Challenges of Second-hand Smoke: Are We Asking the Right Questions?

Second-hand tobacco smoke as defined by WHO is the smoke emitted by a smoker or released from a burnt cigarette or any tobacco product. It is highly prevalent all over the globe but its serious health implications are often neglected by the public and the scientific community alike. Second-hand smoke has everlasting impact on all the body’s major organs, especially among the vulnerable population of children, pregnant ladies, people with chronic diseases and senior citizens. Although India started its war against this menace earlier than other counties, all its efforts remain bootless as its approach and implementation have a wide range of lacunae. This review aims to give a big picture of second-hand smoke, highlighting its pathophysiological changes in the body, socioeconomic impact, various strategies, and the gap that prevents these strategies from finding a favorable result in India. It becomes all the more important to reduce its impact owing to the increase in prevalence among youth reducing their vitality, derailing the society and the nation. It is recommended that the health authorities approach this health problem with utmost seriousness as a laid-back approach could welcome this silent killer’s known and unknown repercussions

The Association between Exposure to Second-Hand Smoke and Disease in the Chinese Population: A Systematic Review and Meta-Analysis / 生物医学与环境科学（英文）

OBJECTIVE@#To analyze the association between exposure to second-hand smoke (SHS) and 23 diseases, categorized into four classifications, among the Chinese population.@*METHODS@#We searched the literature up to June 30, 2021, and eligible studies were identified according to the PECOS format: Participants and Competitors (Chinese population), Exposure (SHS), Outcomes (Disease or Death), and Study design (Case-control or Cohort).@*RESULTS@#In total, 53 studies were selected. The odds ratio (OR) for all types of cancer was 1.79 (1.56-2.05), and for individual cancers was 1.92 (1.42-2.59) for lung cancer, 1.57 (1.40-1.76) for breast cancer, 1.52 (1.12-2.05) for bladder cancer, and 1.37 (1.08-1.73) for liver cancer. The OR for circulatory system diseases was 1.92 (1.29-2.85), with a value of 2.29 (1.26-4.159) for stroke. The OR of respiratory system diseases was 1.76 (1.13-2.74), with a value of 1.82 (1.07-3.11) for childhood asthma. The original ORs were also shown for other diseases. Subgroup analyses were performed for lung and breast cancer. The ORs varied according to time period and were significant during exposure in the household; For lung cancer, the OR was significant in women.@*CONCLUSION@#The effect of SHS exposure in China was similar to that in Western countries, but its definition and characterization require further clarification. Studies on the association between SHS exposure and certain diseases with high incidence rates are insufficient.

Impact of Smoke-Free Legislation on Acute Myocardial Infarction and Subtypes of Stroke Incidence in Shenzhen, China, 2012-2016: An Interrupted Time Series Analysis / 生物医学与环境科学（英文）

OBJECTIVE@#This study assesses the impact of smoke-free legislation on the incidence rate for acute myocardial infarction (AMI) and stroke in Shenzhen.@*METHODS@#Data on ischemic ( n = 72,945) and hemorrhagic ( n = 18,659) stroke and AMI ( n = 17,431) incidence covering about 12 million people in Shenzhen from 2012 to 2016 were used. Immediate and gradual changes in incidence rates were analyzed using segmented Poisson regression.@*RESULTS@#Following the smoke-free legislation, a 9% (95% CI: 3%-15%) immediate reduction was observed in AMI incidence, especially in men (8%, 95% CI: 1%-14%) and in those aged 65 years and older (17%, 95% CI: 9%-25%). The gradual annual benefits were observed only in hemorrhagic and ischemic stroke incidence, with a 7% (95% CI: 2%-11%) and 6% (95% CI: 4%-8%) decrease per year, respectively. This health effect extended gradually to the 50-64 age group. In addition, neither the immediate nor gradual decrease in stroke and AMI incidence rates did not show statistical significance among the 35-49 age group ( P > 0.05).@*CONCLUSION@#Smoke-free legislation was enforced well in Shenzhen, which would generate good experiences for other cities to enact and enforce smoke-free laws. This study also provided more evidence of the health benefits of smoke-free laws on stroke and AMI.

