1
|
Kalkanis A, Diamantidou V, Papadopoulos D, Eleftheriou M, Testelmans D, Buyse B. Smoking cessation in the Greek Air Force: associations with shift work and flight status. BMJ Mil Health 2024; 170:93-94. [PMID: 35654471 DOI: 10.1136/bmjmilitary-2022-002144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/19/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Alexandros Kalkanis
- Department of Respiratory Diseases, KU Leuven University Hospitals Leuven Campus Gasthuisberg, Leuven, Flanders, Belgium
| | - V Diamantidou
- Intensive Care Unit, 251 Air Force General Hospital, Athens, Attica, Greece
| | - D Papadopoulos
- Department of Respiratory Diseases, KU Leuven University Hospitals Leuven Campus Gasthuisberg, Leuven, Flanders, Belgium
| | - M Eleftheriou
- Department of Mathematics, Hellenic Open University, Patras, Western Greece, Greece
| | - D Testelmans
- Department of Respiratory Diseases, KU Leuven University Hospitals Leuven Campus Gasthuisberg, Leuven, Flanders, Belgium
| | - B Buyse
- Department of Respiratory Diseases, KU Leuven University Hospitals Leuven Campus Gasthuisberg, Leuven, Flanders, Belgium
| |
Collapse
|
2
|
Aye YM, Hong SA, Thepthien B, Tiraphat S. Betel quid chewing and its prevalence and determinants: data from Myanmar Demographic Health and Survey of 2015-2016. J Public Health (Oxf) 2022; 44:e181-e191. [PMID: 33791792 DOI: 10.1093/pubmed/fdab044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/15/2021] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although betel quid chewing with tobacco use is one of the major behavioral risk factors for chronic diseases, the prevalence is rather on the increase in Myanmar. This study determined prevalence of betel quid chewing at the national and subnational levels and its associations with tobacco and sociodemographic factors. METHODS This study is a secondary data analysis of Myanmar demographic health survey 2015-2016 with a total of 11 773 women and 4251 men aged 18-49 years. Chi-square tests and multivariable logistic regression tests were performed. RESULTS Prevalence of betel quid chewing was 61.8% in men and 19.5% in women and by regions it ranged from 34 to 82.2% and from 5-8 to 52.9%, respectively. The prevalence of the concurrent use with tobacco was 25.8 and 2.3%, respectively. Women with older age, low education and low wealth and occupation and living with spouse were associated with betel quid chewing, while low education, living with spouse and Myanmar speaker were associated with men. Tobacco use was inversely and positively associated with betel quid chewing in men and women, respectively (P-interaction <0.0001). CONCLUSION Implementation of culturally sensitive intervention and policies including effective community awareness campaigns for anti-betel quid chewing is strongly recommended in Myanmar.
Collapse
Affiliation(s)
- Yin Min Aye
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
| | - S A Hong
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
- Institute for Health and Society, Hanyang University, Seoul 04763, Republic of Korea
| | - B Thepthien
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
| | - S Tiraphat
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom 73170, Thailand
| |
Collapse
|
3
|
Lin J, Zhu K, Soliván-Ortiz AM, Larsen SL, Irwin SP, Schneid TR, Shriver CD, Lee S. Dual use of cigarettes and smokeless tobacco among active duty service members in the US military. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.2004046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jie Lin
- Department of Surgery, John P. Murtha Cancer Center Research Program, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Kangmin Zhu
- Department of Surgery, John P. Murtha Cancer Center Research Program, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Aida M. Soliván-Ortiz
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, San Antonio, Texas, USA
| | - Stacy L. Larsen
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort Bragg, North Carolina, USA
| | - Scott P. Irwin
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, San Antonio, Texas, USA
| | - Thomas R. Schneid
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort Sam Houston, Texas, USA
| | - Craig D. Shriver
- Department of Surgery, John P. Murtha Cancer Center Research Program, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Sukhyung Lee
- Department of Surgery, John P. Murtha Cancer Center Research Program, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| |
Collapse
|
4
|
Tun KH, Hong SA. Patterns of tobacco and alcohol misuse among presumptive TB Patients in Myanmar: prevalence and sociodemographic associations. NAGOYA JOURNAL OF MEDICAL SCIENCE 2020; 82:685-695. [PMID: 33311799 PMCID: PMC7719456 DOI: 10.18999/nagjms.82.4.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study aimed to assess the prevalence and patterns of tobacco and alcohol use and the associations with socio-demographic variables among presumptive TB patients. A cross-sectional study was conducted among 397 presumptive TB patients in a tertiary hospital in Myanmar. Global Adult Tobacco Survey (GATS) questionnaire and AUDIT-C were used to measure daily tobacco use (single, any or dual use of smoked and smokeless tobacco) and harmful alcohol use, respectively. Multiple and multinomial logistic regression were used to examine the associations with socio-demographic factors. The prevalence of daily use of dual tobacco and any tobacco was 28.2% and 65.7%, respectively. Harmful alcohol use was also high (44.8%). While single use of daily tobacco and harmful alcohol was 28.2% and 7.3%, respectively, concurrent tobacco and alcohol use was 37.5%. While being male and having low education were associated with tobacco use, concurrent tobacco and harmful alcohol use were associated with male gender, low education, and occupation with the government or a company. Due to the high prevalence of tobacco and alcohol misuse, identifying those at risk of tobacco and alcohol misuse and providing integrated care services in a health facility should be considered as a joint activity in national TB and tobacco control programmes.
