... t start. If you do use them, quit. Addiction to Smokeless Tobacco Smokeless tobacco contains nicotine, which ... Smoking and Health E-mail: firstname.lastname@example.org Phone: 1-800-CDC-INFO Media Inquiries: Contact CDC’s ...
... in smokeless tobacco include polonium–210 (a radioactive element found in tobacco fertilizer) and polynuclear aromatic hydrocarbons ( ... study of the 40 most widely used popular brands of moist snuff showed that the amount of ...
Full Text Available Smoking, especially cigarette smoking, is the most common form of tobacco consumption world-wide. It is generally accepted that smoking carries health risks for smokers. The combustion and pyrolysis products of tobacco generated during smoking are considered to be responsible for the harmful effects. Smokeless tobacco, another wide-spread form of tobacco use, is not subjected to burning and produces no combustion or pyrolysis products. Therefore, there is an increasingly intense debate about the potential role of smokeless tobacco in reducing the harm of tobacco use.
Ernster, V L
This paper is focused on the approaches used to advertise and promote smokeless tobacco products during the early to mid-1980s. These included traditional motifs that featured rugged-looking masculine models in sporting and outdoor settings as well as an expanded white-collar appeal. Smokeless tobacco was not affected by the ban on broadcast advertising of cigarettes that went into effect in 1971, and, until 1986, both print and broadcast media were used to advertise it. Promotional activities ranged from sponsorship of sporting events to offers for clothing bearing smokeless tobacco product logos. Despite the claims of manufacturers that advertising and promotional efforts were not targeted to youth, smokeless tobacco companies sponsored tobacco-spitting contests with teenage participants, a college marketing program, and college scholarships. In efforts that appeared designed to bolster their public image in the face of growing concern over the consequences of smokeless tobacco use by young people, companies like U.S. Tobacco Company contributed to major social programs, including, ironically, alcohol- and drug-abuse prevention programs. Spurred by public health groups, federal legislation was passed in 1986 that banned television and radio advertising of smokeless tobacco products and required manufacturers to include warning labels on their products on the potential health hazards of smokeless tobacco use.
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for smokeless tobacco. 41.72 Section 41.72 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS...
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for smokeless tobacco. 45.43 Section 45.43 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO REMOVAL OF TOBACCO PRODUCTS AND CIGARETTE PAPERS...
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for smokeless tobacco. 40.216 Section 40.216 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS...
DATA SOURCES—A review of the literature identified demographic, cultural, and marketing variables related to the uptake and continuation of smokeless tobacco use. Government and industry data on production, marketing, and consumption of smokeless tobacco products are presented. METHODS—The Canadian and American markets are compared in terms of prevalence, consumption per capita, and marketing practices. Lessons to be learned from the well-orchestrated development of the American market in the...
Chagué, Frédéric; Guenancia, Charles; Gudjoncik, Aurélie; Moreau, Daniel; Cottin, Yves; Zeller, Marianne
Smokeless tobacco (snuff) is a finely ground or shredded tobacco that is sniffed through the nose or placed between the cheek and gum. Chewing tobacco is used by putting a wad of tobacco inside the cheek. Smokeless tobacco is widely used by young athletes to enhance performance because nicotine improves some aspects of physiology. However, smokeless tobacco has harmful health effects, including cardiovascular disorders, linked to nicotine physiological effects, mainly through catecholamine release. Nicotine decreases heart rate variability and the ventricular fibrillation threshold, and promotes the occurrence of various arrhythmias; it also impairs endothelial-dependent vasodilation and could therefore promote premature atherogenesis. At rest, heart rate, blood pressure, inotropism, cardiac output and myocardial oxygen consumption are increased by nicotine, leading to an imbalance between myocardial oxygen demand and supply. The same occurs at submaximal levels of exercise. These increases are accompanied by a rise in systemic resistances. At maximal exercise, heart rate, cardiac output and maximal oxygen uptake (V˙O2max) are unaffected by nicotine. Because endothelial dysfunction is promoted by nicotine, paradoxical coronary vasoconstriction may occur during exercise and recovery. Nicotine induces a decrease in muscular strength and impairs anaerobic performance. However, nicotine is used in sports as it diminishes anxiety, enhances concentration and agility, improves aerobic performance and favours weight control. Importantly, smokeless tobacco, similar to cigarette smoking, leads to nicotine dependence through dopaminergic pathways. Smokeless tobacco has harmful cardiovascular effects and is addictive: it fulfils all the criteria for inclusion in the World Anti-Doping Agency prohibited list as a doping product. Smokeless tobacco use in sporting activities must be discouraged. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Kostygina, Ganna; Ling, Pamela M
While fruit, candy and alcohol characterising flavours are not allowed in cigarettes in the USA, other flavoured tobacco products such as smokeless tobacco (ST) continue to be sold. We investigated tobacco manufacturers' use of flavoured additives in ST products, the target audience(s) for flavoured products, and marketing strategies promoting products by emphasising their flavour. Qualitative analysis of internal tobacco industry documents triangulated with data from national newspaper articles, trade press and internet. Internally, flavoured products have been consistently associated with young and inexperienced tobacco users. Internal studies confirmed that candy-like sweeter milder flavours (eg, mint, fruit) could increase appeal to starters by evoking a perception of mildness, blinding the strong tobacco taste and unpleasant mouth feel; or by modifying nicotine delivery by affecting product pH. Similar to cigarettes, flavoured ST is likely to encourage novices to start using tobacco, and regulations limiting or eliminating flavours in cigarettes should be extended to include flavoured ST products. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Hatsukami, Dorothy K; Stepanov, Irina; Severson, Herb; Jensen, Joni A; Lindgren, Bruce R; Horn, Kimberly; Khariwala, Samir S; Martin, Julia; Carmella, Steven G; Murphy, Sharon E; Hecht, Stephen S
Smokeless tobacco products sold in the United States vary significantly in yields of nicotine and tobacco-specific nitrosamines (TSNA). With the passage of the Family Smoking Prevention and Tobacco Control Act, the Food and Drug Administration now has the authority to establish product standards. However, limited data exist determining the relative roles of pattern of smokeless tobacco use versus constituent levels in the smokeless tobacco product in exposure of users to carcinogens. In this study, smokeless tobacco users of brands varying in nicotine and TSNA content were recruited from three different regions in the U.S. Participants underwent two assessment sessions. During these sessions, demographic and smokeless tobacco use history information along with urine samples to assess biomarkers of exposure and effect were collected. During the time between data collection, smokeless tobacco users recorded the amount and duration of smokeless tobacco use on a daily basis using their diary cards. Results showed that independent of pattern of smokeless tobacco use and nicotine yields, levels of TSNA in smokeless tobacco products played a significant role in carcinogen exposure levels. Product standards for reducing levels of TSNA in smokeless tobacco products are necessary to decrease exposure to these toxicants and potentially to reduce risk for cancer. ©2014 American Association for Cancer Research.
Timberlake, David S
Cross-sectional data suggests that adolescents' receptivity to the advertising of smokeless tobacco is correlated with use of chewing tobacco or snuff. Lack of longitudinal data has precluded determination of whether advertising receptivity precedes or follows initiation of smokeless tobacco. The objective of this study was to test for the association between advertising receptivity and subsequent initiation of smokeless tobacco among adolescent males. Adolescent males from the 1993-1999 Teen Longitudinal California Tobacco Survey were selected at the baseline survey for never having used smokeless tobacco. Separate longitudinal analyses corresponded to two dependent variables, ever use of smokeless tobacco (1993-1996; N = 1,388) and use on 20 or more occasions (1993-1999; N = 1,014). Models were adjusted for demographic variables, risk factors for smokeless tobacco use, and exposure to users of smokeless tobacco. Advertising receptivity at baseline was predictive of ever use by late adolescence (RR(95% CI) = 2.0 (1.5, 2.8)) and regular use by young adulthood (RR(95% CI) = 3.7 (2.1, 6.7)) in models that were adjusted for covariates. Conclusions/ Importance: The findings challenge the tobacco industry's assertion that tobacco marketing does not impact youth initiation. This is particularly relevant to tobacco control in the United States because the 2009 Tobacco Control Act places fewer restrictions on smokeless tobacco products compared to cigarettes.
Background: Tobacco use in smokeless and smoked forms is preventable cause of mortality and morbidity worldwide. Objective: To determine the prevalence of smokeless tobacco use and the association with tooth loss and oral health problems among adults in Cameroon. Methods: Adults dwelling in the Fokoue area of ...
This podcast helps retailers understand new federal regulations surrounding the sale of unpackaged tobacco products. To comply with the law, retailers may not break open packages of cigarettes or smokeless tobacco to sell or distribute as single or smaller quantities.
Donaldson, S I; Dent, C W; Sussman, S; Stoddard, J L; Severson, H H
Although much is known about the characteristics of employees who smoke cigarettes, very little is known about workers who use smokeless tobacco. The current study was designed to understand the characteristics of smokeless tobacco users in relation to their performance at work and compare them with smokers and former tobacco users. Data were collected via interviews and questionnaires from a random sample of employees working at Pacific Lumber Company (N = 146), the largest single-site lumber mill in California. A total of 63 smokeless tobacco users (21 of whom also smoked cigarettes), 43 cigarette smokers, and 40 employees who had successfully quit using tobacco (34 of whom previously used cigarettes only) provided information about their health behavior, quality of work life, and performance at work. Analyses revealed that smokeless tobacco users reported less healthful sleep patterns, drank alcohol more often, were intoxicated more often, reported less job satisfaction and organizational commitment, and reported that both chewers and smokers do not work as hard and take more breaks than do tobacco-free employees (quitters). Specific differences among chewers-only, smokers-only, smokers-and-chewers, and quitters are presented. Results suggest the organizational value of developing worksite cessation programs for smokeless tobacco users.
Han, Jing; Sanad, Yasser M.; Deck, Joanna; Sutherland, John B.; Li, Zhong; Walters, Matthew J.; Duran, Norma; Holman, Matthew R.
ABSTRACT There are an estimated 8 million users of smokeless tobacco products (STPs) in the United States, and yet limited data on microbial populations within these products exist. To better understand the potential microbiological risks associated with STP use, a study was conducted to provide a baseline microbiological profile of STPs. A total of 90 samples, representing 15 common STPs, were purchased in metropolitan areas in Little Rock, AR, and Washington, DC, in November 2012, March 2013, and July 2013. Bacterial populations were evaluated using culture, pyrosequencing, and denaturing gradient gel electrophoresis (DGGE). Moist-snuff products exhibited higher levels of bacteria (average of 1.05 × 106 CFU/g STP) and diversity of bacterial populations than snus (average of 8.33 × 101 CFU/g STP) and some chewing tobacco products (average of 2.54 × 105 CFU/g STP). The most common species identified by culturing were Bacillus pumilus, B. licheniformis, B. safensis, and B. subtilis, followed by members of the genera Oceanobacillus, Staphylococcus, and Tetragenococcus. Pyrosequencing analyses of the 16S rRNA genes identified the genera Tetragenococcus, Carnobacterium, Lactobacillus, Geobacillus, Bacillus, and Staphylococcus as the predominant taxa. Several species identified are of possible concern due to their potential to cause opportunistic infections and reported abilities to reduce nitrates to nitrites, which may be an important step in the formation of carcinogenic tobacco-specific N′-nitrosamines. This report provides a microbiological baseline to help fill knowledge gaps associated with microbiological risks of STPs and to inform potential regulations regarding manufacture and testing of STPs. IMPORTANCE It is estimated that there 8 million users of smokeless tobacco products (STPs) in the United States; however, there are limited data on microbial populations that exist within these products. The current study was undertaken to better understand the
McAdam, Kevin; Kimpton, Harriet; Vas, Carl; Rushforth, David; Porter, Andrew; Rodu, Brad
There is considerable interest from a regulatory and public health perspective in harmful and potentially harmful constituents in tobacco products, including smokeless tobacco products (STPs). A wide range of commercial STPs from the US and Sweden, representing 80-90 % of the 2010 market share for all the major STP categories in these two countries, were analysed for the IARC Group 2A carcinogen acrylamide. These STPs comprised the following styles: Swedish loose and portion snus, US snus, chewing tobacco, moist snuff, dry snuff, soft pellet, hard pellet and plug. Acrylamide was detected in all the products tested and quantified in all but one product. Concentrations ranged from 62 to 666 ng/g wet weight basis (WWB). The average levels of acrylamide (WWB) by type of STP were not significantly different (p > 0.05) except for US snus which had, on average, greater levels but with a very wide range of individual levels according to the manufacturer. Acrylamide levels in STPs were significantly and positively correlated with pH, but not with levels of either reducing sugars or ammonia nitrogen. Levels of acrylamide increased by sixfold or more (on a dry weight basis) during manufacture of a snus sample and then decreased during subsequent storage for up to 22 weeks. Acrylamide generation in tobacco generally appears to occur at lower temperatures, but longer time scales than found with food production. Acrylamide is a common contaminant of STPs, formed through heat treatment of tobacco. Our data show that exposure to acrylamide from consumption of STPs is small compared with exposure from food consumption or cigarette smoking.
Smokeless tobacco use is a significant part of the overall world tobacco problem. When the habit is introduced early in life, it increases the chance for permanent addiction and primes adolescents for use of harder drugs, exposing them to higher risk of oral cancer and other adverse effects of tobacco. This baseline study ...
Dave, Dhaval; Saffer, Henry
While the prevalence of smokeless tobacco (ST) is low relative to smoking, the distribution of ST use is highly skewed with consumption concentrated among certain segments of the population (rural residents, males, whites, low-educated individuals). Furthermore, there is suggestive evidence that use has trended upwards recently for groups that have traditionally been at low risk of using ST, and thus started to diffuse across demographics. This study provides the first estimates, at the national level, of the effects of magazine advertising on ST use. The focus on magazine advertising is significant given that ST manufacturers have been banned from using other conventional media since the 1986 Comprehensive ST Act and the 1998 ST Master Settlement Agreement. This study is based on the 2003–2009 waves of the National Consumer Survey (NCS), a unique data source that contains extensive information on the reading habits of individuals, matched with magazine-specific advertising information over the sample period. This allows detailed and salient measures of advertising exposure at the individual level and addresses potential bias due to endogeneity and selective targeting. We find consistent and robust evidence that exposure to ST ads in magazines raises ST use, especially among males, with an estimated elasticity of 0.06. There is suggestive evidence that both ST taxes and cigarette taxes reduce ST use, indicating contemporaneous complementarity between these tobacco products. Sub-analyses point to some differences in the advertising and tax response across segments of the population. The effects from this study inform the debate on the cost and benefits of ST use and its potential to be a tool in overall tobacco harm reduction. PMID:23660106
T. A. Don
Full Text Available An important aim during smokeless tobacco product (snus storage is keeping its quantitative and qualitative properties. Another significant factor is its biological safety due to its oral way of consumption. The main factors affecting quality during storage are: temperature, relative humidity, air composition, ventilation rate, surrounding products and package. Snus consumption is growing, but till present it was slightly spread in Russia and as a result little studied, thus studying process of its storage is an actual question. The aims of the research were: studying terms and methods of storage that provide constant product’s quality. Samples with different composition were taken for carrying research. Quality evaluation was carried according to standard for tobacco branch methods and to new methods developed in the laboratory of technologies for manufacturing tobacco products. Products were stored at lowered and room temperatures. It is discovered that snus with herbs added can be stored at room temperature and humidity not more than three months. Snus with coffee added can be stored not more than four months without changing its taste. Adding honey to this product slightly decreases its score by sensory evaluation, but remains it possible for consumption. Sensory testing score after storage at lowered temperature has remained unchanged. Optimal terms of storage were found. For room temperature they are: temperature 17-25 °C, relative air humidity 65 – 75 %, for lowered temperature – 5 °C and relative air humidity 50 -60 %. It was discovered that composition of snus and environmental parameters affect its storage duration.
Dave, Dhaval; Saffer, Henry
While the prevalence of smokeless tobacco (ST) is low relative to smoking, the distribution of ST use is highly skewed with consumption concentrated among certain segments of the population (rural residents, males, whites, low-educated individuals). Furthermore, there is suggestive evidence that use has trended upwards recently for groups that have traditionally been at low risk of using ST, and thus started to diffuse across demographics. This study provides the first estimates, at the national level, of the effects of magazine advertising on ST use. The focus on magazine advertising is significant given that ST manufacturers have been banned from using other conventional media since the 1986 Comprehensive ST Act and the 1998 ST Master Settlement Agreement. This study is based on the 2003-2009 waves of the National Consumer Survey (NCS), a unique data source that contains extensive information on the reading habits of individuals, matched with magazine-specific advertising information over the sample period. This allows detailed and salient measures of advertising exposure at the individual level and addresses potential bias due to endogeneity and selective targeting. We find consistent and robust evidence that exposure to ST ads in magazines raises ST use, especially among males, with an estimated elasticity of 0.06. There is suggestive evidence that both ST taxes and cigarette taxes reduce ST use, indicating contemporaneous complementarity between these tobacco products. Sub-analyses point to some differences in the advertising and tax response across segments of the population. The effects from this study inform the debate on the cost and benefits of ST use and its potential to be a tool in overall tobacco harm reduction. Copyright © 2013 Elsevier B.V. All rights reserved.
The study aim was to establish the prevalence and determinants of smokeless tobacco use in Nigerian adults' population. Across-sectional survey of 1776 adults inYola, North-East Nigeria was carried out in June 2007.A modified World Health Organization (WHO) tobacco survey questionnaire was used for interview and ...
... also called environmental tobacco smoke, involuntary smoking, and passive smoking. Secondhand smoke contains at least 250 toxic ... in tea bag-like pouches or sachets. No matter what it's called, smokeless tobacco is addictive and ...
... warnings that must appear on smokeless tobacco product packages and advertising. The Smokeless Tobacco Act (15 U.S.C. 4402(a)(1) and (b)(1)), requires that smokeless tobacco product packages and advertising... color graphics to accompany the text, increase the required label area from 30 up to 50 percent of the...
This podcast helps retailers understand new federal regulations surrounding the sale of unpackaged tobacco products. To comply with the law, retailers may not break open packages of cigarettes or smokeless tobacco to sell or distribute as single or smaller quantities. Created: 10/28/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products. Date Released: 10/28/2010.
Robertson, J.B.; Bray, J.T.
Using X-ray fluorescence spectrometry, 11 heavy elements at concentrations that are easily detectable have been identified in smokeless tobacco products. These concentrations were found to increase in cheek epithelium samples of the user after exposure to smokeless tobacco. This feasibility study suggests that the level of strontium in the cheek epithelium could be a valid measure of recent smokeless tobacco use. It also demonstrates that strontium levels become undetectable within several days of smokeless tobacco cessation. This absence of strontium could validate a self-report of abstinence from smokeless tobacco. Finally, the X-ray spectrum of heavy metal content of cheek epithelium from smokeless tobacco users could itself provide a visual stimulus to further motivate the user to terminate the use of smokeless tobacco products
Cigarette smoking and use of smokeless tobacco in Moshi rural district of Kilimanjaro region, northern Tanzania. KS Mnyika, E Klouman, K-I Klepp. Abstract. No Abstract. East African Journal of Public Health Vol. 3 (1) April 2006: 24-27. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD ...
Nemeth, J.M.; Liu, S.-T.; Klein, E.G.; Ferketich, A.K.; Kwan, M.P.; Wewers, M.E.
The burden of smokeless tobacco (ST) use disproportionally impacts males in rural Ohio Appalachia. The purpose of this study was to describe the cultural factors contributing to this disparity and to articulate the way in which culture, through interpersonal factors (i.e. social norms and
Kostova, Deliana; Dave, Dhaval
Although the primary form of tobacco use worldwide is cigarette smoking, the large majority of users in India consume smokeless forms of tobacco. There is little evidence on the role of policy-related factors in shaping the demand for smokeless tobacco (ST) in India. This study evaluates the relationship between two such factors, prices and advertising, and ST use in India, using data on 67,737 individuals from the Global Adult Tobacco Survey (GATS) India 2009. We find that ST advertising is more likely to influence ST consumption in women than men, while men are more likely to respond to changes in ST price. We estimate that among adult males in India, the total price elasticity of ST demand is -0.212, which is close to estimates reported for males in the U.S. We do not find strong direct evidence on the economic substitutability or complementarity of smoked and smokeless products. However, the positive association between former smoking and current smokeless use may point to temporal substitutability at the individual level. The findings have implications on the relative effectiveness of policy tools across genders in India - increasing the prices of ST products may discourage ST use particularly among men, and advertising restrictions may play a relatively larger role in the consumption behavior of women in India. Published by Elsevier Ltd.
... proper rotation in different advertising media in sufficient detail to ensure compliance with the Act and... warning statements in smokeless tobacco advertising. 307.12 Section 307.12 Commercial Practices FEDERAL... warning statements in smokeless tobacco advertising. (a) In the case of advertising for a smokeless...
Syamlal, Girija; Jamal, Ahmed; Mazurek, Jacek M
The aim of this study was to examine tobacco use among working adults at least 18 years of age. The 2012 to 2014 National Health Interview Survey (n = 105,779) was used to estimate prevalences for cigarette smoking, other combustible tobacco use, and smokeless tobacco use and prevalence odds ratios (PORs) for any tobacco product use among working adults at least 18 years of age, by industry and occupation. Of the estimated 144 million currently employed adults, 17% were cigarette smokers, 7.0% other noncigarette combustible tobacco users, and 3.4% smokeless tobacco users. Odds of using tobacco varied by sociodemographic characteristics and by industry and occupations. Disparities in tobacco use exist among working adults. Continued implementation of proven interventions to prevent and reduce all forms of tobacco use among U.S. workers is warranted, particularly among those workers with a higher burden of use.
Mushtaq, Nasir; Beebe, Laura A
Variants of the Fagerström Tolerance Questionnaire and Fagerström Test for Nicotine Dependence (FTND) are widely used to study dependence among smokeless tobacco (ST) users. However, there is a need for a dependence measure which is based on the clinical definition of dependence and is easy to administer. The Tobacco Dependence Screener (TDS), a self-administered 10-item scale, is based on the Diagnostic and Statistical Manual, fourth edition (DSM-IV) and ICD-10 definitions of dependence. It is commonly used as a tobacco dependence screening tool in cigarette smoking studies but it has not been evaluated for dependence in ST users. The purpose of this study is to evaluate the TDS as a measure of tobacco dependence among ST users. Data collected from a community-based sample of exclusive ST users living in Oklahoma (n = 95) was used for this study. TDS was adapted to be used for ST dependence as the references for smoking were changed to ST use. Concurrent validity and reliability of TDS were evaluated. Salivary cotinine concentration was used as a criterion variable. Overall accuracy of the TDS was assessed by receiver's operating characteristic (ROC) curve and optimal cutoff scores for dependence diagnosis were evaluated. There was no floor or ceiling effect in TDS score (mean = 5.42, SD = 2.61). Concurrent validity of TDS as evaluated by comparing it with FTND-ST was affirmative. Study findings showed significant association between TDS and salivary cotinine concentration. The internal consistency assessed by Cronbach's alpha indicated that TDS had acceptable reliability (α = 0.765). TDS was negatively correlated with time to first chew/dip and positively correlated with frequency (number of chews per day) and years of ST use. Results of logistic regression analysis showed that at an optimal cutoff score of TDS 5+, ST users classified as dependent had significantly higher cotinine concentration and FTND-ST scores. TDS demonstrated acceptable reliability and
Full Text Available This study targets the lesser-known ingredients of smokeless tobacco products, i.e., the toxic metals, in Indian brands. The metals selected in the study included lead (Pb, cadmium (Cd, arsenic (As, copper (Cu, mercury (Hg, and selenium (Se. The differential pulse anodic stripping voltammetry (DPASV technique was used for estimating the metals Pb, Cd, and Cu; square wave voltammetry for As; and the cold vapor atomic absorption technique for Hg. The resulting levels of the metals were compared to the daily consumption of the smokeless tobacco products. It was observed that almost 30% of gutkha brand samples exceeded the permissible levels of metals Pb and Cu, when compared to the provisional tolerable intake limits determined by the FAO/WHO. The reliability of data was assured by analyzing standard reference materials.
... year (section 2(13) of the Tobacco Control Act). Moreover, advertising, marketing, and promotion of... advertising and promoting smokeless tobacco products.\\28,29\\ Combined advertising and promotion expenditures... billion).\\33\\ The largest category of advertising and promotion for smokeless tobacco products in 2006 was...
Kozlowski, Lynn T
This article presents policy perspectives on the marketing of smokeless tobacco products to reduce population harm from tobacco use. Despite consensus that smokeless tobacco products as sold in the United States are less dangerous than cigarettes, there is no consensus on how to proceed. Diverse factions have different policy concerns. While the tobacco industry is exempted from U.S. Food and Drug Administration (FDA) oversight, the pharmaceutical industry whose nicotine replacement therapy (NRT) medicines compete with smokeless tobacco as noncombustible nicotine-delivery systems are regulated by the FDA. Some public health experts support smokeless tobacco use to reduce population harm from tobacco; other public health experts oppose promoting smokeless tobacco for harm reduction. Adult consumers can freely purchase currently-marketed smokeless tobacco products and even more-deadly cigarettes. Concerns with and advantages of smokeless tobacco products are discussed. In that noncombustible medicinal nicotine-delivery systems have been proven to be effective smoking-cessation aids, smokeless tobacco, as another source of psychoactive doses of nicotine, could be used similarly, in a dose-response fashion as a smoking-cessation aid (consistent with FDA principles for evaluating generic versions of drugs). Price measures should be used on tobacco products to make costs to consumers proportional to product health risks (which would make smokeless tobacco much cheaper than cigarettes), and smokeless tobacco should be encouraged as an option for smoking cessation in adult smokers, particularly for those who have failed to stop smoking using NRT or other methods.
Richter, Patricia; Spierto, Francis W
Smokeless tobacco is a complex chemical mixture, including not only the components of the tobacco leaf but also chemicals added during the manufacturing process. Smokeless tobacco contains the addictive chemical nicotine and more than 20 cancer-causing chemicals, including the potent tobacco-specific nitrosamines. The National Toxicology Program of the National Institutes of Health has concluded that oral use of smokeless tobacco is a human carcinogen. Therefore, smokeless tobacco is not a safe alternative to cigarettes. In fact, smokeless tobacco use begins primarily during early adolescence and can lead to nicotine dependence and increased risk of becoming a cigarette smoker. Under the Comprehensive Smokeless Tobacco Health Education Act of 1986 (15 U.S.C. 4401 et seq., Pub. L. 99-252), tobacco manufacturers report annually to the Centers for Disease Control and Prevention (CDC) on the total nicotine, unprotonated nicotine, pH, and moisture content of their smokeless tobacco products. This information is considered "trade secret," or confidential, in accordance with 5 U.S.C. 552(b)(4) and 18 U.S.C. 1905 and cannot be released to the public. In an effort to provide consumers and researchers with information on the nicotine content of smokeless tobacco, CDC arranged for the analysis of popular brands of smokeless tobacco. The results of this CDC study show that pH is a primary factor in the amount of nicotine that is in the most readily absorbable, unprotonated form. Furthermore, this study found that the brands of moist snuff smokeless tobacco with the largest amount of unprotonated nicotine also are the most frequently sold brands.
Rout, S K; Arora, M
The role of fiscal policy, especially taxation, though has been proved to be an effective instrument of tobacco control, its application is limited in India due to several reasons. This paper examines the tax structure, price and affordability of SLT products in order to provide evidence on how to strengthen the role of fiscal policy in tobacco control. Secondary data on tax structure and revenue from tobacco products were collected from the Ministry of Finance, Government of India. In order to measure the rise of prices corresponding to the increase in tax rate, the retail price index (RPI) and Whole Price Index (WPI) of SLT products were compared with the price index for all commodities for the period 2006-2012. The affordability of tobacco products is calculated by dividing prices of tobacco products by per capita income. During the last 6 years, the tax rate on SLT has gone up leading to a rise in the prices of SLT products more than the general price rise. However, the price rise is less than the per capita income growth indicating increasing affordability. The study observed a decline in the consumption of zarda and kahini due to the price increase during 2008-2013. However, the decline in the consumption of zarda is less compared with khaini due to a very low rise in its price. The prices should be raised more than the growth in income to influence consumption. Tax administration is a major challenge for SLT products and strengthening it could enhance revenue collection from SLT products.
Parita K Chitroda
Full Text Available Various oral mucosal lesions are attributed to tobacco use. The presence of these conditions vanes with particular type of tobacco used (smoking or smokeless and the form in which it is used, such as cigarettes, pipes, cigars and chewing moist snuff. The frequency and duration of use as well as the ways in which the tobacco product is used also contributes to the clinical presentation and seventy of the lesion. The present study is mainly focused on the correlation between the smokeless tobacco-induced lesion and smoke-induced leukoplakia on various aspects with an objective to determine smokeless tobacco as a possible cause for leukoplakia.
Mejia, Adrienne B; Ling, Pamela M; Glantz, Stanton A
Snus (a form of smokeless tobacco) is less dangerous than cigarettes. Some health professionals argue that snus should be promoted as a component of a harm reduction strategy, while others oppose this approach. Major US tobacco companies (RJ Reynolds and Philip Morris) are marketing snus products as cigarette brand line extensions. The population effects of smokeless tobacco promotion will depend on the combined effects of changes in individual risk with population changes in tobacco use patterns. To quantitatively evaluate the health impact of smokeless tobacco promotion as part of a harm reduction strategy in the US. A Monte Carlo simulation of a decision tree model of tobacco initiation and use was used to estimate the health effects associated with five different patterns of increased smokeless tobacco use. With cigarette smoking having a health effect of 100, the base case scenario (based on current US prevalence rates) yields a total health effect of 24.2 (5% to 95% interval 21.7 to 26.5) and the aggressive smokeless promotion (less cigarette use and increased smokeless, health-concerned smokers switching to snus, smokers in smokefree environments switching to snus) was associated with a health effect of 30.4 (5% to 95% interval 25.9 to 35.2). The anticipated health effects for additional scenarios with lower rates of smokeless uptake also overlapped with the base case. Promoting smokeless tobacco as a safer alternative to cigarettes is unlikely to result in substantial health benefits at a population level.
Lewis, Paul C.; Harrell, Joanne S.; Deng, Shibing; Bradley, Chyrise
Examined age, gender, ethnicity, self-esteem, physical activity, parental smoking, and socioeconomic status as predictors of smokeless tobacco use among middle-school students. Student surveys indicated that males, Hispanics, and older students were more likely to be current smokeless-tobacco users. Other influential factors were low self-esteem…
Dabelsteen, S; Christensen, S; Gron, B
on exposure time and on concentration of the tobacco extract. High concentration increased production of HGF 4-fold. KGF production was doubled when high concentration of tobacco was used, low concentration did not stimulate cells. GM-CSF production was low in both stimulated and non-stimulated cells......To investigate the effect of smokeless tobacco (ST) on (1) HGF, KGF and GM-CSF expression by buccal fibroblasts and (2) on keratinocyte and fibroblast proliferation. Buccal fibroblasts were stimulated with different concentrations of ST extracts in a double dilution from 0.50% w/v to 0.03% w....... Keratinocytes and fibroblasts showed no increase in proliferation after stimulation with increased concentrations of ST. The results suggest that HGF and KGF may play an important role as a paracrine growth factor in epithelial hyperplasia in ST lesions....
Full Text Available BackgroundIn the past, studies have compared smokeless tobacco and non-tobacco users for the risk of various chronic diseases. The differences in the risk of chronic diseases between smokeless tobacco user and smokers have not been explored. The objective of this study is to estimate the risk of chronic diseases among smokeless tobacco users compared to smokers.MethodsThe data were used from the Study on Global Ageing and Adult Health (SAGE Wave-1, conducted in 2007–2008 in India. The study sample is the respondents who reported consuming any form of tobacco in last 1 month. The total sample size was 4,038 respondents. The odds ratio of chronic morbidities was estimated taking smokers as the reference category.ResultsThe odds ratios for (self-reported diabetes, asthma, and hypertension were not significant for smokeless tobacco user compared to smoked tobacco users. The odds ratio of chronic lung diseases (CLDs was significantly lower among smokeless tobacco users compared to smoked tobacco users. The odds ratio of hypertension (measured combined with low education and belonging to lowest wealth quintiles were not significant for smokeless tobacco users compared to smoked tobacco users. Duration of the use of smokeless tobacco and quantity of use was found to have no significant relation with risk of chronic diseases as compared to smoking.ConclusionThis study did not find the significantly higher risk of chronic morbidities except for CLD for smokeless tobacco users compared to smoked tobacco users. The study suggests that the use of any form of tobacco may have a similar risk of chronic diseases.
Pakhale, Smita; Samet, Jonathan; Folan, Patricia; Leone, Frank; White, Alexander
On November 10, 2015, the U.S. Food and Drug Administration approved, for the first time, the sale of smokeless tobacco products authorized under the new premarket tobacco application pathway. This Food and Drug Administration regulatory decision draws attention to the growing worldwide use of smokeless tobacco products in general. Use of these tobacco products is particularly popular in low- and middle-income countries of Asia. Due to aggressive and strategic marketing to children, young adults, and current smokers, rates of smokeless tobacco use in men of all ages are on the rise in United States and elsewhere. The tobacco industry also continues to market these products to current cigarette smokers for use in the growing number of "smoke-free environments." Smokeless tobacco products are associated with cancers of the upper aerodigestive tract, particularly the oral cavity, esophagus, and pancreas; cardiovascular diseases; small-for-gestational-age infants; premature births; increased risk of apnea; and stillbirth. There is no convincing evidence regarding the efficacy of smokeless tobacco, including snus, to promote smoking cessation. Rather, studies from Europe and the United States demonstrate that smokeless tobacco use may facilitate regular cigarette smoking by acting as a gateway drug, especially for children. Caution is warranted before proposing smokeless tobacco as a harm-reduction strategy, in part because of the potential for further promoting smokeless tobacco in low- and middle-income countries where use is already widespread. Continued vigilance through comprehensive surveillance is warranted. We strongly recommend the use of graphic warning labels as a "no regrets" strategy for all smokeless tobacco products marketed globally.
Agaku, Israel T; Singh, Tushar; Jones, Sherry Everett; King, Brian A; Jamal, Ahmed; Neff, Linda; Caraballo, Ralph S
Athletes are not a typical at-risk group for smoking combustible tobacco products, because they are generally health conscious and desire to remain fit and optimize athletic performance (1). In contrast, smokeless tobacco use historically has been associated with certain sports, such as baseball (2). Athletes might be more likely to use certain tobacco products, such as smokeless tobacco, if they perceive them to be harmless (3); however, smokeless tobacco use is not safe and is associated with increased risk for pancreatic, esophageal, and oral cancers (4). Tobacco use among youth athletes is of particular concern, because most adult tobacco users first try tobacco before age 18 years (5). To examine prevalence and trends in current (≥1 day during the past 30 days) use of combustible tobacco (cigarettes, cigars) and smokeless tobacco (chewing tobacco, snuff, or dip [moist snuff]) products among athlete and nonathlete high school students, CDC analyzed data from the 2001–2013 National Youth Risk Behavior Surveys. Current use of any tobacco (combustible or smokeless tobacco) significantly declined from 33.9% in 2001 to 22.4% in 2013; however, current smokeless tobacco use significantly increased from 10.0% to 11.1% among athletes, and did not change (5.9%) among nonathletes. Furthermore, in 2013, compared with nonathletes, athletes had significantly higher odds of being current smokeless tobacco users (adjusted odds ratio [AOR] = 1.77, pcombustible tobacco users (AOR = 0.80, p<0.05). These findings suggest that opportunities exist for development of stronger tobacco control and prevention measures targeting youth athletes regarding the health risks associated with all forms of tobacco use.
Brownson, R C; DiLorenzo, T M; Van Tuinen, M; Finger, W W
Although cigarette and smokeless tobacco use are recognized as major problems among school-age youth, few nationwide or statewide data exist on the prevalence and patterns of use. To determine the patterns of tobacco use among children and adolescents in Missouri, self-report information was obtained from a representative sample of 5,431 students in grades 5, 8, and 12. Both cigarette smoking and smokeless tobacco use were more common among males than females for each grade level except the 12th, where 30% of females and 28% of males had smoked during the previous week. Smoking prevalence was considerably lower among blacks than whites. Smokeless tobacco use was rare among both blacks and females. Smokeless tobacco use was more common than cigarette smoking in rural areas, where 17% of 8th-grade males and 31% of 12th-grade males had used smokeless tobacco during the previous week. The mean age at first use of cigarettes was slightly lower in the rural than the urban area, whereas the mean age of initial smokeless tobacco use was more than a year earlier in the rural area. Data regarding the perceived difficulty of quitting smoking and quit rates suggested that adolescent females have more difficulty quitting smoking than males. Male smokeless tobacco users appeared to be more addicted than male cigarette smokers. Smokeless tobacco brand preference indicated that users may switch to progressively stronger types of smokeless tobacco as they get older and a nicotine tolerance is developed. The current study emphasizes the urgent need for carefully targeted tobacco prevention and cessation efforts among school-age youth.
Background Debate about the health implications of using smokeless tobacco products (STPs) has prompted considerable interest in characterising their levels of toxic and carcinogenic components. In the present study seventy smokeless tobacco products from the US and Sweden, categorized as chewing tobacco, dry and moist snuff, hard and soft pellets, plug, and loose and portion snus, were analysed for twenty one polycyclic aromatic hydrocarbons (PAHs). The tested brands represented 80-90% of the 2008 market share for the major STP categories in these two countries. Results There were significant differences in the total and individual PAH concentrations in the different styles of product. Substantially higher levels of total PAHs (10–60 fold) were found in moist and dry snuff and soft pellets than in the other smokeless tobacco styles. The individual PAH concentrations followed the same patterns as total PAHs except for naphthalene, for which the highest concentrations were found in snus and moist snuff. Good correlations were obtained between benzo[a]pyrene (B[a]P) and all the other PAHs except naphthalene, 1-methylnaphthalene and 2-methylnaphthalene, providing evidence for the first time that it can be used as a good marker for PAHs in STPs. Results were generally in good agreement with two previous studies of PAHs in STPs, except for naphthalene for which significantly lower concentrations were found than previously reported. Analysis of the ratios of different PAHs confirmed that the use of fire-cured tobaccos in the snuffs and soft pellet were the major source of PAHs in these product styles, and provided, for the first time, some indications as to the source of PAHs in the other STP styles, including petrogenic and other combustion sources. Conclusions This study confirms the presence of PAHs in STPs, and identifies substantial differences between the levels in different STP categories. Since previous studies of naphthalene concentrations in STPs differed so
peer pressure. Ingredients found in smokeless tobacco include: polonium 210 , nnitrosamines, formaldehyde, nicotine, cadmium, cyanide, arsenic...flavors, preservatives, and sugars are also added. Polynuclear aromatic hydrocarbons, polonium 210 , and nnitrosamines represent the chemical...Nnitrosamines in tobacco by super critical fluid extraction. Journal of Agricultural and Food Chemistry 43, 916–922. 24 Brunnemann KD, Hoffmann D, Qi J
Murukutla, Nandita; Turk, Tahir; Prasad, C V S; Saradhi, Ranjana; Kaur, Jagdish; Gupta, Shefali; Mullin, Sandra; Ram, Faujdar; Gupta, Prakash C; Wakefield, Melanie
Smokeless tobacco consumption in India is a significant source of morbidity and mortality. In order to educate smokeless tobacco users about the health harms of smokeless tobacco and to denormalise tobacco usage and encourage quitting, a national television and radio mass media campaign targeted at smokeless tobacco users was aired for 6 weeks during November and December 2009. The campaign was evaluated with a nationally representative household survey of smokeless tobacco users (n = 2898). The effect of campaign awareness was assessed with logistic regression analysis. The campaign affected smokeless tobacco users as intended: 63% of smokeless-only users and 72% of dual users (ie, those who consumed both smoking and smokeless forms) recalled the campaign advertisement, primarily through television delivery. The vast majority (over 70%) of those aware of the campaign said that it made them stop and think, was relevant to their lives and provided new information. 75% of smokeless-only users and 77% of dual users said that it made them feel concerned about their habit. Campaign awareness was associated with better knowledge, more negative attitudes towards smokeless tobacco and greater cessation-oriented intentions and behaviours among smokeless tobacco users. Social marketing campaigns that utilise mass media are feasible and efficacious interventions for tobacco control in India. Implications for future mass media tobacco control programming in India are discussed.
Rose, M L; Chadha, D; Bhutia, T D
Nearly 15% of youth in India use tobacco. However, few studies have explored the use, knowledge, and attitudes of smokeless tobacco use among youth. To determine the patterns of use as well as knowledge and perceptions of smokeless tobacco among youth in Mumbai attending municipal schools. A cross-sectional survey was performed among 1053 students in the 8th and 9th grades in 16 municipal schools in Mumbai to determine the knowledge and perceptions about smokeless tobacco products as well as the patterns of use. Ever use of smokeless tobacco was reported by 47 (4.7%) students in the survey. Twenty-nine (2.9%) students reported ever using smoked tobacco. Students were more likely to identify cigarettes and bidis as tobacco products compared to smokeless tobacco products such as gutkha, mishri, and khaini. Betel nut products were used by 178 (17.9%) students. The high rate of smokeless tobacco and betel nut use coupled with low levels of knowledge about their contents and harms suggests that tobacco control programs targeting youth should ensure that these products are adequately explained and understood by students.
Smyth, Eoghan M; Kulkarni, Prachi; Claye, Emma; Stanfill, Stephen; Tyx, Robert; Maddox, Cynthia; Mongodin, Emmanuel F; Sapkota, Amy R
Smokeless tobacco products contain numerous chemical compounds, including known human carcinogens. Other smokeless tobacco constituents, including bacteria, may also contribute to adverse health effects among smokeless tobacco users. However, there is a lack of data regarding the microbial constituents of smokeless tobacco. Our goal was to characterize the bacterial microbiota of different smokeless tobacco products and evaluate differences across product types and brands. DNA was extracted from 15 brands of smokeless tobacco products (including dry snuff, moist snuff, snus, and Swedish snus) and 6 handmade products (e.g., toombak) using an enzymatic and mechanical lysis approach. Bacterial community profiling was performed using PCR amplification of the V1-V2 hypervariable region of the 16S rRNA gene, followed by 454 pyrosequencing of the resulting amplicons and sequence analysis using the QIIME package. Total viable counts were also determined to estimate the number of viable bacteria present in each product. Average total viable counts ranged from 0 to 9.35 × 10 7 CFU g -1 . Analysis of the 16S rRNA gene sequences revealed high bacterial diversity across the majority of products tested: dry snuff products where characterized by the highest diversity indices compared to other products. The most dominant bacterial phyla across all products were Firmicutes, Proteobacteria, Actinobacteria, and Bacteroidetes. Significant differences in both bacterial community composition and in silico predicted gene content were observed between smokeless tobacco product types and between brands of specific smokeless tobacco products. These data are useful in order to comprehensively address potential health risks associated with the use of smokeless tobacco products.
Mazurek, Jacek M; Syamlal, Girija; King, Brian A; Castellan, Robert M
Smokeless tobacco causes cancers of the oral cavity, esophagus, and pancreas. CDC analyzed National Health Interview Survey (NHIS) data to estimate the proportion of U.S. working adults who used smokeless tobacco in 2005 and 2010, by industry and occupation. This report describes the results of that analysis, which showed no statistically significant change in the prevalence of smokeless tobacco use among workers from 2005 (2.7%) to 2010 (3.0%). In 2010, smokeless tobacco use was highest among adults aged 25-44 years (3.9%), males (5.6%), non-Hispanic whites (4.0%), those with no more than a high school education (3.9%), and those living in the South (3.9%). By industry, the prevalence of smokeless tobacco use ranged from 1.5% in education services to 18.8% in mining industries, and by occupation from 1.3% in office and administrative support to 10.8% in construction and extraction. These findings highlight opportunities for reducing the health and economic burdens of tobacco use among U.S. workers, especially those in certain industries (e.g., mining) and occupations (e.g., construction and extraction) where use of smokeless tobacco is especially common. CDC recommends best practices for comprehensive tobacco control programs, including effective employer interventions, such as providing employee health insurance coverage for proven cessation treatments, offering easily accessible help for those who want to quit, and establishing and enforcing tobacco-free workplace policies.
Full Text Available Abstract Background Use of smokeless tobacco is common in South Asia. Tobacco is a major preventable cause of morbidity and mortality. Doctors make one of the best avenues to influence patients' tobacco use. However, medical students addicted to tobacco are likely to retain this habit as physicians and are unlikely to counsel patients against using tobacco. With this background, this study was conducted with the objective of determining the prevalence of smokeless tobacco among Pakistani medical students. Methods A cross sectional study was carried out in three medical colleges of Pakistan – one from the north and two from the southern region. 1025 students selected by convenient sampling completed a peer reviewed, pre-tested, self-administered questionnaire. Questions were asked regarding lifetime use (at least once or twice in their life, current use (at least once is the last 30 days, and established use (more than 100 times in their life of smokeless tobacco. Chi square and logistic regression analyses were used. Results Two hundred and twenty (21.5% students had used tobacco in some form (smoked or smokeless in their lifetime. Sixty six (6.4% students were lifetime users of smokeless tobacco. Thirteen (1.3% were daily users while 18 (1.8% fulfilled the criterion for established users. Niswar was the most commonly used form of smokeless tobacco followed by paan and nass. Most naswar users belonged to NWFP while most paan users studied in Karachi. On univariate analysis, lifetime use of smokeless tobacco showed significant associations with the use of cigarettes, student gender (M > F, student residence (boarders > day scholars and location of the College (NWFP > Karachi. Multivariate analysis showed independent association of lifetime use of smokeless tobacco with concomitant cigarette smoking, student gender and location of the medical college. Conclusion The use of smokeless tobacco among medical students cannot be ignored. The
Klein, E.G.; Ferketich, A.K.; Abdel-Rasoul, M.; Kwan, M.P.; Kenda, L.; Wewers, M.E.
Introduction: Smokeless tobacco (ST) use is increasingly prevalent among poor and vulnerable groups, especially rural males. Access to tobacco products, as well as marketing messages, is associated with tobacco usage. In June 2010, the Tobacco Control Act (TCA) marked the beginning of federal
Gupta, Prakash C; Ray, Cecily S; Sinha, Dhirendra N; Singh, Poonam K
Smokeless tobacco use is on the upswing in some parts of the world, including parts of SEAR. It is therefore important to monitor this problem and understand the possible consequences on public health. Material for this review was obtained from documents and data of the World Health Organization, co-authors, colleagues, and searches on key words in PubMed and on Google. Smokeless tobacco use in SEAR, as betel quid with tobacco, declined with increased marketing of cigarettes from the early twentieth century. Smokeless tobacco use began to increase in the 1970s in South Asia, with the marketing of new products made from areca nut and tobacco and convenient packaging. As a consequence, oral precancerous conditions and cancer incidence in young adults have increased significantly. Thailand's successful policies in reducing betel quid use through school health education from the 1920s and in preventing imports of smokeless tobacco products from 1992 are worth emulating by many SEAR countries. India, the largest manufacturing country of smokeless tobacco in the Region, is considering ways to regulate its production. Best practices require the simultaneous control of smokeless and smoking forms of tobacco. Governments in SEAR would do well to adopt strong measures now to control this problem.
Syed, U.F.; Bari, A.; Husain, L.; Husain, L.
Use of smokeless tobacco (SLT) is associated with cancer of the oral cavity. 210 Po, a known carcinogen present in SLT may leach into the saliva when the snuff is held in the mouth. Alpha emission from leached 210 Po can cause oral tissue damage, especially in the presence of non healing ulcers seen frequently in snuff users' mouth. Leaching of 210 Po from SLT in human saliva was determined for six popular US snuff brands. 210 Po was leached into human saliva for 30 min, separated radiochemically and its activity was determined by α-counting. Approximately 2-10% of 210 Po present in SLT was observed to leach. Annual exposure from leached 210 Po, based on average daily consumption of 15 g of SLT, was calculated to range from 1.1 to 3.8 Bq year -1 . (author)
Mohammad Shakhawat Hossain
Full Text Available OBJECTIVE: To estimate the prevalence and identify correlates of smokeless tobacco consumption among married rural women with a history of at least one pregnancy in Madaripur, Bangladesh. MATERIALS AND METHODS: We conducted a cross-sectional survey using an interviewer administered, pre-tested, semi-structured questionnaire. All women living in the study area, aged 18 years and above with at least one pregnancy in their lifetime, who were on the electoral roll and agreed to participate were included in the study. Information on socio-demographic characteristics and smokeless tobacco consumption was collected. Smokeless tobacco consumption was categorized as 'Current', 'Ever but not current' and 'Never'. Associations between smokeless tobacco consumption and the explanatory variables were estimated using simple and multiple binary logistic regression. RESULTS: 8074 women participated (response rate 99.9%. The prevalence of 'Current consumption', 'Ever consumption but not current', and 'Never consumption' was 25%, 44% and 31%, respectively. The mean age at first use was 31.5 years. 87% of current consumers reported using either Shadapata or Hakimpuree Jarda. Current consumption was associated with age, level of education, religion, occupation, being an income earner, marital status, and age at first use of smokeless tobacco. After adjustment for demographic variables, current consumption was associated with being over 25 years of age, a lower level of education, being an income earner, being Muslim, and being divorced, separated or widowed. CONCLUSION: The prevalence of smokeless tobacco consumption is high among rural women in Bangladesh and the age of onset is considerably older than that for smoking. Smokeless tobacco consumption is likely to be producing a considerable burden of non-communicable disease in Bangladesh. Smokeless tobacco control strategies should be implemented.
Klein, Elizabeth G; Quisenberry, Amanda J; Shoben, Abigail B; Cooper, Sarah; Ferketich, Amy K; Berman, Micah; Peters, Ellen; Wewers, Mary Ellen
Little research has examined the impacts of graphic health warnings on the users of smokeless tobacco products. A convenience sample of past-month, male smokeless tobacco users (n = 142; 100% male) was randomly assigned to view a smokeless tobacco advertisement with a graphic health warning (GHW) or a text-only warning. Eye-tracking equipment measured viewing time, or dwell time, in milliseconds. Following the advertisement exposure, participants self-reported smokeless tobacco craving and recalled any content in the health warning message (unaided recall). Linear and logistic regression analyses evaluated the proportion of time viewing the GHW, craving, and GHW recall. Participants who viewed a GHW spent a significantly greater proportion of their ad viewing time on GHWs (2.87 seconds or 30%), compared to those viewing a text-only warning (2.05 seconds or 24%). Although there were no significant differences by condition in total advertisement viewing duration, those participants viewing a GHW had increased recall of health warning messages compared to the text-only warning (76% had any warning message recall compared to 53%; p recall of health warning messages compared to text-only warnings among rural male smokeless tobacco users. Among a sample of rural smokeless tobacco users, GHWs attracted more attention and recall of health warning messages compared to text-only warnings when viewed within smokeless tobacco advertising. These findings provide additional empirical support that GHWs are an effective tobacco control tool for all tobacco products and advertisements. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: email@example.com.
Raymond G. Boyle
Full Text Available Cigarette smokers are being encouraged to use smokeless tobacco (SLT in locations where smoking is banned. We examined state-wide data from Minnesota to measure changes over time in the use of SLT and concurrent use of cigarettes and SLT. The Minnesota Adult Tobacco Survey was conducted four times between 1999 and 2010 and has provided state-wide estimates of cigarette smoking, SLT use and concurrent use of SLT by smokers. The prevalence of SLT was essentially unchanged through 2007, then increased significantly between 2007 and 2010 (3.1% versus 4.3%, P<0.05. Similarly, the prevalence of cigarette smokers who reported using SLT was stable then increased between 2007 and 2010 (4.4% versus 9.6%, P<0.05. The finding of higher SLT use by smokers could indicate that smokers in Minnesota are in an experimental phase of testing alternative products as they adjust to recent public policies restricting smoking in public places. The findings are suggestive that some Minnesota smokers are switching to concurrent use of cigarettes and SLT. Future surveillance reports will be necessary to confirm the results.
Tomar, Scott L
Moist snuff is the most popular form of orally-used smokeless tobacco in North America and parts of Europe. Because moist snuff use conveys lower risks for morbidity or mortality than does cigarette smoking, its use has been proposed as a tobacco harm-reduction strategy. This article critically reviews new and published epidemiologic evidence on health effects of moist snuff and its patterns of use relative to smoking in the United States, Sweden, and Norway. The available evidence suggests that: (1) moist snuff is a human carcinogen and toxin, (2) increased promotion of moist snuff has led to increased sales in those countries, (3) the uptake of moist snuff in these three countries during the past several decades has occurred primarily among adolescent and young adult men, (4) increased prevalence of snuff use has not been associated consistently with a reduction in smoking initiation or prevalence, (5) moist snuff use apparently plays a very minor role in smoking cessation in the U.S. and an inconsistent role in Sweden, (6) U.S. states with the lowest smoking prevalence also tend to have the lowest prevalence of snuff use, (7) there are no data on the efficacy of snuff as a smoking-cessation method, (8) the prevalence of cigarette smoking is relatively high among people who use snuff, and (9) snuff use is more consistently associated with partial substitution for smoking than with complete substitution. The evidence base for promotion of snuff use as a public health strategy is weak and inconsistent.
Curry, Laurel E; Pederson, Linda L; Stryker, Jo Ellen
Concerns about secondhand smoke, increasing indoor smoking bans, and health concerns regarding cigarettes are contributing to the development of new smokeless tobacco (ST) products by the tobacco industry and the repositioning of traditional ST products. The objective of this research was to systematically document the changing advertising strategies and themes of the ST industry. Using descriptive content analysis, this study analyzed 17 nationally circulated magazines for ST advertisements (ads) from 1998-1999 and 2005-2006, recording both magazine and advertisement characteristics (e.g., themes, selling proposition, people portrayed, and setting/surroundings.) Ninety-five unique ads were found during the two time periods-occurring with total frequency of 290 ad placements in 816 issues. One hundred ninety-one ads were found in the 2005-2006 sample, while 99 were found in the 1998-1999 magazines. Significant differences in ST ads were identified between time periods and magazine types. A greater percentage of ads were found in the latter time period, and the average number of ads per issue increased (0.24 in 1998-1999 and 0.49 in 2005-2006, p advertise in men's magazines with themes appealing to men and "traditional" ST users, the ST industry appears to be simultaneously changing its message placement and content in order to include readers of general adult magazines who may not currently use ST.
Nemeth, Julianna M; Liu, Sherry T; Klein, Elizabeth G; Ferketich, Amy K; Kwan, Mei-Po; Wewers, Mary Ellen
The burden of smokeless tobacco (ST) use disproportionally impacts males in rural Ohio Appalachia. The purpose of this study was to describe the cultural factors contributing to this disparity and to articulate the way in which culture, through interpersonal factors (i.e. social norms and social networks) and community factors (i.e. marketing and availability), impacts ST initiation and use of ST among boys and men in Ohio Appalachia. Fifteen focus groups and 23 individual qualitative interviews were conducted with adult (n = 63) and adolescent (n = 53) residents in Ohio Appalachian counties to ascertain factors associated with ST use and the impact of ST marketing. Transcriptions were independently coded according to questions and themes. ST use appears to be a rite of passage in the development of masculine identity in Ohio Appalachian culture. Interpersonal factors had the greatest influence on initiation and continued use of ST. Ohio Appalachian boys either emulated current ST users or were actively encouraged to use ST through male family and peer networks. Users perceived their acceptance into the male social network as predicated on ST use. Community factors, including ST advertisement and access to ST, reinforced and normalized underlying cultural values. In addition to policy aimed at reducing tobacco marketing and access, interventions designed to reduce ST use in Ohio Appalachia should incorporate efforts to (1) shift the perception of cultural norms regarding ST use and (2) address male social networks as vehicles in ST initiation.
Nemeth, Julianna M.; Liu, Sherry T.; Klein, Elizabeth G.; Ferketich, Amy K.; Kwan, Mei-Po; Wewers, Mary Ellen
Background The burden of smokeless tobacco (ST) use disproportionally impacts males in rural Ohio Appalachia. The purpose of this study was to describe the cultural factors contributing to this disparity and to articulate the way in which culture, through interpersonal factors (i.e. social norms and social networks) and community factors (i.e. marketing and availability), impacts ST initiation and use of ST among boys and men in Ohio Appalachia. Methods Fifteen focus groups and twenty-three individual qualitative interviews were conducted with adult (n=63) and adolescent (n=53) residents in Ohio Appalachian counties to ascertain factors associated with ST use and the impact of ST marketing. Transcriptions were independently coded according to questions and themes. Results ST use appears to be a rite of passage in the development of masculine identity in Ohio Appalachian culture. Interpersonal factors had the greatest influence on initiation and continued use of ST. Ohio Appalachian boys either emulated current ST users or were actively encouraged to use ST through male family and peer networks. Users perceived their acceptance into the male social network as predicated on ST use. Community factors, including ST advertisement and access to ST, reinforced and normalized underlying cultural values. Conclusions In addition to policy aimed at reducing tobacco marketing and access, interventions designed to reduce ST use in Ohio Appalachia should incorporate efforts to 1) shift the perception of cultural norms regarding ST use and 2) address male social networks as vehicles in ST initiation. PMID:22427033
Hendlin, Yogi H; Veffer, Jessica R; Lewis, M Jane; Ling, Pamela M
Since 2006, "snus" smokeless tobacco has been sold in the U.S.. However, U.S. Smokeless Tobacco (USST) and Swedish Match developed and marketed pouched moist snuff tobacco (MST) since 1973. Analysis of previously secret tobacco documents, advertisements and trade press. USST partnered with Swedish Match, forming United Scandia International to develop pouch products as part of the "Lotus Project." Pouched MST was not commonly used, either in Sweden or the U.S. prior to the Lotus Project's innovation in 1973. The project aimed to transform smokeless tobacco from being perceived as an "unsightly habit of old men" into a relevant, socially acceptable urban activity, targeting 15-35 year-old men. While USST's initial pouched product "Good Luck," never gained mainstream traction, Skoal Bandits captured significant market share after its 1983 introduction. Internal market research found that smokers generally used Skoal Bandits in smokefree environments, yet continued to smoke cigarettes in other contexts. Over time, pouch products increasingly featured increased flavor, size, nicotine strength and user imagery variation. Marlboro and Camel Snus advertising mirrors historical advertising for Skoal Bandits, designed to recruit new users and smokers subjected to smokefree places. Despite serious efforts, pouched MST marketing has been unable to dispel its association with traditional smokeless tobacco stereotypes as macho and rural. Public education efforts to discourage new users and dual use of MST and cigarettes should emphasize that "new" pouch products are simply repackaging "old" smokeless tobacco.
Wang, Teresa W; Kenemer, Brandon; Tynan, Michael A; Singh, Tushar; King, Brian
Combustible and smokeless tobacco use causes adverse health outcomes, including cardiovascular disease and multiple types of cancer (1,2). Standard approaches for measuring tobacco use include self-reported surveys of use and consumption estimates based on tobacco excise tax data (3,4). To provide the most recently available tobacco consumption estimates in the United States, CDC used federal excise tax data to estimate total and per capita consumption during 2000-2015 for combustible tobacco (cigarettes, roll-your-own tobacco, pipe tobacco, small cigars, and large cigars) and smokeless tobacco (chewing tobacco and dry snuff). During this period, total combustible tobacco consumption decreased 33.5%, or 43.7% per capita. Although total cigarette consumption decreased 38.7%, cigarettes remained the most commonly used combustible tobacco product. Total noncigarette combustible tobacco (i.e., cigars, roll-your-own, and pipe tobacco) consumption increased 117.1%, or 83.8% per capita during 2000-2015. Total consumption of smokeless tobacco increased 23.1%, or 4.2% per capita. Notably, total cigarette consumption was 267.0 billion cigarettes in 2015 compared with 262.7 billion in 2014. These findings indicate that although cigarette smoking declined overall during 2000-2015, and each year from 2000 to 2014, the number of cigarettes consumed in 2015 was higher than in 2014, and the first time annual cigarette consumption was higher than the previous year since 1973. Moreover, the consumption of other combustible and smokeless tobacco products remains substantial. Implementation of proven tobacco prevention interventions (5) is warranted to further reduce tobacco use in the United States.
