The Interest in Betting, Smoking, Alcohol, and Drugs in Malawi: Changing Trends between 2012-2022.

Background: In recent years, the online gambling market has rapidly developed, and betting has become one of the most popular forms of gambling. The aim of this study was to analyse the interest of the Malawian population in terms related to betting, sports betting, alcohol, cigarettes, and some psychoactive drugs through the relative search volumes of Google Trends. Methods: Internet search query data related to betting, sports betting, alcohol, cigarettes, and psychoactive drugs were obtained monthly from Google Trends for the period 2010-2022. Comparisons of interest levels in these topics were conducted in Malawi, and correlation coefficients were calculated. Results: In Malawi, relative search volumes for betting and sports betting terms were the highest (average RSVs: 66% and 30%). It was found that from 2019 onwards, the interest in betting and sports-related search topics and keywords increased significantly (p < 0.001). Strong positive correlations were found between betting-related keywords and alcohol and gross domestic product (r = 0.831 and r = 0.901, p < 0.001). A positive correlation was found between betting and psychoactive drug-related terms (minimum r = 0.417, p < 0.01). Conclusions: This study concludes that the interest of the Malawian population in betting has increased in recent years, while interest in psychoactive drugs and alcohol remains high. Gross domestic product is highly correlated with society's interest in betting. It was additionally found that Google Trends can be used as a tool to predict and monitor future risky behaviours, such as gambling disorder.

Lung cancer: a nationwide analysis of sex and age incidence trends from 1980 to 2022.

BACKGROUND: Lung cancer, once rare, has evolved into the global leading cause of cancer-related mortality, primarily driven by widespread cigarette smoking in the 20th century. This study explores the historical trends of lung cancer incidence in Denmark over four decades, emphasizing the impact of smoking prevalence, age, and gender on the observed patterns. MATERIALS AND METHODS: Drawing upon data from the Danish National Patient Register and information on smoking habits provided by the Danish Health Authority, this study investigates lung cancer incidence rates, demographic shifts, and smoking prevalence from 1980 to 2022. RESULTS: Smoking prevalence exhibited a consistent decline in males from 1950 to 2022, whereas female smoking prevalence maintained a stable level from 1950 to 1987, followed by a subsequent decline from 1987 to 2022. A peak in lung cancer crude incidence rates was identified during 2014-2017, with no significant difference observed before and after this period. Over the period, the gender distribution transitioned from a male majority to an equal male-female ratio, and age-specific disparities indicated declines in patients aged 50-59 and increases in those above 80 years. INTERPRETATION: The certainty of a decline in lung cancer incidence in the coming years remains unclear. Based on smoking prevalence, it might still be a decade away. To ensure a sustained decline in lung cancer incidence, targeted interventions are imperative, including customized smoking cessation programs that could be designed favorably for females. Given the modest decline in smoking prevalence over the last decade, legislation aimed at discouraging young individuals from smoking is pivotal. As of now, these efforts have not been implemented in Denmark.

Examining U.S. disparities in smoking among rural versus urban women of reproductive age: 2002-2019.

OBJECTIVE: This study is part of a programmatic investigation of rural disparities in cigarette smoking examining disparities in smoking prevalence and for the first-time quit ratios among adult women of reproductive age (18-44 years), a highly vulnerable population due to risk for multigenerational adverse effects. METHODS: Data came from 18 years (2002-2019) of the U.S. National Survey on Drug Use and Health (NSDUH) among women (n = 280,626) categorized by rural-urban residence, pregnancy status, using weighted logistic regression models testing time trends and controlling for well-established sociodemographic predictors of smoking (race/ethnicity, education, income). Concerns regarding changes in survey methods used before 2002 and after 2019 precluded inclusion of earlier and more recent survey years in the present study. RESULTS: Overall smoking prevalence across years was greater in rural than urban residents (adjusted odds ratio [AOR] = 1.11; 95%CI, 1.07-1.15; P < .001) including those not-pregnant (AOR = 1.10; 1.07-1.14; P < .001) and pregnant (AOR = 1.29; 1.09-1.52; P < .001). Overall quit ratios across years were lower in rural than urban residents (AOR = 0.93; 0.87-0.99; P < .001) including those not-pregnant (AOR = 0.93; 0.88-1.00, P = .035) and pregnant (AOR = 0.78; 0.62-0.99; P = .039). Interactions of rural versus urban residence with study years for prevalence and quit ratios overall and by pregnancy status are detailed in the main text. CONCLUSIONS: These results support a longstanding and robust rural disparity in smoking prevalence among women of reproductive age including those currently pregnant and provides novel evidence that differences in smoking cessation contribute to this disparity further underscoring a need for greater access to evidence-based tobacco control and regulatory interventions in rural regions.

