Tobacco Hazards Research Articles

Impact of Smoking on Overall and Cancer-Specific Mortality in Prostate Cancer: Elevated Risks in Older and Early-Stage Patients—A Population-Based Study

Prostate cancer (PCa) ranks sixth in cancer mortality among Taiwanese men, with smoking rates remaining high despite the 2009 Tobacco Hazards Prevention Act. This study used the Taiwan Cancer Registry to evaluate smoking’s impact on PCa mortality, providing important information for healthcare strategies and patient management. From 2011 to 2017, 23,107 PCa patients were analyzed, with 7164 smokers and 15,943 non-smokers. The baseline characteristics, clinical stages, comorbidities, and treatment modalities were all included to estimate overall and cancer-specific mortality using the Cox regression model and Kaplan–Meier analysis. The stratified analysis of clinical stage and age group was also estimated. Our study found an association between smoking and increased overall and cancer-specific mortality in PCa patients. Although smokers over 60 had higher risks of overall mortality than non-smokers, cancer-specific mortality did not show significant differences in any age group. Smokers had higher overall mortality than non-smokers across all clinical stages, but cancer-specific mortality was significantly raised only in early-stage cases. In conclusion, smoking is associated with higher overall mortality in PCa patients, with a significant increase in cancer-specific mortality in early-stage cases. Therefore, active smoking management is critical for clinical urologists, particularly in the treatment of early-stage patients.

Health literacy and tobacco cessation among hypertensive individuals: A mixed method study

BACKGROUND: Hypertension and tobacco addiction are two major public health challenges in India that frequently coexist. About 30% of Indian adults have hypertension, while over one-fourth use some form of tobacco. So, the present study aimed to determine the prevalence and patterns of tobacco consumption and identify associated socio-demographic factors among hypertensive patients in urban India and also further explored patient perspectives regarding tobacco use through qualitative interviews. MATERIALS AND METHODS: This mixed-method study was conducted among 305 hypertensive adults recruited from an urban tertiary hospital using interviewer-administered questionnaires. Additionally, 15 tobacco-consuming patients were purposively sampled for in-depth interviews regarding perceptions and behaviors related to tobacco. Descriptive statistics and multi-variable logistic regression models were applied for quantitative analysis and thematic analysis for qualitative data. RESULTS: The prevalence of ever tobacco use among hypertensive patients was 21%. Smokeless tobacco was the predominant form used. Male gender, urban locality, illiteracy, and lack of knowledge about tobacco hazards had a higher likelihood of tobacco consumption. Qualitative interviews provided complementary insights into triggers like peer influences and stress, barriers to quitting including withdrawal effects and system gaps, and participant perspectives on facilitating cessation. CONCLUSION: Tobacco consumption among hypertensives is higher than national averages. Tailored educational, motivational, and policy-level interventions addressing gaps in knowledge, risk perceptions, addiction behaviors, and cessation support systems can enable the promotion of tobacco abstinence and hypertension control in this vulnerable sub-group. The multi-method data provide actionable inputs for planning targeted control and prevention strategies addressing this dual burden.

Tobacco control knowledge and beliefs among healthcare workers in respiratory departments in Fujian Province, China: A cross-sectional study.

Smoking prevalence is high in China, and healthcare workers are important for tobacco control. This study aimed to determine the smoking status, cognition of tobacco hazards, and smoking cessation-related knowledge among respiratory healthcare workers, and to explore their ability to provide smoking cessation assistance. A cross-sectional study was conducted in 2021 among 1028 respiratory healthcare workers from 89 hospitals in Fujian Province, China. A self-designed electronic questionnaire was used to collect data on smoking status, knowledge of smoking hazards, and smoking cessation knowledge. Descriptive statistics were calculated for all questions. Logistic regression analysis was used to explore the relationship between awareness of the tobacco control goals of Healthy China 2030 and demographic characteristics. Among the healthcare workers surveyed, 3.4% were smokers, all of whom were male. Most respondents (99.4%) were aware of smoking as a cause of lung cancer, but awareness of smoking as a cause of non-respiratory cancer was lower. The awareness rate of smoking cessation support was high (>90%), but only 40.0% of participants were aware of the Healthy China 2030 tobacco control targets. Male (HR=2.16; 95% CI: 1.69-2.80) and participation in the cessation clinic (HR=1.47; 95% CI: 1.10-1.96) were associated with higher awareness of the targets. Respiratory healthcare workers in Fujian Province demonstrated a high level of awareness regarding behavioral and pharmacotherapy support for smoking cessation. In order to enable healthcare workers to play a more active role in tobacco control, there is a need to increase public awareness of smoking cessation services in Fujian Province.

