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Ismail A, Hamdar L, Dirawi H, Kanso M, Salem I, Tamim H, Mahfoud Z. Predictors and health outcomes of tobacco smoking among the population of Gaza: A large-scale study. RESEARCH SQUARE 2024:rs.3.rs-4195976. [PMID: 38746468 PMCID: PMC11092850 DOI: 10.21203/rs.3.rs-4195976/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Tobacco smoking, a significant public health concern globally, is associated with a rise in noncommunicable diseases and preventable deaths, with pronounced impacts in conflict zones like Gaza. A study in Gaza focused on individuals over 40 years of age, aiming to identify predictors of tobacco use and its links to diseases like coronary artery disease, chronic lung disease, and stroke. The research, based on the Gaza NCD study data with 4576 participants and a 96.6% response rate, found an overall tobacco smoking prevalence of 19.4%, with higher rates among men. Adjusting for various factors, the study revealed significant associations between cigarette smoking in men and adverse health outcomes, such as coronary artery disease and chronic lung disease. However, after adjusting for independent variables, shisha smoking in men showed no association with these health outcomes. In conflict-affected regions like Gaza, this large-scale study sheds light on predictors of cigarette and shisha smoking and their impact on health outcomes, offering valuable insights for researchers, public health officials, healthcare professionals, and policymakers. The findings aid in predicting smoking prevalence, addressing current health challenges, and mitigating potential health and financial burdens associated with tobacco use in conflict zones.
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Affiliation(s)
- Ali Ismail
- American University of Beirut Medical Center
| | | | - Hiba Dirawi
- American University of Beirut Medical Center
| | | | | | - Hani Tamim
- American University of Beirut Medical Center
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Kibria MG, Islam T, Badiuzzaman M, Mamun AA, Sultana P, Hawlader MDH. Assessing the choice of smoke-free policies for multiunit housing and its associated determinants in Bangladesh: a cross-sectional study. BMJ Open 2024; 14:e074928. [PMID: 38642999 PMCID: PMC11033630 DOI: 10.1136/bmjopen-2023-074928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/11/2023] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES This study aimed to assess the desire for smoke-free housing, determine the choice of smoke-free policies for multiunit housing (MUH), and identify the factors associated with policy choice among MUH residents in Bangladesh. DESIGN We conducted a cross-sectional study from April to November 2019 using a semi-structured survey questionnaire. SETTING This study was conducted in seven divisional cities of Bangladesh: Dhaka, Chattogram, Rajshahi, Khulna, Sylhet, Barishal, and Rangpur. PARTICIPANTS A total of 616 adult individuals living in MUH for at least 2 years participated in the study. PRIMARY OUTCOME MEASURE Multinomial logistic regression was used to identify the determinants of the choice of smoke-free policies for MUH. RESULTS Overall, 94.8% of the respondents wanted smoke-free housing. Among those who wanted smoke-free housing, 44.9% preferred a smoke-free building policy, 28.3% preferred a smoke-free common area policy, 20.2% favoured a smoke-free unit policy, and 6.7% did not know what policy they should choose. Three factors were found to be significantly associated with the choice of a smoke-free building policy: staying at home for more than 12 hours (adjusted OR (aOR): 2.6; 95% CI 1.035 to 6.493), being a non-smoker (aOR: 3.2; 95% CI 1.317 to 7.582), and having at least one family member who smoked (aOR: 3.0; 95% CI 1.058 to 8.422). Results also showed that residents having at least one child under 15 in the family (aOR: 0.3; 95% CI 0.152 to 0.778) were less likely to choose a smoke-free common area policy and that women (aOR: 3.7; 95% CI 1.024 to 13.188) were more likely to choose a smoke-free unit policy. CONCLUSIONS MUH residents in urban Bangladesh highly demanded smoke-free housing. Most residents favoured a smoke-free building policy for MUH. Those who stayed at home for a longer time, were non-smokers, and had smoking family members were more likely to choose this policy.
