Smoking at home is strongly associated with symptoms of asthma and rhinitis in children of primary school age in Trinidad and Tobago

Objective. To compare, in the twin-island republic of Trinidad and Tobago, the prevalence of symptoms of asthma and rhinitis among children of primary school age who are exposed to household environmental tobacco smoke with the prevalence of these symptoms in their colleagues without this exposure. Methods. Between September and December 2002, questionnaires based on the instrument developed for the International Study of Asthma and Allergies in Childhood (ISAAC) were distributed, via the children in their schools, to parents of 6,611 Year 2 pupils (typically 6 years old) or Year 3 pupils (typically 7 years old) in 106 randomly selected schools in Trinidad and Tobago (5,511 pupils on Trinidad and 1,100 pupils on Tobago). We added to the standard ISAAC questionnaires two questions, one on household smoking and one on the ethnicity of the children. Results. A total of 3,170 completed questionnaires were suitable for further analysis (2,618 from Trinidad and 552 from Tobago). On Trinidad 782 of the children (29.9 percent) lived in homes where one or both parents smoked, and 513 (19.6 percent) had other relatives in the household who smoked. On Tobago 94 of the pupils (17.0 percent) had parents who smoked, and 84 (15.4 percent) came from homes where other residents smoked. Parental smoking was significantly associated with wheezing (odds ratio (OR): 1.43; 95 percent confidence interval (CI): 1.11-1.83), exercise-induced wheezing (OR: 2.12; 95 percent CI: 1.59-2.82), nocturnal coughing (OR: 1.64; 95 percent CI: 1.37-1.97), and symptoms of rhinitis (OR:1.35; 95 percent CI: 1.10-1.65) in the last 12 months as well as a history of hay fever/sinus problems (OR: 1.39; 95 percent CI: 1.11-1.74). Smoking in the home by adult residents other than parents was also significantly associated with all of these symptoms as well as a history of asthma (OR: 1.49; 95 percent CI: 1.13-1.97). In terms of ethnic differences, parental smoking was most prevalent in the homes of South Asian students, while smoking by other adults in the home occured most commonly in the households of pupils of mixed race. Conclusions. Even in Trinidad and Tobago, which is a tropical environment where more time is spent outdoors and homes have more open ventilation than in temperate climates, environmental tobacco smoke exposure is closely asociated with an increased prevalence of symptoms of asthma and rhinitis in primary-school-aged children (AU)

Tobacco use by youth: a surveillance report from the Global Youth Survey project

The Global Youth Tobacco Survey (GYTS) project was developed by the World Health Organization and the US Centers for Disease Control and Prevention to track tobacco use among youth in countries across the world, using a common methodology and core questionnaire. The GYTS is school based and employs a two stage sample design to produce representative data on smoking among students aged 13-15 years. The first stage consists of a probabilistic selection of schools. All students in the selected classes are eligible for the survey. In 1999, the GYTS was conducted in 13 countries and is currently in progress in over 30 countries. This report describes data from 12 countries: Barbados, China, Costa Rica, Fiji, Jordan, Poland and the Russian Federation (Moscow), South Africa, Sri Lanka, Ukraine (Kiev), Venezuela and Zimbabwe. The findings show that tobacco use in the surveyed age group ranged from a high of 33 percent to a low of 10 percent. While the majority of current smokers wanted to stop smoking, very few were able to attend a cessation programme. In most countries the majority of young people reported seeing advertisements for cigarettes in media outlets, but anti-tobacco advertising was rare. The majority of young people being taught in school about the dangers of smoking. Environmental tobacco smoke exposure was very high in all countries. These results show that the GYTS surveillance system is enhancing the capacity of countries to design, implement, and evaluate tobacco prevention and control programmes. (AU)

Ethnic origin and care giving styles relevant to cot death

OBJECTIVE: To examine whether ethnic origin is related to care giving styles relevant to sudden infant death. DESIGN: Prospective/Retrospective, descriptive METHOD: In six child health care centres in Amsterdam, the Netherlands, data about sleep position, bedclothes and passive smoking of infants aged 1-5 months were collected by face-to-face interviews of mothers visiting these centres between February 1997 and October 1998. RESULTS: Eligible for study were 1815 infants, 919 boys and 896 girls, mean age 2 months. In Amsterdam 12.5 percent of infants were usually or sometimes put to sleep in a prone position, 31.0 percent usually or now and then in a side position (but not in a prone position) and 56.5 percent usually in a supine position. Prone sleeping position was more frequent among Surinamese infants and less frequent among Moroccan infants compared with Dutch infants. Overall use of a duvet among infants was 22.7 percent. Use of duvets was higher among allochtonous infants; after controlling for demographic factors this difference was not significant, however. 6.3 percent of the infants had slept in the previous night with a pillow. Use of a pillow was much more frequent among allochtonous than among autochtonous infants: 13 percent versus 1.2 percent. Maternal daily smoking during pregnancy and smoking by mothers or others at home at time of interview was found in 15.1 percent and 25.8 percent of the infants respectively. Almost no Moroccan mothers smoked during preganancy (0.4 percent), while Turkish mothers smoked as much as Dutch mothers (18.5 percent and 21.6 percent respectively). No differences in daily smoking at home were found between Surinamese, Moroccan and Dutch families (circa 26 percent). However, daily smoking at home was much more frequent in Turkish families (43.8 percent). CONCLUSION: Health education about a safe sleeping position, about safe bedclothes and about the dangers of passive smoking is needed. Education programmes to prevent sudden infant death must take into account ethnic differences in care giving styles. Special attention must be paid to the use of a pillow among allochtonous infants. (AU)

Gezondheid, in rook opgegaan / Health, gone up in smoke

Presents various aspects of tobacco smoking, such as the disadvantages and psychic influences and/or consequences. Expresses a distinct opinion against smoking, but still discusses the advantages and economic significance of smoking. The smoking behaviour of Surinamese students is also discussed