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      Socioeconomic characteristics, paternal smoking and secondhand tobacco smoke exposure among infants in Jakarta, Indonesia

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          Abstract

          INTRODUCTION

          Prevalence of paternal smoking is high in Asia and babies are vulnerable to secondhand tobacco smoke (SHS) exposure at home. This study assesses socioeconomic characteristics and paternal smoking in households and infants’ exposure to SHS.

          METHODS

          A cross-sectional analysis of data collected as part of a prospective cohort study was conducted in Jakarta, Indonesia during 2017–2019. Participants were 156 mother-baby pairs whose babies reached the age of 6 months. Socioeconomic characteristics and smoking behaviour in the household were assessed by questionnaires. Factors related to paternal smoking and infants’ exposure to SHS were assessed using a multivariate logistic regression model.

          RESULTS

          Almost two-thirds of infants lived with fathers who were smokers. Lower levels of paternal education (OR=2.59; 95% CI: 1.19–5.63; p=0.045) and infants with one sibling (OR=2.41; 95% CI: 1.02–5.67; p=0.044) increased the risk of paternal smoking in the household. Moreover, infants with one sibling (OR=3.09; 95% CI: 1.15–8.32; p=0.026), lower level of father education (OR=18.73; 95% CI: 1.54–227.93; p=0.022), and a high number of other household members who smoke (OR=4.54; 95% CI : 1.42–14.48; p=0.011) were the risk factors of SHS exposure among infants at home.

          CONCLUSIONS

          These findings demonstrate the significant influence of educational level, number of children and/or number of other smokers in the household on paternal smoking and SHS exposure among infants at home. Comprehensive tobacco control programmes to increase adoption of smoke-free homes are likely to be an effective way to reduce SHS exposure and promote decreased cigarette smoking in families with children.

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          Most cited references23

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          Is exposure to secondhand smoke associated with cognitive parameters of children and adolescents?--a systematic literature review.

          Despite the known association of second hand smoke (SHS) with increased risk of ill health and mortality, the effects of SHS exposure on cognitive functioning in children and adolescents are unclear. Through a critical review of the literature we sought to determine whether a relationship exists between these variables. The authors systematically reviewed articles (dated 1989-2012) that investigated the association between SHS exposure (including in utero due to SHS exposure by pregnant women) and performance on neurocognitive and academic tests. Eligible studies were identified from searches of Web of Knowledge, MEDLINE, Science Direct, Google Scholar, CINAHL, EMBASE, Zetoc, and Clinicaltrials.gov. Fifteen articles were identified, of which 12 showed inverse relationships between SHS and cognitive parameters. Prenatal SHS exposure was inversely associated with neurodevelopmental outcomes in young children, whereas postnatal SHS exposure was associated with poor academic achievement and neurocognitive performance in older children and adolescents. Furthermore, SHS exposure was associated with an increased risk of neurodevelopmental delay. Recommendations should be made to the public to avoid sources of SHS and future research should investigate interactions between SHS exposure and other risk factors for delayed neurodevelopment and poor cognitive performance. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.
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            The New Danger of Thirdhand Smoke: Why Passive Smoking Does Not Stop at Secondhand Smoke