Widome, Rachel; Brock, Betsy; Klein, Elizabeth G; Forster, Jean L
We aimed to describe the prevalence, in-store location, and neighborhood predictors of point-of-sale smokeless tobacco advertising. In 2007, we conducted assessments of smokeless tobacco advertising at the point of sale in 484 establishments, which held tobacco licenses and sold tobacco products in a Midwest metropolitan area. Associations between store characteristics, neighborhood characteristics (based on U.S. 2000 census block groups), and smokeless tobacco advertising were calculated. Advertisements for smokeless tobacco were found in 21% (n = 103) of stores. Approximately, 12% (n = 58) of stores had ads within 6 feet of the counter, 3% (n = 14) had ads less than 3 feet from the ground, and 2% (n = 9) had advertisement less than 1 foot from candy or snacks. The racial/ethnic composition and number of households on public assistance within the block group in which a store was situated were related to the amount of smokeless advertising in stores. For instance, having a higher proportion of the population identifying as White was associated with more advertising. Gas stations/convenience stores had more advertising than any other store types. Chain stores had double the amount of advertising as independent stores (p advertising is not uncommon even in an urban metropolitan community. These products are being advertised in a way that youth, especially those living in neighborhoods with certain demographic characteristics, can encounter. With Food and Drug Administration regulation, there are new opportunities to regulate advertising at the point of sale.
Rooban, Thavarajah; Vidya, KM; Joshua, Elizabeth; Rao, Anita; Ranganathan, Shanthi; Rao, Umadevi K; Ranganathan, K
Background: Alcohol and tobacco abuse are detrimental to general and oral health. Though the effects of these harmful habits on oral mucosa had been demonstrated, their independent and combined effect on the dental caries experience is unknown and worthy of investigation. Materials and Methods: We compared 268 alcohol-only abusers with 2426 alcohol and tobacco abusers in chewing and smoking forms to test the hypothesis that various components of their dental caries experience are significantly different due to plausible sociobiological explanations. Clinical examination, Decay, Missing, Filled Teeth (DMFT) Index and Oral Hygiene Index - Simplified were measured in a predetermined format. Descriptive statistics, Chi-square test and one-way ANOVA analysis were done using SPSS Version 16.0. Result: The mean DMFT were 3.31, 3.24, 4.09, 2.89 for alcohol-only abusers, alcohol and chewing tobacco abusers, smoking tobacco and alcohol abusers, and those who abused tobacco in smoke and smokeless forms respectively. There was no significant difference between the oral hygiene care measures between the study groups. Presence of attrition among chewers and those with extrinsic stains experienced less caries than others. Discussion and conclusion: The entire study population exhibited a higher incidence of caries experience. Use of tobacco in any form appears to substantially increase the risk for dental caries. Attrition with use of chewing tobacco and presence of extrinsic stains with tobacco use appear to provide a protective effect from caries. The changes in oral micro-flora owing to tobacco use and alcohol may play a critical role in the initiation and progression of dental caries. PMID:21731272
Carpenter, C M; Connolly, G N; Ayo-Yusuf, O A; Wayne, G Ferris
To investigate whether development of smokeless tobacco products (SLT) is intended to target current smokers. This study analysed internal tobacco industry documents to describe research related to the smokeless tobacco market. Relevant documents included those detailing the development and targeting of SLT products with a particular emphasis on moist snuff. Cigarette and SLT manufacturers recognised that shifting demographics of SLT users, as well as indoor smoking restrictions, health concerns and reduced social acceptability of smoking could impact the growth of the SLT market. Manufacturers developed new SLT products to target cigarette smokers promoting dual cigarette and SLT use. Heavy marketing of new SLT products may encourage dual use and result in unknown public health effects. SLT products have been designed to augment cigarette use and offset regulatory strategies such as clean indoor air laws. In the United States, the SLT strategy may provide cigarette companies with a diversified range of products under the prospect of federal regulation. These products may pose significant challenges to efforts by federal agencies to reduce harm caused by tobacco use.
Bromberg, Julie E; Augustson, Erik M; Backinger, Cathy L
Videos of smokeless tobacco (ST) on YouTube are abundant and easily accessible, yet no studies have examined the content of ST videos. This study assesses the overall portrayal, genre, and messages of ST YouTube videos. In August 2010, researchers identified the top 20 search results on YouTube by "relevance" and "view count" for the following search terms: "ST," "chewing tobacco," "snus," and "Skoal." After eliminating videos that were not about ST (n = 26), non-English (n = 14), or duplicate (n = 42), a final sample of 78 unique videos was coded for overall portrayal, genre, and various content measures. Among the 78 unique videos, 15.4% were anti-ST, while 74.4% were pro-ST. Researchers were unable to determine the portrayal of ST in the remaining 10.3% of videos because they involved excessive or "sensationalized" use of the ST, which could be interpreted either positively or negatively, depending on the viewer. The most common ST genre was positive video diaries (or "vlogs"), which made up almost one third of the videos (29.5%), followed by promotional advertisements (20.5%) and anti-ST public service announcements (12.8%). While YouTube is intended for user-generated content, 23.1% of the videos were created by professional organizations. These results demonstrate that ST videos on YouTube are overwhelmingly pro-ST. More research is needed to determine who is viewing these ST YouTube videos and how they may affect people's knowledge, attitudes, and behaviors regarding ST use.
Ernster, V L; Grady, D G; Greene, J C; Walsh, M; Robertson, P; Daniels, T E; Benowitz, N; Siegel, D; Gerbert, B; Hauck, W W
The effects of smokeless tobacco (ST) use were studied in 1109 members of major and minor league professional baseball teams during spring training in 1988. The prevalence of current ST use was 39%. The median age at initiation among users was 18 years, and the median duration of use was 5 years. Among users, 75% cited a snuff brand as their usual ST product. Oral leukoplakia was present in 46% (196/423) of current-week ST users and 1.4% (7/493) of nonusers (odds ratio, 60; 95% confidence interval, 28 to 130). Prevalence of oral leukoplakia among ST users increased with hours used per day and decreased with time lapsed since last use, and was higher in snuff users than in chewing tobacco users. Of the subjects with oral leukoplakia who underwent punch biopsy, 91 had benign hyperkeratosis and one had mild dysplasia. Overall prevalence of dental caries, gingivitis, and plaque did not differ between ST users and nonusers. In analyses confined to facial surfaces of mandibular incisor teeth, where ST is most commonly used, there were significant increases among users in both gingival recession and attachment loss. Users of ST did not differ from nonusers in blood pressure, pulse, total or high-density lipoprotein cholesterol level, or white blood cell count, but among users high-density lipoprotein cholesterol levels were inversely associated with serum cotinine levels. The major health effects of ST use among professional baseball players are oral leukoplakia and localized periodontal disease. The study population was young, physically fit, and characterized by relatively moderate short-term ST use.
Augustson, Erik M.; Backinger, Cathy L.
Objectives: Videos of smokeless tobacco (ST) on YouTube are abundant and easily accessible, yet no studies have examined the content of ST videos. This study assesses the overall portrayal, genre, and messages of ST YouTube videos. Methods: In August 2010, researchers identified the top 20 search results on YouTube by “relevance” and “view count” for the following search terms: “ST,” “chewing tobacco,” “snus,” and “Skoal.” After eliminating videos that were not about ST (n = 26), non-English (n = 14), or duplicate (n = 42), a final sample of 78 unique videos was coded for overall portrayal, genre, and various content measures. Results: Among the 78 unique videos, 15.4% were anti-ST, while 74.4% were pro-ST. Researchers were unable to determine the portrayal of ST in the remaining 10.3% of videos because they involved excessive or “sensationalized” use of the ST, which could be interpreted either positively or negatively, depending on the viewer. The most common ST genre was positive video diaries (or “vlogs”), which made up almost one third of the videos (29.5%), followed by promotional advertisements (20.5%) and anti-ST public service announcements (12.8%). While YouTube is intended for user-generated content, 23.1% of the videos were created by professional organizations. Conclusions: These results demonstrate that ST videos on YouTube are overwhelmingly pro-ST. More research is needed to determine who is viewing these ST YouTube videos and how they may affect people’s knowledge, attitudes, and behaviors regarding ST use. PMID:22080585
This PSA helps retailers understand new federal regulations surrounding the sale of unpackaged cigarettes and smokeless tobacco. Created: 10/28/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products. Date Released: 10/28/2010.
Timberlake David S
Full Text Available Abstract Some tobacco researchers have argued that the European Union should remove its ban on a form of low-nitrosamine smokeless tobacco referred to as Swedish 'snus'. This argument has developed in to an international debate over the use of smokeless tobacco as a measure of harm reduction for smokers. Leading authorities in the USA have firmly stated that there is no safe tobacco - a message which does not allow for any discussion of comparative tobacco risks. This commentary is intended to review the origin of the controversy over Swedish 'snus', to examine briefly the meta-analysis on cancer risks by Peter Lee and Jan Hamling (published in July in BMC Medicine and to discuss the anticipated direction of the debate on tobacco-harm reduction in the USA. We anticipate that much of the debate will shift from the discussion of epidemiologic data to the discussion of the marketing, health communication and economics of smokeless tobacco. While the Food and Drug Administration's newly approved authority over tobacco will undoubtedly affect the smokeless products, it may not be the sole determinant of harm reduction's fate in the USA. See associated research article by Lee and Hamling: http://www.biomedcentral.com/1741-7015/7/36
... tobacco that is intended to be placed in the oral or nasal cavity or otherwise consumed without being... Postal Service understands that the list may not be available until 180 days after the PACT Act's... Service understands snus to be a form of smokeless tobacco, as defined by the PACT Act, it would fall...
Schensul, Jean J; Nair, Saritha; Bilgi, Sameena; Cromley, Ellen; Kadam, Vaishali; Mello, Sunitha D; Donta, Balaiah
Objective To examine the role of accessibility, product availability, promotions and social norms promotion, factors contributing to the use of smokeless tobacco (ST) products in a typical low-income community of Mumbai community using Geographic Information System (GIS), observational and interview methodologies and to assess implementation of Cigarettes and other Tobacco Products Act (COTPA) legislation. Rationale In India, the third largest producer of tobacco in the world, smokeless tobacco products are used by men, women and children. New forms of highly addictive packaged smokeless tobacco products such as gutkha are inexpensive and rates of use are higher in low-income urban communities. These products are known to increase rates of oral cancer and to affect reproductive health and fetal development. Methods The study used a mixed methods approach combining ethnographic and GIS mapping, observation and key informant interviews. Accessibility was defined as density, clustering and distance of residents and schools to tobacco outlets. Observation and interview data with shop owners and community residents produced an archive of products, information on shop histories and income and normative statements. Results Spatial analysis showed high density of outlets with variations across subcommunities. All residents can reach tobacco outlets within 30–100 feet of their homes. Normative statements from 55 respondents indicate acceptance of men’s, women’s and children’s use, and selling smokeless tobacco is reported to be an important form of income generation for some households. Multilevel tobacco control and prevention strategies including tobacco education, community norms change, licensing and surveillance and alternative income generation strategies are needed to reduce accessibility and availability of smokeless tobacco use. PMID:22387521
Muula Adamson S
Full Text Available Abstract Background Tobacco use is a leading cause of global morbidity and mortality. Much of the epidemiologic research on tobacco focuses on smoking, especially cigarette smoking, but little attention on smokeless tobacco (SLT. Methods Using data from the Republic of Congo Global Youth Tobacco Survey (GYTS of 2006, we estimated the prevalence of SLT use among in-school adolescents. We also assessed the association between SLT use and cigarette smoking as well as the traditional factors which are associated with cigarette smoking among adolescents (e.g. age, sex, parental or peer smoking. Unadjusted odds ratios (OR and adjusted odds ratios (AOR together with their 95% confidence intervals (CI were used to measure magnitudes of associations. Results Of the 3,034 respondents, 18.0% (18.0% males and 18.1% females reported having used smokeless tobacco (chewing tobacco, sniff or dip in the last 30 days. In multivariate analysis, no significant associations were observed between age and sex on one hand and current smokeless tobacco use on the other. Cigarette smokers were more than six times likely to report current use of smokeless tobacco (AOR = 6.65; 95% CI [4.84, 9.14]. Having parents or friends smokers was positively associated with using smokeless tobacco (AOR = 1.98; 95% CI [1.51, 2.59] for parents who smoked cigarettes, AOR = 1.82; 95% CI [1.41, 2.69] for some friends who smoked cigarettes, and AOR = 2.02; 95% CI [1.49, 2.47] for most or all friends who smoked cigarettes. Respondents who reported have seen tobacco advertisement on TV, billboards and in newspapers/magazines were 1.95 times more likely to report current use of smokeless tobacco (AOR = 1.95; 95% CI [1.34, 3.08]. Perception that smoking was harmful to health was negatively associated with current use of smokeless tobacco (AOR = 0.60; 95% CI [0.46, 0.78]. Conclusions Prevention programs aimed to reduce teen [cigarette] smoking must also be designed to reduce other forms of
Rudatsikira, Emmanuel; Muula, Adamson S; Siziya, Seter
Tobacco use is a leading cause of global morbidity and mortality. Much of the epidemiologic research on tobacco focuses on smoking, especially cigarette smoking, but little attention on smokeless tobacco (SLT). Using data from the Republic of Congo Global Youth Tobacco Survey (GYTS) of 2006, we estimated the prevalence of SLT use among in-school adolescents. We also assessed the association between SLT use and cigarette smoking as well as the traditional factors which are associated with cigarette smoking among adolescents (e.g. age, sex, parental or peer smoking). Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) together with their 95% confidence intervals (CI) were used to measure magnitudes of associations. Of the 3,034 respondents, 18.0% (18.0% males and 18.1% females) reported having used smokeless tobacco (chewing tobacco, sniff or dip) in the last 30 days. In multivariate analysis, no significant associations were observed between age and sex on one hand and current smokeless tobacco use on the other. Cigarette smokers were more than six times likely to report current use of smokeless tobacco (AOR = 6.65; 95% CI [4.84, 9.14]). Having parents or friends smokers was positively associated with using smokeless tobacco (AOR = 1.98; 95% CI [1.51, 2.59] for parents who smoked cigarettes, AOR = 1.82; 95% CI [1.41, 2.69] for some friends who smoked cigarettes, and AOR = 2.02; 95% CI [1.49, 2.47] for most or all friends who smoked cigarettes). Respondents who reported have seen tobacco advertisement on TV, billboards and in newspapers/magazines were 1.95 times more likely to report current use of smokeless tobacco (AOR = 1.95; 95% CI [1.34, 3.08]). Perception that smoking was harmful to health was negatively associated with current use of smokeless tobacco (AOR = 0.60; 95% CI [0.46, 0.78]). Prevention programs aimed to reduce teen [cigarette] smoking must also be designed to reduce other forms of tobacco use. The teenagers environment at home, at school and
Khan, Z.; Tonnies, J.; Muller, S.; Khan, Z.
Smokeless tobacco is considered one of the major risk factors for oral cancer. It is estimated that over 90% of the global smokeless tobacco use burden is in South Asia. This paper aims to systematically review publications reporting epidemiological observational studies published in South Asia from 1984 till 2013. Methods. An electronic search in “Medline” and “ISI Web of Knowledge” yielded 734 publications out of which 21 were included in this review. All publications were assessed for quality using a standard quality assessment tool. Effect estimates (odds ratios (OR)) were abstracted or calculated from the given data. A random effects meta-analysis was performed to assess the risk of oral cancer with the use of different forms of smokeless tobacco. Results and Conclusion. The pooled OR for chewing tobacco and risk of oral cancer was 4.7 [3.1-7.1] and for paan with tobacco and risk of oral cancer was 7.1 [4.5-11.1]. The findings of this study suggest a strong causal link between oral cancer and various forms of smokeless tobacco. Public health policies in affected countries should consider SLT specific cessation programs in addition to campaigns and activities incorporated into smoking cessation programs.
Portnoy, David B; Wu, Charles C; Tworek, Cindy; Chen, Jiping; Borek, Nicolette
Curiosity about cigarettes is a reliable predictor of susceptibility to smoking and established use among youth. Related research has been limited to cigarettes, and lacks national-level estimates. Factors associated with curiosity about tobacco products, such as advertising, have been postulated but rarely tested. To describe the prevalence of curiosity about cigarettes, smokeless tobacco, and cigars among youth and explore the association between curiosity and self-reported tobacco advertising exposure. Data from the 2012 National Youth Tobacco Survey, a nationally representative survey of 24,658 students, were used. In 2013, estimates weighted to the national youth school population were calculated for curiosity about cigarettes, smokeless tobacco, and cigars among never users of any tobacco product. Associations between tobacco advertising and curiosity were explored using multivariable regressions. Curiosity about cigarettes (28.8%); cigars (19.5%); and smokeless tobacco (9.7%) was found, and many youth were curious about more than one product. Exposure to point-of-sale advertising (e.g., OR=1.35, 95% CI=1.19, 1.54 for cigarette curiosity); tobacco company communications (e.g., OR=1.70, 95% CI=1.38, 2.09 for cigarette curiosity); and tobacco products, as well as viewing tobacco use in TV/movies (e.g., OR=1.37, 95% CI=1.20, 1.58 for cigarette curiosity) were associated with curiosity about each examined tobacco product. Despite decreasing use of tobacco products, youth remain curious about them. Curiosity is associated with various forms of tobacco advertising. These findings suggest the importance of measuring curiosity as an early warning signal for potential future tobacco use and evaluating continued efforts to limit exposure to tobacco marketing among youth. Published by Elsevier Inc.
Savitz, David A; Meyer, Roger E; Tanzer, Jason M; Mirvish, Sidney S; Lewin, Freddi
Harm reduction strategies involve promoting a product that has adverse health consequences as a substitute for one that has more severe adverse health consequences. Smokeless tobacco low in nitrosamine content offers potential benefits in reducing smoking prevalence rates. Possible harm arises from the potential for such products to serve as a gateway to more harmful tobacco products, public misinterpretation of "less harmful" as "safe," distraction from the public health goal of tobacco elimination, and ethical issues involved in advising those marketing these harmful products. We offer a research agenda to provide a stronger basis for evaluating the risks and benefits of smokeless tobacco as a means of reducing the adverse health effects of tobacco.
... on each brand of the product and (2) be randomly distributed in all parts of the United States in... distribution means that there is nothing in the production or distribution process of a smokeless tobacco..., nothing in these regulations requires the use of more than one warning statement on the label of any brand...
Mutti, Seema; Reid, Jessica L; Gupta, Prakash C; Pednekar, Mangesh S; Dhumal, Gauri; Nargis, Nigar; Hussain, Akm Ghulam; Hammond, David
Globally, smokeless tobacco use is disproportionately concentrated in low-income and middle-income countries like India and Bangladesh. The current study examined comparative patterns of use and perceptions of harm for different smokeless tobacco products among adults and youth in Navi Mumbai, India, and Dhaka, Bangladesh. Face-to-face interviews were conducted on tablets with adult (19 years and older) smokeless tobacco users and youth (16-18 years) users and non-users in Navi Mumbai ( n = 1002), and Dhaka ( n = 1081). A majority (88.9%) of smokeless tobacco users reported daily use. Approximately one-fifth (20.4%) of the sample were mixed-users (used both smoked and smokeless tobacco), of which about half (54.4%) reported that they primarily used smokeless over smoked forms like cigarettes or bidis. The proportion of users planning to quit was higher in India than in Bangladesh (75.7% vs. 49.8%, p < 0.001). Gutkha was the most commonly used smokeless product in India, and pan masala in Bangladesh. Among users in Bangladesh, the most commonly reported reason for using their usual product was the belief that it was "less harmful" than other types. Perceptions of harm also differed with respect to a respondent's usual product. Bangladeshi respondents reported more negative attitudes toward smokeless tobacco compared to Indian respondents. The findings highlight the high daily use of smokeless tobacco, and the high prevalence of false beliefs about its harms. This set of findings reinforces the need to implement effective tobacco control strategies in low and middle-income countries like India and Bangladesh.
Hawkins, Summer Sherburne; Bach, Nicoline; Baum, Christopher F.
Background While increasing cigarette taxes has been a major policy driver to decrease smoking, taxes on other tobacco products have received less attention. Our aims were to evaluate the impact of chewing tobacco/cigar taxes, cigarette taxes, and smoke-free legislation on adolescent male and female use of smokeless tobacco and cigars. Methods We analyzed data on 499,381 adolescents age 14-18 years from 36 US states in the Youth Risk Behavior Surveys (1999-2013) linked to state-level tobacco ...
To support risk management decisions, information from different fields has been integrated in this presentation to provide a realistic quantitative cancer risk assessment of smokeless tobacco. Smoking among Swedish men is currently below 10%, while about 20% use a special smokeless tobacco (snus) as a substitute for cigarettes. Epidemiological data and molecular biomarkers demonstrate that rodent bioassays with tobacco specific nitrosamines (TSNA) overestimate cancer risk from snus by more than one order of magnitude. The underlying reasons are discussed. DNA damage constitutes a necessary, although not sufficient prerequisite for cancer initiation. Individuals who have not used tobacco exhibit DNA lesions identical with those induced by TSNA. No increase above this adduct background can be shown from snus, and extensive epidemiological studies in Sweden have failed to demonstrate elevated cancer risks even in long term users. A "bench mark" for acceptable risk of 1/10(6) derived from rodent data has been suggested when regulating snus. By relating similarly derived estimates for some food contaminants, the implementation even of a limit of 1/10(4) may be unrealistic. The management of smokeless tobacco products has rarely been based on a scientifically sound risk assessment, where attention is given to the outstandingly higher hazards associated with smoking. Copyright © 2017 Elsevier Inc. All rights reserved.
Melikian, Assieh A; Hoffmann, Dietrich
Recently, tobacco companies have been marketing moist smokeless tobacco products that are 'spitless'. These products have lower concentrations of tobacco-specific nitrosamines and of other harmful chemicals than other tobacco products, but can deliver relatively high doses of nicotine. They are packaged in small sachets, similar to tea bags that are placed between cheek and gum. Global promotion of smokeless tobacco products is hotly debated among tobacco control and public health experts. Proponents point to the Swedish experience where snus (Swedish moist snuff) is widely used as an alternative to cigarette smoking among men. Meanwhile, Sweden has low rates of smoking and a lower rate of respiratory diseases and lung cancers by comparison to other developed countries. The opponents argue that snus has its own risks, that no form of tobacco should ever be promoted; and that 'snus is culture-bound and not transferable to other settings'. Critics also suspect that the tobacco industry will use snus marketing as a 'gateway' to promote cigarettes among young people. Research on the effects of marketing snus to smokers is too limited to support using snus as a harm-reduction tool, and the epidemiological data are not conclusive.
Vidhubala, E.; Pisinger, C.; Basumallik, B.
Background: India is the world's third largest consumer of tobacco. There are twice as many users of smokeless tobacco products (STPs) as cigarette smokers. The Government of Tamil Nadu has banned the sale of gutkha and pan masala in 2013. Our aim was to identify the varieties of illegal STP...... not have a pictorial warning; a text warning was printed on 80.8%, but only two products had the messages in Tamil; 70% had promotional messages printed, and 57% had their registration numbers printed. Conclusion: The ban on STP is being systematically violated in Chennai. STP are cheap and easily...
D N Sinha; K M Palipudi; P C Gupta; S Singhal; C Ramasundarahettige; P Jha; A Indrayan; S Asma; G Vendhan
Background: Use of smokeless tobacco (SLT) is widely prevalent in India and Indian subcontinent. Cohort and case-control studies in India and elsewhere report excess mortality due to its use. Objective: The aim was to estimate the SLT use-attributable deaths in males and females, aged 35 years and older, in India. Materials And Methods: Prevalence of SLT use in persons aged 35 years and older was obtained from the Global Adult Tobacco Survey in India and population size and deaths in the rele...
Lorkiewicz, Pawel; Riggs, Daniel W; Keith, Rachel J; Conklin, Daniel J; Xie, Zhengzhi; Sutaria, Saurin; Lynch, Blake; Srivastava, Sanjay; Bhatnagar, Aruni
Cigarette smoking is associated with an increase in cardiovascular disease risk, attributable in part to reactive volatile organic chemicals (VOCs). However, little is known about the extent of VOC exposure due to the use of other tobacco products. We recruited 48 healthy, tobacco users in four groups: cigarette, smokeless tobacco, occasional users of first generation e-cigarette and e-cigarette menthol and 12 healthy nontobacco users. After abstaining for 48 h, tobacco users used an assigned product. Urine was collected at baseline followed by five collections over a 3-h period to measure urinary metabolites of VOCs, nicotine, and tobacco alkaloids. Urinary levels of nicotine were ≃2-fold lower in occasional e-cigarette and smokeless tobacco users than in the cigarette smokers; cotinine and 3-hydroxycotinine levels were similar in all groups. Compared with nontobacco users, e-cigarette users had higher levels of urinary metabolites of xylene, cyanide, styrene, ethylbenzene, and benzene at baseline and elevated urinary levels of metabolites of xylene, N,N-dimethylformamide, and acrylonitrile after e-cigarette use. Metabolites of acrolein, crotonaldehyde, and 1,3-butadiene were significantly higher in smokers than in users of other products or nontobacco users. VOC metabolite levels in smokeless tobacco group were comparable to those found in nonusers with the exception of xylene metabolite-2-methylhippuric acid (2MHA), which was almost three fold higher than in nontobacco users. Smoking results in exposure to a range of VOCs at concentrations higher than those observed with other products, and first generation e-cigarette use is associated with elevated levels of N,N-dimethylformamide and xylene metabolites. This study shows that occasional users of first generation e-cigarettes have lower levels of nicotine exposure than the users of combustible cigarettes. Compared with combustible cigarettes, e-cigarettes, and smokeless tobacco products deliver lower levels of
Jackler, Robert K; VanWinkle, Callie K; Bumanlag, Isabela M; Ramamurthi, Divya
In 2009, the Food and Drug Administration (FDA) banned characterising flavours in cigarettes (except for menthol) due to their appeal to teen starter smokers. In August 2016, the agency deemed all tobacco products to be under its authority and a more comprehensive flavour ban is under consideration. To determine the scope and scale of alcohol-flavoured tobacco products among cigars & cigarillos, hookahs and electronic cigarettes (e-cigarettes). Alcohol-flavoured tobacco products were identified by online search of tobacco purveyors' product lines and via Google search cross-referencing the various tobacco product types versus a list of alcoholic beverage flavours (eg, wine, beer, appletini, margarita). 48 types of alcohol-flavoured tobacco products marketed by 409 tobacco brands were identified. Alcohol flavours included mixed drinks (n=25), spirits (11), liqueurs (7) and wine/beer (5). Sweet and fruity tropical mixed drink flavours were marketed by the most brands: piña colada (96), mojito (66) and margarita (50). Wine flavours were common with 104 brands. Among the tobacco product categories, brands offering alcohol-flavoured e-cigarettes (280) were most numerous, but alcohol-flavoured products were also marketed by cigars & cigarillos (88) and hookah brands (41). Brands by major tobacco companies (eg, Philip Morris, Imperial Tobacco) were well represented among alcohol-flavoured cigars & cigarillos with five companies offering a total of 17 brands. The widespread availability of alcohol-flavoured tobacco products illustrates the need to regulate characterising flavours on all tobacco products. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Sajid, Faiza; Bano, Samina
Dipping tobacco, traditionally referred to as moist snuff, is a type of finely ground, moistened smokeless tobacco product. Naswar is stuffed in the floor of the mouth under the lower lip, or inside the cheek, for extended periods of time. Tobacco use causes dyslipidemia and also induces oxidative stress, leading to alteration in levels of antioxidant enzymes. Dyslipidemia and oxidative stress in turn play a vital role in the development of cardiovascular disease (CVD). Studies conducted on smokeless tobacco products reveal contradictory findings regarding its effects on lipid profile and antioxidant enzymes. As use of Naswar is quite common in Pakistan, the current study aimed to evaluate levels of the antioxidant enzymes viz glutathione per oxidase (GPx) and super oxide dismutase (SOD), alongside lipid profile parameters such as total cholesterol, triglycerides, High density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) to assess the risk of adverse cardiovascular events in Naswar users.90 Healthy males aged 16-43 years, who consumed Naswar daily, were selected for the study, alongside 68 age-matched non-tobacco users as controls. Both GPx and SOD levels as well as serum HDL-C were significantly reduced (Pprofile and antioxidant enzymes thereby placing its consumers at an increased risk of cardiovascular disease.
... (chewing tobacco and snuff) has not been a focus of medical services or research, Epidemiological data suggest that while smoking has continued to decline both in the general population and within the military, the use...
Murukutla, Nandita; Yan, Hongjin; Wang, Shuo; Negi, Nalin Singh; Kotov, Alexey; Mullin, Sandra; Goodchild, Mark
Tobacco control mass media campaigns are cost-effective in reducing tobacco consumption in high-income countries, but similar evidence from low-income countries is limited. An evaluation of a 2009 smokeless tobacco control mass media campaign in India provided an opportunity to test its cost-effectiveness. Campaign evaluation data from a nationally representative household survey of 2898 smokeless tobacco users were compared with campaign costs in a standard cost-effectiveness methodology. Costs and effects of the Surgeon campaign were compared with the status quo to calculate the cost per campaign-attributable benefit, including quit attempts, permanent quits and tobacco-related deaths averted. Sensitivity analyses at varied CIs and tobacco-related mortality risk were conducted. The Surgeon campaign was found to be highly cost-effective. It successfully generated 17 259 148 additional quit attempts, 431 479 permanent quits and 120 814 deaths averted. The cost per benefit was US$0.06 per quit attempt, US$2.6 per permanent quit and US$9.2 per death averted. The campaign continued to be cost-effective in sensitivity analyses. This study suggests that tobacco control mass media campaigns can be cost-effective and economically justified in low-income and middle-income countries. It holds significant policy implications, calling for sustained investment in evidence-based mass media campaigns as part of a comprehensive tobacco control strategy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Liaquat, N.; Jaffar, A.M.; Haroon, M.Z.; Khan, M.B.; Habib, H.
Background: According to World Health Organization (WHO), six million deaths are attributable to tobacco use globally, of which nearly 1.2 million occur in South-East Asia. Use of smokeless tobacco is highly prevalent in subcontinent and is home to over 250 million smokeless tobacco (ST) users. ST is a major public health problem. It cause localized oral lesions and poses risk for developing oral cancers owing to it containing more than 30 cancer causing substances, in addition to nicotine which is a highly addictive. This study was conducted to assess the overall knowledge and compare knowledge, attitude and perceptions of ST users presenting to private and public health care facilities. Methods: This cross sectional comparative study was carried out from April to July 2011 to establish the details of underlying factors and perceptions of areca/ST users presenting in public and private health care facilities of Karachi. Through systematic random sampling, 464 male and female users (=14 years) were interviewed. The data was analysed in SPSS-16. Results: Mean age of the users of Private Clinic (PC) was 25±7.183 years while that of Public hospitals (PH) respondents was 34±11.3 years. The respondents present in PC (94 percentage) had comparatively more knowledge than the users in PH (75 percentage). About 78 percentage of the study population in PH wanted to quit this habit of chewing whereas 88 percentage in PC have the same attitude (p-0.01). About 68 percentage in Public and 89 percentage in Private clinics ever tried to quit but failed; (p-0.000). Conclusion: Although respondents have substantial knowledge about the harmful effects of smokeless tobacco but due to their perceived psychological and emotional dependency, they remain addicted. (author)
Cristine D. Delnevo
Full Text Available As the most preventable cause of death in the world today, understanding tobacco use among one of the fastest growing ethnic/racial groups is warranted. We explore cigarette and smokeless tobacco (SLT use among South Asians in NJ and the Northeast using the Tobacco Use Supplement to the Current Population Survey. Overall, tobacco use rates among South Asians were similar or lower than the population. However, in NJ, South Asian males had the highest SLT rate (2.7% and in the Northeast, White (AOR = 5.8, 95% CI = 3.7–9.4 and South Asian males (AOR = 4.0, 95% CI = 1.5–10.6 had significantly higher odds of current SLT use relative to non-White males. Tobacco use among South Asians was not homogeneous; Pakistanis are overrepresented among cigarette smokers while Indians are overrepresented among SLT users. Given the differential tobacco use among and within South Asian, disaggregating data to understand tobacco use behaviors is necessary to develop effective interventions for tobacco cessation.
Brian G. Danaher
Conclusions: Consistent with previous research, the MyLastDip Web-based tobacco cessation intervention encouraged long-term levels of tobacco and smokeless tobacco abstinence. The addition of nicotine lozenges significantly improved both participant engagement and self-reported 7-day point prevalence tobacco abstinence at 3 months and when considering 3- and 6-month repeated point prevalence tobacco abstinence.
Jena, Pratap Kumar; Bandyopadhyay, Chandan; Mathur, Manu Raj; Das, Sagarika
The term 'hardcore' has been applied to use of smoking tobacco and generally referred to as the inability or unwillingness of regular smokers to quit. The component constructs of hardcore except nicotine dependence are product neutral. With the use of 'time to first chew' as a measure of nicotine dependence, hardcore definition can be extended to characterize smokeless tobacco users. Hardcore users respond less to tobacco cessation interventions, and are prone to tobacco induced diseases including cancer. Thus identifying hardcore users would help in estimate the burden of high risk population for tobacco induced diseases. Smokeless tobacco use is predominant and accounts for more than 50% of oral cancer in India. Hence, hardcore chewing information could be used for planning of tobacco and cancer control interventions. The objective of this study was to assess the prevalence and associated factors of hardcore smokeless tobacco use in India. Global Adult Tobacco Survey (GATS)-India 2010 data were analyzed to quantify hardcore smokeless tobacco use in India with following five criteria: (1) current daily smokeless tobacco use; (2) no quit attempt in the past 12 months of survey or last quit attempt of less than 24 hours duration; (3) no intention to quit in next 12 months or not interested in quitting; (4) time to first use of smokeless tobacco product within 30 minutes of waking up; and (5) knowledge of smokeless tobacco hazards. The number of hardcore smokeless tobacco users among adult Indians is estimated to be 5% (39.5 million). This group comprises 23.2% of daily smokeless tobacco users. The population prevalence varied from 1.4-9.1% across different national regions of India. Logistic regression modeling indicated age, education and employment status to be the major predictors of hardcore smokeless tobacco use in India. The presence of a huge number (39.5 million) of hardcore smokeless tobacco users is a challenge to tobacco control and cancer prevention in
Chaffee, Benjamin W; Urata, Janelle; Couch, Elizabeth T; Gansky, Stuart A
Beliefs that flavored smokeless tobacco (ST) is more pleasant, less potent, or otherwise easier to use could contribute to youth initiation. We evaluated associations between perceived ease-of-use of flavored ST (moist snuff and chewing tobacco) and ST initiation susceptibility in a representative sample of US youth. Among 7,718 tobacco never-users in the Population Assessment of Tobacco and Health study (age: 12-17; collected: 2013-2014), we compared 4 ST susceptibility items (curiosity, expectation, willingness to try, and a composite) according to whether participants reported flavored ST to be "easier to use" than unflavored ST. We calculated marginal prevalences of ST susceptibility and odds ratios adjusted for socio-demographic characteristics, tobacco advertisement receptivity, warning label exposure, and sensation seeking. ST susceptibility was greatest among tobacco never-users who perceived flavored ST as easier to use. Adjusted odds of potential ST susceptibility (≥1 item) were 1.5-fold higher (95% confidence interval: 1.2, 1.8) among adolescents who perceived flavored ST as easier to use than unflavored ST. ST flavors could contribute to perceptions that facilitate youth initiation. Alternatively, youth susceptible to ST use may perceive flavored varieties differently. Prospective studies are warranted to strengthen causal evidence and measure ST initiation according to perceived ease-of-use.
Coral E Gartner
Full Text Available BACKGROUND TO THE DEBATE: The tobacco control community is divided on whether or not to inform the public that using oral, smokeless tobacco (Swedish snus is less hazardous to health than smoking tobacco. Proponents of "harm reduction" point to the Swedish experience. Snus seems to be widely used as an alternative to cigarettes in Sweden, say these proponents, contributing to the low overall prevalence of smoking and smoking-related disease. Harm reduction proponents thus argue that the health community should actively inform inveterate cigarette smokers of the benefits of switching to snus. However, critics of harm reduction say that snus has its own risks, that no form of tobacco should ever be promoted, and that Sweden's experience is likely to be specific to that culture and not transferable to other settings. Critics also remain deeply suspicious that the tobacco industry will use snus marketing as a "gateway" to promote cigarettes. In the interests of promoting debate, the authors (who are collaborators on a research project on the future of tobacco control have agreed to outline the strongest arguments for and against promoting Swedish snus as a form of harm reduction.
Lee, Youn O; Hebert, Christine J; Nonnemaker, James M; Kim, Annice E
Noncigarette tobacco products are increasingly popular. Researchers need to understand multiple tobacco product use to assess the effects of these products on population health. We estimate national prevalence and examine risk factors for multiple product use. We calculated prevalence estimates of current use patterns involving cigarettes, cigars, electronic cigarettes, hookah, smokeless tobacco, and snus using data from the 2012 RTI National Adult Tobacco Survey (N=3627), a random-digit-dial telephone survey of adults aged 18 and over. Associations between use patterns (exclusive single product and multiple products) and demographic characteristics were examined using Pearson chi-square tests and logistic regression. 32.1% of adults currently use 1 or more tobacco products; 14.9% use cigarettes exclusively, and 6.6% use one noncigarette product exclusively, 6.9% use cigarettes with another product (dual use), 1.3% use two noncigarette products, and 2.4% use three or more products (polytobacco use). Smokers who are young adult, male, never married, reside in the West, and made prior quit attempts were at risk for multiple product use. Over 10% of U.S. adults use multiple tobacco products. A better understanding of multiple product use involving combustible products, like cigars and hookah, is needed. Multiple product use may be associated with past quit attempts. Copyright © 2014 Elsevier Inc. All rights reserved.
Full Text Available Introduction: More than one-third of the tobacco consumed in India is of smokeless form. While the smokeless tobacco (ST products have been strongly associated with oral cancer, the association between ST and periodontal disease is less clear. The present study was conducted on industrial workers because in premises, there is a ban on smoking tobacco and hence workers tend to consume more of ST products. Aim: The aim of this study is to assess periodontal status in ST chewers and nonchewers among industrial workers in North Bengaluru. Materials and Methods: A cross-sectional analytical study was conducted on 800 industrial workers (400 ST chewers and 400 nonchewers of North Bengaluru. Information regarding ST habits was obtained using the Global Adult Tobacco Survey questionnaire, followed by clinical examination to assess periodontal status using the community periodontal index and attachment loss. The comparison between chewers and nonchewers was done using Pearson's Chi-square test. Logistic regression analysis was used to estimate the difference of periodontal status and loss of attachment (LOA between chewers and nonchewers. Results: ST chewing habit was observed the maximum (46.5% among age group 25–44 years. Most of male chewers had habit of chewing gutkha followed by khaini, and majority of the female chewers were using khaini followed by betel nut quid. A significantly higher prevalence of bleeding on probing and calculus was found among nonchewers. ST chewers had 2.06 (95% confidence interval [CI]: 1.55–2.75 times more risk of developing periodontal pockets and 2.23 (95% CI: 1.68–2.98 times more risk of having LOA when compared with nonchewers. Conclusions: ST has deleterious effects on the periodontium. Hence, it is one of the important risk factors for periodontal disease.
Gupta, Prakash C; Maulik, Pallab K; Pednekar, Mangesh S; Saxena, Shekhar
The concurrent use of alcohol and tobacco and its deleterious effects have been reported in the western literature. However, studies on the relationship between concurrent alcohol and tobacco use in India are limited. This study outlines the association between concurrent alcohol and tobacco use among a middle-aged and elderly population in a western Indian cohort after controlling for various sociodemographic factors. A total of 35 102 men, 45 years of age and above were interviewed for concurrent alcohol and tobacco use. The sample was part of an earlier cohort drawn from the general population. The data were analysed after controlling for age, education, religion and mother-tongue. Among alcohol users, 51.1% smoked tobacco and 35.6% used smokeless tobacco. The relative risk of alcohol use was highest among those smoking cigarettes or beedis and among those using mishri with betel quid and tobacco. The risk of alcohol use increased with the frequency of tobacco use. The risk also increased with higher amounts of alcohol consumption, but peaked at around 100-150 ml of absolute alcohol use. The study highlights the association between concurrent alcohol and tobacco use among the Indian population. This has important public health implications since concurrent use of these is synergistic for increased risk of oropharyngeal cancers.
Mohammad Nurul Azam
Full Text Available Cost, social acceptability and non-stringent regulations pertaining to smokeless tobacco (SLT product sales have made people choose and continue using SLT. If disaggregated data on smokeless forms and smoked practices of tobacco are reviewed, the incidence of SLT remains static. There is a strong positive correlation of SLT intake with the occurrence of adverse cardiovascular disease, particularly in the low socioeconomic populations.To investigate the prevalence of smokeless tobacco, its initiation influence and risk factors associated with the practice among lower socioeconomic populations of Bangladesh. In this study, we explore the utilization of SLT among lower socioeconomic populations in industrialized zone of Bangladesh.A cross-sectional analysis using both quantitative and categorical approaches was employed. Using systematic random sampling method, four focus group discussions (FGDs were conducted and 459 participants were interviewed. Multiple logistic regression model was applied to distinguish the significant factors among the SLT users.Almost fifty percent of the respondents initiated SLT usage at the age of 15-24 years and another 22 percent respondents were smoking and using SLT concurrently. The bulk of the women respondents used SLT during their pregnancy. Nearly twenty five percent of the respondents tried to quit the practice of SLT and one-quarter had a plan to quit SLT in the future. More than twenty percent respondents were suffering from dental decay. A noteworthy correlation was found by gender (p<0.01, sufferings from SLT related disease (p<0.05. The multiple logistic regression analysis suggested that, males were 2.7 times more knowledgeable than that of females (p<0.01 about the adversative health condition of SLT usage. The respondents suffering from SLT related diseases were 3.7 times as more knowledgeable about the effect of the practice of SLT than the respondents without diseases (p<0.01. Regarding the knowledge
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Seidenberg, Andrew B; Rodgers, Elizabeth J; Rees, Vaughan W; Connolly, Gregory N
Smokeless tobacco (SLT) use among white adolescent males has increased in recent years, and prevalence of SLT use among adolescent males exceeds that for smoking in several U.S. states. Recent reports have described the presence of cigarette-related content on social media Web sites popular among youth; however, little has been reported on SLT content. The YouTube video search engine was searched for the popular SLT brand Skoal, and the first 50 search results were downloaded. Video statistics data were collected for and content analysis was performed on all videos featuring smokeless use (82%). Access to SLT YouTube videos by youth was also determined by assessing whether YouTube permits youth viewing and creation of SLT videos. Mean number of views for videos analyzed was 15,422, and the most watched video had 124,276 views. Descriptions of SLT flavor/smell and social references/interactions were found in 48.8% and 63.4% of videos, respectively. By contrast, references to drug (nicotine) effects (12.2%) and public health messaging (9.8%) were less common. None of the SLT videos in the sample had restrictions that would block youth viewing. In addition, evidence of self-identified youth creating SLT videos was found for 13% of unique users in the sample. YouTube does not restrict youth from creating or viewing "dip videos." Proactive efforts are needed to ensure that YouTube and other online media do not become influential vehicles for tobacco promotion to youth. Copyright Â© 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Rogers, John D; Biener, Lois; Clark, Pamela I
This exploratory study was designed to assess the availability, price, and point-of-purchase marketing strategies for new smokeless tobacco products in 4 test market areas. A random sample of 50 gas stations, convenience and food stores, and tobacco shops was selected in each of 4 test market areas. Pairs of observers visited each store, recorded product information, and engaged vendors in conversation about product demand. Snus was available in 64% of the stores, but availability and price differed by brand. Point-of-purchase marketing also varied by brand on a variety of dimensions and all brands appeared to be marketed primarily to smokers. Camel Snus was described by store attendants as having the highest demand and was also the most expensive of the observed products. In light of the number of test market cities and intensity of promotion at retail locations, Camel Snus was the most intensively marketed product. The results appear to reflect differences in marketing strategy by American snus manufacturers. These strategies may help to predict future marketing of snus and other tobacco products and may provide a baseline for later assessments of product acceptance.
Kaur, Jagdish; Thamarangsi, Thaksaphon; Rinkoo, Arvind Vashishta
South-East Asia Region (SEAR) has more smokeless tobacco users as compared to smokers. The growing prevalence and cultural acceptance of consumption of flavored areca nut and related products, for example, supari and pan masala in many countries are confounding the scenario. The prevalence of a variety of tobacco products makes regulation a challenge which gets more complicated in view of weak enforcement of regulatory policies aggressive marketing of such products by the tobacco industry. Some countries have attempted to regulate smokeless tobacco and related products by enforcing bans. However, limited evidence base along with lack of technical and regulatory capacities have restricted the SEAR countries to effectively implement product regulation in respect of smokeless tobacco and related products. This paper lays out specific priorities for research and need to enhance regulatory capacity for smokeless tobacco and processed areca nut in the SEAR countries. A systematic and comprehensive search was conducted to identify all original published literature related to regulating smokeless tobacco and processed areca nut. Studies reporting on the same were obtained through searches in relevant academic databases. Relevant World Health Organization (WHO) documents and reports on tobacco products regulation were consulted. Generating the right evidence along with the need to build the capacity of the countries to test the smokeless tobacco and processed areca nut products by establishing testing facilities and providing practical guidelines is of paramount importance. The countries of the SEAR need to prioritize the implementation of Articles 9 and 10 of the WHO Framework Convention on Tobacco Control to strengthen the regulation of smokeless tobacco and processed areca nut products.
Adkison, Sarah E; O'Connor, Richard J; Bansal-Travers, Maansi; Cummings, K Michael; Rees, Vaughan W; Hatsukami, Dorothy K
Validated methods to evaluate consumer responses to modified risk tobacco products (MRTPs) are needed. Guided by existing literature that demonstrates a relationship between normative beliefs and future intentions to use tobacco the current research sought to (1) develop a measure of normative beliefs about smokeless tobacco (ST) and establish the underlying factor structure, (2) evaluate the structure with confirmatory factor analysis utilizing an independent sample of youth, and (3) establish the measure's concurrent validity. Respondents (smokers and nonsmokers aged 15-65; N = 2991) completed a web-based survey that included demographic characteristics, tobacco use history and dependence, and a measure of attitudes about ST adapted from the Normative Beliefs about Smoking scale. A second sample of youth (aged 14-17; N = 305) completed a similar questionnaire. Exploratory factor analysis produced the anticipated three-factor solution and accounted for nearly three-quarters of the variance in the data reflecting (1) perceived prevalence of ST use, (2) popularity of ST among successful/elite, and (3) approval of ST use by parents/peers. Confirmatory factor analysis with data from the youth sample demonstrated good model fit. Logistic regression demonstrated that the scales effectively discriminate between ST users and nonusers and are associated with interest in trying snus. Assessment of MRTPs for regulatory purposes, which allows messages of reduced risk, should include measurement of social norms. Furthermore, surveillance efforts that track use of new MRTPs should include measures of social norms to determine how norms change with prevalence of use. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Kuldeep Singh Shekhawat
Full Text Available Background: Tobacco consumption is highest among labor classes and low socioeconomic status (SES, with inclination toward smokeless tobacco (SLT. Aim: The aim of the study was to determine the prevalence and pattern of SLT consumption with secondary objective to profile various sachets of SLT most commonly sold in the study setting. Setting and Design: A cross-sectional questionnaire study conducted in rural Puducherry. Materials and Methods: A self-interviewed structured questionnaire was administered to 150 participants from two villages. Data on education, occupation, and income were collected with details in the form of tobacco consumed, duration of habit, daily consumption, and brand of SLT among other things. Profiling of sachets was done with manufacturing date, date of expiry, presence and absence of warning signs, and name of the manufacturer as parameter. Statistical Analysis: Descriptive analysis was done for frequency distribution and Chi-square test for proportions. Results: The overall prevalence of SLT was 44% with women consuming more than males. 41–50-year-old were highest users of SLT. More than 50% of the participants were unaware of the “pictorial warnings” and 65% did not know about the presence of “contents” on sachets. Pan masala with tobacco was the most preferred form. Only 5 of the 23 commercial brands of sachets had both “pictorial and readable warnings” printed. Conclusion: The prevalence of STC was high when compared to the general population. Steps need to be taken to address the adverse effects printed on sachets for low SES populations. The printed warnings need to be inspected regularly. Dual tobacco use is a new addition to the existing list of challenges.
Peeters, Silvy; Gilmore, Anna B.
Background European Union (EU) legislation bans the sale of snus, a smokeless tobacco (SLT) which is considerably less harmful than smoking, in all EU countries other than Sweden. To inform the current review of this legislation, this paper aims to explore transnational tobacco company (TTC) interests in SLT and pure nicotine in Europe from the 1970s to the present, comparing them with TTCs' public claims of support for harm reduction. Methods and Results Internal tobacco industry documents (in total 416 documents dating from 1971 to 2009), obtained via searching the online Legacy Tobacco Documents Library, were analysed using a hermeneutic approach. This library comprises documents obtained via litigation in the US and does not include documents from Imperial Tobacco, Japan Tobacco International, or Swedish Match. To help overcome this limitation and provide more recent data, we triangulated our documentary findings with contemporary documentation including TTC investor presentations. The analysis demonstrates that British American Tobacco explored SLT opportunities in Europe from 1971 driven by regulatory threats and health concerns, both likely to impact cigarette sales negatively, and the potential to create a new form of tobacco use among those no longer interested in taking up smoking. Young people were a key target. TTCs did not, however, make SLT investments until 2002, a time when EU cigarette volumes started declining, smoke-free legislation was being introduced, and public health became interested in harm reduction. All TTCs have now invested in snus (and recently in pure nicotine), yet both early and recent snus test markets appear to have failed, and little evidence was found in TTCs' corporate materials that snus is central to their business strategy. Conclusions There is clear evidence that BAT's early interest in introducing SLT in Europe was based on the potential for creating an alternative form of tobacco use in light of declining cigarette sales
Full Text Available European Union (EU legislation bans the sale of snus, a smokeless tobacco (SLT which is considerably less harmful than smoking, in all EU countries other than Sweden. To inform the current review of this legislation, this paper aims to explore transnational tobacco company (TTC interests in SLT and pure nicotine in Europe from the 1970s to the present, comparing them with TTCs' public claims of support for harm reduction.Internal tobacco industry documents (in total 416 documents dating from 1971 to 2009, obtained via searching the online Legacy Tobacco Documents Library, were analysed using a hermeneutic approach. This library comprises documents obtained via litigation in the US and does not include documents from Imperial Tobacco, Japan Tobacco International, or Swedish Match. To help overcome this limitation and provide more recent data, we triangulated our documentary findings with contemporary documentation including TTC investor presentations. The analysis demonstrates that British American Tobacco explored SLT opportunities in Europe from 1971 driven by regulatory threats and health concerns, both likely to impact cigarette sales negatively, and the potential to create a new form of tobacco use among those no longer interested in taking up smoking. Young people were a key target. TTCs did not, however, make SLT investments until 2002, a time when EU cigarette volumes started declining, smoke-free legislation was being introduced, and public health became interested in harm reduction. All TTCs have now invested in snus (and recently in pure nicotine, yet both early and recent snus test markets appear to have failed, and little evidence was found in TTCs' corporate materials that snus is central to their business strategy.There is clear evidence that BAT's early interest in introducing SLT in Europe was based on the potential for creating an alternative form of tobacco use in light of declining cigarette sales and social restrictions on
Peeters, Silvy; Gilmore, Anna B
European Union (EU) legislation bans the sale of snus, a smokeless tobacco (SLT) which is considerably less harmful than smoking, in all EU countries other than Sweden. To inform the current review of this legislation, this paper aims to explore transnational tobacco company (TTC) interests in SLT and pure nicotine in Europe from the 1970s to the present, comparing them with TTCs' public claims of support for harm reduction. Internal tobacco industry documents (in total 416 documents dating from 1971 to 2009), obtained via searching the online Legacy Tobacco Documents Library, were analysed using a hermeneutic approach. This library comprises documents obtained via litigation in the US and does not include documents from Imperial Tobacco, Japan Tobacco International, or Swedish Match. To help overcome this limitation and provide more recent data, we triangulated our documentary findings with contemporary documentation including TTC investor presentations. The analysis demonstrates that British American Tobacco explored SLT opportunities in Europe from 1971 driven by regulatory threats and health concerns, both likely to impact cigarette sales negatively, and the potential to create a new form of tobacco use among those no longer interested in taking up smoking. Young people were a key target. TTCs did not, however, make SLT investments until 2002, a time when EU cigarette volumes started declining, smoke-free legislation was being introduced, and public health became interested in harm reduction. All TTCs have now invested in snus (and recently in pure nicotine), yet both early and recent snus test markets appear to have failed, and little evidence was found in TTCs' corporate materials that snus is central to their business strategy. There is clear evidence that BAT's early interest in introducing SLT in Europe was based on the potential for creating an alternative form of tobacco use in light of declining cigarette sales and social restrictions on smoking, with
Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Man Singh; Mir, Imtiyaz Ali; Sin, Shwe
In South and Southeast Asian countries, tobacco is consumed in diverse forms, and smoking among women is very low. We aimed to provide national estimates of prevalence and social determinants of smoking and smokeless tobacco use among men and women separately. Data from Demographic and Health Surveys completed in nine countries (India, Pakistan, Nepal, Bangladesh, Maldives, Philippines, Cambodia, Indonesia, and Timor Leste) were analyzed. Current smoking or smokeless tobacco use was assessed as response "yes" to one or more of three questions, such as "Do you currently smoke cigarettes?" Weighted country-level prevalence rates for socio-economic subgroups were calculated for smoking and smokeless tobacco use. Binary logistic regression analyses were done on STATA/IC (version 10) by 'svy' command. Prevalence and type of tobacco use among men and women varied across the countries and among socio-economic sub groups. Smoking prevalence was much lower in women than men in all countries. Smoking among men was very high in Indonesia, Maldives, and Bangladesh. Smokeless tobacco (mainly chewable) was used in diverse forms, particularly in India, among both men and women. Chewing tobacco was common in Nepal, Bangladesh, Maldives, and Cambodia. Both smoking and smokeless tobacco use were associated with higher age, lower education, and poverty, but their association with place of residence and marital status was not uniform between men and women across the countries. Policymakers should consider type of tobacco consumption and their differentials among various population subgroups to implement country-specific tobacco control policies and target the vulnerable groups. Smokeless tobacco use should also be prioritized in tobacco control efforts.
Persoskie, Alexander; Donaldson, Elisabeth A.; King, Brian A.
Introduction Among young people, curiosity about tobacco products is a primary reason for tobacco experimentation and is a risk factor for future use. We examined whether curiosity about and ever-use of tobacco products among US middle and high school students changed from 2012 to 2014. Methods Data came from the 2012 and 2014 National Youth Tobacco Surveys, nationally representative surveys of US students in grades 6 through 12. For cigarettes, cigars, smokeless tobacco, and e-cigarettes (20...
Wilkinson, Anna V; Koehly, Laura M; Vandewater, Elizabeth A; Yu, Robert K; Fisher-Hoch, Susan P; Prokhorov, Alexander V; Kohl, Harold W; Spitz, Margaret R; Shete, Sanjay
Despite well-established negative health consequences of smokeless tobacco use (STU), the number and variety of alternative non-combustible tobacco products on the market have increased tremendously over the last 10 years, as has the market share of these products relative to cigarettes. While STU among non-Hispanic white youth has decreased over the last 10 years, the prevalence has remained constant among Hispanic youth. Here we examine demographic, psychosocial, and genetic risk associated with STU among Mexican heritage youth. Participants (50.5 % girls) reported on psychosocial risk factors in 2008-09 (n = 1,087, mean age = 14.3 years), and smokeless tobacco use in 2010-11 (mean age = 16.7 years). Participants provided a saliva sample that was genotyped for genes in the dopamine, serotonin and opioid pathways. Overall 62 (5.7 %) participants reported lifetime STU. We identified five single nucleotide polymorphisms that increased the risk for lifetime use. Specifically, rs2023902 on SERGEF (OR = 1.93; 95 % CI: 1.05-3.53), rs16941667 on ALDH2 (OR = 3.14; 95 % CI: 1.65-5.94), and rs17721739 on TPH1 (OR = 1.71; 95 % CI: 1.00-2.91) in the dopamine pathway, rs514912 on TRH-DE (OR = 1.84; 95 % CI: 1.25-2.71) in the serotonin pathway, and rs42451417 on the serotonin transporter gene, SLC6A4 (OR = 3.53; 95 % CI: 1.56-7.97). After controlling for genetic risk, being male (OR = 1.86; 95 % CI: 1.02-3.41), obesity status (OR = 2.22; 95 % CI: 1.21-4.09), and both higher levels of anxiety (OR = 1.04; 95 % CI: 1.01-1.08) and social disinhibition (OR = 1.26; 95 % CI: 1.07-1.48) were associated with increased use. High subjective social status (OR = 0.78; 95 % CI: 0.64-0.93) was protective against use, while higher parental education (OR = 2.01; 95 % CI: 1.03-3.93) was associated with increased use. These data suggest that use of genetic risk, along with psychosocial, demographic, and behavioral risk factors may increase our ability to identify youth at increased risk for STU
Rickert, W S; Joza, P J; Trivedi, A H; Momin, R A; Wagstaff, W G; Lauterbach, J H
Some health experts are recommending that smokers who refuse to quit or refuse to use nicotine replacement therapy (NRT) such as nicotine-containing chewing gum switch to certain types of smokeless tobacco products (STP) such as Swedish snus. Other health experts disagree citing the uncertainty in the composition of commercially available STP, the lack of governmental regulations to ensure that STP advertised to meet certain standards (i.e., GothiaTek) do actually meet such standards, and the uncertainty that any STP can provide as safe as alternative to smoking as NRT. One reason for uncertainty is the dearth of detailed chemical and toxicological information on contemporary STP. Unlike the situation with cigarettes, there are few standardized methods for analytical and toxicological studies of STP. Consequently, the objective for this work was to characterize several types of STP available on the Canadian market using the modifications of the Official Health Canada chemical and toxicological methods developed for cigarettes. Moist snuff samples tested had TSNA and B[a]P levels somewhat above the GothiaTek standard while samples of Swedish snus, low-moisture snuff, and US-style chewing tobacco did not. Use of in vitro assays to assess STP toxicity was of limited utility in distinguishing product types.
