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Wynn Casino Sued over Second-Hand Smoke  

A proposed class action seeks to force The Wynn Hotel and Casino to protect its workers on the casino floor from second-hand smoke. Kanie Kastroll, a dealer at the Wynn, says she suffers with asthma, and the "second-hand smoke she is exposed to ... exacerbates her condition."

Wynn "is aware of the health risks posed by exposure to second-hand smoke," but "has failed to adequately address the problem ... in the gaming area of its casino."

The hotel forbids dealers from designating certain tables as "smoke-free," and they can't request customers to blow smoke away from the table or to move their ashtrays, the lawsuit states. They're also told not to fan their hands at tobacco smoke.

Kastroll says the Wynn even encourages its customers to smoke. "Cocktail servers bring cigars and cigarettes to customers at the gaming tables," and that the hotel gives free smokes to gamblers.

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• Smoking pregnant increases baby's asthma risk: study 

Smoking during pregancy increases the risk of a baby developing asthma up to sixfold, said a Swedish study published at the European Respiratory Society's annual congress on Monday.

The study by Professeur Anders Bjerg of the Sunderby central hospital in Norrbotten and his specialists showed that smoking leads to babies being born underweight, a fact that has an impact on the development of asthma.

The Swedish doctors studied asthma in about 3,400 children between 1996 and 2008.

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Second-hand smoke exposure in cars and respiratory health effects in children 

We examined potential associations of ever asthma, and symptoms of wheeze (past 12 months), hay fever, eczema and bronchitis (cough with phlegm) among school children exposed to second-hand smoke (SHS) in cars, using a modified Irish International Study of Asthma and Allergies in Childhood (ISAAC) protocol. . . .

Approximately one in seven Irish schoolchildren are exposed to SHS in cars and could have adverse respiratory health effects. Further studies are imperative to explore such associations across different population settings.

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Exposure to Tobacco Smoke Before Birth Affects DNA  

Women who smoke while pregnant increase their unborn child's long-term risk for health problems, including childhood asthma, cardiovascular disease and lower pulmonary function, and a new study may help experts understand why.

Researchers at the Keck School of Medicine of the University of Southern California (USC) found that maternal smoking actually changes the unborn child's DNA patterns.

The new study found that fetal exposure to maternal smoking was linked to differences in DNA methylation, an epigenetic mechanism.

Epigenetics is the study of how chemicals that attach to DNA can switch genes on and off, which leads to differences in gene expression without changing basic genetic information, according to background information in a USC news release about the study.

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Smoke exposure interacts with ADAM33 polymorphisms in the development of lung function and hyperresponsiveness  

Introduction: ADAM33 is the first identified asthma gene by positional cloning, especially asthma combined with bronchial hyperresponsiveness (BHR). Moreover, ADAM33 is associated with early-life lung function and decline of forced expiratory volume in 1 s (FEV1) in the general population. In utero and postnatal cigarette smoke exposure (CSE) are associated with reduced lung function, and development of BHR and asthma. We hypothesized that this may occur via interaction with ADAM33.

Aim: To replicate the role of ADAM33 in childhood lung function and development of BHR and asthma. Furthermore, we investigated gene–environment interaction of ADAM33 with in utero and postnatal CSE in the Dutch PIAMA cohort. . . .

Conclusions: We confirm associations between ADAM33 and the development of asthma (+BHR). This is the first study suggesting that interaction of in utero CSE with ADAM33 results in reduced lung function and the development of BHR, which needs further confirmation.

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ADAM33 genotype ‘interacts with in utero smoke exposure’ 

Variations in the so-called asthma gene, ADAM33, interact with exposure to cigarette smoke in utero to influence lung function in childhood, a study has found.

The research, if confirmed, underlines the importance of maternal cigarette smoking as an environmental risk factor for reduced lung function, acting in concert with genetic factors such as ADAM33.

