Did You Know: African Americans in Multiunit Housing are Exposed to Higher Levels of Thirdhand Smoke

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Secondhand smoke (SHS) is a common indoor pollutant in multiunit housing (MUH). It is also the precursor of thirdhand smoke (THS), the toxic mixture of tobacco smoke residue that accumulates in indoor environments where tobacco has been used. A newly published study examined the levels, distribution, and factors associated with THS pollution in low-income MUH. Interviews were conducted 2016-2018 in a cross-sectional study of N=220 MUH homes in San Diego, California.

Findings included:

  • Nicotine was detected in all homes of nonsmokers with indoor smoking bans and smokers regardless of an indoor ban.
  • Approximately 10% of nonsmokers’ homes with smoking bans showed nicotine levels higher than the average level in homes of smokers without smoking bans from previous studies.
  • Housing for seniors, smoking bans on balconies, indoor tobacco use, difficult to reach surfaces, and self-reported African-American race/ethnicity were independently associated with higher THS levels.
  • Individual cases demonstrated that high levels of surface nicotine may persist in nonsmoker homes for years after tobacco use even in the presence of indoor smoking bans.

The researchers recommend that to achieve MUH free of tobacco smoke pollutants, attention must be given to identifying and remediating highly polluted units to implementing smoking policies that prevent new accumulation of THS.

Source: Matt et al. (2020). Persistent Tobacco Smoke Residue in Multiunit Housing: Legacy of Permissive Indoor Smoking Policies and Challenges in the Implementation of Smoking Bans. Preventive Medicine Reports, April (in press)

Young Adults’ Secondhand Smoke Exposure in San Francisco’s Multi-Unit Housing

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A newly published study evaluated young adults’ exposure to drifting secondhand smoke in San Francisco County housing units using the 2014 Bay Area Young Adult Health Survey (N = 1363). Specifically, the study examined whether residing in multiunit housing or in areas with greater neighborhood disorder were risk factors for exposure, and how drifting smoke exposure varied spatially within San Francisco County.

 

Findings included:

  • Residing in buildings with five or more units significantly increased the odds of reporting drifting smoke exposure.
  • Neighborhood disorder was significantly associated with exposure in lower income residential and downtown areas.
  • Multiunit housing was significantly associated with exposure across all neighborhoods.

 

Source: Holmes et al. (2019). Drifting Tobacco Smoke Exposure among Young Adults in Multiunit Housing. Journal of Community Health, Sep 18. [Epub ahead of print]

 

Creating Smokefree Living Spaces For Non-Smoking Partners of Chinese American Smokers

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Chinese men smoke at high rates, and this puts household members at risk for tobacco-related diseases. A newly published qualitative study examines perspectives of Chinese American smoker and nonsmoker household pairs in the Creating Smokefree Living Together Program.
Researchers conducted four focus groups with 30 Chinese American participants (15 smokers and 15 nonsmokers) who, in household pairs, completed smokefree education interventions of either brief or moderate intensity. 
 
Findings included:
·         There was a preference for dyadic and group interventions because of the support offered.
·         Increased knowledge of the health harms of smoke exposure within a pair improved the nonsmoker’s support for smokefree living.
·         Learning communication strategies improved household relationships and assertiveness for smokefree environments.
·         Biochemical feedback was useful but had short-term effects.
·         Project magnets provided cues to action.
 
The researchers concluded that involving household partners is critical to smokefree interventions. Simple reminders at home appear to be more powerful than personal biochemical feedback of smoke exposure for sustaining motivation and engagement in ongoing behavioral changes within the household. 
 
Source: Saw et al. (2018). Perspectives of Chinese American smoker and nonsmoker household pairs about the creating smokefree living together program.
Cancer, 124 Suppl 7:1599-1606

Did You Know? Low Income Linked to E-Cigarette Use

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A recently published study examined associations between sociodemographic factors and e-cigarette use in a nationally representative sample of adults in the United States. Data from the National Health and Nutrition Examination Survey (NHANES) for years 2015-2016 were analyzed to assess e-cigarette use.

