High Tobacco Research Articles

Exploring small retailers’ perspectives on selling tobacco after the tripling of Tasmania’s tobacco licence fee

BackgroundLicensing of tobacco retailers, including high retail licence fees, is one tobacco control measure that may reduce tobacco retail availability. Between 2015 and 2018, the tobacco licence fee in Tasmania,...

The fight against illegal tobacco products

This paper addresses the pressing issue of combating illicit tobacco products, emphasising the legal frameworks at both the national and European levels. It explores the roles and activities of various authorities dedicated to preventing illegal tobacco trade, including the European Anti-Fraud Office (OLAF) and the Criminal Office of the Financial Administration of the Slovak Republic. The study delves into the legislative landscape governing tobacco products, assessing its effectiveness in adapting to the evolving tactics of smuggling networks. In particular, the paper scrutinises how Slovak and European regulations align to counteract the sophisticated and increasingly complex strategies employed in illegal tobacco trafficking. Statistical data highlights the prevalence of contraband tobacco in Slovakia, illustrating the financial, health, and societal ramifications of the black market. The findings also point to a correlation between high tobacco prices and an increased likelihood of exposure to illicit products. Furthermore, the research supports hypotheses regarding the adaptability of Slovak legislation to contemporary tobacco consumption trends and the critical role of inter-European collaboration in enforcement efforts. However, it also identifies potential areas for legislative improvement, particularly in streamlining tobacco regulation. This study contributes valuable insights into the challenges and successes of the Slovak Republic’s ongoing fight against the illegal tobacco trade.

Tobacco Treatment Disparities among California Medicaid Members with and without Chronic Disease who Smoke

Introduction: People who are covered by Medicaid have a higher smoking prevalence than the general population and are at increased risk for tobacco-related disease, a major driver of Medicaid costs. California has the largest Medicaid program, called Medi-Cal, whose members also have higher tobacco use rates and tobacco-related disease. Quitting is beneficial at any age and health professional advice and assistance is a key indicator of smoking cessation. As Medi-Cal transforms to improve population health and health equity, this study aimed to understand both prevention and treatment of tobacco-related disease by comparing health professional advice and assistance among all Medi-Cal members with and without chronic disease who smoke. Materials and Methods: Using data from the California Health Interview Survey (2014, 2016-2018), we examined 3,517 Medi-Cal current smokers (age ≥18) who consulted a health professional and reported about having a chronic disease. The outcomes were receipt of health professional advice or assistance to quit smoking. Adjusted logistic regression models were conducted to examine the association between chronic disease and the outcomes, including adjusting for frequency of office visits. Results: Among 1,227,154 Medi-Cal members who smoke, over half (51.9%) of whom had at least one chronic disease, approximately half received cessation advice, and less than one-third received smoking cessation assistance. Smokers with chronic disease, compared to those without chronic disease, were more likely to receive health professional advice (63.9% vs. 33.7%, P < .001) and assistance (37.7% vs. 20.5%, P < .001). In adjusted models, smokers with chronic disease, compared to those without chronic disease, were almost twice as likely to receive advice (OR=1.97, 95% CI: 1.39, 2.78) and 1.5 times as likely to receive assistance (OR=1.50, 95% CI: 0.94, 2.38), but the latter was not statistically significant. Conclusions: Medi-Cal members who smoke have tobacco treatment disparities by whether they are with or without chronic disease, even after adjusting for the number of office visits. Medi-Cal population health strategies for tobacco cessation treatment will need to improve prevention, not just treatment, of tobacco-related disease to reduce the long-term burden on the health care system and associated costs.

