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Loh SM, Moloantoa T, Yende N, Variava E, Niaura R, Golub JE, Martinson N, Elf JL. A cross-sectional study of attitudes and behaviors of snuff use and cessation among people with and without HIV in South Africa. Tob Use Insights 2023; 16:1179173X231193890. [PMID: 37577008 PMCID: PMC10422901 DOI: 10.1177/1179173x231193890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023] Open
Abstract
Background Despite a high (48%) prevalence of snuff use among women with HIV in South Africa, little is known of the attitudes and behaviors of use, strategies for cessation, and potential health risks. Methods In a cross-sectional study, a questionnaire was administered to adults (≥18 years) with (HIV+) and without HIV (HIV-) who self-reported current snuff use to collect information on demographics, snuff use and cessation attempts, preferred strategies for cessation, other substance use, history of respiratory illness, and mental health. Results 150 (74 HIV+, 76 HIV-) participants were enrolled; 115 (77%) were daily snuff users, 6 (4%) were current smokers, and 17 (11%) former smokers. Top reasons for current snuff use included improving health (n = 48, 32%), reducing stress (n = 26, 16%), and "being a habit" (n = 38, 25%). Participants believed snuff use to have mostly positive (n = 68, 46%) or no (n = 54, 36%) health impacts, and 57 (38%) participants believed snuff cures headaches. 103 (69%) participants reported a previous quit attempt, and 110 (73%) indicated high interest in quitting snuff. Although 105 (70%) participants indicated that advice from a healthcare provider would aid them in quitting snuff, only 30 (20%) reported ever receiving that advice. A majority of participants (n = 141, 94%) suffer from moderate to high levels of perceived stress, and overall few differences were seen by HIV status. Conclusions Education on negative impacts of snuff, advice to quit from healthcare providers, and nicotine replacement therapy should be considered in the development of a snuff cessation program.
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Affiliation(s)
- Samantha M. Loh
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | | | | | - Ebrahim Variava
- Department of Internal Medicine, Klerksdorp Tshepong Hospital Complex, Matlosana, South Africa
| | - Raymond Niaura
- Department of Epidemiology; Department of Social and Behavioral Sciences, New York University, New York, NY, USA
| | - Jonathan E. Golub
- Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Jessica L. Elf
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
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Awokola BI, Amusa GA, Jewell CP, Okello G, Stobrink M, Finney LJ, Mohammed N, Erhart A, Mortimer KJ. Chronic obstructive pulmonary disease in sub-Saharan Africa. Int J Tuberc Lung Dis 2022; 26:232-242. [PMID: 35197163 PMCID: PMC8886964 DOI: 10.5588/ijtld.21.0394] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and an important cause of death in sub-Saharan Africa (SSA). We conducted a systematic review and meta-analysis on the prevalence of and risk factors for COPD in SSA.METHODS: We conducted a protocol-driven systematic literature search in MEDLINE, EMBASE, CINAHL and Global Health, supplemented by a manual search of the abstracts from thoracic conference proceedings from 2017 to 2020. We did a meta-analysis of COPD prevalence and its association with current smoking.RESULTS: We identified 831 titles, of which 27 were eligible for inclusion in the review and meta-analysis. The population prevalence of COPD ranged from 1.7% to 24.8% (pooled prevalence: 8%, 95% CI 6-11). An increased prevalence of COPD was associated with increasing age, smoking and biomass smoke exposure. The pooled odds ratio for the effect of current smoking (vs. never smoked) on COPD was 2.20 (95% CI 1.62-2.99).CONCLUSION: COPD causes morbidity and mortality in adults in SSA. Smoking is an important risk factor for COPD in SSA, and this exposure needs to be reduced through the combined efforts of clinicians, researchers and policymakers to address this debilitating and preventable lung disease.
