scholarly journals Transitions in hookah (Waterpipe) smoking by U.S. sexual minority adults between 2013 and 2015: the population assessment of tobacco and health study wave 1 and wave 2

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mary Rezk-Hanna ◽  
Ian W. Holloway ◽  
Joy Toyama ◽  
Umme Shefa Warda ◽  
Lorree Catherine Berteau ◽  
...  
Keyword(s):  
Multinomial Logistic Regression ◽  
Health Study ◽  
Chi Square ◽  
Population Assessment ◽  
Logistic Regression Models ◽  
Global Epidemic ◽  
Product Use ◽  
Hookah Smoking ◽  
Nationally Representative ◽  
And Gender

Abstract Background Tobacco smoking using a hookah (i.e., waterpipe) is a global epidemic. While evidence suggests that sexual minorities (SM) have higher odds of hookah use compared to heterosexuals, little is known about their hookah use patterns and transitions. We sought to examine transitions between hookah smoking and use of other tobacco and electronic (e-) products among SM adults aged 18 years of age and older versus their heterosexual counterparts. Methods We analyzed nationally representative data of ever and current hookah smokers from Wave 1 (2013–2014; ever use n = 1014 SM and n = 9462 heterosexuals; current use n = 144 SM and n = 910 heterosexuals) and Wave 2 (2014–2015; ever use n = 901 SM and n = 8049 heterosexuals; current use n = 117 SM and n = 602 heterosexuals) of the Population Assessment of Tobacco and Health Study. Comparisons between groups and gender subgroups within SM identity groups were determined with Rao-Scott chi-square tests and multivariable survey-weighted multinomial logistic regression models were estimated for transition patterns and initiation of electronic product use in Wave 2. Results Ever and current hookah smoking among SM adults (ever use Wave 1: 29% and Wave 2: 31%; current use Wave 1: 4% and Wave 2: 3%) was higher than heterosexuals (ever use Wave 1: 16% and Wave 2: 16%; current use Wave 1: 1% and Wave 2: 1%; both p < 0.0001). Among SM adults who reported hookah use at Wave 1, 46% quit hookah use at Wave 2; 39% continued hookah use and did not transition to other products while 36% of heterosexual adults quit hookah use at Wave 2 and 36% continued hookah use and did not transition to other products. Compared with heterosexuals, SM adults reported higher use of hookah plus e-products (Wave 2 usage increased by 65 and 83%, respectively). Conclusions Compared to heterosexuals, in addition to higher rates of hookah smoking, higher percentages of SM adults transitioned to hookah plus e-product use between 2013 and 2015. Results have implications for stronger efforts to increase awareness of the harmful effects of hookah as well as vaping, specifically tailored among SM communities.

scholarly journals Prevalence and determinants of diabetes and prediabetes in southwestern Iran: the Khuzestan comprehensive health study (KCHS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanam Hariri ◽  
Zahra Rahimi ◽  
Nahid Hashemi-Madani ◽  
Seyyed Ali Mard ◽  
Farnaz Hashemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Waist Circumference ◽  
Multinomial Logistic Regression ◽  
Fasting Blood Glucose ◽  
Health Study ◽  
Khuzestan Province ◽  
Logistic Regression Models ◽  
Relative Risks ◽  
Southwestern Iran

