Prevalence Of Smoking In Population Research Articles

The association between smoking and family health with the mediation role of personality among Chinese people: nationwide cross-sectional study

BackgroundThere may be unexplored interactions between family health, personality, and smoking that could help provide new perspectives on tobacco control.ObjectiveTo examine the relationship between the health of one’s family and their smoking habits, as well as investigate the potential influence of personality on this relationship.MethodsFor this cross-sectional investigation, a national survey conducted in China in 2022 recruited a total of 21,916 individuals. The Family Health Scale was utilized to assess the health of the family. The 10-item Big Five Inventory scale was utilized to assess the Big five personality traits. The relationship between big five personality, family health, and smoking were investigated using binary and linear logistic regression. The indirect effects mediated by Big five personality were analyzed using mediation analysis with Sobel tests, and the indirect effects were composited using the Karlson-Holm-Breen method.ResultsThe overall prevalence of smoking in the study population was 14.87%, 26.19% for males and 3.54% for females. Urban and rural smoking prevalence was 13.81% and 16.10% respectively. Binary logistic regression analysis revealed a significant negative relationship between smoking and family health (odds ratio 0.964, 95% CI 0.959, 0.970, P < 0.001) with covariates controlled. The Karlson-Holm-Breen composition facilitated the connection between extraversion (47.81%) and nervousness (52.19%).ConclusionsPreventive interventions for smoking behavior should prioritize family health and the Big five personality as significant areas to focus on. According to this study, in addition to implementing various interventions for different personalities, family health should be strengthened to reduce smoking behavior.

The smoking and vaping model, A user-friendly model for examining the country-specific impact of nicotine VAPING product use: application to Germany

BackgroundSimulation models play an increasingly important role in tobacco control. Models examining the impact of nicotine vaping products (NVPs) and smoking tend to be highly specialized and inaccessible. We present the Smoking and Vaping Model (SAVM),a user-friendly cohort-based simulation model, adaptable to any country, that projects the public health impact of smokers switching to NVPs.MethodsSAVM compares two scenarios. The No-NVP scenario projects smoking rates in the absence of NVPs using population projections, deaths rates, life expectancy, and smoking prevalence. The NVP scenario models vaping prevalence and its impact on smoking once NVPs became popular. NVP use impact is estimated as the difference in smoking- and vaping-attributable deaths (SVADs) and life-years lost (LYLs) between the No-NVP and NVP scenarios. We illustrate SAVM’s adaptation to the German adult ages 18+ population, the Germany-SAVM by adjusting the model using population, mortality, smoking and NVP use data.ResultsAssuming that the excess NVP mortality risk is 5% that of smoking, Germany-SAVM projected 4.7 million LYLs and almost 300,000 SVADs averted associated with NVP use from 2012 to 2060. Increasing the excess NVP mortality risk to 40% with other rates constant resulted in averted 2.8 million LYLs and 200,000 SVADs during the same period.ConclusionsSAVM enables non-modelers, policymakers, and other stakeholders to analyze the potential population health effects of NVP use and public health interventions.

Association between tobacco control policies and smoking behaviour in Europe

Abstract Background Smoking is an important public health problem. The European Health Interview Survey (EHIS) provides regular data on prevalence and determinants of smoking for the populations of European countries, while the Tobacco Control Scale (TCS) quantifies the implementation of tobacco control measures. The aim is to examine the associations between tobacco control policies at country level and individual-level smoking prevalence. Methods Using multi-level regression modelling, individual data from EHIS 2019/2020 and country-level data from TCS 2019 were analysed. The outcome measure was self-reported current smoking (daily or occasional) at the individual level. Predictor variables were at the individual level: gender, age and education attainment level, and at country level: scores of TCS policy components ‘Price', ‘Public place bans', ‘Advertising bans', ‘Health warnings', ‘Treatment’ and ‘Illicit trade'. Microdata from the 3rd wave of EHIS for 28 European countries were used with a total of n = 66.934 individuals aged &amp;gt;15 years. A weighting factor was applied to consider each country proportionally according to its sample size in EHIS. Results There are large cross-national differences in current smoking prevalence ranged from 12.6% (95% confidence interval (CI) 11.9-13.3) in Sweden to 36.2% (95% CI 35.0-37.4) in Bulgaria. In the final multi-level model besides individual variables (female gender, age 60 years and over, medium or high education level), following variables at country level were significantly associated with lower prevalence of current smoking: ‘Price’ (Odds Ratio (OR)=0.96 (p &amp;lt; 0.05) and ‘Treatment’ OR = 0.88; (p &amp;lt; 0.01). For ‘Public place bans', ‘Advertising bans', ‘Health warnings’ and and ‘Illicit trade’ association were in same direction but without significance. Conclusions Tobacco control policies help to reduce the prevalence of smoking in population, although the different measures have differing impact. Key messages • Our study confirms the link between the implementation of tobacco control policies and smoking prevalence using recent data. • Policy components have different effects on smoking prevalence at population level.

