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Sassano M, Mariani M, Pastorino R, Ricciardi W, La Vecchia C, Boccia S. Association of national smoke-free policies with per-capita cigarette consumption and acute myocardial infarction mortality in Europe. J Epidemiol Community Health 2024; 78:388-394. [PMID: 38485217 PMCID: PMC11103332 DOI: 10.1136/jech-2023-220746] [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: 04/19/2023] [Accepted: 02/03/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Evidence on the association between smoke-free policies and per-capita cigarette consumption and mortality due to acute myocardial infarction (AMI) in Europe is limited. Hence, we aimed to assess this association and to evaluate which factors influence it. METHODS We performed an interrupted time series analysis, including 27 member states of the European Union and the UK, on per-capita cigarette consumption and AMI mortality.A multivariate meta-regression was used to assess the potential influence of other factors on the observed associations. RESULTS Around half of the smoke-free policies introduced were associated with a level or slope change, or both, of per-capita cigarette consumption and AMI mortality (17 of 35). As for cigarette consumption, the strongest level reduction was observed for the smoking ban issued in 2010 in Poland (rate ratio (RR): 0.47; 95% CI: 0.41, 0.53). Instead, the largest level reduction of AMI mortality was observed for the intervention introduced in 2012 in Bulgaria (RR: 0.38; 95% CI: 0.34, 0.42).Policies issued more recently or by countries with a lower human development index were found to be associated with a larger decrease in per-capita cigarette consumption. In addition, smoking bans applying to bars had a stronger inverse association with both cigarette consumption and AMI mortality. CONCLUSIONS The results of our study suggest that smoke-free policies are effective at reducing per-capita cigarette consumption and AMI mortality. It is extremely important to monitor and register data on tobacco, its prevalence and consumption to be able to tackle its health effects with concerted efforts.
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Affiliation(s)
- Michele Sassano
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Marco Mariani
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roberta Pastorino
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Luo Z, He X, Lv H, Wang Q, Jia W, Zhao Y, Li X, Yu J, Hao H, Bao Y, Chen N, Li X. Changing profiles of the burden of Alzheimer's disease and other dementias attributable to smoking in the belt and road initiative countries: A secondary analysis of global burden of disease 2019. Heliyon 2024; 10:e27935. [PMID: 38515688 PMCID: PMC10955296 DOI: 10.1016/j.heliyon.2024.e27935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024] Open
Abstract
Objectives This study was aimed at analyzing the burden and trend of Alzheimer's disease and other dementias attributed to smoking (SADD) in the Belt and Road Initiative (BRI) countries during 1990-2019. Methods Data from The 2019 Global Burden of Disease Study was used to extract information on the burden of SADD in terms of the numbers and age-standardized rate of mortality (ASMR) and disability-adjusted life years (ASDALR) in the BRI countries for 1990-2019. The average annual percent change (AAPC) was used to analyze the temporal trends of ASDALR from 1990 to 2019 and in the final decade by Joinpoint regression analysis. Results The DALYs of SADD were the highest in China, India, and the Russian Federation in 1990 and in Lebanon, Montenegro and Bosnia, and Herzegovina in 2019. From 1990 to 2019, the ASDALR in China had increased from 55.50/105 to 66.18/105, but decreased from 2010 to 2019, while that of India had declined from 32.84/105 to 29.35/105, but increased from 2010 to 2019. The ASDALR showed the fastest increase in the Russian Federation, with AAPC of 1.97% (95% confidence interval [CI]: 1.77%, 2.16%), and the fastest decline in Sri Lanka, with AAPC of -2.69% (95% CI: 2.79%, -2.59%). ASMR and ASDALR from SADD showed a substantial decline during 1990-2019 both globally and in the different socio-demographic index (SDI) regions (all P < 0.05, except for the high-middle-SDI region). Compared to the rates in males, the AAPC in ASDALR of females was significantly greater in 20 countries(all P < 0.05). In the age group of 20-54 years, the DALYs rate showed a decreasing trend only in 13 members in the low-SDI region (all P < 0.05). Conclusion Under the premise of eliminating the differences, mobilizing resources in the country itself, the BRI organization, and globally will help reduce the global SADD burden and achieve healthy and sustainable development.
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Affiliation(s)
- Zheng Luo
- Department of Neurology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, 200316, China
| | - Xin He
- Department of Neurology, Kaifeng 155 Hospital, Henan, 475003, China
| | - Huihui Lv
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China
| | - Qizhe Wang
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, 200032, China
| | - Wenchang Jia
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, 200032, China
- School of Public Health, Fudan University, Shanghai, 200032, China
| | - Yajun Zhao
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, 200032, China
| | - Xinyi Li
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, 200032, China
| | - Jiali Yu
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, 200032, China
| | - Hongyu Hao
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, 200032, China
| | - Yun Bao
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, 200032, China
| | - Nuo Chen
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, 200032, China
| | - Xiaopan Li
- Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, 200032, China
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Paraje G, Flores Muñoz M, Wu DC, Jha P. Reductions in smoking due to ratification of the Framework Convention for Tobacco Control in 171 countries. Nat Med 2024; 30:683-689. [PMID: 38321222 PMCID: PMC10957467 DOI: 10.1038/s41591-024-02806-0] [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: 08/07/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024]
Abstract
Smoking globally kills over half of long-term smokers and causes about 7 million annual deaths. The World Health Organization Framework Convention for Tobacco Control (FCTC) is the main global policy strategy to combat smoking, but its effectiveness is uncertain. Our interrupted time series analyses compared before- and after-FCTC trends in the numbers and prevalence of smokers below the age of 25 years (when smoking initiation occurs and during which response to interventions is greatest) and on cessation at 45-59 years (when quitting probably occurs) in 170 countries, excluding China. Contrasting the 10 years after FCTC ratification with the income-specific before-FCTC trends, we observed cumulative decreases of 15.5% (95% confidence interval = -33.2 to -0.7) for the numbers of current smokers and decreases of -7.5% (95% CI = -10.6 to -4.5) for the prevalence of smoking below age 25 years. The quit ratio (comparing the numbers of former and ever smokers) at 45-59 years increased by 1.8% (1.2 to 2.3) 10 years after FCTC ratification. Countries raising taxes by at least 10 percentage points concurrent with ratification observed steeper decreases in all three outcomes than countries that did not. Over a decade across 170 countries, the FCTC was associated with 24 million fewer young smokers and 2 million more quitters.
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Affiliation(s)
- Guillermo Paraje
- Business School, Universidad Adolfo Ibáñez, Santiago, Chile.
- Millennium Nucleus for the Evaluation and Analysis of Drug Policies, Santiago, Chile.
| | | | - Daphne C Wu
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Prabhat Jha
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Hossaini Motlagh A, Alinejad N, Kazembeigi F, Torkashvand J, Tashauoei HR, Fattahi M. Quality variations of leachate resulting from cigarette filter recycling as a challenge for its management. Sci Rep 2024; 14:972. [PMID: 38200131 PMCID: PMC10781975 DOI: 10.1038/s41598-024-51530-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/06/2024] [Indexed: 01/12/2024] Open
Abstract
Recycling is known as a solution for cigarette filter management, but this may cause the release of trapped pollutants in it. Cigarette smoke toxins and chemicals that trapped in the cigarette filter can accumulate in the recycling leachate. In this study, littered cigarette filters and freshly smoked cigarette filters were recycled and the resulting leachate was analyzed. The results showed that the minimum and maximum Chemical Oxygen Demand (COD) of the studied leachates were 2100 mg/L and 11,300 mg/L, respectively. The maximum temporal variation in the studied leachate quality was 74.28%, but the maximum spatial variation was 314.2%. COD in the freshly smoked sample was 2600-9200 mg/L more than the littered samples. The average concentration of chromium, lead, nickel, and cadmium in littered samples was 0.023, 0.024, 0.045, and 0.019 mg/L, respectively. Environmental conditions such as humidity, the efficiency of the urban cleaning system in reducing the resistance of littered filters, the difference in the quality of the filter and tobacco, and the difference in smoking behaviors were effective in this variation. Reducing the toxicity of cigarette smoke and improving the efficiency of the urban cleaning system can lead to the same quality, but leachate treatment is necessary to reduce the environmental risk.
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Affiliation(s)
- Amin Hossaini Motlagh
- Department of Environmental Health Engineering, Faculty of Health, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Navid Alinejad
- Department of Public Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Farogh Kazembeigi
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
- Department of Environmental Health Engineering, School of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Javad Torkashvand
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Tashauoei
- Department of Environmental Health Engineering, Faculty of Public Health and Biomedical Engineering, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Mehdi Fattahi
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam.
- School of Engineering & Technology, Duy Tan University, Da Nang, Vietnam.
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Lauzière A, Brisson D, Tremblay G, Bédard S, Khoury E, Gaudet D. Comparison of the burden of familial hypercholesterolemia between two cohorts of French Canadians hospitalized 25 years apart for coronary heart disease. J Clin Lipidol 2024; 18:e90-e96. [PMID: 38030518 DOI: 10.1016/j.jacl.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/25/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Familial hypercholesterolemia (FH) is associated with lifelong elevated plasma concentrations of low-density lipoprotein cholesterol (LDL-C) and high risk of premature coronary heart disease (CHD). Clinical recommendations and treatments have emerged to facilitate the management of FH patients. Their impact on the burden of FH is however not well documented. OBJECTIVE To compare the burden of FH between patients hospitalized for a CHD event 25 years apart in the French-Canadian founder population. METHODS Lipid profiles, cardiovascular risk factors, treatments and FH status of 2,029 patients consecutively hospitalized for an acute CHD event between 2017 and 2022 (2022 Cohort) were compared to those of 2,506 patients with angiographically-confirmed CHD who were admitted between 1995 and 1998 (1998 Cohort). RESULTS At the time of admission, 24.6 % of CHD patients had LDL-C levels >5.0 mmol/L in 1998 compared to 1.4 % in 2022, and FH was diagnosed in 9.6 % of patients in the 1998 cohort compared to 5.5 % in 2022 (p<0.001). FH patients hospitalized for a CHD event were older in 2022 than in 1998 (p <0.001). The prevalence of premature CHD requiring a hospitalization significantly decreased from 1998 to 2022 (64.3% vs. 44.1 %, p<0.001). At the moment of admission, 18.2 % of FH patients had LDL-C concentration <2.0 mmol/L in 2022 vs 0 % in 1998 (p <0.001). CONCLUSIONS Over 25 years, FH patients tend to be older and contribute to a lower proportion of hospitalizations for CHD in the French-Canadian founder population. Despite significant improvement in diagnosis and treatment, FH management remains however sub-optimal.
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Affiliation(s)
- Alex Lauzière
- Lipidology Unit, Community Genomic Medicine Center, Department of Medicine, Université de Montréal and ECOGENE-21 Clinical and Translational Research Center, Chicoutimi, Quebec, Canada; Lipid Clinic, Chicoutimi Hospital, Chicoutimi, Canada
| | - Diane Brisson
- Lipidology Unit, Community Genomic Medicine Center, Department of Medicine, Université de Montréal and ECOGENE-21 Clinical and Translational Research Center, Chicoutimi, Quebec, Canada
| | | | - Sophie Bédard
- Lipid Clinic, Chicoutimi Hospital, Chicoutimi, Canada
| | - Etienne Khoury
- Lipidology Unit, Community Genomic Medicine Center, Department of Medicine, Université de Montréal and ECOGENE-21 Clinical and Translational Research Center, Chicoutimi, Quebec, Canada
| | - Daniel Gaudet
- Lipidology Unit, Community Genomic Medicine Center, Department of Medicine, Université de Montréal and ECOGENE-21 Clinical and Translational Research Center, Chicoutimi, Quebec, Canada; Lipid Clinic, Chicoutimi Hospital, Chicoutimi, Canada.
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Geyer S, Tetzlaff J, Sperlich S, Safieddine B, Epping J, Eberhard S, Stahmeyer J, Beller J. Decreasing COPD-related incidences and hospital admissions in a German health insurance population. Sci Rep 2023; 13:21293. [PMID: 38042961 PMCID: PMC10693544 DOI: 10.1038/s41598-023-48554-y] [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: 03/06/2023] [Accepted: 11/28/2023] [Indexed: 12/04/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is associated with smoking and work-related health hazards. Most studies have reported prevalences, and the number of studies examining incidences and social inequalities is small. We analyzed the development of social inequalities of COPD-incidences in terms of income and exacerbations in terms of hospital admissions. Findings were based on claims data from a German statutory health insurance covering 2008 to 2019. Outpatient diagnoses were used for defining COPD-cases, hospital admissions were used for detecting exacerbations. Analyses were performed using Cox-regression. Individual incomes were depicted at three levels defined according to national averages for each year. Data of 3,040,137 insured men and women were available. From 2008 to 2019 COPD-incidences in men decreased by 42% and 47% in women. After stratification by income the reduction at the lowest income level was 41% and 50% in women. Respectively, at the highest income level reductions were 28% and 41%. Disease exacerbations decreased over time, and also social inequalities between income groups emerged. COPD-rates decreased over time at all income levels, but at a faster pace in the lowest income group, thus leading to a positive development of diminishing social gradients in men as well as in women.
