Compliance of Oral Snuff (Naswar) Packaging and Sales Practices with National Tobacco Control Laws and the Relevant Articles of Framework Convention on Tobacco Control in Khyber Pakhtunkhwa Pakistan

Abstract Introduction Smokeless tobacco (SLT) is a significant contributor to tobacco-related harm in Pakistan but its control has lags behind that of combustible tobacco. We assessed the compliance of Naswar’s (a widely used SLT product in the Southeast Asia) packaging and sales practices with the national legislations and relevant articles of the WHO framework convention on tobacco control (FCTC). Aims and Methods A cross-sectional observational audit was conducted in three districts of Pakistan. We recruited 286 general point of sale (GPOS) and exclusive Naswar sellers (ENS) through a multistage cluster sampling strategy. Data were gathered on packaging and labeling practices of Naswar and advertisement and promotion practices inside and outside the shops. Statistical tests for association between the dependent variable-advertisement practices, and independent variables-area and vendor types were conducted. Results We analyzed 133 and 49 unique Naswar products sold in 229 GPOS and by 57 ENS, respectively. None of the local products had any written or pictorial health warning. More than half of retailers used one or two methods of advertising Naswar inside the shops while only 9% advertised outside the shops. ENS were more likely to be noncompliant with tobacco advertisement and promotion compared with GPOS. Conclusions The study presents first insights on the compliance of Naswar packaging and sale practices with local regulations and WHO FCTC provisions in Pakistan. Almost all products were on display in the shops and none of the local products had any health warning or contents disclosure on the packages. Implications Naswar is a form of SLT used extensively in Pakistan, Central Asia, and Pashtun populations across the globe. This study provides an important insight into the Naswar retail environment in a geographical setting where the use of Naswar is endemic. The study brings to fore previously unreported issues like an urban–rural disparity, and differences between exclusive and nonENS, with regards to Naswar advertisement and promotion. These findings have potential implication on the implementation of tobacco control retail policies. The lack of health warnings and free display of Naswar brands call for alignment of tobacco control efforts with the FCTC.

Download Full-text

Acceptance of the COVID-19 vaccine in Generation Z: A cross-sectional study in Southeast Sulawesi, Indonesia

Public Health of Indonesia ◽

10.36685/phi.v7i4.460 ◽

2021 ◽

Vol 7 (4) ◽

pp. 139-144

Author(s):

Chevin Ramadhan Hadiwijaya ◽

Muhammad Imam Zan Zabiyla Analuddin ◽

Ayikacantya Sudayasa ◽

Muhammad Hoki Akbar ◽

Lilyana Aritonia Ahmad ◽

...

Keyword(s):

Analytical Study ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Cross Sectional ◽

Effective Strategies ◽

Generation Z ◽

The Media ◽

Cross Sectional Design ◽

Almost All ◽

The City

Background: Adequate health systems and effective strategies are needed to increase trust and acceptance in vaccines. Generation Z is more concerned with environmental issues related to the pandemic situation.Objective: This study aimed to assess the acceptance of the COVID-19 vaccine in Generation Z.Methods: This was an observational analytical study with a cross-sectional design on generation Z in Southeast Sulawesi, Indonesia, from May to July 2021. The samples were taken by cluster sampling using faculty classification. Data was collected using a questionnaire with a google form, included the characteristics, knowledge regarding COVID-19 and vaccine, and the media information.Results: There were 396 participants. Most of them were 20 years (52.6%), female (74.8%), and Muslim (93.7%). About 61.6% live outside the city and had insurance (77.3%). Half of the participants knew the COVID-19 symptoms (51.26%), some participants were hesitant (11.8%) and did not even know (0.76%). Almost all participants were aware of the COVID-19 vaccination program (99.2%), benefits (95.2%), side effects (84.1%), and knew the contents of the COVID-19 vaccine (62.1%). Most of them were willing to take the COVID-19 vaccine (77.8%). However, 17.93% were hesitant, and 4.29% were unwilling to participate. Most participants were not trusting vaccines (43.9%), did not feel the need (29.3%), and felt access was not easy (26.8%). Most of them used social media to get information about COVID-19 (89.1%).Conclusion: Generation Z has a good acceptance of the COVID-19 vaccine, even though there are still doubts and rejects. Accurately and sustainable information is needed.

