Smoking Rates Research Articles

Smoking Among Healthcare Professionals in Australia: A Scoping Review

Studies showed healthcare professionals who are non-smokers are more likely to deliver smoking cessation advice to their patients than those who are smokers. However, healthcare professionals continue to smoke across the globe. This scoping review assessed the available data on the prevalence and predictors of smoking among healthcare professionals in Australia. Following the PRISMA extension for the Scoping Review checklist, a systematic literature search was conducted on CINAHL, MEDLINE, APA PsycINFO, Scopus, Web of Science, and Cochrane Library in August 2024. Articles published between 1990 and 2024 were considered, and finally, 26 papers met the inclusion and exclusion criteria. Australian healthcare professionals showed varying smoking prevalence. For physicians, it was 10.2% in 1990 to 7.4% in 2013; among dentists, 6% in 1993 to 4.9% in 2004; and among nurses, 21.7% in 1991 and 10.3% during 2014–15. The highest smoking rates were observed among Aboriginal health workers (AHWs): 63.6% in 1995 to 24.6% in 2021. Age was a positive predictor for smoking among nurses, and so was male gender among dentists, physicians, and nurses; other predictors included area of specialty, lower emotional wellbeing, etc. This review highlighted a declining trend in smoking among healthcare professionals in Australia; however, it was not proportionate among the different health specialties.

Outcomes of Brain Metastasis from Lung Cancer

Background/Objectives: Little information has been published on patients diagnosed with brain metastasis secondary to lung cancer. Correlating outcome patterns (hospice care, lost to follow-up, death before hospice care or treatment) and specific characteristics of treated and untreated patients may identify subsets of patients who may benefit from treatment. Methods: We evaluated data from the Kentucky Cancer Registry and identified 284 cases who were diagnosed with brain metastasis secondary to non-small cell lung cancer (NSCLC) between 1 August 2016, and 31 December 2019. We evaluated type and timing of treatment received, as well as focused on those patients who did not receive treatment. For those patients who did not receive treatment, various characteristics that may have impacted their decision or ability to undergo follow-up were also evaluated. This included social history, disease burden, as well as oncology treatment timelines. Lastly, due to the high smoking rate in Kentucky, we conducted an analysis of patient tobacco use. Results: Our results show that 61 cases (21.8%) never received treatment for lung cancer with brain metastasis. Further analysis of the non-treated cases demonstrated that 19 cases (31.1%) never met with an oncology team while in the hospital or after discharge; 14 of the 61 cases (23.0%) were too sick to receive treatment and died prior to having the option of treatment; and 47 of the 61 cases (77.0%) may have had the option of treatment but declined. Conclusions: Historically, patients with brain metastases have faced poor prognoses and limited treatment options. However, advancements in systemic chemoimmunotherapy and targeted therapies have introduced new treatment possibilities, offering improved symptom control and the potential for prolonged survival. This analysis is crucial for identifying potential barriers to care, optimizing resource allocation, and guiding future research.

Association Between a Family Caregiver's Relationship to Persons With Dementia and Cardiovascular Disease by Race and Ethnicity: A Secondary Analysis of the Behavioral Risk Factor Surveillance System Data.

Caregiver stress is linked to key mechanisms for developing cardiovascular disease and the burden differs by caregiving relationship (eg, spouse). Furthermore, cardiovascular disease risk in family caregivers (FCGs) has been shown to differ by race and ethnicity. However, little is known about whether the association between caregiving relationship and FCGs' cardiovascular health differs by race and ethnicity. This study examined the association between an FCG's relationship to persons with dementia and risk factors for cardiovascular disease and cardiovascular disease conditions and identified how these associations differed by race and ethnicity in FCGs. This was a secondary analysis of the 2015-2020 Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System data. Logistic regression models were used to examine the associations between predictors (caregiving relationship, race/ethnicity, and their interaction) and outcomes (cardiovascular disease risk and conditions). A sample of 6042 FCGs of persons with dementia were included. When analyzing race/ethnicity groups as a whole, cardiovascular disease risk and conditions differed significantly by caregiving relationship. Notably, spouse caregivers were at higher risk of diabetes, stroke, angina, and myocardial infarction, while showing lower rates of current smoking, heavy drinking, and obesity, compared to adult children. The associations between caregiving relationship and select cardiovascular disease risk factors (depression, previous smoking) differed significantly between racial and ethnic groups. There is a need to develop culturally appropriate cardiovascular preventive health care strategies that reduce cardiovascular disease risks by considering caregiving relationship. Research is especially needed among minoritized racial and ethnic FCG groups.

