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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 26137

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Special Issue Editors

Prof. Dorota Kaleta

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Guest Editor

Department of Hygiene and Epidemiology, Medical University of Lodz, Zeligowskiego 7/9 Str., 90-752 Łódź, Poland
Interests: health promotion; tobacco; sociology of health; tobacco control; health; health education; epidemiology; epidemiology and public health; behavioral health research; metabolic syndrome; tobacco consumption monitoring and determinants; preventive measures and the promotion of tobacco-free lifestyles; smoking cessation; smoke-free legislation; policies aimed at preventing chronic diseases
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Prof. Dr. Kinga Polańska

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1. Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland
2. Department of Hygiene and Epidemiology, Medical University of Lodz, 90-419 Lodz, Poland
Interests: environmental exposure; pregnancy; birth outcomes; child health; child neurodevelopment
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Prof. Dr. Joanna Jurewicz

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Guest Editor

1. Department of Chemical Safety, Nofer Institute of Occupational Medicine, Łódź, Poland
2. Department of Toxicology, Medical University of Lodz, Łódź, Poland
Interests: occupational and environmental health issues; risk assessment of health effects of selected exposures; reproductive health; male and female fertility; exposure to endocrine disrupting chemicals
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We now know much, if not everything, about the health effects of active as well as passive smoking. However, one unsolved problem still remains in this field, which requires further research: the health effects of the use of e-cigarettes and other vaporized nicotine products. The common belief is that tobacco smoking epidemic should be limited as the sole method for avoiding the risks resulting from tobacco use. Therefore, the effectiveness of tobacco control strategies should be examined, including all legislative actions and campaigns supporting such actions. Two strategies are particularly important: firstly, aiming at prevention of smoking initiation (including identification of predictors of tobacco smoking and e-cigarette use susceptibility and effectiveness of relevant strategies); secondly, aiming at overcoming the addiction by those who smoke (effectiveness of various medications, psychotherapeutic methods, etc.). According to the World Health Organization (WHO), quitting tobacco has an immediate impact on health outcomes supporting the provision of strong cessation services.

Epidemiological studies are necessary on the popularity of active and passive smoking and using unconventional nicotine-containing products, with particular emphasis on indicating all the groups that should be reached with relevant programs. Finally, a number of other activities are crucial with regard to this issue: assessment of the health effects of smoking; examination of socio-cultural and economic determinants of health behaviors (associated with tobacco use) of the selected social groups, and their reactivity to pro-health activities; and evaluation of the effectiveness of the implemented legislation (especially against exposure to tobacco) and direct (knowledge) and long-term (beliefs, behaviors) effects of undertaken campaigns, information, and/or educational processes.

This Special Issue aims to present the diversity and progress of research in the field of tobacco health risk and tobacco control. Potential topics include, but are not limited to: tobacco health risks; tobacco consumption monitoring; e-cigarettes use health risk, smoking cessation; tobacco control.

Prof. Dorota Kaleta
Prof. Kinga Polanska
Dr. Joanna Jurewicz
Guest Editors

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Keywords

Tobacco smoking
E-cigarettes
Vaporized nicotine products
Tobacco cessation
Tobacco policy
Secondhand smoke
Nicotine
Health risk
Health effects
Tobacco-related diseases
Public health

Published Papers (9 papers)

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Research

14 pages, 1030 KiB

Open AccessArticle

Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009–2018

by Boram Sim and Myung-Bae Park

Int. J. Environ. Res. Public Health 2021, 18(17), 9284; https://doi.org/10.3390/ijerph18179284 - 02 Sep 2021

