[quote]"" Het moge duidelijk zijn; er is vooralsnog geen enkele (wetenschappelijke) reden om vast te stellen dat meeroken schadelijk is voor de gezondheid.""[\quote]
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7351 studies...
Higher risk of stillbirth among lower and middle income women who do not use tobacco, but live with smokers.
Subramoney S, d'Espaignet ET, Gupta PC.
Nordic School of Public Health, Gothenburg, Sweden. Subramoneys@gmail.com
Abstract
OBJECTIVE: To investigate pregnancy outcomes among women living with smokers. DESIGN: Data were from a cohort study of 1,217 women recruited during 3-7th month of pregnancy and 96% followed-up after delivery. The main objective was to investigate effects of smokeless tobacco on pregnancy outcomes. SETTING: Lower and middle-class neighborhoods in Mumbai, India. Community health volunteers who had good rapport with the local population collaborated with the study personnel to help locate and interact with potential participants. POPULATION: Singleton births from non-tobacco users; n = 924/903/802 for stillbirth/gestational age/birthweight analysis. Non-smoking women who lived with smokers (28%) were categorized as 'exposed' to second hand smoke (SHS). METHODS: House-to-house surveys with questionnaire administration and medical records abstraction by trained personnel at recruitment and follow-up. OUTCOME MEASURES: Stillbirth (no evidence of life at birth after at least 20 weeks of gestation), low birthweight (<or= 2,499 g) and preterm birth (<or= 258 days of gestation). RESULTS: Rates of low birthweight and preterm birth were not significantly different between exposed and non-exposed. Hazard ratio for stillbirth in SHS exposed women (n = 261) was 2.2 (95% confidence interval 1.1-4.4). Survival times differed significantly between exposed and non-exposed, p = 0.012. Exposed and non-exposed groups differed significantly by education, socioeconomic status, parity and access of antenatal care. After adjustment for these potential confounders in Cox proportional hazards models (gestational age in days as timescale), hazard ratios for stillbirth in the exposed group remained unchanged: 2.1 (1.1-4.3). CONCLUSIONS: Pregnant women living with smokers in their household have a significantly higher risk of stillbirth, independent of differences in socio-demographic characteristics and antenatal care
Exposure to secondhand smoke and associated factors among non-smoking pregnant women with smoking husbands in Sichuan province, China.
Yang L, Tong EK, Mao Z, Hu TW.
Department of Health Economics, Huaxi School of Public Health, University of Sichuan, Chengdu, China.
Abstract
BACKGROUND: Secondhand smoke (SHS) exposure harms pregnant women and the fetus. China has the world's largest number of smokers and a high male smoking prevalence rate. OBJECTIVE: To compare exposure to SHS among rural and urban Chinese non-smoking pregnant women with smoking husbands, and analyze factors associated with the level of SHS exposure and hair nicotine concentration. SETTING: Sichuan province, China. POPULATION: In all 1,181 non-smoking pregnant women with smoking husbands recruited from eight district/county Women and Children's hospitals. METHODS: The women completed a questionnaire in April and May 2008. Based on systematic sampling, 186 pregnant women were selected for sampling the nicotine concentration in their hair. Ordinal logistic regression analysis was conducted to examine correlates with self-reported SHS exposure (total and at home); linear regression was conducted for the sub-sample of hair nicotine concentrations. MAIN OUTCOME MEASURES: Secondhand smoking exposure rates, hair nicotine levels. RESULTS: About 75.1% of the non-smoking pregnant women with smoking husbands reported regular SHS exposure. The major source of exposure was through their husband. In the multivariate analysis, the risk of greater SHS exposure (total and at home) and hair nicotine concentration was increased for women who were rural, had a husband with greater cigarette consumption, less knowledge about SHS, less negative attitudes about SHS, and no smoke-free home rules. CONCLUSIONS: The high prevalence rate of SHS exposure suggests that it is important for non-smoking pregnant women, especially rural women, to establish smoke-free home rules and increase knowledge and negative attitudes towards SHS.
German environmental survey IV: children's exposure to environmental tobacco smoke.
Conrad A, Schulz C, Seiwert M, Becker K, Ullrich D, Kolossa-Gehring M.
Federal Environment Agency (Umweltbundesamt), Department for Environmental Hygiene, 14195 Berlin, Germany. andre.conrad@uba.de
Abstract
Different aspects of the environmental tobacco smoke (ETS) exposure of children in Germany have been investigated in the German Environmental Survey for Children (GerES IV). The field work of GerES IV was conducted from 2003 to 2006 using questionnaires, indoor air monitoring and human biomonitoring. About half of Germany's 3- to 14-year-old children lived in households with at least one smoker. The number of smokers in the household had a significant influence on the concentrations of several indoor air contaminants (VOC and aldehydes). Human biomonitoring data on cotinine were used to identify the levels of exposure to ETS. Urinary cotinine is correlated with several predictors of ETS and is also associated with other toxicants in non-smoking children, e.g. cadmium. Temporal comparison indicated that in the last 15 years no decrease of children's ETS exposure has been achieved in Germany. Copyright 2009 Elsevier Ireland Ltd. All rights reserved
Cigarette smoking is a risk factor for Alzheimer's Disease: an analysis controlling for tobacco industry affiliation.