The projected global burden of modifiable risk factors on cardiovascular disease from 2025 to 2100

Abstract Background Cardiovascular diseases (CVDs) are the primary cause of global mortality and morbidity. Controlling modifiable risk factors driving the CVD epidemic is a vital focus of primary prevention efforts worldwide. Understanding the epidemiological trends in these risk factors is therefore essential in designing effective countermeasures against CVDs for the years to come. Purpose This study aims to forecast the disability-adjusted life years (DALYs) associated with CVDs attributable to high systolic blood pressure (SBP), high body-mass index (BMI), high fasting plasma glucose (FPG), high low-density lipoprotein (LDL) and tobacco use from 2025 to 2100, stratified by GBD super-regions, sex, sociodemographic index (SDI), and age-groups. Methods Historical data on DALYs from 1990 to 2019 from the Global Burden of Disease (GBD) study was used to project DALYs associated with modifiable risk factors of CVDs from 2025 to 2100. Trends across GBD super-regions, sex, SDI, and age-groups were also examined. Results Between 2025 and 2100, age-standardised DALY rates (ASDR) per 100,000 population are forecasted to fall across all modifiable risk factors, with the greatest decline seen in tobacco use (-76.0%) and high LDL (-66.9%). Globally, high SBP and high BMI expect the greatest ASDR in 2100 (both 891 per 100,000 population), while tobacco use expects the least (213 per 100,000 population). High BMI is expected to rise 623.0% in South Asia and 221.5% in South-east Asia, East Asia and Oceania from 2025 to 2100, while high FPG is expected to rise 114.2% in North Africa and the Middle-east and 110.6% in South Asia. Females are expected to have lower overall and greater reductions in ASDR across all modifiable risk factors when compared to males from 2025 to 2100. Notably, males expect a 11.0% rise in high BMI worldwide across this period. The age-prevalence of modifiable risk factors is expected to be bimodal in 2100, highest in those aged 50-59 as well as 75-84 years old, possibly suggesting improvements in global screening efforts or the earlier development of metabolic dysfunction. All modifiable risk factors are predicted to fall in high and high-middle SDI regions from 2025 to 2100. In contrast, low, low-middle, and middle SDI regions expect a rise in high FPG and high BMI across this same time frame. The burden of modifiable CVD risk factors is expected to be highest in low-middle SDI regions in 2100, as compared to high-middle SDI regions in 2025. Conclusion While the global decline in ASDR of modifiable risk factors suggests overall improvements in the primary prevention of CVDs, regional spikes in high BMI and FPG calls for the implementation of timely, targeted interventions accounting for local trends in CVD. Moreover, the disproportionate metabolic burden expected in lower SDI regions in the coming decades requires concerted, international support to alleviate the global burden of CVDs.

Level of tobacco dependence and beliefs towards heated tobacco products

Abstract Nicotine dependence affects not only behaviors related directly to smoking, quit attempts or looking for alternative products but also beliefs about smoking. We sought to assess whether the level of tobacco dependence is associated with beliefs and feelings towards heated tobacco products (HTP) and to assess the relationship between tobacco dependence and the motivators to quit HTP use. Random population sample of Polish citizens aged 18+ years, former smokers, current HTP users was recruited. Tobacco dependence was assessed using 5 question; participants were classified into two groups of tobacco dependence (low or high) using a two-stage cluster analysis. An extensive questionnaire on beliefs on HTP use was administered. The χ2 test and logistic regression were used. There were 2,500 participants (62.6% women) of median age=36 years (Q1=29, Q3=45). The median number of years of smoking was 10 (Q1=5, Q3=15) and median number of years of HTP use was 2 (Q1=1, Q3=3). High tobacco dependence was found in 958 (38,3%) participants. Compared to low dependence, high tobacco dependence was related with feeling of strong need for HTP use (69.7% vs. 47.6%, p &amp;lt; 0,001). High level of tobacco dependence was positively related to perceived social pressure against smoking (72.9% vs. 44.9%, p &amp;lt; 0,001), but it did not differentiate perceived social pressure against HTP use. Compared to low tobacco dependence, participants with high tobacco dependence more often indicated fear of illness OR = 1,73 95%CI=1,46-2,07, own resolution OR = 1,32 95%CI =1,12-1,55 and price OR = 1,34 95%CI=1,13-1,59 as possible motivators to quit HTP use. Level of tobacco dependence in former smokers shaped beliefs and feelings towards HTP use. High tobacco dependence contributed to strong need to use HTP and also increased perception of social pressure against smoking, but not against using HTP. It also increased the importance of fear of illness, price and one’s own resolution as motivators to quit HTP use. Key messages • High level of tobacco dependence in former smokers results in stronger perceived social pressure against smoking but not against HTP use. • High tobacco dependence in former smokers is related with stronger need to use HTP.