Perception of tobacco hazards on general and periodontal health and tobacco cessation counseling among dental students.

Tobacco use is one of the leading worldwide health risk factors and a primary cause of premature death and disability. Tobacco cessation programs might work well if provided by all healthcare providers. This study aimed to evaluate dental students' knowledge, attitudes, beliefs, and practices towards tobacco hazards on general and periodontal health and tobacco cessation councling. A descriptive cross-sectional study was conducted among dental students who were in their clinical years (the fourth, fifth and sixth year of study), in Saudia Arabia in 2022. A self-administered questionnaire derived from the TCC questionnaire survey was carried out among 315 dental students. Knowledge was considered poor if correct answers were below the median value. Attitude was on a five-point Likert scale. Adjusted logistic regression analyses were performed. The study revealed that about 52% have poor knowledge, 64% have negative attitudes, 69% have negative beliefs, and 44% poor practice. All these ratings were below median values. It also showed that younger dental students were 2 times more likely to have poor knowledge (AOR=1.97; 95% CI: 1.1-3.53) and smokers were less likely to have poor knowledge (AOR=0.34; 95% CI: 0.12-0.95). One third of students perceived patient resistance as a barrier to TCC while 50% reported lack of knowledge, 32% lack of time, and 24% lack of materials. The study findings urge the inclusion of programs to encourage dental students to help patients quit tobacco use and to make educational material available to them.

Comparing the effectiveness of different health education approaches for preventing tobacco use among school-going students in a government school of Dadra and Nagar Haveli district.

Four out of five people who use tobacco begin before they reach adulthood. Schools provide the opportunity to address the young population before they initiate tobacco use. Different health education approaches have their unique merits and demerits. The present study aims to assess the use of various approaches for effective communication with students regarding tobacco hazards. It was a health education intervention study done at a Government School in Dadra and Nagar Haveli district. The students of class IX and class XI of Government School were educated about the harmful effects of tobacco and government regulations against tobacco use using various methods of health education; chalk and talk, panel discussion, roleplay, pamphlet distribution, etc., The Student "t" test was used to compare scores obtained by students before and after the intervention. The Chi-square test was used to test associations between variables. Bonferroni post hoc test was used to test for significant differences between various methods of health education imparted to students. A total of 367 students participated in the study, with females comprising 53% of the sample. The mean age of the students was 15.7 years (±1.05). The study found the magnitude of a statistically significant increase in mean score percentages for knowledge through various health education methods: chalk and talk (37.0%, P < 0.0001), pamphlet (26.65%, P < 0.0001), roleplay (20.83%, P = 0.0003), panel discussion (14.7%, P = 0.0009), poster (12.6%, P = 0.0025), symposium (8.4%, P = 0.0221), and leaflet (-4.0%, P = 0.0382). Furthermore, the Bonferroni post hoc test demonstrated that the chalk-and-talk method was more effective in enhancing knowledge, while the leaflet method was more influential in shaping attitudes. The chalk-and-talk method is the most effective health education method for awareness of tobacco hazards among class IX and XI students. While planning for health education dissemination, the approach should be chosen wisely considering the content to be delivered.

Mortalidade e carga do câncer de laringe atribuíveis aos riscos ocupacionais no Brasil: estudo da Carga Global de Doença, 2019

