Cigarette Consumption Research Articles

A population level study on smoking and radon induced adenocarcinoma and small-cell carcinoma among males and females in Canada

ObjectiveTo assess if there is a relationship between residential radon exposure and two lung cancer histological types, small-cell carcinoma (diagnosed in people with a smoking history) and adenocarcinoma (the most commonly diagnosed histologic type in people who have never smoked) among males and females in Canada. MethodsWith survey data of long-term radon measurements in residential homes, long-term averaged tobacco consumption rates in the units of cigarettes per day per person and long-term averaged age-standardized lung cancer incidence rates at provincial level, simple linear fitting (ANOVA linear regression) was applied in this study to determine the effect on lung cancer induction by smoking and exposure to indoor radon, and to assess if there is a relationship between residential radon exposure and lung cancer histological types. ResultsLung cancer incidence rates correlate very well with the tobacco consumption rates (P ​< ​0.05). However, females appear to be more likely than males to develop lung cancer at a given amount of cigarette consumption. For both small-cell carcinoma and adenocarcinoma, a statistically significant correlation between incidence rate and mean radon concentration was observed for females, the correlation was much stronger for adenocarcinoma (P ​= ​0.0057) than small-cell carcinoma (P ​= ​0.0483). However, there was no such correlation for males. ConclusionIt is possible that female non-smokers are more susceptible to radon-induced lung cancer, and the joint effect of radon exposure and tobacco smoking may be worse in female smokers compared to males, such that higher incidence rate of adenocarcinoma among females compared to males were observed in recent decades, even though females never smoked more than males.

Patterns and determinants of tobacco purchase behaviors among male cigarette smokers in Vietnam: A latent class analysis.

Understanding smokers' purchasing patterns can aid in customizing tobacco control initiatives aimed at reducing the tobacco smoking prevalence. Therefore, this study identified cigarette purchase behavior among Vietnamese male smokers and associated demographic and consumption factors. We analyzed a secondary dataset of male current tobacco smokers (n=3983) who participated in the Vietnam Global Adult Tobacco Survey in 2015. We applied the latent class analysis (LCA) to identify the classes of purchase behavior among cigarette smokers (n=1241). Multinomial logistic regression was performed to identify demographics (education level, ethnicity, partnership status, and household socioeconomic status) and cigarette consumption variables (smoking years and heavy smoking status) related to purchase behavior classes. The results are reported as an adjusted relative risk ratio (ARRR). The LCA identified four cigarette purchase behaviors classes: Class 1 (price-insensitive and purchased international brand: 44.4%), Class 2 (price-sensitive and purchased domestic brand: 27.6%), Class 3 (price-sensitive and purchased cigarettes in a street vendor: 18.6%), and Class 4: price-sensitive and purchased loose/carton cigarette: 9.4%). The poorer economic groups were more likely to belong to the three price-sensitive classes. Heavy smokers and those who had smoked for a longer period were more likely to belong to Class 3 (ARRR=2.33; 95% CI: 1.51-3.58 and ARRR=1.02; 95% CI: 1.001-1.05, respectively) and Class 4 (ARRR=2.94; 95% CI: 1.71-5.06 and ARRR=1.05; 95% CI: 1.02-1.08, respectively). Varied purchasing behaviors among male cigarette smokers, influenced by divergent price sensitivities and economic backgrounds, underscore the need for comprehensive tobacco control. Future efforts should include targeted policy interventions, behavior modification, and reshaping social norms.

Reduced nicotine in cigarettes in a marketplace with alternative nicotine systems: randomized clinical trial