Prevalence and predictors of indoor secondhand tobacco smoke exposure among Senegalese household population

ABSTRACT Indoor secondhand tobacco smoke (SHS) exposure imposes substantial health risks among all household members, including children. Earlier studies reported high tobacco use in West African country Senegal. Despite the high health risks, no recent study has presented the situation of indoor SHS exposure in Senegal. Using cross-sectional design, we assessed the prevalence and predictors of indoor SHS exposure in Senegal. We used recent demographic and health survey (DHS) 2023 data of 75,080 household members of all ages. Analyzing these data, the prevalence of indoor SHS was assessed, and binomial logistic regression was used to identify predictors of indoor SHS exposure. The prevalence of indoor SHS exposure in Senegal was 24% (95% CI 23.5–24.2). Females, compared to males, were less likely to get indoor SHS exposure (aOR 0.9; 95% CI 0.8–0.9). Compared to the urban population, rural residents were less likely to get indoor SHS exposure (aOR 0.8; 95% CI 0.7–0.8). Individuals lived in households where members experienced shock events (aOR 1.2; 95% CI 1.1–1.2) and had members with psychological issues (aOR 1.5; 95% CI 1.4–1.6) were more susceptible to indoor SHS exposure. We conclude that indoor SHS exposure is high, particularly among Senegalese males, urban residents, and the poorest wealth quintiles. Additionally, susceptibility to indoor SHS increases with the presence of stressors like past adverse shock events and mental health issues. Both of these stressors encourage indoor smoking and intensify the risk of indoor SHS exposure among all household members. Community-based interventions providing behavior change communication on quitting tobacco and preventing indoor smoking are recommended.

RATE OF ASCENDING AORTIC ENLARGEMENT IN A LARGE ECHOCARDIOGRAPHIC COHORT: ASSOCIATED RISK FACTORS AND ADVERSE AORTIC EVENTS

BackgroundUnderstanding ascending aortic aneurysm growth and associated risk factors is critical to advising appropriate echocardiographic follow-up intervals for patients. This study aimed to identify aortic aneurysm growth rate on serial echocardiograms as well as the clinical and demographic variables that contribute to baseline aortic size and subsequent aortic growth. MethodsPatients identified with ascending aortic aneurysm and undergoing serial echocardiograms within five years were evaluated. Ascending aortic size was measured as part of routine echocardiogram exams. Clinical and demographic variables including aortic valve type (trileaflet, bicuspid or prosthetic) were evaluated for association with baseline aortic size as well as with aortic progression rate. Clinical events including aortic dissection, elective or emergent surgical repair were recorded. Results3639 patients were identified, (78% males, median age of 69 years, 175 (4.8%) with bicuspid valve, and 206 (5.6%) with prior aortic valve replacement (AVR). Patients with larger aorta at baseline were older with higher tobacco use and prior prosthetic valves. Over a mean of 2.4 years, aortic growth was observed and differed by valve type (trileaflet valve: 0.08 mm/year , bicuspid valve: 0.4 mm/year , p<0.001). In six patients who developed aortic dissection the estimated average annual growth rate was 0.98 mm/year. ConclusionsIn a large echo cohort, aortic aneurysm growth rate was 0.08 mm/year though higher in those with bicuspid valves ( 0.4 mm/ year), but initial aortic size did not correlate with change in the aortic progression rate. This data may help inform recommended echocardiographic surveillance intervals.

