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Bassi S, Chopra M, Chugh A, Das S, Bhojani U, Nazar GP, Amin A, Dutta J, Lal P, Gupta PC, Arora M. Trends in Level of Implementation of the WHO FCTC Article 5.3 in India. Tob Use Insights 2024; 17:1179173X241271543. [PMID: 39280756 PMCID: PMC11393799 DOI: 10.1177/1179173x241271543] [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: 12/28/2023] [Accepted: 07/03/2024] [Indexed: 09/18/2024] Open
Abstract
Introduction The tobacco industry intends to ensure continuing marketing of tobacco products by influencing and interfering in tobacco control policies. This paper assessed trends of tobacco industry interference (TII), the level of implementation, and the government's response to enforcing Article 5.3 guidelines in India to safeguard tobacco control efforts from commercial and other vested interests of the tobacco industry. Methods We conducted a descriptive comparative analysis of four consecutive India TII Indexes (January 2018-December 2021) based on the seven key 5.3 recommendations and twenty indicators to capture (i) the Level of Industry Participation, (ii) Corporate Social Responsibility (CSR) Activities, (iii) Benefits to the Tobacco Industry, (iv) Forms of Unnecessary Interactions, (v) Transparency, (vi) Conflict of Interest, and (vii) Preventive Measures. The Southeast Asia Tobacco Control Alliance's (SEATCA) TII Index was used to undertake this assessment. Results The comparative analysis showed that the overall score of the India TII Indexes over the years decreased from 72 (2018) to 57 (2021). Improvements were shown over the years in adherence to Article 5.3 for limiting unnecessary interactions with the tobacco industry, avoiding conflicts of interest, and having preventive measures. However, major gaps were observed in restricting industry participation, regulating their so-called CSR, providing benefits to the industry in the form of incentives, exemptions, and maintaining transparency. Conclusion The study provides the status of implementing Article 5.3 and its guidelines in India. Given the gaps in the existing measures, India needs to comprehensively adopt Article 5.3 guidelinesin all states and union territories adopting whole-of-government approach. There is an urgent need to establish an observatory for periodic compilation of the TII indexes to monitor the tobacco industry and report violations at the national and sub-national levels.
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Affiliation(s)
| | | | | | | | | | | | - Adhip Amin
- Institute of Public Health, Bengaluru, India
| | | | - Pranay Lal
- International Union Against Tuberculosis and Lung Disease, New Delhi, India
| | - P C Gupta
- Healis-Sekhsaria Institute for Public Health, Mumbai, India
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Mwai D, Gathecha G, Njuguna D, Ongango J, Mwenda V, Kiptui D, Kendagor A, Cheburet S, Mohamed S, Jaguga F, Mugi B, Okinda K, Odeny L, Olwanda E, Boachie MK. The Economic Costs of Tobacco Related Illnesses in Kenya. Tob Use Insights 2024; 17:1179173X241272385. [PMID: 39139515 PMCID: PMC11320408 DOI: 10.1177/1179173x241272385] [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: 03/12/2024] [Accepted: 07/12/2024] [Indexed: 08/15/2024] Open
Abstract
Objective To estimate the economic costs of selected tobacco-related illnesses (TRI) in Kenya in 2022. Research Design and Methods This study was conducted in 2 phases. Phase 1, conducted between 2021 and 2022, entailed conducting a cross-sectional study conducted in 4 national public referral hospitals in Kenya. Patients with cardiovascular disease, cancer, chronic obstructive pulmonary disease, or tuberculosis were interviewed to compute the indirect and direct medical costs related to the illness. Activity-Based Costing approach was used to capture costs for services along the continuum of care pathway. In the second phase, the Tobacco Attributable Factor was used to estimate the direct, indirect, and ultimately economic cost due to tobacco smoking. Results The estimated health care cost attributed to tobacco use in Kenya is US$396,107,364. Among TRIs included in the study, myocardial infarction had the highest health care cost at US$158,687,627, followed by peripheral arterial disease and stroke with health care cost of US$64,723,181 and US$44,746,700 respectively. The main cost driver across all the illnesses is the cost for medication accounting for over 90% of the total health care cost. The productivity losses from the diseases ranged between US$148 to US$360 and accounted for 27% to 48% of the economic costs. The total cost attributable to tobacco use to Kenya's economy for the selected TRIs was between US$544.74 million and US$756.22 million. Conclusions/interpretation Tobacco related illnesses impose a significant economic burden as reported for direct and indirect costs. These findings underscore the need for strengthened implementation of the provision of the Framework Convention on Tobacco Control and the Tobacco Control Act (2007) to facilitate a reduction in tobacco consumption in the population.
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Affiliation(s)
- Daniel Mwai
- School of Economics, University of Nairobi, Nairobi, Kenya
- Futures Health Economics and Metric
| | - Gladwell Gathecha
- Department of Non-communicable Diseases, Ministry of Health, Nairobi, Kenya
| | - David Njuguna
- Department of Non-communicable Diseases, Ministry of Health, Nairobi, Kenya
| | - Jane Ongango
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Valerian Mwenda
- Department of Non-communicable Diseases, Ministry of Health, Nairobi, Kenya
| | - Dorcas Kiptui
- Department of Non-communicable Diseases, Ministry of Health, Nairobi, Kenya
| | - Ann Kendagor
- Department of Non-communicable Diseases, Ministry of Health, Nairobi, Kenya
| | - Samuel Cheburet
- Department of Non-communicable Diseases, Ministry of Health, Nairobi, Kenya
| | - Shukri Mohamed
- African Population & Health Research Centre, Nairobi, Kenya
| | | | | | | | - Lazarus Odeny
- Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Micheal K. Boachie
- Division of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Manoochehri Z, Rajati F, Rezaei M, Faradmal J. Factors influencing smoking cessation attempts and success in Iranian male adults: national survey data. BMC Public Health 2024; 24:1654. [PMID: 38902662 PMCID: PMC11191190 DOI: 10.1186/s12889-024-19187-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/18/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Smoking cessation is a dynamic process that often involves a series of unsuccessful quit attempts before long-term abstinence is achieved. To implement interventions that lead to long-term abstinence, it will be necessary to understand the determinants of smoking cessation. Therefore, the main objective of the present study was to determine the effect of factors influencing both smoking cessation attempts and successful smoking cessation in the general population of Iran. METHODS The data of 1293 participants whose information was obtained through a national cross-sectional study entitled "Survey of Risk Factors of Noncommunicable Diseases in 2016" were analyzed. There were three response levels: "quit attempt and successful quit", "quit attempt and unsuccessful quit", and "no quit attempt and unsuccessful quit". A multinomial logistic regression model was used to assess the effect of covariates on response. RESULTS The mean (sd) age of all participants was 47.21 (13.65) years. According to the results, 883 people (68.29%) did not attempt to quit smoking, and of those who attempted to quit smoking, only 64 (15.61%) men were successful. The factors of living in an urban area (OR = 1.71) and past smoking intensity (OR = 1.967) were associated with no quit attempt and unsuccessful quitting. In addition, physician recommendation to quit smoking was a protective factor for no quit attempt and unsuccessful quit (OR = 0.599). Alcohol consumption was also a protective factor against successful quitting for both attempters (OR = 0.351) and nonattempters (OR = 0.359). CONCLUSIONS Tobacco control programs should be implemented with a greater focus on heavy smokers and alcohol users. In addition, the role of health professionals in encouraging smokers to quit smoking should not be ignored.
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Affiliation(s)
- Zohreh Manoochehri
- Department of Biostatistics, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health, Health institute, Department of Health Education and Health Promotion, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Rezaei
- Health System observatory secretariat national Institute for Health research(NIHR), Tehran University of Medical Sciences (TU MS), Tehran, Iran
| | - Javad Faradmal
- Modeling of Noncommunicable Diseases Research Center, Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Shahid Fahmideh Boulevard, Hamadan, Iran.
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Mbotwa CH, Rweyemamu LP. Tobacco Use and Associated Factors Among Men in Tanzania: Further Analysis of the 2022 Tanzania Demographic and Health Survey Data. Tob Use Insights 2024; 17:1179173X241259605. [PMID: 38831862 PMCID: PMC11145999 DOI: 10.1177/1179173x241259605] [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: 04/13/2024] [Accepted: 05/20/2024] [Indexed: 06/05/2024] Open
Abstract
Background: Tobacco use is a significant public health challenge, contributing to preventable diseases and premature deaths globally. We aimed to determine the prevalence of tobacco use and associated factors among men in Tanzania. Methods: This was a cross-sectional analysis of data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey. The study population comprised men aged 15-49 years. Weighted logistic regression was performed to identify factors associated with tobacco use. Results: A total of 5763 men with a mean age of 28.6 ± 10 years were included in the analysis. The overall prevalence of tobacco use was 11.1%, with 95% of users consuming smoked products, 17.1% using smokeless products, and 12.1% using both smoked and smokeless products. Older age was associated with increased odds of tobacco use, with odds of tobacco use increasing with each higher age group. Similarly, alcohol consumption was associated with greater odds of tobacco use. On the other hand, having a secondary education or higher, lack of occupation, being the head of the household, and owning a mobile telephone were associated with lower odds of tobacco use. Geographically, men from the Eastern zone and Zanzibar exhibited greater odds of tobacco use, while those from the Southern highlands zone had lower odds. Conclusion: This study revealed a significant prevalence of tobacco use among Tanzanian men and was associated with different individual, interpersonal, and community factors. The findings underscore the need for targeted interventions considering age-specific risk factors and geographical variations.
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Affiliation(s)
- Christopher Hariri Mbotwa
- Department of Social Sciences, Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania
| | - Linus Paul Rweyemamu
- Department of Biochemistry and Pharmacology, Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania
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Pulicherla NK, Kodali PB. Tobacco Imagery in Indian Over-the-Top (OTT) Media and Its Compliance With Existing Tobacco Laws: A Content Analysis. Nicotine Tob Res 2024; 26:752-758. [PMID: 38147534 DOI: 10.1093/ntr/ntad260] [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: 08/17/2022] [Revised: 12/10/2023] [Accepted: 12/20/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION Over-the-top (OTT) media are internet-based content delivery systems offering media services to the viewers bypassing the traditional broadcasting platforms. The OTT media, with limited regulatory oversight, can serve as a source of exposure to tobacco-promoting content. AIMS AND METHODS This study analyzed the depiction of tobacco imagery in Indian OTT programs and assessed their compliance with existing Indian tobacco control policies. We conducted a content analysis of 28 purposively sampled OTT exclusive programs (14 movies and 14 web series) in India. Breathe California method was used to code the OTT content for tobacco imagery. We assessed the prevalence of tobacco imagery, its duration per episode or program, product placements, and brand appearances. We also evaluated OTT programs adherence to existing tobacco control policies in India. RESULTS Tobacco imagery was identified in all of the web series and most OTT-exclusive movies. On average the web series depicted seven incidents of tobacco imagery per episode, whereas there were close to 19 incidents of tobacco imagery per movie. Ten minutes of OTT programming (including movies and web series) had on average 8.40 s of tobacco imagery. None of the OTT programs studied fully complied with Indian tobacco control policies. CONCLUSIONS Depiction of tobacco imagery in OTT exclusive programs is common in India. Streaming platforms need to comply with existing tobacco control policies. Furthermore, there is a need to strengthen these policies and strictly enforce them to ensure tobacco-free mass media. IMPLICATIONS India has more than 267 million tobacco users and accounts for the largest share of smokeless tobacco use globally. OTT platforms are largely unregulated and are considered drivers for global tobacco use. This is one of the few studies examining tobacco imagery in Indian OTT content, reporting the gaps in tobacco control policies in India. This study documents the product placement of smokeless tobacco, duration of exposure to tobacco imagery, and empirically report the compliance of OTT platforms with Indian tobacco control policies. The study findings can aid in strengthening tobacco control policies in India.
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Affiliation(s)
- Naveen Kumar Pulicherla
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
| | - Prakash Babu Kodali
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
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Xiang K, Ren M, Liu F, Li Y, He P, Gong X, Chen T, Wu T, Huang Z, She H, Liu K, Jing Z, Yang S. Tobacco toxins trigger bone marrow mesenchymal stem cells aging by inhibiting mitophagy. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 277:116392. [PMID: 38677065 DOI: 10.1016/j.ecoenv.2024.116392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/01/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
Smoking disrupts bone homeostasis and serves as an independent risk factor for the development and progression of osteoporosis. Tobacco toxins inhibit the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), promote BMSCs aging and exhaustion, but the specific mechanisms are not yet fully understood. Herein, we successfully established a smoking-related osteoporosis (SROP) model in rats and mice through intraperitoneal injection of cigarette smoke extract (CSE), which significantly reduced bone density and induced aging and inhibited osteogenic differentiation of BMSCs both in vivo and in vitro. Bioinformatics analysis and in vitro experiments confirmed that CSE disrupts mitochondrial homeostasis through oxidative stress and inhibition of mitophagy. Furthermore, we discovered that CSE induced BMSCs aging by upregulating phosphorylated AKT, which in turn inhibited the expression of FOXO3a and the Pink1/Parkin pathway, leading to the suppression of mitophagy and the accumulation of damaged mitochondria. MitoQ, a mitochondrial-targeted antioxidant and mitophagy agonist, was effective in reducing CSE-induced mitochondrial oxidative stress, promoting mitophagy, significantly downregulating the expression of aging markers in BMSCs, restoring osteogenic differentiation, and alleviating bone loss and autophagy levels in CSE-exposed mice. In summary, our results suggest that BMSCs aging caused by the inhibition of mitophagy through the AKT/FOXO3a/Pink1/Parkin axis is a key mechanism in smoking-related osteoporosis.
