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Relevant bibliographies by topics / Smoke prevention

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Academic literature on the topic 'Smoke prevention'

Author: Grafiati

Published: 4 June 2021

Last updated: 28 July 2024

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Journal articles on the topic "Smoke prevention"

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Booth, W. H. "SMOKE PREVENTION." Journal of the American Society for Naval Engineers 10, no. 4 (March 18, 2009): 1064–68. http://dx.doi.org/10.1111/j.1559-3584.1898.tb01928.x.

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Xin, Li, Zhang Yuanyuan, Jia Boyan, Zhang Guowei, and Zheng Li. "Effects of Fire Compartmentation and Smoke Exhaust Measures on Smoke Spread Caused by Cable Fire in Utility Tunnel." Advances in Civil Engineering 2021 (November 19, 2021): 1–9. http://dx.doi.org/10.1155/2021/4407919.

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Investigating the behavior of fire smoke in utility tunnel as well as smoke prevention and control measures are of vital significance for exhausting smoke from utility tunnel, realizing efficient firefighting and rescue, and guaranteeing the normal operation of cities. Taking utility tunnel as the research background, this paper builds a simulation calculation model for fire smoke prevention and control in the utility tunnel using PyroSim numerical simulation software and explores the rules of smoke spread under conditions such as building ceiling screen, changing fire compartmentation tightness, and adding smoke exhaust facilities. According to study results, before the tunnel was filled with smoke, ceiling screens lowered smoke spread rate, and smoke spread rate was inversely proportional to the ceiling screen height. When the fire door was opened, fire smoke spread to the adjacent fire compartment, and smoke spread rate was directly proportional to the fire door opening angle. Before the tunnel was filled up, mechanical smoke exhaust facilities significantly lowered the smoke spread rate by as much as 50%. When the entire tunnel was full of smoke, mechanical smoke exhaust facilities significantly reduced the smoke concentration in the utility tunnel; smoke layer temperature dropped by as much as 32°C, while visibility improved by as much as 66%. By studying smoke spread in utility tunnel, this paper aims to determine the optimal measures of preventing and controlling smoke spread in utility tunnel. This paper could also offer some reference for practical engineering applications in smoke prevention and control in utility tunnel.

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Fallavollita, Westley L., Elizabeth K. Do, Julia C. Schechter, Scott H. Kollins, Junfeng (Jim) Zheng, Jian Qin, Rachel L. Maguire, Cathrine Hoyo, Susan K. Murphy, and Bernard F. Fuemmeler. "Smoke-Free Home Rules and Association with Child Secondhand Smoke Exposure among Mother–Child Dyad Relationships." International Journal of Environmental Research and Public Health 18, no. 10 (May 14, 2021): 5256. http://dx.doi.org/10.3390/ijerph18105256.

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Smoke-free home rules restrict smoking in the home, but biomarkers of secondhand smoke exposure are needed to help understand the association between smoke-free homes and child secondhand smoke exposure. Participants (n = 346) were majority Black/African American mother–child dyads from a longitudinal study in North Carolina. Mothers completed questionnaires on household smoking behaviors and rules, and child saliva samples were assayed for secondhand smoke exposure. Regression models used smoke-free home rules to predict child risk for secondhand smoke exposure. Children in households with smoke-free home rules had less salivary cotinine and risk for secondhand smoke exposure. After controlling for smokers in the household, home smoking rules were not a significant predictor of secondhand smoke exposure. Compared to children in households with no smokers, children in households with at least one smoker but a non-smoking mother (OR 5.35, 95% CI: 2.22, 13.17) and households with at least one smoker including a smoking mother (OR 13.73, 95% CI: 6.06, 33.28) had greater risk for secondhand smoke exposure. Results suggest smoke-free home rules are not sufficient to fully protect children from secondhand smoke exposure, especially in homes with smokers. Future research should focus on how household members who smoke can facilitate the prevention of child secondhand smoke exposure.

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Wang, Ruo Jun, Bin Jiang, and Yan Ying Xu. "Subway Station Fire Prevention System Safety Analysis." Applied Mechanics and Materials 405-408 (September 2013): 1861–64. http://dx.doi.org/10.4028/www.scientific.net/amm.405-408.1861.

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Fire prevention system of subway station plays an important role in ensuring passenger safety. The Shenyang Youth Street subway station fire prevention system safety was studied, applying performance-based fire protection design analysis method, using of FDS simulation software on the station fire prevention safety system for the calculation and analysis. Three working conditions were set when subway fire happens. Fire smoke flow characteristics and the distribution of temperature, CO concentration and visibility were analyzed and compared. The results show that the automatic sprinkler system and smoke control system have great effect on the preventing spread of fire. In the automatic sprinkler system and smoke control system conditions, fire hazards have not reached the standards of passengers tolerance.

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Usen, A. E., I. Harold, A. I. Wegbom, P. C. Ajie, G. C. Dimkpa, and O. A. Popoola. "Intention to Smoke Tobacco Products among Senior Secondary School Students in Uyo Local Government Area, Akwa Ibom State." Juvenis Scientia, no. 2 (April 30, 2023): 32–42. http://dx.doi.org/10.32415/jscientia_2023_9_2_32-42.

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Introduction. Adolescence is a period in which many adolescents start exploring certain risky behaviours like tobacco use. Adolescent tobacco use is a significant global public health challenge. This study was conducted to determine the intention to smoke tobacco products among coeducational senior secondary school students in Uyo LGA, Akwa Ibom State. Materials and methods. A cross-sectional study was conducted among 200 senior secondary school students aged 10–19 from January 2020 to December 2020. A multi-stage sampling technique was used to select respondents from four senior secondary coeducational schools. Data were collected using a semi-structured interviewer-assisted questionnaire. Results. Mean age of respondents was 15.3 ± 1.4 years, and 110 (55.0%) of them were males. The prevalence of intention to smoke tobacco products among the respondents was 75 (37.5%). 43 (21.5%) of them reported peer pressure as the reason for their intention to smoke. 190 (95.0%) of them knew that cigarette smoking is harmful to their health. There was a statistically significant association between respondents’ sex, ever smoked, currently smoking, age at first experience, last experience, having a sibling that smokes, having friends that smoke, and intention to smoke tobacco products (p < 0.05). Conclusion. Adolescents with these risk factors should be prioritized by smoking prevention efforts.