Changes in injecting versus smoking heroin, fentanyl, and methamphetamine among people who inject drugs in San Diego, California, 2020-2023.

BACKGROUND: Amidst an increasingly toxic drug supply in North America, people who inject drugs may be transitioning to smoking them. We aimed to assess changes in injecting and smoking opioids and methamphetamine among a cohort of people who inject drugs from San Diego, California. METHODS: Over five six-month periods spanning October 2020-April 2023, we assessed prevalence of injecting and smoking opioids or methamphetamine and whether participants used these drugs more frequently by smoking than injecting. Multivariable Poisson regression via generalized estimating equations was used to examine time trends. RESULTS: Of 362 participants, median age was 40 years; a minority were female (29%), Hispanic/Latinx/Mexican (45%), and housed (33%). Among this cohort, of whom 100% injected (and 84% injected and smoked) in period one (October 2020-April 2021), by period five (November 2022-April 2023), 34% only smoked, 59% injected and smoked, and 7% only injected. By period five, the adjusted relative risk (aRR) of injecting opioids was 0.41 (95% Confidence Interval [CI]: 0.33, 0.51) and the aRR for injecting methamphetamine was 0.50 (95% CI: 0.39, 0.63) compared to period one. Risks for smoking fentanyl rose significantly during period three (aRR=1.44, 95% CI: 1.06, 1.94), four (aRR=1.65, 95% CI: 1.24, 2.20) and five (aRR=1.90, 95% CI: 1.43, 2.53) compared to period one. Risks for smoking heroin and methamphetamine more frequently than injecting these drugs increased across all periods. CONCLUSIONS: Opioid and methamphetamine injection declined precipitously, with notable increases in smoking these drugs. Research is needed to understand the health consequences of these trends.

Smoking out Australia's growing illicit tobacco market: Current trends and future challenges.

Data from the Australian Taxation Office and Australian Border Force show notable recent increases in illicit tobacco seizures across Australia. The illicit tobacco market results in substantial losses in tax revenue, funds organised crime, and perpetuates tobacco use, threatening to undermine Australia's ability to achieve its national commercial tobacco endgame goal of 5 % or less smoking prevalence by 2030. This commentary discusses recent trends in Australia's illicit tobacco trade, reasons why this is of concern, potential drivers of Australians' illicit tobacco use, and policy measures that could be implemented to mitigate increasing illicit tobacco trade such as implementing a track and trace system, increased investment in the Australian Border Force to enhance detection of illicit tobacco shipments at Australia's borders, and encouraging public tip-offs of illicit tobacco sales.

Comparison of Indicators of Dependence for Vaping and Smoking: Trends Between 2017 and 2022 Among Youth in Canada, England, and the United States.

INTRODUCTION: The current study sought to examine trends in indicators of dependence for youth vaping and smoking during a period of rapid evolution in the e-cigarette market. AIMS AND METHODS: Data are from repeat cross-sectional online surveys conducted between 2017 and 2022 among youth aged 16-19 in Canada, England, and the United States (US). Participants were 23 145 respondents who vaped and/or smoked in the past 30 days. Four dependence indicators were assessed for smoking and vaping (perceived addiction, frequent strong urges, time to first use after waking, days used in past month) and two for vaping only (use events per day, e-cigarette dependence scale). Regression models examined differences by survey wave and country, adjusting for sex, age, race, and exclusive/dual use. RESULTS: All six indicators of dependence increased between 2017 and 2022 among youth who vaped in the past 30 days (p < .001 for all). For example, more youth reported strong urges to vape at least most days in 2022 than in 2017 (Canada: 26.5% to 53.4%; England: 25.5% to 45.4%; US: 31.6% to 50.3%). In 2017, indicators of vaping dependence were substantially lower than for smoking; however, by 2022, youth vaping was associated with a greater number of days used in the past month (Canada, US), shorter time to first use (all countries), and a higher likelihood of frequent strong urges (Canada, US) compared to youth smoking. CONCLUSIONS: From 2017 to 2022, indicators of vaping dependence increased substantially. By 2022, vaping dependence indices were comparable to those of smoking. IMPLICATIONS: Indicators of vaping dependence among youth have increased substantially since 2017 to levels that are comparable to cigarette dependence among youth who smoke. Future research should examine factors underlying the increase in dependence among youth who vape, including changes to the nicotine profile and design of e-cigarette products.