Abstract Objective: to describe mortality and disability-adjusted life years (DALYs) due to laryngeal cancer attributable to occupational and behavioral risk factors in Brazil. Methods: this is an ecological study with data from the 2019 Global Burden of Disease. Mortality and DALY rates for laryngeal cancer attributable to occupational (sulfuric acid and asbestos) and behavioral (tobacco and alcohol) risks were obtained from 1990 and 2019. Results: in 2019, the mortality rate from laryngeal cancer attributable to occupational hazards (sulfuric acid and asbestos) totaled 0.28 (95%UI: 0.17; 0.43) and 0.03 (95%UI: 0.02; 0.04), whereas and DALY rates, 7.33 (95%UI: 4.28; 11.44) and 0.64 (95%UI: 0.35; 0.03) in men and women in Brazil, respectively. Sulfuric acid configured the main occupational risk for the disease. The rates attributable to tobacco (mortality: −45.83%; DALYs: −47.36%) and occupational hazards (mortality: −23.20%; DALYs: −26.31%) decreased in Brazil but increased in some Northern and Northeastern states. Conclusion: laryngeal cancer mortality and burden attributable to occupational factors decreased in the period (although less than that for smoking), reinforcing the importance of actions to reduce the impact of occupational risks, such as the regulatory measures applied to tobacco.

A Study to Assess the Effectiveness of Structured Teaching Program on Oral Health Hazards of Tobacco among Adolescent of Selected School of Greater Noida

A Study to Assess the Effectiveness of Structured Teaching Program on Oral Health Hazards of Tobacco among Adolescent of Selected School of Greater Noida

Abstract B124: An assessment of awareness on oral cancer among smokeless tobacco users in the rural skirts of Tamil Nadu, India

Abstract Background In India, the number of newly diagnosed tobacco related cancers has been estimated at approximately 250 000 out of a total of 700 000–900 000 new cancers diagnosed each year. Smokeless tobacco (ST) is tobacco consumed orally, not smoked. It has been in use for as long as other forms of tobacco consumption and its use have increased. The deleterious effects of smokeless tobacco use are perhaps not as well-known as those produced by smoking. Smokeless tobacco use has been recognized as a cause of cancer. In developing countries, tobacco is mostly chewed with other ingredients. The aim of this study is to assess the awareness of health hazards of tobacco among smokeless tobacco users in Kancheepuram District, Tamil Nadu, India. METHODOLOGY The inhabitants of the villages in Kancheepuram district were recruited after ethical clearance from the institutional ethical board, permission from the Village panchayat leader and informed consent from the participants to conduct the study. Inhabitants of the villages aged 18 to 75 years and present on the day data collection and who were willing to participate in the study were included.Random sampling method was used and data was collected from a cross-sectional survey, using a pretested Questionnaire, which included Demographic data, tobacco habits, its frequency and form.Anti-tobacco counselling was given on the spot and followed.The data collected was analysed using SPSS version21. RESULT: The study population consisted of total 800 individuals, male 400 and females 400. From the results it is observed that more than 70% were unaware of the harmful effects of using tobacco products. Majority of the females use smokeless tobacco and smoking tobacco was common among males. Most common cause of tobacco use was pleasure 32.5% and inducing factor were friends 43.7%. High prevalence of potentially malignant lesion were found among this population. Effectiveness of anti-tobacco counselling is greater among the females compared to males. CONCLUSION: The dangers from smoking and chewing tobacco are well documented within the literature but the public’s lack of knowledge of the risks is a concern. Health professionals are encouraged to disseminate information on the subject as widely as possible and improve existing screening programmes to ensure that the public is made aware of these risks, especially those within high-risk groups. Citation Format: Delfin Lovelina Francis, Saravanan SP. An assessment of awareness on oral cancer among smokeless tobacco users in the rural skirts of Tamil Nadu, India [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B124.

The public health risks of e-cigarettes: a systematic review

With the relevant anti-smoking policy introduced by the state, people realized the significance of smoking cessation. Therefore, E-cigarettes were regarded as a replacement of cigarettes. The analysis, which is about prevalence trends, the reason about taking systematical review, and the value of systematical review, explains this reviews stand. In this paper, the 9 articles from PubMed was collected and organized for classification.The dangers of human health is caused by the special component of e-cigarettes. Generally speaking, some countries legislate measures related to tobacco control have not fully met the requirements of the WHO Framework Convention on Tobacco Control and played a role in protecting people from tobacco hazards, displaying in the lack of smoke-free legislation in public places at the national level, relatively low tobacco consumption taxes, no comprehensive ban on tobacco sponsorship. The control of e-cigarettes as tobacco products in many countries may not achieve the purpose of strict regulation. The authority believed to add punishment to people who sell novel flavor e-cigarettes should let them take legal responsibility. Furthermore, schools should increase publicity and education about public and individual health, to promote peoples health awareness and stop them from using e-cigarettes at a relatively young age.The objective of this review is to spot literature and describe the effects of e-cigarettes on public human health. Through researching and comparing articles, this article discusses the reason of smoking, the lack in policies in public health, and the solutions what people should take.

