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1.
Rev Environ Health ; 19(3-4): 291-310, 2021 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-34058084

RESUMO

Environmental tobacco smoke (ETS) can be a major constituent of air pollution in indoor environments, including the home. Regulation on smoking in the workplace and public places has made the home the dominant unregulated source of ETS, with important potential impacts on children. Between 40% and 60% of cbildren in the United Kingdom are exposed to ETS in the home. Many experimental and human and studies have investigated the adverse health effects of ETS. Substantial evidence shows that in adults ETS is associated with increased risk of chronic respiratory illness, including lung cancer, nasal cancer, and cardiovascular disease. In children, ETS increases the risk of sudden infant death syndrome, middle ear disease, lower respiratory tract illness, prevalence of wheeze and cough, and exacerbates asthma. Although banning smoking in the home would be the optimal reduction strategy, several barrier and ventilation methods can be effective. Nevertheless, such methods are not always practical or acceptable, particularly when social pressures contribute to a lack of support for ETS control in the home. Smoking cessation interventions have bad limited success. Research is needed to explore the barriers to adopting ETS risk-reducing behaviors.


Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Habitação , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição do Ar em Ambientes Fechados/prevenção & controle , Saúde da Criança , Exposição Ambiental/efeitos adversos , Exposição Ambiental/prevenção & controle , Humanos , Neoplasias/epidemiologia , Doenças Respiratórias/epidemiologia , Poluição por Fumaça de Tabaco/prevenção & controle
2.
Tuberk Toraks ; 69(1): 49-58, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33853305

RESUMO

Introduction: Tobacco-free college campuses refer to colleges and universities that have implemented policies prohibiting the use of tobacco products at all indoor and outdoor campus locations. We aimed to evaluate university students' smoking behaviors and their attitudes towards "Tobacco-Free Campus Policy". Materials and Methods: A total of 10,383 university students were included in this cross-sectional study. The questionnaire was sent via web-based student information system. Demographical variables, the frequency of tobacco use, the addiction levels of the smoker students, and their perspective on the Tobacco-Free Campus Policy were evaluated. Result: The study population consisted of 5461 (52.6%) males and their mean age was 22.1 ± 3.9 years. Among the students, 3992 (38.4%) were current smokers and the age of first smoking was 16.5 ± 2.78 years. According to FTND scores, 15.1% of participants have high dependence, and 7.5% of them have very high dependence. There was a significant difference among participants who finds unacceptable "Tobacco-Free Campus Policy" in terms of gender (70.7% males vs. 29.3% females, p<0.001) and smoking habit (7% never smoker, 4.1% ex-smoker, 88.9% current smoker, p<0.001). Conclusions: The Tobacco-Free Campus Policy is important to fight against the tobacco industry in order to protect the right to health of all tobacco users and those who do not use it and should be considered as a goal to be achieved in order to live in a healthy environment.


Assuntos
Política Antifumo , Fumantes/psicologia , Prevenção do Hábito de Fumar/métodos , Fumar/psicologia , Estudantes/psicologia , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Fumar/epidemiologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades , Adulto Jovem
3.
Lancet Glob Health ; 9(5): e639-e650, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33865472

