Individual-, social- and policy- factors associated with smoking cessation among adult male cigarette smokers in Hanoi, Vietnam: a longitudinal study.

BACKGROUND: Nearly one-in-two Vietnamese men smoke cigarettes placing them among the highest tobacco consumers in the world. Despite the need for smoking cessation to curb the burden of tobacco-related diseases in Vietnam, this rate remains at less than 30%. Therefore, this study examines individual-, social- and policy factors associated with smoking cessation among adult male smokers in Vietnam. METHODS: We established a longitudinal International Tobacco Control study of male smokers in Hanoi, Vietnam, in September 2018. This paper analyses 1525 men who participated in baseline and one-year follow-up. We applied a weighted multivariable logistic regression to examine the association between smoking cessation and individual-, social- and policy predictors. RESULTS: At follow-up, 14.8% of participants had quit smoking for at least 30 consecutive days during the last year. Among the persistent smokers, 56.6% expressed intention to quit smoking. Factors associated with smoking cessation included a lower number of cigarettes smoked per day (aOR = 0.96, 95% CI: 0.94, 0.99) and having several attempts to quit smoking (aOR = 2.16, 95% CI 1.13, 4.12). Intention to quit smoking was associated with multiple quit attempts, a chronic condition diagnosis, more tobacco-related knowledge, greater self-efficacy, and more worries about their future health. The perceived impact of smoke-free policy and health warning labels were positively associated with intention to quit at any stage. CONCLUSIONS: Interventions aimed at increasing smoking cessation should focus on all aspects of individual, social, and policy factors. Persistent smokers are more motivated to quit if they have made multiple quit attempts, more self-efficacy of quitting and worried about their future health, indicating that increasing smokers' beliefs and knowledge may be important for behavioural change. Health warning labels and tobacco taxation policies should be maintained and promoted as they are perceived to be particularly useful for persistent smokers' intention to quit.

Smoking Cessation, Quit Attempts and Predictive Factors among Vietnamese Adults in 2020.

OBJECTIVE: This study aims to describe the updated smoking cessation and quit attempt rates and associated factors among Vietnamese adults in 2020. METHODS: Data on tobacco use among adults in Vietnam in 2020 was derived from the Provincial Global Adult Tobacco Survey. The participants in the study were people aged 15 and older. A total of 81,600 people were surveyed across 34 provinces and cities. Multi-level logistic regression was used to examine the associations between individual and province-level factors on smoking cessation and quit attempts. RESULTS: The smoking cessation and quit attempt rates varied significantly across the 34 provinces. The average rates of people who quit smoking and attempted to quit were 6.3% and 37.2%, respectively. The factors associated with smoking cessation were sex, age group, region, education level, occupation, marital status, and perception of the harmful effects of smoking. Attempts to quit were significantly associated with sex, education level, marital status, perception of the harmful effects of smoking, and visiting health facilities in the past 12 months. CONCLUSIONS: These results may be useful in formulating future smoking cessation policies and identifying priority target groups for future interventions. However, more longitudinal and follow-up studies are needed to prove a causal relationship between these factors and future smoking cessation behaviors.

Association between perceived harm of tobacco and intention to quit: a cross-sectional analysis of the Vietnam Global Adult Tobacco Survey.

BACKGROUND: Perception of harm plays an important role in predicting intention to quit-an integral part of the cessation process. Perception on harm from bamboo waterpipe tobacco was unknown, even the predominant of this type of tobacco use. This study investigated the effects of perceived harm from cigarette and bamboo waterpipe tobacco on intention to quit among adult male Vietnamese tobacco users. METHODS: From the nationally-representative 2015 Global Adult Tobacco Survey, we included 1,351 adult males (≥ 18 years old) who used cigarettes, bamboo waterpipes, or both. Demographic characteristics, tobacco use behaviors, perceived harm from tobacco use, and regulation/policy exposure were measured. Effects of perceived harm from cigarette and bamboo waterpipe tobacco on intention to quit were assessed by logistic regression. RESULTS: Intention to quit prevalence was 59.0%, 55.0%, and 58.4% for cigarette, waterpipe, and dual users, respectively. Tobacco users who perceived that "using cigarettes and/or waterpipe could cause severe illness" and "waterpipe use is less harmful than cigarette smoking", had tobacco use bans at home, or were exposed to anti-smoking campaigns or encouragement to quit information were more likely to intend to quit. When analyzed by tobacco users, intention to quit was more likely for those users who perceived their tobacco product as more harmful than the other product type, although statistical significance was only observed for cigarette users. CONCLUSIONS: Misperceptions regarding harm from tobacco use could negatively affect intention to quit. Dissemination of accurate information on the risks from all forms of tobacco use and enforcement of tobacco control policies are important for encouraging intention to quit.

