Environmental Tobacco Smoke Exposure at Home and Attributable Problem Behaviors in Korean Children and Adolescents for 2012–2014 in a Nationally Representative Survey

BACKGROUND: This study aimed to examine the environmental tobacco smoke (ETS) exposure at home and associated problem behaviors in Korean children and adolescents. METHODS: Approximately 2,167 children aged 3–18 years were included in the study after excluding 163 active smokers from the Korean Environmental Health Survey in Children and Adolescents (2012–2014). ETS data were obtained using a questionnaire; problem behaviors were measured using the Child Behavior Checklist administered to parents. The relationship between ETS exposure and problem behavior was evaluated using a survey regression model adjusted for region, age, sex, income, and father's education. The population-attributable fraction (PAF%) was calculated based on problem behaviors related to ETS exposure at home. RESULTS: The rates of ETS exposure at home were 20%, 28%, and 39% in children aged 3–5, 6–11, and 12–18 years, respectively; ETS exposure at home was associated with behavioral problems: the exposed group having higher total behavioral problem score (95% confidence interval [CI]) than the non-exposed by 2.46 (0.60–4.32) and 2.74 (0.74–4.74) in children aged 6–11 and 12–18 years, respectively, with no significant association in those aged 3–5 years. The PAF% (95% CI) of total problem behaviors for ETS exposure at home were 2.68 (−10.11–17.78), 10.66 (3.25–17.55), and 11.62 (3.03–18.96) in children aged 3–5, 6–11, and 12–18 years, respectively. Children with externalizing problems had higher PAF% than those with internalizing problems. CONCLUSION: In Korea, ETS exposure at home is associated with problem behaviors in children and adolescents with about more than 10% population attributable fraction.

Affecting Factors of Secondhand Smoke Exposure in Korea: Focused on Different Exposure Locations

Exposure to secondhand smoke (SHS) not only can cause serious illness, but is also an economic and social burden. Contextual and individual factors of non-smoker exposure to SHS depend on location. However, studies focusing on this subject are lacking. In this study, we described and compared the factors related to SHS exposure according to location in Korea. Regarding individual factors related to SHS exposure, a common individual variable model and location-specific variable model was used to evaluate SHS exposure at home/work/public locations based on sex. In common individual variables, such as age, and smoking status showed different relationships with SHS exposure in different locations. Among home-related variables, housing type and family with a single father and unmarried children showed the strongest positive relationships with SHS exposure in both males and females. In the workplace, service and sales workers, blue-collar workers, and manual laborers showed the strongest positive association with SHS exposure in males and females. For multilevel analysis in public places, only SHS exposure in females was positively related with cancer screening rate. Exposure to SHS in public places showed a positive relationship with drinking rate and single-parent family in males and females. The problem of SHS embodies social policies and interactions between individuals and social contextual factors. Policy makers should consider the contextual factors of specific locations and regional and individual context, along with differences between males and females, to develop effective strategies for reducing SHS exposure.

Association Between Exposure to Environmental Tobacco Smoke at the Workplace and Risk for Developing a Colorectal Adenoma: A Cross-Sectional Study

PURPOSE: A colorectal adenoma (CRA) is a well-defined precursor to colorectal cancer (CRC). Additionally, smoking is a potent risk factor for developing a CRA, as well as CRC. However, the association between exposure to environmental tobacco smoke (ETS) and the risk for developing a CRA has not yet been fully evaluated in epidemiologic studies. We performed a cross-sectional analysis on the association between exposure to ETS at the workplace and the risk for developing a CRA. METHODS: The study was conducted on subjects who had undergone a colonoscopy at a health promotion center from January 2012 to December 2012. After descriptive analyses, overall and subgroup analyses by smoking status were performed by using a multivariate logistic regression. RESULTS: Among the 1,129 participants, 300 (26.6%) were diagnosed as having CRAs. Exposure to ETS was found to be associated with CRAs in all subjects (fully adjusted odds ratio [OR], 1.95; 95% confidence interval [CI], 1.08-2.44; P = 0.001). In the subgroup analysis, exposure to ETS in former smokers increased the risk for developing a CRA (fully adjusted OR, 4.44; 95% CI, 2.07-9.51; P < 0.001). CONCLUSION: Exposure to occupational ETS at the workplace, independent of the other factors, was associated with increased risk for developing a CRA in all subjects and in former smokers. Further retrospective studies with large sample sizes may be necessary to clarify the causal effect of this relationship.

Exposure to environmental tobacco smoke among non-smoker adult females in urban households of Aligarh, India.

