Search Results (38)

Background: This review examines the prevalence of substance abuse and related disorders in South Pacific nations. Methods: The review focused on data included in reports published since 2000 from countries like Samoa, Papua New Guinea, Fiji, and French Polynesia, excluding Hawaii, New Zealand, Australia, and American Samoa. Prevalence studies indexed in Medline, CINAHL, PsycInfo, Embase, and Cochrane were screened and retrieved. Joanna Briggs Institute critical appraisal tools were used to assess included studies. Results: Ten studies with diverse methods, such as national surveys, were analysed. Results show high variability in prevalence across countries, sexes, and ethnicities. Notably, tobacco and betel nut use are prevalent. Indigenous populations and men face higher SUD burdens. Discussion: inconsistencies in study methods and reliance on self-reporting limit direct comparison. Data on co-occurring disorders and polysubstance use are limited, highlighting research gaps. The review emphasises the need for culturally sensitive, standardised research to monitor emerging trends like synthetic drug use. Policy suggestions call for targeted interventions and improved surveillance to reduce disparities and support vulnerable populations in Pacific Island communities. Full article

Background: While tobacco smoke remains a leading modifiable risk factor for urologic cancers, comprehensive assessments in BRICS countries are scarce. We aimed to quantify the burden of kidney, prostate, and bladder cancers attributable to tobacco exposure from 1990 to 2021 in BRICS countries. Methods: We estimated tobacco-attributable deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for kidney, prostate, and bladder cancers in BRICS nations using data from the Global Burden of Disease Study 2021. The data were stratified by sex, age, and sociodemographic index (SDI) and analyzed for temporal trends using the estimated annual percentage change (EAPC). Forecasts until 2050 were produced using autoregressive integrated moving average (ARIMA) modeling. Results: In 2021, tobacco-related genitourinary cancers caused approximately 85,000 deaths and 1.8 million DALYs in BRICS countries. While age-standardized DALY rates declined in most countries, absolute burdens rose due to aging and population growth. Bladder cancer contributed the greatest burden, with notable sex disparities: males experienced significantly higher rates across all three cancers. Russia and South Africa had the highest age-standardized rates, while China and India bore the largest absolute burdens. YLLs dominated the total burden, but YLDs increased faster over time, indicating a growing need for survivorship care. Conclusion: Despite some progress in reducing age-standardized rates, tobacco-attributable urologic cancer burdens continue to rise in BRICS countries. Targeted tobacco control, early detection, and long-term survivorship care are essential to mitigate future impacts. Full article

Background: Tobacco use, and particularly cigarette smoking, is elevated among patients with substance use disorders (SUDs), resulting in health inequities. In rural and medically underserved areas (MUAs), healthcare access is limited; thus, patients with SUDs may receive care in substance use treatment centers (SUTCs) and/or medical healthcare centers (MHCs). Healthcare providers in these settings should know the importance and benefits of quitting tobacco use for patients with SUDs, as this is essential for effective cessation care. This study examined baseline provider knowledge/training receipt and knowledge gains following training in SUTCs and MHCs serving rural and MUAs of Texas, USA. Methods: From 2021 to 2024, 428 providers from 8 SUTCs and 8 MHCs completed an e-survey on tobacco knowledge and past-year training. They then completed 1 to 1.5 h of training. Knowledge gain was assessed via a 10-item test delivered pre- and post-training. Results: Pre-training knowledge and past-year training rates were low across settings; providers at SUTCs were more likely than those at MHCs to know that persons with behavioral disorders like substance misuse are 2 times more likely to smoke than the general USA population. Both groups demonstrated significant knowledge gains from training (SUTCs: 37.41% and MHCs: 45.92% increases; ps < 0.0001). Conclusions: Findings support the need for routine tobacco training in healthcare centers serving rural and MUAs of Texas. Brief educational sessions may help address provider knowledge gaps and, ultimately, strengthen cessation care and reduce tobacco-related disparities in these settings. Full article

