Secondhand smoke is associated with peptic ulcer disease and gastroesophageal reflux disease in non-smokers in a large Taiwanese population study.

Background: Active smokers are known to be at an increased risk of both gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD), however the role of passive smoking remains unclear. In this study, we aimed to examine whether secondhand smoke (SHS) is associated with PUD and GERD. Methods: In this population-based study, we conducted a large-scale analysis with 88,297 never-smokers (male: 18,595; female: 69,702; mean age 50.1 ± 11.0 years) from the Taiwan Biobank. The exposure group was comprised of those who had been exposed to SHS, and the no exposure group as those without SHS exposure. According to the frequency of exposure, we further divided the participants into "no exposure," "<1 h per week," and "≥1 h per week" groups. A cutoff point of 1 h per week was chosen according to the median exposure time in our participants. Associations between SHS and SHS frequency with PUD and GERD were assessed. Results: Of the 88,297 enrolled participants, 11,909 (13.5%) had PUD and 76,388 (86.5%) did not. In addition, 11,758 (13.3%) had GERD and 76,539 (86.7%) did not. Multivariable analysis showed a significant association between SHS with PUD (odds ratio [OR] = 1.166; 95% confidence interval [CI] = 1.084-1.254; p < 0.001), and GERD (OR = 1.131; 95% CI = 1.053-1.216; p = 0.001). Furthermore, those exposed to SHS ≥ 1 h per week (vs. no exposure) were associated with higher risks of PUD (OR = 1.232; 95% CI = 1.121-1.355; p < 0.001) and GERD (OR = 1.200; 95% CI = 1.093-1.319; p < 0.001). Conclusion: SHS was significantly associated with PUD and GERD. Furthermore, exposure to SHS ≥ 1 h per week (vs. no exposure) was associated with a 1.23-fold higher risk of PUD and 1.20-fold higher risk of GERD. This study represents the largest population-based investigation to explore the association between SHS with PUD and GERD in Taiwanese never-smokers.

Assessment of exposure to secondhand tobacco smoke in Spain: A scoping review.

INTRODUCTION: There is no consensus on the questions that should be included in questionnaires to properly ascertain exposure to secondhand tobacco smoke (SHS). The objective of this study is to analyze the questions included in studies which have assessed SHS exposure in Spain. METHODS: A scoping review was performed, using PubMed, Embase and Web of Science databases, selecting original articles published in English and Spanish, across the period 2012-2021. We extracted data from each study regarding its design, target population, sample size or geographical scope; we also collected data regarding how studies dealt with exposure to SHS including assessment and intensity of SHS, exposure setting, geographical scope, and the verbatim questions used. RESULTS: Finally, 75 studies were identified. In the 23 studies carried out in children, verbatim questions were included in 8 studies, and the setting most studied was the home. SHS exposure was assessed during pregnancy and postnatally by 8 studies, the verbatim questions used were described in 2 studies, being exposure ascertained at home and workplace. In the adult population, 14 of 44 studies described the verbatim questions; the setting most studied was the home. Verbatim questions varied among studies. CONCLUSIONS: Questionnaire-based assessment of SHS exposure is highly heterogeneous, hindering comparability between studies. Therefore, it is necessary to set a standard questionnaire to assess exposure to SHS.

Impacts of revised smoke-free regulations under the 2020 Japan Health Promotion Act on cigarette smoking and heated tobacco product use in indoor public places and homes: findings from 2018 to 2021 International Tobacco Control (ITC) Japan Surveys.

