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The Impact of Secondhand Smoke on Pub Workers: A 2002 Consultation for the Irish Office of Tobacco Control.
IF 2.1 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-03-14 eCollection Date: 2025-01-01 DOI: 10.1177/1179173X251319860
James L Repace

In June of 2024, I was asked by the Environmental Health Officer of Galway, Ireland, to recount my endeavors in support of the 2002 push to ban smoking in Irish workplaces, led by The Office of Tobacco Control (OTC) for The Republic of Ireland. At that time, OTC's smoke-free campaign was being vigorously opposed by publicans as well as the Irish tobacco industry. Their opposition had downplayed any effects of secondhand smoke on pub workers' health. As a researcher, I had published 46 peer-reviewed papers on the hazard, exposure, dose, risk, and control of secondhand smoke since 1980. In 1998, I had become a secondhand smoke consultant, assisting entities in the U.S. and abroad who were attempting to enact workplace smoking bans. In 2002, OTC's then Director, Tom Power, had contacted me to request my technical assistance to the Irish government in their campaign to enact a workplace smoking ban in Irish pubs. Accordingly, I asked for any local data that might aid me in my effort. He provided me with measurements of carbon monoxide from secondhand smoke in 14 Galway Pubs, performed by the Irish researcher Maurice Mulcahy in support of his Master's Thesis. Using a pharmacokinetic model that enabled mapping secondhand smoke carbon monoxide to its equivalent nicotine metabolite body fluid cotinine, I estimated that based on the Galway pub data, secondhand smoke exposures of nonsmoking Irish pub workers were at the upper extreme for nonsmokers when compared to a study of cotinine in London pub staff relative to the general population. Further, using a dose-response relationship, I was able to estimate that the working-lifetime risk of mortality from workplace secondhand smoke exposure would produce an estimated 150 deaths per year among the ∼28,000 full-time Irish pub workers. I presented this information to the Health Minister and Members of Parliament at the Dail, and in numerous multi-media interviews. These estimates rebutted bogus tobacco industry assertions that ventilation could control secondhand smoke, fired up the effort championed by Health Minister Micheál Martin to ban smoking in pubs, and helped to protect pub workers from being forced to trade their health for a pay cheque.

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引用次数: 0
Patterns of Use of e-Cigarettes and Their Respiratory Effects: A Critical Umbrella Review.
IF 2.1 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-03-11 eCollection Date: 2025-01-01 DOI: 10.1177/1179173X251325421
Giusy Rita Maria La Rosa, Riccardo Polosa, Renée O'Leary

E-cigarettes (ECs) are a well-established consumer product. To study their respiratory health effects, there is the issue of heterogenous patterns of use: concurrently with cigarette smoking (dual use), exclusive use after smoking cessation (exclusive use), or use initiated without any prior or current use of cigarettes (naïve use). Our primary goal was to synthesize the evidence on the respiratory effects of ECs use in adults, categorized by their pattern of use. Additionally, we identified the highest quality systematic reviews and critically evaluated the current literature on this topic. The review was developed with published umbrella review guidelines. The database searches were Medline, Scopus, Cochrane, Epistemonikos, LILACS, and grey literature databases. The criterion for inclusion of systematic reviews was analyses of respiratory tests from randomized controlled trials or cohort studies. Quality assessments were performed with AMSTAR2 and a checklist of reporting biases. A narrative analysis was synthesized by test method: spirometry, impulse oscillometry, breath gasses, biomarkers, and clinical serious adverse events. Twelve systematic reviews were included. The findings on respiratory functioning were statistically non-significant across all patterns of use. Reporting bias was frequently observed. Based on the current research, there is no evidence of significant change in the short or medium term in respiratory function with any pattern of ECs use. We attribute the null findings to the weaknesses of acute studies, the participants' smoking history masking testing, and the inclusion of participants with a low frequency of use.

