1
|
Ricciardone MD, Baker L, Twesten J, Parascandola M. Portfolio analysis of global tobacco control research funding at the National Cancer Institute, 2000-2019. Tob Prev Cessat 2024; 10:TPC-10-13. [PMID: 38440159 PMCID: PMC10910547 DOI: 10.18332/tpc/184041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/06/2024]
Abstract
INTRODUCTION Research in low- and middle-income countries (LMICs), where the majority of global tobacco users reside, is critical to addressing the global tobacco epidemic. This analysis describes the global tobacco control research portfolio funded by the National Cancer Institute from fiscal years 2000 to 2019. METHODS We used the National Institutes of Health Query, View, Report database to identify extramural grants relevant to global tobacco control research. Abstracts were analyzed to describe grant characteristics, including topic areas, tobacco products, countries, and regions of focus. Bibliometric and co-authorship network analyses were performed for publications associated with relevant grants. RESULTS Of the 93 relevant grants with foreign (non-US) involvement, the majority (83.9%) supported research in upper and lower middle-income countries. The majority of grants (86.0%) focused on cigarettes, with a small subset of grants addressing smokeless tobacco, waterpipe use, or other non-cigarette products. Most grants focused on at least one of the six tobacco control policy measures in the World Health Organization MPOWER package; almost half (48.4%) focused on monitoring tobacco use and around one-third (32.3%) focused on offering tobacco cessation treatment, while other MPOWER measures received less attention in the research portfolio. While most of these grants, and the funding initiatives that supported them, emphasized research in low- and middle-income countries (LMICs), only 3 of 93 grants were awarded directly to LMIC-based institutions. CONCLUSIONS There is a critical need for research to develop and test strategies to adapt, implement, and scale up evidence-based interventions across diverse LMIC settings. This study identified gaps in research activity that should be addressed to strengthen global tobacco control research capacity.
Collapse
Affiliation(s)
| | - Laura Baker
- Strategix Management, LLC, Washington, DC 20036, USA
| | - Jenny Twesten
- The Bizzell Group, LLC, New Carrollton, MD 20785, USA
| | - Mark Parascandola
- Center for Global Health, National Cancer Institute, Bethesda, MD 20892, USA
| |
Collapse
|
2
|
Cartujano-Barrera F, Mejia RM, Radusky PD, Cardozo N, Duarte M, Fabian S, Caballero R, Zalazar V, Ramos-Pibernus A, Alpert AB, Cupertino AP, Frola C, Aristegui I. Prevalence and correlates of current cigarette smoking among transgender women in Argentina. Front Public Health 2023; 11:1279969. [PMID: 38115852 PMCID: PMC10728477 DOI: 10.3389/fpubh.2023.1279969] [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: 08/19/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Objective To assess the prevalence of current cigarette smoking among transgender women in Argentina, and to examine the unique associations of current cigarette smoking with demographic and psychosocial factors. Methods This study is a secondary data analysis of the TransCITAR - a prospective cohort study of transgender individuals living in Buenos Aires, Argentina - baseline data. The baseline survey collected information on sociodemographic characteristics, perceived health status, depressive symptoms, suicide attempts, current cigarette smoking, alcohol use disorder, and substance use. Participants were also asked about lifetime experiences of physical and sexual violence perpetrated by partners, clients and/or the police, and experiences of gender identity stigma in the past year from healthcare workers and the police. Lastly, participants were asked if they had ever been arrested. Fisher's exact test was used to compare proportions in categorical variables and student t-test was used for continuous variables. Significant associations with current cigarette smoking were tested in a logistic regression model adjusted for all significant associations. Results A total of 41.7% of participants (n = 393) reported current cigarette smoking. Compared to their non-smoking counterparts, participants who reported current cigarette smoking (1) had completed less education, (2) were more likely to be born in Argentina, (3) more likely to had migrated to Buenos Aires from other parts of the country, (4) more likely to report a history of sex work, (5) more likely to perceive their health as excellent, (6) more likely to screen positive for hazardous alcohol drinking, (7) more likely to report any substance and cocaine use in the past year, (8) more likely to experience gender identity stigma from the police in the past year, and (9) more likely to being arrested in their lifetime (all p's < 0.05). After controlling for all significant associations, education level of less than high school (AOR = 1.79, 95% CI 1.02-2.12), hazardous drinking (AOR = 2.65, 95% CI 1.30-5.37), and any substance use in the last year (AOR = 2.14, 95% CI 1.16-3.94) were positively and independently associated with current cigarette smoking. Conclusion Among transgender women in Argentina, current cigarette smoking was more than double the rate for cisgender women. Current cigarette smoking was associated with education, hazardous drinking, and any drug use. These results will inform future smoking cessation interventions among transgender women in Argentina.