Reducing cigarette addictiveness has the potential to avert millions of yearly tobacco-related deaths worldwide. Substantially reducing nicotine in cigarettes decreases cigarette consumption, but no large clinical trial has determined the effects of reduced-nicotine cigarettes when other nicotine-containing products are available. The aim of this study was to examine the effects of reduced-nicotine cigarettes in the context of the availability of alternative nicotine delivery systems. In a U.S. six-site, open-label, parallel-arm study, smokers were randomized for twelve weeks to an experimental marketplace containing cigarettes with either 0.4mg or 15.8mg nicotine per gram of tobacco; all had access to non-combusted alternative nicotine delivery systems (e.g., e-cigarettes; medicinal nicotine). Group differences in the primary outcomes (cigarettes per day, number of smoke-free days) were examined using linear and negative binomial regression, respectively (Trial Registration: NCT03272685). Among 438 randomized participants (mean [standard deviation (SD), range] age, 44.5 [11.9, 20-73] years, 225 [51.4%] women, 282 [64.4%] White and 339 [77.4%] trial completers), those in the 0.4mg vs. 15.8mg nicotine cigarette condition experienced significantly lower cigarettes per day at the end of intervention (mean [SD], 7.05 [7.88] vs. 12.95 [9.07], adjusted mean difference,-6.21 [95% CI,-7.66 to-4.75], P<0.0001) and greater smoke-free days during intervention (mean [SD], 18.59 [27.97] vs. 5.06 [13.77], adjusted rate ratio, 4.25 [95% CI, 2.58-6.98], P<0.0001). A reduced-nicotine cigarette standard in the context of access to other non-combusted nicotine products has the potential to benefit public health. U.S. NIH/FDA U54DA03165.

Estimating own-price and cross-price elasticity of cigarette consumption by price tiers in Bangladesh

ObjectivesThe overall price elasticity of cigarette consumption in Bangladesh has been studied extensively. The estimates of price elasticity by price tiers are not available in the existing literature.MethodsUsing cohort data...

Affordability of cigarettes in ten Southeastern European countries between 2008 and 2019

BackgroundThe empirical evidence shows that tobacco consumption is strongly associated with its affordability. The nominal growth in tobacco prices imposed by taxation should exceed or at least keep pace with...

Effects of the illicit market on the price elasticity of cigarette consumption in Brazil

BackgroundAn important element to consider in tobacco tax policy is the illicit market of cigarette sales. The objective of this paper is to provide estimates of both conditional and unconditional...

Price elasticity of cigarette smoking in Bangladesh: evidence from the Global Adult Tobacco Surveys (GATS)

IntroductionThe overall prevalence of cigarette smoking has not changed significantly for over a decade in Bangladesh. Raising the price of cigarettes through taxation is an important policy instrument for reducing...

Moral injury among women military veterans and demand for cigarettes: A behavioral economic investigation using a hypothetical purchase task

ObjectivesUnlike the United States general population, veteran women – as opposed to veteran men – have greater smoking prevalence; yet, little is known regarding factors that influence smoking in veteran women. The purpose of this study was to begin examining the relationship between a psychological concept known as moral injury and demand for cigarettes among veteran women. MethodsVeteran women who smoke (n = 44) were recruited for this cross-sectional study from Amazon MTurk, Reddit, and a veteran-serving non-profit organization in June–July 2023. Consenting participants received $2 for completing the cigarette purchase task (CPT), Fagerstrom Test for Nicotine Dependence (FTND), and the military version of the Moral Injury Symptom Scale (MISS-M-SF). We examined five CPT demand indices and calculated a modified exponential demand model stratified by moral injury severity status (i.e., probable vs. unlikely). ResultsProbable morally injured women exhibited significantly higher relative reinforcing value (RRV) for smoking than unlikely morally injured women (F1, 920 = 9.16, p = 0.003). Average cigarette consumption at $0 (i.e., Q0) was 48.56% higher (M = 22.24 vs. M = 13.55) in probable compared to unlikely morally injured women (p = 0.04, Hedge's g = 0.74). FTND scores were significantly correlated with Pmax (i.e., demand elasticity point) and Omax (i.e., maximum expenditure) values in both populations (rs = 0.42–0.68, ps < 0.05). ConclusionsWe provide preliminary evidence of the relatively high RRV of smoking in morally injured veteran women. Continued research is needed to refine the characterization of this relationship.

The cigarette market in Brazil: new evidence on illicit practices from the 2019 National Health Survey

ObjectiveTo explore new evidence on illicit practices, such as selling legal brands below the minimum legal price (MLP), and smugglers selling illicit brands at or above the MLP.MethodsFor the first...