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Affiliation(s)
- Kai Xiang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Mingxing Ren
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Fengyi Liu
- Stomatological Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Yuzhou Li
- Stomatological Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Ping He
- Stomatological Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Xuerui Gong
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Tao Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Tianli Wu
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Ziyu Huang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Hui She
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Kehao Liu
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Zheng Jing
- Stomatological Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| | - Sheng Yang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Noh JW, Cheon J, Seong H, Kwon YD, Yoo KB. Impacts of Smoking Ban Policies on Billiard Hall Sales in South Korea Using Objective Sales Information of a Credit Card Company: Quasi-Experimental Study. JMIR Public Health Surveill 2024; 10:e50466. [PMID: 38630526 PMCID: PMC11063889 DOI: 10.2196/50466] [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] [Received: 07/01/2023] [Revised: 01/01/2024] [Accepted: 03/06/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Smoking ban policies (SBPs) are potent health interventions and offer the potential to influence antismoking behavior. The Korean government completely prohibited smoking in indoor sports facilities, including billiard halls, since the government revised the National Health Promotion Act in December 2017. OBJECTIVE This study aimed to examine the impact of the SBP on the economic outcomes of indoor sports facilities, particularly billiard halls. METHODS This study used credit card sales data from the largest card company in South Korea. Data are from January 2017 to December 2018. Monthly sales data were examined across 23 administrative neighborhoods in Seoul, the capital city of South Korea. We conducted the interrupted time series model using the fixed effects model and the linear regression with panel-corrected standard errors (PCSE). RESULTS The sales and transactions of billiard halls were not significantly changed after the introduction of the SBP in the full PCSE models. The R2 of the full PCSE model was 0.967 for sales and 0.981 for transactions. CONCLUSIONS The introduction of the SBP did not result in substantial economic gains or losses in the sales of billiard halls. In addition to existing price-based policies, the enhanced SBP in public-use facilities, such as billiard halls, can have a positive synergistic effect on reducing smoking prevalence and preventing secondhand smoke. Health policy makers can actively expand the application of SBPs and make an effort to enhance social awareness regarding the necessity and benefits of public SBPs for both smokers and the owners of hospitality facilities.
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Affiliation(s)
- Jin-Won Noh
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Jooyoung Cheon
- Department of Nursing Science, Sungshin Women's University, Seoul, Republic of Korea
| | - Hohyun Seong
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Public Health and Healthcare Management, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki-Bong Yoo
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
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Chandrashekar BR, Chacko TV, Jayashankar HP, Suma S, Anand KM, Kannappan S. Effectiveness of tobacco counseling training module (TCTM) in enhancing the knowledge, attitude, ability to identify oral manifestations, self-confidence, and skills (KAASS) in tobacco counseling among undergraduate dental students - An interventional study. Indian J Cancer 2024; 61:230-237. [PMID: 38155453 DOI: 10.4103/ijc.ijc_405_21] [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: 04/10/2021] [Accepted: 12/01/2021] [Indexed: 12/30/2023]
Abstract
BACKGROUND Tobacco use has emerged as a major public health issue with increasing tobacco-related morbidity and mortality. Despite evidence that even brief tobacco counseling by health care professionals is effective in motivating a tobacco user to quit, there was a lack of customized tobacco counseling training module (TCTM) for students of dentistry in their existing curriculum. This study was undertaken to evaluate the effectiveness of a customized TCTM in improving KAASS in tobacco counseling among undergraduate dental students. METHODS TCTM that was previously pilot tested was implemented as a value addition in Public Health Dentistry for two academic years. Changes in knowledge, attitude, ability to identify oral manifestations, self-confidence, and skills (KAASS) in tobacco counseling were assessed before and after implementation of TCTM. Mean pre and post intervention scores were compared. RESULTS Mean scores for knowledge, attitude, ability to identify oral manifestations, and self-confidence (KAAS) at baseline were 4.4 ± 0.9, 5.1 ± 0.7, 4.5 ± 1.1, and 1.3 ± 0.4, respectively. Mean KAAS scores post intervention were 13.5 ± 1.0, 8.7 ± 0.4, 9.4 ± 0.7, and 3.5 ± 0.5, respectively. There was a significant improvement in the mean KAAS score post intervention compared to baseline. Tobacco counseling skills also significantly improved among the participants following implementation of the training module (68.8%) did well compared to the baseline (0%). CONCLUSION TCTM was effective in enhancing knowledge, attitude, ability to identify oral manifestations, and self-confidence in tobacco counseling among undergraduate dental students.
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Affiliation(s)
- Byalakere R Chandrashekar
- Department of Public Health Dentistry, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, JSS Medical Institutions Campus, SS Nagar, Mysore, Karnataka, India
| | - Thomas V Chacko
- Department of Community Medicine, Believers Church Medical College and Hospital, Saint Thomas Nagar, Kuttapuzha, Thiruvalla, Kerala, India
| | - H P Jayashankar
- Department of Oral Medicine and Radiology, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, JSS Medical Institutions Campus, SS Nagar, Mysore, Karnataka, India
| | - S Suma
- Department of Orthodontics and Dentofacial Orthopedics, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, JSS Medical Institutions Campus, SS Nagar, Mysore, Karnataka, India
| | - K M Anand
- Department of Microbiology, Melaka Manipal Medical College (Manipal Campus), Manipal, Udupi (district), Karnataka, India
| | - Suvetha Kannappan
- Department of Community Medicine, PSG Institute of Medical Sciences, Coimbatore, Tamil Nadu, India
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Graham-DeMello A, Hoek J. How do people who smoke perceive a tobacco retail outlet reduction policy in Aotearoa New Zealand? A qualitative analysis. Tob Control 2024; 33:e25-e31. [PMID: 36720649 PMCID: PMC10958291 DOI: 10.1136/tc-2022-057834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/20/2023] [Indexed: 02/02/2023]
Abstract
BACKGROUND Aotearoa New Zealand plans to greatly reduce tobacco retail outlets, which are concentrated in areas of higher deprivation and perpetuate health inequities caused by smoking and borne particularly by Māori. However, we lack in-depth analyses of how this measure could affect people who smoke. METHODS We undertook in-depth interviews with 24 adults from two urban areas who smoke. We used a novel interactive mapping approach to examine participants' current retail outlets and their views on a scenario where very few outlets would sell tobacco. To inform policy implementation, we probed participants' anticipated responses and explored the measure's wider implications, including unintended impacts. We used qualitative description to interpret the data. RESULTS Most participants anticipated accommodating the changes easily, by using alternative outlets or bulk-purchasing tobacco; however, they felt others would face access problems and increased costs, and greater stress. They thought the policy would spur quit attempts, reduce relapse among people who had quit and protect young people from smoking uptake, and expected more people to switch to alternative nicotine products. However, most foresaw unintended social outcomes, such as increased crime and reduced viability of local businesses. CONCLUSIONS Many participants hoped to become smoke-free and thought retail reduction measures would prompt quit attempts and reduce relapse. Adopting a holistic well-being perspective, such as those developed by Māori, could address concerns about unintended adverse outcomes and provide comprehensive support to people who smoke as they adjust to a fundamental change in tobacco availability.
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Affiliation(s)
| | - Janet Hoek
- Public Health, University of Otago, Wellington, New Zealand
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Pleym K, Dammen T, Wedon-Fekjaer H, Husebye E, Sverre E, Tonstad S, Munkhaugen J. A multi-component intervention increased access to smoking cessation treatment after hospitalization for atherosclerotic cardiovascular disease: a randomized trial. EUROPEAN HEART JOURNAL OPEN 2024; 4:oeae028. [PMID: 38666249 PMCID: PMC11044967 DOI: 10.1093/ehjopen/oeae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
Aims To evaluate the effects of a multi-component intervention for smokers hospitalized for atherosclerotic cardiovascular disease (ASCVD) on the participation rate in community-based cessation programmes and the use of cessation drugs. Additionally, to explore the impact on the cessation rates at 6 months. Methods and results A randomized parallel-group study was conducted at a Norwegian secondary care hospital in 2021. The intervention group was: (i) counselled using motivational interviewing techniques during hospitalization; (ii) given an information leaflet, detailing the cessation programme; and (iii) referred to the community-based smoking cessation treatment including a post-discharge pro-active telephone invitation. The control group received usual care and the same information leaflet containing clear contact details for initiating participation. Data were collected at baseline, 1, 3, and 6 months. Among 99 smokers hospitalized with ASCVD, 40 were excluded. Of 59 randomized patients, 4 were lost to follow-up and 55 completed the study. The mean age was 65.1 (standard deviation 9.3) years, 35% were female, and 88% had smoked >20 years. Co-morbidity was prevalent (mean Charlson score 4.8). The intervention group was more likely to participate in the smoking cessation treatment {48 vs. 7%, difference: 41% [95% confidence interval (CI): 14%, 63%]} and used cessation drugs more frequently [59 vs. 21%, difference: 38% (95% CI: 17%, 59%)]. At the 6 months point prevalence, we observed notable between-group differences in self-reported cessation rate (48 vs. 25%). Conclusion The intervention significantly increased the participation rate at community-based smoking cessation programmes and the use of cessation drugs among multi-morbid smokers hospitalized for ASCVD.
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Affiliation(s)
- Karin Pleym
- Department of Medicine, Drammen Hospital, Vestre Viken Trust, Dronninggata 48, 3004 Drammen, Norway
- Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway
| | - Toril Dammen
- Division of Mental Health and Addiction, Department of Research and Innovation, Oslo University Hospital, Sognsvannsveien 2, 0372 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Klaus Torgårds vei 3, 0372 Oslo, Norway
| | - Harald Wedon-Fekjaer
- Oslo Center for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Sognsvannsveien 9, 0372 Oslo, Norway
| | - Einar Husebye
- Department of Medicine, Drammen Hospital, Vestre Viken Trust, Dronninggata 48, 3004 Drammen, Norway
| | - Elise Sverre
- Department of Medicine, Drammen Hospital, Vestre Viken Trust, Dronninggata 48, 3004 Drammen, Norway
| | - Serena Tonstad
- Department of Endocrinology, Obesity and Preventive Medicine, Section of Preventive Cardiology, Oslo University Hospital, Trondheimsveien 235, 0586 Oslo, Norway
| | - John Munkhaugen
- Department of Medicine, Drammen Hospital, Vestre Viken Trust, Dronninggata 48, 3004 Drammen, Norway
- Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway
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Mundt MP, McCarthy DE, Baker TB, Zehner ME, Zwaga D, Fiore MC. Cost-Effectiveness of a Comprehensive Primary Care Smoking Treatment Program. Am J Prev Med 2024; 66:435-443. [PMID: 37844710 PMCID: PMC10922402 DOI: 10.1016/j.amepre.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION Smoking is the leading preventable cause of death and disease in the U.S. This study evaluates the cost-effectiveness from a healthcare system perspective of a comprehensive primary care intervention to reduce smoking rates. METHODS This pragmatic trial implemented electronic health record prompts during primary care visits and employed certified tobacco cessation specialists to offer proactive outreach and smoking cessation treatment to patients who smoke. The data, analyzed in 2022, included 10,683 patients in the smoking registry from 2017 to 2020. Pre-post analyses compared intervention costs to treatment engagement, successful self-reported smoking cessation, and acute health care utilization (urgent care, emergency department visits, and inpatient hospitalization). Cost per quality-adjusted life year was determined by applying conversion factors obtained from the tobacco research literature to the cost per patient who quit smoking. RESULTS Tobacco cessation outreach, medication, and counseling costs increased from $2.64 to $6.44 per patient per month, for a total post-implementation intervention cost of $500,216. Smoking cessation rates increased from 1.3% pre-implementation to 8.7% post-implementation, for an incremental effectiveness of 7.4%. The incremental cost-effectiveness ratio was $628 (95% CI: $568, $695) per person who quit smoking, and $905 (95% CI: $822, $1,001) per quality-adjusted life year gained. Acute health care costs decreased by an average of $42 (95% CI: -$59, $145) per patient per month for patients in the smoking registry. CONCLUSIONS Implementation of a comprehensive and proactive smoking cessation outreach and treatment program for adult primary care patients who smoke meets typical cost-effectiveness thresholds for healthcare.
