Search Results (204)

Background: School-based tobacco control policies are critical for preventing youth tobacco use. While many districts adopt formal policies to create smoke- and vape-free environments, the degree to which these policies are enforced at the school level may vary, influencing their effectiveness. Little is known about how consistently such policies are implemented across schools within urban school districts. Objectives: This study aimed to examine the existence and enforcement of school-level tobacco control policies in an urban public school system, using Baltimore City schools as a case example. Methods: We conducted a survey of school personnel from 20 high schools in Baltimore City in 2024. The survey instrument assessed the presence and enforcement of policies related to tobacco use prevention, communication, signage, disciplinary actions, and institutional support. Descriptive statistics (frequencies and percentages) were used to summarize responses. Spearman correlations were also used for bivariate correlations. Additional school-level and neighborhood-level contextual data were collected from the internet (neighborhood socioeconomic status and school performance). Results: While many policies existed across the 20 participating schools, their enforcement was widely inconsistent. Most schools reported the existence of policies prohibiting tobacco use in school buildings (60%) and vehicles (55%). However, few schools had visible tobacco-free signage (35%) or offered cessation programs (15%). Communication of policies to students (70%) and staff (65%) was the most commonly enforced aspect of tobacco control policies. Conclusions: Findings suggest that while tobacco control policies may be adopted across urban school systems, their enforcement at the school level remains uneven. Greater attention may be needed to support policy implementation and to reduce variability in school-level practices. Baltimore City serves as a useful case study to understand these challenges and identify opportunities for strengthening school-based tobacco prevention efforts. Full article

Background/Objectives: Laryngeal cancer (LC) accounts for 1–3% of all malignant neoplasms. The aim of this study was to analyze temporal trends in the incidence and mortality of LC in Central Serbia over a 25-year period (1999–2023). Methods: Data on newly diagnosed cases and deaths, stratified by sex and age group, were obtained from the Serbian Cancer Registry. Crude, age-specific, and age-standardized incidence and mortality rates were calculated. Joinpoint regression analysis was used to estimate average annual percent changes (AAPCs) and assess their statistical significance. Results: The average annual age-standardized incidence rate (ASR-W) was 11.1 per 100,000 in men and 1.4 in women, with corresponding mortality rates of 5.4 and 0.5, respectively. The highest incidence was observed in the 60–69 age group for both sexes (61.1/100,000 in men; 7.4/100,000 in women), while the highest mortality was recorded in individuals aged ≥70 (35.7/100,000 in men; 3.8/100,000 in women). A statistically significant annual decline among men was observed in both incidence (ASR-W: −0.7%) and mortality (ASR-W: −2.0%). In contrast, trends among women were not statistically significant, indicating overall stability. Conclusions: Although the Cancer Registry in Serbia faces limitations primarily due to data quality issues, it is a key tool for understanding LC trends, guiding health policies, and effectively allocating resources. Given the substantially higher burden among men, it is essential to strengthen tobacco and alcohol control, improve occupational safety, and promote early detection and timely treatment to reduce the disease burden. Full article

Tobacco control policies have aimed to reduce the global prevalence of smoking. Unfortunately, the recent survey data shows that about 24% of Europeans still smoke. Although combustible cigarettes remain the most used tobacco product, the tendency made evident in the prevalence of smoking-alternative nicotine-containing products increases. Studies that can objectively assess the long-term health effects of the latter products are lacking, so assessing toxic substances associated with smoking-alternative products and comparing them to substances from combustible cigarettes could inform future public health efforts. The manufacturers of these alternative products claim that the use of alternatives to combustible cigarettes reduces exposure to toxic compounds, but the reality is unclear. This study compares the concentrations of toxic substances in generated aerosols and performs calculations based on mainstream cigarette smoke and aerosols from smoking-alternative products. It summarizes the amounts of harmful and potentially harmful constituents per single puff. Alternative smoking products are undoubtedly harmful to non-smokers. Still, based on the analysis of the latest independent studies’ empirical data, the concentrations of inhaled HPHCs using heated tobacco products or e-cigarettes are reduced up to 91–98%, respectively; therefore, for those who cannot quit, these could provide a less harmful alternative. However, more well-designed studies of alternative product emissions are needed, including an analysis of the compounds that are not present in conventional tobacco products (e.g., thermal degradation products of propylene glycol, glycerol, or flavorings) to evaluate possible future health effects objectively. Full article

