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Shi J, Tian J, Fan Y, Hao X, Li M, Li J, Ma D, Guo M, Li S, Xu Y, Shi C. Intelligence, education level, and risk of Parkinson's disease in European populations: A Mendelian randomization study. Front Genet 2022; 13:963163. [PMID: 36437938 PMCID: PMC9684183 DOI: 10.3389/fgene.2022.963163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/20/2022] [Indexed: 09/09/2023] Open
Abstract
Background: A high level of education or intelligence (IQ) is reported to be a risk factor for Parkinson's disease (PD). The purpose of this study was to systematically examine the causal relationships between IQ, educational attainment (EA), cognitive performance, and PD. Methods: We used summary statistics from genome-wide association studies on IQ, EA, cognitive performance, and PD. Four genome-wide association study (GWAS) data for PD were used to comprehensively explore the causal relationship, including PD GWAS (regardless of sex), age at onset of PD GWAS, male with PD GWAS, and female with PD GWAS data. We conducted a two sample Mendelian randomization (MR) study using the inverse-variance weighted (IVW), weighted median, simple mode, and weighted mode methods to evaluate the causal association between these factors. MR-Egger and MR-PRESSO were used for sensitivity analysis to test and correct horizontal pleiotropy. Multivariate MR (MVMR) was also used to account for the covariation between IQ, EA, and cognition, as well as to explore potential mediating factors. Results: Genetically predicted higher IQ was associated with an increased risk of PD in the entire population, regardless of gender. In the analyses using the IVW method, the odds ratio was 1.37 (p = 0.0064). Men with a higher IQ, more years of education, or stronger cognitive ability are more likely to develop PD compared to women. MVMR showed that adjusting for education and cognition largely attenuated the association between IQ and PD, suggesting that education and cognition may mediate the effect of IQ on PD. Conclusion: This study provides genetic support for the causal link between higher IQ and an increased risk of PD.
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Affiliation(s)
- Jingjing Shi
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
| | - Jie Tian
- Zheng Zhou Railway Vocational and Technical College, Zhengzhou, Henan, China
| | - Yu Fan
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
- Academy of Medical Sciences of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaoyan Hao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
- Academy of Medical Sciences of Zhengzhou University, Zhengzhou, Henan, China
| | - Mengjie Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
| | - Jiadi Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
- Academy of Medical Sciences of Zhengzhou University, Zhengzhou, Henan, China
| | - Dongrui Ma
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
| | - Mengnan Guo
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
| | - Shuangjie Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
| | - Changhe Shi
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, Henan, China
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Mohd Yusoff MF, Lim KH, Saminathan TA, Rodzlan Hasani WS, Robert Lourdes TG, Ghazali SM, Abd Hamid HA, Ab Majid NL, Mat Rifin H, Miaw Yn JL. The pattern in prevalence and sociodemographic factors
of smoking in Malaysia, 2011–2019: Findings from national
surveys. Tob Induc Dis 2022; 20:84. [PMID: 36249344 PMCID: PMC9521184 DOI: 10.18332/tid/152410] [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: 01/24/2022] [Revised: 05/11/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Smoking is a major contributor to morbidity and mortality worldwide, with Malaysia no exception. Through the Ministry of Health and other ministries in the government of Malaysia, numerous anti-smoking measures have been introduced to prevent and control smoking in the country. Continuous monitoring of smoking prevalence in the community is essential in order to evaluate the effectiveness of anti-smoking policies. This study aims to update the sociodemographic factors associated with smoking in the past decade in Malaysia. METHODS The study utilized data from three national household surveys in Malaysia, namely the Global Adult Tobacco Survey (GATS) 2011, the National Health and Morbidity Survey (NHMS) 2015 and the National Health and Morbidity Survey (NHMS) 2019. These surveys adopted a multistage stratified sampling design that represents the population in Malaysia. Smoking status was determined based on the GATS protocol and definitions. Complex sample design estimates and complex multivariable logistic regression were used in the analysis. RESULTS A total of 4250, 21410 and 11111 respondents aged ≥15 years participated in GATS 2011, NHMS 2015 and NHMS 2019, respectively, with a response rate between 85% and 87%. The prevalence of smoking was 23.1% (95% CI: 21.2–25.2) in 2011, 22.8% (95% CI: 21.9–23.8) in 2015 and 21.3% (95% CI: 19.9–22.8) in 2019. The prevalence was consistently higher in males (40.5–43.9%), adults aged 25–44 years (25.4–29.0%), Malay (22.6–24.7%), other ethnicities (30.0–35.0%), and the self-employed (33.7–44.6%). Multiple logistic regression analysis showed that the adjusted odds ratio (AOR) of smoking was higher in males, in younger and middle age groups, Malays, and those with lower education level. CONCLUSIONS There were slight changes in the sociodemographic factors of smoking in the past decade in Malaysia. Stern measures and more aggressive strategies are needed to address all the risk factors in controlling smoking behavior in the country.
