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Kang SY, Kim YJ, Cho HJ. COVID-19 Outcome and Tobacco Product Use: Case-Control and Retrospective Cohort Studies Using Nationwide Samples. J Korean Med Sci 2024; 39:e103. [PMID: 38529574 DOI: 10.3346/jkms.2024.39.e103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/14/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Conflicting evidence exists regarding the association between smoking and the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We investigated the association between combustible cigarette (CC) smoking, noncombustible tobacco product (NCTP) use, and the use of any tobacco product with various coronavirus disease 2019 (COVID-19) outcomes. METHODS A case-control study was conducted using the Korea Disease Control and Prevention Agency-COVID19-National Health Insurance Service (NHIS) cohort. A retrospective cohort study was conducted using 12,571,698 individuals from the NHIS cohort. Logistic regression evaluated the association between CC smoking, NCTP use, and use of any tobacco product with SARS-CoV-2 infection. Poisson regression evaluated the association between these forms of tobacco product use and COVID-19-related hospitalization and mortality. RESULTS In the case-control study, we identified 30,878 cases of SARS-CoV-2 infection. The odds ratios (95% confidence intervals [CIs]) for SARS-CoV-2 infection were lower among current CC smokers (0.51, 0.48-0.54), current- and former-NCTP users (0.80, 0.74-0.88; 0.82, 0.74-0.91), and current users of any tobacco product (0.52, 0.49-0.55) relative to never user controls. In retrospective cohort study, we identified 16,521 COVID-19-related hospitalization and 362 COVID-19-related deaths. The relative risks (95% CIs) for COVID-19-related hospitalization were lower among current CC smokers (0.51, 0.48-0.54) and current users of any tobacco product (0.53, 0.50-0.56) relative to never user controls. There was no association between the use of tobacco product and COVID-19-related mortality. CONCLUSION Current CC smokers and current users of any tobacco product showed reduced risk of SARS-CoV-2 infection and COVID-19-related hospitalization. It remains uncertain whether these relationships are causal.
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Affiliation(s)
- Seo Young Kang
- Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
| | - Ye-Jee Kim
- Department of Clinical Epidemiology and Biostatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong-Jun Cho
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Pulicherla NK, Kodali PB. Tobacco Imagery in Indian Over-the-Top (OTT) Media and its Compliance with existing Tobacco Laws: A Content Analysis. Nicotine Tob Res 2023:ntad260. [PMID: 38147534 DOI: 10.1093/ntr/ntad260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Indexed: 12/28/2023]
Abstract
INTRODUCTION Over-the-Top (OTT) media are internet-based content delivery systems offering media services to the viewers bypassing the traditional broadcasting platforms. The OTT media, with limited regulatory oversight, can serve as a source of exposure to tobacco-promoting content. This study analyzed the depiction of tobacco imagery in Indian OTT programmes and assessed their compliance with existing Indian tobacco control policies. METHODS We conducted a content analysis of 28 purposively sampled OTT exclusive programmes (14 movies and 14 web series) in India. Breathe California method was used to code the OTT content for tobacco imagery. We assessed the prevalence of tobacco imagery, its duration per episode/programme, product placements, and brand appearances. We also evaluated OTT programmes adherence to existing tobacco control policies in India. RESULTS Tobacco imagery was identified in all of the web series and most of OTT-exclusive movies. On average the web series depicted seven incidents of tobacco imagery per episode, whereas there were close to 19 incidents of tobacco imagery per movie. Ten minutes of OTT programming (including movies and web series) had on average 8.40 seconds of tobacco imagery. None of the OTT programmes studied fully complied with Indian tobacco control policies. CONCLUSIONS Depiction of tobacco imagery in OTT exclusive programmes is common in India. Streaming platforms need to comply to existing tobacco control policies. Furthermore, there is a need to strengthen these policies and strictly enforce them to ensure tobacco-free mass-media. IMPLICATIONS OF THE STUDY India has more than 267 million tobacco users and accounts for the largest share of smokeless tobacco use globally. OTT platforms are largely unregulated and are considered drivers for global tobacco use. This is one of the few studies examining tobacco imagery in Indian OTT content, reporting the gaps in tobacco control policies in India. This study documents the product placement of smokeless tobacco, duration of exposure to tobacco imagery and empirically report the compliance of OTT platforms with Indian tobacco control policies. The study findings can aid in strengthening tobacco control policies in India.
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Affiliation(s)
- Naveen Kumar Pulicherla
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
| | - Prakash Babu Kodali
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
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Grillo R, Khemiss M, da Silva YS. Cytotoxic and Genotoxic Effects of Waterpipe on Oral Health Status: Systematic review and meta-analysis. Sultan Qaboos Univ Med J 2023; 23:5-12. [PMID: 36865434 PMCID: PMC9974039 DOI: 10.18295/squmj.6.2022.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/12/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
This systematic review and meta-analysis aimed to assess the cytotoxic and genotoxic impacts of waterpipe smoking on oral health. The databases MEDLINE, Cochrane Library and Dimensions were searched to find studies evaluating whether waterpipe smokers exhibited any cytotoxic or genotoxic effects on their oral cells compared to non-smokers, with regard to mouth neoplasms. Particularly, changes in DNA methylation and p53 expression were assessed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adopted for the systematic review. Review Manager was utilised for statistical analysis with a significance level at P <0.05. To assess the grades of the included articles, a risk of bias analysis was summarised. A forest plot, including some of the included articles included, was created regarding the different grades. A total of 20 studies were included in this review. The results showed that waterpipe smoking has cytotoxic and genotoxic effects on oral cells, with a risk difference of 0.16. Although the published articles are few in number, all confirm the devastating effects of waterpipe smoking related to the carcinogenicity. Waterpipe smoking is harmful to oral health. It causes a series of detrimental cellular and genetic modifications such as acanthosis, epithelial dysplasia and hyperparakeratosis. In addition, waterpipe smoke contains several carcinogenic compounds. As it releases many harmful organic compounds, waterpipe smoking increases the incidence of oral cancer.
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Affiliation(s)
- Ricardo Grillo
- Department of Oral and Maxillofacial Surgery, Faculdade São Leopoldo Mandic, Campinas, Brazil,Corresponding Author’s e-mail:
| | - Mehdi Khemiss
- Department of Dental Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Yuri S. da Silva
- Department of Oral & Maxillofacial Surgery, UniFG University Center, Guanambi, Brazil
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Abstract
This review examines the impact of COVID-19 on the substance-abuse landscape and climate with particular attention on Singapore’s. Substance-abuse has received the least attention during the COVID-19 outbreak and this pandemic has further sheared the problem’s visibility and the provision of care for this population of sufferers. The authors examine the current literature to look at the access and utility of street drugs due to border closure, the influence of the pandemic on prevailing drug behaviours as well as the effect of social distancing on drug-users. Two case studies are described. The paper serves to illuminate the ever-present problem of substance-abuse even during a viral pandemic and to remind the local government and healthcare system to continue efforts in caring for this group of patients.