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Chunling, Zhang, and Xu Yumei. "The Dilemma and Countermeasures of Legal Control of Atmospheric Haze and Smoke Dust Pollution." Tobacco Regulatory Science 7, no. 5 (September 30, 2021): 2874–80. http://dx.doi.org/10.18001/trs.7.5.1.55.

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Smoke dust is an important factor leading to haze pollution. There is no doubt about the serious impact of smoke dust pollution on public health, life and economic development. A consensus has been reached on the use of legal means to control smoke dust pollution. However, the existing laws still have too many problems to deal with the increasingly complex smoke dust pollution. It is a must to change the regulatory objects of the current “Air Pollution Prevention and Control Law (APPC Law)”, speed up the establishment of a regional joint prevention and control legal system, and establish local characteristic legislation in accordance with local conditions. We need establish a “three-in-one” legal system for the prevention and control of atmospheric haze and smoke dust pollution with “APPC Law” at the top, local legislations at the bottom and regional joint prevention and control law in the middle.

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Rie, Dongho, and Jioh Ryu. "Sustainable Urban Planning Technique of Fire Disaster Prevention for Subway." Sustainability 12, no. 1 (January 2, 2020): 372. http://dx.doi.org/10.3390/su12010372.

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Subway infrastructure is a representative urban infrastructure for sustainable urban development as part of its policy to harmonize with economic growth. As the transportation infrastructure of large cities develops with high speed and intelligence, more attention will be paid to its safety. The main cause of death in subway fires is asphyxiation, due to the closed specificity of the underground space. Therefore, smoke exhaust facilities should be capable of minimizing the effects of smoke to ensure the safe evacuation of passengers in the event of fire. In this study, three kinds of fire locations are adopted to analyze the distribution of platform temperature, CO, and visibility in connection with the smoke exhaust system operation method. We evaluate the performance of the applicable smoke exhaust system from ASET-based untenable area analysis. Fatality evaluation by escape analysis according to the smoke exhaust system estimates the fatality based on the tenability performance evaluation. Moreover, the FED method was used to evaluate tenability performance. Therefore, the result of this study suggests a solution for sustainable subway Disaster response from the performance evaluation of the subway platform smoke exhaust system for safe evacuation of passengers, which is essential for subway construction or remodeling.

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Aulia, Mochammad Izzur Rizky, Munasir Munasir, Mohammad Budiyanto, and Rizqi Afnan. "The Dangers of Cigarette Smoke and the Role of Guided Inquiry for Prevention and Other Prevention." IJORER : International Journal of Recent Educational Research 4, no. 2 (March 30, 2023): 149–62. http://dx.doi.org/10.46245/ijorer.v4i2.274.

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Objective: The objectives are to discover the health impact of cigarette smoke, the factors make adolescents’ smoking behavior, and how guided inquiry and other rules for preventing smoking behavior. Method: This research uses a literature review research method or literature study, collecting several sources that can later be used as a reference. This research is obtained from the seventy-five journals reviewed. Results: Based on the literature review, so many destructive impacts of cigarette smoke on health. Mostly factor in smoking behavior is an advertisement of cigarettes. Preventive ways to stop adolescents smoking behavior are also available. Nevertheless, the most effective ways are school-based learning. Primarily health education with guided inquiry learning based. Novelty: Previous research by another researcher needs to explain the factors of adolescent smoking behavior sufficiently; the previous research also needs to mention the prevention of that behavior. This research shows the health impact of smoking and prevention in social life, and this research shows the role of guided inquiry for prevention.

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Yudi, Matias B., Omar Farouque, Nick Andrianopoulos, Andrew E. Ajani, Katie Kalten, Angela L. Brennan, Jeffrey Lefkovits, et al. "The prognostic significance of smoking cessation after acute coronary syndromes: an observational, multicentre study from the Melbourne interventional group registry." BMJ Open 7, no. 10 (October 2017): e016874. http://dx.doi.org/10.1136/bmjopen-2017-016874.

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ObjectiveWe aim to ascertain the prognostic significance of persistent smoking and smoking cessation after an acute coronary syndrome (ACS) in the era of percutaneous coronary intervention (PCI) and optimal secondary prevention pharmacotherapy.MethodsConsecutive patients from the Melbourne Interventional Group registry (2005–2013) who were alive at 30 days post-ACS presentation were included in our observational cohort study. Patients were divided into four categories based on their smoking status: non-smoker; ex-smoker (quit >1 month before ACS); recent quitter (smoker at presentation but quit by 30 days) and persistent smoker (smoker at presentation and at 30 days). The primary endpoint was survival ascertained through the Australian National Death Index linkage. A Cox-proportional hazards model was used to estimate the adjusted HR and 95% CI for survival.ResultsOf the 9375 patients included, 2728 (29.1%) never smoked, 3712 (39.6%) were ex-smokers, 1612 (17.2%) were recent quitters and 1323 (14.1%) were persistent smokers. Cox-proportional hazard modelling revealed, compared with those who had never smoked, that persistent smoking (HR 1.78, 95% CI 1.36 to 2.32, p<0.001) was an independent predictor of increased hazard (mean follow-up 3.9±2.2 years) while being a recent quitter (HR 1.27, 95% CI 0.96 to 1.68, p=0.10) or an ex-smoker (HR 1.03, 95% CI 0.87 to 1.22, p=0.72) were not.ConclusionsIn a contemporary cohort of patients with ACS, those who continued to smoke had an 80% risk of lower survival while those who quit had comparable survival to lifelong non-smokers. This underscores the importance of smoking cessation in secondary prevention despite the improvement in management of ACS with PCI and pharmacotherapy.

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Mayasari, Yufitri, Wulan Apridita Sebastian, and Mutiara Rina RR. "SMOKE FEE CAMPAIGN THROUGH SCHOOL-BASED PREVENTION PROGRAM AT MUTIARA HARAPAN ISLAMIC SCHOOL, TANGERANG – BANTEN." ICCD 1, no. 1 (December 22, 2018): 688–91. http://dx.doi.org/10.33068/iccd.vol1.iss1.102.

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Children are susceptible to be passive smokers as a consequence of exposure to cigarette smoke when they are in the surroundings of smokers. Nearly 70% of children aged 13-15 years are exposed to cigarette smoke inside their homes, while 78 percent are exposed to cigarettes outside their homes. Cigarette smoke has a bad impact on health in children, even though they do not understand the dangers of cigarette smoke. For this reason, an extension activity is conducted on the dangers of cigarette smoke, so that children can understand the dangers of cigarette smoke and can be the main driver for parents and their surroundings to live smoke-free.

