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Dieteren CM, Bonfrer I, Brouwer WBF, van Exel J. Public preferences for policies promoting a healthy diet: a discrete choice experiment. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:1429-1440. [PMID: 36445540 PMCID: PMC9707240 DOI: 10.1007/s10198-022-01554-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Worldwide obesity rates have nearly tripled over the past five decades. So far, policies to promote a healthier diet have been less intrusive than those to reduce tobacco and alcohol consumption. Not much is known about public support for policies that aim to promote a healthy diet. In this study, a discrete choice experiment (DCE) was used to elicit stated preferences for policies varying in intrusiveness among a representative sample of the public of The Netherlands. METHODS The choice tasks presented respondents a hypothetical scenario of two policy packages, each comprising a mix of seven potential policies that differed in level of intrusiveness. We estimated mixed logit models (MXL) to estimate respondents' preferences for these policies and performed latent class analyses to identify heterogeneity in preferences. RESULTS The MXL model showed that positive financial incentives like subsidies for vegetables and fruit yielded most utility. A tax of 50% on sugary drinks was associated with disutility while a tax of 20% was associated with positive utility compared to no tax at all. We identified three subgroups with distinct preferences for the seven policies to promote a healthy diet, which were characterized as being "against", "mixed" and "pro" policies to promote a healthy diet. CONCLUSION Preferences for policies promoting a healthy diet vary considerably in the Dutch population, particularly in relation to more intrusive policies. This makes selection and implementation of a policy package that has wide public support challenging.
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Affiliation(s)
- C M Dieteren
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
| | - I Bonfrer
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - W B F Brouwer
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - J van Exel
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
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Gutierrez JA, Hirth JM, Zoorob R, Levine RS. Racial, ethnic and gender trends in lung cancer mortality rates in the United States-Mexico border and non-border areas. Prev Med 2023; 175:107686. [PMID: 37648086 DOI: 10.1016/j.ypmed.2023.107686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/21/2023] [Accepted: 08/26/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Geographic patterns of lung cancer mortality rate differ in the region bordering Mexico in contrast to the US. This study compares lung cancer mortality between border and non-border counties by race/ethnicity and gender. METHODS This study utilized population-level death certificate data from US Centers for Disease Control and Prevention Public Internet Wide-Ranging Online Data for Epidemiologic Research dataset between 1999 and 2020. Established algorithms were implemented to examine lung cancer deaths among US residents. We analyzed the age-adjusted data by year, race/ethnicity, gender, and geographic region. Joinpoint regression was used to determine mortality trends across time. RESULTS Lung cancer mortality rates were lower in border counties compared to non-border counties across time (p < 0.05). Hispanic lung cancer mortality rates were not different in border counties compared to non-border counties during the same period (p > 0.05). Lung cancer mortality among non-Hispanic White living in border counties was lower than non-Hispanic White residing in non-border counties (p < 0.01), and non-Hispanic Black living in border counties had lower lung cancer mortality than non-Hispanic Black in non-border counties in all but three years (p < 0.05). Both female and male mortality rates were lower in border counties compared to non-border counties (p < 0.05). CONCLUSION Differences in lung cancer mortality between border counties and non-border counties reflect lower mortality in Hispanics overall and a decline for non-Hispanic White and non-Hispanic Black living in border counties experiencing lower lung cancer mortality rates than non-border counties. Further studies are needed to identify specific causes for lower mortality rates in border counties.
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Affiliation(s)
- Judith A Gutierrez
- Baylor College of Medicine, Family and Community Medicine Department, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA.
| | - Jacqueline M Hirth
- Baylor College of Medicine, Family and Community Medicine Department, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA
| | - Roger Zoorob
- Baylor College of Medicine, Family and Community Medicine Department, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA
| | - Robert S Levine
- Baylor College of Medicine, Family and Community Medicine Department, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA
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3
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Panakkal N, Lekshmi A, Saraswathy VV, Sujathan K. Effective lung cancer control: An unaccomplished challenge in cancer research. Cytojournal 2023; 20:16. [PMID: 37681073 PMCID: PMC10481856 DOI: 10.25259/cytojournal_36_2022] [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: 09/15/2022] [Accepted: 10/10/2022] [Indexed: 09/09/2023] Open
Abstract
Lung cancer has always been a burden to the society since its non-effective early detection and poor survival status. Different imaging modalities such as computed tomography scan have been practiced for lung cancer detection. This review focuses on the importance of sputum cytology for early lung cancer detection and biomarkers effective in sputum samples. Published articles were discussed in light of the potential of sputum cytology for lung cancer early detection and risk assessment across high-risk groups. Recent developments in sample processing techniques have documented a clear potential to improve or refine diagnosis beyond that achieved with conventional sputum cytology examination. The diagnostic potential of sputum cytology may be exploited better through the standardization and automation of sputum preparation and analysis for application in routine laboratory practices and clinical trials. The challenging aspects in sputum cytology as well as sputum-based molecular markers are to ensure appropriate standardization and validation of the processing techniques.