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Affiliation(s)
| | - Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | | | | | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Nur Liana Ab Majid
- Institute for Public Health, National Institutes of Health, Shah Alam, Malaysia
| | - Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Shah Alam, Malaysia
| | - Jane Ling Miaw Yn
- Institute for Public Health, National Institutes of Health, Shah Alam, Malaysia
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Zhang RQ, Kuo K, Liu FT, Chen SD, Yang YX, Guo Y, Dong Q, Tan L, Zhang C, Yu JT. Shared polygenic risk and causal inferences in Parkinson's disease. BRAIN DISORDERS 2022. [DOI: 10.1016/j.dscb.2022.100048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Bakhshandeh Bavarsad M, Foroughan M, Zanjari N, Ghaedamini Harouni G, Jorjoran Shushtari Z. Development and validation of the geriatrics health behavior questionnaire (GHBQ). BMC Public Health 2022; 22:526. [PMID: 35300652 PMCID: PMC8932145 DOI: 10.1186/s12889-022-12927-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Considering the importance of health behaviors in health outcomes, it is necessary to assess health behaviors precisely. This study aimed to develop and validate The Geriatrics Health Behavior Questionnaire among Iranian older adults. METHODS This cross-sectional and methodological study was conducted on 420 community older adults (age ≥ 60) through random multi-stage sampling. The initial questionnaire has been developed with 22 items and seven subscales based on an extensive literature review, evaluation of related questionnaires, and experts' opinions. Face and content validity were evaluated by interviewing 10 older adults and 18 specialists. The construct validity was evaluated via Known-groups validity and convergent validity. The reliability of the questionnaire was calculated by internal consistency, test-retest, and absolute reliability. RESULTS The face validity was conducted by using interviews with older adults and gathering the specialists' opinions. The items were grammatically and lexically corrected accordingly. Two items were deleted due to CVR < 0.44. Modified Kappa statistic (K*) and I-CVI for all items were higher than 0.88. The average content validity index (S-CVI/Ave) value was 0.94. Three items were deleted to improve the internal consistency; the final GHBQ consisted of 17 items with Cronbach α = 0.72. Acceptable convergent validity was approved by a significant correlation between GHBQ and SF8™ health survey (r = 0.613, P value< 0.001). Independent t-test showed that older adults with education level ≥ high school have significantly higher health behavior scores than those with education level < high school (11.93 ± 2.27 vs. 9.87 ± 2.35, t = - 9.08, p < 0.001). Intra-class correlation coefficient (ICC) for the total questionnaire was 0.92 (95% CI =0.84 to 0.96). Standard Error Measurement (SEM) and Minimal Detectable Change (MDC95) were 0.71 and 1.98, respectively. CONCLUSION The present study results showed that the Geriatrics Health Behavior Questionnaire had suitable validity and reliability among Iranian older adults. It is recommended to consider its comprehensiveness and yet its briefness in other populations after passing validation.