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Dissertations / Theses on the topic "Smoke prevention"

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Gong, Jian, and 龚剑. "Multiple solutions of smoke flow in building fires." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45143456.

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Bai, Yang. "Investigation of the natural smoke exhaust of an atrium by the CFD method." Thesis, University of Macau, 2017. http://umaclib3.umac.mo/record=b3691690.

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Herbert, Rosemary 1955. "Making homes smoke-free : the impact of an empowerment intervention for parents." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=115898.

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One-third of American children under the age of 18 years and one in ten Canadian children aged 0-11 years are exposed to environmental tobacco smoke (ETS) predisposing them to multiple health problems. Although several intervention strategies to reduce ETS exposure among children have been tested, to date there is not enough evidence to recommend one strategy over another. The objectives of this study were: (a) to test if parents' participation in an intervention based on an empowerment ideology and participatory experiences decreases the number of cigarettes smoked in homes; and (b) to identify barriers to making homes and vehicles smoke-free, as well as facilitators used by parents to manage these barriers. To enable informed decision-making on how to measure empowerment, a systematic review was conducted to identify questionnaires that best measure health-related empowerment among adults and in families.
In a randomized controlled trial, 36 families were allocated to the intervention (n=17) or control group (n=19). The six week intervention included three, two hour group sessions, followed by three follow-up telephone calls, all at weekly intervals. Data were collected in interviewer-administered questionnaires at baseline and at six months follow-up.
No significant difference was detected between the intervention and control groups in the number of cigarettes smoked in the home daily at six months follow-up. However empowerment increased and the number of cigarettes smoked in the home decreased in both the intervention and control groups from baseline (median=17) to six-month follow-up (median=5).
Parents identified multiple barriers to smoke-free homes and vehicles including personal factors, factors involving others, and factors related to the physical environment. The most commonly identified barriers to smoke-free homes were personal factors, with tobacco addiction cited most often. In describing how to overcome barriers, parents identified facilitators involving other people as most effective, yet they most often relied on themselves. None ofthe parents identified a health provider as a facilitator. The multiple and complex barriers identified in this study suggest that interventions and practice guidelines should incorporate multiple strategies and individualized approaches to assist parents to make their homes and vehicles smoke-free.

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Carlsson, Noomi. "A Zero-vision for Children’s Tobacco Smoke Exposure : Tobacco prevention in Child Health Care." Doctoral thesis, Linköpings universitet, Pediatrik, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-79331.

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Adverse health effects in children caused by environmental tobacco smoke (ETS) are well known. Children are primarily exposed by their parents’ smoking in their homes. A comprehensive evidence base shows that parental smoking during pregnancy and ETS exposure in early childhood are associated with an increased risk for a range of adverse health problems. Child Health Care nurses, who meet nearly all families in Sweden with children aged 0-6 years, have thus an important role in tobacco preventive work in order to support parents in their ambitions to protect their children from ETS exposure. The overall aim of this thesis was to develop, test and evaluate a new model for tobacco preventive work in Child Health Care (CHC) with special focus on areas with a high prevalence of parental smoking. In a first step CHC nurses’ and parents’ views on tobacco preventive work were analysed in two studies based on questionnaires. The intervention was performed during the second step, based on the results from nurses’ and parents’ experience of the tobacco preventive work in CHC, and with methods from Quality Improvement. An “intervention bundle” was developed which included evidence based methods for prevention of ETS exposure, and four learning sessions for the nurses. The instrument “Smoking in Children’s Environment Test” (SiCET) included in the bundle was evaluated with focus group interviews with the CHC nurses who participated in the intervention. Two urine samples were analysed to measure cotinine levels in children which provide an estimate for ETS exposure. Parents’ answers from the SiCET questionnaire, measurements of cotinine, and data from the nurses’ log-books were used in the evaluation of the effects of the intervention. In areas with a high prevalence of parental smoking 22 nurses recruited 86 families of whom 72 took part for the entire one-year period of the intervention. The results showed that parents wanted to have information on the harmful effects tobacco smoke have on their children and how they can protect their children from ETS exposure. The nurses saw tobacco preventive work as important but they experienced difficulties to reach certain groups such as fathers, foreign-born parents, and those who are socio-economically disadvantaged. The SiCET instrument provided a basis for dialogue with parents. The main results from the intervention showed that ten parents (11%) quit smoking, thirty-two families (44%) decreased their cigarette consumption in the home, and fewer children were exposed to tobacco smoke. Consequently, more children showed levels of urinary cotinine less than 6 ng/ml (base-line n=43, follow up n=54; p=0.05). The total number of outdoor smokers did not change. Seven of the nurses (30%) had successful results in their areas with a decrease of smokers in families with a child of 8 months, from 20% in 2009 to 12% in 2011. The corresponding figures for the whole county as well as the country did not decrease during the same period. The sustainability of the intervention has to be followed and thus measures should be followed prospectively over time. The SiCET instrument was found useful and might be applicable in other arenas where children’s ETS exposure is discussed. The development of an instant cotinine test using dipsticks would make it possible to give parents immediate feedback on the effectiveness of taken protective actions. This could work as a pedagogic resource in the dialogue with parents.

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Smith, Kathryn. "Assessing the Healthcare and Harm Reduction Needs Among Women and Men Who Smoke Crack Cocaine." Thèse, Université d'Ottawa / University of Ottawa, 2011. http://hdl.handle.net/10393/20331.

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This thesis was undertaken to assess the characteristics of individuals who smoke crack cocaine and to examine the health-related risks and healthcare needs of this population. A literature review of 147 published articles was conducted to synthesize evidence regarding behaviours associated with crack use and to assess the risks of disease transmission through crack smoking behaviours. Qualitative interviews were subsequently conducted with thirty Ottawa residents who smoke crack to learn about their experiences with healthcare and harm reduction services. Results identified barriers related to accessing primary healthcare and drug treatment programming among people who smoke crack and gaps within existing harm reduction services. Individuals who smoke crack represent a marginalized population who are often missed through traditional health promotion and harm reduction programming. There is a need for increased coverage of current programming and a reduction of factors which currently hinder the delivery and effectiveness of crack-specific harm reduction programs.

