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BACKGROUND: The health consequences of polytobacco use are not well understood. We evaluated prospective associations between exclusive, dual, and polytobacco use and diagnosed bronchitis, pneumonia, or chronic cough among US youth. METHODS: Data came from Waves 1-5 of the Population Assessment of Tobacco and Health Study. We categorized time-varying past 30-day tobacco use into seven categories: (1) non-current use; exclusive use of 2) cigarettes, 3) e-cigarettes, and 4) other combustible products (OC; pipes, hookah, and cigars); dual use of 5) e-cigarettes + cigarettes or e-cigarettes + OC, and 6) cigarettes + OC; and 7) polyuse of all three products. The outcome was parent-reported diagnosis of bronchitis, pneumonia, or chronic cough among youth. We conducted weighted multilevel Poisson models (person n = 17,517, 43,290 observations) to examine the longitudinal exposure-outcome relationship, adjusting for covariates: sex, age, race and ethnicity, parental education, body mass index, secondhand smoke exposure, and household use of combustible products. RESULTS: Compared to nonuse, exclusive cigarette use (Risk Ratio (RR) = 1.83, 95% CI 1.25-2.68), exclusive e-cigarette use (RR = 1.53, 95% CI 1.08-2.15), combustible product + e-cigarette dual use (RR = 1.90, 95% CI 1.18-3.04), cigarettes + OC dual use (RR = 1.96, 95% CI 1.11-3.48), and polytobacco use (RR = 3.06 95% CI 1.67-5.63) were associated with a higher risk of bronchitis, pneumonia, or chronic cough. In additional analyses, we found that the risk ratio for polytobacco use was higher compared to exclusive e-cigarette use (RR 2.01 CI 95% 1.02-3.95), but not higher compared to exclusive cigarette use (RR 1.67 CI 95% 0.85-3.28). CONCLUSION: We found that exclusive, dual, and poly tobacco use were all associated with higher risk of bronchitis, pneumonia, or chronic cough compared to non-current use.
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Sistemas Electrónicos de Liberación de Nicotina , Humanos , Masculino , Femenino , Adolescente , Estudios Longitudinales , Estados Unidos/epidemiología , Niño , Estudios Prospectivos , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Tos/epidemiología , Uso de Tabaco/epidemiología , Uso de Tabaco/efectos adversos , Bronquitis/epidemiología , Neumonía/epidemiologíaRESUMEN
PURPOSE: To examine whether Tobacco 21 (T21) law coverage moderated associations between cigarette prices and adolescent smoking and associated disparities. METHODS: We used nationally representative, repeated cross-sectional 2014-2020 Monitoring the Future study data (n = 20,547-96,083) to examine associations between state-level average cigarette price per pack and county-level T21 coverage (100% vs. < 100%) on past 30-day smoking participation, first and daily cigarette smoking initiation, and smoking intentions in US adolescents in eighth, 10th, and 12th grade. We implemented weighted, grade-stratified, modified Poisson regression models to test for interactions between price and T21 coverage for each outcome. We also tested for disparities by sex, race and ethnicity, parental education, and college educational expectations. RESULTS: Higher cigarette prices were associated with a lower probability of past 30-day smoking participation among eighth graders in counties with < 100% T21 coverage (average marginal effect = -0.003, 95% confidence interval = -0.006, 0.000) but not among eighth graders in counties with 100% T21 coverage (average marginal effect = 0.001, 95% confidence interval = -0.001, 0.004) (p for interaction = 0.005). There were no associations with other smoking outcomes or grades or evidence of differential associations by sociodemographic factors. DISCUSSION: Our findings suggested that higher cigarette prices were associated with lower adolescent smoking among eighth graders living in counties with < 100% T21 coverage. However, no such association was observed in other grades or smoking outcomes. Further investigation is necessary to determine the best combination of policies to reduce adolescent smoking, related sociodemographic disparities, and the use of other tobacco products in areas with fewer tobacco control policies.
