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1
Evans, Karen. "Second-hand smoke : the evolution of children's exposure." Thesis, University of Bath, 2012. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.558892.
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Second-hand smoke exposure (SHSe) causes significant morbidity and mortality in children. A large proportion of children with smoking parents do not live in smoke-free homes, however, to date, little is known about the prevalence of partial smoking restrictions and their efficacy in reducing children’s SHSe. Given the lack of convincing evidence on how to achieve further reductions in children’s SHSe in the home, the identification of the modifiable factors associated with childhood SHSe is imperative to reduce the burden of disease resulting from childhood SHSe. Analysis of the Omnibus Survey (OS) revealed that the prevalence of smoke-free homes in England did not increase significantly between 2006 and 2008. Only 30% of smokers reported a smoke-free home in 2008. However, during the same time period, the proportion of smokers (who did not have a smoke-free home) reporting that they did not smoke when in the same room as a child increased significantly from 62.5% to 74.8%. Using the Health Survey for England, biologically validated self-reported measures of child SHSe revealed that in 2008 and 2009 approximately 50% of children living with a smoking parent were not exposed to SHSe in the home (0.30ng/ml, 95% confidence interval 0.27-0.32ng/ml). Of the 50% of children who remained exposed inside the home, 29% had a parent that smoked in one room only in the home. These children had significantly lower cotinine concentrations (1.13ng/ml, 95% CI 1.05-1.22) than the 21% of children with smoking parents who smoked in 2 or more rooms in the home (2.36ng/ml, 95% CI 2.08-2.68ng/ml). Although smoking in one room equates to lower risk it does not equate to no risk and so interventions are required to change indoor smoking to outdoor smoking. The OS data found that good knowledge of SHS-related illnesses was predictive of both full and partial smoking restrictions in the home. Increases in the proportion of respondents with good knowledge occurred during 2003-2006, a period when frequent anti-SHS mass media campaigns were aired. A case-study evaluation of a brief mass media campaign in the North West and North East of England, which aimed to move smoking parents to smoke outside, was found to have no statistically significant effect on home smoking behaviour in the short term, however knowledge that SHS caused both heart attack and Sudden Infant Death Syndrome increased in this region following the campaign whilst simultaneous decreases were found in the rest of England. Following the identification of those children most exposed to SHS, and the modifiable factors associated with this exposure, this thesis suggests that a comprehensive multi-level approach to tobacco control policy, which includes emotive media campaigns which include information on SHS-related illnesses, will contribute to the continued reduction of childhood SHSe.
2
Apsley, Andrew. "Second-hand tobacco smoke exposure in different micro-environments." Thesis, University of Aberdeen, 2013. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=201722.
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Background: Data on the typical daily exposure of non-smokers to second-hand smoke (SHS) are limited. The aim of this study was to estimate the SHS exposure encountered by adults and children in Scotland and to examine the proportion of total exposure received within different microenvironments. Methods: Primary research was carried out to gather information on SHS concentrations within cars in both simulated and real-life settings. Observational work was also carried out to determine the prevalence of exposure to SHS in cars. Further work was carried out to gather information on occupational SHS exposure. Data from all of these components were combined with data from previously published sources to produce estimates of how much SHS-derived PM2.5 exposure is typically received by adults and children within different micro-environments. Results: The contribution to total SHS exposure from each micro-environment was calculated. This was carried out for a child living in: a non-smoking home; a home where only the father smokes; a home where only the mother smokes; and a home where both parents smoke. In addition to this the equivalent dose of SHS inhaled (expressed as a mass) were also calculated for each of the micro-environments. This method was also used to determine the SHS contribution of different micro-environments for adult non-smokers. Exposure calculations were carried out assuming that exposure in the home was reduced to the levels found in non-smoking homes and the contribution from the remaining micro-environments unchanged. Observations identified that 2.4% of cars carrying children exposed children to SHS and exposure intensities during smoking car journeys can be particularly high with peak exposures ranging from 55 to 886 μgm-3. Conclusion: This is the first study to estimate the SHS exposure contributions from different microenvironments encountered by children and adults in Scotland. This study indicates that encouraging behavioural change in terms of smoking in home and car micro-environments has the greatest potential to reduce non-smokers’ daily exposure to tobacco derived fine particulate matter.
3
Kwok, Wing-ying Joanne, and 郭詠瑩. "Effectiveness of smoke-free legislation on second hand smoke exposure of children : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206921.
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Background: The tobacco epidemic causes a major burden to long-term global public health. Second hand smoke is one of the modifiable exposures causing adverse health effects to children; 40% of children in the world are regularly exposed to second hand smoke and children account for more than a quarter of all deaths from second hand smoke exposure. The global burden highlights the importance of implementation and enforcement of comprehensive smoke-free legislation. Despite smoke-free legislation having been shown to have a positive effect in reducing the prevalence of tobacco consumption and second hand smoke exposure, displacement of smoking from enclosed public places to homes after implementation of smoke-free legislation might increase second hand smoke exposure in children.
Objectives: This systematic review aims to investigate the effect of smoke-free legislation on second hand smoke exposure in children and to explore the potential risk factors that may affect its effectiveness.
Methods: Studies were searched in online electronic databases, PubMed and EMBASE Classic+ EMBASE 1980-via Ovid (from 1980 to 2014) under the Library website of the University of Hong Kong, by keyword search, hand search of references and Google Scholar for relevant articles published from 2004 to present. Observational studies assessing the effect of smoke-free legislation on second hand smoke exposure in children assessed from cotinine measured before and after the introduction of smoke-free legislation were included.
