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1.
PLoS One ; 15(4): e0232138, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32348362

RESUMEN

Head and neck squamous cell carcinomas (HNSCC) are the seventh most frequent cancers. Among HNSCCs, oral squamous cell carcinomas (OSCCs) include several anatomical locations of the oral cavity, but exclude the oropharynx. The known risk factors for OSCCs are mainly alcohol consumption and tobacco use for at least 75-80% of cases. In addition to these risk factors, Human papillomavirus (HPV) types 16 and 18, classified as high-risk (HR) HPV genotypes, are considered as risk factors for oropharyngeal cancers, but their role in the development of OSCC remains unclear. We tested the hypothesis of viral etiology in a series of 68 well-characterized OSCCs and 14 potentially malignant disorders (PMD) in non-smoking, non-drinking (NSND) patients using broad-range, sensitive molecular methodologies. Deep-sequencing of the transcriptome did not reveal any vertebrate virus sequences other than HPV transcripts, detected in only one case. In contrast, HPV DNA was detected in 41.2% (28/68) and 35.7% (5/14) of OSCC and PMD cases, respectively. Importantly, 90.9% (30/33) of these belonged to the Betapapillomavirus genus, but no viral transcripts were detected. Finally, high-throughput sequencing revealed reads corresponding to transcripts of the Trichomonas vaginalis virus (TVV), which were confirmed by RT-PCR in two OSCCs. Our results strongly suggest that Alphapapillomavirus genotypes classified as HR are not involved in the development of OSCCs in NSND patients and that known oncogenic infectious agents are absent in these specific OSCCs. Any possible direct or indirect role of Betapapillomavirus genus members and TVV in OSCCs remains speculative and requires further investigation.


Asunto(s)
Consumo de Bebidas Alcohólicas/tendencias , Carcinogénesis/patología , Carcinoma de Células Escamosas/etiología , Neoplasias de la Boca/etiología , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/complicaciones , Fumar/tendencias , Adulto , Anciano , Carcinoma de Células Escamosas/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/patología , Papillomaviridae/clasificación , Infecciones por Papillomavirus/virología
2.
Pediatrics ; 145(3)2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32015140

RESUMEN

INTRODUCTION: Identifying trends in smoking behaviors among youth cigarette smokers could inform youth policy and interventions. METHODS: Using 2011-2018 National Youth Tobacco Survey data, logistic/linear regressions were used to analyze trends in smoking frequency, intensity, age of first cigarette use, and electronic cigarette (e-cigarette) use frequency among current smokers. Stratified analyses were conducted among male, female, middle school, and high school students and race and ethnicity subgroups separately. RESULTS: From 2011 to 2018, there was a decrease in smoking ≥10 days (50.0% to 38.3%), ≥20 days (37.2% to 26.3%), and 30 days (26.6% to 18.2%) among current smokers. Smoking prevalence decreased among male, female, high school, non-Hispanic white, and non-Hispanic other students. Overall, light smoking (≤5 cigarettes per day [CPDs]) increased (76.6% to 82.7%), and moderate smoking (6-10 CPDs) decreased (10.7% to 8.3%). Trends in light, moderate, and heavy smoking varied by demographic groups. Age at first cigarette use increased among female (12.28 to 13.29), high school (12.91 to 13.18), and non-Hispanic other students (11.64 to 12.83) and decreased among male students (12.90 to 12.57). From 2014 to 2018, there was an increase in e-cigarette use frequency for ≥10 days (20.8% to 40.9%), ≥20 days (13.5% to 31.7%), and all 30 days (9.3% to 22%). CONCLUSIONS: From 2011 to 2018, current youth cigarette smokers smoked fewer days and fewer CPDs, and age of first cigarette use increased. However, over time, male youth smoked more heavily and started smoking earlier. E-cigarette use increased from 2014 to 2018. Differences by demographic characteristics can inform future research and interventions.


