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1.
N Z Med J ; 133(1520): 99-103, 2020 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-32994598

RESUMO

In this viewpoint we briefly review the evidence for smoke-free car legislation. We find that this legislation has been consistently associated with reduced secondhand exposure in cars with children/youth in all nine jurisdictions studied. Despite this, there are various aspects of this intervention that warrant further study-especially determining its impact on reducing tobacco-related ethnic inequalities. So we argue that the New Zealand Ministry of Health should invest in a thorough evaluation of this important upcoming public health intervention. This could both help the country in further refining the design of the law (if necessary) and would also be a valuable contribution to advancing the knowledge base for international tobacco control.


Assuntos
Automóveis/legislação & jurisprudência , Exposição Ambiental/prevenção & controle , Política Antifumo/legislação & jurisprudência , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Adolescente , Automóveis/normas , Criança , Exposição Ambiental/efeitos adversos , Grupos Étnicos/estatística & dados numéricos , Humanos , Nova Zelândia/epidemiologia , Saúde Pública/economia , Saúde Pública/legislação & jurisprudência , Fatores Socioeconômicos , Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/prevenção & controle
2.
Public Health ; 187: 24-35, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32889229

RESUMO

OBJECTIVE: This study aims to further quantify evidence of the association between exposure to indoor air pollution (IAP), tobacco smoke etc., on the one hand and the risk of contracting tuberculosis (TB) on the other. STUDY DESIGN: This was a systematic review and meta-analysis of articles published between June 2014 and February 2020 in PubMed, Web of Science, among others. METHODS: We only included studies that controlled for confounders, screened both the exposed and unexposed study participants, and passive smoking studies that limited the study population to non-smokers. Quality of studies was assessed using the Newcastle-Ottawa scale. The analysis was conducted using STATA, and pooled effect sizes were calculated using the random-effects model, and heterogeneity was tested for using the Cochran Q test and I2 statistic. RESULTS: A total of 26 articles were included in the final analysis. There was an increased risk of contracting TB among people exposed to IAP (risk ratio [RR] = 1.68, 95% confidence interval [CI] 1.108-2.542). We also observed a two-fold increase in the risk of contracting TB from exposure to secondhand tobacco smoke (RR = 2.15, 95%CI 1.419-3.242). Tobacco smoking doubled the risk of contracting TB (RR = 2.67, 95%CI 2.017-3.527). Furthermore, studies that used microbiological tests showed a higher RR compared to those that used other TB diagnostic methods. CONCLUSION: Exposure to IAP and secondhand tobacco smoke increases the risk of contracting TB. Various disease prevention campaigns should include IAP awareness and encourage a shift to cleaner sources of energy.

3.
Environ Sci Pollut Res Int ; 27(24): 29856-29866, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32483718

RESUMO

Exposure to secondhand smoke (SHS) in the workplace has led many workplaces to set up smoke-free policies to protect non-smoking employees. Although smoke-free workplaces are pervasive, the intensity of the practice is questionable. The purpose of this review is to identify the pooled prevalence estimate of secondhand smoke at smoke-free workplaces and the factors associated with SHS exposure at the workplace despite existing smoke-free policies. Fourteen studies (total 7458 employees) were identified from Pubmed, ScienceDirect, Cinahl, Scopus, and Web of Science from inception to December 2017. Results indicate that despite the existence of smoke-free policies at the workplace, 14 studies reported exposure to secondhand smoke. The pooled prevalence of the SHS exposure was 0.29 (95% CI = 0.23 to 0.36) (P < 0.001). Male young adults working in the hospitality industry are likely to report exposure to secondhand smoke at the smoke-free workplace. While most of the selected studies show the exposure of SHS within the smoking ban workplace, only two studies reported no exposure to secondhand smoke after implementation of smoke-free policies. Although the smoking ban policy at the workplace has been introduced, there are still a number of employees being affected by secondhand smoke. This indicates that there is still a gap of knowledge, attitude, and practice of non-smokers in strengthening the smoke-free policy at the workplace.