Background/Objectives: Lip and oral cavity cancer (LOC) remains a critical public health challenge in Asia. This study evaluated spatiotemporal trends and risk factor contributions to LOC-related disability-adjusted life years (DALYs) from 1990 to 2021 to inform evidence-based healthcare policies. Methods: Using Global Burden of Disease (GBD) 2021 data, we analyzed LOC DALYs stratified by age, gender, risk factors (smoking, alcohol use, tobacco chewing), and subregions in Asia. Temporal trends were quantified via estimated annual percentage change (EAPC) across five geographic regions and sociodemographic index (SDI) categories. Age–period–cohort (APC) modeling was used to assess age-specific risk distributions. Results: From 1990 to 2021, Asia’s age-standardized DALY rate (ASDR) for LOC marginally increased (EAPC: 0.0883, 95% CI: 0.0802–0.0963). The alcohol-related ASDR increased sharply (EAPC: 1.033, 95% CI: 1.00–1.06), whereas decreases were detected in the smoking- and tobacco chewing-attributable ASDRs. Pronounced upward trends were observed in South Asia and low/low-middle-SDI regions. Tobacco chewing was the primary risk factor for women and for the populations in South Asia and lower-SDI regions, whereas smoking dominated among men and those in other geographic regions and in higher-SDI areas. APC analysis revealed age-driven increases in ASDR, with alcohol use and tobacco chewing risk increased with age. Notably, the steepest ASDR increase occurred in individuals aged 20–25 years. Conclusions: The LOC burden in Asia reflects divergent risk factor dynamics. Policy strategies must prioritize geographic and demographic targeting: alcohol control in rapidly developing areas and intensified tobacco cessation programs in endemic zones. Early prevention efforts focusing on adolescents and tailored to subregional risk profiles are essential to mitigate future disease burden. Full article

State preemption of local laws may impede tobacco control, yet little research has examined local policy activity before, during, and after preemption. This study addresses this gap. We summarized state laws preempting local smoke-free workplace, youth access, and licensure laws (CDC’s STATE) and local legislative activity before, during, and after preemption (Americans for Nonsmokers’ Rights Foundation) across 1999–2021. Preemption existed for smoke-free workplaces in 18 states, youth access in 21, and licensure in 13. Regarding smoke-free workplace laws, local laws were passed in 5 of 11 states with preemption throughout; among seven states with partial-period preemption, local laws were enacted before preemption or after repeal in three states but during preemption in two. Regarding youth access, localities adopted laws (e.g., addressing purchase/use/possession or e-cigarettes) in 11 of 18 states with preemption throughout; among the three states with partial-period preemption, localities passed laws before preemption in one state and during preemption in two. For licensure, localities passed laws (e.g., licensing requirements/penalties) in eight of nine states with preemption throughout and three of four states with partial-period preemption. Although state preemption reduced local activity, some localities advanced tobacco control during preemption, underscoring the need for localities to exercise autonomy permitted under preemption. Full article

Tobacco use remains a critical global health issue, with extensive research focusing on its impact on public health, particularly its strong association with oral cavity cancer. It is a leading cause of preventable disease and death worldwide, affecting millions each year. Despite increased awareness and regulatory measures, tobacco continues to pose significant challenges, prompting ongoing investigations into its health effects and related behaviors. Objective: This study aims to conduct a bibliometric analysis of smoking and smokeless tobacco research from 2014 to 2024, focusing on identifying key research trends, influential contributors, emerging topics, and collaborative networks on a global scale. Methods: A dataset of 2694 research papers from PubMed was analyzed using bibliometric tools. Keyword co-occurrence, authorship patterns, and institutional collaborations were mapped to reveal dominant themes and trends. Additionally, country-specific publications were examined to assess geographical contributions and emerging research frontiers. Results: The analysis indicates a 7.3% annual increase in publications, with a peak in 2021 likely influenced by COVID-19. Research topics have shifted from traditional tobacco-related health impacts, such as lung cancer and cardiovascular diseases, to newer areas like e-cigarettes and social determinants of health. Strong international collaborations were noted, with the U.S., China, and Europe as dominant contributors. Emerging research frontiers include electronic nicotine delivery systems and strategies aimed at controlling tobacco-related health risks. Conclusion: This bibliometric study highlights significant growth in tobacco-related research over the past decade. Evolving trends reflect a shift toward newer tobacco products and public health challenges. These findings provide valuable insights for shaping future research agendas and informing global tobacco control policies. Full article