Spiritual Approach and Tiered Counselling as a Non-Pharmacological Therapy to Control Smoking Behavior of Elderly Women in Dieng

Background: The religious atmosphere and various efforts to prevent smoking behavior in the Dieng Plateau have not raised awareness of smoking cessation, especially for elderly female smokers, even though the number of Acute Respiratory Tract infections and chronic respiratory disorders is increasing. To reduce smoking behavior, tiered counseling efforts and spiritual approaches can be used as alternative steps. Objectives: This research was to determine the reduction in smoking rates among elderly women in the Dieng Plateau after being given a spiritual approach as a non-pharmacological therapy. Methods: The type of research used was a quasi-experiment that provided pharmacological therapy (spiritual approach) to the control and intervention groups. Results: The research results showed that the smoking reduction rate was more significant after being given the spiritual approach intervention than the tiered counselling. The mean knowledge of the spiritual approach group was (95.37) and the tiered counselling group was (91.96) with a mean difference of 3.41. Therefore, health promotion using a spiritual approach is more effective in increasing the willingness of elderly women to control their smoking behavior compared to the multi-level counseling media. Conclusion: This study concludes that a spiritual approach is more effective than tiered counselling in reducing smoking rates among elderly female smokers in the Dieng Plateau. However, integrating both methods can better empower elderly women to control their smoking behavior and improve their overall health outcomes.

Study of Demographic Characteristics, Management Details and Early Life Outcomes of Indigenous Infants With Chronic Neonatal Lung Disease in North Queensland.

To study the demographic characteristics, risk factors, management details and clinical outcomes to 12 months corrected age in indigenous and non-indigenous infants with chronic neonatal lung disease in North Queensland. Retrospective cohort study of infants with chronic neonatal lung disease admitted to a tertiary neonatal intensive care unit in regional Queensland from January 2015 to December 2019. There were 139 infants with chronic neonatal lung disease and 425 controls. The incidence of chronic neonatal lung disease in infants born at < 33 weeks gestational age was 32.6% versus 20.4% in indigenous and non-indigenous infants, respectively (OR 1.8, p value 0.001). Indigenous infants had significantly lower birth weight (830 g vs. 1000 g, p value 0.039), higher rate of maternal smoking during the pregnancy (57.4% vs. 25%, p value < 0.001), were less likely to be inborn (71.4% vs. 88.2%, p value 0.017) or receive adequate course of antenatal corticosteroids (30.2% vs. 59.2%, p value < 0.001), had increased incidence of grade 2 intraventricular haemorrhage (17.5% vs. 4%, p value 0.01) and were more likely to reside in a very remote locality (17.4% vs. 3.9%, p < 0.001). Identified risk factors for chronic neonatal lung disease included lower birth weight (OR 0.99, p value 0.014), lower birth gestation (OR 1.57, p value 0.003), longer duration of continuous positive airway pressure (OR 1.004, p value < 0.001), longer duration of humidified high-flow nasal prongs (OR 1.003, p < 0.001), doses of surfactant (OR 1.55, p value 0.038) and receiving post-natal steroids (OR 19.03, p < 0.001). There were no other significant differences in comorbidities, management, complications, number of hospital admissions or weight to 12-months corrected age. Indigenous infants had increased antenatal risk factors for chronic neonatal lung disease and account for a disproportionate number of cases, however, their outcomes to 12 months corrected age were similar to non-indigenous infants.

