Association of Tobacco Use and Exposure to Secondhand Smoke With Suicide Attempts Among Adolescents: Findings From 33 Countries

2019 ◽  
Vol 22 (8) ◽  
pp. 1322-1329 ◽  
Author(s):  
Shannon Lange ◽  
Ai Koyanagi ◽  
Jürgen Rehm ◽  
Michael Roerecke ◽  
André F Carvalho
Keyword(s):  
Logistic Regression ◽  
Cigarette Smoking ◽  
Tobacco Use ◽  
Dose Response ◽  
Low Income ◽  
Secondhand Smoke ◽  
Suicide Attempts ◽  
Income Level ◽  
Middle Income ◽  
Exposure To Secondhand Smoke

Abstract Introduction There is evidence to suggest that tobacco use is associated with suicide attempts. However, it is unclear whether such an association can be extended to include secondhand smoke exposure. Using nationally representative data of school-attending adolescents from 33 countries, we examined the association of tobacco use and exposure to secondhand smoke with suicide attempts. Methods We used data from the Global School–based Student Health Survey, a cross-sectional survey conducted among adolescents 12–15 years of age. We used logistic regression to estimate the country-specific associations. We then conducted random effect meta-analyses to obtain overall and country-income level pooled estimates. Lastly, we used logistic regression analyses to investigate a dose–response association of cigarette smoking and exposure to secondhand smoke with suicide attempts. Results A positive association between tobacco use and suicide attempts among adolescents was present regardless of country-income level (low income: odds ratio 4.98, 95% CI: 3.11–7.96; lower middle income: 3.47, 2.91–4.15; upper middle income: 3.09, 2.75–3.47; and high income: 3.18, 2.63–3.84) and gender (boys: 3.28, 2.86–3.76; girls: 3.86, 3.30–4.51). Exposure to secondhand smoke was associated with suicide attempts, albeit weakly, among girls only (1.26, 1.14–1.39; boys: 1.00, 0.87–1.15). There was some evidence that a dose–response association of cigarette smoking and exposure to secondhand smoke with suicide attempts may only exist among girls. Conclusions Adolescents who use tobacco, and adolescent girls exposed to secondhand smoke were found to be more likely to attempt suicide; however, future longitudinal studies are warranted to assess causality. Implications Our findings indicate that routine screening of adolescents for tobacco use should be implemented globally, especially when assessing suicidal behaviors and risk. Future longitudinal and intervention studies are warranted to assess causality and whether prevention efforts such as tobacco control interventions and programmes targeting tobacco use and exposure to secondhand smoke among adolescents could ultimately lead to a reduction in the occurrence of suicide attempts.

scholarly journals Cigarette: The Silent Killer in the World

2017 ◽  
Vol 4 (9) ◽  
pp. 1624 ◽  
Author(s):  
Hamidreza Sadeghi Gandomani ◽  
Abed Asgari Tarazoj ◽  
Hamid Salehiniya
Keyword(s):  
Cigarette Smoking ◽  
Peer Review ◽  
Tobacco Use ◽  
21St Century ◽  
Low Income ◽  
Tobacco Consumption ◽  
Low Income Countries ◽  
Middle Income ◽  
The World ◽  
Control And Prevention

One of the main challenges of the 21st century is tobacco consumption, and in particular cigarette smoking (Control and Prevention, 2012). Cigarette smoking is a leading cause of death worldwide (Control and Prevention, 2011).About 1 billion people around the world (800 million men and 200 million women) are addicted to cigarette (WHO, 2015). The prevalence of smoking varies across different parts of the world; this variation is due to economic development and income levels. More than 80% of adult male smokers and half of adult female smokers live in low or middle-income countries  (Ng et al., 2014).Tobacco use kills more than 7 million people every year worldwide, and nearly 80% of these deaths occur in low-income countries (WHO, 2017). It is estimated that this figure will increase in 2030 (WHO, 2011). Tobacco use caused 100 million deaths in the 20th worldwide, if this trend continues, this figure will reach 1 billion by the end of the 21st century (Thun et al., 2013). Peer Review Details Peer review method: NO Peer-review policy Plagiarism software screening?: Yes Date of Original Submission: 7 September 2017 Date accepted: 13 September 2017 Peer reviewers approved by: Dr. Lili Hami Editor who approved publication: Dr. Phuc Van Pham  

scholarly journals Prevalence of tobacco use, exposure to secondhand smoke and knowledge on smoking cessation among students of health professions in Central Greece: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036512
Author(s):  
Athina A Samara ◽  
George Rachiotis ◽  
Sofia Pettemeridou ◽  
Konstantinos Papastamatiou ◽  
Konstantinos Tourlakopoulos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Smoking Cessation ◽  
Logistic Regression ◽  
Tobacco Use ◽  
Secondhand Smoke ◽  
Health Professions ◽  
Cross Sectional ◽  
Current Smoking ◽  
Central Greece ◽  
Exposure To Secondhand Smoke