Asthma is a chronic respiratory disease resulting from a complex interplay of genetic, environmental, and occupational factors. Key environmental risks include exposure to tobacco smoke and respiratory sensitizing agents, many of which are prevalent in workplace settings. In adults, asthma is associated with reduced employment, job instability, and work-related disability, resulting in significant social and economic consequences. This scoping review investigates the role of exposure to respiratory sensitizers in the onset and progression of asthma, considering data from the general population to occupational settings, with a focus on sex and gender as key modifiers of risk, disease severity, and occupational outcomes. Biological studies were also considered to clarify the mechanisms underlying observed sex/gender differences. Epidemiological data indicate that women are disproportionately affected by asthma, experiencing more severe symptoms, higher comorbidity rates, and increased exposure in certain professions such as healthcare, cleaning, and textile work. These disparities are attributed to both sex-related factors (e.g., hormonal influences) and gender-related factors (e.g., occupational roles, smoking habits). Although traditional job roles are changing, women continue to face greater occupational asthma risks. As roles evolve, physiological sex-based differences may become increasingly relevant in shaping asthma susceptibility. This review emphasizes the need for sex- and gender-sensitive strategies in asthma prevention, surveillance, and management, especially in occupational health contexts. Full article

Background: Youth tobacco use remains a significant public health concern, particularly in urban communities disproportionately burdened by health disparities. In Baltimore City, where tobacco-related harms are elevated, understanding the relationship between tobacco use—including e-cigarettes—and mental health among high school students is essential for guiding equitable prevention and cessation strategies. The CEASE (Communities Engaged and Advocating for a Smoke-free Environment) program, in collaboration with the American Lung Association’s Not On Tobacco (N-O-T) initiative, developed an online school-based survey to inform community-responsive interventions. Aims: This study aimed to examine the associations between cigarette use, including conventional cigarette use, and self-rated mental health among high school students in Baltimore City. Methods: High school students in Baltimore City completed an anonymous online survey that assessed demographic characteristics, tobacco knowledge and use, mental health, and related behaviors. Self-rated mental health was dichotomized as poor versus fair/good. Tobacco use categories included current use of e-cigarettes and conventional cigarettes. Logistic regression models were used to examine associations between tobacco use and self-rated mental health, adjusting for age, gender, race, and parental education. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Results: No statistically significant associations were found between self-rated mental health and e-cigarette use and conventional tobacco use after adjusting for covariates. Conclusions: The absence of a significant association may reflect unique aspects of the social context in Baltimore City, where youth may not use tobacco products as a coping mechanism for mental health challenges. Alternatively, it may be due to limitations in measurement, particularly the use of a single-item mental health assessment. These findings should be considered preliminary. Future research using more comprehensive mental health measures and larger samples is warranted to further explore these complex relationships. Full article

Background: Tobacco use remains a global challenge to public health, accounting for almost eight million deaths per year worldwide, with a significant portion attributable to tobacco-related cancers. Examining the epidemiology of tobacco-related cancers and assessing the trends in the incidence and mortality will allow for more effective prevention, treatment, and targeted strategies. Methods: We assessed the trends in the incidence and mortality of tobacco-related cancers among adults in the United States using data from United States Cancer Statistics (USCS) 2001–2021 and mortality data 1975–2022 from the National Center for Health Statistics (NCHS). The incidence and mortality rates of tobacco-related cancers were calculated as cases per 1,000,000 persons and age-adjusted to the 2000 United States standard population. Results: There was a recent overall decreasing trend in both the incidence (2001–2021) and mortality rate (2001–2022). Among adults 20–49 years old, there was an increasing trend from 2001 to 2021 in the incidence among non-Hispanic American Indians/Alaska Natives (APC 2.6, 95% CI 2.1–3.0) and those in the West (APC 0.2, 95% CI 0.0–0.4); in Hispanics, the incidence rate increased most recently from 2013 to 2021 (APC 1.7, 95% CI 1.0–3.0). The mortality rate first increased from 1975 to 1990 among females 50–64 years old and males 65+ years old and from 1975 to 2000 among females 65+ years old, and then decreased thereafter. Conclusions: The rising incidence in some younger groups highlights the need for targeted public health interventions to address disparities and improve cancer prevention in these vulnerable populations. Full article

