Tobacco Induced Diseases最新文献

Article 8 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) obligates Parties to enact policies that create 100% smoke-free environments in enclosed workplaces, public places and public transport. This narrative literature review examines studies reporting economic impact of smoke-free policies on tourism industry sectors including hotels, casinos/gambling venues, and sporting venues. A literature search was conducted across academic and gray literature published between 1 January 2004 and 18 June 2024, using the Scopus, Embase, and JSTOR databases. Search terms included variations of 'smoke-free' and 'tourism', 'hospitality', 'casino', 'hotel', and other related terms. Studies were included if they reported direct or indirect economic impacts of smoke-free policies on the tourism sector. The screening process involved an initial review of titles and abstracts, followed by full-text assessment for eligibility. Database searching identified 692 articles, of which 37 met the inclusion criteria. Nearly all identified studies (95%) focused on economic impacts in high income countries. The majority (76%) reported neutral or positive economic impacts following the implementation of smoke-free policies. There is evidence that most hotels and other hospitality venues experienced stable or improved revenues, increased customer satisfaction, and enhanced employee health outcomes after going smoke-free. Some evidence indicates that certain casinos experienced short-term revenue declines. Comprehensive smoke-free policies were more consistently associated with economic benefits, while partial policies often produced mixed results, commonly attributed to enforcement challenges. This review supports the evidence that comprehensive smoke-free policies aligned with WHO FCTC Article 8 deliver both health and economic benefits without harming the tourism sector. Findings can help policymakers counter tobacco industry claims and build political support for stronger smoke-free policies, especially in tourism-dependent jurisdictions. The lack of studies from low- and middle-income countries highlights the need for further research in these contexts.

Introduction: Type 2 diabetes mellitus (T2DM) poses a global health crisis. Smoking, a key risk factor for T2DM, significantly impacts middle-aged and elderly populations. In China, with the world's largest elderly population and a high prevalence of smoking, the burden of smoking-related T2DM remains underrecognized.

Methods: Using GBD 2021 data, we applied joinpoint regression, age-period-cohort analysis, and the ARIMA model for prediction. This is a secondary dataset analysis. The study population included Chinese adults aged ≥55 years.

Results: From 1990 to 2021, deaths and DALYs attributable to smoking-associated T2DM showed a substantial increase, with males experiencing a significant rise in both number of death and DALYs rates, while females exhibited a decrease in death rate though total number of deaths rose. Joinpoint analysis revealed fluctuating trends in mortality and DALYs. The age-period-cohort analysis highlighted the age group of 70-75 years as a high-risk period. Predictive analysis suggested a slight upward trend in mortality for the overall population and males, while the DALYs rate was expected to remain stable but increase among males and decrease among females.

Conclusions: From 1990 to 2021, the impact of smoking on type 2 diabetes mellitus (T2DM) among middle-aged and elderly adults in China continued to rise, with notable gender differences. Strengthening tobacco control and diabetes management, particularly for males and high-risk age groups, is crucial for reducing this burden.

Introduction: Although the relationship between taxation and conventional cigarette use is well established, little is known about the association with electronic cigarette (e-cigarette) use and no study has accounted for the potential delayed effects of e-cigarette policies beyond the observation period. This study aimed to evaluate the impact of China's 2022 e-cigarette tax increase on e-cigarette use.

Methods: A prospective longitudinal observational design was utilized by collecting three-waves of online survey data in China. Participants were recruited through social media platforms. Baseline data were collected in October 2022, with follow-up survey conducted in March and August 2023. Participants were eligible if they were aged ≥18 years, reported using e-cigarettes in the past 30 days at baseline, and provided informed consent to be recontacted for follow-up. The Friedman test and the Cochran's Q test were used to assess differences across the waves. The Wilcoxon signed-rank test and the Tukey test were used to make pairwise comparisons between the groups.

