Auditory and visual reaction times among children of chronic smokers and non-smokers: A comparative study

Background: Tobacco consumption is the primary cause for cancers in men and women in India. Second hand smoking also has toxins in the similar concentration affecting children in particular leading to many health-related conditions including neurological disorders. The present study was done with the hypothesis that passive smoking in children causes delay in their reaction time when compared to the children of non-smokers which indicates cognition deficit. Aims and Objectives: The objectives of the study are as follows: (1) Comparison of the visual simple reaction time (VSRT) and visual choice reaction time (VCRT) among the children of chronic smokers and non-smokers and (2) to compare the auditory simple reaction time (ASRT) and auditory choice reaction time (ACRT) among the children of chronic smokers and non-smokers. Materials and Methods: This was a cross-sectional study. After obtaining necessary permission and consents, 30 children aged between 8 and 14 years with exposure to passive smoking as cases and 30 children of non-smoking parents as controls were included in the study. Audio-visual reaction timer was used. Results: Student’s “t” test was used for analysis. Mean value of VSRT showed 248.3 ms among controls and 277.7 ms in cases; VCRT among controls was 277.4 ms and 309.1 ms in cases (P < 0.05). Means of ASRT in controls was 213 ms and 250.4 in cases; ACRT in controls was 244 ms and among cases was 272.4 ms (P < 0.05). Conclusion: Significant delay in VSRT, VCRT, and ASRT was seen among the children exposed to tobacco smoke. ACRT also showed delayed response but not statistically significant.

Associação entre doenças respiratórias e fumo passivo domiciliar em crianças de 6 a 10 anos atendidas pela atenção primária em Araguaína/TO / Association between respiratory diseases and passive smoking at home in children from the age of 6 to 10 years old assisted by the primary healthcare in Araguaína, Tocantins / Asociación entre enfermedades respiratorias y tabaco pasivo en hogares con niños entre 6 y 10 años atendidos por atención primaria en Araguaína-TO

Introdução: O tabagismo é definido como a dependência física e psicológica de tabaco, e o fumo passivo consiste na inalação da fumaça de derivados do tabaco por não fumantes. As crianças são especialmente vulneráveis à exposição à fumaça do tabaco. Objetivo: Identificar a associação entre fumo passivo domiciliar e morbidade respiratória em pré-escolares de seis a dez anos, por meio de coleta de dados na Atenção Primária à Saúde em Araguaína/TO. Métodos: Estudo de perfil descritivo, com corte transversal de caráter quantitativo, conduzido em três unidades básicas de saúde. Foi determinada uma amostra de 72 entrevistados, selecionados de forma aleatória em meio às unidades básicas. Os resultados foram colhidos de questionários respondidos por familiares ou responsáveis das crianças. Resultados: O teste de Odds Ratio (OR) obteve o resultado de 3,06, com intervalo de confiança de 95% ­ IC95% 1,16 ­ 8,11 e p<0,05, revelando assim a existência de correlação entre o desenvolvimento de doenças respiratórias e o fumo passivo domiciliar em crianças de seis a dez anos. A prevalência do tabagismo passivo domiciliar foi de 44,4%, expondo à fumaça do cigarro as crianças, que manifestam sintomas como tosse seca, chiado no peito, respiração rápida, dor e secreção no ouvido. Conclusões: Foi comprovada a associação entre tabagismo passivo domiciliar e morbidade respiratória entre crianças de seis a dez anos. Não se obteve a conexão entre o tabagismo passivo e o aumento do número de internações por causa respiratória.

Introduction: smoking is defined as the physical and psychological dependence of tobacco, passive smoke consists of inhaling the smoke and tobacco derivatives by non-smokers. Children are especially vulnerable to exposure to tobacco smoke. Objective: identify the association between passive smoking at home and respiratory tract morbidity in pre-school children from the age of 6 to 10 years old, utilizing data gathering in Primary Healthcare units from Araguaína ­ TO. Methods: cross-sectional descriptive research with quantitative character conducted within three Basic Healthcare Units. A sample comprised of 72 interviewed subjects was determined, selected in random fashion at the healthcare units. Results: The Odds Ratio test obtained the result of OR 3.06, with 95%CI 1.16­8.11 and p<0.05, thus evidencing the existence of a correlation between the development of respiratory diseases and the secondhand smoke in children aged 6 to 10 years. The prevalence of passive smoking at home was 44,4%, exposing, this way, the children to cigarette smoke, leading to the manifestation of symptoms such as dry cough, wheezing, fast breathing, pain, and auricular secretions. Conclusions: the association between passive smoking at home and respiratory tract morbidity in children from the age of 6 to 10 years old was proved. No connection between passive smoking and the increase of respiratory tract-related hospitalizations was obtained.

Introducción: El tabaquismo se define como la dependencia física y psicológica al tabaco, el humo de segunda mano consiste en la inhalación del humo del tabaco por parte de los no fumadores. Los niños son especialmente vulnerables a la exposición al humo del tabaco. Objetivo: Identificar la asociación entre el humo de segunda mano en el hogar y la morbilidad respiratoria en niños preescolares de 6 a 10 años, a través de la recolección de datos en la Atención Primaria de Salud en Araguaína-TO. Métodos: estudio descriptivo de perfil, de corte transversal cuantitativo, realizado en tres unidades básicas de salud. Se determinó una muestra de 72 entrevistados, seleccionados aleatoriamente entre las unidades básicas. Resultados: la prueba de Odds Ratio obtuvo el resultado de OR 3.06, con IC95% 1,16­8,11 y p<0,05, evidenciando así la existencia de una correlación entre el desarrollo de enfermedades respiratorias y el humo de segunda mano en niños de 6 a 10 años. La prevalencia de tabaquismo pasivo en el hogar fue del 44,4%, exponiendo así a los niños al humo del cigarrillo, manifestando síntomas como tos seca, sibilancias, respiración acelerada, dolor y secreción en el oído. Conclusiones: se comprobó la asociación entre el tabaquismo pasivo en el hogar y la morbilidad respiratoria en niños de 6 a 10 años. No hubo relación entre el tabaquismo pasivo y el aumento del número de hospitalizaciones por causas respiratorias.