Effects of smoke-free government policy in Qingdao, China: Evidence from the path analysis.

Smoke-free government(SFG), as a key tobacco control measure, has been added in Healthy China 2030 blueprint and Qingdao started the establishment of the demonstrative SFG in 2020.This study examined the effects of SFG policy on smoking and smoke-free(SF) environment after establishing the demonstrative SFG. This cross-sectional survey selected participants by simple random sampling from party and government agencies in Qingdao (N = 3625) and the participants filled in questionnaires online from November 31 to December 15, 2020. We utilized AMOS to set up models to analyze the direct and indirect effects of SFG policy. The findings showed that knowledge of SFG policy was positively associated with SF environment(β = 0.29, P<0.001) and negatively associated with smoking(β = -0.14,P<0.001). Knowledge of SFG policy had indirect effects on SF environment through four channels: independent mediation of discouraging smoking and attitude towards SFG policy, as well as chain mediation of these two factors, and perception of tobacco hazards and discouraging smoking, with indirect effects accounting for 33.5% of the total effect. Knowledge of SFG policy had indirect effects on smoking reduction via SF environment and two chain mediation: SF environment and attitude towards SFG policy, perception of tobacco hazards and intention to quit smoking, with indirect effects accounting for 50.2% of the total effect. The results provided the evidence that SFG policy not only had positive effects on creating SF environment but also on reducing smoking. The efficient policy infiltration to individuals played a vital role in the establishment of SFG. Attitude towards SFG policy, discouraging smoking and SF environment were the potential mediators for SFG policy. Findings in this study added more evidence related to effect mechanism of SFG policy and had a positive influence on promoting the implementation SFG policies for China and other countries.

Novel hazards of waterpipe tobacco and the benefits of stop smoking in men, a prospective cohort study

Waterpipe smoking is an emerging epidemic and a severe public health problem worldwide. Observational studies on the hazards of a specific new waterpipe tobacco product are timely needed. The objectives were to analyze how dangerous waterpipe tobacco smoking is on the causes of all mortality, including cancer, and how effective smoking cessation is for improving health. We analyzed the hazards of exclusive waterpipe smoking through a prospective cohort study in Northern Vietnam. We obtained exposure data on the smoking status of specific cigarette and waterpipe and smoking cessation histories from each study participant. The outcome includes deaths due to all causes. The cause of death for each case is determined based on medical records. HR (95%CI) was estimated using a Cox proportional-hazards–regression analysis for overall mortality and all cancers. The ever-cigarette smoking group as the reference group, the exclusive waterpipe smoking group had a statistical increase in the risk for overall mortality HR (95% CI): 1.63 (1.32, 2.00), and all cancers HR (95%CI): 1.67 (1.18, 2.38). The risk of death increased statistically in the group of waterpipe smoking over 20 years for overall mortality HR (95%CI): 1.82 (1.45, 2.29), and all cancers HR (95%CI): 1.91 (1.27, 2.88). After stopping smoking, the risk of death decreased steadily. The risk of death was reduced by 41% for overall mortality HR (95%CI): 0.59 (0.39, 0.89), and 74% for death from cancers HR (95%CI): 0.26 (0.08, 0.83) after ten years or longer of cessation. Life expectancy was shortened by more than six years for the group of exclusive waterpipe smokers compared to non-smokers. This study found new novel hazards of exclusive waterpipe tobacco smoking. The findings are scientific evidence for developing strategies, policies, and budget allocations to control this novel tobacco product and promote cessation to improve life expectancy.

