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Reducing Tobacco Use and Secondhand Smoke Exposure: Comprehensive Tobacco Control Programs

November 17, 2014 Comments off

Reducing Tobacco Use and Secondhand Smoke Exposure: Comprehensive Tobacco Control Programs
Source: Community Preventive Services Task Force

The Community Preventive Services Task Force recommends comprehensive tobacco control programs based on strong evidence of effectiveness in reducing tobacco use and secondhand smoke exposure. Evidence indicates these programs reduce the prevalence of tobacco use among adults and young people, reduce tobacco product consumption, increase quitting, and contribute to reductions in tobacco-related diseases and deaths. Economic evidence indicates that comprehensive tobacco control programs are cost-effective, and savings from averted healthcare costs exceed intervention costs.

Read the full Task Force Finding and Rationale Statement for details including implementation issues, possible added benefits, potential harms, and evidence gaps.

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Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study

October 16, 2014 Comments off

Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study
Source: BMC Medicine

Background
Excess body weight, physical activity, smoking, alcohol consumption and certain dietary factors are individually related to colorectal cancer (CRC) risk; however, little is known about their joint effects. The aim of this study was to develop a healthy lifestyle index (HLI) composed of five potentially modifiable lifestyle factors – healthy weight, physical activity, non-smoking, limited alcohol consumption and a healthy diet, and to explore the association of this index with CRC incidence using data collected within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

Methods
In the EPIC cohort, a total of 347,237 men and women, 25- to 70-years old, provided dietary and lifestyle information at study baseline (1992 to 2000). Over a median follow-up time of 12 years, 3,759 incident CRC cases were identified. The association between a HLI and CRC risk was evaluated using Cox proportional hazards regression models and population attributable risks (PARs) have been calculated.

Results
After accounting for study centre, age, sex and education, compared with 0 or 1 healthy lifestyle factors, the hazard ratio (HR) for CRC was 0.87 (95% confidence interval (CI): 0.44 to 0.77) for two factors, 0.79 (95% CI: 0.70 to 0.89) for three factors, 0.66 (95% CI: 0.58 to 0.75) for four factors and 0.63 (95% CI: 0.54 to 0.74) for five factors; P-trend <0.0001. The associations were present for both colon and rectal cancers, HRs, 0.61 (95% CI: 0.50 to 0.74; P for trend <0.0001) for colon cancer and 0.68 (95% CI: 0.53 to 0.88; P-trend <0.0001) for rectal cancer, respectively (P-difference by cancer sub-site = 0.10). Overall, 16% of the new CRC cases (22% in men and 11% in women) were attributable to not adhering to a combination of all five healthy lifestyle behaviours included in the index.

Conclusions
Combined lifestyle factors are associated with a lower incidence of CRC in European populations characterized by western lifestyles. Prevention strategies considering complex targeting of multiple lifestyle factors may provide practical means for improved CRC prevention.

Sleep Quality during Exam Stress: The Role of Alcohol, Caffeine and Nicotine

October 14, 2014 Comments off

Sleep Quality during Exam Stress: The Role of Alcohol, Caffeine and Nicotine
Source: PLoS ONE

Academic exam stress is known to compromise sleep quality and alter drug consumption in university students. Here we evaluated if sleeping problems and changes in legal drug consumption during exam stress are interrelated. We used the Pittsburgh Sleep Quality Index (PSQI) to survey sleep quality before, during, and after an academic exam period in 150 university students in a longitudinal questionnaire study. Self-reports of alcohol, caffeine, and nicotine consumption were obtained. The Perceived Stress Questionnaire (PSQ-20) was used as a measure of stress. Sleep quality and alcohol consumption significantly decreased, while perceived stress and caffeine consumption significantly increased during the exam period. No significant change in nicotine consumption was observed. In particular, students shortened their time in bed and showed symptoms of insomnia. Mixed model analysis indicated that sex, age, health status, as well as the amounts of alcohol and caffeine consumed had no significant influence on global sleep quality. The amount of nicotine consumed and perceived stress were identified as significant predictors of diminished sleep quality. Nicotine consumption had a small-to-very-small effect on sleep quality; perceived stress had a small-to-moderate effect. In conclusion, diminished sleep quality during exam periods was mainly predicted by perceived stress, while legal drug consumption played a minor role. Exam periods may pose an interesting model for the study of stress-induced sleeping problems and their mechanisms.