RESUMO

BACKGROUND: Exposure to second-hand smoke from tobacco is a major contributor to global morbidity and mortality. We aimed to evaluate the efficacy and cost-effectiveness of a community-based smoke-free-home intervention, with or without indoor-air-quality feedback, in reducing second-hand-smoke exposure in homes in Bangladesh. METHODS: We did a three-arm, cluster-randomised, controlled trial in Dhaka, Bangladesh, and randomly assigned (1:1:1) mosques and consenting households from their congregations to a smoke-free-home intervention plus indoor-air-quality feedback, smoke-free-home intervention only, or usual services. Households were eligible if they had at least one resident attending one of the participating mosques, at least one adult resident (age 18 years or older) who smoked cigarettes or other forms of smoked tobacco (eg, bidi, waterpipe) regularly (on at least 25 days per month), and at least one non-smoking resident of any age. The smoke-free-home intervention consisted of weekly health messages delivered within an Islamic discourse by religious leaders at mosques over 12 weeks. Indoor-air-quality feedback comprised providing households with feedback on their indoor air quality measured over 24 h. Households in the usual services group received no intervention. Masking of participants and mosque leaders was not possible. The primary outcome was the 24-h mean household airborne fine particulate matter (<2·5 microns in diameter [PM2·5]) concentration (a marker of second-hand smoke) at 12 months after randomisation. Cost-effectiveness was estimated using incremental cost-effectiveness ratios (ICERs). This trial is registered with ISRCTN, 49975452. FINDINGS: Between April 11 and Aug 2, 2018, we enrolled 1801 households from 45 mosques. 640 households (35·5%) were assigned to the smoke-free-home intervention plus indoor-air-quality feedback group, 560 (31·1%) to the smoke-free-home intervention only group, and 601 (33·4%) to the usual services group. At 12 months, the adjusted mean difference in household mean 24-h PM2·5 concentration was -1·0 µg/m3 (95% CI -12·8 to 10·9, p=0·88) for the smoke-free-home intervention plus indoor-air-quality feedback group versus the usual services group, 5·0 µg/m3 (-7·9 to 18·0, p=0·45) for the smoke-free-home intervention only group versus the usual services group, and -6·0 µg/m3 (-18·3 to 6·3, p=0·34) for the smoke-free-home intervention plus indoor-air-quality feedback group versus the smoke-free-home intervention only group. The ICER for the smoke-free-home intervention plus indoor-air-quality feedback versus usual services was US$653 per quality-adjusted life-year (QALY) gained, which was more than the upper limit of the Bangladesh willingness-to-pay threshold of $427 per QALY. INTERPRETATION: The smoke-free-home intervention, with or without indoor-air-quality feedback, was neither effective nor cost-effective in reducing household second-hand-smoke exposure compared with usual services. These interventions are therefore not recommended for Bangladesh. FUNDING: Medical Research Council UK. TRANSLATION: For the Bengali translation of the abstract see Supplementary Materials section.


Assuntos
Poluição do Ar em Ambientes Fechados/economia , Poluição do Ar em Ambientes Fechados/estatística & dados numéricos , Análise Custo-Benefício/métodos , Análise Custo-Benefício/estatística & dados numéricos , Poluição por Fumaça de Tabaco/economia , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bangladesh , Criança , Análise por Conglomerados , Análise Custo-Benefício/economia , Características da Família , Retroalimentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Material Particulado/análise , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adulto Jovem
5.
Nicotine Tob Res ; 23(4): 724-731, 2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-33165535

RESUMO

INTRODUCTION: Smoking among young adults is often associated with social contexts and alcohol use. Although many countries, including New Zealand, have prohibited smoking inside licensed premises, outdoor areas have enabled smoking and alcohol co-use to persist. We examined whether and how outdoor bar areas facilitate and normalize young adult smoking and explored potential policy implications. METHODS: We conducted in-depth interviews with 22 young adults who had recently smoked in a New Zealand bar or nightclub and investigated how physical design attributes (atmospherics) influenced experiences of smoking in outside bar settings. We used qualitative description to identify recurring accounts of the outdoor bar environment and thematic analysis to explore how participants experienced the bar in relation to smoking. RESULTS: Participants valued outdoor smoking areas that were comfortable and relaxing, and saw attributes such as seating, tables, heating, protection from inclement weather, and minimal crowding, as important. We identified four themes; these explained how participants used smoking to gain respite and make social connections, showed how bar settings enabled them to manage smoking's stigma, and identified potential policy measures that would decouple smoking and alcohol co-use. CONCLUSIONS: Evidence bar environments facilitate and normalize smoking among young adults questions whether smokefree policies should be expanded to include all bar areas. Introducing more comprehensive smokefree outdoor policies could reduce the influence of design attributes that foster smoking while also reframing smoking as outside normal social practice. IMPLICATIONS: Bar environments contain many stimuli that cue and reinforce smoking and integrate smoking into social experiences. Expanding smokefree bar settings to include outdoor areas would reduce exposure to these stimuli, decrease opportunities for casual smoking, help maintain young people's smokefree status, and support longer-term goals of sustained reductions in smoking prevalence.


