1
|
Chen S, Underwood BR, Cardinal RN, Chen X, Chen S, Amin J, Jin H, Huang J, Mueller C, Yan LL, Brayne C, Kuper H. Temporal trends in population attributable fractions of modifiable risk factors for dementia: a time-series study of the English Longitudinal Study of Ageing (2004-2019). BMC Med 2024; 22:268. [PMID: 38926751 PMCID: PMC11210022 DOI: 10.1186/s12916-024-03464-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Interest in modifiable risk factors (MRFs) for dementia is high, given the personal, social, and economic impact of the disorder, especially in ageing societies such as the United Kingdom. Exploring the population attributable fraction (PAF) of dementia attributable to MRFs and how this may have changed over time remains unclear. Unravelling the temporal dynamics of MRFs is crucial for informing the development of evidence-based and effective public health policies. This investigation examined the temporal trajectories of MRFs for dementia in England. METHODS We used data from the English Longitudinal Study of Ageing, a panel study over eight waves collected between 2004 and 2019 (76,904 interviews in total). We calculated the PAFs for twelve MRFs (including six early- to mid-life factors and six late-life factors), as recommended by the Lancet Commission, and the individual weighted PAFs (IW-PAFs) for each risk factor. Temporal trends were analysed to understand the changes in the overall PAF and IW-PAF over the study period. Subgroup analyses were conducted by sex and socioeconomic status (SES). RESULTS The overall PAF for dementia MRFs changed from 46.73% in 2004/2005 to 36.79% in 2018/2019, though this trend was not statistically significant. During 2004-2019, hypertension, with an average IW-PAF of 8.21%, was the primary modifiable determinant of dementia, followed by obesity (6.16%), social isolation (5.61%), hearing loss (4.81%), depression (4.72%), low education (4.63%), physical inactivity (3.26%), diabetes mellitus (2.49%), smoking (2.0%), excessive alcohol consumption (1.16%), air pollution (0.42%), and traumatic brain injury (TBI) (0.26%). During 2004-2019, only IW-PAFs of low education, social isolation, and smoking showed significant decreasing trends, while IW-PAFs of other factors either did not change significantly or increased (including TBI, diabetes mellitus, and air pollution). Upon sex-specific disaggregation, a higher overall PAF for MRFs was found among women, predominantly associated with later-life risk factors, most notably social isolation, depression, and physical inactivity. Additionally, hearing loss, classified as an early- to mid-life factor, played a supplementary role in the identified sex disparity. A comparable discrepancy was evident upon PAF evaluation by SES, with lower income groups experiencing a higher dementia risk, largely tied to later-life factors such as social isolation, physical inactivity, depression, and smoking. Early- to mid-life factors, in particular, low education and obesity, were also observed to contribute to the SES-associated divergence in dementia risk. Temporal PAF and IW-PAF trends, stratified by sex and SES, revealed that MRF PAF gaps across sex or SES categories have persisted or increased. CONCLUSIONS In England, there was little change over time in the proportion of dementia attributable to known modifiable risk factors. The observed trends underscore the continuing relevance of these risk factors and the need for targeted public health strategies to address them.
Collapse
Affiliation(s)
- Shanquan Chen
- International Centre for Evidence in Disability, London, School of Hygiene & Tropical Medicine , London, WC1E 7HT, UK.