Background The Middle East and North Africa (MENA) is postulated to have the highest increase in the prevalence of diabetes by 2030; however, studies on the epidemiology of diabetes are rather limited across the region, including in Iran. Methods This study was conducted between 2016 and 2018 among Iranian adults aged 20 to 65 years residing in Khuzestan province, southwestern Iran. Diabetes was defined as the fasting blood glucose (FBG) level of 126 mg/dl or higher, and/or taking antidiabetic medications, and/or self-declared diabetes. Prediabetes was defined as FBG 100 to 125 mg/dl. Multinomial logistic regression models were used to examine the association of multiple risk factors that attained significance on the outcome. Results Overall, 30,498 participants were recruited; the mean (±SD) age was 41.6 (±11.9) years. The prevalence of prediabetes and diabetes were 30.8 and 15.3%, respectively. We found a similar prevalence of diabetes in both sexes, although it was higher among illiterates, urban residents, married people, and smokers. Participants aged 50–65 and those with Body Mass Index (BMI) 30 kg/m2 or higher were more likely to be affected by diabetes [RR: 20.5 (18.1,23.3) and 3.2 (3.0,3.6)]. Hypertension [RR: 5.1 (4.7,5.5)], waist circumference (WC) equal or more than 90 cm [RR: 3.6 (3.3,3.9)], and family history [RR: 2.3 (2.2,2.5)] were also significantly associated with diabetes. For prediabetes, the main risk factors were age 50 to 65 years [RR: 2.6 (2.4,2.8)], BMI 30 kg/m2 or higher [RR: 1.9 (1.8,2.0)], hypertension and WC of 90 cm or higher [RR: 1.7 (1.6,1.8)]. The adjusted relative risks for all variables were higher in females than males, with the exception of family history for both conditions and waist circumference for prediabetes. Conclusions Prediabetes and diabetes are prevalent in southwestern Iran. The major determinants are older age, obesity, and the presence of hypertension. Further interventions are required to escalate diabetes prevention and diagnosis in high-risk areas across Iran.

scholarly journals Waterpipe tobacco package warning exposure’s impact on risk perceptions and use among young adults in the USA: a longitudinal analysis of the population assessment of tobacco and health study

2018 ◽  
Vol 28 (e1) ◽  
pp. e16-e23 ◽  
Author(s):  
Jessica L King ◽  
Beth A Reboussin ◽  
Jennifer Cornacchione Ross ◽  
Erin L Sutfin
Keyword(s):  
Young Adult ◽  
Risk Perceptions ◽  
Health Study ◽  
Regression Analyses ◽  
Population Assessment ◽  
High Exposure ◽  
Factors Associated ◽  
The Usa ◽  
Nationally Representative ◽  
Waterpipe Use

BackgroundAlthough Food and Drug Administration (FDA)-mandated waterpipe tobacco warnings were not required until August 2018, some waterpipe tobacco packaging (WTP) sold in the USA, contained warnings prior to this date. We examined the prevalence of WTP warning exposure and whether exposure influenced risk perceptions or use among young adult (aged 18–24 years) current waterpipe users.MethodsWe used data from waves 1 (2013–2014) and 2 (2014–2015) of the Population Assessment of Tobacco and Health Study, a nationally representative longitudinal study of US adults and youth. We conducted logistic regression analyses to identify factors associated with wave 1 warning exposure, and whether wave 1 WTP warning exposure predicted wave 2 relative risk perceptions and waterpipe use.ResultsMore than one-third of our sample (35.9%, 95% CI 33.5 to 38.4) reported past-month WTP warning exposure. Exposure was higher among males (adjusted OR (AOR)=1.34, 95% CI 1.04 to 1.72), those who usually do not share the waterpipe (AOR=3.10, 95% CI 1.45 to 6.60), those who purchased waterpipe tobacco (AOR=1.73, 95% CI 1.28 to 2.34), and those with a regular brand (AOR=1.84, 95% CI 1.26 to 2.68). Those exposed to WTP warnings at wave 1 were more likely than those not exposed to perceive waterpipe tobacco to be as or more harmful than cigarettes at wave 2 (AOR=1.35, 95% CI 1.02 to 1.78). There was no association between wave 1 WTP exposure and wave 2 waterpipe use.ConclusionsMore than one-third of US young adult current waterpipe users reported WTP warning exposure prior to FDA-mandated warning implementation. Findings suggest the mandated warning may result in high exposure among users; it will be critical to assess exposure’s impact on risk perceptions and behaviour after FDA-mandated warnings are implemented.