Violence and non-fatal injuries among Vietnamese in-school adolescents: national prevalence estimates and associated factors.

School violence and injury are major public health problems worldwide. The data of this study were from the Viet Nam Global School-based Student Health Survey (GSHS) - a nationally representative survey conducted in 2019, with a sample size of 7690 students aged 13-17 years old. We found the prevalence of violence and non-fatal injury to be 14.5% and 21.4%, respectively. Factors related to higher odds of violence and non-fatal injuries in both sexes included smoking cigarettes, drinking alcohol, having mental health problems (loneliness, worrying and suicidal thinking), and truancy. In contrast, parental monitoring was associated with lower odds of violence, and parental respect was a protective factor of both violence and non-fatal injuries. Students who experienced violence had a higher likelihood of having non-fatal injuries in both sexes. Future policies should consider individual factors and parent-child bonding, to mitigate the burden of violence and injury among in-school adolescents in Viet Nam.

Formation of the upper digestive tract by the ileum - right colon for patient with concurrent cancers of the esophagus and the stomach: A case report.

INTRODUCTION AND IMPORTANCE: A very rare case with presence of both esophageal and gastric cancers raised questions on how to perform optimal surgery for such cases. To date, reports on experimental surgery strategies for these rare cases remained sparse in the literatures. CASE PRESENTATION: A 61-year-old male patient having epigastric abdominal pain and swallowing difficulties for a month prior to the hospital. Esophagoscopy and gastroscopy results showed a 2-cm lesion in the esophagus, located around 25 cm away from the teeth arch; and a 2-cm ulcer lesion with high ridge line at the corner of the lesser curvature of stomach. Biopsy results revealed esophageal squamous epithelium carcinoma and poorly differentiated gastric adenocarcinoma. The surgery was esophago-gastrectomy with curettage of the lymph nodes and reconstruction of the upper gastrointestinal tract with the ileum - right colon in the left side of the neck. CLINICAL DISCUSSION: We did not remain the stomach and performed thoracoscopic Ivor Lewis esophagectomy with chest anastomosis, as in previous studies to prevent cancer recurrence. Here, we performed a new surgical method of reconstruct the upper gastrointestinal tract by connecting the upper part of the esophagus at the neck, to the ileum - right colon. CONCLUSIONS: This case could suggest an effective surgical strategy that the ileum - right colon was an organ to be used in replacing the upper gastrointestinal tract in cases of removing the entire stomach and thoracic esophagus, which could serve as a valuable reference for similar rare cases in the future.

Patient-Centered Care: Transforming the Health Care System in Vietnam With Support of Digital Health Technology.