Results: This systematic reviewed identified 8 relevant studies. 3 were assessed as good quality and 5 as average quality. All selected studies reported a decrease in the geometric mean of cotinine concentration after the implementation of smoke-free legislation, but only one of them showed that the reduction in cotinine concentration was significantly reduced from 0.3ng/ml to 0.2ng/ml. An increase in the percentage of cotinine concentrations below the limit of detection and a decrease in the percentage of harmful levels of cotinine concentration were also found. Lower socioeconomic status, more parental smokers and low level of home smoking restriction affected the reduction in second hand smoke exposure after implementation of smoke-free legislation.
Conclusion: Smoke-free legislation has a positive effect towards reduction in second hand smoke exposure in children. There is no evidence supporting the possibility that smokers displace tobacco consumption from public areas to their homes after implementation of smoke-free legislation in Western settings. Whether more effort to encourage smoking cessation among parents and other family members living with children would be particularly effective in reducing the public health burden of tobacco consumption should be investigated. Further tobacco control strategies are suggested to work comprehensively with smoke-free legislation to further reduce the global burden of tobacco epidemic.published_or_final_version
Public Health
Master
Master of Public Health
4
Engku, Ibrahim Tengku Azmina. "Occupational exposure to second-hand smoke in Malaysia : assessing the potential health burden." Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=227587.
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Nazar, G. P. "Smoke-free legislation and active smoking, second hand smoke exposure and health outcomes in low- and middle-income countries." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2017. http://researchonline.lshtm.ac.uk/4433694/.
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Background: Exposure to tobacco smoke imposes a heavy morbidity and mortality burden and exacerbates health inequalities. Whilst the health and economic benefits of smoke-free legislation (SFL) are evident in high income countries (HICs), there is a lack of evidence from low- and middle-income countries (LMICs) where implementation and monitoring mechanisms are generally weak. Objectives: To examine whether the health benefits of SFL identified in HICs are likely to accrue in LMICs and whether any benefits are evenly distributed between socioeconomic status (SES) groups. Methods: 1) A systematic review was undertaken to examine the impact of SFL on socioeconomic inequalities in tobacco-related health outcomes in adults 2) Secondary analyses of the Global Adult Tobacco Survey (GATS) data from 15 LMICs was undertaken to examine inequalities in second hand smoke (SHS) exposure at work and at home 3) Quasi-experimental difference-in-differences study design was used to examine whether the National Tobacco Control Programme (NTCP) in India was associated with reductions in active smoking. Results: 1) Evidence from LMICs examining the health impacts of SFL was sparse. Comprehensive SFL was associated with pro-equity impacts in smoking associated health outcomes in HICs 2) In LMICs, exposure to SHS at workplaces and at homes was higher among the low SES groups. Being employed in a smoke-free workplace in LMICs was associated with reduced exposure to SHS in the home 3) There was no compelling evidence that NTCP reduced bidi and cigarette consumption over and above the general reduction that occurred in all districts in India. Policy implications: Poor implementation of SFL in LMICs is associated with substantial forgone health benefits, especially in the low SES groups. Strengthening tobacco control is key to improve health outcomes and reduce inequalities in LMICs and attainment of the Sustainable Development Goals for Health.
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Zainal, Abidin Emilia. "Indoor air pollution, second-hand smoke exposure and respiratory health symptoms among Malaysian schoolchildren." Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=186220.
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Background: Exposure to indoor air pollutants has been associated with poorer respiratory health in children. This study investigates the respiratory health of Malaysian schoolchildren in relation to indoor air pollution. Methods: This cross-sectional study was conducted among 2,164 schoolchildren aged 10-11 years in urban and semi-rural schools. Parents completed a questionnaire and concentrations of air pollutants were measured in schools. SHS exposure was assessed using salivary cotinine. Results: The WHO Air Quality Guideline for PM2.5 was exceeded for most of the semi-rural schools while almost all of the urban schools exceeded the annual exposure limit for NO2. The Geometric Mean salivary cotinine concentrations for non-smoking schoolchildren were 0.47 ng/ml. The 3 main predictors of nocturnal cough were the presence of a current smoker at home (OR 1.97; 95% CI: 1.31-2.96), the absence of exhaust system in the kitchen (OR 1.67; 95% CI: 1.03-2.68) and the use of air conditioning (OR 3.10; 95% CI: 1.37-5.71). Exposure to SHS of ≥4 hours per day (OR 2.53; 95% CI: 1.55-4.14) explained approximately 6.0% of the likelihood of reporting doctor-diagnosed asthma. For the measure of asthma severity, NO2 and log average family size were the 2 predictors of limited speech during wheeze; NO2 concentrations of >50 μg/m3 contributes an OR of 5.98 (95% CI: 1.02-34.9) and log average family size with an OR of 14.6 (95% CI: 1.70-126). Conclusion: This study has identified that many Malaysian schoolchildren experience exposure to air pollution indoors that exceeds WHO guidance limits for several pollutants. There was no clear relationship between traffic-generated air pollutants and children’s respiratory health but there was a strong relationship between the number of hours children were exposed to SHS and asthma. There is a need for increased enforcement of existing smoke-free legislation and policies to reduce children’s exposure to SHS.
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Talabi, Taiwo. "Workers who continue to be occupationally exposed to second-hand tobacco smoke (SHS) in the UK." Available from the University of Aberdeen Library and Historic Collections Digital Resources. Restricted no access until Sept. 20, 2009, 2008. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=25325.
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Keough, T. Montgomery. "Adverse effects of second hand smoke exposure in non-smoking women: maternal and neonatal outcomes /." Internet access available to MUN users only. Search for this title in:, 2009.
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Nielson, Brian Albert. "Efficacy of Methods Available to Remove Environmental Tobacco Smoke in Vehicles." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5642.
