Search Results (62)

Background/Objectives: Pediatric asthma remains a pressing public health issue, especially among low-income, minority children living in subsidized housing. Methods: This study employed a community-based participatory research approach to explore barriers and potential solutions for improving asthma management in this vulnerable population. Semi-structured interviews were conducted with 22 caregivers of children with asthma and 8 community health workers in Washington, DC—a city marked by high childhood asthma rates and concentrated subsidized housing. Results: Thematic analysis identified six core findings: (1) families frequently encountered multiple home environmental asthma triggers, including pests, mold, secondhand smoke, leaks, poor ventilation, and aging infrastructure; (2) healthy housing services were under implemented, often due to unresponsive landlords, inadequate inspections, and poor maintenance; (3) existing services such as pest control, mold remediation, and smoke-free policies were ineffectively implemented; (4) challenges to service delivery included difficulties faced by landlords and structural barriers tied to geography, race, and socioeconomic status; (5) substandard housing conditions contributed to residents’ feelings of powerlessness, frustration, and distrust, with some taking legal action to address persistent hazards; and (6) participants recommended stronger housing code enforcement, sustained funding for home-based environmental interventions, housing-health liaisons, strengthened landlord accountability, support for landlords to facilitate repairs, centering families’ voices, and advocacy. Conclusions: This study underscores the persistent challenges caregivers face in managing asthma triggers in subsidized housing. The findings highlight the critical need for improved housing conditions, greater landlord and housing authority accountability, and policy reforms to ensure consistent, equitable, and sustainable healthy housing services that reduce pediatric asthma disparities. Full article

Introduction: Increased exposure to air pollution poses a burden to society and healthcare systems worldwide, with increased risk of morbidity and mortality. Indoor concentrations of air pollutants, such as particulate matter, are a public health concern because they can be present in higher concentrations than outside. Unlike the effects of indoor environmental tobacco smoke (ETS), there is a dearth of research that includes the impact of e-cigarettes on particulate matter concentrations in the home, which is the focus of this study. Method: Participant, household, and sensor information were obtained from 164 lower-income households located in Cornwall, South West of England. Daily sensor readings were obtained for PM_2.5 for one year. Descriptive statistics were used to describe study participant characteristics and health status. Mean indoor averages, median PM_2.5 measurements, and two-tailed tests were used to assess differences in concentrations of PM_2.5. Results: The 164 surveyed households included 315 residents (67% female) with a mean adult age of 57 (22–92). Half of all homes were in the 10% most deprived neighbourhoods in England. Thirty-four per cent of participants were current smokers, and of these 36% have asthma and had seen a doctor in the last year (cf. never smokers 14%, ex-smokers 25%). Mean annual PM_2.5 was highest in smoking households (14.07 µg/m³) and smoking and vaping households (9.18 µg/m³), and lower in exclusive vaping households (2.00 µg/m³) and smoke and vape-free households (1.28 µg/m³). Monthly levels of PM_2.5 fluctuated seasonally for all groups, with the highest recordings in winter and the lowest in summer. Discussion and Conclusion: In this preliminary study, we conducted secondary data analyses using monitoring data from a large health and housing study to assess factors leading to elevated indoor concentrations of particulate matter. Indoor concentrations appeared to be highest in homes where residents smoked indoors. The use of e-cigarettes in the home also appeared to modify concentrations of particulate matter, but levels were lower than in homes with tobacco smoke. We were not able to determine the relationship between smoking and/or vaping indoors and particulate matter, which supports the need for studies of larger sample sizes and more complex longitudinal monitoring. This will help assess the timing and extent of exposures resulting from smoking and vaping indoors, along with a range of other chemical and biological exposures and their corresponding health effects. Full article