Assuntos
Política Antifumo , Poluição por Fumaça de Tabaco , Local de Trabalho , Humanos , Masculino , Prevalência , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-32585811

RESUMO

Children exposed to secondhand smoke (SHS) are at increased risk for disease. We sought to estimate the medical costs among Korean children who were exposed to SHS at home. A Markov model was developed, including five diseases (asthma, acute otitis media, acute bronchitis, pneumonia and sudden infant death syndrome) that were significantly associated with SHS in children based on a systematic review. The time horizon of the analysis was 20 years (from birth to adulthood), and the cycle length was 1 week. The direct healthcare costs were discounted annually at 5%. Univariate and probabilistic sensitivity analyses were conducted. The Markov model estimated the healthcare costs for 20 years as 659.61 USD per exposed child, an increase of approximately 30% compared to the cost per unexposed child (507.32 USD). Sensitivity analysis suggested that the younger the age of the exposure, the greater the incremental healthcare costs incurred, implying that infants and young children were especially vulnerable to the SHS exposure. Findings of this study could provide key baseline data for future economic evaluations on SHS control policies in South Korea.


Assuntos
Custos de Cuidados de Saúde , Poluição por Fumaça de Tabaco , Adulto , Criança , Pré-Escolar , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Humanos , Lactente , Modelos Econométricos , República da Coreia/epidemiologia , Fumar , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/análise
5.
Rev Mal Respir ; 37(5): 376-388, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-32334968

RESUMO

In France, shisha (narghile) smoking is increasingly popular among adolescents and young adults and is generally thought to be less harmful and addictive than cigarettes. This systematic review of data on carbon monoxide (CO) poisoning in active or passive shisha tobacco smokers selected 17 studies. Sixteen case reports, including 39 patients (mean age: 22.3 years; males: 51.3%), described acute carbon monoxide poisoning in active shisha smokers. The most common symptoms were dizziness, headache, and nausea. Loss of consciousness occurred in 43.6% of patients. Two patients had an epileptic seizure. The mean carboxy-haemoglobin (HbCO) blood level was 17.3%. Electrocardiographic changes were present in five patients. Most patients were treated with normobaric oxygen therapy while only four received hyperbaric oxygen therapy; two of whom were non tobacco smokers exposed to shisha smoke during their work. The outcome was favourable in all patients. Shisha use must be suspected in cases of CO poisoning, especially in adolescents and young adults. Practitioners must help shisha users to stop their consumption.


Assuntos
Intoxicação por Monóxido de Carbono/epidemiologia , Intoxicação por Monóxido de Carbono/etiologia , Cachimbos de Água/estatística & dados numéricos , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Estudos Transversais/estatística & dados numéricos , Feminino , França/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Fumar/efeitos adversos , Poluição por Fumaça de Tabaco/efeitos adversos , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-32204415

RESUMO

The aim of this review of reviews was to collate the latest evidence from systematic reviews about the maternal and child health outcomes of being exposed to tobacco and nicotine during pregnancy; the effectiveness of interventions designed to reduce these exposures, and barriers to and facilitators of smoking cessation during pregnancy. Two databases were searched to obtain systematic reviews published from 2010 to 2019. Pertinent data from 76 articles were summarized using a narrative synthesis (PROSPERO reference: CRD42018085896). Exposure to smoke or tobacco in other forms during pregnancy is associated with an increased risk of obstetric complications and adverse health outcomes for children exposed in-utero. Counselling interventions are modestly effective, while incentive-based interventions appear to substantially increase smoking cessation. Nicotine replacement therapy is effective during pregnancy but the evidence is not conclusive. Predictors and barriers to smoking cessation in pregnancy are also discussed. Smoking during pregnancy poses substantial risk to mother's and child's health. Psychosocial interventions and nicotine replacement therapy (NRT) appear to be effective in helping pregnant women quit smoking. Barriers to smoking cessation must be identified and steps taken to eradicate them in order to reduce smoking among pregnant women. More research is needed on smoking cessation medications and e-cigarettes.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Abandono do Hábito de Fumar , Poluição por Fumaça de Tabaco , Criança , Feminino , Humanos , Nicotina , Gravidez , Tabaco , Dispositivos para o Abandono do Uso de Tabaco
7.
Public Health ; 179: 100-110, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31770719

