The Lancet Regional Health: Western Pacific最新文献

{"title":"Corrigendum to Policies, resource allocation, and interventions for child and adolescent mental health in low- and middle-income countries in the Western Pacific Region: a scoping review [The Lancet Regional Health—Western Pacific, Vol 62 (2025), 101674]","authors":"Jiang Long , Stephanie Zhang , Lingjun Chu , Juliet Balkian , Isabel Giovannucci , Cody Mui , Yiqun Luan , Odille Chang , Phetsavanh Chanthavilay , Kartika Goundar , Munkh-Erdene Luvsan , Elissa Kennedy , Dang Nguyen , Picholas Kian Ann Phoa , Caroline Mae Ramirez , Bach Xuan Tran , Siyan Yi , Paula Melizza Valera , Sovanvorleak Tep , Mengieng Ung , Chunling Lu","doi":"10.1016/j.lanwpc.2025.101742","DOIUrl":"10.1016/j.lanwpc.2025.101742","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101742"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainable age-friendly cities and communities in China: a scoping review and narrative assessment of national policies","authors":"Yanhui Jia ,&nbsp;Siwon Lee ,&nbsp;Mikiko Kanda ,&nbsp;Pankyu Park ,&nbsp;Sally J. Edwards ,&nbsp;Jiuxuan Gao ,&nbsp;Weiju Zhou ,&nbsp;John S. Ji","doi":"10.1016/j.lanwpc.2025.101723","DOIUrl":"10.1016/j.lanwpc.2025.101723","url":null,"abstract":"<div><h3>Background</h3><div>Climate change, aging populations, and rapid urbanization intersect to pose public health challenges in China, impacting the livelihoods of older adults. This review maps China's national policies shaping Sustainable Age-Friendly Cities and Communities (AFCC), highlights supporting sub-national innovations, and identifies potential policy gaps and opportunities.</div></div><div><h3>Methods</h3><div>We searched 26 national government websites for policy documents published from January 1, 2020, to December 20, 2024, screening 35,809 records and including 125 that met criteria.</div></div><div><h3>Findings</h3><div>National frameworks (National Strategy for Climate Change Adaptation 2035, Healthy China 2030, Healthy Cities) have parallel efforts linking climate resilience and healthy aging. However, policy domains are siloed: age-friendly policies focus on healthcare accessibility, whereas sustainability policies target ecological restoration. Sub-national innovations, such as 15-min life circles, sponge cities for flood, “one old, one young” inter-generational hubs, advance climate adaptation. The large-scale Three-North Shelter Forest Program indirectly benefits older adults respiratory risk by controlling dust and desertification. However, these initiatives run in parallel, with limited shared targets, data systems, and co-financing. Institutional fragmentation and regional disparities in geographic, economic, and administrative capacities impede uniform implementation, risking inefficient spending and missed synergies.</div></div><div><h3>Interpretation</h3><div>Effective action on concurrent aging and climate risks hinges on policy-and-practice integration of AFCC and sustainability agendas. Age-friendly plans should include sustainability and vice versa. China's administrative grid and large-scale ecological programs provide infrastructure for delivery of dual-benefits.</div></div><div><h3>Funding</h3><div>This work is supported by the <span>World Health Organization</span> (<span><span>WPRO/2024-02/AGE-DHP/22552 4</span></span>), the <span>National Natural Science Foundation</span> of China (<span><span>82422064</span></span>, <span><span>82250610230</span></span>, <span><span>42307535</span></span>, <span><span>42577488</span></span>), the <span>Natural Science Foundation of Beijing</span> (<span><span>IS23105</span></span>), and the <span>National Bureau for Disease Control and Prevention</span> (<span><span>20241660047</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101723"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological characteristics of heatstroke in China, 2010–2023: a longitudinal study based on a national heatstroke surveillance system","authors":"Xiaoye Wang ,&nbsp;Fan Ding ,&nbsp;Xiaoqi Qi ,&nbsp;Ziyi Wang ,&nbsp;Yingxin Pei ,&nbsp;Lijie Zhang ,&nbsp;Jinghuan Ren ,&nbsp;Yeping Wang ,&nbsp;Qing Guo ,&nbsp;Biao Zeng ,&nbsp;Shiyao Xu ,&nbsp;Tian Liu ,&nbsp;Rui Wang ,&nbsp;Zhifeng Wang ,&nbsp;Guoqing Shi","doi":"10.1016/j.lanwpc.2025.101722","DOIUrl":"10.1016/j.lanwpc.2025.101722","url":null,"abstract":"<div><h3>Background</h3><div>Heatstroke causes numerous pathophysiological changes and can lead to death. Extreme heat events have been increasing in frequency, duration, and intensity worldwide in recent decades and are causing growing public health concern. However, epidemiological studies of heatstroke are limited in number and scope, and have had relatively small sample sizes. To better understand the epidemiological characteristics of heatstroke and advance evidence-based prevention and control strategies, we conducted an observational study of reported heatstroke cases in China.