Rate Of Tobacco Consumption Research Articles

Abstract A092: Tobacco use and prevalence of oral premalignant lesions, among Malayali tribes, Yelagiri Hills, Tamil nadu, India

Abstract BACKGROUND: India has the second largest tribal population of the world next to the African countries. About half of the world’s autochthonous people live in India, thus making India home to many tribes which have an interesting and varied history of origins, customs and social practices. The present study was conducted to assess the tobacco use and prevalence of precancerous lesions and oral cancer among Malayali tribes, Yelagiri Hills, Tamil nadu, India. METHODOLOGY The inhabitants of the 14 villages of the Yelagiri hills, who have completed 18years and residing for more than 15years present on the day of examination and who were willing to participate in the study were included. Data was collected from a cross-sectional survey, using a Survey Proforma, clinical examination and a pre-tested questionnaire. An intra-oral examination was carried out by a single examiner using WHO Oral Health Surveys – Basic Methods Proforma (1997). ResultsThe overall prevalence of smokeless and smoking tobacco was 78.8% and 65.2% respectively among 1550 study population. Of those who had the habit of smoking, 26% smoked beedi, 10.9% smoked cigarette, 65% chewed raw tobacco, 18% chewed Hans and 28% had a combination of smoking and smokeless tobacco usage. Around 49.8% of samples were stained positive for precancerous and cancerous lesions of the oral cavity. The highest number of positive samples were from buccal mucosa with 46.2% subjects and 12% for labial mucosa. The reason for practicing these habits were as a measure to combat the cold, relieving stress and body pain after work, and the lack of awareness of the hazards of the materials used. Prevalence of oral mucosal lesions in the study population was due to tobacco usage and alcohol consumption and lack of awareness regarding the deleterious effects of the products used. CONCLUSION Oral cancer is highly prevalent in this Malayali tribes owing to high tobacco consumption rates and habits warranting the cessation center a priority. Also, early detection and screening are vital to attaining better outcomes. Citation Format: Delfin Lovelina Francis. Tobacco use and prevalence of oral premalignant lesions, among Malayali tribes, Yelagiri Hills, Tamil nadu, India [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A092.

A population level study on smoking and radon induced adenocarcinoma and small-cell carcinoma among males and females in Canada

ObjectiveTo assess if there is a relationship between residential radon exposure and two lung cancer histological types, small-cell carcinoma (diagnosed in people with a smoking history) and adenocarcinoma (the most commonly diagnosed histologic type in people who have never smoked) among males and females in Canada. MethodsWith survey data of long-term radon measurements in residential homes, long-term averaged tobacco consumption rates in the units of cigarettes per day per person and long-term averaged age-standardized lung cancer incidence rates at provincial level, simple linear fitting (ANOVA linear regression) was applied in this study to determine the effect on lung cancer induction by smoking and exposure to indoor radon, and to assess if there is a relationship between residential radon exposure and lung cancer histological types. ResultsLung cancer incidence rates correlate very well with the tobacco consumption rates (P ​< ​0.05). However, females appear to be more likely than males to develop lung cancer at a given amount of cigarette consumption. For both small-cell carcinoma and adenocarcinoma, a statistically significant correlation between incidence rate and mean radon concentration was observed for females, the correlation was much stronger for adenocarcinoma (P ​= ​0.0057) than small-cell carcinoma (P ​= ​0.0483). However, there was no such correlation for males. ConclusionIt is possible that female non-smokers are more susceptible to radon-induced lung cancer, and the joint effect of radon exposure and tobacco smoking may be worse in female smokers compared to males, such that higher incidence rate of adenocarcinoma among females compared to males were observed in recent decades, even though females never smoked more than males.