Impacto do uso de produtos de tabaco aquecido (HTP) na qualidade do ar em ambientes fechados / Impact of the use of heated tobacco products (HTP) on indoor air quality

Resumo Introdução: Os produtos de tabaco aquecido (HTP) têm ganhado popularidade nos últimos anos. No entanto, tem-se questionado sobre os danos que provocam na saúde, em especial aos impactos decorrentes da exposição a suas emissões. O objetivo deste estudo é avaliar o impacto do uso de HTPs em ambientes internos/fechados na qualidade do ar e/ou na saúde das pessoas expostas passivamente, por meio de uma revisão sistemática de estudos originais. Métodos: Realizou-se busca bibliográfica nas bases de dados Medical Literature Analysis and Retrieval Sistem (MEDLINE), Excerpta Medica Database (EMBASE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e SCOPUS. As etapas de seleção, extração dos dados e avaliação do risco de viés dos estudos foi realizada em dupla, de forma independente, e as divergências foram resolvidas por consenso. Resultados: Foram selecionados 21 estudos, incluídos nesta revisão. Os resultados indicam que os produtos de tabaco aquecido são fonte de poluição ambiental decorrente da emissão de material particulado. Conclusão: Os produtos de tabaco aquecido produzem emissões que podem expor as pessoas às substâncias tóxicas emitidas no ambiente fechado, assim como outros produtos de tabaco.

Abstract Introduction: Heated tobacco products (HTP) have gained popularity in recent years. However, questions have been raised about the damage they cause to health, especially the impacts resulting from exposure to their emissions. This study aims to evaluate the impact of the use of HTPs indoors on air quality and/or the health of passively exposed people, through a systematic review of original studies. Methods: A bibliographic search was carried out in the Medical Literature Analysis and Retrieval System (MEDLINE), Excerpta Medica Database (EMBASE), Latin American and Caribbean Health Sciences (LILACS) and SCOPUS databases. Results: 21 studies were selected and included in this review. The results indicate that heated tobacco products are a source of environmental pollution due to the emission of particulate matter. The stages of selection, data extraction and risk of bias assessment of the studies were performed in pairs, independently, and disagreements were resolved by consensus. Conclusion: Heated tobacco products produce emissions that can expose people to toxic substances emitted indoors, just like other tobacco products.

Association between secondhand smoke exposure in indoor public places and sleep deprivation in children / 中国学校卫生

Objective@#To examine the association between secondhand smoke (SHS) exposure in indoor public places and sleep deprivation, so as to provide a reference for strengthening the management of a smoking ban in public places and to promote better sleep in childhood.@*Methods@#Data were obtained from the second follow up survey of the Huantai Childhood Cardiovascular Health Cohort Study, which was conducted from November to December 2021. A total of 1 284 children aged 10-15 years old were included in the study. The participants were assigned to four groups (0, 1-2, 3-4 and ≥5 days) according to the frequency which they were exposed to SHS in indoor public places in the previous 7 days. Multiple linear regression was performed to examine the trend of children s sleep duration with the frequency of SHS exposure. Multivariate Logistic regression was carried out to determine the association between frequency of SHS and sleep deprivation.@*Results@#After adjusting for age, sex, grade, physical activity, intake of fruits/vegetables, intake of soft drinks, screen duration, body mass index (BMI) and blood pressure, the average sleep duration of children who were exposed to SHS for 0, 1-2, 3-4 and ≥5 days in the previous 7 days was 8.48, 8.41, 8.20 and 8.06 h/d , respectively, and the average sleep duration decreased with exposure frequency of SHS ( t=5.96, 5.89, 5.91, P < 0.01 ). The proportion of sleep deprivation among children who were exposed to SHS in public places for 0, 1-2, 3-4 and ≥5 days in the previous 7 days was 40.02%, 43.07%, 54.65% and 63.41%, respectively. Compared to children who were not exposed to SHS in indoor public places in the past 7 days, those exposed for 3-4 days ( OR=1.93, 95%CI =1.19-3.15) or ≥ 5 days ( OR=2.95, 95%CI = 1.76- 4.94) had a significantly increased risk of sleep deprivation ( P <0.05).@*Conclusion@#Children s sleep time decreases with increasing frequency of exposure to SHS, and children who are frequently exposed to SHS are more likely to experience insufficient sleep. Smoking ban management in public places should be strengthened to promote children s sleep health, especially indoor public places.

Association between secondhand smoke exposure in indoor public places and carotid intima media thickness in children and adolescents / 中国学校卫生

Objective@#To examine the association between secondhand smoke exposure (SHS) in indoor public places and carotid intima media thickness (cIMT) in children and adolescents, so as to provide guidance for the prevention of early abnormal vascular architecture.@*Methods@#The data were obtained from the second follow up of the Children Cardiovascular Health Cohort Study conducted from November to December 2021. A total of 1 297 children and adolescents for who completed data relating to sex, age, cIMT, physical examinations, questionnaires variables and blood biochemical indices, were included for analysis. Linear regression analysis was performed to examine trends in the levels of cIMT with exposure to SHS in indoor public places. Multiple linear regression analysis was carried out to assess the association between SHS exposure in indoor public places and cIMT after adjustment for potential covariates.@*Results@#During the previous 7 days, 407 (31.4%) children and adolescents were exposed to SHS in indoor public places for 1-2 days, 86 (6.6%) for 3-4 days, and 82 (6.3%) for ≥5 days. The levels of cIMT in youth increased on different models, with the duration of SHS exposure during the previous 7 days ( t=3.30, 3.05, 2.87, P <0.05). After adjusting for various covariates, the cIMT values of children and adolescents were[0 day:(551.5±29.3) μm, 1-2 days:(554.0±28.6) μm, 3-4 days:(557.0±27.7) μm, ≥5 days:(559.4±27.5) μm]. Compared to those who were not exposed to SHS in indoor public places during the previous 7 days, those exposed for ≥5 days had significantly higher cIMT levels ( β=7.91, 95%CI=1.47-14.34, P <0.05).@*Conclusion@#Among children and adolescents, exposure to SHS in indoor public places remains high and is significantly associated with cIMT. The findings highlight the need for stricter regulation and tobacco control policies to provide healthy smoke free environments for children and adolescents, and to reduce the risk of early abnormal vascular architecture.