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引用次数: 0
Canadian Youth Preferences for E-Cigarettes: A Discrete Choice Experiment.
IF 2.1 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-03-11 eCollection Date: 2025-01-01 DOI: 10.1177/1179173X251322597
Daniel Eisenkraft Klein, Jiamin Shi, Robert Schwartz

Objectives: The novelty of e-cigarette regulatory policy poses difficulties for evidence-informed decision making because there is little evaluative evidence on the effects of specific policies. One way to provide evidence to inform Canadian policy in this situation is to learn from users how they would behave under different policy scenarios without actually implementing those policies in real-world settings. Discrete Choice Experiments provide an opportunity to undertake this research. Methods: We recruited an online sample of 600 e-cigarette current and past users aged 16-25, using an existing panel of recently recruited e-cigarette users, to participate in a discrete choice experiment. Participants chose their preferred option from a choice of 2 e-cigarette products described by 4 attributes: flavour availability, location availability, nicotine concentration, and price. Results: Our findings provide an overview of how important each attribute (price, nicotine concentration, availability, and flavour) is to young e-cigarette users. Across all features, as price increases, respondents were less willing to purchase. The study provides evidence that while all 4 attributes have strong effects, nicotine concentration and flavour most significantly influenced preferences for e-cigarettes. Conclusion: This could provide points of comparison and a better understanding of how hypothetical regulatory restrictions could prevent youth uptake of e-cigarettes, encourage current youth vapers to quit vaping, and make e-cigarettes available and useful for smokers interested in vaping to help them completely quit combustible cigarette smoking.

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引用次数: 0
Use of Hookah and Age of Asthma Onset Among US Adults.
IF 2.1 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-02-18 eCollection Date: 2025-01-01 DOI: 10.1177/1179173X251321578
Adriana Pérez, Sarah Valencia, Pushan P Jani, Melissa B Harrell

Objective: To explore the association of hookah use on the age of asthma onset among adults who were asthma/COPD free and who did not use cigarettes, cigars, electronic cigarettes or smokeless tobacco prior to asthma onset.

Methods: Secondary data analyses were conducted of the waves 1-6 (2013-2021) of the US nationally representative Population Assessment of Tobacco and Health Study among adults (>18 years). The four hookahs use exposures evaluated were (1) past 30-day (P30D) hookah use at the first wave of participation, (2) total number of waves before asthma onset in which adults reported P30D hookah use, (3) total number of years since first hookah use, and (4) average length of hookah sessions. Lower and upper age limits were estimated using the age reported at the first wave of participation and the number of weeks between follow-up waves until asthma was first reported or censored. Associations of the exposures on the age of asthma onset were estimated using weighted interval-censoring-Cox-regression.

Results: The total sample size for analysis was 5,768, representing 66.6 million adults. There was a lack of statistical power to detect differences in the age of asthma onset by (1) P30D hookah use (Adjusted Hazard Ratio (AHR) 3.77, 95CI%: .90-15.71). There was an association between (2) total number of waves of P30D hookah use (AHR 1.72, 95% CI 1.28-2.30), (3) total number of years since first hookah use (AHR 2.94, 95% CI 1.36-6.36), and (4) average length of hookah sessions (AHR 4.52, 95% CI 1.61-12.67) with the age of asthma onset. Females and Hispanics with over one year since first hookah use had higher risk of earlier age of asthma onset.

Conclusion: Prevention and cessation programs for adults who use hookah are needed to educate the public, protect public health, prevent adverse health outcomes, and motivate hookah users to stop.

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引用次数: 0
Secondhand Smoke Exposure and Smoking Attitudes and Behaviors Among Adolescents in the Gaza Strip: Findings From the 2019 Global Youth Tobacco Survey. 加沙地带青少年二手烟暴露、吸烟态度和行为:2019年全球青少年烟草调查结果
IF 2.1 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-18 eCollection Date: 2025-01-01 DOI: 10.1177/1179173X251314649
Beesan Maraqa, Mahmoud Abu Mayaleh, Seya Arafeh, Kenana Altell, Ahmad Khleif, Abdallah Najjar, Bayyena Abu-Radwan

Background: Secondhand smoke (SHS) exposure remains a critical public health concern, especially for adolescents, who are more susceptible to its harmful effects and may initiate smoking as a result. SHS, comprising both mainstream and sidestream smoke, contains over 7000 chemicals, many of which are carcinogenic. Adolescents exposed to SHS are more likely to experiment with smoking due to environmental influences, peer pressure, and familial smoking behavior.

