Reduce Smoking Rates Research Articles

Comprehensive guide to tobacco control policy implementation

Background: Tobacco use remains one of the leading causes of preventable death and disease worldwide. Effective tobacco control policies are essential in mitigating these health risks. The Framework Convention on Tobacco Control (FCTC), adopted by the World Health Organization (WHO) in 2003, provides a comprehensive framework for implementing evidence-based tobacco control measures globally. This project aims to develop and implement robust tobacco control policies to reduce tobacco consumption and its associated health risks. Methods and Materials: The project involved a comprehensive review of existing tobacco control policies, data collection on tobacco use and related health outcomes, and the development of a multi-sectoral task force. Key strategies included setting clear goals, stakeholder engagement, public awareness campaigns, and the drafting of legislative and policy documents. Implementation mechanisms such as enforcement and evaluation systems were also established to ensure compliance and measure the policy's impact. Results: The implementation of the tobacco control policies resulted in a significant reduction in smoking prevalence and exposure to secondhand smoke. Public awareness of the health risks associated with tobacco use increased, and there was enhanced support for smoking cessation services. The project also identified best practices and strategies that can be adopted by other regions to achieve similar outcomes. Conclusion: This project highlights the importance of comprehensive research, effective coordination, and well-planned implementation in developing and executing tobacco control policies. The findings and recommendations presented serve as a valuable resource for policymakers and public health professionals aiming to reduce smoking rates and protect public health. Continued collaboration and adaptation of these strategies are essential for sustaining the progress made in tobacco control.

Effectiveness of Smoke-Free Campus Implementation on Smoking Behavior Control

The tobacco industry is a significant obstacle in the effort to control smoking behavior, especially since they are allowed to promote their products to the public, including students. To address this issue, the Ministry of Health developed a smoke-free zone that may be implemented in universities to reduce smoking rates among adolescents. To know the effectiveness of implementing a smoke-free campus policy on smoking behavior control at Universitas Prima Indonesia by assessing aspects of student knowledge and compliance levels. This research is a descriptive quantitative study with a cross-sectional design and uses purposive sampling techniques with the criteria of active smoker students, 74 people in the medical study program of the Faculty of Medicine, Dentistry, and Health Sciences at Universitas Prima Indonesia. Data was obtained in February-April by distributing questionnaires directly to student smokers. The results showed that smoking behavior control among students increased in 50 (67.6%) out of 74 respondents. This is supported by the relationship between the level of knowledge and students' attitudes toward smoking behavior control in the smoke-free campus area, as indicated by a p-value<0.05 (0.005<0.05 and 0.001<0.05). This study found that students’ knowledge and attitudes towards smoke-free campus areas are important aspects influencing the effectiveness of the smoke-free campus policy in controlling smoking behavior.

Unveiling the Long-Term Lung Consequences of Smoking and Tobacco Consumption: A Narrative Review.

Smoking and tobacco use present significant public health challenges due to their association with high morbidity and mortality rates worldwide. Despite reductions in smoking rates in many developed countries, global tobacco consumption remains high, especially in developing regions. This review examines the chronic effects of smoking on the respiratory system, detailing the pathological changes in the lungs and the resultant respiratory illnesses such as chronic obstructive pulmonary disease and lung cancer. Additionally, the review explores the impact of smoking on other body systems, including cardiovascular, immune, gastrointestinal, nervous, and reproductive systems. The extensive health implications of smoking emphasize the need for comprehensive public health interventions to reduce tobacco use and mitigate its adverse effects on health.

Exploring the Disparity in Indoor/Outdoor Time and Radon Exposure as Possible Factors Contributing to the Unexpected Increase in Lung Cancer Risk among Non-Smoking Women.

