Tobacco impact on quality of life, a cross-sectional study of smokers, snuff-users and non-users of tobacco

Tooth morbidity and its impact on oral related quality of life in elderly tribal population-The Irula experience

INTRODUCTION

Oral diseases are a major global health challenge, posing health and economic burdens that have profound impacts on the quality of life, disproportionately affecting marginalized populations such as tribal communities. Among scheduled tribes in India, the Irula community belongs to one of the tribes most vulnerable by poor access to health care and education. The elders in the population have increased incidence and prevalence rates of tooth morbidities-an increased incidence of caries, non-carious lesions, and periodontitis-related conditions that affect oral health related quality of life (OHQOL) dimensions.

OBJECTIVES

This study aims to assess tooth morbidity and tooth loss among older Irula community members, identify risk factors, and evaluate how oral and physical comorbidities have been associated with OHRQoL.

METHODS

A cross-sectional study was conducted on elderly persons aged 60 years and above in Thiruvallur district, Tamil Nadu, India. A multi-stage random sampling technique was employed in the study. Data were collected by semi-structured questionnaires covering demographics, medical history, oral health practices, and quality of life by clinical dental examination. The tools used included the International Caries Detection and Assessment System (ICDAS) the Smith and Knight Tooth wear index for non-carious lesions, and the Community Periodontal Index for Treatment Needs (CPITN) index for periodontal disease Furthermore, quality of life assessment was carried out utilizing the Geriatric Oral Health Assessment Index (GOHAI). Subsequently, Descriptive and multivariate logistic regression analyses were performed to determine the predictors of OHRQoL.

RESULTS

The prevalence of carious lesions was 38.5%, non-carious lesions 70%, periodontitis 70.8%, and tooth loss 53.6%. Only 2.3% of participants had restorative dental treatments. Multivariate analysis reveals that illiteracy (AOR = 0.163, p = 0.003), arthritis (AOR = 0.340, p = 0.001), carious lesions (AOR = 1.402, p = 0.031), periodontal disease (AOR = 1.663, p = 0.002), and tooth loss (AOR = 2.744, p = 0.001) affected OHRQoL significantly.

CONCLUSION

The results regarding the elderly community of Irula point towards the severe oral health disparities observed among them; thus, this raises an urgent need to develop a public health intervention for this eminent existing fact. Removing education and socioeconomic barriers, improving access to dental health care, and advocating culturally appropriate preventive programs could increase OHRQoL. Longitudinal study and policy-driven approaches should be carried out in future studies for sustainable health equity of the tribal population.

Canonical correlation analysis of family burden of disease and quality of life in caregivers of people living with schizophrenia: evidence from Schizophrenia-specific cohort in the less-developed multi-ethnic region of Southwest China

BACKGROUND

Health-related quality of life is a multi-dimensional concept that involves individual's perceived physical and mental health, social relationships, and environment. Family members are the primary caregivers of people living with schizophrenia in China, the quality of life of caregiver of people living with schizophrenia is generally poorer, which may indirectly affect the quality of life of the people with schizophrenia.

METHODS

We conducted a comprehensive survey on quality of life in caregivers of people living with schizophrenia based on the Schizophrenia-specific cohort in the Less-developed Multi-ethnic Region of Southwest China to validate the accessibility and effectiveness of the schizophrenia family care model at the family level, caregivers of people living with schizophrenia were selected as participants in Baoshan City, Yunnan Province from September 2022 to March 2023, quality of life, family burden of disease, sociodemographic and behavioral information of participants were collected.

RESULTS

Domain scores for physical, psychological, social relationships, and environment of quality of life were 13.50 ± 2.61, 12.67 ± 2.40, 13.64 ± 2.32, and 12.46 ± 1.76 respectively. In our study, we found that gender, age, education level, personal monthly income, history of smoking and alcohol consumption, subjective sleep quality, relation to the patient, degree of self-care and the number of relapses in patient all influence 1 to 4 domains of quality of life for caregivers, stratified analysis was conducted to minimize the effect of gender on the results, we still found that history of smoking could positively predict the score of psychological domain and history of alcohol consumption could positively predict the score of social relationships domain. Canonical correlation analysis showed that the 'impact on family interaction' in family burden of disease was most closely related to quality of life.