Hureiki, J; Laqueille, X
Some rituals about a regular consumption of tea, smokeless tobacco (chewing) and milk are described by one of the authors at the time of his anthropological investigation among the Tuaregs of Timbuktu's region (Mali). He carries out some ethnographical and clinical materials which highlight the dependence to these substances and the role of their psychostimulant and anorexigene effects in a society much ritualised. The subject of this article appears original in the literature which approaches more the dependence to coffee than tea, to cigarettes than to chewing tobacco. The observation of daily life of a tuareg encampment shows a ritual consumption of tea at four time a day. The motivations of the Tuaregs are the increase of vigilance and performance with that psychostimulant substance. They describe an intoxication syndrome related to caffeineism, observed among European tourists. The Tuaregs are aware of their addiction to tea and distinguish psychological dependence from physical dependence. The psychological dependence corresponds to a powerful desire to drink tea at ritual moments, while the physical dependence appears at waking-up and when the time of preparing this beverage is too late. The Tuaregs describe also a phenomenon of loss tolerance after an abstinence period. In spite of the maraboutic prohibition to drink tea, which diverts Tuaregs of their religious practice, they defy this ban from the waking-up to take that infusion before the matinal prayer. That addiction appears also in the identity of the Tuaregs who are called "the sons of tea". The consumption of chewing tobacco, mixed with ash, rhythms the daily life. The mean number of chewing is about fifteen by day; every chewing last 30 minutes. The first chewing of the day occurs 15 minutes after waking-up. The Tuaregs use tobacco in order to get relaxation and vigilance. They suggest intoxication symptoms and especially a withdrawal syndrome which appears at the waking-up or after an important
Cullen, Doris; Keithly, Lois; Kane, Kevin; Land, Thomas; Paskowsky, Mark; Chen, Lili; Hayes, Rashelle; Li, Wenjun
Sales of smokeless tobacco products have increased in the USA. More than one in eight males in the 12th grade are current users of smokeless tobacco. Surveillance data examining nicotine levels of smokeless tobacco subsequent to 2006 have not been reported in the literature. Data on nicotine levels and design features (eg, pH, moisture content, leaf cut and flavour) of smokeless tobacco products sold in Massachusetts were obtained from manufacturers between 2003 and 2012. Design features, levels and temporal trends in unionised (free) nicotine and nicotine content of smokeless tobacco products were analysed overall and by manufacturer and product type. The annual total number of moist snuff products increased from 99 in 2003 to 127 in 2012. The annual total number of reported snus products increased from 4 in 2003 to the highest level of 62 in 2011, before decreasing to 26 in 2012. Overall, mean unionised (free) nicotine remained relatively stable (β=0.018 (95% CI -0.014 to 0.050) mg/g dry weight/year) from 2003 to 2012. However, both levels and temporal trends of mean free nicotine varied significantly among manufacturers (p<0.001). Since 2003, the free nicotine content of snus has increased at an overall rate of 0.192 (95% CI 0.138 to 0.246) mg/g dry weight/year, but varied by manufacturer (p<0.001). The number of smokeless tobacco products increased in the Massachusetts market. Further, mean unionised (free) nicotine levels in smokeless tobacco products of several manufacturers continued to rise despite decreasing levels from other manufacturers. The current success in tobacco control is very likely undermined without government surveillance, regulation and widespread public disclosure of nicotine levels in these products. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Wackowski, Olivia A; Lewis, M Jane; Delnevo, Cristine D; Ling, Pamela M
Research attention on smokeless tobacco (SLT) has focused on SLT use, health risks, harm-reduction potential, and risk perceptions, but few studies have examined mediated communications about SLT. This study aims to contribute to the literature by providing the first description of SLT coverage in the news, an important communication channel given its ability to educate and shape public opinion about tobacco issues. A content analysis was conducted on SLT-related news and opinion articles between 2006 and 2010 from top circulating national and state newspapers and select news wires. Articles were coded for the main SLT topic, SLT risk references, and slant of opinion articles. SLT was discussed in news/feature articles (n = 677) in terms of business (28%), new products, product regulation and harm reduction (19%), prevention/cessation (11.4%), taxation (10.2%), profiles/trends in use (9%), bans (8.1%), and tobacco industry promotional activities (4.9%). Health risk references (i.e., addictiveness, carcinogenicity, and specific health effects including oral cancer) were found in 40% of articles, though frequency differed by article topic. Although the majority of opinion articles (n = 176) conveyed an anti-SLT slant (64%), 25.6% were pro-SLT. SLT topics of both national and local importance are covered in the news. Public health professionals can participate in SLT coverage by sending in press releases about new study findings, events, or resources and by submitting opinion pieces to share views or respond to previous coverage. Research on SLT news should continue given its potential to shape the public's SLT knowledge and opinions.
Introduction: Research attention on smokeless tobacco (SLT) has focused on SLT use, health risks, harm-reduction potential, and risk perceptions, but few studies have examined mediated communications about SLT. This study aims to contribute to the literature by providing the first description of SLT coverage in the news, an important communication channel given its ability to educate and shape public opinion about tobacco issues. Methods: A content analysis was conducted on SLT-related news and opinion articles between 2006 and 2010 from top circulating national and state newspapers and select news wires. Articles were coded for the main SLT topic, SLT risk references, and slant of opinion articles. Results: SLT was discussed in news/feature articles (n = 677) in terms of business (28%), new products, product regulation and harm reduction (19%), prevention/cessation (11.4%), taxation (10.2%), profiles/trends in use (9%), bans (8.1%), and tobacco industry promotional activities (4.9%). Health risk references (i.e., addictiveness, carcinogenicity, and specific health effects including oral cancer) were found in 40% of articles, though frequency differed by article topic. Although the majority of opinion articles (n = 176) conveyed an anti-SLT slant (64%), 25.6% were pro-SLT. Conclusions: SLT topics of both national and local importance are covered in the news. Public health professionals can participate in SLT coverage by sending in press releases about new study findings, events, or resources and by submitting opinion pieces to share views or respond to previous coverage. Research on SLT news should continue given its potential to shape the public’s SLT knowledge and opinions. PMID:23288875
Meyer, Michael G; Toborg, Mary A; Denham, Sharon A; Mande, Mary J
Appalachia has high rates of tobacco use and related health problems, and despite significant impediments to alcohol use, alcohol abuse is common. Adolescents are exposed to sophisticated tobacco and alcohol advertising. Prevention messages, therefore, should reflect research concerning culturally influenced attitudes toward tobacco and alcohol use. With 4 grants from the National Institutes of Health, 34 focus groups occurred between 1999 and 2003 in 17 rural Appalachian jurisdictions in 7 states. These jurisdictions ranged between 4 and 8 on the Rural-Urban Continuum Codes of the Economic Research Service of the US Department of Agriculture. Of the focus groups, 25 sought the perspectives of women in Appalachia, and 9, opinions of adolescents. The family represented the key context where residents of Appalachia learn about tobacco and alcohol use. Experimentation with tobacco and alcohol frequently commenced by early adolescence and initially occurred in the context of the family home. Reasons to abstain from tobacco and alcohol included a variety of reasons related to family circumstances. Adults generally displayed a greater degree of tolerance for adolescent alcohol use than tobacco use. Tobacco growing represents an economic mainstay in many communities, a fact that contributes to the acceptance of its use, and many coal miners use smokeless tobacco since they cannot light up in the mines. The production and distribution of homemade alcohol was not a significant issue in alcohol use in the mountains even though it appeared not to have entirely disappeared. Though cultural factors support tobacco and alcohol use in Appalachia, risk awareness is common. Messages tailored to cultural themes may decrease prevalence.
... warning statements in advertising, for each brand of smokeless tobacco product ``in accordance with a plan... the Tobacco Control Act amended the Smokeless Tobacco Act to give smokeless tobacco the meaning that..., ``smokeless tobacco'' means any tobacco product that consists of cut, ground, powdered, or leaf tobacco and...
Bergman, Hannah E; Hunt, Yvonne M; Augustson, Erik
Smokeless tobacco (ST) use represents an important target for intervention in the U.S. military population because it impairs "military readiness" and harms the health of the military. This paper aims to provide a systematic review of ST studies conducted in the U.S. military population in order to assess the content of existing ST research in this population, provide estimates of prevalence and clinically relevant use patterns, and discuss how these findings might be used to guide future ST research among this population. We reviewed articles published through December 2010 using PubMed and PsycINFO databases, Google Scholar, and any relevant articles' reference lists. Inclusion criteria included focus on a U.S. military sample, English language, measured tobacco use, and ST prevalence was reported or could be calculated. To the extent possible, each article was coded for demographics, socioeconomic status, prevalence, amount, frequency, and length of use, and quit intentions/attempts. Thirty-nine articles met criteria for inclusion. Less than half focused primarily on ST use among military personnel. The remaining studies measured ST use in the context of other behaviors. Findings related to clinically relevant behaviors included a need for more cohort and intervention studies, a better understanding of ST use in combination with cigarettes (i.e., concurrent use), and identifying risk factors for ST initiation and use. ST use is prevalent among military personnel, as is concurrent use of cigarettes and ST. We provide a number of recommendations to guide future research in this important, yet understudied, area.
Khan, Zohaib; Dreger, Steffen; Shah, Syed Majid Hussain; Pohlabeln, Hermann; Khan, Sheraz; Ullah, Zakir; Rehman, Basheer; Zeeb, Hajo
In the wake of smokeless tobacco (SLT) being advocated as a mean of tobacco harm reduction, it is pertinent to establish individual health risks associated with each SLT product. This case-control study was aimed at assessing the risk of oral cancer associated with a smokeless tobacco product (Naswar). The study was conducted from September 2014 till May 2015 in Khyber Pakhtunkhwa, Pakistan. Exposure and covariate information was collected through a structured questionnaire. Conditional logistic regression was used to calculate odds ratios (OR) along with their 95% confidence intervals (CI). 84 oral cancer cases (62% males) and 174 age- and sex-matched controls were recruited. Ever users of Naswar had more than a 20-fold higher risk of oral cancer compared to never-users (OR 21.2, 95% CI 8.4-53.8). Females had a higher risk of oral cancer with the use of Naswar (OR 29.0, 95% CI 5.4-153.9) as compared to males (OR 21.0, 95% CI 6.1-72.1). Based on this result, 68% (men) and 38% (women) of the oral cancer burden in Pakistan is attributable to Naswar. The risk estimates observed in this study are comparable to risk estimates reported by previous studies on other forms of SLT use and the risk of oral cancer in Pakistan. The exposure-response relationship also supports a strong role of Naswar in the etiology of oral cancer in Pakistan. Although still requiring further validation through independent studies, these findings may be used for smokeless tobacco control in countries where Naswar use is common.
Liu, Min; Jin, Jinshan; Pan, Hongmiao; Feng, Jinhui; Cerniglia, Carl E.; Yang, Maocheng; Chen, Huizhong
To evaluate the toxicity of smokeless tobacco products (STPs) on oral bacteria, seven smokeless tobacco aqueous extracts (STAEs) from major brands of STPs and three tobacco-specific N-nitrosamines (TSNAs) were used in a growth and viability test against 38 oral bacterial species or subspecies. All seven STAEs showed concentration-dependent effects on the growth and viability of tested oral bacteria under anaerobic culture conditions, although there were strain-to-strain variations. In the presence of 1 mg/ml STAEs, the growth of 4 strains decreased over 0.32–2.14 log10 fold, while 14 strains demonstrated enhanced growth of 0.3–1.76 log10 fold, and the growth of 21 strains was not significantly affected. In the presence of 10 mg/ml STAEs, the growth of 17 strains was inhibited 0.3–2.11 log10 fold, 18 strains showed enhanced growth of 0.3–0.97 log10 fold, and 4 strains were not significantly affected. In the presence of 50 mg/ml STAEs, the growth of 32 strains was inhibited 0.3–2.96 log10 fold, 8 strains showed enhanced growth of 0.3–1.0 log10 fold, and 2 strains were not significantly affected. All seven STAEs could promote the growth of 4 bacterial strains, including Eubacterium nodatum, Peptostreptococcus micros, Streptococcus anginosus, and Streptococcus constellatus. Exposure to STAEs modulated the viability of some bacterial strains, with 21.1–66.5% decrease for 4 strains at 1 mg/ml, 20.3–85.7% decrease for 10 strains at 10 mg/ml, 20.0–93.3% decrease for 27 strains at 50 mg/ml, and no significant effect for 11 strains at up to 50 mg/ml. STAEs from snuffs inhibited more tested bacterial strains than those from snus indicating that the snuffs may be more toxic to the oral bacteria than snus. For TSNAs, cell growth and viability of 34 tested strains were not significantly affected at up to 100 μg/ml; while the growth of P. micros was enhanced 0.31–0.54 log10 fold; the growth of Veillonella parvula was repressed 0.33–0.36 log10 fold; and the
Gupta, Bhawna; Johnson, Newell W
This systematic review and meta-analysis aimed to critically appraised data from comparable studies leading to quantitative assessment of any independent association between use of oral smokeless tobacco in any form, of betel quid without tobacco and of areca nut with incidence of oral cancer in South Asia and the Pacific. Studies (case control and/or cohort) were identified by searching Pub Med, CINAHL and Cochrane databases through June 2013 using the keywords oral cancer: chewing tobacco; smokeless tobacco; betel quid; betel quid without tobacco; areca nut; Asia, the Pacific and the reference lists of retrieved articles. A random effects model was used to compute adjusted summary OR(RE) for the main effect of these habits along with their corresponding 95% confidence intervals. To quantify the impact of between-study heterogeneity on adjusted main-effect summary OR(RE), Higgins' H and I2 statistics along with their 95% uncertainty intervals were used. Funnel plots and Egger's test were used to evaluate publication bias. Meta-analysis of fifteen case-control studies (4,553 cases; 8,632 controls) and four cohort studies (15,342) which met our inclusion criteria showed that chewing tobacco is significantly and independently associated with an increased risk of squamous-cell carcinoma of the oral cavity (adjusted main-effect summary for case- control studies OR(RE) = 7.46; 95% CI = 5.86-9.50, Pbetel quid without tobacco to have an independent positive association with oral cancer, with OR = 2.82 (95% CI = 2.35-3.40, Pbetel quid, and betel quid without tobacco, are both strong and independent risk factors for oral cancer in these populations. However, studies with better separation of the types of tobacco and the ways in which it is used, and studies with sufficient power to quantify dose-response relationships are still needed.
Zandonai, Thomas; Chiamulera, Cristiano; Mancabelli, Alberto; Falconieri, Danilo; Diana, Marco
Introduction: Among athletes, an increasing use of nicotine via smokeless tobacco has been reported. However, there are currently unanswered questions about whether the use by athletes is due to nicotine’s addictive properties and/or to benefits in physical and cognitive performance (e.g., decision-making). In this original article we reported about, (i) snus-induced reinforcing effects among snus-user athletes (Survey) and (ii) the effects of snus on the Iowa Gambling Task (IGT) in snus-user skiers (Experimental study). IGT is an experimental neuropsychological task that has been previously used on athletes and addicts to test decision-making. Methods: Survey: data were collected with the modified Cigarette Evaluation Questionnaire (mCEQ) that was administered to 61 winter sport athlete snus-users in Northern Italy. Experimental study: IGT data included: amount of money earned, number of choices from advantageous and disadvantageous decks and overall net score. Eighteen male snus-users were tested under satiety or after 12-h abstinence conditions according to a crossover design. Results: Survey: the comparison between occasional vs. regular snus-users showed a statistically significant difference in satisfaction (P = 0.0088), calm (P = 0.0252), and enjoyment (P = 0.0001) mCEQ items suggesting a snus intake/effect relationship. Experimental study: significantly higher IGT net scores were found during the first 20 choice cards after abstinence vs. satiety conditions (P = 0.0024). Conclusion: In the Survey, regular snus use induces greater satisfaction and psychological reward than occasional use. In the Experimental study, snus intake might produce an early and transient cognitive improvement on IGT in abstinent snus-users, presumably acting as a withdrawal relief. PMID:29593541
Al-Mukhaini, Nawal; Ba-Omar, Taher; Eltayeb, Elsadig; Al-Shehi, Aisha
Afzal is an illegally sold smokeless tobacco product (STP) commonly used by youths and teenagers in Oman. The aim of this study was to analyse the composition of Afzal, also commonly known as sweekah, as it is believed to contain many carcinogens and toxic components. In particular, Afzal's heavy metal content includes cadmium (Cd), chromium (Cr), lead (Pb) and nickel (Ni). This study was conducted between March and June 2013. Three samples of Afzal were first dried and then ground to form a homogenous powder. The powder was digested prior to the heavy metal analysis by inductively coupled plasma-mass spectrometry (ICP-MS). Afzal was shown to have high levels of all heavy metals except for Ni and Pb, which were detected in quantities below acceptable international limits. The concentrations of the tested metals were 15.75 μg/g, 1.85 μg/g, 1.62 μg/g and 1.57 μg/g for Cr, Cd, Pb and Ni, respectively. The estimated daily intake of heavy metals from Afzal was below the maximum permissible limit accepted by the Food and Agriculture Organization and World Health Organization, except for Cr and Ni which were found to be dangerously elevated when compared with international standards. The results of this study showed that Afzal contains a number of heavy metals that may cause health problems. Therefore, urgent regulation of the illegal sale of Afzal is needed at the national level in Oman along with a campaign to address public health education and awareness of Afzal and its health risks.
Full Text Available Objectives: Afzal is an illegally sold smokeless tobacco product (STP commonly used by youths and teenagers in Oman. The aim of this study was to analyse the composition of Afzal, also commonly known as sweekah, as it is believed to contain many carcinogens and toxic components. In particular, Afzal’s heavy metal content includes cadmium (Cd, chromium (Cr, lead (Pb and nickel (Ni. Methods: This study was conducted between March and June 2013. Three samples of Afzal were first dried and then ground to form a homogenous powder. The powder was digested prior to the heavy metal analysis by inductively coupled plasma-mass spectrometry (ICPMS. Results: Afzal was shown to have high levels of all heavy metals except for Ni and Pb, which were detected in quantities below acceptable international limits. The concentrations of the tested metals were 15.75 μg/g, 1.85 μg/g, 1.62 μg/g and 1.57 μg/g for Cr, Cd, Pb and Ni, respectively. The estimated daily intake of heavy metals from Afzal was below the maximum permissible limit accepted by the Food and Agriculture Organization and World Health Organization, except for Cr and Ni which were found to be dangerously elevated when compared with international standards. Conclusion: The results of this study showed that Afzal contains a number of heavy metals that may cause health problems. Therefore, urgent regulation of the illegal sale of Afzal is needed at the national level in Oman along with a campaign to address public health education and awareness of Afzal and its health risks.
Delnevo, Cristine D; Wackowski, Olivia A; Giovenco, Daniel P; Manderski, Michelle T Bover; Hrywna, Mary; Ling, Pamela M
While cigarette consumption in the USA continues to decline, promotion for and consumption of smokeless tobacco (SLT) is growing. However, little research has explored what product features are driving SLT growth, despite awareness that product-level factors may be important in SLT use. This study analyses national sales data to better understand the impact of product features on SLT sales. Data on sales of SLT in US convenience stores from 2005 to 2011 were obtained from Nielsen Research Company. Each listed product was coded for attributes such as type, brand, flavouring and form to calculate their respective total sales, market share and contribution to overall SLT growth. Sales of moist snuff products (including snus) increased by 65.6% between 2005 and 2011. Sales of pouched and flavoured forms of moist snuff increased by 333.8% and 72.1%, respectively, and contributed to 28% and 59.4% of the total growth in the moist snuff category, respectively. Value/discount brands accounted for 42% of moist snuff sales in 2011 among the top 10 selling brands, largely driven by Grizzly. After 2 years on the national market, Camel Snus was also one of the top 10 selling moist snuff brands. Sales of moist snuff, both overall and for particular styles, are increasing. Growing pouch use may be attributed to new SLT users, which may include cigarette smokers using them as starter SLT products. Increased sales of flavoured and discounted snuff raise concerns about use and appeal to youth. Continued surveillance of SLT sales trends is warranted.
Full Text Available Introduction: Among athletes, an increasing use of nicotine via smokeless tobacco has been reported. However, there are currently unanswered questions about whether the use by athletes is due to nicotine’s addictive properties and/or to benefits in physical and cognitive performance (e.g., decision-making. In this original article we reported about, (i snus-induced reinforcing effects among snus-user athletes (Survey and (ii the effects of snus on the Iowa Gambling Task (IGT in snus-user skiers (Experimental study. IGT is an experimental neuropsychological task that has been previously used on athletes and addicts to test decision-making.Methods: Survey: data were collected with the modified Cigarette Evaluation Questionnaire (mCEQ that was administered to 61 winter sport athlete snus-users in Northern Italy. Experimental study: IGT data included: amount of money earned, number of choices from advantageous and disadvantageous decks and overall net score. Eighteen male snus-users were tested under satiety or after 12-h abstinence conditions according to a crossover design.Results: Survey: the comparison between occasional vs. regular snus-users showed a statistically significant difference in satisfaction (P = 0.0088, calm (P = 0.0252, and enjoyment (P = 0.0001 mCEQ items suggesting a snus intake/effect relationship. Experimental study: significantly higher IGT net scores were found during the first 20 choice cards after abstinence vs. satiety conditions (P = 0.0024.Conclusion: In the Survey, regular snus use induces greater satisfaction and psychological reward than occasional use. In the Experimental study, snus intake might produce an early and transient cognitive improvement on IGT in abstinent snus-users, presumably acting as a withdrawal relief.
Full Text Available This systematic review and meta-analysis aimed to critically appraised data from comparable studies leading to quantitative assessment of any independent association between use of oral smokeless tobacco in any form, of betel quid without tobacco and of areca nut with incidence of oral cancer in South Asia and the Pacific.Studies (case control and/or cohort were identified by searching Pub Med, CINAHL and Cochrane databases through June 2013 using the keywords oral cancer: chewing tobacco; smokeless tobacco; betel quid; betel quid without tobacco; areca nut; Asia, the Pacific and the reference lists of retrieved articles. A random effects model was used to compute adjusted summary OR(RE for the main effect of these habits along with their corresponding 95% confidence intervals. To quantify the impact of between-study heterogeneity on adjusted main-effect summary OR(RE, Higgins' H and I2 statistics along with their 95% uncertainty intervals were used. Funnel plots and Egger's test were used to evaluate publication bias.Meta-analysis of fifteen case-control studies (4,553 cases; 8,632 controls and four cohort studies (15,342 which met our inclusion criteria showed that chewing tobacco is significantly and independently associated with an increased risk of squamous-cell carcinoma of the oral cavity (adjusted main-effect summary for case- control studies OR(RE = 7.46; 95% CI = 5.86-9.50, P<0.001, (adjusted main-effect summary for cohort studies RR = 5.48; 95% CI = 2.56-11.71, P<0.001. Furthermore, meta-analysis of fifteen case control studies (4,648 cases; 7,847 controls has shown betel quid without tobacco to have an independent positive association with oral cancer, with OR = 2.82 (95% CI = 2.35-3.40, P<0.001. This is presumably due to the carcinogenicity of areca nut. There was no significant publication bias.There is convincing evidence that smokeless (aka chewing tobacco, often used as a component of betel quid, and betel quid without tobacco
Zakiullah; Saeed, Muhammad; Muhammad, Naveed; Khan, Saeed Ahmad; Gul, Farah; Khuda, Fazli; Humayun, Muhammad; Khan, Hamayun
'Naswar' is a smokeless tobacco product (STP) widely used in Pakistan. It has been correlated with oral and oesophageal cancer in recent clinical studies. The toxic effects associated with STPs have been associated with trace level contaminants present in these products. The toxin levels of Pakistani naswar are reported for the first time in this study. A total of 30 Pakistani brands of naswar were tested for a variety of toxic constituents and carcinogens such as cadmium, arsenic, lead and other carcinogenic metals, nitrite and nitrate, and nicotine and pH. The average values of all the toxins studied were well above their allowable limits, making the product a health risk for consumers. Calculated lifetime cancer risk from cadmium and lead was 1 lac (100,000) to 10 lac (1,000,000) times higher than the minimum 10E-4 (0.00001) to 10E-6 (0.000001), which is the 'target range' for potentially hazardous substances, according to the US Environmental Protection Agency. Similarly, the level of arsenic was in the range of 0.15 to 14.04 μg/g, the average being 1.25 μg/g. The estimated average bioavailable concentration of arsenic is 0.125-0.25 μg/g, which is higher than the allowable standard of 0.01 μg/g. Similarly, the average minimum daily intake of chromium and nickel was 126.97 μg and 122.01 μg, as compared to allowable 30-35 μg and 35 μg, respectively; a 4-5 times higher exposure. However, beryllium was not detected in any of the brands studied. The pH was highly basic, averaging 8.56, which favours the formation of tobacco specific amines thus making the product potentially toxic. This study validates clinical studies correlating incidence of cancer with naswar use in Pakistan. This study shows that the production, packaging, sale and consumption of naswar should be regulated so as to protect the public from the health hazards associated with its consumption.
Gupta, Bhawna; Johnson, Newell W.
Aim This systematic review and meta-analysis aimed to critically appraised data from comparable studies leading to quantitative assessment of any independent association between use of oral smokeless tobacco in any form, of betel quid without tobacco and of areca nut with incidence of oral cancer in South Asia and the Pacific. Methods Studies (case control and/or cohort) were identified by searching Pub Med, CINAHL and Cochrane databases through June 2013 using the keywords oral cancer: chewing tobacco; smokeless tobacco; betel quid; betel quid without tobacco; areca nut; Asia, the Pacific and the reference lists of retrieved articles. A random effects model was used to compute adjusted summary ORRE for the main effect of these habits along with their corresponding 95% confidence intervals. To quantify the impact of between-study heterogeneity on adjusted main-effect summary ORRE, Higgins' H and I2 statistics along with their 95% uncertainty intervals were used. Funnel plots and Egger's test were used to evaluate publication bias. Results Meta-analysis of fifteen case–control studies (4,553 cases; 8,632 controls) and four cohort studies (15,342) which met our inclusion criteria showed that chewing tobacco is significantly and independently associated with an increased risk of squamous-cell carcinoma of the oral cavity (adjusted main-effect summary for case- control studies ORRE = 7.46; 95% CI = 5.86–9.50, Poral cancer, with OR = 2.82 (95% CI = 2.35–3.40, Poral cancer in these populations. However, studies with better separation of the types of tobacco and the ways in which it is used, and studies with sufficient power to quantify dose-response relationships are still needed. PMID:25411778
Full Text Available Abstract Anti-harm-reduction advocates sometimes resort to pseudo-analogies to ridicule harm reduction. Those opposed to the use of smokeless tobacco as an alternative to smoking sometimes suggest that the substitution would be like jumping from a 3 story building rather than 10 story, or like shooting yourself in the foot rather than the head. These metaphors are grossly inappropriate for several reasons, notably including the fact that they are misleading about the actual risk levels. Based on the available literature on mortality from falls, we estimate that smoking presents a mortality risk similar to a fall of about 4 stories, while mortality risk from smokeless tobacco is no worse than that from an almost certainly non-fatal fall from less than 2 stories. Other metaphors are similarly misleading. These metaphors, like other false and misleading anti-harm-reduction statements are inherently unethical attempts to prevent people from learning accurate health information. Moreover, they implicitly provide bad advice about health behavior priorities and are intended to persuade people to stick with a behavior that is more dangerous than an available alternative. Finally, the metaphors exhibit a flippant tone that seems inappropriate for a serious discussion of health science.
Friedman, Katherine L; Roberts, Megan E; Keller-Hamilton, Brittney; Yates, Katherine A; Paskett, Electra D; Berman, Micah L; Slater, Michael D; Lu, Bo; Ferketich, Amy K
Previous studies have examined what adolescents find appealing in tobacco and alcohol advertisements and how different themes in advertisements are used to manipulate consumer behaviors. Yet, we know little about the relationship between the themes portrayed in advertisements and youth attitudes towards those themes. This study compared attitudes towards advertisements for different consumer products in a sample of urban and rural adolescent boys in order to examine how key marketing themes impact adolescent attitudes towards those advertisements. Participants were 11- to 16-year-old boys (N = 1220) residing in either urban or rural Ohio Appalachian counties. Each participant viewed five print advertisements (one each for cigarettes, electronic cigarettes (e-cigarettes), smokeless tobacco (SLT), non-alcoholic beverages, and alcohol), presented in a random order, for eight seconds each. All advertisements had appeared in magazines that adolescent males commonly read. Attitudes towards each of the five advertisements were assessed. The advertisements were then coded for the presence of various themes, including social acceptance and masculinity. Analyses were conducted to determine associations between advertisement type and the attitude measure, and between the presence of a theme and the attitude measure. Overall, participants preferred non-tobacco advertisements to tobacco advertisements, rural participants had less positive attitudes and participants who had peers who used tobacco had more positive attitudes. Social acceptance and entertainment themes increased the appeal of SLT advertisements, and sex appeal increased the appeal of e-cigarette advertisements. Conclusions/Importance: Findings suggest that advertisements that promote the social nature of use in SLT advertisements may be of particular concern for their influence on adolescent boys.
Phillips Carl V
Full Text Available Abstract Background Although smokeless tobacco (ST use has played a major role in the low smoking prevalence among Swedish men, there is little information at the population level about ST as a smoking cessation aid in the U.S. Methods We used the 2000 National Health Interview Survey to derive population estimates for the number of smokers who had tried twelve methods in their most recent quit attempt, and for the numbers and proportions who were former or current smokers at the time of the survey. Results An estimated 359,000 men switched to smokeless tobacco in their most recent quit attempt. This method had the highest proportion of successes among those attempting it (73%, representing 261,000 successful quitters (switchers. In comparison, the nicotine patch was used by an estimated 2.9 million men in their most recent quit attempt, and almost one million (35% were former smokers at the time of the survey. Of the 964,000 men using nicotine gum, about 323,000 (34% became former smokers. Of the 98,000 men who used the nicotine inhaler, 27,000 quit successfully (28%. None of the estimated 14,000 men who tried the nicotine nasal spray became former smokers. Forty-two percent of switchers also reported quitting smoking all at once, which was higher than among former smokers who used medications (8–19%. Although 40% of switchers quit smoking less than 5 years before the survey, 21% quit over 20 years earlier. Forty-six percent of switchers were current ST users at the time of the survey. Conclusion Switching to ST compares very favorably with pharmaceutical nicotine as a quit-smoking aid among American men, despite the fact that few smokers know that the switch provides almost all of the health benefits of complete tobacco abstinence. The results of this study show that tobacco harm reduction is a viable cessation option for American smokers.
Montana State Office of Public Instruction, Helena.
This publication presents K-12 tobacco use prevention lesson plans for schools in the state of Montana. Lessons for students in grades K-6 include: family connections; body tracing; smokeless tobacco; prenatal development; tobacco look-alikes; tobacco chemicals; analyzing tobacco and alcohol ads; tobacco use and the lungs; and a personal health…
for tobacco control. Complementing tobacco use surveillance tools should always be compared or triangulated for a comprehensive picture of tobacco use burden. Higher use of SLTs among women in Timor Leste needs further exploration.
Shahjahan, Md; Harun, Md Golam Dostogir; Chowdhury, A B M Alauddin; Ahmed, Kapil; Khan, Hafiz T A
This study explored factors influencing the initiation of smokeless tobacco (SLT) consumption in a low socioeconomic urban community in Bangladesh. The study conducted four focus group discussions among 33 informants involves school teachers, community leaders, women, and betel-nut shops owners. The results were prepared by thematic analysis of the transcripts where informants mean age was 30 ( SD ± 6.8) years with varying level of education. Tradition of hospitality, curiosity, offer from an elderly person, and avoiding nausea during pregnancy and at time of quitting smoking were key factors for the initiation of SLT consumption. The results also revealed most people were aware about the danger of SLT consumption but, in practice, consumed frequently. The research suggested that doctors might advise people not to use any form of SLT while they seeking health services. Furthermore, community-based awareness program could minimize the wider use of SLT among low-income community in Bangladesh.
Rousu, Matthew C; O'Connor, Richard J; Thrasher, James F; June, Kristie M; Bansal-Travers, Maansi; Pitcavage, James
Epidemiological and toxicological evidence suggests lower risk of smokeless tobacco (ST) products compared to cigarettes. Less is known, however, about consumer perceptions and use of novel forms of ST, including snus and dissolvable tobacco. In this study, we conducted in-person experimental auctions in Buffalo, NY, Columbia, SC, and Selinsgrove, PA with 571 smokers to test the impact of information and product trials on smokers' preferences. Auctions were conducted between November 2010-November 2011. We found no evidence of an impact of product trials on demand in our auctions. Anti-ST information increased demand for cigarettes when presented alone, but when presented with pro-ST information it decreased demand for cigarettes. It did not decrease demand for ST products. Anti-smoking information increased demand for ST products, but did not affect cigarette demand. These findings suggest that credible and effective communications about tobacco harm reduction should reinforce the negative effects of smoking. Copyright © 2013 Elsevier Inc. All rights reserved.
Alsanosy, Rashad Mohammed
Shammah is a traditional form of chewing tobacco [smokeless tobacco, (ST)] that is commonly used in the Middle East especially in Saudi Arabia (KSA), Yemen and Sudan. The Substance Abuse Research Centre (SARC) at Jazan University noted that no adequate research and information on the prevalence of shammah use in the province of Jazan, and KSA as well, has been provided in the scientific literature. An intensive systematic review of online databases was performed, including AMED (The Allied and Complementary Medicine Database), Biological Abstracts, Cochrane Collection Plus, Dentistry and Oral Sciences Source, E-Journals Database, EBSCO Discovery Service, MEDLINE, PEMSoft, PEP Archive, PsycARTICLES, scopus, Sciencedirect and Google Scholar. Shammah is a mixture of powdered tobacco, lime, ash, black pepper, oils and flavorings. ST in KSA is placed in the buccal or lower labial vestibule of the mouth. The user (or dipper) spits out insoluble debris. The importation of ST products is prohibited in KSA. Accessible information on legislative action to control the use of ST in KSA appeared in 1990. The actual percentage use may be higher, than reported since shammah is illegal in KSA and there may be some reluctance to admit to its use. This review paper is an initial step in a funded research project by SARC to understand the pattern of use of shammah and provide adequate epidemiological data. One goal of this review is to generate further data for public health education.
Wackowski, Olivia A; Manderski, Michelle T Bover; Lewis, M Jane; Delnevo, Cristine D
Little research exists on the impact of risk information comparing smokeless tobacco (SLT) use, particularly snus, to cigarette smoking. This study explored this topic using a communication channel where smokers may be exposed to such information-the news media. We randomly assigned 1008 current smokers to read one of three constructed news stories or to a control group (no article). The "favorable" story framed snus as a "safer" smoking alternative while the "cautious" story described snus risks. The "mixed" version described potential risks and harm-reduction benefits. Participants completed a post-article survey with snus risk and harm perception and use intention measures. Article condition was significantly associated with perceived harm of daily snus use relative to smoking (1 = a lot less harmful - 5 = a lot more harmful; p news messages about SLT and snus relative to cigarettes may impact smokers' SLT harm perceptions and use intentions. Tobacco control professionals and FDA officials should consider the potential impact of the news media when communicating about tobacco risks.
Persoskie, Alexander; Donaldson, Elisabeth A; King, Brian A
Among young people, curiosity about tobacco products is a primary reason for tobacco experimentation and is a risk factor for future use. We examined whether curiosity about and ever-use of tobacco products among US middle and high school students changed from 2012 to 2014. Data came from the 2012 and 2014 National Youth Tobacco Surveys, nationally representative surveys of US students in grades 6 through 12. For cigarettes, cigars, smokeless tobacco, and e-cigarettes (2014 only), students were classified as ever-users or never-users of each product. Among never-users, curiosity about using each product was assessed by asking participants if they had "definitely," "probably," "probably not," or "definitely not" been curious about using the product. From 2012 to 2014, there were declines in ever-use of cigarettes (26% to 22%; P = .005) and cigars (21% to 18%; P = .003) overall and among students who were Hispanic (cigarettes, P = .001; cigars, P = .001) or black (cigarettes, P = .004; cigars, P = .01). The proportion of never-users reporting they were "definitely not" curious increased for cigarettes (51% to 54%; P = .01) and cigars (60% to 63%; P = .03). Ever-use and curiosity about smokeless tobacco did not change significantly from 2012 to 2014. In 2014, the proportion of young people who were "definitely" or "probably" curious never-users of each product was as follows: cigarettes, 11.4%; e-cigarettes, 10.8%; cigars, 10.3%; and smokeless tobacco, 4.4%. The proportion of US students who are never users and are not curious about cigarettes and cigars increased. However, many young people remain curious about tobacco products, including e-cigarettes. Understanding factors driving curiosity can inform tobacco use prevention for youth.
Donaldson, Elisabeth A.; King, Brian A.
Introduction Among young people, curiosity about tobacco products is a primary reason for tobacco experimentation and is a risk factor for future use. We examined whether curiosity about and ever-use of tobacco products among US middle and high school students changed from 2012 to 2014. Methods Data came from the 2012 and 2014 National Youth Tobacco Surveys, nationally representative surveys of US students in grades 6 through 12. For cigarettes, cigars, smokeless tobacco, and e-cigarettes (2014 only), students were classified as ever-users or never-users of each product. Among never-users, curiosity about using each product was assessed by asking participants if they had “definitely,” “probably,” “probably not,” or “definitely not” been curious about using the product. Results From 2012 to 2014, there were declines in ever-use of cigarettes (26% to 22%; P = .005) and cigars (21% to 18%; P = .003) overall and among students who were Hispanic (cigarettes, P = .001; cigars, P = .001) or black (cigarettes, P = .004; cigars, P = .01). The proportion of never-users reporting they were “definitely not” curious increased for cigarettes (51% to 54%; P = .01) and cigars (60% to 63%; P = .03). Ever-use and curiosity about smokeless tobacco did not change significantly from 2012 to 2014. In 2014, the proportion of young people who were “definitely” or “probably” curious never-users of each product was as follows: cigarettes, 11.4%; e-cigarettes, 10.8%; cigars, 10.3%; and smokeless tobacco, 4.4%. Conclusion The proportion of US students who are never users and are not curious about cigarettes and cigars increased. However, many young people remain curious about tobacco products, including e-cigarettes. Understanding factors driving curiosity can inform tobacco use prevention for youth. PMID:27657506
Khan, Zohaib; Suliankatchi, Rizwan Abdulkader; Heise, Thomas L; Dreger, Steffen
With an annual increase of 16,000 new cases each year, oral cancer is the second most common cancer in Pakistan. There is conflicting evidence regarding the carcinogenicity of different forms of smokeless tobacco (SLT) from different countries. This difference in evidence may be attributed to the varied composition of SLT products used around the world, necessitating the establishment of individual risks related to each SLT product. An electronic search in relevant databases yielded 119 publications, out of which 6 were included in this review. Effect estimates (odds ratios (OR)) were abstracted or calculated from the given data. A fixed effects meta-analysis was performed to assess the risk of oral cancer with the use of Naswar. Population attributable fractions (PAF) were also calculated. The Meta Odds Ratio (mOR) for oral cancer associated with the "ever use" of Naswar compared to "never use" was 11.8 (95% CI, 8.4-16.4), I2 = 67%. The pooled estimate for oral cancer in "Ever-users" of Naswar compared to "Never-users", in the Khyber Pakhtunkhwa province was 18.3 (95% CI, 8.7-38.5), I2 = 0%. The PAF for oral cancer associated with the use of Naswar in Pakistan was 44% (95% CI, 35%-53%). This review highlights a strong relationship between oral cancer incidence and the use of Naswar in Pakistan and adds to the evidence base on the carcinogenicity of SLT products in humans. Although the synthesized evidence may not be of a high quality, it represents the "best available evidence" which can be used to inform policy. The carcinogenicity of Naswar, a form of smokeless tobacco used extensively in Pakistan, Afghanistan and Central Asia, has yet to be recognized by the International Agency for Research on Cancer (IARC), partly due to the lack of evidence on the association of Naswar use and cancer. Additionally, Naswar is as yet un-regulated in Pakistan and evades the tax net, resulting in it being freely available to both adults and children at very cheap prices compared
Full Text Available The use of electronic cigarettes (e-cigs continues to increase worldwide in parallel with accumulating information on their potential toxicity and safety. In this study, an in vitro battery of established assays was used to examine the cytotoxicity, mutagenicity, genotoxicity and inflammatory responses of certain commercial e-cigs and compared to tobacco burning cigarettes, smokeless tobacco (SLT products and a nicotine replacement therapy (NRT product. The toxicity evaluation was performed on e-liquids and pad-collected aerosols of e-cigs, pad-collected smoke condensates of tobacco cigarettes and extracts of SLT and NRT products. In all assays, exposures with e-cig liquids and collected aerosols, at the doses tested, showed no significant activity when compared to tobacco burning cigarettes. Results for the e-cigs, with and without nicotine in two evaluated flavor variants, were very similar in all assays, indicating that the presence of nicotine and flavors, at the levels tested, did not induce any cytotoxic, genotoxic or inflammatory effects. The present findings indicate that neither the e-cig liquids and collected aerosols, nor the extracts of the SLT and NRT products produce any meaningful toxic effects in four widely-applied in vitro test systems, in which the conventional cigarette smoke preparations, at comparable exposures, are markedly cytotoxic and genotoxic.
Ayo-Yusuf, Olalekan A; Burns, David M
To review the implications of recommending smokeless tobacco (ST) use as a harm reduction approach for low-income and middle-income countries (LMICs). Narrative review of published papers and other data sources (including conference abstracts and internet-based information) on the health risks posed by the use of ST products for individual smokers and for the population with a focus on their implications for LMICs. Swedish snus has a relatively lower toxicity profile than ST products available in other markets, including older products used in the US and products used in Africa and Asia. The experience with snus in Sweden provides information on the effects of snus use in a population where cigarette smoking was already culturally ingrained. However, population effects are likely to be different in those LMICs where smoking is not yet the dominant culturally accepted form of tobacco use. The total effect may be negative in countries where locally-popular ST products have substantially higher disease risks than Swedish snus and where there is limited regulatory and tobacco use surveillance capacity. Issues relating to how populations in LMICs respond to marketing efforts, the risks of the dual use of ST and smoking, and the capacity to regulate ST products need to be considered in making decisions about harm reduction strategies in LMICs. The public health effects of supporting ST as a harm reduction strategy may vary substantively in countries with different pre-existing tobacco use patterns.
This infrastructure, usually in national statistical offices, has been ... Tobacco Control Policy Survey -International Alcohol Control Survey Collecting and sharing ... both tobacco and alcohol data, and apply the same data collection processes.
Olsen, J; Rachootin, P; Schiødt, A V
An epidemiological study of the association between alcohol consumption, tobacco use and subfecundity is presented. Study subjects were recruited for a case-control study whose primary objective was to examine the association between occupational exposures and subfecundity. All 1069 women treated...... occupational exposures and smoking and drinking habits were collected by mailed questionnaires. A response rate of 87% was obtained for both case and control groups. Use of tobacco and alcohol was significantly higher in cases compared to controls. A within-group comparison of alcohol consumption among...... of this finding, along with further analyses, the authors suggest that the statistical association between smoking and subfecundity may be real and ought to be studied further. Moderate alcohol consumption does not seem to play a role in the development of subfecundity. The paper provides a systematic review...
Drug Strategies, Washington, DC.
This report examines alcohol, tobacco, and other drug use in rural parts of Indiana, as well as public and private initiatives to reduce these problems. The report is based on epidemiological, health, and criminal justice indicators; focus groups; and in-depth interviews with local officials, researchers, service providers, and civic leaders.…
Mukherjea, Arnab; Modayil, Mary V; Tong, Elisa K
Asian Indians (AIs) in the United States exhibit disproportionate burdens of oral cancer and cardiovascular disease, which are potentially linked to smokeless tobacco. However, little is known about the use of cultural smokeless tobacco (CST) products in this population. California Asian Indian Tobacco Use Survey data from 2004 (n = 1618) were used to investigate CST prevalence among California's AIs. CST products included paan, paan masala, and gutka. A multivariable logistic regression was conducted to examine factors (socioeconomic status, acculturation measures, and religious affiliation) associated with current CST use versus never use. The current CST prevalence was 13.0% (14.0% for men and 11.8% for women). In contrast, the prevalence of current cigarette use was 5.5% (8.7% for men and 1.9% for women), and the prevalence was lower for cultural smoked tobacco (0.1% for bidis and 0.5% for hookahs). Factors associated with CST use included the following: being male, being 50 years old or older, being an immigrant, speaking an AI language at home, having a higher level of education (adjusted odds ratio [AOR] for high school/some college, 2.6; 95% confidence interval [CI], 1.1-6.5; AOR for college degree or higher, 4.0; 95% CI, 1.7-9.5), having a higher income (AOR for $75,000-$100,000, 2.5; 95% CI, 1.3-4.7; AOR for ≥$100,000, 2.6; 95% CI, 1.4-5.0), identifying as non-Sikh (AOR for Hinduism, 10.0; 95% CI, 6.0-16.5; AOR for other faiths, 10.2; 95% CI, 5.9-17.7), and disagreeing that spiritual beliefs are the foundation of life (AOR, 2.1; 95% CI, 1.2-3.5). The current CST prevalence is relatively high among California's AIs in comparison with the prevalence of smoking, with narrower differences between sexes. The association with a higher socioeconomic status is contrary to typical cigarette smoking patterns. Acculturation and religious affiliation are important factors associated with current use. Health care providers and policymakers should consider such
... smokers (Ref. 5). Research supports the conclusion that tobacco advertising and promotion contribute to... dollars on advertising and promotion each year (Ref. 11). The National Cancer Institute (NCI) Monograph 19..., distribution, * * * access to, [or] the advertising and promotion of, * * * tobacco products.'' If this...
Regan, Annette K; Dube, Shanta R; Arrazola, René
A number of noncigarette tobacco products, including some novel products, recently have been marketed by the tobacco industry, which raises concerns from tobacco control authorities. This study aimed to assess current popularity of several noncigarette tobacco products in the U.S. In 2009, a total of 10,587 adults completed a consumer mail-in survey (ConsumerStyles). Based on survey results, the weighted percentages of adults who heard and tried snus, dissolvable tobacco products, flavored little cigars, and flavored cigarettes were computed in 2010. A subset of this sample (n=4556) completed the HealthStyles survey, which included items about health perceptions of these products and use in the past 30 days. The percentage of U.S. adults in the sample who were aware of these products ranged from 10.4% (dissolvable tobacco) to 44.6% (flavored little cigars). One third of adults who had heard of flavored little cigars tried them and 10.1% had used them in the past 30 days; among those who had heard of them, 27.4% tried flavored cigarettes and 12.6% tried snus. In general, young adults, men, and smokers were most likely to have heard of each product. At least one third of adults were uncertain if these products were as harmful as cigarettes (range=37.3% [snus] to 50.3% [dissolvable tobacco]). The awareness of these tobacco products in this sample varied. Groups with a higher prevalence of smoking and tobacco use (e.g., men, people with low levels of education) may be a target audience for marketing and promotions. As availability of products change, continued surveillance is warranted in the U.S. Published by Elsevier Inc.
Secondhand smoke - risks; Cigarette smoking - risks; Smoking and smokeless tobacco - risks; Nicotine - risks ... tobacco that are known to cause cancer. HEALTH RISKS OF SMOKING OR USING SMOKELESS TOBACCO Knowing the ...
... Advertising Act (FCLAA) when that requirement takes effect. On June 22, 2009, the President signed the Family... Advertising Act, as amended by the Family Smoking Prevention and Tobacco Control Act, when that requirement takes effect. DATES: Although you can comment on any guidance at any time (see 21 CFR 10.115(g)(5)), to...
... Exposure is High in Multiunit Housing Smokeless Products Electronic Cigarettes Youth Tobacco Prevention Tobacco Products Tobacco Ingredient ... Tweet Share Compartir Find Fact Sheets on Products (Cigars, Bidis and Betel Quid with Tobacco (Gutka) and ...
Aims The tobacco and alcohol industries share common policy goals when facing regulation, opposing policies such as tax increases and advertising restrictions. The collaboration between these two industries in the tobacco policy arena is unknown. This study explored if tobacco and alcohol companies built alliances to influence tobacco legislation, and if so, how those alliances worked. Methods Analysis of previously secret tobacco industry documents. Findings In the early 1980s, tobacco companies started efforts to build coalitions with alcohol and other industries to oppose cigarette excise taxes, clean indoor air policies, and tobacco advertising and promotion constraints. Alcohol companies were often identified as a key partner and source of financial support for the coalitions. These coalitions had variable success interfering with tobacco control policymaking. Conclusions The combined resources of tobacco and alcohol companies may have affected tobacco control legislation. These alliances helped to create the perception that there is a broader base of opposition to tobacco control. Advocates should be aware of the covert alliances between tobacco, alcohol, and other industries and expose them to correct this misperception. PMID:23587076
Full Text Available Background: Oral submucous fibrosis (OSMF is a debilitating, potentially cancerous oral condition. Although areca nut is the most important causative agent, it is also considered that the disease is immunologically mediated. Aim of the Study: To establish that autoimmunity and nutritional deficiency play a role in the etiopathogenesis of OSMF. Objectives of the Study: To show that serum immunoglobulin markers (immunoglobulin-G [IgG], immunoglobulin-A [IgA] and nutritional parameters such as total serum protein (TSP, Hemoglobin (Hb play a role in causing OSMF and also to correlate serum, salivary IgG, IgA levels in OSMF patients. Settings and Design: A case-control study was done with 50 patients (25 patients who were provisionally diagnosed as OSMF - Group I, and 25 patients who were chronic smokeless tobacco chewers and who did not have any intraoral lesion - Group II. Materials and Methods: Five milliliters of blood and saliva were collected from both the groups. Quantitative analysis of serum, and salivary IgG, IgA was done by turbidometric immunoassay. TSP and Hemoglobin (Hb were estimated by spectrophotometry. Statistical Analysis: Results were analyzed by independent samples t-test and one-way analysis of variance (ANOVA. Results: All patients of OSMF showed significant (P < 0.01 increase in serum IgG, IgA, and salivary IgG levels as compared to smokeless tobacco chewers. The salivary IgA levels showed a significant decrease in OSMF patients (P < 0.05. TSP and Hb levels showed significant (P < 0.01 decrease in OSMF patients as compared to smokeless tobacco chewers. Conclusion: The elevation of immunoglobulin levels supports the concept of autoimmunity. The decrease in TSP and Hb suggests that nutritional deficiency plays a defined role in the occurrence as well as a further progression of OSMF.
Olalekan A Ayo-Yusuf
Full Text Available BACKGROUND: Some smokeless tobacco products (SLT have been shown to be associated with only a fraction of the risks of cigarettes. This study assessed South African smokers' interest in switching to a hypothetical reduced harm SLT product. METHODS: The 2007 South African Social Attitudes Survey was analysed for 678 exclusive cigarette smokers. Respondents were asked about their perceptions about relative harm of snuff compared to cigarettes, and their interest in switching to snuff if informed it was 99% less harmful than cigarettes. RESULTS: About 49.7% of exclusive cigarette smokers believed that snuff was equally as harmful as cigarettes; 12.9% thought snuff was more harmful; 5.7% thought snuff was less harmful; while 31.8% did not know if there was a difference in harm between snuff and cigarettes. Approximately 24.2% of exclusive cigarette smokers indicated interest in switching to snuff, with significantly greater interest observed among those exposed to 100% smoke-free work environment. Interest in switching was highest (34.7% among smokers who believed a priori that using snuff was more harmful than cigarettes, and lowest (14.5% among those who did not know if there was a difference in harm. In a multi-variable adjusted logistic regression model, this latter group remained less likely to be interested in harm reduction switching (adjusted odds ratio = 0.42; 95% CI: 0.19-0.91. CONCLUSION: About a quarter of smokers indicated interest in harm reduction switching to snuff. SLT products have a potential role in reducing the harm from smoking in South Africa, but only if they are not used to circumvent smoke-free laws that have been associated with reduced smoking.
The aim of my thesis is to find out what is the position of the Czech society to advertising, tobacco and alcoholic products and advertising of these products, if this position differs for men and for women and for university students. In order to achieve my goals, I used the analysis of secondary data from Market & Media & Lifestyle -- TGI, the analysis of primary data obtained from the internet questionnaire and comparison of results of both analyses. On this basis, I came to conclusion tha...
Etemadi, Arash; Khademi, Hooman; Kamangar, Farin; Freedman, Neal D; Abnet, Christian C; Brennan, Paul; Malekzadeh, Reza
There is limited information about the hazards of cigarettes, smokeless tobacco and waterpipe in the Middle East. The aim of this study was to determine the association between different types of tobacco use and earlier death in the Golestan Cohort Study. The Study includes 50 045 adults (aged 40-75 years) from north eastern Iran. The baseline questionnaire (2004-2008) assessed information about use of cigarettes, chewing tobacco (nass) and waterpipe. To assess the use of each type of tobacco compared with never tobacco users, we used Cox regression models adjusted for age, socioeconomic status, area of residence, education and other tobacco used, and stratified by sex, ethnicity and opium use. 17% of participants reported a history of cigarette smoking, 7.5% chewing tobacco (nass) and 1.1% smoking waterpipe, and these figures declined in the later birth cohorts. During a median follow-up of 8 years, 4524 deaths occurred (mean age 64.8+9.9 years). Current (HR=1.44; 95% CI 1.28 to 1.61) and former (HR=1.35; 95% CI 1.16 to 1.56) cigarette smokers had higher overall mortality relative to never tobacco users. The highest cigarette-associated risk was for cancer death among current heavy smokers (HR=2.32; 95% CI 1.66 to 3.24). Current nass chewing was associated with overall mortality (HR=1.16; 95% CI 1.01 to 1.34), and there was a 61% higher risk of cancer death in people chewing nass more than five times a day. We observed an association between the cumulative lifetime waterpipe use (waterpipe-years≥28) and both overall (HR=1.66; 95% CI 1.11 to 2.47), and cancer mortality (HR=2.82; 95% CI 1.30 to 6.11). Regular use of cigarettes, smokeless tobacco and waterpipe were associated with the risk of earlier death (particularly from cancer) in our cohort. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Kausar, Afifa; Giri, Sarbani; Roy, Prasenjit; Giri, Anirudha
Assam is the highest tea producing state in India. A large number of workers are engaged in various units of tea industry. There are few reports on the health status of the tea garden workers. The present cytogenetic biomonitoring study was undertaken to investigate the genotoxic effect associated with workers in tea industries in southern Assam. Smokeless tobacco chewing along with betel nut is very common practice among the workers. Workers also get exposed periodically to mixture of pesticides. Employing buccal micronucleus cytome assay, exfoliated buccal cells were analyzed in 90 female tea garden and compared to 90 age and sex matched non-chewer control as well as 70 chewers who are not tea garden workers. Statistically significant (pworkers compared to both the control groups. The frequency of cell proliferation biomarkers was highest in the chewer controls whereas genotoxic and cell death parameters were highest in tea garden workers. Linear correlation analysis revealed strong positive correlation between the duration of occupation and the frequency of micronucleus (r=0.597; pworkers was relatively lower compared to the control group. Pesticide exposure and chewing areca nut along with smokeless tobacco use may be responsible for changes in cytome parameters in exfoliated buccal cells. Copyright © 2013 Elsevier GmbH. All rights reserved.
gaps in the implementation of key demand-reduction measures with regard to ST. Methods A series of focused literature reviews was conducted and findings were synthesized by relevant Articles (6 - 14 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC. Results We found sufficient evidence to support implementation of key demand-reduction measures for ST. For example, raising taxes can reduce ST consumption, with price elasticity on a par with, or sometimes higher than, cigarettes. Similarly, graphic pictorial warnings on ST packaging are far more effective than text-only warning labels. But despite supportive evidence, countries have either not implemented measures or have kept the bar much lower than that for cigarettes. For example, very few countries regulate the contents of ST products. Some have raised ST taxes but not to the extent of cigarette taxes, risking product substitution. Similarly, health-warning requirements for ST are less strict than those for cigarettes. Even where strong policies exist, compliance has been poor. For example, despite bans on ST advertising, most suppliers continue to promote products, especially at points of sale and via print and digital media. Consequently, ST demand-reduction measures have had limited impact. Conclusions The full implementation of FCTC Articles 6-14 is likely to reduce the global demand for ST, but their current state of implementation lags behind that for cigarettes. The existing policy gaps can be addressed through better knowledge of ST products, setting unambiguous standards, innovative systems for tax administration, building capacity in testing ST products and undertaking targeted research.
Full Text Available Abstract Background People of South Asian-origin are responsible for more than three-quarters of all the smokeless tobacco (SLT consumption worldwide; yet there is little evidence on the effect of SLT cessation interventions in this population. South Asians use highly addictive and hazardous SLT products that have a strong socio-cultural dimension. We designed a bespoke behaviour change intervention (BCI to support South Asians in quitting SLT and then evaluated its feasibility in Pakistan and in the UK. Methods We conducted two literature reviews to identify determinants of SLT use among South Asians and behaviour change techniques (BCTs likely to modify these, respectively. Iterative consensus development workshops helped in selecting potent BCTs for BCI and designing activities and materials to deliver these. We piloted the BCI in 32 SLT users. All BCI sessions were audiotaped and analysed for adherence to intervention content and the quality of interaction (fidelity index. In-depth interviews with16 participants and five advisors assessed acceptability and feasibility of delivering the BCI, respectively. Quit success was assessed at 6 months by saliva/urine cotinine. Results The BCI included 23 activities and an interactive pictorial resource that supported these. Activities included raising awareness of the harms of SLT use and benefits of quitting, boosting clients’ motivation and self-efficacy, and developing strategies to manage their triggers, withdrawal symptoms, and relapse should that occur. Betel quid and Guthka were the common forms of SLT used. Pakistani clients were more SLT dependent than those in the UK. Out of 32, four participants had undetectable cotinine at 6 months. Fidelity scores for each site varied between 11.2 and 42.6 for adherence to content – maximum score achievable 44; and between 1.4 and 14 for the quality of interaction - maximum score achievable was 14. Interviews with advisors highlighted the need for
Background Evidence suggests exposure to film smoking increases youth smoking, and this is also likely to be the case for television. Some evidence suggests alcohol in films and television has similar effects on drinking behaviours. It is therefore important to document the extent to which tobacco and alcohol occur in films and television in the UK. Methods Films (1989-2008) and television broadcasting were content coded for tobacco and alcohol including branding, use, parapherna...
Zeigler, Donald W
This report reviews aspects of trade agreements that challenge tobacco and alcohol control policies. Trade agreements reduce barriers, increase competition, lower prices and promote consumption. Conversely, tobacco and alcohol control measures seek to reduce access and consumption, raise prices and restrict advertising and promotion in order to reduce health and social problems. However, under current and pending international agreements, negotiated by trade experts without public health input, governments and corporations may challenge these protections as constraints on trade. Advocates must recognise the inherent conflicts between free trade and public health and work to exclude alcohol and tobacco from trade agreements. The Framework Convention on Tobacco Control has potential to protect tobacco policies and serve as a model for alcohol control.
de Silva, Varuni; Samarasinghe, Diyanath; Hanwella, Raveen
The harm from alcohol and tobacco use in low- and middle-income countries includes substantial economic cost to the individual. Our aim was to describe the expenditure on concurrent alcohol and tobacco use in relation to family income in two districts in Sri Lanka. A community-based cross-sectional study was carried out in two districts in Sri Lanka. We sampled 2684 men over 18 years of age using multistage cluster sampling. Cost of alcohol and cigarettes was calculated using the retail price for each brand and multiplying by the amount consumed. Among current alcohol users 63.1% were also smokers. Among current smokers 61.9% were also using alcohol. Prevalence of concurrent alcohol and tobacco use in urban areas was 20.1% and in rural areas 14%. The two lowest income categories (meaning in such settings. © 2010 Australasian Professional Society on Alcohol and other Drugs.
Brima, Eid Ibrahim
Objective: The use of Shamma (smokeless tobacco) by certain groups is giving rise to health problems, including cancer, in parts of Saudi Arabia. Our objective was to determine metals levels in Shamma using inductively coupled plasma mass spectrometry (ICP-MS). Methods: Thirty-three samples of Shamma (smokeless tobacco) were collected, comprising four types: brown Shamma (n = 14.0), red Shamma (n = 9.0), white Shamma (n = 4.0), and yellow Shamma (n = 6.0). All samples were collected randomly from Shamma users in the city of Najran. Levels of 11 elements (Al, As, Cd, Co, Cr, Cu, Li, Mn, Ni, Pb, and Zn) were determined by ICP-MS. Results: A mixed standard (20 ppb) of all elements was used for quality control, and average recoveries ranged from 74.7% to 112.2%. The highest average concentrations were found in the following order: Al (598.8–812.2 μg/g), Mn (51.0–80.6 μg/g), and Ni (23.2–53.3 μg/g) in all four Shamma types. The lowest concentrations were for As (0.7–1.0 μg/g) and Cd (0.0–0.06 μg/g). Conclusions: The colour of each Shamma type reflects additives mixed into the tobacco. Cr and Cu were showed significant differences (P awareness about the safety and health effects of Shamma, which is clearly a source of oral exposure to metals. Creative Commons Attribution License
Ness-Jensen, Eivind; Lagergren, Jesper
Gastro-oesophageal reflux disease (GORD) develops when reflux of gastric content causes troublesome symptoms or complications. The main symptoms are heartburn and acid regurgitation and complications include oesophagitis, strictures, Barrett's oesophagus and oesophageal adenocarcinoma. In addition to hereditary influence, GORD is associated with lifestyle factors, mainly obesity. Tobacco smoking is regarded as an aetiological factor of GORD, while alcohol consumption is considered a triggering factor of reflux episodes and not a causal factor. Yet, both tobacco smoking and alcohol consumption can reduce the lower oesophageal sphincter pressure, facilitating reflux. In addition, tobacco smoking reduces the production of saliva rich in bicarbonate, which is important for buffering and clearance of acid in the oesophagus. Alcohol also has a direct noxious effect on the oesophageal mucosa, which predisposes to acidic injury. Tobacco smoking cessation reduces the risk of GORD symptoms and avoidance of alcohol is encouraged in individuals where alcohol consumption triggers reflux. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available OBJECTIVES: to analyze the effect of self-esteem, assertiveness, self-efficacy and resiliency on alcohol and tobacco consumption in adolescents.METHOD: a descriptive and correlational study was undertaken with 575 adolescents in 2010. The Self-Esteem Scale, the Situational Confidence Scale, the Assertiveness Questionnaire and the Resiliency Scale were used.RESULTS: the adjustment of the logistic regression model, considering age, sex, self-esteem, assertiveness, self-efficacy and resiliency, demonstrates significance in the consumption of alcohol and tobacco. Age, resiliency and assertiveness predict alcohol consumption in the lifetime and assertiveness predicts alcohol consumption in the last year. Similarly, age and sex predict tobacco consumption in the lifetime and age in the last year.CONCLUSION: this study can offer important information to plan nursing interventions involving adolescent alcohol and tobacco users.