BACKGROUND: Over the recent decades, Vietnam has attained remarkable achievements in all areas of health care. However, shortcomings including health disparities persist particularly with a rapidly aging population. This has resulted in a shift in the disease burden from communicable to noncommunicable diseases such as dementia, cancer, and diabetes. These medical conditions require long-term care, which causes an accelerating crisis for the health sector and society. The current health care system in Vietnam is unlikely to cope with these challenges. OBJECTIVE: The aim of this paper was to explore the opportunities, challenges, and necessary conditions for Vietnam in transforming toward a patient-centered care model to produce better health for people and reduce health care costs. METHODS: We examine the applicability of a personalized and integrated Bespoke Health Care System (BHS) for Vietnam using a strength, weakness, opportunity, and threat analysis and examining the successes or failures of digital health care innovations in Vietnam. We then make suggestions for successful adoption of the BHS model in Vietnam. RESULTS: The BHS model of patient-centered care empowers patients to become active participants in their own health care. Vietnam's current policy, social, technological, and economic environment favors the transition of its health care system toward the BHS model. Nevertheless, the country is in an early stage of health care digitalization. The legal and regulatory system to protect patient privacy and information security is still lacking. The readiness to implement electronic medical records, a core element of the BHS, varies across health providers and clinical practices. The scarcity of empirical evidence and evaluation regarding the effectiveness and sustainability of digital health initiatives is an obstacle to the Vietnamese government in policymaking, development, and implementation of health care digitalization. CONCLUSIONS: Implementing a personalized and integrated health care system may help Vietnam to address health care needs, reduce pressure on the health care system and society, improve health care delivery, and promote health equity. However, in order to adopt the patient-centered care system and digitalized health care, a whole-system approach in transformation and operation with a co-design in the whole span of a digital health initiative developing process are necessary.

Tobacco and Alcohol Use Among Ethnic Minorities in Vietnam.

This study investigates the prevalence of tobacco and alcohol uses and associated factors among 12 ethnic minorities in Vietnam in 2019. A cross-sectional survey was conducted among 5172 people aged ≥15 years. The prevalence of smoking and drinking was 19.7% and 29.9%, respectively, and significantly higher among men than women. These numbers were heterogeneous across ethnic minorities. Smoking prevalence was high among Ba Na (25.9%), Cham An Giang (22.3%), Khmer (23.5%), La Hu (26.3%), Ta Oi (30.7%), and Bru Van Kieu (29.6%) ethnicities whereas that of Gie Trieng and Mnong ethnicities was low (3.7% and 9.5%, respectively). Drinking prevalence ranged from 1.4% in Cham An Giang ethnicity to 68.6% in Ba Na ethnicity. A wide ethnic disparity on tobacco and alcohol use could be explained by the ethnic variation of lifestyles, social norms, and cultural features. Our findings suggest the need to develop ethnic-specific interventions to mitigate the smoking and drinking prevalence.

Household Financial Burden and Poverty Impacts of Cancer Treatment in Vietnam.

PURPOSE: This paper aims to analyze the household financial burden and poverty impacts of cancer treatment in Vietnam. METHODS: Under the "ASEAN CosTs in ONcology" study design, three major specialized cancer hospitals were employed to assemble the Vietnamese data. Factors of socioeconomic, direct, and indirect costs of healthcare were collected prospectively through both individual interviews and hospital financial records. RESULTS: The rates of catastrophic expenditure based on the cut-off points of 20%, 30%, 40%, and 50% of household's income were 82.6%, 73.7%, 64.7%, and 56.9%, respectively. 37.4% of the households with patient were impoverished by the treatment costs for cancer. The statistically significant correlates of the impoverishment problem were higher among older patients (40-60 years: 1.77, 95% CI 1.14-2.73; above 60 years: 1.75, 95% CI 1.03-2.98); poorer patients (less than 100% national income: 29, 95% CI 18.6-45.24; less than 200% national income: 2.89, 95% CI 1.69-4.93); patients who underwent surgery alone (receiving nonsurgery treatment: 2.46, 95% CI 1.32-4.59; receiving multiple treatments: 2.4, 95% CI 1.38-4.17). CONCLUSIONS: Lots of households were pushed into poverty due to their expenditure on cancer care; more actions are urgently needed to improve financial protection to the vulnerable groups.

Attitudes toward nonsmoking policies and tobacco tax increases: a cross-sectional study among Vietnamese adults.