RESUMO

OBJECTIVES: Long-term exposure to particulate and gaseous air pollution (AP) may trigger the development of Parkinson disease (PD), but this association remains controversial. The relationship between second-hand smoke (SS) and PD risk is also inconclusive. We aimed to systematically review epidemiological studies investigating the association between these AP exposures and PD risk. STUDY DESIGN: This was a systematic review and meta-analysis of studies investigating the relationship of ambient AP and SS with PD risk. METHODS: PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar databases were searched. We used a random-effects model to derive pooled estimates of relative risk (RR) and corresponding 95% confidence intervals (CIs) per increment in pollutant concentration. The studied AP included particulate matter with aerodynamic diameter <2.5 µm (PM2.5), <10 µm (PM10), nitrogen dioxides (NO2, NOx), ozone (O3), and carbon monoxide (CO). RESULTS: In total, 21 studies with 222,051 patients with PD were eligible for inclusion. We found marginally significant increased risk of PD with per 10-µg/m3 increase in concentration of PM2.5 (RR = 1.08, 95% CI = 0.98-1.19), NO2 (RR = 1.03, 95% CI = 0.99-1.07), and O3 (RR = 1.01, 95% CI = 1.00-1.02). A positive but non-significant association was also detected for CO (RR = 1.32, 95% CI = 0.82-2.11). Furthermore, an inverse PD-SS relationship was noted irrespective of exposure occasions and timing (at home: RR = 0.73, 95% CI = 0.56-0.95; at work: RR = 0.82, 95% CI = 0.57-1.17; in children: RR = 0.91, 95% CI = 0.76-1.08). Both sensitivity and subgroup analyses generated results comparable with those of the overall analyses. CONCLUSIONS: Our study suggested that exposure to PM2.5, NO2, and O3 might contribute to higher risk of PD, whereas SS conferring reduced PD risk. Public and environmental health strategies that aim at reducing outdoor AP levels might reduce the burden of PD. More prospective cohort studies with personal exposure measurements are warranted in the future.


Assuntos
Poluição do Ar/efeitos adversos , Exposição Ambiental/estatística & dados numéricos , Doença de Parkinson/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Humanos , Risco
8.
Nicotine Tob Res ; 22(1): 3-10, 2020 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-30102383

RESUMO

BACKGROUND: The association between cigarette smoking and schizophrenia is well established. However, up to 90% of people with schizophrenia begin smoking before the onset of their illness; thus, smoking could be an independent risk factor for schizophrenia. Prenatal exposure to maternal cigarette smoke is also associated with psychiatric problems in adolescence. Therefore, our aim was to undertake a systematic review and meta-analysis to explore the effect of smoking, and prenatal smoke exposure, on risk of schizophrenia. METHOD: We systematically searched Medline, EMBASE, PsychInfo, Maternity and Infant Care, and Web of Science (from inception to February 2018) to identify comparative observational studies of the risk of schizophrenia in relation to smoking status. Measures of relative risk (RR) were pooled in a meta-analysis with 95% confidence intervals (CI), using random effects model. RESULTS: Twelve studies (9 cohort, 3 case-control) were included. Odds ratios (OR) and hazard ratios (HR) were pooled together to estimate pooled relative risks and estimates combined in a meta-analysis on an assumption of constant risk over time. Smokers had a significantly increased risk of schizophrenia compared with nonsmokers (RR = 1.99, 95% CI = 1.10% to 3.61%, I2 = 97%, 5 studies). Exposure to prenatal smoke increased the risk of schizophrenia by 29% (95% CI = 1.10% to 1.51%, I2 = 71%, 7 studies). Sensitivity analyses identified no significant differences between the results from studies reporting OR and hazard ratio. CONCLUSIONS: Our findings suggest smoking, and prenatal smoke exposure, may be an independent risk factor for schizophrenia. Care should be taken when inferring causation, given the observational nature of the studies. IMPLICATIONS: In this meta-analysis of 12 studies, smokers had a significantly increased risk of schizophrenia compared with nonsmokers. Exposure to prenatal tobacco smoke also increased the risk of schizophrenia by 29% compared with those with no exposure to prenatal tobacco smoke. Our findings suggest that smoking, and prenatal tobacco smoke exposure, may be independent risk factors for schizophrenia. These results may have important public health implications for decreasing the incidence of schizophrenia. The possibility of a causal link between smoking and schizophrenia warrants further investigation.