According to a NIH study, Lung cancer among individuals who have never smoked is more prevalent in women and occurs at an earlier age than in smokers. The rise in lung cancer rates among female non-smokers might be linked to radon inhalation and should be further investigated. Our theory is based on the differences in radon exposure between males and females, which can be attributed to the variations in time spent indoors versus outdoors. Over the past few years, the smoking rates have shown a steady decline in the United States and other developed countries. This decrease in smoking prevalence has led to a new shift in the primary risk factors associated with lung cancer. Although tobacco smoke historically served as the primary cause of lung cancer, the reduction in smoking rates has allowed other risk factors, such as radon exposure, to come to the forefront. Given that women in certain countries, on average, might spend more time indoors compared to men, they are potentially exposed to higher levels of radon. This increased exposure could explain the rising rates of lung cancer among female non-smokers. The theory is still in its nascent stages and requires further research and validation. However, if proven correct, it could significantly alter our understanding of lung cancer risk factors and lead to new prevention. It is therefore crucial to expedite the review and publication of this theory, given its potential implications for public health.

Smoking cessation influencing factors and interventions in adolescents

Smoking can negatively influence the development of the respiratory and cardiovascular systems of adolescents and increase the risk for chronic diseases in adulthood. Promotion smoking cessation in adolescents is important for the protection of adolescent health and reduction of smoking rate in adults. Although many foreign studies have explored the influencing factors and interventions for smoking cessation in adolescents, limited relevant studies have been conducted in China, especially the study of smoking cessation intervention, which is still in its infancy, so the research and practice in this field need to be strengthened. This paper summarizes the factors associated with smoking cessation in adolescents both at home and abroad from the perspective of individual, family, school, and social surrounding, and introduce existing smoking cessation interventions for adolescents to provide references for future studies.

Overview Smoking Behavior and Quality of Life of Sports Department Students, Faculty of Sports Science, Universitas Negeri Malang

According to the results of the Global Adult Tobacco Survey (GATS) in 2021, there has been a considerable increase in the number of adult smokers over the past ten years, rising from 60.3 million in 2011 to 69.1 million in 2021, an increase of 8.8 million individuals. This study aims to compare the quality of life between actively smoking students and those who are exposed to passive smoking, examining their physical, psychological, social, and environmental health effects. The study utilized a sample of 100 respondents who completed a questionnaire on cigarette use and the WHOQOL quality of life assessment, covering variables such as cigarette type, disruption in daily activities, desire to quit smoking, cigarette consumption, and attitudes towards smoking bans in public places. Calculation of the WHOQOL score revealed that 60 percent of non-smoking student respondents reported a good quality of life. These findings underscore the critical need for enhanced health awareness programs and stricter smoking regulations within the university to foster a healthier environment. The study's insights highlight the importance of developing targeted interventions and policies to reduce smoking rates among students to enhance their overall quality of life.According to the results of the Global Adult Tobacco Survey (GATS) in 2021, there has been a considerable increase in the number of adult smokers over the past ten years, rising from 60.3 million in 2011 to 69.1 million in 2021, an increase of 8.8 million individuals. This study aims to compare the quality of life between actively smoking students and those who are exposed to passive smoking, examining their physical, psychological, social, and environmental health effects. The study utilized a sample of 100 respondents who completed a questionnaire on cigarette use and the WHOQOL quality of life assessment, covering variables such as cigarette type, disruption in daily activities, desire to quit smoking, cigarette consumption, and attitudes towards smoking bans in public places. Calculation of the WHOQOL score revealed that 60 percent of non-smoking student respondents reported a good quality of life. These findings underscore the critical need for enhanced health awareness programs and stricter smoking regulations within the university to foster a healthier environment. The study's insights highlight the importance of developing targeted interventions and policies to reduce smoking rates among students to enhance their overall quality of life.

Effects of Smoking on the Human Organism

Background: Smoking is widely recognized for its adverse impacts on health, contributing to chronic and acute conditions affecting nearly every organ system. This review synthesizes the extensive body of research highlighting the physiological and pathological effects of tobacco use. Methods and Materials: A comprehensive review was conducted using PubMed and additional databases, selecting studies published in the last 25 years. Studies were evaluated for relevance and reliability, focusing on those that provided clear outcomes and substantive evidence on the effects of smoking. Results: The analysis confirms that smoking is responsible for a significant burden of disease, including major risks for cancers, cardiovascular diseases, respiratory conditions, and reproductive health issues. Smoking increases the risk of lung cancer by 80-90% and is a primary factor in cardiovascular and respiratory diseases. Passive smoking further extends the risk to non-smokers, significantly impacting public health. Conclusion: Smoking cessation presents substantial benefits, potentially reversing many adverse effects. Public health policies should continue to focus on reducing smoking rates through education, cessation programs, and legislative measures to mitigate the extensive harm caused by tobacco consumption.