Collapse
Affiliation(s)
- Kyaw Hsan Tun
- United Nation’s Children Fund Lashio Field Office, Northern Shan State, Myanmar
| | - Seo Ah Hong
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand,Institute for Health and Society, Hanyang University, Seoul, Republic of Korea
| |
Collapse
|
5
|
Delahanty J, Ganz O, Hoffman L, Guillory J, Crankshaw E, Farrelly M. Tobacco use among lesbian, gay, bisexual and transgender young adults varies by sexual and gender identity. Drug Alcohol Depend 2019; 201:161-170. [PMID: 31229704 DOI: 10.1016/j.drugalcdep.2019.04.013] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Research shows that tobacco products are disproportionately used by sexual and gender minorities, known collectively as those who are lesbian, gay, bisexual, and transgender (LGBT). While usage varies within this population by identity, differences in tobacco use patterns are not well understood. The present study uses evaluation data for This Free Life, a tobacco public education campaign from the FDA, to examine differences in tobacco use among LGBT young adults by subgroups based on sex at birth, gender and sexual identity. METHODS Data are from 4,057 18-24 LGBT young adults who completed the baseline This Free Life evaluation survey in 2016. Multivariable logistic regression models examined differences in tobacco use (cigarettes, cigars, hookah and electronic nicotine products) and poly use (2+ of any product, 2+ combustibles, at least one combustible and one noncombustible) between LGBT subgroups (cisgender gay males, cisgender bisexual males, cisgender lesbian/gay females, cisgender bisexual females and gender minorities). RESULTS Sexual minority females were more likely than gay males to use any tobacco product, electronic nicotine products and hookah. Cisgender bisexuals were more likely than gay males and gender minorities to use electronic nicotine products. Cisgender bisexual males were less likely than all other groups to use cigarettes. Cisgender sexual minority females were more likely than gender minorities to engage in poly use. CONCLUSIONS Findings suggest that sexual minority females are more likely to use tobacco than other subgroups. More research can help campaign developers better understand reasons for intragroup differences in tobacco use among LGBT subgroups.
Collapse
Affiliation(s)
- Janine Delahanty
- The Center for Tobacco Products at the Food and Drug Administration, White Oak, MD, USA.
| | - Ollie Ganz
- The Center for Tobacco Products at the Food and Drug Administration, White Oak, MD, USA.
| | - Leah Hoffman
- The Center for Tobacco Products at the Food and Drug Administration, White Oak, MD, USA.