Attitude Towards Anti-smoking Measures and Its Associated Factors Among Adults in Sub-urban Area, in Kuala Terengganu, Terengganu, Malaysia

@#Introduction: General population across different countries have shown an overall support for anti-smoking measures that vary significantly by certain population parameters. However, characteristics of the public attitude in a community who has been exposed to prolonged awareness campaigns and smoke-free area legislation is unclear. Consequently, we investigate residents who reside next to Batu Buruk beach in Kuala Terengganu city which has been gazetted as a smoke-free area since 2017. Methods: The cross-sectional study involves self-administered validated questionnaires. Multiple linear regression with forward method was applied to identify significant factors associated with the attitude towards anti-smoking measures. Results: A total of 295 residents participated. Most of them were Malays (96.6%), married (64.4%), attained up to the secondary school level (45.4%) and employed (59.7%). The mean value of the total attitude scores was 181.86 (range: 70-200). Multivariate analyses revealed those having higher monthly income had a higher total attitude scores (adjusted b: 6.91, 95% CI: 2.15, 11.66), while current daily smokers had a lower total attitude scores towards anti-smoking measures than non-smokers (adjusted b: -23.30, 95% CI: -29.55, -17.05). These findings highlight comparatively stronger and more consistent support for anti-smoking measures that may vindicate high-stake investment and legislation against smoking. Conclusion: The novel evidence may also better-inform the strategy to expand the initiatives further through profiling the target population with heightened emphasis on the economic standing and prevalence of current daily smokers. Future research may adopt experimental design to establish causality relationship between predictors and outcomes revealed in this community.

Prevalence And Predictors of Exposure to Second-Hand Smoke Among Never-Tobacco Smokers

Background: Exposure toSecond-hand tobacco smoke (SHS) harms health. It is a risk factor for various diseases like asthma, hypertension, diabetes, heart disease and lung cancer. This study aimed to deter-mine the prevalence and predictors of second-hand tobacco smoke among adult never-smokers.Methods: A cross-sectional study was conducted among 220 participants aged 18 years and above. A pre-tested questionnaire was used to elicit information regarding exposure to second-hand smoke at the home, workplace and various public places. The data was analysed using the Epi Info software for win-dows. Results: The second-hand smoke exposure at home and workplace was 11.4% and 19.1%, respectively. The SHS exposure at bus stops, public transport, government buildings and health care facilities was 33.3%, 13.0%, 7.6% and 3%, respectively. The in-home study participants with a current tobacco smok-er, family member and/or friend had comparatively higher exposure to second-hand tobacco smoke. In the workplace and or public places, male study participants and illiterate individuals had higher expo-sure to second-hand tobacco smoke. Conclusion: The observed level of SHS exposure among non-smokers is a public health concern. Family members should not allow anyone to smoke in their home environment. The public health law prohibit-ing tobacco smoking in workplaces and public places needs further strengthening.

Effectiveness of non-pharmacologic strategies for parental smoking cessation to protect children: A meta-analytic review

@#<p style="text-align: justify;"><strong>Aims:</strong> This meta-analysis aims to synthesize available evidence from published studies on the effectiveness of parental non-pharmacologic smoking cessation programs which aim to reduce children's exposure to secondhand smoke.</p><p style="text-align: justify;"><strong>Methodology:</strong> A database search using The Cochrane Library, PubMed®, Medline, Embase, and Google Scholar, was done by the investigators. This study included 20 randomized controlled trials published up to 2020. Pooled estimates of risk ratio (RR) for quit rates were computed using the random effects model.</p><p style="text-align: justify;"><strong>Results:</strong> Overall, the quit rate among those who underwent parental smoking cessation was 13.4% while the quit rate for controls was 11.9%. The pooled RR demonstrated that the parental smoking cessation program was significantly associated with higher quit rates (RR = 1.22, 95%CI = 1.01 to 1.46, p-value = 0.04). The studies demonstrated moderate heterogeneity only (I2 = 54%). Among studies published prior to year 2000, no significant difference was observed between parental smoking cessation program and control (RR = 1.02, 95% CI = 0.62 to 1.70, p-value = 0.93). On the other hand, the pooled RR demonstrated that among studies published after 2020, parental smoking cessation program was significantly associated with higher quit rates (RR = 1.27, 95%CI = 1.03 to 1.56, p-value <0.0001). Among studies with self-help interventions, parental smoking cessation program has no additional benefit on quit rates (RR = 1.20, 95%CI = 0.94 to 1.58, p-value = 0.14). Among studies with biofeedback intervention also, no significant difference was observed (RR = 1.27, 95% CI = 0.86 to 1.89, p-value = 0.23).</p><p style="text-align: justify;"><strong>Conclusions:</strong> This meta-analysis demonstrated sufficient evidence that non-pharmacologic interventions for parental smoking cessation are effective.</p>

