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Gajos JM, Hawes ES, Chana SM, Mrug S, Wolford-Clevenger C, Businelle MS, Carpenter MJ, Cropsey KL. Daily adherence to nicotine replacement therapy in low-income smokers: The role of gender, negative mood, motivation, and self-efficacy. Addict Behav 2023; 138:107543. [PMID: 36423571 PMCID: PMC9780181 DOI: 10.1016/j.addbeh.2022.107543] [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: 04/07/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Low-income smokers may benefit from interventions promoting nicotine replacement therapies (NRTs), particularly for women, as women have worse smoking cessation outcomes than men. Little is known about factors that affect daily NRT adherence, such as negative mood, motivation, and self-efficacy, and whether gender moderates these associations. METHODS Secondary analysis of a randomized controlled trial comparing a novel, in session sampling of short-acting combination NRT intervention (In Vivo) to standard care smoking cessation behavioral counseling was performed. Low-income smokers (n = 62; Mage = 47.4; 42 % female; 61 % non-White) completed daily surveys using the Insight™ mHealth platform for 55 consecutive days. Three types of NRT adherence were examined: dose amount of short-acting NRT, nicotine patch wear time, and combination NRT (cNRT) (combined nicotine patch and short-acting NRT). RESULTS Generalized multilevel models report same-day negative mood was associated with greater likelihood of nicotine patch adherence in men, but unrelated to women's nicotine patch adherence. Same-day negative mood was associated with greater likelihood of cNRT adherence in men, but less likelihood in women. The relationship between same-day motivation and use of short-acting NRT varied by gender, but simple slope analyses revealed that motivation was unrelated to short-acting NRT use within either group. Same-day self-efficacy was related to an increased likelihood of nicotine patch adherence and cNRT adherence in women but unrelated to men's adherence of either type. CONCLUSIONS Future research should focus on gender differences in low-income smokers' same-day negative mood, motivation, and self-efficacy processes on NRT adherence during smoking cessation interventions.
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Affiliation(s)
- Jamie M Gajos
- University of Alabama at Birmingham, Department of Family and Community Medicine, 930 20th Street South, Birmingham, AL 35205, USA
| | - Elizabeth S Hawes
- University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1670 University Blvd, Birmingham, AL 35233, USA
| | - Sofía Mildrum Chana
- University of Alabama at Birmingham, Department of Psychology, 1720 2nd Avenue South, Birmingham, AL 35294, USA
| | - Sylvie Mrug
- University of Alabama at Birmingham, Department of Psychology, 1720 2nd Avenue South, Birmingham, AL 35294, USA
| | - Caitlin Wolford-Clevenger
- University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1670 University Blvd, Birmingham, AL 35233, USA
| | - Michael S Businelle
- University of Oklahoma Health Sciences Center, Health Promotion Research Center, Stephenson Cancer Center, 655 Research Parkway, Oklahoma City, OK 73104, USA
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Hollings Cancer Center, MUSC, Charleston, SC, USA
| | - Karen L Cropsey
- University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, 1670 University Blvd, Birmingham, AL 35233, USA.
