High Tobacco Research Articles

Indoor Particle's Pollution in Bucharest, Romania.

Air pollution risk factor on human health was surpassed only by high blood pressure, tobacco use and poor diet. Total number of deaths due to air pollution worldwide was estimated to 6.67 million people in 2019. In the European Union, 97% of the urban population is exposed to levels of fine particulate matter above the latest guideline levels set by the World Health Organization. Air pollution accounts for 20% of newborn deaths worldwide, most related to complications of low birth weight and preterm birth. Low birth weight and preterm birth are responsible for 1.8 million deaths worldwide. Bucharest is the capital city of Romania and one of the most polluted cities in Europe, ranking in the 9th position out of 96 of the top cities from Europe and in the 4th position out of 32 of the top cities in Eastern Europe, data from June 2022. The aim of this study was to measure the real time level of indoor particulate pollution levels in different indoor environments from Bucharest, during the pandemic period. The PM2.5/PM10 ratio and its rate of change were also determined for the measured data. The PM2.5/PM10 ratio and its rate of change were also calculated based on the measurement data. The PM2.5/PM10 ratio showed an upward trend on weekends compared to weekdays, suggesting a relationship with outdoor PM where leisure activities and traffic infiltrated the indoors. The fluctuation range of the PM2.5/PM10 ratio was 0.44~0.95, and low measured values were detected on weekdays. Of the seasons, the proportion of particulate in autumn and its rate of change tended to be higher than in summer. It was suggested that outdoor air may have permeated the room. In addition, the relationship was considered, such as it is a holiday period, there are few rainy days, the concentration of coarse particles is high, and the number of residents in the city decreases. When it comes to indoor air quality, the higher this ratio, the more serious the air pollution. PM10 concentrations decreased by 29.1% in the absence of human activity and increased by 35.1% in the presence of humans. PM2.5 concentration decreased by 30.3% without human activity and increased by 3.1% with the presence of humans. Certain trends were suggested for the resumption of human activity and an increase in PM2.5 concentrations. The average relative difference between October 2021, a pandemic period, and October 2022, a post pandemic period, was 64% for PM10 and 47% for PM2.5. The pandemic period brought a significantly better indoor air quality from the particulate pollution point of view.

Associations between prenatal and postnatal substance exposure and salivary C-reactive protein in early childhood

BackgroundExposure to tobacco and cannabis during developmental periods of enhanced vulnerability (e.g., in utero and early childhood) may have long-lasting effects on child health. One potential mechanism underlying these associations is the alteration of inflammatory pathways. Using data from a longitudinal study of mother/child dyads, we examined the adjusted and combined associations of prenatal and postnatal tobacco and cannabis exposure with inflammation in early childhood. Furthermore, we explored the relations between different measures of exposure, partly reflecting differences in timing, dose, and level of fetal exposure (e.g., self-report vs. biomarker), and inflammation. Finally, we explored child sex as a moderator of prenatal and postnatal tobacco and cannabis exposure and inflammation. MethodWomen were recruited from a local hospital during their first prenatal appointment. Repeated assessments were conducted at each trimester, at birth, and when children were 2, 9, 16, 24, 36, and 60 months old (N = 215; 112 female children). To evaluate associations with different measurement approaches, prenatal tobacco and cannabis exposure were assessed using: 1) continuous dose-response variables of maternal self-reported tobacco and cannabis use during each trimester to assess associations with timing and severity of exposure, 2) categorization of children into exposure groups based on drugs and metabolites present in infant meconium reflecting later pregnancy fetal exposure, and 3) categorization into exposure groups using a combination of maternal self-report data and biomarker data derived from maternal saliva samples and infant meconium taking advantage of multiple methods of assessment to examine group differences. Postnatal exposure to tobacco (assessed using child salivary cotinine) and cannabis (assessed using maternal self-reported average joints smoked per day) was measured at each infancy/early childhood assessment. Adjusted pre- and postnatal exposure associations with child inflammation were assessed by including both measures as predictor variables in linear regression models predicting child salivary C-reactive protein (CRP) concentrations at 60 months. Interactions between pre- and postnatal exposure variables were then modeled to investigate the combined relations between pre- and postnatal substance exposure with child salivary CRP concentrations at 60 months. ResultsAdjusting for postnatal exposure variables, there was a significant interaction between the average daily cigarettes and the average daily cannabis joints smoked during the third trimester predicting salivary CRP concentrations in early childhood. At high tobacco exposure, the effect of cannabis on CRP concentrations was negligible, whereas at low tobacco exposure, the effect of cannabis exposure on CRP concentrations was positive. Adjusting for postnatal tobacco and cannabis exposure, children for whom meconium data indicated co-exposure to tobacco and cannabis showed approximately 43% lower CRP concentrations at age 60 months compared to children with no exposure. However, when mother/child dyads were categorized based on a combination of maternal self-report data and biomarker data from saliva samples and infant meconium, there were no differences in salivary CRP concentrations at age 60 months across the three groups (no prenatal exposure, prenatal tobacco exposure only, prenatal co-exposure to tobacco and cannabis), controlling for postnatal associations. Regardless of the measurement method used to assess prenatal exposures in adjusted analyses, prenatal tobacco exposure alone did not predict CRP concentrations in early childhood, nor did postnatal tobacco exposure. Among boys, postnatal cannabis exposure was associated with higher concentrations of CRP at age 60 months, controlling for prenatal exposure relations. There were no significant combined associations of pre- and postnatal exposure with CRP concentrations. ConclusionThis study expands upon known relations between prenatal and postnatal substance exposure and immunological outcomes in early childhood, underscoring the importance of assessing cannabis exposure during gestation and early life in combination with tobacco exposure.

