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Mammadli T, Hong C. Substance Use and Misuse among Sexual and Gender Minority Communities Living in Former Soviet Union Countries: A Scoping Review. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:59-76. [PMID: 38600900 PMCID: PMC10903640 DOI: 10.1080/19317611.2024.2303517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/04/2024] [Indexed: 04/12/2024]
Abstract
Objectives We reviewed literature examining substance use among sexual and gender minorities (SGM) living in the former Soviet Union (USSR) nations. Methods Searches were conducted across five databases (PubMed, SocINDEX, CINAHL, PscyInfo, LGBTQ + Source) to identify peer-reviewed literature. Results Across 19 studies, high hazardous substance use prevalence was documented. Substance use was correlated with (a) sexual health and behaviors and (b) mental wellbeing and the use of other substances. Conclusion We discuss minority stress implications and challenges presented by the paucity of evidence in the literature examining substance use among SGM women and SGM living in countries unrepresented in reviewed studies.
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Affiliation(s)
- Tural Mammadli
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - Chenglin Hong
- Department of Social Welfare, University of California Los Angeles, Los Angeles, CA, USA
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Ji Y, Zhang Y, Yun Q, Chang C. Gender differences in social environmental changes associated with smoking: a cross-sectional study from Chinese internal migrants. BMJ Open 2022; 12:e058097. [PMID: 36414285 PMCID: PMC9685270 DOI: 10.1136/bmjopen-2021-058097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To identify clues for women's tobacco control, this study analyses the gender differences in social environmental changes associated with smoking and the interaction between the environment and individuals' social integration. DESIGN, SETTING AND PARTICIPANTS A cross-sectional design and secondary analysis were used among Chinese internal migrants. Data were from the 2012 Migrant Dynamics Monitoring Survey in China with participants aged 15-59 years old (75 416 women and 83 140 men) who resided in cities for more than 1 month. PRIMARY AND SECONDARY OUTCOME MEASURES Social environmental changes were measured by differences in smoking prevalence and women's empowerment between the migrant-receiving province (MRP) and migrant-sending province (MSP). Social participation and duration of stay (DOS) were adopted as indicators of social integration. Stratified analysis and binary logistic regression models were used to determine the dependent variable (smoking status) and environmental changes after controlling for age, education, income and happiness. RESULTS Differences in the smoking prevalence environment (lower in MRP, OR 0.70, 95% CI 0.60 to 0.83; higher rate in MRP, OR 1.79, 95% CI 1.35 to 2.37) and women's empowerment (lower rate in MRP, OR 0.80, 95% CI 0.68 to 0.97; higher rate in MRP, OR 1.15, 95% CI 1.00 to 1.33) between MRP and MSP were positively correlated with women's smoking. In men, however, migrating to an area with lower smoking prevalence could not reduce smoking risk, whereas moving to an area with higher women's empowerment could. A long DOS was an independent risk factor for smoking in women (ranged from 1.20 to 2.00 in various environmental changes scenarios) but a protective factor for men. An interaction between environmental changes and social integration could not be verified. CONCLUSIONS Tobacco control strategies should consider gender differences, especially women who are experiencing social environmental changes.
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Affiliation(s)
- Ying Ji
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Yan Zhang
- Institute of Nutrition and Food Hygiene, Beijing Centers for Diseases Control and Prevention, Beijing, China
| | - Qingping Yun
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
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Ludvigsson JF, Loboda A. Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees. Acta Paediatr 2022; 111:1341-1353. [PMID: 35466444 PMCID: PMC9324783 DOI: 10.1111/apa.16370] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 12/24/2022]
Abstract
Aim Millions of Ukrainian children have been internally displaced or fled to other countries because of the Russian war. This systematic review focused on their health needs and future challenges for clinicians. Methods A systematic literature search of the Medline, Embase and MedRxiv databases from 1 January 2010 to 31 March 2022 identified 1628 papers on the health of Ukrainian children and 112 were relevant to this review. Results In 2019, under‐5 mortality was 8 per 1000 live births in Ukraine. Underweight and adverse childhood experiences, including child abuse, were frequent compared to other European countries, while childhood obesity seemed less common. Alcohol consumption was common in women of reproductive age, including during pregnancy, risking foetal alcohol syndrome. Neonatal screening programmes provided low coverage. Vaccine hesitancy was common and vaccination rates were low. Other concerns were measles, HIV, antibiotic resistance and multi‐resistant tuberculosis. Many children are expected to suffer from psychological and physical trauma due to the war. Other healthcare challenges include low COVID‐19 vaccination rates and a preference for secondary and tertiary care, rather than primary care. Many people cannot afford medication. Conclusion Ukrainian children often have poor health and host countries need to be aware of their needs.
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Affiliation(s)
- Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Paediatrics Orebro University Hospital Orebro Sweden
- Department of Medicine Columbia University College of Physicians and Surgeons New York New York USA
| | - Andrii Loboda
- Department of Paediatrics, Academic and Research Medical Institute Sumy State University Sumy Ukraine
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Znaor A, Corbex M, Cao B, Laversanne M, Ryzhov A, Smelov V, Bray F. Progress in reducing premature mortality from cancer and cardiovascular disease in the former Soviet Union, 2000-19. Eur J Public Health 2022; 32:624-629. [PMID: 35441219 PMCID: PMC9341639 DOI: 10.1093/eurpub/ckac030] [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] [Indexed: 11/13/2022] Open
Abstract
Background A reduction in non-communicable diseases premature mortality by one-third by 2030 is one of the targets of the UN Sustainable Development Goals (SDG3.4). We examined the mortality profiles in the Newly Independent States of the former Soviet Union (NIS) and the European Union (EU) and assessed progress in reductions of premature mortality from cancer, as compared to cardiovascular disease (CVD). Methods We used WHO’s Global Health Estimates and GLOBOCAN 2020 to examine current mortality profiles and computed the unconditional probabilities of dying at ages 30–70 from CVD and cancer for the years 2000–19 in both sexes, using a linear extrapolation of this trend to predict whether the target of a one-third reduction, as set in 2015, would be met in 2030. Results CVD was the main cause of premature death in the NIS (43%), followed by cancer (23%), inversely from the EU with 42% cancer and 24% CVD deaths. The NIS achieved major reductions in premature CVD mortality, although the probabilities of death in 2019 remained about five times higher in the NIS compared to the EU. For cancer, mortality reductions in most NIS were quite modest, other than large declines seen in Kazakhstan (44%) and Kyrgyzstan (30%), with both on course to meet the 2030 target. Conclusions Limited progress in cancer control in the NIS calls for policy action both in terms of structural changes towards universal health coverage, and scaling up of national cancer control plans, including a shift from opportunistic to evidence-based early detection practices.
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Affiliation(s)
- Ariana Znaor
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Marilys Corbex
- Division of Country Health Programs, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Bochen Cao
- Division of Data, Analytics and Delivery for Impact, World Health Organization, Geneva, Switzerland
| | - Mathieu Laversanne
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Anton Ryzhov
- Department of General Mathematics, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
| | - Vitaly Smelov
- Division of Country Health Programs, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
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5
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Tabyshova A, Estebesova B, Beishenbekova A, Sooronbaev T, Brakema EA, Chavannes NH, Postma MJ, van Boven JFM. Clinical Characteristics, Treatment Patterns and Economic Burden of COPD in Kyrgyzstan: A FRESH AIR Study. Int J Chron Obstruct Pulmon Dis 2021; 16:2833-2843. [PMID: 34703219 PMCID: PMC8523360 DOI: 10.2147/copd.s322778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND COPD prevalence and mortality in Kyrgyzstan are high. Data on clinical and economic impact of COPD in Kyrgyzstan are scarce. This study was part of the FRESH AIR research project that focused on prevention, diagnosis and treatment of chronic lung diseases in low-resource settings. AIM We aimed to evaluate the clinical characteristics, treatment patterns and economic burden of COPD in Kyrgyzstan. METHODS A representative sample of patients with a spirometry-confirmed diagnosis of COPD was included. All patients were registered in one of the five major hospitals in Kyrgyzstan. Patients were surveyed on COPD risk factors, health-care utilization and patient reported outcomes (CCQ, MRC). Associations with high symptom burden (MRC score ≥4) and cost were assessed using logistic regression analyses. RESULTS A total of 306 patients were included with mean age 62.1 (SD: 11.2), 61.4% being male, mean BMI 26.9 (SD: 5.2) and mean monthly income $85.1 (SD: 75.4). Biomass was used for heating and cooking by 71.2% and 52.0%. Current and ex-smokers accounted 14.1% and 32%. Mean FEV1 was 46% (SD: 12.8), 71.9% had COPD GOLD III-IV and most frequent co-morbidities were hypertension (25.2%), diabetes (5.6%) and heart diseases (4.6%). Mean CCQ score was 2.0 (SD: 0.9) and MRC score 3.7 (SD: 0.9). Yearly mean number of hospital days due to COPD was 10.1 (SD: 3.9). Total annual per-patient costs of reimbursed health-care utilization ($107) and co-payments ($224, ie, 22% of patients' annual income) were $331. We found that only GOLD IV and hypertension were significantly associated with high symptom burden. Exacerbations and hypertension were significantly associated with high cost. CONCLUSION The clinical and economic burden of COPD on patients and the government in Kyrgyzstan is considerable. Notably, almost half of interviewed patients were current or ex-smokers and biomass exposure was high.
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Affiliation(s)
- Aizhamal Tabyshova
- Pulmonology Department, National Center of Cardiology and Internal Medicine Named After M.M. Mirrakhimov, Bishkek, Kyrgyzstan
- Department of Health Sciences, Unit of Global Health, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bermet Estebesova
- Kyrgyz-Russian Slavic University (KRSU), Bishkek, Kyrgyzstan
- Primary Care Center of the Ministry of Internal Affairs, Bishkek, Kyrgyzstan
| | | | - Talant Sooronbaev
- Pulmonology Department, National Center of Cardiology and Internal Medicine Named After M.M. Mirrakhimov, Bishkek, Kyrgyzstan
| | - Evelyn A Brakema
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Maarten J Postma
- Department of Health Sciences, Unit of Global Health, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Groningen, The Netherlands
- Department of Pharmacology & Therapy, Airlangga University, Surabaya, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
| | - Job F M van Boven
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
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Novikau A. Tobacco Use Depictions in Popular Soviet and Post-Soviet Movies from 1950 to 2019: The Possible Impact of Restrictive Policies. Subst Use Misuse 2021; 56:1726-1731. [PMID: 34286665 DOI: 10.1080/10826084.2021.1954030] [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] [Indexed: 10/20/2022]
Abstract
To reduce the initiation to smoking and its social acceptance, restrictive policies to decrease tobacco exposure in movies and television shows have been implemented in some countries around the world. What is not as clear is how effective these policies are in reducing tobacco exposure on screen. The objective of this study was to analyze trends in tobacco use in Soviet and post-Soviet films over time and also to assess the effectiveness of restrictive policies. Methods: 140 top commercially successful Soviet and Russian films released from 1950 to 2019 were content analyzed. The outcome data were transformed to approximate multivariate normality before being analyzed with one-way analyses of variance followed by Bonferroni multiple comparison post hoc tests. Results: Smoking rates in the top films fluctuated insignificantly in the 1950s-2000s. Yet, in the 2010s, the number of tobacco events in the movies declined significantly, compared to all other decades studied (p < 0.05). Conclusions: Changes in tobacco consumption in the Soviet Union and Russia did not have significant effects on tobacco use in domestic movies released from 1950 to 2009. The decrease in tobacco use rates found in Russian films in the 2010s can be explained by extensive public policies aiming to reduce tobacco exposure in newly released films.