ASEAN Study Highlights the Philippines as Country with the Fastest Growth in Illicit Cigarettes

October 6, 2014 Comments off

ASEAN Study Highlights the Philippines as Country with the Fastest Growth in Illicit Cigarettes
Source: Oxford Economics

The Philippines is the fastest-growing and now one of the top two illicit cigarette markets within ASEAN (Association of Southeast Asian Nations). Consumption of illicit cigarettes grew by 198% from 2012 to 2013 according to a newly-released study.

The Philippines now accounts for 34% of all illicit cigarette consumption in ASEAN, second only to Vietnam with 39%. However, uniquely within ASEAN,the Philippine problem can be traced back to domestic illicit cigarettes, according to the Asia-14 Illicit Tobacco Indicator 2013 study.

Domestic illicit cigarettes are produced locally and sold without payment of the required taxes, Non-domestic illicit cigarettes are smuggled contraband or counterfeit originating in another country.

+ Full Report (PDF)

Electronic cigarettes: fact and faction

September 22, 2014 Comments off

Electronic cigarettes: fact and faction
Source: British Journal of General Practice

There are a number of public health advocates who appear to consider electronic cigarettes (e-cigarettes) primarily as a threat to public health, and bodies such as the British Medical Association (BMA) and the World Health Organization (WHO) are warning smokers about their potential dangers. This editorial takes a close look at the evidence.

Pre- and Postnatal Exposure to Parental Smoking and Allergic Disease Through Adolescence

September 8, 2014 Comments off

Pre- and Postnatal Exposure to Parental Smoking and Allergic Disease Through Adolescence
Source: Pediatrics

OBJECTIVES: To examine the role of prenatal and postnatal second-hand tobacco smoke (SHS) exposure on asthma, rhinitis, and eczema development up to 16 years of age.

METHODS: A birth cohort of 4089 children was followed for 16 years. Information on parental smoking habits, lifestyle factors, and symptoms of allergic disease was gathered using repeated parental questionnaires. Generalized estimating equations assessed the overall and age-specific associations between SHS exposure and allergic disease at ages 1 to 16 years.

RESULTS: Exposure to SHS in utero was associated with an overall elevated risk of developing asthma up to 16 years (odds ratio [OR] = 1.45; 95% confidence interval [CI], 1.15–1.83) but not for rhinitis or eczema. After additional adjustment for parental smoking throughout childhood, excess overall risks for asthma remained statistically significant. Moreover, a dose-dependent pattern with SHS was observed. Exposure to SHS during infancy was associated with an overall elevated risk of asthma (OR = 1.23; 95% CI, 1.01–1.51), rhinitis (OR = 1.18; 95% CI, 1.01–1.39), and eczema (OR = 1.26; 95% CI, 1.09–1.45) up to 16 years. When age-specific associations were examined, the elevated risks related to SHS exposure in utero or during infancy were mostly confined to early childhood for asthma and rhinitis, whereas the excess risk of eczema appeared greatest at later ages.

CONCLUSIONS: Our findings indicate that early SHS exposure, in utero or during infancy, influences the development of allergic disease up to adolescence. Excess risks for asthma and rhinitis were seen primarily in early childhood, whereas those for eczema occurred at later ages.

Workplace Stress in the United States: Issues and Policies

August 11, 2014 Comments off

Workplace Stress in the United States: Issues and Policies
Source: OECD

Despite relative affluence, workplace stress is a prominent feature of the US labour market. To the extent that job stress causes poor health outcomes – either directly through increased blood pressure, fatigue, muscle pain, etc. or indirectly through increased rates of cigarette smoking – policy to lessen job stress may be appropriate. Focusing predominantly on the United States, this report reviews the literature on a variety of economic concerns related to job stress and health. Areas in which economists may provide valuable insights regarding job stress include empirical selection concerns in identifying the effect of stress on health; measurement error with respect to stress; the existence and magnitude of compensating differentials for stress; and the unique “job lock” effect in the United States created by a system of employer-provided health insurance. This report concludes with a brief discussion of US policies related to job stress.

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