Influence of family smoking on children’s exposure to second-hand smoke in rural Taizhou City / 上海预防医学

Objective:To analyze the household smoking behavior of smokers in rural Taizhou City of Zhejiang Province， and to provide the basis for the intervention measures to reduce children's second-hand smoke （SHS） exposure. Methods:The investigation started in May 2018. A total of 418 smoking families in Luqiao and Linhai were included. Field face-to-face questionnaire survey was conducted and cotinine level in children's urine was measured. Kernel density estimation was used for curve fitting. The results were analyzed by Wilcoxon rank sum test and chi square test. Results:The age distribution of smokers in the family was bimodal. The younger smoker group was mainly the parents. The older group was mainly the other relatives such as grandfather. The age started smoking in the parent group was younger than that in relative group， but the average number of cigarettes smoked per day in relative group was higher than that in parent group （P<0.05）. The parent group had higher proportion than the relative group in having family smoking regulations or agreeing not to smoke in the room in the presence of children （P<0.001）.The proportion of the parent group who has heard about third hand smoke and electronic cigarette was higher than that of the relative group （P<0.001）.The detection rates of cotinine in urine of children were 91.05% and 86.96% in parent group and relative group， respectively. The urine cotinine level of the children in the parent group was higher than that in the grandfather group （P=0.049）. Conclusion:Children are more exposed to SHS when the smoker in the household are parents. In order to reduce children's SHS exposure， we should pay more attention to educate the parents with a family based tobacco control program.

Analysis of second-hand smoke exposure and lung cancer death trend among population in Huizhou area / 公共卫生与预防医学

Objective To investigate the relationship between second-hand smoke exposure and lung cancer death trend in Huizhou area. Methods The corresponding records of lung cancer in the tumor registration system in Huizhou area from January 2019 to December 2019 were collected to investigate the subjects' second-hand smoke exposure. Linear regression model was used to analyze the correlation between the mortality of lung cancer patients and the second-hand smoke exposure rate. Logistic regression model was used to analyze the correlation between second-hand smoke exposure and death of lung cancer patients. Results In 2019, the mortality rate of lung cancer patients in Huizhou was the highest in the third quarter, and the second-hand smoke exposure rate of lung cancer patients was also the highest in the third quarter. The mortality rate of lung cancer patients in Huizhou was significantly positively correlated with the second-hand smoke exposure rate (r2 = 0.985 9, P<0.05). The second-hand smoke exposure rate, second-hand smoke exposure concentration, and the extent of second-hand smoke environmental enclosure of dead cancer patients were significantly higher than those of lung cancer patients in the survival group, and the difference was statistically significant (P<0.05). The second-hand smoke exposure, second-hand smoke concentration and the extent of the enclosure of second-hand smoke environment were independent risk factors influencing the death of lung cancer patients (P<0.05). Conclusion The trend of lung cancer deaths in Huizhou in 2019 was consistent with the prevalence of second-hand smoke exposure. The second-hand smoke exposure is an important factor for lung cancer deaths.

