The Origins of “Big Tobacco” Cigarette Manufacturing and the Prevalence of Smoking in Colonial Cyprus, 1920-1960

Prevalence of Cigarette Use Among 14 Racial/Ethnic Populations

The purpose of this study is to evaluate the prevalence and trends of cigarette smoking among young military conscripts, military officers, and military university students during recently 10 years in Taiwan. Repeated cross-sectional surveys were conducted annually among young military conscripts and military university students from 2006 to 2014. All the young conscripts were reviewed within 1 month at the military training center and before retiring after 1 year of military services. The military officers were included using purposive sampling from 2004 to 2008 and 2013 to 2014 in different military services. Military university students were included in this study. Freshman and senior students were random sampled as the study subjects. Participants completed a structured questionnaire that included questions on general demographics and health-related behaviors. Current smokers is defined as subjects who smoked ≥1 cigarette/day during the past 30 days or had smoked ≥100 cigarettes in their lifetime or still have the habit of smoking during study. We used a χ2 test to examine the difference between the prevalence of cigarette smoking among different groups. The Cochran-Armitage test for trend was applied to examine the change of prevalence of smoking after repeated cross-sectional surveys among populations. The prevalence of cigarette smoking within military training center and after 1-year military services was 48.6% and 48.1% on 2006, which became 39.2% and 38.6% on 2010, and then further declined to 31.0% and 30.1% on 2014. For military officers, the trends of prevalence of smoking among different military services showed slight decline from 2004 to 2008, but decreased significantly between 2013 and 2014. The prevalence of smoking in 2014 was 32.1%, 32.8%, and 32.4% for the Army, Navy, and Air Force, respectively. More interestingly, the prevalence of smoking of freshman and senior students increased during the first 5 years (2007-2011) of survey and then decreased after 2012. Furthermore, in 2014, the prevalence of smoking decreased as the difference became smaller, 4.5% and 6.1% for freshman and senior, respectively. During this 10-year period, the smoking cessation programs include in-class education course, out-door physical training, antismoking clinic, and group therapy. After these military health promoting programs, there are some beneficial effects to decline the prevalence of cigarette smoking for military personnel in Taiwan. However, more active intervention and health promoting programs in prevention and cessation of smoking are needed for the military. The military also have to develop specific approaches and programs to prevent cigarette smoking among conscripts and officers.

Cigarette Smoking Among Adults in the United States

Background: Cigarette smoking is a shared risk factor for a variety of health conditions. Aims: To estimate the prevalence of cigarette smoking among Iranian adolescents and young adults. Methods: In this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Scopus and domestic databases from January 2001 to December 2018. Cross-sectional studies that reported the prevalence of cigarette smoking among high school students, university students or general population aged 14–30 years were eligible. Data on prevalence of smoking, age and gender of subjects, sample size, date, and location of studies were extracted by 2 independent reviewers. Results: We included 99 studies in the analysis. For high school students, the pooled life-time prevalence of cigarette smoking was 13% in girls and 23% in boys. For university students, the life-time prevalence was 11% in women and 33% in men. The pooled prevalence of current and regular smoking among high school boys was 9% and 5%, respectively, compared with 3% and 1% in girls. The pooled prevalence of current and regular smoking among male university students was 22% and 11%, respectively, compared with 5% and 1% among female students. The prevalence of current smoking among the general population aged 15–24 years was 3.3–13.9%. The prevalence of regular smoking among this population was 1.0–10.2%. Conclusion: Cigarette smoking is notable among Iranian young adults especially boys and university students. Our findings call for reinforcement of tobacco prevention and control policies across Iranian schools and universities.

