1
|
Jani CT, Singh H, Abdallah N, Mouchati C, Arora S, Kareff S, Salciccioli J, Thomson CC, Velcheti V. Trends in Lung Cancer Incidence and Mortality (1990-2019) in the United States: A Comprehensive Analysis of Gender and State-Level Disparities. JCO Glob Oncol 2023; 9:e2300255. [PMID: 38127772 PMCID: PMC10752493 DOI: 10.1200/go.23.00255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/13/2023] [Accepted: 10/10/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Lung cancer is the leading cause of cancer-related deaths in the United States. This study aims to analyze lung cancer incidence, mortality, and related statistics from 1990 to 2019, focusing on national- and state-level trends and exploring potential disparities between sexes. METHODS The Global Burden of Disease database was used to extract tracheal, bronchus, and lung cancer mortality data from 1990 to 2019 for both males and females and across all states of the United States. Age-standardized incidence rates, age-standardized mortality rates, disability-adjusted life years (DALYs), and mortality-to-incidence indices (MIIs) were studied to assess for gender-based, geographic, and temporal disparities. Joinpoint regression analysis was performed to further evaluate trends. RESULTS The incidence of these cancers in the United States decreased between 1990 and 2019 by 23.35%, with a more significant decline in males (37.73%) than females (1.41%). Similarly, for mortality, a decrease was observed for both sexes combined (26.83%), but much more significantly for males (40.23%) than females (6.01%). The MIIs decreased overall, but there were variations across states. DALYs decreased for both sexes combined, with males experiencing a larger reduction, but an increase was noted in some states for females. CONCLUSION This analysis reveals diverse trends pertaining to the incidence, mortality, and disability burden associated with lung cancer by sex and states in the United States, emphasizing the need for targeted interventions to reduce disparities. These findings contribute to our understanding of the current landscape of lung cancer and can inform future strategies for prevention, early detection, and management.
Collapse
Affiliation(s)
- Chinmay T. Jani
- Sylvester Comprehensive Cancer Center at University of Miami, Miami, FL
- MDR Collaborative Group, London, United Kingdom
- Mount Auburn Hospital, Harvard Medical School, Cambridge, MA
| | - Harpreet Singh
- MDR Collaborative Group, London, United Kingdom
- Medical College of Wisconsin, Milwaukee, WI
| | - Nour Abdallah
- MDR Collaborative Group, London, United Kingdom
- Cleveland Clinic, Cleveland, OH
| | - Christian Mouchati
- MDR Collaborative Group, London, United Kingdom
- Case Western Reserve University School of Medicine, Cleveland, OH
| | - Shreya Arora
- MDR Collaborative Group, London, United Kingdom
- Mount Auburn Hospital, Harvard Medical School, Cambridge, MA
| | - Samuel Kareff
- Sylvester Comprehensive Cancer Center at University of Miami, Miami, FL
| | - Justin Salciccioli
- MDR Collaborative Group, London, United Kingdom
- Brigham and Women's Hospital—Harvard Medical School, Boston, MA
| | | | | |
Collapse
|
2
|
Chadwick G, Dobbs PD, Gluesenkamp K, Vinzant D, Everett KD. Components in tobacco-free school policies-A coding tool for assessment. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 35930361 DOI: 10.1080/07448481.2022.2103374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 06/24/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To develop an instrument to examine tobacco-free campus policy components. PARTICIPANTS Missouri two- and four-year, specialized/technical, and religious colleges and universities (N = 76). Methods: The instrument was informed via literature review and expert interviews. Coder agreement was strong (κ = .80). Qualitative policy language examples were identified. RESULTS Model policy components including consideration for population, prohibited products, location restrictions, enforcement, consequences, promotions, communications, cessation, designated smoking areas and exemptions; comprehensive policies included all populations, for all tobacco products, and at all locations on the campus. Nineteen campuses had comprehensive tobacco-free policies, five had comprehensive smoke-free policies (cigarettes and e-cigarettes), and no policy included all model components. Fifty-two were non-comprehensive. CONCLUSIONS This instrument can allow campuses to identify components for comprehensive and model tobacco-free campus policies and assist officials in improving policy language. Future research can use this instrument to examine the effectiveness of components and their impact on tobacco use outcomes.