| | | | | | | |
Collapse
|
6
|
Hong SA, Peltzer K. Early Adolescent Patterns of Alcohol and Tobacco Use in Eight Association of South-East Asian Nations (ASEAN) Member States. Subst Use Misuse 2019; 54:288-296. [PMID: 30463459 DOI: 10.1080/10826084.2018.1517797] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Though alcohol and tobacco are the most commonly used substances among adolescents, little is known about the patterning of early adolescent substance use in Association of South-East Asian Nations (ASEAN) member states. OBJECTIVES This study examined past month patterns of substances use and its gender difference among adolescents. METHODS Cross-sectional samples among adolescents aged 13-16 years who completed the Global School-based Student Health Survey (GSHS) from eight ASEAN countries were included in the analysis (n = 40,212). RESULTS Prevalence of past month any tobacco use was relatively high in Brunei, Indonesia, Malaysia, Thailand, and the Philippines (11-15%), but prevalence of dual cigarette and other forms of tobacco use was about 2-5% in the five countries. Past month alcohol consumption prevalence was also high in Thailand, Viet Nam, and the Philippines (16-24%), compared to the rest countries (1.4-8.2%). Moreover, prevalence of the concurrent alcohol and tobacco use was higher in Thailand and the Philippines (7 and 10%, respectively), particularly in boys (13 and 15%, respectively). Conclusions/importance: Almost 30-40% of the boys and 10-20% of girls in Malaysia, Philippines, Thailand, and Viet Nam are engaged in at least one of the two risk behaviors, and the concurrent alcohol and tobacco use was also relatively high among boys in those countries (5-15%). This study may provide some valuable insights on alcohol and tobacco policy in the region and requires to begin prevention and treatment programs in ASEAN member states.
Collapse
Affiliation(s)
- Seo Ah Hong
- a ASEAN Institute for Health Development, Mahidol University , Salaya, Phutthamonthon, Nakhon Pathom , Thailand.,b Institute for Health and Society, Hanyang University , Seoul , Republic of Korea
| | - Karl Peltzer
- c Department of Research and Innovation, University of Limpopo , Turfloop , South Africa.,d HIV/AIDS/STIs and TB Research Programme, Human Sciences Research Council , Pretoria , South Africa
| |
Collapse
|
7
|
Jones DM, Popova L, Weaver SR, Pechacek TF, Eriksen MP. A National Comparison of Dual Users of Smokeless Tobacco and Cigarettes and Exclusive Cigarette Smokers, 2015-2016. Nicotine Tob Res 2018; 20:S62-S70. [PMID: 30125015 PMCID: PMC6093383 DOI: 10.1093/ntr/nty010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 01/19/2018] [Indexed: 12/13/2022]
Abstract
Introduction While smoking rates have declined, use of smokeless tobacco (ST) has remained constant. ST is heavily marketed to cigarette smokers, and many ST users smoke cigarettes. This study provides updated comparisons of the characteristics, smoking behaviors, and perceptions of US adult dual ST and cigarette users and exclusive cigarette smokers in 2015-2016. Methods Data were from nationally representative, cross-sectional surveys from 2015 and 2016. Adult smokers reported past 30-day use of ST, current cigarette smoking, risk perceptions, smoking, and quitting behaviors. We estimated Rao-Scott χ2 and adjusted odds ratios (AORs) to compare dual users and exclusive smokers. Results Dual users were more likely to be younger, reside in nonmetropolitan statistical areas (MSA) and outside the Northeast United States. Adjusting for covariates, dual users did not differ significantly from exclusive smokers on most smoker characteristics, including number of past year quit attempts. Dual users were more likely to report past 30-day use of novel tobacco products (AORs 2.90 [little cigars and cigarillos] to 11.02 [hookah]). Dual users who reported at least 1 past year cigarette quit attempt were more likely than exclusive smokers to report using ST, traditional cigars, hookah, or heat-not-burn as a past year quit method (AOR: 9.54 [95% CI: 3.22 to 28.23]). Conclusions Smokers who use ST are more likely than exclusive smokers to attempt to quit smoking cigarettes using other tobacco products. These findings may be attributed to increasing use prevalence of novel products. We recommend further monitoring to assess polytobacco use and differences among these populations. Implications Many current ST users smoke cigarettes and ST promotions often target cigarette smokers. As the FDA considers ST regulations and implements a nicotine centered regulatory framework, it is imperative to evaluate how these policies and promotion of ST as potentially reduced risk products impact dual and polytobacco use. Our study found that many dual users engage in novel tobacco use in general and as a cessation method. Consideration of ST and polytobacco use among smokers may be helpful in the development of forthcoming FDA regulations, messaging, and interventions.
