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Visscher K, Everaars B, Suijkerbuijk AW, Lambooij M, de Wit GA. Intended changes in smoking behaviour of Dutch young adults after an increase in excise tax: a cross-sectional survey. BMJ Open 2023; 13:e065535. [PMID: 38154901 PMCID: PMC10759063 DOI: 10.1136/bmjopen-2022-065535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/17/2023] [Indexed: 12/30/2023] Open
Abstract
OBJECTIVES Increasing the price of tobacco is one of the most effective measures to reduce the prevalence of smoking. In the Netherlands, the excise tax on tobacco increased by €1.14 in 2020, raising the price of a standard package of cigarettes to €8.00. This study investigates how young adults intend to change their smoking behaviour in the case of hypothetical price increases of a pack of cigarettes, and which background characteristics are associated with intended behaviour change. DESIGN A cross-sectional online survey was carried out between September and November 2020. Smokers indicated how they would react to several hypothetical increases in price. Four behavioural options were investigated: smoking less, quitting smoking, switching to another/cheaper product and buying cheaper cigarettes cross-border. PARTICIPANTS Data were obtained from 776 Dutch smokers between 15 and 25 years. RESULTS At a hypothetical price of €10 per package, most respondents reported an intention to smoke less (67%), followed by switching to another/cheaper product (61%), quitting smoking (49%) and shopping for cigarettes cross-border (47%). Prior quit attempts, agreeing with the increase in excise tax and the intention to quit smoking in the future increased the odds of changing behaviour. Higher self-efficacy decreased the odds of behavioural change. CONCLUSION Many young adults intend to change their smoking behaviour in the event of increased prices. Although intended behaviour can deviate significantly from actual behaviour, an increase in excise tax may result in a significant amount of quit attempts and reduced smoking among young adults.
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Affiliation(s)
- Kirsten Visscher
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Babette Everaars
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Anita Wm Suijkerbuijk
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Mattijs Lambooij
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Erasmus Universiteit Rotterdam Erasmus School of Health Policy and Management, Rotterdam, The Netherlands
| | - G Ardine de Wit
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Health Sciences, VU Amsterdam, Amsterdam, The Netherlands
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Nathaniel FA, Amtha R, Gunardi I, Hartanto FK, Sari EF. Enhanced Knowledge Inversed Attitude of Oral Cancer Risk Habit Associated With Sociocultural: A Quantitative and Qualitative Pilot Study. J Int Soc Prev Community Dent 2023; 13:380-387. [PMID: 38124722 PMCID: PMC10729886 DOI: 10.4103/jispcd.jispcd_20_23] [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: 02/06/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 12/23/2023] Open
Abstract
Aim In 2023, the global incidence of oral cancer reached 54,540 new cases, with risk factors including smoking (S), alcohol consumption (A), and betel quid chewing (BQC). The knowledge and attitudes about these risk factors impact this practice, particularly in communities that follow local traditions. The aim of this study was to determine the level of knowledge and attitude regarding risk factors for oral cancer on Flores Island, East Indonesia. Materials and Methods This was an analytical observational study with a cross-sectional design using quantitative and qualitative approaches. Structured questionnaires and focus group discussions (FGDs) were conducted with the community, local government, and dentists to obtain data; quantitative analysis was performed using regression; and qualitative analysis was performed using themes. Results Of 542 participants (men 66.42 %; women 33.57 %), 64.4% had a high level of knowledge and a low level of attitude for S = 62.5%, A = 66.7%, and BQC = 50.0%. There was a correlation between knowledge and attitudes about S (P = 0.009) and BQC (P = 0.011). The FGDs yielded 14 subjects (five men and nine women) with three themes of knowledge (betel nut ingredients, causes of cancer, and impacts of habits) and three themes of attitude (type of habit, desire to stop, and oral cancer prevention programs). On the basis of FGDs, most of the subjects already knew the causes of oral cancer, but the desire to stop and prevent oral cancer was difficult. Conclusion The population on Flores Island has a high level of knowledge but a low level of attitude. Nevertheless, it is difficult to minimize or eliminate oral cancer-risk behaviors due to their cultural and socioeconomic conditions.