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Affiliation(s)
- B I Awokola
- Centre for Health Informatics, Computing & Statistics (CHICAS), Lancaster Medical School, Lancaster University, Bailrigg, Lancaster, UK, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - G A Amusa
- Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria, Department of Medicine, University of Jos, Jos, Nigeria
| | - C P Jewell
- Centre for Health Informatics, Computing & Statistics (CHICAS), Lancaster Medical School, Lancaster University, Bailrigg, Lancaster, UK
| | - G Okello
- University of Cambridge Institute for Sustainability Leadership, Cambridge, UK, African Centre for Clean Air, Kampala, Uganda
| | - M Stobrink
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - L J Finney
- COPD Research Group, Imperial College, London, UK
| | - N Mohammed
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - A Erhart
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - K J Mortimer
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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Roy MP. Socio-demographic factors of COPD mortality in India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Addressing the disease burden of asthma and chronic bronchitis due to tobacco consumption: a study of Kanpur, India. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01040-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Elf JL, Variava E, Chon S, Lebina L, Motlhaoleng K, Gupte N, Niaura R, Abrams D, Martinson N, Golub JE. Prevalence and Correlates of Snuff Use, and its Association With Tuberculosis, Among Women Living With HIV in South Africa. Nicotine Tob Res 2020; 21:1087-1092. [PMID: 29986070 DOI: 10.1093/ntr/nty137] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/03/2018] [Indexed: 11/14/2022]
Abstract
INTRODUCTION A higher proportion of people living with HIV (PLWH) smoke compared to the general population, but little information exists about the prevalence and correlates of smokeless tobacco use among PLWH. In South Africa, dry powdered tobacco is inhaled nasally as snuff. METHODS A cross-sectional survey among PLWH attending three HIV clinics was conducted. Snuff use was assessed via self-report and urine cotinine. RESULTS Given the low (3%) prevalence of snuff use among men, analysis was restricted to n = 606 nonsmoking women living with HIV. Half (n = 298, 49%) were snuff users, the majority of whom (n = 244, 84%) had a positive urine cotinine test. In adjusted analysis, snuff use was negatively associated with higher education (relative risk [RR] 0.55; 95% confidence interval [CI]: 0.39, 0.77) and mobile phone ownership (RR 0.83; 95% CI: 0.71, 0.98), and positively associated with ever having tuberculosis (TB) (RR 1.22; 95% CI: 1.03, 1.45). In adjusted analysis, with current TB as the outcome, snuff use was marginally statistically significantly associated with a twofold increase in odds of a current TB diagnosis (odds ratio [OR] 1.99; 95% CI: 0.98, 4.15). DISCUSSION A high proportion of nonsmoking South African women living with HIV use snuff, which was a risk factor for TB. Additional research is needed to understand the relationship between snuff, TB, and other potential health risks. IMPLICATIONS PLWH have a higher prevalence of smoking than their seronegative peers, but there is a paucity of research on smokeless tobacco use in this population, especially in low-resource settings. TB is the leading cause of death among PLWH, and with improvements to HIV treatment and care, PLWH are at greater risk of tobacco-related diseases. We report an extremely high prevalence of snuff use among women living with HIV in South Africa. Further, in this population snuff use is positively associated with ever having a TB diagnosis, as well as currently having TB.
