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Yari-Boroujeni R, Cheraghi L, Masihay-Akbar H, Azizi F, Amiri P. Cardiometabolic Profile in Young Adults With Diverse Cigarette Smoking Histories: A Longitudinal Study From Adolescence. J Am Heart Assoc 2024:e032603. [PMID: 38842270 DOI: 10.1161/jaha.123.032603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 04/15/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND For the first time, the present study investigated smoking trajectory and cardiometabolic profile from adolescence to young adulthood in a middle-income developing country facing a high prevalence of smoking and cardiovascular disease-related outcomes. METHODS AND RESULTS Data on 1082 adolescents (12-18 years of age) who participated in the TLGS (Tehran Lipid and Glucose Study) were gathered, and participants were followed for a median of 12.5 years (baseline: 1999-2002, last follow-up: 2014-2017). Participants were categorized as non/rare smokers, experimenters, and escalators using group-based trajectory models. Statistical analysis was used to compare the trajectory groups' cardiometabolic components, clinical characteristics, and cardiometabolic changes due to the individuals' placement in experimenter and escalator groups compared with non/rare smokers. The smoking trajectory groups in young adulthood differ significantly in blood pressure, triglycerides, high-density lipoprotein cholesterol, waist circumference, and body mass index, with the escalator group having the highest risk values for each component. Significant differences were observed in blood pressure (P=0.014), triglycerides (P<0.001), and waist circumference (P<0.001) status after using clinical cut points. The adjusted linear regression revealed that the escalator group had 3.16 mm Hg-lower systolic blood pressure SBP (P=0.016), 2.69 mm Hg-lower diastolic blood pressure (P=0.011), and 4.42 mg/dL-lower high-density lipoprotein cholesterol (P=0.002), compared with the non/rare smoker group. CONCLUSIONS Despite elevated risks in unadjusted analyses for all cardiometabolic components among smokers, our study identified a modest protective link between early smoking and blood pressure in addition to a remarkable harmful association with high-density lipoprotein cholesterol levels exclusively in the escalator group during the developmental stage to young adulthood, using adjusted analyses.
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Affiliation(s)
- Reza Yari-Boroujeni
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Leila Cheraghi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
- Department of Epidemiology and Biostatics, Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Hasti Masihay-Akbar
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran
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Mojtabai R, Susukida R, Nejat K, Amin-Esmaeili M. Association of cigarette excise taxes and clean indoor air laws with change in smoking behavior in the United States: a Markov modeling analysis. J Public Health Policy 2024; 45:100-113. [PMID: 38155242 DOI: 10.1057/s41271-023-00458-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/30/2023]
Abstract
The rates of cigarette smoking in the United States have declined over the past few decades in parallel with increases in cigarette taxes and introduction of more stringent clean indoor air laws. Few longitudinal studies have examined association of taxes and clean indoor air policies with change in smoking nationally. This study examined the association of state and local cigarette taxes and clean indoor laws with change in smoking status of 18,499 adult participants of the longitudinal 2010-2011 Tobacco Use Supplement of the Current Population Survey over a period of 1 year. Every $1 increase in cigarette excise taxes was associated with 36% higher likelihood of stopping smoking among regular smokers. We found no association between clean indoor air laws and smoking cessation nor between taxes and clean indoor air laws with lower risk of smoking initiation. Cigarette taxes appear to be effective anti-smoking policies. Some state and local governments do not take full advantage of this effective policy measure.
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Affiliation(s)
- Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA
| | - Ryoko Susukida
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA
| | | | - Masoumeh Amin-Esmaeili
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA.