CONCLUSION

Building harmonious family relationships can help improve the quality of life for caregivers of People living with schizophrenia.

Geriatric Oral Health and Quality of Life Among the Indigenous Irula Tribes of Tamil Nadu

OBJECTIVES

This study aims to assess the oral health-related quality of life (OHRQoL) among the Irula tribes and to know the factors influencing quality of life among the elderly irula tribes of Tamil Nadu.

METHODS

This cross-sectional study was conducted in the Northern district of Tamil Nadu, including 486 Irula individuals aged 65 and above. Participants were selected using a multistage sampling method. Data were collected through a structured questionnaire, including the Geriatric Oral Health Assessment Index (GOHAI) to evaluate OHRQoL. The study tool covered demographics, medical history, and oral health issues. Data analysis was performed using SPSS version 23, with logistic regression applied to account for confounders.

RESULTS

The sample primarily consisted of individuals aged 65-69 years (55.6%), with a predominance of females (76.3%). The majority were Hindu (94.9%) and lived in nuclear families (88.3%). Educational levels were low, with 66.5% being illiterate. Most participants were agricultural laborers (64.6%) and had low monthly incomes. GOHAI results revealed that many respondents faced significant oral health challenges, including difficulties with eating, speaking, and discomfort. Multivariate analysis showed that educational level significantly affected OHRQoL, with higher education correlating with better quality of life. Arthritis was associated with poorer OHRQoL, while other health conditions did not show significant impacts.

CONCLUSION

The study highlights severe oral health issues among the Irula community, with significant physical and psychological impacts. Educational attainment plays a crucial role in OHRQoL, while arthritis notably affects quality of life. The findings emphasize the need for targeted oral health interventions and increased awareness in tribal communities to improve overall health outcomes. Further research in larger populations is necessary to comprehensively understand and address geriatric oral health needs.

Is smokeless tobacco a healthier option in patients with AUD? A follow-up study during treatment

INTRODUCTION

Smoking is negatively related to mental health, but there is a paucity of research on the relationship between the use of smokeless tobacco, such as snus, and mental health outcomes, especially in people with alcohol use disorders (AUD). The aim of the present study was to examine the development of mental distress and quality of life (QoL) among AUD patients in treatment who did or did not use snus.

METHOD

The study included 128 AUD patients (27% female) from three rehabilitation clinics in Eastern Norway who were interviewed at admission, at 6 weeks, and after 6 months. Patients were asked about their mental health-related problems, alcohol, and substance use, QoL, and physical activity. Information about tobacco use was gathered with the questions "Do you smoke cigarettes?" and "Do you use snus?", with follow-up questions "How often?".

RESULT

There were 39 current snus users (31%), of which 20 were also current smokers (dual users). Seventy-five patients (59%) were smokers only, and only 14 (11%) patients were abstainers. Those who used snus only had a lower severity of dependence score than the other groups (p < 0.05). The dual use group reported lower QoL than the no tobacco use group. In a regression model adjusted for sex and age, smokers and dual users, but not users of snus, had higher levels of mental distress and poorer QoL compared to nontobacco users (p < 0.05). There were no differences between tobacco groups at follow-ups.

CONCLUSION

In this study, among AUD patients, snus users reported QoL and mental distress close to that of non-smokers, indicating a lower problem load among snus users compared to smokers.

IMPLICATIONS

Previous studies have shown conflicting results regarding the potential harm reduction effect of snus use among patients with AUD who smoke regarding their tobacco use, quality of life and mental health problems. This study suggests that snus use could also be a viable alternative to smoking for patients with addictions.