Sociodemographic determinants of high tobacco use in Gond tribe of central India.

Background The prevalence of tobacco use is high in rural India, but limited information on tobacco use among the tribal population is available. We assessed the prevalence of tobacco use and type of tobacco use in the Gond tribal population. Methods We did a cross-sectional survey among the Gond tribal population residing in the Kundam block of Jabalpur district in Madhya Pradesh state in India. The study was carried out among persons aged 6 years and above during February-May 2017. Pre-tested interview schedules were used by trained field investigators to collect information on tobacco use. Results A total of 3351 individuals were included in this study, of which 58% were using some form of tobacco. The prevalence of tobacco use was higher among men compared to women, and it increased significantly from age 6 to 25 in both men and women. Tobacco use was significantly associated with age, gender and educational status of the respondents. Conclusion The study highlights a high tobacco use in the Gond tribe population. The high prevalence of tobacco use in younger ages is a matter of serious concern. The study establishes a need for information, education and communication and behavioural change communication activities; health camps focusing on the harmful effects of tobacco use and tobacco control campaign among tribal communities, tribal schools and ashrams.

Symptoms of tobacco dependence among middle and high school tobacco users – Data from the 2019–2020 National Youth Tobacco Survey

IntroductionPrevious studies have indicated that youth who use tobacco products, including cigarettes, cigars, and smokeless tobacco, demonstrate dependence symptoms. However, the tobacco marketplace has expanded dramatically in recent years, and few studies have examined dependence symptoms among youth who use novel products. This study combined 2019–2020 National Youth Tobacco Survey data to report the prevalence and determinants of tobacco dependence symptoms among U.S. middle and high school current (past 30-day) tobacco users. MethodsPrevalence estimates were calculated to examine dependence outcomes and other covariates by user groups (single product users and multiple product users). Multivariable logistic regression analyses were used to identify independent predictors of tobacco dependence among current users of cigarettes, cigars (regular cigars, cigarillos, and little cigars), e-cigarettes, heated tobacco products, hookah, pipe tobacco, bidis, and smokeless tobacco products (chew, snuff, dip, snus, and dissolvables). ResultsAmong current tobacco users, 15.7 % (95 % CI: 14.2–17.3) reported wanting to use tobacco within 30 min of waking and 28.3 % (95 % CI: 26.3–30.5) reported strong cravings for tobacco in the past 30 days. Nearly-two-thirds of current users were single product users, of which 80.5 % reported using e-cigarettes. Reporting of dependence symptoms was generally associated with multiple product use, higher frequency of use, earlier initiation age, and use of flavored products. ConclusionsAmong U.S. adolescents, a considerable amount of current tobacco product users, even infrequent users, reported symptoms of dependence. These findings highlight the continued importance of prevention strategies for youth tobacco experimentation and progression to regular use.

