Socioeconomic status and smoking cessation: neighborhood context as an underlying mechanism

Environmental influences on E-cigarette use among young people: A systematic review

E-cigarettes are a popular mode of delivery for nicotine, tobacco and cannabis. The prevalence of vaping among youth is increasing and this review aims to identify features of the neighbourhood environment, e.g., retailers, advertisements, and policies, that are associated with youth vaping. We included 48 studies. Of these, approximately 40% and 60% reported that presence of e-cigarette retailers, and advertisements, was associated with statistically higher odds of e-cigarette use in youth, respectively. Approximately 30% of studies reported that policies affecting e-cigarette availability were associated with statistically lower odds of vaping. Identifying these influential features of the neighbourhood environment will help formulate appropriate policies to reduce e-cigarette use among youth.

The effects of smoking habit change on the risk of depression-Analysis of data from the Korean National Health Insurance Service

BACKGROUND

We examined the effects of smoking habit change on the risk of depression using the National Health Insurance Service-National Health Screening Cohort database of Korea.

METHODS

This nationwide population-based cohort study included 88,931 men aged 40 years or older. The participants were divided into baseline heavy (≥20 cigarettes/day), moderate (10-19 cigarettes/day), and light (<10 cigarettes/day) smokers, quitters, and never smokers. Smokers were then categorized as continual smokers, reducers, quitters, and non-smokers based on the two-year change in smoking status between the first and second health examinations. The participants were followed from the index date to 2013 to assess depression status. Cox proportional models were used to examine the effects of smoking habit change on the risk of depression.

RESULTS

After a median 7.7 years of follow-up, 2,833 depression cases were identified. Never smokers and long-term quitters had a lower risk of depression than heavy continual smokers (hazard ratio, HR 0.817; 95% CI, confidence interval 0.689-0.967 and HR: 0.691; 95% CI: 0.559-0.853, respectively). Short-term quitters and reducers had a lower risk of depression, but it was not significant. The influence of smoking on depression was prominent among men in their 50 s (HR: 0.585; 95% CI: 0.419-0.820 in long-term quitters, HR:.0.738; 95% CI: 0.570-0.954 in never smokers).

LIMITATIONS

The information about smoking habits was based on self-reported questionnaires. This study examined only men because the smoking rate among women in Korea is very low.

CONCLUSIONS

This population-based study found that never smokers and long-term quitters have lower risk of depression. The risk of depression decreased when the amount of smoking decreased, but the difference was not statistically significant. Furthermore, more attention should be paid to middle-aged men when formulating smoking cessation policies.

Home and Workplace Neighborhood Socioeconomic Status and Behavior-related Health: A Within-individual Analysis

Background

The influence of individual and home neighborhood socioeconomic status (SES) on health-related behaviors have been widely studied, but the majority of these studies have neglected the possible impact of the workplace neighborhood SES.

Objective

To examine within-individual associations between home and work place neighborhood SES and health-related behaviors in employed individuals.

Methods

We used participants from the Swedish Longitudinal Occupational Survey of Health who responded to a minimum of two surveys between 2012 and 2018. Data included 12,932 individuals with a total of 35,332 observations. We used fixed-effects analysis with conditional logistic regression to examine within-individual associations of home, workplace, as well as time-weighted home and workplace neighborhood SES index, with self-reported obesity, physical activity, smoking, excessive alcohol consumption, sedentary lifestyle, and disturbed sleep.

Results

After adjustment for covariates, participants were more likely to engage in risky alcohol consumption when they worked in a workplace that was located in the highest SES area compared to time when they worked in a workplace that was located in the lowest SES area (adjusted odds ratios 1.98; 95% confidence interval: 1.12 to 3.49). There was an indication of an increased risk of obesity when individuals worked in the highest compared to the time when they worked in the lowest neighborhood SES area (1.71; 1.02–2.87). No associations were observed for the other outcomes.

Conclusion

These within-individual comparisons suggest that workplace neighborhood SES might have a role in health-related behaviors, particularly alcohol consumption.

