Heather Robertson

Strength of smoke-free air laws and indoor air quality

INTRODUCTION Smoke-free air laws have been implemented in many Kentucky communities to protect the public from the harmful effects of secondhand smoke exposure. The impact of different strengths of smoke-free air laws on indoor air quality was assessed. METHODS Indoor air quality in hospitality venues was assessed in seven communities before and after comprehensive smoke-free air laws and in two communities only after partial smoke-free air laws. One community was measured three times: before any smoke-free air law, after the initial partial law, and after the law was strengthened to cover all workplaces and public places with few exemptions. Real-time measurements of particulate matters with 2.5 mum aerodynamic diameter or smaller (PM(2.5)) were obtained. RESULTS When comprehensive smoke-free air laws were implemented, indoor PM(2.5) concentrations decreased significantly from 161 to 20 microg/m3. In one community that implemented a comprehensive smoke-free law after initially passing a partial law, indoor PM(2.5) concentrations were 304 microg/m3 before the law, 338 microg/m3 after the partial law, and 9 microg/m3 after the comprehensive law. DISCUSSION The study clearly demonstrated that partial smoke-free air laws do not improve indoor air quality. A significant linear trend indicated that PM(2.5) levels in the establishments decreased with fewer numbers of burning cigarettes. Only comprehensive smoke-free air laws are effective in reducing indoor air pollution from secondhand tobacco smoke.

Air quality in and around airport enclosed smoking rooms

INTRODUCTION Smoking rooms have been installed in some airports to allow indoor smoking. There have been few field studies to measure fine particle leakage in operational smoking rooms. The objective of the research was to assess air quality inside and outside the 4 smoking rooms located within a medium-sized, regional commercial airport. METHODS Particulate matter less than 2.5-microm (PM(2.5)) concentrations were simultaneously measured inside and outside the 4 smoking rooms in the airport and in the public lobby. The monitoring was conducted during normal hours of operation. Numbers of people and smokers were counted. The airport had separate ventilation systems for all 4 rooms checked by the airport prior to monitoring, and they were operating properly. RESULTS Although there were few smokers in each room, average PM(2.5) concentrations inside the smoking rooms were significantly higher than the National Ambient Air Quality Standard for 24 hr (35 microg/m(3)). Fine particles from secondhand smoke (SHS) leaked to the outside in 3 of the 4 smoking rooms, exposing workers and the public. DISCUSSION Although the ventilation systems in the smoking rooms were operating properly, fine particles from SHS leaked to the surrounding smoke-free areas in the airport. Indoor space inside airports should be completely nonsmoking, and enclosed smoking rooms are not recommended.

Radon potential, geologic formations, and lung cancer risk.

Objective Exposure to radon is associated with approximately 10% of U.S. lung cancer cases. Geologic rock units have varying concentrations of uranium, producing fluctuating amounts of radon. This exploratory study examined the spatial and statistical associations between radon values and geological formations to illustrate potential population-level lung cancer risk from radon exposure. Method This was a secondary data analysis of observed radon values collected in 1987 from homes (N = 309) in Kentucky and geologic rock formation data from the Kentucky Geological Survey. Radon value locations were plotted on digital geologic maps using ArcGIS and linked to specific geologic map units. Each map unit represented a package of different types of rock (e.g., limestone and/or shale). Log-transformed radon values and geologic formation categories were compared using one-way analysis of variance. Results Observed radon levels varied significantly by geologic formation category. Of the 14 geologic formation categories in north central Kentucky, four were associated with median radon levels, ranging from 8.10 to 2.75 pCi/L. Conclusion Radon potential maps that account for geologic factors and observed radon values may be superior to using observed radon values only. Knowing radon-prone areas could help target population-based lung cancer prevention interventions given the inequities that exist related to radon.

Secondhand smoke exposure is associated with smoke-free laws but not urban/rural status

The objective was to determine secondhand smoke (SHS) exposure with and without smoke-free laws in urban and rural communities. The research hypothesis was that SHS exposure in public places could be improved by smoke-free law regardless of urban and rural status. Indoor air quality in hospitality venues was assessed in 53 communities (16 urban and 37 rural) before smoke-free laws; 12 communities passed smoke-free laws during the study period. Real-time measurements of particulate matter with 2.5 µm aerodynamic diameter or smaller (PM2.5) were taken 657 times from 586 distinct venues; about 71 venues had both pre- and post-law measurements. Predictors of log-transformed PM2.5 level were determined using multilevel modeling. With covariates of county-level percent minority population, percent with at least high school education, adult smoking rate, and venue-level smoker density, indoor air quality was associated with smoke-free policy status and venue type and their interaction. The geometric means for restaurants, bars, and other public places in communities without smoke-free policies were 22, 63, and 25 times higher than in those with smoke-free laws, respectively. Indoor air quality was not associated with urban status of venue, and none of the interactions involving urban status were significant. SHS exposure in public places did not differ by urban/rural status. Indoor air quality was associated with smoke-free law status and venue type. Implications: This study analyzed 657 measurements of indoor PM2.5 level in 53 communities in Kentucky, USA. Although indoor air quality in public places was associated with smoke-free policy status and venue type, it did not differ by urban and rural status. The finding supports the idea that population in rural communities can be protected with smoke-free policy. Therefore, it is critical to implement smoke-free policy in rural communities as well as urban areas.

