Differential impact of the Canadian point-of-sale tobacco display bans on quit attempts and smoking cessation outcomes by sex, income and education: longitudinal findings from the ITC Canada Survey

SignificanceThis study examines the differential effects of Canadian point-of-sale (POS) tobacco display bans across provinces on quit attempts and smoking cessation, by sex, education and income.MethodsWe analysed survey data from five waves (waves 4–8) of the International Tobacco Control Canada Survey, a population-based, longitudinal survey, where provinces implemented display bans between 2004 and 2010. Primary outcomes were quit attempts and successful cessation. We used generalised estimating equation Poisson regression models to estimate associations between living in a province with or without a POS ban (with a 24-month threshold) and smoking outcomes. We tested whether these associations varied by sex, education and income by including interaction terms.ResultsAcross survey waves, the percentage of participants in provinces with POS bans established for more than 24 months increased from 5.0% to 95.8%. There was no association between POS bans and quit attempts for provinces with bans in place for 0–24 months or more than 24 months, respectively (adjusted relative risk (aRR)=0.99, 95% CI: 0.89 to 1.10; 1.03, 95% CI: 0.88 to 1.20). However, we found a differential impact of POS bans on quit attempts by sex, whereby bans were more effective for women than men for bans of 0–24 months. Participants living in a province with a POS ban for at least 24 months had a higher chance of successful cessation (aRR=1.49; 95% CI: 1.08 to 2.05) compared with those in a province without a ban. We found no differences in the association between POS bans and quit attempts or cessation by education or income, and no differences by sex for cessation.ConclusionPOS bans are associated with increased smoking cessation overall and more quit attempts among women than men.

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Perceived Addiction as a Predictor of Smoking Cessation Among Occasional Smokers

The Journal of Smoking Cessation ◽

10.1017/jsc.2015.19 ◽

2016 ◽

Vol 12 (3) ◽

pp. 165-172 ◽

Cited By ~ 3

Author(s):

Michael Chaiton ◽

Joanna E. Cohen ◽

Sue J. Bondy ◽

Peter Selby ◽

K. Stephen Brown ◽

...

Keyword(s):

Smoking Cessation ◽

Predictive Ability ◽

Estimating Equation ◽

Population Based ◽

Smoking Behaviour ◽

Clinical Settings ◽

Proportional Hazard ◽

Quit Attempt ◽

Measures Of Dependence ◽

Quit Attempts

Introduction: Common short screening measures of dependence that use number of cigarettes per day may not be appropriate for use in populations of occasional smokers.Aims: In this study, we investigate whether perceived addiction (PA) predicts quit attempts and successful cessation among occasional smokers.Methods: Current occasional smokers (18+) in the Ontario Tobacco Survey (OTS) longitudinal cohort study followed up every six months for up to three years. Respondents rated their self-perceived level of addiction (very vs. somewhat or not very addicted). Generalised Estimating Equation models and proportional hazard models were used to test the predictive ability of PA.Results/Findings: Occasional smokers with very high PA had a higher likelihood of reporting a quit attempt (RR: 2.49; 95% CI: 1.88, 3.30) after adjusting for demographics. Given an incident quit attempt, occasional smokers who reported being very addicted were 2.93 times more likely to relapse (95%: 2.01, 4.28). The effect of PA was independent of other predictors of smoking behaviour.Conclusions: For some, occasional smokers, smoking cessation is a difficult process that may require significant support. Asking occasional smokers about PA is an effective way to predict likely success in quitting smokers that may be easily assessed in population based, as well as in community and clinical, settings.

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E-cigarette Usage Is Associated With Increased Past-12-Month Quit Attempts and Successful Smoking Cessation in Two US Population–Based Surveys

Nicotine & Tobacco Research ◽

10.1093/ntr/nty211 ◽

2018 ◽

Vol 21 (10) ◽

pp. 1331-1338 ◽

Cited By ~ 9

Author(s):

Linda Johnson ◽

Yinjiao Ma ◽

Sherri L Fisher ◽

Alex T Ramsey ◽

Li-Shiun Chen ◽

...