Key messages of the WHO European Regional Obesity Report

Abstract Obesity is a complex multifactorial disease defined by excessive adiposity and is linked to an increased risk for many noncommunicable diseases (NCDs). Overweight and obesity affect almost 60% of adults and nearly one in three children in the WHO European Region. Recent estimates suggest that overweight and obesity is the fourth most common risk factor for NCDs in the Region, after high blood pressure, dietary risks and tobacco. It is also the leading risk factor for disability and obesity is linked to greater morbidity and mortality from COVID-19. And obesity is considered a cause of at least 13 different types of cancer including cancers of the breast, colorectum, kidney, liver and ovary, multiple myeloma and meningioma. None of the countries in the Region are on track to achieve the obesity related target set in 2013. Early studies from a number of countries in the Region indicate that the prevalence of overweight and obesity and/or mean body mass index has increased in children and adolescents during the COVID-19 pandemic. This latest WHO European report on obesity examines the growing challenge and impact of obesity in the Region, building on past publications and aligning with initiatives to tackle cancer. The report focuses on managing obesity throughout the life course and tackling obesogenic environments; it also considers more recent challenges, including problematic digital marketing to children and the impact of the COVID-19 pandemic on obesity prevalence. Policy options to prevent obesity are outlined for consideration by Member States together with a suite of population-level approaches. The report highlights the importance of including prevention and control of obesity within measures to build back better in the wake of the COVID-19 pandemic. Whilst highlighting that single intervention will not be sufficient in any country, it examines the challenges faced by countries to implement known interventions to tackle obesity.

Severe atmospheric pollution in the Middle East is attributable to anthropogenic sources

In the Middle East, desert dust is assumed to dominate air pollution, being in permanent violation of public health guidelines. Here we present ship-borne measurements from around the Arabian Peninsula and modeling results to show that hazardous fine particulate matter is to a large extent of anthropogenic origin (>90%), and distinct from the less harmful, coarse desert dust particles. Conventionally, it was understood that desert dust dominates both the fine and coarse aerosol size fractions, which obscures the anthropogenic signal. We find that the annual excess mortality from the exposure to air pollution is 745 (514-1097) per 100,000 per year, similar to that of other leading health risk factors, like high cholesterol and tobacco smoking. Furthermore, anthropogenic pollution particles account for a major part (~53%) of the visible aerosol optical depth. Therefore, in the Middle East anthropogenic air pollution is a leading health risk and an important climatic factor.

Culturally specific health-related features on cigarette packs sold in China

BackgroundChina is the country with the highest burden of tobacco-caused disease. We characterised the extent to which cigarette pack marketing features (eg, imagery, text, pack color) could potentially mislead consumers...

Trends in smoking prevalence in urban and rural China, 2007 to 2018: Findings from 5 consecutive nationally representative cross-sectional surveys.