Collapse
Affiliation(s)
| | - Raul M. Mejia
- Division of Implementation Research, Fundación Huésped, Buenos Aires, Argentina
- Department of Ambulatory Care, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Pablo D. Radusky
- Division of Implementation Research, Fundación Huésped, Buenos Aires, Argentina
| | - Nadir Cardozo
- Division of Implementation Research, Fundación Huésped, Buenos Aires, Argentina
- Asociación de Travestis, Transexuales y Transgéneros de Argentina, Buenos Aires, Argentina
| | - Mariana Duarte
- Division of Implementation Research, Fundación Huésped, Buenos Aires, Argentina
- Casa Trans, Buenos Aires, Argentina
| | - Solange Fabian
- Division of Implementation Research, Fundación Huésped, Buenos Aires, Argentina
- Hotel Gondolín, Buenos Aires, Argentina
| | - Romina Caballero
- Division of Implementation Research, Fundación Huésped, Buenos Aires, Argentina
| | - Virginia Zalazar
- Division of Implementation Research, Fundación Huésped, Buenos Aires, Argentina
| | - Alixida Ramos-Pibernus
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR, United States
| | - Ash B. Alpert
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
- Division of Hematology, Department of Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, United States
| | - Claudia Frola
- Division of Implementation Research, Fundación Huésped, Buenos Aires, Argentina
| | - Ines Aristegui
- Division of Implementation Research, Fundación Huésped, Buenos Aires, Argentina
| |
Collapse
|
3
|
Duan Z, Abroms LC, Cui Y, Wang Y, LoParco CR, Levine H, Bar-Zeev Y, Khayat A, Berg CJ. Exposure to e-cigarette advertisements and non-advertising content in relation to use behaviors and perceptions among US and Israeli adults. Tob Prev Cessat 2023; 9:35. [PMID: 38033881 PMCID: PMC10685321 DOI: 10.18332/tpc/173558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION As e-cigarette marketing strategies diversify, it is important to examine exposure to and impact of e-cigarette advertisements and non-advertising content (e.g. on social media) via multiple media channels among adults in different regulatory contexts. METHODS Using 2021 cross-sectional data among 2222 adults in the US (n=1128) and Israel (n=1094), multivariable regression examined past-month e-cigarette advertisement and non-advertising content exposure in relation to past-month e-cigarette use (logistic regression), as well as use intentions and risk perceptions (linear regressions), controlling for sociodemographics and tobacco use. RESULTS Overall, 20.3% reported past-month e-cigarette use (15.5% US, 25.2% Israel), 46.1% any advertisement exposure (28.7% digital media, 25.2% traditional media, 16.8% retail settings), and 34.1% any non-advertising exposure (19.4% social media, 13.6% websites, 12.3% movie/television/theater, 5.8% radio/podcasts). Exposure to digital media advertisements (AOR=1.95; 95% CI: 1.42-2.66), traditional media advertisements (AOR=2.00; 95% CI=1.49-2.68), and social media non-advertising (AOR=1.72; 95% CI: 1.25-2.36) correlated with e-cigarette use. Exposure to traditional media advertisements (β=0.23; 95% CI: 0.08-0.38) and social media non-advertising (β=0.26; 95% CI: 0.09-0.43) correlated with use intentions. Exposure to digital media advertisements (β= -0.32; 95% CI: -0.57 - -0.08), retail setting advertisements (β= -0.30; 95% CI: -0.58 - -0.03), and radio/podcast non-advertising (β= -0.44; 95% CI: -0.84 - -0.03) correlated with lower perceived addictiveness. Radio/podcast non-advertising exposure (β= -0.50; 95% CI: -0.84 - -0.16) correlated with lower perceived harm. However, retail setting advertisement exposure was associated with e-cigarette non-use (AOR=0.61; 95% CI: 0.42-0.87), and traditional media advertisement (β=0.38; 95% CI: 0.15-0.61) and social media non-advertising exposure (β=0.40; 95% CI: 0.14-0.66) correlated with greater perceived addictiveness. CONCLUSIONS E-cigarette-related promotional content exposure across media platforms impacts perceptions and use, thus warranting regulation.
Collapse
Affiliation(s)
- Zongshuan Duan
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, United States
| | - Lorien C. Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
- George Washington Cancer Center, George Washington University, Washington, United States
| | - Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
- George Washington Cancer Center, George Washington University, Washington, United States
| | - Cassidy R. LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Centre, Jerusalem, Israel
| | - Yael Bar-Zeev
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Centre, Jerusalem, Israel
| | - Amal Khayat
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Centre, Jerusalem, Israel
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
- George Washington Cancer Center, George Washington University, Washington, United States
| |
Collapse
|
4
|
Twesten JE, Stecher C, Arinaitwe J, Parascandola M. Tobacco control research on the African continent: a 22-year literature review and network analysis. Tob Control 2023:tc-2022-057760. [PMID: 37068947 DOI: 10.1136/tc-2022-057760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/04/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE Describe the landscape of tobacco-related topics, funders and institutional networks in Africa. DATA SOURCES We searched PubMed, Embase and African Index Medicus for published articles from January 1996 to August 2018 in any language. STUDY SELECTION Two researchers independently reviewed titles and abstracts for a focus on nicotine or tobacco product(s) and describe data or recommendations specific to Africa. Ultimately, 818 articles were identified. DATA EXTRACTION Three independent coders conducted qualitative analyses of articles and extracted funders, study populations, countries of research focus, research topics, tobacco products, study design and data source. A bibliometric analysis estimated coauthorship networks between the countries of authors' primary institutional affiliation. DATA SYNTHESIS All 54 African countries were represented in two or more articles. The coauthorship network included 2714 unique authors representing 90 countries. Most articles employed a cross-sectional study design with primary data collection, focused on cigarettes and studied use behaviour. Few articles examined tobacco farming or interventions for cessation or prevention. The most frequently cited funder was the US National Institutes of Health (27.2%). A range of coauthorship patterns existed between African institutions with some coauthoring with one institution while others coauthored with 761 institutions in other African countries. CONCLUSIONS The literature review identified the need for implementation research for tobacco control interventions and policies, economic and development impacts of tobacco use research, and tobacco industry and tobacco production and farming research. Numbers of research collaborations between institutions in Africa vary, suggesting the need for regional institutional capacity building.
Collapse
Affiliation(s)
| | - Chad Stecher
- College of Health Solutions, Arizona State University, Tempe, Arizona, USA
| | - Jim Arinaitwe
- Center for Tobacco Control in Africa, Kampala, Uganda
| | - Mark Parascandola
- Center for Global Health, National Cancer Institute, Bethesda, Maryland, USA
| |
Collapse
|
5
|
Rodríguez-Bolaños R, Ramírez-Palacios P, Bolaños A, Lara D, Millan G, Gallegos-Carrillo K, Flores YN, Mejia RM, Cupertino AP, Cartujano-Barrera F. Decídetexto México: Recruitment and baseline characteristics of Mexican individuals who smoke in a cessation study. Tob Use Insights 2023; 16:1179173X231157378. [PMID: 37425216 PMCID: PMC10326465 DOI: 10.1177/1179173x231157378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
The objective of this study was to evaluate the effectiveness of digital and traditional methods and strategies in the recruitment of Mexican individuals who smoke into a cessation study. Recruitment method refers in general to either digital or traditional recruitment. Recruitment strategies refer to the particular recruitment type utilized within each recruitment method. Traditional recruitment strategies included radio interviews, word of mouth, newspaper advertisement, posters/banners placed in primary healthcare clinics, and medical referrals. Digital recruitment strategies involved emails and study advertisements through social media (i.e., Facebook, Instagram and Twitter) and website. In a 4-month period, 100 Mexican individuals who smoke were successfully enrolled into a smoking cessation study. The majority of participants were enrolled via traditional recruitment strategies (86%) compared to the digital recruitment strategies (14%). Individuals screened in the digital method were more likely to be eligible to participate in the study, compared to the traditional method. Similarly, in comparison to the traditional method, individuals in the digital method were more likely to enroll in the study. However, these differences were not statistically significant. Both traditional and digital strategies made important contributions to the overall recruitment effort.