Assuntos
Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Esquizofrenia/etiologia , Fumar/efeitos adversos , Poluição por Fumaça de Tabaco/efeitos adversos , Feminino , Humanos , Incidência , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Fatores de Risco , Esquizofrenia/epidemiologia
9.
Nicotine Tob Res ; 22(4): 458-465, 2020 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-30874290

RESUMO

INTRODUCTION: To identify studies reporting costs arising from tobacco use and detail their (1) economic approaches, (2) health outcomes, and (3) other cost areas included. METHODS: We searched PubMed, Scopus, Cochrane Library, EconLit, and Google Scholar for studies published between 2008 and April 2018 in English. Eligible articles reported tobacco-related costs and included all tobacco-using populations (multinational, national, subpopulations, and involuntary smokers). All economic approaches that resulted in monetary outcomes were included. We reported USD or converted local currencies to USD. Two health economists extracted and two researchers independently reviewed the data. RESULTS: From 4083 articles, we reviewed 361 abstracts and examined 79 full-texts, with 63 (1.6%) deemed eligible. There were three multinational, thirty-four national, twenty-one subpopulation or condition(s)-specific analyses, and five evaluating involuntary smoking. The diverse approaches and outcomes precluded integrating costs, but these were substantial in all studies. For instance, about USD 1436 billion in global health expenditures and productivity losses in 2012 and USD 9 billion in lost productivity in China, Brazil, and South Africa in 2012. At the national level, costs ranged from USD 4665 in annual per respondent health expenses (Germany 2006-2008) to USD 289-332.5 billion in medical expenses (United States 1964-2014). CONCLUSIONS: Despite wide variations in the methods used, the identified costs of tobacco are substantial. Studies on tobacco cost-of-illness use diverse methods and hence produce data that are not readily comparable across populations, time, and studies, precluding a consistent evidence-base for action and measurement of progress. Recommendations are made to improve comparability. IMPLICATIONS: In addition to the health and financial costs to individual smokers, smoking imposes costs on the broader community. Production of comparable estimates of the societal cost of tobacco use is impaired by a plethora of economic models and inconsistently included costs and conditions. These inconsistencies also cause difficulties in comparing relative impacts caused by differing factors. The review systematically documents the post-2007 literature on tobacco cost-of-illness estimations and details conditions and costs included. We hope this will encourage replication of models across settings to provide more consistent data, able to be integrated across populations, over time, and across risk factors.


Assuntos
Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Gastos em Saúde , Fumar/economia , Poluição por Fumaça de Tabaco/economia , Análise Custo-Benefício , Humanos
10.
Artigo em Inglês | MEDLINE | ID: mdl-31861215

RESUMO

Enabling parents to create a smoke-free home is one of the key ways that children's exposure to second-hand smoke (SHS) can be reduced. Smoke-free home interventions have largely targeted mothers who smoke, and there is little understanding of the barriers and facilitators that fathers experience in creating a smoke-free home. Systematic searches combining terms for fathers, homes, and SHS exposure were run in April 2019 in Web of Science's Citation Indices, PsycINFO, and PubMed for English-language studies published since 2008. The searches identified 980 records for screening, plus 66 records from other sources. Twelve studies reported in 13 papers were included in this scoping review. Eight of the studies were conducted in Asian countries (five in China, one in India, one in Japan, and one in Iran), three were conducted in Canada, and one in Turkey. Findings were extracted in verbatim text for thematic analysis. The review identified that attitudes and knowledge, cultural and social norms, gender power relations, and shifting perceptions and responsibilities related to fatherhood can impact on fathers' views of their role in relation to creating and maintaining a smoke-free home. There were too few published studies that had assessed smoke-free home interventions with fathers to draw conclusions regarding effective approaches. Research is clearly needed to inform our understanding of fathers' roles, successes and challenges in creating and maintaining a smoke-free home, so that father-inclusive rather than mother-led interventions can be developed to benefit entire households and improve gender equity as well as health.


Assuntos
Pai/psicologia , Poluição por Fumaça de Tabaco/análise , Adulto , Criança , Características da Família , Feminino , Humanos , Masculino , Mães
11.
Prev Med ; 129: 105833, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31505203

RESUMO

Our aim was to provide a systematic review of studies on the burden of disease due to second-hand smoke (SHS) exposure, reviewing methods, exposure assessment, diseases causally linked to SHS, health outcomes, and estimates available to date. A literature review of studies on the burden of disease from SHS exposure, available in PubMed and SCOPUS, published 2007-2018 in English language, was carried out following the PRISMA recommendations. Overall, 588 studies were first identified, and 94 were eligible. Seventy-two studies were included in the systematic review. Most of them were based on the comparative risk assessment approach, assessing SHS exposure using mainly surveys on exposure at home/workplaces. Diseases more frequently studied were: lung cancer, ischemic heart disease, stroke, chronic obstructive pulmonary disease, asthma and breast cancer in adults; lower respiratory tract infection, otitis media, asthma, sudden infant death syndrome and low birth weight in children. The SHS exposure assessment and the reported population attributable fractions (PAF) were largely heterogeneous. As an example, the PAF from lung cancer varied between 0.6% and 20.5%. Moreover, PAF were estimated applying relative risks and SHS exposures with no consistent definitions or with different age classes. The research gap on the SHS exposure burden is shrinking. However, estimates are not yet available for a number of countries, particularly the Middle Eastern and African countries, and not all diseases with the strongest evidence of causation, such as sudden infant death syndrome, have been explored. Moreover, in some cases the applied methodology revealed relatively low quality of data.


