Assessing contraband tobacco in two jurisdictions: a direct collection of cigarette butts.

BACKGROUND: The sale of contraband tobacco allows for tobacco tax evasion, which can undermine the effectiveness of tobacco tax policies in reducing the number of smokers. Estimates of the proportion of contraband vary widely as do the methods used to measure the proportion of contraband being smoked. The purpose of this study is to determine the proportion of contraband use in two different jurisdictions. METHODS: A cross-sectional direct collection of cigarette butts was conducted in Peel and Brantford, Ontario, Canada in 2013 and 2014, respectively. Cigarette butts were collected from a variety of locations within both regions. Cigarette butts were assessed and classified into one of the following categories: contraband, legal Canadian, legal Native, International, unknown, and discards. RESULTS: The overall proportion of contraband cigarettes in Peel was 5.3 %, ranging from 2.8 to 8.6 % by location. In Brantford, the proportion of contraband was 33.0 %, with a range from 32.8 to 33.1 % by location. CONCLUSIONS: The direct collection of cigarette butts was determined to be a feasible method for a local public health unit in determining the proportion of contraband cigarettes. This approach showed that Brantford has a higher proportion of contraband consumption compared to Peel, which may be due to geographic location and proximity to the United States (US)-Canada border and Native Reserves. More research is needed to confirm this geographic association with other jurisdictions.

The effect of supplemental vitamins and minerals on the development of prostate cancer: a systematic review and meta-analysis.

BACKGROUND: Vitamin supplementation is used for many purposes with mainly alleged benefits. One of these is the use of various vitamins for the prevention of prostate cancer. METHODS: We conducted a systematic review and meta-analysis on this topic. Pubmed, Embase and the Cochrane Database were searched; as well, we hand searched the references in key articles. Randomized controlled trials (RCTs), cohort studies and case-control studies were included. The review assessed the effect of supplemental vitamins on the risk of prostate cancer and on disease severity and death in men with prostate cancer. RESULTS: Fourteen articles were included in the final assessment. Individually, a few of these studies showed a relationship between the ingestion of supplemental vitamins or minerals and the incidence or severity of prostate cancer, especially in smokers. However, neither the use of multivitamin supplementation nor the use of individual vitamin/mineral supplementation affected the overall occurrence of prostate cancer or the occurrence of advanced/metastatic prostate cancer or death from prostate cancer when the results of the studies were combined in a meta-analysis. We also conducted several sensitivity analyses by running meta-analysis using just the higher quality studies and just the RCTs. There were still no associations found. CONCLUSIONS: There is no convincing evidence that the use of supplemental multivitamins or any specific vitamin affects the occurrence or severity of prostate cancer. There was high heterogeneity among the studies so it is possible that unidentified subgroups may benefit or be harmed by the use of vitamins.

A descriptive analysis of hospitalization due to acute gastrointestinal illness in Canada, 1995-2004.

BACKGROUND: Gastrointestinal illness (GI) remains a leading cause of morbidity and mortality worldwide. In Canada, research has already demonstrated a rate in excess of one episode per person-year. National passive surveillance programs may be enhanced by information from hospitalizations for acute gastrointestinal disease. The objective of this report is to explore the incidence of acute GI in hospital administrative data collected by the Canadian Institute for Health Information (CIHI)--specifically the hospital morbidity database (HMDB). METHODS: Data from acute care facilities and select chronic care and rehabilitation facilities across Canada were analyzed using standardized rates, and age- and sex-adjusted rates for the years 1995-2004. RESULTS: The results indicate that GI causes at least 92,765 hospital admissions per year in Canada. In the majority (78.3%) of gastrointestinal hospitalizations, no specific etiology was recorded. Of the remaining diagnoses, 11.6% were due to viruses, 9.7% to bacteria and 0.3% to parasites. Age-standardized rates of hospitalizations for acute GI appear to have declined over the 10-year period. CONCLUSION: Gastrointestinal illness is still present in the Canadian population and presents a significant burden to the health care system. Whereas the HMDB likely underestimates the true rate of GI, it does capture cases that are serious enough to require hospitalization. This is a unique source of data and highlights other pathogen-specific disease data not currently collected through national surveillance tools (e.g., viruses).

Prevalence of smoking associated with pregnancy in three Southern Ontario Health Units.

OBJECTIVES: The objectives of this study were to determine the prevalence of pregnancy-associated smoking among women residing in three Southern Ontario Health Units and to examine potential risk factors for smoking during pregnancy, using an existing data collection mechanism. METHODS: During May 2001, questions about pregnancy-associated smoking were asked during the telephone follow-up of postpartum women living in the three health units in Southern Ontario; this follow-up is routinely conducted by public health nurses. Sociodemographic data were also obtained. Data from 1,134 women were analyzed concerning smoking before and after the occurrence of the pregnancy was known, during each trimester, and immediately postpartum. RESULTS: The rates of smoking before and after the pregnancy was known, in the first, second, and third trimesters, and immediately postpartum were 17.8%, 10.4%, 9.6%, 8.7%, 8.1%, and 7.9%, respectively. For all six estimates of smoking, Canadian-born women had rates 2.5 to 4 times higher than those of women born outside Canada. Age less than 25 years and lower educational attainment were also independent risk factors for smoking during pregnancy. CONCLUSIONS: The Ontario Tobacco Strategy goal of eliminating smoking in pregnancy has not yet been realized. Ongoing smoking cessation programs among pregnant women are needed as part of a comprehensive strategy to reduce the overall prevalence of smoking. In planning such programs, particular attention should be paid to the needs of women who are Canadian-born, have lower educational attainment, and are under the age of 25.