</div></div><div><h3>Methods</h3><div>Cases included in this study were patients clinically diagnosed with heatstroke during the study period of 2010–2023, reported through a dedicated heatstroke surveillance system established by China CDC. We used descriptive statistical methods to determine the epidemiological characteristics of heatstroke in China.</div></div><div><h3>Findings</h3><div>There were 86,406 heatstroke cases reported during the study period, with an increasing reporting trend (Spearman correlation coefficient <em>r</em> = 0·79). Annual incidence (Spearman <em>r</em> = 0·77) and proportion of severe cases (Pearson <em>r</em> = 0·67) were positively correlated with the number of nationwide average annual high-temperature days. The overall incidence was 44·83 per 10 million person-years, and the mortality rate was 0·89 per 10 million person-years; 32·02% of cases were severe; the overall case fatality rate (CFR) was 1·98%, and the CFR for severe cases was 6·19%. Most cases and deaths were reported in summer, with peaks in late July. The peaks of incidence, duration, and severity varied by region. The mean age was (50·46 ± 18·73) years, with male cases younger than female cases (49·21 ± 17·41 vs 53·60 ± 21·36; <em>t</em> = −28·73, <em>p</em> &lt; 0·0001). For every five-year increase in age, the risks of severe heatstroke and death increased by 14·64% (95% <em>CI</em>: 1·1415–1·1513) and 25·76% (<em>CI:</em> 1·2400–1·2755), respectively. The male:female ratio was 2·49:1; males exhibited a higher risk of suffering from heatstroke and having greater disease severity than females.</div></div><div><h3>Interpretation</h3><div>Our study provides a clear profile of heatstroke cases, and highlights differences by population, region, and time of year. Results inform formulation of evidence-based strategies for enhanced heatstroke preparedness and response, such as enhancing public health early warning systems, prioritizing protection for vulnerable groups, and advancing localized interventions for risk communication and clinical management.</div></div><div><h3>Funding</h3><div><span>Public Health Talent Program of China’s National Disease Control and Prevention Administration</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101722"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk-stratified classification of pulmonary nodule malignancy via a machine learning model integrating imaging and cell-free DNA: a model development and validation study (DECIPHER-NODL)","authors":"Huiting Wang ,&nbsp;Hairong Huang ,&nbsp;Feng Li ,&nbsp;Ying Deng ,&nbsp;Changyong Wang ,&nbsp;Wei Wei ,&nbsp;Song Wang ,&nbsp;Dongqin Zhu ,&nbsp;Hao Xu ,&nbsp;Hua Bao ,&nbsp;Zheng Li ,&nbsp;Wenjun Ye ,&nbsp;Yuan Zhang ,&nbsp;Caichen Li ,&nbsp;Bo Cheng ,&nbsp;Xiwen Liu ,&nbsp;Liping Liu ,&nbsp;Zheng Li ,&nbsp;Jing Yang ,&nbsp;Wei Chen ,&nbsp;Wenhua Liang","doi":"10.1016/j.lanwpc.2025.101730","DOIUrl":"10.1016/j.lanwpc.2025.101730","url":null,"abstract":"<div><h3>Background</h3><div>Accurate risk stratification of pulmonary nodules is critical for early lung cancer detection. This study aimed to improve malignancy classification and invasiveness prediction using machine learning models integrating low-dose computed tomography (LDCT) radiomics and plasma cell-free DNA (cfDNA) fragmentomics.</div></div><div><h3>Methods</h3><div>This multicenter study enrolled 1356 participants across discovery (n = 1147) and external validation (n = 209) cohorts. A deep learning-based imaging model processed LDCT scans for automated lung nodule detection and malignancy classification. A parallel cfDNA model analyzed four whole-genome fragmentation features: copy number variation, fragment size ratio, fragment-based methylation, and mutation context and signature. The two models were integrated via a stacked ensemble algorithm. An invasion prediction model evaluated tumor aggressiveness.