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Affiliation(s)
- Siegfried Geyer
- Medical Sociology Unit, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
| | - Juliane Tetzlaff
- Medical Sociology Unit, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Stefanie Sperlich
- Medical Sociology Unit, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Batoul Safieddine
- Medical Sociology Unit, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Jelena Epping
- Medical Sociology Unit, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - Sveja Eberhard
- General Local Statutory Health Insurance of Lower Saxony, Hannover, Germany
| | - Jona Stahmeyer
- General Local Statutory Health Insurance of Lower Saxony, Hannover, Germany
| | - Johannes Beller
- Medical Sociology Unit, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
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Zuhal SH, Kimura T, Tamakoshi A. Association of the age at smoking initiation and cessation on all-cause and cause-specific mortality: The Japan Collaborative Cohort Study. NAGOYA JOURNAL OF MEDICAL SCIENCE 2023; 85:691-712. [PMID: 38155620 PMCID: PMC10751493 DOI: 10.18999/nagjms.85.4.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/11/2022] [Indexed: 12/30/2023]
Abstract
We estimated the association between the age at smoking initiation and cessation and all-cause and cause-specific mortality among Japanese men (n = 41,711; age 40-79 years) by analyzing data from the Japan Collaborative Cohort Study for the Evaluation of Cancer Risks. From 1988 and 1990 to 2009, 13,429 all-cause deaths (cancers, n = 4999; cardiovascular diseases, n = 3682) occurred in this cohort. Fitted Cox proportional hazard models, with never smokers as the reference group, were created. Former smokers demonstrated a lower risk for all-cause and cause-specific mortality than current smokers, with a dose-dependent reduction in the risk based on smoking-initiation age. Among former smokers who quit smoking aged 50 years or more, the highest hazard ratios were detected for those who started smoking at <20 years of age (all-cause, cancer, and cardiovascular disease mortality, hazard ratio [95% confidence interval] 1.51 [1.29-1.77], 1.68 [1.27-2.23], and 1.48 [1.12-1.96], respectively). Former smokers who quit smoking at <50 years of age had negligible all-cause or cardiovascular disease mortality regardless of the smoking-initiation age, whereas the cancer mortality risk remained significantly high among those who quit smoking at 40-49 years of age. Thus, smoking cessation significantly reduces the all-cause mortality risk; however, early initiation and later cessation do not provide a huge benefit, which earlier cessation does. Therefore, all smokers should be encouraged to quit smoking earlier in life regardless of their age at smoking initiation.
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Affiliation(s)
- Sulaiman Haares Zuhal
- Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Takashi Kimura
- Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, Japan
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Poirier MJ, Lin G, Watson LK, Hoffman SJ. Classifying European cigarette consumption trajectories from 1970 to 2015. Tob Control 2023; 32:559-566. [PMID: 34996862 PMCID: PMC10447409 DOI: 10.1136/tobaccocontrol-2021-056627] [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: 03/01/2021] [Accepted: 11/29/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To systematically code and classify longitudinal cigarette consumption trajectories in European countries since 1970. DESIGN Blinded duplicate qualitative coding of periods of year-over-year relative increase, plateau, and decrease of national per capita cigarette consumption and categorisation of historical cigarette consumption trajectories based on longitudinal patterns emerging from the data. SETTING 41 countries or former countries in the European region for which data are available between 1970 and 2015. RESULTS Regional trends in longitudinal consumption patterns identify stable or decreasing consumption throughout Northern, Western and Southern European countries, while Eastern and Southeastern European countries experienced much greater instability. The 11 emergent classes of historical cigarette consumption trajectories were also regionally clustered, including a distinctive inverted U or sine wave pattern repeatedly emerging from former Soviet and Southeastern European countries. CONCLUSIONS The open-access data produced by this study can be used to conduct comparative international evaluations of tobacco control policies by separating impacts likely attributable to gradual long-term trends from those more likely attributable to acute short-term events. The complex, regionally clustered historical trajectories of cigarette consumption in Europe suggest that the enduring normative frame of a gently sloping downward curve in cigarette consumption can offer a false sense of security among policymakers and can distract from plausible causal mechanisms among researchers. These multilevel and multisectoral causal mechanisms point to the need for a greater understanding of the political economy of regional and global determinants of cigarette consumption.
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Affiliation(s)
- Mathieu Jp Poirier
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
- School of Global Health, York University, Toronto, Ontario, Canada
| | - Gigi Lin
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
| | - Leah K Watson
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
| | - Steven J Hoffman
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, York University, Toronto, Ontario, Canada
- School of Global Health, York University, Toronto, Ontario, Canada
- Osgoode Hall Law School, York University, Toronto, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact and McMaster Health Forum, McMaster University, Hamilton, Ontario, Canada
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Long J, Zhai M, Jiang Q, Li J, Xu C, Chen D. The incidence and mortality of lung cancer in China: a trend analysis and comparison with G20 based on the Global Burden of Disease Study 2019. Front Oncol 2023; 13:1177482. [PMID: 37621689 PMCID: PMC10446846 DOI: 10.3389/fonc.2023.1177482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/26/2023] [Indexed: 08/26/2023] Open
Abstract
Background Lung cancer is a significant health concern in China. There is limited available data of its burden and trends. This study aims to evaluate the trends of lung cancer across different age groups and genders in China and the Group of Twenty (G20) countries, explore the risk factors, and predict the future trends over a 20-year period. Methods The data were obtained from the GBD study 2019. The number of cases, age standardized rate (ASR), and average annual percentage changes (AAPC) were used to estimate the trend in lung cancer by age, gender, region and risk factor. The trend of lung cancer was predicted by autoregressive integrated moving average (ARIMA) model by the "xtarimau" command. The joinpoint regression analysis was conducted to identify periods with the highest changes in incidence and mortality. Additionally, the relationship between AAPCs and socio-demographic index (SDI) was explored. Results From 1990 to 2019, both the incidence and mortality of lung cancer in China and G20 significantly increased, with China experiencing a higher rate of increase. The years with the highest increase in incidence of lung cancer in China were 1998-2004 and 2007-2010. Among the G20 countries, the AAPC in incidence and mortality of lung cancer in the Republic of Korea was the highest, followed closely by China. Although India exhibited similarities, its AAPC in lung cancer incidence and mortality rates was lower than that of China. The prediction showed that the incidence in China will continue to increase. In terms of risk factors, smoking was the leading attributable cause of mortality in all countries, followed by occupational risk and ambient particulate matter pollution. Notably, smoking in China exhibited the largest increase among the G20 countries, with ambient particulate matter pollution ranking second. Conclusion Lung cancer is a serious public health concern in China, with smoking and environmental particulate pollution identified as the most important risk factors. The incidence and mortality rates are expected to continue to increase, which places higher demands on China's lung cancer prevention and control strategies. It is urgent to tailor intervention measures targeting smoking and environmental pollution to contain the burden of lung cancer.
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Affiliation(s)
- Jianhai Long
- Department of Pulmonary and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medicine University, Beijing, China
| | - Mimi Zhai
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Qin Jiang
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiyang Li
- Department of Pulmonary and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medicine University, Beijing, China
| | - Cixian Xu
- Public Health Emergency Center, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Duo Chen
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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10
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Zheng Y, Shi Y, Ji Y, Liu X, Lin H, Chen M, Yun Q, Chang C. Defining indicators for the scoping stage of health impact assessment to evaluate tobacco control policy in the city of Beijing. BMC Public Health 2023; 23:1092. [PMID: 37280602 DOI: 10.1186/s12889-023-15982-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION Beijing initiated the nation's most comprehensive tobacco control program that adheres to the WHO Framework Convention on Tobacco Control. This study aimed to identify a set of indicators for the scoping of an Health Impact Assessment (HIA) to assess this policy. METHODS This study used a modified Delphi process. It proposed a tobacco control health impact framework based on the Driving forces- Pressure- State- Exposure- Effect- Action model and the Determinants of Health Theory. After a review of current surveillance system and literature, a working group of 13 experts with multidisciplinary background was established to formulate indicator evaluation criteria and conduct indicator scoring. Each indicator was scored by experts according to four evaluation criteria chosen. Indicators that obtained a total score above 80% and with standard error less than 5 were selected as the final set of indicators. Kendall's coefficient of concordance was calculated. RESULTS Twenty-three out of 36 indicators were selected. Smoking prevalence, mortality rate, hospital admission rate, tobacco consumption and hospital admission fees of smoking related diseases achieved more than 90% of total scores and ranked as the top five. Kendall's concordance coefficient was 0.218 for all indicators. For all model composition, Kendall's concordance coefficients were statistically significant. CONCLUSION This study identified a set of twenty-three indicators for scoping of HIA of a comprehensive tobacco control policy in Beijing based on a tobacco control health impact conceptual framework. The set of indicators achieved high scores and statistically significant consistency and has great potential to promote the evaluation of tobacco control policy in a global city. Further study might use the set of indicators for HIA on tobacco control policy to analyze empirical data.
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Affiliation(s)
- Yunting Zheng
- School of Health Management, Fujian Medical University, Fuzhou, 350122, China
- Department of Social Medicine and Health Education, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Yuhui Shi
- Department of Social Medicine and Health Education, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Ying Ji
- Department of Social Medicine and Health Education, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Xiurong Liu
- Beijing Center for Disease Prevention and Control, Beijing, 100013, China
| | - Haoxiang Lin
- Department of Social Medicine and Health Education, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China
| | - Meijun Chen
- University of Hong Kong, Hongkong, 999077, China
| | - Qingping Yun
- Shenzhen Institutes of Advanced Technology, Shenzhen, 518055, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China.
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Zheng Y, Shi Y, Ji Y, Chang C. Multiple streams approach to tobacco control policymaking in the capital city of the world's largest tobacco consuming country. Health Policy Plan 2023; 38:321-329. [PMID: 36639931 PMCID: PMC10019569 DOI: 10.1093/heapol/czad004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/25/2022] [Accepted: 01/13/2023] [Indexed: 01/15/2023] Open
Abstract
The aim of this study was to analyse the policymaking process of Beijing tobacco control regulations based on a multiple streams framework to provide a reference for other cities, at the national level and for the international community to promote the development of tobacco control policy. Twenty-one documents related to tobacco control in Beijing were collected, nine informants were interviewed and the interview data were analysed by a thematic framework method. It was found that indicators, feedback and a focus event in the problem stream drew the attention of policymakers and the society for tobacco control. In 2011, Ying Songnian, a representative of the Beijing Municipal People's Congress, put forward tobacco control legislation, which was just in time for the legislative reform of the Congress. The proposal was studied by the Congress, and a strategy of 'social co-governance' was founded. In the political stream, the government actively promoted tobacco control and social organizations extensively participated in it. In 2013, the General Office of the Central Committee of the Chinese Communist Party and the General Office of the State Council issued a notice on matters related to leading cadres taking the lead in banning smoking in public places, which opened a policy window for decision-makers who were hesitatant. The issue of tobacco control was successfully put on the policy agenda and contributed to the introduction of the Beijing Municipal Regulations on Smoking Control. Development of the factors in problem stream, policy stream and political stream promoted the setting up of the tobacco control policy agenda in Beijing. It is suggested that more cities should learn from the experience of Beijing, seize the opportunity of the ideological change of the ruling party, actively identify the problems, mobilize and advocate for representatives and introduce the concept of 'social co-governance' to promote tobacco control legislation.
