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Ambrusz A, Németh F, Borbély Z, Malét-Szabó E. [Relationship between the subjective health status and smoking among police officers]. Orv Hetil 2024; 165:584-594. [PMID: 38619880 DOI: 10.1556/650.2024.33006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/04/2024] [Indexed: 04/17/2024]
Affiliation(s)
- Aliz Ambrusz
- 1 Szabolcs-Szatmár-Bereg Vármegyei Rendőr-főkapitányság Nyíregyháza, Bujtos u. 2-4., 4400 Magyarország
- 2 Sárospataki Református Hittudományi Egyetem Sárospatak Magyarország
- 3 Debreceni Egyetem, Humán Tudományok Doktori Iskola, Pszichológia Doktori Program Debrecen Magyarország
| | - Ferenc Németh
- 4 Vas Vármegyei Markusovszky Egyetemi Oktatókórház, Pszichiátriai Osztály Szombathely Magyarország
| | - Zsuzsanna Borbély
- 5 Repülőtéri Rendőr Igazgatóság, Liszt Ferenc Nemzetközi Repülőtér Budapest Magyarország
| | - Erika Malét-Szabó
- 3 Debreceni Egyetem, Humán Tudományok Doktori Iskola, Pszichológia Doktori Program Debrecen Magyarország
- 5 Repülőtéri Rendőr Igazgatóság, Liszt Ferenc Nemzetközi Repülőtér Budapest Magyarország
- 6 Belügyminisztérium Budapest Magyarország
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Roczen J, Bolte G, Reineke B, Kuhnert R, Starker A, Mena E. Gender equality and smoking among 15 to 25 year olds-a time-based ecological analysis of developments in Germany from 1960 to 2005. Front Public Health 2024; 12:1295050. [PMID: 38435291 PMCID: PMC10904588 DOI: 10.3389/fpubh.2024.1295050] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Smoking is a major risk factor for premature death and health problems in which there are significant gender differences in the prevalence of smoking. This ecological study examines the correlation between changes in gender equality and prevalence of smoking among young adults (15-25 years old) in Germany over a period of 45 years (1960-2005). Methods Gender inequality was measured using the United Nations Gender Inequality Index (GII), which is composed of three dimensions; health, empowerment and labour market. It was calculated for the entire registered German population in five-year intervals with values between 0 and 1 (1 = highest inequality). The smoking prevalence of young women and men in Germany was established using a reconstruction method. A gender smoking ratio (GSR) with values between 0 and 1 was determined (1 = identical smoking prevalence among men and women). The smoking behaviour was illustrated and stratified by education. The correlation between the GII and the GSR was analysed. Results The GII decreased from 0.98 to 0.56 between 1960 and 2005. The GSR increased from 0.34 to 0.93. There was a strong negative correlation between the GII and the GSR (r = -0.71). The strength of the correlation fell slightly as the level of education decreased. An increase in gender equality as measured by the GII came along with similarities of smoking prevalence between young women and young men. Conclusion Successful tobacco prevention among young women and men may benefit from involving experts in gender-specific public health research to develop counter-advertising and gender-specific information as needed.
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Affiliation(s)
- Jana Roczen
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Birgit Reineke
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Ronny Kuhnert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anne Starker
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Emily Mena
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- Department of Prevention and Health Promotion, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
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van Walbeek C, Hill R, Filby S. Quitting behavior during the tobacco sales ban in South Africa: Results from a broadly nationally representative survey. Tob Induc Dis 2023; 21:102. [PMID: 37551390 PMCID: PMC10398832 DOI: 10.18332/tid/168594] [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: 10/30/2022] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION In response to COVID-19, the South African government banned the sale of tobacco products for 20 weeks. Before the ban, the illicit cigarette market was well-entrenched and smoking cessation services were not widely available. Several surveys conducted to ascertain cigarette smokers' responses to the ban reported substantial differences in the proportion of smokers who quit. This study provides a broadly nationally representative ex-post investigation into cigarette smokers' quitting behavior related to the sales ban. METHODS We used data from wave three of NIDS-CRAM (the National Income Dynamics Study-Coronavirus Rapid Mobile Survey) conducted in November-December 2020. We first investigated the proportion of people who quit and who continued smoking during and after the sales ban. We subsequently linked the NIDS-CRAM survey to the fifth wave of NIDS (2017) to identify a subset of established smokers, and considered whether their quitting behavior differed from that of all smokers who smoked at the start of the sales ban. RESULTS The cross-sectional analysis showed that 7.8% of cigarette smokers quit during the sales ban, but that 55% of these quitters relapsed after it was lifted. Of the pre-ban smokers, 3.5% indicated that they did not smoke both during and after the sales ban, and 3.7% quit after the ban was lifted. The longitudinal analysis showed that 7% of people who were smoking in 2017, quit smoking cigarettes during the tobacco sales ban, but that >70% of quitters relapsed after it was lifted. Only 2% of pre-ban established smokers indicated that they did not smoke during or after the ban. CONCLUSIONS The sales ban did not have the intended objective of encouraging large-scale smoking cessation. This reflects policy failures to provide smokers with appropriate cessation support and to effectively control the illicit market both prior to and during the sales ban.
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Affiliation(s)
- Corné van Walbeek
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
| | - Robert Hill
- Development Policy Research Unit, School of Economics, University of Cape Town, Rondebosch, South Africa
| | - Samantha Filby
- Research Unit on the Economics of Excisable Products, School of Economics, University of Cape Town, Rondebosch, South Africa
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Le TTT, Warner KE, Mendez D. The Evolution of Age-Specific Smoking Cessation Rates in the United States From 2009 to 2018. Res Sq 2023:rs.3.rs-3030197. [PMID: 37398051 PMCID: PMC10312979 DOI: 10.21203/rs.3.rs-3030197/v1] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Objective Tracking the US smoking cessation rate over time is of great interest to tobacco control researchers and policymakers since smoking cessation behaviors have a major effect on the public's health. A couple of recent studies have employed dynamic models to estimate the US cessation rate through observed smoking prevalence. However, none of those studies has provided recent annual estimates of the cessation rate by age group. Methods We employed a Kalman filter approach to investigate the annual evolution of age-group-specific cessation rates, unknown parameters of a mathematical model of smoking prevalence, during the 2009-2018 period using data from the National Health Interview Survey. We focused on cessation rates in the 24-44, 45-64 and 65 + age groups. Results The findings show that cessation rates follow a consistent u-shaped curve over time with respect to age (i.e., higher among the 25-44 and 65 + age groups, and lower among 45-64-year-olds). Over the course of the study, the cessation rates in the 25-44 and 65 + age groups remained nearly unchanged around 4.5% and 5.6%, respectively. However, the rate in the 45-64 age group exhibited a substantial increase of 70%, from 2.5% in 2009 to 4.2% in 2017. The estimated cessation rates in all three age groups tended to converge to the weighted average cessation rate over time. Conclusions The Kalman filter approach offers a real-time estimation of cessation rates that would be helpful for monitoring smoking cessation behavior, of interest in general but also for tobacco control policymakers.
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Affiliation(s)
- Thuy T T Le
- University of Michigan School of Public Health
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Affiliation(s)
- Henry M Marshall
- The University of Queensland Thoracic Research Centre, Brisbane, Queensland, Australia
- The Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Kwun M Fong
- The University of Queensland Thoracic Research Centre, Brisbane, Queensland, Australia
- The Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, Queensland, Australia
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Zong Q, Li H, Jiang N, Gong Y, Zheng J, Yin X. Prevalence and determinants of smoking behavior among physicians in emergency department: A national cross-sectional study in China. Front Public Health 2022; 10:980208. [PMID: 36324466 PMCID: PMC9620959 DOI: 10.3389/fpubh.2022.980208] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/16/2022] [Indexed: 01/25/2023] Open
Abstract
Objectives To understand the current status of smoking behavior among emergency physicians in China and to explore its determinants. Background The emergency department is considered a more appropriate setting for tobacco interventions. However, the smoking behavior of emergency physicians can reduce the effectiveness of interventions for patient smoking behavior. Methods From July to August 2018, we conducted a structured online questionnaire among Chinese emergency medicine physicians. We used descriptive analysis with binary logistic regression to analyze the current smoking status of Chinese emergency physicians and its determinants. Results A total of 10,457 emergency physicians were included in this study. The prevalence of smoking among physicians was 25.35% (with 34.15 and 1.59% among male and female physicians, respectively). Results of logistic regression showed that postgraduate education (OR = 0.52, 95% CI: 0.41-0.66), chief-level title (OR = 0.79, 95% CI: 0.65-0.97), and regular exercise habits (OR = 0.83, 95% CI: 0.76-0.92) were associated with a lower risk of smoking behavior. However, being over 50 years old (OR = 1.71, 95% CI: 1.29-2.27), being fixed-term (OR = 1.25, 95% CI: 1.10-1.42), and having depressive symptoms (OR = 1.43, 95% CI: 1.28-1.61) were associated with a higher risk of smoking. Conclusion The prevalence of smoking behavior among emergency physicians in China is high. Hospital management could reduce the incidence of smoking behavior among emergency physicians by strengthening smoking cessation training, paying attention to physicians' psychological health, reducing pressure on physicians in fixed-term positions, and encouraging physicians to develop regular exercise habits.
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Affiliation(s)
- Qiao Zong
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Li
- School of Health Services Management, Anhui Medical University, Hefei, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianwei Zheng
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Jianwei Zheng
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Xiaoxv Yin
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Michas G, Magriplis E, Micha R, Chourdakis M, Koutelidakis A, Dimitriadis G, Panagiotakos D, Zampelas A. WITHDRAWN: Prevalence and factors associated with smoking in a nationally representative sample of Greek adults: The Hellenic National Nutrition and Health Survey (HNNHS). Hellenic J Cardiol 2022:S1109-9666(22)00068-9. [PMID: 35605945 DOI: 10.1016/j.hjc.2022.05.006] [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: 10/25/2021] [Revised: 05/02/2022] [Accepted: 05/14/2022] [Indexed: 11/18/2022] Open
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published, https://doi.org/10.1016/j.hjc.2022.05.005. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
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Affiliation(s)
- George Michas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Renata Micha
- Department of Food Science and Nutrition, School of Agricultural Sciences, University of Thessaly, 43 100, Karditsa, Greece
| | - Michail Chourdakis
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54 124 Thessaloniki, Greece
| | - Antonis Koutelidakis
- Department of Food Science and Nutrition, University of Aegean, Mytilini, Greece
| | - George Dimitriadis
- 2(nd) 1Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens, Attikon University Hospital, Haidari, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University, Athens, Eleftheriou Venizelou 70, 176 76 Athens, Greece
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece.
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Opazo Breton M, Gillespie D, Pryce R, Bogdanovica I, Angus C, Hernandez Alava M, Brennan A, Britton J. Understanding long-term trends in smoking in England, 1972-2019: an age-period-cohort approach. Addiction 2022; 117:1392-1403. [PMID: 34590368 DOI: 10.1111/add.15696] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 09/09/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS Smoking prevalence has been falling in England for more than 50 years, but remains a prevalent and major public health problem. This study used an age-period-cohort (APC) approach to measure lifecycle, historical and generational patterns of individual smoking behaviour. DESIGN APC analysis of repeated cross-sectional smoking prevalence data obtained from three nationally representative surveys. SETTING England (1972-2019). PARTICIPANTS Individuals aged 18-90 years. MEASUREMENTS We studied relative odds of current smoking in relation to age in single years from 18 to 90, 24 groups of 2-year survey periods (1972-73 to 2018-19) and 20 groups of 5-year birth cohorts (1907-11 to 1997-2001). Age and period rates were studied for two groups of birth cohorts: those aged 18-25 years and those aged over 25 years. FINDINGS Relative to age 18, the odds of current smoking increased with age until approximately age 25 [odds ratio (OR) = 1.48, 95% confidence interval (CI) = 1.41-1.56] and then decreased progressively to age 90 (OR = 0.06, 95% CI = 0.04-0.08). They also decreased almost linearly with period relative to 1972-73 (for 2018-19: OR = 0.30, 95% CI = 0.26-0.34) and with birth cohort relative to 1902-06, with the largest decreased observed for birth cohort 1992-96 (OR = 0.44, 95% CI = 0.35-0.46) and 1997-2001 (OR = 0.35, 95% CI = 0.74-0.88). Smoking declined in the 18-25 age group by an average of 7% over successive 2-year periods and by an average of 5% in those aged over 25. CONCLUSIONS Smoking in England appears to have declined over recent decades mainly as a result of reduced smoking uptake before age 25, and to a lesser extent to smoking cessation after age 25.
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Affiliation(s)
- Magdalena Opazo Breton
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Duncan Gillespie
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Robert Pryce
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Ilze Bogdanovica
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Monica Hernandez Alava
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - John Britton
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
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Zhang G, Zhan J, Fu H. Trends in Smoking Prevalence and Intensity between 2010 and 2018: Implications for Tobacco Control in China. Int J Environ Res Public Health 2022; 19:670. [PMID: 35055491 PMCID: PMC8776183 DOI: 10.3390/ijerph19020670] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 12/10/2022]
Abstract
BACKGROUND China is the world's largest producer and consumer of cigarettes. Since 2010, the Chinese government has implemented many policies to combat the tobacco epidemic, yet little is known about their overall impacts. This study aims to investigate the trends in smoking prevalence and intensity between 2010 and 2018. METHODS We use five waves of data from China Family Panel Studies (CFPS), a nationally representative survey, to examine the trends in smoking prevalence and intensity. We use the chi-square test and t-test to examine differences across waves. Binary logistic regressions and linear regressions are applied to examine the association between smoking behaviors and risk factors. RESULTS The current smoking prevalence dropped from 30.30% in 2010 (90% CI 29.47-31.31) to 28.69% (90% CI 27.69-29.69) in 2018. As for smoking intensity, the average daily cigarettes consumption decreased steadily from 16.96 cigarettes (90% CI 16.55-17.36) in 2010 to 15.12 cigarettes (90% CI 15.07-15.94) in 2018. Smoking risk factors for men included marriage status, education level, employment status, alcohol consumption, and physical activities. The smoking risk was higher for women with a lower education level, lower household income, unemployment status, and alcohol consumption behavior. CONCLUSIONS Our study shows declined trends in both smoking prevalence and intensity between 2010 and 2018, suggesting some positive progress in tobacco control in China. Nonetheless, to achieve the goal of reducing smoking prevalence among people aged 15 and above to less than 20% by 2030, the Chinese government needs to take stronger anti-tobacco measures.