ObjectivesThe aim of this study was to assess the prevalence of tobacco use and exposure to secondhand smoke among students of health professions (SHPs) and determine possible risk factors for current smoking. In addition, we sought to investigate the level of students’ knowledge regarding smoking cessation.DesignCross-sectional.SettingCentral Greece.ParticipantsA convenient sample of 822 SHP volunteers were used, composed of 365 medical students, 123 students from a biochemistry department, 71 students from a nursing department, 176 from medical laboratory department and 84 students from a veterinary medicine department.Primary and secondary outcome measuresWe investigated the prevalence of current smoking and secondhand smoke, their determinants and SHP’s knowledge and attitudes regarding smoking cessation. Univariate and logistic regression statistical analysis were used in order to identify risk factors associated with current smoking.ResultsThe prevalence of current smoking was estimated at 23.5% (95% CI 20.7% to 26.5%), while 49% of current smokers reported they wanted to quit smoking. The prevalence of current e-cigarette use was 1.2%. In addition, 96.5% (95% CI 94.9% to 97.5%) of SHP have been exposed to secondhand smoke at least 1 day per week. Logistic regression analysis showed that increasing age (p<0.001), alcohol consumption (p<0.001) and exposure to secondhand smoke in the home (p<0.001) were independent risk factors for current smoking. Notably, only 11.6% of the participants had learnt about methods to be used for smoking cessation.ConclusionsOur results underline the need for integrated tobacco control initiatives that should discourage tobacco use among SHP, promote smoke free schools of health science, and implement programs that train SHP in effective cessation-counseling techniques.

scholarly journals Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis

2021 ◽  
pp. archdischild-2020-321385
Author(s):  
Omar Irfan ◽  
Fiona Muttalib ◽  
Kun Tang ◽  
Li Jiang ◽  
Zohra S Lassi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Disease Severity ◽  
World Bank ◽  
Low Income ◽  
Meta Analysis ◽  
Severe Disease ◽  
Income Level ◽  
Clinical Findings ◽  
Middle Income ◽  
Middle Income Countries

ObjectiveCompare paediatric COVID-19 disease characteristics, management and outcomes according to World Bank country income level and disease severity.DesignSystematic review and meta-analysis.SettingBetween 1 December 2019 and 8 January 2021, 3350 articles were identified. Two reviewers conducted study screening, data abstraction and quality assessment independently and in duplicate. Observational studies describing laboratory-confirmed paediatric (0–19 years old) COVID-19 were considered for inclusion.Main outcomes and measuresThe pooled proportions of clinical findings, treatment and outcomes were compared according to World Bank country income level and reported disease severity.Results129 studies were included from 31 countries comprising 10 251 children of which 57.4% were hospitalised. Mean age was 7.0 years (SD 3.6), and 27.1% had a comorbidity. Fever (63.3%) and cough (33.7%) were common. Of 3670 cases, 44.1% had radiographic abnormalities. The majority of cases recovered (88.9%); however, 96 hospitalised children died. Compared with high-income countries, in low-income and middle-income countries, a lower proportion of cases were admitted to intensive care units (ICUs) (9.9% vs 26.0%) yet pooled proportion of deaths among hospitalised children was higher (relative risk 2.14, 95% CI 1.43 to 3.20). Children with severe disease received antimicrobials, inotropes and anti-inflammatory agents more frequently than those with non-severe disease. Subgroup analyses showed that a higher proportion of children with multisystem inflammatory syndrome (MIS-C) were admitted to ICU (47.1% vs 22.9%) and a higher proportion of hospitalised children with MIS-C died (4.8% vs 3.6%) compared with the overall sample.ConclusionPaediatric COVID-19 has a favourable prognosis. Further severe disease characterisation in children is needed globally.

scholarly journals Long-Term Effect of Income Level on Mortality after Stroke: A Nationwide Cohort Study in South Korea

2020 ◽  
Vol 17 (22) ◽  
pp. 8348
Author(s):  
Seungmin Jeong ◽  
Sung-il Cho ◽  
So Yeon Kong
Keyword(s):  
Low Income ◽  
Income Group ◽  
Income Level ◽  
High Income ◽  
High Income Group ◽  
Stroke Mortality ◽  
Stroke Event ◽  
Middle Income ◽  
Medical Aid ◽  
Post Stroke