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Environmental tobacco smoke (ETS) is a serious public health threat. Residual ETS in vehicles unknowingly exposes future occupants to environmental tobacco smoke. Reducing or removing exposure to ETS has been proven to reduce long-term health complications. This quasi-experimental study investigated 5 cleaning methods and their effect on air particulate matter2.5 (PM2.5) along with the correlation between air nicotine levels and PM2.5 levels. Study variables included cleaning methods as the independent variable, and changes in air nicotine and PM2.5 levels as the dependent variables. This study is framed within primary prevention and risk reduction based on the harm reduction theory. The harm reduction theory professes that when a hazard cannot be completely removed, methods to reduce the social and personal costs associated with the hazard should be developed. Fifty vehicles were placed in 5 groups: car wash vacuumed, shop vac vacuumed, air change, hand held vacuumed, and Hepa filtration air cleaned. Nicotine and PM2.5 levels were measured before and after cleaning. A Wilcoxon ranked test analysis of the data showed all methods of cleaning studied had a statistically significant decrease in both air nicotine (Z = -6.154, p < .001) and PM2.5 levels (Z = -5.934, p < .001). Kruskall-Wallis analysis showed no statistical significance between cleaning methods. Correlation analysis determined no correlation between nicotine and PM2.5 (r value = <.3). Results of this study provides public health program professionals with information linking cleaning methods to reduction of exposure to ETS. Positive social change comes when programs are developed to training and education people to reduce their exposure, resulting in an increase in health and a decrease in medical costs.
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Austin, Stephen R. "The impact of self-reported Second Hand Smoke exposure on asthma severity and hospital length of stay in a state-wide pediatric inpatient asthmatic population." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522320203934472.
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Pilkington, Paul Andrew. "Exposure to second hand smoke (SHS) in the workplace : investigating knowledge, attitudes and experiences of casino workers in London." Thesis, University of the West of England, Bristol, 2007. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.444435.
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Letourneau, Alyssa Rose. "Timing and Predictors of Postpartum Return to Smoking in Women Who Quit Smoking During Pregnancy." Yale University, 2007. http://ymtdl.med.yale.edu/theses/available/etd-06282006-112209/.
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This study prospectively examined the timing and predictors of returning to smoking after pregnancy in a group of women who quit smoking cigarettes during pregnancy. We interviewed women during the postpartum hospital stay and at their infants 2-week and 2-month health supervision visits. Urine cotinine levels were measured at each interview. Fifty-three women were interviewed during the postpartum stay, 37 women at the 2-week and 36 women at the 2 month visits. At the 2-week visit, 40.5% had returned to smoking, and at the 2-month visit, 47.2% had returned to smoking. Factors associated with a return to smoking at 2 weeks included a lower level of education (high school graduate/GED vs. some college education; 13/37 vs. 2/37, p=0.02), the presence of someone else in the household who smoked (14/37 vs. 1/37, p=0.001), formula-feeding their infant at the time of interview (14/37 vs. 1/37, p=0.003), having smoking discussed with a doctor or nurse during pregnancy (12/37 vs. 3/27, p=0.009), and being African-American vs. Caucasian or Hispanic (10/37 vs. 5/37, p=0.008). Predictors of a return to smoking at 2 months included the presence of someone else in the household who smoked (17/36 vs. 0/36, p<0.001) and smoking at least 1 cigarette during pregnancy after initially quitting (12/36 vs. 5/36, p=0.02). Women who quit smoking cigarettes during pregnancy are likely to resume in the days immediately after delivery. The presence of household smokers and formula feeding are the strongest predictors of resuming smoking within 2 weeks.
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Zhou, Xuan, and 周璇. "A study on second and third hand smoke exposure and self-protection behaviors among sick school-aged children in Guangzhou, China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hub.hku.hk/bib/B50534233.
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Introduction: Due to the high prevalence of smoking in China, exposure to second hand smoke (SHS) is a serious public health issue. However, school-aged children’s behavioral responses to SHS exposure and the associated factors are unclear.
Aims: This study aims to (a) identify the sources and settings of SHS exposure among school-aged sick children and their mothers in Guangzhou, China; (b) describe the behavioral responses of those children and mothers when exposed to SHS; and (c) examine the personal and environmental factors associated with children’s responses to SHS exposure.
Methods: Qualitative and quantitative methods were combined in this study. Forty-five in-depth individual interviews were conducted to investigate sick school-aged children and their mothers’ understanding of and responses to SHS. A pilot survey was used to assess the validity and reliability of the questionnaire and the feasibility of the study. A cross-sectional survey was conducted with the children and their mothers at three hospitals in Guangzhou in 2012. All sick children who were aged 6 to 12 years, able to communicate in Mandarin Chinese, and not acutely or severely ill, along with their nonsmoking mothers, were invited to join this study.
Results: A total of 339 pairs of sick children and their mothers were included in the data analysis. Of these pairs, 169 (49.9%) lived with smokers. All sick children and their mothers experienced high-level SHS and third hand smoke (THS) exposure inside or outside the home. Those living with nonsmokers were also at risk of household SHS and THS exposure from guests. Most of the sick school-aged children were unaware of the dangers of SHS and THS, while the mothers had a better understanding of SHS and THS. The majority of children would adopt self-protective behaviors when exposed to SHS. The regression model for children’s behavioral responses to SHS exposure by family smokers found two significant factors: amount of social support and family smoke-free policy. Five factors were associated with children’s behavioral responses to SHS exposure by guest smokers, including boys, living with smokers, amount of social support, family members informed of the dangers of smoking, and fathers protecting children from SHS. The amount of social support, and fathers protecting children from SHS were also associated with children’s behavioral responses to SHS exposure by stranger smokers.