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Affiliation(s)
- Yunting Zheng
- School of Health Management, Fujian Medical University, NO. 1 Xue Yuan Road, University Town, FuZhou, Fujian 350122, China
- School of Public Health, Peking University, NO. 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Yuhui Shi
- School of Public Health, Peking University, NO. 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Ying Ji
- School of Public Health, Peking University, NO. 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Chun Chang
- School of Public Health, Peking University, NO. 38 Xue Yuan Road, Haidian District, Beijing 100191, China
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12
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Rezakhani L, Darbandi M, Khorrami Z, Rahmati S, Shadmani FK. Mortality and disability-adjusted life years for smoking-attributed cancers from 1990 to 2019 in the north Africa and middle east countries: a systematic analysis for the global burden of disease study 2019. BMC Cancer 2023; 23:80. [PMID: 36694168 PMCID: PMC9875390 DOI: 10.1186/s12885-023-10563-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
AIM AND BACKGROUND Smoking is a modifiable risk factor for cancers. The aim of the study is to estimate the trend of mortality and DALYs of smoking-attributed cancers in the North Africa and Middle East (NAME) countries. METHODS In this study, estimates from the Global Burden of Disease 2019 (GBD-2019) study were used to report the mortality and DALYs for 16 smoking-attributed cancers. The mortality and DALYs rates from smoking-attributed cancers were evaluated by age, sex, and the 21 countries of the NAME countries from 1990 to 2019. RESULTS Age standardized mortality rates (ASMR) for the 29 smoking-attributed cancers in the NAME countries in 1990 and 2019 were estimated to be 24.7 (95% Uncertainty Interval: 21.5, 27.8) and 22.4 (95%UI: 19.8, 25.4) respectively, which shows a 9.2% decrease in the three decades. DALYs/100,000 for smoking-attributed cancers was, also, estimated to be 600.3 (95%UI: 521.6, 682.6) and 515.6 (95%UI: 454.9, 585.4) respectively, which indicates a 14.1% decreased in these three decades. In the last three decades, the percentage changes in DALYs/100,000 for smoking-attributed cancers in males and females were - 0.16 and - 0.03, respectively. Plus, The percentage changes in ASMR in males and females were - 12% and 8%, respectively. Furthermore, The highest ASMR and DALYs were observed in Lebanon, Turkey, and Palestine in 2019. CONCLUSION The mortality rates of cancers from smoking have increased substantially among females, in most countries of the NAME region, in recent years. The burden caused by smoking can be reduced through modifying lifestyle and applying strict laws on smoking by governments and policymakers.
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Affiliation(s)
- Leila Rezakhani
- grid.412112.50000 0001 2012 5829Fertility and Infertility Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran ,grid.412112.50000 0001 2012 5829Department of Tissue Engineering, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Darbandi
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Khorrami
- grid.411600.2Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shima Rahmati
- grid.440801.90000 0004 0384 8883Cancer Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Fatemeh Khosravi Shadmani
- grid.412112.50000 0001 2012 5829Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Wu Y, Wang Z, Zheng Y, Wang M, Wang S, Wang J, Wu J, Wu T, Chang C, Hu Y. Trends in Hospital Admissions for Chronic Obstructive Pulmonary Diseases After Comprehensive Tobacco Control Policies in Beijing, China. Nicotine Tob Res 2022; 24:1978-1984. [PMID: 35808957 DOI: 10.1093/ntr/ntac137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 04/12/2022] [Accepted: 05/30/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Only a few studies have examined the effectiveness of tobacco control policies on respiratory conditions, and the results were less consistent. The 2015 Beijing tobacco control policy package incorporating all six components of MPOWER has been implemented since Jun 2015. The present study aimed to evaluate the impact of a comprehensive tobacco control policy package on hospital admissions for chronic obstructive pulmonary disease (COPD) in Beijing, China. AIMS AND METHODS An interrupted time-series study was conducted based on the hospital admission information for about 18 million residents, who were covered by the Beijing Medical Claim Data for Employees from January 2013 to June 2017. The average percentage change of COPD hospital admission rates and reductions in hospital admission numbers were estimated by segmented Poisson regression models. RESULTS There were 54 040 COPD hospital admissions with a crude rate of 67.2 per 100 000 residents during the observational period. After the implementation of the policy package, the hospital admission rates of COPD were reduced by -14.7% (95%CI: -17.8%, -11.5%) immediately. The secular trend was slowed down by -3.0% (95% CI: -5.6%, -0.4%) annually. A total of 5 581 reductions in COPD hospital admissions were estimated during the 25 months post-law period, accounting for 17.5% (95% CI: 12.5%, 22.5%) of overall COPD hospital admissions. More reductions were shown in males and those aged over 65 years old. CONCLUSIONS The results indicated significant protections against hospitalization of COPD after the 2015 Beijing comprehensive tobacco control policy package. The results provide support for public health benefits for respiratory conditions from WHO-recommended tobacco control measures. IMPLICATIONS Only a few studies have examined the effectiveness of tobacco control policies on respiratory conditions, and the results were less consistent. Based on medical records for about 18 million residents, this study showed an association between comprehensive tobacco control policies and significant reductions of hospital admissions for chronic obstructive pulmonary disease. The results provide support for public health benefits for respiratory conditions from WHO-recommended tobacco control measures.
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Affiliation(s)
- Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Zijing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
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Su Z, McDonnell D, Cheshmehzangi A, Ahmad J, Šegalo S, da Veiga CP. A call to ban the sale of tobacco products. Front Public Health 2022; 10:904971. [PMID: 36438262 PMCID: PMC9684640 DOI: 10.3389/fpubh.2022.904971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/26/2022] [Indexed: 11/12/2022] Open
Abstract
Tobacco is both toxic and addictive. Mounting evidence shows that tobacco use has a detrimental impact on almost every aspect of human health, causing or worsening deadly public health crises from the cancer epidemic to the COVID-19 pandemic. However, while tobacco use is a threat to both personal and public health, it continues to surge across the world, especially in China and other low- and middle-income countries. To this end, this article argues in favor of using a ban on the sale of all tobacco products as a practical solution to the global tobacco use epidemic. It is our hope that insights provided by our work will inspire swift policy actions in countries such as China and beyond to curb the tide of rising tobacco consumption, so that populations around the world could be better shielded from the pervasive and long-lasting damage that tobacco products cause or compound.
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Affiliation(s)
- Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China,*Correspondence: Zhaohui Su
| | - Dean McDonnell
- Department of Humanities, Institute of Technology Carlow, Carlow, Ireland
| | - Ali Cheshmehzangi
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China,Network for Education and Research on Peace and Sustainability, Hiroshima University, Hiroshima, Japan
| | | | - Sabina Šegalo
- Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Fried ND, Oakes JM, Whitehead AK, Lazartigues E, Yue X, Gardner JD. Nicotine and novel tobacco products drive adverse cardiac remodeling and dysfunction in preclinical studies. Front Cardiovasc Med 2022; 9:993617. [PMID: 36277777 PMCID: PMC9582354 DOI: 10.3389/fcvm.2022.993617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background The heart undergoes structural and functional changes in response to injury and hemodynamic stress known as cardiac remodeling. Cardiac remodeling often decompensates causing dysfunction and heart failure (HF). Cardiac remodeling and dysfunction are significantly associated with cigarette smoking. Although cigarette smoking has declined, the roles of nicotine and novel tobacco products (including electronic cigarettes and heat-not-burn tobacco) in cardiac remodeling are unclear. In this perspective, we present evidence demonstrating maladaptive cardiac remodeling in nicotine-exposed mice undergoing hemodynamic stress with angiotensin (Ang)-II infusion and review preclinical literature linking nicotine and novel tobacco products with cardiac remodeling and dysfunction. Methods Adult, male C57BL/6J mice were exposed to room air or chronic, inhaled nicotine for 8 weeks. A subset of mice was infused with Ang-II via subcutaneous osmotic mini-pumps during the final 4 weeks of exposure. Left ventricular structure and function were assessed with echocardiography. Results Chronic, inhaled nicotine abrogated Ang-II-induced thickening of the left ventricular posterior wall, leading to reduced relative wall thickness. Ang-II infusion was associated with increased left ventricular mass index in both air- and nicotine-exposed mice. Conclusions These changes suggest a phenotypic shift from concentric hypertrophy to eccentric hypertrophy in nicotine-exposed, hemodynamically-stressed mice which could drive HF pathogenesis. These findings join a growing body of animal studies demonstrating cardiac remodeling and dysfunction following nicotine and electronic cigarette exposure. Further exploration is necessary; however, clinicians and researchers should not overlook these emerging products as potential risk factors in the pathogenesis of cardiac remodeling and associated diseases including HF.
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Affiliation(s)
- Nicholas D. Fried
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Joshua M. Oakes
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Anna K. Whitehead
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Eric Lazartigues
- Department of Pharmacology & Experimental Therapeutics, Louisiana State University Health Sciences Center, New Orleans, LA, United States,Cardiovascular Center of Excellence, New Orleans, LA, United States,Neuroscience center of Excellence, Louisiana State University Health Sciences Center, New Orleans, LA, United States,Southeast Louisiana Veterans Health Care Systems, New Orleans, LA, United States
| | - Xinping Yue
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Jason D. Gardner
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, LA, United States,*Correspondence: Jason D. Gardner
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16
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Zhao Y, Di X, Li S, Zeng X, Wang X, Nan Y, Xiao L, Koplan J, Chen Z, Liu S. Prevalence, frequency, intensity, and location of cigarette use among adolescents in China from 2013-14 to 2019: Findings from two repeated cross-sectional studies. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 27:100549. [PMID: 35923777 PMCID: PMC9340429 DOI: 10.1016/j.lanwpc.2022.100549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The burden of disease caused by tobacco use is a grave public health concern in China. Preventing smoking initiation among adolescents will lower the prevalence of adult tobacco use later. Surveillance of tobacco use among adolescents helps set priorities in developing tobacco control policies. We aim to ascertain the prevalence and differences of cigarette use across sex, grade, and region among middle and high school students in 2019 and associated changes from 2013-14 to 2019 among middle school students. METHODS Using a multistage stratified cluster-randomized sampling design with national and provincial representativeness, we conducted two school-based cross-sectional surveys in 2013-14 and in 2019. A total of 155 117 middle school students in grades 7-9 in 2013-14 and 288 192 middle and high school students in grades 7-12 in 2019 were interviewed. Self-reported experimental and current (past 30-day) cigarette use among middle school and high school students; frequent use (≥20 days in the past 30 days) and intensity (>20 cigarettes per day) of smoking among current cigarette users; and location of smoking among current cigarette users were investigated. All estimates were weighted based on the complex sampling design. FINDINGS The 2013-14 survey (overall response rate: 98.1%) included 155 117 middle school students (47.1% girl). The 2019 survey (overall response rate: 98.7%) included 147 270 middle school students (46.5% girl), 106 432 academic high school students (50.8% girl) and 34 490 vocational high school students (43.8% girl). In 2019, the prevalence rate of experimental and current cigarette use was 12.9% and 3.9% for middle school students, 21.6% and 5.6% for academic high school students, and 30.3% and 14.7% for vocational high school students, respectively, with large sex and regional differences. The prevalences of smoking on 20 or more days and daily cigarette use in the past 30 days were higher in vocational high school (5.9%, 4.1%) than in academic high school (1.8%, 1.2%) and middle school (0.7%, 0.5%), and higher among boys than girls. The proportions of current cigarette users smoking more than 20 cigarettes per day in the past 30 days for girls were higher than for boys in academic high school. Students usually smoke at school and at home. Boys were more likely to use cigarettes in an internet cafe, while girls often smoked at social venues. From 2013-14 to 2019, the prevalences of experimental and current cigarette use declined by 5.0% and 2.0% (percentage points), respectively, among middle school students but increased by 1.4% and 0.5% (percentage points) among rural girls. Among current cigarette users in middle school students, the proportions of heavy cigarette use (>20 cigarettes per day) have increased by 1.8 percentage points, mainly among boys, by 2.2% (percentage points). INTERPRETATION From 2013-14 to 2019, the prevalences of experimental and current cigarette use among middle school students decreased overall but increased among rural girls, while the intensity of cigarette use rose among boys. Cigarette use among Chinese adolescents differs across sex and regions, with higher rates among boys, in rural areas, and in the Western region (low socioeconomic status). Smoking is much more prevalent in vocational high schools than the other settings. Effective targeted tobacco control interventions among adolescents are urgently needed in China. FUNDING Dr. Zhuo Chen is supported by National Natural Science Foundation (Grant#: 72174098) through the University of Nottingham Ningbo China.
