E-cigarette awareness and use, among adult residents in Shanghai, China.

INTRODUCTION: The widespread popularity of e-cigarettes is considered an important public health concern. However, only some studies have investigated the prevalence of e-cigarette use in Shanghai, China. Research on the perceived harmfulness of e-cigarettes and public support for e-cigarette regulations in China is limited. This study aimed to estimate e-cigarette awareness, prevalence, and associated factors among adults in Shanghai, China. METHODS: This study used data from a representative survey conducted in Shanghai, China, in 2019. The survey was conducted at 64 surveillance points in Shanghai, China, using a multistage, stratified, cluster-randomized sampling design, recruiting community-based Chinese adults aged ≥15 years. Based on the principles outlined in the Global Adult Tobacco Survey (GATS) China Project, data were collected by conducting face-to-face interviews in households. Of the 3200 selected households, 3060 people completed the individual survey. The overall response rate was 97.4%. RESULTS: In all, 72.3% of the respondents had heard of e-cigarettes. The respondents who had used e-cigarettes at some point in their life, used them in the last 12 months, and used them currently were 5.8%, 2.6%, and 1.3%, respectively. Among adult residents who had heard of e-cigarettes, 38.2% thought they were less harmful than traditional cigarettes. The respondents who perceived e-cigarettes as more harmful than traditional cigarettes were less likely to have ever used e-cigarettes (AOR=0.2; 95% CI: 0.1-0.5, p=0.0015) and more likely to support incorporating e-cigarettes into the regulation of smoking control (AOR=3.9; 95% CI: 1.8-8.6, p=0.0008). CONCLUSIONS: Our findings reveal that the awareness about e-cigarettes was high, and the prevalence of e-cigarette use was similar to the findings from previous studies in China. The harmful perception of e-cigarettes warrants further attention from public health practitioners.

Adult Secondhand Smoke Exposure - Shanghai Municipality, 2018.

WHAT IS ALREADY KNOWN ON THIS TOPIC?: The average secondhand smoke exposure rate was 68.1% in China in 2018. The World Health Organization suggests that legislation must be used to achieve a 100% smoke-free environment and protect nonsmokers from secondhand smoke. WHAT IS ADDED BY THIS REPORT?: This study showed that the implementation of the Amendment Regulations on Smoking Control in Public Places of Shanghai had a significant effect on reducing the exposure rate of secondhand smoke. The rate in 2018 was 46.7%, which was significantly lower than that (58.5%) before implementation in 2016. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Considering the high exposure and the harm of secondhand smoke in China, it is necessary to promote smoke-free legislation and enforce tobacco control measures.

Comparison of the Geriatric Depression Scale-15 and the Patient Health Questionnaire-9 for screening depression in older adults.

AIM: To examine the reliability and validity of the Geriatric Depression Scale-15 (GDS-15) and the Patient Health Questionnaire-9 (PHQ-9) for evaluating depression in older adults. METHODS: A total of 1546 participants aged ≥60 years were investigated face-to-face with the PHQ-9 and GDS-15 anonymously. Internal consistency reliability was evaluated with Cronbach's α, and structural equation modeling was used to study the construct validity of the scale. Logistic regression was used to discusses the impact of demographic characteristics on the scale. RESULTS: The consistency rate between the GDS-15 and PHQ-9 was 96.10%. The Cronbach's α and split-half reliability in the scales were >0.7. The model fit indices χ2 /df., comparative fit index and root mean square error of approximation in the GDS-15 were 2.769, 0.815 and 0.077, respectively. The minimum fit function χ2 in the PHQ-9 model was 93.742, with 27 df., the comparative fit index was acceptably low (comparative fit index 0.837) and the root mean square error of approximation was acceptably high (root mean square error of approximation 0.118). Item standardized path regression coefficients of the GDS-15 model varied between 0.07 and 0.76, among which the coefficients of item 2 and item 9 were 0.12 and 0.07, respectively. Whereas in the PHQ-9, the item standardized path regression coefficients were high (r > 0.45), except for item 3 (r = 0.34). The GDS-15 was affected by urban-rural distribution (OR = 2.104, P = 0.027), whereas the PHQ-9 was affected by sex (OR = 4.266, P = 0.007). CONCLUSIONS: The similar psychometric performance of the PHQ-9, along with its ease of use and relative brevity, makes it attractive compared with the longer GDS-15 for use in Chinese older adults, whereas the influence of sex distribution on the PHQ-9 should be paid attention to. Geriatr Gerontol Int 2020; 20: 138-143.

