Addressing vaccination coverage among pediatric solid organ transplant candidates and recipients in the post-coronavirus disease 2019 pandemic period of increased vaccine hesitancy.

Objective: To identify the main causes of morbidity in early childhood in Ecuador through a systematic literature review. Methodology: A bibliographic search was conducted in national and international databases between 2014 and 2025. From an initial 384 records, 40 studies that met methodological and thematic criteria were included. Results: Five main groups of morbidity causes were identified in children under five years of age: acute respiratory diseases, such as pneumonia and bronchiolitis, the leading cause of pediatric hospitalization; digestive and parasitic diseases, with over 14,000 hospitalizations for diarrhea in 2019 and parasitic prevalence up to 45%; nutritional problems, primarily chronic malnutrition (20.1%) and iron-deficiency anemia (over 100,000 cases in 2024); neurodevelopmental disorders, including autism, with official figures below international estimates; and oral health issues, with caries prevalence exceeding 60% in preschoolers and up to 87% in rural areas. Social determinants—poverty, territorial inequity, maternal education, access to clean water, and health services—were decisive factors in the disease burden. Conclusions: Early childhood in Ecuador faces a double burden of disease: persistence of preventable infectious illnesses and an increase in chronic and developmental conditions. The findings highlight the need for intersectoral policies to strengthen prevention and reduce inequalities affecting children.

Smoking remains a leading cause of preventable illness and death in the United Kingdom, but little is known about recent trends in smoking disparities between disabled and non-disabled adults, particularly in the context of the coronavirus disease 2019 (COVID-19) pandemic. We analysed UK Annual Population Survey data from 2017 to 2023 for adults aged ≥18 years. Smoking status was classified as current, ex-, or never smoker, and disability status was defined according to the Equality Act. Multinomial logistic regression was used to estimate pooled adjusted relative risk ratios (RRRs) for smoking outcomes by disability status, and then separately for periods before (2017-19) and after (2020-23) the pandemic onset. To test whether the pandemic had an effect beyond underlying trends, we fitted a joint model including survey year and a post-2020 indicator. Adjusted average marginal effects quantified absolute percentage point (pp) differences in predicted probabilities between disabled and non-disabled adults. The analytic sample comprised 1087678 adults, of whom 26.7% (n = 290536) reported a disability. In pooled adjusted analyses covering all survey years, and controlling for age, sex, education, ethnicity, marital status, and region of residence, disabled adults had higher relative risk ratios of being current smokers (RRR = 1.78; 95% CI: 1.75-1.80; P < .001) and ex-smokers (RRR = 1.44; 95% CI: 1.42-1.45; P < .001) compared with never smokers. Period-stratified analyses (not adjusted for temporal trends) showed adjusted RRRs for current smoking of 1.65 (95% CI: 1.62-1.68; P < .001) before and 1.95 (95% CI: 1.91-1.99; P < .001) after the pandemic onset. In the fully adjusted joint model accounting for temporal trends (survey year) and pandemic period, the disability × pandemic period interaction was not statistically significant (χ2 = 3.11; P = .21). Adjusted average marginal effects from the trend-adjusted model showed that disabled adults had a higher predicted probability of current smoking both before (+5.63 percentage points; 95% CI: 5.30-5.96; P < .001) and after (+4.60 pp; 95% CI: 4.25-4.96; P < .001) the pandemic onset, representing a modest narrowing of the absolute gap (difference = -1.03 pp; P = .001). Disabled adults remained substantially more likely to smoke than their non-disabled counterparts. After accounting for underlying temporal trends, the onset of the COVID-19 pandemic did not independently change this association, highlighting the continued need for disability-inclusive cessation strategies.