Asunto(s)
Fumar/epidemiología , Fumar/tendencias , Adolescente , Distribución por Edad , Grupos de Población Continentales/estadística & datos numéricos , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Prevalencia , Distribución por Sexo , Productos de Tabaco , Estados Unidos/epidemiología
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1420-1425, 2019 Nov 10.
Artículo en Chino | MEDLINE | ID: mdl-31838815

RESUMEN

Objective: To understand the trends of smoking and passive smoking exposure in adults in Shaanxi province from 2007 to 2015. Methods: Data was from China Chronic Disease and Risk Factor Surveillance in 2007, 2010, 2013 and 2015 to calculate the rates of smoking, smoking cessation and passive smoking exposure, as well as the amount of smoking of smokers indicated by each surveillance. Cochran-Armitage test was used to assess the trends across survey periods. The weighting rate was calculated by using sampling weight and data from the 6(th) national census in 2010. Sensitivity analysis was done to test the trends as well. Results: The results of the surveillance indicated that the smoking rate in 2007 was 38.26%, highest in the results of four surveys, it decreased to 30.95% in 2013 and then increased to 34.11% in 2015 (Cochran-Armitage test: Z=2.46, P=0.014). The amount of smoking increased from 16.90 cigarettes per day in 2007 to 17.76 cigarettes per day in 2015. The overall rate of smoking cessation was 11.02% in 2007 and 16.95% in 2015 (Cochran- Armitage test: Z=-4.18, P<0.01). We observed the passive smoking exposure rate was 48.10% in 2010 and 63.88% in 2015 (Cochran-Armitage test: Z=-10.60, P<0.01). We found no difference in trends by sensitivity analysis. Conclusions: The smoking rate and amount of cigarettes smoked in adults in Shaanxi remained stable and at a high level. The rate of smoking cessation increased gradually, while the passive smoking exposure rate increased rapidly.


Asunto(s)
Vigilancia de la Población/métodos , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/epidemiología , Fumar/tendencias , Contaminación por Humo de Tabaco/estadística & datos numéricos , Adolescente , Adulto , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Fumar/etnología , Cese del Hábito de Fumar/psicología , Encuestas y Cuestionarios
4.
Orv Hetil ; 160(52): 2047-2053, 2019 Dec.
Artículo en Húngaro | MEDLINE | ID: mdl-31868011

RESUMEN

Introduction: The harmful effects represent an important public health problem in tha world. Aim: Our aim is to report and compare the results of screenings performed in Hungary's Comprehensive Health Screening Program 2010-2020-2030 (MÁESZ) with international data. Method: During the 9-year continuous screening, we analyzed the data of 71 922 women and 60 934 men in the 18-80-year-old population and examined the occurrence of regular daily smokers. Data were collected with the help of special screening data sheets. Results: 24.4% of males and 24.2% of females smoked regularly during the 9-year screening period. Between 2012 and 2015, smoking prevalence showed a temporary significant decline, then, from 2016, it started to increase again. The downturn coincided with the opening of national tobacco stores. In men, the proportion of smokers was significantly higher in young adults (18-25 years) than in women. Later in life, the difference leveled off and even between 46-55 years, the prevalence of smoking was greater in women. There is a difference in smoking patterns between the two genders, which is probably related to marriage and motherhood in women. After 56 years, the proportion of smokers in both genders decreased rapidly. The prevalence of smoking in Hungary in all age groups significantly exceeds the European and world average. Transient increases in middle-aged women have also been reported in European surveys. Conclusion: Compared to 2010, the proportion of smokers has decreased in Hungary, but a new surge observed after 2015 is not a positive phenomenon. We find the high proportion of smoking women worrying. Orv Hetil. 2019; 160(52): 2047-2053.


Asunto(s)
Fumar/epidemiología , Tabaquismo/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Hungría/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Distribución por Sexo , Factores Sexuales , Fumar/tendencias , Cese del Hábito de Fumar , Tabaco sin Humo , Adulto Joven
5.
J Bras Pneumol ; 45(5): e20180384, 2019.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31721893

RESUMEN

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.