Collapse
Affiliation(s)
| | - Paula Ramírez-Palacios
- Unidad de Investigación
Epidemiológica y en Servicios de Salud Delegación Morelos, Instituto Mexicano del Seguro
Social, Cuernavaca, Mexico
| | - Alejandra Bolaños
- Departamento de Investigación Sobre
Tabaco, Instituto Nacional de Salud
Pública, Cuernavaca, Mexico
| | - Daimarelys Lara
- Department of Public Health
Sciences, University of Rochester Medical
Center, Rochester, NY, USA
| | - Gabriel Millan
- Departamento de Investigación Sobre
Tabaco, Instituto Nacional de Salud
Pública, Cuernavaca, Mexico
| | - Katia Gallegos-Carrillo
- Unidad de Investigación
Epidemiológica y en Servicios de Salud Delegación Morelos, Instituto Mexicano del Seguro
Social, Cuernavaca, Mexico
| | - Yvonne N Flores
- Unidad de Investigación
Epidemiológica y en Servicios de Salud Delegación Morelos, Instituto Mexicano del Seguro
Social, Cuernavaca, Mexico
| | - Raúl M Mejia
- Departamento de Medicina
Ambulatoria, Universidad de Buenos
Aires, Buenos Aires, Argentina
| | - Ana Paula Cupertino
- Department of Public Health
Sciences, University of Rochester Medical
Center, Rochester, NY, USA
| | | |
Collapse
|
6
|
Levine H, Duan Z, Bar-Zeev Y, Abroms LC, Khayat A, Tosakoon S, Romm KF, Wang Y, Berg CJ. IQOS Use and Interest by Sociodemographic and Tobacco Behavior Characteristics among Adults in the US and Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3141. [PMID: 36833831 PMCID: PMC9961058 DOI: 10.3390/ijerph20043141] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
Heated tobacco products (HTPs) have expanded globally. IQOS, a global HTP leader, was launched in Israel in 2016 and the US in 2019. To inform tobacco control efforts, it is critical to understand who is likely to use HTPs in different countries with distinct regulatory and marketing contexts. Thus, we conducted a cross-sectional survey among adult (ages 18-45) online panelists in the US (n = 1128) and Israel (n = 1094), oversampling tobacco users, in the fall of 2021, and used multivariable regression to identify correlates of (1) ever using IQOS; (2) past-month vs. former among ever users; and (3) interest in trying IQOS among never users. Among US adults, correlates of ever use included being Asian (aOR = 3.30) or Hispanic (aOR = 2.83) vs. White, and past-month use of cigarettes (aOR = 3.32), e-cigarettes (aOR = 2.67), and other tobacco (aOR = 3.34); in Israel, correlates included being younger (aOR = 0.97), male (aOR = 1.64), and cigarette (aOR = 4.01), e-cigarette (aOR = 1.92) and other tobacco use (aOR = 1.63). Among never users, correlates of greater interest included cigarette and e-cigarette use in the US (β = 0.57, β = 0.90) and Israel (β = 0.88, β = 0.92). IQOS use prevalence was low (US: 3.0%; Israel: 16.2%) but represented in vulnerable subpopulations (younger adults, racial/ethnic minorities).
Collapse
Affiliation(s)
- Hagai Levine
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah, Jerusalem 9112002, Israel
| | - Zongshuan Duan
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Yael Bar-Zeev
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah, Jerusalem 9112002, Israel
| | - Lorien C. Abroms
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Amal Khayat
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah, Jerusalem 9112002, Israel
| | - Sararat Tosakoon
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Katelyn F. Romm
- TSET Health Promotion Research Center, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Yan Wang
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Carla J. Berg
- Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| |
Collapse
|
7
|
Xu Y, Gu Z, Zhang Y, He M, Gerber BS, Sadasivam RS, Liu F, Wang Z. Global trends in smoking cessation research from 2002 to 2021: A bibliometric and visual analysis. Prev Med Rep 2022; 30:101991. [PMID: 36193091 PMCID: PMC9525896 DOI: 10.1016/j.pmedr.2022.101991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 11/17/2022] Open
Abstract
Our study is the first bibliometric and visual analysis on smoking cessation research of the past two decades. Our study identifies productive countries/regions, institutions, authors, journals, and reveals a global network of collaborations of smoking cessation research. The Co-occurrence Analysis of Keywords shed lights on the research frontier, trends and hot topics on smoking cessation research.
This study aimed to analyze the scientific outputs of smoking cessation research and explore its hotspots and frontiers from 2002 to 2021, using bibliometric methods. We use the core collection of Web of Science as a data source, and apply bibliometric methods to visually analyze articles published in smoking cessation research from 2002 to 2021, including publication year, countries/regions, journals, authors, institutions, and keywords. The VOSviewer (1.6.16) tool was used for the analysis. A total of 8797 articles related to smoking cessation research were identified. The USA was the leading contributor with 4671 publications. NICOTINE&TOBACCO RESEARCH contributed the most publications (528), with the most citations (13746) and the highest H-index (59). The most contributing institutions were the University College London and University of California San Francisco. Robert West was most productive author. We found active collaborations among both productive authors and productive institutions. There were five hot topics in smoking cessation research: (1) Public health harm from tobacco; (2) The role of e-health in smoking cessation; (3) Role of primary health care in eliminating tobacco dependence; (4) Nicotine replacement therapy and pharmacotherapy; (5) The biological and clinical understanding of addiction. Our current study showed a growing trend in smoking cessation based on the number of published articles over the last 20 years. There was active cooperation between institutions, and authors. Electronic cigarettes, mHealth, eHealth, public health and mental health are foci of new and emerging research.
