Gender differences in cigarette consumption in Turkey: evidence from the Global Adult Tobacco Survey

Demographic, Clinical, and Angiographic Characteristics of Atrial Fibrillation Patients Suffering From de novo Acute Myocardial Infarction: A Subgroup Analysis of the MINOCA-TR Study Population

Background

Atrial fibrillation (AF) prevalence in patients with acute myocardial infarction (MI) ranges from 3% to 25%. However demographic, clinical, and angiographic characteristics of AF patients who admitted with de novo MI are unclear. The aim of this study was to investigate the prevalence of patients presenting with de novo MI with AF.

Methods

The study was performed as a sub-study of the MINOCA-TR (Myocardial Infarction with Non-obstructive Coronary Arteries in Turkish Population) Registry, a multicenter, cross-sectional, observational, all-comer registry. MI patients without a known history of stable coronary artery disease and/or prior coronary revascularization were enrolled in the study. Patients were divided into AF and Non-AF groups according to presenting cardiac rhythm.

Results

A total of 1793 patients were screened and 1626 were included in the study. The mean age was 61.5 (12.5) years. 70.7% of patients were men. The prevalence of AF was 3.1% (51 patients). AF patients were older [73.4 (9.4) vs. 61.0 (12.4) years, p<0.001] than non-AF patients. The proportion of women to men in the AF group was also higher than in the non-AF group (43.1% vs. 28.7%, p=0.027). Only 1 out of every 5 AF patients (10 patients, 19.6%) was using oral anticoagulants (OAC).

Conclusions

AF prevalence in patients presenting with de novo MI was lower than previous studies that issued on AF prevalence in MI cohorts. The majority of AF patients did not have any knowledge of their arrhythmia and were not undergoing OAC therapy at admission, emphasizing the vital role of successful diagnostic strategies, patient education, and implementations for guideline adaptation.

Tobacco smoking initiation among students in Samoa and health concerns

Background

High prevalence of tobacco smoking among young students remains a serious health concern given the positive association between smoking and NCDs. More recently, some studies also noted young smokers were more likely to get infected with COVID-19 compared to non-smokers. This study aims to assess the factors that influence smoking uptake among young students in Samoa. Findings from this study will provide valuable insight to policymakers and health authorities on policies and strategies to combat smoking among youth in Samoa and the Pacific Island Countries (PICs).

Methods

The 2017 Global Youth Tobacco Survey data of Samoa, available from the World Health Organization is used in the analysis. We use the multinominal logistic model to investigate the effects of socio-economic and demographics factors on young students’ uptake of smoking in Samoa.

Result

The main findings of this study indicate that sex, age, friendship, parental smoking, family discussion, outside influence, pocket money, and mother’s education are important determinants of tobacco smoking initiation among youths in Samoa.

Conclusion

Our findings contribute towards the evidence of the imperative health impact of friends, parents, and public smoking on students in Samoa. This warrants strategies that are effective in discouraging parents from smoking and implement measures that prevent smoking in public places. Moreover, educational efforts, particularly those that encourage more discussion at home settings on the harmful effects of smoking are strongly recommended. Parents are strongly encouraged to regularly monitor children’s spending behaviour.

Pattern of cigarette smoking: intensity, cessation, and age of beginning: evidence from a cohort study in West of Iran

BACKGROUND

Smoking is a social epidemic and one of the main risk factors for premature deaths and disabilities worldwide. In the present study, we investigated the Pattern of Cigarette Smoking: intensity, cessation, and age of the beginning.

METHODS

Data collected from the recruitment phase of Ravansar (a Kurd region in western Iran) Non-Communicable Disease (RaNCD) cohort study was analyzed by using Chi-square test, univariate and multivariate logistic regressions, Poisson regression, and linear regression.

RESULTS

Totally 10,035 individuals (47.42% males) participated in the study. Mean age was lower for males (47.45 yr) than for females (48.36 yr). Prevalence of smoking was 20% (36.4% of males and 5.23% of females). Compared to female participants, males showed a 7-fold higher prevalence of smoking and started smoking about 4 years earlier. Being married, having a lower BMI, living in rural areas, and being exposed to secondhand smoke (SHS) were predictors of higher smoking prevalence rates. Furthermore, current exposure to SHS, higher smoking intensity, later smoking initiation, male gender, younger age, lower education, and lower BMI were related to lower likelihood of stopping smoking. Heavy smokers began to smoke about 4 years earlier than casual smokers did. Finally, being divorced/ widow/ widower/ single and childhood exposure to SHS were found to increase the likelihood of becoming a smoker.

CONCLUSIONS

Based on present research results, health programs specific to smoking cessation should take socio-demographic factors, smoking history, and current smoking behavior into account.

Determining correlates of the average number of cigarette smoking among college students using count regression models

College students, as a large part of young adults, are a vulnerable group to several risky behaviors including smoking and drug abuse. This study aimed to utilize and to compare count regression models to identify correlates of cigarette smoking among college students. This was a cross-sectional study conducted on students of Hamadan University of Medical Sciences. The Poisson, negative binomial, generalized Poisson, exponentiated-exponential geometric regression models and their zero-inflated counterparts were fitted and compared using the Vuong test (α = 0.05). A number of 1258 students participated in this study. The majority of students were female (60.8%) and their average age was 23 years. Most of the students were non-smokers (84.6%). Negative binomial regression was selected as the most appropriate model for analyzing the data (comparable fit and simpler interpretation). The significant correlates of the number of cigarettes smoked per day included gender (male: incident-rate-ratio (IRR = 9.21), birth order (Forth: IRR = 1.99), experiencing a break-up (IRR = 2.11), extramarital sex (heterosexual (IRR = 2.59), homosexual (IRR = 3.13) vs. none), and drug abuse (IRR = 5.99). Our findings revealed that several high-risk behaviors were associated with the intensity of smoking, suggesting that these behaviors should be considered in smoking cessation intervention programs for college students.