Efectos de la exposición pasiva al aerosol de los cigarrillos electrónicos: una revisión de tema / Effects of passive exposure to aerosol from electronic cigarettes: a review

Resumen Los cigarrillos electrónicos sustituyeron el tabaco del cigarrillo convencional por un e-liquid compuesto por varios compuestos orgánicos; estos entraron al mercado sin mayores pruebas toxicológicas preclínicas o ensayos de seguridad a nivel mundial, generando un gran número de personas expuestas al aerosol de segunda mano, en quienes los posibles riesgos aún no han sido dilucidados. El objetivo de esta revisión es identificar los riesgos para la salud de personas expuestas al aerosol de segunda mano de cigarrillos electrónicos. La búsqueda bibliográfica realizó una revisión en las bases de datos PubMed, Scielo y EBSCO, incluyendo estudios realizados en humanos, animales e in vitro. Los principales hallazgos fueron exacerbaciones de asma, enfermedad pulmonar obstructiva crónica, efectos proinflamatorios, estrés oxidativo y ansiedad. La evidencia encontró efectos adversos en personas expuestas al aerosol de segunda mano del cigarrillo electrónico; se destacan exacerbaciones de asma, neumonitis por hipersensibilidad, inflamación y estrés oxidativo.

Abstract Electronic cigarettes replaced the tobacco leaf in conventional cigarettes with an e-liquid composed of multiple organic compounds; these entered the market without major preclinical toxicological tests or safety trials worldwide. Generating a large number of people exposed to second-hand aerosol, to whom the possible risks have not yet been elucidated. The objective of this review was to identify the health risks of people exposed to second-hand aerosol from electronic cigarettes. The review was carried out using PubMed, Scielo and EBSCO databases, including studies carried out in humans, animals and invitro. The main findings were exacerbations of asthma and chronic obstructive pulmonary disease, pro-inflammatory effects, oxidative stress and anxiety. Evidence found adverse effects in people exposed to second-hand aerosol from electronic cigarettes; highlighting exacerbations of asthma, hypersensitivity pneumonitis, inflammation and oxidative stress.

Passive smoking may be associated with bleeding of cerebral arteriovenous malformation in non-smoking women: a retrospective analysis / O tabagismo passivo pode estar associado com o sangramento de malformação arteriovenosa cerebral em mulheres não fumantes: uma análise retrospectiva

ABSTRACT Background Smoking has been considered to be a risk factor for cardiovascular disease, cancer, depression and other diseases in previous reports, and active smoking is considered to be a risk factor for hemorrhagic stroke. In addition, a retrospective study showed that male smokers were at increased risk of bleeding from arteriovenous malformation (AVM), compared with non-smokers. However, the effect of passive smoking on rupturing of cerebral AVM in non-smoking women has not been addressed. Objective This study aimed to assess the impact of tobacco exposure on AVM bleeding risk in non-smoking women. Methods A total of 393 non-smoking women diagnosed with AVM were included. They were divided into a bleeding group (205 women) and a non-bleeding group (188 women). We conducted univariate and multivariate analysis on these two groups. In univariate analysis, risk factors that might be related to AVM bleeding were analyzed. In multivariate analysis, the relationship between passive smoking and AVM rupture was analyzed by correcting confounding factors. Results Multivariate analysis showed that the proportion of passive smoking was statistically different between the bleeding group and the non-bleeding group (OR = 1.609; CI = 1.031-2.509; p = 0.036). Conclusion Passive smoking may increase the risk of AVM bleeding in non-smoking women. This increased risk may be related to the inflammatory response, vascular wall damage, hemodynamic disorders, changes in atherosclerosis and changes in gene expression caused by passive smoking.

RESUMO Antecedentes O tabagismo tem sido considerado fator de risco para doenças cardiovasculares, câncer, depressão e outras doenças em relatos anteriores, e o tabagismo ativo é considerado fator de risco para acidente vascular cerebral hemorrágico. Além disso, um estudo retrospectivo mostrou que os fumantes do sexo masculino apresentavam risco aumentado de sangramento por malformação arteriovenosa (MAV), em comparação com os não fumantes. No entanto, o efeito do tabagismo passivo na ruptura da MAV cerebral em mulheres não fumantes não foi abordado. Objetivo: Este estudo teve como objetivo avaliar o impacto da exposição ao tabaco no risco de sangramento de MAV em mulheres não fumantes. Métodos Foram incluídas 393 mulheres não fumantes diagnosticadas com MAV. Elas foram divididas em um grupo com sangramento (205 mulheres) e um grupo sem sangramento (188 mulheres). Realizamos análise univariada e multivariada nesses dois grupos. Na análise univariada, foram analisados ​​os fatores de risco que podem estar relacionados ao sangramento de MAV. Na análise multivariada, a relação entre tabagismo passivo e ruptura de MAV foi analisada por meio da correção de fatores de confusão. Resultados A análise multivariada mostrou que a proporção de tabagismo passivo foi estatisticamente diferente entre o grupo com sangramento e o grupo sem sangramento (OR = 1,609; IC = 1,031-2,509; p = 0,036). Conclusão O tabagismo passivo pode aumentar o risco de sangramento de MAV em mulheres não fumantes. Esse risco aumentado pode estar relacionado à resposta inflamatória, danos na parede vascular, distúrbios hemodinâmicos, alterações na aterosclerose e alterações na expressão gênica causadas pelo tabagismo passivo.

A review of progress in research of relationship between air pollution and perinatal depression / 环境与职业医学

In recent years, the increasing incidence of perinatal depression has become an important public health problem. In addition to the traditional social demographic factors, biological factors, obstetric factors, etc., the association between air pollution and perinatal depression (PND) has also attracted more and more attention. In this paper, studies on the association between air pollution and PND were reviewed, especially the associations of PND with ambient air pollutants such as PM2.5, PM10, NO2, and O3 as well as indoor air pollutants such as tobacco smoke, and the characteristics and possible biological mechanisms of the influence of different pollutants on PND were summarized. Based on the available studies, various outdoor air pollutants are associated with PND, and some pollutants may exhibit a dose-response relationship with it. As for indoor air pollution, studies only have focused on the impact of tobacco exposure on PND, and as yet, no study has explored the association between other indoor pollutants (e.g. cooking oil smoke and solid fuel) and PND. Current studies indicate that air pollution may act on PND through oxidative stress and neuroendocrine mechanisms, but the exact biological mechanism remains to be further studied. In the future, further studies should be encouraged on the epidemiological associations of other indoor air pollutants with PND and the interactions between other factors and air pollution on PND, and the underlying biological mechanisms, to provide new insights for the prevention of PND from the perspective of environmental health.