Download Full-text

Hotspots of unimproved sources of drinking water in Ethiopia: Mapping and Spatial analysis of Ethiopia Demographic and Health Survey Data 2016

10.21203/rs.2.18991/v1 ◽

2019 ◽

Author(s):

Getahun Gebre Bogale

Keyword(s):

Drinking Water ◽

Statistical Tests ◽

National Level ◽

Population Based ◽

Cross Sectional Study ◽

Moran’S I ◽

Systematic Sampling ◽

Cluster Sampling ◽

Cross Sectional ◽

Moran's I

Abstract Background: More than 35% of Ethiopian population is using drinking water from unimproved sources. As per the United Nations’ Sustainable Development Goals, Ethiopia is aspiring to achieve universal and equitable access to safe and affordable drinking water for all by 2030. For these goals to be accomplished, it is important to map the country’s hotspot areas of unimproved source of drinking-water so that resource allocation and disease control can be optimized there. Methods: A population based cross-sectional study was conducted in Ethiopia from January 18 to June 27, 2016. Data were collected from 10,064 households using a pretested and structured questionnaire. A stratified two-stage cluster sampling was employed where the enumeration areas were primary sampling units and households were secondary sampling units. Systematic sampling with probability proportional to size was employed to select samples. Data were cleaned in spreadsheet and entered in to SaTScan and ArcGIS soft-wares for mapping and analysis. The Global Moran’s I and spatial scan statistical tests (Bernoulli model) were done to explore the presence of clustering in the study area and local spatial clusters (hotspots) of unimproved sources of drinking water using ArcGIS version 10.3 and Kuldorff’s SaTScan version 9.4 soft-wares, respectively. Moran’s I value closer to +1 declared presence of clustering at national level and Log-Likelihood ratio (LLR) greater than the critical value with p<0.05 declared statistical significant hotspots across the regions. Results: In this study, unimproved sources of drinking water were spatially clustered at the study area (Moran’s I: 0.35, p<0.05). A total of 143 significant clusters were identified. Of which, eight were most likely (primary) clusters and the rest 135 were secondary clusters. The first spatial window which contains primary clusters was located in Amhara and Afar regions (LLR: 78.89, at p<0.001). The rest 33 spatial windows which contain secondary clusters were found in all regions, except Gambela region and Addis Abeba city administration (with a range of LLR: 10.09-78.89, p<0.001). Conclusions: This study identified non-random clusters and hot spots of unimproved sources of drinking water. Therefore, the result helps decision makers for their geographical interventions to combat problems related to hotspots.

Download Full-text

Peran Keluarga terhadap Penurunan Tingkat Kecemasan Lanjut Usia

Journal of Nursing Education and Practice ◽

10.53801/jnep.v1i2.37 ◽

2021 ◽

Vol 1 (2) ◽

pp. 31-37

Author(s):

Dewi Puspa Cipta Utami

Keyword(s):

Statistical Tests ◽

Sampling Technique ◽

The Elderly ◽

P Value ◽

Cluster Sampling ◽

Family Role ◽

Chi Square ◽

Cross Sectional ◽

The Family

Introduction: The role of the family is the specific behavior expected by someone in the family member. Anxiety is a fear that is not clear and is not supported by the situation. Objective: To Know the Relationship of Family Role to the Level of Anxiety in the Elderly in Hamlet 01 Kukusan Beji-Depok Method: The research method uses analytics with a cross-sectional approach. The study population was 288 people with a sample of 81 respondents using the Slovin formula. In the sampling technique using cluster sampling. Results: The results showed that the respondents with a bad family role as many as 41 (50.6%) anxiety levels of the middle aged were 59 (72.8%). The results of statistical tests using the chi-square test indicate that there is a significant or significant relationship between the role of the family and the level of anxiety of the elderly with a value of p-value 0.01. Conclusion: It was concluded that there was a relationship between the role of the family and the level of anxiety of the elderly in the Hamlet 01 Kukusan Beji District Depok City.

Download Full-text

Monitoring compliance with Senegal’s tobacco products packaging and labelling requirements 6 months after implementation of the law

Tobacco Control ◽

10.1136/tobaccocontrol-2021-056973 ◽

2022 ◽

pp. tobaccocontrol-2021-056973

Author(s):

Mamadou Bamba Sagna ◽

Mary Clare Rosemeyer ◽

Oumar Ba ◽

Fatou Diouf ◽

Karoline Walter ◽

...

