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Hoffman CM, Versluis A, Chirila S, Kirenga BJ, Khan A, Saeed S, Sooronbaev T, Tsiligianni I, Arvind DK, Bauld LC, van den Brand FA, Chavannes NH, Pinnock H, Powell PD, van der Schans J, Siddiqi K, Williams S, van der Kleij MJJR. The FRESHAIR4Life study: Global implementation research on non-communicable disease prevention targeting adolescents' exposure to tobacco and air pollution in disadvantaged populations. NPJ Prim Care Respir Med 2024; 34:14. [PMID: 38834570 DOI: 10.1038/s41533-024-00367-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/03/2024] [Indexed: 06/06/2024] Open
Abstract
The FRESHAIR4Life study aims to reduce the non-communicable disease (NCD) burden by implementing preventive interventions targeting adolescents' exposure to tobacco use and air pollution (AP) worldwide. This paper presents the FRESHAIR4Life methodology and initial rapid review results. The rapid review, using various databases and PubMed, aimed to guide decision-making on risk factor focus, target areas, and populations. It showed variable NCD mortality rates related to tobacco use and AP across the participating countries, with tobacco as the main risk factor in the Kyrgyz Republic, Greece, and Romania, and AP prevailing in Pakistan and Uganda. Adolescent exposure levels, sources, and correlates varied. The study will continue with an in-depth situational analysis to guide the selection, adaptation, and integration of evidence-based interventions into the FRESHAIR4Life prevention package. This package will be implemented, evaluated, assessed for cost-effectiveness, and iteratively refined. The research places a strong emphasis on co-creation, capacity building, and comprehensive communication and dissemination.
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Affiliation(s)
- Charlotte M Hoffman
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Anke Versluis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Sergiu Chirila
- Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Bruce J Kirenga
- Lung Institute & Department of Medicine, Makerere University, Kampala, Uganda
| | | | - Saima Saeed
- Indus Hospital and Health Network, Karachi, Pakistan
| | - Talant Sooronbaev
- National Center of Cardiology and Internal Medicine named after academician Mirrakhimov, Bishkek, Kyrgyzstan
| | | | - D K Arvind
- School of Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Linda C Bauld
- Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, UK
| | - Floor A van den Brand
- Department of Family Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Hilary Pinnock
- Allergy and Respiratory Research Group, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Jurjen van der Schans
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
| | - Siân Williams
- International Primary Care Respiratory Group, London, UK
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Cui Y, Bar-Zeev Y, Levine H, LoParco CR, Duan Z, Wang Y, Abroms LC, Khayat A, Berg CJ. Heated tobacco product marketing: a mixed-methods study examining exposure and perceptions among US and Israeli adults. HEALTH EDUCATION RESEARCH 2024:cyae018. [PMID: 38739472 DOI: 10.1093/her/cyae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/06/2024] [Accepted: 04/17/2024] [Indexed: 05/16/2024]
Abstract
The marketing of heated tobacco products (HTPs), like IQOS, influences consumers' perceptions. This mixed-methods study analyzed (i) survey data (2021) of 2222 US and Israeli adults comparing perceptions of 7 IQOS attributes (design, technology, colors, customization, flavors, cost and maintenance) and 10 marketing messages (e.g. 'Go smoke-free…') across tobacco use subgroups and (ii) qualitative interviews (n = 84) regarding IQOS perceptions. In initial bivariate analyses, those never using HTPs (86.2%) reported the least overall appeal; those currently using HTPs (7.7%) reported the greatest appeal. Notably, almost all (94.8%) currently using HTPs also currently used cigarettes (82.0%) and/or e-cigarettes (64.0%). Thus, multivariable linear regression accounted for current cigarette/e-cigarette use subgroup and HTP use separately; compared to neither cigarette/e-cigarette use (62.8%), cigarette/no e-cigarette use (17.1%) and e-cigarette/no cigarette use (6.5%), those with dual use (13.5%) indicated greater overall IQOS appeal (per composite index score); current HTP use was not associated. Qualitative data indicated varied perceptions regarding advantages (e.g. harm, addiction and complexity) of IQOS versus cigarettes and e-cigarettes, and perceived target markets included young people, those looking for cigarette alternatives and females. Given the perceived target markets and particular appeal to dual cigarette/e-cigarette use groups, IQOS marketing and population impact warrant ongoing monitoring to inform regulation.