Asunto(s)
Fumar/epidemiología , Fumar/tendencias , Adolescente , Adulto , Anciano , Brasil/epidemiología , Estudios Transversales , Escolaridad , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Prevalencia , Análisis de Regresión , Distribución por Sexo , Factores de Tiempo , Adulto Joven
7.
Pneumologie ; 73(10): 592-596, 2019 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-31499561

RESUMEN

AIM: To describe the smoking behavior of adolescents from England and Germany over a period of 15 years. METHODS: Eleven repeated cross-sectional surveys involving a total of 107,485 persons aged 11 to 15 years were carried out between 2001 and 2016 in England and Germany. The following data were assessed: a) the relative proportion of young people who ever smoked a conventional tobacco product, and b) the relative proportion of adolescents, who were current smokers, i. e. teenagers who smoked "occasionally" or "constantly" or "regularly". RESULTS: In the observational period, there was a significant stronger reduction in the proportion of young people who ever smoked in Germany (from 52 % to 10 %) compared to England (from 44 % to 19 %). In the same period, the proportion of young people who smoked currently dropped by 16 percentage points to 3 % in Germany and by 12 percentage points to 7 % in England (no significant difference). CONCLUSIONS: Data indicate a stronger trend towards never smoking in Germany compared to England, and a similar falling trend on "current" smoking in both countries. Causal conclusions are not possible due to the study design.


Asunto(s)
Fumar/epidemiología , Adolescente , Conducta del Adolescente , Niño , Estudios Transversales , Inglaterra/epidemiología , Femenino , Alemania/epidemiología , Humanos , Masculino , Fumar/tendencias
8.
Subst Abuse Treat Prev Policy ; 14(1): 34, 2019 08 20.
Artículo en Inglés | MEDLINE | ID: mdl-31429769

RESUMEN

BACKGROUND: The current study utilizes system dynamics to model the determinants of youth smoking and simulate effects of anti-smoking policies in the context of North Dakota, a state with one of the lowest cigarette tax rates in the USA. METHODS: An explanatory model was built to replicate historical trends in the youth smoking rate. Three different policies were simulated: 1) an increase in cigarette excise taxes; 2) increased funding for CDC-recommended comprehensive tobacco control programs; and 3) enforcement of increased retailer compliance with age restrictions on cigarette sales. RESULTS: The explanatory model successfully replicated historical trends in adolescent smoking behavior in North Dakota from 1992 to 2014. The policy model showed that increasing taxes to $2.20 per pack starting in 2015 was the most effective of the three policies, producing a 32.6% reduction in youth smoking rate by 2032. Other policies reduced smoking by a much lesser degree (7.0 and 3.2% for comprehensive tobacco control program funding and retailer compliance, respectively). The effects of each policy were additive. CONCLUSIONS: System dynamics modeling suggests that increasing cigarette excise taxes are particularly effective at reducing adolescent smoking rates. More generally, system dynamics offers an important complement to conventional analysis of observational data.


Asunto(s)
Conducta del Adolescente , Política de Salud , Prevención del Hábito de Fumar/tendencias , Fumar/tendencias , Análisis de Sistemas , Adolescente , Simulación por Computador , Humanos , Modelos Psicológicos , North Dakota , Impuestos
9.
Soc Sci Med ; 230: 37-48, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30959305

RESUMEN

Studies across Europe and the US report that childhood socioeconomic disadvantage is associated with poorer health in adulthood. By contrast, a study in Japan suggests that childhood socioeconomic disadvantage may be positive for adult health. In this paper, we assess the association between intergenerational income mobility and self-rated health in Japan, using detailed childhood income data for 1610 men and 1885 women aged 30-49 years. We use an instrumental variable approach to identify the causal effect of upward income mobility on adult health. We find that low father's income during childhood is associated with smoking and alcohol consumption in adult life for both men and women. For men, upward income mobility was associated with worse health. Certain behavioural choices related to income mobility, such as long working hours, may have detrimental health effects.


Asunto(s)
Autoevaluación Diagnóstica , Renta/estadística & datos numéricos , Relaciones Intergeneracionales , Acontecimientos que Cambian la Vida , Movilidad Social , Adulto , Consumo de Bebidas Alcohólicas/tendencias , Niño , Padre/estadística & datos numéricos , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Pobreza , Fumar/tendencias
10.
Am J Public Health ; 109(5): 771-773, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30897002