Collapse
Affiliation(s)
- Dina M Jones
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA
| | - Lucy Popova
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA
- Division of Health Promotion and Behavior, School of Public Health, Georgia State University, Atlanta, GA
| | - Scott R Weaver
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA
| | - Terry F Pechacek
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA
- Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA
| | - Michael P Eriksen
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA
- Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA
| |
Collapse
|
8
|
Lin J, Zhu K, Soliván-Ortiz AM, Larsen SL, Schneid TR, Shriver CD, Lee S. Deployment and Smokeless Tobacco Use Among Active Duty Service Members in the U.S. Military. Mil Med 2018; 184:e183-e190. [DOI: 10.1093/milmed/usy186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/15/2018] [Accepted: 07/12/2018] [Indexed: 01/29/2023] Open
Abstract
Abstract
Introduction
The prevalence of smokeless tobacco use among U.S. active duty service members has been much higher than in the U.S. general population. The association between deployment and smokeless tobacco use has not been well studied. We investigated the association between deployment and smokeless tobacco use among U.S. active duty service members. We also evaluated the modification effects from other factors related to smokeless tobacco use on the deployment-smokeless tobacco use association.
Materials and Methods
Eligible active duty service members stationed at two military installations (Fort Bragg, NC, USA and Lackland Air Force Base, TX, USA) were recruited from July 2015 to May 2016. Each participant completed a self-administered questionnaire. Multivariable logistic regression was used to assess the association between deployment and smokeless tobacco use and estimated odds ratio (OR) and 95% confidence interval (CI). Stratified analysis was performed to evaluate modification effects from other commonly known factors related to smokeless tobacco use in military, specifically, cigarette smoking status, use among family members (family history of use), perception of harm, and use among military peers.
Results
Out of 2,465 study participants who completed the questionnaire, 548 were smokeless tobacco users. Service members who had been deployed to a combat zone had 1.39 fold (95% CI = 1.03–1.87) increased odds of using smokeless tobacco than those who never deployed to a combat zone. The odds of smokeless tobacco use among those who had been deployed once, twice, three times and four or more times to a combat zone were 1.27 (95% CI = 0.91–1.78), 1.30 (95% CI = 0.85–1.99), 2.49 (95% CI = 1.45–4.28), and 2.88 (95% CI = 1.71–4.86), respectively, with a significant dose–response trend (p for trend <0.0001). Further, subjects who served in combat units during deployment exhibited more than two-fold increased odds of use as compared with those who had never been deployed (OR = 2.03, 95% CI = 1.41–2.93). In stratified analysis, the association between deployment and smokeless tobacco use was only present among subjects who never smoked cigarettes, those without family history of smokeless tobacco use, and those who had low perception of harm of use.
Conclusions
Military deployment was associated with smokeless tobacco use among active service members. However, the influence of military deployment on smokeless tobacco use was not equally strong on all service members. Subjects who never smoked cigarettes, who had no family history of use and who had low perception of harm were the most susceptible subgroups to deployment-related smokeless tobacco use. This study has implications to identify high-risk subgroups to reduce smokeless tobacco use in the U.S. military.
Collapse
Affiliation(s)
- Jie Lin
- John P. Murtha Cancer Center, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Rockville, MD
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Kangmin Zhu
- John P. Murtha Cancer Center, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Rockville, MD
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Aida M Soliván-Ortiz
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, San Antonio, TX
| | - Stacy L Larsen
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort Bragg, NC
| | - Thomas R Schneid
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Fort Sam Houston, TX
| | - Craig D Shriver
- John P. Murtha Cancer Center, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Rockville, MD
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Sukhyung Lee
- John P. Murtha Cancer Center, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Rockville, MD
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
| |
Collapse
|
9
|
Abstract
Objectives Identifying characteristics associated with the use of new and emerging tobacco products is a priority. The enumeration and baseline characteristics of a new cohort of adult tobacco users are described. Methods Residents, ≥18 years of age, in urban Franklin County, or one of 6 rural Appalachian counties, and who were exclusive users of combustible, smokeless (SLT), or electronic nicotine delivery systems (ENDS) tobacco products, or were dual users, were targeted for recruitment. Participants were interviewed in-person at baseline on sociodemographic characteristics, tobacco product use, and cognitive/affective and purchasing factors. Results We recruited 1210 participants (urban, N = 595; rural, N = 615). Urban participants were less likely to use tobacco daily, began using tobacco later, used tobacco for less time, and had higher cessation interest. ENDS users were significantly less likely to have made a quit attempt than users of other tobacco products. Duration of tobacco use and nicotine dependence also differed by product type. Conclusion This cohort's enumeration allowed us to compare factors associated with tobacco product preferences and the use of novel products. The inclusion of rural Appalachia-a region with high tobacco use and disease burden-may provide additional insights into the implementation of tobacco control interventions.
