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Burnett J. What are the roles for health professionals in addressing the rising threat of the use of nuclear weapons? With particular reference to the activities of the Medical Association for the Prevention of War 1951-1963. Med Confl Surviv 2023; 39:291-299. [PMID: 37431657 DOI: 10.1080/13623699.2023.2231691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Affiliation(s)
- Jack Burnett
- MSc Public Health, London School of Hygiene and Tropical Medicine, London, UK
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Hu H, Liu W, Zhang S, Pan J, Zheng X. Depression mediates the relationship between smoking and pain: Evidence from a nationally representative study in a low- and middle-income country. Addict Behav 2021; 119:106937. [PMID: 33848759 DOI: 10.1016/j.addbeh.2021.106937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/10/2021] [Accepted: 03/25/2021] [Indexed: 02/03/2023]
Abstract
Evidence from high-income countries suggests that depressive symptoms may mediate the relationship between smoking and pain. However, the relationship remains poorly understood for the population in low- and middle-income countries (LMICs), who account for 80% of the current tobacco consumers. Using cross-sectional data from a nationally representative longitudinal survey in China, this study conducted the mediation analysis within the structural equation model (SEM) framework. It tested the indirect effect using the Monte Carlo method. Among the 16,575 participants, 29.2% (n = 4,839) reported being current smokers, 8.5% (n = 1,412) being former smokers, and 62.3% (n = 10,324) being never smokers. Phenotypic characteristics of smokers revealed some distinct characteristics concerning smoking rates, gender, and education attainment compared with results from high-income countries. Besides, current smokers reported significantly higher pain severity than never and former smokers and more depressive symptoms compared with never smokers. The mediation analysis indicated that the self-reported pain was mediated by depressive symptoms 62.7% of the association with smoking and 82.1% of the connection to the number of years quit. However, no mediation effect of depressive symptoms was found for the relationship between the amount smoked and pain severity. This study may fill the literature gap in examining depressive symptoms' mediating role in the relationship between smoking and pain severity for LMICs.
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Hepatic and renal damage by alcohol and cigarette smoking in rats. Toxicol Res 2021; 37:209-219. [PMID: 33868978 DOI: 10.1007/s43188-020-00057-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 07/18/2020] [Accepted: 07/23/2020] [Indexed: 12/23/2022] Open
Abstract
Chronic use of alcohol and tobacco cigarettes is associated to millions of deaths per year, either by direct or indirect causes. However, few studies have explored the additional risks of the combined use of these drugs. Here we assessed the effect of the combined use of alcohol and cigarette smoke on liver or kidney morphology, and on biochemical parameters in chronically treated rats. Male Wistar rats were allocated to receive 2 g/kg alcohol orally, which was followed by the inhalation of smoke from six cigarettes during 2 h (ALTB group) for 28 days. Other groups received alcohol alone (AL) or were exposed to cigarette smoke (TB) alone and were compared to control (CT) rats, which received water followed by ambient air. On day 29, rats were euthanized and blood samples were collected for aminotransferase enzymes (AST and ALT), creatinine, and urea analysis. Liver and kidney were weighted, dissected, fixed, and stained with hematoxylin and eosin for morphological analysis. Our results showed that necrosis was elevated in the AL, TB, and mainly the ALTB group in both liver and kidney of rats. Serum levels of AST and ALT were reduced by cigarette smoke exposure, independently of alcohol use. Serum creatinine levels increased after tobacco smoke exposure. On the other hand, TB and AL groups decreased serum urea levels, and their association restored that decrease. Absolute liver and kidney weights were lower in the cigarette smoke exposure rats. Lastly, body weight gain was lower in TB group and combined use restored it. Thus, we may infer that the use of alcohol, exposure to tobacco cigarette smoke or, mainly, their association promotes liver and kidney injuries, and this damage is related with biochemical changes in rats.
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Iken O, Cadmus E, Ahmed B. Correlates of quit intentions among current Nigerian smokers: Evidence from the 2012 Global Adult Tobacco Surveys (GATS). Tob Prev Cessat 2020; 6:13. [PMID: 32548350 PMCID: PMC7291887 DOI: 10.18332/tpc/115168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/23/2019] [Accepted: 12/09/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Approximately 3.1 million people use tobacco in Nigeria contributing to the burden of tobacco-related morbidity and mortality. However, many tobacco users who have tried to quit have been unable to do so at the first try, but may succeed or give up after multiple attempts. The transtheoretical model helps by classifying those with quit intentions into preparation, contemplation and precontemplation stages. These assist in the development of targeted interventions towards smokers in each stage for more effective results. There is limited evidence about cessation and quitting behaviour in the Nigerian context. This study aimed to explore the factors related to the intention to quit among current tobacco smokers in Nigeria using the transtheoretical model. METHODS The study was a secondary data analysis of the Nigeria 2012 Global Adult Tobacco Survey (GATS). The survey included non-institutionalized men and women aged ≥15 years. Data were analysed using SPSS version 21. The primary outcome variable was smoking quit intention. The correlates of quit intentions were determined for a p<0.05. RESULTS A total of 429 current smokers were mostly in precontemplation (64.7%) while 14.9% were in the preparation stage. Exposure to anti-tobacco media messages was associated with increased quit attempts, however, knowledge about the harmful effects of tobacco was associated with fewer quit intentions. Very few had access to cessation therapy and none had accessed a quitline. Male respondents were 9 times more likely to have a quit intention compared to females (OR=9.615; 95% CI: 1.449-1.478). Respondents with primary education were nearly three times more likely to have quit intentions than those with tertiary education (OR=2.991; 95% CI: 2.930-3.053). CONCLUSIONS While attention is on smoking prevention, most smokers in Nigeria are not considering quitting. There is a need for targeted interventions to reach smokers at various stages.
