20 only. Among 1208 persistent non-smokers, cotinine fell by 1.47 ng/ml (95% CI: 1.37, 1.57), 86% decline. Absolute falls in cotinine were greater in manual occupational groups, in the Midlands and Scotland compared to southern England, although percentage decline was very similar across groups. Conclusions A marked decline in ETS exposure occurred in Britain between 1978 and 2000, which is likely to have reduced ETS-related disease risks appreciably before the introduction of legislation banning smoking in public places. [source] Evidence-based clinical policy: case report of a reproducible process to encourage understanding and evaluation of evidenceINTERNAL MEDICINE JOURNAL, Issue 7 2006G. Rikard-Bell Abstract We report within a case study a reproducible process to facilitate the explicit incorporation of evidence by a multidisciplinary group into clinical policy development. To support the decision-making of a multidisciplinary Intersectoral Advisory Group (IAG) convened by the Royal Australasian College of Physicians Health Policy Unit, a systematic review of randomized controlled trials about environmental tobacco smoke and smoking cessation interventions in paediatric settings was first undertaken. As reported in detail here, IAG members were then formally engaged in a transparent and replicable process to understand and interpret the synthesized evidence and to proffer their independent reactions regarding policy, practice and research. Our intention was to ensure that all IAG members were democratically engaged and made aware of the available evidence. As clinical policy must engage stakeholder representatives from diverse backgrounds, a process to equalize understanding of the evidence and ,democratize' judgment about its implications is needed. Future research must then examine the benefits of such explicit steps when guidelines, in turn, are implemented. We hypothesize that changes to future practice will be more likely if processes undertaken to develop guidelines are transparent to clinicians and other target groups. [source] Consumer response to tobacco smoke in service settingsJOURNAL OF CONSUMER BEHAVIOUR, Issue 4 2010Frederic B. Kraft Establishing smoking policies which accommodate customers' smoking preferences is a major problem for restaurants, bars, hotels, and other firms in the service industry. This study is based on the premise that tobacco smoke can be considered a component of both the physical and ambient retail service environment. Because of legal and ethical concerns, the presence or absence of environmental tobacco smoke (ETS) in two types of eating facilities (bar and fine dining restaurant) was operationalized by the presentation to respondents of photographs which pictured customers in a setting where smoking was either present or absent. The success of this method of manipulation of the treatment variable was assessed with a thought listing procedure. Thought listing responses indicate that both treatments (type of facility and smoking policy) were adequately conveyed by the photographs. Results indicate that cognitive, emotional, and behavioral responses were all negatively affected by the presence of tobacco smoke. The conclusion is that managers who permit smoking in their facilities risk losing non-smoking patrons while smokers are little affected by either the presence or absence of smoke. The major contributions of this study include both the exploration of tobacco smoke as part of the retail service environment for eating establishments and the use of thought listings as a manipulation check for variables which were manipulated through use of photographs depicting the treatment conditions. Copyright © 2010 John Wiley & Sons, Ltd. [source] Salient Environmental and Perceptual Correlates of Current and Established Smoking for 2 Representative Cohorts of Indiana AdolescentsJOURNAL OF SCHOOL HEALTH, Issue 3 2009Dong-Chul Seo PhD ABSTRACT PURPOSE:, A secondary analysis of 2000 and 2004 Indiana Youth Tobacco Survey (IYTS) data was conducted to investigate salient environmental and perceptual correlates of adolescents' current and established smoking while controlling for demographic variables such as gender, grade, and race/ethnicity and to compare the pattern of significant correlates between the years. METHODS:, The IYTS was an anonymous school-based survey regarding tobacco use; familiarity with pro- and anti-tobacco media messages; exposure to environmental tobacco smoke (ETS); minors' access to tobacco products; and general knowledge, attitudes, and beliefs about tobacco. In 2000, a representative sample of 1416 public high school students in grades 9-12 and 1516 public middle school students in grades 6-8 (71.44% and 72.53% response rates, respectively) were surveyed. In 2004, 3433 public high school students and 1990 public middle school students (63.04% and 65.44 % response rates, respectively) were