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van der Eijk Y, Tan GPP, Makhbal B. Is It Time to Ban Flavored Cigarettes in Asia-Pacific Countries? A Scoping Review. Asia Pac J Public Health 2024; 36:542-549. [PMID: 39054851 DOI: 10.1177/10105395241266042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Flavored cigarettes encourage youth smoking and deter quitting. No country in Asia-Pacific, a region with some of the world's highest smoking rates, has regulated tobacco flavors. We examined market data, academic literature, and gray literature to describe what is known on flavored cigarettes in the Asia-Pacific region. Of the 12 countries for which market data were available, ten had substantial flavored cigarette market shares ranging from 10% to 97%. With no regulations and growing markets for flavor capsule variants, the tobacco industry's ongoing promotion of flavored cigarettes, which targets primarily youth and women, is expected to drive further increases in smoking prevalence. There are significant research and monitoring gaps on the industry's marketing tactics and use of flavored cigarettes in the region. Given the large market shares, Asia-Pacific countries stand to benefit substantially from a tobacco flavors ban.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Grace Ping Ping Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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Parwanto E, Tjahyadi D, Sisca S, Amalia H, Hairunisa N, Edy HJ, Oladimeji AV, Djebli N. Low Doses of Kretek Cigarette Smoke Altered Rat Lung Histometric, and Overexpression of the p53 Gene. Open Respir Med J 2024; 18:e18743064285619. [PMID: 39130649 PMCID: PMC11311747 DOI: 10.2174/0118743064285619240327055359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 02/26/2024] [Accepted: 03/13/2024] [Indexed: 08/13/2024] Open
Abstract
Background The components of kretek cigarettes include tobacco as the main part, clove, and sauce. Filtered kretek cigarettes are kretek cigarettes that have one end filtered. Cigarette smoke contributes to the disruption of the respiratory system, so it is necessary to know the effect of low doses of cigarette smoke on changes in the histometric of the respiratory system, and whether it affects p53 gene expression. This study aims to determine changes in the histometric of the respiratory system and p53 gene expression. Methods In this study, we used Sprague-Dawley rats. Group I of rats breathing normal air, were not exposed to filtered kretek cigarette smoke (as a control). Group II of rats, as a treatment group, were exposed to filtered kretek cigarette smoke 1 stick/day for 3 months. The results of lung histometry measurements and p53 gene expression between groups were analyzed using the Independent Sample T-test. The difference between groups is significant if the test results show P < 0.05. Results Bronchioles length, width, area, and perimeter in group I were 40.55±1.57 μm, 14.82±0.41 μm, 494.61±5.62 μm2, and 233.87±4.51 μm, respectively. Bronchioles length, width, area, and perimeter in group II were 30.76±0.78 μm, 9.28±0.40 μm, 297.32±2.53 μm2, and 177.84±5.15 μm, respectively. The area and perimeter of respiratory bronchioles in group I were 17.68±0.49 μm2, and 26.60±0.52 μm respectively, while those in group II were 19.28±0.35 μm2, and 29.28±0.35 μm, respectively. Mucus was found in the bronchioles and respiratory bronchioles in group II, however, there was no visible mucus observed in group I. In addition, it was also concluded that exposure to low doses of filtered kretek cigarette smoke, 1 cigarette/day for 3 months, increased the expression of the p53 gene in the lungs of rats. Conclusion The size of bronchioles in rats decreased after being exposed to filtered kretek cigarette smoke 1 stick/day for 3 months, while the size of respiratory bronchioles increased. In addition, exposure to filtered kretek cigarette smoke increased the expression of the p53 gene in the rat lungs.