The prevalence and clustering of alcohol consumption, gambling, smoking, and excess weight in an English adult population

BackgroundThe aim of this study was to examine the prevalence and clustering of four health risks (increasing−/higher-risk drinking, current smoking, overweight/obesity, and at-risk gambling), and to examine variation across sociodemographic groups in the English adult population. MethodsWe analysed data from the 2012, 2015, 2016, and 2018 Health Survey for England (n = 20,698). Prevalence odds ratios (POR) were calculated to examine the clustering of risks. We undertook a multinomial multilevel regression model to examine sociodemographic variation in the clustering of health risks. ResultsOverall, 23.8% of the adult English population had two or more co-occurring health risks. The most prevalent was increasing−/higher-risk drinking and overweight/obesity (17.2%). Alcohol consumption and smoking were strongly clustered, particularly higher-risk drinking and smoking (POR = 2.68; 95% CI = 2.31, 3.11; prevalence = 1.7%). Higher-risk drinking and at-risk gambling were also clustered (POR = 2.66; 95% CI = 1.76, 4.01), albeit with a very low prevalence (0.2%). Prevalence of multiple risks was higher among men for all risk combinations except smoking and obesity. The odds of multiple risks were highest for men and women aged 35–64 years. Unemployed men and women with lower educational qualifications had a higher odds of multiple risks. The relationship between deprivation and multiple risks depended on the definition of multiple risks, with the clearest socioeconomic gradients seen for the highest risk health behaviours. ConclusionAn understanding of the prevalence, clustering, and risk factors for multiple health risks can help inform effective prevention and treatment approaches and may support the design and use of multiple behaviour change interventions.

1439-P: Smoking Prevalence in Diabetes Population in Europe

Smoking cessation is part of holistic management of type 2 diabetes but prevalence of smoking and smoking cessation in diabetes population is not well known. We aimed to determine prevalence of smokers and ex-smokers and associated factors in older diabetes population in Europe. A sample of European population ≥50 years of age (46,327 participants, 14.90 %/6,903 with diabetes: 57.36 % female, average age 70.85+-9.31, BMI 27.16+-4.76) from 27 countries from a wave 8 (2019/2020) of the Survey of Health, Ageing and Retirement in Europe was used. The data was collected from computer-assisted personal interviews using one common questionnaire, translated into national languages. Diagnosis of diabetes and smoking status were based on self-report of participants. X2 test and multinomial logistic regression models were used for statistical analyses. Prevalence of smokers in Europe was 13.93/12.15/14.24 % (whole/diabetes/nondiabetes group). Prevalence of ex-smokers was 27.06/29.87/26.57 % and prevalence of never smokers 59.01/57.97/59.19 %. Among countries diabetes populations, highest prevalence of ex-smokers (57.62 %) with low prevalence of smokers (9.52 %) was seen in the Netherlands. Highest prevalence of never smokers (84.21 %) was in Latvia, with lowest ex-smoker and low smoker prevalence (7.89 % for each). Highest prevalence of current smokers (17.94 %) with below average ex-smoker prevalence (26.46 %) was seen in Austria. Obesity was associated with higher ex-smoker prevalence, whilst normal weight, overweight, lower education, age 50-74, living without a partner and being male were associated with higher smoking prevalence. Lower ex-smoker prevalence was associated with ≥ 80 years of age and being female. Higher prevalence of ex-smokers in diabetes group might reflect diabetes diagnosis being an impulse for smoking cessation, nevertheless smoking prevalence remains high among older diabetes population in Europe. Smoking cessation interventions should be addressed repeatedly over the course of diabetes. Disclosure J. Malinovska: Employee; Boehringer Ingelheim s.r.o. M. Lustigova: None. J. Urbanova: None. P. Krollová: Advisory Panel; Boehringer-Ingelheim. Other Relationship; Sanofi. J. Michalec: None. J. Broz: None. Funding European Commission, DG RTD through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N°211909, SHARE-LEAP: GA N°227822, SHARE M4: GA N°261982, DASISH: GA N°283646); Horizon 2020 (SHARE-DEV3: GA N°676536, SHARE-COHESION: GA N°870628, SERISS: GA N°654221, SSHOC: GA N°823782, SHARE-COVID19: GA N°101015924); DG Employment, Social Affairs &amp; Inclusion (VS 2015/0195, VS 2016/0135, VS 2018/0285, VS 2019/0332, VS 2020/0313); German Ministry of Education and Research; Max Planck Society for the Advancement of Science; National Institute on Aging (U01AG09740-13S2, P01AG005842, P01AG08291, P30AG12815, R21AG025169, Y1AG455301, IAGBSR0611, OGHA04064, HHSN271201300071C, RAG052527A)

