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Jackson AB, Gibbons FX, Fleischli ME, Haeny AM, Bold KW, Suttiratana SC, Fagan P, Krishnan-Sarin S, Gerrard M. Association of racial discrimination in health care settings and use of electronic cigarettes to quit smoking among Black adults. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 155:208985. [PMID: 36822270 PMCID: PMC10442461 DOI: 10.1016/j.josat.2023.208985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/28/2022] [Accepted: 02/12/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Black people are disproportionately burdened by tobacco-related diseases and are less successful at cigarette cessation with current treatments. We know little about the effectiveness of e-cigarettes as a smoking cessation method compared to currently approved methods in Black adults who smoke. Many Black adults report experiencing racial discrimination in health care, but if discrimination is related to utilization of smoking cessation aids including e-cigarettes and success with smoking cessation in this population is unclear. Therefore, this exploratory study aimed to understand how negative experiences and racial discrimination in health care influence use of e-cigarettes for cigarette cessation and success with cigarette cessation among Black adults. METHODS The study interviewed 201 Black adults who used cigarettes and tried to quit in their lifetime from the Family and Community Health Study in 2016. The study asked if they had tried and successfully quit cigarettes with e-cigarettes vs. other methods (support groups, medications, nicotine replacement therapies, call-in help lines, cold turkey [quit on their own], counseling) and asked about their negative experiences and racial discrimination in health care. We performed separate logistic regressions that evaluated the association of negative experiences and racial discrimination in health care with 1) use of e-cigarettes for cigarette cessation vs. other quitting methods and 2) success with cigarette cessation using any method among Black adults while controlling for age, sex, socioeconomic status, health insurance status, and age of onset of cigarette use. RESULTS More reported negative experiences and racial discrimination in health care were associated with ever trying to quit with e-cigarettes compared to other methods (OR:1.75, 95 % CI [1.05-2.91]), but negative experiences and racial discrimination in health care were not associated with cigarette quitting success. Interestingly, trying e-cigarettes was associated with being less successful at quitting compared to using other methods to quit smoking (OR: 0.40, 95 % CI [0.20, 0.81]). CONCLUSIONS These results suggest that educating health care professionals that anticipated discrimination in health care settings may be driving Black adults who smoke to engage in non-evidence-based smoking cessation practices, such as e-cigarettes instead of those that are evidence-based, and may be more effective in this population.
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Affiliation(s)
- Asti B Jackson
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America.
| | - Frederick X Gibbons
- Department of Psychological Sciences, University of Connecticut, United States of America
| | - Mary E Fleischli
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, United States of America
| | - Angela M Haeny
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
| | - Krysten W Bold
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
| | - Sakinah C Suttiratana
- Department of Chronic Disease Epidemiology, Yale School of Public Health, United States of America
| | - Pebbles Fagan
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, United States of America
| | | | - Meg Gerrard
- Department of Psychological Sciences, University of Connecticut, United States of America
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Chaiton M. Commentary on Stepankova et al. : Try, try, try again-smoking cessation clinics and their role in the cessation journey. Addiction 2021; 116:356-357. [PMID: 33191559 DOI: 10.1111/add.15304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/19/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Michael Chaiton
- Ontario Tobacco Research Unit, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Lubitz SF, Flitter A, Wileyto EP, Ziedonis D, Stevens N, Leone F, Mandell D, Kimberly J, Beidas R, Schnoll RA. History and Correlates of Smoking Cessation Behaviors Among Smokers With Serious Mental Illness. Nicotine Tob Res 2021; 22:1492-1499. [PMID: 31816049 DOI: 10.1093/ntr/ntz229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/06/2019] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Individuals with serious mental illness (SMI) smoke at rates two to three times greater than the general population but are less likely to receive treatment. Increasing our understanding of correlates of smoking cessation behaviors in this group can guide intervention development. AIMS AND METHODS Baseline data from an ongoing trial involving smokers with SMI (N = 482) were used to describe smoking cessation behaviors (ie, quit attempts, quit motivation, and smoking cessation treatment) and correlates of these behaviors (ie, demographics, attitudinal and systems-related variables). RESULTS Forty-three percent of the sample did not report making a quit attempt in the last year, but 44% reported making one to six quit attempts; 43% and 20%, respectively, reported wanting to quit within the next 6 months or the next 30 days. Sixty-one percent used a smoking cessation medication during their quit attempt, while 13% utilized counseling. More quit attempts were associated with lower nicotine dependence and carbon monoxide and greater beliefs about the harms of smoking. Greater quit motivation was associated with lower carbon monoxide, minority race, benefits of cessation counseling, and importance of counseling within the clinic. A greater likelihood of using smoking cessation medications was associated with being female, smoking more cigarettes, and receiving smoking cessation advice. A greater likelihood of using smoking cessation counseling was associated with being male, greater academic achievement, and receiving smoking cessation advice. CONCLUSIONS Many smokers with SMI are engaged in efforts to quit smoking. Measures of smoking cessation behavior are associated with tobacco use indicators, beliefs about smoking, race and gender, and receiving cessation advice. IMPLICATIONS Consideration of factors related to cessation behaviors among smokers with SMI continues to be warranted, due to their high smoking rates compared to the general population. Increasing our understanding of these predictive characteristics can help promote higher engagement in evidence-based smoking cessation treatments among this subpopulation.
