Tobacco Use Insights最新文献

[This corrects the article DOI: 10.1177/1179173X251389206.].

Introduction: Considering the scarcity of specialist cessation service providers in resource-constrained Low- & middle-income countries (LMICs), the dental healthcare system can be used as an alternate source of cessation support. This study assessed dental healthcare providers' current practices and perceptions about cessation support in teaching dental hospitals.

Methods: We assessed the cessation-related practices and perceptions of 348 dentists working in 10 teaching dental hospitals, using a cross-sectional design in the Khyber Pakhtunkhwa province of Pakistan. Participants were selected using simple random sampling technique and data were collected using a modified version of a previously used structured questionnaire, through face-to-face interviews by trained dentists. The Chi-squared test and logistic regression were used to determine associations between cessation support practices, cessation support perceptions, and their potential predictors.

Results: Overall, 13% of dentists provided cessation support, while 36% of participants practiced routine screening for tobacco use. 95% of dentists opined that cessation support should be provided in dental settings, with minimal counselling (5 As) being the preferred method. There was a strong association between dentists having formal training in cessation support and providing cessation support (aOR 6.58, 95% CI 1.95-22.11).

Conclusion: There is a lack of cessation training for DHCPs and a dearth of cessation services in the dental settings of Khyber Pakhtunkhwa, Pakistan. However, most DHCPs were willing to provide cessation services.

Implications: Cessation support falls behind compared to other MPOWER measures in Pakistan. As a resource-constrained LMIC, Pakistan can consider dental settings as a cost-efficient avenue for delivering cessation support-related services. Cessation services can be integrated into routine dental health care using a dental health workforce trained in cessation support. This untapped resource can help in curbing tobacco use in Pakistan and other similar contexts.

Tobacco use remains a critical public health challenge in Vietnam, contributing to significant health and economic burdens. Despite comprehensive tobacco control policies, cessation rates remain low. This study investigates how tobacco control awareness, media exposure, and health knowledge influence quit intentions among Vietnamese smokers. A cross-sectional analysis of 17 387 adult current smokers from the 2024 Provincial Global Adult Tobacco Survey (PGATS) was conducted. Structural equation modeling (SEM) tested direct and mediated pathways between tobacco control awareness, anti-/pro-tobacco media exposure, health knowledge, and quit intentions, adjusting for age and gender. Multiple imputation addressed missing data (3.7%), and model fit was assessed using AIC, BIC, and SRMR. Health knowledge and anti-tobacco media exposure were the strongest predictors of quit intentions (β = 0.107, P = 0.002; β = 0.250, P < 0.001, respectively). Pro-tobacco media exposure significantly strengthened quit intentions among smokers already planning to quit (interaction β = 0.445, P = 0.026). Multi-group analyses revealed health knowledge and media effects were significant only among male smokers. Educational stratification showed lower-educated smokers benefited more from health information, while higher-educated smokers responded better to anti-tobacco media campaigns. Individual-level health knowledge and anti-tobacco media campaigns drive quit intentions among Vietnamese smokers. The pro-tobacco media paradox, operating through psychological reactance among motivated quitters, highlights opportunities for targeted counter-advertising. Gender and educational disparities underscore the need for tailored interventions: clear health messaging and sophisticated media campaigns.

Introduction: Among dual-smoking couples, both partners have smoking-related motivations that may either facilitate or hinder cessation efforts. Existing research typically focuses on individual-level motivation, which may be inadequate for capturing aspects of concordance and discrepancy. This study characterized couples' motivational profiles and examined their associations with smoking cessation outcomes.

