Tobacco Use Factors Research Articles

Risk factors of carotid plaque and carotid common artery intima-media thickening in a high-stroke-risk population.

IntroductionTo analyze the risk factors of carotid plaque (CP) and carotid common artery intima‐media thickening (CCAIMT) and the association between the risk factors and CP numbers and the side of the CCAIMT in a high‐stroke‐risk population.MethodsCarotid ultrasonography was conducted in 2025 participants with high stroke risk. Participants were divided into different groups according to the results of the ultrasound. The risk factors and blood biochemical indices were recorded.ResultsThe presence of CP and CCAIMT were 38.9% and 24.8% respectively. Multivariate logistic regression indicated that the risk factors of CP were age, high LDL‐C and FBG levels, male gender, stroke, diabetes, hypertension, and tobacco use. Compared with participants without CPs, the participants who were male, and older in age, with risk factors of tobacco use, diabetes, high LDL‐C levels, and a family history of hypertension were likely to have a single CP, whereas the participants with risk factors of tobacco use, diabetes, hypertension, male gender, older age, high LDL‐C levels, stroke and AF or valvulopathy were prone to have multiple CPs. The risk factors of CCAIMT were male gender, stroke, hypertension, diabetes, AF or valvulopathy, tobacco use and age. Compared with the N‐CCAIMT subgroup, the risk factors of left CCAIMT were tobacco use, diabetes, male gender, and age. The risk factors of right CCAIMT were male gender, high FBG levels, age, AF or valvulopathy. The risk factors of dual CCAIMT were high frequency of drinking milk, tobacco use, male gender, age, stroke, and hypertension.ConclusionThese findings revealed the risk factors of CP and CCAIMT, and an association between the risk factors and the CP numbers and the side of the CCAIMT.

Prevalence and correlates of smoking and e-cigarette use among young men who have sex with men and transgender women

BackgroundAlthough the prevalence of cigarette smoking in the United States has decreased, rates remain elevated among sexual and gender minorities (SGMs). This study examined rates and correlates of tobacco use among young men who have sex with men (YMSM) and transgender women. MethodsParticipants (N=771) were drawn from the baseline assessment of an ongoing longitudinal cohort study of racially diverse MSM aged 16–29 years. Data collection took place in 2015–2016. Socio-demographic and SGM-specific (e.g., gender identity, sexual identity, physical attraction) correlates of cigarette smoking and electronic cigarette (e-cigarette) use were identified using logistic regression. ResultsTwenty-one percent were current cigarette smokers. Nearly 40% ever tried an e-cigarette, but regular e-cigarette use was low (3.8%). Smokers were more likely to be older (vs. aged 16–18), less educated, homeless, bisexual or identify as some other sexual minority (vs. gay), attracted to males and females equally or more attracted to females than males (vs. males only), and HIV-positive. E-cigarette users were more likely to be transgender women (vs. cisgender men), White (vs. Black), more educated, and mostly attracted to females. ConclusionsFindings highlight important risk factors for tobacco use among SGM youth. Correlates of smoking mirrored findings observed in the general population, but also included factors specific to SGM youth (e.g., sexual orientation, HIV status, homelessness). Although some variables (gender identity, attraction) demonstrated similar relationships with smoking and e-cigarette use, others (race/ethnicity, education) demonstrated opposite patterns. Findings underscore the urgent need for tobacco prevention and cessation interventions for SGM youth.