Impact of passive smoking on renal vascular morphology

ABSTRACT Objective To determine whether passive smoking causes morphological and structural changes in the arcuate arteries of rats exposed for 7 to 28 days. Methods Wistar rats aged eight weeks and weighing 260g on average were allocated to a Control or a Smoker Group. Groups were further divided into 4 groups containing 5 animals each. Morphological-functional analysis of the right kidneys was carried out after 7 and 28 days of exposure to the smoke of 40 cigarettes per day. Cigarettes were burned at set times using automated cigarette-burning equipment ("Smoking Machine" - SM-MC-01). At the end of each exposure period, the kidneys were dissected and submitted to histological processing for morphological and quantitative analysis. Results Exposure to cigarette smoke for 7 days led to a decrease in inner vascular diameter. Decreased thickness of the vascular tunica media was observed after exposure for 28 days. Increased thickness of the tunica adventitia, increased total vascular wall thickness, increased total vascular diameter and qualitative increase in collagen deposition were observed. Vascular volume increased after 28 days of exposure. Conclusion Passive smoking has a negative impact on renal vasculature.

"Tobacco denormalization at home": the contribution of the smoking ban in enclosed workplaces in Brazil / "Desnormalização do uso de tabaco em casa": a contribuição da proibição de fumar em ambientes fechados de trabalho no Brasil / "Desnormalización del tabaco en casa": contribución de la prohibición de fumar en lugares de trabajo cerrados en Brasil

Estimates suggest that exposure to environmental tobacco smoke is related to 1.2 million deaths per year worldwide. Synergy between various anti-smoking legislative and educational measures is essential to stimulate cessation and prevent initiation. This article aimed to explore how legislative protection from exposure to environmental tobacco smoke in enclosed workplaces in Brazil, whose strengthening occurred in a phased manner between 1996 and 2014, possibly contributed to the protection from passive smoking at home. We evaluated, via generalized linear models, the absolute and relative differences in the proportion of individuals living in smoke-free homes between those exposed and not exposed to passive smoking in enclosed workplaces, both crude and adjusted by sociodemographic and smoking behavior variables, and stratified by non-smokers and smokers. Data from three national surveys conducted in 2008, 2013, and 2019 were used. Regardless of smoking status and year when the data were analyzed, individuals who were employed in smoke-free workplaces were more likely to live in smoke-free homes than smokers who were employed in workplaces that allowed smoking. Adjusted absolute difference increased from +5.5% in 2008 to +10.5% in 2013 among non-smokers, and from +7.1% in 2013 to 15.6% in 2019 among smokers (p-values for additive interaction ≤ 0.05). Strengthening the Brazilian smoke-free legislation was likely associated with a reduction in passive smoking at home, which, therefore, may also reduce the burden of mortality, morbidity, and costs for society related to smoking.

Estima-se que a exposição à fumaça ambiental de tabaco esteja relacionada a 1,2 milhão de mortes por ano no mundo. A sinergia das diversas medidas antitabaco, tanto legislativas quanto educativas, é essencial para estimular a cessação e prevenir a iniciação do tabagismo. O artigo tem como objetivo explorar a possível contribuição da proteção legislativa contra a exposição à fumaça ambiental de tabaco nos locais fechados de trabalho no Brasil, cujo fortalecimento ocorreu por fases entre 1996 e 2014, para a proteção contra o tabagismo passivo em casa. Foram utilizados modelos lineares generalizados para avaliar as diferenças absolutas e relativas na proporção de brasileiros que vivem em domicílios sem fumaça ambiental de tabaco, entre aqueles expostos e não expostos ao tabagismo passivo em locais de trabalho fechados, brutas e ajustadas por variáveis sociodemográficas e de comportamento de tabagismo, estratificadas entre fumantes e não fumantes. Foram usados os dados de três inquéritos nacionais, realizados em 2008, 2013 e 2019. Independentemente de condição de tabagista e do ano de análise, os indivíduos empregados em locais de trabalho livres de tabaco apresentaram maior probabilidade de residir em domicílios livres de tabaco, comparado com aqueles que trabalhavam em locais onde fumar era permitido. A diferença absoluta ajustada aumentou de +5,5% em 2008 para +10,5% em 2013 entre não fumantes, e de +7,1% em 2013 para +15,6% em 2019 entre fumantes (valores de p de interação aditiva ≤ 0,05). É provável que o fortalecimento da legislação antitabaco no Brasil esteve associado a uma redução no tabagismo passivo em casa, o que, portanto, pode reduzir a carga de morbimortalidade e de custos para a sociedade, relacionados ao tabagismo.

Se estimó que la exposición al humo del tabaco ambiental está relacionada con 1,2 millones de muertes por año en todo el mundo. La sinergia de varias medidas antitabaco legislativas y educacionales es esencial para estimular dejar de fumar y prevenir comenzar a fumar. La propuesta de este artículo fue explorar la posible contribución de la protección legislativa ante la exposición al humo del tabaco ambiental en lugares de trabajo cerrados en Brasil, cuyo afianzamiento se produjo de manera gradual entre 1996 y 2014, para la protección de los fumadores pasivos en casa. Se utilizaran modelos lineales generalizados para evaluar las diferencias absolutas y relativas en la proporción de individuos que viven en hogares libres de humos, entre quienes estaban expuestos y no expuestos como fumadores pasivos en lugares de trabajo cerrados, crudas y ajustadas por variables sociodemográficas y comportamiento de fumador, y estratificadas por no fumadores y fumadores. Se usaron los datos de las tres encuestas nacionales llevadas a cabo en 2008, 2013 y 2019. Independientemente del estatus del consumo de tabaco y el año de análisis, los individuos que fueron empleados en un lugar de trabajo libre de humos tenían más probabilidades de vivir en un hogar libre de humos en comparación con los fumadores que trabajaban en donde se fumaba. La diferencia ajustada absoluta aumentó del +5,5% en 2008 al +10,5% en 2013 entre no fumadores, y del +7,1% en 2013 al +15,6% en 2019 entre fumadores (valores de p de interacción aditiva ≤ 0,05). El fortalecimiento de la legislación antitabaco en Brasil estuvo presumiblemente asociado con una reducción con los fumadores pasivos en el hogar, y, por consiguiente, podría también reducir la carga de mortalidad, morbilidad y costes para la sociedad en relación con el tabaquismo.