Cited by 11 | Viewed by 2101

Abstract

This study aimed to estimate the secondhand smoke (SHS) exposure using urinary cotinine (UCo) to prove that the SHS exposure could not be properly assessed by self-reporting (SR). In total, 28,574 nonsmokers aged >19 years were selected from the Korean National Health and Nutrition Examination Survey data (2009–2018). First, changes in the annual concentration of UCo were analyzed, and the annual SHS exposure rates were measured based on SR and UCo from 2009 to 2018. Then, the average UCo concentration and UCo-measured SHS exposure rate were confirmed according to the subjects’ characteristics. Finally, factors associated with the UCo-measured SHS exposure rate were identified based on multiple regression analysis. The findings showed that the annual UCo concentrations and self-reported SHS exposure rates dropped significantly over the past decade. In contrast, the UCo-measured SHS exposure rate indicated that >80% of nonsmokers are still exposed to SHS. Moreover, we found vulnerable groups using UCo-measured SHS exposure rate. In particular, the self-reported SHS exposure at home and in workplaces and house type was highly associated with SHS exposure. Thus, these findings indicate that the actual SHS exposure could not be properly assessed by SR and should be verified using a biomarker, such as UCo. Considering that even a short-term exposure can be harmful to health, the goal of the policy should be to keep cotinine concentration as low as possible. Full article

(This article belongs to the Special Issue Tobacco Health Risk)

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11 pages, 323 KiB

Open AccessArticle

Gender Differences in the Extended Theory of Planned Behaviour on Smoking Cessation Intention in Young Soldiers

by Yi-Chun Liu, Li-Chen Yen, Fang-Yih Liaw, Ming-Han Lin, Shih-Hung Chiang, Fu-Gong Lin, Ching-Huang Lai, Senyeong Kao, Yu-Tien Chang, Chia-Chao Wu and Yu-Lung Chiu

Int. J. Environ. Res. Public Health 2021, 18(15), 7834; https://doi.org/10.3390/ijerph18157834 - 23 Jul 2021

Cited by 1 | Viewed by 2067

Abstract

Background: The theory of planned behaviour (TPB) explanation of smoking cessation intentions consists of gender differences. The purpose of this study is to adopt the extended TPB to discuss factors influencing the smoking cessation intentions of young adult volunteer soldiers and to further compare the respective factors for both genders. Methods: This is a cross-sectional study. Data were collected from 139 and 165 male and female volunteer soldiers who smoked, respectively. Research participants completed a self-administered questionnaire that comprised items pertaining to the participants’ demographic characteristics, smoking behaviours, smoking cessation experiences, social environments, and TPB variables. Results: Subjective norms (friends) are a positive key factor for young adult male (β = 0.033, p = 0.012) and female (β = 0.076, p < 0.001) volunteer soldiers’ smoking cessation intentions, and perceived behavioural control is a key factor for male young (β = 0.226, p = 0.040) adult volunteer soldiers’ smoking cessation intention. The extended TPB accounted for 27.9% and 53.2% of the variance in the intention to quit smoking in the male and female volunteer soldiers, respectively. Conclusions: We suggest that smoking cessation strategies can reinforce gender-specific intervention strategies to assist young adult volunteer soldiers in smoking cessation. Full article

(This article belongs to the Special Issue Tobacco Health Risk)

8 pages, 712 KiB

Open AccessFeature PaperArticle

Persistent Misperceptions about Nicotine among US Physicians: Results from a Randomized Survey Experiment

by Michelle T. Bover Manderski, Michael B. Steinberg, Olivia A. Wackowski, Binu Singh, William J. Young and Cristine D. Delnevo

Int. J. Environ. Res. Public Health 2021, 18(14), 7713; https://doi.org/10.3390/ijerph18147713 - 21 Jul 2021

Cited by 10 | Viewed by 5434

Abstract

We conducted a survey experiment among US physicians to evaluate whether question wording impacted perceptions about the health effects of nicotine. 926 physicians were randomized to receive one of two versions of a question matrix that asked about the “extent to which they agree or disagree that ‘nicotine’ (Version 1) or ‘nicotine, on its own,’ (Version 2) directly contributes to” birth defects, cardiovascular disease (CVD), cancer, depression, and chronic obstructive pulmonary disease (COPD). We evaluated whether question condition predicted strong agreement and/or agreement with each statement, and assessed demographic correlates of each outcome while adjusting for question version. Physicians who received Version 2 were less likely to “strongly agree” that nicotine directly caused birth defects (Prevalence Ratio (PR) 0.84, 95% CI 0.72–0.98), CVD (PR 0.89, 95% CI 0.84–0.95), cancer (PR 0.81, 95% CI 0.75–0.87), and COPD (PR 0.78, 95% CI 0.72–0.84). Females were more likely to “strongly agree” that nicotine directly contributes to birth defects and cancer, and family physicians were most likely to “strongly agree” that nicotine directly contributes to CVD, cancer, and COPD. Question wording is important when measuring physicians’ beliefs about nicotine; however, even after accounting for question version, misperceptions about the direct health effects of nicotine were common and varied by sex and specialty. Full article