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Affiliation(s)
- Yan Zhao
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, 27# Nanwei Road, Xicheng District, Beijing 100050, China
- Department of Public Health, School of Public Health, Inner Mongolia Medical University, Huhehot, Inner Mongolia 010110, China
| | - Xinbo Di
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, 27# Nanwei Road, Xicheng District, Beijing 100050, China
| | - Sixuan Li
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, 27# Nanwei Road, Xicheng District, Beijing 100050, China
- Ningbo Municipal Center for Disease Control and Prevention, 237# Yongfeng Road, Haishu District, Ningbo, Zhejiang Province 315010, China
| | - Xinying Zeng
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, 27# Nanwei Road, Xicheng District, Beijing 100050, China
| | - Xiaofeng Wang
- Information Center, Chinese Center for Disease Control and Prevention, 155# Changbei Road, Changping District, Beijing 102206, China
| | - Yi Nan
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, 27# Nanwei Road, Xicheng District, Beijing 100050, China
| | - Lin Xiao
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, 27# Nanwei Road, Xicheng District, Beijing 100050, China
| | - Jeffrey Koplan
- Emory Global Health Institute, Emory University, Atlanta 30322 Georgia, USA
| | - Zhuo Chen
- College of Public Health, University of Georgia, Athens 30602 Georgia, USA
- School of Economics, University of Nottingham Ningbo China 315100 Ningbo, Zhejiang Province, China
| | - Shiwei Liu
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, 27# Nanwei Road, Xicheng District, Beijing 100050, China
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Zyambo C, Olowski P, Mulenga D, Liamba F, Syapiila P, Siziya S. School tobacco-related curriculum and behavioral factors
associated with cigarette smoking among school-going
adolescents in Zambia: Results from the 2011 GYTS study. Tob Induc Dis 2022; 20:42. [PMID: 35592593 PMCID: PMC9069453 DOI: 10.18332/tid/146960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 12/16/2021] [Accepted: 02/25/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Tobacco smoking is a global public health concern. It has been projected that children and young people who are alive today in developing countries will bear the most burden of tobacco-related morbidity and mortality in the near future. This study investigated the school tobacco-related curriculum and behavioral factors associated with cigarette smoking among school-going adolescents. METHODS We accessed secondary data in a public domain collected using a cross-sectional study design. Altogether, 3377 seventh to ninth grade students were selected by stratified two-stage cluster sampling. Data were collected using a Global Youth Tobacco Survey (GYTS) Core Questionnaire. Multivariate logistic regression models were used to determine associations of school tobacco-related curriculum and behavioral factors with current cigarette smoking status. Adjusted odds ratios and their 95% confidence intervals are reported. RESULTS Of the 2611students included in the analysis, 6.8% (7.8% of males and 5.8% of females) reported smoking cigarettes. Slightly over half of the students were taught in schools about the effects of smoking (53.6%) and the dangers of smoking (64.1%). Adolescents who had friends who smoked were more likely to smoke compared to those who did not have friends who smoked. Adolescents whose parents smoked were more likely to smoke compared to those who did not have parents who smoked. Adolescents who were not taught at school about the dangers of smoking, or were not sure about it, were more likely to smoke compared to those who were taught (AOR=1.94; 95% CI: 1.28–2.94). CONCLUSIONS Schools play an important role in shaping smoking behavior among school-going adolescents. Based on our findings, school programs aimed at reducing cigarette smoking among school-going adolescents may achieve greater impact by implementing anti-smoking interventions that involve parents and peers in smoking prevention activities, and have a robust tobacco school curriculum.
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Affiliation(s)
- Cosmas Zyambo
- Department of Community and Family Medicine, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Pawel Olowski
- Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia
| | - David Mulenga
- Department of Clinical Sciences, Copperbelt University School of Medicine, Ndola, Zambia
| | - Franklin Liamba
- Department of Community and Family Medicine, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Paul Syapiila
- Department of Clinical Sciences, Copperbelt University School of Medicine, Ndola, Zambia
| | - Seter Siziya
- Department of Clinical Sciences, Copperbelt University School of Medicine, Ndola, Zambia
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Radó MK, Laverty AA, Hone T, Chang K, Jawad M, Millett C, Been JV, Filippidis FT. Cigarette taxation and neonatal and infant mortality: A longitudinal analysis of 159 countries. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000042. [PMID: 36962262 PMCID: PMC10021450 DOI: 10.1371/journal.pgph.0000042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/15/2021] [Indexed: 11/19/2022]
Abstract
Previous studies on the associations between cigarette taxes and infant survival have all been in high-income countries and did not examine the relative benefits of different taxation levels and structures. We evaluated longitudinal associations of cigarette taxes with neonatal and infant mortality globally. We applied country-level panel regressions using 2008-2018 annual mortality and biennial WHO tobacco taxation data. Complete data was available for 159 countries. Outcomes were neonatal and infant mortality. We conducted analyses by type of taxes (i.e. specific cigarette taxes, ad valorem taxes, and other taxes, import duties and VAT) and the income group classification of countries. Covariates included scores for other WHO recommended tobacco control policies, socioeconomic, health-care, and air quality measures. Secondary analyses investigated the associations between cigarette tax and cigarette consumption. We found that a 10 percentage-point increase in total cigarette tax as a percentage of the retail price was associated with a 2.6% (95% Confidence Interval [CI]: 1.9% to 3.2%) decrease in neonatal mortality and a 1.9% (95% CI: 1.3% to 2.6%) decrease in infant mortality globally. Estimates were similar for both excise and ad valorem taxes. We estimated that 231,220 (95% CI: 152,658 to 307,655) infant deaths could have been averted in 2018 if all countries had total cigarette tax at least 75%. 99.2% of these averted deaths would have been in low- and middle-income countries (LMICs). The secondary analysis supported causal interpretation of results by finding that a 10 percentage-point increase in taxes was associated with a reduction of 94.6 (95% CI: 32.7 to 156.5) in annual cigarette consumption per capita. Although causal inference is precarious due to the quasi-experimental design, we used a robust analytical approach and focused on within-country changes. Limitations include an inability to include data on roll-your-own tobacco, other forms of tobacco use, and reliance on taxation data only for the cigarette brands most sold in each country. In line with limited existing evidence conducted in HICs, we found that raising taxes on tobacco was associated with a reduction in neonatal and infant mortality globally. Implementing recommended levels of taxation in LMICs should be a priority since this is where the lowest levels of taxation and the largest potential infant mortality benefits exist.
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Affiliation(s)
- Márta K Radó
- Division of Neonatology, Department of Paediatrics, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Thomas Hone
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Kiara Chang
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Mohammed Jawad
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Jasper V Been
- Division of Neonatology, Department of Paediatrics, Erasmus MC Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Asthma UK Centre for Applied Research, Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Filippos T Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
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Parimi N, Bikkina N, Bommireddy V, Tejaswi M, Edupalli S, Adapa VSK. Assessment of nicotine dependence among cigarette smokers seeking oral health care using fagerström test for nicotine dependence: A cross-sectional study. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_16_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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20
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Recycling Cigarette Butts in Ceramic Tiles. BUILDINGS 2021. [DOI: 10.3390/buildings12010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cigarettes are one of the favoured commodities on our planet. However, the annual consumption of 5.7 trillion cigarettes and 75% littering rate results in cigarette butts (CBs) being one of the most critical environmental issues. The leachate of heavy metals and toxic chemicals is polluting our ecosystem and threatening the wildlife species. Therefore, it is crucial to find effective and efficient recycling methods to solve the growing CB waste issue. In this study, unglazed fired ceramic tiles were manufactured with 0%, 0.5%, 1.0%, and 1.5% shredded CBs by dry mass to investigate the feasibility of the proposed sustainable recycling method. The chemical and mineralogical characterisation, density, shrinkage, bulk density, breaking strength, water absorption, and modulus of rupture were investigated and compared with the Australian Standards for ceramic tiles (AS 4459). The results revealed that tiles incorporating 0.5% CBs by mass demonstrated the greatest performance compared to the other mixtures. The water absorption for all tile–CB mixtures was found to be greater than 10%, with a positive growth tendency. The addition of 0.5% CBs by mass slightly improved flexural strength from 15.56 MPa for control samples to 16.63 MPa. Tiles containing 0.5% CBs by mass satisfied the modulus of rupture and water absorption limits for group III class according to the Australian Standards (AS 13006), and they may be suitable to be used as wall tiles. The result of a simulation equation predicts that an energy savings of up to 7.79% is achievable during the firing process for ceramic tiles incorporating 1% CBs by mass.
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Yang X, Zhang T, Zhang H, Sang S, Chen H, Zuo X. Temporal trend of gastric cancer burden along with its risk factors in China from 1990 to 2019, and projections until 2030: comparison with Japan, South Korea, and Mongolia. Biomark Res 2021; 9:84. [PMID: 34784961 PMCID: PMC8597246 DOI: 10.1186/s40364-021-00340-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 12/25/2022] Open
Abstract
Background Identifying and projecting the epidemiological burden of gastric cancer (GC) can optimize the control strategies, especially in high-burden areas. Methods We collected incidence, deaths, disability-adjusted life-years (DALYs), age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized DALY rate (ASDR) of GC from 1990 to 2019 in China, Japan, South Korea, and Mongolia from the Global Burden of Disease Study 2019. The average annual percentage change (AAPC) was calculated to quantify the temporal trends, and the projection was estimated by applying the Bayesian age-period-cohort model. Results In China, the ASIR of GC declined slightly from 37.56/100000 in 1990 to 30.64/100000 in 2019 (AAPC of − 0.41), while the declines of ASMR and ASDR were pronounced (AAPC of − 1.68 and − 1.98, respectively), which were weaker than Japan and South Korea. Although the age-standardized rates of gastric cancer in most countries have declined overall in the past 30 years, the downward trend in the last 4 years has become flattened. Smoking remained one main contributor to DALYs of GC in China, Japan, South Korea, and Mongolia, with more than 24%. The contribution from high-sodium diet was similar between men and women, and kept relatively stable over the three decades. The predicted ASMRs among the four East Asian countries continued to decline until 2030, but the absolute deaths would still increase significantly, especially in South Korea and Mongolia. Conclusions Although the age-standardized rates of GC in most countries have declined, the absolute burden of GC in the world, especially in China and Mongolia, is on the rise gradually. Low socio-demographic index and aging along with Helicobacter pylori infection, smoking, and high-salt diet were the main risk factors of GC occurrence and should be paid more attention. Supplementary Information The online version contains supplementary material available at 10.1186/s40364-021-00340-6.
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Affiliation(s)
- Xiaorong Yang
- Department of Gastroenterology, Qilu Hospital, School of Medicine, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China. .,Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China. .,Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China.
| | - Tongchao Zhang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
| | - Hong Zhang
- Department of Gastroenterology, Qilu Hospital, School of Medicine, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China.,Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
| | - Shaowei Sang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
| | - Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
| | - Xiuli Zuo
- Department of Gastroenterology, Qilu Hospital, School of Medicine, Cheeloo College of Medicine, Shandong University, 107 Wenhuaxi Road, Jinan, 250012, Shandong, China. .,Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan, China.
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Koka KM, Yadlapalli S, Pillarisetti P, Yasangi MK, Yaragani A, Kummamuru S. The barriers for tobacco cessation counseling in teaching health care institutions: A qualitative data analysis using MAXQDA software. J Family Med Prim Care 2021; 10:3262-3267. [PMID: 34760741 PMCID: PMC8565150 DOI: 10.4103/jfmpc.jfmpc_19_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 06/12/2021] [Accepted: 06/20/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction: Recently, Dental Council of India directed all the teaching dental institutions in the country to set up tobacco cessation centers (TCC). International experiences suggest that there are many barriers for the provision of tobacco cessation counseling at dental clinics. In this context, it is important to understand the dental students’ attitudes toward this initiative of tobacco cessation counseling at dental settings. Materials and Methods: This qualitative study to document the dental students’ perspectives toward the provision of tobacco cessation counseling using focus group interviews was conducted in two teaching dental institutions in the state of Andhra Pradesh, India. 133 house surgeons from two dental institutions participated in the study and were interviewed as 13 focus groups. MAXQDA (version 12, VERBI GmbH, Berlin, Germany) was used for data analysis. All the interviews were audio recorded and the transcripts were open coded by three independent investigators. Results: The response rate in this study was 78.45%. The following themes were extracted from the views and opinions shared by the students: the reluctance of patients to discuss tobacco-related problems; tobacco use among students discouraging them to actively participate in counseling; an opinion that dental clinics are not suitable for the provision of tobacco cessation counseling; belief among students that they are not qualified enough. Conclusion: The directives given by the Ministry of Health and Family Welfare in association with Dental council of India to set up TCC at every teaching dental institution are laudable and demonstrate the commitment at policy level toward bringing down tobacco consumption in the country. However, few reforms need to be made in the curriculum to better execute the delegated responsibilities, which include orientation programs for dental students on the scope of the dental profession and workshops on tobacco cessation counseling.
