{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:16:35Z","timestamp":1773101795886,"version":"3.50.1"},"reference-count":62,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,4,21]],"date-time":"2020-04-21T00:00:00Z","timestamp":1587427200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: The initiation of tobacco addiction is complex, and several factors contribute to the onset of this behavior. It is presumed that the influence of family environment may pose a key factor in tobacco addiction. Tobacco-use has been highly observed in the Jamnagar district of Saurashtra region of Gujarat, India. No earlier study has focused on determining the pervasiveness of tobacco-use in families of tobacco users and non-users in this geographical area. Thus, this study aimed to assess the practice and pattern of tobacco-use (smoking and\/or tobacco-chewing) in the families of tobacco-user patients. Methods: We studied the families of 65 tobacco-user patients (Group 1) who visited an outpatient clinic of an Ayurvedic post-graduate hospital with complaints of cough were studied and compared with age and gender-matched non-tobacco users (Group 2). The prevalence of tobacco use among the parents, siblings, and children of both groups was analyzed and compared. Results: The findings revealed that tobacco use among parents, siblings, and children in Group 1 was higher than Group 2 (p &lt; 0.001). This meant that the problems of tobacco addiction are not always related to the individual, and therefore, tobacco-prevention strategies should focus on the entire family. Conclusions: These findings offer further insight into the promotion of smoking prevention interventions. Nevertheless, further research is warranted.<\/jats:p>","DOI":"10.3390\/ijerph17082868","type":"journal-article","created":{"date-parts":[[2020,4,22]],"date-time":"2020-04-22T04:15:13Z","timestamp":1587528913000},"page":"2868","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Influence of Family Environment and Tobacco Addiction: A Short Report from a Post-Graduate Teaching Hospital, India"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3682-3573","authenticated-orcid":false,"given":"Rohit","family":"Sharma","sequence":"first","affiliation":[{"name":"Institute of Medical Sciences, Department of Rasashastra and Bhaishajya Kalpana, Faculty of Ayurveda, Banaras Hindu University, Varanasi 221005, India"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5934-5201","authenticated-orcid":false,"given":"Nat\u00e1lia","family":"Martins","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal"},{"name":"Institute for Research and Innovation in Health (i3S), University of Porto, 4200-135 Porto, Portugal"}]},{"given":"Arunabh","family":"Tripathi","sequence":"additional","affiliation":[{"name":"National Institute of Indian Medical Heritage, CCRAS, Ministry of AYUSH, Government of India, Hyderabad, Telangana 500036, India"}]},{"given":"Pasquale","family":"Caponnetto","sequence":"additional","affiliation":[{"name":"Department of Education, University of Catania, 2 Ofelia, 95124 Catania, Italy"},{"name":"Center of Excellence for the Acceleration of Harm Reduction, University of Catania, 95123 Catania, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2227-8292","authenticated-orcid":false,"given":"Neha","family":"Garg","sequence":"additional","affiliation":[{"name":"Institute of Medical Sciences, Department of Medicinal Chemistry, Faculty of Ayurveda, Banaras Hindu University, 221005 Varanasi, India"}]},{"given":"Eugenie","family":"Nepovimova","sequence":"additional","affiliation":[{"name":"Department of Chemistry, Faculty of Science, University of Hradec Kr\u00e1lov\u00e9, 50003 Hradec Kr\u00e1lov\u00e9, Czech Republic"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5816-1673","authenticated-orcid":false,"given":"Kamil","family":"Ku\u010da","sequence":"additional","affiliation":[{"name":"Department of Chemistry, Faculty of Science, University of Hradec Kr\u00e1lov\u00e9, 50003 Hradec Kr\u00e1lov\u00e9, Czech Republic"}]},{"given":"Pradeep Kumar","family":"Prajapati","sequence":"additional","affiliation":[{"name":"Department of Rasashastra and Bhaishajya Kalpana, All India Institute of Ayurveda, New Delhi 110076, India"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ehbc.2004.02.006","article-title":"Smoking is a major cause of premature death worldwide","volume":"8","author":"Gavin","year":"2004","journal-title":"Evid. Based Health Care"},{"key":"ref_2","unstructured":"WHO (2005). The Millennium Development Goals and Tobacco Control, World Health Organization."},{"key":"ref_3","first-page":"1","article-title":"Mortality attribute to tobacco: Review of different methods","volume":"72","author":"Tachfouti","year":"2014","journal-title":"Arch. Pub. Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/S0140-6736(03)14338-3","article-title":"Estimates of global mortality attributable to smoking in 2000","volume":"362","author":"Ezzati","year":"2003","journal-title":"Lancet"},{"key":"ref_5","unstructured":"Reddy, K.S., and Gupta, P.C. (2004). Report on Tobacco Control in India, Ministry of Health and Family Welfare, Government of India."},{"key":"ref_6","first-page":"167","article-title":"Social and Cultural Aspects of Drug Abuse in Adolescents","volume":"12","author":"Jiloha","year":"2009","journal-title":"Delhi Psychiatry J."