| | - Benjamin R Underwood
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
| | - Rudolf N Cardinal
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
| | - Xi Chen
- School of Public Health, Yale University, New Haven, CT, USA
| | - Shu Chen
- The ARC Centre of Excellence in Population Ageing Research (CEPAR), School of Risk and Actuarial Studies, University of New South Wales, Sydney, Australia
| | - Jay Amin
- Clinical Neurosciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Huajie Jin
- King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
- Institute for Global Health and Development, Peking University , Beijing, China
| | - Christoph Mueller
- King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Lijing L Yan
- Institute for Global Health and Development, Peking University , Beijing, China
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
- School of Public Health, Wuhan University, Wuhan, China
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Carol Brayne
- Institute of Public Health, Forvie Site, University of Cambridge, Cambridge, CB2 2SR, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London, School of Hygiene & Tropical Medicine , London, WC1E 7HT, UK
| |
Collapse
|
2
|
Jackson SE, Brown J, Beard E. Associations of Prevalence of E-cigarette Use With Quit Attempts, Quit Success, Use of Smoking Cessation Medication, and the Overall Quit Rate Among Smokers in England: A Time-Series Analysis of Population Trends 2007-2022. Nicotine Tob Res 2024; 26:826-834. [PMID: 38214664 PMCID: PMC11190046 DOI: 10.1093/ntr/ntae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/06/2023] [Accepted: 01/06/2024] [Indexed: 01/13/2024]
Abstract
INTRODUCTION This study aimed to (1) provide up-to-date estimates of how changes in the prevalence of e-cigarette use have been associated with changes in smoking cessation activities and use of licensed treatments among smokers in England and (2) explore any changes in these associations over time. METHODS Data were aggregated quarterly on 67 548 past-year smokers between Q1-2007 and Q4-2022. Explanatory variables were the prevalence of (1) current e-cigarette use among smokers and (2) e-cigarette use during a quit attempt. Outcomes were rates of quit attempts and overall quits among past-year smokers, and the quit success rate and use of licensed treatments among those who made a quit attempt. RESULTS The success rate of quit attempts increased by 0.040% (95% CI 0.019; 0.062) for every 1% increase in the prevalence of e-cigarette use during a quit attempt. No clear evidence was found for an association between current e-cigarette use and the quit attempt rate (Badj = 0.008 [95% CI -0.045; 0.061]) or overall quit rate (Badj = 0.063 [-0.031; 0.158]); or between use of e-cigarettes during a quit attempt and the overall quit rate (Badj = 0.030 [-0.054; 0.114]), use of prescription medication (varenicline/bupropion/nicotine replacement therapy [NRT]: Badj = -0.036 [-0.175; 0.102]), or use of over-the-counter NRT (Badj = -0.052 [-0.120; 0.015]). There was no clear evidence this pattern of associations has changed substantially over time. CONCLUSIONS Changes in the prevalence of e-cigarette use in England through 2022 have been positively associated with the success rate of quit attempts but not clearly associated with the quit attempt rate, overall quit rate, or use of licensed smoking cessation treatments. IMPLICATIONS If the association between the increase in e-cigarette use and the quit success rate is causal, then the use of e-cigarettes in quit attempts has helped in the region of 30 000 to 50 000 additional smokers in England to successfully quit each year since they became popular in 2013, over and above the number who were quitting before the advent of e-cigarettes.
Collapse
Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Emma Beard
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| |
Collapse
|
3
|
Jackson SE, Shahab L, Brown J. Examining the influence of tobacco control mass media campaign expenditure on the association between motivation to stop smoking and quit attempts: A prospective study in England. Addict Behav 2023; 144:107744. [PMID: 37126918 DOI: 10.1016/j.addbeh.2023.107744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To explore whether expenditure on national tobacco control mass media campaigns moderates the association between motivation to stop smoking and future quit attempts. METHOD Data were from 2601 people who smoke participating in a population survey with 12-month follow-up between April 2015 and February 2021. We used logistic regression to test associations of (i) baseline level of motivation to stop smoking, (ii) mean monthly tobacco control mass media campaign expenditure in England between baseline and follow-up, and (iii) their interaction, on past-year quit attempts assessed at 12-month follow-up. Covariates included age, sex, occupational social grade, and region. RESULTS Between baseline and follow-up, 38.6% of participants made a quit attempt. Each one-point increase in baseline motivation to stop smoking was associated with 1.37 times greater odds (95%CI = 1.31-1.43) of making a quit attempt over 12-month follow-up. Each one standard deviation increase in tobacco control mass media expenditure between baseline and 12-month follow-up was associated with 13% greater odds of making a quit attempt (95%CI = 1.05-1.23). There was no significant interaction between mass media expenditure and motivation to stop on quit attempts (OR = 1.01, 95%CI = 0.97-1.05); the data provided strong evidence for the null (Bayes factors = 0.07 and 0.04 based on expected effect sizes of OR = 1.5 and OR = 0.67, respectively). CONCLUSIONS Among people who smoke, self-reported level of motivation to stop strongly predicted whether they made a quit attempt in the subsequent year. Increased expenditure on tobacco control mass media campaigns was associated with increased quit attempts. The association between motivation and quit attempts did not differ according to tobacco control mass media expenditure over this period.
Collapse
Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK; SPECTRUM Consortium, UK.
