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.

Exposure to secondhand smoke among patients with asthma: a cross-sectional study / Exposição à fumaça secundária do cigarro entre pacientes com asma: estudo transversal

ABSTRACT Objective To estimate the frequency of secondhand smoke exposure among patients with asthma. Methods A cross-sectional study of asthma patients and non-asthmatic controls using questionnaires to identify secondhand smoke exposure at home, school, work, and public places. Results We studied 544 severe asthma patients, 452 mild/moderate asthma patients, and 454 non-asthmatic patients. Among severe patients, the mean age was 51.9 years, 444 (81.6%) were female, 74 (13.6%) were living with a smoker, 383 (71.9%) reported exposure in public spaces and, of the 242 (44.5%) who worked/ studied, 46 (19.1%) reported occupational exposure. Among those with mild/moderate asthma, the mean age was 36.8 years, 351 (77.7%) were female, 50 (11.1%) reported living with a smoker, 381 (84.9%) reported exposure in public settings and, of the 330 (73.0%) who worked/ studied, 58 (17.7%) reported occupational exposure. An association between secondhand smoke exposure and disease control was found among patients with mild/moderate asthma. Among those interviewed, 71% of severe asthma patients and 63% of mild/moderate asthma patients avoided certain places due to fear of secondhand smoke exposure. Conclusion Secondhand smoke exposure is a situation frequently reported by a significant proportion of asthma patients. Individuals with asthma are exposed to this agent, which can hamper disease control, exacerbate symptoms and pose unacceptable limitations to their right to come and go in public settings.

RESUMO Objetivo Estimar a frequência de exposição à fumaça secundária do cigarro entre pacientes com asma. Métodos Estudo transversal, que avaliou pacientes com asma e controles sem asma, por meio de questionários, para identificar a exposição secundária à fumaça do cigarro no ambiente domiciliar, escolar, no trabalho e em ambientes públicos. Resultados Estudamos 544 asmáticos graves, 452 com asma leve/moderada e 454 sem asma. Entre os asmáticos graves, a média de idade foi de 51,9 anos, 444 (81,6%) eram do sexo feminino, 74 (13,6%) tinham fumantes em sua residência, 383 (71,9%) relataram exposição em ambientes públicos e, dos 242 (44,5%) que trabalhavam e/ou estudavam, 46 (19,1%) admitiram exposição ocupacional. Entre asmáticos leves/moderados, a média de idade foi de 36,8 anos, 351 (77,7%) eram do sexo feminino, 50 (11,1%) afirmaram haver tabagistas em sua residência, 381(84,9%) relataram exposição em ambientes públicos e, dos 330 (73,0%) que trabalhavam e/ou estudavam, 58 (17,7%) referiram exposição ocupacional. Encontrou-se associação entre exposição à fumaça secundária do cigarro e controle da doença entre pacientes com asma leve/moderada. Entre os entrevistados, 71% dos pacientes asmáticos graves e 63% daqueles com asma leve/moderada relataram evitar frequentar certos ambientes pelo receio da exposição à fumaça secundária do cigarro − relato mais associado aos pacientes com asma grave. Conclusão A exposição secundária à fumaça do cigarro é uma situação frequente e relatada por uma proporção significativa de asmáticos. Indivíduos com asma encontram-se expostos a este agente, que pode dificultar o controle da doença, exacerbar sintomas e lhes impor limitação inaceitável ao direito de ir e vir em ambientes públicos.

Factores asociados con la exposición al humo de tabaco de segunda mano en lugares públicos y privados en México. Encodat 2016 / Correlates of secondhand smoke exposure in public and private settings in Mexico. Encodat 2016

Resumen: Objetivo: Determinar los factores asociados con la exposición al humo de tabaco de segunda mano (HTSM) en lugares públicos y privados. Material y métodos: Se analizó la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016. La exposición al HTSM se evaluó mediante modelos Poisson multinivel. La muestra del estudio incluye únicamente no fumadores. Resultados: La exposición al HTSM fue similar en los estados que tienen prohibición total para fumar en espacios cerrados en comparación con estados con prohibición parcial. Adultos jóvenes, hombres y personas con nivel educativo alto tienen mayor exposición al HTSM en bares y restaurantes. Los hombres tienen mayor exposición al HTSM en el trabajo, los adultos de mayor edad en el transporte público, mientras las mujeres y adolescentes en el hogar. Conclusiones: La exposición al HTSM continúa elevada y afecta diferencialmente a la población mexicana. Para reducirla, se requiere aplicar totalmente el artículo octavo del Convenio Marco para el Control del Tabaco.