Trends in the Prevalence of Korean Adolescent Smokers According to Smoking Cessation Policy and COVID-19

This study evaluates the influence of smoking cessation policies and COVID-19 on the prevalence of smoking among Korean adolescents from 2011 to 2020. Based on the Korea Youth Risk Behavior Web-based Survey, trends in adolescent smoking behaviors were examined, including the impact of cigarette price increases, Pictorial Warning Labels (PWLs), and the onset of COVID-19. We used joinpoint regression analysis to discern annual changes in the prevalence of adolescent smokers. Results indicate that the implementation of increased cigarette prices and pictorial warnings was associated with a significant decrease in smoking prevalence among adolescents. We found a yearly reduction in smoking prevalence by 10.5% for cigarette-only smokers, 10.3% for e-cigarette-only smokers, and 9.2% for those who used both. The onset of COVID-19 further accelerated the decline in adolescent smoking. The findings suggest that the Korean government’s smoking cessation strategies and pandemic-related changes have effectively reduced smoking rates among adolescents.

Impact of warning pictorials and size on perceived effectiveness of cigar warning labels in a nationally representative between-subjects experiment

BackgroundPeople who smoke cigars often have misperceptions about the associated risks, contributing to rises in smoking rates. This study investigates the perceived warning effectiveness (PWE) of health warning labels (HWLs)...

Appreciation of intensive care unit staff regarding cardiological and neurological risk factors

Introduction: the number of cardiovascular, neurological and psychological diseases has increased over time due to changes in working conditions in the health system. Objective: determinar los factores de riesgo cardiológicos y neurológicos y sus elementos asociados en pacientes de una UTI.Methods: observational, descriptive study of medical and non-medical personnel working in the intensive care unit of Hospital HIGA Luisa C. de Gandulfo de Lomas de Zamora, in the southern area of Buenos Aires province. To obtain the information we used a survey based on cardiovascular and neurological risk factors. Results: 10 % had hypertension and 60 % were smokers. Sixty percent were of normal weight, 45,5 % were overweight and 21 % obese; in addition, 73 % were physically active. Neurological factors such as fatigue were reported by 82,2 %, and 90 % experienced stress. 82,8 % of the respondents had more than one job.Conclusion: the health of intensive care unit (ICU) staff is compromised by factors such as chronic stress, long working hours and exposure to intense situations. These aspects contribute to an alarming rate of hypertension, dyslipidemia and smoking, as well as neurological problems such as fatigue. It is crucial to implement strategies that address these challenges, including psychological support and policies that promote work-life balance, to improve staff well-being and the quality of patient care

A comparative analysis of smoking status among the Roma and the general population during pregnancy: The critical role of midwives in smoking cessation.

Tobacco consumption poses severe health risks, particularly for pregnant women, where it exacerbates maternal and fetal morbidity and mortality. This issue is especially critical among minority groups such as the Roma, who face unique socio-economic and cultural challenges that contribute to higher smoking rates. This study investigates the smoking behaviors of pregnant Roma women and the general population, highlighting the role of midwives in smoking cessation. The study involved 142 pregnant women, split equally between Roma women from specific regions in Greece and their counterparts from the general population in 2023. We conducted data collection through multiple site visits, utilizing a comprehensive questionnaire that covered aspects like tobacco use, exposure to passive smoking, and the role of midwives. We performed statistical analysis using SPSS, focusing on differences between the two groups using chisquared tests and linear regression analyses. We noted significant differences between the groups in age, education level, income, and living conditions (p<0.05). The Roma participants displayed a higher prevalence of smoking during pregnancy (76% vs 54.9%, p=0.018). A higher proportion of the Roma group exhibited moderate to high nicotine dependence compared to the non-Roma group, with 27.8% having moderate and 24.1% having high nicotine dependence (p=0.029). The study also found that Roma women are less likely to have structured healthcare support (17.2% had monitoring from a specific doctor compared to 78.9% of non-Roma, p=0.020) and more likely to engage midwives in discussions about smoking cessation (56.5% vs 48.7%, p=0.024). The findings emphasize the need for culturally informed healthcare interventions that enhance the training of midwives in smoking cessation techniques. Such approaches are vital for improving health outcomes for pregnant women within marginalized communities like the Roma, where socio-economic and cultural barriers significantly influence health behaviors.