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Affiliation(s)
- Edy Parwanto
- Department of Biology, Faculty of Medicine, Universitas Trisakti, Jl. Kyai Tapa, Kampus B, No.260 Grogol 11440, Jakarta, Indonesia
| | - David Tjahyadi
- Department of Histology, Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia
| | - Sisca Sisca
- Department of Biology, Faculty of Medicine, Universitas Trisakti, Jl. Kyai Tapa, Kampus B, No.260 Grogol 11440, Jakarta, Indonesia
| | - Husnun Amalia
- Department of Ophthalmology, Faculty of Medicine, Universitas Trisakti, Jakarta, Indonesia
| | - Nany Hairunisa
- Department of Occupational Medicine, Faculty of Medicine,Universitas Trisakti, Jakarta, Indonesia
| | - Hosea Jaya Edy
- Study Program of Pharmacy, Faculty of Math, and Natural Sciences, Universitas Sam Ratulangi, Manado, Indonesia
| | | | - Noureddine Djebli
- Department of Biologie, Faculty of Natural and Life Sciences, Abdelhamid Ibn Badis University, Mostaganem, Algeria
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Picanço JMA, Limberger RP, Apel MA. Where should I start? A scoping review about the publications on clove cigarettes. Crit Rev Toxicol 2022; 52:259-293. [PMID: 35971813 DOI: 10.1080/10408444.2022.2097053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The general lack of knowledge about the composition of clove cigarettes and the large number of terms that can be used to define different types of cigarettes that contain cloves makes it difficult to find scientific articles focused on the subject. We reviewed the publications that cited clove cigarettes to assess their relevance. METHODS We searched publications on Scopus, ScienceDirect, PubMed, and Portal CAPES during the first semester of 2021, without date restrictions. Through a quality assessment, the studies found were assorted in ten different categories. RESULTS Indonesian clove cigarettes-also known as kretek-are a mixture of tobacco and cloves rolled in a cigarette and sprayed with oils, plant extract, and food flavorings, in an unknown quantity and composition, different from each brand, which is usually kept in secret. Due to the relatively low prevalence of use in the general population, most publications on tobacco products tend to ignore clove cigarettes or place them in an existing category. Clove cigarettes can be hand-rolled, machine-made, filtered, unfiltered, and each form can be named differently. The interchangeable use of each term, sometimes grouping conventional cigarettes in the mix, can lead the researcher to consider a publication that should be excluded. CONCLUSION The existing regulations on flavored cigarettes, although well-intentioned, are still somewhat vague and broad, leaving possible loopholes that can be exploited by the tobacco industries. Fully understanding the precise effects caused by clove cigarettes can be an important tool in future discussions about tobacco control.
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Affiliation(s)
| | | | - Miriam Anders Apel
- Faculty of Pharmacy, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Jansen MAC, Dalmeijer GW, Saldi SRF, Grobbee DE, Baharuddin M, Uiterwaal CSPM, Idris NS. Pre-pregnancy parental BMI and offspring blood pressure in infancy. Eur J Prev Cardiol 2019; 26:1581-1590. [PMID: 31238715 PMCID: PMC6753651 DOI: 10.1177/2047487319858157] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/29/2019] [Indexed: 12/11/2022]
Abstract
AIMS A growing body of evidence suggests that a higher maternal pre-pregnancy body mass index results in higher offspring's blood pressure, but there is inconsistency about the impact of father's body mass index. Furthermore, evidence is limited with regard to low and middle income countries. We aimed to determine the association between parental pre-pregnancy body mass index and offspring's blood pressure during the first year of life. METHODS In 587 infants of the BReastfeeding Attitude and Volume Optimization (BRAVO) trial systolic and diastolic blood pressure were measured twice at the right leg in a supine position, using an automatic oscillometric device at day 7, month 1, 2, 4, 6, 9 and 12. Parental pre-pregnancy body mass index was based on self-reported weight and height. Linear mixed models were performed to investigate the associations between parental pre-pregnancy body mass index and offspring blood pressure patterns. RESULTS Each unit increase in maternal body mass index was associated with 0.24 mmHg (95% confidence interval 0.05; 0.44) and 0.13 mmHg (0.01; 0.25) higher offspring's mean systolic and diastolic blood pressure, respectively, during the first year of life. A higher offspring blood pressure with increased maternal pre-pregnancy body mass index was seen at birth and remained higher during the first year of life. The association with systolic blood pressure remained similar after including birth size and offspring's weight and height over time. The association with diastolic blood pressure attenuated slightly to a non-significant result after including these variables. Paternal body mass index was not associated with offspring's blood pressure. CONCLUSION Higher maternal pre-pregnancy body mass index, but not paternal pre-pregnancy body mass index, is associated with higher offspring blood pressure already from birth onwards.