Collapse
Affiliation(s)
- Yingxin Xu
- Department of Information Center, The First Hospital of China Medical University, Shenyang, China.,College of Health Management, China Medical University, Shenyang, China
| | - Zhengmin Gu
- Department of Information Center, The First Hospital of China Medical University, Shenyang, China
| | - Ye Zhang
- Department of Information Center, The First Hospital of China Medical University, Shenyang, China.,College of Health Management, China Medical University, Shenyang, China
| | - Miao He
- Department of Information Center, The First Hospital of China Medical University, Shenyang, China
| | - Ben S Gerber
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Rajani S Sadasivam
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Feifan Liu
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Zhongqing Wang
- Department of Information Center, The First Hospital of China Medical University, Shenyang, China
| |
Collapse
|
8
|
Shankar A, Parascandola M, Sakthivel P, Kaur J, Saini D, Jayaraj NP. Advancing Tobacco Cessation in LMICs. Curr Oncol 2022; 29:9117-9124. [PMID: 36547127 PMCID: PMC9777415 DOI: 10.3390/curroncol29120713] [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: 09/29/2022] [Revised: 11/08/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Tobacco kills more than 8 million people worldwide every year. Over 80% of the world's 1.3 billion tobacco users live in low- and middle-income countries (LMICs), where the future burden is projected to grow. At the same time, progress in tobacco control has not advanced as far as in many LMICs. In particular, the implementation of tobacco-cessation programs and interventions remains limited. The bulk of the evidence for tobacco-cessation interventions comes from high-income countries and may not reflect the context in LMICs, particularly as resources and training for tobacco cessation are limited. This paper summarizes the current evidence for tobacco-cessation interventions in LMICs and highlights some key challenges and research gaps. Overall, there is a need to build capacity for locally relevant research and implementation science to support tailored cessation interventions and strategies for LMICs.
Collapse
Affiliation(s)
- Abhishek Shankar
- Department of Radiation Oncology, All India Institute of Medical Sciences, Patna 801507, India
- Correspondence:
| | - Mark Parascandola
- Research and Training Branch, Center for Global Health, National Cancer Institute, Bethesda, MD 20892, USA
| | - Pirabu Sakthivel
- Department of ENT & Head-Neck Surgery, KMCH Institute of Health Sciences and Research, Coimbatore 641014, India
| | - Jagdish Kaur
- Department of Healthier Populations and Non-Communicable Diseases (NCDs), WHO Regional Office for South-East Asia, New Delhi 110011, India
| | - Deepak Saini
- Materia Medica Department, Lal Bahadur Shastri Homoeopathic Medical College and Hospital, Prayagraj 211013, India
| | - Naveen Prabhu Jayaraj
- Department of Community Medicine, Karpagam Faculty of Medical Sciences and Research, Coimbatore 641032, India
| |
Collapse
|
9
|
Zhang B, Zhang Y, Dang W, Xing B, Yu C, Guo P, Pi J, Deng X, Qi D, Liu Z. The anti-tumor and renoprotection study of E-[c(RGDfK)2]/folic acid co-modified nanostructured lipid carrier loaded with doxorubicin hydrochloride/salvianolic acid A. J Nanobiotechnology 2022; 20:425. [PMID: 36153589 PMCID: PMC9509648 DOI: 10.1186/s12951-022-01628-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Poor in vivo targeting of tumors by chemotherapeutic drugs reduces their anti-cancer efficacy in the clinic. The discovery of over-expressed components on the tumor cell surface and their specific ligands provide a basis for targeting tumor cells. However, the differences in the expression levels of these receptors on the tumor cell surface limit the clinical application of anti-tumor preparations modified by a single ligand. Meanwhile, toxicity of chemotherapeutic drugs leads to poor tolerance to anti-tumor therapy. The discovery of natural active products antagonizing these toxic side effects offers an avenue for relieving cancer patients’ pain during the treatment process. Since the advent of nanotechnology, interventions, such as loading appropriate drug combinations into nano-sized carriers and multiple tumor-targeting functional modifications on the carrier surface to enhance the anti-tumor effect and reduce toxic and side effects, have been widely used for treating tumors.
Results
Nanocarriers containing doxorubicin hydrochloride (DOX) and salvianolic acid A (Sal A) are spherical with a diameter of about 18 nm; the encapsulation efficiency of both DOX and salvianolic acid A is greater than 80%. E-[c(RGDfK)2]/folic acid (FA) co-modification enabled nanostructured lipid carriers (NLC) to efficiently target a variety of tumor cells, including 4T1, MDA-MB-231, MCF-7, and A549 cells in vitro. Compared with other preparations (Sal A solution, NLC-Sal A, DOX solution, DOX injection, Sal A/DOX solution, NLC-DOX, NLC-Sal A/DOX, and E-[c(RGDfK)2]/FA-NLC-Sal A/DOX) in this experiment, the prepared E-[c(RGDfK)2]/FA-NLC-Sal A/DOX had the best anti-tumor effect. Compared with the normal saline group, it had the highest tumor volume inhibition rate (90.72%), the highest tumor weight inhibition rate (83.94%), led to the highest proportion of apoptosis among the tumor cells (61.30%) and the lowest fluorescence intensity of proliferation among the tumor cells (0.0083 ± 0.0011). Moreover, E-[c(RGDfK)2]/FA-NLC-Sal A/DOX had a low level of nephrotoxicity, with a low creatinine (Cre) concentration of 52.58 μmoL/L in the blood of mice, and no abnormalities were seen on pathological examination of the isolated kidneys at the end of the study. Sal A can antagonize the nephrotoxic effect of DOX. Free Sal A reduced the Cre concentration of the free DOX group by 61.64%. In NLC groups, Sal A reduced the Cre concentration of the DOX group by 42.47%. The E-[c(RGDfK)2]/FA modification reduced the side effects of the drug on the kidney, and the Cre concentration was reduced by 46.35% compared with the NLC-Sal A/DOX group. These interventions can potentially improve the tolerance of cancer patients to chemotherapy.
Conclusion
The E-[c(RGDfK)2]/FA co-modified DOX/Sal A multifunctional nano-drug delivery system has a good therapeutic effect on tumors and low nephrotoxicity and is a promising anti-cancer strategy.
Graphical Abstract
Collapse
|
10
|
Jiang X, Jackson LJ, Syed MA, Avşar TS, Abdali Z. Economic evaluations of tobacco control interventions in low- and middle-income countries: a systematic review. Addiction 2022; 117:2374-2392. [PMID: 35257422 DOI: 10.1111/add.15821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 12/24/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Tobacco consumption and its associated adverse outcomes remain major public health issues, particularly in low- and middle-income countries. This systematic review aimed to identify and critically assess full economic evaluations for tobacco control interventions in low- and middle-income countries. METHODS Electronic databases, including EMBASE, MEDLINE and PsycINFO and the grey literature, were searched using terms such as 'tobacco', 'economic evaluation' and 'smoking' from 1994 to 2020. Study quality was assessed using the Consensus Health Economic Criteria and the Philips checklist. Studies were included which were full economic evaluations of tobacco control interventions in low- and middle-income settings. Reviews, commentaries, conference proceedings and abstracts were excluded. Study selection and quality assessment were conducted by two reviewers independently. A narrative synthesis was conducted to synthesize the findings of the studies. RESULTS This review identified 20 studies for inclusion. The studies evaluated a wide range of interventions, including tax increase, nicotine replacement therapy (nicotine patch/gum) and financial incentives. Overall, 12 interventions were reported to be cost-effective, especially tax increases for tobacco consumption and cessation counselling. There were considerable limitations regarding data sources (e.g. using cost data from other countries or assumptions due to the lack of local data) and the model structure; sensitivity analyses were inadequately described in many studies; and there were issues around the transferability of results to other settings. Additionally, the affordability of the interventions was only discussed in two studies. CONCLUSIONS There are few high-quality studies of the cost-effectiveness of tobacco use control interventions in low- and middle-income countries. The methodological limitations of the existing literatures could affect the generalizability of the findings.
