OBJECTIVETo reduce tobacco consumption and exposure to passive smoking in China.

METHODSDiscussion consisting of 80 focus groups and 35 interviews were held in three rural intervention counties of Jiangxi, Henan, and Sichuan Provinces. Participants came from hospitals, schools, rural areas, and urban areas.

RESULTSTobacco use and exposure to passive smoking were widely prevalent in the investigated schools, hospitals, county towns, and rural areas. Knowledge of the risks for passive smoking on health is lacking, especially in rural areas. Barriers to the control of tobacco use in public places include reluctance of administrators to implement tobacco control policies, lack of consistent policies, difficulties with regulations and enforcement, and reluctance of non-smokers to exercise their right to clean air.

CONCLUSIONTo curb the current tobacco epidemic in China, tobacco control efforts must focus on reducing exposure to passive smoking. A strategy should be formulated to reduce the factors that contribute to tobacco use and exposure to passive smoking.

China ; epidemiology ; Data Collection ; Health Knowledge, Attitudes, Practice ; Hospitals ; Humans ; Schools ; Smoking ; psychology ; Social Responsibility ; Tobacco ; adverse effects ; Tobacco Smoke Pollution ; adverse effects ; prevention & control ; statistics & numerical data

BACKGROUND AND OBJECTIVEStudies of passive smoking exposure in China however are of particular interest, because of the high lung cancer rate in people who are mostly non-smokers. The aim of this study is to explore the relationship between passive smoking and lung cancer among non-smoking Chinese.

METHODSBy searching Medline, PubMed, CENTRAL (the Cochrane central register of controlled trials), CBM, CNKI and VIP, et al, we collected both domestic and overseas published documents between 1987 and 2007 on passive smoking and lung cancer among non-smoking Chinese. Random or fixed effect models were applied to conduct meta-analysis on the case control study results, and the combined odds ratio (OR) and the 95% confidence interval (CI) were calculated as well.

RESULTSSixteen documents were included into the combined analysis, which indicated that there was statistical significance between passive smoking and lung cancer (OR = 1.13, 95% CI: 1.05-1.21, P = 0.001). It was significant of lung cancer among non-smoking subjects associated with amount of tobacco passively smoked more than 20 cigarettes daily, with life period in adulthood passive smoking exposure, with gender female, and with exposure to workplace. The P value, OR and 95% CI were P = 0.0003, OR = 1.78, 95% CI: 1.30-2.43; P = 0.0001, OR = 1.50, 95% CI: 1.23-1.83; P = 0.000 7, OR = 1.50, 95% CI: 1.19-1.90; P < 0.0001, OR = 1.41, 95% CI: 1.19-1.66; respectively. And there was no significant difference between passive smoking and lung cancer with amount of tobacco passively smoked within 20 cigarettes daily, with life period in childhood passive smoking exposure, with gender male and with exposure to spouse and parents.

CONCLUSIONPassive smoking is an important risk factor of lung cancer among non-smoking Chinese, and for non-smoking women who expose to environment tobacco smoke in a long period of time have a close relationship with lung cancer risk.

China ; epidemiology ; Female ; Humans ; Lung Neoplasms ; etiology ; Male ; Risk Factors ; Tobacco Smoke Pollution ; adverse effects ; statistics & numerical data

Objective: To understand the rate on tobacco use and associated factors in junior middle school students in Shaanxi province. Methods: We used a multi-stage stratified random sampling method to select students from 30 junior middle schools in 10 areas of Shaanxi province in 2013. All the participants completed a self-administered questionnaire. Results: A total of 4 633 questionnaires were dispatched and 4 298 were qualified for further analysis. The current smoking rate of junior middle school students in Shaanxi was 6.5%, with rate in male (11.1%) higher than that of female students (1.7%). The current smoking rate of students in grade three (9.3%) was higher than those of students in grade one (3.5%) or in grade two (7.0%). The smoking rate of students with pocket money more than 31 Yuan per week was (10.0%) higher than those of students with pocket money less than 10 Yuan (4.6%) or 10-30 Yuan (6.3%) per week. Results from the logistic regression analysis showed that factors as: male, school located in the city, older age, with more pocket money, having smokers in the family and exposure to second hand smoking were high risk factors for current smoking. Conclusion: Rate on current smoking was high in junior middle schools students in Shaanxi, suggesting that comprehensive intervention programs be developed to reduce the rate of tobacco use in junior middle school students.
China/epidemiology* ; Cities ; Cross-Sectional Studies ; Female ; Humans ; Male ; Prevalence ; Schools ; Smoking/epidemiology* ; Students/statistics & numerical data* ; Surveys and Questionnaires ; Tobacco Smoke Pollution/adverse effects* ; Tobacco Use/epidemiology*