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Daama A, Mugamba S, Ddaaki W, Nalwoga GK, Kasango A, Nalugoda F, Bulamba R, Nkale JM, Kyasanku E, Bulamu R, Nakigozi G, Kigozi G, Kagaayi J, Kisaka S. Motivations for continued tobacco smoking and reasons for quitting among youths in Wakiso district, Uganda: a qualitative study. BMC PRIMARY CARE 2023; 24:263. [PMID: 38053058 PMCID: PMC10696750 DOI: 10.1186/s12875-023-02218-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Efforts have been invested towards cessation of tobacco use among youths aged 18-35 years, however, motivators for continued tobacco smoking and reasons for quitting are limited in Ugandan settings. Therefore, this study aimed to explore motivations for continued tobacco smoking and reasons for quitting in Wakiso district Uganda. METHODS This study used explanatory sequential method. Data from a Population-based survey collected from October 2019 to September 2020 was used to select participants for this qualitative study. Twenty-three in-depths interviews were conducted from July to October 2021 among youths (18-35years old) who reported continued tobacco use and those who quit. Data were analyzed using a team-based thematic content approach with the help of NVivo. RESULTS Data was collected from a total of twenty three participants, fourteen were tobacco quitters and nine were current tobacco smokers. Recurrent habit, desire to complement the use of other drugs, peer pressure, using smoking as a replacement for alcohol consumption, low tobacco prices, smoking as a tradition were reported as motivators for continued tobacco smoking. However, reported reasons for quitting smoking by youths included; packaging health warnings, school based prevention programs, fear of associated health risks due to tobacco use, embarrassment from family members. CONCLUSION Targeted, and tailored tobacco prevention counselling through family support programs, intensified health education on the risks of smoking, and implementing stronger health warnings on tobacco packaging can be employed to reduce or stop tobacco use among urban youth.
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Affiliation(s)
- Alex Daama
- Africa Medical and Behavioral Sciences Organization, Plot 7441, Nansana, Hoima Road, P.O Box 25974, Nansana, Uganda.
- Makerere University School of Public Health, Kampala, Uganda.
| | - Stephen Mugamba
- Africa Medical and Behavioral Sciences Organization, Plot 7441, Nansana, Hoima Road, P.O Box 25974, Nansana, Uganda
| | - William Ddaaki
- Africa Medical and Behavioral Sciences Organization, Plot 7441, Nansana, Hoima Road, P.O Box 25974, Nansana, Uganda
| | - Grace Kigozi Nalwoga
- Africa Medical and Behavioral Sciences Organization, Plot 7441, Nansana, Hoima Road, P.O Box 25974, Nansana, Uganda
| | - Asani Kasango
- Makerere University School of Public Health, Kampala, Uganda
| | - Fred Nalugoda
- Africa Medical and Behavioral Sciences Organization, Plot 7441, Nansana, Hoima Road, P.O Box 25974, Nansana, Uganda
| | - Robert Bulamba
- Africa Medical and Behavioral Sciences Organization, Plot 7441, Nansana, Hoima Road, P.O Box 25974, Nansana, Uganda
- Makerere University School of Public Health, Kampala, Uganda
| | - James Menya Nkale
- Africa Medical and Behavioral Sciences Organization, Plot 7441, Nansana, Hoima Road, P.O Box 25974, Nansana, Uganda
| | - Emmanuel Kyasanku
- Africa Medical and Behavioral Sciences Organization, Plot 7441, Nansana, Hoima Road, P.O Box 25974, Nansana, Uganda
| | - Ritah Bulamu
- Africa Medical and Behavioral Sciences Organization, Plot 7441, Nansana, Hoima Road, P.O Box 25974, Nansana, Uganda
| | - Gertrude Nakigozi
- Africa Medical and Behavioral Sciences Organization, Plot 7441, Nansana, Hoima Road, P.O Box 25974, Nansana, Uganda
| | - Godfrey Kigozi
- Africa Medical and Behavioral Sciences Organization, Plot 7441, Nansana, Hoima Road, P.O Box 25974, Nansana, Uganda
| | - Joseph Kagaayi
- Makerere University School of Public Health, Kampala, Uganda
| | - Stevens Kisaka
- Makerere University School of Public Health, Kampala, Uganda