Tobacco use rate and associated factors in middle school students in China

Objective: To understand tobacco use rate and explore the factors associated with tobacco use in middle school students in China. Methods: A self-administered questionnaire survey was conducted among 155 117 eligible middle students selected through multi-stage stratified cluster sampling from 31 provinces of China. The questionnaire consists of the following topics: tobacco use and cessation, passive smoking, access to tobacco products, tobacco control and tobacco advertisement, and knowledge about and attitudes to tobacco. Software SAS 9.3 was used for sample weighting and data analysis. Results: Current tobacco use rate was 6.9% in middle school students in China. The rate was higher in boys (11.2%) than in girls (2.2%), and in rural area (7.8%) than in urban area (4.8%). Students in western area had the highest tobacco use rate (10.3%), followed by the students in middle area (6.4%), and the rate in students in eastern area was lowest (4.5%). Parent smoking (especially mother smoking), friend smoking, teacher smoking, pocket money for a week>20 yuan, tobacco advertisement or promotion, passive smoking, misconception of tobacco addiction, active attitude to smoking behavior were the risk factors for tobacco use. Conclusions: Smoking rate in boys in China was higher than the average global level. A comprehensive intervention strategy by Framework Convention on Tobacco Control should be used to reduce tobacco use in adolescents, including health education, increasing cigarette price, banning tobacco advertisement and promotion, and smoke-free legislation.

Using a Collaborative Approach to Tobacco Control Efforts in Marginalized Communities

ObjectiveTo examine community engagement as a means to strengthentobacco-related policies and programs use in marginalizedpopulations.IntroductionAlthough significant progress has been made in tobacco control inthe United States (US) over the past 50 years, more than 15% of thepopulation currently use tobacco products.1Tobacco use continuesto be the leading cause of preventable death, contributing to over480,000 deaths and about $300 billion in economic costs each year.To achieve theHealthy People 2020(HP2020) objective of 12%national adult smoking rate by 2020, it is important to focus ourtobacco control efforts on surveillance and addressing disparitiesin tobacco use prevalence and tobacco-induced diseases acrossdifferent subpopulations and geographic areas.2Utah reportedthe lowest prevalence rate (9.7% in 2014), while rates as high as28% were identified in central Appalachia. Modern epidemiologyis limited in its ability to explain patterns of tobacco use andtobacco-related interventions and policies in these highly prevalent,marginalized environments. Therefore, a combination of quantitativeand community-based participatory research (CBPR), as proposedin Public Health 3.0, will expand the scope and reach to addressall factors of tobacco use, including cross-sector collaboration andmulti-level actions.3This study aimed to comprehensively investigatecounties in the Northeast Tennessee region where tobacco useprevalence is disproportionately highest, and to identify regionaland culturally specific evidence-based practices for tobacco control.Additionally, the study examined how these practices can be scaledup to address similar high tobacco use and disadvantaged populationselsewhere in the US and worldwide.MethodsGrounded by the CBPR framework, a mixed-methods approachtriangulated multiple sources of data using a three-prong assemblageofProtection,Prevention, andCessation, to develop tobaccocontrol recommendations and goals as part of a Population HealthImprovement Plan for Tennessee. Information gained from healthcouncil discussions, focus groups, interviews, and stakeholdermeetings were combined with quantitative analyses of secondarydata from Tennessee Department of Health, school-based surveys,and qualitative analyses conducted for descriptive and inferentialstatistics. All discussions and interviews involving 222 individualsfrom 91 organizations were recorded and organized using NVivo10, thematically coded using grounded theory, and analyzed usingdescriptive statistics. The results utilized aggregated themes generatedfrom the data.ResultsTobacco use in the Northeast Tennessee region comprises cigarettesmoking and smokeless tobacco, with increasing uptake of electroniccigarettes across all age groups. Among others, culture of tobaccouse and cultivation was identified as the most salient factor fortobacco use. Reducing tobacco use requires a foundation built oninformatics, community engagement, and a model for sustainablefunding to support infrastructure and program interventions. Whilestate and national policies and programs have received less attentionin this region, several effective community-based policies andprograms to prevent tobacco use were identified, including incentiveprograms such as Baby and Me, voluntary smoke-free campuspolicies by businesses and colleges, 100% screening programs byhospitals, and nicotine-free employee population. Overall, a total of25 recommendations were identified, with 14 aimed at protection,four at prevention, and seven at cessation. These recommendationsculminated into five overarching goals:Protectthe population fromtobacco and secondhand smoke exposure through policy enforcementand implementation and counter-marketing;Preventinitiation oftobacco use with comprehensive youth-focused programs that increaseknowledge and awareness;Expandaccess to cessation resources andtreatment, especially in high risk populations;Fostercollaborationand partnership; andMonitordata for evaluation and validity.ConclusionsThis is one of the few comprehensive attempts to address the socialdynamics of tobacco use and identify population and geographicpolicies and programs in highly prevalent communities. Amongthe myriad issues identified, the expansion of surveillance data toinform tobacco policy and culturally-tailored tobacco policies andprograms are essential to reduce tobacco use in population subgroups.Combining CBPR with actionable data can spur innovations inlocal efforts, highlight social determinants of health, and contributeto evidence-based policy. While the results of this study primarilyprovide in-depth descriptions of central Appalachia’s tobacco-relatedrisks and their perceptions of and reactions to tobacco preventionintervention, the policies and programs identified through the processmay be more readily adopted and scaled-up to address the disparitiesin tobacco use and tobacco-induced diseases, particularly pertainingto low-income, disadvantaged, and hard-to-reach populations.