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK; SPECTRUM Consortium, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK; SPECTRUM Consortium, UK
| |
Collapse
|
4
|
Groves S, McCutchan G, Quaife SL, Murray RL, Ostroff JS, Brain K, Crosbie PAJ, Yorke J, Baldwin D, Field JK, McWilliams L. Attitudes towards the integration of smoking cessation into lung cancer screening in the United Kingdom: A qualitative study of individuals eligible to attend. Health Expect 2022; 25:1703-1716. [PMID: 35514094 PMCID: PMC9327806 DOI: 10.1111/hex.13513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION There is limited research exploring how smoking cessation treatment should be implemented into lung cancer screening in the United Kingdom. This study aimed to understand attitudes and preferences regarding the integration of smoking cessation support within lung cancer screening from the perspective of those eligible. METHODS Thirty-one lung cancer screening eligible individuals aged 55-80 years with current or former smoking histories were recruited using community outreach and social media. Two focus groups (three participants each) and 25 individual telephone interviews were conducted. Data were analysed using the framework approach to thematic analysis. RESULTS Three themes were generated: (1) bringing lung cancer closer to home, where screening was viewed as providing an opportunity to motivate smoking cessation, depending on perceived personal risk and screening result; (2) a sensitive approach to cessation with the uptake of cessation support considered to be largely dependent on screening practitioners' communication style and expectations of stigma and (3) creating an equitable service that focuses on ease of access as a key determinant of uptake, where integrating cessation within the screening appointment may sustain increased quit motivation and prevent loss to follow-up. CONCLUSIONS The integration of smoking cessation into lung cancer screening was viewed positively by those eligible to attend. Screening appointments providing personalized lung health information may increase cessation motivation. Services should proactively support participants with possible fatalistic views regarding risk and decreased cessation motivation upon receiving a good screening result. To increase engagement in cessation, services need to be person-centred. PATIENT OR PUBLIC CONTRIBUTION This study has included patient and public involvement throughout, including input regarding study design, research materials, recruitment strategies and research summaries.
Collapse
Affiliation(s)
- Samantha Groves
- School of Health Sciences, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Grace McCutchan
- Wales Cancer Research Centre, Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
| | - Samantha L. Quaife
- Centre for Prevention, Detection and Diagnosis, Wolfson Institute of Population HealthQueen Mary University of LondonLondonUK
| | - Rachael L. Murray
- Academic Unit of Lifespan and Population Health, Faculty of MedicineUniversity of NottinghamNottinghamUK
| | - Jamie S. Ostroff
- Memorial Sloan‐Kettering Cancer Center, Behavioral Sciences ServiceNew YorkNew YorkUSA
| | - Kate Brain
- Wales Cancer Research Centre, Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
| | - Philip A. J. Crosbie
- LydiaBecker Institute of Immunology and Inflammation, Division of Immunology, Immunity to Infection and Respiratory MedicineThe University of ManchesterWythenshaweUK
| | - Janelle Yorke
- School of Health Sciences, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Christie Patient‐Centred Research, Division of Nursing, Midwifery and Social Work, The Christie NHS Foundation TrustThe University of ManchesterManchesterUK
| | - David Baldwin
- Department of Respiratory MedicineNottingham University Hospitals NHS TrustNottinghamUK
| | - John K. Field
- Institute of Systems, Molecular and Integrative Biology, Molecular and Clinical Cancer Medicine, Faculty of Health and Life SciencesUniversity of LiverpoolLiverpoolUK
| | - Lorna McWilliams
- School of Health Sciences, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| |
Collapse
|
5
|
Paolini M, Keeser D, Rauchmann BS, Gschwendtner S, Jeanty H, Reckenfelderbäumer A, Yaseen O, Reidler P, Rabenstein A, Engelbregt HJ, Maywald M, Blautzik J, Ertl-Wagner B, Pogarell O, Rüther T, Karch S. Correlations Between the DMN and the Smoking Cessation Outcome of a Real-Time fMRI Neurofeedback Supported Exploratory Therapy Approach: Descriptive Statistics on Tobacco-Dependent Patients. Clin EEG Neurosci 2022; 53:287-296. [PMID: 34878329 PMCID: PMC9174614 DOI: 10.1177/15500594211062703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/28/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study was to explore the potential of default mode network (DMN) functional connectivity for predicting the success of smoking cessation in patients with tobacco dependence in the context of a real-time function al MRI (RT-fMRI) neurofeedback (NF) supported therapy.Fifty-four tobacco-dependent patients underwent three RT-fMRI-NF sessions including resting-state functional connectivity (RSFC) runs over a period of 4 weeks during professionally assisted smoking cessation. Patients were randomized into two groups that performed either