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Affiliation(s)
- Maryam Bakhshandeh Bavarsad
- Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahshid Foroughan
- Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Nasibeh Zanjari
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Zahra Jorjoran Shushtari
- Ph.D., Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Kankaria A, Sahoo SS, Verma M. Awareness regarding the adverse effect of tobacco among adults in India: findings from secondary data analysis of Global Adult Tobacco Survey. BMJ Open 2021; 11:e044209. [PMID: 34183338 PMCID: PMC8240568 DOI: 10.1136/bmjopen-2020-044209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 06/17/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To quantify the extent of awareness regarding the harmful effects of tobacco among the users (both smoked and smokeless) and non-users in India, and explore the determinants of comprehensive knowledge among the participants of the Global Adult Tobacco Survey (GATS), India. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS The nationally representative GATS I (2009-2010) included 69 296 participants using a multistage sampling method, while GATS II (2015-2016) interviewed 74 037 respondents aged >15 years using a similar sampling method from all the states and union territories in India. PRIMARY AND SECONDARY OUTCOME MEASURES Comprehensive score were derived from nine items that explored awareness regarding the adverse effects of tobacco use among both users and non-users of tobacco in GATS II. Secondary outcome included predictors of awareness regarding adverse effects of tobacco and changes in the awareness compared with the previous round of the survey. RESULTS About 60.2%, 57.5% and 66.5% of the smokers, smokeless tobacco (SLT) users and non-users were aware of the adverse effects of tobacco, respectively. The awareness depicted significant age, gender, marital status, education status, urban-rural, wealth and regional disparities (p<0.05). Intention to quit tobacco use also varied significantly with awareness. Among smokers, awareness was high in those residing in eastern India and the poorest participants. Among SLT users, awareness was more among male participants, those who were poorest and lived in western India. Among non-users, awareness was more among middle-aged, more educated, rich participants of west India. Compared with GATS I, an increase in awareness was observed in GATS II across gender, age groups, residential areas and geographical regions in India. CONCLUSIONS Comprehensive awareness of tobacco's harmful effects is far from desirable among Indian users. We recommend further customised health promotion campaigns to counter the regional disparities, adopt a gender-neutral approach and target adolescents.
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Affiliation(s)
- Ankita Kankaria
- Department of Community & Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India
| | - Soumya Swaroop Sahoo
- Department of Community & Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India
| | - Madhur Verma
- Department of Community & Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India
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Akiki Z, Saadeh D, Farah R, Hallit S, Sacre H, Hosseini H, Salameh P. Asthma prevalence and associated factors among lebanese adults: the first national survey. BMC Pulm Med 2021; 21:162. [PMID: 33985479 PMCID: PMC8120928 DOI: 10.1186/s12890-021-01529-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 05/06/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND No national research has yet explored the prevalence of asthma among adults in Lebanon. This study aims to evaluate the prevalence of physician-diagnosed asthma and current asthma, and their determinants among Lebanese adults 16 years old or above. METHODS A cross-sectional study was carried out using a multistage cluster sampling. The questionnaire used collected information on asthma, respiratory symptoms, and risk factors. RESULTS The prevalence of physician-diagnosed asthma was 6.7% (95% CI 5-8.7%), and that of current asthma was 5% (95% CI 3.6-6.9%). Chronic symptoms such as cough, wheezing, and shortness of breath were worst at night. Factors positively associated with physician-diagnosed asthma were a secondary educational level (adjusted OR, aOR = 4.45), a family history of chronic respiratory diseases (aOR = 2.78), lung problems during childhood (15.9), and allergic rhinitis (4.19). Additionally, consuming fruits and vegetables less than once per week (3.36), a family history of chronic respiratory diseases (3.92), lung problems during childhood (9.43), and allergic rhinitis (8.12) were positively associated with current asthma. CONCLUSIONS The prevalence of asthma was within the range reported from surrounding countries. However, repeated cross-sectional studies are necessary to evaluate trends in asthma prevalence in the Lebanese population.
