Low-intensity daily smoking and mortality risk among Mexican women.

OBJECTIVE: To examine the association between low-intensity smoking (10 or less cigarettes per day) and all-cause and cause-specific mortality risk among women who smoke and by age at cessation among women who previously smoked. METHODS: In this study, 104 717 female participants of the Mexican Teachers' Cohort Study were categorised according to self-reported smoking status at baseline (2006/2008) and were followed for mortality through 2019. We estimated HRs and 95% CIs for all-cause and cause-specific mortality using multivariable Cox proportional hazards regression models with age as the underlying time metric. RESULTS: Smoking as few as one to two cigarettes per day was associated with higher mortality risk for all causes (HR: 1.36; 95% CI 1.10 to 1.67) and all cancers (HR: 1.46; 95% CI 1.05 to 2.02), compared with never smoking. Similarly, slightly higher HRs were observed among participants smoking ≥3 cigarettes per day (all causes HR: 1.43; 95% CI 1.19 to 1.70; all cancers HR: 1.48; 95% CI 1.10 to 1.97; cardiovascular disease HR: 1.58; 95% CI 1.09 to 2.28). CONCLUSIONS: In this large study of Mexican women, low-intensity smoking was associated with higher mortality risk for all causes and all cancers. Interventions are needed to promote cessation among women who smoke at low-intensity in Mexico, regardless of how few cigarettes they smoke per day.

Trends in cigarette brand preference among Mexican smokers: the rise of Pall Mall.

OBJECTIVE: To analyse trends in cigarette brand preference among Mexican smokers during the implementation period of key WHO's Framework Convention on Tobacco Control recommendations. METHODS: Data came from two nationally representative, comparable surveys, namely the Global Adult Tobacco Survey 2009 and 2015 and the National Survey on Addictions 2011 and 2016. Logistic models were used to estimate the adjusted prevalence of each brand purchased, as well as individual correlates of purchasing the single brand with a large growth over the study period. Multiple linear regressions were also employed to analyse cigarette prices across brands. RESULTS: Six brand families accounted for about 90% of the cigarette market, with Marlboro clearly dominating all brands at 54%-61%. Only the share of Pall Mall brand, however, registered a rapid increase over the period-from 1% in 2009 to 14% in 2016. Women and younger smokers (15-24 years) were more likely to prefer Pall Mall over other brands. While the typical price segmentation between international (premium) brands and national (discount) brands was observed, the price of Pall Mall is within the range of the latter. Importantly, most varieties of this brand include flavour capsule varieties (FCVs). CONCLUSIONS: This study suggests that the strong campaign of brand migration, the pricing strategy and the aggressive introduction of FCVs expanded Pall Mall in the Mexican cigarette market. Therefore, better control policies of cigarette contents and taxes that reduce price differentials across brands should be encouraged to promote public health.

Smoking trends in Mexico, 2002-2016: before and after the ratification of the WHO's Framework Convention on Tobacco Control.

INTRODUCTION: Mexico was the first Latin American country to ratify the Framework Convention on Tobacco Control (FCTC) in 2004, after which it implemented some key FCTC policies (e.g., taxes, smoke-free, pictorial warnings and ad bans). This study assessed trends in the prevalence of current, daily and non-daily smoking in Mexico before and after the implementation of key FCTC policies. METHODS: Data were analysed from two comparable, nationally representative surveys (i.e., the National Survey on Addictions 2002, 2011 and 2016, and the Global Adult Tobacco Survey 2009 and 2015). The pooled sample comprised 100 302 persons aged 15-65 years. Changes in the prevalence of current, daily and non-daily smoking were assessed. RESULTS: From 2002 to 2016, the prevalence of current smoking fell 11% in relative terms (from 21.5% to 19.0%). The decrease was registered between 2002 and 2009, and after that, a slight increase was observed (from 16.5% in 2009 to 19% in 2016). The prevalence of daily smoking decreased by about 50% between 2002 and 2016 (from 13.5% to 7.0%) with most of the decrease occurring by 2009. Conversely, the prevalence of non-daily smoking increased by 35% between 2009 and 2016 (from 8.8% to 11.9%). CONCLUSIONS: Full implementation of the FCTC is necessary to further reduce smoking. Specific interventions may be needed to target non-daily smokers, who now comprise more than half of current smokers in Mexico.

