scholarly journals Tobacco Cessation in Economically Disadvantaged Dominican Republic Communities: Who are the Ex-Users?

2015 ◽  
Vol 11 (4) ◽  
pp. 239-249 ◽  
Author(s):  
Deborah J. Ossip ◽  
Zahíra Quiñones ◽  
Sergio Diaz ◽  
Kelly Thevenet-Morrison ◽  
Susan Fisher ◽  
...  
Keyword(s):  
Dominican Republic ◽  
Tobacco Use ◽  
Economically Disadvantaged ◽  
Tobacco Cessation ◽  
Effective Means ◽  
Control Measures ◽  
Vulnerable Groups ◽  
Caribbean Region ◽  
Middle Income ◽  
Health Crisis

Introduction: Tobacco use and its harm continue to increase in low and middle income countries (LMICs) globally. Smoking cessation is the most effective means of reducing morbidity and mortality from tobacco use. Increasing the prevalence of ex-users is an indicator of population cessation.Aims: This study provides the first examination of factors associated with ex-tobacco use status in the Dominican Republic (DR), a LMIC in the Latin America and Caribbean region.Methods: Baseline surveillance was conducted for 1,177 randomly selected households in seven economically disadvantaged DR communities (total N = 2,680 adult household members).Results: Ex-user prevalence was 10.6% (1.0%–18.5% across communities), 14.8% were current users (9.1–20.4), and quit ratios were 41.7% (9.7%–52.7%). Among ever users, females (OR 2.02, 95% CI 1.41, 2.90), older adults (45–64: OR 1.75, 95% CI 1.12, 2.74; 65+: OR 2.09, 95% CI 1.29, 3.39), and those who could read/write (OR 1.64, 95% CI 1.08, 2.50), had health conditions (OR 1.63, 95% CI 1.11, 2.41), and lived with ex-users (OR 1.70, 95% CI 1.12, 2.58) were over 60% to two times as likely to be ex-users. Those from remote communities (OR 0.52, 95% CI 0.36, 0.74), using chewed tobacco (OR 0.14, 95% CI 0.04, 0.48) and living with tobacco users (OR 0.55, 95% CI 0.37, 0.81) were less likely to be ex-users.Conclusions: Ex-user prevalence and quit ratios were lower than for high income countries. Implementing broad tobacco control measures, combined with clinically targeting vulnerable groups, may increase tobacco cessation to most effectively reduce this public health crisis.

scholarly journals Lessons Learned from Twelve Years of Partnered Tobacco Cessation Research in the Dominican Republic

2016 ◽  
Vol 11 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Deborah J. Ossip ◽  
Sergio Díaz ◽  
Zahira Quiñones ◽  
Scott McIntosh ◽  
Ann Dozier ◽  
...  
Keyword(s):  
Dominican Republic ◽  
Tobacco Control ◽  
Tobacco Cessation ◽  
Early Stage ◽  
Lessons Learned ◽  
Middle Income ◽  
Health Crisis ◽  
Challenges And Opportunities ◽  
Tobacco Epidemic ◽  
The One

Engaging partners for tobacco control within low and middle income countries (LMICs) at early stages of tobacco control presents both challenges and opportunities in the global effort to avert the one billion premature tobacco caused deaths projected for this century. The Dominican Republic (DR) is one such early stage country. The current paper reports on lessons learned from 12 years of partnered United States (US)-DR tobacco cessation research conducted through two NIH trials (Proyecto Doble T, PDT1 and 2). The projects began with a grassroots approach of working with interested communities to develop and test interventions for cessation and secondhand smoke reduction that could benefit the communities, while concurrently building local capacity and providing resources, data, and models of implementation that could be used to ripple upward to expand partnerships and tobacco intervention efforts nationally. Lessons learned are discussed in four key areas: partnering for research, logistical issues in setting up the research project, disseminating and national networking, and mentoring. Effectively addressing the global tobacco epidemic will require sustained focus on supporting LMIC infrastructures for tobacco control, drawing on lessons learned across partnered trials such as those reported here, to provide feasible and innovative approaches for addressing this modifiable public health crisis.