Abstract Introduction Carshalton in Southwest London has an established Integrated Neighbourhood Team (INT). Smoking prevalence in Carshalton is higher than elsewhere in the borough of Sutton. Data taken from the GP Patient Survey shows that 1 in 5 adults registered with a Carshalton GP are a current smoker [1] Local Tobacco Control Profiles show that smoking prevalence is back up to the level seen around 10 years ago [2]. The local authority commission a stop smoking service from Community Pharmacy and they were keen to support some out-reach work to increase quit rates in Carshalton. Aim The aim of the study was to show the impact of Community Pharmacy’s role in supporting INT priorities by conducting group consultations as an outreach concept and signposting to local community pharmacy stop smoking services. Methodology Patients recorded as smoking and registered with Carshalton GP practices were contacted to attend one of six group consultations held at various locations across Carshalton. Ethical approval was not required for this project. This one-hour group consultation was conducted by a Community Pharmacist and included measuring the Carbon Monoxide (CO) level of those attending and discussing the various ways in which people can give up smoking. The patients were then signposted to a local Community Pharmacy that provided the locally commissioned stop smoking service. Results In total, 69 patients registered to attend a group consultation. 33 patients attended 6 sessions held over a time period of 10 weeks. 79% of the smokers who attended had CO levels in the red zone over 11ppm. 82% of the patients who attended were assessed as having moderate to high nicotine dependence as validated by the Fagerstrom score [3]. 27% of patients quit smoking as validated with a low CO reading at 4 weeks. 67% of patients are still intending to quit or quitting. With 6% of patients not wanting to quit at all after attending the session. Discussion Smoking is the leading cause of preventable illness and premature death in England, with about half of all lifelong smokers dying prematurely, losing on average around 10 years of life [4]. The benefit of neighbourhood working as an integrated team incorporating Community Pharmacy is evident from this study. Community Pharmacy is often able to offer a solution to managing local health and wellbeing priorities. In this study, we were able to show the benefit of joint working between the local authority, the GP practices and the local community pharmacy network in Carshalton. 27% of people who attended did quit smoking and the feedback they gave as to why included the fact that they felt this was the first time the GP practice has reached out to help them, offered them an event to attend and then showed them where and how to get behavioural support by attending a community pharmacy. The ‘did not attend’ rate for the events was 52% and in a future study, we would like to try find out why people did not attend the events despite registering.

Urgent action needed to address the epidemiological threat of prolonged war in Gaza.

Disclosure: K. Mercado: None. N. Delcid: None. K.E. Izuora: None.Introduction: Vaccine preventable illnesses are more severe among patients with diabetes, yet the vaccination rate in this population is low. The purpose of this quality improvement project was to improve the process for pneumococcal vaccination assessment for patients with diabetes at our clinic. Methods: Following a root cause analysis, we identified inconsistent assessment of vaccination status of our patients during clinic visits as a key reason for low vaccination rates documented in the electronic medical record (EMR). We conducted a workflow analysis and identified several potential areas of modification. We implemented a specific modification that incorporated vaccine assessment into the medical assistant rooming workflow. This involved creation of a customized EMR assessment module that is based on CDC Standards for Adult Immunization Practice. Following assessment, if a patient is unvaccinated, a recommendation is made with administration or referral if patient is agreeable to receive the vaccine. Our outcome measures included successful implementation of the modified workflow and improvement of our pneumonia vaccination rates. Results: The modification to our clinic workflow was well received by our clinic staff and did not result in significant delays during actual patient encounters. We observed that the time spent conducting the vaccine assessment was usually the time patients spent waiting in the exam room before the encounter. Compared to our baseline vaccination rate of 5.7% (61/1066), so far, we have observed an increase to 8.7% after 5 months of modifying the workflow. One limitation we observed was the lack of automated communication between the EMR and the state Immunization Information System (IIS) to update vaccine information from outside our system. Conclusion: Implementation of a modification to the clinic workflow was feasible and resulted in minimal delays during the visit. The modest improvement in our vaccination rates suggests continued effort is necessary to sustain the implementation of our modifications and efforts should be directed towards improving communication between the EMR and IIS.Presentation: Saturday, July 12, 2025