BACKGROUND: In April 2020, Japan's revised Health Promotion Act (HPA) banned cigarette smoking and heated tobacco products (HTP) use in indoor public places but exempted small establishments and permitted smoking-designated/HTP-designated rooms. This pre-post study evaluated the effectiveness of the HPA. METHODS: Data were from waves 1 to 4 (2018-2021) of the International Tobacco Control Japan Surveys among a national cohort of adults who smoke cigarettes, use HTPs and do not use any tobacco products. The sample sizes in the respective surveys were 4615, 4222, 4387 and 4254. Multivariable logistic regression models employing generalised estimating equations estimated the prevalence of observed and self-reported indoor smoking/HTP use in key public venues (restaurants/cafés, bars/pubs and workplaces), smoke-free places, and homes, and smoke-free/HTP aerosol-free home policies (model 1). The models were additionally adjusted for waves 1-4 to estimate the impacts of the HPA (model 2). RESULTS: The implementation of the HPA significantly reduced observed indoor smoking in bars/pubs (model 1: 82.2% (pre) to 55.5% (post), model 2: p=0.04) but not in restaurants/cafés (model 1: 53.0%-24.9%, model 2: p=0.15) or workplaces (model 1: 35.3%-30.1%, model 2: p=0.62). Observed indoor HTP use was also common postimplementation (restaurants/cafés: 19.6%, bars/pubs: 53.9%, workplaces: 36.4%). The implementation of the HPA was associated with a significant increase in observed HTP use in smoke-free places (model 1: 26.3%-33.3%, model 2: p=0.001) and a suggestive increase in homes without HTP aerosol-free policies among adults who smoke (model 1: 64.0%-77.0%, model 2: p=0.09). CONCLUSIONS: The implementation of the HPA was limited in its effectiveness. Comprehensive regulations with no exemptions are needed in Japan.

Evaluating the effectiveness of Smoke-Free Home SafeCare, an integrated intervention, among families at risk for secondhand smoke exposure and child maltreatment in the United States: a study protocol for a hybrid type 1 trial.

BACKGROUND: Secondhand smoke exposure (SHS) and child maltreatment (CM) are preventable yet have negative lifelong impacts on health. When considered together, the risk for negative health outcomes may be compounded, especially for people living in low-resource settings. Evidence-based interventions exist for preventing CM and reducing SHS among families with low resources; however, no programs jointly target SHS exposure and maltreatment risk. METHODS: This study is a hybrid type 1 trial to examine the effectiveness of a systematically braided intervention to target CM risk and SHS in the home. Fifty SafeCare Providers will be randomized to deliver either standard SafeCare (i.e., the SafeCare model alone; active treatment control; n = 25) or Smoke-Free Home SafeCare (SFHSC; treatment condition; n = 25), the braided intervention that includes both SafeCare and the Smoke-Free Homes: Some Things are Better Outside intervention to N = 500 families. Aim 2 is to assess family-level outcomes. The primary outcome is a full home smoking ban, validated by air nicotine monitors; secondary outcomes include parenting and smoking outcomes. Aim 3 is to evaluate process and implementation outcomes, including cost-benefit. We will use multilevel models and ROC analyses to evaluate and validate the primary outcome. We will use tests of non-inferiority to evaluate secondary outcomes. Cost-effectiveness analyses will be used to assess cost-benefit of SFHSC. DISCUSSION: This study will be the first to document the outcomes of a multi-component intervention to address cumulative risk factors that impact cancer risk among children whose parents are at risk or involved in child-protective services. Integrating an evidence-based intervention that targets SHS exposure in the home with a broadly disseminated CM prevention intervention may be a sustainable way to help reduce the compounded effects of SHS in the home and CM. TRIAL REGISTRATION: Clinicaltrials.gov, NCT05000632. Registered on August 11, 2021.

Best practices for expansion of smoke-free and aerosol-free environments in Europe: Protocol for the consultation to experts.