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Affiliation(s)
- Aliaksandr Novikau
- Department of International Relations and Public Administration, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Kulmambetova G, Shtefanov I, Aitkulova A, Imanbekova M, Iskakova A, Makishev A, Ramankulov Y. Association of polymorphisms in TP53 and the promoter region of IL10 with gastric cancer in a Kazakh population. Bosn J Basic Med Sci 2020; 20:539-546. [PMID: 32651972 PMCID: PMC7664782 DOI: 10.17305/bjbms.2020.4761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/02/2020] [Indexed: 12/19/2022] Open
Abstract
The emerging evidence indicates that single nucleotide polymorphisms (SNPs) of the tumor necrosis factor (TNF), interleukin 10 (IL10), tumor protein p53 (TP53), and cluster of differentiation 14 (CD14) genes may determine individual susceptibility to gastric cancer (GC). We aimed to investigate the associations for polymorphisms of the TNF, IL10, TP53, and CD14 genes in a population of Kazakhs, to identify potential risk or protective associations of the SNPs with GC. A case group of 143 patients hospitalized for GC was enrolled. Controls were 355 volunteers with no history of any cancer and frequency matched with cases by age. Differences in proportions for categorical variables and the assessment of genotypic frequencies conforming to the Hardy-Weinberg equilibrium law were evaluated by the Chi-square test. Associations between genetic polymorphisms and the risk of GC were estimated by regression analysis. For genetic analysis, three genetic models (additive, dominant, and recessive) were used. Four significant associations were found. The SNPs rs1042522 of TP53 and rs1800896 of IL10 were risk factors for GC by the additive model. Two polymorphisms of IL10 were protective of GC, namely, rs1800872 by additive model and rs1800871 by recessive model. No significant associations were observed between the TNF and CD14 polymorphisms and GC. The polymorphisms TP53 rs1042522 and IL10 rs1800896 are associated with GC risk, while the polymorphisms IL10 rs1800872 and rs1800871 are protective of GC in the population of Kazakhs.
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Affiliation(s)
- Gulmira Kulmambetova
- Biotechnology Core Facility, National Center for Biotechnology, Nur-Sultan, Kazakhstan
| | - Ivan Shtefanov
- Department of Oncology, City Oncology Center, Nur-Sultan, Kazakhstan
| | - Akbota Aitkulova
- Biotechnology Core Facility, National Center for Biotechnology, Nur-Sultan, Kazakhstan
| | - Meruyert Imanbekova
- Biotechnology Core Facility, National Center for Biotechnology, Nur-Sultan, Kazakhstan
| | - Aisha Iskakova
- Biotechnology Core Facility, National Center for Biotechnology, Nur-Sultan, Kazakhstan
| | - Abay Makishev
- Department of Oncology, City Oncology Center, Nur-Sultan, Kazakhstan
| | - Yerlan Ramankulov
- Biotechnology Core Facility, National Center for Biotechnology, Nur-Sultan, Kazakhstan
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Topuridze M, Berg CJ, Dekanosidze A, Torosyan A, Grigoryan L, Bazarchyan A, Sargsyan Z, Hayrumyan V, Maglakelidze N, Sturua L, Haardörfer R, Kegler MC. Smokers' and Nonsmokers' Receptivity to Smoke-Free Policies and Pro- and Anti-Policy Messaging in Armenia and Georgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155527. [PMID: 32751714 PMCID: PMC7432748 DOI: 10.3390/ijerph17155527] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 12/02/2022]
Abstract
Garnering support for smoke-free policies is critical for their successful adoption, particularly in countries with high smoking prevalence, such as Armenia and Georgia. In 2018, we surveyed 1456 residents (ages 18–64) of 28 cities in Armenia (n = 705) and Georgia (n = 751). We examined support for cigarette and electronic nicotine delivery systems (ENDS)/heated tobacco product (HTP) smoke-free policies in various locations and persuasiveness of pro- and anti-policy messaging. Participants were an average age of 43.35, 60.5% female, and 27.3% current smokers. Nonsmokers versus smokers indicated greater policy support for cigarette and ENDS/HTP and greater persuasiveness of pro-policy messaging. Armenians versus Georgians generally perceived pro- and anti-policy messaging more persuasive. In multilevel linear regression, sociodemographics (e.g., female) and tobacco use characteristics (e.g., smoking less frequently, higher quitting importance) correlated with more policy support. Greatest policy support was for healthcare, religious, government, and workplace settings; public transport; schools; and vehicles carrying children. Least policy support was for bar/restaurant outdoor areas. The most compelling pro-policy message focused on the right to clean air; the most compelling anti-policy message focused on using nonsmoking sections. Specific settings may present challenges for advancing smoke-free policies. Messaging focusing on individual rights to clean air and health may garner support.
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Affiliation(s)
- Marina Topuridze
- Non-Communicable Diseases Department, National Center for Disease Control and Public Health, Tbilisi 0198, Georgia; (M.T.); (A.D.); (N.M.); (L.S.)
- School of Natural Sciences and Medicine, Ilia State University, Tbilisi 0162, Georgia
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington Cancer Center, George Washington University, Washington, DC 20052, USA
- Correspondence:
| | - Ana Dekanosidze
- Non-Communicable Diseases Department, National Center for Disease Control and Public Health, Tbilisi 0198, Georgia; (M.T.); (A.D.); (N.M.); (L.S.)
| | - Arevik Torosyan
- National Institute of Health Named after Academician S. Avdalbekyan, MoH, Yerevan 0051, Armenia; (A.T.); (L.G.); (A.B.)
| | - Lilit Grigoryan
- National Institute of Health Named after Academician S. Avdalbekyan, MoH, Yerevan 0051, Armenia; (A.T.); (L.G.); (A.B.)
| | - Alexander Bazarchyan
- National Institute of Health Named after Academician S. Avdalbekyan, MoH, Yerevan 0051, Armenia; (A.T.); (L.G.); (A.B.)
| | - Zhanna Sargsyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan 0019, Armenia; (Z.S.); (V.H.)
| | - Varduhi Hayrumyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan 0019, Armenia; (Z.S.); (V.H.)
| | - Nino Maglakelidze
- Non-Communicable Diseases Department, National Center for Disease Control and Public Health, Tbilisi 0198, Georgia; (M.T.); (A.D.); (N.M.); (L.S.)
| | - Lela Sturua
- Non-Communicable Diseases Department, National Center for Disease Control and Public Health, Tbilisi 0198, Georgia; (M.T.); (A.D.); (N.M.); (L.S.)
- Public Health Department Petre Shotadze Tbilisi Medical Academy, Tbilisi 0144, Georgia
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (R.H.); (M.C.K.)
| | - Michelle C. Kegler
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (R.H.); (M.C.K.)
- Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
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Emadzadeh M, Vakili V. Steps toward community health promotion: Application of transtheoretical model to predict stage transition regarding smoking. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:177. [PMID: 32953906 PMCID: PMC7482633 DOI: 10.4103/jehp.jehp_719_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 03/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Recently, the Iranian Ministry of Health estimated about 750,000 deaths are attributed smoking complications. The aim of this study was to apply the transtheoretical model (TTM) on general population of Mashhad city to evaluate the stages of change and possible cultural factors regarding smoking cessation. METHODS This descriptive, cross-sectional population-based study was conducted in Mashhad, Iran. A total number of 562 participants selected by multistage sampling. They were asked about stages of change for smoking cessation for both hookah and cigarette smoking. Stages of change refer to an orderly sequence of changes in smoking behavior that people progress through according to the TTM. Its six stages are as follows: precontemplation (PC) (no intention to quit smoking within 6 months), contemplation (planning to quit smoking in the following 6 months), preparation (planning to stop smoking within 1 month), action (quit smoking for <6 months), maintenance (stopped smoking for 6 months or more), and termination (will never smoke again). Data were analyzed using tests such as Chi-square, Kruskal-Wallis, and logistic regression by SPSS 11.5. RESULTS About 18% and 19% of people in this study were regular hookah and cigarette smokers, respectively. There was significant difference between cigarette smoking and sex (P < 0.001) and marital status (P = 0.01). There was a statistically significant difference between stages of change in men and women from the point of cigarette smoking (P < 0.001). Male sex, hookah smoking, and alcohol abuse were predictors of PC, and age was the only predictor of termination stage for cigarette smoking. Sex did not have any role in hookah smoking. CONCLUSION Targeted education based on gender and marital status warrant attention. Community-wide education and interventions such as increasing the price of cigarettes are desired.
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Affiliation(s)
- Maryam Emadzadeh
- Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Veda Vakili
- Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Shkolnikov VM, Churilova E, Jdanov DA, Shalnova SA, Nilssen O, Kudryavtsev A, Cook S, Malyutina S, McKee M, Leon DA. Time trends in smoking in Russia in the light of recent tobacco control measures: synthesis of evidence from multiple sources. BMC Public Health 2020; 20:378. [PMID: 32293365 PMCID: PMC7092419 DOI: 10.1186/s12889-020-08464-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 03/05/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The study aims at identifying long-term trends and patterns of current smoking by age, gender, and education in Russia, including the most recent period from 2008 during which tobacco control policies were implemented, and to estimate the impact on mortality of any reductions in prevalence. We present an in-depth analysis based on an unprecedentedly large array of survey data. METHODS We examined pooled micro-data on smoking from 17 rounds of the Russian Longitudinal Monitoring Study of 1996-2016, 11 other surveys conducted in Russia in 1975-2017, and two comparator surveys from England and the USA. Standardization by age and education, regression and meta-analysis were used to estimate trends in the prevalence of current smoking by gender, age, and educational patterns. RESULTS From the mid-1970s to the mid-2000s smoking prevalence among men was relatively stable at around 60%, after which time prevalence declined in every age and educational group. Among women, trends in smoking were more heterogeneous. Prevalence more than doubled above the age of 55 years from very low levels (< 5%). At younger ages, there were steep increases until the mid-2000s after which prevalence has declined. Trends differed by educational level, with women in the lowest educational category accounting for most of the long-term increase. We estimate that the decline in male smoking may have contributed 6.2% of the observed reduction in cardiovascular deaths among men in the period 2008-16. CONCLUSIONS The implementation of an effective tobacco control strategy in Russia starting in 2008 coincided with a decline in smoking prevalence among men from what had been stable, high levels over many decades regardless of age and education. Among women, the declines have been more uneven, with young women showing recent downturns, while the smoking prevalence in middle age has increased, particularly among those with minimal education. Among men, these positive changes will have made a small contribution to the reduction in mortality seen in Russia since 2005.
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Affiliation(s)
- Vladimir M Shkolnikov
- Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany.
