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Danielsen D, Vinther JL, Holt DH, Jakobsen GS, Bast LS, Andersen S. Factors sustaining legitimacy of smoking in Vocational Education and Training (VET) schools: a qualitative needs assessment. BMC Public Health 2024; 24:683. [PMID: 38438986 PMCID: PMC10913276 DOI: 10.1186/s12889-024-18033-8] [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: 09/01/2023] [Accepted: 02/07/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Most adult smokers started smoking in their teenage years, which increases the risk of nicotine dependence. In Denmark, there is a high prevalence of youth smoking among students in Vocational Education and Training (VET). However, reducing and preventing smoking in this group is a major challenge. This article presents a needs assessment aimed to explore factors sustaining legitimacy of smoking in VET schools and consider the measures needed to prepare VET schools' implementation of smoking reduction and prevention interventions. METHODS Participant observations were conducted in four VET classes representing three VET schools in Denmark with a duration of four days each. Individual, semi-structured interviews were conducted with teachers, managers, and a student advisor, as well as four focus groups with a total of 20 students. Interviews were audio-taped, transcribed, and the data material was analyzed following Malterud's systematic text condensation. FINDINGS Factors that helped sustain legitimacy of smoking in VET schools included a positive and normalized attitude towards smoking at home and among friends, an understanding of smoking as an integral and expected practice in VET professions and schools, a perceived reliance on smoking as an icebreaker in new social relations and as a pedagogical tool, and smoking as a habit and a means to deal with boredom and stress relief. CONCLUSIONS The factors sustaining legitimacy of smoking in VET schools are reciprocal and call for smoking reduction and prevention intervention efforts which consider and address social influence, habitual behavior, and psychological needs, as well as changes at the policy level.
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Affiliation(s)
- Dina Danielsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
| | - Johan Lerbech Vinther
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ditte Heering Holt
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Gitte Sofie Jakobsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Susan Andersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Bou-Hamad I, Hoteit J, Yehya N, Ghandour L. Personality traits and high cigarette dependence among university students: Insights from Lebanon. PLoS One 2024; 19:e0298193. [PMID: 38359081 PMCID: PMC10868771 DOI: 10.1371/journal.pone.0298193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/20/2024] [Indexed: 02/17/2024] Open
Abstract
PURPOSE The use of tobacco and cigarette products remains widespread globally, with varying patterns across countries. Understanding the factors influencing cigarette dependence among young adults is crucial for effective smoking prevention and control programs. Personality traits are one of the factors that influence smoking behaviour, yet the evidence on their role in high cigarette dependence among young adults remains inconclusive. This study aims to provide insights and initial evidence on the potential association between personality dimensions, sociodemographic factors, lifestyle habits, and high cigarette dependence among Lebanese university students. METHODS A convenient sample of 212 student smokers from one private and one public university in Lebanon participated in an online survey. The survey included measures of personality traits using the Big-Five framework, sociodemographic factors, lifestyle habits, and the Fagerström Test for Cigarette Dependence (FTCD). Logistic regression models and mediation analysis were used to analyze the data. RESULTS The results revealed significant associations between personality dimensions and high cigarette dependence among Lebanese university students. Smokers with higher levels of Openness to Experience were more likely to have high cigarette dependence (β = 0.408, p < = 0.015). Conversely, smokers with higher levels of Conscientiousness (β = -0.500, p < 0.001) and Agreeableness (β = -0.491, p < 0.01) were less likely to have high cigarette dependence. Additionally, attending a public university (β = 1.198, p = 0.018), having more close friends who smoke (β = 0.525, p < 0.01), and switching to a cheaper cigarette brand (β = 0.928, p < 0.05) were associated with a higher cigarette dependence. CONCLUSION These findings highlight the importance of considering personality dimensions, sociodemographic factors, and lifestyle habits in understanding high cigarette dependence among Lebanese university students. The results can inform the development of targeted interventions to address high cigarette dependence in this population.
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Affiliation(s)
- Imad Bou-Hamad
- Department of Business Information and Decision Systems, Suliman S. Olayan School of Business, American University of Beirut, Beirut, Lebanon
| | - Jaafar Hoteit
- Department of Business Information and Decision Systems, Suliman S. Olayan School of Business, American University of Beirut, Beirut, Lebanon
| | - Nadine Yehya
- Department of Public Affairs and Marketing, University of California, Davis, California, United States of America
| | - Lilian Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Prom-Wormley EC, Wells JL, Landes L, Edmondson AN, Sankoh M, Jamieson B, Delk KJ, Surya S, Bhati S, Clifford J. A scoping review of smoking cessation pharmacogenetic studies to advance future research across racial, ethnic, and ancestral populations. Front Genet 2023; 14:1103966. [PMID: 37359362 PMCID: PMC10285878 DOI: 10.3389/fgene.2023.1103966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/25/2023] [Indexed: 06/28/2023] Open
Abstract
Abstinence rates among smokers attempting to quit remain low despite the wide availability and accessibility of pharmacological smoking cessation treatments. In addition, the prevalence of cessation attempts and abstinence differs by individual-level social factors such as race and ethnicity. Clinical treatment of nicotine dependence also continues to be challenged by individual-level variability in effectiveness to promote abstinence. The use of tailored smoking cessation strategies that incorporate information on individual-level social and genetic factors hold promise, although additional pharmacogenomic knowledge is still needed. In particular, genetic variants associated with pharmacological responses to smoking cessation treatment have generally been conducted in populations with participants that self-identify as White race or who are determined to be of European genetic ancestry. These results may not adequately capture the variability across all smokers as a result of understudied differences in allele frequencies across genetic ancestry populations. This suggests that much of the current pharmacogenetic study results for smoking cessation may not apply to all populations. Therefore, clinical application of pharmacogenetic results may exacerbate health inequities by racial and ethnic groups. This scoping review examines the extent to which racial, ethnic, and ancestral groups that experience differences in smoking rates and smoking cessation are represented in the existing body of published pharmacogenetic studies of smoking cessation. We will summarize results by race, ethnicity, and ancestry across pharmacological treatments and study designs. We will also explore current opportunities and challenges in conducting pharmacogenomic research on smoking cessation that encourages greater participant diversity, including practical barriers to clinical utilization of pharmacological smoking cessation treatment and clinical implementation of pharmacogenetic knowledge.
