Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 76
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-34501529

RESUMO

OBJECTIVE: Smoking status does not indicate the amount or length of tobacco use, and thus, it is an imperfect measure to assess the association between cigarette smoking and severe coronavirus disease 2019 (COVID-19) outcomes. This investigation assessed whether cigarette smoking status, intensity of smoking (i.e., average daily packs of cigarettes smoked), duration of smoking, and pack-years of smoking are associated with severe outcomes among adults diagnosed with COVID-19. METHODS: We conducted a retrospective, cross-sectional study in which we identified consecutive patients diagnosed with COVID-19 at the University of Cincinnati healthcare system between 13 March 2020 and 30 September 2020 who had complete information on smoking status, severe COVID-19 outcomes, and covariates (i.e., demographics and comorbidities). We used logistic regression to evaluate the associations of smoking status and intensity of smoking with COVID-19 severity, defined as hospitalization, admission to intensive care unit (ICU), or death, adjusting for sociodemographics and comorbidities. RESULTS: Among the 4611 COVID-19 patients included in the analysis, 18.2% were current smokers and 20.7% were former smokers. The prevalence of COVID-19 outcomes was 28.9% for hospitalization, 9.8% for ICU admission, and 1.4% for death. In the adjusted analysis, current smoking (AOR: 1.23, 95% CI: 1.02-1.49), former smoking (AOR: 1.28, 95% CI: 1.07-1.54), and pack-years of smoking (AOR: 1.09, 95% CI: 1.02-1.17) were associated with a higher prevalence of hospitalization. Average daily packs of cigarettes smoked was associated with a higher prevalence of hospitalization (AOR: 1.30, 95% CI: 1.10-1.53) and ICU admission (AOR: 1.23, 95% CI: 1.04-1.44). CONCLUSIONS: Smoking status, pack-years, and intensity of smoking were associated with hospitalizations in patients with COVID-19 and intensity of smoking was associated with ICU admission. The findings underscore the need for detailed information beyond smoking status when evaluating smokers with COVID-19 so that the potential for adverse sequelae may be optimally managed in at-risk patients.


Assuntos
COVID-19 , Adulto , Estudos Transversais , Hospitalização , Humanos , Estudos Retrospectivos , SARS-CoV-2 , Fumar/epidemiologia
2.
Sleep Med ; 86: 99-105, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34479053

RESUMO

OBJECTIVE/BACKGROUND: Inadequate sleep and tobacco smoke exposure (TSE) have been separately linked to adverse childhood health consequences. Our objective was to assess the association between home TSE status and inadequate sleep among U.S. school-aged children. METHODS: We analyzed 2018-2019 National Survey of Children's Health data, and included 17,851 children ages 6-11 years. Children were classified into three parent-report TSE groups: (1) did not live with a smoker (no TSE at home); (2) lived with a smoker who did not smoke inside the home (thirdhand smoke (THS) exposure only); and (3) lived with a smoker who smoked inside the home (secondhand smoke (SHS) and THS exposure). Parent-report of inadequate sleep on most weeknights was defined as <9 h, following age-specific national guidelines. We fitted a weighted multivariable logistic model to assess the association between TSE groups and inadequate sleep, adjusting for child covariates (sociodemographics, overweight status, health status, physical activity, and screen time). RESULTS: About 13% and 1% of school-aged children were exposed to home THS only and home SHS and THS, respectively; approximately 36% overall had inadequate sleep. Compared to children with no TSE at home, children who were exposed to home THS only had higher odds of inadequate sleep (AOR = 1.44, 95%CI = 1.20-1.73); those exposed to home SHS and THS had higher odds of inadequate sleep (AOR = 1.83, 95%CI = 1.20-2.78). CONCLUSIONS: TSE is associated with school-aged children having inadequate sleep, even when smokers did not smoke inside the home. Promoting parental smoking cessation is essential to fully protect children from related risks.