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Affiliation(s)
- Jessica L Elf
- Center for TB Research, Johns Hopkins School of Medicine, Baltimore, MD.,The Schroeder Institute for Tobacco Research and Polity Studies at Truth Initiative, Washington, DC
| | - Ebrahim Variava
- Perinatal HIV Research Unit (PHRU), SAMRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Soweto, South Africa.,Department of Internal Medicine and Department of Health, Klerksdorp Tshepong Hospital Complex, Matlosana, South Africa
| | - Sandy Chon
- Center for TB Research, Johns Hopkins School of Medicine, Baltimore, MD
| | - Limakatso Lebina
- Perinatal HIV Research Unit (PHRU), SAMRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Soweto, South Africa
| | - Katlego Motlhaoleng
- Perinatal HIV Research Unit (PHRU), SAMRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Soweto, South Africa.,Department of Internal Medicine and Department of Health, Klerksdorp Tshepong Hospital Complex, Matlosana, South Africa
| | - Nikhil Gupte
- Center for TB Research, Johns Hopkins School of Medicine, Baltimore, MD
| | - Raymond Niaura
- The Schroeder Institute for Tobacco Research and Polity Studies at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins School of Public Health, Balitimore, MD
| | - David Abrams
- The Schroeder Institute for Tobacco Research and Polity Studies at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins School of Public Health, Balitimore, MD
| | - Neil Martinson
- Perinatal HIV Research Unit (PHRU), SAMRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Soweto, South Africa
| | - Jonathan E Golub
- Center for TB Research, Johns Hopkins School of Medicine, Baltimore, MD
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Malesker MA, Callahan-Lyon P, Madison JM, Ireland B, Irwin RS. Chronic Cough Due to Stable Chronic Bronchitis: CHEST Expert Panel Report. Chest 2020; 158:705-718. [PMID: 32105719 DOI: 10.1016/j.chest.2020.02.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/27/2020] [Accepted: 02/06/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Chronic cough due to chronic bronchitis (CB) causes significant impairment in quality of life, and effective treatment strategies are needed. We conducted a systematic review on the management of chronic cough due to CB to update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic. METHODS This systematic review asked three questions: (1) What are the clinical features of the history that suggest a patient's cough-phlegm syndrome is due to CB? (2) Can treatment of stable CB improve or eliminate chronic cough? (3) Can therapy that targets chronic cough due to CB prevent or reduce the occurrence of acute CB exacerbations? Studies of adult patients with CB were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using the CHEST organization methodology. RESULTS The search strategy used an assortment of descriptors and assessments to identify studies of chronic cough due to CB. CONCLUSIONS The evidence supporting the management of chronic cough due to CB is limited overall and of low quality. This article provides guidance on treatment by presenting suggestions based on the best currently available evidence and identifies gaps in our knowledge and areas for future research.
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Affiliation(s)
- Mark A Malesker
- Pharmacy Practice Department, Creighton University, Omaha, NE.
| | | | - J Mark Madison
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA
| | | | - Richard S Irwin
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA
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Otorhinolaryngological symptoms among smokeless tobacco (Maras powder) users. North Clin Istanb 2018; 6:284-292. [PMID: 31650117 PMCID: PMC6790918 DOI: 10.14744/nci.2018.50024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/04/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE: This study aims to investigate the relationship between smokeless tobacco (maras powder) consumption and otorhinolaryngological symptoms. METHODS: This descriptive study was carried out on 599 participants. The participants were divided into two groups. Of these, 299 (49.9%) patients aged over 18 years were the first group; they used smokeless tobacco for at least 5 years. The remaining patients comprised the second group, which included 300 (50.1%) healthy volunteers who did not use tobacco or its products and demonstrated some similarities with the first group. For the purpose of data collection, a questionnaire consisting of 45 questions was administered to the participants. RESULTS: Cough, sputum, shortness of breath, dysphagia, snoring, and apnea-hypopnea were found to be significantly increased in smokeless tobacco users. The highest odds ratio (OR) found was for sputum at 2.615. Similarly, other oral cavity symptoms such as mouth tickling, dryness of throat, mouth sores, halitosis, taste disorders, and toothache were found to be significantly increased in smokeless tobacco users. It is noteworthy that halitosis was 9.4 times more prevalent among smokeless tobacco users than in the non-tobacco users. Sinonasal symptoms such as sneezing, headache, facial fullness, and anorexia were found to be significantly increased in smokeless tobacco users. However, there were no differences between the groups in terms of ear symptoms. CONCLUSION: This study demonstrated that the negative effects of smokeless tobacco consumption were particularly higher in the oral cavity, which in turn gave rise to a number of serious upper respiratory tract complaints.