Assuntos
Restaurantes/legislação & jurisprudência , Política Antifumo/legislação & jurisprudência , Fumantes/psicologia , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/análise , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Adulto , Feminino , Humanos , Masculino , Nova Zelândia/epidemiologia , Pesquisa Qualitativa , Restaurantes/estatística & dados numéricos , Fumar/legislação & jurisprudência , Adulto Jovem
6.
Nicotine Tob Res ; 23(4): 643-653, 2021 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-33098295

RESUMO

INTRODUCTION: Childhood secondhand smoke exposure (SHSe) is linked with increased morbidity and mortality. Hospital or secondary care contact presents a "teachable moment" to support parents to change their home smoking behaviors to reduce children's SHSe. AIMS AND METHODS: This mixed-methods review explores: (1) if existing interventions in this context are effective, (2) if they are reported in sufficient detail to be replicated, (3) the experiences of health care professionals delivering such interventions, and (4) the experiences of parents receiving such interventions. Five electronic databases and the gray literature were searched for relevant literature published and indexed January 1980 to February 2020. Fourteen papers reporting 12 studies (nine quantitative and five qualitative) were included. Aligned with the Joanna Briggs Institute method, a segregated approach was used involving independent syntheses of the quantitative and qualitative data followed by an overall mixed-methods synthesis. RESULTS: There was some evidence of effective interventions that resulted in a short-term (<6 months) reduction in children's SHSe when SHSe was subjectively measured. This was not seen in longer-term follow-up (>6 months) or when SHSe was measured objectively. Inconsistencies with reporting make replication challenging. Experiential evidence suggests a mismatch between stakeholder preferences and interventions being offered. CONCLUSIONS: The pediatric secondary care interventions included in this analysis failed to show statistically significant evidence of longer-term effectiveness to reduce children's SHSe in all but one low-quality study. There was also inadequate reporting of interventions limiting assessment of effectiveness. It offers further insights into areas to target to develop effective interventions. IMPLICATIONS: This review used rigorous methods to explore the current, global literature on how children's exposure to secondhand smoke is being tackled in secondary care. This review identified only one low-quality intervention study showing a statistically significant reduction in children's SHSe beyond 6 months. Synthesis with qualitative research identifies a mismatch between what parents want in an intervention and what has been delivered to date. Reporting quality needs to be improved to ensure that interventions can be replicated and studies conducted within the National Health Service to ensure suitability to this setting.


Assuntos
Educação em Saúde , Pessoal de Saúde/psicologia , Pais/educação , Atenção Secundária à Saúde/normas , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Adulto , Criança , Humanos , Pais/psicologia , Prevenção do Hábito de Fumar , Adulto Jovem
7.
Nicotine Tob Res ; 23(1): 63-70, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-32123908

RESUMO

INTRODUCTION: Smoke-free homes (SFHs), the voluntary adoption of home smoking restrictions, are associated with reduced secondhand smoke exposure. However, SFHs are uncommon in permanent supportive housing (PSH) for formerly homeless adults, who have fivefold higher smoking rates than the general population. We pilot-tested a brief intervention to increase voluntary adoption of SFHs among PSH residents in the San Francisco Bay Area. AIMS AND METHODS: We pilot-tested a brief intervention to increase voluntary adoption of SFHs among PSH residents in the San Francisco Bay Area. Rest of the methods, PSH residents (n = 100) and staff (n = 62) from 15 PSH sites participated in the intervention between October 2017 and February 2018. Research staff provided counseling to PSH residents on how to adopt an SFH and trained PSH staff on how to counsel residents on smoking cessation. The primary outcome was self-reported voluntary adoption of an SFH for ≥90 days, and the secondary outcome was carbon monoxide-verified PPA at 6-month follow-up. PSH staff completed the Smoking Knowledge, Attitudes, and Practices survey at baseline and 3-month follow-up. RESULTS: At 6 months, 31.3% of PSH residents had adopted an SFH (vs. 13.0% at baseline) and 16.9% reported carbon monoxide-verified PPA. A positive attitude toward an SFH policy was associated with increased odds of SFH adoption (adjusted odds ratio = 8.68, 95% confidence interval: 2.42, 31.17). Voluntary SFH adoption was associated with increased PPA (adjusted odds ratio = 26.27, 95% confidence interval: 3.43, 201.30). PSH staff reported improved attitudes toward and self-efficacy in delivering cessation care, and decreased barriers to discussing smoking cessation among PSH residents between baseline and 3-month follow-up. CONCLUSIONS: In this single-arm study, a brief intervention increased SFH adoption and PPA among PSH residents. IMPLICATIONS: To date, few interventions have addressed SFHs and their association with tobacco use among PSH residents. A "ground-up" approach that relies on buy-in from residents and that promotes voluntary SFHs is an innovative way to increase smoke-free living environments in PSH. This approach could pave a pathway for smoke-free policy implementation in these sites. PSH can play a role in reducing the burden of tobacco use by empowering its residents to adopt voluntary SFHs, which could increase smoking cessation among residents.