Changes in prevalence and incidence of dementia and risk factors for dementia: an analysis from cohort studies

Some cohort studies have reported a decline in dementia prevalence and incidence over time, although these findings have not been consistent across studies. We reviewed evidence on changes in dementia prevalence and incidence over time using published population-based cohort studies that had used consistent methods with each wave and aimed to quantify associated changes in risk factors over time using population attributable fractions (PAFs). We searched for systematic reviews of cohort studies examining changes in dementia prevalence or incidence over time. We searched PubMed for publications from database inception up to Jan 12, 2023, using the search terms "systematic review" AND "dementia" AND ("prevalence" OR "incidence"), with no language restrictions. We repeated this search on March 28, 2024. From eligible systematic reviews, we searched the references and selected peer-reviewed publications about cohort studies where dementia prevalence or incidence was measured in the same geographical location, at a minimum of two timepoints, and that reported age-standardised prevalence or incidence of dementia. Additionally, data had to be from population-based samples, in which participants' cognitive status was assessed and where validated criteria were used to diagnose dementia. We extracted summary-level data from each paper about dementia risk factors, contacting authors when such data were not available in the published paper, and calculated PAFs for each risk factor at all available timepoints. Where possible, we linked changes in dementia prevalence or incidence with changes in the prevalence of risk factors. We identified 1925 records in our initial search, of which five eligible systematic reviews were identified. Within these systematic reviews, we identified 71 potentially eligible primary papers, of which 27 were included in our analysis. 13 (48%) of 27 primary papers reported change in prevalence of dementia, ten (37%) reported change in incidence of dementia, and four (15%) reported change in both incidence and prevalence of dementia. Studies reporting change in dementia incidence over time in Europe (n=5) and the USA (n=5) consistently reported a declining incidence in dementia. One study from Japan reported an increase in dementia prevalence and incidence and a stable incidence was reported in one study from Nigeria. Overall, across studies, the PAFs for less education or smoking, or both, generally declined over time, whereas PAFs for obesity, hypertension, and diabetes generally increased. The decrease in PAFs for less education and smoking was associated with a decline in the incidence of dementia in the Framingham study (Framingham, MA, USA, 1997-2013), the only study with sufficient data to allow analysis. Our findings suggest that lifestyle interventions such as compulsory education and reducing rates of smoking through country-level policy changes could be associated with an observed reduction, and therefore future reduction, in the incidence of dementia. More studies are needed in low-income and middle-income countries, where the burden of dementia is highest, and continues to increase. National Institute for Health and Care Research Three Schools' Dementia Research Programme.

Intention to Quit Tobacco due to Media Advertisements in India: Findings from Global Adult Tobacco Survey 2016-17.

Tobacco has been among the most important causes of morbidity and mortality worldwide. In reducing tobacco consumption, media campaigns are crucial in raising awareness and encouraging individuals to quit. The present study aimed to profile participants of GATS-2, including tobacco usage patterns and media exposure, and explore the factors associated with quitting in the presence of media exposure. Secondary data analysis of Global Adult Tobacco Survey-India (2016-17) data was done among current daily cigarette smokers and smokeless tobacco users. The primary independent variable was an intention to quit, while media exposure was the primary independent variable. Respondents were profiled as per various socio-demographic variables, and exposure to media advertisements and intention to quit were assessed using weighted bivariate analysis and multivariate log regression analysis. Males, and respondents aged 15 to 45, had more exposure to media and advertisements than female respondents. Cigarette smokers with moderate consumption, better awareness, those who had made any quit attempts in the last 12 months, and moderate to high media exposure depicted better intention to quit. In SLT users, intention to quit depicted significant odds per education level quit attempts and exposure to media and advertisements. We report a high intention to quit among those exposed to advertisements. Media campaigns play an important role in promoting tobacco control. There is a need to assess the impact of such advertisements on behavioral aspects. At the same time, comprehensive tobacco control policies should go hand in hand in reducing smoking rates.