Incidence trends and spatial distributions of lung adenocarcinoma and squamous cell carcinoma in Taiwan

Lung cancer is the second most common cancer in Taiwan. After Taiwan implemented the Tobacco Hazards Prevention Act in 1997, smoking rates declined. However, the incidence rates of lung cancer for both sexes are still increasing, possibly due to risk factors other than smoking. We used age–period–cohort analysis to examine the secular trends of lung cancer incidence rates by histological type in Taiwan. A stabilized kriging method was employed to map these lung cancer incidence rates. Lung adenocarcinoma incidence rates increased, but lung squamous cell carcinoma incidence rates decreased, for both the sexes in recent birth cohorts, particularly in women. In Taiwan, the hotspots of lung adenocarcinoma incidence rates were in the northern, northeastern, and western coastal areas; the incidence rates increased rapidly in the western and southern coastal regions and southern mountainous regions. The high incidence rates of lung squamous cell carcinoma in men were in the southwestern and northeastern coastal areas. The incidence rates rapidly increased in the central and southern coastal and mountainous regions. For both sexes in Taiwan, lung squamous cell carcinoma incidence rates declined from 1997 to 2017, but lung adenocarcinoma increased. The increased incidence rates of lung adenocarcinoma may be related to indoor and outdoor air pollution. Some areas in Taiwan have increasing lung cancer incidence rates, including the northwestern and southern coasts and mountains, and warrant particular attention.

Practical experiences from the Changhua County Community Mental Health Center

&lt;p&gt;本文為彰化縣社區心理衛生中心的實務經驗介紹：一、服務佈點：配合社會安全網全力推動轄區內服務佈點，以八大生活圈規劃1中心8副中心27據點；二、個案管理為共同照護整合服務，以家庭為中心，發掘「潛在個案」並給予協助及資源連結。三、簡介中心6項特色服務：1.高齡者整合式健康檢查（4D健檢）、2.物質濫用防治&amp;mdash;菸害防制教育、3.物質濫用防治&amp;mdash;第三、四級毒品危害講習、4.精神病友照顧者成長團體、5.長照2.0家庭照顧者支持網絡計畫、6.安寧居家療護；四、人員訓練機制。期能讓各界更了解地方社區心理衛生中心提供的服務與資源，照顧需要的病友，進而減緩家庭照顧者之壓力。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;This article introduces the practical experiences of the Changhua County Community Mental Health Center. Part I. Service deployment. Changhua County Government has aligned itself with the effort to establish a social safety net and has established service locations across 8 regions of the county, with services available at 1 center, 8 subcenters, and 27 other locations. Part II. Case management. It involves shared care and integrated services that are family-centered. We identify potential cases of mental illnesses, provide them with assistance, and connect them with resources. Part III. Brief introduction to the 6 featured services of the center. (1) Integrated geriatric health check (a.k.a. the 4D health check). (2) Substance abuse prevention: tobacco hazard prevention education. 3. Substance abuse prevention: Lectures on the hazards of Category 3 and Category 4 narcotics. 4. Growth group for caregivers of patients with mental illnesses. 5. Long-term Care 2.0 Plan&amp;rsquo;s family caregiver support network program. 6. Hospice home care. Part IV. Personnel training. We hope to offer further understanding to the services and resources provided by local community mental health centers, to care for patients, and to ameliorate the stress of family caregivers. &lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Awareness of hazards due to tobacco among people aged 15 years and older in Chongqing, China, in 2020: A cross-sectional analysis.

Tobacco smoke contains a large number of harmful substances and carcinogens. Smoking and secondhand smoke cause a variety of cancers and diseases, seriously endangering human health. However, the status and characteristics of the awareness of hazards due to tobacco among people aged ≥15 years in Chongqing, China, are still unknown. A multistage stratified cluster random sampling method was used to select ten districts and counties in Chongqing Municipality, China and a total of 6622 people were investigated between August and October 2020. The chi-squared test was used to analyze the awareness of hazards due to tobacco in various populations after the data had been cleaned and weighted. In 2020, the awareness rates of people aged ≥15 years in Chongqing, China, about a specific disease caused by smoking were lung cancer (77.1%), heart disease (45.1%), stroke (40.1%), and penile erectile dysfunction (24.2%). However, only 22.1% of the respondents knew that smoking could simultaneously lead to all four diseases mentioned above. Adult lung cancer was the disease with the highest awareness rating (72.5%), followed by children's lung disease (54.2%) and adult heart disease (46.1%). A total of 42.0% of respondents knew that secondhand smoke could cause the three diseases simultaneously. Only 22.0% of those correctly understood the harm of low-tar cigarettes. The logistic regression results showed that education level and occupation were risk factors for lack of awareness of hazards due to tobacco. In contrast, media campaigns on tobacco control were a protective factor. The awareness of hazards due to tobacco among people aged ≥15 years in Chongqing, China, still needs to be improved. More graphic health warning labels and mass media campaigns about the hazards of tobacco should be carried out to raise people's awareness and warn about the health risks of smoking.