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Affiliation(s)
- Marlon P Mundt
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
| | - Danielle E McCarthy
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin; Department of Medicine, Division of General Internal Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin; Department of Medicine, Division of General Internal Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Mark E Zehner
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Deejay Zwaga
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Michael C Fiore
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin; Department of Medicine, Division of General Internal Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
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Alpers SE, Druckrey-Fiskaaen KT, Madebo T, Vold JH, Pallesen S, Skogen JC, Lunde LH, Mæland S, Fadnes LT. The association of psychological distress and economic and health worries with tobacco smoking behavior during the COVID-19 pandemic: a two-year longitudinal cohort study. BMC Public Health 2024; 24:375. [PMID: 38317145 PMCID: PMC10840189 DOI: 10.1186/s12889-024-17943-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/01/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and other life events may trigger worries and psychological distress. These impacts may lead to unhealthy behaviors, such as tobacco smoking, but the degree of such associations is unclear. The current three-wave longitudinal study examines changes in tobacco smoking in Norway between 2020 and 2022 and their associations with psychological distress as well as health- and economy-related worries. METHODS Data were collected in April 2020 (baseline), January 2021, and January 2022 in Bergen, Norway, from an online longitudinal population-based survey. Smoking tobacco (the outcome variable) was dichotomized based on the responses to the question of whether participants smoked cigarettes or not. Tobacco smoking and its associations with psychological distress were assessed among 24,914 participants (response rate 36%) in a mixed model regression presented with coefficients and 95% confidence intervals (CI), adjusting for COVID-19-related worries, home office/study, occupational situation, age, gender, education, having children below 18 years living at home, living alone, and alcohol consumption. RESULTS A total of 10% of the study sample were current smokers at baseline. At baseline, smoking tobacco was associated with high levels of psychological distress (absolute difference 13%, 95% CI 10%; 15%), advanced age (50-59 years: 11%, CI 10%; 13%), and hazardous alcohol use (4%, CI 3%; 5%) compared to their counterparts. Higher education (-5%, CI -6%; -4%), working from home (-4%, CI -5%; -4%), and higher physical activity levels (-4%, CI -5%; -3%) were associated with non-smoking. The prevalence of smoking among individuals experiencing severe psychological distress decreased slightly over time (-2% per year, CI -3%; -1%). CONCLUSIONS Smoking was associated with severe psychological distress, advanced age, and hazardous alcohol use at baseline; non-smoking was associated with high education, working from home, and high physical activity. Nevertheless, the smoking rate among individuals experiencing severe psychological distress slightly decreased over the course of the COVID-19 pandemic.
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Affiliation(s)
- Silvia Eiken Alpers
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.
| | - Karl Trygve Druckrey-Fiskaaen
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Tesfaye Madebo
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Respiratory Medicine, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Jørn Henrik Vold
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Linn-Heidi Lunde
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Silje Mæland
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Lars Thore Fadnes
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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Sultan Y, Salman Z, Alzaatreh M, Edilbi A, Alani R, Sultan I, Alfaar AS, Qaddoumi I. Smoking-Related Disease Impact in the Eastern Mediterranean Region: A Comprehensive Assessment Using Global Burden of Disease Data. Asian Pac J Cancer Prev 2024; 25:495-505. [PMID: 38415535 PMCID: PMC11077135 DOI: 10.31557/apjcp.2024.25.2.495] [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] [Received: 08/03/2023] [Accepted: 02/11/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Smoking remains a significant risk factor for numerous health issues, including lung cancer, chronic obstructive pulmonary disease, ischemic heart disease, stroke, and respiratory infections. This study investigates the burden of tobacco-related diseases in the Middle East and North Africa (MENA) region. METHODS Utilizing the GBD data, we examined the risk of smoking and second-hand smoke exposure and their related causes of death and disability in the 22 MENA countries. Smoking prevalence and disease burden data were analyzed with estimates reported as age-standardized rates. RESULTS Tobacco abuse accounted for 14.5% of all deaths and 23.2% of deaths tied to known risk factors, with an age-standardized death rate of 110.8 per 100,000. Cardiovascular diseases were the primary cause of smoking-related deaths and DALYs, representing 53.4% of all deaths and 50.3% of all DALYs. This was followed by neoplasms (24.6% of all deaths and 20.3% of all DALYs), chronic respiratory diseases(12.4% of all deaths and 11.9% of all DALYs), and respiratory infections and tuberculosis(4% of all deaths and 3.4% of all DALYs). Second-hand smoking caused 20.5% of tobacco-related deaths and 21.5% of tobacco-related DALYs, disproportionately affecting younger individuals. An increasing disease burden was observed in Lebanon, Turkey, Syria, Tunisia, UAE, and Libya, and declining rates were most evident in Oman and Qatar. CONCLUSION Our study emphasizes the impact of smoking on cardiovascular disease, the primary cause of smoking-related mortality and morbidity in the MENA region. Our findings highlight the urgent need for effective tobacco control policies and interventions.
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Affiliation(s)
| | - Zeena Salman
- Department of Global Pediatric Medicin, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States.
| | - Mohammed Alzaatreh
- St. Richard’s Hospital, University Hospitals Sussex NHS Trust, West Sussex, England.
| | - Adib Edilbi
- Research Office, King Hussein Cancer Center, Amman, Jordan.
| | - Ruba Alani
- Research Office, King Hussein Cancer Center, Amman, Jordan.
| | - Iyad Sultan
- Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan.
- Artificial Intelligence and Data Innovation Office; King Hussein Cancer Center, Amman, Jordan.
| | | | - Ibrahim Qaddoumi
- Department of Global Pediatric Medicin, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States.
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Mišković I, Kuiš D, Špalj S, Pupovac A, Prpić J. Periodontal Health Status in Adults Exposed to Tobacco Heating System Aerosol and Cigarette Smoke vs. Non-Smokers: A Cross-Sectional Study. Dent J (Basel) 2024; 12:26. [PMID: 38392230 PMCID: PMC10887685 DOI: 10.3390/dj12020026] [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: 12/07/2023] [Revised: 01/21/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
Tobacco heating systems (THS) are new products on the market, advertised as a less harmful alternative for smokers, in which tobacco is heated and not burned like in conventional cigarettes. This research explored the effect on periodontal tissues in contact with heating and burning tobacco residual products (smoke and tobacco). METHODS The sample included 66 subjects, patients of the Clinic of Dentistry in Rijeka, Croatia, aged 26-56 (median 38), 64% females. Three age- and gender-matched groups were formed (each N = 22): non-smokers, classic cigarettes smokers and THS smokers. Probing depth (PD) and clinical attachment loss (CAL) were primary research parameters. RESULTS Three groups differed in average PD and CAL (p ≤ 0.002), with cigarette smokers having the highest and non-smokers the lowest values (p ≤ 0.002). THS consumers generally had lower values of periodontal indices than smokers, but only CAL differed significantly (p = 0.011). Periodontal indices CAL and PD were worse in THS consumers than non-smokers, but they did not reach a level of statistical significance. Cigarette smoking was the only predictor of periodontitis (average CAL ≥ 4 mm) in logistic regression models, with an odds ratio of 4.7 (95% confidence interval 1.2-18.3; p = 0.027). CONCLUSIONS Exposure to nicotine-containing aerosol of THS in adults has a less harmful effect on periodontal tissues, measurable through periodontal indices (PD and CAL), compared to burning tobacco of conventional cigarettes. THS, presented as an alternative product to classic cigarettes, also has a detrimental effect on the periodontium.
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Affiliation(s)
- Ivana Mišković
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
| | - Davor Kuiš
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
- Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
| | - Stjepan Špalj
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
| | - Aleksandar Pupovac
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
| | - Jelena Prpić
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
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Rizkita AD, Dewi SA, Fakih TM, Lee CC. Effectiveness of sesquiterpene derivatives from Cinnamomum genus in nicotine replacement therapy through blocking acetylcholine nicotinate: a computational analysis. J Biomol Struct Dyn 2024:1-14. [PMID: 38268238 DOI: 10.1080/07391102.2024.2305315] [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: 10/25/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
Cigarette smoking poses various health risks, such as increasing the susceptibility to respiratory infections, contributing to osteoporosis, causing reproductive issues, delaying postoperative recovery, promoting ulcer formation and heightening the risk of diabetes. While many harmful effects of smoking are attributed to other cigarette components, it is nicotine's pharmacological effects that underlie tobacco addiction. Nicotine replacement therapy (NRT) aims to alleviate the urge to smoke and mitigate physiological and psychomotor withdrawal symptoms by delivering nicotine. This study explores the potential of sesquiterpene derivative compounds derived from the Cinnamomum genus using computational techniques. The research incorporates molecular docking analyses, Lipinski's rule of five filtration for drug-likeness, pharmacokinetic and toxicity predictions to assess safety profiles and molecular dynamics (MD) simulations to gauge interaction stability. The findings reveal that all sesquiterpene derivative compounds from the Cinnamomum genus can potentially inhibit nicotinic acetylcholine receptors (nAChRs), particularly nAChRÿ7. However, only abscisic acid exhibit active inhibition, along with suitable drug properties, pharmacokinetics and toxicity profiles. MD studies confirm the stability of interactions between abscisic acid with nAChRÿ7. Consequently, abscisic acid, as sesquiterpene derivatives from the Cinnamomum genus, holds substantial promise for further investigation as nAChRÿ7 inhibitors.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Aden Dhana Rizkita
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Sekolah Tinggi Ilmu Kesehatan (STIKES) Bogor Husada, Bogor, West Java, Indonesia
| | - Sintia Ayu Dewi
- Graduate Institute of Pharmacognosy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Taufik Muhammad Fakih
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Islam Bandung, Bandung, West Java, Indonesia
| | - Cheng-Chung Lee
- The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
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Hameed A, Malik D. Clinical study protocol on electronic cigarettes and nicotine pouches for smoking cessation in Pakistan: a randomized controlled trial. Trials 2024; 25:9. [PMID: 38167206 PMCID: PMC10759381 DOI: 10.1186/s13063-023-07876-y] [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] [Received: 10/09/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Pakistan is one of most vulnerable low- and middle-income countries with 29 million adult active tobacco users. Smoking cessation services are lacking as the tobacco control initiatives have largely failed to address the smoking endemic. Over the last 5 years, Pakistan has witnessed the use of innovative tobacco harm reduction (THR) products such as e-cigarettes and nicotine pouches. However, their use remains limited. THR products are imported legally as consumer goods and are taxable. The lack of sufficient data for THR and its application is a challenge in gauging their effectiveness in assisting smokers quit combustible smoking. Evidence-based studies can help in measuring the effectiveness of e-cigarettes and nicotine pouches as smoking cessation aids. METHOD Keeping in view the study objectives, a sample size of 600 participants will be sufficient to assess the effectiveness of e-cigarettes and nicotine pouches for smoking cessation in Pakistan. Of these, 200 participants each will receive e-cigarettes and nicotine pouches along with basic care counselling, while the remaining 200 participants will only receive basic care counselling for 48 weeks. The association of participants' characteristics with smoking and health status will be based on the bivariate and multivariate analysis. The simple t-test and variance analysis will assess the differences in intervention indicators between the control and treatment groups. For the inferential analysis, the average treatment impact will be based on the quasi-experimental techniques such as difference in difference (DID) or propensity score matching (PMS). DISCUSSION The study will evaluate the participants at the baseline as they decide the quit date. After every 12 weeks, a follow-up survey with the participants will be conducted. Results are anticipated to inform the public, decision-makers, and researchers about the effects of using e-cigarettes and nicotine pouches in the short- and medium-term periods. Critically, the potential of e-cigarettes and other alternative nicotine delivery systems as smoking cessation aid will be assessed. TRIAL REGISTRATION ClinicalTrials.gov NCT05715164 . Registered on February 6, 2023. PROTOCOL VERSION Protocol version 1.0, 14-12-2022 Trial in progress and not yet recruiting participants. Estimated primary data collection date-April 2024.
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Affiliation(s)
- Abdul Hameed
- Department of Research, Alternative Research Initiative, Islamabad, Pakistan.
| | - Daud Malik
- Department of Research, Alternative Research Initiative, Islamabad, Pakistan
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Arabi S, Jahanmehr N, Khoramrooz M. National and regional economic inequalities in first- and second-hand tobacco consumption among women of reproductive ages in Iran. BMC Public Health 2023; 23:2532. [PMID: 38110920 PMCID: PMC10726556 DOI: 10.1186/s12889-023-17287-y] [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] [Received: 09/25/2022] [Accepted: 11/21/2023] [Indexed: 12/20/2023] Open
Abstract
INTRODUCTION The epidemic of tobacco consumption is one of the major public health threats the world has been facing so far. This study was performed to investigate the economic inequalities in tobacco consumption among women of reproductive ages at national and regional levels in Iran. METHODS We used data from 10,339 women of reproductive ages (18-49 years) who participated in Iran's 7th Non-Communicable Disease Risk Factor Surveillance (STEPS). Wagstaff normalized concentration index and decomposition method were applied to measure economic inequalities in first- and second-hand tobacco consumption and determine their corresponding contributory factors, respectively. RESULTS The prevalence of women's first-hand tobacco consumption, and their exposure to second-hand smoke in the home, and workplace were 3.6%, 28.3%, and 8.4%, respectively. First- and second-hand tobacco consumption was significantly more concentrated among low-economic women. Exposure to home second-hand smoke, education, and economic status had the largest contributions to the measured inequality in first-hand tobacco consumption (48.9%, 38.9%, and 30.8%, respectively). The measured inequality in women's secondhand smoke exposure at home was explained by their level of education (43.8%), economic status (30.3%), and residency in rural areas (18%), and at work by residency in rural areas (42.2%), economic status (38.8%), and level of education (32%). Our results also revealed diversity in the geographical distribution of inequalities in rural and urban areas and five regions of the country. CONCLUSION The present study highlighted the need for more enforcement of tobacco control rules and increasing tobacco taxes as general measures. Furthermore, there is a need for gender-sensitive initiatives at national and regional levels to educate, support, and empower low-economic women and households for tobacco cessation, and complying with restrictive smoking rules.