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Fumar Cigarrillos , Comercio , Productos de Tabaco , Humanos , Adolescente , Masculino , Femenino , Productos de Tabaco/economía , Productos de Tabaco/estadística & datos numéricos , Estudios Transversales , Fumar Cigarrillos/epidemiología , Fumar Cigarrillos/economía , Estados Unidos , Comercio/estadística & datos numéricos , Conducta del AdolescenteRESUMEN
The spatiotemporal distribution of industrial heat sources (IHS) is an important indicator for assessing levels of energy consumption and air pollution. Continuous, comprehensive, dynamic monitoring and publicly available datasets of global IHS (GIHS) are lacking and urgently needed. In this study, we built the first long-term (2012-2021) GIHS dataset based on the density-based spatiotemporal clustering method using multi-sources remote sensing data. A total of 25,544 IHS objects with 19 characteristics are identified and validated individually using high-resolution remote sensing images and point of interest (POI) data. The results show that the user's accuracy of the GIHS dataset ranges from 90.95% to 93.46%, surpassing other global IHS products in terms of accuracy, omission rates, and granularity. This long-term GIHS dataset serves as a valuable resource for understanding global environmental changes and making informed policy decisions. Its availability contributes to filling the gap in GIHS data and enhances our knowledge of global-scale industrial heat sources.
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Background: The health consequences of polytobacco use are still well not understand. We evaluated prospective associations between exclusive, dual, and polytobacco use and diagnosed bronchitis, pneumonia, or chronic cough among US youth. Methods: Data came from Waves 1-5 of the Population Assessment of Tobacco and Health Study. We categorized time-varying past 30-day tobacco use into seven categories: (1) non-current use; exclusive use of 2) cigarettes, 3) electronic nicotine delivery systems (ENDS), or 4) other combustible products (OC; pipes, hookah, and cigars); dual use of 5) ENDS + cigarettes or ENDS + OC 6) cigarettes + OC; or 7) polyuse of all three products. The outcome was incident diagnosis of bronchitis, pneumonia, or chronic cough. We conducted weighted multilevel Poisson models (person n = 17,517, 43,290 observations) to examine the longitudinal exposure-outcome relationship, adjusting for covariates: sex, age, race and ethnicity, parental education, body mass index, secondhand smoke exposure, and household use of combustible products. Results: Compared to nonuse, exclusive cigarette use (Incidence Rate Ratio (IRR) = 1.83, 95% CI 1.25-2.68), exclusive ENDS use (IRR = 1.53, 95% CI 1.08-2.15), combustible product + ENDS dual use (IRR = 1.90, 95% CI 1.18-3.04), cigarettes + OC dual use (IRR = 1.96, 95% CI 1.11-3.48), and polytobacco use (IRR = 3.06 95% CI 1.67-5.63) were associated with a higher incidence of bronchitis, pneumonia, or chronic cough. Conclusion: We found that exclusive, dual, and poly tobacco use was associated with higher incidence of bronchitis, pneumonia, or chronic cough; Moreover, the incidence rate ratio for polytobacco use was higher than the incidence rate ratio for exclusive use compared to non-current use.
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INTRODUCTION: Achieving cessation in people with established smoking patterns remains a challenge. Increasing cigarette prices has been one of the most successful strategies for lowering smoking rates. The extent to which it has remained effective in encouraging cessation among adults in recent years and how the effectiveness has varied by sociodemographic characteristics is unclear. AIMS AND METHODS: Using repeated cross-sectional data collected by the Tobacco Use Supplement of the Current Population Survey, we investigate the relationship between cigarette prices and cessation from 2003 to 2019 in adults at least 25 years old. We examine the associations between price and cessation in the population overall and by sex, race and ethnicity, and socioeconomic status. RESULTS: We found mixed support for associations between greater local prices and cessation. Unadjusted models showed that greater local prices were associated with greater odds of cessation, but the associations did not persist after controlling for sociodemographic characteristics. The associations did not significantly differ by respondent characteristics. Sensitivity analysis using alternative specifications and retail state price as the main predictor showed similar results. Sensitivity analysis with controls for e-cigarette use in the 2014-2019 period showed that greater local price was associated with cessation among adults with less than a high school degree. When stratified by year of data collection, results show that greater local prices were associated with cessation after 2009. CONCLUSIONS: Overall, the study adds to the conflicting evidence on the effectiveness of increasing prices on smoking cessation among adults with established smoking patterns. IMPLICATIONS: Higher cigarette prices have been one of the most successful tools for lowering smoking prevalence. It remains unclear how effective they have been in recent years in encouraging adults with established smoking patterns to quit. The study's results show that greater local prices were associated with higher odds of cessation, but the association did not persist after sociodemographic adjustment. In a sensitivity analysis, greater local price was associated with cessation among people with less than a high school degree in models controlling for e-cigarette use. We also found evidence that greater local price was associated with cessation after 2009. More comprehensive smoke-free coverage was also associated with greater odds of cessation. The study's results highlight that encouraging cessation among adults with an established smoking pattern remains a challenging policy problem even when cigarette prices rise.
