Co-variation in dimensions of smoking behaviour: a multivariate analysis of individuals and communities in Canada

Global, regional, and national burdens of rheumatoid arthritis in young adults from 1990 to 2019

Introduction

Our aim was to analyze the regional and national levels of the global burden of rheumatoid arthritis (RA) among young adults (aged 15-49) in order to identify long-term trends.

Material and methods

The data for this study were obtained from the Global Burden of Disease Study (GBD) 2019, which assessed 369 diseases and injuries as well as 87 risk factors in 204 countries and 21 regions. To evaluate a nation's level of development, a composite statistic called the socio-demographic index (SDI) was utilized. We analyzed the age-standardized incidence rate (ASIR) and disability-adjusted life years (DALY) related to RA in individuals in young adults. Additionally, we estimated the annual percentage changes (EAPCs) for the aforementioned parameters.

Results

From 1990 to 2019, there was a positive trend in the ASIR of and age-standardized DALY rate due to RA in young adults. The high-SDI region experienced the highest ASIR and age-standardized DALY rates due to RA, with significant increases in these parameters during the same period (EAPC = 0.46 and 0.41, respectively). The region that witnessed the largest increase in the ASIR of RA in young adults was Andean Latin America (EAPC = 1.48), while Qatar had the largest increase among countries (EAPC = 2.30). Similarly, Andean Latin America recorded the largest increase in the age-standardized DALY rate due to RA (EAPC = 0.98), with Qatar having the largest increase among countries (EAPC = 2.01).

Conclusions

From 1990 to 2019, there was a notable increase in both the age-standardized DALY rates and ASIRs associated with RA in young adults. This positive trend was particularly evident in high-SDI regions. However, it is worth noting that the impact of RA on young adults in low-income areas of Andean Latin America was also substantial.

Socioeconomic status and lifestyle behaviours in cancer survivors: smoking and physical activity

PURPOSE

Smoking cessation and increased physical activity (pa) have been linked to better outcomes in cancer survivors. We assessed whether socioeconomic factors influence changes in those behaviours after a cancer diagnosis.

METHODS

As part of a cross-sectional study, a diverse group of cancer survivors at the Princess Margaret Cancer Centre (Toronto, ON), completed a questionnaire about past and current lifestyle behaviours and perceptions about the importance of those behaviours with respect to their health. The influence of socioeconomic indicators on smoking status and physical inactivity at 1 year before and after diagnosis were assessed using multivariable logistic regression with adjustment for clinico-demographic factors.

RESULTS

Of 1222 participants, 1192 completed the smoking component. Of those respondents, 15% smoked before diagnosis, and 43% of those smokers continued to smoke after. The proportion of survivors who continued to smoke increased with lower education level (p = 0.03). Of the 1106 participants answering pa questions, 39% reported being physically inactive before diagnosis, of whom 82% remained inactive afterward. Survivors with a lower education level were most likely to remain inactive after diagnosis (p = 0.003). Lower education level, household income, and occupation were associated with the perception that pa had no effect or could worsen fatigue and quality of life (p ≤ 0.0001).

CONCLUSIONS

In cancer survivors, education level was a major modifier of smoking and pa behaviours. Lower socioeconomic status was associated with incorrect perceptions about pa. Targeting at-risk survivors by education level should be evaluated as a strategy in cancer survivorship programs.

Association of regional and cultural factors with the prevalence of rheumatoid arthritis in the Mexican population: a multilevel analysis

BACKGROUND

The overall estimated prevalence of rheumatoid arthritis (RA) in Mexico is 1.6%, but there are major variations in different geographic areas of the country.

OBJECTIVE

This study aimed to determine the impact of individual and regional variables on the geographic distribution of RA in Mexico.

METHODS

This multilevel analysis used data from a cross-sectional study that investigated the prevalence of RA among 19,213 individuals older than 18 years throughout 5 geographic regions in Mexico. Logistic regression models were used to determine predictors of RA, including individual and regional variables as well as cultural factors. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were determined.

RESULTS

The prevalence of RA varied from 0.77% to 2.8% across the 5 regions. Individual factors associated with RA were sex (OR, 2.32; 95% CI, 1.74-3.07), previous medical diagnosis of RA ( OR 3.3, 95%CI: 2919–5.1 [corrected]), disability (OR, 2.07; 95% CI, 1.48-2.93), and the 56- to 65-year age group (OR, 1.95; 95% CI, 1.08-3.74). The regional factor of speaking an indigenous language had an OR of 2.27 (95% CI, 1.13-4.55).

CONCLUSIONS

Various individual and regional factors were associated with variations in the prevalence of RA in the Mexican population.

Tobacco use, smoking quit rates, and socioeconomic patterning among men and women: a cross-sectional survey in rural Andhra Pradesh, India

BACKGROUND

Tobacco use is common in India and a majority of users are in rural areas. We examine tobacco use and smoking quit rates along gender and socioeconomic dimensions in rural Andhra Pradesh.

DESIGN AND METHODS

Data come from a cross-sectional survey. Markers of socioeconomic status (SES) were education, occupation, and income. Regression analyses were undertaken to examine determinants of current smoking, smoking quit rates, tobacco use by type (cigarettes, bidis, and chewing), and quantity consumed (number per day, pack-years).

RESULTS

The weighted prevalence of current smoking and tobacco chewing was higher in men (50.3%, 95% confidence interval, CI, 48.1-52.6 and 5.0%, 95% CI 4.1-5.9, respectively) compared with women (4.8%, 95% CI 3.9-5.7 and 1.0%, 95% CI 0.6-1.4, respectively) and higher among older age groups. The quit rate was higher in women (45.5%, 95% CI 38.7-52.2) compared to men (18.8%, 95% CI 16.7-20.9). Illiterate individuals were more likely to be current smokers of any type compared to those with secondary/higher education (odds ratio, OR, 3.25, 95% CI 2.54-4.16), although cigarette smoking was higher in men of high SES. Smoking quit rates were positively associated with SES (OR 2.56, 95% CI 1.76-3.71) for secondary/higher education vs. illiterates. Level of consumption increased with SES and those with secondary/higher education smoked an additional 1.93 (95% CI 1.08-2.77) cigarettes or bidis per day and had an additional 1.87 (95% CI 0.57-3.17) pack-years vs. illiterates.

CONCLUSIONS

The social gradients in cigarette smoking and level of consumption contrasted those for indigenous forms of tobacco (bidi smoking and chewing). International prevention and cessation initiatives designed at modifying Western-style cigarette usage will need to be tailored to the social context of rural Andhra Pradesh to effectively influence the use of cigarettes and equally harmful indigenous forms of tobacco.