Background:In low-resource environments, severe acute malnutrition (SAM) continues to be a major cause of mortality and morbidity in children under five. The objective of the present research was to identify and assess the risk factors for severe acute malnutrition in children under five. Methodology:This hospital-based descriptive cross-sectional study was carried out at Sheikh Khalifa Bin Zayed Al Nahyan Combined Military Hospital (CMH), Rawalakot, a tertiary care hospital located in District Poonch, Azad Jammu and Kashmir. The study was conducted over one year, from 1st April 2022 to 30th March 2023. A total of 260 children diagnosed with SAM based on WHO criteria were included. Data on socio-demographic characteristics, feeding practices, health-related factors, maternal status, and household conditions were collected using a structured questionnaire. Statistical analysis involved chi-square, and p&lt;0.05 was considered significant. Results:Children with SAM were more likely to belong to low-income families (p = 0.0001), have larger households (p = 0.0003), live in rural areas (p = 0.0002), and reside in joint family systems (p = 0.0029). Health-related factors, including incomplete immunization (p = 0.0001), recent diarrhea (p = 0.0001), and low birth weight (p = 0.0001), were also linked. Maternal illiteracy (p = 0.0001), inadequate antenatal care (p = 0.0001), and maternal malnutrition (p = 0.0001). Conclusion:SAM is strongly associated with inadequate nutrition, maternal and household factors, and preventable illnesses. Targeted community-level interventions are urgently needed.

Kenya continues to face a high burden of childhood mortality driven by preventable illnesses such as diarrhea, malaria, and pneumonia. Integrated community case management (iCCM) offers a strategy for mitigating this burden through community-level diagnosis, treatment, and referral. This study assessed the role of digitalization and performance management in enhancing the effectiveness of the iCCM strategy in Busia County. Using a quasi-experimental design, a comparison of iCCM intervention outcomes in Nambale sub-county with a non-iCCM comparison site in Teso South sub-county was done. Data were collected through household surveys and in-depth interviews. Results showed a significant improvement in healthcare-seeking behavior in the intervention site, with 56% of caregivers reporting that they sought care for pneumonia on the same day of symptom onset, compared to 35% in the comparison site (p = 0.031). Additionally, findings indicate that CHPs were a preferred point of care for iCCM cases in the intervention site, managing 38% of malaria cases, 19% of pneumonia cases, and 25% of diarrhea cases at the community level. This contrasts with the comparison site, where only 16, 3.7, and 0% of malaria, pneumonia, and diarrhea cases, respectively, were managed by CHPs, all differences being statistically significant (p < 0.05). The significantly higher proportion of iCCM cases managed by CHPs in the intervention site was associated with a lower reliance on facility-based care. Only 42% of ARI cases were managed at government facilities in the intervention site compared to 62% in the comparison site (p = 0.024), while just 1.9% of cases were handled at private facilities in the intervention site versus 12.2% in the comparison site (p = 0.03). These improvements were made possible by the integration of the digital tools and robust performance management practices. This combination enhanced CHWs effectiveness, strengthened health seeking behaviors, and contributed to the overall success of the iCCM strategy in the intervention area. In conclusion, digitalization and robust performance management strengthen the iCCM strategy leading to improved by improving health care seeking for childhood illnesses behaviors and reduce health system burden in low-resource settings.

Individuals with schizophrenia face significantly higher mortality rates than the general population, with a typical reduction in life expectancy of 15–20 years. This study investigated 10-year all-cause mortality and its clinical correlates in a Romanian cohort of patients with schizophrenia, using real-world clinical and hospital and forensic records. A total of 635 individuals hospitalized between 2010 and 2013 were followed for 10 years. Mortality rates, causes of death, and risk factors were assessed using Cox regression models and standardized mortality ratios (SMRs). During the follow-up, 123 patients (19.37%) died, corresponding to a mortality rate of 21.3 per 1000 person-years. The SMR was 1.58 compared to the Romanian general population. Non-violent causes predominated, with cardiovascular disease (27.64%) and infections (17.07%) being the most frequent. Violent deaths, including suicides and accidents, accounted for 17.07% of all mortality. The mean age at death was 58.97 years, reflecting a 17-year reduction in life expectancy. Age was the strongest independent predictor of mortality (HR = 1.07, p < 0.001). Use of second-generation antipsychotics (HR = 0.37, p < 0.001) and low frequency hospitalization (HR = 0.09, p < 0.001) were significantly associated with reduced all-cause and cause-specific mortality. Schizophrenia is associated with significantly increased premature mortality, primarily due to preventable physical illnesses and violent deaths. Early intervention, sustained treatment adherence, and integrated medical care are essential to improve survival outcomes.