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Affiliation(s)
- Md Golam Kibria
- Department of Research, Centre for Development Action, Dhaka, Bangladesh
| | - Taslima Islam
- Department of Monitoring, Evaluation and Learning, Social Development Foundation, Dhaka, Bangladesh
- Centre for Development Action, Dhaka, Bangladesh
| | - Muhammad Badiuzzaman
- Centre for Development Action, Dhaka, Bangladesh
- Department of Research and Policy, Transparency International Bangladesh, Dhaka, Bangladesh
| | - Abdullah Al Mamun
- Centre for Development Action, Dhaka, Bangladesh
- High Court Division, Supreme Court of Bangladesh, Dhaka, Bangladesh
| | - Papia Sultana
- Centre for Development Action, Dhaka, Bangladesh
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
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Boderie NW, Sheikh A, Lo E, Sheikh A, Burdorf A, van Lenthe FJ, Mölenberg FJ, Been JV. Public support for smoke-free policies in outdoor areas and (semi-)private places: a systematic review and meta-analysis. EClinicalMedicine 2023; 59:101982. [PMID: 37256097 PMCID: PMC10225670 DOI: 10.1016/j.eclinm.2023.101982] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 06/01/2023] Open
Abstract
Background Smoke-free policies are essential to protect people against tobacco smoke exposure. To successfully implement smoke-free policies that go beyond enclosed public places and workplaces, public support is important. We undertook a comprehensive systematic review of levels and determinants of public support for indoor (semi-)private and outdoor smoke-free policies. Methods In this systematic review and meta-analysis, six electronic databases were searched for studies (published between 1 January 2004 and 19 January 2022) reporting support for (semi-)private and outdoor smoke-free policies in representative samples of at least 400 respondents aged 16 years and above. Two reviewers independently extracted data and assessed risk of bias of individual reports using the Mixed Methods Appraisal Tool. The primary outcome was proportion support for smoke-free policies, grouped according to location covered. Three-level meta-analyses, subgroup analyses and meta-regression were performed. Findings 14,749 records were screened, of which 107 were included; 42 had low risk of bias and 65 were at moderate risk. 99 studies were included in the meta-analyses, reporting 326 measures of support from 896,016 individuals across 33 different countries. Support was pooled for indoor private areas (e.g., private cars, homes: 73%, 95% confidence interval (CI): 66-79), indoor semi-private areas (e.g., multi-unit housing: 70%, 95% CI: 48-86), outdoor hospitality areas (e.g., café and restaurant terraces: 50%, 95% CI: 43-56), outdoor non-hospitality areas (e.g., school grounds, playgrounds, parks, beaches: 69%, 95% CI: 64-73), outdoor semi-private areas (e.g., shared gardens: 67%, 95% CI: 53-79) and outdoor private areas (e.g., private balconies: 41%, 95% CI: 18-69). Subcategories showed highest support for smoke-free cars with children (86%, 95% CI: 81-89), playgrounds (80%, 95% CI: 74-86) and school grounds (76%, 95% CI: 69-83). Non-smokers and ex-smokers were more in favour of smoke-free policies compared to smokers. Support generally increased over time, and following implementation of each smoke-free policy. Interpretation Our findings suggested that public support for novel smoke-free policies is high, especially in places frequented by children. Governments should be reassured about public support for implementation of novel smoke-free policies. Funding Dutch Heart Foundation, Lung Foundation Netherlands, Dutch Cancer Society, Dutch Diabetes Research Foundation and Netherlands Thrombosis Foundation.
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Affiliation(s)
- Nienke W. Boderie
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Asiyah Sheikh
- Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - Erika Lo
- Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Alex Burdorf
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Frank J. van Lenthe
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Famke J.M. Mölenberg
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Jasper V. Been
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
- Division of Neonatology, Department of Neonatal and Paediatric Intensive Care, Erasmus MC Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
- Department of Obstetrics and Gynaecology, Erasmus MC Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
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Dimitrova E, Kotzeva T. Adolescent risk behaviours and family settings in Bulgaria: An evidence-based approach to effective family support policies. JOURNAL OF MOTHER AND CHILD 2022; 25:139-150. [PMID: 35143718 PMCID: PMC9097663 DOI: 10.34763/jmotherandchild.20212503si.d-21-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/22/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND The paper focuses on Bulgarian adolescents' behaviours that put their health at risk and their relationship to family-related characteristics: structure of family and material status, family support, communication with parents, parental monitoring and school-related parental support. It also discusses intervention programs with a focus on parent support gradient. MATERIAL AND METHODS The analysis is based on the Bulgarian sample of Health Behaviour in School-Aged Children survey, the 2018 round. Logistic regression models of current cigarette smoking, regular alcohol consumption, sexual debut and current cannabis use are applied. Main national programs on adolescent health and the parental involvement component in them are also discussed. RESULTS The statistical analyses reveal significant gender and age differences in Bulgarian adolescents' health risk behaviours. Girls have significantly higher odds of smoking and are less likely to report an early start of sexual life. Odds of cigarette smoking and regular alcohol consumption increase with age. Children living with one parent have significantly higher odds of smoking, regular alcohol consumption and current cannabis use. Interactions between FAS and family support reveal that students who report low family support, regardless of the material status of the family, have significantly higher odds of health risk behaviours. CONCLUSION The main contribution of the analysis reveals the alleviating effect of family support on socio-economic inequalities between families. An evidence-based approach delineating a preventive potential of family support on Bulgarian adolescents' health risk behaviours despite the level of family affluence provides solid arguments for increasing national family support programs.