Objective: This study aims to examine the relationship between SHS exposure and smoking attitudes and behaviors among adolescents aged 13-15 in the Gaza Strip, where SHS exposure and tobacco use remain prevalent.

Methods: Data were obtained from the 2019 Global Youth Tobacco Survey (GYTS), a cross-sectional, school-based survey targeting students in Gaza. The study employed a two-stage cluster sampling design to ensure a representative sample. SHS exposure was assessed in multiple contexts, including home, public enclosed spaces, and outdoor areas. Smoking attitudes, initiation behaviors, and demographic variables were also analyzed using descriptive statistics, Chi-square tests, and multivariable logistic regression to identify predictors of smoking behaviors.

Results: Of the 1536 adolescents surveyed, 62.3% reported SHS exposure at home, and 53.9% reported exposure in enclosed public spaces. Adolescents exposed to SHS were significantly more likely to experiment with smoking, with curiosity (62.2%) and peer influence being key motivators. Additionally, SHS exposure in both indoor and outdoor environments was associated with a higher likelihood of shisha experimentation. Females reported higher SHS exposure rates than males across all environments (P < .001).

Conclusion: SHS exposure significantly increases the risk of smoking initiation among adolescents in the Gaza Strip. These findings emphasize the need for targeted public health interventions, including stricter smoke-free legislation, parental education, and awareness campaigns aimed at reducing SHS exposure and preventing smoking uptake in youth.

背景:二手烟暴露仍然是一个重要的公共卫生问题,特别是对青少年来说,他们更容易受到其有害影响,并可能因此开始吸烟。SHS包括主流和侧流烟雾,含有超过7000种化学物质,其中许多是致癌物质。由于环境影响、同伴压力和家庭吸烟行为,暴露于二手烟环境的青少年更有可能尝试吸烟。目的:本研究旨在调查加沙地带13-15岁青少年的二手烟暴露与吸烟态度和行为之间的关系,该地区二手烟暴露和烟草使用仍然普遍。方法:数据来自2019年全球青少年烟草调查(GYTS),这是一项针对加沙学生的横向学校调查。本研究采用两阶段整群抽样设计,以确保样本具有代表性。在多种情况下评估了SHS暴露,包括家庭、公共封闭空间和室外区域。使用描述性统计、卡方检验和多变量逻辑回归分析吸烟态度、开始行为和人口统计学变量,以确定吸烟行为的预测因素。结果:在调查的1536名青少年中,62.3%报告在家中暴露于SHS, 53.9%报告在封闭的公共场所暴露。接触过二手烟的青少年更有可能尝试吸烟,好奇心(62.2%)和同伴影响是主要动机。此外,在室内和室外环境中接触SHS与水烟实验的可能性较高有关。在所有环境中,女性报告的SHS暴露率高于男性(P < 0.001)。结论:接触二手烟会显著增加加沙地带青少年开始吸烟的风险。这些研究结果强调需要有针对性的公共卫生干预措施,包括更严格的无烟立法、父母教育和旨在减少二手烟暴露和防止青少年吸烟的宣传运动。
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引用次数: 0
Corrigendum to "Prospective Association Between Tobacco Use and at-Risk Alcohol Consumption Among Swedish Adolescents: Outlining the Influence of Tobacco Product, Frequency of Use and Gender in the LoRDIA Cohort". “瑞典青少年烟草使用与高危酒精消费之间的前瞻性关联:概述LoRDIA队列中烟草产品、使用频率和性别的影响”的更正。
IF 2.1 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-07 eCollection Date: 2025-01-01 DOI: 10.1177/1179173X241311036

[This corrects the article DOI: 10.1177/1179173X241298524.].