Smoke-free legislation has been shown to positively impact reducing secondhand smoke (SHS) exposure, especially in countries that have implemented comprehensive legislation rather than partial bans. Also, secondhand aerosols (SHA) that come from the heating of tobacco or liquids, with or without nicotine, in electronic nicotine delivery systems (ENDS) have been proven to increase levels of harmful substances in the air. Therefore, protection against SHS and SHA exposure and expansion of smoke- and aerosol-free environments (SAFE) should be taken into account when creating or trying to expand or enforce clean air policies. This article aims to present the protocol for a consultation with experts on tobacco and nicotine control in order to identify best practices, barriers, and opportunities for the expansion of SAFE in Europe. We identified experts among policymakers, researchers, and tobacco regulators in European countries and invited them to participate in the consultation by completing an online survey designed, programmed, and pilot-tested using Survey Monkey. The responses to the questionnaire contained quantitative and qualitative information that was thematically analyzed. The experts' consultation allowed us to produce a report on barriers and opportunities for SAFE, a report and a position paper on SAFE best practices, a web-based repository of best practices, and a weight of evidence paper that assembles evidence supporting the expansion of SAFE on indoor and outdoor spaces.

Exposure to secondhand smoke among school-going adolescents in Malaysia: Results from the National Health and Morbidity Survey (NHMS) 2022: Adolescent Health Survey (AHS).

INTRODUCTION: The adverse effects of secondhand smoke (SHS) exposure on health have been well established. Using the NHMS 2002: Adolescent Health Survey (AHS), this study attempts to evaluate the extent and factors associated with SHS exposure among Malaysian school-going adolescents. METHODS: We conducted the NHMS 2022: AHS to gather a representative sample of school-age teenagers. We employed a cross-sectional study design and a multi-stage sampling procedure. We utilized a pre-validated self-administered questionnaire to collect data from the selected respondents. The data analysis included adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs). Additionally, we investigated the possible two-way interactions between the independent variables. RESULTS: The SHS prevalence was 42.0%. Exposure to secondhand smoke (SHS) was associated with male gender (AOR=1.28; 95 CI: 1.20-1.38), older age (AOR=1.46; 95% CI: 1.33-1.60), Malay (AOR=1.88; 95% CI: 1.49-2.37), Bumiputra Sabah (AOR=2.23; 95% CI: 1.67-2.99), Bumiputra Sarawak (AOR=2.43; 95% CI: 1.80-3.28), and Chinese ethnicity (AOR=2.89; 95 CI: % 2.30-3.64), as well as current smoking (AOR=2.78; 95% CI: 2.50-3.09), having separated or divorced parents (AOR=1.12; 95% CI: 1.02-1.23), and parental tobacco product use (AOR=4.75; 95% CI: 4.44-5.08). We found significant interactions between: 1) Age group with gender and ethnicity; 2) Gender and ethnicity; and 3) Parental smoking status with gender, response to tobacco use, parents' marital status, and ethnicity. CONCLUSIONS: Parental characteristics, sociodemographic characteristics, and SHS exposure are strongly correlated. In addition, there is evidence of smoking displacement to the house from other areas by parents/guardians. This study offers a fresh perspective on how these variables influence the likelihood of SHS exposure for Malaysian school-age teenagers. More efforts should focus on parental variables and sociodemographic traits, especially parental smoking cessation support.

Overcoming Challenges to Adopting Smoke-Free Multi-Unit Housing Policies in a Large U.S. Metropolitan Area: Insights and Recommendations From Affected Groups in 20 Los Angeles County Cities.

PURPOSE: Community members and non-academic partners ("affected groups") were asked to identify factors that can influence public support, impede adoption, and mitigate challenges related to adopting local smoke-free multi-unit housing policies. APPROACH: A series of key informant interviews were conducted with affected groups from a large U.S. metropolitan area. SETTING: 20 cities in Los Angeles County without a smoke-free multi-unit housing ordinance. PARTICIPANTS: Interviewees were recruited from affected groups with knowledge about their community's civic and political landscape (n = 63). METHOD: Data were collected and analyzed using thematic analysis to identify, code and compare themes. RESULTS: Most interviewees indicated civic groups, those who do not smoke, and/or groups who are educated about the negative health effects of secondhand smoke exposure would be more likely to support smoke-free multi-unit housing policies. Interviewees reported several challenges to policy adoption, including competing city priorities, public disengagement, and the cost and social burden of enforcing these ordinances. To overcome them, interviewees recommended working synergistically with local governments to build diverse coalitions, educate the public, and develop clear enforcement plans. CONCLUSION: Insights and recommendations from affected groups in 20 U.S. cities suggest that communicating with the public and priming impacted communities to support smoke-free multi-unit housing policies are promising interventions for protecting at-risk families from secondhand smoke exposure in their homes.