Abstract Background Access to healthcare is essential for the wellbeing and integration of refugee and immigrant women. In Australia, women of African descent—both refugees and immigrants—encounter substantial challenges in accessing healthcare services, despite the availability of free or subsidised programs such as breast and cervical cancer screenings. This study aims to map the existing literature on healthcare access and utilisation among African refugee and immigrant women in Australia. Methodology A systematic scoping review was conducted using Levac et al.’s framework. Searches were performed in the CINAHL, Medline, Scopus, and Web of Science databases for studies published between 2014 and 2024. This process initially identified 842 records from the databases, along with eight manual entries. After removing duplicates, 471 articles were screened based on their titles and abstracts, excluding 428. Of the 43 full-text articles assessed, 20 met the inclusion criteria and were subjected to thematic analysis. Results The findings indicate that refugee and immigrant women of African origin in Australia primarily seek healthcare for breast and cervical cancer screenings, contraceptives, antenatal care, maternity services and mental healthcare. Factors affecting access include inadequate health literacy, limited knowledge of sexual and reproductive health, contraceptive options, and cancer screenings, compounded by cultural and religious beliefs, gender norms, and misconceptions. Cultural insensitivity, stigmatisation and fear of medical interventions further inhibit access to healthcare services. Additionally, language barriers and unfamiliarity with the healthcare system delay diagnoses and worsen health outcomes. The preference for traditional medicine underscores the need for culturally sensitive healthcare solutions. Addressing these challenges requires culturally tailored interventions, community engagement, and enhanced health literacy, as well as improved access to healthcare. Conclusion Women of African origin in Australia, including both refugees and immigrants, face various constraints that limit their access to healthcare services. Improved utilisation of healthcare among this population could lead to better sexual and reproductive health, enhanced maternal and child health outcomes, reduced rates of preventable illnesses, and improved mental wellbeing.

Mistrust and barriers to influenza vaccination are well-documented in the literature. Underserved populations, including the Hispanic community, experience social determinants of health that exacerbate their health outcomes, including for common preventable illnesses such as influenza (flu). There is currently a gap in the literature regarding the knowledge, barriers to access, and trust of the Hispanic community regarding the influenza vaccine. The objective of this study was to assess knowledge, barriers to access, and trust regarding the influenza vaccine among Hispanic individuals in Metro Detroit. We administered a descriptive, mixed quantitative and qualitative survey, including predominantly Likert-style statements, to nearly 120 Hispanic individuals in Metro Detroit during the influenza seasons of 2023 and 2024 at our clinic and in public community spaces to assess these three domains. We also gathered information regarding demographics and previous vaccination history. These surveys were completed both via interviewer-administered and self-reported formats. For analysis, Likert-type items were collapsed, Chi-squared tests were performed, and the significance threshold was set at p <0.05. Findings included average knowledge of the vaccine, as 34% of individuals agreed they did not need the flu vaccine if they got it the prior year, while 44% of individuals disagreed. Trust in the vaccine was high, as 67% of respondents felt government influenza vaccination programs were trustworthy. Few overall barriers to vaccination were reported, as insurance was only reported by 19% as a barrier, while time was cited as the most common self-reported barrier by 51% of respondents. Subgroup analysis showed that, on average, males and younger individuals were less likely to trust influenza vaccines. Further research is needed to address time-related barriers and increase vaccine knowledge and trust through community initiatives. Such efforts will lead to improved vaccination rates and influenza outcomes for all Hispanic individuals.

Climate change is anticipated to continue to adversely affect public health, with heat stress the predominant threat. Accordingly, heat-related illness is predicted to increase as extremely hot days become more frequent. Heat stroke, the most serious heat-related illness, is a medical emergency that may be fatal if it is not promptly recognized, addressed with early and rapid cooling, and accompanied by multidisciplinary supportive care as clinically indicated. Heat stroke is a preventable illness that occurs in 2 distinct forms-classic and exertional-that have distinct demographic profiles and clinical courses but similar management paradigms.

