Association between income and education with quit attempts, use of cessation aids, and short-term success in tobacco smokers: A social gradient analysis from a population-based cross-sectional household survey in Germany (DEBRA study)

INTRODUCTION: Smoking is more prevalent in smokers from lower compared with higher socioeconomic (SES) groups, but studies are inconsistent regarding underlying mechanisms. We aimed to assess associations between SES indicators and three distinct aspects of the smoking cessation process: attempting to quit; use of evidence-based cessation treatments; and success. METHODS: We analysed data of 12,161 last-year smokers (i.e., current smokers and recent ex-smokers who quit ≤ 12 months) from 20 waves (June/July 2016 to August/September 2019) of the German Study on Tobacco Use (DEBRA) - a representative household survey. Associations between indicators of SES (income and education) and (1) last-year quit attempts; (2) use of evidence-based cessation treatment or electronic cigarettes during the last attempt; and (3) short-term self-reported abstinence were analysed using multivariable logistic regression, adjusted for potential confounders. RESULTS: Of all last-years smokers, 18.6% had attempted to quit, of whom 15.2% had successfully stopped. Higher income (OR 0.82, 95%CI = 0.77-0.88 per 1000€) but low vs. high education (OR 0.83, 95%CI = 0.73-0.95) were associated with lower odds of quit attempts. In smokers with quit attempts, higher income but not education was associated with higher odds of using cessation medication (OR 1.31, 95%CI = 1.08-1.59 per 1000 €). Neither income nor education were associated with using behavioural support or success. CONCLUSIONS: In the German healthcare system without free access to evidence-based cessation therapy, low-income smokers are more likely to make a quit attempt but less likely to use cessation medication than high-income smokers. Equitable access to such medication is crucial to reduce SES-related health disparities

Alcohol consumption and associations with sociodemographic and health-related characteristics in Germany: a population survey

BACKGROUND: To assess the prevalence of ever-drinking and hazardous drinking among adults in Germany, and investigate the factors associated with level of alcohol consumption. METHODS: Cross-sectional population survey of a representative sample of 11,331 adults in Germany (2018 to 2019). The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) was used to define ever-drinking (AUDIT-C>=1), hazardous drinking (AUDIT-C>=5) and an overall AUDIT-C (alcohol consumption) score (from 0 to 12). Regression models were used to examine sociodemographic and health-related characteristics associated with AUDIT-C score. RESULTS: The prevalence of ever-drinking and hazardous drinking was 84.7% (95% CI = 84.1–85.4) and 19.4% (95% CI = 18.6–20.1), respectively. The mean AUDIT-C score was 2.8 (SD = 2.16). AUDIT-C scores were independently positively associated with having medium (Badj = 0.12, 95% CI = 0.02–0.21) and high (Badj = 0.11, 95% CI = 0.01–0.21) educational qualifications (compared with low), monthly income (Badj = 0.31 per €1,000, 95% CI = 0.26–0.36), being a current smoker (Badj = 0.94, 95% CI = 0.86–1.02), anxiety (Badj = 0.26, 95% CI = 0.02–0.50), and living in North East (Badj = 0.43, 95% CI = 0.29–0.58), North West (Badj = 0.47, 95% CI = 0.39–0.55) and South East (Badj = 0.79, 95% CI = 0.64–0.93) Germany (compared with South West), and negatively associated with age (Badj = -0.17, 95% CI = -0.21- −0.13), being female (Badj = -1.21, 95% CI = -1.28- −1.14) and depression (Badj = -0.22, 95% CI = -0.43- −0.02). CONCLUSIONS: In a large, representative sample of adults in Germany, the majority were ever-drinkers and one fifth were hazardous drinkers. Higher alcohol consumption scores were associated with being younger, male, current smoker, of high socioeconomic position, anxiety, and not living in South West Germany, and lower scores were associated with depression. These groups may benefit from targeted alcohol reduction policies and support

Inertial modes of rigidly rotating neutron stars in Cowling approximation

In this article, we investigate inertial modes of rigidly rotating neutron stars, i.e. modes for which the Coriolis force is dominant. This is done using the assumption of a fixed spacetime (Cowling approximation). We present frequencies and eigenfunctions for a sequence of stars with a polytropic equation of state, covering a broad range of rotation rates. The modes were obtained with a nonlinear general relativistic hydrodynamic evolution code. We further show that the eigenequations for the oscillation modes can be written in a particularly simple form for the case of arbitrary fast, but rigid rotation. Using these equations, we investigate some general characteristics of inertial modes, which are then compared to the numerically obtained eigenfunctions. In particular, we derive a rough analytical estimate for the frequency as a function of the number of nodes of the eigenfunction, and find that a similar empirical relation matches the numerical results with unexpected accuracy. We investigate the slow rotation limit of the eigenequations, obtaining two different sets of equations describing pressure and inertial modes. For the numerical computations we only considered axisymmetric modes, while the analytic part also covers nonaxisymmetric modes. The eigenfunctions suggest that the classification of inertial modes by the quantum numbers of the leading term of a spherical harmonic decomposition is artificial in the sense that the largest term is not strongly dominant, even in the slow rotation limit. The reason for the different structure of pressure and inertial modes is that the Coriolis force remains important in the slow rotation limit only for inertial modes. Accordingly, the scalar eigenequation we obtain in that limit is spherically symmetric for pressure modes, but not for inertial modes.Comment: 13 pages, 10 figures Fixed some typos, reformulated a few paragraphs, added 3 reference