Conclusions: To our knowledge, this is the first study to describe self-protective behavioral responses to SHS exposure among sick school-aged children in mainland China and the personal and environmental factors associated with these responses. Boys, living with smokers, and a partial smoke-free policy at home were negatively related to children’s responses to SHS exposure; however, more information about smoking, fathers’ protection from SHS, and information about the harms of smoking by family members were associated with greater self-protection among sick school-aged children. Therefore, multiple-direction interventions should be considered for children’s health promotion about smoking and SHS.published_or_final_version
Nursing Studies
Master
Master of Philosophy
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Fischer, Florian [Verfasser], Alexander [Akademischer Betreuer] Krämer, and E. Jürgen [Akademischer Betreuer] Flöthmann. "Challenges for environmental epidemiology in evidence-based public health - the example of second-hand smoke / Florian Fischer ; Alexander Krämer, E.-Jürgen Flöthmann." Bielefeld : Universitätsbibliothek Bielefeld, 2016. http://d-nb.info/1122599609/34.
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Li, Qianhui, and 李茜晖. "Second-hand smoke exposure of pregnant women and a randomized controlled trial of brief intervention for non-smoking pregnant womenin Guangzhou, China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46939325.
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Wang, Liang, Hadii M. Mamudu, Arsham Alamian, James Li Anderson, and Billy Brooks. "Independent and Joint Effects of Prenatal Maternal Smoking and Maternal Exposure to Second-Hand Smoke on the Development of Adolescent Obesity: A Longitudinal Study." Digital Commons @ East Tennessee State University, 2014. https://doi.org/10.1111/jpc.12667.
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AIM: To examine associations of prenatal maternal smoking and second-hand smoke (SHS) exposure with the development of adolescent obesity.
METHODS: Longitudinal data (1991-2007) from National Institute of Child Health and Human Development Study of Early Child Care and Youth Development involving mothers that smoked and or exposed to SHS during the year before birth were analysed. Adolescent obesity in ages 12.0-15.9 years was defined as a BMI ≥ 95th percentile. Generalised estimating equations (GEE) were used for the analyses.
RESULTS: Obesity was more prevalent among adolescents whose mothers smoked or had SHS exposure than those that did not smoke or exposed to SHS. After adjusting for maternal and child factors, GEE models showed that odds of adolescent obesity increased with prenatal maternal smoking (OR = 1.57, 95% CI = 1.03-2.39) and SHS exposure (OR = 1.53, 95% CI = 1.04-2.27). The odds for obesity increased more than two times among adolescents exposed to both maternal smoking and SHS (OR = 2.10, 95% CI = 1.24, 3.56) compared with those without exposure. Additionally, not breastfeeding, maternal obesity, and longer screen viewing hours per day were associated with increased odds of obesity.
CONCLUSIONS: There is possibly a long-term joint effect of prenatal maternal smoke (smoking and SHS) exposure on obesity among adolescent offspring, and the effect is independent of birthweight. These findings suggest that adolescent obesity could possibly be curtailed with the development and promotion of smoking cessation programmes for families during the year before birth.
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Wallby, Thomas. "Lika för alla? : Social position och etnicitet som determinanter för amning, föräldrars rökvanor och kontakter med BVC." Doctoral thesis, Uppsala universitet, Pediatrik, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-170037.
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Child Health Services (CHS) in Sweden are offered free of charge to all Swedish parents with children 0-5 years of age. The regular service schedule includes home visits, health examinations, vaccinations and participation in parenting groups. The CHS should pay extra attention to disadvantaged families. The aim of this thesis was to investigate to what extent the CHS reaches groups of families with special needs, e.g. immigrant families, low income families, young and single mothers, with universal or selective measures, as well as to investigate the variation of two determinants of child health, second hand smoke and breastfeeding, in these groups of families. The thesis also aimed at investigating validity of data in the county CHS quality database (Basta). The thesis is based on data from Basta together with several national registers. The CHS equally reached all families with infants with the universal program except for participation in parenting group. Foreign born, young, single and low-income mothers had lower participation rates. Smoking rates were lower in foreign-born than in Swedish-born mothers and higher for foreign-born than in Swedish-born fathers. Smoking was more common among single and low income parents and young mothers. Young and single mothers had lower breastfeeding rates at 6 months. At 12 months the breastfeeding rates were higher among foreign-born mothers. The validity test of data in the Basta database showed sensitivity values for immunizations, breastfeeding and smoking at 90-100 % and for any home visit, participation in parenting group at any time, a minimum number of 6 visits at the Child Health Centre (CHC) and a minimum number of 11 visits at the CHC at 88 - 96 %. The sensitivity value for the exact match of number of CHC visits (+/- 3 visits) was 88 %. Conclusions: The universal programme was equally distributed in different immigrant and socio-demographic populations. However, the results did not indicate equality according to the assumption that some families need more input than others in order to achieve equity of outcome. Individual data routinely collected from CHS records to a quality database provides data of good quality that can be used for both quality surveillance and research.
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Silveira, Andréa Fernanda. "Tabagismo e políticas públicas: uma análise sobre a lógica de diferentes estabelecimentos do ramo de entretenimento sobre a proibição de fumar em ambientes fechados." Pontifícia Universidade Católica de São Paulo, 2007. https://tede2.pucsp.br/handle/handle/17199.
