ABSTRACT
BACKGROUND: The present study sought to analyze smoking prevalence and smoking-attributable mortality estimates produced by the 2017 Global Burden of Disease Study for Brazil, 26 states, and the Federal District. METHODS: Prevalence of current smokers from 1990 to 2017 by sex and age was estimated using spatiotemporal Gaussian process regression. Population-attributable fractions were calculated for different risk-outcome pairs to generate estimates of smoking-attributable mortality. A cohort analysis of smoking prevalence by birth-year cohort was performed to better understand temporal age patterns in smoking. Smoking-attributable mortality rates were described and analyzed by development at state levels, using the Socio-Demographic Index (SDI). Finally, a decomposition analysis was conducted to evaluate the contribution of different factors to the changes in the number of deaths attributable to smoking between 1990 and 2017. RESULTS: Between 1990 and 2017, prevalence of smoking in the population (≥ 20 years old) decreased from 35.3 to 11.3% in Brazil. This downward trend was seen for both sexes and in all states, with a marked reduction in exposure to this risk factor in younger cohorts. Smoking-attributable mortality rates decreased by 57.8% (95% UI - 61.2, - 54.1) between 1990 and 2017. Overall, larger reductions were observed in states with higher SDI (Pearson correlation 0.637; p < 0.01). In Brazil, smoking remains responsible for a considerable amount of deaths, especially due to cardiovascular diseases and neoplasms. CONCLUSIONS: Brazil has adopted a set of regulatory measures and implemented anti-tobacco policies that, along with improvements in socioeconomic conditions, have contributed to the results presented in the present study. Other regulatory measures need to be implemented to boost a reduction in smoking in order to reach the goals established in the scope of the 2030 United Nations Agenda for Sustainable Development.
Subject(s)
Smoking/epidemiology , Smoking/trends , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Brazil/epidemiology , Female , Global Burden of Disease , Humans , Life Expectancy , Male , Middle Aged , Quality-Adjusted Life Years , Residence Characteristics , Sex Distribution , Smoking/adverse effects , Smoking/mortality , Socioeconomic Factors , Young AdultABSTRACT
Objectives: The present study investigated the relationships of enculturation and depressive symptoms with health risk behavior engagement in Mexican-American college students and examined how these relationships differed by gender. Previous research has noted consistent gender differences in health risk behavior (e.g. alcohol use, substance use, and risky sexual behavior) among Latina/os, and emphasized the role of U.S. acculturation in this difference. Research examining the role of heritage cultural retention (i.e. enculturation), and including the added influence of mental health variables, such as depressive symptoms, is currently lacking. This study sought to address this gap.Design: A large sample (N = 677) of Mexican-American college students from four universities (located in New York, California, Florida, and Texas) completed an online questionnaire assessing health risk behaviors and corresponding variables.Results: We found that males who endorsed more behavioral enculturation and depressive symptoms were more likely to engage in health risk behavior than all others in the sample. Contrary to previous literature, no relationship was found between behavioral enculturation and health risk behavior in females.Conclusion: The current study found behavioral enculturation to be associated with depressive symptoms, and in turn with health risk behaviors among the males in our sample. Additional research will be needed to identify the mechanism underlying the relationship between enculturation and depressive symptoms as well as between depressive symptoms and risky behavior.
Subject(s)
Acculturation , Depression/psychology , Health Risk Behaviors , Mediation Analysis , Mexican Americans/statistics & numerical data , Adult , Alcohol Drinking/psychology , Female , Humans , Internet , Male , Sex Factors , Sexual Behavior/psychology , Smoking/trends , Students/psychology , Surveys and Questionnaires , United States , Universities , Young AdultABSTRACT
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.
Subject(s)
Smoking/epidemiology , Smoking/trends , Adolescent , Adult , Aged , Brazil/epidemiology , Cross-Sectional Studies , Educational Status , Female , Humans , Interviews as Topic , Male , Middle Aged , Prevalence , Regression Analysis , Sex Distribution , Time Factors , Young AdultABSTRACT
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.
