Comparing cigarette smoking knowledge and attitudes among smokers and non-smokers

Predictors of quitting smoking behavior: evidence from Pakistan

This study attempts to identify factors that significantly encourage the cessation of smoking in the context of Pakistan. The study distributes a modified questionnaire among 421 respondents (current as well as former smokers) in the capital city of Pakistan, Islamabad. The binary regression method was employed to data for analyzing predictors of making quit attempts and successful smoking cessation. The result indicates that respondents having strong intentions to quit, high socioeconomic status, low nicotine dependency, and past quit attempts, and those having no-smoking friends, are more likely to quit cigarette smoking successfully. On the other hand, factors like social pressure to quit smoking, religious information against smoking, intention to quit smoking, and public regulation on smoking are more likely to encourage smokers to make quit attempts. The study calls for community and school-wide smoking cessation campaigns involving officials, peers and parents, religious leaders, and other influential individuals to inform people about the dangers of smoking. In addition, religious leaders should be encouraged to issue rulings against smoking especially during "Friday Prayer." Furthermore, the government should pronounce more strict and comprehensive regulations on smoking by properly monitoring its implementation to encourage cessation of cigarette smoking.

Effects of smoke-free government policy in Qingdao, China: Evidence from the path analysis

Smoke-free government(SFG), as a key tobacco control measure, has been added in Healthy China 2030 blueprint and Qingdao started the establishment of the demonstrative SFG in 2020.This study examined the effects of SFG policy on smoking and smoke-free(SF) environment after establishing the demonstrative SFG. This cross-sectional survey selected participants by simple random sampling from party and government agencies in Qingdao (N = 3625) and the participants filled in questionnaires online from November 31 to December 15, 2020. We utilized AMOS to set up models to analyze the direct and indirect effects of SFG policy. The findings showed that knowledge of SFG policy was positively associated with SF environment(β = 0.29, P<0.001) and negatively associated with smoking(β = -0.14,P<0.001). Knowledge of SFG policy had indirect effects on SF environment through four channels: independent mediation of discouraging smoking and attitude towards SFG policy, as well as chain mediation of these two factors, and perception of tobacco hazards and discouraging smoking, with indirect effects accounting for 33.5% of the total effect. Knowledge of SFG policy had indirect effects on smoking reduction via SF environment and two chain mediation: SF environment and attitude towards SFG policy, perception of tobacco hazards and intention to quit smoking, with indirect effects accounting for 50.2% of the total effect. The results provided the evidence that SFG policy not only had positive effects on creating SF environment but also on reducing smoking. The efficient policy infiltration to individuals played a vital role in the establishment of SFG. Attitude towards SFG policy, discouraging smoking and SF environment were the potential mediators for SFG policy. Findings in this study added more evidence related to effect mechanism of SFG policy and had a positive influence on promoting the implementation SFG policies for China and other countries.

Determinants Analysis Regarding Household Chemical Indoor Pollution

Indoor household pollution is not yet sufficiently studied in the general population. Over 4 million people die prematurely every year due to air pollution in households. This study aimed to propose quantitative data research through the administration of a KAP (Knowledge, Attitudes, and Practices) Survey Questionnaire. This cross-sectional study administered questionnaires to adults from the metropolitan city of Naples (Italy). Three Multiple Linear Regression Analyses (MLRA) were developed, including Knowledge, Attitudes, and Behavior regarding household chemical air pollution and the related risks. One thousand six hundred seventy subjects received a questionnaire to be filled out and collected anonymously. The mean age of the sample was 44.68 years, ranging from 21-78 years. Most of the people interviewed (76.13%) had good attitudes toward house cleaning, and 56.69% stated paying attention to cleaning products. Results of the regression analysis indicated that positive attitudes were significantly higher among subjects who graduated, with older age, male and non-smokers, but they were correlated with lower knowledge. In conclusion, a behavioral and attitudinal program targeted those with knowledge, such as younger subjects with high educational levels, but do not engage in correct practices towards household indoor chemical pollution.