Assuntos
Exposição Ambiental/estatística & dados numéricos , Habitação Popular/estatística & dados numéricos , Política Antifumo/legislação & jurisprudência , Abandono do Hábito de Fumar/psicologia , Poluição por Fumaça de Tabaco/prevenção & controle , Uso de Tabaco/epidemiologia , Idoso , Intervenção Médica Precoce , Emigrantes e Imigrantes/psicologia , Feminino , Pessoas em Situação de Rua/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , São Francisco/epidemiologia , Inquéritos e Questionários , Poluição por Fumaça de Tabaco/estatística & dados numéricos
8.
Nicotine Tob Res ; 23(1): 57-62, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31407779

RESUMO

INTRODUCTION: Despite knowledge about major health effects of secondhand tobacco smoke (SHS) exposure, systematic incorporation of SHS screening and counseling in clinical settings has not occurred. METHODS: A three-round modified Delphi Panel of tobacco control experts was convened to build consensus on the screening questions that should be asked and identify opportunities and barriers to SHS exposure screening and counseling. The panel considered four questions: (1) what questions should be asked about SHS exposure; (2) what are the top priorities to advance the goal of ensuring that these questions are asked; (3) what are the barriers to achieving these goals; and (4) how might these barriers be overcome. Each panel member submitted answers to the questions. Responses were summarized and successive rounds were reviewed by panel members for consolidation and prioritization. RESULTS: Panelists agreed that both adults and children should be screened during clinical encounters by asking if they are exposed or have ever been exposed to smoke from any tobacco products in their usual environment. The panel found that consistent clinician training, quality measurement or other accountability, and policy and electronic health records interventions were needed to successfully implement consistent screening. CONCLUSIONS: The panel successfully generated screening questions and identified priorities to improve SHS exposure screening. Policy interventions and stakeholder engagement are needed to overcome barriers to implementing effective SHS screening. IMPLICATIONS: In a modified Delphi panel, tobacco control and clinical prevention experts agreed that all adults and children should be screened during clinical encounters by asking if they are exposed or have ever been exposed to smoke from tobacco products. Consistent training, accountability, and policy and electronic health records interventions are needed to implement consistent screening. Increasing SHS screening will have a significant impact on public health and costs.


Assuntos
Aconselhamento/métodos , Exposição Ambiental/análise , Política Antifumo/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Adulto , Criança , Humanos
9.
Nicotine Tob Res ; 23(2): 364-372, 2021 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-32803265