Collapse
Affiliation(s)
- Xiaobin Jiang
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Louise J Jackson
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Muslim Abbas Syed
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Tuba Saygın Avşar
- Department of Applied Health Research, University College London, London, UK
| | - Zainab Abdali
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| |
Collapse
|
11
|
Lencucha R, Neupane S. The use, misuse and overuse of the 'low-income and middle-income countries' category. BMJ Glob Health 2022; 7:bmjgh-2022-009067. [PMID: 35672116 PMCID: PMC9185671 DOI: 10.1136/bmjgh-2022-009067] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/23/2022] [Indexed: 12/16/2022] Open
Affiliation(s)
- Raphael Lencucha
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Sujaya Neupane
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| |
Collapse
|
12
|
Weinberger AH, Steinberg ML, Mills SD, Dermody SS, Heffner JL, Kong AY, Pang RD, Rosen RL. Assessing Sex, Gender Identity, Sexual Orientation, Race, Ethnicity, Socioeconomic Status, and Mental Health Concerns in Tobacco Use Disorder Treatment Research: Measurement Challenges and Recommendations From a Society for Research on Nicotine and Tobacco Pre-conference Workshop. Nicotine Tob Res 2022; 24:643-653. [PMID: 34622932 PMCID: PMC8962699 DOI: 10.1093/ntr/ntab201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/04/2021] [Indexed: 11/15/2022]
Abstract
This paper reports on topics discussed at a Society for Research on Nicotine and Tobacco pre-conference workshop at the 2019 annual Society for Research on Nicotine and Tobacco meeting. The goal of the pre-conference workshop was to help develop a shared understanding of the importance of several tobacco-related priority groups in tobacco use disorder (TUD) treatment research and to highlight challenges in measurement related to these groups. The workshop focused on persons with minoritized sex, gender identity, and sexual orientation identities; persons with minoritized racial and ethnic backgrounds; persons with lower socioeconomic status (SES); and persons with mental health concerns. In addition to experiencing commercial tobacco-related health disparities, these groups are also underrepresented in tobacco research, including TUD treatment studies. Importantly, there is wide variation in how and whether researchers are identifying variation within these priority groups. Best practices for measuring and reporting sex, gender identity, sexual orientation, race, ethnicity, SES, and mental health concerns in TUD treatment research are needed. This paper provides information about measurement challenges when including these groups in TUD treatment research and specific recommendations about how to measure these groups and assess potential disparities in outcomes. The goal of this paper is to encourage TUD treatment researchers to use measurement best practices in these priority groups in an effort to conduct meaningful and equity-promoting research. Increasing the inclusion and visibility of these groups in TUD treatment research will help to move the field forward in decreasing tobacco-related health disparities. Implications: Tobacco-related disparities exist for a number of priority groups including, among others, women, individuals with minoritized sexual and gender identities, individuals with minoritized racial and ethnic backgrounds, individuals with lower SES, and individuals with mental health concerns. Research on TUD treatments for many of these subgroups is lacking. Accurate assessment and consideration of these subgroups will provide needed information about efficacious and effective TUD treatments, about potential mediators and moderators, and for accurately describing study samples, all critical elements for reducing tobacco-related disparities, and improving diversity, equity, and inclusion in TUD treatment research.
Collapse
Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marc L Steinberg
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Sarah D Mills
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah S Dermody
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Jaimee L Heffner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA,USA
| | - Amanda Y Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Raina D Pang
- Department of Preventive Medicine, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Rachel L Rosen
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| |
Collapse
|
13
|
Nazar GP, Sharma N, Chugh A, Abdullah SM, Lina S, Mdege ND, John RM, Huque R, Bauld L, Arora M. Impact of tobacco price and taxation on affordability and consumption of tobacco products in the South-East Asia Region: A systematic review. Tob Induc Dis 2021; 19:97. [PMID: 34992513 PMCID: PMC8669701 DOI: 10.18332/tid/143179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 09/29/2021] [Accepted: 10/19/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The objective of the review was to study the impact of tobacco taxes or prices on affordability and/or consumption of tobacco products in WHO South-East Asia Region (SEAR) countries, overall and by socioeconomic status; and change in consumption of one tobacco product for a given change in price/tax on another tobacco product. METHODS The searches were made in five databases (Medline, Embase, Cinahl, EconLit, Tobacconomics) using keywords such as 'tobacco', 'tax', 'price', 'impact' with their synonyms. Additionally, the first 100 articles through google search and e-reports from targeted sources were also reviewed. Studies illustrating the impact of prices/taxes on consumption/affordability of tobacco products in SEAR, in English and with no limitation on year, were included in the review. After two steps of screening, data from 28 studies were extracted using a structured and pre-tested data extraction form. RESULTS Of the 28 studies, 12 studies reported an inverse association between price and consumption/affordability, while 11 studies reported no or positive association between price and consumption/affordability of tobacco products. Five studies had unclear interpretations. The majority of studies estimated that the less affluent group were more price responsive compared to the more affluent group. Some studies indicated increased consumption of one product in response to price rise of another product, although, the findings were inconsistent. CONCLUSIONS The findings of our review support the use of tobacco tax and price measures as effective tools to address the tobacco epidemic. Our findings, however, also emphasize the importance of increasing tobacco product taxes and prices sufficiently to outweigh the effects of income growth, in order for the measures to be effective in reducing the affordability and consumption of tobacco products.
