Public Support for Tobacco Endgame Policies: A Systematic Review and Meta-analysis.

INTRODUCTIONS: An increasing number of countries are adopting the tobacco endgame goal. High levels of public support can accelerate momentum towards implementing tobacco endgame policies. We aimed to conduct a systematic review of public support for tobacco endgame policies and to examine the geographical distribution of studies, support among key populations (adolescents and young adults, people who smoke), and the association between survey design and support. METHODS: We searched Embase, PubMed, Scopus, Web of Science, and Google Scholar for studies published from 2013 onwards. Google was used to search the grey literature. The reference lists of included articles were hand-searched. Studies were included if they reported the proportions of people supporting one or more endgame policies. Risk of bias was assessed using the JBI checklist for prevalence studies. RESULTS: Forty-seven articles were included. Aotearoa/New Zealand and the United States were the countries with the most studies (n=11, respectively). Three-level meta-analyses showed the highest support for mandating a very low nicotine content in tobacco products (76%, 95% CI 61-87%). Meta-regressions were performed to assess the associations of population subgroup and survey design with support levels. The level of support was lower among people who smoke compared to the general population (ß range: -1.59 to -0.51). Support for some policies was lower when neutral or don't know response options were included. CONCLUSIONS: Public support for most tobacco endgame policies was high. IMPLICATIONS: Assessing public support can assist with progressing tobacco endgame policies. Policies that are widely supported by the public may be more politically feasible to implement. Qualitative studies and trial studies can further inform communication and implementation strategies for tobacco endgame policies.

Symptoms and Conditions in Children and Adults up to 90 Days after SARS-CoV-2 Infection: A Retrospective Observational Study Utilizing the Common Data Model.

Background/Objectives: There have been widespread reports of persistent symptoms in both children and adults after SARS-CoV-2 infection, giving rise to debates on whether it should be regarded as a separate clinical entity from other postviral syndromes. This study aimed to characterize the clinical presentation of post-acute symptoms and conditions in the Korean pediatric and adult populations. Methods: A retrospective analysis was performed using a national, population-based database, which was encoded using the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). We compared individuals diagnosed with SARS-CoV-2 to those diagnosed with influenza, focusing on the risk of developing prespecified symptoms and conditions commonly associated with the post-acute sequelae of COVID-19. Results: Propensity score matching yielded 1,656 adult and 343 pediatric SARS-CoV-2 and influenza pairs. Ninety days after diagnosis, no symptoms were found to have elevated risk in either adults or children when compared with influenza controls. Conversely, at 1 day after diagnosis, adults with SARS-CoV-2 exhibited a significantly higher risk of developing abnormal liver function tests, cardiorespiratory symptoms, constipation, cough, thrombophlebitis/thromboembolism, and pneumonia. In contrast, children diagnosed with SARS-CoV-2 did not show an increased risk for any symptoms during either acute or post-acute phases. Conclusions: In the acute phase after infection, SARS-CoV-2 is associated with an elevated risk of certain symptoms in adults. The risk of developing post-acute COVID-19 sequelae is not significantly different from that of having postviral symptoms in children in both the acute and post-acute phases, and in adults in the post-acute phase. These observations warrant further validation through studies, including the severity of initial illness, vaccination status, and variant types.

Association between tobacco industry advertising expenses and tobacco advertising exposure among Korean adolescents.