RESUMO

INTRODUCTION: Toxic tobacco smoke residue, also known as thirdhand smoke (THS), can persist in indoor environments long after tobacco has been smoked. This study examined the effects of different cleaning methods on nicotine in dust and on surfaces. AIMS AND METHODS: Participants had strict indoor home smoking bans and were randomly assigned to: dry/damp cleaning followed by wet cleaning 1 month later (N = 10), wet cleaning followed by dry/damp cleaning (N = 10) 1 month later, and dry/damp and wet cleaning applied the same day (N = 28). Nicotine on surfaces and in dust served as markers of THS and were measured before, immediately after, and 3 months after the cleaning, using liquid chromatography with triple quadrupole mass spectrometry (LC-MS/MS). RESULTS: Over a 4-month period prior to cleaning, surface nicotine levels remained unchanged (GeoMean change: -11% to +8%; repeated measures r = .94; p < .001). Used separately, dry/damp and wet cleaning methods showed limited benefits. When applied in combination, however, we observed significantly reduced nicotine on surfaces and in dust. Compared with baseline, GeoMean surface nicotine was 43% lower immediately after (z = -3.73, p < .001) and 53% lower 3 months later (z = -3.96, p < .001). GeoMean dust nicotine loading declined by 60% immediately after (z = -3.55, p < .001) and then increased 3 months later to precleaning levels (z = -1.18, p = .237). CONCLUSIONS: Cleaning interventions reduced but did not permanently remove nicotine in dust and on surfaces. Cleaning efforts for THS need to address persistent pollutant reservoirs and replenishment of reservoirs from new tobacco smoke intrusion. THS contamination in low-income homes may contribute to health disparities, particularly in children. IMPLICATIONS: Administered sequentially or simultaneously, the tested cleaning protocols reduced nicotine on surfaces by ~50% immediately after and 3 months after the cleaning. Nicotine dust loading was reduced by ~60% immediately after cleaning, but it then rebounded to precleaning levels 3 months later. Cleaning protocols were unable to completely remove THS, and pollutants in dust were replenished from remaining pollutant reservoirs or new secondhand smoke intrusion. To achieve better outcomes, cleaning protocols should be systematically repeated to remove newly accumulated pollutants. New secondhand smoke intrusions need to be prevented, and remaining THS reservoirs should be identified, cleaned, or removed to prevent pollutants from these reservoirs to accumulate in dust and on surfaces.


Assuntos
Poluição do Ar em Ambientes Fechados/análise , Poeira/análise , Habitação , Nicotina/análise , Política Antifumo/tendências , Poluição por Fumaça de Tabaco/análise , Poluição por Fumaça de Tabaco/prevenção & controle , Idoso , Biomarcadores/análise , Feminino , Humanos , Masculino , Distribuição Aleatória , Fumaça/análise , Tabaco
11.
J UOEH ; 42(4): 335-338, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33268611

RESUMO

Secondhand smoke (SHS) caused by smoking on apartment verandas is a severe social problem in Japan. If someone smokes on a veranda, SHS drifts into other residents' rooms through their windows. Most non-smoking residents are annoyed by this, but they do not confront the person responsible. To study this situation, we burned cigarettes and measured the spread of SHS in terms of fine particle (PM2.5) concentrations. Cigarette smoke generated on a lower veranda spread to upper and horizontal neighboring verandas and into rooms through windows, reaching a maximum concentration of 139 µg/m3. The Health Promotion Act that was revised in 2018 and enacted in 2019-2020 requires all smokers to avoid producing SHS, even outdoors and at home. It is expected that combining the measurement of SHS from verandas to other verandas and rooms with the revised Health Promotion Act could create a national consensus on "no smoking on apartment verandas."


Assuntos
Exposição Ambiental/análise , Exposição Ambiental/prevenção & controle , Características da Família , Habitação , Poluição por Fumaça de Tabaco/análise , Poluição por Fumaça de Tabaco/prevenção & controle , Exposição Ambiental/efeitos adversos , Promoção da Saúde/legislação & jurisprudência , Japão , Tamanho da Partícula , Poluição por Fumaça de Tabaco/efeitos adversos
12.
BMJ Open ; 10(12): e039787, 2020 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-33334831