Objective: The number of children with polydactyly is increasing. In addition to genetic factors, an influence of maternal behavior or environmental effects during pregnancy is becoming increasingly apparent. However, epidemiological data on these effects are lacking. Methods: This hospital-based, case-control study enrolled 143 infants with polydactyly and 286 controls without genetic diseases to evaluate the association between active and passive maternal smoking during pregnancy and the likelihood of giving birth to a child with polydactyly. Results: Active and passive maternal smoking during pregnancy was associated with an increased risk of giving birth to a child with polydactyly (active smoking: OR=4.74, 95%CI: 1.43-15.65, P=0.011; passive smoking: OR=2.42, 95%CI: 1.32-4.44, P=0.004). After adjusting for confounders, smoking during pregnancy remained significant influence on polydactyly (active smoking: aOR=7.27, 95%CI: 1.72-30.72, P=0.007; passive smoking: aOR=2.41, 95%CI: 1.11-5.23, P=0.026). Conclusion: Active and passive maternal smoking during pregnancy appears to be a risk factor for polydactyly in newborns.
Case-Control Studies ; Child ; Female ; Fingers/abnormalities* ; Humans ; Infant ; Infant, Newborn ; Inhalation Exposure/statistics & numerical data* ; Maternal Exposure/statistics & numerical data* ; Polydactyly/epidemiology* ; Pregnancy ; Pregnancy Complications/etiology* ; Risk Factors ; Smoking/adverse effects* ; Tobacco Smoke Pollution/statistics & numerical data*

OBJECTIVEOver the past few decades, secondhand smoke exposure among children become more serious and with China's implementation of the national policy of family planning and the family structure change, domestic pet has gradually become popular. This survey aimed to investigate the interactive effects of pet ownership and environmental tobacco smoke (ETS) on children's respiratory diseases and symptoms.

METHODUsing a cluster random sampling method, 5 elementary schools and 10 kindergartens were randomly selected from each district of Shenyang, and all children from the selected schools were recruited in this survey. The information about the children's respiratory diseases, conditions of pets ownership and ETS exposure were collected by an international standard questionnaire from American Thoracic Society.

RESULTA total of 9679 questionnaires were distributed to all the students enrolled in the selected schools, and 8798 completed questionnaires were collected with a response rate of 90.9%. Finally, 8733 questionnaires were used for further analysis. The results showed that the number of the patients and the prevalence of persistent cough, persistent phlegm, doctor-diagnosed asthma, current asthma, wheeze, and allergic rhinitis in children were 835 (9.57%), 366 (4.42%), 559 (6.40%), 215 (2.46%), 229 (2.62%), 397 (4.55%), respectively. After controlling for the effects of age, gender and other confounding factors, the results from the multivariate unconditional logistic regression analysis showed that either pet ownership or the ETS exposure significantly increased the risk of prevalence of respiratory diseases and symptoms in children. Compared with control group children, only the prenatal exposure to passive smoking or domestic pets made the risk of children with allergic rhinitis increased respectively 34% (OR = 1.34, 95%CI = 0.99 - 1.80) and 106% (OR = 2.06, 95%CI = 1.28 - 3.31), while the exposure of these two factors made the risk of children with allergic rhinitis increased 376% (OR = 4.76, 95%CI = 2.65 - 8.85), compared with the separate effect, the range of increase was 2.5 times.There was a significant interaction between pet ownership and ETS exposure on persistent cough, persistent phlegm, and allergic rhinitis in children, whereas, the combined effects of these two factors on doctor-diagnosed asthma, current asthma, and wheeze was approximately as expected on the basis of their independent effects on an additive scale.

CONCLUSIONThis study provides evidence that pet ownership and ETS exposure increases the risk of respiratory diseases and symptoms in children, and there was a significant interaction effects between these two factors on some respiratory diseases and symptoms.

Air Pollution, Indoor ; adverse effects ; statistics & numerical data ; Animals ; Asthma ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Environmental Exposure ; adverse effects ; statistics & numerical data ; Female ; Humans ; Logistic Models ; Male ; Pets ; Prevalence ; Respiratory Sounds ; etiology ; Respiratory Tract Diseases ; epidemiology ; etiology ; Rhinitis, Allergic, Perennial ; epidemiology ; etiology ; Risk Factors ; Surveys and Questionnaires ; Tobacco Smoke Pollution ; adverse effects

