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Lachi A, Viscardi C, Cereda G, Carreras G, Baccini M. A compartmental model for smoking dynamics in Italy: a pipeline for inference, validation, and forecasting under hypothetical scenarios. BMC Med Res Methodol 2024; 24:148. [PMID: 39003462 PMCID: PMC11245805 DOI: 10.1186/s12874-024-02271-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 06/27/2024] [Indexed: 07/15/2024] Open
Abstract
We propose a compartmental model for investigating smoking dynamics in an Italian region (Tuscany). Calibrating the model on local data from 1993 to 2019, we estimate the probabilities of starting and quitting smoking and the probability of smoking relapse. Then, we forecast the evolution of smoking prevalence until 2043 and assess the impact on mortality in terms of attributable deaths. We introduce elements of novelty with respect to previous studies in this field, including a formal definition of the equations governing the model dynamics and a flexible modelling of smoking probabilities based on cubic regression splines. We estimate model parameters by defining a two-step procedure and quantify the sampling variability via a parametric bootstrap. We propose the implementation of cross-validation on a rolling basis and variance-based Global Sensitivity Analysis to check the robustness of the results and support our findings. Our results suggest a decrease in smoking prevalence among males and stability among females, over the next two decades. We estimate that, in 2023, 18% of deaths among males and 8% among females are due to smoking. We test the use of the model in assessing the impact on smoking prevalence and mortality of different tobacco control policies, including the tobacco-free generation ban recently introduced in New Zealand.
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Affiliation(s)
- Alessio Lachi
- Department of Statistics, Computer Science, Applications "Giuseppe Parenti" (DiSIA), University of Florence, Viale Giovanni Battista Morgagni 59/65, Florence, 50134, Italy.
- Epidemiology and Health Research Lab, Institute of Clinical Physiology of the Italian National Research Council (IFC-CNR), Via Giuseppe Moruzzi 1, Pisa, 56124, Italy.
| | - Cecilia Viscardi
- Department of Statistics, Computer Science, Applications "Giuseppe Parenti" (DiSIA), University of Florence, Viale Giovanni Battista Morgagni 59/65, Florence, 50134, Italy
- Florence Center for Data Science, University of Florence, Viale Giovanni Battista Morgagni 59, Florence, 50134, Italy
| | - Giulia Cereda
- Department of Statistics, Computer Science, Applications "Giuseppe Parenti" (DiSIA), University of Florence, Viale Giovanni Battista Morgagni 59/65, Florence, 50134, Italy
- Florence Center for Data Science, University of Florence, Viale Giovanni Battista Morgagni 59, Florence, 50134, Italy
| | - Giulia Carreras
- Oncologic Network, Prevention and Research Institute (ISPRO), Servizio Sanitario della Toscana, Via Cosimo il Vecchio 2, Florence, 50139, Italy
| | - Michela Baccini
- Department of Statistics, Computer Science, Applications "Giuseppe Parenti" (DiSIA), University of Florence, Viale Giovanni Battista Morgagni 59/65, Florence, 50134, Italy.
- Florence Center for Data Science, University of Florence, Viale Giovanni Battista Morgagni 59, Florence, 50134, Italy.
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Yusuf HAA, Galal M, Kaddah S, el Sharkawy M, Mousa MS, Moussa H. A preliminary study: MUC5B promoter polymorphism and its association with IPF. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2020. [DOI: 10.1186/s43168-020-00015-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The (T) allele of MUC5B gene is strongly correlated with idiopathic pulmonary fibrosis (IPF) and interstitial lung diseases (ILD) related to autoimmune conditions in Caucasians, but no data is available regarding this polymorphism in the Egyptian patients.
Results
This study is an observational cross-sectional study; the percentage of the (T) allele of MUC5B gene promoter in normal Egyptian persons in this study was 20%. This polymorphism is strongly related with risk for development of UIP/IPF in Egyptian patients compared to the other 2 groups (P value < 0.001). The MUC5B polymorphism has no role for developing interstitial lung disease in autoimmune diseases.
Conclusions
This study showed the potential role of MUC5B promoter polymorphism in IPF patients. Further multicentric studies are essential to be conducted deploying larger cohorts and different ethnic populations for further evaluation of these polymorphisms correlation.