Background: Environmental tobacco smoke is a serious global public health problem. A better understanding of the correlates of Environmental tobacco smoke exposure could guide the development of evidence based Environmental tobacco smoke exposure reduction interventions. The study is conducted with the objective to describe the pattern of and factors associated with Environmental tobacco smoke exposure among non-smoking adult females in urban areas of Aligarh, Uttar Pradesh, India. Methods: A total of 439 households were selected by systematic random sampling. One non-smoker adult female was selected randomly from each household. Her exposure to Environmental tobacco smoke was recorded along with socio-demographic characteristic as age, education, occupation, type of family, socio-economic status using a semi-structured questionnaire based on Global Adult Tobacco Survey methodology. Her knowledge regarding harmful effects of Environmental tobacco smoke was also enquired. Data analysis was done using Chi Square test. Results: Environmental tobacco smoke exposure rate at home among the participants was 33.5%. Females with lower levels of education and lower socio-economic status had higher exposure to Environmental tobacco smoke than their counterparts with the difference being statistically significant. Only 59.2% of the participants considered exposure to Environmental tobacco smoke to be harmful to health with the knowledge being significantly poor in those who were not exposed to Environmental tobacco smoke and had lower levels of education and socio-economic status. Conclusion: The findings suggest the need for comprehensive tobacco control measures that would improve public understanding about health hazards of Environmental tobacco smoke exposure at home and encourage educational initiatives to promote smoke-free homes.

Environmental Tobacco Smoke And Its Association With Asthma Like Symptoms Among Malaysianchildren Under 6 Years Old

Children less than 6 years old are the most vulnerable group to get harm from Environmental Tobacco Smoke (ETS) exposure, especially their respiratory system. To determine the prevalence of ETS exposure and its association with asthma like symptoms among children less than 6 years old. A cross sectional study was conducted in between January till April 2014 among parents with children less than 6 years old in Selangor, Malaysia. A total of 142 parents were selected by simple random sampling and data were collected using guided questionnaire on ETS exposure and asthma like symptoms (cough and wheeze) among their children. A total of 52.8% of children found to be exposed to ETS, and 43.7% were exposed from their father. ETS exposure significantly associated with cough without cold (adjusted OR=5.46, 95% CI 2.37, 12.61), dry cough at night (adjusted OR=3.74, 95%CI 1.41, 9.95) and cough upon physical activity (adjusted OR=3.08, 95% 1.07, 8.89) among these children. Children less than 6 years old are vulnerable to respiratory problem due to ETS exposure especially on cough symptoms. More strategies should be developing to reduce the exposure to ETS.

Cotinina urinaria en embarazadas expuestas al humo ambiental del tabaco que concurren a controles prenatales en la ciudad de Gualeguaychú / Urinary cotinine values and exposure to environmental snuff in pregnant women who attend prenatal examinations in the city of Gualeguaychú

El tabaco es uno de los factores de riesgo prevenibles más importante de las enfermedades crónicas no trasmisibles (ECNT). Los efectos de fumar no están limitados a los fumadores activos, involucran además a los individuos que sufren los efectos de los tóxicos del humo del tabaco ambiental (HTA): los fumadores pasivos. Las mujeres embarazadas fumadoras activas o expuestas al HTA son una población muy sensible a los efectos tóxicos del tabaco, ya que los mismos repercuten también sobre el feto en formación. La cotinina es en la actualidad el marcador biológico más adecuado para medir exposición al HTA tanto activa como pasiva. Objetivo: determinar el nivel de cotinina en mujeres embarazadas que manifestaron ser fumadoras pasivas, relacionando los valores obtenidos con los días de exposición manifestados. Materiales y métodos: se trabajó con 443 embarazadas que concurrieron a centros de salud públicos y a un centro privado de Gualeguaychú para su control prenatal, solicitándoles a las que manifestaron estar expuestas al HTA una muestra de orina para el dosaje de cotinina. Se aplicó un diseño de tipo no experimental, retrospectivo y de corte transversal. El dosaje de cotinina se realizó en orina, empleando una metodología quimioluminiscente. Previamente se obtuvo un valor referencial de cotinina urinaria inferior a los 15,2 ng/ml para el 98 % de sujetos no fumadores no expuestos al HTA. Resultados: los análisis de los niveles de cotinina en las embarazadas fumadoras pasivas revelaron que, el 82 % en los centros públicos y el 42 % en el centro privado, presentaron un nivel de cotinina superior a 15,2 ng/ml. Teniendo en cuenta los días de exposición, el registro promedio de cotinina para las que manifestaron estar expuestas los últimos siete días fue de 52,3 ng/ml en el sector público y 64,1 ng/ml en el privado. Discusión y conclusiones: la medición de cotinina resulta de utilidad para tener datos fidedignos de la exposición pasiva al HTA. En los centros públicos el 82 % de las embarazadas que manifestaron estar expuestas tenían valores de cotinina urinaria que coincidían con lo expresado, mientras que en el centro privado el 42 % de las que manifestaron la misma situación presentaba valores del indicador que denotaban exposición al tabaco. Se observó un aumento progresivo del promedio del indicador biológico de acuerdo a los días de exposición en ambos sectores, superando los 50ng/ml cuando la exposición declarada fue durante los últimos 7 días, lo que es indicativo de una exposición al HTA severa. El interés y preocupación manifestados por las embarazadas que participaron en este estudio indica que la implementación de este tipo de diagnóstico puede contribuir a las campañas de prevención contra el consumo de tabaco y promover el derecho de quienes no fuman a vivir en ambientes saludables libres de los compuestos tóxicos del mismo.