Collapse
Affiliation(s)
- Ginny Chadwick
- Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Page D Dobbs
- Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas, USA
| | - Kathryn Gluesenkamp
- Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Delanie Vinzant
- Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| | - Kevin D Everett
- Family and Community Medicine, University of Missouri, Columbia, Missouri, USA
| |
Collapse
|
3
|
Selove R, Aghili M, Green C, Brown C. Use of implementation science to plan adoption of a tobacco-free policy on a historically black college/university (HBCU) campus. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1341-1346. [PMID: 32877633 PMCID: PMC7952039 DOI: 10.1080/07448481.2020.1809429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/25/2020] [Accepted: 08/02/2020] [Indexed: 06/11/2023]
Abstract
Objective: Implementation science tools were used to identify facilitators and barriers to adopting a tobacco-free policy on a historically Black college/university (HBCU). Participants: Study participants included 13 University staff, two students, and two public health educators/school alumni. Data were collected in 2015-2016. Methods: The Consolidated Framework for Implementation Research (CFIR) was used to develop questions for focus groups and individual interviews. The CFIR was also used by two research team members to code transcripts independently, using an iterative deduction process to achieve ≥85% agreement on CFIR domains. Coded quotations were evaluated using the Qualitative Implementation Framework (QIF) to ascertain next adoption planning steps. Results: Qualitative data suggested that building capacity for tobacco control, linking policy to HBCU identity and priorities such as addressing marijuana use might facilitate adoption of a tobacco-free campus policy. Conclusions: Implementation science tools may be useful for planning adoption of comprehensive tobacco-free policies at HBCUs.
Collapse
Affiliation(s)
- Rebecca Selove
- Center for Prevention Research,Tennessee State University, Nashville, Tennessee, USA
| | - Mahnaz Aghili
- Tennessee State University, Nashville, Tennessee, USA
| | - Cheryl Green
- Office of the President, Governors State University, University Park, Illinois, USA
| | - Charles Brown
- Health Administration, Health Sciences & Public Health, Tennessee State University, Nashville, Tennessee, USA
| |
Collapse
|
4
|
Lui CK, Mulia N, Ye Y, Patterson D, Trieu SL. School and Community Factors Associated With the Adoption of 100% Smoke-free Policy by California Community Colleges, 2003-2019. Am J Health Promot 2022; 36:869-875. [PMID: 35081765 DOI: 10.1177/08901171211073732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Smoke- and tobacco-free policy (SFP) is an effective strategy that can reduce tobacco-related health disparities among young adults. DESIGN Longitudinal design using administrative, survey, policy data sources, and geocoded tobacco outlet and American Community Survey data. SETTING California community colleges (CC) and cities/communities where colleges are located, 2003-2019. SAMPLE 114 California CCs. DATA School-level (i.e., student population and demographics) and community-level data (socio-demographics, local tobacco control policy, tobacco-related norms and availability, and health resources) from 2003 to 2019. MEASURES Key outcome is the year CC adopted a 100% SFP. ANALYSIS Bivariate and multivariate Cox survival models were used to analyze timing of SFP adoption. RESULTS By 2019, 61 out of 114 (53.5%) CCs were 100% SFP. While community smoking prevalence and tobacco availability were not significant, CCs in rural areas were less likely to be smoke-free. CCs located in cities with stronger tobacco policies (hazard ratio (HR) = 1.08, P < .05), which reported higher student health fees (HR = 2.00, P < .05) and received technical assistance for SFP (HR = 4.59, P < .01) were significantly associated with having 100% SFP. CONCLUSION Findings suggest that key community factors (strong city tobacco policies) and school and community resources (student health fees, SFP technical assistance) are associated with the presence of 100% SFP at CCs. Resources from the community or within a college might support remaining CCs in becoming 100% smoke-free.