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Affiliation(s)
- Elizabeth C. Prom-Wormley
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Jonathan L. Wells
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Lori Landes
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Amy N. Edmondson
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Mariam Sankoh
- Department of Integrative Life Sciences, Virginia Commonwealth University, Richmond, VA, United States
| | - Brendan Jamieson
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Kayla J. Delk
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Sanya Surya
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Shambhavi Bhati
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - James Clifford
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, United States
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Mat Salleh R, Baharom N, Siau CS, Chan CMH, Amit N, Sia PY, Wee LH. E-Cigarette Users' Profiles and Their Association with Identified Impacts of COVID-19 on Vaping among Young Adults in Malaysia. Healthcare (Basel) 2023; 11:healthcare11030434. [PMID: 36767009 PMCID: PMC9914650 DOI: 10.3390/healthcare11030434] [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: 12/12/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Electronic cigarettes (ECs) users' profiles and behaviors during the COVID-19 pandemic remain unclear. This cross-sectional study aimed to explore Malaysian EC users' profiles and their associations with related behaviors during the pandemic. The EC users (N = 351) were recruited from an official national vape entity. Respondents were predominantly of Malay ethnicity (90.6%), aged 31 to 35 years (27.6%), males (97.7%), married (68.7%), from Malaysia's west region states (63.5%) and tertiary educated (69.2%). The majority (80.3%) were non-dual users, and most purchased their vaping products online (77.2%), liked that they can vape while working at home (83.8%) and vaped more because of boredom (55.3%), had low and moderate nicotine addiction levels (94.9%), had low motivation level to quit EC use (92.6%) and were more likely to perceive that vaping did not increase the chances of complications from COVID-19. Respondents with moderate to high addiction levels had twice the odds of checking on their current EC supplies, whilst respondents with low motivation to quit had higher odds of using their tank/pod until the last drop and distancing from others when vaping. EC users should be encouraged to quit EC use, especially during the COVID-19 pandemic.
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Affiliation(s)
- Rawaida Mat Salleh
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Nizam Baharom
- Primer Care Health Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Bandar Baru Nilai, Nilai 71800, Negeri Sembilan, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Caryn Mei Hsien Chan
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Noh Amit
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Pei Yin Sia
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Lei Hum Wee
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
- Faculty of Health and Medical Sciences, Taylors University Lakeside Campus, No. 1 Jalan Taylor’s, Subang Jaya 47500, Selangor, Malaysia
- Correspondence: or
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Vedøy TF, Lund KE. Beliefs about harms of cigarette smoking among Norwegian adults born from 1899 to 1969. Do variations across education, smoking status and sex mirror the decline in smoking? PLoS One 2022; 17:e0271647. [PMID: 35921379 PMCID: PMC9348701 DOI: 10.1371/journal.pone.0271647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 07/05/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND AND AIM Smoking is one of the most important causes of socioeconomic disparities in morbidity and mortality. The aim of this study was to examine if beliefs about harms of smoking differed across gender, smoking status and education among Norwegian adults born between 1899 and 1969. METHODS Using data from a nationally representative survey of smoking habits and a multinomial logit/negative binomial two-stage hurdle model design, we examined (first hurdle) the associations between birth cohort, gender, education and smoking status and four beliefs about cigarette smoking: i) smoking is not harmful, ii) do not know if smoking is harmful, iii) any number of cigarettes per day (CPD) is harmful and iv) smoking more than a given nonzero number of CPD is harmful, and (second hurdle) the predicted number of CPD that could be smoked without causing harm (from outcome iv). RESULTS The probability of believing that smoking was not harmful was close to zero, regardless of birth cohort, sex, education and smoking status. The probability of not knowing if smoking was harmful decreased from around 0.7 to almost zero across cohorts. The probability of believing that smoking more than zero CPD was harmful increased from less than 0.1 to around 0.7, while the probability of believing that there is some safe level of smoking increased with cohorts born from 1900 to 1930 before declining. Respondents with primary/secondary education consistently believed smoking to be less harmful compared to respondents with tertiary education, but cohort trajectories were similar. DISCUSSION The similar birth cohort trajectories in beliefs about the harms of smoking do not support the idea that Norwegian adults with lower education has had qualitatively different beliefs about the harmfulness of smoking compared to those with higher education. The persistent and large socioeconomic gradient is likely a result of other factors.
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Affiliation(s)
- Tord Finne Vedøy
- Department of Alcohol, Norwegian Institute of Public Health, Tobacco and Drugs, Oslo, Norway
| | - Karl Erik Lund
- Department of Alcohol, Norwegian Institute of Public Health, Tobacco and Drugs, Oslo, Norway
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Adhikari N, Uddin S. Health Inequalities in Older Norwegians and the Mediating Role of Social Networks. Int J Aging Hum Dev 2022:914150221112281. [PMID: 35837689 DOI: 10.1177/00914150221112281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to contribute to understanding how social networks serve as an intervening pathway leading to socioeconomic health inequality among older adults in Norway. Longitudinal survey data from the second and the third waves of the Norwegian Life Course, Ageing, and Generation Study were used in this paper. Hayes PROCESS was used to estimate the mediating effect of the contact frequency and the support potential of friends on the impact of social-economic position (SEP) at wave 2 on health outcomes at wave 3. The total indirect effect of the income on physical health observed was 0.04. The total indirect effect of the highest level of education attained on physical health observed was 0.12. The result showed a social-economic gradient in health among older adults in Norway where the social network is a crucial pathway via which SEP influences peoples' health.