Objectives: This study aims to examine the ecological-level association between active and passive tobacco use and periodontal disease in Latin America from 2000 to 2024. Methods: A cross-sectional ecological study was conducted using secondary data from the Global Burden of Disease Study. Data from 20 Latin American countries were analyzed, stratified by country, sex, and age group. Multiple regression models were used to assess the relationship between tobacco consumption and periodontal disease prevalence, adjusted for age and sex. Results: The prevalence of periodontal disease was high in both sexes, particularly among individuals older than 55 years. The countries with the highest age-standardized rates were Colombia, Panama, and Costa Rica, with nearly 35,000 cases per 100,000 population. Regression models indicated that passive tobacco exposure explained 90.4% of the variability in women (R² = 0.9041) and 92.5% in men (R² = 0.9253). Active tobacco use showed weaker associations, with R² values of 0.3721 in women and 0.4601 in men. Passive exposure demonstrated better predictive accuracy, with lower Root MSE values (3192.8 and 3261.7). Conclusions: There is a significant ecological-level association between tobacco use and periodontal disease in Latin America, particularly for passive exposure. These findings highlight the need to strengthen tobacco control policies and preventive strategies targeting environmental exposure. However, due to the ecological nature of the study, these associations do not imply causality at the individual level. Longitudinal studies with individual-level data are needed to explore the underlying biological and contextual factors. Full article

Background: Gastrointestinal cancer imposes a heavy public health burden worldwide. The six major subtypes of GI cancer cases accounted for over a quarter of the total cancer cases in China. We examined and predicted the amount and trend of the burden of gastrointestinal cancer in China. Methods: We collected the crude incidence rate (CIR), age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), crude DALY rate, age-standardized DALY rate, crude death rate (CDR), and age-standardized death rate (ASDR) by gender, age, and risk factors from the Global Burden of Disease 2021 database, covering the period from 1990 to 2021. We used an age–period–cohort (APC) model to calculate the age, period, and cohort effects separately and a Bayesian APC model to predict the epidemiological trends and the age-specific incidence. Results: In 2021, 1,957,948 incidence cases of gastrointestinal cancers were estimated in China, with an incidence rate of 137.62 per 100,000. The burden was notably higher for males, with tobacco use accounting for 26.48% of male GI cancer DALYs versus dietary risks (13.22%) being predominant in females. Metabolic risk factors showed concerning growth trends, with high fasting plasma glucose increasing by 166.06% in males and 275.72% in females. The age–period–cohort analysis revealed peak incidence at advanced ages (>80 years) for most GI cancers. By 2050, China’s gastrointestinal cancer burden is projected to increase substantially, with total cases reaching 2.92 (95% CI: 2.27, 3.77) million (49.06% increase) and crude incidence rate rising to 230.51 (95% CI: 178.98, 298.03) per 100,000 (a 67.49% increase), predominantly driven by colorectal cancer (41.74%) and stomach cancer (21.47%). While crude incidence rates show consistent increases across all GI cancers, particularly in males, age-standardized incidence rates are predicted to decrease for most cancer types except for male colorectal and biliary tract cancers. Conclusions: The burden of gastrointestinal cancer in China is growing rapidly and will continue to increase. The performance of ASIR indicated that population aging is a potential driver of the increasing burden. Cancer control policies should focus on older people. It is critical to distinguish prevention strategies by gender and age according to the major risk factors. Full article

