Providing Coaching and Cotinine Results to Preteens to Reduce Their Secondhand Smoke Exposure

Hovell, Melbourne F.; Wahlgren, Dennis R.; Liles, Sandy; Jones, Jennifer A.; Hughes, Suzanne; Matt, Georg E.; Ji, Ming; Lessov‐Schlaggar, Christina N.; Swan, Gary E.; Chatfield, Dale A.; Ding, Ding

doi:10.1378/chest.10-2609

Cited by 27 publications

(25 citation statements)

References 37 publications

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“…Our results call for longitudinal and experimental studies to determine the extent of cumulative exposure over time and the extent to which such exposure can be reduced or prevented. Such studies guided by our results and our previous research will inform regulatory actions to limit toxicants, including benzene in hookah tobacco and charcoal products, and call to action for the implementation of voluntary smoke-free home rules (80)(81)(82). In the interim, health providers need to include hookah tobacco smoking as a health hazard in their health risk behavior screenings to tailor primary preventive measures to limit exposure to hookah tobacco smoke in all settings including the home.…”

Section: Percent Of Non-smokers Time Spent In Minutesmentioning

confidence: 76%

Benzene Uptake in Hookah Smokers and Non-smokers Attending Hookah Social Events: Regulatory Implications

Kassem

Jackson

Liles

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Benzene is a human hematotoxicant and a leukemogen that causes lymphohematopoietic cancers, especially acute myelogenous leukemia. We investigated uptake of benzene in hookah smokers and non-smokers attending hookah social events in naturalistic settings where hookah tobacco was smoked exclusively.Methods: We quantified S-phenylmercapturic acid (SPMA), a metabolite of benzene, in the urine of 105 hookah smokers and 103 non-smokers. Participants provided spot urine samples the morning of and the morning after attending an indoor hookah-only smoking social event at a hookah lounge or in a private home.Results: Urinary SPMA levels in hookah smokers increased significantly following a hookah social event (P < 0.001). This increase was 4.2 times higher after hookah lounge events (P < 0.001) and 1.9 times higher after home events (P ¼ 0.003). In non-smokers, urinary SPMA levels increased 2.6 times after hookah lounge events (P ¼ 0.055); however, similar urinary SPMA levels were detected before and after home events, possibly indicating chronic exposure to benzene (P ¼ 0.933).Conclusions: Our data provide the first evidence for uptake of benzene in hookah smokers and non-smokers exposed to hookah tobacco secondhand smoke at social events in private homes compared with their counterparts in hookah lounges. Hookah tobacco smoke is a source of benzene exposure, a risk factor for leukemia.Impact: Because there is no safe level of exposure to benzene, our results call for interventions to reduce or prevent hookah tobacco use, regulatory actions to limit hookah-related exposure to toxicants including benzene, initiate labeling of hookah-related products, and include hookah smoking in clean indoor air legislation. Cancer Epidemiol Biomarkers Prev; 23(12); 2793-809. Ó2014 AACR.

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Section: Percent Of Non-smokers Time Spent In Minutesmentioning

confidence: 76%

Benzene Uptake in Hookah Smokers and Non-smokers Attending Hookah Social Events: Regulatory Implications

Kassem

Jackson

Liles

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Seventy-five full-text articles were read. Forty-five studies were excluded for the following reasons: no relevant outcomes, 18 studies [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] ; the trial did not include a control group, 7 studies [56][57][58][59][60][61][62] ; the interventions were not aimed at parents of young children, 3 studies [63][64][65] ; the reporting period was ,1 month, 2 studies 66,67 ; data necessary for analysis were missing, 10 studies [68][69][70][71][72][73][74][75][76][77] ; the paper was a review article, 1 study 78 ; the article was a protocol, 2 studies 79,80 ; the article was a follow-up of a previous study, 1 study 81 ; there was no true control group (eg, 2 active interventions were compared), 1 study 82 .…”