scholarly journals Tobacco intervention research in low- and middle-income countries: lessons learned and future directions

2016 ◽  
Vol 11 (2) ◽  
pp. 61-64 ◽  
Author(s):  
Kenneth D. Ward
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Tobacco Dependence ◽  
Lessons Learned ◽  
Future Directions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Tobacco Intervention

Treating tobacco dependence is paramount for global tobacco control efforts, but is often overshadowed by other policy priorities. As stated by Jha (2009), “cessation by current smokers is the only practical way to avoid a substantial proportion of tobacco deaths worldwide before 2050.” Its importance is codified in Article 14 of the Framework Convention on Tobacco Control (FCTC), and in the WHO's MPOWER package of effective country-level policies. Unfortunately, only 15% of the world's population have access to appropriate cessation support (WHO, 2015). Moreover, parties to the FCTC have implemented only 51% of the indicators within Article 14, on average, which is far lower than many other articles (WHO, 2014). Further, commenting on the use of “O” measures (Offer help to quit tobacco use) in the MPOWER acronym, WHO recently concluded, “while there has been improvement in implementing comprehensive tobacco cessation services, this is nonetheless a most under-implemented MPOWER measure in terms of the number of countries that have fully implemented it” (WHO, 2015). To the detriment of global tobacco control efforts, only one in eight countries provides comprehensive cost-covered services, only one in four provide some cost coverage for nicotine replacement therapy, and fewer than one third provide a toll-free quit line (WHO, 2015).

scholarly journals Potential for health economics to influence policies on tobacco use during pregnancy in low-income and middle-income countries: a qualitative case study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e045624
Author(s):  
Tuba Saygın Avşar ◽  
Louise Jackson ◽  
Hugh McLeod
Keyword(s):  
Health Economics ◽  
Pregnant Women ◽  
Tobacco Use ◽  
Low Income ◽  
Tobacco Cessation ◽  
Qualitative Case Study ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Specific

IntroductionTobacco control during pregnancy is a policy priority in high-income countries (HICs) because of the significant health and inequality consequences. However, little evidence exists on interventions to reduce tobacco use in low-income and middle-income countries (LMICs), especially for pregnant women. This study aimed to assess how health economics evidence, which is mainly produced in HICs, could be adopted for tobacco cessation policies for pregnant women in LMICs.MethodsA qualitative case study was conducted in an international public health organisation. The organisation was chosen due to its capacity to influence health policies around the world. Tobacco control experts working in the organisation were identified through purposeful sampling and snowballing. Semistructured interviews were conducted with 18 informants with relevant experience of countries from all of the regions covered by the organisation. Data were analysed using the framework method.ResultsIn practice, tobacco cessation during pregnancy was not viewed as a priority in LMICs despite international recognition of the issue. In LMICs, factors including the recorded country-specific prevalence of tobacco use during pregnancy, availability of healthcare resources and the characteristics of potential interventions all affected the use of health economics evidence for policy making.ConclusionThe scale of tobacco use among pregnant women might be greater than reported in LMICs. Health economics evidence produced in HICs has the potential to inform health policies in LMICs around tobacco cessation interventions if the country-specific circumstances are addressed. Economic evaluations of cessation interventions integrated into antenatal care with a household perspective would be especially relevant in LMICs.

scholarly journals A qualitative study of tobacco use in eight economically disadvantaged Dominican Republic communities

2016 ◽  
Vol 24 (4) ◽  
pp. 23-32 ◽  
Author(s):  
Nancy Chin ◽  
Ann Dozier ◽  
Zahira Quinones ◽  
Sergio Diaz ◽  
Emily Weber ◽  
...  
Keyword(s):  
Dominican Republic ◽  
Tobacco Use ◽  
Economically Disadvantaged ◽  
Rapid Assessment ◽  
Assessment Process ◽  
Smoking During Pregnancy ◽  
Targeted Interventions ◽  
Technology Centers ◽  
Community Technology ◽  
Exposure To Secondhand Smoke