Second Hand Smoke Exposure among Pregnant Women in Nigeria

Background:Despite the ban on smoking in public places in Nigeria, second-hand smoke exposure is common across the country. It is increasingly being viewed as a severe women’s issue because of the high prevalence among women, and its harmful effects on pregnant women. However, second-hand smoke exposure among pregnant women in Nigeria is hugely under-researched.Aim:This study aims to determine the prevalence of second-hand smoke exposure among pregnant women in Nigeria, and determine their knowledge and avoidance behavior towards second-hand smoke. Methodology: This cross-sectional study was conducted among 314 pregnant women in ten health facilities in Sokoto state, Nigeria. The health facilities were selected through simple random sampling.Results: The prevalence of second-hand smoke exposure was 72.9%. The majority of the respondents (61.1%) were exposed to second-hand smoke in homes of others, 20.4% in school 18.5% in restaurants, 43.3% in their own homes, 49.7% in public transport, 20.4% at work, and 15% in health facilities. Factors significantly associated with second-hand smoke exposure included knowing it causes miscarriage (OR=0.39, 95% CI=0.23 –0.64, P= <.001), and being able to keep a distance from smokers (OR=0.5, 95% CI= 0.28 –0.76, P=.002).Conclusion:This study revealed a high prevalence of exposure to second-hand smoke. Knowledge about the harmful effects of second-hand smoke was one of the significant factors associated with exposure. These findings indicate the need for appropriate education ofall pregnant women about the harmful effects of second-hand smoke and adequate enforcement of the ban on smoking in public places

Displace of Smoking Into the Home and Second-hand Smoke Exposure at Home Among Malaysian Adults -findings From Two National Population-based Studies in Malaysia

@#Introduction: Expansion of smoke-free areas in public domains is suspected to displace smoking into the home. However, the scarcity of such information in Malaysia warrants an investigation to determine SHS exposure at home among adults in Malaysia. Methods: This study studied 4,250 and 21,445 adults who participated in the 2011 Global Adult Tobacco Survey-Malaysia (GATS-M) and, the National Health and Morbidity Survey (NHMS) 2015, respectively. Multivariable logistic regression modelling was used to compare the odds of SHS exposure at home among adults in 2011 (GATS-M) to odds of SHS exposure at home among adults in 2015 (NHMS 2015). Results: Approximately one third of respondents were exposed to SHS at home in 2011 (38.4%) and 2015 (37.9%). MLR analysis revealed the odds of SHS exposure at home was not significantly different from 2011 [AOR 1.14, 95 % CI (0.99-1.31). 2015 exposure to SHS as reference]. This study also indicates no significant displacement of smoking into the home by socio-demographic and smoking status between 2011 and 2015. Conclusion: The findings suggest that smoking has not been displaced into the home in the past four years although the number of smoke-free public areas have increased. More public smoke free areas should be established.

Creation of a Smoke-free Environment for Children: An Assessment of Compliance to COTPA 2003 Legislation in an Urban Area

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

Effect of secondhand smoke exposure on lung function among non-smoking population

Background: Secondhand Smoke (SHS) exposure is known to be associated with various cardiovascular and respiratory problems but its effect on pulmonary function remains unexplored. This study was done to evaluate the effect of Secondhand Smoke (SHS) exposure on lung function among non-smoking population.Methods: This cross-sectional study was conducted in Bahour, Pondicherry from 2017-2018. 350 participants, age 40 year and older, with no respiratory symptoms or prior lung diseases were included in this study. Both self-reported history and measurement of urinary cotinine level were used to evaluate the smoking status. Spirometry data, including FVC and FEV1 were used to assess lung function. Diverse variables between groups were compared using T- test and Chi-square test. Analysis of covariance (ANCOVA) adjusted for age, height, alcohol consumption, and level of exercise was used to see any statistical differences in lung function parameters between non-SHS exposed and SHS-exposed groups.Results: Among 350 non-smokers, 120 were SHS-exposed. The urinary cotinine levels clearly distinguished SHS exposure, and the mean urinary cotinine levels were 7±0.3 and 11±0.4 in non-SHS exposed group vs SHS-exposed group, respectively. However, both groups had no significant difference in lung function and was found normal.Conclusions: SHS exposure urinary cotinine is a valuable marker.