Relative deprivation and its association with health indicators: Lower inequality may not improve health

This study tested the hypothesis of relative deprivation (RD) to investigate how inequality is associated with health and health related behaviors in a developing country context. Data from two nationally representative surveys in 2010, 2012, and 2014 were used to estimate logit and ordered logit models stratified by sex. RD was calculated based on both income and education, unlike most studies in the earlier literature that relied only on income. All results of the study were found to be robust to alternative reference groups. First, consistent with the earlier literature, RD was found to be positively correlated with indicators of poor health. Secondly, and more interestingly, unlike the results in the earlier RD literature, women with more income or education (and lower RD) were found to be more likely to be current smokers and more likely to consume a higher number of cigarettes. The main policy implication is that reducing inequality can help improve self-rated health indicators, but it will not be sufficient to achieve health policy goals. Unless smoking patterns change, reducing inequalities in income or education among women will not necessarily lead to better health; because smoking is more common among better educated and richer women.

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We investigate how relative deprivation (RD) is associated with health and health related behaviors.

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We use data from two nationally representative surveys in 2010–2014 in Turkey.

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Higher RD is positively correlated with indicators of poor health.

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More interestingly, higher RD is negatively correlated with smoking among women.

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Reducing inequalities in income or education among women will not necessarily lead to better health.

Different Effects of Social Support on Adolescent Smoking and the Mediation by Smartphone Dependence

BACKGROUND AND AIMS

This study examines the relationship between social support (from parents and peers) and cigarette use, through the mediating effect of smartphone dependence, among adolescents.

STUDY DESIGN

Prospective cohort study.

METHODS

A survey, conducted among 472 adolescents (average age = 16.2 years) attending classes in 3 schools in Lille, France, provides the data. The theoretical model features social support (parental and peer) and cigarette use, with smartphone dependence as a mediator, such that the authors simultaneously examine direct (support → cigarette use) and indirect (eg, peer support → smartphone dependence → cigarette use) paths.

RESULTS

The results illustrate that both parental support and peer support discourage cigarette use, but the indirect effect through smartphone dependence is positive. That is, smartphone dependence mediates the relationship between peer support and cigarette use. Parental support and peer support shape adolescents' cigarette use and smartphone dependence differently, depending on the adolescents' gender.

CONCLUSIONS

Policy makers should acknowledge the positive effects of social support, the negative effect of smartphone dependence, and the importance of gender when developing anti-smoking policies and campaigns.

Distinctive role of opinion leaders in the social networks of school adolescents: an investigation of e-cigarette use

OBJECTIVES

This study examines a diverse set of social motives (e.g. peer support, peer pressure, social loneliness) for e-cigarette use, through the mediating effects of opinion leadership, among both male and female adolescents.

STUDY DESIGN

Prospective cohort study.

METHODS

The data were obtained from a survey conducted among 666 adolescents across 14 school classes, namely, students at three urban schools, public and private, in Lille, France. The proposed integrative model includes social motives, opinion leadership and e-cigarette use in a trilateral relationship; gender is proposed and tested as a potential moderator in a structural equation model.

RESULTS

More positive peer support is negatively associated with opinion leadership and e-cigarette use. Both loneliness and susceptibility to peer influence are positively related to opinion leadership and e-cigarette use. Moreover, social support from peers and opinion leadership shape e-cigarette use differently across genders.

CONCLUSIONS

Policy makers should account for the various (positive and negative) roles of peers and consider the gender of their audience when designing anti-e-cigarette policies.

A longitudinal study on determinants of the intention to start smoking among Non-smoking boys and girls of high and low socioeconomic status

BACKGROUND

This study identifies differences in socio-cognitive factors as they relate to the intention to smoke among boys and girls living in high socioeconomic status (HSES) and low socioeconomic status (LSES) neighborhoods.

METHODS

A total of 1,643 children (aged 10-12 years) completed a web-based questionnaire assessing their intention, attitude, social influences, and self-efficacy toward smoking at baseline and at one year follow-up. Logistic regression analyses were conducted to examine the relations between intention and predictor variables (i.e. attitude, social influence, and self-efficacy). Three-way interaction terms were added to the first analysis to examine potential interactions of gender, socioeconomic status and predictor variables. A 3-way interaction effect was present, and therefore subgroup analyses for HSES and LSES boys and girls were warranted.

RESULTS

The results indicated that positive attitudes toward smoking were related to the intention to smoke among HSES boys, whereas HSES girls had higher intentions to smoke if they perceived fewer disadvantages of smoking (OR: 0.42; 95 % CI: 0.22-0.82). The intention to smoke among LSES boys was predicted by perceived social norms (OR: 0.49; 95 % CI: 0.25-0.93); in LSES girls, the smoking behavior of people in their environment was most strongly related to their smoking intention (OR: 5.55; 95 % CI: 2.81-10.93).

CONCLUSIONS

To prevent youth smoking, HSES boys and girls may benefit from interventions that address attitudes. Boys from an LSES neighborhood may profit from smoking prevention interventions that target social norms, while LSES girls may benefit from strategies aimed at resisting the influence of smokers in their environment.

TRIAL REGISTRATION

The 'Fun without Smokes' study is approved by the Medical Ethics Committee of the Atrium-Orbis-Zuyd Hospital (NL32093.096.11/MEC 11-T-25) and registered in the Dutch Trial Register ( NTR3116 ).