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Affiliation(s)
- Krishna M Koka
- Conservative Dentistry and Endodontics, KIMS Dental College, Amalapuram, Andhra Pradesh, India
| | - Sravanthi Yadlapalli
- Prosthodontics, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India
| | | | - Manoj Kumar Yasangi
- Prosthodontics, MNR Dental College and Hospital, Sanga Reddy, Telangana, India
| | - Anusha Yaragani
- Orthodontics, KIMS Dental College, Amalapuram, Andhra Pradesh, India
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Hu Z, Pan Z, Yang L, Wang K, Yang P, Xu Z, Yu H. Metabolomics analysis provides new insights into the medicinal value of flavonoids in tobacco leaves. Mol Omics 2021; 17:620-629. [PMID: 34137416 DOI: 10.1039/d1mo00092f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Tobacco is a traditional Chinese medicine containing a variety of biologically active substances. In addition to being used to make cigarettes, tobacco is also a vastly underdeveloped medicinal resource. In order to identify and clarify the biological activities and medicinal value of tobacco leaves, the metabolomes of tobacco leaves were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) based on multiple reaction monitoring (MRM). In total, 1169 metabolites were identified and quantified. The results showed that the metabolic profiles of the tobacco cultivars K326 and Yun87 are similar to each other but different from that of Hongda. Moreover, the curing process affects the metabolic profiles of tobacco leaves. Flavonoids are the largest class of metabolites in tobacco leaves. Flavonoids have multiple biological functions; for example, they can promote or inhibit inflammation. We found that quercetin provides anti-inflammatory activity by inhibiting the il-1β mRNA expression, while glycitin and neohesperidin can promote il-1β and il-6 production. Our results provide in-depth insights into the medical uses and biological mechanisms of tobacco leaves.
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Affiliation(s)
- Zuojian Hu
- Anhui Key Laboratory of Tobacco Chemistry, Anhui Tobacco Industrial Co., Ltd., 9 Tianda Road, Hefei 230088, China. and Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021 Guangxi, China
| | - Ziyue Pan
- Minhang Hospital & Shanghai Stomatological Hospital & Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, P. R. China.
| | - Lujie Yang
- Minhang Hospital & Shanghai Stomatological Hospital & Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, P. R. China.
| | - Ke Wang
- Minhang Hospital & Shanghai Stomatological Hospital & Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, P. R. China.
| | - Pengyuan Yang
- Minhang Hospital & Shanghai Stomatological Hospital & Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, P. R. China.
| | - Zhiqiang Xu
- Anhui Key Laboratory of Tobacco Chemistry, Anhui Tobacco Industrial Co., Ltd., 9 Tianda Road, Hefei 230088, China.
| | - Hongxiu Yu
- Minhang Hospital & Shanghai Stomatological Hospital & Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, P. R. China.
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Wu Y, Wang Z, Zheng Y, Wang M, Wang S, Wang J, Wu J, Wu T, Chang C, Hu Y. The impact of comprehensive tobacco control policies on cardiovascular diseases in Beijing, China. Addiction 2021; 116:2175-2184. [PMID: 33404152 DOI: 10.1111/add.15406] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/20/2020] [Accepted: 12/23/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS China has a high smoking prevalence, but lacks effective tobacco control interventions. In 2015, comprehensive policies that incorporated all six aspects of MPOWER were implemented in Beijing and were considered the strictest tobacco control policy implemented in China to date. Decreases in the prevalence of active smoking and secondhand smoke (SHS) exposure were observed thereafter. This study aimed to evaluate the impact of Beijing's 2015 tobacco control policy package on cardiovascular diseases (CVDs). DESIGN Interrupted time-series study. SETTING Beijing, China. PARTICIPANTS A total of 17.7 million employees enrolled in Urban Employee Basic Medical Insurance (UEBMI) between January 2013 to June 2017. INTERVENTIONS Beijing's 2015 comprehensive tobacco policy package, combining a complete ban on smoking in indoor public places, cessation support, more comprehensive bans on advertising, and tax rises. MEASUREMENTS The main outcome was hospital admissions for all CVDs and five major cause-specific CVDs, including ischaemic heart disease (IHD), heart failure (HF), heart rhythm disturbances (HRDs), stroke and other cerebrovascular diseases (CBDs). The absolute number and proportion of reductions in the number of hospital admissions after the policies are reported. FINDINGS A total of 419 875 hospital admissions for CVD were identified. In total, 13.4% [95% confidence interval (CI) = 11.5%, 15.3%] of hospital admissions for CVD were averted by the tobacco control policies. For major cause-specific CVDs, significant hospital admission reductions occurred for IHD (5.4%, 95% CI = 2.6%, 8.3%), stroke (21.2%, 95% CI = 17.8%, 24.6%) and other CBDs (25.9%, 95% CI = 20.8%, 31.0%), but not for HF (4.7%, 95% CI = -4.2%, 13.5%) or HRDs (4.7%, 95% CI = -2.9%, 12.3%). CONCLUSIONS Beijing's 2015 tobacco control policy package appears to have been associated with a more than 10% reduction in all cardiovascular hospital admissions, including a more than 20% reduction in admissions for cerebrovascular diseases.
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Affiliation(s)
- Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zijing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
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Exposure-lag response of smoking prevalence on lung cancer incidence using a distributed lag non-linear model. Sci Rep 2021; 11:14478. [PMID: 34262067 PMCID: PMC8280159 DOI: 10.1038/s41598-021-91644-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 05/11/2021] [Indexed: 12/24/2022] Open
Abstract
The prevalence of smokers is a major driver of lung cancer incidence in a population, though the “exposure–lag” effects are ill-defined. Here we present a multi-country ecological modelling study using a 30-year smoking prevalence history to quantify the exposure–lag response. To model the temporal dependency between smoking prevalence and lung cancer incidence, we used a distributed lag non-linear model (DLNM), controlling for gender, age group, country, outcome year, and population at risk, and presented the effects as the incidence rate ratio (IRR) and cumulative incidence rate ratio (IRRcum). The exposure–response varied by lag period, whilst the lag–response varied according to the magnitude and direction of changes in smoking prevalence in the population. For the cumulative lag–response, increments above and below the reference level was associated with an increased and decreased IRRcum respectively, with the magnitude of the effect varying across the lag period. Though caution should be exercised in interpretation of the IRR and IRRcum estimates reported herein, we hope our work constitutes a preliminary step towards providing policy makers with meaningful indicators to inform national screening programme developments. To that end, we have implemented our statistical model a shiny app and provide an example of its use.
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Reitsma MB, Kendrick PJ, Ababneh E, Abbafati C, Abbasi-Kangevari M, Abdoli A, Abedi A, Abhilash ES, Abila DB, Aboyans V, Abu-Rmeileh NME, Adebayo OM, Advani SM, Aghaali M, Ahinkorah BO, Ahmad S, Ahmadi K, Ahmed H, Aji B, Akunna CJ, Al-Aly Z, Alanzi TM, Alhabib KF, Ali L, Alif SM, Alipour V, Aljunid SM, Alla F, Allebeck P, Alvis-Guzman N, Amin TT, Amini S, Amu H, Amul GGH, Ancuceanu R, Anderson JA, Ansari-Moghaddam A, Antonio CAT, Antony B, Anvari D, Arabloo J, Arian ND, Arora M, Asaad M, Ausloos M, Awan AT, Ayano G, Aynalem GL, Azari S, B DB, Badiye AD, Baig AA, Bakhshaei MH, Banach M, Banik PC, Barker-Collo SL, Bärnighausen TW, Barqawi HJ, Basu S, Bayati M, Bazargan-Hejazi S, Behzadifar M, Bekuma TT, Bennett DA, Bensenor IM, Berfield KSS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bibi S, Bijani A, Bintoro BS, Biondi A, Birara S, Braithwaite D, Brenner H, Brunoni AR, Burkart K, Butt ZA, Caetano dos Santos FL, Cámera LA, Car J, Cárdenas R, Carreras G, Carrero JJ, Castaldelli-Maia JM, Cattaruzza MSS, Chang JC, Chen S, Chu DT, Chung SC, Cirillo M, Costa VM, Couto RAS, Dadras O, Dai X, Damasceno AAM, Damiani G, Dandona L, Dandona R, Daneshpajouhnejad P, Darega Gela J, Davletov K, Derbew Molla M, Dessie GA, Desta AA, Dharmaratne SD, Dianatinasab M, Diaz D, Do HT, Douiri A, Duncan BB, Duraes AR, Eagan AW, Ebrahimi Kalan M, Edvardsson K, Elbarazi I, El Tantawi M, Esmaeilnejad S, Fadhil I, Faraon EJA, Farinha CSES, Farwati M, Farzadfar F, Fazlzadeh M, Feigin VL, Feldman R, Fernandez Prendes C, Ferrara P, Filip I, Filippidis F, Fischer F, Flor LS, Foigt NA, Folayan MO, Foroutan M, Gad MM, Gaidhane AM, Gallus S, Geberemariyam BS, Ghafourifard M, Ghajar A, Ghashghaee A, Giampaoli S, Gill PS, Glozah FN, Gnedovskaya EV, Golechha M, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Greaves F, Guha A, Guo Y, Gupta B, Gupta RD, Gupta R, Gupta T, Gupta V, Hafezi-Nejad N, Haider MR, Hamadeh RR, Hankey GJ, Hargono A, Hartono RK, Hassankhani H, Hay SI, Heidari G, Herteliu C, Hezam K, Hird TR, Hole MK, Holla R, Hosseinzadeh M, Hostiuc S, Househ M, Hsiao T, Huang J, Iannucci VC, Ibitoye SE, Idrisov B, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Irvani SSN, Islam JY, Islam RM, Islam SMS, Islami F, Iso H, Itumalla R, Iwagami M, Jaafari J, Jain V, Jakovljevic M, Jang SI, Janjani H, Jayaram S, Jeemon P, Jha RP, Jonas JB, Joo T, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kanchan T, Kandel H, Kapoor N, Karimi SE, Katikireddi SV, Kebede HK, Kelkay B, Kennedy RD, Khoja AT, Khubchandani J, Kim GR, Kim YE, Kimokoti RW, Kivimäki M, Kosen S, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kugbey N, Kumar GA, Kumar N, Kurmi OP, Kusuma D, Lacey B, Lam JO, Landires I, Lasrado S, Lauriola P, Lee DW, Lee YH, Leung J, Li S, Lin H, Linn S, Liu W, Lopez AD, Lopukhov PD, Lorkowski S, Lugo A, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mamun AA, Manjunatha N, Mansouri B, Mansournia MA, Martinez-Raga J, Martini S, Mathur MR, Medina-Solís CE, Mehata S, Mendoza W, Menezes RG, Meretoja A, Meretoja TJ, Miazgowski B, Michalek IM, Miller TR, Mirrakhimov EM, Mirzaei H, Mirzaei-Alavijeh M, Misra S, Moghadaszadeh M, Mohammad Y, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Monasta L, Moni MA, Moradi G, Moradi-Lakeh M, Moradzadeh R, Morrison SD, Mossie TB, Mubarik S, Mullany EC, Murray CJL, Naghavi M, Naghshtabrizi B, Nair S, Nalini M, Nangia V, Naqvi AA, Narasimha Swamy S, Naveed M, Nayak S, Nayak VC, Nazari J, Nduaguba SO, Neupane Kandel S, Nguyen CT, Nguyen HLT, Nguyen SH, Nguyen TH, Nixon MR, Nnaji CA, Norrving B, Noubiap JJ, Nowak C, Ogbo FA, Oguntade AS, Oh IH, Olagunju AT, Oren E, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Pakhale S, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Pandey A, Parekh U, Park EC, Park EK, Pashazadeh Kan F, Patton GC, Pawar S, Pestell RG, Pinheiro M, Piradov MA, Pirouzpanah S, Pokhrel KN, Polibin RV, Prashant A, Pribadi DRA, Radfar A, Rahimi-Movaghar V, Rahman A, Rahman MHU, Rahman MA, Rahmani AM, Rajai N, Ram P, Ranabhat CL, Rathi P, Rawal L, Renzaho AMN, Reynales-Shigematsu LM, Rezapour A, Riahi SM, Riaz MA, Roever L, Ronfani L, Roshandel G, Roy A, Roy B, Sacco S, Saddik B, Sahebkar A, Salehi S, Salimzadeh H, Samaei M, Samy AM, Santos IS, Santric-Milicevic MM, Sarrafzadegan N, Sathian B, Sawhney M, Saylan M, Schaub MP, Schmidt MI, Schneider IJC, Schutte AE, Schwendicke F, Seidu AA, Senthil Kumar N, Sepanlou SG, Seylani A, Shafaat O, Shah SM, Shaikh MA, Shalash AS, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shigematsu M, Shiri R, Shishani K, Shivakumar KM, Shivalli S, Shrestha R, Siabani S, Sidemo NB, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Silva JP, Singh A, Singh JA, Singh V, Sinha DN, Sitas F, Skryabin VY, Skryabina AA, Soboka M, Soriano JB, Soroush A, Soshnikov S, Soyiri IN, Spurlock EE, Sreeramareddy CT, Stein DJ, Steiropoulos P, Stortecky S, Straif K, Suliankatchi Abdulkader R, Sulo G, Sundström J, Tabuchi T, Tadakamadla SK, Taddele BW, Tadesse EG, Tamiru AT, Tareke M, Tareque MI, Tarigan IU, Temsah MH, Thankappan KR, Thapar R, Tichopad A, Tolani MA, Topouzis F, Tovani-Palone MR, Tran BX, Tripathy JP, Tsegaye GW, Tsilimparis N, Tymeson HD, Ullah A, Ullah S, Unim B, Updike RL, Vacante M, Valdez PR, Vardavas C, Varona Pérez P, Vasankari TJ, Venketasubramanian N, Verma M, Vetrova MV, Vo B, Vu GT, Waheed Y, Wang Y, Welding K, Werdecker A, Whisnant JL, Wickramasinghe ND, Yamagishi K, Yandrapalli S, Yatsuya H, Yazdi-Feyzabadi V, Yeshaw Y, Yimmer MZ, Yonemoto N, Yu C, Yunusa I, Yusefzadeh H, Zahirian Moghadam T, Zaman MS, Zamanian M, Zandian H, Zar HJ, Zastrozhin MS, Zastrozhina A, Zavala-Arciniega L, Zhang J, Zhang ZJ, Zhong C, Zuniga YMH, Gakidou E. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet 2021; 397:2337-2360. [PMID: 34051883 PMCID: PMC8223261 DOI: 10.1016/s0140-6736(21)01169-7] [Citation(s) in RCA: 496] [Impact Index Per Article: 165.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/15/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. METHODS We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. FINDINGS Globally in 2019, 1·14 billion (95% uncertainty interval 1·13-1·16) individuals were current smokers, who consumed 7·41 trillion (7·11-7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5-28·5] reduction) and females (37·7% [35·4-39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98-1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16-8·20) deaths and 200 million (185-214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3-21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. INTERPRETATION In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. FUNDING Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