</div></div><div><h3>Findings</h3><div>The integrated imaging-cfDNA model outperformed individual models, with an AUC of 0.950 (95% CI: 0.926–0.975) in the internal test set and 0.966 (95% CI: 0.940–0.991) in the external validation. The combined model's specificity increased to 0.60 (95% CI: 0.49–0.71) while maintaining 95% sensitivity, compared to specificities of 0.50 (95% CI: 0.41–0.59) and 0.33 (95% CI: 0.23–0.44) at equivalent sensitivity levels for the imaging and cfDNA models, respectively. The combined model consistently outperformed the other two models across nodule characteristics, with particular improvement for 10–20 mm and pure solid nodules. The invasion prediction model stratified lung cancers with an AUC of 0.884 (internal) and 0.880 (external). Prediction scores increased stepwise with tumor aggressiveness, from adenocarcinoma in situ to minimally invasive adenocarcinoma, and were highest for invasive adenocarcinoma.</div></div><div><h3>Interpretation</h3><div>This multimodal approach enhances pulmonary nodule risk stratification by integrating radiomic and molecular biomarkers. The model significantly improves diagnostic accuracy, potentially reducing unnecessary procedures while minimizing missed diagnoses, supporting its clinical utility in lung cancer screening.</div></div><div><h3>Funding</h3><div><span>Noncommunicable Chronic Diseases-National Science and Technology Major Project</span>, <span>National Key Research &amp; Development Programme</span>, <span>China National Science Foundation</span>, the <span>Science and Technology Planning Project of Guangzhou</span>, and <span>Guangzhou National Laboratory</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101730"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-resistant gram-negative bacterial infections in children in the Oceania region: review of the epidemiology, antimicrobial availability, treatment, clinical trial and pharmacokinetic data, and key evidence gaps","authors":"Daniel K. Yeoh ,&nbsp;Alison Boast ,&nbsp;Sophie CH. Wen ,&nbsp;Phoebe CM. Williams ,&nbsp;Lesley Voss ,&nbsp;Brett Ritchie ,&nbsp;Mona Mostaghim ,&nbsp;Flora Lutui ,&nbsp;Alice Lei ,&nbsp;Tony Lai ,&nbsp;Adam D. Irwin ,&nbsp;Kiera Harwood ,&nbsp;Thomas Ewin ,&nbsp;Celia Cooper ,&nbsp;Emma Best ,&nbsp;Sarah Bannister ,&nbsp;Amanda Gwee","doi":"10.1016/j.lanwpc.2025.101735","DOIUrl":"10.1016/j.lanwpc.2025.101735","url":null,"abstract":"<div><div>Gram-negative bacterial infections remain a major cause of morbidity and mortality in children and neonates globally, compounded by the rise of antimicrobial resistance. Barriers to paediatric antibiotic licencing lead to reduced availability of potentially effective agents for treatment. For children and neonates in the Oceania region, specific challenges remain including a paucity of surveillance data on local rates of antimicrobial resistance, and lack of availability of newer, more costly agents. In this review, we summarise available regional epidemiological data on the WHO priority pathogens: extended spectrum B-lactamase (ESBL)-producing Enterobacterales, carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant <em>Pseudomonas aeruginosa</em>, and carbapenem-resistant <em>Acinetobacter baumannii</em> (CRAB). Paediatric clinical trial and pharmakinetic data for the antimicrobials recommended for treatment of these pathogens are reviewed, and paediatric knowledge gaps identified to inform future collaborative research.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101735"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes stigma and underdiagnosis: time to change the narrative in the Western Pacific region","authors":"The Lancet Regional Health – Western Pacific","doi":"10.1016/j.lanwpc.2025.101764","DOIUrl":"10.1016/j.lanwpc.2025.101764","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101764"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surveillance epidemiology of heatstroke in China: when numerators are denominators","authors":"John S. Ji","doi":"10.1016/j.lanwpc.2025.101751","DOIUrl":"10.1016/j.lanwpc.2025.101751","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101751"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone based cognitive behavioural therapy for adults with no or minimal depressive symptoms in Japan: an exploratory secondary analysis of RESiLIENT trial","authors":"Rie Toyomoto ,&nbsp;Aran Tajika ,&nbsp;Yan Luo ,&nbsp;Masatsugu Sakata ,&nbsp;Tatsuo Akechi ,&nbsp;Takeo Nakayama ,&nbsp;Naoki Kondo ,&nbsp;Shingo Fukuma ,&nbsp;Masaru Horikoshi ,&nbsp;James M.S. Wason ,&nbsp;Hisashi Noma ,&nbsp;Toshi A. Furukawa","doi":"10.1016/j.lanwpc.2025.101741","DOIUrl":"10.1016/j.lanwpc.2025.101741","url":null,"abstract":"<div><h3>Background</h3><div>Although cognitive behavioural therapy (CBT) is a well-established intervention for both the prevention and treatment of depression, its potential role in mentally healthy individuals remains underexplored. We aimed to evaluate the effects of smartphone CBT in mentally healthy adults.