Prevalence and Determinants of Smoking and Smokeless Tobacco in the Rural Population of Karnataka, India

Background: Tobacco is known as a major cause of various preventable non-communicable diseases and kills half of all its users. With a greater prevalence in the rural community compared to the urban, this global health burden is substantially malignant. This study aimed to bridge the gap in the lack of adequate statistical information pertaining to prevalence and determinants of smoking and smokeless tobacco use in the rural population of Karnataka.Subjects and Method: This randomized community interventional study was conducted in primary health center areas of Karnataka, India. A total of 4,576 persons were interviewed (2,087 males and 2,489 females). Subjects ?30 years of age and residents for a minimum of six months were included. Mentally challenged, bedridden or differently abled subjects were excluded. The study employed a validated questionnaire adapted from the WHO STEPS questionnaire concerning demographical information, behavioral, physical, and biochemical measurements. Besides tobacco, informa-tion on use of beedis, cigarettes, and smokeless tobacco products (snuff, chewing tobacco) were also elicited. Data analysis of socio-demographic characteristics (age, educational/ marital/ occupational status) was carried out only for the participants with a current smoking habit. Data were analyzed using SPSS Version 18.0.Results: The overall prevalence rate of current smoking and smokeless tobacco habit in the study population was 54.8% (95%CI= 53.40 to 56.20) and the prevalence rate of ever/past users was 39.7% (95%CI= 38.26 to 41.10). Genderwise analysis predicted a higher prevalence of males currently smoking, and among them, most were 50 to 59 years of age (43.3%), illiterate (42.7%), widowed/ separated (39.8%), unskilled (44%), and semi-skilled workers (30%).Conclusion: Both genders participate in tobacco use, prevalence of smoking was higher among men and consumption of smokeless tobacco was higher among women. Subjects aged 50-59 years, illiterate, divorced/widowed/separated and, involved in unskilled or semi-skilled labor exhibited greater prevalence of tobacco habit compared to other determinants.Keywords: noncommunicable diseases, global health, tobacco use, tobacco smoking, smokeless tobacco. Correspondence: Dinesh Rajaram, Associate Professor. Department of Community Medicine, M.S. Ramaiah Medical college and Hospital, Bengaluru 560054, Karnataka, India. Email id.: dinesh.gayathri6@gmail.com. Mobile: +919980336893.

A Smoking Cessation Mobile App for Persons Living With HIV: Preliminary Efficacy and Feasibility Study.