Unveiling rural and Appalachian disparities in cigarette smoking through the social vulnerability index and other county-level characteristics.

Mitigating tobacco-related disparities in the Appalachian region and rural areas is crucial. This study seeks to gauge cigarette smoking prevalence in Virginia counties, uncover rurality and Appalachian-linked disparities, and explore local drivers of these gaps. A 2011-2019 Virginia BRFSS data were used to estimate county-level cigarette smoking rates in adults aged 18 or older. Counties were categorized as urban/rural and Appalachian/non-Appalachian, with a focus on rural-Appalachian. Disparities in cigarette smoking rates and associated factors were analyzed via the Blinder-Oaxaca decomposition method. The study assessed 4 dimensions of the Centers for Disease Control and Prevention's social vulnerability index (SVI): socioeconomic, minority status, household composition, and housing. Additionally, county-specific factors such as tobacco agriculture, physician availability, coal mining, and tobacco retailer density were examined. Rural areas exhibited a 6.18% higher cigarette smoking prevalence compared to urban areas (P<.001). SVI dimensions accounted for 53.2% of the disparity, county features explained 16.4%, and 30.4% remained unexplained. Appalachian areas had a 6.79% higher cigarette smoking prevalence than non-Appalachian areas (P<.001). SVI dimensions explained 51.4% of the disparity, county features accounted for 21.8%, leaving 26.8% unexplained. Rural-Appalachian areas showed a 7.8% higher cigarette smoking prevalence (P<.001). SVI dimensions contributed to 51.7% of the disparity, county features explained 9.6%, and 38.7% remained unexplained. Substantial disparities in cigarette smoking prevalence exist in underserved areas of Virginia, including rural, Appalachian, and rural-Appalachian regions. While SVI dimensions, physician availability, tobacco agriculture, and coal mining contribute, yet notable gaps remain unexplained. Targeted interventions must tackle unique challenges in disadvantaged areas to reduce smoking and promote health equity.

Tailored text-messaging versus standard Quitline telephone counselling for smoking cessation among people who smoke from a low-socio-economic status background in Australia: A study protocol for a non-inferiority randomized controlled trial (The Quit By Phone Study).

Signficant inequalities in tobacco smoking exist, with higher smoking rates among people from low-socio-economic status (low-SES) populations. Tailored technology-based programs for low-SES smoking populations have the potential for high reach, but require effectiveness data from large-scale trials. This trial among Australians who smoke from a low-SES background will determine the effectiveness and cost-effectiveness of tailored text-message (TTM) support compared with standard Quitline (SQL) telephone support service. This is a two-arm, parallel group, randomized, non-inferiority trial with allocation concealment and blinded outcome assessment in an Australian population within the greater Sydney region in New South Wales. Participants are adults who smoke daily (n = 1246), are interested in quitting and currently receiving a government pension or allowance, and will be recruited via advertisements. Participants will be randomized (1:1 ratio) to receive either 12 months of TTM quit support or enrolment in SQL telephone support. Assessments will be completed at baseline (telephone interview), within 1 month (check-in call), at 3months (on-line questionnaire) and 12 months (telephone interview) post-randomization. The primary outcome will be 6-month continuous abstinence verified by carbon monoxide breath test at 12-month follow-up. The study will test whether TTM is non-inferior to SQL by a non-inferiority margin of 2%, i.e. the quit rate in the TTM group will be no worse than 2% less than the quit rate in the SQL group. Secondary outcomes will include self-reported continuous and point prevalence abstinence and acceptability and cost-effectiveness of TTM versus SQL. Should the tailored text-message support prove non-inferior and more cost-effective than Quitline for this population, this will provide an opportunity for the upscaling of an effective, inexpensive and tailored quit support service. The trial findings will inform cessation treatment policy for priority populations in Australia and globally.

