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Irshad HA, Jehanzeb H, Raja S, Saleem U, Shaikh WA, Shahzad A, Amirali A, Iqbal N, Khan JA. Heated tobacco products- well known or well understood? A national cross-sectional study on knowledge, attitudes and usage in Pakistan. BMC Public Health 2024; 24:1328. [PMID: 38755586 PMCID: PMC11100178 DOI: 10.1186/s12889-024-18825-y] [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: 01/11/2024] [Accepted: 05/10/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Heated tobacco products (HTPs) are reshaping the tobacco industry and just recently, a plan was sought to regularize HTPs in Pakistan. Pakistan provides an intriguing case study in this context, as tobacco use is deeply ingrained in public use. To ensure that future evidence-based policy recommendations are grounded in the public's knowledge, attitudes, and usage of HTPs, a nationwide survey must be conducted. METHODS A cross-sectional study was conducted using an online-based questionnaire nationwide in Pakistan. The questionnaire was validated and distributed through convenience sampling. The questionnaire assessed participants' knowledge, attitudes, and usage of HTPs. Descriptive statistics was used to describe participants' response and linear regression was performed at a p-value of < 0.05 using SPSS version 26. RESULTS In our sample of 1195 respondents (mean age of 33 years, 41.8% males and 58.2% females), 54.7% had previously heard about HTPs and 16.9% reported using HTPs at least once. Additionally, 38.24% were unsure of the legality of HTP use. Those with monthly household incomes of PKR 100,000 to 500,000, were more likely to have higher knowledge scores (OR:1.80[1.07-3.04]). On the other hand, males (OR:0.70 [0.55-0.89]) and respondents from Balochistan (OR:0.40 [0.22-0.71]) were more likely to have lower knowledge scores. The strongest motivators were the enjoyability of HTPs (55.73%) and usage as a cigarette alternative (54.64%), while the strongest deterrents were the negative health effects (82.68%) and potential for addiction (81.01%). CONCLUSION Our study underscores the need for awareness campaigns and interventions concerning HTPs, given prevalent preconceived notions and mixed attitudes among respondents. It was found that women and households with higher incomes scored higher on knowledge. Subjective enjoyment and a substitute for cigarettes were important motivators, but the most mentioned deterrents were the possibility of addiction and the detrimental effects on health. These insights form the basis for informed policy making for non-cigarette tobacco products.
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Affiliation(s)
| | - Hamzah Jehanzeb
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | - Sajjan Raja
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | - Umair Saleem
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | | | - Akmal Shahzad
- Medical College, Aga Khan University, Karachi, 74800, Pakistan
| | - Atiqa Amirali
- Jinnah Medical and Dental College, Karachi, 74800, Pakistan
| | - Nousheen Iqbal
- Jinnah Medical and Dental College, Karachi, 74800, Pakistan
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University Hospital, Karachi, 74800, Pakistan
| | - Javaid Ahmed Khan
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University Hospital, Karachi, 74800, Pakistan.
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Mujoo S, Alqahtani AS, Hamdi BA, Rajhi TJ, Ghazwani HH, Dubey A, Madi Hakami AK. Knowledge and Perception about Health Risks of Cigarette Smoking among Youngsters in Jazan Region, Saudi Arabia. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S308-S313. [PMID: 38595467 PMCID: PMC11001078 DOI: 10.4103/jpbs.jpbs_503_23] [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: 08/06/2023] [Revised: 08/16/2023] [Accepted: 08/29/2023] [Indexed: 04/11/2024] Open
Abstract
Context Cigarette smoking is a global public health concern, particularly in developing countries. Saudi Arabia has a high prevalence of smoking among young individuals, highlighting the need for interventions to address this issue. Aims This study aimed to evaluate the awareness, attitude, smoking rates, and perception of health risks among young individuals in the Jazan region of Saudi Arabia. The goal was to identify areas for improvement and develop effective strategies to combat smoking and promote healthier lifestyles. Methods and Materials A cross-sectional survey was conducted at the out-patient department of the College of Dentistry, Jazan University, over a 3-month period. A questionnaire consisting of 15 open-ended questions was administered to eligible patients. Statistical Analysis Used Statistical analysis was performed using the Chi-squared test with a P- value of <0.05. Results Out of 300 participants, the majority were males, university students, and non-smokers. Among smokers, electronic cigarettes were the most used form. Starting smoking with friends was a common trend. Females smoked fewer times per day compared to males. Participants expressed concerns about the damaging effects of smoking on health. Conclusions Targeted interventions and educational programs are needed to address smoking behaviors among young individuals in the Jazan region. Gender-specific interventions, family involvement, and promoting school connectedness are crucial in reducing smoking rates. Graphic health warnings on cigarette packs have the potential to improve knowledge and quitting intentions. Continued research and surveillance are necessary to inform evidence-based policies and interventions to combat youth smoking.
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Affiliation(s)
- Sheetal Mujoo
- Department of Maxillofacial, Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Ahmed Shaher Alqahtani
- Department of Maxillofacial, Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | | | | | - Alok Dubey
- Department of Preventive Dental, Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Naznin E, George J, Driezen P, Palazzi K, Wynne O, Nargis N, Fong GT, Bonevski B. Trend over time on knowledge of the health effects of cigarette smoking and smokeless tobacco use in Bangladesh: Findings from the International Tobacco Control Policy Evaluation Bangladesh Surveys. Drug Alcohol Rev 2023; 42:1838-1849. [PMID: 37565295 PMCID: PMC11031133 DOI: 10.1111/dar.13735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 07/04/2023] [Accepted: 07/26/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Cigarette smoking and smokeless tobacco (ST) use are prevalent in Bangladesh. This longitudinal study examined how knowledge of the health effects of smoking and ST use in Bangladesh has changed overtime with the country's acceleration of tobacco control efforts. METHODS Data were analysed from the International Tobacco Control Survey, a nationally representative longitudinal study of users and non-users of tobacco (aged 15 and older) in Bangladesh, across four waves conducted in 2009 (n = 4378), 2010 (n = 4359), 2012 (n = 4223) and 2015 (n = 4242). Generalised estimating equations assessed the level of knowledge about harms of tobacco use across four waves. Multivariable logistic regressions assessed whether knowledge of health effects from cigarette smoking and ST use in 2015 differed by user group. RESULTS In 2015 survey, most tobacco users were aware that cigarette smoking causes stroke (92%), lung cancer (97%), pulmonary tuberculosis (97%) and ST use causes mouth cancer (97%) and difficulty in opening mouth (80%). There were significant increases in the total knowledge score of smoking related health harm from 2010 to 2012 (mean difference = 0.640; 95% confidence interval [CI] 0.537, 0.742) and 2012 to 2015 (mean difference = 0.555; 95% CI 0.465, 0.645). Participants had greater odds of awareness for ST health effects from 2010 to 2015. DISCUSSION AND CONCLUSIONS The results suggest that increasing efforts of awareness policy interventions is having a positive effect on tobacco-related knowledge in Bangladesh. These policy initiatives should be continued to identify optimal methods to facilitate behaviour change and improve cessation of smoking and ST use.
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Affiliation(s)
- Eva Naznin
- Research higher degree, School of Medicine and Public Health, The University of Newcastle, University Drive Callaghan, NSW 2308, Australia
| | - Johnson George
- Senior lecturer, Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
| | - Pete Driezen
- Research Assistant Professor, Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Kerrin Palazzi
- Senior Statistician, Hunter Medical Research Institute (HMRI), Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Olivia Wynne
- Health Research Economist, Hunter Medical Research Institute (HMRI), Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Nigar Nargis
- Senior Scientific Director, Surveillance and Healthy Equity Science. American Cancer Society, 555 11th Street NW suite 300, Washington DC, 20004
| | - Geoffrey T. Fong
- Professor, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Billie Bonevski
- Professor and Lead of Public Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, Adelaide 5042, Australia
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Yang Y, Xu R, Yang M, Xu Q, Miao C, Guo J, Mou W, Du H, Wei G, Hu L, Hu Z. Characterization of bacterial community in tobacco leaves at flue-curing and redrying processing stages. Sci Rep 2023; 13:13333. [PMID: 37587237 PMCID: PMC10432385 DOI: 10.1038/s41598-023-40502-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/11/2023] [Indexed: 08/18/2023] Open
Abstract
During the processing of tobacco leaves, flue-curing and redrying can affect the structure of bacterial community, having an effect on the aging quality of tobacco leaves. In order to characterize the effects of flue-curing and redrying on the bacterial community of tobacco leaves, the bacterial community of samples at different processing stages (before flue-curing, after flue-curing, before redrying and after redrying) was analyzed using Illumina sequencing. A total of 33 phyla, 79 classes, 195 orders, 344 families, 826 genera and 7922 ASVs were obtained from 36 samples. There was no significant difference in the core bacterial groups of tobacco leaf at four processing stages. Proteobacteria dominated at the phylum level. Sphingomonas, Pseudomonas and Methylobacterium were the main genera shared by all samples. The functional prediction by PICRUSt showed an increase in the relative abundance of pathway related to metabolism after flue-curing and pathway related to environmental information processing after redrying. This study, we analyzed the changes of bacterial community and structural composition of tobacco leaves from flue-curing to redrying, and found that flue-curing had a greater effect on the microbial community than redrying. This is conducive for the exploration of microbial resources and improvement of tobacco leaf quality.
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Affiliation(s)
- Yue Yang
- China Tobacco Jiangsu Industrial Co., Ltd., Nanjing, 210000, Jiangsu, China
| | - Ruyan Xu
- China Tobacco Jiangsu Industrial Co., Ltd., Nanjing, 210000, Jiangsu, China
| | - Mengmeng Yang
- Zhengzhou Tobacco Research Institute of CNTC, Zhengzhou, 450001, Henan, China
| | - Qiang Xu
- China Tobacco Jiangsu Industrial Co., Ltd., Nanjing, 210000, Jiangsu, China
| | - Chenlin Miao
- China Tobacco Jiangsu Industrial Co., Ltd., Nanjing, 210000, Jiangsu, China
| | - Jianhua Guo
- Zhengzhou Tobacco Research Institute of CNTC, Zhengzhou, 450001, Henan, China
| | - Wenjun Mou
- Zhengzhou Tobacco Research Institute of CNTC, Zhengzhou, 450001, Henan, China
| | - Hang Du
- China Tobacco Jiangsu Industrial Co., Ltd., Nanjing, 210000, Jiangsu, China
| | - Gang Wei
- China Tobacco Jiangsu Industrial Co., Ltd., Nanjing, 210000, Jiangsu, China
| | - Liwei Hu
- Zhengzhou Tobacco Research Institute of CNTC, Zhengzhou, 450001, Henan, China.
| | - Zongyu Hu
- China Tobacco Jiangsu Industrial Co., Ltd., Nanjing, 210000, Jiangsu, China.
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Prevalence of Use and Knowledge about Tobacco Products and Their Harmful Effects among University Students in Southern Croatia. Healthcare (Basel) 2023; 11:healthcare11050771. [PMID: 36900776 PMCID: PMC10001000 DOI: 10.3390/healthcare11050771] [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: 11/18/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Understanding students' attitudes toward smoking and tobacco products is essential for effective smoking prevention interventions. This questionnaire-based cross-sectional survey aims to determine the prevalence of use and knowledge about cigarettes, heated tobacco products, and electronic cigarettes and their harmful effects among university students. The survey was conducted using a self-administered online questionnaire among 1184 students. Questions were related to the respondents' demographic characteristics, tobacco use patterns, and opinions about exposure to health warnings and tobacco product advertising messages. Data were analyzed using descriptive statistics and generalized linear regression analysis. The results showed that 30.2% of the students use tobacco products (74.5% smoked conventional cigarettes; 7.9% used electronic cigarettes; and 17.6% used heated tobacco products). The median (interquartile range) score of the students' knowledge (maximum = 27) was 16 (12-22). The results showed that students from technical, social, humanities, natural, and biotechnology scientific programs had lower levels of knowledge about tobacco products and their harmful effects than biomedical students (p ≤ 0.001). In addition, past and current use of tobacco products was significantly associated with higher overall knowledge of tobacco products and their harmful effects (adjusted odds ratio (OR) 1.90, % confidence interval (CI) 1.09-3.31, p = 0.023; OR 1.41, CI 1.08-1.84, p = 0.011). The research findings confirm the lack of knowledge and misconceptions about the harmful effects associated with tobacco product use. They also emphasize the need for better prevention and awareness of the harmful effects of smoking on human health.