New Estimates of Smoking-Attributable Mortality in the U.S. From 2020 Through 2035.

INTRODUCTION: The often-cited Centers for Disease Control and Prevention (CDC) estimate of 480,000 annual U.S. smoking-attributable deaths (SADs), including 439,000 first-hand smoke deaths, derives from 2005 to 2009 data. Since then, adult smoking prevalence has decreased by 40%, while the population has grown and the smoking population aged. An updated estimate is presented to determine whether the CDC figure remains accurate or has changed substantially. In addition, the likely annual smoking-related mortality toll is projected through 2035. METHODS: A well-established model of smoking prevalence and health effects is employed to estimate annual SADs among individuals exposed to first-hand smoke in the U.S. for two distinct periods: 2005-2009 and 2020-2035. The estimate for 2005-2009 serves as a benchmark to evaluate the reliability of the model's estimate in comparison to CDC's. The projections for 2020-2035 provide up-to-date figures for SADs, predicting how annual SADs are likely to change in the coming years. Data were collected between 2005 and 2020. The analysis was conducted in 2023. RESULTS: This study's estimate of 420,000 first-hand smoke deaths over 2005-2009 is 95.7% of CDC's estimate during the same period. The model projections indicate that SADs among individuals who currently smoke or formerly smoked have increased modestly since 2005-2009. Beginning in 2020, annual SADs will remain relatively stable at approximately 450,000 before starting to decline around 2030. CONCLUSIONS: These findings suggest that the CDC estimate of the annual mortality burden of smoking remains valid. Despite U.S. population growth and the aging of the smoking population, substantial reductions in smoking will finally produce a steady, if gradual, decline in SADs beginning around 2030.

COVID-19 and Smoking: An Opportunity to Quit When Vaccinated / COVID-19 y fumar: una oportunidad para dejar de fumar cuando se vacunan

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Trends in smoking prevalence in all Brazilian capitals between 2006 and 2017 / Tendências de indicadores relacionados ao tabagismo nas capitais brasileiras entre os anos de 2006 e 2017

ABSTRACT Objective: To evaluate the trends in smoking prevalence in all Brazilian capitals between 2006 and 2017. Methods: This was a study of temporal trends in smoking, based on information from the Telephone-based System for the Surveillance of Risk and Protective Factors for Chronic Diseases. The trends in smoking prevalence were stratified by gender, age, level of education, and capital of residence. We used linear regression analysis with a significance level of 5%. Results: From 2006 to 2017, the overall prevalence of smoking in the Brazilian capitals declined from 19.3% to 13.2% among men and from 12.4% to 7.5% among women (p < 0.05 for both). Despite the overall decline in the prevalence of smoking in all of the capitals, the rate of decline was lower in the more recent years. There was also a reduction in the prevalence of former smoking (22.2% in 2006 to 20.3% in 2017). In contrast, there was an upward trend in the prevalence of former smoking among individuals with a lower level of education (from 27.9% in 2006 to 30.0% in 2017). In 2017, the prevalence of smoking among men was highest in the cities of Curitiba, São Paulo, and Porto Alegre, whereas it was highest among women in the cities of Curitiba, São Paulo, and Florianópolis. Conclusions: There have been improvements in smoking prevalence in Brazil. Annual monitoring of smoking prevalence can assist in the battle against chronic noncommunicable diseases.

RESUMO Objetivo: Avaliar a tendência de indicadores relacionados ao tabagismo nas capitais brasileiras entre os anos de 2006 e 2017. Métodos: Estudo de tendência temporal a partir de informações do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico. Os indicadores do tabagismo foram estratificados por sexo, idade, escolaridade e capitais. Utilizou-se análise de regressão linear com nível de significância de 5%. Resultados: Considerando-se toda a série, a prevalência de tabagismo caiu de 19,3% (2006) para 13,2% (2017) no sexo masculino e de 12,4% para 7,5% no sexo feminino (p < 0,05 para ambos). Todas as capitais apresentaram um declínio na prevalência de tabagismo para ambos os sexos; entretanto, a velocidade desse declínio foi menor nos últimos anos. Ocorreu uma redução da proporção de ex-fumantes (de 22,2% em 2006 para 20,3% em 2017). Em contrapartida, houve uma tendência de aumento entre os ex-fumantes que tinham escolaridade de 0-8 anos (de 27,9% em 2006 para 30,0% em 2017). Em 2017, as maiores prevalências de tabagismo do sexo masculino foram em Curitiba, São Paulo e Porto Alegre; em relação ao sexo feminino, essas foram em Curitiba, São Paulo e Florianópolis. Conclusões: Houve melhoria dos indicadores relacionados ao tabagismo no Brasil. O monitoramento anual dos indicadores de tabagismo auxilia no enfrentamento das doenças crônicas não transmissíveis.