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Affiliation(s)
- Guoting Zhang
- Department of Health Policy and Management, School of Public Health, Peking University Health Science Center, Beijing 100191, China;
| | - Jiajia Zhan
- Department of Economics and Public Policy, Business School, Imperial College London, London SW7 2AZ, UK;
| | - Hongqiao Fu
- Department of Health Policy and Management, School of Public Health, Peking University Health Science Center, Beijing 100191, China;
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Gangadi M, Kalpourtzi N, Gavana M, Vantarakis A, Chlouverakis G, Hadjichristodoulou C, Trypsianis G, Voulgari PV, Alamanos Y, Karakosta A, Touloumi G, Karakatsani A. Prevalence of tobacco smoking and association with other unhealthy lifestyle risk factors in the general population of Greece: Results from the EMENO study. Tob Prev Cessat 2021; 7:61. [PMID: 34585029 PMCID: PMC8432411 DOI: 10.18332/tpc/140242] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/23/2021] [Accepted: 07/15/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The EMENO (National Morbidity and Risk Factors) survey is one of the first and most representative population-based surveys in Greece due to its study design and sampling procedure. We aimed to estimate the prevalence of smoking, secondhand smoking (SHS) and their potential associations with other socioeconomic and unhealthy lifestyle risk factors. METHODS EMENO is a cross-sectional health status survey conducted in Greece from May 2013 to June 2016. The survey was performed using face-to-face interviews and enrolled 6006 adults. Data were collected through questionnaires administered by trained interviewers. Current smoking (CS) and SHS were based on self-reporting. Analysis accounted for study design. RESULTS Information on smoking was available for 5862 individuals (97.6%). Overall, 37.8% were current and 16.1% former smokers. More males (44.3%) than females (31.6%) were current smokers. CS increased during adulthood and declined sharply in the elderly (p<0.001). Smoking initiation by the age of 17 years was reported by 48.7% of males and 36.2% of females. Multivariable analysis showed that higher alcohol consumption (>7 glasses/ week, OR=2.52; 95% CI: 1.97–3.23) and lower education level in men were positively associated with ever smoking. Moreover, women aged >35 years and respondents with low adherence to the Mediterranean diet (MD) (high/ low, OR= 0.35; 95% CI: 0.21–0.58) had higher odds to be current smokers than former smokers. Finally, the overall prevalence of exposure to SHS at work, home and public places was 38.8%, 30% and 44.6 %, respectively. CONCLUSIONS Unhealthy lifestyles of smokers, increased rates of CS in vulnerable groups, such as females and young adults, and early age of smoking initiation constitute alarming public health issues in Greece.
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Affiliation(s)
- Maria Gangadi
- 2nd Pulmonary Department, 'Attikon' University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Natasa Kalpourtzi
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Magda Gavana
- Department of Primary Care, General Practice and Health Services Research, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Vantarakis
- Environmental Microbiology Unit, Department of Public Health, Medical School, University of Patras, Patra, Greece
| | - Gregory Chlouverakis
- Division of Biostatistics, School of Medicine, University of Heraklion, Heraklion, Greece
| | | | - Gregory Trypsianis
- Department of Medical Statistics, Medical Faculty, Democritus University of Thrace, Alexandroupolis, Greece
| | - Paraskevi V Voulgari
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Yannis Alamanos
- Institute of Epidemiology Preventive Medicine and Public Health, Corfu, Greece
| | - Argiro Karakosta
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Contributed equally
| | - Anna Karakatsani
- 2nd Pulmonary Department, 'Attikon' University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Contributed equally
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Christopoulou R, Mavropoulos G, Voucharas G. The Greek smoking epidemic from a life-course perspective. J Public Health (Oxf) 2021; 44:e479-e486. [PMID: 34498081 PMCID: PMC9715303 DOI: 10.1093/pubmed/fdab342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 05/28/2021] [Accepted: 08/17/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Smoking rates in Greece are the highest recorded among OECD countries, but the historical and life-course evolution of smoking patterns is largely unknown. The present paper addresses this gap. METHODS We produce nationally representative life-course trajectories of smoking and related mortality of eight generations of Greek men and women. We estimate the smoking-mortality correlation conditional on several confounders and project the estimates forward. RESULTS We show that smoking prevalence among Greek men has plateaued at >60% for all but the youngest generation. For women, smoking prevalence is relatively lower, lags by several generations and follows a hump-shaped pattern. Smoking-attributable mortality is currently peaking for men (nearing 40% of total deaths) and is rising for women. We estimate that it takes ~20 years of smoking to maximize the smoking-mortality correlation (at 0.48 for men and 0.32 for women). Based on this estimation, we forecast that mortality rates will begin falling within the current decade. CONCLUSIONS The breadth of the Greek smoking epidemic has been high by international standards, reflecting the ineffective tobacco control efforts in the country. While smoking popularity fell during the Great Recession, policy vigilance is necessary to prevent a relapse once the economy recovers.
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Affiliation(s)
| | - Georgios Mavropoulos
- Department of Economic Sciences, University of Macedonia, 156 Egnatia Str, Thessaloniki 54636, Greece
| | - Georgios Voucharas
- Department of Economic Sciences, University of Macedonia, 156 Egnatia Str, Thessaloniki 54636, Greece
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Tanaka H, Kobayashi Y. [Trends in smoking prevalence by occupations defined in the Japan Standard Occupational Classification: A repeated cross-sectional analysis of the Comprehensive Survey of Living Conditions, 2001-2016]. Nihon Koshu Eisei Zasshi 2021; 68:433-443. [PMID: 33790096 DOI: 10.11236/jph.20-118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objectives Few studies have focused on the relationship between smoking habits and occupation in Japan. This study aimed to examine the changes in smoking prevalence by occupation, specifically those occupations defined in the Japan Standard Occupational Classification (JSOC).Methods We analyzed data from the Comprehensive Survey of Living Conditions, a large nationally representative survey conducted in Japan every three years, between 2001 and 2016. Survey participants were asked whether they (1) "never smoked," (2) "smoked daily," (3) "smoked occasionally but not every day," or (4) "used to smoke daily (before, at least one month)." Participants who answered (2) "smoked daily" or (3) "smoked occasionally but not every day" were considered "current smokers." Age-standardized smoking prevalence was computed based on the JSOC (10 categories: administrative and managerial; professional; clerical; sales; services; security; agriculture, forestry, and fishing; transport; manufacturing, construction, mining, carrying, cleaning, and packaging; and unemployment). The analyses were restricted to workers and unemployed men and women aged 25 to 64 years old.Results Between 2001 and 2016, the smoking prevalence (of the entire population aged 25 to 64 years old) decreased from 56.0% (95% confidence interval [95% CI]: 55.8-56.3%) to 38.4% (95% CI: 38.1-38.6%) among men, and from 17.0% (95% CI 16.8-17.2%) to 13.0% (95% CI 12.8-13.1%) among women. In 2016, the smoking prevalence for clerical (the lowest smoking prevalence) and transport workers (the highest smoking prevalence) was 27.9% (95% CI: 27.0-28.8%) and 48.3% (95% CI: 46.8-49.7%), respectively, for men, and 9.4% (95% CI: 9.0-9.7%), and 38.5% (95% CI: 32.6-44.5%), respectively, for women. Between 2001 and 2016, the smoking prevalence for men decreased for all occupations, whereas for women, the smoking prevalence decreased for all occupations except for security and for transport workers. The largest reduction rate of smoking prevalence between 2001 and 2016 for men and for women was observed in clerical workers (-21.0%) and sales workers (-7.2%), respectively. We also found that clerical workers had the lowest smoking prevalence across the 5-year age categories for both sexes, especially the younger age, which resulted in the largest differences in smoking prevalence by occupation among men aged 30 to 34 years old.Conclusion We confirmed that, between 2001 and 2016, the lowest and highest smoking prevalence for both sexes is found among clerical workers and among transport workers, respectively. Although smoking prevalence has declined among working-aged men and women between 2001 and 2016, large differences by occupations consistently exist in Japan. It is necessary to take measures against smoking habits in consideration of their social backgrounds and work environments.
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Affiliation(s)
- Hirokazu Tanaka
- Department of Public Health, Erasmus University Medical Center.,Department of Public Health, Graduate School of Medicine, the University of Tokyo
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, the University of Tokyo
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Gallus S, Borroni E, Odone A, van den Brandt PA, Gorini G, Spizzichino L, Pacifici R, Lugo A. The Role of Novel (Tobacco) Products on Tobacco Control in Italy. Int J Environ Res Public Health 2021; 18:1895. [PMID: 33669394 PMCID: PMC7920305 DOI: 10.3390/ijerph18041895] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/28/2022]
Abstract
In Italy, electronic cigarettes have spread since 2010 and heated tobacco products (HTP) since 2016. We investigated their public health consequences on conventional cigarette smoking, taking advantage of a series of cross-sectional studies annually conducted between 2001 and 2019 in Italy. Every year, the sample, including around 3000 individuals, was representative of the general Italian population aged ≥15 years. In Italy, smoking prevalence steadily declined from 29.1% in 2001 to 20.6% in 2013, then increased to 22.0% in 2019. In 2017-2019, current electronic cigarette users were 2.1% and in 2019 current HTP users were 1.1%. Among 498 ever electronic cigarette users, 23.2% started or re-started smoking and 15.7% quit smoking after electronic cigarette use; of 49 ever HTP users, 19.1% started or re-started smoking combusted cigarettes and 14.6% quit smoking after HTP use. The availability of novel products in Italy resulted in a halt of the decreasing trend in smoking prevalence. For the first time, we observed an increase of Italians inhaling nicotine, concurrently with the spread of novel (tobacco) products. More importantly, the use of novel products appears to increase-rather than decrease-the likelihood of smoking conventional cigarettes. Considering this evidence, we see no argument to justify the huge fiscal and regulatory benefits these products continue to have, at least in Italy.
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Affiliation(s)
- Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
| | - Elisa Borroni
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- School of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Piet A. van den Brandt
- Department of Epidemiology, CAPHRI-School for Public Health and Primary Care, Maastricht University Medical Centre, 6211 LK Maastricht, The Netherlands;
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, 6211 LK Maastricht, The Netherlands
| | - Giuseppe Gorini
- Oncologic Network, Prevention and Research Institute (ISPRO), 50139 Florence, Italy;
| | - Lorenzo Spizzichino
- Italian Ministry of Health, Center for Disease Prevention and Control, 00144 Rome, Italy;
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
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14
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Gallus S, Lugo A, Liu X, Behrakis P, Boffi R, Bosetti C, Carreras G, Chatenoud L, Clancy L, Continente X, Dobson R, Effertz T, Filippidis FT, Fu M, Geshanova G, Gorini G, Keogan S, Ivanov H, Lopez MJ, Lopez-Nicolas A, Precioso J, Przewozniak K, Radu-Loghin C, Ruprecht A, Semple S, Soriano JB, Starchenko P, Trapero-Bertran M, Tigova O, Tzortzi AS, Vardavas C, Vyzikidou VK, Colombo P, Fernandez E. Who Smokes in Europe? Data From 12 European Countries in the TackSHS Survey (2017-2018). J Epidemiol 2021; 31:145-151. [PMID: 32249267 PMCID: PMC7813769 DOI: 10.2188/jea.je20190344] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 01/21/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Population data on tobacco use and its determinants require continuous monitoring and careful inter-country comparison. We aimed to provide the most up-to-date estimates on tobacco smoking from a large cross-sectional survey, conducted in selected European countries. METHODS Within the TackSHS Project, a face-to-face survey on smoking was conducted in 2017-2018 in 12 countries: Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania, and Spain, representing around 80% of the 432 million European Union (EU) adult population. In each country, a representative sample of around 1,000 subjects aged 15 years and older was interviewed, for a total of 11,902 participants. RESULTS Overall, 25.9% of participants were current smokers (31.0% of men and 21.2% of women, P < 0.001), while 16.5% were former smokers. Smoking prevalence ranged from 18.9% in Italy to 37.0% in Bulgaria. It decreased with increasing age (compared to <45, multivariable odds ratio [OR] for ≥65 year, 0.31; 95% confidence interval [CI], 0.27-0.36), level of education (OR for low vs high, 1.32; 95% CI, 1.17-1.48) and self-rated household economic level (OR for low vs high, 2.05; 95% CI, 1.74-2.42). The same patterns were found in both sexes. CONCLUSIONS These smoking prevalence estimates represent the most up-to-date evidence in Europe. From them, it can be derived that there are more than 112 million current smokers in the EU-28. Lower socio-economic status is a major determinant of smoking habit in both sexes.