Passive smoking is a major cause of respiratory morbidity, and is associated with increased bronchial responsiveness in children. To evaluate the effect of smoking by a parent on asthma symptoms, atopy, and airway hyperresponsiveness (AHR), we conducted a cross-sectional survey of 503 schoolchildren that involved questionnaires, spirometry, allergy testing, and a bronchial challenge test. If the PC20 methacholine was less than 16 mg/mL, the subject was considered to have AHR. The prevalence of a parent who smoked was 68.7%. The prevalence of AHR was 45.0%. The sensitization rate to common inhalant allergens was 32.6%. Nasal symptoms such as rhinorrhea, sneezing, nasal itching, and nasal obstruction were present in 42.7%. Asthma symptoms such as cough and wheezing were present in 55.4%. The asthma symptoms were significantly more prevalent in children who had a parent who smoked than in those whose parents did not. The nasal symptoms, atopy, and AHR did not differ according to whether a parent smoked. In a multiple logistic regression model, the asthma symptoms and atopy were independently associated with AHR, when adjusted for confounding variables. Passive smoking contributed to asthma symptoms in schoolchildren and was not an independent risk factor of airway hyperresponsiveness in an epidemiological survey.
Adult ; Asthma/*epidemiology/physiopathology ; Bronchial Hyperreactivity/*epidemiology/physiopathology ; Child ; Data Collection ; Female ; Human ; Hypersensitivity/*epidemiology/physiopathology ; Male ; Parents ; Prevalence ; Risk Factors ; Support, Non-U.S. Gov't ; Tobacco Smoke Pollution/*adverse effects/*statistics & numerical data

OBJECTIVETo investigate the clinical epidemiologic characteristics and analyze risk factors for acute respiratory syncytial virus (RSV) infection in hospitalized infants with acute lower respiratory tract infection (ALRI).

METHODALRI infants admitted to Children's Hospital of Fudan University from March 1st, 2011 to February 29th, 2012, were enrolled in this study. Patient information included demographic characteristics, feeding history, family status, clinical presentation, accessory examination, treatment and prognosis. According to the etiology of ALRI infants, we compared the seasonal distribution, demographic characteristics, household characteristics and underlying diseases between RSV-positive patients and RSV-negative patients. Univariate and multiple Logistic regression analyses were used to determine factors that were associated with risk of RSV infection.

RESULTAmong 1 726 ALRI infants, there were 913 RSV-positive infants (52.9%). The occurrence of RSV infection had a seasonal variation, with a peak in winter (59.1%). The median (P25, P75) age of RSV infants was 64 (21-155) days. The gestational age (GA) and body weight (BW) was (37.5 ± 2.4) weeks and (3.07 ± 0.66) kg, respectively. The male/female ratio among these was 1.9: 1. RSV infection was more popular among infants in the families with smoking members, crowded living conditions, history of atopic mother. Differences of the proportion of patients with underlying disease between RSV-positive and negative groups were statistically significant (59.4% vs. 54.2%, P < 0.05). Univariate logistic regression demonstrated that factors increasing the risk of RSV infection were: GA<37 weeks (OR = 1.346, 95%CI: 1.037-1.748), birth weight <2 500 g (OR = 1.447, 95%CI: 1.103-1.898), underlying diseases (OR = 1.232, 95%CI: 1.018-1.492), underlying CHD (OR = 1.391, 95%CI: 1.120-1.728), environmental tobacco smoke exposure (OR = 1.254, 95%CI: 1.035-1.519), mother with atopic diseases (OR = 1.827, 95%CI: 1.296-2.573), crowded house with four or more than four family members (OR = 1.232, 95%CI: 1.013-1.498), autumn or winter infection (OR = 1.351, 95%CI: 1.024-1.783; OR = 1.713, 95%CI: 1.332-2.204). Multivariate logistic regression determined the factors increasing the risk of RSV infection were: underlying CHD (OR = 1.298, 95%CI: 1.002-1.681), mother with atopic diseases (OR = 1.766, 95%CI: 1.237-2.520), autumn or winter infection (OR = 1.481, 95%CI: 1.105-1.985; OR = 1.766, 95%CI: 1.358-2.296).

CONCLUSIONThe prevalence of RSV infection was the highest in winter, while preterm and low birth weight infants were more susceptible. Underlying diseases were found in 59.4% cases, CHD was the most common one. The factors increasing the risk of RSV infection were: CHD, mother with atopic diseases, autumn or winter infections.

Acute Disease ; China ; epidemiology ; Environmental Exposure ; adverse effects ; Female ; Hospitalization ; statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Prevalence ; Respiratory Syncytial Virus Infections ; epidemiology ; prevention & control ; Respiratory Syncytial Virus, Human ; isolation & purification ; Respiratory Tract Infections ; epidemiology ; prevention & control ; virology ; Retrospective Studies ; Risk Factors ; Seasons ; Socioeconomic Factors ; Tobacco Smoke Pollution