surveyed. RESULTS:, Significant predictors of adolescents' current and established smoking habits included exposure to ETS either in homes or in cars, exposure to pro-tobacco messages, perceived benefit of smoking, and perceived peer acceptance of smoking. The influence of exposure to pro-tobacco messages greatly outweighed exposure to any anti-tobacco messages. CONCLUSIONS:, The findings of this study warrant that more efforts and resources be placed on preventing youth from being exposed to ETS, and to control pro-tobacco marketing and improve the tobacco counter-marketing messages. The perceived benefits of smoking found here indicate that smoking for relaxation and weight control may be major influencing factors on adolescent smoking. [source] The Kalgoorlie Otitis Media Research Project: rationale, methods, population characteristics and ethical considerationsPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 1 2008Deborah Lehmann Summary Otitis media (OM) is one of the most common paediatric illnesses for which medical advice is sought in developed countries. Australian Aboriginal children suffer high rates of OM from early infancy. The resultant hearing loss can affect education and quality of life. As numerous factors contribute to the burden of OM, interventions aimed at reducing the impact of single risk factors are likely to fail. To identify key risk factors and understand how they interact in complex causal pathways, we followed 100 Aboriginal and 180 non-Aboriginal children from birth to age 2 years in a semi-arid zone of Western Australia. We collected demographic, obstetric, socio-economic and environmental data, breast milk once, and nasopharyngeal samples and saliva on seven occasions. Ear health was assessed by clinical examination, tympanometry, transient evoked otoacoustic emissions and audiometry. We considered the conduct of our study in relation to national ethical guidelines for research in Aboriginal and Torres Strait Islander health. After 1 year of community consultation, the study was endorsed by local committees and ethical approval granted. Fieldwork was tailored to minimise disruption to people's lives and we provided regular feedback to the community. We saw 81% of non-Aboriginal and 65% of Aboriginal children at age 12 months. OM was diagnosed on 55% and 26% of routine clinical examinations in Aboriginal and non-Aboriginal children respectively. Aboriginal mothers were younger and less educated, fewer were employed and they lived in more crowded conditions than non-Aboriginal mothers. Sixty-four per cent of Aboriginal and 40% of non-Aboriginal babies were exposed to environmental tobacco smoke. Early consultation, provision of a service while undertaking research, inclusion of Aboriginal people as active members of a research team and appropriate acknowledgement will assist in ensuring successful completion of the research. [source] Preterm delivery and exposure to active and passive smoking during pregnancy: a case,control study from ItalyPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2007Guglielmina Fantuzzi Summary The aim of this study was to assess the relationship between preterm/early preterm delivery and active smoking as well as environmental tobacco smoke (ETS) exposure in a sample of pregnant Italian women. A case,control study was conducted in nine cities in Italy between October 1999 and September 2000. Cases of preterm birth were singleton babies born before the 37th gestational week; babies born before the 35th gestational week were considered early preterm births. Controls were babies with gestational ages , 37th week. A total of 299 preterm cases (including 105 early preterm) and 855 controls were analysed. A self-administered questionnaire was used to assess active smoking and ETS exposure, as well as potential confounders. Multivariable logistic regression analysis showed a relationship between active smoking during pregnancy and preterm/early preterm delivery [adjusted ORs: 1.53; 95% CI 1.05, 2.21 and 2.00; 95% CI 1.16, 3.45, respectively]. A dose,response relationship was found for the number of cigarettes smoked daily. The adjusted ORs were 1.54 and 1.69 for preterm babies and 1.90 and 2.46 for early preterm babies for 1,10 and >10 cigarettes/day respectively. ETS exposure was associated with early preterm delivery [adjusted OR 1.56; 95% CI 0.99, 2.46] with a dose,response relationship with the number of smokers in the home. Smoking during pregnancy was strongly associated with preterm delivery with a dose,response effect. ETS exposure in non-smoking women was associated only with early preterm delivery. [source] The influence of maternal cigarette smoking, snuff use and passive smoking on pregnancy outcomes: the Birth To Ten StudyPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2 2006Krisela Steyn Summary Steyn K, de Wet T, Saloojee Y, Nel H, Yach D. The influence of maternal cigarette smoking, snuff