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Hakola R, Leino T, Luukkonen R, Kauppi P. Occupational health check-ups and health-promoting programs and asthma. BMC Public Health 2020; 20:1313. [PMID: 32867741 PMCID: PMC7457532 DOI: 10.1186/s12889-020-09403-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 08/18/2020] [Indexed: 11/17/2022] Open
Abstract
Background The focus in occupational health check-ups is in work and health, but they offer also a possibility to assess health behavior and give guidance e.g. on weight control. We wanted to study whether having occupational health checks-up, receiving physicians’ advice to change health behavior or participation in health promotion programs had an effect on obesity in a five-year follow-up from 1998 to 2003 in asthmatic and non-asthmatic workers. Methods Altogether 23,220 individuals aged 20–54 years were picked up from a randomized Finnish population sample. Univariate and multivariate logistic regression analysis was used to calculate the risk for obesity in 2003. The variables used in the modelling were gender, age, smoking, asthma, depression, and physical workload. Results Both asthmatic and non-asthmatic workers gained weight during the follow-up. Of the asthmatics 48 and 47% of the non-asthmatics had occupational health-check-up in the last 5 years. Of the asthmatics 18 and 14% of the non-asthmatics had received physician’s advice to change their health behavior (p < 0.001). Associated factors for obesity (BMI > 30) in 2003 were gender (men OR 1.19), older age (OR 1.25), smoking (OR 1.07) or depression (OR 1.44). Conclusions Results show that having occupational health checks-up or receiving physicians’ advice to change health behavior or participation in health promotion programs did not stop gain of weight during a five-year follow-up. Asthmatic workers did not differ from non-asthmatics. Male gender, older age, smoking, and depression were associated with obesity but not the physical workload.
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Affiliation(s)
- Riina Hakola
- Department of Public Health, University of Helsinki, PO Box 40, 00014, Helsinki, Finland.
| | - Timo Leino
- The Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ritva Luukkonen
- The Finnish Institute of Occupational Health, Helsinki, Finland
| | - Paula Kauppi
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
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Bartolini L, Caranci N, Gnavi R, Di Girolamo C. Educational inequalities in the prevalence and outcomes of diabetes in the Emilian Longitudinal Study. Nutr Metab Cardiovasc Dis 2020; 30:1525-1534. [PMID: 32580888 DOI: 10.1016/j.numecd.2020.04.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIM Studies carried out in Italy in the last decades reported an effect modification in the association between socioeconomic position and diabetes outcomes, and the disease integrated care approach has been suggested as an explanatory factor. Whether this is true in Emilia-Romagna region in recent years is unknown and the aim of this study is to describe the role of educational level both on diabetes prevalence and health outcomes among the adult population with and without diabetes enrolled in the Emilian Longitudinal Study. METHODS AND RESULTS Inequalities in diabetes prevalence were evaluated through standardised estimates and prevalence ratios by educational level and inequalities in outcomes through standardised hospitalisation and mortality ratios and rate ratios by educational level. The lower the education the greater the diabetes prevalence; such differences were larger among women and younger age groups. Diabetes conferred a higher risk of hospitalisation and mortality; those outcomes also presented a social gradient with the less educated bearing the higher risk. However, educational differences were slightly stronger among the disease-free subjects, especially in the case of mortality. In both genders, inequalities tended to disappear with age. CONCLUSION This study confirms that diabetes increases the risk of unfavourable outcomes, but does not increase social inequalities in outcomes as might be expected. Similarly to what has been previously shown, it is likely that the protective effect of diabetes on the negative health effects of the low social position is attributable to the disease integrated care approach.