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Affiliation(s)
- Ho Teck Tan
- Department of Psychological Medicine, National University Health System (NUHS), Singapore
| | - Boon Ceng Chai
- Department of Psychological Medicine, National University Health System (NUHS), Singapore
| | - Yit Shiang Lui
- Department of Psychological Medicine, National University Health System (NUHS), Singapore
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Lopes J, Silva I. Prevalence of Tobacco Smoking in Patients with Schizophrenia and Bipolar Disorder in a Portuguese Hospital. ACTA MEDICA PORT 2021; 34:321-322. [PMID: 34214427 DOI: 10.20344/amp.15909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/15/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Joana Lopes
- Serviço de Psiquiatria. Hospital de Vila Franca de Xira. Vila Franca de Xira. Portugal
| | - Inês Silva
- Serviço de Psiquiatria. Hospital de Vila Franca de Xira. Vila Franca de Xira. Portugal
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Kittaneh AA, Patel S, Sidhu NK, Lechner WV, Kenne DR. Tobacco Use Status as a Function of Transgender Identity: The Mediating Role of Psychological Distress. Tob Use Insights 2021; 14:1179173X211004267. [PMID: 33854393 PMCID: PMC8013634 DOI: 10.1177/1179173x211004267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/19/2021] [Indexed: 11/15/2022] Open
Abstract
Aim The current study examined differences between individuals identifying as transgender and people identifying as cisgender in terms of (1) psychological distress (eg, anxiety, depression, and suicidal ideation), (2) rates of combustible and e-cigarette use, and (3) the potential for elevated psychological distress stemming from transgender identification to be associated with increased rates of smoking and vaping. Method This was a secondary analysis of data from a study examining behavioral health, perceptions and behaviors associated with alcohol and other drug use, and mental health status at a large mid-western university. Differences in current use of cigarette and e-cigarette products were examined between self-identified transgender (n = 253) and cisgender (n = 18 371) respondents. Results Overall, 17.2% (n = 2727) of the sample endorsed past 30-day use of cigarettes or e-cigarettes. Results demonstrated a significant effect of gender identity, with individuals identifying as transgender reporting higher odds of using cigarettes or e-cigarettes (AOR = 2.82, 95% CI 1.26-6.31). Regression analyses revealed significant effects of transgender identity on symptoms of anxiety (b = 3.45, 95% CI = 1.64, 5.25, P < .001.); depression, (b = 4.14, 95% CI = 2.21, 6.07, P < .001); and suicidal ideation, (b = 2.51, 95% CI = 1.48, 3.55, P < .001.), respectively. Finally, we observed significant indirect effects of transgender identity on cigarette and e-cigarette product use via increased symptoms of depression (indirect effect = 0.13, 95% CI [0.07, 0.19], P < .05), and suicidal ideation (indirect effect = 0.22, 95% CI [0.15, 0.28], P < .05), but not symptoms of anxiety. Discussion This is the first study of our knowledge to examine the association between psychological symptoms and smoking and vaping products with transgender identity. The results of this study support previous findings that transgender individuals are at risk for elevated substance use and extend the literature by demonstrating this this risk is associated with elevated psychological distress.
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Affiliation(s)
- Ahmad A Kittaneh
- Department of Psychological Sciences, Kent State University, OH, USA
| | - Sweta Patel
- Center for Public Policy and Health, Kent State University, OH, USA
| | - Natasha K Sidhu
- Department of Psychological Sciences, Kent State University, OH, USA
| | - William V Lechner
- Department of Psychological Sciences, Kent State University, OH, USA
| | - Deric R Kenne
- Center for Public Policy and Health, Kent State University, OH, USA
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Al-Hinaai H, Al-Busaidi I, Al Farsi B, Al Saidi Y. The Prevalence of Substance Misuse and its Effects among Omani College Students: A Cross-sectional Study. Oman Med J 2021; 36:e224. [PMID: 33585045 PMCID: PMC7868041 DOI: 10.5001/omj.2021.04] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/11/2020] [Indexed: 12/22/2022] Open
Abstract
Objectives Many studies have confirmed that the use of alcohol, tobacco, and cannabis is prevalent among university students. This study aimed to assess the prevalence of substance misuse among college students in Oman, identifying the most commonly used substances, and reviewing the effect of substance misuse on the students’ performance. Methods This cross-sectional study was conducted in a higher learning institution in an urban setting in Oman from April 2018 to December 2018. A descriptive, self-administered online questionnaire, the Alcohol, Smoking, and Substance Involvement Screening Test, version 3.0 (Arabic version), adapted from the World Health Organization was sent to 12 000 students at the college. The sample size was calculated using online software (Raosoft), with a margin of error of 5% and a confidence level of 95%. Results A total of 375 students responded (response rate = 3.1%). The overall lifetime prevalence for any substance misuse (including tobacco and alcohol) among the participants was 41.3%, with the overall prevalence without tobacco or alcohol at 29.9%. Tobacco was the most common substance used, with a prevalence of around 23.5%, followed by alcohol at 10.7%. Male students had a significantly higher rate of substance abuse, for any substance, compared to female students (p < 0.001). There was a significant correlation between tobacco use, alcohol misuse, and misuse of other substances. Most of the adverse effects attributed to substance misuse reported by the respondents in this study were social (27.7%) and health-related (25.8%) problems. The impact of substance abuse on their performance was also high (23.8%). Furthermore, 15.4% of the respondents had financial problems, and 4.7%% were struggling with legal issues. Notably, only 49.1% of the respondents perceived that substance misuse was a serious problem. Conclusions Although college students are expected to be more aware of the negative impacts of substance misuse, this study found a high prevalence of smoking, alcohol, and other substance misuses among the group of Omani college students. Further research in this field is essential, and the results of this study have shed light on a critical problem among Omani college students. It is hoped that the findings of this study will be used and built on in future research to recognize students at risk of substance misuse from early school life, leading to early intervention, and potentially preventing the possible negative consequences.
