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Exposure and Health Effects of Secondhand Smoke

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (1 November 2016) | Viewed by 47908

Special Issue Editors

Lecturer in Applied Health Research, Institute of Applied Health Research, Public Health Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
Interests: secondhand smoke; harm reduction; smoke-free environments; smoke-free homes; e-cigarettes; secondhand vapour; child and maternal health; health inequalities; complex interventions; qualitative; mixed-methods; systematic review; qualitative synthesis
Lecturer in Epidemiology, Institute of Applied Health Research, Public Health Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
Interests: smoking cessation interventions; tobacco harm reduction interventions; smoking cessation related weight gain; lifestyle and chronic disease; chronic disease management; public health; systematic review

Special Issue Information

Dear Colleagues,

Globally, 600,000 non-smokers die prematurely as a result of being exposed to secondhand smoke (SHS) each year. Exposure to SHS is causally linked to death and disability and is estimated to account for ~1% of the total global burden of disease. There is no safe level of exposure, and given the large number of non-smokers who are at risk of exposure to SHS in private and public spaces, there is a need for effective tobacco control strategies to protect those at risk.

There are an increasing number of jurisdictions that have enacted legislation mandating smoke-free environments, principally in workplaces and public spaces, which has reduced non-smokers’ SHS exposure and related morbidity and mortality. However, such smoke-free legislation does not cover homes, resulting in homes being a predominant source of SHS exposure for non-smokers, particularly for children. Globally, 40% of children under the age of 14 years are regularly exposed to SHS.

The most effective way to reduce children’s SHS exposure would be to support their caregivers to quit smoking altogether. However, for those caregivers who are unable or unwilling to quit, the next best option is to promote harm reduction strategies such as supporting them to make their homes smoke-free. To date, there is mixed evidence of effectiveness for interventions to protect non-smokers from SHS and so there is a need for more high-quality, robust studies with objective exposure validation.

This Special Issue is open to any subject area relevant to exposure to and the health effects of secondhand smoke. The listed keywords suggest just a few of the many possibilities.

Dr. Laura L. Jones
Dr. Amanda Farley
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • tobacco smoking
  • public health
  • secondhand tobacco smoke
  • third-hand tobacco smoke
  • e-cigarettes/secondhand vapour
  • harm reduction
  • smoke-free environments (homes, cars)
  • clean-indoor air laws, public smoking bans
  • economic costs of tobacco exposure
  • smoking cessation, smoking initiation
  • tobacco control interventions

Published Papers (10 papers)