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Tanaka H, Mackenbach JP, Kobayashi Y. Widening Socioeconomic Inequalities in Smoking in Japan, 2001-2016. J Epidemiol 2021; 31:369-377. [PMID: 32595181 PMCID: PMC8126678 DOI: 10.2188/jea.je20200025] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/12/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Japan is one of the world's largest tobacco epidemic countries but few studies have focused on socioeconomic inequalities. We aimed to examine whether socioeconomic inequalities in smoking have reduced in Japan in recent times. METHODS We analyzed data from the Comprehensive Survey of Living Conditions, a large nationally representative survey conducted every 3 years (n ≈ 700,000 per year) in Japan, during 2001-2016. Age-standardized smoking prevalence was computed based on occupational class and educational level. We calculated smoking prevalence difference (PD) and ratio (PR) of (a) manual workers versus upper non-manual workers and (b) low versus high educational level. The slope index of inequality (SII) and relative index inequality (RII) by educational level were used as inequality measures. RESULTS Overall smoking prevalence (25-64 years) decreased from 56.0% to 38.4% among men and from 17.0% to 13.0% among women during 2001-2016. The PD between manual and upper non-manual workers (25-64 years) increased from 11.9% (95% confidence interval [CI], 11.0-12.9%) to 14.6% (95% CI, 13.5-15.6%) during 2001-2016. In 2016, smoking prevalence (25-64 years) for low, middle, and highly educated individuals were 57.8%, 43.9%, and 27.8% for men, and 34.7%, 15.9%, and 5.6% for women, respectively. SII and RII by educational level increased among both sexes. Larger socioeconomic differences in smoking prevalence were observed in younger generations, which suggests that socioeconomic inequalities in smoking evolve in a cohort pattern. CONCLUSIONS Socioeconomic inequalities in smoking widened between 2001 and 2016 in Japan, which indicates that health inequalities will continue to exist in near future.
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Affiliation(s)
- Hirokazu Tanaka
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Public Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Johan P. Mackenbach
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
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Lin X, Wang H, Rong X, Huang R, Peng Y. Exploring stroke risk and prevention in China: insights from an outlier. Aging (Albany NY) 2021; 13:15659-15673. [PMID: 34086602 PMCID: PMC8221301 DOI: 10.18632/aging.203096] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/11/2021] [Indexed: 01/01/2023]
Abstract
In contrast to the declining trend in most regions worldwide, the incidence of stroke is increasing in China and is leading to an alarming burden for the national healthcare system. In this review, we have generated new insights from this outlier, and we aim to provide new information that will help decrease the global stroke burden, especially in China and other regions sharing similar problems with China. First of all, several unsolved aspects fundamentally accounting for this discrepancy were promising, including the serious situation of hypertension management, underdiagnosis of atrial fibrillation and underuse of anticoagulants, and unhealthy lifestyles (e.g., heavy smoking). In addition, efforts for further alleviating the incidence of stroke were recommended in certain fields, including targeted antiplatelet regimes and protections from cold wave-related stroke. Furthermore, advanced knowledge about cancer-related strokes, recurrent strokes and the status preceding stroke onset that we called stroke-prone status herein, is required to properly mitigate patient stroke risk, and to provide improved outcomes for patients after a stroke has occurred.
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Affiliation(s)
- Xinrou Lin
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hongxuan Wang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoming Rong
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ruxun Huang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ying Peng
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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Fried ND, Morris TM, Whitehead A, Lazartigues E, Yue X, Gardner JD. Angiotensin II type 1 receptor mediates pulmonary hypertension and right ventricular remodeling induced by inhaled nicotine. Am J Physiol Heart Circ Physiol 2021; 320:H1526-H1534. [PMID: 33577434 PMCID: PMC8260386 DOI: 10.1152/ajpheart.00883.2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/08/2021] [Accepted: 02/08/2021] [Indexed: 01/07/2023]
Abstract
Use of electronic cigarettes is rapidly increasing among youth and young adults, but little is known regarding the long-term cardiopulmonary health impacts of these nicotine-containing devices. Our group has previously demonstrated that chronic, inhaled nicotine induces pulmonary hypertension (PH) and right ventricular (RV) remodeling in mice. These changes were associated with upregulated RV angiotensin-converting enzyme (ACE). Angiotensin II receptor blockers (ARBs) have been shown to reverse cigarette smoking-induced PH in rats. ACE inhibitor and ARB use in a large retrospective cohort of patients with PH is associated with improved survival. Here, we utilized losartan (an ARB specific for angiotensin II type 1 receptor) to further explore nicotine-induced PH. Male C57BL/6 mice received nicotine vapor for 12 h/day, and exposure was assessed using serum cotinine to achieve levels comparable to human smokers or electronic cigarette users. Mice were exposed to nicotine for 8 wk and a subset was treated with losartan via an osmotic minipump. Cardiac function was assessed using echocardiography and catheterization. Although nicotine exposure increased angiotensin II in the RV and lung, this finding was nonsignificant. Chronic, inhaled nicotine significantly increased RV systolic pressure and RV free wall thickness versus air control. These parameters were significantly lower in mice receiving both nicotine and losartan. Nicotine significantly increased RV internal diameter, with no differences seen between the nicotine and nicotine-losartan group. Neither nicotine nor losartan affected left ventricular structure or function. These findings provide the first evidence that antagonism of the angiotensin II type 1 receptor can ameliorate chronic, inhaled nicotine-induced PH and RV remodeling.NEW & NOTEWORTHY Chronic, inhaled nicotine causes pulmonary hypertension and right ventricular remodeling in mice. Treatment with losartan, an angiotensin II type 1 receptor antagonist, ameliorates nicotine-induced pulmonary hypertension and right ventricular remodeling. This novel finding provides preclinical evidence for the use of renin-angiotensin system-based therapies in the treatment of pulmonary hypertension, particularly in patients with a history of tobacco-product use.
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MESH Headings
- Angiotensin II Type 1 Receptor Blockers/pharmacology
- Animals
- Arterial Pressure/drug effects
- Disease Models, Animal
- E-Cigarette Vapor
- Hypertension, Pulmonary/chemically induced
- Hypertension, Pulmonary/metabolism
- Hypertension, Pulmonary/physiopathology
- Hypertension, Pulmonary/prevention & control
- Hypertrophy, Right Ventricular/chemically induced
- Hypertrophy, Right Ventricular/metabolism
- Hypertrophy, Right Ventricular/pathology
- Hypertrophy, Right Ventricular/prevention & control
- Inhalation Exposure
- Losartan/pharmacology
- Male
- Mice, Inbred C57BL
- Nicotine
- Pulmonary Artery/drug effects
- Pulmonary Artery/metabolism
- Pulmonary Artery/physiopathology
- Receptor, Angiotensin, Type 1/drug effects
- Receptor, Angiotensin, Type 1/metabolism
- Signal Transduction
- Time Factors
- Ventricular Function, Right/drug effects
- Ventricular Remodeling/drug effects
- Mice
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Affiliation(s)
- Nicholas D Fried
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Tamara M Morris
- Department of Pharmacology & Experimental Therapeutics, Louisiana State University Health Sciences Center, New Orleans, Louisiana
- Southeast Louisiana Veterans Health Care Systems, New Orleans, Louisiana
| | - Anna Whitehead
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Eric Lazartigues
- Department of Pharmacology & Experimental Therapeutics, Louisiana State University Health Sciences Center, New Orleans, Louisiana
- Southeast Louisiana Veterans Health Care Systems, New Orleans, Louisiana
| | - Xinping Yue
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Jason D Gardner
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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30
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Yan M, Wu Y, Peng W, Fu C, Giunta S, Chang M, Zhang G, Dou M, Xia S, Li H, Zhou J, Shen Y. Exposure to particulate matter 2.5 and cigarette smoke induces the synthesis of lipid droplets by glycerol kinase 5. Clin Exp Pharmacol Physiol 2021; 48:498-507. [PMID: 33462866 DOI: 10.1111/1440-1681.13463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/26/2020] [Indexed: 12/20/2022]
Abstract
Particulate matter (PM2.5) and cigarette smoke exposure are leading factors contributing to various diseases, especially respiratory diseases. The purpose of this research was to study the effects of PM2.5 and cigarette smoke on glycerol kinase 5 (GK5) expression and the possible mechanisms by which GK5 participates in lipid droplet (LD) synthesis in alveolar epithelial A549 cells. Real-time polymerase chain reaction (RT-PCR) and western blotting have been used for the detection of messenger RNA (mRNA) and protein expression respectively. GK5 overexpressing cells were established by lentivirus transfection, whereby lentiviral vectors deliver the gene into chromosomes, allowing stable expression. Affymetrix microarray analysis, a widely used tool for measuring genome-wide gene expression, has been used to explore differential gene expression profiles. A549 cells stimulated with PM2.5 and cigarette smoke extract (CSE) showed elevated GK5 expression in a dose-dependent manner. Transmission electron microscopy and oil red O staining were used to observe LDs in cells. Further, GK5 overexpressing cells showed increased LDs and upregulation of genes and proteins related to lipogenesis and lipid transportation. Affymetrix microarray analysis revealed that GK5 overexpression resulted in the differential expression of more than 109 genes, which were mainly involved in the regulation of cell death, cell survival, cellular movement and migration, and those involved in cellular growth and proliferation pathways. Overall, this study demonstrates that GK5 is upregulated during PM2.5 and cigarette smoke exposure and induces LD synthesis.
