Four-type of Masks and its Effectiveness Based on Reduced Level of Expiratory Carbon-monoxide

Introduction

Carbon-monoxide (CO) is a major component of motor-vehicles related air pollution. Motor-vehicles emissions are a major source of air pollution in urban areas and give significant adverse effects on human life.

Aim

This study aimed to assess the change of expiratory carbon-monoxide levels after using four-type of masks in people around Universitas Sumatera Utara.

Methods

This was an experimental study with a consecutive sampling technique involved 100 non-smoker subjects. They were divided into four groups based on masks given: fabric, surgical, carbon, and an N95 mask. Expiratory CO was measured by a smokerlyzer device. Data were analyzed using SPSS software with Wilcoxon and Kruskal Wallis Test.

Results

There was a significant change of carbon-monoxide mean level after using the mask for 8 hours in a surgical mask, N95 mask, and carbon mask (p-value: 0.002; 0.000; 0.000). After analyzed using Kruskal Wallis Test, there was a significant difference in the change of mean of pre and post wearing mask (ΔCO) among four-type of masks with p-value < 0.001. Post Hoc Analysis showed the significant difference was in the comparison between N95 mask vs Fabric Mask and Carbon Mask vs Fabric Mask (p-value: 0.002; 0.021).

Conclusion

All three type of masks such as surgical mask, N95 mask, and carbon mask was effective to reduce CO levels from air pollution with the most significant was N95 and carbon mask. Fabric mask has the poorest protection from CO levels.

Smoking cessation with smartphone applications (SWAPP): study protocol for a randomized controlled trial

Background

Tobacco smoking remains one of the biggest public health threats. Smartphone apps offer new promising opportunities for supporting smoking cessation in real-time. The social context of smokers has, however, been neglected in smartphone apps promoting smoking cessation. This randomized controlled trial investigates the effectiveness of a smartphone app in which smokers quit smoking with the help of a social network member.

Methods

This protocol describes the design of a single-blind, two-arm, parallel-group, intensive longitudinal randomized controlled trial. Participants of this study are adult smokers who smoke at least one cigarette per day and intend to quit smoking at a self-set quit date. Blocking as means of group-balanced randomization is used to allocate participants to intervention or control conditions. Both intervention and control group use a smartphone-compatible device for measuring their daily smoking behavior objectively via exhaled carbon monoxide. In addition, the intervention group is instructed to use the SmokeFree Buddy app, a multicomponent app that also facilitates smoking-cessation specific social support from a buddy over a smartphone application. All participants fill out a baseline diary for three consecutive days and are invited to the lab for a background assessment. They subsequently participate in an end-of-day diary phase from 7 days before and until 20 days after a self-set quit date. Six months after the self-set quit date a follow-up diary for three consecutive days takes place. The primary outcome measures are daily self-reported and objectively-assessed smoking abstinence and secondary outcome measures are daily self-reported number of cigarettes smoked.

Discussion

This is the first study examining the effectiveness of a smoking cessation mobile intervention using the SmokeFree Buddy app compared to a control group in a real-life setting around a self-set quit date using a portable objective measure to assess smoking abstinence. Opportunities and challenges with running studies with smoking participants and certain design-related decisions are discussed.

Trial registration

This trial was prospectively registered on 04/04/2018 at ISRCTNregistry: ISRCTN11154315.

Effectiveness of a new multi-component smoking cessation service package for patients with hypertension and diabetes in northern Thailand: a randomized controlled trial (ESCAPE study)

Background

Smoking cessation is an achievable behavioral change, which reduces the risks of cardiovascular diseases, cancers and tobacco-related diseases. There is a need for an effective smoking cessation service for low and middle income country settings where the smoking rate is generally very high whilst a cessation service is not usually accessible. This study devised a new smoking cessation service package and assessed its effectiveness in the primary health care setting of northern Thailand.

Methods

This randomized controlled trial was centered at Maetha district hospital, Lampang province, Thailand, and its network of mobile non-communicable disease clinics at seven primary care units. A total of 319 eligible patients who consented to participate in the study, were randomly allocated to an intervention arm (160) and a control arm (159), applying block randomization. The multi-component intervention service consisted of:

regular patient motivation by the same nurse over a 3-month period;

a monthly piCO+ Smokerlyzer test for 3 months;

continual assistance from a trained family member, using a smoking-cessation- diary; and

optional nicotine replacement chewing gum therapy.

The control group received the routine service comprising of brief counseling and casual follow-up. Smoking cessation, confirmed by six months of abstinence and the piCo+ Smokerlyzer breath test, was compared between the two services after a year follow-up.

The trial is registered as an international current control trial at the ISRCTN registry. ISRCTN89315117.

Results

The median age of the participants was 64 years, with females constituting 28.84%. Most of the participants smoke hand-rolled cigarettes (85%). The intervention arm participants achieved a significantly higher smoking cessation rate than the control arm 25.62% vs 11.32%, with an adjusted odd ratio of 2.95 and 95% confidence interval 1.55–5.61.

Conclusion

In relation to accessing smoking cessation services within the primary health care setting, participants who received the evidence-based intervention package were about three times more likely to succeed in giving up smoking than those who received the routine service. Utilizing community resources as major intervention components, the evidence from this trial may provide a useful and scalable smoking cessation intervention for low and middle income countries.

Trial registration

Current controlled trials ISRCTN89315117.

WHO international clinical trial identifier number: U1111–1145-6916; 3/2013.

Bangladesh Chars Tobacco Assessment Project (CTAP) 2018: a data note

OBJECTIVES

The Chars Tobacco Assessment Project 2018 is a holistic survey conducted in the chars (riverine islands) of Gaibandha in Northern Bangladesh, covering 985 households over 24 clusters. The survey was conducted with two objectives: (1) to assess levels of tobacco consumption and evaluate prevailing socio-economic, behavioral and health status of the chars population, and (2) to look at the effectiveness of advocacy campaigns to reduce tobacco consumption through behavioral nudges via randomized controlled trials (RCTs) in rural Bangladesh. The study site was purposively chosen due to its high tobacco consumption rate, and the geographical segregation of the chars aided in reducing spillovers for RCT design.

DATA DESCRIPTION

In addition to detailed information on tobacco (smoking and smokeless) consumption and perception, data was collected on: household composition, housing and plot ownership, consumption, risks and shocks coping, dowry, farm production, loans, savings and lending, labor income, asset holdings, migration and remittance, anthropometry, respiratory diseases, co-morbidities, reproductive history, risk and time preference. Unique to the dataset are carbon monoxide readings for accurate short term smoking measurement and FEV1 and PEF values for identification of long term lung damage. The data is representative only for the chars of Gaibandha.