A systematic review of secondhand tobacco smoke exposure and smoking behaviors: Smoking status, susceptibility, initiation, dependence, and cessation
Introduction
Secondhand tobacco smoke exposure (SHSe) remains a global health problem with 40% of children and 34% of non-smoking adults exposed and resulting in 603,000 attributable deaths from ischemic heart disease, respiratory infections, asthma, and lung cancer (Öberg et al., 2011). This global impact continues to spur the need for tobacco control measures that aim to limit and protect individuals from SHSe. Particularly, Article 8 of the WHO Framework Convention recommends effective measures to protect exposure from tobacco smoke in both indoor and public spaces (World Health Organization, 2009). These recommendations come from extensive studies suggesting that there is no risk free level of SHSe (U.S. Department of Health and Human Services, 2006). Indeed, even brief and transient SHSe confers health risks (Flouris et al., 2010, Raupach et al., 2006).
Although the adverse physical health consequences of SHSe is extensively recognized, (Barnoya and Glantz, 2005, Jones et al., 2011, U.S. Department of Health and Human Services, 2010, Zhong et al., 2000) a growing body of research has begun to assess its behavioral effects. Notably, studies have demonstrated the neurocognitive detriments (Herrmann et al., 2008, Llewellyn et al., 2009, Swan and Lessov-Schlaggar, 2007, Yolton et al., 2005) and mental health effects (Bandiera, 2011, Bandiera et al., 2010, Bandiera et al., 2011, Hamer et al., 2011, Hamer et al., 2010) associated with SHSe. Given its acknowledged psychological and neurocognitive effects, the risks conferred by SHSe may extend to behaviors which reinforce smoking. For instance, environments of tobacco smoke exposure are associated with increased smoking cues that may potentiate smoking behaviors among smokers (Field et al., 2007, McRobbie et al., 2008). Additionally, through the psychoactive effect of nicotine exposure from SHSe, novice smokers may be at increased susceptibility to initiate tobacco use (Anthonisen & Murray, 2005). Indeed, clinical studies have found that SHSe results in increased occupancy of nicotine-acetylcholine receptors in the brains of adult smokers and nonsmokers, (Brody et al., 2011) suggesting increased neural vulnerability to nicotine exposure from SHS.
Despite the putative mechanisms of action whereby SHSe may influence smoking behavior, it is important to first determine to what extent SHSe is associated with such behaviors. Therefore, our study aims to systematically examine the literature for studies assessing the associations between SHSe and smoking behaviors; particularly smoking status, susceptibility, initiation, dependence, and cessation. The finding of this review will be informative in strengthening policies to limit SHSe, prevent smoking uptake, and to promote strategies for cessation.
Section snippets
Methods
We performed a literature search for published articles in the English language that reported on the relationship between SHSe and smoking related behaviors (i.e., smoking status, smoking susceptibility, smoking initiation, nicotine dependence and smoking cessation) prior to December 2013, through PubMed electronic database. Key terms used for the search were as follows: Secondhand tobacco smoke OR Environmental tobacco smoke AND smoking initiation OR smoking susceptibility OR risk for smoking
Description of studies
The retrieved studies consisted of 27 (77%) cross-sectional analyses, seven (20%) longitudinal analyses, and one (3%) case–control study; representing findings from a population of 1,138,101 participants. The samples represent 14 countries with thirteen (37.1%) studies from the United States, six (17.1%) from Canada, four (11.4%) from China or Hong Kong, two (5.7%) from Turkey, one combined Global Health Survey data from Cambodia, Laos, and Vietnam, one combined Global Youth Tobacco Survey data
Discussion
The association between SHSe and smoking behaviors has been elucidated through several clinical and epidemiological studies. Relationships between SHSe and smoking behaviors include: a) an increased likelihood of being a smoker; b) increased susceptibility to smoking; c) increased likelihood of smoking initiation; d) greater nicotine dependence symptoms; and e) reduced attempts and success in smoking cessation. These findings provide important considerations for future research and directions
Limitations
Several limitations need to be considered in interpreting the findings of this review. First, the variability in SHSe measures and outcome measures reported in each study precluded the possibility of meta-analytic procedures in summarizing the studies. Second, the majority of studies were cross-sectional in nature which limits the causal inferences in explaining the relationship between SHSe and main outcomes of interest. Among the prospective studies, the majority relied on self-report
Conclusions
In summary, despite inherent limitations in the designs of studies, clinical and epidemiological studies have demonstrated a relationship between SHSe and smoking behaviors. Specifically, longitudinal studies from our review suggest that SHSe is predictive of current smoking status among children and adults, (Glover et al., 2011, Homish et al., 2011, Hopenhayn et al., 2013) smoking initiation among children, (Becklake et al., 2005, Glover et al., 2011, Wang et al., 2011) and poor success in
Role of funding sources
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors
Contributors
Chizimuzo Okoli conceived, planned, conducted, and drafted the report of the manuscript. Jonathan Kodet conducted the data retrieval and review of articles for the study. Jonathan Kodet also assisted in drafting sections of the report.