Risk factors for smoking in adolescence: evidence from a cross-sectional survey in Switzerland

BackgroundCigarette smoking during adolescence is a major public health concern with far-reaching health implications. Adolescents who smoke are at an increased risk of developing long-term health problems and are more likely to continue smoking into adulthood. Therefore, it is vital to identify and understand the risk factors that contribute to adolescent smoking – which in turn facilitate the development of targeted prevention and intervention programs.MethodsData was drawn from a cross-sectional survey conducted between October and December 2021, encompassing adolescents of adolescents aged 14 to 19 residing in Switzerland (n = 2,683). Multiple logistic regression analysis was employed to explore which demographic, household, behavioural and psychographic factors are associated with current smoking status.ResultsThe regression results showed higher odds of smoking for female respondents (OR 1.39; p-value 0.007); older adolescents (OR 1.30; p-value < 0.001); those living in the French-speaking part of Switzerland (OR 1.39; p-value 0.021), in suburban areas (OR 1.35; p-value 0.023) and with a smoker in the same household (OR 2.41; p-value < 0.001); adolescents consuming alcohol (OR 4.10; p-value < 0.001), cannabis products (OR 6.72; p-value < 0.001) and hookah (OR 5.07; p-value < 0.001) at least once a month; respondents not engaging in sports (OR 1.90; p-value < 0.001) or music (OR 1.42; p-value 0.031) as top five leisure activities and those experiencing high stress levels at home (OR 1.74; p-value < 0.001). Adolescents with high scores in health awareness (OR 0.33; p-value < 0.001), on the relational self-esteem scale (OR 0.78; p-value 0.054) and on the general well-being scale (OR 0.52; p-value 0.022) were less likely to smoke than their counterparts with lower scores. High risk-seeking was associated with higher odds of smoking (OR 2.15; p-value < 0.001).ConclusionsOur results suggest the importance of a comprehensive approach at both individual and institutional levels to reduce smoking rates in adolescents. More specifically, a holistic strategy that encompasses adolescents, families, schools and policymakers ranging from strengthening adolescents’ self-esteem, smoking cessation support for parents, to increasing engagement in musical and physical activities, and enhancing health awareness in the school curriculum.

Tobacco Quitline utilization compared with cigarette smoking prevalence in Virginia across rurality and Appalachian Status, 2011–2019

IntroductionWhile cigarette smoking rates have declined, rural and Appalachian populations in the United States have not seen similar decreases. Quitline programs are promising strategies in reducing disparities in these areas, but research on their usage is limited. MethodsWe employed Small Area Estimation on the Virginia Behavioral Risk Factor Surveillance System (2011–2019) to estimate county-level smoking prevalence and utilized The Quit Now Virginia Quitline data (2011–2019) to estimate Quitline users. We analyzed differences in Quitline utilization by rurality and Appalachian status using statistical t-tests. Stepwise regression assessed the absolute estimate of county features, including poverty rate, tobacco retailer density, physician availability, coal mining industry, and tobacco agriculture, on Quitline usage. ResultsWhile the average smoking rate overall was 15.3 %, only 7.4 % of smokers accessed Quitline services from 2011 to 2019. Appalachian regions exhibited higher smoking rates (20.9 %) and lower quitline usage (4.8 %) compared to non-Appalachian areas (14 % smoking prevalence, 8 % quitline usage). Rural regions had higher smoking prevalence (19.0 %) than urban areas (12.9 %), but no significant difference in Quitline utilization (7.6 % vs. 7.2 %, p = 0.7). Stepwise regression revealed counties with more tobacco agriculture had 3.2 % (p = 0.04) lower Quitline utilization. Also, more physicians availability in the county was associated with 3.9 % higher Quitline usage (p = 0.03) and Appalachian counties exhibited a 3.6 % lower Quitline usage rate compared to non-Appalachian counties. ConclusionA significant gap exists between cigarette smoking prevalence and Quitline utilization, particularly in underserved rural and Appalachian areas, despite no clear barriers to accessing this remote cessation resource. ImplicationThe study underscores persistent disparities in smoking rates, with rural and Appalachian regions in the United States facing higher smoking prevalence and limited utilization of Quitline services. Despite no clear barriers to access, the gap between smoking prevalence and Quitline usage remains significant, particularly in underserved areas. Tailoring interventions to address regional disparities and factors like tobacco agriculture and physician availability is essential to reduce smoking rates and improve Quitline utilization in these communities.