Health Risks Associated with Tobacco Consumption in Humans: An Overview

Tobacco use remains a significant public health concern globally, with over 8 million anticipated deaths annually by 2030, despite declining rates in some high-income nations. Smoking is prevalent worldwide, particularly in developing and middle-income countries, where over 80% of smokers reside. The inhalation of tobacco substances leads to various diseases, including cancer and respiratory ailments, resulting in more deaths than AIDS, tuberculosis, and other major causes combined. Secondhand smoke exposure also poses significant health risks. The economic burden of tobacco-related deaths and diseases is substantial, especially in low- and middle-income economies, where almost 80% of tobacco-related deaths occur. Lack of awareness, societal influence, and ineffective enforcement of anti-tobacco laws contribute to widespread tobacco use. Although anti-tobacco campaigns and policies have shown some success, challenges persist, particularly in rural areas where tobacco dependence is high. In India, despite declining tobacco use attributed to awareness campaigns and increased taxes on cigarettes, certain demographics, such as middle-aged individuals, illiterates, and rural residents, continue to have high tobacco consumption rates due to inadequate implementation of anti-tobacco norms and limited access to information. Quitting smoking can significantly extend life expectancy and reduce the risk of smoking-related diseases. However, nicotine addiction poses a challenge, with only a small percentage of users successfully quitting without assistance. Professional support and cessation drugs can double the likelihood of successful quitting, and nicotine replacement therapy has shown effectiveness. Overall, there is no safe level of cigarette use, emphasizing the importance of comprehensive tobacco control efforts to mitigate the global health and economic impacts of tobacco use. This review deals with the health risks associated with tobacco consumption in humans. Keywords: Tobacco, Nicotine, Carcinogens, Cancer, Cardiovascular diseases.

Prevalence of tobacco use among cancer patients in Iran: a systematic review and meta-analysis.

The prevalence of tobacco use among various cancer types in Iran remains a significant concern, necessitating a comprehensive analysis to understand the extent and patterns of consumption. This study aimed to systematically review and analyze existing literature to delineate the prevalence of tobacco use across different cancer types in Iran, thereby providing a robust basis for future interventions and policy formulations. Adhering to the PRISMA guidelines, we conducted a systematic review and meta-analysis of literature available in PubMed and Scopus databases. The initial search identified 351 records, out of which 44 studies were selected based on their relevance and design. These studies spanned various time frames, starting from the 2001s up until 2022, and encompassed diverse geographical locations and cancer types in Iran. To avoid bias and potential data overlap, we opted to incorporate a single comprehensive study from the Golestan Cohort, encompassing all data, while excluding 10 other studies. Our final analysis incorporated data from 34 studies, which accounted for 15,425 patients and 5,890 reported smokers. Statistical analyses were performed to calculate the overall proportion of tobacco consumption and to conduct subgroup analyses based on different variables such as cancer types, gender, geographical locations, and types of tobacco used. The analysis revealed a substantial prevalence of tobacco use among cancer patients in Iran, with an overall consumption rate of 43%. This rate varied significantly, ranging from 10 to 88% across individual studies. Subgroup analyses further highlighted disparities in tobacco consumption rates across different demographics, geographic areas, and cancer types. Notably, the 'ever' smokers category exhibited the highest prevalence of tobacco use. The study also identified a worrying trend of high cigarette smoking rates, along with variable consumption patterns of other forms of tobacco, including waterpipe, 'Naas', and 'Pipe'. This systematic review and meta-analysis underscores a significant association between tobacco consumption and various cancer types in Iran, with a prevalence rate among cancer patients being three times higher than the average Iranian population. The findings indicate substantial heterogeneity in tobacco use patterns, emphasizing the need for targeted interventions to address this pressing health issue. The study serves as a critical resource for shaping future policies and strategies aimed at curbing tobacco use and mitigating its adverse effects on cancer prevalence in Iran.

Prevalence of periodontal disease in nicotine dependent students of UNIANDES

The prevalence rate of periodontal diseases corresponding to nicotine consumption by means of traditional or electric cigarettes is critical and deserves the attention of dental professionals because tobacco consumption contributes to an aggravation of periodontal disease making dental treatments less successful and increasing the risk of complications. The objective of the study was to determine the prevalence of periodontal disease in relation to the consumption of conventional and electronic cigarettes in students of the Universidad Regional Autónoma de los Andes UNIANDES, Ibarra campus. A survey was carried out with the objective of analyzing the incidence of cigarette consumption, whether traditional or electronic, in students from third to sixth level of the Dentistry course of the Universidad Regional Autónoma de los Andes UNIANDES, Ibarra campus. In addition, articles extracted from PubMed were reviewed to contribute to the research on the consequences of the consumption of nicotine products. It was found that there was a higher rate of tobacco consumption in women, who opt for the use of traditional cigarettes, which is worrisome because despite knowing that it affects their oral health and have bleeding when brushing their teeth, they continue to consume nicotine products. It is concluded that the rate of consumption of nicotine products is high and despite the fact that the students already show warning signs such as bleeding when brushing their teeth, they continue with their habitual consumption

Exploring parenthood in first episode of psychosis: the potential role of the offspring in the outcome of women.