Collapse
Affiliation(s)
- Camillia K Lui
- 1665Alcohol Research Group at Public Health Institute, Emeryville, CA, USA
| | - Nina Mulia
- 1665Alcohol Research Group at Public Health Institute, Emeryville, CA, USA
| | - Yu Ye
- 1665Alcohol Research Group at Public Health Institute, Emeryville, CA, USA
| | - Deidre Patterson
- 1665Alcohol Research Group at Public Health Institute, Emeryville, CA, USA
| | | |
Collapse
|
5
|
Yang JS, Faruqui A, Sou A, Mackey TK. Non-compliance with university tobacco-free policies: A qualitative exploration. Tob Prev Cessat 2022; 8:14. [PMID: 35515713 PMCID: PMC8988849 DOI: 10.18332/tpc/146713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Though university smoke-free and tobacco-free campus policies have been proliferating across the US, compliance and enforcement remain challenges. This study examined perceptions and behaviors of employees and students who used tobacco products on tobacco-free campuses, to better understand policy non-compliance. METHODS Students (n=56) and employees (n=20) from two tobacco-free 4-year public universities in Southern California who self-reported using tobacco products on campus participated in focus groups, stratified by university and student or employee (faculty and staff) status, to discuss attitudes toward campus tobacco policies and on-campus smoking. Focus group discussions were transcribed and analyzed after structured coding and subcoding. RESULTS Participants were generally aware that smoking and vaping were not allowed on campus, though few could correctly identify their campus as tobacco-free. Attitudes toward the policy varied by subgroup and by campus, with students and employees at different universities expressing varying levels of support. Non-compliance was a unique interaction of individual, institutional, and interpersonal factors including a desire to smoke or vape to reduce stress, lack of formal enforcement or penalty for violating the policy, and efforts to smoke or vape in ways that reduce harm to others as a way of rationalizing non-compliance. CONCLUSIONS Attitudes toward university tobacco-free policies are campus- and constituency-specific, with similarities in individual, institutional, and interpersonal factors underlying non-compliance. Interventions to increase compliance should address individual, institutional, and interpersonal influences on non-compliance through efforts tailored to specific campus constituencies based on their particular knowledge and attitudes towards tobacco-free policies.
Collapse
Affiliation(s)
- Joshua S. Yang
- Department of Public Health, California State University, Fullerton, United States
| | - Afsana Faruqui
- Department of Public Health, California State University, Fullerton, United States
| | - Angela Sou
- Department of Public Health, California State University, Fullerton, United States
| | - Tim K. Mackey
- Department of Anthropology, University of California, San Diego, United States
| |
Collapse
|
6
|
Yang JS, Cuomo RE, Purushothaman V, Nali M, Shah N, Bardier C, Obradovich N, Mackey T. Campus Smoking Policies and Smoking-Related Twitter Posts Originating From California Public Universities: Retrospective Study. JMIR Form Res 2021; 5:e33331. [PMID: 34951597 PMCID: PMC8742203 DOI: 10.2196/33331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/26/2022] Open
Abstract
Background The number of colleges and universities with smoke- or tobacco-free campus policies has been increasing. The effects of campus smoking policies on overall sentiment, particularly among young adult populations, are more difficult to assess owing to the changing tobacco and e-cigarette product landscape and differential attitudes toward policy implementation and enforcement. Objective The goal of the study was to retrospectively assess the campus climate toward tobacco use by comparing tweets from California universities with and those without smoke- or tobacco-free campus policies. Methods Geolocated Twitter posts from 2015 were collected using the Twitter public application programming interface in combination with cloud computing services on Amazon Web Services. Posts were filtered for tobacco products and behavior-related keywords. A total of 42,877,339 posts were collected from 2015, with 2837 originating from a University of California or California State University system campus, and 758 of these manually verified as being about smoking. Chi-square tests were conducted to determine if there were significant differences in tweet user sentiments between campuses that were smoke- or tobacco-free (all University of California campuses and California State University, Fullerton) compared to those that were not. A separate content analysis of tweets included in chi-square tests was conducted to identify major themes by campus smoking policy status. Results The percentage of positive sentiment tweets toward tobacco use was higher on campuses without a smoke- or tobacco-free campus policy than on campuses with a smoke- or tobacco-free campus policy (76.7% vs 66.4%, P=.03). Higher positive sentiment on campuses without a smoke- or tobacco-free campus policy may have been driven by general comments about one’s own smoking behavior and comments about smoking as a general behavior. Positive sentiment tweets originating from campuses without a smoke- or tobacco-free policy had greater variation in tweet type, which may have also contributed to differences in sentiment among universities. Conclusions Our study introduces preliminary data suggesting that campus smoke- and tobacco-free policies are associated with a reduction in positive sentiment toward smoking. However, continued expressions and intentions to smoke and reports of one’s own smoking among Twitter users suggest a need for more research to better understand the dynamics between implementation of smoke- and tobacco-free policies and resulting tobacco behavioral sentiment.