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Affiliation(s)
- Elitsa Dimitrova
- Institute for Population and Human Studies – Bulgarian Academy of Sciences & Plovdiv University Paisii HilendarskiPlovdivBulgaria, E-mail:
| | - Tatyana Kotzeva
- Burgas Free University & Institute for Population and Human Studies – Bulgarian Academy of SciencesBurgasBulgaria
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Hanafin J, Sunday S, Clancy L. Friends and family matter Most: a trend analysis of increasing e-cigarette use among Irish teenagers and socio-demographic, personal, peer and familial associations. BMC Public Health 2021; 21:1988. [PMID: 34732172 PMCID: PMC8567623 DOI: 10.1186/s12889-021-12113-9] [Citation(s) in RCA: 3] [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: 06/17/2021] [Accepted: 10/01/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND E-cigarette ever-use and current-use among teenagers has increased worldwide, including in Ireland. METHODS We use data from two Irish waves (2015, 2019) of the European School Survey Project on Alcohol and other Drugs (ESPAD) to investigate gender and teenage e-cigarette use (n = 3421 16-year-olds). Using chi-square analyses, we report changes in e-cigarette ever-use, current-use, and associated variables. Using multivariable logistic regression, we analyse the increase in e-cigarette use and socio-demographic, personal, peer and familial associations, focusing on gender differences. RESULTS E-cigarette ever-use increased from 23% in 2015 to 37% in 2019, and current-use from 10 to 18%. Compared with 2015, the odds in 2019, of becoming both an e-cigarette ever-user and current-user, were significantly higher for girls than boys (ever-use: AOR 2.67 vs 2.04; current-use: AOR 3.11 vs 1.96). Smoking and e-cigarette use are linked but never-smokers who try e-cigarettes rose significantly from 33 to 67% and those using e-cigarettes to quit smoking decreased significantly from 17 to 3%. Almost two-thirds of respondents (66%) in 2019 said that their reason for trying e-cigarettes was "out of curiosity". Peer smoking is significantly associated with likelihood of e-cigarette ever-use (AOR 6.52) and current-use (AOR 5.45). If "Most/All friends smoke", odds were significantly higher for boys than for girls (ever-use AOR 7.07 vs 6.23; current-use AOR 5.90 vs 5.31). Less parental monitoring is significantly associated with greater e-cigarette ever-use (AOR 3.96) and current-use (4.48), and having parents who usually don't know where their child is on Saturday nights was also associated with significantly higher odds for boys than for girls (ever-use AOR 5.42 vs 3.33; current-use AOR 5.50 vs 3.50). CONCLUSION Respondents had significantly higher odds of being e-cigarette ever- and current-users in 2019 compared with 2015. Use is higher among boys but girls are increasingly at risk. Two-thirds had never smoked cigarettes at first e-cigarette use; two-thirds used out of curiosity but few (3%) for smoking cessation. The most prominent risk factors for e-cigarette use were peer- and parent-related, especially so for boys. Interventions that take account of friend and family influences may provide mechanisms for preventing an increasing risk of nicotine addiction.
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Affiliation(s)
- Joan Hanafin
- TobaccoFree Research Institute Ireland (TFRI), FOCAS Institute, TU Dublin, Dublin, Ireland
| | - Salome Sunday
- TobaccoFree Research Institute Ireland (TFRI), FOCAS Institute, TU Dublin, Dublin, Ireland
| | - Luke Clancy
- TobaccoFree Research Institute Ireland (TFRI), FOCAS Institute, TU Dublin, Dublin, Ireland.