Keyword(s):

Smoking Cessation ◽

Electronic Cigarettes ◽

Population Level ◽

Population Based ◽

Cigarette Use ◽

Positive Effects ◽

Quit Attempts ◽

The Us ◽

Interview Survey ◽

Demographic Shifts

Abstract Introduction We examined past-12-month quit attempts and smoking cessation from 2006 to 2016 while accounting for demographic shifts in the US population. In addition, we sought to understand whether the current use of electronic cigarettes was associated with a change in past-12-month quit attempts and successful smoking cessation at the population level. Methods We analyzed data from 25- to 44-year-olds from the National Health Interview Survey (NHIS) from 2006 to 2016 (N = 26,354) and the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) in 2006–2007, 2010–2011, and 2014–2015 (N = 33,627). Data on e-cigarette use were available in the 2014–2016 NHIS and 2014–2015 TUS-CPS surveys. Results Past-12-month quit attempts and smoking cessation increased in recent years compared with 2006. Current e-cigarette use was associated with higher quit attempts (adjusted odds ratio [aOR] = 2.29, 95% confidence interval [CI] = 1.87 to 2.81, p < .001) and greater smoking cessation (aOR = 1.64, 95% CI = 1.21 to 2.21, p = .001) in the NHIS. Multivariable logistic regression of the TUS-CPS data showed that current e-cigarette use was similarly significantly associated with increased past-12-month quit attempts and smoking cessation. Significant interactions were found for smoking frequency (everyday and some-day smoking) and current e-cigarette use for both outcomes (p < .0001) with the strongest positive effects seen in everyday smokers. Conclusions Compared with 2006, past-12-month quit attempts and smoking cessation increased among adults aged 25–44 in recent years. Current e-cigarette use was associated with increased past-12-month quit attempts and successful smoking cessation among established smokers. These findings are relevant to future tobacco policy decisions. Implications E-cigarettes were introduced into the US market over the past decade. During this period, past-12-month quit attempts and smoking cessation have increased among US adults aged 25–44. These trends are inconsistent with the hypothesis that e-cigarette use is delaying quit attempts and leading to decreased smoking cessation. In contrast, current e-cigarette use was associated with significantly higher past-12-month quit attempts and past-12-month cessation. These findings suggest that e-cigarette use contributes to a reduction in combustible cigarette use among established smokers.

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Evaluation of a federally funded mass media campaign and smoking cessation in pregnant women: a population-based study in three states

BMJ Open ◽

10.1136/bmjopen-2017-016826 ◽

2017 ◽

Vol 7 (12) ◽

pp. e016826 ◽

Cited By ~ 10

Author(s):

Lucinda England ◽

Van T Tong ◽

Karilynn Rockhill ◽

Jason Hsia ◽

Tim McAfee ◽

...

Keyword(s):

Smoking Cessation ◽

Pregnant Women ◽

Population Based ◽

Federally Funded ◽

Third Trimester ◽

The Third ◽

Quit Attempts ◽

Control And Prevention ◽

Former Smokers ◽

Adjusted Logistic Regression

ObjectivesIn 2012, theCenters for Disease Control and Prevention initiated a national anti-smoking campaign,Tips from Former Smokers(Tips). As a result of the campaign, quit attempts among smokers increased in the general population by 3.7 percentage points. In the current study, we assessed the effects ofTipson smoking cessation in pregnant women.MethodsWe used 2009–2013 certificates of live births in three US states: Indiana, Kentucky and Ohio. Smoking cessation by the third trimester of pregnancy was examined among women who smoked in the 3 months prepregnancy. Campaign exposure was defined as overlap between the airing ofTips2012 (March 19–June 10) and the prepregnancy and pregnancy periods. Women who delivered beforeTips2012 were not exposed. Adjusted logistic regression was used to determine whether exposure toTipswas independently associated with smoking cessation.ResultsCessation rates were stable during 2009–2011 but increased at the timeTips2012 aired and remained elevated. Overall, 32.9% of unexposed and 34.7% of exposed smokers quit by the third trimester (p<0.001). Exposure toTips2012 was associated with increased cessation (adjusted OR: 1.07, 95% CI 1.05 to 1.10).ConclusionsExposure to a national anti-smoking campaign for a general audience was associated with smoking cessation in pregnant women.