RESUMO

OBJECTIVES: Children, pregnant women and the elderly at a global level are all being dangerously exposed to tobacco use in the household (HH). However, there is no understanding of the familial and socio-cultural factors that provide barriers to ensuring tobacco-free homes in Bangladesh either in urban or rural areas (U&RAs). This study therefore investigates those barriers to help enable a move towards tobacco-free homes in Bangladesh. DESIGN: Comparative cross-sectional study. SETTINGS: Data were collected from both urban and rural settings in Bangladesh. PARTICIPANTS: A probability proportional sampling procedure was used to select 808 participants in U&RAs out of a total of 3715 tobacco users. Semi-structured interviews through the use of a questionnaire were conducted with the participants followed by a multivariate logistic regression analysis of the data in order to explore the familial and socio-cultural factors associated with tobacco use at home. RESULTS: The prevalence of tobacco use at home was 25.7% in urban areas and 47.6% in rural areas. In urban areas: marital status (adjusted OR (AOR)=3.23, 95% CI 1.37 to 6.61), education (AOR=2.14, 95% CI 1.15 to 3.99), the smoking habits of elderly family members (AOR=1.81, 95% CI 0.91 to 2.89), offering tobacco as a traditional form of leisure activity at home (AOR=1.85, 95% CI 0.94 to 2.95) and lack of religious practices (AOR=2.39, 95% CI 1.27 to 4.54) were identified as significant socio-cultural predictors associated with tobacco use at home. In rural areas: age (AOR=5.11, 95% CI 2.03 to 12.83), extended family (AOR=3.08, 95% CI 1.28 to 7.38), lack of religious practices (AOR=4.23, 95% CI 2.32 to 7.72), using children to buy or carry tobacco (AOR=3.33, 95% CI 1.11 to 9.99), lack of family guidance (AOR=4.27, 95% CI 2.45 to 7.42) and offering tobacco as a traditional form of leisure activity at home (AOR=3.81, 95% CI 2.23 to 6.47) were identified as significant determinants for tobacco use at home. CONCLUSION: This study concludes that socio-cultural traditions and familial norms in Bangladesh provide significant barriers for enabling tobacco-free homes. The identification of these barriers can aid policymakers and programme planners in Bangladesh in devising appropriate measures to mitigate the deadly consequences of tobacco use in the home. The consequences also include the dangers involved in family members being exposed to secondhand smoke.


Assuntos
Produtos do Tabaco , Poluição por Fumaça de Tabaco , Uso de Tabaco , Tabaco , Idoso , Bangladesh/epidemiologia , Criança , Estudos Transversais , Características Culturais , Feminino , Humanos , Masculino , Gravidez , População Rural , Poluição por Fumaça de Tabaco/prevenção & controle
13.
Artigo em Inglês | MEDLINE | ID: mdl-33212796

RESUMO

(1) Background: Monthly variability in smoking behaviors in caregivers of pediatric asthmatics yields questions of how much and when does smoking reduction result in improved environmental and clinical outcomes. (2) Methods: Post hoc analysis of data from a 6 month pilot randomized-control trial occurring from May 2017 to May 2018 in Baltimore City (MD, USA). The initial trial's primary intervention explored the utility of financial incentives in modifying caregiver smoking behaviors. Post hoc analyses examined all dyads independent of the initial trial's randomization status. All caregivers received pediatric tobacco smoke harm reduction education, in addition to monthly encouragement to access the state tobacco quitline for individual phone-based counseling and nicotine replacement therapy. Maternal caregivers who were active cigarette smokers and their linked asthmatic child (aged 2-12 years) were grouped into two classifications ("high" versus "low") based on the child and caregiver's cotinine levels. A "low" cotinine level was designated by at least a 25% reduction in cotinine levels during 3 months of the trial period; achieving ≤2 months of low cotinine levels defaulted to the "high" category. Twenty-seven dyads (caregivers and children) (total n = 54) were assigned to the "high" category, and eighteen dyads (caregivers and children) (total n = 36) were allocated to the "low" category. The primary outcome measure was the correlation of caregiver cotinine levels with pediatric cotinine values. Secondary outcomes included asthma control, in addition to caregiver anxiety and depression. (3) Results: Caregivers with 3 months of ≥25% decrease in cotinine levels had a significantly greater mean change in child cotinine levels (p = 0.018). "Low" caregiver cotinine levels did not significantly improve pediatric asthma control (OR 2.12 (95% CI: 0.62-7.25)). Caregiver anxiety and depression outcomes, measured by Patient Health Questionnaire (PHQ)-4 scores, was not significantly different based on cotinine categorization (p = 0.079); (4) Conclusion: Reduced pediatric cotinine levels were seen in caregivers who reduced their smoking for at least 3 months, but clinical outcome measures remained unchanged.


