Prevalence of cigarette smoking and associated factors among secondary school teachers in Malaysia

Longitudinal analysis of the impact of smoking exposure on atopic indices and allergies in early childhood

Background

Exposure to smoking is recognized as a health hazard; however, a longitudinal analysis of the impact of smoking exposure in families on the allergic reactions related to childhood atopic diseases has not been well addressed.

Methods

Children who completed a three-year follow-up period from the birth cohort were included in this study. The history of smoking exposure was recorded, and the urine cotinine levels were measured at 1 and 6 months, and 1, 2, and 3 years of age. Specific IgE levels against food and mite allergens were measured at age 6 months, and 1, 2, and 3 years. Their relevance to family smoking exposure and the subsequent development of atopic diseases was also analyzed. This study was approved by the Ethics Committee of Chang Gung Memorial Hospital (No. 102-1842C).

Results

A total of 198 infants were enrolled in this study. The prevalence of passive smoking exposure among these children was as high as 45%. The urine cotinine levels were significantly higher in children with history of smoking exposure (P < 0.001). At 6 months of age, the food-specific IgE levels and the prevalence of eczema were significantly higher in children with smoking exposure than in those without smoking exposure (P < 0.05). By contrast, the urine cotinine levels were significantly higher in children with IgE sensitization (>100 kU/L, P < 0.05) at 3 years of age, which was also significantly associated with a higher prevalence of allergic rhinitis and development of asthma (P < 0.01).

Conclusion

Family smoking exposure appears to be strongly associated with food sensitization in infancy and with IgE production in later childhood. This could potentially increase the susceptibility of developing infantile eczema and subsequent childhood airway allergies.

Tobacco Consumption Among Young Population in Rural Indonesia: Prevalence and Associated Factors

Introduction: Tobacco consumption among youths is increasing in Indonesia and other middle-income countries. In rural areas, its prevalence is even higher compared to urban settings. Understanding the extent and associated factors of tobacco consumption within this population is essential to inform the formulation of appropriate prevention and control strategies. Aims: This study aims at analyzing the prevalence and associated factors of tobacco consumption among the young population living in rural Indonesia. Methods: Data were obtained from Indonesia Family Life Survey wave 5 (IFLS-5). A total of 2,786 responses from respondents aged 15-24 years and living in rural areas were taken into analysis. Binary logistic regression was used to examine the association between tobacco consumption with the predictors. Results: The prevalence of tobacco consumption among youths in rural Indonesia was 26.5%. Binary logistic regression discovered that factors significantly associated with tobacco consumption among young population were aged 20-24 years (AOR = 4.760, 95% CI: 3.557-6.368), less educated (AOR = 5.988, 95% CI: 3.193-11.229), being married (AOR = 2.484, 95% CI: 1.631- 3.782), and having smoking parent (AOR = 1.346, 95% CI: 1.016-1.783). Young males had a much higher tobacco use prevalence (57.1%). Whereas females had significant negative association with tobacco consumption (AOR = 0.001, 95% CI: 0.000-0.002). Conclusion: A large portion of youth in rural Indonesia were identified to have tobacco-use behavior. Appropriate prevention and control strategies are needed to address the population groups identified in this study. Policymakers should anticipate challenges that may occur resulting from geographical and cultural differences. 

Association between Emotional Exhaustion and Tobacco Consumption in Teachers

Teachers have been reported as having high levels of emotional exhaustion (EE). It has also been observed that tobacco consumption (TC) is higher during stressful events. However, there is little evidence about the association between EE and TC among teachers. A total of n = 560 teachers took part in this study, where 71.79% (n = 402) were women. For data gathering, the EE dimension of the Maslach Inventory for teachers was used, along with a TC questionnaire and the sociodemographic data of the participants. A binary logistical regression model was used for statistical analysis. Regarding TC, over 30% of teachers declared that they smoked; 65% of the teachers presented medium-high EE and 31% of teachers presented high EE. Teachers who said they were smokers had a greater risk of presenting high EE (OR: 1.7, p < 0.05), along with younger teachers (≤44 years; OR: 2.1, p < 0.01). In addition, teachers with high EE also have a high risk of TC. The present study reports an association between TC and high EE category among teachers, regardless of gender. An important association is also observed between the under-45 age group and high EE. These results indicate that teachers should have psychological support and interventions aiding them with facing work stress and TC habits, especially for younger teachers.