Children’s tobacco smoke exposure (CTSE) is a public health concern, particularly in low-income and minority communities. Interventions to reduce CTSE have had modest success, and so research must identify mechanisms to improve intervention efficacy. This study investigated mediators of CTSE reduction in an intervention designed to facilitate CTSE protection and maternal smoking abstinence. We analyzed data from the Babies Living Safe and Smokefree (BLiSS) trial, which evaluated the efficacy of a multilevel behavioral smoking intervention initiated in community clinics serving low-income mothers. We estimated direct and indirect effects to evaluate the role of two mediators of the intervention on CTSE at post-intervention follow-up: mothers’ skills in managing smoking urges and their protective behaviors to shield children from TSE. CTSE was measured using mothers’ reports and child cotinine (a CTSE biomarker). The BLiSS intervention was linked to statistically significant lower longitudinal reported CTSE directly and indirectly by increasing mothers’ urge management skills and CTSE protection behaviors (p-values < 0.05). The intervention was not directly linked to child cotinine. However, evidence of a statistically significant indirect effect (p-value = 0.028) suggested that the intervention reduced longitudinal child cotinine levels by increasing CTSE protection behaviors. Two non-program factors, nicotine dependence and total smokers in the home, also increased child cotinine and reported CTSE (p-values < 0.001). Interventions that improve maternal smokers’ urge management skills and CTSE protections can mitigate CTSE. In addition, it is essential to target barriers to CTSE reduction, such as nicotine dependence levels and the presence of other smokers in the home. Full article

Background: During the 2019 coronavirus disease (COVID-19) pandemic, lockdown was implemented, which likely reduced maternal 25(OH)D levels in pregnancy due to reduced sun exposure from social distancing measures and confinement at home. At the same time, however, due to the lockdown and the ban on the free movement of vehicles, the emissions of many atmospheric pollutants also decreased. We know that air pollution and low ground level ultraviolet B radiation (UVB; 290–315) can deteriorate the body’s vitamin D status in healthy women living in a polluted area, which plays a significant independent role in vitamin D deficiency (VDD) and, hence, residence can be one of the main reasons of vitamin D status in women. The reduction in air pollution likely produced positive changes in maternal 25(OH)D levels. Methods: We studied serum 25(OH)D in mothers who came for delivery, with stratified random sampling, from 27 September 2019 to April 14, 2021. We divided our sample into the pre-COVID period and the post-COVID period. Quantitative results of 25(OH)D vitamin levels on the mother were converted to qualitative variables assessing lack of 25(OH)D, adequacy, deficiency, and severe deficiency of maternal concentrations and, thus, defined. The results of 25(OH)D are presented as means ± standard deviations or by frequencies and percentages. The Chi-square test was used to find an association between maternal 25(OH)D concentrations within the COVID-19 period. Results: The results of our study showed a paradox. The mean values of 25(OH)D levels of the mothers were statistically significantly higher during the COVID-19 period compared to the pre-COVID-19 period. Conclusions: In conclusion, pregnant women should be encouraged to lead a healthier lifestyle, avoid being outside during rush hours, take nature walks, not smoke, exercise, take leisurely morning walks in the sun, and taking take their vitamin D supplements, which are recommended according to the gestational age, imitating all that they did during the pandemic, in order to avoid VDD. Full article

This study examined variations in cigarette smoking status, home smoking and vaping rules, and attitudes toward smoking rules among U.S. adults. We analyzed data from the 2019 U.S. Census Bureau’s Current Population Survey Supplements (n = 40,296 adults) and calculated weighted prevalence estimates of adult cigarette smoking based on housing type. In 2019, multi-unit housing (MUH) residents who currently smoked were predominantly residents of privately rented housing (66.9%), followed by privately owned (17.6%) and public housing (15.5%). MUH residents who currently smoked had the highest proportions of allowing smoking (26.7%) or vaping (29.1%) anywhere inside their homes and were least likely to support rules allowing smoking inside all MUH apartments or living areas. In the adjusted models, MUH residents with a current smoking status were 92% less likely to have a complete smoking ban. More than one in four MUH residents with a current smoking status allowed all smoking inside the home and supported allowing smoking inside all MUH apartment or living areas, reinforcing how MUH residents may be at higher risk of experiencing secondhand smoke or aerosol exposure, or incursions within their places of residence. Our results can inform the development, implementation, and sustainment of strategies to reduce exposures from tobacco and nicotine products in all living environments. Full article