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Affiliation(s)
| | - Issa Al-Busaidi
- Department of Family Medicine, Royal Oman Police Hospital, Muscat, Oman
| | - Badriya Al Farsi
- Department of Family Medicine, Armed Forces Hospital, Muscat, Oman
| | - Yaqoub Al Saidi
- Department of Family Medicine, Sultan Qaboos University Hospital, Muscat, Oman
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Abstract
Tobacco users can be charged health insurance Marketplace premiums up to 1.5 times higher than premiums for nonusers of tobacco. Despite being charged higher premiums, low- and middle-income tobacco users receive premium subsidies identical to those received by nonusers and cannot apply the subsidy to pay for any portion of their tobacco surcharge. Premium increases over time have exacerbated the discrepancy in premium prices based on tobacco use.
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Affiliation(s)
- Karina C Manz
- Karina C. Manz is a biomedical data scientist in the Department of Health Management and Policy, College of Public Health, University of Kentucky, in Lexington, Kentucky
| | - Teresa M Waters
- Teresa M. Waters is an endowed professor in and chair of the Department of Health Management and Policy, College of Public Health, University of Kentucky
| | - Cameron M Kaplan
- Cameron M. Kaplan is an assistant professor in the Gehr Family Center for Health Systems Science and Innovation, Keck School of Medicine, University of Southern California, in Los Angeles, California
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Yousaf A, Patterson J, Hobbs G, Davis SM, Yousaf M, Hafez M, Albandar H, Hogan T, Kolodney J. Smoking is associated with adrenal adenomas and adrenocortical carcinomas: a nationwide multicenter analysis. Cancer Treat Res Commun 2020; 25:100206. [PMID: 32871402 DOI: 10.1016/j.ctarc.2020.100206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/03/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022]
Abstract
MICROABSTRACT The effect of smoking on adrenal cancer is poorly understood. A clear association of adrenal adenoma and adrenocortical carcinoma with smoking among the United States population is observed. This association points to the possibility of environmental carcinogenic and/or lifestyle factors contributing to adrenal cancer formation. Our results support the association of tobacco use with adrenal adenomas and adrenal cortical carcinoma. BACKGROUND Smoking has been suggested as a risk factor for adrenal cortical carcinoma (ACC), but this hypothesis has only been inferred from a single study using all types of adrenal cancers including pheochromocytoma, neuroblastoma, as well as ACC. Given the high rate of tobacco use in West Virginia, we hypothesized that smoking might contribute to increased prevalence of ACC. MATERIALS AND METHODS De-identified institutional review board-exempted records were analyzed in the Surveillance, Epidemiology, and End Results (SEER) Program from 2001-2016 and in patients from the United States nationwide, multicenter TriNetX database of 41,063,707 patients from 2008-2018. In addition, the state-level ratio of smoking to ACC prevalence was computed in all 50 states using data from SEER and the Center for Disease Control. West Virginia Health System data from 2008-2018 was extracted to confirm population-level findings. Melanoma was used as a cancer control in both databases. RESULTS 6,946 ACC cases were identified. West Virginia had the highest smoking rate and the second highest rate of ACC. A significant association was found between smoking and ACC (Pearson correlation coefficient r = 0.4887, p=.0004). From 2008 to 2018 using TriNetX, 846 ACC and 36,434 AA were extracted. Both adrenal neoplasm cohorts had increased prevalence of tobacco use compared with melanoma controls, where 23.5% were smokers compared to 36.4% and 33.9% in the ACC and AA groups, respectively (p<0.0001 each). CONCLUSION To our knowledge, this is the first United States population-based study supporting smoking as a risk factor for adrenal carcinogenesis and ACC.
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Affiliation(s)
- Ahmed Yousaf
- Department of Dermatology, West Virginia University, Morgantown, WV, USA
| | - Jessica Patterson
- Department of Dermatology, West Virginia University, Morgantown, WV, USA
| | - Gerald Hobbs
- Department of Statistics, West Virginia University, Morgantown, WV, USA
| | - Stephen M Davis
- Department of Health Policy, Management & Leadership, West Virginia University, Morgantown, WV, USA; Department of Emergency Medicine, West Virginia University, Morgantown, WV, USA
| | - Muhammad Yousaf
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Maria Hafez
- Department of Medicine, Section of Hematology / Oncology, West Virginia University, Morgantown, WV, USA
| | - Heidar Albandar
- Department of Medicine, Section of Hematology / Oncology, West Virginia University, Morgantown, WV, USA
| | - Thomas Hogan
- Department of Medicine, Section of Hematology / Oncology, West Virginia University, Morgantown, WV, USA
| | - Joanna Kolodney
- Department of Medicine, Section of Hematology / Oncology, West Virginia University, Morgantown, WV, USA.
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Abstract
Introduction Although socioeconomic status (SES) resources influence population and individual health behaviors, socially marginalized groups gain significantly less health from their SES indicators, such as education and income, compared to the socially privileged groups. This pattern is called marginalization-related diminished returns (MDRs). However, most of the MDRs literature is derived from studies that have defined marginalization based on race and ethnicity. As a result, more research is needed on MDRs due to immigration. To extend what is known about MDRs due to immigration, the current study compared a national sample of immigrants and non-immigrants for the effects of education and income on current cigarette smoking of adults in the United States. Methods This is a cross-sectional study. The 2015 National Health Interview Survey (NHIS) enrolled 14,149 individuals who were either immigrants (n=1977; 14.0%) or non-immigrants (n=12,166; 86.0%). The independent variables (IV) were education and income that were treated as categorical variables. The dependent variable was current cigarette smoking. Age, gender, race, ethnicity, marital status, employment, and region were confounders. Immigration was the moderator. Logistic regression was used for data analysis. Results High education and income were associated with lower odds of current cigarette smoking. However, immigration showed significant statistical interactions with both education and income. These interactions were suggestive of smaller protective effects of high education and income on current cigarette smoking for immigrant than non-immigrant adults. Conclusion In line with the MDRs, the effects of education and income on tobacco use is weaker for immigrant than non-immigrant adults.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA
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Little M, Ebbert JO, Krukowski RA, Halbert J, Kalpinski MR, Patten CA, Talcott GW, Klesges RC. Factors Associated with Cigarette Use During Airmen's First Year of Service in the United States Air Force. Mil Med 2020; 185:e212-e220. [PMID: 31287888 DOI: 10.1093/milmed/usz155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/18/2019] [Accepted: 06/07/2019] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Despite declines of cigarette use in the civilian population, military personnel report alarmingly high rates of cigarette use. Enlisted Air Force recruits are required to remain tobacco-free for the first 12 weeks of training, and the majority express confidence they will not use tobacco after the ban; however, most previous smokers return to smoking and many nonsmokers initiate. Understanding the factors associated with cigarette-smoking initiation among non-users and re-initiation among former users is critical for the development of successful tobacco control efforts. MATERIALS AND METHODS The current study examines predictors of cigarette smoking among a sample of 2,188 USAF personnel after their first year of service. Logistic regression analyses examined associations between baseline predictors and initiation and re-initiation of cigarette smoking at a one-year follow-up. RESULTS Compared to never smokers at both time points, the strongest predictor of smoking initiation over the past 12 months was having owned cigarette-branded merchandise (OR 3.81, 95% CI 1.67, 8.71). Compared to former smokers who remained abstinent, the strongest predictor of re-initiation was intention to use tobacco (OR 2.08, 95% CI 1.53, 2.83). Compared to individuals who initiate, the strongest predictors of re-initiation were prior use of other tobacco products and tobacco use intentions (ORs range 1.85 to 4.63). CONCLUSIONS Multiple risk factors are associated with tobacco use. Given that Airmen are tobacco-free for the first 12 weeks of training, tobacco interventions during this period might be more effective. Our findings can be used to tailor interventions to prevent tobacco use in the U.S. military.