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Nian Q, Hardesty JJ, Cohen JE, Xie X, Kennedy RD. Perceived effectiveness of four different cigarette health warning label themes among a sample of urban smokers and non-smokers in China. Tob Control 2023; 32:205-210. [PMID: 34400570 PMCID: PMC9985749 DOI: 10.1136/tobaccocontrol-2021-056703] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/22/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study, conducted in China, evaluated the effectiveness of four different themes of health warning labels (HWLs) that used both text and pictures: (1) self-harm from using cigarettes, (2) harming family or children with secondhand smoke, (3) reinforcing compliance with existing smoke-free policies and (4) anticigarette gift giving practices. METHODS A cross-sectional randomised experimental survey was conducted among 3247 adult (aged 18+ years) participants in Beijing, Shanghai and Shenzhen in 2017, using quotas for age group, gender and smoking status. Participants were randomly assigned to one of the four HWL themes. Each participant viewed eight HWLs and rated how effective these themed-labels were in terms of credibility, raising awareness of health harms of smoking on family and children, improving compliance with public smoking bans, stopping the practice of gifting cigarettes, thinking about quitting and preventing smoking using a 10-point scale, with 10 being most effective. Analysis of variance and independent t-tests were used to analyse these data. FINDINGS All four HWL themes performed well for each outcome with average ratings >6.5. Harming family or children with secondhand smoke was the theme that received the highest ratings for each outcome, with credibility (8.0, 95% CI 7.86 to 8.09) and prevention of smoking (8.8, 95% CI 8.63 to 8.91) outcomes being significantly higher (p<0.05). Overall, analysis of ratings by gender, income and education did not impact outcomes. CONCLUSION All four HWL themes tested could be effective in China; the theme of secondhand smoke harming family or children may be a particularly credible/effective theme.
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Affiliation(s)
- Qinghua Nian
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jeffrey J Hardesty
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Ryan David Kennedy
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Hosseini Z, Jafari M, Homayuni A, Rafati S, Nikparvar M. Differences between smokers and non-smokers in personality traits: the role of sensation seeking and core self-evaluations. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2144501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Zahra Hosseini
- Health Education and Health Promotion, Tobacco and Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammad Jafari
- Health Education and Health Promotion, School of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Atefeh Homayuni
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shideh Rafati
- Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Marzieh Nikparvar
- Cardiology, Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Gao X, Shen F, Li S, Zhang R, Jiang W, Li B, Wang R. The estimated influence of assumed physicians' advice for tobacco smoking cessation among current smokers in Shanghai, China: A cross-sectional study. Tob Induc Dis 2022; 20:86. [PMID: 36317058 PMCID: PMC9574849 DOI: 10.18332/tid/153508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/27/2022] [Accepted: 09/05/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Evidence indicates that physicians' smoking cessation advice is significant for tobacco control, which is an impetus to encourage smoking cessation among smokers, but the estimated influence of physicians' smoking cessation advice on smokers' intention to quit is limited in Shanghai, China. METHODS We enrolled 1104 participants who were current smokers in the SJ (Songjiang) and FX (Fengxian) districts in Shanghai in 2021. An electronic questionnaire was used to collect data and SAS 9.4 was used for data analysis. Univariate and multivariate logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to estimate the influence of the assumed physicians' advice for smoking cessation on current smokers' smoking cessation plan. RESULTS A total of 1104 participants provided information of which 914 were male smokers (82.8%) and 190 (17.2%) were female smokers. Multivariate logistic regression demonstrated that female smokers (OR=2.47; 95% CI: 1.66-3.68), smokers with at least 1 type of non-communicable disease (OR=2.09; 95% CI: 1.42-3.07), smoking intensity <20 cigarettes/day (OR=1.64; 95% CI: 1.22-2.17), with personal tobacco burden less than 20% (OR=1.52; 95% CI: 1.10-2.13), exposed to secondhand smoke (OR=1.99; 95% CI:1.44-2.76), and previous smoking cessation attempt (OR=4.43; 95% CI: 3.23-6.08), were more likely to report an intent to quit smoking. Moreover, approximately 50% of participants without a plan to quit in a year had also reported their intention to quit smoking with the presumption that the physicians would advise them to quit, irrespective of their sex, age, NCD status and secondhand tobacco smoke exposure. CONCLUSIONS Physicians' cessation advice could promote smokers to consider stopping smoking. The reported cessation intention was higher among female smokers, and smokers with NCD, lower smoking intensity and burden, with smoking cessation attempts, all of which could be incorporated into the implementation of tobacco control measures in the future in Shanghai.
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Affiliation(s)
- Xiangjin Gao
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China,School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fanlingzi Shen
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China,School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Siyuan Li
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China,School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rui Zhang
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Wencheng Jiang
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Bin Li
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Ruiping Wang
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China,School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Sakboonyarat B, Rangsin R, Mittleman MA. Incidence and risk factors of metabolic syndrome among Royal Thai Army personnel. Sci Rep 2022; 12:15692. [PMID: 36127360 PMCID: PMC9489720 DOI: 10.1038/s41598-022-19024-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/23/2022] [Indexed: 11/14/2022] Open
Abstract
Metabolic Syndrome is a clustering of obesity, hyperglycemia/insulin resistance, dyslipidemia, and hypertension. We aimed to determine the incidence of metabolic syndrome among Royal Thai Army (RTA) personnel and its risk factors. We conducted a retrospective cohort study using data from 2017 to 2021. Metabolic syndrome was defined by NCEP ATP III (2005 Revision). A total of 98,264 participants were enrolled in the present study. The overall incidence rate of metabolic syndrome was 3.7 per 100 person-year (95% CI 3.7–3.8). The statistically significant risk factors for metabolic syndrome included male sex (aHR 1.40; 95% CI 1.29–1.51), age > 35 years, current alcohol consumption, and no exercise. When stratified by sex, the incidence rate of metabolic syndrome among participants aged ≥ 45 years was higher than those aged < 35 years with aHR 6.34; 95% CI 6.01–6.70 for males and aHR 9.59; 95% CI 7.55–12.19 for females. Our data demonstrated that metabolic syndrome is a common health issue, especially among RTA personnel over 35 years. Alcohol consumption and sedentary behavior played an essential role in facilitating metabolic syndrome in this study population and are potential targets for intervention to enhance primary prevention of the sequelae of metabolic syndrome.
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Affiliation(s)
- Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Murray A Mittleman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
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Kwok KO, Li KK, Leung CLK, Tang A, Chan EYY, Tsoi MTF, Wei WI, McNeil EB, Wong SYS. The way forward to achieve high COVID-19 vaccination and revaccination coverage in a city amid a period of tranquility. Front Public Health 2022; 10:935243. [PMID: 36187671 PMCID: PMC9515959 DOI: 10.3389/fpubh.2022.935243] [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: 05/03/2022] [Accepted: 08/12/2022] [Indexed: 01/25/2023] Open
Abstract
Background Amid the current COVID-19 pandemic, there is an urgent need for both vaccination and revaccination ("boosting"). This study aims to identify factors associated with the intention to receive a booster dose of the coronavirus (COVID-19) vaccine among individuals vaccinated with two doses and characterize their profiles in Hong Kong, a city with a low COVID-19 incidence in the initial epidemic waves. Among the unvaccinated, vaccination intention is also explored and their profiles are investigated. Methods From December 2021 - January 2022, an online survey was employed to recruit 856 Hong Kong residents aged 18 years or over from an established population-based cohort. Latent class analysis and multivariate logistic regression modeling approaches were used to characterize boosting intentions. Results Of 638 (74.5%) vaccinated among 856 eligible subjects, 42.2% intended to receive the booster dose. Four distinct profiles emerged with believers having the highest intention, followed by apathetics, fence-sitters and skeptics. Believers were older and more likely to have been vaccinated against influenza. Older age, smoking, experiencing no adverse effects from a previous COVID-19 vaccination, greater confidence in vaccines and collective responsibility, and fewer barriers in accessing vaccination services were associated with higher intentions to receive the booster dose. Of 218 unvaccinated, most were fence-sitters followed by apathetics, skeptics, and believers. Conclusion This study foretells the booster intended uptake lagging initial vaccination across different age groups and can help refine the current or future booster vaccination campaign. Given the fourth COVID-19 vaccine dose may be offered to all adults, strategies for improving boosting uptake include policies targeting young adults, individuals who experienced adverse effects from previous doses, fence-sitters, apathetics, and the general public with low trust in the health authorities.
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Affiliation(s)
- Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China,Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China,Hong Kong Institute of Asia-Pacific Studies, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China,Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China,*Correspondence: Kin On Kwok
| | - Kin Kit Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Cyrus Lap Kwan Leung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Arthur Tang
- College of Computing and Informatics, Sungkyunkwan University, Seoul, South Korea
| | - Emily Ying Yang Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China,Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, Hong Kong, China,Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom,GX Foundation, Hong Kong, China,Accident & Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Margaret Ting Fong Tsoi
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Wan In Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Edward B. McNeil
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
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Wang Q. Smoking Outcome Expectancies in Chinese Young Adults. J Psychoactive Drugs 2022:1-12. [PMID: 35848499 DOI: 10.1080/02791072.2022.2101405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The aims of this study were to: 1) validate the factor structure of the short-form smoking consequences questionnaire (S-SCQ) in Chinese young adults; 2) assess measurement invariance of the S-SCQ across smokers and never-smokers; 3) examine factors of the S-SCQ in relation to smoking-related variables. Data from 1,540 respondents (757 smokers, 783 never-smokers) were collected anonymously via an online survey in June, 2021. All respondents completed the S-SCQ and other smoking-related items. Confirmatory factor analysis (CFA) was conducted to validate the factor structure of S-SCQ. Measurement invariance of the S-SCQ was examined across smoking status. Relations between outcome expectancies and other smoking-related variables were further examined. CFA results supported the four-factor structure of the S-SCQ. Measurement invariance tests supported configural, metric, partial scalar, and strict invariance of the S-SCQ across smoking status. Never-smokers exposed to household SHS or intending to smoke had weight control and reinforcement expectancies. Smokers exposed to moderate household SHS or scored higher on the FTND had greater positive reinforcement expectancies. For never-smokers, household SHS exposure and future smoking intentions may be key constructs to target in smoking prevention efforts. For smokers, smoking-induced sensory satisfaction may be a key construct to transform in expectancy-based interventions.
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Affiliation(s)
- Qian Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Minhang, SH, China
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Tran TPT, Park J, Nguyen TNP, Hoang VM, Lim MK. Association between perceived harm of tobacco and intention to quit: a cross-sectional analysis of the Vietnam Global Adult Tobacco Survey. BMC Public Health 2022; 22:909. [PMID: 35524326 PMCID: PMC9077992 DOI: 10.1186/s12889-022-13348-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perception of harm plays an important role in predicting intention to quit-an integral part of the cessation process. Perception on harm from bamboo waterpipe tobacco was unknown, even the predominant of this type of tobacco use. This study investigated the effects of perceived harm from cigarette and bamboo waterpipe tobacco on intention to quit among adult male Vietnamese tobacco users. METHODS From the nationally-representative 2015 Global Adult Tobacco Survey, we included 1,351 adult males (≥ 18 years old) who used cigarettes, bamboo waterpipes, or both. Demographic characteristics, tobacco use behaviors, perceived harm from tobacco use, and regulation/policy exposure were measured. Effects of perceived harm from cigarette and bamboo waterpipe tobacco on intention to quit were assessed by logistic regression. RESULTS Intention to quit prevalence was 59.0%, 55.0%, and 58.4% for cigarette, waterpipe, and dual users, respectively. Tobacco users who perceived that "using cigarettes and/or waterpipe could cause severe illness" and "waterpipe use is less harmful than cigarette smoking", had tobacco use bans at home, or were exposed to anti-smoking campaigns or encouragement to quit information were more likely to intend to quit. When analyzed by tobacco users, intention to quit was more likely for those users who perceived their tobacco product as more harmful than the other product type, although statistical significance was only observed for cigarette users. CONCLUSIONS Misperceptions regarding harm from tobacco use could negatively affect intention to quit. Dissemination of accurate information on the risks from all forms of tobacco use and enforcement of tobacco control policies are important for encouraging intention to quit.
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Affiliation(s)
- Thi Phuong Thao Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro Ilsandong-gu, Goyang-si, Gyeounggi-do, 410-769, Republic of Korea
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Jinju Park
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro Ilsandong-gu, Goyang-si, Gyeounggi-do, 410-769, Republic of Korea
| | - Thi Ngoc Phuong Nguyen
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Van Minh Hoang
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Min Kyung Lim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro Ilsandong-gu, Goyang-si, Gyeounggi-do, 410-769, Republic of Korea.
- College of Medicine, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, Republic of Korea.