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Research

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561 KiB  
Article
Estimation of Saliva Cotinine Cut-Off Points for Active and Passive Smoking during Pregnancy—Polish Mother and Child Cohort (REPRO_PL)
by Kinga Polanska, Anna Krol, Pawel Kaluzny, Danuta Ligocka, Karolina Mikolajewska, Seif Shaheen, Robert Walton and Wojciech Hanke
Int. J. Environ. Res. Public Health 2016, 13(12), 1216; https://doi.org/10.3390/ijerph13121216 - 08 Dec 2016
Cited by 22 | Viewed by 4798
Abstract
A reliable assessment of smoking status has significant public health implications and is essential for research purposes. The aim of this study was to determine optimal saliva cotinine cut-off values for smoking during pregnancy. The analyses were based on data from 1771 women [...] Read more.
A reliable assessment of smoking status has significant public health implications and is essential for research purposes. The aim of this study was to determine optimal saliva cotinine cut-off values for smoking during pregnancy. The analyses were based on data from 1771 women from the Polish Mother and Child Cohort. Saliva cotinine concentrations were assessed by high performance liquid chromatography coupled with tandem mass spectrometry (HPLC-ESI + MS/MS). The saliva cotinine cut-off value for active smoking was established at 10 ng/mL (sensitivity 96%, specificity 95%) and for passive smoking at 1.5 ng/mL (sensitivity 63%, specificity 71%). About 5% of the self-reported non-smoking women were classified as smokers based on the cotinine cut-off value. Significantly more younger, single, and less educated self-reported non-smokers had a cotinine concentration higher than 10 ng/mL compared to those who were older, married, and who had a university degree. Close to 30% of the non-smokers who indicated that smoking was not allowed in their home could be classified as exposed to passive smoking based on the cut-off value. The study suggests that self-reported smoking status is a valid measure of active smoking, whereas in the case of passive smoking, a combination of questionnaire data and biomarker verification may be required. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
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274 KiB  
Article
The Effect of a Pilot Pediatric In-Patient Department-Based Smoking Cessation Intervention on Parental Smoking and Children’s Secondhand Smoke (SHS) Exposure in Guangxi, China
by Kaiyong Huang, Li Yang, Jonathan P. Winickoff, Jing Liao, Guangmin Nong, Zhiyong Zhang, Xia Liang, Gang Liang and Abu S. Abdullah
Int. J. Environ. Res. Public Health 2016, 13(11), 1109; https://doi.org/10.3390/ijerph13111109 - 08 Nov 2016
Cited by 4 | Viewed by 3618
Abstract
Children’s exposure to secondhand smoke (SHS) at home has numerous adverse health effects. This study evaluated the effects of a pediatric in-patient department-based pilot smoking cessation intervention for household members to reduce children’s SHS exposure and encourage smoking cessation. A pre-post test design [...] Read more.
Children’s exposure to secondhand smoke (SHS) at home has numerous adverse health effects. This study evaluated the effects of a pediatric in-patient department-based pilot smoking cessation intervention for household members to reduce children’s SHS exposure and encourage smoking cessation. A pre-post test design study was designed to assess the effectiveness of a telephone counseling intervention on household members of hospitalized children in pediatric departments. Data were collected with a standardized Chinese language questionnaire. At the three-month follow-up survey, the proportions of household members who reported adopting complete smoking restriction at home (55%), did not smoke at home at all (37%), did not allow others to smoke in the car (70%), or did not allow others to smoke around the child (57%) were significantly higher than the self-reported responses at the baseline survey. The proportions of household members who reported smoking at home (49%) and in the car (22%) were significantly lower than the baseline survey. Overall, 7% of the participants had reported quitting smoking after three months. Pediatric in-patient department-based telephone counseling for smoking cessation was found to be acceptable to Chinese parents. The intervention encouraged few parents to quit smoking, but encouraged more parents to take measures to reduce children’s SHS exposure. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
292 KiB  
Article
“He Doesn’t Listen to My Words at All, So I Don’t Tell Him Anything”—A Qualitative Investigation on Exposure to Second Hand Smoke among Pregnant Women, Their Husbands and Family Members from Rural Bangladesh and Urban India
by Cath Jackson, Rumana Huque, Veena Satyanarayana, Shammi Nasreen, Manpreet Kaur, Deepa Barua, Prashanta Nath Bhowmik, Mithila Guha, Mukesh Dherani, Atif Rahman, Kamran Siddiqi and Prabha S. Chandra
Int. J. Environ. Res. Public Health 2016, 13(11), 1098; https://doi.org/10.3390/ijerph13111098 - 08 Nov 2016
Cited by 14 | Viewed by 4855