Assuntos
Doença Crônica/epidemiologia , Efeitos Psicossociais da Doença , Poluição por Fumaça de Tabaco/efeitos adversos , Humanos , Medição de Risco
12.
BMC Public Health ; 19(1): 1071, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395051

RESUMO

BACKGROUND: Household smoke-free home rules cannot fully protect nonsmokers from secondhand smoke (SHS) if they live in multi-unit housing (MUH). Instead, property-level smoke-free policies are needed to prevent SHS incursion into apartment units and to keep common areas smoke-free. Smoke-free policies are usually at the discretion of property management companies and owners within the context of market-rate and privately-owned affordable housing in the U.S. METHODS: Semi-structured interviews on the policy development, implementation and enforcement experiences of 21 different privately-owned affordable housing management companies were conducted with representatives from properties in North Carolina and Georgia who had established smoke-free policies before 2016. RESULTS: The decision to adopt was typically made by corporate leadership, board members, owners or property managers, with relatively little resident input. Policy details were influenced by property layout, perceptions of how best to facilitate compliance and enforcement, and cost of creating a designated smoking area. Policies were implemented through inclusion in leases, lease addenda or house rules with 6 months' notice most common. Participants thought having a written policy, the norms and culture of the housing community, public norms for smoke-free environments, and resident awareness of the rules and their consequences, aided with compliance. Violations were identified through routine inspections of units and resident reporting. Resident denial and efforts to hide smoking were shared as challenges to enforcement, along with a perception that concrete evidence would be needed in eviction court and that simply the smell of SHS was insufficient evidence of violation. Over half had terminated leases or evicted residents due to violations of the smoke-free policy. The most common benefits cited were reduced turnover cost and time, and lower vacancy rates. CONCLUSIONS: Understanding the smoke-free policy process in privately-owned affordable housing can help practitioners encourage policies within subsidized housing contexts. The study identified salient benefits (e.g., reduced cost, time, and vacancies) that can be highlighted when encouraging MUH partners to adopt policies. Additionally, study findings provide guidance on what to consider when designing smoke-free policies (e.g., layout, costs), and provide insights into how to enhance compliance (e.g., resident awareness) and manage enforcement (e.g., routine inspections).


Assuntos
Habitação/organização & administração , Setor Privado , Política Antifumo , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Adulto , Idoso , Custos e Análise de Custo , Feminino , Georgia , Habitação/economia , Habitação/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , North Carolina , Pesquisa Qualitativa , Adulto Jovem
13.
Environ Pollut ; 254(Pt B): 113036, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31465899

RESUMO

Ambient air pollution (AAP) is recognized a cardiovascular risk factor and lipid profile dysregulation seems to be one of the potential mediators involved. However, results from epidemiologic research on the association between exposure to AAP and altered lipid profile have been inconsistent. This study aims to systematically review and meta-analyse epidemiologic evidence on the association between exposure to ambient air pollutants (particulate matter, nitrogen oxides, sulphur dioxide, ozone, carbon monoxide, back carbon) and lipid profile parameters (Total cholesterol; High-Density Lipoprotein Cholesterol; Low-Density Lipoprotein Cholesterol; TG-Triglycerides) or dyslipidaemia. Systematic electronic literature search was performed in PubMed, Web of Science and Scopus databases (last search on 24th May 2019) using keywords related to the exposure (ambient air pollutants) and to the outcomes (lipid profile parameters/dyslipidaemia). Qualitative and quantitative information of the studies were extracted and fixed or random-effects models were used to obtain a pooled effect estimate per each pollutant/outcome combination. 22 studies were qualitatively analysed and, from those, 3 studies were quantitatively analysed. Particulate matters were the most studied pollutants and a considerable heterogeneity in air pollution assessment methods and outcomes definitions was detected. Age, obesity related measures, tobacco consumption, sex and socioeconomic factors were the most frequent considered variables for confounding adjustment in the models. In a long-term exposure scenario, we found a 3.14% (1.36%-4.95%) increase in TG levels per 10 µg/m3 PM10 increment and a 4.24% (1.37%-7.19%) increase in TG levels per 10 µg/m3 NO2 increment. No significant associations were detected for the remaining pollutant/outcome combinations. Despite the few studies included in the meta-analysis, our study suggests some epidemiologic evidence supporting the association between PM10 and NO2 exposures and increased TG levels. Due to the very low level of evidence, more studies are needed to clarify the role of lipid profile dysregulation as a mediator on the AAP adverse cardiovascular effects.