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13
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McLeary JG, Walcott G, Abel W, Mitchell G, Lalwani K. Prevalence, perceived risk and associated factors of tobacco use amongst young, middle-aged and older adults: analysis of a national survey in Jamaica. Pan Afr Med J 2022; 43:185. [PMID: 36915416 PMCID: PMC10007706 DOI: 10.11604/pamj.2022.43.185.36517] [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: 07/26/2022] [Accepted: 10/17/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction tobacco smoking remains a significant threat to public health. This paper sought to examine the prevalence, perceived risk and the associated factors of current tobacco use amongst Jamaican adults. Methods this study is a secondary data analysis of the Jamaican National Household Survey 2016. The data for this study was extracted from a pre-coded questionnaire using a standardized extraction sheet. Adults were categorized into young adults (18-35), Middle-aged adults (36-55) and Older adults (56 and older) groups. Statistical analysis was performed to determine the prevalence, perceived risk and associated factors of tobacco use among Jamaican adults. Results young adults had the lowest lifetime prevalence of tobacco smoking at 23% yet the highest percentage of current users at 48.3% (p=0.000), with gender being the only significant associated factor. Males were 2.565 times more likely to be current tobacco users than females (p < 0.01). In middle-aged adults, and older adults the highest predictive factor was risk perception. Current tobacco use was 3.375 times higher in middle-aged adults (p=0.044) and 2.815 times higher in older adults with low risk perception (p=0.025). Conclusion four out of 10 Jamaican adult tobacco users are current users. Young adults had significantly fewer mitigating factors to tobacco usage despite being the most prevalent group for current use. Significantly, perception of risk impacted current usage in middle-aged and older adults but not in younger adults. Innovative and targeted approaches are needed in young adults such as incorporating the health and wellness promotion model with tobacco emphasis.
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Affiliation(s)
- Joni-Gaye McLeary
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Jamaica
| | - Geoffrey Walcott
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Jamaica
| | - Wendel Abel
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Jamaica
| | - Gabrielle Mitchell
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Jamaica
| | - Kunal Lalwani
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Jamaica
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14
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He T, Liu L, Huang J, Li G, Guo X. Health Knowledge about Smoking, Role of Doctors, and Self-Perceived Health: A Cross-Sectional Study on Smokers' Intentions to Quit. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073629. [PMID: 33807331 PMCID: PMC8037039 DOI: 10.3390/ijerph18073629] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 01/04/2023]
Abstract
Limited empirical work has been done to compare the effects that health knowledge and advice from doctors have on smokers’ intentions to quit. This paper examines the association of smokers’ intentions to quit with health knowledge, advice from doctors, and self-perceived health. A sample of 2509 smokers aged 15–69 years old in Ningbo was used from China’s National Health Literacy Surveillance survey, conducted in 2018 and 2019. Respondents were asked whether they agree smoking causes stroke, heart attack, lung cancer; and heart diseases in adults, lung illnesses in children, and lung cancer in adults, by secondhand smoke, respectively. Using the logistic model, we found that knowing that smoking causes stroke and lung cancer more than doubles the odds of one’s intention to quit (OR = 2.705, p < 0.01), the effect of which is much greater than knowing that smoking causes lung cancer only (OR = 1.795, p < 0.01). Doctors’ advice to quit is more important than health knowledge, in terms of predicting smokers’ past cessation behaviours. In addition, smokers’ self-perceived health is negatively associated with their decisions to quit. This paper highlights that more resources should be directed towards training health care providers to advise smokers to quit, which might be more effective than health education alone.
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Affiliation(s)
- Tianfeng He
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, 38 Xueyuan Road, Beijing 100191, China; (T.H.); (J.H.); (G.L.)
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China
| | - Lefan Liu
- Center for Health Economics, School of Economics, University of Nottingham Ningbo China, Ningbo 315100, China;
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, 38 Xueyuan Road, Beijing 100191, China; (T.H.); (J.H.); (G.L.)
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, 38 Xueyuan Road, Beijing 100191, China; (T.H.); (J.H.); (G.L.)
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, 38 Xueyuan Road, Beijing 100191, China; (T.H.); (J.H.); (G.L.)
- Correspondence: ; Tel.: +86-10-82801062
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15
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Tregobov N, Poureslami I, Shum J, Aran N, McMillan A, FitzGerald JM. Assessing factors influencing smoking and smoking cessation within Chinese communities in the Greater Vancouver Area: A qualitative exploratory study. Tob Prev Cessat 2020; 6:57. [PMID: 33163703 PMCID: PMC7643582 DOI: 10.18332/tpc/126631] [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: 05/04/2020] [Revised: 08/14/2020] [Accepted: 08/21/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The prevalence of smoking is high within Chinese-Canadian communities and there is a lack of culturally and linguistically appropriate smoking cessation resources and services. We aimed to ascertain factors affecting smoking and smoking cessation from the perspectives of current smokers and key informants. METHODS As part of a multistage mixed-methods study taking place from January 2013 to June 2014, a qualitative exploratory study design was conducted applying a community-based participatory research approach. Focus groups and interviews were conducted with adult (aged ≥19 years) Chinese-Canadian current smokers (≥5 cigarettes per day for the past 30 days) and interviews were held with key informants in Vancouver, Canada. A constant comparison method was applied to code data, and an inductive approach was used to identify emergent themes. RESULTS In all, 35 smokers from the target communities (11 female, 24 male) participated in 4 focus group sessions and 17 key informants (14 female, 3 male) were individually interviewed. Internal and external factors influencing smoking onset, continuation, and cessation from the perspectives of smokers and key informants were identified. Male smokers thought that the most influential factor influencing smoking initiation was social pressure, while female smokers thought that it was stress. Female smokers reported refraining from seeking cessation assistance due to a perceived negative image of female smokers within the community. Both key informants and participants indicated that involving friends and family in the quitting process may help to motivate smokers. CONCLUSIONS Smokers from Chinese-Canadian communities may benefit from linguistically appropriate and culturally relevant smoking cessation interventions that consider prevailing attitudes, perceptions, and beliefs. The knowledge gained may inform the development of future smoking cessation programs and resources for the target community, while our approach may be applicable to other ethnocultural or immigrant communities.
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Affiliation(s)
- Noah Tregobov
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada.,Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Iraj Poureslami
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
| | - Jessica Shum
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
| | - Niloufar Aran
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
| | - Austin McMillan
- Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - J Mark FitzGerald
- Division of Respiratory Medicine, Centre for Heart and Lung Health, Vancouver Coastal Health Research Institute, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.,Gordon and Leslie Diamond Health Care Centre, Vancouver General Hospital, University of British Columbia Hospital, Vancouver, Canada
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16
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Farah R, Haddad C, Sacre H, Hallit S, Salameh P. Knowledge and attitude toward waterpipe smoking: scale validation and correlates in the Lebanese adult population. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:31250-31258. [PMID: 32483715 DOI: 10.1007/s11356-020-09425-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 05/22/2020] [Indexed: 05/21/2023]
Abstract
The World Health Organization declared waterpipe smoking as a growing public health concern. Our study aimed to assess waterpipe smoking knowledge and attitude among current waterpipe smokers in comparison with nonsmokers and to evaluate its association with current and cumulative waterpipe smoking. A cross-sectional study was carried between May and December 2018 using a multistage cluster sample across Lebanon. Nonsmokers or exclusive current waterpipe smokers were eligible to participate. A total of 4046 adult individuals participated in the study, 38.3% (n = 1550) being current waterpipe smokers. Current waterpipe smoking was positively associated with female gender [adjusted odds ratio (aOR) 1.79, 95%CI 1.40-2.28] and having a mother who is a regular smoker (aOR 1.47, 95%CI 1.15-1.88) while it was negatively associated with better knowledge about waterpipe smoking harm (aOR 0.95, 95%CI 0.93-0.97) and positive attitude toward waterpipe smoking ban (aOR 0.98, 95%CI 0.96-0.99). Cumulative waterpipe smoking was negatively associated with female gender (β = - 0.012), higher education level (β = - 0.28), and positive attitude toward WPS ban (β = - 0.06). Waterpipe smoking is largely present among the Lebanese population, with waterpipe smokers showing lower knowledge about harm and more intolerant attitude about banning. Health awareness supported by media campaigns and governmental initiatives should be conducted to educate people and change their perceptions regarding waterpipe smoking.
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Affiliation(s)
- Rita Farah
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- INSERM, Univ. Limoges, CHU Esquirol, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
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17
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Inadequate Knowledge, Attitude and Practices about Second-Hand Smoke among Non-Smoking Pregnant Women in Urban Vietnam: The Need for Health Literacy Reinforcement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103744. [PMID: 32466270 PMCID: PMC7277525 DOI: 10.3390/ijerph17103744] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 01/29/2023]
Abstract
The rate of exposure to second-hand smoke (SHS) is relatively high in several countries, including Vietnam, and health issues related to SHS have worsened in recent years, especially for pregnant women and their infants. Enhancement of knowledge, attitude, and practice (KAP) scores of pregnant women in Vietnam could raise practical interventions to protect their health and reduce complications of SHS. A cross-sectional study of 432 pregnant women who came to the Obstetrics Department of Bach Mai Hospital, Hanoi, Vietnam for antenatal care was conducted in 2016 to collect information about their KAP related to SHS. Composite mean scores from survey questions assessing their KAP were calculated on a 10-point scale, finding mean scores of 4.19, 7.45, and 4.30, respectively. Higher scores indicated better knowledge, attitude, and practice. Generalized linear models identified that age, occupation, living place, and sources of information were associated with SHS-related KAP. Findings from this study indicate that suitable programs related to SHS should be implemented to improve and reinforce health literacy to both mothers and smokers to reduce the harmfulness of smoking on women and their infants' health.
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18
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van Mourik DJA, Nagelhout GE, Willemsen MC, van den Putte B, de Vries H. Differences in smokers' awareness of the health risks of smoking before and after introducing pictorial tobacco health warnings: findings from the 2012-2017 international tobacco control (ITC) Netherlands surveys. BMC Public Health 2020; 20:512. [PMID: 32381050 PMCID: PMC7206780 DOI: 10.1186/s12889-020-08667-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 04/06/2020] [Indexed: 11/23/2022] Open
Abstract
Background As of May 2016, pictorial health warnings (PHWs) showing the harms of smoking were implemented in the European Union. After one year they had to be fully implemented. We studied changes in awareness of the health risks of smoking after implementation of PHWs among smokers from the Netherlands, whether the trend before the implementation changed after the implementation, and whether there were differences between subgroups. Methods We used survey data from six yearly waves of the International Tobacco Control (ITC) Netherlands Survey from 2012 to 2017. The number of participating smokers ranged between 1236 and 1604 per wave. Data were analyzed using Generalized Estimating Equations (GEE) analyses. Results Indicators of awareness of the health risks of smoking that did not change between 2015 and 2017 were perceived susceptibility (β = 0.043, p = 0.059) and perceived severity (β = − 0.006, p = 0.679) regarding lung problems. Perceived susceptibility, however, was more pronounced between 2015 and 2017 than between 2012 and 2015(p value of interaction: p = 0.044). Noticing information about the dangers of smoking (β = 0.119, p < 0.001) and knowledge about the health risks of smoking (β = 0.184, p < 0.001) increased between 2015 and 2017. These increases were both more pronounced when compared to 2012–2015 (p values of interactions: p = 0.002 and p < 0.001 respectively). Compared to high educated smokers, low educated smokers (β = − 1.137, p < 0.001) and moderate educated smokers (β = − 0.894, p < 0.001) were less knowledgeable about the health risks of smoking in 2016 and 2017. Conclusions Introducing PHWs coincided with an increase in smokers’ knowledge about the health risks of smoking. Dutch tobacco control policy and campaigns should focus on improving Dutch smokers’ awareness of the health risks of smoking even more, especially among low educated smokers.
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Affiliation(s)
- Dirk-Jan A van Mourik
- Department of Health Promotion, Maastricht University (CAPHRI), PO Box 616, 6200 MD, Maastricht, the Netherlands.
| | - Gera E Nagelhout
- Department of Health Promotion, Maastricht University (CAPHRI), PO Box 616, 6200 MD, Maastricht, the Netherlands.,Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, the Netherlands.,IVO Research Institute, The Hague, the Netherlands
| | - Marc C Willemsen
- Department of Health Promotion, Maastricht University (CAPHRI), PO Box 616, 6200 MD, Maastricht, the Netherlands.,Netherlands Expertise Center for Tobacco Control (NET), Trimbos Institute, Utrecht, the Netherlands
| | - Bas van den Putte
- Netherlands Expertise Center for Tobacco Control (NET), Trimbos Institute, Utrecht, the Netherlands.,Department of Communication, University of Amsterdam, Amsterdam, the Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University (CAPHRI), PO Box 616, 6200 MD, Maastricht, the Netherlands
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19
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Haddad C, Lahoud N, Akel M, Sacre H, Hajj A, Hallit S, Salameh P. Knowledge, attitudes, harm perception, and practice related to waterpipe smoking in Lebanon. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:17854-17863. [PMID: 32162227 DOI: 10.1007/s11356-020-08295-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 03/02/2020] [Indexed: 06/10/2023]
Abstract
Waterpipe smoking (WPS) is one of the most emerging popular trends in Lebanon, with a prevalence of 36.9%, the highest among all Middle Eastern countries. Thus, the primary objective of the study was to examine the factors associated with knowledge, attitudes, and practice (KAP) related to WPS among a representative sample of waterpipe smokers. The secondary objective was to examine the effect of KAP on cumulative waterpipe dose and dependence. This cross-sectional study was carried out between May and December 2018 and enrolled a representative sample of 1550 waterpipe smokers from all Lebanese districts. The questionnaire used was specifically designed for this study. High knowledge score (Beta = 0.02, p = 0.002) were significantly associated with higher waterpipe harm perception score. In addition, high knowledge score (Beta = 0.32, p = 0.007) were significantly associated with higher attitude score toward smoking ban. Higher waterpipe harm perception score (Beta = - 1.30, p < 0.001), higher attitude (Beta = - 0.21, p < 0.001), and higher knowledge score (Beta = - 0.11, p < 0.001) were significantly associated with lower waterpipe dependence. In addition, higher waterpipe dependence (Beta = 2.02, p < 0.001) was significantly associated with higher cumulative waterpipe smoking, while higher waterpipe harm perception score (Beta = - 1.96, p = 0.009) and higher knowledge score (Beta = 0.27, p < 0.001) were significantly associated with lower cumulative waterpipe smoking. Our main finding was that better knowledge and perception of the harmful effects of waterpipe were related to a better attitude toward smoking bans and a lower waterpipe smoking. Therefore, health care providers and policymakers should join efforts to make awareness campaigns across Lebanon and develop adequate interventions to curb the use of waterpipe among the population.