</div></div><div><h3>Methods</h3><div>This exploratory secondary analysis from the RESiLIENT trial (UMIN000047124), a master protocol trial consisting of four 2 × 2 factorial trials, included 1,425 adults with no or very mild depressive symptoms (PHQ-9 ≤4). Participants were recruited nationwide and randomly assigned via a centralized web-based system to one of 12 six-week programs (n = 117 to 120 each): five single-skill CBT interventions (Behavioural Activation [BA], Cognitive Restructuring [CR], Problem Solving [PS], Assertion Training [AT] and Behaviour therapy for Insomnia [BI]), 4 combinations in which BA was paired with another skill, and three control conditions (Health Information [HI], Self-check [SC], Delayed Treatment [DT]). HI, serving as the primary comparator, delivered general health information in a format similar to active interventions. The primary outcome was change in depressive symptoms (PHQ-9) from baseline to weeks 6 and 26. Secondary outcomes included anxiety (GAD-7), insomnia (ISI), and well-being (SWEMWBS).</div></div><div><h3>Findings</h3><div>The follow-up rate was 96% at week 6 and adherence to the app was 83%. At week 6, all interventions except PS and BA + PS were superior to HI (SMDs −0.62 to −0.22). At week 26, BA, AT and BI or BA + CR appeared to retain moderate efficacy (SMDs −0.30 to −0.27). BA and AT reduced anxiety, and AT and BI improved sleep quality at week 6. In contrast, CR and PS showed limited effects and lower adherence. There was insufficient evidence to show that the interventions improved overall well-being. No serious adverse events were reported.</div></div><div><h3>Interpretation</h3><div>Single-skill smartphone CBT, especially BA and AT, reduced depressive and anxiety symptoms in healthy adults, supporting its use as a scalable public health prevention tool and suggesting that the efficacy of individual CBT skills may differ based on baseline symptom severity, highlighting the importance of tailored interventions for mental health maintenance.</div></div><div><h3>Funding</h3><div>This study was supported by AMED (grant no. JP21de0107005) and JSPS KAKENHI (grant no. 22K21171).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101741"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritizing interventions for echinococcosis prevention in China: a population attributable fraction analysis","authors":"Shuaiming Xu ,&nbsp;Quzhen Danzeng ,&nbsp;Bing Guo ,&nbsp;Peidi Xu ,&nbsp;Lingxi Gu ,&nbsp;Yajie Zhao ,&nbsp;Xiong Guo ,&nbsp;Yuling Tang ,&nbsp;Yang Chang ,&nbsp;Gonghua Wu ,&nbsp;Xing Zhao","doi":"10.1016/j.lanwpc.2025.101738","DOIUrl":"10.1016/j.lanwpc.2025.101738","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Despite population-level control efforts, human echinococcosis continues to pose a public health challenge in China. Targeting modifiable risk factors at the individual level could be another recipe, but the priority targets for intervention remain unclear. Our aim was to quantify the potential health gains of hypothetical interventions on modifiable risk factors for human echinococcosis, informing effective control strategies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We collected and aggregated data on the association between modifiable risk factors and human echinococcosis and national total echinococcosis (cystic echinococcosis [CE], alveolar echinococcosis [AE], and other unclassified cases) incidence during 2007–2020 in China. A Bayesian hierarchical model was developed to pool effect estimates for modifiable risk factors associated with total echinococcosis and its subtypes (CE and AE), while accounting for the adequacy of confounding adjustment. Additionally, we evaluated the preventable burden of human echinococcosis via the annual number of total echinococcosis cases attributable to modifiable risk factors deriving from the population attributable fractions (PAFs).