Tobacco smoking prevalence in Pacific Island countries and territories: a review.

AIM: To comprehensively review adult and youth smoking prevalence data in Pacific Island countries and territories (PICT). METHODS: MEDLINE search for period 1986-2006 and search of World Health Organization and Centres for Disease Control and Prevention databases. RESULTS: Smoking prevalence in PICT ranges from 22%-57% (males) and from 0.6%-51% (females). All PICT male populations (except Palau) report higher rates than in Australia and New Zealand. Nauru, Tokelau, French Polynesia, New Caledonia, and Kiribati report high rates of female smoking. Youth rates of smoking range from 3%-68% (although unavailable for many PICT). Palau, Northern Mariana Islands, Guam, Cook Islands, and American Samoa report very high levels of youth smoking in both males and females. Smoking prevalence appears to have decreased in the last 30 years in male populations with a variable picture in female populations. CONCLUSIONS: PICT continue to show high levels of smoking prevalence, with youth smoking rates particularly concerning. There is a need for more robust and systematic collection and publication of smoking prevalence data in PICT, especially youth data, but this should not delay urgently required action to reduce tobacco use in PICT. The Framework Convention on Tobacco Control provides a powerful tool, but its provisions should be implemented rapidly, particularly increased tobacco taxation.

Asthma phenotypes in Niue Islanders.

OBJECTIVE: The aim of this study was to identify asthma phenotypes in patients of Niue Island ancestry that might be suitable for susceptibility gene mapping studies. METHODOLOGY: Two hundred and sixteen Niue Islanders with physician-diagnosed asthma that was not secondary to other medical conditions were recruited through community organisations. Fifty-one of the subjects with asthma were resident on Niue Island and 165 in New Zealand. Each subject was interviewed and tested for atopy, serum [IgE] (5% quantile, median, 95% quantile) and lung function. RESULTS: There were two groups of subjects defined by an age of onset of asthma less than 12 years of age (childhood-onset, boys:girls 64:65) and greater than 12 years of age (adult-onset, men:women 11:76). A positive response (wheal > 3 mm) to at least one aeroallergen was seen in 181 patients, with 168/181 (92.8%) responding to house dust mite. Twenty-eight subjects with asthma were non-atopic (no detectable wheal) and the atopy status of seven subjects with asthma could not be determined (wheal < 3 mm). In childhood-onset asthma, serum IgE levels were higher (P < 0.0001) in subjects with atopic than in subjects with non-atopic asthma. In adult-onset asthma, serum IgE levels were higher (P < 0.0001) in subjects with atopic asthma than in either subjects with non-atopic asthma or matched non-atopic subjects without asthma. The asthma phenotypes in Niue Island and New Zealand residents were similar. CONCLUSIONS: Both atopic and non-atopic asthma phenotypes exist in Niue Islanders resident in Niue and New Zealand. The potential for mapping asthma susceptibility genes in this isolated population is discussed.