Smoking is an important risk factor for various diseases, especially cancer. To estimate the prevalence of cigarette and waterpipe smoking and its association with cancer incidence in Middle Eastern countries. We searched Medline, Google Scholar, and PubMed for original articles published between 2000 and 2020 using a combination of the terms smoking, cigarettes, waterpipe, hookah, tobacco, prevalence, Middle East, and the names of countries in the Middle East. Data were analysed using STATA version 14. We performed a random-effect meta-analysis to obtain pooled smoking prevalence estimates with 95% CI and used the I² statistic to assess heterogeneity between studies. We conducted subgroup analyses by sex, country, residence, and age to explore the sources of heterogeneity, and used visual examination of the funnel plot and Egger's test to identify publication bias. We included 90 articles in this meta-analysis. The pooled prevalence of current cigarette and waterpipe smoking in Middle East countries was 17.41% and 6.92%, respectively. The prevalence of current cigarette and waterpipe smoking among men was significantly higher than among women. In the past decade, the prevalence of cigarette smoking decreased by 7.21% but the prevalence of waterpipe smoking increased by 7.80%. The highest population attributable risk was shown for oesophageal (35.0%), lung (30.50%), and gastric (8.20%) cancers. Cigarette smoking is still a public health problem especially among adult men in the Middle East. About 30% of oesophageal and lung cancers in this region were attributed to cigarette smoking. The increasing trend in waterpipe smoking during the last decade is of concern. Prevention programmes are needed as a top priority for health interventions.

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessNondaily Smoking Increases in People With Mental IllnessMark MoranMark MoranSearch for more papers by this authorPublished Online:4 Oct 2018https://doi.org/10.1176/appi.pn.2018.9b13AbstractThe development of targeted tobacco control public health approaches that address common mental health and substance use problems in the community may be needed to lower the prevalence of smoking, researchers say.Nondaily cigarette smoking by U.S. adults with common mental health and substance use problems increased significantly between 2005 and 2014, while simultaneously declining among those without these disorders, according to a report in the Journal of Clinical Psychiatry. iStock/fuzznailsThe report also found daily smoking declined among those with and without these disorders. “While the decrease in daily cigarette smoking among persons with MHSUP [mental health or substance use problem] is promising, the prevalence of cigarette smoking among persons with MHSUP remained very high,” wrote Andrea H. Weinberger, Ph.D., an assistant professor of psychology of Yeshiva University in New York, and colleagues. According to the researchers, the overall prevalence of smoking among people with mental illness and substance use problems in 2014 was more than twice that of those without those conditions.“There is a commonly held view that nondaily cigarette smoking is not harmful,” the researchers wrote. “However, nondaily cigarette smoking has negative health consequences, many nondaily smokers eventually increase to daily cigarette consumption and nondaily cigarette smokers are less likely to express an intention to quit, relative to daily smokers.”Weinberger and colleagues analyzed data from the National Survey on Drug Use and Health from 2005 and 2014, comparing current, daily, and nondaily cigarette smoking among adults with and without any mental health or substance use problem. Individuals who reported experiencing past-year major depressive episode, serious psychological stress, substance use disorders, alcohol use disorders, heavy alcohol use, or daily cannabis use were classified as having a mental health or substance use problem (MHSUP). People with a history of smoking who smoked cigarettes 1 to 29 days of the previous 30 days were classified as nondaily smokers, while those who smoked 30 of the previous 30 days were classified as daily smokers.The prevalence of nondaily cigarette smoking increased from 29.54 percent in 2005 to 33.73 percent in 2014 among people with MHSUP. In contrast, nondaily smoking declined among people without these disorders from 29.13 percent in 2005 to 27.43 percent in 2014. The prevalence of daily smoking declined significantly over the same period among individuals in both groups (from 29.42 percent to 24.21 percent among people with MHSUP; from 13.48 percent to 10.21 percent among people without MHSUP).“It is not clear whether the increase in nondaily cigarette smoking for persons with MHSUP is due to persons decreasing cigarette smoking from daily to nondaily levels or incident nondaily cigarette smoking,” the researchers wrote. “Future studies should examine reasons for the increase in nondaily cigarette smoking to determine what resources are most needed. Persons who present with both mental health and substance use problems may need additional research and clinical attention to understand and address their greater increasing trend in nondaily smoking.” They noted as well that the 2008 update to the Clinical Practice Guidelines for Treating Tobacco Use and Dependence recommends routine screening for cigarette smoking, including the use by physicians of “the 5 A’s”: Ask patients if they smoke. Advise patients to quit. Assess patients’ motivation for quitting. Assist with quit attempts.Arrange follow-up contacts.“When patients enter treatment for MHSUP, it provides an opportunity to identify smokers (nondaily and daily) and provide cessation treatment options,” Weinberger and colleagues wrote. The study was supported by a National Institutes of Health/National Institute on Drug Abuse grant. ■“Nondaily Smoking Is Increasing Among People With Common Mental Health and Sub-stance Abuse Problems in the United States: Data From Representative Samples of U.S. Adults, 2005-2014” can be accessed here. “Treating Tobacco Use and Dependence: 2008 Update—Clinical Practice Guideline” is available here. ISSUES NewArchived