Patrón de tabaquismo y nivel socioeconómico en dos cohortes de adultos jóvenes / Pattern of smoking and socioeconomic status in two cohorts of young adults

Background: One in five deaths that occur in Chile can be attributed to smoking whose prevalence remains high, despite interventions aimed at reducing it. Aim: To compare the prevalence of smoking and its intensity among young adults born 15 years apart and determine their association with socioeconomic status (SES). Material and Methods: Two cohorts of young adults living in the Valparaiso Region of Chile were evaluated in the third decade of life. Cohort 1 was evaluated between 2000 and 2002 (n = 1232) and cohort 2 between 2014 and 2017 (n = 1078). Results: In cohort 1, 57.5% (95% Confidence Interval (CI) 54.6-58.7) of the subjects reported smoking, with a median of 3 (Interquartile range (ICR:1-6) cigarettes/day. This percentage fell to 40.2% (CI: 37.5-43.1) with a similar median in cohort 2. Analyzing cohort 2, the odds ratio (OR) for smoking was 2.24 (CI 1.48-3.38) in the medium SES, compared with the medium high SES. The figures for low medium and low SES were 2.72 (CI: 1.85-3.99) and 3.01 (1.85-4.88). Similarly, in this cohort there was a significantly higher risk of being a heavy smoker in lower SES. No associations between smoking or its intensity and SES were observed in cohort 1. Conclusions: Smoking behavior has decreased among young adults evaluated at the same age in two generational cohorts in the third decade of life. In the most recent cohort analyzed, smoking and its intensity increase along with a decrease in SES.

Terapia de remplazo nicotínico asociada con reducción gradual del consumo de cigarrillos como estrategia de cesación de tabaco. Reporte de caso / Nicotinic Replacement Therapy Associated with Gradual Reduction as a Strategy of Smoking Cessation. Case report

El habitual proyecto de definir una fecha para dejar de fumar abruptamente ha sido refutado por muchos pacientes que han mostrado interés por reducir su consumo de modo gradual. La reducción progresiva utilizando terapia sustitutiva con nicotina previa a la cesación permitiría tratar a un mayor número de fumadores. El artículo presenta el caso de un paciente con alta dependencia a la nicotina, interesado en dejar de fumar, pero no de manera abrupta.

The usual approach to the treatment of smoking to set a date to stop smoking abruptly has been refuted by many patients who show interest in reducing their consumption gradually. The Progressive reduction using nicotine replacement therapy prior to cessation would treat a greater number of smokers. It's the case of a patient with high nicotine dependence, interested in quitting but not abruptly.

Evolução de indicadores do tabagismo segundo inquéritos de telefone, 2006-2014 / Evolución de indicadores del tabaquismo según encuestas por teléfono, de 2006-2014 / Evolution of tobacco use indicators according to telephone surveys, 2006-2014

Resumo: O objetivo do estudo foi descrever a tendência de indicadores de tabagismo em adultos nas capitais brasileiras. Utilizou-se regressão linear simples para analisar a tendência do tabagismo segundo dados do inquérito telefônico VIGITEL, entre 2006-2014. A prevalência de fumantes no Brasil caiu 0,645p.p. por ano no período, variando de 15,6% (2006) a 10,8% (2014). Houve redução por sexo, escolaridade, grandes regiões, e na maioria das faixas etárias. A prevalência de ex-fumantes passou de 22,2% (2006) para 21,2% (2014), fumo de 20 cigarros ou mais por dia de 4,6% (2006) para 3% (2014). Fumo passivo no domicílio reduziu 0,614p.p. ao ano, desde 2009, sendo de 9,4% em 2014. Fumo passivo no trabalho reduziu 0,54p.p. ao ano, chegando a 8,9% em 2014. A tendência da prevalência de fumantes é declinante, para ambos os sexos, níveis de escolaridade e grandes regiões, em quase todas as faixas etárias. Isso aponta que a meta global de redução de 30% do tabagismo até 2025 tem potencial para ser alcançada, refletindo importantes ações de controle desse fator de risco no país.