Collapse
Affiliation(s)
- Gaurang P. Nazar
- Health Related Information Dissemination Amongst Youth, New Delhi, India
- Health Promotion Division, Public Health Foundation of India, Gurugram, India
| | - Nitika Sharma
- Health Related Information Dissemination Amongst Youth, New Delhi, India
| | - Aastha Chugh
- Health Related Information Dissemination Amongst Youth, New Delhi, India
| | - S. M. Abdullah
- Department of Economics, University of Dhaka, Dhaka, Bangladesh
- ARK Foundation, Dhaka, Bangladesh
| | | | - Noreen D. Mdege
- Department of Health Sciences, University of York, York, United Kingdom
| | - Rijo M. John
- Rajagiri College of Social Sciences, Kochi, India
| | - Rumana Huque
- Department of Economics, University of Dhaka, Dhaka, Bangladesh
- ARK Foundation, Dhaka, Bangladesh
| | - Linda Bauld
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- SPECTRUM Consortium, University of Edinburgh, Edinburgh, United Kingdom
| | - Monika Arora
- Health Related Information Dissemination Amongst Youth, New Delhi, India
- Health Promotion Division, Public Health Foundation of India, Gurugram, India
| |
Collapse
|
14
|
Cartujano-Barrera F, Rodríguez-Bolaños R, Arana-Chicas E, Allaham F, Sandoval L, Rubado M, Gallegos-Carrillo K, Colugnati FAB, Galil AG, Mejia RM, Cupertino AP. Smoking Cessation Mobile Interventions in Latin America: A Systematic Review. HISPANIC HEALTH CARE INTERNATIONAL 2021; 20:122-132. [PMID: 34263686 DOI: 10.1177/15404153211020410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To systematically review published articles reporting the use of smoking cessation mobile health (mHealth) interventions in Latin America. METHODS Five different databases were searched from database inception to 2020. Criteria: (1) the research was a smoking cessation randomized controlled trial (RCT), quasi-experimental research, or single-arm study; (2) the intervention used at least one type of mHealth intervention; (3) the research was conducted in Latin American; and (4) the research reported the cessation rate. RESULTS Of the seven selected studies, four were conducted in Brazil, two in Mexico, and one in Peru. Only one study was an adequately powered RCT. Interventions relied on text messages (n = 3), web-based tools (n = 2), and telephone calls (n = 3). Some studies (n = 4) provided pharmacotherapy support. Smoking cessation outcomes included self-reported (n = 5) and biochemically verified (n = 2) abstinence. Follow-ups were conducted at Month 6 (n = 2), Week 12 (n = 4), and Day 30 (n = 1). Cessation rates varied from 9.4% at Week 12 to 55.5% at Day 30. CONCLUSION Despite the promising cessation rates of mHealth interventions in Brazil, Mexico, and Peru, there is a need to rigorously evaluate these interventions in different Latin American countries with RCTs that are long-term, adequately powered, and use biochemical verification of cessation.
Collapse
Affiliation(s)
| | - Rosibel Rodríguez-Bolaños
- Departamento de Investigación sobre Tabaco, 37764Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Fatema Allaham
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Lizbeth Sandoval
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle Rubado
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| | - Katia Gallegos-Carrillo
- Unidad de Investigación Epidemiológica y en Servicios de Salud Delegación Morelos, 37767Instituto Mexicano del Seguro Social. Cuernavaca, Morelos, Mexico
| | | | - Arise G Galil
- Faculdade de Medicina, Universidade Federal de Juiz de Fora. Juiz de Fora, Minas Gerais, Brazil
| | - Raul M Mejia
- Programa de Medicina Interna General, 28196Universidad de Buenos Aires. Buenos Aires, Argentina
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, 6923University of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
15
|
Rossouw L. Socioeconomic status and tobacco consumption: Analyzing inequalities in China, Ghana, India, Mexico, the Russian Federation and South Africa. Tob Prev Cessat 2021; 7:47. [PMID: 34222728 PMCID: PMC8231441 DOI: 10.18332/tpc/137085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Globally, there has been a rapid rise in non-communicable diseases driven by changing lifestyle choices and health behaviors. Different lifestyle choices threaten to exacerbate existing health inequalities, yet evidence monitoring the extent of this impact in emerging economies is lacking. The article sets out to measure the level of wealth-related inequality and its drivers in one of these lifestyle choices, tobacco consumption, among populations aged ≥50 years in six Low- and Middle-Income Countries. METHODS The study provides empirical evidence of the inequality in tobacco consumption across wealth groups in China, Ghana, India, Mexico, the Russian Federation and South Africa using the Erreygers’ corrected concentration indices. These inequalities are then decomposed to gain a deeper understanding of the factors and broader social forces driving inequality. The WHO SAGE data set, collected between 2008 and 2010, is used for the analysis. RESULTS Current tobacco consumption is concentrated among the poor in China, Ghana, India, and South Africa, and among the wealthy in the Russian Federation and Mexico. The inequalities widen when we focus solely on the male population. Although the results differ by country, the major drivers of inequality include wealth, locality, and gender. CONCLUSIONS The focus on tobacco consumption in this age group is key to curbing rising healthcare costs and ensuring longevity. Policies aimed at reducing wealth-related inequalities should especially target high tobacco consumption rates among males, while simultaneously pre-empting and curbing rising rates among women.
Collapse
Affiliation(s)
- Laura Rossouw
- School of Economics and Finance, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
16
|
Mohanapriya S, Maheswaran T, Ganapathy N, Yoithapprabhunath TR, Dineshshankar J, Ilayaraja V, Vinodhini RS, Devi R. Evaluation of DNA damage in tobacco associated human buccal cells using comet assay. Med Pharm Rep 2021; 94:214-219. [PMID: 34013193 PMCID: PMC8118208 DOI: 10.15386/mpr-1692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/10/2020] [Accepted: 09/30/2020] [Indexed: 11/28/2022] Open
Abstract
Aim and objective To assess the DNA damage in tobacco associated human buccal cells using comet assay. Methods The study included 75 study subjects, which were divided into 3 groups on the basis of tobacco usage. Group I - 25 individuals with no history of tobacco usage, Group II - 25 individuals with tobacco usage but without oral lesions and Group III - 25 individuals with tobacco associated oral lesions. Cytological smears collected from these individuals were used to assess the tobacco associated DNA damage by measuring the tail length in the comet assay method. Results The average tail length was found to be 1.46 μm in the normal mucosa, 2.86 μm in tobacco users without oral lesions, 3.86 μm in the lesional sites of tobacco users and 3.67 μm in the non-lesional sites of these individuals. Factors like age, gender, duration and different forms of tobacco habit had their own impact on the oral mucosa. Conclusion Comet assay helps assess the subclinical genetic changes of oral mucosa even before the clinical manifestations of the precancerous lesions appeared due to tobacco usage. Thus, comet assay may bloom out as a novel adjuvant tool for the prevention of oral cancer in the near future.