Abstract: Objective: To assess the correlates of secondhand smoke exposure (SHS) in public and private settings. Materials and methods: Data came from the 2016 National Survey of Drug, Alcohol and Tobacco use. Multilevel Poisson models were conducted to evaluate factors associated with SHS. Results: Having a higher education, being male and being a young adult were associated with higher SHS in bars and restaurants. Men had greater SHS at work, while women and adolescents had greater exposure at home. Adults older than 45 years had higher SHS on public transportation compared to adolescents between 12-17 years old. Conclusions: Exposure to SHS remains high and affects the population differentially. To reduce SHS, it is necessary to apply Article 8 of the Framework Convention on Tobacco Control.

Secondhand smoking, knowledge/attitudes and socioeconomic status among married Bangladeshi women: a cross-sectional study

ABSTRACT BACKGROUND: There is a paucity of research on knowledge/attitudes regarding the dangers of exposure to secondhand smoking (SHS) among women. The relationship between exposure to SHS, socioeconomic status (SES) and knowledge/attitudes regarding the risks of SHS has often been ignored. We therefore aimed to examine (1) whether SES and exposure to SHS were independently associated with knowledge/attitudes regarding the risks of SHS; and (2) whether women with low SES and exposure to SHS were uniquely disadvantaged in terms of deficient knowledge and more dismissive attitudes towards the risks of SHS. DESIGN AND SETTING: Cross-sectional study in the Rajshahi district, Bangladesh. METHODS: A total of 541 women were interviewed. Knowledge of and attitudes towards the risks of SHS were the outcomes of interest. RESULTS: A majority of the respondents were exposed to SHS at home (49.0%). Only 20.1% had higher levels of knowledge, and only 37.3% had non-dismissive attitudes towards the risks of SHS. Participants in the low SES group and those exposed to SHS had lower odds of higher knowledge and their attitudes towards the risks of SHS were more dismissive. Regarding deficient levels of knowledge and scores indicating more dismissive attitudes, women in the low SES group and who were exposed to SHS were not uniquely disadvantaged. CONCLUSIONS: Exposure to SHS and low SES were independently associated with deficient knowledge and scores indicating more dismissive attitudes. Regarding knowledge/attitudes, the negative effect of exposure to SHS extended across all socioeconomic backgrounds and was not limited to women in either the low or the high SES group.

Axial Spondyloarthritis after bariatric surgery: a 7-year retrospective analysis

Abstract Background: In recent decades, obesity has become a public health problem in many countries. The objective of this study was to evaluate the main joint and extra-articular manifestations related to spondyloarthritis (SpA) after bariatric surgery (BS) in a retrospective cohort. Methods: Demographic, clinical, laboratory and imaging data from nine patients whose SpA symptoms started after a BS have been described. Modified New York (mNY) criteria for ankylosing spondylitis (AS) and the Assessment of Spondyloarthritis International Society (ASAS) criteria for axial (ax-SpA) and peripheral (p-SpA) spondyloarthritis were applied. Results: The mean weight reduction after BS was 49.3 ±21.9 kg. The BS techniques were Roux-en-Y gastric bypass (n =8; 88.9%) and biliopancreatic diversion with duodenal switch (n = 1; 11.1%). Four (44.4%) patients had no axial or peripheral pain complaints before BS, while the other four (44.4%) had sporadic non-inflammatory back pain that had been attributed to obesity. One patient (11.1%) had persistent chronic back pain. In all nine cases, patients reported back pain onset or pattern (intensity or night pain) change after BS (mean time 14.7 ± 18 months). In addition, 8 of them (88.9%) were human leukocyte antigen (HLA)-B27 positive. All nine patients could be classified according to ASAS criteria as ax-SpA and five (55.6%) patients were classified as AS, according to the mNY criteria. Conclusion: Our data highlight a temporal link between SpA onset symptoms and the BS, suggesting a possible causal plausibility between the two events.

Tabaquismo pasivo y su efecto en la salud infantil: ¿Qué cambió en 11 años?: Hospital Zubizarreta / Passive smoking and its effect on children's health: What changes in 11 years?: Zubizarreta Hospital

Investigación que sigue los hallazgos de un estudio previo realizado entre junio de 2005 y junio de 2006, sobre el humo ambiental de tabaco y sus efectos en las madres y sus hijos, donde se encuestaron 100 madres de niños que se atendieron en el Hospital Zubizarreta. de la Ciudad de Buenos Aires. La presente investigación tuvo como objetivo determinar cuál es la situación actual de las familias que asisten al mismo hospital, en relación a la exposición al tabaco y si hay algún cambio en la distribución de fumadores en los hogares de los pacientes, o si se expone menos a los niños fumando fuera de las viviendas en las familias de fumadores. Se realizó un estudio epidemiológico descriptivo transversal para el que se confeccionó una encuesta semiestructurada anónima que se les realizó a las madres de niños/as entre 4 meses y 12 años de edad que concurrieron al hospital. La misma fue administrada por médicos del Consultorio Externo de Pediatría y una voluntaria que concurrió por 1 mes para efectuarla. El estudio se llevó a cabo entre julio de 2016 y julio de 2017, y se trabajó sobre las variables socio demográficas incluidas en el Índice de Graffar modificado, como tipo de vivienda, trabajo, escolaridad entre otros. A su vez se incluyen datos de salud, sobre antecedentes obstétricos de la madre y de procesos de enfermedad de los/as hijos/as y del consumo o no de tabaco, entre otras variables