Understanding social conditions prior to intervention design can enhance tobacco control interventions. This paper describes formative research conducted in 2010 about tobacco use in eight economically disadvantaged Dominican Republic communities, four of which participated in a previous intervention study (2003–2008). A combined US-Dominican team used a rapid assessment process to collect qualitative social and cultural data on tobacco use, knowledge and attitudes; plus observations about social and policy factors, such as exposure to secondhand smoke (SHS), tobacco regulations, pregnancy, health care provider (HCP) practices and sustainability of the 2003–2008 intervention. This assessment found that tobacco use varied by age. While all ages typically used cigarettes, older adults used relatively more unprocessed tobacco, which is seen as less harmful and less addictive. Middle-aged smokers typically used commercial cigarettes, which are viewed as dangerous, addictive, expensive and offensive. Young adults reported avoiding smoking, but using relatively more smokeless tobacco. Smoking during pregnancy has reportedly decreased. SHS was viewed as harmful, although smoke-free homes were uncommon. HCPs discussed tobacco issues mostly for patients with tobacco-related conditions. Sustainability of the 2003–2008 intervention appeared to be linked to active Community Technology Centers with strong leadership, and community social capital. This information could be used to design better targeted interventions in these communities.

scholarly journals Tobacco use in six economically disadvantaged communities in the Dominican Republic

2008 ◽  
Vol 10 (5) ◽  
pp. 851-860 ◽  
Author(s):  
Deborah Ossip-Klein ◽  
Susan Fisher ◽  
Sergio Diaz ◽  
Zahira Quinones ◽  
Essie Sierra ◽  
...  
Keyword(s):  
Dominican Republic ◽  
Tobacco Use ◽  
Economically Disadvantaged ◽  
Disadvantaged Communities

scholarly journals 1392Decline in current tobacco use and socio-economic inequalities in 22 Sub-Saharan African countries- 2003-2018

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Chandrashekhar Sreeramareddy
Keyword(s):  
Tobacco Use ◽  
Control Measures ◽  
Vulnerable Groups ◽  
African Countries ◽  
Country Level ◽  
Index Of Inequality ◽  
Sub Saharan ◽  
Ssa Countries ◽  
Current Tobacco ◽  
Economic Inequalities

Abstract Background Tobacco companies have shifted their marketing and production to Sub-Saharan African countries which are in an early stage of tobacco epidemic. We report changes in current tobacco use and socio-economic inequalities between 2003 and 2019. Methods We estimated country-level, sex-wise, age-standardized prevalence estimates of current tobacco use in 22 SSA countries using sequential Demographic and Health Survey data. On pooled baseline (2003-11) and most recent survey (2011-19) data, prevalence by education, wealth, and age groups; Slope index of inequality and relative index of inequality were estimated. Change in prevalence in each country and by socio-economic subgroups and change in socio-economic inequalities (pooled data) were calculated. Results Tobacco use among men ranging [6·1% (Ghana) to 38·3 (Lesotho)] at baseline and [4·5% (Ghana) to 46·0% (Lesotho)] most recent surveys. Decline in prevalence points ranged from 1·5% (Ghana) to 9·6% (Sierra Leone). For women countries where prevalence was <1% rose from nine to 15. In most countries prevalence of current tobacco use significantly declined. WHO target of 30% decline was achieved in 15 and 10 countries for women and men, respectively. In both sexes, tobacco use rate and decline were higher among less educated and poor while magnitude and direction of inequalities were consistently declined. Absolute inequalities three-fold higher among men, while relative inequalities were nearly twice higher among women. Conclusions Tobacco use declined in a third of SSA countries. Persistence of socio-economic inequalities warrants stricter implementation of tobacco control measures to reach the vulnerable groups and continued monitoring of inequalities. Key messages Contrary to the projections, tobacco use had significantly declined in most of the countries, and many achieved the WHO target of 30% reduction. Country-level monitoring by regular surveys is needed to track the equitable progress to international goals.

scholarly journals COVID-19 and Its Impact on Tobacco Use – Is India Prepared to Unlock the link?