active NF of an addiction-related brain region or sham NF. After preprocessing, the RSFC baseline data were statistically evaluated using seed-based ROI (SBA) approaches taking into account the smoking status of patients after 3 months (abstinence/relapse).The results of the real study group showed a widespread functional connectivity in the relapse subgroup (n = 10) exceeding the DMN template and mainly low correlations and anticorrelations in the within-seed analysis. In contrast, the connectivity pattern of the abstinence subgroup (n = 8) primarily contained the core DMN in the seed-to-whole-brain analysis and a left lateralized correlation pattern in the within-seed analysis. Calculated Multi-Subject Dictionary Learning (MSDL) matrices showed anticorrelations between DMN regions and salience regions in the abstinence group. Concerning the sham group, results of the relapse subgroup (n = 4) and the abstinence subgroup (n = 6) showed similar trends only in the within-seed analysis.In the setting of a RT-fMRI-NF-assisted therapy, a widespread intrinsic DMN connectivity and a low negative coupling between the DMN and the salience network (SN) in patients with tobacco dependency during early withdrawal may be useful as an early indicator of later therapy nonresponse.
Collapse
Affiliation(s)
- Marco Paolini
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
| | - Daniel Keeser
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sarah Gschwendtner
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Hannah Jeanty
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Arne Reckenfelderbäumer
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Omar Yaseen
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Paul Reidler
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
| | - Andrea Rabenstein
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Hessel Jan Engelbregt
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Hersencentrum Mental Health Institute, Amsterdam, the
Netherlands
| | - Maximilian Maywald
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Janusch Blautzik
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Institute for Radiology and Nuclear
Medicine St. Anna, Luzern, Switzerland
| | - Birgit Ertl-Wagner
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Division of Neuro-Radiology, The Hospital for Sick Children,
University of Toronto, Toronto, Canada
| | - Oliver Pogarell
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Rüther
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
6
|
Levy DT, McNeill A, Jarvis MJ, Brown J, Li Y. Response to Braillon (2021): No, not the exception. Addiction 2021; 116:2924-2926. [PMID: 34159670 DOI: 10.1111/add.15618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 12/01/2022]
Affiliation(s)
| | | | | | | | - Yameng Li
- Georgetown University, Washington, DC, USA
| |
Collapse
|
7
|
Opazo Breton M, Britton J, Brown J, Beard E, Bogdanovica I. Was the implementation of standardised tobacco packaging legislation in England associated with changes in smoking prevalence? A segmented regression analysis between 2006 and 2019. Tob Control 2021; 32:tobaccocontrol-2021-056694. [PMID: 34326193 DOI: 10.1136/tobaccocontrol-2021-056694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/22/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND AIM In 2016, England initiated the implementation of standardised tobacco packaging, introduced in conjunction with minimum pack sizes and other measures included in the 2014 European Tobacco Products Directive, over the course of a 1-year sell-off period ending in May 2017. These measures have been shown to have been associated with increases in tobacco prices and product diversity. We now investigate the association between implementation of the new legislation and smoking status in England. DESIGN Segmented regression analysis of repeated cross-sectional surveys using a generalised linear model with individual-level data to test for a change in trend and immediate step change. SETTING England. PARTICIPANTS Participants in the Smoking Toolkit Study, which involves repeated, cross-sectional household surveys of individuals aged 16 years and older in England. The sample included 278 219 individual observations collected between November 2006 and December 2019. INTERVENTION Implementation of standardised packaging legislation (May 2016 and May 2017). MEASUREMENTS Individual-level current smoking status adjusted for implementation of tobacco control policies, cigarette price, seasonality and autocorrelation. FINDINGS The implementation of standardised packaging was associated with a significant step reduction in the odds of being a smoker after May 2017 (OR: 0.93; 95% CI 0.87 to 0.99). The magnitude of the association was similar when modelling the step change in May 2016 at the start of the 1-year policy implementation period (OR: 0.90; 95% CI: 0.83 to 0.97). CONCLUSIONS This is the first independent study demonstrating that implementation of standardised packaging was associated with a reduction in smoking in England which occurred in anticipation of, rather than after, full policy implementation. It appears that the odds of being a smoker were affected by the prospect of the move to standardised packs and accompanying legislation.