It Takes Two to Tango: Patients' and Providers' Perspectives in Tobacco Cessation and Head/Neck Cancer

BACKGROUND

Tobacco cessation among patients with head/neck cancer continues to be challenging despite evidence that cessation improves treatment outcomes. The purpose of this study was to understand barriers/facilitators to tobacco cessation among patients with head/neck cancer and health care providers and to obtain perspectives toward the development of a patient-centered tobacco cessation intervention.

MATERIALS AND METHODS

In-depth qualitative interviews with 10 health care providers and 21 patients with head/neck cancer (12 inpatients and 9 outpatients) who were current or former smokers.

RESULTS

Health was a common motivator to quit among patients. Although most patients indicated that their health care provider asked and advised them to quit, they were unaware of cessation resources. Suggestions for a tobacco cessation program included involvement of former smokers, health care provider involvement/counseling, supporting written materials, and incorporating follow-up and family support. Health care providers identified patients' anger/frustration associated with the disease, social/demographic issues, and poor quality of life as the three most frequent challenges in treating patients. Although all providers reported asking about tobacco use, 70% emphasized a lack of formal training in tobacco cessation and lack of time. Their suggestions for a cessation program included having a "quarterback" responsible for this component with support from the entire health care team and continuity between outpatient and inpatient services to promote cessation, prevent relapse, and highlight the importance of follow-up and social support.

CONCLUSION

There is great interest and need, both from patients and providers, for tobacco cessation services in the oncology setting tailored for patients with head/neck cancer in the context of cancer care.

IMPLICATIONS FOR PRACTICE

Although the combination of pharmacotherapy and cognitive-behavioral intervention is the standard evidence-based treatment for tobacco dependence, it must be adapted to meet the needs and wants of patients and providers to be effective. This study provides an in-depth examination of such needs among patients with head and neck cancer and providers in the context of cancer care. Providers and patients emphasized the need of having a trained health care provider dedicated to providing tobacco cessation through seamless integration between outpatient and inpatient services as well as follow-up with an emphasis on family involvement throughout the process.

Gender-Specific Prevalence of Risk Factors for Non-Communicable Diseases by Health Service Use among Schoolteachers in Afghanistan

Objectives of this study were: (1) to examine gender differences in biomedical indicators, lifestyle behaviors, self-health check practices, receipt of professional non-communicable disease (NCD)-related lifestyle advice, and the use of health services among teachers in Afghanistan; and (2) to seek the patterns of these indicators among users and non-users of health services among both male and female teachers. This cross-sectional study was carried out among 600 schoolteachers in Kabul city in February 2017. Gender differences in percentage distributions of abnormal biomedical indicators, lifestyle behaviors, self-health check practices, and receipt of professional lifestyle advice were examined. These patterns were further analyzed according to the use of health services in the previous 12 months by both genders. The results showed that male teachers had a higher prevalence of hypertension, increased serum triglycerides, physically active lifestyle, and tobacco use than female teachers (28.2/20.4, p = 0.038; 47.0/37.9, p = 0.040; 54.3/40.9, p = 0.002; 15.8/0.7, p < 0.001, respectively); female teachers had a higher prevalence of increased serum LDL cholesterol, overweight/obesity, and frequent consumption of fruits/vegetables than male teachers (61.3/50.8, p = 0.018; 64.7/43.5, p < 0.001; 71.4/53.8, p < 0.001, respectively). Female teachers were more likely to receive professional lifestyle advice related to NCDs than male teachers. Although users of health services practiced self-health checks and received professional lifestyle advice more frequently than non-users, abnormal biomedical indicators were similarly shown among users and non-users of health services in both genders. In conclusion, high prevalence of abnormal biomedical indicators was indicated in both male and female teachers, although the specific abnormal biomedical indicators differed by gender. Users and non-users of health services presented a similar prevalence of these abnormal indicators. Understanding the differences in patterns of NCD risk factors is essential when developing gender-informed policies.