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Increased serum cotinine and obesity negatively impact asthma exacerbations and hospitalizations: A cross-sectional analysis of NHANES. J Clin Transl Sci 2023; 7:e10. [PMID: 36755538 PMCID: PMC9879909 DOI: 10.1017/cts.2022.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Background Asthma is the most common non-communicable chronic airway disease worldwide. Obesity and cigarette use independently increase asthma morbidity and mortality. Current literature suggests that obesity and smoking synergistically increase asthma-related wheezing. Objective To assess whether increased serum cotinine and obesity act synergistically to increase the likelihood of having an asthma exacerbation, emergency department (ED) visit, or hospitalization. Methods A cross-sectional analysis of the 2011-2015 iterations of NHANES database was performed. Patients aged 18 years or greater with asthma were included. Serum cotinine was utilized as an accurate measurement of cigarette use. Logistic regression models were constructed to determine whether elevated serum cotinine and obesity were associated with self-reported asthma exacerbations, asthma-specific ED usage, and hospitalizations for any reason in the past year. Odds ratios were adjusted for age, gender, race, and ethnicity. Interactions were assessed by multiplying the adjusted effect sizes for elevated cotinine and obesity. Results We identified 2179 (N = 32,839,290) patients with asthma, of which 32.2% were active smokers and 42.7% were obese. Patients with an elevated cotinine and asthma were significantly more likely to have had an asthma-related ED visit in the past year (adjusted odds ratio [AOR] 1.82; 95% CI 1.19-2.79), have a physician-prescribed asthma medication (AOR 2.04; 95% CI 1.11-3.74), and have a hospitalization for any reason (AOR 3.65; 95% CI 1.88-7.07) compared to those with low cotinine. Patients with asthma and obesity were more likely to have an asthma-related ED visit (AOR 1.67; 95% CI 1.06-2.62) or hospitalization for any reason in the past year compared to non-obese patients (AOR 2.76; 95% CI 1.69-4.5). However, a statistically significant interaction between obesity and cotinine was only identified in patients who currently have asthma compared to a previous asthma diagnosis (AOR 1.76; 95% CI 1.10-2.82). There were no synergistic interactions among ED usage or asthma exacerbations. Conclusion Nearly one-third of patients with asthma were current smokers, and almost half were obese. This study identified elevated serum cotinine, a metabolite of cigarette use, and obesity as key risk factors for asthma exacerbations, asthma-related ED visits, and hospitalizations for any reason. Elevated serum cotinine and obesity were not found to act synergistically in increasing asthma exacerbations or ED visits. However, the presence of both risk factors increased the risk of currently having asthma (compared to a previous diagnosis) by 76%. Serum cotinine may be useful in predicting asthma outcomes.
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Shankar A, Parascandola M, Sakthivel P, Kaur J, Saini D, Jayaraj NP. Advancing Tobacco Cessation in LMICs. Curr Oncol 2022; 29:9117-9124. [PMID: 36547127 PMCID: PMC9777415 DOI: 10.3390/curroncol29120713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/08/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Tobacco kills more than 8 million people worldwide every year. Over 80% of the world's 1.3 billion tobacco users live in low- and middle-income countries (LMICs), where the future burden is projected to grow. At the same time, progress in tobacco control has not advanced as far as in many LMICs. In particular, the implementation of tobacco-cessation programs and interventions remains limited. The bulk of the evidence for tobacco-cessation interventions comes from high-income countries and may not reflect the context in LMICs, particularly as resources and training for tobacco cessation are limited. This paper summarizes the current evidence for tobacco-cessation interventions in LMICs and highlights some key challenges and research gaps. Overall, there is a need to build capacity for locally relevant research and implementation science to support tailored cessation interventions and strategies for LMICs.