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Affiliation(s)
- Samira Arabi
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nader Jahanmehr
- Health Economics, Management, and Policy Department, Virtual School of Medical Education & Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Khoramrooz
- Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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Hoff TA, Heller S, Reichel JL, Werner AM, Schäfer M, Tibubos AN, Simon P, Beutel ME, Letzel S, Rigotti T, Dietz P. Cigarette Smoking, Risky Alcohol Consumption, and Marijuana Smoking among University Students in Germany: Identification of Potential Sociodemographic and Study-Related Risk Groups and Predictors of Consumption. Healthcare (Basel) 2023; 11:3182. [PMID: 38132073 PMCID: PMC10742791 DOI: 10.3390/healthcare11243182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/30/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
(1) Background: Cigarette smoking, risky alcohol consumption, and marijuana smoking are the most common behaviors related to legal and illicit drug use worldwide, including among university students. To plan effective evidence-based programs to prevent the risky consumption of these substances among university students, the present study aimed to identify potential sociodemographic and study-related risk groups and predictors of consumption. (2) Methods: A cross-sectional online health survey with approximately 270 health-related items was conducted among students at the University of Mainz, Germany. Cigarette smoking, risky alcohol consumption (AUDIT-C score: female ≥ 4, male ≥ 5), and marijuana smoking were chosen as dependent variables. Of the 270 health-related items, 56 were chosen as independent variables and collated into five groups (sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior). The prevalence of cigarette smoking, risky alcohol consumption, and marijuana smoking was assessed using established and validated instruments. Pearson's chi-square test was used to analyze the differences in prevalence between the sociodemographic and study-related groups, and binary logistic regression was used for analyses with stepwise inclusion of the five variable groups. (3) Results: Of the 3991 university students who entered the analyses, 14.9% reported smoking cigarettes, 38.6% reported risky alcohol consumption, and 10.9% reported smoking marijuana. The prevalence of these differed between genders, fields of study, and aspired degree level, among other factors. Binary logistic regression analyses revealed nine significant predictors (p ≤ 0.05) of cigarette smoking (Nagelkerke R2 = 0.314), 18 significant predictors of risky alcohol consumption (Nagelkerke R2 = 0.270), and 16 significant predictors of marijuana smoking (Nagelkerke R2 = 0.239). (4) Conclusions: This study showed cigarette smoking, risky alcohol consumption, and marijuana smoking among university students in Germany to be associated with multiple factors, especially health behaviors. Furthermore, each of the substances was highly associated with each of the two other substances we examined. Other variable groups, such as psychological or psychosocial variables, seemed to play a rather minor role. Therefore, our recommendation for future prevention programs is that substance use among university students should be addressed as a whole, not just in terms of specific substances.
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Affiliation(s)
- Thilo A. Hoff
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the Johannes Gutenberg University, 55131 Mainz, Germany; (T.A.H.); (S.H.); (J.L.R.); (S.L.)
| | - Sebastian Heller
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the Johannes Gutenberg University, 55131 Mainz, Germany; (T.A.H.); (S.H.); (J.L.R.); (S.L.)
| | - Jennifer L. Reichel
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the Johannes Gutenberg University, 55131 Mainz, Germany; (T.A.H.); (S.H.); (J.L.R.); (S.L.)
| | - Antonia M. Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (A.M.W.); (A.N.T.); (M.E.B.)
| | - Markus Schäfer
- Department of Communication, Johannes Gutenberg University, 55122 Mainz, Germany;
| | - Ana Nanette Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (A.M.W.); (A.N.T.); (M.E.B.)
- Nursing Science, Diagnostics in Healthcare and E-Health, Trier University, 54296 Trier, Germany
| | - Perikles Simon
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sport Science, Johannes Gutenberg University, 55122 Mainz, Germany;
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany; (A.M.W.); (A.N.T.); (M.E.B.)
| | - Stephan Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the Johannes Gutenberg University, 55131 Mainz, Germany; (T.A.H.); (S.H.); (J.L.R.); (S.L.)
| | - Thomas Rigotti
- Department of Work, Organizational and Business Psychology, Institute of Psychology, Johannes Gutenberg University, 55122 Mainz, Germany;
- Leibniz Institute of Resilience Research, 55122 Mainz, Germany
| | - Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the Johannes Gutenberg University, 55131 Mainz, Germany; (T.A.H.); (S.H.); (J.L.R.); (S.L.)
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Palacios A, Alcaraz A, Casarini A, Rodriguez Cairoli F, Espinola N, Balan D, Perelli L, Augustovski F, Bardach A, Pichon-Riviere A. The health, economic and social burden of smoking in Argentina, and the impact of increasing tobacco taxes in a context of illicit trade. HEALTH ECONOMICS 2023; 32:2655-2672. [PMID: 37525366 DOI: 10.1002/hec.4741] [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: 05/02/2022] [Revised: 03/15/2023] [Accepted: 06/12/2023] [Indexed: 08/02/2023]
Abstract
Tobacco tax increases, the most cost-effective measure in reducing consumption, remain underutilized in low and middle-income countries. This study estimates the health and economic burden of smoking in Argentina and forecasts the benefits of tobacco tax hikes, accounting for the potential effects of illicit trade. Using a probabilistic Markov microsimulation model, this study quantifies smoking-related deaths, health events, and societal costs. The model also estimates the health and economic benefits of different increases in the price of cigarettes through taxes. Annually, smoking causes 45,000 deaths and 221,000 health events in Argentina, costing USD 2782 million in direct medical expenses, USD 1470 million in labor productivity loss costs, and USD 1069 million in informal care costs-totaling 1.2% of the national gross domestic product. Even in a scenario that considers illicit trade of tobacco products, a 50% cigarette price increase through taxes could yield USD 8292 million in total economic benefits accumulated over a decade. Consequently, raising tobacco taxes could significantly reduce the health and economic burdens of smoking in Argentina while increasing fiscal revenue.
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Affiliation(s)
- Alfredo Palacios
- Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
- Centre for Health Economics (CHE), University of York, York, UK
| | - Andrea Alcaraz
- Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Agustín Casarini
- Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | | | - Natalia Espinola
- Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Dario Balan
- Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Lucas Perelli
- Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Federico Augustovski
- Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
- CONICET (National Scientific and Technical Research Council, Argentina), Buenos Aires, Argentina
- School of Public Health, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | - Ariel Bardach
- Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
- CONICET (National Scientific and Technical Research Council, Argentina), Buenos Aires, Argentina
| | - Andrés Pichon-Riviere
- Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
- CONICET (National Scientific and Technical Research Council, Argentina), Buenos Aires, Argentina
- School of Public Health, University of Buenos Aires (UBA), Buenos Aires, Argentina
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20
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Johansson L, Guo X, Sacuiu S, Fässberg MM, Kern S, Zettergren A, Skoog I. Longstanding smoking associated with frontal brain lobe atrophy: a 32-year follow-up study in women. BMJ Open 2023; 13:e072803. [PMID: 37802622 PMCID: PMC10565256 DOI: 10.1136/bmjopen-2023-072803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/18/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE To examine the association between midlife tobacco smoking and late-life brain atrophy and white matter lesions. METHODS The study includes 369 women from the Prospective Population Study of Women in Gothenburg, Sweden. Cigarette smoking was reported at baseline 1968 (mean age=44 years) and at follow-up in 1974-1975 and 1980-1981. CT of the brain was conducted 32 years after baseline examination (mean age=76 years) to evaluate cortical atrophy and white matter lesions. Multiple logistic regressions estimated associations between midlife smoking and late-life brain lesions. The final analyses were adjusted for alcohol consumption and several other covariates. RESULTS Smoking in 1968-1969 (adjusted OR 1.85; 95% CI 1.12 to 3.04), in 1974-1975 (OR 2.37; 95% CI 1.39 to 4.04) and in 1980-1981 (OR 2.47; 95% CI 1.41 to 4.33) were associated with late-life frontal lobe atrophy (2000-2001). The strongest association was observed in women who reported smoking at all three midlife examinations (OR 2.63; 95% CI 1.44 to 4.78) and in those with more frequent alcohol consumption (OR 6.02; 95% CI 1.74 to 20.84). Smoking in 1980-1981 was also associated with late-life parietal lobe atrophy (OR 1.99; 95% CI 1.10 to 3.58). There were no associations between smoking and atrophy in the temporal or occipital lobe, or with white matter lesions. CONCLUSION Longstanding tobacco smoking was mainly associated with atrophy in the frontal lobe cortex. A long-term stimulation of nicotine receptors in the frontal neural pathway might be harmful for targeted brain cell.
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Affiliation(s)
- Lena Johansson
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Sahlgrenska universitetssjukhuset, Goteborg, Sweden
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Xinxin Guo
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden
| | - Simona Sacuiu
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden
| | - Madeleine Mellqvist Fässberg
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden
| | - Silke Kern
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), Institute of Neuroscience and Physiology, University of Gothenburg, Goteborg, Sweden
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21
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Gebreslassie M, Galanti MR, Feldman I, Lager A. Should Nicotine Replacement Therapy be Provided Free of Charge? A Cost-Utility Analysis in Sweden. Nicotine Tob Res 2023; 25:1762-1769. [PMID: 37367182 DOI: 10.1093/ntr/ntad103] [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: 11/28/2022] [Revised: 06/07/2023] [Accepted: 06/26/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Treatment with nicotine replacement therapy (NRT) during an attempt to quit smoking increases the likelihood of success by about 55%. However, out-of-pocket payment for NRT can hinder its use. AIMS AND METHODS This study aims therefore to assess the cost-effectiveness of subsidizing NRT in Sweden. A homogeneous cohort-based Markov model was used to assess the lifetime costs and effects of subsidized NRT from a payer and societal perspective. Data to populate the model were retrieved from the literature, and selected parameters were varied in deterministic and probabilistic sensitivity analyses to assess robustness of model outputs. Costs are presented in USD, year 2021. RESULTS A 12-week treatment with NRT was estimated to cost USD 632 (474-790) per person. From a societal perspective, subsidized NRT was a cost-saving alternative in 98.5% of the simulations. NRT is cost-saving across all ages, but the health and economic gains are somewhat larger among younger smokers from a societal perspective. When a payer perspective was used, the incremental cost-effectiveness ratio was estimated at 14 480 (11 721-18 515) USD per QALY which was cost-effective at a willingness to pay of 50 000 USD per QALY in 100 % of the simulations. Results were robust with realistic changes in the inputs during scenario and sensitivity analyses. CONCLUSIONS Subsidizing NRT is potentially a cost-saving smoking cessation strategy from a societal perspective and cost-effective from a payer perspective. IMPLICATIONS This study found that subsidizing NRT is potentially a cost-saving smoking cessation policy alternative compared to current practice from a societal perspective. From a healthcare payer perspective, subsidizing NRT is estimated to cost USD 14 480 to gain an extra QALY. NRT is cost-saving across all ages, but the health and economic gains are somewhat larger among younger smokers from a societal perspective. Moreover, subsidizing NRT removes the financial barriers that are mostly faced by socioeconomically disadvantaged smokers which might reduce health inequalities. Thus, future economic evaluations should further investigate the health inequality impacts with methods that are more suitable for this.
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Affiliation(s)
| | - Maria Rosaria Galanti
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anton Lager
- Centre for Epidemiology and Community Medicine, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
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22
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Masoudkabir F, Mohammadifard N, Mani A, Ignaszewski A, Davis MK, Vaseghi G, Mansourian M, Franco C, Gotay C, Sarrafzadegan N. Shared Lifestyle-Related Risk Factors of Cardiovascular Disease and Cancer: Evidence for Joint Prevention. ScientificWorldJournal 2023; 2023:2404806. [PMID: 37520844 PMCID: PMC10386903 DOI: 10.1155/2023/2404806] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 02/25/2023] [Accepted: 06/09/2023] [Indexed: 08/01/2023] Open
Abstract
Cardiovascular disease (CVD) and cancer are leading causes of mortality and morbidity worldwide and are the major focus of the World Health Organization's joint prevention programs. While, diverse diseases, CVD and cancer, have many similarities. These include common lifestyle-related risk factors and shared environmental, metabolic, cellular, inflammatory, and genetic pathways. In this review, we will discuss the shared lifestyle-related and environmental risk factors central to both diseases and how the strategies commonly used to prevent atherosclerotic vascular disease can be applied to cancer prevention.