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Affiliation(s)
- Oluwatomi Iken
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Eniola Cadmus
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Bolaji Ahmed
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
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Cheng HG, Parker MA, Anthony JC. Female-male differences in prescription pain reliever dependence levels: Evidence on newly incident adolescent and young adult users in the United States, 2002-2014. Drug Alcohol Depend 2019; 204:107466. [PMID: 31518887 PMCID: PMC6878123 DOI: 10.1016/j.drugalcdep.2019.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 05/02/2019] [Accepted: 05/02/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND A comprehensive epidemiology of dependence on prescription opioid pain relievers requires evidence about age-specific female-male differences, possibly manifest during adolescent and early adult years. In this study, we identified newly incident extra-medical users of prescription pain relievers (EMPPR), all observed with onsets before the 22nd birthday. We then quantified female-male differences in clinical features or manifestations of opioid dependence (OD), devised a measurement-equivalent OD dimension, and estimated age-specific female-male differences in OD levels. METHOD The population under study included 12-to-21-year-old non-institutionalized civilian community residents of United States sampled for recent nation-scale surveys. Confidential computer-assisted self-interviews identified newly incident EMPPR users (n = 10,188). Analysis-weighted estimation procedures yielded cumulative incidence proportions for each OD feature, evaluated measurement non-equivalence across subgroups, and estimated female-male differences age-by-age. RESULTS (1) Tolerance and salience ('spending a lot of time') are most common OD features. (2) Measurement non-equivalence (bias) was found across sex- and onset-age groups. (3) With biasing features removed, we can see elevated OD levels for female new initiates, age-by-age. Subsidiary analyses suggested possibly accelerated progression toward higher OD levels when extra-medical PPR use starts before age 18. CONCLUSIONS Dimensional approaches to OD and other drug use disorders have gained popularity but can be fragile when differential measurement biases are left uncontrolled. This study's bias-corrected dimensional view of female-male differences shows elevated OD levels among newly incident female EMPPR users relative to new male initiates. Future studies can check for accelerated progression to higher OD levels when EM use starts before age 18 years.
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Affiliation(s)
- Hui G. Cheng
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, 48824, USA
| | - Maria A. Parker
- Department of Psychiatry, Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, 05401, USA
| | - James C. Anthony
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, 48824, USA
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Noubiap JJ, Nansseu JR, Endomba FT, Ngouo A, Nkeck JR, Nyaga UF, Kaze AD, Bigna JJ. Active smoking among people with diabetes mellitus or hypertension in Africa: a systematic review and meta-analysis. Sci Rep 2019; 9:588. [PMID: 30679752 PMCID: PMC6345945 DOI: 10.1038/s41598-018-37858-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 12/15/2018] [Indexed: 12/27/2022] Open
Abstract
The objective was to summarize existing data on the prevalence of active tobacco smoking among patients with hypertension or diabetes mellitus in Africa. We searched PubMed, EMBASE, and AJOL to include studies published from January 01, 2000 to August 23, 2017 reporting on the prevalence of active smoking in individuals aged ≥15 years with hypertension or diabetes mellitus residing inside Africa. We used a random-effects meta-analysis model to pool studies. The pooled prevalence of active smoking among patients with hypertension or diabetes was 12.9% (95%CI: 10.6–15.3; 50 studies; 16,980 patients) and 12.9% (95%CI: 9.6–16.6; 42 studies; 18,564 patients), respectively. For both conditions, the prevalence of active smoking was higher in males than in females (p < 0.001), and in Northern compared to sub-Saharan Africa (p < 0.001). There was no difference between urban and rural settings, and between community-based and hospital-based studies, except for patients with diabetes for whom the prevalence was higher in hospital-based studies (p = 0.032). The prevalence of active smoking is high among patients with hypertension or diabetes mellitus in Africa, with the heaviest burden in Northern Africa. Interventions for smoking prevention or cessation should be implemented in these high risk populations, targeting particularly the males.
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Affiliation(s)
- Jean Jacques Noubiap
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Jobert Richie Nansseu
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.,Department for the Control of Disease, Epidemics and Pandemics, Ministry of Public Health, Yaoundé, Cameroon
| | - Francky Teddy Endomba
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Anderson Ngouo
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Jan René Nkeck
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Ulrich Flore Nyaga
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Arnaud D Kaze
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jean Joel Bigna
- Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon. .,Faculty of Medicine, University of Paris Sud XI, Le Kremlin-Bicêtre, France.
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Owusu D, Wang KS, Quinn M, Aibangbee J, John RM, Mamudu HM. Health Care Provider Intervention and Utilization of Cessation Assistance in 12 Low- and Middle-Income Countries. Nicotine Tob Res 2019; 21:188-196. [PMID: 29420833 PMCID: PMC6329400 DOI: 10.1093/ntr/nty028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 02/02/2018] [Indexed: 11/14/2022]
Abstract
Background and Aim There is a need to improve utilization of cessation assistance in low- and middle-income countries (LMICs), and tobacco cessation research has been identified as priority in LMICs. This study evaluates the relationship between health care provider intervention and cessation assistance utilization in LMICs. Methods Data from 13 967 participants (aged ≥15 years, 90.3% males) of the Global Adults Tobacco Survey conducted in 12 LMICs (74.3%-97.3% response rates) were analyzed with utilization of counseling/cessation clinic, WHO-recommended medications, and quitline as outcome variables. Health care provider intervention ("no intervention," only "tobacco screening," "quit advice") was the exposure variable. Weighted multiple logistic regression models were used to examine the relationship between each outcome variable and the exposure variable, adjusting for other covariates. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) are reported. Results Approximately 52%, 8%, and 40% of participants received no intervention, only tobacco screening, and advice to quit, respectively. Overall, 0.4%, 1.9%, 3.0%, and 4.5% used quitline, WHO-recommended medications, counseling/cessation clinic, and any cessation assistance, respectively. Compared with no intervention, quit advice was associated with increased utilization of quitline (OR = 2.24, 95% CI = 1.2 to 4.4), WHO-recommended medications (OR = 1.67, 95% CI = 1.2 to 2.3), counseling/cessation clinic (OR = 4.41, 95% CI = 3.2 to 6.1), and any assistance (any of the three types) (OR = 2.80, 95% CI = 2.2 to 3.6). Conclusion The findings of this study suggest that the incorporation of quit advice by health care providers in tobacco control programs and health care systems in LMICs could potentially improve utilization of cessation assistance to improve smoking cessation in LMICs. Implications This first study of association between health care provider intervention and the utilization of cessation assistance in LMICs reports that there was a missed opportunity to provide quit advice to about 60% of smokers who visited a health care provider in the past year. The odds of utilization of counseling/cessation clinic, WHO-recommended medications, and quitline were significantly increased in participants who were advised to quit smoking. The results suggest that effective integration and implementation of advice to quit in tobacco control programs and the national health care systems may increase the use of cessation assistance to quit smoking.