Background/Objectives: Despite national efforts, smoking rates during pregnancy remain high among certain demographics, particularly American Indian/Alaska Native and younger women. This study examines the causal link between maternal smoking, maternal and fetal mortality, and social determinants of health, highlighting disparities faced by Black, Indigenous, and People of Color (BIPOC) and American Indian/Alaskan Native (AIAN) pregnant persons. Methods: Data from various sources, including national reports and committee findings, were analyzed to assess trends in maternal smoking, mortality rates, and associated factors. While smoking rates among all groups have declined, disparities persist. Young women, BIPOC, and American Indian/Alaska Native women, and those with lower educational attainment, have higher smoking rates. Black women exhibit significantly higher maternal mortality rates, often linked to cardiac/coronary conditions. Stress, exacerbated by social determinants of health like poverty and housing insecurity, emerges as a key factor driving smoking behavior, particularly among African Americans. The leading causes of pregnancy-related deaths vary by race and ethnicity, with preventability noted in 80% of cases. Perinatal exposure to cigarette smoking is also identified as a leading cause of poor infant health outcomes, emphasizing the importance of addressing smoking behavior during and after pregnancy. Results: This report advocates for a comprehensive approach to reducing maternal and fetal mortality rates, with a focus on adapting existing smoking cessation programs to adopt culturally tailored agendas in order to address social and political determinants of health as well as behavioral drivers of tobacco use among pregnant persons. Full article

Introduction: Non-communicable diseases (NCDs) represent a major global health challenge, particularly in low- and middle-income countries like India, with significant gender disparities in mortality and disease burden. This study aims to investigate these disparities, using data from national health surveys, to inform gender-specific public health strategies and align with global health goals. Methodology: The study uses data from the Longitudinal Aging Study in India (LASI) and National Family Health Surveys (NFHS-4 and NFHS-5). Result: The results from the Longitudinal Ageing Study in India (LASI) and National Family Health Surveys (NFHS-4 and NFHS-5) indicate significant demographic and health-related variations among 65,562 participants. Key findings show gender disparities in lifestyle habits such as alcohol and tobacco use, and differences in health outcomes across age, education, and socioeconomic status. Notably, an increase in NCD prevalence, particularly hypertension and diabetes, was observed from NFHS-4 to NFHS-5, highlighting evolving health challenges in India. Conclusions: The study emphasizes the importance of gender in the prevalence and management of non-communicable diseases (NCDs) in India, advocating for public health strategies that address gender differences, socio-economic factors, and urban-rural disparities to achieve health equity. Full article

Ethnic and racial sexual minority men with HIV have a disproportionately higher risk of HIV-related cardiovascular disease (CVD). There is a lack of tailored and culturally salient behavioral interventions to address HIV-related chronic illness in ethnic and racial sexual minority men, and literature on their understanding and awareness of modifiable behavioral risks is limited. The purpose of this study was to assess illness perceptions about HIV and HTN, and describe physical activity, tobacco, and e-cigarette use in Black and Latinx sexual minority men living with HIV. We used the validated Illness Perception Questionnaire-Revised (IPQ-R) to assess perceptions about two interrelated chronic diseases, HIV and CVD. To assess CVD behavioral risk, we assessed physical activity using the International Physical Activity Questionnaire. Tobacco and e-cigarette use were assessed using items from the Behavioral Risk Factor Surveillance System. Sleep difficulties were the most prevalent symptom attributed to HIV, and were statistically associated with fatigue, upset stomach, and loss of strength. Anxiety was reported to be caused by HIV (57%) and HTN (39%). Half of the participants engaged in vigorous activity for 128 min (SD = 135) daily, and 63% engaged in moderate activity for 94 min (SD = 88) daily. Over a third reported current tobacco use and 20% reported current e-cigarette use. This study provides formative data to better understand how Black and Latinx sexual minority men with HIV perceive intersecting chronic illnesses and their engagement in modifiable CVD risk behaviors. Sleep, mental health disparities, and financial hardships were commonly reported. More research is needed to address intersecting chronic illnesses and mental health conditions that are influenced by social positioning over the life course, and impact CVD risk factors. This study was not registered. Full article