Tobacco is one of the preventable risk factors, which is most important in the chronic non-communicable diseases (NCDs). The effects of smoking are not limited to active smokers; it also involves individuals who suffer the effects of environmental tobacco smoke (ETS): passive smokers. Pregnant women who are active smokers or exposed to ETS are a very sensitive population to the toxic effects of snuff, since they also affect the developing fetus. Cotinine is currently the most suitable biomarker for measuring ETS exposure both active and passive. Objective: To determine the level of cotinine in pregnant women who reported being passive smokers, relating the values obtained with the indicated days of exposure. Materials and methods: We worked with 443 pregnant women attending public health centers and a private centre in Gualeguaychú for prenatal care, asking to be exposed to ETS showed a urine sample for cotinine dosage. We performed a non-experimental, retrospective and cross-sectional design. The dosage of cotinine in urine was performed using a chemiluminescent method. Previously we obtained a reference value of urinary cotinine less than 15,2ng/ml for 98% of non smokers unexposed to ETS. Results: The analysis of cotinine levels in passive smoking pregnant women show tHTA in public centers, 82% has a cotinine level greater than 15,2ng/embaml, whereas in the private centre, 42% have the same range values. Considering the days of exposure, the average cotinine log for those who said were exposed for the past seven days, was 52.32 ng/ml in the public sector and 64.17 ng/ml in the private one. Discussion and conclusion: The measurement of cotinine is useful to have reliable data from passive exposure to ETS. In public centers, 82% of pregnant women who said were exposed had urinary cotinine levels consistent with the statement, while in the private centre the 42% who said had the same situation had indicator values denoting exposure to snuff. There was a progressive increase in average biological indicator according to the days of exposure in both sectors, exceeding 50ng/ml when the declared exposure was during the last 7 days, which is indicative of a severe ETS exposure. The interest and concern expressed by the pregnant women who participated in this study indicates HTA the implementation of this kind of diagnosis may contribute to prevention campaigns against snuff consumption and promote the right of nonsmokers to live in healthy environments free of the toxic compounds thereof.

The Effect of Second-Hand Smoke Exposure during Pregnancy on the Newborn Weight in Malaysia

Background: There was strong evidence from studies conducted in developed countries that second-hand smoke (SHS) exposure is detrimental to the birth weight of newborn. This study was conducted to determine the effect of exposure to SHS smoke during pregnancy on the weight of newborns. Methods: A retrospective cohort study was conducted. The exposed group consists of 209 postnatal women who experienced SHS exposure at home because of a husband or other housemate who smoked inside the house throughout the pregnancy. The non-exposed group included 211 women who did not experience SHS exposure at home or at work during pregnancy. We excluded non-Malay ethnicity, multiple births, and congenital defects. Results: There was a significant difference in the adjusted mean birth weight between exposed infants [2893.0 g (95% confidence interval (CI): 2781.3, 3004.7)] and not exposed infants to SHS [3046.1 g (95% CI 2929.5, 3162.6) (P < 0.001)] after controlling for significant maternal factors. There was a 12.9 g (95% CI: 7.01, 18.96) reduction in birth weight for a corresponding increase in the exposure to the smoke of one cigarette (P < 0.001). The incidence of low birth weight (LBW) was higher in exposed women, [10% (95% CI: 5.94, 14.06)] compared to non-exposed women [4.7% (95% CI: 1.85, 7.55)]. Conclusions: This study found a significant association between SHS exposure during pregnancy and decreased birth weight.

Avaliação do desenvolvimento do sistema nervoso central de camundongos Balb/c expostos à fumaça do cigarro no início do período pós-natal / Evaluation of the brain development in BALB/c mice exposed to environmental tobacco smoke in the early postnatal period

Diversos estudos relatam os efeitos da exposição à nicotina nos períodos pré e pós-natal, contudo, pouco se sabe a respeito dos efeitos da fumaça do cigarro na cascata de eventos que caracteriza o desenvolvimento do sistema nervoso central (SNC). Neste contexto, o objetivo deste trabalho foi esclarecer se a exposição à fumaça do cigarro no início do período pós-natal induz prejuízo ao desenvolvimento do SNC na infância, e as possíveis consequências na adolescência e na fase adulta. Camundongos BALB/c foram expostos a uma mistura de fumaça central e lateral do cigarro referência 3R4F (Universidade de Kentucky, EUA), desde o 3° dia de vida pós-natal (P) até P14 por duas horas diárias. Nossos resultados indicam que a exposição à fumaça do cigarro no início do período pós-natal induz prejuízo ao processo de aprendizado e memória e aumento na ansiedade em todas as idades avaliadas, além de induzir diminuição da atividade locomotora na infância e na adolescência. Ainda, observamos diminuição dos níveis de BDNF e das proteínas sinápticas sinapsina e sinaptofisina no hipocampo, cerebelo, córtex pré-frontal e estriado. A fumaça do cigarro também induz diminuição na porcentagem de fibras mielinizadas no nervo óptico e aumento da proteína básica de mielina (PBM) no cerebelo na infância, além de diminuição da PBM no telencéfalo e tronco encefálico na adolescência e no cerebelo na fase adulta. Nossos resultados sugerem que a exposição à fumaça do cigarro no início do período pós-natal causa prejuízo ao desenvolvimento do SNC, sendo que não há reversão dos efeitos observados no aprendizado e memória ou mesmo nos níveis de proteína pré-sináptica na adolescência e na fase adulta