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Affiliation(s)
- Nabaraj Adhikari
- International Social Welfare and Health Policy Scholar, 418298Oslo Metropolitan University, Oslo, Norway.,Master of Public Health, The Royal Tropical Institute (KIT), Amsterdam, the Netherlands
| | - Shahad Uddin
- International Social Welfare and Health Policy Scholar, 418298Oslo Metropolitan University, Oslo, Norway
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Rahman T, Baker AL, Gould GS, Palazzi K, Lambkin D, Kennedy M. Factors Associated with Smoke-Free Pregnancy among Aboriginal and Torres Strait Women and Their Experience of Quitting Smoking in Pregnancy: A Mixed Method Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11240. [PMID: 34769756 PMCID: PMC8583423 DOI: 10.3390/ijerph182111240] [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] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/10/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022]
Abstract
Smoke-free pregnancies have long-term health benefits for mothers and babies. This paper quantitatively examines factors associated with smoke-free pregnancies among Aboriginal and Torres Strait Islander women (hereafter Aboriginal women) and qualitatively explores their smoking cessation (SC) experiences during pregnancy. An Aboriginal-led online cross-sectional study on SC was conducted with Aboriginal women and in partnership with Aboriginal communities, between July and October 2020. The present analysis includes participants who made a pregnancy-related quit attempt (N = 103). Chi-squared tests, logistic regression models, and thematic analysis of free-form text responses were performed. The adjusted odds of having smoke-free pregnancies were 4.54 times higher among participants who used Aboriginal Health Services (AHS) (AOR = 4.54, p-value 0.018). Participants living in urban settings had 67% lower odds of having smoke-free pregnancies compared to their regional/remote counterparts (AOR = 0.33, p-value 0.020). Qualitative data revealed strong motivations to reduce tobacco-related harms to the fetus and variability in quitting experiences at different stages of and across pregnancies. Smoking cessation care (SCC) can support Aboriginal women meaningfully if their quitting experiences are considered in SCC development and implementation. Consistent funding for AHS-led SCC is needed to garner health benefits for Aboriginal peoples. More research into urban versus regional/remote differences in maternal SC is recommended.
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Affiliation(s)
- Tabassum Rahman
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Amanda L. Baker
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Gillian S. Gould
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW 2450, Australia;
| | - Kerrin Palazzi
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - David Lambkin
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
| | - Michelle Kennedy
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2308, Australia; (A.L.B.); (M.K.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia; (K.P.); (D.L.)
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Menthol Smoking and Nicotine Dependence among Black/African American Women Smokers Living in Low-Resource, Rural Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010877. [PMID: 34682623 PMCID: PMC8535496 DOI: 10.3390/ijerph182010877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 12/23/2022]
Abstract
Black/African American women from low-resource, rural communities bear a disproportionate burden of tobacco-related morbidity and mortality. This study examined associations between menthol smoking and socioeconomic deprivation with nicotine dependence and quitting behaviors among Black/African American women cigarette and/or little cigar/cigarillo smokers, aged 18–50 living in low-resource, rural communities. Baseline survey data from a randomized controlled behavioral/intervention trial (#NCT03476837) were analyzed (n = 146). Outcomes included time to first tobacco product (cigarette/little cigar/cigarillo) use within 5 min of waking, Fagerstrom Test for Nicotine Dependence (FTND) score, and ever attempting to quit cigarettes. Socioeconomic deprivation measures included education, income, and receiving supplemental nutritional assistance (SNAP) program benefits. In adjusted regression analyses, menthol smoking was associated with both greater FTND scores and time to first tobacco product use within 5 min of waking, but not ever attempting to quit cigarettes. Regardless of menthol status, only 25.0% of smokers reported that they would quit smoking if menthol cigarettes were banned. The proportion of smokers who smoked their first tobacco product within 5 min of waking increased slightly with greater socioeconomic deprivation. Additional research and targeted efforts are needed to reduce nicotine dependence among Black/African American women smokers living in rural, low-resource communities where access to cessation services is limited.
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Lund I, Moan IS. The role of alcohol use and cigarette smoking in sickness absence: Are there social inequalities? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 94:103190. [PMID: 33713965 DOI: 10.1016/j.drugpo.2021.103190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 11/21/2020] [Accepted: 02/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND While studies have found a social gradient in negative consequences of drinking and smoking, evidence is less clear for a gradient also in alcohol use and smoking's association with sickness absence. We investigate the association between alcohol use and cigarette smoking and general sickness absence, and examine the moderating role of socio-economic status for these associations when controlling for general health status. METHOD Questions on alcohol use, measured by the Alcohol Use Disorders Identification Test (AUDIT-C), smoking, general health and sickness absence were included in annual national cross-sectional telephone surveys on alcohol, tobacco and drug use (2015-18) amongst Norwegian adults aged 16-79-years (average response rate=59%). The analytic sample comprised 4719 full- and part-time employees aged 25-79 years (46.7% were female, mean age=44.3 years). Individual-level data on education were obtained from national registries. RESULTS In adjusted negative binomial regression analyses, current and former daily smoking were associated with a higher occurrence of sickness absence in groups with low educational attainment, but not in groups with high educational attainment. Alcohol use was negatively associated with sickness absence. While a significantly higher number of sickness days was reported by smokers in the low compared with the high education group, educational attainment did not moderate the alcohol use - sickness absence association. CONCLUSION Daily smoking is associated with sickness absence. A negative social gradient was found in the smoking - absence association. Reduced daily smoking might give a reduction in sickness absence.