use and passive smoking on pregnancy outcomes: the Birth To Ten Study. Paediatric and Perinatal Epidemiology 2006; 20: 90,99. This article describes the patterns and effects of maternal snuff use, cigarette smoking and exposure to environmental tobacco smoke during pregnancy on birthweight and gestational age, in women living in Johannesburg and Soweto in 1990. A cohort of 1593 women with singleton live births provided information about their own and household members' usage of tobacco products during pregnancy. The women completed a questionnaire while attending antenatal services. Data on gestational age and birthweight were obtained from birth records. Women who smoked cigarettes or used snuff during pregnancy accounted for 6.1% and 7.5% of the study population respectively. The mean birthweight of non-tobacco users was 3148 g [95% CI 3123, 3173] and that of the smokers 2982 g [95% CI 2875, 3090], resulting in a significantly lower mean birthweight of 165 g for babies of smoking mothers (P = 0.005). In contrast, women using snuff gave birth to infants with a mean birthweight of 3118 g [95% CI 3043, 3192], which is a non-significant (P = 0.52) decrease (29.4 g) in their infants' birthweights compared with those not using tobacco. A linear regression analysis identified short gestational age, female infant, a mother without hypertension during pregnancy, coloured (mixed racial ancestry), and Asian infants compared with black infants, lower parity, less than 12 years of education and smoking cigarettes as significant predictors of low birthweight, while the use of snuff during pregnancy was not associated with low birthweight. The snuff users, however, had a significant shorter gestational age than the other two groups of women. The birthweight reduction adjusted for possible confounders was 137 g [95% CI 26.6, 247.3 (P = 0.015)] for cigarette smokers and 17.1 g [95% CI ,69.5, ,102.7, P = 0.69] for snuff users respectively, compared with the birthweight of non-tobacco users. Among women who did not smoke cigarettes or use snuff, exposure to environmental tobacco smoke did not result in significant effects on the birthweight of their infants. In conclusion, infants of cigarette smokers had significantly lower birthweights than those of non-tobacco users or snuff users who are exposed to nicotine during pregnancy. Passive smoking did not affect birthweight significantly in this population. [source] Maternal, paternal and environmental tobacco smoking and breast feedingPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2002Gabriel M. Leung Summary The effects of environmental tobacco smoke (ETS) on breast-feeding patterns are poorly understood, while those of parental smoking on breast-feeding initiation vs. duration have not been clearly delineated. We conducted a prospective, population-based birth cohort study to examine the independent effects of maternal, paternal and ETS on breast-feeding initiation and duration. A total of 6747 Hong Kong Chinese infants were recruited and followed up in 1997,8. We obtained detailed household smoking history and recorded breast-feeding patterns in three follow-up interviews over 9 months. We found that both maternal and paternal smoking were associated with not initiating breast feeding (odds ratio [OR] for ever maternal smoking = 2.51, 95% confidence interval [CI] = 1.63, 3.86; OR for ever paternal smoking = 1.22, 95% CI = 1.08, 1.39). Exposure to ETS in utero and post partum were also related to not starting breast feeding (ORETS in utero = 1.10, 95% CI = 0.99,1.24; ORETS post partum = 1.21, 95% CI = 1.08, 1.36). These effects, however, did not persist for breast-feeding duration of , 4 months. Cox proportional hazards modelling confirmed the lack of association between any form of smoking and breast-feeding duration. Our findings suggest that smoking of any kind, during or after pregnancy, is a strong risk indicator for not initiating breast feeding. Smoking as a risk indicator for underlying socio-economic, demographic and psychosocial factors is probably responsible for most of the observed adverse effects, although we cannot rule out direct contributions from pathophysiological mechanisms. Public health strategies directed at these underlying factors should be vigorously pursued to reduce the adverse effects of tobacco on breast feeding and infant health in general. [source] Intrauterine exposure to polycyclic aromatic hydrocarbons, fine particulate matter and early wheeze.PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 4p2 2010Prospective birth cohort study in 4-year olds Jedrychowski WA, Perera FP, Maugeri U, Mrozek-Budzyn D, Mroz E, Klimaszewska-Rembiasz M, Flak E, Edwards S, Spengler J, Jacek R, Sowa A. Intrauterine exposure to polycyclic aromatic hydrocarbons, fine particulate matter and early wheeze. Prospective birth cohort study in 4-year olds. Pediatr Allergy Immunol 2010: 21: e723,e732. © 2010 John