Prevalence Of Current Smoking Research Articles

Prevalence of tobacco smoking and related factors in people aged 15 years and above in Beijing, 2014-2021

Objective: To evaluate the effect of the implementation of Beijing Smoking Control Regulation in 2015 on the smoking prevalence in people aged ≥15 years in Beijing during 2014-2021, and explore factors associated with tobacco use behavior in local population. Methods Using a pooled cross-sectional design, data from Beijing Adult Tobacco Survey in 2014, 2016, 2019 and 2021 (4 surveys) were combined into one dataset. The 4 surveys used same multistage cluster sampling procedure. After complex survey weighting, multiple logistic regression models were constructed to analyze factors influencing smoking status. Results: A total of 8 484, 9 372, 8 534 and 10 551 respondents were included in the surveys in 2014, 2016, 2019 and 2021, respectively. The smoking prevalence rate was 23.4%, 22.3%, 20.3% and 19.9%, respectively, in Beijing residents aged ≥15 years, exhibiting a linear declining trend (P=0.010). Factors associated with current smoking in men were age 25-44 years (OR=2.22, 95%CI: 1.68-2.95) and 45-64 years, (OR=2.64, 95%CI: 2.06-3.39), educational level of high school (OR=0.69, 95%CI: 0.49-0.95) and undergraduate and above (OR=0.46, 95%CI: 0.33-0.63), and awareness of smoking causing stroke (OR=0.71, 95%CI: 0.61-0.81), and awareness of smoking causing lung cancer (OR=0.53, 95%CI: 0.42-0.66), the differences were significant (all P<0.05). After controlling interfering factors, the current smoking prevalence in men in 2019 (OR=0.73, 95%CI: 0.63-0.87, P<0.001) and 2021 (OR=0.72, 95%CI: 0.61-0.88, P<0.001) were significantly lower than that in 2014. Factors associated with current smoking in women were living alone (OR=1.80, 95%CI: 1.33-2.44), educational level of undergraduate and above (OR=0.43, 95%CI: 0.27-0.69), other occupations except doctor and teacher (OR=8.54, 95%CI: 2.80-26.02) or being retired/unemployed (OR=9.39, 95%CI: 3.19-27.65), and awareness of smoking causing cardiovascular events (OR=0.58, 95%CI: 0.39-0.84), and awareness of smoking causing lung cancer (OR=0.54, 95%CI: 0.35-0.83), the differences were significant (all P<0.05). No significant change in smoking status in women was found in 4 surveys. Conclusions: The smoking prevalence rate in men in Beijing has declined since the implementation of Beijing Smoking Control Regulation 5 years, indicating the effectiveness of legislative approach in tobacco control. Socio-demographic factors and the awareness level of tobacco harm could influence smoking status. Future tobacco control programs should target the people with lower education level, young men, women living alone, and those with occupations other than teachers/doctors or the unemployed/retired and include more comprehensive health education.

A Two‐stage Bayesian Small Area Estimation Approach for Proportions

SummaryWith the rise in popularity of digital Atlases to communicate spatial variation, there is an increasing need for robust small area estimates. However, current small area estimation methods suffer from various modelling problems when data are very sparse or when estimates are required for areas with very small populations. These issues are particularly heightened when modelling proportions. Additionally, recent work has shown significant benefits in modelling at both the individual and area levels. We propose a two‐stage Bayesian hierarchical small area estimation approach for proportions that can account for survey design, reduce direct estimate instability and generate prevalence estimates for small areas with no survey data. Using a simulation study, we show that, compared with existing Bayesian small area estimation methods, our approach can provide optimal predictive performance (Bayesian mean relative root mean squared error, mean absolute relative bias and coverage) of proportions under a variety of data conditions, including very sparse and unstable data. To assess the model in practice, we compare modelled estimates of current smoking prevalence for 1,630 small areas in Australia using the 2017–2018 National Health Survey data combined with 2016 census data.

Disparities in Smoking and Heavy Drinking Behaviors by Disability Status and Age of Disability Onset: Secondary Analysis of National Health Interview Survey Data.