Collapse
Affiliation(s)
- Shanmugam Mohanapriya
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Tamilnadu, India
| | - Thangadurai Maheswaran
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Tamilnadu, India
| | - Nalliapan Ganapathy
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Tamilnadu, India
| | | | - Janardhanam Dineshshankar
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Tamilnadu, India
| | - Vadivel Ilayaraja
- Department of Oral and Maxillofacial Pathology, Vivekanandha Dental College for Women, Tamilnadu, India
| | | | - Renuga Devi
- Vivekanandha Dental College for Women, Tamilnadu, India
| |
Collapse
|
17
|
Kumar N, Janmohamed K, Jiang J, Ainooson J, Billings A, Chen GQ, Chumo F, Cueto L, Niaura R, Zhang A. Tobacco cessation in low- to middle-income countries: A scoping review of randomized controlled trials. Addict Behav 2021; 112:106612. [PMID: 33002679 DOI: 10.1016/j.addbeh.2020.106612] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/24/2020] [Accepted: 08/15/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The growing prevalence of tobacco use in low "to middle" income countries (LMICs) and the hurdles of conducting tobacco cessation in that context necessitates a focus on the scope of randomized controlled trials (RCTs) in LMICs to guide tobacco cessation in this environment. We conducted a scoping review to identify LMIC tobacco cessation RCTs. METHODS Consistent with PRISMA-ScR guidelines and without language restrictions, we systematically searched peer-reviewed databases (MEDLINE, Embase, PsycINFO, articles published since inception, latest searches in March 2020) and gray literature (clinical trials registries, searches between September and December 2019). We searched for data on RCT type, outcome significance and intervention description. Inclusion: research conducted in LMICs; tobacco cessation; RCT. Exclusion: research conducted in high income countries; non-RCT; studies involving only those aged <18. Data was extracted from published reports. We generated narrative summaries of each LMIC's tobacco cessation RCT research environment. RESULTS Of 8404 articles screened, we identified 92 studies. Tobacco cessation RCTs were recorded in 16 of 138 countries/territories in LMICs. Evidence was weak in quality and severely limited. Most RCTs were psychosocial, with limited behavioral and pharmacological variants. CONCLUSIONS Tobacco control within LMICs is essential to reduce the tobacco mortality burden. Researchers should be cognizant that tobacco cessation in LMICs is still not an environment where best practice has been established. We suggest that developing solutions specific for LMICs is key to effective tobacco control in LMICs.
Collapse
|
18
|
Meng N, Dong Y, Huo T, Song M, Jiang X, Xiao Y, Lv P. Past Exposure to Cigarette Smoke Aggravates Cognitive Impairment in a Rat Model of Vascular Dementia via Neuroinflammation. Cell Mol Neurobiol 2020; 42:1021-1034. [PMID: 33156450 DOI: 10.1007/s10571-020-00992-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/28/2020] [Indexed: 12/11/2022]
Abstract
Smoking is a risk factor for dementia. Cognitive function can be partially restored after quitting smoking, but still lower than never smoked group. The underlying mechanisms still remain unclear. The effects of smoking cessation combined with cerebral chronic hypoperfusion (CCH) on cognitive function have never been described. Here, we established a cigarette smoking cessation model, a CCH model, and a cigarette smoking cessation plus CCH model. We investigated cognitive function in these models and the mechanisms of the neuroinflammation, nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3(NLRP3)/cysteine aspartate-specific proteinase (caspase-1)/interleukin- 1β (IL-1β) pathway, and eucaryotic initiation factor 2α (eIF2α) /autophagy pathway. We used morris water maze (MWM) and novel object recognition (NOR) test to evaluate cognitive function in rats. Nissl staining was performed to observe cell morphology in the hippocampal CA1 area. A neuroinflammatory marker (glial fibrillary acidic protein, GFAP) was assessed by Western blot analysis and immunohistochemistry staining. IL-1β levels were detected by ELISA. The protein levels of NLRP3/caspase-1/ IL-1β and eIF2α/autophagy pathway were evaluated by Western blot analysis. LC3 was assessed by immunofluorescence staining. CCH can affect cognitive function by influencing neuroinflammation, NLRP3/caspase-1/IL-1β pathway, and eIF2α/autophagy pathway. Past exposure to cigarette smoke can also affect cognitive function by influencing neuroinflammation and NLRP3/caspase-1/IL-1β pathway, which may be induced by smoking and may not be alleviated after smoking cessation. Past exposure to cigarette smoke does not influence autophagy, which may be increased by smoking and then decrease to normal levels after smoking cessation. Past exposure to smoking can further aggravate cognitive impairment and neuroinflammation in VaD animals: cognitive impairment induced by CCH via neuroinflammation, NLRP3/caspase-1/IL-1β, and eIF2α/autophagy pathway and cognitive impairment induced by past exposure to cigarette smoke via neuroinflammation and NLRP3/caspase-1/IL-1β pathway. The combined group had the worst cognitive impairment because of harmful reasons.
Collapse
Affiliation(s)
- Nan Meng
- Department of Neurology, Hebei Medical University, No. 361 Zhongshan East Road, Changan District, Shijiazhuang, 050017, Hebei Province, People's Republic of China.,Department of Neurology, Hebei General Hospital, No. 348 Heping West Road, Xinhua District, Shijiazhuang, 050051, Hebei Province, People's Republic of China
| | - Yanhong Dong
- Department of Neurology, Hebei General Hospital, No. 348 Heping West Road, Xinhua District, Shijiazhuang, 050051, Hebei Province, People's Republic of China
| | - Tiantian Huo
- Department of Neurology, Hebei General Hospital, No. 348 Heping West Road, Xinhua District, Shijiazhuang, 050051, Hebei Province, People's Republic of China
| | - Meiyi Song
- Department of Neurology, Hebei Medical University, No. 361 Zhongshan East Road, Changan District, Shijiazhuang, 050017, Hebei Province, People's Republic of China
| | - Xin Jiang
- Department of Neurology, Hebei General Hospital, No. 348 Heping West Road, Xinhua District, Shijiazhuang, 050051, Hebei Province, People's Republic of China
| | - Yining Xiao
- Department of Neurology, Hebei General Hospital, No. 348 Heping West Road, Xinhua District, Shijiazhuang, 050051, Hebei Province, People's Republic of China
| | - Peiyuan Lv
- Department of Neurology, Hebei Medical University, No. 361 Zhongshan East Road, Changan District, Shijiazhuang, 050017, Hebei Province, People's Republic of China. .,Department of Neurology, Hebei General Hospital, No. 348 Heping West Road, Xinhua District, Shijiazhuang, 050051, Hebei Province, People's Republic of China.