Resumen: El objetivo del estudio fue describir la tendencia de indicadores de tabaquismo en adultos dentro de las capitales brasileñas. Se utilizó una regresión lineal simple para analizar la tendencia del tabaquismo, según datos de la encuesta telefónica VIGITEL, entre 2006-2014. La prevalencia de fumadores en Brasil cayó 0,645p.p. por año durante el período, variando de un 15,6% (2006) a un 10,8% (2014). Hubo una reducción por sexo, escolaridad, grandes regiones, y en la mayoría de las franjas de edad. La prevalencia de ex-fumadores pasó de 22,2% (2006) a 21,2% (2014), el consumo de 20 cigarrillos o más al día de un 4,6% (2006) a un 3% (2014). Los fumadores pasivos en el domicilio se redujeron 0,614p.p. al año, desde 2009, siendo de un 9,4% en 2014. Los fumadores pasivos en el trabajo se redujeron un 0,54p.p. al año, llegando a un 8,9% en 2014. La tendencia de la prevalencia de fumadores esa la baja, para ambos sexos, los niveles de escolaridad y grandes regiones, en casi todas las franjas de edad. Esto apunta a que la meta global de reducción de un 30% del tabaquismo hasta 2025 tiene potencial para ser alcanzada, reflejando importantes acciones de control de ese factor de riesgo en el país.

Abstract: The goal of this study was to describe the trend of tobacco-use indicators for adults in Brazilian state capitals. Simple linear regression was used to analyze tobacco-use trends according to data from telephone survey VIGITEL between 2006 and 2014. The prevalence of smokers in Brazil dropped 0.645p.p. per year this period, from 15.6% (2006) to 10.8% (2014). There was a decrease per sex, schooling, major regions, and in most age groups. The prevalence of former smokers dropped from 22.2% (2006) to 21.2% (2014); smoking 20 cigarettes or more per day went from 4.6% (2006) to 3% (2014). Passive smoking at home dropped 0.614p.p. per year since 2009, and was 9.4% in 2014. Passive smoking at the workplace decreased 0.54p.p. a year, reaching 8.9% in 2014. The prevalence trend of smokers is declining for sexes, schooling, and major regions in almost all age groups. This indicates that the global target of 30% reduction in tobacco use until 2025 is possible to be reached, reflecting the effectiveness of control actions for this risk factor in Brazil.

Prevalencia y perfil de uso del cigarrillo electrónico en España (2014) / Prevalence and user profile of electronic cigarettes in Spain (2014)

Objetivo: Describir la prevalencia y el perfil de uso de los cigarrillos electrónicos en la población adulta española y evaluar el potencial uso dual de estos dispositivos con el tabaco combustible o convencional, en España, en 2014. Métodos: Estudio transversal en una muestra representativa de la población adulta (16-75 años de edad) española (n=1016). Se realizó una encuesta telefónica asistida por ordenador en el año 2014. Se calcularon prevalencias y sus intervalos de confianza del 95% (IC95%) para el uso del cigarrillo electrónico estratificado por sexo, edad, consumo de tabaco y clase social. Se ponderó la muestra y se ajustó un modelo de regresión logística para calcular las odds ratios (OR) crudas y ajustadas por sexo, edad y clase social. Resultados: El 10,3% (IC95%: 8,6-12,4) de la población adulta española declaró haber usado en alguna ocasión el cigarrillo electrónico (2% usuarios/as actuales, 3,2% usuarios/as en el pasado y 5,1% usuarios/as experimentadores/as). Entre los/las usuarios/as actuales de cigarrillos electrónicos, el 57,2% fumaba también tabaco combustible o convencional, el 28% nunca había fumado y el 14,8% eran ex fumadores/as. La prevalencia de uso del cigarrillo electrónico fue mayor entre la población joven (OR ajustada=23,8; IC95%: 2,5-227,7) y entre las personas fumadoras de tabaco combustible (OR ajustada=10,1; IC95: 5,8-17,5). Conclusiones: El uso de cigarrillos electrónicos en España es poco frecuente y predomina en las personas jóvenes y las fumadoras de tabaco. Sin embargo, uno/a de cada cuatro usuarios/as actuales del cigarrillo electrónico nunca habían fumado. Por ello, debería reforzarse la regulación de estos dispositivos para evitar una posible puerta de entrada al uso de productos con nicotina (AU)