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Affiliation(s)
- Neeraja Panakkal
- Division of Cancer Research, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
- Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Asha Lekshmi
- Division of Cancer Research, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | | | - Kunjuraman Sujathan
- Division of Cancer Research, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Nguyen T, Shah G, Barefield AC. The Influence of E-cigarette Warning Labels on Youths' Use Intentions - A Mediation Analysis of Role of Perceived Harm. Subst Use Misuse 2023; 58:709-716. [PMID: 36861946 DOI: 10.1080/10826084.2023.2184205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Background: Electronic cigarettes (e-cigarettes) were introduced to the United States marketplace in 2007 and had dominated all other tobacco products used by youth by 2014. In May 2016, the Food and Drug Administration extended the final rule to include e-cigarettes in implementing text-based health warnings on cigarette packs and advertising, as required by the 2009 Tobacco Control Act. This study tested the hypothesis that youth's perceived harm of using e-cigarettes mediates the impact of seeing warning labels on their use intentions. Methods: We used a cross-sectional quantitative research design to analyze the 2019 National Youth Tobacco Survey data from 12,563 students in middle schools (grades 6 - 8) and high schools (grades 9 - 12) in the U.S. We conducted the 4-step Baron and Kenny Mediation Analysis using IBM SPSS® Hayes' PROCESS macro analysis. Results: Our study revealed a mediational process's presence, confirming the mediational role of youth's perceived harm of e-cigarettes on the relationship between seeing a warning label and their use intentions. Conclusion: This study provided insights into the relationship between seeing warning labels and the intention to use e-cigarettes among youth. Through the Tobacco Control Act, influential warning labels potentially increase youth's perception of harm in e-cigarettes, lowering their intention to use.
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Affiliation(s)
- Tran Nguyen
- College of Allied Health Sciences, Augusta University, Augusta, GA, USA
| | - Gulzar Shah
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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5
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Muresanu C, Khalchitsky S. Updated Understanding of the Causes of Cancer, and a New Theoretical Perspective of Combinational Cancer Therapies, a Hypothesis. DNA Cell Biol 2022; 41:342-355. [PMID: 35262416 DOI: 10.1089/dna.2021.1118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
We present an integrative understanding of cancer as a metabolic multifactorial, multistage disease. We focus on underlying genetics-environmental interactions, evidenced by telomere changes. A range of genetic and epigenetic factors, including physical agents and predisposing factors such as diet and lifestyle are included. We present a structured model of the causes of cancer, methods of investigations, approaches to cancer prevention, and polypharmaceutical multidisciplinary complex treatment within a framework of personalized medicine. We searched PubMed, National Cancer Institute online, and other databases for publications regarding causes of cancer, reports of novel mitochondrial reprogramming, epigenetic, and telomerase therapies and state-of-the-art investigations. We focused on multistep treatment protocols to enhance early detection of cancer, and elimination or neutralization of the causes and factors associated with cancer formation and progression.Our aim is to suggest a model therapeutic protocol that incorporates the patient's genome, metabolism, and immune system status; stage of tumor development; and comorbidity(ies), if any. Investigation and treatment of cancer is a challenge that requires further holistic studies that improve the quality of life and survival rates, but are most likely to aid prevention.