- National Research University Higher School of Economics, Bolshoy Trekhsvyatitelsiy pereulok 3, Moscow, Russian Federation, 109038.
| | - Elena Churilova
- National Research University Higher School of Economics, Bolshoy Trekhsvyatitelsiy pereulok 3, Moscow, Russian Federation, 109038
| | - Dmitry A Jdanov
- Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany
- National Research University Higher School of Economics, Bolshoy Trekhsvyatitelsiy pereulok 3, Moscow, Russian Federation, 109038
| | - Svetlana A Shalnova
- National Medical Research Centre for Preventive Medicine, Petroverigskiy pereulok 10, Moscow, Russian Federation, 101990
| | - Odd Nilssen
- UiT the Arctic University of Norway, 9037, Tromsø, Norway
| | - Alexander Kudryavtsev
- Northern State Medical University, Troitskiy Avenue 51, Arkhangelsk, Russian Federation, 163000
| | - Sarah Cook
- London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK
| | - Sofia Malyutina
- Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Sciences, Vladimirovsky spusk 2a, Novosibirsk, Russian Federation, 630003
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK
| | - David A Leon
- UiT the Arctic University of Norway, 9037, Tromsø, Norway
- London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK
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Pärna K, Ringmets I, Siida S. Self-rated health and smoking among physicians and general population with higher education in Estonia: results from cross-sectional studies in 2002 and 2014. ACTA ACUST UNITED AC 2019; 77:49. [PMID: 31788242 PMCID: PMC6876104 DOI: 10.1186/s13690-019-0376-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 11/04/2019] [Indexed: 11/10/2022]
Abstract
Background Poor self-rated health (SRH) and smoking have consistently been shown to be related to mortality. The aim of this study was to explore SRH and smoking among physicians and general population with higher education in Estonia in 2002 and 2014 and to analyse the association of SRH with smoking and sociodemographic factors. Methods This study was based on cross-sectional postal surveys among physicians and general population with higher education in Estonia n in 2002 and 2014. Calculation of age-standardized prevalence of SRH and current smoking with 95% confidence intervals (CI) was performed. Multivariate logistic regression analysis was used to measure association between SRH (at-least-good vs less-than good) and smoking status, study year, age group, ethnicity, and marital status. Fully adjusted odds ratios (OR) with 95% CI were computed. Results Age-standardized prevalence of at-least-good SRH was 71.3 and 80.6% among male physicians, 68.4 and 83.1% among female physicians, 45.4 and 67.4% among men with higher education, and 44.7 and 63.1% among women with higher education in 2002 and 2014, respectively. Age-standardized prevalence of current smoking was 26.0 and 15.6% among male physicians, 10.2 and 5.9% among female physicians, 38.7 and 22.2% among men with higher education, and 20.9 and 16.4% among women with higher education in 2002 and 2014, respectively. There was no significant gender difference in at-least-good SRH, but prevalence of current smoking was significantly higher among men in both study groups in 2002 and 2014. Compared to year 2002, odds to have at-least-good SRH was higher in 2014 (OR = 1.64; 95% CI 1.16-2.31 among male and OR = 2.36; 95% CI 2.02-2.75 among female physicians, OR = 1.49; 95% CI 1.07-2.07 among men and OR = 2.40; 95% CI 1.84-3.13). Odds to have at-least-good SRH was significantly higher among non-smokers (except female physicians), in the youngest age group, and among Estonians. Conclusions This study gave an overview of differences in SRH and smoking between two target groups with higher education in two timepoints highlighting the importance of addressing smoking cessation counselling and health promotion campaigns in the population by different subgroups in Estonia.
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Affiliation(s)
- Kersti Pärna
- Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
| | - Inge Ringmets
- Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
| | - Sävelin Siida
- Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
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12
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Berg CJ, Dekanosidze A, Torosyan A, Grigoryan L, Sargsyan Z, Hayrumyan V, Topuridze M, Sturua L, Harutyunyan A, Kvachantiradze L, Maglakelidze N, Gamkrelidze A, Abovyan R, Bazarchyan A, Kegler MC. Examining smoke-free coalitions in Armenia and Georgia: baseline community capacity. HEALTH EDUCATION RESEARCH 2019; 34:495-504. [PMID: 31504495 PMCID: PMC6758643 DOI: 10.1093/her/cyz024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023]
Abstract
Local coalitions can advance public health initiative but have not been widely used or well-studied in low- and middle-income countries. This paper provides (i) an overview of an ongoing matched-pairs community-randomized controlled trial in 28 communities in Armenia and Georgia (N = 14/country) testing local coalitions to promote smoke-free policies/enforcement and (ii) characteristics of the communities involved. In July-August 2018, key informants (e.g. local public health center directors) were surveyed to compare their non-communicable disease (NCD) and tobacco-related activities across countries and across condition (intervention/control). More than half of the informants (50.0-57.1%) reported their communities had programs addressing hypertension, diabetes, cancer and human papilloma virus, with 85.7% involving community education and 32.1% patient education programs. Eleven communities (39.3%) addressed tobacco control, all of which were in Georgia. Of those, all included public/community education and the majority (72.7-81.8%) provided cessation counseling/classes, school/youth prevention programs, healthcare provider training or activities addressing smoke-free environments. Informants in Georgia versus Armenia perceived greater support for tobacco control from various sectors (e.g. government, community). No differences were found by condition assignment. This paper provides a foundation for presenting subsequent analyses of this ongoing trial. These analyses indicate wide variability regarding NCD-related activities and support across communities and countries.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, USA
- Winship Cancer Institute, Emory University, 1365 Clifton Road NE, Atlanta, GA, USA
| | - Ana Dekanosidze
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Arevik Torosyan
- National Institute of Health named after academician S. Avdalbekyan, MoH, Komitasi Ave. 49/4, Yerevan, Armenia
| | - Lilit Grigoryan
- National Institute of Health named after academician S. Avdalbekyan, MoH, Komitasi Ave. 49/4, Yerevan, Armenia
| | - Zhanna Sargsyan
- Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan, Armenia
| | - Varduhi Hayrumyan
- Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan, Armenia
| | - Marina Topuridze
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Lela Sturua
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Arusyak Harutyunyan
- Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave., Yerevan, Armenia
| | - Lela Kvachantiradze
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Nino Maglakelidze
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Amiran Gamkrelidze
- National Center for Disease Control and Public Health, 4 Kakheti Hwy, Tbilisi, Georgia
| | - Romela Abovyan
- Department of Epidemiology of Noncommunicable and Nosocomial Infectious Disease, National Center for Disease Control and Prevention, MOH RA, Mkhitar Heratsu St. 12, Yerevan, Armenia
| | - Alexander Bazarchyan
- National Institute of Health named after academician S. Avdalbekyan, MoH, Komitasi Ave. 49/4, Yerevan, Armenia
| | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, USA
- Winship Cancer Institute, Emory University, 1365 Clifton Road NE, Atlanta, GA, USA
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13
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Kossova T, Kossova E, Sheluntcova M. Anti-smoking policy in Russia: Relevant factors and program planning. EVALUATION AND PROGRAM PLANNING 2018; 69:43-52. [PMID: 29674222 DOI: 10.1016/j.evalprogplan.2018.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 03/09/2018] [Accepted: 04/08/2018] [Indexed: 06/08/2023]
Abstract
In this paper, we consider anti-smoking policy in Russia and the socioeconomic factors that influence an individual's decision to smoke. Among various factors, we investigate the individual time preferences of Russians. To estimate individual time preferences, we use an experiment in which survey respondents are given hypothetical money prizes. We find that being middle-aged, being unmarried and having parents who smoke are positively correlated with both men and women's likelihood of taking up smoking in Russia. We consider the possible endogeneity of an individual's health status and find a positive relationship between smoking and the time preferences of Russians. Our findings confirm that decisionmakers should devote their efforts primarily to developing restrictive anti-smoking policy. The choice of policy measures should be guided by the individual characteristics of target population groups. Social advertising, public lectures and preventive care should be actively engaged in forming public attitudes towards smoking.
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Affiliation(s)
- Tatiana Kossova
- National Research University Higher School of Economics, 20 Myasnitskaya Street, Moscow 101000, Russia
| | - Elena Kossova
- National Research University Higher School of Economics, 20 Myasnitskaya Street, Moscow 101000, Russia
| | - Maria Sheluntcova
- National Research University Higher School of Economics, 20 Myasnitskaya Street, Moscow 101000, Russia.
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14
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Gugushvili A, McKee M, Azarova A, Murphy M, Irdam D, King L. Parental transmission of smoking among middle-aged and older populations in Russia and Belarus. Int J Public Health 2018; 63:349-358. [PMID: 29302722 PMCID: PMC5978922 DOI: 10.1007/s00038-017-1068-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 06/12/2017] [Accepted: 12/14/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The very high rates of smoking among men and the rapid changes among women in the Post-Soviet countries mean that this region offers an opportunity to understand better the intergenerational role of parental influences on smoking. METHODS In this study, we exploit a unique data set, the PrivMort cohort study conducted in 30 Russian and 20 Belarusian towns in 2014-2015, which collects information on behaviours of middle-aged and older individuals and their parents, including smoking. We explored the associations between smoking by parents and their offspring using multiply imputed data sets and multilevel mixed-effect Poisson regressions. RESULTS Adjusting for a wide array of social origin, socio-demographic, and socio-economic variables, our analysis suggests that sons of regularly smoking fathers have prevalence ratios of 1.35 [95% confidence intervals (CI) 1.21-1.50] and 1.39 (CI 1.23-1.58) of smoking, while the figures for daughters of regularly smoking mothers are 1.91 (CI 1.40-2.61) and 2.30 (CI 1.61-3.28), respectively, in Russia and Belarus. CONCLUSIONS Intergenerational paternal and maternal influences on smoking should be taken into account in studies seeking to monitor the rates of smoking and the impact of tobacco control programmes.
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Affiliation(s)
- Alexi Gugushvili
- Department of Social Policy and Intervention and Nuffield College, University of Oxford, Barnett House, 32 Wellington Square, Oxford, OX1 2ER, UK.
- Department of Sociology, University of Cambridge, Cambridge, UK.
| | - Martin McKee
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Michael Murphy
- London School of Economics and Political Science, London, UK
| | - Darja Irdam
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Lawrence King
- Department of Sociology, University of Cambridge, Cambridge, UK
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15
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Davis A, Terlikbayeva A, Aifah A, Hermosilla S, Zhumadilov Z, Berikova E, Rakhimova S, Primbetova S, Darisheva M, Schluger N, El-Bassel N. Risks for tuberculosis in Kazakhstan: implications for prevention. Int J Tuberc Lung Dis 2018; 21:86-92. [PMID: 28157470 DOI: 10.5588/ijtld.15.0838] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
SETTING Four regions in Kazakhstan where participants were recruited from June 2012 to May 2014. OBJECTIVE To examine associations between incarceration history and tobacco, alcohol, and drug consumption, and human immunodeficiency virus (HIV) infection and diabetes mellitus (DM) with TB. DESIGN This matched case-control study included 1600 participants who completed a survey on sociodemographics, history of incarceration, tobacco, alcohol and drug use, and HIV and DM diagnosis. Conditional logistic regression analysis was used to examine associations between a TB diagnosis and risk factors. RESULTS Participants who had ever smoked tobacco (aOR 1.73, 95%CI 1.23-2.43, P 0.01), ever drank alcohol (aOR 1.41, 95%CI 1.03-1.93, P 0.05), were HIV-positive (aOR 36.37, 95%CI 2.05-646.13, P 0.05) or had DM (aOR 13.96, 95%CI 6.37-30.56, P 0.01) were more likely to have TB. CONCLUSIONS The association between TB and tobacco use, alcohol use, HIV and DM in Kazakhstan suggests a need for comprehensive intervention and prevention approaches that also address tobacco and alcohol use, DM and HIV.