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Affiliation(s)
- Melissa Little
- Center for Addiction and Prevention Research, University of Virginia Medical School, 59 MDW/ 59 SGOWMP, 1100 Wilford Hall Loop, Bldg 4554, Joint Base Lackland AFB, TX 78236
| | - Jon O Ebbert
- Mayo Clinic, 200 First Street SW, Rochester, MN 55905
| | - Rebecca A Krukowski
- University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163-2181
| | - Jennifer Halbert
- Department of Public Health Sciences, Center for Addiction and Prevention Research, University of Virginia, 560 Ray C. Hunt Drive, PO Box 800717, Charlottesville, VA 22908
| | | | | | - Gerald W Talcott
- Department of Public Health Sciences, Center for Addiction and Prevention Research, University of Virginia, 2200 Bergquist Dr Ste 1, Joint Base Lackland AFB, TX 78236
| | - Robert C Klesges
- Department of Public Health Sciences, Center for Addiction and Prevention Research, University of Virginia, 560 Ray C. Hunt Drive, PO Box 800717, Charlottesville, VA 22908
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Sisti JS, Jasek JP, Farley SM. Heterogeneity in Current Cigarette Smoking among Hispanic/Latino Heritage Groups in New York City, 2003-2016. Ethn Dis 2020; 30:97-108. [PMID: 31969789 DOI: 10.18865/ed.30.1.97] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives We assessed differences in trends, prevalence, and sociodemographic correlates of current smoking among several predominant Hispanic/Latino heritage groups (Puerto Ricans, Dominicans, Central and South Americans, and other Hispanic/Latinos) in New York City (NYC). We additionally compared current smoking prevalence between heritage groups and non-Hispanic/Latino Whites. Design and Methods Data from the Community Health Survey, a representative, dual-frame landline/cellphone survey, were analyzed to assess age-adjusted prevalence of current smoking, separately among heritage groups from 2003-2016. Logistic regression was used to estimate odds ratios and 95% CIs for current smoking by Hispanic/Latino heritage group relative to non-Hispanic/Latino Whites in combined 2012-2016 data. Logistic regression was also used to examine correlates of smoking among each heritage group, separately. Results Between 2003-2016, current smoking prevalence decreased among all Hispanic/Latinos heritage groups except Puerto Ricans, who had the highest smoking prevalence among all groups examined. Sex-stratified trend analyses showed decreases among all groups except Puerto Rican and other Hispanic/Latino males. In multivariable-adjusted models, relative to non-Hispanic/Latino Whites, there was no association with current smoking among Puerto Ricans, but odds of smoking were lower among all other heritage groups. Female sex was inversely associated with current smoking among all heritage groups, and acculturation was positively associated with smoking among all groups except Central/South Americans. Lower educational attainment was strongly associated with smoking among Puerto Ricans. Conclusions Lack of progress in reducing smoking among Puerto Ricans in NYC is concerning. Opportunities for cultural, sex-specific, and other targeted outreach to this community should be explored.
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Affiliation(s)
- Julia S Sisti
- Bureau of Chronic Disease Prevention, New York City Department of Health and Mental Hygiene, Queens, NY
| | - John P Jasek
- Bureau of Chronic Disease Prevention, New York City Department of Health and Mental Hygiene, Queens, NY
| | - Shannon M Farley
- Bureau of Chronic Disease Prevention, New York City Department of Health and Mental Hygiene, Queens, NY
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Hernandez EM, Vuolo M, Frizzell LC, Kelly BC. Moving Upstream: The Effect of Tobacco Clean Air Restrictions on Educational Inequalities in Smoking Among Young Adults. Demography 2019; 56:1693-1721. [PMID: 31388944 PMCID: PMC6800635 DOI: 10.1007/s13524-019-00805-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Education affords a range of direct and indirect benefits that promote longer and healthier lives and stratify health lifestyles. We use tobacco clean air policies to examine whether policies that apply universally-interventions that bypass individuals' unequal access and ability to employ flexible resources to avoid health hazards-have an effect on educational inequalities in health behaviors. We test theoretically informed but competing hypotheses that these policies either amplify or attenuate the association between education and smoking behavior. Our results provide evidence that interventions that move upstream to apply universally regardless of individual educational attainment-here, tobacco clean air policies-are particularly effective among young adults with the lowest levels of parental or individual educational attainment. These findings provide important evidence that upstream approaches may disrupt persistent educational inequalities in health behaviors. In doing so, they provide opportunities to intervene on behaviors in early adulthood that contribute to disparities in morbidity and mortality later in the life course. These findings also help assuage concerns that tobacco clean air policies increase educational inequalities in smoking by stigmatizing those with the fewest resources.