Dual Exposure to E-Cigarette Vapour and Cigarette Smoke Results in Poorer Airway Cell, Monocyte, and Macrophage Function Than Single Exposure.

E-cigarette users predominantly also continue to smoke cigarettes. These Dual Users either consume e-cigarettes in locations where smoking is not allowed, but vaping is, or to reduce their consumption of cigarettes, believing it will lead to harm reduction. Whilst it is known that e-cigarette vapour is chemically less complex than cigarette smoke, it has a distinct chemical profile, and very little is known about the health impacts of exposure to both chemical profiles vs. either alone. We simultaneously exposed cells in vitro to non-toxic levels of e-cigarette vapour extract (EVE) and cigarette smoke extract (CSE) to determine their effects on 16HBE14o- airway epithelial cell metabolism and inflammatory response, as well as immune cell (THP-1 cells and monocyte-derived macrophages (MDM) from healthy volunteers) migration, phagocytosis, and inflammatory response. We observed increased toxicity, reduced metabolism (a marker of proliferation) in airway epithelial cells, and reduced monocyte migration, macrophage phagocytosis, and altered chemokine production after exposure to either CSE or EVE. These cellular responses were greater after dual exposure to CSE and EVE. The airway epithelial cells from smokers showed reduced metabolism after EVE (the Switcher model) and dual CSE and EVE exposure. When EVE and CSE were allowed to interact, the chemicals were found to be altered, and new chemicals were also found compared to the CSE and EVE profiles. Dual exposure to e-cigarette vapour and cigarette smoke led to worse functional outcomes in cells compared to either single exposure alone, adding to limited data that dual use may be more dangerous than smoking only.

FAKTOR YANG MEMPENGARUHI PENGGUNAAN ROKOK ELEKTRIK PADA KALANGAN PEROKOK DEWASA DI INDONESIA

Indonesia is experiencing a tobacco epidemic, with smokers known to be the largest consumers of cigarettes. The increasing use of e-cigarettes among adults raises important public health concerns. E-cigarettes are as harmful as any other tobacco product. Awareness of this trend has sparked discussion about the reasons behind e-cigarette use among adult smokers. This study aimed to determine the factors influencing e-cigarette use among adults. This study used secondary data from the Global Adult Tobacco Survey (GATS) Indonesia 2021. The target population included all men and women aged 15 years or older. The data analysis used was logistic regression. The results showed that the variables that significantly influenced the use of e-cigarettes included nicotine addiction (p-value = 0.000), use in places where smoking is prohibited (p-value = 0.016), perception of e-cigarettes is not more dangerous than cigarettes (p-value = 0.002), e-cigarettes are cheaper than tobacco cigarettes (p-value = 0.000).

Assessment of muscle dysfunction in COPD patients: A case-control study

Introduction: peripheral muscle dysfunction satellite of chronic obstructive pulmonary disease (COPD) has emerged in recent years as a major factor which limits patients' ability to exercise. Methods: This study is a case-control investigation of the associations between COPD and muscle dysfunction. Cases and control subjects were recruited to evaluate their body composition using bioelectrical impedance (BIA). Quadriceps strength and endurance tests were performed. Dyspnoea was estimated by the mMRC scale. The patients were redirected from the department of pulmonary diseases of Batna, Algeria. The healthy subjects were volunteers without any lung, heart or systemic diseases or handicap in physical effort. Results: 175 patients with stable COPD (9 female and 166 male) aged between 40–86 years, mean FEV1 52 ± 21% and 175 age-and-sex-matched healthy subjects (FEV1: 91± 9%) were included in this study. The cigarette consumption was 35 (20) pack/years in COPD patients vs 15 (15) pack/years in healthy subjects. The classification of airflow limitation showed that 19.43% of patients were classified GOLD I, 30.29% (GOLD II), 33.71% (GOLD III), and 16.57% (GOLD IV). 22. 85% of COPD patients were classified in (category A) ,17.14% (category B) ,16.57% (category C) and 43.42% (category D). fat-free mass index (FFMI) was 19.3 (1.6) kg/m2 in COPD patients vs 18 (4.7) kg/m2 in controls. Quadriceps strength was 109.27 (42.8) Nm in COPD patients vs 141.6 (15) Nm in healthy subjects. The quadriceps endurance was 3.75 (1.14) min in patients vs 16.6 (15) min in controls. Conclusion: This study supports the idea that skeletal muscle mass, quadriceps strength and endurance, were adversely affected in patients with COPD.