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Affiliation(s)
- Daniel Owusu
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA
| | - Ke-Sheng Wang
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN
| | - Megan Quinn
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN
| | - Jocelyn Aibangbee
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN
| | - Rijo M John
- Centre for Public Policy Research, Kochi, India
| | - Hadii M Mamudu
- Department of Health Services Management and Policy, East Tennessee State University, Johnson City, TN
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Meghea CI, Brinzaniuc A, Sidor A, Chereches RM, Mihu D, Iuhas CI, Stamatian F, Caracostea G, Dascal MD, Foley K, Baban A, Voice TC, Blaga OM. A couples-focused intervention for smoking cessation during pregnancy: The study protocol of the Quit Together pilot randomized controlled trial. Tob Prev Cessat 2018; 4:17. [PMID: 30906906 PMCID: PMC6430127 DOI: 10.18332/tpc/89926] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 11/24/2022]
Abstract
Tobacco smoking remains the leading global cause of preventable disease and death. Preconception and pregnancy smoking are high in Central and Eastern Europe. Quit Together is a partnership between a US university and a Romanian university, obstetrics and gynecology clinics in Romania, and other community partners in Romania. The objective of the Quit Together pilot study is to adapt, enhance and test the implementation feasibility and initial efficacy of an evidence-based pregnancy and postnatal couple intervention for smoking cessation in Romania. Quit Together builds on the Motivation and Problem Solving (MAPS) approach, enhanced by targeting the couples' smoking behavior and focusing on dyadic efficacy for smoking cessation. The study is an ongoing randomized controlled trial of 120 Romanian pregnant smokers and their partners. Participants are randomized to: 1) an intervention arm consisting, typically, of up to 8 prenatal and postnatal telephone counseling calls for the women and 4 for their partners, combining motivational strategies and problem-solving/coping skills to encourage the woman to quit smoking and the partner to support her decision; and 2) a control arm (usual care). The primary outcome is maternal biochemically verified smoking abstinence at 3 months postpartum. Quit Together has the potential to identify effective strategies to increase maternal smoking cessation during pregnancy and smoking abstinence after birth. If effective, Quit Together is expected to have a sustainable positive impact on the health of the child, mother and partner, and potentially reduced health system costs.
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Affiliation(s)
- Cristian I. Meghea
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Michigan, USA
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Alexandra Brinzaniuc
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Alexandra Sidor
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Razvan M. Chereches
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Dan Mihu
- Iuliu Hatieganu University of Medicine and Pharmacy, Department of Obstetrics and Gynaecology Dominic Stanca Clinic, Cluj-Napoca, Romania
| | - Cristian I. Iuhas
- Iuliu Hatieganu University of Medicine and Pharmacy, Department of Obstetrics and Gynaecology Dominic Stanca Clinic, Cluj-Napoca, Romania
| | - Florin Stamatian
- Iuliu Hatieganu University of Medicine and Pharmacy, Department of Obstetrics and Gynaecology Clinic I, Cluj-Napoca, Romania
| | - Gabriela Caracostea
- Iuliu Hatieganu University of Medicine and Pharmacy, Department of Obstetrics and Gynaecology Clinic I, Cluj-Napoca, Romania
| | - Marina D. Dascal
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Kristie Foley
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest University, North Carolina, USA
| | - Adriana Baban
- Department of Psychology, Babeșș-Bolyai University, Cluj-Napoca, Romania
| | - Thomas C. Voice
- Department of Civil and Environmental Engineering, College of Engineering, Michigan State University, Michigan, USA
| | - Oana M. Blaga
- Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babeșș-Bolyai University, Cluj-Napoca, Romania
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Stubbs B, Vancampfort D, Veronese N, Kahl KG, Mitchell AJ, Lin PY, Tseng PT, Mugisha J, Solmi M, Carvalho AF, Koyanagi A. Depression and physical health multimorbidity: primary data and country-wide meta-analysis of population data from 190 593 people across 43 low- and middle-income countries. Psychol Med 2017; 47:2107-2117. [PMID: 28374652 DOI: 10.1017/s0033291717000551] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite the known heightened risk and burden of various somatic diseases in people with depression, very little is known about physical health multimorbidity (i.e. two or more physical health co-morbidities) in individuals with depression. This study explored physical health multimorbidity in people with clinical depression, subsyndromal depression and brief depressive episode across 43 low- and middle-income countries (LMICs). METHOD Cross-sectional, community-based data on 190 593 individuals from 43 LMICs recruited via the World Health Survey were analysed. Multivariable logistic regression analysis was done to assess the association between depression and physical multimorbidity. RESULTS Overall, two, three and four or more physical health conditions were present in 7.4, 2.4 and 0.9% of non-depressive individuals compared with 17.7, 9.1 and 4.9% among people with any depressive episode, respectively. Compared with those with no depression, subsyndromal depression, brief depressive episode and depressive episode were significantly associated with 2.62, 2.14 and 3.44 times higher odds for multimorbidity, respectively. A significant positive association between multimorbidity and any depression was observed across 42 of the 43 countries, with particularly high odds ratios (ORs) in China (OR 8.84), Laos (OR 5.08), Ethiopia (OR 4.99), the Philippines (OR 4.81) and Malaysia (OR 4.58). The pooled OR for multimorbidity and depression estimated by meta-analysis across 43 countries was 3.26 (95% confident interval 2.98-3.57). CONCLUSIONS Our large multinational study demonstrates that physical health multimorbidity is increased across the depression spectrum. Public health interventions are required to address this global health problem.
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Affiliation(s)
- B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust,Denmark Hill,London SE5 8AZ,UK
| | - D Vancampfort
- KU Leuven Department of Rehabilitation Sciences,Leuven,Belgium
| | - N Veronese
- Geriatrics Division, Department of Medicine-DIMED,University of Padova,Padova,Italy
| | - K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy,Hannover Medical School,Hannover,Germany
| | - A J Mitchell
- Department of Cancer and Molecular Medicine,University of Leicester,Leicester,UK
| | - P-Y Lin
- Department of Psychiatry,Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine,Kaohsiung,Taiwan
| | - P-T Tseng
- Department of Psychiatry,Tsyr-Huey Mental Hospital,Kaohsiung Jen-Ai's Home,Taiwan
| | | | - M Solmi
- Department of Neurosciences,University of Padova,Padova,Italy
| | - A F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine,Federal University of Ceará,Fortaleza, CE 60430-040,Brazil
| | - A Koyanagi
- Research and Development Unit,Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu,Dr. Antoni Pujadas, 42,Sant Boi de Llobregat,Barcelona 08830,Spain
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10
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Kuehnle D, Wunder C. The Effects of Smoking Bans on Self-Assessed Health: Evidence from Germany. HEALTH ECONOMICS 2017; 26:321-337. [PMID: 26749275 DOI: 10.1002/hec.3310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 11/09/2015] [Accepted: 12/01/2015] [Indexed: 06/05/2023]
Abstract
We examine the effects of smoking bans on self-assessed health in Germany taking into account heterogeneities by smoking status, gender and age. We exploit regional variation in the dates of enactment and dates of enforcement across German federal states. Using data from the German Socio-Economic Panel, our difference-in-differences estimates show that non-smokers' health improves, whereas smokers report no or even adverse health effects in response to bans. We find statistically significant health improvements especially for non-smokers living in households with at least one smoker. Non smokers' health improvements materialise largely with the enactment of smoking bans. Copyright © 2016 John Wiley & Sons, Ltd.