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Affiliation(s)
- Cristian Muresanu
- Research Center for Applied Biotechnology in Diagnosis and Molecular Therapies, Cluj-Napoca, Romania.,Department of Ecology, Taxonomy and Nature Conservation, Institute of Biology, Romanian Academy, Bucharest, Romania
| | - Sergei Khalchitsky
- H. Turner National Medical Research Center for Children's Orthopedics and Trauma Surgery of the Ministry of Health of the Russian Federation, Saint-Petersburg, Russia
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Miracolo A, Sophiea M, Mills M, Kanavos P. Sin taxes and their effect on consumption, revenue generation and health improvement: a systematic literature review in Latin America. Health Policy Plan 2021; 36:790-810. [PMID: 33885782 PMCID: PMC8173601 DOI: 10.1093/heapol/czaa168] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 11/14/2022] Open
Abstract
Sin or public health taxes are excise taxes imposed on the consumption of potentially harmful goods for health [sugar-sweetened beverages (SSBs), tobacco, alcohol, among others], aiming to reduce consumption, raise additional revenue and/or improve population health. This paper assesses the extent to which sin taxes (a) can reduce consumption of potentially harmful goods, (b) raise revenue for national health systems and (c) contribute to population health in Latin America. A systematic literature review was conducted on peer-reviewed and grey literature; endpoints included: impact of raising sin taxes on consumption, ability to raise revenue for health and the possibility of population health improvements. Risk of bias for each study was assessed. The synthesis of the literature on sin tax implementation showed improvements in all three endpoints across the study countries. Following the introduction of sin taxes or by simulating their potential impact, nearly all studies explicitly reported that consumption of potentially harmful goods (mainly SSBs and tobacco) declined; revenue was found to have increased in almost all countries, suggesting that there may be additional scope for further tax increase. Simulated improvements in population health have also been shown, by demonstrating a relationship between sin tax increases and reduction in prevalence of diabetes, stroke, heart attacks and associated deaths. However, sin tax effects on health would be better quantified over the long-term. Data quality and availability challenges did place some limitations on sin tax impact assessment. Sin taxes can be effective in reducing consumption of potentially harmful goods, improve population health and generate additional revenue. Promoting further research on this topic should be a priority.
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Affiliation(s)
- Aurelio Miracolo
- Department of Health Policy and Medical Technology Research Group - LSE Health, The London School of Economics and Political Science, Cowdrey House, Houghton Street, London WC2A 2AE, UK
| | - Marisa Sophiea
- Faculty of Medicine, School of Public Health, Imperial College, London, Medical School Building, St Mary's Hospital, Norfolk Place, London W2 1PG, UK
| | - Mackenzie Mills
- Department of Health Policy and Medical Technology Research Group - LSE Health, The London School of Economics and Political Science, Cowdrey House, Houghton Street, London WC2A 2AE, UK
| | - Panos Kanavos
- Department of Health Policy and Medical Technology Research Group - LSE Health, The London School of Economics and Political Science, Cowdrey House, Houghton Street, London WC2A 2AE, UK
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7
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Acosta-Deprez V, Jou J, London M, Ai M, Chu C, Cermak N, Kozlovich S. Tobacco Control as an LGBTQ+ Issue: Knowledge, Attitudes, and Recommendations from LGBTQ+ Community Leaders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5546. [PMID: 34067341 PMCID: PMC8196887 DOI: 10.3390/ijerph18115546] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 11/16/2022]
Abstract
Tobacco companies use price discounts, including coupons and rebates, to market their products. Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities are targeted by these marketing strategies, contributing to inequitably high tobacco use. Some localities have adopted policies restricting tobacco price discounts; for successful implementation, community buy-in is crucial. From July-October 2018, Equality California staff conducted semi-structured interviews with seven participants in Los Angeles, CA. Themes included familiarity with tobacco price discounts, their perceived impact on tobacco use in LGBTQ+ communities, and attitudes toward potential policy restrictions. Interview notes were analyzed using a deductive approach to qualitative analysis. Awareness of tobacco price discounts varied; some interviewees were familiar, while others expressed surprise at their ubiquity. Price discounts were seen to disproportionately impact LGBTQ+ individuals, especially those who additionally identify with other vulnerable groups, including young people and communities of color. Support for policy restrictions was unanimous; however, interviewees expressed concern over political opposition and emphasized a need for culturally competent outreach to LGBTQ+ communities. Community organizations are essential in mobilizing support for policy reform. Understanding the perceptions and recommendations of community leaders provides tools for policy action, likely improving outcomes to reduce LGBTQ+ tobacco use through restricting tobacco price discounts.
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Affiliation(s)
- Veronica Acosta-Deprez
- Department of Health Science, California State University, Long Beach, CA 90802, USA; (V.A.-D.); (J.J.); (N.C.)
| | - Judy Jou
- Department of Health Science, California State University, Long Beach, CA 90802, USA; (V.A.-D.); (J.J.); (N.C.)
| | - Marisa London
- OUT Against Big Tobacco Program, Equality California, Los Angeles, CA 90010, USA; (M.L.); (M.A.)
| | - Mike Ai
- OUT Against Big Tobacco Program, Equality California, Los Angeles, CA 90010, USA; (M.L.); (M.A.)