Study on the willingness to quit smoking and its influencing factors among current smokers in rural areas in China

Objective: To study the willingness of current smokers to quit smoking in rural areas and related factors to provide a reference for tobacco control. Methods: The data were collected from the China Chronic Disease and Risk Factor Surveillance in 2018. A multi-stage stratified cluster sampling was used to select 184 509 residents (≥18 years old); among the residents, 10 241 current smokers in rural areas were included in the study. χ2/F test was used to analyze the factors such as willingness to quit smoking and demographic information, tobacco use, cognition of tobacco-related hazard knowledge, the prevalence of chronic diseases, and other factors. Unconditional multifactor logistic regression analysis was used in multivariate analysis. Results: A total of 3 453 (37.46%) considered quitting smoking in the next 12 months. Logistic regression analysis showed that occasional smokers were more willing to quit smoking than daily smokers (OR=0.693, 95%CI: 0.494-0.971), and those who smoked less than 1 pack per day were more willing to quit than those who smoked 1 pack or more per day (OR=0.628,95%CI: 0.511-0.771), those who had quit smoking within 12 months were more willing to quit than those who had not quit within 12 months (OR=0.438, 95%CI: 0.357-0.537), and those with high awareness of tobacco hazards were more willing to quit smoking (OR=1.056, 95%CI: 1.028-1.086). The differences were statistically significant (P<0.05). Conclusions: The willingness of current smokers in rural areas to quit smoking is related to the smoking situation, smoking intensity, previous smoking cession experience, and knowledge of the specific health effects of smoking. It suggests that health education should be strengthened through more efficient health communication methods in rural areas and provide brief smoking cessation interventions to improve rural smokers' willingness to quit smoking.

The Knowledge and Attitude about New Generation Tobacco Products among Physicians.

Health hazards of e-cigarettes including "e-cigarette or vaping product use-associated lung injury" are better understood today. Just as e-cigarettes, heated tobacco products release toxic emissions. We aimed to determine the knowledge and attitude about new generation tobacco products among physicians who were the members of an organization for health care professionals, the majority of whom are pulmonologists. In this cross-sectional study, a self-administered online questionnaire-based survey was conducted among the physicians from April to October 2019. The survey included questions about demographics (gender, age, graduation date from medical institution, and academic title), their smoking status, their knowledge and attitudes toward new generation tobacco products, and additionally about whether new generation tobacco products can be used to aid in smoking cessation. Among the 506 members who responded to the survey, 56.7 % were female; the mean age was 42.4 ± 10.9 years (20-74). About 74.5% were pulmonologists, 5.5% were thoracic surgeons, and 20% were other physicians. Among the responders, the frequency of those who have not heard of new generation tobacco products before was determined as 9.5%, 24.5%, and 41.3%. At least 58.9% of participants lacked the knowledge necessary to discuss these products with their patients and the rate reached 76.7% for the heated tobacco product. To the question of whether new generation tobacco products can be used in smoking cessation, 68.4% responded "I never agree that they can be used." Non-current smokers (P = .003), elders (P = .001), those who had training on smoking cessation assistance (P = .001), and those who had experience in smoking cessation assistance (P = .009) were significantly more prevalent in the group who answered: "I never agree that they can be used." Physicians must become considerably more knowledgeable about the new generation tobacco products and hazards. Otherwise, these new tobacco products may pose new threats to national and global tobacco control efforts.

A Long-Term National Survey of Compliance with the Ban on Selling Tobacco Products to Adolescents of Taiwan's Tobacco Hazards Prevention Act.