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Affiliation(s)
- Su Fen Lubitz
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Alex Flitter
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - E Paul Wileyto
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA
| | - Douglas Ziedonis
- Department of Psychiatry, University of California, San Diego, CA
| | - Nathaniel Stevens
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Frank Leone
- Department of Medicine, Pulmonary, Allergy, & Critical Care Division, University of Pennsylvania, Philadelphia, PA
| | - David Mandell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - John Kimberly
- Department of Management, The Wharton School of Business, University of Pennsylvania, Philadelphia, PA
| | - Rinad Beidas
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA
| | - Robert A Schnoll
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Jacot Sadowski I, Rat C, Selby K, Cornuz J. Arrêt du tabac : comment mieux impliquer le patient dans le choix du traitement. Rev Mal Respir 2019; 36:625-632. [DOI: 10.1016/j.rmr.2018.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 06/28/2018] [Indexed: 11/30/2022]
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5
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Riahi F, Rajkumar S, Yach D. Tobacco smoking and nicotine delivery alternatives: patterns of product use and perceptions in 13 countries. F1000Res 2019; 8:80. [PMID: 31131094 PMCID: PMC6518446 DOI: 10.12688/f1000research.17635.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2019] [Indexed: 12/17/2023] Open
Abstract
Background: Smoking tobacco products remains a significant public health problem. The Foundation for a Smoke-Free World commissioned a 13-country survey to gain a clearer understanding of the current landscape of smoking behavior and preferences across the world. Methods: Over 17,000 participants in 13 countries, representing different regions and income groups, answered questions on their smoking patterns and product use, their social context, their motivation to smoke, quit, or switch, and their perception of risks of products and substances. Rim weighting was done for each country to align responses with population demographics, and an additional 200 smokers for each country were surveyed to achieve sufficient sample size for sub-analyses of smoker data. Results: The observed prevalence of smoking ranged from an age-adjusted high of 57.5% in Lebanon to 8.4% in New Zealand among men, with lower rates for women. The majority of smokers were between 25-54 years old, had daily routines and social patterns associated with smoking, used boxed cigarettes, and rated their health more poorly compared to never smokers. Among a range of products and substances, smokers tended to give both cigarettes and nicotine the highest harm ratings. Smokers in high income countries were largely familiar with electronic nicotine delivery systems; the most commonly given reasons for using them were to cut down or quit smoking. A majority of smokers had tried to quit at least once, and while many tried without assistance, motivations, intentions, and methods for smoking cessation, including professional help, nicotine replacement therapies or medications, or electronic cigarettes, varied among countries. Conclusions: Smoking is deeply integrated in smokers' lives worldwide. Although a majority of smokers have tried to quit, and are concerned for their health, they do not seek help. Smokers lack understanding of the harmful components of smoking tobacco products and the risk profile of alternatives.