Methods: We conducted secondary analyses from a randomized controlled pilot study of 95 dual-smoking couples to examine how dyadic motivations to quit smoking predicted individual and joint point-prevalence abstinence at 3 months. Both partners reported their own motivation to quit (self-oriented) and their motivation for their partner to quit (partner-oriented). We examined dyadic motivation to quit smoking on abstinence across four goal characterizations: (1) Parallel Goals (partners' self-oriented motivations), (2) System-Oriented Goals (an individual's self- and partner-oriented motivation), (3) Shared Target Goals (both partners' motivation for one individual to quit), and (4) Parallel Partner-Oriented Goals (each partner's motivation for the other to quit). Using response surface analyses with logistic regression, we estimated the effects of alignment (a₁) and misalignment (a₂) in the couples'' motivation levels on individual and joint cessation outcomes.

Results: For individual cessation, quitting odds were higher when self-motivation or partner-oriented motivation aligned within the couple (Parallel goals: a₁ = 0.725; Shared Target goals: a₁ = 0.881; Parallel Partner-Oriented goals: a₁ = 0.729), when self-motivation exceeded partner's self-motivation (Parallel goals: a₃ = 0.453), or exceeded partner-oriented motivation (System-Oriented goals: a₃ = 1.094). Joint quitting was more likely when both partners had high self-motivation (Parallel goals: a₁ = 0.918), high self- and partner-oriented motivation (System-Oriented goals: a₁ = 0.310), high shared motivation for one partner to quit (Shared Target goals: a₁ = 0.673), or high partner-oriented motivation for each other (Parallel Partner-Oriented goals: a₁ = 0.965). All effects were statistically significant (P < .05).

Conclusion: The findings highlight the role of dyadic motivations in predicting individual and dyadic abstinence among dual-smoking couples. Couple-based interventions that aim to increase and align partners' motivations to quit could improve cessation outcomes in this population.

Introduction: Numerous guidelines have been developed worldwide to support healthcare professionals in providing evidence-based interventions to help individuals quit smoking and other forms of tobacco use. The evaluation of the quality of the guidelines of tobacco cessation is however deficient and lacking.

Methodology: PubMed, Embase, Scopus and Cochrane Databases were electronically searched. Additional search was carried out in National Institute for Health Care Excellence, Guidelines International Network, Google Scholar and references of relevant articles to screen studies relevant to this review. Guidelines on both health and allied health professionals in English language were included. The assessment of the guidelines in this review was carried out using the AGREE II instrument by four appraisers.

Results: Twenty guidelines were included in this review. A comparative evaluation of all the guidelines revealed consistently higher scores in clarity of presentation domain (74.4 ± 20.9) followed by scope and purpose (65.23 ± 17.19), stakeholder involvement (63.84 ± 18.29) and rigour of development domain (61.76 ± 20.24). Lower scores were reported in Applicability (59.18 ± 18.02) and least in Editorial Independence domain (58.29 ± 19.36).

Conclusion: Further guidelines developed should address the gaps identified in this review and be both evidence-based and feasible to implement in diverse clinical contexts.

Background: California's Central Valley has high rates of tobacco product use and low rates of access to healthcare providers, making it difficult for residents to acquire effective tobacco cessation treatment. To address this disparity, California pharmacists can act as healthcare providers, with the ability to provide counseling and independently prescribe nicotine replacement therapy (NRT) medications through a process known as "furnishing".

Methods: All corporate and independent pharmacies in the Central Valley who serve the general community were contacted (n = 586) to ask whether pharmacists furnished NRT. The authors visited pharmacy locations (n = 23) that indicated they furnished NRT to request participation in a survey and interview. The authors analyzed if pharmacies furnished NRT, the characteristics of those that furnished, the creation of implementation of protocols, barriers, and facilitators, and how services were fostered.

Results: In interviews, pharmacists expressed generally positive attitudes toward furnishing, but were concerned about barriers, including concerns about feasibility and affordability, lack of administrative support, and perceived limited demand.

Conclusions: Despite the region's high tobacco usage rates, few pharmacies (n = 5; 0.88%) furnished NRT. To increase furnishing rates, corporate policy changes, recognition of pharmacists as providers by insurance companies, and support from the California Board of Pharmacy are likely needed. Increasing advertising, building rapport, and knowing patients' tobacco history may increase NRT utilization.