Alvarez-Aguirre, Alicia; Alonso-Castillo, María Magdalena; Zanetti, Ana Carolina Guidorizzi
to analyze the effect of self-esteem, assertiveness, self-efficacy and resiliency on alcohol and tobacco consumption in adolescents. a descriptive and correlational study was undertaken with 575 adolescents in 2010. The Self-Esteem Scale, the Situational Confidence Scale, the Assertiveness Questionnaire and the Resiliency Scale were used. the adjustment of the logistic regression model, considering age, sex, self-esteem, assertiveness, self-efficacy and resiliency, demonstrates significance in the consumption of alcohol and tobacco. Age, resiliency and assertiveness predict alcohol consumption in the lifetime and assertiveness predicts alcohol consumption in the last year. Similarly, age and sex predict tobacco consumption in the lifetime and age in the last year. this study can offer important information to plan nursing interventions involving adolescent alcohol and tobacco users.
Alvarez-Aguirre, Alicia; Alonso-Castillo, María Magdalena; Zanetti, Ana Carolina Guidorizzi
OBJECTIVES: to analyze the effect of self-esteem, assertiveness, self-efficacy and resiliency on alcohol and tobacco consumption in adolescents. METHOD: a descriptive and correlational study was undertaken with 575 adolescents in 2010. The Self-Esteem Scale, the Situational Confidence Scale, the Assertiveness Questionnaire and the Resiliency Scale were used. RESULTS: the adjustment of the logistic regression model, considering age, sex, self-esteem, assertiveness, self-efficacy and resiliency, demonstrates significance in the consumption of alcohol and tobacco. Age, resiliency and assertiveness predict alcohol consumption in the lifetime and assertiveness predicts alcohol consumption in the last year. Similarly, age and sex predict tobacco consumption in the lifetime and age in the last year. CONCLUSION: this study can offer important information to plan nursing interventions involving adolescent alcohol and tobacco users. PMID:25591103
... past 30 days. † Any tobacco product includes cigarettes, cigars, smokeless tobacco (including chewing tobacco, snuff, dip, snus, and dissolvable tobacco), tobacco pipes, bidis, hookah, and electronic cigarettes. § Where percentages are missing, sample sizes were ...
Scott, Molly M; Cohen, Deborah A; Schonlau, Matthias; Farley, Thomas A; Bluthenthal, Ricky N
Historically, the alcohol and tobacco industries have been the biggest users of outdoor advertising. However, the 1999 Master Settlement Agreement (MSA) outlawed tobacco billboards and transit furniture (e.g., bus, bench) ads, and the Outdoor Advertising Association of America (OAAA) has pledged to voluntarily eliminate ads for alcohol and tobacco within 500 feet of schools, playgrounds, and churches. Outdoor advertisements were observed (2004-2005) in a sample of urban census tracts (106 in pre-Katrina southern Louisiana and 114 in Los Angeles County) to evaluate tobacco and alcohol advertisers' compliance with the MSA and the OAAA Code of Industry Principles. Data were analyzed in 2007-2008. More than one in four tobacco ads in Louisiana failed to comply with the MSA. In Los Angeles, 37% of alcohol ads and 25% of tobacco ads were located within 500 feet of a school, playground, or church; in Louisiana, roughly one in five ads promoting alcohol or tobacco fell within this distance. In Los Angeles, low-income status and the presence of a freeway in the tract were associated with 40% more alcohol and tobacco billboards near children. In Louisiana, each additional major roadway-mile was associated with 4% more tobacco ads-in violation of MSA-and 7% more small ads near schools, playgrounds, and churches; city jurisdiction accounted for 55% of MSA violations and more than 70% of the violations of OAAA guidelines. Cities must be empowered to deal locally with violations of the MSA. Legislation may be needed to force advertisers to honor their pledge to protect children from alcohol and tobacco ads.
Rossheim, Matthew E; Thombs, Dennis L; O'Mara, Ryan J; Bastian, Nicholas; Suzuki, Sumihiro
To examine the event-specific relationship between alcohol intoxication and nighttime tobacco smoking among college bar patrons. In this secondary analysis of existing data, we examined event-specific associations between self-report measures of tobacco smoking and breath alcohol concentration (BrAC) readings obtained from 424 patrons exiting on-premise drinking establishments. In a multivariable logistic regression analysis, acute alcohol intoxication was positively associated with same-night incidents of smoking tobacco, adjusting for the effects of established smoking practices and other potential confounders. This investigation is the first known study using data collected in an on-premise drinking setting to link alcohol intoxication to specific incidents of tobacco smoking.
Tauchmann, Harald; Göhlmann, Silja; Requate, Till; Schmidt, Christoph M.
The question of whether two drugs – namely alcohol and tobacco – are used as complements or substitutes is of crucial interest if side-effects of anti-smoking policies are considered. Numerous papers have empirically addressed this issue by estimating demand systems for alcohol and tobacco and subsequently calculating cross-price effects. However, this traditional approach often is seriously hampered by insufficient price-variation observed in survey data. We therefore suggest an alternative ...
Healthy Lifestyle Quit smoking Get the facts about chewing tobacco and other forms of smokeless tobacco. They' ... than you might think. By Mayo Clinic Staff Chewing tobacco and other smokeless tobacco products may be ...
Gay, Christopher; Clements-Nolle, Kristen; Packham, John; Ackerman, Gerald; Lensch, Taylor; Yang, Wei
Rural youth have higher rates of alcohol and tobacco use compared to their urban counterparts. However, the economic dependence of rural communities may differentially influence risk behaviors. While research has shown that adults working in mining have elevated rates of alcohol and tobacco use, the influence of living in a mining community on early adolescent substance use is unknown. Using data from a representative sample of 4,535 middle school students in a state with heavy reliance on mining, we conducted weighted logistic regression to investigate whether community-level mining economic dependence influences rural-urban differences in adolescent alcohol and tobacco use. All models adjusted for sociodemographics, military family involvement, parental monitoring, and length of residence. Over one quarter of the sampled students lived in rural counties and approximately half of these counties met the USDA mining economic typology. After stratifying rural counties by mining and nonmining economic dependence, students in rural mining counties had significantly higher odds of all measures of alcohol use (AORs ranged from 1.83 to 3.99) and tobacco use (AORs ranged from 1.61 to 5.05) compared to students in urban counties. Only use of smokeless tobacco was higher among students in rural nonmining counties. Our findings demonstrate rural-urban disparities in adolescent substance use that are particularly pronounced among youth living in counties with economic dependence on mining. Future research on this subject should include a wider range of community-level factors that may have specific relevance in rural settings to inform the development of population-level interventions. © 2018 National Rural Health Association.
Conclusions: Frequent depictions of smoking and drinking in tobacco industry lifestyle magazines might have reinforced norms about paired use of tobacco and alcohol among young adults. The pairing of tobacco and alcohol may particularly target young men. Anti-tobacco interventions need to address the co-use of tobacco and alcohol, change the social acceptability of smoking in social settings, and tailor anti-tobacco messaging by gender.
... Exposure is High in Multiunit Housing Smokeless Products Electronic Cigarettes Youth Tobacco Prevention Tobacco Products Tobacco Ingredient ... Performance Don’t get trapped. Nicotine in cigarettes, cigars, and spit tobacco is addictive. Nicotine narrows your ...
Nayra Soares do Amaral
Full Text Available Tobacco and alcohol are the leading environmental risk factors in the development of human diseases, such as cancer, cardiovascular disease, and liver injury. Despite the copious amount of research on this topic, by 2030, 8.3 million deaths are projected to occur worldwide due to tobacco use. The expression of noncoding RNAs, primarily microRNAs (miRNAs and long noncoding RNAs (lncRNAs, is modulated by tobacco and alcohol consumption. Drinking alcohol and smoking cigarettes can modulate the expression of miRNAs and lncRNAs through various signaling pathways, such as apoptosis, angiogenesis, and inflammatory pathways—primarily interleukin 6 (IL-6/signal transducer and activator of transcription 3 (STAT3, which seems to play a major role in the development of diseases associated with these risk factors. Since they may be predictive and prognostic biomarkers, they can be used both as predictors of the response to therapy and as a targeted therapy. Further, circulating miRNAs might be valuable noninvasive tools that can be used to examine diseases that are related to the use of tobacco and alcohol. This review discusses the function of noncoding RNAs in cancer and other human tobacco- and alcohol-associated diseases.
Wang, Kesheng; Liu, Ying; Ouedraogo, Youssoufou; Wang, Nianyang; Xie, Xin; Xu, Chun; Luo, Xingguang
Early alcohol, tobacco and drug use prior to 18 years old are comorbid and correlated. This study included 6239 adults with major depressive disorder (MDD) in the past year and 72,010 controls from the combined data of 2013 and 2014 National Survey on Drug Use and Health (NSDUH). To deal with multicollinearity existing among 17 variables related to early alcohol, tobacco and drug use prior to 18 years old, we used principal component analysis (PCA) to infer PC scores and then use weighted multiple logistic regression analyses to estimate the associations of potential factors and PC scores with MDD. The odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. The overall prevalence of MDD was 6.7%. The first four PCs could explain 57% of the total variance. Weighted multiple logistic regression showed that PC 1 (a measure of psychotherapeutic drugs and illicit drugs other than marijuana use), PC 2 (a measure of cocaine and hallucinogens), PC 3 (a measure of early alcohol, cigarettes, and marijuana use), and PC 4 (a measure of cigar, smokeless tobacco use and illicit drugs use) revealed significant associations with MDD (OR = 1.12, 95% CI = 1.08-1.16, OR = 1.08, 95% CI = 1.04-1.12, OR = 1.13, 95% CI = 1.07-1.18, and OR = 1.15, 95% CI = 1.09-1.21, respectively). In conclusion, PCA can be used to reduce the indicators in complex survey data. Early alcohol, tobacco and drug use prior to 18 years old were found to be associated with increased odds of adult MDD. Copyright © 2018 Elsevier Ltd. All rights reserved.
Rizov, Marian; Herzfeld, Thomas; Huffman, Sonya K
The paper presents evidence on the impact of individual characteristics as well as regional macroeconomic factors on changes in fat, protein, alcohol and tobacco consumption, and on diet's diversity during the transition period 1994 - 2004 in Russia. The results from estimating first difference demand functions using Russian Longitudinal Monitoring Survey (RLMS) data suggest that individual characteristics such as initial consumption patterns, gender, education, household income, and access to a garden plot all have a significant impact on the consumption behaviour. Regarding the macroeconomic variables, inflation has a significant impact on alcohol and tobacco consumption, while unemployment significantly impacts only smoking behaviour. Russian consumers respond to own prices of fat and protein as well as to own prices of alcohol and tobacco but to a lesser extent. Analysis of subsamples based on different initial consumption patterns reveals significant heterogeneity in consumption responses.
... Health Education Act (Smokeless Tobacco Act), as amended by the Family Smoking Prevention and Tobacco... the manufacture, marketing, and distribution of tobacco products to protect public health generally... appear on smokeless tobacco product packages and advertising, and to require that rotational warning...
Full Text Available Abstract Background Smokeless tobacco is an alternative for smokers who want to quit but require nicotine. Reliable evidence on its effects is needed. Boffetta et al. and ourselves recently reviewed the evidence on cancer, based on Scandinavian and US studies. Boffetta et al. claimed a significant 60–80% increase for oropharyngeal, oesophageal and pancreatic cancer, and a non-significant 20% increase for lung cancer, data for other cancers being "too sparse". We found increases less than 15% for oesophageal, pancreatic and lung cancer, and a significant 36% increase for oropharyngeal cancer, which disappeared in recent studies. We found no association with stomach, bladder and all cancers combined, using data as extensive as that for oesophageal, pancreatic and lung cancer. We explain these differences. Methods For those cancers Boffetta et al. considered, we compared the methods, studies and risk estimates used in the two reviews. Results One major reason for the difference is our more consistent approach in choosing between study-specific never smoker and combined smoker/non-smoker estimates. Another is our use of derived as well as published estimates. We included more studies, and avoided estimates for data subsets. Boffetta et al. also included some clearly biased or not smoking-adjusted estimates. For pancreatic cancer, their review included significantly increased never smoker estimates in one study and combined smoker/non-smoker estimates in another, omitting a combined estimate in the first study and a never smoker estimate in the second showing no increase. For oesophageal cancer, never smoker results from one study showing a marked increase for squamous cell carcinoma were included, but corresponding results for adenocarcinoma and combined smoker/non-smoker results for both cell types showing no increase were excluded. For oropharyngeal cancer, Boffetta et al. included a markedly elevated estimate that was not smoking-adjusted, and
Kurpas, Donata; Mroczek, Bozena; Bielska, Dorota; Wojtal, Mariola; Seń, Mariola; Steciwko, Andrzej
To determine the level of alcohol intake (including risky drinking) and tobacco smoking among students of higher medical schools, as well as the level of students' knowledge about epidemiology and consequences of alcohol abuse. The study was conducted in 2010-2012 and involved 1054 students of medical school. The majority of the participants were female (82.3%). Average age of respondents was 25.13 years (SD = 6.64, median = 24). The questionnaire was to determine the students' knowledge of alcohol abuse, short version of AUDIT and questions about tobacco smoking. The average 100% alcohol intake in Poland was correctly identified by 32.0% (318) of students. The alcohol level in blood which indicates the state after alcohol intake was correctly determined by 57.2% (571) of respondents. Tobacco was the choice of 13.8% (138) of students as the main health risk factor and cause of premature deaths in Europe, alcohol was chosen by 17.8% (177). Cirrhosis was recognized correctly by 52% of students (521) as the most frequent disease caused by alcohol in European men. Regarding the question about the biochemical indicators helpful in diagnostics of alcohol abuse only 27.6% (275) indicated correctly: MCV and GGT. In short version of AUDIT 32.2% (238) of women gained 4 points and above, 56.2% (91) of men gained 5 points and above. Among women: 3.5% (28) have 14 and above standardized portions of an alcoholic drinks during week. Among men: 6.5% (11) have 28 and above standardized portions of an alcoholic drinks during week. Non-smokers represent 20.6% (205) of respondents. A majority (39.4%, 82) indicate they smoke not more than 5 cigarettes per day. The students first began smoking in secondary (21.7%, 45) and high school (45.9%, 95). Smokers statistically significantly more often (palcohol. More than four times higher percentage of smokers (10.0% vs 2.3% non-smokers) drink in a day when they drink 10 or more standardized portions of an alcoholic drink (palcoholic drink
Turk, Tahir; Chaturvedi, Pankaj; Murukutla, Nandita; Mallik, Vaishakhi; Sinha, Praveen; Mullin, Sandra
The evidence on the efficacy of tobacco control messages in low and middle-income country (LMIC) settings is limited but growing. Low message salience and disengagement, in the face of tobacco control messages, are possible barriers to self-efficacy and cessation-related behaviours of tobacco users. Although adaptations of existing pretested graphic and emotional appeals have been found to impact on behaviours, more personalised, culturally relevant and compelling appeals may more fully engage message receivers to elicit optimal behavioural responses. The objective of these case studies is to use lessons learnt from high-income country tobacco control communication programmes, and adapt practical approaches to provide cost-effective, culturally nuanced, graphic and personalised messages from tobacco victims to achieve the optimal behavioural impact for population-level communication campaigns in the resource-constrained settings of LMICs. The 'raw and real' messaging approach, which emanated from message pretesting in India, outlines creative and production processes for the production of tobacco victim testimonials, given the need to source patients, facing life-threatening conditions. This cost-efficient approach uses real tobacco victims, doctors and family members in a cinéma vérité style approach to achieve more personalised and culturally resonant messages. The methodological approach, used for the development of a number of patient testimonial messages initially in India, and later adapted for tobacco cessation, smoke-free and graphic health warning communication campaigns in other countries, is outlined. Findings from campaigns evaluated to date are encouraging as a result of the simple fact that true stories of local people's suffering are simply too difficult to ignore. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Meyer, Michael G.; Toborg, Mary A.; Denham, Sharon A.; Mande, Mary J.
Context: Appalachia has high rates of tobacco use and related health problems, and despite significant impediments to alcohol use, alcohol abuse is common. Adolescents are exposed to sophisticated tobacco and alcohol advertising. Prevention messages, therefore, should reflect research concerning culturally influenced attitudes toward tobacco and…
Dull, R. Thomas; Williams, Franklin P., III
Concludes little relationship exists between the three substances marihuana, alcohol and tobacco. Youthful subjects tend to overestimate the relationships between the three substances and cannot be generalized to other populations. Suggests an explanation of this youthful association focuses on simultaneous experimentation rather than causal…
Cook, Michael B; Guénel, Pascal; Gapstur, Susan M
BACKGROUND: The etiology of male breast cancer is poorly understood, partly due to its relative rarity. Although tobacco and alcohol exposures are known carcinogens, their association with male breast cancer risk remains ill-defined. METHODS: The Male Breast Cancer Pooling Project consortium prov...
Objective. To determine the prevalence of, and factors associated with conjoint alcohol and tobacco use among tuberculosis (TB) patients in South Africa (SA). Methods. In a cross-sectional survey, 4 900 (54.5% men, 45.5% women) consecutively selected TB patients (including new TB and new TB retreatment patients) ...
Objectives. We investigated tobacco companies’ knowledge about concurrent use of tobacco and alcohol, their marketing strategies linking cigarettes with alcohol, and the benefits tobacco companies sought from these marketing activities. Methods. We performed systematic searches on previously secret tobacco industry documents, and we summarized the themes and contexts of relevant search results. Results. Tobacco company research confirmed the association between tobacco use and alcohol use. Tobacco companies explored promotional strategies linking cigarettes and alcohol, such as jointly sponsoring special events with alcohol companies to lower the cost of sponsorships, increase consumer appeal, reinforce brand identity, and generate increased cigarette sales. They also pursued promotions that tied cigarette sales to alcohol purchases, and cigarette promotional events frequently featured alcohol discounts or encouraged alcohol use. Conclusions. Tobacco companies’ numerous marketing strategies linking cigarettes with alcohol may have reinforced the use of both substances. Because using tobacco and alcohol together makes it harder to quit smoking, policies prohibiting tobacco sales and promotion in establishments where alcohol is served and sold might mitigate this effect. Smoking cessation programs should address the effect that alcohol consumption has on tobacco use. PMID:21852637
Jiang, Nan; Ling, Pamela M
We investigated tobacco companies' knowledge about concurrent use of tobacco and alcohol, their marketing strategies linking cigarettes with alcohol, and the benefits tobacco companies sought from these marketing activities. We performed systematic searches on previously secret tobacco industry documents, and we summarized the themes and contexts of relevant search results. Tobacco company research confirmed the association between tobacco use and alcohol use. Tobacco companies explored promotional strategies linking cigarettes and alcohol, such as jointly sponsoring special events with alcohol companies to lower the cost of sponsorships, increase consumer appeal, reinforce brand identity, and generate increased cigarette sales. They also pursued promotions that tied cigarette sales to alcohol purchases, and cigarette promotional events frequently featured alcohol discounts or encouraged alcohol use. Tobacco companies' numerous marketing strategies linking cigarettes with alcohol may have reinforced the use of both substances. Because using tobacco and alcohol together makes it harder to quit smoking, policies prohibiting tobacco sales and promotion in establishments where alcohol is served and sold might mitigate this effect. Smoking cessation programs should address the effect that alcohol consumption has on tobacco use.
Wagener, Theodore L; Tackett, Alayna P; Borrelli, Belinda
The study examined caregivers' interest in using potentially reduced exposure tobacco products for smoking cessation, reduction, and to help them not smoke in places such as around their child, as all three methods would potentially lead to reduced secondhand smoke exposure for their children. A sample of 136 caregivers completed carbon monoxide testing to assess smoking status and a brief survey. Few caregivers had ever used potentially reduced exposure tobacco products (smoke around their child or in the home (55%). Caregivers less motivated to quit smoking and with no home smoking ban were more interested in using potentially reduced exposure tobacco products to help them quit/stay quit from smoking (p < .05). © The Author(s) 2015.
... Exposure is High in Multiunit Housing Smokeless Products Electronic Cigarettes Youth Tobacco Prevention Tobacco Products Tobacco Ingredient ... 2004 [accessed 2015 Aug 17]. National Cancer Institute. Cigars: Health Effects and Trends [ PDF –2.93 MB] . ...
Jiang, Nan; Cortese, Daniel K; Lewis, M Jane; Ling, Pamela M
Advertising influences people's health behaviors. Tobacco companies have linked tobacco and alcohol in their marketing activities. We examined how depictions of alcohol were placed in lifestyle magazines produced by tobacco companies, and if these references differed depending on if the magazine was oriented towards men, women, or if it was unisex. Content analysis of 6 different tobacco industry lifestyle magazines (73 issues), including 73 magazine covers, 1558 articles, 444 tobacco ads, and 695 non-tobacco ads. 14 of 73 (19%) magazine covers featured alcohol; 581 of 1558 (37%) magazine articles mentioned alcohol; 119 of 444 (27%) tobacco ads showed alcohol images; and 57 of 695 (8%) non-tobacco ads portrayed alcohol. Male-oriented magazines ( Unlimited , CML , and Real Edge ) contained the most alcohol references, and the references were mainly beer, mixed drinks, and liquor or spirits. Female-oriented magazines ( All Woman and Flair ) contained the fewest alcohol references, and wine and mixed drinks were the major types of alcoholic beverage portrayed. For unisex magazine ( P.S. ), the frequency of alcohol references fell between the male- and female-oriented magazines, and most frequently mentioned mixed drinks. Frequent depictions of smoking and drinking in tobacco industry lifestyle magazines might have reinforced norms about paired use of tobacco and alcohol among young adults. The pairing of tobacco and alcohol may particularly target young men. Anti-tobacco interventions need to address the co-use of tobacco and alcohol, change the social acceptability of smoking in any social settings, and tailor alcohol related anti-tobacco messaging by gender.
Whittamore, Kathy; Britton, John; Leonardi-Bee, Jo
Abstract To determine the extent to which video games include alcohol and tobacco content and assess the association between playing them and alcohol and smoking behaviors in adolescent players in Great Britain. Assessment of substance in the 32 UK bestselling video games of 2012/2013; online survey of adolescent playing of 17 games with substance content; and content analysis of the five most popular games. A total of 1,094 adolescents aged 11–17 years were included as participants. Reported presence of substance content in the 32 games; estimated numbers of adolescents who had played games; self-reported substance use; semiquantitative measures of substance content by interval coding of video game cut scenes. Nonofficial sources reported substance content in 17 (44 percent) games but none was reported by the official Pan European Game Information (PEGI) system. Adolescents who had played at least one game were significantly more likely ever to have tried smoking (adjusted odds ratio [OR] 2.70, 95 percent confidence interval [CI] 1.75–4.17) or consumed alcohol (adjusted OR 2.35, 95 percent CI 1.70–3.23). In the five most popular game episodes of alcohol actual use, implied use and paraphernalia occurred in 31 (14 percent), 81 (37 percent), and 41 (19 percent) intervals, respectively. Tobacco actual use, implied use, and paraphernalia occurred in 32 (15 percent), 27 (12 percent), and 53 (24 percent) intervals, respectively. Alcohol and tobacco content is common in the most popular video games but not reported by the official PEGI system. Content analysis identified substantial substance content in a sample of those games. Adolescents who play these video games are more likely to have experimented with tobacco and alcohol. PMID:27428030
Mutti-Packer, Seema; Reid, Jessica L; Thrasher, James F; Romer, Daniel; Fong, Geoffrey T; Gupta, Prakash C; Pednekar, Mangesh S; Nargis, Nigar; Hammond, David
There is strong evidence showing that pictorial health warnings are more effective than text-only warnings. However, much of this evidence comes from high-income countries and is limited to cigarette packaging. Moreover, few studies have identified mechanisms that might explain the impact of warnings. The current study examined the potential mediating role of negative affect and the moderating influence of message credibility in perceived effectiveness of smokeless tobacco warnings in two low- and middle-income countries (LMICs). Field interviews were conducted in India and Bangladesh, with adult (19+ years) smokeless tobacco users (n=1053), and youth (16-18years) users (n=304) and non-users (n=687). Respondents were randomly assigned to view warnings in one of four conditions: (1) Text-only, (2) pictorial with symbolic imagery, (3) pictorial with graphic images of health effects, or (4) pictorial with personalized graphic images plus a personal testimonial. The findings provide support for the mediating influence of negative affect in perceived effectiveness, for adult and youth smokeless tobacco users who viewed pictorial warnings (vs. text-only), and graphic health warnings (vs. personal testimonials). Among adults, message credibility moderated the indirect effect; the association was stronger when credibility was high and weaker when it was low. Among youth users and non-users, message credibility did not moderate the indirect effect. Consistent with research from high-income countries, these findings highlight the importance of selecting imagery that will elicit negative emotional reactions and be perceived as credible. Differential effects among adults and youth highlight the importance of pre-testing images. Copyright © 2017 Elsevier Ltd. All rights reserved.
Hussain, Azmina; Zaheer, Sidra; Shafique, Kashif
With 600 million people using betel quid (BQ) globally, and smokeless tobacco (SLT) use being more wide-spread; the duo is an uphill public health concern in South Asian countries. SLT and/or BQ use increases the risk for morbidity and mortality from oral cancer. Because SLT and/or BQ use is initiated during adolescence, it renders this group more vulnerable; and particular attention is needed to curb SLT and/or BQ use to reduce related disease burden. We aimed to observe the differential individual, social and environmental features amongst SLT and/or BQ users to determine the key influencers of its use in adolescents. This study was a cross-sectional survey of 2140 adolescents from secondary schools of Karachi, Pakistan. The main outcome measure was SLT and/or BQ use based on their consumption in the past 30 days. Univariate and multivariate regression binary logistic analyses were employed while reporting results in both crude form and adjusted odds ratio (after adjusting for all remaining individual, social and environmental level variables) with 95% confidence level. A p-value of co-education schools. Students whose peers (OR = 6.79, 95% CI 4.67-9.87, p-value co-education, parents and peers use, lack of knowledge based sessions on harmful health effects of SLT and/or BQ, and easy availability of the product from hawkers outside school all contribute towards enhanced risk of SLT and/or BQ use in adolescents.
How do consumers perceive differences in risk across nicotine products? A review of relative risk perceptions across smokeless tobacco, e-cigarettes, nicotine replacement therapy and combustible cigarettes.
Czoli, Christine D; Fong, Geoffrey T; Mays, Darren; Hammond, David
To systematically review the literature regarding relative risk perceptions (RRPs) across non-combustible nicotine products. MEDLINE and PsycINFO databases were searched for articles published up to October 2014. Of the 5266 records identified, articles not published in English that did not quantitatively assess RRPs across categories of non-combustible nicotine products were excluded, yielding 55 records. One reviewer extracted measures and findings of RRPs for product comparisons of smokeless tobacco (SLT), e-cigarettes (ECs) and nicotine replacement therapy (NRT) to one another, and to combustible cigarettes (CCs). A total of 157 samples from 54 studies were included in the analyses. The accuracy of RRPs differed based on the products being compared: although the accuracy of RRPs was variable across studies, substantial proportions of respondents reported inaccurate beliefs about the relative harmfulness of SLT versus CCs, as well as of ECs versus NRT. In addition, in most studies, respondents did not know the relative harmfulness of SLT versus NRT. In contrast, respondents in many studies correctly perceived NRT and ECs as less harmful than CCs. Cigarette smokers and users of non-combustible nicotine products tended to correctly perceive the relative harmfulness of products more often than non-users. Measures used to assess RRPs varied across studies, with different approaches characterised by certain strengths and limitations. The highly variable and context-specific nature of non-combustible nicotine product RRPs have direct implications for researchers and present several challenges for policymakers working with modified risk products, including issues of measurement, health risk communication and behaviour change. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
O'Connor, Richard J; Lindgren, Bruce R; Schneller, Liane M; Shields, Peter G; Hatsukami, Dorothy K
Subjective effects of drugs, representing pharmacological and non-pharmacological effects, have been shown to be associated with future use and abuse. This also is the case for tobacco products and so measuring subjective effects, such as liking, satisfaction, and aversion, is crucial to gaining an understanding of consumer perception leading to increased use. This study examined the predictive validity of subjective drug and product effects with respect to product adoption. Smokers (N=151) were enrolled in Minneapolis, Columbus, and Buffalo. Participants were shown two snus products (Camel Snus Winterchill and Robust), asked to try each of the products for 5min and to rate them using the Product Evaluation Scale (PES) and Drug Effects Questionnaire (DEQ). This was followed by a one-week use period of their preferred product and those who used at least 1 unit of Camel Snus per day (or at least 7 pouches total) were eligible to enroll in the Clinical Trial Phase assessing the impact of complete switching or dual use with smoking. Key outcomes for this study were product evaluation, extent of product use, and Clinical Trial enrollment. We noted no relationships between participant characteristics such as gender, age, prior smokeless use, baseline cigarettes per day (CPD), or PES and DEQ scores with any of these outcome variables. Subjective effects were weak predictors of product use, which totaled approximately 3units of snus per day. Regardless of product, it appears that PES and DEQ ratings were uniformly poor predictors of trial enrollment and retention, though they do predict the amount of snus used during the sampling phase. Findings indicate that while subjective effects predict product preference in the short-term, they did not consistently predict extent of use or enrollment in the trial, suggesting that these initial measures have limited implications for long-term behavior. Copyright © 2017. Published by Elsevier Ltd.
Armstrong, R W
Data from 100 Chinese, 50 Malay, and 50 Indian adults resident in 1980 in the greater urban area of Kuala Lumpur, Malaysia, indicate a heavy use of cigarettes among males of all ethnic groups, light use among female Chinese, and none among female Malay and Indian. Consumption of other tobacco products was important only among Indian males; chewing betal quid among Indian males and also among Malay and Indian females. Alcohol use is increasing among both sexes and all ethnic groups, but Chinese and Indian groups use alcoholic drinks more frequently and in larger quantity than Malay. Beer and liquor are the most common drinks.
Tobacco and alcohol are major risk factors for upper aerodigestive tract (UADT) cancer and significant variation is observed in UADT cancer rates across Europe. We have estimated the proportion of UADT cancer burden explained by tobacco and alcohol and how this varies with the incidence rates across Europe, cancer sub-site, gender and age. This should help estimate the minimum residual burden of other risk factors to UADT cancer, including human papillomavirus. We analysed 1981 UADT cancer cases and 1993 controls from the ARCAGE multicentre study. We estimated the population attributable risk (PAR) of tobacco alone, alcohol alone and their joint effect. Tobacco and alcohol together explained 73% of UADT cancer burden of which nearly 29% was explained by smoking alone, less than 1% due to alcohol on its own and 44% by the joint effect of tobacco and alcohol. Tobacco and alcohol together explained a larger proportion of hypopharyngeal\\/laryngeal cancer (PAR=85%) than oropharyngeal (PAR=74%), esophageal (PAR=67%) and oral cancer (PAR=61%). Tobacco and alcohol together explain only about half of the total UADT cancer burden among women. Geographically, tobacco and alcohol explained a larger proportion of UADT cancer in central (PAR=84%) than southern (PAR=72%) and western Europe (PAR=67%). While the majority of the UADT cancers in Europe are due to tobacco or the joint effect of tobacco and alcohol, our results support a significant role for other risk factors in particular, for oral and oropharyngeal cancers and also for UADT cancers in southern and western Europe.
Jiang, Nan; K. Cortese, Daniel; Jane Lewis, M.; M. Ling, Pamela
Background: Advertising influences people's health behaviors. Tobacco companies have linked tobacco and alcohol in their marketing activities. We examined how depictions of alcohol were placed in lifestyle magazines produced by tobacco companies, and if these references differed depending on the magazine’s orientation, if it was towards men, women, or if it was unisex. Methods: Content analysis of 6 different tobacco industry lifestyle magazines (73 issues), including 73 magazine covers, 1...
... campaigns. TABLE. Frequency of current use of cigarettes, e-cigarettes, cigars, and smokeless tobacco among middle and high ... States, 2014 Days of use Tobacco product Cigarettes E-cigarettes Cigars Smokeless tobacco % (95% CI) Estimated no. of ...
Background: Smokeless and cigarette tobacco use is becoming increasingly popular among Nigerian adolescents. This study aimed to evaluate predictors of intention to quit tobacco use among adolescents that currently use tobacco products in Nigeria. Materials and Methods: A total of 536 male and female high school ...
Goldstein, A O; Sobel, R A; Newman, G R
Tobacco and alcohol use among youth are major public health problems, but the extent to which children are routinely exposed to tobacco and alcohol products in children's films is unknown. To identify the prevalence and characteristics associated with tobacco and alcohol use portrayed in G-rated, animated feature films. Design All G-rated, animated feature films released between 1937 and 1997 by 5 major production companies (Walt Disney Co, MGM/United Artists, Warner Brothers Studios, Universal Studios, and 20th Century Fox) that were available on videotape were reviewed for episodes of tobacco and alcohol use. Presence of tobacco and alcohol use in each film, type of tobacco or alcohol used, duration of use, type of character using substance (bad, neutral, or good), and any associated effects. Of 50 films reviewed, 34 (68%) displayed at least 1 episode of tobacco or alcohol use. Twenty-eight (56%) portrayed 1 or more incidences of tobacco use, including all 7 films released in 1996 and 1997. Twenty-five films (50%) included alcohol use. Smoking was portrayed on screen by 76 characters for more than 45 minutes in duration; alcohol use was portrayed by 63 characters for 27 minutes. Good characters use tobacco and alcohol as frequently as bad characters. Cigars and wine are shown in these films more often than other tobacco or alcohol substances. More than two thirds of animated children's films feature tobacco or alcohol use in story plots without clear verbal messages of any negative long-term health effects associated with use of either substance.
Jan 4, 2007 ... The effect of Jharda powder (smokeless tobacco) on some hematological and biochemical parameters in consumers was investigated. Hematological parameters including hemoglobin content and white blood cell and leukocyte counts were higher in jharda powder consumers, while monocytes and.
The effect of Jharda powder (smokeless tobacco) on some hematological and biochemical parameters in consumers was investigated. Hematological parameters including hemoglobin content and white blood cell and leukocyte counts were higher in jharda powder consumers, while monocytes and basophiles counts were ...
Kaur, P; Rao, S R; Radhakrishnan, E; Ramachandran, R; Venkatachalam, R; Gupte, M D
Cardiovascular diseases are one of the leading causes of death in India. There is high prevalence of cardiovascular risk factors in urban Tamil Nadu. There are limited data on the prevalence of behavioral risk factors and overweight in rural Tamil Nadu. We estimated prevalence of behavioral risk factors, overweight and central obesity in a rural population in Tamil Nadu, India. We conducted a cross-sectional survey in 11 villages in Kancheepuram/Thiruvallur districts, Tamil Nadu. Study population included 10,500 subjects aged 25-64 years. We collected data on behavioral risk factors and anthropometric measurements. Body mass index (BMI) was categorized using the classification recommended for Asians. Central obesity was defined as waist circumference ≥90 cm for men and ≥80 cm for women. We computed proportions for all risk factors and used trend chi-square to examine trend. Among the 10,500 subjects, 4927 (47%) were males. Among males, 1852 (37.6%) were current smokers and 3073 (62.4%) were current alcohol users. Among females, 840 (15.1%) were smokeless tobacco users. BMI was ≥23.0 kg/m 2 for 1618 (32.8%) males and 2126 (38.2%) females. 867 (17.6%) males and 1323 (23.7%) females were centrally obese. Most commonly used edible oil was palm oil followed by sunflower oil and groundnut oil. We observed high prevalence of tobacco use, alcohol use and central obesity in the rural population in Tamil Nadu. There is need for health promotion programs to encourage adoption of healthy lifestyle and policy interventions to create enabling environment.
Bell, Kirsten; McNaughton, Darlene; Salmon, Amy
...) have become accept able responses to the 'risks' that alcohol, tobacco and obesity are perceived to pose. Hailing from Canada, Australia, the United Kingdom and the USA, and drawing on examples from all four countries, contributors interrogate the ways in which alcohol, tobacco and 'fat' have come to be constructed as 'problems'...
West, Joshua H.; Blumberg, Elaine J.; Kelley, Norma J.; Hill, Linda; Sipan, Carol L.; Schmitz, Katherine E.; Kolody, Bohdan; Chambers, Christina D.; Friedman, Lawrence S.; Hovell, Melbourne F.
Parents can impact adolescent substance use, but it is unclear which substances are most affected. This study compared associations between parenting behaviors and alcohol and tobacco use to see if parenting was equally related to both behaviors. Alcohol and tobacco use data were collected from 252 Latino adolescents living along the San…
White, James; Halliwell, Emma
This longitudinal study tested the direction of associations between family meals and alcohol and tobacco consumption during early adolescence. We examined family meal frequency, family connectedness, alcohol (binge drinking, drunkenness), and tobacco consumption (past year, daily frequency) in 671 adolescents (51% women; mean age, Wave 1 = 14.05…
Hunnicutt, David; Davis, Joe
This report describes alcohol, tobacco, and other drug use among 715 University of Nebraska at Omaha (UNO) students. The report focuses on drug use at the higher frequency levels, rather than reporting proportions who have ever used various drugs. The separate classes of drugs distinguished are alcohol, tobacco, cocaine, marijuana, and…
Objective: To better understand conjoint alcohol and tobacco use among male hospital out-patients, the purposes of this study were: (1) to assess the prevalence of conjoint use and (2) to determine the factors associated with the conjoint alcohol use and tobacco use. Methods: In a cross-sectional survey, consecutive male ...
Rouner, Donna; Slater, Michael; Long, Marilee; Stapel, Linda
Using a nationally representative sample, this study examined the relationship between amount of alcohol and tobacco advertising and related news-editorial content. This study found less tobacco and alcohol advertising in newspapers than did previous research and no relationship between coverage and number of advertisements.
Rouner, Donna; Slater, Michael; Long, Marilee; Stapel, Linda
Using a nationally representative sample, this study examined the relationship between amount of alcohol and tobacco advertising and related news-editorial content. This study found less tobacco and alcohol advertising in newspapers than did previous research and no relationship between coverage and number of advertisements.
Jiang, Nan; Lee, Youn O; Ling, Pamela M
Young adults frequently report social smoking. This study examined the relationship between different social smoking definitions and the co-use of cigarettes and alcohol, tobacco-related attitudes, and quitting efforts. Cross-sectional data were collected at bars using randomized time location sampling among young adults aged 21-26 in San Diego, California from 2010 to 2011 (73% response rate). Multivariable logistic regression examined if current smoking and quit attempts were associated with tobacco-related attitudes, and whether social smoking self-identification or behavior was associated with cigarette-and-alcohol co-use, tobacco-related attitudes, quit attempts, or quitline use. Among 537 current smokers, 80% self-identified and 49% behaved as social smokers. Social smoking self-identification was positively associated with cigarette-and-alcohol co-use, and quit attempts. Social smoking behavior was negatively associated with tobacco marketing receptivity, quit attempts, and quitline use. Tobacco-related attitudes were associated with smoking but did not generally differ by social smoking status. Identification and behavior as a social smoker have opposing associations with co-use of cigarettes and alcohol and quit attempts. Tobacco cessation programs for self-identified social smokers should address co-use. Interventions denormalizing the tobacco industry or emphasizing the health effects of temporary smoking and secondhand smoke may address smoking among young adult bar patrons regardless of social smoking status. Copyright © 2014 Elsevier Inc. All rights reserved.
Williams, Gerard; Daly, Michelle; Proude, Elizabeth M; Kermode, Steven; Davis, Michelle; Barling, Jan; Haber, Paul S
Tobacco use and heavy alcohol consumption are associated with increased morbidity and mortality. There is limited research on the correlation between tobacco and risky levels of alcohol use and the possible complications associated with a hospital admission. The underestimation of problem drinking, in particular, has obvious repercussions for the management of patients in hospital. If alcohol-related problems go undetected or unrecorded, treatment may be inadequate or inappropriate. The aims of the project were to assess the prevalence of high-risk alcohol and tobacco use in orthopaedic in-patients and to examine any relationship between alcohol and tobacco use and the number and type of complications, management and length of stay. One hundred and fifty-three consecutive orthopaedic admissions to the Orthopaedic Ward at Lismore Base Hospital were screened using the Drinkcheck questionnaire, which is based on the Alcohol Use Disorders Identification Test (AUDIT), but which also screens for tobacco use. Nursing staff on the ward completed a Complications Evaluation Questionnaire (CEQ). The risk status of the subjects was compared to the number and type of complications, to assess any effects of alcohol and tobacco on post-surgical complications. Significant correlations were found between tobacco use, hazardous and harmful alcohol use and numerous medical complications and behavioural problems. Behavioural problems associated with risky alcohol use included verbal abuse, agitation and sleep disturbances, particularly in men; problems associated with tobacco use included agitation and non-compliance. Orthopaedic patients who smoke and/or drink heavily prior to surgery may have more non-medical complications than non-smokers and light or non-drinkers. All surgery patients should thus be screened for alcohol and tobacco use and alcohol withdrawal, which may cause other symptoms such as behavioural problems, non-compliance and verbal abuse post-surgery.
Full Text Available Objective: To better understand conjoint alcohol and tobacco use among male hospital out-patients, the purposes of this study were: (1 to assess the prevalence of conjoint use and (2 to determine the factors associated with the conjoint alcohol use and tobacco use. Methods: In a cross-sectional survey, consecutive male out-patients from four district hospitals in Nakhon Pathom province in Thailand were assessed with the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST, Hospital Anxiety and Depression Scale (HADS, selfreported chronic conditions and health-seeking behaviour. The sample included 2208 study participants, with a mean age of 36.2 years (SD = 11.7 and an age range of 18–60 years. Results: Overall, 34.5% of the male hospital out-patients were conjoint moderate or high-risk alcohol and tobacco users, and 31.1% were moderate or high-risk alcohol or tobacco users. In multivariate analysis, younger age, having primary or less education, being separated, divorced or widowed, not having diabetes and not being obese were associated with conjoint moderate or high-risk alcohol and tobacco use. Conclusion: High prevalence and several risk factors of conjoint alcohol and tobacco use were found among hospital male out-patients. The findings of this study call for dual-intervention approaches for both alcohol and tobacco.
García-Díaz, Vanesa; Fernández-Feito, Ana; Arias, Lucía; Lana, Alberto
To examine the association between smoking and alcohol consumption and the type of working day in the Spanish population Cross-sectional study among employees residing in Spain aged >18 years (N=8,736). We took data from the National Health Survey (2011-2012). Information was collected on the type of working day (morning, afternoon, evening, part-time, reduced hours, and shift-work) and smoking and drinking habits. Demographic characteristics and health- and work-related factors were also taken into account. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated through log-binomial regressions. Among respondents, 32.1% smoked regularly, especially those working the night shift (43.5%). Moderate alcohol consumption was found in 54.8% of workers and excessive consumption in 1.5%. Most of the moderate and heavy drinkers worked part-time, with 57.6% and 1.8% respectively. The aOR of being a smoker was higher among night workers (OR=1.58; 95% CI: 1.01-2.46). None of the work shifts were significantly associated with alcohol consumption. Night shift work was associated with regular smoking. This collective of workers should be monitored closely by occupational health services and regularly undergo programs to control tobacco consumption and smoking-related diseases. Additional research to elucidate the reasons for this association could help to achieve preventive and therapeutic success. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.
Hawkins, Benjamin; Holden, Chris; Eckhardt, Jappe; Lee, Kelley
Tobacco is widely considered to be a uniquely harmful product for human health. Since the mid-1990s, the strategies of transnational tobacco corporations to undermine effective tobacco control policy has been extensively documented through internal industry documents. Consequently, the sale, use and marketing of tobacco products are subject to extensive regulation and formal measures to exclude the industry from policy-making have been adopted in the Framework Convention on Tobacco Control. In contrast to tobacco, alcohol is subject to less stringent forms of regulation, and the alcohol industry continues to play a central role in policy-making in many countries and at the global level. This article examines whether there is a sufficient rationale for such different regulatory approaches, through a comparative analysis of the political economy of the tobacco and alcohol industries including the structure of the industries, and the market and political strategies they pursue. Despite some important differences, the extensive similarities which exist between the tobacco and alcohol industries in terms of market structure and strategy, and political strategy, call into question the rationale for both the relatively weak regulatory approach taken towards alcohol, and the continued participation of alcohol corporations in policy-making processes.
Neufeld, K J; Peters, D H; Rani, M; Bonu, S; Brooner, R K
This study provides national estimates of regular tobacco and alcohol use in India and their associations with gender, age, and economic group obtained from a representative survey of 471,143 people over the age of 10 years in 1995-96, the National Sample Survey. The national prevalence of regular use of smoking tobacco is estimated to be 16.2%, chewing tobacco 14.0%, and alcohol 4.5%. Men were 25.5 times more likely than women to report regular smoking, 3.7 times more likely to regularly chew tobacco, and 9.7 times more likely to regularly use alcohol. Respondents belonging to scheduled castes and tribes (recognized disadvantaged groups) were significantly more likely to report regular use of alcohol as well as smoking and chewing tobacco. People from rural areas had higher rates compared to urban dwellers, as did those with no formal education. Individuals with incomes below the poverty line had higher relative odds of use of chewing tobacco and alcohol compared to those above the poverty line. The regular use of both tobacco and alcohol also increased significantly with each diminishing income quintile. Comparisons are made between these results and those found in the United States and elsewhere, highlighting the need to address control of these substances on the public health agenda.
Pfinder, Manuela; Liebig, Stefan; Feldmann, Reinhold
The study aimed to investigate (a) the association between low to moderate prenatal alcohol exposure (PAE) and the use of alcohol, tobacco and illicit drugs in adolescence and (b) whether the associations are modified by gender and ethnicity. The subjects of the study were 5922 children and adolescents, aged from 11 to 17 years, enrolled in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents (the KiGGS study). Information on PAE is based on parental self-report questionnaires. Use of alcohol, tobacco and illicit drugs was assessed through self-report questionnaires for adolescents. Low to moderate PAE was associated with an increased risk of drinking alcohol (adjusted odds ratio (OR) 1.73, 95% confidence interval (CI) 1.34, 2.18) and also of illicit drug use (adjusted OR 1.62, 95% CI 1.23, 2.14). The associations between PAE and the use of alcohol, tobacco and illicit drugs differed according to gender and ethnicity. Gender-stratified analyses resulted in adverse effects of PAE on drinking alcohol, smoking and illicit drug use in females; however, in German males, the associations disappeared. Stronger associations between PAE and the outcome measures were found in non-Germans. Our findings indicate that low to moderate levels of maternal alcohol intake during pregnancy are a risk factor for use of alcohol, tobacco and illicit drugs by the offspring, with stronger associations in females and non-Germans.
Cohen, Elisia L; Caburnay, Charlene A; Rodgers, Shelly
This study content analyzed 928 tobacco- and alcohol-related advertisements from a 3-year national sample of Black (n = 24) and general audience (n = 11) newspapers from 24 U.S. cities. The authors compared the frequency of tobacco and alcohol product and control advertising in Black versus general audience newspapers, as well as the presence of 5 message cues: model ethnicity, presence of health official, referral to resources, personal behavior mobilization, and localization. Results within health issues show that Black newspapers had more alcohol product advertising than did general audience newspapers. In contrast, Black newspapers had less alcohol and tobacco control advertising than general audience newspapers. Black newspapers' tobacco/alcohol product advertisements had more African American models than did general audience newspapers' tobacco/alcohol advertising, whereas general audience newspapers' tobacco control advertisements were significantly more likely to feature public health officials than ads in Black newspapers. Fewer message cues such as personal behavior mobilization, referral to resources, and localization were present in Black versus general audience newspapers. Results suggest that Black newspapers may have greater dependency than do general audience newspapers on these risk-related advertisements that target African American consumers. Given the current advertising environment, public health initiatives are needed to counter unhealthy alcohol product advertising messages that target vulnerable populations.
Chávez-Ayala, Rubén; Rivera-Rivera, Leonor; Leyva-López, Ahideé; Sánchez-Estrada, Marcela; Lazcano-Ponce, Eduardo
To quantify the association between gender role orientation and tobacco and alcohol use among young people of the State of Morelos. Study conducted in 2004-2005, students aged 14 to 24 years (n = 1 730). Sociodemographic variables (area of residence, socioeconomic status), family (parental education and violence), psycho-sociological (gender role, self-esteem, depression, alcohol consumption, tobacco, locus of control, sexual abuse). Logistic regression analysis. Factors associated with use of tobacco: In women, being androgynous undesirable, masculine role, attempted sexual abuse and urban areas. For men, depression and submission. Factors associated with alcohol use: In women, masculine gender role; and in men to be older than 20 years, living in semi-urban and urban area, and internal locus. The machismo is one of the gender role orientations with greater association with the use of tobacco primarily in girls in Mexico, and the masculine or instrumental role with alcohol.
Shortt, Niamh K; Tisch, Catherine; Pearce, Jamie; Mitchell, Richard; Richardson, Elizabeth A; Hill, Sarah; Collin, Jeff
There is a strong socio-economic gradient in both tobacco-and alcohol-related harm. One possible factor contributing to this social gradient may be greater availability of tobacco and alcohol in more socially-deprived areas. A higher density of tobacco and alcohol outlets is not only likely to increase supply but also to raise awareness of tobacco/alcohol brands, create a competitive local market that reduces product costs, and influence local social norms relating to tobacco and alcohol consumption. This paper examines the association between the density of alcohol and tobacco outlets and neighbourhood-level income deprivation. Using a national tobacco retailer register and alcohol licensing data this paper calculates the density of alcohol and tobacco retail outlets per 10,000 population for small neighbourhoods across the whole of Scotland. Average outlet density was calculated for neighbourhoods grouped by their level of income deprivation. Associations between outlet density and deprivation were analysed using one way analysis of variance. There was a positive linear relationship between neighbourhood deprivation and outlets for both tobacco (p sales alcohol (p sales and on-sales alcohol outlets. The social gradient evident in alcohol and tobacco supply may be a contributing factor to the social gradient in alcohol- and tobacco-related disease. Policymakers should consider such gradients when creating tobacco and alcohol control policies. The potential contribution to public health, and health inequalities, of reducing the physical availability of both alcohol and tobacco products should be examined in developing broader supply-side interventions.
... for State Tobacco Control Programs Basic Information Health Effects Cancer Heart Disease and Stroke Chronic Obstructive Pulmonary Disease (COPD) Smoking During Pregnancy Secondhand Smoke Smokeless Products Electronic Cigarettes Youth Tobacco Prevention Tobacco ...
Gruber, Enid L; Thau, Helaine M; Hill, Douglas L; Fisher, Deborah A; Grube, Joel W
Content analyses examined mention of alcohol, tobacco, and illicit substances in music videos (n = 359) broadcast in 2001, as well as genre and presence of humor. Findings indicated that references to illicit substances were more prevalent than tobacco in music videos. Humor was 2.5 times as likely to appear in videos containing references to substances than those without substances.
Clement Chinedu Azodo
Conclusions: Data from this survey revealed that the majority of the participants rated their oral health as good/excellent. The prevalence of tobacco use and alcohol consumption among prison officials was higher than reported values among the general population in Nigeria. This indicates that more surveillance and intervention studies are needed to evaluate the best way to control tobacco use and alcohol consumption among prison officials in Nigeria.
Damiani, P; Masse, H; Aubenque, M
An analysis of the distribution of tobacco consumption and alcohol-related mortality in France by sex and department is presented for the population aged 45 to 64. It is shown that the "population can be decomposed into two sets such that, for each of them, tobacco and alcohol consumption distributions are log-normal. [It is suggested] that consumption is normal for one set and an endogenous predisposition for the other." (summary in ENG) excerpt
Chavez, Laura J.; Ornelas, India J.; Lyles, Courtney R.; Williams, Emily C.
Experiences of discrimination are associated with tobacco and alcohol use, and work is a common setting where individuals experience racial/ethnic discrimination. Few studies have evaluated the association between workplace discrimination and these behaviors, and none have described associations across race/ethnicity.To examine the association between workplace discrimination and tobacco and alcohol use in a large, multistate sample of U.S. adult respondents to the Behavioral Risk Factor Surv...
Christine Godfrey; Melanie Powell
Pre-budget months of recent years have seen the opposing factions of industrial and public health lobbies jostling for influence over the Chancellor's alcohol and tobacco tax policy. Industry petitions for lower tax rates, citing factory closures and redundancy figures as evidence of the consequences of past budget decisions. The public health lobby demand increased taxation, citing rising trends in indicators of alcohol and tobacco related harm as evidence for a public health approach. In th...
Tauchmann, Harald; Göhlmann, Silja; Requate, Till; Schmidt, Christoph M.
The question of whether two drugs – namely alcohol and tobacco – are used as complements or substitutes is of crucial interest if side-effects of anti-drug policies are considered. Numerous papers have empirically addressed this issue by estimating demand systems for alcohol and tobacco and subsequently calculating cross-price effects. However, this traditional approach often is seriously hampered by insufficient price-variation observed in survey data. We, therefore, suggest an alternative i...
Brown, Qiana L; Hasin, Deborah S; Keyes, Katherine M; Fink, David S; Ravenell, Orson; Martins, Silvia S
Understanding the relationship between health insurance coverage and tobacco and alcohol use among reproductive age women can provide important insight into the role of access to care in preventing tobacco and alcohol use among pregnant women and women planning to become pregnant. We examined the association between health insurance coverage and both past month alcohol use and past month tobacco use in a nationally representative sample of women age 12-44 years old, by pregnancy status. The women (n=97,788) were participants in the National Survey of Drug Use and Health (NSDUH) in 2010-2013. Logistic regression models assessed the association between health insurance (insured versus uninsured), past month tobacco and alcohol use, and whether this was modified by pregnancy status. Pregnancy status significantly moderated the relationship between health insurance and tobacco use (p-value≤0.01) and alcohol use (p-value≤0.01). Among pregnant women, being insured was associated with lower odds of alcohol use (adjusted odds ratio [AOR]=0.47; 95% confidence interval [CI]=0.27-0.82), but not associated with tobacco use (AOR=1.14; 95% CI=0.73-1.76). Among non-pregnant women, being insured was associated with lower odds of tobacco use (AOR=0.67; 95% CI=0.63-0.72), but higher odds of alcohol use (AOR=1.23; 95% CI=1.15-1.32). Access to health care, via health insurance coverage is a promising method to help reduce alcohol use during pregnancy. However, despite health insurance coverage, tobacco use persists during pregnancy, suggesting missed opportunities for prevention during prenatal visits. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Hollands, Gareth J; Shemilt, Ian; Marteau, Theresa M; Jebb, Susan A; Lewis, Hannah B; Wei, Yinghui; Higgins, Julian Pt; Ogilvie, David
Background Overeating and harmful alcohol and tobacco use have been linked to the aetiology of various non-communicable diseases, which are among the leading global causes of morbidity and premature mortality. As people are repeatedly exposed to varying sizes and shapes of food, alcohol and tobacco products in environments such as shops, restaurants, bars and homes, this has stimulated public health policy interest in product size and shape as potential targets for intervention. Objectives 1)...
Paulo Cesar Ribeiro Barbosa
Full Text Available The aims of this study were to assess the impact of ceremonial use of ayahuasca—a psychedelic brew containing N,N-dimethyltryptamine (DMT and β-carboline —and attendance at União do Vegetal (UDV meetings on substance abuse; here we report the findings related to alcohol and tobacco use disorder. A total of 1,947 members of UDV 18+ years old were evaluated in terms of years of membership and ceremonial attendance during the previous 12 months. Participants were recruited from 10 states from all major regions of Brazil. Alcohol and tobacco use was evaluated through questionnaires first developed by the World Health Organization and the Substance Abuse and Mental Health Services Administration. Analyses compared levels of alcohol and tobacco use disorder between the UDV and a national normative sample (n = 7,939. Binomial tests for proportions indicated that lifetime use of alcohol and tobacco was higher in UDV sample compared to the Brazilian norms for age ranges of 25–34 and over 34 years old, but not for the age range of 18–24 years old. However, current use disorders for alcohol and tobacco were significantly lower in the UDV sample than the Brazilian norms. Regression analyses revealed a significant impact of attendance at ayahuasca ceremonies during the previous 12 months and years of UDV membership on the reduction of alcohol and tobacco use disorder.
Thomas, Samantha L; David, Jennifer; Randle, Melanie; Daube, Mike; Senior, Kate
To explore the attitudes and opinions of public health experts in gambling and related unhealthy commodity industries towards the tactics used by the gambling industry to prevent reform and the advocacy responses to these tactics. In-depth interviews (30-60 minutes) with a convenience sample of 15 public health experts and stakeholders with a public health approach to gambling (n=10), or other unhealthy commodity industries (food, alcohol, tobacco, n=5). Participants described the influences of political lobbying and donations on public policy, and industry framing of problem gambling as an issue of personal responsibility. Industry funding of, and influence over, academic research was considered to be one of the most effective industry tactics to resist reform. Participants felt there was a need to build stronger coalitions and collaborations between independent academics, and to improve the utilisation of media to more effectively shift perceptions of gambling harm away from the individual and towards the product. Gambling industry tactics are similar to the tactics of other unhealthy commodity industries. However, advocacy initiatives to counter these tactics in gambling are less developed than in other areas. The formation of national public health coalitions, as well as a strong evidence base regarding industry tactics, will help to strengthen advocacy initiatives. © 2015 Public Health Association of Australia.
Brinkman, William B; Epstein, Jeffery N; Auinger, Peggy; Tamm, Leanne; Froehlich, Tanya E
The association of attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) with tobacco and alcohol use has not been assessed in a young adolescent sample representative of the U.S. population. Data are from the 2000-2004 National Health and Nutrition Examination Survey, a cross-sectional sample representative of the U.S. population. Participants were age 12-15 years (N=2517). Exposure variables included diagnosis of ADHD and CD, and counts of ADHD and CD symptoms based on caregiver responses to the Diagnostic Interview Schedule for Children. Primary outcomes were adolescent-report of any use of tobacco or alcohol and age of initiating use. Multivariate logistic regression and Cox proportional hazard models were conducted. Adolescents with ADHD+CD diagnoses had a 3- to 5-fold increased likelihood of using tobacco and alcohol and initiated use at a younger age compared to those with neither disorder. Having ADHD alone was associated with an increased likelihood of tobacco use but not alcohol use. Hyperactive-impulsive symptom counts were not independently associated with any outcome, while every one symptom increase in inattention increased the likelihood of tobacco and alcohol use by 8-10%. Although participants with a diagnosis of CD alone (compared to those without ADHD or CD) did not have a higher likelihood of tobacco or alcohol use, for every one symptom increase in CD symptoms the odds of tobacco use increased by 31%. ADHD and CD diagnoses and symptomatology are linked to higher risk for a range of tobacco and alcohol use outcomes among young adolescents in the U.S. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Corelli, Robin L; Chai, Tiffany; Karic, Alda; Fairman, Melinda; Baez, Karina; Hudmon, Karen Suchanek
To characterize the extent to which state and national professional pharmacy associations have implemented formal policies addressing the sale of tobacco and alcohol products in community pharmacies. To determine existence of tobacco and alcohol policies, national professional pharmacy associations (n = 10) and state-level pharmacy associations (n = 86) affiliated with the American Pharmacists Association (APhA) and/or the American Society of Health-System Pharmacists (ASHP) were contacted via telephone and/or e-mail, and a search of the association websites was conducted. Of 95 responding associations (99%), 14% have a formal policy opposing the sale of tobacco products in pharmacies and 5% have a formal policy opposing the sale of alcohol in pharmacies. Of the associations representing major tobacco-producing states, 40% have a formal policy against tobacco sales in pharmacies, significantly more than the 8% of non-tobacco state associations with such policies. Among national professional pharmacy associations, only APhA and ASHP have formal policy statements opposing the sale of both tobacco and alcohol in pharmacies. Most state-level professional pharmacy associations affiliated with these two national organizations have no formal policy statement or position.