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2
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Satpathy N, Epari V, Jena PK, Kishore J. Inclusion of nicotine replacement therapy in the national essential drug list in India: Benediction for tobacco quitters? Tob Prev Cessat 2022; 8:43. [PMID: 36561466 PMCID: PMC9731483 DOI: 10.18332/tpc/156449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Nancy Satpathy
- Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, India
| | - Venkatarao Epari
- Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, India
| | - Pratap K. Jena
- KIIT School of Public Health, Kalinga Institute of Industrial Technology, Bhubaneswar, India
| | - Jugal Kishore
- Department Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi University, New Delhi, India
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Mohamed R, Bullen C, Hairi FM, Nordin ASA. A systematic review of group therapy programs for smoking cessation in Asian countries. Tob Induc Dis 2021; 19:63. [PMID: 34413718 PMCID: PMC8336625 DOI: 10.18332/tid/140089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/26/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Tobacco causes more than 8 million deaths each year. Behavioral interventions such as group therapy, which provides counselling for smoking cessation, can be delivered in group form and smokers who receive cessation counselling are more likely to quit smoking compared to no assistance. We review the evidence of group-based counselling for smoking cessation for smokers in Asian countries. METHODS The review aims to determine the availability of group-based therapy for smoking cessation in Asian countries. The outcome measured was abstinence from smoking following group therapy. Electronic database searches in PubMed, OVID Medline, SCOPUS, Google Scholar, and PsycINFO, using keywords such as: ‘smoking’, ‘cigarette’, ‘tobacco’, ‘nicotine’, ‘group therapy’ and ‘cessation’ (smok*, *cigarette*, tobacco, nicotine, group therap*, cessation) were used. The results were reported following PRISMA and PROSPERO guidelines. Review Manager was used for data analysis. RESULTS A total of 21251 records were retrieved for screening the abstracts. In all, 300 articles for review were identified and assessed for eligibility. Nine articles, including Cochrane reviews, randomized control trials, cohort, observational and cross-sectional studies, were included in the final review. There were three observational qualitative studies, two prospective cohort studies, two crosssectional studies, one non-randomized quasi-experimental study and a single cluster-randomized, controlled trial. Group therapy was found to significantly increase the abstinence rate. Group therapy provided at the workplace, smoking cessation services, availability of pharmacotherapy, and socioeconomic status, appear to be key factors determining success. CONCLUSIONS Evidence of the use of group therapy for smoking cessation in Asian countries is still lacking despite publications in the Western population showed that group therapy was effective. Further research on group-based interventions for smoking cessation in Asian countries is required and direct one-to-one comparisons between group therapy and individual therapy for smokers who want to quit smoking, are needed.
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Affiliation(s)
- Rashidi Mohamed
- Department of Family Medicine, Faculty of Medicine, National University of Malaysia, Bangi, Malaysia
| | - Christopher Bullen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Farizah Mohd Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Amer Siddiq Amer Nordin
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.,University of Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
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4
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Jones EE, Jarman KL, Goldstein AO. Providing Nicotine Replacement Therapy in Focus Groups. Nicotine Tob Res 2018; 20:399-400. [DOI: 10.1093/ntr/ntx090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Ellen E Jones
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Kristen L Jarman
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Adam O Goldstein
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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5
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Pharmacokinetic characterization of three novel 4-mg nicotine lozenges
. Int J Clin Pharmacol Ther 2018; 56:113-119. [PMID: 29350176 PMCID: PMC5822134 DOI: 10.5414/cp203097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Nicotine replacement therapy (NRT) increases the probability of smoking cessation. This study was conducted to determine if three prototype 4-mg nicotine lozenges produced locally in India were bioequivalent to a globally marketed reference product, Nicorette® 4-mg nicotine lozenge. MATERIALS AND METHODS Healthy adult smokers (N = 39) were treated with three prototype 4-mg nicotine lozenges in comparison with a reference 4-mg lozenge in this single-center, randomized, open-label, single-dose, 4-way crossover study. Pharmacokinetic sampling was obtained to test for bioequivalence using maximal plasma concentration (Cmax) and extent of absorption (AUC0-t). Secondarily, AUC;0-∞, time to maximal plasma concentration (tmax), half-life (T1/2), elimination rate constant (Kel), and safety of the prototype lozenges versus the reference lozenge were compared. RESULTS Each prototype 4-mg nicotine lozenge was found to be bioequivalent to the reference 4-mg nicotine lozenge based on the ratio of geometric means and 90% confidence intervals for Cmax, AUC0-t, and AUC;0-∞. Although tmax; was significantly longer for prototype III, all four lozenges achieved maximum plasma nicotine concentrations at a median of 1.5 hours. The safety profiles of the three prototype 4-mg lozenges did not differ from that of the 4-mg reference product. CONCLUSION Each prototype 4-mg nicotine lozenge was bioequivalent to the reference 4-mg nicotine lozenge and was well tolerated. Furthermore, as these bioequivalent prototypes differed in in-vitro dissolution profiles, these data suggest that performance from the in -vitro method deployed is not a firm predictor of pharmacokinetic behavior.