The goal of this study was to assess the joint role of race/ethnicity and a health insurance coverage type (private, Medicare, Medicaid) in current cigarette use among adults in the U.S. Data from the 2019 Tobacco Use Supplement and the 2019 Annual Social and Economic Supplement of the Current Population Survey were merged (n = 39,882). Bivariate associations between each coverage type and smoking prevalence were examined within each of six racial/ethnic groups. A multiple logistic regression model (for the odds of current cigarette use) was estimated to explore the interactions between race/ethnicity and an indicator of each type of coverage among Hispanic, non-Hispanic (NH) Black/African American, and NH White adults. All analyses included survey weights. Results of bivariate analyses indicated that private and Medicare coverage were associated with significantly lower smoking prevalence (compared to no such coverage), while Medicaid coverage was associated with significantly higher smoking prevalence (all p ≤ 0.05). Some of these associations were significant among NH Black/African American and NH White adults (all p ≤ 0.05). The model indicated that the interaction between race/ethnicity and the indicator of private coverage was significant (p = 0.044): private coverage was significantly associated with lower prevalence among NH White adults only (AOR = 0.59, 98.3%, CI = 0.46:0.76). In addition, Medicaid coverage was significantly associated with higher smoking prevalence (overall). The study points to possible racial/ethnic disparities in the quality of smoking-related health care that people with the same type of coverage receive and possible underutilization of health care services even among adults with health insurance coverage, especially among communities of color and Medicaid enrollees. Full article

Head and neck squamous cell carcinoma (HNSCC) is a group of malignancies, involving the oral cavity, pharynx, hypopharynx, larynx, nasal cavity, and salivary glands, that together compose the seventh most common cancer diagnosis worldwide. With 890,000 new cases and 450,000 deaths annually per GLOBOCAN estimates, HNSCC accounts for roughly 4.5% of cancer diagnoses and deaths. In the developing world, the incidence of HNSCC is growing with increasing consumption of tobacco (smoked or chewed), alcohol, and areca nut (betel quid). Alcohol and tobacco have a synergistic effect, with the heavy consumption of both increasing HNSCC risk 40-fold. In developed nations, HPV-related HNSCC surpasses tobacco- and alcohol-related disease. HPV-related HNSCC more commonly affects the oropharynx, hypopharynx, and larynx than the oral cavity, and is associated with a significantly longer median survival (130 months vs. 20 months). Discrepancies in etiology as well as disparities in lifestyle choices and access to healthcare may account for the greater incidence and poorer survival of HNSCC among minority and lower-socioeconomic-status communities in developed nations. Pharmacotherapy and counseling together have been shown to be effective in promoting smoking and alcohol cessation. Education on cancer risk and community engagement have reduced areca nut consumption in Asia as well as in diaspora communities. HPV vaccination, starting at age 11–12 for both sexes, has been shown to reduce the prevalence of high-risk HPV serologies and prevent pre-cancerous lesions of the cervix, vagina, and vulva. As of 2020, 58.6% of eligible adolescents in the US have received the full two-vaccine series. Increased adoption of vaccination, education on safe sex practices, and routine visual oral screening for high-risk patients would curb growing HNSCC incidence in developed nations. Full article

Menthol cigarettes have had a profound adverse effect on public health. On 1 June 2020, Massachusetts became the first state to ban the sale of menthol cigarettes. We explored how perceptions of the ban and smoking behaviors changed over time among a group of 27 individuals who smoked menthol cigarettes at our safety-net hospital. In a convergent mixed methods study, we administered questionnaires and interviews simultaneously at two timepoints: 1 month pre-ban and 6 months post-ban. Pre-ban, we assessed perceptions of the ban and anticipated smoking behaviors after the ban. Post-ban, we assessed participants’ actual smoking behaviors and elicited suggestions to avoid unintended consequences that might undermine intended policy effects. Several respondents perceived the Massachusetts ban as positive because it could promote smoking cessation, prevent youth initiation, and mitigate unfair targeting of socioeconomically disadvantaged populations. Others perceived the ban as an overreach of government policy, financially motivated, and unfairly targeting the Black community. Many continued to smoke menthol cigarettes obtained outside Massachusetts. Individuals suggested promoting tobacco treatment for people affected by the ban and a national ban to circumvent out-of-state purchasing of menthol cigarettes. Our findings suggest that in order to be most effective, healthcare systems must promote tobacco treatment and ensure that treatment is accessible to all individuals affected by the ban. Full article