3.
Environ Res ; 202: 111722, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34297932

RESUMO

BACKGROUND: Children's overall tobacco smoke exposure (TSE) consists of both inhalation of secondhand smoke (SHS) and ingestion, dermal uptake, and inhalation of thirdhand smoke (THS) residue from dust and surfaces in their environments. OBJECTIVES: Our objective was to compare the different roles of urinary cotinine as a biomarker of recent overall TSE and hand nicotine as a marker of children's contact with nicotine pollution in their environments. We explored the differential associations of these markers with sociodemographics, parental smoking, child TSE, and clinical diagnoses. METHODS: Data were collected from 276 pediatric emergency department patients (Median age = 4.0 years) who lived with a cigarette smoker. Children's hand nicotine and urinary cotinine levels were determined using LC-MS/MS. Parents reported tobacco use and child TSE. Medical records were reviewed to assess discharge diagnoses. RESULTS: All children had detectable hand nicotine (GeoM = 89.7ng/wipe; 95 % CI = [78.9; 102.0]) and detectable urinary cotinine (GeoM = 10.4 ng/ml; 95%CI = [8.5; 12.6]). Although hand nicotine and urinary cotinine were highly correlated (r = 0.62, p < 0.001), urinary cotinine geometric means differed between racial groups and were higher for children with lower family income (p < 0.05), unlike hand nicotine. Independent of urinary cotinine, age, race, and ethnicity, children with higher hand nicotine levels were at increased risk to have discharge diagnoses of viral/other infectious illness (aOR = 7.49; 95%CI = [2.06; 27.24], p = 0.002), pulmonary illness (aOR = 6.56; 95%CI = [1.76; 24.43], p = 0.005), and bacterial infection (aOR = 5.45; 95%CI = [1.50; 19.85], p = 0.03). In contrast, urinary cotinine levels showed no associations with diagnosis independent of child hand nicotine levels and demographics. DISCUSSION: The distinct associations of hand nicotine and urinary cotinine suggest the two markers reflect different exposure profiles that contribute differentially to pediatric illness. Because THS in a child's environment directly contributes to hand nicotine, additional studies of children of smokers and nonsmokers are warranted to determine the role of hand nicotine as a marker of THS exposure and its potential role in the development of tobacco-related pediatric illnesses.

4.
Nicotine Tob Res ; 2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34297130

RESUMO

INTRODUCTION: To offset tobacco use among college students, many universities have implemented tobacco-free campus policies. Given how easily e-cigarette users can discreetly vape in places where it is prohibited without being detected (i.e., stealth vape), it is important to assess whether students are subverting these policies. This study examined the prevalence of stealth vaping on-campus among students at multiple universities, including frequency and methods for stealth vaping. METHODS: A convenience sample of college students was obtained from four geographically distinct, large, public universities with established policies prohibiting all forms of tobacco use on campus. Participants (N=863 current e-cigarette users) reported on demographics and e-cigarette use. Those who previously stealth vaped on-campus (n=422) completed additional questions, including common locations, techniques, and devices/e-liquids used for stealth vaping. RESULTS: Nearly half (48.9%) of past 30-day e-cigarette users reported previously stealth vaping on-campus. Among stealth vapers, 48.1% owned a smaller device for stealth vaping and 38.9% used e-liquids with low visibility vapors. Common on-campus stealth vaping locations included bathrooms, libraries, parking garages, and classrooms. Techniques used for stealth vaping included deep inhale, blowing a hit into one's clothes, and swallowing a hit. CONCLUSIONS: A large percentage of respondents commonly violated campus tobacco-free policies by stealth vaping. For such policies to be effective at reducing on-campus e-cigarette use, there is a need for enhanced monitoring and enforcement. More research is needed to better understand factors influencing stealth vaping behaviors and public health implications. IMPLICATIONS: This sample of college student e-cigarette users commonly violated campus smoke- and tobacco-free policies by stealth vaping on campus. Respondents used a range of methods (e.g., smaller device, low visibility e-liquids) and locations (e.g., bathrooms, libraries, parking garages) for stealth vaping. If campus policies are to be effective at reducing on-campus e-cigarette use, there is a need for enhanced monitoring and enforcement. E-cigarette devices specifically designed and marketed to facilitate stealth vaping (e.g., resembling USB flash drives, pens, etc.) may require regulatory action. More research is needed to better understand factors influencing stealth vaping behaviors and public health implications.