},{"key":"ref_7","first-page":"158","article-title":"Role of families on early childhood development and education: Dhaka city perspective","volume":"11","author":"Naomee","year":"2013","journal-title":"Int. J. Social Sci."},{"key":"ref_8","first-page":"47","article-title":"A study on prevalence of smoking and tobacco chewing among adolescents in rural areas of Jamnagar district, Gujarat state","volume":"1","author":"Makwana","year":"2007","journal-title":"J. Med. Sci. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"105","DOI":"10.4103\/0970-0218.62560","article-title":"A study on prevalence of chewing form of tobacco and existing quitting patterns in urban population of Jamnagar, Gujarat","volume":"35","author":"Joshi","year":"2010","journal-title":"Indian J. Community Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.canep.2016.10.007","article-title":"Evaluating the use of friend or family controls in epidemiologic case-control studies","volume":"46","author":"Zhong","year":"2017","journal-title":"Cancer Epidemiol."},{"key":"ref_11","first-page":"5","article-title":"Pedigree Profile: A valuable tool in the risk assessment of coronary artery disease in young","volume":"12","author":"Dwivedi","year":"2008","journal-title":"South East Asian J. Prev. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"134","DOI":"10.4103\/ayu.AYU_52_19","article-title":"Illusion of the \u201cp-value\u201d theory in Ayurveda research: A need for perceptible alternative","volume":"40","author":"Tripathi","year":"2019","journal-title":"AYU"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"137","DOI":"10.4103\/0970-2113.95314","article-title":"Clinico-epidemiological profile of tobacco users attending a tobacco cessation clinic in a teaching hospital in Bangalore city","volume":"29","author":"Rekha","year":"2012","journal-title":"Lung India"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1002\/gepi.1028","article-title":"Influence of genes and family environment on adult smoking behavior assessed in an adoption study","volume":"21","author":"Osler","year":"2001","journal-title":"Genet. Epidemiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"130","DOI":"10.3329\/jhpn.v31i1.14757","article-title":"Role of family milieu in tobacco addiction: A study in a tertiary-care institution in India","volume":"31","author":"Dwivedi","year":"2013","journal-title":"J. Health Popul. Nutr."},{"key":"ref_16","first-page":"167","article-title":"Family influence on current smoking habits among secondary school children in Kota Bharu, Kelantan","volume":"41","author":"Shamsuddin","year":"2000","journal-title":"Singap. Med. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/0306-4603(83)90003-5","article-title":"Generational continuity in the use of substances: The impact of parental substance use on adolescent substance use","volume":"8","author":"Fawzy","year":"1983","journal-title":"Addict. Behav."},{"key":"ref_18","first-page":"1","article-title":"Parental smoking and related behaviours influence adolescent tobacco smoking: Results from the 2001 New Zealand national survey of 4th form students","volume":"116","author":"Scragg","year":"2003","journal-title":"N. Z. Med. J."},{"key":"ref_19","first-page":"89","article-title":"The relationship of parental drug use and parents\u2019 attitude concerning adolescent drug use to adolescent drug use","volume":"19","author":"McDermott","year":"1984","journal-title":"Adolescence"},{"key":"ref_20","unstructured":"U.S. Department of Health and Human Services, ICF International (2019, June 12). Protecting Children in Families Affected by Substance Use Disorders, Available online: https:\/\/www.childwelfare.gov\/pubPDFs\/substanceuse.pdf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/87565640802564366","article-title":"Maternal smoking during pregnancy and child outcomes: Real or spurious effect?","volume":"34","author":"Knopik","year":"2009","journal-title":"Dev. Neuropsychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1159\/000070980","article-title":"Maternal Smoking and Smoking in Adolescents: A prospective community study of adolescents and their mothers","volume":"9","author":"Lieb","year":"2003","journal-title":"Eur. Addict. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1097\/00004583-199907000-00020","article-title":"Maternal smoking during pregnancy and psychopathology in offspring followed to adulthood","volume":"38","author":"Weissman","year":"1999","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1080\/14622200050011295","article-title":"Prenatal tobacco exposure: Is it a risk factor for early tobacco experimentation?","volume":"2","author":"Cornelius","year":"2000","journal-title":"Nicotine Tob. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1176\/appi.ajp.160.11.1978","article-title":"Elevated risk of tobacco dependence among offspring of mothers who smoked during pregnancy: A 30-year prospective study","volume":"160","author":"Buka","year":"2003","journal-title":"Am. J. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1159\/000028270","article-title":"Prostaglandin E2 in human placenta: Its vascular effects and activation of prostaglandin E2 formation by nicotine and cotinine","volume":"58","author":"Hemontolor","year":"1999","journal-title":"Pharmacology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1097\/00004583-200106000-00007","article-title":"Behavioral and neural consequences of prenatal exposure to nicotine","volume":"40","author":"Ernst","year":"2001","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1038\/sj.npp.1300401","article-title":"Prenatal nicotine exposure alters the response to nicotine administration in adolescence: Effects on cholinergic systems during exposure and withdrawal","volume":"29","author":"Seidler","year":"2004","journal-title":"Neuropsychopharmacology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1111\/j.1360-0443.2006.01323.x","article-title":"Prediction of adolescent smoking from family and social risk factors at 5 years, and maternal smoking in pregnancy and at 5 and 14 years","volume":"101","author":"Najman","year":"2006","journal-title":"Addiction"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"McGee, C.E., Trigwell, J., Fairclough, S.J., Murphy, R.C., Porcellato, L., Ussher, M., and Foweather, L. (2015). Influence of family and friend smoking on intentions to smoke and smoking-related attitudes and refusal self-efficacy among 9-10-year-old children from deprived neighbourhoods: A cross-sectional study. BMC Public Health, 15.","DOI":"10.1186\/s12889-015-1513-z"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"656","DOI":"10.3109\/10826084.2010.528122","article-title":"Does mother\u2019s smoking influence girls\u2019 smoking more than boys\u2019 smoking? A 20-year review of the literature using a sex-and gender-based analysis","volume":"46","author":"Sullivan","year":"2011","journal-title":"Subst. Use Misuse"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.jadohealth.2013.01.020","article-title":"Changes in friends and parental influences on cigarette smoking from early through late adolescence","volume":"53","author":"Liao","year":"2013","journal-title":"J. Adolesc. Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e274","DOI":"10.1542\/peds.2008-2251","article-title":"Parental smoking and adolescent smoking initiation: An intergenerational perspective on tobacco control","volume":"123","author":"Gilman","year":"2009","journal-title":"Paediatrics"},{"key":"ref_34","first-page":"146","article-title":"Cigarette smoking among school children in Singapore. Part II--Development of the smoking habit","volume":"32","author":"Emmanuel","year":"1991","journal-title":"Singap. Med. J."},{"key":"ref_35","unstructured":"Bandura, A. (1986). Social Foundations of Thought and Action, Prentice Hall."},{"key":"ref_36","unstructured":"Bandura, A. (1975). Social Learning Theory, Prentice-Hall Inc."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e568","DOI":"10.1542\/peds.2013-0067","article-title":"Parent and Child Cigarette Use: A Longitudinal, Multigenerational Study","volume":"132","author":"Vuolo","year":"2013","journal-title":"Pediatrics"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1136\/thx.2010.153379","article-title":"Exposure to parental and sibling smoking and the risk of smoking uptake in childhood and adolescence: A systematic review and meta-analysis","volume":"66","author":"Britton","year":"2011","journal-title":"Thorax"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.ypmed.2007.02.009","article-title":"Modifiable family and school factors associated with smoking status among adolescents in Guangzhou, China","volume":"45","author":"Wen","year":"2007","journal-title":"Prev. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.ypmed.2004.05.029","article-title":"Family characteristics and smoking among urban and rural adolescents living in China","volume":"40","author":"Shakib","year":"2005","journal-title":"Prev. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1016\/j.addbeh.2012.06.019","article-title":"The role of environmental smoking in smoking-related cognitions and susceptibility to smoking in never-smoking 9-12-year-old children","volume":"37","author":"Schuck","year":"2012","journal-title":"Addict. Behav."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.1111\/j.1559-1816.2010.00663.x","article-title":"Using the implicit association test to assess children\u2019s implicit attitudes toward smoking","volume":"40","author":"Andrews","year":"2010","journal-title":"J. Appl. Soc. Psychol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/j.1360-0443.2005.01297.x","article-title":"Prospective prediction of children\u2019s smoking transitions: Role of parents\u2019 and older siblings\u2019 smoking","volume":"101","author":"Bricker","year":"2005","journal-title":"Addiction"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1093\/ntr\/ntw140","article-title":"The Association of Cigarette Smoking with Depression and Anxiety: A Systematic Review","volume":"19","author":"Fluharty","year":"2017","journal-title":"Nicotine Tob. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1037\/bul0000003","article-title":"Anxiety, depression, and cigarette smoking: A transdiagnostic vulnerability framework to understanding emotion-smoking comorbidity","volume":"141","author":"Leventhal","year":"2015","journal-title":"Psychol. Bull."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"311","DOI":"10.4103\/ijph.IJPH_174_17","article-title":"Depression, anxiety, stress, and stressors among rural adolescents studying in Pune and a rural block of Nanded district of Maharashtra, India","volume":"62","author":"Shaikh","year":"2018","journal-title":"Indian J. Public Health"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Ho, C.S.H., Tan, E.L.Y., Ho, R.C.M., and Chiu, M.Y.L. (2019). Relationship of anxiety and depression with respiratory symptoms: Comparison between depressed and non-depressed smokers in Singapore. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16010163"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Davison, K.M., Lin, S.L., Tong, H., Kobayashi, K.M., Mora-Almanza, J.G., and Fuller-Thomson, E. (2019). Nutritional Factors, Physical Health and Immigrant Status Are Associated with Anxiety Disorders among Middle-Aged and Older Adults: Findings from Baseline Data of the Canadian Longitudinal Study on Aging (CLSA). Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17051493"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Assari, S., Smith, J., Mistry, R., Farokhnia, M., and Bazargan, M. (2019). Substance Use among Economically Disadvantaged African American Older Adults; Objective and Subjective Socioeconomic Status. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16101826"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Assari, S., Smith, J.L., Zimmerman, M.A., and Bazargan, M. (2019). Cigarette Smoking among Economically Disadvantaged African-American Older Adults in South Los Angeles: Gender Differences. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16071208"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Mak, Y.W., Leung, D., and Loke, A.Y. (2019). The vulnerability to alcohol, tobacco, and drug use of adolescents in Hong Kong: A phenomenological study. BMC Pediatr., 19.","DOI":"10.1186\/s12887-019-1678-1"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"van den Brand, F., Nagtzaam, P., Nagelhout, G., Winkens, B., and van Schayck, C.P. (2019). The association of peer smoking behavior and social support with quit success in employees who participate in smoking cessation interventions in the workplace. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16162831"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Leshargie, C.T., Alebel, A., Kibret, G.D., Birhanu, M.Y., Mulugeta, H., Malloy, P., Wagnew, F., Ewunetie, A.A., Ketema, D.B., and Aderaw, A. (2019). The impact of peer pressure on cigarette smoking among high school and university students in Ethiopia: A systemic review and meta-analysis. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0222572"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/j.2044-8309.1989.tb00861.x","article-title":"Adolescent Smoking: Attitude, norms and parental influence","volume":"28","author":"Eiser","year":"1989","journal-title":"Br. J. Soc. Psychol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1006\/pmed.1998.0451","article-title":"Does Parental Smoking Cessation Discourage Adolescent Smoking?","volume":"28","author":"Farkas","year":"1999","journal-title":"Prev. Med."},{"key":"ref_56","first-page":"28","article-title":"Prevalence, smoking habit and factors related to smoking and nicotine addiction among lower secondary school male students in Kota Tinggi district, Johor, Malaysia","volume":"10","author":"Lim","year":"2010","journal-title":"Malays. J. Pub. Health Med."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Kovess, V., Pilowsky, D.J., Boyd, A., Pez, O., Bitfoi, A., Carta, M., Eke, C., Golitz, D., Kuijpers, R., and Lesinskiene, S. (2013). Parental Smoking in the Vicinity of Children and Tobacco Control Policies in the European Region. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0056783"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s12098-012-0768-y","article-title":"A Framework to Prevent and Control Tobacco among Adolescents and Children: Introducing the IMPACT Model","volume":"80","author":"Arora","year":"2013","journal-title":"Indian J. Pediatr."},{"key":"ref_59","first-page":"867","article-title":"Prohibiting tobacco advertising, promotions & sponsorships: Tobacco control best buy","volume":"137","author":"Arora","year":"2013","journal-title":"Indian J. Med. Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2597","DOI":"10.2174\/1381612824666180821165741","article-title":"Herbal and Holistic solutions for Neurodegenerative and Depressive disorders: Leads from Ayurveda","volume":"24","author":"Sharma","year":"2018","journal-title":"Curr. Pharm. Des."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1080\/14737175.2019.1596803","article-title":"Traditional Ayurvedic and herbal remedies for Alzheimer\u2019s disease: From bench to bedside","volume":"19","author":"Sharma","year":"2019","journal-title":"Expert. Rev. Neurother."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Sharma, R., Martins, N., Kuca, K., Chaudhary, A., Kabra, A., Rao, M.M., and Prajapati, P.K. (2019). Chyawanprash: A Traditional Indian Bioactive Health Supplement. Biomolecules, 26.","DOI":"10.3390\/biom9050161"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/8\/2868\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:09:11Z","timestamp":1760364551000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/8\/2868"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,21]]},"references-count":62,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,4]]}},"alternative-id":["ijerph17082868"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17082868","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,21]]}}}