The study aimed to explore the role of parenthood at first episode of psychosis (FEP) on recovery, with a focus on potential sex differences. Sociodemographic, clinical, and neurocognitive information was considered on 610 FEP patients form the PAFIP cohort (Spain). Baseline and three-year follow-up comparisons were carried out. Chi-square tests and ANCOVA analysis were performed controlling for the effect of age and years of education. Men comprised 57.54% of the sample, with only 5.41% having offspring when compared to 36.29% of women. Parenthood was related to shorter duration of untreated illness (DUI) in women with children (12.08months mothers vs. 27.61months no mothers), showing mothers better premorbid adjustment as well. Childless men presented the worst premorbid adjustment and the highest cannabis and tobacco consumption rates. Mothers presented better global cognitive function, particularly in attention, motor dexterity and executive function at three-year follow-up. Diminished parental rates among FEP men could be suggested as a consequence of a younger age of illness onset. Sex roles in caregiving may explain the potential role of parenthood on premorbid phase, with a better and heathier profile, and a more favorable long-term outcome in women. These characteristics may be relevant when adjusting treatment specific needs in men and women with and without offspring.

Impact of Tobacco Consumption During COVID-19 Lockdown: Insights from Employees at a Government Medical College in Gujarat

Background: Tobacco consumption is consistently harmful to one's well-being, and for individuals with respiratory conditions, it can elevate the likelihood of contracting infections, raise the potential for complications, and enhance the probability of transmission. In this study awareness about the association and the impact of the lockdown on tobacco use among current tobacco users of Government Medical College, Gujarat was assessed. Objectives: To evaluate the level of insight regarding the connection between COVID-19 and tobacco use and to assess the influence of COVID-19 related lockdown measures on the rate of tobacco consumption among current tobacco users at Government Medical College, Gujarat. Methods: A study was conducted among Class 3 &amp; Class 4 employees of Government Medical College using convenient sampling technique. Study population who was ready to participate in the study and had been actively engaged in the 10-month counselling program from January 2020 to November 2020. Data was gathered through a pre-tested closed-ended questionnaire. Statistical analysis was carried out using the SPSS software (version 22). Ethical approval was obtained from the Institute Ethical Committee, and written informed consent was acquired from all the participants. Results: A significant majority, comprising 68% of tobacco users, lacked awareness of the link between tobacco use and COVID-19. Among the 173 current tobacco users, 49 of them successfully abstained from tobacco use during the lockdown period. The primary reasons cited for this change were the unavailability and higher prices of tobacco products. Conclusions: The level of awareness regarding the connection between tobacco and COVID-19 played a crucial role in motivating tobacco users to discontinue their tobacco consumption.

A Comparative Analysis of Lung Cancer Incidence and Tobacco Consumption in Canada, Norway and Sweden: A Population-Based Study.

Risk factors for developing lung cancer include tobacco smoking, exposure to second-hand smoke, radon gas, asbestos and other carcinogens, as well as air pollution and aging. Canada, Norway and Sweden are three Arctic countries that are very similar in socioeconomic status, similar in the social determinants of health and many environmental factors, including current smoking rates. However, lung cancer incidence rates differ significantly among the three countries. Since tobacco smoking is the principal risk factor for developing lung cancer, and there is a long lag time between tobacco consumption and lung cancer incidence at the population average level, a comparative analysis is conducted with historical data available publicly in the three countries to demonstrate how tobacco consumption in the past impacts lung cancer incidence decades late. The analysis shows that lung cancer incidence rates increase proportionally with the increasing tobacco consumption rates with a lag time of 20-30 years. On average, one more cigarette smoked per person per day can increase lung cancer cases by 2 to 5 per 100,000 population.

Occurrence of Oral Premalignant Lesions Among Tobacco Users in a Tribal Population: A Systematic Review and Meta-Analysis.