Background: Diarrheal diseases continue to pose a major public health burden in low-resource rural communities, particularly in Pakistan, where sanitation infrastructure and health awareness remain insufficient. These preventable illnesses disproportionately affect vulnerable populations, especially children under five, due to poor hygiene practices, contaminated water sources, and limited access to effective health education. Community-driven interventions tailored to local contexts are essential to mitigate these risks and improve health outcomes in underserved settings. Objective: To assess the effectiveness of a targeted, community-based health education intervention in improving awareness and prevention of diarrheal diseases in a rural village in Sindh, Pakistan. Methods: This participatory intervention was conducted in Punhal Khan Chandio Village through a four-phase framework: initial community assessment, educational content development, session implementation, and outcome evaluation. Risk factors such as poor hygiene (90%), unsafe water usage (85%), low health literacy (80%), improper food handling (75%), and suboptimal housing conditions (70%) were identified through informal interviews and observations. Educational sessions utilized a multi-method approach: lecture/discussion/chart-based teaching (22.7%), audio-visual aids (18.2%), and hands-on demonstrations (13.6%)—with emphasis on home-based ORS preparation. Sessions were delivered in small household settings due to infrastructure limitations. Results: Feedback indicated strong community engagement: 90% of participants reported positive reception, 85% actively participated, and 70% asked questions during sessions. Women showed particularly improved understanding of hygiene and ORS use. Key barriers included lack of public teaching spaces, absence of digital teaching tools, school closures, and no follow-up evaluation due to time and resource constraints. Conclusion: This study demonstrated that culturally sensitive, low-cost health education can significantly enhance community knowledge and engagement regarding diarrhea prevention in low-literacy, rural settings.

Flooding has become a recurring nightmare in Pakistan, exacerbated by both natural and human-induced factors. The devastating monsoon floods of 2022 exposed the country’s deep vulnerability, damaging nearly 2,000 health facilities showing 13% of all in the country, and displacing more than 600,000 people. Vast areas of farmland, including three million acres of cereal crops and over 1.2 million livestock, were lost, severely disrupting food security and livelihoods. Since July 2022, floods have inundated 116 districts, affecting 33 million people and placing immense strain on the already fragile healthcare system. More than 1,000 people lost their lives, 1,500 were injured, and over 161,000 were forced into overcrowded and unhygienic relief camps. As of now, 66 districts remain critically impacted. This crisis is not just a one-off disaster it is a symptom of worsening climate extremes, poor planning, and under-resourced public infrastructure. In 2025 alone, Pakistan has already witnessed deadly spring weather, including severe hailstorms, which claimed at least 32 lives. The 2025 Climate Risk Index ranks Pakistan as the world’s most climate-impacted country, based on data from 2022. A third of the country was submerged, over 1,700 lives were lost, and economic damages surpassed $30 billion. At least 6.4 million people still require humanitarian assistance, and healthcare access remains dangerously limited. Although roughly half of the displaced population has returned home, the absence of clean water and sanitation continues to drive the spread of disease. As the nation reels under relentless monsoon rains and deteriorating conditions, a public health emergency is unfolding silently alongside the visible destruction. The World Health Organization (WHO) has warned that flooding is fueling outbreaks of diseases such as dengue, malaria, acute watery diarrhea, COVID-19, and polio. With immunization campaigns disrupted and stagnant water everywhere, disease is spreading unchecked. Even before the floods, Pakistan had recorded over 4,500 measles cases and 15 instances of wild poliovirus. These fragile public health gains are now at grave risk. In response, the World Health Organization (WHO) and Pakistan's Ministry of National Health Services are maintaining emergency operations in the affected regions. They are concentrating on long-term preparedness, healthcare restoration, medicine supply, and disease surveillance. However, it is imperative that these endeavors be dramatically increased. Millions of individuals continue to be vulnerable to preventable illnesses due to their lack of access to basic care and proper sanitation. This crisis is no longer solely about water; it is also about the future of healthcare, resilience, and survival in a world that is warming. Pakistan's silent emergency may soon become too loud to ignore if sustained action is not taken.