Heated tobacco product use frequency, smoking quit attempts, and smoking reduction among Mexican adult smokers.

Heated tobacco products (HTPs) are promoted as less harmful than cigarettes; nonetheless, whether HTPs help smokers quit is uncertain. Data from 4067 Mexican adult smokers surveyed longitudinally every four months (November 2019-March 2021) were analyzed. Mixed-effects multinomial models regressed HTP use frequency (no use=reference; monthly; weekly; and daily use) on sociodemographics and tobacco/nicotine-related variables. Among participants who completed at least two surveys (n=2900) over four months, the duration of their longest smoking quit attempt (SQA) between surveys (SQAs: <30 days; ≥30 days; no SQA=reference) was regressed on HTP use frequency, and changes in the number of cigarettes smoked per day were regressed on HTP initiation between surveys, adjusting for covariates. Consistent predictors of all HTP use frequencies (monthly, weekly, or daily vs no use) were daily smoking >5 cigarettes (ARRR=1.69 [95% CI: 1.12-2.55], 1.88 [95% CI: 1.26-2.81] and 6.46 [95% CI: 3.33-12.52], respectively); e-cigarette use (ARRR =5.68 [95% CI: 3.38-9.53], 6.54 [95% CI: 4.06-10.55] and 2.59 [95% CI: 1.26-5.30]); lower HTP risk perceptions (ARRR=2.12 [95% CI: 1.50-30.00], 2.25 [95% CI: 1.63-3.10] and 2.00 [95% CI: 1.25-3.22]); exposure to HTP information inside (ARRR=2.13 [95% CI: 1.44-3.15], 2.13 [95% CI: 1.49-3.05] and 3.72 [95% CI: 2.28-6.09]) and outside stores (ARRR=2.36 [95% CI: 1.56-3.57], 2.32 [95% CI: 1.65-3.25] and 2.44 [95% CI: 1.41-4.24]) where tobacco is sold; having family (ARRR=2.46 [95% CI: 1.54-3.91], 2.90 [95% CI: 1.93-4.37] and 2.96 [95% CI: 1.52-5.77]) and friends (ARRR=5.78 [95% CI: 3.60-9.30], 4.98 [95% CI: 3.22-7.72] and 6.61 [95% CI: 2.91-15.01]) who use HTPs. HTP use frequency was not associated with quit attempts, except for monthly HTP use predicting SQAs lasting ≥30 days (ARRR=2.12 [95% CI: 1.17-3.85]). Initiation of HTP use was not associated with changes in smoking frequency. Limiting analysis to those who intend to quit smoking also yielded null results. Among Mexican adult smokers, frequency of HTP use was mostly not associated with either cessation behaviors or changes in cigarette consumption, suggesting that HTPs have limited to no effectiveness for smoking cessation.

Impact of New York City Cigarette Floor Price Policy on Reducing Smoking Disparities.

