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Brown C, Nkemjika S, Ratto J, Dube SR, Gilbert L, Chiang L, Picchetti V, Coomer R, Kambona C, McOwen J, Akani B, Kamagate MF, Low A, Manuel P, Agusto A, Annor FB. Adverse Childhood Experiences and Associations with Mental Health, Substance Use, and Violence Perpetration among Young Adults in sub-Saharan Africa. CHILD ABUSE & NEGLECT 2024; 150:106524. [PMID: 38854869 PMCID: PMC11160582 DOI: 10.1016/j.chiabu.2023.106524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background Adverse childhood experiences (ACEs) can have debilitating effects on child well-being, with consequences persisting into adulthood. Most ACE studies have been conducted in high-income countries and show a graded relationship between multiple ACE exposures and adverse health outcomes. Less is known about the types and burden of ACEs in sub-Saharan Africa (SSA). Objective To estimate the pooled prevalence of six individual and cumulative ACE exposures (physical, sexual, and emotional violence; orphanhood; witnessing interparental and community violence) and assess their association with mental health outcomes, substance use, and violence perpetration among young adults in SSA. Participants and setting Aggregate data from the Violence Against Children and Youth Survey (VACS) in Cote d'Ivoire 2018, Kenya 2019, Lesotho 2018, Mozambique 2019, and Namibia 2019 included a sample of 11,498 young adults aged 18-24 years. Methods Cumulative ACEs were defined by an integer count of the total number of individual ACEs (0 to 6). Weighted prevalence and adjusted odds ratios were estimated. Result ACEs prevalence ranged from 7.8% (emotional violence) to 55.0% (witnessing community violence). Strong graded relationships between cumulative ACE exposure and all study outcomes for both males and females were observed. Among females, witnessing interparental violence was the only individual ACE risk factor significantly associated with increased odds of substance use; among males, emotional violence was significantly associated with all outcomes. Conclusion ACEs are associated with adverse mental health, substance use, and violence perpetration in SSA. Gender-specific and culturally sensitive intervention strategies are needed to effectively mitigate ACEs in this population.
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Affiliation(s)
- Colvette Brown
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Stanley Nkemjika
- Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA
| | - Jeffrey Ratto
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Shanta R. Dube
- Levine College of Health Sciences, Wingate University, Wingate, North Carolina
| | - Leah Gilbert
- National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development
| | - Laura Chiang
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Viani Picchetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
| | - Rachel Coomer
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Namibia
| | - Caroline Kambona
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Kenya
| | - Jordan McOwen
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | - Bangaman Akani
- Department of Public Health, Felix Houphouet Boigny University, Abidjan, Cote d’ Ivoire
| | - Maman Fathim Kamagate
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Cote d’ Ivoire
| | - Andrea Low
- International Center for AIDS Care and Treatment Program (ICAP)at Columbia University, NY
| | - Pedro Manuel
- Division of Global Health HIV and TB, Centers for Disease Control and Prevention, Mozambique
| | | | - Francis B. Annor
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, USA
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Jaswal H, Sohi I, Rehm J, Churchill S, Sherk A, Stockwell T, Levesque C, Sanger N, Edalati H, Butt PR, Paradis C, Shield KD. A drink equals how many cigarettes? Equating mortality risks from alcohol and tobacco use in Canada. Front Public Health 2024; 12:1331190. [PMID: 38476483 PMCID: PMC10928000 DOI: 10.3389/fpubh.2024.1331190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/22/2024] [Indexed: 03/14/2024] Open
Abstract
Objective To quantify and communicate risk equivalencies for alcohol-and tobacco-attributable mortality by comparing per standard drinks consumed to per number of cigarettes smoked in Canada. Methods Alcohol-and tobacco-attributable premature deaths (≤75 years of age) and years of life lost (YLL) were estimated using a lifetime risk modeling approach. Alcohol-attributable death statistics were obtained from the 2023 Canadian Guidance on Alcohol and Health data source. Tobacco-attributable death statistics were derived from the Mortality Population Risk Tool (MPoRT) model. Results The risk of alcohol use on premature death and YLL increased non-linearly with the number of drinks consumed, while the risk for tobacco use on these two measures increased linearly with the number of cigarettes smoked. Males who consumed 5 drinks/day-a standard drink contains 13.45 grams of alcohol in Canada-had an equivalent risk as smoking 4.9 cigarettes/day (when modeling for premature death) and 5.1 cigarettes/day (when modeling for YLL). Females who consumed 5 drinks/day experienced an equivalent risk as smoking 4.2 cigarettes/day for premature deaths and YLL. At all levels of alcohol consumption females and males who consumed <5 drinks/day have less risks from consuming a standard drink than from smoking a cigarette. For males who consumed 5 drinks/day, the increased risks of death from per drink consumed and per cigarette smoked were equal. Conclusion Risk equivalencies comparing alcohol use to tobacco use could help people who drink improve their knowledge and understanding of the mortality risks associated with increased number of drinks consumed per day.
