Associations of exposure to secondhand smoke with hypertension risk and blood pressure values in adults

BACKGROUND@#The effects of environmental chemical exposure on blood pressure (BP) have been confirmed, but the association between exposure to secondhand smoke (SHS) and hypertension risk and BP in the general population remains unknown.@*METHODS@#Cross-sectional associations between SHS exposure and hypertension risk and BP values were evaluated using data for subjects who participated in the National Health and Nutrition Examination Survey (NHANES), 1999-2016. Logistic regression and linear regression were performed after adjusting for age, sex, race, alcohol consumption, poverty-to-income ratio (PIR), body mass index (BMI), estimated glomerular filtration rate, physical activity, diabetes, cardiovascular disease, and NHANES cycle. Restricted cubic spline models were created to display the potential nonlinear association between SHS and BP levels.@*RESULTS@#Higher risk of hypertension was found at the highest SHS concentrations (OR = 1.13, 95% CI 1.04, 1.24, P for trend = 0.007). Additionally, SHS exposure had a strong positive association with systolic blood pressure (SBP) but was negatively associated with diastolic blood pressure (DBP). Furthermore, the nonlinear model result showed a significant association between SHS and SBP (P = 0.017); however, the nonlinear model result was not significant for SHS or DBP.@*CONCLUSIONS@#Our results suggest a potential association between high SHS exposure and the risk of hypertension. Further research is needed to elucidate the underlying mechanisms.

Burden of Disease Due to Secondhand Smoke among Korean Adults at Sub-National Level

BACKGROUND: Exposure to secondhand smoke (SHS) is one of the biggest health hazards. Quantifying the related burden of disease (BOD) is a powerful tool for making evidence-based policies. This study calculated the BOD due to SHS at sub-national level using the most recent statistics of Korea. METHODS: SHS related diseases were selected by the systematic review of previous studies. Population attributable fraction (PAF) was calculated by using the standard formula using prevalence of exposure derived from Community Health Survey (CHS) 2013. SHS burden was calculated by multiplying nonsmoker's disability adjusted life years (DALYs) with PAF of SHS. RESULTS: SHS burden at sub-national level ranged between 460 DALYs in Cheonan to 5 DALYs in Pyeongtaek, Songtan region. Median of DALY was highest in districts of metropolitan cities and lowest in small towns and rural areas. Twelve out of fifteen regions with highest DALY per 1,000 were small towns and rural areas. Gender and age standardized DALY was highest in Seogwipo (west) in Jeju-do (1.66/1,000) and lowest in Dong-gu, Ulsan (0.17/1,000). CONCLUSION: There were substantial variations between regions according to BOD. Regional governments should implement policies according to specific situation in each region and regular monitoring should be done by calculating BOD. Big cities need to focus more on control of active and SHS prevalence. Resources in small towns and rural areas need to be allocated more towards implementation of screening programs, early diagnosis and treatment of diseases especially in the elderly population.

Assertive Behavior in Asking Smokers Not to Smoke among Patients with Vascular Diseases

PURPOSE: The purpose of this study was to identify the assertive behavior of asking smokers not to smoke and investigate the factors related to assertive behavior in patients with vascular diseases. METHODS: Participants were 203 adult Korean patients with vascular diseases such as cerebral infarction and myocardial infarction. Data were collected using questionnaires that included the characteristics of secondhand smoke (SHS), secondhand smoke-related variables (Health belief model factors, health promotion model factors) and level of assertive behavior. Descriptive statistics, t-test, ANOVA and multiple regression using SPSS/WIN 18.0 were performed. RESULTS: Participants who never ask smokers not to smoke was 39.9%, whereas participants who always ask was 7.4%. There was a weak positive relationship between assertive behavior and susceptibility to disease (r=.18), severity of disease (r=.19), benefit of assertive behavior to SHS exposure (r=.10), barrier of assertive behavior to SHS exposure (r=.24), and self-rated health (r=.21) respectively. There was a moderate positive relationship between assertive behavior and self-efficacy of assertive behavior to SHS exposure (r=.49). Health belief model factors explained 15.7% variance and health promotion model factors explained 27.0% of assertive behavior. CONCLUSION: The findings of this study suggest that self-efficacy of assertive behavior to SHS exposure is a very important factor. Therefore the development of a program to foster self-efficacy of assertive behavior regarding SHS exposure in patients with vascular diseases is needed.

Consequences of Incomplete Smoke-Free Legislation in the Republic of Korea: Results from Environmental and Biochemical Monitoring: Community Based Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: In some countries with high smoking prevalence, smoke-free legislation has only been implemented in specific public places, as opposed to a comprehensive ban on smoking in all public places. The purpose of this study was to provide valid data on second-hand smoke (SHS) exposure that reflect the consequences of incomplete smoke-free legislation, and provide a rationale for expanding this legislation. MATERIALS AND METHODS: Indoor and outdoor environmental exposure (fine particulate matter [PM2.5], air nicotine, and dust 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone [NNK]) was monitored in 35 public places where smoking is prohibited by law in Goyang, Republic of Korea. Biomarkers of SHS exposure (urinary cotinine, hair nicotine, and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol) were measured in 37 non-smoking employees. Geometric means and standard deviations were used in comparison of each measure. RESULTS: Considerable exposure of SHS was detected at all indoor monitoring sites (PM2.5, 95.5 mug/m3 in private educational institutions; air nicotine, 0.77 mug/m3 in large buildings; and dust NNK, 160.3 pg/mg in large buildings); environmental measures were higher in private or closed locations, such as restrooms. Outdoor measures of SHS exposure were lowest in nurseries and highest in government buildings. Biochemical measures revealed a pattern of SHS exposure by monitoring site, and were highest in private educational institutions. CONCLUSION: The evidence of SHS exposure in legislative smoke-free places in Korea suggests that incomplete smoke free legislation and lack of enforcement of it might not protect people from exposure to smoke. Therefore, active steps should be taken toward a comprehensive ban on smoking in all public places and its enforcement.