Survey of exposure to second-hand smoke in residents aged 15 years and over one year after implementation of tobacco control regulation in public places in Beijing / 中华流行病学杂志

Objective@#To monitor the second-hand smoke (SHS) exposure in residents aged 15 years and over in public venues, indoor workplaces, on public transportation vehicles and at home in Beijing and evaluate the effect of Beijing Tobacco Control Regulation.@*Methods@#Data from 2014 and 2016 Beijing Adult Tobacco Survey were used. The surveys covered 16 districts in Beijing. The study subjects were selected through multi-stage cluster sampling with probability proportional to population size, and data were collected by using electronic questionnaire in face-to-face household interviews. A total of 8 484 and 9 372 valid questionnaires were collected for the surveys in 2014 and 2016, respectively. Statistical packages SPSS 20.0 and R 3.4.4 were used for data analyses. After weighting the samples using complex survey designs, the SHS exposure rates in different places in adults of Beijing were estimated. χ2 tests were performed for the comparison.@*Results@#The SHS exposure rates of residents aged 15 years and over in Beijing who visited health care facilities, government buildings, universities, primary and secondary schools and restaurants declined from 12.8%, 19.7%, 24.3%, 32.8% and 65.7% in 2014 to 6.2%, 10.8%, 12.5%, 19.1% and 32.5% in 2016, respectively. The SHS exposure rates in bars/nightclubs were 89.5% in 2014 and 80.3% in 2016. From 2014 to 2016, the SHS exposure rates declined from 35.7% to 20.0% in indoor workplaces and declined from 3.9% to 2.5% on public transportation vehicles. The SHS exposure rates at home were 39.8% in 2014 and 37.6% in 2016, respectively.@*Conclusions@#The SHS exposure rates in public places declined obviously in Beijing after the one year implementation of Beijing Tobacco Control Regulation, indicating the effect of the regulation implementation.

Determinants of Voluntary Smoke- Free Home Among Non- Smoking Women in Alor Gajah, Melaka

Abstract@#Introduction: Second hand smoke exposure to cigarette smoke leads to many medical conditions including asthma and lung cancer. Women are the most vulnerable adults of passive smoking at home. Even though Malaysia had its own smoke- free policy, the smoke- free home is voluntary in nature. Thus, this study was aimed to explore the practice of voluntary smoke- free- home among women in Alor Gajah and its determinants. Methods: A cross-sectional study based on multistage sampling was conducted among 180 non- smoking women in areas implemented Community Intervention Program (KOSPEN), which emphasized on healthy lifestyle, in Alor Gajah, Melaka from April 2018 to May 2018. Data on sociodemographic characteristic, characteristic of second hand smoke (SHS) exposure at home, knowledge, attitude and avoidance behaviour from SHS were collected using questionnaires. The data were then analysed using IBM Statistical Package for Social Science (SPSS) version 24.0 involving descriptive and inferential statistics. Results: Majority of the respondents practised smoke- free home (72.8%). The predictors of smoke- free home were those who attained higher education (AOR= 11.939, 95% CI 1.175- 121.277), did not live with any children (AOR= 3.546, 95% CI 0.985- 12.765) and lived with smokers other than their husband (AOR= 3.793, 95% CI 1.192- 12.076). Conclusion: Education level and household factors were significant predictors of smoke- free home. Thus, few measures were suggested to increase tobacco bans at home among women including periodic health programs, community empowerment programs and creating smoke- free housing.

Prevalence and Factors Associated With Total Smoking Restriction at Home in Malaysia: Findings From a Nationwide Population-Based Study

Abstract@#Introduction: Total restriction on smoking in the home is an effective tool to reduce Second-hand smoke (SHS) exposure in private dwellings. The aim of this study is to determine the prevalence of total smoking restrictions in Malaysian homes and factors associated with its adoption. Methods: We analyzed data from a cross-sectional, household study – the Global Adult Tobacco Survey 2011, which involved a representative sample of Malaysian adults. Factors associated with the adoption of a totally smoke free home policy was determined by multivariable logistic regression. Results: Out of the 4250 respondents studied, 40.9% (95% CI 38.1-43.8) adopted a total smoking restriction within their homes. Adoption of total smoke-free home policy was significantly higher among Chinese and Indians, those without smokers in the house, non-smokers and government employees. The likelihood of adopting the total smoking restriction at home was lower among current smokers, of Malay ethnicity, low education attainment, having at least one house member who smoked, residing in rural areas, single or widow/widower/divorcee, those working in the private sector or self-employed. Conclusions: Less than half of Malaysian households implemented a total smoking restriction in their residence. Targeted activities to encourage the adoption of voluntary smoke-free rules among groups least likely to implement 100% smoking restrictions in the home are urgently needed with participation of all stakeholders to ensure its success.