[这更正了文章DOI: 10.1177/1179173X241298524.]。
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引用次数: 0
Marketing Strategies and Consumer and Sellers Perception About Oral Nicotine Pouches in Karachi, Pakistan. 市场营销策略和消费者和销售商对口服尼古丁袋的看法在卡拉奇,巴基斯坦。
IF 2.1 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-16 eCollection Date: 2024-01-01 DOI: 10.1177/1179173X241308145
Ghazala Akhlaque, Muhammad Muneeb Ullah Siddiqui, Romaina Iqbal, Abid Ali Vancy, Javaid Ahmed Khan, Sabahat Naz

Background: The availability of novel nicotine products like oral nicotine pouches (ONP) has been rising in South Asian countries, including Pakistan. We aimed to assess ONP marketing strategies at point-of-sale (POS) and understand the perceptions among consumers and sellers regarding its use in Karachi, Pakistan. Methods: We conducted a mixed-methods study in low, middle, and high socioeconomic neighborhoods of District East Karachi. For the quantitative component, we used a cross-sectional design, collecting data through observations and surveys. The observation checklist included items about advertising, product placement, display, and promotional aids. The survey questionnaire included questions on marketing tactics, product placement, and advertising strategies for ONP. For the qualitative component, we conducted in-depth interviews with ONP consumers and sellers to explore their perceptions and understand marketing strategies. Frequencies and percentages were used to report quantitative data, while thematic analysis was conducted for qualitative findings. Results: We observed 90 POS of ONP and found that 20% (n = 18) were located within 200 meters of schools. ONP advertisements were found in 67% (n = 60) of the surveyed shops, 59% (n = 53) displayed ONP next to candy, and 70% (n = 63) displayed at child's eye level. A higher proportion of consumers (n = 66, 73%) use ONP as a cessation aid for tobacco. Most sellers (n = 48, 53%) were approached by the companies to sell ONP, and 40% received a commission while achieving the targets on ONP sell. About one-fourth of sellers (n = 21, 23%) reported selling ONP to students less than 18 years. Our qualitative findings revealed marketing strategies, peer influence, ease of use in tobacco-restricted areas, and the perception of reduced harm compared to cigarettes as key drivers of ONP consumption. Conclusion: Our study highlights a critical public health concern and offers valuable insights that could inform the development of policies to regulate tobacco sales.

背景:在包括巴基斯坦在内的南亚国家,口服尼古丁袋(ONP)等新型尼古丁产品的可得性一直在上升。我们旨在评估销售点(POS)的ONP营销策略,并了解消费者和卖家对其在巴基斯坦卡拉奇使用的看法。方法:我们在卡拉奇东区低、中、高社会经济街区进行了一项混合方法研究。对于定量部分,我们使用了横断面设计,通过观察和调查收集数据。观察清单包括关于广告、产品放置、展示和促销辅助的项目。调查问卷包括关于ONP的营销策略、产品植入和广告策略的问题。对于定性部分,我们对ONP消费者和卖家进行了深入访谈,以探索他们的看法并了解营销策略。频率和百分比用于报告定量数据,而专题分析用于报告定性结果。结果:我们观察到90个ONP的POS,发现20% (n = 18)位于学校200米以内。在67% (n = 60)的受访商店中发现了ONP广告,59% (n = 53)的商店在糖果旁边展示了ONP广告,70% (n = 63)的商店在儿童的视线水平处展示了ONP广告。较高比例的消费者(n = 66,73%)使用ONP作为戒烟辅助手段。大多数卖家(n = 48, 53%)被公司接洽销售ONP, 40%的卖家在实现ONP销售目标的同时获得了佣金。大约四分之一的卖家(n = 21,23%)报告说,他们向18岁以下的学生出售ONP。我们的定性研究结果揭示了营销策略、同伴影响、在烟草限制地区使用的便利性以及与卷烟相比危害降低的认知是ONP消费的主要驱动因素。结论:我们的研究突出了一个重要的公共卫生问题,并提供了有价值的见解,可以为制定烟草销售监管政策提供信息。
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引用次数: 0
Patient reactions to proactive tobacco cessation counseling using a decision aid in primary care: A qualitative study. 患者对初级医疗中使用决策辅助工具进行主动戒烟咨询的反应:定性研究。
IF 2.1 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-12 eCollection Date: 2024-01-01 DOI: 10.1177/1179173X241304271
Anne Boesch, Marie-Anne Durand, Ines Habfast-Robertson, Isabelle Jacot-Sadowski, Ivan Berlin, Kevin Selby