5.
J Sch Health ; 91(6): 482-489, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33786816

RESUMO

BACKGROUND: We assessed whether self-descriptions, self-perceptions, perceived substance use of friends, and actual substance use were associated with high school girls' frequency of making social comparisons to peers. METHODS: We analyzed data from the Adolescent Health Risk Behavior Survey data for 357 high school girls using multinomial logistic regression. RESULTS: Compared to those who "never/rarely" made social comparisons, participants who self-described as fearing something constantly (p = .014) and forced to imitate the people they like (p = .009) were more likely to "usually" compare themselves to peers. Participants who described themselves as feeling forced to imitate the people they like (p = .022), were not the person they would like to be (p = .005), and did not remain calm under pressure (p = .010), were more likely to "often/always" make social comparisons. Participants who perceived themselves as unattractive (p = .034) and self-centered (p = .016) were more likely to "often/always" make social comparisons. Participants who perceived a larger proportion of friends use illicit drugs were less likely to "usually" make social comparisons (p = .027). Participants who perceived a larger proportion of friends drink alcohol were more likely to "often/always" make social comparisons (p = .018). CONCLUSIONS: Girls who perceive and describe themselves more negatively are at increased odds of making social comparisons to peers.

6.
Am J Health Promot ; 35(7): 966-972, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33641482

RESUMO

PURPOSE: The '5-2-1-0' guidelines recommend that children: eat ≥5 servings of fruits/vegetables ('5'), have ≤2 hours of screen-time ('2'), have ≥1 hour of activity ('1'), and drink 0 sugar-sweetened beverages ('0') daily. The pediatric emergency department (PED) treats children at risk for obesity and tobacco smoke exposure (TSE). We examined body mass index (BMI), overweight, obesity, TSE, and '5-2-1-0' rates in children with TSE in the PED. DESIGN: Cross-sectional study of PED children. SETTING: The PED of a children's hospital. SAMPLE: Children with TSE >6 months-5 years old (N = 401). MEASURES: Sociodemographics, '5-2-1-0' behaviors, BMI, and cotinine-confirmed TSE. ANALYSIS: Associations between '5-2-1-0' and sociodemographics were examined with logistic regression. RESULTS: Mean (SD) age = 2.4 (1.6) years; 53.1% were Black; 65.8% had low-income; and 93.4% had TSE. Of 2-5-year-olds, mean (SD) BMI percentile was 66.2 (30.1), 16.1% were overweight and 20.6% were obese. In total, 10.5% attained '5', 72.6% attained '2', 57.8% of 2-5-year-olds attained '1', and 9.8% attained '0'. Compared to White children, "other" race children were more likely to meet '5' (aOR(95% CI):4.67(1.41, 5.45)); 2-5-years-olds (aOR(95%CI):0.60(0.38, 0.95)) and Black children (aOR(95%CI):0.36(0.21, 0.60)) were at decreased odds to meet '2' compared to younger or White children, respectively. Compared to younger children, 2-5-year-olds were at decreased odds to meet '0' (aOR(95%CI):0.08(0.02, 0.26)). CONCLUSION: Racially diverse, low-income children with TSE had low '5-2-1-0' attainment. Interventions are needed to improve lifestyle habits in this population.


Assuntos
Poluição por Fumaça de Tabaco , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos Transversais , Humanos , Obesidade , Sobrepeso/epidemiologia , Tabaco , Poluição por Fumaça de Tabaco/efeitos adversos
7.
Prev Med ; 147: 106505, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33667467