External Validation of a Single-Item Scale to Measure Motivation to Stop Smoking: Findings from a Representative Population Survey (DEBRA Study)

Aims: The Motivation to Stop Scale (MTSS) is a single-item English language scale for predicting attempts to quit smoking. The aim of the study was an external validation of a German version of the MTSS (Motivation zum Rauchstopp Skala, MRS) based on a sample of current tobacco smokers in Germany. Methods: We used data from the first 18 waves (June 2016-May 2019) of the DEBRA study (German Study on Tobacco Use): a nationwide, face-to-face household survey of persons aged 14 years and older with one follow-up telephone interview after 6 months. We analysed data from 767 current smokers. The MRS was used at baseline (level 1-7 = no to highest motivation). At follow-up, the number of quit attempts since baseline were measured. We conducted logistic regression analyses and calculated the discriminant accuracy of MRS using the Area Under the Receiver Operating Characteristic Curve (ROC-AUC). Results: At baseline, 61.1 % (n = 469; 95 % confidence interval (CI) = 57.7-64.6) of current 767 tobacco smokers were not motivated to quit smoking (MRS level 1-2). Overall, 185 of the 767 smokers (24.1 %; CI = 21.1-27.1) made at least one quit attempt between the baseline and follow-up survey. The odds of reporting a quit attempt increased with increasing motivation to stop smoking on the MRS: odds ratio = 1.37, 95 % CI = 1.25-1.51. The discriminative accuracy of the MRS was ROC-AUC = 0.64. Conclusion: The MRS is a brief and valid measurement for assessing the motivation to stop smoking in the German language

Rapid model comparison of equations of state from gravitational wave observation of binary neutron star coalescences

The discovery of the coalescence of binary neutron star GW170817 was a watershed moment in the field of gravitational wave astronomy. Among the rich variety of information that we were able to uncover from this discovery was the first non-electromagnetic measurement of the neutron star radius, and the cold nuclear equation of state. It also led to a large equation of state model-selection study from gravitational-wave data. In those studies Bayesian nested sampling runs were conducted for each candidate equation of state model to compute their evidence in the gravitational-wave data. Such studies, though invaluable, are computationally expensive and require repeated, redundant, computation for any new models. We present a novel technique to conduct model-selection of equation of state in an extremely rapid fashion (~minutes) on any arbitrary model. We test this technique against the results of a nested-sampling model-selection technique published earlier by the LIGO/Virgo collaboration, and show that the results are in good agreement with a median fractional error in Bayes factor of about 10%, where we assume that the true Bayes factor is calculated in the aforementioned nested sampling runs. We found that the highest fractional error occurs for equation of state models that have very little support in the posterior distribution, thus resulting in large statistical uncertainty. We then used this method to combine multiple binary neutron star mergers to compute a joint-Bayes factor between equation of state models. This is achieved by stacking the evidence of the individual events and computing the Bayes factor from these stacked evidences for each pairs of equation of state

Public attitudes towards healthcare policies promoting tobacco cessation in Germany: results from the representative German study on tobacco use (DEBRA study)

Objective The aim of this study was to assess public acceptance of four possible healthcare policies supporting tobacco dependence treatment in line with the Framework Convention for Tobacco Control, Article 14 recommendations in Germany. Design Cross-sectional household survey. Setting Data were drawn from the German population and collected through computer-assisted, face-to-face interviews. Participants Representative random sample of 2087 people (>14 years) from the German population. Outcome measures Public acceptance was measured regarding (1) treatment cost reimbursement, (2) standard training for health professionals on offering cessation treatment, and making cessation treatment a standard part of care for smokers with (3) physical or (4) mental disorders. Association characteristics with smoking status and socio-economic status (SES) were assessed. Results Support for all policies was high (50%–68%), even among smokers (48%–66%). Ex-smokers and neversmokers were more likely to support standard training on cessation for health professionals than current smokers (OR 1.43, 95%CI 1.07 to 1.92; OR 1.43; 95%CI 1.14 to 1.79, respectively). Ex-smokers were also more likely than current smokers to support cessation treatment for smokers with mental disorders (OR 1.39, 95%CI 1.11 to 1.73). Men were less likely than women to support cessation treatment for smokers with physical diseases (OR 0.74, 95%CI 0.60 to 0.91) and free provision of treatment (OR 0.80, 95%CI 0.66 to 0.97). Offering cessation treatment to smokers with physical disorders was generally more accepted than to those with mental health issues. Conclusions The majority of the German population supports healthcare policies to improve the availability and affordability of tobacco dependence treatment. Nonsmokers were more supportive than current smokers of two of the four policies, but odds of support were only about 40% higher. SES characteristics were not consistently associated with public acceptance