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Ossip DJ, Quiñones Z, Diaz S, Thevenet-Morrison K, Fisher S, Holderness H, Cai X, McIntosh S, Dozier A, Chin N, Weber E, Sanchez JJ, Bautista A, Héctor A. Tobacco Cessation in Economically Disadvantaged Dominican Republic Communities: Who are the Ex-Users? J Smok Cessat 2016; 11:239-249. [PMID: 28025600 PMCID: PMC5181849 DOI: 10.1017/jsc.2015.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Tobacco use and harm continue to increase in low- and middle income countries (LMICs) globally. Smoking cessation is the most effective means of reducing morbidity and mortality from tobacco use. Increasing the prevalence of ex-users is an indicator of population cessation. AIMS This study provides the first examination of factors associated with ex-tobacco use status in the Dominican Republic (DR), a LMIC in the Latin America and Caribbean region. METHODS Baseline surveillance was conducted for 1177 randomly selected households in 7 economically disadvantaged DR communities (total N=2680 adult household members). RESULTS Ex-user prevalence was 10.6% (1.0%-18.5% across communities), 14.8% were current users (9.1-20.4), and quit ratios were 41.7% (9.7%-52.7%). Among ever-users, females (OR 2.02, 95% CI 1.41, 2.90), older adults (45-64: OR 1.75, 95% CI 1.12, 2.74; 65+: OR 2.09, 95% CI 1.29, 3.39), and those who could read/write (OR 1.64, 95% CI 1.08, 2.50), had health conditions (OR 1.63, 95% CI 1.11, 2.41), and lived with ex-users (OR 1.70, 95% CI 1.12, 2.58) were over 60% to two times as likely to be ex-users. Those from remote communities (OR 0.52, 95% CI 0.36, 0.74), using chewed tobacco (OR 0.14, 95% CI 0.04, 0.48) and living with tobacco users (OR 0.55, 95% CI 0.37, 0.81) were less likely to be ex-users. CONCLUSIONS Ex-user prevalence and quit ratios were lower than for high income countries. Implementing broad tobacco control measures, combined with clinically targeting vulnerable groups, may increase tobacco cessation to most effectively reduce this public health crisis.
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Affiliation(s)
- Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Zahíra Quiñones
- Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic
| | - Sergio Diaz
- Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic
- Hospital Regional Universitario José Maria Cabral y Baez, Santiago, Dominican Republic
| | - Kelly Thevenet-Morrison
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Susan Fisher
- Department of Clinical Sciences, Temple University School of Medicine, Philadelphia, PA, USA
| | - Heather Holderness
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Xeuya Cai
- Department of Biostatistics, University of Rochester Medical Center, Rochester, NY, USA
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Ann Dozier
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Nancy Chin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Emily Weber
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Jose Javier Sanchez
- Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic
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Abstract
Electronic cigarette (e-cigarette) simulates the act of tobacco smoking by vaporizing a mixture of propylene glycol, nicotine, and flavoring agents. e-cigarette has been proposed as a product able to aid to stop smoking. The aim of the study is to verify the clinical variations of periodontal health induced by e-cigarettes use and, moreover, to investigate about the awareness of the e-smokers about their health variations and about their hypothetical need to turn back to smoke combustible cigarettes.This clinical observational pilot study involved 110 out of 350 smokers, who switched to e-cigarette. Patients were subjected to oral examinations. A questionnaire to self-assess the variations of some parameters of general health, and to self-assess the need to smoke combustible cigarettes, was distributed to such subjects involved in the study.At the end of the study, we registered a progressive improvement in the periodontal indexes, as well as in the general health perception. Finally, many patients reported an interesting reduction in the need to smoke.In the light of this pilot study, the e-cigarette can be considered as a valuable alternative to tobacco cigarettes, but with a positive impact on periodontal and general health status.
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13
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Tulloch HE, Pipe AL, Els C, Clyde MJ, Reid RD. Flexible, dual-form nicotine replacement therapy or varenicline in comparison with nicotine patch for smoking cessation: a randomized controlled trial. BMC Med 2016; 14:80. [PMID: 27233840 PMCID: PMC4884360 DOI: 10.1186/s12916-016-0626-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Extended use of combined pharmacotherapies to treat tobacco dependence may increase smoking abstinence; few studies have examined their effectiveness. The objective of this study was to evaluate smoking abstinence with standard nicotine patch (NRT), extended use of combined formulations of nicotine replacement therapy (NRT+), or varenicline (VR). METHODS A total of 737 smokers, including those with medical and psychiatric comorbidities, were randomly assigned to one of the above three treatment conditions. The NRT group received 10 weeks of patches (21 mg daily maximum); the NRT+ group received patches (35 mg daily maximum) and gum or inhaler for up to 22 weeks; and the VR group received 1 mg twice daily for up to 24 weeks (22 weeks post target quit date). All participants also received six standardized 15-minute smoking cessation counseling sessions by nurses experienced in tobacco dependence treatment. The primary outcome was carbon monoxide-confirmed continuous abstinence rates (CAR) from weeks 5-52. Secondary outcomes were: CAR from weeks 5-10 and 5-22, and carbon monoxide-confirmed 7-day point prevalence (7PP) at weeks 10, 22, and 52. Adjusted and unadjusted logistic regression analyses were conducted using intention-to-treat procedures. RESULTS The CARs for weeks 5-52 were 10.0 %, 12.4 %, and 15.3 % in the NRT, NRT+, and VR groups, respectively; no group differences were observed. Results with 7PP showed that VR was superior to NRT at week 52 (odds ratio (OR), 1.84; 97.5 % Confidence Interval (CI), 1.04-3.26) in the adjusted intention-to-treat analysis. Those in the VR group had higher CAR at weeks 5-22 (OR, 2.01; CI, 1.20-3.36) than those in the NRT group. Results with 7PP revealed that both NRT+ (OR, 1.72; CI, 1.04-2.85) and VR (OR, 1.96; CI, 1.20-3.23) were more effective than NRT at 22 weeks. As compared to NRT monotherapy, NRT+ and VR produced significant increases in CAR for weeks 5-10 (OR, 1.52; CI, 1.00-2.30 and OR, 1.58; CI, 1.04-2.39, respectively); results were similar, but somewhat stronger, when 7PP was used at 10 weeks (OR, 1.57; CI, 1.03-2.41 and OR, 1.79; CI, 1.17-2.73, respectively). All medications were well tolerated, but participants in the VR group experienced more fatigue, digestive symptoms (e.g., nausea, diarrhea), and sleep-related concerns (e.g., abnormal dreams, insomnia), but less dermatologic symptoms than those in the NRT or NRT+ groups. The frequency of serious adverse events did not differ between groups. CONCLUSIONS Flexible and combination NRT and varenicline enhance success in the early phases of quitting. Varenicline improves abstinence in the medium term; however, there is no clear evidence that either varenicline or flexible, dual-form NRT increase quit rates in the long-term when compared to NRT monotherapy. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01623505 ; Retrospectively registered on July 13, 2011.
