Improving Prediction of Tobacco Use Over Time: Findings from Waves 1-4 of the Population Assessment of Tobacco and Health Study.

INTRODUCTION: First-order Markov models assume future tobacco use behavior is dependent on current tobacco use and are often used to characterize patterns of tobacco use over time. Higher-order Markov models that assume future behavior is dependent on current and prior tobacco use may better estimate patterns of tobacco use. AIMS AND METHODS: This study compared Markov models of different orders to examine whether incorporating information about tobacco use history improves model estimation of tobacco use and estimated tobacco use transition probabilities. We used data from four waves of the Population Assessment of Tobacco and Health Study. In each Wave, a participant was categorized into one of the following tobacco use states: never smoker, former smoker, menthol cigarette smoker, non-menthol cigarette smoker, or e-cigarette/dual user. We compared first-, second-, and third-order Markov models using multinomial logistic regression and estimated transition probabilities between tobacco use states. `RESULTS: The third-order model was the best fit for the data. The percentage of former smokers, menthol cigarette smokers, non-menthol cigarette smokers, and e-cigarette/dual users in Wave 3 that remained in the same tobacco use state in Wave 4 ranged from 63.4% to 97.2%, 29.2% to 89.8%, 34.8% to 89.7%, and 20.5% to 80.0%, respectively, dependent on tobacco use history. Individuals who were current tobacco users, but former smokers in the prior two years, were most likely to quit. CONCLUSIONS: Transition probabilities between tobacco use states varied widely depending on tobacco use history. Higher-order Markov models improve estimation of tobacco use over time and can inform understanding of trajectories of tobacco use behavior. IMPLICATIONS: Findings from this study suggest that transition probabilities between tobacco use states vary widely depending on tobacco use history. Tobacco product users (cigarette or e-cigarette/dual users) who were in the same tobacco use state in the prior two years were least likely to quit. Individuals who were current tobacco users, but former smokers in the prior two years, were most likely to quit. Quitting smoking for at least two years is an important milestone in the process of cessation.

A Pilot Study Assessing Treatment Outcomes in Neovascular Glaucoma Using Ahmed Glaucoma Valve with and without Cyclophotocoagulation.

Purpose: The purpose of this retrospective pilot study was to examine the short-term effect of simultaneous Ahmed Glaucoma Valve implantation and cyclophotocoagulation on postoperative outcomes in patients with neovascular glaucoma. Methods and materials: Patient charts were selected for inclusion in this study if they carried a diagnosis of neovascular glaucoma and underwent Ahmed glaucoma valve implantation only, Ahmed glaucoma valve implantation with cyclophotocoagulation, or cyclophotocoagulation only. A total of 55 eyes of 54 patients were selected for data collection and analysis. Main outcome measures included 1-, 3-, and 6-month intraocular pressure and occurrence of the hypertensive phase. Other outcomes included visual acuity, surgical complication rate, and a number of 6-month postoperative ophthalmic medications. Results: A significantly lower intraocular pressure was seen in the group that received Ahmed glaucoma valve implantation + cyclophotocoagulation compared to the Ahmed glaucoma valve-only group at 3 and 6 months (p = 0.03 and <0.001, respectively). The difference in the occurrence of the hypertensive phase between the Ahmed glaucoma valve-only group and the Ahmed glaucoma valve + cyclophotocoagulation group approached but did not reach significance (p = 0.052). A significantly lower intraocular pressure was also seen in the cyclophotocoagulation-only group compared to the Ahmed glaucoma valve-only group at 3 months (p = 0.006). Conclusion: Simultaneous Ahmed glaucoma valve implantation and cyclophotocoagulation significantly lowered intraocular pressure at 3 and 6 months compared to Ahmed glaucoma valve implantation alone in patients with neovascular glaucoma. Clinical significance: Neovascular glaucoma is difficult to manage medically and surgically. When surgery is performed, intraocular pressure often remains elevated postoperatively despite aggressive medical management. This study examines a novel method to lower intraocular pressure after Ahmed glaucoma valve implantation in patients with neovascular glaucoma. How to cite this article: Ford RL, Knight ORJ, Klifto MR, et al. A Pilot Study Assessing Treatment Outcomes in Neovascular Glaucoma Using Ahmed Glaucoma Valve with and without Cyclophotocoagulation. J Curr Glaucoma Pract 2022;16(1):4-10.