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Affiliation(s)
- Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Xiaoqiu Liu
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Panagiotis Behrakis
- Institute of Public Health of the American College of Greece, Athens, Greece
| | - Roberto Boffi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cristina Bosetti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Giulia Carreras
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Florence, Italy
| | - Liliane Chatenoud
- Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Luke Clancy
- TobaccoFree Research Institute Ireland, Dublin, Ireland
| | - Xavier Continente
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP) (Biomedical Research Centre Network for Epidemiology and Public Health), Madrid, Spain
- Institut d’investigació Biomèdica Sant Pau (IIB St. Pau), Barcelona, Spain
| | | | - Tobias Effertz
- University of Hamburg, Hamburg Business School, Institute for Law & Economics, Hamburg, Germany
| | | | - Marcela Fu
- Tobacco Control Unit, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Unit, Institut d’Investigació Biomèdica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
- Universitat de Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | | | - Giuseppe Gorini
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Florence, Italy
| | - Sheila Keogan
- TobaccoFree Research Institute Ireland, Dublin, Ireland
| | | | - María J. Lopez
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP) (Biomedical Research Centre Network for Epidemiology and Public Health), Madrid, Spain
- Institut d’investigació Biomèdica Sant Pau (IIB St. Pau), Barcelona, Spain
| | | | - José Precioso
- Instituto de Educação, Universidade do Minho, Braga, Portugal
| | - Krzysztof Przewozniak
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Foundation “Smart Health - Health in 3D”, Warsaw, Poland
- Collegium Civitas, Warsaw, Poland
| | | | - Ario Ruprecht
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Joan B. Soriano
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
- Hospital Universitario La Princesa, Madrid, Spain
| | | | - Marta Trapero-Bertran
- Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Olena Tigova
- Tobacco Control Unit, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Unit, Institut d’Investigació Biomèdica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Anna S. Tzortzi
- Institute of Public Health of the American College of Greece, Athens, Greece
| | | | | | | | - Esteve Fernandez
- Tobacco Control Unit, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Unit, Institut d’Investigació Biomèdica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
- Universitat de Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - the TackSHS Project Investigators
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
- Institute of Public Health of the American College of Greece, Athens, Greece
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
- Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Florence, Italy
- Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
- TobaccoFree Research Institute Ireland, Dublin, Ireland
- Agència de Salut Pública de Barcelona, Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP) (Biomedical Research Centre Network for Epidemiology and Public Health), Madrid, Spain
- Institut d’investigació Biomèdica Sant Pau (IIB St. Pau), Barcelona, Spain
- University of Stirling, Stirling, Scotland
- University of Hamburg, Hamburg Business School, Institute for Law & Economics, Hamburg, Germany
- Department of Primary Care and Public Health, Imperial College, London, UK
- Tobacco Control Unit, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, Spain
- Tobacco Control Research Unit, Institut d’Investigació Biomèdica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
- Universitat de Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
- Smoke Free Life Coalition, Sofia, Bulgaria
- Universidad Politécnica de Cartagena, Cartagena, Spain
- Instituto de Educação, Universidade do Minho, Braga, Portugal
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Foundation “Smart Health - Health in 3D”, Warsaw, Poland
- Collegium Civitas, Warsaw, Poland
- European Network for Smoking Prevention, Bruxelles, Belgium
- Hospital Universitario La Princesa, Madrid, Spain
- Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya (UIC), Barcelona, Spain
- DOXA Institute, Milan, Italy
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Nargis N, Li Q, Griffin L, Asare S, Bandi P, Majmundar A, Westmaas JL, Jemal A. Association of teleworking and smoking behavior of U.S. wage and salary workers. J Occup Health 2021; 63:e12283. [PMID: 34599638 PMCID: PMC8487165 DOI: 10.1002/1348-9585.12283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has led to a major shift in workspace from office to home. This report examined how telecommuting is related to smoking behavior of wage and salary workers. METHODS Self-reported smoking behavior of 1,390 U.S. wage and salary workers aged 16-64 years from the Tobacco Use Supplement of the Current Population Survey 2018/19 were linked to the 2018 American Time Use Survey. Weighted multivariate logistic regression predicting smoking probability and generalized linear regression predicting smoking intensity were used for analysis. RESULTS Almost a fifth (19%) of wage and salary workers reported working from home and over a half (52%) reported working in telecommuting amenable occupations. Nearly 12% were current smokers, smoking 14.7 cigarettes daily on average. Compared to their counterparts, smoking prevalence (percentage points) was lower among those employed in telecommuting amenable occupations (-0.52, p < .001 for all; 0.01, p = .862 for men; -2.40, p < .001 for women) and who worked more frequently from home (-0.21, p < .001 for all; -0.76, p < .001 for men; -0.03, p = .045 for women). Smoking intensity (cigarettes per day) was lower among those employed in telecommuting amenable occupations (-3.39, p = .03 for all; -0.36, p = .90 for men; -4.30, p = .21 for women). We found no statistically significant association between smoking intensity and telecommuting frequency. CONCLUSIONS The lower likelihood of smoking and lower level of smoking intensity among telecommuting wage and salary workers suggests the need for proactive efforts to address the potential exacerbation in occupation-related smoking disparities between occupations that are and are not amenable to telecommuting.
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Affiliation(s)
| | - Qing Li
- American Cancer SocietyAtlantaGeorgiaUSA
- Viametric Solutions LLCAtlantaGeorgiaUSA
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Septiono W, Kuipers MAG, Ng N, Kunst AE. The impact of local smoke-free policies on smoking behaviour among adults in Indonesia: a quasi-experimental national study. Addiction 2020; 115:2382-2392. [PMID: 32386096 PMCID: PMC7687215 DOI: 10.1111/add.15110] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 11/25/2019] [Accepted: 05/01/2020] [Indexed: 01/17/2023]
Abstract
AIMS To investigate to what extent the adoption of local smoke-free policies (SFPs) in Indonesia in 2007-13 was associated with changes in adult smoking behaviour. DESIGN A quasi-experimental study. SETTING Indonesia, 2007 and 2013. PARTICIPANTS A total of 1 052 611 > 25-year-old adults. Data were derived from the 2007 and 2013 Indonesian national health survey. MEASUREMENTS For both years, provincial and district SFPs were identified from government documents in 497 districts in 33 provinces. Multi-level logistic regression analysis assessed the association of adoption of provincial and district SFPs between 2007 and 2013 with smoking continuation (among ever-smokers), current smoking and high smoking intensity (among current smokers). We controlled for survey year, SFP in 2007, socio-demographics and district characteristics. FINDINGS Provincial SFP exposure was associated with lower odds of smoking continuation [strong SFP versus no SFP: odds ratio (OR) = 0.71, 95% confidence interval (CI) = 0.66-0.76] and smoking intensity (strong SFP: OR= 0.91, 95% CI = 0.86-0.97), but also with higher odds of current smoking (strong SFP versus no SFP: OR = 1.08; 95% CI = 1.04-1.12). District SFP exposure was associated with higher odds of smoking continuation (strong SFP versus no SFP: OR = 1.07, 95% CI = 1.01-1.14) and current smoking (strong SFP versus no SFP: OR = 1.09, 95% CI = 1.05-1.14), but with lower odds of smoking intensity (moderately strong SFP versus no SFP: OR = 0.95, 95% CI = 0.91-0.99). CONCLUSIONS There may be an association between the adoption of local smoke-free policies in Indonesia and decreased adult smoking intensity. However, the evidence is inconsistent, which may reflect problems with policy implementation and enforcement.
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Affiliation(s)
- Wahyu Septiono
- Department of Public Health, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Mirte A. G. Kuipers
- Department of Public Health, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - Nawi Ng
- Department of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Epidemiology and Global Health, Faculty of MedicineUmeå UniversityUmeåSweden
| | - Anton E. Kunst
- Department of Public Health, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
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Mansouri M, Sadeghi O, Roshanfekr P, Sharifi F, Varmaghani M, Yaghubi H, Ghaffari S, Masjedi MR. Prevalence of smoking and its association with health-related behaviours among Iranian university students: a large-scale study. East Mediterr Health J 2020; 26:1251-1261. [PMID: 33103753 DOI: 10.26719/emhj.20.053] [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] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 12/12/2018] [Indexed: 11/09/2022]
Abstract
Background The prevalence of smoking and contributing factors among Iranian university students has been paid little attention. Aims The aim of this study was to assess the prevalence of smoking in Iranian university students and its association with health-related behaviours. Methods This cross-sectional study was carried out on a sample of 82 806 Iranian university students admitted in 2012-2013. Information on demographic characteristics and health-related behaviours, including physical activity, sleep pattern, use of electronic devices and dietary habits, were collected using a standardized questionnaire. Weight and height were measured using a standard protocol and body mass index calculated. Smokers were defined as students who smoked ≥ 1 cigarette per week. Results Smoking was prevalent among 6.0% of university students (males 6.6%, females 5.6%). Moderate physical activity was inversely associated with odds of smoking. A significant positive association was also found between obesity and odds of being a smoker. Higher intake of fruits and dairy products were associated with lower odds of smoking. However, intake of vegetables, fast foods and carbonated beverages was positively associated with smoking. Breakfast consumption was also associated with greater odds of being a smoker. Conclusions Demographic characteristics and health-related behaviours, including marital status, occupation, economic status, sleep pattern, physical activity, use of electronic devices and dietary intake, were significantly associated with smoking.
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Affiliation(s)
- Masoume Mansouri
- Student Health Services, Students' Health and Consultation Centre, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Omid Sadeghi
- Students' Scientific Research Centre, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Payam Roshanfekr
- Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran
| | - Farshad Sharifi
- Elderly Health Research Centre, Endocrinology and Metabolism Population Sciences Research Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mehdi Varmaghani
- Social Determinants of Health Research Centre, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran
| | - Hamid Yaghubi
- Department of Psychology, Shahed University, Tehran, Islamic Republic of Iran
| | - Sonia Ghaffari
- Tobacco Control Research Centre (Iranian Anti-Tobacco Association), Tehran, Islamic Republic of Iran
| | - Mohammad Reza Masjedi
- Tobacco Control Research Centre (Iranian Anti-Tobacco Association), Tehran, Islamic Republic of Iran
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Bafunno D, Catino A, Lamorgese V, Del Bene G, Longo V, Montrone M, Pesola F, Pizzutilo P, Cassiano S, Mastrandrea A, Ricci D, Petrillo P, Varesano N, Zacheo A, Galetta D. Impact of tobacco control interventions on smoking initiation, cessation, and prevalence: a systematic review. J Thorac Dis 2020; 12:3844-3856. [PMID: 32802466 PMCID: PMC7399441 DOI: 10.21037/jtd.2020.02.23] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Indexed: 11/15/2022]
Abstract
This article investigates the effects of tobacco control policies on smoking initiation, cessation and prevalence by examining the papers published in the last 5 years. Twenty-one articles have been selected by two authors and sorted by four types of tobacco control: tobacco prices, anti-smoking campaigns for young people, mass media intervention and public smoking bans. Price/tax increase has deterrent effect on smoking initiation but does not promote smoking cessation; intervention on young people could reduce the smoking initiation if carried out at an early age and if acted on social skills and with peer-led approach, as opposed to restraining measures which hare generally easily circumvented by young people. The mass media campaigns showed positive effect on attempts to quit among smokers if carried forward over time and by involving multiple communication channels (TV, internet, radio). The bans in public have little effect on smoking cessation but could improve the overall well-being of non-smokers. Heterogeneous results have been described by different studies probably because of different research methodologies, cultural aspects and the really effective implementation of the rules for each country. In conclusion, comprehensive tobacco control interventions to reduce smoking prevalence and modify the smoking behavior are recommended. Moreover, the use of e-cigarettes and heat-not-burn (HnB) products, as possible helping tool for smoke cessation, currently remains controversial.
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Affiliation(s)
- Daniela Bafunno
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Annamaria Catino
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Vito Lamorgese
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Gabriella Del Bene
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Vito Longo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Michele Montrone
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Francesco Pesola
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Pamela Pizzutilo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Sandro Cassiano
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | | | - Donata Ricci
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Patrizia Petrillo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Niccolò Varesano
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Antonella Zacheo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Domenico Galetta
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
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Itani T, Martin R, Rai D, Jones T, Taylor G, Thomas K, Munafo M, Davies N, Taylor A. Use of varenicline and nicotine replacement therapy in people with and without general practitioner-recorded dementia: retrospective cohort study of routine electronic medical records. BMJ Open 2019; 9:e027569. [PMID: 31473613 PMCID: PMC6720236 DOI: 10.1136/bmjopen-2018-027569] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 05/24/2019] [Accepted: 06/26/2019] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Our primary objective was to estimate smoking prevalence and prescribing rates of varenicline and nicotine replacement therapy (NRT) in people with and without general practitioner (GP)-recorded dementia. Our secondary objective was to assess and compare quit rates of smokers with versus without GP-recorded dementia who were prescribed varenicline or NRT for smoking cessation. DESIGN A retrospective cohort study based on the analysis of electronic medical records within the Clinical Practice Research Datalink (2007-2015). SETTING 683 general practices in England. PARTICIPANTS People with and without GP-recorded dementia, aged 18 years and have a code indicating that they are a current smoker. INTERVENTION Index prescription of varenicline or NRT (from 1 September 2006). OUTCOME MEASURES The primary outcomes were smoking prevalence and prescribing rates of varenicline and NRT (2007-2015). The secondary outcome was smoking cessation at 2 years. RESULTS Age and sex-standardised prevalence of smoking was slightly higher in people with GP-recorded dementia than in those without. There were 235 314 people aged 18 years and above prescribed NRT or varenicline. Among smokers with GP-recorded dementia (N=447), 409 were prescribed NRT and 38 varenicline. Smokers with GP-recorded dementia were 74% less likely (95% CI 64% to 82%) to be prescribed varenicline than NRT, compared with smokers without GP-recorded dementia. Compared with people without GP-recorded dementia, people with GP-recorded dementia had consistently lower prescribing rates of varenicline from 2007 to 2015. Two years after prescription, there was no clear evidence for a difference in the likelihood of smoking cessation after prescription of these medications between individuals with and without dementia (OR 1.0, 95% CI 0.8 to 1.2). CONCLUSIONS Between 2007 and 2015, people with GP-recorded dementia were less likely to be prescribed varenicline than those without dementia. Quit rates following prescription of either NRT or varenicline were similar in those with and without dementia.