Towards a smoke-free world? South America became the first 100% smoke-free subregion in the Americas / ¿Hacia un mundo libre de humo? América del Sur se convierte en la primera subregión 100% libre de humo en la Región de las Américas / Rumo a um mundo livre de fumo? A América do Sul tornou-se a primeira sub-região 100% livre de fumaça de tabaco nas Américas

ABSTRACT Almost 20 years after the launching by the Pan American Health Organization of its "Smoke-Free Americas" initiative in 2001, in December 2020, South America became the first subregion in the Americas to accomplish 100% smoke-free environments in line with Article 8 of the World Health Organization Framework Convention on Tobacco Control (FCTC). Some of these countries adopted legal measures that are more robust than others, including in their laws specific outdoor places in the smoking ban (like Argentina and Uruguay) and/or novel nicotine and tobacco products under their scope (like Ecuador and Paraguay). The 10 countries took different paths to adopt this public health measure, either through executive or legislative measures or a combination of both. A few countries, like Argentina, Brazil, and Venezuela, started at the subnational level and then moved on to the national level, similar to the rest of the countries. For achieving this milestone, an adequate context was crucial: the broad ratification of the FCTC and the relevance given to the human right to health, civil society efforts, commitments made by intergovernmental bodies, media and communication strategies, and the development of scientific evidence. Countries faced obstacles, including the well-known interference of the tobacco industry, which among other strategies used litigation; however, courts and judges upheld comprehensive legal measures on smoke-free environments. The process by which South America achieved this milestone represents a role model for other subregions of the Americas and the world.

RESUMEN Casi 20 años después del lanzamiento de la iniciativa "América libre de humo" de la Organización Panamericana de la Salud en el año 2001, en diciembre del 2020, América del Sur se convirtió en la primera subregión de la Región de las Américas en lograr que 100% de los entornos sean libres de humo, en consonancia con el Artículo 8 del Convenio Marco para el Control del Tabaco de la Organización Mundial de la Salud (CMCT). Algunos de países de la subregión adoptaron medidas legales más sólidas e incluyeron en su legislación la prohibición de fumar en lugares al aire libre concretos (como Argentina y Uruguay) o de introducir nuevos productos de nicotina y tabaco en su alcance jurídico (como Ecuador y Paraguay). Los diez países tomaron diferentes caminos para adoptar esta medida de salud pública, ya fuera mediante disposiciones ejecutivas, legislativas o una combinación de ambas. Algunos países, como Argentina, Brasil y Venezuela, empezaron a nivel subnacional y luego, de un modo similar al del resto de países, pasaron al nivel nacional. Para lograr este hito fue crucial un contexto adecuado: una amplia ratificación del CMCT y la relevancia dada al derecho humano a la salud, los esfuerzos de la sociedad civil, los compromisos asumidos por los órganos intergubernamentales, los medios y las estrategias de comunicación, y el progreso de la evidencia científica. Los países se enfrentaron a obstáculos, entre ellos la conocida interferencia de la industria tabacalera, que entre otras estrategias empleó el uso de litigios; sin embargo, distintos tribunales y jueces respaldaron medidas legales integrales de ambientes libres de humo de tabaco. El proceso mediante el cual América del Sur ha logrado este objetivo representa un modelo a seguir para otras subregiones de las Región de las Américas y el mundo.

RESUMO Em dezembro de 2020, quase 20 anos depois do lançamento da iniciativa "Américas sem Fumo" pela Organização Pan-Americana da Saúde, em 2001, a América do Sul tornou-se a primeira sub-região das Américas a alcançar ambientes 100% livres de fumaça de tabaco, em conformidade com o Artigo 8 da Convenção-Quadro para o Controle do Tabaco da Organização Mundial da Saúde (CQCT). Alguns desses países adotaram medidas legais mais robustas que outros, com a inclusão da proibição de fumar em determinados locais ao ar livre (como Argentina e Uruguai) e/ou de novos produtos de nicotina e tabaco no escopo de suas leis (como Equador e Paraguai). Os dez países seguiram caminhos diferentes ao adotarem essa medida de saúde pública, por meio de medidas executivas ou legislativas ou ainda por uma combinação de ambas. Alguns países, como Argentina, Brasil e Venezuela, começaram no âmbito subnacional e depois passaram ao âmbito nacional, de maneira semelhante aos demais países. Para alcançar esse marco, foi crucial ter um contexto adequado: a ampla ratificação da CQCT, bem como a importância dada ao direito humano à saúde, os esforços da sociedade civil, os compromissos assumidos por organismos intergovernamentais, as estratégias de mídia e comunicação e o desenvolvimento de evidências científicas. Os países enfrentaram obstáculos, incluindo a conhecida interferência da indústria do tabaco, que, entre outras estratégias, recorreu ao litígio; entretanto, os tribunais e juízes mantiveram medidas legais abrangentes sobre ambientes livres de fumo. O processo pelo qual a América do Sul alcançou esse marco constitui um exemplo para outras sub-regiões das Américas e para o mundo.

Exposure to second hand smoking among middle school students in Beijing in 2019 / 中国学校卫生

Objective@#To understand the exposure to second hand smoking (SHS) and associated factors among middle school students in Beijing, and to provide data support for tobacco control.@*Methods@#The two stage stratified cluster random sampling method were used to select 10 532 students from 370 classes in 48 junior middle schools, 34 senior high schools and 14 vocational high schools in 16 districts of Beijing. The national unified paper questionnaire was used to collect the information.@*Results@#During the past 7 days, 71.5% (95% CI =70.2%-72.7%) of students reported exposure to SHS. The proportion of exposure was highest (60.3%) in outdoor public places, followed by indoor public places (48.9%), at home (34.1%), and public transport (19.1%). About 31.6% of students reported people smoking in the campus in the past 30 days. Risk factors of SHS exposure included one or more parents was smoker( OR =2.62), friends who smoked( OR =2.13), received education on tobacco hazards in school( OR = 0.74 ), and senior high school( OR =0.68-0.73)( P <0.05).@*Conclusion@#High exposure to second hand smoking among middle school students in Beijing is common. Implementation of the regulations and the publicity of tobacco hazards and tobacco control in schools should be strengthened. Smoke free household should be advocated, and middle school students, especially junior middle school students, should be protected from the harm of SHS.