RESUMO

The study aimed to investigate the relationships between current exclusive e-cigarette use, exclusive combustible cigarette smoking, and dual use of e-cigarettes and combustible cigarettes, and insufficient sleep among U.S. adolescents. We conducted a secondary data analysis of the 2017 Youth Risk Behavior Survey including 11,296 U.S. high school students. Current (past 30-day) tobacco use groups included exclusive e-cigarette users, exclusive combustible cigarette smokers, and dual-product users. We performed weighted unadjusted and adjusted logistic regression analyses. Insufficient sleep was defined as <8 h/night and < 7 h/night. Overall, 73.4% of adolescents reported insufficient sleep <8 h/night. Compared with non-tobacco users, exclusive e-cigarette users were more likely to report insufficient sleep <8 h/night (odds ratio [OR] = 1.55, 95%CI = 1.12-2.14; adjusted OR [aOR] = 1.57, 95%CI = 1.01-2.43) and < 7 h/night (OR = 1.55, 95%CI = 1.19-2.01; aOR = 1.61, 95%CI = 1.16-2.24). Dual-product users were at increased odds to report insufficient sleep <8 h/night (OR = 3.15, 95%CI = 1.87-5.32) and < 7 h/night (OR = 2.64, 95%CI = 1.87-3.72; aOR = 1.73, 95%CI = 1.14-2.62) than non-tobacco users. Exclusive combustible cigarette smokers were less likely to report insufficient sleep <8 h/night (aOR = 0.49, 95%CI = 0.29-0.84) than non-tobacco users, but no differences were found based on insufficient sleep <7 h/night. When comparing current use groups, exclusive e-cigarette users were at 3.20 increased odds (95%CI = 1.65-6.22) and dual-product users were at 3.26 increased odds (95%CI = 1.51-7.03) to report insufficient sleep <8 h/night when compared with exclusive combustible cigarette smokers after covariate adjustment. Dual-product users were 1.89 times more likely (95%CI = 1.01-3.51) to report insufficient sleep <7 h/night when compared with exclusive combustible cigarette smokers. School-based prevention efforts for tobacco use may promote sufficient sleep in youth.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Vaping , Adolescente , Humanos , Instituições Acadêmicas , Privação do Sono , Fumar , Estudantes
8.
PLoS One ; 16(2): e0247179, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33621228

RESUMO

BACKGROUND: Tobacco smoke exposure (TSE) places an economic toll on the U.S. healthcare system. There is a gap in the literature on pediatric emergency department (ED) and urgent care related healthcare costs and utilization specific to tobacco smoke-exposed patients. The objectives were to assess pediatric ED visits, urgent care visits and hospital admissions longitudinally, and baseline visit costs among tobacco smoke-exposed children (TSE group) relative to unexposed children (non-TSE group). METHODS AND FINDINGS: We conducted a retrospective study using electronic medical records of 380 children ages 0-17 years in the TSE group compared to 1,140 in the non-TSE group propensity score matched via nearest neighbor search by child age, sex, race, and ethnicity. Linear and Poisson regression models were used. Overall, children had a mean of 0.19 (SE = 0.01) repeat visits within 30-days, and 0.69 (SE = 0.04) pediatric ED visits and 0.87 (SE = 0.03) urgent care visits over 12-months following their baseline visit. The percent of children with ≥ 1 urgent care visit was higher among the TSE group (52.4%) than the non-TSE group (45.1%, p = 0.01). Children in the TSE group (M = $1,136.97, SE = 76.44) had higher baseline pediatric ED visit costs than the non-TSE group (M = $1,018.96, SE = 125.51, p = 0.01). Overall, children had 0.08 (SE = 0.01) hospital admissions over 12-months, and the TSE group (M = 0.12, SE = 0.02) had higher mean admissions than the non-TSE group (M = 0.06, SE = 0.01, p = 0.02). The child TSE group was at 1.85 times increased risk of having hospital admissions (95% CI = 1.23, 2.79, p = 0.003) than the non-TSE group. CONCLUSIONS: Tobacco smoke-exposed children had higher urgent care utilization and hospital admissions over 12-months, and higher pediatric ED costs at baseline. Pediatric ED visits, urgent care visits, and hospitalizations may be opportune times for initiating tobacco control interventions, which may result in reductions of preventable acute care visits.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Poluição por Fumaça de Tabaco/efeitos adversos , Adolescente , Fatores Etários , Criança , Pré-Escolar , Grupos Étnicos/estatística & dados numéricos , Feminino , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Lactente , Masculino , Fatores Sexuais , Poluição por Fumaça de Tabaco/estatística & dados numéricos
10.
Tob Control ; 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33632806