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Affiliation(s)
| | - Rahmi Amtha
- Department of Oral Medicine, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Indrayadi Gunardi
- Department of Oral Medicine, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | | | - Elizabeth Fitriana Sari
- Dentistry Discipline, Department of Rural Clinical Science, La Trobe Rural Health School, La Trobe University, Melbourne, Australia
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Gao X, Shen F, Li S, Zhang R, Jiang W, Li B, Wang R. The estimated influence of assumed physicians' advice for tobacco smoking cessation among current smokers in Shanghai, China: A cross-sectional study. Tob Induc Dis 2022; 20:86. [PMID: 36317058 PMCID: PMC9574849 DOI: 10.18332/tid/153508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/27/2022] [Accepted: 09/05/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Evidence indicates that physicians' smoking cessation advice is significant for tobacco control, which is an impetus to encourage smoking cessation among smokers, but the estimated influence of physicians' smoking cessation advice on smokers' intention to quit is limited in Shanghai, China. METHODS We enrolled 1104 participants who were current smokers in the SJ (Songjiang) and FX (Fengxian) districts in Shanghai in 2021. An electronic questionnaire was used to collect data and SAS 9.4 was used for data analysis. Univariate and multivariate logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to estimate the influence of the assumed physicians' advice for smoking cessation on current smokers' smoking cessation plan. RESULTS A total of 1104 participants provided information of which 914 were male smokers (82.8%) and 190 (17.2%) were female smokers. Multivariate logistic regression demonstrated that female smokers (OR=2.47; 95% CI: 1.66-3.68), smokers with at least 1 type of non-communicable disease (OR=2.09; 95% CI: 1.42-3.07), smoking intensity <20 cigarettes/day (OR=1.64; 95% CI: 1.22-2.17), with personal tobacco burden less than 20% (OR=1.52; 95% CI: 1.10-2.13), exposed to secondhand smoke (OR=1.99; 95% CI:1.44-2.76), and previous smoking cessation attempt (OR=4.43; 95% CI: 3.23-6.08), were more likely to report an intent to quit smoking. Moreover, approximately 50% of participants without a plan to quit in a year had also reported their intention to quit smoking with the presumption that the physicians would advise them to quit, irrespective of their sex, age, NCD status and secondhand tobacco smoke exposure. CONCLUSIONS Physicians' cessation advice could promote smokers to consider stopping smoking. The reported cessation intention was higher among female smokers, and smokers with NCD, lower smoking intensity and burden, with smoking cessation attempts, all of which could be incorporated into the implementation of tobacco control measures in the future in Shanghai.
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Affiliation(s)
- Xiangjin Gao
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fanlingzi Shen
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Siyuan Li
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rui Zhang
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Wencheng Jiang
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Bin Li
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Ruiping Wang
- Clinical Research Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Nayak R, Kamath A, Li J, Kulkarni MM, Kamath VG, Kumar P, Naik A, Parrott S, Mdege ND. The association between the retail price of manufactured cigarettes and bidis on current smoking status in India. Tob Induc Dis 2022; 20:43. [PMID: 35600725 PMCID: PMC9074849 DOI: 10.18332/tid/146904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/27/2022] [Accepted: 02/23/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION In India, the retail prices of bidis and cigarettes varied between the two Global Adult Tobacco Surveys (GATS) conducted in 2009-2010 and 2016-2017. The relationship between the retail price of smoked tobacco products and their use is unclear for India. Our study thus aimed to use available datasets to investigate the association between the retail price and current smoking status of bidis and cigarettes in India. METHODS Current smoking status data for bidis and cigarettes were obtained from the two GATS rounds. The average state-level retail prices of bidis and cigarettes were obtained from India's Consumer Price Index- Industrial Workers database. Descriptive statistics were used to describe current smoking status patterns. Generalized Linear Mixed Models were used to investigate the association between the retail prices and current smoking status of bidis and cigarettes. RESULTS For cigarettes, an increase in the average retail price by one Indian Rupee was associated with a reduction in the odds of being a current smoker of 7% (OR=0.925; 95% CI: 0.918-0.932, p<0.001). For bidis, the association between the retail price and current smoking status was not statistically significant (OR=1.01; 95% CI: 1.00-1.02, p=0.082). CONCLUSIONS Current increases in the retail prices of tobacco products in India seem to have an impact on the use of cigarettes but not bidis. This highlights the need for tobacco product tax increases that result in sufficient retail prices increase to make all tobacco products less affordable and reduce their use.