Cataldo JK, Prochaska JJ, Glantz SA.
Department of Physiological Nursing, Gerontology, University of California, San Francisco, San Francisco, CA 94143-0610, USA. cataldo@nursing.ucsf.edu
Abstract
To examine the relationship between smoking and Alzheimer's disease (AD) after controlling for study design, quality, secular trend, and tobacco industry affiliation of the authors, electronic databases were searched; 43 individual studies met the inclusion criteria. For evidence of tobacco industry affiliation,
http://legacy.library.ucsf.edu was searched. One fourth (11/43) of individual studies had tobacco-affiliated authors. Using random effects meta-analysis, 18 case control studies without tobacco industry affiliation yielded a non-significant pooled odds ratio of 0.91 (95% CI, 0.75-1.10), while 8 case control studies with tobacco industry affiliation yielded a significant pooled odds ratio of 0.86 (95% CI, 0.75-0.98) suggesting that smoking protects against AD. In contrast, 14 cohort studies without tobacco-industry affiliation yielded a significantly increased relative risk of AD of 1.45 (95% CI, 1.16-1.80) associated with smoking and the three cohort studies with tobacco industry affiliation yielded a non-significant pooled relative risk of 0.60 (95% CI 0.27-1.32). A multiple regression analysis showed that case-control studies tended to yield lower average risk estimates than cohort studies (by -0.27 +/- 0.15, P=0.075), lower risk estimates for studies done by authors affiliated with the tobacco industry (by -0.37 +/- 0.13, P=0.008), no effect of the quality of the journal in which the study was published (measured by impact factor, P=0.828), and increasing secular trend in risk estimates (0.031/year +/- 0.013, P=0.02). The average risk of AD for cohort studies without tobacco industry affiliation of average quality published in 2007 was estimated to be 1.72 +/- 0.19 (P< 0.0005). The available data indicate that smoking is a significant risk factor for AD
Is the smokers exposure to environmental tobacco smoke negligible?
Piccardo MT, Stella A, Valerio F.
Environmental Chemistry Laboratory, National cancer Research Institute, Genoa Lgo Rosanna Benzi n 10, 16132 Genoa, Italy. mariateresa.piccardo@istge.it
Abstract
BACKGROUND: Very few studies have evaluated the adverse effect of passive smoking exposure among active smokers, probably due to the unproven assumption that the dose of toxic compounds that a smoker inhales by passive smoke is negligible compared to the dose inhaled by active smoke. METHODS: In a controlled situation of indoor active smoking, we compared daily benzo(a)pyrene (BaP) dose, estimated to be inhaled by smokers due to the mainstream (MS) of cigarettes they have smoked, to the measured environmental tobacco smoke (ETS) they inhaled in an indoor environment. For this aim, we re-examined our previous study on daily personal exposure to BaP of thirty newsagents, according to their smoking habits. RESULTS: Daily BaP dose due to indoor environmental contamination measured inside newsstands (traffic emission and ETS produced by smoker newsagents) was linearly correlated (p = 0.001 R2 = 0.62) with estimated BaP dose from MS of daily smoked cigarettes. In smoker subjects, the percentage of BaP daily dose due to ETS, in comparison to mainstream dose due to smoked cigarettes, was estimated with 95% confidence interval, between 14.6% and 23% for full flavour cigarettes and between 21% and 34% for full flavour light cigarettes. CONCLUSIONS: During indoor smoking, ETS contribution to total BaP dose of the same smoker, may be not negligible. Therefore both active and passive smoking exposures should be considered in studies about health of active smokers
Secondhand smoke, vascular disease, and dementia incidence: findings from the cardiovascular health cognition study.
Barnes DE, Haight TJ, Mehta KM, Carlson MC, Kuller LH, Tager IB.
University of California, San Francisco, 4150 Clement Street, 151R, San Francisco, CA 94121, USA. deborah.barnes@ucsf.edu
Abstract
Recent studies have found that smoking is associated with an increased risk of dementia, but the effects of secondhand smoke (SHS) on dementia risk are not known to have previously been studied. The authors used Cox proportional hazards marginal structural models to examine the association between self-reported lifetime household SHS exposure and risk of incident dementia over 6 years among 970 US participants in the Cardiovascular Health Cognition Study (performed from 1991 to 1999) who were never smokers and were free of clinical cardiovascular disease (CVD), dementia, and mild cognitive impairment at baseline. In addition, because prior studies have found that SHS is associated with increased risk of CVD and that CVD is associated with increased risk of dementia, the authors tested for interactions between SHS and measures of clinical and subclinical CVD on dementia risk. Moderate (16-25 years) and high (>25 years) SHS exposure levels were not independently associated with dementia risk; however, subjects with >25 years of SHS exposure and >25% carotid artery stenosis had a 3-fold increase (hazard ratio = 3.00, 95% confidence interval: 1.03, 9.72) in dementia risk compared with subjects with no/low (0-15 years) SHS exposure and < or =25% carotid artery stenosis. High lifetime SHS exposure may increase the risk of dementia in elderly with undiagnosed CVD.