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Affiliation(s)
- Elaine M Hernandez
- Department of Sociology, Indiana University, Ballantine Hall 744, 1020 E. Kirkwood Avenue, Bloomington, IN, 47405-7103, USA.
| | - Mike Vuolo
- Department of Sociology, The Ohio State University, 238 Townshend Hall, 1885 Neil Avenue Mall, Columbus, OH, 43210, USA
| | - Laura C Frizzell
- Department of Sociology, The Ohio State University, 238 Townshend Hall, 1885 Neil Avenue Mall, Columbus, OH, 43210, USA
| | - Brian C Kelly
- Department of Sociology, Purdue University, 700 W State Street, West Lafayette, IN, 47907, USA
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Boykan R, Blair R, Baldelli P, Owens S. Using Motivational Interviewing to Address Tobacco Cessation: Two Standardized Patient Cases for Pediatric Residents. MedEdPORTAL 2019; 15:10807. [PMID: 30931386 PMCID: PMC6415006 DOI: 10.15766/mep_2374-8265.10807] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/25/2019] [Indexed: 05/21/2023]
Abstract
INTRODUCTION Motivational interviewing (MI) is a well-established evidence-based method of working with patients to promote health behavior change. Standardized patient (SP) simulation allows trainees to practice and receive feedback on clinical and communication skills and may be useful in applying MI techniques to address tobacco use and exposure. METHODS We developed two SP cases for pediatric residents to practice addressing tobacco use with parents of their patients. RESULTS Thirty-six residents participated, 26 of whom had prior MI training. Resident postencounter self-reflection identified MI-specific skills, including eliciting the SP's view on positive/negative aspects of smoking, identifying stressors/triggers associated with smoking, eliciting reasons for smoking, asking about motivation/willingness to quit, eliciting benefits of quitting smoking, letting the SP do the talking, and guiding the SP in making a quit plan. On paired-samples t tests, resident self-evaluation checklist scores averaged 6.79 out of 8.00 (SD = 1.018, SEM = 0.165), compared with SP checklist scores, which averaged 7.08 out of 8.00 (SD = 1.217, SEM = 0.197). DISCUSSION These two SP cases were useful in many ways, allowing residents with prior MI training the opportunity for practice/feedback on skills learned and introducing residents with no prior MI training to MI concepts through experience/feedback. Residents consistently identified using MI concepts on postencounter self-reflection; resident self-evaluation and SP evaluation of residents showed agreement. These sessions could be utilized within a communication/MI curriculum or as stand-alone sessions to introduce MI concepts/techniques for addressing tobacco cessation in the pediatric setting.
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Affiliation(s)
- Rachel Boykan
- Associate Program Director, Residency Training Program, Department of Pediatrics, Stony Brook University School of Medicine
- Corresponding author:
| | - Robyn Blair
- Clinical Associate Professor, Department of Pediatrics, Stony Brook University School of Medicine
- Program Director, Residency Training Program, Department of Pediatrics, Stony Brook University School of Medicine
| | - Perrilynn Baldelli
- Director, Clinical Simulation Center, Stony Brook University School of Medicine
| | - Susan Owens
- Simulation Education Coordinator, Clinical Simulation Center, Stony Brook University School of Medicine
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Braciszewski JM, Vose-O’Neal A, Gamarel KE, Colby SM. Combustible Cigarette Smoking and Alternative Tobacco Use in a Sample of Youth Transitioning from Foster Care. Child Youth Serv Rev 2019; 96:231-236. [PMID: 31571706 PMCID: PMC6768414 DOI: 10.1016/j.childyouth.2018.11.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Among the struggles faced by youth currently in or recently exiting foster care, tobacco use remains a low priority for practitioners and researchers, alike. Indeed, despite the dramatically altered landscape of tobacco products on the market, there have been no studies evaluating the use of alternative tobacco products among this vulnerable population. The current study aimed to determine the prevalence of lifetime and current combustible and non-combustible tobacco use among youth exiting foster care, and report on the prevalence of nicotine dependence, motivation to quit, and preferred methods of tobacco cessation. Youth aged 18-24 (M = 20.13, SD = 1.16) who were transitioning from foster care (N = 154) completed a survey of tobacco product use adapted from the Population Assessment of Tobacco and Health Baseline Survey. Most participants (76%) reported lifetime use of combustible cigarettes, while almost half (42%) were current combustible cigarette smokers. Current use of electronic cigarettes was comparable to general population rates. Many participants (76%) reported interest in quitting and willingness to try through patches/gum (56%) and technology-based (61%) approaches. Youth exiting foster care are at high risk for smoking and other tobacco product use, as well as dependence, yet are rarely screened for use or advised to quit. As tobacco use remains among the most preventable causes of mortality and morbidity, future work should involve implementation of screening within child welfare and tailoring interventions to the unique needs of this population. The current results underscore a missed opportunity to promote public health in a vulnerable population.
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Affiliation(s)
- Jordan M. Braciszewski
- Henry Ford Health System, Center for Health Policy & Health Services Research, 1 Ford Place, Detroit, MI, USA 48202
| | - Adam Vose-O’Neal
- Pacific Institute for Research and Evaluation, Decision Sciences Institute, 1005 Main St., Suite 8120, Pawtucket, RI, USA 02860
| | - Kristi E. Gamarel
- University of Michigan, School of Public Health, Department of Health Behavior and Health Education, 3826 SPH I, 1415 Washington Heights, Ann Arbor, MI, USA 48109
| | - Suzanne M. Colby
- Brown University, Center for Alcohol & Addiction Studies, Box G-121S-4, Providence, RI, USA 02912
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Ali SA, Telgi RL, Tirth A, Tantry IQ, Aleem A. Lactate Dehydrogenase and β-Glucuronidase as Salivary Biochemical Markers of Periodontitis Among Smokers and Non-Smokers. Sultan Qaboos Univ Med J 2018; 18:e318-e323. [PMID: 30607272 DOI: 10.18295/squmj.2018.18.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/27/2018] [Accepted: 04/12/2018] [Indexed: 01/19/2023] Open
Abstract
Objectives This study aimed to establish lactate dehydrogenase (LDH) and β-glucuronidase as salivary biomarkers of periodontitis among smokers and non-smokers. Methods This cross-sectional case-control study was conducted at the Aligarh Muslim University, Aligarh, India, between January and June 2017. A total of 200 participants were divided into four groups based on their periodontal and smoking statuses. Unstimulated mixed saliva samples were collected to estimate LDH and β-glucuronidase levels. In addition, total protein was estimated using Lowry's method. Results There was a significant increase in enzyme activity in the periodontitis groups compared to the non-periodontitis groups (P <0.001). However, significantly lower enzyme activity was observed among smokers, irrespective of periodontal status (P <0.001). Nevertheless, a receiver operating characteristic curve analysis indicated the diagnostic potential of both enzymes to be fair-to-excellent. Conclusion Although smoking was found to significantly alter enzyme activity, LDH and β-glucuronidase were reliable salivary biomarkers of periodontitis among both smokers and non-smokers.