Collapse
|
10
|
Linde BD, Ebbert JO, Schroeder DR, Hanson AC, Talcott GW, Klesges RC. Smokeless tobacco use among United States Air Force trainees. Subst Abus 2016; 38:278-284. [PMID: 28027011 DOI: 10.1080/08897077.2016.1275924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The prevalence of smokeless tobacco use in the United States Air Force (USAF) exceeds civilian use rates. The prevalence and correlates of smokeless tobacco use were assessed and evaluated in a sample of USAF trainees. METHODS We conducted a cross-sectional survey of USAF technical training school personnel at Joint Base San Antonio-Lackland and Fort Sam Houston (N = 14,810). Survey completion rate was 78%. Logistic regression was used to analyze the associations between demographic variables, tobacco use, and social factors for both regular and infrequent smokeless tobacco (e.g., chewing tobacco, snuff) users. RESULTS Overall, 16% of Airmen had ever used smokeless tobacco and 10% regularly used smokeless tobacco. In multivariate analyses, men had greater odds than women of regular smokeless tobacco use (adjusted odds ratio [OR] = 15.2; 95% confidence interval [CI]: 10.8-21.5) and infrequent smokeless tobacco use (adjusted OR = 4.2; 95% CI: 3.1-5.7). Smokeless tobacco use was associated with participation in high school sports (adjusted OR = 1.9; 95% CI: 1.6-2.3 for regular users; adjusted OR = 1.4; 95% CI: 1.1-1.7 for infrequent users), smoking cigarettes (adjusted OR = 4.3; 95% CI: 3.6-5.1 for regular users; adjusted OR = 4.0; 95% CI: 3.2-5.0 for infrequent users), or living with someone who used smokeless tobacco (adjusted OR = 2.2; 95% CI: 1.9-2.6 for regular users; adjusted OR = 1.4; 95% CI: 1.1-1.7 for infrequent users). Black or African Americans were less likely than whites to be regular (adjusted OR = 0.3; 95% CI: 0.1-0.4) or infrequent (adjusted OR = 0.3; 95% CI: 0.2-0.4) users of smokeless tobacco. CONCLUSIONS Smokeless tobacco use among incoming Air Force recruits is common and negatively impacts the Air Force's goal to be tobacco-free. Understanding sociodemographic characteristics perpetuating smokeless tobacco use in the Air Force population can inform the development of health promotion interventions.
Collapse
Affiliation(s)
- Brittany D Linde
- a Organizational Wellness and Learning Systems , Fort Worth , Texas , USA
| | - Jon O Ebbert
- b Division of Primary Care Internal Medicine , Department of Medicine , Mayo Clinic , Rochester , Minnesota , USA
| | - Darrell R Schroeder
- c Division of Biomedical Statistics and Informatics. Department of Health Sciences Research , Mayo Clinic , Rochester , Minnesota , USA
| | - Andrew C Hanson
- c Division of Biomedical Statistics and Informatics. Department of Health Sciences Research , Mayo Clinic , Rochester , Minnesota , USA
| | - G Wayne Talcott
- d Department of Preventive Medicine, Center for Population Sciences , University of Tennessee Health Science Center , Memphis , Tennessee , USA
| | - Robert C Klesges
- d Department of Preventive Medicine, Center for Population Sciences , University of Tennessee Health Science Center , Memphis , Tennessee , USA
| |
Collapse
|
11
|
Sinha DN, Suliankatchi RA, Amarchand R, Krishnan A. Prevalence and Sociodemographic Determinants of Any Tobacco Use and Dual Use in Six Countries of the WHO South-East Asia Region: Findings From the Demographic and Health Surveys. Nicotine Tob Res 2016; 18:750-6. [PMID: 26729735 DOI: 10.1093/ntr/ntv286] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 12/23/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND Tobacco control is an important strategy to reduce the disease burden caused by several noncommunicable diseases. An in-depth understanding of the sociodemographic variations in tobacco use is an important step in achieving effective tobacco control. AIMS We aimed to estimate the age-standardized prevalence of any tobacco use and dual tobacco use and determine their association with sociodemographic variables in six countries (Bangladesh, Indonesia, India, Maldives, Nepal, and Timor Leste) of the WHO South-East Asia Region. METHODS The main outcome variables "any tobacco use" and "current dual use" were created from the latest available Demographic and Health Surveys data for each country. The prevalence estimates were weighted using