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Affiliation(s)
- Radhika Nayak
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Asha Kamath
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Jinshuo Li
- Department of Health Sciences, University of York, York, United Kingdom
| | - Muralidhar M. Kulkarni
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Veena G. Kamath
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Praveen Kumar
- Department of Commerce, Manipal Academy of Higher Education, Manipal, India
| | - Ashwath Naik
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Steve Parrott
- Department of Health Sciences, University of York, York, United Kingdom
| | - Noreen D. Mdege
- Department of Health Sciences, University of York, York, United Kingdom
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Zhao S. A Study on China's Tobacco Taxation and Its Influencing Factor on Economic Growth. Front Psychol 2022; 13:832040. [PMID: 35282251 PMCID: PMC8910603 DOI: 10.3389/fpsyg.2022.832040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/27/2022] [Indexed: 11/26/2022] Open
Abstract
Tobacco is a significant product providing considerable economic benefits to countries worldwide, while its increased consumption causes health and socio-economic losses for smokers and non-smokers. This paper constructs a decomposition system of tobacco taxation: the population aging factor is included in the influencing factors of personal tax, and personal tax revenue is regarded as the product of tax structure, macro tax burden, regional economy, reciprocal aging, and the elderly population. This article conducts an empirical study on the relationship between taxation and economic growth. The estimated coefficients of business tax and corporate income tax are significant at the significance level of 0.1, with a consumption tax and time-variable coefficients reporting a 0.02 level of significance. The T statistic value and the explanatory degree of the variables involved in the model to the explained variables are also very high, reaching more than 95%. We find that increasing the macro tax burden negatively impacts economic growth. Therefore, the study suggests that for fostering the industry’s economic growth, the country needs to ensure the optimal macro tax burden of 17.5%, with different types of taxes influencing economic growth. Personal tax reform should pay attention to the phenomenon of aging, adjust the tax structure to increase personal tax income, provide policy support and guarantee for the elderly labor force, and encourage the re-employment of silver-haired people to alleviate the adverse impact of aging on taxation.
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Affiliation(s)
- Shuang Zhao
- School of Economics, Inner Mongolia University for Nationalities, Tongliao, China
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Dauchy EP, John RM. The Effect of Price and Tax Policies on the Decision to Smoke or Use Smokeless Tobacco in India. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1101-1114. [PMID: 35275359 DOI: 10.1007/s11121-022-01360-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 10/18/2022]
Abstract
This paper investigates the impact of cigarette prices on adults' smoking and smokeless tobacco (SLT) use initiation and cessation decisions in India from 1980 to 2017. We use individual-level data from the 2017 Global Adult Tobacco Survey (GATS) to recreate the smoking history of current or past adult tobacco users using self-reported data on the years of tobacco use, initiation, and cessation merged with historical data on cigarettes, bidis, and SLT product prices. To estimate the effect of price changes on smoking and SLT use transitions, we use a pooled linear model and propensity score matching (PSM) to construct an artificial treatment group where weights capture the likelihood of being an ever-smoker. We find that price increases are a statistically significant deterrent to smoking initiation, with price elasticity of initiation being on average -0.0236 (CI: -0.024 -0.023) and -0.000428 (0.0 - 0.0) for smoking and SLT, respectively. This implies, for example, that a 10% increase in prices results in a 0.24% smaller smoking initiation and 0.004% smaller SLT use initiation. We find that prices can also encourage quitting, but the effects are not always significant, with elasticities of 0.0218 (CI: 0.017 0.026) and 0.0026 (CI: 0.001 0.004) for smoking and SLT, respectively. This implies that a 10% increase in prices will result in a 0.22% increase in the probability of quitting smoking and a 0.03% increase in the probability of quitting SLT use. The elasticity varied by income group, gender, and between young and all adults, with larger effects among lower-income adults and especially among young females. Higher cigarette prices that can be achieved by tobacco tax increases can significantly reduce initiation and encourage cessation, thus improving public health, especially among the most vulnerable population subgroups.