Switching Away From Smoking and Reduction in Cigarette Consumption Among U.S. Adult Purchasers of the JUUL System Across 24 Months Including Diverse Subpopulations Disproportionately Affected by Cigarette Smoking.

Electronic nicotine-delivery systems (ENDS) can reduce tobacco-related health risks for adults who smoke cigarettes (AWS) by facilitating complete switching away from cigarettes. However, little is known about ENDS use and switching among subpopulations that have been disproportionately affected by smoking. AWS (age ≥ 21 years) were recruited following their first purchase of a JUUL Starter Kit in 2018. Participants who self-reported switching (no past-30-day cigarette smoking) at 1-, 2-, 3-, 6-, 9-, 12-, 15-, 18-, 21-, and 24-month follow-ups. Percent switched and percent with substantial smoking reduction (≥50% decrease in cigarettes per day among those who continued smoking) were calculated. Analyses focused on racial and ethnic minorities, persons with low income and education levels, sexual minorities, and those with mental and physical health conditions. Overall rates of switching away from cigarettes increased across follow-ups to 51.2% (month-12) to 58.6% (month-24, 87% of whom used ENDS). Among those who continued to smoke at 24 months, 45.4% reduced cigarettes per day by ≥ 50%. Rates of switching and substantial smoking reduction were largely similar across subgroups, with some statistically significant, but small, differences in month-24 switching rates (eg, education, mental and physical health conditions; switch rate range: 42%-57%). AWS demonstrated progressively increasing switching rates over 2 years after purchasing JUUL products. Similar trends in switching and smoking reduction were observed across populations disproportionately affected by smoking. By facilitating switching and smoking reduction, ENDS products such as JUUL may provide an opportunity to reduce smoking-related harm among some populations disproportionately affected by smoking, potentially reducing tobacco-related health disparities. ENDS have the potential to benefit population health if they can replace cigarettes. This benefit must extend to populations disproportionately affected by smoking. In this real-world study, 59% of JUUL purchasers reported complete switching 2 years later (no past-30-day smoking, with most continuing to use ENDS). Furthermore, 45% of those who continued to smoke reduced cigarette consumption by at least half. These rates of switching and smoking reduction were largely comparable across populations disproportionately affected by smoking (defined, eg, by ethnicity and income). ENDS can serve as an effective harm reduction strategy to complement current efforts to reduce tobacco-related disparities.

Evaluation of a smoking cessation program for adults with severe mental illness in a public mental health service.