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Affiliation(s)
- Taha Itani
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
| | - Richard Martin
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Dheeraj Rai
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
- Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | - Tim Jones
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Gemma Taylor
- Addiction and Mental Health Group (AIM) Department of Psychology, University of Bath, Bath, UK
| | - Kyla Thomas
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus Munafo
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
| | - Neil Davies
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Amy Taylor
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Gehricke JG, Gevorkian J, Stehli A, Alejo SD, Dawson M, Kopelevich A. Discrepancies in the Validity of Self-Reported Cigarette Smoking in Adults With and Without ADHD. J Dual Diagn 2019; 15:177-183. [PMID: 31156069 PMCID: PMC6711780 DOI: 10.1080/15504263.2019.1620399] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Attention-deficit/hyperactivity disorder (ADHD) is associated with an increased smoking prevalence and impairments in executive function, which may negatively affect the validity of self-reported smoking rates. This study compares the utility of self-reported smoking with salivary cotinine in adult smokers and nonsmokers with and without ADHD. Methods: Participants (N = 82) were adult smokers and nonsmokers with and without ADHD (n = 35 ADHD and n = 47 controls) from an observational study. Odds ratios (ORs) for accuracy of self-reported smoking compared to salivary cotinine were calculated using diagnosis (ADHD vs. control), gender, age, education, employment, and number of cigarettes per day as predictors. Post-hoc analysis stratified sensitivity, specificity, and accuracy of self-reported smoking in individuals with ADHD and without ADHD. Results: The initial analysis identified education as a significant independent predictor of odds of accuracy, OR = 6.22, p = .013, after adjusting for diagnosis, gender, age, employment, and cigarettes per day. Post-hoc analysis revealed that sensitivity, specificity, and accuracy of self-reported smoking was 100% for individuals with ADHD who had more than high school education compared to those with high school or less, which was 83.3%, 45.5%, and 65.2%, respectively. Self-reported smoking of control participants with greater than a high school education had a sensitivity of 85.7%, a specificity of 91.7%, and an accuracy of 88.5%. Control participants with a high school or lower education had a sensitivity of 54.6%, a specificity of 90%, and an accuracy of 71.4% for their self-reported smoking. Conclusions: Individuals with ADHD and high school or lower education showed the lowest specificity and accuracy in their self-reported smoking, which may affect documented smoking prevalence rates. This is a secondary analysis of data collected as part of a clinical trial registered as NCT00915798 at www.clinicaltrials.gov .
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Affiliation(s)
- Jean-G Gehricke
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Jonathan Gevorkian
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Annamarie Stehli
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Sharina Dyan Alejo
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Meghan Dawson
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Alexei Kopelevich
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
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Nasser AMA, Zhang X. Knowledge and factors related to smoking among university students at Hodeidah University, Yemen. Tob Induc Dis 2019; 17:42. [PMID: 31516485 PMCID: PMC6662901 DOI: 10.18332/tid/109227] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/10/2019] [Accepted: 05/08/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Tobacco smoking, especially among university students, remains a significant issue worldwide. This survey aims to investigate and evaluate the smoking behavior and smoking-related knowledge and their relationship in students of Hodeidah University, Yemen. METHODS A cross-sectional study was performed among students at Hodeidah University. Using a global youth tobacco survey and a global health professional survey, data were collected from three colleges (Commerce and Economics, Engineering, and Medicine) from April to June 2017, from 420 randomly chosen students. RESULTS The smoking prevalence among university students was 33.1% (cigarettes 13.6%, waterpipe 9.3%, and 10.2% for dual cigarettes and waterpipe use), with a higher rate of smoking among males than females (36.3% vs 28.0%, p<0.001). The percentage of individuals participating in the three types of smoking among males and females, respectively, were 18.9% vs 5.0% for cigarettes, 1.9% vs 21.1% for waterpipe, and 15.4% vs 1.9% for dual cigarettes and waterpipe use, with a student mean age of 21.93 ± 2.55 years. The regression outcome revealed that year of study was highly associated with smoking (OR=0.87, 95% CI: 0.85-0.89, p<0.001). Age (OR=0.96, 95% CI: 0.94-0.99, p<0.05), residence (OR=1.05, 95% CI: 1.00-1.09, p<0.05) and family income (OR=1.03, 95% CI: 1.00-1.06, p<0.05) were also significant predictors of smoking. CONCLUSIONS According to this study, most of the male students were cigarette users, while female students were waterpipe users. The prevalence of waterpipe use among females, as opposed to males, is an issue of concern. Policy makers may need to initiate anti-smoking programmes in Yemeni universities.
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Affiliation(s)
- Abdulsalam M. A. Nasser
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Rinkūnienė E, Petrulionienė Ž, Dženkevičiūtė V, Gimžauskaitė S, Mainelis A, Puronaitė R, Jucevičienė A, Gargalskaitė U, Laucevičius A. Trends in Cigarette Smoking among Middle-Aged Lithuanian Subjects Participating in the Primary Prevention Program between 2009 and 2016. ACTA ACUST UNITED AC 2019; 55:medicina55050130. [PMID: 31083613 PMCID: PMC6571725 DOI: 10.3390/medicina55050130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/03/2019] [Accepted: 05/08/2019] [Indexed: 11/25/2022]
Abstract
Background and Objectives: The aim of the study was to evaluate trends in smoking among middle-aged men and women based on the data from the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention program between 2009 and 2016. Materials and Methods: A community-based cross-sectional study comprised 92373 Lithuanian adults (41.6% men and 58.4% women). We compared the prevalence of smoking, smoking cessation activity and smoking intensity by gender and age groups. Results: There was a statistically significant upward trend in the number of smoking subjects (average annual percent change (AAPC) 2.99%, p < 0.001). The number of smoking male subjects remained much higher than the number of smoking female subjects during the 2009–2016 period. The study showed a significant increase in the percentage of smoking quitters in the whole group (AAPC 7.22%, p < 0.001) and among men and women separately. There was no significant change in smoking intensity in groups of male and female smokers separately. Conclusions: The analysis showed that the prevalence of smoking in Lithuania is still increasing due to women smoking despite all the governmental tobacco control efforts to reduce it.
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Affiliation(s)
- Egidija Rinkūnienė
- Department of Cardiovascular Medicine, Vilnius University, 08661 Vilnius, Lithuania.
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Santariškių Str. 2, 08661 Vilnius, Lithuania.
| | - Žaneta Petrulionienė
- Department of Cardiovascular Medicine, Vilnius University, 08661 Vilnius, Lithuania.
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Santariškių Str. 2, 08661 Vilnius, Lithuania.
| | - Vilma Dženkevičiūtė
- Faculty of Medicine, Vilnius University, 08661 Vilnius, Lithuania.
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Santariškių Str. 2, 08661 Vilnius, Lithuania.
| | | | - Antanas Mainelis
- Vilnius University Hospital Santaros Klinikos, 08611 Vilnius, Lithuania.
| | - Roma Puronaitė
- Vilnius University Hospital Santaros Klinikos, 08611 Vilnius, Lithuania.
| | - Agnė Jucevičienė
- Department of Cardiovascular Medicine, Vilnius University, 08661 Vilnius, Lithuania.
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Santariškių Str. 2, 08661 Vilnius, Lithuania.
| | - Urtė Gargalskaitė
- Department of Cardiovascular Medicine, Vilnius University, 08661 Vilnius, Lithuania.
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Santariškių Str. 2, 08661 Vilnius, Lithuania.
| | - Aleksandras Laucevičius
- Department of Cardiovascular Medicine, Vilnius University, 08661 Vilnius, Lithuania.
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Santariškių Str. 2, 08661 Vilnius, Lithuania.
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Sun R, Mendez D. Initiation versus Cessation Control Policies: Deriving Optimal Resource Allocation Strategies to Decrease Smoking Prevalence Under a Fixed Budget. MDM Policy Pract 2019; 4:2381468319832036. [PMID: 30859127 PMCID: PMC6402062 DOI: 10.1177/2381468319832036] [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: 12/07/2017] [Accepted: 11/30/2018] [Indexed: 11/17/2022] Open
Abstract
Background. Over several decades the tobacco control community has recommended and implemented smoking initiation and cessation interventions to reduce the smoking toll. It is necessary to study the combined effect of these interventions to allocate resources optimally. However, there is a paucity of studies that address the right combination of initiation and cessation policies over time to reduce smoking prevalence. Objective. To derive optimal trajectories of initiation and cessation interventions that minimize overall smoking prevalence over a specified period while satisfying a budget constraint. Methods. Using an established dynamic model of smoking prevalence, we employ an optimal control formulation to minimize overall smoking prevalence within a specified time period. The budget constraint is handled through an iterative application of a penalty function on above-budget expenditures. We further derive the optimal cost ratio of initiation versus cessation programs over time. To parameterize our model, we use results from two empirical interventions. The demographic data are from the National Health Interview Survey in the United States. Results. For our example, our results show that the optimal cost ratio (initiation over cessation) starts around 2.02 and gradually increases to 5.28 in 30 years. Smoking prevalence decreases significantly compared with the status quo, 8.54% in 30 years with no interventions versus the estimated 6.43% with interventions. In addition, the optimal units of initiation and cessation interventions increase over time. Conclusions. Our model provides a general framework to incorporate policy details in determining the optimal mix of smoking interventions.
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Affiliation(s)
- Ruoyan Sun
- Department of Health Management and Policy, University of Michigan Ann Arbor, Ann Arbor, Michigan
| | - David Mendez
- Department of Health Management and Policy, University of Michigan Ann Arbor, Ann Arbor, Michigan
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Abstract
Among the multiple aetiologies identified for pancreatic cancer (PC), cigarette smoking and diabetes are considered “moderate risk factors”. Analysis of PC mortality trends is important as changes in incidence and mortality of this tumour can be partially attributable to changes in smoking patterns. A recent Mexican study examined PC mortality trends and showed a favourable trend from 2000 to 2014 [1]. However, the impact of new tobacco tax/laws which were implemented in Mexico in 2007/2008 was not assessed in this study. In this re-analysis we assessed their impact on PC mortality and found a non-statistically significant trend from 1999 to 2008 - however, PC mortality statistically decreased from 2008 with an annual percent change or APC of −1.27, −1.23 and −1.17 in both sexes, females and males respectively, p < 0.05. These declines are likely resulting in part from new tobacco tax/laws which are likely contributing to the decrease over time of smoking prevalence and environmental tobacco smoke exposure.
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Affiliation(s)
- Eduardo Hernández-Garduño
- Department of Education and Health Research, Instituto de Seguridad Social del Estado de México y Municipios (ISSEMyM), Toluca, México 50080, Mexico
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Kuipers MAG, Beard E, West R, Brown J. Associations between tobacco control mass media campaign expenditure and smoking prevalence and quitting in England: a time series analysis. Tob Control 2018; 27:455-462. [PMID: 28667091 PMCID: PMC6047146 DOI: 10.1136/tobaccocontrol-2017-053662] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/06/2017] [Accepted: 05/30/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND It has been established that mass media campaigns can increase smoking cessation rates, but there is little direct evidence estimating associations between government expenditure on tobacco control mass media campaigns and smoking cessation. This study assessed the association over 8 years between mass media expenditure in England and quit attempts, smoking cessation and smoking prevalence. METHODS Autoregressive integrated moving average modelling with exogenous variables (ARIMAX) was applied to monthly estimates from the Smoking Toolkit Study between June 2008 and February 2016. We assessed the association between the trends in mass media expenditure and (1) quit attempts in the last two months, (2) quit success among those who attempted to quit and (3) smoking prevalence. Analyses were adjusted for trends in weekly spending on tobacco by smokers, tobacco control policies and the use of established aids to cessation. RESULTS Monthly spending on mass media campaigns ranged from nothing to £2.4 million, with a mean of £465 054. An increase in mass media expenditure of 10% of the monthly average was associated with a 0.51% increase (of the average) in success rates of quit attempts (95% CI 0.10% to 0.91%, p=0.014). No clear association was detected between changes in mass media expenditure and changes in quit attempt prevalence (β=-0.03, 95% CI -2.05% to 2.00%, p=0.979) or smoking prevalence (β=-0.03, 95% CI -0.09% to 0.03%, p=0.299). CONCLUSION Between 2008 and 2016, higher monthly expenditure on tobacco control mass media campaigns in England was associated with higher quit success rates.