Several studies show the effects of nicotine exposure during pre- and postnatal period. However, little is known about the effects of environmental tobacco smoke (ETS) in the cascade of events that characterizes the brain development. Thus, the aim of this study was to evaluate the effects of ETS in early brain development. BALB/c mice were exposed to a mixture of mainstream and sidestream of tobacco smoke of reference cigarettes 3R4F (University of Kentucky, EUA) from the 3rd (P3) to the 14th (P14) day of life, during 2h/day. Our results showed that ETS induced impairment in learning and memory and increased anxiety in all the ages evaluated. In addition, there was a decrease in locomotor activity during childhood and adolescence. ETS also induced impairment in synaptic transmission, by a decrease in synapsin, synaptophysin and BDNF in hippocampus, cerebellum and prefrontal cortex as compared to the control group. The percentage of myelinated fibers in the optic nerve in childhood and in myelin basic protein (MBP) in the telencephalon and brainstem were lower in adolescents mice exposed to ETS when compared to the control group. In cerebellum, there was an increase in MBP in infants and a decrease in adults compared to the control group. Taken all together, our results suggest that the exposure to ETS in the early postnatal period induces impairment to the brain development. It is noteworthy that the effects on learning and memory or even in the presynaptic protein levels were not reversed in adolescence and adulthood

Environmental risk factors related to the development of canine non-Hodgkin's lymphoma / Fatores de risco ambientais relacionados ao desenvolvimento do linfoma não Hodgkin canino

This research aimed to investigate the possible risk factors associated with the development of canine non-Hodgkin's lymphoma. Owners of 83 dogs with non-Hodgkin's lymphoma and of 84 healthy dogs answered an epidemiological questionnaire. Dogs who lived outside of the house and within 100 meters of busy streets or avenues (defined as more than 50 vehicles per minute) had a higher risk for developing the disease (OR: 3.1, 95% CI: 1.4-6.9, P=0.005). These results suggest that air pollution derived from vehicle traffic may be associated with the development of canine non-Hodgkin's lymphoma.

Este trabalho teve como objetivo investigar os possíveis fatores de risco ambientais, associados com o desenvolvimento de linfoma não-Hodgkin nos cães. Um questionário epidemiológico foi aplicado aos proprietários de 83 cães com linfoma não-Hodgkin e 84 proprietários de cães saudáveis. Os cães que viviam permanentemente no lado de fora da casa e em torno de 100 metros de ruas movimentadas ou avenidas (mais de 50 veículos por minuto) tiveram um maior risco de desenvolvimento da doença (OR: 3,1, IC 95%: 1,4-6,9, P=0,005). Esses resultados sugerem que a poluição do ar oriunda do tráfego veicular pode estar associada com o desenvolvimento de linfomas não-Hodgkin canino.

Impacto do tabagismo parental sobre a asma infantil / Impact of parental smoking on childhood asthma

OBJETIVO: Avaliar a exposição da população infantil à FCA em nossa comunidade e sua relação com os sintomas de asma. MÉTODOS: Foi realizado um estudo transversal usando o questionário de estudo ISAAC em crianças e adolescentes da nossa comunidade. Pelo questionário, fez-se a definição por "já ocorreu sibilância", "asma atual", "asma grave" e "asma induzida pelo exercício". O tabagismo parental foi classificado em quatro categorias mutuamente excludentes: 1) nenhum dos pais fuma; 2) somente a mãe fuma; 3) somente o pai fuma; e 4) ambos os pais fumam. Calculou-se a odds ratio da prevalência de sintomas de asma, de acordo com a exposição à FCA, usando regressão logística. RESULTADOS: Foram incluídas, no total, 10.314 crianças e 10.453 adolescentes. Mais de 51% das crianças e adolescentes foram expostos à FCA em casa. A FCA se associa a uma prevalência mais alta de sintomas de asma, particularmente se a mãe ou ambos os pais fumam. CONCLUSÕES: A prevalência da FCA continua a ser alta em nossa comunidade, embora com uma tendência para diminuição nos últimos 15 anos. A FCA se associa a uma prevalência mais alta de asma.

OBJETIVE: To evaluate the exposure to environmental tobacco smoke (ETS) of the childhood population in this community and its relationship with asthma symptoms. METHODS: A cross-sectional study was conducted using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire on children and adolescents in this community. The symptoms "wheezing ever", "current asthma", "severe asthma", and "exercise-induced asthma" were defined by this questionnaire. Parental smoking was classified into four mutually exclusive categories: 1) no parent smokes; 2) only the mother smokes; 3) only the father smokes; and 4) both parents smoke. The odds ratio of the prevalence of asthma symptoms according to ETS exposure was calculated using logistic regression. RESULTS: A total of 10,314 children and 10,453 adolescents were included. Over 51% of the children and adolescents were exposed to ETS at home. ETS is associated with a higher prevalence of asthma symptoms, particularly if the mother or both parents smoke. CONCLUSION: The prevalence of ETS is still high in this community, although there has been a decreasing tendency in the last 15 years. ETS is associated with higher prevalence of asthma.