Smoking rates have decreased in the general population but remain high among people with severe mental illness (SMI). An individualized smoking cessation program was tested with 99 adults with SMI. The program showed it is possible to help people with SMI smoke fewer cigarettes and reduce nicotine addiction. Customized smoking cessation programs are essential for those with high nicotine dependence and mental health challenges. Mental health services should offer tailored tobacco cessation programs because these programs can improve the health of people with mental illness who smoke. It is important for mental health services to follow government guidelines and provide evidence-based support. INTRODUCTION: Despite significant reductions in smoking rates in the general population over recent decades, smoking rates remain relatively unchanged among people with SMI. To evaluate the feasibility and preliminary effectiveness of the Keep Quitting in Mind pilot program, an individualized smoking cessation program for people experiencing SMI. In total, 99 adult participants with SMI and engaged with a community mental health service, participated in the intervention. The intervention included motivational interviewing and goal setting, in addition to provision of pharmaceutical aids (including nicotine replacement therapy). Analysis determined that the Keep Quitting in Mind pilot program was feasible in a public adult mental health service and participation in the program was associated with reductions in the number of cigarettes smoked daily and level of nicotine addiction. This real-world pilot program demonstrated feasibility and potential effectiveness in reducing smoking among adults with mental illness. Aligning with government guidelines, tailored smoking cessation programs are crucial due to high nicotine dependence and mental health complexities. Given the high rates of cigarette smoking by people with mental illness and the cardiometabolic health risks associated with this, mental health services should consider adding evidence-based and bespoke tobacco cessation programs as part of core business.

Knowledge and Perception about Health Risks of Cigarette Smoking among Youngsters in Jazan Region, Saudi Arabia.

Cigarette smoking is a global public health concern, particularly in developing countries. Saudi Arabia has a high prevalence of smoking among young individuals, highlighting the need for interventions to address this issue. This study aimed to evaluate the awareness, attitude, smoking rates, and perception of health risks among young individuals in the Jazan region of Saudi Arabia. The goal was to identify areas for improvement and develop effective strategies to combat smoking and promote healthier lifestyles. A cross-sectional survey was conducted at the out-patient department of the College of Dentistry, Jazan University, over a 3-month period. A questionnaire consisting of 15 open-ended questions was administered to eligible patients. Statistical analysis was performed using the Chi-squared test with a P- value of <0.05. Out of 300 participants, the majority were males, university students, and non-smokers. Among smokers, electronic cigarettes were the most used form. Starting smoking with friends was a common trend. Females smoked fewer times per day compared to males. Participants expressed concerns about the damaging effects of smoking on health. Targeted interventions and educational programs are needed to address smoking behaviors among young individuals in the Jazan region. Gender-specific interventions, family involvement, and promoting school connectedness are crucial in reducing smoking rates. Graphic health warnings on cigarette packs have the potential to improve knowledge and quitting intentions. Continued research and surveillance are necessary to inform evidence-based policies and interventions to combat youth smoking.

The impact of chronic disease diagnoses on smoking behavior change and maintenance: Evidence from China.

Managing chronic diseases and tobacco use is a formidable challenge in low- and middle-income countries (LMICs) with limited health literacy and access to quality healthcare. This study examines the empirical evidence from China, utilizing quasi-experimental approaches to assess the causal effect of chronic disease diagnoses on smoking behavior. Employing the diagnosis of chronic disease in the older cohorts of the population as a natural experiment, this study utilizes recent advancements in difference-in-difference estimation methods (CS-DID) to investigate the effect of a diagnosis on smoking behavior. Self-reported new diagnoses of conditions ascertained chronic disease diagnoses. CS-DID was run using the study sample from the 2011 to 2018 waves of the China Health and Retirement Longitudinal Study, comparing results with traditional two-way fixed effects and event-study models. The average treatment effect (ATT) of CS-DID is slightly greater than the effects reported using conventional difference-in-difference methods. We found that diagnoses of cancer, heart disease, and stroke reduced smoking rates by 16% (95% CI: -24 - -8), smoking intensity by 0.31 (95% CI: -0.46 - -0.15), and had lasting impacts on smoking cessation behavior (one wave after diagnosis ATT= -0.17; 95% CI: -0.34 - -0.00, two waves after diagnosis ATT= -0.17; 95% CI: -0.37-0.03). A diagnosis of a mild chronic disease, such as hypertension, diabetes, asthma, chronic lung disease, liver disease, or gastric disease, had more negligible and transient effects on smoking behavior. Efforts to enhance smoking cessation in middle-aged and elderly patients with chronic diseases are crucial to improving health outcomes. The 'teachable moment' of chronic disease diagnosis should be seized to provide smoking cessation assistance to achieve the goal of healthy ageing.

Association Between Smoking Habits and Body Weight Among General Population in Saudi Arabia.