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Affiliation(s)
- Heather E Tulloch
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4 W7, Canada. .,Faculty of Medicine, University of Ottawa, Ottawa, Canada. .,School of Psychology, University of Ottawa, Ottawa, Canada.
| | - Andrew L Pipe
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4 W7, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Charl Els
- Department of Psychiatry, 1E1 Walter Mackenzie Health Sciences Centre, University of Alberta, Edmonton, AB, T6G 2R7, Canada
| | - Matthew J Clyde
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4 W7, Canada.,School of Psychology, University of Ottawa, Ottawa, Canada
| | - Robert D Reid
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4 W7, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada
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14
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The impact of regional economic reliance on the tobacco industry on current smoking in China. Health Place 2015; 33:159-71. [DOI: 10.1016/j.healthplace.2014.12.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/18/2014] [Accepted: 12/24/2014] [Indexed: 11/23/2022]
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15
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Schenberg EE, de Castro Comis MA, Chaves BR, da Silveira DX. Treating drug dependence with the aid of ibogaine: a retrospective study. J Psychopharmacol 2014; 28:993-1000. [PMID: 25271214 DOI: 10.1177/0269881114552713] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Ibogaine is an alkaloid purported to be an effective drug dependence treatment. However, its efficacy has been hard to evaluate, partly because it is illegal in some countries. In such places, treatments are conducted in underground settings where fatalities have occurred. In Brazil ibogaine is unregulated and a combined approach of psychotherapy and ibogaine is being practiced to treat addiction. To evaluate the safety and efficacy of ibogaine, we conducted a retrospective analysis of data from 75 previous alcohol, cannabis, cocaine and crack users (72% poly-drug users). We observed no serious adverse reactions or fatalities, and found 61% of participants abstinent. Participants treated with ibogaine only once reported abstinence for a median of 5.5 months and those treated multiple times for a median of 8.4 months. This increase was statistically significant (p < 0.001), and both single or multiple treatments led to longer abstinence periods than before the first ibogaine session (p < 0.001). These results suggest that the use of ibogaine supervised by a physician and accompanied by psychotherapy can facilitate prolonged periods of abstinence, without the occurrence of fatalities or complications. These results suggest that ibogaine can be a safe and effective treatment for dependence on stimulant and other non-opiate drugs.
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Affiliation(s)
- Eduardo Ekman Schenberg
- Universidade Federal de São Paulo, Departamento de Psiquiatria, Instituto Plantando Consciência, São Paulo, Brazil
| | | | | | - Dartiu Xavier da Silveira
- Universidade Federal de São Paulo, Programa de Orientação e Atendimento a Dependentes (PROAD), Departamento de Psiquiatria, Instituto Plantando Consciência, São Paulo, Brazil
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16
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Tulloch H, Pipe A, Els C, Aitken D, Clyde M, Corran B, Reid RD. Flexible and extended dosing of nicotine replacement therapy or varenicline in comparison to fixed dose nicotine replacement therapy for smoking cessation: rationale, methods and participant characteristics of the FLEX trial. Contemp Clin Trials 2014; 38:304-13. [PMID: 24861558 DOI: 10.1016/j.cct.2014.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/13/2014] [Accepted: 05/16/2014] [Indexed: 01/23/2023]
Abstract
Quitting smoking is the single most effective strategy to reduce morbidity and premature mortality in smokers. Research has demonstrated the effectiveness of pharmacotherapy in smoking cessation, but few studies have directly compared varenicline and monotherapy nicotine replacement therapy (NRT) and none have examined varenicline and combinations of NRT products. The majority of smoking cessation trials involve carefully circumscribed populations, making their results less generalizable to those with severe medical conditions or psychiatric comorbidities. This paper reports on the rationale, methodology and participant characteristics of a randomized controlled trial designed to: (1) determine which pharmacotherapy - NRT, long term combinations of NRT, or varenicline - is most effective in achieving abstinence; (2) investigate the incidence of neuropsychiatric symptoms among participants over the course of their quit attempt; and (3) assess whether there is a significant difference in the incidence of neuropsychiatric symptoms in those receiving differing pharmacotherapies, and between those with and without psychiatric illnesses. The primary outcome was carbon monoxide confirmed abstinence from weeks 5-52 following a target quit date. Secondary outcomes included neuropsychiatric (i.e., depression, suicidal ideation, anxiety, anger) and withdrawal symptoms. Smokers (N=737) were randomly assigned to one of three treatment conditions, and were scheduled to attend 8 follow-up appointments over 12 months. All participants received 6-15 minute practical counseling sessions with nurse counselors experienced in treating tobacco dependence. We expect that the results will lead to an enhanced understanding of the efficacy of these pharmacotherapies, including those with a history of psychiatric illness.
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Affiliation(s)
- Heather Tulloch
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada.
| | - Andrew Pipe
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Charl Els
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Debbie Aitken
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Matthew Clyde
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Brigitte Corran
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Robert D Reid
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
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17
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Goodwin RD, Kim JH, Weinberger AH, Taha F, Galea S, Martins SS. Symptoms of alcohol dependence and smoking initiation and persistence: a longitudinal study among US adults. Drug Alcohol Depend 2013; 133:718-23. [PMID: 24183052 PMCID: PMC4363125 DOI: 10.1016/j.drugalcdep.2013.08.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/26/2013] [Accepted: 08/26/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND A large number of adults report symptoms of, but do not meet diagnostic criteria for, an alcohol use disorder. Yet, little is known about the relationship between symptoms of alcohol use disorders and the initiation and persistence of smoking. This study prospectively examines the relationship between having 1-2 symptoms of alcohol dependence (without abuse) and smoking initiation and persistence as well as nicotine dependence over a 3-year period among adults in the United States. METHODS Data were drawn from Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Relationships between Wave 1 symptoms of alcohol dependence, alcohol abuse, and alcohol dependence and initiation and persistence of cigarette smoking and nicotine dependence at Wave 2 were examined using logistic regression analyses. Analyses were adjusted for demographics, mood and anxiety disorders. RESULTS Symptoms of alcohol dependence were associated with smoking initiation at Wave 2. There was no association between symptoms of alcohol dependence and smoking persistence. Symptoms of alcohol dependence predicted incident and persistent nicotine dependence. Findings persisted after adjusting for demographic characteristics and mood/anxiety disorders. CONCLUSIONS Even 1-2 symptoms of alcohol dependence are associated with increased vulnerability to smoking initiation and onset and persistence of nicotine dependence at a similar strength as alcohol use disorders. Efforts at smoking cessation must address problematic alcohol use, even at the subclinical level, in order to improve efficacy.