Subject(s)
Alcohol Drinking/epidemiology , Alcohol Drinking/trends , Nurses/trends , Physicians/trends , Surveys and Questionnaires , Adult , Alcohol Drinking/psychology , Brazil/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Nurses/psychology , Physicians/psychology , Religion and Psychology , Risk Factors , Sex Factors , Smoking/epidemiology , Smoking/trends , Young AdultABSTRACT
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.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Smoking/trends , Smoking/epidemiology , Time Factors , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Interviews as Topic , Regression Analysis , Sex Distribution , Educational StatusABSTRACT
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.
Subject(s)
Smoking/epidemiology , Social Class , Adult , Chile/epidemiology , Cohort Studies , Female , Humans , Male , Prevalence , Smoking/trends , Young AdultABSTRACT
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.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Social Class , Smoking/epidemiology , Smoking/trends , Chile/epidemiology , Prevalence , Cohort StudiesABSTRACT
Introduction: Lesbian, gay, bisexual, or queer/questioning (LGBQ) microaggressions refer to often-unintentional insults, assaults, and invalidations that denigrate sexual minorities. While experiencing hostile discrimination and violence has previously been associated with elevated rates of smoking cigarettes for LGBQ college students, the relationship between LGBQ microaggressions and smoking is unknown. Methods: Data from a national anonymous online survey of sexual and gender minority college students were used to examine the relationship between past month cigarette smoking and interpersonal LGBQ microaggressions. Multivariable logistic regression assessed the relationship between smoking and frequent (chronic) experiences of microaggressions, using a hierarchical procedure to control for demographics, predictors of smoking, and academic factors. Results: Past year frequent LGBQ microaggression was reported by 48% of respondents and was more common among students who smoked in past 30 days. Experiencing past year physical violence was reported by 15% and did not differ by smoking status. Past year frequent experience of microaggressions was associated with increased odds of 1.72 (95% CI 1.03-2.87) for past 30-day smoking after adjusting for age, gender, race, socioeconomic indicators, alcohol misuse, physical violence, as well as academic stress and engagement. Conclusions: The results indicate that frequently experiencing LGBQ microaggressions is a risk factor for LGBQ college students smoking cigarettes. The mechanisms underlying this relationship require additional research, as does identifying positive coping strategies and institutional strategies to address LGBQ microaggressions on campuses. Tobacco control efforts should consider the impact of microaggression on the social environment for the prevention and treatment of tobacco use among LGBQ individuals. Implications: Microaggressions related to sexual minority identity include subtle forms of discrimination experienced during daily interactions that can create hostile and stressful social environments for a socially disadvantaged group. Prior research has demonstrated that LGBQ college students have higher rates of cigarette smoking, and that experiencing identity-based violence is a risk factor. This study revealed that experiencing frequent LGBQ microaggressions on college campus is associated with increased likelihood of current smoking among LGBQ college students.
Subject(s)
Aggression/psychology , Sexual and Gender Minorities/psychology , Smoking/psychology , Smoking/trends , Students/psychology , Universities/trends , Adolescent , Adult , Crime Victims/psychology , Cross-Sectional Studies , Female , Hostility , Humans , Male , Sexual Behavior/psychology , Smoking/epidemiology , Violence/psychology , Violence/trendsABSTRACT
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.
Subject(s)
Smoking/trends , Tobacco Use Cessation/methods , Harm ReductionABSTRACT
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.
