Tobacco Induced Diseases最新文献

Introduction: While tobacco industry corporate social responsibility (CSR) activities as marketing strategies have been documented globally, the narrative mechanisms through which media coverage legitimizes tobacco industry charitable donations remain understudied, particularly within China's unique state-monopoly context. This study examines how tobacco industry donations function as marketing through media narratives.

Methods: We conducted a secondary systematic content and narrative analysis of news coverage documenting tobacco industry charitable donations recorded in the 2021 China Tobacco Yearbook. Using purposive sampling, we identified 85 news reports from 2020, through comprehensive online searches. Two trained coders independently analyzed all materials using a coding framework based on narrative theory, examining eight dimensions including narrator types, character construction, narrative perspectives, and framing strategies (Cohen's κ=0.85; 95% CI: 0.78-0.91).

Results: Analysis revealed systematic narrative strategies designed to enhance tobacco companies' public image. Key findings include: 82.35% (n=70) of headlines explicitly mentioned tobacco company names; reporting frames emphasized national policy alignment (37.65%; n=32), health benefits (34.12%; n=29), and corporate social responsibility (30.6%; n=26); tobacco companies appeared as primary actors in 97.6% (n=83) of reports; 100% (n=85) of coverage maintained positive valence toward donations. Chi-squared analysis demonstrated significant associations between character construction and framing strategies (χ²=42.84; degrees of freedom, df=4; p<0.001; Cramer's V=0.710).

Conclusions: News coverage of tobacco industry donations employs sophisticated narrative strategies that function as a form of tobacco promotion and marketing with implications for World Health Organization Framework Convention on Tobacco Control (WHO FCTC) Article 13 implementation. These findings suggest the need for further research on regulatory approaches to address all forms of tobacco promotion, including charitable donations and their media coverage, to support effective WHO FCTC implementation.

Introduction: Secondhand smoke (SHS) exposure remains a significant global public health issue. Identifying the factors contributing to SHS exposure is crucial for developing targeted, evidence-based interventions to mitigate its impact. This study examines the patterns and determinants of SHS exposure at home among non-smoking Malaysians.

Methods: Data were derived from the National Health and Morbidity Survey (NHMS) 2019, which employed a cross-sectional design and multistage sampling to gather a representative sample of Malaysians aged ≥15 years. Demographic data and information on SHS exposure at home within the past month, were collected via a structured questionnaire. Weighted data were analyzed using chi-square tests and multivariable logistic regression.

Results: Of the 1876 participants (representing an estimated 3.54 million individuals), 19.8% (95% CI: 18.5-21.1) reported SHS exposure at home. Several sociodemographic factors were significantly associated with SHS exposure. Logistic regression analysis revealed higher odds of exposure among females (adjusted odds ratio, AOR=1.85; 95% CI: 1.55-2.29), Malays (AOR=2.65; 95% CI: 1.86-3.78), Bumiputera Sabah (AOR=4.16; 95% CI: 2.72-6.37), and Bumiputera Sarawak (AOR=3.67; 95% CI: 2.32-5.80). Other significant factors included being aged ≤24 years (AOR=1.87; 95% CI: 1.26-2.78) and belonging to a low income group (quintile 1; AOR=1.42; 95% CI: 1.12-1.95). Interaction analysis also identified significant two-way interactions between sex and some sociodemographic independent variables.

Conclusions: Approximately two in ten non-smoking Malaysians were exposed to SHS at home. These findings underscore the need for comprehensive tobacco control measures that raise awareness about the health risks of SHS exposure at home. Educational campaigns should focus on promoting smoke-free home environments, particularly among the high-risk groups identified in this study.

Introduction: The rapid proliferation of electronic cigarettes (e-cigarettes) among adolescents represents a significant public health challenge globally. This qualitative study explored adolescents' perspectives on effective characteristics of e-cigarette prevention videos to inform evidence-based prevention strategies.