German Public Support for Tobacco Control Policy Measures: Results from the German Study on Tobacco Use (DEBRA), a Representative National Survey

Smoking prevalence in Germany remains high at approximately 28%. We assessed public support for tobacco legislation and associations between level of support and smoking and socio-demographic characteristics. Data from 2087 people were collected as part of the German Study on Tobacco Use (“DEBRA”): a nationally representative, face-to-face household survey. Public support was measured on total ban of sale, raising the minimum age for sales, taxation of tobacco industry sales, research into e-cigarettes, and ban of smoking in cars when children are present. Associations were assessed with multivariate logistic regression. Over 50% of the German population support taxing industry profits (57.3%) and assessing e-cigarettes as an aid to quit smoking (55.5%). Over 40% support raising the legal age of sale (43.1%), and 22.9% support a total ban on tobacco sales. A smoking ban in cars when children are present was most popular (71.5%), even among current smokers (67.0%). There is public support for stricter tobacco control measures in Germany. A smoking ban in cars when children are present could be a feasible policy to implement

Effectiveness of training general practitioners to improve the implementation of brief stop-smoking advice in German primary care: study protocol of a pragmatic, 2-arm cluster randomised controlled trial (the ABCII trial)

Background: The German clinical guideline on tobacco addiction recommends that general practitioners (GPs) provide brief stop-smoking advice to their patients according to the “5A” or the much briefer “ABC” method, but its implementation is insufficient. A lack of training is one barrier for GPs to provide such advice. Moreover, the respective effectiveness of a 5A or ABC training regarding subsequent delivery of stop-smoking advice has not been investigated. We developed a training for GPs according to both methods, and conducted a pilot study with process evaluation to optimize the trainings according to the needs of GPs. This study aims at evaluating the effectiveness of both trainings. Methods: A pragmatic 2-arm cluster randomised controlled trial with a pre-post data collection will be conducted in 48 GP practices in North Rhine-Westphalia (Germany). GPs will be randomised to receive a 3.5-h-training in delivering either 5A or ABC, including peer coaching and intensive role plays with professional actors. The patient-reported primary outcome (receipt of GP advice to quit: yes/no) and secondary outcomes (recommendation rates of smoking cessation treatments, group comparison (5A versus ABC): receipt of GP advice to quit) will be collected in smoking patients routinely consulting their GP within 4 weeks prior, and 4 weeks following the training. Additional secondary outcomes will be collected at 4, 12 and 26 weeks following the consultation: use of cessation treatments during the last quit attempt (if so) since the GP consultation, and point-prevalence abstinence rates. The primary data analysis will be conducted using a mixed-effects logistic regression model with random effects for the cluster variable. Discussion: If the training increases the rates of delivery of stop-smoking advice, it would offer a low-threshold strategy for the guideline implementation in German primary care. Should one method prove superior, a more specific guideline recommendation can be propose

First Measurement of the Transverse Spin Asymmetries of the Deuteron in Semi-Inclusive Deep Inelastic Scattering

First measurements of the Collins and Sivers asymmetries of charged hadrons produced in deep-inelastic scattering of muons on a transversely polarized 6-LiD target are presented. The data were taken in 2002 with the COMPASS spectrometer using the muon beam of the CERN SPS at 160 GeV/c. The Collins asymmetry turns out to be compatible with zero, as does the measured Sivers asymmetry within the present statistical errors.Comment: 6 pages, 2 figure

Gluon polarization in the nucleon from quasi-real photoproduction of high-pT hadron pairs

We present a determination of the gluon polarization Delta G/G in the nucleon, based on the helicity asymmetry of quasi-real photoproduction events, Q^2<1(GeV/c)^2, with a pair of large transverse-momentum hadrons in the final state. The data were obtained by the COMPASS experiment at CERN using a 160 GeV polarized muon beam scattered on a polarized 6-LiD target. The helicity asymmetry for the selected events is = 0.002 +- 0.019(stat.) +- 0.003(syst.). From this value, we obtain in a leading-order QCD analysis Delta G/G=0.024 +- 0.089(stat.) +- 0.057(syst.) at x_g = 0.095 and mu^2 =~ 3 (GeV}/c)^2.Comment: 10 pages, 3 figure