Medications for smoking cessation can double quit rates but are underused in primary care. This qualitative study aimed to explore: (1) patients' perspectives regarding having their general practitioner (GP) use a proactive approach to smoking cessation treatment using an encounter decision aid (DA), and (2) their expectations regarding their GP's role. We conducted qualitative semi-structured interviews with participants of the FIRST randomized trial (adults who smoke daily with any level of motivation for tobacco quitting). In the FIRST study, the intervention was a half-day course teaching GPs to use a proactive approach using a DA. Control GPs received a 1-h refresher training. Phone interviews were run 5-16 weeks after a routine visit with their GP. A thematic data analysis was performed with 20% double independent coding. We conducted 20 semi-structured interviews (mean age 49 years, 55% female). In the intervention group (n = 12), 7 participants appreciated the DA, saw it as useful, usable, and valuable. Two participants did not find it helpful and 3 did not recall having used it. Participants felt their GP provided moral support, more than from a specialist (cardiologist or pulmonologist) because their GP knows them better and has more time during the visit. They felt that the most important factor influencing smoking cessation was their own motivation, not treatment. Most participants appreciated the DA. Most participants did not perceive medications as part of quitting. They thought quitting was a matter of motivation. A DA could be an acceptable way to encourage use of treatments to aid with tobacco cessation. An early presentation of treatment options to all persons who smokes may encourage them to request a treatment when ready to quit smoking. Patient perceptions of the role of GPs and treatments for smoking cessation may be a barrier to seeking help to quit.

戒烟药物可使戒烟率提高一倍,但在全科医疗中的使用率却很低。本定性研究旨在探讨:(1)患者对其全科医生(GP)使用会诊辅助决策系统(DA)进行主动戒烟治疗的看法;(2)患者对全科医生角色的期望。我们对 FIRST 随机试验的参与者(每天吸烟且有任何戒烟动机的成年人)进行了半结构化定性访谈。在FIRST研究中,干预措施是通过为期半天的课程,教导全科医生使用DA主动戒烟法。对照组全科医生接受了 1 小时的复习培训。在全科医生例行就诊 5-16 周后进行电话访谈。我们对数据进行了专题分析,并进行了 20% 的双重独立编码。我们进行了 20 次半结构化访谈(平均年龄 49 岁,55% 为女性)。在干预组(n = 12)中,7 名参与者对诊断书表示赞赏,认为诊断书有用、可用且有价值。两名参与者认为它没有帮助,3 名参与者不记得使用过它。参与者认为全科医生提供的精神支持多于专科医生(心脏病专家或肺病专家)提供的精神支持,因为全科医生更了解他们,在就诊时有更多的时间。他们认为影响戒烟的最重要因素是自己的动机,而不是治疗。大多数参与者对DA表示赞赏。大多数参与者并不认为药物治疗是戒烟的一部分。他们认为戒烟是一个动机问题。戒烟咨询可能是鼓励使用戒烟治疗的一种可接受的方式。及早向所有吸烟者介绍治疗方案可能会鼓励他们在准备戒烟时申请治疗。患者对全科医生的角色和戒烟治疗的看法可能会阻碍他们寻求戒烟帮助。
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引用次数: 0
Predictors of Enrollment and Adherence in a Randomized Tobacco Cessation Clinical Trial. 随机戒烟临床试验的注册和坚持治疗的预测因素。
IF 2.1 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-12 eCollection Date: 2024-01-01 DOI: 10.1177/1179173X241308136
Zhanette Coffee, Chiu-Hsieh Hsu, Todd W Vanderah, Judith S Gordon

Background: New therapeutic cessation approaches are being tested in clinical trials to engage and retain people who smoke. Our team is conducting a pragmatic randomized clinical trial (RCT) to evaluate a new treatment for tobacco dependence, but enrolling participants and ensuring adherence has been more challenging than in previous trials.