People with childhood-onset disabilities are living into adulthood, and the prevalence of smoking and illicit drug use among adults with disabilities is high. We evaluated the relationship between disability status and age of disability onset, current cigarette smoking status, and heavy alcohol drinking. We conducted a secondary data analysis of the National Health Interview Survey (NHIS), a US survey on illness and disability. Among 2020 NHIS participants aged 22-80 years (n = 28 225), we compared self-reported prevalence of current cigarette smoking and heavy alcohol drinking among those with and without disabilities and among those with childhood- versus adult-onset disabilities. We used adjusted logistic regression analysis to calculate the adjusted odds ratios (AORs) of current smoking and heavy alcohol drinking based on disability status and age of disability onset. Compared with adults without disabilities, adults with disabilities were significantly more likely to report current smoking (23.5% vs 11.2%; P < .001) and significantly less likely to report heavy alcohol drinking (5.3% vs 7.4%; P = .001). The prevalence of these behaviors did not vary significantly by age of disability onset. In adjusted logistic regression models, adults with disabilities had significantly higher odds of current smoking (AOR = 1.76; 95% CI, 1.53-2.03) and similar odds of heavy alcohol drinking (AOR = 0.82; 95% CI, 0.65-1.04) compared with adults without disabilities. The odds of these health behaviors did not vary significantly by age of disability onset. Adults with disabilities overall may be at high risk for these unhealthy behaviors, particularly smoking, regardless of age of disability onset. Routine screening and cessation counseling related to smoking and unhealthy alcohol use are important for all people with disabilities.

Prevalence and predictors of cigarette smoking among people with HIV in Western Jamaica

ABSTRACT With highly active antiretroviral therapy, HIV infection has become a treatable chronic disease. However, modifiable risk factors such as cigarette smoking continue to impact the morbidity and mortality of people with HIV (PWH). We assessed the prevalence and factors associated with cigarette smoking and motivation to quit among PWH in Western Jamaica. A cross-sectional study was conducted in which 392 adults seeking HIV care at health facilities in Western Jamaica completed an interviewer-administered questionnaire. Current smoking prevalence among participants was 17.4%. Current smoking was significantly associated with being male (OR = 2.99), non-Christian/non-Rastafarian (OR = 2.34), living or working with another smoker (aOR =1.86), being moderate to severely depressed (OR = 3.24), having an alcohol drinking problem (OR = 1.84), and never being asked by a healthcare provider if they smoked (OR = 3.24). Among the PWH who currently smoke, 36.7% are moderately to highly dependent on nicotine. One-third of people who smoke (33.8%) started smoking for the first time after HIV diagnosis, while 66.2% initiated smoking before; 88% were willing to quit smoking. These findings provide baseline information for designing and implementing a comprehensive smoking cessation program that considers the needs of PWH in Jamaica, with the potential of becoming a replicable model for other HIV-specialized healthcare settings in the Caribbean.

Prevalence of tobacco smoking and the knowledge and attitudes on prevention of tobacco smoking among schooling adolescents in the age group of 13 &amp;ndash; 15 years in the Kandy district in 2018

Introduction: The early age of tobacco smoking initiation among adolescents reported in Sri Lanka highlights the need to initiate tobacco prevention at a very young age.Objectives: To determine the prevalence of tobacco smoking, the knowledge, and attitudes on prevention of tobacco smoking among schooling adolescents in government schools in the age group of 13-15 years in the Kandy district in 2018.Methodology: A cross-sectional study was conducted among 1395 students in selected government schools in the Kandy district. The subjects were selected using a stratified multi-stage cluster sampling method. A pretested self-administered questionnaire was used.Results: The response rate was 97.1%. The Prevalence of ever tobacco smoking in the age group of 13 to 15 years, was 6.02% (95% CI, 4.83% - 7.40%). The prevalence of current smokers was 4.16% (3.23% - 5.24%). Satisfactory knowledge of the harmful effects of tobacco smoking was shown by 49.6% (n=692) of ever smokers. The majority (71.5%, n=997) showed favourable attitudes towards the prevention of smoking. There was a higher likelihood of smoking among students who had unsatisfactory knowledge (OR = 8.203; 95% CI = 4.142 – 16.247) and attitudes (OR=1.172; 95% CI=1.112 – 1.225) compared to students who had satisfactory knowledge and attitudes.Conclusions: The prevalence of tobacco smoking in the selected age group was high in the Kandy district compared to the national rates. School interventions should target more students who already smoke to improve their knowledge and attitudes.