In 2017, New York City (NYC) passed a minimum floor price law (MFPL) to raise the minimum price of a pack of cigarettes to $13.00. Evaluation of the MFPL in NYC is limited and has yet to examine its potential as a proequity policy. Data (n = 20 241; prepolicy n = 15 037, postpolicy n = 5204) were obtained from the New York State Adult Tobacco Survey, a quarterly repeated cross-sectional survey. Using the Difference-in-Differences approach, we compared changes in reported cigarette prices, cigarette consumption, and smoking status among NYC residents before and after policy implementation to changes in the same outcomes among residents in the rest of the state (ROS) over the same period. For some smokers, cigarette price increased in NYC for the postpolicy period; moreover, prices increased more in NYC than in ROS. NYC smokers who reported higher income, more education, or White or "Other" race, reported a bigger price increase than their ROS counterparts. Cigarette consumption decreased more in the postpolicy period for people in the ROS, in general and among certain groups. Everyday smoking status decreased similarly in both NYC and ROS, whereas someday smoking status decreased primarily in the ROS during the analysis period. Cigarette prices in NYC increased after the 2017 MFPL; these increases were greater than those occurring elsewhere in the state, suggesting the policy might be a factor in the change. However, the increases were concentrated among relatively higher-priced purchases, and groups with lower smoking prevalence. Changes in smoking status and cigarette consumption did not correspond to study hypotheses. This study provides an empirical analysis of a real-world policy in tobacco control. It examines the potential of the MFPL in NYC as a proequity policy. Findings extend the current MFPL literature and suggest that they may be able to raise cigarette prices for some purchases, but also may have a limited impact on smoking behaviors.

Susceptibility to Electronic Cigarette and Consumption Patterns in Adolescents.

The use of electronic cigarettes (ECs) is a major problem globally. Susceptibility and curiosity are important factors that develop prior to the onset of substance use, such as ECs, and are therefore considered as predictors. Both factors are used to obtain an extended index of susceptibility (ESIe-c), which allows the identification of adolescents who are at risk of starting to use these devices. The aim of this study was to determine the prevalence of EC consumption and to assess the association of possible predictors with susceptibility to use and experimentation with ECs among adolescents. A cross-sectional study was carried out in 377 adolescents (53.0% female). Participants were compared according to their experimentation with ECs. A total of 45.9% had already used electronic cigarettes, and 20.8% were current users. Among those who had not tried electronic cigarettes, 43.3% had a medium-high susceptibility to EC initiation. Consumption among close friends, receiving offers of consumption and alcohol consumption were associated with initiation. There was an inverse association between a medium susceptibility index electronic cigarette score and the consumption of cigarettes and positive affect; on the other hand, the lack of premeditation was associated with a higher susceptibility index score. Intrapersonal factors and social factors seem to influence the ESIe-c and onset of EC use, respectively. The main conclusion in this study is that susceptibility is influenced by intrapersonal factors such as affectivity and impulsivity through the lack of premeditation, and by social factors such as EC consumption by best friends.

Edukasi Bahaya Rokok Pada Anak Usia Dini di SD Lempeh Sumbawa Besar

Smokers in Indonesia are ranked third in the world. More than 60 million Indonesians smoke. Cigarette consumption in 2008 reached 240 billion cigarettes or 658 million cigarettes per heart. This means money worth around Rp. 330 billion are "burned" by smokers in a day (TCSC-IAKMI, 2012). In Indonesia, 36.2% of boys and 4.3% of girls (i.e. 20.3% of all students) are users of smoked and/or smokeless tobacco. The initial age of smoking initiation for 43.2% was 12-13 years. Of smokers, 81.8% stated that they had tried to quit smoking in the last 12 months. Of the 88.2% of smokers who want to quit, only 24% have received help from a smoking cessation program or professional (WHO-SEARO, 2014). This community service activity was carried out on Saturday, April 18 2024 from 08.30 to 11.00 WITA. The service process is carried out using a collective counseling mechanism using education and socialization methods with lectures and joint discussions. This service also involved 10 fourth semester students. The conclusion of this community service is that by providing education to children about the harmful effects of tobacco, it can increase caregivers' knowledge and it is hoped that caregivers can prevent children from being exposed to cigarette smoke. Other service providers are advised to develop training topics and training models to increase public awareness, especially about smoking prevention.

Causal associations between platelet count, alcohol consumption, and the risk of liver hepatocellular carcinoma based on a Mendelian randomization study.