Full Text Available Formation of Australia’s National Drug Strategy (NDS included an extensive consultation process that was open not only to community and public health stakeholders, but also to representatives of the tobacco and alcohol industries. Australia is bound by the World Health Organization Framework Convention on Tobacco Control, which requires governments to protect tobacco control measures from interference by the tobacco industry. NDS consultation submissions made by these conflicted industries are not publicly available for scrutiny. The NDS goals are at odds with the commercial agenda of industries that support regulatory stagnation, oppose and undermine effective action, ignore and distort evidence, and prioritise profits over health.
Freeman, Becky; MacKenzie, Ross; Daube, Mike
Formation of Australia's National Drug Strategy (NDS) included an extensive consultation process that was open not only to community and public health stakeholders, but also to representatives of the tobacco and alcohol industries. Australia is bound by the World Health Organization Framework Convention on Tobacco Control, which requires governments to protect tobacco control measures from interference by the tobacco industry. NDS consultation submissions made by these conflicted industries are not publicly available for scrutiny. The NDS goals are at odds with the commercial agenda of industries that support regulatory stagnation, oppose and undermine effective action, ignore and distort evidence, and prioritise profits over health.
Thyssen, Jacob P; Johansen, Jeanne D; Menné, Torkil
There is evidence that stimulants such as alcohol and tobacco have an effect on the immune system, but little is known about how these lifestyle factors affect the prevalence of contact sensitization. This study investigated whether smoking and alcohol consumption were associated with contact...
Mar 22, 2016 ... southern Thailand 90.5% were moderate or high-risk tobacco users and 44.6% were moderate or high-risk alcohol users.3 Among general hospital patients in Brazil the rate of comorbidity between alcohol use disorder and nicotine dependence was 3.6%;4 in primary health care TB patients in. South Africa ...
Nunez-Smith, Marcella; Wolf, Elizabeth; Huang, Helen Mikiko; Chen, Peggy G.; Lee, Lana; Emanuel, Ezekiel J.; Gross, Cary P.
The authors systematically reviewed 42 quantitative studies on the relationship between media exposure and tobacco, illicit drug, and alcohol use among children and adolescents. Overall, 83% of studies reported that media was associated with increased risk of smoking initiation, use of illicit drugs, and alcohol consumption. Of 30 studies…
Jiang, Nan; Ling, Pamela
The tobacco and alcohol industries share common policy goals when facing regulation, opposing policies such as tax increases and advertising restrictions. The collaboration between these two industries in the tobacco policy arena is unknown. This study explored if tobacco and alcohol companies built alliances to influence tobacco legislation and, if so, how those alliances worked. Analysis of previously secret tobacco industry documents. In the early 1980s, tobacco companies started efforts to build coalitions with alcohol and other industries to oppose cigarette excise taxes, clean indoor air policies and tobacco advertising and promotion constraints. Alcohol companies were often identified as a key partner and source of financial support for the coalitions. These coalitions had variable success interfering with tobacco control policy-making. The combined resources of tobacco and alcohol companies may have affected tobacco control legislation. These alliances helped to create the perception that there is a broader base of opposition to tobacco control. Advocates should be aware of the covert alliances between tobacco, alcohol and other industries and expose them to correct this misperception. © 2013 Society for the Study of Addiction.
To assess the likelihood that young adolescents perceive that parents have legitimate authority regarding cigarette smoking and alcohol consumption; to test whether perceived parental authority predicts adolescents' use of tobacco and alcohol, and to test the association between parenting style and the legitimacy of parental authority regarding tobacco and alcohol. Survey data were obtained in 1997 from 1220 sixth and eighth grade adolescents enrolled in a central North Carolina school district. The sample comprised 72.3% of 1687 eligible students and 92.3% of 1321 students with parental consent; 83.8% of the sample was European-American and 16.2% African-American. Students completed self-report questionnaires administered in classrooms. Logistic regression models were used to test the study hypotheses. Adolescents were significantly more likely to legitimize parental authority regarding tobacco and alcohol than parental authority regarding conventional or contemporary issues. Failure to legitimize parental authority was associated with significantly greater odds of current smoking (OR = 4.06; p parental authority regarding tobacco and alcohol varied significantly by parenting style. The results discredit the myth that adolescents uniformly disregard parental values and rules regarding tobacco and alcohol. The results also showed that general parenting style covaried strongly with adolescents' perceptions of parental authority regarding substance use. Additional research is warranted to test for causal relations between general parenting style, adolescents' perceptions of parental authority regarding substance use, and adolescents' risk of substance use.
Rafael C. Freire
Full Text Available BACKGROUND: Studies have documented high use of tobacco, alcohol and illicit drugs in patients with panic disorder (PD. The comorbid substance use disorders worsen the prognosis of mood and anxiety disorders. The respiratory subtype (RS of PD seems to represent a more severe and distinct form of this disorder associated with higher familial history of PD and more comorbidity with other anxiety disorders. OBJECTIVES: Describe the patterns of tobacco, alcohol or illicit drug use in PD patients, and also to ascertain if patients with the RS use these substances more than those of the non-respiratory subtype. METHODS: This is a cross-sectional study with 71 PD patients. The Alcohol Use Disorders Identification Test and Fagerstrom Tobacco Questionnaire were used in the evaluation. Patients with four or five respiratory symptoms were classified in the RS, the remaining patients were classified as non-respiratory subtype. RESULTS: In our sample 31.0% were smokers, 11.3% were hazardous alcohol users and none of them was using illicit drugs. There were no differences between the respiratory and non-respiratory subtypes regarding the use of tobacco, alcohol, cannabis, cocaine, stimulants and hallucinogens. DISCUSSION: The RS was not correlated to the use of tobacco, alcohol and illicit drugs. Additional epidemiological and clinical studies focusing the relationship between PD and substance use are warranted.
Full Text Available BACKGROUND: This study focuses on a variety of social determinants of alcohol and tobacco consumption, which have been reported as an alarming epidemic in the post-Soviet Ukraine. Authors look at the intersections of social determinants of tobacco and alcohol use in Ukraine as perceived by the study participants, and their perception of structural effects of economic and cultural transition on the prevalence of these harmful lifestyles. METHODS: This study is part of a mixed-methods research, informed by an intersectional framework, focusing on complex health and health care experiences of Ukrainians. This study uses findings from 21 community consultations in 11 regions, corresponding to Ukraine’s diverse demographics, culture, and geography. At these consultations, participants discussed their health, experiences in seeking healthcare and provided recommendations for healthcare reforms. RESULTS: The study identifies the important demographic factors like age, gender, SES, and place of residence, and how their intersections influence tobacco and alcohol consumption in Ukraine. People of lower SES have reportedly higher rates of consuming alcohol and tobacco, but younger individuals of low SES are most affected by these unhealthy lifestyles. The study also points to broader structural factors, such as stress, unemployment, poor law enforcement, poor social support, lack of health promotion, features of the built environment, and tobacco and alcohol availability, which affect the uptake of unhealthy behaviors. CONCLUSIONS: The community consultations revealed people’s perceptions about the complex nature of tobacco and alcohol consumption in the post-Soviet setting. People shared their concern about the vulnerability of certain social groups to using alcohol and tobacco, and their understanding of the detrimental effects these substances have on the health of these groups. This intersectionality-based study concludes that there is a need to
Cranwell, Jo; Murray, Rachael; Lewis, Sarah; Leonardi-Bee, Jo; Dockrell, Martin; Britton, John
To quantify tobacco and alcohol content, including branding, in popular contemporary YouTube music videos; and measure adolescent exposure to such content. Ten-second interval content analysis of alcohol, tobacco or electronic cigarette imagery in all UK Top 40 YouTube music videos during a 12-week period in 2013/14; on-line national survey of adolescent viewing of the 32 most popular high-content videos. Great Britain. A total of 2068 adolescents aged 11-18 years who completed an on-line survey. Occurrence of alcohol, tobacco and electronic cigarette use, implied use, paraphernalia or branding in music videos and proportions and estimated numbers of adolescents who had watched sampled videos. Alcohol imagery appeared in 45% [95% confidence interval (CI) = 33-51%] of all videos, tobacco in 22% (95% CI = 13-27%) and electronic cigarettes in 2% (95% CI = 0-4%). Alcohol branding appeared in 7% (95% CI = 2-11%) of videos, tobacco branding in 4% (95% CI = 0-7%) and electronic cigarettes in 1% (95% CI = 0-3%). The most frequently observed alcohol, tobacco and electronic cigarette brands were, respectively, Absolut Tune, Marlboro and E-Lites. At least one of the 32 most popular music videos containing alcohol or tobacco content had been seen by 81% (95% CI = 79%, 83%) of adolescents surveyed, and of these 87% (95% CI = 85%, 89%) had re-watched at least one video. The average number of videos seen was 7.1 (95% CI = 6.8, 7.4). Girls were more likely to watch and also re-watch the videos than boys, P branding. © 2014 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.
Harling, Melanie; Strehmel, Petra; Schablon, Anja; Nienhaus, Albert
Abstract Background In this cross-sectional study the association between psychosocial stress, demoralization and the consumption of psychotropic substances in veterinarians was examined using data from a sample of 1,060 subjects (52.7% response). Methods Multiple logistic regression models were used to determine risk factors for psychosocial stress, demoralization, tobacco consumption (≹ 10 items/day), high-risk alcohol consumption (men > 20 g pure alcohol/day, women > 10 g pure alcohol/day)...
Thebault, Jean-Laurent; Falcoff, Hector; Favre, Madeleine; Noël, Frédérique; Rigal, Laurent
Data about tobacco and alcohol consumption are essential in many types of studies. These data can be obtained by directly questioning patients or by using the information collected from physicians. Agreement between these two sources varies according to the characteristics of patients but probably also those of physicians. The purpose of this study was to analyze the characteristics of general practitioners (GPs) associated with agreement between them and their patients about the patients' consumption of alcohol and tobacco. Data came from an observational survey among GPs who were internship supervisors in the Paris metropolitan area. Fifty-two volunteer GPs completed a self-administered questionnaire about the organization of their practice and their training. For each GP, a random sample of 70 patients, aged 40 to 74 years, answered questions about their personal tobacco and alcohol consumption. GPs simultaneously answered similar questions about each patient. We used a mixed logistic model to assess the association between physicians' characteristics and agreement for patients' smoking status and alcohol consumption. Data were collected from both patient and physician for 2599 patients. The agreement between patients and their physicians was 60.4% for smoking status and 48.7% for alcohol consumption. Physicians with continuing medical education in management of smokers and those reporting specific skill in managing hypertension had the best agreement for smoking. Physicians who taught courses at the university medical school and those reporting specific skill in managing alcoholism had the best agreement for alcohol consumption. Agreement increases with physicians' training and skills in management of patients with tobacco and alcohol problems. It supports the importance of professional training for improving the quality of epidemiologic data in general practice. Researchers who use GPs as a source of information about patients' tobacco and alcohol consumption
Tickle, Jennifer J; Beach, Michael L; Dalton, Madeline A
To evaluate the usefulness of Motion Picture Association of America (MPAA) ratings for parental selection of appropriate films for children, the 100 top grossing movies each year from 1996 through 2004 (N = 900) were content analyzed to measure risk behaviors in each film. More restrictive MPAA ratings (R and PG-13) were associated with increased mean seconds of portrayals of tobacco use, alcohol use, and sexual content; increased frequency of violent content; and increased salience of drug use. MPAA ratings, however, did not clearly distinguish films based on tobacco or alcohol use. Fifty percent of R-rated movies contained 124 seconds or more of tobacco use, comparable with 26% of PG-13 and 17% of PG movies. Fifty percent of R-rated movies contained 162 seconds or more of alcohol use, comparable with 49% of PG-13 and 25% of PG movies. Because of the high degree of overlap in alcohol and tobacco content between rating categories, the MPAA rating system, as currently defined, is not adequate for parents who wish to limit their children's exposure to tobacco or alcohol content in movies.
Berg, Carla J; Henriksen, Lisa; Cavazos-Rehg, Patricia A; Haardoerfer, Regine; Freisthler, Bridget
The emerging retail market for recreational marijuana use warrants research and surveillance as such markets are established in more US states. This research can be informed by the existing literature regarding tobacco and alcohol, which highlights the impact of spatial access to tobacco and alcohol retailers and exposure to tobacco and alcohol marketing on smoking and drinking among youth and young adults. Prior research indicates that tobacco and alcohol retailers, as well as medical marijuana dispensaries, are disproportionately located in neighborhoods characterized by socioeconomic disadvantage and by higher proportions of racial/ethnic minorities and young adults. Moreover, retail marketing or point-of-sale practices may differentially target subpopulations and differ by neighborhood demography and local policy. This literature and the methods employed for studying the tobacco and alcohol market could inform research on the retail environment for marijuana, as current gaps exist. In particular, much of the existing literature involves cross-sectional research designs; longitudinal studies are needed. Moreover, standardized measures are needed for systematic monitoring of industry marketing practices and to conduct research examining neighborhood differences in exposure to retail marketing for marijuana and its contribution to use modality and frequency, alone and in combination with nicotine and alcohol. The use of standardized measures for tobacco and alcohol marketing have been critical to develop an evidence base from cross-sectional and longitudinal studies that document the impact of retail marketing on substance use by adolescents and adults. Similar research is needed to establish an evidence base to inform federal, state, and local regulations of marijuana. Copyright © 2018 Elsevier Ltd. All rights reserved.
Díaz Geada, Ainara; Busto Miramontes, Alicia; Caamaño Isorna, Francisco
Social inequalities have been associated with morbidity and mortality. Gender, ethnic group and inequalities were studied in an adolescent population to analyze alcohol, tobacco and cannabis consumption. We carried out a cross-sectional study of pupils from high schools in Burela (northern Spain) (n=238). We used the "Factors de Risc en Estudiants de Secundária" questionnaire designed by Agència de Salut Pública de Barcelona. nationality and weekly pocket money. Dependent variables: expectations and consumption of alcohol, tobacco and marihuana. Logistic regression was used. Participation in the study reached 91%. The proportion of pupils that have tried alcohol on occasion increases with age (27.3%, 47.7%, 75.9%), as with tobacco (1.8%, 7.6%, 17.0%), and cannabis (0%, 3.1%, 7.0%). Higher levels of spending money constitute a risk factor for tasting alcohol (OR=3.01), for high-risk consumption (OR=3.35), for getting drunk (OR=6.45) and for trying marijuana (OR=15.30). Sex and nationality were not shown to be associated with the use of any of these three drugs. The results of our study show that consumption of alcohol, tobacco and cannabis increases with age and with increased spending money. The data do not support the argument that foreign pupils are a risk group for alcohol consumption, so they should not be stigmatized.
DuRant, R H; Rome, E S; Rich, M; Allred, E; Emans, S J; Woods, E R
Music videos from five genres of music were analyzed for portrayals of tobacco and alcohol use and for portrayals of such behaviors in conjunction with sexuality. Music videos (n = 518) were recorded during randomly selected days and times from four television networks. Four female and four male observers aged 17 to 24 years were trained to use a standardized content analysis instrument. All videos were observed by rotating two-person, male-female teams who were required to reach agreement on each behavior that was scored. Music genre and network differences in behaviors were analyzed with chi-squared tests. A higher percentage (25.7%) of MTV videos than other network videos portrayed tobacco use. The percentage of videos showing alcohol use was similar on all four networks. In videos that portrayed tobacco and alcohol use, the lead performer was most often the one smoking or drinking and the use of alcohol was associated with a high degree of sexuality on all the videos. These data indicate that even modest levels of viewing may result in substantial exposure to glamorized depictions of alcohol and tobacco use and alcohol use coupled with sexuality.
Oleg R. Karatayev
Full Text Available Objective to identify and assess the share of counterfeit products in the total volume of alcohol and tobacco products in the consumer market of Tatarstan Republic which will allow the inspection bodies to deal more effectively to prevent the spreading of counterfeit products. Methods the research proposed in this paper used methods of probability theory and mathematical statistics and the method of sampling analysis of certificates for products in accordance with applicable laws and regulations of Rosstandart. Results basing on a sampling of certificates for products directly from retail outlets analysis of the state alcohol and tobacco consumer market of Tatarstan was carried out. Improper filling of the form of the certificate for products was identified violating all existing norms and laws which are strictly prescribed in technical regulations. On the basis of these violations the validity of certificates for products was assessed and the conclusion was made about the products quality. The share of counterfeit alcohol and tobacco products in the total sales in the consumer market was assessed. The shortcomings of the inspection authorities to detect counterfeit products were identified. Scientific novelty the consumer market was researched basing on the method of sampling using probability theory and mathematical statistics to estimate the share of counterfeit alcohol and tobacco products in the consumer market of Tatarstan. The error sampling for counterfeit products in the consumer market was defined. Practical significance the obtained results will allow the inspection authorities to better and more accurately identify counterfeit goods and to restrict the access of counterfeit alcohol and tobacco products to the consumer market of Tatarstan. It is necessary to strengthen the role of state regulation of commercial activities in the consumer market of Russia to stop the flow of counterfeit alcohol and tobacco products to the consumer
Fullerton, Carol S; McKibben, Jodi B A; Reissman, Dori B; Scharf, Ted; Kowalski-Trakofler, Kathleen M; Shultz, James M; Ursano, Robert J
We examined the relationship of probable posttraumatic stress disorder (PTSD), probable depression, and increased alcohol and/or tobacco use to disaster exposure and work demand in Florida Department of Health workers after the 2004 hurricanes. Participants (N = 2249) completed electronic questionnaires assessing PTSD, depression, alcohol and tobacco use, hurricane exposure, and work demand. Total mental and behavioral health burden (probable PTSD, probable depression, increased alcohol and/or tobacco use) was 11%. More than 4% had probable PTSD, and 3.8% had probable depression. Among those with probable PTSD, 29.2% had increased alcohol use, and 50% had increased tobacco use. Among those with probable depression, 34% indicated increased alcohol use and 55.6% increased tobacco use. Workers with greater exposure were more likely to have probable PTSD and probable depression (ORs = 3.3 and 3.06, respectively). After adjusting for demographics and work demand, those with high exposure were more likely to have probable PTSD and probable depression (ORs = 3.21 and 3.13). Those with high exposure had increased alcohol and tobacco use (ORs = 3.01 and 3.40), and those with high work demand indicated increased alcohol and tobacco use (ORs = 1.98 and 2.10). High exposure and work demand predicted increased alcohol and tobacco use, after adjusting for demographics, work demand, and exposure. Work-related disaster mental and behavioral health burden indicate the need for additional mental health interventions in the public health disaster workforce.
Delobelle, Peter; Sanders, David; Puoane, Thandi; Freudenberg, Nicholas
Noncommunicable diseases (NCDs) impose a growing burden on the health, economy, and development of South Africa. According to the World Health Organization, four risk factors, tobacco use, alcohol consumption, unhealthy diets, and physical inactivity, account for a significant proportion of major NCDs. We analyze the role of tobacco, alcohol, and…
Coomber, Kerri; Toumbourou, John W.; Miller, Peter; Staiger, Petra K.; Hemphill, Sheryl A.; Catalano, Richard F.
Purpose: There are inconsistent research findings regarding the impact of rurality on adolescent alcohol, tobacco, and illicit substance use. Therefore, the current study reports on the effect of rurality on alcohol, tobacco, and illicit drug use among adolescents in 2 state representative samples in 2 countries, Washington State (WA) in the…
White, James; Halliwell, Emma
Despite evidence that frequent family meals are associated with low levels of substance use during adolescence, prior studies have not examined the role of how adolescents perceive mealtimes. We examined family meal frequency, family connectedness, perceived priority, atmosphere and structure of mealtimes as predictors of alcohol and tobacco consumption, using data from 550 adolescents (50% boys; age range 11-16). Frequent family meals were significantly associated with a lower likelihood of alcohol and tobacco use. However, this association was explained by adolescents' perception of the atmosphere at mealtimes. These findings suggest adolescents' perception of the mealtime environment contributes to family meals' protective effect.
Barrio, Pablo; Reynolds, Jillian; García-Altés, Anna; Gual, Antoni; Anderson, Peter
Drug use accounts for one of the main disease groups in Europe, with relevant consequences to society. There is an increasing need to evaluate the economic consequences of drug use in order to develop appropriate policies. Here, we review the social costs of illegal drugs, alcohol and tobacco in the European Union. A systematic search of relevant databases was conducted. Grey literature and previous systematic reviews were also searched. Studies reporting on social costs of illegal drugs, alcohol and tobacco were included. Methodology, cost components as well as costs were assessed from individual studies. To compare across studies, final costs were transformed to 2014 Euros. Forty-five studies reported in 43 papers met the inclusion criteria (11 for illegal drugs, 26 for alcohol and 8 for tobacco). While there was a constant inclusion of direct costs related to treatment of substance use and comorbidities, there was a high variability for the rest of cost components. Total costs showed also a great variability. Price per capita for the year 2014 ranged from €0.38 to €78 for illegal drugs, from €26 to €1500 for alcohol and from €10.55 to €391 for tobacco. Drug use imposes a heavy economic burden to Europe. However, given the high existing heterogeneity in methodologies, and in order to better assess the burden and thus to develop adequate policies, standardised methodological guidance is needed. [Barrio P, Reynolds J, García-Altés A, Gual A, Anderson P. Social costs of illegal drugs, alcohol and tobacco in the European Union: A systematic review. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.
Popova, Lucy; Kostygina, Ganna; Sheon, Nicolas M.; Ling, Pamela M.
Cigarette companies increasingly promote novel smokeless tobacco products to smokers, encouraging them to use smokeless tobacco in smoke-free environments. New messages may counteract this promotion. We developed 12 initial anti-smokeless message ideas and tested them in eight online focus groups with 75 US smokers. Those smokers who never tried…
... products'' as ``cigars, cigarettes, smokeless tobacco, pipe tobacco, and roll-your-own tobacco.'' Each of..., and all electronic or mailed comments TTB has received or will receive in response to [[Page 52915...
Background & Objectives:Students of colleges may be vulnerable to consume tobacco, alcohol and psychoactive drugs due to various factors. This study was conducted with objectives of determining the prevalence of smoking, alcohol and psychoactive drug use among the bachelor level college students of Chitwan.Materials & Methods:This is a descriptive cross sectional study among the 132 bachelor level students at various colleges of Bharatpur, Chitwan district of Nepal. The students were ...
Ruiz-Moral, Roger; Palenzuela-Paniagua, Sara; Magallón-Botaya, Rosa; Jiménez-García, Celia; Fernández García, Jose Angel; Pérula de Torres, Luis Angel
Preventive strategies are the most effective approach for dealing with issues of substance abuse, particularly in teenagers. Such strategies adapt well to this target population. Our objective was to reveal the opinions and beliefs held by teenagers about tobacco and alcohol as types of drugs, and their effects on health. In this cross-sectional study, participants completed a self-administered questionnaire based on the World Health Organization "Health Behaviour of School-aged Children" study. Our sample included 1,005 schoolchildren aged between 11 and 13 years, resident in the province of Córdoba in Spain. Descriptive and univariate analyses were performed using a chi-squared test. Of respondents, 25% (95% confidence interval [CI]: 22.2-27.6%) and 61% (95% CI: 58.0-64.1%), respectively, did not consider tobacco or alcohol to be drugs. No relationship was found between tobacco and alcohol use, and the belief that these are drugs (p = 0.477 and p = 0.217, respectively). A total 98.2% of adolescents surveyed (95% CI: 97.3-99.1%) believed that tobacco causes physical damage, mainly to the lungs, heart, and to the developing fetus. Additionally, 92.4% (95% CI: 90.6-94.0%) believed that alcohol is detrimental to health and identified the liver as the organ most frequently damaged by alcohol consumption. The media was identified as the main source of information about these substances by 78.0% of respondents (95% CI: 75.4-80.6%). Teenagers possess an acceptable level of knowledge and information about the negative effects of tobacco and alcohol on health; however, many of them do not consider these substances to be drugs.
This project was developed as an educational tool to increase awareness of tobacco related issues such as lifestyle choices, health risks, advertising, saying no, cessation, second hand smoke and smokeless tobacco...
Smoking, alcohol consumption and diet were among the criteria selected to screen health status among the residents of the urban migrant council-built hostels of Langa, Nyanga and. Guguletu outside Cape Town. Smoking patterns fell within the range found elsewhere. Problems associated with alcohol consumption were ...
Results: In adolescents with unplanned pregnancies, the prevalence of active smoking was 21.2% and of alcohol consumption, 41.5%. The percentage of smoking at home was 57.4% and alcohol consumption, 77.5%. Approximately, 80.3% of adolescents with unplanned pregnancies had friends who smoked and 90.6% ...
... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Federal Bureau of Investigation, Drug Enforcement Administration, Bureau of Alcohol, Tobacco, Firearms, and Explosives, Bureau of Prisons, Federal... Administrative Matters § 0.138 Federal Bureau of Investigation, Drug Enforcement Administration, Bureau of...
Dunn, Michael S.; Kitts, Cathy; Lewis, Sandy; Goodrow, Bruce; Scherzer, Gary D.
Background: Alcohol, tobacco, marijuana use, and sexual behaviors are consistently reported by high school students in the United States and can contribute to reduced quality of life. Empirical research finds that many assets may act as a protective factor for adolescent risk behaviors. As such, the purpose of this study was to examine the…
Hodge, David R.; Andereck, Kathleen; Montoya, Harry
The costs associated with the use of addictive substances and practices underscore the need for research on protective factors that inhibit use. In this study, the protective influences of various spiritual-religious lifestyle profiles on tobacco smoking, alcohol use, and gambling frequency and expenditures are examined. Among the predominantly…
Lai, T.; Habicht, J.; Reinap, M.; Chisholm, D.; Baltussen, R.M.P.M.
OBJECTIVE: To assess the population-level costs, effects and cost-effectiveness of different alcohol and tobacco control strategies in Estonia. DESIGN: A WHO cost-effectiveness modelling framework was used to estimate the total costs and effects of interventions. Costs were assessed in Estonian
Palmedo, P Christopher; Dorfman, Lori; Garza, Sarah; Murphy, Eleni; Freudenberg, Nicholas
Countermarketing campaigns use health communications to reduce the demand for unhealthy products by exposing motives and undermining marketing practices of producers. These campaigns can contribute to the prevention of noncommunicable diseases by denormalizing the marketing of tobacco, alcohol, and unhealthy food. By portraying these activities as outside the boundaries of civilized corporate behavior, countermarketing can reduce the demand for unhealthy products and lead to changes in industry marketing practices. Countermarketing blends consumer protection, media advocacy, and health education with the demand for corporate accountability. Countermarketing campaigns have been demonstrated to be an effective component of comprehensive tobacco control. This review describes common elements of tobacco countermarketing such as describing adverse health consequences, appealing to negative emotions, highlighting industry manipulation of consumers, and engaging users in the design or implementation of campaigns. It then assesses the potential for using these elements to reduce consumption of alcohol and unhealthy foods.
Background Research demonstrates that tobacco packaging elements (including health warning labels, descriptive characteristics, and corporate branding) are associated with knowledge of health risks and product appeal with cigarettes. Yet, little research has assessed this with smokeless tobacco (SLT) packaging. This study evaluates the association between three SLT packaging elements with knowledge of health risks and perceptions of novelty and appeal. Additionally, we assess how effects of these messages may differ across age groups, including youth (14-17 years), young adults (18-25 years), and older adults (26-65 years). Methods 1000 participants were administered a web-based survey in 2010 and shown three sets of SLT packs in random order, varied by descriptor (flavor descriptor vs. none), warning label format (graphic vs. text), and corporate branding (branded vs. plain packaging). Participants rated the packs compared with “no difference” on appeal, novelty, and risk perceptions associated with product use. Chi-square tests were used to test for significant differences in pack selections. Multinomial regression was employed to evaluate the association between effects of packaging elements and participant age. Results More respondents selected the pack with the graphic warning label as the pack to make them consider the health risks associated with SLT use, attract their attention, and be least attractive to a smoker. The product with the text warning label was the product someone their age would want to be seen using and would appeal to peers. The SLT pack with the flavor descriptor was not associated with health risks associated with product use. The pack with corporate branding was selected as more appealing, to attract attention, and one they would want to be seen using; the plain pack was less attractive to smokers. Youth and young adults were more likely to indicate that pack elements affected their perceptions of appeal and risk associated with SLT
Objective: To determine the association between living in a non-intact family household and the presence of smokers and ... Smoking and alcohol consumption at home are not ..... tended pregnancy rates in the United States, Perspectives.
Wilson, Nance; Battistich, Victor; Syme, S Leonard; Boyce, W Thomas
To assess whether alcohol, tobacco, and other drug (ATOD) use in elementary school may have serious implications for continued ATOD use in middle school and beyond. Longitudinal analyses were conducted on questionnaire data from 331 middle school students who had previously provided ATOD-use data during elementary school. Non-school personnel administered questionnaires in three participating school districts in three different states. The sample of students was ethnically and geographically diverse, including students from a range of low socioeconomic status backgrounds living in rural, urban or inner-city environments. Middle school alcohol use was almost three times as likely to occur if alcohol use had occurred in elementary school (OR = 2.94, p Elementary school use of tobacco and marijuana also greatly increased the likelihood of middle school use (OR = 5.35, p elementary school, during the middle childhood years.
Richmond, R; Heather, N; Holt, P
This article presents findings from a survey of programmes available for tobacco and alcohol users working in 455 of Australia's top 600 companies. Companies were twice as likely to have programmes for smokers (43%) as for problem drinkers (24%) and these programmes were more apparent in large companies. The majority of programmes for smoking were delivered within a health promotion context which included other life-style issues, such as nutrition, exercise, weight management and stress management. Although Employee Assistance Programs (EAPs) were the most commonly available type of work-place programme for excessive drinkers and other drug users, followed by Alcoholics Anonymous and local hospital clinics, only 6% had an EAP for alcohol. Only 21% of programmes for smokers and 12% for excessive alcohol users were evaluated. Around one-quarter of companies knew the costs of smoking programmes, and 9% reported costs of conducting programmes for excessive alcohol consumers.
McCreadie, Robin G
Specialised services should be developed to help people with schizophrenia and associated substance misuse. The extent of the problem therefore needs to be known. To determine the use of drugs, alcohol and tobacco by people with schizophrenia drawn from rural, suburban and urban settings, and to compare use by general population control subjects. People with schizophrenia (n=316) and general population controls of similar gender distribution, age and postcode area of residence (n=250) were identified in rural, urban and suburban areas of Scotland. Use of drugs and alcohol was assessed by the Schedules for Clinical Assessment in Neuropsychiatry, and use of tobacco by a questionnaire. More patients than controls reported problem use of drugs in the past year (22 (7%) v. 5 (2%)) and at some time before then (50 (20%) v. 15 (6%)) and problem use of alcohol in the past year (42 (17%) v. 25 (10%)) but not at some time previously (99 (40%) v. 84 (34%)). More patients were current smokers (162 (65%) v. 99 (40%)). Problem use of drugs and alcohol by people with schizophrenia is greater than in the general population, but absolute numbers are small. Tobacco use is the greatest problem.
Full Text Available Background & Objectives:Students of colleges may be vulnerable to consume tobacco, alcohol and psychoactive drugs due to various factors. This study was conducted with objectives of determining the prevalence of smoking, alcohol and psychoactive drug use among the bachelor level college students of Chitwan.Materials & Methods:This is a descriptive cross sectional study among the 132 bachelor level students at various colleges of Bharatpur, Chitwan district of Nepal. The students were chosen by purposive sampling. A standard pre tested questionnaire was used to collect the data.Results:A total of 90 (68.2% were males and 42 (31.8% were females. The mean age was 22.2 ± 1.7 years. Seventy four (56.06% responded that they had never consumed tobacco in any form.The number of cigarette smoked ranged from one to 20, with a mean of 7.85± 4.94 years. Forty eight (36.36% never consumed alcohol and (87.87% had never used psychoactive drugs.The most common motivator of the use of smoking, tobacco and psychoactive drugs was curiosity.Conclusion:The prevalence of smoking among the bachelor level students participating in our study was 43.94%, alcohol consumption was 63.63% and psychoactive drugs use was 12.12%.
Bertazzo-Silveira, Eduardo; Kruger, Cristian Maikel; Porto De Toledo, Isabela; Porporatti, André Luís; Dick, Bruce; Flores-Mir, Carlos; De Luca Canto, Graziela
The aim of this systematic review was to answer the focused question, "In adults, is there any association between sleep bruxism (SB) and alcohol, caffeine, tobacco, or drug abuse?" This systematic review included studies in which the investigators assessed SB diagnosis by using questionnaires, clinical assessment, or polysomnography and evaluated its association with alcohol, caffeine, tobacco, or drug abuse. The authors graded SB as possible, probable, or definitive. The authors developed specific search strategies for Latin American and Caribbean Health Sciences Literature, PsycINFO, PubMed, ScienceDirect, and Web of Science. The authors searched the gray literature by using Google Scholar and ProQuest. The authors evaluated the methodological quality of the included studies by using the Meta-Analysis of Statistics Assessment and Review Instrument. From among 818 studies, the authors selected 7 for inclusion in which samples ranged from 51 through 10,229 participants. SB was associated highly with alcohol and tobacco use. In 1 study, the investigators noted a positive and weak association for heavy coffee drinkers. The odds for SB seem to increase almost 2 times for those who drank alcohol, almost 1.5 times for those who drank more than 8 cups of coffee per day, and more than 2 times for those who were current smokers. The abuse of methylenedioxymethamphetamine associated with SB remained without sufficient evidence. On the basis of limited evidence, SB was associated positively with alcohol, caffeine, and tobacco. The association between the studied drugs could not be discredited; however, there is still a need for stronger evidence based on studies with greater methodological rigor. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.
Bach Xuan Tran
Full Text Available Introduction: The expansion of methadone maintenance treatment (MMT program requires more data about the factors affecting the effectiveness of treatment, especially behavioral data such as smoking and alcohol use among patients. This study aimed to examine the prevalence of tobacco and alcohol consumption and identify related factors among MMT patients in the Vietnamese rural mountainside. Methods: We interviewed 241 MMT patients in two clinics in Tuyen Quang, a mountainous province in Vietnam. Patients were asked to report the smoking status (current smoker or not, nicotine dependence (by Fagerström test for nicotine dependence - FTND and alcohol use (by using the Alcohol Use Disorders Identification Test – AUDIT-C. EuroQol-5 dimensions-5 levels (EQ-5D-5L and EQ-Visual analogue scale (EQ-VAS were employed to measure health-related quality of life. Multivariate logistic and Tobit regressions were used to identify the associated factors. Results: The majority of respondents were current smokers (75.7% and a low proportion were hazardous drinkers (18.3%. People receiving treatment in a rural clinic (OR=0.45; 95%CI=0.22–0.92 and had problems in usual activities (OR=0.20; 95%CI=0.06–0.70 were less likely to be smokers. Q-VAS score (Coef.=0.03; 95%CI=0.02–0.05 and having problems in mobility (Coef.=0.72; 95%CI=0.03–1.42 was found to be associated with the increase of nicotine dependence. In terms of alcohol drinking, people with other jobs were more likely to drink hazardously compared to unemployed patients (OR=2.86; 95%CI=1.20–6.82. Similarly, patients having higher duration of MMT had higher likelihood of being hazardous drinkers (OR=1.07; 95%CI=1.01–1.13. Conclusions: This study highlights the low rate of alcohol abusers but a considerably high proportion of current smokers among MMT patients in the rural mountainside area. Alcohol and tobacco counseling programs combined with social and family support also play an essential role
Hackbarth, D P; Silvestri, B; Cosper, W
This paper describes a study of billboard advertising of tobacco and alcohol products in the city of Chicago. All billboards were counted and their advertising themes noted. These data were matched with information on population and race from the 1990 census in order to document which geographic areas of the city, if any, had excess tobacco or alcohol billboards. The data revealed that minority wards were burdened with three times as many tobacco billboards and five times as many alcohol billboards when compared to white wards. The findings are congruent with studies conducted in other urban areas, which demonstrate a consistent pattern of tobacco and alcohol advertisers targeting poor and minority neighborhoods for outdoor advertising of their dangerous products. Chicago legislative initiatives based on the billboard study are described.
Chavez, Laura J; Ornelas, India J; Lyles, Courtney R; Williams, Emily C
Experiences of discrimination are associated with tobacco and alcohol use, and work is a common setting where individuals experience racial/ethnic discrimination. Few studies have evaluated the association between workplace discrimination and these behaviors, and none have described associations across race/ethnicity. To examine the association between workplace discrimination and tobacco and alcohol use in a large, multistate sample of U.S. adult respondents to the Behavioral Risk Factor Surveillance System survey Reactions to Race Module (2004-2010). Multivariable logistic regression analyses evaluated cross-sectional associations between self-reported workplace discrimination and tobacco (current and daily smoking) and alcohol use (any and heavy use, and binge drinking) among all participants and stratified by race/ethnicity, adjusting for relevant covariates. Data were analyzed in 2013. Among respondents, 70,080 completed the workplace discrimination measure. Discrimination was more common among black non-Hispanic (21%), Hispanic (12%), and other race respondents (11%) than white non-Hispanics (4%) (pdiscrimination was associated with current smoking (risk ratio [RR]=1.32, 95% CI=1.19, 1.47), daily smoking (RR=1.41, 95% CI=1.24, 1.61), and heavy drinking (RR=1.11, 95% CI=1.01, 1.22), but not binge or any drinking. Among Hispanics, workplace discrimination was associated with increased heavy and binge drinking, but not any alcohol use or smoking. Workplace discrimination among black non-Hispanics and white Non-Hispanics was associated with increased current and daily smoking, but not alcohol outcomes. Workplace discrimination is common, associated with smoking and alcohol use, and merits further policy attention, given the impact of these behaviors on morbidity and mortality. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.
Gneiting, Uwe; Schmitz, Hans Peter
Smoking and drinking constitute two risk factors contributing to the rising burden of non-communicable diseases in low- and middle-income countries. Both issues have gained increased international attention, but tobacco control has made more sustained progress in terms of international and domestic policy commitments, resources dedicated to reducing harm, and reduction of tobacco use in many high-income countries. The research presented here offers insights into why risk factors with comparable levels of harm experience different trajectories of global attention. The analysis focuses particular attention on the role of dedicated global health networks composed of individuals and organizations producing research and engaging in advocacy on a given health problem. Variation in issue characteristics and the policy environment shape the opportunities and challenges of global health networks focused on reducing the burden of disease. What sets the tobacco case apart was the ability of tobacco control advocates to create and maintain a consensus on policy solutions, expand their reach in low- and middle-income countries and combine evidence-based research with advocacy reaching beyond the public health-centered focus of the core network. In contrast, a similar network in the alcohol case struggled with expanding its reach and has yet to overcome divisions based on competing problem definitions and solutions to alcohol harm. The tobacco control network evolved from a group of dedicated individuals to a global coalition of membership-based organizations, whereas the alcohol control network remains at the stage of a collection of dedicated and like-minded individuals. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2016; all rights reserved.
Erritzoe, D.; Frokjaer, V. G.; Haugbol, S.
receptor (5-HT(2A)) in humans, we tested in 136 healthy human subjects if body mass index (BMI), degree of alcohol consumption and tobacco smoking was associated to the cerebral in vivo 5-HT(2A) receptor binding as measured with (18)F-altanserin PET. The subjects' BMI's ranged from 18.4 to 42.8 (25.......2+/-4.3) kg/m(2). Cerebral cortex 5-HT(2A) binding was significantly positively correlated to BMI, whereas no association between cortical 5-HT(2A) receptor binding and alcohol or tobacco use was detected. We suggest that our observation is driven by a lower central 5-HT level in overweight people, leading...
Fernández-Artamendi, Sergio; Secades-Villa, Roberto; Fernández Hermida, Jose Ramon; García-Fernández, Gloria; García-Rodríguez, Olaya
The sample is made up of 1,190 adolescents (52.8% boys; mean age = 16.81) from 37 random schools in the urban and rural areas of Asturias (northern Spain). The survey was conducted in 2008, assessing the use and patterns of use of alcohol and other drugs, age at onset of use, and psychosocial consequences. Items from the ESPAD and FRIDA questionnaires were employed. Univariate analyses and binary logistic regression analyses were carried out to determine the different predictive value for boys and girls of early-onset alcohol and tobacco use. The study's limitations and implications are noted.
Lucero, J; Harlow, B L; Barbieri, R L; Sluss, P; Cramer, D W
To examine the effects of alcohol, caffeine, and tobacco use on early follicular phase FSH, LH, E2, and sex hormone-binding globulin (SHBG). Cross-sectional study. Academic medical center. Four hundred ninety-eight women selected from the general population, ages 36-45, who were not currently pregnant, breast feeding, or using exogenous hormones. A general questionnaire assessing demography, anthropometry, and smoking habits and a standardized dietary questionnaire assessing food and beverage frequencies, including sources of alcohol and caffeine. FSH, LH, E2, and SHBG levels measured during the early follicular phase of the menstrual cycle. Significant associations observed in a univariate analysis included age > or =40 and current smoking associated with higher FSH; higher body mass index (BMI) associated with lower SHBG levels; and daily alcohol use, cholesterol consumption greater than the median, and coffee use >1 cup/d associated with higher E2 levels. In a multivariate model, total caffeine use was significantly associated with E2 levels after adjustment for age, BMI, total calories, current smoking, alcohol, cholesterol consumption, and day of sampling. Early follicular phase E2 increased from 28.2 pg/mL for women consuming or =500 mg of caffeine per day, about a 70% increase. Coffee consumption and total caffeine use may increase early follicular phase E2 levels independent of related habits of alcohol or tobacco use.
Sabra, Sally; Malmqvist, Ebba; Almeida, Laura; Gratacos, Eduard; Gomez Roig, Maria Dolores
Maternal exposure to tobacco and alcohol is a known cause, among others, for fetal growth restriction (FGR). Clinically, FGR can be subclassified into two forms: intrauterine growth restriction (IUGR) and small for gestational age (SGA), based on the severity of the growth retardation, and abnormal uterine artery Doppler or cerebro-placental ratio. This study aimed at investigating any differential correlation between maternal exposures to these toxins with the two clinical forms of FGR. Therefore, a case-control study was conducted in Barcelona, Spain. Sixty-four FGR subjects, who were further subclassified into IUGR (n = 36) and SGA (n = 28), and 89 subjects matched appropriate-for-gestational age (AGA), were included. The levels of nicotine (NIC) and ethyl glucuronide (EtG), biomarkers of tobacco and alcohol exposure, respectively, were assessed in the maternal hair in the third trimester. Our analysis showed 65% of the pregnant women consumed alcohol, 25% smoked, and 19% did both. The odds ratios (ORs) of IUGR were 21 times versus 14 times for being SGA with maternal heavy smoking, while with alcohol consumption the ORs for IUGR were 22 times versus 37 times for the SGA group. The differential correlations between these toxins with the two subtypes of FGR suggest different mechanisms influencing fetal weight. Our alarming data of alcohol consumption during pregnancy should be considered for further confirmation among Spanish women. Copyright © 2018 Elsevier Inc. All rights reserved.
McPherson, Mary Elizabeth
This study examines the relationship of role parenting behaviors and adolescent depression in adolescent outcomes. Parenting behaviors considered were authoritative parenting, parental monitoring, and parental care. Adolescent outcomes considered were depression, alcohol use, tobacco use, and grades. A path model was employed to examine these variables together. A sample of (n=3,174) of 9th -12th grade high school students from seven contiguous counties in rural Virginia were examined on ...
Oleg R. Karatayev
Objective to identify and assess the share of counterfeit products in the total volume of alcohol and tobacco products in the consumer market of Tatarstan Republic which will allow the inspection bodies to deal more effectively to prevent the spreading of counterfeit products. Methods the research proposed in this paper used methods of probability theory and mathematical statistics and the method of sampling analysis of certificates for products in accordance with applicable laws and...
Carlo Eduardo Medina-Solís
Full Text Available Oral diseases are a major burden on individuals and health systems. The aim of this study was to determine whether consumption of tobacco and alcohol were associated with the prevalence of oral/dental problems in Mexican adults. Using data from the National Performance Evaluation Survey 2003, a cross-sectional study part of the World Health Survey, dental information from a representative sample of Mexico (n = 22,229, N = 51,155,740 was used to document self-reported oral/dental problems in the 12 months prior to the survey. Questionnaires were used to collect information related to sociodemographic, socioeconomic, and other risk factors. Three models were generated for each age group (18–30, 31–45 and 46–98 years. The prevalence of oral/dental conditions was 25.7%. Adjusting for sex, schooling, socioeconomic position, diabetes, and self-reported health, those who used tobacco (sometimes or daily (OR = 1.15, p = 0.070; OR = 1.24, p < 0.01; and OR = 1.16, p < 0.05, for each age group respectively or alcohol (moderate or high (OR = 1.26, p < 0.001; OR = 1.18, p < 0.01 and OR = 1.30, p < 0.001, for each age group respectively had a higher risk of reporting oral/dental problems. Because tobacco and alcohol use were associated with self-reported oral/dental problems in one out of four adults, it appears advisable to ascertain how direct is such link; more direct effects would lend greater weight to adopting measures to reduce consumption of tobacco and alcohol for the specific purpose of improving oral health.
Fenoglio, Philippe; Parel, Véronique; Kopp, Pierre
AIM, DESIGN AND SETTING: The economic costs of alcohol, tobacco and illicit drugs to French society are estimated using a cost of illness framework. For the cause of disease or death (using ICD-9 categories), pooled relative risk estimates from meta-analyses were combined with prevalence data by age and gender to derive the proportion attributable to alcohol, tobacco and/or illicit drugs. The resulting estimates of attributable deaths and hospitalizations were used to calculate the associated health care, law enforcement, productivity and other costs. The results were compared with those of other studies, and sensitivity analyses were conducted by alternative ways of measuring risk attribution and costs. The use of alcohol, tobacco and illicit drugs cost more than 200 billion francs (FF) in France in 1997, representing 3714 FF per capita or 2.7% of the gross domestic product (GDP). Alcohol is the drug that gives rise to the greatest cost in France, i.e. 115420.91 million FF (1.42% of GDP) or an expenditure per capita of 1966 FF in 1997. Alcohol takes more than half of the social cost of drugs to society. The greatest share of the social cost of alcohol comes from the loss of productivity (57555.66 million FF), due to premature death (53168.60 million FF), morbidity (3884.0 million FF) and imprisonment (503.06 million FF). Tobacco leads to a social cost of 89256.90 million FF, that is an expenditure per capita of 1520.56 FF or 1.1% of GDP. Productivity losses amount to 50446.70 million FF, with losses of 42765.80 million FF as a result of premature death and 7680.90 million FF linked to morbidity. Health care costs for tobacco occupy second place at 26973.70 million FF. Illicit drugs generate a social cost of 13350.28 million FF, that is an expenditure per capita of 227.43 FF or 0.16% of GDP. Productivity losses reach 6099.19 million FF, with 5246.92 million FF linked to imprisonment and 852.27 million FF to premature death. The cost of enforcing the law for illicit
Andrade Palos, Patricia; Pérez de la Barrera, Citlalli; Alfaro Martínez, Lilia Bertha; Sánchez Oviedo, Martha Elba; López Montes de Oca, Alicia
Drug consumption constitutes a public health problem in Mexico. In the international literature and from the health promotion perspective, the Life Skills Approach proposed by the World Health Organization identifies the ability to resist pressure as a key component in the prevention of legal and illegal drug use among adolescents. An instrument for measuring this ability was developed and validated in order to confirm whether, as the empirical evidence suggests, it differs between users and non-users of alcohol and tobacco. The sample was made up of 5651 adolescents, 2637 (47.9%) of whom were male and 2864 (52.1%) female. These participants were selected at random from among public high school pupils in Mexico City, and average age was 16.7 years. The instrument used was that validated in the first phase of the study. To measure patterns of use, we used a scale based on indicators derived from the National Addiction Survey (2002). Factor analysis yielded three factors: peer pressure acceptance, partner pressure acceptance and peer/partner pressure resistance. Non-users of alcohol and tobacco scored higher in the ability to resist pressure than those who had used alcohol and tobacco in the last month. Based on these results, the aim is to develop an addiction prevention program for public high school pupils in Mexico City.
Ahlberg, J.; Hublin, C.; Lobbezoo, F.; Rose, R. J.; Murtomaa, H.; Kaprio, J.
Introduction: Higher levels of smoking, leading to increased levels of nicotine and dopamine release, may be more strongly related to bruxism, although this relationship has remained unclear. Thus, the aim of the present study was to investigate the possible effect of cumulative tobacco use on bruxism in a large sample of young adults. Methods: The material of the present study derives from the FinnTwin16, which consists of five birth cohorts born in 1975–1979. A total of 3,124 subjects (mean age 24 years, range 23–27 years) provided data in 2000–2002 on frequency of bruxism and tobacco use. Multinomial logistic regression was used to explore the relationships of frequency of bruxism with smoking and smokeless tobacco use while controlling covariates (alcohol intoxication, alcohol problems [Rutgers Alcohol Problem Index, RAPI], illicit drug use, psychological distress [General Health Questionnaire], and coffee use). Results: Based on subjective response and multivariate analyses, weekly bruxers were more than two times more likely to report heavy smoking than never bruxers (odds ratio [OR] 2.5, 95 % CI 1.8–3.4). The significant association between heavy smoking and bruxism held when the effects of other tobacco use and multiple covariates were controlled. In addition, the use of smokeless tobacco emerged as an independent risk factor for bruxism. Discussion: Given the observed associations with both heavy smoking and smokeless tobacco and a dose–response relationship, the present results support our hypothesis of a link between nicotine intake and bruxism. PMID:20427458
... Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn ... as smuggling, illicit manufacturing and counterfeiting. The tobacco industry and others often argue that high tobacco product ...
M G Inderjit
Full Text Available Background: The cross-sectional survey was conducted to assess and compare tobacco and alcohol usage among male medical and dental students among students belonging to dental and medical colleges in Davangere city. Materials and Methods: A self-designed questionnaire containing 20 close-ended questions was prepared to collect the required and relevant information pertaining to tobacco and alcohol consumption. The questionnaire was distributed among 400 students belonging to dental and medical colleges in Davangere city. Results: Among the 400 respondents, 48.5% were smokers and 45.75% of students were alcoholics. Among smokers, 55.70% were house surgeon students and 23.07% were 1 st year. Significant difference was found in the percentage of tobacco consumption among medical and dental house surgeon students. The main reason for smoking was examination preparation and workload. Among alcoholics, 51.67% were house surgeon students and 21.9% were 1 st year. The main reason for alcohol consumption was to get relief from tensions. Conclusions: Final year students and house surgeons had more influence of tobacco and alcohol consumption habits when compared to 1 st year students in both dental as well in medical college. Academic demand, work pressure, examination stress, and anxiety were found to be significantly influencing tobacco and alcohol habits among both medical and dental students.
Terry, Mary Beth; Neugut, Alfred I; Mansukhani, Mahesh; Waye, Jerome; Harpaz, Noam; Hibshoosh, Hanina
The p53 tumor suppressor gene is commonly mutated in colorectal cancer. While the effect of p53 mutations on colorectal cancer prognosis has been heavily studied, less is known about how epidemiologic risk factors relate to p53 status, particularly in early colorectal neoplasia prior to clinically invasive colorectal cancer (including adenomas, carcinoma in situ (CIS), and intramucosal carcinoma). We examined p53 status, as measured by protein overexpression, in 157 cases with early colorectal neoplasia selected from three New York City colonoscopy clinics. After collecting paraffin-embedded tissue blocks, immunohistochemistry was performed using an anti-p53 monoclonal mouse IgG 2 a [BP53-12-1] antibody. We analyzed whether p53 status was different for risk factors for colorectal neoplasia relative to a polyp-free control group (n = 508). p53 overexpression was found in 10.3%, 21.7%, and 34.9%, of adenomatous polyps, CIS, and intramucosal cases, respectively. Over 90% of the tumors with p53 overexpression were located in the distal colon and rectum. Heavy cigarette smoking (30+ years) was associated with cases not overexpressing p53 (OR = 1.8, 95% CI = 1.1–2.9) but not with those cases overexpressing p53 (OR = 1.0, 95% CI = 0.4–2.6). Heavy beer consumption (8+ bottles per week) was associated with cases overexpressing p53 (OR = 4.0, 95% CI = 1.3–12.0) but not with cases without p53 overexpression (OR = 1.6, 95% CI = 0.7–3.7). Our findings that p53 overexpression in early colorectal neoplasia may be positively associated with alcohol intake and inversely associated with cigarette smoking are consistent with those of several studies of p53 expression and invasive cancer, and suggest that there may be relationships of smoking and alcohol with p53 early in the adenoma to carcinoma sequence
Manrique-Abril, Fred G; Ospina, Juan M; Garcia-Ubaque, Juan C
Characterising tobacco and alcohol consumption, the linked psychosocial risk factors and protection factors in a sample of secondary / technical students in Tunja during 2009. A prevalence study was carried out, assessing consumption prevalence and determinants in a sample of 1,515 schoolchildren aged 13 to 18 who were studying in grades 8 to 11. Mean age was 15.2 years (SD=1.42), 50.2% were female; life prevalence: 73.5 % alcohol and 50.6 % cigarette consumption, 51.7 % drunkenness. Main consumption determinants were having a dysfunctional family, peer pressure and influence from partners, academic difficulties and conflicts with parents or guardians. Mean age at onset: transitional period between 12 and 13 years. Complete freedom of access to alcoholic beverages and cigarettes was reported. It was found that alcohol and tobacco consumption frequency was quite high in this age group. Related factors were also determinant as they are subject to educational intervention and should be considered as a priority, particularly those related to the family environment and peer group, given the enormous influence exerted by friends and members of recreational or sports team groups on adolescents at this age.
Full Text Available Background FCTC Article 5.3 requires protection against tobacco industry interference in policy-making. By contrast, manufacturers of alcohol and ultra-processed food and drink products are often identified as potential partners in multi-sectoral health initiatives, including via the Sustainable Development Goals (SDGs. This divergence has been questioned given evidence of strategic similarities across sectors, to which this presentation adds an examination of structural links and their implications for health policy. This focuses on an analysis of 'interlocking directorates', via which directors of one organisation also occupy positions on different boards, widely as the principal indicator of network ties across corporations. Methods Using data from corporate websites, annual reports and business databases, we employ UCINET social network analysis software to examine interlocks in the top six transnational companies of each sector within and across tobacco, alcohol and food companies, with political elites, and with health and development agencies. Results We present findings via (i profiles of individual tobacco industry directors, highlighting strategically valuable links to other actors; (ii a quantitative comparison of interlocks across the three sectors, with no direct links between tobacco and food companies but with alcohol companies providing several bridges between them, and with food companies more extensively linked to political elites and health agencies; (iii a case study of the board of brewing giant SAB Miller at the time of its mega-merger with AB InBev to highlight the significance to tobacco control of wider interactions enabled by interlocks. Conclusions This account of linkages across tobacco, alcohol and ultra-processed food companies calls into question regulatory approaches that treat the tobacco industry as an exceptional case. Neglecting conflicts of interest with other unhealthy commodity producers is potentially
Petrie, Jane; Bunn, Frances; Byrne, Geraldine
We conducted a systematic review of controlled studies of parenting programmes to prevent tobacco, alcohol or drug abuse in children less than 18. We searched Cochrane Central Register of Controlled Trials, specialized Register of Cochrane Drugs and Alcohol Group, Pub Med, psych INFO, CINALH and SIGLE. Two reviewers independently screened studies,…
Health behaviour patterns in older groups, including tobacco and alcohol use, are key factors in chronic disease prevention. We explore ageing self-perceptions as motivating factors behind smoking and drinking alcohol in older adults, and the complex reasons why individuals engage harmfully in these behaviours.
Leatherdale, Scott T.; Ahmed, Rashid
Data from the Canadian Youth Smoking Survey (n = 27,030 in 2006; n = 16,705 in 2004; n = 11,757 in 2002) were used to examine changes in the prevalence and comorbid use of alcohol, tobacco, and marijuana over time and examine if demographic factors and binge drinking are associated with comorbid substance use among youth. Alcohol was the most…
Full Text Available To examine the associations between job exposure to the public (e.g., customers, guests, users of a public service, patients and alcohol, tobacco and cannabis use.From the French population-based CONSTANCES cohort, 16,566 men and 17,426 women currently working were included between 2012 and 2016. They reported their exposure to the public (daily versus no daily, and among the daily exposed participants (10,323 men and 13,318 women, the frequency of stressful exposure (often versus rarely. Dependent variables were: chronic alcohol consumption (42(28 drinks per week in men(women, heavy episodic drinking (never, at most once a month, more than once a month, alcohol use risk with Alcohol Use Disorders Identification Test (mild, dangerous, problematic or dependence, tobacco use (non-smoker, former smoker, 1-9, 10-19, >19 cigarettes per day and cannabis use (never, not in past year, less than once a month, once a month or more. Logistic regressions provided odds ratios of substance use, stratifying for gender and adjusting for sociodemographic confounders, depression, effort-reward imbalance and perceived health status.Exposed men had higher risks of alcohol (chronic alcohol consumption, heavy episodic drinking and alcohol use risk, tobacco and cannabis use. Exposed women had higher risks of tobacco and cannabis use. In men, stressful exposure was associated with increased risks of heavy episodic drinking, tobacco and cannabis use. In women, stressful exposure was associated with increased risks of chronic alcohol consumption, alcohol use risk, tobacco and cannabis use. All these findings remained significant in multivariable analyses, taking into account sociodemographic variables, depressive symptoms, perceived health status and effort-reward imbalance.Interventions to reduce emotional job demand should systematically integrate assessment and prevention measures of addictive behaviors. Vulnerable workers may be offered more specific interventions to
Airagnes, Guillaume; Lemogne, Cédric; Goldberg, Marcel; Hoertel, Nicolas; Roquelaure, Yves; Limosin, Frédéric; Zins, Marie
To examine the associations between job exposure to the public (e.g., customers, guests, users of a public service, patients) and alcohol, tobacco and cannabis use. From the French population-based CONSTANCES cohort, 16,566 men and 17,426 women currently working were included between 2012 and 2016. They reported their exposure to the public (daily versus no daily), and among the daily exposed participants (10,323 men and 13,318 women), the frequency of stressful exposure (often versus rarely). Dependent variables were: chronic alcohol consumption (42(28) drinks per week in men(women)), heavy episodic drinking (never, at most once a month, more than once a month), alcohol use risk with Alcohol Use Disorders Identification Test (mild, dangerous, problematic or dependence), tobacco use (non-smoker, former smoker, 1-9, 10-19, >19 cigarettes per day) and cannabis use (never, not in past year, less than once a month, once a month or more). Logistic regressions provided odds ratios of substance use, stratifying for gender and adjusting for sociodemographic confounders, depression, effort-reward imbalance and perceived health status. Exposed men had higher risks of alcohol (chronic alcohol consumption, heavy episodic drinking and alcohol use risk), tobacco and cannabis use. Exposed women had higher risks of tobacco and cannabis use. In men, stressful exposure was associated with increased risks of heavy episodic drinking, tobacco and cannabis use. In women, stressful exposure was associated with increased risks of chronic alcohol consumption, alcohol use risk, tobacco and cannabis use. All these findings remained significant in multivariable analyses, taking into account sociodemographic variables, depressive symptoms, perceived health status and effort-reward imbalance. Interventions to reduce emotional job demand should systematically integrate assessment and prevention measures of addictive behaviors. Vulnerable workers may be offered more specific interventions to
Ortega-García, Juan A; Gutierrez-Churango, Jorge E; Sánchez-Sauco, Miguel F; Martínez-Aroca, Miguel; Delgado-Marín, Juan L; Sánchez-Solis, M; Parrilla-Paricio, J J; Claudio, Luz; Martínez-Lage, Juan F
We aimed to assess the effects of exposure to tobacco smoke, alcohol and illegal drugs during early pregnancy on the head circumference (HC) at birth of otherwise healthy neonates. A follow-up study from the first trimester of pregnancy to birth was carried out in 419 neonates. An environmental reproductive health form was used to record data of substance exposure obtained during the first obstetric visit at the end of the first trimester. A multiple linear regression model was created for this purpose. Alcohol intake during pregnancy and medical ionizing radiation exposure were the most significant predictors of HC. The mothers' alcohol consumption increased with the mothers' and fathers' education level, net family income and fathers' alcohol consumption. In contrast, maternal smoking decreased with increasing mothers' and fathers' education level and net family income. About 13% of the surveyed embryos were exposed to illegal drugs. Mild to moderate alcohol consumption diminishes the at-birth HC of theoretically healthy newborns in a linear form. There was no threshold dose. We perceived a need for increasing the awareness, and for training, of health care professionals and parents, in regard to risks of alcohol consumption and for recommending abstinence of these substances in both parents during pregnancy. It should also be remembered that medical ionizing radiation should be performed only during the first half of the cycle in fertile women. We think that our study has an important social impact as it affords data for implementing policies for promoting "healthy pregnancies".