One of the most challenging problems related to the operation of smart microgrids is the optimal home energy management scheme with multiple and conflicting objectives. Moreover, there is a noticeable increase in homes equipped with renewable energy sources (RESs), where the coordination of loads and generation can achieve extra savings and minimize peak loads. In this paper, a solar-powered smart home with optimal energy management is designed in an affordable and secure manner, allowing the owner to control the home from remote and local sites using their smartphones and PCs. The Raspberry Pi 4 B is used as the brain of the proposed smart home automation management system (HAMS). It is used to collect the data from the existing sensors and store them, and then take the decision. The home is monitored using a graphical interface that monitors room temperature, humidity, smoke, and lighting through a set of sensors, as well as PIR sensors to monitor the people movement. This action enables remote control of all home appliances in a safe and emission-free manner. This target is reached using Cayenne, which is an IoT platform, in addition to building some codes related to some appliances and sensors not supported in Cayenne from scratch. Convenience for people with disabilities is considered by using the Amazon Echo Dot (Alexa) to control home appliances and the charging point by voice, implementing the associated code for connecting the Raspberry pi with Alexa from scratch, and simulating the system on LabVIEW. To reach the optimal operation and reduce the operating costs, an optimization framework for the home energy management system (HEMS) is proposed. The operating costs for the day amounted to approximately 16.039 €. There is a decrease in the operating costs by about 23.13%. The consumption decreased after using the smart HAMS by 18.161 kWh. The results of the optimization also show that the least area that can be used to install solar panels to produce the desired energy with the lowest cost is about 118.1039 m², which is about 23.62% of the total surface area of the home in which the study was conducted. The obtained results prove the effectiveness of the proposed system in terms of automation, security, safety, and low operating costs. Full article

Previous studies have shown that greater self-efficacy (SE) to modify smoking behaviors during treatment improves long-term post-treatment outcomes. Little is known about factors that might enhance SE for smoking abstinence and for reducing children’s tobacco smoke exposure (TSE). The present study investigated hypothesized predictors of end-of-treatment SE to abstain from smoking and to protect children from TSE by conducting secondary multiple regression analyses of data (N = 327) from the Kids Safe and Smokefree (KiSS) behavioral intervention trial. KiSS aimed to reduce parental smoking and child TSE in urban, low-income, and minority communities. The results showed that partner support and initiating a planned quit attempt during treatment were positively related to SE to abstain from smoking and to reduce children’s TSE (all p’s < 0.001) at the end of treatment (EOT). Further, lower baseline nicotine dependence and the use of nicotine replacement were related to higher SE to abstain from smoking at EOT (p < 0.01), whereas more restrictive residential smoking rules and lower children’s TSE at baseline was associated with higher SE to reduce children’s TSE at EOT (all p’s < 0.05). These findings inform theory and future intervention design, identifying individual and social-environmental factors that might enhance smoking-behavior-change SE. Full article

Environmental tobacco smoke remains a major risk factor, for both smokers and non-smokers, able to trigger the initiation and/or the progression of several human diseases. Although in recent times governments have acted with the aim of banning or strongly reducing its impact within public places and common spaces, environmental tobacco smoke remains a major pollutant in private places, such as the home environment or cars. Several inflammatory and long-term biomarkers have been analysed and well-described, but the list of mediators modulated during the early phases of inhalation of environmental tobacco smoke needs to be expanded. The aim of this study was to measure the short-term effects after exposure to side-stream smoke on Nerve Growth Factor and its receptors Tropomyosin-related kinase A and neurotrophin p75, molecules already described in health conditions and respiratory diseases. Twenty-one non-smokers were exposed to a home-standardized level of SS as well as to control smoke-free air. Nerve Growth Factor and inflammatory cytokines levels, as well the expression of Tropomyosin-related kinase A and neurotrophin receptor p75, were analysed in white blood cells. The present study demonstrates that during early phases, side-stream smoke exposure induced increases in the percentage of neurotrophin receptor p75-positive white blood cells, in their mean fluorescent intensity, and in gene expression. In addition, we found a positive correlation between the urine cotinine level and the percentage of neurotrophin receptor-positive white blood cells. For the first time, the evidence that short-term exposure to side-stream smoke is able to increase neurotrophin receptor p75 expression confirms the very early involvement of this receptor, not only among active smokers but also among non-smokers exposed to SS. Furthermore, the correlation between cotinine levels in urine and the increase in neurotrophin receptor p75-positive white blood cells could represent a potential novel molecule to be investigated for the detection of SS exposure at early time points. Full article

