Adoption of Tobacco- and Smoke-Free Policies in a US National Sample of Postsecondary Educational Institutions.

OBJECTIVES: To examine the institutional characteristics associated with the adoption of tobacco- and smoke-free policies among US postsecondary educational institutions. METHODS: In 2017, we collected information on tobacco policy types and institutional characteristics of a national sample of US postsecondary educational institutions (n = 605) attended by the participants of the NEXT Generation Health Study. We used logistic regression to examine the relationships between these variables. RESULTS: Overall, 35.2% of these institutions adopted tobacco-free policies (i.e., prohibit all tobacco product use on campus), 10.1% had smoke-free policies (i.e., prohibit smoking but not other tobacco product use on campus), and 53.7% did not have tobacco- or smoke-free policies. Proprietary (privately owned, for-profit) institutions (vs public institutions) were the least likely to have tobacco- or smoke-free policies (P < .05), which were disproportionately attended by racial/ethnic minority students. Adoption of these policies also varied by census region (P < .05). CONCLUSIONS: Prevalence of tobacco- and smoke-free policies among US postsecondary educational institutions is low. Public Health Implications. Wide dissemination of evidence-based interventions to accelerate adoption of tobacco-free policies in all postsecondary educational institutions is warranted.

Self-reported health among immigrants in Luxembourg: insights from a nationally representative sample.

Aim: Although immigrants account for nearly half of Luxembourg's population, few studies have investigated differences in self-reported health by nationality in Luxembourg. Our study aimed to explore the association between nationality and self-reported health in Luxembourg. Subject and methods: Cross-sectional data from the 2015-2016 Panel Socio-Economique Liewen zu Lëtzebuerg (PSELL3) were used. Nationalities included Luxembourger, Portuguese, French, Italian, Belgian and German. Multivariable logistic regression analyses examined the association between nationality and three self-reported health measures: general health status, limitation in activity due to a health problem, and living with a chronic illness or condition. Results: Of 8084 participants, 65% were Luxembourgers, 20% were Portuguese, and the remaining 15% were French, Italian, Belgian, or German. Italian nationals were more likely to report fair, poor, or very poor health [aOR = 1.54; 95% CI = 1.07, 2.22] and Portuguese nationals demonstrated both higher odds of fair, poor, or very poor health [aOR = 1.57; 95% CI = 1.28, 1.92] and limitation in activity [aOR = 1.32; 95% CI = 1.07, 1.64] compared to Luxembourgers. However, Portuguese nationals were also less likely to report living with a chronic illness [aOR = 0.79; 95% CI = 0.63, 0.98]. In education-stratified models, primary-educated Portuguese nationals were more likely to report fair, poor, or very poor health [aOR = 1.78, 95% CI = 1.36, 1.92] and limitation in activity [aOR = 1.36, 95% CI = 1.04, 1.79], but not less likely to report living with a chronic illness. Conclusions: Nationality and education level should be considered in future studies concerning self-reported health in Luxembourg. Further research is needed to examine disparities in self-reported health among Portuguese and Italian nationals.

Clotting Propensity in Trauma Patients According to Marijuana Use: A Descriptive Analysis.

Marijuana use has been reported to promote hypercoagulable states among trauma patients, particularly respecting venous thromboembolism (VTE), a major contributor to morbidity and mortality in patients sustaining traumatic injury. We sought to investigate this further through a retrospective, single institutional study performed from January 2018 through June 2021, utilizing data from patients presenting to a Level 1 Trauma Center as a trauma activation. We observed less frequent VTE development in the marijuana-positive group compared to the marijuana-negative group, with patient thromboelastography revealing a longer mean R-time in the marijuana-positive group. Overall occurrence of VTE was too low for definitive conclusions, but a trend toward reduction in VTE frequency among marijuana users compared to nonusers was noted. More studies with larger populations and more VTE occurrences are needed to confirm a potential correlation between marijuana use and VTE development.