| | - Carolyn Chu
- Urban and Regional Planning Masters Program, University of California, Los Angeles, CA 90095, USA;
| | - Nhi Cermak
- Department of Health Science, California State University, Long Beach, CA 90802, USA; (V.A.-D.); (J.J.); (N.C.)
| | - Shannon Kozlovich
- Programs Department, Equality California, Los Angeles, CA 90010, USA
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8
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Santosh ABR, R. Collins J, Jones T, Brache M, Toro M, Tumanyan S, Walters C, White S, Elias-Boneta A. The SmoCar Study: A Caribbean-Based Multicenter Study on the Prevalence and Disparities Linked to Smoking and Gingival Health. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2020; 40:321-330. [DOI: 10.1177/0272684x19895901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of the SmoCar (Smoking in the Caribbean) study was to estimate the prevalence of smoking and the disparities in the smoking practices of three regions in the Caribbean: Jamaica, Dominican Republic, and Puerto Rico. The secondary objective was to assess the prevalence and severity of gingivitis in relation to the smoking practices. The study population comprised 1,847 (weighted N = 1,830) individuals (18 years and older) who were volunteer participants from the capitals of Jamaica, Dominican Republic, and Puerto Rico. A structured interview was used to assess the participants’ smoking behaviors. The gingival index was used to determine the extent of gingival inflammation. Polytomous regression was used to estimate the adjusted odds ratios (aORs) for smoking status (current, past, or never), according to risk factors (sex, age-group, education, marital status, tooth-brushing frequency, and city of residence). Logistic regression models were used to assess the associations between different smoking status variables and mild to moderate/severe gingivitis. The majority of the participants were never-smokers, with current smokers being found most commonly in Kingston (33.22%), followed by San Juan (12.76%) and Santo Domingo (8.8%). Both current (aOR = 2.22, 95% confidence interval [1.45, 3.40]) and past (aOR = 1.87, 95% confidence interval [1.19, 2.93]) smoking (vs. never smoking) was strongly associated with severe gingivitis. Smoking was the most prevalent in Jamaicans and the least prevalent in Dominicans. The study population of current smokers was found to have a fourfold increased risk of severe gingivitis and a twofold increased risk of moderate gingivitis.
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Affiliation(s)
| | - James R. Collins
- School of Dentistry, Pontificia Universidad Católica Madre y Maestra, Santo Domingo, Dominican Republic
| | - Thaon Jones
- University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Michael Brache
- School of Dentistry, Pontificia Universidad Católica Madre y Maestra, Santo Domingo, Dominican Republic
| | - Milagros Toro
- School of Dental Medicine, Universidad de Puerto Rico, San Juan, Puerto Rico
| | - Sona Tumanyan
- School of Dental Medicine, Universidad de Puerto Rico, San Juan, Puerto Rico
| | | | - Sharon White
- University of the West Indies, Mona Campus, Kingston, Jamaica
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Baxter NB, Chung KC. Navigating the Intersection of Evidence and Policy in Hand Surgery Practice. Hand Clin 2020; 36:123-129. [PMID: 32307041 DOI: 10.1016/j.hcl.2020.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Collaboration with organizations beyond the clinical setting is necessary to identify safety hazards that contribute to the high incidence and severity of hand conditions. Hand surgeons are acutely aware of obstacles patients face while navigating the health care system. Advocacy efforts encourage the development of equitable insurance policies and improve health resource allocation so that hand surgeons can treat a larger patient population. Participation in quality initiatives supports the development of evidence-based clinical guidelines. Further evidence must be generated to ensure that surgeons remain proficient in the latest techniques and uphold high standards of care as hand surgery procedures evolve.
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Affiliation(s)
- Natalie B Baxter
- Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Michigan Medicine, 1500 East Medical Center Drive, 2130 Taubman Center, Ann Arbor, MI 48109-5231, USA
| | - Kevin C Chung
- Section of Plastic Surgery, Michigan Medicine, 1500 East Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, MI 48109-5340, USA.