sample weights and age standardized using the WHO standard population. Associations between the sociodemographic variables and tobacco use were calculated by performing multivariable logistic regression analysis. Analyses were performed in Stata 12 using "svyset" and "svy" commands. RESULTS The highest prevalence of any tobacco use among men was in Indonesia (76.4%) and among women in Nepal (15.7%). Also, Nepal had the highest prevalence of dual tobacco use in both men (17.9%) and women (1.5%). With regard to sociodemographic determinants, despite the inter-country variations, any and dual tobacco use were significantly associated with age, higher education, greater wealth, rural residence, and ever-married marital status. The poor and uneducated had a higher odds ratio for these practices. CONCLUSION Prevalence of dual tobacco use and its underlying socioeconomic disparities should be taken into account for the planning of tobacco control activities in the region. IMPLICATIONS The dual tobacco use phenomenon is being increasingly recognized as a distinct entity in the fight against tobacco addiction. When compared with single product users, dual users have a greater risk of developing tobacco related diseases and are less likely to quit their habits. However, this phenomenon has not been studied adequately in the South-East Asia region. In this context, this study has provided a detailed and comprehensive view of dual tobacco use and its sociodemographic determinants in six countries of the region. This study recommends that tobacco control interventions should be targeted specifically at the disadvantaged sections of the society, such as the poor and the uneducated, who are more likely to engage in "dual" as well as "any" tobacco use. This study could prove as an important reference and tool for policy making in the South-East Asia region.
Collapse
Affiliation(s)
- Dhirendra N Sinha
- Tobacco Free Initiative Unit, World Health Organization, Regional Office for South-East Asia, New Delhi, India;
| | - Rizwan A Suliankatchi
- Department of Community Medicine, Velammal Medical College Hospital and Research Institute, Madurai, India
| | - Ritvik Amarchand
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anand Krishnan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
12
|
Little MA, Derefinko KJ, Colvin L, Ebbert JO, Bursac Z, Talcott GW, Richey PA, Klesges RC. The Prevalence of E-cigarette Use in a Sample of U.S. Air Force Recruits. Am J Prev Med 2015; 49:402-8. [PMID: 25896193 PMCID: PMC4546868 DOI: 10.1016/j.amepre.2015.02.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 02/17/2015] [Accepted: 02/26/2015] [Indexed: 01/24/2023]
Abstract
INTRODUCTION The prevalence of electronic cigarette (e-cigarette) use is increasing markedly in the general population. Yet, remarkably little research exists to examine these ongoing trends in at-risk populations, and nothing is known about the prevalence of e-cigarette use among military personnel. The purpose of the current study is to provide recent (2013-2014) data on the prevalence of regular e-cigarette use in a population of recruits prior to their entry into the U.S. military. METHODS The study utilized a cross-sectional assessment of e-cigarette and other tobacco and nicotine-containing product (TNCP) use in 2013-2014 among 10,043 U.S. Air Force (USAF) recruits in Technical Training. Chi-square tests, the Cochran-Armitage test for trend, and logistic regression models tested differences and trends across time for e-cigarette use. RESULTS The rate of e-cigarette use among recruits was 5.2%, which doubled (3% to 6.5%, p<0.0001) across a 1-year period. E-cigarette use was associated with increased odds of all measured TNCPs, as well as dual and poly use (all p<0.0001). CONCLUSIONS Rates of e-cigarette use are slightly higher in young USAF recruits than in the general population, and e-cigarette users are likely to be using other TNCPs in tandem. Although additional work is needed to understand the reasons for this concomitant use, this is a necessary first step to understanding e-cigarette use prevalence in military populations. Historic trends suggest that, like general populations, e-cigarette use is on the rise for those entering the USAF and should be monitored to inform future prevention programming.