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Yau, Pui-lam Josephine, and 游貝琳. "A randomized controlled trial of a family intervention in reducing secondhand smoke exposure to infants under 18-months." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B48079777.

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Background: Secondhand smoke exposure (SHS) causes many fatal diseases to children and there is no safe level of exposure. In Hong Kong, around 41%of infants are exposed to household SHS and leading to the additional hospital admissions of the infants. Objectives: To study the effectiveness of a theory-based family intervention delivered by the smoking cessation counselor (SCCs) which aims to reduce household SHS exposure to infants under 18-months, by helping fathers to quit smoking and motivating mothers to establish a smoke-free home . Methods: Families with a smoking father, non-smoking mother and an infant attended the Maternal and Child Health Centres (MCHCs) were invited to join this randomized controlled trial. The family (mother and father) was randomized after the completion of mother’s baseline questionnaire and the collection of saliva samples from mothers and infants. Father was then contacted for telephone baseline interview. Individual interventions were provided to both mothers and fathers at baseline, 1-week and 1-month, and a family session involving both parents was offered to the intervention group. The control group received information on the hazards of SHS and the benefits of smoking cessation. The intervention and control groups were followed-up at 6-and 12-monthsto assess father’s smoking behavior and the execution of a complete no-smoking policy at home. Chi-squares and independent t-tests were used to assess the group differences in father’s smoking behavior and the initiation of a smoke-free home. Generalized estimating equations were used to examine the group changes of mothers’ and infants’ saliva cotinine levels from baseline to 12-month. Logistic regressions were performed to identify the predictors on father’s smoking behavior and the initiation of a smoke-free home. Results: There were 1,158 families randomized. Significantly more fathers in the intervention groupattainedhigher7-day point prevalence quit rate at 6-(8.0% vs 4.1%, p= .007)and 12-months (13.7% vs 8.0%, p= .002)respectively, stopped smoking at home at 12-month (35.7% vs 28.8%, p= .023), higher continuous quit rates at 6-(3.3% vs 0.7%, p= .002) and 12-month (1.8% vs 0.2%, p= .006), reduction of daily cigarette consumption over 50% at 12-month (33.4% vs 23.9%, p= .006), improvement in the stage of readiness to quit smoking at 6-month (13.0% vs 8.9%, p= .04) and more quit attempts (30.9% vs 24.1%, p=.015). No group differences were found in the establishment of the smoke-free home and the changes of saliva cotinine levels of infants and mothers from baseline to follow-ups. Discussion: This theory-based family intervention is effective in reducing household SHS exposure to infants by helping fathers to quit and stopped them to smoking at home, but it is less effective in motivating the mothers to initiate a smoke-free home. Significance: This is the first study testing a theory-based family intervention in reducing household SHS exposure to healthy infants. The family intervention provides a new insight in using ‘family’ as a unit for the intervention to reduce household SHS exposure to healthy infants by improving fathers' household smoking behavior and helping them to quit smoking.
published_or_final_version
Nursing Studies
Doctoral
Doctor of Philosophy

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Xue, Yuan. "Precancerous lesions induced by cigarette smoke : possible molecular mechanisms and prevention by dietary vitamin A intake but with potential osteoporotic risk /." Search for this dissertation online, 2006. http://wwwlib.umi.com/cr/ksu/main.

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Sebastian, Fjaestad. "Ökad riskmedvetenhet hos allmänheten genom riktade kommunikationsinsatser med fokus på hembesök : -En intervjustudie." Thesis, Luleå tekniska universitet, Institutionen för samhällsbyggnad och naturresurser, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-72825.

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Varje år åker Sveriges räddningstjänster på cirka 6000 larm om brand eller brandtillbud i bostäder med följd att även cirka 100 personer omkommer årligen i sina hem. Att det är cirka 100 personer som omkommer varje år är något som ses som ett problem då det oftast är okunskap eller begränsande möjligheter att undsätta sig själv i säkerhet som ligger bakom bränderna och dödsfallen. Att som räddningstjänst utföra hembesök med att åka hem till olika personer och prata om brandskydd och risker i hemmet är något som visats vara väldigt effektivt i Storbritannien. Varje år gör räddningstjänster runt om i Storbritannien cirka 670 000 hembesök i syfte att öka kunskaper och frekvensen av brandvarnare i hemmen. Arbetet med hembesök påbörjades i slutet av 90-talet och har fram tills nu resulterat i att antalet insatser och dödsfall till följd av brand har mer än halverats. I Sverige är det förebyggande arbetet med hembesök inte lika utbrett men flera räddningstjänster har under de senaste åren startat upp och påbörjat genomförandet av hembesök. Myndigheten för samhällsskydd och beredskap, MSB, uppmanar fler räddningstjänster i Sverige att påbörja ett förebyggande arbete själva eller tillsammans med andra räddningstjänster för ökad riskmedvetenhet, kunskap och brandvarnarfrekvens i hemmen. Räddningstjänsten Syd är en av räddningstjänsterna i Sverige som arbetat med hembesök under lång tid och som kunnat visa effekter och statistiska skillnader på att hembesök verkligen gör nytta. Räddningstjänsten Syd har visat en nedåtgående trend på antalet insatser och har en lägre genomsnittlig dödsbrandsstatistik än den samlade dödsbrandsstatistiken för övriga Sverige. Rapporten grundar sig i en förstudie och en intervjustudie där 10 intervjuer genomförts med 8 olika räddningstjänster runt om i Sverige. De intervjuade har olika yrkesroller inom räddningstjänsten som antingen arbetat administrativt eller som utförare av hembesök. Hembesök genomförs främst av operativ personal där den skiftgående styrkan ägnar några timmar i veckan eller månaden på hembesök. Hur hembesök påverkar den operativa förmågan upplever samtliga respondenter som positiv då brandmännen får en bra områdesöversikt och grundläggande kunskaper i byggnadens utformning. Kunskaperna kan sedan visas vara värdefull vid eventuella insatser och insatsens verkan. Inställningen till att arbeta förebyggande med hembesök är något som varierar bland den operativa personalen där det upplevs att det finns motståndare till sådana här typer av arbetsuppgifter. Samtliga respondenter anser att hembesök är något som räddningstjänsten ska fortsätta att arbeta med tillsammans med andra förebyggande åtgärder. Hembesök utgör en viktig del i det förebyggande arbetet men att bara fokusera på hembesök är inte rätt lösning enligt många av respondenterna. Att arbeta med mer riktade och anpassade hembesök mot olika riskgrupper i samhället är något som räddningstjänsterna har som målsättning men att det då krävs en bättre samverkan mellan olika kommunala aktörer för arbetets effekt. Många av respondenterna menar att det administrativa arbetet med hembesök är något som är ganska besvärligt och tidskrävande att hantera då det är mycket information och statistiska uppföljningar som behandlas. Tekniska lösningar kopplade till redan befintliga programvaror är något som räddningstjänsterna vill se framöver för att kunna underlätta planering och administrering. Hur arbetet med hembesök ska kunna förbättras för att komma åt dödsbränder i samhället finns det förslag på förbättringsåtgärder, till exempel att i samband med hembesök även arbeta med individanpassat brandskydd eller tillsyner. Tillsyner är något som aldrig görs mot bostäder men som genomförs på hotell, köpcentrum, industrier etc. Individanpassat brandskydd innebär att brandskyddet anpassas efter individens förutsättningar till ett säkert boende exempelvis personer med olika typer av handikapp eller kognitiva nedsättningar.