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Affiliation(s)
- Mirte A G Kuipers
- Department of Epidemiology and Public Health, University College London, London, UK
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Emma Beard
- Department of Epidemiology and Public Health, University College London, London, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Robert West
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jamie Brown
- Department of Epidemiology and Public Health, University College London, London, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Li S, Levy D, Clancy L. Tobacco Free Ireland 2025: SimSmoke prediction for the end game. Tob Prev Cessat 2018; 4:23. [PMID: 32411849 PMCID: PMC7205082 DOI: 10.18332/tpc/91427] [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: 03/20/2018] [Revised: 05/04/2018] [Accepted: 05/22/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study estimates the impact of tobacco control policies implemented between 1998 and 2016 on smoking prevalence reduction in Ireland by 2016. It then assesses the potential of further strong policies, relative to a scenario of inaction, to see if Tobacco Free Ireland 2025 is feasible. METHODS SimSmoke, the dynamic simulation model of tobacco control policy, was adapted to examine the impact of Irish tobacco control policies on smoking prevalence, through initiation and cessation, and smoking-attributable deaths and to make predictions for the future. RESULTS Between 1998 and 2016, the model prediction of smoking prevalence is reasonably close to those from several surveys. As a result of policies implemented in this period, the smoking rate was reduced by 42% from 32.2% in 1998 to 18.7% in 2016. If tobacco control policies remain unchanged from their 2016 levels, smoking prevalence is projected to be 15.8% in 2025. With the introduction of stricter MPOWER-compliant policies in 2017, the smoking prevalence could be reduced to 12.4% in 2025. CONCLUSIONS Predictions from the SimSmoke Ireland model confirm that the policies implemented between 1998 and 2016 have had a considerable effect. In addition, implementing policies fully compliant with MPOWER could further reduce the smoking prevalence afterwards. However, even under the stricter MPOWER-compliant policies, there is still a gap between the predicted rate in 2025 and the Tobacco Free Ireland target of 5%. Therefore, new policies going beyond MPOWER are needed.
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Affiliation(s)
- Shasha Li
- TobaccoFree Research Institute, Ireland
| | - David Levy
- Georgetown University, Washington, D.C., USA
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Qian X, Gu H, Wang L, Wang X, Xuan Z, Zheng P, Fu C. Changes in smoking prevalence after the enforcement of smoking control regulations in urban Shanghai, China: Findings from two cross-sectional surveys. Tob Induc Dis 2018; 16:27. [PMID: 31516427 PMCID: PMC6659492 DOI: 10.18332/tid/91095] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 04/09/2018] [Accepted: 05/16/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The Smoking Control Regulation in Public Places (hereafter, the ‘regulations’) has been implemented in Shanghai since 2010. This study explores the changes in smoking prevalence and its influencing factors among urban Shanghai residents. METHODS Two rounds of household investigations (the Health Status and Health Service Utilization Survey) were carried out using a multistage probability proportionate-to-size sampling method in an urbanized district in 2010 and 2015. Descriptive and logistic regression analyses were applied to the statistics. RESULTS From 2010 to 2015, the standardized current smoking rate fell from 24.8% to 19.1% (38.3% to 32.0% among men, and 1.9% to 1.4% among women). Meanwhile, the standardized smoking cessation rate increased from 18.1% to 23.3%. Smoking prevalence in respondents aged 45 to 59 years was still higher than that of other age groups. Changes in smoking prevalence and cessation rates were more obvious in respondents aged 30–44 and over 75 years. Sex, age, education, marital status, and alcohol use were influencing factors of current smoking, while sex, age and alcohol use were influencing factors of smoking cessation. CONCLUSIONS The implementation of smoking control regulations may be beneficial for reducing smoking and increasing smoking cessation, especially among middle-aged and older men. Nevertheless, tobacco control in urban Shanghai still faces huge challenges. Therefore, more targeted and comprehensive measures should be taken.
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Affiliation(s)
- Xiaolin Qian
- Department of Chronic Disease Prevention and Control, Xuhui District Center for Disease Control and Prevention, Shanghai, China
| | - Haiyan Gu
- Department of Chronic Disease Prevention and Control, Xuhui District Center for Disease Control and Prevention, Shanghai, China
| | - Lan Wang
- Department of Chronic Disease Prevention and Control, Xuhui District Center for Disease Control and Prevention, Shanghai, China
| | - Xian Wang
- Department of Chronic Disease Prevention and Control, Xuhui District Center for Disease Control and Prevention, Shanghai, China
| | - Zeliang Xuan
- Department of Chronic Disease Prevention and Control, Xuhui District Center for Disease Control and Prevention, Shanghai, China
| | - Pinpin Zheng
- School of Public Health, Fudan University, Shanghai, China
| | - Chaowei Fu
- School of Public Health, Fudan University, Shanghai, China
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Dono J, Bowden J, Kim S, Miller C. Taking the pressure off the spring: the case of rebounding smoking rates when antitobacco campaigns ceased. Tob Control 2018; 28:233-236. [PMID: 29627797 PMCID: PMC6580791 DOI: 10.1136/tobaccocontrol-2017-054194] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 12/08/2017] [Revised: 03/19/2018] [Accepted: 03/27/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Smoking rates have been compared with a spring, requiring continuous downward pressure against protobacco forces, rather than a screw, which once driven down stays down. Quality antitobacco mass media campaigns put downward pressure on smoking rates. The suspension of a major Australian state campaign provided a natural experiment to assess effects on smoking. Furthermore, we document the positive influence of robust monitoring and mature advocacy on the political decision to reinstate funding. We also document the misuse by industry of South Australian smoking data from the period between Australia's implementation and subsequent evaluation of plain packaging. METHODS A time series analysis was used to examine monthly smoking prevalence trends at each of four intervention points: (A) commencement of high-intensity mass media campaign (August 2010); (B) introduction of plain packaging (December 2012), (C) defunding of campaign (July 2013); and (D) reinstatement of moderate-intensity campaign (July 2014). FINDINGS The suspension of the antitobacco campaign was disruptive to achieving smoking prevalence targets. There was an absence of a downward monthly smoking prevalence trajectory during the non-campaign period. Moreover, there was a significant decline in smoking prevalence during the period of high-intensity advertising, which continued after the introduction of plain packaging laws, and at the recommencement of campaign activity. CONCLUSIONS While the observed declines in smoking prevalence are likely due to a combination of interventions and cannot be attributed exclusively to antitobacco advertising, the results reinforce the political decision to reinstate the campaign and demonstrate the need for maintained investment to keep downward pressure on smoking rates.
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Affiliation(s)
- Joanne Dono
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Jacqueline Bowden
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Susan Kim
- Heart Health, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Caroline Miller
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,School of Population Health and Clinical Practice, University of Adelaide, Adelaide, South Australia, Australia
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Drope J, Liber AC, Cahn Z, Stoklosa M, Kennedy R, Douglas CE, Henson R, Drope J. Who's still smoking? Disparities in adult cigarette smoking prevalence in the United States. CA Cancer J Clin 2018; 68:106-115. [PMID: 29384589 DOI: 10.3322/caac.21444] [Citation(s) in RCA: 233] [Impact Index Per Article: 38.8] [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: 10/11/2017] [Revised: 12/11/2017] [Accepted: 12/12/2017] [Indexed: 12/16/2022] Open
Abstract
The continuing high prevalence of cigarette smoking among specific subpopulations, many of them vulnerable, is one of the most pressing challenges facing the tobacco control community. These populations include individuals in lower education and/or socioeconomic groups; from certain racial/ethnic groups; in the lesbian, gay, bisexual, and transgender community; with mental illness; and in the military, particularly among those in the lowest pay grades. Although traditional tobacco control measures are having positive health effects for most groups, the effects are not sufficient for others. More attention to and support for promising novel interventions, in addition to new attempts at reaching these populations through conventional interventions that have proven to be effective, are crucial going forward to find new ways to address these disparities. CA Cancer J Clin 2018;68:106-115. © 2018 American Cancer Society.
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Affiliation(s)
- Jeffrey Drope
- Vice President, Economic and Health Policy Research, American Cancer Society, Atlanta, GA
| | - Alex C Liber
- Data Analyst, Economic and Health Policy Research Program, American Cancer Society, Atlanta, GA
| | - Zachary Cahn
- Director, Economic and Health Policy Research, American Cancer Society, Atlanta, GA
| | - Michal Stoklosa
- Senior Economist, Taxation and Health, Economic and Health Policy Research Program, American Cancer Society, Atlanta, GA
| | - Rosemary Kennedy
- Program Consultant, Global Cancer Prevention and Early Detection, American Cancer Society, Atlanta, GA
| | - Clifford E Douglas
- Vice President for Tobacco Control and Director, Center for Tobacco Control, American Cancer Society, Atlanta, GA
| | - Rosemarie Henson
- Senior Vice President for Prevention and Early Detection, American Cancer Society, Atlanta, GA
| | - Jacqui Drope
- Managing Director, Global Cancer Prevention and Early Detection, American Cancer Society, Atlanta, GA
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Rozema AD, Hiemstra M, Mathijssen JJP, Jansen MWJ, van Oers HJAM. Impact of an Outdoor Smoking Ban at Secondary Schools on Cigarettes, E-Cigarettes and Water Pipe Use among Adolescents: An 18-Month Follow-Up. Int J Environ Res Public Health 2018; 15:E205. [PMID: 29370137 DOI: 10.3390/ijerph15020205] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 01/19/2018] [Accepted: 01/23/2018] [Indexed: 11/16/2022]
Abstract
The effectiveness of outdoor smoking bans on smoking behavior among adolescents remains inconclusive. This study evaluates the long-term impact of outdoor school ground smoking bans among adolescents at secondary schools on the use of conventional cigarettes, e-cigarettes (with/without nicotine) and water pipes. Outdoor smoking bans at 19 Dutch secondary schools were evaluated using a quasi-experimental design. Data on 7733 adolescents were obtained at baseline, and at 6 and 18-month follow-up. The impact of outdoor smoking bans on ‘ever use of conventional cigarettes’, ‘smoking onset’, ‘ever use of e-cigarette with nicotine’, ‘e-cigarette without nicotine’, and ‘water pipe’ was measured. Multilevel logistic regression analysis was used. At schools with a ban, implementation fidelity was checked. At schools where a ban was implemented, at 18-month follow-up more adolescents had started smoking compared to the control condition. No effect of implementation of the ban was found for smoking prevalence, e-cigarettes with/without nicotine, and water pipe use. Implementation fidelity was sufficient. No long-term effects were found of an outdoor smoking ban, except for smoking onset. The ban might cause a reversal effect when schools encounter difficulties with its enforcement or when adolescents still see others smoking. Additional research is required with a longer follow-up than 18 months.
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Jankovic J, Stamenkovic Z, Stojanovski K, Goodwin RD, Janevic T. Predictors of prenatal smoking and attempted smoking cessation during pregnancy: a community-based study of Romani women in Southeastern Europe. J Public Health (Oxf) 2017; 39:e186-e193. [PMID: 27899475 DOI: 10.1093/pubmed/fdw123] [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] [Indexed: 11/13/2022] Open
Abstract
Background The objective of this study was to examine predictors of prenatal smoking, and attempted smoking cessation during pregnancy among Romani women. Methods A community-based, cross-sectional study (November 2012 to February 2013) of 410 Romani women in Roma settlements in Serbia and Macedonia was conducted. Logistic regression was used to identify predictors of prenatal smoking and attempted smoking cessation during pregnancy. Results Romani women older than 30 years and those who were living with a man were over twice as likely (adjusted odds ratio (aOR) 2.48, 95% confidence interval (CI) 1.12-5.46; aOR 2.09, 95% CI 1.27-3.43) to smoke during pregnancy, compared to women <20 and married women, respectively. An inverse relationship between education and prenatal smoking was observed (for primary education versus no education, aOR 0.56, 95% CI 0.32-0.98; for secondary or higher education versus no education, aOR 0.38, 95% CI 0.16-0.90). Having a husband/partner who smokes was associated with significantly increased likelihood of prenatal smoking (aOR 3.71, 95% CI 2.20-6.25) and decreased likelihood of attempting to quit (aOR 0.51, 95% CI 0.24-1.06). Conclusions Culturally sensitive and comprehensive prevention strategies and intervention programs are needed to reduce smoking during pregnancy among Romani women, including interventions targeting male partners.
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Affiliation(s)
- Janko Jankovic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Dr Subotica 15, 11000 Belgrade, Serbia
| | - Zeljka Stamenkovic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Dr Subotica 15, 11000 Belgrade, Serbia
| | - Kristefer Stojanovski
- Center for Regional Policy Research and Cooperation, Studiorum, Nikola Parapunov br. 41, PO Box 24, 1020 Skopje, Macedonia
| | - Renee D Goodwin
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), 65-30 Kissena Boulevard, Queens, NY 11367, USA.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Teresa Janevic
- Department of Population Health Science and Health Policy, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029, USA
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Do TC, Boettiger D, Law M, Pujari S, Zhang F, Chaiwarith R, Kiertiburanakul S, Lee MP, Ditangco R, Wong WW, Nguyen KV, Merati TP, Pham TT, Kamarulzaman A, Oka S, Yunihastuti E, Kumarasamy N, Kantipong P, Choi JY, Ng OT, Durier N, Ruxrungtham K. Smoking and projected cardiovascular risk in an HIV-positive Asian regional cohort. HIV Med 2017; 17:542-9. [PMID: 27430354 DOI: 10.1111/hiv.12358] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of the study was to assess the prevalence and characteristics associated with current smoking in an Asian HIV-positive cohort, to calculate the predictive risks of cardiovascular disease (CVD), coronary heart disease (CHD) and myocardial infarction (MI), and to identify the impact that simulated interventions may have. METHODS Logistic regression analysis was used to distinguish associated current smoking characteristics. Five-year predictive risks of CVD, CHD and MI and the impact of simulated interventions were calculated utilizing the Data Collection on Adverse Effects of Anti-HIV Drugs Study (D:A:D) algorithm. RESULTS Smoking status data were collected from 4274 participants and 1496 of these had sufficient data for simulated intervention calculations. Current smoking prevalence in these two groups was similar (23.2% vs. 19.9%, respectively). Characteristics associated with current smoking included age > 50 years compared with 30-39 years [odds ratio (OR) 0.65; 95% confidence interval (CI) 0.51-0.83], HIV exposure through injecting drug use compared with heterosexual exposure (OR 3.03; 95% CI 2.25-4.07), and receiving antiretroviral therapy (ART) at study sites in Singapore, South Korea, Malaysia, Japan and Vietnam in comparison to Thailand (all OR > 2). Women were less likely to smoke than men (OR 0.11; 95% CI 0.08-0.14). In simulated interventions, smoking cessation demonstrated the greatest impact in reducing CVD and CHD risk and closely approximated the impact of switching from abacavir to an alternate antiretroviral in the reduction of 5-year MI risk. CONCLUSIONS Multiple interventions could reduce CVD, CHD and MI risk in Asian HIV-positive patients, with smoking cessation potentially being the most influential.