Methods: We conducted four focus groups with 40 middle-school students aged 13-15 years in 2021 in Beijing and Kunming, China. Using purposive sampling, we selected participants (n=40) from schools in cities with contrasting tobacco control environments. After viewing four international e-cigarette prevention videos varying in style and content, participants discussed perceived effective and ineffective characteristics. We employed Braun and Clarke's six-phase reflexive thematic analysis approach, using NVivo 12 for data management.

Results: Thematic analysis identified two main domains: effective and ineffective video characteristics. Effective features included authentic case studies demonstrating real consequences, specific health hazards with visual impact, disclosure of harmful chemical components, and appropriately disturbing imagery that created emotional response. Fear appeals and emotional narratives proved particularly impactful when combined with concrete information. Ineffective characteristics included animation formats, overly complex or vague information, didactic expert testimonials, and excessive video length (>2 minutes). Participants recommended that future videos incorporate real-life cases, specific health consequences, moderate fear appeals, and concise messaging within 1-3 minutes.

Conclusions: Chinese adolescents respond most effectively to prevention videos featuring authentic narratives and specific health consequences rather than animated or didactic content. The preference for fear appeals combined with factual information suggests that emotionally engaging yet informative content may optimize prevention effectiveness. These findings provide evidence for developing culturally appropriate e-cigarette prevention video development for Chinese youth, particularly given ongoing challenges in policy enforcement and youth access to e-cigarettes.

Introduction: The effect of smoking cessation during pregnancy on preventing adverse birth outcomes has been shown in studies of US birth certificate data, and in other nations. There is a paucity of data to optimize community-based maternal tobacco cessation programs to improve birth outcomes. Our objective is to evaluate the real-world effectiveness of a multi-component, community-based maternal smoking cessation program in preventing adverse infant outcomes using components of known efficacy.

Methods: The Comprehensive Tobacco Treatment Program (CTTP) was a state-funded maternal tobacco smoking cessation program serving pregnant women in San Bernardino County, California, the largest county in the contiguous US. CTTP used a six-to-eight-week behavioral intervention with components of known efficacy (i.e. incentives, biomarker testing, feedback, and motivational interviewing). We conducted a retrospective cohort study of the 1402 pregnant women enrolled in CTTP during 2012-2019. We conducted a multivariable logistic regression analysis with adverse infant outcomes [premature birth (PTB), low birthweight (LBW), and NICU admission] as the dependent variables, abstinence achieved during [prolonged abstinence (PA) through weekly urinary cotinine tests] or after the program [self-reported point prevalence abstinence (PPA)] as the main effect exposures, and pertinent confounders.

Results: We found that PA during the program significantly decreased the odds of LBW (OR=0.67; 95% CI: 0.47-0.96, p=0.03), and this association remained for self-report of PPA at 2-4 months after the program (OR=0.70; 95% CI: 0.54-0.90, p=0.006), and six months after the program (OR=0.65; 95% CI: 0.47-0.90, p=0.01). Similar, albeit weaker, trends were found for PTB (OR=0.80). In these models, older age, early trimester at enrollment, and African American/Black ethnicity also trended toward higher rates of LBW and PTB.

Conclusions: Abstinence achieved during a multi-component behavioral smoking cessation intervention program using components of known efficacy, significantly reduced low birthweight deliveries in a multi-ethnic population.

Introduction: This study examines how prevalence and behaviors of smoking differ by ethnicity and their associations with chronic obstructive pulmonary disease (COPD) among elderly people of four ethnicities in rural southwest China.

Methods: A cross-sectional survey of 5642 adults aged ≥60 years was conducted in rural southwest China. Data on the demographics, smoking habits, and post-bronchodilator spirometry were collected.

Results: Among the participants, the prevalence of current smoking (48.8% vs 0.8%) and COPD (12.7% vs 4.5%) was significantly higher in males compared to females (p<0.01). Filtered cigarettes were the most popular form of tobacco used, comprising 76.6% of tobacco consumed. Bai ethnic minority participants had the highest prevalence of current smoking and COPD, and the highest number of cigarettes smoked per day compared to the other three studied ethnicities (p<0.01). Ha Ni ethnic minority participants had the lowest rate of smoking cessation (8.7%) and the highest rate of smoking in public places (66.8%) (p<0.01). The results of multivariable logistic regression indicated that current smokers were more likely to suffer from COPD across all four studied ethnicities (p<0.05). Further, the association of current smoking with COPD in Bai ethnicity elderly participants was stronger compared to other ethnic groups (p<0.01).