The role of residential history in cancer research: A scoping review

The role of residential history in cancer prevention, diagnosis, treatment, and survivorship is garnering increasing attention in cancer research. To our knowledge, there is no comprehensive synthesis of the current state of knowledge in the field. We reviewed the extant literature on this topic and conducted a scoping analysis to examine two main research questions: (a) To what degree, and how, have researchers accounted for residential history/mobility in cancer research? and (b) What are the gaps in the literature based on a knowledge synthesis using scoping review and concept mapping? To answer these questions, this scoping analysis focuses on how researchers compile, analyze and discuss residential history/mobility in studies on cancer. The study is focused on peer-reviewed articles from 6 different datasets (PubMed, Cinahl, Scopus, Web of Science and JSTOR, ERIC) from 1990 to August 2020. The review captured 1951 results in total, which was scoped to 281 relevant peer-reviewed journal articles. First, we examined these articles based on cancer continuum, cancer type and the main theme. Second, we identified 21 main themes and an additional 16 sub-themes in the pool of the selected articles. We utilized concept mapping to provide a conceptual framework and to highlight the underlying socioecological assumptions and paradigms. Results show that cancer research incorporating residential histories is primarily focused on incidence and estimating cumulative exposure, with little consideration across the cancer continuum. Additionally, our review suggests that although the social environment plays an important role across the cancer continuum, a small number of articles were focused on such factors and this area remains relatively unexplored. Additionally, the expansion of interdisciplinary research on residential mobility before and after cancer diagnosis will enhance understanding of the role of environmental and socioeconomic characteristics and exposures on cancer continuum.

Effects of individual and neighborhood socioeconomic status on antiretroviral therapy adherence: The role of adherence self-efficacy

This study aimed to examine the potential mediation effect of adherence self-efficacy on the associations between individual and neighborhood socioeconomic status and antiretroviral therapy adherence in a sample of 337 people living with HIV in South Carolina, United States. Results showed that there were no direct effects of individual or neighborhood socioeconomic status on antiretroviral therapy adherence, whereas both individual socioeconomic status and neighborhood socioeconomic status were associated with adherence self-efficacy, which in turn were related to antiretroviral therapy adherence. These findings suggest that interventions targeting adherence self-efficacy may improve antiretroviral therapy adherence among people living with HIV with low socioeconomic status or those living in socioeconomically disadvantaged neighborhoods.

Cultural buffering as a protective factor against electronic cigarette use among Hispanic emergency department patients

INTRODUCTION

Hispanics in the U.S. historically use tobacco at lower rates than other racial and ethnic groups. Cultural buffering, the process by which aspects of traditional Hispanic culture delay the adoption of unhealthy behaviors, is believed to be a protective factor against tobacco use. Electronic cigarettes (e-cigarettes) are a new tobacco product that have not been extensively studied, and it is unknown if cultural factors that protect against tobacco use will buffer against e-cigarette use among the Hispanic population.

METHODS

This cross-sectional study was conducted at the emergency department (ED) in a safety-net hospital in 2014. Patients visiting the ED participated in a survey assessing demographics and substance use. Cultural buffering was operationalized as participants' primary language spoken at home. Multivariate logistic regression and generalized estimating equations examined the association between Hispanic cultural buffering and e-cigarette ever-use.

RESULTS

Of the 1476 Hispanic ED patients (age: 46.6M±14.5SD, 49.3% male), 7.6% reported e-cigarette ever-use and 11.1% reported current combustible cigarette use. In adjusted models, Spanish speakers were half as likely to report e-cigarette ever-use (O.R.: 0.54, 95% C.I.: 0.34-0.84, p=0.007), compared with English speakers. Combustible cigarette use remained the most significant factor associated with e-cigarette ever-use (O.R.: 9.28, 95% C.I.:7.44-11.56, p<0.001). In higher-income neighborhoods, English speakers reported e-cigarette ever-use at higher rates than Spanish speakers (28.2% vs. 5.9%, p<0.001).

CONCLUSIONS

Cultural buffering was protective against e-cigarette ever-use, especially in higher-income neighborhoods. These results support research on culturally-sensitive prevention programs for new and emerging tobacco products in Hispanic communities.