Neighborhood environment and quality of life of older adults in eastern Nepal: findings from a cross-sectional study

INTRODUCTION

Quality of life (QoL) is a subjective measure reflecting individuals' evaluations based on their personal goals and values. While global research shows the role of neighborhood factors like ethnic diversity and socio-cultural dynamics on QoL, these are unexplored in the Nepali context. Therefore, this study examined the relationship between neighborhood environment and QoL among Nepali older adults in eastern Nepal.

METHODS

This cross-sectional study involved 847 non-institutionalized older adults (aged ≥ 60 years) from two districts in eastern Nepal. QoL was evaluated using the 13-item brief Older People's Quality of Life questionnaire, where a mean score of < 3 indicated low/poor QoL. The neighborhood environment, conceptualized across three domains (demographic, socio-cultural, and built environment), included ethnic diversity, connections with family, friends, and neighbors, cultural ties, residential stability, and rurality. Their association with QoL was examined using multivariable logistic regression.

RESULTS

Around 20% of older adults reported poor QoL. Higher ethnic diversity (adjusted Odds Ratio [aOR] = 0.12, 95% confidence interval [CI]: 0.04-0.36), moderate contact with family and relatives (aOR = 0.26, CI: 0.11-0.61), and high contact with neighbors (aOR = 0.09, CI: 0.03-0.21) were associated with lower odds of poor QoL. Conversely, high contact with friends (aOR = 2.29, CI: 1.30-4.04) and unstable residence (OR = 6.25, CI: 2.03-19.23) increased the odds of poor QoL. Additionally, among the covariates, chronic disease, tobacco use, unemployment, and lack of education were also significantly associated with poor QoL.

CONCLUSION

Overall, the demographic environment, socio-cultural factors, and the built environment of the neighborhood influence QoL. Therefore, diversifying the neighborhood's ethnic composition, promoting social connections such as frequent contact with family, relatives, and neighbors, and ensuring residential stability can enhance the QoL of older adults.

Quality of life among people with mental illness attending a psychiatric outpatient clinic in Ethiopia: a structural equation model

Background

Mental illness is one of the most severe, chronic, and disabling public health problems that affects patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023.

Methods

A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total study participants who had a follow-up appointment during the data collection period (2400), by the total sample size 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the quality of life (QoL) of people with mental illness. The domains of QoL were identified, and indirect and direct effects of variables were calculated using structural equation modelling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance.

Results

A total of 636 (99.7%) participants agreed to participate and completed the data collection. The mean score of overall QoL of people with mental illness in the outpatient clinic was 49.6 ± 10 Sd. The highest QoL was found in the physical health domain (50.67 ± 9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41 ± 10 Sd). Rural residence, drug nonadherence, suicidal ideation, not getting counselling, moderate or severe subjective severity, family does not participate in patient care and a family history of mental illness had an indirect negative effect on QoL. Alcohol use and psychological health domain had direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having history of mental illness in the family had both direct and indirect effect on QoL. Furthermore, sociodemographic factors (rural residence, illiterate educational status, not married marital status), social support-related factors (poor self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use) and clinical factors (high objective and subjective severity of illness, not getting counselling, suicidal ideation, higher number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL.

Conclusions

In this study, the QoL of people with mental illness was poor, with the psychological health domain the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors, directly and indirectly affected QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the QoL of those with mental illness, including the development of policy and practice responses that address the above identified factors.

Impact of global smoking prevalence on mortality: a study across income groups

BACKGROUND

Smoking significantly contributes to the mortality rates worldwide, particularly in non-communicable and preventable diseases such as cardiovascular ailments, respiratory conditions, stroke, and lung cancer. This study aims to analyse the impact of smoking on global deaths, and its association with mortality across the main income groups.

METHODS

The comprehensive analysis spans 199 countries and territories from 1990 to 2019. The study categorises countries into four income groups: high income, upper middle income, lower middle income, and low income.

RESULTS

The findings underscore the profound impact of global tobacco smoking on mortality. Notably, cardiovascular disease mortality is notably affected in both upper-middle-income and high-income groups. Chronic respiratory disease mortality rates show a significant impact across all income groups. Moreover, stroke-related mortality is observed in the lower-middle, upper-middle, and high-income groups. These results highlight the pervasive influence of smoking prevalence on global mortality, affecting individuals across various socioeconomic levels.