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Affiliation(s)
- Letizia Bartolini
- Health and Social Care Agency, Emilia-Romagna Region, Bologna, Italy
| | - Nicola Caranci
- Health and Social Care Agency, Emilia-Romagna Region, Bologna, Italy
| | - Roberto Gnavi
- Epidemiology Unit, ASL TO3, Piedmont Region, Grugliasco (TO), Italy
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La Torre G, Sestili C, Cocchiara RA, Cianfanelli S, Lia L, Mannocci A. Passive Smoking Indicators in Italy: Does the Gross Domestic Product Matter? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092045. [PMID: 30231580 PMCID: PMC6165307 DOI: 10.3390/ijerph15092045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/03/2018] [Accepted: 09/14/2018] [Indexed: 11/16/2022]
Abstract
Background: The aim of this study is to analyse the correlation between regional values of Gross Domestic Product (GDP) and passive smoking in Italy. Methods: The outcome measures were smoking ban respect in public places, workplaces and at home, derived from the PASSI surveillance for the period 2011–2017. The explanatory variable was GDP per capita. The statistical analysis was carried out using bivariate and linear regression analyses, taking into consideration two different periods, Years 2011–2014 and 2014–2017. Results: GDP is showed to be positively correlated with smoking ban respect in public places (r = 0.779 p < 0.001; r = 0.723 p < 0.001 in the two periods, respectively), as well as smoking ban respect in the workplace (r = 0.662 p = 0.001; r = 0.603 p = 0.004) and no smoking at home adherence (r = 0.424 p = 0.056; r = 0.362 p = 0.107). In multiple linear regression GDP is significantly associated to smoking ban respect in public places (adjusted β = 0.730 p < 0.001; β = 0.698 p < 0.001 in the two periods, respectively), smoking ban in workplaces (adjusted β = 0.525 p = 0.020; β = 0.570 p = 0.009) and no smoking at home (adjusted β = 0.332 p = 0.070; β = 0.362 p = 0.052). Conclusions: Smoking ban is more respected in Regions with higher GDP. For a better health promotion, systematic vigilance and sanctions should be maintained and strengthened, particularly in regions with low compliance with smoking bans.
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Affiliation(s)
- Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Cristina Sestili
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Rosario Andrea Cocchiara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Sara Cianfanelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Lorenza Lia
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Alice Mannocci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
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Coppo A, Baldissera S, Migliardi A, Minardi V, Quarchioni E, Ferrante G, Dal Molin A, Faggiano F. Quit attempts and smoking cessation in Italian adults (25-64 years): factors associated with attempts and successes. Eur J Public Health 2018; 27:717-722. [PMID: 28108591 DOI: 10.1093/eurpub/ckw262] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Over the past 50 years there was a substantial decrease in the prevalence of smoking in Italy. The objective of this work is to describe attempts to quit and cessation success in Italian smokers. Methods A surveillance on health-related behaviors (PASSI) was conducted in 2007-13 on a sample of 203 610 Italian adults 25-64 years of age. An analysis of smokers' characteristics and behaviors was performed, focusing on attempts to quit and quit success. Data from national surveys (ISTAT) from 1983 to 2013 (Italian adults, 25-64 years of age, 1983: 46 634; 1987: 40 915; 1990: 36 622; 2000: 77 531; 2005: 71 032; 2013: 64 205) were used to explore if a cessation trend in Italy exists. Results Smokers who quit in the previous year and were still abstinent when interviewed increased from 1990 to 2013. In the years 2011-13, 38% of people who had smoked in the last 12 months reported at least a quit attempt during the same period and 7% were still abstinent when interviewed. An association of successful recent quit attempts with higher educational level, absence of economic difficulties and younger age was found. In the years 2007-13, the great majority tried to stop unaided. Having received assistance from a cessation program did not increase the probability of enduring abstinence. Conclusions In Italy interventions to drive more smokers to quit should be focused in particular on disadvantaged groups. Initiatives have to be studied not only to incentive more smokers to try to quit, but also to maintain abstinence over time.