Collapse
Affiliation(s)
- Melissa A Little
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee.
| | - Karen J Derefinko
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Lauren Colvin
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| | | | - Zoran Bursac
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Gerald W Talcott
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Phyllis A Richey
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Robert C Klesges
- Department of Preventive Medicine and Center for Population Sciences, University of Tennessee Health Science Center, Memphis, Tennessee
| |
Collapse
|
13
|
Talcott GW, Ebbert JO, Klesges RC, Linde BD, Seals RW, Krukowski RA, Grieser EA, Oh JY, Martin-Zona DM. Tobacco Research in the Military: Reflections on 20 Years of Research in the United States Air Force. Mil Med 2015; 180:848-50. [PMID: 26226525 PMCID: PMC6677132 DOI: 10.7205/milmed-d-14-00501] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The U.S. military is one of the world's largest employers. Approximately 30% of active duty military personnel smoke cigarettes and more than 14% use smokeless tobacco. The military has historically supported tobacco use and more recently is attempting to combat its use. Through 20 years of collaborative research with the United States Air Force, we have learned that smoking bans are effective, recruits who have never previously smoked cigarettes initiate tobacco use, smokeless tobacco serves as a gateway for smoking initiation, smoking is associated with discharge, smoking adds significant proximal training costs, tobacco use increases during deployment, and tobacco quitline counseling with a provision of medication is effective. Our findings may provide groundwork for future tobacco control efforts in the U.S. military.
Collapse
Affiliation(s)
- G Wayne Talcott
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 Pauline, Suite 633, Memphis, TN 38163
| | - Jon O Ebbert
- Division of Primary Care Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905
| | - Robert C Klesges
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 Pauline, Suite 633, Memphis, TN 38163
| | - Brittany D Linde
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 Pauline, Suite 633, Memphis, TN 38163
| | - Robert W Seals
- 60 MDOS/SGOW, 101 Bodin Circle, Travis Air Force Base, CA 94535
| | - Rebecca A Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, 66 Pauline, Suite 633, Memphis, TN 38163
| | - Emily A Grieser
- Wilford Hall Ambulatory Surgical Center, 2200 Bergquist Drive, Suite 1, Lackland Air Force Base, TX 78236
| | - John Y Oh
- Air Force Medical Support Agency, Surgeon General of the Air Force, Healthcare Operations (SG3), 7700 Arlington Boulevard, Suite 5158, Falls Church, VA 22042
| | - Denise M Martin-Zona
- Wilford Hall Ambulatory Surgical Center, 2200 Bergquist Drive, Suite 1, Lackland Air Force Base, TX 78236
| |
Collapse
|
14
|
Soneji S, Sargent J, Tanski S. Multiple tobacco product use among US adolescents and young adults. Tob Control 2014; 25:174-80. [PMID: 25361744 PMCID: PMC4547881 DOI: 10.1136/tobaccocontrol-2014-051638] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 10/13/2014] [Indexed: 12/04/2022]
Abstract
Objective To assess the extent to which multiple tobacco product use among adolescents and young adults falls outside current Food and Drug Administration (FDA) regulatory authority. Methods We conducted a web-based survey of 1596 16–26-year-olds to assess use of 11 types of tobacco products. We ascertained current (past 30 days) tobacco product use among 927 respondents who ever used tobacco. Combustible tobacco products included cigarettes, cigars (little filtered, cigarillos, premium) and hookah; non-combustible tobacco products included chew, dip, dissolvables, e-cigarettes, snuff and snus. We then fitted an ordinal logistic regression model to assess demographic and behavioural associations with higher levels of current tobacco product use (single, dual and multiple product use). Results Among 448 current tobacco users, 54% were single product users, 25% dual users and 21% multiple users. The largest single use category was cigarettes (49%), followed by hookah (23%), little filtered cigars (17%) and e-cigarettes (5%). Most dual and multiple product users smoked cigarettes, along with little filtered cigars, hookah and e-cigarettes. Forty-six per cent of current single, 84% of dual and 85% of multiple tobacco product users consumed a tobacco product outside FDA regulatory authority. In multivariable analysis, the adjusted risk of multiple tobacco use was higher for males, first use of a non-combustible tobacco product, high sensation seeking respondents and declined for each additional year of age that tobacco initiation was delayed. Conclusions Nearly half of current adolescent and young adult tobacco users in this study engaged in dual and multiple tobacco product use; the majority of them used products that fall outside current FDA regulatory authority. This study supports FDA deeming of these products and their incorporation into the national media campaign to address youth tobacco use.
Collapse
Affiliation(s)
- Samir Soneji
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - James Sargent
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Susanne Tanski
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| |
Collapse
|