Gender differences in the price elasticity of demand for waterpipe and cigarette smoking in Lebanon, Jordan and Palestine: a volumetric choice experiment

OBJECTIVES

This study assessed the extent to which the elasticity of cigarette and waterpipe tobacco products differs between men and women. We also explored the levels of substitution and complementarity in tobacco products among men and women.

SETTING

The study examines tobacco elasticities in three Arab countries: Lebanon, Jordan and the West Bank of Palestine.

PARTICIPANTS

We used data from nationally representative surveys of adults aged ≥18 years in Lebanon (n=1680), Jordan (n=1925) and Palestine (n=1679). The proportion of women was 50.0% of the sample in Lebanon and Palestine, and 44.6% in Jordan.

PRIMARY AND SECONDARY OUTCOME MEASURES

A zero-inflated Poisson regression model estimated own-price and cross-price elasticities for two variations of cigarettes and five variations of waterpipe tobacco products. Elasticities were measured based on eight scenarios of prices.

RESULTS

Demand for waterpipe tobacco products was elastic for both men and women. The cross-price elasticities in the three countries indicate the existence of substitution between cigarettes and waterpipe products and by different varieties within each of the two tobacco products. Gender differences varied across the three countries whereby higher cross-price elasticities were observed for women in Jordan and Palestine. For example, the price elasticity for discount waterpipe was -1.4 and -0.6 for women and men in Jordan, respectively.

CONCLUSIONS

Results on the elasticity of demand for tobacco products and the existence of substitution between tobacco products reveal the higher responsiveness of men and women to changes in tobacco prices. This should be taken into consideration in tobacco control strategies particularly when reducing tobacco consumption via taxation policies.

Secondhand smoke in the densely populated urban setting: A cross-sectional survey of exposure, knowledge, attitudes, and respiratory symptoms

Secondhand smoke (SHS) remains a common health threat in densely populated, urban settings. We estimated the prevalence of exposure and associated respiratory symptoms, knowledge, attitudes, and behaviors in a multi-ethnic, weighted sample of Singapore residents using a cross-sectional survey of 1806 adults. We weighted data to match the national population in terms of gender, ethnicity, and education level and analyzed data using descriptive statistics, bivariate analyses, multiple linear and logistic regressions, and a multinomial logistic regression model. About 88% of respondents reported regular SHS exposure. Nearly 57% reported exposure to neighbors' SHS at home. Respiratory symptoms were reported by 32.5% and significantly associated with exposure to daily (AOR = 2.63, 95% CI = 1.62-4.36), non-daily (AOR = 1.75, 95% CI = 1.14-2.77), and neighbors' (AOR = 1.37, 95% CI = 1.07-1.76) SHS. More knowledge of SHS was associated with male gender (β = 0.28, p = 0.0009) and higher household income (linear trend; p = 0.0400). More negative attitudes to SHS were associated with older age (linear trend; p < 0.0001). Engaging in behaviors to avoid SHS was associated with a more negative attitude to SHS (AOR = 1.09-1.23). SHS exposure is common in Singapore's densely populated setting and associated with respiratory symptoms, even if exposure is non-daily or from neighboring homes.

Indicadores hospitalarios y comportamiento de pacientes internados en hospital psiquiátrico que adoptó la prohibición de fumar