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Nilan K, Raw M, McKeever TM, Murray RL, McNeill A. Progress in implementation of WHO FCTC Article 14 and its guidelines: a survey of tobacco dependence treatment provision in 142 countries. Addiction 2017; 112:2023-2031. [PMID: 28600886 PMCID: PMC5655744 DOI: 10.1111/add.13903] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 02/07/2017] [Accepted: 06/02/2017] [Indexed: 11/28/2022]
Abstract
AIMS To (1) estimate the number of Parties to the Framework Convention on Tobacco Control (FCTC) providing tobacco dependence treatment in accordance with the recommendations of Article 14 and its guidelines; (2) assess association between provision and countries' income level; and (3) assess progress over time. DESIGN Cross-sectional study. SETTING Online survey from December 2014 to July 2015. PARTICIPANTS Contacts in 172 countries were surveyed, representing 169 of the 180 FCTC Parties at the time of the survey. MEASUREMENTS A 26-item questionnaire based on the Article 14 recommendations including tobacco treatment infrastructure and cessation support systems. Progress over time was assessed for those countries that also participated in our 2012 survey and did not change country income level classification. FINDINGS We received responses from contacts in 142 countries, an 83% response rate. Overall, 54% of respondents reported that their country had an officially identified person responsible for tobacco dependence treatment, 32% an official national treatment strategy, 40% official national treatment guidelines, 25% a clearly identified budget for treatment, 17% text messaging, 23% free national quitlines and 26% specialized treatment services. Most measures were associated positively and significantly with countries' income level (P < 0.001). Measures not associated significantly with income level included mandatory recording of tobacco use (30% of countries), offering help to health-care workers (HCW) to stop using tobacco (44%), brief advice integrated into existing services (44%), and training HCW to give brief advice (81%). Reporting having an officially identified person responsible for tobacco cessation was the only measure with a statistically significant improvement over time (P = 0.0351). CONCLUSION Fewer than half of countries that are Parties to the Framework Convention on Tobacco Control have implemented the recommendations of Article 14 and its guidelines, and for most measures, provision was greater the higher the country's income. There was little improvement in treatment provision between 2012 and 2015 in all countries.
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Affiliation(s)
- Kapka Nilan
- UK Centre for Tobacco and Alcohol Studies, School of MedicineUniversity of NottinghamNottinghamUK
| | - Martin Raw
- UK Centre for Tobacco and Alcohol Studies, School of MedicineUniversity of NottinghamNottinghamUK
| | - Tricia M. McKeever
- UK Centre for Tobacco and Alcohol Studies, School of MedicineUniversity of NottinghamNottinghamUK
| | - Rachael L. Murray
- UK Centre for Tobacco and Alcohol Studies, School of MedicineUniversity of NottinghamNottinghamUK
| | - Ann McNeill
- UK Centre for Tobacco and Alcohol Studies, Institute of PsychiatryPsychology and Neuroscience (IoPPN)King's College LondonLondonUK
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Affiliation(s)
- Sabine Oertelt-Prigione
- Violence Prevention Clinic, Institute of Legal Medicine, Charité – Universitätsmedizin Berlin, Germany
| | - Angela HEM Maas
- Women’s Cardiac Health Program, Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
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8
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Carroll AJ, Labarthe DR, Huffman MD, Hitsman B. Global tobacco prevention and control in relation to a cardiovascular health promotion and disease prevention framework: A narrative review. Prev Med 2016; 93:189-197. [PMID: 27717667 PMCID: PMC5125629 DOI: 10.1016/j.ypmed.2016.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/18/2016] [Accepted: 10/03/2016] [Indexed: 11/21/2022]
Abstract
The purpose of this review is to emphasize the role of tobacco prevention and control in cardiovascular health (CVH) promotion and cardiovascular disease (CVD) prevention, including the importance of these endpoints for measuring the full impact of tobacco-related policies, programs, and practices. In this review, we describe an overview of tobacco control interventions that have led to substantial declines in tobacco use and the relationship between these declines with CVH and CVD. We review interventions that have had success in high-income countries (HICs) as well as those that are gaining traction in low- and middle-income countries (LMICs). We emphasize the challenges to comprehensive tobacco prevention and control strategies faced by LMICs, and highlight the special role of cardiovascular health professionals in achieving CVH promotion and CVD prevention endpoints through tobacco control. Tobacco prevention and control strategies have a strong scientific basis, yet a distinct gap remains between this evidence and implementation of tobacco control policies, particularly in LMICs. Health professionals can contribute to tobacco control efforts, especially through patient-level clinical interventions, when supported by a health care system and government that recognize and support tobacco control as a critical strategy for CVH promotion and CVD prevention. Understanding, supporting, and applying current and evolving policies, programs, and practices in tobacco prevention and control is the province of all health professionals, especially those concerned with CVH promotion and CVD prevention. A new tobacco control roadmap from the World Heart Federation provides a strong impetus to the needed interdisciplinary collaboration.