Wiley & Sons A/S The main goal of the study was to determine the relationship between prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) measured by PAH-DNA adducts in umbilical cord blood and early wheeze. The level of PAH-DNA adducts in the cord blood is assumed to reflect the cumulative dose of PAHs absorbed by the foetus over the prenatal period. The effect of prenatal PAH exposure on respiratory health measured by the incidence rate ratio (IRR) for the number of wheezing days in the subsequent 4 yr follow-up was adjusted for potential confounding factors such as personal prenatal exposure to fine particulate matter (PM2.5), environmental tobacco smoke (ETS), gender of child, maternal characteristics (age, education and atopy), parity and mould/dampness in the home. The study sample includes 339 newborns of non-smoking mothers 18,35 yr of age and free from chronic diseases, who were recruited from ambulatory prenatal clinics in the first or second trimester of pregnancy. The number of wheezing days during the first 2 yr of life was positively associated with prenatal level of PAH-DNA adducts (IRR = 1.69, 95%CI = 1.52,1.88), prenatal particulate matter (PM2.5) level dichotomized by the median (IRR = 1.38; 95%CI: 1.25,1.51), maternal atopy (IRR = 1.43; 95%CI: 1.29,1.58), mouldy/damp house (IRR = 1.43; 95%CI: 1.27,1.61). The level of maternal education and maternal age at delivery was inversely associated with the IRRs for wheeze. The significant association between frequency of wheeze and the level of prenatal environmental hazards (PAHs and PM2.5) was not observed at ages 3 or 4 yrs. Although the frequency of wheezing at ages 3 or 4 was no longer associated with prenatal exposure to PAHs and PM2.5, its occurrence depended on the presence of wheezing in the first 2 yr of life, which nearly tripled the risk of wheezing in later life. In conclusion, the findings may suggest that driving force for early wheezing (<24 months of age) is different to those leading to later onset of wheeze. As we reported no synergistic effects between prenatal PAH (measured by PAH-DNA adducts) and PM2.5 exposures on early wheeze, this suggests the two exposures may exert independent effects via different biological mechanism on wheeze. [source] Second-hand smoking and carboxyhemoglobin levels in children: a prospective observational studyPEDIATRIC ANESTHESIA, Issue 1 2010BRANDEN E. YEE MD Summary Aim:, To establish baseline noninvasive carboxyhemoglobin (COHb) levels in children and determine the influence of exposure to environmental sources of carbon monoxide (CO), especially environmental tobacco smoke, on such levels. Background:, Second-hand smoking may be a risk factor for adverse outcomes following anesthesia and surgery in children (1) and may potentially be preventable. Patients and Methods:, Parents and their children between the ages of 1,12 were enrolled on the day of elective surgery. The preoperative COHb levels of the children were assessed noninvasively using a CO-Oximeter (Radical-7 Rainbow SET Pulse CO-Oximeter; Masimo, Irvine, CA, USA). The parents were asked to complete an environmental air-quality questionnaire. The COHb levels were tabulated and correlated with responses to the survey in aggregate analysis. Statistical analyses were performed using the nonparametric Mann,Whitney and Kruskal,Wallis tests. P < 0.05 was statistically significant. Results:, Two hundred children with their parents were enrolled. Children exposed to parental smoking had higher COHb levels than the children of nonsmoking controls. Higher COHb values were seen in the youngest children, ages 1,2, exposed to parental cigarette smoke. However, these trends did not reach statistical significance, and confidence intervals were wide. Conclusions:, This study revealed interesting trends of COHb levels in children presenting for anesthesia and surgery. However, the COHb levels measured in our patients were close to the error margin of the device used in our study. An expected improvement in measurement technology may allow screening children for potential pulmonary perioperative risk factors in the future. [source] The effects of exposure to environmental tobacco smoke on pulmonary function in children undergoing anesthesia for minor surgeryPEDIATRIC ANESTHESIA, Issue 5 2006JAMES M. O'ROURKE FFARCSI Summary Background:, The objectives of this study were to assess whether children exposed to environmental tobacco smoke (ETS) present for surgery with poorer pulmonary function, and experience a more pronounced deterioration in pulmonary function following anesthesia and surgery, than non-ETS-exposed children. Methods:, Fifty-four children aged 5,15 years with a history of ETS exposure from one or both parents and 54 children with no such ETS history were included in the study. All participants were presenting for ambulatory surgery and were judged to conform to American Society of