Parental smoking and congenital heart disease: a meta-analysis / 中华围产医学杂志

Objective:To assess the association between maternal smoking, passive exposure to smoking, or paternal smoking in the first trimester and the risk of congenital heart disease (CHD) in offspring.Methods:A meta-analysis was performed on selected case-control studies on parents in the first trimester and CHD involving CHD patients regardless of age or ethnicity, after searching PubMed, Web of Science, Cochrane Library, CNKI, WanFang Data, and China Biology Medicine up to April 2021. The main outcome was CHD confirmed by cardiac ultrasound or cardiac surgery and the quality of included studies was assessed using the Newcastle-Ottawa Scale (≥4 scores). Statistical analysis was carried out using RevMan5.4 software and heterogeneity was determined by Q test combined with I 2 test. In accordance with the heterogeneity test results, the appropriate model (random or fixed) was selected. Subgroup analysis was performed according to the subtype of CHD. Potential publication bias was assessed by funnel plots. Results:A total of 35 studies involving 38 125 subjects were included. The pooled results showed that the risk of CHD in offspring born to mothers who were active or passive smokers in the first trimester was 1.20 ( OR=1.20, 95% CI:1.15-1.26, Z=8.15, P<0.001, I 2=35%) and 1.95 times ( OR=1.95, 95% CI:1.70-2.24, Z=9.52, P<0.001, I 2= 69%) that of non-smoking mothers. The risk of CHD in offspring of fathers who smoked in the first trimester was 1.88 times higher than that of non-smoking parents ( OR=1.88, 95% CI:1.49-2.36, Z=5.39, P<0.001, I 2= 69%). Subgroup analysis indicated an association between active maternal smoking in the first trimester and an increased risk of atrial septal defect ( OR=1.41, 95% CI:1.03-1.92, P=0.030, I 2= 71%) as well as between maternal passive smoking and increased risk of atrioventricular septal defect ( OR=1.76, 95% CI:1.37-2.26, P<0.001, I 2= 11%). Conclusion:Maternal and paternal smoking in the first trimester may both increase the risk of CHD in offspring.

Intrauterine and postnatal exposure to tobacco and wood smoke on hypothalamic development and cognition: an integrative review of the literature / Exposición intrauterina y postnatal al humo de tabaco y de leña en el desarrollo hipotalámico y la cognición: una revisión integrativa de la literatura

SUMMARY: Exposure to air pollution and its pollutants has been associated with important effects on human health since the first years of life, thus it has been seen that exposure to tobacco smoke and wood smoke is directly related to cardiovascular and pulmonary diseases, respiratory and cancers. However, exposure to air pollution during fetal development and its effects on brain structure and function during early childhood and adolescence have been little studied. In this review we have analyzed the literature on prenatal exposure to tobacco and wood smoke and its relationship with hypothalamic development and cognition in the first years of life.The molecular, morphological and physiological aspects of the relationship between pre- and postnatal exposure to tobacco and wood smoke with neural developmental, cognitive and behavioral problems during early childhood and adolescence have not yet been fully clarified. The information available in the scientific literature based on antecedents obtained from epidemiological studies has been negatively affected by confounding variables and great methodological challenges that make it impossible to affirm an exact causal relationship with certainty.

RESUMEN: La exposición a la contaminación del aire se ha asociado con importantes efectos en la salud humana desde los primeros años de vida. Estudios han demostrado con certeza que la exposición al humo de tabaco y humo de leña está directamente relacionada con enfermedades cardiovasculares, pulmonares, respiratorias y cánceres. Sin embargo, la exposición a la contaminación del aire durante el desarrollo fetal y sus efectos a posteriori sobre la estructura y función del cerebro durante la primera infancia y la adolescencia son aún desconocidos. En esta revisión analizamos la literatura sobre la exposición prenatal al tabaco y al humo de leña y su relación con el desarrollo hipotalámico y la cognición en los primeros años de vida. Los aspectos moleculares, morfológicos y fisiológicos de la asociación entre la exposición pre y postnatal al humo de tabaco o al humo de leña con problemas del desarrollo neurológico normal, cognitivos y de comportamiento durante la primera infancia y la adolescencia aún no se han aclarado completamente. La información disponible en la literatura científica basada en antecedentes obtenidos de estudios epidemiológicos ha sido afectada negativamente por variables de confusión y grandes desafíos metodológicos que hacen imposible afirmar una relación directa y causal exacta con certeza.

Análise da associação entre fumo passivo e consumo de álcool e drogas entre adolescentes / Analysis of the association between passive smoking and alcohol and drug consumption among adolescents

Analisar a associação entre o fumo passivo e o consumo de álcool e drogas ilícitas entre adolescentes. Estudo epidemiológico, descritivo, com abordagem quantitativa e abrangência estadual, em uma amostra de 6.264 adolescentes, captados por amostragem aleatória por conglomerados. Os dados foram recolhidos por meio do Global School-Based Student Health Survey. O teste do Qui-quadrado de Pearson (x²) e a regressão logística binária foram utilizados nas análises dos dados. Observou-se exposição significante ao fumo passivo (70,7%), e identificou-se que a exposição ao fumo passivo esteve associado com o consumo de álcool (OR = 2,04; IC 95%: 1,72 2,42) e drogas ilícitas (OR = 4,33; IC 95%: 2,72 6,90), mesmo entre aqueles adolescentes que não fumam e seus pais não fumam e independentemente do sexo, idade e escolaridade materna. O fumo passivo esteve associado ao consumo de álcool e drogas ilícitas pelos adolescentes, excluindo uso de cigarro por parte dos jovens e dos seus pais

To analyze an association between secondhand smoke and alcohol and illicit drug use among adolescents. Epidemiological, descriptive study, with a quantitative approach and state coverage, in a sample of 6,264 adolescents, captured by random sampling by clusters. Data were collected using the Global School-Based Student Health Survey. Pearson's chi-square test (x²) and binary logistic regression were used in the data analysis. There was a significant exposed to secondhand smoke (70.7%). In addition, it was found that exposure to secondhand smoke was associated with alcohol consumption (OR = 2.04; 95% CI: 1.72 2.42) and illicit drugs (OR = 4.33; 95% CI: 2.72 6.90), even among those adolescents who do not smoke and their parents do not smoke and regardless of gender, age and maternal education. Passive smoking was associated with alcohol and illicit drug use by adolescents, excluding the use of cigarettes by young people and their parents