Assuntos
Poluição do Ar/estatística & dados numéricos , Exposição Ambiental/análise , Lipídeos/análise , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Monóxido de Carbono/análise , Poluentes Ambientais/análise , Feminino , Humanos , Masculino , Óxidos de Nitrogênio/análise , Ozônio/análise , Material Particulado/análise , Fatores Socioeconômicos , Dióxido de Enxofre/análise
14.
Indian Pediatr ; 56(10): 837-840, 2019 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-31441433

RESUMO

OBJECTIVE: To ascertain the compliance to Cigarette and Other Tobacco Products Act (COTPA) 2003 which ensures the protection of children from the adverse health effects of second hand smoke. METHODS: This cross-sectional study assessed the compliance of 32 educational institutions and 157 points of sale of Shimla city. RESULTS: About 88% of the educational institutions and mere 7.6% points of sale were found having good compliance to the key indicators. No point of sale was found within the premises of educational institutions; however, 26% were found selling tobacco products within 100 metres radius of an educational institution. 7.6% points of sale were found selling a tobacco product to children. CONCLUSIONS: Despite having the status of a smoke-free city, lapses were observed in compliance to the Act. Strict adherence to the provisions of the Act would ultimately lead to a smoke-free environment for our children.


Assuntos
Fidelidade a Diretrizes/estatística & dados numéricos , Política Antifumo/legislação & jurisprudência , Abandono do Hábito de Fumar/legislação & jurisprudência , Produtos do Tabaco/legislação & jurisprudência , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Distribuição de Qui-Quadrado , Criança , Estudos Transversais , Exposição Ambiental/prevenção & controle , Feminino , Guias como Assunto , Humanos , Índia , Masculino , Saúde Pública , Poluição por Fumaça de Tabaco/legislação & jurisprudência
15.
Medicine (Baltimore) ; 98(28): e16454, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305478

RESUMO

OBJECTIVE: Tobacco smoke contains carcinogens known to damage somatic and germ cells. In this study, we investigated the effect of tobacco smoking on the risk of childhood acute lymphoblastic leukemia (ALL) and myeloid leukemia (AML). METHODS: Information about tobacco smoking exposures of the mother before, during, and after pregnancy was collected via PubMed, Embase, and Web of Science databases through November 5, 2018. We performed to evaluate the association between smoking exposure and the risk of childhood ALL and AML. Study selection, data abstraction, and quality assessment were performed by 2 independent reviewers. Random effects models were used to obtain summary odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Nineteen case-control studies of childhood leukemia (age < 15 years) conducted in 9 countries from 1974 to 2018. Maternal smoking exposures did not a significant association with childhood ALL (OR = 1.004, 95% CI 0.953-1.058, P = .881) and AML (OR = 0.92, 95% CI 0.815-1.038, P = .177) during exposure time windows. However, there was an association with paternal smoking and ALL (OR = 1.15, 95% CI 1.038-1.275, P = .007). Paternal smoking in AML showed there was no association with smoking exposures and childhood AML (OR = 1.133, 95% CI 0.943-1.362, P = .181). Next, maternal daily cigarettes consumption showed no associations with ALL (OR = 1.08, 95% CI 1.000-1.168, P = .051) during pregnancy. No association with maternal daily smoking and AML (OR = 0.909, 95% CI 0.682-1.211, P = .514). Paternal daily cigarettes consumption was associated with increased risks of childhood ALL (OR = 1.200, 95% CI 1.112-1.302, P = .000). The higher consumption of paternal smoking (more than 10 per day) was significantly related to childhood ALL. Paternal daily smoking consumption also was related to AML (OR = 1.242, 95% CI 1.031-1.496, P = .022). CONCLUSION: Maternal smoking before, during, or after pregnancy was not associated with childhood ALL or AML. However, paternal smoking was related to a significantly elevated risk of childhood ALL during pregnancy, but not for AML. Maternal daily smoking consumption was not associated with ALL or AML during pregnancy. The higher consumption of paternal smoking were, the higher the risk of childhood ALL or AML.