The data on long-term trends and factors of tobacco retailers’ compliance in Taiwan are limited. The new regulations of the Tobacco Hazards Prevention Act were established in 2009. Now, the government is planning to raise the minimum legal age (MLA) for purchasing tobacco products from 18 to 20, so the results of this study will be an important reference to promote new regulations in the future. We carried out an observational mystery shopping study design and data were collected from 2009 to 2019. In total, 6320 undercover tests were conducted to investigate selling by tobacco retailers to persons aged less than 18 years by an impartial third party annually. Logistic regression was used to analyze the factors influencing compliance by adjusting test variables and independent variables. The compliance rate increased by 8.4% annually and was better among tests conducted during summer vacation (AOR = 1.324), chain convenience stores (AOR = 3.651), supermarkets or hypermarkets (AOR = 1.973), and verifications with age (AOR = 15.345). It is the first study to explore long-term and national tobacco retailers’ enforcement effects by an impartial third party in Asia. The findings suggest that local health agencies should enhance enforcement on those stores which were tested during non-summer holidays and weekends, betel nut stands, and grocery stores.

Factors associated with secondhand smoke exposure among non-smoking employees in the workplace: A cross-sectional study in Qingdao, China.

ObjectiveThis study was conducted to describe secondhand smoke (SHS) exposure among non-smoking employees in the workplace, and identify factors related to SHS exposure in Qingdao.MethodsThe study participants covered key non-smoking places stipulated in the “Qingdao City Smoking Control Regulations,” which included three categories: restaurants, bars, and office buildings. Airborne nicotine concentration in the workplace and saliva cotinine concentration of employees were measured. The questionnaire included employees’ demographic factors, smoke-free measures in the workplace, employers’ tobacco hazard knowledge, and attitudes towards smoke-free policy.ResultsA total of 222 non-smoking employees and 46 non-smoking employers were included in the study. The median concentrations of airborne nicotine and salivary cotinine were 0.389 μg/m3 and 0.575 ng/mL, respectively. Educational status, average number of workplace smokers per day, exposure time to SHS in the workplace, and whether smoking and non-smoking areas were divided significantly related to airborne nicotine concentration. Age, educational status, exposure time to SHS in the workplace, tobacco control training and publicity, and whether the employers support the “Qingdao Tobacco Control Regulation” were significantly related to salivary cotinine concentration.ConclusionsDespite the implementation of the “Qingdao Smoking Control Regulations” in 2013, the workplace remains an important location for SHS exposure. Interventions such as raising workers’ awareness of the risks associated with SHS exposure through health education and developing smoking prevention and cessation programs to reduce SHS exposure in the workplace are urgently needed.

Socioeconomic inequalities in tobacco cessation among Indians above 15 years of age from 2009 to 2017: evidence from the Global Adult Tobacco Survey (GATS)

BackgroundTobacco is strongly associated with socioeconomic status (SES), however evidence on differences in tobacco cessation by socio-economic attributes remains fragmented, especially in developing countries. The present study aims to estimate socioeconomic inequalities in tobacco cessation among Indian men and women above 15 years of age.MethodsTwo rounds of the Global Adult Tobacco Survey (2009–2010 and 2016–2017), India was used to estimate the association between socioeconomic indicators (wealth index and educational attainment) with tobacco cessation using a multinomial modeling approach.ResultsAfter adjusting for SES and demographic variables, we found significantly lower odds in tobacco cessation rates among respondents of GATS-2 (2016–2017) compared to GATS-1 (2009–2010). Additionally, huge regional variations in smoking and smokeless tobacco cessation rates were observed. Population belonging to the low wealth-asset score had higher odds of cessation compared to the high asset index. While greater educational attainment was seen to have a positive effect on cessation, the results were insignificant. Individuals belonging to the northeastern geographic region were seen to have the lowest odds of cessation. Though awareness about the health hazards of tobacco increased, cessation declined for both men and women. Quitting smokeless tobacco among men and women was observed to be lower than smoking.ConclusionThis study is the first to provide national-level evidence on the association between tobacco cessation and socioeconomic attributes among Indians above 15 years of age. Findings suggest the need to scale up tobacco cessation services separately for men and women, and also for smoking and smokeless tobacco forms.

The 1964 US Surgeon General's report on smoking and health.

The 1964 report of the US Surgeon General on smoking and health made an authoritative case that tobacco smoking was a cause of premature deaths from lung cancer and chronic bronchitis. It justified the practice of drawing causal inferences from epidemiological studies, specified influential criteria for doing so, and made use of an early form of meta-analysis.