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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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Kibria MG, Islam T, Badiuzzaman M, Mamun AA, Sultana P, Hawlader MDH. Assessing the choice of smoke-free policies for multiunit housing and its associated determinants in Bangladesh: a cross-sectional study. BMJ Open 2024; 14:e074928. [PMID: 38642999 PMCID: PMC11033630 DOI: 10.1136/bmjopen-2023-074928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/11/2023] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES This study aimed to assess the desire for smoke-free housing, determine the choice of smoke-free policies for multiunit housing (MUH), and identify the factors associated with policy choice among MUH residents in Bangladesh. DESIGN We conducted a cross-sectional study from April to November 2019 using a semi-structured survey questionnaire. SETTING This study was conducted in seven divisional cities of Bangladesh: Dhaka, Chattogram, Rajshahi, Khulna, Sylhet, Barishal, and Rangpur. PARTICIPANTS A total of 616 adult individuals living in MUH for at least 2 years participated in the study. PRIMARY OUTCOME MEASURE Multinomial logistic regression was used to identify the determinants of the choice of smoke-free policies for MUH. RESULTS Overall, 94.8% of the respondents wanted smoke-free housing. Among those who wanted smoke-free housing, 44.9% preferred a smoke-free building policy, 28.3% preferred a smoke-free common area policy, 20.2% favoured a smoke-free unit policy, and 6.7% did not know what policy they should choose. Three factors were found to be significantly associated with the choice of a smoke-free building policy: staying at home for more than 12 hours (adjusted OR (aOR): 2.6; 95% CI 1.035 to 6.493), being a non-smoker (aOR: 3.2; 95% CI 1.317 to 7.582), and having at least one family member who smoked (aOR: 3.0; 95% CI 1.058 to 8.422). Results also showed that residents having at least one child under 15 in the family (aOR: 0.3; 95% CI 0.152 to 0.778) were less likely to choose a smoke-free common area policy and that women (aOR: 3.7; 95% CI 1.024 to 13.188) were more likely to choose a smoke-free unit policy. CONCLUSIONS MUH residents in urban Bangladesh highly demanded smoke-free housing. Most residents favoured a smoke-free building policy for MUH. Those who stayed at home for a longer time, were non-smokers, and had smoking family members were more likely to choose this policy.
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Affiliation(s)
- Md Golam Kibria
- Department of Research, Centre for Development Action, Dhaka, Bangladesh
| | - Taslima Islam
- Department of Monitoring, Evaluation and Learning, Social Development Foundation, Dhaka, Bangladesh
- Centre for Development Action, Dhaka, Bangladesh
| | - Muhammad Badiuzzaman
- Centre for Development Action, Dhaka, Bangladesh
- Department of Research and Policy, Transparency International Bangladesh, Dhaka, Bangladesh
| | - Abdullah Al Mamun
- Centre for Development Action, Dhaka, Bangladesh
- High Court Division, Supreme Court of Bangladesh, Dhaka, Bangladesh
| | - Papia Sultana
- Centre for Development Action, Dhaka, Bangladesh
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
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Mbulo L, Palipudi K, Smith T, Owusu D, Williams F, Dean AK, Mamudu HM. Secondhand Smoke Exposure Inside the Home Among Adults in Eight Countries in Sub-Saharan Africa: Global Adult Tobacco Survey, 2012-2018. Nicotine Tob Res 2023; 25:828-837. [PMID: 36272102 PMCID: PMC10032190 DOI: 10.1093/ntr/ntac247] [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: 12/21/2021] [Revised: 10/06/2022] [Accepted: 10/21/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Secondhand tobacco smoke (SHS) exposure causes diseases and death in adults and children. Evidence indicates that most SHS exposures occur at home and in the workplace. Therefore, home is a major place where adults and children can be effectively protected from SHS. This study examined the magnitude of SHS exposure at home and associated factors in eight sub-Saharan African countries. AIMS AND METHODS We analyzed 2012-2018 Global Adult Tobacco Survey data for Botswana, Cameroon, Ethiopia, Kenya, Nigeria, Senegal, Tanzania, and Uganda. We computed prevalence estimates of self-reported monthly SHS exposure at home reported as anyone smoking inside their home daily, weekly, or monthly. We calculated SHS exposure at home prevalence and applied multivariable logistic regression models to identify related factors. RESULTS Overall median prevalence of SHS exposure at home was 13.8% in the eight countries; ranging from 6.6% (95% CI: 5.7%, 7.6%) in Nigeria to 21.6% (95% CI: 19.4%, 24.0%) in Senegal. In multivariable analysis across the countries, SHS exposure at home was associated with living with a smoker, ranging from an adjusted odds ratio (AOR) of 4.6 (95% CI: 3.6, 5.8) in Botswana to 27.6 (95% CI: 20.1, 37.8) in Nigeria. SHS exposure at home was significantly associated with lower education attainment (Kenya and Ethiopia), and lower wealth index (Uganda, Senegal, and Botswana). CONCLUSIONS SHS exposure in homes was associated with the presence of a smoker in the home and lower socioeconomic status.