Relationship between Cancer Incidence and Health Behaviors from Ecological Study in Korea.

The aim of this ecological study was to examine the correlation between cancer incidence and health behaviors such as smoking, alcohol consumption, and obesity, and investigated whether there were differences in this correlation between metropolitan areas and other regions. Data on health behaviors exposure/prevalence and cancer incidence rates for 227 administrative districts (cities and counties) were obtained. The average exposure proportion measured annually from 2008 to 2011 in the Korea Community Health Survey data and the age-standardized cancer incidence data from 2014 to 2018, obtained through the cancer registry data, were downloaded from the Statistics Korea website. To examine the relationship between smoking, alcohol consumption, obesity exposure rate (prevalence), and cancer incidence, a correlation analysis was conducted, and Pearson's correlation coefficient was calculated. The correlation coefficient between male smoking and male cancer incidence rate across 227 districts was 0.259. This significance was more pronounced in large metropolitan areas, where the correlation coefficient was 0.631 in the 73 districts belonging to these areas. In large metropolitan areas, the correlation coefficient between alcohol consumption rate and cancer incidence rate was 0.390. In the correlation analysis between obesity prevalence and cancer incidence rate, no correlation was found in large metropolitan areas, while in areas outside of large cities, the correlation coefficient was -0.295, indicating a significant negative correlation. This ecological study demonstrated that the relationship between cancer incidence and health behaviors differed between large metropolitan areas and areas outside of large cities.

Religion, Religiosity, and Smoking Among Older Adults: Results from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), 2019-2021.

Religion and religiosity have long been associated with various health outcomes and behaviors. This study explored the relationship between religion/religiosity and smoking among 8,703 participants enrolled in The Brazilian Longitudinal Study of Aging (ELSI-Brazil). The logistic regression model was used to test this association, which was then adjusted for sociodemographic factors, health indicators, and alcohol consumption. The results evidenced a negative association between smoking and religious affiliation, as well as the frequency of religious attendance. These results suggest that incorporating religious and spiritual considerations into health care strategies could be beneficial in reducing smoking rates among the elderly population, potentially improving overall health outcomes within this group.

Factors associated with not smoking among Aboriginal and Torres Strait Islander adolescents and young people: Analysis of data from the 2014 to 15 National Aboriginal and Torres Strait Islander Social Survey.

Smoking rates have been steadily declining among Aboriginal and Torres Strait Islander people. Examining the factors associated with not smoking in young people is crucial for understanding the motivations and influences that lead individuals to adopt healthy behaviours. Secondary analysis was undertaken of data collected as part of the National Aboriginal and Torres Strait Islander Social Survey (NATSISS) 2014-15 (n = 1456). Factors associated with not smoking were explored with three multivariate regressions: (1) socio-demographic characteristics; (2) health, social and emotional factors; and (3) cultural identity characteristics. Overall, 66% of Aboriginal and Torres Strait Islander young people aged 15-24 years did not smoke. Factors associated with not smoking included being younger, female, and engaged in study or employment. Those who lived with no smoking in the house, had lower illicit drug and alcohol use, and participated in Aboriginal or Torres Strait Islander sports carnivals were also more likely to be non-smokers. Study findings reinforce the influence of social determinants on smoking behaviour. Efforts to reduce smoking among Aboriginal and Torres Strait Islander young people should focus on removing barriers to education and employment, promoting positive peer and family influences within households, taking a multi-drug approach to cessation, and considering cultural identity and its role in promoting healthy lifestyles. SO WHAT?: Understanding the protective factors associated with not smoking in young Aboriginal and Torres Strait Islander people will help with developing effective policies and initiatives to improve health outcomes.