Anesthesiology class I or II. Spirometry was performed preoperatively, postoperatively in the recovery ward when the child met criteria for discharge (Aldrete score 8), and before discharge from the day ward. Results:, The ETS-exposed group had a significantly lower mean preoperative peak expiratory flow rate (PEFR) (9.5 points lower percent predicted, 95% confidence interval ,18.1 to ,1.0, P = 0.03). Although not statistically significant, they also had lower percent predicted baseline mean values of the other spirometric variables that were measured (forced expiratory volume in 1 s ,4.5%, P = 0.07; forced vital capacity ,4.1%, P = 0.10; forced expiratory flow between 25% and 75%,3.6%, P = 0.44). Pulmonary function tests (PFTs) performed in recovery were between 8% and 14% worse than preoperative values, but the results were similar in the two groups of children. PFTs performed before hospital discharge demonstrated an near-complete recovery to baseline values. Again the pattern was similar in exposed and nonexposed children. Conclusions:, Environmental tobacco smoke exposure is associated with lower preoperative PEFR values, but does not impact on recovery from anesthesia for healthy children undergoing ambulatory anesthesia. [source] Association of tobacco smoke exposure and respiratory syncitial virus infection with airways reactivity in early childhoodPEDIATRIC PULMONOLOGY, Issue 6 2001Alan Adler MD Abstract Exposure to infectious agents and environmental tobacco smoke are thought to induce bronchial hyperresponsiveness (BHR). This study was undertaken to determine the effects of passive exposure to tobacco smoke and respiratory syncitial virus (RSV) lower respiratory infection (LRI) during infancy on the occurrence of BHR in the first 2 years of life. Eighty-six cases of documented RSV (mean age, 188 days) and 78 controls (mean age, 162 days) were enrolled from the clinic and in-patient service of a single hospital. None had a history of prior LRI. Subjects were studied at 6-month intervals up to 19 months of age with a standardized respiratory illness and parental smoking questionnaire, partial expiratory flow-volume curves by the "hug" (rapid thoracic compression) technique, and methacholine challenge. Exposure to maternal and paternal cigarette smoking, maternal history of asthma, and mold exposure were associated with decreased levels of length-corrected maximal flow at functional residual capacity (V,maxFRC). RSV-LRI was not related to V,maxFRC. After adjustment of V,maxFRC for these factors, V,maxFRC was a significantly and positively correlated with a methacholine concentration provoking a 40% fall in V,maxFRC (PC40) and negatively correlated with dose-response slope. After adjustment for V,maxFRC, there were no independent effects of tobacco smoke exposure or RSV-LRI on methacholine responses. These data do not support a role for RSV as a risk factor for airways reactivity in childhood and indicate that exposure to tobacco smoke affects airways reactivity through its effects on airways. Pediatr Pulmonol. 2001; 32:418,427. © 2001 Wiley-Liss, Inc. [source] Rural-Urban Differences in the Social Climate Surrounding Environmental Tobacco Smoke: A Report From the 2002 Social Climate Survey of Tobacco ControlTHE JOURNAL OF RURAL HEALTH, Issue 1 2004Robert McMillen PhD ABSTRACT: Context: Although previous research has found smoking rates to be higher among residents of rural areas, few studies have investigated rural-urban differences in exposure to environmental tobacco smoke (ETS). Objective: This study contrasted the social climate surrounding ETS among Americans who resided in 5 levels of county urbanization. Design: Data were collected via telephone interviews administered to a representative sample of 3,009 civilian, noninstitutionalized adults over age 18 in the United States. Households were selected using random digit dialing procedures. Findings: Compared to residents of urban counties, rural residents reported fewer restrictions on smoking in the presence of children and lower incidences of smoking bans in households, family automobiles, work areas, convenience stores, fast-food restaurants, and restaurants. Interestingly, when rural-urban variations in knowledge and attitudes about ETS were examined, the magnitude of rural-urban differences was smaller or nonexistent for these indicators. Moreover, logistic regression models indicated that none of these rural-urban differences in knowledge and attitudes persisted after statistically controlling for region, smoking status, gender, race, age, and education factors. This suggests that the observed rural-urban differences in ETS bans could not be explained adequately by rural-urban differences in knowledge and attitudes about the dangers of ETS. Conclusions: The policy implications of this research point to a greater need in rural America for programs focusing on the restriction and elimination of