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Affiliation(s)
- Renee D. Goodwin
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), 65–30 Kissena Boulevard, Flushing, NY 11367, USA, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA,Corresponding author at: Department of Psychology, Queens College, City University of New York (CUNY), 65–30 Kissena Boulevard, Flushing, NY 11367, USA. Tel.: +1 718 997 3247; fax: +1 212 342 5170. , (R.D. Goodwin)
| | - June H. Kim
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Andrea H. Weinberger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA, Cancer Prevention and Control Research Program, Yale Cancer Center, New Haven, CT 06520, USA
| | - Farah Taha
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), 65–30 Kissena Boulevard, Flushing, NY 11367, USA
| | - Sandro Galea
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Silvia S. Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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18
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Reda AA, Kotz D, Biadgilign S. Adult tobacco use practice and its correlates in eastern Ethiopia: a cross-sectional study. Harm Reduct J 2013; 10:28. [PMID: 24171800 PMCID: PMC4175506 DOI: 10.1186/1477-7517-10-28] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2011] [Accepted: 10/27/2013] [Indexed: 11/17/2022] Open
Abstract
Background There is paucity of data on the smoking habits of rural populations in developing countries. This study aimed to explore cigarette smoking practices of a rural community in Ethiopia. Methods A community based cross-sectional study was conducted among 548 individuals from a random sample of households in a rural town and its surrounding rural districts. Descriptive statistics and logistic regression were performed. Results Twenty-eight percent (95% CI: 24.3% - 31.6%) of the respondents were current smokers. A total of 105 (68%) smokers expressed an interest to quit while 37 (34%) had tried to quit previously but without success. There was high exposure to second-hand smoke: 285 (52%) homes allowed indoor smoking, and in 181 (33%) indoor smoking took place daily. Current smoking was strongly associated with male sex (OR = 83.0; 95% CI: 11.5 – 599.0), and being a student was found to be protective of smoking (OR = 0.04; 95% CI: 0.005 – 0.05). Conclusion Cigarette smoking is prevalent among the male rural town population in Ethiopia. In addition, a high level of exposure to indoor second-hand smoke exists. There is a need for investment in rural tobacco control, including educational campaigns and cost-effective smoking cessation services.
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Affiliation(s)
- Ayalu Alex Reda
- Population Studies and Training Center, Brown University, Providence, RI, USA.
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19
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Cheng HG, McBride O, Phillips MR. Relationship between knowledge about the harms of smoking and smoking status in the 2010 Global Adult Tobacco China Survey. Tob Control 2013; 24:54-61. [PMID: 23988861 PMCID: PMC4283701 DOI: 10.1136/tobaccocontrol-2013-051163] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND This analysis estimates the association between smoking-related knowledge and smoking behaviour in a Chinese context. To identify the specific knowledge most directly related to smoking status, we used a novel latent variable analysis approach to adjust for the high correlations between different measures of knowledge about tobacco smoking. METHOD Data are from the Global Adult Tobacco China Survey, a nationally representative sample of 13 354 household-dwelling individuals 15 years of age or older. Multinomial logistic regressions estimated the association between smoking status (ie, never smoked, current smoker or past smoker) and four smoking-related beliefs: whether or not smoking causes lung cancer, heart attack and stroke, and whether or not low-tar cigarettes are less harmful. A latent variable approach reassessed these associations while taking into account the general level of knowledge about smoking. RESULTS After demographic variables and general knowledge about smoking had been controlled for, the belief that low-tar cigarettes are not less harmful was more prevalent in persons who had never smoked than in current smokers (OR=1.3 (95% CI 1.0 to 1.7) in men and OR=2.8 (95% CI 1.3 to 5.9) in women); this association was even stronger when past smokers and current smokers were compared (OR=2.1 (95% CI 1.5 to 3.0) in men and OR=5.0 (95% CI 1.3 to 20.1) in women). CONCLUSIONS Compared with those who have never smoked and those who have ceased smoking, current smokers in China are more likely to believe that low-tar cigarettes are less harmful than regular cigarettes.
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Affiliation(s)
- Hui G Cheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Orla McBride
- School of Psychology, University of Ulster, Londonderry, Northern Ireland
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China Departments of Psychiatry and Global Health, Emory University, Atlanta, Georgia, USA
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20
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Constantine ML, Adejoro OO, D'Silva J, Rockwood TH, Schillo BA. Evaluation of Use of Stage of Tobacco Epidemic to Predict Post-Immigration Smoking Behaviors. Nicotine Tob Res 2013; 15:1910-7. [DOI: 10.1093/ntr/ntt077] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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21
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Hosseinpoor AR, Bergen N, Kunst A, Harper S, Guthold R, Rekve D, d'Espaignet ET, Naidoo N, Chatterji S. Socioeconomic inequalities in risk factors for non communicable diseases in low-income and middle-income countries: results from the World Health Survey. BMC Public Health 2012; 12:912. [PMID: 23102008 PMCID: PMC3507902 DOI: 10.1186/1471-2458-12-912] [Citation(s) in RCA: 145] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 10/22/2012] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Monitoring inequalities in non communicable disease risk factor prevalence can help to inform and target effective interventions. The prevalence of current daily smoking, low fruit and vegetable consumption, physical inactivity, and heavy episodic alcohol drinking were quantified and compared across wealth and education levels in low- and middle-income country groups. METHODS This study included self-reported data from 232,056 adult participants in 48 countries, derived from the 2002-2004 World Health Survey. Data were stratified by sex and low- or middle-income country status. The main outcome measurements were risk factor prevalence rates reported by wealth quintile and five levels of educational attainment. Socioeconomic inequalities were measured using the slope index of inequality, reflecting differences in prevalence rates, and the relative index of inequality, reflecting the prevalence ratio between the two extremes of wealth or education accounting for the entire distribution. Data were adjusted for confounding factors: sex, age, marital status, area of residence, and country of residence. RESULTS Smoking and low fruit and vegetable consumption were significantly higher among lower socioeconomic groups. The highest wealth-related absolute inequality was seen in smoking among men of low- income country group (slope index of inequality 23.0 percentage points; 95% confidence interval 19.6, 26.4). The slope index of inequality for low fruit and vegetable consumption across the entire distribution of education was around 8 percentage points in both sexes and both country income groups. Physical inactivity was less prevalent in populations of low socioeconomic status, especially in low-income countries (relative index of inequality: (men) 0.46, 95% confidence interval 0.33, 0.64; (women) 0.52, 95% confidence interval 0.42, 0.65). Mixed patterns were found for heavy drinking. CONCLUSIONS Disaggregated analysis of the prevalence of non-communicable disease risk factors demonstrated different patterns and varying degrees of socioeconomic inequalities across low- and middle-income settings. Interventions should aim to reach and achieve sustained benefits for high-risk populations.