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Affiliation(s)
- T C Do
- HIVNAT/Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | - D Boettiger
- The Kirby Institute, UNSW Australia, Sydney, Australia
| | - M Law
- The Kirby Institute, UNSW Australia, Sydney, Australia
| | - S Pujari
- Institute of Infectious Diseases, Pune, India
| | - F Zhang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - R Chaiwarith
- Research Institute for Health Sciences, Chiang Mai, Thailand
| | - S Kiertiburanakul
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - M P Lee
- Queen Elizabeth Hospital, Hong Kong, China
| | - R Ditangco
- Research Institute for Tropical Medicine, Manila, Philippines
| | - W W Wong
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - K V Nguyen
- National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - T P Merati
- Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia
| | - T T Pham
- Bach Mai Hospital, Hanoi, Vietnam
| | - A Kamarulzaman
- University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - S Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - E Yunihastuti
- Working Group on AIDS Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - N Kumarasamy
- Chennai Antiviral Research and Treatment Clinical Research Site (CART CRS), YRGCARE Medical Centre, VHS, Chennai, India
| | - P Kantipong
- Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
| | - J Y Choi
- Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - O T Ng
- Tan Tock Seng Hospital, Singapore
| | - N Durier
- TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
| | - K Ruxrungtham
- HIVNAT/Thai Red Cross AIDS Research Center, Bangkok, Thailand.,Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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van der Deen FS, Wilson N, Cleghorn CL, Kvizhinadze G, Cobiac LJ, Nghiem N, Blakely T. Impact of five tobacco endgame strategies on future smoking prevalence, population health and health system costs: two modelling studies to inform the tobacco endgame. Tob Control 2017. [PMID: 28647728 DOI: 10.1136/tobaccocontrol-2016-053585] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE There is growing international interest in advancing 'the tobacco endgame'. We use New Zealand (Smokefree goal for 2025) as a case study to model the impacts on smoking prevalence (SP), health gains (quality-adjusted life-years (QALYs)) and cost savings of (1) 10% annual tobacco tax increases, (2) a tobacco-free generation (TFG), (3) a substantial outlet reduction strategy, (4) a sinking lid on tobacco supply and (5) a combination of 1, 2 and 3. METHODS Two models were used: (1) a dynamic population forecasting model for SP and (2) a closed cohort (population alive in 2011) multistate life table model (including 16 tobacco-related diseases) for health gains and costs. RESULTS All selected tobacco endgame strategies were associated with reductions in SP by 2025, down from 34.7%/14.1% for Māori (indigenous population)/non-Māori in 2011 to 16.0%/6.8% for tax increases; 11.2%/5.6% for the TFG; 17.8%/7.3% for the outlet reduction; 0% for the sinking lid; and 9.3%/4.8% for the combined strategy. Major health gains accrued over the remainder of the 2011 population's lives ranging from 28 900 QALYs (95% Uncertainty Interval (UI)): 16 500 to 48 200; outlet reduction) to 282 000 QALYs (95%UI: 189 000 to 405 000; sinking lid) compared with business-as-usual (3% discounting). The timing of health gain and cost savings greatly differed for the various strategies (with accumulated health gain peaking in 2040 for the sinking lid and 2070 for the TFG). CONCLUSIONS Implementing endgame strategies is needed to achieve tobacco endgame targets and reduce inequalities in smoking. Given such strategies are new, modelling studies provide provisional information on what approaches may be best.
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Affiliation(s)
- Frederieke S van der Deen
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme (BODE3), University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme (BODE3), University of Otago, Wellington, New Zealand
| | - Christine L Cleghorn
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme (BODE3), University of Otago, Wellington, New Zealand
| | - Giorgi Kvizhinadze
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme (BODE3), University of Otago, Wellington, New Zealand
| | - Linda J Cobiac
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme (BODE3), University of Otago, Wellington, New Zealand.,Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Nhung Nghiem
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme (BODE3), University of Otago, Wellington, New Zealand
| | - Tony Blakely
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme (BODE3), University of Otago, Wellington, New Zealand.,Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Shang C, Huang J, Cheng KW, He Y, Chaloupka FJ. The Association between Warning Label Requirements and Cigarette Smoking Prevalence by Education-Findings from the Global Adult Tobacco Survey (GATS). Int J Environ Res Public Health 2017; 14:ijerph14010098. [PMID: 28117729 PMCID: PMC5295348 DOI: 10.3390/ijerph14010098] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/16/2017] [Accepted: 01/18/2017] [Indexed: 11/16/2022]
Abstract
Introduction: The Guidelines for the implementation of Article 11 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) require that cigarette health warning labels should include pictures and take up 50% or more of the principal display area. This study examined how the association between large pictorial warnings, those covering ≥50% of the front and back of the package, and the prevalence of cigarette smoking varies by educational attainment. Methods: We pooled individual-level tobacco use data from the Global Adult Tobacco Survey (GATS) in 18 countries between 2008 and 2013 and linked them with warning label requirements during the same period from the MPOWER database and reports regarding warnings. The respondents’ self-reported exposure to warnings was examined according to education. Logistic regressions were further employed to analyze education-specific associations between large pictorial warnings and smoking prevalence, and whether such association differed by education was examined using an interaction test. Results: At the time of the survey, eight out of 18 countries had imposed graphic warning labels that covered ≥50% of the package. These warnings were associated with a 10.0% (OR = 0.89; 95% CI: 0.81, 0.97; p ≤ 0.01) lower cigarette smoking prevalence among adults with less than a secondary education or no formal education, but not among respondents with at least a secondary education. Less educated respondents were also less likely to be exposed to warnings in all 18 countries. The association between strong warnings and lower smoking prevalence among less educated respondents could be greater if their exposure to warnings increases. Conclusions: Prominent pictorial warning labels can potentially reduce health disparities resulting from smoking across different education levels.
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Affiliation(s)
- Ce Shang
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA.
| | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA.
| | - Kai-Wen Cheng
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA.
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA.
- Department of Economics, University of Illinois at Chicago, Chicago, IL 60607, USA.
| | - Yanyun He
- Department of Economics, University of Illinois at Chicago, Chicago, IL 60607, USA.
| | - Frank J Chaloupka
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA.
- Department of Economics, University of Illinois at Chicago, Chicago, IL 60607, USA.
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Ansari K, Farooqi FA. Comparison and prevalence of smoking among Saudi females from different Departments of the College of Applied Medical Sciences in Dammam. Int J Health Sci (Qassim) 2017; 11:56-62. [PMID: 29114195 PMCID: PMC5669512] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of this study is to estimate the prevalence of smoking and factors associated with smoking habits among female students in all departments of College of Applied Medical Science (CAMS) at the University of Dammam. METHODS A cross-sectional study was conducted at CAMSs, University of Dammam. Only female students were included from all the departments of CAMS. The modified structured Global Youth Tobacco Survey was used to collect detailed information about smoking habits and factors associated with smoking. RESULTS A total of 332 out of 408 female students responded to the questionnaire with a response rate of 81%. The overall prevalence of those who tried smoking was 13.3%. Of those, 0.9% were active smokers. Among departments, Respiratory Care Department has the highest prevalence of smoking (25%; n = 11 out of 63) compared to clinical nutrition department where only 11.4% (n = 5 out of 54) either tried smoking or active smokers. The associated factors for smoking were high grade point average (P = 0.01). Interestingly, 61.3% of the sample reported that their first smoking trail was because of their experience to see someone they know is smoking (P = 0.01). CONCLUSION The study results suggest that the prevalence of the current smoking is not significantly high. However, our data of this study suggests that some students tried to smoke in the past which may be considered as a risk factor of becoming regular smokers in the future. The study also reveals that the most common trigger to start smoking is their experience of seeing someone they know is smoking.
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Affiliation(s)
- Khalid Ansari
- Department of Respiratory Care, College of Applied Medical Science, University of Dammam, Dammam, Saudi Arabia,Address for correspondence: Khalid Ansari, Department of Respiratory Care, College of Applied Medical Science, University of Dammam, Dammam, Saudi Arabia. Phone: 00966553589299. E-mail:
| | - Faraz Ahmed Farooqi
- Department of Academic AffairsCollege of Dentistry, University of Dammam, Dammam, Saudi Arabia
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Anderson CL, Becher H, Winkler V. Tobacco Control Progress in Low and Middle Income Countries in Comparison to High Income Countries. Int J Environ Res Public Health 2016; 13:E1039. [PMID: 27783060 PMCID: PMC5086778 DOI: 10.3390/ijerph13101039] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/12/2016] [Accepted: 10/13/2016] [Indexed: 11/25/2022]
Abstract
The study aimed to describe worldwide levels and trends of tobacco control policy by comparing low and middle income countries with other income categories from 2007 to 2014 and to analyze the corresponding relation to recent changes in smoking prevalence. Policy measure data representing years 2007 to 2014 were collected from all available World Health Organization (WHO) reports on the global tobacco epidemic. Corresponding policy percentage scores (PS) were calculated based on MPOWER measures. Age-standardized smoking prevalence data for years 2010 and 2015 were collected from the WHO Global Health Observatory Data Repository. Trends of PS were analysed with respect to WHO region and OECD country income category. Scatter plots and regression analysis were used to depict the relationship between tobacco control policy of 2010 and change in smoking prevalence between 2015 and 2010 by sex and income category. Combined PS for all countries increased significantly from 47% in 2007 to 61% by 2014 (p < 0.001). When grouped by income category and region, policies were strengthened in all categories, albeit with varying progression. By 2014, tobacco control policy legislation had reached 45% in the Least Developed Countries (LDCs), 59% in Low Middle Income Countries (LMICs), 66% in Upper Middle Income Countries (UMICs) and 70% in High Income Countries (HICs). Overall, there was a negative relationship between higher policy scores and change in smoking prevalence. Although policy strengthening had been conducted between 2007 and 2014, room for considerable global improvement remains, particularly in LDCs.
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Affiliation(s)
- Carrie L Anderson
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Volker Winkler
- Institute of Public Health, University of Heidelberg, 69120 Heidelberg, Germany.
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Nicolaou SA, Heraclides A, Markides KS, Charalambous A. Prevalence and social determinants of smoking in the adult Greek Cypriot population. Hippokratia 2016; 20:284-291. [PMID: 29416301 PMCID: PMC5788227] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Smoking remains a major public health concern in Europe. In the current study, we investigate the prevalence and socioeconomic factors that contribute to smoking disparities in Greek Cypriot adults. Material and methods: In 2009, using the Countrywide Integrated Noncommunicable Disease Intervention questionnaire a representative sample of Greek Cypriot adults was surveyed (response rate 100%). Socioeconomic and demographic data were collected and analyzed. RESULTS The prevalence of smoking in Greek Cypriot adults was 50.8 % among men and 21.2 % among women. Sociodemographic disparities in smoking prevalence were identified, characterized by higher prevalence in urban vs rural centers (especially among women), and higher prevalence among employed women vs housewives. Socioeconomic inequalities in prevalent smoking were gender-specific, with occupational social class showing an inverse association among men and a direct among women, with income showing an inverse association (mostly among men), and educational attainment showing a clear inverse gradient among men and a direct gradient among women. CONCLUSION Striking gender-specific bidirectional associations between socioeconomic factors and smoking prevalence were identified among Greek Cypriot adults, which may promote targeted intervention programmes aiming at halting and reversing smoking behaviors in Cyprus. Hippokratia 2016, 20(4): 284-291.
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Affiliation(s)
- S A Nicolaou
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - A Heraclides
- Medical School, Center of Primary Care and Population Health, University of Nicosia, Nicosia, Cyprus
| | - K S Markides
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, USA
| | - A Charalambous
- Medical School, Center of Primary Care and Population Health, University of Nicosia, Nicosia, Cyprus
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Fleischer NL, Thrasher JF, Reynales-Shigematsu LM, Cummings KM, Meza R, Zhang Y, Levy DT. Mexico SimSmoke: how changes in tobacco control policies would impact smoking prevalence and smoking attributable deaths in Mexico. Glob Public Health 2016; 12:830-845. [PMID: 26837721 DOI: 10.1080/17441692.2015.1123749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 10/22/2022]
Abstract
We examined the effect of tobacco control policies in Mexico on smoking prevalence and smoking-related deaths using the Mexico SimSmoke model. The model is based on the previously developed SimSmoke simulation model of tobacco control policy, and uses population size, smoking rates and tobacco control policy data for Mexico. It assesses, individually, and in combination, the effect of six tobacco control policies on smoking prevalence and smoking-related deaths. Policies included: cigarette excise taxes, smoke-free laws, anti-smoking public education campaigns, marketing restrictions, access to tobacco cessation treatments and enforcement against tobacco sales youth. The model estimates that, if Mexico were to adopt strong tobacco control policies compared to current policy levels, smoking prevalence could be reduced by 30% in the next decade and by 50% by 2053; an additional 470,000 smoking-related premature deaths could be averted over the next 40 years. The greatest impact on smoking and smoking-related deaths would be achieved by raising excise taxes on cigarettes from 55% to at least 70% of the retail price, followed by strong youth access enforcement and access to cessation treatments. Implementing tobacco control policies in Mexico could reduce smoking prevalence by 50%, and prevent 470,000 smoking-related deaths by 2053.