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Affiliation(s)
- Farzad Masoudkabir
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Mohammadifard
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arya Mani
- Yale Cardiovascular Genetics Program, Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Andrew Ignaszewski
- Division of Cardiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Margot K. Davis
- Division of Cardiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Golnaz Vaseghi
- Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Epidemiology and Biostatistics Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Christopher Franco
- Division of Cardiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carolyn Gotay
- School of Population & Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Mohd Noordin Z, Neoh CF, Ibrahim@ Ghazali NH, Karuppannan M. "A person who do not smoke will not understand a person who smokes and trying to quit…" Insights From Quit Smoking Clinics' Defaulters: A Qualitative Study. J Patient Exp 2023; 10:23743735231184690. [PMID: 37424538 PMCID: PMC10328151 DOI: 10.1177/23743735231184690] [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] [Indexed: 07/11/2023] Open
Abstract
This study explored the factors contributing to discontinuation of people who smoke (PWS) from quit smoking clinic prior to achieving 6-month abstinence. Fifteen active PWS were interviewed via telephone and face-to-face. Interviews were audio-recorded, transcribed and analysed using thematic analysis. At individual level, low intrinsic motivation including unreadiness to quit, low self-efficacy and ambivalence on smoking cessation were barriers to attain successful cessation. Influence of extrinsic factors such as work-related factors, social interaction and ill-health burden lead to poor commitment with QSC. At the clinic level, healthcare professional's competency, personal attributes, pharmacotherapy's efficacy, safety and availability were important components that may affect a participant's effort to quit. Working commitment was highlighted as the primary barrier for a successful cessation. Hence, effective intervention and collaborative effort between healthcare facilities and employers are essential to optimise cessation adherence among employees who smoke which subsequently will enhance their abstinence rates.
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Affiliation(s)
- Zakiah Mohd Noordin
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
- Cardiology Therapeutics Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
| | - Chin Fen Neoh
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | | | - Mahmathi Karuppannan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
- Cardiology Therapeutics Research Group, Faculty of Pharmacy, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
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24
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Raspe M, Bals R, Bölükbas S, Faber G, Krabbe B, Landmesser U, Al Najem S, Przibille O, Raupach T, Rupp A, Rustler C, Tuffman A, Urlbauer M, Voigtländer T, Andreas S. [Smoking cessation in hospitalised patients - Initiate among inpatients, continue when outpatients - A Position Paper by the German Respiratory Society (DGP) Taskforce for Smoking Cessation]. Pneumologie 2023. [PMID: 37186277 DOI: 10.1055/a-2071-8900] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Tobacco smoking is the greatest preventable health risk. The effects are serious, both individually and societal. Nevertheless, the current prevalence of tobacco smokers in Germany is still high at around 35 %. A recent strong increase in actively smoking adolescents (14- to 17-year-olds, current prevalence approx. 16 %) and young adults (18- to 24-year-olds, current prevalence approx. 41 %) is also a cause for concern. About a third of all inpatients continue smoking while being treated. The hospitalization of active smokers in acute and rehabilitation hospitals serves as a "teachable moment" for initiation of cessation offers. An intervention that begins in hospital and continues for at least a month after discharge results in about 40 % additional smokefree patients. It is scientifically well-researched, effective and cost-efficient. After initiation in hospital these measures can be continued via ambulatory cessation programs, rehabilitation facilities, an Internet or telephone service. In Germany, there are structured and quality-assured cessation offers, both for the inpatient and for the outpatient area. The biggest obstacle to broad establishment of such offers is the lack of reimbursement. Two feasible ways to change this would be the remuneration of the existing OPS 9-501 "Multimodal inpatient treatment for smoking cessation" and the establishment of quality contracts according to § 110a SGB V. An expansion of tobacco cessation measures in healthcare facilities would reduce smoking prevalence, associated burden of disease and consecutive costs.
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Affiliation(s)
- Matthias Raspe
- Charité - Universitätsmedizin Berlin, Mitglied der Freien Universität Berlin, Humboldt-Universität zu Berlin, und des Berlin Institute of Health, Fächerverbund für Infektiologie, Pneumologie und Intensivmedizin, Klinik für Pneumologie, Beatmungsmedizin und Intensivmedizin mit dem Arbeitsbereich Schlafmedizin, Berlin
| | - Robert Bals
- Klinik für Innere Medizin V - Pneumologie, Allergologie, Beatmungsmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Serve Bölükbas
- Klinik für Thoraxchirurgie, Universitätsmedizin Essen - Ruhrlandklinik, Essen
| | - Gerhard Faber
- CELENUS Teufelsbad Fachklinik Blankenburg, Blankenburg
| | - Bernd Krabbe
- Herz-Kreislaufmedizin/Angiologie, UKM Marienhospital Steinfurt, Steinfurt
| | - Ulf Landmesser
- Deutsches Herzzentrum der Charité, Klinik für Kardiologie, Angiologie und Intensivmedizin, Berlin
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin
- DZHK (German Centre for Cardiovascular Research), partner site Berlin
| | | | | | - Tobias Raupach
- Universitätsklinikum Bonn (AÖR), Institut für Medizindidaktik, Bonn
| | | | - Christa Rustler
- Deutsches Netz Rauchfreier Krankenhäuser & Gesundheitseinrichtungen DNRfK e. V., Berlin
| | - Amanda Tuffman
- Medizinische Klinik und Poliklinik V, Klinikum der Universität München, Standort Innenstadt, München, außerdem Deutsches Zentrum für Lungenforschung
| | - Matthias Urlbauer
- Medizinische Klinik 3 (Schwerpunkt Pneumologie) am Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Nürnberg
| | - Thomas Voigtländer
- Deutsche Herzstiftung e. V., Frankfurt
- MVZ CCB Frankfurt und Main-Taunus, Frankfurt
| | - Stefan Andreas
- Lungenfachklinik Immenhausen, Immenhausen, außerdem Abteilung Kardiologie und Pneumologie der Universitätsmedizin Göttingen und Deutsches Zentrum für Lungenforschung
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GONDI SUHAS, CHOKSHI DAVEA. Cities as Platforms for Population Health: Past, Present, and Future. Milbank Q 2023; 101:242-282. [PMID: 37096598 PMCID: PMC10126988 DOI: 10.1111/1468-0009.12612] [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] [Received: 04/13/2022] [Revised: 08/12/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points
Cities have long driven innovation in public health in response to shifting trends in the burden of disease for populations. Today, the challenges facing municipal health departments include the persistent prevalence of chronic disease and deeply entrenched health inequities, as well as the evolving threats posed by climate change, political gridlock, and surging behavioral health needs.
Surmounting these challenges will require generational investment in local public health infrastructure, drawn both from new governmental allocation and from innovative financing mechanisms that allow public health agencies to capture more of the value they create for society.
Additional funding must be paired with the local development of public health data systems and the implementation of evidence‐based strategies, including community health workers and the co‐localization of clinical services and social resources as part of broader efforts to bridge the gap between public health and health care.
Above all, advancing urban health demands transformational public policy to tackle inequality and reduce poverty, to address racism as a public health crisis, and to decarbonize infrastructure. One strategy to help achieve these ambitious goals is for cities to organize into coalitions that harness their collective power as a force to improve population health globally.
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Affiliation(s)
| | - DAVE A. CHOKSHI
- New York University Grossman School of Medicine and City University of New York Graduate School of Public Health and Health Policy
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26
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Chia KH, Chang YY, Chen TY, Hsieh PY, Huang CC, Lee TH, Chen CH, Chen WL, Chou CC, Lin YR. The adjusted impact of different severities of acute exacerbations and medications on the risk of developing dementia in COPD patients. BMC Pulm Med 2023; 23:103. [PMID: 36991385 DOI: 10.1186/s12890-023-02386-8] [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: 11/02/2022] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Although a relationship between chronic obstructive pulmonary disease (COPD) and dementia has been reported, the initial severity upon emergency department (ED) visits and the medications used have not been well evaluated as risk factors for increased dementia occurrence. We aimed to analyze the risks of dementia development over 5 years among patients with COPD compared to matched controls (primary) and the impact of different severities of acute exacerbations (AEs) of COPD and medications on the risk of dementia development among COPD patients (secondary). METHOD This study used the Taiwanese government deidentified health care database. We enrolled patients during the 10-year study period (January 1, 2000, to December 31, 2010), and each patient was followed up for 5 years. Once these patients received a diagnosis of dementia or died, they were no longer followed up. The study group included 51,318 patients who were diagnosed with COPD and 51,318 matched (in terms of age, sex, and the number of hospital visits) non-COPD patients from the remaining patients as the control group. Each patient was followed up for 5 years to analyze the risk of dementia with Cox regression analysis. Data on medications (antibiotics, bronchodilators, corticosteroids) and severity at the initial ED visit (ED treatment only, hospital admission, or ICU admission) were collected for both groups, as well as demographics and baseline comorbidities, which were considered confounding factors. RESULTS In the study and control groups, 1,025 (2.0%) and 423 (0.8%) patients suffered from dementia, respectively. The unadjusted HR for dementia was 2.51 (95% CI: 2.24-2.81) in the study group. Bronchodilator treatment was associated with the HRs, especially among those who received long-term (> 1 month) treatment (HR = 2.10, 95% CI: 1.91-2.45). Furthermore, among 3,451 AE of COPD patients who initially visited the ED, patients who required ICU admission (n = 164, 4.7%) had a higher risk of dementia occurrence (HR = 11.05, 95% CI: 7.77-15.71). CONCLUSION Bronchodilator administration might be associated with a decreased risk of dementia development. More importantly, patients who suffered AEs of COPD and initially visited the ED and required ICU admission had a higher risk of developing dementia.
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Affiliation(s)
- Kuo-Hua Chia
- Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Department of Emergency Medicine, Yuanlin Changhua Christian Hospital, Changhua, Taiwan
| | - Yao-Yuan Chang
- Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Tren-Yi Chen
- Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Pei-You Hsieh
- Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Cheng-Chieh Huang
- Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Tsung-Han Lee
- Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Cheng Hsu Chen
- Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Wen-Liang Chen
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Chu-Chung Chou
- Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Department of Post Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yan-Ren Lin
- Department of Emergency and Critical Care Medicine, Changhua Christian Hospital, Changhua, Taiwan.
- Department of Post Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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Fathi JT. Integration of Tobacco Dependence Treatment in Lung Cancer Screening and Other Ambulatory Care Settings. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Baliunas D, Selby P, de Oliveira C, Kurdyak P, Rosella L, Zawertailo L, Fu L, Sutradhar R. Primary care-based smoking cessation treatment and subsequent healthcare service utilisation: a matched cohort study of smokers using linked administrative healthcare data. Tob Control 2023; 32:72-79. [PMID: 34083493 PMCID: PMC9763184 DOI: 10.1136/tobaccocontrol-2021-056522] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/10/2021] [Accepted: 04/27/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND No research has assessed the individual-level impact of smoking cessation treatment delivered within a general primary care patient population on multiple forms of subsequent healthcare service use. OBJECTIVE We aimed to compare the rate of outpatient visits, emergency department (ED) visits and hospitalisations during a 5-year follow-up period among smokers who had and had not accessed a smoking cessation treatment programme. METHODS The study was a retrospective matched cohort study using linked demographic and administrative healthcare databases in Ontario, Canada. 9951 patients who accessed smoking cessation services between July 2011 and December 2012 were matched to a smoker who did not access services, obtained from the Canadian Community Health Survey, using a combination of hard matching and propensity score matching. Outcomes were rates of healthcare service use from index date (programme enrolment or survey response) to March 2017. RESULTS After controlling for potential confounders, patients in the overall treatment cohort had modestly greater rates of the outcomes: outpatient visits (rate ratio (RR) 1.10, 95% CI: 1.06 to 1.14), ED visits (RR 1.08, 95% CI: 1.03 to 1.13) and hospitalisations (RR 1.09, 95% CI: 1.02 to 1.18). Effect modification of the association between smoking cessation treatment and healthcare service use by prevalent comorbidity was found for outpatient visits (p=0.006), and hospitalisations (p=0.050), but not ED visits. CONCLUSIONS Patients who enrolled in smoking cessation treatment offered through primary care clinics in Ontario displayed a modest but significantly greater rate of outpatient visits, ED visits and hospitalisations over a 5-year follow-up period.
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Affiliation(s)
- Dolly Baliunas
- School of Public Health, The University of Queensland, Herston, Queensland, Australia,Clinical Research Addictions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Peter Selby
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Claire de Oliveira
- Centre for Health Economics and Hull York Medical School, University of York, York, UK,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Paul Kurdyak
- Department of Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Laura Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada
| | - Laurie Zawertailo
- Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Pharmacology and Toxicology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | | | - Rinku Sutradhar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,Division of Biostatistics, University of Toronto, Toronto, Ontario, Canada
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Madae’en S, Istaiteyeh R, Adeinat M, Obeidat N, Baninasur RA, Haddad M. Smoking cessation economic benefits in a human capital approach: emerging evidence in Jordan. PHARMACIA 2022. [DOI: 10.3897/pharmacia.69.e96801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Smoking is a major cause globally of morbidity and mortality hence life years lost, this issue manifested in 399 Million Jordanian dinars (JD)($562.3 million USD) lost yearly due to productivity lost as a consequence of smoking in Jordan1. It is no surprise that quitting smoking will reduce the loss in life years and hence productivity. In this study, using cohort simulation, we want to quantify the gains in productivity from smoking cessation aids usage for one course of smoking cessation aid varenicline or nicotine replacement therapy in comparison to physician counseling only without pharmacological therapy, in the population that intends to quit at a point of time, through campaigns nationwide, among the working-age population followed up until retirement.
Methodology: We present a transparent, generic model based on accepted analytic methods that allow users to assess the present value of lifetime earnings gained (PVLE) in smokers who intend to quit. It is shown in previous studies that smoking cessation aids are cost-effective in Jordan (Madae’en et al. 2020), yet the benefit of using smoking cessation aids goes further to reduce productivity loss by reducing life years lost. Our model incorporates life-years gained from the Markov Model in Madae’en et al. (2020), simulation of Jordanian male smokers’ cohort in three scenarios of either using varenicline or nicotine replacement therapy or only physician consultation, to estimate life-years gained and hence reduction in lost productivity costs.
