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Prevalence and factors associated with exposure to secondhand smoke (SHS) among young people: a cross-sectional study from the Gambia.

ABSTRACT: BACKGROUND:Annually, 600?000 deaths are attributed to exposure of non-smokers to secondhand smoke (SHS). These include 165?000 among children, about 60% of which occur in Africa and Southeast Asia. As of 2017, only seven countries in the African region had comprehensive smoke-free legislation covering all public places. Given the increasing prevalence of smoking in many low-income countries, preventing exposure to SHS is an urgent public health priority, particularly in Sub-Saharan Africa. OBJECTIVES:The objective of this study is to obtain a reliable and nationally representative estimate of the prevalence of exposure to SHS and to identify the major risk factors among young people in The Gambia. SETTINGS AND METHODS:We used a two-stage cluster random sampling to select students in secondary schools throughout The Gambia and a self-administered questionnaire to collect data on demographic characteristics and detailed indicators of exposure to SHS. RESULTS:Of the 10?392 eligible students, 10?289 (99%; 55% girls and 44% boys, age 12-20 years) participated. The proportion of students reporting any exposure to SHS was 97.0% (enclosed public places 59.2%, outdoor public places 61.4%, school 21.3% and home 38.2%), with 96.4% reporting some exposure outside the home. Exposure to SHS in the home was more common in girls and among older students. Parental education, living with parents and being sent to purchase cigarettes were associated with exposure to SHS both within and outside the home. More than 50% of students supported public smoking ban in both enclosed and outdoor public places. About 35% of students were unaware of the harmful effects of exposure to SHS. CONCLUSIONS:Exposure to SHS is highly prevalent among students in The Gambia and occurs mostly outside of the home. Interventions to reduce SHS exposure in students are urgently needed.

SUBMITTER: Jallow IK

PROVIDER: S-EPMC5857680 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Prevalence and factors associated with exposure to secondhand smoke (SHS) among young people: a cross-sectional study from the Gambia.

Jallow Isatou K IK Britton John J Langley Tessa T

BMJ open 20180314 3

<h4>Background</h4>Annually, 600 000 deaths are attributed to exposure of non-smokers to secondhand smoke (SHS). These include 165 000 among children, about 60% of which occur in Africa and Southeast Asia. As of 2017, only seven countries in the African region had comprehensive smoke-free legislation covering all public places. Given the increasing prevalence of smoking in many low-income countries, preventing exposure to SHS is an urgent public health priority, particularly in Sub-Saharan Afric ...[more]

PMID: 29540414

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Project description:ObjectivesTo assess the levels of secondhand smoke (SHS) exposure before and after the implementation of the Tobacco Free Cities (TFC) initiative.DesignCity-wide representative, cross-sectional surveys (Tobacco Questions for Surveys, TQS) were conducted in each participating city before and after the implementation of TFC.SettingFive large Chinese cities (Chengdu, Chongqing, Wuhan, Xiamen and Xi'an) participated in the TFC initiative.ParticipantsA total of 10 184 adults participated in the 2015 TQS survey, and 10 233 adults participated in the 2018 TQS survey, respectively.InterventionsThe TFC initiative, which included targeted media campaigns, educational programmes, implementing city-wide smoke-free policies and providing cessation interventions, was implemented in these five cities between 2015 and 2018.Main outcomeSelf-reported past 30-day (P30D) SHS exposure in indoor workplaces, restaurants and homes.Data analysisThe pre-TFC and post-TFC SHS exposure levels were compared among all residents and among certain population subgroups. Multivariate logistic regressions were used to estimate the adjusted associations between P30D SHS exposure and individual characteristics.ResultsAcross all five cities, the overall rate of self-reported P30D SHS exposure declined in indoor workplaces (from 49.6% (95% CI: 46.4% to 52.8%) to 41.2% (95% CI: 37.7% to 44.7%)), restaurants (from 72.4% (95% CI: 69.8% to 74.9%) to 61.7% (95% CI: 58.7% to 64.7%)) and homes (from 39.8% (95% CI: 36.9% to 42.7%) to 34.7% (95% CI: 31.5% to 37.8%)) from 2015 to 2018. These declines were statistically significant after controlling for individual characteristics. The P30D SHS exposure was associated with sex, age, education level, occupation and current smoking status. The associations varied by venues.ConclusionsOur analysis showed that compared with the nationwide SHS exposure levels reported in concurrent national surveys, the declines in P30D SHS exposure in five Chinese cities that implemented the TFC initiative were larger in indoor workplaces and restaurants. Our findings suggest that the TFC initiative was effective in reducing SHS exposure in Chinese cities.