Collapse
Affiliation(s)
- Joshua S Yang
- Department of Public Health, California State University Fullerton, Fullerton, CA, United States
| | - Raphael E Cuomo
- Global Health Policy and Data Institute, San Diego, CA, United States.,Department of Anesthesiology, University of California San Diego, San Diego, CA, United States
| | - Vidya Purushothaman
- Global Health Policy and Data Institute, San Diego, CA, United States.,Department of Anesthesiology, University of California San Diego, San Diego, CA, United States
| | - Matthew Nali
- Global Health Policy and Data Institute, San Diego, CA, United States.,Department of Anesthesiology, University of California San Diego, San Diego, CA, United States.,S-3 Research, San Diego, CA, United States
| | - Neal Shah
- Global Health Policy and Data Institute, San Diego, CA, United States
| | - Cortni Bardier
- Global Health Policy and Data Institute, San Diego, CA, United States.,S-3 Research, San Diego, CA, United States.,Global Health Program, Department of Anthropology, University of California, San Diego, La Jolla, CA, United States
| | - Nick Obradovich
- Center for Humans and Machines, Max Planck Institute for Human Development, Berlin, Germany
| | - Tim Mackey
- Global Health Policy and Data Institute, San Diego, CA, United States.,S-3 Research, San Diego, CA, United States.,Global Health Program, Department of Anthropology, University of California, San Diego, La Jolla, CA, United States
| |
Collapse
|
7
|
Berg CJ, Yang YT, Pratt-Chapman ML, Douglas Evans W, Cupertino AP, Horn K, Bernat DH, Abroms LC, Tercyak KP. Campus tobacco control policies and cessation interventions in college students: a commentary calling for research and action to address tobacco-related health disparities. Transl Behav Med 2021; 11:1030-1036. [PMID: 32893870 PMCID: PMC8075612 DOI: 10.1093/tbm/ibaa083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Tobacco-related health disparities (TRHDs) have a significant impact on population health in the USA. Effectively preventing and controlling TRHDs among young adult populations require multiple prevention and cessation points, including within college/university contexts. This commentary addresses current campus tobacco control policies and cessation interventions for U.S. college students, with an emphasis on TRHDs and opportunities for research and research translation to reduce these disparities. This commentary is informed by literature published between 2010 and 2020 regarding (a) prevalence and impact of campus tobacco control policies; and/or (b) behavioral outcomes from cessation interventions for young adults attending colleges. Despite a doubling of college campuses adopting tobacco-free policies from 2012 to 2017, roughly two-thirds continue to operate without such policies. Few policies address alternative tobacco products (e.g., e-cigarettes, cigars/cigarillos, and hookah), and communication about and enforcement of existing policies is extremely limited. A broad range of cessation intervention strategies have targeted individuals in this age group, but with little focus on TRHDs and limited intervention dissemination. Importantly, college students representing populations at risk for TRHDs (e.g., racial/ethnic/sexual/gender minorities, low socioeconomic status) are less likely to be exposed to strong tobacco control policies or supports for cessation. There are untapped opportunities for behavioral medicine approaches to reduce TRHDs in college settings. Research findings regarding multilevel (policy, community-level, and individual-level) interventions must be translated to policy/practice in order to address tobacco use, particularly among vulnerable college student populations.