ETS. They also suggest that programs focusing only on influencing the levels of ETS knowledge and attitudes among the general population may not be adequate in producing the desired change. [source] Effect of Gene-environment Interactions on Mental Development in African American, Dominican, and Caucasian Mothers and NewbornsANNALS OF HUMAN GENETICS, Issue 1 2010Shuang Wang Summary The health impact of environmental toxins has gained increasing recognition over the years. Polycyclic aromatic hydrocarbons (PAHs) and environmental tobacco smoke (ETS) are known to affect nervous system development in children, but no studies have investigated how polymorphisms in PAH metabolic genes affect child cognitive development following PAH exposure during pregnancy. In two parallel prospective cohort studies of non-smoking African American and Dominican mothers and children in New York City and of Caucasian mothers and children in Krakow, Poland, we explored the effect of gene-PAH interaction on child mental development index (MDI). Genes known to play important roles in the metabolic activation or detoxification of PAHs were selected. Genetic variations in these genes could influence susceptibility to adverse effects of PAHs in polluted air. We explored the effects of interactions between prenatal PAH exposure and 21 polymorphisms or haplotypes in these genes on MDI at 12, 24, and 36 months among 547 newborns and 806 mothers from three different ethnic groups. Significant interaction effects between haplotypes and PAHs were observed in mothers and their newborns in all three ethnic groups after Bonferroni correction. The strongest and most consistent effect observed was between PAH and haplotype ACCGGC of the CYP1B1 gene. [source] Household smoking behaviours and exposure to environmental tobacco smoke among infants: are current strategies effectively protecting our young?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2010Justine B. Daly Abstract Objective: To determine the prevalence of infant exposure to environmental tobacco smoke (ETS) among infants attending child health clinics in regional NSW; the association between such exposure and household smoking behaviours; and the factors associated with smoking restrictions in households with infants. Methods: Parents completed a computer-based questionnaire and infant urine samples were collected. Information was obtained regarding the smoking behaviours of household members and samples were analysed for cotinine. Results: Twenty seven per cent of infants had detectable levels of cotinine. Infant ETS exposure was significantly associated with the smoking status of household members, absence of complete smoking bans in smoking households and having more than one smoker in the home. Smoking households were significantly less likely to have a complete smoking ban in place. Conclusions: This study suggests that a significant proportion of the population group most vulnerable to ETS were exposed. Implications: Future efforts to reduce children's exposure to ETS need to target cessation by smoking parents, and smoking bans in households of infants where parents are smokers if desired reductions in childhood ETS-related illness are to be realised. [source] Regulation of environmental tobacco smoke by Australian drug treatment agenciesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2005Raoul A. Walsh Objective: To determine how smoking is regulated in alcohol and other drug treatment agencies. Method: Australian drug treatment agencies were mailed questionnaires for completion by the manager and one other staff member (553 packages posted). Results: Questionnaires were returned by 260 (59.8%) eligible agencies. Most respondents (82.5% managers, 76.7% other staff) indicated their agency had a written policy regulating smoking. The vast majority (88.2% managers, 82.3% other staff) reported smoking was banned inside their agency, with the highest proportion of bans being in the area health category (95.8% managers, 93.7% other staff) and the lowest in the residential rehabilitation category (75.6% managers, 62.8% other staff). Of the respondents reporting a ban, 19.1% of managers and 27.5% of other staff reported their agency's ban was not ,always' enforced. Paired analyses suggested that other staff were more likely to indicate that the agency had no written policy or be unsure and managers were more likely to report that smoking bans were ,always' stringently enforced. Overall, a substantial minority of respondents (managers 28.6%, other staff 40.2%) indicated that smoking occurred inside their agency at least occasionally. Conclusions and Implications: A substantial proportion of Australian drug and alcohol agencies continue to permit smoking inside their premises. Policy initiatives and educational campaigns are required to promote the expansion of smoke-free conditions in this sector. Serious consideration should be