Residential Environmental Tobacco Smoke Exposure During Pregnancy and Low Birth Weight of Neonates: Case Control Study in a Public Hospital in Lucknow, India.

Objective: To determine whether residential environmental tobacco smoke (ETS) exposure during pregnancy is associated with low birth weight (LBW) neonates and establish a dose response relationship. Design: Case control study. Setting: Tertiary care hospital. Methodology: Mothers giving birth to LBW neonate (<2.5 kg) were cases and those whose neonates weighed ≥2.5 kg at birth were controls. Excluded were women smokers and tobacco chewers, high parity (>3), multiple pregnancy and still births. Included were 100 cases and 200 controls, aged 20 to 30 years. Information was collected on ETS exposure and other risk factors of LBW within 24 hours of delivery. Clinical information like maternal haemoglobin levels, birth weight and gestational age of the neonate was extracted from hospital records. R E S E A R C H P A P E R Results: On univariate analysis, preterm pregnancy, low socioeconomic status, previous LBW neonate, no utilization of antenatal care (ANC), severe anemia and ETS exposure were statistically significantly associated with LBW neonate and controlling for these in logistic regression analysis, adjusted Odds ratio for ETS exposure association with LBW neonate was 3.16 (95% CI=1.88-5.28). A dose response relationship was also found which was statistically significant (10-20 cigarettes smoked/day: OR = 4.06, 95% CI=1.78-9.26 and >20 cigarettes smoked/day, OR = 17.62, 95% CI= 3.76-82.43). Conclusion: Exposure to ETS during pregnancy is associated with LBW of neonates. Hence, there is an urgent need to increase awareness about health hazards of ETS during pregnancy and bring about behavioural changes accordingly as a one of the strategies to reduce LBW deliveries in India.

Changes in knowledge and behavior related to tobacco consumption among urban population before and after the enforcement of the Smoke Control Ordinance in Public Places of Hangzhou in 2010 / 中华流行病学杂志

Objective To examine the changes in tobacco related knowledge,smoking habit and the amount if environmental tobacco smoke (ETS) among urban population before and after the enforcement of the Smoke Control Ordinance in Public Places of Hangzhou in March 2010.Methods Two independent cross-sectional surveys were conducted on random samples from adults aged 18-64 years in three districts of Hangzhou city between two petiods:October 2008 to August 2009 and June 2011 to February 2012.Results A total of 2016 adults at the initial stage and 2016adults during the follow-up program completed the survey.Nine out of the ten indices related to the knowledge on tobacco presented an improvement during the follow-up process.All the participants (22.4％ vs.17.7％,P＜0.001) and men (44.2％ vs.37.3％,P=0.004) showed statistically significant declines in the prevalence of smoking,when compared with women (1.7％ vs.1.2％,P=0.379).The proportions of individuals who had noticed anyone smoking in the previous 30 days demonstrated statistically significant declines in nine types of places:school (5.6％ vs.2.7％,P＜0.001),health centre (11.4％ vs.3.7％, P＜0.001),public transportation (19.2％ vs.12.2％,P＜0.001),government building (11.3％ vs.5.6％,P＜ 0.001),restaurant (67.0％ vs.61.3％,P=0.002),workplace (49.7％ vs.38.3％,P＜0.001),private office building (23.6％ vs.19.9％,P=0.023),home (41.0％ vs.35.5％,P=0.003),friend's home (33.9％ vs.29.5％,P=0.017).Conclusion Positive changes were noticed among urban population with respect to tobacco related knowledge,prevalence of smoking,and the environmental tobacco smoke (ETS) after the enforcement of the Smoke Control Ordinance in Public Places of Hangzhou.

A study of the prevalence, pattern and health effects of passive smoking in a slum area of Ahmedabad city.

Background: According to WHO, Passive smoking/ Environmental tobacco smoke (ETS) carries serious risk especially for children & those chronically exposed. Objectives: To know the pattern of smoking, proportion of household passive smokers, subjective and health effects amongst passive smokers. Methods: The present study is a cross sectional study carried out in Shankar Bhuvan na Chhapara slum area of the Ahmedabad by using a pre-designed and pre-tested proforma. A house to house survey was carried out to collect the information as per the format. Those households which were having at least one active tobacco smoker in any form, were included in study and all members of such households were surveyed.Results: Total 118 houses out of 250 total houses had at least one smoker in them and were covered in the survey. Total population surveyed was 683 out of which 131 were smokers and 552 were non-smokers. The ratio of active versus passive smokers in the survey population was 1: 4.21. The mean age of smokers was 45.24+12.97 years whereas mean age of passive smokers was 20.13+14.44 years. The mean active smokers per family were 1.11 and passive smokers per family were 4.72. Firewood and kerosene were the most common fuels and majority of houses had no separate cooking area. Bidi was most commonly smoked stuff. Majority were chronic smokers and smoking on average 20.16+14.28 items per day. Amongst the subjective feelings unpleasant smell was present in 74% of respondents on acute exposure to tobacco smoke and coughing was the most common immediate symptom experienced by the passive smokers. Sixty nine percent children of less than 5 years of age had history of repeated Acute Respiratory Tract Infections as per mothers. Conclusions: Women and children are the victims of the exposure to ETS and indoor air pollution due to use of Bio-mass fuel and substandard housing add to this problem. Over and above that the immediate adverse subjective feelings amongst passive smokers are un-noticed and not given importance. All these are bared by the passive smokers constantly multiple times a day and may affect their mental health. The damage to physical health is a well known fact.