25P - Tobacco consumption pattern among auto rickshaw drivers in Chennai city, Tamil Nadu, India

Background: Tobacco use is a major preventable cause of premature death and diseases, currently leading to five million deaths worldwide which are expected to raise over eight million deaths worldwide by 2030. India is the second largest consumer of tobacco in the world. This study is contemplated with an aim to assess the prevalence of tobacco consumption and the associated factors involved in its consumption, as this group of the population is under constant pressure and account for the workforce of the country. So through this study we could be able to know the awareness of ill effect, reasons & amount of consumption. Methods: Across sectional descriptive study was conducted among Auto Rickshaw Drivers in Chennai City. Auto drivers who were working for more than two years and present on the day of examination and who were willing to participate in the study were included. Cluster random sampling technique was used. 400 samples were selected from 40 auto stands of various parts of Chennai City. Data was collected using a Survey Proforma which comprised of a Questionnaire which can assess the frequency of consumption, age of initiation, the amount of consumption, mental stress, economic factors, any past history of disease and most importantly the awareness towards oral cancer. Age, tobacco consumption pattern, reasons of consumption, amount of consumption, harmful effects of tobacco are the variables. Results: Prevalence among auto rickshaw drivers for consumption of tobacco products was very high (87%). Auto rickshaw drivers were mostly used tobacco in the form of Gutkha (72%) and bidi (40%) in comparison to other products. It also shows that they use cheap tobacco products. Most of the auto rickshaw drivers start using tobacco products in age less than 18 years (80%) and associated factors for tobacco use are due to friends and their influence (78%). Awareness level among auto rickshaw driver was high (70%) but still uses tobacco products because of its addiction (66%). In the opinion of auto rickshaw drivers increase in tax may reduce it consumption and the majority of drivers (70%) think that tobacco must be banned. Conclusions: Prevalence of tobacco use among auto rickshaw drivers was very high. They are in definite need of tobacco cessation activities. Legal entity responsible for the study: N/A Funding: N/A Disclosure: The author has declared no conflicts of interest.

Interactive effects of sleep duration and morning/evening preference on cardiovascular risk factors.

Sleep duration and morningness/eveningness (circadian preference) have separately been associated with cardiovascular risk factors (i.e. tobacco use, physical inactivity). Interactive effects are plausible, resulting from combinations of sleep homeostatic and circadian influences. These have not been examined in a population sample. Multivariable regression models were used to test the associations between combinations of sleep duration (short [≤6 h], adequate [7-8 h], long [≥9 h]) and morning/evening preference (morning, somewhat morning, somewhat evening, evening) with the cardiovascular risk factors of tobacco use, physical inactivity, high sedentary behaviour, obesity/overweight and eating fewer than 5 daily servings of fruit and vegetables, in a cross-sectional sample of 439 933 adults enrolled in the United Kingdom Biobank project. Participants were 56% female, 95% white and mean age was 56.5 (SD = 8.1) years. Compared with adequate sleep with morning preference (referent group), long sleep with evening preference had a relative odds of 3.23 for tobacco use, a 2.02-fold relative odds of not meeting physical activity recommendations, a 2.19-fold relative odds of high screen-based sedentary behaviour, a 1.47-fold relative odds of being obese/overweight and a 1.62-fold relative odds of <5 fruit and vegetable daily servings. Adequate sleep with either morning or somewhat morning preference was associated with a lower prevalence and odds for all cardiovascular risk behaviours except fruit and vegetable intake. Long sleepers with evening preference may be a sleep phenotype at high cardiovascular risk. Further work is needed to examine these relationships longitudinally and to assess the effects of chronotherapeutic interventions on cardiovascular risk behaviours.