Results: There were 116 participants recruited at baseline and 91 (78.5%) of them complete all three surveys. E-cigarette use (ECU) decreased by 33.0% (95% CI: 23.7-42.3) in wave 2 after the tax increase was implemented, and by an additional 35.2% (95% CI: 26.8-43.7) in wave 3. The overall quit rate was 68.2% (95% CI: 60.3-75.9). However, 74.2% (95% CI: 65.9-82.5) of e-cigarette users whose quit switched to conventional cigarettes, resulting in an absolute cessation prevalence of only 17.6% (95% CI: 7.8-25.4). While perceived risk for ECU (χ²=0.41, p>0.05), perceived severity for ECU (χ²=1.02, p>0.05), and behavioral beliefs (χ²=2.28, p>0.05) did not change following the e-cigarette tax increase. Friends' attitudes (χ²=8.74, p<0.05), coworkers' attitudes (χ²=4.71, p<0.05), and exposure to e-cigarette advertising (Q=9.76, p<0.01) showed significant decreases.

Conclusions: This study suggests a possible association between the China's 2022 e-cigarette tax increase and changes in e-cigarette use. However, its effectiveness was diminished due to the large number of e-cigarette users who switched to conventional cigarettes. China's 2022 e-cigarette tax increase also affected social norms regarding e-cigarette use and exposure to e-cigarette advertising. The findings may inform future policy considerations for a comprehensive strategy.

Introduction: Tobacco exposure is a leading modifiable risk factor for preventable deaths, harming the digestive system, and leading to a large number of deaths.

Methods: A secondary assessment of Global Burden of Disease (GBD) datasets was conducted. From 1990 to 2021, data on deaths from tobacco exposure on digestive diseases, including various genders and age groups, from the 2021 GBD Study were utilized. Trends across 204 countries/territories, 21 GBD, and 5 sociodemographic index (SDI) regions were analyzed. Additionally, a detailed analysis was conducted. Pearson correlation analysis, frontier analysis, age-period-cohort (APC) model, and the Bayesian APC (BAPC) model was utilized.

Results: From 1990 to 2021, the global number of deaths from tobacco-attributable digestive diseases decreased from 52789 (95% uncertainty interval (UI): 36999-68307) to 34061 (95% UI: 23821-46548). The age-standardized rate also decreased, from 1.34 (95% UI: 0.93-1.73) to 0.40 (95% UI: 0.28-0.55). Overall, SDI was negatively associated with disease burden, and the Quality of Care Index for digestive diseases increased with SDI. Results from the APC analysis showed that the mortality rate increased with age; more recently born cohorts had lower mortality rates at the same age; and the mortality rate across all age groups decreased over time. Predictions indicated that the death burden of tobacco-attributable digestive diseases will continue to decline for both males and females from 2022 to 2042.

Conclusions: Global tobacco-attributable digestive diseases mortality may have decreased due to tobacco control and medical advances. The disease burden in older adults, males, and regions with middle to high SDI deserves special attention. Countries with a relatively high disease burden should learn from those with a lower burden among nations at the same SDI level regarding tobacco control and healthcare management.

Introduction: Tobacco use remains a major preventable cause of morbidity and mortality worldwide. Despite economic development and growing health system capacity, countries in the Gulf Cooperation Council (GCC) region face rising tobacco use and a shifting burden of smoking-attributed diseases. This study systematically analyzes age-specific and age-standardized smoking-related mortality trends across six Gulf countries Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates over a 30-year period.

Methods: We extracted and analyzed smoking-attributed mortality data from the Global Burden of Disease 2021 dataset (1990-2019), including death rates per 100000 population for age groups 15-49, 50-69, and ≥70 years, and the age-standardized percentage of deaths due to smoking. We conducted descriptive trend analysis, heatmap visualization, correlation assessment, and linear projections to 2030.

Results: Bahrain and Kuwait exhibited the highest smoking-attributed mortality rates with 14.3% of all deaths in 2019, particularly among those aged ≥70 years, with death rates exceeding 1300 per 100000. In contrast, Saudi Arabia and Oman maintained relatively lower and stable rates. Strong correlations were observed between mid-life and elderly smoking mortality (r about 0.97), while slightly lower in the ≥70 years group (r about 0.85). Projections indicate a highest burden increase in Bahrain (about 13.5%) and slight increases in Qatar and UAE (about 9%, each) by 2030 without policy intensification.