Conclusions: The present study shows that ethnicity plays a significant role in influencing both the prevalence and behaviors related to smoking among elderly people in rural southwest China. Future efforts to prevent and reduce tobacco use in rural China should consider ethnicity, as culturally tailored tobacco control strategies could help prevent and manage the COPD epidemic.

Introduction: Adolescent suicidality poses a serious barrier to healthy growth and development. This study examines the association between secondhand smoke (SHS) exposure and suicidality among adolescents from multicultural families in South Korea, using a secondary analysis of the Korea Youth Risk Behavior Webbased Survey (KYRBS).

Methods: This cross-sectional study used pooled secondary data from the 2021 and 2024 waves of the KYRBS, a nationally representative survey of adolescents in South Korea, collected through self-administered questionnaires. This is a secondary dataset analysis of the KYRBS using logit regression models to assess the associations between the duration and setting-specific frequency of SHS exposure and suicidality among adolescents. The mediating role of perceived stress was examined using the Karlson-Holm-Breen (KHB) method.

Results: SHS exposure is significantly associated with increased suicidality likelihood among adolescents, with particularly strong associations observed in those from multicultural families. Among multicultural adolescents, each additional total day of SHS exposure is significantly associated with the likelihood of suicidal ideation (AOR=1.117; 95% CI: 1.084-1.151), suicide planning (AOR=1.095; 95% CI: 1.052-1.139), and suicide attempts (AOR=1.117; 95% CI: 1.069-1.168). SHS exposure showed a stronger association with suicidality in multicultural families versus non-multicultural families. A higher frequency of SHS exposure across multiple settings is significantly associated with elevated odds of suicidal ideation (AOR=1.422; 95% CI: 1.247-1.621), suicide planning (AOR=1.395; 95% CI: 1.153-1.689), and suicide attempts (AOR=1.524; 95% CI: 1.222-1.902). Further analysis reveals that perceived stress partially mediates the association between SHS exposure and suicidality among multicultural adolescents. Perceived stress indirectly mediated 23.19% of the effect of SHS exposure on suicide attempts. It also mediated 30.67% and 34.18% of the effects on suicidal ideation and planning, respectively.

Conclusions: SHS exposure was associated with a higher likelihood of suicidality among adolescents, with this association observed in greater magnitude in adolescents from multicultural families. Moreover, perceived stress partially mediates the association between SHS exposure and suicide attempts among multicultural adolescents.

Introduction: The health implications of electronic cigarette (e-cigarette) use remain uncertain despite their increasing global prevalence. This study evaluates the health hazards of e-cigarettes on railway workers by comparing the differences in clinical and biochemical health indicators resulting from exposure to different smoking methods.

Methods: Using a retrospective cohort design, this study analyzed 7719 routine physical examinations and clinical health records from male railway workers in Shanghai (March 2022). Participants were stratified into four smoking subgroups: non-users, e-cigarette users, cigarette smokers, and dual users (concurrent e-cigarette and cigarette use). A multinomial logistic regression analysis evaluated the potential health impacts associated with each type of cigarette use, while a linear regression analyzed the impact of accumulated smoking years on these health indicators.