Inequalities in exposure to second-hand smoke among adolescent boys and girls in 122 countries: Evidence from the Global Youth Tobacco Survey.

BACKGROUND: Secondhand smoke exposure (SHS) is a major modifiable risk factor for morbidity and premature mortality. No study has assessed inequalities by sex in SHS exposure among adolescents globally. This study aims to explore the variations in SHS exposure among adolescents globally based on sex. METHODS: Most recent data from 122 countries and territories that conducted the Global Youth Tobacco Survey between 1 January 2013 and 31 December 2020, comprising 557,332 respondents aged 11-17 years, were used to assess the prevalence of SHS exposure at home, in other enclosed public places, and at school. Multivariable Poisson regression models were performed to investigate the association between sex and SHS exposure in each country. RESULTS: A total of 195,299 (35.0 %) adolescents reported exposure to SHS at home, 256,938 (46.1 %) in other enclosed public places, 258,528 (46.4 %) at school, and 399,644 (71.7 %) in any place. There were important inequalities in the prevalence of SHS exposure between countries. More girls than boys reported exposure to SHS at home in 54 countries (vs. one country with prevalence higher in boys than girls) and in other enclosed public places in 50 countries (vs. six countries). In contrast, the prevalence of SHS exposure at school was significantly higher in boys than girls in 25 countries while the opposite was observed in 14 countries. CONCLUSIONS: These findings emphasize the disparities in SHS exposure between adolescent boys and girls and, hence, highlight the urgent need to strengthen smoke-free policies and adopt targeted policies to address them.

Maternal exposure to smoking and wheezing phenotypes in children: a cohort study of the Japan Environment and Children's Study.

BACKGROUND: Previous studies have shown that prenatal maternal smoking and maternal secondhand smoke exposure during pregnancy were associated with an increased risk of wheezing and asthma development. However, few studies have examined the influence of different sources of tobacco exposure in different perinatal timeframes (preconception, prenatal, and postnatal) on wheezing phenotypes in children. Using national survey data from Japan, we investigated the effects of exposure to tobacco smoke during pregnancy on wheezing phenotypes in children before the age of 3 years. METHODS: Pregnant women who lived in the 15 regional centers in the Japan Environment and Children's Study were recruited. We obtained information on prenatal and postnatal exposure to active and secondhand smoke (SHS) and wheeze development up to 3 years of age. Multiple logistic regression analysis was performed to determine the association between tobacco smoke exposure and wheezing phenotypes in children. RESULTS: We analyzed 73,057 singleton births and identified four longitudinal wheezing phenotypes: never wheezing; early transient wheezing (wheezing by age 1 year but not thereafter); late-onset wheezing (wheezing by age 2-3 years but not beforehand); and persistent wheezing. Maternal smoking during pregnancy was significantly associated with early transient and persistent wheezing in children compared with no maternal smoking [early transient wheezing: 1-10 cigarettes per day, adjusted odds ratio (aOR) 1.43, 95% confidence interval (CI) 1.23-1.66; ≥ 11 cigarettes per day, aOR 1.67, 95% CI 1.27-2.20; persistent wheezing: 1-10 cigarettes per day, aOR 1.64, 95% CI 1.37-1.97; ≥ 11 cigarettes per day, aOR 2.32, 95% CI 1.70-3.19]. Smoking cessation even before pregnancy was also significantly associated with increased risk of early transient wheezing, late-onset wheezing, and persistent wheezing in children. Moreover, maternal exposure to SHS during pregnancy was significantly associated with increased risk of early transient and persistent wheezing compared with no such exposure. CONCLUSIONS: Maternal smoking before and throughout pregnancy was associated with wheeze development in children up to 3 years of age. It appears that smoking is detrimental compared to never smoking, regardless of whether individuals quit smoking before or after becoming aware of the pregnancy.