Keyword(s):

Tobacco Control ◽

Capital City ◽

Lateral Side ◽

African Region ◽

Control Laws ◽

Health Warning ◽

Type Size ◽

Substantial Progress ◽

Tobacco Packaging ◽

Packaging And Labelling

IntroductionAs of December 2021, 22 countries and one jurisdiction in WHO African Region (AFRO) have adopted pictorial health warning labels on tobacco packaging, but only 13 have implemented them. In 2014, Senegal enacted a comprehensive tobacco control law, which requires strong provisions on tobacco packaging and labelling. The objective of this study was to assess the level of compliance with these provisions in Senegal 6 months after implementation.MethodsData collection took place in Senegal’s capital city of Dakar across 12 districts in February 2018, following the Tobacco Pack Surveillance System Field Protocol developed by the Institute for Global Tobacco Control at Johns Hopkins Bloomberg School of Public Health. Unique tobacco packs were purchased from a total of 48 tobacco vendors, and compliance with new packaging and labelling provisions was assessed.ResultsIn total, seven unique cigarette packs were confirmed to be legally available for sale in Dakar, Senegal. All packs complied with all health warning provisions (type, size, location, language and quitline information) as well as bans on quantitative emissions yields. However, no pack complied with the descriptive constituents and emissions statement required on the lateral side, and four of the seven packs violated the ban on misleading brand descriptors.ConclusionsAFRO countries have made substantial progress in adopting comprehensive tobacco control laws that bring them closer into alignment with the Framework Convention on Tobacco Control. This study found areas of effective implementation of FCTC recommended packaging and labelling requirements, as well as areas in need of stronger enforcement.

Download Full-text

Marriage Patterns and Childbearing: Results From a Quantitative Study in North of Iran

Global Journal of Health Science ◽

10.5539/gjhs.v8n3p1 ◽

2015 ◽

Vol 8 (3) ◽

pp. 1 ◽

Cited By ~ 5

Author(s):

Ziba Taghizadeh ◽

Fereshteh Behmanesh ◽

Abbas Ebadi

Keyword(s):

Quantitative Study ◽

Sampling Strategy ◽

Cluster Sampling ◽

Font Size ◽

Cross Sectional ◽

Reproductive Behaviors ◽

Factors Affecting ◽

Marriage Patterns ◽

The North ◽

North Of Iran

Social changes have rapidly removed arranged marriages and it seems the change in marriage pattern has played a role in childbearing. On the other hand, there is a great reduction in population in many countries which requires a comprehensive policy to manage the considerable drop in population. To achieve this goal, initially, the factors affecting fertility must be precisely identified. This study aims to examine the role of marriage patterns in childbearing. In this cross-sectional quantitative study, 880 married women 15-49 years old, living in the north of Iran were studied using a cluster sampling strategy. The results showed that there are no significant differences in reproductive behaviors of three patterns of marriage in Bobol city of Iran. It seems there is a convergence in childbearing due to the different patterns of marriage and Policymakers should pay attention to other determinants of reproductive behaviors in demographic planning.

Download Full-text

Prevalence and risk factors of airflow obstruction in a Caribbean population

The International Journal of Tuberculosis and Lung Disease ◽

10.5588/ijtld.19.0578 ◽

2020 ◽

Vol 24 (5) ◽

pp. 512-519

Author(s):

L. Conyette ◽

F. Lutchmansingh ◽

S. Sakhamuri ◽

D. Simeon ◽

M. A. Ivey ◽

...

Keyword(s):

Risk Factors ◽

General Population ◽

Trinidad And Tobago ◽

Airflow Obstruction ◽

Forced Expiratory Volume ◽

Cluster Sampling ◽

Cross Sectional ◽

History Of ◽

Caribbean Population ◽

Almost All

SETTING: The prevalence of airflow obstruction (AO) in the Caribbean population is unknown.OBJECTIVE: To measure the prevalence of and risk factors for AO (post-bronchodilator ratio of forced expiratory volume in 1 sec to forced vital capacity of <0.7) in the Trinidad and Tobago general population using the Burden of Obstructive Lung Disease methodology.DESIGN: National cross-sectional, stratified, cluster sampling of adults aged ≥40 years.RESULTS: AO prevalence was 9.5% among 1104 participants, most of whom were unaware of this. Compared to those aged 40–49 years, the adjusted odds ratio of AO by age group was 2.73 (60–69 years) and 3.30 (≥70 years). Risk factors for AO were unemployment (OR 4.31), being retired (OR 2.17), smoking ≥20 pack-years (OR 1.88) and exposure to dusty jobs for more than 1 year (OR 2.06). Related symptoms were history of wheezing, unscheduled visits to the doctor or admission to hospital for breathing problems and in subjects with at least one respiratory symptom (OR 1.90), at least one risk factor (OR 2.81), either symptoms or risk factors (OR 3.71) and both symptoms and risk factors (OR 5.78) (P < 0.05 in all cases).CONCLUSION: AO prevalence in the general population of Trinidad and Tobago aged ≥40 years was 9.5%, almost all of which was undiagnosed. AO was associated with smoking, age >59 years, lack of employment and working in a dusty job.