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Affiliation(s)
- Estelle P Dauchy
- International Research, Campaign for Tobacco-Free Kids, Washington, DC, 20005, USA.
| | - Rijo M John
- Rajagiri College of Social Sciences, Rajagiri PO, Kochi, Kerala, 683104, India
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Wei L, Chen S, Qiang Y, Kuai L, Zhou M, Luo Y, Luo Y, Song J, Fei X, Zhang R, Yu N, Jiang W, Li X, Wang R, Li B. Tobacco smoking was positively associated with metabolic
syndrome among patients with psoriasis in Shanghai:
A cross-sectional study. Tob Induc Dis 2022; 20:05. [PMID: 35110983 PMCID: PMC8780213 DOI: 10.18332/tid/144228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/15/2021] [Accepted: 11/24/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION A number of studies have reported a high correlation between psoriasis and metabolic syndrome (MetS), and tobacco smoking is one independent risk factor accounting for the increased prevalence both for psoriasis and MetS. However, few studies have been conducted to assess the effects of tobacco smoking on co-morbidities of psoriasis and MetS. METHODS We conducted a cross-sectional study with 1014 psoriasis patients recruited from January to May 2021. Patients were recruited with a cluster survey method in Yueyang Hospital (affiliated with Shanghai University of Traditional Chinese Medicine) and Shanghai Skin Diseases Hospital (affiliated with Tongji University). Data were collected by face-to-face questionnaire interviews which included basic information, personal life habits, medical history, and clinical examinations. SPSS 24.0 was used for data analysis and a p<0.05 was considered statistically significant. RESULTS The 1014 psoriasis patients were predominantly males (65.58%), with an average age of 45.98 years (IQR: 34.00–57.00). Of these, 25.74% (261) of psoriasis had MetS and 31.85% (323) were tobacco smokers. Male psoriasis patients had higher tobacco smoking prevalence than female patients. With increasing age and BMI, the prevalence of tobacco smoking among psoriasis patients increased dramatically (p<0.01). Logistic regression indicated that psoriasis patients with tobacco smoking had 1.78 times (95% CI: 1.21–2.60) the probability to have MetS than those without tobacco smoking, even adjusting for potential confounding factors. Moreover, smoking psoriasis patients with MetS consumed more cigarettes per day, with longer smoking duration, but with an older age of smoking initiation. CONCLUSIONS The prevalence of tobacco smoking and MetS among psoriasis patients was high in Shanghai, and tobacco smoking was positively associated with the MetS among psoriasis patients. Clinicians should recommend psoriasis patients to abstain from tobacco smoking and provide tobacco cessation assistance regularly.
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Affiliation(s)
- Lei Wei
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- CORRESPONDENCE TO Ruiping Wang. Clinical Research and Innovation Transformation Center, Shanghai Skin Diseases Hospital, Tongji University, 1278 Baode Road, Jing’an District, Shanghai 200443, China. E-mail: ORCID ID: https://orcid.org/0000-0003-4183-5795
| | - Siting Chen
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Qiang
- Clinical Research and Innovation Transformation Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Le Kuai
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mi Zhou
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Luo
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Yue Luo
- Department of Dermatology, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Jiankun Song
- Department of Dermatology, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Xiaoya Fei
- Department of Dermatology, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Rui Zhang
- Clinical Research and Innovation Transformation Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Ning Yu
- Department of Dermatology, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Wencheng Jiang
- Department of Dermatology, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ruiping Wang
- Clinical Research and Innovation Transformation Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
| | - Bin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Clinical Research and Innovation Transformation Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai, China