Impact of smoke-free legislation on stroke risk: A systematic review and meta-analysis.

PURPOSE: Secondhand smoke significantly increases the risk of cerebrovascular diseases, prompting recent public smoking bans. We aimed to ascertain the effects of smoke-free legislation on stroke incidence and mortality. METHODS: We systematically searched Medline, Embase, Cochrane Library, and Scopus up to August 13, 2023, for studies reporting changes in stroke incidence following partial or comprehensive smoking bans. A random-effects meta-analysis was conducted on hospital admissions and mortality for stroke, stratified based on comprehensiveness of the ban ((i) workplaces-only, (ii) workplaces and restaurants, (iii) workplaces, restaurants and bars). The effect of post-ban follow-up duration was assessed visually by a forest plot, while meta-regression was employed to evaluate for any dose-response relationship between ban comprehensiveness and stroke risk. FINDINGS: Of 3987 records identified, 15 studies analysing bans across a median follow-up time of 24 months (range: 3-67) were included. WRB bans were associated with reductions in the rates of hospital admissions for stroke (nine studies; RR, 0.918; 95% CI, 0.872-0.967) and stroke mortality (three studies; RR, 0.987; 95% CI, 0.952-1.022), although the latter did not reach statistical significance. There was no significant difference in the risk of stroke admissions for studies with increased ban comprehensiveness and no minimum duration for significant post-ban effects to be observed. DISCUSSION AND CONCLUSION: Legislative smoking bans were associated with significant reductions in stroke-related hospital admissions, providing evidence for its utility as a public health intervention.

Secondhand Smoke Exposure and Its Impact on Pediatric Lung Function, Aerobic Fitness, and Body Mass: Evidence from a Cross-Sectional Study.

BACKGROUND: Several studies have documented the detrimental impacts of secondhand smoke (SHS) exposure to a range of pediatric respiratory conditions, including asthma, bronchitis, and reduced lung function. The aim of the study was to investigate the influence of SHS exposure on lung function, physical fitness, and body mass index (BMI) in children aged 10 to 14 years. METHODS: This cross-sectional study included children aged 10 to 14 years at the Elementary School "Trilj" in Trilj, Croatia. Data on SHS exposure were collected using a questionnaire. Antropometric and spirometry measurements were performed. Physical fitness was assessed using the shuttle run (BEEP) test. RESULTS: This study included 157 children, 89 (56.69%) boys and 68 (43.31%) girls. Children exposed to every day SHS in households had significantly lower values of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, peak expiratory flow (PEF) (p < 0.001) and higher z-score BMI levels (p = 0.018) in comparison to unexposed children. Logistic regression showed that children unexposed to SHS had higher odds for better results in the BEEP test (OR 62.45, 95% CI 21.26-179.24, p < 0.001). Children with poorer physical fitness, expressed by lower BEEP score levels, had significantly lower FVC, FEV1, FEV1/FVC, and PEF (p < 0.001). CONCLUSIONS: Every day SHS exposure in children was associated with poorer lung function, higher BMI, and poorer physical fitness.

Changes of campus tobacco control environment and the impact on tobacco control behaviors among secondary school personnel in Shanghai, China.