BackgroundThe prevalence of smoking in the United States general population has gradually declined to the lowest rate ever recorded; however, this has not been true for persons with HIV.ObjectiveWe conducted a pilot test to assess the feasibility and efficacy of the Lumme Quit Smoking mobile app and smartwatch combination with sensing capabilities to improve smoking cessation in persons with HIV.MethodsA total of 40 participants were enrolled in the study and randomly assigned 1:1 to the control arm, which received an 8-week supply of nicotine replacement therapy, a 30-minute smoking cessation counseling session, and weekly check-in calls with study staff, or to the intervention arm, which additionally received the Lumme Quit Smoking app and smartwatch.ResultsOf the 40 participants enrolled, 37 completed the follow-up study assessments and 16 used the app every day during the 56-day period. During the 6-month recruitment and enrollment period, 122 people were screened for eligibility, with 67.2% (82/122) deemed ineligible. Smoking criteria and incompatible tech were the major reasons for ineligibility. There was no difference in the proportion of 7-day point prevalence abstinence by study arm and no significant decrease in exhaled carbon monoxide for the intervention and control arms separately. However, the average exhaled carbon monoxide decreased over time when analyzing both arms together (P=.02).ConclusionsResults suggest excellent feasibility and acceptability of using a smoking sensor app among this smoking population. The knowledge gained from this research will enable the scientific community, clinicians, and community stakeholders to improve tobacco cessation outcomes for persons with HIV.Trial RegistrationClinicalTrials.gov NCT04808609; https://clinicaltrials.gov/ct2/show/NCT04808609

Estimation of smoking-related mortality and its contribution to educational inequalities in life expectancy in Spain: an observational study, 2016–2019

ObjectiveTo estimate smoking-related mortality and its contribution to educational inequalities in life expectancy in Spain.DesignNationwide, observational study from 2016 to 2019. Population-attributable fractions were used to estimate age, sex and...

Correlation between obstructive sleep apnea and ventricular function: a cross-sectional hospital-based study

Background Obstructive sleep apnoea (OSA) is a major cause of cardiovascular morbidity and mortality worldwide. Previous studies showed high prevalence of OSA in heart failure. We aimed to evaluate the association of OSA with cardiac dysfunction and the importance of myocardial performance index (Tei) in identifying cardiac dysfunction. Methods Participants with OSA and sinus rhythm were included, while participants with arrhythmia, debilitating disease, or significant valvular heart disease were excluded. Thirty participants were enrolled, consecutively allocated in a single group, and underwent nocturnal polysomnography, electrocardiogram, and transthoracic echocardiography. Results The prevalence of hypertension, diabetes, and smoking in the study population was 50%, 30%, and 23.3%, respectively. The mean body mass index and apnoea-hypopnoea index (AHI) of the study population was 40.11 ± 7.5 kg/m2 and22.12 ± 13.54 events/h, respectively. There were statistically significant differences between mild, moderate, and severe OSA regarding the left ventricular end diastolic diameter, left ventricular end systolic diameter, ejection fraction, and fractional shortening (p = 0.006, p = 0.002, p = 0.014 and p = 0.011),respectively. There were statistically significant regular positive correlations between the AHI and the right and left Tei (r = 0.447, p = 0.001 and r = 0.391, p = 0.003),respectively. Conclusions The prevalence of OSA was more in patients with comorbidities especially hypertension and diabetes. OSA was significantly associated with ventricular remodelling and cardiac dysfunction. A significant regular positive correlation was observed between the severity of OSA and worsening cardiac function as measured by Tei. Echocardiographic evaluation of the right and left ventricles and the right and left Tei could be considered as potentially valid, reproducible, and clinically applicable non-invasive methods for estimation of ventricular global function in patients with OSA.