BackgroundTobacco smoking is a leading cause of premature death in China, especially among adult men. Since the implementation of the Framework Convention on Tobacco Control in 2005, nationwide tobacco control has been strengthened, but its long-term impact on smoking prevalence is unclear.Methods and findingsFive nationally representative surveys of the China Chronic Disease and Risk Factor Surveillance (CCDRFS) were conducted in 2007, 2010, 2013, 2015, and 2018. A total of 624,568 adults (278,605 men and 345,963 women) aged 18 to 69 years were randomly selected from 31 provinces (or equivalent) in China. Temporal changes in smoking prevalence and patterns (e.g., percentages of those smoking manufactured cigarettes, amount smoked, and age at smoking initiation) were analyzed, overall and by sex, urban or rural residence, year of birth, education and occupation, using linear regression methods. Among men, the standardized prevalence of current smoking decreased from 58.4% (95% confidence interval [CI]: 56.1 to 60.7) to 50.8% (95% CI: 49.1 to 52.5, p < 0.001) between 2007 and 2018, with annual decrease more pronounced in urban (55.7% [95% CI: 51.2 to 60.3] to 46.3% [95% CI: 43.7 to 49.0], p < 0.001) than rural men (59.9% [95% CI: 57.5 to 62.4] to 54.6% [95% CI: 52.6 to 56.6], p = 0.05) and in those born before than after 1980. Among rural men born after 1990, however, the prevalence increased from 40.2% [95% CI: 34.0 to 46.4] to 52.1% ([95% CI: 45.7 to 58.5], p = 0.007), with the increase taking place mainly before 2015. Among women, smoking prevalence remained extremely low at around 2% during 2007 to 2018. No significant changes of current smoking prevalence (53.9% to 50.8%, p = 0.22) were observed in male patients with at least 1 of major chronic diseases (e.g., hypertension, diabetes, myocardial infarction, stroke, chronic obstructive pulmonary disease (COPD)). In 2018, 25.6% of adults aged ≥18 years smoked, translating into an estimated 282 million smokers (271 million men and 11 million women) in China. Across 31 provinces, smoking prevalence varied greatly. The 3 provinces (Yunnan, Guizhou, and Hunan) with highest per capita tobacco production had highest smoking prevalence in men (68.0%, 63.4%, and 61.5%, respectively), while lowest prevalence was observed in Shanghai (34.8%). Since the children and teenage groups were not included in the surveys, we could not assess the smoking trends among youths. Furthermore, since the smoking behavior was self-reported, the smoking prevalence could be underestimated due to reporting bias.ConclusionsIn this study, we observed that the smoking prevalence has decreased steadily in recent decades in China, but there were diverging trends between urban and rural areas, especially among men born after 1980. Future tobacco control strategies should target rural young men, regions with high tobacco production, and patients suffering from chronic diseases.

Enhancing Tobacco Treatment for Medicaid Recipients.

Medicaid recipients are vulnerable to increased morbidity and mortality secondary to high tobacco use prevalence and barriers to accessing tobacco treatment. The purpose of the pilot study was to explore managed care administrators' perceptions of the facilitators and barriers to tobacco treatment for Medicaid recipients. Focus groups with key informants (n = 14) from managed care organizations were conducted in fall 2018. Participants included case, integrated care, quality and field care managers, and individuals working in provider and network relations. Facilitators to tobacco treatment were universal quality reporting requirements, access to medications, and the role of case management in identifying and engaging tobacco users in treatment. Barriers included bias regarding smokers' ability to quit, communication challenges, and competing priorities. The analysis provided data to support the development of a policy brief and recommendations to the Department for Medicaid Services for enhancing tobacco dependence treatment.

Evaluation of Restrictions on Tobacco Sales to Youth Younger Than 21 Years in Cleveland, Ohio, Area