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Tobacco use may be considered a global epidemic and has a great impact on health as well as social, economic and sanitarian consequences. Besides the damage to smoker s health, second hand smoke is very critical to collective health and environment. It is the third leading preventable cause of death in the world. Tobacco control is a public health issue and has been the target of an international framework convention. Among tobacco control policies in Brazil, the 9294/96 law that forbids smoking indoors was chosen to be the purpose of this study. This law is not widely accepted by entertainment establishments (restaurants, bars, fast-food places, cafes, disco houses). Implied is the need to better understand owners and managers rationale concerning to this political issue. In fact, it is important to identify the factors that may influence their decision to adopt this law. For this, an exploratory study was conducted in two phases: a qualitative phase with 11 face-to-face interviews in which the content analysis generated a questionnaire answered by 60 participants in the quantitative phase. To guarantee validity, a panel of 8 experts analyzed the instrument and it was retested by a sub sample of 30 participants. Statistical tests performed showed that 73,3% of participants do not favor the law mentioned above, and that there is no significant difference of opinion among all the segments investigated. Data showed that both political and social factors play a relevant role in this matter. Both variables can not be analyzed apart from each other, as SANDOVAL (2001) and AIRHIHENBUWA (1995) had defended in their theoretical models (political conscientiousness and PEN- 3, respectively). Based on these models, some arguments identified were the law is not enforced, government initiatives are culturally discredited, competition between establishments is great, and owners and managers fear that they would lose business. There is inter- and intra-group favoritism that leads establishments to accept smokers behavior. Data suggests that tobacco control policies for these places must be revisited
O tabagismo é uma epidemia global que provoca danos sérios à saúde, com conseqüências sociais, econômicas e sanitárias. Além dos malefícios que causa à saúde do próprio fumante, a fumaça exalada pelo consumo dos derivados do tabaco também é prejudicial à saúde coletiva e ao meio ambiente. A Poluição Tabágica Ambiental é a terceira maior causa de morte evitável no mundo. Trata-se de uma questão de saúde pública que ganhou notória ênfase nas últimas décadas, dando origem ao primeiro tratado mundial de saúde pública, que fixa padrões internacionais para o controle do tabaco. Entre as políticas no Brasil, destacou-se, para fins do presente estudo, a Lei n.º 9.294/96, que proíbe fumar em ambientes fechados. Essa lei não chega a ser amplamente adotada pelos estabelecimentos do ramo do entretenimento (restaurante, bar, lanchonete, danceteria, café, shopping center), o que pode ser considerado como um fenômeno político e reforça a necessidade de se entender que fatores compõem a lógica dos seus proprietários e gerentes. Para tanto, uma pesquisa exploratória foi conduzida em duas etapas: uma qualitativa, com 11 entrevistas face a face, cuja análise do seu conteúdo gerou um questionário, aplicado a 60 participantes na fase quantitativa. Para validação desse instrumento, foi feita uma avaliação por 8 profissionais de diferentes áreas de atuação e a sua reaplicação com uma subamostra de 30 participantes. Os testes estatísticos revelaram que 73,3% dos pesquisados não adotam a lei e que não existem divergências de opinião significativas entre os diversos segmentos investigados. Além disso, os dados apontam uma inter-relação de fatores políticos e sociais como pano de fundo da decisão de se adotar ou não a lei em questão. Ficou claro que essas variáveis não podem ser analisadas isoladamente, corroborando o pressuposto pelos modelos teóricos utilizados para explicar esse fenômeno, isto é, o modelo de consciência política (SANDOVAL, 2001) e o PEN-3 (AIRHIHENBUWA, 1995). Com base nesses modelos, alguns argumentos foram identificados: a lei não é regulamentada; as ações do governo estão ou são culturalmente desacreditadas; a concorrência com outros estabelecimentos do mesmo ramo é grande e seus administradores temem perder a clientela; existe um favorecimento inter e intragrupal que leva os estabelecimentos à conivência com o comportamento dos fumantes. Os resultados sugerem que as políticas de controle do tabaco para essas empresas carecem de adequação
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Yi-Chang and 蔡易昌. "Second-hand Smoke-Induced Hepatic Injuryin Hamster Fetus." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/87611053738478044768.
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碩士中山醫學大學
生化暨生物科技研究所
100
Second-hand smoke and tobacco smoke products are recognized global risks for human health. It can cause cardiovascular disease and cancer that exposure of second- hand smoke, especially pregnant women and fetus. Several studies have shown an effect of second hand smoke exposure during pregnancy upon lung function in the newborn infant and after birth. However, it is less explored that the liver damage of second-hand smoke exposure. The liver is an exceptional organ in terms of its metabolic, synthetic, and detoxifying function. Recent reports has referred the relationship between second-hand smoke and non-alcoholic fatty liver disease, but not include the liver damage in fetus. In our experiment, we want to understand affect and explore mechanism about that the fetal liver exposure of second-hand smoke. Experimentally, using hamster fetus, in the injury of secondhand smoke treatment , respectively by gelatin zymography and Western blot observation of hamster fetus liver protein expression in case. The results showed that exposure of second- hand smoke can increase the release of MMP-9, CRP, iNOS , other inflammatory factors and IL-1β in the liver, and lead to increase inflammatory response. It can also be NF-κB activation through P38, AKT and ERK signaling pathways to regulate the inflammatory response,. As well as a significant increase in cell lipid peroxidation and ROS injury degree , so that the immune inflammatory reaction of liver in progress. Meanwhile, the second-hand smoke also can make liver cells to induce apoptosis by the performance of p53/21 protein, and increase oxidative stress thereby enabling the liver lipid accumulation. It belongs to non-alcoholic fatty liver disease in diseases classification . There is no effective drug available for treatment in clinical practice. Therefore, observe inflammation message path of hamster fetal liver. So future we can find a treatment method and reduce second-hand smoke damage to the fetal liver.
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Ndlovu, Nkanyiso. "Prevalence of second hand smoke exposure among adults in Bulawayo, Zimbabwe." Thesis, 2016. http://hdl.handle.net/10386/1498.