Background: Cigarette smoking is known as a gateway drug for illicit drug use in youth. The objective of this study is to assess the prevalence of cigarette smoking in the college students in Iran. Methods: We searched electronic databases including Scopus, Medline/PubMed, Google Scholar and Web of Science, and national databases such as Magiran, Scientific Information Database, Iranmedex, Medlib, Irandoc, and IranPsych from 1946 to 21st July 2018 without any language restriction using a proper search strategy. We used a random effect model to calculate the pooled prevalence of cigarette smoking in college students in Iran. Chi-square test and I2 index were used to evaluate the heterogeneity between the studies. We used the meta-regression and subgroup analysis to assess the potential source of heterogeneity. Stata software, version 11 (StataCorp, TX) was used for all statistical analysis. Results: We included 60 eligible articles in our study. The pooled prevalence of cigarette smoking at least once in the lifetime was 19% (95%CI: 17-22). The I2 index indicated considerable between-study heterogeneity (I2 =98%, p<0.001). The pooled prevalence of cigarette smoking at least once in the lifetime in males and females was 28% (95% CI: 23-34) and 9% (95% CI: 6-13), respectively. In multivariable meta-regression, a significant association was shown between the year of study (β=-13.1, p=0.011) and sampling method (β=-12.8 p=0.017) and daily use in the last month. Conclusions: Increasing prevalence of smoking among Iranian university students is an important health priority. Increasing preventive and health education programs are recommended.

Cigarette and tobacco smoking are closely associated with chronic cardiovascular disease and lung cancer. We aimed to assess the prevalence and 5-year incidence rate (IR) of these two risk factors for cardiovascular diseases in Kerman, southeastern of Iran. 10015 individuals aged 15-80 were recruited to the study between 2014 and 2018 (Kerman coronary artery disease (CAD) risk factors study, KERCADRS) of which 2820 had also participated in the first phase (5 years earlier). We took fasting blood samples and collected demographic information and data on cigarette and water-pipe tobacco smoking (WPTS) through interviews. The overall prevalence of cigarette smoking increased from 8.1% in phase1 to 8.8% in phase 2. During the same period, the prevalence of WPTS increased from 10% to 14%, especially in the age groups of 15-45 years. The prevalence of opium dependance was higher among cigarette smokers compared to WPT users. The overall 5-year IR of cigarette and WPTS was 3.6 and 4.65 per 1000 person-years respectively. The highest IRs of cigarette smoking and WPTS were reported in the age group of 15-39 years, and IR of WPTS was higher among women. Obesity, diabetes, and hypertension associated with a reduced IRs of cigarette and WPTS. Over the past five years, the prevalence of cigarette smoking has increased slightly, but WPTS has increased more rapidly, especially among women. The highest prevalence of cigarette and WPT smoking was in the age groups of 15-39 years. Smoking is shifting from cigarette smoking to WPTS. Age- and gender-oriented interventions would help correct the unhealthy life style in the community and prevent further smoking-related morbidities and mortalities.