Effects of prenatal tobacco smoke on cerebellum histomorphological changes at critical developmental stages in CD-1 mice / Efectos del humo de tabaco en los cambios histomorfológicos del cerebelo en las etapas críticas del desarrollo prenatal en ratones CD-1

SUMMARY: In this study the consequences of prenatal exposure to tobacco smokes on the histo-morphological changes of cerebellum was assessed by comparing the smoker mice to the nonsmoker mice. A total of 30 pregnant cd-1 mice were divided into three groups of 10 mice each and with two replicates per group (5 mice each). Following acclimation for five days, the mice were placed in a special modified smoking machine for 2 hours per day over a two- and three-week period for group two and group three, respectively. Group one was considered as a control group. Mice in the control group were exposed simultaneously to fresh air from the room, while those in the treatment groups were exposed to tobacco smoke from six commercial filter cigarettes, containing 0.8 mg of nicotine, 10 mg of tar, and 10 mg of carbon monoxide, for three 1-hour exposure periods every day for three weeks. The mice in the control group were exposed to room air for three 1-hour periods every day for the same period of three weeks. The results from this study showed a correlation between maternal smoking and histological changes in Neuron purkinjense (Purkinje cells) of the cerebellum. They also showed that prenatal smoking period may have caused more damage in the histology and structure of Neuron purkinjense in some juvenile mice. An increased incidence of morphology damage of the cerebellum's Neuron purkinjense' structures was also observed in fetuses with prolonged exposure to tobacco smoking. Exposure of in utero maternal smoking may interfere with brain biological development parameters, giving rise to structural abnormalities of the cerebellum. This study concluded that tobacco smoke exposure to pregnant mice may affect neurodevelopment which may induce behavioural changes as a result of reduced cerebellar size and function.

RESUMEN: Se evaluaron los efectos producidos por la exposición prenatal al humo de tabaco en ratones expuestos y no expuestos y los cambios histomorfológicos observados en el cerebelo en ambos grupos. Un total de 30 ratones cd-1 preñados se dividieron en tres grupos de 10 ratones cada uno y con dos réplicas por grupo (5 ratones cada uno). Después de la aclimatación durante cinco días, los ratones se colocaron en una máquina de fumar modificada, especial durante 2 horas al día, durante un período de dos y tres semanas para el grupo dos y el grupo tres, respectivamente. El grupo uno se consideró como grupo control. Los ratones del grupo de control fueron expuestos simultáneamente al aire limpio de la habitación, mientras que los grupos de tratamiento fueron expuestos al humo de tabaco de seis cigarrillos comerciales, que contenían 0,8 mg de nicotina, 10 mg de alquitrán y 10 mg de monóxido de carbono. durante tres períodos de 1 hora diariamente, durante tres semanas. Los ratones del grupo de control se expusieron al aire ambiente durante tres períodos de 1 hora todos los días durante el mismo período de tres semanas. Los resultados de este estudio mostraron una correlación entre el tabaquismo materno y los cambios histológicos en las neuronas purkinjenses (células de Purkinje). Se observó además que el período de tabaquismo prenatal puede haber causado mayor daño en la histología y estructura de las neuronas purkinjenses en algunos ratones jóvenes. También se observó una mayor incidencia de daño morfológico de las estructuras de las neuronas purkinjenses del cerebelo en fetos con exposición prolongada al tabaquismo. La exposición al tabaquismo materno en el útero puede interferir con los parámetros de desarrollo biológico del cerebro, dando lugar a anomalías estructurales del cerebelo. Este estudio concluyó que la exposición al humo del tabaco en ratones preñados puede afectar el desarrollo neurológico, lo que puede inducir cambios de comportamiento como resultado de la reducción del tamaño y la función del cerebelo.

Individual and contextual variables associated with smoking and alcohol consumption during pregnancy / Variables individuales y contextuales asociadas con el fumo y el consumo de bebidas alcohólicas durante el embarazo / Variáveis individuais e contextuais associadas ao tabagismo e consumo de bebidas alcoólicas durante a gravidez

ABSTRACT Objective: to analyze the association between individual characteristics and housing context with smoking and alcohol consumption during pregnancy. Methods: a cross-sectional study with a probabilistic sample of 3,580 pregnant women who underwent prenatal care in the Unified Health System in 2019. The outcomes were firsthand, secondhand smoke and alcohol consumption during pregnancy. Individual characteristics and the living environment were used as exploratory variables. Results: living in a neighborhood with episodes of violence, without social cohesion and without urban elements that encourage physical activity was associated with smoking. Alcohol consumption during pregnancy was associated with living in environments that do not encourage physical activity. Smoking was also associated with lower income and education. Conclusions: individual characteristics and the living environment are associated with smoking, secondhand smoke and alcohol consumption during pregnancy.

RESUMEN Objetivo: analizar la asociación entre características individuales y contexto habitacional con el tabaquismo y el consumo de alcohol durante el embarazo. Métodos: estudio transversal con una muestra probabilística de 3580 gestantes que se sometieron a atención prenatal en el Sistema Único de Salud en 2019.Los resultados fueron tabaquismo activo, pasivo y consumo de bebidas alcohólicas durante el embarazo. Las características individuales y el entorno de vida se utilizaron como variables exploratorias. Resultados: vivir en un barrio con episodios de violencia, sin cohesión social y sin elementos urbanos que incentiven la actividad física se asoció con el tabaquismo. El consumo de bebidas alcohólicas durante el embarazo se asoció con vivir en ambientes que no estimulan la actividad física. El tabaquismo también se asoció con menores ingresos y educación. Conclusiones: las características individuales y el entorno de vida se asocian con el tabaquismo, el tabaquismo pasivo y el consumo de alcohol durante el embarazo.

RESUMO Objetivo: analisar a associação entre características individuais e contexto de moradia ao tabagismo e consumo de bebidas alcoólicas durante a gestação. Métodos: estudo transversal, com amostra probabilística de 3.580 gestantes que realizaram pré-natal no Sistema Único de Saúde em 2019. Os desfechos foram fumo ativo, passivo e consumo de bebidas alcoólicas durante a gestação. Utilizaram-se como variáveis exploratórias características individuais e do ambiente de moradia. Resultados: Residir em vizinhança com episódios de violência, sem coesão social e sem elementos urbanos que estimulem atividade física esteve associado com o fumo. O consumo de bebidas alcoólicas durante a gravidez esteve associado com residir em ambientes que não estimulam a atividade física. O fumo também foi associado com renda e escolaridade mais baixas. Conclusão: características individuais e do ambiente de moradia estão associadas ao tabagismo, fumo passivo e ingestão de bebidas alcoólicas durante a gestação.