[Prevalence, proportion and correlates of flavorcapsule cigarette use in Mexico: results fromthe Ensanut 2018-19]. / Cigarros con cápsulas de sabor en México: prevalencia, proporción de uso entre fumadores y predictores de consumo. Ensanut 2018-19.

OBJECTIVE: To estimate the prevalence of flavor capsule cigarette, use among Mexicans who are 10 years and older, to determine the proportion of smokers who use flavor capsules, and to characterize the sociodemographic correlates of flavor capsule cigarette use. MATERIALS AND METHODS: Data came from the National Health and Nutrition Survey 2018-19. The prevalence and proportion of flavor capsule cigarette use were estimated by sex, age, education, and wealth. Poisson models were used to evaluate sociodemographic factors as-sociated with flavor capsule cigarette use. RESULTS: Among Mexicans,the prevalence of flavor capsule cigarettes use was 6.6%, which is 43% of all smokers. Women, adolescents, and young adults were more likely than other groups to use flavor capsule cigarettes. CONCLUSIONS: Mexicans report a high prevalence of flavor capsule cigarette use. Banning cigarettes with flavors may reduce the appeal of smoking, particularly for youth and women.

OBJETIVO: Calcular la prevalencia de consumo de cigarros con cápsula de sabor, la proporción de uso entre los usuarios de tabaco en la población mexicana de 10 años o más, y los factores asociados a su consumo. MATERIAL Y MÉTODOS: Se utilizó la Encuesta Nacional de Salud y Nutrición 2018-19. Se utilizó un modelo Poisson para obtener la razón de prevalen-cias del uso de cigarros con cápsulas de sabor ajustando por sexo, edad, educación e índice de bienestar. RESULTADOS: El 6.6% de los mexicanos fuma cigarros con cápsulas de sabor, lo que corresponde a 43% del total de usuarios de tabaco. Las mujeres, adolescentes y adultos jóvenes son los grupos con la mayor proporción de consumo. CONCLUSIONES: México tiene una alta prevalencia de consumo de cigarros con cápsula de sabor. Para reducirla, se deben implementar políticas para prohibir la venta de cigarros con saborizantes y eliminar los diseños atractivos en las cajetillas de los cigarros.

[Correlates of secondhand smoke exposure in public and private settings in Mexico. Encodat 2016.] / Factores asociados con la exposición al humo de tabaco de segunda mano en lugares públicos y privados en México. Encodat 2016.

OBJECTIVE: To assess the correlates of secondhand smoke exposure (SHS) in public and private settings. MATERIALS AND METHODS: Data came from the 2016 National Survey of Drug, Alcohol and Tobacco use. Multilevel Poisson models were conducted to evaluate factors associated with SHS. RESULTS: Having a higher education, being male and being a young adult were associated with higher SHS in bars and restaurants. Men had greater SHS at work, while women and adolescents had greater exposure at home. Adults older than 45 years had higher SHS on public transportation compared to adolescents between 12-17 years old. CONCLUSIONS: Exposure to SHS remains high and affects the population differentially. To reduce SHS, it is necessary to apply Article 8 of the Framework Convention on Tobacco Control.