 

Findings included:

  • Compared with adults aged ≥55 years, odds of e-cigarette use were 4.77 times higher among ages 18 to 34 years and 2.16 times higher among ages 35 to 54 years.
  • Higher odds of e-cigarette use were observed among widowed/divorced/separated participants compared with those who were married/living with a partner, among participants with less than high school or high school/general educational development (GED) education compared with those with college degrees/some college, and among those with incomes below the poverty level compared with above the poverty level.
  • For non-smokers of conventional cigarettes, higher odds of e-cigarette use were observed among males compared with females, Mexican Americans/Other Hispanics compared with non-Hispanic whites, and non-working participants compared with those who were working.

 

Overall findings indicate that individuals who are widowed/divorced/separated, individuals with lower education, and with incomes below the poverty level are more likely to report ever use of e-cigarettes.

Source: Stallings-Smith & Ballantyne (2019). Ever Use of E-Cigarettes Among Adults in the United States: A Cross-Sectional Study of Sociodemographic Factors. Inquiry, Jan-Dec, 56:46958019864479.

Did You Know? Low Wage Worksites may Benefit from Tobacco Communication Evidence-Based Practice Implementation

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A recently published study assessed whether tobacco policy, program, and communication evidence-based practice implementation is associated with employee tobacco outcomes (current smoking; quit attempt; smokeless tobacco (SLT) use; and perceived worksite support for cessation) at small low-wage worksites. The study found that communication practice implementation was associated with better perceived worksite support for cessation. Policy and program implementation were associated with increased odds of being a current SLT user.

Tobacco communication evidence-based practice implementation was associated with favorable perceptions of worksite support for cessation; more may be needed to change tobacco use behavior.

 

Source: Kava et al. (2019). Tobacco Evidence-Based Practice Implementation and Employee Tobacco-Related Outcomes at Small Low-Wage Worksites. Journal of Occupational and Environmental Medicine, Apr 19. doi: 10.1097/JOM.0000000000001618. [Epub ahead of print]

Did You Know? Study Shows that Increasing Smoke-Free Homes among Low-Income Populations Can Reduce Income Disparities in Smoking Cessation

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Lower rates of successful quitting among low-income populations in the United States may be from slower dissemination of smoke-free homes, a predictor of cessation. A recently published study explored the role of smoke-free homes in cessation behavior across income levels. Researchers analyzed data from the 2002-2003 (n = 2801) and 2010-2011 (n = 2723) Tobacco Use Supplements to the Current Population Survey.

 

Findings included:

  • Between the two surveys, heavy smoking (≥ 1 pack/day) declined by 17%, and smoking prevalence declined by 15% among those with higher-incomes.
  • Although similar in 2002, the prevalence of smoke-free homes was 33% lower among individuals living <300% FPL than those living ≥300% FPL.
  • Whereas smoking ≥ 1 pack/ day was associated with lower odds of 30+ days abstinence, having a higher income and a smoke-free home were associated with greater odds of 30+ day abstinence.

 

The researchers concluded that increasing the diffusion of smoke-free homes among low-income populations may attenuate at least a third of the income disparities in smoking cessation, highlighting the need for interventions to increase adoption of smoke-free homes among low-income households.

 

Source: Vijayaraghavan et al. (2018). Income disparities in smoking cessation and the diffusion of smoke-free homes among U.S. smokers: Results from two longitudinal surveys. PloS One, Jul 27;13(7):e0201467. doi: 10.1371/journal.pone.0201467. eCollection 2018.

Urban and Rural Differences in Tobacco Retailer Exposure among Adolescents

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A newly published study whether self-reported and geographically estimated tobacco retailer exposures differ by participant or neighborhood characteristics among urban and rural adolescents. The data for this study were part of a cohort study of 1220 adolescent males residing in urban and rural (Appalachian) regions in Ohio. The baseline survey asked participants how often they visited stores that typically sell tobacco in the past week (self-reported exposures). The number of tobacco retailers between home and school was determined using ArcGIS software (potential exposures).