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Affiliation(s)
- Ingeborg Lund
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Tobacco and Drugs PB 222 Skøyen, 0213 Oslo, Norway.
| | - Inger Synnøve Moan
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Tobacco and Drugs PB 222 Skøyen, 0213 Oslo, Norway
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Lund M, Kvaavik E. Methods Used in Smoking Cessation and Reduction Attempts: Findings from Help-Seeking Smokers. J Smok Cessat 2021; 2021:6670628. [PMID: 34306230 PMCID: PMC8279185 DOI: 10.1155/2021/6670628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/17/2021] [Accepted: 02/21/2021] [Indexed: 11/17/2022] Open
Abstract
In addition to traditional smoking cessation methods like nicotine replacement therapy (NRT), new methods such as mobile applications and e-cigarettes have been added to the toolbox. The purpose of this study was to examine which methods smokers currently use in quit or reduction attempts and map characteristics of users of the various methods. In this study, participants were smokers who visited a website or called a quit line for smoking cessation and who were currently in quit or reduction attempts (N = 740). Data were collected in Norway in 2013-2017 through a web survey. Most smokers were currently trying to quit, and the most frequently used methods were a smoking cessation app for mobile phones, nicotine replacement therapies (NRTs), and e-cigarettes. Logistic regression analyses identified older daily smokers with high cigarette consumption as NRT users, while the users of a cessation app were younger females. The use of e-cigarettes was associated with older, low educated smokers with low cigarette consumption. The use of the mobile phone app was associated with having made several recent quit attempts. The study provides insight into help-seeking smokers' preferences for smoking cessation methods and user characteristics. This knowledge is relevant for further work in smoking cessation planning and policies.
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Knaappila N, Marttunen M, Fröjd S, Lindberg N, Kaltiala R. Changes in cannabis use according to socioeconomic status among Finnish adolescents from 2000 to 2015. J Cannabis Res 2020; 2:44. [PMID: 33526131 PMCID: PMC7819333 DOI: 10.1186/s42238-020-00052-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Despite reduced sanctions and more permissive attitudes toward cannabis use in the USA and Europe, the prevalences of adolescent cannabis use have remained rather stable in the twenty-first century. However, whether trends in adolescent cannabis use differ between socioeconomic groups is not known. The aim of this study was to examine trends in cannabis use according to socioeconomic status among Finnish adolescents from 2000 to 2015. METHODS A population-based school survey was conducted biennially among 14-16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for any and frequent cannabis use over time according to socioeconomic adversities were calculated using crosstabs and chi-square test. Associations between any and frequent cannabis use, time, and socioeconomic adversities were studied using binomial logistic regression results shown by odds ratios with 95% confidence intervals. RESULTS At the overall level, the prevalences of lifetime and frequent cannabis use varied only slightly between 2000 and 2015. Cannabis use was associated with socioeconomic adversities (parental unemployment in the past year, low parental education, and not living with both parents). The differences in any and frequent cannabis use between socioeconomic groups increased significantly over the study period. CONCLUSIONS Although the overall changes in the prevalence of adolescent cannabis use were modest, cannabis use increased markedly among adolescents with the most socioeconomic adversities. Socioeconomic adversities should be considered in the prevention of adolescent cannabis use.
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Affiliation(s)
- Noora Knaappila
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Mauri Marttunen
- Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, FI-00014 Helsinki, Finland
| | - Sari Fröjd
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Nina Lindberg
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, PO Box 590, 00029 HUS, Helsinki, Finland
| | - Riittakerttu Kaltiala
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
- Vanha Vaasa Hospital, Vierinkiventie 1, 65380 Vaasa, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, 33380 Pitkäniemi, Finland
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Põld M, Pärna K. Changes in Addressing Patients' Smoking: Cross-Sectional Data from 2002 and 2014 among Physicians in Estonia. Tob Use Insights 2020; 13:1179173X20949269. [PMID: 32922108 PMCID: PMC7446266 DOI: 10.1177/1179173x20949269] [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: 05/11/2020] [Accepted: 07/08/2020] [Indexed: 11/23/2022] Open
Abstract
Background: For health professionals, personal and contextual factors influence addressing patients’ smoking habits. The objective of the study was to describe frequency of addressing patients’ smoking in 2002 and 2014 and to analyse factors related to addressing patients’ smoking habits. Methods: Data of physicians from 2 postal cross-sectional surveys were used (n = 4140 in 2002, n = 5666 in 2014). The number of respondents was 2747 in 2002 and 2903 in 2014. The corrected response rate was 67.8% and 53.1%, respectively. Age-standardized frequency of addressing patients’ smoking during the last 7 days was determined. Distribution of other variables along with confidence intervals (CI) was calculated. Logistic regression was used to analyse association of addressing patients’ smoking with attitudes and perceived barriers regarding addressing patients’ smoking and with background factors. Fully adjusted odds ratios (OR) with 95% CIs were calculated. Results: The age-standardized prevalence of addressing patients’ smoking habits among men was 84.4% (95% CI 80.3–88.5) in 2002 and 88.3% (95% CI (84.5–92.2) in 2014, among women 82.1% (95% CI 80.2–83.9) and 89.0% (95% CI 87.2–90.8), respectively. According to logistic regression analysis, in 2014, significantly more physicians agreed that it is doctors’ responsibility to convince people to stop smoking (among men, OR 2.32; 95% CI 1.19–4.54, among women OR 1.41; 95% CI 1.06–1.88), that smoking prevention should form part of health professionals’ training, that physicians should have smoking related hand-out materials, and that lack of time was a barrier to addressing patients’ smoking. Addressing patients’ smoking was significantly associated with attitudes and perceived barriers regarding addressing patients’ smoking, age, and other background factors (among women only). Conclusions: Addressing patients’ smoking habits was more common in 2014 than in 2002, but the change was significant among women only. Compared to 2002, in 2014 physicians’ attitudes regarding addressing patients’ smoking were more approving. Results of this study are useful for policymakers and institutions involved in organization and development of smoking prevention training and cessation services.