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Affiliation(s)
- Abhishek Shankar
- Department of Radiation Oncology, All India Institute of Medical Sciences, Patna 801507, India
- Correspondence:
| | - Mark Parascandola
- Research and Training Branch, Center for Global Health, National Cancer Institute, Bethesda, MD 20892, USA
| | - Pirabu Sakthivel
- Department of ENT & Head-Neck Surgery, KMCH Institute of Health Sciences and Research, Coimbatore 641014, India
| | - Jagdish Kaur
- Department of Healthier Populations and Non-Communicable Diseases (NCDs), WHO Regional Office for South-East Asia, New Delhi 110011, India
| | - Deepak Saini
- Materia Medica Department, Lal Bahadur Shastri Homoeopathic Medical College and Hospital, Prayagraj 211013, India
| | - Naveen Prabhu Jayaraj
- Department of Community Medicine, Karpagam Faculty of Medical Sciences and Research, Coimbatore 641032, India
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Luu MN, Han M, Bui TT, Tran PTT, Lim MK, Oh JK. Smoking trajectory and cancer risk: A population-based
cohort study. Tob Induc Dis 2022; 20:71. [PMID: 36118557 PMCID: PMC9413414 DOI: 10.18332/tid/152137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/30/2022] [Accepted: 07/15/2022] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Smoking behavior can change with time and lead to different health outcomes. This study explored the trajectory of smoking and its relationship with cancer incidence and mortality among Korean male adults. METHODS We used 2002–2018 data from the National Health Insurance Service (NHIS). Smoking status was repeatedly measured in four waves of general health examinations provided by the NHIS between 2002 and 2009. Cancer incidence and mortality were tracked from 2010 to 2018. Trajectory analysis was used to identify the patterns of smoking. The hazard ratio was calculated using Cox proportional regression models. RESULTS For the 2448548 men (≥20 years), 137788 cases of cancers and 41146 cancer deaths were found. We identified six trajectory groups: never smokers, former smokers, new current smokers, decreasing light smokers, steady moderate smokers, and steady heavy smokers. All smoking groups had an increased risk of cancer. The steady heavy smokers showed higher cancer incidence and mortality rate than the steady non-smokers (hazard ratio, HR=1.53; 95% CI: 1.49–1.58 and HR=2.64; 95% CI: 2.50–2.79, respectively). The cancer-specific analysis showed that the larynx and lung cancer incidence and mortality rate of the smoking group were higher than in never smokers. CONCLUSIONS Smoking, even at low doses, increases the risk of most cancers in men. Quitting or reducing smoking, especially at a young age, can lower cancer incidence and mortality. This study may provide more objective results on the relationship between smoking and cancer, because smoking behavior was examined at multiple time points.
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Affiliation(s)
- Minh N. Luu
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
- Department of Research Methodology and Biostatistics, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Minji Han
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
| | - Tra T. Bui
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
| | - Phuong Thao T. Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
| | - Min-Kyung Lim
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Jin K. Oh
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Republic of Korea
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
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Romm KF, Wang Y, Duan Z, Bennett B, Fuss C, Ma Y, Blank MD, Bray BC, Ahluwalia JS, Berg CJ. Psychosocial predictors of longitudinal changes in tobacco and cannabis use among young adults. Addict Behav 2022; 129:107264. [PMID: 35134629 PMCID: PMC9021279 DOI: 10.1016/j.addbeh.2022.107264] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/01/2022] [Accepted: 01/28/2022] [Indexed: 01/22/2023]
Abstract
INTRODUCTION In recent years, cigarette use has decreased, but alternative tobacco product and cannabis use has increased in young adults. Thus, research regarding intraindividual changes in tobacco product and cannabis use in this population, and related psychosocial predictors, is warranted. METHODS We analyzed data from 3,006 young adults (Mage = 24.56 [SD = 4.72], 54.8% female, 31.6% sexual minority, 60.2% racial/ethnic minority) in a 2-year, 5-wave longitudinal study (2018-2020). Latent growth modeling analyzed the outcomes of past 6-month use of cigarettes, e-cigarettes, traditional cigars, little cigars/cigarillos, smokeless tobacco (SLT), hookah, and cannabis across Waves 1-5 among all participants; psychosocial predictors included depressive symptoms, adverse childhood experiences (ACEs), and personality traits. RESULTS Results indicated decreases in likelihood of using each tobacco product over time, but no significant change in likelihood of cannabis use. Psychosocial predictors of baseline use across products included depressive symptoms and extraversion, as well as ACEs and openness for nearly all products (e.g., except traditional cigars). Psychosocial predictors of less decreases in use likelihood over time included: for cigarettes and traditional cigars, ACEs; for e-cigarettes, extraversion; for little cigars/cigarillos, depressive symptoms and extraversion; for SLT, openness; and for hookah, neuroticism (controlling for sociodemographics). Predictors of greater decreases in likelihood of use over time included: for e-cigarettes and hookah, conscientiousness; and for cannabis, agreeableness. CONCLUSIONS Interventions to reduce young adults' use might target distinct risk/protective factors for using different products (and combinations). Moreover, results regarding decreasing likelihood of using tobacco products but not cannabis over time warrant replication and explanation in other samples.