scholarly journals Correlates of tobacco product initiation among youth and adults in the USA: findings from the PATH Study Waves 1–3 (2013–2016)

2020 ◽  
Vol 29 (Suppl 3) ◽  
pp. s191-s202 ◽  
Author(s):  
Karin A Kasza ◽  
Kathryn C Edwards ◽  
Zhiqun Tang ◽  
Cassandra A Stanton ◽  
Eva Sharma ◽  
...  
Keyword(s):  
Older Adults ◽  
Tobacco Product ◽  
Health Study ◽  
Product Use ◽  
Frequent Use ◽  
The Us ◽  
The Usa ◽  
Nationally Representative ◽  
Tobacco Initiation

ObjectiveTo report on demographic and tobacco product use correlates of tobacco product initiation (cigarettes, electronic nicotine delivery systems (ENDS), cigars, hookah and smokeless tobacco) among the US population.DesignData were from the first three waves (2013–2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth (aged 12–17 years) and adults (aged 18+ years). Never users of at least one type of tobacco product at Wave 1 (W1, 2013/14) or Wave 2 (W2, 2014/15) were included (n=12 987 youth; n=25 116 adults). Generalised estimating equations were used to evaluate the association between demographic and tobacco product use characteristics at baseline, and tobacco product initiation at follow-up (ever, past 30 day (P30D), frequent (use on 20 or more of thepast 30 days)) over two 1-year periods (W1–W2 and W2–Wave 3).ResultsYouth aged 15–17 years were more likely than youth aged 12–14 years and adults aged 18–24 years were more likely than older adults to initiate P30D tobacco use across products; non-heterosexuals were more likely than heterosexuals to initiate P30D cigarette and ENDS use. Older adults were more likely than young adults, and males were more likely than females, to be frequent users of ENDS on initiation. Ever use of another tobacco product predicted P30D initiation of each tobacco product.DiscussionOther tobacco product use and age predict P30D tobacco initiation across products whereas associations with other demographic characteristics vary by product. Continued contemporary evaluation of initiation rates within the changing tobacco product marketplace is important.

scholarly journals Deaths, Disparities, and Cumulative (Dis)Advantage: How Social Inequities Produce an Impairment Paradox in Later Life

2021 ◽  
Author(s):  
Heide Jackson ◽  
Michal Engelman
Keyword(s):  
Black Women ◽  
Multinomial Logistic Regression ◽  
Functional Limitations ◽  
Later Life ◽  
Functional Health ◽  
Race And Gender ◽  
Nationally Representative ◽  
And Gender ◽  
Gender Groups ◽  
The Impact

Abstract Background Research on health across the life course consistently documents widening racial and socioeconomic disparities from childhood through adulthood, followed by stabilization or convergence in later life. This pattern appears to contradict expectations set by cumulative (dis)advantage (CAD) theory. Informed by the punctuated equilibrium perspective, we examine the relationship between midlife health and subsequent health change and mortality and consider the impact of earlier socioeconomic exposures on observed disparities. Methods Using the Health and Retirement Study, we characterize the functional impairment histories of a nationally-representative sample of 8,464 older adults between 1994-2016. We employ non-parametric and discrete outcome multinomial logistic regression to examine the competing risks of mortality, health change, and attrition. Results Exposures to disadvantages are associated with poorer functional health in midlife and mortality. However, a higher number of functional limitations in midlife is negatively associated with the accumulation of subsequent limitations for white men and women and for Black women. The impact of educational attainment, occupation, wealth, and marriage on later life health differs across race and gender groups. Conclusions Observed stability or convergence in later-life functional health disparities is not a departure from the dynamics posited by CAD, but rather a result of the differential impact of racial and socioeconomic inequities on mortality and health at older ages. Higher exposure to disadvantages and a lower protective impact of advantageous exposures lead to higher mortality among Black Americans, a pattern which masks persistent health inequities later in life.

scholarly journals Is it possible to overcome the ‘long arm’ of childhood socioeconomic disadvantage through upward socioeconomic mobility?