PREVALENCE OF NON-COMMUNICABLE DISEASE RISK FACTOR AMONG THE ADULT POPULATION OF BHARATPUR METROPOLITAN CITY, CHITWAN, NEPAL

Background: Non-communicable diseases (NCDs) are the leading causes of disease burden worldwide. The data from Nepal indicated 6% increase in the deaths caused by non-communicable diseases from 2014 to 2018. The nationwide STEPS survey of non-communicable disease risk factor, 2019 showed high prevalence of risk factors, posing a greater threat for the NCD epidemic in future in the country. Thus, this study aims to find out the prevalence of non-communicable disease risk factors among the adult population of Bharatpur Metropolitan City in Chitwan, Nepal. Methods: A descriptive, community-based cross-sectional study was conducted among 310 respondents residing in Bharatpur Metropolitan. Four wards were selected purposively and convenient sampling was used to select the sample. A semi-structured questionnaire based on WHO NCD STEPS instrument adapted to the local context, was used to collect the data. A descriptive analysis was carried out to analyze the data. Results: The prevalence of current smoking, alcohol consumption, low intake of vegetables and fruits, raised salt intake and low physical activity was found to be 18.1%, 38.7%, 94.6%, 80% and 66.5% respectively. Regarding metabolic risk factors, the prevalence of ever-raised blood pressure, blood sugar and cholesterol was 50%, 28.4% and 17.4% respectively. Conclusions: The study revealed a high prevalence of behavioral and metabolic risk factor which varied in the age group of 40-60 years. The findings call for population specific policy and interventions and focused actions for the behavior modification through primary prevention module and behavior change communication strategy.

Validation of the Global Health Professions Students Survey questionnaire in Italy

Background: The World Health Organization, the U.S. Centers for Disease Control and Prevention (CDC), and the Canadian Public Health Association have developed the Global Health Professions Student Survey (GHPSS) questionnaire in order to collect data on tobacco use and cessation counselling among health- profession students. The aims of the study were to evaluate the reliability and validity of the GHPSS questionnaire in Italy among health-profession students and to examine the prevalence of tobacco use, knowledge and attitudes to it and tobacco cessation training among students attending Italian medical schools using the standardised GHPSS approach. Methods: Before testing tobacco use prevalence, knowledge and attitudes, and tobacco cessation training, we calculated the Cronbach’s alpha to assess the internal validity with the intention of avoiding misleading results. The questionnaire was administered to 100 health-profession students and data were collected in March 2009, during regular class sessions among students of two Italian Schools of Medicine. The original GHPSS instrument was translated into the Italian language and modified by adding three specific questions regarding I) the knowledge about the use of antidepressants, ii) Acetylcholine Receptor Partial Agonists, and iii) counselling techniques used in tobacco cessation programs. Statistical analysis was performed using SPSS 13.0, statistical software for windows. Results: Cronbach’s alpha was higher on 17 items (alpha= 0.872), belonging to section I and IV (respectively: “Tobacco Use Prevalenceú and “Behaviour/Cessationú). The addition, also, of only one more of the others items (section)made the alpha value worse. Cronbach’s alpha for section VI for all items together (n. 44 items) was 0.815, which implies that the questionnaire had a very satisfactory internal validity. The prevalence of current smokers was 33%, while only 12% of students declared to be tobacco users. Interestingly, students who were tobacco users were 80% less likely to consider that health professionals needed training on smoking cessation techniques in comparison to non tobacco users. Conclusions: The questionnaire showed excellent reliability properties in the sample studied. In terms of internal consistency and validity, it appears to have an acceptable performance. Given the high prevalence of smokers among medical students, teaching them about the damages related to tobacco use, and how to help them quit smoking or tobacco use, emerged as important issues. Further studies to investigate these important issues, using a standardized method like GHPSS, are needed.

Multiple Behavioral Risk Factors As Assets for Chronic Disease Prevention: Observations From Urban Primary Care Settings in Crete, Greece.

This study aimed to assess the health profile of patient-attendees visiting primary healthcare (PHC) practice settings in the midst of the COVID-19 pandemic and to explore the relationships between multiple behavioral risk factors (MBRFs) and consultation-driven health information. Multiple behavioral risk factors involve a variety of unhealthy behaviors that are associated with an increased prevalence of non-communicable diseases (NCDs). The study design was based on a dataset analysis, afterward exploring the feasibility and diagnostic capacity of respiratory morbidity aspects from a study previously conducted. The study dataset contained information regarding socio-demographic characteristics, health habits, clinical information, and reported comorbidities from 183 primary care patient-attendees. A categorical regression analysis was performed, using as a numeric variable the multiple MBRFs (clustering of 0to four factors) in order to examine relationships with the basic and clinical characteristics of the patient-attendees. Based on this secondary analysis, it was found that the prevalence of MBRFs is quite common among patient-attendees visiting urban PHC facilities. The prevalence of current smoking, sleep deprivation, increased body weight, and medium/high perceived stress levels were 33.9%, 52.5%, 83.1%, and 35.0%, respectively. An increased occurrence of MBRFs might be significantly predicted by the lower age of patient-attendees (b = -0.221, p = 0.05), by the absence of gray hair at an early age (b = -0.144, p = 0.042), by the physical discomfort during activities (b = 0.191, p = 0.017), or by the lower oxygen saturation (b = -0.184, p = 0.004). Diabetes mellitus (25.1%) was the most prevalent condition, followed by bronchial asthma (18.6%) and depression (15.8%). Lower age, absence of premature hair whitening, physical discomfort during activities, and lower oxygen saturation are linked with an increased occurrence of MBRFs, leading to a neglected way of living. Those factors could be used to alert researchers, policymakers, and PHC professionals to act accordingly in order to prevent or early diagnose NCDs.