Self-reported tobacco use is high in the male adult Emirati population (males ~36% vs. females ~3%); however, there are minimal data on tobacco use or exposure to environmental tobacco smoke (ETS) during pregnancy in the United Arab Emirates (UAE). This study investigated the prevalence of, and factors associated with, tobacco use and exposure to environmental tobacco smoke (ETS) amongst pregnant women in the UAE. Baseline cross-sectional data were analysed from the Mutaba’ah Study. Expectant mothers completed a self-administered questionnaire collecting sociodemographic information, maternal tobacco use, and ETS exposure during antenatal visits at three hospitals in Al Ain (UAE; May 2017–February 2021). Amongst 8586 women included in the study, self-reported tobacco use during pregnancy was low (0.7%), paternal tobacco use was high (37.9%), and a third (34.8%) of expectant mothers were exposed to ETS (28.0% at home only). Pregnant women who were employed (adjusted odds ratio (aOR): 1.35, 95% confidence interval (CI): 1.19–1.52), with childbirth anxiety (aOR 1.21, 95% CI 1.08–1.36), and with an increased number of adults living in the same household (aOR 1.02 95% CI 1.01–1.03) were independently more likely to be exposed to ETS. Pregnant women with higher education levels (aOR 0.84, 95% CI 0.75–0.94) and higher gravidity (aOR 0.95, 95% CI 0.92–0.99) were less likely to be exposed to ETS. Public health efforts targeting smoking cessation amongst husbands and promoting smoke-free homes are warranted to help reduce prenatal ETS exposure in the UAE. Full article

The objective of this study was to examine long-term trends in serum cotinine (COT) concentrations, as a measure of secondhand smoke (SHS) exposure, in U.S. nonsmokers using data from the National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2018. We analyzed NHANES serum COT results from 8 continuous NHANES 2 year cycles from 2003 to 2018 using a liquid chromatography–tandem mass spectrometry assay that has been maintained continuously at the Centers for Disease Control and Prevention (CDC) since 1992. Serum COT concentrations (based on the geometric means) among nonsmokers in the U.S. decreased by an average of 11.0% (95% confidence interval (CI) [8.8%, 13.1%]; p < 0.0001) every 2 year cycle. From 2003 to 2018, serum COT concentrations in U.S. nonsmokers declined by 55.0%, from 0.065 ng/mL in 2003–2004 to 0.029 ng/mL in 2017–2018 (p < 0.0001). Significant decreases in serum COT concentrations were observed in all demographic groups. While disparities between these groups seems to be shrinking over time, several previously observed disparities in SHS exposure remain in 2017–2018. Serum COT concentrations of the non-Hispanic Black population remained higher than those of non-Hispanic Whites and Mexican Americans (p < 0.0001). Additionally, serum COT concentrations were significantly higher for children aged 3–5 years than other age groups (p ≤ 0.0002), and men continued to have significantly higher serum COT concentrations than women (p = 0.0384). While there is no safe level of exposure to SHS, the decrease in serum COT concentrations in the U.S. population as well as across demographic groupings represents a positive public health outcome and supports the importance of comprehensive smoke-free laws and policies for workplaces, public places, homes, and vehicles to protect nonsmokers from SHS exposure. Full article

Neonatal intensive care units (NICUs) have a disproportionately higher number of parents who smoke tobacco compared to the general population. A baby’s NICU admission offers a unique time to prompt behaviour change, and to emphasise the dangerous health risks of environmental tobacco smoke exposure to vulnerable infants. We sought to explore the views of mothers, fathers, wider family members, and healthcare professionals to develop an intervention to promote smoke-free homes, delivered on NICU. This article reports findings of a qualitative interview and focus group study with parents whose infants were in NICU (n = 42) and NICU healthcare professionals (n = 23). Thematic analysis was conducted to deductively explore aspects of intervention development including initiation, timing, components and delivery. Analysis of inductively occurring themes was also undertaken. Findings demonstrated that both parents and healthcare professionals supported the need for intervention. They felt it should be positioned around the promotion of smoke-free homes, but to achieve that end goal might incorporate direct cessation support during the NICU stay, support to stay smoke free (relapse prevention), and support and guidance for discussing smoking with family and household visitors. Qualitative analysis mapped well to an intervention based around the ‘3As’ approach (ask, advise, act). This informed a logic model and intervention pathway. Full article