RESUMO

BACKGROUND: We examined whether the implementation of electronic cigarette (e-cigarette) policies at the state level (e-cigarette-inclusive smoke-free (ESF) policies, excise taxes on e-cigarettes and raising tobacco legal purchasing age to 21 years (T21)) affected recent upward trends in youth e-cigarette use. METHODS: Data were from participants from 34 US states who completed the Youth Risk Behavior Survey (YRBS) state surveys in 2017 and 2019 (n=278 271). States were classified as having or not having ESF policies, any e-cigarette excise tax and T21 policies by 1 January 2019. Participants reported ever, past 30-day and frequent (≥20 days) e-cigarette use; past 30-day combustible cigarette smoking; and age, sex and race/ethnicity. Weighted multivariable logistic regression models assessed whether changes in e-cigarette use over time differed by policy status, adjusting for participants' demographics and combustible cigarette smoking. RESULTS: Prevalence of ever and past 30-day youth e-cigarette use in states with ESF policies decreased during 2017-2019, while the prevalence of these measures in states without ESF policies increased. States with T21 policies showed non-significant changes in prevalence of ever and past 30-day youth e-cigarette use, whereas states without T21 policies showed significant increases in ever and past 30-day youth e-cigarette use. States with ESF and T21 policies showed slower increases in youth frequent e-cigarette use. E-cigarette excise taxes were not associated with decreasing prevalence of youth e-cigarette use. CONCLUSIONS: State-level ESF and T21 policies could be effective for limiting growth of youth e-cigarette use despite an overall national increase. Higher e-cigarette excise tax rates may be needed to effectively reduce youth e-cigarette use.

11.
Prev Med ; 145: 106429, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33476680

RESUMO

The use of electronic cigarettes (e-cigarettes) and marijuana remain prevalent problems among adolescents nationwide. We assessed current (past 30-day) exclusive e-cigarette use, exclusive marijuana use, and concurrent use with unintentional injury and violent behaviors, alcohol and other drug use behaviors, and sexual behaviors among U.S. high school students. We analyzed 2017 Youth Risk Behavior Survey data including 12,578 high school students nationwide. Multivariable logistic regression models were performed to compare these health-risk behaviors among exclusive e-cigarette users, exclusive marijuana users, and concurrent users with non-users among the overall sample, and then to compare exclusive e-cigarette users and exclusive marijuana users with concurrent users among current users only. All models adjusted for adolescent sex, grade, and race/ethnicity, and other tobacco product use. Approximately 77% of students were non-users, 5.2% were exclusive e-cigarette users, 9.9% were exclusive marijuana users, and 7.8% were concurrent users. Compared to non-users, exclusive e-cigarette users and exclusive marijuana users were more likely to engage in most negative health-risk behaviors associated with unintentional injuries and violence, alcohol and other drug use, and sexual behaviors. Among current users only, exclusive e-cigarette users and exclusive marijuana users were at reduced odds of engaging in most of these health-risk behaviors when compared to concurrent users of both substances. The relationship between exclusive and concurrent e-cigarette and marijuana use and health-risk behaviors highlights the importance of comprehensive educational efforts during high school. Findings suggest need for more studies on influence of e-cigarette and marijuana use on injury and violence risk among youth.


Assuntos
Comportamento do Adolescente , Sistemas Eletrônicos de Liberação de Nicotina , Uso da Maconha , Produtos do Tabaco , Adolescente , Humanos , Uso da Maconha/epidemiologia , Assunção de Riscos , Instituições Acadêmicas , Estudantes
12.
Am J Prev Med ; 60(2): 267-275, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33131989