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Mertens AEJ, Kunst AE, Lorant V, Alves J, Rimpelä A, Clancy L, Kuipers MAG. Smoking cessation among adolescents in Europe: The role of school policy and programmes. Drug Alcohol Depend 2021; 227:108945. [PMID: 34333281 DOI: 10.1016/j.drugalcdep.2021.108945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION European estimates of adolescent smoking cessation are lacking and studies on the role of schools in quit behaviour are scarce. We aimed to describe smoking cessation attempts and success among adolescents in Europe and explored the association with school policy and programmes. METHODS We used cross-sectional data from the 2013 and 2016-2017 surveys of the European SILNE and SILNE-R projects. We included 4,509 12-19-year-old current or ex-smokers in 67 secondary schools in seven countries (Belgium, Germany, Finland, Ireland, Italy, the Netherlands, and Portugal). School staff reported strength of smoke-free school policies (SFSPs), proportion of grades in which anti-tobacco education was offered, and whether the school offered any form of cessation support programme. Multilevel logistic regression analysis determined school-level variation and the association of school-level and individual-level variables with self-reported and self-defined quit attempts and quit success. RESULTS Over three quarters (77.3%) of students reported a quit attempt and half of them (50.1%) reported quit success. Prevalence rates of quit success and quit attempts, showed relatively small variations between schools within countries. Associations of smoke-free school policy, tobacco educational programmes and cessation programmes with quit attempts and quit success could not be demonstrated with statistical significance. Quit attempts and quit success were inversely associated with alcohol use, parental smoking, and friend smoking. CONCLUSION This study demonstrates that adolescence is an important time to encourage quitting and to support quit attempts. We did not find evidence for a contribution of school policies and programmes to quit behaviour of adolescent smokers.
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Affiliation(s)
- Aukje E J Mertens
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Vincent Lorant
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Joana Alves
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal; Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Arja Rimpelä
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland; Tampere University Hospital, Department of Adolescent Psychiatry, Tampere, Finland
| | - Luke Clancy
- TobaccoFree Research Institute, Focas Research Institute, Dublin, Ireland
| | - Mirte A G Kuipers
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
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Kim SY, Jang M, Yoo S, JeKarl J, Chung JY, Cho SI. School-Based Tobacco Control and Smoking in Adolescents: Evidence from Multilevel Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3422. [PMID: 32423028 PMCID: PMC7277168 DOI: 10.3390/ijerph17103422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 11/16/2022]
Abstract
Since 2015, universal comprehensive school-based tobacco control programs have been provided in all primary and secondary schools in Korea. This study explored the association of school-level tobacco control with adolescent smoking, and the interactions to investigate whether gender moderates the impact of school tobacco control programs and school-level norms. Both school- and individual-level data were drawn from the 2015 School-Based Tobacco Prevention Program Survey. Multilevel logistic regression analyses were performed using data from 4631 students (ages 10-18 years) who were nested in 62 secondary schools in Seoul, Korea. Students who participated in more prevention programs were less likely to smoke (OR = 0.47, 95% CI 0.30-0.74). The effect of the programs was significantly moderated by gender. For boys, exposure to a greater number of programs decreased the risk of smoking (OR = 0.32, 95% CI 0.18-0.57) but not for girls. At the school level, the school norm regarding tobacco control regulations was negatively associated with smoking (OR = 0.28, 95% CI 0.11-0.76), and its effect was significant for girls only (OR = 0.35, 95% CI 0.17-0.76). This study highlights how the school environment is associated with adolescent smoking behavior, and the effects of programs and norms are different by gender. The findings suggest the need to develop strategies to enhance school-based tobacco control programs and the school norm considering gender differences.
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Affiliation(s)
- Seong Yeon Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea; (S.Y.K.); (S.Y.)
| | - Myungwha Jang
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea;
| | - Seunghyun Yoo
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea; (S.Y.K.); (S.Y.)
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea;
| | - Jung JeKarl
- Department of Health Convergence, College of Science and Industry Convergence, Ewha Womans University, Seoul 03760, Korea;
| | | | - Sung-il Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea; (S.Y.K.); (S.Y.)
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea;
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