Resumen Objetivo: comparar indicadores de internación, alta, costo con medicamentos y comportamientos de los pacientes antes y después de la prohibición del tabaquismo en un hospital psiquiátrico. Método: estudio ecológico, longitudinal y retrospectivo realizado en un hospital psiquiátrico. Fueron obtenidos datos secundarios, a partir de consulta a las fichas médicas, referentes a 2.142 internaciones. Fue aplicado el test de medianas para comparación de las variables antes y después de la prohibición. Resultados: con la implementación de la prohibición el porcentaje de ocupación de las camas fue reducido en las unidades masculinas de trastornos mentales (88,8% para 48,4%) y de dependencia química (94,4% para 42,8%). La media de días de internación fue reducida en la unidad masculina de dependencia química (13,5 para 12,6) en comparación con la unidad femenina (14,7 para 19,5). Los costos con psicofármacos y expectorantes, las agresiones verbales/físicas y las contenciones físicas/químicas fueron reducidas. Conclusión: la prohibición de fumar alteró los indicadores hospitalarios, redujo costos y mejoró el comportamiento de los pacientes, contrariando el mito de que esta resulta en hostilidad. Se espera que este estudio contribuya para que los enfermeros revisen sus creencias relacionadas con la prohibición del tabaquismo, considerando los resultados positivos para las relaciones interpersonales y para la administración de los servicios de salud mental, que fueron obtenidos.

Hospital indicators and inpatient behavior in a psychiatric hospital that implemented the smoking ban

Abstract Objective: to compare hospitalization and discharge indicators, medication costs and patient behavior before and after the implementation of the smoking ban in a psychiatric hospital. Method: ecological, longitudinal and retrospective study carried out in a psychiatric hospital. Secondary data referring to 2142 hospitalizations were collected from medical records. The median test was used to compare the variables before and after the ban. Results: after the implementation of the ban, there was a reduction in bed occupancy rate in male units for mental disorders (from 88.8% to 48.4%) and substance dependence (from 94.4% to 42.8%). There was a reduction in the mean length of hospital stay in the male chemical dependency unit (from 13.5 to 12.6) compared to the female unit (from 14.7 to 19.5). There was a reduction in costs of psychotropic drugs and expectorants, episodes of verbal/physical aggressions and physical/chemical restraints. Conclusion: the smoking ban changed hospital indicators, reduced costs and improved patient behavior, contradicting the myth that it results in hostility. It is hoped that this study will help nurses to review their beliefs related to smoking cessation, as there were positive results for interpersonal relationships and for the management of mental health services.

Hospital indicators and inpatient behavior in a psychiatric hospital that implemented the smoking ban

OBJECTIVE

to compare hospitalization and discharge indicators, medication costs and patient behavior before and after the implementation of the smoking ban in a psychiatric hospital.

METHOD

ecological, longitudinal and retrospective study carried out in a psychiatric hospital. Secondary data referring to 2142 hospitalizations were collected from medical records. The median test was used to compare the variables before and after the ban.

RESULTS

after the implementation of the ban, there was a reduction in bed occupancy rate in male units for mental disorders (from 88.8% to 48.4%) and substance dependence (from 94.4% to 42.8%). There was a reduction in the mean length of hospital stay in the male chemical dependency unit (from 13.5 to 12.6) compared to the female unit (from 14.7 to 19.5). There was a reduction in costs of psychotropic drugs and expectorants, episodes of verbal/physical aggressions and physical/chemical restraints.

CONCLUSION

the smoking ban changed hospital indicators, reduced costs and improved patient behavior, contradicting the myth that it results in hostility. It is hoped that this study will help nurses to review their beliefs related to smoking cessation, as there were positive results for interpersonal relationships and for the management of mental health services.

Gender and socioeconomic disparities in reasons for not smoking cigarettes among Danish adolescents

OBJECTIVE

To examine gender and socioeconomic differences in adolescents' reasons for not smoking cigarettes using self-reported data from Danish 14-year-olds (N = 1,559) collected in 2018. χ2-tests were used to assess whether the proportion of students who rated 12 statements as important reasons for not smoking cigarettes differed according to gender and family occupational social class (OSC).