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Comercio , Cese del Hábito de Fumar , Productos de Tabaco , Humanos , Cese del Hábito de Fumar/economía , Cese del Hábito de Fumar/estadística & datos numéricos , Estados Unidos/epidemiología , Masculino , Femenino , Adulto , Productos de Tabaco/economía , Estudios Transversales , Persona de Mediana Edad , Comercio/estadística & datos numéricos , Comercio/economíaRESUMEN
INTRODUCTION: ENDS use is highly prevalent among U.S. youth, and there is concern about its respiratory health effects. However, evidence from nationally representative longitudinal data is limited. METHODS: Using youth (aged 12-17 years) data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study, multilevel Poisson regression models were estimated to examine the association between ENDS use; cigarettes; and diagnosed bronchitis, pneumonia, or chronic cough. Current product use was lagged by 1 wave and categorized as (1) never/noncurrent use, (2) exclusive cigarette use, (3) exclusive ENDS use, and (4) dual ENDS/cigarette use. Multivariable models adjusted for age, sex, race and ethnicity; parental education; asthma; BMI; cannabis use; secondhand smoke exposure; and household use of combustible products. Data analysis was conducted in 2022-2023. RESULTS: A total of 7.4% of respondents were diagnosed with bronchitis, pneumonia, or chronic cough at follow-up. In the multivariable model, exclusive cigarette use (incident rate ratio=1.85, 95% CI=1.29, 2.65), exclusive ENDS use (incident rate ratio=1.49, 95% CI=1.06, 2.08), and dual use (incident rate ratio=2.70, 95% CI=1.61, 3.50) were associated with a higher risk of diagnosed bronchitis, pneumonia, or chronic cough than never/noncurrent use. CONCLUSIONS: These results suggest that ENDS and cigarettes, used exclusively or jointly, increased the risk of diagnosed bronchitis, pneumonia, or chronic cough among U.S. youth. However, dual use was associated with the highest risk. Targeted policies aimed at continuing to reduce cigarette smoking and ENDS use among youth, especially among those with dual use, are needed.
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OBJECTIVE: The current broad definition of Long COVID, and an overreliance on clinical and convenience samples, is leading to a wide array of Long COVID estimates with limited generalizability. Our objective was to examine Long COVID symptoms using a statewide population-based probability sample. METHODS: Among 8000 sampled adults with polymerase-chain-reaction-confirmed SARS-CoV-2 between June 2020 and July 2021 in the Michigan Disease Surveillance System, 2533 completed our survey (response rate 32.2%). Using modified Poisson regression, we examined sociodemographic, behavioral, and clinical predictors of eight Long COVID symptom clusters, defined as at least one applicable symptom lasting 90 or more days post COVID-19 onset. RESULTS: Neuropsychiatric Long COVID symptoms, including brain fog, were most prevalent (23.7%), followed by systemic symptoms (17.1%), including fatigue, musculoskeletal (11.4%), pulmonary (10.4%), dermatologic (6.7%), cardiovascular (6.1%), gastrointestinal (5.4%), and ear, nose, and throat symptoms (5.3%). In adjusted analyses, female sex, a pre-existing psychological condition, and intensive care unit admission were strong predictors of most Long COVID symptom clusters. Older age was not associated with a higher prevalence of all symptoms - cardiovascular and dermatologic symptoms were most prevalent among middle-aged adults and age was not associated with neuropsychiatric or gastrointestinal symptoms. Additionally, there were fewer associations between pre-existing conditions and cardiovascular, neuropsychiatric, and dermatologic symptoms compared to other symptom clusters. CONCLUSIONS: While many predictors of Long COVID symptom clusters were similar, the relationship with age and pre-existing conditions varied across clusters. Cardiovascular, neuropsychiatric, and dermatologic symptoms require further study as potentially distinct from other Long COVID symptoms.