Results: We found productivity loss was reduced in males who attempted to quit in their productive years. Using Varenicline, the researchers calculated the expected future payments (wages) count for years gained due to varenicline use for a wage average of 507 JDs ($714.5 USD) per month discounted by 8% for the rest of their productive life. As well as for the other two scenarios, the gained productivity from one course of varenicline to the male adults over 30 who intend to quit will reduce loss by more than 72 billion JDs ($101.42 billion USD) among the working-age population followed up until retirement.
Conclusion: policy change must be approached to reimbursement of smoking cessation aid in the Jordanian formulary.
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Global evidence of environmental and lifestyle effects on medical expenditures across 154 countries. Prev Med Rep 2022; 30:102036. [DOI: 10.1016/j.pmedr.2022.102036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/07/2022] Open
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Goyal LD, Verma M, Garg P, Bhatt G. Variations in the patterns of tobacco usage among indian females - findings from the global adult tobacco survey India. BMC Womens Health 2022; 22:442. [DOI: 10.1186/s12905-022-02014-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/18/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Males dominate in tobacco usage, as well as in tobacco research, knowing that women face more severe health consequences. There is a specific lack of information on epidemiological statistics, risks, and the level of knowledge among women regarding tobacco. This study examines the Global Adult Tobacco Survey (GATS)-India dataset to estimate female tobacco usage and assess socio-economic variations in tobacco consumption, awareness regarding the adverse effects of tobacco, noticing pack health warnings (PHW), and intention to quit tobacco use well as factors influencing these domains.
Methods
Using a geographically clustered multistage sampling method, the nationally representative GATS II (2016–17) interviewed 40,265 female respondents aged 15 years and above from all Indian states and union territories. Standard operational definitions were used to estimate the primary independent variables (community, individual, and household categories) and dependent variables like awareness regarding the adverse effects of tobacco, noticing pack health warning (PHW), and intention to quit tobacco. Sampling weights were adjusted while performing the analysis. Bivariate and multivariable analysis were used to generate the estimates.
Results
Of the total female respondents, 84.2% were never-users, 13.3% ever consumed Smokeless Tobacco (SLT) products, 1.8% ever smoked tobacco, and 0.8% were dual users once in their lives. Around 16% of the women had exposure to Second Hand Smoke (SHS) either at their homes, workplaces or in public places. Overall, maximum awareness was seen among non-smoker females (64.7%) and dual users (64.7%), followed by women exposed to SHS, SLT users, and smokers. PHW was noticed more by the bidi smokers, followed by SLT users and cigarette smokers. Factors that positively affected intention to quit smoking included younger age, secondary school education, self-employed status, the habit of buying packed cigarettes/bidi, believing that smoking causes serious illness, and attempted quitting in the last 12 months.
Conclusion
A high proportion of women consume tobacco which is significantly influenced by socio-demographic factors. Tobacco regulators should be especially concerned about women as the tobacco marketing experts target them. Mobilizing self-help groups and organizations working for women and children could assist broader campaigns to generate awareness and motivate quitting attempts.
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Shao Y, Zha S, Qin M, Zhu Q, Yang X, Yang C, Wang X, Zhang Y, Yang W, Zhou K, Li Y, Tang X, Yu Q. Prevalence and correlates of cigarette smoking among Dulong adults in China: A cross-sectional survey in 2020. Front Public Health 2022; 10:973583. [PMID: 36311566 PMCID: PMC9608327 DOI: 10.3389/fpubh.2022.973583] [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: 06/20/2022] [Accepted: 09/15/2022] [Indexed: 01/25/2023] Open
Abstract
Background The Dulong people are one of the minorities in China with the lowest population. In recent years, the lifestyle of the Dulong people has also changed drastically due to income growth and urbanization. This study aims to identify cigarette smoking prevalence and potential risk factors among Dulong adults in China. Methods This study was conducted among 1,018 adults based on the Dulong Health Status Investigation and Evaluation (DHSIE) in Gongshan Dulong and Nu Autonomous County of Yunnan province, Southwest China. A cross-sectional design and face-to-face questionnaire were used to collect cigarette smoking habits and demographic information. Data were weighted by post-stratification weights according to the age and gender composition of Dulong resident. We also analyzed univariate and multivariate unconditional logistic regression to explore current smoking correlates. Results The weighted prevalence of ever-smoking, currently smoking, and formerly smoking among Dulong adults is 31.3, 27.7, and 3.6%, respectively. The prevalence of ever-smoking and currently smoking among male participants (57.0 and 50.6%) is much higher than that of female participants (4.0 and 3.4%). Nearly 60% of ever-smokers and current smokers smoked more than 20 cigarettes per day, which are higher than former smokers (35.2%). Among current smokers, 33.1% relapsed, and 28.3% intend to quit smoking. By adjusting for potential confounding variables, multiple logistic regression analysis indicated that male participants (OR = 48.982, 95% CI: 25.026-95.869) and current drinkers (OR = 4.450, 95% CI: 2.556-7.746) are more likely to be current smokers. On the contrary, current smokers are also more likely to be exposed to secondhand smoke (OR = 4.269, 95% CI: 2.330-7.820) and have a higher risk of chronic respiratory disease (OR = 4.955, 95% CI: 1.669-14.706). Conclusion Cigarette smoking is highly prevalent among the Dulong people in Southwest China. An appropriate and effective tobacco control strategy is an urgent need for this population.
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Affiliation(s)
- Ying Shao
- Division for Prevention and Control of Chronic Non-communicable Disease, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Shun Zha
- Division for Prevention and Control of Chronic Non-communicable Disease, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Mingfang Qin
- Executive Office, Yunnan Institute of Endemic Disease Control, Dali, China,*Correspondence: Mingfang Qin
| | - Qiuyan Zhu
- Division for Prevention and Control of Chronic Non-communicable Disease, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Xiliang Yang
- Division for Prevention and Control of Chronic Non-communicable Disease, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Cangjiang Yang
- Division for Prevention and Control of Chronic Non-communicable Disease, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Xinlin Wang
- Department for Prevention and Control of Chronic Non-communicable Disease, Nujiang Prefecture Center for Disease Control and Prevention, Lushui, China
| | - Yanli Zhang
- Executive Office, Gonshan County Center for Disease Control and Prevention, Gongshan, China
| | - Weimei Yang
- Department for Prevention and Control of Chronic Non-communicable Disease, Nujiang Prefecture Center for Disease Control and Prevention, Lushui, China
| | - Kunhua Zhou
- Executive Office, Gonshan County Center for Disease Control and Prevention, Gongshan, China
| | - Yanmei Li
- Executive Office, Gonshan County Center for Disease Control and Prevention, Gongshan, China
| | - Xian Tang
- Division for Prevention and Control of Chronic Non-communicable Disease, Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Qiuli Yu
- Division for Prevention and Control of Chronic Non-communicable Disease, Yunnan Center for Disease Control and Prevention, Kunming, China
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Economic loss attributable to cigarette smoking in the USA: an economic modelling study. THE LANCET PUBLIC HEALTH 2022; 7:e834-e843. [DOI: 10.1016/s2468-2667(22)00202-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/21/2022] [Accepted: 08/02/2022] [Indexed: 11/20/2022] Open
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Mat Rifin H, Jane Ling MY, Robert Lourdes TG, Saminathan TA, Rodzlan Hasani WS, Ab Majid NL, Hamid HAA, Riyadzi MR, Ahmad A, Mohd Yusoff MF, Muhamad NA. Small/Kiddie Cigarette Packaging Size and Its Impact on Smoking: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12051. [PMID: 36231349 PMCID: PMC9566128 DOI: 10.3390/ijerph191912051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/23/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
Background: Small cigarette pack sizes contain less than 20 cigarette sticks in a pack. Smaller packs may suggest lower costs, increasing affordability among lower-income users, especially the younger generation, which could lead to tobacco-related diseases and economic costs, including human capital lost results from tobacco-attributable morbidity and mortality. This concern has caused many countries to ban the sale of single cigarette sticks or kiddie packs. However, small cigarette pack sizes were proposed recently to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. This would demean efforts in combating tobacco consumption based on the existing tobacco control policies to prevent minors from purchasing cigarettes. Given the competing influences of affordability and availability of tobacco on consumption and the dearth of evidence-based review on the impact of pack size on smoking, this systematic review was conducted to identify the link between kiddie packs and smoking specifically on the initiation of smoking, urge/tendency to buy cigarettes among the general population and attempt to reduce cigarette consumption and prevalence of smoking using kiddie packs among current smokers. Methods: We include all studies except for reviews, guidelines, conference papers, commentaries, editorials, or opinion pieces. A database search was conducted in PubMed, EMBASE, CENTRAL, Web of Science and Scopus on 27 November 2021. The results were presented in the form of narrative synthesis under four groups: initiation of smoking; urge/tendency to buy cigarettes; the prevalence of smoking, and attempt to reduce cigarette consumption. The literature search identified 1601 articles, of which 21 articles had met the inclusion criteria. The methodological quality of all included articles was determined using a validated 16-item quality assessment tool (QATSDD). The average quality score for all papers was 34.8%. Discussion: Given the diverse study settings of the articles and despite the challenges of the methodological quality of some articles, this review provides some evidence that kiddie packs may increase the urge/tendency to buy cigarettes and mixed evidence on the attempt to reduce cigarette consumption. This review also found some evidence that kiddie pack purchasing among teenage smokers was higher compared to adults. However, we are uncertain about the link between kiddie packs and smoking initiation. Nevertheless, since most studies were of low quality, further high-quality studies are needed to conclude about the impact of kiddie packs on smoking to assist the policymakers and stakeholders in formulating new policies and strengthening existing strategies related to the kiddie packs.
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Affiliation(s)
- Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Miaw Yn Jane Ling
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Tania Gayle Robert Lourdes
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Thamil Arasu Saminathan
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Wan Shakira Rodzlan Hasani
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Nur Liana Ab Majid
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Hamizatul Akmal Abd Hamid
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Mohd Ruhaizie Riyadzi
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Ahzairin Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | | | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
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Stolz D, Mkorombindo T, Schumann DM, Agusti A, Ash SY, Bafadhel M, Bai C, Chalmers JD, Criner GJ, Dharmage SC, Franssen FME, Frey U, Han M, Hansel NN, Hawkins NM, Kalhan R, Konigshoff M, Ko FW, Parekh TM, Powell P, Rutten-van Mölken M, Simpson J, Sin DD, Song Y, Suki B, Troosters T, Washko GR, Welte T, Dransfield MT. Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission. Lancet 2022; 400:921-972. [PMID: 36075255 PMCID: PMC11260396 DOI: 10.1016/s0140-6736(22)01273-9] [Citation(s) in RCA: 202] [Impact Index Per Article: 101.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 05/23/2022] [Accepted: 06/28/2022] [Indexed: 10/14/2022]
Abstract
Despite substantial progress in reducing the global impact of many non-communicable diseases, including heart disease and cancer, morbidity and mortality due to chronic respiratory disease continues to increase. This increase is driven primarily by the growing burden of chronic obstructive pulmonary disease (COPD), and has occurred despite the identification of cigarette smoking as the major risk factor for the disease more than 50 years ago. Many factors have contributed to what must now be considered a public health emergency: failure to limit the sale and consumption of tobacco products, unchecked exposure to environmental pollutants across the life course, and the ageing of the global population (partly as a result of improved outcomes for other conditions). Additionally, despite the heterogeneity of COPD, diagnostic approaches have not changed in decades and rely almost exclusively on post-bronchodilator spirometry, which is insensitive for early pathological changes, underused, often misinterpreted, and not predictive of symptoms. Furthermore, guidelines recommend only simplistic disease classification strategies, resulting in the same therapeutic approach for patients with widely differing conditions that are almost certainly driven by variable pathophysiological mechanisms. And, compared with other diseases with similar or less morbidity and mortality, the investment of financial and intellectual resources from both the public and private sector to advance understanding of COPD, reduce exposure to known risks, and develop new therapeutics has been woefully inadequate.
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Affiliation(s)
- Daiana Stolz
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland; Clinic of Respiratory Medicine and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Takudzwa Mkorombindo
- Lung Health Center, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Desiree M Schumann
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
| | - Alvar Agusti
- Respiratory Institute-Hospital Clinic, University of Barcelona IDIBAPS, CIBERES, Barcelona, Spain
| | - Samuel Y Ash
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mona Bafadhel
- School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK; Department of Respiratory Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Chunxue Bai
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - James D Chalmers
- Scottish Centre for Respiratory Research, University of Dundee, Dundee, UK
| | - Gerard J Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Shyamali C Dharmage
- Centre for Epidemiology and Biostatistics, School of Population and Global health, University of Melbourne, Melbourne, VIC, Australia
| | - Frits M E Franssen
- Department of Research and Education, CIRO, Horn, Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Urs Frey
- University Children's Hospital Basel, Basel, Switzerland
| | - MeiLan Han
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Nadia N Hansel
- Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Nathaniel M Hawkins
- Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Ravi Kalhan
- Department of Preventive Medicine and Division of Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Melanie Konigshoff
- Division of Pulmonary, Allergy and Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Fanny W Ko
- The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Trisha M Parekh
- Lung Health Center, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Maureen Rutten-van Mölken
- Erasmus School of Health Policy & Management and Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Jodie Simpson
- Priority Research Centre for Healthy Lungs, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Don D Sin
- Centre for Heart Lung Innovation and Division of Respiratory Medicine, Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, BC, Canada
| | - Yuanlin Song
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; Shanghai Respiratory Research Institute, Shanghai, China; Jinshan Hospital of Fudan University, Shanghai, China
| | - Bela Suki
- Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - Thierry Troosters
- Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium
| | - George R Washko
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tobias Welte
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease, German Center for Lung Research, Hannover, Germany
| | - Mark T Dransfield
- Lung Health Center, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; Birmingham VA Medical Center, Birmingham, AL, USA.