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Affiliation(s)
- Mengnan Yan
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuanyuan Wu
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wenjun Peng
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Cuiping Fu
- Department of Pulmonary Medicine, The First Hospital Affiliated to Soochow University, Suzhou, China
| | - Sergio Giunta
- Casa di Cura Prof. Nobili-GHC Garofalo Health Care, Bologna, Italy
| | - Meijia Chang
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ge Zhang
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Maosen Dou
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shijin Xia
- Department of Geriatrics, Shanghai Institute of Geriatrics, Huadong Hospital, Fudan University, Shanghai, China
| | - Huayin Li
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jian Zhou
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yao Shen
- Department of Pulmonary Medicine, Pudong Hospital Affiliated to Fudan University, Shanghai, China
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Khan A, King C, Saif-Ur-Rahman KM, Khandaker G, Lawler S, Gartner C. Development of an Evidence and Gap Map (EGM) of interventions to increase smoking cessation: A study protocol. Tob Prev Cessat 2020; 6:44. [PMID: 33083677 PMCID: PMC7549522 DOI: 10.18332/tpc/124117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 11/24/2022]
Abstract
Smoking remains one of the leading risk factors contributing to the global burden of disease. Sub-optimal implementation of evidence-based tobacco control and smoking cessation practice is a major challenge despite a substantial evidence base for interventions to increase smoking cessation globally. We aim to develop an Evidence and Gap Map (EGM) to collate the existing evidence and identify the gap in research on interventions to increase smoking cessation worldwide. A conceptual framework was developed followed by the formulation of a search strategy with key search terms and search period (1970 – date of search). The search will be conducted in relevant bibliographic databases (e.g. MEDLINE, Embase, SCOPUS), systematic reviews databases (e.g. Cochrane Library, Joanna Briggs systematic reviews, EPPI-Reviewer) and impact evaluation databases (e.g. 3ie Impact Evaluation repository and Cochrane tobacco addiction group specialized register) with support from a research librarian. Subsequently, two coders will screen and retrieve systematic reviews and individual impact evaluation studies. The adapted SURE (Supporting the Use of Research Evidence) checklist will be used to evaluate the quality of the included systematic reviews. A narrative synthesis from the systematic review findings and line listing of the impact evaluations will form the basis of this EGM. The EGM report will be presented in an interactive visual format. The proposed EGM will organise the pieces of evidence generated in systematic reviews and impact evaluations on smoking cessation interventions and identify the current research gaps, if any. The findings will inform evidence-based practice and future research.
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Affiliation(s)
- Arifuzzaman Khan
- School of Public Health, The University of Queensland, Brisbane, Australia.,Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Australia
| | - Catherine King
- Faculty of Medicine and Health, The Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, Australia
| | - K M Saif-Ur-Rahman
- Department of Public Health and Health Systems, University of Nagoya, Nagoya, Japan.,Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Gulam Khandaker
- School of Public Health, The University of Queensland, Brisbane, Australia.,Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Australia
| | - Sheleigh Lawler
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Coral Gartner
- School of Public Health, The University of Queensland, Brisbane, Australia
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Zatoński W, Zatoński M. Poland as the country with the steepest decline in per capita cigarette consumption in Europe. Tob Prev Cessat 2020. [DOI: 10.18332/tpc/128479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Fried ND, Gardner JD. Heat-not-burn tobacco products: an emerging threat to cardiovascular health. Am J Physiol Heart Circ Physiol 2020; 319:H1234-H1239. [PMID: 33006919 DOI: 10.1152/ajpheart.00708.2020] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cigarette smoking is at all-time lows globally, but the use of electronic cigarettes has increased profoundly. Recent reports of electronic cigarette or vaping use-associated lung injury may lead individuals to explore novel methods of nicotine consumption, such as heat-not-burn devices. IQOS from Philip Morris, a heat-not-burn device, became available for purchase in the United States in October 2019. Philip Morris claims that 8.8 million people have abandoned traditional cigarettes in favor of IQOS; however, evidence suggests that it may act as a gateway or complement to cigarette smoking, rather than a replacement. Surveys indicate that 96% of Korean IQOS users also smoke cigarettes, and 45% of Italian users of IQOS had never smoked cigarettes. In the United States, Canada, and England, susceptibility of youth to trying IQOS was slightly lower than electronic cigarettes, but higher than cigarette smoking. Heat-not-burn products produce mainstream and second-hand emissions of harmful chemicals, including nicotine, particulate matter, benzene, acrolein, and tobacco-specific nitrosamines. The levels of these emissions, despite being less than those of traditional cigarettes, are potentially harmful to cardiovascular health. A study of current smokers showed similar acute effects of heat-not-burn tobacco products and traditional cigarettes on heart rate, blood pressure, and arterial stiffness. Rats exposed to IQOS had similar vascular endothelial function impairment to those exposed to cigarettes. Heat-not-burn aerosol exposure of cultured macrophages elicited increased oxidative stress, although less than that induced by cigarette smoke. Further studies are needed to better understand the cardiovascular effects of heat-not-burn tobacco products.
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Affiliation(s)
- Nicholas D Fried
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Jason D Gardner
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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Radó MK, van Lenthe FJ, Sheikh A, Been JV. Investigating the effects of comprehensive smoke-free legislation on neonatal and infant mortality in Thailand using the synthetic control method. EClinicalMedicine 2020; 27:100560. [PMID: 33033797 PMCID: PMC7533363 DOI: 10.1016/j.eclinm.2020.100560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Almost all of the evidence on the benefits of smoke-free legislation on child health comes from evaluations in high-income countries. We investigated the effects of Thailand's 2010 comprehensive smoke-free legislation on neonatal and infant mortality. METHODS To overcome some of the methodological issues inherent to traditional quasi-experimental methods, we applied the novel synthetic control approach. Using 2001-2017 country-level panel data from the World Bank and Penn World datasets, we estimated the effects of smoke-free legislation as the difference between the outcome trends in Thailand versus those in a synthetic control country. The synthetic control country was composed of 'control' middle-income countries without comprehensive smoke-free legislation to recreate trends in Thailand in the 2001-2009 pre-legislation outcomes and covariates. We compared the legislation effects to 'placebo effects' obtained for each control country by fictitiously assuming that comprehensive smoke-free legislation was introduced there in 2010, similar to Thailand. FINDINGS Neonatal and infant mortality decreased by 2.9% and 2.8%/year respectively following smoke-free legislation, with an estimated 7463 infant deaths (including 4623 neonatal deaths) having been averted over eight years. The results were robust to different specifications of the control countries. Comparison with placebo effects indicated that the findings were unlikely to be attributable to factors other than the smoke-free legislation. INTERPRETATION Expanding comprehensive smoke-free policies to middle-income countries can support national efforts to achieve Sustainable Development Goal 3.2 for reducing preventable early-life deaths. FUNDING Netherlands Lung Foundation, HDRUK, Asthma UK center for Applied Research and NIHR Global Respiratory Health Unit (RESPIRE).
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Affiliation(s)
- Márta K. Radó
- Division of Neonatology, Department of Paediatrics, Erasmus MC – Sophia Children's Hospital, University Medical Centre Rotterdam, PO Box 2060, 3000 CB Rotterdam, the Netherlands
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Frank J. van Lenthe
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute, The University of Edinburgh, Edinburgh, UK
- Centre of Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jasper V. Been
- Division of Neonatology, Department of Paediatrics, Erasmus MC – Sophia Children's Hospital, University Medical Centre Rotterdam, PO Box 2060, 3000 CB Rotterdam, the Netherlands
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
- Asthma UK Centre for Applied Research, Usher Institute, The University of Edinburgh, Edinburgh, UK
- Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
- Corresponding author at: Division of Neonatology, Department of Paediatrics, Erasmus MC – Sophia Children's Hospital, University Medical Centre Rotterdam, PO Box 2060, 3000 CB Rotterdam, the Netherlands.
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Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Costafreda SG, Dias A, Fox N, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Ogunniyi A, Orgeta V, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020; 396:413-446. [PMID: 32738937 PMCID: PMC7392084 DOI: 10.1016/s0140-6736(20)30367-6] [Citation(s) in RCA: 4124] [Impact Index Per Article: 1031.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 01/31/2020] [Accepted: 02/07/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
| | - Jonathan Huntley
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - David Ames
- National Ageing Research Institute and Academic Unit for Psychiatry of Old Age, University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia
| | | | - Sube Banerjee
- Faculty of Health: Medicine, Dentistry and Human Sciences, University of Plymouth, Plymouth, UK
| | - Carol Brayne
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Alistair Burns
- Department of Old Age Psychiatry, University of Manchester, Manchester, UK
| | - Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Heczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel; Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Amit Dias
- Department of Preventive and Social Medicine, Goa Medical College, Goa, India
| | - Nick Fox
- Dementia Research Centre, UK Dementia Research Institute, University College London, London, UK; Institute of Neurology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MA, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Helen C Kales
- Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Sacramento, CA, USA
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
| | - Karen Ritchie
- Inserm, Unit 1061, Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, University of Montpellier, Montpellier, France; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Kenneth Rockwood
- Centre for the Health Care of Elderly People, Geriatric Medicine Dalhousie University, Halifax, NS, Canada
| | - Elizabeth L Sampson
- Division of Psychiatry, University College London, London, UK; Barnet, Enfield, and Haringey Mental Health Trust, London, UK
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MA, USA
| | - Lon S Schneider
- Department of Psychiatry and the Behavioural Sciences and Department of Neurology, Keck School of Medicine, Leonard Davis School of Gerontology of the University of Southern California, Los Angeles, CA, USA
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Geriatric Department, Oslo University Hospital, Oslo, Norway
| | - Linda Teri
- Department Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, WA, USA
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
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36
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Zheng Y, Wu Y, Wang M, Wang Z, Wang S, Wang J, Wu J, Wu T, Chang C, Hu Y. Impact of a comprehensive tobacco control policy package on acute myocardial infarction and stroke hospital admissions in Beijing, China: interrupted time series study. Tob Control 2020; 30:tobaccocontrol-2020-055663. [PMID: 32669389 PMCID: PMC8237181 DOI: 10.1136/tobaccocontrol-2020-055663] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/16/2020] [Accepted: 04/21/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate a comprehensive tobacco control policy package on hospital admissions for acute myocardial infarction (AMI) and stroke in a global city. DESIGN Interrupted time series study. SETTING Beijing, China. POPULATION 31 707 AMI and 128 116 stroke hospital admissions recorded by the Beijing Medical Claim Data for Employees in 17.7 million residents from January 2013 to June 2017. INTERVENTION The policy package including all components of MPOWER has been implemented since June 2015. MAIN OUTCOME MEASURES The immediate change of AMI and stroke hospital admissions and the annual change in the secular trend. RESULTS There was a secular increase trend for the crude hospital admission rates of AMI and stroke during the observational period. After implementation of the policy, immediate reductions were observed in the hospital admissions for both AMI (-5.4%, 95% CI -10.0% to -0.5%) and stroke (-5.6%, 95% CI -7.8% to -3.3%). In addition, the secular increase trend for stroke was slowed down by -15.3% (95% CI -16.7% to -13.9%) annually. Compared with the hypothetical scenario where the policy had not taken place, an estimated 18 137 (26.7%) stroke hospital admissions had been averted during the 25 months of postpolicy period. CONCLUSIONS The results indicated significant health benefits on cardiovascular morbidity after the Beijing tobacco control policy package, which highlighted the importance for a comprehensive tobacco control policy at the national level in China. Similar tobacco control policy which consists of all components of MPOWER is urgently needed in other areas, especially in settings with high tobacco consumption, to achieve greater public health gains.
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Affiliation(s)
- Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zijing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
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Lee C, Gao M, Ryff CD. Conscientiousness and Smoking: Do Cultural Context and Gender Matter? Front Psychol 2020; 11:1593. [PMID: 32733344 PMCID: PMC7358448 DOI: 10.3389/fpsyg.2020.01593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 06/15/2020] [Indexed: 01/26/2023] Open
Abstract
Prior studies have found that conscientiousness has a protective effect against smoking, but evidence for this relationship mostly comes from Western contexts. In societies where smoking is pervasive and less stigmatized, the protective effect of conscientiousness on smoking may be less evident. Moreover, whether smoking is viewed as normal or deviant also may vary by gender norms attached to smoking. Using surveys of Midlife Development in the United States (MIDUS) and Japan (MIDJA), we examined patterns in the association between conscientiousness and smoking status (never, former, current) for men and women. We found that in the United States, where the social unacceptability of smoking has dramatically increased, there is an inverse association between conscientiousness and smoking status for both genders. In Japan, where the stigma attached to smoking operates for women but not men, the association between conscientiousness and smoking status varies by gender. For Japanese men, levels of conscientiousness do not differ across smoking statuses. For Japanese women, those who formerly smoked show lower levels of conscientiousness than those who never smoked and those who currently smoke. We interpret these findings in light of differing cultural and historical backgrounds of smoking for men and women.