Incidental Findings Protocol Implementation at a Level-I Trauma Center: A Review of Patient Follow-Up.

OBJECTIVES: Pan scanning in trauma patients has become routine, resulting in increased identification of incidental findings (IF), findings unrelated to the reason for the scan. This has posed a conundrum of ensuring patients have appropriate follow-up for these findings. We sought to evaluate our compliance and follow-up for patients after implementation of an IF protocol at our level-I trauma center. METHODS: We performed a retrospective review from 9/2020 to 4/2021, to encompass before and after protocol implementation. Patients were separated into PRE and POST groups. Charts were reviewed evaluating several factors including three- and six-month follow-ups on IF. Data were analyzed comparing PRE and POST groups. RESULTS: A total of 1989 patients were identified, 31.22% (n = 621) with an IF. 612 patients were included in our study. Compared to PRE, POST showed a significant increase in PCP notification (35% vs 22%, P < .001) and patient notification (82% vs 65%, P < .001). As a result, patient follow-up regarding IF at six months was significantly higher in POST (44%) v. PRE (29%), (P < .001). There was no difference in follow-up based on insurance carrier. There was no difference in patient age for PRE (63 y) and POST (66 y) overall, (P = .089); nor in age of patients who followed up; 68.8 PRE vs 68.2 years POST (P = .819). CONCLUSION: Implementation of an IF protocol with patient and PCP notification was significantly improved in overall patient follow-up for category one and two IF. Utilizing the results of this study, the protocol will be further revised to improve patient follow-up.

Adoption of electronic-cigarette-free, hookah-free and American College Health Association recommended tobacco-free policies among a national sample of postsecondary educational institutions.

Objective: To examine the prevalence of various types of tobacco-free policies among a US national sample of postsecondary educational institutions (PEIs). Participants: A national sample of US PEIs (N = 605) attended by the participants of the NEXT Generation Health Study. Methods: Tobacco policies of these PEIs were reviewed to determine if they were e-cigarette-free (yes/no), hookah-free (yes/no), and ACHA-recommended tobacco-free (yes/no) in June-December 2017. Logistic regression models were used to examine the relationships between institutional characteristics and tobacco policies. Results: Overall, 39.2, 26.0, and 20.0% of the sample adopted e-cigarette-free, hookah-free, and ACHA-recommended tobacco-free policies, respectively. Proprietary PEIs (vs. public) were less likely to have ACHA-recommended tobacco-free policies, while PEIs in the South and Midwest (vs. West) were more likely to have ACHA-recommended tobacco-free policies (p < 0.05). Conclusions: Most sampled PEIs did not have ACHA-recommended tobacco-free polices. Subsequent research needs to investigate how ACHA-recommended tobacco policies influence tobacco use.

Heterogeneity in Tobacco-Use Behaviors Among U.S. Blacks per Global Region of Origin.

Heterogeneity in tobacco-use behaviors among U.S. blacks by global region of origin and age at immigration was examined. Self-identified black participants from the 2006-2015 Tobacco Use Supplement to the Current Population Survey were included (n = 47,857). Countries of origin were classified by global regions (U.S., Africa, Europe, West Indies). Multivariable logistic regression models, adjusted for sociodemographic characteristics, were used to examine the association of global region of origin and age at immigration with tobacco-use behaviors. Prevalence of current cigarette smoking among U.S. blacks varied significantly by global region of origin (U.S.-born = 17.4%, Europe-born = 17.7%, Africa-born = 4.7%, West-Indies-born = 4.9%; p < 0.01). Furthermore, foreign-born blacks were less likely than U.S.-born blacks to smoke menthol flavored cigarettes (p < 0.05). Participants who immigrated to the U.S. at ≥ 13 years old were less likely than U.S.-born blacks to start regular smoking as minor (p < 0.05). Tobacco-use behaviors differ by global region of origin and age at immigration in the U.S. black population.