The finding is reported in the journal Allergy by Dutch researchers, who analyzed data from a birth cohort study, the Prevention and Incidence of Mite Allergy. The study, which began in 1996, included 4146 children, 1327 of whom were considered at high risk based on a positive maternal history of atopy.

Dirkje Postma (University of Groningen) and fellow authors first sought to verify the previously reported association between ADAM33 genotype and asthma risk.

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• Passive smoking in pregnancy linked to asthma risk in children 

Children born to women exposed to environmental tobacco smoke (ETS) during pregnancy face an increased risk for asthma symptoms in early life, researchers warn.

“Smoking during pregnancy has been shown to be a considerable risk factor for changes in growth and maturation of the fetal lungs and the later development of wheeze and asthma,” explain Paraskevi Xepapadaki (University of Athens, Greece) and team in the journal Pediatric Allergy and Immunology.

But they add it is not known whether passive smoking in pregnancy is associated with an increased risk for asthma and allergies in offspring.

To investigate, the researchers studied data on 2374 preschool children, aged between 1 and 6 years, from 115 nurseries in five counties of Greece.

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Association of passive exposure of pregnant women to environmental tobacco smoke with asthma symptoms in children  

Environmental tobacco smoke (ETS) is a significant risk factor for the presence and increased severity of asthma- and allergy-related symptoms in children. Smoking during pregnancy has detrimental effects on asthma-associated outcomes in childhood. Whether passive exposure of pregnant women to ETS may also lead to asthma in their offspring, is not known. The aim of this study was to investigate the association of passive exposure of pregnant women to ETS and asthma- and/or allergy-related symptoms in Preschool children. Cross-sectional data were collected with questionnaires from 2374 Preschool children, recruited from public and private nurseries and day-care centers. Parental smoking was significantly associated with wheezing symptoms in their children. Mother's active smoking during pregnancy significantly increased the risk for occurrence of asthma symptoms and/or medically diagnosed asthma in Preschool children in a dose-dependent manner. Passive exposure to ETS, mainly during the third trimester of pregnancy, was significantly associated with asthma- and allergy-related symptoms after adjusting for several confounders in a multivariate analysis (current wheeze: OR = 1.42, 95% CI = 1.06–1.91, pruritic rash ever: OR= 1.45, 95% CI = 1.01–2.08). Passive exposure of pregnant women to ETS during the third trimester is positively associated with asthma- and allergy-related symptoms in their Preschool age children. Public health policies should be oriented not only towards smoking cessation, but also reinforce elimination of ETS exposure of pregnant women.

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Parental stress increases the effect of traffic-related air pollution on childhood asthma incidence  

These results suggest that children from stressful households are more susceptible to the effects of TRP and in utero tobacco smoke on the development of asthma.

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Stressed parents up asthma risk 

Stressed parents may play a role in childhood asthma, researchers believe.

They found the children of tense parents who lived in polluted areas were far more likely to have asthma than friends in the same neighbourhood.

The University of Southern California team believe parental anxieties combine with other known risk factors to increase a child's asthma risk.

They told Proceedings of the National Academy of Sciences there might be an underlying biological explanation. . . .

These results suggest that children from stressful households are more susceptible to the effects of traffic-related pollution and in utero tobacco smoke on the development of asthma

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Parental Stress Boosts Kids' Asthma Risk  

Air pollution from cars can increase a child's chances of developing asthma, but add parental stress and the odds for asthma get even higher, a new study finds.

For children exposed to smoking while still in the womb, another asthma risk, parental stress also increases the risk for asthma, the researchers noted.

"There is an association between air pollution and asthma, and it grows with increasing exposure to stress in the household," said lead researcher Ketan Shankardass, a postdoctoral research fellow at the Centre for Research on Inner City Health at The Li Ka Shing Knowledge Institute of St. Michael's Hospital in Toronto.

"The cause of asthma is still unknown," Shankardass said. "It's a major illness that affects a lot of people all around the world and we still don't really have a handle on what causes it so we can't control it very well. But this finding contributes to our understanding of that causal process."

The report is published in this week's online edition of the Proceedings of the National Academy of Sciences.