Background: As tobacco is the main risk factor for oral cancer, it is important to understand the burden of this disease in light of the Framework Convention on Tobacco Control. For MERCOSUR, tobacco control is a topic of interest. The aim of this study was to describe MPOWER measure scores and to evaluate the trends in lip and oral cavity cancer (LOC) incidence, mortality and Disability-Adjusted Life Years (DALYs), from 2005 to 2021, in MERCOSUR countries. Methods: This is an ecological descriptive study, where the MPOWER measure scores were extracted from the Global Health Observatory of World Health Organization, and the Age-standardized Rates (ASRs) of LOC for MERCOSUR countries were obtained from the Global Burden of Diseases 2021 results tool. The trends of LOC ASRs were obtained using the Prais–Winsten method. Results: Paraguay and Venezuela had lower MPOWER scores over time than Argentina, Brazil and Uruguay. These last three countries showed LOC trends decreasing for most indicators among males, while Paraguay and Venezuela showed increasing trends in incidence for both males and females, and no decreasing trends. Conclusion: This study suggests that MERCOSUR countries with a history of more rigorous MPOWER tobacco control policies are exhibiting decreasing trends in LOC burden. Full article

An emerging area of research is the impact of tobacco product waste (TPW) on the environment. Waste product assessment is of great interest to public health professionals and communities, and methods to collect waste products can easily lend themselves to community participation. Indeed, waste product collection can mobilize communities, but a standard methodology for collecting and assessing waste does not exist. This study utilizes two existing protocols for TPW collections across residential environments to determine the operational usability of these methods for citizen scientists (i.e., ease, time, and process of data collection). Citizen scientists surveyed two residential areas in Central California using two debris survey protocols (A and B). After waste products were recorded, citizen scientists were interviewed on their views about and experience with both protocols. Both protocols had strengths and suggested areas of improvement. This area of investigation is well suited to the citizen scientist approach of data collection, particularly in areas with fewer available resources. Moreover, this work can be utilized to motivate tobacco control efforts by highlighting how community-based TPW collection methods can support tobacco prevention and promote effective policy enforcement, with the ultimate goal of protecting community and environmental health. Full article

The rising prevalence of diseases linked to factors such as excessive alcohol and tobacco use, sedentary lifestyles, and poor nutrition has led to a greater focus on Personal Health Promotion (PHP) as a preventive measure. PHP emphasizes improving quality of life and well-being, driven by advances in medical technology, including virtual and augmented reality. However, as PHP systems grow in popularity, concerns over personal data security, such as account theft and information breaches, have become increasingly important. To address these concerns, this study proposes a game-based personalized health promotion system that integrates Key-Policy Attribute-Based Encryption (KP-ABE), key insulation, time-bound encryption. These methods ensure data security through hierarchical access control and dynamic time management, protecting personal health records and exercise prescriptions. The system also incorporates key insulation to enhance the security of private keys. This multi-layered security approach provides a robust solution for safeguarding sensitive data within PHP systems while accommodating dynamic subscription needs and legal access requirements. Full article

This study examines the effects of the plain packaging policy implemented in Türkiye, analyzing how different demographic groups perceive health warnings on cigarette packaging. Employing advanced eye-tracking technology, the research identifies distinct visual attention patterns between smokers and non-smokers when exposed to ‘Anxiety’ and ‘Disturbing’ visual cues. Detailed metrics, including fixation counts, durations, and saccade amplitudes, are used to measure and analyze the responses of these groups to the health warnings. The findings reveal that non-smokers significantly focus more on textual warnings, suggesting that text-based elements are more impactful for this group. Conversely, smokers tend to either avoid or become desensitized to disturbing imagery. Additionally, the study finds that female participants exhibit higher saccade amplitudes compared to males, indicating a more thorough examination of the packaging. This gender-specific difference is especially pronounced in their responses to ‘Disturbing’ images, where females show greater engagement, pointing to an increased sensitivity to such stimuli. These insights not only advance our understanding of effective health communication but also underscore the importance of designing public health interventions that cater to the unique responses of different demographic groups. This research significantly enriches the field of tobacco control, providing evidence-based strategies to enhance the effectiveness of visual warnings, thereby supporting targeted smoking cessation efforts. Full article