Association between smoking and lack of HIV virological suppression in a cross-sectional study of persons with HIV on antiretroviral therapy in Uganda.

Smoking and alcohol use frequently co-occur and are the leading causes of preventable death in sub-Saharan Africa (SSA) and are common among people living with HIV (PLWH). While alcohol use has been shown to be associated with reduced adherence to antiretroviral treatment (ART), which may affect HIV viral suppression, the independent effect of smoking on HIV outcomes in SSA is unknown. We aimed to 1) describe the prevalence of current smoking and correlates of smoking; 2) assess the association of smoking with viral suppression, adjusting for level of alcohol use; 3) explore the relationship between smoking and CD4 cell count <350 cells/mm3, among participants who are virally suppressed. We analyzed data from the Drinkers Intervention to Prevent Tuberculosis (DIPT) and the Alcohol Drinkers' Exposure to Preventive Therapy for TB (ADEPTT) studies conducted in Southwest Uganda. The studies enrolled PLWH who were on ART for at least 6 months and co-infected with latent tuberculosis and dominated with participants who had unhealthy alcohol use. Current smoking (prior 3 months) was assessed by self-report. Alcohol use was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C, modified for prior 3 months) and phosphatidylethanol (PEth), an alcohol biomarker. We used logistic regression to estimate the cross-sectional association between smoking and lack of virological suppression (≥40 copies/ml), adjusting for level of alcohol use and other covariates, and to examine the association between smoking and CD4 cell counts among PLWH with viral suppression. Of the 955 participants enrolled from 2017 to 2021 who had viral load (VL) results, 63% were men, median age was 40 years (interquartile range [IQR] 32-47), 63% engaged in high/very high-risk alcohol use (AUDIT-C≥6 or PEth≥200 ng/mL), and 22% reported smoking in the prior 3 months. Among 865 participants (91%) with viral suppression and available CD4 count, 11% had a CD4 cell count <350 cells/mm3. In unadjusted and adjusted analyses, there was no evidence of an association between smoking and lack of virological suppression nor between smoking and CD4 count among those with viral suppression. The prevalence of smoking was high among a study sample of PLWH in HIV care with latent TB in Southwest Uganda in which the majority of persons engaged in alcohol use. Although there was no evidence of an association between smoking and lack of virological suppression, the co-occurrence of smoking among PLWH who use alcohol underscores the need for targeted and integrated approaches to reduce their co-existence and improve health.

Abstract P265: Housing Instability and Cardiometabolic Health in the Rural South: Findings From Alabama Subcohort of the Rural Study

Introduction: Housing instability may be an important determinant contributing to cardiometabolic health. However, studies have focused largely on urban contexts. Further, there may be race- and sex-related differences in housing instability, which may help explain racial and sex disparities in cardiometabolic health. We examined the association between housing instability and cardiometabolic health among rural adults and analyzed potential race and sex differences. Methods: Data are from the Risk Underlying Rural Areas Longitudinal subcohort (mean [SD] age, 48.8 [11.0] years; 70.1% women; 79.8% Black) sampled in two rural Counties in Alabama (n=903). Housing stability (range: 0-10) was defined using the Rollins Index with higher scores indicating greater housing instability. We examined multiple measures of cardiometabolic health including BMI, HDL and LDL cholesterol, triglycerides, current smoking status (yes/no), and coronary artery calcification (CAC &gt; 0). Multivariable linear and logistic regression models adjusted for age, education, and income were used to examine continuous and categorical measures of cardiometabolic health, respectively. We further examined differences by self-reported race and sex in the association between housing instability and cardiometabolic health. Results: In the overall sample, mean (SD) housing instability was 1.1 (1.6). The prevalence of housing instability (Rollins Index ≥ 1) was higher for Black participants compared to White participants (60.5% vs. 27.4%, p&lt;.0001). Housing instability did not differ by sex (52.9% women vs. 57.4% men, p=0.187). In multivariable-adjusted models, greater housing instability was associated with presence of CAC among Black participants (OR 1.12; 95% CI: 1.00, 1.26) but with lower prevalence of CAC among White participants (OR 0.49; 95% CI: 0.25, 0.90). Housing instability was also associated with higher HDL cholesterol levels (b=1.04; 95% CI: 0.08, 2.01) among Black participants and higher triglyceride levels among White participants (b=29.40; 95% CI: 0.49, 58.31). Housing instability was not associated with BMI in either group and was associated with higher prevalence of current smoking among Black participants only (OR 1.20; 95% CI: 1.07, 1.34). We did not observe statistically significant associations between housing instability and cardiometabolic health in sex-stratified analyses. Conclusion: Housing instability may be a social determinant of cardiometabolic health; however, findings were mixed and appear to vary for Black adults compared to White adults. Future research should utilize a longitudinal design to assess how changes in housing stability may affect cardiometabolic health over time.