CARDIOVASCULAR DISEASE RISK PREDICTION IN EASTERN EUROPE ACCORDING TO 5-YEARS PROSPECTIVE STUDY

Objective: The aim of the study was to identify the most significant risk factors for cardiovascular diseases in Eastern European. Design and method: We conducted 5-years prospective andomised study of 3,500 individuals of the Belarusian population living in a district of Vitebsk in 2007/2008 (coverage of the survey was 97.9%), 2010/2011 (coverage of the survey was 77.8%) and 2012/2013 (coverage of the survey was 84.3%). The survey included standard questionnaires for detection of cardiovascular risk factors, measurements of blood pressure, electrocardiography, blood chemistry (serum CRP, uric acid and cholesterol data). In 5 years we registered new cases of hypertension, myocardial infarction, stroke and death from cardiovascular diseases in the studied population. Results: According to multifactorial regression analysis the risk factors for hypertension development included in the final model (df = 10; 2 Walda = 422,98; p &lt; 0,001) were traditional risk factors, such as age (p &lt; 0,001), sex (p &lt; 0,23), high systolic blood pressure (&gt;120 mmHg) (p &lt; 0,001), high body mass index (&gt;25,7 kg/m2) (p &lt; 0,001), alcohol abuse (p &lt; 0,01), heart rate (&gt;70 beats/min) (p &lt; 0,01), hereditary burden of stroke (p &lt; 0,05) and new risk factors - high uric acid level (&gt;338 mol/l) (p &lt; 0,001), and high level of amount of ECG peaks SV1+RV5–V6 (&gt;25 mm) (p &lt; 0,001). The risk factors for the development of new cases of myocardial infarction, stroke and death from cardiovascular diseases included in the final model (df = 1; 2Walda = 32,2; p &lt; 0,001) were age (p &lt; 0,001), sex (p &lt; 0,001), heart failure (p &lt; 0,01), hypertension (p &lt; 0,05), edema (p &lt; 0,05) as well as low HDL (&lt;1,08 mmol/l) (p &lt; 0,01) and comorbidity, especially COPD (p &lt; 0,01). The special role of COPD can be explained by the high prevalence of smoking in the Belarusian population (men - 60.6%, women - 13.8% (p &lt; 0,001)). Conclusions: In the Belarusian population as well as traditional risk factors for cardiovascular diseases and cardiovascular death new risk factors, such as high uric acid level, high level of amount of ECG peaks SV1+RV5–V6, low HDL cholesterol and COPD, were established.

Smoker characteristics and trends in tobacco smoking in Rakai, Uganda, 2010-2018.

INTRODUCTIONTobacco use is a major public health concern, particularly in low- and middle-income countries where 80% of the world’s smokers reside. There is limited population-based data from rural Africa on patterns of tobacco smoking and smoker characteristics. We assessed trends in rates of smoking, characteristics of smokers, and factors associated with smoking using repeat population-based cross-sectional surveys in south-central Uganda.METHODSData accrued over five survey rounds (2010–2018) of the Rakai Community Cohort Study (RCCS) from consenting individuals aged 15–49 years including sociodemographic and behavioral characteristics and smoking status. Proportions of smokers per survey were compared using χ2 test for trends, and factors associated with smoking were assessed by multivariable logistic regression.RESULTSThe prevalence of tobacco smoking in the general population declined from 7.3% in 2010–2011 to 5.1% in 2016–2018, p<0.001. Smoking rates declined among males (13.9–9.2%) and females (2.2–1.8%) from 2010–2011 to 2016–2018. Smoking prevalence was higher among previously married (11.8–11.7%) compared to currently (8.4–5.3%) and never married persons (3.1–1.8%) from 2010–2011 to 2016–2018. Older age (≥35 years) was associated with higher odds of smoking (AOR=8.72; 95% CI: 5.68–13.39 in 2010–2011 and AOR=9.03; 95% CI: 5.42–15.06 in 2016–2018) compared to those aged <35 years (AOR=4.73; 95% CI: 3.15–7.12 in 2010–2011 and AOR=4.83; 95% CI: 2.95–7.91 in 2016–2018). Primary and secondary/higher education level was significantly associated with lower odds of smoking (AOR=0.20; 95% CI: 0.14–0.29 in 2010–2011 and AOR=0.26; 95% CI: 0.18–0.39 in 2016–2018) compared to no education (AOR=0.43; 95% CI: 0.31–0.59 in 2010–2011 and AOR=0.48; 95% CI: 0.34–0.68 in 2016–2018). Number of sexual partners and HIV status were not associated with smoking.CONCLUSIONSWe observed declining trends in tobacco smoking in the Rakai region of rural Uganda. Smoking was more prevalent in men, older individuals, individuals who were previously married, and individuals with lower education. The decline in smoking may be due to tobacco control efforts, but there is a continued need to target sub-populations with higher smoking prevalence.

Gender effect on onset, prevalence and surgical treatment of cataract in patients with Myotonic Dystrophy type 1.