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Affiliation(s)
- Syed A Ali
- Department of Public Health Dentistry, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh, India
| | - Ravi L Telgi
- Department of Public Health Dentistry, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh, India
| | - Amit Tirth
- Department of Public Health Dentistry, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh, India
| | - Irfan Q Tantry
- Department of Biochemistry, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Abdul Aleem
- Department of Periodontology, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Tsoh JY, Quach T, Duong TB, Sa Nan Park E, Wong C, Huang SM, Nguyen TT. Interactive Mobile Doctor (iMD) to Promote Patient-Provider Discussion on Tobacco Use among Asian American Patients in Primary Care: A Pilot Study. J Am Board Fam Med 2018; 31:869-80. [PMID: 30413543 DOI: 10.3122/jabfm.2018.06.180018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 06/12/2018] [Accepted: 06/20/2018] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION This study examined the feasibility, acceptability, and efficacy of an interactive "Mobile Doctor" intervention (iMD) for Korean and Vietnamese American men, population groups with high smoking prevalence rates. METHODS The iMD delivers 5As (Ask, Advise, Assess, Assist, and Arrange) via tailored in-language video messages on a mobile tablet to Korean and Vietnamese male daily smokers right before a health care visit. A single-group trial was conducted with Korean- and Vietnamese-speaking patients at a federally qualified health center. Outcomes were assessed by self-reported surveys obtained postvisit and 3-month follow-up, and by examining electronic health record (EHR) progress notes from 3 consecutive primary care visits to evaluate impacts. RESULTS Among 47 male daily smokers (87% participation rate), 98% were limited English proficient and 53% had no intent to quit smoking within 6 months. On average, iMD took 12.9 minutes to complete. All participants reported discussing smoking with their providers during the visit, and more than 90% thought iMD was at least somewhat helpful in their decision about quitting and in communicating with their providers. EHR-documented 5As were significantly higher at the iMD visit for Assess (38.3%), Assist (59.6%), and Arrange (36.2%) compared with other visits without iMD. At 3 months, 51% made at least 1 24-hour quit attempt since the intervention. The self-reported 7-day point prevalence abstinence was 19%. CONCLUSIONS iMD is feasible and acceptable to Korean and Vietnamese male smokers, including those who were not intending to quit smoking. It is a promising tool for increasing patient-provider discussion of tobacco use and possibly smoking cessation among Asian American male smokers.
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Aryanpur M, Khosravi A, Yousefifard M, Hosseini M, Oraii A, Heydari G, Kazempour-Dizaji M, Sharifi H, Hessami Z, Jamaati H. Estimating of Net Transition Probabilities in Triple Stages of Cigarette Consumption in Iranian Men. Tanaffos 2018; 17:233-240. [PMID: 31143213 PMCID: PMC6534800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The present study was designed to estimate the net transition probabilities in triple stages of cigarette consumption in Iranian men over 15 years old. MATERIALS AND METHODS Data from the national surveillance of risk factors of non-communicable diseases in 2011 were entered in the present study. Data of 3130 Iranian men between the ages of 15 and 69 years old were included. Individuals were divided to three groups of current smoker, past smoker and nonsmoker based on cigarette consumption. Afterwards, net transition probability of different stages of cigarette consumption over a year was assessed. RESULTS Net transition probability from nonsmoker to smoker was at its highest level until 30 years of age at 19.1 per 1000 men and then net transition reduces to reach zero per 1000 men at the age of 45 years old. However, net transition probability from smoker to nonsmoker was at a very low level until 45 years of age but, it increases afterwards to reach a plateau at the age of 64 years old. Net transition probability from smoker to nonsmoker is estimated to be 23.1 per 1000 men at the age of 69 years old. CONCLUSION For the first time, the present study has estimated the transition probabilities in different stages of cigarette consumption in Iranian adults. Findings showed that risk of becoming a smoker in younger individuals is much higher than the risk in middle-aged and old population. However, tendency to quit smoking is increased after the age of 45 years old. Therefore, health policy makers should concentrate on younger age groups in their preventive strategies regarding control of tobacco consumption.
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Affiliation(s)
- Mahshid Aryanpur
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Khosravi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahmoud Yousefifard
- Physiology Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,,Correspondence to: Hosseini M, Address: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Email address:
| | - Alireza Oraii
- Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Heydari
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Kazempour-Dizaji
- Mycobacteriology Research Center, Biostatistics Unit, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hooman Sharifi
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Hessami
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Jamaati
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kyung SY, Kim YJ, Son ES, Jeong SH, Park JW. The Phosphodiesterase 4 Inhibitor Roflumilast Protects against Cigarette Smoke Extract-Induced Mitophagy-Dependent Cell Death in Epithelial Cells. Tuberc Respir Dis (Seoul) 2018; 81:138-147. [PMID: 29589382 PMCID: PMC5874143 DOI: 10.4046/trd.2017.0115] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 11/14/2017] [Accepted: 11/18/2017] [Indexed: 12/01/2022] Open
Abstract
Background Recent studies show that mitophagy, the autophagy-dependent turnover of mitochondria, mediates pulmonary epithelial cell death in response to cigarette smoke extract (CSE) exposure and contributes to the development of emphysema in vivo during chronic cigarette smoke (CS) exposure, although the underlying mechanisms remain unclear. Methods In this study, we investigated the role of mitophagy in the regulation of CSE-exposed lung bronchial epithelial cell (Beas-2B) death. We also investigated the role of a phosphodiesterase 4 inhibitor, roflumilast, in CSE-induced mitophagy-dependent cell death. Results Our results demonstrated that CSE induces mitophagy in Beas-2B cells through mitochondrial dysfunction and increased the expression levels of the mitophagy regulator protein, PTEN-induced putative kinase-1 (PINK1), and the mitochondrial fission protein, dynamin-1-like protein (DRP1). CSE-induced epithelial cell death was significantly increased in Beas-2B cells exposed to CSE but was decreased by small interfering RNA-dependent knockdown of DRP1. Treatment with roflumilast in Beas-2B cells inhibited CSE-induced mitochondrial dysfunction and mitophagy by inhibiting the expression of phospho-DRP1 and -PINK1. Roflumilast protected against cell death and increased cell viability, as determined by the lactate dehydrogenase release test and the MTT assay, respectively, in Beas-2B cells exposed to CSE. Conclusion These findings suggest that roflumilast plays a protective role in CS-induced mitophagy-dependent cell death.