Sociodemographic Disparities in Tobacco Retailer Density in the United States, 2000-2017.

INTRODUCTION: Studies find differences in tobacco retailer density according to neighborhood sociodemographic characteristics, raising issues of social justice, but not all research is consistent. AIMS AND METHODS: This study examined associations between tobacco retailer density and neighborhood sociodemographic characteristics in the United States at four timepoints (2000, 2007, 2012, and 2017) and investigated if associations remained stable over time. Data on tobacco retailers came from the National Establishment Time-Series Database. Adjusted log-linear models examined the relationship between retailer density and census tract sociodemographic characteristics (% non-Hispanic Black [Black], % Hispanic, % vacant housing units, median household income), controlling for percentage of youth, urbanicity, and US region. To examine whether the relationship between density and sociodemographic characteristics changed over time, additional models were estimated with interaction terms between each sociodemographic characteristic and year. RESULTS: Tobacco retailer density ranged from 1.22 to 1.44 retailers/1000 persons from 2000 to 2017. There were significant, positive relationships between tobacco retailer density and the percentage of Black (standardized exp(b) = 1.05 [95% CI: 1.04% to 1.07%]) and Hispanic (standardized exp(b) = 1.06 [95% CI: 1.05% to 1.08%]) residents and the percentage of vacant housing units (standardized exp(b) =1.08 [95% CI: 1.07% to 1.10%]) in a census tract. Retailer density was negatively associated with income (standardized exp(b) = 0.84 [95% CI: 0.82% to 0.86%]). From 2000 to 2017, the relationship between retailer density and income and vacant housing units became weaker. CONCLUSIONS: Despite the weakening of some associations, there are sociodemographic disparities in tobacco retailer density from 2000 to 2017, which research has shown may contribute to inequities in smoking. IMPLICATIONS: This study examines associations between tobacco retailer density and neighborhood sociodemographic characteristics in the United States at four timepoints from 2000 to 2017. Although some associations weakened, there are sociodemographic disparities in tobacco retailer density over the study period. Research suggests that sociodemographic disparities in retailer density may contribute to inequities in smoking. Findings from this study may help identify which communities should be prioritized for policy intervention and regulation.

Beliefs About the Health Effects of Smoking Among Adults in the United States.

The majority of U.S. adults believe that smoking is a cause of lung cancer, but research suggests that the percentage of adults who believe smoking causes other types of cancers and chronic disease is lower. This study examines the correlates of beliefs about several established health effects of smoking in a nationally representative sample of U.S. adults. Data for this study come from Wave 4 of the Population Assessment of Tobacco and Health Study conducted from December 2016 to January 2018. Participants responded to questions assessing their beliefs about the health effects of smoking. Logistic regression models were used to examine the relationship between beliefs about the health effects of smoking and sociodemographic characteristics (smoker status, age, sex, education, race/ethnicity), exposure to antitobacco campaigns, smokers' health, and nicotine dependence. The percentage of U.S. adults who endorsed a health effect can be caused from smoking ranged from 56.4% for blindness to 97.4% for lung disease. Respondents who were older, less educated, current or former smokers, and had less exposure to antitobacco campaigns were generally less likely (p < .05) to endorse that an established health effect was caused by smoking. Smokers with lower nicotine dependence and worse health were generally more likely (p < .05) to endorse that an established health effect was caused by smoking. In summary, knowledge about the health effects of smoking varies across health conditions. Public health would benefit from campaigns targeting segments of the population with less knowledge about the health effects of smoking.

A machine learning approach to determine the prognosis of patients with Class III malocclusion.