Results: E-cigarette use was associated with increased odds of elevated systolic blood pressure (AOR=1.12; 95% CI: 1.01-1.24; AOR=1.18; 95% CI: 1.06-1.31) and heart rate (AOR=1.18; 95% CI: 1.06-1.33) per 10-unit increase, as well as reduced urine pH (AOR=0.64; 95% CI: 0.52-0.80; AOR=0.70; 95% CI: 0.56-0.88) compared to non-users and cigarette smokers. Compared to cigarette use, e-cigarette use was associated with higher hemoglobin levels (AOR=1.22; 95% CI: 1.05-1.42) and increased aspartate aminotransferase levels for every 10-unit increment (AOR=1.23; 95% CI: 1.01-1.51). Furthermore, relative to non-users, e-cigarette users showed higher levels of white blood cells and carcinoembryonic antigen, with the largest effect sizes observed among e-cigarette users compared to other subgroups. In addition, the number of accumulated smoking years significantly impacted clinical and biochemical health indicators in both cigarette and e-cigarette users.

Conclusions: E-cigarette use was associated with adverse alterations in several clinical and biochemical health indicators, some of which were comparable to or more pronounced than those observed in cigarette smokers. Public health policies are necessary to regulate their use, particularly in occupational settings.

Introduction: In Bangladesh, a significantly lower minimum retail price and preferential ad valorem tax rate for low-price cigarettes incentivized manufacturers to avoid tax by expanding the low-price cigarettes market. The effect of this industry response on government tax revenue has not been quantified yet. This study aims to fill this gap.

Methods: Using cigarette sales data (2019-2020) of British American Tobacco (BAT) Bangladesh in the WHO Tobacco Tax Simulation Model, we estimated the gap of actual from potential revenue by simulating four counterfactual scenarios involving government tax interventions and cigarette manufacturers' decision to expand low-price cigarette sales. We analyzed optimal government policy response vis-à-vis manufacturers' actions in a game theoretic framework based on a payoff matrix of tax revenue and industry revenue.

Results: The revenue gap due to expansion of low-price cigarette sales (scenario 1) was BDT 22.1 billion (US$ 0.26 billion; US$ 1≈ BDT85 in Year 2020), equivalent to around 10% of the collected revenue in 2019-2020. Due to lower minimum price of low-price cigarettes (scenario 2), the revenue gap was BDT 14.7 billion (US$ 0.17 billion). The revenue gap was BDT 30.5 billion (US$ 0.36 billion) for the lower minimum price and lower excise tax rate of low-price cigarettes (scenario 3). The revenue gap due to lower minimum price, lower excise tax rate of low-price cigarettes and low-price cigarette sales expansion (scenario 4) was BDT 49.4 billion (US$ 0.58 billion).

Conclusions: In Bangladesh, revising the tiered excise tax structure by raising prices in the low-tier and unifying tax rates across tiers can curb tax avoidance, boost government revenue, and promote public health.

Tobacco use is a major risk factor for any surgical intervention. Offering patients help with giving up smoking before surgery increases cessation rates and lowers the risk of complications. The aim of this clinical trial is to evaluate the efficacy of an intensive presurgical intervention for promoting smoking cessation in smokers undergoing either orthopedic surgery with implants or general/urological surgery. We will conduct a stratified randomized clinical trial [intervention group (IG) and control group (CG), 1:1 allocation] at the Vall d'Hebron University Hospital, Barcelona, Spain. The IG will receive intensive help to quit smoking (psychoeducational and behavioral support, nicotine replacement therapy with follow-up, and an information leaflet). The CG will receive brief advice and the same information leaflet in a single session. Sample size was calculated to include four equal groups (IG and CG in both types of surgery) with an estimated difference of 15 points in abstinence between IG and CG; assuming a loss to follow-up of 10%, a total of 232 subjects will be needed (58 per group). The primary dependent variables are self-reported and verified abstinence from tobacco consumption (expired CO) and surgical complications. We will conduct descriptive and bivariate statistical analysis for independent data. Logistic regression will be performed to assess the efficacy of the intervention. The relative risk of surgical complications will be calculated using Cox regression models. Patient recruitment began in May 2023. This trial will be the first to evaluate an intervention of this nature in Spain. If its efficacy is demonstrated, the results will support the design of a protocol for a smoking cessation program aimed at smokers who are scheduled for surgery.

Clinical trial registration: The study is registered on the official website of ClinicalTrials.gov.

Identifier: ID NCT05961813.