Antenatal Tobacco Use and Secondhand Smoke Exposure in the Home in India.

Antenatal tobacco use and secondhand smoke (SHS) exposure can have grave health consequences. We estimated the prevalence of tobacco use and SHS exposure in the home among pregnant and reproductive age women in India, and identified sociodemographic risk factors. Data were from the National Family Health Survey-3 (2005-2006), a population-based cross-sectional survey. We measured current tobacco use and SHS exposure in the home, and used logistic regression analysis to identify sociodemographic risk factors. Nationally, antenatal tobacco use and SHS exposure in the home were reported by 9% and 25% of women, respectively. Tobacco use rates were slightly higher in reproductive age women (11%) than in pregnant women (9%). Common risk factors for tobacco use in pregnant and reproductive age women included older age, lower education, lower socioeconomic status, Scheduled Tribe status, Muslim religion, and rural residence. Being married lowered the risk of tobacco use among pregnant women, but increased the risk among reproductive age women. Antenatal SHS exposure decreased with older age and higher socioeconomic status. Antenatal tobacco use and SHS exposure in the home is a significant public health problem in India. Programs should target low socioeconomic status pregnant women, including single pregnant mothers. Antenatal tobacco use and SHS exposure in the home are significant public health problems in India. Intervention strategies should target younger women, single and socioeconomically disadvantaged pregnant women.

Determinants of Tobacco Use and Prevalence of Oral Precancerous Lesions in Cab Drivers in Bengaluru City, India.

Background:Tobacco is a most important risk factor for various types of cancer as well as some noncommunicable disease. Around 34.6% of Indian population consume tobacco. The tobacco consumption is higher in some vulnerable population such as drivers, daily wage laborers, and policemen. Tobacco consumption is known to cause oral cancers, and screening for oral cancer in these individuals is known to reduce mortality from cancer. The study was designed to assess the determinants of tobacco use and the prevalence of oral precancerous lesions in cab drivers.Methods:This is a cross-sectional study among cab drivers at prepaid taxi counters in Bengaluru city. A total of 450 cab drivers were enrolled in the study, of which 225 cab drivers were interviewed during morning hours and remaining half at night time using a semi-structured questionnaire. All were screened for oral cancer/precancerous lesions.Results:Nearly 70.88% of cab drivers were consuming tobacco in any form. Long working hours, working at night, and family members consuming tobacco were significant risk factors for tobacco use among cab drivers. Forty-eight drivers were detected to have oral precancerous lesions.Conclusions:It was very evident that long hours of driving and infrequent shifts played a greater role in acquiring the habit. Behavioral counseling and new laws need to be formed to limit the working hours in drivers to have an effective tobacco control.

Socioeconomic Disadvantage and Other Risk Factors for Using Higher-Nicotine/Tar-Yield (Regular Full-Flavor) Cigarettes.