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The estimated effect of graphic warning labels on smoker's intention to quit in Shanghai, China: a cross-sectional study. BMC Public Health 2021; 21:2170. [PMID: 34836519 PMCID: PMC8626992 DOI: 10.1186/s12889-021-12257-8] [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: 08/03/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco consumption is the leading cause of death worldwide. Overwhelming studies demonstrate graphic warning labels (GWLs) on cigarette packs are effective in eliciting negative response to tobacco smoking, modifying beliefs about tobacco dangers, and increasing reported intention to quit, but the estimated effect of GWLs on smoking cessation intention among smokers is still limited in China. In this study, we aim to understand the smoking intensity, smoking duration and smoking cessation intention among current smokers, and to explore how their smoking cessation intention would be influenced by the GWLs in Shanghai. METHODS From January to June 2021, we totally recruited 1104 current smokers in Songjiang district and Fengxian district of Shanghai by multistage sampling design. We used Android pad assisted electronic questionnaire for data collection, and then implemented logistic regression for odds ratio (OR) and 95% confidence interval (CI) calculation to explore how smoking cessation intention would be influenced by the GWLs among current smokers. RESULTS One thousand one hundred four current smokers included 914 males (82.79%), with an average age of 43.61 years. 58.06% of current smokers reported smoking cessation intention due to GWLs. Logistic regression indicated a higher percentage of smoking cessation intention due to GWLs was among female smokers [OR = 2.41, 95% CI (1.61-3.59)], smokers with smoking intensity < 20 cigarette/day [OR = 1.92, 95% CI (1.44-2.55)], smokers with tobacco burden < 20% [OR = 1.94, 95% CI (1.35-2.79)], and among smokers had plan to quit in a year [OR = 6.58, 95% CI (4.71-9.18). Smokers with higher individual monthly income had lower percentage of smoking cessation intention (OR were 0.35, 0.46 and 0.41). Meanwhile, among 642 current smokers without plan to quit in a year, approximately 40% of them reported smoking cessation intention due to GWLs. CONCLUSIONS Smoking cessation intention due to the assumed GWLs on cigarette packs is high among current smokers in Shanghai, especially in female smokers, smokers with light tobacco burden and mild nicotine dependence. Incorporating smoking intensity as well as smoking burden into the implementation of GWLs as tobacco control measures would discourage smoking in China.
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Wang R, Gao X, Qiang Y, Yang Q, Li X, Li B. The Estimated Effect of Physicians' Advice for Smoking Cessation and Assumed Tobacco Retail Price Increase on Smoker's Intention to Quit in Shanghai, China: A Cross-Sectional Study. Front Public Health 2021; 9:740476. [PMID: 34646806 PMCID: PMC8502931 DOI: 10.3389/fpubh.2021.740476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Tobacco consumption produces a heavy disease burden worldwide, and tobacco price increase, an advertisement for tobacco-induced harm, graphic warning labels on cigarette packages and advice of physicians for quitting are policies that have been proved as effective smoking cessation measures. But evidence on the estimated effect of advice of physicians for quitting and assumed tobacco retail price increase on smoking cessation intention among smokers is still limited in China. Methods: From January to April of 2021, we recruited 664 current smokers in Songjiang district of Shanghai by a multistage sampling design. We implemented a logistic regression analysis to calculate the odds ratio (OR) and 95% confidence interval (CI) to explore how smoking cessation intention would be influenced by the assumed tobacco retail price increase as well as advice of physicians for quitting, and used the paired tabulation method to identify the salient tobacco control measures among smokers as well. Results: A total of 664 current smokers included 548 males (82.53%), with an average smoking duration of 22.50 years (SD: 11.52 years). About 68.79 and 43.67% of current smokers reported smoking cessation intention due to advice of physicians for quitting and the assumed tobacco retail price increase, respectively. Logistic regression analysis indicated that female smokers (OR = 2.85 and 4.55), smokers with previous smoking cessation attempt (OR = 3.71 and 3.07), longer smoking duration (OR = 2.26 and 2.68), lower smoking intensity (OR = 1.82 and 1.69), and heavier tobacco burdens (OR = 1.67 and 2.22) had the higher intention of smoking cessation both due to advice of physicians for quitting and due to assumed tobacco price increase, respectively. Meanwhile, the advice of physicians for quitting was more effective and acceptable (over 80%) than the assumed tobacco price increase for inducing smokers to consider quitting in Shanghai. Conclusions: Smokers have a high intention of smoking cessation in Shanghai, and the advice of physicians for quitting is a potentially more salient tobacco control measure than the assumed tobacco retail price increase. Incorporating smoking duration, intensity, personal burden as well as noncommunicable disease (NCD) status of smokers into the implementation of tobacco control measures is beneficial for descending smoking prevalence.