Prevalence of smoking in Brazilian schoolteachers, 2016

This cross-sectional study investigated the prevalence of smoking and associated factors in a nationally representative sample of 6,510 Brazilian schoolteachers. Data were obtained from telephone interviews using a questionnaire on sociodemographic information, health status, work absenteeism, and the characteristics of teaching work. Smoking was analyzed as a dichotomous variable using univariate and multivariate logistic regression. Overall smoking prevalence was 4.4%. Prevalence in men was 5.9% and was higher in those over 55 years of age (10.7%). Prevalence in women was 3.5% and was higher from 45 to 54 years of age (5.5%). The final multivariate model showed a negative association between smoking and female gender (OR = 0.46), being married or living with partner (OR = 0.53), occasional voice problems at work (OR = 0.64), and longer commuting time to and from school (OR = 0.58). The results showed positive associations between smoking and older age (OR = 2.59), living in the South (OR = 1.98) and Southeast Brazil (OR = 2.07), insufficient physical activity (OR = 1.66), and use of anxiolytics or antidepressants (OR = 2.46). Prevalence of smoking in Brazilian schoolteachers was relatively low. Unexpectedly, although cited as inadequate by the teachers, work conditions and demands in the schools did not reach statistical significance with smoking in the current study.

Knowledge, attitude, and usage pattern of tobacco among high school students in Nay Pyi Taw, Myanmar

In Myanmar, although the law prohibits the sale of tobacco products to and by those aged less than 18 years, the use of smoking and smokeless tobacco among high school students is a social problem. There has been no previous study on tobacco use or knowledge of tobacco law among students in Nay Pyi Taw. A survey was conducted to assess the knowledge, attitude, and usage pattern of tobacco among high school students in Nay Pyi Taw, Myanmar. The data were collected in three high schools, from 300 students of Grade 10 and 11, in September 2015, using anonymous self-administered questionnaires which included characteristics of students, knowledge, attitude, and usage pattern of tobacco. Of the 300 students, 104 (34.7%) were smokers and 85 (28.3%) were users of smokeless tobacco. The average age of first use of tobacco was 14 years. Although most students knew about the ill effects of tobacco, only 25% knew about the Tobacco Product Law. The most common source of tobacco was friends and male family members were main smokers in families. Most students had seen male teachers and headmasters smoking in schools. The usage of tobacco and smokeless tobacco was associated with sex and the students’ attitude towards tobacco. This study indicated that the high school students knew about the ill effects of tobacco, but not about the Tobacco Product Law. Schools need to educate students and teachers about tobacco and the Tobacco Product Law and the enforcement of the law is also needed.

Prevalence of Tobacco Use among School Teachers and Effect of Training on Tobacco Use in Western Turkey

BACKGROUND

Tobacco consumption is still a prevalent issue. Given that teachers are respected in society, they have a great responsibility for tobacco control. This study examines, using the Transtheoretical Model (TTM), the prevalence of tobacco use among teachers and their different stages of tobacco use. It also evaluates teachers' views on smoking and the effectiveness of training on tobacco use.

METHODS

This study is quasi-experimental. Pre-test and post-test were used first with a cross-sectional group, then with a single group to determine the frequency of tobacco use. The research participation complied with the voluntary principles and the participation rate was 84.9%. The research sample comprised 450 teachers working at schools (N=17) under the Kemalpasa Directorate of Education. The data form contained 29 questions about socio-demographic characteristics and smoking habits. The Fagerstrom Test for Nicotine Dependence (FTND), Smoking Decisional Balance Scale (SDBS), and the Stage of Change were used. A pre-test was also administered, and training was given between January 13 and March 4, 2014. After the training sessions, two short messages (SMS) were sent on March 12 and March 19, 2014. A post-test was administered between April 1 and May 21, 2014. The relevant institutions and participants gave the requisite permission for the data used in this study. Percentage distribution, dependent t-tests and chi-square tests were used to evaluate the research data.

RESULTS

The median age of the teachers was 37.49±7.84. The teachers' mean score for the pre-test of FTND was 5.7±2.03, and their mean score for the post-test was 3.25±2.07. Post-test scores were remarkably lower than the pre-test scores. It was found that teachers' mean scores for SDBS were different before and after training. After training, anti-smoking attitudes increased (pros-cons scores: pre-test: -3.64±4.68, post-test: -11.25±5.48). The training helped the entire group to make progress in the process change.

CONCLUSION

After training on "the health effects of smoking", teachers' anti-smoking attitudes rose on the smoking decision balance scale, their nicotine dependency was reduced, and they were able to move forward in a positive direction.

Exploring Factors that Influence Smoking Initiation and Cessation among Current Smokers

INTRODUCTION

Worldwide, cigarette smoking kills 5 million people annually, and leads to illness, disability and death. This study aimed to assess the factors influencing smoking initiation and cessation among current smokers in Chennai, India.