(This article belongs to the Special Issue Tobacco Health Risk)

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14 pages, 371 KiB

Open AccessArticle

Organizational-Level Moderators Impacting Tobacco-Related Knowledge Change after Tobacco Education Training in Substance Use Treatment Centers

by Kathy Le, Tzuan A. Chen, Isabel Martinez Leal, Virmarie Correa-Fernández, Ezemenari M. Obasi, Bryce Kyburz, Teresa Williams, Kathleen Casey, Haleem A. Brown, Daniel P. O’Connor and Lorraine R. Reitzel

Int. J. Environ. Res. Public Health 2021, 18(14), 7597; https://doi.org/10.3390/ijerph18147597 - 16 Jul 2021

Cited by 9 | Viewed by 1951

Abstract

Tobacco use is disproportionately elevated among patients with substance use disorders relative to the general U.S. population. Tobacco interventions are lacking within substance use treatment centers (SUTCs) due to lack of knowledge and training. This study examined knowledge gain and the organizational factors that might moderate knowledge gains following tobacco education training provided to employees (N = 580) within 15 SUTCs that were participating in a tobacco-free workplace program. The number of total annual patient visits, unique annual patient visits, number of full-time employees, and organizational readiness for implementing change (ORIC) as assessed prior to implementation were examined as potential moderators. Results demonstrated significant knowledge gain (p < 0.001) after training overall; individually, 13 SUTCs had significant knowledge gain (p’s < 0.014). SUTCs with fewer total annual patient visits and fewer full-time employees showed greater knowledge gains. The ORIC total score and all but one of its subscales (Resource Availability) moderated knowledge gain. SUTCs with greater initial Change Efficacy (p = 0.029), Valence (p = 0.027), and Commitment (p < 0.001) had greater knowledge gain than SUTCs with lower scores on these constructs; SUTCs with greater Task Knowledge (p < 0.001) regarding requirements for change exhibited less knowledge gain. Understanding the organizational-level factors impacting training effectiveness can inform efforts in organizational change and tobacco control program implementation. Full article

(This article belongs to the Special Issue Tobacco Health Risk)

11 pages, 569 KiB

Open AccessArticle

Exposure to Second-Hand Smoke in Public Places and Barriers to the Implementation of Smoke-Free Regulations in The Gambia: A Population-Based Survey

by Bai Cham, Noreen Dadirai Mdege, Linda Bauld, John Britton and Umberto D’Alessandro

Int. J. Environ. Res. Public Health 2021, 18(12), 6263; https://doi.org/10.3390/ijerph18126263 - 09 Jun 2021

Cited by 5 | Viewed by 2732

Abstract

Introduction: Second-hand smoke is associated with more than 1.2 million deaths per year among non-smokers. Smoking in public places is prohibited in The Gambia but there is no information on the level of exposure to second-hand smoke among adolescents and adults 15–64 years. The aim of this study was to assess the level and predictors of exposure to second-hand smoke in public places and compliance with smoke-free regulations in The Gambia. Methods: A population-based survey was conducted in an established Health and Demographic Surveillance System (HDSS). A total of 4547 participants (15–64 years) from households within the Farafenni HDSS were interviewed at their homes but only 3343 were included in our analysis. Factors associated with exposure to second-hand smoke in public places were assessed by three different multivariable regression models. Results: Exposure to tobacco smoke in public places was high (66.1%), and higher in men (79.9%) than women (58.7%). Besides being male, less education, lower household income, urban residence and not aware of smoke-free regulations were strongly associated with exposure to second-hand smoke. Conclusion: Despite existing smoke-free regulations, reported exposure to second-hand smoke remains high in public places in The Gambia. The Ministry of Health should continue to strengthen their advocacy and sensitization programs to ensure smoke-free regulations are fully implemented. Some population subgroups are at a higher risk of exposure and could be targeted by interventions; and settings where these subgroups are exposed should be targeted by enforcement efforts. Full article

