Excessive Exposure to Secondhand Tobacco Smoke among Hospitality Workers in Kyrgyzstan

The aim of this study was to assess the levels of secondhand smoke (SHS) exposure of men and women in public places in Kyrgyzstan. This cross-sectional study involved 10 bars and restaurants in Bishkek the capital city of Kyrgyzstan. Smoking was allowed in all establishments. Median (interquartile range) air nicotine concentrations were 6.82 (2.89, 8.86) μg/m3. Employees were asked about their smoking history and exposure to SHS at work. Employees were exposed to SHS for mean (SD) 13.5 (3.6) hours a day and 5.8 (1.4) days a week. Women were exposed to more hours of SHS at work compared to men. Hospitality workers are exposed to excessive amounts of SHS from customers. Legislation to ban smoking in public places including bars and restaurants is urgently needed to protect workers and patrons from the harmful effects of SHS

Medical students of Kyrgyzstan: smoking prevalence and attitudes to smoking cessation counseling

Study objective: To determine the current prevalence of smoking among medical students and to ascertain their readiness for counseling on smoking cessation. Methods: Cross-sectional randomized study, in which 297 medical students (146 males and 151 females) completed a questionnaire and exhaled carbon monoxide(CO). Setting: Kyrgyz State Medical Academy in Bishkek, Kyrgyzstan. Results: The overall prevalence of smoking among medical students was 35% (47.9% among men and 22.5% among women), with the highest rate among year 6 students(85.7% for men and 58% for women). The CO-adjusted prevalence for the entire sample was 44.8%. Overall 69% of students believed that smoking is related to cancer and chronic diseases however, the longer students were in school, the less confidence they demonstrated in this relationship. While 85.2% reported that advice should be given to smokers to stop, only 63% considered it potentially effective. Only 17.2% were aware of the Framework Convention on Tobacco Control, 90% of these supported its ratification, women significantly more so than men OR = 2.24, p < 0.05. Non-smokers expressed a greater demand for more information on smoking-related diseases and treatment of tobacco dependence (OR = 2.94, p < 0.05). Smokers were more likely to consume alcohol (OR = 4.0, p < 0.001) with no-alcohol students being more committed to tobacco control. Conclusions: Across the years of study, the prevalence of smoking among medical students increased, and reached its peak at year 6. The lack of knowledge about tobacco control along with a decreased potential for anti-smoking advocacy likely reflect deficiencies in the educational curricula. There is an urgent need to address relevant changes in the educational curricula for medical students

Tobacco use among Kyrgyzstan medical students: an 11-year follow-up cross-sectional study

Abstract Background Medical students are the first line active force to combat tobacco epidemic, but they may suffer from high smoking prevalence and wrong attitude themselves. The aim of the study was to assess the effect of current curriculum on smoking behavior of medical students in Kyrgyzstan. Methods 20% random sample of all 6 years of the School of Medicine in Kyrgyz State Medical Academy were interviewed in spring 2016. The questionnaire included sections on tobacco products consumption and knowledge and attitude to counseling. We verified smoking status with exhaled CO measurement using Bedfont Smokelyzer. Results In 618 students (48% female), the overall daily cigarette smoking prevalence was 21% (34% in males and 6% in females), being highest in years 1 and 3 and least in year 5 (prevalence difference 14%). With very low smokeless products and electronic cigarettes use prevalence, ever-smoking prevalence of waterpipe use was very high, reaching 85% in 6-year male students with alarmingly high prevalence in female students also. Only 74% students responded there was 100% evidence of harmful effects of tobacco, unchanged throughout the course of study. Conclusions The use of tobacco products, especially smoking waterpipe, in Kyrgyzstan medical students remains very high. Coupled with poor knowledge and high demand for more information, this demonstrates urgent need for more active and advanced training on tobacco control in medical school

High-altitude alpine therapy and lung function in asthma: systematic review and meta-analysis

We used meta-analysis to measure the effect of high-altitude climate therapy (HACT) on lung function outcomes in asthma, and systematically searched PubMed, Embase and www.elibrary.ru for publications appearing from 1970 to mid-2015. We included studies carried out with children or adults with an exposure of up to 12 weeks at an altitude of ≥1500 m above sea level. Changes in forced expiratory volume in 1 s (FEV1), FEV1/vital capacity ratio or peak expiratory flow rate as the HACT intervention outcomes were analysed. We included data for 907 participants (age range 4–58 years) from 21 studies, altogether including 28 substrata based on asthma type or severity. Only three of 21 included studies had high quality, whereas 93% of substudies reported lung function improvement with an overall pooled standardised mean difference (SMD) of 0.53 (95% CI 0.43–0.62). The measured effect of HACT was greater in adults (SMD 0.75, 95% CI 0.63–0.88, n=14) than in children (SMD 0.24, 95% CI 0.09–0.38, n=14). Studies at altitude >2000 m above sea level yielded the same effect as those at lower altitude. Based on a cut-point of a 0.50 change in SMD to define a meaningful clinical difference, HACT appears to have efficacy as an intervention. This extent of benefit appears to be limited to adults with asthma