Project description:IntroductionSecondhand smoke (SHS) exposure is a risk factor for early childhood caries. Here we examined the association between SHS exposure and early tooth eruption (ETE) to clarify the additional etiology of an increased chance of contact between the tooth's surface and acid produced by fermenting oral bacteria.MethodsData of 388 child-mother pairs who attended health checkups at public health centers were assessed for children aged ≥18 months. SHS exposure was reported as maternal smoking during pregnancy and household smoking after birth. Associations between SHS exposure and ETE (≥3 canines in the oral cavity) were tested using multivariable analyses of the dose-response relationship. Subgroup and sensitivity analyses were performed for birth-weight subgroups and SHS exposure variables, respectively.ResultsETE prevalence was 65.5%, 68.1%, and 76.9% in the no, medium-dose (ceased partway and sometimes), and highest-dose (every day) exposure groups, respectively, during pregnancy, and 61.5%, 75.0%, and 75.5%, respectively, after birth. The association between the highest dose exposure during pregnancy and ETE was not significant (OR=1.42, 95% CI: 0.34-5.96, p=0.631), whereas that between highest dose exposure after birth and ETE was significant (OR=2.13, 95% CI: 1.06-4.31, p=0.034); this association was distinct in the subgroup of children with smaller birth weights (<3000 g) (OR=3.19, 95% CI: 1.08-9.44, p=0.036). The dose-response relationship was consistently significant for exposure after birth (p<0.05). The sensitivity analysis that employed no SHS exposure, as a reference, revealed that exposure after birth but no exposure during pregnancy was significantly associated with ETE (OR=2.29, 95% CI: 1.19-4.40, p=0.013). However, the association between exposure during pregnancy and ETE was consistently non-significant (p>0.05).ConclusionsWhen controlling for variables of birth weight and exposure type, SHS exposure after birth was independently associated with the early eruption of deciduous canines. Further studies are warranted to examine the trajectory of SHS exposure after birth, ETE, and early childhood caries incidence.AbbreviationsETE: Early tooth eruption, SHS: Secondhand smoke.

Project description:INTRODUCTION:Detrimental effects of secondhand smoke (SHS) exposure are well established; however, data on SHS exposure among adolescents in Kuwait are lacking. Hence, this study sought to estimate the prevalence of household SHS exposure among two samples of adolescents in Kuwait and assess its variation by socioeconomic status and parental education level. METHODS:Data from two large school-based cross-sectional studies were analyzed. Adolescents attending public middle (n=3864; aged 11-14 years) and high (n=1959; aged 14-19 years) schools throughout Kuwait were enrolled in 2016-2017, and parental self-reported household SHS exposure was ascertained. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (APRs) and 95% confidence intervals (CIs) were estimated. RESULTS:Overall, 45.8% (1755/3836; 95% CI: 44.2-47.3%) of the enrolled middle school students and 51.6% (998/1936; 95% CI: 49.3-53.8%) of the enrolled high school students were exposed to household SHS. Among middle and high school students, the prevalence of household SHS exposure increased as maternal/paternal education level and family income decreased. Among middle school students, paternal educational attainment of middle school or less compared to bachelor's degree or higher was associated with 1.60 times (95% CI: 1.44-1.79) higher household SHS exposure. Similarly, in the sample of middle school students, the prevalence of household SHS exposure significantly increased from 35.8% among children from families reporting the highest household income to 50.5% among children from families with the lowest reported household income (p-trend<0.001). CONCLUSIONS:Household SHS exposure is substantially high among adolescents in Kuwait. Enrolled adolescents from families with low socioeconomic status or with low parental education level have the highest household SHS exposure. These findings highlight the need for national comprehensive tobacco control policies and increasing parental awareness of the impact of SHS exposure on children.

Dataset Information

Prevalence and factors associated with exposure to secondhand smoke (SHS) among young people: a cross-sectional study from the Gambia.

Publications

Prevalence and factors associated with exposure to secondhand smoke (SHS) among young people: a cross-sectional study from the Gambia.

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