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Affiliation(s)
- A Davis
- Columbia University, New York City, New York, USA
| | - A Terlikbayeva
- Columbia University Global Health Research Center of Central Asia, Almaty, Kazakhstan
| | - A Aifah
- Columbia University, New York City, New York, USA
| | - S Hermosilla
- Columbia University, New York City, New York, USA
| | - Z Zhumadilov
- Center for Life Sciences, Nazarbayev University, Astana, Kazakhstan
| | - E Berikova
- National Center for Tuberculosis, Almaty, Kazakhstan
| | - S Rakhimova
- Center for Life Sciences, Nazarbayev University, Astana, Kazakhstan
| | - S Primbetova
- Columbia University Global Health Research Center of Central Asia, Almaty, Kazakhstan
| | - M Darisheva
- Columbia University Global Health Research Center of Central Asia, Almaty, Kazakhstan
| | - N Schluger
- Columbia University, New York City, New York, USA
| | - N El-Bassel
- Columbia University, New York City, New York, USA
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16
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Murphy A, Johnson CO, Roth GA, Forouzanfar MH, Naghavi M, Ng M, Pogosova N, Vos T, Murray CJL, Moran AE. Ischaemic heart disease in the former Soviet Union 1990-2015 according to the Global Burden of Disease 2015 Study. Heart 2017; 104:58-66. [PMID: 28883037 PMCID: PMC5749345 DOI: 10.1136/heartjnl-2016-311142] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/22/2017] [Accepted: 05/30/2017] [Indexed: 12/16/2022] Open
Abstract
Objective The objective of this study was to compare ischaemic heart disease (IHD) mortality and risk factor burden across former Soviet Union (fSU) and satellite countries and regions in 1990 and 2015. Methods The fSU and satellite countries were grouped into Central Asian, Central European and Eastern European regions. IHD mortality data for men and women of any age were gathered from national vital registration, and age, sex, country, year-specific IHD mortality rates were estimated in an ensemble model. IHD morbidity and mortality burden attributable to risk factors was estimated by comparative risk assessment using population attributable fractions. Results In 2015, age-standardised IHD death rates in Eastern European and Central Asian fSU countries were almost two times that of satellite states of Central Europe. Between 1990 and 2015, rates decreased substantially in Central Europe (men −43.5% (95% uncertainty interval −45.0%, −42.0%); women −42.9% (−44.0%, −41.0%)) but less in Eastern Europe (men −5.6% (−9.0, –3.0); women −12.2% (−15.5%, −9.0%)). Age-standardised IHD death rates also varied within regions: within Eastern Europe, rates decreased −51.7% in Estonian men (−54.0, −47.0) but increased +19.4% in Belarusian men (+12.0, +27.0). High blood pressure and cholesterol were leading risk factors for IHD burden, with smoking, body mass index, dietary factors and ambient air pollution also ranking high. Conclusions Some fSU countries continue to experience a high IHD burden, while others have achieved remarkable reductions in IHD mortality. Control of blood pressure, cholesterol and smoking are IHD prevention priorities.
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Affiliation(s)
- Adrianna Murphy
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Catherine O Johnson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Gregory A Roth
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.,Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Mohammad H Forouzanfar
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Mohsen Naghavi
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Marie Ng
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Nana Pogosova
- National Research Centre for Preventive Medicine, Moscow, Russia
| | - Theo Vos
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Christopher J L Murray
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Andrew E Moran
- Division of General Medicine, Department of Medicine, Columbia University Medical Center, New York, New York, USA
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17
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Lastunen A, Laatikainen T, Isoaho H, Lazutkina G, Tossavainen K. Family members’ and best friend’s smoking influence on adolescent smoking differs between Eastern Finland and Russian Karelia. Scand J Public Health 2017; 45:789-798. [DOI: 10.1177/1403494817723550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: The aim of this study was to find out whether family members’ (mother, father, siblings) and best friend’s smoking is related to 9th grade pupils’ daily smoking in Eastern Finland and in the Pitkäranta district, in the Republic of Karelia, Russia, and whether these relations have changed in these two culturally very different neighbourhood countries from 1995 to 2013. Methods: Data comprised four cross-sectional studies in all schools of the Pitkäranta region and selected schools in Eastern Finland. In data analyses, structural equation modelling techniques were used. Results: Our findings showed that best friend’s smoking had the strongest influence on adolescents’ smoking in both countries and study years (p < .01). The relations among family members were highly different between Pitkäranta and Eastern Finland, particularly in 2013. Conclusions: Results suggest that health promotion in schools should take into account cultural impacts and pay special attention to pupils who have family members and friends who smoke.
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Affiliation(s)
- Annamari Lastunen
- Department of Nursing Science, University of Eastern Finland, Finland
| | - Tiina Laatikainen
- National Institute for Health and Welfare, Finland/ Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | | | - Galina Lazutkina
- State Budgetary Health Care Institution of the Republic of Karelia, Pitkäranta Central Hospital, Republic of Karelia, Russia
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18
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Magee MJ, Darchia L, Kipiani M, Chakhaia T, Kempker RR, Tukvadze N, Berg CJ, Blumberg HM. Smoking behavior and beliefs about the impact of smoking on anti-tuberculosis treatment among health care workers. Int J Tuberc Lung Dis 2017; 21:1049-1055. [PMID: 28664827 DOI: 10.5588/ijtld.17.0023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Tuberculosis (TB) health care facilities throughout Georgia. OBJECTIVE To describe smoking behaviors among health care workers (HCWs) at TB facilities and determine HCWs' knowledge and beliefs regarding the impact of tobacco use on anti-tuberculosis treatment. DESIGN Cross-sectional survey from May to December 2014 in Georgia. Adult HCWs (age 18 years) at TB facilities were eligible. We administered a 60-question anonymous survey about tobacco use and knowledge of the effect of smoking on anti-tuberculosis treatment. RESULTS Of the 431 HCWs at TB facilities who participated, 377 (87.5%) were female; the median age was 50 years (range 20-77). Overall, 59 (13.7%) HCWs were current smokers and 35 (8.1%) were past smokers. Prevalence of current smoking was more common among physicians than among nurses (18.6% vs. 7.9%, P < 0.0001). Among HCWs, 115 (26.7%) believed smoking does not impact anti-tuberculosis treatment, and only 25.3% of physicians/nurses received formal training in smoking cessation approaches. Physicians who smoked were significantly more likely to believe that smoking does not impact anti-tuberculosis treatment than non-smoking physicians (aOR 5.11, 95%CI 1.46-17.90). CONCLUSION Additional education about the effect of smoking on TB treatment outcomes is needed for staff of TB health care facilities in Georgia. Nurses and physicians need more training about smoking cessation approaches for patients with TB.
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Affiliation(s)
- M J Magee
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - L Darchia
- National Center for Tuberculosis and Lung Disease, Tbilisi, Georgia
| | - M Kipiani
- National Center for Tuberculosis and Lung Disease, Tbilisi, Georgia
| | - T Chakhaia
- National Center for Tuberculosis and Lung Disease, Tbilisi, Georgia
| | - R R Kempker
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta
| | - N Tukvadze
- National Center for Tuberculosis and Lung Disease, Tbilisi, Georgia
| | - C J Berg
- Department of Behavioral Sciences and Health Education
| | - H M Blumberg
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Department of Epidemiology and Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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19
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Stefler D, Murphy M, Irdam D, Horvat P, Jarvis M, King L, McKee M, Bobak M. Smoking and Mortality in Eastern Europe: Results From the PrivMort Retrospective Cohort Study of 177 376 Individuals. Nicotine Tob Res 2017; 20:749-754. [DOI: 10.1093/ntr/ntx122] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 05/30/2017] [Indexed: 11/14/2022]
Affiliation(s)
- Denes Stefler
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Michael Murphy
- Department of Social Policy, London School of Economics, London, UK
| | - Darja Irdam
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Pia Horvat
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Martin Jarvis
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Lawrence King
- Department of Sociology, University of Cambridge, Cambridge, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
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20
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Quirmbach D, Gerry CJ. Gender, education and Russia's tobacco epidemic: A life-course approach. Soc Sci Med 2016; 160:54-66. [PMID: 27209365 DOI: 10.1016/j.socscimed.2016.05.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 04/26/2016] [Accepted: 05/04/2016] [Indexed: 10/21/2022]
Abstract
While a number of studies, based on cross-sectional data for Russia, have documented strong increases in female smoking during the past two decades, the analysis of longer-term trends in smoking prevalence is hampered by the lack of representative data for the Soviet era. In this paper we create life-course smoking histories based on retrospective data from the Russia Longitudinal Monitoring Survey of HSE (RLMS-HSE) and the Global Adult Tobacco Survey (GATS) which allow us to examine the dynamics of smoking patterns over the past 7 decades. We find that smoking rates differ most strongly by gender within all cohorts, but that this differential has decreased over time, driven by increases in female smoking and more recently by decreases in smoking among men. For both genders we observe that the education gradient has become steeper over time, with smoking rates having increased at a higher rate among those with the lowest educational attainment. These findings suggest that the development of smoking in Russia mirrors that described in the model of the tobacco epidemic and observed in Western high-income countries.
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Affiliation(s)
- Diana Quirmbach
- London School of Economics and Political Science, Department of Social Policy, Houghton Street, London, WC2A 2AE, United Kingdom; International Centre for Health Economics, Management and Policy, HSE University, St Petersburg, Russian Federation.
| | - Christopher J Gerry
- International Centre for Health Economics, Management and Policy, HSE University, St Petersburg, Russian Federation
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21
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Mentzakis E, Roberts B, Suhrcke M, McKee M. Psychological Distress and Problem Drinking. HEALTH ECONOMICS 2016; 25:337-356. [PMID: 25640167 DOI: 10.1002/hec.3143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 10/06/2014] [Accepted: 12/05/2014] [Indexed: 06/04/2023]
Abstract
We examine the influence of harmful alcohol use on mental health using a flexible two-step instrumental variables approach and household survey data from nine countries of the former Soviet Union. Using alcohol advertisements to instrument for alcohol, we show that problem drinking has a large detrimental effect on psychological distress, with problem drinkers exhibiting a 42% increase in the number of mental health problems reported and a 15% higher chance of reporting very poor mental health. Ignoring endogeneity leads to an underestimation of the damaging effect of excessive drinking. Findings suggest that more effective alcohol policies and treatment services in the former Soviet Union may have added benefits in terms of reducing poor mental health.