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10
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Rezaei N, Farzadfar F. Points to Consider Regarding Tobacco Hindrance. ARCHIVES OF IRANIAN MEDICINE 2020; 23:353-355. [PMID: 32383620 DOI: 10.34172/aim.2020.25] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 01/26/2020] [Indexed: 02/02/2023]
Affiliation(s)
- Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Domvri K, Porpodis K, Zisi P, Apostolopoulos A, Cheva A, Papamitsou T, Papakosta D, Kontakiotis T. Epidemiology of lung cancer in Northern Greece: An 18-year hospital-based cohort study focused on the differences between smokers and non-smokers. Tob Induc Dis 2020; 18:22. [PMID: 32265616 PMCID: PMC7132575 DOI: 10.18332/tid/118718] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/24/2020] [Accepted: 03/03/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Lung cancer remains a leading cause of cancer incidence, yet, in Greece, country-level registry-based data are limited. We have thus investigated the epidemiology of lung cancer and its trends in the George Papanikolaou Hospital, Northern Greece over 18 years (2000–2018). METHODS We analyzed all the cases reported in the Bronchoscopy Unit of the Hospital for the period 2000–2018. In total, 15131 subjects (12300 males and 2831 females) that presented with a mass in the imaging, were submitted to bronchoscopy. Characteristics of patients such as age, sex, smoking history and occupation were collected. Statistical analysis was performed with SPSS 21.0 software package. RESULTS Among all subjects, a total of 5628 (37.2%; mean age: 65.85 ± 9.6 years) cases of primary lung cancer were identified with a male to female ratio of 2:1 (41.1% to 20.4%) (p<0.001). Squamous cell lung cancer was the most common type of lung cancer identified in this population (44%) with a higher proportion in males compared to females (p<0.001). Furthermore, adenocarcinoma was mostly observed in female non-smokers compared to males (p<0.001). The majority of lung cancer cases were identified in patients occupied with agriculture and livestock breeding (41.1%). The mean age at lung cancer diagnosis was 66.13 ± 9.19 years for the whole study population. Lung cancer cases observed with a higher mean of 43.93 ± 10.84 years of smoking compared to cancer-free patients with 39.64 ± 13.23 years of smoking (p<0.001). CONCLUSIONS Apart from smoking, demographic characteristics including age, sex and occupation appear to have an impact on lung cancer development in this population. Smoking history alone could not predict the development of lung cancer in the studied northern Greek population.
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Affiliation(s)
- Kalliopi Domvri
- Department of Respiratory Medicine, Aristotle University of Thessaloniki, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Konstantinos Porpodis
- Department of Respiratory Medicine, Aristotle University of Thessaloniki, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Panagiota Zisi
- Department of Respiratory Medicine, Aristotle University of Thessaloniki, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Apostolos Apostolopoulos
- Department of Respiratory Medicine, Aristotle University of Thessaloniki, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Angeliki Cheva
- Laboratory of Pathology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodora Papamitsou
- Laboratory of Histology-Embryology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Despoina Papakosta
- Department of Respiratory Medicine, Aristotle University of Thessaloniki, George Papanikolaou Hospital, Thessaloniki, Greece
| | - Theodoros Kontakiotis
- Department of Respiratory Medicine, Aristotle University of Thessaloniki, George Papanikolaou Hospital, Thessaloniki, Greece
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Azagba S, Shan L, Manzione LC, Latham K, Rogers C, Qeadan F. Single cigarette purchasers among adult U.S. smokers. Prev Med Rep 2020; 17:101055. [PMID: 32021764 PMCID: PMC6994289 DOI: 10.1016/j.pmedr.2020.101055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/24/2019] [Accepted: 01/15/2020] [Indexed: 11/03/2022] Open
Abstract
Cigarette smoking remains the leading preventable cause of morbidity and mortality. The purchase of single cigarettes, known as loosies, allows for a more affordable cost than a pack of cigarettes. Many of the existing studies on loose cigarettes have used a small non-generalizable sample. This study examined the sociodemographic characteristics of loosie purchasers among adult cigarette smokers in the United States. Data from the 2006/07-2014/15 Tobacco Use Supplement to the Current Population Survey were analyzed. The sociodemographic characteristics of loosie users were examined by multivariable logistic regression. In 2014-2015, approximately 5.4% of adult smokers reported purchasing loosies compared to 3.7% in 2006-2007. Men (OR 1.22, 95% CI 1.10-1.35), non-Hispanic Blacks (OR 3.30, 95% CI 2.89-3.77), Hispanics (OR 1.97, 95% CI 1.67-2.32), and those living in a metropolitan area (OR 1.16, 95% CI 1.02-1.33) had significantly higher odds of single cigarette purchase. Single cigarette use also varied by age, marital status, employment, and geographic region. Menthol cigarette smokers had higher odds of purchasing loosies compared to non-menthol smokers. Likewise, cigarette quit intention was significantly associated with odds of buying loosies. The prevalence of single cigarette purchases among smokers appears to be lower in a national sample compared to previous estimates reported in specific populations. However, certain subpopulations were more likely to purchase a single cigarette and may contribute to persistent disparities among racial and ethnic minorities. Preventing the sale of loosies may improve the health outcomes of underserved communities, specifically those with low socioeconomic status.