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Affiliation(s)
- Mariliis Põld
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Kersti Pärna
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
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Moan IS, Bye EK, Storvoll EE, Lund IO. Self-reported harm from others' alcohol, cigarette and illegal drug use in Norway. NORDIC STUDIES ON ALCOHOL AND DRUGS 2019; 36:413-429. [PMID: 32934576 PMCID: PMC7434141 DOI: 10.1177/1455072519836372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 02/14/2019] [Indexed: 11/25/2022] Open
Abstract
AIMS While it is documented that substance use harms others than the user, less is known about which substances people experience most harm from, and who the victims and perpetrators are. The aims were: (i) to estimate the prevalence of and overlap in self-reported harm from others' alcohol, cigarette, and illegal drug use; (ii) to examine potential differences in the prevalence of harm from close relations' and strangers' use; and (iii) to examine how the prevalence of harm varies according to demographics and the respondents' substance use. METHODS Population surveys conducted among 16-64-year-old Norwegians in 2012 and 2016 (N = 3407) assessed self-reported harm from others' alcohol, cigarette and illegal drug use with identical measures, demographic variables and the respondents' substance use. RESULTS Experience of harm from others' alcohol use was most common, followed by others' smoking. For all three substances, a higher proportion experienced harm from close relations' use. Nearly half had experienced harm from others' use of at least one substance. Women and younger participants were more likely to report harm from others' alcohol and cigarette use. While alcohol and illegal drug users were more often harmed by others' use of these substances, smokers reported being less often harmed by others' smoking. CONCLUSIONS Self-reported harm from others' alcohol, cigarette and illegal drug use corresponds with the prevalence of use of these substances in Norway. For all three substances, close relations' use accounted for more harm than strangers' use. Own substance use was an important correlate of experienced harm.
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Affiliation(s)
- Inger Synnøve Moan
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Norway
| | - Elin K Bye
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Norway
| | - Elisabet E Storvoll
- Norwegian Institute of Public Health, Division of Mental and Physical Health, Norway
| | - Ingunn Olea Lund
- Norwegian Institute of Public Health, Department of Mental Disorders, Norway
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14
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Nargis N, Yong HH, Driezen P, Mbulo L, Zhao L, Fong GT, Thompson ME, Borland R, Palipudi KM, Giovino GA, Thrasher JF, Siahpush M. Socioeconomic patterns of smoking cessation behavior in low and middle-income countries: Emerging evidence from the Global Adult Tobacco Surveys and International Tobacco Control Surveys. PLoS One 2019; 14:e0220223. [PMID: 31490958 PMCID: PMC6730869 DOI: 10.1371/journal.pone.0220223] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 07/11/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Tobacco smoking is often more prevalent among those with lower socio-economic status (SES) in high-income countries, which can be driven by the inequalities in initiation and cessation of smoking. Smoking is a leading contributor to socio-economic disparities in health. To date, the evidence for any socio-economic inequality in smoking cessation is lacking, especially in low- and middle-income countries (LMICs). This study examined the association between cessation behaviours and SES of smokers from eight LMICs. METHODS Data among former and current adult smokers aged 18 and older came from contemporaneous Global Adult Tobacco Surveys (2008-2011) and the International Tobacco Control Surveys (2009-2013) conducted in eight LMICs (Bangladesh, Brazil, China, India, Mexico, Malaysia, Thailand and Uruguay). Adjusted odds ratios (AORs) of successful quitting in the past year by SES indicators (household income/wealth, education, employment status, and rural-urban residence) were estimated using multivariable logistic regression controlling for socio-demographics and average tobacco product prices. A random effects meta-analysis was used to combine the estimates of AORs pooled across countries and two concurrent surveys for each country. RESULTS Estimated quit rates among smokers (both daily and occasional) varied widely across countries. Meta-analysis of pooled AORs across countries and data sources indicated that there was no clear evidence of an association between SES indicators and successful quitting. The only exception was employed smokers, who were less likely to quit than their non-employed counterparts, which included students, homemakers, retirees, and the unemployed (pooled AOR≈0.8, p<0.10). CONCLUSION Lack of clear evidence of the impact of lower SES on adult cessation behaviour in LMICs suggests that lower-SES smokers are not less successful in their attempts to quit than their higher-SES counterparts. Specifically, lack of employment, which is indicative of younger age and lower nicotine dependence for students, or lower personal disposable income and lower affordability for the unemployed and the retirees, may be associated with quitting. Raising taxes and prices of tobacco products that lowers affordability of tobacco products might be a key strategy for inducing cessation behaviour among current smokers and reducing overall tobacco consumption. Because low-SES smokers are more sensitive to price increases, tobacco taxation policy can induce disproportionately larger decreases in tobacco consumption among them and help reduce socio-economic disparities in smoking and consequent health outcomes.