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Affiliation(s)
- Harpreet Jaswal
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Ivneet Sohi
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Samuel Churchill
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | | | - Nitika Sanger
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Hanie Edalati
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Peter R. Butt
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Kevin D. Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
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van der Eijk Y, Woh J. Is secondhand smoke associated with mental health issues? A narrative review of the evidence and policy implications. Health Policy 2023; 136:104900. [PMID: 37651970 DOI: 10.1016/j.healthpol.2023.104900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/20/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023]
Abstract
Secondhand smoke (SHS) is a well-established cause of lung cancer, respiratory disease, heart disease and developmental issues in children, with an overwhelming evidence base spanning over four decades. In this narrative review, we describe studies which have also linked self-reported or cotinine-assessed SHS exposure in the home, workplace and other settings to mental health disorders including depression, suicide, anxiety, and psychological distress in children and adults, sleeping disorders, Attention Deficit Hyperactivity Disorder and behavioural issues in children, and dementia in older adults. In general, evidence indicates that SHS exposure is associated with these disorders in a dose-response manner, with higher odds reported in people who are exposed to SHS at high levels, frequently, and in the home environment. Most studies so far are cross-sectional albeit in large, nationally representative samples from various countries with a smaller number of longitudinal studies. More research is needed in this area to determine whether SHS is a direct cause of adverse mental health outcomes, and whether creating smokefree environments leads to improved mental wellbeing. In particular, more research is needed on the impact of smokefree home environments, an area which has received relatively little focus in smokefree interventions which generally target public places.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, MD1 Tahir Foundation Building, National University of Singapore, 12 Science Drive 2 #09-01C, 117549, Singapore.
| | - Joanne Woh
- Saw Swee Hock School of Public Health, MD1 Tahir Foundation Building, National University of Singapore, 12 Science Drive 2 #09-01C, 117549, Singapore
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Second-Hand Tobacco Smoke Exposure and Smoke-Free Environments in Ethiopia: A Scoping Review and Narrative Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148404. [PMID: 35886256 PMCID: PMC9324201 DOI: 10.3390/ijerph19148404] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 01/27/2023]
Abstract
Ethiopia passed a law prohibiting tobacco smoking in all public places in 2019. We conducted a scoping review to identify gaps in the existing literature on second-hand smoke (SHS) exposure and smoke-free environments in Ethiopia that need to be prioritised for future research to support policy and practice. We conducted systematic searches in January 2022 in the following databases: Medline, EMBASE, and PsycInfo. Two reviewers independently screened the identified study reports for eligibility and extracted data from the eligible studies. The extracted data was descriptively analysed, and research recommendations were drawn. A stakeholder consultation workshop was held to identify research topics on SHS exposure and smoke-free environments in Ethiopia that they perceived to be priorities for primary research. Of the 388 research reports identified, only nine were included in the scoping review. The topics explored includes prevalence of SHS exposure (six studies); knowledge on SHS exposure (three studies); compliance to smoke-free environments legislation (two studies); and exposure to anti-smoking messages (one study). The stakeholders prioritised further research addressing compliance monitoring and enforcement of the smoke free laws in Ethiopia. There is a need for studies that test new methods for compliance monitoring and enforcement, evaluate strategies to increase knowledge on the harms of SHS exposure and the smoke-free legislation, and evaluate the current smoke-free legislation in Ethiopia.
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Effendi DE, Nugroho AP, Handayani S, Novita R, Purwoko S, Agustina ZA. Tobacco Consumption Among Young Population in Rural Indonesia: Prevalence and Associated Factors. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Tobacco consumption among youths is increasing in Indonesia and other middle-income countries. In rural areas, its prevalence is even higher compared to urban settings. Understanding the extent and associated factors of tobacco consumption within this population is essential to inform the formulation of appropriate prevention and control strategies.