Myotonic Dystrophy type 1 (DM1) is the most common muscular dystrophy in adults, affecting 1:8000 individuals. It is a multi-systemic disorder involving muscle, heart, endocrine and respiratory apparatus and eye. The eye symptoms can include ptosis, external ophthalmoplegia, epiphora, and early onset cataracts. Cataracts occur at a much earlier age (usually between 30 and 40) than the general population, where females are usually affected more than men. We studied gender differences in cataract prevalence and treatment age in 243 DM1 patients (134 M; 109 F), aged 18 to 70 years, who were subsequently screened at routine follow-up. For each patient, information was collected on age, sex, CTG expansion, age of cataract onset, and age at cataract surgery, when available. Seventy-three patients, 30 females and 43 males, had cataracts, at a mean age of onset of 41.14 ± 12.64 in females, and 40.36 ± 10.03 in males. Sixty-nine of them underwent cataract surgery, males at an earlier age than females (42.8 ± 9.8 years versus 47.3 ± 12.6 years) and in 52.5% of cases before the age of 40, compared to 17.2% of females. The difference was statistically significant. The assumption that females in general and those with DM1 in particular develop cataracts more frequently and earlier than males is not confirmed, at least in this study. A possible explanation for these results could be related to non-advanced age, the protective role of estrogen and the lower prevalence of smoking in the study population.

Nicotine Dependence in Patients with Major Depressive Disorder and Psychotic Disorders and Its Relationship with Quality of Life.

The aim of the current study was to examine the associations between nicotine dependence and quality of life (QOL) among individuals diagnosed with major depressive disorder (MDD) or psychotic disorders. Methods: A total of 378 participants diagnosed with either MDD or psychotic disorders were recruited. The Fagerstorm Test for Nicotine Dependence was used to measure the level of nicotine dependence. The SF-12 health survey questionnaire was used to measure the QOL. Results: The prevalence of nicotine dependence was 23.3% in this sample population. For those diagnosed with MDD, moderate level of nicotine dependence was negatively associated with Vitality and Mental Component Score. For those diagnosed with a psychotic disorder high nicotine dependence was negatively associated with Role Emotional, Mental Health and Mental Component Score. Discussion: Compared to the general population, the prevalence of smoking in this psychiatric population was 2.4 times higher, while that of nicotine dependence was seven times higher. Individuals with psychotic disorder generally reported better QOL as compared to individuals with MDD. QOL differed across diagnostic groups with regards to socio-demographics, such as age, ethnicity, marital status, education, employment status and monthly income. Among individuals with MDD and psychotic disorders, different levels of nicotine dependence resulted in different levels of association with QOL. More research is needed to better understand the differences in QOL among the varying levels of nicotine dependence.

Beyond “Safe and Effective”: The urgent need for high-impact smoking cessation medications

Smoking cessation medications (SCMs) are an evidence-based cornerstone of comprehensive tobacco control programs globally. However, the impact of SCMs on population smoking prevalence is controversial, with inconsistencies between randomized controlled trials (RCTs) and population-based observational studies. We estimated SCM impact on permanent cessation and population smoking prevalence by extrapolating efficacy estimates from meta-analyses of RCTs, using the standard population impact formula: efficacy*reach. We calculated the potential SCM impact under a range of assumptions for permanent cessation (20%,14%), behavioral support (yes/no), reach (40%–2%), and underlying smoking prevalence. Assuming behavioral support for all, depending on reach, 8%–0.3% of smokers are expected to quit permanently. Without behavioral support, permanent cessation is estimated to be 6.4%–0.2%. Assuming an underlying population smoking prevalence of 14%, (current U.S. prevalence), the maximum impact on population smoking prevalence is 1.12%. Impact on prevalence increases with increasing underlying country-specific levels of prevalence. With current U.S. levels of reach, behavioral support and smoking prevalence, we estimate that, based on a single course of treatment, 2.3% of smokers would quit permanently, contributing to a 0.3% decrease in population level smoking prevalence. Even under ideal conditions, the potential of current first-line SCMs to increase cessation in a substantial proportion of smokers, and reduce population smoking prevalence, is limited. In order to avert the predicted billion tobacco-caused deaths in this century, “safe and effective” medications are not sufficient: SCMs with high population impact are urgently needed. Policies to ensure the availability and accessibility of highly efficacious SCMs, with behavioral support, are crucial.

Modeling the Population Health Impacts of Heated Tobacco Products in Japan

Objective: We evaluated the potential population health impact of launching heated tobacco products (HTP) in Japan. Method: We use a modeling approach to project the effects of HTP use in overall mortality up to 2100 and compare those projections against a baseline scenario based on smoking rates pre-HTP launch, ie, smoking only. The model was informed using data from publicly available sources and the literature, including population size, yearly deaths, and smoking prevalence with the initial year of 2004, and births and migration from 2004 to 2065. Transitions between products were estimated from cross-sectional population surveys in Japan. Result: In a worst-case scenario, population health gains would be seen with HTPs risk about 50% lower risk than smoking. Assuming equal risk for dual use and smoking, HTP risk would need to be at least 10% lower than smoking to achieve a population health benefit by 2100. Potential reduction in life-years lost with the introduction of HTPs was 13 million by 2100 compared with smoking only. Conclusions: In credible scenarios, substantial population harm reduction will follow the introduction of HTPs in Japan.