Hatzenbuehler, Mark L; McLaughlin, Katie A; Xuan, Ziming
Objective: The purpose of this study was to examine whether the composition of social networks contributes to sexual orientation disparities in substance use and misuse. Method: Data were obtained from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative cohort study of adolescents (N = 20,745). Wave 1 collected extensive information about the social networks of participants through peer nomination inventories. Results: Same- and both-sex–attracted youths had higher frequency/quantity of tobacco use in their peer networks than did opposite-sex–attracted youths, and both-sex–attracted youths had higher frequency/quantity of alcohol use and misuse in their peer networks than opposite-sex–attracted youths. Among same- and both-sex–attracted youths, greater frequency/quantity of tobacco use in one’s social network predicted greater use of cigarettes. In addition, greater frequency/quantity of peers’ drinking and drinking to intoxication predicted more alcohol use and alcohol misuse in the both-sex–attracted group. These social network factors mediated sexual orientation–related disparities in tobacco use for both- and same-sex–attracted youths. Moreover, sexual orientation disparities in alcohol misuse were mediated by social network characteristics for the same-sex and both-sex–attracted youths. Importantly, sexual minority adolescents were no more likely to have other sexual minorities in their social networks than were sexual majority youths, ruling out an alternative explanation for our results. Conclusions: These findings highlight the importance of social networks as correlates of substance use behaviors among sexual minority youths and as potential pathways explaining sexual orientation disparities in substance use outcomes. PMID:25486400
Müller-Schulte, Eloise; Kurlemann, Gerhard; Harder, Anja
To determine whether prenatal and perinatal maternal consumption of alcohol, tobacco and/or illicit drugs is associated with risk of neuroblastoma. Medline and Embase (both from inception to February 2017), and reference lists of included studies. To be eligible, a study had to be an original report including data on intake of alcohol, tobacco smoking and/or consumption of illicit drugs during pregnancy and risk of neuroblastoma in the child. From eligible studies, data study characteristics as well as effect measures and confounders were extracted. We assessed unadjusted and confounder-adjusted estimates, performed risk of bias analysis, constructed random-effects models and assessed heterogeneity. We identified 14 case-control studies (1987-2016) involving a total of 3114 children with neuroblastoma. Meta-analysis of unadjusted estimates showed an association between alcohol (OR 1.26; 95% CI 1.07 to 1.49), tobacco (OR 1.22; 95% CI 1.04 to 1.44) and illicit drug consumption during pregnancy and risk of neuroblastoma during childhood, with illicit drug consumption showing the strongest association (OR 3.26; 95% CI 1.36 to 7.86). However, adjusted estimates were highly heterogeneous. All studies were at high risk of bias. Smoking, alcohol or illicit drugs during pregnancy might play a role in the development of neuroblastoma. However, well-designed studies are needed to assess whether these exposures are causal and whether time period during pregnancy, dose or co-consumption of substances is critical. Registration number CRD42016036165. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Warren, Jacob C; Smalley, K Bryant; Barefoot, K Nikki
Ease of access to substances has been shown to have a direct and significant relationship with substance use for school-aged children. Previous research involving rural samples of middle and high school students reveals that perceived ease of access to substances is a significant predictor of recent use among rural adolescents; however, it is unclear if perceived access to substances varies between rural and urban areas. The purpose of the present study was to examine rural-urban differences in perceived ease of access to alcohol, smoking and chewing tobacco, marijuana, and seven other substances in the US state of Georgia in order to better inform and promote future substance use prevention and programming efforts in rural areas. Data were analyzed from the 2013 Georgia Student Health Survey II, administered in all public and interested private/charter schools in the state of Georgia. A total of 513 909 students (18.2% rural) indicated their perceived ease of access to 11 substances on a four-point Likert-type scale. Rural-urban differences were investigated using χ2 analysis. In general, it appeared the rural-urban differences fell along legal/illicit lines. For middle school students, a significant difference in perceived ease of access was found for each substance, with rural students reporting greater access to smoking tobacco, chewing tobacco, and steroids, and urban students reporting greater access to alcohol, marijuana, cocaine, inhalants, ecstasy, methamphetamine, hallucinogens, and prescription drugs. Rural high school students reported higher access to alcohol, smoking tobacco, chewing tobacco, and steroids, with urban students reporting higher access to marijuana, cocaine, inhalants, ecstasy, and hallucinogens. Perceptions of ease of access more than doubled for each substance in both geographies between middle and high school. The present study found multiple and fairly consistent differences between rural and urban students' perceived ease of access
Anne Kathrine Aambø
A web-based pre-test and post-test were conducted with samples of 1000 persons aged 16-60 years. There was a significant increase in knowledge of the introduction of plain packs, from 50 to 77 percent during the campaign period. Knowledge of the main purpose (preventing recruitment of young people increased significantly from 17 to 35 percent. The support for the regulation had a significant increase from 53 to 59 percent for cigarette packs, and from 51 to 58 percent for snus boxes. Mass media campaign can be a useful tool to increase support for new regulations.
Full Text Available The aim of this study was determine the prevalence of tobacco, alcohol and illicit substance use among dental undergraduates at one UK university in 2015. A cross-sectional survey of all 344 dental undergraduates using an anonymous self-report questionnaire was carried out. The response rate was 77%, of which 29% were male and 71% female. Tobacco smoking was reported by 23.6% of males and 12.2% of females, with only 1.6% of females reporting to smoke ≥10 cigarettes per day. Alcohol consumption was reported by 85.5% of males and 84% of females, and reported levels of alcohol consumption increased since becoming undergraduates. Binge drinking was reported by 35.3% of males and 41% of female students. Only 2.6% of males and 0.5% of females reported to be current regular users of cannabis. The vast majority of respondents claimed to have never used any illicit substance. The only other reported regularly used substances by males was Ecstasy (1.3% and by females were LSD (0.5%, Ecstasy (1.5%, Cocaine (0.5%, Inhalants (0.5% and Ketamine (0.5%. These results are encouraging. Fewer students reported smoking than in the general population, levels of binge drinking were considerably lower than previously reported figures, as were the numbers of regular users of cannabis and other illicit substances.
Gan, C Y
As part of a larger study to bring attention to smoking and smokeless tobacco use among the indigenous people of Sabah State in Malaysia, the Bajaus were interviewed in a cross-sectional survey. 74.4% of the men smoked compared to 3.3% of the women and 77% of women used smokeless tobacco compared to 4.3% of men. Local handrolled cigarettes called kirais were popular and smokeless tobacco was used as an ingredient in the ritual of betel-quid chewing. Tobacco was also used because it was thought to have medicinal effects. The prevalence of smokeless tobacco use was significantly lower among the better educated women but for smoking, education had no relation with prevalence. Both habits could be easily maintained as they were cheap practices which were socially and culturally accepted. Awareness of the adverse effects of such tobacco habits was poor and intervention programs to curb tobacco use is required.
Wolfinger, N H
I use data from the 1977-1994 National Opinion Research Council General Social Survey to examine the impact of parental divorce on the alcohol and tobacco consumption of adult offspring. Divorce greatly increases the likelihood of being a smoker and, for men, a problem drinker. Parental remarriage completely offsets the effects of parental divorce on men's drinking but does not substantially affect cigarette use. Respondent socioeconomic characteristics accounted for a portion of the relationship between parental divorce and smoking but did not affect rates of problem drinking. Social control and psychosocial adjustment--two established explanations for the effects of parental divorce--could not adequately explain my findings.
Combined effect of incorporated 90 Sr, ethanol, tobacco smokes on reproduction of warm-blooded animals is studied. It is shown that chronic intake of strontium 90, ethanol and tobacco smokes suppresses the reproduction of animals. But difficulty of obtained data extrapolation to a human being is not a sufficient ground for revising existing hygienic standards for persons being in contact with ionizing radiation and habitual to alcohol and smoking. Nevertheless, they permit to set a problem on negative effect of such habits
Jacquet, Jean-Marc; Peyriere, Hélène; Makinson, Alain; Peries, Marianne; Nagot, Nicolas; Donnadieu-Rigole, Hélène; Reynes, Jacques
To assess the alcohol consumption, tobacco addiction and psychoactive substance use (PSU) of people living with HIV (PLHIV). Cross-sectional study in an HIV outpatient unit. Autoquestionnaire systematically proposed to all patients during their usual clinical care visit during a 6-months period, for alcohol (AUDIT test), tobacco (Short Fagerstrom Test) and PSU (ASSIST V3.0 test). Of 1334 distributed questionnaires, 1018 PLHIV responded: 76.8% were men [528 patients were MSM), and the median age was 49 years (interquartile range: 42-46). A prevalence of excessive alcohol drinking was found in 22% [95% confidence interval (CI) 19.5-24.7%] and 44.6% (CI 41.5-47.7%) were current smokers, with high dependence in 29.1% (CI 24.9-33.7%). The prevalence of PSU was 37.8% (CI 34.8-41%) in the past 3 months: cannabis 27.7%, poppers 16.4%, cocaine 8.9%, psychotropic medications 7.1%, gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL) 4.7%, stimulants 3.1%, synthetic cathinones 2.7%, hallucinogens 1.5%. In the past 3 months, PSU was more prevalent in MSM than in non-MSM patients (46 versus 30%, P poppers) 31.0 versus 1.1%, GHB/GBL 7.8 versus 0.8%, stimulants 5.0 versus 1.1%, synthetic cathinones 4.9 versus 0.3%, and hallucinogens 2.3 versus 0.5%. Given the high prevalence of PSU and other addictions (alcohol and smoking) among PLHIV, and particularly among MSM, a systematic screening of PSU and other addictions should be part of routine clinical care.
... 1 in 3 countries, representing 39% of the world's population, monitors tobacco use by repeating nationally representative youth ... 1.4 billion people, or 20% of the world's population, are protected by comprehensive national smoke-free laws. ...
Beatty, Shelley E; Cross, Donna S; Shaw, Thérèse M
Given the likelihood of engaging in the hazardous use of tobacco and alcohol increases during teenage years, pre-adolescence is a critical time to implement prevention programmes. While social factors other than those associated with parenting play a role in determining a child's risk for initiation of tobacco and alcohol use, parents can have a significant influence on their children's decisions about these issues. The aim of this study was to assess the impact of an in-home parent-directed drug education intervention on parent-child communication about tobacco and alcohol. A group randomised intervention trial was conducted in Perth, Western Australia. Schools were selected using stratified random sampling and randomised to three study conditions. A total of 1201 parents of 10- 11-year-old children were recruited from 20 schools. The impact of a self-help intervention, comprised of five communication sheets containing information and activities designed to encourage parents to talk with their 10- 11-year-old child about issues related to smoking cigarettes and drinking alcohol, was assessed. Intervention-group parents were more likely to have spoken with their children, to have spoken more recently, to have engaged the child during the discussion and to have addressed the topics identified as being protective of children's involvement in tobacco and alcohol. In addition, the duration of talks about alcohol was longer than for parents in the comparison group. Parents of 10- 11-year-old children appear to be receptive to participating in a home-based drug-related educational intervention and the parent-directed intervention seems to have enhanced parent-child tobacco- and alcohol-related communication.
Hotham, E; White, J; Ali, R; Robinson, J
The World Health Organization has identified substance use in the top 20 risk factors for ill health. Risks in pregnancy are compounded, with risk to the woman's health, to pregnancy progression and on both the foetus and the newborn. Intrauterine exposure can result in negative influences on offspring development, sometimes into adulthood. With effectively two patients, there is a clear need for antenatal screening. Biomarker reliability is limited and research efforts have been directed to self-report tools, often attempting to address potential lack of veracity if women feel guilty about substance use and worried about possible stigmatization. Tools, which assume the behaviour, are likely to elicit more honest responses; querying pre-pregnancy use would likely have the same effect. Although veracity is heightened if substance use questions are embedded within health and social functioning questionnaires, such tools may be too lengthy clinically. It has been proposed that screening only for alcohol and tobacco, with focus on the month pre-pregnancy, could enable identification of all other substances. Alternatively, the Revised Fagerstrom Questionnaire could be used initially, tobacco being highly indicative of substance use generally. The ASSIST V.3.0 is readily administered and covers all substances, although the pregnancy 'risk level' cut-off for tobacco is not established. Alcohol tools - the 4Ps, TLFB and 'drug' CAGE (with E: query of use to avoid withdrawal) - have been studied with other substances and could be used. General psychosocial distress and mental ill-health often co-exist with substance use and identification of substance use needs to become legitimate practice for obstetric clinicians.
Gonçalves, Helen; Soares, Ana Luiza Gonçalves; Santos, Ana Paula Gomes Dos; Ribeiro, Camila Garcez; Bierhals, Isabel Oliveira; Vieira, Luna Strieder; Hellwig, Natália Limões; Wehrmeister, Fernando C; Menezes, Ana M B
The objective of this study was to investigate the association between adverse childhood experiences (ACEs) and the use of alcohol, tobacco and illicit drugs among adolescents from a Brazilian cohort. The occurrence of five ACEs, the use of alcohol and tobacco and trying illicit drugs were investigated in the 1993 Pelotas birth cohort at the age of 15 (n = 4,230). A score was created for the ACEs and their association with the use of substances was evaluated. Around 25% of adolescents consumed alcohol, 6% smoked and 2.1% reported having used drugs at least once in their lives. The ACEs were associated with the use of alcohol, tobacco and illicit drugs. A dose-response relation between the number of ACEs and the substance use was found, particularly with regard to illicit drugs. The occurrence of ACEs was positively associated with the use of alcohol, tobacco and illicit drugs among adolescents and the risk may be different for men and women. These results point to the fact that strategies for preventing the use of substances should include interventions both among adolescents and within the family environment.
Agaku, Israel T; Odani, Satomi; Sturgis, Stephanie; Harless, Charles; Glover-Kudon, Rebecca
Smokeless tobacco has been actively promoted by tobacco companies using endorsements by major sport figures, and research indicates that tobacco advertising can lead to youth initiation of tobacco use (1,2). Television and radio advertisements for cigarettes and smokeless tobacco have been prohibited since 1969,* and the 1998 Master Settlement Agreement(†) further prohibited tobacco companies from targeting youths with tobacco product advertisements in specified areas. In 2010, the Food and Drug Administration (FDA), under authority of the 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA), prohibited tobacco-brand sponsorship (i.e., sponsorship of sports and entertainment events or other social or cultural events using the tobacco brand name or anything identifiable with any brand of cigarettes or smokeless tobacco).(§) However, corporate-name tobacco sponsorship (i.e., sponsorship using the name of the corporation that manufactures regulated tobacco products) is still permitted under certain conditions.(¶) To monitor tobacco advertising and promotional activities in sports in the United States, CDC analyzed trends in sports-related marketing expenditures for cigarettes and smokeless tobacco during 1992-2013 using data from the Federal Trade Commission (FTC). During 1992-2013, sports-related marketing expenditures, adjusted by the consumer price index to constant 2013 dollars, decreased significantly for both cigarettes (from $136 million in 1992 to $0 in 2013) and smokeless tobacco (from $34.8 million in 1992 to $2.1 million in 2013). During 2010-2013, after the prohibition of tobacco-brand sponsorship in sports under the FSPTCA, cigarette manufacturers reported no spending (i.e., $0) on sports-related advertising and promotional activities; in contrast, smokeless tobacco manufacturers reported expenditures of $16.3 million on advertising and promoting smokeless tobacco in sports during 2010-2013. These findings indicate that despite prohibitions
So Young Yi
Full Text Available Synechocystis salt-responsive gene 1 (sysr1 was engineered for expression in higher plants, and gene construction was stably incorporated into tobacco plants. We investigated the role of Sysr1 [a member of the alcohol dehydrogenase (ADH superfamily] by examining the salt tolerance of sysr1-overexpressing (sysr1-OX tobacco plants using quantitative real-time polymerase chain reactions, gas chromatography-mass spectrometry, and bioassays. The sysr1-OX plants exhibited considerably increased ADH activity and tolerance to salt stress conditions. Additionally, the expression levels of several stress-responsive genes were upregulated. Moreover, airborne signals from salt-stressed sysr1-OX plants triggered salinity tolerance in neighboring wild-type (WT plants. Therefore, Sysr1 enhanced the interconversion of aldehydes to alcohols, and this occurrence might affect the quality of green leaf volatiles (GLVs in sysr1-OX plants. Actually, the Z-3-hexenol level was approximately twofold higher in sysr1-OX plants than in WT plants within 1–2 h of wounding. Furthermore, analyses of WT plants treated with vaporized GLVs indicated that Z-3-hexenol was a stronger inducer of stress-related gene expression and salt tolerance than E-2-hexenal. The results of the study suggested that increased C6 alcohol (Z-3-hexenol induced the expression of resistance genes, thereby enhancing salt tolerance of transgenic plants. Our results revealed a role for ADH in salinity stress responses, and the results provided a genetic engineering strategy that could improve the salt tolerance of crops.
Bleakley, Amy; Romer, Daniel; Jamieson, Patrick E
To determine the extent to which movies popular with adolescents feature characters who jointly engage in violence and other risk behaviors. We hypothesized that violent characters engage in other risk behaviors equally often in films rated appropriate for children over 12 (PG-13) and Restricted (R)-rated films. Content analysis of a sample of top-grossing movies from 1985 to 2010 (n = 390). We coded movies for the presence of at least 1 main character who was involved in violence and either sex, tobacco, or alcohol use within a 5-minute movie segment and throughout a film. Approximately 90% of the movies contained a segment with a main character involved in violence, and ~77% of the films had the same character engaging in at least 1 other risk behavior. A violent character was portrayed most often partaking in alcohol-related and sexual behaviors. G and PG movies had less co-occurrence than PG-13 or R-rated movies, but there was no statistical difference between PG-13 and R-rated movies with regards to violence co-occurring with other risk behaviors. These trends did not vary over time. Popular films that contain violent characters also show those characters engaging in other risk behaviors. Similar rates of co-occurrence between PG-13 and R-rated films suggest that the Motion Picture Association of America ratings system is not sensitive to the joint portrayal of violence and alcohol, sex, and tobacco-related risk behaviors. The on-screen clustering of violence with other risk behaviors is cause for concern and worthy of additional research.
Bradley, Catherine S; Erickson, Bradley A; Messersmith, Emily E; Pelletier-Cameron, Anne; Lai, H Henry; Kreder, Karl J; Yang, Claire C; Merion, Robert M; Bavendam, Tamara G; Kirkali, Ziya
Diet, fluid intake and caffeine, alcohol and tobacco use may have effects on lower urinary tract symptoms. Constructive changes in these modifiable nonurological factors are suggested to improve lower urinary tract symptoms. To better understand the relationship between nonurological factors and lower urinary tract symptoms, we performed a systematic literature review to examine, grade and summarize reported associations between lower urinary tract symptoms and diet, fluid intake and caffeine, tobacco and alcohol use. We performed PubMed® searches for eligible articles providing evidence on associations between 1 or more nonurological factors and lower urinary tract symptoms. A modified Oxford scale was used to grade the evidence. We reviewed 111 articles addressing diet (28 studies), fluid intake (21) and caffeine (21), alcohol (26) and tobacco use (44). The evidence grade was generally low (6% level 1, 24% level 2, 11% level 3 and 59% level 4). Fluid intake and caffeine use were associated with urinary frequency and urgency in men and women. Modest alcohol use was associated with decreased likelihood of benign prostatic hyperplasia diagnosis and reduced lower urinary tract symptoms in men. Associations between lower urinary tract symptoms and ingestion of certain foods and tobacco were inconsistent. Evidence of associations between lower urinary tract symptoms and diet, fluid intake and caffeine, alcohol and tobacco use is sparse and mostly observational. However, there is evidence of associations between increased fluid and caffeine intake and urinary frequency/urgency, and between modest alcohol intake and decreased benign prostatic hyperplasia diagnosis and lower urinary tract symptoms. Given the importance of these nonurological factors in daily life, and their perceived impact on lower urinary tract symptoms, higher quality evidence is needed. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All
Yel, Daravuth; Bui, Anthony; Job, Jayakaran S; Knutsen, Synnove; Singh, Pramil N
There remains a very high rate of smoked and smokeless tobacco use in the Western Pacific Region. The most recent findings from national adult tobacco surveys indicate that very few daily users of tobacco intend to quit tobacco use. In Cambodia, a nation that is predominantly Buddhist, faith-based tobacco control programs have been implemented where, under the fifth precept of Buddhism that proscribes addictive behaviors, monks were encouraged to quit tobacco and temples have been declared smoke-free. In the present study, we included items on a large national tobacco survey to examine the relation between beliefs (faith-based, other) about tobacco, health, and addiction among adults (18 years and older). In a stratified, multistage cluster sample (n=13,988) of all provinces of Cambodia, we found that (1) 88-93% believe that Buddhist monks should not use tobacco, buy tobacco, or be offered tobacco during a religious ceremony; (2) 86-93% believe that the Wat (temple) should be a smoke-free area; (3) 93-95% believe that tobacco is addictive in the same way as habits (opium, gambling, alcohol) listed under the fifth precept of Buddhism; and (4) those who do not use tobacco are significantly more likely to cite a Buddhist principle as part of their anti-tobacco beliefs. These data indicate that anti-tobacco sentiments are highly prevalent in the Buddhist belief system of Cambodian adults and are especially evident among non-users of tobacco. Our findings indicate that faith-based initiatives could be an effective part of anti-tobacco campaigns in Cambodia.
Barakate, Abdellah; Stephens, Jennifer; Goldie, Alison; Hunter, William N; Marshall, David; Hancock, Robert D; Lapierre, Catherine; Morreel, Kris; Boerjan, Wout; Halpin, Claire
The manipulation of lignin could, in principle, facilitate efficient biofuel production from plant biomass. Despite intensive study of the lignin pathway, uncertainty exists about the enzyme catalyzing the last step in syringyl (S) monolignol biosynthesis, the reduction of sinapaldehyde to sinapyl alcohol. Traditional schemes of the pathway suggested that both guaiacyl (G) and S monolignols are produced by a single substrate-versatile enzyme, cinnamyl alcohol dehydrogenase (CAD). This was challenged by the discovery of a novel sinapyl alcohol dehydrogenase (SAD) that preferentially uses sinapaldehyde as a substrate and that was claimed to regulate S lignin biosynthesis in angiosperms. Consequently, most pathway schemes now show SAD (or SAD and CAD) at the sinapaldehyde reduction step, although functional evidence is lacking. We cloned SAD from tobacco (Nicotiana tabacum) and suppressed it in transgenic plants using RNA interference-inducing vectors. Characterization of lignin in the woody stems shows no change to content, composition, or structure, and S lignin is normal. By contrast, plants additionally suppressed in CAD have changes to lignin structure and S:G ratio and have increased sinapaldehyde in lignin, similar to plants suppressed in CAD alone. These data demonstrate that CAD, not SAD, is the enzyme responsible for S lignin biosynthesis in woody angiosperm xylem.
Barakate, Abdellah; Stephens, Jennifer; Goldie, Alison; Hunter, William N.; Marshall, David; Hancock, Robert D.; Lapierre, Catherine; Morreel, Kris; Boerjan, Wout; Halpin, Claire
The manipulation of lignin could, in principle, facilitate efficient biofuel production from plant biomass. Despite intensive study of the lignin pathway, uncertainty exists about the enzyme catalyzing the last step in syringyl (S) monolignol biosynthesis, the reduction of sinapaldehyde to sinapyl alcohol. Traditional schemes of the pathway suggested that both guaiacyl (G) and S monolignols are produced by a single substrate-versatile enzyme, cinnamyl alcohol dehydrogenase (CAD). This was challenged by the discovery of a novel sinapyl alcohol dehydrogenase (SAD) that preferentially uses sinapaldehyde as a substrate and that was claimed to regulate S lignin biosynthesis in angiosperms. Consequently, most pathway schemes now show SAD (or SAD and CAD) at the sinapaldehyde reduction step, although functional evidence is lacking. We cloned SAD from tobacco (Nicotiana tabacum) and suppressed it in transgenic plants using RNA interference–inducing vectors. Characterization of lignin in the woody stems shows no change to content, composition, or structure, and S lignin is normal. By contrast, plants additionally suppressed in CAD have changes to lignin structure and S:G ratio and have increased sinapaldehyde in lignin, similar to plants suppressed in CAD alone. These data demonstrate that CAD, not SAD, is the enzyme responsible for S lignin biosynthesis in woody angiosperm xylem. PMID:22158465
Hinds, M.W.; Thomas, D.B.; O'Reilly, H.P.
A case-control study of 47 laryngeal cancers in males of three counties of Washington State was conducted. Personal interview was used to obtain information on smoking, alcohol use, exposure to asbestos, and other substances, and x-rays of the head and neck area. Smoking and alcohol consumption were found to increase risk of laryngeal cancer independently, with a clear dose-response relationship. Neither asbestos exposure nor exposure to other substances was found to significantly increase the risk of laryngeal cancer, although the relative risk with asbestos exposure was 1.75. Lifetime history of exposure to dental x-rays on five or more occasions was associated with significantly increased risk of laryngeal cancer among heavy smokers but not among light smokers. The importance of tobacco and alcohol in the epidemiology of laryngeal cancer was re-affirmed, the importance of asbestos exposure was brought into question, and a possible relationship of laryngeal cancer with exposure to dental x-rays among heavy smokers was demonstrated
Sussman, Steve; Arriaza, Bridget; Grigsby, Timothy J.
Background: Relative to youth in regular high schools, alternative high school (AHS) youth are at high risk for alcohol, tobacco, and other drug (ATOD) misuse. Prevention and cessation efforts are needed for this population. Methods: A systematic, exhaustive literature search was completed to identify ATOD misuse prevention and cessation research…
Pacoricona Alfaro, Dibia Liz; Ehlinger, Virginie; Spilka, Stanislas; Ross, Jim; Sentenac, Mariane; Godeau, Emmanuelle
Education policies encourage inclusion of students with mild-intellectual disability (mild-ID) in community/school life. However, such policies potentially increase exposure to substance use. This article examines tobacco, alcohol and cannabis use among French students enrolled in special units for students with disabilities (ULIS) at mainstream junior high schools compared to those of general population of the equivalent age; and explores factors associated with substance use among ULIS students, known to present mostly mild-ID. In 2014, a questionnaire adapted from the international HBSC/WHO study was administered to 700 ULIS students (mean-age 14.2). Comparative data were gathered from 7023 junior high-school students (mean-age 13.6) in the general population. Among students <14 years-old, tobacco and alcohol use rates were similar between ULIS and general population. For students ≥14, alcohol use remained comparable, while tobacco and cannabis use were higher in general population. Among ULIS students, low perceived health/life satisfaction, divorced/separated parents and high perceived academic demands were associated with tobacco use. Bullying, not liking school very much and attending schools outside a deprived area were associated with alcohol use. Having had sexual intercourse and not perceiving one's health as excellent were associated with cannabis use. Having dated was associated with using all three substances. Copyright © 2016 Elsevier Ltd. All rights reserved.
Ennett, Susan T.; Bauman, Karl E.; Foshee, Vangie A.; Pemberton, Michael; Hicks, Katherine A.
Adolescent-parent pairs (N=537) were interviewed concerning their communication about tobacco and alcohol use. Parent communication reports identified three domains: rules and discipline; consequences and circumstances; and media influences. Results show that parent-child communication was not related to initiation of smoking or drinking. However,…
Full Text Available Introduction: The purpose of the present study was to investigate the prevalence of tobacco, hubble-bubble, alcoholic drinks, and other drugs among Karaj high-school students in 2011. Methods: The research method was a descriptive-sectional study. Participants of this study were 447 girl and boy high-school students of Karaj that were selected by clustering random sampling. For data gathering, drug abuse questionnaire, and risk and protective factors inventory were administered among selected sample. Results: According to the results, 57% of students in this study said that they have had experiences with a kind of drug including tobacco, hubble-bubble, alcoholic drinks, and other drugs at least once in their lives. The study showed the prevalence for soft drugs: hubble-bubble, tobacco, and alcoholic drinks, and for hard drugs ecstasy, opium, hashish, meth, crack, and heroin respectively. Conclusion: Soft drugs including hubble-bubble, tobacco, and alcoholic drinks, are the most common among Karaj high-school students. The prevalence of hard drugs among them is rather low.
Jacobs, Wura; Goodson, Patricia; Barry, Adam E.; McLeroy, Kenneth R.
Background: Despite previous research indicating an adolescents' alcohol, tobacco, and other drug (ATOD) use is dependent upon their sex and the sex composition of their social network, few social network studies consider sex differences and network sex composition as a determinant of adolescents' ATOD use behavior. Methods: This systematic…
Inglés, Cándido J; Torregrosa, María S; Rodríguez-Marín, Jesús; García del Castillo, José A; Gázquez, José J; García-Fernández, José M; Delgado, Beatriz
The aim of the present study was to analyze: (a) the relationship between alcohol and tobacco use and academic performance, and (b) the predictive role of psycho-educational factors and alcohol and tobacco abuse on academic performance in a sample of 352 Spanish adolescents from grades 8 to 10 of Compulsory Secondary Education. The Self-Description Questionnaire-II, the Sydney Attribution Scale, and the Achievement Goal Tendencies Questionnaire were administered in order to analyze cognitive-motivational variables. Alcohol and tobacco abuse, sex, and grade retention were also measured using self-reported questions. Academic performance was measured by school records. Frequency analyses and logistic regression analyses were used. Frequency analyses revealed that students who abuse of tobacco and alcohol show a higher rate of poor academic performance. Logistic regression analyses showed that health behaviours, and educational and cognitive-motivational variables exert a different effect on academic performance depending on the academic area analyzed. These results point out that not only academic, but also health variables should be address to improve academic performance in adolescence.
Constantine, Norm; And Others
This report presents findings from the Santa Clara County (California) survey of Drug, Alcohol, and Tobacco Use among Students in Grades 5, 7, 9, and 11 administered during the spring of 1991 to 5,180 students in 51 randomly selected county schools. An executive summary discusses sampling error, sample demographics, and findings on drug use…
Full Text Available Introduction: The assessment of micronuclei in exfoliated cells is a promising tool for the study of epithelial carcinogens and can be used to detect chromosome breakage or mitotic interference, thought to be relevant to carcinogenesis. Aim: The present study aimed to detect micronuclei in exfoliated oral mucosal cells in individuals using various tobacco forms from the last 5 years. Materials and Methods: A total of 75 healthy male subjects (25 smokeless tobacco users, 25 smokers, and 25 non-tobacco users were selected for the study. Smears were obtained with moistened wooden spatula from buccal mucosa and fixed with 95% alcohol. All the cytologic smears were stained by Papanicolaou technique. From each slide, ~1000 cells were examined under the 400× magnification and where micronucleated (MN cells were located, they were examined under the 1000× magnification. Result: MN cells were found to be significantly higher in smokeless tobacco users than in smokers and controls. Conclusion: A positive correlation is found between increased micronucleus frequency and tobacco-using habits. So micronucleus assay can be used as a biomarker of genotoxicity.
Hackbarth, D P; Schnopp-Wyatt, D; Katz, D; Williams, J; Silvestri, B; Pfleger, M
Community activists in Chicago believed their neighborhoods were being targeted by alcohol and tobacco outdoor advertisers, despite the Outdoor Advertising Association of America's voluntary code of principles, which claims to restrict the placement of ads for age-restricted products and prevent billboard saturation of urban neighborhoods. A research and action plan resulted from a 10-year collaborative partnership among Loyola University Chicago, the American Lung Association of Metropolitan Chicago (ALAMC), and community activists from a predominately African American church, St. Sabina Parish. In 1997 Loyola University and ALAMC researchers conducted a cross-sectional prevalence survey of alcohol and tobacco outdoor advertising. Computer mapping was used to locate all 4,247 licensed billboards in Chicago that were within 500- and 1,000-foot radiuses of schools, parks, and playlots. A 50% sample of billboards was visually surveyed and coded for advertising content. The percentage of alcohol and tobacco billboards within the 500- and 1,000-foot zones ranged from 0% to 54%. African American and Hispanic neighborhoods were disproportionately targeted for outdoor advertising of alcohol and tobacco. Data were used to convince the Chicago City Council to pass one of the nation's toughest anti-alcohol and tobacco billboard ordinances, based on zoning rather than advertising content. The ordinance was challenged in court by advertisers. Recent Supreme Court rulings made enactment of local billboard ordinances problematic. Nevertheless, the research, which resulted in specific legislative action, demonstrated the importance of linkages among academic, practice, and grassroots community groups in working together to diminish one of the social causes of health disparities.
Väisänen, Enni E; Smeds, Annika I; Fagerstedt, Kurt V; Teeri, Teemu H; Willför, Stefan M; Kärkönen, Anna
Externally added coniferyl alcohol at high concentrations reduces the growth of Nicotiana cells and seedlings. Coniferyl alcohol is metabolized by BY-2 cells to several compounds. Coniferyl alcohol (CA) is a common monolignol and a building block of lignin. The toxicity of monolignol alcohols has been stated in the literature, but there are only few studies suggesting that this is true. We investigated the physiological effects of CA on living plant cells in more detail. Tobacco (Nicotiana tabacum) Bright yellow-2 cells (BY-2) and Nicotiana benthamiana seedlings both showed concentration-dependent growth retardation in response to 0.5-5 mM CA treatment. In some cases, CA addition caused cell death in BY-2 cultures, but this response was dependent on the growth stage of the cells. Based on LC-MS/MS analysis, BY-2 cells did not accumulate the externally supplemented CA, but metabolized it to ferulic acid, ferulic acid glycoside, coniferin, and to some other phenolic compounds. In addition to growth inhibition, CA caused the formation of a lignin-like compound detected by phloroglucinol staining in N. benthamiana roots and occasionally in BY-2 cells. To prevent this, we added potassium iodide (KI, at 5 mM) to overcome the peroxidase-mediated CA polymerization to lignin. KI had, however, toxic effects on its own: in N. benthamiana seedlings, it caused reduction in growth; in BY-2 cells, reduction in growth and cell viability. Surprisingly, CA restored the growth of KI-treated BY-2 cells and N. benthamiana seedlings. Our results suggest that CA at high concentrations is toxic to plant cells.
PSA to help raise retailers' awareness of the new federal tobacco regulations related to the sale of cigarettes and smokeless tobacco products to people under 18 and the requirement to sell products face-to-face.
Hollands, Gareth J; Shemilt, Ian; Marteau, Theresa M; Jebb, Susan A; Lewis, Hannah B; Wei, Yinghui; Higgins, Julian P T; Ogilvie, David
Overeating and harmful alcohol and tobacco use have been linked to the aetiology of various non-communicable diseases, which are among the leading global causes of morbidity and premature mortality. As people are repeatedly exposed to varying sizes and shapes of food, alcohol and tobacco products in environments such as shops, restaurants, bars and homes, this has stimulated public health policy interest in product size and shape as potential targets for intervention. 1) To assess the effects of interventions involving exposure to different sizes or sets of physical dimensions of a portion, package, individual unit or item of tableware on unregulated selection or consumption of food, alcohol or tobacco products in adults and children.2) To assess the extent to which these effects may be modified by study, intervention and participant characteristics. We searched CENTRAL, MEDLINE, EMBASE, PsycINFO, eight other published or grey literature databases, trial registries and key websites up to November 2012, followed by citation searches and contacts with study authors. This original search identified eligible studies published up to July 2013, which are fully incorporated into the review. We conducted an updated search up to 30 January 2015 but further eligible studies are not yet fully incorporated due to their minimal potential to change the conclusions. Randomised controlled trials with between-subjects (parallel-group) or within-subjects (cross-over) designs, conducted in laboratory or field settings, in adults or children. Eligible studies compared at least two groups of participants, each exposed to a different size or shape of a portion of a food (including non-alcoholic beverages), alcohol or tobacco product, its package or individual unit size, or of an item of tableware used to consume it, and included a measure of unregulated selection or consumption of food, alcohol or tobacco. We applied standard Cochrane methods to select eligible studies for inclusion and
Wills, Thomas A; Gibbons, Frederick X; Sargent, James D; Gerrard, Meg; Lee, Hye-Ryeon; Dal Cin, Sonya
To investigate whether self-control moderates the effect of media influences on tobacco and alcohol use among youth and if so how this effect occurs. In Study 1, a regional sample of 10-year olds (N = 290) was interviewed in households; attention to tobacco/alcohol advertising was assessed. In Study 2, a national sample of youth ages 10-14 years (N = 6,522) was surveyed by telephone; exposure to tobacco/alcohol use in movies was assessed. Good self-control was measured in both studies. Willingness to use substances and affiliation with peer substance users (Study 1); involvement in smoking or drinking (Study 2). In Study 1, the effect of tobacco/alcohol advertising on predisposition for substance use was lower among persons scoring higher on good self-control. In Study 2, the effect of movie smoking/alcohol exposure on adolescent tobacco/alcohol use was lower, concurrently and prospectively, among persons scoring higher on good self-control. Moderation occurred primarily through reducing the effect of movie exposure on positive smoking/alcohol expectancies and the effect of expectancies on adolescent use; some evidence for moderation of social processes was also noted. Covariates in the analyses included demographics, sensation seeking, and IQ. Good self-control reduces the effect of adverse media influences on adolescent tobacco and alcohol use. Findings on the processes underlying this effect may be useful for media literacy and primary prevention programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Hollands, Gareth J; Shemilt, Ian; Marteau, Theresa M; Jebb, Susan A; Lewis, Hannah B; Wei, Yinghui; Higgins, Julian Pt; Ogilvie, David
Background Overeating and harmful alcohol and tobacco use have been linked to the aetiology of various non-communicable diseases, which are among the leading global causes of morbidity and premature mortality. As people are repeatedly exposed to varying sizes and shapes of food, alcohol and tobacco products in environments such as shops, restaurants, bars and homes, this has stimulated public health policy interest in product size and shape as potential targets for intervention. Objectives 1) To assess the effects of interventions involving exposure to different sizes or sets of physical dimensions of a portion, package, individual unit or item of tableware on unregulated selection or consumption of food, alcohol or tobacco products in adults and children. 2) To assess the extent to which these effects may be modified by study, intervention and participant characteristics. Search methods We searched CENTRAL, MEDLINE, EMBASE, PsycINFO, eight other published or grey literature databases, trial registries and key websites up to November 2012, followed by citation searches and contacts with study authors. This original search identified eligible studies published up to July 2013, which are fully incorporated into the review. We conducted an updated search up to 30 January 2015 but further eligible studies are not yet fully incorporated due to their minimal potential to change the conclusions. Selection criteria Randomised controlled trials with between-subjects (parallel-group) or within-subjects (cross-over) designs, conducted in laboratory or field settings, in adults or children. Eligible studies compared at least two groups of participants, each exposed to a different size or shape of a portion of a food (including non-alcoholic beverages), alcohol or tobacco product, its package or individual unit size, or of an item of tableware used to consume it, and included a measure of unregulated selection or consumption of food, alcohol or tobacco. Data collection and
Jarosz, Mirosław; Sekuła, Włodzimierz; Rychlik, Ewa
The study examined the relationships between long-term trends in food consumption, alcohol intake, tobacco smoking, and colorectal cancer (CRC) incidence. Data on CRC incidence rates were derived from the National Cancer Registry, on food consumption from the national food balance sheets; data on alcohol and tobacco smoking reflected official statistics of the Central Statistical Office. It was shown that CRC incidence rates were increasing between 1960 and 1995, which could have been affected by adverse dietary patterns (growing consumption of edible fats, especially animal fats, sugar, red meat, and declining fibre and folate intake), high alcohol consumption, and frequent tobacco smoking noted until the end of the 1980s. Since 1990, the dietary pattern changed favourably (decrease in consumption of red meat, animal fats, and sugar, higher vitamin D intake, increase in vegetables and fruit quantities consumed, and decline in tobacco smoking). These changes could contribute to the stabilisation of CRC incidence among women seen after 1996 and a reduction in the rate of increase among men.
George, A; Varghese, C; Sankaranarayanan, R; Nair, M K
To plan and implement cancer control measures, information about the baseline habit patterns of the community is needed. A coastal village near Trivandrum, Kerala, Southern India, supported mainly by the fishing industry, was identified for this study with regard to establishing measures to control oral cancer there. Oral cancer is prevalent in Kerala. Smoking and chewing tobacco and drinking alcoholic beverages are the major risk factors for this cancer. The socioeconomic status of the fishermen of Kerala is low and their literacy rate is low. The adults in coastal Kerala have been found to have a habit pattern of very high levels of tobacco and alcohol use. A survey was conducted to study the tobacco and alcohol use habits of 146 children and teenagers in this village. The percentages of study subjects with pan-tobacco-chewing, smoking, and drinking habits were 29%, 2%, and 3%, respectively. The habit pattern correlated negatively with education and positively with number of children per family. This survey provides information that can be used to plan cancer education efforts, including redesigning the school curriculum and focusing on high-risk groups.
Nixon, Meredith L. BA; Glantz, Stanton A. Ph.D.
• After making substantial progress on tobacco control in the mid-1990s, the tobacco industry has stifled tobacco control activities in Washington through a mixture of campaign contributions and legal challenges. • Political campaign contributions have remained steadily high throughout the 1990s. Philip Morris, RJ Reynolds, the Tobacco Institute, Lorillard, Brown & Williamson, and the Smokeless Tobacco Council contributed $362,298 to campaigns in 1996 through 2000 election cycles: $1...
Full Text Available Background Tobacco surveys of past decades show that tobacco use prevalence is high in Georgia; According to nationwide Noncommunicable Diseases (NCDC Risk Factors STEPS Survey 2010 30% of adult population are current tobacco users. Another Nationwide Tobacco Survey 2014 reported 28% of tobacco use prevalence among Georgian adults. However, there has been relatively little progress in systematic study of the factors associated with this high tobacco use. The current study aimed to assess the prevalence of tobacco use and its associated sociodemographic, behavioral and environmental factors in Georgia. Methods The current study in Georgia was a population-based STEPS survey of adults aged 18-69. A multi-stage cluster sample design was used to produce representative data for that age range in Georgia. The. A total of 5554 adults participated in the survey. The overall response rate was 75.7%. We assessed sociodemographics, behavioral and other health-related factors. Results The prevalence of current overall tobacco use was 31.1% (95 % CI: 29.0-33.1 which comprised of smoked tobacco use, smoked cigarettes and use of smokeless tobacco, 31.0% (95% 28.9-33.0 smoked tobacco, 29.9 (95% CI: 27.9-32.0 smoked cigarettes and 0.3 (95% CI: 0.0-0.6 use of smokeless tobacco. Smoking prevalence was significantly higher in men 57.1% (95% CI: 53.7-60.4 compared to women 7.1% (95% CI: 5.9-8.4, especially in younger age groups and with other substance abuse history (predominantly alcohol. Conclusions Despite of some efforts in the field of tobacco control, tobacco use (particularly smoking was high in Georgia. Males, younger age groups, and population with addictions to other substances (especially alcohol should be the primary target of behavioral interventions; The stricter implementation of tobacco control measures, including comprehensive ban of tobacco marketing and smoking in public places, improved health warnings on tobacco packages and anti-tobacco
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Pipe tobacco and roll-your-own tobacco tax rates. 41.30 Section 41.30 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS...
Sweeting, Helen N; Bhaskar, Abita; Hunt, Kate
There is concern about the negative impact of modern consumer culture on young people's mental health, but very few studies have investigated associations with substance use. In those which have, positive associations have been attributed to attempts to satisfy the unmet needs of more materialistic individuals. This study examines associations between different dimensions of consumerism and tobacco and alcohol use among Scottish early adolescents. Cross-sectional study. 2937 (92% of those eligible) secondary school pupils (ages 12-14) completed questionnaires in examination conditions. Analyses were restricted to those with complete data on all relevant variables (N=2736 smoking; N=2737 drinking). Dependent variables comprised ever smoking and current drinking. Measures of consumerism comprised number of 'premium' (range 0-7) and 'standard' (range 0-5) material possessions and three Consumer Involvement subscales, 'dissatisfaction', 'consumer orientation' and 'brand awareness' (each range 3-12). Analyses also included school-year group and family affluence. Ever smoking and current drinking were both more prevalent among adolescents with more 'premium' and 'standard' material possessions, greater consumer 'dissatisfaction' and 'brand awareness' (mutually adjusted analyses including school-year group and family affluence). The strongest relationships occurred for 'brand awareness': for each unit increase in 'brand awareness' the ORs (95% CI) of ever smoking were 1.17 (1.08 to 1.26) and 1.23 (1.14 to 1.33) in males and females, respectively; and those for drinking were 1.15 (1.08 to 1.23) and 1.21 (1.13 to 1.30). 'Brand awareness' had an equal or stronger relationship with both smoking and drinking than did family affluence. These results suggest aassociations between consumerism and both smoking and drinking might arise because adolescent identities incorporate both consumerism and substance use, or be the result of promotion (indirectly in the case of tobacco
idade de início de consumo de tabaco e/ou álcool e a intensidade de uso de tabaco. Uso de maconha e idade de início do consumo foram as variáveis de desfecho. Para a análise dos dados se utilizou regressão de Poisson e regressão de Weibull. RESULTADOS: Os escolares apresentaram alta prevalência de consumo de tabaco, álcool maconha (77%, 79% e 23%, respectivamente. O consumo de tabaco na presença de consumo de álcool foi um fator de risco de uso de maconha (RP=10,4; IC 95%: 8,9;12,2. O início tardio de consumo de tabaco (HR=0,85; IC 95%: 0,84;0,86 e álcool (HR=0,90; IC 95%: 0,89;0,91 resultou ser um fator protetor do uso de maconha. A probabilidade de consumo de maconha foi maior naqueles que fumavam diariamente ou quase, em relação àqueles que fumavam somente aos fins de semana (RP=3,11; IC 95%: 2,96;3,26 vs. RP=1,70; IC 95%: 1,58;1,83. CONCLUSÕES: O risco de consumo de maconha se associou significativamente à idade de início de consumo de tabaco, à freqüência de consumo de tabaco e ao consumo simultâneo de álcool. As estratégias de prevenção deveriam proteger os escolares do consumo precoce de tabaco.OBJECTIVE: To assess the relationship between early tobacco and alcohol use and the risk of marijuana consumption among schoolchildren. METHODS: A cross-sectional study comprising data from the Fourth National Study on Drug Use in the Chilean School Population (2001. There were studied 54,001 schoolchildren aged between eight and 20 years. Predictors were self-reported tobacco and alcohol use (ever users, age at initiation of tobacco and/or alcohol use, and intensity of tobacco use. The study outcome was self-reported marijuana use (ever users versus never users and age at initiation of marijuana use. Poisson regression and Weibull regression were used for data analysis. RESULTS: Lifetime prevalence of tobacco use was high: 77%, alcohol 79%, and marijuana 23%. Tobacco consumption increased the likelihood of marijuana use (PR=10.4; 95% CI: 8
van Lier, P.A.C.; Huizink, A.C.; Crijnen, A.A.M.
The distal impact of a school based universal preventive intervention targeting disruptive behavior problems on tobacco and alcohol use from age 10 to 13 years was explored. Second grade classrooms (children aged 7 years) were randomly assigned to the intervention or a control condition. Tobacco and
van Lier, P.A.C.; Huizink, A.; Crijnen, A.A.
The distal impact of a school based universal preventive intervention targeting disruptive behavior problems on tobacco and alcohol use from age 10 to 13 years was explored. Second grade classrooms (children aged 7 years) were randomly assigned to the intervention or a control condition. Tobacco and
Carlini, Beatriz H; Safioti, Luciana; Rue, Tessa C; Miles, Lyndsay
Limited English proficient (LEP) individuals face disparities in accessing substance abuse treatment, but little is known on how to reach this population. This study aimed to test online recruitment methods for tobacco and alcohol screening among LEP Portuguese speakers. The study was advertised in Portuguese using Facebook, Google, online newsletters and E-mail. Participants clicked ads to consent and access a screening for tobacco and alcohol dependence. Ads yielded 690 screening responses in 90 days. Respondents had a mean age of 42.7 (SD 12), with a higher proportion of women than men, 95% born in Brazil with high levels of LEP and low levels of acculturation. Facebook ads yielded 41.4% of responses, and were the lowest cost recruitment channel ($8.9, $31.10 and $20.40 per respondent, hazardous drinker and smoker, respectively). Online recruitment of LEP populations is feasible. Future studies should test similar strategies in other LEP groups.
Moon, Sung Seek; Rao, Uma
In this article, we present the effects of three hypothesized protective factors: social activities, school-related activities, and anti-substance use media messages on adolescent tobacco and alcohol use. Data were drawn from the "Monitoring the Future" (MTF) research project, which was conducted by the Institute for Social Research at the University of Michigan. The sample included 2,551 twelfth-grade students. The results of the structural equation model showed that exposure to media anti-drug messages had an indirect negative effect on tobacco and alcohol use through school-related activity and social activity. The results suggest that comprehensive ecological interventions encompassing media, family, and school can increase on the preventive effects of adolescent's substance use.
Vaysse, Benoît; Gignon, Maxime; Zerkly, Salah; Ganry, Olivier
Excessive alcohol consumption and illicit drug use among students have negative repercussions on their health, education and society in general. Medical students are no exception. The objective of this study was to evaluate the consumption of alcohol, tobacco and cannabis as well as levels of anxiety and depression of students admitted to the second year of medical studies based on anonymous self-administered questionnaires containing the following tests: AUDIT, Fagerstrom, CAST and HAD. 198 of the 207 students involved agreed to participate. Excessive alcohol consumption was higher among women than among men (35% versus 22%), but fewer women were alcohol-dependent (2% versus 8%) (p students were tobacco smokers, with no signs of dependence in 80% of cases. 15% of students smoked cannabis and 52% of them presented problem use. 21% of women had a suspected anxiety disorder and 23% had a proven anxiety disorder, versus 17% and 6% of men, respectively (p = 0.002). 3% had a suspected depressive disorder and 0.5% had a proven depressive disorder. High-risk alcohol consumption was significantly correlated with high-risk cannabis use. No correlation was demonstrated between anxiety or depression and these consumptions. Doctors appear to be particularly affected by psychological disorders or addictions and medical students are paradoxically less likely than the general population to receive appropriate care. Universities must provide monitoring and support for students in order to improve their health, but also to enable them to provide care and appropriate educational messages to their patients.
Full Text Available Evidence gained from animals and humans suggests that the encephalic opioid system might be involved in the development of drug addiction through its role in reward. Our aim is to assess the influence of genetic variations in the opioid receptor mu 1 on alcohol and tobacco consumption in a Spanish population. 763 unrelated individuals (465 women, 298 men aged 18-85 years were recruited between October 2011 and April 2012. Participants were requested to answer a 35-item questionnaire on tobacco and alcohol consumption, as well as to complete the AUDIT and Fagerström tests. Individuals were genotyped for three polymorphisms in the opioid receptor mu 1 (OPRM1 gene, using a TaqMan® protocol. In males, the rs10485057 polymorphism was associated with total pure ethanol intake and with the risk of being an alcohol consumer. Also, this polymorphism was significantly associated with higher Fagerström scores. Rs1799971 had a different influence on adaptive and maladaptive patterns of alcohol use. Despite the limited sample size, our study might enrich current knowledge on patterns of alcohol use, because it encompasses both extreme and adaptive phenotypes, providing thus a wider perspective on this subject.
Viacava, Keitiline R; Weydmann, Gibson J; de Vasconcelos, Mailton F; Jaboinski, Juliana; Batista, Graziele D; de Almeida, Rosa Maria M; Bizarro, Lisiane
The tactical use of visuoperceptual content in marketing may encourage impulsive consumption of unhealthy products. In this study, the application of visuoperceptual content was compared in advertisements used by industries of tobacco, alcohol and food. The aim was to ascertain whether similarities exist in the strategies used as variables for the selection of commercial stimuli, such as color, position and size. Scion Image and Corel Draw Graphics Suite software were used to analyze the content of a non-probabilistic sample of advertising images (N = 150). Differences were identified in the use of the colors green (p = 0.04) and red (p = 0.01), but not in the use of the color blue (p = 0.64), suggesting that induction of feelings of pleasantness resulting from the use of the color blue may be associated with the advertising in the alcohol and tobacco industries. Regarding the position of the commercial stimuli, a predominance of the use of quadrants 'C' (p = 0.00) and 'D' (p = 0.01) was found in all three industries, indicating a similar use of areas perceived as being 'heavier'. As to the size, 78% of advertisements placed the commercial stimuli within a range of 0-25% of the total image. The results showed some similarities in the use of visuoperceptual content in advertisements for tobacco, alcohol and food, especially between tobacco and alcohol. The article offers a convergence analysis of these three industries altogether, providing additional subsidies for the formulation of protection policies. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Moon, Sung Seek; Rao, Uma
In this article, we present the effects of three hypothesized protective factors: social activities, school-related activities, and anti-substance use media messages on adolescent tobacco and alcohol use. Data were drawn from the “Monitoring the Future” (MTF) research project, which was conducted by the Institute for Social Research at the University of Michigan. The sample included 2,551 twelfth-grade students. The results of the structural equation model showed that exposure to media anti-d...
Bray, I; Brennan, P; Boffetta, P
Central European mortality rates for cancer sites related to tobacco and alcohol have increased rapidly in recent decades. From a public health point of view, it is of considerable interest to know whether these past increases in cancer mortality will continue into the future. Cancer mortality rates for the period 1965-1994 in Bulgaria, Czech Republic and Slovakia (analysed together), Hungary, Poland, and Romania were analysed for cancers of the larynx, oral cavity and pharynx, oesophagus, bladder, kidney, and pancreas. Using a Bayesian age-period-cohort approach, we have calculated smoothed observed rates. The effects of period and cohort were extrapolated to estimate mortality projections for 1995-99, 2004-09, and 2005-09. Mortality rates for all sites are projected to increase in most countries. Hungary has the highest projected rates for most sites, and particularly rapid increases are expected for cancers of the oral cavity and pharynx and of the larynx in Hungarian men. The smoothed 1990-94 male mortality rates for these two sites of 16. 32/100,000 and 8.70/100,000, respectively, are projected to reach 35. 17/100,000 for cancer of the oral cavity and pharynx and 14.12/100, 000 for cancer of the larynx by the period 2000-04. For kidney cancer, former Czechoslovakia has the highest observed and projected mortality rates. The smoothed 1990-94 rate of 8.37/100,000 is expected to increase 24% to 10.38/100,000 by 2000-04. Our results indicate that further increases may be expected on top of the already high cancer mortality levels in Central Europe. Policies to reduce alcohol consumption and prevent smoking in younger generations are necessary to reduce mortality as these cohorts age. Copyright 2000 Wiley-Liss, Inc.
Wu, Wei-Chun; Lin, Pei-Chen; Hung, Chun-Chi; Lin, Hung-Hsun; Cheng, Ching-Mei; Lee, Chung-Yin; Chiu, Kuei-Fen; Lin, Wen-Yi; Huang, Chia-Tsuan; Wu, Ming-Tsang
Individuals with prediabetes (100-125 mg/dL) and diabetes mellitus (DM) increase the risk of all-cause and cardiovascular disease (CVD) mortality. Since personal substance use such as cigarette smoking, alcohol drinking, and areca nut chewing may confound the true effect of clinical biochemistries on the risk of prediabetes, this study aims to examine the relationship between clinical biochemical parameters and the risk of prediabetes among Taiwanese without the habits of consuming tobacco, alcohol drinking, or areca nut. Women aged between 40 years and 64 years who came to one community teaching hospital between January 1, 2001 and December 31, 2008 for general health screening for the first time were studied. The general health screening is provided every 3 years gratis. The package of this health screening includes personal history, physical examination, and biochemical tests in serum and urine. In total, 8580 nonsmoking, nondrinking, and nonareca nut chewing women who did not have a history of DM were eligible for this study. Of these, 1861 (21.7%) out of 8580 women were prediabetic. Compared to women with normal fasting glucose (NFG), we found a dose-response relationship of the risk of prediabetes with age and body mass index (BMI) and total cholesterol, triglyceride, glutamic-pyruvic transaminase (GPT), and uric acid in serum. Women with hypertension or proteinuria (≥30 mg/dL) had also an increased risk to have prediabetes. Besides age, the factors of BMI, hypertension, dyslipidemia, GPT, hyperuricemia, and proteinuria are the main risk factors for prediabetes in Taiwanese women without substance uses. A follow-up study is necessary to clarify the causality of these important biochemical parameters and prediabetes. Copyright © 2014. Published by Elsevier B.V.
Albuquerque, Rui; López-López, José; Marí-Roig, Antonio; Jané-Salas, Enric; Roselló-Llabrés, Xavier; Santos, Jorge Rosa
There has been an increase in the incidence of carcinoma of the tongue, particularly among alcohol and tobacco non-users. However, the number of studies that would allow a better understanding of etiological factors and clinical features, particularly in the Portuguese population, is very limited. This study was based on patients with squamous cell carcinoma of the anterior two thirds of the tongue that were treated at the Department of Head and Neck Surgery of the "Instituto Portugues de Oncologia de Lisboa - Francisco Gentil" (IPOLFG) in Lisbon, Portugal, between January 1, 2001 and December 31, 2009. The patients were divided in alcohol and tobacco users and non-users in order to evaluate the differences between these 2 groups based on gender, age, tumor location, denture use, and tumor size, metastasis and stage. Of the 354 cases, 208 were users and 146 were non-users. The main location in both groups was the lateral border of the tongue. Denture use showed no significant effect in both study groups. It was possible to conclude that patients who did not drink or smoke were older and presented with smaller tumor size, lower incidence of ganglion metastasis and lower tumor stage compared with alcohol and tobacco users.
Kelly, Bridget; Baur, Louise A; Bauman, Adrian E; King, Lesley
Determining children's exposure to food and beverage company sponsorship, and the effect of this exposure, is important in establishing the extent to which there may be health and societal consequences. This paper aimed to provide preliminary evidence on the scope and potential effects on children of unhealthy food and beverage sponsorship. A review of published literature and media and marketing reports was conducted to determine the types of food and beverage sponsorship campaigns that children are exposed to, and the effect of corporate sponsorship (including tobacco and alcohol) on children and adolescents. A large range of food and beverage sponsorship activities, in Australia and internationally, were identified for both school and sport settings. In particular, food and beverage companies have attempted to develop a marketing presence at all levels of professional and community sport. No information was identified measuring the effect of food and beverage company sponsorship on children and adolescents. However, empirical evidence from consumer studies relating to tobacco and alcohol sponsorship has repeatedly demonstrated that sponsorship has an impact on children's product recall and product-related attitudes and behavioural intentions. While there is no available research on the direct effect of food and beverage sponsorship, the demonstrated effects of tobacco and alcohol sponsorship on children's product awareness, preferences and consumption are likely to be applicable to food companies.
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Processed tobacco. 40.257 Section 40.257 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND...
Blasco-Alonso, Marta; González-Mesa, Ernesto; Gálvez Montes, Milagros; Lozano Bravo, Isabel; Merino Galdón, Federico; Cuenca Campos, Francisco; Marín Schiaffino, Gema; Pérez Torres, Sergio; Herrera Peral, José; Bellido Estévez, Inmaculada
The prevalence of substance abuse in women who become pregnant is similar to that of the general population, resulting in a high fetal exposure rate during the most vulnerable period regarding neurodevelopment and organogenesis. The present study was intended to assess the level of prenatal exposure to tobacco, alcohol or illicit drugs in the city of Málaga (Spain). It was designed as a cross-sectional study, and based on the anonymous self-reports of participants. A total of 451 pregnant women were recruited in the first, second or third trimester. The prevalence in each of the quarters respectively was 21.2%, 18.5% and 13.3% for smoking, 40.7%, 23.1% and 17.1% for alcohol and 4.8%, 1.9% and 1.2% for cannabis. We also found that a higher educational level was associated with a lower consumption of tobacco (RR 0.659 [0.537-0.810] p<0.0001) and greater exposure to alcohol (RR 1.87 [1.30-2.69] p<0.0007). These results, particularly in regard to alcohol intake, are sufficiently alarming to alert obstetric care providers about the need to implement preventive measures.