Aims: This study aims at analyzing the prevalence and associated factors of tobacco consumption among the young population living in rural Indonesia.
Methods: Data were obtained from Indonesia Family Life Survey wave 5 (IFLS-5). A total of 2,786 responses from respondents aged 15-24 years and living in rural areas were taken into analysis. Binary logistic regression was used to examine the association between tobacco consumption with the predictors.
Results: The prevalence of tobacco consumption among youths in rural Indonesia was 26.5%. Binary logistic regression discovered that factors significantly associated with tobacco consumption among young population were aged 20-24 years (AOR = 4.760, 95% CI: 3.557-6.368), less educated (AOR = 5.988, 95% CI: 3.193-11.229), being married (AOR = 2.484, 95% CI: 1.631- 3.782), and having smoking parent (AOR = 1.346, 95% CI: 1.016-1.783). Young males had a much higher tobacco use prevalence (57.1%). Whereas females had significant negative association with tobacco consumption (AOR = 0.001, 95% CI: 0.000-0.002).
Conclusion: A large portion of youth in rural Indonesia were identified to have tobacco-use behavior. Appropriate prevention and control strategies are needed to address the population groups identified in this study. Policymakers should anticipate challenges that may occur resulting from geographical and cultural differences.
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Boey CPH, Quaye SED, Cook AR, Seow WJ, van der Eijk Y. Secondhand smoke in the densely populated urban setting: A cross-sectional survey of exposure, knowledge, attitudes, and respiratory symptoms. INDOOR AIR 2022; 32:e13069. [PMID: 35762238 DOI: 10.1111/ina.13069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/10/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Secondhand smoke (SHS) remains a common health threat in densely populated, urban settings. We estimated the prevalence of exposure and associated respiratory symptoms, knowledge, attitudes, and behaviors in a multi-ethnic, weighted sample of Singapore residents using a cross-sectional survey of 1806 adults. We weighted data to match the national population in terms of gender, ethnicity, and education level and analyzed data using descriptive statistics, bivariate analyses, multiple linear and logistic regressions, and a multinomial logistic regression model. About 88% of respondents reported regular SHS exposure. Nearly 57% reported exposure to neighbors' SHS at home. Respiratory symptoms were reported by 32.5% and significantly associated with exposure to daily (AOR = 2.63, 95% CI = 1.62-4.36), non-daily (AOR = 1.75, 95% CI = 1.14-2.77), and neighbors' (AOR = 1.37, 95% CI = 1.07-1.76) SHS. More knowledge of SHS was associated with male gender (β = 0.28, p = 0.0009) and higher household income (linear trend; p = 0.0400). More negative attitudes to SHS were associated with older age (linear trend; p < 0.0001). Engaging in behaviors to avoid SHS was associated with a more negative attitude to SHS (AOR = 1.09-1.23). SHS exposure is common in Singapore's densely populated setting and associated with respiratory symptoms, even if exposure is non-daily or from neighboring homes.
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Affiliation(s)
- Clement Peng Hee Boey
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Sharon Esi Duoduwa Quaye
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Wei Jie Seow
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
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Habebo TT, Takian A. Retrospective Policy Analysis of Tobacco Prevention and Control in Ethiopia. Ethiop J Health Sci 2021; 30:427-438. [PMID: 32874086 PMCID: PMC7445944 DOI: 10.4314/ejhs.v30i3.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background The trend of non-communicable diseases is alarmingly increasing and tobacco consumption and exposure to its smoke have been playing the leading role. Thirty-seven Ethiopians deaths per day are attributable to tobacco. Unless appropriately mitigated, this has social, economic and political impacts. Implementation of the appropriate policy is a good remedy; however, the policy process has never been straight forward and always successful. The involvement of different actors makes policy process complex hence agenda setting, policy formulation, implementation, and evaluations have been full of chaos and even may fail at any of these levels. Thus the aim of this review was retrospectively analyzing tobacco-related policies in Ethiopia that are relevant to control tobacco use and mitigate its impacts. Methods Systematically, we searched in pub-med, Scopus, Web of Science and Embase. Additionally, we did hand search on Google scholar and national websites. The terms “tobacco”, “cigar”, “cigarette”, “control”, “prevention”, “policy” and “Ethiopia” were used. Eleven of 128 records met the inclusion criteria and then included. For data analysis, we applied the health policy analysis framework developed by Walt and Gilson. Result Lately, Ethiopia enacted and started to implement tobacco control policies and programs, but its implementation is problematic and consumption rate is increasing. Conclusion Despite the early involvement in tobacco control initiatives and enactment of legal frameworks, Ethiopia's journey and current stand to prevent and control the devastating consequences of tobacco is very limited and unsatisfactory. Therefore, we strongly call for further action, strong involvement of private sector and non-governmental organizations.