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Lu, Liya. "Association between active smoking, secondhand smoke and peripheral arterial disease." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8059/.

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Worldwide, cardiovascular disease (CVD) is the leading cause of death. It is widely accepted that both active smoking and exposure to secondhand smoke (SHS) are associated with CVD. About 20% of the global population smoke tobacco or tobacco-related products. The global prevalence of smoking is increasing, although it is decreasing in some high-income and upper middle-income countries. Globally, about a third of adults and 40% children are regularly exposed to SHS. According to the World Health Organisation (WHO), only 16% of the global population is protected by a comprehensive smoke-free legislation. Coronary heart disease (CHD), stroke and peripheral arterial disease (PAD) are all types of atherosclerosis and often co-exist in the same patients. Therefore, they share many common risk factors including cigarette smoking. However, previous epidemiological studies on CVD including those on cigarette smoking mainly focused on CHD and stroke and pay little attention to PAD. Evidence is increasing in support of the association between exposure to SHS and both CHD and stroke. In contrast, there is a paucity of studies on SHS and the risk of PAD. The overarching aim of this thesis was to collate the published evidence on the association between active cigarette smoking and PAD, and examine the association between exposure to SHS and PAD in the general population. This thesis starts with a systematic review on the association between active cigarette smoking, SHS and PAD undertaken using four databases: Medline, Embase, PubMed and Web of Science to identify existing published evidence up to 30 April 2012 (Chapter 2). Prior to the published studies contained in this thesis, there had been no meta-analyses on the association between active cigarette smoking and PAD and only two studies published on the association between SHS and PAD. Therefore, this systematic review was followed by a meta-analysis on the association between active cigarette smoking and PAD. This meta-analysis identified 55 studies: 43 cross-sectional, 10 cohort and 2 case-control. Of the 68 results for current smokers, 59 (86.8%) were statistically significant and the pooled odds ratio (OR) was 2.72 (95% confidence interval [CI] 2.28-3.21). Of the 40 results for ex-smokers, 29 (72.5%) were statistically significant and the pooled OR was 1.67 (95% CI 1.54-1.81). Active cigarette smoking significantly increases the risk of PAD, compared with never smokers. The magnitude of association between active cigarette smoking and PAD was greater in current smokers than ex-smokers. In contrast, prior to my studies in this thesis, only two studies on SHS were identified. Only one showed an overall association between self-report SHS and PAD in Chinese never smokers, with a clear dose-response relationship. The other study used serum cotinine as measure for SHS exposure and found neither an overall association nor a dose-response relationship but suggested a very high cotinine concentration as threshold. Chapter 3 examines the association between SHS exposure and PAD in adult non-smokers in Scotland. This chapter includes two cross-sectional studies using the Generation Scotland: Scottish Family Health Study (GS: SFHS) and the Scottish Health Survey (SHeS), and one retrospective cohort study using the record linkage of the SHeS. In the cross-sectional study using SFHS, PAD was measured using ankle brachial pressure index (ABPI) but SHS exposure was self-report. Of the 5,686 never smokers, 134 (2.4%) had PAD (defined as an ABPI < 0.9). Participants who reported overall high level of SHS exposure (exposed to ≥40 hours per week) were more likely to have PAD, compared with those who reported no exposure to SHS. After adjustment for potential confounders, the association between SHS and PAD persisted (adjusted OR 4.53, 95% CI 1.51-13.56, p=0.007), with suggestion of a dose-response relationship. In the other cross-sectional study using SHeS, SHS exposure was measured objectively using cotinine concentration but PAD was based on self-report symptoms of intermittent claudication (IC) using the Edinburgh Claudication Questionnaire. Of the 4,231 non-smokers (defined as self-reported non-smokers with a salivary cotinine concentration <15 ng/mL), 134 (3.2%) had IC. Participants with high exposure to SHS (cotinine ≥2.7 ng/mL) were at significantly higher risk of IC, after adjustment for potential confounders (adjusted OR 1.76, 95% CI 1.04-3.00, p=0.036). A dose-response relationship was suggested, whereby the risk of IC increased with increasing cotinine concentration. However, the association varied by age category. Participants aged <60 were more strongly associated with PAD. This may be explained by survival bias. For the third, retrospective cohort study in Chapter 3, I used record linkage of SHeS to Scottish Morbidity Record 01 (SMR01) records and death certificates to identify the first hospital admission/death following the SHeS in which PAD was recorded as the primary or secondary cause. Of the 4,045 confirmed non-smokers who were free of baseline IC were included. Over the follow-up period (mean follow-up 9 years), there were 568 deaths, none of which were coded as due to PAD, and 64 participants were hospitalised for PAD. High exposure to SHS was associated with increased risk of all-cause mortality (adjusted hazard ratio [HR] 1.42, 95% CI 1.09- 1.86, p=0.011) among all non-smokers and increased risk of incident PAD (adjusted HR 2.82, 95% CI 1.14-6.96, p=0.024) among male non-smokers. Increased cotinine concentrations at baseline were associated with increased risk of all-cause mortality, with a dose-response relationship. SHS contains both sidestream smoke, from burning cigarette tips, and exhaled mainstream smoke. Shortened telomere length is broadly viewed as a biomarker for biological ageing including atherosclerosis phenotypes such as PAD. Evidence is strong that active smoking increases telomere length attrition but whether such association occurs between SHS and telomere length is unknown. Therefore, Chapter 4 aimed to add to growing evidence that exposure to SHS is associated with disproportionately higher biomarkers of cardiovascular risk compared with active smoking and may accelerate normal biological ageing. This chapter includes two cross-sectional studies. The first study investigated the relationship between salivary cotinine and several preclinical cardiovascular biomarkers: C-reactive protein (CRP), high-density lipoprotein (HDL) cholesterol, TC/HDL cholesterol ratio and fibrinogen in 10,081 adults from the SHeS. CRP concentration and the TC/HDL cholesterol ratio increased, and HDL cholesterol concentration decreased with increasing cotinine concentration among both non-smokers and active smokers. There were step changes in the relationship between tobacco exposure and cardiovascular biomarkers at the interface of non-smokers exposed to SHS and active smokers. Non-smokers with high exposure to SHS had lower cotinine concentrations than light active smokers but comparable concentrations of CRP (p=0.709), HDL cholesterol (p=0.931) and the TC/HDL cholesterol ratio (p=0.405). Fibrinogen concentration was less clear-cut and only increased in moderate and heavy active smokers. The second study in this chapter explored the association between self-reported levels of SHS exposure and telomere shortening per annum using a subgroup of participants from the SFHS. Of the 1,303 non-smokers, telomere length decreased more rapidly with increasing age among participants with high level of SHS exposure, compared with both those with no exposure (adjusted coefficient -0.006, 95% CI -0.008- -0.004) (high vs no SHS: p=0.010) or low exposure (adjusted coefficient -0.005, 95% CI -0.007- -0.003) (high vs low SHS: p=0.005). In summary, there is now substantial evidence of an association between active cigarette smoking and PAD.
This thesis adds to the limited existing evidence on SHS as an independent risk factor for PAD. There was an overall association between exposure to SHS and PAD, with suggestion of a dose-response relationship. However, the association varied by age category. Individuals aged <60 were more strongly associated with the prevalence of IC. SHS was significantly associated with incident PAD only in men. This thesis further demonstrates that exposure to SHS carries a disproportionately higher cardiovascular risk than active smoking for a given level of smoke exposure. Telomere shortening per year of age may be an intermediate step between SHS and CVD including PAD. This also supports the association between SHS exposure and the atherosclerosis-related biomarkers, which play an important role in the pathophysiology of PAD. Further research is needed in the future to better understand the association between SHS and PAD, and the underlying mechanisms. The research in this thesis supports the need to protect the general public from exposure to SHS.