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Affiliation(s)
- Zeina Akiki
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Danielle Saadeh
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.
- Faculty of Public Health, Lebanese University, Fanar, Lebanon.
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon.
| | - Rita Farah
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Souheil Hallit
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Hassan Hosseini
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Life Sciences and Health Department, Paris-Est University, Paris, France
- Henri Mondor Hospital, Paris, France
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
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Heart rate, intelligence in adolescence, and Parkinson's disease later in life. Eur J Epidemiol 2021; 36:1055-1064. [PMID: 33675447 PMCID: PMC8542538 DOI: 10.1007/s10654-021-00730-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 02/10/2021] [Indexed: 01/29/2023]
Abstract
To investigate whether physical and cognitive fitness measured in late adolescence was associated with future risk of Parkinson’s disease (PD). The cohort included 1,259,485 Swedish men with physical fitness, body mass index (BMI), resting heart rate (RHR), blood pressure, intelligence quotient (IQ), and stress resilience measured at the age of 17–20 in relation to conscription. Incident cases of PD were ascertained from the Swedish Patient Register. Hazard ratios were estimated from Cox models, after controlling for multiple confounders. We further performed Mendelian randomization (MR) analyses to assess the causality of the associations, using GWAS summary statistics with > 800,000 individuals. During follow-up, we identified 1,034 cases of PD (mean age at diagnosis = 53). Men with an RHR > 100 beats per minute had a higher risk of PD compared to men with an RHR of 60–100 beats per minute (HR = 1.47; 95% CI = 1.08–1.99). Men with IQ above the highest tertile had a higher risk of PD compared to men with an IQ below the lowest tertile (HR = 1.46; 95% CI = 1.19–1.79). We found no association for physical fitness, BMI, blood pressure, or stress resilience. A causal relationship was suggested by the MR analysis between IQ and PD, but not between RHR and PD. RHR and IQ in late adolescence were associated with a higher risk of PD diagnosed at relatively young age. The association of IQ with PD is likely causal, whereas the association of RHR with PD suggests that altered cardiac autonomic function might start before 20 years of age in PD.
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Akiki Z, Saadeh D, Haddad C, Sacre H, Hallit S, Salameh P. Knowledge and attitudes toward cigarette and narghile smoking among previous smokers in Lebanon. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:14100-14107. [PMID: 32037494 DOI: 10.1007/s11356-020-07763-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Abstract
To evaluate the proportions of current cigarette smokers (CCS) and current narghile smokers (CNS) as well as previous cigarette smokers (PCS) and previous narghile smokers (PNS) and to assess smoking knowledge and attitudes toward supporting smoking ban or cessation among previous compared with current smokers. This cross-sectional study took place between May and December 2018, and enrolled a sample of 1598 exclusive cigarette smokers (ECS) and 2091 exclusive narghile smokers (ENS), representative of all Lebanese governorates. A questionnaire designed specifically for this study was used to collect data. Among ECS, 45.2% were CCS and 54.8% were PCS. Among ENS, 83.5% were CNS and 16.5% were PNS. Higher age (adjusted odds ratio (aOR) (95% confidence interval (CI)) = 1.02 (1.01; 1.03)), higher knowledge (1.05 (1.02; 1.08)), and attitude scores (1.11(1.09; 1.13)) were significantly associated with higher odds of being PCS. Higher age (1.02 (1.01; 1.03)), being employed (1.32 (1.004; 1.72)), higher knowledge (1.04 (1.02; 1.07)), and attitude scores (1.09 (1.07; 1.12)) were significantly associated with higher odds of being PNS. Previous smokers have higher knowledge and better attitude toward supporting smoking cessation compared with current smokers. A better knowledge along with effective interventions, might lead to a positive attitude toward supporting smoking ban or smoking cessation among the general population.
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Affiliation(s)
- Zeina Akiki
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Public Health, Lebanese University, Fanar, Lebanon.