Uso e exposição à fumaça do tabaco no Brasil: resultados da pesquisa nacional de saúde 2013 / Use of tobacco and exposure to tobacco smoke in Brazil: results from the national health survey 2013 / Uso y exposición al humo de tabaco en Brasil: resultados de la encuesta nacional de salud 2013

OBJETIVO: Descrever indicadores relacionados ao uso e exposição à fumaça do tabaco no Brasil. MÉTODOS: estudo descritivo com dados da Pesquisa Nacional de Saúde 2013. RESULTADOS: a prevalência do uso atual do tabaco foi de 15,0 por cento (IC95 por cento 14,4 por cento-15,5 por cento), sendo a maior parte fumado (14,7 por cento; IC95 por cento 14,2 por cento-15,2 por cento); nos 12 meses anteriores à entrevista, 51 por cento (IC95 por cento 49,3 por cento-52,9 por cento) dos fumantes atuais haviam tentado parar de fumar; a prevalência de ex-fumantes foi de 17,5 por cento (IC95 por cento 16,9 por cento-18,0 por cento), de 19,2 por cento (IC95 por cento 18,3 por cento-20,1 por cento) em homens e de 11,2 por cento (IC95 por cento 10,6 por cento-11,8 por cento) em mulheres; a prevalência da exposição à fumaça do tabaco em casa foi de 10,7 por cento (IC95 por cento 10,2 por cento-11,3 por cento) e em locais fechados de trabalho foi de 13,5 por cento (IC95 por cento 12,6 por cento-14,4 por cento). CONCLUSÃO: na comparação com outros países, a prevalência do consumo do tabaco no Brasil foi baixa, assim como a exposição à fumaça do tabaco; todavia, cerca de um sexto da população consumia algum produto do tabaco.

OBJETIVO: Describir indicadores relacionados al uso y exposición al humo de tabaco en Brasil. MÉTODOS: estudio descriptivo de la Encuesta Nacional de Salud 2013. RESULTADOS: la prevalencia puntual de consumo de tabaco fue 15,0 por ciento (IC95 por ciento; 14,4 por ciento-15,5 por ciento), siendo la mayor parte del consumo (14,7 por ciento; IC95 por ciento 14,2 por ciento-15,2 por ciento); en los 12 meses anteriores a la encuesta, 51 por ciento (IC95 por ciento 49,3 por ciento-52,9 por ciento) de los fumadores había intentado dejar de fumar; la prevalencia de ex-fumadores fue de 17,5 por ciento (IC95 por ciento 16,9 por ciento-18,0 por ciento), 19,2 por ciento (IC95 por ciento 18,3 por ciento-20,1 por ciento) eran hombres y 11,2 por ciento (IC95 por ciento 10,6 por ciento-11,8 por ciento) mujeres; la exposición al humo de tabaco en casa fue de 10,7 por ciento (IC95 por ciento 10,2 por ciento-11,3 por ciento) y 13,5 por ciento (IC95 por ciento 12,6 por iento-14,4 por ciento) en lugares de trabajo cerrados. CONCLUSIÓN: comparado con otros países, el consumo y exposición al humo de tabaco fueron bajas; una sexta parte de la población consume productos de tabaco.

OBJECTIVE: To describe indicators related to tobacco use and exposure to tobacco smoke in Brazil. METHODS : this was a descriptive study using National Health Survey 2013 data. RESULTS: prevalence of current tobacco use was 15.0 per cent (95 per cent CI 14.4 per cent-15.5 per cent), mainly via smoking (14.7 per cent; 95 per cent CI 14.2 per cent-15.2 per cent); in the 12 months preceding the interview, 51 per cent (95 per cent CI 49.3 per cent - 52.9 per cent) of current smokers had tried to quit smoking; the prevalence of former smokers was 17.5 per cent (95 per cent CI 16.9 per cent -18.0 per cent), 19.2 per cent (95 per cent CI 18.3 per cent-20.1 per cent) in males and 11.2 per cent (95 per cent CI 10.6 per cent -11.8 per cent) in females; prevalence of exposure to tobacco smoke at home was 10.7 per cent (95 per cent CI 10.2 per cent -11.3 per cent) whilst in enclosed work places it was 13.5 per cent (95 per cent CI 12.6 per cent -14.4 per cent). CONCLUSION: in comparison with other countries, the prevalence of tobacco consumption in Brazil was low, as was exposure to tobacco smoke; nevertheless, around one-sixth of the population consumed some kind of tobacco product.