2019 ◽  
Vol 41 (3) ◽  
pp. 566-574
Author(s):  
Anusha M Vable ◽  
Paola Gilsanz ◽  
Ichiro Kawachi
Keyword(s):  
Grip Strength ◽  
Walking Speed ◽  
Multinomial Logistic Regression ◽  
Socioeconomic Disadvantage ◽  
Healthy Ageing ◽  
Adult Health ◽  
Socioeconomic Mobility ◽  
Logistic Regression Models ◽  
Nationally Representative ◽  
Childhood Disadvantage

Abstract Objectives Socioeconomically disadvantaged children have worse adult health; we test if this ‘long arm’ of childhood disadvantage can be overcome through upward socioeconomic mobility in adulthood. Methods Four SES trajectories (stable low, upwardly mobile, downwardly mobile and stable high) were created from median dichotomized childhood socioeconomic status (SES; childhood human and financial capital) and adult SES (wealth at age 67) from Health and Retirement Study respondents (N = 6669). Healthy ageing markers, in tertiles, were walking speed, peak expiratory flow (PEF), and grip strength measured in 2008 and 2010. Multinomial logistic regression models, weighted to be nationally representative, controlled for age, gender, race, birthplace, outcome year and childhood health and social capital. Results Upwardly mobile individuals were as likely as the stable high SES group to be in the best health tertile for walking speed (OR = 0.81; 95% CI: 0.63, 1.05; P = 0.114), PEF (OR = 0.97; 95% CI: 0.78, 1.21; P = 0.810) and grip strength (OR = 0.97; 95%CI: 0.74, 1.27; P = 0.980). Discussion Findings suggest the ‘long arm’ of childhood socioeconomic disadvantage can be overcome for these markers of healthy ageing through upward socioeconomic mobility.

scholarly journals IDENTIFYING THE TRAJECTORIES OF MULTIMORBIDITY AND THEIR CORRELATES AMONG KOREAN OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S697-S697
Author(s):  
Sun Ah Lee ◽  
Hey Jung Jun ◽  
Susanna Joo ◽  
Hye Won Chai
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Chronic Diseases ◽  
Psychological Health ◽  
Social Engagement ◽  
Multinomial Logistic Regression ◽  
Growth Mixture Modeling ◽  
Older Adulthood ◽  
Logistic Regression Models ◽  
Nationally Representative

Abstract Multimorbidity, the co-existence of two or more chronic diseases, has become prevalent among the older population. This study focused on identifying different patterns of multimorbidity trajectories across older adulthood and examining their predictors. We used six waves of the Korean Longitudinal Study of Aging (KLoSA), a nationally representative longitudinal data collected every two years from 2006 to 2016. The sample was older adults aged 65 years and older in 2006 (N=1,668). Multimorbidity was measured as the self-reported number of medically-diagnosed chronic diseases, and Growth Mixture Modeling was used to examine multimorbidity trajectories. Identified patterns of multimorbidity trajectories were then used as outcome variables in multinomial logistic regression models. Independent variables were socio-demographic, psychological, health-related behavioral and interpersonal factors at baseline. At Wave1, 76% of the sample had no or one chronic disease and 24% had two or more. At Wave6, 49% had none or one and 51% had two or more. Results identified four patterns of multimorbidity trajectory: “maintaining-low” (59.1%; reference), “maintaining-high” (7.3%), “moderately increasing”(26.4%), and “rapidly increasing” (7.2%). In terms of the correlates of these patterns, female older adults and respondents with higher depressive symptoms were more likely to be in the “maintaining-high” group. In addition, respondents who had less frequent meetings with friends, neighbors or relatives were more likely to be in the “rapidly increasing” group. The findings suggest that there are distinct patterns of multimorbidity trajectories across older adulthood, and interventions focusing on depressive symptoms or social engagement may be useful in preventing the increase in multimorbidity.