Use of machine-estimated higher nicotine/tar yield (regular full-flavor) cigarettes is associated with increased risk of nicotine dependence. The present study examined risk factors for using full-flavor versus other cigarette types, including socioeconomic disadvantage and other risk factors for tobacco use or tobacco-related adverse health impacts. Associations between use of full-flavor cigarettes and risk of nicotine dependence were also examined. Data were obtained from nationally representative samples of adult cigarette smokers from the US National Survey on Drug Use and Health. Logistic regression and classification and regression tree modeling were used to examine associations between use of full-flavor cigarettes and educational attainment, poverty, race/ethnicity, age, sex, mental illness, alcohol abuse/dependence, and illicit drug abuse/dependence. Logistic regression was used to examine risk for nicotine dependence. Each of these risk factors except alcohol abuse/dependence independently predicted increased odds of using full-flavor cigarettes (p < .001), with lower educational attainment the strongest predictor, followed by poverty, male sex, younger age, minority race/ethnicity, mental illness, and drug abuse/dependence, respectively. Use of full-flavor cigarettes was associated with increased odds of nicotine dependence within each of these risk factor groupings (p < .01). Cart modeling identified how prevalence of full-flavor cigarette use can vary from a low of 25% to a high of 66% corresponding to differing combinations of these independent risk factors. Use of full-flavor cigarettes is overrepresented in socioeconomically disadvantaged and other vulnerable populations, and associated with increased risk of nicotine dependence. Greater regulation of this cigarette type may be warranted. Greater regulation of commercially available Regular Full-Flavor Cigarettes may be warranted. Use of this type of cigarette is overrepresented in socioeconomically disadvantaged and other vulnerable populations and associated with increased risk for nicotine dependence.

Tobacco and alcohol use among adolescents in South Africa: shared and unshared risks

Objective: Tobacco and alcohol use by adolescents are major public health concerns in South Africa. However, the extent to which key psychosocial risk factors for tobacco use and alcohol use by adolescents in South Africa are shared or unshared is unclear. This study sought to examine the shared and unshared risk factors for tobacco and alcohol use among adolescents in Johannesburg.Method: Participants comprised 736 males and females aged 12–17 years who were recruited via a household survey conducted during 2004. The participants were interviewed using a questionnaire comprising measures of personal, family (parental bonding and family legal drug use) and contextual (school and neighbourhood) factors. Separate multiple logistic regression analyses were conducted to predict lifetime alcohol use and lifetime tobacco use from variables within each domain (personal, family and contextual), controlling for demographic factors.Results: Personal, family (parental bonding) and contextual factors (school factors) were primarily shared risk factors for tobacco and alcohol use, while family legal drug use and neighbourhood factors were largely unshared.Conclusions: Interventions addressing personal, parenting and schooling factors are likely to have an impact on preventing both tobacco and alcohol use, whereas interventions focused on ameliorating family drug use and neighbourhood factors may need to be more substance-specific.

Management of Hypertension in Patients with Ischemic Heart Disease.

Ischemic heart disease (IHD) affects about 16 million adults in the USA. Many more individuals likely harbor subclinical coronary disease. Hypertension (HTN) continues to be a potent and widespread risk factor for IHD. Among other Framingham risk factors of tobacco use, diabetes mellitus, dyslipidemia, and left ventricular hypertrophy, HTN plays an independent role in augmenting IHD risk, as well as a multiplicative role with respect to adverse outcomes when HTN is present concurrently with the other major IHD risk factors listed above. Over the past two decades, numerous studies and guideline reports have been presented with the aims of (a) elucidating the pathophysiology of IHD, (b) delineating an ideal blood pressure (BP) threshold at which to institute pharmacotherapy, and (c) defining the optimal pharmacologic elements of a therapeutic regimen. While there are active debates surrounding the existence and relevance of the J curve in IHD patients who have HTN, as well as the numerical level of the BP cutoff justifying drug therapy in the general population, there is a general consensus that the BP target in IHD patients should be lower than 140/90 mmHg. The most appropriate class (or classes) of medication recommended will depend on the comorbid conditions associated with each individual patient. Overall, however, there is no major evidence underscoring a significant difference between drug classes, provided the target BP is achieved, although it should be pointed out that the most recent (2015) American Heart Association (AHA)/American College of Cardiology (ACC)/American Society of Hypertension (ASH) guideline statement now elevates beta-blockers (BB) to the same level of recommendation as other classes of hypertension drugs in the treatment of patients who have hypertension and ischemic heart disease. Although most agents that reduce blood pressure will correspondingly lower myocardial workload, BB may exhibit a special advantage in IHD patients because BB (as well as verapamil and diltiazem subclasses of calcium channel blockers or CCB) act to lower HR as well as cardiac inotropy. Moreover, BB will remain an integral if not indispensable part of the management of IHD, especially in those with history of angina pectoris or MI, based on decades of favorable clinical as well as trial experience. This extensive salutary historical background has served as a foundation for the 2015 committee's decision to bring BB into the front rank of BP agents for those hypertensive individuals suffering simultaneously from IHD.