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Thesis (MPH.) -- University of Limpopo, 2016.Introduction: Annually, hundred thousands of people worldwide die as a result of second hand smoke (SHS) exposure. There is no safe exposure level to SHS yet in Bulawayo, smokers have been observed smoking without restraint thus exposing non-smokers to SHS. The purpose of this study was to establish the prevalence and contributing factors of SHS exposure among adults in Bulawayo, Zimbabwe. Methods: A cross sectional study was conducted and participants were randomly selected from residents who visited the 13 municipal revenue halls. A structured questionnaire was used to collect data from respondents. Descriptive and multivariate logistic regression analyses were performed. Results: Home SHS exposure prevalence was 22% and females were 2.11 times more likely than males to be exposed at home. Prevalence of SHS exposure in public transportation, health facilities, educational and food premises was 40.9%, 26.3%, 42,9% and 36.8% respectively. Conclusion: SHS exposure in Bulawayo was high and there is need to reduce SHS exposure to non-smoking adults. Keywords: Second hand smoke (SHS), Bulawayo, Prevalence, Exposure, Adult
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Wu, Jia-Ping, and 吳嘉平. "Mechanisms of cardiomyopathy induced by second-hand smoke exposure in the aging rat hearts." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/q22482.
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McCammon-Tripp, Laura E. "Tenant perceptions of drifting environmental tobacco smoke in multi-unit dwellings." Thesis, 2010. http://hdl.handle.net/10012/4947.
Full textAbstract:
Background and Objectives: Environmental tobacco smoke (ETS) is widely recognized as a serious health hazard. No safe level of exposure to ETS has been identified (USDHHS, 2006; WHO, 2007). The importance of smoke-free spaces in improving health outcomes for both smokers and non-smokers is clearly understood and as such, many individuals living in Ontario have made their homes smoke-free. Although those living in units within multi-unit dwellings (MUDs) have the option of making their own unit smoke-free, they may still be involuntarily exposed to ETS drifting from smoking units to their unit. The present study explores tenant’s perceptions of this drifting ETS and the potential market for smoke-free rental housing.
Methods: Anonymous surveys were sent to 3724 households within rented MUDs (apartments and row housing) with five or more units in Kitchener, Ontario. In addition to demographic questions, the survey addressed respondents’ experiences with, perceptions of, and reactions to drifting ETS and their views on smoke-free rental housing. Three hundred and five surveys were returned, and 291 met the final inclusion criteria to be included in the analysis. Survey data were weighted by age and education level. Descriptive analyses and logistic regression models were run to answer the research questions.
Results: Over half of the respondents who do not smoke in their unit on a daily basis indicated they were exposed to drifting ETS in their home at least ‘sometimes’. Of those who were exposed, 89.5% were bothered and nearly half were bothered ‘a lot’. This suggests drifting ETS is a concern for many tenants living in MUDs. The majority of tenants indicated they did not live in a smoke-free building however there was a strong interest in smoke-free rental housing. Nearly 90% of tenants showed at least some interest in smoke-free rental housing, and many tenants would prefer to live in a building with the strongest possible restrictions on smoking in place. Younger tenants, non-smokers, those who spent less time at home on weekends and those who perceived indoor smoking as a fire risk were more likely to be interested in smoke-free rental housing.
Conclusions and Significance: This study provides insight into the magnitude of the problem of drifting ETS in MUDs and can be used to inform policy on smoke-free MUDs. Many respondents indicated they were exposed to drifting ETS and the majority of those who were exposed were bothered by this exposure. There also appears to be a strong market for smoke-free rental housing. The response rate for this study was low at 8.5% and as such the results must be interpreted with caution. Future research should be completed in other jurisdictions and with larger sample sizes. Landlord surveys and air quality monitoring studies are also needed. While additional research is needed, the current study suggests this is an important public health issue, and provides additional evidence supporting the need to explore policy options in the public and private realm for smoke-free housing.
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Lin, Pi-Li, and 林碧莉. "Second-hand Smoke Exposure and the Factors Associated with Avoidance Behavior among the Kindergarten Children and their Mothers." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/40323904684102655282.
Full textAbstract:
博士慈濟大學
醫學科學研究所
102
Background: Mothers’ avoidance behavior of second-hand smoke (SHS) exposure plays a critical role in the exposure of children to SHS. This study aimed to examine the exposure status of ETS and the factors associated with ETS avoidance behaviors among the mothers of kindergarten children. Methods: A cross-sectional study was used to obtain a sample of the mothers of pre-school children (n = 1,020) in 30 registered kindergartens in eastern Taiwan. Overall, 919 (a response rate of 90%) completed the questionnaires. Regression models were used to identify factors on the avoidance behavior of ETS. Results: The prevalence of exposure to ETS was 70 % and 50 % for the mothers and their children, respectively. After adjusting for other variables, mothers who were current smokers (β= - 0.260, p < 0.001), had spouses who smoked (β= - 0.060, p < 0.05), ETS exposure (β= - 0.138, p < 0.001), and/ or child exposure to ETS (β= - 0.084, p < 0.05) were found to be less likely to avoid ETS, whereas mothers with a high knowledge score about ETS (β= 0.082, p < 0.01), positive attitudes (β=0.274, p<0.001) and a high self-efficacy level as to avoiding ETS (β= 0.397, p < 0.001) were observed to be more likely to avoid ETS. Hierarchical regression analyses confirmed that the significantly associated with the avoidance behavior of ETS were self-efficacy, being a current smoker, and the attitude toward avoiding ETS with 55.5 % of total variance explained (p < 0.001). Conclusions: The high prevalence rate of exposure to ETS for mothers and their children suggests that well-designed future intervention program should be implemented in regard to pre-school children’s mothers in order to prevent these mothers and their children from ETS exposure hazards, more particularly, to strengthen the knowledge base, to enhance self-efficacy and to foster more positive the attitude toward avoiding ETS in the mothers.