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Affiliation(s)
- Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon.
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.
- Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, University of Limoges, UMR 1094, GEIST, 87000, Limoges, France.
- CH Esquirol, Department of Psychiatry, 87025, Limoges, France.
| | - Nathalie Lahoud
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Aline Hajj
- Laboratory of Pharmacology, Clinical Pharmacy and Quality Control of Drugs, Faculty of Pharmacy, Pôle Technologie-Santé (PTS), Faculty of Pharmacy, Saint-Joseph University, Beirut, 1107 2180, Lebanon
- Faculty of Pharmacy, Saint-Joseph University, Beirut, 1107 2180, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- , Building 560, Street 8, Biakout, Lebanon.
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
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20
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Akiki Z, Saadeh D, Haddad C, Sacre H, Hallit S, Salameh P. Knowledge and attitudes toward cigarette and narghile smoking among previous smokers in Lebanon. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:14100-14107. [PMID: 32037494 DOI: 10.1007/s11356-020-07763-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Abstract
To evaluate the proportions of current cigarette smokers (CCS) and current narghile smokers (CNS) as well as previous cigarette smokers (PCS) and previous narghile smokers (PNS) and to assess smoking knowledge and attitudes toward supporting smoking ban or cessation among previous compared with current smokers. This cross-sectional study took place between May and December 2018, and enrolled a sample of 1598 exclusive cigarette smokers (ECS) and 2091 exclusive narghile smokers (ENS), representative of all Lebanese governorates. A questionnaire designed specifically for this study was used to collect data. Among ECS, 45.2% were CCS and 54.8% were PCS. Among ENS, 83.5% were CNS and 16.5% were PNS. Higher age (adjusted odds ratio (aOR) (95% confidence interval (CI)) = 1.02 (1.01; 1.03)), higher knowledge (1.05 (1.02; 1.08)), and attitude scores (1.11(1.09; 1.13)) were significantly associated with higher odds of being PCS. Higher age (1.02 (1.01; 1.03)), being employed (1.32 (1.004; 1.72)), higher knowledge (1.04 (1.02; 1.07)), and attitude scores (1.09 (1.07; 1.12)) were significantly associated with higher odds of being PNS. Previous smokers have higher knowledge and better attitude toward supporting smoking cessation compared with current smokers. A better knowledge along with effective interventions, might lead to a positive attitude toward supporting smoking ban or smoking cessation among the general population.
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Affiliation(s)
- Zeina Akiki
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Public Health, Lebanese University, Fanar, Lebanon.
- Faculty of Nursing and Health Sciences, Notre Dame Louaize University, Barsa, Lebanon.
- Faculty of Health Sciences, University of Balamand, Koura, Lebanon.
| | - Danielle Saadeh
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Chadia Haddad
- Institut d'Epidémiologie et de Neurologie Tropicale, UMR 1094, Neuroépidémiologie Tropicale, Université de Limoges, GEIST, 87000, Limoges, France
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Hala Sacre
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Pascale Salameh
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
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21
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van Mourik DJA, Nagelhout GE, de Vries H, van den Putte B, Cummings KM, Borland R, Fong GT, Willemsen MC. Quasi-experimentally examining the impact of introducing tobacco pictorial health warnings: Findings from the International Tobacco Control (ITC) 4C and Netherlands surveys in the Netherlands, Australia, Canada, United Kingdom, and the United States. Drug Alcohol Depend 2020; 207:107818. [PMID: 31911337 PMCID: PMC7948390 DOI: 10.1016/j.drugalcdep.2019.107818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/11/2019] [Accepted: 12/17/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Our study evaluated the short-term impact of introducing European Union's tobacco pictorial health warnings (PHWs). METHODS Longitudinal data were collected at two time-points from adult smokers, participating in the International Tobacco Control (ITC) surveys, conducted in the Netherlands, Australia, Canada, the United Kingdom and the United States. In the Netherlands, textual health warnings (THWs) were replaced by PHWs between both time-points. Health warning policies did not change in the other countries. Data from continuing smokers were used (N = 3,487) and analyzed using Generalized Estimating Equations. RESULTS Between both time-points, only Dutch smokers showed increases in noticing health warnings (β = 0.712, p < 0.001), self-reports of health warnings leading to a cognitive response such as thinking about smoking health-risks (SHRs) (OR = 1.834, p < 0.001), knowledge about SHRs (β = 0.369, p < 0.001), and avoiding health warnings (OR = 9.869, p < 0.001). However, Dutch smokers showed no changes in attitude towards smoking (β = 0.035, p = 0.518), intention to quit smoking (OR = 0.791, p = 0.157), self-efficacy to quit smoking (β=-0.072, p = 0.286), or reporting that health warnings helped them to resist having a cigarette (OR = 1.091, p = 0.714). CONCLUSIONS Results suggest that introducing the European PHWs was effective in provoking changes closely related to health warnings, but there was no direct impact on variables more closely related to smoking cessation.
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Affiliation(s)
- Dirk-Jan A van Mourik
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, the Netherlands.
| | - Gera E Nagelhout
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, the Netherlands; Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, the Netherlands; IVO Research Institute, The Hague, the Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, the Netherlands
| | - Bas van den Putte
- Department of Communication, University of Amsterdam (ASCoR), Amsterdam, the Netherlands
| | - K Michael Cummings
- Department of Psychiatry and Behavioural Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Ron Borland
- Cancer Council Victoria, Melbourne, Australia
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada; Ontario Institute for Cancer Research, Toronto, Canada
| | - Marc C Willemsen
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, the Netherlands; Trimbos Institute, Netherlands Expertise Center for Tobacco Control (NET), Utrecht, the Netherlands
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Chen X, Zhao D, Wen T, Xiao X, Pan Z, He J, Zheng P, Hao W, Lin H, Abdullah AS. To text or not to text? Acceptability of WeChat and text messaging intervention to promote tobacco control assistance among parents who smoke in rural China. Tob Induc Dis 2019; 17:88. [PMID: 31889950 PMCID: PMC6900876 DOI: 10.18332/tid/114089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/07/2019] [Accepted: 11/07/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Although the use of mobile health (mHealth) to promote tobacco control and smoking cessation interventions has been available in developed countries, their use in low- and middle-income countries (i.e. in China) is lacking. This study examined the acceptance of text messaging and/or WeChat based tobacco control intervention among parents who smoke, in rural China. METHODS Using a structured questionnaire, we surveyed smoker households (n=668) of children aged ≤5 years in two rural regions of southern China. Descriptive analyses were used to characterize respondents; multivariate regression analysis was used to test the associations between participants’ sociodemographic and other characteristics, and their acceptability of text messaging and/or WeChat intervention for tobacco control. RESULTS After adjusting for other variables (i.e. region, ethnicity, age, education level, occupation, attitudes towards smoking, perception of cigarettes addictiveness, and quitting smoking), the overall knowledge about smoking and secondhand smoke (SHS) exposure significantly predicted a higher acceptance to text messaging/WeChat intervention (OR=0.567; 95% CI: 0.457–0.704). Participants who thought smoking made people feel relaxed were less likely to accept text messaging/WeChat intervention than those who did not think so (OR=1.403; 95% CI: 1.080–1.822). CONCLUSIONS Our findings suggest that households in rural China that were more knowledgeable about the hazards of smoking and SHS exposure, and had negative feelings about the benefits of smoking, were more likely to accept text messaging/WeChat for tobacco control intervention. Understanding rural smokers’ preferences to receive intervention and related characteristics can help with the design of targeted tobacco control intervention programs in rural China.
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Affiliation(s)
- Xiaoxiao Chen
- Taizhou City Center for Disease Control and Prevention, Taizhou, China
| | - Duan Zhao
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Tong Wen
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Xia Xiao
- School of Public Health, Kunming Medical University, Kunming, China
| | - Zixian Pan
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Jingyi He
- Department of Preventive Medicine, School of Public Health, Fudan University, Shanghai, China
| | - Pinpin Zheng
- Department of Preventive Medicine, School of Public Health, Fudan University, Shanghai, China
| | - Wei Hao
- Taizhou City Center for Disease Control and Prevention, Taizhou, China
| | - Haijiang Lin
- Taizhou City Center for Disease Control and Prevention, Taizhou, China
| | - Abu S Abdullah
- Global Health Research Center, Duke Kunshan University, Kunshan, China.,Duke Global Health Institute, Duke University, Durham, United States.,Boston Medical Center, Boston University School of Medicine, Boston, United States
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Upadhyay S, Lord J, Gakh M. Health-Information Seeking and Intention to Quit Smoking: Do Health Beliefs Have a Mediating Role? Tob Use Insights 2019; 12:1179173X19871310. [PMID: 31488954 PMCID: PMC6712759 DOI: 10.1177/1179173x19871310] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 07/31/2019] [Indexed: 11/26/2022] Open
Abstract
Background: Smoking is a leading cause of preventable deaths. Smoking cessation can reduce the risk of smoking-associated disease and death. But smoking cessation involves behaviour change. Existing research indicates that health-information seeking and health-promoting behaviours can be positively associated. However, in the context of smoking, the relationship between seeking health information and intending to quit smoking remains only partially understood. Aim: This study aimed to examine the relationship between seeking health information and intending to quit smoking and to determine whether this relationship is mediated by health beliefs. Methods: We used data from the fourth cycle of the US National Cancer Institute’s Health Information National Trends Survey (HINTS). Logistic regression was used to assess the independent variable (ie, health-information seeking) and dependent variable (ie, intention to quit smoking) as mediated by health belief. Results: Our findings suggest that smokers who seek health information have a 2.67 times higher odds of intending to quit smoking than smokers who do not seek health information. However, health beliefs do not have an intervening effect between seeking health information and intending to quit smoking. Discussion: Seeking health information is important in predicting attempts to quit smoking, regardless of the smokers’ pre-existing health beliefs. Our findings support cessation efforts that encourage smokers to seek health information. Determining optimal ways to encourage smokers to seek smoking-related information could support achieving and maintaining smoking cessation. Conclusion: Cessation programmes and policies should encourage smokers to seek health information. Additional research should further examine smokers’ motivators and cues for health-information seeking and should further probe smokers’ beliefs about the risks of smoking.
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Affiliation(s)
- Soumya Upadhyay
- Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Justin Lord
- James K. Elrod Department of Health Administration and Department of Accounting, School of Business, Louisiana State University at Shreveport, Shreveport, LA, USA
| | - Maxim Gakh
- School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, USA
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Association of Smoking-Related Knowledge, Attitude, and Practices (KAP) with Nutritional Status and Diet Quality: A Cross-Sectional Study in China. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5897478. [PMID: 31531358 PMCID: PMC6720361 DOI: 10.1155/2019/5897478] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/23/2019] [Accepted: 07/28/2019] [Indexed: 12/18/2022]
Abstract
Background Smoking is the second leading cause of death. Limited studies are available about smoking and overall diet quality. The current study was aimed at finding an association of s-KAP (smoking-related knowledge, attitude, and practices) with nutritional status and diet quality. Methodology The current study was a cross-sectional community-based study conducted in Jurong city, China. Validated questionnaires were used for the collection of data regarding s-KAP and dietary intake. Correlation and multivariate linear regression analysis were used for the association of s-KAP scores with diet quality scores and nutritional status. Results The total numbers of participants were 7998 with a mean age of 59.3±11.4 years, including 38.5% males and 41.5% females. s-KAP scores were categorized into two groups, i.e., High s-KAP group and low s-KAP group. The High s-KAP group had significantly higher (P<0.05) diet scores and BMI but lower (P<0.05) WC (waist circumference) and WHR (waist to hip ratio) than the Low s-KAP group. Independent positive association (P<0.05) of s-KAP scores with diet scores was observed after the adjustment for age, gender, physical activity, alcohol consumptions, monthly income, and anthropometric measures (BMI, WC, and WHR). Similarly, smoking was positively associated (P<0.05) with diet scores after adjustment for covariates. Conclusion In conclusion, the higher s-KAP scores indicated more knowledge regarding the harmful consequences of the smoking outcomes, positive attitude, less smoking practices, and having a good plan to quit smoking. Individuals with high s-KAP scores had good diet quality and lower adiposity measures. Furthermore, s-KAP scores and smoking status were having an independent positive association with diet scores.