Second hand smoke exposure in workplace by job status and occupations

BACKGROUND: The objective of this study is to evaluate the risk of exposure to second hand smoke (SHS) during working hours by job status and occupation. METHODS: Using the 4th Korean Working Conditions Survey (KWCS), 49,674 respondents who answered the question about SHS were studied. A chi-square test was carried out to determine whether there is a significant different in SHS exposure frequency by general and occupational characteristics and experience of discrimination at work and logistic regression analysis was carried out to identify the risk level of SHS exposure by variables. RESULTS: In this study, we found that male workers in their 40s and 50s, workers employed in workplaces with fewer than 50 employees, daily workers, and people working outdoors had a higher rate of exposure to SHS than the others. The top five occupations with the highest SHS exposure were construction and mining-related occupations, metal core-makers-related trade occupations, wood and furniture, musical instrument, and signboard-related trade occupations, transport and machine-related trade occupations, transport and leisure services occupations. The least five exposed occupations were public and enterprise senior officers, legal and administrative professions, education professionals, and health, social welfare, and religion-related occupations. CONCLUSION: Tobacco smoke is a significant occupational hazard. Smoking ban policy in the workplace can be a very effective way to reduce the SHS exposure rate in the workplace and can be more effective if specifically designed by the job status and various occupations.

Exposure to second hand smoke and its correlates in Northern State of India

Background: Second-hand smoke (SHS) has enormous adverse health impacts with grave health implications for the next generation. Section 4 of Indian legislation, Cigarettes and Other Tobacco Products Act, prohibits smoking at public places, thus protecting people from SHS. Objective: The objective of present study was to assess the exposure to SHS at home and working areas in Punjab, India. Methods: The present cross-sectional study was conducted from December 2015 to March 2016. A three-stage sampling technique was used for collecting data from three randomly selected districts representing three major regions of Punjab, India. A sample size of 510 individuals was divided equally into an urban and rural area with proportionate sampling on the basis of subsets of age groups and gender. The questionnaire based on tobacco questions for the survey, a subset of key questions from global adult tobacco survey was used. Results: At home, the odds of exposure to SHS exposure was higher (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 0.6�3) in urban area, females, low educational status, and nongovernment employee as compared to their counterparts. At workplace, (OR = 3.9 and 95% CI = 1.11�.3) SHS exposure was higher in rural area, among males, primary and middle education and nongovernment or self-employed occupation. Conclusion: SHS exposure was low in Punjab, India especially in females as compared to other states of the country. The socio-economic disadvantaged groups and people with low education were more likely to experience exposure to SHS at workplace, which should be targeted to reduce tobacco consumption.

The Second-Hand Smoke In Pregnancy And Its Impact Toward Low Birth Weight In District Of Aceh Besar, Aceh Province, Indonesia

@#Smoking does not only endangers the smokers themselves but will also harm the people around them. These are the non-smokers also called the passive smokers or second-hand smoke.In particular pregnant women who are the second-hand smoke can lead low birth weight (LBW) babies. This study aims to determine the impact of second- hand smoke in pregnancy toward LBW in the district of Aceh Besar in 2016. A case control study was done in district of Aceh Besar, Aceh province, Indonesia. The total sample was 120 neonates (1:1), 60 neonates were LBW (cases) and 60 neonates were normal weight (controls). Data collection was doneusing a questionnaire filled in by the parents. The univariate analysiswas described with percentages and the Wald-Wolfowithz run test was used for the bivariate analysis. The results showed that the majority of mothers had a good knowledge about the dangers of smoking, ie 91 or 75.8%. Most of the mothers had positive attitudes for male smokers. The smoking men are considered normal and acceptable, consisting of 73 mothers or 60.8%. All the mothers in this study were non-smokers (100.0%). The majority of the fathers were smokers, 88 or 73.3%, and most of them smoked around their pregnant wife, 55 fathers or 62.5%. The results of the bivariate analysis indicated there was a significant impact of the second-hand smoke toward the LBW (P value <0.05). It means, mothers as a second-hand smoke during pregnancy have a risk to born the LBW baby