Determinant factors of tobacco use among ever-married men in Bangladesh

BackgroundThe burden of tobacco use is shifting from developed to developing countries. This study aimed to explore the different types of tobacco use, and to identify the determinant factors associated with the tobacco use among ever-married men in Bangladesh.Data and methodsData of 3,771 ever-married men, 15–54 years of age were extracted from the Bangladesh Demographic and Health Survey 2007. Prevalence rate, chi-square (χ2) test, and binary logistic regression analysis were used as the statistical tools to analyze the data.ResultsTobacco use through smoking (58.68%) was found to be higher than that of chewing (21.63%) among men, which was significantly more prevalent among the poorest, less educated, and businessmen. In bivariate analysis, all the socioeconomic factors were found significantly associated with tobacco use; while in multivariate analysis, age, education, wealth index, and occupation were identified as the significant predictors.ConclusionTobacco use was found to be remarkably common among males in Bangladesh. The high prevalence of tobacco use suggests that there is an urgent need for developing intervention plans to address this major public health problem in Bangladesh.

Smoking among dental students at King Saud University: Consumption patterns and risk factors.

To assess smoking prevalence among dental students at King Saud University (KSU) and to determine possible risk factors of tobacco use. A self-addressed invitation letter was sent to all dental students (males and females) at KSU requesting participation in this study. Data on smoking habits, associated risk factors, and demographic factors, such as age, marital status, residency status, the student's year of study, and grade point average, were collected by an electronic self-administered questionnaire sent via email. Data were analyzed using SPSS. Significant differences between different groups were assessed with a Pearson Chi-Square test at α=0.05. Logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) and to determine the effect of different risk factors on students' smoking habits. Of the 600 registered dental students, 400 students responded (230 males, 170 females), representing a response rate of 67%. More male than female students were current smokers (27.6% vs. 2.4%, p<0.001). Most smokers used shisha tobacco only (N=35, 51.5%), followed by both shisha tobacco and cigarettes (N=17, 25%), or cigarettes only (N=16, 23.5%). Male students were about 4 times more likely to be smokers if all or most of their friends were smokers compared to students who had some friends who smoked (OR=3.9, 95% CI=1.9-7.7). A high proportion of current smokers (47.8%) reported stress as the main reason for smoking. Twenty-six percent of dental students (N=87) who are currently nonsmokers reported that they have used tobacco at some point in their lives. Over two thirds of sampled students (63%) believed that public tobacco usage is not well addressed in the current college curriculum. Approximately one in every four male dental students at KSU is a smoker. Having friends who are smokers was the most important risk factor associated with smoking. There is a general belief among dental students that public tobacco use is not well addressed in the dental college curriculum.