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Affiliation(s)
- Allison J Carroll
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, United States
| | - Darwin R Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, United States
| | - Mark D Huffman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, United States
| | - Brian Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, United States.
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9
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Morphett K, Carter A, Hall W, Gartner C. Medicalisation, smoking and e-cigarettes: evidence and implications. Tob Control 2016; 26:e134-e139. [PMID: 27903957 DOI: 10.1136/tobaccocontrol-2016-053348] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/28/2016] [Accepted: 11/03/2016] [Indexed: 12/13/2022]
Abstract
There is debate in the tobacco control literature about the value of a medical model in reducing smoking-related harm. The variety of medical treatments for smoking cessation has increased, health professionals are encouraged to use them to assist smoking cessation and tobacco dependence is being described as a 'chronic disease'. Some critics suggest that the medicalisation of smoking undermines the tobacco industry's responsibility for the harms of smoking. Others worry that it will lead smokers to deny personal responsibility for cessation, create beliefs in 'magic bullets' for smoking cessation, or erode smokers' confidence in their ability to quit. We argue that the medicalisation of smoking will have limited impact due to the emphasis on population-based interventions in tobacco control, the ambiguous place of nicotine among other drugs and the modest efficacy of current pharmacotherapies. These factors, as well as lay understandings of smoking that emphasise willpower, personal choice and responsibility, have contributed to the limited success of medical approaches to smoking cessation. While the rapid uptake of e-cigarettes in some countries has provided an option for those who reject medical treatments for smoking cessation, current regulatory developments could limit the potential of e-cigarettes to provide non-therapeutic nicotine for those who currently smoke tobacco.
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Affiliation(s)
- Kylie Morphett
- University of Queensland School of Public Health, Herston, Queensland, Australia.,University of Queensland School of Medicine, Royal Brisbane and Women's Hospital Site, Herston, Queensland, Australia
| | - Adrian Carter
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia
| | - Wayne Hall
- University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital Site, Herston, Queensland, Australia.,University of Queensland Centre for Youth Substance Abuse, Floor K, Mental Health Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Coral Gartner
- University of Queensland School of Public Health, Herston, Queensland, Australia.,University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital Site, Herston, Queensland, Australia
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10
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Aghi M, Nagler E, Lando H, Pednekar M, Gupta P, Sorensen G. Training Lay Interventionists to Support Tobacco Cessation among Teachers in India. INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION 2016; 54:304-317. [PMID: 29151809 PMCID: PMC5687280 DOI: 10.1080/14635240.2016.1193761] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Despite the rapidly increasing burden of tobacco-related morbidity and mortality in low- and middle-income countries, tobacco control initiatives - especially cessation - receive little emphasis. This is true despite low-cost methods that have potential for widespread dissemination. The purpose of this paper is to provide a case study example of how lay interventionists may be trained and supported to facilitate tobacco use cessation, based on the successful Tobacco Free Teachers-Tobacco Free Society program (TFT-TFS) implemented in Bihar, India. This school-based program included multiple components, with lay interventionists having a crucial role. The lay interventionists included health educators and lead teachers, both of whom were selected based on formative research, underwent extensive training and received continuing support. We emphasized encouraging and supporting teachers to quit tobacco use and engaging both tobacco users and nonusers to create a supportive environment for cessation. We also stressed that neither the health educators nor lead teachers were being trained as counselors or as cessation experts. We focused on the importance of respecting teachers as individuals and identifying locally relevant methods of cessation. Although we cannot isolate the precise contribution of the lay interventionists to the successful TFT-TFS intervention, the abstinence findings in favor of the intervention at follow up are highly encouraging. Teachers have been neglected as lay interventionists for tobacco cessation despite the fact that they tend to be highly respected and credible. The approach used for TFT-TFS could be disseminable in multiple low- and middle-income country contexts through train-the-trainer programs targeted to teachers.