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Affiliation(s)
- Farhad Riahi
- Health, Science & Technology, Foundation for a Smoke-Free World, Basel, 4052, Switzerland
| | - Sarah Rajkumar
- Health, Science & Technology, Foundation for a Smoke-Free World, Basel, 4052, Switzerland
| | - Derek Yach
- Foundation for a Smoke-Free World, New York, NY, 10017, USA
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Riahi F, Rajkumar S, Yach D. Tobacco smoking and nicotine delivery alternatives: patterns of product use and perceptions in 13 countries. F1000Res 2019; 8:80. [PMID: 31131094 PMCID: PMC6518446 DOI: 10.12688/f1000research.17635.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Smoking tobacco products remains a significant public health problem. The Foundation for a Smoke-Free World commissioned a 13-country survey to gain a clearer understanding of the current landscape of smoking behavior and preferences across the world. Methods: Over 17,000 participants in 13 countries, representing different regions and income groups, answered questions on their smoking patterns and product use, their social context, their motivation to smoke, quit, or switch, and their perception of risks of products and substances. Rim weighting was done for each country to align responses with population demographics, and an additional 200 smokers for each country were surveyed to achieve sufficient sample size for sub-analyses of smoker data. Results: The observed prevalence of smoking ranged from an age-adjusted high of 57.5% in Lebanon to 8.4% in New Zealand among men, with lower rates for women. The majority of smokers were between 25-54 years old, had daily routines and social patterns associated with smoking, used boxed cigarettes, and rated their health more poorly compared to never smokers. Among a range of products and substances, smokers tended to give both cigarettes and nicotine the highest harm ratings. Smokers in high income countries were largely familiar with electronic nicotine delivery systems; the most commonly given reasons for using them were to cut down or quit smoking. A majority of smokers had tried to quit at least once, and while many tried without assistance, motivations, intentions, and methods for smoking cessation, including professional help, nicotine replacement therapies or medications, or electronic cigarettes, varied among countries. Conclusions: Smoking is deeply integrated in smokers' lives worldwide. Although a majority of smokers have tried to quit, and are concerned for their health, they do not seek help. Smokers lack understanding of the harmful components of smoking tobacco products and the risk profile of alternatives.
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Affiliation(s)
- Farhad Riahi
- Health, Science & Technology, Foundation for a Smoke-Free World, Basel, 4052, Switzerland
| | - Sarah Rajkumar
- Health, Science & Technology, Foundation for a Smoke-Free World, Basel, 4052, Switzerland
| | - Derek Yach
- Foundation for a Smoke-Free World, New York, NY, 10017, USA
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Mai Y, Soulakova JN. Retrospective reports of former smokers: Receiving doctor's advice to quit smoking and using behavioral interventions for smoking cessation in the United States. Prev Med Rep 2018; 11:290-296. [PMID: 30116700 PMCID: PMC6082974 DOI: 10.1016/j.pmedr.2018.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/11/2018] [Accepted: 07/21/2018] [Indexed: 11/25/2022] Open
Abstract
The study investigated the over-time changes and racial/ethnic disparities in the quality of health care services for cigarette smoking cessation in the U.S. from 2007 to 2015. The primary measures included receiving a doctor's advice to quit smoking in the year before smoking cessation and using behavioral interventions for smoking cessation (telephone helplines and web-based interventions) while trying to quit smoking. The study was conducted from January to July 2018. We used merged data from the 2010-11 and 2014-15 Tobacco Use Supplement to the Current Population Survey. The sample sizes were 7011 and 12,025, respectively, for the analyses corresponding to two primary measures. The rate of receiving a doctor's advice to quit increased significantly from 66% (SE = 2%) in 2007 to 73% (SE = 4%) in 2015. The rate of usage of telephone helplines or web-based interventions for smoking cessation increased only from 3% (SE = 1%) in 2007 to 5% (SE = 1%) in 2015. These positive trends remained even after adjusting for several important factors. For both measures, the rates were consistently lower among Hispanic smokers than Non-Hispanic Black/African American and White smokers. Despite the availability of states' behavioral interventions for cessation of tobacco use, utilization of these interventions remains very low, indicating that smokers may not be aware of these free resources, may have misconceptions about these interventions being evidence-based, or there are barriers for using these interventions.
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Affiliation(s)
| | - Julia N. Soulakova
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32827, United States of America
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Yu M, Sacco P, Choi HJ, Wintemberg J. Identifying patterns of tobacco use among US middle and high school students: A latent class analysis. Addict Behav 2018; 79:1-7. [PMID: 29227789 DOI: 10.1016/j.addbeh.2017.11.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/17/2017] [Accepted: 11/24/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES This study sought to (a) understand patterns of tobacco use among US middle and high school students based on their lifetime or current use of tobacco products: cigarettes, cigars, chewing tobacco, pipes, e-cigarettes, and hookah tobacco, and (b) examine differences in the underlying patterns by sociodemographic and tobacco-related characteristics (e.g., exposure to tobacco products, tobacco advertising, parental disapproval of tobacco use and feedback from healthcare providers). METHODS We analyzed self-report data from the 2013 National Youth Tobacco Survey (n=18,046). Latent Class Analysis was conducted to identify patterns of tobacco use and tested how sociodemographic and tobacco-related characteristics are associated with such patterns. RESULTS Four subtypes of tobacco use were identified: "Very Low Risk (VLR)," "Lifetime Smoking (LS)," "Lifetime Multiple Tobacco Use (LMT)," and "Past Month Multiple Tobacco Use (PMT)." Latino and Asian American youth were more likely to be in PMT. Compared with students in LS, students in VLR were less likely to receive advice not to use tobacco from their healthcare providers, but more likely to have parental disapproval of smoking. Students in LMT (vs. LS) were more likely to use tobacco coupons and promotional materials, report greater access to tobacco, and receive advice from a healthcare professional. Students in PMT (vs. LS) were more likely to use coupons, take part in tobacco promotions, and be exposed to smoking in a vehicle. CONCLUSIONS Our study suggests that it may be important to consider the underlying patterns and correlates of tobacco use in designing tobacco control programs for youth.