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Affiliation(s)
- Sunday Azagba
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States
| | - Lingpeng Shan
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States
| | - Lauren C Manzione
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States
| | - Keely Latham
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States
| | - Charles Rogers
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States
| | - Fares Qeadan
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States
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Khalil C, Chahine JB, Chahla B, Hobeika T, Khnayzer RS. Characterization and cytotoxicity assessment of nargile smoke using dynamic exposure. Inhal Toxicol 2019; 31:343-356. [DOI: 10.1080/08958378.2019.1683104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Christian Khalil
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
- Institute of Environmental Studies, University of New South Wales (UNSW), Sydney, Australia
| | - Joe Braham Chahine
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Brenda Chahla
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Tamara Hobeika
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Rony S. Khnayzer
- Department of Natural Sciences, Lebanese American University, Chouran, Beirut, Lebanon
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14
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Shankar A, Saini D, Dubey A, Roy S, Bharati SJ, Singh N, Khanna M, Prasad CP, Singh M, Kumar S, Sirohi B, Seth T, Rinki M, Mohan A, Guleria R, Rath GK. Feasibility of lung cancer screening in developing countries: challenges, opportunities and way forward. Transl Lung Cancer Res 2019; 8:S106-S121. [PMID: 31211111 DOI: 10.21037/tlcr.2019.03.03] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Lung cancer is the leading cause of all cancer deaths worldwide, comprising 18.4% of all cancer deaths. Low-dose computed tomography (LDCT) has shown mortality benefit in various trials and now a standard tool for lung cancer screening. Most researches have been carried out in developed countries where lung cancer incidence and mortality is very high. There is an increasing trend in lung cancer incidence in developing countries attributed to tobacco smoking and various environmental and occupational risk factors. Implementation of lung cancer screening is challenging, so organised lung cancer screening is practically non-existent. There are numerous challenges in implementing such programs ranging from infrastructure, trained human resources, referral algorithm to cost and psychological trauma due to over-diagnosis. Pulmonary tuberculosis and other chest infections are important issues to be addressed while planning for lung cancer screening in developing countries. Burden of these diseases is very high and can lead to over-diagnosis in view of cut off of lung nodule size in various studies. Assessment of high risk cases for lung cancer is difficult as various forms of smoking make quantification non-uniform and difficult. Lung cancer screening targets only high risk population unlike screening programs for other cancers where entire population is targeted. There is a need of lung cancer screening for high risk cases as it saves life. Tobacco control and smoking cessation remain the most important long term intervention to decrease morbidity and mortality from lung cancer in developing countries. There is no sufficient evidence supporting the introduction of population-based screening for lung cancer in public health services.
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Affiliation(s)
- Abhishek Shankar
- Preventive Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Deepak Saini
- Indian Society of Clinical Oncology, Delhi, India
| | - Anusha Dubey
- Indian Society of Clinical Oncology, Delhi, India
| | - Shubham Roy
- Indian Society of Clinical Oncology, Delhi, India
| | - Sachidanand Jee Bharati
- Oncoanaesthesia and Palliative Medicine, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Navneet Singh
- Pulmonary Medicine, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | | | - Chandra Prakash Prasad
- Medical Oncology (Lab), Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Mayank Singh
- Medical Oncology (Lab), Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Sunil Kumar
- Surgical Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Bhawna Sirohi
- Medical Oncology, Max Institute of Cancer Care, Delhi, India
| | - Tulika Seth
- Clinical Hematology, All India Institute of Medical Sciences, Delhi, India
| | - Minakshi Rinki
- Biotechnology, Swami Shraddhanand College, Delhi University, Delhi, India
| | - Anant Mohan
- Pulmonary Medicine & Sleep Disorders, All India Institute of Medical Sciences, Delhi, India
| | - Randeep Guleria
- Pulmonary Medicine & Sleep Disorders, All India Institute of Medical Sciences, Delhi, India
| | - Goura Kishor Rath
- Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
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15