Prevalence and Risk Factors of Smoking, and Tobacco use among Secondary School Boy Students in Tabuk Region, Saudi Arabia

As tobacco epidemic continues to increase among adolescents, tobacco control programs based on actual field studies are crucially needed. A cross-sectional study was conducted in Tabuk region to determine the prevalence and risk factors of tobacco use among secondary school boy students. A three-stage stratified random sampling design was used to recruit a sample of 1,680 students from 15 secondary schools. A self-administrated Arabic questionnaire was used to collect the required data. A descriptive and analytic statistical analysis was done. Overall prevalence of cigarette and shisha smoking was 25.7% and 25.9%, respectively. Prevalence of current daily and non-daily smokers was 16.3% and 9.4%, respectively. Prevalence of shisha smokers was 4.3% and 21.6% on regular and non-regular basis, respectively. Odds ratios of important risk factors were: Nationality (1.42), fathers' smoking (1.42), mothers' smoking (2.74), school absenteeism (2.96), sleep disturbance (2.26), and mothers' living status (1.80). Important reasons for smoking were entertainment (43.2%), overcoming the feeling of oppression (36.1%) and peer pressure (11.0%). The majority of students (70.5%) addressed the desire for quitting smoking for health promotion (48.9%); Islamic rules (25.5%) and family dislike (19.9%) reasons. In conclusion, a quarter of the high school students were smokers which necessitate an urgent intervention.

Pattern of Tobacco Consumption and Influencing Factors among Male School Children in Riyadh, Saudi Arabia

This study aimed at studying tobacco consumption patterns among male school children in Riyadh. Methods: A cross-sectional survey was carried out on 5961 male school children, using a modified WHO-GYTS questionnaire. Results: Smoking data was available for 4693(83%) children, among whom 483(10.3%; 95% CI:9.4-11.2%) reported being “current smokers”. Logistic regression reflected independent risk factors for tobacco use to include: educational stage (OR=3.1-4.4 for high school), school type (OR=6.2 for governmental-general compared to private schools), smoking household member (father / mother / brother / friends) (OR=1.5–25.7). Recommendations: Raising awareness of children is important for saving them from taking up the habit and assisting smokers to quit. The school health team should be playing important dual roles: directly for children and indirectly through empowering their teachers in combating tobacco use campaigns. Male school children are mostly affected by their peers, fathers and brothers. Thus, parents and siblings should be role models for their children / siblings, respectively, by not smoking themselves.

High rates of child hypertension associated with obesity: a community survey in China, India and Mexico

Background: Hypertension is a significant risk factor for cardiovascular disease, and epidemiological evidence suggests that it is increasing in parallel with obesity in children and adolescents in low- and middle-income countries.Aim: To identify and determine the relationship between overweight, obesity and hypertension in a community sample of school children.Methods: Anthropometric data were collected from 12,730 school children aged 12–18 years in China, India and Mexico as part of the Community Interventions for Health programme, an international study evaluating community interventions to reduce non-communicable disease by addressing the three main risk factors of tobacco use, unhealthy diets and physical inactivity. Logistic regression was used to examine the association of body mass index and gender and hypertension.Results: Prevalence rates of hypertension were 5·2% in China, 10·1% in India and 14·1% in Mexico, and pre-hypertension rates in China, India and Mexico were 13·4%, 9·4% and 11·2%, respectively. Overweight and obesity prevalence rates varied by country and were 16·6% in China, 4·1% in India and 37·1% in Mexico. In all countries there was a significant association between overweight and obesity and rates of hypertension. Overweight children were 1·7–2·3 times more likely to be hypertensive and obese children 3·5–5·5 more likely to show hypertension than those of normal weight.Conclusions: Rates of hypertension and overweight and obesity are high in school children in China, India and Mexico, and increased bodyweight is a significant risk factor for hypertension.

Environmental Determinants of Smoking Behaviors: The Role of Policy and Environmental Interventions in Preventing Smoking Initiation and Supporting Cessation

Tobacco control strategies have contributed to substantial declines in smoking in the United States. However, smoking still remains the single largest preventable cause of disease and premature deaths in the country. Despite the continuing challenges of implementing tobacco control strategies and the pervasive influence of the tobacco industry to undermine such strategies, there are now unprecedented opportunities to prevent smoking initiation, facilitate cessation, and protect nonsmokers from secondhand smoke. In this paper, we briefly review the most recent literature discussing key strategies that have proven effective in tobacco control including regulations on sales and marketing of tobacco products, taxation, and smoke-free legislation. We focused on these three tobacco control strategies because of their potential to positively influence the environment of both minors and adults regardless of their smoking status. Although research has identified significant individual and social predictors of tobacco use, environmental influences are also important risk factors for tobacco use.