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Affiliation(s)
- Chioun Lee
- Department of Sociology, University of California, Riverside, Riverside, CA, United States,*Correspondence: Chioun Lee,
| | - Manjing Gao
- Department of Sociology, University of California, Riverside, Riverside, CA, United States
| | - Carol D. Ryff
- Institute on Aging and Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
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38
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Lu X, Chen L, Yuan J, Luo J, Luo J, Xie Z, Li D. User Perceptions of Different Electronic Cigarette Flavors on Social Media: Observational Study. J Med Internet Res 2020; 22:e17280. [PMID: 32579123 PMCID: PMC7380993 DOI: 10.2196/17280] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/15/2020] [Accepted: 03/29/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The number of electronic cigarette (e-cigarette) users has been increasing rapidly in recent years, especially among youth and young adults. More e-cigarette products have become available, including e-liquids with various brands and flavors. Various e-liquid flavors have been frequently discussed by e-cigarette users on social media. OBJECTIVE This study aimed to examine the longitudinal prevalence of mentions of electronic cigarette liquid (e-liquid) flavors and user perceptions on social media. METHODS We applied a data-driven approach to analyze the trends and macro-level user sentiments of different e-cigarette flavors on social media. With data collected from web-based stores, e-liquid flavors were classified into categories in a flavor hierarchy based on their ingredients. The e-cigarette-related posts were collected from social media platforms, including Reddit and Twitter, using e-cigarette-related keywords. The temporal trend of mentions of e-liquid flavor categories was compiled using Reddit data from January 2013 to April 2019. Twitter data were analyzed using a sentiment analysis from May to August 2019 to explore the opinions of e-cigarette users toward each flavor category. RESULTS More than 1000 e-liquid flavors were classified into 7 major flavor categories. The fruit and sweets categories were the 2 most frequently discussed e-liquid flavors on Reddit, contributing to approximately 58% and 15%, respectively, of all flavor-related posts. We showed that mentions of the fruit flavor category had a steady overall upward trend compared with other flavor categories that did not show much change over time. Results from the sentiment analysis demonstrated that most e-liquid flavor categories had significant positive sentiments, except for the beverage and tobacco categories. CONCLUSIONS The most updated information about the popular e-liquid flavors mentioned on social media was investigated, which showed that the prevalence of mentions of e-liquid flavors and user perceptions on social media were different. Fruit was the most frequently discussed flavor category on social media. Our study provides valuable information for future regulation of flavored e-cigarettes.
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Affiliation(s)
- Xinyi Lu
- University of Rochester, Rochester, NY, United States
| | - Long Chen
- University of Rochester, Rochester, NY, United States
| | - Jianbo Yuan
- University of Rochester, Rochester, NY, United States
| | - Joyce Luo
- Princeton University, Princeton, NJ, United States
| | - Jiebo Luo
- University of Rochester, Rochester, NY, United States
| | - Zidian Xie
- University of Rochester Medical Center, Rochester, NY, United States
| | - Dongmei Li
- University of Rochester Medical Center, Rochester, NY, United States
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Mehta A, Dhindsa DS, Hooda A, Nayak A, Massad CS, Rao B, Makue LF, Rajani RR, Alabi O, Quyyumi AA, Escobar GA, Wells BJ, Sperling LS. Premature atherosclerotic peripheral artery disease: An underrecognized and undertreated disorder with a rising global prevalence. Trends Cardiovasc Med 2020; 31:351-358. [PMID: 32565142 DOI: 10.1016/j.tcm.2020.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/19/2020] [Accepted: 06/15/2020] [Indexed: 12/24/2022]
Abstract
Premature atherosclerotic peripheral artery disease (PAD) of the lower extremities is characterized by disease diagnosis before the age of 50 years. The global prevalence of premature PAD has increased, and the disease is often underdiagnosed given heterogenous patient symptoms. Traditional cardiovascular risk factors like smoking, diabetes, hypertension, and hyperlipidemia as well as non-traditional risk factors like elevated lipoprotein(a), family history of PAD, hypercoagulability, and systemic inflammation are associated with premature PAD. Patients with premature PAD tend to have an aggressive vascular disease process, a high burden of cardiovascular risk factors, and other concomitant atherosclerotic vascular diseases like coronary artery disease. Prevention of cardiovascular events, improvement of symptoms and functional status, and prevention of adverse limb events are the main goals of patient management. In this review, we discuss the epidemiology, risk factors, clinical evaluation, and management of patients with premature PAD.
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Affiliation(s)
- Anurag Mehta
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia.
| | - Devinder S Dhindsa
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Ananya Hooda
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Aditi Nayak
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Chris S Massad
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Birju Rao
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Leyla Fowe Makue
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Ravi R Rajani
- Division of Vascular Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Olamide Alabi
- Division of Vascular Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Guillermo A Escobar
- Division of Vascular Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Bryan J Wells
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Laurence S Sperling
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia.
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Laverty AA, Millett C, Filippidis FT. Associations between cigarette prices and consumption in Europe 2004-2014. Tob Control 2020; 30:111-113. [PMID: 32546666 PMCID: PMC7803893 DOI: 10.1136/tobaccocontrol-2019-055299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 11/20/2022]
Abstract
Introduction Increases in tobacco price are known to reduce smoking prevalence, but these correlations may be blunted by the availability of budget cigarettes, promoted by the tobacco industry to maintain profits. Objective To investigate the effect of budget cigarettes on cigarette consumption using data from Europe 2004–2014. Methods Data on the annual population-weighted cigarette consumption per adult come from the International Cigarette Consumption Database. Data on the annual tobacco price come from Euromonitor International for 23 European countries. Median prices and price differentials (operationalised as percentages obtained by dividing the difference between median and minimum prices by the median price) were examined. A linear random-effects model was used to assess associations between median prices and price differentials with cigarette consumption within 1 year and with a 1-year time lag. Results Cigarette consumption per capita declined over the study period (−29.5 cigarettes per capita per year, 95% confidence interval −46.8 to −12.1). The analysis suggests that increases in cigarette price differentials, a marker of opportunities for smokers to switch to less expensive cigarettes, may be associated with greater consumption in the same year (6.4 for a 10% increase in differential, −40.0 to 52.6) and are associated with greater consumption in the following year (67.6, 25.8 to 109.5). Conclusion These analyses suggest that even in Europe, where tobacco taxes are relatively high compared with other regions, differential cigarette pricing strategies may undermine tobacco control. Further research is needed on links between tobacco price structures and consumption, and policy design to maximise the effectiveness of tobacco taxation.
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Affiliation(s)
- Anthony A Laverty
- Public health policy evaluation unit, School of Public Health, Imperial College London, London, London, UK
| | - Christopher Millett
- Public health policy evaluation unit, School of Public Health, Imperial College London, London, London, UK
| | - Filippos T Filippidis
- Public health policy evaluation unit, School of Public Health, Imperial College London, London, London, UK
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Hollander M, Deaton C, Gibson I, Kurpas D, Rutten F, Hanssen H, Antonopoulou M, Dendale P, Grobbee DE. The new Primary Care and Risk Factor Management (PCRFM) nucleus of the European Association of Preventive Cardiology: A call for action. Eur J Prev Cardiol 2019; 27:1328-1330. [PMID: 31841052 PMCID: PMC7391478 DOI: 10.1177/2047487319894107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Monika Hollander
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, University of Utrecht, The Netherlands
| | - Christi Deaton
- University of Cambridge School of Clinical Medicine, Department of Public Health and Primary Care, UK.,Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, UK
| | - Irene Gibson
- National Institute for Prevention and Cardiovascular Health, Galway, Ireland
| | - Donata Kurpas
- Department of Family Medicine, Wrocław Medical University, Poland.,Opole Medical School, Poland
| | - Frans Rutten
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, University of Utrecht, The Netherlands
| | - Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Switzerland
| | | | - Paul Dendale
- Jessa Hospital, Heart Centre Hasselt, Belgium.,BIOMED - Biomedical Research Centre, Hasselt University, Belgium
| | - Diederick E Grobbee
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, University of Utrecht, The Netherlands
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Martins SR, Santos UDP. Waterpipe smoking, a form of tobacco consumption that is on the rise. J Bras Pneumol 2019; 45:e20190315. [PMID: 31618292 PMCID: PMC7247768 DOI: 10.1590/1806-3713/e20190315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Stella Regina Martins
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Ubiratan de Paula Santos
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
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Cigarette and E-Cigarette Use and Smoking Cessation Practices among Physicians in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193595. [PMID: 31557913 PMCID: PMC6801531 DOI: 10.3390/ijerph16193595] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/23/2019] [Accepted: 09/23/2019] [Indexed: 01/25/2023]
Abstract
Physicians play a key role in combating tobacco use. This study aims to evaluate the knowledge, attitude, and behaviors toward smoking cessation and vaping cessation interventions among physicians in Poland; to identify factors shaping physicians’ behaviors toward smoking and vaping cessation interventions; and to assess differences in the tobacco cessation interventions recommended for cigarette smokers and users of electronic cigarettes (e-cigarettes). A questionnaire-based survey was conducted in 2018 among physicians attending mandatory public health training courses delivered at the School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland. The questionnaire included 25 questions related to tobacco product use and smoking cessation interventions. Data were obtained from 423 physicians (64.3% female; mean age 32.0 ± 5.8 years) with response rate of 84.6%. Current cigarette smoking was declared by 7.8% of participants; 1.9% of participants were e-cigarette users and 1.9% used heated tobacco. Smoking cessation interventions were offered more often to patients who smoked cigarettes than those who used e-cigarettes (p < 0.001). Physicians’ behaviors toward smoking cessation and vaping cessation interventions were associated with (p < 0.05) physicians’ smoking status and self-declared knowledge about smoking cessation methods. Among physicians in Poland, discussion of smoking cessation was not common behavior and limited mainly to identification of smoking status.
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45
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Affiliation(s)
- Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh EH8 9AG, UK
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46
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Hoffman SJ, Poirier MJP, Rogers Van Katwyk S, Baral P, Sritharan L. Impact of the WHO Framework Convention on Tobacco Control on global cigarette consumption: quasi-experimental evaluations using interrupted time series analysis and in-sample forecast event modelling. BMJ 2019; 365:l2287. [PMID: 31217191 PMCID: PMC6582266 DOI: 10.1136/bmj.l2287] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the impact of the WHO Framework Convention on Tobacco Control (FCTC) on global cigarette consumption. DESIGN Two quasi-experimental impact evaluations, using interrupted time series analysis (ITS) and in-sample forecast event modelling. SETTING AND POPULATION 71 countries for which verified national estimates of cigarette consumption from 1970 to 2015 were available, representing over 95% of the world's cigarette consumption and 85% of the world's population. MAIN OUTCOME MEASURES The FCTC is an international treaty adopted in 2003 that aims to reduce harmful tobacco consumption and is legally binding on the 181 countries that have ratified it. Main outcomes were annual national estimates of cigarette consumption per adult from 71 countries since 1970, allowing global, regional, and country comparisons of consumption levels and trends before and after 2003, with counterfactual control groups modelled using pre-intervention linear time trends (for ITS) and in-sample forecasts (for event modelling). RESULTS No significant change was found in the rate at which global cigarette consumption had been decreasing after the FCTC's adoption in 2003, using either ITS or event modelling. Results were robust after realigning data to the year FCTC negotiations commenced (1999), or to the year when the FCTC first became legally binding in each country. By contrast to global consumption, high income and European countries showed a decrease in annual consumption by over 1000 cigarettes per adult after 2003, whereas low and middle income and Asian countries showed an increased annual consumption by over 500 cigarettes per adult when compared with a counterfactual event model. CONCLUSIONS This study finds no evidence to indicate that global progress in reducing cigarette consumption has been accelerated by the FCTC treaty mechanism. This null finding, combined with regional differences, should caution against complacency in the global tobacco control community, motivate greater implementation of proven tobacco control policies, encourage assertive responses to tobacco industry activities, and inform the design of more effective health treaties.
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Affiliation(s)
- Steven J Hoffman
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, Faculty of Health and Osgoode Hall Law School, York University, 4700 Keele Street, Dahdaleh Building 2120, Toronto, Ontario, M3J 1P3 Canada
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Health Research Methods, Evidence, and Impact and McMaster Health Forum, McMaster University, Hamilton, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Mathieu J P Poirier
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, Faculty of Health and Osgoode Hall Law School, York University, 4700 Keele Street, Dahdaleh Building 2120, Toronto, Ontario, M3J 1P3 Canada
- Department of Health Research Methods, Evidence, and Impact and McMaster Health Forum, McMaster University, Hamilton, Canada
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Canada
| | - Susan Rogers Van Katwyk
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, Faculty of Health and Osgoode Hall Law School, York University, 4700 Keele Street, Dahdaleh Building 2120, Toronto, Ontario, M3J 1P3 Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Prativa Baral
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, Faculty of Health and Osgoode Hall Law School, York University, 4700 Keele Street, Dahdaleh Building 2120, Toronto, Ontario, M3J 1P3 Canada
| | - Lathika Sritharan
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, Faculty of Health and Osgoode Hall Law School, York University, 4700 Keele Street, Dahdaleh Building 2120, Toronto, Ontario, M3J 1P3 Canada
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