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

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

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

Changes in and Factors Affecting Second-hand Smoke Exposure in Nonsmoking Korean Americans in California: A Panel Study

PURPOSE: We evaluated changes in and factors affecting second-hand smoke (SHS) exposure in a panel study of nonsmokers. METHODS: This study was based on data from a larger study of tobacco use among a representative sample of adults of Korean descent residing in California. Participants included 846 males and 1,399 females who were nonsmokers at baseline (2005-2006) and at follow-up (2007-2009). Participants were selected by probability sampling and were interviewed by telephone. RESULTS: At baseline, 50.0% were exposed to any SHS, and at follow-up 2 years later, 60.4% were exposed to any SHS (p < .001). SHS exposure at baseline was associated with acculturation, employment, spousal smoking, and having a friend who smoked (p < .001). Employment, spousal smoking, and other family members smoking were associated with SHS at follow-up (p < .001). The odds ratio of SHS in the employed group declined from 2.01 at baseline to 1.53 at follow-up, that of the group having a smoking spouse increased from 1.88 to 2.36, and that of the group having other family members smoking increased from 1.20 to 1.69. CONCLUSIONS: We showed that SHS exposure increased among Korean American nonsmokers in California, and the most important variables explaining the change in SHS exposure involved smoking among others with whom the subject is associated. These findings could be used as objective evidence for developing public health policies to reduce SHS exposure.

Parental smoking patterns and their association with wheezing in children

OBJECTIVE: To investigate parental smoking patterns and their association with wheezing in children. METHODS: We performed a case-control study that included 105 children between 6 and 23 months of age who were divided into two groups: cases (children with 3 previous episodes of wheezing) and controls (healthy children without wheezing). The children's exposure to cigarette smoking was estimated using a questionnaire completed by the mothers and by the children's urinary cotinine levels. RESULTS: Based on both the questionnaire results and cotinine levels, exposure to cigarette smoking was higher in the households of cases in which the incidence of maternal smoking was significantly higher than that of paternal smoking. Children in this group were more affected by maternal smoking and by the total number of cigarettes smoked inside the house. Additionally, the questionnaire results indicated that the risk of wheezing was dose dependent. The presence of allergic components, such as atopic dermatitis and siblings with allergic rhinitis and asthma, greatly increased the odds ratio when wheezing was associated with cotinine levels. CONCLUSION: Children exposed to tobacco smoke have an increased risk of developing wheezing syndrome. This risk increases in association with the number of cigarettes smoked inside the house and the presence of other allergic components in the family. .

Avaliação da concentração de monóxido de carbono em estudantes universitários da área da saúde / Evaluation of the carbon monoxide concentration in university students of health area

Objetivo - Avaliar o nível de monóxido de carbono exalado em estudantes universitários da área da saúde fumantes, não fumantes, fumantes passivos e ex-fumantes. Método - Participaram do estudo estudantes universitários da área da saúde, maiores de 18 anos, de ambos os sexos, fumantes, não fumantes, fumantes passivos e ex-fumantes. Foram excluídos do estudo estudantes em processo de cessação de tabagismo. Foram coletadas medidas de monóxido de carbono no ar exalado (COex) e nível de dependência de tabagismo através do teste de Fagerstrõm. Resultados - Foram estudados 100 universitários, sendo 65% não fumantes, 11% fumantes, 16% fumantes passivos e 8% ex-fumantes.Houve predomínio do sexo feminino para os estudantes não fumantes (55,48%) e para os fumantes passivos (68,75%). Os fumantes apresentaram grau de dependência do tabagismo de leve a moderada. A média de COex em não fumantes foi de 8,4±7,6 ppm, nos fumantes foi de 32,1±20,1 ppm, nos fumantes passivos de 14,6±8,3 ppm e nos ex-fumantes de 14,4±6,6 ppm. Os cursos que tiveram menos fumantes foram Fisioterapia (9,09%) e Enfermagem (9,09%) e o curso com mais fumante foi o de Medicina (36,36%). Conclusão - Há um percentual considerável de indivíduos fumantes entre os cursos da área da saúde e os níveis de monóxido de carbono no ar exalado destes estudantes fumantes, ex-fumantes, fumantes passivos e não fumantes foram altos.