Disparities in tobacco smoking and risk of cardiovascular disease in people with low socioeconomic status or serious psychological distress: A simulation analysis

High tobacco smoking prevalence in people with low SES or serious psychological distress (SPD) in the U.S. may increase cardiovascular disease (CVD) risk among these marginalized subpopulations. We estimate how smoking disparities contribute to CVD disparities. Using the Simulation of Tobacco and Nicotine Outcomes and Policy model, a validated microsimulation model of tobacco use and clinical outcomes, we used 2004-2019 data from the National Health Interview Survey to first compare 20-year cumulative CVD incidence for 40-year-olds by sex, smoking status, and marginalized subpopulation membership. Second, we simulated the marginalized subpopulations with representative age, sex, and smoking status distributions to estimate 20-year cumulative CVD incidence under status quo and counterfactual scenarios. In the counterfactual scenario, smoking prevalence and trends in the low SES and SPD subpopulations match those in the higher SES and non-SPD subpopulations, respectively. The model-projected impact of smoking on 20-year cumulative CVD incidence is considerably larger than the impact of low SES or SPD; for example, among 40-year-old males, cumulative CVD incidence is 28.3% for low SES people who currently smoke, 13.0% for low SES people who never smoke, and 26.2% for higher SES people who currently smoke. In the second analysis, in the status quo scenario, model-projected 20-year cumulative CVD incidence is 19.3% for low SES and 22.1% for SPD; in the counterfactual scenario, it is 18.1% for low SES and 19.6% for SPD. Interventions focused on reducing smoking disparities could substantially reduce CVD in marginalized subpopulations.

Hidradenitis suppurativa and female infertility: a pilot study conducted amongst 110 dermatological patients

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with severe consequences on quality of life. One aspect of this is that HS has been linked to an increased risk of infertility, but as data is still limited, it is not known if the association reflects causality. We performed a cross-sectional study of 161 female participants included at Zealand University Hospital, Roskilde, Denmark. Data regarding basic demographics, infertility, pregnancies, sexual function, and known factors with impact on fertility was collected. Logistic regressions were performed to analyze the association between HS and infertility, adjusting for factors that influence fertility. The study population consisted of 55 patients with HS, 55 patients with other dermatological diseases (ODD), and 51 healthy controls (HC). The HS group had a higher BMI, lower sexual function, and a higher tobacco use. We found no significant difference between the three groups in terms of whether they had children, the number of children they had, infertility, or whether they had received fertility treatments. The logistic analyses found no correlation between HS and infertility, and adjusting for factors affecting infertility did not alter this result. This study did not find a significant difference in infertility between patients with HS compared to those with ODD or HC. This result was not affected by adjustments for other factors known to influence fertility. Interestingly, the lower sexual function in the HS group did not appear to influence their desire or ability to conceive.

Abstract B018: Changes in prevalence and correlates of tobacco use in 13 high-risk states in the United States from 2023-2024