Long-Term Aspirin Use and Self-Reported Walking Speed in Older Men: The Physicians’ Health Study

2021 ◽  
pp. 1-6
Author(s):  
A.R. Orkaby ◽  
A.B. Dufour ◽  
L. Yang ◽  
H.D. Sesso ◽  
J.M. Gaziano ◽  
...  
Keyword(s):  
Walking Speed ◽  
Multinomial Logistic Regression ◽  
Controlled Trial ◽  
Older Men ◽  
Mobility Limitation ◽  
Health Study ◽  
Logistic Regression Models ◽  
Post Trial ◽  
Propensity Score Adjustment

Background: Mobility limitation is a component of frailty that shares a bidirectional relationship with cardiovascular disease (CVD). Data are limited on the role of established CVD prevention therapies, such as aspirin, for prevention of frailty and mobility limitation. Objectives: Examine the association between long-term aspirin use and walking speed. Design, Setting, Participants: Prospective cohort of 14,315 men who participated in the Physicians’ Health Study I, a completed randomized controlled trial of aspirin (1982-1988), with extended post-trial follow-up. Measurements: Annual questionnaires collected data on aspirin use, lifestyle and other factors. Average annual aspirin use was categorized for each participant: ≤60 days/year and >60 days/year. Mobility was defined according to self-reported walking pace, categorized as: don’t walk regularly (reference), easy/casual <2mph, normal ≥2-2.9mph, or brisk/very brisk ≥3mph. Propensity scoring balanced covariates between aspirin categories. Multinomial logistic regression models estimated odds of being in each self-reported walking category. Results: Mean age was 70±8 years; mean aspirin use 11 years. There were 2,056 (14.3%) participants who reported aspirin use ≤60 days/year. Aspirin use >60 days/year was associated with drinking alcohol, smoking, hypertension, heart disease and stroke, while ≤60 days/year was associated with anticoagulation use and bleeding history. In all, 13% reported not walking regularly, 12% walked <2 mph, 44% walked ≥2-2.9 mph, and 31% walked ≥3 mph. After propensity score adjustment, regular aspirin use was associated with a faster walking speed. Odds ratios (95% confidence intervals) were 1.16 (0.97 to 1.39), 1.24 (1.08 to 1.43), and 1.40 (1.21 to 1.63) for <2 mph, ≥2-2.9 mph and ≥3 mph, respectively, compared to not walking regularly (p-trend<0.001). Conclusions: In this cohort of older men, long-term aspirin use is associated with a greater probability of faster walking speed later in life.

Abstract MP16: Prevalence of Dyslipidemia Patterns among US Hispanics: Results from the Hispanic Community Health Study / Study of Latinos

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Carlos J Rodriguez ◽  
Katrina Swett ◽  
Sylvia Wassertheil-Smoller ◽  
Martha Daviglus ◽  
Robert Kaplan ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Population Based ◽  
Health Study ◽  
Diabetes Diagnosis ◽  
Continuous Variables ◽  
Lower Prevalence ◽  
Chi Square ◽  
Logistic Regression Models ◽  
Low Hdl