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Affiliation(s)
- Nigar Nargis
- American Cancer Society, Atlanta, Georgia, United States of America
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Lazarous Mbulo
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Luhua Zhao
- CDC Foundation, Atlanta, Georgia, United States of America
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Ron Borland
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- VicHealth Centre for Tobacco Control, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Krishna M. Palipudi
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Gary A. Giovino
- School of Public Health and Health Professions, University at Buffalo, SUNY, Buffalo, New York, United States of America
| | - James F. Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Mohammad Siahpush
- Department of Health Promotion, Social & Behavioral Health, College of Public Health, University of Nebraska Medical Center, Nebraska, United States of America
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15
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Nur Atikah AH, Wee LH, Nur Zakiah MS, Chan CMH, Mohamed Haniki NM, Swinderjit JS, Siau CS. Factors associated with different smoking statuses among Malaysian adolescent smokers: a cross-sectional study. BMC Public Health 2019; 19:579. [PMID: 31196055 PMCID: PMC6565528 DOI: 10.1186/s12889-019-6857-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study focused on the associations between socioeconomic status (SES) and adolescent smoking among secondary school students (13 to 17 years) in the Federal Territory of Kuala Lumpur, Malaysia. Our objective was to evaluate the relationships between adolescent demographics, socioeconomic status and smoking status. METHODS The survey data were based on baseline findings from a cross-sectional study (N = 422 adolescents). Chi-square test was used to assess the relationship between demographic characteristics, socioeconomic status (household monthly income and daily allowance) and adolescent smoking status. Exhaled carbon monoxide (CO) reading and the Hooked on Nicotine Checklist (HONC) were used to evaluate adolescent smoking status. A Multivariate Multinomial Logistic Regression (MMLR) was employed to test selected demographic and socioeconomic predictors of smoking status. RESULTS Of the 422 adolescents (M age = 15.58, SD = 1.24), more than half of the participants initiated smoking between 13 to 17 years old (59.0%). A total of 308 (73.0%) were electronic cigarette users, with more than 50% comprising of single users. The mean CO reading was 2.14 ppm with 78.0% of adolescents scoring more than 0 on the Hooked on Nicotine Checklist (HONC). Males and participants aged 15 and 16 years were at increased risks of sole CC smoking. Meanwhile, males, those who are not hooked on smoking and with a non-smoker CO reading were at increased risks of sole EC smoking. Finally, Bumiputeras were at less risk of EC smoking. CONCLUSIONS Demographic variables such as age, gender and ethnicity predicted smoking status predicted smoking risk, but not socioeconomic factors. The findings allow policy makers to target specific high-risk demographic groups when designing smoking cessation programs for adolescents.
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Affiliation(s)
- A H Nur Atikah
- Health Education Program, Community Health Centre, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- Health Education Program, Community Health Centre, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia.
| | - M S Nur Zakiah
- Health Education Program, Community Health Centre, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Caryn Mei Hsien Chan
- Health Education Program, Community Health Centre, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - N M Mohamed Haniki
- Kulliyah of Pharmacy, International Islamic of Malaysia (UIA), Kuala Lumpur, Malaysia
| | - J S Swinderjit
- National Cancer Society Malaysia (NCSM), Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Health Education Program, Community Health Centre, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia.,Faculty of Social Sciences and Liberal Arts, UCSI University, Kuala Lumpur, Malaysia
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16
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Sæbø G, Lund PB. Children's right to smoke-free air: Public support in Norway for banning smoking in vehicles with children present. Health Policy 2019; 123:492-498. [PMID: 30905527 DOI: 10.1016/j.healthpol.2019.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 02/15/2019] [Accepted: 03/05/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Children have a statutory right to a smoke-free environment, and tobacco control advocates are now considering regulation of smoking behavior in the private sphere. The Norwegian Institute of Public Health has investigated the support for a ban on smoking in cars with children compared to other possible extensions of the tobacco act among the Norwegian public. MATERIAL AND METHODS A nationwide representative survey (CAWI) of 5543 participants was conducted in 2014-2015. Respondents were asked to consider several possible new tobacco control measures, through selfreported ranking on 5-point scales for each measure. Multiple logistic regression models were applied to control for confounders (i.a. smoking behavior) for the tendency to state full support. RESULTS A majority (78 % of all respondents, 61.8% of daily smokers) supported a proposal prohibiting smoking in cars when children are present. This proposal received substantially more support than bans on private balconies, in parks and at public transport stops and work entrances. Full support for the latter proposals varied between 39.9% and 58.1% (between 2.7% and 16.8% among smokers). Differences by smoking status were maintained after multiple controls. INTERPRETATION The strong endorsement of the proposal (also provided by the majority of current smokers) suggests high legitimacy and compliance, which means that an implementation could be introduced without serious enforcement problems.
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Affiliation(s)
- Gunnar Sæbø
- Norwegian Institute of Public Health (FHI), PO Box 4404, Nydalen, N-0403 Oslo, Norway.
| | - Pia Blindheim Lund
- Directorate of Immigration (UDI), PO Box 8108 Dep., N-0032 Oslo, Norway.
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17
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Goding Sauer A, Fedewa SA, Kim J, Jemal A, Westmaas JL. Educational attainment & quitting smoking: A structural equation model approach. Prev Med 2018; 116:32-39. [PMID: 30170014 DOI: 10.1016/j.ypmed.2018.08.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/20/2018] [Accepted: 08/26/2018] [Indexed: 11/15/2022]
Abstract
In the United States, disparities in smoking prevalence and cessation by socioeconomic status are well documented, but there is limited research on reasons why and none conducted in a national sample assessing multiple potential mechanisms. We identified smoking and cessation-related behavioral and environmental variables associated with both educational attainment and quitting success. We used a structural equation model of cross-sectional data from respondents ≥25 years from the United States 2010-2011 Tobacco Use Supplement-Current Population Survey. Quitting success was defined as former (n = 2607) versus continuing smokers (n = 7636); categories of educational attainment were ≤high school degree, some college/college degree, and advanced degree. Results indicated that using nicotine replacement therapy (NRT) >1 month and having a home smoking restriction were associated with both educational attainment and quitting success. Those with lower educational attainment versus those with an advanced degree were less likely to report using NRT >1 month (≤high school: β = -0.50, p < 0.001; college: β = -0.24, p = 0.019). Use of NRT >1 month, in turn, was positively associated with quitting success (β = 0.25, p < 0.001). Those with lower educational attainment were also less likely to report a home smoking restriction (≤high school: β = -0.42, p < 0.001; college: β = -0.21, p = 0.009). Having a home smoking restriction was positively associated with quitting success (β = 0.50, p < 0.001). Results were similar with income substituted for education. Using NRT >1 month and having a home smoking restriction are two strategies that may explain the association between low education and lower cessation success; these strategies should be further tested for their potential ability to mitigate this association.