RESULTS

More girls than boys stated that thinking the taste of cigarettes is disgusting, not being allowed to smoke by parents, knowing smoking is dangerous, not being allowed to smoke before the age of 18, not wanting to be addicted to smoking, and that smoking makes you smell bad were important reasons for choosing not to smoke cigarettes. More boys than girls reported exercising a lot and having a partner that does not smoke as important reasons for not smoking cigarettes. More students with a high OSC compared with a low OSC stated exercising a lot and that smoking makes you smell bad were important reasons. In conclusion, reasons for not smoking cigarettes differed substantially across gender and less according to socioeconomic position.

Hypoalbuminemia predicts the outcome of COVID-19 independent of age and co-morbidity

The coronavirus disease 2019 (COVID‐19) has evolved into a pandemic rapidly. Most of the literature show that the elevated liver enzymes in COVID‐19 are of little clinical significance. Lower albumin level is seen in severe COVID‐19 and is not parallel to the changes in alanine aminotransferase and aspartate aminotransferase levels. We aimed to explore the impact of hypoalbuminemia in COVID‐19. This retrospective cohort study included adult patients with confirmed COVID‐19. The relationship between hypoalbuminemia and death was studied using binary logistic analysis. A total of 299 adult patients were included, 160 (53.5%) were males and the average age was 53.4 ± 16.7 years. The median time from the onset of illness to admission was 3 days (interquartile ranges, 2‐5). Approximately one‐third of the patients had comorbidities. Hypoalbuminemia (<35 g/L) was found in 106 (35.5%) patients. The difference in albumin was considerable between survivors and non‐survivors (37.6 ± 6.2 vs 30.5 ± 4.0, P < .001). Serum albumin level was inversely correlated to white blood cell (r = –.149, P = .01) and neutrophil to lymphocyte ratio (r = −.298, P < .001). Multivariate analysis showed the presence of comorbidities (OR, 6.816; 95% CI, 1.361‐34.133), lymphopenia (OR, 13.130; 95% CI, 1.632‐105.658) and hypoalbuminemia (OR, 6.394; 95% CI, 1.315‐31.092) were independent predictive factors for mortality. In conclusion, hypoalbuminemia is associated with the outcome of COVID‐19. The potential therapeutic value of albumin infusion in COVID‐19 should be further explored at the earliest.

Individualized prediction nomograms for disease progression in mild COVID-19

The coronavirus disease 2019 (COVID‐19) has evolved into a pandemic rapidly. The majority of COVID‐19 patients are with mild syndromes. This study aimed to develop models for predicting disease progression in mild cases. The risk factors for the requirement of oxygen support in mild COVID‐19 were explored using multivariate logistic regression. Nomogram as visualization of the models was developed using R software. A total of 344 patients with mild COVID‐19 were included in the final analysis, 45 of whom progressed and needed high‐flow oxygen therapy or mechanical ventilation after admission. There were 188 (54.7%) males, and the average age of the cohort was 52.9  ± 16.8 years. When the laboratory data were not included in multivariate analysis, diabetes, coronary heart disease, T   ≥  38.5℃ and sputum were independent risk factors of progressive COVID‐19 (Model 1). When the blood routine test was included the CHD, T ≥ 38.5℃ and neutrophil‐to‐lymphocyte ratio were found to be independent predictors (Model 2). The area under the receiver operator characteristic curve of model 2 was larger than model 1 (0.872 vs 0.849, P = .023). The negative predictive value of both models was greater than 96%, indicating they could serve as simple tools for ruling out the possibility of disease progression. In conclusion, two models comprised common symptoms (fever and sputum), underlying diseases (diabetes and coronary heart disease) and blood routine test are developed for predicting the future requirement of oxygen support in mild COVID‐19 cases.

This study developed two models and visualized as nomogram for predicting the disease progression in mild COVID‐19. Model 1 only included symptoms and underlying diseases, which was more convenient for patients on self‐isolation to use. Blood routine tests have been added in model 2, which was mainly developed for doctors to assess the risk with simple laboratory examination and facilitated early decision making.