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Affiliation(s)
- Ahmad Reza Hosseinpoor
- Department of Health Statistics and Information Systems, World Health Organization, 20, Avenue Appia, Geneva, CH-1211, Switzerland
| | - Nicole Bergen
- Department of Health Statistics and Information Systems, World Health Organization, 20, Avenue Appia, Geneva, CH-1211, Switzerland
| | - Anton Kunst
- Department of Public Health, AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Sam Harper
- Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada
| | - Regina Guthold
- Department of Chronic Diseases and Health Promotion, World Health Organization, Geneva, Switzerland
| | - Dag Rekve
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | | | - Nirmala Naidoo
- Department of Health Statistics and Information Systems, World Health Organization, 20, Avenue Appia, Geneva, CH-1211, Switzerland
| | - Somnath Chatterji
- Department of Health Statistics and Information Systems, World Health Organization, 20, Avenue Appia, Geneva, CH-1211, Switzerland
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22
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Troost JP, Barondess DA, Storr CL, Elisabeth Wells J, Al-Hamzawi AO, Andrade LH, Bromet E, Bruffaerts R, Florescu S, de Girolamo G, de Graaf R, Gureje O, Haro JM, Hu C, Huang Y, Karam AN, Kessler RC, Lepine JP, Matschinger H, Medina-Mora ME, O’Neill S, Posada-Villa J, Sagar R, Takeshima T, Tomov T, Williams DR, Anthony JC. An updated global picture of cigarette smoking persistence among adults. J Epidemiol Glob Health 2012; 2:135-44. [PMID: 23626929 PMCID: PMC3635135 DOI: 10.1016/j.jegh.2012.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 06/06/2012] [Accepted: 06/28/2012] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Cross-national variance in smoking prevalence is relatively well documented. The aim of this study is to estimate levels of smoking persistence across 21 countries with a hypothesized inverse relationship between country income level and smoking persistence. METHODS Data from the World Health Organization World Mental Health Survey Initiative were used to estimate cross-national differences in smoking persistence--the proportion of adults who started to smoke and persisted in smoking by the date of the survey. RESULTS There is large variation in smoking persistence from 25% (Nigeria) to 85% (China), with a random-effects meta-analytic summary estimate of 55% with considerable cross-national variation. (Cochran's heterogeneity Q statistic = 6845; p < 0.001). Meta-regressions indicated that observed differences are not attributable to differences in country's income level, age distribution of smokers, or how recent the onset of smoking began within each country. CONCLUSION While smoking should remain an important public health issue in any country where smokers are present, this report identifies several countries with higher levels of smoking persistence (namely, China and India).
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Affiliation(s)
- Jonathan P. Troost
- Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - David A. Barondess
- Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Carla L. Storr
- Department of Family and Community Health, School of Nursing, University of Maryland, Baltimore, MD 21201, USA
- Adjunct in Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - J. Elisabeth Wells
- Department of Public Health and General Practice, University of Otago, Christchurch, PO Box 8140, New Zealand
| | - Ali Obaid Al-Hamzawi
- Department of Psychiatry, College of Medicine, Qadisia University, Diwania Province, Iraq
| | - Laura Helena Andrade
- Section of Psychiatric Epidemiology- LIM 23 Department and Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Evelyn Bromet
- Department of Psychiatry, State University of New York at Stony Brook, United States
| | - Ronny Bruffaerts
- Department of Psychiatry, University Hospital Gasthuisberg, Leuven, Belgium
| | - Silvia Florescu
- Scoala Nationala de Sanatate Publica si Perfectionare in Domeniul Sanitar, Bucuresti, Romania
| | | | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | - Chiyi Hu
- Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Shenzhen, China
| | - Yueqin Huang
- Institute of Mental Health, Peking University, Beijing, China
| | - Aimee N. Karam
- Department of Psychiatry and Clinical Psychology, Saint George Hospital University Medical Center, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University Medical School, Beirut, Lebanon
- The Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | | | - Jean-Pierre Lepine
- Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM U 705, CNRS UMR 7157 University Paris Diderot and Paris Descartes Paris, France
| | - Herbert Matschinger
- Institut für Arbeits- und Sozialmedizin, Universität Leipzig, Medizinische Fakultät, Leipzig, Germany
| | | | | | | | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India
| | - Tadashi Takeshima
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan
| | - Toma Tomov
- New Bulgarian University, Institute for Human Relations, Sofia, Bulgaria
| | - David R. Williams
- Professor of Public Health, Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA, USA
| | - James C. Anthony
- Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
- Adjunct in Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
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Picco L, Subramaniam M, Abdin E, Vaingankar JA, Chong SA. Smoking and Nicotine Dependence in Singapore: Findings from a Cross-Sectional Epidemiological Study. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2012. [DOI: 10.47102/annals-acadmedsg.v41n8p325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Smoking is one of the leading preventable causes of death throughout the world and can lead to nicotine dependence, particularly when initiated at a young age. This paper describes the prevalence of smoking and nicotine dependence in the adult Singapore resident population, whilst also exploring rates among the major ethnic groups (Chinese, Malay and Indian), different education levels and those with chronic psychiatric and physical comorbidities. Material and Methods: The Singapore Mental Health Study (SMHS) is a cross-sectional epidemiological study that was conducted between December 2009 and December 2010. Information on smoking status was assessed using the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and the Fagerstrom Test for Nicotine Dependence measured nicotine dependence. Socio-demographic information was also collected. Results: In total, 6616 respondents participated in the SMHS giving a response rate of 75.9%. We found that 16% of the population were current smokers and 4.5% had nicotine dependence. Current smokers were more likely to be younger (18 to 34 years old), males, Malay and have lower education, whilst males had a 4.6 times higher risk of nicotine dependence to that of females. The prevalence of nicotine dependence was also higher in those with alcohol abuse and those experiencing chronic pain. Conclusion: The results from this study highlight the important differences in the prevalence of smoking and nicotine dependence among different age groups, gender and ethnicity in Singapore and are important for developing future health policies and targeted preventive strategies.