Comparison of smoking behaviors and associated factors between HIV-infected and uninfected men in Guilin, China: a case-control study.

Smoking is highly prevalent among HIV-infected individuals and is associated with high morbidity and mortality. Studies on smoking among HIV-infected individuals in China, especially compared to uninfected individuals, are scarce. This study aimed to investigate and compare the prevalence and factors associated with smoking between HIV-infected and uninfected men in Guilin, China. A survey was conducted among 1,395 HIV-infected men at Guilin Third People's Hospital from June to December 2022, with a 1:2 age (±1 year) and education-matched control group of 2,790 HIV-uninfected men, whose data were collected from March to August 2023. Both groups completed an online questionnaire on smoking behaviors and relevant characteristics, with a comparative analysis of associated factors conducted using chi-square tests and multivariable logistic regressions. The rates of former smokers were comparable between HIV-infected and uninfected men [12.3% (95% CI: 10.7-13.9%) vs. 12.0% (95% CI: 10.9-13.1%)], but the current smoking rate was significantly higher in the infected group than in the uninfected group [37.6% (95% CI: 35.2-40.0%) vs. 27.6% (95% CI: 25.9-29.3%), p < 0.05]. In both groups, the following factors were significantly associated with smoking: higher income, presence of chronic diseases, negative coping styles, lower social support, and having depression, anxiety, and suicidal ideation. Additionally, in HIV-infected men, the following factors were exclusively associated with smoking: heterosexual HIV transmission route, lower CD4+ T cell count, longer duration of antiretroviral therapy (ART), and drug use. HIV-infected men had higher smoking rates than their uninfected counterparts, indicating that HIV diagnosis may be a critical timing to initiate behavioral changes and deliver smoking cessation interventions. Furthermore, multiple demographic, clinical, and psychosocial factors were associated with smoking, indicating the need to develop and implement comprehensive smoking cessation prevention and intervention programs.

Association Between Chlamydia trachomatis and Helicobacter pylori with Inflammation in Polycystic Ovary Syndrome: A Cross-Sectional Study.

Objective: Chronic low-grade inflammation occurs in polycystic ovary syndrome (PCOS), and there are many contributing factors. In this study, we aimed to investigate Helicobacter pylori and Chlamydia trachomatis infections in patients with PCOS and to evaluate the association between these microorganisms and the inflammatory process in the etiology of the disease. Materials and Methods: This comparative cross-sectional clinical study was conducted at Balıkesir University Hospital and included 40 female patients diagnosed with PCOS in the gynecology outpatients clinic and 40 healthy female controls. Demographic data were recorded. Blood hormone profiles and biochemical parameters were analyzed. An enzyme-linked immunosorbent assay test kit was used to measure H. pylori IgG and C. trachomatis IgG. Results: According to the analysis of the study data, there was no significant association between the PCOS and non-PCOS groups with regard to the presence of Helicobacter pylori IgG (p = 0.1) and Chlamydia trachomatis IgG (p = 0.338). CRP levels were significantly higher in the PCOS group (p = 0.001). In the subgroup analyses, the CRP levels were not significantly different between the H. pylori and C. trachomatis antibody-positive and -negative groups. Diabetes mellitus was significantly associated with PCOS (p = 0.005). The smoking rate was significantly higher in the control group than in the PCOS group (p = 0.036). Compared to the control group, the BMI, LH, HOMA-IR, TSH, and TG levels were significantly higher in participants with PCOS (p = 0.000; p = 0.004; p = 0.001; p = 0.001; p = 0.043; p = 0.000). FSH was lower in PCOS patients compared to controls (p = 001). In the subgroup analyses, no significant differences were found between the H. pylori and C. trachomatis antibody-positive and -negative groups. Conclusions: PCOS is characterized by chronic nonspecific low-grade inflammation. The etiopathogenesis of PCOS involves comorbidities that cause a chronic inflammatory process. However, the possible infective causes still seem to be open to investigation. In particular, studies on microbiota and periodontal diseases in PCOS may provide important contributions.