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Affiliation(s)
- Sun Young Kyung
- Division of Pulmonary, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Yu Jin Kim
- Division of Pulmonary, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Eun Suk Son
- Division of Pulmonary, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.,Department of Biomedical Chemistry, Konkuk University, Chungju, Korea.,Gachon Medical Research Institute, Gachon University Gil Medical Center, Incheon, Korea
| | - Sung Hwan Jeong
- Division of Pulmonary, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.,Gachon Medical Research Institute, Gachon University Gil Medical Center, Incheon, Korea
| | - Jeong Woong Park
- Division of Pulmonary, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.,Gachon Medical Research Institute, Gachon University Gil Medical Center, Incheon, Korea.
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20
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Kittanamongkolchai W, Mara KC, Mehta RA, Vaughan LE, Denic A, Knoedler JJ, Enders FT, Lieske JC, Rule AD. Risk of Hypertension among First-Time Symptomatic Kidney Stone Formers. Clin J Am Soc Nephrol 2017; 12:476-482. [PMID: 28148559 PMCID: PMC5338710 DOI: 10.2215/cjn.06600616] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 11/02/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVES Prior work has suggested a higher risk of hypertension in kidney stone formers but lacked disease validation and adjustment for potential confounders. Certain types of stone formers may also be at higher risk of hypertension. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In our study, incident symptomatic stone formers in Olmsted County from 2000 to 2011 were manually validated by chart review and age and sex matched to Olmsted County controls. We followed up patients through November 20, 2015. Hypertension was also validated by manual chart review, and the risk of hypertension in stone formers compared with controls was assessed both univariately and after adjusting for comorbidities. The risk of hypertension among different subtypes of stone formers was also evaluated. RESULTS Among 3023 coded stone formers from 2000 to 2011, a total of 1515 were validated and matched to 1515 controls (mean age was 45 years old, and 56% were men). After excluding those with baseline hypertension (20% of stone formers and 18% of controls), 154 stone formers and 110 controls developed hypertension. Median follow-up time was 7.8 years in stone formers and 9.6 years in controls. Stone formers were found to have a higher risk of hypertension compared with controls (hazard ratio, 1.50; 95% confidence interval, 1.18 to 1.92), even after adjusting for age, sex, body mass index, serum creatinine, CKD, diabetes, gout, coronary artery disease, dyslipidemia, tobacco use, and alcohol abuse (hazard ratio, 1.58; 95% confidence interval, 1.12 to 2.21). Results were similar after excluding patients who were ever on a thiazide diuretic (hazard ratio, 1.65; 95% confidence interval, 1.16 to 2.38). Stone composition, radiographic stone burden, number of subsequent stone events, and stone removal surgeries were not associated with hypertension (P>0.05 for all). CONCLUSIONS The risk of hypertension was higher after the first symptomatic kidney stone event. However, kidney stone severity, type, and treatment did not associate with hypertension.
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Abstract
Tobacco use is the world's leading cause of preventable morbidity and mortality. Although Oman remains a country with the lowest tobacco use in the Arab Gulf States, the prevalence of tobacco use is projected to increase to 33.3% by 2025. In 2005, Oman acceded to the World Health Organization's Framework Convention on Tobacco Control, an international treaty with numerous obligations aiming to reduce the global burden of tobacco use. This paper documents, for the first time, Oman's experience in tobacco control by providing a descriptive analysis of the evolution of tobacco control policies in relation to the country's international obligations. In order to curb tobacco use and maintain current low prevalence levels, the paper concludes that Oman needs to accelerate action in adopting the highest attainable policies recommended by the World Health Organization's MPOWER package.
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Affiliation(s)
- Jawad Al-Lawati
- Directorate General of Health Affairs, Ministry of Health, Muscat, Oman
| | - Ruth M Mabry
- Office of the World Health Organization, Muscat, Oman
| | - Zakiya Q Al-Busaidi
- Department of Family Medicine and Public Health, College of Medicine, Sultan Qaboos University, Muscat, Oman
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Martín-Fernández J, Ariza-Cardiel G, Polentinos-Castro E, Gil-Lacruz AI, Gómez-Gascón T, Domínguez-Bidagor J, Del-Cura-González I. Risk-Taking Attitudes of Patients who Seek Health Care: An Exploratory Approach through Lottery Games. Rev Esp Salud Publica 2016; 90:e1-e14. [PMID: 27225445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 05/24/2016] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND The characterization of the risk-taking attitude of individuals may be useful for planning health care interventions. It has been attempted to study expressions of risk-taking attitude and evaluate characteristics of a standard lottery game in a population that seeks health care to elicit these attitudes. METHODS Multicentric cross-sectional study. Demographic and socioeconomic characteristics, quality of life (EuroQol-5D), and health risk behaviors were collected from 662 users of 23 health centers selected by random sampling. Risk-taking attitude was evaluated by means of a self-evaluation scale and two lottery games, (L1 and L2; L2 included the possibility of economic losses). Generalized estimating equations (GEE) explicative models were used to evaluate the variability of risk-taking attitude. RESULTS Nineteen percent out of interviewed people (CI95%: 15.6-22.6%) expressed a high risk appetite, but only 10.0% (CI95% 7.0 to 13.0) were classified as risk-seeking by L2. It was found association between increased risk appetite and having a better perception of health status (0.110, CI95%: 0,007-0,212) or a higher income (0.010, CI95%: 0.017- 0.123) or smoking status (0.059, CI95%: 0.004- 0.114). Being Spanish was associated with lower risk appetite (-0.105, CI95%: -0.005 --0.205), as being over 65 (-0.031, CI95%:- 0.061- -0.001) or a woman (-0.038, CI95%:-0.064- -0.012). The intraclass correlation coefficient for self-evaluation scale was 0.511 (95% CI: 0.372 to 0.629), 0.571 (95% CI: 0.441 to 0.678) for L1 and 0.349 (95% CI: 0.186-0.493) to L2. CONCLUSIONS People who seek health care express certain inclination to risk, but this feature is attenuated when methodologies involving losses are used. Risk appetite seems greater in young people, males, people with better health, or more income, and in immigrants. Lottery games such as the proposed ones are a simple and useful tool to estimate individuals' inclination to risk.