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Paveglio, Travis Brent. "Is Smokey obsolete? : symbolic meanings of wildland fire and communication in the minds of wildland-urban interface residents." Online access for everyone, 2007. http://www.dissertations.wsu.edu/Thesis/Spring2007/T_Paveglio_042507.pdf.

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Books on the topic "Smoke prevention"

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Chaturvedi, Arvind K. Smoke! [Washington, D.C.?]: U.S. Dept. of Transportation, Federal Aviation Administration, 1997.

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Raatma, Lucia. Smoke alarms. Mankato, Minn: Bridgestone Books, 1999.

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Klote, John H. Principles of smoke management. Atlanta, Ga: American Society of Heating, Refrigerating and Air-Conditioning Engineers, 2002.

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British Columbia. Clean Air Policy Steering Committee., ed. Smoke management for the '90s. [Victoria]: BC Environment, 1991.

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Milke, James A. Smoke management in large spaces in buildings. [Melbourne]: Building Control Commission, 1998.

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Montgomery, R. A. Smoke jumpers. Waitsfield, Vt: Chooseco, 2009.

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Montgomery, R. A. Smoke jumper. London: Bantam, 1991.

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Galloway, Arlene. The smoke-free guide: How to eliminate tobacco smoke from your environment. Victoria, B.C., Canada: Qualy Pub., 1988.

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Tuomisaari, Maarit. Visibility of exit signs and low-location lighting in smoky conditions. Espoo, Finland: VTT, Technical Research Centre of Finland, 1997.

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Smoke free in 30 days. New York: Simon & Schuster, 2009.

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Book chapters on the topic "Smoke prevention"

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Csordas, Adam. "Smoking: Prevention and Cessation." In Cigarette Smoke Toxicity, 311–28. Weinheim, Germany: Wiley-VCH Verlag GmbH & Co. KGaA, 2011. http://dx.doi.org/10.1002/9783527635320.ch15.

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Fisher, Sophia, Bertold Spiegelhalder, and Rudolf Preussmann. "Tobacco-Specific Nitrosamines: Underestimated Carcinogens in Tobacco and Tobacco Smoke." In Causation and Prevention of Human Cancer, 107–24. Dordrecht: Springer Netherlands, 1991. http://dx.doi.org/10.1007/978-94-011-3308-1_9.

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Ai, Zubin, Zhensheng Cao, Shengjun Hou, Chenchen Jiang, and Jianbin Zang. "The effect of traffic blockage on fire smoke spreading and safety escape in highway tunnel." In Civil Engineering and Disaster Prevention, 588–601. London: CRC Press, 2023. http://dx.doi.org/10.1201/9781003425823-75.

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Yin, Hang, and Longfei Tan. "A comparative study on determination methods of effective area of natural smoke and heat exhaust ventilator." In Advances in Measurement Technology, Disaster Prevention and Mitigation, 391–97. London: CRC Press, 2022. http://dx.doi.org/10.1201/9781003330172-54.

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Zhou, Lu, Hongshan Dong, and Miaocheng Weng. "Installing air curtains for fire smoke control in long entrances and exits of metro stations without intermediate vertical evacuation staircases." In Advances in Measurement Technology, Disaster Prevention and Mitigation, 300–306. London: CRC Press, 2022. http://dx.doi.org/10.1201/9781003330172-42.

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Salam, Shumona Sharmin, and Caroline Mitchell. "Evaluating Alcohol, Tobacco, and Other Substance Use in Pregnant Women." In Evidence Based Global Health Manual for Preterm Birth Risk Assessment, 53–62. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-04462-5_7.