Liver hepatocellular carcinoma (LIHC) exhibits a multifactorial etiology, insidious onset, and a significantly low 5-year survival rate. We aimed to evaluate the causal impact of exposure factors (Alzheimer's disease, platelet count, ambidextrousness, cigarettes smoked per day, alcohol consumption, and endocarditis) on the risk of LIHC using a two-sample Mendelian randomization (MR) study. Independent single nucleotide polymorphisms (SNPs) strongly associated with Alzheimer's disease, platelet count, ambidextrousness, daily cigarette consumption, alcohol intake, and endocarditis were selected as instrumental variables (IVs) from the corresponding genome-wide association studies (GWAS). Genetic summary statistics for LIHC came from a GWAS that included 168 cases and 372,016 controls of European individuals. Multivariable MR analyses were performed to find the causal association between 6 exposure factors and LIHC risk. The inverse-variance weighted (IVW)-MR was employed as the primary analysis, and the MR-Egger regression, LASSO regression, and weighted Median approaches were performed as complementary analyses. Multivariable MR analysis showed causal association between Alzheimer's disease [Odds ratio (OR) = 0.9999, 95% confidence intervals (CI) = 0.9998-0.9999, p = 0.0010], platelet count (OR = 0.9997, 95% CI = 0.9995-0.9999, p = 0.0066), alcohol consumption (OR = 0.9994, 95% CI = 0.9990-0.9999, p = 0.0098) and the LIHC outcome. After IVW-MR, MR-Egger and LASSO tests, the results are still significant. Next, we used different MR Methods to analyze platelet count, alcohol consumption, and Alzheimer's disease separately. Moreover, both funnel plots and MR-Egger intercepts provided compelling evidence to refute the presence of directional pleiotropy in the association between platelet count, alcohol consumption, Alzheimer's disease and the risk of LIHC. The IVW-MR analysis revealed a significant causal association between an elevated platelet count and a reduced risk of LIHC (OR = 0.9996, 95% CI= 0.9995-0.9998, p = 0.0005). Similarly, the analysis of weighted median revealed a negative correlation between platelet count and the risk of LIHC (OR = 0.9995, 95% CI = 0.9993-0.9999; p = 0.0160). Conversely, we observed a positive causal effect of alcohol consumption on the incidence of LIHC (OR = 1.0004, 95% CI = 0.9999-1.0009). However, no significant causal relationship was found between alcohol assumption, Alzheimer's disease, and LIHC susceptibility. A significant causal relationship exists between platelet count, alcohol consumption, Alzheimer's disease, and an increased risk of LIHC. The study presents compelling evidence for a genetically predicted decreased susceptibility to LIHC based on platelet count. The research implies that elevated platelet count may serve as a protective mechanism against LIHC. These findings may inform clinical strategies for LIHC prevention.

The role of interoceptive awareness in shaping the relationship between desire thinking and cigarette consumption

Interoception, the ability to sense and interpret bodily sensations, has recently emerged as a crucial factor in substance use disorders, including smoking. However, the role of interoceptive awareness in tobacco use remains poorly understood. The relationship between interoceptive ability and addictive behavior is complex, and attempting to conceptualize it as a linear association is unlikely to fully capture the complexity of the mechanisms underlying cravings and urges. We hypothesized that the role played by interoceptive awareness in tobacco use is deeply linked to desire thinking, that is, the conscious and voluntary cognitive process orienting to prefigure images, information, and memories about positive target-related experiences. Desire thinking is typically observed in addiction, where it may contribute to interpreting specific bodily sensations, such as the perceived need for a cigarette. From this perspective, the physiological impact and inclination toward desire thinking contribute to a higher daily cigarette consumption, particularly in situations of low interoceptive awareness. To test this hypothesis, we assessed the physiological activation, the tendency toward desire thinking about smoking, cigarette consumption, and the interoceptive abilities of smoking volunteers. Through a moderation analysis, we showed that desire thinking about smoking predicts a higher number of cigarettes per day in individuals with lower interoceptive awareness (p < .05). These findings suggest that the relationship between desire thinking and interoceptive awareness is a fundamental component of tobacco use, highlighting the importance of taking into account the bodily feedback deriving from the cognitive representation of smoking in addiction research and therapy.

Smoking cessation decreases arterial blood pressure in hypertensive smokers: A subgroup analysis of the randomized controlled trial GENTSMOKING.