| |
Collapse
|
19
|
Kumar N, Ainooson J, Billings A, Chen G, Cueto L, Janmohamed K, Jiang J, Niaura R, Zhang A. The scope of tobacco cessation randomized controlled trials in low- to middle-income countries: protocol for a scoping review. Syst Rev 2020; 9:86. [PMID: 32317003 PMCID: PMC7171801 DOI: 10.1186/s13643-020-01361-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/14/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Tobacco consumption is the leading cause of preventable death globally. The global mortality burden of tobacco use lies predominantly in low- to middle-income countries (LMICs). There is much evidence on the effectiveness of tobacco cessation RCTs in high-income nations. However, the evidence base in LMICs is far more limited. To effectively design randomized controlled trials (RCTs) that mitigate tobacco-related harms in LMICs, further understanding of RCTs in this environment will be helpful. We will provide quality evidence regarding the scope of tobacco cessation RCTs in LMICs. METHODS A scoping review of tobacco cessation RCTs will be conducted. MEDLINE, Embase, PsycINFO, Global Health, Web of Science and Sociological Abstracts will be searched to capture current literature. We will review RCTs that have already been done on tobacco cessation in the LMICs. The key outcome will be tobacco cessation in adults. Examples of the key outcome include smoking abstinence and reduction of tobacco use. Study selection will conform to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines and study quality assessed with a modified version of the Cochrane Collaboration's instrument. DISCUSSION As researchers attempt to minimize the harms from tobacco in LMICs, they need to be aware of scientific evidence to develop RCTs to achieve their aim. The review will complement the evidence base on tobacco cessation in LMICs.
Collapse
Affiliation(s)
- Navin Kumar
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA.
| | - Jessica Ainooson
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Ameera Billings
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Grace Chen
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Lauren Cueto
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Kamila Janmohamed
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Jeannette Jiang
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Raymond Niaura
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, 715 Broadway, New York, NY, USA.,Department of Epidemiology, College of Global Public Health, New York University, 715 Broadway, New York, NY, USA
| | - Amy Zhang
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| |
Collapse
|
20
|
Berg C, Sturua L. THE CRITICAL NEED FOR ENHANCING THE RESEARCH CAPACITY REGARDING THE INTERSECTION OF AIR POLLUTION AND NON-COMMUNICABLE DISEASES IN GEORGIA. GEORGIAN MEDICAL NEWS 2020:178-182. [PMID: 32535585 PMCID: PMC7894988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Globally, 7 million deaths are attributable to the joint effects of indoor and ambient air pollution annually, with ~94% occurring in low- and middle-income countries (LMICs). While 51% of cities in high-income countries with ≥100,000 residents meet WHO air quality guidelines, only 3% of such cities in LMICs meet them. In the country of Georgia, adverse environmental exposures cause 21% of disease burden and 25% of deaths,including30% of disease burden and 14% of deaths among children. According to 2016 WHO data, Georgia's mortality index attributed to ambient and indoor air pollution was 204.9, the 3rd highest in the world. Indoor air pollution is largely a result of indoor cooking/heating using solid fuel and second hand smoke (SHS). Worldwide, 40% of children, 35% of female nonsmokers, and 33% of male nonsmokers are exposed to SHS. Annually, SHS exposure causes ~600,000 deaths (1% of mortality), with half of those deaths in women and over a quarter in children. LMICs are disproportionately impacted by SHS and related morbidity and mortality. In Georgia, the smoking prevalence is 58% in men (6th highest in the world) and 6% in women. Moreover, prior research found that 30% of Georgian adults were exposed the SHS in the past week in public places and 54% at home; 42% reported daily exposure. Georgia's 2017-2021 National Environment and Health Action Planhighlights that addressing air pollution is among the most prominent public health priorities. However, there is limited in-country capacity to conduct research regarding the impact of such environmental hazards on health. Thus, efforts must enhance such research capacity in order to reduce air pollution and its effects on health.
Collapse
Affiliation(s)
- C Berg
- 1Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC; 2George Washington Cancer Center, George Washington University, Washington, DC
| | - L Sturua
- 3National Center for Disease Control and Public Health, Tbilisi; 4Petre Shotadze Tbilisi Medical Academy, Georgia
| |
Collapse
|
21
|
Berg CJ, Bar-Zeev Y, Levine H. Informing iQOS Regulations in the United States: A Synthesis of What We Know. SAGE OPEN 2020; 10:10.1177/2158244019898823. [PMID: 32719733 PMCID: PMC7384757 DOI: 10.1177/2158244019898823] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The tobacco industry offers various products, including heated tobacco products (HTPs). Philip Morris International's (PMI) "iQOS" has the greatest HTP market share, as well as research on its use and impact. iQOS was released in 2014 and is now in more than 40 countries. The U.S. Food and Drug Administration announced permission for PMI to sell iQOS in the United States in April 2019, and iQOS was launched in October 2019. Decisions pending its modified risk tobacco product (MRTP) application will occur subsequently. The U.S. regulatory efforts regarding iQOS could be informed by examining (a) Philip Morris USA other product marketing efforts and (b) the iQOS market in countries where it is available. This article briefly addresses these two points with extant literature and suggests that future research should address important gaps in what is currently known, including strategic international collaborations and research, which historically has been critical for advancing tobacco control globally.
Collapse
Affiliation(s)
- Carla J. Berg
- The George Washington University, Washington, DC, USA
| | | | - Hagai Levine
- The Hebrew University of Jerusalem, Israel
- Hadassah Ein Kerem Medical Center, Jerusalem, Israel
| |
Collapse
|
22
|
Key milestones during 40 years of behavioral medicine at the National Institutes of Health. J Behav Med 2019; 42:34-51. [DOI: 10.1007/s10865-018-9981-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 10/15/2018] [Indexed: 10/27/2022]
|