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COVID-19 , Síndrome Post Agudo de COVID-19 , Adulto , Persona de Mediana Edad , Humanos , Femenino , COVID-19/epidemiología , SARS-CoV-2 , Michigan/epidemiología , PrevalenciaRESUMEN
OBJECTIVE: Understanding the relationship between social factors and persistent COVID-19 health outcomes, such as onset of a disability after a SARS-CoV-2 (the virus that causes COVID-19) infection, is an increasingly important public health issue. The purpose of this paper is to examine associations between social vulnerability and new onset of a mobility disability post-COVID-19 diagnosis. METHODS: We used data from the Michigan COVID-19 Recovery Surveillance Study, a population-based probability survey of adults with PCR-confirmed SARS-CoV-2 infection in Michigan between January 2020-May 2022 (n = 4295). We used the Minority Health Social Vulnerability Index (MHSVI), with high county-level social vulnerability defined at or above the 75th percentile. Mobility disability was defined as new difficulty walking or climbing stairs. We regressed mobility disability on the overall MHSVI, as well as sub-themes of the index (socioeconomic status, household composition/disability, minority and language, housing type, healthcare access, and medical vulnerability), using multivariable logistic regression, adjusting for age, race, sex, education, employment, and income. RESULTS: Living in a county with high (vs. low) social vulnerability was associated with 1.38 times higher odds (95% confidence interval [CI]:1.18-1.61) of reporting a new mobility disability after a COVID-19 diagnosis after adjustment. Similar results were observed for the socioeconomic status and household composition/disability sub-themes. In contrast, residents of highly racially diverse counties had lower odds (odds ratio 0.74, 95% CI: 0.61, 0.89) of reporting a new mobility disability compared to low diversity counties. CONCLUSIONS: Mitigating the effects of social vulnerabilities requires additional resources and attention to support affected individuals.
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COVID-19 , SARS-CoV-2 , Adulto , Humanos , COVID-19/diagnóstico , Vulnerabilidad Social , Prueba de COVID-19 , Michigan/epidemiologíaRESUMEN
AIM: Necrotizing enterocolitis (NEC) is a severe digestive systemic disease. Surgery is critical treatment for NEC patients. However, it is still hard to predict the optimal timing of surgery. Our study aimed to explore the indicative effect of comprehensive risk factors method in surgical intervention in NEC patients. METHODS: Retrospective analysis was made on newborns with NEC, who were divided into group I (patients with NEC conservative therapeutic approach or no necrosis or perforation found in NEC operation) and group II (patients with necrosis or perforation found in NEC operation or failure of NEC conservative approach). Clinical manifestations and complications were recorded and the risk factors scores were calculated. The receiver operating characteristic curve and Youden index were calculated. RESULTS: One hundred and six NEC patients in Huizhou Central People's hospital were analysed. Significant difference was observed in the comprehensive scores of the two groups to judge the indications of NEC surgery. Among the risk factors of NEC surgery, the incidence specificity of abdominal induration, abdominal tenderness, hypotension and pneumoperitoneum was 100% in group II. The area under the curve of the comprehensive score of risk factors was 0.981 (95% confidence interval 0.958-1.000). The best cutoff value obtained by the maximum Youden index is 3.5 (sensitivity 97.2%; specificity 52.8%). When the specificity is 100%, the best interception value is 7.5 (sensitivity 91.4%; specificity 100%). Complications such as surgical intervention, mortality, stenosis after conservative treatment, perforation or necrosis during surgery were significantly different in different comprehensive scores. CONCLUSIONS: Abdominal induration, abdominal tenderness, hypotension and pneumoperitoneum are independent predictors of NEC surgery. Comprehensive risk factors score may be a potentially useful clinical decision-making tool for NEC surgery.
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Enterocolitis Necrotizante , Neumoperitoneo , Recién Nacido , Humanos , Neumoperitoneo/complicaciones , Enterocolitis Necrotizante/cirugía , Estudios Retrospectivos , Curva ROC , Factores de RiesgoRESUMEN
This study investigates the association between the strength of TRL ordinances and adult cigarette use, and differences in the relationship by sociodemographic characteristics, using California as a case study. We merged geocoded data from the California Health Interview Survey with the State of Tobacco Control Reports from the American Lung Association from 2012 to 2019. Each jurisdiction was graded (A-strongest to F-weakest) based on the strength of their TRL ordinance while current cigarette use was defined as respondents who had smoked 100 or more cigarettes in their lifetime and currently smoke cigarettes every day or some days. We estimated multilevel logistic regression models to test the relationship between the strength of the TRL ordinance and current cigarette use and tested for effect modification by including interaction terms for race/ethnicity, income, and education in separate models. 11.6 % of sample participants from all years (n = 132,209) were current cigarette smokers. Adults in jurisdictions with stronger grades (A-D) had lower odds of current cigarette use (OR = 0.89, 95 % CI: 0.79-1.01) compared to adults in jurisdictions with the weakest grade (F), but the association was not statistically significant (p < 0.07). We found no evidence of effect modification by race/ethnicity, income, or education. We found limited evidence that stronger TRL ordinances were associated with lower adult cigarette smoking in California. However, future studies testing the relationship between TRL ordinances and adult smoking outcomes should examine the role of TRL fees across jurisdictions and adult cigarette use.