Download Full-text

Evidence on Article 5.3 of FCTC (Tobacco Industry Interference in tobacco control activities) in India- a Qualitative scoping study

10.21203/rs.3.rs-54074/v2 ◽

2020 ◽

Author(s):

Sonu Goel ◽

Sitanshu Sekhar Kar ◽

Madhur Verma ◽

Parthibane Sivanantham ◽

Bijay Nanda Naik

Keyword(s):

Tobacco Control ◽

Tobacco Industry ◽

Control Measures ◽

Socially Responsible ◽

Cross Sectional ◽

Control Laws ◽

Roles And Responsibilities ◽

Qualitative Research Design ◽

Depth Analysis ◽

Barriers And Challenges

Abstract Background: Tobacco Industry (TI) strives to portray itself as being “socially responsible” and contest for pertinent decision-making positions, which it uses to deter, delay or dilute tobacco control measures. There is little documented evidence of Tobacco Industry Interference (TII) from India, the scope of their interference and challenges faced by the experts for effective tobacco control.Methods: A cross-sectional qualitative research design, based upon in-depth interviews (N=26), was used to explore the opinion of key stakeholders regarding TII in India. The interview schedule collected information about the participant’s roles and responsibilities in tobacco control, the nature of TII faced by the participant, means of influence by TI, barriers and challenges to tobacco control efforts using a set of questions. Results: Most of the respondents were engaged in tobacco control, training, advocacy, and awareness generation activities from the last 5-10 years or more. The respondents defined the TI and its scope as per their experience with the help of power ranking methodology. Most of them perceived TI as ‘Manufacturers’ while others consider them as ‘advertisers’, ‘public relation companies’, ‘wholesalers’, ‘vendors’, and ‘Government firms having TI stocks’ as TI. We identified six major domains (Influencing the policy and administrative decisions, Interference with implementation of tobacco control laws and activities, False propaganda and hiding the truth, manipulating front action groups (FAG), Rampant tobacco advertising and promotion activities, and others) under which TII activities were classified. Most respondents were of opinion that TI players were interfering in the policy decisions, implementation of the tobacco control laws and activities, and manipulating the FAG. A detailed taxonomic classification of the TII strategies that emerged from our analysis were linked to article 5.3 of FCTC. Conclusions: The activity documented a significant level of TII in different domains with stakeholders acting at various hierarchical levels. The study provide insights about the nefarious tactics of TI, enable stakeholders to anticipate and pre-empt the kinds of alliances the TI may attempt to build, stimulate academicians and researchers to undertake in-depth analysis into various strategies and underscore the need for ensuring transparency in official interactions with the TI and their representatives.

Download Full-text

Awareness, perceptions of and compliance with tobacco control policies among naswar vendors in Khyber Pakhtunkhwa Pakistan

Tobacco Control ◽

10.1136/tobaccocontrol-2020-056377 ◽

2021 ◽

pp. tobaccocontrol-2020-056377

Author(s):

Fayaz Ahmad ◽

Zohaib Khan ◽

Kamran Siddiqi ◽

Muhammad Naseem Khan ◽

Zeeshan Kibria ◽

...

Keyword(s):