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Manhanzva R, Marara P, Duxbury T, Bobbins AC, Pearse N, Hoel E, Mzizi T, Srinivas SC. Gender and leadership for health literacy to combat the epidemic rise of noncommunicable diseases. Health Care Women Int 2017; 38:833-847. [PMID: 28524810 DOI: 10.1080/07399332.2017.1332062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Until recently, the noncommunicable diseases (NCDs) epidemic has been considered only a significant burden to men in high-income countries. However, latest figures indicate that half of all NCD-related deaths affect women, especially in low- and middle-income countries (LMICs), with global responses to the NCD epidemic overlooking the significance of women and girls in their approaches and programs. This case study highlights the burden of disease challenging South Africa that disproportionately affects women in the country and suggests that the country, along with other LMICs internationally, requires a shift in the gender-based leadership of health literacy and self-empowerment.
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Affiliation(s)
- Rufaro Manhanzva
- a Faculty of Pharmacy , Rhodes University , Grahamstown , South Africa
| | - Praise Marara
- a Faculty of Pharmacy , Rhodes University , Grahamstown , South Africa
| | - Theodore Duxbury
- a Faculty of Pharmacy , Rhodes University , Grahamstown , South Africa
| | | | - Noel Pearse
- b Rhodes Business School , Rhodes University, Grahamstown , South Africa
| | - Erik Hoel
- c Hedmark University of Applied Sciences , Elverum , Norway
| | - Thandi Mzizi
- d Wellness Centre , Rhodes University , Grahamstown , South Africa
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Mia MN, Hanifi SMA, Rahman MS, Sultana A, Hoque S, Bhuiya A. Prevalence, pattern and sociodemographic differentials in smokeless tobacco consumption in Bangladesh: evidence from a population-based cross-sectional study in Chakaria. BMJ Open 2017; 7:e012765. [PMID: 28122830 PMCID: PMC5278241 DOI: 10.1136/bmjopen-2016-012765] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The health hazards associated with the use of smokeless tobacco (SLT) are similar to those of smoking. However, unlike smoking, limited initiatives have been taken to control the use of SLT, despite its widespread use in South and Southeast Asian countries including Bangladesh. It is therefore important to examine the prevalence of SLT use and its social determinants for designing appropriate strategies and programmes to control its use. OBJECTIVE To investigate the use of SLT in terms of prevalence, pattern and sociodemographic differentials in a rural area of Bangladesh. DESIGN Population-based cross-sectional household survey. SETTING AND PARTICIPANTS A total of 6178 individuals aged ≥13 years from 1753 households under the Chakaria HDSS area were interviewed during October-November 2011. METHODS The current use of SLT, namely sadapatha (dried tobacco leaves) and zarda (industrially processed leaves), was used as the outcome variable. The crude and net associations between the sociodemographic characteristics of respondents and the outcome variables were examined using cross-tabular and multivariable logistic regression analysis, respectively. RESULTS 23% of the total respondents (men: 27.0%, women: 19.3%) used any form of SLT. Of the respondents, 10.4% used only sadapatha,13.6% used only zarda and 2.2% used both. SLT use was significantly higher among men, older people, illiterate, ever married, day labourers and relatively poorer respondents. The odds of being a sadapatha user were 3.5-fold greater for women than for men and the odds of being a zarda user were 3.6-fold greater for men than for women. CONCLUSIONS The prevalence of SLT use was high in the study area and was higher among socioeconomically disadvantaged groups. The limitation of the existing regulatory measures for controlling the use of non-industrial SLT products should be understood and discussion for developing new strategies should be a priority.