RESUMEN

OBJECTIVES: To examine change over time in cigarette smoking among rural and urban adolescents and to test whether rates of change differ by rural versus urban residence. METHODS: We used the 2008 through 2010 and 2014 through 2016 US National Survey of Drug Use and Health to estimate prevalence and adjusted odds of current cigarette smoking among rural and urban adolescents aged 12 to 17 years in each period. To test for rural-urban differences in the change between periods, we included an interaction between residence and time. RESULTS: Between 2008 to 2010 and 2014 to 2016, cigarette smoking rates declined for rural and urban adolescents; however, rural reductions lagged behind urban reductions. Controlling for socioeconomic characteristics, rural versus urban odds of cigarette smoking did not differ in 2008 through 2010; however, in 2014 through 2016, rural youths had 50% higher odds of smoking than did their urban peers. CONCLUSIONS: Differential reductions in rural youth cigarette smoking have widened the rural-urban gap in current smoking rates for adolescents. Public Health Implications. To continue gains in adolescent cigarette abstinence and reduce rural-urban disparities, prevention efforts should target rural adolescents.


Asunto(s)
Fumar Cigarrillos/tendencias , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Conducta del Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , Grupo Paritario , Fumar/tendencias , Factores Socioeconómicos , Tabaquismo/epidemiología , Estados Unidos/epidemiología
11.
BMC Geriatr ; 19(1): 60, 2019 02 28.
Artículo en Inglés | MEDLINE | ID: mdl-30819099

RESUMEN

BACKGROUND: According to a WHO report, nearly 15% of adults aged 60 and over suffer from a mental disorder, constituting 6.6% of the total disability for this age group. Taipei City faces rapid transformation towards an aging society, with the proportion of elderly in the total population rising from 12% in 2008 to 16% in 2016. The aim of this study is to identify the prevalence of mental disorders among the elderly in Taipei City and to elucidate risk factors contributing to mental disorders. METHODS: The elderly health examination database was obtained from the Department of Health, Taipei City government, from 2005 to 2012. A total of 86,061 people underwent publicly funded health examinations, with 348,067 visits. Each year, there are around 43,000 elderly persons in Taipei City using this service. We used a mental health questionnaire including five questions to estimated relative risks among potential risk factors with the generalized estimating equations (GEE) model to measure the mental health status of the elderly. Mood disorders were measured with the Brief Symptom Rating Scale (BSRS-5) questionnaire. Age, education level, gender, marital status, living alone, drinking milk, eating vegetables and fruits, long-term medication, smoking status, frequency of alcohol consumption, frequency of physical activity, BMI, and number of chronic diseases were included as covariates. RESULTS: The results show that being male (odds ratio (OR) 0.57; 95% CI = 0.56, 0.59), higher education (OR 0.88; 95% CI = 0.82, 0.95), no long-term medication (OR 0.57; 95% CI = 0.56, 0.58), and exercising three or more times per week (OR 0.94; 95% CI = 0.91, 0.98) were all positively correlated with better emotional status. However, being divorced (OR = 1.22, 95% CI = 1.09, 1.36), not drinking milk (OR = 1.12, 95% CI = 1.09, 1.14), not eating enough vegetables and fruits every day (OR = 1.78, 95% CI = 1.73, 1.83), daily smoking (OR = 1.15, 95% CI = 1.01, 1.32), and having more chronic diseases (OR = 1.02, 95% CI = 1.01, 1.03) were all correlated with poor mental status among the elderly. CONCLUSIONS: The findings of this research can both estimate the prevalence of mood disorders at the community level, and identify risk factors of mood disorders at the personal level.


Asunto(s)
Servicios Comunitarios de Salud Mental/métodos , Conductas Relacionadas con la Salud , Trastornos del Humor/diagnóstico , Trastornos del Humor/psicología , Encuestas y Cuestionarios , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Servicios Comunitarios de Salud Mental/tendencias , Dieta Saludable/psicología , Dieta Saludable/tendencias , Femenino , Estudios de Seguimiento , Conductas Relacionadas con la Salud/fisiología , Humanos , Estudios Longitudinales , Masculino , Estado Civil , Salud Mental/tendencias , Trastornos del Humor/prevención & control , Estudios Retrospectivos , Factores de Riesgo , Fumar/efectos adversos , Fumar/tendencias
12.
Pediatrics ; 143(2)2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30835247