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Affiliation(s)
- Alessandro Coppo
- Department of Translational Medicine, Avogadro University, Novara, Italy
| | - Sandro Baldissera
- Surveillance and Health Promotion, National Centre of Epidemiology, Rome, Italy
| | | | - Valentina Minardi
- Surveillance and Health Promotion, National Centre of Epidemiology, Rome, Italy
| | - Elisa Quarchioni
- Surveillance and Health Promotion, National Centre of Epidemiology, Rome, Italy
| | - Gianluigi Ferrante
- Surveillance and Health Promotion, National Centre of Epidemiology, Rome, Italy
| | - Alberto Dal Molin
- Department of Translational Medicine, Avogadro University, Novara, Italy
| | - Fabrizio Faggiano
- Department of Translational Medicine, Avogadro University, Novara, Italy
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Kalter-Leibovici O, Chetrit A, Avni S, Averbuch E, Novikov I, Daoud N. Social characteristics associated with disparities in smoking rates in Israel. Isr J Health Policy Res 2016; 5:36. [PMID: 27957321 PMCID: PMC5131466 DOI: 10.1186/s13584-016-0095-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 08/01/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cigarette smoking is a major cause of health disparities. We aimed to determine social characteristics associated with smoking status and age at smoking initiation in the ethnically-diverse population of Israel. METHODS This is a cross-sectional survey, based on data collected during 2010 by the Israel Bureau of Statistics, in a representative nationwide sample of 7,524 adults (≥20 years). Information collected by personal interviews included a broad set of demographic and socio-economic characteristics and detailed information on smoking habits. Associations between social characteristics and smoking habits were tested in multivariable regression models. RESULTS Current smoking was more frequent among men than among women (30.9 % vs. 16.8 %; p < 0.0001). In multivariable regression analysis, the association of some social characteristics with smoking status differed by gender. Lower socioeconomic status (reflected by higher rate of unemployment, lower income, possession of fewer material assets, difficulty to meet living expenses) and lower educational level were significantly associated with current smoking among men but not among women. Family status other than being married was associated with higher likelihood of being a current smoker, while being traditional or observant was associated with a lower likelihood of ever smoking among both gender groups. Arab minority men and male immigrants from the former Soviet Union countries were more frequently current smokers than Israeli-born Jewish men [adjusted odds ratio (95 % confidence interval): 1.53 (1.22, 1.93) and 1.37 (1.01-1.87), respectively]. Compared to Israeli-born men, the age at smoking initiation was younger among male immigrants, and older among Arab minority men [adjusted hazard ratio (95 % confidence interval): 1.360 (1.165-1.586), and 0.849 (0.749-0.962), respectively]. While the prevalence of current smoking was lower in younger birth cohorts, the age at smoking initiation among ever-smokers declined as well. CONCLUSIONS Among several subgroups within the Israeli population the smoking uptake is high, e.g. Arab men, men who are less affluent, who have lower educational level, and male immigrants. These subgroups should be prioritized for intervention to reduce the burden of smoking. To be effective, gender, cultural background and socioeconomic characteristics should be considered in the design and implementation of culturally-congruent tobacco control and smoking prevention and cessation interventions.
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Affiliation(s)
- Ofra Kalter-Leibovici
- Unit of Cardiovascular Epidemiology, The Gertner Institute for Epidemiology & Health Policy Research, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Angela Chetrit
- Unit of Cardiovascular Epidemiology, The Gertner Institute for Epidemiology & Health Policy Research, Tel-Hashomer, Israel
| | - Shlomit Avni
- Reduction of Health Inequalities Unit in the Administration for Strategic and Economic Planning at the Israeli Ministry of Health, Jerusalem, Israel
| | - Emma Averbuch
- Reduction of Health Inequalities Unit in the Administration for Strategic and Economic Planning at the Israeli Ministry of Health, Jerusalem, Israel
| | - Ilya Novikov
- Biostatistics Unit, The Gertner Institute for Epidemiology & Health Policy Research, Tel-Hashomer, Israel
| | - Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Bidoli E, Pappagallo M, Birri S, Frova L, Zanier L, Serraino D. Residential Proximity to Major Roadways and Lung Cancer Mortality. Italy, 1990-2010: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:191. [PMID: 26848674 PMCID: PMC4772211 DOI: 10.3390/ijerph13020191] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 01/22/2016] [Accepted: 01/26/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Air pollution from road traffic has been associated to an increased risk of lung cancer. Herein, we investigated the association between lung cancer mortality and residence near Italian highways or national major roads. METHODS Information on deaths for lung cancer registered from 1990 to 2010 and stratified by age, gender, and urban or rural municipality of residence at death were obtained from the National Institute of Statistics. Distance between the centroid of the municipality of residence and closest major roadways was considered as a proxy of pollution exposure. Relative Risks (RR) and 95% confidence intervals (CI) were computed using Poisson log-linear models adjusted for age, calendar period, deprivation index, North/South gradient, and urban/rural status. RESULTS A gradient in risk for lung cancer mortality was seen for residents within 50 meters (m) of national major roads. In particular, in rural municipalities a statistically significant increased risk for lung cancer death was observed in both sexes (RR = 1.27 for distance <25 m vs. 500-1999 m, 95% CI 1.17-1.42, in men; RR = 1.97, 95% CI 1.64-2.39, in women). In urban municipalities, weak risks of borderline significance were documented in both sexes (RR = 1.06, 95% CI 0.99-1.15 in men; and RR = 1.09, 95% CI 0.97-1.22 in women). No statistically significant association emerged between residence within 100 to 500 m from highways and RRs of death for lung cancer. CONCLUSIONS In Italy, residing near national major roads, in particular in rural municipalities, was related to elevated risks of death for lung cancer.