INTRODUCTION: Youth smoking is a serious public health problem. Nevertheless, a rigorous tobacco-free environment within schools, combined with exemplary tobacco control behavior among school personnel can effectively contribute to reducing adolescent smoking. This study compared the tobacco control environment in Shanghai secondary schools in 2017 and 2021, and explored how the tobacco control environment influenced the tobacco control behaviors of school personnel. METHODS: Two cross-sectional studies were conducted from October to December 2017 and October to December 2021, using stratified cluster random sampling method, and 2403 and 1761 valid questionnaires were collected, respectively. The chi-squared test was used to test the differences between categorical variables. Binary logistic regression was conducted using survey data from 2021 to explore the influencing factors of staff's tobacco control behaviors. RESULTS: Compared with 2017, the percentages of staff members who were current smokers, had smoked on campus in the past year and were exposed to secondhand smoke (SHS) on campus in the past 7 days in 2021 decreased by 2.95%, 2.30% and 8.91%, respectively. However, the proportion of personnel who knew the school had organized tobacco control education decreased. Furthermore, school personnel who had received tobacco control education and agreed the school should strictly prohibit students from smoking (AOR=1.64; 95% CI: 1.25-2.15) were more likely to inform about the harm of tobacco to students. Those who had participated in tobacco control education activities or tobacco control trainings (AOR=1.87; 95% CI: 1.30-2.69) and believed that the school did not strictly prohibit either students (AOR=0.30; 95% CI: 0.22-0.41) or personnel (AOR=0.46; 95% CI: 0.36-0.59) from smoking were more inclined to stop students from smoking. CONCLUSIONS: Compared with 2017, the rates of smoking and secondhand smoke exposure among school personnel decreased in 2021, but some schools still lacked comprehensive education on tobacco control behaviors for the staff. Enhancing the health literacy and strengthening tobacco control education among staff were effective strategies to encouraging their active adoption of tobacco control behaviors.

Outdoor secondhand smoke exposure in public places frequented by minors in the urban area of Hangzhou City, China: A cross-sectional study.

INTRODUCTION: Hangzhou Public Places Smoking Control Regulations (2019) have been gradually adopted, which explicitly stipulate that smoking is strictly prohibited in the outdoor areas of educational and healthcare institutions for minors. However, there are few studies reporting the exposure to secondhand smoke (SHS) in outdoor public places for minors in the urban area of Hangzhou City. METHODS: We aimed to assess the exposure to SHS in public spaces frequented by minors using on-site observations and questionnaires. In this cross-sectional study, the area was divided into core and non-core areas based on the spatial distribution and development process of the city. The core areas included the West Lake commercial district, extending to the Qiantang River, while non-core areas were located beyond this radius. Using stratified random sampling, 30 public places in each area were selected as observation sites. On-site observations measured SHS exposure and smoking control, and questionnaires were administered to 6 individuals at each site. The results were compared between the two investigation methods. RESULTS: Among the 57 valid observation points, 24.6% (14/57) did not display any no-smoking signs. Outdoor SHS exposure rate from on-site observation P1 (observing someone smoking or smelling tobacco smoke), on-site observation P2 (observing someone smoking or smelling tobacco smoke or seeing cigarette butts) and questionnaire survey P3, were 59.6% (95% CI: 45.7-72.2), 91.1% (95% CI: 79.7-96.7) and 41.0% (95% CI: 35.5-46.7), respectively. CONCLUSIONS: The outdoor SHS exposure in areas frequented by minors in the urban district of Hangzhou City remains high, coupled with a lack of awareness of SHS risks among underage individuals. Therefore, controlling outdoor SHS exposure in these key areas is a critical public health issue in Hangzhou, requiring further tobacco control efforts. On-site observation is an important and supplementary research method to investigate outdoor SHS exposure, especially to describe the SHS exposure of focus areas.

Advancements in Cardiovascular Disease Research Affected by Smoking.

The harmful substances in tobacco are widely recognized to exert a significant detrimental impact on human health, constituting one of the most substantial global public health threats to date. Tobacco usage also ranks among the principal contributors to cardiovascular ailments, with tobacco being attributed to up to 30% of cardiovascular disease-related deaths in various countries. Cardiovascular disease is influenced by many kinds of pathogenic factors, among them, tobacco usage has led to an increased year by year incidence of cardiovascular disease. Exploring the influencing factors of harmful substances in tobacco and achieving early prevention are important means to reduce the incidence of cardiovascular diseases and maintain health. This article provides a comprehensive review of the effects of smoking on health and cardiovascular diseases.