OBJETIVO: Determinar los factores asociados con la exposición al humo de tabaco de segunda mano (HTSM) en lugares públicos y privados. MATERIAL Y MÉTODOS: Se analizó la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016. La exposición al HTSM se evaluó mediante modelos Poisson multinivel. La muestra del estudio incluye únicamente no fumadores. RESULTADOS: La exposición al HTSM fue similar en los estados que tienen prohibición total para fumar en espacios cerrados en comparación con estados con prohibición parcial. Adultos jóvenes, hombres y personas con nivel educativo alto tienen mayor exposición al HTSM en bares y restaurantes. Los hombres tienen mayor exposición al HTSM en el trabajo, los adultos de mayor edad en el transporte público, mientras las mujeres y adolescentes en el hogar. CONCLUSIONES: La exposición al HTSM continúa elevada y afecta diferencialmente a la población mexicana. Para reducirla, se requiere aplicar totalmente el artículo octavo del Convenio Marco para el Control del Tabaco.

[Evaluation of physical and psychological dependence in Mexican adult smokers, Encodat 2016.] / Evaluación de la dependencia física y psicológica al tabaco en fumadores mexicanos adultos, Encodat 2016.

OBJECTIVE: To evaluate the physical and psychological dependence to tobacco of Mexican smokers and its association with physical, psychological and social factors. MATERIALS AND METHODS: The 2016 National Alcohol and Tobacco Drug Consumption Survey (n=7 331) was analyzed using the Fagerström nicotine physical dependence scale (FTND) and the short scale of psychological dependence on tobacco (TAPDSc). Bivariate analyzes and generalized ordinal logistic regressions were performed to evaluate the associated factors. RESULTS: 82.3% of daily smokers and 98.8% of occasional smokers reported mild physical dependence, while 47.9 and 37.9% respectively reported moderate psychological dependence. The age of initiation of tobacco use, drug use, high alcohol consumption and high emotional distress were associated with high levels of psychological dependence in all smokers. CONCLUSIONS: The exclusive use of FTND does not allow to adequately evaluate Mexican smokers. The physical and psychological dependence on tobacco should be assessed with independent and validated scales in this population.

OBJETIVO: Evaluar la dependencia física y psicológica de los fumadores mexicanos y su asociación con factores físicos, psicológicos y sociales. MATERIAL Y MÉTODOS: . A partir de la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016 (n=7 331), se analizó la escala de dependencia física a la nicotina de Fagerström (FTND) y la escala corta de dependencia psicológica al tabaco (TAPDSc). Se realizaron análisis bivariados y regresiones logísticas ordinales generalizadas para evaluar los factores asociados. RESULTADOS: 82.3% de fumadores diarios y 98.8% de ocasionales reportaron dependencia física leve, mientras que 47.9 y 37.9%, respectivamente, presentaron dependencia psicológica moderada. La edad de inicio temprana de consumo de tabaco, uso de drogas, consumo alto de alcohol y malestar emocional se asociaron con niveles altos de dependencia psicológica en todos los fumadores. CONCLUSIONES: El uso exclusivo de FNTD no permite evaluar adecuadamente a los fumadores mexicanos. La dependencia física y psicológica al tabaco debe ser diagnosticada con escalas independientes y validadas en esta población.

E-cigarette use frequency and motivations among current users in middle school.

INTRODUCTION: The popularity of electronic cigarettes (e-cigarettes) has increased worldwide among youth, even in countries like Mexico that ban them. This study aimed to assess the correlates of e-cigarette use frequency among Mexican students who currently use ecigarettes, as well as to describe their reasons for use. METHODS: Data were analyzed from a school-based survey of 57 public middle schools from the three largest cities in Mexico. Primary analyses were confined to those who used e-cigarettes in the prior 30 days. Censored binomial models for truncated distributions were estimated, regressing lifetime and past month frequency of use on participant sociodemographics, other substance use (smoking, alcohol, drugs), technophilia (appeal of new technologies), characteristics of e-cigarettes used, and family's and friends' use of nicotine products. RESULTS: Being male (APR = 1.93 95% CI 1.53-2.44), using drugs, (APR = 1.51 95% CI 1.03-2.20), higher technophilia (APR = 1.66 CI 1.21-2.29) and having a family member who uses e-cigarettes and cigarettes were associated with more frequent use in the last month. Students who preferred fruit and combined flavors had used e-cigarettes more often in their lifetime compared to students who preferred mint/menthol flavors. CONCLUSIONS: Some risk factors for more frequent e-cigarette use among Mexican youth are similar to those foudn in other countries (having relatives who use ecigarettes, using drugs, and use of fruit flavors). Additionally, the novel measure of technophilia was positively associated with frequency of e-cigarette use. The appeal of flavors, in particular, suggests the importance of reducing youth access to flavored products to impede product initiation and progression.