Abstract
Second hand smoke (SHS) exposure during pregnancy is associated with poor pregnancy and fetal outcomes. To design interventions to reduce exposure, an in depth understanding of social and cultural factors of smoking behavior at home is important, especially in South Asia where SHS [...] Read more.
Second hand smoke (SHS) exposure during pregnancy is associated with poor pregnancy and fetal outcomes. To design interventions to reduce exposure, an in depth understanding of social and cultural factors of smoking behavior at home is important, especially in South Asia where SHS exposure is high. This study aimed to explore pregnant women’s, their husbands’ and other family members’ knowledge, attitudes and practices regarding home SHS exposure. Semi-structured interviews were conducted with 33 participants in Comilla, Bangladesh and 31 in Bangalore, India (36 pregnant women, 18 husbands, and 10 family members). Data were analyzed using the Framework approach. Husbands smoked in various living areas inside the home, often in the presence of their pregnant wives. Most had never tried to stop smoking at home. Knowledge of the risks was generally poor. Most women had repeatedly asked their husband to smoke outside with little success and only few family members had reprimanded the husbands. Husbands who had stopped did so because of requests from children and their mother. Potential strategies to decrease SHS exposure at home were educating the husband about risks and supporting the pregnant women in negotiation. Interventions must also enlist family support to enhance the woman’s self-efficacy. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
275 KiB  
Article
Smoke-Free Rules and Secondhand Smoke Exposure in Vehicles among U.S. Adults—National Adult Tobacco Survey, 2009–2010 and 2013–2014
by Judy Kruger, Amal Jama, Michelle Kegler, Carissa Baker Holmes, Sean Hu and Brian King
Int. J. Environ. Res. Public Health 2016, 13(11), 1048; https://doi.org/10.3390/ijerph13111048 - 26 Oct 2016
Cited by 4 | Viewed by 3858
Abstract
In the United States (U.S.), secondhand smoke (SHS) exposure causes more than 41,000 deaths among nonsmoking adults annually. Adoption of smoke-free laws in public areas has increased, but private settings such as vehicles remain a source of SHS exposure. This study assessed change [...] Read more.
In the United States (U.S.), secondhand smoke (SHS) exposure causes more than 41,000 deaths among nonsmoking adults annually. Adoption of smoke-free laws in public areas has increased, but private settings such as vehicles remain a source of SHS exposure. This study assessed change in voluntary smoke-free vehicle rules and SHS exposure in personal vehicles among U.S. adults between two periods, 2009–2010 and 2013–2014, using data from the National Adult Tobacco Survey (NATS). NATS is a national landline and cellular telephone survey of non-institutionalized adults aged ≥18 years in the 50 U.S. states and the District of Columbia. We assessed percentage change in the prevalence of smoke-free vehicle rules among all adults and SHS exposure in vehicles among nonsmoking adults, overall, by sociodemographic factors (sex, age, race/ethnicity, education, marital status, annual household income, U.S. region), and by cigarette smoking status. During 2009–2010 to 2013–2014, the percentage of adults with a 100% smoke-free vehicle rule increased from 73.6% to 79.5% (% change = +8.0%; p < 0.05). Among nonsmokers, SHS exposure in vehicles in the previous 7 days decreased from 9.2% to 8.2% (% change = −10.9%; p < 0.05). Smoke-free rules in private settings such as vehicles, in coordination with comprehensive smoke-free policies in indoor public settings, can help reduce SHS exposure and promote smoke-free norms. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
444 KiB  
Article
Children’s Exposure to Secondhand Smoke during Ramadan in Jakarta, Indonesia
by Nurul (Nadia) H.W. Luntungan, M. Justin Byron, Melbourne F. Hovell, Laura J. Rosen, Annisa Anggraeni and Vaughan W. Rees
Int. J. Environ. Res. Public Health 2016, 13(10), 952; https://doi.org/10.3390/ijerph13100952 - 26 Sep 2016
Cited by 7 | Viewed by 4019
Abstract
Secondhand smoke exposure (SHS) causes a disproportionate health burden for children, yet existing smoke-free laws are often poorly enforced. We monitored air quality while observing children and adult nonsmokers present in public venues during Ramadan, a period of Muslim religious observance marked by [...] Read more.
