Secondhand Smoke Exposure Among High-Risk Patients in the United States (NHANES 2001-2012): Implications for Clinical Practice.

INTRODUCTION: Patients with cancer, cardiovascular disease (CVD), and respiratory disease are susceptible to health consequences related to secondhand smoke (SHS) exposure. This study examined the prevalence, time trends, and correlates of SHS exposure among these patients compared with individuals without these diseases (control). METHODS: Data were obtained from the 2001-2012 National Health and Nutrition Examination Survey. All adults (≥20 years old) who were nonsmokers and exposed to SHS (serum cotinine level 0.015-10 ng/mL), had cancer (n = 1,440), CVD (congestive heart failure, coronary heart disease, angina, heart attack, or stroke; n = 1,754), respiratory disease (asthma, chronic bronchitis, emphysema; n = 1,444), or none of these diseases (control; n = 11,615) were included in the analysis. Weighted prevalence, weighted second-degree polynomial linear regression of prevalence on year for trend analysis, and multivariable logistic regression analyses were performed with adjustments to the complex survey design. RESULTS: SHS exposure was the highest among patients with respiratory disease (72.1%), followed by patients with CVD (70.6%), controls (70.4%), and patients with cancer (65.4%). From 2001 to 2012, exposure decreased the most among CVD patients (19.6%), followed by controls (16.0%), cancer patients (14.7%), and respiratory patients (10.0%). Exposed individuals in all groups were more likely to be younger, Black, and less educated. Exposed patients with respiratory disease were more likely to be former smokers (p < .05 for all). CONCLUSIONS: SHS exposure among these patients is high and comparable to the general population. Strengthening smoke-free policies in all settings is critical. More efforts are needed to address SHS exposure more effectively in clinical care settings. IMPLICATIONS: Despite the negative health effect of SHS exposure among patients with cancer, CVD, and respiratory disease, modest progress has been made in reducing their exposure. Continued efforts to strengthen smoke-free policies in workplaces, public place, and multiunit housing is critical. In addition, exposure to SHS among these patients seems to be overlooked in clinical care settings. More efforts are needed to address this problem more effectively in health care settings and investigate specific interventions directed at increasing patients' awareness about the risk of exposure to SHS and helping them to reducing their exposure.

How Do Waterpipe Smoking Establishments Attract Smokers? Implications for Policy.

BACKGROUND: Given the unique social nature of waterpipe smoking, an important factor contributing to its popularity is the spread of waterpipe establishments. OBJECTIVES: With a focus on implications for regulations, we conducted a qualitative assessment of customers' online reviews on Yelp.com to gain insight into their positive and negative perceptions about waterpipe establishments and products, and identify features that are most important to them. METHODS: In June 2016, an online search of Yelp was conducted to identify waterpipe establishments in Miami, Florida. First, we collected information from the websites on establishments' characteristics and their marketing practices. Then we selected customers' waterpipe-related reviews and used an inductive qualitative method to code and identify key themes associated with positive and negative customers' experiences. Thematic analysis was completed upon reaching saturation. The final coding scheme consisted of 32 codes within eight themes. RESULTS: The homepage of the establishment was used to promote special discounts and events, while the online waterpipe menu was used to promote the waterpipe products. Our thematic analysis indicated that the variety of flavored tobacco was the most rated positive factor to customers, while the low-quality charcoal and high price were the most negative factors. Conclusions/Importance: Waterpipe online advertisements and promotions should be monitored and restricted. The availability of flavored tobacco, innovative device/accessories, affordable pricing, and charcoal quality are important domains for waterpipe establishments policy/regulation. Regulatory framework for waterpipe establishments should address the complex context of waterpipe including the venue (i.e., physical, website, menu), the tobacco, the device/accessories, and charcoal.

A cluster randomized pilot trial of a tailored worksite smoking cessation intervention targeting Hispanic/Latino construction workers: Intervention development and research design.

Construction workers have the highest smoking rate among all occupations (39%). Hispanic/Latino workers constitute a large and increasing group in the US construction industry (over 2.6 million; 23% of all workers). These minority workers have lower cessation rates compared to other groups due to their limited access to cessation services, and lack of smoking cessation interventions adapted to their culture and work/life circumstances. Formative research was conducted to create an intervention targeting Hispanic/Latino construction workers. This paper describes the intervention development and the design, methods, and data analysis plans for an ongoing cluster pilot two-arm randomized controlled trial comparing an Enhanced Care worksite cessation program to Standard Care. Fourteen construction sites will be randomized to either Enhanced Care or Standard Care and 126 participants (63/arm) will be recruited. In both arms, recruitment and intervention delivery occur around "food trucks" that regularly visit the construction sites. Participants at Enhanced Care sites will receive the developed intervention consisting of a single face-to-face group counseling session, 2 phone calls, and a fax referral to Florida tobacco quitline (QL). Participants at Standard Care sites will receive a fax referral to the QL. Both groups will receive eight weeks of nicotine replacement treatment and two follow-up assessments at three and six months. Feasibility outcomes are estimated recruitment yield, barriers to delivering the intervention onsite, and rates of adherence/compliance to the intervention, follow-ups, and QL enrollment. Efficacy outcomes are point-prevalence and prolonged abstinence rates at six month follow-up confirmed by saliva cotinine <15 ng/ml.

Physical Exposures, Work Tasks, and OSHA-10 Training Among Temporary and Payroll Construction Workers.

OBJECTIVE: We characterize and compare the self-reported physical exposures, work tasks, and OSHA-10 training in a non-probabilistic sample of temporary and payroll construction workers. METHODS: In June 2016, a total of 250 payroll and temporary general laborers employed at Florida construction sites completed a survey at the job site as part of the falls reported among minority employees (FRAME) study. RESULTS: Workers employed through temp agencies (57.1%) were significantly more likely to report moving or lifting materials more than 100 pounds than payroll workers (38.5%; P < 0.01). Temporary construction workers with 10-hour OSHA training (22.2%) spent significantly less time with intense hand use/awkward hand posture than temporary workers without 10-hour OSHA training (46.9%; P = 0.048). CONCLUSIONS: Temp construction workers with OSHA 10-hour training reported less hazardous physical postures than workers without the same training.