Following the 2009 update of the 2005 Framework Convention on Tobacco Control, Vietnam issued a new policy to ban smoking at workplaces and public places. This cross-sectional survey explored public attitudes toward this new regulation and provides evidence to inform future laws. Using stratified cluster sampling, 10 383 Vietnamese people older than 15 years were drawn from 11 142 selected households. Policies mandating "no smoking at workplaces" were supported by 88.7% of Vietnamese adults, whereas "no smoking in public places" and "increasing the tobacco tax" received less support. Educational level, knowledge of health effects, access to information on quitting and smoking health risks, smoking status, ethnicity, and region had significant associations with positive attitudes toward all 3 tobacco control policies. Adults belonging to the non-Kinh ethnic group, those who do not live in the Red river delta, people with lower educational levels, and current smokers should be targeted in tobacco control communication programs.

Risk factors for chronic disease among rural Vietnamese adults and the association of these factors with sociodemographic variables: findings from the WHO STEPS survey in rural Vietnam, 2005.

INTRODUCTION: Chronic diseases have emerged as a major health threat to the world's population, particularly in developing countries. We examined the prevalence of selected risk factors for chronic disease and the association of these risk factors with sociodemographic variables in a representative sample of adults in rural Vietnam. METHODS: In 2005, we selected a representative sample of 2000 adults aged 25 to 64 years using the World Health Organization's STEPwise approach to surveillance of chronic disease risk factors. We measured subjects' blood pressure, calculated their body mass index (BMI), and determined their self-reported smoking status. We then assessed the extent to which hypertension, being overweight (having a BMI > or =25.0), smoking, and various combinations of these risk factors were associated with subjects' education level, occupational category, and economic status. RESULTS: Mean blood pressure levels were higher among men than among women and increased progressively with age. The prevalence of hypertension was 23.9% among men and 13.7% among women. Sixty-three percent of men were current smokers, and 58% were current daily smokers; less than 1% of women smoked. Mean body mass index was 19.6 among men and 19.9 among women, and only 3.5% of the population was overweight. Education level was inversely associated with the prevalence of hypertension among both men and women and with the prevalence of smoking among men. People without a stable occupation were more at risk of having hypertension than were farmers and more at risk of being overweight than were farmers or government employees. Hypertension was directly associated with socioeconomic status among men but inversely associated with socioeconomic status among women. CONCLUSION: Rural Vietnam is experiencing an increase in the prevalence of many risk factors for chronic diseases and is in urgent need of interventions to reduce the prevalence of these risk factors and to deal with the chronic diseases to which they contribute.

Cardiovascular disease mortality and its association with socioeconomic status: findings from a population-based cohort study in rural Vietnam, 1999-2003.

INTRODUCTION: Cardiovascular disease is an emerging epidemic in Vietnam, but because cause of death and other routine data are not widely available, it is difficult to characterize community-based disease patterns. Using 5-year data from an ongoing cause-specific mortality study conducted within a demographic surveillance system in Vietnam's Bavi district, this article estimates the rates of adult cardiovascular disease mortality in relation to the mortality rates of other noncommunicable diseases in rural northern Vietnam and examines the association of cardiovascular disease with certain demographic and socioeconomic factors. METHODS: All causes of death of adults aged 20 and older occurring from 1999 through 2003 (n = 1067) were determined by using an established demographic surveillance system and data collected by trained interviewers who asked caretakers or relatives of the deceased individuals about signs and symptoms of disease during quarterly household visits. Deaths were classified as cardiovascular disease, cancer, or other noncommunicable diseases. These records were linked to demographic and socioeconomic data. RESULTS: Of the 1067 adult deaths that were recorded, there was an overall noncommunicable disease mortality rate of 7.8 per 1000 person-years. Cardiovascular disease accounted for 33% of male and 31% of female deaths. Compared with cancer and other noncommunicable causes of death in a Cox proportional hazards model, higher cardiovascular disease mortality rates were observed among men, older age groups, and those without formal education. CONCLUSION: To date, cohort studies and population-based mortality data in Vietnam have been scarce; this study provides insights into the public health aspects of cardiovascular disease in transitional Vietnam. The rates of cardiovascular disease mortality in this rural Vietnamese community were high, suggesting the need for both primary prevention and secondary treatment initiatives. The demographic surveillance system is an important tool for characterizing such an epidemic.