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AbstractUse of tobacco, alcohol, and psychoactive substances during pregnancy is associated with increased risks of preterm birth. Concurrent use of these substances is also quite common and further increases the risk of adverse outcomes. Health-care providers should ask pregnant women about their exposure to tobacco, second-hand smoke, alcohol, and illicit substances (past and present) at every antenatal visit using validated screening instruments and offer brief interventions.Pregnant women with alcohol or substance dependence should be assessed individually and offered psychosocial interventions (e.g. motivational interviewing, cognitive behavioural therapy, contingency management). Pregnant women should be advised to quit and referred to detoxification services or opioid substitution treatment (for opioid users). Pharmacological treatment for maintenance and relapse prevention is not recommended for amphetamine, cannabis, and cocaine dependence and requires individual risk-benefit analysis for alcohol dependence. Opioid maintenance therapy with methadone or buprenorphine is recommended for opiate dependence. Pregnant women who are current tobacco users or have recently quit should be offered psychosocial interventions (e.g. counselling, incentives, social support). Evidence on impact of pharmacological interventions for cessation of tobacco use is limited. Interventions to make public places and homes smoke-free are recommended. Evidence of impact of these interventions in reducing PTB especially in LMIC settings is low and further research recommended.

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Jamal, Qazi Mohammad Sajid, Ali H. Alharbi, Mohtashim Lohani, Mughees Uddin Siddiqui, Varish Ahmad, Anupam Dhasmana, Mohammad Azam Ansari, Mohd Haris Siddiqui, and Kavindra Kumar Kesari. "Elucidation of Scavenging Properties of Nanoparticles in the Prevention of Carcinogenicity Induced by Cigarette Smoke Carcinogens: An In Silico Study." In Networking of Mutagens in Environmental Toxicology, 171–83. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-96511-6_10.

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Karadag, Bulent, Elif Dağlı, and Fusun Yildiz. "Preventing tobacco use and exposure to second-hand tobacco smoke in pregnancy." In Supporting Tobacco Cessation, 273–86. Sheffield, United Kingdom: European Respiratory Society, 2021. http://dx.doi.org/10.1183/2312508x.10003520.

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Levine, Wilton C., and Yasmine Tameze. "“Code Red!” Preventing and Managing Fire and Smoke Hazards in the OR." In Principles of Perioperative Safety and Efficiency, 327–37. Cham: Springer International Publishing, 2024. http://dx.doi.org/10.1007/978-3-031-41089-5_20.

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Helianti, Dina, Rosita Dewi, Ayu Munawaroh, and Sheilla Rachmania. "Maximum Effective Dose of Shallot Peel in Preventing Cigarette Smoke-Induced Lung Oxidative Stress." In Proceedings of the 8th International Conference of Food, Agriculture and Natural Resources & the 2nd International Conference of Sustainable Industrial Agriculture (IC-FANRes-IC-SIA 2023), 247–54. Dordrecht: Atlantis Press International BV, 2024. http://dx.doi.org/10.2991/978-94-6463-451-8_22.

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Conference papers on the topic "Smoke prevention"

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Sarkar, Mohamadi, Tamara Koval, Jingzhu Wang, Richard Serafin, Diane Schulz, Jin Yan, and Hans-Juergen Roethig. "Abstract B46: Evaluation of biomarkers of exposure to selected smoke constituents in adult cigarette smokers using unidentified Marlboro Snus." In Abstracts: Frontiers in Cancer Prevention Research 2008. American Association for Cancer Research, 2008. http://dx.doi.org/10.1158/1940-6207.prev-08-b46.

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Vrieling, Alina, H. Bas Bueno-de-Mesquita, Hendriek Boshuizen, and For the EPIC study group. "Abstract A98: Cigarette smoking, environmental tobacco smoke exposure, and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition." In Abstracts: Frontiers in Cancer Prevention Research 2008. American Association for Cancer Research, 2008. http://dx.doi.org/10.1158/1940-6207.prev-08-a98.

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Seimetz, Michael, Nirmal Parajuli, Alexandra Pichl, Johannes-Peter Stasch, Reiner Frey, Ralph T. Schermuly, Werner Seeger, Friedrich Grimminger, Hossein A. Ghofrani, and Norbert Weissmann. "Prevention Of Cigarette Smoke-Induced Pulmonary Hypertension By The Soluble Guanylate Cyclase Stimulator Riociguat." In American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California. American Thoracic Society, 2012. http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a3416.

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Tian, Kun, Xiaoli Huang, Shumei Sun, and Youke Wang. "Research on key points of smoke prevention and exhaust design for rail transit cover development." In Proceedings of the International Conference on Art Design and Digital Technology, ADDT 2022, 16-18 September 2022, Nanjing, China. EAI, 2022. http://dx.doi.org/10.4108/eai.16-9-2022.2324914.

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Klassen, Ann Carroll. "Abstract CN03-01: Dissemination and implementation of cancer prevention policies: The example of smoke-free public housing." In Abstracts: Thirteenth Annual AACR International Conference on Frontiers in Cancer Prevention Research; September 27 - October 1, 2014; New Orleans, LA. American Association for Cancer Research, 2015. http://dx.doi.org/10.1158/1940-6215.prev-14-cn03-01.

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Fukumoto, Koichi, Hidemi Ito, Chiyoung Park, Hideo Tanaka, Keitaro Matsuo, Kazuo Tajima, and Toshiro Takezaki. "Abstract C17: Cigarette smoke inhalation and lung cancer risk: Case-control study in Japan." In Abstracts: Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; Oct 27-30, 2013; National Harbor, MD. American Association for Cancer Research, 2013. http://dx.doi.org/10.1158/1940-6215.prev-13-c17.

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Eng, Lawson, Xin Qiu, Jie Su, M. Catherine Brown, Margaret Irwin, Dan Pringle, Hiten Naik, et al. "Abstract B15: Second-hand smoke (SHS) and smoking cessation in non-tobacco related cancers." In Abstracts: Thirteenth Annual AACR International Conference on Frontiers in Cancer Prevention Research; September 27 - October 1, 2014; New Orleans, LA. American Association for Cancer Research, 2015. http://dx.doi.org/10.1158/1940-6215.prev-14-b15.

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Čurová, Viera, Oľga Orosová, Lenka Abrinková, and Marcela Štefaňáková. "EFFECTIVENESS OF THE PROGRAMS UNPLUGGED AND UNPLUGGED 2 ON ALCOHOL USE AND SMOKING AMONG SCHOOLCHILDREN." In International Psychological Applications Conference and Trends. inScience Press, 2021. http://dx.doi.org/10.36315/2021inpact092.