MATERIALS AND METHODS

This cross-sectional study was conducted in September 2013 in Chennai, India. A convenient sample of 100 current smokers aged >15 years was enrolled. A modified version of Alcohol, Smoking and Substance Involvement Screen Test (ASSIST) questionnaire was used to gather information on socio-demographics, smoking initiation and cessation, expenditure on smoking products and perceptions on incentives for smoking cessation.

RESULTS

Surrounding influence (44%), stress (42%) and fun (40%) were major reasons for smoking initiation. Majority of participants (68%) attempted to quit smoking within past 6 months but failed. Health promotion programs (61%) and financial incentives (20%) were perceived to be helpful in smoking cessation.

CONCLUSION

Smoking cessation strategies, especially at workplaces, should target the multi-factorial nature of smoking initiation and cessation. There is a need to review national guidelines to evaluate the accessibility and availability of smoking products in and around the workplace.

Insights into smoking and its cessation among current smokers in India

BACKGROUND

Initiation, perpetuation and cessation of smoking are all multifactorial. It is essential to explore interactions among various parameters influencing smoking and its cessation for effective smoking cessation interventions.

OBJECTIVES

To obtain insights into smoking and its cessation among current smokers in India.

MATERIALS AND METHODS

The present study was conducted among current smokers visiting the Department of Oral Medicine and Radiology, Manipal College of Dental Sciences (MCODS), Manipal University, Mangalore. Knowledge, attitudes, behavior, worksite practices towards smoking and its cessation, barriers to smoking cessation and socio-demographic variables were explored using a structured, pretested, self-administered questionnaire.

RESULTS

A total of 175 current smokers participated in the study. Mean knowledge, attitude, worksite practice and barrier scores were 15.2±5.67 (66.1%), 57.5±7.67(82.1%), 4.18±2.02 (41.8%) and 57.4±12.37 (63.7%) respectively. Correlation analysis revealed: association of knowledge with education, occupation and religion; attitude with education and occupation; worksite practices with occupation; knowledge with attitude; and barriers negatively with worksite practices. The majority (85.7%) of respondents intended to quit smoking and this was associated with higher attitude scores, whereas actual quit attempts were associated with high knowledge, attitudes, worksite practices and low barrier scores.

CONCLUSIONS

Various socio-demographic factors associated with smoking and its cessation were identified. The present study highlights the importance of identifying and targeting these interactions while framing guidelines and interventions for effective tobacco cessation in a developing country like India.

Prolonged pacifier use during infancy and smoking initiation in adolescence: evidence from a historical cohort study

AIM

To investigate the association between prolonged pacifier use during childhood and smoking in adolescence and early adulthood.

METHODS

A historical cohort study including patients from a dental private office was designed. Dental records were used, which contained complete data about sucking habits from 314 children (2-10 years of age) who had attended a private dental office from 1988 to 1994 in Ibiá, Brazil. Then, we collected data about the smoking habits from 261 subjects who were successfully contacted again from 2004 to 2006. Our outcome variable was smoking, and subjects who had smoked more than 100 cigarettes during their lifetime were classified as smokers. Poisson regression analysis matched the association between oral habits and smoking. Incidence rate ratios (IRR) and 95% confidence intervals (95% CI) were calculated. The level of significance was set at 5%.

RESULTS

We observed a statistically significant association between prolonged pacifier use (more than 24 months) and smoking (IRR = 4.48; 95% CI 2.32-8.65). Breastfeeding, in contrast, was a protective factor (IRR = 0.64; 95% CI 0.42-0.96).

CONCLUSIONS

Prolonged pacifier use during childhood is positively associated with smoking initiation in adolescence and early adulthood.

The relationship between proximity of tobacco retail outlets to schools and tobacco use among school personnel in sub-Saharan Africa

BACKGROUND

We investigated the impact of proximity of tobacco retail outlets to schools on tobacco-related behavior and attitudes of school personnel in sub-Saharan Africa.

METHODS

A pooled analysis of the 2006-2011 Global School Personnel Surveys from 19 sub-Saharan African countries was performed (n=12,201). Multivariate logistic regression analyses were applied to measure the relationship between proximity of tobacco outlets to school premises and school personnel's tobacco-related behavior and attitudes (p<0.05).