Abstract Significance: Overall tobacco use rates are higher in the Midwest and Southern regions of the United States (US) than the rest of the US, yet little is known on correlates of tobacco use, or how rates are changing in recent years. This study examines current correlates of tobacco use among individuals living in the 13 most high-risk states in the US over two years. Methods: First, we examined the prevalence of tobacco use and related correlates in a rapid response survey of 4,550 adults collected between April-May 2023 (18+ years) living in the 13 high-risk states collected by the American Cancer Society. Data were weighted to be representative of the states’ population. Bivariate analyses for demographic characteristics were conducted examining cigarette use, e-cigarette use, and cigar use. Additional data collected from April-May 2024 in a second wave of cross-sectional data (n=4,500) for comparison between years and are currently being analyzed to reflect potential changes in correlates from 2023 to 2024. Results: Respondents in Wave 1 were aged 18-65 (Mean = 41.85; SD=0.32) and were majority Non-Hispanic White (70.9%) and female (51.9%). 47.5% of respondents reported an annual household income of &amp;lt;$75,000 USD. Although most respondents lived in urban (50.2%) or mostly urban areas (26.6%), several participants still resided in mostly rural (11.0%) or all rural (10.2%) as defined by US Census demographic data. The prevalence of any tobacco use was high across all 13 states (33.1%), with 29.5% reporting cigarette, e-cigarette and/or cigar use.21.1% of respondents were persons who currently smoke vs. 11.5% for the national average, while 20.7% were persons who previously smoked and 8.0% were persons who occasionally smoke. 14.0% of respondents reported current e-cigarette use vs 4.5% for the national average and 17.5% reported previous e-cigarette use. 8.7% of respondents reported current cigar use vs 3.5% for the national average and 24.1% reported previous cigar use. Respondents identifying as male (&amp;lt;.001) and with a household income &amp;lt;$75,000 (&amp;lt;.001), a disability (p=.014), or military/veteran status (p=.031) were more likely to currently smoke. Respondents who were male (p=.004) or reported household income &amp;lt;$75,000 (p=.011) were more likely to report current e-cigarettes use; higher use was associated with increasing age (&amp;lt;.001). Respondents who were male (&amp;lt;.001), and nonwhite (&amp;lt;.001) were more likely to report current cigar use; higher use was associated with increasing age. Conclusions: Cigarette use is high among individuals living in this region, and is related to lower household income, military/veteran status, disability status, and male identity. E-cigarette and cigar use increased with age. These high tobacco use rates lead to increased health inequities, with related high rates of cancer and cardiovascular disease. Given that tobacco use continues to be high in these states, tailored cessation programs could help reduce the heavy burden of tobacco use among this population. Citation Format: Minal Patel, Laurel Gibson, Presley Cannon, Shanshan Wang, Nigar Nargis. Changes in prevalence and correlates of tobacco use in 13 high-risk states in the United States from 2023-2024 [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B018.

Abstract A092: Tobacco use and prevalence of oral premalignant lesions, among Malayali tribes, Yelagiri Hills, Tamil nadu, India

Abstract BACKGROUND: India has the second largest tribal population of the world next to the African countries. About half of the world’s autochthonous people live in India, thus making India home to many tribes which have an interesting and varied history of origins, customs and social practices. The present study was conducted to assess the tobacco use and prevalence of precancerous lesions and oral cancer among Malayali tribes, Yelagiri Hills, Tamil nadu, India. METHODOLOGY The inhabitants of the 14 villages of the Yelagiri hills, who have completed 18years and residing for more than 15years present on the day of examination and who were willing to participate in the study were included. Data was collected from a cross-sectional survey, using a Survey Proforma, clinical examination and a pre-tested questionnaire. An intra-oral examination was carried out by a single examiner using WHO Oral Health Surveys – Basic Methods Proforma (1997). ResultsThe overall prevalence of smokeless and smoking tobacco was 78.8% and 65.2% respectively among 1550 study population. Of those who had the habit of smoking, 26% smoked beedi, 10.9% smoked cigarette, 65% chewed raw tobacco, 18% chewed Hans and 28% had a combination of smoking and smokeless tobacco usage. Around 49.8% of samples were stained positive for precancerous and cancerous lesions of the oral cavity. The highest number of positive samples were from buccal mucosa with 46.2% subjects and 12% for labial mucosa. The reason for practicing these habits were as a measure to combat the cold, relieving stress and body pain after work, and the lack of awareness of the hazards of the materials used. Prevalence of oral mucosal lesions in the study population was due to tobacco usage and alcohol consumption and lack of awareness regarding the deleterious effects of the products used. CONCLUSION Oral cancer is highly prevalent in this Malayali tribes owing to high tobacco consumption rates and habits warranting the cessation center a priority. Also, early detection and screening are vital to attaining better outcomes. Citation Format: Delfin Lovelina Francis. Tobacco use and prevalence of oral premalignant lesions, among Malayali tribes, Yelagiri Hills, Tamil nadu, India [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A092.