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Affiliation(s)
| | - Bayard Roberts
- European Centre on Health of Societies in Transition, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Marc Suhrcke
- Centre for Health Economics, University of York, York, UK
| | - Martin McKee
- European Centre on Health of Societies in Transition, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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22
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Berg CJ, Topuridze M, Maglakelidze N, Starua L, Shishniashvili M, Kegler MC. Reactions to smoke-free public policies and smoke-free home policies in the Republic of Georgia: results from a 2014 national survey. Int J Public Health 2016; 61:409-16. [PMID: 26841891 DOI: 10.1007/s00038-016-0793-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 01/14/2016] [Accepted: 01/20/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES We examined receptivity to public smoke-free policies and smoke-free home status among adults in the Republic of Georgia. METHODS In Spring 2014, we conducted a national household survey of 1163 adults. RESULTS Our sample was on average 42.4 years old, 51.1 % male, and 43.2 % urban. Current smoking prevalence was 54.2 % in men and 6.5 % in women. Notably, 42.2 % reported daily secondhand smoke exposure (SHSe). Past week SHSe was 29.9 % in indoor public places and 33.0 % in outdoor public places. The majority reported no opposition to public smoke-free policies. Correlates of greater receptivity to public policies included being older, female, and a nonsmoker. Past week SHSe in homes was 54.2 %; 38.8 % reported daily SHSe at home. Only 14.3 % reported complete smoke-free home policies; 39.0 % had partial policies. The only correlate of allowing smoking in the home was being a smoker. Among smokers, correlates of allowing smoking in the home were being male and lower confidence in quitting. CONCLUSIONS SHSe is prevalent in various settings in Georgia, requiring efforts to promote support for public smoke-free policies and implementation of personal policies.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, 1518 Clifton Road, NE, Room 524, Atlanta, GA, 30322, USA.
| | | | | | - Lela Starua
- National Center for Disease Control, Tbilisi, Georgia
| | | | - Michelle C Kegler
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, 1518 Clifton Road, NE, Room 524, Atlanta, GA, 30322, USA
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Berg CJ, Smith SA, Bascombe TM, Maglakelidze N, Starua L, Topuridze M. Smoke-Free Public Policies and Voluntary Policies in Personal Settings in Tbilisi, Georgia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:156. [PMID: 26821035 PMCID: PMC4772176 DOI: 10.3390/ijerph13020156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 12/31/2015] [Accepted: 01/21/2016] [Indexed: 01/10/2023]
Abstract
Georgia has limited tobacco control policies, particularly in the area of smoke-free public policies, which may influence the adoption of smoke-free home rules. We qualitatively examined knowledge about and reactions to public and personal smoke-free policies among Tbilisi residents. In Spring 2014, we conducted six focus groups among 47 total participants—two among male smokers, one among male nonsmokers, two among female smokers, and one among female nonsmokers. Our sample was 48.9% male and 70.2% past 30-day smokers. Most believed that SHS was dangerous, with particular concern regarding the impact of SHS on children and pregnant women. Many had misconceptions about how to protect others from SHS and the effectiveness of some approaches. Many indicated that they had some type of home rules, but few reported a complete ban on smoking in the home. Even when some restrictions were in place, they rarely were effective or enforced. Common concerns about the partial smoke-free public policy in Georgia included its economic impact, perceived discrimination among smokers, and the policy being against the Georgian culture. These concerns were heightened when participants were asked about the possible implementation of a complete smoke-free policy. Educational programs are needed to promote smoke-free policies in Georgia.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, 1518 Clifton Road, NE, Room 524, Atlanta, GA 30322, USA.
| | - Samantha A Smith
- Health Promotion and Wellness Directorate Army Public Health Center, 8506 Dawnridge Dr., Houston, TX 77071, USA.
| | - Ta Misha Bascombe
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30322, USA.
| | - Nino Maglakelidze
- National Center for Disease Control, 9 M. Asatiani st. Tbilisi, GA 0177, USA.
| | - Lela Starua
- National Center for Disease Control, 9 M. Asatiani st. Tbilisi, GA 0177, USA.
| | - Marina Topuridze
- National Center for Disease Control, 9 M. Asatiani st. Tbilisi, GA 0177, USA.
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Cook S, Quint JK, Vasiljev M, Leon DA. Self-reported symptoms of chronic cough and breathlessness in working-age men in the city of Izhevsk, Russia: associations with cardiovascular disease risk factors and comorbidities. BMJ Open Respir Res 2015; 2:e000104. [PMID: 26793315 PMCID: PMC4709862 DOI: 10.1136/bmjresp-2015-000104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/19/2015] [Accepted: 10/20/2015] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Very little is known about the prevalence of respiratory symptoms or their associations with other health conditions in Russia. METHODS Between 2008 and 2010, a sample of 983 men resident in Izhevsk, Russia, took part in a cross-sectional survey. Presence of respiratory symptoms was determined from self-report of chronic productive cough and breathlessness assessed using the British Medical Research Council (MRC) breathlessness scale. Self-reported physical and mental health were measured using the 12-Item Short-Form Health Survey (SF-12). Hypertension was assessed from mean blood pressure measured at the health check and/or self-reported use of antihypertensive medication. Other comorbidities were assessed from self-report. Logistic regression models were fitted assessing the association between respiratory symptoms and comorbidities. Linear regression models were fitted to investigate the association between respiratory symptoms and self-reported health scores. All models were adjusted for age, education and smoking status. RESULTS The age-standardised prevalence of cough and breathlessness was 20.9% (prevalence with breathlessness MRC grade 3 or above 3.7%). The majority of men with respiratory symptoms (87.3%) were current smokers. Cough and breathlessness were associated with substantially worse self-reported physical and mental health (test for trend with severity of breathlessness p<0.001). Those with chronic cough and grade 3 or above breathlessness had higher odds of having hypertension (OR 3.03; 95% CI 1.36 to 6.74), diabetes (OR 10.55; 95% CI 2.69 to 41.37), angina pectoris (OR 7.54; 95% CI 3.61 to 15.73), previous myocardial infarction (OR 7.61; 95% CI 2.10 to 27.4) and previous stroke (OR 6.61; 95% CI 1.75 to 23.34) compared with those without respiratory symptoms. CONCLUSIONS The prevalence of respiratory symptoms was high. Strong associations were found between respiratory symptoms and cardiovascular comorbidities. These are of particular importance given the extremely high level of cardiovascular disease mortality in Russia.
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Affiliation(s)
- Sarah Cook
- Department of Non Communicable Disease Epidemiology , London School of Hygiene & Tropical Medicine , London , UK
| | - Jennifer K Quint
- Department of Non Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK
| | | | - David A Leon
- Department of Non Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Arctic University of Norway, UiT, Tromsø, Norway
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Effect of Length of Stay on Smoking among Turkish and Eastern European Immigrants in Germany--Interpretation in the Light of the Smoking Epidemic Model and the Acculturation Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15925-36. [PMID: 26694430 PMCID: PMC4690966 DOI: 10.3390/ijerph121215030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/08/2015] [Accepted: 12/10/2015] [Indexed: 12/03/2022]
Abstract
Background: We analyzed changes in smoking by length of stay among immigrants in Germany and related them to the “smoking epidemic” model and the acculturation theory. Methods: We used data from a longitudinal survey (German Socio-economic Panel). Immigrants were identified by country of birth (Turkey: respondents n = 828, observations n = 3871; Eastern Europe: respondents n = 2009, observations n = 7202; non-immigrants: respondents n = 34,011, observations n = 140,701). Smoking status data was available for nine years between 1998 and 2012. Length of stay (LOS, in years) was used as proxy for acculturation. We calculated smoking prevalences, prevalence ratios and a random intercept multilevel logistic regression model. Results: With each year spent in Germany, smoking prevalence increases among Turkish women (OR = 1.14 (95%CI = 1.06–1.21)) and slightly decreases among men. Recently immigrated Turkish women smoke less than non-immigrant women (0–5 years: SPR = 0.25 (95%CI = 0.10–0.57)); prevalences converge with increasing LOS (31+ years: SPR = 1.25 (95%CI = 1.06–1.48)). Among Eastern European immigrants no significant changes were apparent. Conclusions: Immigrants from Turkey “import” their smoking prevalence from a country which is in the earlier stages of the “smoking epidemic”. With increasing LOS (thus, advancing acculturation), they “move” to the later stages. Anti-smoking interventions should consider different smoking attitudes in Turkey/Germany and need to discourage women from initiating smoking. Future research should also identify reasons for the possible differences between immigrant groups.
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Özdemir A, Koçoğlu G. Self-concept and social comparison and their relation with smoking and alcohol consumption in adolescents. Int J Adolesc Med Health 2015; 29:/j/ijamh.ahead-of-print/ijamh-2015-0061/ijamh-2015-0061.xml. [PMID: 26565532 DOI: 10.1515/ijamh-2015-0061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 09/16/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Some attitudes that possess certain risks such as smoking and alcohol consumption rate are increasing among the adolescent age group. For this reason it is very important to shape the attitudes of adolescents during their growth period. OBJECTIVE The aim of this study is to investigate the association of social comparison and self-concept of adolescents' relation with smoking and alcohol consumption. SUBJECTS Study was conducted as a prospective study in nine high schools which are located in city of Bursa, Turkey. Nine hundred and fifty-three (n=953) students were included. METHODS Data were gathered using a questionnaire form especially developed by researchers for this study according to relevant literature. For social comparison and self-concept evaluation Piers-Harris Self Concept Scale and Social Comparison Scale of Gilbert were used. RESULTS The mean age was 15.74±1.27 and 411 of cases (43.1%) were male. It was determined that smoking and alcohol consumption increased as the age of adolescents' age increases. Rate of smoking and alcohol consumption was significantly higher in males compared to females. The mean self-concept scale score of the cases who smoke (52.30±11.01) were found to be lower than the non-smokers (56.07±10.13). The mean social comparison scale score of smoking adolescents' (70.25±23.99) was higher than the non-smokers (69.43±25.47). CONCLUSION The social comparison scale scores were found to be higher in adolescents who consume alcohol and smoke tobacco. In contrast to this result self-concept scale scores were low. As a conclusion this study reveals that attitudes such as smoking and alcohol consumption are mostly influenced by self-concept of the adolescents and family attitudes towards adolescents.
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Aura A, Laatikainen T, Isoaho H, Bykachev K, Lazutkina G, Tossavainen K. Changes in smoking among adolescents in the Republic of Karelia, Russia and Eastern Finland from 1995 to 2013. Scand J Public Health 2015; 43:752-60. [PMID: 26163022 DOI: 10.1177/1403494815587437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2015] [Indexed: 11/17/2022]
Abstract
AIMS The aim of this study was to compare the prevalence of smoking, smoking experimentation and future intention to smoke in the Pitkäranta district, the Republic of Karelia, Russia and Eastern Finland in the years 1995 and 2013. METHODS Cross-sectional studies were carried out among 15-year-old ninth grade adolescents in all schools in the Pitkäranta region (1995: n=385, response rate 95%; 2013: 182, response rate 98%) and a sample of schools in Eastern Finland (1995: n=2098, response rate 91%; 2013: 635 response rate 95%). RESULTS The daily smoking prevalence among adolescents did not change either in Eastern Finland or in the Pitkäranta district from 1995 to 2013. However, smoking among Finnish adolescents was more common than among Russians (p<0.001) and boys, in general, smoke more commonly than girls (p<0.001). In Finland, early smoking experimentations declined by half among both genders but in Pitkäranta the girls' smoking experimentations tripled (relative risk 3.03, 95% confidence interval 1.76-5.20) from 1995 to 2013. The combined effect of country and gender was significant (p<0.001) for future intention to smoke. In Finland future intentions to smoke were very similar in boys and girls compared with obvious gender differences in Russia. CONCLUSIONS These results suggest that more attention should be paid for programmes that consider better gender and culture-specific issues in preventing initiation of smoking and promoting an anti-smoking climate in societies.