Assuntos
Asma , Cuidadores , Abandono do Hábito de Fumar , Adulto , Asma/prevenção & controle , Cuidadores/estatística & dados numéricos , Criança , Pré-Escolar , Cotinina/sangue , Feminino , Humanos , Masculino , Motivação , Fumar/sangue , Abandono do Hábito de Fumar/estatística & dados numéricos , Poluição por Fumaça de Tabaco/prevenção & controle , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Dispositivos para o Abandono do Uso de Tabaco
17.
BMC Pregnancy Childbirth ; 20(1): 642, 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-33087094

RESUMO

BACKGROUND: Pregnant women's exposure to secondhand smoke is a very serious health issue in China. The purpose of our research is to identify factors that predict the probability of exposure to secondhand smoke among pregnant women from the perspective of a family-based open system. METHODS: From September 2014 to August 2015, Urumqi City, Shihezi City, and Shawan County-level City were sampled according to population characteristics. A revised structured questionnaire based on family resources was adapted for use in this study. Questionnaires were collected via convenience sampling at the hospitals with the largest number of local antenatal clients. A total of 1249 pregnant women of age 18-51 years were investigated. Descriptive statistics were calculated to characterize the participants and study variables. Binary logistic regression was performed to assess the impact of family resources corresponding variables on the likelihood that participants would be exposed to SHS. Both unadjusted and adjusted odds ratios (OR/AOR) [with 95% confidence intervals (CI)] were reported. RESULTS: The secondhand smoke exposure rate found in this study was 54.6%. Having good knowledge of the dangers of secondhand smoke had no effect on reducing the prevalence of exposure (P > 0.05). Even pregnant women whose husbands who did not use tobacco or never smoked nearby had a risk of exposure to secondhand smoke [adjusted odds ratio (AOR) 1.568, 95% CI 1.205-2.041] when the data were adjusted for age, gravidity, gestational weeks, knowledge of the dangers of secondhand smoke, location, and work status. Home smoking bans were confirmed to be an important protective factor (AOR 1.710, 95% CI 1.549-1.918); however, only one-third (33.5%) of participants reported having a smoking ban at home. Religion (mainly Islam), as a special external family resource, was a protective factor that reduced secondhand smoke exposure in pregnant women (AOR 0.399, 95% CI 0.312-0.510). CONCLUSIONS: The effect of family resources on tobacco control should be considered in the development of effective and enduring strategies for indoor smoking bans and smoking cessation.


Assuntos
Grupos Minoritários/estatística & dados numéricos , Política Antifumo/legislação & jurisprudência , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Gravidez , Prevalência , Fatores de Proteção , Religião , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Fumar/efeitos adversos , Fumar/legislação & jurisprudência , Abandono do Hábito de Fumar/métodos , Fatores Socioeconômicos , Cônjuges/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-33105823

RESUMO

Children are particularly vulnerable to environmental tobacco smoke (ETS). There is no routine support to reduce ETS in the home. We systematically reviewed trials to reduce ETS in children in order to identify intervention characteristics and behaviour change techniques (BCTs) to inform future interventions. We searched Medline, EMBASE, CINAHL, PsycINFO, ERIC, Cochrane Central Register of Controlled Trials, and Cochrane Tobacco Addiction Group Specialised Register from January 2017 to June 2020 to update an existing systematic review. We included controlled trials to reduce parent/caregiver smoking or ETS in children <12 years that demonstrated a statistically significant benefit, in comparison to less intensive interventions or usual care. We extracted trial characteristics; and BCTs using Behaviour Change Technique Taxonomy v1. We defined "promising" BCTs as those present in at least 25% of effective interventions. Data synthesis was narrative. We included 16 trials, of which eight were at low risk of bias. All trials used counselling in combination with self-help or other supporting materials. We identified 13 "promising" BCTs centred on education, setting goals and planning, or support to reach goals. Interventions to reduce ETS in children should incorporate effective BCTs and consider counselling and self-help as mechanisms of delivery.