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Twelve risk factors for human echinococcosis were identified from 25 studies across nine endemic provinces and autonomous regions in China, with PAFs ranging from 2.2% to 41.2%. The highest PAFs were observed for surface water sources for drinking (PAF: 41.2%; 95% confidence interval [CI]: 18.9–55.9) and the presence of stray dogs around residences (PAF: 34.9%; 15.8–55.1), accounting for 1437 (95% CI: 658–1947) and 1216 (552–1921) preventable annual total echinococcosis cases, respectively. Drinking unboiled water followed, with a PAF of 33.5% (6.2–54.8) and 1167 (217–1910) preventable cases annually. In contrast, the lowest PAF was estimated for exposure to foxes or fox-derived materials (PAF: 2.2%; 0.5–4.3). Surface water sources for drinking and free-roaming owned dogs showed the highest PAFs for CE (42.6%; 19.7–56.5) and AE (49.4%; 34.8–60.2), respectively. Simultaneously eliminating the presence of stray dogs around residences and surface water sources for drinking was the most-effective among available pair-wise combination of risk factors, in which 75.3% (1621/2152) of preventable total echinococcosis cases are concentrated in Xinjiang Uygur Autonomous Region (833; 519–1005), Qinghai Province (396; 247–478), and Sichuan Province (392; 244–473).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Interventions targeting drinking water safety and responsible dog management could reduce echinococcosis incidence in China. Public health efforts should prioritize high-prevalence regions such as Xinjiang Uygur Autonomous Region, Qinghai Province, and Sichuan Province to maximize impact.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;&lt;span&gt;NHC Key Laboratory of Echinococcosis Prevention and Control&lt;/span&gt; (no. &lt;span&gt;&lt;span&gt;21H1234&lt;/sp","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101738"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in smoking prevalence before and after the emergence of vaping in Aotearoa/New Zealand among 14–15-year-olds identifying as Māori, Pacific, European, or Asian: an interrupted time series analysis of repeated cross-sectional data, 2003–2024","authors":"Sam Egger ,&nbsp;Andrew Waa ,&nbsp;Michael David ,&nbsp;Judith McCool ,&nbsp;Lucy Hardie ,&nbsp;Marianne F. Weber ,&nbsp;Qingwei Luo ,&nbsp;Jamie Egger ,&nbsp;Becky Freeman","doi":"10.1016/j.lanwpc.2025.101721","DOIUrl":"10.1016/j.lanwpc.2025.101721","url":null,"abstract":"<div><h3>Background</h3><div>Ethnic inequities in health and mortality in Aotearoa/New Zealand have been driven in part by historic and ongoing inequities in smoking prevalence, with Māori and Pacific peoples most affected. Although overall smoking rates among year 10 students aged 14–15 years have declined substantially in recent decades, recent analyses suggested that e-cigarette use (vaping) may have slowed the decline in ever- and regular-smoking, while having little or no impact on daily smoking. However, it remains unclear whether these patterns differ for Māori, Pacific, European, or Asian adolescents.</div></div><div><h3>Methods</h3><div>Interrupted time series analyses of the Snapshot Survey data (2003–2024; n = 588,143) to assess changes in smoking trends before and after the emergence of vaping in Aotearoa among 14–15-year-old Māori, Pacific, European, and Asian adolescents.</div></div><div><h3>Findings</h3><div>From 2003 to 2024, ever-, regular-, and daily-smoking prevalence declined substantially among Māori, Pacific, European, and Asian adolescents. However, the rates of decline in ever-smoking slowed significantly from 2010 onwards—coinciding with the emergence of vaping in Aotearoa—for Māori (p = 0.025), European (p &lt; 0.001), and Asian (p = 0.018) adolescents. Similarly, declines in regular-smoking slowed significantly for Māori (p = 0.012), Pacific (p = 0.003), and European (p &lt; 0.001) adolescents. A significant change in the rate of decline in daily smoking was observed only for European adolescents, who showed a small slowing (p = 0.004). Findings were robust to different time series interruption-points (change-years) and controlling for cigarette affordability.</div></div><div><h3>Interpretation</h3><div>We found no evidence that vaping is displacing adolescent smoking among any of the four ethnic groups analysed. On the contrary, our findings suggest that the emergence and rise of vaping in Aotearoa may have undermined progress in reducing regular-smoking among Māori, Pacific, and European adolescents, but with more serious implications for Māori and Pacific youth.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"64 ","pages":"Article 101721"},"PeriodicalIF":8.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}