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Affiliation(s)
- Annamari Aura
- Department of Nursing Science, University of Eastern Finland, Finland
| | - Tiina Laatikainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland National Institute for Health and Welfare, Finland
| | | | - Kirsi Bykachev
- Department of Nursing Science, University of Eastern Finland, Finland
| | - Galina Lazutkina
- State Budgetary Health Care Institution of the Republic of Karelia, Russian Federation
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Prevalence and Social Determinants of Smoking in 15 Countries from North Africa, Central and Western Asia, Latin America and Caribbean: Secondary Data Analyses of Demographic and Health Surveys. PLoS One 2015; 10:e0130104. [PMID: 26131888 PMCID: PMC4488463 DOI: 10.1371/journal.pone.0130104] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 05/15/2015] [Indexed: 11/24/2022] Open
Abstract
Background Article 20 of the World Health Organisation Framework Convention on Tobacco Control calls for a cross-country surveillance of tobacco use through population-based surveys. We aimed to provide country-level prevalence estimates for current smoking and current smokeless tobacco use and to assess social determinants of smoking. Methods Data from Demographic and Health Surveys done between 2005 and 2012, among men and women from nine North African, Central and West Asian countries and six Latin American and Caribbean countries were analyzed. Weighted country-level prevalence rates were estimated for ‘current smoking’ and ‘current use of smokeless tobacco (SLT) products’ among men and women. In each country, social determinants of smoking among men and women were assessed by binary logistic regression analyses by including men's and women's sampling weights to account for the complex survey design. Findings Prevalence of smoking among men was higher than 40% in Armenia (63.1%), Moldova (51.1%), Ukraine (52%), Azerbaijan (49.8 %), Kyrgyz Republic (44.3 %) and Albania (42.52%) but the prevalence of smoking among women was less than 10% in most countries except Ukraine (14.81%) and Jordan (17.96%). The prevalence of smokeless tobacco use among men and women was less than 5% in all countries except among men in the Kyrgyz Republic (10.6 %). Smoking was associated with older age, lower education and poverty among men and higher education and higher wealth among women. Smoking among both men and women was associated with unskilled work, living in urban areas and being single. Conclusion Smoking among men was very high in Central and West Asian countries. Social pattern of smoking among women that was different from men in education and wealth should be considered while formulating tobacco control policies in some Central and West Asian countries.
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Gegia M, Magee MJ, Kempker RR, Kalandadze I, Chakhaia T, Golub JE, Blumberg HM. Tobacco smoking and tuberculosis treatment outcomes: a prospective cohort study in Georgia. Bull World Health Organ 2015; 93:390-9. [PMID: 26240460 PMCID: PMC4450709 DOI: 10.2471/blt.14.147439] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 01/24/2015] [Accepted: 02/16/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To assess the effect of tobacco smoking on the outcome of tuberculosis treatment in Tbilisi, Georgia. METHODS We conducted a prospective cohort study of adults with laboratory-confirmed tuberculosis from May 2011 to November 2013. History of tobacco smoking was collected using a standardized questionnaire adapted from the global adult tobacco survey. We considered tuberculosis therapy to have a poor outcome if participants defaulted, failed treatment or died. We used multivariable regressions to estimate the risk of a poor treatment outcome. FINDINGS Of the 591 tuberculosis patients enrolled, 188 (31.8%) were past smokers and 271 (45.9%) were current smokers. Ninety (33.2%) of the current smokers and 24 (18.2%) of the participants who had never smoked had previously been treated for tuberculosis (P < 0.01). Treatment outcome data were available for 524 of the participants, of whom 128 (24.4%) - including 80 (32.9%) of the 243 current smokers and 21 (17.2%) of the 122 individuals who had never smoked - had a poor treatment outcome. Compared with those who had never smoked, current smokers had an increased risk of poor treatment outcome (adjusted relative risk, aRR: 1.70; 95% confidence interval, CI: 1.00-2.90). Those who had ceased smoking more than two months before enrolment did not have such an increased risk (aRR: 1.01; 95% CI: 0.51-1.99). CONCLUSION There is a high prevalence of smoking among patients with tuberculosis in Georgia and smoking increases the risk of a poor treatment outcome.
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Affiliation(s)
- Medea Gegia
- University Research Company LLC Branch in Georgia, United States Agency for International Development Georgia Tuberculosis Prevention Project, Tbilisi, Georgia
| | - Matthew J Magee
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, One Park Place NE, Atlanta, GA 30303, United States of America (USA)
| | - Russell R Kempker
- Department of Medicine, Emory University School of Medicine, Atlanta, USA
| | | | - Tsira Chakhaia
- University Research Company LLC Branch in Georgia, United States Agency for International Development Georgia Tuberculosis Prevention Project, Tbilisi, Georgia
| | | | - Henry M Blumberg
- Department of Medicine, Emory University School of Medicine, Atlanta, USA
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Klumbiene J, Sakyte E, Petkeviciene J, Prattala R, Kunst AE. The effect of tobacco control policy on smoking cessation in relation to gender, age and education in Lithuania, 1994-2010. BMC Public Health 2015; 15:181. [PMID: 25886060 PMCID: PMC4349467 DOI: 10.1186/s12889-015-1525-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 02/12/2015] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the association between tobacco control policies and trends in smoking cessation according to gender, age and educational level in Lithuania in 1994-2010. METHODS The data were obtained from nine cross-sectional postal surveys conducted biennially within the framework of Finbalt Health Monitor project during 1994-2010. Each survey was based on a nationally representative random sample drawn from the National population register. The sample consisted of 3000 citizens aged 20-64 in 1994-2008 surveys and 4000 in the 2010 survey. In total, 17161 individuals participated in all surveys. The development of tobacco control policy in Lithuania was assessed using the Tobacco Control Scale (TCS). The association of the TCS scores with short-term and long-term quitting according to gender, age and education was examined using logistic regression analysis with control for secular trends. RESULTS Over the last two decades, a large improvement in the development of tobacco control policy has been achieved in Lithuania. At the same time, this progress was associated with the increase in smoking cessation. A significant increase in both short-term and long-term quit ratios was found among people aged 20-44. An increase by 10 points on the TCS was associated with 17% increase in the odds of short-term quitting and with 15% increase in the odds of long-term quitting. The association between tobacco control policies and long-term quitting was stronger among younger than older people. No differential effect of tobacco control policies on smoking cessation was found in relation to gender and educational level. CONCLUSIONS The improvement in Lithuanian tobacco control policies was associated with an increase in smoking cessation in long-term perspective. These policies have not only benefitted highly educated groups, but lower educated groups as well. Nonetheless, further development of comprehensive tobacco control policies is needed in order to decrease social inequalities in smoking cessation.
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Affiliation(s)
- Jurate Klumbiene
- Public Health Faculty, Lithuanian University of Health Sciences, Siaures av. 57, LT-49264, Kaunas, Lithuania.
| | - Edita Sakyte
- Public Health Faculty, Lithuanian University of Health Sciences, Siaures av. 57, LT-49264, Kaunas, Lithuania.
| | - Janina Petkeviciene
- Public Health Faculty, Lithuanian University of Health Sciences, Siaures av. 57, LT-49264, Kaunas, Lithuania.
| | - Ritva Prattala
- National Institute for Health and Welfare, Helsinki, Finland.
| | - Anton E Kunst
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
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Stickley A, Koyanagi A, Roberts B, Leinsalu M, Goryakin Y, McKee M. Smoking status, nicotine dependence and happiness in nine countries of the former Soviet Union. Tob Control 2015; 24:190-7. [DOI: 10.1136/tobaccocontrol-2014-052092] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Vlasoff T, Laatikainen T, Korpelainen V, Uhanov M, Pokusajeva S, Tossavainen K, Vartiainen E, Puska P. Trends and educational differences in non-communicable disease risk factors in Pitkäranta, Russia, from 1992 to 2007. Scand J Public Health 2014; 43:91-8. [PMID: 25420711 DOI: 10.1177/1403494814556646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM Mortality and morbidity from non-communicable diseases (NCDs) is a major public health problem in Russia. The aim of the study was to examine trends and educational differences from 1992 to 2007 in NCD risk factors in Pitkäranta in the Republic of Karelia, Russia. METHODS Four cross-sectional population health surveys were carried out in the Pitkäranta region, Republic of Karelia, Russia, in 1992, 1997, 2002, and 2007. An independent random sample of 1000 persons from the general population aged 25-64 years was studied in each survey round. The total number of respondents in the four surveys was 2672. The surveys included a questionnaire, physical measurements, and blood sampling, and they were carried out following standard protocols. RESULTS The NCD risk factor trends generally increased in Pitkäranta during the study period with the exception of systolic blood pressure and smoking among men. Especially significant increases were observed in alcohol consumption among both sexes and in smoking among women. Educational differences and differences in trends were relatively small with the exception of a significant increase in smoking in the lowest female educational category. CONCLUSIONS Trends showing an increase in some major NCD risk factors and signs of emerging socio-economic differences call for stronger attention to effective health promotion and preventive policies in Russia.
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Affiliation(s)
| | - Tiina Laatikainen
- Division of Welfare and Health Promotion, National Institute for Health and Welfare, Finland Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland North Karelia Hospital District, Finland
| | | | - Mihail Uhanov
- Central Hospital of Pitkäranta, Republic of Karelia, Russia
| | | | | | - Erkki Vartiainen
- Division of Welfare and Health Promotion, National Institute for Health and Welfare, Finland
| | - Pekka Puska
- Division of Welfare and Health Promotion, National Institute for Health and Welfare, Finland
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Selivanova A, Cramm JM. The relationship between healthy behaviors and health outcomes among older adults in Russia. BMC Public Health 2014; 14:1183. [PMID: 25410349 PMCID: PMC4251861 DOI: 10.1186/1471-2458-14-1183] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 11/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Worldwide, populations are aging and the health of elderly individuals is deteriorating. Healthy habits may slow the process of health deterioration, but research investigating relationships between health and various health behaviors is lacking. This study aimed to investigate the relationships between health and health behaviors (alcohol consumption, smoking, dietary behavior, and physical activity) among older men and women in Russia. METHODS Wave 1 Study on Global AGEing and Adult Health data (2007-2010) collected in the European portion of the Russian Federation, southern federal districts of the European portion of Russia and from the Asian portion of the country were used for this study. Relationships between self-rated health and four risk behavior measures [physical activity, alcohol consumption, smoking, and dietary behavior (fruit and vegetable consumption)] were examined. Analyses controlled for several socioeconomic factors: gender, age, marital status, educational level, area of residence, ethnicity, and employment status. To estimate the effect of healthy behavior on the probability that participants rated their health as very good/good/moderate/bad/very bad, the ordered logit model and average marginal effects were used. RESULTS Sufficient physical activity affected self-rated health most significantly in both genders, whereas excessive alcohol consumption had no significant effect. Smoking had explanatory power (being a current smoker decreased the probability of a very good health assessment and increased the probability of a very bad rating compared with being a non-smoker) among men, but not women. Fruit and vegetable consumption had a strong effect on self-rated health among women, but not men. CONCLUSIONS The results of this study indicate that health behaviors, especially physical activity, are important for the health of Russia's older population. Smoking behavior had a strong impact on the health of men, whereas fruit and vegetable consumption was a relevant factor for women. Policies promoting smoking reduction and healthy diet should thus target older men and women, respectively.