RESUMEN

Electronic cigarettes (e-cigarettes) are the most commonly used tobacco product among youth. The 2016 US Surgeon General's Report on e-cigarette use among youth and young adults concluded that e-cigarettes are unsafe for children and adolescents. Furthermore, strong and consistent evidence finds that children and adolescents who use e-cigarettes are significantly more likely to go on to use traditional cigarettes-a product that kills half its long-term users. E-cigarette manufacturers target children with enticing candy and fruit flavors and use marketing strategies that have been previously successful with traditional cigarettes to attract youth to these products. Numerous toxicants and carcinogens have been found in e-cigarette solutions. Nonusers are involuntarily exposed to the emissions of these devices with secondhand and thirdhand aerosol. To prevent children, adolescents, and young adults from transitioning from e-cigarettes to traditional cigarettes and minimize the potential public health harm from e-cigarette use, there is a critical need for e-cigarette regulation, legislative action, and counterpromotion to protect youth.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Vapeo/efectos adversos , Vapeo/tendencias , Adolescente , Niño , Sistemas Electrónicos de Liberación de Nicotina/métodos , Humanos , Fumar/efectos adversos , Fumar/epidemiología , Fumar/tendencias , Vapeo/epidemiología
13.
BMJ Open ; 9(3): e020120, 2019 03 03.
Artículo en Inglés | MEDLINE | ID: mdl-30833307

RESUMEN

OBJECTIVE: This study aimed to analyse the impact of comprehensive smoke-free legislation (SFL) on the prevalence and incidence of adult smoking in primary healthcare (PHC) patients from three Spanish regions, overall and stratified by sex. DESIGN: Longitudinal observational study conducted between 2008 and 2013. SETTING: 66 PHC teams in Catalonia, Navarre and the Balearic Islands (Spain). PARTICIPANTS: Population over 15 years of age assigned to PHC teams. PRIMARY AND SECONDARY OUTCOMES MEASURES: Quarterly age-standardised prevalence of non-smoker, smoker and ex-smoker and incidence of new smoker, new ex-smoker and ex-smoker relapse rates were estimated with data retrieved from PHC electronic health records. Joinpoint analysis was used to analyse the trends of age-standardised prevalence and incidence rates. Trends were expressed as annual percentage change and average annual percent change. RESULTS: The overall standardised smoker prevalence rate showed a significant downward trend (higher in men than women) and the overall standardised ex-smoker prevalence rate showed a significant increased trend (higher in women than men) in the three regions. Standardised smoker and ex-smoker prevalence rates were higher for men than women in all regions. With regard to overall trends of incidence rates, new smokers decreased significantly in Catalonia and Navarre and similarly in men and women, new ex-smokers decreased significantly and more in men in Catalonia and the Balearic Islands, and ex-smoker relapse increased in Catalonia (particularly in women) and decreased in Navarre. CONCLUSIONS: Trends in smoking behaviour in PHC patients remain unchanged after the implementation of comprehensive SFL. The impact of the comprehensive SFL might have been lessened by the effect of the preceding partial SFL.


Asunto(s)
Atención Primaria de Salud , Política para Fumadores/legislación & jurisprudencia , Fumadores , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar , Adulto , Femenino , Humanos , Incidencia , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Evaluación de Resultado en la Atención de Salud , Prevalencia , Atención Primaria de Salud/métodos , Atención Primaria de Salud/estadística & datos numéricos , Fumadores/psicología , Fumadores/estadística & datos numéricos , Fumar/epidemiología , Fumar/tendencias , España/epidemiología
14.
Alcohol ; 75: 105-112, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30640073