(This article belongs to the Special Issue Tobacco Health Risk)

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12 pages, 353 KiB

Open AccessArticle

The Frequency of Use and Harm Perception of Heated Tobacco Products (HTPs): The 2019 Cross-Sectional Survey among Medical Students from Poland

by Paulina Majek, Mateusz Jankowski, Bartłomiej Nowak, Maksymilian Macherski, Maciej Nowak, Aleksandra Gil, Piotr Nakiela, Barbara Lewicka, Joshua Allan Lawson, Jan Eugeniusz Zejda and Grzegorz Marek Brożek

Int. J. Environ. Res. Public Health 2021, 18(7), 3381; https://doi.org/10.3390/ijerph18073381 - 24 Mar 2021

Cited by 7 | Viewed by 3704

Abstract

Heated tobacco products (HTPs) are devices for generating a nicotine aerosol by heating the tobacco sticks. This study aimed to assess (1) the prevalence of HTP and tobacco cigarette usage among medical students, (2) to characterize smoking habits and (3) to assess students’ awareness and opinions about HTPs. A cross-sectional survey on the frequency and attitudes toward cigarettes, e-cigarettes and HTP use was performed between 2019–2020 at the Medical University of Silesia in Katowice (Poland). The data were obtained from 1344 students aged 21.8 ± 1.9 years (response rate: 66.9%). Current traditional tobacco use was 13.2%, e-cigarettes use 3.5%, and HTP use 2.8% of students. Duration of use was shorter among HTPs users comparing to cigarette smokers (p < 0.001) although the number of tobacco sticks used daily was similar (p = 0.1). Almost 30% of respondents have ever tried HTPs. HTPs were considered safe by 5.3% of respondents (43.2% of HTP users vs. 3.9% of non-HTP users, p < 0.001). HTP users were more likely to report that heating tobacco is not addictive (odds ratio (OR) = 8.9, 95% confidence interval (CI): 1.8–45.8) and disagreed with a public ban on HTP use (OR = 4.9, 95%CI: 2.5–9.8). Among students, HTP use was less popular than cigarette smoking, but awareness of their presence is widespread. Full article

(This article belongs to the Special Issue Tobacco Health Risk)

7 pages, 334 KiB

Open AccessCommunication

Cigarette, E-Cigarette and Waterpipe Use among Young Adults: Differential Cognitions about These Three Forms of Smoking

by Mark J.M. Sullman, Maria-Eugenia Gras, Antonios Kagialis, Ioulia Papageorgi and Sílvia Font-Mayolas

Int. J. Environ. Res. Public Health 2020, 17(11), 3787; https://doi.org/10.3390/ijerph17113787 - 27 May 2020

Cited by 6 | Viewed by 2075

Abstract

Background: Polytobacco use is common among young adults. The purpose of the present study was to investigate a number of cognitions related to the use of three tobacco products (cigarettes, e-cigarettes and waterpipes) among young adults. Methods: Participants (n = 799, 59.4% women) aged 18–25 years old (M = 21.8, SD = 1.7) completed an online tobacco cognitions questionnaire. Results: For all three tobacco products, there was significantly more agreement with the cognition “I would smoke if my best friend offered” among tobacco users (used one or more tobacco products) than among non-users. For e-cigarettes and waterpipes, there was significantly more agreement with the cognition “It would be easy to quit these products” than was reported by non-users. Polytobacco users (three tobacco products) endorsed the cognitions scale (the six cognition items were combined to form a single cognitions scale for each tobacco product) significantly more than non-users for cigarettes and e-cigarettes. Furthermore, waterpipe users, polytobacco users, dual users and single users all endorsed the combined cognitions scales more strongly than non-users. Conclusions: Efforts to prevent polytobacco use should ensure that young adults have the necessary self-efficacy to resist peer pressure and provide them with clear information about the health risks associated with using alternative tobacco products. Full article