INTRODUCTION: The conundrum of determining how to treat a patient with Class III malocclusion is significant, creating a burden on the patient and challenging the orthodontist. The objective of this study was to employ a statistical prediction model derived from our previous cephalometric data on 5 predominant subtypes of skeletal Class III malocclusion to test the hypothesis that Class III subtypes are associated with treatment modalities (eg, surgical vs nonsurgical) and treatment outcome. METHODS: Pretreatment lateral cephalometric records of 148 patients were digitized for 67 cephalometric variables, and measurements were applied to a mathematical equation to assign a Class III subtype. Subjects were assigned to either a surgical or nonsurgical group depending on the treatment received. Treatment outcome was determined by facial profile and clinical photographs. Log binomial models were used for statistical analysis. RESULTS: Subtype 1 (mandibular prognathic) patients were 3.5 × more likely to undergo orthognathic surgery than subtypes 2/3 (maxillary deficient) and 5.3 × more likely than 4/5 (combination). Subtype 1 patients were also 1.5 × more likely to experience treatment failure than subtypes 2/3 (maxillary deficient) and 4/5 (combination). CONCLUSIONS: This assessment of a systematic method to characterize patients with Class III malocclusion into subtypes revealed that subtype 1 (mandibular prognathic) showed a likelihood to undergo orthognathic surgery while subtypes 2/3 experienced significantly lower treatment failure (in response to orthodontics alone). Further refinement of the equation may yield a reliable prediction model for earlier identification of surgical patients and also provide predictive power of Class III treatment outcomes.

State-Level Patterns and Trends in Cigarette Smoking Across Racial and Ethnic Groups in the United States, 2011-2018.

INTRODUCTION: Reducing racial/ethnic disparities in smoking is a priority for state tobacco control programs. We investigated disparities in cigarette use by race/ethnicity, as well as trends in cigarette use across racial/ethnic groups from 2011 to 2018 in 50 US states and the District of Columbia. METHODS: We used data from the Behavioral Risk Factor Surveillance System. In each state, smoking prevalence and corresponding 95% CIs were estimated for each racial/ethnic group in 2011, 2014, and 2018. We used logistic regression models to examine state-specific linear and quadratic time trends in smoking prevalence from 2011 to 2018. RESULTS: Racial/ethnic disparities in smoking prevalence varied across states. From 2011 to 2018, compared with White adults, the odds of smoking were lower among Black adults in 14 states (odds ratio [OR] range, 0.58-0.91) and were higher in 9 states (OR range, 1.10-1.98); no differences were found in the odds of smoking in 13 states. Compared with White adults, the odds of smoking were lower among Hispanic adults in most states (OR range, 0.33-0.84) and were typically higher among Other adults (OR range, 1.19-2.44). Significant interactions between year and race/ethnicity were found in 4 states, indicating that time trends varied across racial/ethnic groups. In states with differential time trends, the decline in the odds of smoking was typically greater among Black, Hispanic, and Other adults compared with White adults. CONCLUSION: Some progress in reducing racial/ethnic disparities in smoking has been made, but additional efforts are needed to eliminate racial/ethnic disparities in smoking.

The Relationship Between Menthol Cigarette Use, Smoking Cessation, and Relapse: Findings From Waves 1 to 4 of the Population Assessment of Tobacco and Health Study.

INTRODUCTION: Some, but not all, studies suggest that menthol cigarette smokers have more difficulty quitting than non-menthol cigarette smokers. Inconsistent findings may be a result of differences in smoker characteristics (eg, daily vs. non-daily smokers) across studies. This study examines the relationship between menthol cigarette use, cessation, and relapse in a longitudinal, nationally representative study of tobacco use in the United States. AIMS AND METHODS: Data come from four waves of the Population Assessment of Tobacco and Health Study. Waves 1-4 were conducted approximately annually from September 2013 to January 2018. Generalized estimating equation models were used to prospectively examine the relationship between menthol cigarette use, cessation, and relapse in non-daily and daily adult (18+) smokers. Cessation was defined as smokers who had not used cigarettes within the past 30 days at their subsequent assessment. Relapse was defined as cessation followed by past 30-day smoking in the next assessment. RESULTS: Among daily smokers (n = 13 710), 4.0% and 5.3% of menthol and non-menthol smokers quit after 1 year, respectively. In an adjusted model, menthol smokers were less likely to quit compared with non-menthol smokers (odds ratio [OR] = 0.76 [0.63, 0.91]). When the sample was stratified by race/ethnicity, African American (OR = 0.47 [0.24, 0.91]) and White (OR = 0.78 [0.63, 0.97]) daily menthol users were less likely to have quit. Among non-daily smokers (n = 3608), there were no significant differences in quit rates. Among daily and non-daily former smokers, there were also no differences in relapse rates between menthol and non-menthol smokers. CONCLUSIONS: Menthol cigarette use is associated with lower odds of cessation. IMPLICATIONS: Findings from this study suggest that menthol cigarette use is associated with lower odds of cessation, but not relapse. Removing menthol cigarettes from the market may improve cessation rates.