RESULTS

Among all school personnel, there was a significant association between the presence of tobacco outlets on school premises and current cigarette smoking (adjusted odds ratio [aOR]=3.89; 95% confidence interval [CI]: 2.17-7.20), current smokeless tobacco use (aOR=2.63; 95%CI: 1.04-6.65), and permissiveness towards tobacco industry sponsorship activities in school (aOR=2.27; 95%CI: 1.37-3.78). Complete smoke-free school policies were associated with lower odds of current cigarette smoking (aOR=0.42; 95%CI: 0.23-0.74), but were not significantly associated with current smokeless tobacco use. Among lifetime any tobacco users, there was a significant association between the presence of tobacco outlets on school premises and use of combustible (aOR=2.03; 95%CI: 1.09-3.75) and smokeless (aOR=3.85; 95%CI: 1.51-9.81) tobacco products on campus within the past year.

CONCLUSIONS

Policies limiting the distance of tobacco outlets from schools, coupled with complete tobacco-free school policies may reduce tobacco use among school personnel.

Social determinants of tobacco consumption among Nepalese men: findings from Nepal Demographic and Health Survey 2011

Background

In the 20th century, 100 million people across the globe lost their lives due to consumption of tobacco. Every year 15,000 deaths in Nepal are attributable to tobacco smoking and using other products of tobacco. This study aimed to establish the proportion and the social determinants of tobacco use among Nepalese men based on the Nepal Demographic and Health Survey (NDHS), 2011.

Methods

This study used the NDHS 2011 data. The prevalence of cigarette smoking, other forms of tobacco 16 smoking and use of tobacco in any form is reported as a percentage (%). The significance of association of the statistically significant variables established using Chi-square test was further tested by using multiple logistic regression.

Results

Of the 4121 participants, the prevalence of consuming any form of tobacco was 51.9% [95% confidence interval (CI) (49.6%- 54.3%)]; chewing/sniffing tobacco was 34.8% (95% CI: 32.4%- 37.3%) and tobacco smoking was 33.6% (95% CI 31.3%-36.0%).

Men with no education [Odds Ratio (OR) 3.477; 95% CI (2.380-5.080)], from an older age group (36–49) [OR 2.399; 95% CI (1.858-3.096)] who were from a manual occupation [OR 1.538; 95% CI (1.188-1.985)], who were married[OR 1.938; 95% CI ( 1.552-2.420)], and who were from the Terai region [OR 1.351; 95% CI (1.083-1.684)] were more likely to consume tobacco. Men who watched television at least once a week [OR 0.642; 95% CI (0.504-0.819)] were less likely to consume tobacco.

Conclusions

The current study showed that over half of Nepalese men consume tobacco. There is an urgent need to fully implement Nepal’s Tobacco Control and Regulation Act which will ban smoking in public places; enforced plain packaging and display of health warnings over 75% of the packaging, and has banned selling of tobacco products to those under 18 years of age. There is a need to increase the social unacceptability of tobacco in Nepal by raising awareness through different electronic and cultural media. Anti-tobacco campaigns should focus on those who are less educated, have manual occupations, are in poorer economic groups, and are from the Terai region of Nepal.

Prevalence of tobacco smoking among school teachers in Botswana

BACKGROUND

Tobacco is a leading cause of death worldwide, and nearly 80% of all smokers live in low to middle income countries. Previous research has suggested that smoking rates vary by occupation, with relatively low rates commonly seen among educators. Despite this fact, little is known about the smoking habits of teachers in Botswana. The objective of this study, therefore, was to investigate prevalence and correlates of tobacco use among school teachers in Botswana.

RESULTS

The prevalence of smoking among school teachers in Botswana was found to be relatively low. Of the 1732 participants in the study, only 3.2% reported being current smokers, 5.3% were ex-smokers and 91.5% had never smoked. Smoking was more common among male teachers when compared to females, being 10.8% and 0.4%, respectively. Factors such as school level, marital status and body mass index were found to be positively associated with tobacco smoking, whereas age, length of employment and weekly working hours were not.

CONCLUSION

This study suggests that Botswana school teachers have a low prevalence of tobacco smoking. While this result may be attributed to tobacco control measures that have been put in place, there is still need to put in place systems to monitor compliance and programs to help those who want to quit smoking. Such protocols would represent a major step forward in further reducing the prevalence of smoking in the education profession.