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Affiliation(s)
- Anna Selivanova
- />Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Jane M Cramm
- />Institute of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000, DR Rotterdam, the Netherlands
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Goryakin Y, Suhrcke M, Roberts B, McKee M. Mental health inequalities in 9 former Soviet Union countries: evidence from the previous decade. Soc Sci Med 2014; 124:142-51. [PMID: 25461871 DOI: 10.1016/j.socscimed.2014.11.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In the previous two decades, countries of the former Soviet Union underwent substantive economic and social changes. While there has been some limited evidence on the relationship between socioeconomic well-being and mental health in the developing and transitional economies, the evidence on economic inequalities in mental health has so far been scarce. In this paper, we analyse two unique datasets collected in 2001 (N = 18,428) and in 2010 (N = 17,998) containing data on 9 countries of the former Soviet Union, exploring how mental health inequalities have changed between 2001 and 2010. Using regression analysis, as well as the indirect standardization approach, we found that mental health appears to have substantially improved in most studied countries during the past decade. Specifically, both the proportion of people with poor mental health, as well as wealth-related inequalities in poor mental health, decreased in almost all countries, except Georgia. Hence, we did not find evidence of a trade-off between changes in average and distributional mental health indicators between 2001 and 2010. Our findings give ground for optimism that at least on these measures, the most difficult times associated with the transition to a market economy in this region may be coming to an end.
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Affiliation(s)
- Yevgeniy Goryakin
- Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.
| | - Marc Suhrcke
- Centre for Health Economics, University of York, York YO10 5DD, UK
| | - Bayard Roberts
- European Centre on Health of Societies in Transition, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 5-17 Tavistock Place, London WC1H 9SH, UK
| | - Martin McKee
- European Centre on Health of Societies in Transition, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 5-17 Tavistock Place, London WC1H 9SH, UK
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Igissinov N, Zatoskikh V, Moore MA, Igissinov S, Aldiyarova G, Tokmurziyeva G, Valieva S, Alpeissova S, Sarsenova S. Laryngeal cancer in Kazakhstan - ethnic, age and gender differences over time. Asian Pac J Cancer Prev 2014; 14:7033-8. [PMID: 24377645 DOI: 10.7314/apjcp.2013.14.11.7033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The purpose of the present study was to provide an assessment of the incidence of cancer of the larynx in Kazakhstan with especial attention to ethnicity and gender, as well as age. The retrospective design covered all new cases of laryngeal cancer in 11 years (1999-2009). The total number was 4,967 cases, 4,535 (91.3%) in males and 432 (8.7%) in women, with a gender ratio of 10.5:1. Patients of Kazakh (31.2%) and Russian (51.4%) ethnicity accounted for the vast majority (82.6%), with Russians predominating in both sexes, but particularly in females. Age peak in Kazakhs was 70 years and older (14.6 ± 0.70/0000), and in Russians was 60-69 years (21.6 ± 1.30/0000). In the dynamics, the rates had the tendency to decrease more markedly in Russian than Kazakh men, especially in the younger groups, while increase was noted in the youngest females of both ethnicities, but again greater in Russians, presumably reflecting change in underlying lifestyle factors.
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Affiliation(s)
- Nurbek Igissinov
- Central Asia Cancer Institute and Research Institute of Traumatology and Orthopedics, Astana, Kazakhstan E-mail : nurbek_igisinov@ mail.ru,
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Pärna K, Pürjer ML, Ringmets I, Tekkel M. Educational differences in cigarette smoking among adult population in Estonia, 1990-2010: does the trend fit the model of tobacco epidemic? BMC Public Health 2014; 14:709. [PMID: 25012070 PMCID: PMC4226950 DOI: 10.1186/1471-2458-14-709] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 07/02/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In developed countries, smoking spreads through society like an epidemic in which adults from higher socioeconomic groups are the first to adopt and earlier to quit smoking, and in which exists a lag in adoption of smoking between men and women. The objective of this study was to describe trends in daily and occasional smoking, to investigate association between smoking status and education, and to examine if the associations in 1990-2010 in Estonia fit the pattern predicted by the model of tobacco epidemic. METHODS The study was based on a 20-64-year-old subsample (n = 18740) of nationally representative postal cross-sectional surveys conducted every second year in Estonia during 1990-2010. Cigarette smoking and education were examined. χ2 test for trend was used to determine daily and occasional smoking trends over study years. Multinomial logistic regression model was used to test educational differences in daily and occasional smoking for every study year. Adjusted relative risk ratios (RRRs) with 95% confidence intervals were calculated. RESULTS In 1990-2010, daily smoking varied largely between genders showing decreasing trend among men, but not among women. In 2010, one third of men and one fifth of women were daily smokers. Daily smoking was not clearly associated with education among men in 1990-1994 and among women in 1990-2000. Men revealed inverse relationship between daily smoking and education since 1996, but women since 2002. In 2010, compared to men and women with higher education, relative risk ratio of daily smoking was 2.92 (95% CI = 2.01-4.25) among men and 2.29 (95% CI = 1.65-3.17) among women with secondary education, but 4.98 (95% CI 3.12-7.94) among men and 6.62 (95% CI = 4.07-10.76) among women with basic education.In 1990-2010, occasional smoking was stable and similar (varying between 7-10%) among men and women, no association with education was found. CONCLUSIONS Daily smoking patterns in Estonia fit the model of tobacco epidemic in developed countries. Educational differences in daily smoking highlight the importance of addressing smoking behaviour in the general population by educational subgroups in Estonia.
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Affiliation(s)
- Kersti Pärna
- Department of Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
| | - Mari-Liis Pürjer
- Department of Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
- Estonian Cancer Registry, National Institute for Health Development, Hiiu 42, 10619 Tallinn, Estonia
| | - Inge Ringmets
- Department of Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia
| | - Mare Tekkel
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 10619 Tallinn, Estonia
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Affiliation(s)
- Olena O Seminog
- Unit of Health-Care Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
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Finegold JA, Asaria P, Francis DP. Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations. Int J Cardiol 2013; 168:934-45. [PMID: 23218570 PMCID: PMC3819990 DOI: 10.1016/j.ijcard.2012.10.046] [Citation(s) in RCA: 530] [Impact Index Per Article: 48.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 10/24/2012] [Accepted: 10/28/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Ischaemic heart disease (IHD) is the leading cause of death worldwide. The World Health Organisation (WHO) collects mortality data coded using the International Statistical Classification of Diseases (ICD) code. METHODS We analysed IHD deaths world-wide between 1995 and 2009 and used the UN population database to calculate age-specific and directly and indirectly age-standardised IHD mortality rates by country and region. RESULTS IHD is the single largest cause of death worldwide, causing 7,249,000 deaths in 2008, 12.7% of total global mortality. There is more than 20-fold variation in IHD mortality rates between countries. Highest IHD mortality rates are in Eastern Europe and Central Asian countries; lowest rates in high income countries. For the working-age population, IHD mortality rates are markedly higher in low-and-middle income countries than in high income countries. Over the last 25 years, age-standardised IHD mortality has fallen by more than half in high income countries, but the trend is flat or increasing in some low-and-middle income countries. Low-and-middle income countries now account for more than 80% of global IHD deaths. CONCLUSIONS The global burden of IHD deaths has shifted to low-and-middle income countries as lifestyles approach those of high income countries. In high income countries, population ageing maintains IHD as the leading cause of death. Nevertheless, the progressive decline in age-standardised IHD mortality in high income countries shows that increasing IHD mortality is not inevitable. The 20-fold mortality difference between countries, and the temporal trends, may hold vital clues for handling IHD epidemic which is migratory, and still burgeoning.
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Affiliation(s)
- Judith A Finegold
- International Centre for Circulatory Health, National Heart and Lung Institute, London, UK.
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Footman K, Roberts B, Mills A, Richardson E, McKee M. Public satisfaction as a measure of health system performance: A study of nine countries in the former Soviet Union. Health Policy 2013; 112:62-9. [DOI: 10.1016/j.healthpol.2013.03.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 02/26/2013] [Accepted: 03/09/2013] [Indexed: 11/16/2022]
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Igissinov N, Zatoskikh V, Moore MA, Igissinov S, Toulebaeyev R, Mustafina M, Valieva S, Aldiyarova G, Bukeyeva Z, Venglovskiy A. Epidemiological evaluation of laryngeal cancer incidence in Kazakhstan for the years 1999-2009. Asian Pac J Cancer Prev 2013; 14:3969-74. [PMID: 23886216 DOI: 10.7314/apjcp.2013.14.6.3969] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The purpose was to provide a descriptive epidemiological assessment of the incidence of cancer of the larynx in Kazakhstan and spatial evaluation with gender characteristics. This retrospective study covered all new cases of laryngeal cancer in 11 years (1999-2009). The total number was 4,967 cases, 4,535 (91.3%) in males and 432 (8.7%) in women, with a ratio of 10.5:1. The higher incidence in men compared to women was evident in all age groups, the differences being statistically significant (p<0.05). At the same time revealed a unimodal growth with age, peaking at 70 years and older both sexes. In the dynamics, incidence rates of laryngeal cancer demonstrated a tendency to decrease, in women (T=-6.7%) this being more pronounced than in men (T=-3.3%). Levels were determined to produce cartograms of cancer of the larynx for male and female populations, clear geographical variation being evidenced. The data are discussed with reference to possible risk factors.
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Mentzakis E, Suhrcke M, Roberts B, Murphy A, McKee M. Estimating the causal effect of alcohol consumption on well-being for a cross-section of 9 former Soviet Union countries. Soc Sci Med 2013; 89:1-7. [DOI: 10.1016/j.socscimed.2013.04.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 04/17/2013] [Accepted: 04/18/2013] [Indexed: 11/25/2022]
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Tobacco use and nicotine dependence among conflict-affected men in the Republic of Georgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:2185-97. [PMID: 23759953 PMCID: PMC3717731 DOI: 10.3390/ijerph10062185] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 05/06/2013] [Accepted: 05/16/2013] [Indexed: 11/17/2022]
Abstract
Background: There is very little evidence globally on tobacco use and nicotine dependence among civilian populations affected by armed conflict, despite key vulnerability factors related to elevated mental disorders and socio-economic stressors. The study aim was to describe patterns of smoking and nicotine dependence among conflict-affected civilian men in the Republic of Georgia and associations with mental disorders. Methods: A cross-sectional household survey using multistage random sampling was conducted in late 2011 among conflict-affected populations in Georgia. Respondents included in this paper were 1,248 men aged ≥18 years who were internally displaced persons (IDPs) and former IDPs who had returned in their home areas. Outcomes of current tobacco use, heavy use (≥20 cigarettes per day), and nicotine dependence (using the Fagerström Test for Nicotine Dependence) were used. PTSD, depression, anxiety and hazardous alcohol use were also measured, along with exposure to traumatic events and a range of demographic and socio-economic characteristics. Results: Of 1,248 men, 592 (47.4%) smoked and 70.9% of current smokers were heavy smokers. The mean nicotine dependence score was 5.0 and the proportion with high nicotine dependence (≥6) was 41.4%. In multivariate regression analyses, nicotine dependence was significantly associated with PTSD (β 0.74) and depression (β 0.85), along with older age (except 65+ years), and being a returnee (compared to IDPs). Conclusions: The study reveals very high levels of heavy smoking and nicotine dependence among conflict-affected persons in Georgia. The associations between nicotine dependence, PTSD and depression suggest interventions could yield synergistic benefits.