given to making the adoption and enforcement of internal smoke-free policies a condition of any continued government funding. [source] Environmental tobacco smoke in homes, motor vehicles and licensed premises: community attitudes and practicesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 6 2002Raoul A. Walsh Objective: To assess community knowledge, attitudes and practices in relation to environmental tobacco smoke (ETS) especially in homes, private motor vehicles and licensed premises, and to document levels of support for further government legislation. Methods: 656 persons aged 18 years and over, a sub-sample in a computer-assisted telephone survey of 2,087 randomly selected respondents across NSW, answered 12 ETS-specific questions The whole sample was asked demographic, smoking status and household membership questions. The overall response rate was 61.4% (consent rate 75.4%). Results: Overall, 32.8% (95% CI 27.8,37.8) of children aged 0,4 years in the households surveyed were reported to live with at least one smoker. Agreement about ETS hazards was lowest in relation to child ear problems (31.2%) and sudden infant death syndrome (50.6%). Complete bans on smoking were reported in 69.9% of homes and 77.1% of private motor vehicles The percentages favouring total bans in homes (p<0.001) and private motor vehicles (p<0.001) were significantly lower among smokers than non-smokers. Overall, 55.8% supported legislation to ban smoking in private vehicles carrying children. The majority support restrictions on smoking in non-eating areas of licensed clubs (88.7%) and hotels (84.8%). Overall, the data indicate a ban on smoking in licensed premises is likely to increase business. Conclusion: Smoking is banned in most NSW homes and private motor vehicles Acceptance of ETS risks is high but there are important knowledge gaps. Considerable support exists for further government regulation of ETS. Media campaigns are likely to reinforce a public environment already receptive of the need for more government ETS restrictions. [source] Environmental tobacco smoke exposure as a risk factor for infections in infancyACTA PAEDIATRICA, Issue 7 2009F Ladomenou Abstract Aim:, This prospective observational study investigated the effect of environmental tobacco smoke (ETS) on frequency and severity of common infantile infections. Methods:, In a representative sample of 926 infants, parental smoking was recorded at months 1 and 9 postpartum, and all infantile infectious episodes were recorded at 1, 3, 6, 9 and 12 months postpartum. Results:, Both parents were regular smokers all through the first year in 107 (11.6%), at least one smoked regularly or occasionally in 492 (53.1%), and parents did not smoke at all in 327 (35.3%) families. Among mothers, 168 (18.1%) smoked perinatally. Infantile ETS exposure was associated with increased frequency of total infectious episodes (p = 0.025) and hospitalizations for infection (p = 0.007). In ETS exposed infants, birth in autumn and presence of siblings contributed to increased frequency of most infections and of hospital admissions for infection. By contrast, exclusive breastfeeding protected against the effect of ETS on total infantile infections (OR 0.982, 95% CI 0.965,0.999; p = 0.036), hospital admissions for infection (OR 0.980, 95% CI 0.961,0.999; p = 0.036) and thrush (OR 0.973, 95% CI 0.951,0.996; p = 0.022). Conclusion:, Our findings point to harmful effect of ETS on infantile health and further suggest that this effect may be enhanced or diminished by other factors. ETS should be regarded as a preventable risk factor for infections in infancy. [source] Effect of strategies to reduce exposure of infants to environmental tobacco smoke in the home: cross sectional surveyCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2003Lisa Arai No abstract is available for this article. [source] Do parents with an atopic family history adopt a ,prudent' lifestyle for their infant? (KOALA Study)CLINICAL & EXPERIMENTAL ALLERGY, Issue 4 2006I. Kummeling Summary Background Atopic parents may adopt lifestyle characteristics that allegedly protect against atopic disease. If this is true, infants from atopic parents will be characterized by low-risk behaviour. Consequently, aetiologic studies on lifestyle factors and allergic disease in childhood may be biased by confounding by indication. Objective We explored whether the prevalence of ,prudent' lifestyle characteristics differs between atopic and non-atopic families. Methods Information about a family history of atopic manifestations and lifestyle characteristics was collected by repeated questionnaires in the Dutch KOALA Birth Cohort Study in 2469 infants from families with divergent lifestyle practices (conventional vs. alternative). Results In conventional lifestyle families, infants were less often exposed to environmental tobacco smoke when parents were atopic than when they were