Tobacco 21 (T21) policies raise the minimum legal age to purchase tobacco from 18 to 21 years to curb youth access to tobacco products. While some studies have found that T21 is associated with reducing prevalence of youth tobacco use, little is known about the impact it may have on youth of different racial and ethnic identities. To evaluate the association of T21 policy with the prevalence of high school youth tobacco use across sex, race, and ethnicity. This survey study used representative survey data collected from the local biennial Youth Risk Behavior Survey from 2013 to 2017 comparing Cleveland, Ohio (which has a T21 policy), to proximal jurisdictions in the first-ring suburbs in Cuyahoga County (which do not have T21 policies). Within-Cleveland demographic information was also collected for 2013 to 2019. Overall high school youth tobacco use rates were compared between Cleveland and the first-ring suburbs and then examined within Cleveland among Hispanic, non-Hispanic Black, and non-Hispanic White high school students. Percentage data were adjusted to more closely align with local population demographics. Data were analyzed from January to June 2022. T21 was implemented in Cleveland in 2016 and not adopted in proximal jurisdictions or at the state and federal level until at least 1 year later. The main outcomes were prevalence of past 30-day cigarette, cigar product, or e-cigarette use, measured using geographically representative high school youth survey data from 2013 to 2015 (prelegislation) and 2017 to 2019 (postlegislation) and compared using a difference-in-differences analysis. The unweighted sample included 12 616 high school students (27.0% [95% CI, 26.9%-28.0%] in 10th grade; 50.9% [95% CI, 50.3%-51.6%] females) participating in 1 or more Youth Risk Behavior Surveys from 2013 to 2019, including 7064 students in Cleveland and 5552 students in the first-ring suburbs. Compared with the first-ring suburbs, Cleveland had a greater proportion of younger students (1623 [28.5%] ninth grade students vs 2179 [34.0%] ninth grade students) and Hispanic students (436 students [1.1%] vs 1433 students [12.6%]) and non-Hispanic Black students (2000 students [53.1%] vs 3971 students [75.1%]). Cigars were the most commonly used tobacco product in Cleveland, with use reported by 6201 students (19.8%) in 2013, 5877 students (21.3%) in 2015, and 5784 students (16.8%) in 2019. Compared with the first-ring suburbs, there was a greater decline in prevalence of use of cigars in Cleveland (β = 0.18 [SE, 0.05]; P < .001). The disparity across race, ethnicity, and sex decreased for all current tobacco product use. For example, the maximum difference between demographic subpopulations in current cigarette use was 11.6 (95% CI, 9.5-13.7) percentage points in 2013 between White females (16.1% [95% CI, 11.3%-20.8%]) and Black males (4.5% [95% CI, 3.5%-5.4%]). This maximum difference in current cigarette use decreased significantly to 5.1 (95% CI, 3.5-6.7) percentage points in 2019 between White females (6.9% [95% CI, 3.4%-10.3%]) and Black females (1.8% [95% CI, 0.7%-2.8%]). This survey study found that there was a decline in youth-reported tobacco use across every tobacco product category from 2013 to 2019. This decline changed the trajectory of use among several demographic groups and brought the youth populations with the highest tobacco product use to similar rates of others.

Burden and determinants of substance abuse among urban adolescents of Shimla city

Background: Substance abuse is a major but neglected public health problem across the globe. Most of the time it starts during adolescence, which is also considered a critical risk period for the initiation of substance use. Materials and Methods: We conducted a cross-sectional analytical study to estimate the prevalence and determine the association of socio-demographic and other risk factors with substance abuse among adolescents in an urban area of Himachal Pradesh. A multi-stage cluster with probability proportional to size sampling technique was followed and a semi-structured, pretested questionnaire was used as the study tool. Results: We studied a total of 728 participants and 39.6% were females. The mean age was 15.6 ± 1.3 years. Out of these, 12.1% reported any substance abuse earlier in their lifetime. Among ever users, most commonly abused substance was alcohol (8.9%), followed by smoked tobacco (7.1%), bhang (3.7%), hard liquor (2.8%), charas/ganja (1.4%), chewing tobacco (1.4%), inhalants (fluid/eraser) 0.82%, prescription drugs (cough syrup/tablets 0.69% and injecting drugs 0.27%), Chitta (0.27%), opium and heroin with 0.14% each. On multiple logistic regression analysis, male gender (AOR=1.82), among friend’s tobacco smoking (AOR=2.33), alcohol abuse (AOR=4.52), and cannabis abuse (AOR=2.99) were found to be associated with an increased likelihood of substance abuse. High socio-economic status (AOR=0.59) and tobacco chewing among friends (AOR=0.49) had a protective effect on indulgence in substance abuse. Conclusion: The influence of peers played the most significant predictor while the presence of substance abuse in the family was also associated with an increased likelihood of abuse by adolescents.

Discovering Tuberosin and Villosol as Potent and Selective Inhibitors of AKT1 for Therapeutic Targeting of Oral Squamous Cell Carcinoma.

