florida department of health: shino oba msph, ursula bauer ph.d, robert g brooks md
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Environmental Tobacco Smoke (ETS) Exposure among Middle and High School Students: Results from the Florida Youth Tobacco Survey, 1998 to 2000. Florida Department of Health: Shino Oba MSPH, Ursula Bauer Ph.D, Robert G Brooks MD. Background:. - PowerPoint PPT PresentationTRANSCRIPT
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Environmental Tobacco Smoke (ETS) Exposure among Middle and High School Students: Results from the Florida Youth Tobacco Survey, 1998 to 2000
Florida Department of Health: Shino Oba MSPH,
Ursula Bauer Ph.D,
Robert G Brooks MD
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Background:
Adverse Health Effect of ETS Exposure among Adolescents and Children
Increases risk for Lung cancer later in life Asthma Lower and upper respiratory tract infection Fluid in the middle ear
Decreases HDL-Cholesterol level
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Methods:
Sample Size 1998 1999 2000 (2001)
Middle 11,865 11,724 14,311 (4,327)High 10,675 9,254 9,484 (4,366)
Schools: 255 242 243 (146*) of
266 266 266 (156 ) selected*Including 49 of the original 266 schools
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Sample selected by region (7) Large sample size, overall 1500 MS, 1500 HS students/region State level sample in 2001
Two stage cluster sample design
NorthEast
Panhandle
NorthCentral
TampaBay
SouthCentral
Palm Bch/Broward
Dade/Monroe
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Response Rate
1998 1999 2000 (2001)
Middle 80% 82% 82% (73%)
High 72% 70% 81% (74%)
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Analysis
Weighting adjustment by grade and gender Nesting adjustment for clustering (SUDAAN) Descriptive - prevalence Multiple Logistic Regression
Controlled for demographic and behavioral variables: grade, gender, race/ethnicity, average grade, receptivity to tobacco promotion, number of smoker friends, smoker in the household, survey year
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Results – Prevalence:
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Fig.1 ETS Exposure among Florida Public School Students in 2000
87.2
54.2
57.9
77.8
38.6
42.8
90.1
62.2
68.5
81.0
38.7
48.2
0
20
40
60
80
100Perc
ent
in rooms in cars in rooms in cars
Middle School High School
Smokers Non-Smokers Overall
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Fig. 2 ETS Exposure by Receptivity to Tobacco Company Promotional Items among Non-smoking Students
48.5%64.8%
76.4%
55.5%70.6%
76.2%
0%
20%
40%
60%
80%
100%
Middle School High School
Low Moderate High
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Fig. 3 ETS Exposure by Smoker(s) among the 4 Best Friends
51.7%72.5%
76.8%79.0%
78.5%
56.4%76.3%
80.3%84.2%
82.9%
0%
20%
40%
60%
80%
100%
Middle School High School
0 friend smoke 1 friend smokes 2 friends smoke3 friends smoke 4 friends smoke
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Fig. 4 ETS Exposure by Smoker in Household
83.8%
43.3%
86.2%
54.3%
0%
20%
40%
60%
80%
100%
Middle School High School
There is smoker(s) in householdThere is no smoker in household
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Fig.5 ETS Exposure by Rules about Smoking in Household
53.4%
89.0%
61.2%
87.2%
0%
20%
40%
60%
80%
100%
Middle School High School
Rules prohibiting smoking in the homeNo rules prohibiting smoking in the home
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Fig. 6 ETS Exposure by Cigarette Smoking Status
92.5%
59.1%
94.5%
65.4%
0%
20%
40%
60%
80%
100%
Middle School High School
Current cigarette smokers non-smokers
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Fig. 7 Where Youth are Exposed to ETS, FYTS 2001
At home34.3%
At school3.8%
At work3.9%
In a restaurant11.8%
Public place/ Malll7.9%
Someone else's house15.7%
Parent's car3.5%
Someone else's car6.7%
Other12.4%
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Fig. 8 Who’s Smoking When Youth are Exposed to ETS, FYTS 2001
Parents32.1%
Relative18.9%
Friends19.2%
Someone at work4.3%
Stranger25.5%
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Results – Multivariate Analysis:
Weighted adjusted odds ratios (OR) and 95% confidence intervals (CI) of exposure to environmental tobacco smoke, in various locations, among 46,423 non-smoking public middle and high school students, 1998-2000 Florida Youth Tobacco Survey.
(Please refer the attached table)
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Other Results:
ETS and Cigarette Smoking Students who are exposed to ETS were
3.39 (2.98-3.85) times more likely to be current cigarette smokers than students who were not exposed to ETS
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Other Results (continued):
ETS and Rules about Smoking in Household: The rule that prohibits smoking in home
significantly decreases the exposure to ETS among students OR=0.21(0.19-0.23) for non-smoking students OR=0.66(0.24-0.44) for smoking students
In the household with a smoker, the same rule prevent students from exposure in similar way OR=0.36 (0.31-0.41) for non-smoking students OR=0.43 (0.27-0.68) for smoking students
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Limitations:
Cross-sectional study design Need to follow youth over time to
establish temporal direction of associations
Validity and Reliability of Self-reported Exposure Student self-report of exposure was not
independently verified
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Conclusion and Recommendations:
Too many youth are exposed to environmental tobacco smoke
ETS exposure varies by students’ gender, race/ethnicity, grade level, academic grade, receptivity to tobacco company promotion, cigarette smoking status, friends’ smoking status, home environment
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Conclusion and Recommendations (continued): Interventions to reduce youth exposure to ETS
can be implemented at a number of levels: Policy level interventions will reduce youth
exposure to ETS in public places and work sites
Educational interventions targeted to adults and parents can reduce exposure at home and in cars
Interventions to reduce youth and adult smoking can reduce youth exposure to ETS from peers, parents, and other adults.