Collapse
Affiliation(s)
| | - John Britton
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Jamie Brown
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK
| | - Emma Beard
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Cancer Research UK Health Behaviour Research Centre, University College London, London, UK
| | | |
Collapse
|
8
|
Levy DT, Sánchez-Romero LM, Li Y, Yuan Z, Travis N, Jarvis MJ, Brown J, McNeill A. England SimSmoke: the impact of nicotine vaping on smoking prevalence and smoking-attributable deaths in England. Addiction 2021; 116:1196-1211. [PMID: 32949419 PMCID: PMC9364758 DOI: 10.1111/add.15269] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/14/2020] [Accepted: 09/11/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS Whereas the use of nicotine vaping products (NVPs) is widespread, their impact on smoking prevalence is controversial. This study considered the potential impact of NVPs on smoking prevalence in England. DESIGN Indirect simulation model. The England SimSmoke model is validated through 2012, before NVP use became more widely used by smokers. Because information on NVP-related transitions is limited, an indirect method is used; the difference in observed smoking prevalence (reflecting NVPs) is compared with a 2012-2019 counterfactual No-NVP scenario (without NVPs) to estimate the impact of NVPs on smoking and smoking-attributable deaths. SETTING England, 2000-2019. PARTICIPANTS Nationally representative sample of population. MEASUREMENTS England's population, mortality rates and smoking prevalence estimates from three national surveys and tobacco control policies. FINDINGS Between 2000 and 2012, SimSmoke projected a decline in age 18+ smoking prevalence of 23.5% in men and 27.0% in women. These projections, as well as those by specific age groups, were generally consistent with findings from the three national surveys. Comparing 2012-2019 relative reduction in age 18+ prevalence from the Annual Population Survey (males, 27.5%) with the model-predicted No-NVP reduction (males, 7.3%), the implied NVP-attributable relative reduction in adult smoking prevalence was 20.2% (95% CI, 18.8%-22.0%) for males and 20.4% (18.7%-22.2%) for females. The NVP-attributable reduction was 27.2% (22.8%-31.6%) for males and 31.7% (27.4%-36.5%) for females ages 18-24 and 18.6% (15.2%-21.8%) for males and 15.0% (11.1%-18.8%) for females ages 25-34, with similar reductions for ages 35+. The implied reduction in smoking prevalence between 2012 and 2019 equates to 165 660 (132 453-199 501) averted deaths by 2052. Other surveys yielded smaller, but relatively consistent results. CONCLUSIONS An indirect method of simulation modelling indicates that substantial reductions in smoking prevalence occurred in England from 2012-2019 coinciding with the growth in nicotine vaping product use.
Collapse
Affiliation(s)
- David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | | | - Yameng Li
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Zhe Yuan
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Nargiz Travis
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Martin J Jarvis
- Department of Behavioural Science and Health, University College London, Gower Street, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, Gower Street, London, UK
| | - Ann McNeill
- National Addiction Centre, King's College London, UK
| |
Collapse
|
9
|
Carpenter MJ, Hughes JR. If at First You Don't Try …. Nicotine Tob Res 2020; 22:1431-1432. [PMID: 32266393 DOI: 10.1093/ntr/ntaa062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/06/2020] [Indexed: 01/31/2023]
Affiliation(s)
- Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, SC.,Department of Public Health Sciences, MUSC, Charleston, SC.,Hollings Cancer Center, MUSC, Charleston, SC
| | - John R Hughes
- Department of Psychiatry, University of Vermont, Burlington, VT
| |
Collapse
|
10
|
Kotz D, Batra A, Kastaun S. Smoking Cessation Attempts and Common Strategies Employed. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 117:7-13. [PMID: 32008606 DOI: 10.3238/arztebl.2020.0007] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 06/11/2019] [Accepted: 10/10/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Clinical guidelines on smoking cessation contain recommendations for various evidence-based methods. The goal of this study was to provide a represen- tative analysis for Germany of the percentage of smokers who try to quit smoking at least once per year, the use of evidence-based methods and other methods of smoking cessation, and potential associations of the use of such methods with the degree of tobacco dependence and with socioeconomic features. METHODS Data from 19 waves of the German Smoking Behavior Questionnaire (Deutsche Befragung zum Rauchverhalten, DEBRA), from the time