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Affiliation(s)
- Nancy L Fleischer
- a Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health , University of Michigan , Ann Arbor , MI , USA
| | - James F Thrasher
- b Department of Health Promotion, Education, and Behavior, Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.,c Department of Tobacco Research, Center for Population Health Research , National Institute of Public Health , Cuernavaca , Mexico
| | - Luz Myriam Reynales-Shigematsu
- c Department of Tobacco Research, Center for Population Health Research , National Institute of Public Health , Cuernavaca , Mexico
| | - K Michael Cummings
- d Department of Psychiatry & Behavioral Sciences , Medical University of South Carolina , Charleston , SC , USA
| | - Rafael Meza
- e Department of Epidemiology , University of Michigan , Ann Arbor , MI , USA
| | - Yian Zhang
- f Department of Oncology , Georgetown University , Washington , DC , USA
| | - David T Levy
- g Lombardi Comprehensive Cancer Center , Georgetown University , Washington , DC , USA
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Winkler V, Lan Y, Becher H. Tobacco prevention policies in west-African countries and their effects on smoking prevalence. BMC Public Health 2015; 15:1216. [PMID: 26646580 PMCID: PMC4673866 DOI: 10.1186/s12889-015-2562-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 12/03/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The WHO Framework Convention on Tobacco Control was shown to effectively lower smoking prevalence in in high income countries, however knowledge for low and middle income settings is sparse. The objective of this study was to describe WHO MPOWER policy measures in thirteen West-African countries and to investigate their correlation with smoking prevalence. METHODS Age-standardized smoking prevalence data and policy measures were collected from various WHO reports. For analysis MPOWER measures from 2008 and 2010, were combined with prevalence data from 2009 and 2011. Multiple linear regression models were set up. RESULTS In West-Africa mean smoking prevalence was approximately 20% among males and approximately 3% among females. Policy measures were mostly at a middle or low level. Regression analysis showed that tobacco cessation programs, health warnings on cigarettes, and higher price of cigarettes were negatively correlated with smoking prevalence. Significant effects were observed for only one policy measure (tobacco cessation programs) and only within the male population where smoking prevalence is generally higher. CONCLUSIONS Tobacco control policies are enforced at relatively low levels in West-African countries. However, improving tobacco control policy implementation according to the WHO Framework Convention on Tobacco Control should assist in the reduction of smoking prevalence in African countries, thereby counteracting pro-smoking initiatives set forth by the tobacco industry.
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Affiliation(s)
- Volker Winkler
- Institut für Public Health, Universitätsklinikum Heidelberg, Heidelberg, Germany.
| | - Yong Lan
- Institut für Public Health, Universitätsklinikum Heidelberg, Heidelberg, Germany.
| | - Heiko Becher
- Institut für Public Health, Universitätsklinikum Heidelberg, Heidelberg, Germany.
- Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
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John U, Hanke M. Lung cancer mortality and years of potential life lost among males and females over six decades in a country with high smoking prevalence: an observational study. BMC Cancer 2015; 15:876. [PMID: 26553055 PMCID: PMC4640109 DOI: 10.1186/s12885-015-1807-7] [Citation(s) in RCA: 11] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 10/16/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Little is known about sex-specific trends in lung cancer mortality and years of potential life lost (YPLL) attributable to lung cancer over more than five decades. The aim of the present study was to describe mortality and YPLL due to lung cancer over 61 years of observation in a country with a high smoking prevalence. METHODS We obtained data on trends in lung cancer mortality, population-level vital statistics, sales of taxed tobacco products, and survey data on smoking behavior among the German population. We then undertook joinpoint regression analyses to determine sex-specific trends in lung cancer mortality and YPLL. RESULTS Rates of lung cancer mortality and rates of lung cancer among all causes of death increased more among females than among males. Although YPLL among females increased from 6.6 in 1952 to 11.3 in 2012, this figure was found to have decreased from 7.3 to 4.4 among males in the same period. Sales of tobacco subject to tax increased from 1,509 cigarette equivalents per resident aged 15 or older in 1952 to 2,916 in 1976 - after which there was a decline. The prevalence of current smoking among females aged 35 years or older remained stable between 17.9 and 18.9 % in the period from 1989 to 2009. Among males in the same age group, however, prevalence decreased from 36.7 % in 1989 to 27.5 % in 2009. CONCLUSIONS Lung cancer mortality and YPLL among females increased over the six decades studied. Women should be more considered in smoking policies.
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Affiliation(s)
- Ulrich John
- University Medicine Greifswald, Institute of Social Medicine and Prevention, Walther-Rathenau-Str. 48, D-17475, Greifswald, Germany.
| | - Monika Hanke
- University Medicine Greifswald, Institute of Social Medicine and Prevention, Walther-Rathenau-Str. 48, D-17475, Greifswald, Germany.
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Annamalai A, Singh N, O’Malley SS. Smoking Use and Cessation Among People with Serious Mental Illness. Yale J Biol Med 2015; 88:271-7. [PMID: 26339210 PMCID: PMC4553647] [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] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
Abstract
Smoking rates in people with serious mental illness (SMI) are disproportionately high compared to the general population. It is a leading contributor to the early mortality in this population. Smoking cessation rates are low in this group, though patients are motivated to quit. Unfortunately, health care providers do not always prioritize smoking cessation for this population. This review provides an overview of prevalence rates, biological effects that maintain smoking, and evidence-based treatments for smoking cessation in SMI. In addition, objective and qualitative data from a chart review of 78 patients with SMI prescribed smoking cessation treatment at one community mental health center are described. Of these, 30 (38.5 percent) were found to either quit (16/78) or reduce (14/78) smoking. Varenicline appeared to be particularly effective. Review of the literature and results of this study suggest that smoking cessation pharmacotherapies are effective for SMI patients and should be offered to those who smoke.
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Affiliation(s)
- Aniyizhai Annamalai
- Yale School of Medicine, New Haven, Connecticut,To whom all correspondence should be addressed: Aniyizhai Annamalai, MD, Yale School of Medicine, 34 Park St., New Haven, CT 06519; Tele: 203-974-7497; Fax: 203-974-7322;
| | - Noreen Singh
- University of California at San Francisco, Santa Rosa, California
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Ekpu VU, Brown AK. The Economic Impact of Smoking and of Reducing Smoking Prevalence: Review of Evidence. Tob Use Insights 2015; 8:1-35. [PMID: 26242225 PMCID: PMC4502793 DOI: 10.4137/tui.s15628] [Citation(s) in RCA: 161] [Impact Index Per Article: 17.9] [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: 03/26/2014] [Revised: 07/24/2014] [Accepted: 08/28/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Tobacco smoking is the cause of many preventable diseases and premature deaths in the UK and around the world. It poses enormous health- and non-health-related costs to the affected individuals, employers, and the society at large. The World Health Organization (WHO) estimates that, globally, smoking causes over US$500 billion in economic damage each year. OBJECTIVES This paper examines global and UK evidence on the economic impact of smoking prevalence and evaluates the effectiveness and cost effectiveness of smoking cessation measures. STUDY SELECTION SEARCH METHODS We used two major health care/economic research databases, namely PubMed and the National Institute for Health Research (NIHR) database that contains the British National Health Service (NHS) Economic Evaluation Database; Cochrane Library of systematic reviews in health care and health policy; and other health-care-related bibliographic sources. We also performed hand searching of relevant articles, health reports, and white papers issued by government bodies, international health organizations, and health intervention campaign agencies. SELECTION CRITERIA The paper includes cost-effectiveness studies from medical journals, health reports, and white papers published between 1992 and July 2014, but included only eight relevant studies before 1992. Most of the papers reviewed reported outcomes on smoking prevalence, as well as the direct and indirect costs of smoking and the costs and benefits of smoking cessation interventions. We excluded papers that merely described the effectiveness of an intervention without including economic or cost considerations. We also excluded papers that combine smoking cessation with the reduction in the risk of other diseases. DATA COLLECTION AND ANALYSIS The included studies were assessed against criteria indicated in the Cochrane Reviewers Handbook version 5.0.0. OUTCOMES ASSESSED IN THE REVIEWPrimary outcomes of the selected studies are smoking prevalence, direct and indirect costs of smoking, and the costs and benefits of smoking cessation interventions (eg, "cost per quitter", "cost per life year saved", "cost per quality-adjusted life year gained," "present value" or "net benefits" from smoking cessation, and "cost savings" from personal health care expenditure). MAIN RESULTS The main findings of this study are as follows: The costs of smoking can be classified into direct, indirect, and intangible costs. About 15% of the aggregate health care expenditure in high-income countries can be attributed to smoking. In the US, the proportion of health care expenditure attributable to smoking ranges between 6% and 18% across different states. In the UK, the direct costs of smoking to the NHS have been estimated at between £2.7 billion and £5.2 billion, which is equivalent to around 5% of the total NHS budget each year. The economic burden of smoking estimated in terms of GDP reveals that smoking accounts for approximately 0.7% of China's GDP and approximately 1% of US GDP. As part of the indirect (non-health-related) costs of smoking, the total productivity losses caused by smoking each year in the US have been estimated at US$151 billion.The costs of smoking notwithstanding, it produces some potential economic benefits. The economic activities generated from the production and consumption of tobacco provides economic stimulus. It also produces huge tax revenues for most governments, especially in high-income countries, as well as employment in the tobacco industry. Income from the tobacco industry accounts for up to 7.4% of centrally collected government revenue in China. Smoking also yields cost savings in pension payments from the premature death of smokers.Smoking cessation measures could range from pharmacological treatment interventions to policy-based measures, community-based interventions, telecoms, media, and technology (TMT)-based interventions, school-based interventions, and workplace interventions.The cost per life year saved from the use of pharmacological treatment interventions ranged between US$128 and US$1,450 and up to US$4,400 per quality-adjusted life years (QALYs) saved. The use of pharmacotherapies such as varenicline, NRT, and Bupropion, when combined with GP counseling or other behavioral treatment interventions (such as proactive telephone counseling and Web-based delivery), is both clinically effective and cost effective to primary health care providers.Price-based policy measures such as increase in tobacco taxes are unarguably the most effective means of reducing the consumption of tobacco. A 10% tax-induced cigarette price increase anywhere in the world reduces smoking prevalence by between 4% and 8%. Net public benefits from tobacco tax, however, remain positive only when tax rates are between 42.9% and 91.1%. The cost effectiveness ratio of implementing non-price-based smoking cessation legislations (such as smoking restrictions in work places, public places, bans on tobacco advertisement, and raising the legal age of smokers) range from US$2 to US$112 per life year gained (LYG) while reducing smoking prevalence by up to 30%-82% in the long term (over a 50-year period).Smoking cessation classes are known to be most effective among community-based measures, as they could lead to a quit rate of up to 35%, but they usually incur higher costs than other measures such as self-help quit-smoking kits. On average, community pharmacist-based smoking cessation programs yield cost savings to the health system of between US$500 and US$614 per LYG.Advertising media, telecommunications, and other technology-based interventions (such as TV, radio, print, telephone, the Internet, PC, and other electronic media) usually have positive synergistic effects in reducing smoking prevalence especially when combined to deliver smoking cessation messages and counseling support. However, the outcomes on the cost effectiveness of TMT-based measures have been inconsistent, and this made it difficult to attribute results to specific media. The differences in reported cost effectiveness may be partly attributed to varying methodological approaches including varying parametric inputs, differences in national contexts, differences in advertising campaigns tested on different media, and disparate levels of resourcing between campaigns. Due to its universal reach and low implementation costs, online campaign appears to be substantially more cost effective than other media, though it may not be as effective in reducing smoking prevalence.School-based smoking prevalence programs tend to reduce short-term smoking prevalence by between 30% and 70%. Total intervention costs could range from US$16,400 to US$580,000 depending on the scale and scope of intervention. The cost effectiveness of school-based programs show that one could expect a saving of approximately between US$2,000 and US$20,000 per QALY saved due to averted smoking after 2-4 years of follow-up.Workplace-based interventions could represent a sound economic investment to both employers and the society at large, achieving a benefit-cost ratio of up to 8.75 and generating 12-month employer cost savings of between $150 and $540 per nonsmoking employee. Implementing smoke-free workplaces would also produce myriads of new quitters and reduce the amount of cigarette consumption, leading to cost savings in direct medical costs to primary health care providers. Workplace interventions are, however, likely to yield far greater economic benefits over the long term, as reduced prevalence will lead to a healthier and more productive workforce. CONCLUSIONS We conclude that the direct costs and externalities to society of smoking far outweigh any benefits that might be accruable at least when considered from the perspective of socially desirable outcomes (ie, in terms of a healthy population and a productive workforce). There are enormous differences in the application and economic measurement of smoking cessation measures across various types of interventions, methodologies, countries, economic settings, and health care systems, and these may have affected the comparability of the results of the studies reviewed. However, on the balance of probabilities, most of the cessation measures reviewed have not only proved effective but also cost effective in delivering the much desired cost savings and net gains to individuals and primary health care providers.