Secondhand smoke exposure (SHS) causes a disproportionate health burden for children, yet existing smoke-free laws are often poorly enforced. We monitored air quality while observing children and adult nonsmokers present in public venues during Ramadan, a period of Muslim religious observance marked by family and social gatherings, in Jakarta, Indonesia. A repeated-measures design was used to assess indoor air quality during and after Ramadan in 43 restaurants and in five smoke-free control venues. Fine particulate matter of 2.5 microns or less (PM2.5) was sampled. The average number of children and active smokers present in each venue was also observed. PM2.5 levels were significantly higher during Ramadan (mean 86.5 µg/m3) compared with post-Ramadan (mean 63.2 µg/m3) in smoking venues (p = 0.015). During Ramadan, there were more active smokers (p = 0.012) and children (p = 0.051) observed in venues where smoking occurred, compared with the same venues post-Ramadan. Poor enforcement of the smoke-free law in Jakarta has failed to protect children from SHS exposure in public venues during Ramadan. Collaboration between the government, NGOs (such as the Indonesian Cancer Foundation (YKI) and the Smoking Control Foundation (LM3)), religious leaders, and venue owners and managers must be developed to ensure that the comprehensive smoking bans apply to all venues, and that smoke-free laws are enforced. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
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273 KiB  
Article
Disadvantaged Parents’ Engagement with a National Secondhand Smoke in the Home Mass Media Campaign: A Qualitative Study
by Neneh Rowa-Dewar and Amanda Amos
Int. J. Environ. Res. Public Health 2016, 13(9), 901; https://doi.org/10.3390/ijerph13090901 - 09 Sep 2016
Cited by 11 | Viewed by 4313
Abstract
Mass media campaigns can be effective in tobacco control but may widen health inequalities if they fail to engage disadvantaged smokers. This qualitative study explored how parents with young children living in disadvantaged circumstances engaged with a national campaign which aimed to raise [...] Read more.
Mass media campaigns can be effective in tobacco control but may widen health inequalities if they fail to engage disadvantaged smokers. This qualitative study explored how parents with young children living in disadvantaged circumstances engaged with a national campaign which aimed to raise awareness of the importance of smokefree homes. Individual semi-structured interviews were carried out with 17 parents before and after the Scottish 2014 “Right Outside” mass media campaign. A conceptual framework exploring meaningful exposure (recall and understanding), motivational responses (protecting children from secondhand smoke (SHS)) and opportunities to act (barriers) was used to thematically analyse the findings. Campaign recall and engagement, and motivation to protect children were high. Parents identified with the dramatized scenario and visual impact of SHS harm to children in the TV advertisement. Some reported changed smoking practices. However, supervising young children in limited accommodation when caring alone constrained opportunities to smoke outside. Instead, parents described actions other than smoking outside that they had taken or were planning to take to create smokefree homes. Mass media campaigns using emotive, real-life circumstances can be effective in engaging parents about SHS. However, the behavioural impact may be limited because of difficult home environments and circumstances. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
304 KiB  
Article
National and State-Specific Attitudes toward Smoke-Free Parks among U.S. Adults
by Judy Kruger, Amal Jama, Michelle Kegler, Kristy Marynak and Brian King
Int. J. Environ. Res. Public Health 2016, 13(9), 864; https://doi.org/10.3390/ijerph13090864 - 31 Aug 2016
Cited by 7 | Viewed by 4145
Abstract
Outdoor places, such as parks, remain a source of secondhand smoke (SHS) exposure. We assessed attitudes toward smoke-free parks among U.S. adults. Data came from the 2009–2010 National Adult Tobacco Survey, a landline and cellular telephone survey of noninstitutionalized adults aged ≥18 in [...] Read more.
Outdoor places, such as parks, remain a source of secondhand smoke (SHS) exposure. We assessed attitudes toward smoke-free parks among U.S. adults. Data came from the 2009–2010 National Adult Tobacco Survey, a landline and cellular telephone survey of noninstitutionalized adults aged ≥18 in the 50 U.S. states and D.C. Descriptive statistics and logistic regression were used to assess the prevalence and sociodemographic correlates of attitudes toward smoke-free parks, overall and by current tobacco use. Overall, 38.5% of adults reported favorable attitudes toward complete smoke-free parks; prevalence ranged from 29.2% in Kentucky to 48.2% in Maine. Prevalence of favorable attitudes toward smoke-free parks was higher among nonusers of tobacco (44.6%) and noncombustible-only users (30.0%) than any combustible users (21.3%). The adjusted odds of having a favorable attitude were higher among: women; Hispanics and Black non-Hispanics, American Indian and Alaska Native non-Hispanics, and other non-Hispanics; those with an unspecified sexual orientation; and those with children aged ≤17 in the household, relative to each characteristics respective referent group. Odds were lower among: any combustible tobacco and noncombustible-only tobacco users; adults aged 45–64; and those with some college or an undergraduate degree. Opportunities exist to educate the public about the benefits of smoke-free outdoor environments. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)