- Faculty of Nursing and Health Sciences, Notre Dame Louaize University, Barsa, Lebanon.
- Faculty of Health Sciences, University of Balamand, Koura, Lebanon.
| | - Danielle Saadeh
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Chadia Haddad
- Institut d'Epidémiologie et de Neurologie Tropicale, UMR 1094, Neuroépidémiologie Tropicale, Université de Limoges, GEIST, 87000, Limoges, France
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Hala Sacre
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Pascale Salameh
- INSPECT- LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
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Shkolnikov VM, Churilova E, Jdanov DA, Shalnova SA, Nilssen O, Kudryavtsev A, Cook S, Malyutina S, McKee M, Leon DA. Time trends in smoking in Russia in the light of recent tobacco control measures: synthesis of evidence from multiple sources. BMC Public Health 2020; 20:378. [PMID: 32293365 PMCID: PMC7092419 DOI: 10.1186/s12889-020-08464-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 03/05/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The study aims at identifying long-term trends and patterns of current smoking by age, gender, and education in Russia, including the most recent period from 2008 during which tobacco control policies were implemented, and to estimate the impact on mortality of any reductions in prevalence. We present an in-depth analysis based on an unprecedentedly large array of survey data. METHODS We examined pooled micro-data on smoking from 17 rounds of the Russian Longitudinal Monitoring Study of 1996-2016, 11 other surveys conducted in Russia in 1975-2017, and two comparator surveys from England and the USA. Standardization by age and education, regression and meta-analysis were used to estimate trends in the prevalence of current smoking by gender, age, and educational patterns. RESULTS From the mid-1970s to the mid-2000s smoking prevalence among men was relatively stable at around 60%, after which time prevalence declined in every age and educational group. Among women, trends in smoking were more heterogeneous. Prevalence more than doubled above the age of 55 years from very low levels (< 5%). At younger ages, there were steep increases until the mid-2000s after which prevalence has declined. Trends differed by educational level, with women in the lowest educational category accounting for most of the long-term increase. We estimate that the decline in male smoking may have contributed 6.2% of the observed reduction in cardiovascular deaths among men in the period 2008-16. CONCLUSIONS The implementation of an effective tobacco control strategy in Russia starting in 2008 coincided with a decline in smoking prevalence among men from what had been stable, high levels over many decades regardless of age and education. Among women, the declines have been more uneven, with young women showing recent downturns, while the smoking prevalence in middle age has increased, particularly among those with minimal education. Among men, these positive changes will have made a small contribution to the reduction in mortality seen in Russia since 2005.
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Affiliation(s)
- Vladimir M Shkolnikov
- Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany.
- National Research University Higher School of Economics, Bolshoy Trekhsvyatitelsiy pereulok 3, Moscow, Russian Federation, 109038.