Conclusions: Despite regional advances in tobacco control, the burden of smoking-related mortality remains high in parts of the Gulf, especially among older adults. Immediate, targeted interventions particularly for middle-aged smokers are necessary to prevent further escalation. These findings support prioritizing tobacco cessation and surveillance as part of GCC public health strategies.

Introduction: The ongoing assessment of smoking rates and their related factors is a crucial component of anti-smoking initiatives and is essential for evaluating the success of anti-smoking strategies and policies. This research aimed to ascertain the prevalence of smoking and to identify the sociodemographic factors linked to smoking among adults in Malaysia aged ≥15 years.

Methods: We analyzed the secondary data of GATS-M 2023, which employed a cross-sectional design with a representative sample of 4269 adults in Malaysia aged ≥15 years, selected through a stratified, two-stage proportionate-to-size sampling technique. The research team collected the GATS-M data through face-to-face interviews conducted by trained research assistants, using a standardized, validated questionnaire. A multivariable logistic regression analysis was performed to identify sociodemographic factors associated with smoking among Malaysians.

Results: The overall smoking prevalence was found to be 19.0% (95% CI: 17.1-21.1), with males exhibiting a significantly higher prevalence than females (35.7%; 95% CI: 32.0-39.5 vs 1.5%; 95% CI: 0.8-3.1). The highest rates of smoking were noted among individuals of other ethnic backgrounds (39.1%), those aged 25-44 years (24.9%), and individuals who completed primary school but less than secondary school 95% CI: 2.60-5.91 (23.6%). Multivariable analysis revealed that Males from Malay (AOR=3.92; 95% CI: 2.60-5.91), Indian (AOR=3.17; 95% CI: 1.50-3.74), Other Bumiputra (AOR=3.14; 95% CI: 1.83-0.33), and other ethnic groups (AOR=4.77; 95% CI: 2.36-9.65) (Chinese ethnic as reference), and individuals with primary (AOR=2.98; 95% CI: 1.81-4.90) and secondary education level, showed a higher risk of being current smokers (AOR=1.81; 95% CI: 1.17-2.80, tertiary education level as reference) whilst no similar trends were found among female adults.

Conclusions: The smoking prevalence among Malaysian adults aged ≥15 years showed a slight decrease. There is a need for more anti-smoking policies or interventions, particularly aimed at males, Malays, younger adults, and those with lower levels of education, to further reduce the smoking prevalence in Malaysia.

Introduction: In 2024, Canada became the first country to implement warning messages on cigarette sticks. Warnings were required on king-size cigarettes in April 2024 at the manufacturer level and July 2024 at the retail level. The purpose of this study was to evaluate responses to cigarette stick warnings among adults who smoke in Canada using a standard survey and a daily diary study.

Methods: We used two separate online survey (i.e. questionnaire) methods with Canadian adults who smoke daily and use king-size cigarettes, with data collected in February, May, and August 2024. The first method was a standard cohort survey (observations=1724; participants=999), with one survey each data collection period. Participants were followed up in subsequent waves. Participants reported noticing health information on cigarette sticks 'any' vs 'none', and ≥ 'almost all' vs 'fewer cigarettes' in last month. The second method was a daily diary study (observations=10572; participants=527), with brief surveys every evening for two weeks during each data collection period. Participants reported noticing health information on cigarette sticks ('any' vs 'none' in last 24 hours). Samples for the two studies were distinct. In both studies, we also assessed feelings about the look of cigarette sticks (1=very bad to 5=very good), forgoing cigarettes normally smoked (no vs yes), and quit motivation (continuous). Generalized estimating equations regressed outcomes on survey period, adjusting for sociodemographic and smoking-related covariates.