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Affiliation(s)
| | - Geertje W Dalmeijer
- Julius Center for Health Sciences and
Primary Care, University Medical Center Utrecht, The Netherlands
| | - Siti RF Saldi
- Department of Child Health/Center for
Clinical Epidemiology and Evidence Based Medicine (CEEBM), Cipto Mangunkusumo
National General Hospital, Indonesia
| | - Diederick E Grobbee
- Julius Center for Health Sciences and
Primary Care, University Medical Center Utrecht, The Netherlands
| | | | - Cuno SPM Uiterwaal
- Julius Center for Health Sciences and
Primary Care, University Medical Center Utrecht, The Netherlands
| | - Nikmah S Idris
- Julius Center for Health Sciences and
Primary Care, University Medical Center Utrecht, The Netherlands
- Department of Child Health/Center for
Clinical Epidemiology and Evidence Based Medicine (CEEBM), Cipto Mangunkusumo
National General Hospital, Indonesia
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Kristina SA, Endarti D, Sendjaya N, Pramestuty O. Estimating the Burden of Cancers Attributable to Smoking Using Disability Adjusted Life Years in Indonesia. Asian Pac J Cancer Prev 2017; 17:1577-81. [PMID: 27039808 DOI: 10.7314/apjcp.2016.17.3.1577] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Tobacco use is a well-established risk factor for many types of cancers. Recent data on selected cancer incidence and mortality related to smoking in the Indonesian population are provided in this study. Morbidity and mortality data were derived from GLOBOCAN 2012 and the population attributable fraction (PAF) was estimated using the standard methodology developed by the World Health Organization. Using these data, we calculated disability adjusted life year (DALY) values for smoking-related cancer. The DALY was estimated by summation of the years lived with disability (YLD) and years life lost due to premature death (YLL). The cancer cases related to smoking in Indonesia numbered 45,132, accounting for 35,580 cancer deaths. The morbidity and mortality of lung cancer can be considered as the highest priority in both men and women. Furthermore the greatest YLD due to smoking in Indonesian men and women were from pancreas and lung cancers. For YLL among men, the highest years lost were from lung and liver cancers. On the other hand, among women lung oral cavity and lip were most important. Based on the DALY indicator, burden priorities for Indonesian men were lung cancer (298,980), liver cancer (60,367), and nasopharynx (46,185), while among Indonesian women they were lung cancer (34,119), cervix uteri (9,213) and pancreas cancer (5,433). In total, Indonesian burden of cancers attributed to smoking was 638,682 DALY. This study provides evidence about the burden of cancers caused by smoking as a rational basis for initiating national tobacco control policies in Indonesia.
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Affiliation(s)
- Susi Ari Kristina
- Pharmaceutics, Pharmacy, Gadjah Mada University, Yogyakarta, Indonesia E-mail :
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Savitri AI, Zuithoff P, Browne JL, Amelia D, Baharuddin M, Grobbee DE, Uiterwaal CSPM. Does pre-pregnancy BMI determine blood pressure during pregnancy? A prospective cohort study. BMJ Open 2016; 6:e011626. [PMID: 27515754 PMCID: PMC4985806 DOI: 10.1136/bmjopen-2016-011626] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To evaluate if pre-pregnancy body mass index (BMI) determines blood pressure throughout pregnancy and to explore the role of gestational weight gain in this association. In addition, the effects of pre-pregnancy BMI and gestational weight gain on the occurrence of gestational hypertension and pre-eclampsia were investigated. DESIGN Prospective cohort study. SETTING Maternal and child health primary care referral centre, Jakarta, Indonesia. POPULATION AND MEASUREMENTS 2252 pregnant women visiting Budi Kemuliaan Hospital and its branch for regular antenatal care visits from July 2012 to April 2015. Pre-pregnancy BMI (kg/m(2)) was based on self-reported pre-pregnancy weight and measured height at first visit. Gestational weight gain was calculated as weight at the day of delivery minus the pre-pregnancy weight. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured during pregnancy at every visit. Linear mixed models were used to analyse this relation with repeated blood pressure measures as the outcome and pre-pregnancy BMI as the predictor. When looking at gestational hypertension and pre-eclampsia as outcomes, (multiple) logistic regression was used in the analysis. RESULTS Independent of pre-pregnancy BMI, SBP and DBP increased by 0.99 mm Hg/month and 0.46 mm Hg/month, respectively. Higher pre-pregnancy BMI was associated with higher pregnancy SBP (0.25 mm Hg/kg/m(2); 95% CI 0.17 to 0.34; p<0.01) and DBP (0.18 mm Hg/kg/m(2); 0.13 to 0.24; p<0.01) in adjusted analysis. Every 1 kg/m(2) higher pre-pregnancy BMI was associated with 6% and 9% higher odds for gestational hypertension (adjusted OR (aOR) 1.06; 95% CI 1.03 to 1.09; p<0.01) and pre-eclampsia (aOR 1.09; 1.04 to 1.14; p<0.01). Accounting for gestational weight gain did not attenuate these associations. CONCLUSIONS Pre-pregnancy BMI determines the level, but not the change, of blood pressure in pregnancy and is linked to higher odds for gestational hypertension and pre-eclampsia, independent of gestational weight gain.
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Affiliation(s)
- Ary I Savitri
- Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Peter Zuithoff
- Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joyce L Browne
- Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | | | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cuno S P M Uiterwaal
- Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center Utrecht, Utrecht, The Netherlands
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