High blood pressure in hypertensive smokers is affected by nicotine consumption. This study aimed to evaluate the effect of smoking cessation treatments on blood pressure in hypertensive smokers. A total of 113 hypertensive smokers on antihypertensives during smoking cessation treatment in the randomized controlled trial GENTSMOKING were considered for analysis. At Baseline (T0) and Week 12 (T12), systolic and diastolic blood pressure (SBP and DBP), and heart rate (HR) were measured using a semi-automated digital oscillometric device. Mean arterial pressure (MAP) and delta differences for SBP, DBP, HR, and MAP were calculated. Smoking cessation was confirmed by measuring carbon monoxide (CO) in exhaled air. After 12 weeks of treatment, 72 participants ceased smoking (cessation group) and 41 did not (no cessation group). At T0, there was no statistically meaningful difference between groups with respect to age, body mass index, CO, and daily cigarette consumption. At T12, daily cigarette consumption and CO had decreased in both groups (p<0.001). The cessation group showed decreased SBP (131 ± 2 vs 125 ± 2 mmHg, p=0.004), DBP (79 ± 1 vs 77 ± 1 mmHg, p=0.031), MAP (96 ± 1 vs 93 ± 1 mmHg, p=0.005), and HR (79 ± 1 vs 74 ± 1 beats/min, p=0.001), and increased body weight (77.4 ± 2.1 vs 79.2 ± 2.2 kg, p<0.001). No significant differences were seen for these variables in the no cessation group. Decrease in blood pressure was significantly higher among hypertensive participants with SBP ≥130 mmHg: SBP (145 ± 2 vs 132 ± 2 mmHg, p<0.001), DBP (85 ± 2 vs 80 ± 1 mmHg, p=0.002), MAP (105 ± 1 vs 97 ± 1 mmHg, p<0.001), and HR (81 ± 2 vs 74 ± 2 beats/min, p=0.002). A positive correlation was found between HR and CO (r=0.34; p=0.001). Smoking cessation treatment reduced blood pressure in hypertensive smokers, allowing them to reach therapeutic targets for hypertension management. Smoking cessation has a positive impact on hypertension treatment; therefore, it should be encouraged in clinical practice. NCT03362099.

A Cross-Country Study of Cigarette Affordability and Single-Stick Purchases Using Survey Data From African Countries.

Reducing cigarette affordability is paramount for reducing cigarette consumption. Measuring affordability requires data on cigarette prices. Unlike the commonly used retail price of a 20-pack of the most-sold cigarette domestically, survey-derived cigarette prices reflect differences arising from the brand variety and the types of packaging in which cigarettes are purchased. This paper uses self-reported cigarette price data from the eight African countries that have implemented the Global Adult Tobacco Survey (GATS) to construct country-level Relative Income Prices. The relationship between cigarette affordability, cigarette smoking prevalence, and cigarette smoking intensity, is examined using logit models for smoking participation (N = 51122) and generalized linear models for conditional cigarette demand (N = 2443). GATS data are also used to produce nationally representative estimates of the prevalence of single-stick cigarette purchases in the sampled countries. The estimated affordability elasticity of cigarette smoking participation is -0.245 (95% CI = -0.411 to -0.078). The estimated affordability elasticity of smoking intensity is -0.155 (95% CI = -0.286 to -0.023). Single-stick cigarette sales dominate all-markets. The proportion of smokers who reported buying cigarettes in the form of single sticks during their most recent cigarette purchase exceeds 90% in Kenya, Tanzania, and Uganda. The results point to the need for governments in the countries sampled to increase excise taxes in a manner that renders cigarettes less affordable over time, and to enact and enforce legislation that prohibits the sale of single cigarettes. These findings highlight that measures to reduce both the demand and supply of cigarettes will be required to reduce their use in the region. This study is the first to examine the prevalence of single-stick cigarette purchases, and the association between cigarette affordability and smoking outcomes, in the African setting, using data from the GATS. Findings provide local evidence for the countries sampled, which represent over half of sub-Saharan Africa's adult population (aged 15 and older), on the importance of implementing excise tax increases that reduce cigarette affordability over time. They also highlight the need to enact and enforce legislation that prohibits the sale of single cigarettes.