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Green AC, Driezen P, Noar SM, Hammond D, Fong GT. Impact of adding and removing warning label messages from cigarette packages on adult smokers' awareness about the health harms of smoking: findings from the ITC Canada Survey. Tob Control 2019; 28:e56-e63. [PMID: 31253717 PMCID: PMC7495415 DOI: 10.1136/tobaccocontrol-2018-054885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Adding messages to cigarette health warning labels (HWLs) about the harms of smoking increases awareness of these health facts, but little is known about the impact of removing messages. This is the first study to directly investigate the impact of adding and removing messages from cigarette HWLs on smokers' awareness of harms. METHODS Data were drawn from nine waves of the International Tobacco Control (ITC) Canada Survey, a national representative cohort of adult smokers (n=5863) conducted nearly annually between 2002 and 2013-2014. Two analytical approaches were conducted: generalised estimating equation (GEE) regression models estimated adjusted percentages of correct smoking-related health statements at each wave and segmented regression analyses modelled temporal trends in awareness before and after the revisions by measuring the difference in slopes. RESULTS Adding messages to HWLs significantly increased awareness that smoking causes blindness (OR=3.36 (95% CI 2.71 to 4.18); p<0.001; estimated increase of 1.01 million smokers in Canada) and bladder cancer (OR=2.14 (95% CI 1.71 to 2.66), p<0.001; estimated increase of 1.09 million smokers). Adding the warning that nicotine causes addiction did not significantly impact smokers' awareness. Removing messages was shown to decrease awareness that cigarette smoke contains carbon monoxide (OR=0.53 (95% CI 0.41 to 0.70), p<0.001; estimated decrease of 342 000 smokers) and smoking causes impotence (p=0.007 for the difference in slopes; estimated decrease of 354 000 smokers). CONCLUSIONS Adding messages to HWLs increases smokers' awareness of health facts, but removing messages decreases awareness. These findings demonstrate the importance of carefully considering the implications of adding and especially removing messages from HWLs and the importance of regularly revising warnings.
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Affiliation(s)
- Annika C Green
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Seth M Noar
- School of Journalism and Mass Communication, University of North Carolina, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Exposure to Messages on Risk Factors for Noncommunicable Diseases in a Rural Province of Vietnam. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7962947. [PMID: 31183375 PMCID: PMC6515187 DOI: 10.1155/2019/7962947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/25/2019] [Accepted: 04/11/2019] [Indexed: 11/17/2022]
Abstract
Background Providing messages on risk factors for noncommunicable diseases (NCDs) plays an important role in preventing disease. Objectives This study investigated how often adults living in a rural area in northern Vietnam heard about risks factor for NCD and where they obtained that information. Methods A cross-sectional survey was conducted using a multistage stratified cluster sampling to recruit 2970 participants. Data analyses were adjusted for all variables in a two-level multilevel Poisson regression model. Results Overall, 77% of respondents had heard about NCDs, while 38.3 to 50% had been exposed to messages on risk factors of NCDs in the last month. Television, radio, and friends/neighbors were the most common sources of information. Most people exposed information no more than one or two sources. Factors associated with exposure to messages about risk were occupation, age group, education, and economic status. Conclusion Intervention programs should focus on providing information primarily through television, considering influencing factors as well ensuring that messages reach target audiences.
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Hikita N, Haruna M, Matsuzaki M, Sasagawa E, Murata M, Yura A, Oidovsuren O. Comparison of Knowledge about Smoking and Passive Smoking and Urinary Cotinine Levels in Pregnant Women and their Partners in Mongolia: A Cross-sectional Study. Asian Pac Isl Nurs J 2019; 4:47-56. [PMID: 31037272 PMCID: PMC6484199 DOI: 10.31372/20190401.1032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This study aimed to compare knowledge about smoking, including passive smoking, and urinary cotinine (UC) levels in pregnant women and their partners in Mongolia. The study was conducted between November 2015 and January 2016 in Darkhan-Uul Province, Mongolia. Pregnant women with less than 20 weeks' gestation were recruited, and their partners were also invited to participate. Self-administered questionnaires and urine samples were used to collect data. Knowledge about smoking including passive smoking was measured using 14 questions. Data were analyzed using a Student's t-test, a chi-squared test, a one-way analysis of variance, and the Tukey-Kramer method for post-hoc analysis. Correlations were measured by computing Pearson's r or Spearman's ρ. A total of 508 pregnant women and 227 partners participated in this study; of these, 221 couples' data were analyzed. Pregnant women's scores on knowledge about smoking and passive smoking were significantly higher than those of their partners (9.4 ± 2.9 and 8.7 ± 3.1, respectively; p = 0.017). Pregnant women's and their partners' scores were slightly correlated (r = 0.163, p = 0.015). Pregnant women's and their partners' UC levels were significantly correlated (ρ = 0.250, p < 0.001). This study is the first to examine knowledge about smoking and passive smoking and UC levels among pregnant women and their partners in Mongolia. Because pregnant women's and their partners' scores and UC levels were positively correlated, health education on the harm caused by smoking and passive smoking should be provided to both pregnant women and their partners.
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Affiliation(s)
- Naoko Hikita
- Department of Midwifery and Women's Health, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Megumi Haruna
- Department of Midwifery and Women's Health, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masayo Matsuzaki
- Department of Children & Women's Health, Division of Health Science, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Emi Sasagawa
- Department of Midwifery and Women's Health, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Ariunaa Yura
- Darkhan-Uul General Hospital, Darkhan-Uul, Mongolia
| | - Otgontogoo Oidovsuren
- Pharmaceutical Department, Mongolian National University of Medical Sciences, Darkhan-Uul Medical School, Darkhan-Uul, Mongolia
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28
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U.S. adult perceptions of the harmfulness of tobacco products: descriptive findings from the 2013-14 baseline wave 1 of the path study. Addict Behav 2019; 91:180-187. [PMID: 30502927 DOI: 10.1016/j.addbeh.2018.11.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 11/16/2018] [Accepted: 11/16/2018] [Indexed: 02/01/2023]
Abstract
INTRODUCTION This study is the first nationally representative survey of U.S. adults (18+) to examine perceptions of the relative harms of eight non-cigarette tobacco products. METHODS Data are from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study Adult Questionnaire, a nationally representative study of 32,320 adults in the United States conducted from September 2013 to December 2014. RESULTS 40.7% of adults believed that electronic cigarettes were less harmful than cigarettes, and 17.8% of adults believed that hookah was less harmful than cigarettes. Those less knowledgeable about the health risks of smoking were more likely to believe that the non-cigarette products were less harmful than cigarettes. Current non-cigarette tobacco product users were more likely to perceive that product to be less harmful than cigarettes (except filtered cigars). There was a significant positive correlation between beliefs that cigarettes were harmful and the likelihood of using hookah; perceptions of the harmfulness of cigarettes was not associated with the likelihood of using any other product. CONCLUSIONS Perceptions of harmfulness varied widely across non-cigarette tobacco products. E-cigarettes and hookah in particular are seen as less harmful compared to cigarettes.
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Wang Q, Mati K. Intention to Quit among Smokers in Kazakhstan: Data from 2014 Global Adult Tobacco Survey. J Epidemiol Glob Health 2019; 9:23-28. [PMID: 30932386 PMCID: PMC7310764 DOI: 10.2991/jegh.k.190212.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 01/16/2019] [Indexed: 12/14/2022] Open
Abstract
Kazakhstan is one of the countries with higher-than-average smoking prevalence and tobacco-related mortality. Intention to quit is a key step toward smoking cessation, yet has not been studied in Kazakhstan. This study explored prevalence and correlates of intention to quit among smokers in Kazakhstan. We drew data from the nationally representative survey, the Global Adult Tobacco Survey (GATS), conducted during 2014 in Kazakhstan. Our sample consisted of 649 smokers aged ≥15 years. We examined prevalence of intention to quit by demographics, knowledge of tobacco-related diseases, nicotine dependence, attempt to quit in the past 12 months, household smoking restrictions, and awareness of antismoking messages. Univariate and multivariate logistic regressions were used to test the significance of these correlates. Prevalence of intention to quit was around 75.9% among smokers. Older age (p < 0.001), knowledge of tobacco-related diseases (p < 0.01), moderate nicotine dependence (p < 0.001), attempt to quit within the past 12 months (p < 0.001), and having household smoking restrictions (p < 0.001) were all significant correlates. We suggest investing in efforts to promote cessation activities for smokers of all ages, to disseminate comprehensive information on tobacco-related diseases, and to uphold and strengthen policies on smoking bans.
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Affiliation(s)
- Qian Wang
- Department of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Komi Mati
- Dobson DaVanzo & Associates, Vienna, VA 22180, USA
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Trofor AC, Papadakis S, Lotrean LM, Radu-Loghin C, Eremia M, Mihaltan F, Driezen P, Kyriakos CN, Mons U, Demjén T, Nogueira SO, Fernández E, Tountas Y, Przewoźniak K, McNeill A, Fong GT, Vardavas CI. Knowledge of the health risks of smoking and impact of cigarette warning labels among tobacco users in six European countries: Findings from the EUREST-PLUS ITC Europe Surveys. Tob Induc Dis 2019; 16:A10. [PMID: 31516464 PMCID: PMC6661855 DOI: 10.18332/tid/99542] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/27/2018] [Accepted: 11/02/2018] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The aim of this study was to examine knowledge of health effects of smoking and the impact of cigarette package warnings among tobacco users from six European Union (EU) Member States (MS) immediately prior to the introduction of the EU Tobacco Products Directive (TPD) in 2016 and to explore the interrelationship between these two factors. METHODS Cross-sectional data were collected via face-to-face interviews with adult smokers (n=6011) from six EU MS (Germany, Greece, Hungary, Poland, Romania, Spain) between June-September 2016. Sociodemographic variables and knowledge of health risks of smoking (KHR) were assessed. Warning salience, thoughts of harm, thoughts of quitting and foregoing of cigarettes as a result of health warnings were assessed. The Label Impact Index (LII) was used as a composite measure of warning effects. Linear and logistic regression analyses were used to examine sociodemographic predictors of KHR and LII and the inter-relationship between knowledge and LII scores. RESULTS The KHR index was highest in Romania and Greece and lowest in Hungary and Germany. While the majority of smokers knew that smoking increases the risk for heart diseases, lung and throat cancer, there was lower awareness that tobacco use caused mouth cancer, pulmonary diseases, stroke, and there were very low levels of knowledge that it was also associated with impotence and blindness, in all six countries. Knowledge regarding the health risks of passive smoking was moderate in most countries. The LII was highest in Romania and Poland, followed by Spain and Greece, and lowest in Germany and Hungary. In almost all countries, there was a positive association between LII scores and higher KHR scores after controlling for sociodemographic variables. Several sociodemographic factors were associated with KHR and LII, with differences in these associations documented across countries. CONCLUSIONS These data provide evidence to support the need for stronger educational efforts and policies that can enhance the effectiveness of health warnings in communicating health risks and promoting quit attempts. Data will serve as a baseline for examining the impact of the TPD.