Cigarette smoking is on the rise among adolescents in the United States. Although both African-American and white adolescents have experienced increases in cigarette smoking over time, the prevalence of smoking has remained consistently lower among African-American adolescents than their white counterparts. The purpose of this study was to determine whether the race differential in the prevalence of cigarette smoking is attributed to differences in selected lifestyle behaviors and demographic factors. A cross-sectional study was conducted among African-American and white adolescents (aged 12 to 17 years) who participated in the Youth Risk Behavior Survey supplement to the 1992 National Health Interview Survey. Analyses were restricted to those who had complete data on all study variables (n = 5569). Logistic regression analysis was used to estimate the prevalence odds ratios (POR) of current smoking for white adolescents (versus African-American adolescents) before and after adjustment for confounding factors. The crude POR of current smoking for white adolescents compared with African-American adolescents was 2.8 (95% confidence interval = 2.1 to 3.9). Simultaneous adjustment for confounding factors resulted in a POR of 2.6 (95% confidence interval = 1.8 to 3.7). Selected lifestyle behaviors and demographic factors do not account for the race differential in the prevalence of adolescent cigarette smoking. This study underscores the need for more research on contributors to the race gap. Such research could advance theoretical understanding of the etiology of cigarette smoking among adolescents and lead to more effective smoking prevention programs for all youths.

BackgroundAlthough the prevalence of adolescents’ cigarette smoking has increased in recent decades, little is known regarding its epidemiology in certain Saudi regions, including the Madinah region. The aim of this study was to determine the prevalence and predictors of adolescent cigarette smoking in Madinah, Saudi Arabia.MethodsA school-based cross-sectional study was carried out in the Madinah region during 2013. A multistage stratified cluster sample was taken and included 3400 students (11–19 years) from 34 intermediate and secondary schools. Data concerning sociodemographic and smoking-related factors were collected using a valid and reliable self-administered questionnaire. The prevalence of smoking was estimated, and appropriate statistical analyses were performed, including univariate, predictive and multivariate regression analyses.ResultsThe overall response rate was 97.7%. The prevalence of cigarette smoking in the respondents’ 3322 adolescents was 15.17% (95% CI = 13.95-16.39) with significant differences in sociodemographic factors. The most important predictors were most or all friends smoking (OR = 12.5; 95% CI = 9.40-16.8). Other significant less important factors were parental smoking, belief in the harmful effects of smoking, cigarette advertisement in mass media, and pocket money.ConclusionsCigarette smoking prevalence is a relatively low among adolescents in Madinah region. However, friends and parents smoking play an important role in the increased risk of smoking in the studied adolescents. These predictors must be included in any antismoking education programs targeting to this sector of population in the region.

Background&#x0D; Tobacco smoke is the second leading risk factor for death worldwide. This report aims to determine the recent prevalence of and factors associated with cigarette smoking in Saudi Arabia.&#x0D; Methods&#x0D; Data were pooled from two nationwide cross-sectional surveys conducted in 2018 across the 13 regions of Saudi Arabia. The study targeted Arabic-speaking Saudi residents aged 18 years or older between March and July 2018.&#x0D; Results &#x0D; A total of 7,317 adults across the 13 regions of Saudi Arabia were included in this study. The prevalence of cigarette smoking was 21.4% of the population. The prevalence of smoking was 32.5% among males and 3.9% among females. There is a disparity in cigarette smoking prevalence from one region to another. The Aljwaf, Northen Borders, Riyadh, and Eastern regions have the highest prevalence, while the fewest cigarette smokers live in Aseer Jizan and Albaha.&#x0D; Conclusion&#x0D; The prevalence of cigarette smoking was relatively high among males, those aged 25–44 year old, and those who live in the northern regions.