Background: The aim of this study was to document how Mexico adopted a WHO Framework Convention on Tobacco Control (FCTC)-based national tobacco control law. Methods: We analyzed publicly available documents and interviewed 14 key stakeholders. We applied the Multiple Streams Framework (MSF) to analyze these findings. Results: Previous attempts to approve comprehensive FCTC-based initiatives failed due to a lack of political will, the tobacco industry’s close connections to policymakers, and a lack of health advocacy coordination. Applying the MSF reveals increased attention towards collecting and sharing data to frame the severity of the problem (problem stream). The expansion of a coordinated health advocacy coalition and activities led to increased support for desired FCTC policy solutions (policy stream). The election of President López Obrador and legislative changes led to a deep renewed focus on tobacco control (politics stream). These three streams converged to create a policy window to secure a strong FCTC-based initiative on the political agenda that was ultimately passed. Conclusions: The Mexican experience illustrates the importance of continued health advocacy and political will in adopting FCTC-based policies. Other countries should follow Mexico’s lead by collecting and sharing data through coordinating efforts in order to be prepared to seize political opportunity windows when strong political will is present. Full article

Tobacco use is one of the main risk factors for non-communicable diseases. Avoiding youth initiation and treating addiction are fundamental public health issues to ensure better health. Among tobacco control policies, increasing tobacco price is the single most effective intervention. It reduces tobacco consumption, especially among youths, while representing a government financing source. This study aimed to assess the agreement with the proposal of a one-euro increase in tobacco price earmarked to health issues among students at Sapienza University. Two convenience samples were surveyed, five years apart, on World No Tobacco Days. Smoking habits, agreement with the proposal and reasons for it were collected. Results from the 208 questionnaires (107 in 2014, 101 in 2019) showed 46.6% of agreement with the proposal (53.3% in 2014, 39.2% in 2019, p = 0.044). Main predictive factor for agreement was being a non-smoker (OR = 6.33 p < 0.001), main reason (64.8%) was it could trigger smokers to quit or reduce consumption. Several factors might have influenced this finding, including the introduction of novel tobacco products and their increased advertisement on social media. In 2024, European Union is planning to update the Tobacco Taxation Directive which could greatly contribute to the reduction of non-communicable diseases and premature deaths. Full article

As an important factor affecting ecological sustainability, the food industry’s ecological efficiency (EE) deserves great attention and control. In 2013, China implemented a carbon emissions trading policy (CETP) to limit carbon emissions from various industries to promote the optimization of the ecological environment. To explore the ecological sustainability of China’s food industry, identify the factors affecting the EE of the food industry, and study the influence heterogeneity and influencing mechanisms, the impact of the CETP on the food industry, which emits high volumes of greenhouse gasses, requires evaluation. Many scholars have studied the policy’s effect from the perspective of EE, but they have ignored the food industry, which is the main carbon emitting sector, and there is a lack of heterogeneity analyses of the influencing factors. This study reviewed the implementation process and characteristics of the CETP in the past decades. Using provincial panel data from 2003 to 2019, this study measured the EE in the food industry through the difference-in-difference model, evaluated the emission reduction and economic effects of the CETP on the food industry, characterized the heterogeneity of the policy’s effectiveness, and analysed its mechanism using three-stage mediating regression. The results showed that (1) the CETP significantly affected the food industry’s EE, which increased by 38.3% on average in experimental provinces compared with non-experimental provinces. (2) For the food industry, the policy’s effect was most significant in the food manufacturing and tobacco subsectors, and these subsectors in the experimental provinces increased by 66.0% and 39.7%, respectively; meanwhile, the policy’s effect was not significant in agriculture and subsidiary food processing and beverage manufacturing. By industrial area, the policy’s effects were significantly higher in the eastern region compared with the central and western regions. The influence on the food industry’s EE in the eastern region was close to 150%, while in the central and western regions, it was not significant. (3) The CETP promoted the food industry’s EE by improving energy consumption structure and technological innovation. The proportion of coal consumption decreased by 6.34% on average, and the technological innovation level increased by 25.1% on average in the experimental provinces’ food industries. The research findings indicate that the CEPT is a good practice and worth spreading. For food industry enterprises with high carbon emissions, attention should be paid to low-carbon transformation through technological upgrading and management optimization. For policymakers, targeted policies are needed to establish a national unified carbon trading market so that the national carbon emissions can be controlled, and the gap between regional carbon emissions can be narrowed. Full article