Tobacco Control ◽

Rural Areas ◽

Regulatory Compliance ◽

Tobacco Product ◽

Self Report ◽

Cluster Sampling ◽

Control Policies ◽

Control Laws ◽

Khyber Pakhtunkhwa ◽

Tobacco Control Policies

IntroductionRegulatory compliance in the retail environment is integral to the success of tobacco control. We assessed compliance among naswar (smokeless tobacco product widely used in South Asia) vendors with tobacco control laws. We also assessed their awareness of tobacco-related harms and policies and perceived effect of policies on their sales.MethodsWe surveyed 286 naswar vendors in three districts of the Khyber Pakhtunkhwa province of Pakistan. We recruited general and specialty vendors from urban and rural areas through multistage cluster sampling. Compliance was measured for promotion, sale to/by minors and tax paid on naswar. We used logistic regression analyses for assessing the association between the outcome variables (awareness of tobacco harms and laws, perceptions about the effect of policies on business and compliance with laws) and their predictors.ResultsMost vendors (70%) were aware of tobacco-related harms of naswar. Although educated vendors were more aware of tobacco control policies, the greatest awareness was for a ban on sales to/by minors (21% overall). The majority of vendors (76%) violated this policy (measured by self-report), and violations were more common among rural than urban vendors (OR 2.27, 95% CI 1.05 to 4.96). Most vendors (71%) violated a ban on promotion of naswar. Vendors perceived tax increases and sales ban to/by minors as most detrimental for business.ConclusionsThere was poor awareness and compliance among naswar vendors in Pakistan with tobacco control laws. This study finds potential areas for policy interventions that can reduce urban/rural disparities in implementation of and compliance with tobacco control laws.

Download Full-text

Associations between Health Literacy and Sociodemographic Factors: A Cross-Sectional Study in Malaysia Utilising the HLS-M-Q18

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094860 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4860

Author(s):

Arina Anis Azlan ◽

Mohammad Rezal Hamzah ◽

Jen Sern Tham ◽

Suffian Hadi Ayub ◽

Abdul Latiff Ahmad ◽

...

Keyword(s):

Health Status ◽

Health Literacy ◽

Health Inequalities ◽

Random Sampling ◽

Demographic Factors ◽

Sampling Strategy ◽

Simple Random Sampling ◽

Cluster Sampling ◽

Cross Sectional Survey ◽

Cross Sectional

Health literacy is progressively seen as an indicator to describe a nation’s health status. To improve health literacy, countries need to address health inequalities by examining different social demographic factors across the population. This assessment is crucial to identify and evaluate the strengths and limitations of a country in addressing health issues. By addressing these health inequalities, a country would be better informed to take necessary steps to improve the nation’s health literacy. This study examines health literacy levels in Malaysia and analyses socio-demographic factors that are associated with health literacy. A cross-sectional survey was carried out using the HLS-M-Q18 instrument, which was validated for the Malaysian population. Multi-stage random sampling strategy was used in this study, utilising several sampling techniques including quota sampling, cluster sampling, and simple random sampling to allow random data collection. A total of 855 respondents were sampled. Our results showed that there were significant associations between health literacy and age, health status, and health problems. Our findings also suggest that lower health literacy levels were associated with the younger generation. This study’s findings have provided baseline data on Malaysians’ health literacy and provide evidence showing potential areas of intervention.

Download Full-text

The Association Between Menopausal Symptoms and General Health Among Iranian Women With Menopause: A Cross-Sectional Study

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2019.33 ◽

2018 ◽

Vol 7 (2) ◽

pp. 196-203

Author(s):

Nasibeh Sharifi ◽

Shahnaz Najar ◽

Nazanin Rezaii ◽

Lida Jalili ◽

Hamideh Yazdizadeh ◽

...

Keyword(s):

Sleep Disorders ◽

General Health ◽

Statistical Tests ◽

Hot Flashes ◽

Cross Sectional Study ◽

Menopausal Symptoms ◽

Cluster Sampling ◽

Cross Sectional ◽

The Relationship

Objectives: Health promotion leads to a higher quality of life among women. The present study aimed to investigate the relationship between menopausal symptoms and general health among women with menopause. Materials and Methods: In this cross-sectional, 600 postpartum women in Ahvaz, Iran were selected and recruited using the randomized cluster sampling method during 2013-2014. The data were collected by the women’s demographic characteristics instrument, as well as the Goldenberg’s and menopausal symptoms questionnaires. In addition, descriptive statistics and logistic regression were employed for data analysis by the SPSS software, version 19. The statistical tests were performed at 95% confidence interval. Results: As regards the menopausal symptoms, sleep disorders (39%), myalgia (42.7%), and hot flashes (32.5%) were reported as moderate, severe, and very severe, respectively. Further, 50.2% of the participants had impaired general health. Finally, job, hot flashes, sleep disorders, myalgia, depression, and aggressiveness were associated with general health (P<0.05). Conclusions: In general, there is a need to improve public health and reduce menopausal symptoms among postmenopausal women since menopause is changed to a crisis in a woman’s life.

Download Full-text