Prevalence, determinants and impact of unawareness about the health consequences of tobacco use among 17,929 school personnel in 29 African countries.

Objectives: To assess prevalence, determinants and impact of unawareness about the health consequences of tobacco use among school personnel in Africa. Design: Cross-sectional surveys. Setting: Twenty-nine African countries. Participants: Representative samples of school personnel from 29 African countries (n=17 929), using data from the 2006-2011 Global School Personnel Surveys. Outcome: We assessed if school personnel were aware of the following five facts about tobacco use: (1) tobacco use is addictive; (2) secondhand smoke exposure is harmful; (3) smoking causes lung cancer; (4) smoking causes heart disease and (5) smoking does not cause malaria. Using multivariate logistic regression, we measured the impact of unawareness of the health consequences of tobacco use on behaviour and attitudes towards tobacco control. Results: A median of 62.6% of school personnel were unaware of at least one health consequence of tobacco use. School personnel in countries with mandatory cigarette health warning labels had lower odds of being unaware of any health consequence of tobacco use than countries where health warning labels were not mandatory (adjusted OR [aOR]=0.51; 95% CI 0.37 to 0.71). A significant dose-response relationship was seen between being ignorant of 1; 2; or ≥3 tobacco use health consequences respectively (compared with not being ignorant of any), and the odds of the following outcomes: non-support of bans on tobacco industry sponsorship of school or extracurricular activities (aOR=1.47; 1.91; and 2.98); non-support of bans on all tobacco advertisements (aOR=1.24; 1.78; and 2.68) and non-support of policies prohibiting tobacco use by school personnel on campus (aOR=1.79; 4.45; and 4.56). Conclusions: Unawareness of the health consequences of tobacco use was associated with poor support for tobacco control policies. Intensified efforts are needed in African countries to warn about the dangers of tobacco use

Geographic variation and socio-demographic determinants of the co-occurrence of risky health behaviours in 27 European Union member states.

BACKGROUND: Risky health behaviours such as tobacco and alcohol abuse, physical inactivity and poor diet may play an important role in disease development. The aim of the present study was to assess the geographical distribution and socio-demographic determinants of risky health-related behaviours in 27 member states (MSs) of the European Union (EU). METHODS: Data from the 2009 Eurobarometer survey (wave 72.3; n = 26 788) were analysed. Tobacco use, alcohol consumption, physical activity and fruit consumption were assessed through a self-reported questionnaire provided to participants from 27 EU MSs. Within the analyses, participants with three or more lifestyle risk factors were classified as individuals with co-occurrence of risk factors. RESULTS: Among respondents aged 15 or older, 28.2% had none of the aforementioned behavioural risk factors, whereas 9.9% had three or more lifestyle risk factors. Males [adjusted odds ratio (aOR) = 2.50; 95% confidence interval (95% CI): 2.17-2.88] and respondents of middle (aOR = 1.60; 95% CI: 1.36-1.89) or lower income (aOR = 2.63; 95% CI: 2.12-3.26) were more likely to report co-occurrence of behavioural risk factors, as well as respondents in Northern (aOR = 1.43; 95% CI: 1.14-1.78), Western (aOR = 1.28; 95% CI: 1.06-1.56) and Eastern Europe (aOR = 1.28; 95% CI: 1.06-1.55), when compared with Southern European respondents. CONCLUSIONS: The above analyses indicate significant geographical and social variation in the distribution of the co-occurrence of behavioural risk factors for disease development

Waterpipe tobacco use in the United Kingdom: A cross-sectional study among university students and stop smoking practitioners

© 2016 Jawad et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction: Despite cigarette-like adverse health outcomes associated with waterpipe tobacco smoking and increase in its use among youth, it is a much underexplored research area. We aimed to measure the prevalence and patterns of waterpipe tobacco use and evaluate tobacco control policy with respect to waterpipe tobacco, in several universities across the UK. We also aimed to measure stop smoking practitioners' encounter of waterpipe tobacco smoking. Methods: We distributed an online survey to six UK universities, asking detailed questions on waterpipe tobacco. Multivariable logistic regression models, adjusted for age, gender, ethnicity, graduate status, university and socioeconomic status (SES) assessed associations between waterpipe tobacco smoking (single use and dual use with cigarettes) and sociodemographic variables. SES was ascertained by average weekly self-spend on non-essentials. We also descriptively analysed data from a 2012 survey of stop smoking practitioners to assess the proportion of clients that used waterpipe regularly. Results: f 2217 student responses, 66.0%(95% CI 63.9-68.0%) had tried waterpipe tobacco smoking; 14.3%(95% CI 12.8-15.8%) reported past-30 day use, and 8.7% (95% CI 7.6-9.9%) reported at least monthly users. Past-30 day waterpipe-only use was associated with being younger (AOR 0.95, 95% CI 0.91-0.99), male (AOR 1.44, 95% CI 1.08-1.94), higher SES (AOR 1.16, 95% CI 1.06-1.28) and belonging to non-white ethnicities (vs. white, AOR 2.24, 95% CI 1.66-3.04). Compared to less than monthly users, monthly users were significantly more likely to have urges to smoke waterpipe (28.1% vs. 3.1%,

Adherence to treatment to help quit smoking: effects of task performance and coping with withdrawal symptoms

Background: Currently the combined cognitive-behavioral and pharmacological treatment is the best option to quit smoking, although success rates remain moderate. This study aimed to identify predictors of continuous abstinence in an assisted smoking cessation program using combined treatment. In particular, we analyzed the effects of socio-demographic, smoking-, and treatment-related variables. In addition, we analyzed the effect of several risk factors on abstinence, and estimated a model of risk for smoking relapse.Methods: Participants were 125 workers at the University of Granada (50 males), with an average age of 46.91 years (SD = 8.15). They were recruited between 2009 and 2013 at an occupational health clinic providing smoking cessation treatment. Baseline measures included socio-demographic data, preferred brand of cigarettes, number of years smoking, use of alcohol and/or tranquilizers, past attempts to quit, Fargerström Test for Nicotine Dependence, Smoking Processes of Change Scale, and Coping with Withdrawal Symptoms Interview. Participants were invited to a face-to-face assessment of smoking abstinence using self-report and cooximetry hemoglobin measures at 3, 6, and 12 months follow-up. The main outcome was smoking status coded as “relapse” versus “abstinence” at each follow-up. Kaplan-Meier survival analysis was performed to estimate the probability of continued abstinence during 12 months and log-rank tests were used to analyze differences in continued abstinence as a function of socio-demographic, smoking-, and treatment-related variables. Cox regression was used to analyze the simultaneous effect of several risk factors on abstinence.Results: Using alcohol and/or tranquilizers was related to shorter abstinence. Physical exercise, the number of treatment sessions, performance of treatment tasks, and coping with withdrawal symptoms were related to prolonged abstinence. In particular, failure to perform the treatment tasks tripled the risk of relapse, while lack of coping doubled it.Conclusions: Our results show that physical exercise, performance of treatment-related tasks, and effective coping with withdrawal symptoms can prolong abstinence from smoking. Programs designed to help quit smoking can benefit from the inclusion of these factors.This research was supported by the Occupational Medicine Area (Prevention Service) of the University of Granada