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Affiliation(s)
- Lazarous Mbulo
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Krishna Palipudi
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tenecia Smith
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Daniel Owusu
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Anna K Dean
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Noninfectious Diseases Program, CDC Foundation, Atlanta, GA, USA
| | - Hadii M Mamudu
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
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Ou Z, Gao Y, Jiang D, Cui J, Ren Y, Tang S, Duan D, Yu D, Wang Z. Global Trends in Death, Years of Life Lost, and Years Lived With Disability Caused by Breast Cancer Attributable to Secondhand Smoke From 1990 to 2019. Front Oncol 2022; 12:853038. [PMID: 35425702 PMCID: PMC9001985 DOI: 10.3389/fonc.2022.853038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/07/2022] [Indexed: 12/09/2022] Open
Abstract
Background Secondhand smoke is an important risk factor to breast cancer patients’ survival. This article aimed to describe the epidemiological changes of health loss caused by female breast cancer attributable to secondhand smoke from 1990 to 2019. Methods Data on breast cancer was derived from the Global Burden of Disease study 2019. The epidemiological status and trends were estimated using the number, age-standardized rate (ASR), and estimated annual percentage change (EAPC). Results In 2019, secondhand smoke-related breast cancer caused 168.33×102 death, 5242.58×102 years of life lost (YLLs), and 334.03×102 years lived with disability (YLDs) globally. The overall ASR of death and YLLs caused by breast cancer attributable to secondhand smoke presented decreasing trends from 1990 to 2019, with the respective EAPCs of −0.78 and −0.87. Meanwhile, decreasing trends occurred in most geographic regions, particularly that of YLLs in high-income North America (EAPC = −3.35). At the national level, most countries/territories had decreasing trends of death and YLLs, particularly Denmark, in which the respective EAPCs were −4.26 and −4.64. However, the ASR of YLDs showed an increasing trend globally (EAPC = 0.32). Meanwhile, increasing trends were observed in most regions and countries, particularly the Solomon Islands and Lesotho, with the respective EAPCs being 6.18 and 4.33. The changing trends were closely associated with sociodemographic development. Conclusions Trends in secondhand smoke-related death and YLLs caused by breast cancer declined from 1990 to 2019. However, secondhand smoke remains a challenge to the patients’ longevity and quality of life. The findings informed strategies should be strengthened the control of secondhand smoking.
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Affiliation(s)
- Zejin Ou
- Department of Central Laboratory, Guangzhou Twelfth People's Hospital, Guangzhou, China.,Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Yunxia Gao
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Diwei Jiang
- School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
| | - Jiaxin Cui
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yixian Ren
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Shihao Tang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Danping Duan
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Danfeng Yu
- Department of Medical Intensive Care Unit (MICU), Guangdong Women and Children Hospital, Guangzhou, China
| | - Zhi Wang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
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Singh A, Dobbie F, Kinnunen TI, Okello G, Semple S, Okyere PB, Logo DD, Lartey KF, McNeil A, Britton J, Bauld L, Owusu-Dabo E. Adherence to smoke-free policies in Ghana: Findings from a cross-sectional survey of hospitality venue owners and staff. Tob Prev Cessat 2021; 7:4. [PMID: 33474517 PMCID: PMC7811357 DOI: 10.18332/tpc/131058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Implementation of and compliance with smoke-free policies (SFPs) can be problematic in many low- and middle-income countries (LMICs) due to limited resources. This study evaluated knowledge, opinions and compliance related to Ghana’s SFPs among owners and staff of hospitality venues by city, staff designation, and venue type. METHODS A cross-sectional study design was used in venue types including hotels, bars, pubs and restaurants in the three cities of Kumasi, Accra, and Tamale, in Ghana. Data were collected between July and September 2019. Interviewer administered face-to-face surveys were conducted with owners and staff (n=142) recruited from randomly selected hospitality venues (n=154) in these three large cities of Ghana. The relationship between knowledge, opinions, and compliance items on SFPs, and city, venue type and staff designation was first studied using χ2 or a Fisher’s exact test, and then with univariate logistic regression model analysis. RESULTS Of the 142 respondents, some had heard of Ghana’s 2012 Tobacco Control Act (27.5%), smoking restriction in public places (29%), smoke-free places (22%), and display of ‘no smoking’ signage (6.3%). Knowledge levels were higher in Accra compared to Tamale (OR=3.08; 95% CI: 1.10–8.60). Staff designation and type of venue did not have any relationship with knowledge levels. Support for SFPs was over 80%, but opinions in support of SFPs were lower in Accra than Tamale (OR=0.25; 95% CI: 0.08–0.71). Compliance with SFPs was similar in the three cities. Hotels were three times more compliant compared to bars and pubs (OR=3.16; 95% CI: 1.48–6.71). CONCLUSIONS The study highlights the strong support for restriction of smoking in public places including hospitality venues despite poor knowledge and low compliance levels with the current SFPs. A review of the current SFP in Ghana together with education of hospitality staff on the benefits and requirements of SFPs is recommended.
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Affiliation(s)
- Arti Singh
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Fiona Dobbie
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Tarja I Kinnunen
- Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland
| | | | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, United Kingdom
| | - Portia Boakye Okyere
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Kwabena Fosu Lartey
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ann McNeil
- King's College London, London, United Kingdom
| | - John Britton
- University of Nottingham, Nottingham, United Kingdom
| | - Linda Bauld
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Khokhar MA, Siddiqi K. Smoke-Free Policies in the Global South. NICOTINE & TOBACCO RESEARCH : OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON NICOTINE AND TOBACCO 2020; 22:2125-2126. [PMID: 33049050 DOI: 10.1093/ntr/ntaa210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 11/14/2022]
Affiliation(s)
- Mariam A Khokhar
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, Heslington, York, UK
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