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Affiliation(s)
- Ruiping Wang
- Shanghai Skin Disease Hospital, Tongji University, Shanghai, China
- College of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiangjin Gao
- College of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Qiang
- Shanghai Skin Disease Hospital, Tongji University, Shanghai, China
| | - Qiong Yang
- Songjiang Fang Song Community Health Service Center, Shanghai, China
| | - Xiaopan Li
- Shanghai Pudong Disease Prevention and Control Center, Shanghai, China
| | - Bin Li
- Shanghai Skin Disease Hospital, Tongji University, Shanghai, China
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Wang R, Sun T, Yang Q, Yang Q, Wang J, Li H, Tang Y, Yang L, Sun J. Low birthweight of children is positively associated with mother's prenatal tobacco smoke exposure in Shanghai: a cross-sectional study. BMC Pregnancy Childbirth 2020; 20:603. [PMID: 33032551 PMCID: PMC7542738 DOI: 10.1186/s12884-020-03307-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 10/02/2020] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Low birthweight (LBW) is a significant public health issue, and maternal smoking is the most prevalent preventable cause of LBW. But there is limited evidence on association of LBW among children and cigarette smoke exposure in mothers in China. In this cross-sectional study, we try to explore if the LBW in children is positively associated with mothers' prenatal cigarette smoke exposure. METHODS We selected 8, 586 mothers and their singleton children in 2018 in Songjiang district, Shanghai. Birthweight of children and gestational weeks of mother was identified by birth records in the hospital, we classified mothers' prenatal cigarette smoke status into the first-hand smoke (FHS) exposure and the second-hand smoke (SHS) exposure. We use SAS 9.1.3 software to calculate the prevalence of children's LBW and the prevalence of mothers' prenatal cigarette smoke exposure including FHS and SHS. Chi-square test and logistic regression were used to analyze the difference. RESULTS In 8, 586 women, The prenatal FHS and SHS exposure prevalence was 0.9 and 20.8%, respectively. The mean birthweight of children was 3315.5 g with a standard deviation of 497.2 g, the mean birthweight was 167.7 g and 66.1 g lower in children born to mothers with prenatally FHS and SHS exposure compared with those children whose mother were not exposed, respectively. The children's LBW prevalence was 4.7% in this study. By comparing with children whose mother were not exposed, the LBW prevalence was higher among children whose mother were prenatally exposed to FHS [OR (Odds Ratios) = 2.91, 95% confidence interval (CI) (1.49, 5.68)], and SHS [OR = 2.35, 95% CI (1.90, 2.89)]. CONCLUSIONS Children's LBW is positively associated with mothers' prenatal tobacco smoke exposure both for FHS and SHS. So implementing tobacco control measures is crucial to lower smoking prevalence among women, and decrease smoking prevalence of their family members as well as work fellows.
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Affiliation(s)
- Ruiping Wang
- Office of Clinical Research Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 GanHe Road, Hongkou District, Shanghai, 200437 China
| | - Ting Sun
- Songjiang Maternal and Child Health-care Hospital, Shanghai, China
| | - Qiong Yang
- Songjiang Fang Song Community Health Service Center, Shanghai, China
| | - Qing Yang
- Songjiang Maternal and Child Health-care Hospital, Shanghai, China
| | - Jian Wang
- Jing’an Institute of Maternal and Child Health-care, Shanghai, China
| | - Huan Li
- Songjiang Maternal and Child Health-care Hospital, Shanghai, China
| | - Yue Tang
- Songjiang Maternal and Child Health-care Hospital, Shanghai, China
| | - Liang Yang
- Jing’an Institute of Maternal and Child Health-care, Shanghai, China
| | - Jie Sun
- Jing’an Institute of Maternal and Child Health-care, Shanghai, China
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Household Exposure to Secondhand Smoke among Chinese Children: Status, Determinants, and Co-Exposures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155524. [PMID: 32751695 PMCID: PMC7432650 DOI: 10.3390/ijerph17155524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 11/17/2022]
Abstract
Smoking prevalence stays high among adults in China, which also makes children exposed to secondhand smoke (SHS) in their households. This study aimed to investigate the status of SHS exposure among Chinese children, identify the influencing factors, and determine "co-exposure" to tobacco and other smokes in households. A total of 41,439 children aged 6-17 years were recruited from 30 provinces in Mainland China through the first Chinese Environmental Exposure-Related Human Activity Model Survey for Children (CEERHAPS-C). Information regarding children's demographics, socioeconomic status, and exposures to SHS and solid fuel smoke (SFS) in households was collected using a comprehensive questionnaire. Factors that affected exposures to household smokes were identified using multivariable logistic regressions. The overall prevalence of household SHS exposure was 41.7%, and the average duration was 14.7 ± 14.6 min/day among the exposed participants. Prevalence of household SHS exposure increased among children in older age groups and with parents in lower education levels. Among SHS-exposed children, 34% had co-exposure to SFS, and they had a significantly higher risk of co-exposure than non-SHS exposed children (odds ratio = 1.12, 95% confidence interval: 1.061, 1.162). The prevalence of household SHS exposure remains high among school-age children, suggesting the need to develop and implement smoking-free home programs.
