Secondhand Smoke

Research

Florida researchers find social hookah smoking packs a carbon monoxide punch
New research demonstrates that patrons of hookah cafes are exposed to levels of carbon monoxide (CO) that are over three times higher than patrons of traditional bars. The study was conducted in Florida, which has a statewide smoke-free policy that permits smoking only in establishments where less than 10% of revenue is generated from food sales. The data showed that 18% of hookah bar patrons had CO levels above the Occupational Safety and Health Administration’s maximum level for exposure, compared to only 1.5% of patrons of traditional bars. This was the first study to measure carbon monoxide exposure among hookah smokers in a real-world situation, outside of a laboratory environment. Hookah bars have vastly grown in popularity among young people in recent years, and there is a common misperception that hookah smoke is less hazardous than cigarette smoke. Click here for more details, or click here to read more in the March issue of the American Journal of Preventive Medicine.

Secondhand smoke isn't just bad for kids' bodies, it's bad for their brains
New research published in the Archives of Pediatrics and Adolescent Medicine shows that youth exposed to secondhand smoke are more likely to develop symptoms of mental health problems than those that are not. Researchers used data from the 2001-2004 National Health and Nutrition Examination Survey (NHANES) to gather mental health information and serum cotinine levels from about 2,901 youth aged 8 to 15. The results indicated that there was a strong positive association between serum cotinine level and symptoms of attention-deficit/hyperactivity disorder (ADHD); there were also weaker associations with symptoms of other mental health disorders such as major depressive disorder, generalized anxiety disorder, and conduct disorder. While this study cannot link secondhand smoke exposure to the diagnosis of any of these mental disorders, the results support other studies linking tobacco smoke exposure and mental health outcomes, and underscore the need for the prevention of secondhand smoke exposure. Click here to read more, or click here to read the study abstract.

Modeling geographic and demographic variability in residential concentrations of environmental tobacco smoke using national data sets
A new study from the Harvard School of Public Health provides estimates of particulate matter (PM) concentrations in environmental tobacco smoke (ETS) in the homes of different sociodemographic and geographic U.S. subpopulations. Investigators used data from the 2006-2007 Current Population Survey-Tobacco Use Supplement and the 2007 American Housing Survey to create models that characterized smoking and air exchange to estimate ETS-PM exposure. The models estimate an average environmental tobacco smoke particulate matter concentration of 16 micrograms per cubic meter (mg/m3) among homes where any smoking had taken place, although this concentration varied significantly among homes. The model shows that the South and Midwest regions, rural populations, and low-income households had the highest likelihood of exposure. The results presented in this study can be used by communities to characterize risk from indoor pollutants within subpopulations, a starting point to protective action. Click here to read the abstract of the article, published in the Journal of Exposure Science and Environmental Epidemiology.

Increasing prevalence of smoke-free homes and decreasing rates of sudden infant death syndrome in the United States: an ecological association study
According to a new study published online in Tobacco Control, voluntary smoking restrictions in the home may reduce the incidence of sudden infant death syndrome (SIDS). Researchers used an ecological study design to explore the associations between trends in SIDS rates and prevalence of smoke-free homes with infants from 1995 to 2006. When controlling for sleep position, they found that for every 1% increase in the prevalence of smoke-free homes with infants, SIDS rates decreased by 0.4%. The authors estimate that 534 fewer SIDS deaths were attributable to secondhand smoke in 2006 than in 1995, and that between 4,402 and 6,406 SIDS deaths occurred due to secondhand smoke exposure over the course of the twelve year study period. The findings support voluntary home smoking restrictions as a way to prevent infant deaths, although more research is needed to demonstrate a causative link between secondhand smoke exposure and SIDS. Click here to read the study abstract.

Sources and frequency of secondhand smoke exposure during pregnancy
Relying upon partner smoking status alone could cause researchers to misclassify secondhand smoke exposure among pregnant women, according to a new study. Researchers surveyed 245 pregnant women in serious relationships, gathering information on their smoking status, partner’s smoking status, smoking status of members of their social network, and frequency of secondhand smoke exposure. They found that while the most common source of secondhand smoke exposure was their partner, pregnant women were also exposed to secondhand smoke from relatives and friends. Pregnant smokers and women in a relationship with a smoker were exposed to higher levels of secondhand smoke throughout their pregnancy than nonsmokers and those with nonsmoking partners. These results indicate there is a need to reduce pregnant women’s SHS exposure from social contacts other than their partner in order to improve maternal and child health outcomes and maternal smoking cessation efforts. Click here to read the abstract of the study, which can be found in Nicotine and Tobacco Research.