Unveiling socioeconomic disparities in maternal smoking during pregnancy: a comprehensive analysis of rural and Appalachian areas in Virginia utilizing the multi-dimensional YOST index

BackgroundMaternal smoking during pregnancy carries significant health risks for both mothers and infants, especially in vulnerable regions like rural and Appalachian areas with high smoking rates. Understanding the causes of high smoking rates in vulnerable areas is crucial for designing effective interventions to promote smoking cessation and reduce preventable health disparities.MethodsData from the Virginia Pregnancy Risk Assessment Monitoring System (PRAMS; years 2009–2020) comprised of 7,861 women aged over 18 were used in this cross-sectional observational study. Pregnant individuals were categorized as smoking if they reported smoking during the last trimester. A multi-level logistic regression was employed to examine the association of individual sociodemographic factors, rurality, Appalachian status, and county socioeconomic status (SES) proxied by Yost Index quintiles with smoking behaviors during pregnancy. The county of residence was considered as a random factor in the analysis. Trend analysis were also conducted.ResultsOut of the overall sample, 92.8% (n = 7,292) were non-smokers, while 7.2% (n = 569) were smokers. The multi-level logistic regression analysis showed pregnant individuals aged 18–24 had 1.06 times higher odds of smoking compared to those over 35 (95% CI [1.02–1.10]). Those with a college education or higher had significantly reduced odds (OR: 0.10, 95% CI [0.10, 0.10]), as did racially minoritized individuals (OR: 0.59, 95% CI [0.51–0.68]) and Hispanic individuals (OR: 0.14, 95% CI [0.09–0.21]). Living in rural areas was associated with a 26% higher likelihood of smoking during pregnancy compared to urban areas (OR: 1.26, 95% CI [1.21–1.31]), while residing in Appalachian regions led to a 25% higher probability of smoking. Additionally, lower SES quintiles were linked to higher odds of smoking, with the lowest quintile at OR: 2.10 (95% CI [1.67–2.65]) and the second quintile at OR: 1.64 (95% CI [1.53–1.76]) as compared with the most affluent quintile. Trend analsysis shows smoking has declined across all quintiles, but a substantial gap persists between lowest and highest SES regions.ConclusionsSmoking rates during pregnancy have dropped overall but remain alarmingly high in specific rural and Appalachian areas. As smoking during pregnancy poses significant health risks, targeted interventions and resources for tobacco cessation programs are needed in these highly vulnerable regions.Trial registrationNot Applicable.

Assessing the effects of Enhanced Multicomponent Proactive Navigator-Assisted Cessation of Tobacco Use within a federally qualified health center (EMPACT-Us): a protocol study

BackgroundCalifornia’s relatively low smoking rate (10.1% in 2019–2020) (About CHIS, UCLA Center for Health Policy Research, 2024) masks deep disparities among low-income populations, where smoking rates are nearly double that of their middle- to upper-income peers. Low-income smokers report a similar desire to quit and similar rates of recent quit attempts as smokers from other groups; yet, they often face barriers in accessing effective resources to facilitate successful cessation.MethodsOur team will conduct a pragmatic stepped-wedge cluster, randomized controlled trial of Enhanced Multicomponent Proactive Navigator-Assisted Cessation of Tobacco Use (EMPACT-Us), a suite of tobacco cessation services supported by patient navigators, designed in close partnership with patients, providers, and community stakeholders. The study will take place at Family Health Centers of San Diego (FHCSD), the largest federally qualified health center (FQHC) in San Diego. Eight primary care clinics are included, where 70% (n = 13,496) of smokers at FHCSD receive care.DiscussionWe hypothesize that multiple points of engagement and integration of navigation services into the workflow of existing staff will improve utilization and cessation success. This study will examine if the enhanced suite of services offers insights on how to best integrate evidence-based tobacco treatment services into usual care.Trial registrationClinicalTrials.gov, NCT05750537, Registered on March 1, 2023.https://clinicaltrials.gov/study/NCT05750537.