2020 ◽  
Vol 2 (6) ◽  
Author(s):  
Radhakrishnan Jayakrishnan
Keyword(s):  
Tobacco Use ◽  
Tobacco Cessation ◽  
Communicable Diseases ◽  
Visual Media ◽  
Control Measures ◽  
Economic Costs ◽  
Non Communicable Diseases ◽  
Long Run ◽  
Support Mechanisms ◽  
Regional Languages

Reports from around the globe has highlighted that people with existing non communicable diseases when infected with COVID 19 are highly vulnerable to severe ill effects. Considering the fact that tobacco use is associated with many of the non-communicable diseases it is important to incorporate tobacco control measures as well into the broader prevention arena of the COVID 19 control strategy. Considering the economic costs associated with the treatment of tobacco related diseases, it is important for a developing country like India to grab this opportunity to undertake sensitization campaigns against COVID 19 and its consequences among tobacco users. Further promotion of tobacco cessation campaigns using toll free quit line support mechanisms in regional languages, online platforms and print and visual media needs to be done keeping in mind a favorable net result in the long run.

Coronavirus: Towards controlling of the pandemic - Indian scenario

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 462-468
Author(s):  
Latika kothari ◽  
Sanskruti Wadatkar ◽  
Roshni Taori ◽  
Pavan Bajaj ◽  
Diksha Agrawal
Keyword(s):  
Control Measures ◽  
The Novel ◽  
Medical Treatments ◽  
Health Crisis ◽  
The Public ◽  
Infection Control Measures ◽  
The Social ◽  
Asking Questions ◽  
The Government ◽  
Novel Coronavirus

Coronavirus disease 2019 (COVID-19) is a communicable infection caused by the novel coronavirus resulting in severe acute respiratory syndrome coronavirus 2 (SARS-CoV). It was recognized to be a health crisis for the general population of international concern on 30th January 2020 and conceded as a pandemic on 11th March 2020. India is taking various measures to fight this invisible enemy by adopting different strategies and policies. To stop the COVID-19 from spreading, the Home Affairs Ministry and the health ministry, of India, has issued the nCoV 19 guidelines on travel. Screening for COVID-19 by asking questions about any symptoms, recent travel history, and exposure. India has been trying to get testing kits available. The government of India has enforced various laws like the social distancing, Janata curfew, strict lockdowns, screening door to door to control the spread of novel coronavirus. In this pandemic, innovative medical treatments are being explored, and a proper vaccine is being hunted to deal with the situation. Infection control measures are necessary to prevent the virus from further spreading and to help control the current situation. Thus, this review illustrates and explains the criteria provided by the government of India to the awareness of the public to prevent the spread of COVID-19.

scholarly journals Climate drivers of plague epidemiology in British India, 1898–1949

2020 ◽  
Vol 287 (1928) ◽  
pp. 20200538
Author(s):  
Warren S. D. Tennant ◽  
Mike J. Tildesley ◽  
Simon E. F. Spencer ◽  
Matt J. Keeling
Keyword(s):  
Predictive Models ◽  
Control Measures ◽  
Climate Data ◽  
British India ◽  
Middle Income ◽  
Middle Income Countries ◽  
Complex Interactions ◽  
The World ◽  
Spatio Temporal

Plague, caused by Yersinia pestis infection, continues to threaten low- and middle-income countries throughout the world. The complex interactions between rodents and fleas with their respective environments challenge our understanding of human plague epidemiology. Historical long-term datasets of reported plague cases offer a unique opportunity to elucidate the effects of climate on plague outbreaks in detail. Here, we analyse monthly plague deaths and climate data from 25 provinces in British India from 1898 to 1949 to generate insights into the influence of temperature, rainfall and humidity on the occurrence, severity and timing of plague outbreaks. We find that moderate relative humidity levels of between 60% and 80% were strongly associated with outbreaks. Using wavelet analysis, we determine that the nationwide spread of plague was driven by changes in humidity, where, on average, a one-month delay in the onset of rising humidity translated into a one-month delay in the timing of plague outbreaks. This work can inform modern spatio-temporal predictive models for the disease and aid in the development of early-warning strategies for the deployment of prophylactic treatments and other control measures.

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