Objective: To determine the predictors of enrollment and adherence in the RCT.

Design: A secondary analysis of data from a tobacco cessation RCT.

Methods: Data was collected during a two-group RCT testing the efficacy of an integrative guided imagery vs behavioral treatment, with both conditions involving six weekly, hour-long sessions over 9 weeks.

Results: Of the 1074 randomized participants, 803 (74.8%) enrolled (completed the first session), and 631 (78.6%) of those were adherent (attended all scheduled sessions). Variables associated with enrollment included age (adjusted odds ratio [AOR], 1.01; 95% CI, 1.0003-1.02; P = 0.04) and state of residence (West Virginia vs New York (NY), AOR, 0.66; 95% CI, 0.46-0.94; P = 0.02), with older participants and those from NY more likely to enroll. Variables associated with adherence included race (Black vs White) (AOR, 2.09; 95% CI, 1.05-4.16; P = 0.04), higher education (at least some college vs high school or less) (AOR, 2.27; 95% CI, 1.58-3.26; P < 0.0001), marital status (all others vs single/never married) (AOR, 1.66; 95% CI, 1.11-2.48; P = 0.01), and state of residence (Arizona vs NY) (AOR, 0.52; 95% CI, 0.34-0.78; P = 0.002). Within Arizona, older age increased enrollment, while higher education and marriage improved adherence. Within NY, higher education was associated with both increased enrollment and adherence, while higher number of household smokers, and not reporting substance use were associated with increased adherence.

Conclusion: Enrolling and retaining people who smoke in cessation trials requires novel strategies. Identifying predictors of enrollment and adherence offers valuable insights for overcoming barriers in future tobacco cessation RCTs.

背景:临床试验正在测试新的戒烟治疗方法,以吸引和留住吸烟者。我们的团队正在开展一项务实的随机临床试验(RCT),以评估一种治疗烟草依赖的新疗法,但与以往的试验相比,招募参与者并确保其坚持治疗更具挑战性:目标:确定RCT的入组和坚持治疗的预测因素:设计:对一项戒烟 RCT 数据进行二次分析:在一项测试综合引导想象疗法与行为疗法疗效的两组 RCT 试验中收集了数据,两种疗法均在 9 周内每周进行 6 次、每次一小时的疗程:在 1074 名随机参与者中,有 803 人(74.8%)注册(完成第一次疗程),其中 631 人(78.6%)坚持治疗(参加了所有预定疗程)。与注册相关的变量包括年龄(调整赔率 [AOR],1.01;95% CI,1.0003-1.02;P = 0.04)和居住州(西弗吉尼亚州 vs 纽约州,AOR,0.66;95% CI,0.46-0.94;P = 0.02),年龄较大和来自纽约州的参与者更有可能注册。与坚持治疗相关的变量包括种族(黑人 vs 白人)(AOR,2.09;95% CI,1.05-4.16;P = 0.04)、受教育程度(至少大专 vs 高中或以下)(AOR,2.27;95% CI,1.58-3.26;P <0.0001)、婚姻状况(所有其他 vs 单身/从未结婚)(AOR,1.66;95% CI,1.11-2.48;P =0.01)和居住州(亚利桑那州 vs 纽约州)(AOR,0.52;95% CI,0.34-0.78;P =0.002)。在亚利桑那州,年龄越大,注册人数越多,而教育程度越高和婚姻状况越好。在纽约州,受教育程度越高,加入人数越多,坚持率也越高,而家庭吸烟人数越多、未报告药物使用情况则与坚持率提高有关:结论:在戒烟试验中招募和留住吸烟者需要新的策略。确定入组和坚持治疗的预测因素为克服未来戒烟研究试验中的障碍提供了宝贵的见解。
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引用次数: 0
Patterns and Correlates of Multiple tobacco Product use Among people With HIV in India. 印度艾滋病毒感染者使用多种烟草产品的模式和相关性
IF 2.1 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-09 eCollection Date: 2024-01-01 DOI: 10.1177/1179173X241303587
Catherine S Nagawa, Poongulali Selvamuthu, Nagalingeswaran Kumarasamy, Faith Beulah Balakrishnan, Nancy A Rigotti, Gina R Kruse