[How is the compliance with the tobacco control law in hospitaty terraces?] / ¿Se cumple la ley de control del tabaquismo en las terrazas de hostelería?

OBJECTIVE: To describe tobacco consumption and the compliance with the law on hospitality terraces in Barcelona. METHOD: Cross-sectional study by observation in a sample of 120 hospitality terraces in Barcelona. 30-minute observations were made using a standardized record sheet. The study variables were number of people smoking, number of cigarettes smoked, cigarette butts, socioeconomic status of the neighborhood, time of observation, consumption regulation, number of chairs and number of persons. RESULTS: There were people smoking at the time of the observation in 97.5% of the terraces, with no differences according to socioeconomic level of the neighborhood or the regulation of the terrace. There was no compliance with the law in 100% of the terraces where smoking was banned. CONCLUSIONS: The widespread non-compliance with the current law indicates the need to implement a smoking ban without exceptions on hospitality terraces.

Secondhand tobacco exposure assessed using urinary cotinine among 10-year-old children in Japan: An 11-year repeated cross-sectional study.

INTRODUCTION: The emergence of heated tobacco products (HTPs) has made it important to monitor HTP-generated aerosols in addition to combustible cigarette (CC) smoke as a source of secondhand tobacco (SHT) exposure. We investigated the trend of SHT exposure in school-aged children and assessed whether SHT exposure depended on household tobacco use status. METHODS: This repeated cross-sectional study from 2011 to 2021 (15,927 participants) was based on data from an annual survey of fourth-grade students (aged 10 years) in Kumagaya City, Japan. In addition to a questionnaire which includes questions about household tobacco use status, we measured urinary cotinine levels of each participant by their first morning urine sample to objectively assess SHT exposure. We defined the participants with urinary cotinine levels ≥5.0 ng/ml as being exposed to SHT. RESULTS: The prevalence of SHT exposure decreased over the 11-year period from 18.6% in 2011 to 5.3% in 2021. It was significantly higher in households with tobacco users than without tobacco users (t-test P<0.001). Prevalence of SHT exposure was 1.4% among the 68.1% of households not using tobacco, 22.9% among the 16.5% using only CC, 3.1% among the 12.3% using only HTP and 27.6% among the 3.9% of households using CC and HTP. CONCLUSIONS: While the prevalence of SHT exposure showed a decreasing trend from 2011 to 2021, the prevalence of SHT exposure was higher in children with household members using tobacco products, regardless of the type of tobacco product, than in those without tobacco users. IMPLICATIONS: This study observed that the prevalence of SHT exposure was higher among children in households with tobacco users than among those without tobacco users, regardless of the type of tobacco product. Our findings highlight the importance of advocating that HTPs do not reduce the likelihood of SHT exposure to bystanders.

Tobacco in hotels: A study of smoke exposure and resident risk.

Objectives: Extended-stay hotels (ESH) are a reliable and accessible housing option for low-income, minoritized renters, who are disproportionately exposed to secondhand and thirdhand cigarette smoke (SHS and THS). This study explores ESH residents' perceptions of their SHS and THS exposure, harms related to this exposure, their willingness to mitigate these harms, and the contextual factors associated with smoking in hotels. Methods: Eighty ESH renters from the metropolitan Atlanta region were recruited to complete a survey about the perceived harm and persistence of tobacco smoke, exposure experiences, knowledge, attitudes, self-efficacy, and intentions to protect oneself. Eleven of these participants completed semi-structured interviews, during which they discussed their daily SHS and THS exposure at their ESHs in greater detail. Results: Of the survey respondents, 62% reported being bothered by their level of smoke exposure, and 77% said they believed smoke particulates remained in their rooms even after housekeeping cleaned them. Approximately half of survey respondents had attempted to stop smoking in the 3 months prior to the study, and 29 of these individuals were still on their smoking cessation journeys. Most interview participants agreed that SHS and THS exposure exacerbated their existing chronic illnesses and could possibly result in death in the long term. Participants agreed with the benefits of smoke-free policies, but also acknowledged other priorities for ESH living-affordability, safety, and proximity to the workplace-that overshadowed their desires for such policies. Conclusion: Overall, study findings suggest that ESH renters understand the dangers of smoking and SHS/THS and want to decrease their exposure, but the persistence of cultural and contextual factors prevents them from fully engaging with 100% smoke-free policies.