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Affiliation(s)
- Ettore Bidoli
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano 33081, Italy.
| | - Marilena Pappagallo
- Division for Socio-Demographic and Environmental Statistics-Statistics on Health and Social Security, National Institute of Statistics, Rome 00184, Italy.
| | - Silvia Birri
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano 33081, Italy.
| | - Luisa Frova
- Division for Socio-Demographic and Environmental Statistics-Statistics on Health and Social Security, National Institute of Statistics, Rome 00184, Italy.
| | - Loris Zanier
- Direzione Centrale Salute, Friuli Venezia Giulia, Servizio Regionale di Epidemiologia, Udine 33100, Italy.
| | - Diego Serraino
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano 33081, Italy.
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Reduction of risk of dying from tobacco-related diseases after quitting smoking in Italy. TUMORI JOURNAL 2015; 101:657-63. [PMID: 26108248 DOI: 10.5301/tj.5000307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2015] [Indexed: 11/20/2022]
Abstract
AIMS AND BACKGROUND The aims of this paper are to compute the risks of dying of ischemic heart disease (IHD), lung cancer (LC), stroke, and chronic obstructive pulmonary disease (COPD) for Italian smokers by gender, age and daily number of cigarettes smoked, and to estimate the benefit of stopping smoking in terms of risk reduction. METHODS Life tables by sex and smoking status were computed for each smoking-related disease based on Italian smoking data, and risk charts with 10-year probabilities of death were computed for never, current and former smokers. RESULTS Men aged 45-49 years, current smokers, have a 8, 10, 3 and 1 in 1,000 chance of dying of IHD, LC, stroke and COPD, respectively, whereas women with the same characteristics have a 2, 6, 3 and 1 in 1,000 chance, respectively, for all smokers combined, i.e., independent of the smoking intensity. The risk reduction rates from quitting smoking are remarkable: a man who quits smoking at 45-49 years can reduce the risk of dying of IHD, LC, stroke and COPD in the next 10 years by 43%, 53%, 57% and 55%, respectively; a woman by 49%, 49%, 59% and 57%, respectively. CONCLUSIONS Estimates of risk reduction by quitting smoking are useful to provide a sounder scientific basis for public health messages and clinical advice.
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Raho E, van Oostrom SH, Visser M, Huisman M, Zantinge EM, Smit HA, Verschuren WMM, Hulsegge G, Picavet HSJ. Generation shifts in smoking over 20 years in two Dutch population-based cohorts aged 20-100 years. BMC Public Health 2015; 15:142. [PMID: 25884440 PMCID: PMC4340284 DOI: 10.1186/s12889-015-1481-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 01/27/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Younger and older generations may differ substantially in their lifetime smoking habits, which may result in generation-specific health challenges. We aimed to quantify generation shifts in smoking over a period of 25 years. METHODS We used the Doetinchem Cohort Study (baseline 1987-1991; 7768 individuals; 20-60 years; follow-up 1993-2012) and the Longitudinal Aging Study Amsterdam (baseline 1992-1993; 3017 individuals; 55-85 years; follow-up 1995-2009). Generation shifts were studied between 10-year generations (age range: 20-100 years). Generation shifts were examined graphically and by using logistic random effect models for men and women. RESULTS Among men, significant generation shifts in current smoking were found between two non-successive generations: for instance men in their 40s at baseline smoked much more than men in their 40s at follow-up (33.6% vs. 23.1%, p < 0.05). Among women, the most recently born generation showed a favourable significant generation shift in current smoking (-7.3%) and ever smoking (-10.1%). For all other generations, the prevalence of ever smoking among women was significantly higher in every more recently born generation, whereas no other generation shifts were observed for current smoking. The unfavourable generation shifts were mainly found among the lower educated. CONCLUSIONS The future burden of disease due to smoking is expected to be reduced among men, but not yet among women. Educational differences in smoking-related health problems are expected to increase.