INTRODUCTION: Monitoring the activities and impacts of tobacco industries is vital for tobacco control. Based on tobacco industry financial statements and a nationally representative survey of Korean adolescents, we examined the association between tobacco industry commercial advertising expenses and advertising exposure among Korean adolescents. METHODS: The commercial advertising expenses of three major tobacco industries in Korea (KT&G, Philip Morris Korea, and British and American Tobacco Korea) were identified in a repository (Data Analysis Retrieval and Transfer System) established by the Korean Financial Supervisory Service. The yearly advertising expenses were merged with data from the Korean Youth Risk Behavior Survey (2015-2018 and 2021, total N=309 190). We used logistic regression analyses to analyse the associations between tobacco industry advertising expenses and adolescent tobacco advertisement exposure. RESULTS: In 2021, the total advertising expenses of the three companies exceeded US$260 million, and the proportion of Korean adolescents exposed to tobacco advertisements ranged from 65.9% to 78.7% during 2015-2018 and 2021. Higher advertising expense sizes were associated with the risk of exposure to tobacco advertisements in both girls and boys, with OR of 1.009 (95% CI (1): 1.008 to 1.010) and 1.010 (95% CI: 1.009 to 1.011), respectively. CONCLUSION: Tobacco industry advertising expenses are associated with tobacco marketing exposure among adolescents. We used financial data to identify the reach of tobacco advertising among Korean adolescents. It is essential to increase tobacco industry surveillance using various data sources and to regulate tobacco advertising more strongly.

Systematic review of changed smoking behaviour, smoking cessation and psychological states of smokers according to cigarette type during the COVID-19 pandemic.

OBJECTIVES: Although the global COVID-19 pandemic has increased interest in research involving high-risk smokers, studies examining changed smoking behaviours, cessation intentions and associated psychological states among smokers are still scarce. This study aimed to systematically review the literature related to this subject. DESIGN: A systematic review of published articles on cigarettes and COVID-19-related topics DATA SOURCES: Our search was conducted in January 2021. We used the keywords COVID-19, cigarettes, electronic cigarettes (e-cigarettes) and psychological factors in PubMed and ScienceDirect and found papers published between January and December 2020. DATA SELECTION: We included articles in full text, written in English, and that surveyed adults. The topics included smoking behaviour, smoking cessation, psychological state of smokers and COVID-19-related topics. DATA EXTRACTION AND SYNTHESIS: Papers of low quality, based on quality assessment, were excluded. Thirteen papers were related to smoking behaviour, nine papers were related to smoking cessation and four papers were related to psychological states of smokers. RESULTS: Owing to the COVID-19 lockdown, cigarette users were habituated to purchasing large quantities of cigarettes in advance. Additionally, cigarette-only users increased their attempts and willingness to quit smoking, compared with e-cigarette-only users. CONCLUSIONS: Owing to the COVID-19 outbreak, the intention to quit smoking was different among smokers, according to cigarette type (cigarette-only users, e-cigarette-only users and dual users). With the ongoing COVID-19 pandemic, policies and campaigns to increase smoking cessation intentions and attempts to quit smoking among smokers at high risk of COVID-19 should be implemented. Additionally, e-cigarette-only users with poor health-seeking behaviour require interventions to increase the intention to quit smoking.

Generic Logic Model for Coronavirus Disease-2019 Responses Based on the South Korean Experience.

BACKGROUND: As the global coronavirus disease-2019 (COVID-19) pandemic continues, many countries have implemented public health policies, such as lockdowns and physical distancing measures, to prevent its spread. South Korea's response to COVID-19, which prevented an increase in confirmed cases and increased resilience, has been considered very effective. PURPOSE: To analyze Korea's response to COVID-19 in 2020 and develop a logic model to evaluate performance effectiveness in follow-up studies. METHODS: By content analysis of Korea Disease Control and Prevention Agency (KDCA) press releases, we defined the problems and identified the causes of the health and social effects of the COVID-19 outbreak. Next, we created a problem tree and developed a logic model that comprised inputs, activities, outputs, outcomes, and impacts. Finally, we held expert consultations to obtain expert opinions regarding the logic model and to ensure the model's validity. RESULTS: South Korea's COVID-19 response policy mitigated the social and health impacts. The 2020 COVID-19 responses had four outcomes (identifying cases on time, preventing transmission of coronavirus infection, effective treatment of COVID-19 cases, protecting public resilience and well-being) and 12 outputs; South Korea conducted 32 activities. CONCLUSION: The results can be a practical reference for managing problems faced in other countries. Korean policy may be of interest in the future for international decision-makers in charge of policy enforcement and those who may be called on to respond to new infectious diseases.