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Affiliation(s)
- Jesús Martín-Fernández
- Consultorio de Villamanta. Gerencia de Atención Primaria. Servicio Madrileño de Salud and Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos, Madrid and Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)
| | - Gloria Ariza-Cardiel
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)and Unidad Docente de Atención Familiar y Comunitaria Oeste. Gerencia de Atención Primaria. Servicio Madrileño de Salud
| | - Elena Polentinos-Castro
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)and Unidad Docente de Atención Familiar y Comunitaria Norte. Gerencia de Atención Primaria. Servicio Madrileño de Salud
| | - Ana Isabel Gil-Lacruz
- Departamento de Dirección y Organización de Empresas. Escuela de Ingeniería y Arquitectura. Universidad de Zaragoza
| | - Tomás Gómez-Gascón
- FIIBAP, Consejería de Sanidad Madrid and Facultad de Medicina, Universidad Complutense de Madrid and Instituto de Investigación i + 12 Hospital 12 de Octubre
| | - Julia Domínguez-Bidagor
- Servicio Promoción de Salud Subdirección Gral. de Promoción, Prevención y Educación para la Salud. Dirección General de Salud Pública. Madrid
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Heydari ST, Izedi S, Sarikhani Y, Kalani N, Akbary A, Miri A, Mahmoodi M, Akbari M. The Prevalence of Substance use and Associated Risk Factors Among University Students in the City of Jahrom, Southern Iran. Int J High Risk Behav Addict 2015; 4:e22381. [PMID: 26097836 PMCID: PMC4464575 DOI: 10.5812/ijhrba.4(2)2015.22381] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/24/2014] [Accepted: 12/16/2014] [Indexed: 11/18/2022]
Abstract
Background: Substance use among college students in Iran is a serious problem. Determining the pattern of substance use among University students is an important issue for implementing prevention and treatment programs. Objectives: The present survey attempts to determine the prevalence of substance usage and associated risk factors among the students of Jahrom University of Medical Sciences and Islamic Azad University of Jahrom, Jahrom, Iran. Patients and Methods: This cross-sectional study was carried out from December 2012 to February 2013 and included 1149 randomly selected students of two Jahrom universities. A standard questionnaire was used for data gathering. Data were analyzed using the SPSS version 15 for Windows. T-test and Chi-square T-test and Chi-square and Logestic regression tests were used for data analysis. Results: Tobacco (28.3%), alcohol (13.0%), and cannabis and marijuana (5.2%) were the most common substances used by the students. The prevalence of substance use among the male students was significantly higher (OR: 1.5, 95%CI: 1.42 - 2.68, P < 0.001). The risk of at least single episode of substance usage was higher among the students which were living alone (OR: 3.03, 95%CI: 1.74 - 5.28, P < 0.001) The most important motivators for beginning substance use were curiosity, in 46.4%, and seeking pleasure, in 28.8%. Conclusions: Substance usage is considered as a risk factor for students’ health among University students in Iran. Design of educational courses addressing the detrimental effects and dire consequences of substance usage could help to improve control programs. Universities could improve their drug abuse control programs by focusing on the high risk groups determined by relevant studies.
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Affiliation(s)
- Seyed Taghi Heydari
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Somayeh Izedi
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, IR Iran
| | - Yaser Sarikhani
- Research Center of Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, IR Iran
- Corresponding author: Yaser Sarikhani, Research Center of Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, IR Iran. Tel/Fax: +98-7132309615, E-mail:
| | - Navid Kalani
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, IR Iran
| | - Ali Akbary
- Department of Psychiatry, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, IR Iran
| | - Abolfazl Miri
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, IR Iran
| | - Mojtaba Mahmoodi
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Maryam Akbari
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
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Abstract
PURPOSE While the potential benefit of a chronic disease registry for tobacco use is great, outcome reports have not been generated. We examined the effect of implementing a tobacco use registry, including a decision support tool, on treatment outcomes within an academic family medicine clinic. METHODS A chart review of 200 patients who smoked and attended the clinic before and after registry implementation assessed the number of patients with clinic notes documenting (1) counseling for tobacco use, (2) recommendations for cessation medication, (3) a set quit date, (4) referrals to the on-site Nicotine Dependence Program (NDP) and/or QuitlineNC, and (5) pneumococcal vaccine. Data from the NDP, QuitlineNC, and clinic billing records before and after implementation compared the number of clinic-generated QuitlineNC fax referrals, new scheduled appointments for the NDP, and visits coded for tobacco counseling reimbursement. RESULTS Significant increases in documentation occurred across most chart review variables. Significant increases in the number of clinic-generated fax referrals to QuitlineNC (from 27 to 96), initial scheduled appointments for the NDP (from 84 to 148), and coding for tobacco counseling (from 101 to 287) also occurred when compared with total patient visits during the same time periods. Patient attendance at the NDP (52%) and acceptance of QuitlineNC services (31%) remained constant. CONCLUSIONS The tobacco use registry's decision support tool increased evidenced-based tobacco use treatment (referrals, medications, and counseling) for patients at an academic family medicine clinic. This novel tool offers standardized care for all patients who use tobacco, ensuring improved access to effective tobacco use counseling and medication treatments.
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Weinberger AH, Mazure CM, McKee SA, Caulin-Glaser T. The Association of Tobacco Use and Gender to Cardiac Rehabilitation Outcomes: A Preliminary Investigation. J Subst Use 2013; 19:171-175. [PMID: 24817825 DOI: 10.3109/14659891.2013.765515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Cardiac rehabilitation (CR) outcomes are measured in terms of cardiovascular disease (CVD) risk factor reductions, and these predict long-term cardiac status. This report examines whether reported tobacco use has differential effects on successful cardiovascular risk factor modification, especially for women who have greater smoking-related CVD consequences than men. METHODS A retrospective cohort analysis was conducted on 1138 adults (74% male) with diagnosed CVD who participated in ≥7 weeks of a comprehensive CR program. Eleven CVD risk factors were assessed at CR entry and completion. Tobacco use was assessed by self-report at CR entry. The primary outcomes were attainment of goal levels for each risk factor. RESULTS Fewer current and former tobacco users reached the preset goal for Maximal Exercise Capacity. Fewer women than men reached the preset goal for HDL. Women who were current or former tobacco users were less likely to meet the target goals for Triglycerides and more likely to meet target goals for Total Cholesterol and Non-HDL Cholesterol. CONCLUSIONS This preliminary study suggests the importance of identifying the effect of tobacco use and gender on CR outcomes and the need to evaluate modification of key cardiovascular risk factors for subgroups of cardiac patients.
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Affiliation(s)
- Andrea H Weinberger
- Department of Psychiatry and Women's Health Research at Yale , Yale University School of Medicine; Cancer Prevention and Control Research Program, Yale Cancer Center, New Haven, CT, USA
| | - Carolyn M Mazure
- Department of Psychiatry and Women's Health Research at Yale, Yale University School of Medicine, New Haven, CT, USA
| | - Sherry A McKee
- Department of Psychiatry and Women's Health Research at Yale, Yale University School of Medicine, New Haven, CT, USA
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