Association of Race-Ethnicity Intersection with Disparities in Cigarette Smoking in US Adults.

Detailed estimates of disparities in cigarette smoking across single- and multi-race groups and their intersections with ethnicity are lacking. This study estimates the prevalence of self-reported current smoking among intersecting adult race-ethnicity groups in the United States. The analysis uses 2018-2019 data from the Tobacco Use Supplement - Current Population Supplement (TUS-CPS; n=137,471). Self-reported Hispanic origin and race were recoded into 19 mutually-exclusive race by ethnicity intersecting groups. Weighted race-ethnicity group smoking prevalence were compared to the overall population prevalence and one another. Compared to the US population current smoking prevalence (11.4% [95% CI=11.2%-11.6%]), smoking was particularly higher in non-Hispanic American Indian/Alaska Native (AI/AN) groups (20.7% [95% CI=17.8%-24.0%]) and non-Hispanic multiracial AI/AN/White (24.4% [95% CI = 20.3%-29.1%]) and AI/AN/Black (22.4% [95% CI = 14.4%-33.2%]) groups. Non-Hispanic single-race Asian (5.0% [95% CI = 4.4%-5.6%]) and Hispanic single-race White (7.2% [95% CI = 6.7%-7.7%]) smoking prevalence undercut the overall US population prevalence. In pairwise comparisons, smoking prevalence was higher in various non-Hispanic single- and multi-race AI/AN groups than non-AI/AN groups and was lower in various Hispanic groups than non-Hispanic groups. Smoking prevalence disparities are not monolithic across complex diversity of race and ethnicity in the US. Accurate identification of priority populations in need of targeted tobacco control efforts may benefit by acknowledging multinomial heterogeneity across intersecting racial and ethnic identities. Understanding racial and ethnic disparities in cigarette smoking can inform national strategies for reducing health inequities. This study examines cigarette smoking disparities among 19 adult intersecting race-ethnicity groups in the United States using the 2018-2019 TUS-CPS data. Results show higher smoking rates in some non-Hispanic American Indian/Alaska Native and Black groups, while lower rates are seen in Asian and Hispanic individuals. These findings emphasize the need for disaggregated data to tackle smoking disparities and guide targeted prevention efforts.

The social determinants of Aboriginal and Torres Strait Islander adults who do not smoke in regional Australia.

Commercial tobacco use was systematically embedded as a valuable commodity through colonisation that continues to be exploited for profit by the Tobacco Industry. There have been significant declines in current smoking prevalence among Aboriginal and Torres Strait Islander peoples 18 years and over, from 55% in 1994 to 43% in 2018-2019. This paper seeks to better understand smoke-free behaviours, and to systematically quantify associations between a range of SDOH and non-smoking/never-smoking among Aboriginal and Torres Strait Islander adults (≥18) living in regional Australia. To explore the social determinants of health (SDOH) related to non- and never-smoking among Aboriginal and Torres Strait Islander peoples in regional Australia. Cross-sectional analysis of the NATSIHS, weighted to the Aboriginal and Torres Strait Islander adult population living in regional Australia, was conducted. Participants were characterised as people who were current smokers, never-smokers and non-smokers (ex- and never-smokers). The social determinants of health exposures related to socioeconomic position, well-being and access to healthcare. Regional Australia is distinct from urban and remote areas, based on the ASGS Remoteness Structure (ABS) 2018-2019. Aboriginal and Torres Strait Islander adults (≥18 years) who were selected, consented and asked questions about smoking in the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS 2018/19). High income was associated with non-smoking (Prevalence Ratio [PR] = 2.07; 95% CI: 1.66-2.57) and never-smoking (PR = 2.02; 1.46-2.79), as was completing year 10 (non-smoking PR = 1.34; 1.12-1.61 and never-smoking PR = 1.56; 1.20-2.03). Better food security was associated with a higher prevalence of never-smoking (PR = 2.42; 1.48-3.98). Lower psychological distress scores were associated with non-smoking (PR = 1.30; 1.10-1.53) and never-smoking (PR = 1.56; 1.21-2.01). Never-smoking was more frequent in participants reporting no experiences of unfair treatment (PR = 1.59; 1.22-2.06). Having a usual healthcare provider was associated with non-smoking (PR = 1.38; 1.02-1.86). Positive exposure to the SDOH were associated with non- and never-smoking among Aboriginal and Torres Strait Islander adults in regional Australia. Structural and systemic changes to address the SDOH, including discrimination and racism, are expected to accelerate non-smoking behaviours and improve health outcomes for Aboriginal and Torres Strait Islander peoples.

