A Smoke-Free Paso del Norte: impact over 10 years on smoking prevalence using the Behavioral Risk Factor Surveillance System

Risk Factors for 30-day Hospital Readmissions After Peripheral Vascular Interventions in Peripheral Artery Disease Patients at the US-Mexico Border

Peripheral artery disease (PAD) is associated with high rates of readmission following endovascular interventions and contributes to a significant hospital readmission burden. Quality metrics like hospital readmissions affect hospital performance, but must adjust to local trends. Our primary goal was to evaluate risk factors and readmission rates post-percutaneous peripheral intervention in a US-Mexico border city, at a single tertiary university hospital. We performed a retrospective review of patients with PAD undergoing first time peripheral intervention from July 2015 to June 2020. Among 212 patients, 58% were readmitted with median 235-day follow-up (inter-quartile range (IQR) 42-924); 35.3% of readmissions occurred within 30 days, and 30.2% of those were within 7 days. Median time to readmission was 62 days. Active smokers had 84% higher risk of readmission (hazard ratio (HR) 1.84, 95% CI 1.23-2.74, P < .01). Other significant factors noted were insurance status-Medicaid or uninsured (HR 1.94, 95% CI 1.22-3.09), prior amputation (HR 1.69, 95% CI 1.13-2.54), heart failure, both preserved (HR 4.35, 95% CI 2.07-9.16) and reduced ejection fraction (HR 1.88, 95% CI 1.14-3.10). Below the knee, interventions were less likely to be readmitted (adjusted HR .64, 95% CI 0.42-.96). Readmission rates were unrelated to medication adherence.

A three wave assessment of a tobacco free campus policy within a minority serving institution

OBJECTIVE

This study assessed changes (in relation to smoking status) in tobacco use, attitudes toward TFC policies, and tobacco use risk knowledge by applying a three Wave repeated cross-sectional assessment.

PARTICIPANTS

Participants were students at Wave 1 (n = 2,169), Wave 2 (n = 2,576), and Wave 3 (n = 2,169) and faculty at Wave 1 (n = 256), Wave 2 (n = 204), and Wave 3 (n = 180).

METHODS

Measures regarding sociodemographics, tobacco use, attitudes toward TFC policies, and tobacco use risk knowledge were completed.

RESULTS

Compared with Wave 1, more students reported having quit smoking within the last six months at Waves 2 and 3. The negative attitudes toward TFC policies of those who reported quitting in the last six months aligned with those of nonsmokers.

CONCLUSIONS

Study findings suggest smoking status as a relevant covariate to focus on to further strengthen and refine existing TFC policies.

Smoking trends in Mexico, 2002-2016: before and after the ratification of the WHO's Framework Convention on Tobacco Control

INTRODUCTION

Mexico was the first Latin American country to ratify the Framework Convention on Tobacco Control (FCTC) in 2004, after which it implemented some key FCTC policies (e.g., taxes, smoke-free, pictorial warnings and ad bans). This study assessed trends in the prevalence of current, daily and non-daily smoking in Mexico before and after the implementation of key FCTC policies.

METHODS

Data were analysed from two comparable, nationally representative surveys (i.e., the National Survey on Addictions 2002, 2011 and 2016, and the Global Adult Tobacco Survey 2009 and 2015). The pooled sample comprised 100 302 persons aged 15-65 years. Changes in the prevalence of current, daily and non-daily smoking were assessed.

RESULTS

From 2002 to 2016, the prevalence of current smoking fell 11% in relative terms (from 21.5% to 19.0%). The decrease was registered between 2002 and 2009, and after that, a slight increase was observed (from 16.5% in 2009 to 19% in 2016). The prevalence of daily smoking decreased by about 50% between 2002 and 2016 (from 13.5% to 7.0%) with most of the decrease occurring by 2009. Conversely, the prevalence of non-daily smoking increased by 35% between 2009 and 2016 (from 8.8% to 11.9%).

CONCLUSIONS

Full implementation of the FCTC is necessary to further reduce smoking. Specific interventions may be needed to target non-daily smokers, who now comprise more than half of current smokers in Mexico.

