Secondhand Smoke

Research

Hair nicotine levels in nonsmoking pregnant women whose spouses smoke outside of the home
A new Korean study indicates that smokers who only smoke outside of the home do not eliminate their pregnant spouses’ nicotine exposure entirely. Researchers analyzed hair nicotine levels and spousal smoking behavior among 896 nonsmoking pregnant women to determine whether smoke exposure differed based on whether their spouse smoked in the home, smoked outside of the home only, or was a nonsmoker. Hair nicotine levels for women with nonsmoking spouses was found to be 0.33 ng/mg; this level was 0.51 ng/mg in women with spouses who smoked only outside of the home and 0.58 ng/mg in women with spouses who smoked in the home. This suggests that separating pregnant women from their spouses’ smoking activity may not be an adequate way of preventing secondhand smoke exposure. Read the abstract of the article, published in Tobacco Control.

Can infants' wheezing be prevented?
An international study of approximately 29,000 children shows that having a mother that smoked during pregnancy is associated with wheezing in infants. Parents in several Latin American and European countries answered questionnaires about the first year of their child’s life during routine health visits to report occasional and recurrent wheezing episodes and potential risk factors. The most important independent risk factors were having a cold during the first three months of life and attending daycare, while the most protective factor was having been breastfed for over three months. Additionally, smoking during pregnancy was associated with a 44-48% increase in the risk of recurrent wheezing. While there is variation by geographical location, overall, the results indicate that avoiding daycare and maternal smoking while promoting breastfeeding and maternal education would decrease the prevalence of wheezing globally. Read more here, or click here to read the abstract of the study, published in Pediatric Allergy and Immunology.

Secondhand smoke may harm mental health
Researchers have found that nonsmokers exposed to secondhand smoke were 49% more likely to have psychological distress than unexposed nonsmokers. Over 10,000 study participants were followed for six years, with their levels of psychological distress, admissions to psychiatric hospitals, and levels of salivary cotinine (a biomarker of smoke exposure) being tracked during that time period. The results show that compared to those who were not exposed to secondhand smoke, nonsmokers with the highest cotinine levels were 62% more likely to report psychological distress, and smokers were 2.45 times more likely to do so. Also, the risk of psychiatric hospitalization was 2.8 times greater for smoke-exposed nonsmokers and 3.7 times greater for smokers than for unexposed nonsmokers. While a causal relationship cannot be established through this study, the associations found were still strong after controlling for several other factors that could influence secondhand smoke exposure and mental health issues, such as socioeconomic status and alcohol intake. Click here to read more, or read the study, published in the Archives of General Psychiatry.

Smoking bans linked to less secondhand smoke in children
New research shows that in areas where there are comprehensive smokefree policies, cotinine levels are reduced in youth who live in smoke-free homes. Data from the 1999-2006 National Health and Nutrition Examination Survey were used to determine serum cotinine levels for 11,486 youth from 117 locations; each location was categorized as having extensive, limited, or no coverage by a smokefree law. It was found that among youth not exposed to smoke at home, the prevalence of detectable cotinine was 60% less in those living in counties with extensive smokefree laws than in those not living in an area covered by a smokefree law. This suggests that the smokefree policies are effective in reducing cotinine levels in youth not exposed to smoke at home; no difference was found among youth who were exposed to secondhand smoke at home. Click here to read an article about the study, or click here to read the study abstract in Pediatrics.

For heart attack, prevention strategies seem to work
A new study published in the New England Journal of Medicine found that the incidence of heart attacks has decreased significantly since 2000, indicating that community-based prevention techniques implemented during that time period were likely at least partially responsible for the drop. Researchers used health plan databases to analyze data from 46,086 hospitalizations for heart attack that occurred between 1999 and 2008 to determine incidence trends. They found that hospital admissions for heart attack dropped by 24% during the study period, from a high of 287 per 100,000 person-years in 2000 to a low of 208 per 100,000 person-years in 2008. The study period coincided with public health efforts like smokefree policies, lower target levels for blood pressure and cholesterol levels, and increased use of preventative medications such as aspirin, statins, and beta blockers, suggesting that these approaches could be accountable for the decrease. Read more here, or read the study abstract here.