Full Text Available The aim of this study was to examine the prevalence of alcohol/tobacco consumption among adolescents (N = 370 aged 14 to 19 years in three groups: 205 adolescents with normal weight, 82 adolescents from the community with overweight or obesity, and 83 adolescents with overweight or obesity and in outpatient treatment for weight control. We also examined the roles of age, gender, weight, treatment condition, and psychosocial variables (psychopathological symptoms, social support, and emotional skills in the presence of those risk behaviors. Our major findings were that the clinical group of overweight adolescents had fewer risk behaviors, than the overweight community group and the normal weight controls, particularly for risk behaviors related to alcohol use. The increase of age and lower satisfaction with family predicted tobacco consumption. The increase of age, not being integrated in a treatment for weight control and higher satisfaction with intimate relationships predicted alcohol consumption. Weight status was not a predictor of alcohol and cigarette use. This study discusses the theoretical and practical implications of these findings.
Sweeting, Helen N; Bhaskar, Abita; Hunt, Kate
Background There is concern about the negative impact of modern consumer culture on young people's mental health, but very few studies have investigated associations with substance use. In those which have, positive associations have been attributed to attempts to satisfy the unmet needs of more materialistic individuals. Objectives This study examines associations between different dimensions of consumerism and tobacco and alcohol use among Scottish early adolescents. Design Cross-sectional study. Setting and participants 2937 (92% of those eligible) secondary school pupils (ages 12–14) completed questionnaires in examination conditions. Analyses were restricted to those with complete data on all relevant variables (N=2736 smoking; N=2737 drinking). Measures Dependent variables comprised ever smoking and current drinking. Measures of consumerism comprised number of ‘premium’ (range 0–7) and ‘standard’ (range 0–5) material possessions and three Consumer Involvement subscales, ‘dissatisfaction’, ‘consumer orientation’ and ‘brand awareness’ (each range 3–12). Analyses also included school-year group and family affluence. Results Ever smoking and current drinking were both more prevalent among adolescents with more ‘premium’ and ‘standard’ material possessions, greater consumer ‘dissatisfaction’ and ‘brand awareness’ (mutually adjusted analyses including school-year group and family affluence). The strongest relationships occurred for ‘brand awareness’: for each unit increase in ‘brand awareness’ the ORs (95% CI) of ever smoking were 1.17 (1.08 to 1.26) and 1.23 (1.14 to 1.33) in males and females, respectively; and those for drinking were 1.15 (1.08 to 1.23) and 1.21 (1.13 to 1.30). ‘Brand awareness’ had an equal or stronger relationship with both smoking and drinking than did family affluence. Conclusions These results suggest aassociations between consumerism and both smoking and drinking might arise because
Kerr, S; Lawrence, M; Darbyshire, C; Middleton, A R; Fitzsimmons, L
The behavioural determinants of health among people with mild/moderate intellectual disabilities (ID) are of increasing concern. With the closure of long-stay institutions, more people with ID are living in the community. As they lead more ordinary and less restricted lives, people with ID may be exposed to social and environmental pressures that encourage them to adopt behaviours that impact negatively on their health. Levels of smoking and alcohol consumption in this client group are of particular concern. We undertook a mixed method review of the literature, aiming to assess the Feasibility, Appropriateness, Meaningfulness and Effectiveness (FAME) of interventions designed to address the use of tobacco and/or alcohol in people with mild/moderate ID. Key electronic databases were searched (e.g., Medline, Cochrane Register of Controlled Trials, PsycINFO) from 1996 to 2011. The search was developed using appropriate subject headings and key words (e.g., intellectual disability, tobacco use, alcohol drinking, health promotion). On completion of the database searches, inclusion/exclusion criteria, based on an adaptation of the PICO framework (Population, Intervention, Comparison, Outcomes), were applied. Methodological quality was assessed using a seven-point rating scale. Database searches identified 501 unique records, of which nine satisfied the inclusion criteria. Four focused on tobacco, three on alcohol and two on both tobacco and alcohol. Located in the U.K., the U.S.A. and Australia, the studies aimed to increase knowledge levels and/or change behaviour (e.g., to encourage smoking cessation). One was a randomised controlled trial, one a quasi-experiment and the others were before and after studies and/or case studies. Methodological quality was poor or moderate. The combined studies had a sample size of 341, with ages ranging from 14 to 54 years. The interventions were delivered by professionals (e.g., in health, social care, education) during sessions that
Wagoner, Kimberly G.; Sutfin, Erin L.; Song, Eunyoung Y.; King, Jessica L.; Egan, Kathleen L.; Reboussin, Beth; Debinski, Beata; Spangler, John; Wolfson, Mark
Objective: Colleges have implemented policies to limit tobacco use on-campus; however, the off-campus environment is often overlooked in tobacco control efforts. We assessed availability, marketing, and promotion of cigarettes, snus, and traditional smokeless tobacco (SLT) in a sample of communities surrounding 11 college campuses in North…
Choquet, Marie; Hassler, Christine; Morin, Delphine; Falissard, Bruno; Chau, Nearkasen
To assess associations between parental control or parental emotional support and current tobacco, alcohol or cannabis use among 12-18-year-old students, according to gender and family structure (intact family, reconstituted family, single-parent family). A cross-sectional survey was conducted in a national representative sample in France (2003) of 6-12th grade students (N = 16,532), as a part of the ESPAD study (European Study Project on Alcohol and Other Drugs). The self-administered questionnaire included questions on last 30 days' consumption of alcohol, tobacco and cannabis as well as on socio-demographic characteristics, school characteristics, and some simple questions on parental control and parental emotional support. Logistic modelling was carried out and (adjusted Odds Ratio) Ora calculated, adjusted for age, parental educational and characteristics of the school. A negative relationship exists between parental control and substance use, but this relationship is more marked for tobacco (OR a between 1.8 and 5.6 according to level of control, family status and gender) and cannabis (OR between 1.5 and 6.4) than for alcohol (OR a between 1.0 and 2.7). Parental control is more markedly related to substance use in girls than in boys. These tendencies were observed for intact families as well as for single-parent families or reconstituted families. Parental control has a greater impact than emotional support. Among girls, emotional support has a greater impact than among boys. There is a gradient relationship between parental control and current consumption, especially among girls. Thus, there may be a need for parental control, whatever the family structure.
Full Text Available Abstract Background Previous population-based studies have found that delusional-like experiences (DLE are prevalent in the community, and are associated with a wide range of mental health disorders including substance use. The aim of the study was to explore the association between DLE and three commonly used substances - tobacco, alcohol and cannabis. Methods Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007. The Composite International Diagnostic Interview was used to identify DLE, common psychiatric disorders, and substance use. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. Results Of 8 773 participants, 8.4% (n = 776 subjects endorsed one or more DLE. With respect to tobacco use, compared to nonusers, DLE were more common in those who (a had daily use, (b commenced usage aged 15 years or less, and (c those who smoked heavily (23 or more cigarettes per day. Participants with cannabis use disorders were more likely to endorse DLE; this association was most prominent in those with an onset of 16 years or younger. In contrast, the pattern of association between DLE versus alcohol use or dependence was less consistent, however those with early onset alcohol use disorders were more likely to endorse DLE probe items. Conclusions While cannabis use disorders have been previously linked with DLE, our findings linking alcohol and tobacco use and DLE suggest that the influence of these substances on psychosis-related outcomes warrants closer scrutiny in longitudinal prospective studies.
Kariche, Nora; Hortal, Montserrat Torres; Benyahia, Samir; Alemany, Laia; Moulaï, Nabila; Clavero, Omar; Muñoz, Marleny; Ouahioune, Wahiba; Djennaoui, Djamel; Touil-Boukoffa, Chafia; de Sanjosé, Silvia; Bourouba, Mehdi
Despite the increasing incidence of laryngeal squamous cell carcinoma (LSCC) in Algeria, scarce information is available on the importance of the preventable etiological factors which may drive the disease. Remarkably, a significant number of cases occur in nonsmoker and nondrinker patients; hence, suggesting that alternative risk factors, like Human papillomavirus (HPV), might be etiologically involved. To gain more insight on the risk factors associated with the disease in the country, we evaluated the etiological fraction of HPV in comparison to tobacco and alcohol intake in LSCC patients. To evaluate the etiopathologic fraction (EF) for HPV compared to history of tobacco and alcohol in LSCC, HPV DNA presence in 46 invasive and 3 non-invasive formalin-fixed paraffin-embedded laryngeal tumors was screened using the SPF10-DEIA-LiPA25 Assay. Demographic data and information related to exposure to the risk factors were gathered through interviewer-assisted questionnaires. We observed that 40.8% of all LSCC cases were associated with smoking, 40.8% had combined tobacco and alcohol exposure history, and 14.3% did not show prior exposure to either risk factor. 1 out of 3 in-situ carcinoma cases was positive for HPV-6. HPV prevalence was null in the invasive tumors. HPV DNA was detected in 2.38% for all studied cases. 10.2% of LSCC patients did not associate with any of the studied risk factors. Here we show that HPV etiological fraction in LSCC Algerian patients is low and smoking and alcohol remain the principal etiopathologic risk for LSCC burden in Algeria.
Damiani, Isabelle; Morreel, Kris; Danoun, Saïda; Goeminne, Geert; Yahiaoui, Nabila; Marque, Christiane; Kopka, Joachim; Messens, Eric; Goffner, Deborah; Boerjan, Wout; Boudet, Alain-Michel; Rochange, Soizic
In angiosperms, lignin is built from two main monomers, coniferyl and sinapyl alcohol, which are incorporated respectively as G and S units in the polymer. The last step of their synthesis has so far been considered to be performed by a family of dimeric cinnamyl alcohol dehydrogenases (CAD2). However, previous studies on Eucalyptus gunnii xylem showed the presence of an additional, structurally unrelated, monomeric CAD form named CAD1. This form reduces coniferaldehyde to coniferyl alcohol, but is inactive on sinapaldehyde. In this paper, we report the functional characterization of CAD1 in tobacco (Nicotiana tabacum L.). Transgenic tobacco plants with reduced CAD1 expression were obtained through an RNAi strategy. These plants displayed normal growth and development, and detailed biochemical studies were needed to reveal a role for CAD1. Lignin analyses showed that CAD1 down-regulation does not affect Klason lignin content, and has a moderate impact on G unit content of the non-condensed lignin fraction. However, comparative metabolic profiling of the methanol-soluble phenolic fraction from basal xylem revealed significant differences between CAD1 down-regulated and wild-type plants. Eight compounds were less abundant in CAD1 down-regulated lines, five of which were identified as dimers or trimers of monolignols, each containing at least one moiety derived from coniferyl alcohol. In addition, 3-trans-caffeoyl quinic acid accumulated in the transgenic plants. Together, our results support a significant contribution of CAD1 to the synthesis of coniferyl alcohol in planta, along with the previously characterized CAD2 enzymes.
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Importation of tobacco products, cigarette papers and tubes, and processed tobacco. 41.1 Section 41.1 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO...
Baumann, Michèle; Spitz, Elisabeth; Guillemin, Francis; Ravaud, Jean-François; Choquet, Marie; Falissard, Bruno; Chau, Nearkasen
The aim was to assess the relationships between social and material deprivation and the use of tobacco, excessive alcohol and psychotropic drugs by both sexes and in various age groups. Greater knowledge concerning these issues may help public health policy-makers design more effective means of preventing substance abuse. The sample comprised 6,216 people aged > or 15 years randomly selected from the population in north-eastern France. Subjects completed a post-mailed questionnaire covering socio-demographic characteristics, occupation, employment, income, smoking habit, alcohol abuse and "psychotropic" drug intake (for headache, tiredness, nervousness, anxiety, insomnia). A deprivation score (D) was defined by the cumulative number of: low educational level, manual worker, unemployed, living alone, nationality other than western European, low income, and non-home-ownership. Data were analysed using adjusted odds ratios (ORa) computed with logistic models. Deprivation was common: 37.4% of respondents fell into category D = 1, 21.2% into D = 2, and 10.0% into D > or 3a re men than women reported tobacco use (30.2% vs. 21.9%) and alcohol abuse (12.5% vs. 3.3%), whereas psychotropic drug use was more common among women (23.8% vs. 41.0%). Increasing levels of deprivation were associated with a greater likelihood of tobacco use (ORa vs. D = 0: 1.16 in D = 1, 1.49 in D = 2, and 1.93 in D > or = 3), alcohol abuse (1.19 in D = 1, 1.32 in D = 2, and 1.80 in D > or = 3) and frequent psychotropic drug intake (1.26 in D = 1, 1.51 in D = 2, and 1.91 in D > or = 3). These patterns were observed in working/other non-retired men and women (except for alcohol abuse in women). Among retired people, deprivation was associated with tobacco and psychotropic drug use only in men. Preventive measures should be designed to improve work conditions, reduce deprivation, and help deprived populations to be more aware of risk and to find remedial measures.
Shahab, Lion; Brown, Jamie; Hagger-Johnson, Gareth; Michie, Susan; Semlyen, Joanna; West, Robert; Meads, Catherine
To assess the association between tobacco and hazardous alcohol use and sexual orientation and whether such an association could be explained by other sociodemographic characteristics. Cross-sectional household survey conducted in 2014-2016. England, UK. Representative English population sample (pooled n=43 866). Sexual orientation identity (lesbian/gay, bisexual, heterosexual, prefer-not-to-say); current tobacco and hazardous alcohol use (defined as Alcohol Use Disorders Identification Test Score ≥8). All outcomes were self-reported. Due to interactions between sexual orientation and gender for substance use, analyses were stratified by gender. Tobacco use prevalence was significantly higher among lesbian/gay (women: 24.9%, 95% CI 19.2% to 32.6%; men: 25.9%, 95% CI 21.3% to 31.0%) and bisexual participants (women: 32.4%, 95% CI 25.9% to 39.6%; men: 30.7%, 95% CI 23.7% to 30.7%) and significantly lower for prefer-not-to-say participants in women (15.5%, 95% CI 13.5% to 17.8%) but not men (22.7%, 95% CI 20.3% to 25.3%) compared with heterosexual participants (women: 17.5%, 95% CI 17.0% to 18.0%; men: 20.4%, 95% CI 19.9% to 21.0%; psexual orientation groups among both women and men. By contrast, sexual orientation differences in hazardous alcohol use remained even after adjustment among women but not for bisexual and gay men. In England, higher rates of tobacco use among sexual minority men and women appear to be attributable to other sociodemographic factors. Higher rates of hazardous alcohol use among sexual minority men may also be attributable to these factors, whereas this is not the case for sexual minority women. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Full Text Available Abstract Background The aim was to assess the relationships between social and material deprivation and the use of tobacco, excessive alcohol and psychotropic drugs by both sexes and in various age groups. Greater knowledge concerning these issues may help public health policy-makers design more effective means of preventing substance abuse. Methods The sample comprised 6,216 people aged ≥ 15 years randomly selected from the population in north-eastern France. Subjects completed a post-mailed questionnaire covering socio-demographic characteristics, occupation, employment, income, smoking habit, alcohol abuse and "psychotropic" drug intake (for headache, tiredness, nervousness, anxiety, insomnia. A deprivation score (D was defined by the cumulative number of: low educational level, manual worker, unemployed, living alone, nationality other than western European, low income, and non-home-ownership. Data were analysed using adjusted odds ratios (ORa computed with logistic models. Results Deprivation was common: 37.4% of respondents fell into category D = 1, 21.2% into D = 2, and 10.0% into D ≥ 3. More men than women reported tobacco use (30.2% vs. 21.9% and alcohol abuse (12.5% vs. 3.3%, whereas psychotropic drug use was more common among women (23.8% vs. 41.0%. Increasing levels of deprivation were associated with a greater likelihood of tobacco use (ORa vs. D = 0: 1.16 in D = 1, 1.49 in D = 2, and 1.93 in D ≥ 3, alcohol abuse (1.19 in D = 1, 1.32 in D = 2, and 1.80 in D ≥ 3 and frequent psychotropic drug intake (1.26 in D = 1, 1.51 in D = 2, and 1.91 in D ≥ 3. These patterns were observed in working/other non-retired men and women (except for alcohol abuse in women. Among retired people, deprivation was associated with tobacco and psychotropic drug use only in men. Conclusion Preventive measures should be designed to improve work conditions, reduce deprivation, and help deprived populations to be more aware of risk and to find remedial
Nasrollahzadeh, D; Kamangar, F; Aghcheli, K; Sotoudeh, M; Islami, F; Abnet, C C; Shakeri, R; Pourshams, A; Marjani, H A; Nouraie, M; Khatibian, M; Semnani, S; Ye, W; Boffetta, P; Dawsey, S M; Malekzadeh, R
The very high incidence of oesophageal squamous cell carcinoma (ESCC) in Golestan Province in northeastern Iran was suggested by studies in the 1970s as partly due to opium use, which is not uncommon in this area, but based on limited numbers. From December 2003 to June 2007, we administered a validated structured questionnaire to 300 ESCC cases and 571 controls, matched on neighbourhood of residence, age (±2 years), and sex. We used conditional logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) adjusted for potential confounders. Compared with those who used neither tobacco nor opium, risk of ESCC was increased in those who used tobacco only (OR, 95% CI: 1.70, 1.05–2.73), in those who used opium only (2.12, 1.21–3.74), and in those who used both tobacco and opium (2.35, 1.50–3.67). All forms of tobacco use (cigarettes, hookah, and nass) were associated with higher ESCC risk. Similarly, use of both crude opium and other forms of opium were associated with higher risk. Alcohol consumption was seen in only 2% of the cases and 2% of the controls, and was not associated with ESCC risk. PMID:18475303
Bansal-Travers, Maansi; Fong, Geoffrey T; Quah, Anne C K; Sansone, Genevieve; Pednekar, Mangesh S; Gupta, Prakash C; Sinha, Dhirendra N
Tobacco companies are utilizing similar strategies to advertise and promote their products in developing countries as they have used successfully for over 50 years in developed countries. The present study describes how adult smokers, smokeless tobacco users, and non-users of tobacco from the Tobacco Control Project (TCP) India Pilot Survey, conducted in 2006, responded to questions regarding their perceptions and observations of pro-tobacco advertising and promotion and beliefs about tobacco use. Analyses found that 74% (n=562) of respondents reported seeing some form of pro-tobacco advertising in the last six months, with no differences observed between smokers (74%), smokeless tobacco users (74%), and nonsmokers (73%). More than half of respondents reported seeing pro-tobacco advertising on store windows or inside shops. Overall, this study found that a significant percentage of tobacco users and non-users in India report seeing some form of pro-tobacco advertising and promotion messages. Additional analyses found that smokers were more likely to perceive tobacco use as harmful to their health compared with smokeless tobacco users and non-users (padvertising and promotion of tobacco products in India. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.
Bansal-Travers, Maansi; Fong, Geoffrey T.; Quah, Anne C.K.; Sansone, Genevieve; Pednekar, Mangesh S.; Gupta, Prakash C.; Sinha, Dhirendra N.
Tobacco companies are utilizing similar strategies to advertise and promote their products in developing countries as they have used successfully for over 50 years in developed countries. The present study describes how adult smokers, smokeless tobacco users, and non-users of tobacco from the Tobacco Control Project (TCP) India Pilot Survey, conducted in 2006, responded to questions regarding their perceptions and observations of pro-tobacco advertising and promotion and beliefs about tobacco use. Analyses found that 74% (n=562) of respondents reported seeing some form of pro-tobacco advertising in the last six months, with no differences observed between smokers (74%), smokeless tobacco users (74%), and nonsmokers (73%). More than half of respondents reported seeing pro-tobacco advertising on store windows or inside shops. Overall, this study found that a significant percentage of tobacco users and non-users in India report seeing some form of pro-tobacco advertising and promotion messages. Additional analyses found that smokers were more likely to perceive tobacco use as harmful to their health compared with smokeless tobacco users and non-users (padvertising and promotion of tobacco products in India. PMID:25455648
Full Text Available Objectives: The aim of this study was to assess the prevalence of alcohol consumption, tobacco use and risky sexual behaviour among adolescents, and to evaluate the socioeconomic factors potentially influencing these behaviours. Methods: This cross-sectional study was conducted from January to April 2011 among 376 adolescents (15–19 years old studying in different schools and colleges in Udupi, India. The Youth Risk Behavior Survey questionnaire and guidelines were followed for data collection. Participants’ alcohol consumption, smoking habits and sexual behaviour patterns were explored. Univariate analysis followed by multivariate logistic regression was done. Results: The prevalence of alcohol consumption, tobacco use and sexual activity was found to occur in 5.7%, 7.2% and 5.5% of participants, respectively. The mean age of the participants’ first sexual activity, consumption of alcohol and tobacco use was reported to be approximately 16.8 years. Multivariate analysis showed that males were more likely to have used alcohol and tobacco. Other factors, such as religion and tobacco use among family members, were found to be influential. Conclusion: The potential coexistence of multiple risk behaviours in a student demands an integrated approach. Emphasis should be placed on health education in schools and an increased awareness among parents in order to prevent adolescents’ behaviours from becoming a risk to their health.
I sought to identify what kinds of promotion for alcohol and tobacco products are found in televised sports programming, as well as how frequently they occur. I compared my findings with data from 5 and 10 years earlier to examine the effects of the Master Settlement Agreement and detect industry trends. Method. A content analysis of more than 83 hours of televised sports programming from 2000 through 2002 was conducted. Composite week sampling was used to ensure results were representative of the overall population of television sports programs. Programs were examined for traditional advertising (commercials) and nontraditional advertising (stadium signs, announcer voiceovers, etc.). Rates of certain types of alcohol advertising have decreased, but what remains is strategically chosen to increase the likelihood of audience exposure. Despite the Master Settlement Agreement, tobacco advertising remains prevalent in many sports. A new trend of placing alcohol and tobacco brand names in commercials for other products is evident. Alcohol and tobacco marketers appear able to cleverly adapt to advertising challenges, such as digital video recorders and legislation. Alcohol and tobacco brands remain visible on sports programming.
Ling, Pamela M; Haber, Lawrence A; Wedl, Stefani
Rodeo is one of the few sports still sponsored by the tobacco industry, particularly the US Smokeless Tobacco Company. Rodeo is popular in rural communities, where smokeless tobacco use is more prevalent. We used previously secret tobacco industry documents to examine the history and internal motivations for tobacco company rodeo sponsorship. Rodeos allow tobacco companies to reach rural audiences and young people, enhance brand image, conduct market research, and generate positive press. Relationships with athletes and fans were used to fight proposed restrictions on tobacco sports sponsorship. Rodeo sponsorship was intended to enhance tobacco sales, not the sport. Rural communities should question the tradition of tobacco sponsorship of rodeo sports and reject these predatory marketing practices.
Haber, Lawrence A.; Wedl, Stefani
Rodeo is one of the few sports still sponsored by the tobacco industry, particularly the US Smokeless Tobacco Company. Rodeo is popular in rural communities, where smokeless tobacco use is more prevalent. We used previously secret tobacco industry documents to examine the history and internal motivations for tobacco company rodeo sponsorship. Rodeos allow tobacco companies to reach rural audiences and young people, enhance brand image, conduct market research, and generate positive press. Relationships with athletes and fans were used to fight proposed restrictions on tobacco sports sponsorship. Rodeo sponsorship was intended to enhance tobacco sales, not the sport. Rural communities should question the tradition of tobacco sponsorship of rodeo sports and reject these predatory marketing practices. PMID:19910357
Full Text Available Severin Haug Swiss Research Institute for Public Health and Addiction at Zurich University, Zurich, Switzerland Background: Alcohol and tobacco use are major causes of the disease burden in most countries of the world. Mobile phone text messaging is very popular among adolescents and young adults and has the potential to deliver individualized information to large population groups at low costs. Objective: To provide a narrative review on studies testing the appropriateness and effectiveness of text messaging-based programs to reduce alcohol and tobacco use in young people. Results: Two published studies on text message-based programs for the reduction of problem drinking and two studies on programs for enhancing smoking cessation were identified. A US-American pilot experimental study tested the feasibility and initial efficacy of a text messaging-based assessment and brief intervention among young adults identified during their emergency department visit with hazardous drinking. It demonstrated the feasibility of the text messaging-based program to collect drinking data in young adults after emergency department discharge. A Swiss pre–post study tested the appropriateness and initial effectiveness of a combined, individually tailored web- and text messaging (SMS-based program to reduce problem drinking in vocational school students. It provided evidence for the appropriateness of the intervention and initial evidence for its efficacy to reduce problem drinking. One of the two studies addressing smoking cessation was a US-American pilot randomized controlled trial. Participants were recruited via online advertisements and received text messages tailored according to their quitting stage. The intervention significantly affected self-reported quitting rates at 4 weeks but not at 3 months after the quit date. Within a cluster-randomized controlled trial conducted in Switzerland, smoking students were proactively recruited within vocational
Full Text Available An institutional study was carried out in 102 patients to investigate the site specific effect of addictions, that is, tobacco smoking and tobacco chewing (smokeless, both independently and synergistically in development of malignancies in upper aerodigestive tract through retrograde questionnaire. The histopathologically proven cases were interviewed regarding different forms of addictions followed by clinical examination and investigations for grading (according to Modified Broadmann’s method and TNM staging (according to UICC according to the tumor site. Statistical analysis was done by Pearson test. Out of all proven cases of cancers, 29.4% were only tobacco chewers (smokeless, 25.5% were only smokers, 42.2% were having both types of tobacco addictions (smoke and smokeless, and only 2.9% were having no addiction. Out of only tobacco chewers (smokeless, 83.3% were of oral cavity cancers, 6.7% were of oro- and hypopharynx and the rest were of others. Among only smokers, 69.2% cases were of laryngeal and oro- and hypopharynx as compared to 11.5% of oral cavity cancers (nearly 6 times. Tobacco (smokeless chewing is associated with oral cancers whereas tobacco smoking is associated with laryngeal and hypopharyngeal carcinoma. Both smoking and smokeless tobacco act in synergy with each other.
Conway, Kevin P; Green, Victoria R; Kasza, Karin A; Silveira, Marushka L; Borek, Nicolette; Kimmel, Heather L; Sargent, James D; Stanton, Cassandra; Lambert, Elizabeth; Hilmi, Nahla; Reissig, Chad J; Jackson, Kia J; Tanski, Susanne E; Maklan, David; Hyland, Andrew J; Compton, Wilson M
Although non-cigarette tobacco product use is increasing among U.S. adults, their associations with substance use and mental health problems are unclear. This study examined co-occurrence of tobacco use, substance use, and mental health problems, and its moderation by gender, among 32,202U.S. adults from Wave 1 (2013-2014) of the nationally representative longitudinal Population Assessment of Tobacco and Health (PATH) Study. Participants self-reported current cigarette, e-cigarette, traditional cigar, cigarillo, filtered cigar, hookah, smokeless tobacco and other tobacco product use; past year alcohol, marijuana, and other drug use; and past year substance use, internalizing and externalizing problems. Compared to non-current tobacco users, current users were more likely to report alcohol or drug use (adjusted odds ratio (AOR)=2.6; 95% confidence interval (CI): 2.3, 2.9), with the strongest associations observed for cigarillo and hookah users. Across all tobacco product groups, users were more likely to report internalizing (AOR=1.9; 95% CI: 1.7, 2.1), externalizing (AOR=1.6; 95% CI: 1.5, 1.8), and substance use (AOR=3.4; 95% CI: 2.9, 4.1) problems than non-users. Gender moderated many of these associations and, of these, all non-cigarette tobacco product associations were stronger among females. This nationally representative study of U.S. adults is the first to comprehensively document tobacco use, substance use, and mental health comorbidities across the range of currently available tobacco products, while also demonstrating that female tobacco users are at increased risk for substance use and mental health problems. These findings may point to gender differences in vulnerability and suggest that interventions incorporate gender-specific approaches. Copyright © 2017 Elsevier B.V. All rights reserved.
Lynn T. Kozlowski
Full Text Available Abstract Background Leading themes have guided tobacco control efforts, and these themes have changed over the decades. When questions arose about health risks of tobacco, they focused on two key themes: 1 how bad is the problem (i.e., absolute risk and 2 what can be done to reduce the risk without cessation (i.e., prospects for harm reduction. Using the United States since 1964 as an example, we outline the leading themes that have arisen in response to these two questions. Initially, there was the recognition that “cigarettes are hazardous to health” and an acceptance of safer alternative tobacco products (cigars, pipes, light/lower-tar cigarettes. In the 1980s there was the creation of the seminal theme that “Cigarettes are lethal when used as intended and kill more people than heroin, cocaine, alcohol, AIDS, fires, homicide, suicide, and automobile crashes combined.” By around 2000, support for a less-dangerous light/lower tar cigarette was gone, and harm reduction claims were avoided for products like cigars and even for smokeless tobacco which were summarized as “unsafe” or “not a safe alternative to cigarettes.” Discussion The Surgeon General in 2014 concluded that by far the greatest danger to public health was from cigarettes and other combusted products. At the same time the evidence base for smokeless tobacco and alternative nicotine delivery systems (ANDS had grown. Product innovation and tobacco/nicotine bio-behavioral, epidemiological and public health sciences demonstrate that low nitrosamine smokeless tobacco (e.g., Swedish snus, and ANDS have substantially lower harms than cigarettes. Going forward, it is important to sharpen themes and key messages of tobacco control, while continuing to emphasize the extreme lethality of the inhaled smoke from cigarettes or from use of any combusting tobacco product. Summary Implications of updating the leading themes for regulation, policymaking and advocacy in tobacco control
Krogsgaard, M R; Frølich, A; Lund, B
alcohol consumption or cumulative tobacco consumption and bone mineral content in each group. Gastrectomized women smoked much more than control women, and smoking may be a determinant factor for the bone loss, as it is in healthy persons. Operated patients had a lower intake of milk products. All...... patients were exposed to sunlight for more than 3 hours/week. It is suggested that osteopenia after gastrectomy might be caused by calcium depletion rather than lack of vitamin D. The consumption of tobacco but not of alcohol was connected to bone loss....
Hayley, Amie C; Stough, Con; Downey, Luke A
The DSM-5 Tobacco use disorder diagnosis incorporates tobacco misuse, addictive behaviors and withdrawal symptomology. Tobacco use is bidirectionally associated with sleep pathology; however, no epidemiological studies have yet evaluated the associations between DSM-5 Tobacco use disorder and self-reported sleep disturbance. The current study aimed to evaluate health, medical and sleep-related factors among individuals within this diagnostic stratum. A total of N = 36,177 adults who participated in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III) were included for analyses. The adjusted odd ratios (AOR) for individual classifications of DSM-5 Tobacco use disorder among those with subjective sleep disturbances were used as the primary outcome measure and relevant demographic, clinical and medical factors were considered in all univariate and multivariable analyses. Current and lifetime DSM-5 tobacco use disorder diagnoses were associated with poorer health and medical outcomes and higher rates of subjective sleep disturbances (all p DSM-5 tobacco use disorder and subjective sleep disturbances were maintained in multivariable analyses following adjustment for a range of health, lifestyle, and psychiatric factors (adjusted OR 1.11, 95%CI 1.00-1.23 and adjusted OR = 1.24, 95%CI 1.15-1.34, respectively); however, these relationships were fully explained by diagnoses of DSM-5 alcohol use disorder. Data from this large, representative survey indicate that the association between DSM-5 Tobacco use disorder and sleep disturbance is explained by underlying diagnoses of DSM-5 alcohol use disorder. Multifaceted substance abuse treatment protocols may improve treatment outcomes for affected patient groups.
Isabel Cristina Gonçalves Leite
Full Text Available This hospital-based, case-control study investigated the possible associations between family history of malformations, parental consanguinity, smoking and alcohol drinking and nonsyndromic orofacial cleft (OC, subdivided in 2 main groups: CL/P - cleft lip with or without cleft palate and CP - cleft palate alone. 274 cases were matched (age, sex and place of residence to 548 controls. Odds ratios (OR and 95% confidence intervals (95% CI - adjusted for maternal age, schooling and smoking / alcohol use - were calculated by conditional logistic regression. The results demonstrated that the history of oral clefts either in the father's (CL/P: OR = 16.00, 5.64-69.23; CP: OR = 6.64, 1.48-33.75 or in the mother's family (CL/P: OR = 5.00, 2.31-10.99, CP: OR = 12.44, 1.33-294.87 was strongly associated with both types of clefts, but parental consanguinity was associated only with CL/P (OR = 3.8, 1.27-12.18. Prevalence of maternal smoking during the first trimester of pregnancy was higher among cases but the OR (1.13, 0.81-1.57 was not statistically significant. Maternal passive smoking (nonsmoking mothers during pregnancy was associated with CL/P (1.39, 1.01-1.98 but not with CP. Maternal alcohol use during the 1st trimester increased odds for CL/P (OR = 2.08, 1.27-3.41 and CP (OR = 2.89, 1.25-8.30, and odds for OC tended to increase with dose. Neither smoking nor alcohol use by fathers increased risks for OC. This study provides further evidence of a possible role of maternal exposure to tobacco smoke and alcohol in the etiology of nonsyndromic oral clefts.
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for pipe tobacco. 45.45a Section 45.45a Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO REMOVAL OF TOBACCO PRODUCTS AND CIGARETTE PAPERS AND TUBES...
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Record of processed tobacco. 40.182 Section 40.182 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS...
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for pipe tobacco. 41.72a Section 41.72a Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES...
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Authorization to package processed tobacco. 40.527 Section 40.527 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE...
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for pipe tobacco. 40.216a Section 40.216a Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS...
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Record of processed tobacco. 40.521 Section 40.521 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS...
Cook, Jessica W.; Fucito, Lisa M.; Piasecki, Thomas M.; Piper, Megan E.; Schlam, Tanya R.; Berg, Kristin M.; Baker, Timothy B.
Objective: Alcohol consumption is associated with smoking cessation failure in both community and clinical research. However, little is known about the relation between alcohol consumption and smoking cessation milestones (i.e., achieving initial abstinence, avoiding lapses and relapse). Our objective in this research was to examine the relations…
Jones, Deborah J.; Olson, Ardis L.; Forehand, Rex; Gaffney, Cecelia A.; Zens, Michael S.; Bau, J. J.
Four years of longitudinal data from 2,153 families with a 5th- or 6th-grade preadolescent participating in a family-focused pediatric primary-care-based prevention program were used to examine whether prevention effects were moderated by positive parenting and/or adolescent gender. Alcohol and tobacco use, internalizing problems, and…
Belcher, Harolyn M. E.; Lockhart, Paula J.; Perkins-Parks, Susan; McNally, Margaret
Describes an evaluation of a substance abuse prevention curriculum, Preventing the Abuse of Tobacco, Narcotics, Drugs, and Alcohol (PANDA), taught to African American Head Start preschool students, examining changes in children's self-concept following participation. Overall, students demonstrated significantly improved self-concept, and PANDA…
Blackman, Ian; de Crespigny, Charlotte; Parker, Steve
This study seeks to identify factors that influence the perceived complexity of providing nursing care to others (who are dependent on alcohol and tobacco) and the confidence of undergraduate student nurses to carry out this care. The research project is designed to explore whether there is a difference between the perceived complexities of 57…
Early epidemiologic studies have reported that tobacco smoking, which is causally associated with liver cancer, is an independent risk factor for non-alcoholic fatty liver diseases (NAFLD). Lycopene from tomatoes has been shown to be a potential preventive agent against NAFLD and hepatocellular carc...
Turhan, Abdullah; Onrust, Simone; ten Klooster, Peter M.; Pieterse, Marcel E.
AIMS: To test the effectiveness of the Healthy School and Drugs (HSD) programme on tobacco and alcohol use in Dutch secondary special education (SE) schools, and whether this depends upon subtypes of SE schools and the level of implementation. DESIGN: In a quasi-experimental design with baseline and
Zimmermann, Adam; Lubman, Dan I.; Cox, Merrilee
Previous research has consistently documented high rates of tobacco smoking and substance use disorders among young people with serious mental illness. However, limited studies have been conducted outside traditional clinical settings. In an attempt to address this shortfall and to better understand the needs of young people accessing its…
Jasna Čuk Rupnik
In this research by the abstinence of heroin the program of CPTAID fits to successful ones.By smoking of tobacco the patients treated with methadone are very endangered population. The percentage of chronicaly infected by hepatitis C viruses is lower compared to themajority of other European countries
Strycharz-Dudziak, Małgorzata; Nakonieczna-Rudnicka, Marta; Bachanek, Teresa; Kobyłecka, Elżbieta
Accessibility of the Internet allows obtaining information on different areas of life, including the impact of smoking, alcohol consumption and energy drinks on health. Environmental exposure to tobacco smoke and active smoking are a serious risk for women's health, especially for women in reproductive age and children at any time in their lives. Alcohol is a risk factor for the development of general diseases, and consumed by pregnant women has a toxic effect on the body of women and a child in the prenatal period. Due to the increased consumption of energy drinks containing among others nervous system stimulants and carbohydrates, their consumption should be a conscious choice of the consumers. Knowledge of the health risks resulting from the lifestyle can be a decisive factor for the implementation of health behaviour. The aim of the study was to determine the sources from which men and women acquire information concerning the effects of cigarette smoking, alcohol consumption and energy drinks on health. The respondents interest in the above mentioned subjects was also evaluated. The survey study was carried out in a group of 160 persons (114 women and 46 men), aged 19-60 years, randomly selected from the patients presenting to the Department of Conservative Dentistry with Endodontics of the Medical University of Lublin. An author's questionnaire was prepared for this research. The data were analyzed statistically with the use of Pearson's X2 test. Statistically significant test values were those with psource of information about the impact of smoking cigarettes on health for 52.63% women and 56.52% men, about the alcohol effect on health for 57.02% women and 45.65% men, while about energy drinks for 61.40 % of women and 47.83% men. Differences between sex of the respondents and indicated source of information were not statistically significant. Obtaining information from television programmes on the impact of smoking on health reported 70.18% of women and 63
Bandyopadhyay, Alokenath; Bhuyan, Lipsa; Panda, Abikshyeet; Dash, Kailash C; Raghuvanshi, Malvika; Behura, Shyam S
This study aimed to assess oral hygiene-related knowledge and practices among engineering students of Bhubaneswar city and also to evaluate the concepts about the side effects of tobacco usage among those students. The study was conducted using a self-administered, close-ended questionnaire to assess the oral hygiene knowledge and practices and study the concepts on tobacco usage among 362 engineering students of Bhubaneswar city, Odisha, India. The obtained data were statistically analyzed using Statistical Package for the Social Sciences software version 20.0. This survey found that 26.51% of the students had never visited a dentist. Nearly 43.64% of the participants were cognizant of the fact that improper brushing is the reason of tooth decay. About 47% of the participants consumed alcohol and 32.6% had the habit of chewing tobacco, though 80% were aware that use of smokeless tobacco can impair oral health and cause cancer and use of alcohol has detrimental effect on oral health. Knowledge with respect to oral health among engineering students of Bhubaneswar city is adequate regarding using fluoridated toothpaste and flosses. However, an unhealthy snacking habit, overusage of toothbrushes, consumption of alcohol, and practicing tobacco habit show the lack of oral health knowledge in these students. Our study provides an idea about the present scenario in terms of oral hygiene and tobacco usage in young individuals. This can form the basis for oral health education and tobacco cessation program. Moreover, as the habit of tobacco usage starts early during college life, adequate knowledge about its ill-effects would prevent deadly diseases, such as potentially malignant disorders and oral cancer.
Jané-Llopis, Eva; Matytsina, Irina
This paper reviews some major epidemiological studies undertaken in high-income countries during the last 15 years which have reported the prevalence of mental disorders and substance use disorders and their relationship. Comorbidity between mental and substance use disorders is highly prevalent across countries. In general, people with a substance use disorder had higher comorbid rates of mental disorders than vice versa, and people with illicit drug disorders had the highest rates of comorbid mental disorders. There is a strong direct association between the magnitude of comorbidity and the severity of substance use disorders. While causal pathways differ across substances and disorders, there is evidence that alcohol is a casual factor for depression, in some European countries up to 10% of male depression. Policies that reduce the use of substances are likely to reduce the prevalence of mental disorders. Treatment should be available in an integrated fashion for both mental and substance use disorders. There is a need to expand the evidence base on comorbidity, particularly in low-income countries.
Gaete, Jorge; Araya, Ricardo
We studied the association between individual and contextual variables and the use of tobacco, alcohol, or cannabis in the last 30 days preceding the study, considering the hierarchical nature of students nested in schools. We used the 7th Chilean National School Survey of Substance Use (2007) covering 45,273 students (aged 12-21 years old) along with information from 1465 schools provided by the Chilean Ministry of Education. Multilevel univariable and multivariable logistic regression models were performed. We found a significant intra-class correlation within schools for all substances in the study. Common (e.g., availability of pocket money, more time spent with friends, poor parental monitoring, poor school bonding, bullying others, and lower risk perception of substance use) and unique predictors (e.g., school achievement on national tests) were identified. These findings may help in planning and conducting preventive interventions to reduce substance use. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Full Text Available Youth tobacco, alcohol, and other substance abuse is a serious concern in the State of Florida, as well as across the nation. 4-H Health Rocks! is a positive youth development prevention program that utilizes experiential learning methods and youth-adult partnerships. The program and supporting curriculum were designed to foster personal and social skills to better equip adolescents to overcome pressures to participate in substance use. The purpose of this article is to describe the implementation of Health Rocks! in Florida and program evaluation including its impact on participants’ drug knowledge, drug beliefs and attitudes, and drug resistance skills. Program evaluation indicates that 4-H Health Rocks! resulted in statistically significant improvement in each of these categories for hundreds of youth reached in 2009-2012. The importance of program components in preventing and influencing adolescent substance abuse are discussed.
PSA helps raise retailers awareness of the new federal tobacco regulations related to sale of cigarettes and smokeless tobacco products to people under 18. Created: 7/8/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products. Date Released: 7/8/2010.
This podcast helps raise retailers awareness of the new federal tobacco regulations. Under the new regulations, retailers can not sell cigarettes or smokeless tobacco to anyone younger 18. Created: 7/8/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products. Date Released: 7/8/2010.
This podcast reviews new federal tobacco product regulations that require retailers to sell cigarettes and smokeless tobacco products in a face-to-face exchange. Created: 9/30/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products. Date Released: 9/30/2010.
Pachankis, John E.; Hatzenbuehler, Mark L.; Starks, Tyrel J.
Stigma occurs at both individual and structural levels, but existing research tends to examine the effect of individual and structural forms of stigma in isolation, rather than considering potential synergistic effects. To address this gap, our study examined whether stigma at the individual level, namely gay-related rejection sensitivity, interacts with structural stigma to predict substance use among young sexual minority men. Sexual minority (n = 119) participants completed online measures of our constructs (e.g., rejection sensitivity). Participants currently resided across a broad array of geographic areas (i.e., 24 U.S. states), and had attended high school in 28 states, allowing us to capture sufficient variance in current and past forms of structural stigma, defined as (1) a lack of state-level policies providing equal opportunities for heterosexual and sexual minority individuals and (2) negative state-aggregated attitudes toward sexual minorities. To measure daily substance use, we utilized a daily diary approach, whereby all participants were asked to indicate whether they used tobacco or alcohol on nine consecutive days. Results indicated that structural stigma interacted with rejection sensitivity to predict tobacco and alcohol use, and that this relationship depended on the developmental timing of exposure to structural stigma. In contrast, rejection sensitivity did not mediate the relationship between structural stigma and substance use. These results suggest that psychological predispositions, such as rejection sensitivity, interact with features of the social environment, such as structural stigma, to predict important health behaviors among young sexual minority men. These results add to a growing body of research documenting the multiple levels through which stigma interacts to produce negative health outcomes among sexual minority individuals. PMID:24507912
Odukoya Oluwakemi Ololade
Lagos state, Nigeria,. E-mail: firstname.lastname@example.org ... associated with cigarette smoking and alcohol drinking among this sample of men who .... measure nicotine addiction, the desire to smoke cigarettes first thing in the morning is a ...
Goncy, Elizabeth A; Mrug, Sylvie
This study examined the location and time of adolescent use of cigarettes, alcohol, and marijuana. Age, gender, and racial differences in location and time of use were studied for each substance. Using cross-sectional data collected through the schoolwide Pride Survey, 20,055 students between the ages of 10 and 19 years (53.6% female, 55.1% Black, 44.9% White) in one metropolitan area reported on their frequency of cigarette, alcohol, and marijuana use, as well as the location and time of use of each substance. Chi-square tests compared the rates, locations, and times for each substance across boys and girls; Black and White students; and early, middle, and late adolescents. Older adolescents reported higher rates of substance use at friends' homes, at school, and in cars and lower rates of alcohol use at home compared with younger youth. Males were more likely to report alcohol and marijuana use at school and on weeknights and alcohol use in cars, whereas females were more likely to report alcohol and marijuana use on the weekends. No gender differences emerged for times and locations of cigarette use. Compared with Black youth, White adolescents were more likely to use all substances at friends' homes and on weekends; to smoke cigarettes at school, in the car, and on weeknights; and to use alcohol at home. Black adolescents were more likely to report using alcohol at home, at school, in cars, during and after school, and on weeknights and were more likely to report using marijuana at school. The location and time of adolescent substance use vary substantially by age, gender, and race. These differences may help tailor substance use prevention and intervention programs to specific subgroups of youth to improve program effectiveness.
Barakate, Abdellah; Stephens, Jennifer; Goldie, Alison; Hunter, William N.; Marshall, David; Hancock, Robert D.; Lapierre, Catherine; Morreele, Kris; Boerjane, Wout
The manipulation of lignin could, in principle, facilitate efficient biofuel production from plant biomass. Despite intensive study of the lignin pathway, uncertainty exists about the enzyme catalyzing the last step in syringyl (S) monolignol biosynthesis, the reduction of sinapaldehyde to sinapyl alcohol. Traditional schemes of the pathway suggested that both guaiacyl (G) and S monolignols are produced by a single substrate-versatile enzyme, cinnamyl alcohol dehydrogenase (CAD). This was cha...
Tamborero Cao, G
Advertising undoubtedly influences our daily habits. In this sense, the promotion of cigarettes and alcoholic beverages is no exception, being a potential stimulus for their use. For the purpose of studying different aspects of the cigarette and alcoholic beverage advertising which appeared in a sample os Spanish weeklies was taken, these being six of the weeklies having one of the largest circulations, three of which were aimed mainly at women readers, while the other three were general information magazines. The advertising of these two products represents a significant percentage of the total advertising printed in the magazines studied (11%). The promotion of alcoholic beverages widely surpasses that of cigarettes (by 7 to 1). With regard to the groups of alcoholic beverages, whisky in the leading beverage advertised. The topics to which reference is made in the advertising slogans are widely varied, are lacking in informative elements and are limited to means of persuading one to identify with said product. Marked differences are observed between the magazines of providing general information magazines and those preferably aimed at women with regard to the amount and content of the advertising of cigarettes and alcoholic beverages. The methodological differences arising on studying the advertising-use relationship are discussed. Lastly, a number of activities for contradicting the effect of the massive advertising of cigarettes ald alcoholic beverages appearing in our weeklies are proposed.
Full Text Available The purpose of this study is to analyse the relation between risk and protective factor and substance use in adolescence, including tobacco use, drunkenness and consumption of illicit drugs. The sample included 3494 students, mean age 15 years old, in the 8th and 10th grades from the public school system, of primary and secondary schools in Portugal. Data collection was held within the HBSC (Health Behavior in School-aged Children survey from 2010. For the purpose of this specific study, the questionnaire includes questions about risk and protective behaviors and substance use, namely tobacco, drunkenness and illicit drug consumption. Results confirmed that adolescents with higher levels of protective factors seem to consume fewer substances and adolescents who present higher levels of risk factors are more likely to consume all the substances in the study. There were statistically significant differences for the majority of risk and protective behaviours regarding tobacco, drunkenness and illicit drugs. Although risk factors have a higher impact on substance use, the existence of protective factors seems to fade such impact.
Thrul, Johannes; Lisha, Nadra E.; Ling, Pamela M.
Purpose Use of other tobacco products (smokeless tobacco, hookah, cigarillo, e-cigarettes) is increasing, particularly among young adults, and there are few regulations on marketing for these products. We examined the associations between tobacco marketing receptivity and other tobacco product (OTP) use among young adult bar patrons (aged 18-26 years). Methods Time-location sampling was used to collect cross-sectional surveys from 7,540 young adult bar patrons from January 2012 through March of 2014. Multivariable logistic regression analyses in 2015 examined if tobacco marketing receptivity was associated (1) with current (past 30 day) OTP use controlling for demographic factors, and (2) with dual/poly use among current cigarette smokers (n=3,045), controlling for demographics and nicotine dependence. Results Among the entire sample of young adult bar patrons (Mage=23.7, SD=1.8; 48.1% female), marketing receptivity was consistently associated with current use of all OTP including smokeless tobacco (adjusted odds ratio [AOR]= 2.49, 95% confidence interval [CI] 1.90-3.27, pmarketing receptivity was significantly associated with use of smokeless tobacco (AOR=1.44, 95% CI 1.05-1.98, pmarketing receptivity. Efforts to limit tobacco marketing should address OTP in addition to cigarettes. PMID:27707516
Thrul, Johannes; Lisha, Nadra E; Ling, Pamela M
Use of other tobacco products (smokeless tobacco, hookah, cigarillo, and e-cigarettes) is increasing, particularly among young adults, and there are few regulations on marketing for these products. We examined the associations between tobacco marketing receptivity and other tobacco product (OTP) use among young adult bar patrons (aged 18-26 years). Time-location sampling was used to collect cross-sectional surveys from 7,540 young adult bar patrons from January 2012 through March of 2014. Multivariable logistic regression analyses in 2015 examined if tobacco marketing receptivity was associated (1) with current (past 30 day) OTP use controlling for demographic factors and (2) with dual/poly use among current cigarette smokers (n = 3,045), controlling for demographics and nicotine dependence. Among the entire sample of young adult bar patrons (Mean age = 23.7, standard deviation = 1.8; 48.1% female), marketing receptivity was consistently associated with current use of all OTP including smokeless tobacco (adjusted odds ratio [AOR]= 2.56, 95% confidence interval [CI] 2.08-3.16, p marketing receptivity was significantly associated with use of smokeless tobacco (AOR = 1.63, 95% CI 1.22-2.18, p marketing receptivity. Efforts to limit tobacco marketing should address OTP in addition to cigarettes. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available Pilar Horner1, Andy Grogan-Kaylor2, Jorge Delva2, Cristina B Bares3, Fernando Andrade4, Marcela Castillo51School of Social Work, Michigan State University, East Lansing, MI, USA; 2School of Social Work, University of Michigan, Ann Arbor, MI, USA; 3School of Social Work, Virginia Commonwealth University, Richmond, VA, USA; 4School of Education, University of Michigan, Ann Arbor, MI, USA; 5Instituto de Nutrición y Tecnología de los Alimentos (INTA, Universidad de Chile, Santiago, ChileAbstract: Research on adolescent use of substances has long sought to understand the family factors that may be associated with use of different substances such as alcohol, tobacco, and marijuana. However, scant attention has been focused on these questions in Latin American contexts, despite growing concerns about substance use among Latin American youth. Using data from a sample of 866 Chilean youth, we examined the relationship of family and neighborhood factors with youth substance abuse. We found that in a Latin American context, access to substances is an important predictor of use, but that neighborhood effects differ for marijuana use as opposed to cigarettes or alcohol. Age of youth, family and peer relationships, and gender all play significant roles in substance use. The study findings provide additional evidence that the use of substances is complex, whereby individual, family, and community influences must be considered jointly to prevent or reduce substance use among adolescents.Keywords: substance use, adolescence, international, peers
Couch, Elizabeth T; Chaffee, Benjamin W; Gansky, Stuart A; Walsh, Margaret M
Tobacco products in the United States and the patterns of tobacco use are changing. Although cigarette smoking prevalence has declined, dental professionals are likely to encounter substantial numbers of patients who have tried and are continuing to use new and alternative tobacco products, including cigars, water pipes (hookahs), and electronic cigarettes, as well as conventional and new smokeless tobacco products. The authors reviewed conventional and new tobacco products in the United States, their adverse oral and systemic health effects, and their prevalence of use. Tobacco products other than cigarettes account for a substantial portion of tobacco use. For this reason, tobacco-use prevention and cessation counseling provided by dental health care professionals must address all tobacco products, including cigarettes, cigars, water pipes, and electronic cigarettes, as well as conventional and new smokeless tobacco products. Cigarette smoking and smokeless tobacco use are associated with immediate and long-term adverse health effects, including nicotine addiction, oral and systemic disease, and death. Novel products may attract new tobacco users, potentially leading to addiction that results in enduring tobacco product use and associated adverse health effects. This critical review of conventional, new, and emerging tobacco products presents information that dental professionals can use in providing tobacco-related counseling to patients who use or who are at risk for using tobacco products. It is essential that dental professionals are knowledgeable about tobacco products and are able to answer patients' questions and provide them with evidence-based tobacco-related counseling. This information may prevent patients from initiating use or help reduce or cease use to avoid immediate and long-term adverse health effects, including nicotine addiction, oral and systemic disease, and death. Copyright © 2016 American Dental Association. Published by Elsevier Inc
Pierce, John P; Sargent, James D; White, Martha M; Borek, Nicolette; Portnoy, David B; Green, Victoria R; Kaufman, Annette R; Stanton, Cassandra A; Bansal-Travers, Maansi; Strong, David R; Pearson, Jennifer L; Coleman, Blair N; Leas, Eric; Noble, Madison L; Trinidad, Dennis R; Moran, Meghan B; Carusi, Charles; Hyland, Andrew; Messer, Karen
Non-cigarette tobacco marketing is less regulated and may promote cigarette smoking among adolescents. We quantified receptivity to advertising for multiple tobacco products and hypothesized associations with susceptibility to cigarette smoking. Wave 1 of the nationally representative PATH (Population Assessment of Tobacco and Health) study interviewed 10 751 adolescents who had never used tobacco. A stratified random selection of 5 advertisements for each of cigarettes, e-cigarettes, smokeless products, and cigars were shown from 959 recent tobacco advertisements. Aided recall was classified as low receptivity, and image-liking or favorite ad as higher receptivity. The main dependent variable was susceptibility to cigarette smoking. Among US youth, 41% of 12 to 13 year olds and half of older adolescents were receptive to at least 1 tobacco advertisement. Across each age group, receptivity to advertising was highest for e-cigarettes (28%-33%) followed by cigarettes (22%-25%), smokeless tobacco (15%-21%), and cigars (8%-13%). E-cigarette ads shown on television had the highest recall. Among cigarette-susceptible adolescents, receptivity to e-cigarette advertising (39.7%; 95% confidence interval [CI]: 37.9%-41.6%) was higher than for cigarette advertising (31.7%; 95% CI: 29.9%-33.6%). Receptivity to advertising for each tobacco product was associated with increased susceptibility to cigarette smoking, with no significant difference across products (similar odds for both cigarette and e-cigarette advertising; adjusted odds ratio = 1.22; 95% CI: 1.09-1.37). A large proportion of US adolescent never tobacco users are receptive to tobacco advertising, with television advertising for e-cigarettes having the highest recall. Receptivity to advertising for each non-cigarette tobacco product was associated with susceptibility to smoke cigarettes. Copyright © 2017 by the American Academy of Pediatrics.
Carter, Patrice; Bignardi, Giacomo; Hollands, Gareth J; Marteau, Theresa M
Reducing harmful consumption of food, alcohol, and tobacco products would prevent many cancers, diabetes and cardiovascular disease. Placing information-based cues in the environments in which we select and consume these products has the potential to contribute to changing these behaviours. In this review, information-based cues are defined as those which comprise any combination of words, symbols, numbers or pictures that convey information about a product or its use. We specifically exclude cues which are located on the products themselves. We conducted a systematic review of randomised, cluster- randomised, and non-randomised controlled trials to assess the impact of such cues on selection and consumption. Thirteen studies met the inclusion criteria, of which 12 targeted food (most commonly fruit and vegetables), one targeted alcohol sales, and none targeted tobacco products. Ten studies reported statistically significant effects on some or all of the targeted products, although studies were insufficiently homogenous to justify meta-analysis. Existing evidence suggests information-based cues can influence selection and consumption of food and alcohol products, although significant uncertainty remains. The current evidence base is limited both in quality and quantity, with relatively few, heterogeneous studies at unclear or high risk of bias. Additional, more rigorously conducted studies are warranted to better estimate the potential for these interventions to change selection and consumption of food, alcohol and tobacco products. PROSPERO. 2016; CRD42016051884 .
Full Text Available Objective. To examine and compare overall prevalence and time trends in tobacco and alcohol portrayals and brand appearances in youth-rated US and nationally-produced films that were the most successful in Argentina and Mexico from 2004-2012. Materials and methods. Top-grossing nationally produced films from Argentina (n=73, Mexico (n=85 and the US (n=643 were content analyzed. Logistic regression was used to determine differences between Mexican, Argentine and US produced films. Linear regression models assessed significant cross-country differences in the mean number of tobacco and alcohol seconds. Results. Films from Mexico and Argentina were more likely than US films to contain tobacco, (OR=4.2; p<0.001 and (OR=7.2; p<0.001. Alcohol was present in 93% of Argentine, 83% in Mexican and 83% US films. Conclusions. Smoking and alcohol were highly prevalent in nationally produced films. They may have a significant impact and should be targeted by policies to reduce youth exposure to portrayals of risk behaviors.