A case-control study of association between e-cigarettes with smoking tendency in adolescents / 中国学校卫生

Objective@#To investigate the influencing factors of smoking tendency of adolescents and to analyze the influence of e-cigarette on smoking tendency of teenagers and the possible interaction, to provide evidence for tobacco control measures.@*Methods@#Stratified multistage cluster probability sampling method was used to select 6 178 students from junior middle school, high school and vocational high school students in Shanghai for questionnaire survey from September to October 2019. Students with smoking tendency were taken as case group, adolescents with same sex and similar age(within 1 year) were mathed in 1∶3 ratio. A total of 631 adolescents with smoking tendency and 1 870 non-smoking tendency were included in the study. Conditional Logistic regression was used to analyze the influencing factors and possible interactions.@*Results@#After adjusting gender, age and other covariates, conditional Logistic analysis results showed that the smoking tendency of middle school students was associated with factors such as their friends smoking, trying cigarettes and trying e-cigarettes. The OR value and 95%CI were 3.26(2.47-4.29), 5.90(3.76-9.24), and 3.28(2.11-5.10), respectively. The interaction analysis results showed that the OR value and 95%CI of the multiplying interaction between friends smoking and trying e-cigarettes, trying smoking and trying e-cigarettes were 8.62(4.90-15.17) and 12.01(6.02-23.95), respectively. There was no additive interaction.@*Conclusion@#Tobacco control interventions, such as e-cigarette harm publicity and peer education, can help to change teenagers smoking tendency and further reduce their tobacco use rate.

Dynamic development of metabolic syndrome and its risk prediction in Chinese population: a longitudinal study using Markov model.

BACKGROUND: With the increasing prevalence of metabolic syndrome (MS), there is a need to track and predict the development of MS. In this study, we established a Markov model to explore the natural history and predict the risk of MS. METHODS: A total of 21,777 Chinese individuals who had at least two consecutive health check-ups between 2010 and 2015 were studied. MS was defined using the Chinese Diabetes Society criteria. Twelve metabolic abnormal states (the no component state, four isolated component states, six 2-component states, and the MS state) were contained in each Markov chain. The transition probability was the mean of five probabilities for the transition between any two states in 2 consecutive years. RESULTS: The dyslipidemia or overweight/obesity components were most likely to initiate the progress of MS in individuals aged 18-49. However, for individuals over 50 years old, the most likely initiating component of MS was dyslipidemia or hypertension. People who initially had dyslipidemia were most likely to develop the combined state of dyslipidemia with overweight/obesity before the age of 50, but after 50 years of age, the state of dyslipidemia merged with hypertension was the most common. Subjects (with the exception of males over 50 years of age who initially had an isolated state of hyperglycemia) who initially had an isolated state of overweight/obesity, hypertension, or hyperglycemia were most likely to develop a combination of one of these initial states with dyslipidemia. Males who initially had isolated hyperglycemia tended to develop hypertension after age 50. There was a greater chance for subjects who initially had an isolated hyperglycemia state or 2-component state that contained hyperglycemia to develop MS within 10 years compared to those who initially had other abnormal metabolic states. CONCLUSIONS: The occurrence of MS primarily began with overweight/obesity or dyslipidemia in people aged 18-49. However, for those over 50 years old, MS primarily initiated under the conditions of dyslipidemia or hypertension. When MS started under the conditions of overweight/obesity, hypertension or hyperglycemia, dyslipidemia tended to occur next. People who initially had isolated hyperglycemia or a 2-component state that contained hyperglycemia had a higher risk of developing MS than those with other initiating states.