Background:Tobacco use is one of the leading causes of preventable deaths in the world. The aim of this study was to determine the prevalence of all common types of tobacco use and identify factors associated with tobacco use among adults in Tehran based on information from the population-based Burden of Obstructive Lung Disease study in Tehran.Materials and Methods:This study had a stratified cluster sampling strategy with proportional allocation within strata. The target population was all noninstitutionalized residents of Tehran over 18 years of age in 2013. A total of 1798 individuals were visited in 22 districts of Tehran; 811 (45.1%) men and 987 (54.9%) women participated in structured interviews.Results:The estimated prevalence of current cigarette smoking was 10.6% overall, 20.9% in men and 2.2% in women. The prevalence of smoking was the highest among respondents between 45 and 54 years in both males and females. The mean age of initiation of tobacco smoking was 21.04 ± 6.42 years. The mean Fagerström test score was 2.87 ± 2.36 among current smokers. The mean number f cigarettes smoked daily by the participants was 11.39 ± 10.92 cigarettes/day (95% confidence interval = 12.58–10.21) (range 1–60 cigarettes).Conclusions:The 10.6% prevalence of cigarette smoking is alarming in Tehran. We found that male gender, hookah smoking experience, and poor health status were major risk factors in our study population. Hookah smoking can be considered as a reflection of tobacco smoking in the society.

Limited data on cigarette smoking among population subgroups hinder the development and implementation of intervention strategies for those subgroups. Because of small sample sizes or inadequate study formats, cigarette smoking among youths has been studied mostly among broad racial or ethnic categories (e.g., Asian, Hispanic) instead of subgroups (e.g., Vietnamese, Cuban). The objective of this study was to evaluate cigarette smoking among U.S. youths by racial and ethnic subgroups. The study used a nationally representative sample of youths aged 12 to 17 years who participated in the National Survey on Drug Use and Health in 1999, 2000, or 2001. Outcomes measured include prevalence of cigarette smoking, mean age of smoking initiation, and susceptibility to start smoking. The prevalence of smoking among youths aged 12 to 17 years varied among racial and ethnic subgroups, ranging from 27.9% for American Indians and Alaska Natives to 5.2% for Japanese. Among youths aged 12 to 17 years, the age of smoking initiation ranged from 11.5 years (American Indians and Alaska Natives) to 13.2 years (Japanese); the overall mean age of initiation was 12.3 years. White and African American youths were the only groups that showed a significant sex difference in age of initiation among all 14 subgroups; white and African American boys initiated smoking a few months earlier than white and African American girls. One of every four never-smokers aged 12 to 17 years was classified as susceptible to becoming a smoker. The prevalence of cigarette smoking among youths varies widely by racial and ethnic subgroup. There is a need for sustained, culturally appropriate interventions to prevent and control cigarette smoking among youths, particularly within racial and ethnic subgroups with a high prevalence of cigarette smoking.

Do population trends in adolescent electronic cigarette use coincide with changes in prevalence of cigarette smoking?

Adolescent cigarette smoking remains a concern globally, including in Thailand. This research aimed to elucidate the prevalence and determinants of cigarette smoking among Thai adolescents. Study Design: A cross-sectional study. A cross-sectional analysis of data from the 2021 Thailand Global School-Based Health Survey with 5545 adolescents aged 13-17 with complete information was conducted on their cigarette smoking status. Bivariate analysis and multivariable logistic regression were performed to discern the determinants of tobacco smoking among adolescents. The overall weighted prevalence of cigarette smoking was 11.5% (95% confidence interval [CI]=9.7%, 13.5%), with adolescent males at 18.2% (95% CI=15.3%, 21.4%) and adolescent females at 5.6% (95% CI=4.2%, 7.4%). The multivariable logistic regression also revealed that males were more likely to be smokers (Adjusted Odd Ratio [AOR]=1.58; 95% CI=1.02, 2.45, P=0.040) compared to females. The presence of smokers in their vicinity significantly increased the odds of smoking (AOR=2.21, 95% CI=1.46, 3.36, P<0.001). Current alcohol use (AOR=3.37, 95% CI=2.21-5.14, P<0.001) and current marijuana use (AOR=4.53, 95% CI=2.06, 9.99, P<0.001) were both significant determinants of smoking. Notably, early initiation of cigarette use (before age 14) was associated with a lower likelihood of current smoking (AOR=0.54, 95% CI=0.33, 0.92, P=0.022). With an overall prevalence of smoking among adolescents at 11.5%, our study highlights a significant public health concern. The positive determinants of the identified tobacco smoking include being male, having smokers in their vicinity, and currently using alcohol, and marijuana, while early initiation of cigarette use before age 14 is identified as an inverse determinant.