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Prasad S, Kaisar MA, Cucullo L. Unhealthy smokers: scopes for prophylactic intervention and clinical treatment. BMC Neurosci 2017; 18:70. [PMID: 28985714 PMCID: PMC5639581 DOI: 10.1186/s12868-017-0388-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/21/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Globally, tobacco use causes approximately 6 million deaths per year, and predictions report that with current trends; more than 8 million deaths are expected annually by 2030. Cigarette smokings is currently accountable for more than 480,000 deaths each year in United States (US) and is the leading cause of preventable death in the US. On average, smokers die 10 years earlier than nonsmokers and if smoking continues at its current proportion among adolescents, one in every 13 Americans aged 17 years or younger is expected to die prematurely from a smoking-related illness. Even though there has been a marginal smoking decline of around 5% in recent years (2005 vs 2015), smokers still account for 15% of the US adult population. What is also concerning is that 41,000 out of 480,000 deaths results from secondhand smoke (SHS) exposure. Herein, we provide a detailed review of health complications and major pathological mechanisms including mutation, inflammation, oxidative stress, and hemodynamic and plasma protein changes associated with chronic smoking. Further, we discuss prophylactic interventions and associated benefits and provide a rationale for the scope of clinical treatment. CONCLUSIONS Considering these premises, it is evident that much detailed translational and clinical studies are needed. Factors such as the length of smoking cessation for ex-smokers, the level of smoke exposure in case of SHS, pre-established health conditions, genetics (and epigenetics modification caused by chronic smoking) are few of the criteria that need to be evaluated to begin assessing the prophylactic and/or therapeutic impact of treatments aimed at chronic and former smokers (especially early stage ex-smokers) including those frequently subjected to second hand tobacco smoke exposure. Herein, we provide a detailed review of health complications and major pathological mechanisms including mutation, inflammation, oxidative stress, and hemodynamic and plasma protein changes associated with chronic smoking. Further, we discuss about prophylactic interventions and associated benefits and provide a rationale and scope for clinical treatment.
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Affiliation(s)
- Shikha Prasad
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, 60611, USA
| | - Mohammad Abul Kaisar
- Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, 1300 S. Coulter Street, Amarillo, TX, 79106, USA
| | - Luca Cucullo
- Department of Pharmaceutical Sciences, School of Pharmacy, Texas Tech University Health Sciences Center, 1300 S. Coulter Street, Amarillo, TX, 79106, USA. .,Center for Blood Brain Barrier Research, Texas Tech University Health Sciences Center, Amarillo, TX, 79106, USA.
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16
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Layoun N, Salameh P, Waked M, Aoun Bacha Z, Zeenny RM, El Hitti E, Godin I, Dramaix M. Motivation to quit smoking and acceptability of shocking warnings on cigarette packages in Lebanon. Patient Prefer Adherence 2017; 11:331-342. [PMID: 28280306 PMCID: PMC5338928 DOI: 10.2147/ppa.s122877] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Health warnings on tobacco packages have been considered an essential pillar in filling the gap of knowledge and communicating the health risks of tobacco use to consumers. Our primary objective was to report the perception of smokers on the textual health warnings already appearing on tobacco packages in Lebanon versus shocking pictures about the health-related smoking consequences and to evaluate their impact on smoking behaviors and motivation. METHODS A pilot cross-sectional study was undertaken between 2013 and 2015 in five hospitals in Lebanon. Participants answered a questionnaire inquiring about sociodemographic characteristics, chronic respiratory symptoms, smoking behavior and motivation to quit smoking. Only-text warning versus shocking pictures was shown to the smokers during the interview. RESULTS Exactly 66% of the participants reported that they thought shocking pictorial warnings would hypothetically be more effective tools to reduce/quit tobacco consumption compared to only textual warnings. Also, 31.9% of the smokers who were motivated to stop smoking reported that they actually had stopped smoking for at least 1 month secondary to the textual warnings effects. A higher motivation to quit cigarette smoking was seen among the following groups of smokers: males (odds ratio [OR] =1.8, P=0.02), who had stopped smoking for at least 1 month during the last year due to textual warning (OR =2.79, P<0.001), who considered it very important to report health warning on cigarette packs (OR =1.92, P=0.01), who had chronic expectoration (OR =1.81, P=0.06) and who would change their favorite cigarette pack if they found shocking images on the pack (OR =1.95, P=0.004). CONCLUSION Low-dependent smokers and highly motivated to quit smokers appeared to be more hypothetically susceptible to shocking pictorial warnings. Motivation to quit was associated with sensitivity to warnings, but not with the presence of all chronic respiratory symptoms.