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Assessing the evidence on the differential impact of menthol versus non-menthol cigarette use on smoking cessation: A systematic review

10.21203/rs.3.rs-52105/v1 ◽

2020 ◽

Author(s):

Mimi Kim ◽

Geoffrey Curtin

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Cigarette Use ◽

Qualitative Synthesis ◽

Differential Impact ◽

Menthol Cigarette ◽

Strength Of Evidence ◽

Quit Attempts ◽

Moderate Change ◽

Poor Individual

Abstract Background: This systematic review followed PRISMA guidelines to examine the Key Question: Does menthol cigarette use have a differential impact on smoking cessation compared with non-menthol cigarette use?Methods: The original protocol was registered on March 22, 2016 (updated January 10, 2019; PROSPERO: CRD42019119301). Six databases were queried from inception to December 14, 2018.Results: Fifty-seven studies (27 rated “good”, 27 rated as “fair”, and three studies rated as “poor” individual study quality) that compared menthol and non-menthol smokers were qualitatively synthesized across the following cessation measures (total adjusted studies; strength of evidence grade): duration of abstinence (2; low); quit attempts (14; insufficient); rate of abstinence/quitting (28; moderate); change in smoking quantity/frequency (3; insufficient); and return to smoking/relapse (2; insufficient). Overall, the qualitative synthesis failed to show a consistent trend for the association of menthol cigarette use and smoking cessation across the outcomes. Further, meta-analytic results found no difference between menthol and non-menthol cigarette use and the two measures of quit attempts and duration of abstinence.Implications: The overall strength of evidence for an association between menthol cigarette use and smoking cessation was graded as “low”, based on deficiencies of indirectness and inconsistency in the available body of evidence. Therefore, there is no consistent, significant, or differential association between menthol cigarette use and smoking cessation.

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Assessing the evidence on the differential impact of menthol versus non-menthol cigarette use on smoking cessation in the U.S. population: a systematic review and meta-analysis

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-021-00397-4 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Mimi M. Kim ◽

Geoffrey M. Curtin

Keyword(s):

Public Health ◽

Systematic Review ◽

Smoking Cessation ◽

Systematic Reviews ◽

Cochrane Central Register ◽

Cigarette Use ◽

Differential Impact ◽

Menthol Cigarette ◽

Strength Of Evidence ◽

Quit Attempts

Abstract Background The potential impact of menthol versus non-menthol cigarette use on smoking behaviors is an intensely scrutinized topic in the public health arena. To date, several general literature reviews have been conducted, but findings and conclusions have been discordant. This systematic review followed PRISMA guidelines to examine the Key Question, “Does menthol cigarette use have a differential impact on smoking cessation compared with non-menthol cigarette use?” Methods Six databases—Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, MEDLINE, Embase and PsycInfo—were queried from inception to June 12, 2020. Articles comparing menthol versus non-menthol cigarette smokers in terms of at least one predefined smoking cessation outcome were included. Risk of bias was assessed using the Agency for Healthcare Research and Quality Evidence-Based Practice Center approach. A random-effects model utilizing the DerSimonian and Laird method to pool adjusted odds ratio was applied. Variations among pooled studies were assessed using Cochran’s Q statistic, and heterogeneity was quantified using the inconsistency index (I2). Results Forty-three demographically adjusted studies (22 rated “good”, 20 rated “fair”, and one study rated “poor” individual study quality) comparing menthol and non-menthol smokers were qualitatively synthesized across the following measures (study count; strength of evidence): duration of abstinence (2; low); quit attempts (15; insufficient); rate of abstinence/quitting (29; moderate); change in smoking quantity/frequency (5; insufficient); and, return to smoking/relapse (2; insufficient). Overall, the qualitative synthesis failed to show a consistent trend for an association between menthol cigarette use and smoking cessation across outcomes. Meta-analyses found no difference between menthol and non-menthol cigarette use and either quit attempts or abstinence. Conclusions Given the lack of consistency or statistical significance in the findings—combined with a “low” overall strength of evidence grade, based on deficiencies of indirectness and inconsistency—no consistent or significant associations between menthol cigarette use and smoking cessation were identified. Recommendations for future studies include increased focus on providing longitudinal, adjusted data collected from standardized outcome measures of cessation to better inform long-term smoking cessation and menthol cigarette use. Such improvements should also be further considered in more methodologically rigorous systematic reviews characterized by objectivity, comprehensiveness, and transparency with the ultimate objective of better informing public health and policy decision making.