Cross-sectional and longitudinal associations of neighbourhood social environment and smoking behaviour: the multiethnic study of atherosclerosis

BACKGROUND

Social features of neighbourhood environments may influence smoking by creating a stressful environment or by buffering stress through social cohesion. However, the association of the overall neighbourhood social environment (NSE) with smoking, and the association of specific neighbourhood social factors with change in smoking behaviour over time, has rarely been examined.

METHODS

This study included 5856 adults aged 45-84 years from the Multi-Ethnic Study of Atherosclerosis (2000-2012, average follow-up: 7.8 years). Outcomes included current smoking status and smoking intensity (average number of cigarettes smoked per day among baseline smokers). NSE was assessed as a composite score composed of aesthetic quality, safety and social cohesion scales (derived from neighbourhood surveys). Generalised linear mixed models evaluated the association of baseline NSE (composite score and individual scales) with current smoking (modified Poisson models) and smoking intensity (negative binomial models) cross-sectionally and longitudinally.

RESULTS

Each SD increase in baseline NSE composite score was associated with 13% lower prevalence of smoking at baseline (adjusted prevalence ratio (aPR) 0.87 (95% CI 0.78 to 0.98). Neighbourhood safety and aesthetic quality were similarly associated with lower smoking prevalence (aPR 0.87 (0.78 to 0.97) and aPR 0.87 (0.77 to 0.99), respectively) but the association with social cohesion was weaker or null. No significant associations were observed for smoking intensity among baseline smokers. Baseline NSE was not associated with changes in smoking risk or intensity over time.

CONCLUSIONS

Results suggest that neighbourhood social context influences whether older adults smoke, but does not promote smoking cessation or reduction over time.

The Global Laboratory of Tobacco Control: Research to Advance Tobacco Cessation in LMICs

For over half a century, the U.S. National Cancer Institute (NCI) has supported research on tobacco and health, which has contributed to reductions in tobacco-caused morbidity and mortality in the U.S. But while tobacco use has been slowly declining in most high-income nations, including the US, it has continued to increase in other parts of the globe. Of the 800 million adult men who currently smoke cigarettes, over 80% are in low- and middle-income countries (LMICs), and these countries will bear an increasing share of the health and economic burden of tobacco use. At the same time, there are additional challenges to implementing tobacco control programs in LMICs, including a diversity of tobacco products, limited capacity and resources for tobacco control, and competing health priorities. While a large body of evidence has been generated around tobacco dependence treatment and other measures in high-income countries, this work is only partly applicable to many LMICs. In this paper we focus on research needs and opportunities around tobacco cessation interventions for LMICs, highlighting four areas: understanding diverse tobacco products, development of low-cost cessation interventions, integrating tobacco cessation into health systems, and understanding tobacco use behaviors across different contexts. Expanding tobacco control research and research capacity in LMICs is crucial to reducing tobacco use and cancer rates worldwide. Furthermore, research conducted in countries around the world can yield important insights for understanding tobacco use behaviors and the effectiveness of tobacco control interventions in the US.

Dysbiotic drift: mental health, environmental grey space, and microbiota

Advances in research concerning the mental health implications of dietary patterns and select nutrients have been remarkable. At the same time, there have been rapid increases in the understanding of the ways in which non-pathogenic microbes can potentially influence many aspects of human health, including those in the mental realm. Discussions of nutrition and microbiota are often overlapping. A separate, yet equally connected, avenue of research is that related to natural (for example, green space) and built environments, and in particular, how they are connected to human cognition and behaviors. It is argued here that in Western industrial nations a ‘disparity of microbiota’ might be expected among the socioeconomically disadvantaged, those whom face more profound environmental forces. Many of the environmental forces pushing against the vulnerable are at the neighborhood level. Matching the developing microbiome research with existing environmental justice research suggests that grey space may promote dysbiosis by default. In addition, the influence of Westernized lifestyle patterns, and the marketing forces that drive unhealthy behaviors in deprived communities, might allow dysbiosis to be the norm rather than the exception in those already at high risk of depression, subthreshold (subsyndromal) conditions, and subpar mental health. If microbiota are indeed at the intersection of nutrition, environmental health, and lifestyle medicine (as these avenues pertain to mental health), then perhaps the rapidly evolving gut-brain-microbiota conversation needs to operate through a wider lens. In contrast to the more narrowly defined psychobiotic, the term eco-psychotropic is introduced.