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Affiliation(s)
- Antigona C Trofor
- University of Medicine and Pharmacy, 'Grigore T. Popa' Iasi, Iasi, Romania
- Aer Pur România, București, România
| | - Sophia Papadakis
- University of Crete (UoC), Heraklion, Greece
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Lucia M Lotrean
- Aer Pur România, București, România
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cornel Radu-Loghin
- European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
| | | | - Florin Mihaltan
- Aer Pur România, București, România
- University of Medicine and Pharmacy 'Carol Davilla', Bucharest, Romania
| | - Pete Driezen
- Department of Psychology, University of Waterloo (UW), Waterloo, Canada
| | - Christina N Kyriakos
- University of Crete (UoC), Heraklion, Greece
- European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
| | - Ute Mons
- Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tibor Demjén
- Smoking or Health Hungarian Foundation (SHHF), Budapest, Hungary
| | - Sarah O Nogueira
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), Barcelona, Spain
- Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), Barcelona, Spain
- Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute, Barcelona, Spain
| | - Yannis Tountas
- National and Kapodistrian University of Athens (UoA), Athens, Greece
| | - Krzysztof Przewoźniak
- Health Promotion Foundation (HPF), Warsaw, Poland
- Maria Skłodowska-Curie Institute-Oncology Center (MSCI), Warsaw, Poland
| | - Ann McNeill
- National Addiction Centre, Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London (KCL), London, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, London, United Kingdom
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo (UW), Waterloo, Canada
- School of Public Health and Health Systems, University of Waterloo (UW), Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Constantine I Vardavas
- University of Crete (UoC), Heraklion, Greece
- European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
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Rosen LJ, Rier DA, Schwartz R, Talitman M, Zwanziger L. Knowledge and risk perceptions of Israelis towards combustible cigarettes: the need for immediate remedial action. Isr J Health Policy Res 2019; 8:10. [PMID: 30642402 PMCID: PMC6330745 DOI: 10.1186/s13584-018-0276-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 12/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Devastation from the tobacco epidemic continues, with strong government tobacco control policy absent in most countries. Knowledge of the full scope of tobacco harm in populations may form the basis for healthier behavior, de-normalization of smoking, and a consensus about necessary public policy. However, many populations may be poorly-informed about the risks, and this ignorance may undermine both effective policy-making and implementation of tobacco control policies. We present knowledge and risk perceptions about smoking tobacco smoke exposure in Israel. METHODS A nationally-representative phone survey was conducted in Israel (n = 505; response rate = 61%). We assessed knowledge about active and passive smoking using four questions, three of which addressed knowledge about harm, and one of which addressed knowledge of tobacco-related harm relative to knowledge of harm due to traffic accidents. The three questions which addressed knowledge of harm were combined into a composite score. We also asked four risk perception questions concerning tobacco smoke exposure, which were measured on a 7-point Likert scale and then combined. Multivariable logistic regression and linear models were used to identify whether smoking status or socio-demographic variables were associated with knowledge of harm, comparative knowledge of harm, and risk perceptions. RESULTS Just two in five respondents, and one in five respondents who were current smokers, accurately answered three simple questions about harms of smoking. Fewer than three in ten respondents, and fewer than one in five smokers, knew that smoking causes more damage than traffic accidents. Many (30.3%) were unaware that tobacco smoke exposure causes both lung cancer and heart disease, 27.7% did not know that smoking both shortens life and injures quality of life, and 31.1% did not know that smoking-attributable health problems will afflict all or most heavy smokers. Overall, risk perceptions regarding tobacco smoke exposure were high (mean = 24.5, SD:4.5, on a scale of 7-28, with 28 the indicating highest level). Smoking status was consistently associated with lower levels of knowledge, comparative knowledge, and risk perceptions, with current smokers having the lowest levels of knowledge and the lowest risk perceptions. CONCLUSIONS Like many others, Israelis, and particularly Israeli smokers, do not fully grasp tobacco's true dangers. Effective communication of the full range of tobacco risks to the public, with a focus on communication with smokers, is an essential component of comprehensive tobacco control policy.
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Affiliation(s)
- Laura J. Rosen
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, 69978 Ramat Aviv, Israel
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 USA
| | - David A. Rier
- Department of Sociology and Anthropology, Bar Ilan University, 5290002 Ramat-Gan, Israel
| | | | - Michal Talitman
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, 69978 Ramat Aviv, Israel
- Department of Statistics, Tel Aviv University, 69978 Ramat Aviv, Israel
| | - Lior Zwanziger
- Sackler Medical School, Tel Aviv University, 69978 Ramat Aviv, Israel
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Nogueira SO, McNeill A, Fu M, Kyriakos CN, Mons U, Fernández E, Zatoński WA, Trofor AC, Demjén T, Tountas Y, Przewoźniak K, Quah ACK, Fong GT, Hitchman SC, Vardavas CI. Impact of anti-smoking advertising on health-risk knowledge and quit attempts across 6 European countries from the EUREST-PLUS ITC Europe Survey. Tob Induc Dis 2018; 16:A5. [PMID: 31516461 PMCID: PMC6659515 DOI: 10.18332/tid/96251] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/10/2018] [Accepted: 09/24/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Exposure to anti-smoking advertising and its effects differ across countries. This study examines the reported exposure to anti-smoking advertising among smokers and its relation to knowledge of smoking harms and quit attempts in six European countries. METHODS Data come from Wave 1 of the International Tobacco Control (ITC) 6 European Country (6E) Survey (Germany, Greece, Hungary, Poland, Romania, Spain) carried out among smokers between June and September 2016 (n=6011). Key measures included whether participants had noticed anti-smoking advertising in the last six months in 6 different channels, their knowledge of 13 adverse smoking/second-hand smoking health effects and if they had made at least one quit attempt in the last 12 months. Multivariate logistic regression models were used in the analysis. RESULTS Across the six countries, only 35.2% of smokers reported being exposed to any anti-smoking advertising. Television was the most common channel identified (25.7%), followed by newspapers and magazines (13.8%), while social media were the least reported (9.5%). Participants 18-24 years old were significantly more likely to have noticed advertisements on the Internet than participants >55 years old (24.3% vs 4.9%; OR=5.15). Participants exposed to anti-smoking advertising in all six channels were twice more likely to have a higher knowledge of smoking risks than those not exposed (2.4% vs 97.6%, respectively; OR=2.49). The likelihood of making a quit attempt was increased by 10% for each additional channel through which smokers were exposed to anti-smoking advertising. CONCLUSIONS Knowledge of health risks of smoking tended to be higher in countries that aired a campaign in recent years. Exposure to anti-smoking advertising, in the six channels combined, was related to higher smoking knowledge of risks and to more quit attempts. Future anti-smoking mass media campaigns should consider advertising in all dissemination channels to increase the awareness of the dangers of smoking.
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Affiliation(s)
- Sarah O. Nogueira
- Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
- King’s College London (KCL), London, United Kingdom
| | - Ann McNeill
- King’s College London (KCL), London, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, King’s College London (KCL), London, United Kingdom
| | - Marcela Fu
- Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Christina N. Kyriakos
- European Network on Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
- University of Crete (UoC), Heraklion, Greece
| | - Ute Mons
- Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Esteve Fernández
- Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Witold A. Zatoński
- Health Promotion Foundation (HPF), Warsaw, Poland
- European Observatory of Health Inequalities, The President Stanisław Wojciechowski State University of Applied Sciences, Kalisz, Poland
| | - Antigona C. Trofor
- University of Medicine and Pharmacy ‘Grigore T. Popa’ Iasi, Iasi, Romania
- Aer Pur Romania, Bucharest, Romania
| | - Tibor Demjén
- Smoking or Health Hungarian Foundation (SHHF), Budapest, Hungary
| | | | - Krzysztof Przewoźniak
- Health Promotion Foundation (HPF), Warsaw, Poland
- Maria Skłodowska-Curie Institute-Oncology Center (MSCI), Warsaw, Poland
| | | | - Geoffrey T. Fong
- University of Waterloo (UW), Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Sara C. Hitchman
- UK Centre for Tobacco and Alcohol Studies, King’s College London (KCL), London, United Kingdom
- National Addiction Centre, King’s College London, London, United Kingdom
| | - Constantine I. Vardavas
- European Network on Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
- University of Crete (UoC), Heraklion, Greece
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Yu NN, Zhu X. Affordable care encourages healthy living: Theory and evidence from China's new cooperative medical scheme. HEALTH ECONOMICS 2018; 27:2051-2066. [PMID: 30126021 DOI: 10.1002/hec.3820] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 01/28/2018] [Accepted: 07/13/2018] [Indexed: 06/08/2023]
Abstract
In developing a theory of medical insurance and health behavior with bequest motive, we discover that whether ex ante moral hazard or the opposite occurs hinges upon the differential effects of health behavior on morbidity and mortality. Providing insurance can encourage healthy living by making longevity more affordable. We test the theory utilizing a unique experiment of China introducing the new cooperative medical scheme, unique in its long-term credibility necessary for our proposed channel. This scheme reduced cigarette use by around 9%. Further empirical analysis failed to falsify our theory or the alternative mechanism of health insurance reducing stress and thus the demand for cigarettes and hard liquor. Both newly proposed mechanisms alleviate concerns over ex ante moral hazard caused by providing affordable care for the poor.
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Affiliation(s)
- Ning Neil Yu
- School of Economics, Nanjing Audit University, Nanjing, China
- Rural Education Action Program, Stanford University Freeman Spogli Institute for International Studies, Stanford, California
| | - Xi Zhu
- Antai College of Economics and Management, Shanghai Jiao Tong University, Shanghai, China
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Ibrahim BA, Al-Humaish S, Al-Obaide MAI. Tobacco Smoking, Lung Cancer, and Therapy in Iraq: Current Perspective. Front Public Health 2018; 6:311. [PMID: 30416993 PMCID: PMC6212484 DOI: 10.3389/fpubh.2018.00311] [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: 12/14/2017] [Accepted: 10/09/2018] [Indexed: 01/16/2023] Open
Abstract
Tobacco smoking is a research topic of high interest to the public health in Iraq. Although Iraq is a country with a high percentage of smokers, we noticed the dearth of adequate studies and programs to deal with this problem. The percentage of smokers exceed 30% of the population and smoking problem becomes a permanent habit in adults and young people. The problems associated with tobacco smoking behavior related to individuals' post-traumatic stress disorder following post-war conflicts, and the social and cultural environment. The health consequences of tobacco smoking can harm almost every organ in the body, and there are reports confirmed the tobacco smoking is a high-risk factor for lung cancer and other diseases. The relative risk of lung cancer increases with increasing duration and intensity of smoking. Also, smoking associated with bladder, prostate, and head and neck cancers, in addition to respiratory diseases. Intervention efforts should focus on reducing the prevalence of cigarette smoking, introduce effective treatments for cancer and quit smoking. In this perspective article, we present our viewpoint and three scenarios to deal with the problem of tobacco smoking in Iraq. We recommend introducing educational, health and legislative policies for quitting smoking and using effective treatments for cancer.
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Milcarz M, Polanska K, Bak-Romaniszyn L, Kaleta D. Tobacco Health Risk Awareness among Socially Disadvantaged People-A Crucial Tool for Smoking Cessation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102244. [PMID: 30322112 PMCID: PMC6211097 DOI: 10.3390/ijerph15102244] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/05/2018] [Accepted: 10/06/2018] [Indexed: 11/16/2022]
Abstract
The goal of this cross-sectional survey was to assess the level of knowledge on harmful effects of environmental tobacco smoke (ETS) exposure and active smoking among socially-disadvantaged people in Poland. The study was conducted among 1817 respondents aged 18–59 years, who used aid services from local social care institutions in Piotrkowski district. Majority of the participants were aware of the fact that smoking may cause serious diseases and lung cancer (92%). However, those percentages were lower for awareness of ETS and health risk (69.4%) and for awareness of smoking/ETS-associated risk of stroke and heart attack (57%, 68%). The male respondents and smokers had much higher odds of lacking knowledge that smoking causes serious diseases and lung cancer compared to the females (OR = 1.47 and OR = 1.86; p < 0.05) and non-smokers (OR = 2.35 and OR = 2.31; p < 0.001). In addition, those with temporary jobs and the unemployed had a higher risk of lack of knowledge on smoking and lung cancer risk (OR = 2.14 and OR = 1.66; p < 0.05) as well as ETS and the risk of stroke (OR = 1.52 and OR = 1.51; p < 0.05) as compared to those with permanent jobs. The smokers who were aware of four health consequences of smoking indicated an intention to quit smoking within the next month more frequently when compared to those who did not have the knowledge on all of the analyzed harmful effects of tobacco use (19.7% vs. 13.1%; p < 0.05). There is a need to improve knowledge on the dangers associated with active and passive smoking among socially disadvantaged populations.
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Affiliation(s)
- Marek Milcarz
- Department of Hygiene and Epidemiology, Medical University of Lodz, 90-647 Lodz, Poland.
| | - Kinga Polanska
- Department of Hygiene and Epidemiology, Medical University of Lodz, 90-647 Lodz, Poland.
| | - Leokadia Bak-Romaniszyn
- Department of Nutrition in Digestive Tract Diseases, Medical University of Lodz, 90-647 Lodz, Poland.
| | - Dorota Kaleta
- Department of Hygiene and Epidemiology, Medical University of Lodz, 90-647 Lodz, Poland.