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Affiliation(s)
- Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, 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 Medical Center, 7 Ramat Gan, Jerusalem, 9112102, Israel
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, 7 Ramat Gan, Jerusalem, 9112102, Israel
| | - Cassidy R LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC 20052, USA
| | - Zongshuan Duan
- School of Public Health, Georgia State University, 140 Decatur St. SE, Atlanta, GA 30303, USA
| | - Yan Wang
- GW Cancer Center, George Washington University, 800 22nd Street NW, Washington, DC 20052, USA
| | - Lorien C Abroms
- GW Cancer Center, George Washington University, 800 22nd Street NW, Washington, DC 20052, USA
| | - Amal Khayat
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, 7 Ramat Gan, Jerusalem, 9112102, Israel
| | - Carla J Berg
- GW Cancer Center, George Washington University, 800 22nd Street NW, Washington, DC 20052, USA
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Roșioară AI, Năsui BA, Ciuciuc N, Sîrbu DM, Curșeu D, Pop AL, Popescu CA, Popa M. Status of Healthy Choices, Attitudes and Health Education of Children and Young People in Romania-A Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:725. [PMID: 38792908 PMCID: PMC11123286 DOI: 10.3390/medicina60050725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: This study aims to assess the health status and factors influencing healthy choices among children and young people in Romania, as well as the efficacy of related health education programs. Through understanding these dynamics, the study seeks to provide insights that can shape targeted interventions, policies, and educational strategies to improve this demographic's overall health and well-being. Materials and Methods: For this study, we performed a literature review of original published papers on the health status, healthy habits, health education, predisposition to making healthy choices in the future, and accessibility to the paediatric health system of Romanian children and young people, as well as the effects of different types of educational interventions on this demographic in Romania. Results: The prevalence of dental caries is high in Romania. In terms of eating habits and nutritional status, a worrying proportion of children are overweight or obese, which can lead to a variety of future physical and psychological problems. In terms of physical activity, few adolescents demonstrate regular fitness practices. Romania presents an increase in alcohol and tobacco consumption among adolescents. The mental health of students has become a pressing public health concern, exacerbated by the COVID-19 pandemic. The use of social networks is linked to mental health issues among young people. Romania still has one of the highest rates of sexually transmitted diseases and faces a high incidence of cervical cancer, with a mortality rate three times higher than the EU average. High rates of teenage pregnancies are linked to limited information about sexuality and a lack of access to family planning at a young age. There are large discrepancies in the accessibility of medical services between urban and rural areas. Conclusions: Romania faces significant obstacles to providing high-quality healthcare to children and young people. Improving nutrition, immunisation rates, and access to medical services represent essential areas for enhancing the health of children and young people in Romania.
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Affiliation(s)
- Alexandra-Ioana Roșioară
- Department of Community Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.-I.R.); (N.C.); (D.M.S.); (D.C.); (M.P.)
- Research Center in Preventive Medicine, Health Promotion and Sustainable Development, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Bogdana Adriana Năsui
- Department of Community Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.-I.R.); (N.C.); (D.M.S.); (D.C.); (M.P.)
- Research Center in Preventive Medicine, Health Promotion and Sustainable Development, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Nina Ciuciuc
- Department of Community Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.-I.R.); (N.C.); (D.M.S.); (D.C.); (M.P.)
- Research Center in Preventive Medicine, Health Promotion and Sustainable Development, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Dana Manuela Sîrbu
- Department of Community Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.-I.R.); (N.C.); (D.M.S.); (D.C.); (M.P.)
- Research Center in Preventive Medicine, Health Promotion and Sustainable Development, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Daniela Curșeu
- Department of Community Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.-I.R.); (N.C.); (D.M.S.); (D.C.); (M.P.)
- Research Center in Preventive Medicine, Health Promotion and Sustainable Development, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Anca Lucia Pop
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, 020945 Bucharest, Romania;
| | - Codruța Alina Popescu
- Department of Abilities Human Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Monica Popa
- Department of Community Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (A.-I.R.); (N.C.); (D.M.S.); (D.C.); (M.P.)
- Research Center in Preventive Medicine, Health Promotion and Sustainable Development, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
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Momosaka T, Saito J, Otsuki A, Yaguchi-Saito A, Fujimori M, Kuchiba A, Katanoda K, Takaku R, Shimazu T. Associations of individual characteristics and socioeconomic status with heated tobacco product harmfulness perceptions in Japan: A nationwide cross-sectional study (INFORM Study 2020). J Epidemiol 2024:JE20230177. [PMID: 38191179 DOI: 10.2188/jea.je20230177] [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: 01/10/2024] Open
Abstract
IntroductionIn Japan, heated tobacco products (HTPs) are promoted by the tobacco industry as reduced-risk tobacco products despite the lack of evidence for this claim. This study determined the distribution of HTP-harmfulness perception and identify the explanatory factors associated with the perception of HTP as less harmful than conventional cigarettes.MethodsA nationwide cross-sectional survey was conducted with Japanese people aged 20 years or older (INFORM Study 2020) using a self-administered questionnaire. We performed descriptive analysis and weighted logistic regression analysis to examine the relationship between explanatory factors (e.g., individual characteristics, socioeconomic status, and trusted sources of cancer information) and the perception of HTPs as less harmful.ResultsAmong 3,420 participants (response rate: 35.2%), the proportions of those who perceived HTPs as less harmful were 40.3% and 18.3% for users and non-users of tobacco, respectively. For participants aged 20-39 years, the proportion were 49.9% and 30.4%, respectively. Among 1,160 non-tobacco users who were familiar with HTPs, male, aged under 39 years, and had lower education were associated with the perception of HTPs as less harmful. Trusted sources of cancer information were not associated with the perception of HTPs as less harmful.ConclusionsThis study showed that, among non-tobacco users, being male, aged under 39 years, and lower education were associated with a perception of HTPs as less harmful. Public health stakeholders should provide the latest evidence about HTP harmfulness in their daily practice, and strengthen the regulations on HTP marketing directed at both tobacco- and non-tobacco users.
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Affiliation(s)
- Takumi Momosaka
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control
- School of International and Public Policy, Hitotsubashi University
| | - Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control
| | - Aki Otsuki
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control
| | - Akiko Yaguchi-Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control
- Faculty of Human Sciences, Tokiwa University
| | - Maiko Fujimori
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control
| | - Aya Kuchiba
- Graduate School of Health Innovation, Kanagawa University of Human Services
- Division of Biostatistical Research, Institution for Cancer Control/Biostatistics Division, Center for Research Administration and Support, National Cancer Center
| | - Kota Katanoda
- Division of Population Data Science, National Cancer Center Institute for Cancer Control
| | - Reo Takaku
- School of International and Public Policy, Hitotsubashi University
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control
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