Objective - To evaluate the level of exhaled carbon monoxide in university students in the health area smokers, nonsmokers, passive smokers and former smokers. Method - Participants were college students in the health area, over 18 years, of both sexes, smokers, nonsmokers, passive smokers and former smokers. The study excluded students in the process of smoking cessation. We collected measurements of carbon monoxide in exhaled air and level of dependence on smoking by the Fagerstrõm test. Results - There were 100 students, 65% nonsmokers,11% smokers, passive smokers 16% and 8% former smokers. There were more female students to nonsmokers (55.48%) and passive smokers (68.75%). Smokers had the degree of tobacco dependence treatment of mild to moderate. The mean expired CO in nonsmokers was 8.4 ±7.6 ppm, in smokers was 32.1 ± 20.1 ppm, in passive smokers, and 14.6 ± 8.3 ppm and in former smokers, 14.4 ± 6.6 ppm. The courses had fewer smokers were physiotherapy (9.09%) and nurses (9.09%) and the course was more smoking medicine (36.36%). Conclusion - There is a considerable percentage of smokers among the courses in the area of health and levels of carbon monoxide in exhaled air of student smokers, former smokers, passive smokers and nonsmokers were high.

Tobacco use and cessation counseling in India-data from the Global Health Professions Students Survey, 2005-09.

Context: Tobacco use by health professionals reflects the failure of healthcare systems in protecting not only beneficiaries of the system but also those involved in health care delivery. Aim: The aim of this study was to report findings from the Global Health Professions Students Survey (GHPSS) conducted in medical, dental, nursing and pharmacy schools in India. Settings and Design: A cross-sectional survey was conducted in Indian dental and medical schools (in 2009), nursing (in 2007), and pharmacy (in 2008) schools. Materials and Methods: Anonymous, self-administered GHPSS questionnaire covering demographics, tobacco use prevalence, secondhand smoke (SHS) exposure, desire to quit smoking and training received to provide cessation counseling to patients was used. Statistical Analysis: Proportions and prevalence were computed using SUDAAN and SPSS 15.0. Results: Current cigarette smoking and other tobacco use ranged from 3.4-13.4% and 4.5-11.6% respectively, in the four health professional schools, with the highest numbers for medical schools and males. Enforcement of smoking ban in medical schools was low (53%) compared to nursing (86.4%), pharmacy (85.5%), and dental (90.8%) schools. Ninety percent students thought health professionals have a role in giving smoking cessation advice to their patients. Three out of five current smokers wanted to quit. However, one out of two reported receiving help/advice to quit. Although all expressed the need, 29.1-54.8% students received cessation training in their schools. Conclusion: Tobacco control policy, cessation training and initiatives to help students quit smoking should be undertaken.

Determinants of exposure to second-hand smoke at home and outside the home among students aged 11-17 years: Results from the Mumbai Student Tobacco Survey 2010.

Background: While no level of exposure to Second-hand smoke (SHS) is free of risk, 37% of students from South-East Asia region were exposed to SHS. Aims: To estimate the prevalence of exposure to SHS and identify predictors of exposure to SHS at home and outside the home among 1,511 school students aged 11-17 years. Setting: The City of Mumbai. Study Design: This study used a two-stage cluster sampling design. Materials and Methods: Mumbai Student Tobacco Survey (MSTS) was a cross-sectional study, using anonymous self-administered structured questionnaire among students. The probability of schools being selected was proportional to the enrolment into grades 8 to 10. The study aimed to sample around 60 students from selected classes in each chosen school. Statistical Analysis: Proportions, 95% confidence interval and adjusted odds ratios (AOR) were used. Results: About 79.9% students were aware about the current smoking ban at public places and 88.1% were knowledgeable about the deleterious influence of SHS on them. Overall, 16.5% of students were exposed to SHS at home, and 39.9% outside of the home. Students from families where at least one parent used tobacco were at the greatest risk of SHS exposure at home in addition to outside the home exposure. Those students who were not aware about the smoking ban in public places were at a significantly higher risk of SHS exposure outside the home. Conclusion: Self-reported tobacco use status, age, parents' tobacco use, close friends' smoking, and the route they take to school were significant determinants of exposure to SHS at home and outside the home.

Tabagismo passivo no Brasil: resultados da Pesquisa Especial Do Tabagismo, 2008 / Passive smoking in Brazil: results from the 2008 Special Survey on Smoking

O objetivo foi descrever prevalência e características sócio-demográficas associadas ao tabagismo passivo no domicílio e no trabalho, em participantes (15+ anos) de amostra populacional da Pesquisa Especial do Tabagismo, sub-amostra da PNAD 2008. O tabagismo passivo é definido como a exposição ao tabaco por não-fumante, em casa, no trabalho ou em outros locais fechados, excluídas ocupações ao ar livre. Associações com características sócio-demográficas foram estimadas por análise de regressão logística. Nos 25.005 não-fumantes, a exposição domiciliar é diária para 12,5 por cento e ocasional para 21 por cento. À regressão multinomial (referência: não-expostos), a exposição diária diminui com aumento de idade e tanto a exposição diária como a ocasional diminuem com maiores escolaridade e renda. Comparada à Região Sudeste, há menor exposição diária no Norte e no Centro-Oeste, e maior ocasional no Nordeste. Dos 10.933 trabalhadores, 55 por cento dos homens e 45 por cento das mulheres relataram exposição no trabalho e 67 por cento exposição domiciliar adicional. A exposição no trabalho é maior em homens, nos mais velhos (55+anos) e com menor escolaridade e renda; e menor no Sul. A desigualdade social no Brasil se revela também na maior exposição ao tabagismo passivo daqueles com menor escolaridade e renda.