CONCLUSION

The study underscores the critical implications of smoking on mortality rates, particularly in high-income countries. It emphasises the urgency of targeted interventions in these regions to address the specific challenges posed by tobacco smoking on public health. Policy recommendations include implementing prohibitive measures extending to indoor public areas such as workplaces and public transportation services. Furthermore, allocating funds for research on tobacco and health, is imperative to ensure policymakers are consistently informed about emerging facts and trends in this complex domain.

EQ-5D-5L Population Norms and Quality-Adjusted Life Expectancy by Sociodemographic Characteristics and Modifiable Risk Factors for Adults in Queensland, Australia

OBJECTIVES

Over half of Australia's disease burden is due to morbidity, predominantly chronic conditions. Health-related quality of life instruments provide measures of morbidity and health status across different dimensions with EQ-5D being one of the most widely used. This study reports EQ-5D-5L general population norms for Queensland, Australia using the recently published Australian value set.

METHODS

Population survey results from cross-sectional computer-assisted telephone interviews for Queensland adults in 2022 and 2023 were analyzed. EQ-5D-5L, as well as modifiable risk factors and sociodemographic data were collected. Using the recently published final Australian EQ-5D-5L value set, mean utility scores were calculated for Queensland, as well as by sociodemographic characteristics, including remoteness and socioeconomic area-based measures, and modifiable risk factors, such as smoking and body mass index. Results were combined with life tables to estimate quality-adjusted life expectancy (QALE) for subgroups with different lifestyles.

RESULTS

The EQ-5D utility score for the Queensland adult population was 0.916. Smoking daily, being obese or older in age, or living in the most disadvantaged socioeconomic area were associated with lower mean scores. QALE was 6.1 and 7.9 years shorter than the life expectancy for Queensland males and females, respectively, but generally, those who reported having healthier lifestyles had higher mean utility scores and thus longer QALE.

CONCLUSIONS

In addition to reporting Queensland EQ-5D-5L general population norms, these results demonstrate potential QALE gains in people following healthier lifestyles. The results support investment in prevention and may motivate further studies in this important area.

The prevalence and sociodemographic determinants of tobacco and nicotine use among students in healthcare disciplines in Saudi Arabian universities: a cross-sectional survey

Background

Tobacco smoking is one of the most significant health-related problems worldwide. However, the prevalence and sociodemographic determinants of tobacco and nicotine use among students on healthcare courses in Saudi Arabia are limited.

Methods

This cross-sectional study used a questionnaire that was distributed via SurveyMonkey between November 2022 and June 2023 to all student universities offering healthcare courses. Data are presented as frequency and percentages. The associated sociodemographic factors with current tobacco and nicotine use were subjected to logistic regression.

Results

Overall, 5,012, of whom 3,872 (77.25%) were males, responded to the online survey. The prevalence of current tobacco and nicotine use was 3,553 (71%). The majority of users used electronic nicotine delivery systems (1,622: 32.36%). The current use of cigarettes (AOR: 1.75 (1.42 to 2.15)), e-cigarettes (AOR: 1.17 (1.01 to 1.37)), and smokeless tobacco substances (AOR: 1.35 (1.02 to 1.90)) were more pronounced among males compared to female students. However, the current use of a hookah was less among males (AOR: 0.74 (95% CI: 61 to 0.91)). Smoking cigarettes was practiced less among students living in other regions compared to the Central Region. However, smokeless tobacco substances seem to be more prevalent in the Western, Southern, and Northern Regions, (AOR: 1.57 (95% CI: 1.09 to 2.26)), (AOR: 1.43 (95% CI: 1.04 to 1.95)), and (AOR: 1.57 (95% CI: 1.09 to 2.26)), respectively.

Conclusion

Smoking is prevalent among students in the healthcare disciplines, with electronic nicotine delivery systems being the most used product. Several sociodemographic factors were associated with higher tobacco or nicotine use.