RESUMEN

The consequences of alcohol use are closely related to its pattern of intake. The aim of this study is to analyze the pattern of alcohol use by doctors and nurses. Associated co-factors have also been considered. We calculated a representative sample of doctors and nurses from two hospitals in Maranhão, Northeastern Brazil. The Alcohol Use Disorders Identification Test (AUDIT) was employed to assess patterns of alcohol consumption. A score ≥8 was defined as alcohol misuse, and an answer to question number 3 > 1 was indicative of heavy episodic drinking (HED). In order to identify factors associated with HED and alcohol misuse, bivariate and multiple logistic regression analyses were performed with SPSS v20.0. A sample of 510 professionals was examined and 25% of those were abstainers; among those who had drinks containing alcohol, 86% were classified as low-risk alcohol use, scoring lower than 8, while 10.6% of the whole sample was categorized as alcohol misusers, scoring more than 8. The habit of smoking (OR = 6.02; CI: 1.71-21.16), following the Catholic religion (OR = 3.55; CI: 2.47-8.58), and also gender (OR = 3.09; CI: 1.68-5.71) were independently associated with alcohol misuse. HED was found in 14.3%. Younger age (OR = 0.96; CI: 0.92-0.98), male gender (OR = 5.13; CI: 2.55-10.30), the Catholic religion (OR = 3.22; CI: 1.44-7.21), and smoking habits (OR = 5.25; CI: 1.26-21.75) were associated with HED. Therefore, physicians and nurses have a lesser prevalence of abstainers, similar rates of alcohol misuse, and greater prevalence of HED when compared to the general Brazilian adult population. More studies involving these professionals need to be carried out in other Brazilian states in order to determine whether the results can be understood as widespread throughout the country.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/tendencias , Enfermeras y Enfermeros/tendencias , Médicos/tendencias , Encuestas y Cuestionarios , Adulto , Consumo de Bebidas Alcohólicas/psicología , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros/psicología , Médicos/psicología , Religión y Psicología , Factores de Riesgo , Factores Sexuales , Fumar/epidemiología , Fumar/tendencias , Adulto Joven
15.
J Neurointerv Surg ; 11(3): 320-322, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30314993

RESUMEN

OBJECTIVE: To determine the incidence and trends in subarachnoid hemorrhage in Ireland using data from a national database. MATERIALS AND METHODS: We performed a retrospective nationwide query of the Irish Hospital In-patient Enquiry System (HIPE). This is a national database of all in-patient activity in acute public hospitals in Ireland. Each HIPE entry records one episode of in-patient care. The study period ranged from 1997 to 2015. Population data was obtained from the Irish Central Statistics Office, and the annual prevalence of smoking from the Irish National Tobacco Control Office. We were therefore able to calculate both crude annual acute subarachnoid hemorrhage (SAH) incidence rates, as well as population-standardized rates, and compared them with trends in the annual smoking rates. RESULTS: The mean number of SAH cases per year is 549, with 465 cases in 1997 and 517 in 2015 (range: 465-624). The absolute incidence of SAH, therefore, remained relatively stable. Due to population increases over time, the population-adjusted rate of SAH therefore decreased, from 126.9/million people/year in 1997 to 111.5/million people/year in 2015. Nationally, there was a decrease in smoking prevalence, from 31% in 1998 to 19.2% in 2015. There was a statistically significant correlation between decreasing smoking rates and decreasing population-adjusted incidence of SAH (P=<0.0001). CONCLUSIONS: Our data suggests that the incidence of non-traumatic subarachnoid hemorrhage in our population appears to be decreasing, a decrease which is correlated with decreasing smoking rates. This provides important data both in terms of the epidemiology of SAH, as well as the possible role of public-health interventions in tackling both smoking and declining rates of SAH.


Asunto(s)
Bases de Datos Factuales/tendencias , Fumar/epidemiología , Fumar/tendencias , Hemorragia Subaracnoidea/epidemiología , Adulto , Anciano , Femenino , Humanos , Incidencia , Irlanda/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Hemorragia Subaracnoidea/diagnóstico
16.
Nicotine Tob Res ; 21(7): 871-878, 2019 06 21.
Artículo en Inglés | MEDLINE | ID: mdl-29342304

RESUMEN

INTRODUCTION: Factory-made cigarettes (FMC) and roll-your-own (RYO) tobacco have had to be produced in standardized packaging since May 20, 2016 in the United Kingdom, with a minimum pack size of 20 sticks for FMC and 30 g for RYO. Manufacturers and retailers were given a 12-month transition period. METHODS: An observational study was conducted using monthly Electronic Point of Sale data from 500 small retailers in England, Scotland, and Wales, between May 2016 and May 2017. The 20 top selling tobacco products (15 FMC, 5 RYO) were monitored to observe when standardized packs were first introduced, the proportion of retailers selling each fully branded and standardized product, and the average number of monitored fully branded and standardized products sold by each retailer. The number of unique tobacco-related product codes sold by each retailer was also recorded each month. RESULTS: Eighteen of the fully branded products continued to be sold throughout the transition period and no standardized variants were sold in the first 5 months. It was not until month eleven that the average number of standardized products sold by retailers exceeded the fully branded products. The average number of unique tobacco-related product codes sold by each retailer decreased by a third over the transition period. CONCLUSIONS: Tobacco companies used the transition period to delay the removal of fully branded products and gradually introduce standardized variants. This staggered introduction may have mitigated some of the immediate intended effects of the legislation by desensitizing consumers to new pack designs. IMPLICATIONS: Evaluation research from countries which have introduced standardized packaging for tobacco products is key to help inform future implementation. This is the first study to monitor the transition from fully branded to standardized products using real-time retail data. The findings demonstrate that tobacco companies delayed the introduction of standardized products and removal of fully branded packaging. Countries seeking to introduce standardized packaging should consider what length of transition is allowed, as the protracted 12-month period in the United Kingdom appeared longer than needed to transition stockholding and may have mitigated immediate intended effects by desensitizing consumers to new pack designs.