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Ahluwalia IB, Smith T, Arrazola RA, Palipudi KM, Garcia de Quevedo I, Prasad VM, Commar A, Schotte K, Garwood PD, Armour BS. Current Tobacco Smoking, Quit Attempts, and Knowledge About Smoking Risks Among Persons Aged ≥15 Years - Global Adult Tobacco Survey, 28 Countries, 2008-2016. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2018; 67:1072-1076. [PMID: 30260941 PMCID: PMC6188126 DOI: 10.15585/mmwr.mm6738a7] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Elton-Marshall T, Wijesingha R, Kennedy RD, Hammond D. Disparities in knowledge about the health effects of smoking among adolescents following the release of new pictorial health warning labels. Prev Med 2018; 111:358-365. [PMID: 29195760 DOI: 10.1016/j.ypmed.2017.11.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/13/2017] [Accepted: 11/26/2017] [Indexed: 11/28/2022]
Abstract
This paper examined knowledge about the health effects of smoking among health equity groups following the 2012 introduction of refreshed pictorial health warning labels (HWLs) in Canada. Data are from the 2012/2013 Youth Smoking Survey a representative school-based survey of 47,203 adolescents in Grades 6-12 in nine provinces. Regression models examined overall knowledge about eight health effects of smoking included in the HWLs. Less than one-third of adolescents (32.2%) knew that smoking causes vision loss/blindness and 33.7% knew that smoking causes bladder cancer. Whereas knowledge was high for lung cancer (93.9%), knowledge about other health effects ranged from 52.9% for chronic bronchitis/emphysema to 77.6% for gum or mouth disease. Non-smoking adolescents who were: susceptible to future smoking, male, ethnic minorities, and who had less spending money were significantly less likely to be knowledgeable of the health effects of smoking. There were fewer disparities in knowledge about the health effects of smoking among smokers. Smokers who bought loose or bagged cigarettes rather than cigarettes in packages or cartons were significantly less likely to be knowledgeable about the health effects of smoking. There are significant disparities in knowledge about the health effects of smoking by health equity groups particularly among non-smoking adolescents. Warning labels have the potential to reduce disparities in knowledge about the health effects of smoking when exposure to the warning labels is universal. Complementary strategies such as mass media campaigns are needed to address disparities in knowledge.
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Affiliation(s)
- Tara Elton-Marshall
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Affiliated Scientist, Ontario Tobacco Research Unit, Toronto, Ontario, Canada.
| | - Rochelle Wijesingha
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, Ontario, Canada; Department of Sociology, McMaster University, Hamilton, Ontario, Canada
| | - Ryan David Kennedy
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Zheng Y, Ji Y, Dong H, Chang C. The prevalence of smoking, second-hand smoke exposure, and knowledge of the health hazards of smoking among internal migrants in 12 provinces in China: a cross-sectional analysis. BMC Public Health 2018; 18:655. [PMID: 29793454 PMCID: PMC5968586 DOI: 10.1186/s12889-018-5549-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 05/07/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Previous studies have provided inconsistent findings on smoking among migrants, and very limited data exist on their second-hand smoke exposure. This study aims to investigate internal migrants' smoking prevalence, second-hand smoke exposure among non-smokers, and knowledge of the health hazards of smoking in 12 major migrant provinces in China in 2013. METHODS Data from the 2013 Migrant Dynamics Monitoring Survey in China published by the National Commission of Health and Family Planning was used in this study. Descriptive analysis, Chi-square analysis, and sex-stratified multivariate logistic regression analysis were used to explore the determinants of current smoking and second-hand smoke exposure. RESULTS Among 7200 migrants, 34.1% (55% male, 4% female) were current smokers. For males, factors associated with current smoking were education year (aOR = 0.95, 95% CI: 0.93-0.98), duration of stay (aOR = 1.01, 95% CI: 1.00-1.03) and occupation (aOR = 1.25, 95% CI: 1.03-1.53). For females, household registration status (aOR = 1.70, 95% CI: 1.04-2.80) was the most important factor associated with current smoking. Sixty five percent of non-smokers were exposed to second-hand smoke. Factors associated with exposure to second-hand smoke were duration of stay (aOR = 1.01, 95% CI: 1.00-1.02), divorced/widowed marital status (aOR = 0.48, 95% CI: 0.25-0.91), occupation (aOR = 1.29, 95% CI: 1.05-1.58) and the nature of employer (aOR = 0.77, 95% CI: 0.60-0.97). About 95% of participants were aware that lung cancer is one of the hazards of smoking. Non-current smokers had a better knowledge of fertility reduction and accelerated aging as hazards of smoking than current smokers (p < 0.01). Knowledge of the impact of smoking on cardiovascular diseases was relatively low compared with knowledge of other smoking-related hazards (26.1-44.3%). CONCLUSIONS Current smoking and exposure to second-hand smoke among internal migrants in China is high. Socio-demographic characteristics and migration status were strongly associated with current smoking and second-hand smoke exposure. We recommend specifically targeted tobacco control interventions to help to address these risk factors, such as focusing on divorced/widowed women.
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Affiliation(s)
- Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, 100191 People’s Republic of China
- Department of Personnel, Beijing University of Chinese Medicine, Beijing, 100029 People’s Republic of China
| | - Ying Ji
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, 100191 People’s Republic of China
| | - Hongbo Dong
- Graduate School, Peking Union Medical College, Beijing, 100730 People’s Republic of China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, 100191 People’s Republic of China
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Spence W, Zhu L. Perceptions of smoking cessation among Glasgow's Chinese community. Tob Prev Cessat 2017; 3:127. [PMID: 32432201 PMCID: PMC7232811 DOI: 10.18332/tpc/77942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/28/2017] [Accepted: 09/23/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Health related needs and services are stratified by ethnicity in UK. The Chinese community is Scotland’s second-largest minority ethnic group but a relatively under-researched one. This study aimed to explore the views and experiences of smoking cessation and related services among Chinese community members in Glasgow and to inform them about smoking cessation interventions. METHODS This cross-sectional study was conducted in 2016 using a qualitative research method. Purposive sampling methods were used to recruit 15 Chinese community members in Glasgow. Semi-structured interviews were audio-recorded and data transcribed, translated, and thematically analysed. RESULTS Many factors influenced participants’ smoking: concern for personal health, advice from medical professionals, expenditure, family pressure, tobacco-control policies, nicotine dependence, self-efficacy, and acculturation. Smoking initiation and relapse were influenced by interpersonal relations, emotional factors, Chinese social norms, and acculturation. Barriers reported to accessing and participating in cessation services included: excessive or inflexible working hours, low confidence in cessation services, language barriers, cultural barriers and unsuitability of cessation services for Chinese smokers. Employing community resources, improving language support, working with cultural values, and accommodating degrees of acculturation may improve services and their uptake. CONCLUSIONS Smoking-cessation services should consider the culture of this ethnic minority population to improve cessation uptake. Further investigation of this community’s needs and expectations is needed to tailor smoking-cessation interventions for Chinese immigrants in Glasgow.
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Affiliation(s)
| | - Lanyu Zhu
- University of Glasgow, Glasgow, Scotland
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Chan SSC, Cheung YTD, Wong DCN, Jiang CQ, He Y, Yang L, Jiang B, Wu L, Tan SY, Cheng KK, Lam TH. Promoting smoking cessation in China: a foot-in-the-door approach to tobacco control advocacy. Glob Health Promot 2017; 26:41-49. [PMID: 28853637 DOI: 10.1177/1757975917720799] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The Chinese government's implementation of the MPOWER policies and compliance with the WHO Framework Convention on Tobacco Control requirements has been slow. We used the 'foot-in-the-door' approach to promote tobacco control advocacy through capacity building of healthcare leaders, and establishment of smoking cessation clinics in Guangzhou and Beijing (two of the largest cities in China). METHODS This collaborative pilot project involved the University of Hong Kong and three major hospitals in Guangzhou and Beijing. A steering committee conducted the smoking cessation training workshops starting from April 2006, and set up three smoking cessation model clinics during August 2006 to October 2008. We followed up the trained health care professionals (HCPs) in 2014 and 2015 to assess their impacts on tobacco control beyond smoking cessation. RESULTS We emphasized the importance of the general tobacco control atmosphere during smoking cessation training of 139 HCPs to motivate them to engage in tobacco control advocacy. In addition to enhancing their knowledge and skills in cessation, the HCPs were then involved in the establishment of three in-hospital smoking cessation clinics and served as smoking cessation counselors since June 2008. Moreover, they ventured outside the clinics and the community to publicize smoking cessation. Their effort has contributed to smoke-free legislation, better surveillance on smoking and media advocacy on tobacco control in China. CONCLUSIONS The training and establishment of smoking cessation clinics could serve as a means to motivate and empower HCPs who could contribute to broaden tobacco control policy in China.
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Affiliation(s)
| | | | | | | | - Yao He
- Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Li Yang
- Guangzhou No.12 Hospital, Guangdong Province, China
| | - Bin Jiang
- Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | - Lei Wu
- Institute of Geriatrics, Chinese PLA General Hospital, Beijing, China
| | | | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, UK
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong
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Reid JL, Mutti-Packer S, Gupta PC, Li Q, Yuan J, Nargis N, Hussain AKMG, Hammond D. Influence of Health Warnings on Beliefs about the Health Effects of Cigarette Smoking, in the Context of an Experimental Study in Four Asian Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080868. [PMID: 28767068 PMCID: PMC5580572 DOI: 10.3390/ijerph14080868] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 11/16/2022]
Abstract
Cigarette package health warnings can be an important and low-cost means of communicating the health risks of smoking. We examined whether viewing health warnings in an experimental study influenced beliefs about the health effects of smoking, by conducting surveys with ~500 adult male smokers and ~500 male and female youth (age 16-18) in Beijing, China (n = 1070), Mumbai area, India (n = 1012), Dhaka, Bangladesh (n = 1018), and Republic of Korea (n = 1362). Each respondent was randomly assigned to view and rate pictorial health warnings for 2 of 15 different health effects, after which they reported beliefs about whether smoking caused 12 health effects. Respondents who viewed relevant health warnings (vs. other warnings) were significantly more likely to believe that smoking caused that particular health effect, for several health effects in each sample. Approximately three-quarters of respondents in China (Beijing), Bangladesh (Dhaka), and Korea (which had general, text-only warnings) thought that cigarette packages should display more health information, compared to approximately half of respondents in the Mumbai area, India (which had detailed pictorial warnings). Pictorial health warnings that convey the risk of specific health effects from smoking can increase beliefs and knowledge about the health consequences of smoking, particularly for health effects that are lesser-known.
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Affiliation(s)
- Jessica L Reid
- School of Public Health & Health Systems, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada.
| | - Seema Mutti-Packer
- School of Public Health & Health Systems, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada.
- Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
| | - Prakash C Gupta
- Healis-Sekhsaria Institute for Public Health, 501 Technocity, TTC Industrial Area, Mahape, Navi Mumbai, Maharashtra 400701, India.
| | - Qiang Li
- Tobacco Control Office, Chinese Center for Disease Control and Prevention (China CDC), 27 Nan Wei Road, Beijing 100050, China.
- Boehringer Ingelheim (China) Investment Co. Ltd., 18/F, Pingan International Finance Center, Xinyuan S. Rd., Beijing 100027, China.
| | - Jiang Yuan
- Tobacco Control Office, Chinese Center for Disease Control and Prevention (China CDC), 27 Nan Wei Road, Beijing 100050, China.
| | - Nigar Nargis
- American Cancer Society, 555 11th St. NW, Washington, DC 20004, USA.
- Department of Economics, University of Dhaka, Dhaka 1000, Bangladesh.
| | | | - David Hammond
- School of Public Health & Health Systems, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada.
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Parashar M, Singh M, Agarwalla R, Panda M, Pathak R. Predictors of intention to quit tobacco among construction site workers in Delhi, India. Indian J Psychiatry 2017; 59:208-213. [PMID: 28827869 PMCID: PMC5547863 DOI: 10.4103/psychiatry.indianjpsychiatry_368_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Information on predictors of quitting behavior among construction site tobacco users is scarce in India. Hence, this study was conducted to assess the intention of tobacco users toward quitting and its predictors with reference to sociodemographic profile. METHODOLOGY A community-based, observational study was conducted on adult 172 construction site workers in a university campus of Delhi. Data were collected by an interview using the WHO-adopted, pretested, semi-structured questionnaire. Chi-square test was used for univariate analysis. Pearson's correlation coefficient and multivariate logistic regression model were used to identify the predictors. RESULTS Of the 172 users, 73% had intention to quit. More than half of smokers (56.5%) and 81% of smokeless tobacco users intended to quit. Majority of the tobacco users who intended to quit were literate (75.0%), started tobacco use >15 years of age (75.4%), occasional tobacco users (78.9%), and less dependent on nicotine (74.4%). CONCLUSIONS Suitable plan for quitting keeping in mind this vulnerable group of workers should be developed depending on the literacy, type of tobacco used, and nicotine dependency.