Dogs plus pollutants may raise asthma risk in kids
Researchers investigating the effects of multiple exposures on asthma development have found that combined exposures to multiple allergens may put a child at higher risk of developing asthma. Data were collected from 380 children at risk of asthma, including information on exposures to secondhand smoke, dog allergens, and nitrogen dioxide (NO2, a product of fuel burning). The results show that by age seven, children exposed to both dogs and NO2 were 4.8 times as likely to have asthma than children exposed to neither; those exposed to dogs and secondhand smoke were 2.7 times as likely to have developed asthma. The mechanism through which these exposures cause asthma is unknown, but the researchers suspect that the particles may damage the airway lining and trigger inflammation. Click here to read more, or read the study abstract, published in the European Respiratory Journal.

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Reports

Fourth national report on human exposure to environmental chemicals
The Centers for Disease Control and Prevention has released the fourth National Report on Human Exposure to Environmental Chemicals, an assessment of the U.S. population’s exposure to 212 environmental chemicals. Researchers used blood and urine samples from a random sample of National Health and Nutrition Examination Survey (NHANES) participants to measure levels of various chemicals that enter the body from the environment. Among the exposures that were studied were acrylamide, a byproduct of tobacco smoke and cooking carbohydrates at high temperatures, and cotinine, an indicator of environmental tobacco smoke exposure. The results show that while acrylamide exposure is very common in the U.S. population, blood cotinine levels have decreased 70% in the past 15 years, a sign that interventions to reduce secondhand smoke exposure have been successful. Other chemical exposures that were assessed include mercury, lead, arsenic, perchlorate, and cadmium. Click here to read the executive summary, or click here for the full report

New clean indoor air factsheets from NALBOH, NACCHO, and ASTHO
A new set of Clean Indoor Air Factsheets is comprised of six documents developed by the National Association of Local Boards of Health, (NALBOH), National Association of County and City Health Officials (NACCHO), and the Association of State and Territorial Health Officials (ASTHO). Three factsheets are devoted to assisting boards of health with varying tobacco control legal authority work on clean indoor air laws. There are also two factsheets for state and local health department staff. The final factsheet is a compendium of resources on secondhand smoke. The fact sheets can be ordered for free on the NALBOH website. Every order placed will provide the requestor with all six factsheets. Click here to order the fact sheets, and to view a complete list of NALBOH’s publications.

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International

Secondhand smoke: Assessing the burden of disease at national and local levels
This guide, published by the World Health Organization, describes how to estimate the burden of disease caused by exposure to secondhand smoke (SHS) on a national or local level. It summarizes the evidence linking SHS exposure to health and the methods for estimating health impacts on a population basis. This is done in a practical step-by-step approach that can be adapted to local circumstances. The generated information can raise awareness and support decision-making on measures to protect the population from SHS. Click here to access the full document, or to request a calculation tool that complements the guide.

Heart attack admissions fall after smoking ban (England)
New research indicates that there was a 2.4% drop in hospital admissions for heart attacks in England during the year following the July 2007 implementation of a smokefree law. The study, commissioned by the Department of Health, used hospital admissions records to determine heart attack rates before and after the law went into effect, adjusting for other variables that can influence heart attacks, such as the weather or influenza rates. The results show a 2.4% drop in heart attack admissions in the year after the smoking ban, equaling about 1,200 fewer hospitalizations. The researchers note that the observed effect of the law was smaller than in similar studies in other countries, partially because the heart attack rate was already dropping in England, and partially because this study took other influencing factors into account that others have not. Read more here, or read the study abstract, published in the British Medical Journal.

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