This review aimed to comprehensively assess the association between tobacco use and oral health outcomes, specifically the presence of premalignant lesions (PMLs), through a synthesis of multiple assessments conducted in diverse populations. A systematic search of relevant literature was performed, and studies meeting the inclusion criteria were selected using appropriate Medical Subject Headings (MeSH) words and Boolean operators. Data from these studies was pooled and analysed using Review Manager 5.4 (The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen). The Newcastle-Ottawa scale was used to assess the methodological quality of the studies included. The pooled analysis of the five selected papers revealed a significant correlation between tobacco use and an increased prevalence of PMLs among tobacco users. Tobacco users had an odds ratio of 15.22 (95% CI: 10.01-23.15) as compared to non-user cohorts, significant at p 0.0001. This comprehensive synthesis of assessments underscores the detrimental impact of tobacco use on oral health, particularly in terms of potentially malignant lesions. The findings emphasise the urgency of targeted public health interventions to address tobacco consumption and promote oral health awareness, especially in populations with high tobacco consumption rates. Standardisation of methodologies and representation of diverse populations in future research would strengthen the evidence base and facilitate more effective strategies to improve oral health outcomes globally.

Analyzing the Frequency of Premalignant Lesions and Oral Malignancy in Indian Subjects Attending Outpatient Department From the Low Socioeconomic Group.

Oral cancer is a rapidly growing disease among Indian subjects mainly in the low socioeconomic group. Socially and economically marginalized subjects are at high risk for oral cancer because of smoke and smokeless tobacco consumption. To evaluate the prevalence of precancerous lesions and oral cancerand evaluate tobacco as a causative factor in Indian subjects visiting the outpatient department of the institute. Around 658 subjects were analyzed forfrequency of premalignant lesions and oral malignancy in Indian subjects from the low socioeconomic group. Patientsvisited for pain, burning, or ulceration in the oral cavity were clinically assessed for any tissue growths, leathery alterations, ulcerative changes,and white or red lesions in the oral cavity. Results:The overall prevalence of smokeless and smoking tobacco was 78.8% (n=518) and 65.2% (n=429) respectively in the present study. Around 39.8% (n=262) of samples were stained positive for precancerous and cancerous lesions of the oral cavity. The highest number of positive samples were from buccal mucosa with 36.2% (n=238) subjects and 6.1% (n=40) for labial mucosa. Oral cancer is highly prevalent in Indian subjects owing to high tobacco consumption rates and habits warranting the cessation center a priority. Also, early detection and screening are vital to attaining better outcomes. More tobacco cessation centers areneededto stop the habit and early diagnosis will prevent dysplastic changes.

On the results of the coordinated state policy in the field of tobacco control among young people

Introduction. Trend analysis of tobacco consumption rates is important for assessing the effectiveness of national tobacco control measures in Belarus. &#x0D; Materials and methods. The study aims to monitor tobacco smoking among adolescents in Belarus by three repeat national cross sectional surveys conducted before and after introduction the regulatory act tobacco measures entered into force. Prevalence of smoking tobacco, cigarettes, electronic cigarettes and other aspects related to smoking among 13–15 years adolescents were estimated from the 2004, 2015 and 2021 Global Youth Tobacco (GYT) Surveys (n = 4523, &#x0D; n = 2992, n = 3493 respectively) conducted in Belarus. &#x0D; Results. The data evidenced a successful anti-tobacco policy and an improvement in the tobacco consumption and tobacco consumption by 13–15 years adolescents, expressed in reduction of many indicators. Prevalence of current cigarettes smokers significantly decreased from 26.5% in 2004 to 4.7% in 2021. Despite of current reduction of various types of tobacco smokers current GYTS data revealed that electronic cigarettes are extremely popular among adolescents – around 15%. The number of smokeless tobacco users significantly increased by 3 times. &#x0D; Limitations. In order to study the tobacco consumption levels and other aspects related to smoking a survey of 11,000 adolescent students in 2004, 2015 and 2021 was conducted among schoolchildren (13–15 years old), which is a sufficient reference sample.&#x0D; Conclusions. Thus, the identified positive trends in tobacco smoking (5-fold reduction in the number of cigarette smokers, decrease in susceptibility to smoking, reducing the number of tobacco products smokers and decrease the number of ever tobacco smokers and ever cigarette smokers, decreasing the number of frequent cigarette smokers) indicated the effectiveness of a complex multidisciplinary anti-tobacco measures in Belarus. New challenges and negative trends were determined. Amount of electronic cigarettes users were significantly greater than current cigarette smokers’ amount. Moreover, prevalence of users of smokeless tobacco products is getting increased. Despite of extensive legislative framework for the tobacco control there remains substantial potential to strengthen them.&#x0D; Keywords: smoking; tobacco; tobacco use; cigarettes; electronic cigarettes; adolescents; smokeless tobacco; GYTS&#x0D; Compliance with ethical standards: the Local ethics committee of the Republican unitary enterprise «Scientific and Practical Centre of Hygiene» of the Ministry of Health.&#x0D; Patient consent. Each participant of the study (or his/her legal representative) gave informed voluntary written consent to participate in the study and publish personal medical information in an impersonal form in the journal "Gigiena i Sanitariya (Hygiene and Sanitation, Russian journal)".