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Trends in the delivery of reimbursed nicotine replacement therapies between 2016 and 2019 in France. Therapie 2022; 77:561-570. [DOI: 10.1016/j.therap.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/20/2021] [Accepted: 01/14/2022] [Indexed: 11/19/2022]
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Wu Y. Tobacco Control Measures' Role in Improving Employees' Health Under the Impact of Health Education and Media Campaign. Front Public Health 2022; 10:904894. [PMID: 35874977 PMCID: PMC9301119 DOI: 10.3389/fpubh.2022.904894] [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: 03/26/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022] Open
Abstract
The overarching purpose of this study was to investigate the impact of health education, media campaigns, and peer counselor training on employees' health. This study also attempted to evaluate the function of tobacco control as a mediator in the relationship between employees' health and health education, media campaigns, and peer counselor training. Data were collected from 440 tobacco industry workers in China using a questionnaire technique. Smart-PLS software and a structural equation modeling (SEM) technique were used to evaluate the data. Employees' health was found to be significantly improved by health education, media campaigns, and peer counselor training. Furthermore, tobacco control was discovered to moderate the association between employee health and health education, media campaigns, and peer counselor training. By analyzing the impact of health education, media campaigns, and peer counselor training on employees' health, this research provided an important theoretical contribution. In terms of practical applications, this study would help employees consuming tobacco to maintain a healthy and safe atmosphere that encourages them to be engaged and perform well. Furthermore, this study could prove effective in resolving difficulties linked to controlling employee tobacco addiction and improving their performance. The tiny sample size of this study, which included solely employees working in the Chinese tobacco sector, was one of its limitations. In addition, future studies can incorporate other constructs to acquire a deeper knowledge of the factors that influence employees' health.
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Affiliation(s)
- Yu Wu
- Media and Communication College, Weifang University, Weifang, China
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Hossain MM, Abdulla F, Rahman A, Huq MN. Cigarette waste: A burden to the health, environment, and economy. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 239:113661. [PMID: 35605330 DOI: 10.1016/j.ecoenv.2022.113661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/14/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Md Moyazzem Hossain
- Department of Statistics, Jahangirnagar University, Savar, Dhaka, Bangladesh; School of Mathematics, Statistics and Physics, Newcastle University, Newcastle upon Tyne, UK.
| | - Faruq Abdulla
- Department of Applied Health and Nutrition, RTM Al-Kabir Technical University, Sylhet, Bangladesh.
| | - Azizur Rahman
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW 2678, Australia.
| | - Mohammed Nazmul Huq
- Department of Statistics, Jahangirnagar University, Savar, Dhaka, Bangladesh.
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Napirah MR, Vidyanto V, Hotary DF, Erwani E. Health Belief Model of Smoking Behavior Model as Effort on Tobacco Control Policy within Students in Public Junior High School (SMP Negeri 1) Palu. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND: Smoking is among adults and is also frequently found in young smokers. In the world and Indonesia, the trend of smoking tends to increase and this trend does not only happen in adults but also in adolescents.
AIM: The purpose of this study was to determine the Health Belief Model of smoking behavior as a follow-up of tobacco control policies for junior high school students at SMP Negeri 1 Palu.
METHODS: The type of research was qualitative research with a case study approach. The informants in this study consisted of one key informant (the principal of SMP Negeri 1 Palu), the regular informant (five male students at SMP Negeri 1 Palu), and additional informants (two parents of students of SMP Negeri 1 Palu), the number of informants in this study was eight people. The data were collected through triangulation techniques, such as in-depth interviews, observation, and documentation using interview guidelines.
RESULTS: In the case of medical illness, these dimensions include acceptance of the diagnosis results, personal estimation of the presence of susceptibility (sensitivity), and susceptibility to disease in general (perceived susceptibility). The informant’s statement explained that smoking could increase the seriousness of a disease, especially those who already have a history of previous illness (perceived severity). The benefits of quitting smoking, namely, that life will be healthier, reduce spending much money, and avoid disease (perceived benefits). Perceived barriers are perceived barriers to change or when individuals encounter barriers to taking these actions. A person’s difficulty in quitting smoking is social factors and the surrounding environment. Adolescents seek a sense of comfort and attachment to peers and make adolescents have self-socialization, namely, putting pressure on themselves to adopt behaviors that they think are liked by others.
CONCLUSION: Social and environmental factors have a significant influence on adolescent behavior; this is influenced because they want to join in seeing their friends in doing a smoking behavior, such as wanting to be seen that he can also do this, wanting to look slang in the eyes of his friends, incitement from friends to engage in smoking behavior.
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Yang H, Chen B, Guo A, Song J, Cheng X, Jin C. Association of Householder Smoking With Poverty and the Mediating Effect of NCDs in Relatively Underdeveloped Regions in China. Front Public Health 2022; 10:858761. [PMID: 35664093 PMCID: PMC9160790 DOI: 10.3389/fpubh.2022.858761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background:Studies have not provided clear enough evidence on the direct association between cigarette smoking and poverty. This study aims to assess the association of householder smoking with near-poverty households, and the potential mediating effect of NCDs.MethodsA cross-sectional survey was conducted from November 2019 to October 2020 in relatively underdeveloped regions in China. In total, 2,409 households were investigated in areas under the jurisdiction of 24 primary health care (PHC) institutions of eight provinces. Pearson's χ2-test was performed, and multivariable logistic regression and extended probit regression models were fitted to examine the association between householder smoking and near-poverty households. Moreover, generalized structural equation modeling was used to explore the mediating effect of NCDs.ResultsAfter adjusting for all other potential confounding factors, compared with households headed by never-smokers, households headed by smokers exhibited significantly elevated risks of being near poverty, with an odds ratio of 2.01 (95% CI: 0.48–0.91). We also found that living in rural areas and having a low education level both had a negative effect on being near poverty. Additionally, NCDs had a significantly positive mediating effect, with a 31.57% effect of householder smoking on near-poverty status mediated by NCDs; the indirect effect was estimated to be 0.17 (95% CI: 0.04–0.31).ConclusionsHouseholder smoking significantly elevated the risk of the household being near poverty, and suffering NCDs had a positive mediating effect.
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Affiliation(s)
- Huimin Yang
- Department of Child Health Development, Capital Institute of Pediatrics, Beijing, China
| | - Bowen Chen
- Department of Child Health Development, Capital Institute of Pediatrics, Beijing, China
| | - Aili Guo
- Community Health Association of China, Beijing, China
| | - Jiarui Song
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Xi Cheng
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Chenggang Jin
- Research Center for Health and Social Policy, Beijing Normal University, Zhuhai, China
- *Correspondence: Chenggang Jin
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Validity of the DSM-5 tobacco use disorder diagnostics in adults with problematic substance use. Drug Alcohol Depend 2022; 234:109411. [PMID: 35338898 PMCID: PMC9035622 DOI: 10.1016/j.drugalcdep.2022.109411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND DSM-5 tobacco use disorder (TUD) nosology differs from DSM-IV nicotine dependence (ND) by including craving and DSM-IV abuse criteria, a lower threshold (≥ 2 criteria), and severity levels (mild; moderate; severe). We assessed concurrent and prospective validity of the DSM-5 TUD diagnosis and severity and compared validity with DSM-IV ND diagnosis. METHODS The sample included U.S. adults with current problematic substance use and past year cigarette smoking (N = 396). Baseline assessment collected information on DSM-IV ND and DSM-5 TUD criteria, smoking-related variables, and psychopathology. Over the following 90 days, electronic daily assessments queried smoking and cigarette craving. Variables expected to be related to TUD were validators: cigarette consumption, cigarette craving scale, Fagerström Test for Nicotine Dependence, and psychiatric disorders. Regression models estimated the association of each validator with DSM-5 TUD and severity levels, and differential association between DSM-5 TUD and DSM-IV ND diagnoses. RESULTS DSM-5 TUD and DSM-IV ND were associated with most baseline validators (p-values < 0.05), with significantly stronger associations with DSM-5 TUD for number of days smoked (p = 0.023) and cigarette craving scale (p = 0.007). Baseline DSM-5 TUD and DSM-IV ND predicted smoking and craving on any given day during follow-up, with stronger associations for DSM-5 TUD (association difference [95% CI%]: any smoking, 0.53 [0.27, 0.77]; number of cigarettes smoked, 1.36 [0.89, 1.78]; craving scale, 0.19 [0.09, 0.28]). Validators were associated with TUD severity in a dose-dependent manner. CONCLUSION DSM-5 TUD diagnostic measures as operationalized here demonstrated concurrent and prospective validity. Inclusion of new criteria, particularly craving, improved validity and clinical relevance.
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Jayasinghe S, Faghy MA, Hills AP. Social justice equity in healthy living medicine - An international perspective. Prog Cardiovasc Dis 2022; 71:64-68. [PMID: 35490871 DOI: 10.1016/j.pcad.2022.04.008] [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] [Received: 04/24/2022] [Accepted: 04/24/2022] [Indexed: 10/18/2022]
Abstract
Irrespective of geographical location, disadvantaged people are disproportionately affected by unnecessary disease and suffering caused by inequalities in health. Although equal access to opportunities for healthy living medicine regardless of legal, political, economic, or other circumstances should be a basic human right, it is increasingly improbable for scores of people, particularly in Africa, Asia, Latin America, and the Caribbean, to acquire this. In recent times, global initiatives have attempted to make 'healthy lifestyles' more equitable by pledging to be relevant to all economies, promoting prosperity, environmental protection, climate change interventions, and purposeful action to meet the needs of vulnerable populations, including women and children. Yet there remains much to be done to address and reduce the substantial international health equity gaps. Reducing disparities that disproportionately affect the lower end of social strata must entail collaborative and systemic action from important stakeholders across the whole system, an approach that translates theory and research into practice. Ideally, realist approaches that appreciate the importance of the context of problems and assume nothing works everywhere or for everyone, should be prioritised over linear/simple and non-scalable intervention strategies.
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Affiliation(s)
- Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia.
| | - Mark A Faghy
- Human Sciences Research Centre, University of Derby, Derby, UK; Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
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do Amaral LM, Ronzani TM, Cruvinel E, Richter K, Oliveira Andrade RD, Lanzieri IO, de Macêdo ÂCDAD, Leite ICG. Text messaging interventions to support smoking cessation among hospitalized patients in Brazil: a randomized comparative effectiveness clinical trial. BMC Res Notes 2022; 15:119. [PMID: 35346351 PMCID: PMC8962029 DOI: 10.1186/s13104-022-06002-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/14/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE A clinical trial carried out in patients hospitalized for clinical and surgical conditions. This study evaluated the effectiveness of text messaging interventions (TM) versus telephone counseling (TC) to promote smoking cessation among hospitalized smokers in a middle-income country. Seven-day abstinence was measured during follow-up phone calls one month after discharge. The comparative cost of the two interventions considered the cost of calls, time spent on phone calls and sending SMS and cost of the professional involved in the approaches. RESULTS Past 7-day tobacco abstinence was not statistically different between groups (30.5% in TM group and 26% in TC, p = 0.318). Costs were significantly lower in the TM group (U$9.28 × U$19.45- p < 0,001). Continuous abstinence was reported by 26% of TM participants and 24.5% of TC participants (p = 0.730). In the 3-month follow-up, 7-day abstinence was 23% in the TMI and 27% in the TC (p = 0.356) group. Continuous abstinence was reported by 20% of TM participants and 24% of TC participants (p = 0.334). TRIAL REGISTRATION ClinicalTrials.gov ID: NCT03237949 Registred on: 30th May 2017.
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Affiliation(s)
- Lígia Menezes do Amaral
- Clinical Medicine Department, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Telmo Mota Ronzani
- Department of Psychology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Erica Cruvinel
- Population Health Department, University of Kansas Medical Center, Kansas City, KS, USA
| | - Kimber Richter
- Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA
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Prabandari YS, Bintoro BS, Purwanta P. A Comprehensive Tobacco Control Policy Program in a Mining Industry in Indonesia: Did It Work? Front Public Health 2022; 10:853862. [PMID: 35400041 PMCID: PMC8987008 DOI: 10.3389/fpubh.2022.853862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/21/2022] [Indexed: 11/22/2022] Open
Abstract
Background Risk factor controls, including smoking cessation and prevention, impact health costs. This study aimed to describe the Kaltim Prima Coal (KPC), one of Indonesia's largest coal mining operations, comprehensive tobacco control policy program in 2015 and its impact on smoking behavior among the employees. Method A survey among 404 employees was conducted to assess the impact of the smoke-free KPC programs. In addition to the descriptive analysis, logistic regression was used to measure the association of intention to the smoking behavior change and the association between intention and the determinants using the Theory of Planned Behavior in 102 smokers. Results A series of tobacco control programs: advocacy, health education, brief interventions for smoking cessation, peer counselor training, media campaigns, and policy regulations were implemented. About 95.5% of the respondents attended the KPC Smoke-Free 2015 programs, and 97.8% reported they already knew that KPC is a total smoke-free area. Nearly 50% of the respondents expressed that the staff complied with the rules and no longer smoked in KPC. Majority of smokers (76.6%) reduced their consumption, and 5.6% of them quit smoking. Among smokers, we found that attitude toward smoking cessation, subjective norm, and perceived control for quitting were related to the intention to stop smoking. Conclusions The KPC smoke-free policy has been comprehensively implemented. Regulations on smoking and tobacco controls should be maintained, and monitoring should be consistently done. Media campaigns on the regulations and the availability of trained peer educators for smoking cessation help need to be applied continuously.
