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Levy DT, Issabakhsh M, Warner KE, Liber A, Meza R, Cummings M. Evaluating trends in cigarette and HTP use in Japan and measurement issues in the National Health and Nutrition Survey. Tob Control 2024:tc-2023-058526. [PMID: 38906697 DOI: 10.1136/tc-2023-058526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 06/11/2024] [Indexed: 06/23/2024]
Abstract
INTRODUTION Studies have reported that the rapid rise in heated tobacco product (HTP) sales in Japan accompanied an accelerated decline in cigarette sales. However, these studies do not distinguish whether those who previously smoked cigarettes became dual users with HTPs (smoking fewer cigarettes) or instead switched completely to HTPs. If HTPs present lower health risks than cigarettes, replacing cigarettes with HTPs is more likely to improve public health than cigarette users continuing as dual users. METHODS To evaluate the role of HTP introduction relative to smoking prevalence, we examine trends in cigarette prevalence as related to trends in HTP use using Japan's National Health and Nutrition Survey (NHNS) from 2011 to 2019. We develop measures of relative changes in smoking prevalence use by age and gender in the pre-HTP and post-HTP periods. We then analyse prevalence data by year using joinpoint regression to statistically distinguish changes in trend. RESULTS Compared with the pre-HTP 2011-2014 period, cigarette prevalence decreased more rapidly during the post-HTP 2014-2017 period, particularly among younger age groups. However, the changing format of NHNS questions limits our ability to determine the impact on smoking prevalence, particularly after 2017. CONCLUSIONS While suggesting that HTPs helped some people who smoke to quit smoking, this study also shows the difficulties in eliciting accurate survey responses about product use and distinguishing the impact of a potentially harm-reducing product in an environment subject to rapidly evolving patterns of use.
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Affiliation(s)
- David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Mona Issabakhsh
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Kenneth E Warner
- School of Public Health, University of Michigan-Ann Arbor, Ann Arbor, Michigan, USA
| | - Alex Liber
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
- Research Triangle Institute, Research Triangle Park, North Carolina, USA
| | - Rafael Meza
- Department of Integrative Oncology, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Michael Cummings
- Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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Sawada T, Yasukawa T, Imaizumi H, Matsubara H, Kimura K, Terasaki H, Ishikawa H, Murakami T, Takeuchi M, Mitamura Y, Mizusawa Y, Takamura Y, Murata T, Kogo J, Ohji M. Subtype prevalence and baseline visual acuity by age in Japanese patients with neovascular age-related macular degeneration. Jpn J Ophthalmol 2023; 67:149-155. [PMID: 36879074 DOI: 10.1007/s10384-023-00981-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 12/21/2022] [Indexed: 03/08/2023]
Abstract
PURPOSE To investigate age-specific prevalence of disease subtypes and baseline best-corrected visual acuity (BCVA) in Japanese patients with treatment-naïve neovascular age-related macular degeneration (nAMD). STUDY DESIGN Retrospective multicenter case series. METHODS We reviewed the records of patients with treatment-naïve nAMD who underwent initial treatment in 14 institutions in Japan sometime during the period from 2006 to 2015. In patients in whom both eyes were treated, only the eye treated first was included for analysis. The patients were stratified by age for the analysis. RESULTS In total, 3096 eyes were included. The overall prevalence of subtypes was as follows: typical AMD, 52.6%; polypoidal choroidal vasculopathy (PCV), 42.8%; retinal angiomatous proliferation (RAP), 4.6%. The number of eyes in each age group was as follows: younger than 60 years, 199; 60s, 747; 70s, 1308; 80s, 784; 90 years or older, 58. The prevalence of typical AMD in each age group was 51.8%, 48.1%, 52.1%, 57.7%, and 55.2%, respectively. The prevalence of PCV was 46.7%, 49.1%, 44.7%, 34.4%, and 19.0%, respectively. The prevalence of RAP was 1.5%, 2.8%, 3.2%, 7.9%, and 25.9%, respectively. The prevalence of PCV decreased with age, whilst that of RAP increased. The prevalence of RAP was higher than that of PCV in patients aged 90 years or older. The mean baseline BCVA (logMAR) was 0.53. In each age group, the mean baseline BCVA was 0.35, 0.45, 0.54, 0.62, and 0.88, respectively. The mean logMAR BCVA at baseline significantly worsened with age (P < 0.001). CONCLUSION The prevalence of nAMD subtypes differed according to age in Japanese patients. The baseline BCVA worsened with age.