CORRELATION OF BRONCHOALVEOLAR LAVAGE WITH TRANSBRONCHIAL LUNG BIOPSY

Background: Lung cancer is the leading cause of cancer related deaths in men and in women it has surpassed even breast cancer. Pulmonary cytology and histopathology are valuable tools in the diagnosis of lung malignancies. This Methods: was one-year prospective study between February 2021 to February 2022.. Bronchoalveolar lavage was done in 120 patients presenting with signicant complains. Histopathology correlation was done for same. Results: Adenocarcinoma were most common lesions. Malignancy was reported in 82 cases. Pulmonary cytology and histopathology are valuable tools in the diagnosis of lung malignancies. Conclusion: Pulmonary diseases especially malignancies have shown a male predilection and this trend seems to be due to a higher rate of tobacco consumption amongst the males.

Exposure to potentially toxic elements through the soil-tobacco-human pathway: causative factors and probabilistic model

High concentrations of potentially toxic elements (PTEs) in tobacco leaves are possible from the soil contamination and would have adverse health risks on residents. A large-scale survey of 306 tobacco fields in southern China was conducted to investigate the accumulation of PTEs in tobacco leaves through the soil-tobacco-human pathway and the associated health risks for local smokers and passive smokers. Significant enrichment of As, Cd, Hg, and Pb was observed in the investigated tobacco fields, with industrial emissions and applied fertilizers as the major potential sources. Dynamic interactions between factors in the soil acidic labile pool showed site-specific effects on the uptake of PTEs by tobacco plants. It was 99.6% and 91.8% probable that exposure of local adult men smokers to Cd and As exceeded the permitted safety limits, respectively. The population of men smokers had a 20-fold higher Cd exposure risk than did passive smokers. A probability-based transfer model was developed to demonstrate that interactions between soil factors could affect the Cd exposure risk of men smokers of locally harvested tobacco. Optimizing the pH (>6.0) and organic matter content (>40 g kg−1) of tobacco-growing soils, and setting a safe tobacco consumption rate of 2.80 g dry weight per day would help protect 90.4% of men smokers from excessive risks of exposure to Cd.

Comparative Performance of Three Methods to Classify Smokers Data

Since recently tobacco epidemic is one of the most important health hazards that face Iraqi individuals and communities in spite of the large information supported by the Iraqi Ministry of Health and the available statistics that link smoking with many life threatening illnesses to human. Tobacco consumption rates are increasing nowadays among university students. Iraqi Ministry of Health confirmed the need to take a serious action to support research that examines the tobacco epidemic among students, in an attempt to find the causes and the appropriate solutions.It is, therefore, our main objective is to investigate the student smokers from the University of Kufa in Iraq. The research attempted to study the behaviour of smokers using questionnaires. The performance of Latent Classes (LC) is evaluated by attempting to classify the student smokers and then compared it to two clustering methods namely K-means and Two-Step method.

Sociocultural Reasons for Tobacco Consumption in France

In order to understand the high rates of tobacco consumption in France, various aspects of French culture and law were analyzed. After seeing the actual number of people considered daily smokers in France by organizations such as the Organisation for Economic Co-operation and Development (OECD) and the World Health Organisation (WHO), it was considered multiple aspects of French culture that might enhance tobacco consumption practices. Through comparing these practices with the United States, along with the perspectives people have about smoking in these two countries (US and France), it is shown how the perception of a practice in a certain place could determine how much this practice is done by people in that place. That way, after comparing the perception of smoking practices in France and the United States, it was shown that while in the US smoking is stigmatized, in France it is not. Consequently, in France, smoking is more commonly practiced than in the United States. France has a strong restaurant eating culture and tobacco consuming might be strongly correlated to eating out in restaurants. Thus, after analyzing the concept of craving and how much a person’s environment could trigger craving a drug (tobacco, in this case), it could be seen that in France, where the environment is so welcoming to smoke tobacco, it is easy for a tobacco consumer to maintain this practice for years in France. Lastly, the social environment might play a significant role in tobacco consumption, especially in a place where such practice is not stigmatized but welcomed. After analyzing these aspects and seeing how each one plays a significant role in the tobacco consumption practices in France, it was concluded that it is the accumulation of these various factors that enhance smoking in France, that explain why this practice is so commonly seen in this country.