            Passive smoking exposure is a topic of great concern for public health because of its well-known adverse effects on human health (International Agency for Research on Cancer 2004). Two news articles on this topic were published in the February 2011 issue of Environmental Health Perspectives (Burton 2011; Lubick 2011). Lubick (2011) discussed the global health burden of secondhand smoke, and Burton (2011) emphasized a new and alarming consequence of 
smoking in indoor environments—“thirdhand smoke”—a term first coined in 2006 (Szabo 2006). Secondhand smoke is defined as “the combination of smoke emitted from the burning end of a cigarette or other tobacco products and smoke exhaled by the smoker” (World Health Organization 2007). Thus, secondhand smoke exposure consists of an unintentional inhalation of smoke that occurs close to people smoking and/or in indoor environments where tobacco was recently used. Thirdhand smoke is a complex phenomenon resulting from residual tobacco smoke pollutants that adhere to the clothing and hair of smokers and to surfaces, furnishings, and dust in indoor environments. These pollutants persist long after the clearing of secondhand smoke. They are reemitted into the gas phase or react with oxidants or other compounds present in the environment to form secondary contaminants, some of which are carcinogenic or otherwise toxic for human health (Matt et al. 2011). Thus, thirdhand smoke exposure consists of unintentional intake (mainly through inhalation but also via ingestion and dermal routes) of tobacco smoke and other related chemicals that occurs in the absence of concurrent smoking. Exposure can even take place long after smoking has ceased, through close contact with smokers and in indoor environments in which tobacco is regularly smoked. Lubick (2011) considers secondhand smoke synonymous with passive smoking, as do the majority of the authors publishing on this topic. However, in light of new evidence about thirdhand smoke (Matt et al. 2011), it is no longer appropriate to use the term “secondhand smoke” as a synonym for passive smoking or environmental tobacco smoke, because it represents a pars pro toto. In other words, using the term “secondhand smoke” mistakes one part of the problem for the whole. Instead, we propose that “passive smoking” or “environmental tobacco smoke” be used as a more inclusive term to describe any tobacco smoke exposure outside of active smoking. This question of terminology is of particular concern for researchers evaluating passive smoking exposure in indoor settings, especially in domestic environments. Since numerous countries have introduced smoking bans in enclosed public places, domestic environments have become the main sources of passive smoking exposure (World Health Organization 2007). We believe researchers should determine the independent contributions of secondhand and thirdhand smoke when they assess the magnitude of pollutant intake due to passive smoking exposure.
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              Effects of secondhand smoke on the birth weight of term infants and the demographic profile of Saudi exposed women

              Background Maternal exposure to tobacco smoke during pregnancy is associated with detrimental effects on the mother and the fetus including; impaired fetal growth, low birth weight and preterm delivery. In utero exposure to tobacco is implicated in the etiology of many adults’ diseases including obesity, diabetes and hypertension. The objectives of this study were to evaluate the effects of Secondhand Tobacco Smoke (SHS) exposure on newborns’ anthropometric measurements and to compare the demographic profile of the women exposed to SHS to those who were not. Method This is a retrospective cohort study investigating the effects of SHS during pregnancy on newborns’ anthropometry. Women who self-reported SHS exposure were compared with those not exposed. The primary outcomes were birth weight, newborn length and head circumference. Univariate analysis and multivariate regression analysis were performed. Adjusted differences with 95% confidence intervals were calculated. Results Mothers exposed to SHS constituted 31% of the cohort. The mean birth weight of infants of exposed mothers was significantly lower by 35 g, 95% CI: 2–68 g, (P = 0.037) and the mean length was shorter by 0.261 cm, 95% CI 0.058-0.464 cm, (P = 0.012) compared to the infants of unexposed mothers. Women exposed to SHS, were younger, of lower parity and more likely to be illiterate than those who were not exposed in addition, exposed women were less likely to be primiparous. Conclusion The prevalence of exposure of Saudi pregnant women to SHS is high at 31% and it is associated with reduced birth weight, and shorter length of the newborn.
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                Author and article information

                Journal
                Tob Induc Dis
                Tob Induc Dis
                TID
                Tobacco Induced Diseases
                European Publishing on behalf of the International Society for the Prevention of Tobacco Induced Diseases (ISPTID)
                2070-7266
                1617-9625
                05 May 2020
                2020
                : 18
                : 38
                Affiliations
                [1 ]Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
                [2 ]Department of Nutrition, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
                Author notes
                CORRESPONDENCE TO Siti R. Nadhiroh. Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Kampus C Unair, Mulyorejo Street, Surabaya, East Java, 60115, Indonesia. E-mail: sitinadhiroh@ 123456fkm.unair.ac.id ORCID ID: https://orcid.org/0000-0002-2870-6094
                Article
                38
                10.18332/tid/120077
                7213345
                32398977
                17e41ff9-58a0-431e-b067-e5f966af6942
                © 2020 Nadhiroh S.R. et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License.

                History
                : 06 December 2019
                : 27 March 2020
                : 05 April 2020
                Categories
                Research Paper

                Respiratory medicine
                paternal smoking,secondhand tobacco smoke,infants,socioeconomic characteristics

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