non-atopic (10.0% vs. 14.7%, P=0.001). In alternative lifestyle families, exposure to smoking was very rare in both groups (1.7% vs. 2.6%). Pets were less often present in families with than without parental atopy (38.8% vs. 51.1%, P=0.008 for conventional lifestyle families; 43.0% vs. 48.4%, P=0.014 for alternative lifestyle families). Infants with atopic siblings had less often been vaccinated according to the standard scheme than infants with non-atopic siblings in conventional lifestyle families (76.6% vs. 85.5%, P<0.001). In alternative lifestyle families, the difference was in the same direction but not statistically significant (30.1% vs. 40.5%, P=0.143). Antibiotic use, breastfeeding and consumption of organic foods were unrelated to a family history of atopic manifestations. Conclusion Some ,prudent' lifestyle characteristics differed between atopic and non-atopic families, depending on whether atopic manifestations were present in parents or older siblings. This has important consequences for the validity in epidemiological studies on the aetiology of allergy in children. Confounding by indication because of a family history of atopic manifestations can best be controlled for by considering atopy in parents and siblings as separate confounders. [source] Adverse health effects related to tobacco smoke exposure in a cohort of three-year oldsACTA PAEDIATRICA, Issue 3 2008AnnaKarin Johansson Abstract Aim: To analyse the importance of mothers' smoking during pregnancy and/or environmental tobacco smoke (ETS) exposure in early childhood for children's health and well-being at the age of 3 years. Methods: Four groups from a population based cohort (n = 8850) were compared: children with nonsmoking mother during pregnancy and nonsmoking parents at the age of 3 years (n = 7091); children with only foetal exposure (n = 149); children exposed only postnatally (n = 895) and children exposed both pre- and postnatally (n = 595). Odds ratios and 95% confidence intervals were calculated. Results: Children exposed both pre- and postnatally had more wheezing (1.14; 1.07,1.21) and rhinitis (1.16; 1.06,1.26), used more cough-mixture (1.07; 1.01,1.14) and broncodilatating drugs (1.08; 1.02,1.15) and suffered more from excessive crying (1.31; 1.13,1.51) and irritability (1.27; 1.09,1.48) compared to children with nonsmoking parents. Children exposed only postnatally had more rhinitis (1.24; 1.12,1.37), used more cough-mixture (1.14; 1.05,1.29) and suffered more from poor sleep (1.26; 1.07,1.47) than children of nonsmoking parents. Children with prenatal exposure only used more broncodilatating drugs (1.45; 1.03,2.04) and suffered more from poor sleep (2.06; 1.09,3.87). Conclusion: Health differences, small but significant, indicate that prenatal and/or postnatal ETS exposure alone, or in combination, seems to interfere with child health, supporting the importance of zero tolerance. However, as most smoking parents in Sweden try to protect their children from ETS exposure, the results also might indicate that protective measures are worthwhile. [source] Policy interpretation network on children's health and environmentACTA PAEDIATRICA, Issue 2006PETER VAN DEN HAZEL Abstract Aim: The main objective of PINCHE is to provide policy recommendations aiming at protecting children's health and environment based on completed scientific research. The project focused on four themes: indoor and outdoor air pollutants, carcinogens, neurotoxicants, and noise. The data were evaluated in workpackages on exposure assessment, epidemiology, toxicology, and risk and health impact assessment. The data were analysed according to a framework of questions. The workpackage on socioeconomic factors studied the influence of socioeconomic status on exposures and on health effects. In the workpackage on science-policy interface, recommendations on how to improve children's environmental health were formulated. Results: The policy recommendations resulting from the analysis were grouped according to relevant policy levels: European Commission or the European Parliament, member states and other stakeholders at regional or local level. These recommendations are general guidelines for taking action. Regional differences and variation must be reflected when policy is actually implemented. In addition, recommendations related to education and personal behaviour are presented in the reports. Conclusions: The policy recommendations are important input for policy advisers, policy makers and public health authorities at all policy levels. The recommendations are also of direct relevance to interest groups, such as environmental NGOs including child health and advocacy groups. The policy recommendations for each policy level were prioritized. High priorities were given to reduce exposure to environmental tobacco smoke, transport related air pollution, indoor air and mercury. [source] | |||||||||||||||||||||||||