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Chiu, Chin-Hsuan, and 邱稚軒. "Factors Related to Self-efficacy on Avoidance of Household Second Hand Smoke among Elementary Schoolchildren in Southern Taiwan." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/12659095731662073769.
Full textAbstract:
碩士高雄醫學大學
口腔衛生科學研究所碩士在職專班
98
Objective: To analyze children’s household SHS (Second Hand Smoke) and factors related to self-efficacy to avoid SHS in southern Taiwan after 2009 Tobacco Hazards Prevention Act. Method: Two cross-sectional surveys were conducted on the schoolchildren enrolled in the third to sixth grades selected respective 26 elementary schools in 2008 and 2009 academic years. A total of 4450 valid questionnaires were obtained, with a response rate of 92.85%. Hierarchical regression models were therefore to analyze the related factors of children’s self-efficacy to avoid household SHS. Results: Higher mean score of self-efficacy of avoid SHS was found after new act (P<0.05). More than 60% of children were living with a family smoked in front of them and 35 % of them were exposed to household SHS more than 4 days a week. Schoolchildren’s positive attitude toward smoking (β=-0.05~-0.06，P<0.001) and household SHS exposure (β=-0.34~-0.47，P<0.05) were associated with children’s self-efficacy of avoid SHS. Compared to girl students, boys had lower score in the knowledge of tobacco hazards and that was related to self-efficacy of avoid SHS(β=0.13~0.14，P<0.001). Other observed significant factors were ever-smoking and grade. Conclusion: After the law implemented in 2009, yet high percentages of schoolchildren exposed to household SHS. The exposure days and attitude toward smoking were not changed by the short-term policy. The influential factors for 2008 differed from those for 2009. The findings suggested that intervention program should enhance positive attitude toward anti-smoking and self-efficacy to avoid SHS, more particularly, to provide tobacco hazards knowledge in the boy students in order to reduce SHS exposure at home.
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Hsu, Yi-Ting, and 許伊婷. "An Exploration by Q Method of the Beliefs of Parents in Protecting Children from Exposure to Second-Hand Smoke." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/71828533883603593233.
Full textAbstract:
碩士國立臺灣師範大學
健康促進與衛生教育學系
105
Chemicals in second-hand smoke have been already confirmed by many researches as having a widespread impact on human health. Not only do carcinogens in second-hand smoke cause a variety of cancers, but the release of second-hand smoke by smoking, the burning of the remnant of extinguished cigarettes and smoke residues in clothing or in the surrounding environment can also be hazardous to health, particularly that of vulnerable groups such as infants and young children who are more likely to be exposed to second-hand smoke.The aim of this study was to explore the important beliefs, enforceable effective strategies and methods of parents to protect their children from exposure to second-hand smoke.This study used "Q methodology" with 50 parents as subjects who have young children at residences in the Health Center of Sanchong District, of which 42 Q-statements of parents concerning their beliefs about protecting children from exposure to second-hand smoke were classified. The quantitative statistical analysis of research results was performed by PQ Method 2.35 statistical software. The number of respondents was 43, with the explained variation at 65%. Parents were divided into five types according to their beliefs: first type is to avoid interpersonal conflict, the second type is to go along with what’s senseless, the third type is to strengthen environmental awareness, the fourth type is to avoid a smoking hazard and the fifth type is to tolerate family member’s smoking. In addition to helping explore the views, attitudes, and intentions of parents in protecting their children from exposure to second-hand smoke, this study also expected that health workers would be more effective in controlling the environment from second-hand smoke exposure to children through parental perspectives derived from this research as well as be able to serve as advice for future strategic planning of intervention in smoking.
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Seixas, Pedro Francisco Afonso Salgado Amaral. "Benefícios da cessação tabágica e das políticas de espaços livres de fumo no doente coronário." Master's thesis, 2016. http://hdl.handle.net/10400.6/5349.
Full textAbstract:
Introdução: Mundialmente, as Doenças Cardiovasculares são a principal causa de
mortalidade. A Doença Cardíaca Coronária é reconhecida como umas das principais Doenças
Cardiovasculares, sendo responsável por elevada morbi-mortalidade: 42% das mortes por
Doença Cardiovascular, em 2012.
Desse modo, o investimento em estratégias de prevenção primária e secundária assume um
papel preponderante para a redução da carga de doença e custos associados às Doenças
Cardiovasculares.
A literatura científica é clara no que toca ao papel do tabagismo ativo e do Fumo Ambiental
de Tabaco neste contexto, não só relativamente ao seu contributo para o aumento da
incidência de Doença Arterial Coronária e Síndrome Coronário Agudo, como também devido às
implicações prognósticas decorrentes da exposição a estes fatores de risco no doente
coronário.
Uma vez que a cessação tabágica e a evicção da exposição ao Fumo Ambiental de Tabaco se
encontram descritas pela literatura científica como das medidas mais custo-efetivas para o
prognóstico do doente coronário, a presente monografia pretende realizar uma revisão acerca
dos benefícios das diversas intervenções nesta área, bem como da sua inserção nos Programas
de Reabilitação Cardíaca.
Objetivo Geral: Revisão da evidência científica existente no que toca aos benefícios das
intervenções de cessação tabágica e das políticas livres de fumo nos pacientes com Doença
Cardíaca Coronária, inseridos nos Programas de Reabilitação Cardíaca.
