RESUMEN
INTRODUCTION: Patients with cancer, cardiovascular disease (CVD), and respiratory disease are susceptible to health consequences related to secondhand smoke (SHS) exposure. This study examined the prevalence, time trends, and correlates of SHS exposure among these patients compared with individuals without these diseases (control). METHODS: Data were obtained from the 2001-2012 National Health and Nutrition Examination Survey. All adults (≥20 years old) who were nonsmokers and exposed to SHS (serum cotinine level 0.015-10 ng/mL), had cancer (n = 1,440), CVD (congestive heart failure, coronary heart disease, angina, heart attack, or stroke; n = 1,754), respiratory disease (asthma, chronic bronchitis, emphysema; n = 1,444), or none of these diseases (control; n = 11,615) were included in the analysis. Weighted prevalence, weighted second-degree polynomial linear regression of prevalence on year for trend analysis, and multivariable logistic regression analyses were performed with adjustments to the complex survey design. RESULTS: SHS exposure was the highest among patients with respiratory disease (72.1%), followed by patients with CVD (70.6%), controls (70.4%), and patients with cancer (65.4%). From 2001 to 2012, exposure decreased the most among CVD patients (19.6%), followed by controls (16.0%), cancer patients (14.7%), and respiratory patients (10.0%). Exposed individuals in all groups were more likely to be younger, Black, and less educated. Exposed patients with respiratory disease were more likely to be former smokers (p < .05 for all). CONCLUSIONS: SHS exposure among these patients is high and comparable to the general population. Strengthening smoke-free policies in all settings is critical. More efforts are needed to address SHS exposure more effectively in clinical care settings. IMPLICATIONS: Despite the negative health effect of SHS exposure among patients with cancer, CVD, and respiratory disease, modest progress has been made in reducing their exposure. Continued efforts to strengthen smoke-free policies in workplaces, public place, and multiunit housing is critical. In addition, exposure to SHS among these patients seems to be overlooked in clinical care settings. More efforts are needed to address this problem more effectively in health care settings and investigate specific interventions directed at increasing patients' awareness about the risk of exposure to SHS and helping them to reducing their exposure.
Asunto(s)
Asma/epidemiología , Enfermedades Cardiovasculares/epidemiología , Neoplasias/epidemiología , Encuestas Nutricionales/métodos , Política para Fumadores , Contaminación por Humo de Tabaco/efectos adversos , Adulto , Asma/inducido químicamente , Asma/diagnóstico , Enfermedades Cardiovasculares/inducido químicamente , Enfermedades Cardiovasculares/diagnóstico , Cotinina/análisis , Exposición a Riesgos Ambientales/análisis , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/inducido químicamente , Neoplasias/diagnóstico , Prevalencia , Contaminación por Humo de Tabaco/prevención & control , Estados Unidos/epidemiología , Lugar de Trabajo , Adulto JovenRESUMEN
Sight is an important indicator of health and quality of life. Approximately, 3.4 million Americans 40 years of age and older are visually impaired or blind. Evidence suggests that smoking increases the risk of the most common sight-threatening conditions of eye disease. Half a century after the release of the 1964 landmark Surgeon General's report on smoking and health, tobacco smoking continues to be the leading public health problem in the United States, and nearly half a million adults annually die prematurely from smoking-related diseases. On the historic occasion of the 50(th) anniversary of the 1964 report, the 2014 Surgeon General's report is devoted to smoking and health. This report provides new evidence about the link between cigarette smoking and eye disease, which signifies a new role for eye-care professionals in tobacco control on two levels. First, on a clinical level, eye care professionals should integrate smoking cessation treatment in the standard care of patients' management in eye-care settings in order to motivate and help smoking patients in quitting smoking. Second, on a political level, eye care providers can serve as powerful public advocates against tobacco use, thereby significantly enhancing public awareness about the link between smoking and eye disease.