Prevalence of smoking habits, attitudes and knowledge on counteractive strategies among a sample of healthcare employees: results of the smoking-free health environments project in the province of Palermo, Italy.

Tobacco use is responsible for over 7 million deaths annually, making smoking the leading cause of preventable mortality globally. Over the last two decades in Italy, the prevalence of smoking among physicians has consistently decreased, while it remains higher and is gradually decreasing among non-physician healthcare workers. The aim of this study was to investigate the Prevalence of smoking habits, attitudes, and knowledge on counteractive strategies among employees in the Primary Healthcare Facilities in the Province of Palermo, Italy. A cross-sectional survey was conducted between June 2020 and December 2020 through a previously validated anonymous questionnaire structured in four sections including 34 items. Data were analyzed using Stata/MP 12.1 statistical software. Overall, 2,645 participants answered the questionnaire. The prevalence of either current or former smokers was 18.6%. Based on the multivariable analysis conducted, a significantly higher frequency of current smokers was observed among male participants (AdjOR: 1.29; CI95%: 1.02-1.64) and those belonging to the Surgical Unit (AdjOR: 1.92; CI95%: 1.27-2.90). Conversely, the prevalence of current smokers was significantly lower among those with at least one child (AdjOR: 0.67; CI95%: 0.49-0.91), with an educational qualification equal to or greater than a graduation degree (AdjOR: 0.56; CI95%: 0.43-0.73), those who considered second-hand smoke harmful (AdjOR: 0.06; CI95%: 0.008-0.60), those who had observed smoking or detected the smell of smoke in their workplace (AdjOR: 0.64; CI95%: 0.45-0.91). Furthermore, the prevalence of current smokers was significantly lower among participants who believed that healthcare professionals could play a crucial role in influencing their patients' lifestyles (AdjOR: 0.67; CI95%: 0.50-0.90) and among those who recommend their patients to quit smoking (AdjOR: 0.35; CI95%: 0.24-0.51). The results of the current research demonstrate that, despite the decline in smoking prevalence among physicians, the rate of smokers among healthcare facility employees remains unacceptably high. This underscores the need to re-evaluate current anti-tobacco strategies in the workplace.

The Diversity in Tobacco Use Among Women of Reproductive Age (15-49 Years) in Pakistan: A Secondary Analysis of a Multiple Indicator Cluster Survey 2016-2018.