Key words: Ethnicity, Gender, Population, Prevalence
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Usmanova G, Neumark Y, Baras M, McKee M. Patterns of adult tobacco use in Uzbekistan. Eur J Public Health 2011; 22:704-7. [DOI: 10.1093/eurpub/ckr125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Shmulewitz D, Keyes KM, Wall MM, Aharonovich E, Aivadyan C, Greenstein E, Spivak B, Weizman A, Frisch A, Grant BF, Hasin D. Nicotine dependence, abuse and craving: dimensionality in an Israeli sample. Addiction 2011; 106:1675-86. [PMID: 21545668 PMCID: PMC3163441 DOI: 10.1111/j.1360-0443.2011.03484.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AIMS Evidence-based changes planned for Diagnostic and Statistical Manual 5th edition (DSM-5) substance use disorders (SUDs) include combining dependence and three of the abuse criteria into one disorder and adding a criterion indicating craving. Because DSM-IV did not include a category for nicotine abuse, little empirical support is available for aligning the nicotine use disorder criteria with the DSM-5 criteria for other SUDs. DESIGN Latent variable analyses, bootstrap tests and likelihood ratio tests were used to explore the unidimensionality, psychometric properties and information of the nicotine criteria. SETTING AND PARTICIPANTS A sample of household residents selected from the Israeli population register yielded 727 life-time cigarette smokers. MEASUREMENTS DSM-IV nicotine dependence criteria and proposed abuse and craving criteria, assessed with a structured interview. FINDINGS Three abuse criteria (hazardous use, social/interpersonal problems and neglect roles) were prevalent among smokers, formed a unidimensional latent trait with nicotine dependence criteria, were intermixed with dependence criteria across the severity spectrum and significantly increased the diagnostic information over the dependence-only model. A craving criterion was shown to fit well with the other criteria. CONCLUSION Similar to findings from research on other substances, nicotine dependence, abuse and craving criteria appear to derive from a common underlying dimension. The results support alignment of nicotine criteria with those for alcohol and drug use disorders in Diagnostic and Statistical Manual 5th edition.
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Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurol 2011; 10:819-28. [PMID: 21775213 DOI: 10.1016/s1474-4422(11)70072-2] [Citation(s) in RCA: 1725] [Impact Index Per Article: 132.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
At present, about 33·9 million people worldwide have Alzheimer's disease (AD), and prevalence is expected to triple over the next 40 years. The aim of this Review was to summarise the evidence regarding seven potentially modifiable risk factors for AD: diabetes, midlife hypertension, midlife obesity, smoking, depression, cognitive inactivity or low educational attainment, and physical inactivity. Additionally, we projected the effect of risk factor reduction on AD prevalence by calculating population attributable risks (the percent of cases attributable to a given factor) and the number of AD cases that might be prevented by risk factor reductions of 10% and 25% worldwide and in the USA. Together, up to half of AD cases worldwide (17·2 million) and in the USA (2·9 million) are potentially attributable to these factors. A 10-25% reduction in all seven risk factors could potentially prevent as many as 1·1-3·0 million AD cases worldwide and 184,000-492,000 cases in the USA.
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Affiliation(s)
- Deborah E Barnes
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA 94121, USA.
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Yang J, Hammond D, Driezen P, O'Connor RJ, Li Q, Yong HH, Fong GT, Jiang Y. The use of cessation assistance among smokers from China: Findings from the ITC China Survey. BMC Public Health 2011; 11:75. [PMID: 21288361 PMCID: PMC3044660 DOI: 10.1186/1471-2458-11-75] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 02/02/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Stop smoking medications significantly increase the likelihood of smoking cessation. However, there are no population-based studies of stop-smoking medication use in China, the largest tobacco market in the world. This study examined stop-smoking medication use and its association with quitting behavior among a population-based sample of Chinese smokers. METHODS Face-to-face interviews were conducted with 4,627 smokers from six cities in the ITC China cohort survey. Longitudinal analyses were conducted using Wave 1 (April to August, 2006) and Wave 2 (November 2007 to January 2008). RESULTS Approximately 26% of smokers had attempted to quit between Waves 1 and 2, and 6% were abstinent at 18-month follow-up. Only 5.8% of those attempting to quit reported NRT use and NRT was associated with lower odds of abstinence at Wave 2 (OR = 0.11; 95%CI = 0.03-0.46). Visiting a doctor/health professional was associated with greater attempts to quit smoking (OR = 1.60 and 2.78; 95%CI = 1.22-2.10 and 2.21-3.49 respectively) and being abstinent (OR = 1.77 and 1.85; 95%CI = 1.18-2.66 and 1.13-3.04 respectively) at 18-month follow-up relative to the smokers who did not visit doctor/health professional. CONCLUSIONS The use of formal help for smoking cessation is low in China. There is an urgent need to explore the use and effectiveness of stop-smoking medications in China and in other non-Western markets.
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Affiliation(s)
- Jilan Yang
- Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Canada
| | - David Hammond
- Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Canada
| | - Pete Driezen
- Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Canada
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Qiang Li
- National Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hua-Hie Yong
- The Cancer Council Victoria, Melbourne, Australia
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Yuan Jiang
- National Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
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Posada-Villa J, Cheng HG, Martins SS, Storr CL, Aguilar-Gaxiola SA, Anthony JC. The tobacco dependence dimension in Colombia. Rev Panam Salud Publica 2011; 29:52-56. [PMID: 21390420 PMCID: PMC4802498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 10/26/2010] [Indexed: 05/30/2023] Open
Abstract
This epidemiological study of a sample of smokers from the general population of Colombia examined the population distribution and dimensionality of eight hypothesized inter-correlated clinical features (CFs) associated with tobacco dependence syndrome (TDS). Data were drawn from interviews of 4 426 smokers conducted in a national survey in Colombia as part of the World Mental Health Survey Initiative. Daily smokers completed a Spanish-language TDS module, and the 237 smokers who had begun smoking during the five years prior to the assessment were selected. Confirmatory factor analysis (CFA) for a unidimensional TDS provided discrimination and difficulty parameter estimates. Two CFs that were reported very infrequently among the study sample were dropped from the CFA. Among the six remaining CFs, discrimination (D1) estimates ranged from 1.1 to 6.0 and difficulty (D2) estimates ranged from 1.1 to 2.2, providing evidentiary support for a unidimensional tobacco dependence construct. The Spanish-language TDS module used in this study could serve as a valuable tool in future studies for evaluating public health outreach and early intervention programs directed toward community residents who have begun smoking tobacco.
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Affiliation(s)
- Jose Posada-Villa
- Centro Médico de la Sabana, Universidad Colegio Mayor de Cundinamarca, Bogota, Colombia
| | - Hui G. Cheng
- Department of Epidemiology, Michigan State University, East Lansing, Michigan, United States of America
| | - Silvia S. Martins
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Carla L. Storr
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, Maryland, United States of America
| | - Sergio A. Aguilar-Gaxiola
- Department of Internal Medicine, School of Medicine, University of California–Davis, Sacramento, California, United States of America
| | - James C. Anthony
- Department of Epidemiology, Michigan State University, East Lansing, Michigan, United States of America
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