Assuntos
Leucemia Mieloide Aguda/epidemiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Adolescente , Criança , Feminino , Humanos , Fatores de Risco
16.
Sci Rep ; 9(1): 8535, 2019 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-31189894

RESUMO

Secondhand smoke exposure of non-smoking women during pregnancy is associated with a higher risk of adverse birth outcomes. However, the available evidence regarding the association between expectant mothers' secondhand smoke exposure and breastfeeding outcomes remains limited. This systematic review aimed to examine associations between secondhand smoke exposure of nonsmoking women during pregnancy with the initiation, prevalence, and duration or breastfeeding compared to women who were breastfeeding and had not been exposed to secondhand smoke. Women who smoked during pregnancy were excluded. We included case-control, cross-sectional, and cohort studies with a comparison control group. Medline CINAHL, and EMBASE were searched in January 2017. After screening 2777 records we included eight prospective cohort studies. The risk of bias assessment tool for non-randomized studies indicated a high risk of outcome assessment blinding. Meta-analysis of two studies established that the odds of discontinuation of any brestfeeding before six months were significantly increased in the secondhand smoke exposed women (pooled odds = 1.07 [95%CI = 1.01, 1.14], two studies, 1382 women). Therefore, secondhand smoke might be associated with discontinuing any breastfeeding before six months. More research is necessary to understand the association between secondhand smoke and the initiation, prevalence and duration of breastfeeding.


Assuntos
Aleitamento Materno , Exposição Materna/efeitos adversos , Poluição por Fumaça de Tabaco/efeitos adversos , Feminino , Humanos , Gravidez , Prevalência
17.
PLoS One ; 14(6): e0217845, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31173615

RESUMO

BACKGROUND: Understanding patterns of socio-economic inequalities in tobacco consumption is key to design targeted public health policies for tobacco control. This study examines socio-economic inequalities in smoking and involuntary exposure to tobacco smoke between 2005 and 2013. METHODS: Data were derived from the Argentine National Risk Factors Surveys, conducted in 2005, 2009, and 2013. Two inequality measures were calculated: the age-adjusted prevalence ratio (PR) and the disparity index (DI). Educational level, household income per consumer unit and employment status were used as proxies for socio-economic status (SES). Generalized linear models were used in the analysis. RESULTS: Prevalence of smoking decreased from 29.7% to 25.1% between 2005 and 2013, mainly in women (p<0.001). Despite the overall prevalence reduction, socio-economic inequalities in smoking persisted. For both men and women, the DI was moderately high for smoking (14.47%-33.06%) across the three surveys. In men, the PR indicated a higher smoking prevalence for lower educational levels and lower household income throughout the analyzed period. In women, unlike previous years, the 2013 survey showed disparity related to unemployment. Involuntary exposure to tobacco smoke in 2013 was associated with educational level and household income, with lower involuntary exposure among those with higher SES. CONCLUSIONS: While overall smoking rates have decreased in Argentina, socio-economic disparities related to tobacco smoking persist. Comprehensive tobacco control programs targeted to address these inequalities are essential in developing strategies to reduce health disparities in tobacco-related diseases.


Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Fumar Tabaco/epidemiologia , Tabaco/efeitos adversos , Adolescente , Adulto , Idoso , Argentina/epidemiologia , Estudos Transversais , Feminino , Disparidades nos Níveis de Saúde , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Classe Social , Uso de Tabaco/efeitos adversos , Uso de Tabaco/epidemiologia , Adulto Jovem
18.
Int J Tuberc Lung Dis ; 23(4): 412-421, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31064619

RESUMO

OBJECTIVES To examine: 1) whether exposure to secondhand smoke (SHS) at home is associated with symptoms of self-reported illness among mother-child pairs (MCPs); and 2) the relationship between low socio-economic status and SHS exposure and the role these play as obstacles to the reduction of risk of illness in MCPs. METHOD A cross-sectional study was conducted in Rajshahi District, Bangladesh, from May to July 2017. A total of 541 MCPs were interviewed. RESULTS The prevalence of SHS exposure at home in our sample data was 49.0%. SHS exposure was found to be associated with a higher likelihood of any self-reported rhinitis, any respiratory symptoms and any reproductive health problems among mothers. SHS exposure in children was found to be associated with a higher likelihood of any self-reported rhinitis and food sensitisation, any respiratory symptoms and otitis media. Our findings also suggested that although SHS had an independently adverse effect on MCPs, wealth moderated the likelihood of illness. CONCLUSIONS MCPs who were both poor and exposed to SHS were uniquely disadvantaged in terms of their poor health conditions than MCPs who were wealthier and exposed to SHS. .