Background: Prevalence and determinants of dyslipidemia among Hispanics/Latinos are not well known. Methods: Lipid and lipoprotein data from the HCHS/SOL -- a population-based cohort study of 16,415 US Hispanic/Latino participants, ages 18-74, from Cuban, Dominican, Mexican, Puerto Rican, and Central and South American backgrounds -- were used. Criteria for dyslipidemia are based on National Cholesterol Education Program Adult Treatment Panel III guidelines as low density lipoprotein-cholesterol (LDL-C) >130 mg/dl, triglycerides (TG) >200 mg/dl, non-high density lipoprotein (non-HDL-C) >160 mg/dl, or low HDL-C (<40 mg/dl for men and <50 mg/dl for women). Differences across Hispanic/Latino groups were tested using Mantel- Haenszel Chi-square and analysis of variance for categorical and continuous variables, respectively. Demographics, anthropometric measurements, lifestyle factors, dietary and metabolic profiles in those with abnormal vs. normal lipid components were compared using multivariable logistic regression models. Results: Mean age was 40.7 years (SE 0.23) and 48.3% are male. The overall prevalence of any dyslipidemia was 65.1%; prevalence of elevated LDL-C was 35.5%, and highest among Cubans (44.5%; p<0.001). Low HDL-C was present in 41.9% overall, Central Americans had the highest prevalence (44.1%) but not significantly different from other groups (p=0.09). High TGs were seen in 14.9% overall, most commonly among Cubans (17.5%; p<0.001). Elevated non-HDL-C was seen in 34.3% of the sample, and highest among Cubans (43.2%). Dominicans had the lowest prevalence of all four types of dyslipidemia. Multivariate analyses, across all Hispanics, show that prevalence of any dyslipidemia was significantly associated with increasing body mass index and diabetes diagnosis. Higher age was associated with a significantly lower prevalence of low HDL but a higher prevalence of all other dyslipidemia types. Female sex was associated with higher prevalence of low HDL-C but a lower prevalence of elevated TGs, non-HDL-C or LDL-C. Low physical activity was significantly associated with elevated TGs and low HDL-C. Alcohol use was associated with a lower prevalence of low HDL-C only. Conclusion: Dyslipidemia is very common among Hispanics/Latinos; Cubans seem particularly at risk. Low HDL-C and elevated LDL-C are most commonly seen. Across all Hispanics, determinants of dyslipidemia varied depending on the type of dyslipidemia. To prevent dyslipidemias, effective public health measures among the Hispanic/Latino population are needed.

scholarly journals Flavour types used by youth and adult tobacco users in wave 2 of the Population Assessment of Tobacco and Health (PATH) Study 2014–2015

2019 ◽  
pp. tobaccocontrol-2018-054852 ◽  
Author(s):  
Shyanika W Rose ◽  
Amanda L Johnson ◽  
Allison M Glasser ◽  
Andrea C Villanti ◽  
Bridget K Ambrose ◽  
...  
Keyword(s):  
Young Adult ◽  
Age Groups ◽  
Tobacco Product ◽  
Health Study ◽  
Age Group ◽  
Population Assessment ◽  
Product Use ◽  
Type 3

BackgroundMost youth and young adult (YA) tobacco users use flavoured products; however, little is known about specific flavours used.MethodsWe report flavour types among US tobacco users from the Population Assessment of Tobacco and Health Study, wave 2, 2014–2015. At wave 2, we examined (1) flavour use and type at past 30-day use; (2) new flavoured tobacco product use and type; (3) product-specific flavour patterns across youth (ages 12–17) (n=920), YA (18–24) (n=3726) and adult (25+) (n=10 346) past 30-day and new tobacco users and (4) concordance between self-coded and expert-coded brand flavour type among all adults (18+).ResultsPrevalence of flavoured tobacco product use was highest among youth, followed by YA and adult 25+ any tobacco users. Within each age group, flavoured use was greatest among hookah, e-cigarette and snus users. Overall, menthol/mint, fruit and candy/sweet were the most prevalent flavour types at first and past 30-day use across age groups. For past 30-day use, all flavour types except menthol/mint exhibited an inverse age gradient, with more prevalent use among youth and YAs, followed by adults 25+. Prevalence of menthol/mint use was high (over 50% youth, YAs; 76% adults 25+) and exhibited a positive age gradient overall, though the reverse for cigarettes. Brand-categorised and self-reported flavour use measures among adults 18+ were moderately to substantially concordant across most products.ConclusionsCommon flavours like menthol/mint, fruit and candy/sweet enhance appeal to young tobacco users. Information on flavour types used by product and age can inform tobacco flavour regulations to addess flavour appeal especially among youth.

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