RESUMO

INTRODUCTION: This study assesses the associations of child salivary cotinine, parent-reported smoking, and child tobacco smoke exposure with the number of child healthcare visits and hospital admissions over a 6-month period. This study also assesses the relationships between participant characteristics and child cotinine. METHODS: Longitudinal data were evaluated from a sample of 313 clinically ill children aged 0-9 years who lived with a smoker and presented to a pediatric emergency department or urgent care in 2016-2018. In 2020, cotinine measurements were log transformed, and Poisson and linear regression were performed. RESULTS: The majority of the children came from low-income homes (66.1%) and had public insurance/self-pay (95.5%). Child cotinine concentrations ranged from 0.1 to 332.0 ng/mL (geometric mean=4.8 ng/mL, 95% CI=4.1, 5.5). Poisson regression results indicated that each 1-unit increase of log-cotinine concentration was associated with an increase in pediatric emergency department visits over a 6-month period after the baseline visit, with an adjusted RR of 1.16 (95% CI=1.01, 1.34). Each 1-unit increase of log-cotinine concentration was associated with an increase in the frequency of hospital admissions over the 6-month period, with an adjusted RR of 1.50 (95% CI=1.08, 2.09). No differences were found between parent-reported smoking or child tobacco smoke exposure and healthcare utilization. Linear regression results indicated that children who were younger (ß= -0.227, p=0.049), were White (geometric mean=5.5 ng/mL), had a medical history of prematurity (geometric mean=8.1 ng/mL), and had a winter baseline visit (geometric mean=6.5 ng/mL) had higher cotinine concentrations. Children living in apartments (geometric mean=5.5 ng/mL) and multiunit homes (geometric mean=5.5 ng/mL) had higher cotinine concentrations than those in single-family homes (geometric mean=3.6 ng/mL). CONCLUSIONS: Routine biochemical screening could identify children who are in need of intensive tobacco smoke exposure reduction interventions.


Assuntos
Cotinina , Poluição por Fumaça de Tabaco , Criança , Cotinina/análise , Disparidades em Assistência à Saúde , Humanos , Pobreza , Fumar , Poluição por Fumaça de Tabaco/análise
13.
J Pediatr Health Care ; 35(1): 32-41, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32861591

RESUMO

INTRODUCTION: This study investigated the prevalence and correlates of current mental health and neurodevelopmental conditions among U.S. school-age children with tobacco smoke exposure (TSE). METHOD: Data from the 2016-17 National Survey of Children's Health were analyzed. Multivariable logistic regression analyses among 6-11-year-olds (n = 21,539) and among subsamples aged 6-8 years (n = 10,100) and 9-11 years (n = 11,439) were conducted. RESULTS: Among 6-11-year-olds who lived with a smoker with no home TSE, the top mental health/neurodevelopmental conditions were other mental health conditions (22.1%), behavioral/conduct problems (21.7%), attention deficit disorder or attention deficit hyperactivity disorder (20.5%), depression (21.7%), and learning disability (19.3%). Children who lived with a smoker, with or without home TSE, were at increased odds of having anxiety problems, depression, attention deficit disorder or attention deficit hyperactivity disorder, behavioral/conduct problems, other mental health conditions, or learning disabilities. Many associations were more notable in younger children with home TSE. DISCUSSION: TSE is associated with mental health and neurodevelopmental conditions. Interventions to decrease TSE are needed to protect children.

14.
J Pediatr Psychol ; 46(4): 454-464, 2021 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-33355348

RESUMO

OBJECTIVES: This study examined the association between tobacco smoke exposure (TSE) and temperament among children 0-5 years old overall and within age groups: 0-2 and 3-5 years. METHODS: Data were obtained from the 2017-2018 NSCH (N = 14,345). TSE status was defined as whether children lived with a smoker who: does not smoke inside the home (no home TSE) or smokes inside the home (home TSE). We conducted logistic regression analyses while controlling for covariates. RESULTS: Overall, 12.5% of children lived with a smoker with no home TSE and 1.1% had home TSE. Children with home TSE were at increased odds to not always: be affectionate and tender (aOR = 1.74, 95% CI = 1.18-2.58), show interest and curiosity (aOR = 1.81, 95% CI = 1.23-2.68), and smile and laugh (aOR = 1.77, 95% CI = 1.13-2.77) than those with no TSE. Among 0- to 2-year-olds, those with home TSE were more likely to not always be affectionate and tender (aOR = 1.97, 95% CI = 1.04-3.74). Among 3- to 5-year-olds, those who lived with a smoker with no home TSE were more likely to not always: bounce back quickly (aOR = 1.21, 95% CI = 1.05-1.40) and smile and laugh (aOR = 1.26, 95% CI = 1.03-1.54), and those with home TSE were more likely to not always: show interest and curiosity (aOR = 2.24, 95% CI = 1.40-3.59) and smile and laugh (aOR = 2.43, 95% CI = 1.43-4.11). CONCLUSIONS: Tobacco smoke-exposed children were at increased odds of not always demonstrating positive early childhood temperament behaviors, with 3- to 5-year-olds having more pronounced odds.