Tobacco use in women of reproductive age group (15-9 years) may contribute to poor maternal and child health outcomes. We estimated the prevalence of smokeless tobacco (ST), cigarette, and waterpipe use among these women in Pakistan and explored associations with socio-economic differences and birth weights after recent childbirths (past 2 years). We used the Multiple Indicator Cluster Surveys datasets from three provinces in Pakistan. Prevalence was generated for current use of tobacco among women with recent childbirth (WWRC) and without recent childbirth (WWoRC). We further compared socio-economic status and birth weights between tobacco users and non-users. The prevalence of current ST use was 1.4% and 2.5%, and waterpipe smoking was 1.2% and 1.8%, in WWRC and WWoRC, respectively. ST use varied across Pakistan's provinces by 13 percentage points in WWRC and WWoRC while waterpipe smoking by 10 and 15 percentage points, respectively. The odds of using any form of tobacco were significantly lower with higher levels of education or wealth index. Compared to children born to mothers who did not use tobacco, the birth weight of children born to mothers who smoked waterpipe was on average 0.83 kg (95% CI -1.6 to -0.1) lower whereas it was 0.33 kg (95% CI -0.9 to 0.3) higher for ST users. Tobacco use among women of reproductive age in Pakistan varied significantly based on province and tobacco type. Waterpipe smoking was associated with a reduction in birth weight. Raising awareness of the harms of tobacco use among women of reproductive age and targeting interventions in high-burden regions of Pakistan should be prioritized. The prevalence of current smokeless tobacco use and waterpipe smoking varied significantly in Pakistan (~13 and ~15 percentage points, respectively) among women of reproductive age, and there seems to be little change in tobacco use behavior around pregnancy and early motherhood. The study highlights a need to better understand the prevalence of tobacco use in Pakistan, and further contextual research is warranted to understand the reasons for such high tobacco use in certain areas. This information highlights the need for improving current tobacco control interventions and policies, including measures that could help reduce its use and prevent its uptake. Furthermore, compared to children born to mothers who did not use any form of tobacco, we found a statistically significant difference (830 g) in birth weight for babies born to mothers who at the time of the interview smoked waterpipe and a non-statistically significant difference of about 330 g for children born to mothers who at the time of the interview used smokeless tobacco. In addition to our findings, some literature suggests the association of waterpipe smoking with low birth weight. A possible explanation could be the exposure to smoke that contains toxicants from the tobacco product itself in addition to the burning of charcoal, which is required when using waterpipe. Waterpipe smoking also results in high exposures to carbon monoxide and polycyclic aromatic hydrocarbons, which are known to be carcinogenic and teratogenic. In terms of smokeless tobacco use, further research is warranted to understand its impact on birth outcomes through longitudinal studies accounting for diverse products, its constituents and the amount of consumption.

Impact of regulatory tightening of the Hungarian tobacco retail market on availability, access and cigarette smoking prevalence of adolescents

IntroductionPolicies that reduce tobacco retail density to decrease tobacco use among the youth are critical for the tobacco endgame. This paper reviews a Hungarian tobacco regulatory measure, which, since 2013,...

Cigarette smoking behaviors and nicotine dependence at the intersection of sexual identity and sex in the United States: Findings from the National Survey on Drug Use and Health

Introduction: Cigarette smoking is disproportionately high among lesbian, gay, and bisexual (LGB) adults. Yet, collapsing these identities into a monolith can disguise important within group disparities (e.g., lesbian/gay versus bisexual female). The purpose of this study is to report recent national prevalence estimates and trends of cigarette smoking behaviors and nicotine dependence by sexual identity and sex. Methods: Data were from the 2015–2019 National Survey on Drug Use and Health (n = 210,392; adults 18+), a nationally representative, repeated cross-sectional study of substance use and mental health in the U.S. We examined bivariate and multivariable associations between sexual identity and cigarette smoking measures (i.e., former smoking, lifetime smoking, current smoking, current daily smoking, nicotine dependence) by sex. We also examined linear time trends in current and former smoking. Covariates included age, race/ethnicity, education, annual household income, and survey year. Results: Bisexual women had the highest unadjusted prevalence of current smoking (31 %) and lowest of former smoking (25 %). LGB females and males had higher adjusted prevalence of current smoking, daily smoking, and nicotine dependence than heterosexual adults. Bisexual females and gay and bisexual males had lower adjusted prevalence of former smoking (adjusted prevalence ratio range: 0.78–0.85) than heterosexual counterparts. Discussion: This is the first study to identify disproportionately low prevalence of former smoking among bisexual females. Paired with findings of high prevalence of current cigarette smoking and nicotine dependence, these data suggest that tobacco control interventions targeted toward bisexual females are urgently needed to reduce the burden of cigarette smoking among these individuals.

Tobacco use and its associated factors among Bachelor’s level public health students of Koshi Province

Tobacco use and its associated factors among Bachelor’s level public health students of Koshi Province

Factors associated with intentions to quit tobacco use in Lebanon: A cross-sectional survey