Impact of smoke-free ordinance strength on smoking prevalence and lung cancer incidence.

Smoke-free ordinances (SFO) have been shown to be effective public health interventions, but there is limited data on the impact SFO on lung cancer outcomes. We explored the effect of county-level SFO strength with smoking prevalence and lung cancer incidence in Indiana. We obtained county-level lung cancer incidence from the Indiana State Cancer Registry and county-level characteristics from the Indiana Tobacco Prevention and Cessation Commission's policy database between 1995 and 2016. Using generalized estimating equations, we performed multivariable analyses of smoking prevalence and age-adjusted lung cancer rates with respect to the strength of smoke-free ordinances at the county level over time. Of Indiana's 92 counties, 24 had a SFO by 2011. In 2012, Indiana enacted a state-wide SFO enforcing at least moderate level SFO protection. Mean age-adjusted lung cancer incidence per year was 76.8 per 100,000 population and mean smoking prevalence per year was 25% during the study period. Counties with comprehensive or moderate SFO had a smoking prevalence 1.2% (95% CI [-1.88, -0.52]) lower compared with counties with weak or no SFO. Counties that had comprehensive or moderate SFO also had an 8.4 (95% CI [-11.5, -5.3]) decrease in new lung cancer diagnosis per 100,000 population per year compared with counties that had weak or no SFO. Counties with stronger smoke-free air ordinances were associated with decreased smoking prevalence and fewer new lung cancer cases per year. Strengthening SFO is paramount to decreasing lung cancer incidence.

Approccio integrato per la gestione di pazienti con disturbi psichiatrici-tabagisti tra U.O. CSM Catanzaro e Centro Antifumo - S.S. Ser.D. Soverato

The use of tobacco is one of the major social and health problems of our times, the leading cause of preventable death.The steady reduction in the prevalence of smoking in the general population in recent decades has not been observed in populations with psychiatric disorders.Hence a pilot project that aims to promote a territorial network between the Mental Health Services and the Anti-Smoking Centers for a global intervention strategy to combat smoking in patients with psychiatric disorders trying to create conditions of "Tobacco Services-Free", including employees, at any point inside and outside the structure.The experience made with a Protocol is particularly significant in the first place to dispel the clich&amp;eacute;s on the problem of smoking and mental illness in accordance with the scientific data present in the literature.The treatment of these patients can be successful if psychiatric services in addressing the problem offer behavioral motivational support to their patients.Collaboration with specialist Centers is essential for the treatment of addiction.Varenicline was effective in helping patients achieve abstinence or reduce the number of cigarettes smoked, and did not show a significant increase in neuropsychiatric adverse events.It is desirable that all Mental Health Services be able to carry out informational-motivational counseling onsmoking-related risks, favoring access for motivated patients to specific cessation programs in collaboration with specialized services (Anti-Smoking Centers).

Prevalence of smoking in the Kuwaiti adult population in 2014: a cross-sectional study.

The study objective was to assess tobacco smoking prevalence in Kuwaiti adults in relation to sociodemographic characteristics. A cross-sectional study survey was conducted in 2014 on 3917 Kuwaiti citizens (18–69 years) following the World Health Organization (WHO) STEPwise Approach to Surveillance (STEPS) methodology. The study assessed prevalence of self-reported ever-smoking or currently smoking tobacco products and exposure to secondhand smoke in relation to demographic and smoking-related characteristics. The prevalence of “ever smoker” in men and women was 49.9% and 4.4%, respectively, whereas the prevalence of “current smoker” was 39.2% and 3.3%, respectively. Sex (adjusted OR [AOR], 19.2 [95% confidence interval (CI) 13.0–28.3], male versus female) was significantly associated with current smoking. Among daily smokers, 87.1% used manufactured cigarettes. The average daily number of manufactured cigarettes for men and women was 21.8 and 13.0, respectively. Mean age at smoking initiation was 17.5 years (95% CI 17.2–17.9). The prevalence of secondhand smoke at home and work was 38.6% and 29.9%, respectively. Half of Kuwaiti men have smoked at some point in their life with most of these being current smokers. Secondhand smoke is a common exposure at home and work, posing serious health risks to the population.

