Tobacco use in Lao People's Democratic Republic: Results from the 2015 National Adult Tobacco Survey

Is It Time to Ban Flavored Cigarettes in Asia-Pacific Countries? A Scoping Review

Flavored cigarettes encourage youth smoking and deter quitting. No country in Asia-Pacific, a region with some of the world's highest smoking rates, has regulated tobacco flavors. We examined market data, academic literature, and gray literature to describe what is known on flavored cigarettes in the Asia-Pacific region. Of the 12 countries for which market data were available, ten had substantial flavored cigarette market shares ranging from 10% to 97%. With no regulations and growing markets for flavor capsule variants, the tobacco industry's ongoing promotion of flavored cigarettes, which targets primarily youth and women, is expected to drive further increases in smoking prevalence. There are significant research and monitoring gaps on the industry's marketing tactics and use of flavored cigarettes in the region. Given the large market shares, Asia-Pacific countries stand to benefit substantially from a tobacco flavors ban.

Secondhand Smoke Exposure in Lao People's Democratic Republic: Results From the 2015 National Adult Tobacco Survey

Objectives: Second-hand smoke (SHS) exposure causes >600,000 deaths annually worldwide, however, information regarding SHS exposure in Lao People's Democratic Republic (Lao PRD) is limited; we report SHS exposure prevalence at home, inside workplaces, and indoor public spaces in Lao PDR. Methods: Data were from the 2015 Lao National Adult Tobacco Survey, a nationally representative sample of 7,562 participants aged ≥15 years recruited through a stratified 2-stage cluster sampling approach. Results: 88.3% (83.9% of non-smokers) reported SHS exposure at home and 63.0% (54.0% of non-smokers) at workplaces. Among non-smokers, women had greater exposure at home than men (86.6 vs. 77.0%). Lower education levels were associated with exposure at home or the workplace. 99.2% reported SHS exposure at any public place; specifically for restaurants/food stores 57.7%, government offices 56.2%, public transport 31.6%, and health care facilities 11.7%. Conclusion: SHS exposure at home and workplace in Lao PDR is among the highest in South-East Asia. Comprehensive smoke-free policies at government-owned workplaces and facilities, stricter enforcement of these smoke-free policies, and strategies to encourage smoke-free environments at homes and in public places are urgently needed.

Microbial contamination in the communal-use Lao tobacco waterpipe

BACKGROUND

The use of the Asian tobacco waterpipe (TWP) in the Lao People's Democratic Republic represents a potential communal source of infectious disease. This practice of smoking can lead to weakened defences of a smoker's respiratory epithelium, making the smoker vulnerable to respiratory diseases such as coronavirus disease 2019, tuberculosis and others.

METHODS

This study evaluated the water quality and hygiene factors among 43 smokers of five villages in rural Luang Namtha Province. Water samples were collected from participant's TWPs and assessed for the presence of Escherichia coli, coliforms and aerobic plate count (APC) bacteria using the 3M Petrifilm.

RESULTS

The microbial indicator testing results were 95% positive for the APC, 38% positive for coliforms and 17% positive for the E. coli indicator. The concentrations were highest for the APC, with an average of 106 colony forming units (cfu)/ml, followed by coliforms with <100 cfu/ml and lowest for E. coli with <10 cfu/ml. Most TWPs were infrequently cleaned, heavily used and contained a warm, brown-coloured water.

CONCLUSIONS

The warm, dark and moist internal water container may facilitate microbial survival and growth. The use of a TWP adds several unstudied modes of transmission to a complex and common biobehavioural and environmental pathogen exposure. Future TWP cessation activities should be tailored to consider risks of infectious disease transmission.

Mobile-health intervention for smoking cessation among Cambodian people living with HIV: A mixed-methods pilot study

This mixed methods study aimed to evaluate the feasibility and preliminary efficacy of a fully automated, interactive smartphone-delivered intervention for smoking cessation among people living with HIV in Cambodia. We used the explanatory sequential design, with a pilot two-group single-blind randomized controlled trial (N = 50) followed by in-depth interviews with all trial participants. In the trial, participants were randomized to Standard Care (SC) or Automated Messaging (AM) group. SC comprised brief advice to quit and self-help materials. AM consisted of the SC components plus a fully automated smartphone-based treatment program that involved interactive and tailored proactive messaging for 2 months. Results showed that the AM approach was highly feasible and efficacious. Feasibility was supported by high rates of treatment engagement (e.g., 81% of delivered messages and assessments were read or completed) and high retention (96%) through the 2-month follow-up. Biochemically verified point prevalence abstinence at follow-up was 40% for the AM group and 8% for the SC group (relative risk: 5.0, 95% confidence interval: 1.2, 20.5). Being able to avoid other smokers, having coping skills, and having social/familial support contributed to successful abstinence. The AM program has the potential for wide-scale implementation in Cambodia and other low-income countries.

Factors Associated with Cigarette Smoking Cessation in Lao People's Democratic Republic: Results from the 2015 National Adult Tobacco Survey

Cigarette smoking represents a major public health problem in Lao People's Democratic Republic (Lao PDR). This study aims to examine factors associated with cigarette smoking cessation attempts and intention to quit. Data were from the Lao National Adult Tobacco Survey that consisted of 7562 participants ≥15 years old. Multivariable logistic regression models were used to evaluate the associations, adjusted for sex, age groups, education level, income per day, and smoking frequency. Results show that past quit attempts were associated with visiting a healthcare provider in the past year (adjusted odds ratio [AOR]: 1.74, 95% confidence intervals [CI]: 1.28-2.35), home smoking bans (AOR: 5.52, 95% CI: 2.13-14.33), noticing media-based messages informing the dangers of smoking or encouraging quitting (AOR: 3.25, 95% CI: 2.28-4.63), noticing health warnings on cigarette packages in the past 30 days (AOR: 3.33, 95% CI: 2.21-5.03), and believing that smoking is seriously harmful to their health (AOR: 3.45, 95% CI: 1.24-9.57). The Lao PDR government should continue implementing tobacco control policies that demonstrated associations with cessation attempts or intention to quit, such as smoke-free environments and required health warnings on cigarette packages. Tobacco cessation treatment programs are pressingly needed in Lao PDR.