Results: Noticing stick warnings increased in both surveys [standard 'any': May=58%, August=73%, OR=2.29 (95% CI: 1.81-2.91); standard ≥ 'almost all': May=27%, August=44%, OR=2.56 (95% CI: 1.99-3.30); daily diary: February=6%, May=10%, OR=1.77 (95% CI: 1.29-2.44), August=16%, OR=2.92 (95% CI: 1.73-4.93), all p<0.001]. Over time, negative feelings toward sticks [February=4.10, August=3.91, mean diff= -0.19 (95% CI: -0.32 - -0.05), p=0.006], forgoing cigarettes [February=56%, August=63%, OR=1.44 (95% CI: 1.12-1.86), p=0.004] and quit motivation [February=4.74, August=5.03, mean diff=0.30 (95% CI: 0.06-0.53), p=0.014] increased in the standard surveys, but not the daily diary study.

Conclusions: Canadian adults who smoke king-size cigarettes increasingly noticed cigarette stick warnings over the early implementation period. The standard survey also found increases in cessation-related responses to stick warnings. Future research should assess long-term impacts of this policy and validate standard and daily diary survey methods for evaluating labeling policies.

Introduction: Low- and middle-income countries (LMICs) face a disproportionate exposure and disease burden from secondhand smoke (SHS). Creating completely smoke-free indoor public places is effective in protecting people from SHS. This study examines how online news outlets in LMICs discuss existing smoke-free policies and their implementation.

Methods: In September 2023, we used Tobacco Watcher (www.tobaccowatcher.org), a tobacco news surveillance platform, to identify articles using the built-in topic 'Air' (i.e. smoke-free policy) and search terms 'implementation' or 'compliance' in 10 LMICs from 2022 to 2023. Two trained coders independently assessed all articles for their relevance (either substantially discussing in multiple paragraphs or holding a clear position on smoke-free policy implementation). A content analysis was conducted, with the coders independently coding each article for argument position, content, evaluation of current implementation efforts, and argument presenters until reaching 80% agreement or higher. Discrepancies in coding were resolved through discussion.

Results: Among 634 articles retrieved, 345 met the inclusion criteria. Most of these articles (81%, n=276) supported implementation of existing smoke-free policies; 31% (n=107) considered current smoke-free policy implementation efforts unsuccessful, citing lack of enforcement, signage, and other violations, while 20% (n=70) considered implementation to be successful; 21% (n=74) suggested a need for stronger smoke-free policies, including the elimination of designated smoking areas. Common argument presenters included government agencies (84%, n=291), civil society organizations (e.g. civil society: 40%, n=139), WHO (19%, n=67), and researchers or experts (18%, n=62).

Conclusions: Discourse around smoke-free policy implementation in online news media of LMICs was generally supportive, praising complete bans and active implementation. However, coverage highlights that enforcement remained a challenge and pointed to a need for stronger policies. News media can be utilized as avenues for raising awareness surrounding tobacco control challenges, building support for policy, and countering tobacco industry narratives.

Introduction: Practicing smoking cessation counseling with real patients is often limited in pharmacy education. To address this gap, artificial intelligence (AI) was employed to simulate patient interactions for role-playing, providing a flexible and pressure-free learning experience. This study aimed to evaluate the use of an AI-simulated patient (ChatGPT) for smoking cessation counseling in pharmacy education by assessing students' satisfaction, perceived learning impact, benefits, and difficulties encountered.

Methods: A quasi-experimental one-group post-test design was conducted with fourth-year pharmacy students enrolled in the smoking-cessation skills course at the Faculty of Pharmacy, Chiang Mai University, during the first semester of 2024 academic year. All students registered and attending the course were eligible and invited to participate. Case scenarios based on the 5As framework were developed and implemented in ChatGPT to simulate real-time counseling. After completing the AI session, students completed a self-administered questionnaire.

Results: Among 145 fourth-year pharmacy students, 66% reported satisfaction with the AI activity, and 84.4% indicated improved understanding of smoking cessation. Reported benefits included enhanced self-assessment and adaptability in the learning process, while common challenges involved technical limitations and limited understanding of how AI functions.

Conclusions: Overall, students expressed satisfaction with the AI-based activity, reported improved learning, and identified both benefits and areas for improvement. These findings support the integration of AI tools like ChatGPT as a student-centered, scalable approach in smoking cessation education, aligned with SDG 4: Quality Education.