Assuntos
Comportamento , Exposição Ambiental , Abandono do Hábito de Fumar , Poluição por Fumaça de Tabaco , Criança , Exposição Ambiental/prevenção & controle , Humanos , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar , Poluição por Fumaça de Tabaco/prevenção & controle
19.
Artigo em Inglês | MEDLINE | ID: mdl-33036327

RESUMO

Exposure to second-hand smoke (SHS) in the home is largely associated with socio-economic disadvantage. Disadvantaged parents face specific challenges creating a smoke-free home, often caring for children in accommodation without access to outdoor garden space. Existing smoke-free home interventions largely fail to accommodate these constraints. Innovative approaches are required to address this inequality. In this two-phase study, we engaged with parents living in disadvantaged areas of Edinburgh, Scotland, to explore tailored approaches to creating a smoke-free home and develop and pilot-test an intervention based on their views and preferences. In Phase 1, qualitative interviews with 17 parents recruited from Early Years Centres explored alternative approaches to smoke-free home interventions. In Phase 2, an intervention based on parents' views and preferences was pilot-tested with parents recruited through Early Years and Family Nurse Partnership centres. Seventeen parents took part in an interview to share their views/experiences of the intervention. Data from both study phases were thematically analysed. Phase 1 findings suggested that parents associated nicotine replacement therapy (NRT) with quit attempts but supported the idea of NRT use for temporary abstinence to create a smoke-free home, viewing this as a safer option than using e-cigarettes indoors. In Phase 2, 54 parents expressed an interest in accessing NRT to create a smoke-free home, 32 discussed NRT product choice during a home visit from a smoking adviser, and 20 collected their free NRT prescription from the pharmacy. NRT was used for up to 12 weeks in the home, with ongoing advice available from pharmacy staff. During qualitative interviews (n = 17), parents self-reported successfully creating a smoke-free home, quitting smoking, and reduced cigarette consumption, often exceeding their expectations regarding changes made. The intervention was acceptable to parents, but the multi-step process used to access NRT was cumbersome. Some participants were lost to this process. Parents living in disadvantaged circumstances may benefit from access to NRT for temporary abstinence in the home to assist them to protect their children from SHS exposure. Further research using a more streamlined approach to NRT access is required to determine the feasibility and cost-effectiveness of this approach.


Assuntos
Poluição do Ar em Ambientes Fechados/prevenção & controle , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Exposição Ambiental/prevenção & controle , Pais/psicologia , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/métodos , Poluição por Fumaça de Tabaco/prevenção & controle , Populações Vulneráveis , Adulto , Criança , Pré-Escolar , Feminino , Habitação , Humanos , Lactente , Masculino , Pesquisa Qualitativa , Escócia/epidemiologia , Dispositivos para o Abandono do Uso de Tabaco
20.
Artigo em Inglês | MEDLINE | ID: mdl-32933121

RESUMO

The Framework Convention on Tobacco Control (FCTC) developed by the State Parties to the World Health Organization was ratified in Slovakia in 2004 and in Finland in 2005. The aim of this study was to explore and compare compliance with the FCTC in Finland and Slovakia. This is a two-country comparative study of tobacco control policy based on implementation of the FCTC in Slovakia and Finland. Compliance with the FCTC was measured similarly in Slovakia and Finland in terms of their institutional structure supporting a smoking free environment and implementation of selected articles of the FCTC. In Finland the responsibilities for anti-tobacco policy are clearly assigned. Slovakia does not have specifically responsible institutions. Finland has a clear plan for achieving the goal of a smoking-free country based on empirical evidence. Slovakia meets only the minimum standard resulting from its commitment as ratified in the FCTC and data are out of date or missing completely.


Assuntos
Controle de Medicamentos e Entorpecentes/legislação & jurisprudência , Fidelidade a Diretrizes/estatística & dados numéricos , Prevenção do Hábito de Fumar , Indústria do Tabaco , Produtos do Tabaco , Poluição por Fumaça de Tabaco/prevenção & controle , Comparação Transcultural , Finlândia , Regulamentação Governamental , Cooperação Internacional , Eslováquia , Fumar/legislação & jurisprudência , Tabaco , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Organização Mundial da Saúde
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