Factors Related to Adolescent Smoking: A Nationally Representative Cross-Sectional Study in Thailand

Objective: This study aimed to explore the individual, familial, and social factors associated with different smoking status in Thai adolescents from the 2017 Cigarette Smoking and Alcohol Drinking Behavior Survey (CSAD) Methods: The nationally representative sample of 6046 adolescents aged 15-19 years who took part in the 2017 CSAD in Thailand. Multinomial logistic regression analysis was conducted to explore the associations between the individual, familial, and social factors and different smoking status. Results: The daily smoking and occasional smoking was 6.4% and 3.3%, respectively. Gender, alcohol use, substance use, attitudes toward smoking, exposure to secondhand smoke at home, anti-smoking social media campaign, and graphic warning labels were related to both daily and occasional smoking. Daily smoking was associated with exposure to secondhand smoke at school, restaurant, and public transport, and exposure to tobacco advertising. Conclusion: These findings suggest that smoking prevention intervention should particularly focus on these factors and also need to develop the anti-smoking policies for smoking prevention among adolescents.

Prevalence and Correlates of Current Tobacco use and Non-user Susceptibility to using Tobacco Product Among School-going Adolescents in 22 African Countries, 2013-2018

Background Our study examined the prevalence and associated factors of tobacco product use and non-users’ susceptibility to using tobacco products among school-going adolescents in 22 African countries.MethodsWe analysed the cross-sectional 2013-2018 GYTS data from 22 African countries. We conducted complex sampling descriptive and logistic regression analyses. We reported our results using frequencies and proportions for descriptive statistics and adjusted odd ratios and 95% confidence intervals for logistic model.ResultsThe overall prevalence of current use of any tobacco product among adolescents was 19.1%, with more males (23.7%) than females (13.7%) being current users. Zimbabwe and Morocco were the highest (47.1%) and least (12.6%) reported prevalence respectively. Being male (AOR=1.930;95%CI:1.614-2.307), exposure to secondhand smoke within (AOR=2.069;95%CI:1.763-2.429) and outside (AOR=1.364;95%CI:1.138-1.635) the home, not knowledgeable about the harmful effect of secondhand smoke (AOR=1.413;95%CI:1.178-1.693), exposure to tobacco industry promotion (AOR=3.027;95%CI:2.653-3.453) and not in favour of banning smoking in enclosed places (AOR=1.222;95%CI:1.014-1.472) were associated with current use of any tobacco product. The prevalence of the susceptibility to using tobacco products among never users of tobacco products was 12.2%, with no significant gender difference. Mozambique (24.6%) and Algeria (4.5%) had the highest and least prevalence of the susceptibility to using tobacco products among never users, respectively. Exposure to tobacco industry promotion (AOR=1.730;95%CI:1.485-2.015) and those not in favour of banning smoking in enclosed places (AOR= 1.323;95%CI:1.142-1.532) were associated with susceptibility to using any tobacco product among never users of tobacco products.ConclusionOur study reports that tobacco use and non-user susceptibility to using tobacco product among school-going adolescents in the 22 African countries is high. As part of public health efforts, governments and other stakeholders need to fully implement anti-tobacco use campaigns, enforce a complete ban on tobacco promotion and advertising, institute educational programs for families, and anti-tobacco use education for the general public and in schools in line with WHO Framework Convention on Tobacco Control guidelines.

A qualitative study on the impact of COVID-19 on the behavior and attitudes of smokers and non-smokers in South Korea

Background The COVID-19 pandemic has affected all aspects of human society, including education, culture, and the economy, and has also introduced changes in people’s health behaviors such as drinking alcohol, nutrition intake, and practicing healthy living. This study conducted qualitative research in the Korean context to examine the changes in the smoking behavior of smokers and secondhand smoke exposure of non-smokers during the COVID-19 pandemic. Methods Focus group interviews were conducted with 36 Korean participants (18 men and 18 women). The groups were composed of cigarette smokers, e-cigarette users, heated tobacco product users, and non-smokers. Results During the pandemic, it was found that there was an increase in the frequency of use, irrespective of the tobacco product, in users who refrained from social interaction and worked or studied from home. Users who continued to be socially active increased the amount used with each usage. Smokers showed a tendency to avoid smoking rooms and to smoke alone in places unoccupied by people. In addition, non-smokers’ exposure to secondhand smoke did not decrease, but since non-smokers used masks, they reported more relief from the risk of exposure to secondhand smoke than before. Conclusions Despite smokers being a high-risk group for COVID-19, the risk did not result in smoking cessation among smokers. Therefore, policies and educational campaigns to raise awareness about the dangers of smoking and to encourage smoking cessation are needed in the future.

Social media: An opportunity to reduce hookah smoke during an outbreak of COVID-19

The tobacco epidemic is one of the biggest public health warnings in the world, and 8 million people die every year due to smoking, of which 7 million die due to direct smoking and 2.1 million due to exposure to secondhand smoke [1].

Associations of exposure to secondhand smoke with hypertension risk and blood pressure values in adults

Background The effects of environmental chemical exposure on blood pressure (BP) have been confirmed, but the association between exposure to secondhand smoke (SHS) and hypertension risk and BP in the general population remains unknown. Methods Cross-sectional associations between SHS exposure and hypertension risk and BP values were evaluated using data for subjects who participated in the National Health and Nutrition Examination Survey (NHANES), 1999–2016. Logistic regression and linear regression were performed after adjusting for age, sex, race, alcohol consumption, poverty-to-income ratio (PIR), body mass index (BMI), estimated glomerular filtration rate, physical activity, diabetes, cardiovascular disease, and NHANES cycle. Restricted cubic spline models were created to display the potential nonlinear association between SHS and BP levels. Results Higher risk of hypertension was found at the highest SHS concentrations (OR = 1.13, 95% CI 1.04, 1.24, P for trend = 0.007). Additionally, SHS exposure had a strong positive association with systolic blood pressure (SBP) but was negatively associated with diastolic blood pressure (DBP). Furthermore, the nonlinear model result showed a significant association between SHS and SBP (P = 0.017); however, the nonlinear model result was not significant for SHS or DBP. Conclusions Our results suggest a potential association between high SHS exposure and the risk of hypertension. Further research is needed to elucidate the underlying mechanisms.

Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009–2018

This study aimed to estimate the secondhand smoke (SHS) exposure using urinary cotinine (UCo) to prove that the SHS exposure could not be properly assessed by self-reporting (SR). In total, 28,574 nonsmokers aged >19 years were selected from the Korean National Health and Nutrition Examination Survey data (2009–2018). First, changes in the annual concentration of UCo were analyzed, and the annual SHS exposure rates were measured based on SR and UCo from 2009 to 2018. Then, the average UCo concentration and UCo-measured SHS exposure rate were confirmed according to the subjects’ characteristics. Finally, factors associated with the UCo-measured SHS exposure rate were identified based on multiple regression analysis. The findings showed that the annual UCo concentrations and self-reported SHS exposure rates dropped significantly over the past decade. In contrast, the UCo-measured SHS exposure rate indicated that >80% of nonsmokers are still exposed to SHS. Moreover, we found vulnerable groups using UCo-measured SHS exposure rate. In particular, the self-reported SHS exposure at home and in workplaces and house type was highly associated with SHS exposure. Thus, these findings indicate that the actual SHS exposure could not be properly assessed by SR and should be verified using a biomarker, such as UCo. Considering that even a short-term exposure can be harmful to health, the goal of the policy should be to keep cotinine concentration as low as possible.