Background and objective: Electronic cigarettes use among pregnant individuals who currently or formerly smoked cigarettes was not previously examined in Romania. This study aimed at measuring the prevalence of ever using e-cigarette and its associated factors in a sample of pregnant individuals in Romania who currently or formerly smoked cigarettes. Design: Cross sectional study from formative and baseline phases of a randomized control trial. Methods: This study utilized data from a Randomized control trial (RCT) that was conducted between 2016 and 2019 in Romania. Data was collected via structured questionnaire at formative stage and was self-administered through the study website at baseline. The sample included 316 pregnant individuals (155 from formative phase, and 161 from baseline phase), of whom 75% were currently and 25% were formerly smoking cigarettes. Results: Ever using e-cigarette was reported by 122 (41.2%) of the 296 pregnant individuals who responded to this question, of whom 42 (34.4%) were currently using e-cigarettes. A total of 249 (84.4%) individuals attempted to quit smoking, of which 100 (40.2%) ever used e-cigarettes, and 35 (14.1%) used e-cigarettes at their last attempt to quit. Of the individuals who were currently using e-cigarettes, 4 (9.5%) were formerly smoking cigarettes (sole e-cigarette users) and 38 (90.5%) were currently smoking cigarettes (use both combustible and electronic cigarettes [dual users]). Low education was significantly associated with ever using e-cigarettes (OR = 5.94; 95% CI: 2.50-14.10; P = 0.001). Conclusions: High percentage of pregnant individuals used e-cigarettes and a notable percentage of them have reported current e-cigarette use. Half of the individuals who reported current e-cigarette use indicated they were using them with the intention of quitting cigarette smoking during pregnancy, though many continued to use both products (became dual users), highlighting a potential failure of cessation and ongoing nicotine exposure.

Background: The Western Pacific Region has the highest rate of cigarette smoking in the world. In this region, Mongolia has ratified the WHO FCTC treaty and, as part of treaty implementation, has monitored school tobacco use in children using the Global Youth Tobacco Survey (GYTS). Our objective was to examine the spatial (student report of cigarette availability near schools) and economic factors (cigarette pricing relative to student pocket money) associated with cigarette use in schoolchildren of Mongolia.

Methods: The 2014 and 2019 GYTS are the most recent national surveys of tobacco use in schoolchildren in Mongolia and are cross-sectional, stratified, multi-stage cluster surveys of 13-15-year-old schoolchildren (7298 in 2014, 4146 in 2019). We conducted logistic regression modelling of the two surveys to examine whether spatial, economic, and environmental factors were predictors of cigarette use.

Results: We found that (1) the prevalence of students reporting the availability of cigarettes near schools increased from 65.3% [95% confidence interval(CI) = 61.1-69.4] in the 2014 GYTS to 94.3% [95% CI = 93.5-95.1] in the 2019 GYTS, (2) student report of cigarette availability near schools was associated with increased current smoking of all cigarettes and this effect increased from a non-significant 31% increase in odds in 2014 (OR [95% confidence interval(CI)] = 1.31 [0.99-1.73], P = .06) to a 416% significant increase in odds in 2019 (OR [95% CI] = 5.16[3.31-8.05], P < .0001), (3) student report of cigarette availability near schools was associated with a significant increase in odds of smoking single cigarettes in 2014 (OR [95% CI] = 1.85 [1.19, 2.89], P = .008 and in 2019 (OR[95% CI] = 2.70 [1.42-5.12], P = .005). For both surveys, we also found that cigarette smoking prevalence was higher when students' pocket money exceeded the price of the cigarette pack (approximately 1.8 USD).

Conclusions: Despite the 2012 National Tobacco Laws banning sales of cigarettes and single cigarettes to schoolchildren near schools, our analyses of national samples of schoolchildren indicate that the proportion of students reporting cigarettes being available near their schools remained high (65-94%) during 2014 to 2019.