Cole, Adam G; Kennedy, Ryan David; Chaurasia, Ashok; Leatherdale, Scott T
Within tobacco prevention programming, it is useful to identify youth that are at risk for experimenting with various tobacco products and e-cigarettes. The susceptibility to smoking construct is a simple method to identify never-smoking students that are less committed to remaining smoke-free. However, the predictive validity of this construct has not been tested within the Canadian context or for the use of other tobacco products and e-cigarettes. This study used a large, longitudinal sample of secondary school students that reported never using tobacco cigarettes and non-current use of alternative tobacco products or e-cigarettes at baseline in Ontario, Canada. The sensitivity, specificity, and positive and negative predictive values of the susceptibility construct for predicting tobacco cigarette, e-cigarette, cigarillo or little cigar, cigar, hookah, and smokeless tobacco use one and two years after baseline measurement were calculated. At baseline, 29.4% of the sample was susceptible to future tobacco product or e-cigarette use. The sensitivity of the construct ranged from 43.2% (smokeless tobacco) to 59.5% (tobacco cigarettes), the specificity ranged from 70.9% (smokeless tobacco) to 75.9% (tobacco cigarettes), and the positive predictive value ranged from 2.6% (smokeless tobacco) to 32.2% (tobacco cigarettes). Similar values were calculated for each measure of the susceptibility construct. A significant number of youth that did not currently use tobacco products or e-cigarettes at baseline reported using tobacco products and e-cigarettes over a two-year follow-up period. The predictive validity of the susceptibility construct was high and the construct can be used to predict other tobacco product and e-cigarette use among youth. This study presents the predictive validity of the susceptibility construct for the use of tobacco cigarettes among secondary school students in Ontario, Canada. It also presents a novel use of the susceptibility construct for
Inicio en el consumo de alcohol y tabaco y transición a otras drogas en estudiantes de Morelos, México Onset of alcohol and tobacco use and transition to other drug use among students from Morelos, Mexico
Full Text Available OBJETIVO: Estimar la probabilidad acumulada de ocurrencia del primer uso de alcohol y tabaco, y el riesgo de transitar hacia el uso inicial de otras sustancias (marihuana, cocaína y heroína, entre otras en estudiantes adolescentes y adultos jóvenes de Morelos, México. MATERIAL Y MÉTODOS: Se llevó a cabo un estudio transversal en el ciclo escolar 1998-1999, en el estado de Morelos, en una muestra probabilística de estudiantes de entre 11 a 24 años de edad (n=13 293 a quienes se distribuyó un cuestionario auto-aplicable validado. Los datos se restructuraron para construir una cohorte sintética que se estudió con métodos de sobrevida y unidades discretas de tiempo. Se obtuvieron riesgos relativos y sus intervalos de confianza de 95%, con modelos multivariados de regresión de Cox. RESULTADOS: Sesenta por ciento de los varones iniciaron el uso de alcohol en promedio a los 17 y el uso de tabaco a los 18 años de edad. Las mujeres iniciaron el uso de alcohol y tabaco un año después que los hombres. El uso de otras drogas ocurrió a los 19 años de edad en promedio en 5% de las mujeres y 13% de los varones. Nueve de cada 100 estudiantes que consumieron drogas ilegales iniciaron directamente sin antes haber usado alcohol ni tabaco. En general, los estudiantes usuarios de alcohol o tabaco, o ambos, presentaron mayor riesgo de iniciar el uso de otras drogas que los no usuarios (RR=6.72; IC 95%=4.13-10.93. CONCLUSIONES: Son claras las implicaciones potenciales del presente estudio al considerar que, junto con intervenciones encaminadas a disminuir el consumo de drogas, resulta igualmente importante retardar la edad de inicio de alcohol y tabaco por sexo, ya que mediante un nuevo enfoque brinda evidencia epidemiológica que relaciona el uso de estas sustancias con el uso posterior de otras drogas en estudiantes mexicanos.OBJECTIVE: To estimate the cumulative probability of occurrence of first use of alcohol and tobacco, and the risk of
Concentration of 90 Sr and 20 Po in kidneys and bone tissues was measured both separately and in combination with ethanol introduction. Carbon oxide (CO), which content was measured by a gas analyser, served as an index of tobacco smokes in a chamber with test animals. It is shown that ethanol had no noticeable effect either on the character or the levels of radionuclide accumulation in kidneys and bone tissues. Under experimental conditions quantitative characteristics of studied factors (intensity, the effect time and levels) remained stable within the specified limits independent on their combination
Dhumal, G G; Pednekar, M S; Gupta, P C; Sansone, G C; Quah, A C K; Bansal-Travers, M; Fong, G T
Global Adult Tobacco Survey India 2009-2010 revealed that more than one-third (35%) of adults in India use tobacco in some form: 21% use smokeless tobacco, 9% smoke, and 5% are mixed users (they smoke and use smokeless tobacco), and the quit rate is very low. In an effort to decrease prevalence of tobacco use, it is thus important to understand the factors that are related to intention to quit among Indian tobacco users. Research has shown consistently that intention to quit is a strong predictor of future quitting. The present study reports the factors encouraging quitting tobacco products in India. Cross-sectional data from Wave 1 of the International Tobacco Control Policy Evaluation India Survey conducted in four cities and surrounding rural areas (i.e. Mumbai [Maharashtra], Patna [Bihar], Indore [Madhya Pradesh], and Kolkata [West Bengal]) between August 2010 and December 2011 were analyzed. A total of 8051 tobacco users (15+ years) were randomly sampled from 8586 households: 1255 smokers, 5991 smokeless users, and 805 mixed (smoke and smokeless) users. Validated, standardized questions were asked about current tobacco use, intention to quit, and factors encouraging quitting. Overall, 19.6% of tobacco users intended to quit. Smokers had less intention to quit as compared to smokeless tobacco users whereas mixed users had more intention to quit (odds ratio [OR] =1.48, 95% confidence interval [CI] =1.12-1.97) compared to smokeless tobacco users. Highly educated people were more likely to report intention to quit (OR = 1.82, 95% CI = 1.09-3.02) compared to less educated. Advice by doctors to quit tobacco had a strong impact on intention to quit (OR = 1.68, CI = 1.29-2.15). Tobacco users who were exposed to antitobacco messages at work places (OR = 1.74, CI = 1.23-2.46), at restaurants (OR = 1.65, CI = 1.12-2.43), bars (OR = 1.81, CI = 1.07-3.06), on public transportation (OR = 2.14, CI = 1.49-3.08) and on tobacco packages (OR = 1.77, CI = 1.29-2.14) also
Módena, Sérgio Ferreira; Caldeira, Eduardo José; Peres, Marco Antonio O; Andreollo, Nelson Adami
New findings point out that the mechanism of formation of the hernias can be related to the collagenous tissues, under activity of aggressive agents such as the tobacco, alcohol and diabetes. To analyze the collagen present in the cremaster muscle in patients with inguinal hernias, focusing the effect of tobacco, alcohol, and diabetes. Fifteen patients with inguinal hernia divided in three groups were studied: group I (n=5) was control; group II (n=5) were smokers and/or drinkers; and group III (n=5) had diabetes mellitus. All subjects were underwent to surgical repair of the inguinal hernias obeying the same pre, intra and postoperative conditions. During surgery, samples of the cremaster muscle were collected for analysis in polarized light microscopy, collagen morphometry and protein. The area occupied by the connective tissue was higher in groups II and III (ptabaco, o álcool e o diabete. Avaliar o colágeno presente no músculo cremaster em pacientes com hérnias inguinais enfocando o efeito do tabaco, álcool e diabete. Foram estudados 15 pacientes com hérnias inguinais divididos em: grupo I (n=5) controles; grupo II (n=5) indivíduos fumantes e/ou etilistas; e grupo III (n=5) indivíduos que apresentavam diabete melito. Todos foram submetidos à correção cirúrgica das hérnias inguinais obedecendo às mesmas condições pré, intra e pós-operatórias. Durante o procedimento cirúrgico, amostras do músculo cremaster foram coletadas para análises em microscopia de luz polarizada, morfometria do colágeno e de proteínas. A área ocupada por tecido conjuntivo foi maior nos grupos II e III (ptabaco, o álcool e o diabete ocasionam remodelação no músculo cremaster, levando à perda de suporte ou alteração estrutural nesta região, podendo intensificar as ocorrências e os danos relacionados às hérnias inguinais.
paucity of cessation clinics in India. Women are reluctant and fear the stigma of approaching cessation clinics. Proactive measures must be used to motivate women to go through the cessation follow up.
Full Text Available AIMS – Our aim was to assess the demographic and social factors associated with lifetime use of tobacco, alcohol and cannabis among school students aged 15–16 in Albania in order to make information and knowledge available for health promotion specialists working on substance use prevention. DESIGN – This cross-sectional study was conducted in March–May 2011 in the framework of the European School Survey Project on Alcohol and Other Drugs (ESPAD. In total, 3189 students born in 1995 participated in the survey. The standardised ESPAD questionnaire was used to collect data about substance use. RESULTS – Our multivariable adjustment analysis showed that being a male and having easy access to cigarettes were the only universal factors significantly increasing the likelihood of ever using tobacco, alcohol or cannabis. Own smoking was strongly and significantly associated with alcohol and cannabis use. The associations of own substance use with peer substance consumption were weak to moderate. CONCLUSIONS – Own smoking seems to be the most important single independent risk factor which strongly and significantly predicted alcohol and cannabis use among Albanian school students. Policy makers need to strengthen the rule of law whereas health promotion professionals should firmly address smoking in adolescence through target interventions.
Perez, Arlene de Maria; Benseñor, Isabela Martins
The lifestyle of military personnel has been little studied in Brazil. This study evaluated the frequencies of tobacco and alcohol use, sexual behavior and mental health among military students. Cross-sectional study at the Police Academy, in São Paulo. Students answered a questionnaire about tobacco use, alcohol consumption, sexual behavior and common mental disorders (CMDs). To analyze associations among the frequencies of smoking and alcohol use, sexually transmitted diseases (STDs) and CMDs during the undergraduate years, we built a multinomial logistic regression model adjusted for age and sex. All 473 students were invited to participate and 430 (90.9%) agreed (10.5% were women). Most were white (76.6%), aged < 30 years, from the upper middle class (78.1%). The frequency of smoking was 6.5%, alcohol consumption 69.3%, STDs 14% and CMDs 15.6%. The use of condoms was low. Fourth-year students presented a lower odds ratio (OR) for STDs than the first-year students: 0.44 (95% confidence interval: 0.22-0.90). Third-year students presented a lower OR for CMDs than the first-year students. The frequencies of smoking and CMDs were low, while the frequency of alcohol consumption was similar to that of the Brazilian population. The use of condoms was low, in comparison with previous studies with similar samples. The results suggest that there was a certain degree of protection against CMDs and STDs during the undergraduate years.
Harrell, Paul T; Naqvi, Syeda Mahrukh H; Plunk, Andrew D; Ji, Ming; Martins, Silvia S
Despite significant declines in youth cigarette smoking, overall tobacco usage remains over 20% as non-cigarette tobacco product usage is increasingly common and polytobacco use (using 1+ tobacco product) remains steady. The present study was designed to identify patterns of youth tobacco use and examine associations with sociodemographic characteristics and tobacco dependence. The current analysis uses Latent Class Analysis (LCA) to examine the 6,958 tobacco users (n = 2,738 female) in the National Youth Tobacco Survey (2012 and 2013). We used as indicators past month use of tobacco products (cigarettes, cigars, smokeless tobacco, e-cigarettes, hookah, snus, pipes, bidis, and kreteks) and regressed resulting classes on sociodemographic characteristics and tobacco dependence. Nine classes emerged: cigarette smokers (33.4% of sample, also included small probabilities for use of cigars and e-cigarettes), cigar smokers (16.8%, nearly exclusive), smokeless tobacco users (12.3%, also included small probabilities for cigarettes, cigars, snus), hookah smokers (11.8%), tobacco smokers/chewers (10.7%, variety of primarily traditional tobacco products), tobacco/hookah smokers (7.2%), tobacco/snus/e-cig users (3.3%), e-cigarette users (2.9%,), and polytobacco users (1.7%, high probabilities for all products). Compared to cigarette smokers, tobacco/hookah smokers and hookah smokers were more likely to report Hispanic ethnicity. Polytobacco users were more likely to report dependence (AOR:2.77, 95% CI:[1.49-5.18]), whereas e-cigarette users were less likely (AOR:0.49, 95% CI:[0.24-0.97]). Findings are consistent with other research demonstrating shifts in adolescent tobacco product usage towards non-cigarette tobacco products. Continuous monitoring of these patterns is needed to help predict if this shift will ultimately result in improved public health.
Mohanan, Padma; Swain, Subhashisa; Sanah, Noore; Sharma, Vikram; Ghosh, Deboporna
Objectives: The aim of this study was to assess the prevalence of alcohol consumption, tobacco use and risky sexual behaviour among adolescents, and to evaluate the socioeconomic factors potentially influencing these behaviours. Methods: This cross-sectional study was conducted from January to April 2011 among 376 adolescents (15–19 years old) studying in different schools and colleges in Udupi, India. The Youth Risk Behavior Survey questionnaire and guidelines were followed for data collecti...
Bonhomme, Michèle G; Holder-Hayes, Enver; Ambrose, Bridget K; Tworek, Cindy; Feirman, Shari P; King, Brian A; Apelberg, Benjamin J
Limited data exist on flavoured non-cigarette tobacco product (NCTP) use among US adults. Data from the 2013 to 2014 National Adult Tobacco Survey (N=75 233), a landline and cellular telephone survey of US adults aged ≥18, were assessed to estimate past 30-day NCTP use, flavoured NCTP use and flavour types using bivariate analyses. During 2013-2014, 14.4% of US adults were past 30-day NCTP users. Nationally, an estimated 10.2 million e-cigarette users (68.2%), 6.1 million hookah users (82.3%), 4.1 million cigar smokers (36.2%) and 4.0 million smokeless tobacco users (50.6%) used flavoured products in the past 30 days. The most prevalent flavours reported were menthol/mint (76.9%) for smokeless tobacco; fruit (74.0%) for hookah; fruit (52.4%), candy/chocolate/other sweet flavours (22.0%) and alcohol (14.5%) for cigars/cigarillos/filtered little cigars; fruit (44.9%), menthol/mint (43.9%) and candy/chocolate/other sweet flavours (25.7%) for e-cigarettes and fruit (56.6%), candy/chocolate/other sweet flavours (26.5%) and menthol/mint (24.8%) for pipes. Except for hookah and pipes, past 30-day flavoured product use was highest among 18-24-year olds. By cigarette smoking, never smoking e-cigarette users (84.8%) were more likely to report flavoured e-cigarette use, followed by recent former smokers (78.1%), long-term former smokers (70.4%) and current smokers (63.2%). Flavoured NCTP use is prominent among US adult tobacco users, particularly among e-cigarette, hookah and cigar users. Flavoured product use, especially fruit and sweet-flavoured products, was higher among younger adults. It is important for tobacco prevention and control strategies to address all forms of tobacco use, including flavoured tobacco products. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Elmore, Kristen; Scull, Tracy M.; Kupersmidt, Janis B.
Adolescents’ media environment offers information about who uses substances and what happens as a result—how youth interpret these messages likely determines their impact on normative beliefs about alcohol and tobacco use. The Message Interpretation Processing (MIP) theory predicts that substance use norms are influenced by cognitions associated with the interpretation of media messages. This cross-sectional study examined whether high school adolescents’ (n=817, 48% female, 64% white) media-related cognitions (i.e., similarity, realism, desirability, identification) were related to their perceptions of substance use norms. Results revealed that adolescents’ media-related cognitions explained a significant amount of variance in perceived social approval for and estimated prevalence of peer alcohol and tobacco use, above and beyond previous use and demographic covariates. Compared to prevalence norms, social approval norms were more closely related to adolescents’ media-related cognitions. Results suggest that critical thinking about media messages can inhibit normative perceptions that are likely to increase adolescents’ interest in alcohol and tobacco use. PMID:27837371
Full Text Available Abstract Background Health behaviours among doctors has been suggested to be an important marker of how harmful lifestyle behaviours are perceived. In several countries, decrease in smoking among physicians was spectacular, indicating that the hazard was well known. Historical data have shown that because of their higher socio-economical status physicians take up smoking earlier. When the dangers of smoking become better known, physicians began to give up smoking at a higher rate than the general population. For alcohol consumption, the situation is quite different: prevalence is still very high among physicians and the dangers are not so well perceived. To study the situation in Switzerland, data of a national survey were analysed to determine the prevalence of smoking and alcohol drinking among primary care physicians. Methods 2'756 randomly selected practitioners were surveyed to assess subjective mental and physical health and their determinants, including smoking and drinking behaviours. Physicians were categorised as never smokers, current smokers and former smokers, as well as non drinkers, drinkers (AUDIT-C Results 1'784 physicians (65% responded (men 84%, mean age 51 years. Twelve percent were current smokers and 22% former smokers. Sixty six percent were drinkers and 30% at risk drinkers. Only 4% were never smokers and non drinkers. Forty eight percent of current smokers were also at risk drinkers and 16% of at risk drinkers were also current smokers. Smoking and at risk drinking were more frequent among men, middle aged physicians and physicians living alone. When compared to a random sample of the Swiss population, primary care physicians were two to three times less likely to be active smokers (12% vs. 30%, but were more likely to be drinkers (96% vs. 78%, and twice more likely to be at risk drinkers (30% vs. 15%. Conclusion The prevalence of current smokers among Swiss primary care physicians was much lower than in the general
Strong, David R; Myers, Mark G; Pulvers, Kim; Noble, Madison; Brikmanis, Kristin; Doran, Neal
With an increase in marijuana use among adults in the United States (US), understanding the potential impact of marijuana use on tobacco use and associated behavioral and health consequences, including respiratory conditions, is necessary. Survey responses from Wave 1 of the nationally representative Population Assessment of Tobacco and Health (PATH) Study were used to assess tobacco use and marijuana use among non-current tobacco users (n = 17,952) and current established tobacco-users classified as: cigarette only users (n = 8689), e-cigarette only users (n = 437), cigar only (traditional, cigarillo, or filtered) users (n = 706), hookah only users (n = 461), smokeless tobacco only users (n = 971), cigarette + e-cigarette users (n = 709), and users of multiple tobacco products (n = 2314). When compared to non-current tobacco users, each tobacco user group except smokeless only users had higher odds (odds ratios ranging from 3.86-8.07) of reporting current marijuana use. Among current tobacco users, higher levels of tobacco dependence did not explain the relationship between tobacco use and marijuana use. Additionally, concurrent marijuana use was associated with lower odds of attempts to quit tobacco (OR = 0.86, 95% CI = 0.79, 0.94, p users of tobacco and marijuana. Copyright © 2018 Elsevier B.V. All rights reserved.
Lindgren, Kristen P; Neighbors, Clayton; Gasser, Melissa L; Ramirez, Jason J; Cvencek, Dario
This paper provides an overview of the self-concept as it relates to substance use. Self-concept has a long history in psychological theory and research; however, substance self-concept (e.g., viewing one's self as a drinker or smoker) is an understudied area of research with the potential to expand existing conceptualizations of substance use, addiction, and prevention and treatment efforts, and should receive greater research attention. First, we review and provide a theoretical framework of substance self-concept that draws from dual process models and distinguishes between implicit and explicit self-concept. Next, we summarize key findings related to substance use in the extant literature, focusing on alcohol and tobacco (smoking). Across both substances, there is converging evidence that substance self-concept is associated with substance use outcomes, including quantity and frequency of use and problems associated with use, and that change in substance self-concept is associated with recovery from substance misuse. Recommendations for the substance self-concept research agenda include routine assessment of substance self-concept, expanded use of implicit measures, investigation of moderators of substance self-concept, and targeting substance self-concept directly in prevention and intervention efforts. Ultimately, we suggest that substance self-concept is a promising, but understudied, construct. Greater research attention to substance self-concept could clarify its potential as an important risk factor for hazardous use and addiction as well as its utility as a prevention and treatment target.
Russell, Cristel Antonia; Russell, Dale W
Television (TV) is a key socialization agent, especially amongst youth. According to cultivation theory, youth heavily exposed to TV content, where positive images of smoking and drinking abound, should hold more positive beliefs concerning drinking and smoking outcomes. This research investigates the role of the sensation-seeking personality trait in moderating this TV cultivation effect. A French national research company contacted its panel members with children aged 13-17. Parents completed a short survey and were asked for consent for their child to participate in a study. The children were then contacted, informed, and asked for assent. Assenters completed a survey that included measures of TV exposure, personality traits, drinking and smoking behaviors, and beliefs about the outcomes associated with drinking and smoking (expectancies). Parental drinking, smoking, and strictness were included as controls. Survey data from 1040 adolescents (54.2% males) and their parents reveal that the relationship between cumulative TV exposure and drinking and smoking behavior, mediated through expectancies, is strongest amongst high sensation seeking adolescents. The moderated mediation analysis shows that sensation seeking trait moderates the relationship between TV exposure and the beliefs adolescents hold about the consequences of alcohol and tobacco use, which themselves are related to greater likelihood to engage in substance use. Key personality traits and TV exposure levels must be accounted for to identify youth at risk of using substances at a time when many lifelong maladaptive behaviors and beliefs form. Copyright © 2018 Elsevier B.V. All rights reserved.
Full Text Available OBJETIVO: Cuantificar la asociación entre orientación al rol de género y uso de tabaco y alcohol en jóvenes del estado de Morelos. MATERIAL Y MÉTODOS: Estudio transversal realizado en 2004-2005, en jóvenes de 14 a 24 años (n=1 730. Variables sociodemográficas (zona de residencia, nivel socioeconómico; familiares (educación y violencia paternal; psicosociológicas (rol de género, autoestima, depresión, consumo de alcohol, tabaco, locus de control, abuso sexual. Análisis por regresión logística. RESULTADOS: Factores asociados con uso de tabaco: en mujeres, andrógina, no deseable, machista, intento de abuso sexual y zona urbana. Para hombres, depresión y sumisión. Factores asociados con uso de alcohol: en mujeres, rol masculino, y hombres, edad más de 20 años, vivir en zona semiurbana y urbana y locus interno. CONCLUSIONES: El machismo es una de las orientaciones al rol de género con mayor asociación con el uso de tabaco principalmente en las jóvenes, y la orientación masculina o instrumental se asocia con el alcohol.OBJECTIVE: To quantify the association between gender role orientation and tobacco and alcohol use among young people of the State of Morelos. MATERIALS AND METHODS: Study conducted in 2004-2005, students aged 14 to 24 years (n = 1 730. Sociodemographic variables (area of residence, socioeconomic status, family (parental education and violence, psycho-sociological (gender role, self-esteem, depression, alcohol consumption, tobacco, locus of control, sexual abuse. Logistic regression analysis. RESULTS: Factors associated with use of tobacco: In women, being androgynous undesirable, masculine role, attempted sexual abuse and urban areas. For men, depression and submission. Factors associated with alcohol use: In women, masculine gender role; and in men to be older than 20 years, living in semi-urban and urban area, and internal locus. CONCLUSIONS: The machismo is one of the gender role orientations with greater
Brock, Betsy; Choi, Kelvin; Boyle, Raymond G; Moilanen, Molly; Schillo, Barbara A
In 2013, the State of Minnesota Legislature passed a tobacco tax increase that increased the combined cigarette excise and sales tax by US$1.75 (from US$1.60 to US$3.35) and increased the tax on non-cigarette tobacco products from 70% to 95% of the wholesale price. The current study explores the change in tobacco prices in retail locations and whether the tax increase was fully passed to consumers. An observational study of tobacco retail prices was performed in a sample of 61 convenience stores in Minnesota, North Dakota, South Dakota and Wisconsin. Six rounds of data were collected between May 2013 and January 2014. In each round, purchases were made at the same stores for the same four tobacco products (Camel Blue cigarettes, Marlboro Gold cigarettes, Grizzly Wintergreen moist smokeless tobacco and Copenhagen Wintergreen moist smokeless tobacco). For all studied tobacco products, prices in Minnesota increased significantly after the tax increase (Round 1-Round 6). After controlling for price changes in neighbouring states, the average price difference in Minnesota for the two cigarette brands increased by US$1.89 and US$1.81, which are both more than the US$1.75 tax increase. For moist smokeless, the average price difference increased by US$0.90 and US$0.94. Significant price changes were not observed in the comparison states. After the introduction of the minimum moist smokeless tax, a significantly higher proportion of Minnesota stores offered price promotions on smokeless tobacco. A large tobacco tax resulted in an average retail cigarette price exceeding the tax, suggesting the industry over-shifted the cigarette tax increase to consumers in Minnesota. The findings support the known public health benefit of tobacco tax increases while highlighting the need for additional information about how, or if, tobacco companies use price promotions to blunt the impact of tax increases. Published by the BMJ Publishing Group Limited. For permission to use (where not
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Manufacture of tobacco... MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Scope of Regulations § 40.1 Manufacture of tobacco products, cigarette papers and tubes, and processed tobacco. This part contains...
Bairstow, B M; Burke, V; Beilin, L J; Deutscher, C
The records of 62 men and 43 women, 14-88 years old, admitted to general medical wards in a public teaching hospital during 1991 were examined for discharge medications and for the recording of alcohol-drinking, tobacco-smoking and discharge diagnosis. Drinking and smoking status was unrecorded in 22.9% and 21.9% of patients respectively. Twenty-four patients had 31 potential drug interactions which were related to the number of drugs prescribed and to drinking alcohol; 10.5% of the patients had interactions involving alcohol and 2.9% tobacco. Six patients received relatively or absolutely contraindicated drugs, including one asthmatic given two beta-blockers. The drugs prescribed indicated that some patients had conditions such as gastro-oesophageal disorders, diabetes and obstructive airways disease which had not been recorded. Inadequate recording of diagnoses, alcohol and smoking status creates risks to patients and may cause opportunities for preventive care to be missed. This study provides the basis for the development of undergraduate and postgraduate education programmes to address these issues and so decrease risks to patients which arise from inadequate recording practices. Incomplete diagnoses also adversely affect hospital funding where this depends on case-mix diagnostic groups. Quality assurance programmes and other strategies are being implemented to improve medical recording and prescribing habits.
Thrasher, James F.; Sargent, James D.; Vargas, Rosa; Braun, Sandra; Barrientos-Gutierrez, Tonatiuh; Sevigny, Eric L.; Billings, Deborah L.; Arillo-Santillán, Edna; Navarro, Ashley; Hardin, James
Background This study aimed to determine between-country differences and changes over time in the portrayal of youth risk behaviors in films rated for youth in Argentina, Brazil, Mexico and the United States. Methods Content and ratings were analyzed for 362 films that were popular across all four countries from 2002–2009. Country-specific ratings were classified as either youth or adult, and Generalized Estimating Equations were used to determine between-country differences in the presence of tobacco, alcohol, drugs, sexual content, and violence in youth-rated films. Within-country differences in this content over time were also assessed, comparing films released from 2002–2005 with those released from 2006–2009. Results In the US, films rated for youth were less likely to contain all five risk behaviors than in youth-rated films in Argentina, Brazil, and, when the “15 and older” rating was considered a youth rating, in Mexico. All three Latin American countries “downrated” films that received an adult rating in the US. Nevertheless, tobacco and drug use in youth-rated films declined over time in all countries, whereas moderate to extreme alcohol use and violence involving children or youth increased in all countries. Conclusions Tobacco and drug use have declined in popular US films, but these behaviors are still prevalent in films rated for youth across the Americas. The apparent success of advocacy efforts to reduce tobacco and other drugs in films suggests that similar efforts be directed to reduce alcohol portrayals. PMID:24316001
Thrasher, James F; Sargent, James D; Vargas, Rosa; Braun, Sandra; Barrientos-Gutierrez, Tonatiuh; Sevigny, Eric L; Billings, Deborah L; Arillo-Santillán, Edna; Navarro, Ashley; Hardin, James
This study aimed to determine between-country differences and changes over time in the portrayal of youth risk behaviors in films rated for youth in Argentina, Brazil, Mexico and the United States. Content and ratings were analyzed for 362 films that were popular across all four countries from 2002 to 2009. Country-specific ratings were classified as either youth or adult, and Generalized Estimating Equations were used to determine between-country differences in the presence of tobacco, alcohol, drugs, sexual content, and violence in youth-rated films. Within-country differences in this content over time were also assessed, comparing films released from 2002 to 2005 with those released from 2006 to 2009. In the US, films rated for youth were less likely to contain all five risk behaviors than in youth-rated films in Argentina, Brazil, and, when the "15 and older" rating was considered a youth rating, in Mexico. All three Latin American countries "downrated" films that received an adult rating in the US. Nevertheless, tobacco and drug use in youth-rated films declined over time in all countries, whereas moderate to extreme alcohol use and violence involving children or youth increased in all countries. Tobacco and drug use have declined in popular US films, but these behaviors are still prevalent in films rated for youth across the Americas. The apparent success of advocacy efforts to reduce tobacco and other drugs in films suggests that similar efforts be directed to reduce alcohol portrayals. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for roll-your-own tobacco. 40.216b Section 40.216b Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS...
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for roll-your-own tobacco. 45.45b Section 45.45b Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO REMOVAL OF TOBACCO PRODUCTS AND CIGARETTE PAPERS...
... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Notice for roll-your-own tobacco. 41.72b Section 41.72b Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS...
... because that's how many accidents occur. What Is Alcoholism? What can be confusing about alcohol is that ... develop a problem with it. Sometimes, that's called alcoholism (say: al-kuh-HOL - ism) or being an ...
If you are like many Americans, you drink alcohol at least occasionally. For many people, moderate drinking ... risky. Heavy drinking can lead to alcoholism and alcohol abuse, as well as injuries, liver disease, heart ...
Navarro Junior, L.
The alcohol production as a secondary energy source, the participation of the alcohol in Brazilian national economic and social aspects are presented. Statistical data of alcohol demand compared with petroleum by-products and electricity are also included. (author)
Sadeu, J C; Hughes, Claude L; Agarwal, Sanjay; Foster, Warren G
Reproductive function and fertility are thought to be compromised by behaviors such as cigarette smoking, substance abuse, and alcohol consumption; however, the strength of these associations are uncertain. Furthermore, the reproductive system is thought to be under attack from exposure to environmental contaminants, particularly those chemicals shown to affect endocrine homeostasis. The relationship between exposure to environmental contaminants and adverse effects on human reproductive health are frequently debated in the scientific literature and these controversies have spread into the lay press drawing increased public and regulatory attention. Therefore, the objective of the present review was to critically evaluate the literature concerning the relationship between lifestyle exposures and adverse effects on fertility as well as examining the evidence for a role of environmental contaminants in the purported decline of semen quality and the pathophysiology of subfertility, polycystic ovarian syndrome, and endometriosis. The authors conclude that whereas cigarette smoking is strongly associated with adverse reproductive outcomes, high-level exposures to other lifestyle factors are only weakly linked with negative fertility impacts. Finally, there is no compelling evidence that environmental contaminants, at concentrations representative of the levels measured in contemporary biomonitoring studies, have any effect, positive or negative, on reproductive health in the general population. Further research using prospective study designs with robust sample sizes are needed to evaluate testable hypotheses that address the relationship between exposure and adverse reproductive health effects.
potential conflicts related to DoD personnel participating in non-DoD sponsored conferences. professional meetings. publication/presentation disclosures to...manual substance (smokeless tobacco > combustible tobacco) limiting and accounting for participant dropout • Evaluated publication bias using funnel
Full Text Available AIMS - The aims were to compare past-year at-risk and problem gambling (ARPG and other at-risk behaviours (computer gaming, risky alcohol consumption, tobacco smoking by age and gender, and to explore how ARPG is associated with risky alcohol consumption, tobacco smoking, poor mental health and loneliness in males and females. DESIGN - Data from respondents aged 15-28 (n = 822 were derived from a cross-sectional random sample of population-based data (n = 4484. The data were collected in 2011-2012 by telephone interviews. The Problem Gambling Severity Index (PGSI, score≥2 was used to evaluate ARPG. Prevalence rates for risk behaviours were compared for within gender-specific age groups. Regression models were gender-specific. RESULTS - The proportion of at-risk and problem gamblers was higher among males than females in all age groups except among 18-21-year-olds, while frequent computer gaming was higher among males in all age groups. The odds ratio (95% CI of being a male ARPGer was 2.57 (1.40-4.74 for risky alcohol consumption; 1.95 (1.07-3.56 for tobacco smoking; 2.63 (0.96-7.26 for poor mental health; and 4.41 (1.20-16.23 for feeling lonely. Likewise, the odds ratio (95% CI of being a female ARPGer was 1.19 (0.45-3.12 for risky alcohol consumption; 4.01 (1.43-11.24 for tobacco smoking; 0.99 (0.18-5.39 for poor mental health; and 6.46 (1.42-29.34 for feeling lonely. All 95% CIs of ARPG correlates overlapped among males and females. CONCLUSIONS - Overall, past-year at-risk and problem gambling and computer gaming seem to be more common among males than females; however, for risky alcohol consumption similar gender differences were evident only for the older half of the sample. No clear gender differences were seen in correlates associated with ARPG.
Cummings, K M; Sciandra, R; Lawrence, J
Recent studies have described tobacco advertising in the print media, on billboards, and through sponsorship of cultural and sporting events. However, little attention has been given to another common and unavoidable source of tobacco advertising, that which is encountered in retail stores. In July 1987, we conducted a survey of 61 packaged goods retail stores in Buffalo, NY, to assess the prevalence and type of point-of-sale tobacco advertising. In addition, store owners or managers were surveyed to determine their store's policy regarding tobacco advertising, receipt of monetary incentives from distributors for displaying tobacco ads, and willingness to display antitobacco ads. Six types of stores were involved in the study: 10 supermarkets, 10 privately owned grocery stores, 9 chain convenience food stores that do not sell gasoline, 11 chain convenience food stores that sell gasoline, 11 chain pharmacies, and 10 private pharmacies. Two-thirds of the stores displayed tobacco posters, and 87 percent had promotional items advertising tobacco products, primarily cigarettes. Larger stores, and those that were privately owned, tended to display more posters and promotional items. Eighty percent of tobacco product displays were for cigarettes, 16 percent for smokeless tobacco products, and 4 percent for cigars and pipe tobacco. Convenience stores selling gasoline had the most separate tobacco product displays. Of tobacco product displays, 24 percent were located adjacent to candy and snack displays. Twenty-nine of the 61 store owners or managers indicated that their store had a policy regulating the display of tobacco ads and tobacco product displays.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1910192
Arlene de Maria Perez
Full Text Available CONTEXT AND OBJECTIVE: The lifestyle of military personnel has been little studied in Brazil. This study evaluated the frequencies of tobacco and alcohol use, sexual behavior and mental health among military students.DESIGN AND SETTING: Cross-sectional study at the Police Academy, in São Paulo.METHODS: Students answered a questionnaire about tobacco use, alcohol consumption, sexual behavior and common mental disorders (CMDs. To analyze associations among the frequencies of smoking and alcohol use, sexually transmitted diseases (STDs and CMDs during the undergraduate years, we built a multinomial logistic regression model adjusted for age and sex.RESULTS: All 473 students were invited to participate and 430 (90.9% agreed (10.5% were women. Most were white (76.6%, aged < 30 years, from the upper middle class (78.1%. The frequency of smoking was 6.5%, alcohol consumption 69.3%, STDs 14% and CMDs 15.6%. The use of condoms was low. Fourth-year students presented a lower odds ratio (OR for STDs than the first-year students: 0.44 (95% confidence interval: 0.22-0.90. Third-year students presented a lower OR for CMDs than the first-year students.CONCLUSION: The frequencies of smoking and CMDs were low, while the frequency of alcohol consumption was similar to that of the Brazilian population. The use of condoms was low, in comparison with previous studies with similar samples. The results suggest that there was a certain degree of protection against CMDs and STDs during the undergraduate years.
To compare the current status of global alcohol corporations with tobacco in terms of their role in global governance and to document the process by which this difference has been achieved and the consequences for alcohol control policy. Participant observation in the global political arena, review of industry materials (submissions, publications, conference presentations, websites) and review of published literature formed the basis for the current analysis. Recent events in the global political arena have highlighted the difference in perception of the alcohol and tobacco industries which has allowed alcohol corporations to participate in the global governance arena in a way in which tobacco has not been able. The transnational producers of alcohol have waged a sophisticated and successful campaign during the past three decades, including sponsorship of intergovernmental events, funding of educational initiatives, research, publications and sponsoring sporting and cultural events. A key aspect has been the framing of arguments to undermine perceptions of the extent of alcohol-related harms to health by promoting ideas of a balance of benefits and harms. An emphasis on the heaviest drinkers has been used to promote the erroneous idea that 'moderate' drinkers experience no harm and a goal of alcohol policy should be to ensure they are unaffected by interventions. This leads to highly targeted interventions towards the heaviest drinkers rather than effective regulation of the alcohol market. A sophisticated campaign by global alcohol corporations has promoted them as good corporate citizens and framed arguments with a focus on drinkers rather than the supply of alcohol. This has contributed to acceptance in the global governance arena dealing with policy development and implementation to an extent which is very different from tobacco. This approach, which obscures the contribution supply and marketing make to alcohol-related harm, has also contributed to failure by
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Methyl alcohol. 21.116 Section 21.116 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS FORMULAS FOR DENATURED ALCOHOL AND RUM Specifications for Denaturants § 21...
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Isopropyl alcohol. 21.113 Section 21.113 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS FORMULAS FOR DENATURED ALCOHOL AND RUM Specifications for Denaturants § 21...
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Alcohol. 19.398 Section 19.398 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE... Articles Bottling, Packaging, and Removal of Products § 19.398 Alcohol. (a) Containers. Subject to the...
Thyssen, J P; Linneberg, A; Menné, T
heavy smokers (OR = 1.38; CI = 0.99-1.92) compared with never-smokers. CONCLUSIONS: Tobacco smoking was positively associated with hand eczema among adults from the general population in Denmark. Apparently, current light smokers (... were analysed with logistic regression analyses and associations were expressed as odds ratios (ORs) with 95% confidence intervals (CI). RESULTS: The prevalence of hand eczema was higher among previous smokers (OR = 1.13; CI = 0.90-1.40), current light smokers (OR = 1.51; CI = 1.14-2.02) and current...... smokers (> 15 g daily) but this needs to be reconfirmed. Alcohol consumption was not associated with hand eczema....
Gupta, Bhawna; Bray, Freddie; Kumar, Narinder; Johnson, Newell W
This study examines the association between the incidence of oral cancer in India and oral hygiene habits, diet, chewing and smoking tobacco, and drinking alcohol. We also assessed the effects of oral hygiene habits with oral cancer risk among chewers versus never chewers. A hospital-based case-control study was conducted in Pune, India, based on face-to-face interviews, anthropometry, and intra-oral examinations conducted for 187 oral cancer cases and 240 controls. Poor oral hygiene score was associated with a significant risk of oral cancer (adjusted OR=6.98; 95%CI 3.72-13.05). When stratified by tobacco-chewing habit, the poor oral hygiene score was a significant risk factor only among ever tobacco chewers (adjusted OR=14.74; 95%CI 6.49-33.46) compared with never chewers (adjusted OR=0.71; 95%CI 0.14-3.63). Dental check-ups only at the time of pain by ever-chewers with poor oral hygiene was associated with an elevated risk (adjusted OR=4.22; 95%CI 2.44-7.29), while consumption of green, yellow, and cruciferous vegetables and citrus fruits was protective. A linear dose-response association was observed between oral cancer and chewing tobacco in terms of age at initiation, duration, and frequency of chewing per day (P25 years (adjusted OR=2.31; 95%CI 1.14-4.71) elevated the risk of oral cancer. Good oral hygiene habits - as characterized by healthy gums, brushing more than once daily, use of toothpaste, annual dental check-ups, and a minimal number of missing teeth - can reduce the risk of oral cancer significantly. In addition to refraining from chewing/smoking tobacco, a diet adequate in fruits and vegetables may protect against the disease. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Three patients with progressive visual loss, chronic alcoholism and tabagism were submitted to a complete neuro-ophthalmic examination and to retinal nerve fiber layer (RNFL measurements using optical coherence tomography (OCT scanning. Two patients showed marked RNFL loss in the temporal sector of the optic disc. However, a third patient presented RNFL measurements within or above normal limits, based on the Stratus-OCT normative database. Such findings may be due to possible RNFL edema similar to the one that may occur in the acute phase of toxic optic neuropathies. Stratus-OCT was able to detect RNFL loss in the papillomacular bundle of patients with tobacco-alcohol-induced toxic optic neuropathy. However, interpretation must be careful when OCT does not show abnormality in order to prevent diagnostic confusion, since overestimation of RNFL thickness measurements is possible in such cases.
Full Text Available Abstract Background The prevalence of alcohol, tobacco and illicit drug use has been reported to be higher amongst lesbian and bisexual women (LBW than their heterosexual counterparts. However, few studies have been conducted with this population in Australia and rates that have been reported vary considerably. Methods A self-completed questionnaire exploring a range of health issues was administered to 917 women aged 15-65 years (median 34 years living in Western Australia, who identified as lesbian or bisexual, or reported having sex with another woman. Participants were recruited from a range of settings, including Perth Pride Festival events (67.0%, n = 615, online (13.2%, n = 121, at gay bars and nightclubs (12.9%, n = 118, and through community groups (6.9%, n = 63. Results were compared against available state and national surveillance data. Results LBW reported consuming alcohol more frequently and in greater quantities than women in the general population. A quarter of LBW (25.7%, n = 236 exceeded national alcohol guidelines by consuming more than four standard drinks on a single occasion, once a week or more. However, only 6.8% (n = 62 described themselves as a heavy drinker, suggesting that exceeding national alcohol guidelines may be a normalised behaviour amongst LBW. Of the 876 women who provided data on tobacco use, 28.1% (n = 246 were smokers, nearly double the rate in the female population as a whole. One third of the sample (33.6%, n = 308 reported use of an illicit drug in the previous six months. The illicit drugs most commonly reported were cannabis (26.4%, n = 242, meth/amphetamine (18.6%, n = 171, and ecstasy (17.9%, n = 164. Injecting drug use was reported by 3.5% (n = 32 of participants. Conclusion LBW appear to use alcohol, tobacco and illicit drugs at higher rates than women generally, indicating that mainstream health promotion messages are not reaching this group or are not perceived as relevant. There is an urgent
Abstract Over the past five years there has been exponential expansion of interest in tobacco harm reduction (THR), with a concomitant increase in the number of published studies. The purpose of this manuscript is to review and analyze influential contributions to the scientific and medical literature relating to THR, and to discuss issues that continue to stimulate debate. Numerous epidemiologic studies and subsequent meta-analyses confirm that smokeless tobacco (ST) use is associated with m...
Barik, Anamitra; Rai, Rajesh Kumar; Gorain, Ashoke; Majumdar, Saikat; Chowdhury, Abhijit
India houses over 275 million tobacco users, with 164 million users of only smokeless tobacco, 69 million exclusive smokers, and 42 million users of both smoking and smokeless tobacco. This study aims to examine the socio-economic factors associated with types of tobacco use in a selected rural Indian population. A cross-sectional study was conducted with surveillance data from the Birbhum Population Project (BIRPOP). Total respondents of 29,783 individuals (16,038 men and 13,745 women) aged ≥15 years were surveyed between October 2010 and January 2011. Apart from bivariate analyses, a binary logistic regression was applied to estimate the adjusted odds ratio for socio-economic factors (religion, social group, education, occupation, and wealth quintile) associated with current tobacco use, current smokeless tobacco use, and current bidi use among men and women. Nearly 22% of men and 26% of women were using smokeless tobacco. While 46% of men were smoking bidi, only 4% of women reported smoking bidi. Overall, men are more likely to use tobacco. Irrespective of gender, with increasing years of education, people are less inclined to use tobacco, and unemployed people are less likely to use tobacco. With increasing income, the odds of smokeless tobacco use and the odds of smoking bidi are higher among women and men, respectively. The BIRPOP study indicates that irrespective of gender and income, raising the level of awareness through household-based health education could be an effective intervention to minimise the level of tobacco use. © Royal Society for Public Health 2015.
Nargis, Nigar; Thompson, Mary E; Fong, Geoffrey T; Driezen, Pete; Hussain, A K M Ghulam; Ruthbah, Ummul H; Quah, Anne C K; Abdullah, Abu S
Smoking and passive smoking are collectively the biggest preventable cause of death in Bangladesh, with major public health burden of morbidity, disability, mortality and community costs. The available studies of tobacco use in Bangladesh, however, do not necessarily employ nationally representative samples needed to monitor the problem at a national scale. This paper examines the prevalence and patterns of tobacco use among adults in Bangladesh and the changes over time using large nationally representative comparable surveys. Using data from two enumerations of the International Tobacco Control (ITC) Bangladesh Project conducted in 2009 and 2012, prevalence estimates are obtained for all tobacco products by socio-economic determinants and sample types of over 90,000 individuals drawn from over 30,000 households. Household level sample weights are used to obtain nationally representative prevalence estimates and standard errors. Statistical tests of difference in the estimates between two time periods are based on a logistic regression model that accounts for the complex sampling design. Using a multinomial logit model, the time trend in tobacco use status is identified to capture the effects of macro level determinants including changes in tobacco control policies. Between 2009 and 2012, overall tobacco use went down from 42.4% to 36.3%. The decline is more pronounced with respect to smokeless tobacco use than smoking. The prevalence of exclusive cigarette smoking went up from 7.2% to 10.6%; exclusive bidi smoking remained stable at around 2%; while smoking both cigarette and bidi went down from 4.6% to 1.8%; exclusive smokeless tobacco use went down from 20.2% to 16.9%; and both smokeless tobacco use and smoking went down from 8.4% to 5.1%. In general, the prevalence of tobacco use is higher among men, increases from younger to older age groups, and is higher among poorer people. Smoking prevalence is the highest among the slum population, followed by the tribal
Full Text Available Smoking and passive smoking are collectively the biggest preventable cause of death in Bangladesh, with major public health burden of morbidity, disability, mortality and community costs. The available studies of tobacco use in Bangladesh, however, do not necessarily employ nationally representative samples needed to monitor the problem at a national scale. This paper examines the prevalence and patterns of tobacco use among adults in Bangladesh and the changes over time using large nationally representative comparable surveys.Using data from two enumerations of the International Tobacco Control (ITC Bangladesh Project conducted in 2009 and 2012, prevalence estimates are obtained for all tobacco products by socio-economic determinants and sample types of over 90,000 individuals drawn from over 30,000 households. Household level sample weights are used to obtain nationally representative prevalence estimates and standard errors. Statistical tests of difference in the estimates between two time periods are based on a logistic regression model that accounts for the complex sampling design. Using a multinomial logit model, the time trend in tobacco use status is identified to capture the effects of macro level determinants including changes in tobacco control policies.Between 2009 and 2012, overall tobacco use went down from 42.4% to 36.3%. The decline is more pronounced with respect to smokeless tobacco use than smoking. The prevalence of exclusive cigarette smoking went up from 7.2% to 10.6%; exclusive bidi smoking remained stable at around 2%; while smoking both cigarette and bidi went down from 4.6% to 1.8%; exclusive smokeless tobacco use went down from 20.2% to 16.9%; and both smokeless tobacco use and smoking went down from 8.4% to 5.1%. In general, the prevalence of tobacco use is higher among men, increases from younger to older age groups, and is higher among poorer people. Smoking prevalence is the highest among the slum population
Evans, William Douglas; Horn, Kimberly A; Gray, Tiffany
With more tobacco products now available and heavily marketed, dual tobacco use is increasing among youth. We systematically reviewed literature on dual tobacco use interventions, with an emphasis on mass health communication strategies. The review identified 46 articles meeting initial criteria and ultimately included 8 articles. Included studies reported a mix of health communication and social marketing techniques. Although there is a body of research on dual tobacco use, there is limited literature describing interventions aimed at controlling it. Design and evaluation of such interventions showing reductions in dual use of cigarettes, smokeless, and alternative products would advance the field. Copyright © 2015 Elsevier Inc. All rights reserved.
Berg, Carla J.; Haardörfer, Regine; Lewis, Michael; Getachew, Betelihem; Lloyd, Steven A.; Thomas, Sarah Fretti; Lanier, Angela; Trepanier, Kelleigh; Johnston, Teresa; Grimsley, Linda; Foster, Bruce; Benson, Stephanie; Smith, Alicia; Barr, Dana Boyd; Windle, Michael
Objectives We examined psychographic characteristics associated with tobacco use among Project DECOY participants. Methods Project DECOY is a 2-year longitudinal mixed-methods study examining risk for tobacco use among 3418 young adults across 7 Georgia colleges/universities. Baseline measures included sociodemographics, tobacco use, and psychographics using the Values, Attitudes, and Lifestyle Scale. Bivariate and multivariable analyses were conducted to identify correlates of tobacco use. Results Past 30-day use prevalence was: 13.3% cigarettes; 11.3% little cigars/cigarillos (LCCs); 3.6% smokeless tobacco; 10.9% e-cigarettes; and 12.2% hookah. Controlling for sociodemographics, correlates of cigarette use included greater novelty seeking (p fashion orientation (p = .007). Correlates of smokeless tobacco use included greater novelty seeking (p = .006) and less intellectual curiosity (p fashion orientation (p = .044), and self-focused thinking (p = .002), and less social conservatism (p products. PMID:27103410
Full Text Available The transition from high school to college is a high-risk stage for the initiation and escalation of substance use. Substance use and its associated risk factors have been thoroughly described in developed countries, such as the United States, but largely neglected in Argentina, a South American country with patterns of a collectivist culture. The present cross-sectional study describes the occurrence of alcohol, tobacco, and marijuana use and the association between these behaviors and the age of onset of substance use and cognitive (i.e., risk perception and social (i.e., prescriptive variables in a large sample of Argentinean college freshmen (n = 4083, 40.1% men; mean age = 19.39 ± 2.18 years. The response rate across courses was ≥90% and was similarly distributed across sex. Participants completed a survey that measured substance use (alcohol [with a focus on heavy drinking and binge drinking behaviors], tobacco, and marijuana, age of onset of the use of each substance, perceived risk associated with various substance use behaviors, prescriptive norms associated with substance use, and descriptive norms for alcohol use (AU. The results indicated that AU is nearly normative (90.4 and 80.3% with last year and last month use, respectively in this population, and heavy drinking is highly prevalent (68.6 and 54.9% with heavy episodic and binge drinking, respectively, especially among those with an early drinking onset (97.8 and 93.6% with last year and last month use and 87.8 and 76.3% with heavy episodic and binge drinking, respectively. The last-year occurrence of tobacco and marijuana use was 36 and 28%, respectively. Early substance use was associated with the greater use of that specific substance. The students overestimated their same-sex friend’s AU, and women overestimated the level of AU of their best male friend. At the multivariate level, all of the predictors, with the exception of the parents’ prescriptive norms
Barik, Anamitra; Rai, Rajesh Kumar; Chowdhury, Abhijit
Aim To measure the prevalence of self-reported morbidity and its associated factors among adults (aged ⩾15 years) in a select rural Indian population. Self-reporting of smoking has been validated as population-based surveys using self-reported data provide reasonably consistent estimates of smoking prevalence, and are generally considered to be sufficiently accurate for tracking the general pattern of morbidity associated with tobacco use in populations. However, to gauge the true disease burden using self-reported morbidity data requires cautious interpretation. During 2010-2011, a cross-sectional survey was conducted under the banner of the Health and Demographic Surveillance System, Birbhum, an initiative of the Department of Health and Family Welfare, Government of West Bengal, India. With over 93.6% response rate from the population living in 12 300 households, this study uses the responses from 16 354 individuals: 8012 smokers, and 8333 smokeless tobacco users. Smokers and smokeless tobacco users were asked whether they have developed any morbidity symptoms due to smoking, or smokeless tobacco use. Bivariate, as well as multivariate logistic regression analyses were deployed to attain the study objective. Findings Over 20% of smokers and over 9% of smokeless tobacco users reported any morbidity. Odds ratio (OR) with 95% confidence interval (CI) estimated using logistic regression shows that women are less likely to report any morbidity attributable to smoking (OR: 0.69; CI: 0.54-0.87), and more likely to report any morbidity due to smokeless tobacco use (OR: 1.68; CI: 1.36-2.09). Non-Hindus have higher odds, whereas the wealthiest respondents have lower odds of reporting any morbidity. With a culturally appropriate intervention to change behaviour, youth (both men and women) could be targeted with comprehensive tobacco cessation assistance programmes. A focussed intervention could be designed for unprocessed tobacco users to curb hazardous effects of
Brook, Judith S; Lee, Jung Yeon; Rubenstone, Elizabeth; Brook, David W; Finch, Stephen J
We modeled triple trajectories of tobacco, alcohol, and marijuana use from adolescence to adulthood as predictors of antisocial personality disorder (ASPD) and generalized anxiety disorder (GAD). We assessed urban African American and Puerto Rican participants (n = 816) in the Harlem Longitudinal Development Study, a psychosocial investigation, at 4 time waves (mean ages = 19, 24, 29, and 32 years). We used Mplus to obtain the 3 variable trajectories of tobacco, alcohol, and marijuana use from time 2 to time 5 and then conducted logistic regression analyses. A 5-trajectory group model, ranging from the use of all 3 substances (23%) to a nonuse group (9%), best fit the data. Membership in the trajectory group that used all 3 substances was associated with an increased likelihood of both ASPD (adjusted odds ratio [AOR] = 6.83; 95% CI = 1.14, 40.74; P disorders. Treatment programs should address the use of all 3 substances to decrease the likelihood of comorbid psychopathology.
Grevenstein, Dennis; Nagy, Ede; Kroeninger-Jungaberle, Henrik
While several studies have investigated the relationship between risk perception and substance use, surprisingly little is known about mutual influences between both variables over time. The present study aimed to explore two different hypotheses separately for tobacco, alcohol and cannabis: influences from risk perception on behavior (motivational hypothesis) and influences from behavior on risk perception (risk reappraisal hypothesis). A prospective and longitudinal cross-lagged panel design was used with substance use and risk perception measured five times over the course of 10 years. Participants were 318 German youths aged 14-15 at the beginning of the study. Risk perception and substance use frequency were measured using self-reports. Structural equation modeling indicated significant influences of risk perception on substance use behavior for all substances, which supports the motivational hypothesis. Changes in risk perception predict changes in future substance use of tobacco, alcohol and cannabis. Specifically for cannabis, influences of substance use on risk perception can also be shown, thus, supporting the risk reappraisal hypothesis. While there is support for the rationale behind adequate risk perception as a goal of preventive interventions, the possibility of risk reappraisal should not be neglected, especially regarding illicit substances.
Kim, Hyungjin Myra; Smith, Eric G; Stano, Claire M; Ganoczy, Dara; Zivin, Kara; Walters, Heather; Valenstein, Marcia
Observational research frequently uses administrative codes for mental health or substance use diagnoses and for important behaviours such as suicide attempts. We sought to validate codes (International Classification of Diseases, 9th edition, clinical modification diagnostic and E-codes) entered in Veterans Health Administration administrative data for patients with depression versus a gold standard of electronic medical record text ("chart notation"). Three random samples of patients were selected, each stratified by geographic region, gender, and year of cohort entry, from a VHA depression treatment cohort from April 1, 1999 to September 30, 2004. The first sample was selected from patients who died by suicide, the second from patients who remained alive on the date of death of suicide cases, and the third from patients with a new start of a commonly used antidepressant medication. Four variables were assessed using administrative codes in the year prior to the index date: suicide attempt, alcohol abuse/dependence, drug abuse/dependence and tobacco use. Specificity was high (≥ 90%) for all four administrative codes, regardless of the sample. Sensitivity was ≤75% and was particularly low for suicide attempt (≤ 17%). Positive predictive values for alcohol dependence/abuse and tobacco use were high, but barely better than flipping a coin for illicit drug abuse/dependence. Sensitivity differed across the three samples, but was highest in the suicide death sample. Administrative data-based diagnoses among VHA records have high specificity, but low sensitivity. The accuracy level varies by different diagnosis and by different patient subgroup.
Rosario, Margaret; Corliss, Heather L; Everett, Bethany G; Russell, Stephen T; Buchting, Francisco O; Birkett, Michelle A
We examined the role of adolescent peer violence victimization (PVV) in sexual orientation disparities in cancer-related tobacco, alcohol, and sexual risk behaviors. We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys. We classified youths with any same-sex sexual attraction, partners, or identity as sexual minority and the remainder as heterosexual. We had 4 indicators of tobacco and alcohol use and 4 of sexual risk and 2 PVV factors: victimization at school and carrying weapons. We stratified associations by gender and race/ethnicity. PVV was related to disparities in cancer-related risk behaviors of substance use and sexual risk, with odds ratios (ORs) of 1.3 (95% confidence interval [CI] = 1.03, 1.6) to 11.3 (95% CI = 6.2, 20.8), and to being a sexual minority, with ORs of 1.4 (95% CI = 1.1, 1.9) to 5.6 (95% CI = 3.5, 8.9). PVV mediated sexual orientation disparities in substance use and sexual risk behaviors. Findings were pronounced for adolescent girls and Asian/Pacific Islanders. Interventions are needed to reduce PVV in schools as a way to reduce sexual orientation disparities in cancer risk across the life span.
Afshin, Ashkan; Babalola, Damilola; Mclean, Mireille; Yu, Zhi; Ma, Wenjie; Chen, Cheng-Yu; Arabi, Mandana; Mozaffarian, Dariush
Novel interventions are needed to improve lifestyle and prevent noncommunicable diseases, the leading cause of death and disability globally. This study aimed to systematically review, synthesize, and grade scientific evidence on effectiveness of novel information and communication technology to reduce noncommunicable disease risk. We systematically searched PubMed for studies evaluating the effect of Internet, mobile phone, personal sensors, or stand-alone computer software on diet, physical activity, adiposity, tobacco, or alcohol use. We included all interventional and prospective observational studies conducted among generally healthy adults published between January 1990 and November 2013. American Heart Association criteria were used to evaluate and grade the strength of evidence. From 8654 abstracts, 224 relevant reports were identified. Internet and mobile interventions were most common. Internet interventions improved diet (N=20 studies) (Class IIa A), physical activity (N=33), adiposity (N=35), tobacco (N=22), and excess alcohol (N=47) (Class I A each). Mobile interventions improved physical activity (N=6) and adiposity (N=3) (Class I A each). Evidence limitations included relatively brief durations (generally Internet and mobile interventions improve important lifestyle behaviors up to 1 year. This systematic review supports the need for long-term interventions to evaluate sustainability. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
... relationship between tobacco advertising and promotion and increased tobacco use. With respect to marketing of... rulemaking to obtain information related to the regulation of outdoor advertising of cigarettes and smokeless... section of that final rule for future rulemaking on restrictions related to the outdoor advertising of...
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Cases of industrial alcohol. 19.608 Section 19.608 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE... Cases of industrial alcohol. (a) Mandatory marks. Each case, including encased containers, of alcohol...
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Withdrawal of fuel alcohol. 19.997 Section 19.997 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU... and Transfers § 19.997 Withdrawal of fuel alcohol. For each shipment or other removal of fuel alcohol...
PSA to help raise retailers' awareness of the new federal tobacco regulations related to the sale of cigarettes and smokeless tobacco products to people under 18 and the requirement to sell products face-to-face. Created: 9/30/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products. Date Released: 9/30/2010.
Southwell, Brian G; Kim, Annice E; Tessman, Greta K; MacMonegle, Anna J; Choiniere, Conrad J; Evans, Sarah E; Johnson, Robin D
The latest generation of smokeless tobacco products encompasses a wide range of offerings, including what is commonly referred to as dissolvable tobacco. Designed to deliver nicotine upon dissolving or disintegrating in a user's mouth, dissolvable tobacco products currently appear in various United States markets as strips, orbs, sticks, and lozenges. The emergence of these new products poses distinct opportunities and challenges for social and behavioral science and public health research and raises important public policy questions.
O'Connor, Richard J.
A wide variety of non-cigarette forms of tobacco and nicotine exists and their use varies regionally and globally. Smoked forms of tobacco such as cigars, bidis, kreteks, and waterpipes have high popularity and are often perceived erroneously as less hazardous than cigarettes, when in fact their health burden is similar. Smokeless tobacco products vary widely around the world in both form and health hazards, with some clearly toxic forms (e.g. South Asia), and some forms with far fewer hazard...
Full Text Available Background Tobacco use prevalence in Africa is projected to rise over the next 15 years without stronger tobacco control measures. However, little research details the scope of tobacco control research being conducted in Africa. A systematic literature review was conducted to better understand the landscape of tobacco control efforts in Africa. Methods A literature search of tobacco research conducted in all African countries from 1996 to 2016 was performed in PubMed, Embase, and African Index Medicus. Published abstracts meeting the inclusion criteria of focusing on nicotine or tobacco product(s and having been conducted in one or more African countries were selected for full coding and analysis. The authors coded on study characteristics such as type of research, tobacco product, and country. Three coders double-coded 5% of the articles reviewed to ensure agreement. Results This review found 645 relevant articles, in French and English, representing 52 African countries. South Africa was the focus of the greatest proportion of these published tobacco control research articles (23%, followed by Nigeria (17%, Egypt (13%, and Tunisia (12%. Reporting the prevalence of tobacco use was the focus of 51% of these articles. Other areas of research included the potential determinants of tobacco use (28%; knowledge, attitudes, and beliefs about tobacco products or policies (26%; and biological consequences of tobacco use (25%. Most studies (63% discussed cigarettes, and 15% studied smokeless tobacco. Youth-targeted studies comprised 25% of all research in Africa. Publications per year increased between 1996 and 2015, quadrupling in number by 2015. Conclusions A comprehensive review of the literature provides a baseline understanding of the tobacco control landscape and the increased attention countries are showing to tobacco and tobacco control. This research may inform opportunities for further research and for strengthening networks and thereby the
Alcohol is one of the most widely used addictive substances. It can be assumed that everybody encounters alcohol--ethanol in various forms and concentrations in the course of their lives. A global and social problem of our civilization is alcohol consumption which has a rising trend. Since 1989 the consumption of alcoholic beverages is rising and the mean annual consumption of concentrated ethanol per head is cea 10 litres. In ethanol abuse the organism is damaged not only by ethanol alone but in particular by substances formed during its metabolism. Its detailed knowledge is essential for the knowledge and investigations of the metabolic and toxic effect of ethanol on the organism. Ingested alcohol is in 90-98% eliminated from the organism by three known metabolic pathways: 1-alcohol dehydrogenase, 2-the microsomal ethanol oxidizing system and 3-catalase. Alcohol is a frequent important risk factor of serious "diseases of civilization" such as IHD, hypertension, osteoporosis, neoplastic diseases. Cirrhosis of the liver and chronic pancreatitis are the well known diseases associated with alcohol ingestion and also their most frequent cause. It is impossible to list all organs and diseases which develop as a result of alcohol consumption. It is important to realize that regular and "relatively" small amounts in the long run damage the organism and may be even fatal.
Full Text Available Background Tobacco use is attributed for deaths of 3.5 to 4 million people globally, which is expected to increase to about 10 million during 2020 and around more than two-third will be occurring in developing countries as they are showing an increasing trends of tobacco use. Anti-tobacco messages or campaigns do not reach the Tribal regions. Tobacco use is ingrained in many of the cultural practices of tribal people. This study aimed to a