Prevalence of type of Chewing Tobacco in Tobacco Users in Patients Reported in Private Dental Institution

Tobacco use is one of the leading preventable causes of early death, disease around the world. India has a high prevalence rate of tobacco consumption, both smoking and smokeless forms. There are many types of chewing tobacco such as pan masala, khaini, mawa, snuff, zarda, mishri etc. The aim of this study is to find the prevalence rate of the type of chewing tobacco in tobacco users in patients reported to, Chennai. It's a retrospective cross-sectional study in a university setting. Case records were collected and analysed the data of 41000 patients between June 2019 and March 2020 from the private dental institution. A total of 194 cases were recorded with patients who have a habit of chewing tobacco. The data was tabulated with parameters such as age, gender, type of chewing tobacco and type of habit. Data was then imported to IBM-SPSS v20 for statistical analysis. Descriptive statistics was done for further analysis. Among types of chewing tobacco, pan masala was prevalent (55.7%), with male predilection being 92.3%. The common age group which was seen chewing tobacco was 18-30 years-28.4%, with type of habit being only chewing tobacco-87.1%. Within the limits of the study, prevalence was seen in males with 18-30 age group being the most affected. Pan masala was the most prevalent type of chewing tobacco followed by gutka. As pan and gutka are the most common types used in Chennai, it is more carcinogenic than other types of chewing tobacco and its usage is increasing among the youth. Precautions must be taken such as anti-tobacco intervention to decrease the consumption of tobacco which causes a decrease in chances of cancer formation.

Anabasine-based measurement of cigarette consumption using wastewater analysis.

Community tobacco use can be monitored over time using wastewater-based epidemiological approaches by estimating the mass loads of nicotine and its metabolites, cotinine, or hydroxycotinine, in wastewater. However, due to the use of nicotine in smoking cessation products, other sources of nicotine contribute to cotinine and hydroxycotinine loads. The use of nicotine replacement therapies could vary in space and time and mask the true rates of tobacco consumption. Therefore, this work evaluated the content of tobacco specific markers, anatabine and anabasine, in cigarettes, in urine of smokers, and in wastewater. The results indicated that the anabasine content in both licit and illicit cigarettes in Australia is less variable than anatabine and is therefore considered a better measure of tobacco consumption. A study determining the excretion of tobacco-specific alkaloids of smoking and non-smoking volunteers gave an average urinary mass load of anabasine of 4.38 μg/L/person and a daily mass load of 1.13 μg/day/person. Finally, this was compared with the mass loads of anabasine from wastewater-based epidemiology data of 3 μg/day/person to estimate cigarette rates in a South Australian city: equivalent to 2.6 cigarettes/person/day. The rate of decline of cigarette use was greater when using anabasine as a measure of consumption compared with cotinine. This is the first study to estimate the rate of anabasine excretion, which can be used to estimate tobacco use independent of therapeutically prescribed nicotine.

First nation-wide estimation of tobacco consumption in Spain using wastewater-based epidemiology

Wastewater-based epidemiology (WBE) has become a very useful tool to monitor a population's drug consumption or exposure to environmental and food contaminants. In this work, WBE has been applied to estimate tobacco consumption in seven Spanish regions. To this end, 24 h composite wastewater samples were taken daily for one week in 17 wastewater treatment plants, covering altogether a population of ca. 6 million inhabitants. The samples were treated by enzymatic deconjugation and the wastewater content of two human-specific nicotine metabolites (namely, cotinine and trans-3′-hydroxycotinine) was measured to estimate the daily consumption of nicotine. The population-weighted average nicotine consumption in the seven analyzed regions was 2.2 g/(day∙1000 inh.), without any daily pattern. This average estimated nicotine consumption value agreed with the value derived from official tobacco sales data. Differences in consumption among the seven studied regions were found, being Galicia, the region with the lowest rate, and the Basque Country and Catalonia those with the highest rates. However, no conclusive correlation was found between those values and the prevalence data taken from two different national surveys, nor sociodemographic and health data. This study demonstrates that this tool can complement other indicators in order to accurately assess tobacco consumption rates at regional and national levels and provides the most extensive application of the approach in the Spanish territory.