(This article belongs to the Special Issue Tobacco Health Risk)

12 pages, 311 KiB

Open AccessArticle

Connectivity of Real-Time Video Counselling Versus Telephone Counselling for Smoking Cessation in Rural and Remote Areas: An Exploratory Study

by Judith Byaruhanga, Christine L. Paul, John Wiggers, Emma Byrnes, Aimee Mitchell, Christophe Lecathelinais and Flora Tzelepis

Int. J. Environ. Res. Public Health 2020, 17(8), 2891; https://doi.org/10.3390/ijerph17082891 - 22 Apr 2020

Cited by 6 | Viewed by 2796

Abstract

This study compared the connectivity of video sessions to telephone sessions delivered to smokers in rural areas and whether remoteness and video app (video only) were associated with the connectivity of video or telephone sessions. Participants were recruited into a randomised trial where two arms offered smoking cessation counselling via: (a) real-time video communication software (201 participants) or (b) telephone (229 participants). Participants were offered up to six video or telephone sessions and the connectivity of each session was recorded. A total of 456 video sessions and 606 telephone sessions were completed. There was adequate connectivity of the video intervention in terms of no echoing noise (97.8%), no loss of internet connection during the session (88.6%), no difficulty hearing the participant (88.4%) and no difficulty seeing the participant (87.5%). In more than 94% of telephone sessions, there was no echoing noise, no difficulty hearing the participant and no loss of telephone line connection. Video sessions had significantly greater odds of experiencing connectivity difficulties than telephone sessions in relation to connecting to the participant at the start (odds ratio, OR = 5.13, 95% confidence interval, CI 1.88–14.00), loss of connection during the session (OR = 11.84, 95% CI 4.80–29.22) and hearing the participant (OR = 2.53, 95% CI 1.41–4.55). There were no significant associations between remoteness and video app and connectivity difficulties in the video or telephone sessions. Real-time video sessions are a feasible option for smoking cessation providers to provide support in rural areas. Full article

(This article belongs to the Special Issue Tobacco Health Risk)

11 pages, 303 KiB

Open AccessArticle

Organizational and Financial Analysis of Polish Tobacco Control Program in 2000–2018

by Łukasz Balwicki, Anna Tyrańska-Fobke, Małgorzata Balwicka-Szczyrba, Marlena Robakowska and Michal Stoklosa

Int. J. Environ. Res. Public Health 2020, 17(7), 2532; https://doi.org/10.3390/ijerph17072532 - 07 Apr 2020

Cited by 2 | Viewed by 2189

Abstract

In accordance with the provisions of the WHO Framework Convention on Tobacco Control (FCTC), each country shall promote and strengthen public awareness of tobacco control issues (Article 12). Many parties to the FCTC have adopted national tobacco control programs to organize their tobacco control activities. The aim of our study was to analyze the organization and funding of the Polish Tobacco Control Program in years 2000–2018. Document analysis of The Program and reports from its implementation were performed in accordance to the Agency for Health Technology Assessment in Poland (AHTAPol) recommendations and the WHO FCTC guidelines for Article 12 implementation. Spending was also analyzed. The study showed both inadequate planning of and funding for Polish Tobacco Control Program. The Program was developed without use of best practices detailed in the WHO FCTC guidelines as well as in national guidelines prepared by AHTAPol. The experience of Poland shows that although earmarking tobacco taxes has existed in the law, it has been largely ineffective due to the poor Tobacco Control Program design and insufficient funding resulting from a poor execution of the earmarking law. This may be a warning to other countries to strive to create law, compliance with which can be verified and controlled. Full article

(This article belongs to the Special Issue Tobacco Health Risk)

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