Assuntos
Exposição Ambiental/efeitos adversos , Pobreza/estatística & dados numéricos , Poluição por Fumaça de Tabaco/efeitos adversos , Adolescente , Adulto , Bangladesh/epidemiologia , Pré-Escolar , Estudos Transversais , Exposição Ambiental/economia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Prevalência , Fatores de Risco , Autorrelato , Fatores Socioeconômicos , Poluição por Fumaça de Tabaco/economia , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-30991759

RESUMO

Previous studies have suggested an association between secondhand smoke (SHS) exposure and risk of depressive symptoms. However, it remains unclear whether there is a dose-response relationship. The effect estimates were pooled using fixed-effect or random-effect models based on homogeneity analysis. The dose-response meta-analysis was performed by linear and non-linear regression. Subgroup analyses were conducted to explore the possible sources of heterogeneity. Twenty-four studies were included in this meta-analysis. SHS exposure was significantly associated with increased odds of depressive symptoms (odds ratio (OR) = 1.32, 95% confidence interval (CI) 1.25-1.39). For SHS exposure expressed as an ordinal variable, the dose-response meta-analysis revealed a monotonically increasing relationship between SHS exposure and depressive symptoms. A similar dose-response relationship was observed for SHS exposure expressed as a continuous variable (OR = 1.57, 95% CI = 1.26-1.87). Our findings suggest that SHS exposure is associated with increasing odds of depressive symptoms in a dose-response manner.


Assuntos
Depressão/epidemiologia , Poluição por Fumaça de Tabaco/análise , Depressão/induzido quimicamente , Relação Dose-Resposta a Droga , Humanos , Prevalência , Fatores de Risco
20.
Environ Sci Pollut Res Int ; 26(13): 12648-12661, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30903465

RESUMO

Ambient air pollution is nowadays one of the most crucial contributors to deteriorating health status worldwide. The components of air pollution include PM2.5 and PM10, NO2, SO2, CO, O3, and organic compounds. They are attributed to several health outcomes, for instance, cardiovascular diseases (CVD), respiratory diseases, birth outcomes, neurologic diseases, and psychiatric diseases. The objective of this study is to evaluate the association between different ambient air pollutants and the above-mentioned health outcomes. In this systematic review, a total of 76 articles was ultimately selected from 2653 articles, through multiple screening steps by the aid of a set of exclusion criteria as non-English articles, indoor air pollution assessment, work-related, occupational and home-attributed pollution, animal studies, tobacco smoking effects, letters to editors, commentaries, animal experiments, reviews, case reports and case series, out of 19,862 published articles through a systematic search in PubMed, Web of Science, and Scopus. Then, the associations between air pollution and different health outcomes were measured as relative risks and odds ratios. The association between air pollutants, PM2.5 and PM10, NO2, SO2, CO, O3, and VOC with major organ systems health was investigated through the gathered studies. Relative risks and/or odds ratios attributed to each air pollutant/outcome were ultimately reported. In this study, a thorough and comprehensive discussion of all aspects of the contribution of ambient air pollutants in health outcomes was proposed. To our knowledge up to now, there is no such comprehensive outlook on this issue. Growing concerns in concert with air pollution-induced health risks impose a great danger on the life of billions of people worldwide. Should we propose ideas and schemes to reduce ambient air pollutant, there will be dramatic reductions in the prevalence and occurrence of health-threatening conditions.


Assuntos
Poluição do Ar/efeitos adversos , Doenças Cardiovasculares/epidemiologia , Exposição Ambiental/efeitos adversos , Doenças do Sistema Nervoso/epidemiologia , Doenças Respiratórias/epidemiologia , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/mortalidade , Exposição Ambiental/análise , Feminino , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Neoplasias/epidemiologia , Neoplasias/etiologia , Doenças do Sistema Nervoso/etiologia , Material Particulado/efeitos adversos , Material Particulado/análise , Gravidez , Resultado da Gravidez , Doenças Respiratórias/etiologia
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