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Affiliation(s)
- Enrico Raho
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - Sandra H van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands. .,EMGO+ Institute for Health and Care Research, Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
| | - Martijn Huisman
- EMGO+ Institute for Health and Care Research, Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands. .,Department of Sociology, VU University, Amsterdam, The Netherlands.
| | - Else M Zantinge
- Centre for Health and Society, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - Henriette A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. .,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Gerben Hulsegge
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. .,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - H Susan J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
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Verlato G, Accordini S, Nguyen G, Marchetti P, Cazzoletti L, Ferrari M, Antonicelli L, Attena F, Bellisario V, Bono R, Briziarelli L, Casali L, Corsico AG, Fois A, Panico M, Piccioni P, Pirina P, Villani S, Nicolini G, de Marco R. Socioeconomic inequalities in smoking habits are still increasing in Italy. BMC Public Health 2014; 14:879. [PMID: 25159912 PMCID: PMC4159540 DOI: 10.1186/1471-2458-14-879] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 08/18/2014] [Indexed: 11/10/2022] Open
Abstract
Background Socioeconomic inequalities in smoking habits have stabilized in many Western countries. This study aimed at evaluating whether socioeconomic disparities in smoking habits are still enlarging in Italy and at comparing the impact of education and occupation. Methods In the frame of the GEIRD study (Gene Environment Interactions in Respiratory Diseases) 10,494 subjects, randomly selected from the general population aged 20–44 years in seven Italian centres, answered a screening questionnaire between 2007 and 2010 (response percentage = 57.2%). In four centres a repeated cross-sectional survey was performed: smoking prevalence recorded in GEIRD was compared with prevalence recorded between 1998 and 2000 in the Italian Study of Asthma in Young Adults (ISAYA). Results Current smoking was twice as prevalent in people with a primary/secondary school certificate (40-43%) compared with people with an academic degree (20%), and among unemployed and workmen (39%) compared with managers and clerks (20-22%). In multivariable analysis smoking habits were more affected by education level than by occupation. From the first to the second survey the prevalence of ever smokers markedly decreased among housewives, managers, businessmen and free-lancers, while ever smoking became even more common among unemployed (time-occupation interaction: p = 0.047). At variance, the increasing trend in smoking cessation was not modified by occupation. Conclusion Smoking prevalence has declined in Italy during the last decade among the higher socioeconomic classes, but not among the lower. This enlarging socioeconomic inequality mainly reflects a different trend in smoking initiation.
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Affiliation(s)
- Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
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Mucin 5B promoter polymorphism is associated with susceptibility to interstitial lung diseases in Chinese males. PLoS One 2014; 9:e104919. [PMID: 25121989 PMCID: PMC4133265 DOI: 10.1371/journal.pone.0104919] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 07/13/2014] [Indexed: 12/30/2022] Open
Abstract
The variation of G>T in the MUC5B promoter (rs35705950) has been associated with idiopathic pulmonary fibrosis (IPF) and familial interstitial pneumonia (FIP) in Caucasians, but no information is available regarding this variant in the Chinese population. We recruited 405 patients with interstitial lung diseases (ILD), including 165 IPF patients and 2043 healthy controls, for genotyping the MUC5B gene in the Chinese population. One hundred three patients with pneumonia and 360 patients with autoimmune diseases (ADs) were recruited as disease controls. Our results indicated that the prevalence of the minor allele (T) of the polymorphism rs35705950 in healthy Chinese subjects was approximately 0.66%, which was lower than that described in the Caucasian population. The frequencies of the T allele were 3.33% and 2.22% in IPF and ILD patients, respectively, and these values were significantly higher than those of healthy controls (P = 0.001, OR = 4.332 for IPF, and P = 0.002, OR = 2.855 for ILD). A stratified analysis showed that this variant in MUC5B associated with the risk for ILD mainly in older male Chinese subjects. No difference was observed between patients with pneumonia, AD patients, and healthy controls.