Objective: To describe the prevalence and user profile of electronic cigarettes among Spanish adults and evaluate the potential dual use of these devices with combustible or conventional tobacco in 2014 in Spain. Methods: Cross-sectional study of a representative sample of the Spanish adult (16-75 years old) population (n=1,016). A computer-assisted telephone survey was conducted in 2014. The prevalence and 95% confidence intervals (95% CI) for the use of electronic cigarettes stratified by gender, age, tobacco consumption and social status were calculated. The sample was weighted and a logistic regression model adjusted to obtain the crude odds ratios (OR) adjusted by gender, age and social status. Results: 10.3% (95% CI: 8.6-12.4) of the Spanish adult population stated being ever users of electronic cigarettes (2% current users, 3.2% past users and 5.1% experimental users). Among current electronic cigarette users, 57.2% also smoked combustible or conventional tobacco, 28% had never smoked and 14.8% were former smokers. The prevalence of electronic cigarette use was higher in the younger population (adjusted OR=23.8; 95% CI: 2.5-227.7) and smokers of combustible tobacco (adjusted OR=10.1; 95% CI: 5.8-17.5). Conclusions: The use of electronic cigarettes in Spain is scarce and is most prevalent among young people and tobacco smokers. Nevertheless, one out of four current electronic cigarette users have never smoked. Hence, the regulation of these devices should be reinforced to avoid a possible gateway to nicotine products among never smokers (AU)

Tendencias en la distribución del tabaquismo en una población urbana en las últimas décadas / Trends in smoking in an urban population over recent decades

Introducción: El objetivo de este trabajo es presentar la distribución del tabaquismo en la población y valorar los cambios y tendencias en las últimas décadas. Material y método: Estudio transversal en una muestra de población residente no institucionalizada (n = 3.509) en Barcelona (Cataluña, España), a partir de los datos de los mayores de 14 años de la encuesta de salud de 2011, analizando tendencias entre 1983 y 2011 mediante encuestas anteriores. Las variables dependientes son haber sido alguna vez fumador/a, haber dejado de fumar, fumar actualmente y fumar diariamente. Las variables explicativas son el sexo, la edad y el período. Se estiman prevalencias y proporciones, estratificando o ajustando por edad. Resultados: La prevalencia de personas fumadoras diarias es de un 18,8% en 2011: un 22,2% en hombres y un 15,9% en mujeres. Los grupos de edad más fumadores son el de 25-34 años en hombres y el de 15-24 años en mujeres. Entre 1983 y 2011 la disminución de la prevalencia en hombres ha sido intensa y en mujeres se aprecia el descenso desde 2000. En ambos sexos la proporción de personas fumadoras que no fuman diariamente es cada vez mayor. Conclusiones: La evolución de la epidemia tabáquica en los últimos años muestra tendencias esperanzadoras. Los datos no apoyan la hipótesis de que las personas fumadoras actualmente sean más adictas. Fumar es cada vez más minoritario, aunque para mejorar la salud pública sería deseable que el descenso fuera más rápido (AU)

Introduction: The objective of this study is to describe the distribution of smoking in the population and to assess changes and trends over recent decades. Material and method: Cross sectional study in a sample of the non-institutionalized resident population (n = 3,509) in Barcelona (Catalonia, Spain) using data from persons over 14 years of age from the health survey of 2011, and assessing trends for 1983-2011 using previous surveys. Dependent variables are having ever been a smoker, having quit, being a current smoker, and smoking daily. Independent variables include sex, age, and time. Prevalence and proportions are estimated, stratifying or adjusting for age. Results: The prevalence of daily smokers is 18.8% in 2011: 22.2% for men and 15.9% for women. The age groups with higher smoking prevalence are 25-34 years for men and 15-24 for women. From 1983 to 2011 the reduction among men has been intense, and for women the prevalence has been decreasing since the survey of 2000. Among smokers, the proportion of both genders who do not smoke daily has increased. Conclusions: The smoking epidemic over the last years shows promising trends. The data do not lend support to the hardening hypothesis for current smokers. Smokers are a shrinking minority, although to improve public health it would be desirable to speed the process of change (AU)

Avaliação Prévia da Percepção de Autoeficácia do Paciente Tabagista / Preliminary assessment of the self-efficacy perception of smokers