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Affiliation(s)
- Victor U Ekpu
- Adam Smith Business School (Economics Division), University of Glasgow, Glasgow, UK
| | - Abraham K Brown
- Nottingham Business School (Marketing Division), Nottingham Trent University, Nottingham, UK
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Rothwell L, Britton J, Bogdanovica I. The relation between cigarette price and hand-rolling tobacco consumption in the UK: an ecological study. BMJ Open 2015; 5:e007697. [PMID: 26078312 PMCID: PMC4480014 DOI: 10.1136/bmjopen-2015-007697] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 05/21/2015] [Accepted: 05/22/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Cigarette price increases reduce smoking prevalence but as a tobacco control policy are undermined by the availability of lower cost alternatives such as hand-rolling tobacco. The aim of this descriptive study is to explore time trends in the price of manufactured cigarettes and hand-rolling tobacco, and in the numbers of people who smoke these products, over recent years in the UK. SETTINGS AND PARTICIPANTS UK. OUTCOME MEASURES Trends in the most popular price category (MPPC) data for cigarettes and hand-rolling tobacco from 1983 to 2012 adjusted for inflation using the Retail Price Index, and trends in smoking prevalence and the proportion of smokers using hand-rolling tobacco from 1974 to 2010. RESULTS After adjustment for inflation, there was an increase in prices of manufactured cigarettes and hand-rolling tobacco between 1983 and 2012. Between 1974 and 2010, the prevalence of smoking fell from 45% to 20%, and the estimated total number of smokers from 25.3 to 12.4 million. However the number of people smoking hand-rolling tobacco increased from 1.4 to 3.2 million, and MPPC cigarette price was strongly correlated with number of people smoking hand-rolling tobacco. CONCLUSIONS Although the ecological study design precludes conclusions on causality, the association between increases in manufactured cigarette price and the number of people smoking hand-rolling tobacco suggests that the lower cost of smoking hand-rolling tobacco encourages downtrading when cigarette prices rise. The magnitude of this association indicates that the lower cost of hand-rolling tobacco seriously undermines the use of price as a tobacco control measure.
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Affiliation(s)
| | - John Britton
- Division of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
| | - Ilze Bogdanovica
- Division of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
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Abstract
Researchers often use the discrepancy between self-reported and biochemically assessed active smoking status to argue that self-reported smoking status is not reliable, ignoring the limitations of biochemically assessed measures and treating it as the gold standard in their comparisons. Here, we employ econometric techniques to compare the accuracy of self-reported and biochemically assessed current tobacco use, taking into account measurement errors with both methods. Our approach allows estimating and comparing the sensitivity and specificity of each measure without directly observing true smoking status. The results, robust to several alternative specifications, suggest that there is no clear reason to think that one measure dominates the other in accuracy.
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Affiliation(s)
- Vidhura Tennekoon
- Department of Economics, Indiana University Purdue University, School of Liberal Arts, 425 University Boulevard, Cavanaugh Hall, Room 524, Indianapolis, IN 46202, USA. . 1-317-278-2845. Fax 1-317-274-0097
| | - Robert Rosenman
- School of Economic Sciences, Washington State University, Pullman, WA 99164, USA. . 1-509-335-1193. Fax 1-509-335-1173
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Sims M, Salway R, Langley T, Lewis S, McNeill A, Szatkowski L, Gilmore AB. Effectiveness of tobacco control television advertising in changing tobacco use in England: a population-based cross-sectional study. Addiction 2014; 109:986-94. [PMID: 24467285 PMCID: PMC4114556 DOI: 10.1111/add.12501] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 11/14/2013] [Accepted: 01/17/2014] [Indexed: 11/29/2022]
Abstract
AIM To examine whether government-funded tobacco control television advertising shown in England between 2002 and 2010 reduced adult smoking prevalence and cigarette consumption. DESIGN Analysis of monthly cross-sectional surveys using generalised additive models. SETTING England. PARTICIPANTS More than 80 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey. MEASUREMENTS Current smoking status, smokers' daily cigarette consumption, tobacco control gross rating points (GRPs-a measure of per capita advertising exposure combining reach and frequency), cigarette costliness, tobacco control activity, socio-demographic variables. FINDINGS After adjusting for other tobacco control policies, cigarette costliness and individual characteristics, we found that a 400-point increase in tobacco control GRPs per month, equivalent to all adults in the population seeing four advertisements per month (although actual individual-level exposure varies according to TV exposure), was associated with 3% lower odds of smoking 2 months later [odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.95, 0.999] and accounted for 13.5% of the decline in smoking prevalence seen over this period. In smokers, a 400-point increase in GRPs was associated with a 1.80% (95%CI = 0.47, 3.11) reduction in average cigarette consumption in the following month and accounted for 11.2% of the total decline in consumption over the period 2002-09. CONCLUSION Government-funded tobacco control television advertising shown in England between 2002 and 2010 was associated with reductions in smoking prevalence and smokers' cigarette consumption.
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Affiliation(s)
- Michelle Sims
- UK Centre for Tobacco and Alcohol StudiesDepartment for HealthUniversity of BathBathUK,Correspondence to: Anna B. Gilmore, Tobacco Control Research Group, Department for Health, University of Bath, Claverton Down, Bath BA2 7AY, UK. E‐mail:
| | - Ruth Salway
- Department for HealthUniversity of BathBathUK
| | - Tessa Langley
- UK Centre for Tobacco and Alcohol StudiesDivision of Epidemiology and Public HealthUniversity of NottinghamNottinghamUK
| | - Sarah Lewis
- UK Centre for Tobacco and Alcohol StudiesDivision of Epidemiology and Public HealthUniversity of NottinghamNottinghamUK
| | - Ann McNeill
- UK Centre for Tobacco and Alcohol StudiesNational Addiction CentreInstitute of PsychiatryKing's College LondonLondonUK
| | - Lisa Szatkowski
- UK Centre for Tobacco and Alcohol StudiesDivision of Epidemiology and Public HealthUniversity of NottinghamNottinghamUK
| | - Anna B. Gilmore
- UK Centre for Tobacco and Alcohol StudiesDepartment for HealthUniversity of BathBathUK
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Kohler S, Minkner P. Smoke-free laws and direct democracy initiatives on smoking bans in Germany: a systematic review and quantitative assessment. Int J Environ Res Public Health 2014; 11:685-700. [PMID: 24394216 PMCID: PMC3924468 DOI: 10.3390/ijerph110100685] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 12/19/2013] [Accepted: 12/20/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Germany's 16 states regulate smoking differently within health protection principles laid down in the federal law. All state smoke-free laws in Germany have undergone at least one change since taking effect. METHODS We systematically review federal and state laws regulating smoking, as well as petitions, popular initiatives and referenda that aimed at changing statutory smoking bans. Data generated through the systematic review were correlated with state smoking rates. RESULTS The protection from the dangers of secondhand smoke is the primary motive for smoking bans in Germany. The first smoke-free laws affecting smoking in pubs, restaurants and several other public places were introduced in 2007. In 2008, the Federal Constitutional Court of Germany ruled in a leading decision on the smoke-free laws of two states that some common smoking ban exemptions of the introduced smoke-free laws violate the basic right to freely exercise a profession and mandated revisions. All states but Bavaria and Saarland, whose smoking bans were more and less comprehensive than those judged by the constitutional court, respectively, needed to change the smoking ban exemptions to reconcile their smoke-free laws with the constitution. Direct democracy initiatives to change smoking bans were only successful in Bavaria in 2010, but a total of 15 initiatives by citizens' or interest groups attempted to influence non-smokers protection legislation through direct democratic procedures. Early ratification of a smoking ban in a federal state correlates with a higher reduction in the smoking rate from 2005 to 2009 (Spearman's ρ = 0.51, p = 0.04). CONCLUSIONS The federal government structure and direct democratic participation in smoke-free legislation in Germany has produced a diversity of local smoking bans and exemptions.
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Affiliation(s)
- Stefan Kohler
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin 10117, Germany.
| | - Philipp Minkner
- Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin 10117, Germany.
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Abdulghani HM, Alrowais NA, Alhaqwi AI, Alrasheedi A, Al-Zahir M, Al-Madani A, Al-Eissa A, Al-Hakmi B, Takroni R, Ahmad F. Cigarette smoking among female students in five medical and nonmedical colleges. Int J Gen Med 2013; 6:719-27. [PMID: 23986648 PMCID: PMC3754488 DOI: 10.2147/ijgm.s48630] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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] [Indexed: 11/23/2022] Open
Abstract
Objectives This study was conducted to determine the prevalence of smoking, knowledge about the ill effects of smoking on health, and the influence of family members’ smoking habits among Saudi female students. Methods This is a type of cross-sectional study. A sample of 1,070 female students was selected by a nonrandom and convenient sampling method from five colleges (Medicine, Business and Administration, Computer Sciences, Education, and Languages and Translation) of King Saud University, Riyadh, Saudi Arabia. A self-administrated questionnaire was used to determine the personal, social, and educational characteristics of the respondents. In addition, questions about their smoking types, status, duration of smoking, knowledge about the ill effects of smoking, daily cigarette consumption, and reasons for quitting smoking were included. Results The students’ response rate was 85%. The prevalence of current smoking was 4.3% and 5.6% for cigarettes and water-pipes, respectively, whereas 3.9% of the participants were ex-smokers. The prevalence of current smoking was highest in the College of Business and Administration (10.81%) and lowest in the College of Medicine (0.86%). The majority (77%) of the smokers’ parents (current and ex-smokers) were also smokers. More than half (54%) of the smokers started their smoking habit for entertainment, and 44.4% of the participants did not know that smoking causes serious health problems. The most common factors for quitting smoking were health concerns (54%), religious beliefs (29%), and parent’s advice (17%). Conclusion The study concludes that the prevalence of smoking varies in different subject streams and that family and friends have a great influence on individuals starting or stopping smoking. Extensive health education programs are needed to educate young women on the health hazards of smoking and help stop them from smoking.
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Affiliation(s)
- Hamza M Abdulghani
- Department of Medical Education, King Saud University, Riyadh, Saudi Arabia
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Coady MH, Jasek J, Davis K, Kerker B, Kilgore EA, Perl SB. Changes in smoking prevalence and number of cigarettes smoked per day following the implementation of a comprehensive tobacco control plan in New York City. J Urban Health 2012; 89:802-8. [PMID: 22544658 DOI: 10.1007/s11524-012-9683-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [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] [Indexed: 10/28/2022]
Abstract
The New York City (NYC) Health Department has implemented a comprehensive tobacco control plan since 2002, and there was a 27% decline in adult smoking prevalence in NYC from 2002 to 2008. There are conflicting reports in the literature on whether residual smoker populations have a larger or smaller share of "hardcore" smokers. Changes in daily consumption and daily and nondaily smoking prevalence, common components used to define hardcore smokers, were evaluated in the context of the smoking prevalence decline. Using the NYC Community Health Survey, an annual random digit dial, cross-sectional survey that samples approximately 10,000 adults, the prevalence of current heavy daily, light daily, and nondaily smokers among NYC adults was compared between 2002 and 2008. A five-level categorical cigarettes per day (CPD) variable was also used to compare the population of smokers between the 2 years. From 2002 to 2008, significant declines were seen in the prevalence of daily smoking, heavy daily smoking, and nondaily smoking. Among daily smokers, there is also evidence of population declines in all but the lowest smoking category (one to five CPD). The mean CPD among daily smokers declined significantly, from 14.6 to 12.5. After an overall decline in smoking since 2002, the remaining smokers may be less nicotine dependent, based on changes in daily consumption and daily and nondaily smoking prevalence. These findings suggest the need to increase media and cessation efforts targeted towards lighter smokers.
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Jeon J, Meza R, Krapcho M, Clarke LD, Byrne J, Levy DT. Chapter 5: Actual and counterfactual smoking prevalence rates in the U.S. population via microsimulation. Risk Anal 2012; 32 Suppl 1:S51-68. [PMID: 22882892 PMCID: PMC3478148 DOI: 10.1111/j.1539-6924.2011.01775.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The smoking history generator (SHG) developed by the National Cancer Institute simulates individual life/smoking histories that serve as inputs for the Cancer Intervention and Surveillance Modeling Network (CISNET) lung cancer models. In this chapter, we review the SHG inputs, describe its outputs, and outline the methodology behind it. As an example, we use the SHG to simulate individual life histories for individuals born between 1890 and 1984 for each of the CISNET smoking scenarios and use those simulated histories to compute the corresponding smoking prevalence over the period 1975-2000.
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Affiliation(s)
- Jihyoun Jeon
- Program in Biostatistics and Biomathematics, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
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Cui Y, Baldwin SB, Lightstone AS, Shih M, Yu H, Teutsch S. Small area estimates reveal high cigarette smoking prevalence in low-income cities of Los Angeles county. J Urban Health 2012; 89:397-406. [PMID: 21947903 PMCID: PMC3368049 DOI: 10.1007/s11524-011-9615-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Los Angeles County has among the lowest smoking rates of large urban counties in the USA. Nevertheless, concerning disparities persist as high smoking prevalence is found among certain subgroups. We calculated adult smoking prevalence in the incorporated cities of Los Angeles County in order to identify cities with high smoking prevalence. The prevalence was estimated by a model-based small area estimation method with utilization of three data sources, including the 2007 Los Angeles County Health Survey, the 2000 Census, and the 2007 Los Angeles County Population Estimates and Projection System. Smoking prevalence varied considerably across cities, with a more than fourfold difference between the lowest (5.3%) and the highest prevalence (21.7%). Higher smoking prevalence was generally found in socioeconomically disadvantaged cities. The disparities identified here add another layer of data to our knowledge of the health inequities experienced by low-income urban communities and provide much sought data for local tobacco control. Our study also demonstrates the feasibility of providing credible local estimates of smoking prevalence using the model-based small area estimation method.
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Affiliation(s)
- Yan Cui
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA, USA.
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