We investigated whether income level has long-term effects on mortality rate in stroke patients and whether this varies with time after the first stroke event, using the National Health Insurance Service National Sample Cohort data from 2002 to 2015 in South Korea. The study population was new-onset stroke patients ≥18 years of age. Patients were categorized into Category (1) insured employees and Category (2) insured self-employed/Medical Aid beneficiaries. Each category was divided into three and four income level groups, retrospectively. The study population comprised of 11,668 patients. Among the Category 1 patients (n = 7720), the low-income group’s post-stroke mortality was 1.15-fold higher than the high-income group. Among the Category 2 patients (n = 3948), the lower income groups had higher post-stroke mortality than the high-income group (middle-income, aOR (adjusted odds ratio) 1.29; low-income, aOR 1.70; Medical Aid beneficiaries, aOR 2.19). In this category, the lower income groups’ post-stroke mortality risks compared to the high-income group were highest at 13–36 months after the first stroke event(middle-income, aOR 1.52; low-income, aOR 2.31; Medical Aid beneficiaries, aOR 2.53). Medical Aid beneficiaries had a significantly higher post-stroke mortality risk than the high-income group at all time points.

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 ANALISIS KONSUMSI PANGAN TINGKAT RUMAH TANGGA DI PROPINSI LAMPUNG

Agro Ekonomi ◽  
2006 ◽  
Vol 13 (2) ◽  
Author(s):  
Meliyanah Meliyanah ◽  
Suhatmini Hardyastuti ◽  
Djuwari Djuwari
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Household Consumption ◽  
Income Level ◽  
High Income ◽  
Middle Income ◽  
Household Level ◽  
Rural And Urban Areas ◽  
Rural And Urban

This research diamed to: 1) knowing the selft-price elasticity, cross-price elasticity and income elasticity of consumption per food item on household level according to location and income level; and 2) knowing the reation between level of income and food consumption on household level according to location and income level.This research used data from SUSENAS of Lmapung Province in 2002 with number of sample of 2091 household, which being differed between rural and urban areas based on low, middle, and high level of income. The data analysis used tobit model and sensored regression.The result showed that: 1) the demand of rice and beeh for household consumption in every level of income in rural and urban areas were inelastic; 2) Coen only been consumed by low income level household in rural areas and the demand was inelastic; 3) the demand of cassava for household consumption on low income level in urban area was elastic, While in middle income level, high income level and every level of income in rural area, cassava demand was inelastic. Cassava was considered as inferior goods; 4) The demand of fish for household consumption an every level of income in rural and urban areas was elastic. Household in rural area on every level of income and in urban areas on middle and high income level consider fish as a main necessity. While on low income level  household in urban areas, it was considered as classy/exclusive good; 5) the demand of chicken; for household in rural areas on middle and high income level was inelastic. When in rural low income level and urban middle and high income level, was inelastic chicken meat was considend as classy/exclusive good the rural low income level household; 6) egg demand for household consumption in rural areas on every level of income was inelastic, while in urban area it was elastic for every level income; 7) the rural and urban household on every level of income considered rice as the stpale food; 8) Household in rural and urban areas on middle and high level of income considered beef as main necessity; 9) On household with middle income level in rural areas, egg was considere as inferior good; while an low income level in urban areas, egg was considere as expensive good.

scholarly journals Disparities in Rural Tobacco Use, Smoke-Free Policies, and Tobacco Taxes

2019 ◽  
Vol 41 (8) ◽  
pp. 1184-1202 ◽  
Author(s):  
Kelly Buettner-Schmidt ◽  
Donald R. Miller ◽  
Brody Maack
Keyword(s):  
Tobacco Use ◽  
Secondhand Smoke ◽  
Local Level ◽  
Control Policy ◽  
The United States ◽  
Rural Populations ◽  
Left Behind ◽  
Tobacco Taxes ◽  
Policy Work ◽  
Exposure To Secondhand Smoke

Tobacco use and exposure to secondhand smoke (SHS) remain leading causes of preventable disease, disability, and mortality in the United States. Rural populations are among those being left behind in the recent declining smoking rates and have become a focus of discussions on tobacco-related disparities. This article describes tobacco-related disparities in rural populations including tobacco use, exposure to SHS, smoke-free policies, and tobacco taxes. Nurses, as social justice and tobacco control policy advocates, are needed especially at the local level, where much of the policy work occurs and where nursing’s voice is respected and can be powerful.

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