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Intention to Quit Smoking, Attempts to Quit, and Successful Quitting among Hong Kong Chinese Smokers: Population Prevalence and Predictors

American Journal of Health Promotion ◽

10.4278/0890-1171-19.5.346 ◽

2005 ◽

Vol 19 (5) ◽

pp. 346-354 ◽

Cited By ~ 25

Author(s):

Abu Saleh M. Abdullah ◽

HK Yam

Keyword(s):

Smoking Cessation ◽

Hong Kong ◽

Population Based ◽

Intention To Quit ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated ◽

Quit Smoking ◽

Quit Attempts ◽

Structured Questionnaire

Purpose. To assess the prevalence of each step in the smoking-cessation process (intention to quit, attempts to quit, and successful quitting) and to examine the factors associated with them among Chinese smokers. Design. A cross-sectional survey of subjects from randomly selected households. Setting. Four thousand one hundred forty-two households in Hong Kong. Subjects. A total of 11,779 persons, aged 15 years or older, were enumerated (response rate = 74.0%). Measures. A validated structured questionnaire was used for data collection. The questionnaire sought information on the subject's sociodemographic background, smoking habits, and workplace attitude to smoking. The predictors for successful quitting, past quitting attempts, and intention to quit were assessed by χ2 tests and multiple logistic regression. Results. Of the respondents, 14.4% were current smokers, 7.5% were ex-smokers, and 78.1% were nonsmokers. Of the daily smokers, 52% intended to quit. The factors associated with quitting were being married, being in the student/retired/others category, being older, having received higher education, not smoking to kill time, and smoking because of curiosity. Being married and not smoking to kill time were associated with past quitting attempts. Being male, married, and not smoking to kill time were associated with the intention to quit smoking. Conclusion. The findings of this study indicate that differing predictors may contribute to the different transitional stages of smoking cessation. Population-based smoking-cessation programs should take these predictors into consideration in the design of interventions.

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Employment outcome for people with schizophrenia in rural v. urban China: population-based study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.112.118927 ◽

2013 ◽

Vol 203 (4) ◽

pp. 272-279 ◽

Cited By ~ 19

Author(s):

Lawrence H. Yang ◽

Michael R. Phillips ◽

Xianyun Li ◽

Gary Yu ◽

Jingxuan Zhang ◽

...

Keyword(s):

Regression Models ◽

Population Based ◽

Urban China ◽

Future Research ◽

Adjusted Relative Risk ◽

Employment Outcome ◽

Community Based ◽

Population Based Study ◽

Urban Settings ◽

Rural And Urban

BackgroundAlthough outcomes among people with schizophrenia differ by social context, this has rarely been examined across rural v. urban settings. For individuals with schizophrenia, employment is widely recognised as a critical ingredient of social integration.AimsTo compare employment for people with schizophrenia in rural v. urban settings in China.MethodIn a large community-based study in four provinces representing 12% of China's population, we identified 393 people with schizophrenia (112 never treated). We used adjusted Poisson regression models to compare employment for those living in rural (n = 297) v. urban (n = 96) settings.ResultsAlthough rural and urban residents had similar impairments due to symptoms, rural residents were three times more likely to be employed (adjusted relative risk 3.27, 95% Cl 2.11-5.07, P<0.001).ConclusionsPeople with schizophrenia have greater opportunities to use their capacities for productive work in rural than urban settings in China. Contextual mechanisms that may explain this result offer a useful focus for future research.

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Starchy Vegetables and Metabolic Syndrome in Costa Rica

Nutrients ◽

10.3390/nu13051639 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1639

Author(s):

Zhongyao Li ◽

Dongqing Wang ◽

Edward A. Ruiz-Narváez ◽

Karen E. Peterson ◽

Hannia Campos ◽

...

Keyword(s):

Metabolic Syndrome ◽

Regression Models ◽

Fasting Blood Glucose ◽

Population Based ◽

Cross Sectional Study ◽

Costa Rican ◽

Least Square ◽

Inverse Association ◽

Linear Regression Models ◽

Cross Sectional

Only a few studies primarily examined the associations between starchy vegetables (other than potatoes) and metabolic syndrome (MetS). We aimed to evaluate the association between starchy vegetables consumption and MetS in a population-based sample of Costa Rican adults. We hypothesized that a higher overall intake of starchy vegetables would not be associated with higher MetS prevalence. In this cross-sectional study, log-binomial regression models were used to estimate prevalence ratios (PRs) of MetS across quintiles of total, unhealthy, healthy starchy vegetables, and individual starchy vegetables (potatoes, purple sweet potatoes, etc.), among 1881 Costa Rican adults. Least square means and 95% confidence intervals (CIs) from linear regression models were estimated for each MetS component by categories of starchy vegetable variables. Higher intakes of starchy vegetables were associated with a higher prevalence of MetS in crude models, but no significant trends were observed after adjusting for confounders. A significant inverse association was observed between total starchy and healthy starchy vegetables consumption and fasting blood glucose. In this population, starchy vegetables might be part of a healthy dietary pattern.