Utility gains from reducing lung cancer morbidity and mortality from residential radon interventions in Canada

Background/Aim: Lung cancer is the leading cause of cancer mortality in Canada, and radon is the second most important cause of lung cancer. The goal is to estimate the utility gains from radon interventions in new housing, and in existing housing built without preventive measures, to reduce the burden from radon attributable lung cancer morbidity and mortality in Canada. Methods: A lifetable analysis is conducted using the 2016 population data, including mortality and smoking prevalence, the recent Canadian Cancer Registry data on lung cancer stage at diagnosis, and the results of the 2009-2011 national radon survey. Markov modelling of lung cancer incidence and survival time is conducted for small cell and non-small cell lung cancer, over a lifetime horizon and using a discount rate of 1.5%. Years lived with lung cancer morbidity are evaluated using quality of life decrements reported for local, regional and distant stages of lung cancer. Results: Installing passive preventive radon measures in new housing over a 100 years is estimated to result in an average annual increase of 5,612 discounted quality-adjusted life years, preventing an average of 2,336 lung cancer cases and 1,286 lung cancer deaths annually. Based on a radon action level of 200 (100) Bq/m3, testing and mitigation of existing housing at current rates over a 100 years is estimated to result in an average annual increase of 150 (410) discounted quality-adjusted life years, preventing an average of 35 (102) lung cancer cases and 19 (57) lung cancer deaths annually. Conclusions: Including the reduced lung cancer morbidity in addition to mortality results in larger utility gains from interventions in new and in existing housing in Canada. Future inclusion of costs of radon interventions and health care use in this lung cancer model would refine cost-effectiveness estimates of residential radon interventions in Canada.

S0747 Smoking and Ulcerative Colitis: An Overview of the National Trends

INTRODUCTION: Tobacco has a complex relationship with Inflammatory Bowel Disease (IBD). While tobacco smoking is a risk factor for poor outcome in Crohn's Disease (CD), it has shown to be protective against the development of Ulcerative Colitis (UC). Prevalence of smoking has been consistently decreasing in the United States, however, its impact on the epidemiology of IBD in this modern era is unknown. METHODS: The National In-patient Sample (NIS) Database was queried from 2005 to 2014 and hospital admissions with a primary or secondary diagnosis of IBD were included. We used ICD-9 CM coding system to identify patients with CD (ICD-9: 555.x) and UC (ICD-9: 556.x). We studied the changes in the IBD hospitalizations in correlation to the changes in the smoking prevalence in the adult U.S. population. We used the smoking data published by U.S. Department of Health and Human Services- National Health Interview Survey 2015. RESULTS: As per the National Health Interview Survey, prevalence of smoking in the adult U.S. population has decreased from 20.9 % in 2005 to 16.8 % in 2014 reflecting an overall decrease of 4.1%. Simultaneously, we noted the increase in the UC hospitalizations from 75,301 (in 2005) to 114,645 (in 2014) presenting an overall 52.2% increase in the number of hospitalizations. The highest increase in the number of UC hospitalizations was seen in patients who were between 51 to 65 years of age (67.5%). Patients between 18 to 35 and those above 65 years of age had relatively similar increase in the UC hospitalizations (54.2 % and 57.7% respectively). Using Pearson's correlation coefficient of association between prevalence of smoking in the general population and number of UC hospitalization, we found a negative linear correlation between prevalence of smoking and number of UC hospitalizations. (r = −0.781, P < 0.05). Even though the number of CD hospitalizations has also increased in the last decade, the overall percentage of increase in CD hospitalizations (43.6%) was lower compared to UC (52.2%). CONCLUSION: Our study suggests that the number of IBD hospitalizations in the US has been increasing consistently with the increase in the UC hospitalizations higher than CD. The rates of cigarette smoking were inversely correlated and fewer smokers in the US may explain the increase in UC hospitalizations. Although we do not advocate smoking in our UC patients, the protective effect of cigarettes in UC remains a fascinating unknown.Figure 1Table 1