Tobacco, Alcohol and Family History of Cancer as Risk Factors of Oral Squamous Cell Carcinoma: Case-Control Retrospective Study

The aim of the study is to observe retrospectively the correlation between Oral Squamous Cell Carcinoma (OSCC) and risk factors; including tobacco, alcohol and Family History of Cancer (FHC). A total of 478 patients were included retrospectively from the database of the Department of Oral Sciences and Maxillofacial Surgery, Sapienza University of Rome. A Test Group (TG) consisted of 239 patients with a confirmed diagnosis of OSCC. A Control Group (CG) consisted of 239 patients without history and/or diagnosis of oral cancer. The logistic regression models were used to calculate the adjusted Odd Ratios (ORs) associated with alcohol, tobacco and FHC; including the General Family History of Cancer (GFHC) and Family History of Head and Neck Cancer (FHHNC) and their 95% Confidence Intervals (CI). The high rate of tobacco consumption was associated with an OR of 1.035 (95% CI 1.001–1.070) and a statistical significance (p = 0.041). Drinker patients showed a significant risk of developing OSCC (p = 0.05) and the OR was 1.035 (95% CI 1.010–1.061). The GFHC was associated with a marginal risk of OSCC with an OR of 1.095 (95% CI 0.953–1.259), without significance (p = 0.199). The FHHNC showed a notable risk increase with an OR of 1.871 (95% CI 0.902–3.882), without significance (p = 0.092). Alcohol and tobacco may be associated with an increase in the risk of OSCC.

Prevalence and Determinants of Substance Abuse Among Slum Dwellers in Islamabad- Pakistan

Background: The slums are illegal settlements and are always left out in health surveys. However, studies around the world show that substance or drug abuse is higher among slum dwellers and may have different patterns and determinants which need to be studied in order to frame targeted programs and policies. The present study was aimed at estimating the magnitude as well as determinants of substance/drug abuse among slum dwellers in Islamabad, the capital city of Pakistan.&#x0D; Methodology: This community-based cross-sectional study was conducted among the residents of slums/nomadic settlements of Islamabad. A total of 207 statistically calculated sample size comprised of adults from both genders aged 15 years and above, consenting to participate from the randomly selected 9 clusters in Islamabad was needed for the study. From each cluster, 23 households, and from each household one individual was randomly selected for estimating the prevalence. All those who were abusing substances were counted as cases and others as controls for case-control analysis. A structured questionnaire was used to gather information on demographics, trends, types of substances abused, risk factors for getting engaged in substance abuse, whether they had tried to quit at any stage and what difficulties they faced when trying to quit. Results were entered and analyzed using Epi-info version 7.2.&#x0D; Results: A total of 204 participants were enrolled in this study. Among these 68 (33%) were substance or drug abusers. For the case-control study, substance/drug users were considered as cases 68 and rest as controls. Bivariate analysis of the risk factors indicated that easy of availability of drugs in slum areas (OR: 20.3, p= 0.000); exposure to tobacco smoking (OR: 8.8, p= 0.000); and being a working child (OR: 6.0, p= 0.000) were the strong predictors of high substance abuse. Education (OR: 0.2, p= 0.000) and living with own parents during childhood (OR: 0.7 p= 0.2) had protective effects against substance abuse.&#x0D; Conclusion and Implications for Translation: The study concludes that the following were the determinants of substance/drug abuse among the slum dwellers in the study: easy availability due to unregulated sales of drugs, high rate of tobacco consumption, poverty, low level of literacy, and being a working-child. Specific policies and plans focused on law enforcement for curbing the illegal drug sales and reduction of child labor along with the provision of education should be devised and implemented to help these neglected communities and modify the determinants.&#x0D; Key words: • Substance abuse • Drug abuse • Slum dwellers • Case-control • Islamabad • Pakistan&#x0D; &#x0D; Copyright © 2019 Faiza et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.