Subject(s)
Smoking/epidemiology , Smoking/trends , Tobacco Use/epidemiology , Tobacco Use/trends , Adolescent , Adult , Age Distribution , Aged , Brazil/epidemiology , Educational Status , Female , Health Surveys/methods , Humans , Male , Middle Aged , Prevalence , Risk Factors , Sex Factors , Telephone , Young AdultABSTRACT
Mexican immigrants have lower smoking rates than US-born Mexicans, which some scholars attribute to health selection-that individuals who migrate are healthier and have better health behaviors than their non-migrant counterparts. Few studies have examined smoking selectivity using binational data and none have assessed whether selectivity remains constant over time. This study combined binational data from the US and Mexico to examine: 1) the extent to which recent Mexican immigrants (<10years) in the US are selected with regard to cigarette smoking compared to non-migrants in Mexico, and 2) whether smoking selectivity varied between 2000 and 2012-a period of declining tobacco use in Mexico and the US. We combined repeated cross-sectional US data (n=10.901) on adult (ages 20-64) Mexican immigrants and US-born Mexicans from the 1999/2000 and 2011/2012 National Health Interview Survey, and repeated cross-sectional Mexican data on non-migrants (n=67.188) from the 2000 Encuesta Nacional de Salud and 2012 Encuesta Nacional de Salud y Nutrición. Multinomial logistic regressions, stratified by gender, predicted smoking status (current, former, never) by migration status. At both time points, we found lower overall smoking prevalence among recent US immigrants compared to non-migrants for both genders. Moreover, from the regression analyses, smoking selectivity remained constant between 2000 and 2012 among men, but increased among women. These findings suggest that Mexican immigrants are indeed selected on smoking compared to their non-migrating counterparts, but that selectivity is subject to smoking conditions in the sending countries and may not remain constant over time.
Subject(s)
Emigrants and Immigrants/statistics & numerical data , Health Behavior , Smoking/epidemiology , Adult , Age Factors , Female , Humans , Male , Mexico/epidemiology , Mexico/ethnology , Prevalence , Risk Factors , Sex Factors , Smoking/trends , United States/epidemiologyABSTRACT
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.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Smoking/trends , Smoking/epidemiology , Tobacco Use/trends , Tobacco Use/epidemiology , Telephone , Brazil/epidemiology , Sex Factors , Prevalence , Risk Factors , Health Surveys/methods , Age Distribution , Educational Status , Middle AgedABSTRACT
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.
Subject(s)
Adolescent Behavior , Alcohol Drinking/trends , Illicit Drugs , Risk-Taking , Sexual Behavior/statistics & numerical data , Smoking/trends , Adolescent , Alcohol Drinking/epidemiology , Brazil/epidemiology , Cohort Studies , Cross-Sectional Studies , Female , Humans , Male , Prevalence , Sex Factors , Smoking/epidemiology , Socioeconomic FactorsABSTRACT
OBJECTIVES: To assess socioeconomic and ethnic inequalities in smoking during pregnancy over three decades (1982-2011). SETTING: Population-based study in Pelotas City, Brazil. PARTICIPANTS: All urban women giving birth in the city hospitals in 1982 (5909), 1993 (5223) and 2004 (4201), plus all urban and rural women delivering from January 2011 to April 2012 (6275). PRIMARY OUTCOME: Self-reported smoking during pregnancy. RESULTS: The prevalence of smoking during pregnancy fell from 35.7% in 1982 to 21.0% in 2011. In each survey, prevalence decreased with increasing income (p<0.001). In the poorest quintile, smoking fell by 27.4% in the period studied compared to 67.1% in the wealthiest quintile. In all surveys, prevalence was lower among white women than among those who classified themselves as black or brown (p<0.001). Over time, smoking declined by 50.0% among the former and 30.7% among the latter. Absolute and relative inequalities both increased over time. CONCLUSIONS: The reduction in smoking during pregnancy was primarily due to a decline among white, high-income women. Further efforts are needed to reduce smoking among all population groups.