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Affiliation(s)
- Mohammad Nahid Mia
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - S M A Hanifi
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - M Shafiqur Rahman
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Amena Sultana
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Shahidul Hoque
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Abbas Bhuiya
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
- Future Institute, Dhaka, Bangladesh
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Abstract
Cigarette smoking is known to cause a wide range of damaging health outcomes; however, the effects of non-cigarette tobacco products are either unknown or perceived as less harmful than cigarettes. Smokeless tobacco, cigar smoking, and waterpipe smoking have increased in usage over the past few decades. Some experts believe that their use is reaching epidemic proportions. Factors such as a perception of harm reduction, targeted advertising, and unrecognized addiction may drive the increased consumption of non-cigarette tobacco products. In particular, the need for social acceptance, enjoyment of communal smoking activities, and exotic nature of waterpipe smoking fuels, in part, its popularity. The public is looking for "safer" alternatives to smoking cigarettes, and some groups advertise products such as smokeless tobacco and electronic cigarettes as the alternatives they seek. Though it is clear that cigar and waterpipe tobacco smoking are probably as dangerous to health as cigarette smoking, there is an opinion among users that the health risks are less compared to cigarette smoking. This is particularly true in younger age groups. In the cases of smokeless tobacco and electronic cigarettes, the risks to health are less clear and there may be evidence of a harm reduction compared to cigarettes. In this article, we discuss commonly used forms of non-cigarette tobacco products, their impacts on lung health, and relevant controversies surrounding their use.
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Adeloye D, Basquill C, Papana A, Chan KY, Rudan I, Campbell H. An estimate of the prevalence of COPD in Africa: a systematic analysis. COPD 2014; 12:71-81. [PMID: 24946179 DOI: 10.3109/15412555.2014.908834] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is among the leading causes of death globally, accounting for about 3 million deaths worldwide in 2011. We aimed to estimate the prevalence of COPD in Africa in the year 2010 to provide the information that could assist health policy in the region. METHODS We conducted a systematic review of Medline, EMBASE and Global Health for studies on COPD published between 1990 and 2012. We included original population based studies providing estimates of the prevalence of COPD. We considered the reported estimates in terms of the mean age of the sample, sex ratio, the year of study and the country of the study as possible covariates. RESULTS from two different types of studies, i.e., based on spirometric and non-spirometric diagnosis of COPD, were further compared. The United Nation Population Division's population figures were used to estimate the number of COPD cases in the year 2010. RESULTS Our search returned 243 studies, from which only 13 met our selection criteria and only five were based on spirometry. The difference in the median prevalence of COPD in persons aged 40 years or older based on spirometry data (13.4%; IQR: 9.4%-22.1%) and non-spirometry data (4.0%; IQR: 2.1%-8.9%) was statistically significant (p = 0.001). There was no significant effect of the gender or the year of the study on the reported prevalence of COPD in either set of studies. The prevalence of COPD increased with age in spirometry-based studies (p = 0.017), which is a plausible finding suggesting internal consistency of spirometry-based estimates, while this trend was not observed in studies using other case definitions. When applied to the appropriate age group (40 years or more), which accounted for 196.4 million people in Africa in 2010, the estimated prevalence translates into 26.3 million (18.5-43.4 million) cases of COPD. Comparable figures for the year 2000 based on the same prevalence rates would amount to 20.0 million (14.1-33.1), suggesting an increase of 31.5% over a decade that is attributable to ageing of the African population alone. CONCLUSION Our findings suggest that COPD is likely to already represent a very large public health problem in Africa. Moreover, rapidly ageing African population should expect a steady increase in the number of COPD cases in the next decade and beyond. The quantity and quality of available evidence does not match the size of the problem. There is a need for more research on COPD prevalence, but also incidence, mortality and risk factors in Africa. We hope this study will raise awareness of COPD in Africa and encourage further research.