Prenatal Exposure to Sodium Arsenite Alters Placental Glucose 1, 3, and 4 Transporters in Balb/c Mice.

Inorganic arsenic (iAs) exposure induces a decrease in glucose type 4 transporter (GLUT4) expression on the adipocyte membrane, which may be related to premature births and low birth weight infants in women exposed to iAs at reproductive age. The aim of this study was to analyze the effect of sodium arsenite (NaAsO2) exposure on GLUT1, GLUT3, and GLUT4 protein expression and on placental morphology. Female Balb/c mice (n = 15) were exposed to 0, 12, and 20 ppm of NaAsO2 in drinking water from 8th to 18th day of gestation. Morphological changes and GLUT1, GLUT3, and GLUT4 expression were evaluated in placentas by immunohistochemical and image analysis and correlated with iAs and arsenical species concentration, which were quantified by atomic absorption spectroscopy. NaAsO2 exposure induced a significant decrease in fetal and placental weight (P < 0.01) and increases in infarctions and vascular congestion. Whereas GLUT1 expression was unchanged in placentas from exposed group, GLUT3 expression was found increased. In contrast, GLUT4 expression was significantly lower (P < 0.05) in placentas from females exposed to 12 ppm. The decrease in placental GLUT4 expression might affect the provision of adequate fetal nutrition and explain the low fetal weight observed in the exposed groups.

Cigarros con cápsulas de sabor en México: prevalencia, proporción de uso entre fumadores y predictores de consumo. Ensanut 2018-19 / Prevalence, proportion and correlates of flavor capsule cigarette use in Mexico: results from the Ensanut 2018-19

Resumen: Objetivo: Calcular la prevalencia de consumo de cigarros con cápsula de sabor, la proporción de uso entre los usuarios de tabaco en la población mexicana de 10 años o más, y los factores asociados a su consumo. Material y métodos: Se utilizó la Encuesta Nacional de Salud y Nutrición 2018-19. Se utilizó un modelo Poisson para obtener la razón de prevalencias del uso de cigarros con cápsulas de sabor ajustando por sexo, edad, educación e índice de bienestar. Resultados: El 6.6% de los mexicanos fuma cigarros con cápsulas de sabor, lo que corresponde a 43% del total de usuarios de tabaco. Las mujeres, adolescentes y adultos jóvenes son los grupos con la mayor proporción de consumo. Conclusiones: México tiene una alta prevalencia de consumo de cigarros con cápsula de sabor. Para reducirla, se deben implementar políticas para prohibir la venta de cigarros con saborizantes y eliminar los diseños atractivos en las cajetillas de los cigarros.

Abstract: Objective: To estimate the prevalence of flavor capsule cigarette, use among Mexicans who are 10 years and older, to determine the proportion of smokers who use flavor capsules, and to characterize the sociodemographic correlates of flavor capsule cigarette use. Materials and methods: Data came from the National Health and Nutrition Survey 2018-19. The prevalence and proportion of flavor capsule cigarette use were estimated by sex, age, education, and wealth. Poisson models were used to evaluate sociodemographic factors associated with flavor capsule cigarette use. Results: Among Mexicans, the prevalence of flavor capsule cigarettes use was 6.6%, which is 43% of all smokers. Women, adolescents, and young adults were more likely than other groups to use flavor capsule cigarettes. Conclusions: Mexicans report a high prevalence of flavor capsule cigarette use. Banning cigarettes with flavors may reduce the appeal of smoking, particularly for youth and women.