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SIGNIFICANCE: This study examines the differential effects of Canadian point-of-sale (POS) tobacco display bans across provinces on quit attempts and smoking cessation, by sex, education and income. METHODS: We analysed survey data from five waves (waves 4-8) of the International Tobacco Control Canada Survey, a population-based, longitudinal survey, where provinces implemented display bans between 2004 and 2010. Primary outcomes were quit attempts and successful cessation. We used generalised estimating equation Poisson regression models to estimate associations between living in a province with or without a POS ban (with a 24-month threshold) and smoking outcomes. We tested whether these associations varied by sex, education and income by including interaction terms. RESULTS: Across survey waves, the percentage of participants in provinces with POS bans established for more than 24 months increased from 5.0% to 95.8%. There was no association between POS bans and quit attempts for provinces with bans in place for 0-24 months or more than 24 months, respectively (adjusted relative risk (aRR)=0.99, 95% CI: 0.89 to 1.10; 1.03, 95% CI: 0.88 to 1.20). However, we found a differential impact of POS bans on quit attempts by sex, whereby bans were more effective for women than men for bans of 0-24 months. Participants living in a province with a POS ban for at least 24 months had a higher chance of successful cessation (aRR=1.49; 95% CI: 1.08 to 2.05) compared with those in a province without a ban. We found no differences in the association between POS bans and quit attempts or cessation by education or income, and no differences by sex for cessation. CONCLUSION: POS bans are associated with increased smoking cessation overall and more quit attempts among women than men.
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Cese del Hábito de Fumar , Masculino , Humanos , Femenino , Nicotiana , Canadá/epidemiología , Fumar/epidemiología , Encuestas y CuestionariosRESUMEN
This study examined the chemical compounds and bioactivity of the aqueous extract of Clitoria ternatea blue petals and investigated its beneficial effects in vivo on a mouse model of obesity and metabolic syndrome. The extract mainly contained flavonoids, and nine compounds were tentatively identified. Male C57BL/6J mice were either fed a standard diet (SD) or a high-fat, high-fructose diet (HFFD) for 16 weeks, and HFFD-fed animals were treated with 0.25%, 0.5%, and 2% (w/w) of the aqueous extract in drinking water. The aqueous extract ameliorated oxidative stress and inflammation mediators. Furthermore, the aqueous extract reduced plasma leptin, free fatty acid, low-density lipoprotein cholesterol levels and hepatic malondialdehyde content. The aqueous extract significantly reduced total cholesterol and ameliorated insulin resistance. The results demonstrated that the aqueous extract of C. ternatea blue petals contains bioactive anthocyanins that exert substantial hypolipidemic and anti-inflammatory effects by promoting reverse cholesterol transport in HFFD-fed mice.
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Clitoria , Fructosa , Masculino , Ratones , Animales , Fructosa/efectos adversos , Antocianinas , Ratones Endogámicos C57BL , Obesidad/tratamiento farmacológico , Obesidad/prevención & control , Inflamación/prevención & control , Estrés Oxidativo , ColesterolRESUMEN
OBJECTIVES: Fragmented industry and occupation surveillance data throughout the COVID-19 pandemic has left public health practitioners and organizations with an insufficient understanding of high-risk worker groups and the role of work in SARS-CoV-2 transmission. METHODS: We drew sequential probability samples of noninstitutionalized adults (18+) in the Michigan Disease Surveillance System with COVID-19 onset before November 16, 2020 (N = 237,468). Among the 6000 selected, 1839 completed a survey between June 23, 2020, and April 23, 2021. We compared in-person work status, source of self-reported SARS-CoV-2 exposure, and availability of adequate personal protective equipment (PPE) by industry and occupation using weighted descriptive statistics and Rao-Scott χ2 tests. We identified industries with a disproportionate share of COVID-19 infections by comparing our sample with the total share of employment by industry in Michigan using 2020 data from the US Bureau of Labor Statistics. RESULTS: Employed respondents (n = 1244) were predominantly female (53.1%), aged 44 and under (54.4%), and non-Hispanic White (64.0%). 30.4% of all employed respondents reported work as the source of their SARS-CoV-2 exposure and 78.8% were in-person workers. Work-related exposure was prevalent in Nursing and Residential Care Facilities (65.2%); Justice, Public Order, and Safety Activities (63.3%); and Food Manufacturing (57.5%). By occupation, work-related exposure was highest among Protective Services (57.9%), Healthcare Support (56.5%), and Healthcare Practitioners (51.9%). Food Manufacturing; Nursing and Residential Care; and Justice, Public Order, and Safety Activities were most likely to report having adequate PPE "never" or "rarely" (36.4%, 27.9%, and 26.7%, respectively). CONCLUSIONS: Workplaces were a key source of self-reported SARS-CoV-2 exposure among employed Michigan residents during the first year of the pandemic. To prevent transmission, there is an urgent need in public health surveillance for the collection of industry and occupation data of people infected with COVID-19, as well as for future airborne infectious diseases for which we have little understanding of risk factors.