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Changing patterns of fruit and vegetable intake in countries of the former Soviet Union. Public Health Nutr 2013; 16:1924-32. [PMID: 23701712 DOI: 10.1017/s1368980013001316] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess how the frequency of low fruit and vegetable consumption has changed in countries of the former Soviet Union (FSU) between 2001 and 2010 and to identify factors associated with low consumption. DESIGN Cross-sectional surveys. A standard questionnaire was administered at both time points to examine fruit and vegetable consumption frequency. Logistic regression analysis was used to examine the relationship between demographic, socio-economic and health behavioural variables and low fruit and vegetable consumption in 2010. SETTING Nationally representative population samples from Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. SUBJECTS Adults aged 18 years and older. RESULTS Between 2001 and 2010 notable changes occurred in fruit and vegetable consumption in many countries resulting in a slight overall deterioration in diet. By 2010 in six countries about 40% of the population was eating fruit once weekly or less often, while for vegetables the corresponding figure was in excess of 20% in every country except Azerbaijan. A worse socio-economic situation, negative health behaviours (smoking and alcohol consumption) and rural residence were all associated with low levels of fruit and vegetable consumption. CONCLUSIONS International dietary guidelines emphasise the importance of fruit and vegetable consumption. The scale of inadequate consumption of these food groups among much of the population in many FSU countries and its link to socio-economic disadvantage are deeply worrying. This highlights the urgent need for a greater focus to be placed on population nutrition policies to avoid nutrition-related diseases in the FSU countries.
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Abstract
Smoking is prevalent across Europe, but the severity and stage of the smoking epidemic, and policy responses to it, vary substantially between countries. Much progress is now being made in prohibition of paid-for advertising and in promotion of smoke-free policies, but mass media campaigns are widely underused, provision of services for smokers trying to quit is generally poor, and price policies are undermined by licit and illicit cheap supplies. Monitoring of prevalence is inadequate in many countries, as is investment in research and capacity to address this largest avoidable cause of death and disability across Europe. However, grounds for optimism are provided by progress in implementation of the WHO Framework Convention on Tobacco Control, and in the development of a new generation of nicotine-containing devices that could enable more widespread adoption of harm-reduction strategies. The effect of commercial vested interests has been and remains a major barrier to progress.
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Affiliation(s)
- John Britton
- UK Centre for Tobacco Control Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
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Footman K, Roberts B, Stickley A, Kizilova K, Rotman D, McKee M. Smoking cessation and desire to stop smoking in nine countries of the former Soviet Union. Nicotine Tob Res 2013; 15:1628-33. [PMID: 23548415 DOI: 10.1093/ntr/ntt034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Smoking rates and corresponding levels of premature mortality from smoking-related diseases in the former Soviet Union (fSU) are among the highest in the world. To reduce this health burden, greater focus on smoking cessation is needed, but little is currently known about rates and characteristics of cessation in the fSU. METHODS Nationally representative household survey data from a cross-sectional study of 18,000 respondents in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine were analyzed to describe patterns of desire and action taken to stop smoking, quit ratios (former ever-smokers as a percent of ever-smokers, without a specified recall period), and help used to stop smoking. Multivariate logistic regression was used to analyze characteristics associated with smoking cessation and desire to stop smoking. RESULTS Quit ratios varied from 10.5% in Azerbaijan to 37.6% in Belarus. About 67.2% of respondents expressed a desire to quit, and 64.9% had taken action and tried to stop. The use of help to quit was extremely low (12.6%). Characteristics associated with cessation included being female, over 60, with higher education, poorer health, lower alcohol dependency, higher knowledge of tobacco's health effects, and support for tobacco control. Characteristics associated with desire to stop smoking among current smokers included younger age, poorer health, greater knowledge of tobacco's health effects, and support for tobacco control. CONCLUSIONS Quit ratios are low in the fSU but there is widespread desire to stop smoking. Stronger tobacco control and cessation support are urgently required to reduce smoking prevalence and associated premature mortality.
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Affiliation(s)
- Katharine Footman
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK.
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Rechel B, Roberts B, Richardson E, Shishkin S, Shkolnikov VM, Leon DA, Bobak M, Karanikolos M, McKee M. Health and health systems in the Commonwealth of Independent States. Lancet 2013; 381:1145-55. [PMID: 23541055 DOI: 10.1016/s0140-6736(12)62084-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The countries of the Commonwealth of Independent States differ substantially in their post-Soviet economic development but face many of the same challenges to health and health systems. Life expectancies dropped steeply in the 1990s, and several countries have yet to recover the levels noted before the dissolution of the Soviet Union. Cardiovascular disease is a much bigger killer in the Commonwealth of Independent States than in western Europe because of hazardous alcohol consumption and high smoking rates in men, the breakdown of social safety nets, rising social inequality, and inadequate health services. These former Soviet countries have embarked on reforms to their health systems, often aiming to strengthen primary care, scale back hospital capacities, reform mechanisms for paying providers and pooling funds, and address the overall shortage of public funding for health. However, major challenges remain, such as frequent private out-of-pocket payments for health care and underdeveloped systems for improvement of quality of care.
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Affiliation(s)
- Bernd Rechel
- European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK.
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Footman K, Roberts B, Tumanov S, McKee M. The comorbidity of hypertension and psychological distress: a study of nine countries in the former Soviet Union. J Public Health (Oxf) 2013; 35:548-57. [PMID: 23480878 DOI: 10.1093/pubmed/fdt019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mental health problems in those with physical ailments are often overlooked, especially in the former Soviet Union (fSU) where this comorbidity has received little attention. Our study examines the comorbidity of psychological distress and hypertension in the fSU. METHODS Nationally representative household survey data from Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine in 2001 and 2010 were analysed to compare the levels of psychological distress in people with and without self-reported hypertension. Multivariate regression analysed determinants of psychological distress in hypertensive respondents, and prevalence rate ratios were calculated to compare the change in distress between the two groups. RESULTS There were significantly higher levels of psychological distress among hypertensive respondents (9.9%) than in the general population (4.9%), and a significant association between the two conditions [odds ratio (OR) = 2.27 (1.91; 2.70)]. Characteristics associated with distress among hypertensive respondents included residing in Armenia or Kyrgyzstan, being female, over age 50, with a poor economic situation, lower education, poor emotional support and limited access to medical drugs. Levels of distress declined between 2001 and 2010, but at a lesser rate in hypertensive respondents [rate ratio (RR) = 0.85 (0.75; 0.95)] than non-hypertensive respondents [RR = 0.65 (0.56; 0.75)]. CONCLUSIONS There is a significant association between psychological distress and hypertension in the region.
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Affiliation(s)
- Katharine Footman
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
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Mir H, Roberts B, Richardson E, Chow C, McKee M. Analysing compliance of cigarette packaging with the FCTC and national legislation in eight former Soviet countries. Tob Control 2012; 22:231-4. [PMID: 23047889 DOI: 10.1136/tobaccocontrol-2012-050567] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To analyse compliance of cigarette packets with the Framework Convention on Tobacco Control (FCTC) and national legislation and the policy actions that are required in eight former Soviet Union countries. METHODS We obtained cigarette packets of each of the 10 most smoked cigarette brands in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Moldova, Russia and Ukraine. The packets were then analysed using a standardised data collection instrument. The analysis included the placing, size and content of health warning labels and deceptive labels (eg, 'Lights'). Findings were assessed for compliance with the FCTC and national legislation. RESULTS Health warnings were on all packets from all countries and met the FCTC minimum recommendations on size and position except Azerbaijan and Georgia. All countries used a variety of warnings except Azerbaijan. No country had pictorial health warnings, despite them being mandatory in Georgia and Moldova. All of the countries had deceptive labels despite being banned in all countries except Russia and Azerbaijan where still no such legislation exists. CONCLUSIONS Despite progress in the use of health warning messages, gaps still remain-particularly with the use of deceptive labels. Stronger surveillance and enforcement mechanisms are required to improve compliance with the FCTC and national legislation.
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Affiliation(s)
- Hassan Mir
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, UK
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Giovino GA, Mirza SA, Samet JM, Gupta PC, Jarvis MJ, Bhala N, Peto R, Zatonski W, Hsia J, Morton J, Palipudi KM, Asma S. Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys. Lancet 2012; 380:668-79. [PMID: 22901888 DOI: 10.1016/s0140-6736(12)61085-x] [Citation(s) in RCA: 487] [Impact Index Per Article: 40.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Despite the high global burden of diseases caused by tobacco, valid and comparable prevalence data for patterns of adult tobacco use and factors influencing use are absent for many low-income and middle-income countries. We assess these patterns through analysis of data from the Global Adult Tobacco Survey (GATS). METHODS Between Oct 1, 2008, and March 15, 2010, GATS used nationally representative household surveys with comparable methods to obtain relevant information from individuals aged 15 years or older in 14 low-income and middle-income countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam). We compared weighted point estimates and 95% CIs of tobacco use between these 14 countries and with data from the 2008 UK General Lifestyle Survey and the 2006-07 US Tobacco Use Supplement to the Current Population Survey. All these surveys had cross-sectional study designs. FINDINGS In countries participating in GATS, 48·6% (95% CI 47·6-49·6) of men and 11·3% (10·7-12·0) of women were tobacco users. 40·7% of men (ranging from 21·6% in Brazil to 60·2% in Russia) and 5·0% of women (0·5% in Egypt to 24·4% in Poland) in GATS countries smoked a tobacco product. Manufactured cigarettes were favoured by most smokers (82%) overall, but smokeless tobacco and bidis were commonly used in India and Bangladesh. For individuals who had ever smoked daily, women aged 55-64 years at the time of the survey began smoking at an older age than did equivalently aged men in most GATS countries. However, those individuals who had ever smoked daily and were aged 25-34-years when surveyed started to do so at much the same age in both sexes. Quit ratios were very low (<20% overall) in China, India, Russia, Egypt, and Bangladesh. INTERPRETATION The first wave of GATS showed high rates of smoking in men, early initiation of smoking in women, and low quit ratios, reinforcing the view that efforts to prevent initiation and promote cessation of tobacco use are needed to reduce associated morbidity and mortality. FUNDING Bloomberg Philanthropies' Initiative to Reduce Tobacco Use, Bill and Melinda Gates Foundation, Brazilian and Indian Governments.
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Affiliation(s)
- Gary A Giovino
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY 14214-8028, USA. ggiovino@buff alo.edu
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Roberts B, Stickley A, Gilmore AB, Danishevski K, Kizilova K, Bryden A, Rotman D, Haerpfer C, McKee M. Knowledge of the health impacts of smoking and public attitudes towards tobacco control in the former Soviet Union. Tob Control 2012; 22:e12. [PMID: 22705600 DOI: 10.1136/tobaccocontrol-2011-050249] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To describe levels of knowledge on the harmful effects of tobacco and public support for tobacco control measures in nine countries of the former Soviet Union and to examine the characteristics associated with this knowledge and support. METHODS Standardised, cross-sectional nationally representative surveys conducted in 2010/2011 with 18 000 men and women aged 18 years and older in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Respondents were asked a range of questions on their knowledge of the health effects of tobacco and their support for a variety of tobacco control measures. Descriptive analysis was conducted on levels of knowledge and support, along with multivariate logistic regression analysis of characteristics associated with overall knowledge and support scores. RESULTS Large gaps exist in public understanding of the negative health effects of tobacco use, particularly in Azerbaijan, Kazakhstan, Kyrgyzstan and Moldova. There are also extremely high levels of misunderstanding about the potential effects of 'light' cigarettes. However, there is popular support for tobacco control measures. Over three quarters of the respondents felt that their governments could be more effective in pursuing tobacco control. Higher levels of education, social capital (membership of an organisation) and being a former or never-smoker were associated with higher knowledge on the health effects of tobacco and/or being more supportive of tobacco control measures. CONCLUSIONS Increasing public awareness of tobacco's health effects is essential for informed decision-making by individuals and for further increasing public support for tobacco control measures.
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Affiliation(s)
- Bayard Roberts
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK
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