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Affiliation(s)
- Katelyn F Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; George Washington Cancer Center, George Washington University, Washington, DC 20052, USA.
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Zongshuan Duan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Breesa Bennett
- Department of Epidemiology, Milken Institute School of Public Helath, George Washington University, Washington, DC 20052, USA
| | - Caroline Fuss
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Yan Ma
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown WV 26506, USA
| | - Bethany C Bray
- Institute for Health Research and Policy, The Univeristy of Illinois Chicago, Chicago IL 60607, USA
| | - Jasjit S Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, and Brown University Cancer Center, Providence RI 02912, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; George Washington Cancer Center, George Washington University, Washington, DC 20052, USA
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Drabble LA, Munroe C, Mericle AA, Zollweg S, Trocki KF, Karriker-Jaffe KJ. Impact of the policy environment on substance use among sexual minority women. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 3. [PMID: 35813352 PMCID: PMC9262325 DOI: 10.1016/j.dadr.2022.100058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Sexual minority women (SMW) are at greater risk for heavy episodic drinking, frequent marijuana use, and tobacco use than heterosexual women. Because past research has suggested the political and social environment may influence disparities in substance use by sexual orientation, this study examined associations of the U.S. state-level policy environment on substance use by SMW. Methods: A total of 732 SMW participants were recruited from two national online panels: a general population panel (n = 333) and a sexual minority-specific panel (n = 399). Past year substance use was defined by number of days of heavy episodic drinking (HED; 4+ drinks in a day), weekly tobacco use (once a week or more vs. less or none), and weekly marijuana use (once a week or more vs. less or none). Comprehensive state policy protection was defined by enactment of five policies protecting rights of sexual minorities. Regression models compared substance use outcomes for SMW living in states with comprehensive policy protections to SMW living in states with fewer or no protections. Models also assessed the impact of state policies related to alcohol (state monopoly on alcohol wholesale or retail sales), tobacco (state enactment of comprehensive smoke-free workplace laws) and marijuana (legalization of purchase, possession, or consumption of marijuana for recreational use). Results: Comprehensive policy protections were associated with fewer HED days. Recreational marijuana legalization was associated with higher odds of weekly use. Conclusions: Findings underscore the importance of policy protections for sexual minorities in reducing substance use, particularly HED, among SMW.
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Affiliation(s)
- Laurie A. Drabble
- San Jose State University College of Health and Human Sciences, San Jose, CA, USA
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
- Corresponding author.
| | - Cat Munroe
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Amy A. Mericle
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | | | - Karen F. Trocki
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
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Paraje G, Stoklosa M, Blecher E. Illicit trade in tobacco products: recent trends and coming challenges. Tob Control 2022; 31:257-262. [PMID: 35241598 PMCID: PMC8899477 DOI: 10.1136/tobaccocontrol-2021-056557] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/26/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Illicit trade in tobacco products is a menace to the goal of eliminating tobacco consumption. Although tax policy is very effective in reducing consumption, illicit trade can reduce (though not eliminate) its effectiveness. METHODS This article discusses the recent evolution of illicit trade and the context in which it occurred; the new methods that have been developed to measure it and, finally, the challenges in the next phase in the control of illicit trade. RESULTS There has been a remarkable stability in the penetration of cigarette illicit trade in the past decade. Such a stability, however, occurred in a world of shrinking tobacco consumption, implying a decreasing absolute illicit trade. Most countries have progressed in increasing tobacco taxes and changing tax structures. Prices of illicit cigarettes follow legal cigarette prices. Concomitantly, many new studies, independent from the tobacco industry, have been conducted allowing for better understanding of the illicit trade and providing inputs to its solution. The entry into force of the WHO FCTC Protocol to Eliminate Illicit Trade in Tobacco Products provides both a global and a national policy framework to further curb illicit trade. Instruments such as track-and-trace systems must be promoted and adopted to maximise reductions in illicit trade. CONCLUSIONS Global efforts to curb the illicit trade in tobacco products are gaining momentum and progress has been made in many parts of the world. The next decade can witness a decisive decrease in tobacco consumption, both licit and illicit, if countries further engage in international collaboration.