Tipo de estudo: Monografia – Revisão Temática da Literatura Científica
Metodologia: A metodologia teve como base a pesquisa bibliográfica nas plataformas online
da American Heart Association (http://www.heart.org/HEARTORG/), Centers for Disease
Control and Prevention (http://www.cdc.gov/), National Heart, Lung and Blood Institute
(http://www.nhlbi.nih.gov/), World Heart Federation (http://www.world-heartfederation.
org/), World Health Organization (http://www.who.int/en/); Direção Geral da
Saúde (https://www.dgs.pt/); bem como nas bases de dados PubMed
(http://www.ncbi.nlm.nih.gov/pubmed/), MeSH (http://www.ncbi.nlm.nih.gov/mesh/)
Medscape (http://www.medscape.com/), B-on (http://www.b-on.pt/) e Cochrane
(http://www.cochranelibrary.com/). Conclusões: A evidência científica demonstra que uma cessação tabágica bem-sucedida e a evicção da exposição ao Fumo Ambiental de Tabaco, apresentam um impacto considerável no prognóstico do doente coronário. Neste contexto, a sistematização de intervenções breves que englobem a abordagem do comportamento tabágico, os benefícios de deixar de fumar e a referenciação para intervenções intensivas de cessação tabágica, demonstram ser medidas custo-efetivas, devendo ser integradas na abordagem multidisciplinar dos Programas de Reabilitação Cardíaca. Para tal, e uma vez que se encontra comprovado que este tipo de atuação é escasso e insuficiente por parte dos profissionais de saúde, a presente monografia realça a necessidade da educação médica e formação pós-graduada nesta vertente.Introduction: Worldwide, cardiovascular diseases are the leading cause of death worldwide. Coronary Heart Disease is recognized as one of the main causes of morbidity and mortality, contributing to 42% of mortality attributable to cardiovascular diseases in 2012. Thus, the primary and secondary Coronary Heart Disease prevention play a key role in reducing the burden of cardiovascular diseases. The scientific evidence is clear regarding the role of smoking and second-hand tobacco smoke exposure: both increase the incidence of Coronary Artery Disease and Acute Coronary Syndrome and worsen the prognosis of Coronary Heart Disease patients. Smoking cessation and prevention of second-hand tobacco smoke are among the most cost-effective interventions regarding coronary patients. This study aims to review the benefits of smoking cessation and second-hand tobacco smoke prevention focusing in Cardiac Rehabilitation Programs. Main Objective: To perform a scientific literature review focusing on the benefits of smoking cessation and smoke free policies in patients with Coronary Heart Disease, and its importance on Cardiac Rehabilitation Programs. Type of study: Monograph - Thematic Review of Scientific Literature Methods: Literature research on the following: American Heart Association (http://www.heart.org/HEARTORG/), Centers for Disease Control and Prevention (http://www.cdc.gov/), National Heart, Lung and Blood Institute (http://www.nhlbi.nih.gov/), World Heart Federation (http://www.world-heart-federation.org/), World Health Organization (http://www.who.int/en/); Direção Geral da Saúde (https://www.dgs.pt/); as well as on the next database searchers: PubMed (http://www.ncbi.nlm.nih.gov/pubmed/), MeSH (http://www.ncbi.nlm.nih.gov/mesh/) Medscape (http://www.medscape.com/), B-on (http://www.b-on.pt/) e Cochrane (http://www.cochranelibrary.com/). Conclusions: Successful smoking cessation and prevention of second-hand tobacco smoke exposure have considerable impact on the prognosis of coronary patient. Systematic brief interventions regarding tobacco health hazards and the benefits of cessation and referral to intensive cessation support are significantly associated with increased quit rates. In addition, these interventions are very cost-effective. Smoking cessation should be integrated in multidisciplinary Cardiac Rehabilitation Programs. However, many studies show that this approach is seldom included in coronary care and in clinical practice. This monograph highlights the need for fostering medical education and postgraduate training in cessation skills in order to improve the prognosis of coronary patients.
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PARKINSON, MATTHEW RAMCHARAN. "Established and suspected risk factors for breast cancer: A case-control study in Vancouver, BC and Kingston, ON." Thesis, 2011. http://hdl.handle.net/1974/6650.
Full textAbstract:
More than half of all cases of breast cancer occur among women without any known risk factors. More research is needed on suspected risk factors in order to refine current breast cancer screening tools. The objectives of this thesis were: to determine the breast cancer risk associated with known risk factors (ethnicity, family history, breast biopsy, age at menarche, age at first birth, alcohol, HRT, and BMI), suspected risk factors (smoking, second-hand smoke exposure, smoked/grilled foods, and NSAID use), and to examine the above associations according to tumour receptor status, histologic grade, and menopausal status, with potential confounders also considered. This thesis project was conducted within the framework of the Molecular Epidemiology of Breast Cancer study, a case-control study of women in Vancouver, BC and Kingston, ON, with 1140 cases and 1169 controls recruited from 2005-2010. Information was collected from a detailed questionnaire.
Cases and controls were similar in terms of age at menarche, age at first birth, smoking history, second-hand smoke exposure, lifetime smoked/grilled food consumption, HRT, and BMI. Among cases, there were significantly less Europeans and more Chinese, Japanese, and Filipino subjects compared to controls. Cases were more likely to have a first degree relative with breast cancer, as well as a previous benign breast biopsy. Alcohol consumption and past NSAID usage was higher among controls. The level of education completed was higher among controls. Cases were also more likely to be postmenopausal.
Family history was associated with breast cancer risk (OR=1.59, CI=1.30-1.94), as was BMI (OR=1.28, CI=1.05-1.58 for overweight and OR=2.28, CI=1.35-3.86 for obese class II). Second-hand smoke was also found to be associated with breast cancer risk (OR=1.42, CI=1.02-1.97 for individuals with a less than 10 pack-year smoking history). Due to reduced sample size with stratification and marginally significant results, it is not possible to draw definitive conclusions regarding pathology sub-types.
In summary, these results provide support for the association between several risk factors and breast cancer risk. More research is needed to ascertain how receptor status, histologic grade, and menopausal status affect these associations.Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2011-08-15 19:43:06.689