IntroductionThe prevalence of tobacco smoking in Lebanon is among the highest globally. This study aims to determine past attempts to quit smoking among adults and identify factors associated with intentions to quit. MethodsA nationally representative telephone survey was conducted between June and August 2022. Eligibility criteria included people aged >=18 years residing in Lebanon. The questionnaire was divided into three components: socio-demographic characteristics, cigarette and waterpipe tobacco use behaviours. Binary logistic regression was used to examine factors associated with intention to quit cigarette and waterpipe tobacco use. ResultsA total of 2003 respondents were included in the study. The prevalence of any tobacco product use was 41%, the prevalence of current cigarette smoking was 41% and the prevalence of current waterpipe tobacco use was 20%. Approximately 24% of adults who smoke cigarettes and 26% of those who use waterpipe tobacco had previous quit attempts mainly due to health concerns. Intentions to quit smoking within the next 6 months were reported among 12% of survey respondents. Among adults who smoke, past quit attempts increased the likelihood of intentions to quit cigarette smoking by 5-fold (OR: 5.11; 95% CI: 1.80–14.47, p = 0.002) and waterpipe tobacco use by 7-fold (OR: 6.98, 95% CI: 2.63–18.51, p = <0.001). Age and income were associated with intentions to quit cigarette but not waterpipe tobacco use. ConclusionIntention to quit smoking was strongly associated with past quitting attempts. Understanding factors associated with intentions to quit can help inform the development of context specific smoking cessation interventions.

Prevalence and correlates of current cigarette smoking among transgender women in Argentina.

To assess the prevalence of current cigarette smoking among transgender women in Argentina, and to examine the unique associations of current cigarette smoking with demographic and psychosocial factors. This study is a secondary data analysis of the TransCITAR - a prospective cohort study of transgender individuals living in Buenos Aires, Argentina - baseline data. The baseline survey collected information on sociodemographic characteristics, perceived health status, depressive symptoms, suicide attempts, current cigarette smoking, alcohol use disorder, and substance use. Participants were also asked about lifetime experiences of physical and sexual violence perpetrated by partners, clients and/or the police, and experiences of gender identity stigma in the past year from healthcare workers and the police. Lastly, participants were asked if they had ever been arrested. Fisher's exact test was used to compare proportions in categorical variables and student t-test was used for continuous variables. Significant associations with current cigarette smoking were tested in a logistic regression model adjusted for all significant associations. A total of 41.7% of participants (n = 393) reported current cigarette smoking. Compared to their non-smoking counterparts, participants who reported current cigarette smoking (1) had completed less education, (2) were more likely to be born in Argentina, (3) more likely to had migrated to Buenos Aires from other parts of the country, (4) more likely to report a history of sex work, (5) more likely to perceive their health as excellent, (6) more likely to screen positive for hazardous alcohol drinking, (7) more likely to report any substance and cocaine use in the past year, (8) more likely to experience gender identity stigma from the police in the past year, and (9) more likely to being arrested in their lifetime (all p's < 0.05). After controlling for all significant associations, education level of less than high school (AOR = 1.79, 95% CI 1.02-2.12), hazardous drinking (AOR = 2.65, 95% CI 1.30-5.37), and any substance use in the last year (AOR = 2.14, 95% CI 1.16-3.94) were positively and independently associated with current cigarette smoking. Among transgender women in Argentina, current cigarette smoking was more than double the rate for cisgender women. Current cigarette smoking was associated with education, hazardous drinking, and any drug use. These results will inform future smoking cessation interventions among transgender women in Argentina.

Comparison of Cardiovascular Health Profiles Across Population Surveys From 5 High- to Low-Income Countries

BackgroundTo facilitate the shift from risk-factor management to primordial prevention of cardiovascular disease, the American Heart Association developed guidelines to score and track cardiovascular health (CVH). How the prevalence and trajectories of a high level of CVH across the life course compare among high- and lower-income countries is unknown. MethodsNationally representative survey data with CVH variables (physical activity, cigarette smoking, body mass index, blood pressure, blood glucose, and total cholesterol levels) were identified in Ethiopia, Bangladesh, Brazil, England, and the US for adults (aged 18–69 years and not pregnant). Data were harmonized, and CVH metrics were scored using the American Heart Association guidelines, as high (2), moderate (1), or low (0), with the prevalence of high scores (better CVH) across the life course compared across countries. ResultsAmong 28,092 adults (Ethiopia n = 7686, 55.2% male; Bangladesh n = 6731, 48.4% male; Brazil n = 7241, 47.9% male; England n = 2691, 49.5% male, and the US n = 3743, 50.3% male), the prevalence of high CVH scores decreased as country income level increased. Declining CVH with age was universal across countries, but differences were already observable in those aged 18 years. Excess body weight appeared to be the main driver of poor CVH in higher-income countries, and the prevalence of current smoking was highest in Bangladesh. ConclusionsOur findings suggest that CVH decline with age may be universal. Interventions to promote and preserve CVH throughout the life course are needed in all populations, tailored to country-specific time courses of the decline. In countries where the level of CVH remains relatively high, protection of whole societies from risk-factor epidemics may still be feasible.