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Affiliation(s)
- Guillermo Paraje
- Business School, Universidad Adolfo Ibanez, Santiago de Chile, Chile
| | - Michal Stoklosa
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Evan Blecher
- Fiscal Policies for Health, World Health Organization, Geneva, Switzerland
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Paraje G, Valdés N. Changes in parental smoking behavior and children's health status in Chile. Prev Med 2021; 153:106792. [PMID: 34506821 DOI: 10.1016/j.ypmed.2021.106792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/26/2021] [Accepted: 09/05/2021] [Indexed: 11/18/2022]
Abstract
Studies on parental smoking behavior have mostly been conducted for developed countries and show that current parental smoking is negatively associated with children's current health. Using four waves of a Chilean longitudinal survey (Encuesta de Protección Social), we estimate probit and ordinary least squares models relating parents' self-report of their children's current health status to several covariates, including current parental smoking status and change (transitions) in parental smoking status across the waves of the survey. The data were collected in the years 2004, 2006, 2009, and 2015. The working sample includes 25,052 observations. The study revealed that parents' self-report of their children's current health status is strongly associated with current and past parental smoking status. Parents who smoke have an increased 11.17% probability of reporting that their children are in fair, poor, or very poor health status, when compared to non-smoking parents. The effect is stronger if the smoker is the mother, and it is exacerbated if she is less educated or unemployed/inactive. In addition, quitting smoking has a significant positive effect on children's reported health status, which is greater if the mother quits smoking. Cessation among mothers who are unemployed or inactive is also associated with a more positive assessment of their children's health status. The findings suggest that cessation programs may have health benefits not only for smoking parents, but also for their children. Improving coverage or establishing a national cessation program may have important present and future effects on population health and well-being.
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Affiliation(s)
- Guillermo Paraje
- Escuela de Negocios, Universidad Adolfo Ibáñez, Avenida Diagonal Las Torres 2640, Peñalolén, Santiago de Chile, Chile.
| | - Nieves Valdés
- Escuela de Negocios, Universidad Adolfo Ibáñez, Avenida Diagonal Las Torres 2640, Peñalolén, Santiago de Chile, Chile.
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Thepthien BO, Tinn CS, Ofuchi T, Kim B. An analysis of e-cigarette and polysubstance use patterns of adolescents in Bangkok, Thailand. Tob Induc Dis 2021; 19:88. [PMID: 34824571 PMCID: PMC8582419 DOI: 10.18332/tid/142894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The prevalence of adolescent e-cigarette use has increased markedly in recent years. Specifically, the prevalence of e-cigarette use over the past 30 days was higher than the prevalence of use of other tobacco products. However, there is no definitive data on e-cigarette use among adolescents, including a description of how e-cigarette use is part of a more widespread pattern of substance abuse. The objective of this study was to assess the prevalence of e-cigarette use in combination with tobacco, alcohol, or marijuana, and the risk of polysubstance use among a sample of Thai adolescents, analyzed by sociodemographic characteristics. METHODS Data were extracted from the Bangkok Behavioral Surveillance Survey (BBSS) cross-sectional survey conducted in 2019. The survey used self-reports from a sample of adolescents aged 14–17 years in Bangkok (n=6167). Multinomial logistic regression was used to determine the status of poly drug use in combination with e-cigarettes. RESULTS In all, 6.8% of adolescents in this sample reported having used e-cigarettes in the last 30 days. Among the students who used e-cigarettes, the majority (72.0%) reported using other substances along with e-cigarettes, and alcohol was the most common addictive substance used in combination with e-cigarette use. The use of e-cigarettes only and e-cigarettes in combination with other addictive substances (compared to the non-e-cigarette group) tended to be higher among male students, having low academic achievement, having a friend who smokes, being persuaded by a close friend, having ever had sex (OR: 1.48–3.70), and having close friends who drink alcohol (vs none) (OR=3.26). CONCLUSIONS Polysubstance use is highly prevalent among adolescents who use e-cigarettes. There should be extensive screening for e-cigarette consumption, including use of other addictive substances, especially alcohol. Early and comprehensive prevention efforts to reduce the use of e-cigarettes and other addictive substances can have a huge impact on the health of the adolescent population.