Asunto(s)
Comercio/normas , Comercio/tendencias , Embalaje de Productos/normas , Embalaje de Productos/tendencias , Fumar/tendencias , Productos de Tabaco/normas , Comercio/legislación & jurisprudencia , Humanos , Mercadotecnía/legislación & jurisprudencia , Mercadotecnía/tendencias , Embalaje de Productos/legislación & jurisprudencia , Estándares de Referencia , Fumar/legislación & jurisprudencia , Factores de Tiempo , Productos de Tabaco/legislación & jurisprudencia , Reino Unido/epidemiología
17.
Nicotine Tob Res ; 21(8): 1001-1010, 2019 07 17.
Artículo en Inglés | MEDLINE | ID: mdl-29579233

RESUMEN

INTRODUCTION: Smoking in pregnancy is a substantial public health issue, but, apart from nicotine replacement therapy (NRT), pharmacological therapies are not generally used to promote cessation. Bupropion and varenicline are effective cessation methods in nonpregnant smokers and this systematic review investigates their safety in pregnancy. METHODS: We searched MEDLINE, EMBASE, CINAHL, and PsychINFO databases for studies of any design reporting pregnancy outcomes after bupropion or varenicline exposure. We included studies of bupropion used for smoking cessation, depression, or where the indication was unspecified. Depending on study design, quality was assessed using the Newcastle-Ottawa Scale or Cochrane Risk of Bias Tool. Most findings are reported narratively but meta-analyses were used to produce pooled estimates for the proportion of live births with congenital malformations and of the mean birthweight and gestational age at delivery following bupropion exposure. RESULTS: In total, 18 studies were included: 2 randomized controlled trials, 11 cohorts, 2 case- control studies, and 3 case reports. Study quality was variable. Gestational safety outcomes were reported in 14 bupropion and 4 varenicline studies. Meaningful meta-analysis was only possible for bupropion exposure, for which the pooled estimated proportion of congenital malformations amongst live-born infants was 1.0% (95% CI = 0.0%-3.0%, I2 = 80.9%, 4 studies) and the mean birthweight and mean gestational age at delivery was 3305.9 g (95% CI = 3173.2-3438.7 g, I2 = 77.6%, 5 studies) and 39.2 weeks (95% CI = 38.8-39.6 weeks, I2 = 69.9%, 5 studies), respectively. CONCLUSIONS: There was no strong evidence that either major positive or negative outcomes were associated with gestational use of bupropion or varenicline. PROSPERO registration number CRD42017067064. IMPLICATIONS: We believe this to be the first systematic review investigating the safety of bupropion and varenicline in pregnancy. Meta-analysis of outcomes following bupropion exposure in pregnancy suggests that there are no major positive or negative impacts on the rate of congenital abnormalities, birthweight, or premature birth. Overall, we found no evidence that either of these treatments might be harmful in pregnancy, and no strong evidence to suggest safety, but available evidence is of poor quality.