Conflict of interest
All authors declare that they have no conflicts of interest.
References (95)
What are candidate biobehavioral mechanisms underlying the association between secondhand smoke exposure and mental health?
Medical Hypotheses
(2011)- et al.
Nicotine dependence symptoms among young never-smokers exposed to secondhand tobacco smoke
Addictive Behaviors
(2008) - et al.
Susceptibility to initiate smoking among junior and senior high school nonsmokers in Taiwan
Preventive Medicine
(2009) - et al.
Progression to established smoking: the influence of tobacco marketing
American Journal of Preventive Medicine
(2002) - et al.
Is exposure to secondhand tobacco smoke in the home related to daily smoking among youth?
Australian and New Zealand Journal of Public Health
(2003) - et al.
Peering through the smoke: The effect of parental smoking behavior and addiction on daily smokers' attentional bias to smoking cues
Addictive Behaviors
(2012) - et al.
Parental influences predict adolescent smoking in the United States, 1989–1993
Journal of Adolescent Health
(1998) - et al.
Driving kids to smoke? Children's reported exposure to smoke in cars and early smoking initiation
Addictive Behaviors
(2011) - et al.
Correlates of tobacco dependence and motivation to quit among young people receiving mental health treatment
Drug and Alcohol Dependence
(2012) - et al.
Factors associated with smoking abstinence after diagnosis of early stage lung cancer
Lung Cancer
(2013)
Mechanisms of adolescent smoking cessation: Roles of readiness to quit, nicotine dependence, and smoking of parents and peers
Drug and Alcohol Dependence
Parental influence on adolescent smoking cessation: Is there a gender difference?
Addictive Behaviors
Tobacco use and low-income African Americans: Policy implications
Addictive Behaviors
Sensitivity to secondhand smoke exposure predicts smoking susceptibility in 8–13-year-old never smokers
Journal of Adolescent Health
Smoking behaviour, cessation attempts and the influence of parental smoking in older adult women: A cross-sectional analysis from Italy
Public Health
Motivation to quit using cigarettes: A review
Addictive Behaviors
Worldwide burden of disease from exposure to second-hand smoke: A retrospective analysis of data from 192 countries
The Lancet
Sex differences in smoking initiation among children and adolescents
Public Health
Do researcher-derived classifications of youths' smoking behavior correspond with youths' characterizations of their behavior?
Addictive Behaviors
Behavioral effects of nicotine exposure from secondhand tobacco smoke among bar and restaurant workers
Addictive Behaviors
An examination of the relationship between adolescents' initial smoking experience and their exposure to peer and family member smoking
Addictive Behaviors
Non-smoking youths' “perceived” addiction to tobacco is associated with their susceptibility to future smoking
Addictive Behaviors
Predictors of nicotine dependence symptoms among never-smoking adolescents: A longitudinal analysis from the Nicotine Dependence in Teens Study
Drug and Alcohol Dependence
Viewing tobacco use in movies: does it shape attitudes that mediate adolescent smoking?