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Affiliation(s)
- Bang-On Thepthien
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand
| | - Chit Su Tinn
- Nuffield Department of Medicine, Trinity College, University of Oxford, Oxford, United Kingdom
| | - Takuma Ofuchi
- School of Social Sciences, London Metropolitan University, London, United Kingdom
| | - Bee Kim
- Addiction Science Department, SahmYook University, Namyang ju Si, South Korea
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Kunst AE. Tobacco use in young people: being emic to end the epidemic. LANCET PUBLIC HEALTH 2021; 6:e439-e440. [PMID: 34051922 DOI: 10.1016/s2468-2667(21)00114-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Anton E Kunst
- Department of Public and Occupational Health Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, Netherlands.
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Das A, Johnson JK, Hard GA, Jones AA. State Medical Marijuana Laws and Initiation of Cigarettes among Adolescents in the U.S., 1991-2015. CANNABIS (RESEARCH SOCIETY ON MARIJUANA) 2021; 4:60-68. [PMID: 36405952 PMCID: PMC9674114 DOI: 10.26828/cannabis/2021.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective Although cigarette use has declined among adolescents, marijuana use has increased in subgroups of this population. The association between medical marijuana laws (MMLs) and cigarette initiation among adolescents, however, needs further examination. We investigated the association between MMLs and age of cigarette initiation and stratified findings by gender, race/ethnicity, and state dispensary status. Method Data were from N=939,725 adolescents in 9th-12th grade living in 46 states who participated in the Youth Risk Behavior Surveillance System between 1991-2015. Participants were asked the age they first smoked a cigarette and other sociodemographic characteristics. States were categorized as MML states if they had legalized marijuana for medicinal purposes by 2015. We used a difference-in-difference methodology and logistic regressions to assess the relationship between MMLs and cigarette initiation. Results Our results indicate lower odds of initiating cigarettes, in every age group (8 years old or younger, 9-10, 11-12, 13-14, 15-16, 17 years old or older) in states with MMLs when compared to non-MML states. After stratification, we find lower odds of cigarette initiation in certain age groups by gender, race/ethnicity, and state dispensary status. We report no difference in state MML implementation and age of cigarette initiation among Hispanic adolescents in every age group, and Black adolescents 8 years or younger and 17 years or older. Conclusions Cigarette initiation has decreased among adolescents in MML states compared with those in non-MML states. Further research should evaluate how MMLs and recreational marijuana policies are associated with e-cigarette initiation and use.
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Affiliation(s)
- Abhery Das
- Program in Public Health, University of California, Irvine, 653 East Peltason Drive, Irvine, CA 92617
| | - Julie K. Johnson
- Cannabis Policy Research Center of Excellence, Research Department, Cannabis Control Commission, Commonwealth of Massachusetts, 2 Washington Square, 2nd Floor, Worcester, MA 01604
| | - Gregory A. Hard
- MGH Institute of Health Professions, 36 First Avenue, Boston MA 02129
| | - Abenaa A. Jones
- Department of Human Development and Family Studies, The Pennsylvania State University, 105 Health and Human Development Building, University Park, PA 16802, USA
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