Realizing Effective Behavioral Management of Health: The Metamorphosis of Behavioral Science Methods

The past two centuries have shown radical improvements in health and longevity, with hygiene as the key contributor to this trend in the 19th century and antibiotics and vaccinations in the 20th century. With most infectious diseases largely at bay in the developed world, the greatest contributors to suboptimal health today are largely behavioral. For example, there are three behavioral risk factors-tobacco use, poor diet, and inactivity-that contribute to four chronic diseases: heart disease, type 2 diabetes, lung disease, and some cancers. Together, these behaviors account for more than 50% of preventable deaths (see the Web site 3four50.com). While medical advances will surely continue, it is likely that the next great advancements in health in the 21st century will occur via more effective behavior management.

Oral cavity tumors in younger patients show a poor prognosis and do not contain viral RNA

Oral cavity and in particular oral tongue cancers occur with a rising incidence in younger patients often lacking the typical risk factors of tobacco use, alcohol use, and human papilloma virus (HPV) infection. Their prognosis when treated with chemoradiation has not been well studied and responsible risk factors remain elusive. A viral etiology (other than HPV) has been hypothesized. First we analyzed outcomes from 748 head and neck cancer patients with locoregionally advanced stage tumors treated with curative-intent chemoradiation by anatomic site. Second, we analyzed seven oral tongue (OT) tumors from young, non-smokers/non-drinkers for the presence of viral mRNA using short-read massively-parallel sequencing (RNA-Seq) in combination with a newly-developed digital subtraction method followed by viral screening and discovery algorithms. For positive controls we used an HPV16-positive HNC cell line, a cervical cancer, and an EBV-LMP2A transgene lymphoma. Younger patients with oral cavity tumors had worse outcomes compared to non-oral cavity patients. Surprisingly none of the seven oral tongue cancers showed significant presence of viral transcripts. In positive controls the expected viral material was identified. Oral cavity tumors in younger patients have a poor prognosis and do not appear to be caused by a transcriptionally active oncovirus.

A Cross-Sectional Study on Tobacco Consumption Pattern among Auto Rickshaw Drivers in Jaipur City, Rajasthan

Introduction - Tobacco use is a major preventable cause of premature death and diseases, currently leading to five million deaths worldwide which are expected to raise over eight million deaths worldwide by 2030. Globally, this group of the population is under constant pressure and accounts for the workforce of the country so through this study we want to assess the prevalence of tobacco consumption and the associated factors involve in its consumption. Objective - The broad objective of study was To assess the prevalence of tobacco consumption pattern among the auto rickshaw drivers and to study associated factors involve in tobacco use as well as associated risk factors of tobacco use in Jaipur, Methodology - A cross sectional, descriptive study was done on auto rickshaw drivers of Jaipur city, Rajasthan. Study was done during April- May 2013 with a sample size of 94 with 95% of confidence level and 10% confidence interval. Results - Study finding shows that Prevalence among auto rickshaw drivers for consumption of tobacco products was very high (87%). Auto rickshaw drivers were mostly used tobacco in the form of Gutkha (72%) and bidi (40%) in comparison to other products. It also shows that they use cheap tobacco products. Most of the auto rickshaw drivers start using tobacco products in age less than 18 years (80%) and associated factors for tobacco use are due to friends and their influence (78%). Awareness level among auto rickshaw driver was high (70%) but still uses tobacco products because of its addiction (66%). In the opinion of auto rickshaw drivers increase in tax may reduce it consumption and the majority of drivers (70%) think that tobacco must be banned in Rajasthan. Conclusion - Prevalence among auto rickshaw drivers of consumption of tobacco products was very high. Auto rickshaw drivers were mostly used tobacco in the form of Gutkha (smokeless) and bidi (smoke) in comparison to other products.