Meta-analysis of the association between secondhand smoke exposure and stroke
New research indicates that there is an association between secondhand smoke exposure and risk of stroke. Researchers conducted a systematic review and meta-analysis, pooling results of twenty studies that gathered data from 885,307 individuals to estimate the relationship between secondhand smoke exposure and risk of stroke. The results showed that those exposed to secondhand smoke were 1.25 times more likely to have a stroke than those who were not exposed, with the relative risk increasing from 1.16 to 1.56 as exposure increased from 5 cigarettes per day to 40 cigarettes per day. These findings strengthen the evidence of a causal relationship between secondhand smoke exposure and stroke risk, and demonstrate the need for measures that reduce exposure. Click here to read the abstract of the study, published in the Journal of Public Health.

Stillbirth in the U.S. can be prevented
Researchers have found that preventable risk factors such as smoking and obesity are responsible for many of the stillbirths that occur each year in the U.S. Researchers analyzed 96 studies examining risk factors for stillbirth in high-income countries (U.S., Australia, Canada, Netherlands, and U.K.) to determine how these factors would affect stillbirth rates. They found that of the 26,000 stillbirths that occur in the U.S. each year, about 4,000 can be attributed to obesity, 1,097 to smoking, and 1,116 to advanced maternal age. These modifiable factors can all be targets for intervention to prevent stillbirth, as well as a number of other adverse health outcomes, in the U.S. Click here to read more, or click here to read the abstract of the study, published as part of a series on stillbirth in The Lancet.

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Reports

ANRF's updated smoke-free lists and maps now online
The Americans for Nonsmokers’ Rights Foundation (ANRF) has updated the lists and maps of U.S. municipalities and states with smoke-free laws now in effect. The highlights include a new smoke-free law in effect in the U.S. Virgin Islands and several local-level laws in Mississippi, Missouri, and South Carolina. With the newly enacted laws, 62.6% of the U.S. population now lives in cities or states with smoke-free non-hospitality workplaces, 74.5% in areas with smoke-free restaurants, and 63.7% in areas with smoke-free bars. Nearly half of the population, 47.9%, is currently protected in all three categories. All data shown are as of April 1, 2011. See the full lists here.

Keeping your hospital property smoke-free: Successful strategies for effective policy enforcement and maintenance
The Joint Commission has released a new toolkit designed to assist healthcare organizations in ongoing implementation and enforcement of smoke-free policies in their facilities. The toolkit was developed using input from administrators of 182 U.S. hospitals that have enacted 100% smoke-free policies. The toolkit is divided into seven sections which detail: 1) planning ahead for enforcement and maintenance 2) creating and maintaining a supportive environment; 3) effective communication for a smooth transition; 4) monitoring implementation; 5) enforcement tips and techniques; 6) avoiding common pitfalls; and 7) additional considerations for mental health facilities. Click here to access the toolkit.

Smoke-free foster care: Policy options and the duty to protect - a policy options brief
The Public Health Law Center has released a new policy brief that describes policy options for state and local agencies seeking to provide foster children with smoke-free living environments. The brief maintains that enacting smoke-free policies for foster homes and vehicles transporting foster children is part of the foster system’s responsibility to ensure safe, healthy environments for foster children. The document describes the risks of secondhand smoke to children in foster care, presents an overview of the foster care legal and regulatory system, and explores policy considerations and challenges in regulating smoke-free foster homes. Click here to access this new publication.

Survey: Smoke-free casinos preferred by most New Englanders
The findings of a new poll indicate that, contrary to gaming industry claims, most New England residents would prefer smoke-free casinos over facilities that permit smoking. Almost 4,000 residents of six New England states were surveyed about their gambling habits and whether they would be more or less likely to visit smoke-free casinos. The results showed that only 15% of those surveyed said they would be less likely to visit a casino where smoking is prohibited, with 35% saying it would not affect their decision to visit a casino. Of those who had been to a casino in the past year, 53% said they preferred smoke-free gaming floors. Casinos in New England are currently subject to a variety of state laws and tribal government agreements that set minimum amounts of smoke-free space in the facilities. The poll results suggest that including New England casinos in comprehensive smoke-free laws should not hurt business. Click here to read more.

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