Smoking is a significant cause of mortality and is strongly associated with the development of morbid diseases, such as obesity. There is a considerable interest in understanding the impact of smoking on body weight. The exact nature remains unclear due to the mixed results observed in the literature review. The aim of this study is to evaluate the association between smoking and body weight concerning demographic characteristics in the western region of Saudi Arabia. This cross-sectional study was carried out in the western region of Saudi Arabia from November 15, 2022to July 15, 2023. To collect data, an online survey was utilized, and the survey link was shared across various social media platforms. The survey was completed by a total of 744 individuals who were at least 18 years old and answered a self-reported questionnaire on the web. Analysis showed that (39%) of participants lead a sedentary lifestyle, and (58.8%) have an abnormal BMI. Among them approximately 25%are overweight, 12.4% are obese, and 7.4%are extremely obese. Moreover, a greater number of them were traditional smokers. Our study reported that individuals who had quit smoking were more likely to be overweight. Regarding self-perception of their weight, almost half of the participants consider themselves overweight and they're more likely to smoke, whether it be traditional or electronic cigarettes. This study revealed a strong link between smoking habits and increased weight status, as measured by body mass indexes. These findings have important implications for public health interventions aimed at reducing smoking rates and obesity levels. By recognizing the potential connection between these two risk factors, experts in public health can develop more effective strategies to promote healthy behaviors and prevent chronic diseases among young 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

Head and neck cancers: epidemiology, diagnosis and treatments

Introduction: Head and neck cancers (HNC) affect many subsites in the upper aero-digestive tract. The risk factors include tobacco smoking, chewing betel nut/paan, excessive alcohol consumption, hereditary factors and viruses such as human papillomavirus (HPV) and Epstein–Barr virus (EBV). Early diagnosis, lifestyle changes and HPV vaccination will improve survival. Epidemiology: Globally, recent estimates from GLOBOCAN shows there are 890,000 cases of head and neck cancers annually and 450,000 deaths annually (1). There is an increasing incidence of oral cavity, lip, buccal cancers in the developing world due to higher consumption of tobacco, alcohol and chewing areca nut. There has been an increasing incidence of some HNC due to high-risk strains of human papillomavirus (HPV) (2). Cancers caused by HPV include tonsil cancer, tongue base cancer and unknown primary cancers. The EBV causes nasopharyngeal cancers especially in the Far East. There is a decreasing incidence of some cancers caused by smoking such as laryngeal and hypopharyngeal cancers mainly due to the reduction in smoking rates in some developed countries. Overall, there is a predicted increase in HNC of up to 30% annually by 2030 (2). The HPV-associated cancers affect mainly younger males, who do not necessarily smoke or drink alcohol. The HPV is a strong prognostic factor so patients with HPV positive cancers respond better to treatment as there are less genetic mutations when compared to cancers driven by tobacco smoking. These trends are alarming with socioeconomic impacts. Diagnosis: Symptoms of HNC include difficulty swallowing, persistent sore throat, difficulty breathing, hoarseness, neck lumps, referred pain to the ear, weight loss, and systemic symptoms in advanced disease. A full ENT examination is performed of the oral cavity, oropharynx, neck and ideally flexible nasendoscopy. Ultrasound-guided FNAC or core biopsy of neck lumps are performed. Cross-sectional imaging with CT or MRI scans followed by tumour biopsies either under local or general anaesthetic. Tumour biopsies are assessed using H&amp;E stains, and tests for HPV detection (p. 16 immunohistochemistry, in situ hybridisation or polymerase chain reaction). A PETCT scan is useful for staging cancers, identifying the origin of unknown primary cancers and for surveillance. Treatments: The head and neck cancer multidisciplinary team reviews all investigations and recommends either curative or palliative treatment options that are in every patient’s best interests. Surgery can be open, endoscopic or with the use of a robot. Microvascular reconstruction with flaps is performed as necessary to improve function and quality of life. Oncologic treatments include intensity-modulated radiotherapy (IMRT), which can be combined with chemotherapy. Immunotherapy is a second-line treatment for recurrent HNC currently. Advanced cancers can be treated with palliative intent or best supportive care especially if the patients are frail and have significant comorbidities. There are ongoing clinical trials and research studies exploring better, less-toxic treatments. Multiomics approach and artificial intelligence are exciting developments. Conclusion: There is an increasing incidence of some HNC especially cancers driven by tobacco smoking, alcohol consumption and high-risk human papillomaviruses. Smoking cessation, HPV vaccination, early diagnosis and improvements in treatments are important factors in ensuring good outcomes.