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Affiliation(s)
- Nelly Layoun
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, UniversitéLibre de Bruxelles, Brussels, Belgium
- Doctoral School of Sciences and Technologies, Lebanese University, Beirut, Lebanon
- Correspondence: Nelly Layoun, Nada Bakhous Building, 1st floor, Dekwaneh, Mount Lebanon, Lebanon, Tel +961 03 520 362, Email
| | - Pascal Salameh
- Doctoral School of Sciences and Technologies, Lebanese University, Beirut, Lebanon
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Mirna Waked
- Department of Pulmonology, St George Hospital University Medical Center; Faculty of Medicine, Balamand University, Beirut, Lebanon
| | - Z Aoun Bacha
- Department of Pulmonary and Critical Care Medicine, Hotel-Dieu de France, Beirut, Lebanon
| | - Rony M Zeenny
- Pharmacy Practice Department, School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Eric El Hitti
- Department of Pulmonology, St George Hospital University Medical Center; Faculty of Medicine, Balamand University, Beirut, Lebanon
| | - Isabelle Godin
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, UniversitéLibre de Bruxelles, Brussels, Belgium
| | - Michèle Dramaix
- Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health, UniversitéLibre de Bruxelles, Brussels, Belgium
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17
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Warren GW, Cummings KM. Tobacco and lung cancer: risks, trends, and outcomes in patients with cancer. Am Soc Clin Oncol Educ Book 2015:359-64. [PMID: 23714547 DOI: 10.14694/edbook_am.2013.33.359] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Tobacco use, primarily associated with cigarette smoking, is the largest preventable cause of cancer mortality, responsible for approximately one-third of all cancer deaths. Approximately 85% of lung cancers result from smoking, with an additional fraction caused by secondhand smoke exposure in nonsmokers. The risk of lung cancer is dose dependent, but can be dramatically reduced with tobacco cessation, especially if the person discontinues smoking early in life. The increase in lung cancer incidence in different countries around in the world parallels changes in cigarette consumption. Lung cancer risks are not reduced by switching to filters or low-tar/low-nicotine cigarettes. In patients with cancer, continued tobacco use after diagnosis is associated with poor therapeutic outcomes including increased treatment-related toxicity, increased risk of second primary cancer, decreased quality of life, and decreased survival. Tobacco cessation in patients with cancer may improve cancer treatment outcomes, but cessation support is often not provided by oncologists. Reducing the health related effects of tobacco requires coordinated efforts to reduce exposure to tobacco, accurately assess tobacco use in clinical settings, and increase access to tobacco cessation support. Lung cancer screening and coordinated international tobacco control efforts offer the promise to dramatically reduce lung cancer mortality in the coming decades.
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Affiliation(s)
- Graham W Warren
- From the Department of Radiation Oncology, Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Department of Psychiatry and Behavioral Sciences, Hollings Cancer Center, Medical University of South Carolina, Charleston SC
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19
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Cummings KM, Proctor RN. The changing public image of smoking in the United States: 1964-2014. Cancer Epidemiol Biomarkers Prev 2014; 23:32-6. [PMID: 24420984 PMCID: PMC3894634 DOI: 10.1158/1055-9965.epi-13-0798] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Tobacco use behaviors in the U.S. have changed significantly over the past century. After a steep increase in cigarette use rates over the first half of the 20th century, adult smoking prevalence rates started declining from their peak reached in 1964. Improved understanding of the health risks of smoking has been aided by the U.S. Surgeon General's Reports, issued on a nearly annual basis starting in 1964. Among the many forces driving down smoking prevalence were the recognition of tobacco use as an addiction and cause of cancer, along with concerns about the ill effects of breathing secondhand smoke. These factors contributed to the declining social acceptance of smoking, especially with the advent of legal restrictions on smoking in public spaces, mass media counter-marketing campaigns, and higher taxes on cigarettes. This article reviews some of the forces that have helped change the public image of smoking, focusing on the 50 years since the 1964 Surgeon General's Report on smoking and health.
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Affiliation(s)
- K. Michael Cummings
- Department of Psychiatry & Behavioral Sciences Medical University of South Carolina
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20
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Boiselle PM, White CS. Current readings: computed tomography screening for lung cancer. Semin Thorac Cardiovasc Surg 2013; 25:323-7. [PMID: 24673962 DOI: 10.1053/j.semtcvs.2013.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2013] [Indexed: 11/11/2022]
Abstract
Computed tomography screening for lung cancer is rapidly transitioning from the research realm to the clinical arena, but important questions remain regarding the ideal selection criteria, the optimal frequency and duration of screening, and other factors. The purpose of this review is to familiarize readers with recently published articles that address computed tomography screening for lung cancer and other synergistic methods to reduce mortality among individuals with a history of tobacco use. In this review, we summarize the key points from each article and discuss the relevance of these findings for thoracic surgeons. The articles reviewed here add to the growing body of knowledge about screening and have the potential to help maximize the benefits of screening while minimizing the risks.
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Affiliation(s)
- Phillip M Boiselle
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
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