Humo ambiental de tabaco y afecciones respiratorias en niños preescolares / Environmental tobacco smoke and respiratory diseases in preschool children

Objetivo: determinar la relación entre el humo ambiental de tabaco y las afecciones respiratorias en preescolares. Material y métodos: estudio cuantitativo- correlacional de diseño transversal; la muestra estuvo constituida por 107 niños conforme criterios de inclusión: niños en cuyas viviendas fumen, aceptación voluntaria de los padres, niños que asisten regularmente a la escuela. Para recolectar datos se utilizó dos cuestionarios, el primero identificó los hábitos de consumo de tabaco en los miembros de la familia, y el segundo cuestionario abordó el tema de afecciones respiratorias en niños, ambas fueron aplicadas a través de la entrevista; además, se usaron las tiras reactivas de cotinina en la orina del niño. Para el procesamiento y análisis de datos se utilizó el programa Excel y el programa estadístico Epiinfo. Resultados: el 42% de niños estuvieron expuestos al humo ambiental de tabaco en el hogar o entorno social. Del totalde niños expuestos, el 60% presentó alguna afección respiratoria arrojando un OR: 1,32 en la investigación. Conclusiones: la mayoría de preescolares expuestos al humo ambiental de tabaco tienen resultados positivos de cotinina en orina, así como afecciones respiratorias.

Objetive: Determine the relationship between environmental smoke snuff and respiratory diseases in preschool children. Material and Methods: A quantitative study of cross-sectional and correlational, the sample consisted of 107 children under inclusion criteria: children whose homes smoke, voluntary acceptance of parents, children attending school regularly. To collect data, we used two questionnaires, the first identified snuff consumption habits in the family members, and the second questionnaire addressed the issue of respiratory disease in children, both were applied through the interview also were used cotinine test strips in urine of children. For processing and analysis program was used Excel and EpiInfo statistical program. Results: 42% of children were exposed to environmental smoke at home or snuff social environment. Of the children exposed, 60% had some respiratory condition yielding an OR: 1,32 in the investigation. Conclusions. Most preschoolers exposed to environmental smoke snuff have positive results of cotinine in urine andrespiratory conditions.

The need for gender specific tobacco control strategies: KAP survey findings on environmental tobacco smoke exposure among women in the reproductive age group / Necesidad de estrategias de control del tabaco específicas por género hallazgos de la encuesta CAP acerca de la exposición al humo del tabaco ambiental entre mujeres en el grupo de edad reproductiva

OBJECTIVE: The study was done to assess knowledge, attitudes and practices of women within the child bearing age with regard to smoking and exposure to environmental tobacco smoke (ETS) on children's health. SUBJECTS AND METHODS: A cross-sectional study with quantitative and qualitative components was designed to collect data from women in the child-bearing age. The sample comprised of persons from the two largest combined family planning and antenatal clinics in Kingston, Jamaica. RESULTS: The women surveyed had a fair level of knowledge about ETS health risks, negative attitudes to smoking in general, and most supported a ban on smoking in public places. Significant knowledge differences existed between young and older women and between smokers and non-smokers. CONCLUSION: Women with the highest level of knowledge were the non-smokers: of the low knowledge score group (current smokers), 50% were in the 15-24-year age range. There is a need for more public education on smoking and the consequences ofenvironmental tobacco smoke exposure on children s health.

OBJETIVO: El estudio fue realizado para evaluar los conocimientos, actitudes y prácticas de las mujeres en edad de procrear, en relación con el hábito de fumar y la exposición al humo de tabaco ambiental (HTA) sobre la salud de los niños. SUJETOS Y MÉTODOS: Se diseñó un estudio transversal con componentes cuantitativos y cualitativos con el propósito de recopilar datos de las mujeres en edad fértil. La muestra abarcó personas de las dos clínicas más grandes en Kingston, que combinan la atención prenatal con la planificación familiar. RESULTADOS: Las mujeres encuestadas tenían un nivel razonable de conocimientos acerca de los riesgos del HTA para la salud, actitudes negativas hacia el hábito de fumar en general, y la mayoría apoyaban la prohibición de fumar en lugares públicos. Se hallaron diferencias significativas en el conocimiento existente entre las mujeres jóvenes y mayores, así como entre las fumadoras y no fumadoras. CONCLUSIÓN: Las mujeres con el más alto nivel de conocimientos fueron las no fumadoras. Del grupo de bajo puntaje de conocimiento (actuales fumadoras), el 50% estaban en el rango de edad de 15-24 años. Existe una necesidad de mayor educación pública acerca del hábito de fumar y las consecuencias de la exposición al humo de tabaco ambiental sobre la salud de los niños.