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Yang Q, Pan L, Shen C, Yao H, Zhu Q, Cheng C, Wang R. Mothers' prenatal tobacco smoke exposure is positively associated with the occurrence of developmental coordination disorder among children aged 3-6 years: A cross-sectional study in a rural area of Shanghai, China. Tob Induc Dis 2020; 18:25. [PMID: 32292315 PMCID: PMC7152785 DOI: 10.18332/tid/119115] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Prenatal tobacco smoke exposure is a potential risk factor for developmental coordination disorder (DCD) in children, but evidence on the relationship between DCD in children and tobacco smoke exposure in women is limited in China. We conducted a cross-sectional study to understand the prevalence of prenatal tobacco smoke exposure among mothers and the prevalence of DCD among children and to explore if mothers’ prenatal tobacco smoke exposure is positively associated with the occurrence of DCD among children. METHODS During 2018, we sampled 8586 children aged 3–6 years and their mothers in Songjiang district, Shanghai. DCD in children was identified by MABC-2 screening combined with pediatrician confirmation. Prenatal tobacco smoke exposure among mothers was classified into firsthand smoke (FHS) and secondhand smoke (SHS) exposure. SAS 9.2 software was applied to calculate the prevalence of DCD in children, the prevalence of prenatal FHS and SHS exposure in mothers and to analyze the differences by chi-squared test and logistic regression. RESULTS Among the 8586 women, the prevalence of prenatal FHS and SHS exposure was 0.94% and 20.79%, respectively. The prevalence of DCD in children was 6.65%, which was significantly higher in boys (7.64%) than in girls (5.51%), and children aged 3 years (9.77%) had a higher prevalence of DCD than children aged 4, 5 or 6 years (7.44%, 5.27% and 4.28%, respectively). In comparison with children whose mother was not exposed to prenatal FHS or SHS, the odds of having DCD was higher in children whose mother was exposed to prenatal FHS (OR=4.42; 95% CI: 2.62–7.44) and SHS (OR=1.77; 95% CI: 1.47–2.14), even after adjustment for potential confounders. CONCLUSIONS The occurrence of DCD among children is positively associated with prenatal tobacco smoke exposure among the mothers. It is crucial to implement tobacco control measures to decrease the prevalence of smoking among pregnant women and SHS exposure at home as well as in the work environment. ABBREVIATIONS DCD: developmental coordination disorder, ADHD: attention deficit hyperactivity disorder, FHS: firsthand smoke, SHS: secondhand smoke, MABC-2: movement assessment battery for children-2nd edition, GATS: global adult tobacco survey, SD: standard deviation, OR: odds ratio, CI: confidence interval, DAGs: directed acyclic graphs.
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Affiliation(s)
- Qing Yang
- Songjiang Maternal and Child Health-care Hospital, Shanghai, China
| | - Liqin Pan
- Songjiang Maternal and Child Health-care Hospital, Shanghai, China
| | - Cuili Shen
- Songjiang Maternal and Child Health-care Hospital, Shanghai, China
| | - Huilin Yao
- Songjiang Huating Kindergarten, Shanghai, China
| | - Qingqing Zhu
- Songjiang Maternal and Child Health-care Hospital, Shanghai, China
| | - Chunfen Cheng
- Songjiang Maternal and Child Health-care Hospital, Shanghai, China
| | - Ruiping Wang
- Office of Clinical Research Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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