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Affiliation(s)
- Yayi S. Prabandari
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center of Health Behavior and Promotion, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bagas S. Bintoro
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Center of Health Behavior and Promotion, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Purwanta Purwanta
- Department of Mental Health and Community Health Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Knowledge, Attitude, Practices, and Preparedness of Dental Professionals in Prescribing Nicotine Replacement Therapy. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5782228. [PMID: 35237688 PMCID: PMC8885202 DOI: 10.1155/2022/5782228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 02/01/2022] [Indexed: 11/17/2022]
Abstract
Objective To assess the knowledge, practice, attitude, and preparedness of dental professionals in prescribing nicotine replacement therapy (NRT). Methodology. A prevalidated voluntary web-based questionnaire was generated as a link through Google Drive and was sent to 117 dental professionals in North India using Whatsapp, Messenger, and Instagram social media platforms. A total of 94 responses were received and out of which 76 responses were analyzed (18 forms were excluded due to incomplete or duplicate responses). Frequency analysis was done using SPSS software version 21. Result The participation rate was found to be 80.3%. More than half of the study population were familiar with the term NRT (77.6%) and its uses (67.1%), but approximately less than half of the total study subjects knew the duration (32.9%), cost (27.6%), dosage (25%), and contraindications (36.8%) of the NRT. Approximately 56.6% of the study participants showed a positive attitude towards helping patients to quit smoking through tobacco cessation counseling. Nearly one-fourth of the study population, i.e., 27.6%, were confident in explaining the negative impacts of tobacco, while 22.4% knew about the tobacco cessation protocol. Among the participants, only 27.6% reported that they practice NRT and out of which approximately less than 20% of the study participants were prescribing correct dose of NRT. Conclusion Though study subjects had an ample knowledge regarding NRT use in tobacco cessation, it does not reflect their current attitude and preparedness. Thus, there is a need for continuing education to further train dental professionals for prescribing NRT.
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Weiger C, Hoe C, Cohen JE. Seven-year tobacco tax plan in Ukraine: a case study of the actors, tactics and factors motivating policy passage. BMJ Open 2022; 12:e049833. [PMID: 35149561 PMCID: PMC8845221 DOI: 10.1136/bmjopen-2021-049833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 01/18/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE In December 2017, the Ukrainian Rada passed legislation that would increase tobacco taxes for the next 7 years to meet requirements of the European Union-Ukraine Association Agreement (EU-UAA). We analysed factors motivating passage of Ukraine's 7-year tobacco tax plan as well as tactics used by both opponents and proponents to describe how the plan was passed. DESIGN A case study approach was used. Data were gathered from semistructured interviews (n=12) and document review (n=24) and analysed using inductive and deductive coding. RESULTS The European Union-Ukraine Association Agreement, a significant budget deficit and a history of tobacco tax success were all contextual factors contributing to policy passage. Proponents of high tobacco taxes capitalised on this opportunity, using media advocacy, generating scientific evidence and collaborating effectively across multiple sectors to support the passage of the plan. Opponents used media advocacy and lobbied to water down several features of the plan, resulting in smaller increases that might not meet EU-UAA requirements. CONCLUSION Industry interference via lobbying continues to hamper passage of high tobacco taxes and should be addressed via legislation that aligns with Article 5.3 of the Framework Convention on Tobacco Control. Proponents should look for windows of opportunity caused by external events, create a multisectoral coalition, including tax experts and use media advocacy to support tax increases. Further work should continue to document what contextual factors support tobacco control policy change.
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Affiliation(s)
- Caitlin Weiger
- Health, Behavior & Society Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Connie Hoe
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- International Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Ahsan A, Afin R, Amalia N, Hindriyani M, Jacinda AR, Kramer E. FCTC ratification, smoking prevalence, and GDP per capita: lessons for Indonesia and the rest of the world. Global Health 2022; 18:11. [PMID: 35123526 PMCID: PMC8818242 DOI: 10.1186/s12992-022-00810-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 01/25/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Indonesia's stagnated progress towards tobacco control could be addressed through the implementation of a comprehensive national framework, such as the World Health Organization's (WHO) Framework Convention of Tobacco Control (FCTC). However, national tobacco industry supporters argue that accepting the FCTC will have negative economic implications for the country. These arguments have, thus far, discouraged the Indonesian government from ratifying the FCTC. Drawing from an analysis of the impact of the FCTC on other countries' smoking rates and Gross Domestic Product (GDP) per capita, this study offers empirical evidence against industry arguments concerning the potential negative economic impacts of FCTC adoption. This study applies a two stage least square estimation strategy to unbalanced panel data at country level. In the first stage we estimate the impact of FCTC ratification on smoking rates, and in the second step, we estimate the influence of smoking activity on macroeconomic performance. RESULTS The result of this study shows that FCTC ratification has a negative impact on a country's smoking prevalence. While FCTC ratification positively correlates with reduced smoking prevalence, a decline in smoking prevalence is not related to a decline in GDP per capita. CONCLUSIONS The results of this study shows that FCTC ratification, which can be an important driver for more effective tobacco control, does not necessarily have a negative impact on the economy. Instead, FCTC ratification may be beneficial for both health and economic outcomes, as it provides comprehensive guidance for reducing smoking prevalence that take into account social and economic factors.
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Affiliation(s)
- Abdillah Ahsan
- Department of Economics, Faculty of Economics and Business, University of Indonesia, Depok, West Java, 16424, Indonesia.
| | - Rifai Afin
- Department of Economics, University of Trunojoyo Madura, Banegkalan, Indonesia
| | - Nadira Amalia
- Department of Economics, Faculty of Economics and Administration, University of Malaya, Kuala Lumpur, Malaysia
| | - Martha Hindriyani
- Faculty of Economics and Business, Gadjah Mada University, Yogyakarta, Indonesia
| | - Ardhini Risfa Jacinda
- Center for Islamic Economics and Business, Faculty of Economics and Business, University of Indonesia, Depok, Indonesia
| | - Elisabeth Kramer
- Sydney Southeast Asia Centre, University of Sydney, Sydney, Australia
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LORENSIA AMELIA, PRATAMA ANGGARAMARTHA, HERSANDIO RIZKI. Knowledge and attitudes on smoking cessation of e-cigarettes: a mixed-methods study of pharmacy students in Surabaya, Indonesia. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 62:E918-E925. [PMID: 35603251 PMCID: PMC9104658 DOI: 10.15167/2421-4248/jpmh2021.62.4.2330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022]
Abstract
Background Pharmacy students as candidates for health workers who will take part in smoking cessation. Knowledge and attitudes of smoking cessation can help map the behavior of pharmacists in the future. This study aimed to explore knowledge and attitudes on smoking cessation of e-cigarettes with the mixed methods study of pharmacist students. Method This research was conducted in Januari-Juni 2021 in Surabaya. The research design was mix-method with sequential explanatory strategy. The variables were knowledge and attitudes on smoking cessation of e-cigarettes. The sample in this qualitative approach was derived from a sample of quantitative data. Respondents were interviewed in depth until the data reached the saturation level in order to obtain good and usable qualitative data. Results This study involved 31 respondents. The highest level of knowledge about dangers of e-cigarettes, especially related to nicotine (100% of respondents answered correctly). The highest positive level of attitude about dangers of e-cigarettes, especially e-cigarettes harmful to passive smokers (27% of respondents had positive attitude). Cigarettes were harmful to lung and cardiovascular health, regarding the dangers of passive smoking, some agree and disagree. Non-smokers didn't need to be recommended for e-cigarettes, e-cigarettes can be recommended for tobacco smokers, e-cigarettes cause addiction, and e-cigarettes can be a good recommendation for those who want to carry out smoking cessation. Regulation of e-cigarettes in Indonesia was considered to be lacking and needs to be improved. Conclusions Pharmacist students have a high level of knowledge and a positive attitude towards smoking cessation.
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Affiliation(s)
- AMELIA LORENSIA
- Department of Clinical-Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Ubaya, Indonesia
- Correspondence: Amelia Lorensia, S.Farm., M.Farm-Klin., Apt., Fakultas Farmasi Universitas Surabaya, Jl. Raya Kalirungkut Surabaya, 60293, Ubaya, Indonesia. E-mail: ;
| | | | - RIZKI HERSANDIO
- Bachelor Student of Faculty of Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Ubaya, Indonesia
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CNN-Based Smoker Classification and Detection in Smart City Application. SENSORS 2022; 22:s22030892. [PMID: 35161637 PMCID: PMC8839928 DOI: 10.3390/s22030892] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
To better regulate smoking in no-smoking areas, we present a novel AI-based surveillance system for smart cities. In this paper, we intend to solve the issue of no-smoking area surveillance by introducing a framework for an AI-based smoker detection system for no-smoking areas in a smart city. Moreover, this research will provide a dataset for smoker detection problems in indoor and outdoor environments to help future research on this AI-based smoker detection system. The newly curated smoker detection image dataset consists of two classes, Smoking and NotSmoking. Further, to classify the Smoking and NotSmoking images, we have proposed a transfer learning-based solution using the pre-trained InceptionResNetV2 model. The performance of the proposed approach for predicting smokers and not-smokers was evaluated and compared with other CNN methods on different performance metrics. The proposed approach achieved an accuracy of 96.87% with 97.32% precision and 96.46% recall in predicting the Smoking and NotSmoking images on a challenging and diverse newly-created dataset. Although, we trained the proposed method on the image dataset, we believe the performance of the system will not be affected in real-time.
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Nontypeable Haemophilus influenzae Redox Recycling of Protein Thiols Promotes Resistance to Oxidative Killing and Bacterial Survival in Biofilms in a Smoke-Related Infection Model. mSphere 2022; 7:e0084721. [PMID: 35044805 PMCID: PMC8769201 DOI: 10.1128/msphere.00847-21] [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] [Indexed: 11/21/2022] Open
Abstract
Smoke exposure is a risk factor for community-acquired pneumonia, which is typically caused by host-adapted airway opportunists like nontypeable Haemophilus influenzae (NTHi). Genomic analyses of NTHi revealed homologs of enzymes with predicted roles in reduction of protein thiols, which can have key roles in oxidant resistance. Using a clinical NTHi isolate (NTHi 7P49H1), we generated isogenic mutants in which homologs of glutathione reductase (open reading frame NTHI 0251), thioredoxin-dependent thiol peroxidase (NTHI 0361), thiol peroxidase (NTHI 0907), thioredoxin reductase (NTHI 1327), and glutaredoxin/peroxiredoxin (NTHI 0705) were insertionally inactivated. Bacterial protein analyses revealed that protein oxidation after hydrogen peroxide treatment was elevated in all the mutant strains. Similarly, each of these mutants was less resistant to oxidative killing than the parental strain; these phenotypes were reversed by genetic complementation. Analysis of biofilm communities formed by the parental and mutant strains showed reduction in overall biofilm thickness and density and significant sensitization of bacteria within the biofilm structure to oxidative killing. Experimental respiratory infection of smoke-exposed mice with NTHi 7P49H1 showed significantly increased bacterial counts compared to control mice. Immunofluorescent staining of lung tissues showed NTHi communities on lung mucosae, interspersed with neutrophil extracellular traps; these bacteria had transcript profiles consistent with NTHi biofilms. In contrast, infection with the panel of NTHi mutants showed a significant decrease in bacterial load. Comparable results were observed in bactericidal assays with neutrophil extracellular traps in vitro. Thus, we conclude that thiol-mediated redox homeostasis is a determinant of persistence of NTHi within biofilm communities. IMPORTANCE Chronic bacterial respiratory infections are a significant problem for smoke-exposed individuals, especially those with chronic obstructive pulmonary disease (COPD). These infections often persist despite antibiotic use. Thus, the bacteria remain and contribute to the development of inflammation and other respiratory problems. Respiratory bacteria often form biofilms within the lungs; during growth in a biofilm, their antibiotic and oxidative stress resistance is incredibly heightened. It is well documented that redox homeostasis genes are upregulated during this phase of growth. Many common respiratory pathogens, such as NTHi and Streptococcus pneumoniae, are reliant on scavenging from the host the necessary components they need to maintain these redox systems. This work begins to lay the foundation for exploiting this requirement and thiol redox homeostasis pathways of these bacteria as a therapeutic target for managing chronic respiratory bacterial infections, which are resistant to traditional antibiotic treatments alone.
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