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Rees R, Seyfoddin A. The effectiveness of naltrexone combined with current smoking cessation medication to attenuate post smoking cessation weight gain: a literature review. J Pharm Policy Pract 2017; 10:20. [PMID: 28702203 PMCID: PMC5504719 DOI: 10.1186/s40545-017-0109-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 06/29/2017] [Indexed: 11/10/2022] Open
Abstract
Background Smoking is the number one cause of preventable morbidity and mortality globally and although many countries have invested heavily in smoking cessation programs, 21% of the global population still smoke. Post cessation weight gain has been identified as a barrier to attempting cessation and is implicated in the high rates of relapse. Naltrexone has been touted as a possible solution to address post smoking cessation weight gain. Results The results from seven original studies assessing the effectiveness of naltrexone in combination with existing smoking cessation medications to attenuate post smoking cessation weight gain were obtained and critically reviewed. Five returned positive results and two returned results that were statistically insignificant. The positive results were seen more often in those identified as more likely to exhibit hedonic eating behaviour for example women and participants who were categorised as overweight or obese. Conclusion The evidence suggests further investigation in to a combination of naltrexone and approved smoking cessation medications is warranted and could provide a solution to attenuate post smoking cessation weight gain especially in women and those classified as overweight or obese. This may provide the tool required to remove a perceived barrier to smoking cessation and improve global statistics.
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Affiliation(s)
- Raewyn Rees
- School of Interprofessional Health Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Ali Seyfoddin
- School of Interprofessional Health Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.,Drug Delivery Research Group, School of Science, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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Çakir B, Taş A, Şanver TM, Aslan D. Doctor’s enquiry: an opportunity for promoting smoking cessation—findings from Global Adult Tobacco Surveys in Europe. Eur J Public Health 2017; 27:921-925. [DOI: 10.1093/eurpub/ckx094] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Huang K, Yang L, Winickoff JP, Liao J, Nong G, Zhang Z, Liang X, Liang G, Abdullah AS. The Effect of a Pilot Pediatric In-Patient Department-Based Smoking Cessation Intervention on Parental Smoking and Children's Secondhand Smoke (SHS) Exposure in Guangxi, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1109. [PMID: 27834840 PMCID: PMC5129319 DOI: 10.3390/ijerph13111109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/20/2016] [Accepted: 11/02/2016] [Indexed: 11/25/2022]
Abstract
Children's exposure to secondhand smoke (SHS) at home has numerous adverse health effects. This study evaluated the effects of a pediatric in-patient department-based pilot smoking cessation intervention for household members to reduce children's SHS exposure and encourage smoking cessation. A pre-post test design study was designed to assess the effectiveness of a telephone counseling intervention on household members of hospitalized children in pediatric departments. Data were collected with a standardized Chinese language questionnaire. At the three-month follow-up survey, the proportions of household members who reported adopting complete smoking restriction at home (55%), did not smoke at home at all (37%), did not allow others to smoke in the car (70%), or did not allow others to smoke around the child (57%) were significantly higher than the self-reported responses at the baseline survey. The proportions of household members who reported smoking at home (49%) and in the car (22%) were significantly lower than the baseline survey. Overall, 7% of the participants had reported quitting smoking after three months. Pediatric in-patient department-based telephone counseling for smoking cessation was found to be acceptable to Chinese parents. The intervention encouraged few parents to quit smoking, but encouraged more parents to take measures to reduce children's SHS exposure.
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Affiliation(s)
- Kaiyong Huang
- School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Li Yang
- School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Jonathan P Winickoff
- MGH Center for Child and Adolescent Health Research and Policy, Harvard Medical School, Boston, MA 02115, USA.
| | - Jing Liao
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Guangmin Nong
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Zhiyong Zhang
- School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Xia Liang
- Foreign Language School, Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Gang Liang
- Pharmaceutical School, Guangxi Medical University, Nanning 530021, Guangxi, China.
| | - Abu S Abdullah
- Global Health Program, Duke Kunshan University, Kunshan 215316, Jiangsu, China.
- Duke Global Health Institute, Duke University, Durham, NC 27708, USA.
- Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA.
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