Section: Description Of Studiesmentioning

confidence: 99%

Meta-analysis of Parental Protection of Children From Tobacco Smoke Exposure

Rosen¹,

Myers²,

Hovell

et al. 2014

Pediatrics

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BACKGROUND AND OBJECTIVE: Worldwide, roughly 40% of children are exposed to the damaging and sometimes deadly effects of tobacco smoke. Interventions aimed at reducing child tobacco smoke exposure (TSE) have shown mixed results. The objective of this study was to perform a systematic review and meta-analysis to quantify effects of interventions aimed at decreasing child TSE.METHODS: Data sources included Medline, PubMed, Web of Science, PsycNet, and Embase. Controlled trials that included parents of young children were selected. Two reviewers extracted TSE data, as assessed by parentally-reported exposure or protection (PREP) and biomarkers. Risk ratios and differences were calculated by using the DerSimonian and Laird random-effects model. Exploratory subgroup analyses were performed.RESULTS: Thirty studies were included. Improvements were observed from baseline to follow-up for parentally-reported and biomarker data in most intervention and control groups. Interventions demonstrated evidence of small benefit to intervention participants at follow-up (PREP: 17 studies, n = 6820, relative risk 1.12, confidence interval [CI] 1.07 to 1.18], P , .0001). Seven percent more children were protected in intervention groups relative to control groups. Intervention parents smoked fewer cigarettes around children at follow-up than did control parents (P = .03). Biomarkers (13 studies, n = 2601) at follow-up suggested lower child exposure among intervention participants (RD 20.05, CI 20.13 to 0.03, P = .20).CONCLUSIONS: Interventions to prevent child TSE are moderately beneficial at the individual level. Widespread child TSE suggests potential for significant population impact. More research is needed to improve intervention effectiveness and child TSE measurement. KEY WORDS secondhand smoke exposure, tobacco smoke exposure, metaanalysis, systematic review, child ABBREVIATIONS CCR-cotinine/creatinine ratio CI-confidence interval CT-controlled trial PREP-parentally reported exposure or protection RCT-randomized controlled trial RD-relative difference RR-relative risk SHS-secondhand smoke THS-thirdhand smoke TSE-tobacco smoke exposure Dr Rosen conceptualized and designed the study, oversaw all aspects of the research, performed the systematic review of the literature, extracted data from the original studies, contributed to the statistical analysis, wrote sections of the manuscript, and edited the entire manuscript; Ms Myers contributed to systematically reviewing the literature, extracted data from the original articles, contributed to the data analysis, and contributed to the writing of the manuscript; Dr Hovell contributed to the design of the meta-analysis and interpretation of the data and edited the manuscript for scientific content; Dr Zucker assisted with various statistical issues in the analysis of the manuscript and edited the manuscript; Ms Ben Noach contributed to the design of the study, the systematic review of the literature, data extraction, data analysis, data interpretation, and writing of the m...

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“…Counseling-only interventions have been effective in some studies, with predominantly modest effects [9,36]. Such modest effects may be due to limited affordable counseling time, the inability to provide understandable and credible feedback on the level of smoke exposure in the home, or the inability to contextualize specific smoking practices and their relationship to SHS levels.…”

Section: Discussionmentioning

confidence: 99%

Promoting Smoke-Free Homes: A Novel Behavioral Intervention Using Real-Time Audio-Visual Feedback on Airborne Particle Levels

et al. 2013

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Interventions are needed to protect the health of children who live with smokers. We pilot-tested a real-time intervention for promoting behavior change in homes that reduces second hand tobacco smoke (SHS) levels. The intervention uses a monitor and feedback system to provide immediate auditory and visual signals triggered at defined thresholds of fine particle concentration. Dynamic graphs of real-time particle levels are also shown on a computer screen. We experimentally evaluated the system, field-tested it in homes with smokers, and conducted focus groups to obtain general opinions. Laboratory tests of the monitor demonstrated SHS sensitivity, stability, precision equivalent to at least 1 µg/m3, and low noise. A linear relationship (R2 = 0.98) was observed between the monitor and average SHS mass concentrations up to 150 µg/m3. Focus groups and interviews with intervention participants showed in-home use to be acceptable and feasible. The intervention was evaluated in 3 homes with combined baseline and intervention periods lasting 9 to 15 full days. Two families modified their behavior by opening windows or doors, smoking outdoors, or smoking less. We observed evidence of lower SHS levels in these homes. The remaining household voiced reluctance to changing their smoking activity and did not exhibit lower SHS levels in main smoking areas or clear behavior change; however, family members expressed receptivity to smoking outdoors. This study established the feasibility of the real-time intervention, laying the groundwork for controlled trials with larger sample sizes. Visual and auditory cues may prompt family members to take immediate action to reduce SHS levels. Dynamic graphs of SHS levels may help families make decisions about specific mitigation approaches.

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Providing Coaching and Cotinine Results to Preteens to Reduce Their Secondhand Smoke Exposure

Cited by 27 publications

References 37 publications

Benzene Uptake in Hookah Smokers and Non-smokers Attending Hookah Social Events: Regulatory Implications

Benzene Uptake in Hookah Smokers and Non-smokers Attending Hookah Social Events: Regulatory Implications

Meta-analysis of Parental Protection of Children From Tobacco Smoke Exposure

Promoting Smoke-Free Homes: A Novel Behavioral Intervention Using Real-Time Audio-Visual Feedback on Airborne Particle Levels

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