Perceptions of children and young people in England on the smokefree generation policy: a focus group study.

Modelling shows smokefree generation (SFG) policies could effectively reduce smoking rates by banning tobacco sales to those born after a specific year. Little is known about how young people perceive the legitimacy and impact of the planned SFG policy in England. We conducted 7 semi-structured focus groups with 36 participants aged 12 - 21 (mean = 15) in England over video call and in person. 21 participants were female and 15 male. Participants were purposively sampled to include those from areas of greater deprivation and for use of tobacco or e-cigarettes. Data was analysed using the framework approach. Participants expressed broadly negative perceptions towards tobacco and its manufacturers. Most participants supported SFG policy goals and its focus on freedom from addiction and harm; some believed it should also encompass electronic cigarettes. Many believed the law would only be successful if it included stringent enforcement, accompanying tobacco licensing, and input from young people. A minority raised concerns about the loss of freedom to purchase tobacco. Communication of the freedom-giving nature of SFG is likely to resonate with many young people. Enforcement, communication, and involvement of young people in SFG should be considered carefully to maximise policy impact. The smokefree generation (SFG) policy's potential to offer freedom from addiction and disease can resonate with young people. Its effectiveness could be maximised through targeted enforcement in areas with high youth smoking rates and low adherence to age-of-sale laws, and through introduction of additional policies that offer restrictive licensing of tobacco retailers. A phased approach to SFG, initially covering tobacco and later incorporating e-cigarettes as smoking prevalence declines, could balance reducing youth vaping and harm reduction; future research could investigate optimal policy conditions for this approach.

Global, Regional, and National Burden of Tracheal, Bronchus, and Lung Cancer in 2022: Evidence from the GLOBOCAN Study.

Tracheal Bronchus and Lung cancers (TBL) represent one of the leading causes of cancer deaths worldwide. This study aimed to examine the disease and economic burden of TBL cancers in 185 countries worldwide in 2022. The estimates of TBL cancer incidence and mortality (counts and age-standardized rates) were obtained from the GLOBOCAN 2022 data produced by the International Agency for Research on Cancer. Mortality-to-incidence ratios (MIR) were utilized as a proxy of 5-year survival rates. Multivariate regression was utilized to examine the association between TBL cancer burden and tobacco use prevalence. Globally, there were 2.48 million incident cases and 1.82 million deaths due to TBL cancers in 2022. Males accounted for 63.4% of incident cases (1.57 million) and 67.85% of TBL deaths (1.23 million) in 2022. For both sexes combined, the age-standardized rate was 23.1 per 100,000, and the age-standardized mortality rate was 16.8/100,000. The Mortality-to-incidence ratio (MIR) at the global level stood at 0.71. Eastern Asia had the largest burden of TBL cancers among the 21 UN-defined regions, with around 51% of incident cases (1.24 million) and 46.9% of global deaths (851,876), followed by Northern America (incidence: 257,284; deaths: 150,675) and Eastern Europe (incidence: 158,141; deaths: 126,840). At the country level, human development index (HDI) and adult tobacco use prevalence could explain 67% and 64% variation in ASIR and ASMR, respectively. HDI was statistically significantly related to MIR, explaining a 48% variation in MIR. With 1.9 million deaths in 2022, TBL cancer is a significant global cause of mortality. Despite the knowledge and awareness of smoking and lung cancer, adult smoking rates remain high in many countries, including the United States and China. Renewed and sustained global efforts are needed to reduce smoking prevalence and PM2.5 levels, particularly in China and low- and middle-income countries.