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Affiliation(s)
- Mira Aghi
- Healis, Sekhsaria Institute for Public Health, 601/B, Great Eastern Chambers, Plot No. 28, Sector 11, CBD Belapur, Navi Mumbai - 400 614 India Tel. 91 22 2757 5487
| | - Eve Nagler
- Dana-Farber Cancer Institute/Harvard School of Public Health, 450 Brookline Avenue Boston, MA 02215 USA, Tel. 617 582 8156
| | - Harry Lando
- University of Minnesota, 1300 S. 2 Street, Minneapolis, MN 55454 USA, tel. 612 624 1877
| | - Mangesh Pednekar
- Healis, Sekhsaria Institute for Public Health, 601/B, Great Eastern Chambers, Plot No. 28, Sector 11, CBD Belapur, Navi Mumbai - 400 614 India, Tel. 91 22 2757 5487
| | - Prakash Gupta
- Healis, Sekhsaria Institute for Public Health, 601/B, Great Eastern Chambers, Plot No. 28, Sector 11, CBD Belapur, Navi Mumbai - 400 614 India., Tel. 91 22 2757 5487
| | - Glorian Sorensen
- Dana-Farber Cancer Institute/Harvard School of Public Health, 450 Brookline Avenue, Boston, MA 02215 USA, Tel. 617 632 2183
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11
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Martin G, MacLachlan M, Labonté R, Larkan F, Vallières F, Bergin N. Globalization and Health: developing the journal to advance the field. Global Health 2016; 12:6. [PMID: 26961760 PMCID: PMC4785659 DOI: 10.1186/s12992-016-0143-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 02/09/2016] [Indexed: 11/10/2022] Open
Abstract
Founded in 2005, Globalization and Health was the first open access global health journal. The journal has since expanded the field, and its influence, with the number of downloaded papers rising 17-fold, to over 4 million. Its ground-breaking papers, leading authors -including a Nobel Prize winner- and an impact factor of 2.25 place it among the top global health journals in the world. To mark the ten years since the journal's founding, we, members of the current editorial board, undertook a review of the journal's progress over the last decade. Through the application of an inductive thematic analysis, we systematically identified themes of research published in the journal from 2005 to 2014. We identify key areas the journal has promoted and consider these in the context of an existing framework, identify current gaps in global health research and highlight areas we, as a journal, would like to see strengthened.
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Affiliation(s)
- Greg Martin
- Centre for Global Health, Trinity College, University of Dublin, Dublin, Ireland.
| | - Malcolm MacLachlan
- Centre for Global Health, Trinity College, University of Dublin, Dublin, Ireland. .,School of Psychology, Trinity College, University of Dublin, Dublin, Ireland. .,Centre for Rehabilitation Studies, Stellenbosch University, Stellenbosch, South Africa. .,Palacky University, Olomouc, Czech Republic.
| | - Ronald Labonté
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada
| | - Fiona Larkan
- Centre for Global Health, Trinity College, University of Dublin, Dublin, Ireland.,School of Medicine, Trinity College, University of Dublin, Dublin, Ireland
| | - Frédérique Vallières
- Centre for Global Health, Trinity College, University of Dublin, Dublin, Ireland.,School of Psychology, Trinity College, University of Dublin, Dublin, Ireland
| | - Niamh Bergin
- Masters in Global Mental Health Programme, University of Glasgow, Glasgow, Scotland
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12
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Beaglehole R, Bonita R, Yach D, Mackay J, Reddy KS. A tobacco-free world: a call to action to phase out the sale of tobacco products by 2040. Lancet 2015; 385:1011-8. [PMID: 25784348 DOI: 10.1016/s0140-6736(15)60133-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The time has come for the world to acknowledge the unacceptability of the damage being done by the tobacco industry and work towards a world essentially free from the sale (legal and illegal) of tobacco products. A tobacco-free world by 2040, where less than 5% of the world's adult population use tobacco, is socially desirable, technically feasible, and could become politically practical. Three possible ways forward exist: so-called business-as-usual, with most countries steadily implementing the WHO Framework Convention on Tobacco Control (FCTC) provisions; accelerated implementation of the FCTC by all countries; and a so-called turbo-charged approach that complements FCTC actions with strengthened UN leadership, full engagement of all sectors, and increased investment in tobacco control. Only the turbo-charged approach will achieve a tobacco-free world by 2040 where tobacco is out of sight, out of mind, and out of fashion--yet not prohibited. The first and most urgent priority is the inclusion of an ambitious tobacco target in the post-2015 sustainable development health goal. The second priority is accelerated implementation of the FCTC policies in all countries, with full engagement from all sectors including the private sector--from workplaces to pharmacies--and with increased national and global investment. The third priority is an amendment of the FCTC to include an ambitious global tobacco reduction goal. The fourth priority is a UN high-level meeting on tobacco use to galvanise global action towards the 2040 tobacco-free world goal on the basis of new strategies, new resources, and new players. Decisive and strategic action on this bold vision will prevent hundreds of millions of unnecessary deaths during the remainder of this century and safeguard future generations from the ravages of tobacco use.