The scope of this article was to describe indoor passive smoking, at home and at work, among Brazilians (15+ years) participants of the "Special Research on Smoking", a sub-sample of the PNAD 2008. Non-smokers who reported exposure to indoor household smoking were classified as daily or occasional passive smokers, based on the frequency of exposure. Associations with socio-demographic factors were verified by logistic regression analysis. Among 25,005 participants, prevalence of daily and occasional household exposure were 12.5 percent and 21 percent, respectively. Compared to those not exposed, daily exposure decreased with increasing age, schooling and income. Occasional exposure is not influenced by age, but decreases with increasing schooling and income. Compared to the Southeast Region, daily exposure was lower in the North and Central West and higher in the Northeast. Among those 10,933 with indoor occupations, 55 percent of men and 45 percent of women reported worksite exposure and 67 percent of them also reported household exposure. Prevalence of exposure at work is higher in men, older adults (55+ years) and among those with lower schooling and income and lower among South Region residents. Social inequality in Brazil is seen in greater exposure to passive smoking among those with lower incomes and less education.

Avaliação do conhecimento sobre tabagismo em pacientes internados / Evaluation of hospitalized patients in terms of their knowledge related to smoking

OBJETIVO: Determinar características relacionadas ao tabagismo e avaliar o conhecimento sobre a relação entre dependência nicotínica e doenças relacionadas ao tabaco em pacientes internados. MÉTODOS: Foram avaliados em 186 pacientes (59 por cento de homens; média de idade = 51,3 ± 16,8 anos) internados em um hospital público quanto a características demográficas, diagnóstico de internação, história tabágica e tabagismo passivo. Todos os pacientes responderam um questionário sobre o conhecimento da relação tabagismo/doença. RESULTADOS: Dos 186 pacientes, 42 (22,6 por cento) eram fumantes, 64 (34,4 por cento) eram ex-tabagistas e 80 (43 por cento) referiam nunca ter fumado; 136 (73 por cento) referiam exposição passiva ao fumo. O diagnóstico de admissão foi o de doença possivelmente relacionada ao tabaco em 21,5 por cento dos pacientes e em 39 por cento dos fumantes ativos e ex-fumantes. A proporção de fumantes e ex-fumantes que não conheciam a associação entre o tabagismo e a causa de internação foi similar (56 por cento vs. 65 por cento). Apenas 19 por cento dos fumantes e 32 por cento dos ex-fumantes acreditavam que o tabagismo tivesse afetado sua saúde (p = 0,22). A proporção de ex-fumantes e de não fumantes que acreditavam que parar de fumar é uma questão de vontade foi significativamente maior que aquela de fumantes ativos (64 por cento e 53 por cento, respectivamente, vs. 24 por cento; p < 0,001 e p = 0,008). Embora 96 por cento dos pacientes acreditassem que o tabagismo cause dependência, apenas 60 por cento identificavam o tabagismo como uma doença. CONCLUSÕES: Este estudo mostra a contradição entre o reconhecimento do tabagismo como causa de dependência e o reconhecimento do tabagismo como uma doença, além do desconhecimento de que o tabagismo atual e pregresso é um fator de risco para o desenvolvimento e a evolução de doenças.

OBJECTIVE: To identify characteristics related to smoking in hospitalized patients and to assess the knowledge that such patients have regarding the relationship between nicotine dependence and smoking-related diseases. METHODS: The study included 186 patients (males, 59 percent; mean age, 51.3 ± 16.8 years) who were evaluated regarding demographic characteristics, diagnosis at admission, smoking history and passive smoke exposure. All of the patients completed a questionnaire regarding their knowledge of the relationship between smoking and disease. RESULTS: Of the 186 patients, 42 (22.6 percent) were smokers, 64 (34.4 percent) were former smokers and 80 (43 percent) stated they were never smokers; 136 (73 percent) reported passive smoke exposure. In the sample as a whole, 21.5 percent of the patients were diagnosed with a smoking-related disease at admission, compared with 39 percent of those who were smokers or former smokers. The proportion of individuals who were unaware of the relationship between smoking and the cause of hospitalization was similar among current smokers and former smokers (56 percent and 65 percent, respectively). Only 19 percent of the current smokers believed that smoking might have affected their health, compared with 32 percent of the former smokers (p = 0.22). The proportion of individuals who believed that quitting smoking depends on willpower was significantly higher among former smokers and never smokers than among current smokers (64 percent and 53 percent, respectively, vs. 24 percent; p < 0.001 and p = 0.008). Although 96 percent of the patients believed that smoking causes dependence, only 60 percent identified smoking as a disease. CONCLUSIONS: This study shows the disconnect between the recognition of smoking as a cause of dependence and the recognition of smoking as a disease, as well as the general lack of awareness that former and current smoking constitute a risk factor for the development and ...