Association between exposure to air pollution and increased ischaemic stroke incidence: a retrospective population-based cohort study (EP-PARTICLES study)

Abstract Aims Short-term effects of Polish smog, particularly benzo(alpha)pyrene [B(a)P], are unclear. We aimed to examine the association between short-term exposure to air pollution and ischaemic stroke (IS) incidence. Methods and results We conducted a retrospective population-based cohort study including an EP-PARTICLES cohort of 8 million inhabitants in the years 2011–20 (80 million person-years of observation). Individual clinical data on emergency hospitalizations due to IS (ICD-10: I63.X) was analysed. We used quasi-Poisson models to examine municipality-specific associations between air pollutants and IS, considering various covariates. We recorded 146 262 cases of IS with a dominance of females (51.8%) and people over 65 years old (77.6%). In the overall population, exposure to PM2.5, NO2, B(a)P, and SO2 increased the risk of IS onset on the day of exposure by 2.4, 1, 0.8, and 0.6%, respectively. Age and sex were modifying variables for PM2.5, NO2, and B(a)P exposure with more pronounced effects in non-elderly individuals and women (all Pinteraction &amp;lt; 0.001). Residents of regions with high tobacco and alcohol consumption were more sensitive to the effects of PM2.5 and SO2. The slopes of response–effect curves were non-linear and steeper at lower concentrations. Conclusion Exposure to air pollution may be associated with higher IS incidence, particularly posing a higher risk to non-elderly women. Harmful lifestyle habits might exacerbate its impact. Exposure to even low levels of air pollutants had negative effects. Registration The study was registered at ClinicalTrials.gov (NCT05198492).

Predictors of white matter hyperintensities in the elderly Congolese population.

White matter hyperintensities (WMHs) are strongly linked to cardiovascular risk factors and other health conditions such as Alzheimer's disease. However, there is a dearth of research on this topic in low-income countries and underserved populations, especially in the Democratic Republic of Congo (DRC) where the population is aging rapidly with increasing cardiovascular risk factors and dementia-related diseases. This study evaluates health factors associated with WMH in the elderly Sub-Saharan Africa (SSA), specifically Congolese adults. In a cross-sectional study of 77 people from the DRC, participants underwent neuroimaging to analyze WMH volume and completed clinical evaluation, laboratory-based blood exams, self-reported questionnaires, and interviews. A simple linear regression model was conducted to test the association between WMH and potential predictors (neurological status, age, sex, hypertension, diabetes, tobacco abuse, stroke, high cholesterol, cardiovascular medication, and alcohol abuse). Stepwise selection and backward elimination analyses were performed to obtain the final model. Finally, a multiple linear regression model was conducted to assess the association between WMH and variables retained in the final model (neurological status, sex, and age). Of the 77 individuals, 47 (61%) had dementia, 40 (52.6%) were males, and the mean age was 73 years (± 8.0 years standard deviation). In simple linear regression models, WMH was significantly associated with dementia (expβ1=1.75, 95% CI=1.14 - 2.71, p-value=0.01) though it had a weak association with age (expβ1=1.03, 95% CI=1.00 - 1.05, p-value=0.05) and sex (male) (expβ1=0.66, 95% CI=0.43 - 1.01, p-value=0.05). In multiple linear regression models, WMH was statistically significantly associated with dementia (expβ1=1.97, 95% CI=1.31 - 2.95, p-value =0.001), male sex (expβ2=0.54, 95% CI=0.36 - 0.80, p-value=0.003), and age (expβ3=1.03, 95% CI=1.00 - 1.06, p-value=0.03). However, WMH was not significantly associated with common cardiovascular risk factors, such as high blood pressure, diabetes, tobacco use, obesity, and high cholesterol levels. WMH is significantly associated with neurological status, sex, and age in the Congolese population. Understanding these predictors may improve our ability to diagnose, assess, and develop preventative treatments for white matter disease in SSA/DRC populations, where neuroimaging is difficult to obtain.