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Affiliation(s)
| | - Ruth Bonita
- University of Auckland, Auckland, New Zealand
| | - Derek Yach
- Vitality Institute (part of Discovery Holdings), New York, USA
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13
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Ward KD, Asfar T, Ali R, Rastam S, Weg MV, Eissenberg T, Maziak W. Randomized trial of the effectiveness of combined behavioral/pharmacological smoking cessation treatment in Syrian primary care clinics. Addiction 2013; 108:394-403. [PMID: 22882805 PMCID: PMC7942391 DOI: 10.1111/j.1360-0443.2012.04048.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 03/12/2012] [Accepted: 08/02/2012] [Indexed: 11/30/2022]
Abstract
AIMS Effectiveness of nicotine replacement therapy (NRT) for smoking cessation has not been evaluated in low income countries, such as Syria, where it is expensive and not widely available. We evaluated whether nicotine patch boosts smoking cessation rates when used in conjunction with behavioral support in primary care clinics in Aleppo, Syria. DESIGN Two arm, parallel group, randomized, placebo controlled, double-blinded multi-site trial. SETTING Four primary care clinics in Aleppo, Syria. PARTICIPANTS Two hundred and sixty-nine adult primary care patients received behavioral cessation counseling from a trained primary care physician and were randomized to receive six weeks of treatment with nicotine versus placebo patch. MEASUREMENTS Primary end-points were prolonged abstinence (no smoking after a 2-week grace period) at end of treatment, and 6 and 12 months post-quit day, assessed by self-report and exhaled carbon monoxide levels of <10 p.p.m. FINDINGS Treatment adherence was excellent and nicotine patch produced expected reductions in urges to smoke and withdrawal symptoms, but no treatment effect was observed. The proportion of patients in the nicotine and placebo groups with prolonged abstinence was 21.6% and 20.0%, respectively, at end of treatment, 13.4% and 14.1% at 6 months, and 12.7% and 11.9% at 12 months. CONCLUSIONS Nicotine patches may not be effective in helping smokers in low-income countries to stop when given as an adjunct to behavioural support.
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Affiliation(s)
- Kenneth D. Ward
- Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA,Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Taghrid Asfar
- Syrian Center for Tobacco Studies, Aleppo, Syria,Department of Epidemiology & Public Health, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Radwan Ali
- Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Samer Rastam
- Syrian Center for Tobacco Studies, Aleppo, Syria,University of Aleppo School of Medicine, Aleppo, Syria
| | - Mark Vander Weg
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA,Department of Psychology, University of Iowa, Iowa City, IA, USA,The Center for Comprehensive Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA, USA
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syria,Institute for Drug and Alcohol Studies, and Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Waim Maziak
- Syrian Center for Tobacco Studies, Aleppo, Syria,Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
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14
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Chapman S, Mackenzie R. Can it be Ethical to Apply Limited Resources in Low-income Countries to Ineffective, Low-reach Smoking Cessation Strategies? A Reply to Bitton and Eyal. Public Health Ethics 2012. [DOI: 10.1093/phe/phr035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Bitton A, Eyal N. Too Poor To Treat? The Complex Ethics of Cost-Effective Tobacco Policy in the Developing World. Public Health Ethics 2011. [DOI: 10.1093/phe/phr014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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