The influence of experimental tobacco smoke exposure on brain neurotransmitters in mice / 中华行为医学与脑科学杂志

Objective To explore the mechanism of the influence on mice brain of environmental tobacco smoke. Methods After the mice were placed into the bench for 8 weeks, the region of the mice brain was localized and the expression of neurotransmitters and neurotransmitters receptors were detected by immunohistochernistry.Results ( 1 ) The expression of GABA in the mice cerebral cortex ( CC ) ( 0. 25 ± 0. 06 ) and the hippocampus (Hip) (0. 19 ± 0. 07 ) were much higher in the ETS-exposed group than that in the control group(P＜ 0. 05 ). (2)The expression of nAChR on CC(0. 31 ±0. 10) was much more in the ETS-exposed group than that in control group(P＜0.05). (3) The expression of NMDAR( Glu receptors) on the CC and striate cortex were much higher in the ETS-exposed group(0.32 ±0. 10,0.38 ±0. 14), NIC-inhaling group(0.31 ±0. 08,0.31 ± 0. 11 ) than that in control group(P＜0. 05 ). Conclusions Long-term ETS-exposed and NiC-exposed environment could change the expression of neurotransmitter and its receptors.

Humo ambiental de tabaco en el hogar y percepción de riesgo en la población cubana / Environmental tobacco smoke at home and the risk perception in Cuban population

El tabaquismo constituye uno de los mayores retos de la Salud Pública cubana de hoy. OBJETIVOS: Identificar las características de la prevalencia de exposición al humo ambiental de tabaco en el hogar y describir la percepción del riesgo de exposición en grupos seleccionados. MÉTODOS: Estudio transversal, que incluyó la población urbana de Cuba (≥15 años), basado en la II Encuesta Nacional de Factores de Riesgo y Afecciones crónicas no trasmisibles (año 2001). Universo de estudio: población no fumadora del área urbana del país. Diseño muestral complejo estratificado y por conglomerados polietápicos. Se exploraron variables sociodemográficas relacionadas con la exposición al humo ambiental de tabaco y la percepción del riesgo. RESULTADOS: En el hogar 54 por ciento (IC: 95 por ciento 52,3-57,0) de las familias estaba expuesta, con predominio de las mujeres (razón mujer/hombre 1.2). Estaban expuestos 4 de cada 10 no fumadores y mujeres en edad fértil; 5 de cada 10 embarazadas y menores de 15 años, así como 60 por ciento de los adolescentes de 15 a 19 años. La percepción del riesgo fue inadecuada en 2 de cada 10 encuestados en los grupos seleccionados. Es el primer estudio que a escala de país identificó los niveles de exposición al humo ambiental de tabaco en diferentes grupos de población y la percepción del riesgo. CONCLUSIONES: Los niveles de exposición al humo ambiental de tabaco y la inadecuada percepción de este riesgo, denotan una insuficiente conducta de autoprotección, de responsabilidad con la salud de otros y un insuficiente conocimiento del problema y sus consecuencias, que podría comprometer los futuros resultados de la salud pública cubana.

Smoking is one of the major current challenges of Cuban public health. OBJECTIVE: To identify the prevalent characteristics of the environmental tobacco smoke exposition at home and to describe the risk exposition in selected groups. Methods: Present paper is a cross-sectional study including the urban Cuban population (=15 years) based on the II National Survey on Risk Factors and chronic non-communicable affections (2001 year). Study universe: Non-smoker population from urban area of the country. Complex stratified sample design and by multistage combination. The sociodemographic variables were explored which were related to environmental tobacco smoke and the risk perception. RESULTS: At home, the 54 percent (95 percent CI 52.3-57.0) of families was exposed with a female predominance (women/man 1.2 ratio). Also, 4 of each 10 non-smokers were exposed and the women in fertile age; 5 of each 10 pregnant and those aged under 15 years as well as the 60 percent of adolescents aged 15 to 19. Risk perception was inappropriate in 2 of each 10 person polled in the selected groups. This is the first study that at national scale identified the levels of environmental tobacco smoke exposition in different groups of population and the risk perception. CONCLUSIONS: Te levels of environmental tobacco smoke exposition and the inappropriate risk perception indicate an insufficient behavior of self-protection, the responsibility to the health of other persons and a scarce knowledge of the problem and its consequences that could to compromise the future results of the Cuban public health.

Percepción sobre políticas de espacios libres de humo de tabaco en bares y restaurantes del centro de México / Perception over smoke-free policies amongst bar and restaurant representatives in central Mexico

Objetivo. Analizar las percepciones y apreciaciones sobre espacios libres de humo de tabaco de los responsables de bares y restaurantes en cuatro ciudades del centro de México. Material y métodos. Se encuestó a los administradores de 219 bares y restaurantes de la Ciudad de México, Colima, Cuernavaca y Toluca, acerca de opiniones e implementación de espacios libres de humo. Simultáneamente, se monitorearon concentraciones de nicotina ambiental. Resultados. La mayoría de los encuestados consideró que los espacios públicos deben ser libres de humo, más de la mitad refirió preocupación por pérdidas económicas. La implementación de espacios libres de humo fue más frecuente en la Ciudad de México (85.4 por ciento) que en las demás ciudades (15.3 por ciento global), lo que se refleja en menores concentraciones de nicotina ambiental. Conclusión. Los administradores reconocen la necesidad de crear espacios libres de humo. La preocupación sobre posibles efectos económicos negativos de la prohibición podría explicar, al menos parcialmente, el rechazo a la implementación de este tipo de políticas.