ABSTRACTBackgroundOver five million children die annually from preventable and treatable illnesses. Most of these deaths occur in sub-Saharan Africa, predominantly in socioeconomically deprived regions. With nearly half of pediatric mortality occurring at the community level, serious illnesses must be detected early in the prehospital setting. The purpose of this 18-month, prospective, observational pilot study was to introduce the first use of the proinflammatory biomarker, CRP, in the prehospital setting to community health workers and to develop a prehospital predictive model to identify sick children requiring health center admission.MethodsWe recruited 636 children presenting to one of four community health worker teams who completed a prehospital evaluation and referred each child to the closest health center. The primary outcome for this study was admission at the health center for more than 24 h. We used logistic regression to quantify the area under the receiver operating characteristic curve (AUC).ResultsWe found poor discrimination of danger signs and CRP, with AUCs of 0.55 (95% CI 0.52–0.57) and 0.52 (95% CI 0.47–0.57), respectively. A model comprising vital signs demonstrated superior discrimination, with an AUC of 0.66 (95% CI 0.62–0.71), which improved with the addition of danger signs (AUC 0.69; 95% CI 0.64–0.73), and when restricted to children who tested negative for malaria (n = 327; AUC 0.71; 95% CI 0.65–0.77).ConclusionsWe demonstrate that performing advanced point-of-care tests is feasible in resource-limited community settings and present one of the first prehospital prediction models developed with community health workers.

In this Viewpoint, former members of the Advisory Committee on Immunization Practices (ACIP) caution that the sudden change in the ACIP may reverse the achievements of US immunization policy, including impeding access to lifesaving vaccines and putting US families at risk of dangerous and preventable illnesses.

Consumption of unhealthy food has become a leading cause of premature deaths and preventable illnesses around the world. Research shows that marketing by the companies that produce, distribute, and sell unhealthy foods and beverages is associated with increased consumption of these products. To date, however, limited research has focused on the cumulative exposure and impact of various modes of marketing employed to reach distinct populations. In this narrative review, we summarize 25 years of scientific evidence and findings from 108 empirical studies and 19 systematic and scoping reviews of various forms of unhealthy food marketing to adolescents (aged 13 to 17) and young adults (aged 18 to 25). These are populations often targeted by food advertising, globally. The review offers insights into young people's exposure to unhealthy food marketing, how this exposure and its impacts vary by age, socioeconomic status, and race/ethnicity, and what is known about the cumulative effects of multi-platform food marketing. Our findings reveal patterns of disproportionate exposure among lower-income and racial/ethnic minority youth, especially Black and Latinx adolescents in the U.S., across different media platforms. Additionally, more than 90% of impact studies in our sample found that exposure to unhealthy food marketing is associated with higher consumption of advertised products, with social media influencer marketing gaining an increasingly prominent role. Despite emerging evidence on multi-platform marketing, cumulative exposure remains insufficiently researched. Based on these findings, we suggest paths for future research to reduce the harmful impact of marketing unhealthy food and beverages to young people.

Cervical cancer is a preventable illness, and early vaccination can serve as a primary prevention strategy. Currently, HPV vaccination has not been introduced at the national level in Pakistan, and the vaccine remains unavailable in most regions. However, efforts are underway to launch the HPV vaccination program soon. For a successful roll-out, it is essential to address circumstantial challenges and mitigate vaccine hesitancy, which stems from a complex interplay of sociocultural and contextual factors. Therefore, this study aims to comprehensively evaluate the multifaceted sociocultural, contextual, and demographic factors influencing the uptake of HPV vaccination at the community level. 1.To assess the current level of knowledge, belief, and factors associated with the acceptability of HPV vaccination among potential vaccine recipients and their parents/caregivers 2. To explore stakeholders' perspectives on the launch of HPV vaccination, considering the dynamics of the local population in the resource-constrained country, Pakistan (OBJ 2). 3.To identify the social and behavioral factors that influence HPV vaccination acceptance and hesitancy within a local community (Punjab) (OBJ 3). The ethical approval of the study has been already obtained from the ethical review board of Rawalpindi Medical University (843 IREF/RMU/2024). Data will be collected after obtaining informed written consent from parents and assent from daughters. Data collection will start from April 2025 and will be completed in six months. Data compilation and results are expected by December 2025. A convergent mixed methods design will be used as it will enable the merging of qualitative and quantitative data. Data collection will involve a quantitative phase in which data will be collected from potential vaccine recipients (girls between 9-16 years) and their parents/caregivers to assess the current level of knowledge, belief, and HPV vaccine hesitancy. The qualitative phase aims to explore key stakeholders' perspective on the health system's preparedness and capacity for launch and uptake of HPV vaccination. The quantitative findings will be integrated with the qualitative data via the merging and expanding integration techniques to generate confirmed, expanded, and discordant meta-inferences. This study will comprehensively identify the multilevel contextual and health system factors that influence HPV vaccine uptake. This study will significantly contribute in field of Public Health by providing a foundational basis of first step of cultural adaptation and validation of BeSD tool specifically for HPV Vaccination.