Factors Associated With Staff Engagement in Patients’ Tobacco Treatment in a State Psychiatric Facility

BACKGROUND: Persons with mental illnesses (MI) who use tobacco are likely to experience poorer physical health and worsened psychiatric symptomology as compared to their non–tobacco-using counterparts. Therefore, engaging them in treatment is an important aspect of evidence-based care. OBJECTIVE: To use the theory of planned behavior to examine factors associated with intentions to provide and the provision of evidence-based tobacco treatment. DESIGN: This study is based on a cross-sectional analysis of survey data from 195 staff at a state psychiatric hospital. Results: When controlling for demographic variables, attitudes, subjective norms, and perceived behavioral control toward providing tobacco treatment were associated with intentions to provide tobacco treatment, but only subjective norms and perceived behavioral control were associated with reported provision of evidence-based tobacco treatment. CONCLUSIONS: Understanding factors that influence provider delivery of tobacco treatment can better determine strategies to reduce the disproportionate tobacco use and related illnesses in behavioral health settings.

Behavioral and Physiological Responses to Nicotine Patch Administration Among Nonsmokers Based on Acute and Chronic Secondhand Tobacco Smoke Exposure.

Introduction: Despite the large amount that is known about the physical health effects of secondhand tobacco smoke (SHS) exposure, little is known about the behavioral health effects. Nicotine, the principle psychoactive substance in SHS, elicits subjective mood and physiological responses in nonsmokers. However, no studies have examined the subjective mood or physiological responses to nicotine in nonsmokers while accounting for prior chronic or acute SHS exposure. Methods: A 7-mg nicotine patch was administered to 17 adult nonsmokers for 2 hr. Main outcome measures obtained at ½ hr, 1 hr, and 2 hr were subjective behavioral drug effects (based on eleven 10-cm Visual Analog Scales [VASs]) and the physiological measures of heart rate, blood pressure, and serum nicotine levels. Analysis of outcome data was based on participants’ chronic (using hair nicotine) or acute (using saliva cotinine) SHS exposure. Results: Greater chronic SHS exposure was negatively associated with pleasurable responses to nicotine administration (“drug feels good” score at 2-hr time point, Spearman’s ρ = −.65, p < .004), whereas greater acute SHS exposure was associated with positive responses (“like feeling of drug” score at 2-hr time point, Spearman’s ρ = .63, p < .01). There were no associations between chronic or acute exposure and physiological changes in response to nicotine administration. Discussion: The findings of this study may be useful in providing preliminary empirical data for future explorations of the mechanism whereby SHS exposure can influence behavioral outcomes in nonsmokers. Such studies can inform future interventions to reduce the physical and behavioral health risks associated with SHS exposure.

Results of a Test and Win Contest to Raise Radon Awareness in Urban and Rural Settings.

Background Radon is a leading cause of lung cancer, but few test their homes to determine radon levels. Purpose The study assessed feasibility and success of a Test and Win Contest to promote radon testing in rural and urban communities. Methods The prospective, quasi-experimental study tested a novel contest to raise radon awareness. Paid and earned media recruited homeowners who received a free test kit and were eligible to win free home mitigation. Urban homeowners with the 5 highest radon levels and rural participants with the 3 highest won free radon mitigation systems. Cross-sectional surveys were completed via Internet or phone at enrollment. Results Most returned the radon test kits (71% urban; 86% rural). Participation was more prevalent in the rural location most likely due to longer media recruitment (6 weeks vs. 11 days) and more money spent on media advertising (

SECONDHAND SMOKE AND INDOOR PUBLIC SPACES IN PADUCAH, KENTUCKY

1.86 vs.

Dual Home Screening and Tailored Environmental Feedback to Reduce Radon and Secondhand Smoke: An Exploratory Study

0.21 per eligible household). The contest attracted 102 per 10 000 households to test for radon in the rural area compared to 19 per 10 000 households in urban counties. Discussion The contest was a feasible and successful population-based strategy in both locations. Translation to Health Education Practice The Test and Win Contest is a promising health education strategy to promote radon testing.