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COVID-19 , Equipo de Protección Personal , Adulto , Femenino , Humanos , Masculino , COVID-19/epidemiología , Pandemias/prevención & control , SARS-CoV-2 , Autoinforme , Michigan/epidemiología , Ocupaciones , Personal de SaludRESUMEN
INTRODUCTION: Anti-tobacco media campaigns can prevent youth smoking, but there is little research on how adult-targeted campaigns affect youth. We investigated the association between the Tips From Former Smokers (Tips) campaign and youth smoking behaviors and anti-tobacco attitudes, and variation by sex, race and/or ethnicity, or socioeconomic status. AIMS AND METHODS: We used data from the monitoring of the future study, a nationally representative survey on 8th, 10th, and 12th graders, from 2013-2015. Quartiles of Tips gross rating points (GRPs) were used to estimate exposure. Youth smoking behavior outcomes included smoking prevalence, initiation, and susceptibility. The anti-tobacco attitude outcomes included the extent that anti-tobacco ads made participants (1) less favorable towards smoking or (2) less likely to smoke cigarettes. Modified Poisson regression models estimated average marginal effects; separate additive interactions between Tips GRP exposure and sex, race and/or ethnicity, parents' highest education, and college plans (12th graders only) were used to test for effect modification. RESULTS: Tips GRPs were not associated with smoking behaviors within any grade. However, 12th graders in the highest quartile of Tips had a 7.0 percentage point higher probability (95% CI = 0.023-0.116) of responding that anti-tobacco ads made them less likely to smoke. Tips GRPs were associated with a lower probability of past 30-day smoking prevalence among 10th grade females, but not males (joint P-value = .002). No additional statistically significant interactions were found for any other outcomes for any grade. CONCLUSIONS: This study revealed the potential for adult-targeted campaigns to increase youth's anti-smoking attitudes, but campaign exposure was not associated with smoking behaviors. IMPLICATIONS: Few studies have examined the potential for anti-smoking media campaigns to influence audiences outside their targeted audience. In this study, we show the potential for adult-targeted campaigns to impact youth and suggest that Tips exposure may promote anti-smoking attitudes among youth.
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Cese del Hábito de Fumar , Adulto , Femenino , Adolescente , Humanos , Fumadores , Nicotiana , Prevención del Hábito de Fumar , Fumar/epidemiología , Promoción de la SaludRESUMEN
The goal of our study is to understand the impact of Tobacco 21 (T21) laws on youth smoking and health equity. We conducted modified Poisson regression models using 2014-2019 Monitoring the Future data to measure the impact of attending school in a county 100% covered by a T21 law versus counties with <100% T21 coverage on past 30-day smoking participation (n = 262,632), first cigarette smoking initiation (n = 189,698), and daily smoking initiation among 8th, 10th, and 12th graders (n = 214,496), separately. Additive interactions were tested between T21 coverage and sex, race/ethnicity, parental education, and college plans. T21 coverage was associated with a lower likelihood of smoking participation among 12th graders. T21 coverage was most strongly associated with a lower likelihood of smoking participation among: Hispanic and NH (Non-Hispanic) Other/Multiracial individuals; respondents with parents who had less than a college education; and respondents who were not definitely planning on attending college. T21 laws were associated with a lower likelihood of smoking participation among 12th graders. T21 policies were most impactful for individuals disproportionately impacted by tobacco, indicating T21 laws might help reduce tobacco-related health disparities.