Asunto(s)
Bupropión/uso terapéutico , Complicaciones del Embarazo/tratamiento farmacológico , Agentes para el Cese del Hábito de Fumar/uso terapéutico , Cese del Hábito de Fumar/métodos , Fumar/tratamiento farmacológico , Vareniclina/uso terapéutico , Bupropión/efectos adversos , Estudios de Casos y Controles , Femenino , Humanos , Agonistas Nicotínicos/efectos adversos , Agonistas Nicotínicos/uso terapéutico , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo/epidemiología , Fumar/epidemiología , Fumar/tendencias , Agentes para el Cese del Hábito de Fumar/efectos adversos , Vareniclina/efectos adversos
18.
Tob Control ; 28(2): 233-236, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-29627797

RESUMEN

OBJECTIVE: Smoking rates have been compared with a spring, requiring continuous downward pressure against protobacco forces, rather than a screw, which once driven down stays down. Quality antitobacco mass media campaigns put downward pressure on smoking rates. The suspension of a major Australian state campaign provided a natural experiment to assess effects on smoking. Furthermore, we document the positive influence of robust monitoring and mature advocacy on the political decision to reinstate funding. We also document the misuse by industry of South Australian smoking data from the period between Australia's implementation and subsequent evaluation of plain packaging. METHODS: A time series analysis was used to examine monthly smoking prevalence trends at each of four intervention points: (A) commencement of high-intensity mass media campaign (August 2010); (B) introduction of plain packaging (December 2012), (C) defunding of campaign (July 2013); and (D) reinstatement of moderate-intensity campaign (July 2014). FINDINGS: The suspension of the antitobacco campaign was disruptive to achieving smoking prevalence targets. There was an absence of a downward monthly smoking prevalence trajectory during the non-campaign period. Moreover, there was a significant decline in smoking prevalence during the period of high-intensity advertising, which continued after the introduction of plain packaging laws, and at the recommencement of campaign activity. CONCLUSIONS: While the observed declines in smoking prevalence are likely due to a combination of interventions and cannot be attributed exclusively to antitobacco advertising, the results reinforce the political decision to reinstate the campaign and demonstrate the need for maintained investment to keep downward pressure on smoking rates.


Asunto(s)
Publicidad/tendencias , Medios de Comunicación de Masas/tendencias , Cese del Hábito de Fumar/métodos , Prevención del Hábito de Fumar/métodos , Fumar/epidemiología , Publicidad/estadística & datos numéricos , Australia/epidemiología , Estudios Transversales , Humanos , Embalaje de Productos , Fumar/tendencias , Industria del Tabaco/métodos
20.
Drug Alcohol Depend ; 194: 225-229, 2019 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-30463051

RESUMEN

OBJECTIVE: To evaluate the longitudinal relationship between repeated measures of alcohol consumption and risk of developing fatty liver. PATIENTS AND METHODS: This study includes 5407 men and women from a British population-based cohort, the Whitehall II study of civil servants, who self-reported alcohol consumption by questionnaire over approximately 30 years (1985-1989 through to 2012-2013). Drinking typologies during midlife were linked to measures of fatty liver (the fatty liver index, FLI) when participants were in older age (age range 60-84 years) and adjusted for age, socio-economic position, ethnicity, and smoking. RESULTS: Those who consistently drank heavily had two-fold higher odds of increased FLI compared to stable low-risk moderate drinkers after adjustment for covariates (men: OR = 2.04, 95%CI = 1.53-2.74; women: OR = 2.24, 95%CI = 1.08-4.55). Former drinkers also had an increased FLI compared to low-risk drinkers (men: OR = 2.09, 95%CI = 1.55-2.85; women: OR = 1.68, 95%CI = 1.08-2.67). There were non-significant differences in FLI between non-drinkers and stable low-risk drinkers. Among women, there was no increased risk for current heavy drinkers in cross sectional analyses. CONCLUSION: Drinking habits among adults during midlife affect the development of fatty liver, and sustained heavy drinking is associated with an increased FLI compared to stable low-risk drinkers. After the exclusion of former drinkers, there was no difference between non-drinkers and low-risk drinkers, which does not support a protective effect on fatty liver from low-risk drinking. Cross-sectional analyses among women did not find an increased risk of heavy drinking compared to low-risk drinkers, thus highlighting the need to take a longitudinal approach.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/tendencias , Hígado Graso Alcohólico/epidemiología , Vigilancia de la Población , Autoinforme , Adulto , Anciano , Estudios de Cohortes , Estudios Transversales , Hígado Graso Alcohólico/diagnóstico , Femenino , Humanos , Londres/epidemiología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Vigilancia de la Población/métodos , Factores de Riesgo , Autoinforme/normas , Fumar/epidemiología , Fumar/tendencias , Factores de Tiempo
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