Subject(s)
Ethnicity/statistics & numerical data , Income/statistics & numerical data , Pregnancy Complications/epidemiology , Smoking/epidemiology , Adult , Black People/statistics & numerical data , Brazil/epidemiology , Female , Humans , Pregnancy , Pregnancy Complications/ethnology , Prevalence , Smoking/ethnology , Smoking/trends , White People/statistics & numerical data , Young AdultABSTRACT
In this narrative review, we explore the history of tobacco smoking, its associations and portrayal of its use with luxury and glamour in the past, and intriguingly, its subsequent transformation into a mass consumption industrialized product encouraged by advertising and film. Then, we describe the next phase where tobacco in parts of the world has become an unwanted product. However, the number of smokers is still increasing, especially in new markets, and increasingly younger individuals are being attracted to it, despite the well-known health consequences of tobacco use. We also explore current smoking behaviors, looking at trends in the prevalence of consumption throughout the world, discrimination against smokers, light and/or intermittent smokers, and the electronic cigarette (e-cigarette). We place these changes in the context of neuroscience, which may help explain why the cognitive effects of smoking can be important reinforcers for its consumption despite strong anti-smoking pressure in Western countries.
Subject(s)
Smoking/epidemiology , Smoking/psychology , Social Stigma , Brain/drug effects , Cognition/drug effects , Electronic Nicotine Delivery Systems/psychology , Electronic Nicotine Delivery Systems/statistics & numerical data , History, 16th Century , History, 17th Century , History, 20th Century , History, 21st Century , History, Ancient , Humans , Nicotine/pharmacology , Smoking/history , Smoking/trendsABSTRACT
OBJECTIVE: To describe trends, correlates of use and consumer perceptions related to the product design innovation of flavour capsules in cigarette filters. METHODS: Quarterly surveys from 2012 to 2014 were analysed from an online consumer panel of adult smokers aged 18-64, living in the USA (n=6865 observations; 4154 individuals); Mexico (n=5723 observations; 3366 individuals); and Australia (n=5864 observations; 2710 individuals). Preferred brand varieties were classified by price (ie, premium; discount) and flavour (ie, regular; flavoured without capsule; flavoured with capsule). Participants reported their preferred brand variety's appeal (ie, satisfaction; stylishness), taste (ie, smoothness, intensity), and harm relative to other brands and varieties. GEE models were used to determine time trends and correlates of flavour capsule use, as well as associations between preferred brand characteristics (ie, price stratum, flavour) and perceptions of relative appeal, taste and harm. RESULTS: Preference for flavour capsules increased significantly in Mexico (6% to 14%) and Australia (1% to 3%), but not in the USA (4% to 5%). 18-24â year olds were most likely to prefer capsules in the USA (10%) and Australia (4%), but not Mexico. When compared to smokers who preferred regular brands, smokers who preferred brands with capsules viewed their variety of cigarettes as having more positive appeal (all countries), better taste (all countries), and lesser risk (Mexico, USA) than other brand varieties. CONCLUSIONS: Results indicate that use of cigarettes with flavour capsules is growing, is associated with misperceptions of relative harm, and differentiates brands in ways that justify regulatory action.
Subject(s)
Consumer Behavior , Flavoring Agents/administration & dosage , Smoking/psychology , Smoking/trends , Taste Perception , Taste , Tobacco Products , Adolescent , Adult , Australia , Commerce , Female , Flavoring Agents/adverse effects , Flavoring Agents/economics , Health Behavior , Health Knowledge, Attitudes, Practice , Humans , Male , Mexico , Middle Aged , Product Labeling , Risk Assessment , Smoking/adverse effects , Smoking/economics , Surveys and Questionnaires , Time Factors , Tobacco Products/adverse effects , Tobacco Products/economics , United States , Young AdultABSTRACT
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 20072008 (JHLS-II) and included participants who were 2574 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.
Subject(s)
Humans , Male , Female , Smoking/trends , Nicotiana , JamaicaABSTRACT
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)
Subject(s)
Humans , Male , Female , Smoking , Tobacco Use Cessation , Self Efficacy , Smoking/adverse effects , Smoking/epidemiology , Smoking/mortality , Smoking/prevention & control , Smoking/psychology , Smoking/trends , Smoking/therapyABSTRACT
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 0.941.01, 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 0.961.06 (Table 5), whereas former and never smokers' mortality declined...
Subject(s)
Smoking/trends , Acute Coronary SyndromeABSTRACT
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.