Assuntos
Poluição por Fumaça de Tabaco , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Fumar , Temperamento , Tabaco
15.
Artigo em Inglês | MEDLINE | ID: mdl-33158230

RESUMO

We examined the efficacy of a pediatric emergency visit-based screening, brief intervention, and referral to treatment (SBIRT) condition compared to a control condition (Healthy Habits Control, HHC) to help parental smokers quit smoking. We enrolled 750 parental smokers who presented to the pediatric emergency setting with their child into a two-group randomized controlled clinical trial. SBIRT participants received brief cessation coaching, quitting resources, and up to 12-weeks of nicotine replacement therapy (NRT). HHC participants received healthy lifestyle coaching and resources. The primary outcome was point-prevalence tobacco abstinence at six weeks (T1) and six months (T2). The mean (SD) age of parents was 31.8 (7.7) years, and 86.8% were female, 52.7% were Black, and 64.6% had an income of ≤$15,000. Overall abstinence rates were not statistically significant with 4.2% in both groups at T1 and 12.9% and 8.3% in the SBIRT and HHC groups, respectively, at T2. There were statistically significant differences in SBIRT versus HHC participants on the median (IQR) reduction of daily cigarettes smoked at T1 from baseline (-2 [-5, 0] versus 0 [-4, 0], p = 0.0008),at T2 from baseline (-4 [-9, -1] vs. -2 [-5, 0], p = 0.0006), and on the mean (SD) number of quit attempts at T2 from baseline (1.25 (6.5) vs. 0.02 (4.71), p = 0.02). Self-reported quitting rates were higher in SBIRT parents who received NRT (83.3% vs. 50.9%, p = 0.04). The novel use of the pediatric emergency visit to conduct cessation interventions helped parents quit smoking. The near equivalent abstinence rates in both the SBIRT and HHC groups may be due to underlying parental concern about their child's health. Cessation interventions in this setting may result in adult and pediatric public health benefits.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Abandono do Hábito de Fumar , Adulto , Criança , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Nicotina , Dispositivos para o Abandono do Uso de Tabaco
16.
Tob Prev Cessat ; 6: 63, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33241163

RESUMO

INTRODUCTION: Pediatric emergency department (PED) visits are opportune times in which to provide smoking cessation interventions for parents who smoke. This study reports on the costs of providing parental smokers who bring their children to the emergency setting, with a screening, brief intervention, and assisted referral to treatment (SBIRT) intervention, which includes counseling about tobacco cessation and nicotine replacement therapy. METHODS: Cost data were collected during a randomized controlled trial with 750 parental smokers whose child was presented to a PED or pediatric Urgent Care unit with a potential tobacco smoke exposure-related illness. Interventionist training, screening, and SBIRT costs are reported from the organizational perspective (i.e. that of the providing hospital). A spreadsheet tool was created to allow for organizations to estimate their own costs based on their settings, for each aspect of the intervention. RESULTS: The mean costs per parent included interventionist training, screening and enrollment, SBIRT delivery, distribution of take-home materials and nicotine replacement therapy, booster text messages, and follow-up phone contact. The total cost per parent was approximately $97. Varying the underlying cost assumptions led to total costs ranging from $85 to $124 per treated parent. CONCLUSIONS: The emergency setting is an important locus of tobacco control that could have a large public health benefit to parents and children. The costs reported in this report and the accompanying spreadsheet tool will permit emergency settings to estimate the costs and assist with planning, staffing and resource allocation necessary to implement an SBIRT smoking cessation intervention in research-based and clinically-based cessation interventions into adult or pediatric emergency visits.