Review

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598 KiB  
Review
Facilitators and Barriers of Smokers’ Compliance with Smoking Bans in Public Places: A Systematic Review of Quantitative and Qualitative Literature
by Li Zhou, Lu Niu, Hui Jiang, Caixiao Jiang and Shuiyuan Xiao
Int. J. Environ. Res. Public Health 2016, 13(12), 1228; https://doi.org/10.3390/ijerph13121228 - 11 Dec 2016
Cited by 25 | Viewed by 5863
Abstract
Background: Environmental tobacco smoke (ETS) exposure is associated with an increased risk of many diseases. Many countries have ratified a national smoking ban in public places, but studies on factors related to smoking issues in public places post-ban are lacking. Aim: [...] Read more.
Background: Environmental tobacco smoke (ETS) exposure is associated with an increased risk of many diseases. Many countries have ratified a national smoking ban in public places, but studies on factors related to smoking issues in public places post-ban are lacking. Aim: To identify facilitators and barriers that influenced smokers’ compliance with smoking bans in public places. Methods: Using PubMed, MEDLINE, and the Web of Science database, we conducted a systematic search of English articles published before June 2015 on factors of smokers’ compliance with the smoking bans in public places. Results: A total of 390 references were identified, among which seventeen articles (twelve quantitative studies, two qualitative studies, three mixed-method studies) were included in this review. These studies focused on four types of public places including recreational venues (n = 7), hospital (n = 5), school (n = 4), and workplace (n = 1). Factors at the individual-, interpersonal-, and organizational-level were identified: at the individual level, nicotine dependence, insufficiency of tobacco-related knowledge, and the negative attitudes towards smoking bans were the most commonly identified barriers; at the interpersonal level, the smoking behaviors of people around, close relatives, and friends’ approval were the main barriers; and at the organizational level, the main barriers were inefficient implementation of the bans and the inconvenience of the designative smoking areas. Conclusions: This synthesis of the literature provided evidence of the identified barriers and facilitators of smokers’ compliance with the smoking bans. It will be beneficial for the policy-maker to consider interventions on multiple levels of factors to overcome the barriers and enhance smokers’ compliance with the smoking bans in public places. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
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433 KiB  
Review
Secondhand Smoke Is an Important Modifiable Risk Factor in Sickle Cell Disease: A Review of the Current Literature and Areas for Future Research
by S. Christy Sadreameli, Benjamin T. Kopp, Susan E. Creary, Michelle N. Eakin, Sharon McGrath-Morrow and John J. Strouse
Int. J. Environ. Res. Public Health 2016, 13(11), 1131; https://doi.org/10.3390/ijerph13111131 - 12 Nov 2016
Cited by 13 | Viewed by 5983
Abstract
Sickle cell disease (SCD) is an autosomal recessive hemoglobinopathy that causes significant morbidity and mortality related to chronic hemolytic anemia, vaso-occlusion, and resultant end-organ damage. Tobacco smoke exposure (TSE) through secondhand smoke exposure in people with SCD of all ages and through primary [...] Read more.
Sickle cell disease (SCD) is an autosomal recessive hemoglobinopathy that causes significant morbidity and mortality related to chronic hemolytic anemia, vaso-occlusion, and resultant end-organ damage. Tobacco smoke exposure (TSE) through secondhand smoke exposure in people with SCD of all ages and through primary smoking in adolescents and adults is associated with significantly increased morbidity, with increased rates of emergency department visits and hospitalizations for painful vaso-occlusive crises and acute chest syndrome (ACS). Secondhand smoke is also associated with pulmonary function abnormalities in children with SCD who are already at risk for pulmonary function abnormalities on the basis of SCD. TSE is emerging as one of the few modifiable risk factors of SCD. This review discusses the current state of the evidence with respect to TSE and SCD morbidity, discusses potential mechanisms, and highlights current gaps in the evidence and future research directions. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
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285 KiB  
Review
The Impact of Secondhand Smoke Exposure on Children with Cystic Fibrosis: A Review
by Benjamin T. Kopp, Juan Antonio Ortega-García, S. Christy Sadreameli, Jack Wellmerling, Estelle Cormet-Boyaka, Rohan Thompson, Sharon McGrath-Morrow and Judith A. Groner
Int. J. Environ. Res. Public Health 2016, 13(10), 1003; https://doi.org/10.3390/ijerph13101003 - 12 Oct 2016
Cited by 27 | Viewed by 5656
Abstract
Secondhand smoke exposure (SHSe) has multiple adverse effects on lung function and growth, nutrition, and immune function in children; it is increasingly being recognized as an important modifier of disease severity for children with chronic diseases such as cystic fibrosis (CF). This review [...] Read more.
Secondhand smoke exposure (SHSe) has multiple adverse effects on lung function and growth, nutrition, and immune function in children; it is increasingly being recognized as an important modifier of disease severity for children with chronic diseases such as cystic fibrosis (CF). This review examines what is known regarding the prevalence of SHSe in CF, with the majority of reviewed studies utilizing parental-reporting of SHSe without an objective biomarker of exposure. A wide range of SHSe is reported in children with CF, but under-reporting is common in studies involving both reported and measured SHSe. Additionally, the impact of SHSe on respiratory and nutritional health is discussed, with potential decreases in long-term lung function, linear growth, and weight gain noted in CF children with SHSe. Immunologic function in children with CF and SHSe remains unknown. The impact of SHSe on cystic fibrosis transmembrane conductance regulator (CFTR) function is also examined, as reduced CFTR function may be a pathophysiologic consequence of SHSe in CF and could modulate therapeutic interventions. Finally, potential interventions for ongoing SHSe are delineated along with recommended future areas of study. Full article
(This article belongs to the Special Issue Exposure and Health Effects of Secondhand Smoke)
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