Understanding the factors that influence cigarette smoking among adolescents is critical. We identified personal, community, and environmental factors associated with current cigarette smoking among adolescents. This population-based cross-sectional analysis study was conducted using the 2012 Taiwan Global Youth Tobacco Survey and the sociodemographic statistics of the city or county from Taiwan’s Ministry of the Interior. A total of 27,524 participants (age: 12–18-years) was included. The associated factors were identified through logistic regression. A path analysis was performed to examine the pathway from the associated factors to current cigarette smoking. According to this analysis, the following factors were prominently and positively associated with adolescent cigarette smoking: one personal factor (pocket money), five environmental factors (home secondhand smoke (SHS) exposure, smoker friends, outside SHS exposure, school SHS exposure, and smoker parents), and two community factors (free cigarettes from tobacco companies and indigenous population). By contrast, five personal factors (feeling less comfortable smoking at social occasions, feeling indifferent about smoking or not smoking at social occasions, female sex, feeling that quitting is difficult, and feeling that quitting after having smoked is harmful to health) and one environmental factor (school antismoking education) had negative effects. Thus, comprehensive interventions promoting the perception of harm caused by smoking and interrupting access to cigarettes through social networks can reduce cigarette smoking in adolescents. Full article

Objectives: Policy responses to the COVID-19 pandemic in 2020 led to behaviour changes in the UK’s population, including a sudden shift towards working from home. These changes may have affected overall exposure to fine particulate matter (PM_2.5), an air pollutant and source of health harm. We report the results of a simulation model of a representative sample of the UK’s population, including workers and non-workers, to estimate PM_2.5 exposure before and during the pandemic. Methods: PM_2.5 exposure was simulated in April and August 2017–2020 for 10,000 individuals across the UK drawn from the 2011 nationwide census. These data were combined with data from the UK’s ambient PM_2.5 monitoring network, time use data and data on relevant personal behaviour before and during the first stage of the pandemic (such as changes in smoking and cooking). Results: The simulated exposures were significantly different between each year. Changes in ambient PM_2.5 resulted in regional and temporal variation. People living in homes where someone smoked experienced higher exposure than those in smoke-free homes, with an increase of 4 µg/m³ in PM_2.5 exposure in 2020. Conclusions: Changes in PM_2.5 exposure were minimal for most individuals despite the simulated increases in cooking activity. Those living in smoking homes (estimated to be around 11% of the UK population) experienced increased exposure to PM_2.5 during COVID lockdown measures and this is likely to have increased mortality and morbidity among this group. Government policy should address the risk of increased exposure to second-hand smoke in the event of future COVID-19-related restrictions. Full article

One of the sustainable development goals adopted by the United Nations is to ensure healthy lives and promote well-being for all. Tobacco consumption is a serious health problem that affects smokers and non-smokers exposed to secondhand smoke (SHS), particularly children. This study aims to describe parental perceptions of smoke-free rules, to analyze parental awareness about health risks associated with children’s exposure to SHS, and to describe the prevalence of avoidance behaviors related to tobacco smoke, according to parental smoking status. This study includes 1175 parents from a representative sample of 1511 Portuguese children aged 4 to 9 years old in 2016. Parents who were non-smokers reported a higher level of agreement regarding smoke-free rules at home, inside the car, at playgrounds, and near the school entrance than smokers. A higher percentage of nonsmoking parents agreed that children whose parents smoke at home are more likely to become smokers themselves. Nonsmoking parents reported adopting more avoidance behaviors regarding exposure to SHS. The findings indicate that parental exposure perceptions and avoidance behaviors towards SHS were lower and less frequent among smokers. Health education, smoking cessation programs and smoking bans are needed to raise parental awareness and to protect children from SHS exposure. Full article

Report back is active sharing of research findings with participants to prompt behavior change. Research on theory-driven report back for environmental risk reduction is limited. The study aim is to evaluate the impact of a stage-tailored report back process with participants who had high home radon and/or air nicotine levels. An observational one-group pre-post design was used, with data collection at 3, 9, and 15 months post intervention. Participants from the parent study (N = 515) were randomized to the treatment or control group and this sample included all 87 treatment participants who: (1) had elevated radon and/or air nicotine at baseline; and (2) received stage-tailored report back of their values. Short-term test kits measured radon; passive airborne nicotine samplers assessed secondhand smoke (SHS) exposure. Stage of action was categorized as: (1) ‘Unaware’, (2) ‘Unengaged’, (3) ‘Deciding’, (4) ‘Action’, and (5) ‘Maintenance’. Interventions were provided for free, such as in-person radon and SHS test kits and a brief telephonic problem-solving consultation. Stage of action for radon mitigation and smoke-free policy increased from baseline to 3 months and remained stable between 3 and 9 months. Stage of action for radon was higher at 15 months than baseline. Among those with high baseline radon, observed radon decreased by 15 months (p < 0.001). Tailored report back of contaminant values reduced radon exposure and changed the health behavior necessary to remediate radon and SHS exposure. Full article