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Affiliation(s)
- Mamta Parashar
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India
| | - Mitasha Singh
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India
| | - Rashmi Agarwalla
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India
| | - Meely Panda
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India
| | - Rambha Pathak
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard University, New Delhi, India
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Prevalence of Tobacco Smoking and Determinants of Success in Quitting Smoking among Patients with Chronic Diseases: A Cross-Sectional Study in Rural Western China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020167. [PMID: 28208782 PMCID: PMC5334721 DOI: 10.3390/ijerph14020167] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 02/06/2017] [Indexed: 02/07/2023]
Abstract
Tobacco use is one of the behavioral risk factors for chronic diseases. The aim of the study was to investigate smoking prevalence in chronically ill residents and their smoking behavior in western rural China, to identify factors associated with success in quitting smoking, and to provide appropriate intervention strategies for tobacco control. Cross-sectional survey data from patients with chronic diseases from rural western China were analyzed. Among the 906 chronically ill patients, the current smoking prevalence was 26.2%. About 64.3% of smokers with chronic diseases attempted to quit smoking, 21.0% of which successfully quitted. The odds ratio (OR) of smokers with only one chronic disease to quit smoking successfully was higher than that of those who have other diseases (OR = 2.037, 95% confidence interval (CI) = 1.060-3.912; p < 0.05). The smokers who were always restricted to smoking in public places were more likely to quit smoking successfully than those who were free to smoke (OR = 2.188, 95% CI = 1.116-4.291; p < 0.05). This study suggests that health literacy, comorbidity of diseases, and psychological counseling should be considered when developing targeted tobacco prevention strategies. Strengthening tobacco control measures in public places such as rural medical institutions will be effective.
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Islami F, Torre LA, Drope JM, Ward EM, Jemal A. Global Cancer in Women: Cancer Control Priorities. Cancer Epidemiol Biomarkers Prev 2017; 26:458-470. [PMID: 28183824 DOI: 10.1158/1055-9965.epi-16-0871] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/08/2016] [Indexed: 11/16/2022] Open
Abstract
This review is an abbreviated version of a report prepared for the American Cancer Society Global Health department and EMD Serono, Inc., a subsidiary of Merck KGaA, Darmstadt, Germany, which was released at the Union for International Cancer Control World Cancer Congress in Paris in November 2016. The original report can be found at https://www.cancer.org/health-care-professionals/our-global-health-work/global-cancer-burden/global-burden-of-cancer-in-women.html. Staff in the Intramural Research Department of the American Cancer Society designed and conducted the study, including analysis, interpretation, and presentation of the review. The funding sources had no involvement in the study design, data analysis and interpretation, or preparation of the reviewThe global burden of cancer in women has recently received much attention, but there are few comprehensive reviews of the burden and policy approaches to reduce it. This article, second in series of two, summarizes the most important cancer control priorities with specific examples of proven interventions, with a particular focus on primary prevention in low- and middle-income countries (LMIC). There are a number of effective cancer control measures available to countries of all resource levels. Many of these measures are extremely cost-effective, especially in the case of tobacco control and vaccination. Countries must prioritize efforts to reduce known cancer risk factors and make prevention accessible to all. Effective treatments and palliative care are also needed for those who develop cancer. Given scarce resources, this may seem infeasible in many LMICs, but past experience with other diseases like HIV, tuberculosis, and malaria have shown that it is possible to make affordable care accessible to all. Expansion of population-based cancer registries and research in LMICs are needed for setting cancer control priorities and for determining the most effective interventions. For LMICs, all of these activities require support and commitment from the global community. Cancer Epidemiol Biomarkers Prev; 26(4); 458-70. ©2017 AACRSee related article by Torre et al. in this CEBP Focus section, "Global Cancer in Women."
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Affiliation(s)
- Farhad Islami
- Intramural Research, American Cancer Society, Atlanta, Georgia.
| | - Lindsey A Torre
- Intramural Research, American Cancer Society, Atlanta, Georgia
| | - Jeffrey M Drope
- Intramural Research, American Cancer Society, Atlanta, Georgia
| | | | - Ahmedin Jemal
- Intramural Research, American Cancer Society, Atlanta, Georgia
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Tee GH, Aris T, Rarick J, Irimie S. Social Determinants of Health and Tobacco Use in Five Low and Middle-Income Countries - Results from the Global Adult Tobacco Survey (GATS), 2011 - 2012. Asian Pac J Cancer Prev 2017; 17:1269-76. [PMID: 27039759 DOI: 10.7314/apjcp.2016.17.3.1269] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco consumption continues to be the leading cause of preventable deaths globally. The objective of this study was to examine the associaton of selected socio-demographic variables with current tobacco use in five countries that participated in the Phase II Global Adult Tobacco Survey in 2011 - 2012. MATERIALS AND METHODS We analysed internationally comparable representative household survey data from 33,482 respondents aged ≥ 15 years in Indonesia, Malaysia, Romania, Argentina and Nigeria for determinants of tobacco use within each country. Socio-demographic variables analysed included gender, age, residency, education, wealth index and awareness of smoking health consequences. Current tobacco use was defined as smoking or use of smokeless tobacco daily or occasionally. RESULTS The overall prevalence of tobacco use varied from 5.5% in Nigeria to 35.7% in Indonesia and was significantly higher among males than females in all five countries. Odds ratios for current tobacco use were significantly higher among males for all countries [with the greatest odds among Indonesian men (OR=67.4, 95% CI: 51.2-88.7)] and among urban dwellers in Romania. The odds of current tobacco use decreased as age increased for all countries except Nigeria where. The reverse was true for Argentina and Nigeria. Significant trends for decreasing tobacco use with increasing educational levels and wealth index were seen in Indonesia, Malaysia and Romania. Significant negative associations between current tobacco use and awareness of adverse health consequences of smoking were found in all countries except Argentina. CONCLUSIONS Males and the socially and economically disadvantaged populations are at the greatest risk of tobacco use. Tobacco control interventions maybe tailored to this segment of population and incorporate educational interventions to increase knowledge of adverse health consequences of smoking.
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Affiliation(s)
- Guat Hiong Tee
- Institute for Public Health, National Institutes of Health, Ministry of Health, Malaysia E-mail :
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Content and Methods used to Train Tobacco Cessation Treatment Providers: An International Survey. J Smok Cessat 2016; 12:213-220. [PMID: 29861787 DOI: 10.1017/jsc.2016.22] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction There are limited existing data describing the training methods used to educate tobacco cessation treatment providers around the world. Aims To measure the prevalence of tobacco cessation treatment content, skills training and teaching methods reported by tobacco treatment training programs across the world. Methods Web-based survey in May-September 2013 among tobacco cessation training experts across six geographic regions and four World Bank income levels. Response rate was 73% (84 of 115 countries contacted). Results Of 104 individual programs from 84 countries, most reported teaching brief advice (78%) and one-to-one counseling (74%); telephone counseling was uncommon (33%). Overall, teaching of knowledge topics was more commonly reported than skills training. Programs in lower income countries less often reported teaching about medications, behavioral treatments and biomarkers and less often reported skills-based training about interviewing clients, medication management, biomarker measurement, assessing client outcomes, and assisting clients with co-morbidities. Programs reported a median 15 hours of training. Face-to-face training was common (85%); online programs were rare (19%). Almost half (47%) included no learner assessment. Only 35% offered continuing education. Conclusion Nearly all programs reported teaching evidence-based treatment modalities in a face-to-face format. Few programs delivered training online or offered continuing education. Skills-based training was less common among low- and middle-income countries (LMICs). There is a large unmet need for tobacco treatment training protocols which emphasize practical skills, and which are more rapidly scalable than face-to-face training in LMICs.
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Driezen P, Abdullah AS, Nargis N, Hussain AKMG, Fong GT, Thompson ME, Quah ACK, Xu S. Awareness of Tobacco-Related Health Harms among Vulnerable Populations in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E848. [PMID: 27571090 PMCID: PMC5036681 DOI: 10.3390/ijerph13090848] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/03/2016] [Accepted: 08/19/2016] [Indexed: 11/16/2022]
Abstract
This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011-2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco's harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO's Framework Convention on Tobacco Control.
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Affiliation(s)
- Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
| | - Abu S Abdullah
- Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, USA.
- Global Health Program, Duke Kunshan University, Kunshan 215347, China.
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA.
| | - Nigar Nargis
- Economic and Health Policy Research Unit, American Cancer Society, Atlanta, GA 30303-1002, USA.
| | | | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
- Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada.
| | - Mary E Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
| | - Steve Xu
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
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Cheung YTD, Leung JPK, Cheung CKC, Li WHC, Wang MP, Lam TH. Motivating smokers at outdoor public smoking hotspots to have a quit attempt with a nicotine replacement therapy sample: study protocol for a randomized controlled trial. Trials 2016; 17:355. [PMID: 27456342 PMCID: PMC4960677 DOI: 10.1186/s13063-016-1485-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 06/03/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND About half of the daily smokers in Hong Kong have never tried and have no intention to quit smoking. More than one-third (37.9 %) of daily smokers have attempted to quit but failed. Nicotine replacement therapy (NRT) is a safe and effective pharmacotherapy to increase abstinence by reducing withdrawal symptoms during the early stage of smoking abstinence. However, the prevalence of NRT use in Hong Kong is lower than in most developed countries. The proposed study aims to assess the effectiveness of providing free NRT samples to smokers on increasing quit attempts and the quit rate. METHODS Trained university undergraduate students as ambassadors will invite smokers at outdoor public smoking hotspots to participate in the randomized controlled trial, in which eligible smokers will be randomized to receive a 1-week free NRT sample and medication counselling (intervention) or advice to purchase NRT on their own (control). The primary outcome is self-reported quit attempts (no smoking for at least 24 hours) in the past 30 days at 1-month and 3-month telephone follow-up. DISCUSSION The findings will inform the effectiveness of delivering free NRT samples at outdoor public smoking hotspots to increase quit attempts and abstinence. The study will also provide information on smokers' adherence to the NRT sample, side effects and safety issues related to the usage. This will improve the design of a large trial to test the effect of the NRT sample. TRIAL REGISTRATION ClinicalTrials.gov NCT02491086 . Registered on 7 July 2015.
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Affiliation(s)
- Yee Tak Derek Cheung
- School of Public Health, The University of Hong Kong, Hong Kong, China. .,School of Nursing, The University of Hong Kong, Hong Kong, China.
| | | | | | | | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Jiang S, Beaudoin CE. Smoking Prevention in China: A Content Analysis of an Anti-Smoking Social Media Campaign. JOURNAL OF HEALTH COMMUNICATION 2016; 21:755-764. [PMID: 27232655 DOI: 10.1080/10810730.2016.1157653] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The China Tobacco Control Media Campaign on Sina Weibo is novel in the context of smoking prevention and cessation in China and has not to date been evaluated. This study draws on health behavior theories and dialogic theory in public relations to analyze microblog campaign postings and their relationships with the outcome of online audience engagement. Microblog postings from May 2011 to January 2015 were content analyzed, showing that the most common persuasive content characteristic was perceived risk, followed by subjective norms and self-efficacy. Perceived risk and self-efficacy postings positively influenced online audience engagement, whereas subjective norm postings was a nonsignificant predictor. Postings were more likely to share information than aim to interact with audience members. However, both information sharing and audience interaction postings were positive predictors of online audience engagement. There was also evidence of main and interactive effects of message originality on online audience engagement. The current study has, to the best of our knowledge, broken new ground in 2 regards: (a) using health behavior theories as a basis for analyzing the content of an anti-smoking social media campaign and (b) examining the content of an anti-smoking media campaign of any type in China.
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Affiliation(s)
- Shaohai Jiang
- a Department of Communication , Texas A&M University , College Station , Texas , USA
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Dawood OT, Rashan MAA, Hassali MA, Saleem F. Knowledge and perception about health risks of cigarette smoking among Iraqi smokers. J Pharm Bioallied Sci 2016; 8:146-51. [PMID: 27134468 PMCID: PMC4832906 DOI: 10.4103/0975-7406.171738] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Smoking is a major public health problem, especially in Iraq. There is very little information had been documented regarding smoking risk factors and quit intention among Iraqi smokers. OBJECTIVES The main objectives of this study are to determine smokers' knowledge and perception about smoking health risks; and to determine smoking behavior and quitting intentions among Iraqi smokers; as well as to predict the factors that may associate with quit intentions. METHODS A cross-sectional study was conducted at the outpatient clinic in Tikrit Teaching Hospital, Tikrit City, Iraq. Adult smokers who are smoking cigarette everyday and able to communicate with the researcher were invited to participate in the study. A self-administered questionnaire was used to collect data from 386 participants. RESULTS This study showed that smokers had low awareness about some risk effects of smoking such as lung cancer in nonsmokers (30.1%), impotence in male smokers (52.6%), premature ageing (64%), and stroke (66.3%). In addition, the high score of knowledge and perception was significantly associated with quitting intention. CONCLUSION Smokers' knowledge and perception regarding smoking health effects were low, especially in terms of secondhand smokers. Many efforts needed from health policy-makers and health care professionals to disseminate information about the risks of smoking and health benefits of give up smoking.
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Affiliation(s)
- Omar Thanoon Dawood
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, University of Science Malaysia, Penang, Malaysia
| | | | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, University of Science Malaysia, Penang, Malaysia
| | - Fahad Saleem
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, University of Science Malaysia, Penang, Malaysia
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