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BACKGROUND AND AIMS: Tobacco control policies may differentially impact smoking initiation among socio-demographic groups. We measured longitudinal associations between exposure to smoke-free laws in grade 12 (modal age 18 years) and patterns of smoking initiation in the United States. DESIGN: Prospective longitudinal analysis. SETTING AND PARTICIPANTS: We used data on US young adults sampled at modal age 18 years from the Monitoring the Future Survey. Baseline data were collected between 2000 and 2017, with the last year of follow-up in 2018. The sample number varied by outcome and time-point, ranging from 7314 to 17 702. MEASUREMENTS: Smoke-free law coverage in work-places and hospitality venues (restaurants/bars) was measured as the percentage of the county population covered by each type of law. We examined associations with any past 30-day smoking initiation and daily smoking initiation at modal ages 19/20, 21/22 and 23/24, using Poisson regression and calculating average marginal effects. We explored effect modification by sex, race/ethnicity and parental education by testing the significance of interaction terms. FINDINGS: Work-place law coverage at modal age 18 was associated with a lower probability of daily smoking initiation at modal ages 21/22 [-2.4 percentage points (p.p.); 95% confidence interval (CI) = -3.9, -0.9] and 23/24 (-2.0 p.p.; 95% CI = -3.9, -0.2). Hospitality law coverage was associated with a lower probability of daily smoking initiation at modal ages 19/20 (-1.6 p.p.; 95% CI = -2.8, -0.4), 21/22 (-2.3 p.p.; 95% CI = -3.7, -0.9) and 23/24 (-1.8 p.p.; 95% CI = -3.6, -0.0). Findings were inconclusive with regard to associations with any past 30-day smoking initiation and with regard to effect modification, after adjusting for multiple testing. CONCLUSIONS: Exposure to smoke-free laws at age 18 appears to be prospectively associated with reduced daily smoking initiation 1-6 years later.
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Política para Fumadores , Contaminación por Humo de Tabaco , Adolescente , Adulto , Humanos , Estudios Prospectivos , Restaurantes , Fumar/epidemiología , Estados Unidos/epidemiología , Adulto JovenRESUMEN
INTRODUCTION: To analyze the impact of Truth and state-sponsored anti-tobacco media campaigns on youth smoking in the United States, and their potential to reduce tobacco-related health disparities. AIMS AND METHODS: Our study included data from the 2000-2015 Monitoring the Future study, an annual nationally representative survey of youth in 8th (n = 201 913), 10th (n = 194 468), and 12th grades (n = 178 379). Our primary exposure was Gross Rating Points (GRPs) of Truth or state-sponsored anti-tobacco advertisements, from Nielsen Media Research. Modified Poisson regression was used to assess the impact of a respondent's GRPs on smoking intentions, past 30-day smoking participation, and first and daily smoking initiation. Additive interactions with sex, parental education, college plans, and race/ethnicity were used to test for differential effects of campaign exposure on each outcome. RESULTS: Greater campaign exposure (80th vs. 20th GRP percentile) was associated with lower probabilities of smoking intentions among 8th graders, smoking participation among 8th and 12th graders, and initiation among 8th graders. Greater exposure was associated with a greater reduction in the likelihood of smoking participation among 10th and 12th grade males than females; 10th and 12th graders with parents of lower education versus those with a college degree; and 12th graders who did not definitely plan to go to college relative to those who did. CONCLUSIONS: Media campaign exposure was associated with a lower likelihood of youth smoking behaviors. Associations were more pronounced for groups disproportionately affected by smoking, including youth of lower socioeconomic status. Media campaigns may be useful in reducing smoking disparities and improving health equity. IMPLICATIONS: Few recent studies have investigated the impact of anti-tobacco media campaigns on youth smoking and their potential to reduce tobacco-related health disparities in the United States. We found media campaigns-specifically state-sponsored media campaigns-reduced the likelihood of several smoking outcomes among youth, with some evidence that they mitigate disparities for disproportionately affected groups.
