Passive Smoking Exposure in Living Environments Reduces Cognitive Function: A Prospective Cohort Study in Older Adults

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Abstract

There is currently no consensus regarding the effects of passive smoking exposure on cognitive function in older adults. We evaluated 7000 permanent residents from six regions within Zhejiang Province, China, aged ≥60 years, without cognitive impairment at baseline and during follow-up examinations for two years. The Chinese version of the Mini-Mental State Examination was used to assess the participants’ cognitive function. Multivariate regression analyses were carried out to calculate the adjusted relative risks (RRs) as measures of the association between passive smoking exposure and cognitive impairment after adjusting for potential confounders. The results showed an association between passive smoking exposure in the living environment and increased risk of cognitive impairment (RR: 1.16; 95% confidence interval (CI): 1.01–1.35). No dose–response relationship between the cumulative dose of passive smoking exposure (days) and cognitive impairment was observed. The results of stratified analyses suggested a harmful effect of passive smoking exposure on cognitive function in non-smokers (RR: 1.24; 95% CI: 1.06–1.46), but not in smokers (RR: 1.11; 95% CI: 0.71–1.92). Therefore, passive smoking exposure increased the risk of cognitive impairment in older adults, especially non-smokers. More effective measures to restrict smoking in the living environment should be developed and implemented.

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Most cited references 32

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Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries.

Mattias Öberg, Maritta Jaakkola, Alistair Woodward … (2011)

Exposure to second-hand smoke is common in many countries but the magnitude of the problem worldwide is poorly described. We aimed to estimate the worldwide exposure to second-hand smoke and its burden of disease in children and adult non-smokers in 2004. The burden of disease from second-hand smoke was estimated as deaths and disability-adjusted life-years (DALYs) for children and adult non-smokers. The calculations were based on disease-specific relative risk estimates and area-specific estimates of the proportion of people exposed to second-hand smoke, by comparative risk assessment methods, with data from 192 countries during 2004. Worldwide, 40% of children, 33% of male non-smokers, and 35% of female non-smokers were exposed to second-hand smoke in 2004. This exposure was estimated to have caused 379,000 deaths from ischaemic heart disease, 165,000 from lower respiratory infections, 36,900 from asthma, and 21,400 from lung cancer. 603,000 deaths were attributable to second-hand smoke in 2004, which was about 1·0% of worldwide mortality. 47% of deaths from second-hand smoke occurred in women, 28% in children, and 26% in men. DALYs lost because of exposure to second-hand smoke amounted to 10·9 million, which was about 0·7% of total worldwide burden of diseases in DALYs in 2004. 61% of DALYs were in children. The largest disease burdens were from lower respiratory infections in children younger than 5 years (5,939,000), ischaemic heart disease in adults (2,836,000), and asthma in adults (1,246,000) and children (651,000). These estimates of worldwide burden of disease attributable to second-hand smoke suggest that substantial health gains could be made by extending effective public health and clinical interventions to reduce passive smoking worldwide. Swedish National Board of Health and Welfare and Bloomberg Philanthropies. Copyright Â© 2011 Elsevier Ltd. All rights reserved.

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Cardiovascular effects of secondhand smoke: nearly as large as smoking.

Joaquin Barnoya, Stanton A. Glantz (2005)

Secondhand smoke increases the risk of coronary heart disease by approximately 30%. This effect is larger than one would expect on the basis of the risks associated with active smoking and the relative doses of tobacco smoke delivered to smokers and nonsmokers. We conducted a literature review of the research describing the mechanistic effects of secondhand smoke on the cardiovascular system, emphasizing research published since 1995, and compared the effects of secondhand smoke with the effects of active smoking. Evidence is rapidly accumulating that the cardiovascular system--platelet and endothelial function, arterial stiffness, atherosclerosis, oxidative stress, inflammation, heart rate variability, energy metabolism, and increased infarct size--is exquisitely sensitive to the toxins in secondhand smoke. The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking. The effects of secondhand smoke are substantial and rapid, explaining the relatively large risks that have been reported in epidemiological studies.

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Cotinine as a biomarker of environmental tobacco smoke exposure.

Neal L. Benowitz, N Benowitz (1995)

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Author and article information

Journal

Journal ID (nlm-ta): Int J Environ Res Public Health

Journal ID (iso-abbrev): Int J Environ Res Public Health

Journal ID (publisher-id): ijerph

Title: International Journal of Environmental Research and Public Health

Publisher: MDPI

ISSN (Print): 1661-7827

ISSN (Electronic): 1660-4601

Publication date (Electronic): 21 February 2020

Publication date (Print): February 2020

Volume: 17

Issue: 4

Electronic Location Identifier: 1402

Affiliations

[1 ]Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China; fhe@ 123456cdc.zj.cn

[2 ]Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; zjlinjunfen@ 123456163.com (J.L.); fdli@ 123456cdc.zj.cn (F.L.); yjzhai@ 123456cdc.zj.cn (Y.Z.); tzhang@ 123456cdc.zj.cn (T.Z.); xgu@ 123456cdc.zj.cn (X.G.)

[3 ]Mailman School of Public Health, Columbia University Medical Center, New York, NY 10032, USA; tl2882@ 123456cumc.columbia.edu

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[* ]Correspondence: gmzhao@ 123456shmu.edu.cn ; Tel.: +86-021-54237334

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Fan He https://orcid.org/0000-0001-6027-7157

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Publisher ID: ijerph-17-01402

DOI: 10.3390/ijerph17041402

PMC ID: 7068506

PubMed ID: 32098188

SO-VID: d0449e1a-235f-4ac7-b733-73859d821225

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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

Passive Smoking Exposure in Living Environments Reduces Cognitive Function: A Prospective Cohort Study in Older Adults

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Most cited references 32

Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries.

Cardiovascular effects of secondhand smoke: nearly as large as smoking.

Cotinine as a biomarker of environmental tobacco smoke exposure.

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