| | - Elena Churilova
- National Research University Higher School of Economics, Bolshoy Trekhsvyatitelsiy pereulok 3, Moscow, Russian Federation, 109038
| | - Dmitry A Jdanov
- Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany
- National Research University Higher School of Economics, Bolshoy Trekhsvyatitelsiy pereulok 3, Moscow, Russian Federation, 109038
| | - Svetlana A Shalnova
- National Medical Research Centre for Preventive Medicine, Petroverigskiy pereulok 10, Moscow, Russian Federation, 101990
| | - Odd Nilssen
- UiT the Arctic University of Norway, 9037, Tromsø, Norway
| | - Alexander Kudryavtsev
- Northern State Medical University, Troitskiy Avenue 51, Arkhangelsk, Russian Federation, 163000
| | - Sarah Cook
- London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK
| | - Sofia Malyutina
- Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Sciences, Vladimirovsky spusk 2a, Novosibirsk, Russian Federation, 630003
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK
| | - David A Leon
- UiT the Arctic University of Norway, 9037, Tromsø, Norway
- London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK
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Pärna K, Ringmets I, Siida S. Self-rated health and smoking among physicians and general population with higher education in Estonia: results from cross-sectional studies in 2002 and 2014. ACTA ACUST UNITED AC 2019; 77:49. [PMID: 31788242 PMCID: PMC6876104 DOI: 10.1186/s13690-019-0376-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 11/04/2019] [Indexed: 11/10/2022]
Abstract
Background Poor self-rated health (SRH) and smoking have consistently been shown to be related to mortality. The aim of this study was to explore SRH and smoking among physicians and general population with higher education in Estonia in 2002 and 2014 and to analyse the association of SRH with smoking and sociodemographic factors. Methods This study was based on cross-sectional postal surveys among physicians and general population with higher education in Estonia n in 2002 and 2014. Calculation of age-standardized prevalence of SRH and current smoking with 95% confidence intervals (CI) was performed. Multivariate logistic regression analysis was used to measure association between SRH (at-least-good vs less-than good) and smoking status, study year, age group, ethnicity, and marital status. Fully adjusted odds ratios (OR) with 95% CI were computed. Results Age-standardized prevalence of at-least-good SRH was 71.3 and 80.6% among male physicians, 68.4 and 83.1% among female physicians, 45.4 and 67.4% among men with higher education, and 44.7 and 63.1% among women with higher education in 2002 and 2014, respectively. Age-standardized prevalence of current smoking was 26.0 and 15.6% among male physicians, 10.2 and 5.9% among female physicians, 38.7 and 22.2% among men with higher education, and 20.9 and 16.4% among women with higher education in 2002 and 2014, respectively. There was no significant gender difference in at-least-good SRH, but prevalence of current smoking was significantly higher among men in both study groups in 2002 and 2014. Compared to year 2002, odds to have at-least-good SRH was higher in 2014 (OR = 1.64; 95% CI 1.16-2.31 among male and OR = 2.36; 95% CI 2.02-2.75 among female physicians, OR = 1.49; 95% CI 1.07-2.07 among men and OR = 2.40; 95% CI 1.84-3.13). Odds to have at-least-good SRH was significantly higher among non-smokers (except female physicians), in the youngest age group, and among Estonians. Conclusions This study gave an overview of differences in SRH and smoking between two target groups with higher education in two timepoints highlighting the importance of addressing smoking cessation counselling and health promotion campaigns in the population by different subgroups in Estonia.
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Affiliation(s)
- Kersti Pärna
- Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
| | - Inge Ringmets
- Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
| | - Sävelin Siida
- Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
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Reile R, Pärna K. Exposure to second-hand smoke in the context of tobacco policy changes in Estonia, 1996-2016. Eur J Public Health 2019; 29:772-778. [PMID: 30851110 DOI: 10.1093/eurpub/ckz027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Exposure to second-hand smoke (SHS) is a preventable cause of disease and disability that can effectively be tackled by tobacco legislation. The aim of the study was to analyse the trends of SHS exposure and its sociodemographic patterning during 1996-2016 in the context of tobacco policy changes in Estonia. METHODS Nationally representative data from biennial health surveys in 1996-2016 (n = 14 629) were used to present prevalence ratios for SHS exposure among non-smokers in Estonia. Joinpoint regression and multivariable logistic regression were used to study the sociodemographic and socio-economic differences in SHS exposure and its changes during the period. RESULTS Exposure to SHS among non-smoking men and women has declined 3.6 and 5 times, respectively, during 1996-2016. While the rate of change was constant among men throughout the period, the decline in SHS exposure among women became significantly faster after 2006 compared with the previous period. However, 15.6% [95% confidence interval (CI) 13.1-18.3%] of men and 8.8% (95% CI 7.1-10.6%) of women were still exposed to SHS in 2016 with higher odds found for younger age groups, non-Estonians and those with lower education and income. CONCLUSIONS The consistently declining prevalence of SHS exposure among non-smoking population can be at least partially attributed to implementation of tobacco legislations in 2000s. However, the existing sociodemographic and socio-economic differences in SHS exposure require further attention as those in more vulnerable positions are also more exposed to SHS-related health harms.