Global burden of breast cancer and attributable risk factors in 204 countries and territories, from 1990 to 2021: results from the Global Burden of Disease Study 2021

Background and objectiveBreast cancer is a leading cause of morbidity and mortality among women worldwide. This study aimed to assess the global burden of breast cancer and identify attributable risk factors across 204 countries and territories from 1990 to 2021.MethodsUsing data from the Global Burden of Disease Study 2021, we analyzed the incidence, mortality, disability-adjusted life years (DALYs), and risk factors associated with breast cancer. We obtained and analyzed the age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized DALYs rate from 1990 to 2021. We assessed geographical variations and the impact of the Socio-demographic Index (SDI) using regression analysis and stratification by SDI quintiles. Additionally, we estimated the risk factors attributable to breast cancer deaths and DALYs using the comparative risk assessment framework of the GBD study.ResultsGlobally, breast cancer incident cases increased from 875,657 in 1990 to 2,121,564 in 2021. The ASIR rose from 16.42 to 26.88 per 100,000 (95% CI: 1.54–1.60). High SDI regions showed the highest ASIR (66.89 per 100,000 in 2021), while Low SDI regions had the lowest (6.99 per 100,000 in 2021). The global ASDR decreased from 10.42 to 8.54 per 100,000, and the age-standardized DALYs rate decreased from 313.36 to 261.5 per 100,000 between 1990 and 2021. However, these improvements were not uniform across SDI regions. Risk factors included high body-mass index, alcohol use, tobacco, and high fasting plasma glucose, with variations across SDI regions.ConclusionThe global burden of breast cancer has increased significantly from 1990 to 2021, with disparities observed across SDI regions. While high SDI areas show improvements in mortality and DALYs, lower SDI regions face increasing burdens. Targeted interventions addressing modifiable risk factors and improving healthcare access in less developed regions are crucial for reducing the global impact of breast cancer.

Tobacco retailer density and its association with birth outcomes in the USA: 2000–2016

IntroductionSignificant progress has been made in reducing maternal exposure to tobacco smoke and subsequent adverse birth outcomes, however, reductions may require strategies that reduce the availability of tobacco retailers. In...

Patterns and Influencing Factors of Organisms and Sensitivity in Sputum at Sylhet

Background: Respiratory tract infections, especially pneumonia and tuberculosis, remain significant public health problems in Bangladesh. This information alone is critical to manage local pathogen distributions, antibiotic susceptibility, and response plans. Objectives: To evaluate the frequency of bacterial pathogens in sputum samples, test their antibacterial sensitivity, and relate them to various demographic factors among patients in Sylhet, Bangladesh. Methods: This cross-sectional study was carried out in the Chest Disease Clinic, Sylhet from January to June 2024.Sputum samples were taken from 120 patients diagnosed with lower respiratory tract infections. Colony and bacterial identification was done microbiologically, and antibiotic susceptibility was determined by using the Kirby-Bauer disk diffusion method. Results: The cocci were the most prevalent, with gram-positive bacteria constituting 75% of all isolates: Staphylococcus aureus 29. Co-amoxiclav had the highest sensitivity of 23 percent, while the highest resistance was recorded for linezolid at 50 percent. Tobacco use was described in 79. Overall, there was a significant association between TB-positive status and the isolation of Klebsiella pneumoniae (p = 0.032). Most participants were of lower SES, and this was observed in 59.32% of the study’s participants. Conclusions: This research found that gram-positive organisms are the most frequent cause of respiratory infections in Sylhet, with S. aureus being the most dominant isolate. The high tobacco use and the link to S. aureus colonization indicate that interventions could and should be targeted. Concerning antibiotic susceptibility patterns, the need to exercise reasonable use of antibiotics and constant monitoring of antimicrobial resistance cannot be overemphasized. These findings may help the local clinicians, help set up empirical antibacterial therapy, and facilitate the design of some targeted health interventions. Scholars Middle East Publishers Browse Journals Payments Publication Ethics SUBMIT ARTICLE

Analysis of Export Competitiveness of Agri-Food Products at the EU-27 Level through the Perspective of Technical Complexity

This paper aims to identify the export competitiveness of agri-food products at the level of the European Union Member States, considering indicators/elements belonging to technical innovation (technical complexity) as well as qualitative elements. The main research problem is to examine the differences in the technical complexity of agri-food exports (EXPY) between EU Member States. Through detailed analysis of product categories and Member States’ performance, we have identified significant differences in the technical complexity of exports. Products such as dairy, meat, cereal and vegetable preparations were associated with high technical complexity, while fruit, tobacco and oils were classified in the low technical complexity category. We also identified Member States with exports characterised by high technical complexity, including Cyprus, Ireland and Luxembourg, and those with low technical complexity, such as Slovakia, Latvia and Croatia. These findings suggest the influence of various factors, such as economic specialisation, natural resources and R&amp;D investment on shaping the agri-food export landscape in the European Union. In-depth analysis of these issues provides significant insights for understanding the economic and technical dynamics in the European agri-food sector.