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Affiliation(s)
- Tomoko Sawada
- Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. .,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan.
| | - Tsutomu Yasukawa
- Department of Ophthalmology, Nagoya City University, Aichi, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Hiroko Imaizumi
- Department of Ophthalmology, Sapporo City General Hospital, Hokkaido, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Hisashi Matsubara
- Department of Ophthalmology, Mie University, Mie, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Kazuhiro Kimura
- Department of Ophthalmology, Yamaguchi University, Yamaguchi, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University, Kagoshima, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Hiroto Ishikawa
- Department of Ophthalmology, Hyogo College of Medicine, Hyogo, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Tomoya Murakami
- Department of Ophthalmology, University of Tsukuba, Ibaraki, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Masaru Takeuchi
- Department of Ophthalmology, National Defense Medical College, Saitama, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Yoshinori Mitamura
- Department of Ophthalmology, Tokushima University, Tokushima, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Yutaro Mizusawa
- Department of Ophthalmology, Nara Medical University, Nara, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Yoshihiro Takamura
- Department of Ophthalmology, University of Fukui, Fukui, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Toshinori Murata
- Department of Ophthalmology, Shinshu University, Nagano, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Jiro Kogo
- Department of Ophthalmology, St. Marianna University School of Medicine, Kanagawa, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
| | - Masahito Ohji
- Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.,J-CREST (Japan Clinical Retinal Study Team) Study Group, Tokyo, Japan
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Old story, new twist: reducing salt and increasing potassium intake as a social issue according to the INTERMAP Japan. Hypertens Res 2023; 46:526-528. [PMID: 36357617 DOI: 10.1038/s41440-022-01082-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/19/2022] [Indexed: 11/11/2022]
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Sugiyama T, Ikeda N, Minowa K, Nishi N. Estimation of the Effect of Salt-Intake Reduction on Cardiovascular Mortality Decline between 1950 and 2017 in Japan: A Retrospective Simulation Study. Nutrients 2022; 14:nu14183747. [PMID: 36145122 PMCID: PMC9506165 DOI: 10.3390/nu14183747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 11/18/2022] Open
Abstract
In Japan, a decrease in cardiovascular mortality has coincided with reduced population salt intake since the 1950s. The purpose of this study was to quantify the effect of reduced population salt intake on the long-term trends of cardiovascular mortality. Using government statistics and epidemiological study results in people of 20–69 years old from 1950 to 2017, including the National Health and Nutrition Survey, we developed a system dynamics model of age-specific cardiovascular mortality and salt intake. We estimated the period and cohort effects on mortality and calibrated the model for the historical mortality rate. We then simulated the counterfactual scenario of no decrease in salt intake to estimate the reduction in cardiovascular deaths associated with decreased mean salt intake. Compared with the base run and calibrated to the actual data, approximately 298,000 and 118,000 excess deaths were observed in men and women, respectively, assuming no change in salt intake over the entire period. The model suggests that the decline in salt intake since the 1950s has contributed to a non-negligible reduction in cardiovascular mortality.
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Affiliation(s)
- Takehiro Sugiyama
- Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
- Correspondence:
| | - Nayu Ikeda
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
| | - Kazuko Minowa
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
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Li R, Sun J, Wang T, Huang L, Wang S, Sun P, Yu C. Comparison of Secular Trends in Esophageal Cancer Mortality in China and Japan during 1990-2019: An Age-Period-Cohort Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610302. [PMID: 36011937 PMCID: PMC9408772 DOI: 10.3390/ijerph191610302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 05/04/2023]
Abstract
Esophageal cancer is a prevalent and often fatal malignancy all over the world, with China and Japan bearing a disproportionately high burden. Consequently, we explored and compared the long-term changes in esophageal cancer mortality in China and Japan from 1990 to 2019 to see if there were any etiological clues. From 1990 to 2019, data on mortality in China and Japan were gathered from the Global Burden of Disease Study 2019 (GBD 2019). The age-period-cohort (APC) model was utilized to evaluate the effects of age, period, and cohort. Between 1990 and 2019, the age-standardized mortality rates (ASMRs) for esophageal cancer fell in both nations, with China showing a tremendous reduction after 2005. The overall net drifts per year were more impressive in China (-5.22% [95% CI, -5.77 to -4.68] for females, -1.98% [-2.22 to -1.74] for males) than in Japan (-0.50% [-0.91 to -0.08] for females, -1.86% [-2.12 to -1.59] for males), and the local drift values in both countries were less than zero in all age groups for both sexes. The longitudinal age curves of esophageal cancer mortality increased as age advances and the sex disparity gradually exacerbates with age. The period and cohort effects were uncovered to have similar declining patterns for both sexes in both nations; however, the improvement of cohort effects for China's younger generation has stagnated. The ASMRs, period effects, and cohort effects have decreased for both countries and sexes over the 1990-2019 period. The decline in cohort effects for China's younger generation has plateaued, possibly due to the rising rates of smoking and obesity among Chinese youngsters. Comprehensive population-level treatments aimed at smoking cessation, obesity prevention, and gastrointestinal endoscopy screening should be carried out immediately, particularly for men and older birth cohorts at a higher risk of esophageal cancer.