Introduction: Multiple tobacco product (MTP) use may intensify nicotine dependence and reduce the chances of quitting success. Characterizing MTP use in people with HIV (PWH) in low- and middle-income countries (LMICs) is needed to guide cessation approaches in this group. This study aimed to identify patterns and correlates of MTP use among PWH in a single clinic. Methods: This study was conducted among PWH at a clinic in Chennai, India. Participants completed an in-person survey providing information on tobacco use, demographics, and cessation-related factors. This analysis focused on PWH who reported current tobacco use. We used Fisher's exact test (categorical variables) and the Wilcoxon rank-sum test (continuous variables) to assess statistical differences in demographics and cessation-related factors between PWH who used single vs multiple tobacco products. Results: Of 154 PWH adults surveyed, 58 (37.7%) reported current tobacco use. Most PWH currently using tobacco were male (n = 49/58, 84%), with a median age of 21 years (IQR: 10). Forty-six percent (n = 27/58; 95% CI: 33% - 60%) reported MTP use, combining three products (IQR: 3) on average. Those who used multiple products were more likely to have a higher education level (n = 12/27, 44%; 95% CI: 25% - 65%) compared to those who used a single product (n = 2/16, 12%; 95% CI: 1% - 38%) (P-value = 0.03). A lower proportion of participants who reported MTP use were unemployed (n = 1/27, 97%; 95% CI: 0% - 19%) compared to those who used a single product (n = 5/16, 31%; 95% CI: 11% - 59%) (P-value = 0.04). All other factors, including gender, primary language, marital status, and cessation-related factors, were comparable between PWH who used a single tobacco product and those who used multiple products. Conclusion: Among PWH who currently smoke, almost half use tobacco combined multiple products. MTP use in PWH was linked to higher education levels and employment in this single clinical setting.

多种烟草制品(MTP)的使用可能会加剧尼古丁依赖,降低戒烟成功的机会。需要确定中低收入国家艾滋病毒感染者(PWH)中MTP使用情况的特征,以指导这一群体的戒烟方法。本研究旨在确定单一诊所PWH患者使用MTP的模式和相关因素。方法:本研究在印度金奈一家诊所的PWH中进行。参与者完成了一项面对面的调查,提供了有关烟草使用、人口统计和戒烟相关因素的信息。该分析侧重于报告当前烟草使用情况的PWH。我们使用Fisher精确检验(分类变量)和Wilcoxon秩和检验(连续变量)来评估使用单一和多种烟草制品的PWH在人口统计学和戒烟相关因素方面的统计差异。结果:接受调查的154名PWH成年人中,58人(37.7%)报告目前有烟草使用。目前使用烟草的大多数PWH为男性(n = 49/58, 84%),中位年龄为21岁(IQR: 10)。46% (n = 27/58;95% CI: 33% - 60%)报告使用MTP,平均结合三种产品(IQR: 3)。使用多种产品的人更有可能具有较高的教育水平(n = 12/27, 44%;95% CI: 25% - 65%)与使用单一产品的患者相比(n = 2/16, 12%;95% CI: 1% - 38%) (p值= 0.03)。报告使用MTP的参与者中失业的比例较低(n = 1/ 27,97%;95% CI: 0% - 19%)与使用单一产品的患者相比(n = 5/16, 31%;95% CI: 11% - 59%) (p值= 0.04)。所有其他因素,包括性别、主要语言、婚姻状况和戒烟相关因素,在使用单一烟草制品的PWH和使用多种烟草制品的PWH之间具有可比性。结论:在目前吸烟的PWH中,近一半使用烟草组合多种产品。PWH的MTP使用与高等教育水平和单一临床环境中的就业有关。
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Tobacco Use Insights
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