Changes in Prevalence of Childhood Exposure to Secondhand Smoke in India: A Secondary Analysis of GATS Survey (2009-2017).

BACKGROUND: Children are susceptible to early life inequalities stemming from their limited control over their environment and their physical incapability to handle the health and developmental consequences of smoke exposure. Additionally, their lack of awareness regarding the detrimental effects of secondhand smoke (SHS) exposure on their well-being emphasizes the crucial need to comprehend the extent of SHS exposure among the younger population. OBJECTIVE: The study aims to analyze the magnitude and factors influencing SHS exposure among children under 15 years, along with the shifts in SHS exposure in India and its states between 2009-10 and 2016-17. METHODS: The study utilized two rounds of the nationally representative cross-sectional Global Adult Tobacco Survey (GATS) conducted in 2009-10 and 2016-17, respectively. The study included a total of 47,494 households with 108,814 children under 15 years of age for GATS1 and 46,874 households with 1,000,167 children under 15 years of age for GATS2. Bivariate analysis and Multivariable logistic regression was employed. RESULTS: Forty-five percent of children experienced SHS exposure at home. Although most states saw a reduction in exposure rates, Jammu and Kashmir, Punjab, and Tamil Nadu  exhibited increases between 2009-10 and 2016-17. Multivariate analysis revealed that children from the North-Eastern (OR = 6.51, CI = (5.93-7.15)) and North (OR = 7.51, CI = 6.88-8.19)) regions, rural areas (OR = 1.45, CI = (1.37-1.52)), Scheduled Tribes (OR = 1.76, CI = (1.63-1.90)),  and those with household adults lacking knowledge of SHS's harmful health effects on children (OR = 1.15, CI = (1.04-1.27)) were more likely to be exposed to SHS at home. CONCLUSION: India has made strides in reducing child SHS exposure, yet challenges persist in rural and impoverished homes. Comprehensive tobacco control measures can break the cycle of poverty driven by smoking-related expenses, fostering a tobacco-free generation.

The association between cognitive decline and exposure to secondhand smoke at work in economically active older adults.

OBJECTIVES: Secondhand smoking may contribute to cognitive decline, but evidence on this subject is limited in the working economically active older adults. This study aimed to investigate the association between cognitive decline and exposure to secondhand smoke at work in economically active adults aged 65 years or above. STUDY DESIGN: Cross-sectional study using nationwide data. METHODS: Data were from the 2022 Korea Community Health Survey. Chi-squared test was used to perform descriptive statistics. The association between cognitive decline and exposure to secondhand smoke at work was analysed using multivariable logistic regression analysis. Subgroup analysis was performed based on to exposure status to secondhand smoke at home and diabetes mellitus. RESULTS: Of a total of 28,197 adults, 8767 (28.5%) individuals reported cognitive decline. Compared to individuals without exposure to passive smoking at work, those with such exposure were more likely to report cognitive decline (odds ratio: 1.30, 95% confidence interval: 1.14-1.47). This association was particularly strong in individuals with exposure to passive smoking at both work and home and in those diagnosed with diabetes mellitus. CONCLUSIONS: Exposure to secondhand smoking at work is associated with a higher likelihood of cognitive decline in older-aged economically active individuals. The findings infer the importance of monitoring passive smoking and implementing public health measures to reduce workplace secondhand smoke exposure.