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Affiliation(s)
- Ruiqing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Jinyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Tong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Lihong Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Shuwen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Panglin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan 430071, China
- Global Health Institute, Wuhan University, Wuhan 430071, China
- Correspondence:
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An analysis of predictors for heavy alcohol drinking using nationally representative survey data in Japan. BMC Public Health 2021; 21:359. [PMID: 33593302 PMCID: PMC7885596 DOI: 10.1186/s12889-021-10382-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Predictors of heavy or moderate alcohol drinking behavior have not been investigated using recent nationally representative survey data in Japan. This study investigated the effects of the predictors of heavy and moderate alcohol drinking in Japan using nationally representative survey data. Methods Anonymous data from the 2013 Comprehensive Survey of Living Conditions in Japan were used to compare the predictors of heavy and moderate drinkers with those who abstain. Anonymized data that are resampled from all the survey data from the Ministry of Health, Labour and Welfare were obtained. Age group, marital status, living arrangements, educational level, household income, smoking status, and employment type were used as the explanatory variables. In addition, the drinking status (i.e., heavy drinker, moderate drinker, or abstainer) was used as the outcome variable. A multinomial logistic regression model was used, and an analysis comparing heavy drinkers and abstainers, as well as moderate drinkers and abstainers, was conducted. Results Moderate drinking was positively associated with high educational level or high household income for men and women, as well as married status for men. In addition, unemployment was found to be negatively associated with heavy drinking for men and women, and an unmarried status was also found to be negatively associated with heavy drinking for men. Moreover, lower educational levels and smoking prevalence were found to be associated with heavy drinking for men and women. Furthermore, living alone for men and working in a large-scale company for women were also found to be predictors of heavy drinking. Conclusions The preventive measures for heavy drinking were suggested to be particularly needed for those with lower educational levels and smokers. A call for attention among men living alone and among female employees in large-scale workplaces is also needed.
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Okui T. Socioeconomic Disparities in All-Cause and Cause-Specific Mortality Rates among Municipalities in Japan, 1999-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9213. [PMID: 33317152 PMCID: PMC7763490 DOI: 10.3390/ijerph17249213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022]
Abstract
Differences in all-cause and cause-specific mortality rates depending on municipal socioeconomic status (SES) in Japan have not been revealed over the last 20 years. This study exposes the difference in 1999 and 2019 using the Vital Statistics. All of the municipalities were grouped into five quintiles based on their SES, and standardized mortality ratio (SMR) of each municipal quintile compared with all of Japan was calculated for all-cause mortality and representative cause of deaths. As a result, although SMR for all-cause mortality for women tended to be lower in low SES quintiles in 1999, the reverse phenomenon was observed in 2019. Additionally, although SMR for all-cause of mortality for men was the lowest in the highest SES quintiles already in 1999, the difference in the SMR for all-cause mortality rates between the lowest and highest SES quintiles increased in 2019. The improvement of the SMR in the highest SES quintile and the deterioration in the lowest was also observed in representative types of cancer, heart disease, stroke, pneumonia, liver disease, and renal failure for men and women. Therefore, this study indicates a disparity in mortality depending on municipal SES enlarged in the last 20 years.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka City 812-8582, Japan
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An Age-Period-Cohort Analysis of Biomarkers of Lifestyle-Related Diseases Using the National Health and Nutrition Survey in Japan, 1973-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218159. [PMID: 33158284 PMCID: PMC7663829 DOI: 10.3390/ijerph17218159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 11/03/2020] [Accepted: 11/03/2020] [Indexed: 12/15/2022]
Abstract
Studies of biomarkers of lifestyle-related diseases in Japanese cohorts are scarce. This study aimed to analyze trends in risk markers of lifestyle-related diseases using age-period-cohort (APC) analysis. Data on systolic blood pressure and BMI from 1973 to 2018 and serum glucose, triglyceride, and high-density lipoprotein cholesterol levels from 1989 to 2018 available from the National Health and Nutrition Survey were used. Values for each of the risk markers for each age, period, and cohort were estimated using APC analysis. For women, a decrease in all the risk markers of lifestyle-related diseases was observed in individuals born between the 1930s and approximately 1970. Therefore, female individuals born in approximately 1970 were considered to have the lowest risk of developing lifestyle-related and cardiovascular diseases. Meanwhile, the cohort effect on all the risk markers deteriorated for the younger cohorts, and changes in lifestyle behavior are needed for cohorts born more recently. For men, the trends in risk markers across the cohorts differed, and the relative risk of lifestyle-related diseases for each cohort differed according to disease. These results could help understand cohort-specific risks for lifestyle-related disease and enable identification of high-risk populations who could benefit from preventive measures.
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Okui T. An Age-Period-Cohort Analysis of Prevalence and Consultation Rate for Dyslipidemia in Japan. Asia Pac J Public Health 2020; 33:46-52. [PMID: 33030030 DOI: 10.1177/1010539520963643] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study involved an age-period-cohort analysis of the consultation rate and prevalence of dyslipidemia in Japan, based on Patient Survey data from 1999 to 2017 and open data of national database of health insurance claims and specific health checkups in Japan from 2013 to 2016. Our results showed that the consultation rates were lower than the prevalence, regardless of age, year, and sex, and particularly among middle-aged and male respondents. Additionally, both the consultation rate and prevalence increased with increasing age to a greater extent among women than men, and the degree of increase in the consultation rate was larger than that in prevalence among women. Furthermore, although the cohort effect on prevalence began to decrease among men in cohorts born in approximately 1960, the effect decreased among women in cohorts born between the 1930s and 1960s and exhibited an increasing trend thereafter.
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