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Self-Rated Health Status Based on the Type of Health Insurance: A Socioeconomic Perspective

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/00469580211028171 ◽

2021 ◽

Vol 58 ◽

pp. 004695802110281

Author(s):

Minsung Sohn ◽

Minsoo Jung ◽

Mankyu Choi

Keyword(s):

Socioeconomic Status ◽

Health Insurance ◽

Health Status ◽

Regression Models ◽

Private Health Insurance ◽

Public And Private ◽

Logistic Regression Models ◽

Self Rated Health ◽

Interaction Terms ◽

Healthcare Coverage

To investigate the effects of public and private health insurance on self-rated health (SRH) status within the National Health Insurance (NHI) system based on socioeconomic status in South Korea. The data were obtained from 10 867 respondents of the Korea Health Panel (2008-2011). We used hierarchical panel logistic regression models to assess the SRH status. We also added the interaction terms of socioeconomic status and type of health insurance as moderators. Medical aid (MA) recipients were 2.10 times more likely to have a low SRH status than those who were covered only by the NHI, even though the healthcare utilization was higher. When the interaction terms were included, those not covered by the NHI and had completed elementary school or less were 16.59 times more likely to have a low SRH status than those covered by the NHI and had earned a college degree or higher. Expanding healthcare coverage to reduce the burden of non-payment and unmet use to improve the health status of MA beneficiaries should be considered. Particularly, the vulnerability of less-educated groups should be focused on.

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Long-term exposure to iron and copper in fine particulate air pollution and their combined impact on reactive oxygen species concentration in lung fluid: a population-based cohort study of cardiovascular disease incidence and mortality in Toronto, Canada

International Journal of Epidemiology ◽

10.1093/ije/dyaa230 ◽

2020 ◽

Author(s):

Zilong Zhang ◽

Scott Weichenthal ◽

Jeffrey C Kwong ◽

Richard T Burnett ◽

Marianne Hatzopoulou ◽

...

Keyword(s):

Reactive Oxygen Species ◽

Cardiovascular Disease ◽

Regression Models ◽

Population Based ◽

Sensitivity Analyses ◽

Oxygen Species ◽

Lung Fluid ◽

Fine Particulate ◽

Combined Impact

Abstract Background Exposure to fine particulate (PM2.5) air pollution is associated with increased cardiovascular disease (CVD), but less is known about its specific components, such as metals originating from non-tailpipe emissions. We investigated the associations of long-term exposure to metal components [iron (Fe) and copper (Cu)] in PM2.5 with CVD incidence. Methods We conducted a population-based cohort study in Toronto, Canada. Exposures to Fe and Cu in PM2.5 and their combined impact on the concentration of reactive oxygen species (ROS) in lung fluid were estimated using land use regression models. Incidence of acute myocardial infarction (AMI), congestive heart failure (CHF) and CVD death was ascertained using health administrative datasets. We used mixed-effects Cox regression models to examine the associations between the exposures and health outcomes. A series of sensitivity analyses were conducted, including indirect adjustment for individual-level cardiovascular risk factors (e.g. smoking), and adjustment for PM2.5 and nitrogen dioxide (NO2). Results In single-pollutant models, we found positive associations between the three exposures and all three outcomes, with the strongest associations detected for the estimated ROS. The associations of AMI and CHF were sensitive to indirect adjustment, but remained robust for CVD death in all sensitivity analyses. In multi-pollutant models, the associations of the three exposures generally remained unaltered. Interestingly, adjustment for ROS did not substantially change the associations between PM2.5 and CVD, but attenuated the associations of NO2. Conclusions Long-term exposure to Fe and Cu in PM2.5 and their combined impact on ROS were consistently associated with increased CVD death.

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