Objective. To analyze the perceptions and appreciations over smoke-free environments of restaurant and bar managers from four cities in central Mexico. Material and Methods. Managers from 219 restaurants and bars from Mexico City, Colima, Cuernavaca and Toluca were surveyed about smoke-free environments opinions and implementation. Simultaneously, environmental nicotine was monitored. Results. The majority of surveyed managers considered public places should be smoke-free, although more than half were concerned with potential economic loses. Implementation of smoke-free environments was more frequent in Mexico City (85.4 percent) than in the other cities (15.3 percent overall), with consequently lower environmental nicotine concentrations. Conclusion. Managers acknowledge the need to create smoke-free environments. Concerns over economic negative effects derived from the prohibition could explain, at least partially, the rejection of this sector towards the implementation of this type of policy.

Exposición a humo de tabaco ajeno en lugares públicos de la Ciudad de México, Guadalajara y Monterrey / Tobacco smoke exposure in public places in Mexico City, Guadalajara and Monterrey

Objetivo. Cuantificar la exposición al humo de tabaco ajeno (HTA) en lugares públicos de México, con el fin de impulsar políticas locales de ambientes 100 por ciento libres de humo de tabaco. Material y métodos. Se monitoreó aleatoriamente 20 por ciento de las áreas interiores de hospitales, escuelas y oficinas públicas de Monterrey, Guadalajara y la Ciudad de México. La concentración mediana de nicotina ambiental fue estimada por ciudad, tipo de espacio público y área interior. Resultados. La concentración mediana en los espacios donde se detectó nicotina fue de 0.06 µg/m3 (P25=0.03, P75=0.12 µg/m3), las mayores concentraciones se obtuvieron en la Ciudad de México y en las oficinas públicas. No se detectó nicotina en 75 por ciento de los espacios monitoreados. Conclusiones. El monitoreo ambiental de nicotina es una herramienta útil para fortalecer la implementación y evaluar el cumplimiento de la política de ambientes 100 por ciento libres de humo de tabaco.

Objective. To quantify environmental tobacco smoke exposure in public places in Mexico to promote policies of 100 percent smoke-free environments. Materials and Methods. In hospitals, schools and public offices of Monterrey, Guadalajara and Mexico City 20 percent of inner areas were monitored. Median nicotine concentrations were estimated by city, type of public space and type of inner area. Results. Median concentration in areas where nicotine was detected was 0.06 µg/m3 (P25=0.03, P75=0.12 µg/m3). Higher concentrations were found in Mexico City and in public offices. Nicotine was not detected in 75 percent of monitored areas. Conclusions. Monitoring environmental nicotine is a useful tool to evaluate compliance of public places with the smoke-free environments legislation, and could constitute an important source of information to strengthen implementation efforts.

Evaluación científico-técnica de la Ley General para el Control del Tabaco de México / Scientific and technical evaluation of Mexico’s General Law for Tobacco Control

La Ley General para el Control del Tabaco, aprobada en febrero de 2008, busca proteger a la población mexicana de los efectos nocivos del tabaco y asegurar el derecho de los no fumadores a vivir y convivir en espacios 100 por ciento libres de humo de tabaco. La Ley considera el desarrollo de espacios libres de humo, pero también posibilita la existencia de áreas interiores para fumar. El presente ensayo examina la Ley y su Reglamento, artículo por artículo, evaluando su capacidad para asegurar la protección a la salud de la población de los efectos del humo de tabaco ambiental. El análisis revela imprecisiones conceptuales y operativas importantes, pero principalmente, señala de manera puntual las razones por las que las áreas interiores para fumar representan un riesgo a la salud de la población. Se concluye que la Ley debe ser reformada, eliminando la provisión de áreas interiores para fumar, de cualquier estructura cubierta en las áreas para fumar al aire libre y definiendo la distancia mínima entre estas áreas y las áreas 100 por ciento libres de humo de tabaco.

The General Law for Tobacco Control, signed in February 2008, aims to protect the Mexican population against the negative effects associated with tobacco consumption and to guarantee the non-smoker's rights to live and relate in 100 percent smoke-free environments. The Law supports the development of smoke-free areas, but it also allows for indoor smoking areas. The present essay examines the Law and its Rule of Procedure, article by article, evaluating its capability to assure the protection of the population against the effects of environmental tobacco smoke. The analysis reveals conceptual and operative important imprecision, but mainly, discusses in detail the reasons why indoor smoking areas represent a health risk for the population. It concludes that the Law must be reformed, eliminating the provision of indoor smoking areas, any kind of roof in outdoor smoking areas and establising a minimum distance between these areas and the 100 percent smoke-free environments.