Oral squamous cell carcinoma (OSCC) is a major cause of death in developing countries because of high tobacco consumption. RAC-alpha serine-threonine kinase (AKT1) is considered as an attractive drug target because its prolonged activation and overexpression are associated with cancer progression and metastasis. In addition, several AKT1 inhibitors are being developed to control OSCC and other associated forms of cancers. We performed a screening of the IMPPAT (Indian Medicinal Plants, Phytochemistry and Therapeutics) database to discover promising AKT1 inhibitors which pass through various important filters such as ADMET (absorption, distribution, metabolism, excretion, and toxicity) properties, physicochemical properties, PAINS (pan-assay interference compounds) filters, PASS (prediction of activity spectra for substances) analysis, and specific interactions with AKT1. Molecules bearing admirable binding affinity and specificity towards AKT1 were selected for further analysis. Initially, we identified 30 natural compounds bearing appreciable affinity and specific interaction with AKT1. Finally, tuberosin and villosol were selected as potent and selective AKT1 inhibitors. To obtain deeper insights into binding mechanism and selectivity, we performed an all-atom molecular dynamics (MD) simulation and principal component analysis (PCA). We observed that both tuberosin and villosol strongly bind to AKT1, and their complexes were stable throughout the simulation trajectories. Our in-depth structure analysis suggested that tuberosin and villosol could be further exploited in the therapeutic targeting of OSCC and other cancers after further clinical validations.

Tobacco Consumption Among Young Population in Rural Indonesia: Prevalence and Associated Factors

Introduction: Tobacco consumption among youths is increasing in Indonesia and other middle-income countries. In rural areas, its prevalence is even higher compared to urban settings. Understanding the extent and associated factors of tobacco consumption within this population is essential to inform the formulation of appropriate prevention and control strategies.&#x0D; Aims: This study aims at analyzing the prevalence and associated factors of tobacco consumption among the young population living in rural Indonesia.&#x0D; Methods: Data were obtained from Indonesia Family Life Survey wave 5 (IFLS-5). A total of 2,786 responses from respondents aged 15-24 years and living in rural areas were taken into analysis. Binary logistic regression was used to examine the association between tobacco consumption with the predictors.&#x0D; Results: The prevalence of tobacco consumption among youths in rural Indonesia was 26.5%. Binary logistic regression discovered that factors significantly associated with tobacco consumption among young population were aged 20-24 years (AOR = 4.760, 95% CI: 3.557-6.368), less educated (AOR = 5.988, 95% CI: 3.193-11.229), being married (AOR = 2.484, 95% CI: 1.631- 3.782), and having smoking parent (AOR = 1.346, 95% CI: 1.016-1.783). Young males had a much higher tobacco use prevalence (57.1%). Whereas females had significant negative association with tobacco consumption (AOR = 0.001, 95% CI: 0.000-0.002).&#x0D; Conclusion: A large portion of youth in rural Indonesia were identified to have tobacco-use behavior. Appropriate prevention and control strategies are needed to address the population groups identified in this study. Policymakers should anticipate challenges that may occur resulting from geographical and cultural differences.

High Pretreatment Mean Corpuscular Volume Can Predict Worse Prognosis in Patients With Esophageal Squamous Cell Carcinoma who Have Undergone Curative Esophagectomy: A Retrospective Multicenter Cohort Study.

To establish the prognostic value of mean corpuscular volume (MCV) in patients with esophageal squamous cell carcinoma (ESCC) who have undergone esophagectomy. The MCV increases in patients with high alcohol and tobacco consumption. Such a lifestyle can be a risk factor for malnutrition, comorbidities related to those habits, and multiple primary malignancies, which may be associated with frequent postoperative morbidity and poor prognosis. This study included 1673 patients with ESCC who underwent curative esophagectomy at eight institutes between April 2005 and November 2020. Patients were divided into normal and high MCV groups according to the standard value of their pretreatment MCV. Clinical background, short-term outcomes, and prognosis were retrospectively compared between the groups. Overall, 26.9% of patients had a high MCV, which was significantly associated with male sex, habitual smoking and drinking, multiple primary malignancies, and malnutrition, as estimated by the body mass index, hemoglobin and serum albumin values, and the Geriatric Nutritional Risk Index. Postoperative respiratory morbidity (P = 0.0075) frequently occurred in the high MCV group. A high MCV was an independent prognostic factor for worse overall survival (hazard ratio, 1.27; 95% confidence interval, 1.049-1.533; P = 0.014) and relapse-free survival (hazard ratio, 1.23; 95% confidence interval, 1.047-1.455; P = 0.012). A high MCV correlates with habitual drinking and smoking, malnutrition, and multiple primary malignancies and could be a surrogate marker of worse short-term and long-term outcomes in patients with ESCC who undergo esophagectomy.