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Carrozzi L, Falcone F, Carreras G, Pistelli F, Gorini G, Martini A, Viegi G. Life gain in Italian smokers who quit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:2395-406. [PMID: 24577282 PMCID: PMC3986982 DOI: 10.3390/ijerph110302395] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 02/13/2014] [Accepted: 02/13/2014] [Indexed: 12/03/2022]
Abstract
This study aims to estimate the number of life years gained with quitting smoking in Italian smokers of both sexes, by number of cigarettes smoked per day (cig/day) and age at cessation. All-cause mortality tables by age, sex and smoking status were computed, based on Italian smoking data, and the survival curves of former and current smokers were compared. The more cig/day a man/woman smokes, and the younger his/her age of quitting smoking, the more years of life he/she gains with cessation. In fact, cessation at age 30, 40, 50, or 60 years gained, respectively, about 7, 7, 6, or 5, and 5, 5, 4, or 3 years of life, respectively, for men and women that smoked 10–19 cig/day. The gain in life years was higher for heavy smokers (9 years for >20 cig/day) and lower for light smokers (4 years for 1–9 cig/day). Consistently with prospective studies conducted worldwide, quitting smoking increases life expectancy regardless of age, gender and number of cig/day. The estimates of the number of years of life that could be gained by quitting smoking, when computed specifically for a single smoker, could be used by physicians and health professionals to promote a quit attempt.
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Affiliation(s)
- Laura Carrozzi
- Pulmonary Unit, CardioThoracic and Vascular Department, University Hospital of Pisa, via Paradisa 2, Cisanello, Pisa 56124, Italy.
| | - Franco Falcone
- Italian Association of Hospital Pulmonologists (AIPO) Research,Via Antonio Da Recanate, 2, Milan 20124, Italy.
| | - Giulia Carreras
- Unit of Environmental and Occupational Epidemiology, Cancer Prevention and Research Institute (ISPO), via delle Oblate 2, Florence 50139, Italy.
| | - Francesco Pistelli
- Pulmonary Unit, CardioThoracic and Vascular Department, University Hospital of Pisa, via Paradisa 2, Cisanello, Pisa 56124, Italy.
| | - Giuseppe Gorini
- Unit of Environmental and Occupational Epidemiology, Cancer Prevention and Research Institute (ISPO), via delle Oblate 2, Florence 50139, Italy.
| | - Andrea Martini
- Unit of Environmental and Occupational Epidemiology, Cancer Prevention and Research Institute (ISPO), via delle Oblate 2, Florence 50139, Italy.
| | - Giovanni Viegi
- Unit of Pulmonary Environmental Epidemiology, Institute of Clinical Physiology, Italian National Research Council (IFC-CNR), via Trieste 41, Pisa 56126, Italy.
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Carreras G, Gorini G. Time trends of Italian former smokers 1980-2009 and 2010-2030 projections using a Bayesian age period cohort model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 11:1-12. [PMID: 24452251 PMCID: PMC3924433 DOI: 10.3390/ijerph110100001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 11/25/2013] [Accepted: 11/26/2013] [Indexed: 11/28/2022]
Abstract
This study aimed to describe past time trends of the prevalence of former smokers in Italy and to estimate prevalence projections using a Bayesian approach. An age-period-cohort (APC) analysis has been carried out in order to investigate the effect of the age, period and birth cohort on the prevalence of former smokers during 1980–2009. A Bayesian APC model with an autoregressive structure for the age, period and cohort parameters has been used to estimate future trends. Results showed that awareness of harm from smoking occurred at younger ages with each advancing cohort, and that women were more likely to attempt to stop smoking during pregnancies and breastfeeding, whereas men attempted to quit only when smoking-related diseases became evident. Projections of future trend recorded a further increase in the number of former smokers in future decades, showing an estimate of the “end of smoking” around years 2060 and 2055 in men and women, respectively. The application of the APC analysis to study the prevalence of former smokers turned out to be a useful method for the evaluation of past smoking trends, reflecting the effects of tobacco control policies on time and generations, and to make projections of future trend.
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Affiliation(s)
- Giulia Carreras
- Cancer Prevention and Research Institute, via delle Oblate 2, Florence 50139, Italy.
| | - Giuseppe Gorini
- Cancer Prevention and Research Institute, via delle Oblate 2, Florence 50139, Italy.
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