American Journal of Preventive Medicine
Current models of nicotine dependence: what is known and what is needed to advance understanding of tobacco etiology among youth
Drug and Alcohol Dependence
Exposure to environmental tobacco smoke in a general population
Respiratory Medicine
Smoking family, secondhand smoke exposure at home, and nicotine addiction among adolescent smokers
Addictive Behaviors
Modifiable family and school environmental factors associated with smoking status among adolescents in Guangzhou, China
Preventive Medicine
Association of secondhand smoke exposure with nicotine dependence among Black smokers
Addictive Behaviors
Exposure to environmental tobacco smoke and the risk of lung cancer: A meta-analysis
Lung Cancer
The Global Youth Tobacco Survey: 2001–2002 in Riyadh region, the Kingdom of Saudi Arabia
Substance Abuse and Rehabilitation
Correlates of smoking initiation among young adults in Ukraine: Cross-sectional study
BMC Public Health
A new childhood pathway for transmission of an increased likelihood of smoking?
CMAJ
Secondhand smoke exposure and depressive symptoms
Psychosomatic Medicine
Secondhand smoke exposure and mental health among children and adolescents
Archives of Pediatrics & Adolescent Medicine
Cardiovascular effects of secondhand smoke: Nearly as large as smoking
Circulation
Childhood predictors of smoking in adolescence: A follow-up study of Montreal schoolchildren
Canadian Medical Association Journal
Nicotine addiction
New England Journal of Medicine
Defining “smoker”: College student attitudes and related smoking characteristics
Nicotine & Tobacco Research
Psychosocial factors in adolescent nicotine dependence symptoms: A sample of high school juniors who smoke daily
Substance Use & Misuse
Effect of secondhand smoke on occupancy of nicotinic acetylcholine receptors in brain
Archives of General Psychiatry
Smoking in the movies increases adolescent smoking: A review
Pediatrics
Defining cigarette smoking status in young adults: A comparison of adolescent vs adult measures
American Journal of Health Behavior
A sensitization-homeostasis model of nicotine craving, withdrawal, and tolerance: Integrating the clinical and basic science literature
Nicotine & Tobacco Research
After the smoke has cleared: Evaluation of the impact of a new national smoke-free law in New Zealand
Tobacco Control
Seeing, wanting, owning: The relationship between receptivity to tobacco marketing and smoking susceptibility in young people
Tobacco Control
The smoking Stroop and delay discounting in smokers: Effects of environmental smoking cues
Journal of Psychopharmacology
Cited by (58)
Associations of timing, level, and pattern of secondhand smoke exposure with early alcohol initiation: A cohort study
2023, Drug and Alcohol DependenceSecond-hand smoke exposure in adolescents in Latin America and the Caribbean: a pooled analysis
2023, Lancet Regional Health - AmericasYouth susceptibility to tobacco use in the Gulf Cooperation Council Countries, 2001–2018
2022, Preventive Medicine ReportsCitation Excerpt :The study identified a relationship between key FCTC provisions and youth susceptibility to tobacco use. Like results in several studies (Okoli and Kodet, 2015; Xi et al., 2016), exposure to smoking in public places was a significant factor for those who had never used tobacco in the GCC countries. Smoking in public places, such as restaurants and cafes, is allowed in designated areas in at least Bahrain, Saudi Arabia, and the UAE.
Pre- and postnatal maternal smoking and offspring smoking trajectories: Evidence from a 20-year birth cohort
2021, Preventive MedicineCitation Excerpt :Similarly, early childhood is a sensitive period for brain development: exposure to nicotine through second-hand smoke during this period could also play an important role and help explain increased smoking risk in offspring exposed to maternal smoking during childhood. Furthermore, social modeling effects tied to maternal smoking in the presence of the child may be a plausible mechanism contributing to these associations (Okoli and Kodet, 2015; Bélanger et al., 2008). The fact that some studies found similar increases in risk in youth exposed to maternal or paternal smoking supports the notion that social modeling and/or genetic factors are involved (Taylor et al., 2014).
Age, Period, and Cohort Analysis of Smoking Intensity Among Current Smokers in Malaysia, 1996-2015
2023, Nicotine and Tobacco Research