period June/July 2016 to June/July 2019, were analyzed. Current smokers and recent ex-smokers (<12 months without smoking) were asked about their smoking cessation attempts in the past year and the methods they used during the last attempt (naming more than one method was permitted). The degree of tobacco dependence in current smokers was assessed with the Heaviness of Smoking Index. RESULTS Out of 11 109 current smokers and 407 recent ex-smokers, 19.9% (95% confidence interval: [19.1; 20.6]) had tried to quit smoking at least once in the preceding year. 13.0% of them [11.6; 14.5] had used at least one evidence-based method during their last attempt. The stronger the tobacco dependence, the more likely the use of an evidence-based method (odds ratio [OR] = 1.27 [1.16; 1.40]). Pharmacotherapy (nicotine replacement therapy, medication) was used more com- monly by persons with higher incomes (OR = 1.44 per 1000 euro/month [1.28; 1.62]). Electronic cigarettes were the most commonly used single type of smoking cessation support (10.2 % [9.0; 11.6]). CONCLUSION In Germany, only one in five smokers tries to quit smoking at least once per year. Such attempts are only rarely supported by evidence-based methods and are thus likely to fail. The high cost of treatment must be borne by the individual and thus fall disproportionately on poorer smokers. It follows that there is an urgent need for vered by health insurance pro- viders, in order to give all smokers fair and equal access to the medical care they need.
Collapse
Affiliation(s)
- Daniel Kotz
- Institute of General Medicine, Addiction Research and Clinical Epidemiology Unit, Medical Faculty ofthe Heinrich-Heine University Düsseldorf; Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care,University College London, London, UK; Section for Addiction Medicine and Addiction Research, Department of Psychiatry and Psychotherapy, University Hospital and Faculty of Medicine, Tübingen
| | | | | |
Collapse
|
11
|
Beard E, Brown J, Jackson S, West R, Anderson W, Arnott D, Shahab L. Long-term evaluation of the rise in legal age-of-sale of cigarettes from 16 to 18 in England: a trend analysis. BMC Med 2020; 18:85. [PMID: 32264873 PMCID: PMC7140583 DOI: 10.1186/s12916-020-01541-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/20/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To assess the long-term impact of the increase in age-of-sale of cigarettes from 16 to 18 in England in October 2007. METHODS Data were collected between November 2006 and September 2018 on 252,601 participants taking part in a nationally representative survey of adults aged 16+ in England, the Smoking Toolkit Study (STS). We assessed the impact of the introduction of the increase in age-of-sale on prevalence of ever smoking, current smoking, and quit attempts, among 16-17 year olds compared with 18-24 year olds. RESULTS Following the increase in age-of-sale, there was a declining trend in ever smoking that was greater among 16-17 year olds than 18-24 year olds (OR 0.990 versus OR 0.993; p = 0.019). Data on current smoking were insensitive to detect a difference between the age groups in a step-level change or change in trend following the increase in age-of-sale (Bayes factors (BFs) 0.75 and 2.10). Data on quit attempts were also insensitive to detect a change in trend (BF 0.71), and despite a greater step-level decline among those aged 16-17 (OR 0.311 versus OR 0.547, p = 0.025), quit attempts remained higher among those aged 16-17. Secondary analysis indicated that post-policy change, trends in current and ever smoking were linear for 16-17 year olds but quadratic for 18-24 year olds (slowing decline). CONCLUSION There is some evidence from an assessment of long-term trends in the Smoking Toolkit Study that the increase in legal age-of-sale of cigarettes in England was associated with a greater long-term decline in ever smoking among those aged 16-17 compared with those aged 18-24.
Collapse
Affiliation(s)
- Emma Beard
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, UK
| | - Sarah Jackson
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, UK
| | | | | | - Lion Shahab
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, UK
| |
Collapse
|
12
|
Serrano-Alarcón M, Kunst AE, Bosdriesz JR, Perelman J. Retiring from smoking: Reply to Kleykamp (2019). Addiction 2020; 115:586-587. [PMID: 31691438 DOI: 10.1111/add.14879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 10/30/2019] [Indexed: 11/29/2022]
Affiliation(s)
| | - Anton E Kunst
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Jizzo R Bosdriesz
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Julian Perelman
- Escola Nacional de Saúde Pública, NOVA University of Lisbon, Lisbon, Portugal
- Centro de Investigação em Saúde Pública, Lisbon, Portugal
| |
Collapse
|