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"Objectives: The aim of the study is to examine the long-term effectiveness of the school-based drug prevention programs Unplugged and Unplugged2 using a Solomon design and supplemented with n-Prevention booster sessions on the cumulative index (CI) of reported alcohol use (AU) and smoking. Methods: In 2013/2014, Unplugged was implemented during 12 consecutive weeks in Slovak primary schools. A sample of 744(M=12.5; 58.72%girls) was collected before program implementation(T1) and 12months later(T3). In 2017/2018, Unplugged2 was implemented by each school over 6months. A sample of 408(M=14.48; 51.96%girls) was collected before program implementation (T1), immediately after implementation(T2) and 12months later(T3). Participation in Unplugged was divided into control and experimental groups and Unplugged2 into control, experimental and experimental groups with n-Prevention, a pre-test and post-test or with post-test only. CI in the past 30 days was dichotomized (0-not used,1-AU, smoking or both). Binary logistic regressions were used to analyze the data at every measurement point. The moderation effect of gender was examined. The CI at T1 in Unplugged and Unplugged2 with a pre-test and post-test, and CI at T2 in Unplugged2 with a post-test were used as the control variables. Results: There was no significant effect of Unplugged and Unplugged2 with the pre-test and post-test. Unplugged2 with a post-test was significantly associated with CI at T3. The experimental group with n- Prevention was less likely to use alcohol and/or smoke. There was no significant effect or moderation effect of gender. Conclusions: The results show the long-term effectiveness of a preventive program is more pronounced with booster sessions, specifically with the post-test design."

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Lakshmi, N., C. D. K. Dasanayake, and B. S. S. De Silva. "The Most Influencing Factors for Cigarette Smoking Among Adolescents: A Systematic Review." In SLIIT International Conference on Advancements in Sciences and Humanities 2023. Faculty of Humanities and Sciences, SLIIT, 2023. http://dx.doi.org/10.54389/wrxq6558.

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Cigarette smoking is a major public health problem in the world, and smoking leads to diseases and disabilities and harms nearly every organ of the body. All forms of cigarettes are harmful, and there is no safe level of exposure to tobacco. Nicotine is one of the toxic chemicals found in tobacco and can cause carcinomas. A significant number of students experimented for the first time with cigarette smoking in adolescence. Cigarette smoking during adolescence causes significant health problems, such as an increase in the number and severity of respiratory illnesses, decreased physical fitness, and potential effects on lung growth and function. The participants who smoked had poor academic performance, drank alcohol, were sexually active, and were more likely to smoke with other adolescents. This study aims to identify the most influencing factors for cigarette smoking among adolescents. This systematic review included literature from 2017 to 2022 through databases such as PUBMED, CINHAL, and MEDLINE. The review includes six studies that revealed the influencing personal, environmental, and community factors for cigarette smoking among adolescents through multivariate logistic regression and path analyses in several countries. The probability of smoking was found to be higher among adolescents with male gender, high body mass index, social anxiety, high grades, sufficient pocket money, and positive attitudes toward smoking. Peer smoking, second hand smoking (SHS) exposure, smoker parents, free cigarettes from tobacco companies, the indigenous population, and parenting patterns were found as influencing factors to combat the threat of cigarette smoking among adolescents. To combat the threat of cigarette smoking among adolescents, gender- and culture-sensitive prevention programs are required.

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Teixeira, José C. F., Senhorinha F. C. F. Teixeira, Pedro Cunha, and Angela M. Silva. "Thermal Driven Dispersion of Smoke in a Parking Space." In ASME 2016 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2016. http://dx.doi.org/10.1115/imece2016-67498.

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Multi store parking spaces are complex buildings that pose specific problems to hazard management resulting from fire and pollutant release from the exhaust gases of automobiles. They are often characterized by large open spaces which do not prevent the spread of fire and smoke. The presence of large quantities of fuel just adds to the risk. In addition, the random occupancy of the space and existence of large openings make difficult the hazard containment. Structural details such as columns and beams can facilitate the accumulation of smoke in pockets. A combination of fire resistant doors and forced ventilation are the usual methods for smoke/fire mitigation. The current legislation defines the acceptable limits for CO concentration for both continuous (50 ppm over 8 hours) and peak (200 ppm) conditions. If the parking space is above ground and has side openings, forced ventilation is not mandatory and it is acceptable that risk prevention and management can be dealt by natural ventilation only. The commissioning of the space often requires that tests are carried out in which a smoke tracer is released into the space in order to evaluate its dispersion over time. This is performed at ambient temperature and the thermal effects on the plume are not taken into account resulting in a lower dispersion rate. The objective of the present work is to evaluate the influence of the temperature of the release source into the smoke dispersion in a parking space. This is a large public space 113 m long, 76 m wide and 3 m in height. The computational model is implemented within the Ansys Fluent. In this, the continuity, momentum, energy and species equations are solved for the physical model which includes the building structural details and vehicles. The fluid is assumed as a mixture of CO, N2 and O2. The boundary conditions assume various conditions for the external wind through the side openings and the heat source is modeled as that resulting from the combustion of gasoline from an open fire. The time dependent variation of the heat load is assumed with a peak of 8 MW. The results show that the temperature at the source promotes a stratification of the plume to the ceiling of the building leaving the occupied (lower) levels with a much clear atmosphere. Beams also facilitate the concentration of high levels of CO in isolated pockets. These proved to be stable while the atmosphere temperature remains high; subsequent cooling drives the smoke/pollutants to the power levels. Such behavior is also dependent upon the entrance of fresh air through the lateral openings.

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Reports on the topic "Smoke prevention"

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Sierra, Ricardo, and Inder J. Ruprah. Mothers Are Right: Eat Your Vegetables And Keep Away From The Girls (Boys): Bullying Victimization Profile in the Caribbean. Inter-American Development Bank, August 2014. http://dx.doi.org/10.18235/0008446.

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About 29 percent of teenagers are bullied at school in the Caribbean. Victims of bullying are more lonely, sleep less, and have fewer friends than do their nonbullied peers. Although victims of bullying eat more frequently at fast food restaurants, they also experience more periods of hunger than do nonbullied children. Acting out with the goal of being considered a "cool" teenager does not work; even if adolescents frequently smoke cigarettes, bullies may still intimidate and harass them. The opposite is true for virgins. Good parenting can, however, make a difference in preventing a child from being a victim of bullying. Growing international evidence has shown that school-based programs can reduce the prevalence of bullying and that bullying has long-term negative consequences into adult life (for both bullies and victims).

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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.

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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.

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