A qualitative study on the impact of COVID-19 on the behavior and attitudes of smokers and non-smokers in South Korea.

BACKGROUND: The COVID-19 pandemic has affected all aspects of human society, including education, culture, and the economy, and has also introduced changes in people's health behaviors such as drinking alcohol, nutrition intake, and practicing healthy living. This study conducted qualitative research in the Korean context to examine the changes in the smoking behavior of smokers and secondhand smoke exposure of non-smokers during the COVID-19 pandemic. METHODS: Focus group interviews were conducted with 36 Korean participants (18 men and 18 women). The groups were composed of cigarette smokers, e-cigarette users, heated tobacco product users, and non-smokers. RESULTS: During the pandemic, it was found that there was an increase in the frequency of use, irrespective of the tobacco product, in users who refrained from social interaction and worked or studied from home. Users who continued to be socially active increased the amount used with each usage. Smokers showed a tendency to avoid smoking rooms and to smoke alone in places unoccupied by people. In addition, non-smokers' exposure to secondhand smoke did not decrease, but since non-smokers used masks, they reported more relief from the risk of exposure to secondhand smoke than before. CONCLUSIONS: Despite smokers being a high-risk group for COVID-19, the risk did not result in smoking cessation among smokers. Therefore, policies and educational campaigns to raise awareness about the dangers of smoking and to encourage smoking cessation are needed in the future.

Can Different Forest Structures Lead to Different Levels of Therapeutic Effects? A Systematic Review and Meta-Analysis.

In recent decades, forests have expanded from natural resources for conservation and production to health-promoting resources. With the growing body of evidence supporting the therapeutic effects of forests, the number of investigations on the relationship between forest characteristics and therapeutic effects have increased. However, quantitative synthesis of primary studies has rarely been conducted due to a limited number of health studies including forest description and high heterogeneity of forest variables. In this study, we conducted a systematic review and meta-analysis to evaluate the relationship between the forest structure and the therapeutic effect. We systematically searched the studies examining the therapeutic effects of forests with different stand density and canopy density and synthesized the results. As a result of subgroup analysis, we found that stand density modifies the therapeutic effects. Emotional and cognitive restoration showed greatest improvement in low-density forests with a stand density of less than 500/ha and the therapeutic effects diminish as the stand density increases. The impact of canopy density was not found due to a lack of studies reporting canopy density. Although some limitations remain, the findings in this study have great significance in providing the basis for establishing management strategies of forests for therapeutic use.

Effects of Emotional Labor Factors and Working Environment on the Risk of Depression in Pink-Collar Workers.

Analyzing men and women separately, we examined the associations between six key elements of the psychosocial work environment of pink-collar workers (n = 7633) and the risk of depression, using logistic regression analysis with data from the Fifth Korean Working Conditions Survey (KWCS) conducted in 2017. We assessed the risk of depression according to the presence of emotional display rules (EDR), health and safety information (HSI), and emotional labor. In males, the risk of depression increased when there were no EDR and they had to interact with angry customers (OR 1.94, 95% CI 1.14-3.30). For women, the risk of depression increased if they had to interact with angry customers and EDR were present (OR, 1.73; 95% CI, 1.00-3.00), and if they did not receive HSI but had to interact with angry customers (OR, 1.66; 95% CI, 1.02-2.71), or hid their emotions and did not receive HSI (OR, 1.90; 95% CI, 1.50-2.40). The risk of depression increased more in the presence of EDR among women who hid their emotions (OR 1.80, 95% CI, 1.40-2.31) compared to women who did not hide their emotions and in the absence of EDR. Therefore, it is necessary to consider the effects of gender-specific factors on the risk of depression and revise current guidelines accordingly.