Despite successful public health campaigns, tobacco use persists as a major cause of preventable illness and death. While tobacco taxation is recognized as an effective control strategy, concerns remain about potential financial strain on lower socioeconomic groups. This study investigates the relationship between household tobacco expenditure and financial stress in Australia, a country with high tobacco taxes and declining smoking rates. Household data from the 2015-16 Australian Household Expenditure Survey were analysed (N=10,036). Financial stress was measured using a scale based on nine self-reported indicators. Respondents were asked to report if their household had experienced any of these difficulties, e.g. inability to pay utility bills or going without meals. Negative binomial regression models assessed the association between tobacco expenditure share and financial stress, adjusting for sociodemographic factors, household wealth, and other expenditures. Financial stress was more prevalent among households that did (45.0%; (95% CI: 42.5, 47.5)) versus did not (25.4%) purchase tobacco. All levels of tobacco expenditure were significantly associated with higher financial stress bivariably, after controlling for covariates. For instance, households in the second-lowest tobacco expenditure share quintile had a higher mean financial stress score than non-purchasing households (RR=1.59, CI, 1.36, 1.85, p<0.001). In Australia, financial stress is prevalent among tobacco-purchasing households and household tobacco expenditure is significantly associated with increased financial stress even at modest levels of spending, i.e. the lower quintiles of tobacco expenditure. These findings underscore the need for targeted policies to mitigate financial strain and support smoking cessation among vulnerable populations. This study found that the prevalence of financial stress is higher in Australian households that purchase tobacco, regardless of their spending on tobacco. Although tobacco price increases reduce overall tobacco use, our study shows that increased prices exacerbate strain among financially disadvantaged smokers. Further research into associations between financial well-being and tobacco use is needed, both nationally and internationally. Longitudinal research should also examine the longer-term health and economic impacts mediated by financial stress.

Nicotine addiction is a leading cause of preventable illness and death worldwide. This review summarizes current treatment options, focusing on both behavioral and pharmacological methods used in Poland and internationally. Effective strategies include nicotine replacement therapy (NRT), medications like cytisine, varenicline, and bupropion, as well as structured psychotherapy. Combining medical and psychological approaches significantly improves cessation outcomes and reduces the global burden of tobacco use. Introduction Tobacco use remains a major global health issue, contributing to millions of deaths annually. Nicotine’s addictive properties make quitting challenging despite widespread awareness of its risks. Effective treatment requires a comprehensive approach, combining behavioral support and pharmacotherapy. This paper reviews current methods of nicotine addiction treatment, with an emphasis on practices in Poland and globally. Aim of the Study This study aims to present a clear overview of evidence-based nicotine addiction treatments, with a focus on therapies available in Poland. It evaluates the effectiveness of both behavioral and pharmacological interventions to support healthcare professionals in smoking cessation efforts. Materials and Methods A literature review was conducted using PubMed and Google Scholar. The study includes international and Polish guidelines, scientific articles, and clinical data related to nicotine addiction therapy. Sources span behavioral interventions, NRT, and pharmacological treatments like cytisine, varenicline, and bupropion. Conclusion Nicotine dependence is treatable through a combination of behavioral and pharmacological methods. In Poland, comprehensive treatment programs and modern pharmacotherapy are available and effective. Increasing access to these resources is essential to reducing smoking rates and improving public health.