 

Findings included:

·         Adolescents who were non-Hispanic black or other racial/ethnic minority, had used tobacco in the past, and lived in rural areas had higher self-reported exposures.

·         Urban adolescents, non-Hispanic black or other racial/ethnic minority, and those living in neighborhoods with a higher percentage of poverty had more potential exposures to tobacco retailers in their path between home and school.

 

The researchers concluded that rural adolescents had more self-reported marketing exposures than urban adolescents. However, urban adolescents had more potential tobacco exposures between home and school. Thus, point of sale marketing limitations might be a more effective policy intervention in rural areas whereas limits on tobacco retailers might be more effective for urban areas.

 

Source: Burgoon et al. (2019). Exposures to the tobacco retail environment among adolescent boys in urban and rural environments. American Journal of Drug and Alcohol Abuse, Jan 2:1-10. doi: 10.1080/00952990.2018.1549562. [Epub ahead of print]

Did You Know? California has Reduced Smoking Faster than the Rest of the US

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Three cigarette smoking behaviors influence lung cancer rates: how many people start, the amount they smoke, and the age they quit. California has reduced smoking faster than the rest of the US and trends in these 3 smoking behaviors should inform lung cancer trends. A newly published study examined trends in smoking behavior (initiation, intensity, and quitting) in California and the rest of US by regression models using the 1974-2014 National Health Interview Surveys (n=962,174).

 

Findings included:

·                     Among those aged 18- 35 years, California had much larger declines than the rest of the US in smoking initiation and intensity, and increased quitting.

·                     In 2012-14, among this age group, only 19% had ever smoked; smokers consumed only 6.3 cigarettes/day; and 46% of ever-smokers had quit by age 35.

·                     Each of these metrics was at least 24% better than in the rest of the US.

·                     There was no marked California effect on quitting or intensity among seniors. From 1986-2013, annual lung cancer mortality decreased more rapidly in California and by 2013 was 28% lower than in the rest of the US.

·                     California’s tobacco control efforts were associated with a major reduction in cigarette smoking among those under age 35 years.

 

The researchers concluded that these changes will further widen the lung cancer gap that already exists between California and the rest of the US.

 

Source: Pierce et al. (2018). Trends in lung cancer and cigarette smoking: California compared to the rest of the United States. Cancer Prevention Research, Oct 10. pii: canprevres.0341.2018. doi: 10.1158/1940-6207.CAPR-18-0341. [Epub ahead of print]

Did You Know? Rural Residents Less Supportive Of Secondhand Smoke Restrictions

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A newly published study compared support for secondhand smoke (SHS) restrictions across rural and urban areas. Smoking inside the home was assessed along with attitudes toward smoking in bars, casinos, playgrounds, cars, and cars with kids.

Findings included:

·         Urban respondents were significantly more supportive of all SHS policies: (e.g. smoking in bars [57.9% vs. 51.4%]; support for kids in cars [94.8% vs. 92.5%].

·         Greatest difference between urban-rural residents was in Mid-Atlantic (bar restrictions) and Southeast (home bans): almost 10% less supportive.

·         Rural residents were least likely to support SHS in homes, in cars, on playgrounds and in bars.

·         South Central rural residents were significantly less likely to support SHS policies-home bans, smoking in cars with kids, on playgrounds, in bars and casinos; while Heartland rural residents were significantly more supportive of policies restricting smoking in cars, cars with kids and on playgrounds.

Source: Stillman et al. (2018). Variations in support for secondhand smoke restrictions across diverse rural regions of the United States. Preventive Medicine, Sep 24;116:157-165. doi: 10.1016/j.ypmed.2018.09.014. [Epub ahead of print]

Read the paper at: https://www.sciencedirect.com/science/article/pii/S0091743518302925?via%3Dihub