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Fumar , Productos de Tabaco , Adolescente , Femenino , Humanos , Masculino , Fumar/epidemiología , Prevención del Hábito de Fumar , Fumar Tabaco , Uso de Tabaco , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVE: To investigate the better time of initiation of enteral nutrition for critically ill patients, such as at admission or 24 to 48 hours after admission. METHODS: This was a prospective, randomized, parallel-controlled, single-blind, interventional clinical trial. A total of 100 patients admitted to the intensive care unit (ICU) of our hospital between January 2017 and December 2018 were recruited in this study. These patients had been divided into the control group or intervention group by a computer-generated random number table, and each group had 50 patients. For the control group, a gastric tube was inserted to start enteral nutrition at 24 to 48 hours after admission. For the intervention group, a nasojejunal tube was placed to start enteral nutrition at admission. The main endpoints included serum albumin and prealbumin at admission and on days 3, 7, and 14 after admission, length of ICU stay, ventilator time, and complications such as diarrhea, gastric retention, esophageal reflux, and pulmonary infection. RESULTS: The results showed that serum albumin and prealbumin were significantly higher in the intervention group than in the control group (P < 0.05). The length of ICU stay (P < 0.05) and ventilator time (P < 0.05) were both significantly shorter in the intervention group than in the control group. The incidences of gastric retention, esophageal reflux, and pulmonary infection were significantly lower in the intervention group than those in the control group (P < 0.05). CONCLUSION: In the absence of contraindications, enteral nutrition can be initiated immediately after admission to the ICU (within 6 hours), and feeding nasojejunal tube is recommended. It can improve the nutritional status and prognosis of critical patients, improve the feeding effect, shorten the length of stay in the ICU and the use of the ventilator, and reduce the incidence of complications.
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BACKGROUND: Little is known regarding long-term impacts of anti-tobacco media campaigns on youth smoking and related disparities in the United States. METHODS: We examined longitudinal cohort data from Monitoring the Future (MTF) between 2000 and 2017 in modified Poisson regression models to understand the long-term impacts of televised Truth and state-sponsored ad campaign exposure at baseline (age 18) on first cigarette and daily smoking initiation 1 to 2 years later (at modal ages 19/20). We also used additive interactions to test for potential effect modification between campaign exposure and smoking outcomes by sex, race/ethnicity, and parental educational attainment. RESULTS: We found no evidence for baseline media campaign exposure to be associated with first cigarette or daily smoking initiation at modal age 19/20. Further, results showed no evidence for effect modification between campaign exposure and first cigarette or daily smoking initiation. CONCLUSIONS: We found no evidence that baseline Truth and state-sponsored ad exposure was associated with first cigarette or daily smoking initiation at follow up, nor did we find any evidence for effect modification by sex, race/ethnicity, or parental education. We hypothesize that anti-tobacco media campaigns might have had a short-term impact on smoking behaviors, though these effects were not sustained long term.
Asunto(s)
Nicotiana , Productos de Tabaco , Adolescente , Adulto , Preescolar , Promoción de la Salud , Humanos , Lactante , Medios de Comunicación de Masas , Fumar , Prevención del Hábito de Fumar , Fumar Tabaco , Estados Unidos/epidemiología , Adulto JovenRESUMEN
INTRODUCTION: This study examines whether smoke-free laws are differentially associated with youth smoking outcomes by parental education, race/ethnicity, sex, and college plans in a U.S. METHODS: This study assessed the relationships between smoke-free laws in workplaces and hospitality venues (restaurants/bars) and past 30-day smoking participation, first cigarette initiation, and daily smoking initiation within a repeated cross-sectional sample of 8th, 10th, and 12th graders from the Monitoring the Future study. Data were collected between 2001 and 2018 and were analyzed in 2020-2021. Grade-stratified Poisson models were used to calculate prevalence ratios and average marginal effects, incorporating interaction terms to examine differential associations across groups. RESULTS: Hospitality smoke-free laws were significantly associated with lower probabilities of smoking participation in all grades as well as with first cigarette and daily smoking initiation in 8th and 10th grade. Workplace smoke-free laws were associated with lower probabilities of smoking participation among 10th and 12th graders as well as with first cigarette and daily smoking initiation among 10th graders. Average marginal effects ranged from -0.4 percentage points (hospitality laws and daily smoking initiation in 8th and 10th grades) to -2.2 percentage points (workplace laws and smoking participation in 10th grade). Associations between smoke-free laws and a lower probability of smoking participation were most pronounced among students who definitely planned to attend college. Other instances of effect modification suggested more pronounced associations for students who were female and from high-SES households; however, relationships varied by grade. CONCLUSIONS: Smoke-free laws were associated with reduced smoking among youth; however, associations varied by grade, sex, parental education, and college plans.