O estudo objetivou verificar a percepção de autoeficácia que o paciente tabagista possui ao iniciar o tratamento para cessação do cigarro num Ambulatório de Especialidades do Município de São Paulo, tendo como referência o Programa Nacional de Controle do Tabagismo PNCT-INCA. Foram aplicadas duas questões em escala analógica visuais para o paciente avaliar a Importância em parar de fumar e sua Confiança que irá conseguir. Também foram coletados dados sociodemográficos e perfil tabágico do paciente, os dados foram analisados em um estudo transversal com 170 pacientes que participaram do Programa no período de Março/2011 a Abril/2016. Os resultados mostram que grande parte dos pacientes tentaram parar de fumar anteriormente em períodos inferiores a um mês e consideram muito Importante parar de fumar mas com relação a Confiança os escores são mais dispersos e baixos. Conhecer esta percepção de autoeficácia do paciente colabora na elaboração de um plano de tratamento mais apropriado para seu estágio motivacional que trabalhe as crenças pessoais tornando o tratamento, que sabe-se tão complexo e necessário, mais empático e eficaz.(AU)

Socio-economic health disparities in tobacco smoking among Afro-Caribbean adults: Findings from the Jamaica Health and Lifestyle Survey 2007–2008

OBJECTIVES: To evaluate whether education attainment oroccupation class was associated with the prevalence of tobacco smoking among Jamaican adults. SUBJECTS AND METHODS: This study was a secondary analysis of data collected from the Jamaica Health and Lifestyle Survey 2007–2008 (JHLS-II) and included participants who were 25–74 years old. Data on current tobacco smoking, highest educational attainment and usual occupation were collected using an interviewer-administered questionnaire. Poisson regression models were used to estimate sex-specific, age-adjusted prevalence and prevalence ratios (PR). RESULTS: Analyses included 2299 participants (696 men,1603 women) with mean age of 42.9 years. Prevalence of current smoking among men and women was 25.8% and 7.8%, respectively (p < 0.001). Age-adjusted prevalence of current smoking in men was highest in the primary education group (36.5%) and lowest in the post-secondary education group (10.2%), p (trend) = 0.003. Among women, prevalence was highest among those with junior secondary education (10.2%) and lowest among those with primary education (4.7%), p (trend) = 0.014. Using post secondary education as the reference category, age adjusted PR showed statistically significant two- to three fold higher prevalence of current smoking for all the lower education groups among men. Prevalence ratios for women were lower and not statistically significant. Disparity patterns for occupation were similar, with statistically significant higher age-adjusted prevalence among men in the lower occupational categories, but not among women. CONCLUSION: There are large socio-economic disparities in tobacco smoking among men, but less so among women in Jamaica. Interventions to reduce smoking should consider these socio-economic disparities.

Temporal trends in all-cause mortality according to smoking status: Insights from the Global Registry of Acute Coronary Events

Objective: Smoking has been shown to be a risk factor for heart disease. However, it was recently reported that despite the evolution in therapy for acute coronary syndrome (ACS), smokers have not demonstrated improved outcomes.The aim of the present study was to evaluate the temporal trends in the treatments and outcomes across a broad spectrum of ACS patients (STEMI and non-ST-elevation ACS [NSTEACS]) according to smoking status on presentation in the Global Registry of Acute Coronary Events (GRACE). Methods Our cohort was stratified into 3 groups: current smokers, former smokers and never smokers. We evaluated trends in demographics, treatment modalities and outcomes in these 3 groups from 1999 to 2007.ResultsThe study population comprised a total of 63,015 patients admitted to hospital with an ACS and with identifiable baseline smoking status. Smokers presented with STEMI more often than non-smokers. There was an unadjusted decline in 30-day mortality in all 3 groups. However, the adjusted decline was not statistically significant among current smokers (HR = 0.98 per study year, 95% CI 0.94–1.01, p = 0.20). A subgroup analysis of 22,894 STEMI patients demonstrated no reduction in annual adjusted 30-day mortality rates among smokers (HR = 1.01, 95% CI 0.96–1.06 (Table 5), whereas former and never smokers' mortality declined...