The 2015 China Adult Tobacco Survey: exposure to second-hand smoke among adults aged 15 and above and their support to policy on banning smoking in public places / 中华流行病学杂志

Objective To understand the situation on exposure to second-hand smoke among Chinese adults aged 15 and above and their support to policy on banning smoking in public places in 2015.Methods A cross-sectional survey was conducted based on the protocol on Global Adult Tobacco Survey.Stratified multi-stage cluster sampling was used to select 16 800 households in China.Data were collected through household survey,using the electronic devices.One eligible respondent was selected by random sampling in each household.Standardized questionnaire was used from Global Tobacco Surveillance System.Data were weighted and analyzed by SAS 9.3 and SUDAAN 10.0.1 complex survey data analysis program.Results 93.1％ (60 128 × 103/64 575 × 103),76.3％(455 473 × 103/596 782 × 103),57.1％ (621 793 × 103/1 089 582 × 103),54.3％ (218 792 × 103/402 732 × 103),38.1％ (61 208 × 103/160 574 × 103),26.9％ (119 783 × 103/444 679 × 103),23.8％(17 598 × 103/73 993 × 103),17.2％ (41 099 × 103/239 022 × 103) and 16.4％ (102 153 × 103/623 015 ×103) of the respondents reported that smoking did exsit in the following places as:inside of bars or night clubs,in the restaurants,households homes,working places,government buildings,health care facilities,universities,primary and high schools (both indoor and outdoor areas),and on public transportation,respectively.Compared with those data in 2010,the proportions of exposure to indoor areas of restaurants,government buildings,health care facilities,primary and high schools (both indoor and outdoor areas),public transportation,and homes all significantly decreased after standardization of data.Results also showed that most respondents were supportive to the policy on banning smoking in public and working places.However,the proportions of exposure to indoor areas of restaurants were still high but almost 70％ of the respondents thought smoking should not be allowed in indoor areas of restaurants.Conclusion From 2010 to 2015,proportions of exposure to indoor areas of public places,working places,public transportation and homes were obviously declining in China.The Chinese public seemed supportive to the policy on banning smoking in public places.

The 2015 China Adult Tobacco Survey: exposure to second-hand smoke among adults aged 15 and above and their support to policy on banning smoking in public places / 中华流行病学杂志

Objective To understand the situation on exposure to second-hand smoke among Chinese adults aged 15 and above and their support to policy on banning smoking in public places in 2015.Methods A cross-sectional survey was conducted based on the protocol on Global Adult Tobacco Survey.Stratified multi-stage cluster sampling was used to select 16 800 households in China.Data were collected through household survey,using the electronic devices.One eligible respondent was selected by random sampling in each household.Standardized questionnaire was used from Global Tobacco Surveillance System.Data were weighted and analyzed by SAS 9.3 and SUDAAN 10.0.1 complex survey data analysis program.Results 93.1％ (60 128 × 103/64 575 × 103),76.3％(455 473 × 103/596 782 × 103),57.1％ (621 793 × 103/1 089 582 × 103),54.3％ (218 792 × 103/402 732 × 103),38.1％ (61 208 × 103/160 574 × 103),26.9％ (119 783 × 103/444 679 × 103),23.8％(17 598 × 103/73 993 × 103),17.2％ (41 099 × 103/239 022 × 103) and 16.4％ (102 153 × 103/623 015 ×103) of the respondents reported that smoking did exsit in the following places as:inside of bars or night clubs,in the restaurants,households homes,working places,government buildings,health care facilities,universities,primary and high schools (both indoor and outdoor areas),and on public transportation,respectively.Compared with those data in 2010,the proportions of exposure to indoor areas of restaurants,government buildings,health care facilities,primary and high schools (both indoor and outdoor areas),public transportation,and homes all significantly decreased after standardization of data.Results also showed that most respondents were supportive to the policy on banning smoking in public and working places.However,the proportions of exposure to indoor areas of restaurants were still high but almost 70％ of the respondents thought smoking should not be allowed in indoor areas of restaurants.Conclusion From 2010 to 2015,proportions of exposure to indoor areas of public places,working places,public transportation and homes were obviously declining in China.The Chinese public seemed supportive to the policy on banning smoking in public places.