Tobacco Packaging Design in China, Thailand, and New Zealand: A Comparative Study

Packaging design has received much interest from the academic and industrial worlds. Numerous studies have shown that packaging significantly impacts purchase intent, product satisfaction, and repeat purchases. However, to some extent, tobacco packaging is not used to fulfil its consumer target’s demands or increase the repeat purchase rate. By contrast, it has the official duty to discourage tobacco use, as it is a highly regulated business. Nevertheless, tobacco manufacturers do their best to find the last opportunity to advertise on tobacco boxes because the packet is their final or only marketing or advertising tool in many countries. Thus, tobacco packaging design could be the most challenging advertising practice in many nations because two contradicting advertising contents (persuasion and dissuasion) emerge in one medium simultaneously. In this paper, I comparatively content-analysed 65 popular cigarette brands from China, Thailand, and New Zealand to find out how tobacco companies use cigarette packaging to communicate with their customers. The results suggested that Chinese tobacco packaging is highly market-oriented and emphasises the use of traditional Chinese cultural elements. Conversely, tobacco packaging in Thailand and New Zealand focuses on health communication. But warning labels in the two countries are platitudes. The results also indicate that although policy factors have had a positive impact on tobacco packaging in terms of its discouraging function and contributing to tobacco control over the past decades, there is a need for policies to be tailored to the socio-cultural context. Efforts should focus on improving tobacco packaging from the perspective of smokers’ psychology. This adjustment is deemed necessary due to the declining effectiveness of current tobacco packaging control policies in reducing smoking rates in recent years.

Tobacco Market Transformation in Hungary

Smoking has emerged as a longstanding global concern, with a significant number of individuals within our immediate and bariatric circles becoming addicted to this detrimental habit. The gravity of the issue is reflected in the staggering statistics, as smoking claims the lives of more than six million people worldwide annually, earning its notorious title as the leading cause of preventable death according to the World Health Organization (WHO). Despite strict regulations and restrictions on smoking imposed by many countries to combat the escalating health risks, smoking habits persist as a major problem, particularly among young people. In the 1960s, smoking was widely accepted in society, and smoking rates remained high across nations. However, the tides began to turn with the growing awareness of the dire health risks associated with smoking. Health professionals and policymakers took active measures against smoking, contributing to a decline in its prevalence. Nevertheless, the extent of change in smoking habits varies significantly from country to country. The intricate web of factors influencing smoking habits encompasses social and economic elements, stress and mental health considerations, as well as the alluring temptations surrounding tobacco products. Raising awareness about the devastating health impacts of smoking and taking relentless action against this harmful habit are pivotal in reducing smoking rates globally. However, it is crucial to acknowledge the diverse cultural, socioeconomic, and psychological aspects that underpin smoking behavior to implement effective strategies tailored to specific regions and demographics. To combat the persistent smoking epidemic, comprehensive and integrated efforts are required, ranging from targeted public health campaigns to comprehensive tobacco control policies. Empowering individuals with knowledge about the hazards of smoking and equipping them with effective cessation resources can be transformative in curbing the addiction. Equally vital is fostering a supportive environment that promotes mental well-being and addresses stressors, offering healthier alternatives to cope with challenges. In conclusion, the fight against smoking demands unwavering commitment from policymakers, health professionals, and society at large. By understanding the complex drivers behind smoking habits and adopting a multifaceted approach, we can endeavor to save lives, promote healthier communities, and ultimately work towards a smoke-free future for generations to come.