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Affiliation(s)
- Rainer Reile
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.,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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Broström E, Jõgi R, Gislason T, Benediktsdottir B, Burney PGJ, Janson C. The prevalence of chronic airflow obstruction in three cities in the Nordic-Baltic region. Respir Med 2018; 143:8-13. [PMID: 30261997 DOI: 10.1016/j.rmed.2018.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/23/2018] [Accepted: 08/12/2018] [Indexed: 12/21/2022]
Abstract
BACK GROUND Chronic airflow obstruction (CAO) is the primary characteristic of Chronic obstructive pulmonary disease (COPD) but is also seen in chronic asthma. OBJECTIVE To compare the prevalence of CAO and possible risk factors between Tartu in Estonia, Reykjavik in Iceland and Uppsala in Sweden. METHODS All participants underwent spirometry testing of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) before and after bronchodilation. CAO was defined as post-bronchodilator FEV1/FVC below lower limit of normal. Information on respiratory diseases and smoking status, was obtained through questionnaires administered by trained interviewers. RESULTS 1037 men and 956 women participated in the study. The prevalence of CAO was lower in women in Tartu compared to the other centres (4.9% vs. 13.4 and 8.7% in Reykjavik and Uppsala, respectively, p = 0.002) while no difference was found for men. A similar picture was seen for the proportion of participants that had smoked 10 pack years or more which was much lower in Tartu for women than in Reykjavik and Uppsala, respectively (13.2% vs. 33.7 and 29.2%, p < 0.001). (Fig. 1). Of the participants with CAO the majority (57-67%) did not have a previous diagnosis of asthma or COPD. CONCLUSION The prevalence of CAO was lower in Estonian women than in women from Iceland and Sweden. The reason for this was probably that the Estonian women had smoked less than the female participants from Iceland and Sweden. The majority of those with CAO do not have a diagnosed lung disease.
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Affiliation(s)
- Erika Broström
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Sweden
| | - Rain Jõgi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Thorarinn Gislason
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Iceland
| | | | | | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Sweden; National Heart and Lung Institute, Imperial College, London, UK.
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Aareleid T, Zimmermann ML, Baburin A, Innos K. Divergent trends in lung cancer incidence by gender, age and histological type in Estonia: a nationwide population-based study. BMC Cancer 2017; 17:596. [PMID: 28854969 PMCID: PMC5577806 DOI: 10.1186/s12885-017-3605-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/24/2017] [Indexed: 01/06/2023] Open
Abstract
Background Lung cancer (LC) is the leading cause of cancer deaths in men and the second most frequent cause of cancer deaths in women in Estonia. The study aimed to analyze time trends in LC incidence and mortality in Estonia over the 30-year period, which included major social, economic and health care transition. The results are discussed in the context of changes in tobacco control and smoking prevalence. Long-term predictions of incidence and mortality are provided. Methods Data for calculating the incidence and mortality rates in 1985–2014 were obtained from the nationwide population-based Estonian Cancer Registry and the Causes of Death Registry. Joinpoint regression was used to analyze trends and estimate annual percentage change (APC) with 95% confidence interval (CI). Nordpred model was used to project future incidence and mortality trends for 2015–2034. Results Incidence peaked among men in 1991 and decreased thereafter (APC: -1.5, 95% CI: -1.8; −1.3). A decline was seen for all age groups, except age ≥ 75 years, and for all histological types, except adenocarcinoma and large cell carcinoma. Incidence among women increased overall (APC: 1.6, 95% CI: 1.1; 2.0) and in all age groups and histological types, except small cell carcinoma. Age-standardized incidence rate (world) per 100,000 was 54.2 in men and 12.9 in women in 2014. Changes in mortality closely followed those in incidence. According to our predictions, the age-standardized incidence and mortality rates will continue to decrease in men and reach a plateau in women. Conclusions The study revealed divergent LC trends by gender, age and histological type, which were generally consistent with main international findings. Growing public awareness and stricter tobacco control have stimulated overall favorable changes in men, but not yet in women. Large increase in incidence was observed for adenocarcinoma, which in men showed a trend opposite to the overall decline. LC will remain a serious public health issue in Estonia due to a high number of cases during the next decades, related to aging population, and previous and current smoking patterns. National tobacco control policy in Estonia should prioritize preventing smoking initiation and promoting smoking cessation, particularly among women.