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Affiliation(s)
- Ann Goding Sauer
- Intramural Research Department, American Cancer Society, 250 Williams Street NW, Atlanta, GA 30303, United States of America.
| | - Stacey A Fedewa
- Intramural Research Department, American Cancer Society, 250 Williams Street NW, Atlanta, GA 30303, United States of America
| | - Jihye Kim
- Bagwell College of Education, Kennesaw State University, 580 Parliament Garden Way, Kennesaw, GA 30144, United States of America
| | - Ahmedin Jemal
- Intramural Research Department, American Cancer Society, 250 Williams Street NW, Atlanta, GA 30303, United States of America
| | - J Lee Westmaas
- Intramural Research Department, American Cancer Society, 250 Williams Street NW, Atlanta, GA 30303, United States of America
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18
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Mittal S, Bjørnevik K, Im DS, Flierl A, Dong X, Locascio JJ, Abo KM, Long E, Jin M, Xu B, Xiang YK, Rochet JC, Engeland A, Rizzu P, Heutink P, Bartels T, Selkoe DJ, Caldarone BJ, Glicksman MA, Khurana V, Schüle B, Park DS, Riise T, Scherzer CR. β2-Adrenoreceptor is a regulator of the α-synuclein gene driving risk of Parkinson's disease. Science 2018; 357:891-898. [PMID: 28860381 DOI: 10.1126/science.aaf3934] [Citation(s) in RCA: 294] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 02/13/2017] [Accepted: 06/23/2017] [Indexed: 12/21/2022]
Abstract
Copy number mutations implicate excess production of α-synuclein as a possibly causative factor in Parkinson's disease (PD). Using an unbiased screen targeting endogenous gene expression, we discovered that the β2-adrenoreceptor (β2AR) is a regulator of the α-synuclein gene (SNCA). β2AR ligands modulate SNCA transcription through histone 3 lysine 27 acetylation of its promoter and enhancers. Over 11 years of follow-up in 4 million Norwegians, the β2AR agonist salbutamol, a brain-penetrant asthma medication, was associated with reduced risk of developing PD (rate ratio, 0.66; 95% confidence interval, 0.58 to 0.76). Conversely, a β2AR antagonist correlated with increased risk. β2AR activation protected model mice and patient-derived cells. Thus, β2AR is linked to transcription of α-synuclein and risk of PD in a ligand-specific fashion and constitutes a potential target for therapies.
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Affiliation(s)
- Shuchi Mittal
- Neurogenomics Laboratory and Parkinson Personalized Medicine Program, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA.,Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Kjetil Bjørnevik
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway
| | - Doo Soon Im
- Brain and Mind Research Institute, Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada
| | - Adrian Flierl
- The Parkinson's Institute and Clinical Center, Sunnyvale, CA 94085, USA
| | - Xianjun Dong
- Neurogenomics Laboratory and Parkinson Personalized Medicine Program, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA.,Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Joseph J Locascio
- Neurogenomics Laboratory and Parkinson Personalized Medicine Program, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Kristine M Abo
- Neurogenomics Laboratory and Parkinson Personalized Medicine Program, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Elizabeth Long
- Neurogenomics Laboratory and Parkinson Personalized Medicine Program, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Ming Jin
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Bing Xu
- Department of Pharmacology, University of California at Davis, Davis, CA 95616, USA
| | - Yang K Xiang
- Department of Pharmacology, University of California at Davis, Davis, CA 95616, USA
| | - Jean-Christophe Rochet
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN 47907, USA
| | - Anders Engeland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Patrizia Rizzu
- German Center for Neurodegenerative Diseases (DZNE), Tübingen 72076, Germany
| | - Peter Heutink
- German Center for Neurodegenerative Diseases (DZNE), Tübingen 72076, Germany
| | - Tim Bartels
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Dennis J Selkoe
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Barbara J Caldarone
- Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA.,Harvard NeuroDiscovery Center, Harvard Medical School, Boston, MA 02115, USA
| | - Marcie A Glicksman
- Harvard NeuroDiscovery Center, Harvard Medical School, Boston, MA 02115, USA
| | - Vikram Khurana
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA.,Harvard Stem Cell Institute, Cambridge, MA 02138, USA
| | - Birgitt Schüle
- The Parkinson's Institute and Clinical Center, Sunnyvale, CA 94085, USA
| | - David S Park
- Brain and Mind Research Institute, Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada
| | - Trond Riise
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,The Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Norway
| | - Clemens R Scherzer
- Neurogenomics Laboratory and Parkinson Personalized Medicine Program, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA. .,Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
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19
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Owusu D, Quinn M, Wang KS, Aibangbee J, Mamudu HM. Intentions to quit tobacco smoking in 14 low- and middle-income countries based on the transtheoretical model. Drug Alcohol Depend 2017; 178:425-429. [PMID: 28710966 DOI: 10.1016/j.drugalcdep.2017.05.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 05/08/2017] [Accepted: 05/15/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Over 80% of the world's one billion tobacco smokers reside in low- and middle-income countries (LMICs); therefore, it is important to understand factors that promote intention to quit smoking in these countries. This study evaluated factors associated with three stages of intention to quit tobacco smoking among adults in LMICs. METHODS Data from 43,540 participants of the Global Adult Tobacco Survey in 14 LMICs were analyzed. Intentions to quit smoking were categorized into precontemplation (referent category), contemplation, and preparation stages based on the transtheoretical model. A multinomial logit model was used to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS Approximately 82%, 14%, and 4% of the smokers were in precontemplation, contemplation, and preparation stages, respectively. Rural residents had increased odds of being in contemplation stage (OR=1.41, 95% CI=1.09-1.83) compared to urban residents. Compared to homes where smoking was allowed, smoke-free homes were associated with increased odds of contemplation (OR=1.77, 95% CI=1.41-2.23) and preparation (OR=2.18, 95% CI=1.78-2.66). Exposure to anti-smoking messages in more than one media channel was associated with increased odds of contemplation (OR=1.60, 95% CI=1.33-1.92) and preparation (OR=1.73, 95% CI=1.28-2.33) compared to no exposure to anti-smoking messages. CONCLUSION The results suggest that anti-smoking media campaigns and smoke-free policies may promote intention to quit smoking in LMICs. While these suggest the need for implementation of comprehensive anti-smoking campaigns and smoke-free policies, longitudinal studies are required to confirm these findings and to evaluate how intention to quit translates into quit attempts in LMICs.