Personalised multicomponent interventions for tobacco dependence management in low socioeconomic populations: a systematic review and meta-analysis

BackgroundThere remains a disproportionally high tobacco smoking rate in low-income populations. Multicomponent tobacco dependence interventions in theory are effective. However, which intervention components are necessary to include for low socioeconomic...

In a behavioural bioassay, effluents from cigarette butts, cured tobacco and tree leaves differentially affect resting site selection in the land snail Cornu aspersum

ABSTRACT Cigarette butts (CBs) contain a plethora of chemicals, including many that are toxic. Although numerous studies have demonstrated the toxicity of CBs to aquatic organisms, there is less evidence that terrestrial organisms are severely impacted. Because CBs are commonly discarded on the ground, ground-dwelling organisms such as land snails may be especially affected. Many land snails are generalist detritivores/herbivores and ingest a variety of plant secondary compounds as they feed. This evolutionary exposure may render CBs (made principally of cured tobacco leaves) less toxic to these land snails than CBs are to less exposed aquatic animals. We investigated this possibility of reduced effects using a new behavioural assay to test the choice of ‘flavoured’ vertical resting sites in the land snail Cornu aspersum, which commonly rests on upright surfaces. In four experiments, regions of container walls were coated with different concentrations of CB and cured tobacco effluents, and effluents from three tree species and cured tobacco. Snails avoided high CB and tobacco effluent concentrations, which is consistent with toxicity. However, snails preferentially rested on dilute concentrations of both CBs and tobacco. Preference among tree leaf effluents was less evident, with a trend towards snails preferring the more readily eaten maple than the less readily eaten oak. Selection of the preferred tobacco concentration did not differ from that of tree leaves, indicating that C. aspersum was not repelled by dilute tobacco effluent. These results indicate that compounds leaching from discarded CBs may have little effect on snails and perhaps other soil organisms under environmentally realistic conditions.

Agronomics of high density tobacco (Nicotiana tabacum) production for protein and chemicals in Canada

Twenty eight tobacco (Nicotiana tabacum) cultivars were grown under a high density, multi-cropped production system, to determine the impact of stand density and supplemental nitrogen on biomass yields and protein, lutein and solanesol concentrations. At 75,000 plants ha−1, total biomass yields ranged from 5.69 to 8.02 dry t ha−1. In the first growing season, yield was marginally influenced by supplemental nitrogen up to 160 kg ha−1, but increasing stand density from 40,000 to 125, 000 plants ha−1 increased yield significantly. Protein yields did not vary statistically between cultivars, but did respond positively to increasing nitrogen. Both lutein and solanesol levels varied between cultivars and increased as supplemental nitrogen increased. The results support the viability of using tobacco as a source of protein, small molecules and biomass. Additional research on large scale processing and extraction of valuable compounds from tobacco is required to further develop this production system.

Perceptions of Game cigarillo packaging among young adult tobacco users: The effect of package color and the “natural leaf” descriptor

IntroductionTobacco packaging elements have been shown to influence product perceptions and use intentions. Garcia y Vega’s Game cigarillos are distinct from other brands in their use of “natural leaf” on packaging. The term “natural” has been linked to misperceptions about lower risk in the context of cigarettes. This study examines the impact of the “natural leaf” descriptor and pack color on young adults’ cigarillo perceptions and intentions. MethodsIn April-June 2020, we conducted an online experiment with 1,063 young adults (ages 18–34) that were past year users of cigars, vaping products, or marijuana. Subjects were randomly assigned to view one of eight images of Game cigarillo packs that varied in color and presence of the “natural leaf” descriptor. ResultsPurple packaging increased perceptions that the product tasted good, smelled nice, was flavored, and that a typical user was young. “Natural leaf” increased beliefs that the product contained high quality tobacco and that a typical user was trendy. When on grey packs, it increased favorable perceptions compared to when on brightly colored packs, including perceptions that the product tasted good, was fresh, that a typical user was trendy, and that the product was flavored. ConclusionsThis study is the first to present quantitative evidence on the impact of the “natural leaf” descriptor on cigarillo perceptions and intentions, extending work that has been done in the context of cigarettes. Utilizing highly realistic stimuli, findings demonstrate that both the term “natural leaf” and packaging color can increase favorable perceptions of cigarillos.