Consumo y exposición al humo de tabaco en mujeres embarazadas de Ecuador / Smoking and exposure to tobacco smoke among pregnant women in Ecuador

OBJETIVOS: Determinar la frecuencia de tabaquismo y exposición ambiental al humo de tabaco en mujeres embarazadas de Ecuador y describir los perfiles sociodemográficos asociados con esos factores de riesgo perinatal. MÉTODOS: Estudio descriptivo transversal mediante una encuesta aplicada a mujeres de 18 a 46 años con más de 3 meses de embarazo que asistieron entre octubre de 2004 y septiembre de 2005 a sus consultas de seguimiento en siete servicios de maternidad de seis ciudades de Ecuador. Se analizaron los datos demográficos y de exposición medioambiental (variables independientes) y su relación con el hábito de fumar cigarrillos y la exposición ambiental al humo de tabaco. RESULTADOS: De las 746 mujeres analizadas, 53,3 por ciento había fumado ocasionalmente y 4,3 por ciento había fumado habitualmente; de estas, 75,0 por ciento había dejado de fumar antes o durante el embarazo. De las encuestadas, 12,9 por ciento estuvo expuesta con frecuencia o siempre al humo de tabaco en ambientes cerrados. Tener mayor educación (11 años o más) y un nivel socioeconómico medio o alto, ser caucásica y considerar aceptable que las mujeres de su comunidad fumen se asoció significativa y directamente con el hábito de fumar cigarrillos (P < 0,001). En general, 12,9 por ciento de las mujeres estuvo expuesta al humo de tabaco y esto se asoció significativamente con ser soltera y cohabitar con fumadores o trabajadores vinculados con la industria del tabaco (P < 0,001). CONCLUSIONES: Se deben diseñar e implementar medidas específicas dirigidas no solo a estimular el abandono de este hábito en las embarazadas, sino también a prevenir que las mujeres en edad reproductiva comiencen a fumar y controlar el entorno fumador en el hogar.

OBJECTIVES: To determine the frequency of smoking and second-hand smoke exposure among pregnant women in Ecuador and to describe the sociodemographic profiles associated with these perinatal risk factors. METHODS: A cross-sectional descriptive study using a survey of women 18-46 years of age who were more than three months pregnant and attended follow-up consultations in seven maternity clinics in six cities in Ecuador between October 2004 and September 2005. Demographics and environmental exposure (independent variables) data and their relationship to cigarette smoking and secondhand-smoke exposure were analyzed. RESULTS: Of the 746 women studied, 53.3 percent had smoked occasionally, and 4.3 percent, regularly; of these, 75 percent had quit smoking before or during pregnancy. Of the respondents, 12.9 percent were frequently or always exposed to secondhand smoke indoors. Having more education (11 or more years), being in the middle or upper socioeconomic classes, being Caucasian, and it being considered acceptable for women in the community to smoke were significantly and directly associated with cigarette smoking (P < 0.001). Overall, 12.9 percent of women were being exposed to secondhand smoke and this was significantly associated with being single and cohabiting with smokers or employees connected to the tobacco industry (P < 0.001). CONCLUSIONS: Specific measures must be designed and implemented to not only encourage smoking cessation during pregnancy, but also to prevent women of reproductive age from taking up smoking and to limit smoking in the home environment.

global youth tobacco survey - 2007. Comparison with the global youth tobacco survey 2001-2002 in Saudi Arabia

To primarily describe both smoking pattern in the youth population and a comparison with the Global Youth Tobacco Survey [GYTS] in 2001-2002. The standard 2-stage methodology and a cross-sectional design were used to select randomly a representative sample of intermediate schools, classes, and students from all regions in the Kingdom of Saudi Arabia from January to June 2007. Comparing results with the 2001 GYTS, the prevalence of ever and current smoking, use of other tobacco products, and initiation of smoking by never smokers in the next year increased among males, but with improvement in the students' knowledge and attitudes towards smokers. The second-hand tobacco smoke items were not distinguished, however, one or both parent smokers increased by 6% over 6 years. Media anti-smoking messages and awareness improved, however, the widespread display and proliferation of items with a cigarette brand logo on it, encourages participants to buy more cigarettes. Teaching hazards of smoking to students improved, however, the reasons why people of their age smoke were not discussed interactively. Females less than 18 years of age [minors] were not denied cigarette purchase compared to male participants of the same. The National Tobacco Control Programs is apparently working effectively but differentially against smoking. The program needs to be evaluated systematically and accordingly and intensified further to reduce smoking among youths in the Kingdom of Saudi Arabia