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News briefs from the July issue of Chest 

SMOKING CESSATION MAY PROVIDE IMMEDIATE BENEFIT TO HEART

A new article suggests smoking cessation provides immediate benefits to patients. Researchers from the Feinstein Institute for Medical Research in Manhasset, NY, examined specific inflammatory biomarkers associated with cardiovascular disease (CVD) in "at risk" women during the smoking cessation process. . . .

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Judith Palfrey: Is Asthma in Children Preventable?  

The worldwide increase in asthma is thought to be due to many factors, including air pollution, climate change, environmental allergens, respiratory infections, and stress. By keeping the home environment free of triggers such as dust, mites, animal dander, and cockroaches, parents can minimize the chance that children will have wheezing attacks. To protect children from infections that can trigger asthma, parents should ensure that children keep on up-to-date on their immunizations as recommended by the American Academy of Pediatrics, including an annual flu shot. Children should all be taught good hand-washing techniques.

One of the major causes of asthma and many other childhood afflictions is smoking. Parents who smoke are more likely to have premature babies whose lungs are more prone to develop asthma. Once the baby is born, parental smoking makes the asthma come on more frequently and worsens attacks. The Julius B. Richmond Center of Excellence at the American Academy of Pediatrics offers great tips for families to stop smoking so that their children will not suffer asthma as the result of a truly preventable cause.

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• Impact of Environmental Tobacco Smoke and Active Tobacco Smoking on the Development and Outcomes of Asthma and Rhinitis  

Summary: Several deleterious effects have been described in asthma because of smoking: accelerated decline in lung function, more severe symptoms, impairment in quality of life and diminished therapeutic response to steroids. The harmful effect of tobacco smoking is not only on asthma but also on rhinitis playing a role in disease outcomes. Tobacco exposure can influence innate immunity diminishing innate production of antigen-presenting cells cytokines, as well as an impaired response to toll-like receptor ligands. Active smoking is associated with current symptoms of asthma and rhinitis and seems to be a risk factor for developing new asthma in patients with rhinitis. Tobacco smoking has been also found among the factors inducing nasal obstruction and decreased muco-ciliary clearance in nonallergic rhinitis. . . .

The early exposure to ETS, both prenatal and postnatal, increases the risk of IgE sensitization to indoor inhalant and, in particular, food allergens[13••,14] and subsequently may have effects on atopy and airway hyperresponsiveness, with the consequent presence of atopic diseases.[15,16]

More studies are needed to gain insight in the relationship between tobacco smoking, ETS and the immune response and inflammatory lower and upper respiratory illnesses. . . .

All these findings suggest tobacco exposure control should be a tool in the management of asthma.

Conclusion

1. Tobacco smoking provokes a strong immunological imbalance to those exposed. The innate immunity is impaired by tobacco exposure.

2. As a consequence, typical allergic diseases such as rhinitis and asthma could initiate or aggravate preexisting conditions or both. Active smoking is a factor for nasal obstruction in NAR.

3. Tobacco smoking (and probably ETS also) has a detrimental effect on the efficacy of inhaled corticosteroids, leukotriene receptor antagonists and on those patients in programs for controlling asthma in deprived populations.

4. Robust evidence is provided in order to empower both primary and secondary prevention by physicians.

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Asthma and Smoking Could Be Dangerous Combo  

Doctors say smoking and asthma can also be a dangerous combination. “None of your medications will work,” says Dr. Kay Walker, an allergies and asthma physician. “Not only just your simple quick inhaler, but the long term medications which cut down on the inflammation simply cannot be as effective in somebody who is an active smoker.”

Doctor Walker says the chemicals in cigarettes paralyze parts of the lungs that clear out dust and particles. The damage can also prevent inhalers and medicines from helping you during a life-threatening asthma attack. “Because you are continually damaging the lungs, you are continually causing more inflammation, which overwhelms our ability to try and control it.”

Second-hand smoke can also be a problem for asthma sufferers of all ages.

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