Stroke in Djibouti

• Sub-Saharan Africa is experiencing an increasing burden of stroke, with current prevalence as high as 1.46 per 1000 population. • Limited cohort studies exist to profile the epidemiological, clinical and paraclinical characteristics of stroke in this setting. • Identifying the most at-risk population for ischemic and haemorrhagic stroke can improve approaches for prevention in this setting. Stroke is a neurological emergency affecting both developed and developing countries. In Djibouti, stroke is the fourth leading cause of death. Our objective was to describe the demographic, clinical, paraclinical profile of stroke in Djibouti and identify the possible underlying risk factors. We conducted a cross-sectional multicentre study carried out over a period of 6 months in the medical services of the Soudano-Djibouti military hospital, the General Peltier hospital and the emergency department of the National fund for social security health centre. A total of seventy patients were included. The mean age was 59.61 years with a male predominance (sex ratio: 2.5) and a statistically significant female-related difference beyond the age of 60 years (p <10 −3 ). Cardiovascular risk factors were mainly hypertension (73%), khat chewing (64%) and tobacco use (50%). Khat chewing and tobacco use were associated with a younger age of occurrence of stroke (p=0.020 and p=0.004, respectively). Diabetes mellitus and hypercholesterolemia were found respectively in 30% and 19% of cases, and were more associated with ischemic stroke. Coronary disease (11%), heart failure (3%) and obesity (4%) (significantly associated with the female gender; p= 0,021) were less common. Motor deficits (94%) were the most common clinical manifestations, followed by sensory deficits (51%) and alteration of consciousness (37%). Stroke was ischemic in 61.5% of patients. The most affected territory in ischemic stroke was the territory of the middle cerebral artery, and capsulo-thalamic involvement in haemorrhagic stroke which was significantly associated with the alteration of consciousness(p=0,003). Stroke had primarily modifiable risk factors in Djiboutian patients dominated by high blood pressure, tobacco use and khat chewing especially in the male population under the age of 60 years. These findings could have implications on future preventive measures and a better approach to public health policy.

Local Ties, Trans-Local Ties, and Substance Use among Rural-to-Urban Migrants in China.

China has witnessed unprecedented rural-to-urban migration since the early 1980s. While trying to assimilate into the city, rural-to-urban migrants still maintain close ties with their home communities. This study examines how local ties and trans-local ties of rural-to-urban migrants affect their alcohol and tobacco use. Data were obtained from the 2016 and 2018 China Labor-force Dynamics Survey, a nationally representative sample of adults aged over 15 in 29 provinces in China. Participants included 1426 rural-to-urban migrant workers and 6438 urban residents in China. We found that compared to urban natives, rural-to-urban migrants had higher tobacco use prevalence (logit = 0.19, 95% CI = [0.03, 0.35]; p < 0.05) and more frequent alcohol use (logit = 0.27, 95% CI = [0.11, 0.42]; p < 0.001) after adjusting for sociodemographic characteristics. Migrants with more local social ties engaged in more frequent drinking (having >10 local friends vs. having 0 local friends: logit = 0.58, [0.10, 1.06], p < 0.05), whereas trans-local ties were not a significant correlate. In contrast, migrants who returned to their hometown more times (an indicator of trans-local ties) were more likely to be current tobacco users (logit = 0.01, 95% CI = [0.00, 0.02], p < 0.01) after adjusting for sociodemographic variables. These findings extended the research on social networks and health behaviors by identifying how local and trans-local ties differentially affected the vulnerabilities of tobacco and alcohol use among rural-to-urban migrants in China. The findings suggested that policies and interventions on reducing migrants’ health risk behaviors should focus on the role of different types of social ties.