Collapse
Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC USA
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
| | - Y Tony Yang
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
- Center for Health Policy and Media Engagement, School of Nursing, George Washington University, Washington, DC, USA
| | - Mandi L Pratt-Chapman
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
| | - W Douglas Evans
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC USA
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
| | - Ana-Paula Cupertino
- Department of Public Health Sciences, Wilmot Cancer Institute, Community Outreach, Engagement, and Disparities Research, University of Rochester, Rochester, NY, USA
| | - Kimberly Horn
- Department of Population Health Sciences, Virginia Tech-Carilion Fralin Biomedical Research Institute, Virginia Tech, Blacksburg, VA, USA
| | - Debra H Bernat
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC USA
- George Washington University Cancer Center, George Washington University, Washington, DC, USA
| | - Kenneth P Tercyak
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| |
Collapse
|
8
|
Smoking behaviours and attitudes towards campus-wide tobacco control policies among staff and students: a cross-sectional survey at the University of Birmingham. BMC Public Health 2020; 20:252. [PMID: 32075621 PMCID: PMC7031967 DOI: 10.1186/s12889-020-8321-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 02/04/2020] [Indexed: 12/03/2022] Open
Abstract
Background Tobacco control policies have potential to be an effective strategy for the reduction of smoking prevalence and secondhand smoke (SHS) exposure in tertiary educational settings worldwide. The aims of this study were to collect baseline data among staff and students, to measure smoking behaviours and attitudes towards introduction of campus-wide tobacco control policies within a UK higher education setting. Methods Cross-sectional study using data collected by web-based questionnaire administered to employed staff and enrolled students (undergraduate/postgraduate) at the University of Birmingham from May 2016 to April 2017. Information was obtained regarding demographic characteristics, tobacco usage patterns and attitudes towards a revised campus tobacco control policy using a 21-item survey tool. Logistic regression analyses were used to explore associations between participant characteristics and support for smoke-free or tobacco-free campus policy options, evaluated by crude and adjusted Odds Radios (OR) after controlling for confounding factors (significance level: P < 0.05). Results A total of 934 survey responses were received, of whom 780 participants provided complete information on staff or student status and were included in the present analysis. Current smoking prevalence was 14% (N = 109; 95% confidence interval (CI) 11.6–16.6). Overall, 66.3% (95% CI: 62.9–69.7) of participants supported a smoke-free campus; 68.5% (95% CI: 65.2–71.8) endorsed restrictions for tobacco sales and just under half of respondents (47.3%; 95% CI: 43.8–50.9) supported a ban for electronic cigarettes/vaping device use on campus. Smoking status was an independent predictor of support for tobacco control, with the lowest level of support for a smoke-free campus among daily (adjusted OR 0.02; 95% CI: 0.01–0.05) and intermittent smokers (adjusted OR 0.06; 95% CI: 0.02–0.16). Conclusions Overall, the majority of staff and students participating in this baseline survey supported implementation of a smoke-free or comprehensive tobacco-free campus policy. These findings may inform the development and future implementation of a revised tobacco control policy at the university which reflects contemporary attitudes and considers a broad range of implementation issues, including behaviour change and environmental adaptations.
Collapse
|
9
|
Abstract
See Article by https://10.1161/JAHA.118.009829
Collapse
Affiliation(s)
- Yoshihiro Kokubo
- 1 Department of Preventive Cardiology National Cerebral and Cardiovascular Center Suita Japan.,2 Institute of Cardiovascular and Medical Sciences University of Glasgow United Kingdom
| | - Sandosh Padmanabhan
- 2 Institute of Cardiovascular and Medical Sciences University of Glasgow United Kingdom
| |
Collapse
|
10
|
Sarna L, Hollen PJ, Heath J, Bialous SA. Increased adoption of smoke-free policies on campuses with schools of nursing. Nurs Outlook 2019; 67:760-764. [PMID: 31277897 DOI: 10.1016/j.outlook.2019.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/12/2019] [Accepted: 06/15/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND In 2015, the majority of U.S. American Association of Colleges of Nursing (AACN)-accredited schools of nursing resided on campuses without smoke-free policies. PURPOSE To determine the presence of smoke-free policies at AACN-accredited after resolutions from AACN and the American Academy of Nursing, and the creation of online resources. METHODS Smoke-free policies (2015-2017) were determined through listings on the ANRF College Campus Policy Database© and survey responses from nursing deans. RESULTS Smoke-free policies for 689 schools of nursing increased from 36% in 2015 to 91% in 2017. There were no significant differences by nursing program types or geographic area. Twenty percent of deans reported using the resources, with over 1700-page views. CONCLUSION Smoke-free policies increased after support from two national nursing organizations. Learning in a smoke-free environment should be an expectation for nursing students to protect their own health, and to support their future critical role in tobacco control.
Collapse
Affiliation(s)
- Linda Sarna
- School of Nursing, University of California, Los Angeles, Los Angeles, CA.
| | | | - Janie Heath
- College of Nursing, University of Kentucky, Lexington, KY
| | | |
Collapse
|