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Affiliation(s)
- Davies Adeloye
- 1Centre for Population Health Sciences, The University of Edinburgh Medical School , Edinburgh , UK
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Underner M, Perriot J. [Smokeless tobacco]. Rev Mal Respir 2011; 28:978-94. [PMID: 22099403 DOI: 10.1016/j.rmr.2011.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 03/18/2011] [Indexed: 02/05/2023]
Abstract
Use of smokeless tobacco (ST) (chewing tobacco and snuff) can lead to a number of consequences detrimental to health. ST rapidly delivers high doses of nicotine, which can lead to dependence and is also a source of carcinogenic nitrosamines. Changes usually develop in the mouth area where the ST is most often placed. Non-malignant oral lesions include leuko-oedema, hyperkeratotic lesions of the oral mucosa and localised periodontal disease. Oral premalignant lesions are leukoplakia, erythroplakia, submucosal fibrosis and lichen planus. Betel chewing, with or without tobacco, may increase the incidence of oral cancer. There is conflicting evidence with regard to snuff users about the risk of oral and gastro-oesophageal cancer. ST use is a risk factor for pancreatic cancer and may increase the risk of fatal myocardial infarction and ischemic stroke. During pregnancy, ST is associated with an increase in pre-eclampsia, preterm delivery and stillbirth. Nicotine replacement therapy and bupropion reduce withdrawal symptoms and tobacco craving during ST cessation. However, they have not been shown to help long-term abstinence. Information concerning the potential hazards of ST products should be incorporated into educational programmes to discourage its use and to help users to quit. Smokeless tobacco is not recommended to help smoking cessation.
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Affiliation(s)
- M Underner
- Service de Pneumologie, Unité de Tabacologie, Pavillon René-Beauchant, CHU La-Milétrie, BP 577, 2, rue Milétrie, 86021 Poitiers cedex, France.
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Omole OB, Ogunbanjo GA, Ayo-Yusuf OA. Review of alternative practices to cigarette smoking and nicotine replacement therapy: how safe are they? S Afr Fam Pract (2004) 2011. [DOI: 10.1080/20786204.2011.10874077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- OB Omole
- Department of Family Medicine, University of Witwatersrand, Johannesburg, South Africa
| | - GA Ogunbanjo
- Department of Family Medicine and Primary Health Care, University of Limpopo (Medunsa Campus), Pretoria South Africa
| | - OA Ayo-Yusuf
- c Department of Community Dentistry, School of Dentistry, University of Pretoria, Tshwane, South Africa
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Mehrotra A, Akanbi MO, Gordon SB. The burden of COPD in Africa: a literature review and prospective survey of the availability of spirometry for COPD diagnosis in Africa. Trop Med Int Health 2009; 14:840-8. [PMID: 19702594 DOI: 10.1111/j.1365-3156.2009.02308.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To ascertain the known burden of chronic obstructive pulmonary disease (COPD) in Africa and of spirometry use to indicate the possibility of further unpublished data becoming shortly available. METHOD Literature review. RESULTS Screening of 132 articles yielded 22 relevant articles, of which only six used spirometry based data. A total of 106 physicians in 34 countries were contacted and only 23 reported satisfactory use and availability of spirometry. CONCLUSIONS Current estimates of COPD burden in Africa are based on an unreliably small dataset. Acquisition of further data will require substantial investment in lung function equipment and training.
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Ayo-Yusuf OA, Szymanski B. Epidemiological profile of non-daily smokers in South Africa: implications for practice. S Afr Fam Pract (2004) 2009. [DOI: 10.1080/20786204.2009.10873855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Abstract
Humans consume tobacco in dozens of guises, all of which are toxic; globally, a tenth of deaths among adults are caused by tobacco. Tobacco may be combusted (e.g., cigarettes, bidis, kreteks); heated (e.g., waterpipes, hookah, nargile); or taken orally or nasally (e.g., snuff, betel quid, chewing tobacco). The predominant forms vary among cultures, but the use of cigarettes has grown most dramatically in the past century. While smoking rates among women are comparable to those among men in Europe and North America, in other regions the rate is ten or more times higher among men; this gender gap is closing among young people. Per capita tobacco use in the USA doubled in the first half of the twentieth century, and has since declined to less than the 1900 levels. While cigarettes were only 2% of tobacco consumed in the USA in 1900 (half was chewing tobacco) 50 years later they were over 80%. A similar increase in tobacco consumption, and a shift to cigarettes, has been occurring globally, with a concomitant increase in tobacco-related death and disease that is not expected to peak for another two decades.
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Affiliation(s)
- S Katharine Hammond
- School of Public Health, University of California, 50 University, Hall, Berkeley, CA 94720-7360, USA.
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