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Affiliation(s)
- Daniel Owusu
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN, USA.
| | - Megan Quinn
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN, USA
| | - Ke-Sheng Wang
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN, USA
| | - Jocelyn Aibangbee
- Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN, USA
| | - Hadii M Mamudu
- Department of Health Services Management and Policy, East Tennessee State University, Johnson City, TN, USA
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20
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Bærug A, Laake P, Løland BF, Tylleskär T, Tufte E, Fretheim A. Explaining socioeconomic inequalities in exclusive breast feeding in Norway. Arch Dis Child 2017; 102:708-714. [PMID: 28235835 DOI: 10.1136/archdischild-2016-312038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/01/2017] [Accepted: 02/02/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND OBJECTIVE In high-income countries, lower socioeconomic position is associated with lower rates of breast feeding, but it is unclear what factors explain this inequality. Our objective was to examine the association between socioeconomic position and exclusive breast feeding, and to explore whether socioeconomic inequality in exclusive breast feeding could be explained by other sociodemographic characteristics, for example, maternal age and parity, smoking habits, birth characteristics, quality of counselling and breastfeeding difficulties. METHODS We used data from a questionnaire sent to mothers when their infants were five completed months as part of a trial of a breastfeeding intervention in Norway. We used maternal education as an indicator of socioeconomic position. Analyses of 1598 mother-infant pairs were conducted using logistic regression to assess explanatory factors of educational inequalities in breast feeding. RESULTS Socioeconomic inequalities in exclusive breast feeding were present from the beginning and persisted for five completed months, when 22% of the most educated mothers exclusively breast fed compared with 7% of the least educated mothers: OR 3.39 (95% CI 1.74 to 6.61). After adjustment for all potentially explanatory factors, the OR was reduced to 1.49 (95% CI 0.70 to 3.14). This decrease in educational inequality seemed to be mainly driven by sociodemographic factors, smoking habits and breastfeeding difficulties, in particular perceived milk insufficiency. CONCLUSIONS Socioeconomic inequalities in exclusive breast feeding at 5 months were largely explained by sociodemographic factors, but also by modifiable factors, such as smoking habits and breastfeeding difficulties, which can be amenable to public health interventions. TRIAL REGISTRATION NUMBER NCT01025362.
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Affiliation(s)
- Anne Bærug
- Norwegian National Advisory Unit on Breastfeeding, Women and Children's Division, Oslo University Hospital, Oslo, Norway
| | - Petter Laake
- Centre for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway
| | - Beate Fossum Løland
- Norwegian National Advisory Unit on Breastfeeding, Women and Children's Division, Oslo University Hospital, Oslo, Norway
| | | | - Elisabeth Tufte
- Norwegian National Advisory Unit on Breastfeeding, Women and Children's Division, Oslo University Hospital, Oslo, Norway
| | - Atle Fretheim
- Knowledge Centre for the Health Services, Norwegian Institute of Public Health, Oslo, Norway.,Institute of Health and Society, University of Oslo, Oslo, Norway
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21
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Nagai M, Ohira T, Zhang W, Nakano H, Maeda M, Yasumura S, Abe M. Lifestyle-related factors that explain disaster-induced changes in socioeconomic status and poor subjective health: a cross-sectional study from the Fukushima health management survey. BMC Public Health 2017; 17:340. [PMID: 28427361 PMCID: PMC5397819 DOI: 10.1186/s12889-017-4247-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 04/08/2017] [Indexed: 11/25/2022] Open
Abstract
Background Socioeconomic status (SES) and lifestyle-related factors are determinants of subjective health. However, changes in SES are inevitable in times of natural disaster, while lifestyle-related factors remain modifiable. The aim of this study was to use a cross-sectional approach to examine lifestyle-related factors that may attenuate the negative impact of disaster-induced changes in SES on poor subjective health. Methods We analyzed 33,350 men and women aged 20–64 years who were living in evacuation zones due to the radiation accident in Fukushima, Japan. Disaster-induced changes in SES were defined by living arrangements and working conditions. Using Poisson regression analysis adjusted for confounders (model 1) and lifestyle-related factors as intermediate variables (model 2), we compared the prevalence ratios (PRs) of poor subjective health of participants who did not undergo disaster-induced changes in SES (did not become unemployed, income did not decrease, and living in relative’s home/own home) with that of participants who did undergo disaster-induced changes in SES (became unemployed, decreased income, or lived in an evacuation shelter, temporary housing, or rental housing/apartment). We calculated the percentage of excess risks explained by lifestyle-related factors as follows: ((PRmodel 1 − PRmodel 2)/(PRmodel 1–1)) × 100. Results Disaster-induced changes in SES were significantly associated with poor subjective health. The PRs (95% CIs) among participants who underwent disaster-induced changes in SES were 2.02 (1.81–2.24) for men and 1.80 (1.65–1.97) for women. After adjusting for lifestyle-related factors, we found that the PRs in men and women were remarkably attenuated, decreasing to 1.56 (1.40–1.73) and 1.43 (1.31–1.55), respectively. Controlling for lifestyle-related factors resulted in PR attenuation by 45.1% (men) and 46.3% (women). Satisfaction of sleep and participation in recreation and community activity particularly contributed to this attenuation. Conclusions While disaster-induced changes in SES are unavoidable, lifestyle-related factors have the potential to attenuate the impact of these changes on poor subjective health. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4247-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Masato Nagai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan. .,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Wen Zhang
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masafumi Abe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
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