Prevalência e fatores associados ao tabagismo em escolares da Região Sul do Brasil / Prevalence and risk factors associated with smoking among school children, Southern Brazil

OBJETIVO: Estimar a prevalência do tabagismo em estudantes e os fatores associados. MÉTODOS: Foram utilizados dados secundários, provenientes do inquérito Vigescola realizado em Curitiba (PR), Florianópolis (SC) e Porto Alegre (RS) em 2002 e 2004. A amostra compreendeu 3.690 escolares de 13 a 15 anos, cursando as sétima e oitava séries do ensino fundamental e primeira do ensino médio, em escolas públicas e privadas. Para a análise dos resultados foram estimadas proporções ponderadas, odds ratio (OR), e utilizada a técnica de regressão logística múltipla. RESULTADOS: As taxas de prevalência de tabagismo corresponderam a 10,7 por cento (IC 95 por cento: 10,2;11,3) em Florianópolis, 12,6 por cento (IC 95 por cento: 12,4;12,9) em Curitiba e 17,7 por cento (IC 95 por cento: 17,4;18,0) em Porto Alegre. Os fatores associados ao tabagismo em escolares em Curitiba foram: sexo feminino (OR=1,49), pai fumante (OR=1,59), amigos fumantes (OR=3,46), exposição à fumaça do tabaco fora de casa (OR=3,26) e possuir algum objeto com logotipo de marca de cigarro (OR=3,29). Em Florianópolis, as variáveis associadas ao tabagismo foram escolares do sexo feminino (OR=1,26), ter amigos fumantes (OR=9,31), exposição à fumaça do tabaco em casa (OR=2,03) e fora de casa (OR=1,45) e ter visto propaganda em cartazes (OR=1,82). Em Porto Alegre, as variáveis que estiveram associadas com o uso de tabaco pelos escolares foram sexo feminino (OR=1,57), idade entre 14 anos (OR=1,77) e 15 anos (OR=2,89), amigos fumantes (OR=9,12), exposição à fumaça do tabaco em casa (OR=1,87) e fora de casa (OR=1,77) e possuir algo com logotipo de marca de cigarro (OR=2,83). CONCLUSÕES: Há elevada prevalência de tabagismo entre escolares de 13 a 15 anos, cujos fatores significativamente associados comuns às três capitais são: ter amigos fumantes e estar exposto à fumaça ambiental fora de casa.

OBJECTIVE: To estimate the prevalence of smoking among students and associated factors. METHODS: Secondary data from the Vigescola Survey, conducted in the cities of Curitiba, Florianópolis and Porto Alegre (Southern Brazil) between 2002 and 2004, were used. Sample comprised 3,690 school children, aged between 13 and 15 years, and enrolled in the 7th and 8th grades of primary school and 1st grade of high school, in public and private schools. Weighted proportions and odds ratio (OR) were estimated and multiple logistic regression was used to analyze results. RESULTS: Smoking prevalence rates were 10.7 percent (95 percent CI: 10.2;11.3) in Florianópolis, 12.6 percent (95 percent CI: 12.4;12.9) in Curitiba and 17.7 percent (95 percent CI: 17.4;18.0) in Porto Alegre. Risk factors associated with smoking among schoolchildren in Curitiba were: female sex (OR=1.49), smoking father (OR=1.59), smoking friends (OR=3.46), exposure to secondhand tobacco smoke outside the home (OR=3.26), and having some object with cigarette brand logos (OR=3.29). In Florianópolis, variables associated with smoking were: female schoolchildren (OR=1.26), having smoking friends (OR=9.31), exposure to secondhand tobacco smoke at home (OR=2.03) and outside the home (OR=1.45) and having seen advertisements on posters (OR=1.82). In Porto Alegre, variables associated with tobacco use among school children were: female sex (OR=1.57), aged between 14 years (OR=1.77) and 15 years (OR=2.89), smoking friends (OR=9.12), exposure to secondhand tobacco smoke at home (OR=1.87) and outside the home (OR=1.77) and having some object with cigarette brand logos (OR=2.83). CONCLUSIONS: Smoking prevalence among school children aged between 13 and 15 years is high. Factors significantly associated with it and common to the three capitals were as follows: having smoking friends and being exposed to environmental smoke outside the home.