Our Homes, Our Health: Strategies, Insight, and Resources to Support Smoke-Free Multiunit Housing

Tobacco use remains the single most preventable cause of disease, disability, and death in the United States. Almost 500,000 people die every year in the United States because of tobacco use; approximately one in eight of those deaths are attributable to secondhand smoke exposure. Significant disparities exist in terms of which groups bear the greatest burden of tobacco-related illness and mortality. Reducing tobacco use and exposure in groups most affected and most at risk is a national public health priority. Tobacco control advocates can promote health equity by prioritizing policies that are likely to decrease tobacco use and secondhand smoke exposure and improve access to tobacco cessation resources among populations most at risk for tobacco-related disparities, including people who live in subsidized multiunit housing. In this article, we share the context, process, key milestones, and lessons learned as stakeholders in El Paso, Texas explored and implemented smoke-free policy in subsidized public housing. Partners including the local housing authority, a nonprofit health foundation, the local public health department, and a local university facilitated a thoughtful and community-engaged process that acknowledged the right of residents to breathe clean air in their own homes, potential challenges residents who choose to smoke may face in adapting to smoke-free policy, and the need for support for those who choose to quit. We conclude with five key lessons learned and share resources for other communities, health professionals, and coalitions advocating for and supporting smoke-free housing policy in their communities.

Effect of Local Smoke-Free Ordinances on Smoking Prevalence in Kentucky, 2002-2009

OBJECTIVES

Many local communities in Kentucky, a state with one of the highest smoking prevalence rates in the United States, have enacted smoke-free ordinances that prohibit smoking in workplaces and enclosed buildings open to the public. Research has shown that such ordinances are clearly beneficial for public health, but their influence on smoking prevalence in the populations they cover remains unclear. This study explores the effect of local smoke-free ordinances on smoking prevalence in Kentucky.

METHODS

We used a database of smoke-free ordinances maintained by the Kentucky Center for Smoke-Free Policy, Kentucky Behavioral Risk Factor Surveillance System survey data, and US Census data. We estimated the proportion of Kentucky adults living in counties with smoke-free ordinances of varying strength; examined bivariate associations between smoke-free ordinances and smoking prevalence; and fit regression models that adjusted for various county-level demographic, socioeconomic, and geographic factors.

RESULTS

Smoking prevalence was approximately 5% lower in counties with smoke-free ordinances, even after adjusting for other relevant factors, including a trend in decreasing prevalence throughout the study region. There was a slight dose-response effect related to the strength of smoke-free ordinances after adjustment for these covariates. Smoke-free ordinances appear to have a modest effect on smoking prevalence across the span of several years.

CONCLUSIONS

Findings demonstrate that although smoking prevalence fell throughout the state during the study period, counties with smoke-free ordinances experienced a greater decline. Future research should examine the strength of smoke-free ordinances in greater detail to better understand their influence on smoking prevalence.

Professional Development Through Policy Advocacy

Communicating and advocating for evidence-based public health policy is a key component of health promotion practice, but public health professionals often lack experience in policy advocacy. This article provides perspectives from public health professionals who participated in successful public health policy advocacy efforts in their community. Their experiences using evidence-based research to advocate for policies that promote health equity contributed significantly to their career development, and also contributed to community capacity to reduce tobacco-related disparities. This article builds on previous work emphasizing the value of career development opportunities that enhance and diversify the public health workforce, and provides practical tips and “lessons learned” that are relevant to a wide range of public health professionals.

Internal Structure Analysis of a Tobacco Control Network on the U.S.-México Border

Tobacco control (TC) networks (in which multiple agencies collaborate) are essential components within comprehensive TC efforts. The aim of this study was to assess the internal coalition outcomes hierarchy model (via the Internal Coalition Effectiveness [ICE] scale) in the present sample. Participants (members of a TC Network on the U.S.-México border; independent Waves 1 [N = 30] and 2 [N = 33; at a 1-year subsequent assessment]) completed a background questionnaire and an adapted version of the ICE scale. Mean values for ICE subscales suggested a strong enthusiasm of Network members and recognition of the importance of a cohesive social vision, employment of efficient practices, a need for improved and maintained knowledge/training, and stable social relationships among members. However, no significant differences were observed between data waves in the ICE subscales, multivariate analysis of variance: λ = .97, F(4, 43) = 0.31, p > .86. Considering a multifaceted assessment may enhance the understanding of the dynamics and strengths of the Network. Finally, including an assessment of the leadership's perspective regarding internal coalition outcome hierarchy model constructs to compare them with members' perspective is warranted.