Evaluación de la dependencia física y psicológica al tabaco en fumadores mexicanos adultos, Encodat 2016 / Evaluation of physical and psychological dependence in Mexican adult smokers, Encodat 2016

Resumen: Objetivo: Evaluar la dependencia física y psicológica de los fumadores mexicanos y su asociación con factores físicos, psicológicos y sociales. Material y métodos: A partir de la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016 (n=7 331), se analizó la escala de dependencia física a la nicotina de Fagerström (FTND) y la escala corta de dependencia psicológica al tabaco (TAPDSc). Se realizaron análisis bivariados y regresiones logísticas ordinales generalizadas para evaluar los factores asociados. Resultados: 82.3% de fumadores diarios y 98.8% de ocasionales reportaron dependencia física leve, mientras que 47.9 y 37.9%, respectivamente, presentaron dependencia psicológica moderada. La edad de inicio temprana de consumo de tabaco, uso de drogas, consumo alto de alcohol y malestar emocional se asociaron con niveles altos de dependencia psicológica en todos los fumadores. Conclusión: El uso exclusivo de FNTD no permite evaluar adecuadamente a los fumadores mexicanos. La dependencia física y psicológica al tabaco debe ser diagnosticada con escalas independientes y validadas en esta población.

Abstract: Objective: To evaluate the physical and psychological dependence to tobacco of Mexican smokers and its association with physical, psychological and social factors. Materials and methods: The 2016 National Alcohol and Tobacco Drug Consumption Survey (n=7 331) was analyzed using the Fagerström nicotine physical dependence scale (FTND) and the short scale of psychological dependence on tobacco (TAPDSc). Bivariate analyzes and generalized ordinal logistic regressions were performed to evaluate the associated factors. Results: 82.3% of daily smokers and 98.8% of occasional smokers reported mild physical dependence, while 47.9 and 37.9% respectively reported moderate psychological dependence. The age of initiation of tobacco use, drug use, high alcohol consumption and high emotional distress were associated with high levels of psychological dependence in all smokers. Conclusion: The exclusive use of FTND does not allow to adequately evaluate Mexican smokers. The physical and psychological dependence on tobacco should be assessed with independent and validated scales in this population.

Factores asociados con la exposición al humo de tabaco de segunda mano en lugares públicos y privados en México. Encodat 2016 / Correlates of secondhand smoke exposure in public and private settings in Mexico. Encodat 2016

Resumen: Objetivo: Determinar los factores asociados con la exposición al humo de tabaco de segunda mano (HTSM) en lugares públicos y privados. Material y métodos: Se analizó la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016. La exposición al HTSM se evaluó mediante modelos Poisson multinivel. La muestra del estudio incluye únicamente no fumadores. Resultados: La exposición al HTSM fue similar en los estados que tienen prohibición total para fumar en espacios cerrados en comparación con estados con prohibición parcial. Adultos jóvenes, hombres y personas con nivel educativo alto tienen mayor exposición al HTSM en bares y restaurantes. Los hombres tienen mayor exposición al HTSM en el trabajo, los adultos de mayor edad en el transporte público, mientras las mujeres y adolescentes en el hogar. Conclusiones: La exposición al HTSM continúa elevada y afecta diferencialmente a la población mexicana. Para reducirla, se requiere aplicar totalmente el artículo octavo del Convenio Marco para el Control del Tabaco.

Abstract: Objective: To assess the correlates of secondhand smoke exposure (SHS) in public and private settings. Materials and methods: Data came from the 2016 National Survey of Drug, Alcohol and Tobacco use. Multilevel Poisson models were conducted to evaluate factors associated with SHS. Results: Having a higher education, being male and being a young adult were associated with higher SHS in bars and restaurants. Men had greater SHS at work, while women and adolescents had greater exposure at home. Adults older than 45 years had higher SHS on public transportation compared to adolescents between 12-17 years old. Conclusions: Exposure to SHS remains high and affects the population differentially. To reduce SHS, it is necessary to apply Article 8 of the Framework Convention on Tobacco Control.