17.
J Ethn Subst Abuse ; : 1-11, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33000993

RESUMO

Marijuana use among adolescents is a major public health problem. The purpose of this study was to examine whether past-year marijuana use among African American adolescent males differed based on age and school factors. Data from the 2015-2018 National Survey on Drug Use and Health (NSDUH) were analyzed. A national sample of African American students in grades 7 through 12 (n = 5,738) completed the survey. Results indicated that 14.7% reported using marijuana in the past year. Those at highest risk for past-year marijuana use were those who were male, were 16 to 17 years old, were in 9th through 12th grade, did not like going to school, and thought that most/all students in their grade used marijuana. Prevention professionals should consider the links among school attitudes, perceived social norms, and marijuana use when developing programs and interventions. Efforts are needed that are culturally competent and culturally sensitive to help reduce marijuana use rates among African American male adolescents. Future research is needed to further examine school perceptions and marijuana use among this population.

18.
J Asthma ; : 1-11, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32867555

RESUMO

OBJECTIVES: The objectives were to examine the relationships between current asthma and anxiety and family resilience and overall health status in US adolescents. METHODS: Data were from parents of adolescents (12-17 years) who completed the 2017-2018 National Survey of Children's Health (NSCH). Examined variables included: current asthma and anxiety diagnoses, family resilience, child health status, number of adverse childhood experiences (ACEs), family poverty, parent education, and child demographic factors. Multinomial logistic regression models were performed. RESULTS: Findings indicated that compared to adolescents with high resilience scores, adolescents with anxiety only and comorbid asthma and anxiety were more likely to have moderate or low family resilience scores than adolescents with no asthma or anxiety. Compared with adolescents with an excellent/very good health status, youth with asthma only, anxiety only, and asthma and anxiety had higher odds of having good or fair/poor health status than adolescents with no asthma or anxiety. Among those with current diagnoses, adolescents with asthma only were less likely to have moderate and low resilience scores than adolescents with asthma and anxiety. Adolescents with asthma only and anxiety only were also at reduced odds to have good or fair/poor health status than those with comorbid diagnoses. CONCLUSIONS: Results indicated that anxiety is linked to family resilience of adolescents with and without comorbid asthma. Experiencing a higher number of ACEs was a risk factor for lower family resilience scores and health status. Future research should consider the impact of other mental health problems and family resilience and health status.

19.
Tob Prev Cessat ; 6: 30, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760865

RESUMO

INTRODUCTION: Although the administration of free Nicotine Replacement Therapy (NRT) is effective in helping smokers quit, the feasibility, acceptability and safety of this practice have not been examined in the emergency setting of the pediatric emergency department (PED) or urgent care (UC). We examined the characteristics of parental smokers who were interested and eligible for free NRT during their child's emergency visit and the uptake, usage, and associated side effects of NRT use. METHODS: We analyzed data from 377 parental smokers who were randomized to receive cessation counseling and free NRT as part of an emergency visit-based randomized controlled trial. Parents interested in NRT were screened for medical contraindications; eligible parents were given a 6-week supply of NRT patches or lozenges during their child's emergency visit and offered another supply 6 weeks later. We conducted Wilcoxon rank-sum tests and chi-squared tests to address our main study objective. RESULTS: The majority of parents were female (87.5%), non-Hispanic Black (52.5%), and mean (SD) age was 33.1 (8.2) years. A total of 252 (66.8%) parents were interested in receiving NRT. Compared to uninterested parents, interested parents were more likely to: be older [33.6 (8.2) vs 31.9 (8.2), years]; be non-Hispanic Black (54.0% vs 49.6%); have older children [5.5 (5.0) vs 4.2 (4.6)]; have a higher readiness to quit [7.0 (2.4) vs 5.2 (2.6)]; and have a child being evaluated in UC compared to the PED (72.4% vs 56.5%). A total of 53 (21%) interested parents had >1 NRT contraindications. At 6 weeks, 94 (79.0%) parents reported some ≥NRT usage and 50 (53.2%) requested an additional 6-week supply. There were no serious adverse events and 5 (5.3%) reported minor side effects. CONCLUSIONS: Parental smokers in the emergency setting are interested in receiving free NRT, the majority use it, and use is not associated with adverse side effects. The emergency visit may be an optimal time to offer NRT to parental smokers.

20.
Pediatr Res ; 88(4): 522, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32702708
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...