Oral lesions diagnosed in users of a Buccal Diagnosis Service in a city in Pernambuco: Cross-sectional study

The oral cavity, besides showing variations on its normality standard, it also might express clinical signs of local lesions or clinical signs of systemic diseases which require a specific therapeutic approach. Therefore, the early recognition of oral lesions represents a clinical challenge in Stomatology. Thus, this research aimed to characterize in a qualitative and quantitative way the lesions found in the oral cavity of users of the bucal diagnosis, in the secondary health care, in a pernambucano county. This research is a cross-sectional study carried out between October of 2022 and March of 2023, with patients who required specialized care in bucal diagnosis. Were diagnosed 22 lesions in the sample which was comprised by 45 individuals. The lesions were devided in two groups for a better comprehension of the presentations. In the first group, the lesions with a higher prevalence were fibrous hyperplasia 37% (n=10), followed by denture stomatitis 15% (n=4). In the second group, the lesions with a higher prevalence were leukoplakia 20% (n=4) followed by vacular lesions with the same percentagem. It was concluded that life habits and sociodemographic factors were directly related to some lesions present in the oral cavity. The presence of lesions in the oral cavity, as well as the high tobacco load, of the smoker individuals were related to lesions found in their oral cavity in the physical exam.

Early-life tobacco exposure is causally implicated in aberrant RAG-mediated recombination in childhood acute lymphoblastic leukemia.

Acute lymphoblastic leukemia (ALL) is the most common cancer in children, yet few environmental risk factors have been identified. We previously found an association between early-life tobacco smoke exposure and frequency of somatic deletions of 8 leukemia driver genes among childhood ALL patients in the California Childhood Leukemia Study. To expand analysis genome-wide and examine potential mechanisms, we conducted tumor whole-genome sequencing in 35 ALL patients, including 18 with high prenatal tobacco exposure and 17 with low exposure as determined by established epigenetic biomarkers. High tobacco exposure patients had significantly more structural variants (P < .001) and deletions (P = .001) genome-wide than low exposure patients. Investigation of off-target RAG recombination revealed that 41% of deletions in the high tobacco exposure patients were putatively RAG-mediated (full RAG motif identified at one or both breakpoints) compared with only 21% in the low exposure group (P = .001). In a multilevel model, deletions in high tobacco exposure patients were 2.44-fold (95% CI:1.13-5.38) more likely to be putatively RAG-mediated than deletions in low exposure patients. No point mutational signatures were associated with prenatal tobacco exposure. Our findings suggest that early-life tobacco smoke exposure may promote leukemogenesis by driving development of somatic deletions in pre-leukemic lymphocytes via off-target RAG recombination.

Caracterización de los hábitos y estilos de vida saludables en estudiantes universitarios de Tunja, Colombia

Introduction: healthy lifestyles are behaviors based on the interaction between conditions in a broad sense, and individual patterns determined by sociocultural factors and personal characteristics. Objective: to quantify the lifestyle habits of a university population. Methodology: an observational, descriptive, cross-sectional study, including Universidad de Boyacá students aged 18 to 29 years. Results: of 248 subjects included, 38.7% had healthy lifestyle habits and 57.26% were females. Discussion: overall, said students did not have good nutrition habits, took high-calorie unbalanced diets and did not get enough physical activity despite being aware of their beneficial effects on their health. Besides, a high alcohol and tobacco consumption was evidenced among these youngsters. Conclusions: thus, there is the need to develop novel and creative health programs promoting heathy lifestyles among university students.