Understanding cardiometabolic health among lesbian, gay, and bisexual (LGB) people is challenged by methodological constraints, as most studies are either based on nonprobability samples or assume that missing values in population-based samples occur at random. Linking multiple years of nationally representative surveys, hospital records, and geocoded data, we analyzed selection biases and health disparities by self-identified sexual orientation in Canada. The results from 202,560 survey respondents of working age identified 2.6% as LGB, 96.4% as heterosexual, and <1.0% with nonresponse to the sexual identity question. Those who did not disclose their sexual identity were older, less highly educated, less often working for pay, and less often residing in rural and remote communities; they also had a diagnosed cardiometabolic condition or experienced a cardiometabolic-related hospitalization more often. Among those reporting their sexual identity, LGB individuals were younger, more likely to smoke tobacco or drink alcohol regularly, more likely to have heart disease, and less likely to have a regular medical provider than heterosexual persons. This investigation highlighted the potential of leveraging linked population datasets to advance measurements of sexual minority health disparities. Our findings indicated that population health survey questions on sexual identity are not generally problematic, but cautioned that those who prefer not to state their sexual identity should neither be routinely omitted from analysis nor assumed to have been randomly distributed. Full article

Menthol cigarette use is disproportionately higher among sexual- and gender-minoritized (SGM; 36%) individuals compared to cisgender, heterosexual (29%), individuals. The FDA has announced intentions to ban menthol in cigarettes, citing these use and health disparities as partial motivation. This study identified potential outcomes of a menthol cigarette ban among SGM individuals who smoke menthol cigarettes (N = 72). Potential outcomes were identified via concept mapping using the prompt: “If menthol in cigarettes was banned, a specific action I would take related to my tobacco use is…” Participants generated 82 response statements, sorted them, and rated them on personal relevance. Eight thematic clusters were identified: (1) Thoughtful Consideration of the Ban, (2) Negative Reactions to the Ban, (3) Positive Aspects of the Ban, (4) Strategies to Reduce Cravings, (5) Intent to Quit and Cessation Strategies, (6) Support-Seeking and Engagement in Positive Behaviors, (7) Strategies to Maintain Menthol-Flavored Product Use, and (8) Substance Use Alternatives to Menthol Cigarettes. Cluster differences based on sociodemographic factors, smoking behavior, and quitting interest were identified. Results provide insight into potential responses to a menthol cigarette ban and can contribute to public health prevention and intervention efforts, messaging campaigns, and support services for SGM people who smoke menthol cigarettes, specifically. Full article

Disparities in resources and access to material opportunities are important determinants of income-related health inequality. This paper hypothesises that the gradient of the inequality in health between the poor and the rich is likely to depend on differences in lifestyle practices including tobacco use and alcohol abuse. Using the 2015/16 Namibia Household Income and Expenditure Survey and the Erreygers corrected concentration index, we estimate the effect of tobacco and alcohol use on income-related health inequalities. A decomposition technique was used to estimate the separate and joint contribution of tobacco and alcohol use to income-related health inequalities. The results indicate that tobacco use widens the income-related health inequality gap while alcohol consumption reduces health disparities. The simultaneous consumption of these goods has a stronger multiplicative effect on income-related health inequality. For instance, the simultaneous consumption of both goods contribute up to 1.03% of the inequality in health while tobacco use alone contributed only 0.6%. While policy options for each of these goods could be essential in reducing inequalities in health, there is a need to advocate additional measures that could simultaneously control the consumption of both goods. Full article