Tendências e desigualdades nos comportamentos de risco em adolescentes: comparação das coortes de nascimentos de Pelotas, Rio Grande do Sul, Brasil / Trends and inequalities in risk behaviors among adolescents: a comparison of birth cohorts in Pelotas, Rio Grande do Sul State, Brazil / Tendencias y desigualdades en los comportamientos de riesgo en adolescentes: comparación de las cohortes de nacimientos de Pelotas, Río Grande do Sul, Brasil

Resumo: O objetivo do presente trabalho é descrever tendências e desigualdades nos comportamentos de risco à saúde em adolescentes. Estudo transversal, comparando duas coortes de nascimentos da cidade de Pelotas, Rio Grande do Sul, Brasil. Foram incluídos 1.281 adolescentes da coorte de 1982 e 4.106 da coorte de 1993 acompanhados em 2001 e 2011, respectivamente. Foi avaliado o consumo de álcool, uso de drogas ilícitas, uso de tabaco, iniciação sexual < 16 anos, não uso de preservativo e múltiplos parceiros sexuais. Foram calculadas prevalências totais para cada coorte, estratificadas por sexo e renda per capita, e medidas de desigualdades absoluta e relativa. Houve diminuição, de 2001 para 2011, na prevalência de uso experimental de álcool, uso de drogas, fumo e não uso de preservativos, e aumento no número de parceiros sexuais. O gap na prevalência conforme sexo aumentou para o não uso de preservativo, e para os outros aumentou. O gap entre grupos de renda diminuiu para iniciação sexual < 16 anos e aumentou para episódios de embriaguez. Apesar da tendência de diminuição na prevalência dos comportamentos de risco, as desigualdades socioeconômicas persistiram.

Abstract: This study focuses on trends and inequalities in health risk behaviors among adolescents. A cross-sectional study compared two birth cohorts in the city of Pelotas, Rio Grande do Sul State, Brazil. The sample included 1,281 adolescents from the 1982 cohort and 4,106 from the 1993 cohort, followed in 2001 and 2011, respectively. The study recorded alcohol intake, illegal drug use, smoking, sexual initiation < 16 years, lack of condom use, and multiple sex partners. Total prevalence rates were calculated for each cohort, stratified by gender and per capita income, besides absolute and relative measures of inequality. There was a decrease from 2001 to 2011 in prevalence rates for trying alcohol, illegal drug use, smoking, and lack of condom use, and an increase in the number of sex partners. The gap between boys and girls increased for non-use of condoms and decreased for the other behaviors. The gap between income groups decreased for sexual initiation before 16 years of age and increased for episodes of intoxication. Socioeconomic inequalities persist, despite the downward trend in prevalence of risk behaviors.

Resumen: El objetivo del presente estudio es describir tendencias y desigualdades en los comportamientos de riesgo a la salud en adolescentes. Estudio transversal, comparando dos cohortes de nacimientos de la ciudad de Pelotas, Río Grande do Sul, Brasil. Se incluyeron a 1.281 adolescentes de la cohorte de 1982 y 4.106 de la cohorte de 1993 acompañados en 2001 y 2011, respectivamente. Se evaluó el consumo de alcohol, uso de drogas ilícitas, uso de tabaco, iniciación sexual < 16 años, el no uso de preservativo y múltiples compañeros sexuales. Se calcularon prevalencias totales para cada cohorte, estratificadas por sexo y renta per cápita, y medidas de desigualdades absoluta y relativa. Hubo disminución, de 2001 a 2011, en la prevalencia de uso experimental de alcohol, uso de drogas, tabaco y en el no uso de preservativos, y un aumento en el número de compañeros sexuales. El gap en la prevalencia, según el sexo, aumentó en el caso del no uso de preservativo, mientras que para los otros aumentó. El gap entre grupos de renta disminuyó en iniciación sexual < 16 años y aumentó en episodios de embriaguez. A pesar de la tendencia de disminución en la prevalencia de los comportamientos de riesgo, las desigualdades socioeconómicas persistieron.

Methodology for the estimation of use of tobacco, alcohol and other drugs

The objective of this article is to revise the methods used for the assessment of the use of tobacco, alcohol and other drugs. Analysing the advantages of using one method or the other, as well as the most frequent methodological difficulties and problems in medication and classification of each one of these indicators. The main sources of information available from European, National and Madrid Autonomous Community levels have been consulted to estimate the most relevant aspects of these forms of substance abuse (AU)

El objetivo de este trabajo es revisar los métodos utilizados para la estimación del consumo de tabaco, alcohol y otras drogas. Analizar las ventajas de utilizar unos u otros métodos, así como las dificultades y problemas metodológicos más frecuentes en la medición y clasificación de cada uno de estos indicadores. Se recogen las principales fuentes de información disponibles a nivel Europeo, Nacional y en la Comunidad de Madrid para estimar los aspectos más relevantes del consumo de este tipo de sustancias (AU)

Utilidad de los microespirómetros en las unidades y consultas de tabaquismo / Use of microspirometry in the smoking cessation units and offices

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