Individual and contextual variables associated with smoking and alcohol consumption during pregnancy / Variables individuales y contextuales asociadas con el fumo y el consumo de bebidas alcohólicas durante el embarazo / Variáveis individuais e contextuais associadas ao tabagismo e consumo de bebidas alcoólicas durante a gravidez

ABSTRACT Objective: to analyze the association between individual characteristics and housing context with smoking and alcohol consumption during pregnancy. Methods: a cross-sectional study with a probabilistic sample of 3,580 pregnant women who underwent prenatal care in the Unified Health System in 2019. The outcomes were firsthand, secondhand smoke and alcohol consumption during pregnancy. Individual characteristics and the living environment were used as exploratory variables. Results: living in a neighborhood with episodes of violence, without social cohesion and without urban elements that encourage physical activity was associated with smoking. Alcohol consumption during pregnancy was associated with living in environments that do not encourage physical activity. Smoking was also associated with lower income and education. Conclusions: individual characteristics and the living environment are associated with smoking, secondhand smoke and alcohol consumption during pregnancy.

RESUMEN Objetivo: analizar la asociación entre características individuales y contexto habitacional con el tabaquismo y el consumo de alcohol durante el embarazo. Métodos: estudio transversal con una muestra probabilística de 3580 gestantes que se sometieron a atención prenatal en el Sistema Único de Salud en 2019.Los resultados fueron tabaquismo activo, pasivo y consumo de bebidas alcohólicas durante el embarazo. Las características individuales y el entorno de vida se utilizaron como variables exploratorias. Resultados: vivir en un barrio con episodios de violencia, sin cohesión social y sin elementos urbanos que incentiven la actividad física se asoció con el tabaquismo. El consumo de bebidas alcohólicas durante el embarazo se asoció con vivir en ambientes que no estimulan la actividad física. El tabaquismo también se asoció con menores ingresos y educación. Conclusiones: las características individuales y el entorno de vida se asocian con el tabaquismo, el tabaquismo pasivo y el consumo de alcohol durante el embarazo.

RESUMO Objetivo: analisar a associação entre características individuais e contexto de moradia ao tabagismo e consumo de bebidas alcoólicas durante a gestação. Métodos: estudo transversal, com amostra probabilística de 3.580 gestantes que realizaram pré-natal no Sistema Único de Saúde em 2019. Os desfechos foram fumo ativo, passivo e consumo de bebidas alcoólicas durante a gestação. Utilizaram-se como variáveis exploratórias características individuais e do ambiente de moradia. Resultados: Residir em vizinhança com episódios de violência, sem coesão social e sem elementos urbanos que estimulem atividade física esteve associado com o fumo. O consumo de bebidas alcoólicas durante a gravidez esteve associado com residir em ambientes que não estimulam a atividade física. O fumo também foi associado com renda e escolaridade mais baixas. Conclusão: características individuais e do ambiente de moradia estão associadas ao tabagismo, fumo passivo e ingestão de bebidas alcoólicas durante a gestação.

Morphofunctional study on the effects of passive smoking in kidneys of rats / Estudo morfofuncional sobre os efeitos do tabagismo passivo em rins de ratos

ABSTRACT Objective To analyze whether passive inhalation of cigarette smoke causes morphological, structural, and functional changes in kidneys of rats. Methods Wistar rats, aged eight weeks, weighing on average 260g, were divided into Control Group and Smoking Group. Each group was subdivided into four groups of ten animals for morphofunctional analysis, in a period of seven and 28 days. The Smoking Group was exposed to smoke of 40 cigarettes per day, at certain times and in automated equipment for cigarette burning, called smoking machine (SM-MC-01). After the exposure period, urine and blood samples were collected for the functional analyses, and the kidneys were dissected and submitted to histological procedures for morphoquantitative analyses. Results After exposure of animals of the Smoking Group, the following were observed: lower weight gain; lower water and feed intake; decreased renal weight, diameter, and volume; reduction in cortical thickness and glomerular volume density; decrease in glomerular and capsular diameter; increase in mesangial density; decreased urine volume; increased levels of glucose, serum creatinine and microalbuminuria; decreased urinary creatinine levels and creatinine clearance rate. Conclusion Passive smoking negatively influences renal morphology and glomerular filtration rate, with effects similar to those described in the literature regarding active smoking.

RESUMO Objetivo Analisar se a inalação passiva da fumaça do cigarro proporciona alterações morfológicas, estruturais e funcionais nos rins de ratos. Métodos Ratos Wistar, com oito semanas de idade, pesando, em média, 260g, foram divididos em Grupo Controle e Grupo Tabagista. Cada grupo foi subdividido em quatro grupos de dez animais para análise morfofuncional, em um período de sete e 28 dias. O Grupo Tabagista foi exposto à fumaça de 40 cigarros por dia, em horários determinados e equipamento automatizado de queima de cigarros, denominado smoking machine (SM-MC-01). Após o período de exposição, foram coletadas amostras de urina e sangue para as análises funcionais, e os rins foram dissecados e submetidos a procedimentos histológicos para análises morfoquantitativas. Resultados Após a exposição dos animais do Grupo Tabagista, observou-se menor ganho de peso; menor consumo de água e ração; menor peso, diâmetro e volume renal; redução em espessura cortical e densidade de volume glomerular; diminuição no diâmetro glomerular e capsular; aumento na densidade mesangial; volume urinário diminuído; níveis aumentados de glicose, creatinina sérica e microalbuminúria; níveis reduzidos de creatinina urinária e redução da taxa de depuração da creatinina. Conclusão O tabagismo passivo influencia negativamente na morfologia renal e na taxa de filtração glomerular, com efeitos semelhantes aos descritos na literatura em relação ao tabagismo ativo.

Reflections on passive smoking and COVID-19

Despite substantial evidence on the negative effect of active smoking to Covid-19, the impact of passive smoking in the course of disease remains largely unclear. Our aim was to reflect passive smoking as a risk factor in the current pandemic. Studies are needed to increase our knowledge on passive smoking and Covid-19 implications. The reflections current findings strongly support interventions and policies to curb the tobacco epidemic.