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Affiliation(s)
- Teshome Tesfaye Habebo
- Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran.,department of health management and economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Kembata Tembaro Zone Health Department, SNNPRS, Ethiopia
| | - Amirhossein Takian
- department of health management and economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.,department of global health & public policy, school of public health, Tehran University of medical sciences, Tehran-Iran.,Health Equity Research center (HERC), Tehran University of medical sciences, Tehran-Iran
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Shakeri J, Farnia V, Jouybari TA, Salemi S, Rahami B, Soltani B, Moradinazar M, Alikhani M. Cognitive avoidance as a coping mechanism in patients with opioid use disorders (OUDs): a cross-sectional study in Western Iran. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1875066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Jalal Shakeri
- Psychiatry Department, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Vahid Farnia
- Psychiatry Department, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Touraj Ahmadi Jouybari
- Psychiatry Department, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Safora Salemi
- Psychiatry Department, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bahareh Rahami
- Psychiatry Department, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Bahareh Soltani
- Psychiatry Department, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- Psychiatry Department, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Psychiatry Department, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Sun MC, Frédéric JDS. Knowledge of secondhand smoke and behaviour towards its exposure among teachers in Mauritius. Tob Prev Cessat 2020; 6:32. [PMID: 33033786 PMCID: PMC7537475 DOI: 10.18332/tpc/120940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION A literature review has revealed an absence of studies investigating the knowledge and behaviour of teachers towards secondhand smoke (SHS). This study was thus designed with the following objectives: 1) Assess the knowledge of SHS among primary school teachers, 2) Determine their behaviour towards SHS, and 3) Identify any relationship between knowledge and behaviour of participants. METHODS A national cross-sectional study was conducted among a representative sample from 28 primary schools in all four educational zones of Mauritius in 2017. A self-administered questionnaire was used to collect data from primary school teachers. Data analysis was performed on 389 questionnaires. RESULTS The mean knowledge score was found to be 28.9 (SD=4.8), which is just above the threshold score (>27) for good knowledge. Less than two-thirds of the participants (63.2%) were in the 'good knowledge' category. The mean behaviour score was found to be 26.6 (SD=6.8), which is situated in the range for 'satisfactory behaviour' in terms of avoiding SHS. Pearson correlation testing revealed a significant association between knowledge of SHS and behaviour towards exposure to SHS. CONCLUSIONS This study showed that nearly two-thirds of teachers had good knowledge of the health dangers of SHS and applied this knowledge in their behaviour by keeping away from cigarette smoke.
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Affiliation(s)
- Marie Chan Sun
- Department of Medicine, Faculty of Science, University of Mauritius, Réduit, Mauritius
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Nunziata L, Toffolutti V. "Thou Shalt not Smoke": Religion and smoking in a natural experiment of history. SSM Popul Health 2019; 8:100412. [PMID: 31338409 PMCID: PMC6626118 DOI: 10.1016/j.ssmph.2019.100412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/25/2019] [Accepted: 05/14/2019] [Indexed: 11/16/2022] Open
Abstract
We provide a new identification strategy to analyse the implications of religious affiliation on unhealthful behaviour by focusing on the link between religiousness and smoking. Our quasi-experimental research design exploits the exogenous dramatic fall in religious affiliation that took place in East Germany after the post-war separation. Our conditional difference-in-differences estimates on data from the German Socio-Economic Panel (SOEP) for the period 1998-2006 indicate that individuals who are not affiliated to any religious denomination are consistently 13-19 percentage points more likely to smoke than are religious individuals. We interpret our results on the basis of a restraining effect of religious ethics on unhealthy behaviour, confirming the view that religion is a far-reaching vehicle for the enforcement of social norms.
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