Background: Drastic life events, such as a cancer diagnosis, do not necessarily lead to a reduction in unhealthy and dysfunctional behaviors like smoking. Continued smoking among cancer survivors significantly increases the risk of recurrence and worsens treatment outcomes. While evidence-based smoking cessation treatments have demonstrated their effectiveness in acute cancer care, their impact among long-term cancer survivors remains limited, and overall quit rates remain low. To cessation outcome and improve long-term support strategies, it is essential to better understand the experiences, attitudes, and perceived barriers of both current and former smoking cancer survivors.

Materials and methods: This qualitative study included semi-structured interviews with six cancer survivors (50% female), aged 34 to 81 years, with different cancer types (breast, skin, lung, urinary bladder cancer, and GIST). At the time of the interview, three participants were still smoking, two had quit at the time of their diagnosis, and one had quit beforehand. All had completed cancer treatment at least four years prior without relapse. Interviews were transcribed verbatim and analyzed using qualitative content analysis, applying an inductive approach to identify recurring themes and categorize the data using computer-assisted analysis software.

Results: Four main categories emerged from the interviews: (1) motivations for quitting, (2) perceived barriers, (3) facilitators of cessation, and (4) contextual influences.Key motives for continued smoking after a cancer diagnosis included managing nicotine cravings and stress, experiencing pleasure and boredom relief, and a perceived lack of negative health consequences. Some participants reported smoking to cope with treatment-related discomfort. A general lack of knowledge regarding the link between smoking and cancer contributed to low motivation to quit and limited risk awareness. Participants who had successfully quit cited improvements in health and well-being as primary reasons for cessation, alongside external factors such as financial savings and the aversion to cigarette odor. Medical advice and support from healthcare providers were mentioned frequently - both as motivating factors and, in cases where such support was absent or discouraging, as barriers.Barriers to quitting included a persistent smoking environment, negative emotions during cessation attempts, poor timing related to the cancer experience, and previous failed quit attempts.Conversely, facilitators of cessation included external regulations (eg, smoking bans, legal restrictions), a tobacco-free environment, strong internal motivation, individual coping strategies for withdrawal symptoms and craving, medical recommendations, and support from family or peers.

Discussion/conclusion: The results highlight the need for a better adaptation of smoking cessation inte

Objectives: Smokeless tobacco (SLT) use is common in South Asia and strongly associated with oral cancer. In Bangladesh, where SLT use is widespread, evidence remains limited. This study examined the association between SLT use and oral cancer among Bangladeshi adults and estimated the population-level burden.

Methods: This first hospital-based case-control study from Bangladesh examined the association between SLT use and oral cancer. Conducted in Dhaka between July and December 2015. A total of 169 newly diagnosed oral cancer cases and 338 frequency-matched controls were recruited. Structured interviews collected data on SLT use, smoking, alcohol, BMI, and socio-demographic variables. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. Population attributable fractions (PAFs) were calculated based on national SLT prevalence.

Results: SLT use was strongly associated with oral cancer (adjusted OR: 8.78; 95% CI: 5.14-15.00). Risk was higher in women (OR: 14.33, 95% CI: 6.33-32.42) than in men (OR: 5.29, 95% CI: 2.62-10.67). Male dual users of SLT and smoked tobacco had the greatest risk (OR: 17.23, 95% CI: 5.70-52.01). Analysis by SLT type indicated significant independent associations with oral cancer for both Betel Quid (BQ) usage with tobacco (OR: 8.93, 95% CI: 5.23-15.27) and without tobacco (OR: 4.43, 95% CI: 1.94-10.10). A dose-response relationship was observed, particularly in women. SLT use accounted for an estimated 41% of male and 76% of female oral cancer cases in Bangladesh.

Conclusion: SLT is a major, modifiable risk factor for oral cancer in Bangladesh, particularly among women and dual tobacco users. These findings support the need for stronger regulation, gender-sensitive education, and targeted SLT control strategies. Local evidence such as this is vital to shaping national and international oral cancer prevention policies.