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Affiliation(s)
- Tiiu Aareleid
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
| | - Mari-Liis Zimmermann
- Estonian Cancer Registry, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
| | - Aleksei Baburin
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia
| | - Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
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Yaya S, Bishwajit G, Shah V, Ekholuenetale M. Socioeconomic Disparities in Smoking Behavior and Early Smoking Initiation Among Men in Malawi. Tob Use Insights 2017; 10:1179173X17726297. [PMID: 28839446 PMCID: PMC5560509 DOI: 10.1177/1179173x17726297] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 06/15/2017] [Indexed: 11/16/2022] Open
Abstract
Background: Tobacco smoking is a growing concern for health care systems as it is projected to become the leading cause of death in the developing world. Knowledge of how smoking behavior differs across socioeconomic groups is crucial for designing effective preventive policies and alleviating the disparities. The aim of this study was to report the prevalence of (1) smoking status, (2) early smoking initiation, and (3) association with socioeconomic status (SES) of the 2 among Malawian men. Methods: Cross-sectional data on 1693 men aged between 15 and 49 years were collected from the latest 2013-2014 Multiple Indicator Cluster Survey in Malawi. Educational qualification and wealth index quintile were used as the indicators of SES. Outcome variables were smoking status, first age of smoking being below 18 years, and ever using any form of smokeless tobacco products. Multiple logistic regression models were used to see the contribution of SES to smoking status and early smoking initiation. Results: Mean age of the sample population was 33.23 years (SD: 8.25). Prevalence of smoking, early initiation, and ever using any form of smokeless tobacco were, respectively, 46.6%, 33.7%, and 6%. Compared with men who had higher education, those who had no formal education, primary-level, and secondary-level qualification had, respectively, 21% (adjusted odds ratio [AOR] = 1.209; 95% confidence interval [CI] = 0.498-2.935), 40% (AOR = 1.4; 95% CI = 0.647-3.029), and 26% (AOR = 1.256; 95% CI = 0.593-2.661) higher odds of being a smoker. Those who had no formal education were 2.7 times (AOR = 2.734; 95% CI = 1.123-6.653) as likely to try smoking before reaching 18 years of age. Compared with the richest, those in the lowest wealth quintile had 32% lower odds (AOR = 0.676; 95% CI = 0.455-1.006) of early onset of smoking, 63% lower odds (AOR = 0.372; 95% CI = 0.201-0.690) of trying other tobacco products. Conclusions: Addressing the socioeconomic disparities could play a vital role in delaying early onset and limiting overall consumption of tobacco. Ongoing health policy talks to reduce the prevalence of smoking should take into consideration improving educational and material well-being among men.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
| | - Ghose Bishwajit
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Vaibhav Shah
- Interdisciplinary School Health Sciences, University of Ottawa, Ottawa, ON, Canada
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Stefler D, Murphy M, Irdam D, Horvat P, Jarvis M, King L, McKee M, Bobak M. Smoking and Mortality in Eastern Europe: Results From the PrivMort Retrospective Cohort Study of 177 376 Individuals. Nicotine Tob Res 2017; 20:749-754. [DOI: 10.1093/ntr/ntx122] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 05/30/2017] [Indexed: 11/14/2022]
Affiliation(s)
- Denes Stefler
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Michael Murphy
- Department of Social Policy, London School of Economics, London, UK
| | - Darja Irdam
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Pia Horvat
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Martin Jarvis
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Lawrence King
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
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