Publications by authors named "Luong Ngoc Khue"

22 Publications

  • Page 1 of 1

Quality of life among advanced cancer patients in Vietnam: a multicenter cross-sectional study.

Support Care Cancer 2021 Feb 3. Epub 2021 Feb 3.

Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ, UK.

Purpose: Cancer is a leading cause of death in Vietnam. To maximize quality of life (QOL) at the end of life, valid and clinically useful instruments are needed to assess palliative care needs and the effectiveness of palliative care interventions.

Methods: We aimed to (i) determine psychometric properties of the Vietnamese version of the WHO abbreviated quality of life scale (WHOQOL-BREF) among advanced cancer patients, (ii) measure HR-QOL, and (iii) identify predictors of HR-QOL. We collected demographic, clinical, and HR-QOL data from stage III/IV adult cancer patients at two major Vietnamese cancer centers. We determined the internal consistency (Cronbach's alpha), construct validity (confirmatory factor analysis (CFA)), and discriminant validity (known-groups comparison) of the Vietnamese instrument. HR-QOL was analyzed descriptively. Multinomial logistic regressions identified predictors of HR-QOL.

Results: A total of 825 patients participated. Missing data were completely at random (MCAR) (chi-square = 14.270, df = 14, p = 0.430). Cronbach's alpha for all items was 0.904. CFA loadings of physical, psychological, social relationship, and environment domains onto HR-QOL were 0.81, 0.82, 0.34, and 0.75, respectively. Prediction of scores differed significantly by functional status (Wilks' lambda = 0.784, chi-square = 197.546, df = 4, p < 0.01, correct prediction = 74.6%). HR-QOL was reported as very bad/bad by n = 188 patients (22.8%) and general health as very bad/bad by n = 430 (52.1%). Multinomial logistic regression (likelihood ratio test: chi-square = 35.494, df = 24, p = 0.061, correct prediction = 62.2%) and the Pearson correlations revealed worse HR-QOL was associated with inpatient status, high ECOG score, and having dependent children.

Conclusion: The Vietnamese version of the WHOQOL-BREF has excellent internal consistency reliability and sound construct and discriminant validity in advanced cancer patients. Advanced cancer inpatients, those with dependent children, and those with poorer physical function appear to have the greatest palliative care needs.
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http://dx.doi.org/10.1007/s00520-021-06012-3DOI Listing
February 2021

The Interdependence of Blood Pressure and Glucose in Vietnam.

High Blood Press Cardiovasc Prev 2021 Mar 16;28(2):141-150. Epub 2021 Jan 16.

Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.

Introduction: Modelling of associations of systolic blood pressure (BP) and blood glucose (BG) with their explanatory factors in separate regressions treats them as having independent biological mechanisms. This can lead to statistical inferences that are unreliable because the substantial overlap in their etiologic and disease mechanisms is ignored.

Aim: This study aimed to examine the relationship of systolic blood pressure (BP) and blood glucose (BG) with measures of obesity and central fat distribution and other factors whilst taking account of the inter-dependence between them.

Methods: Participants (n = 14706, 53.5 % females) aged 25-64 years were selected by multi-stage stratified cluster sampling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols.

Results: Structural modelling identified direct effects for BG (men P = 0.000, women P = 0.029), age (men P = 0.000, women P = 0.000) and body mass index (BMI) (men P = 0.000, women P = 0.000) in the estimation of systolic BP, and for systolic BP (men P = 0.036, women P = 0.000) and waist circumference (WC) (men P = 0.032, women P = 0.009) in the estimation of BG. There were indirect effects of age, cholesterol, physical activity and tobacco smoking via their influence on WC and BMI. The errors in estimation of systolic BP and BG were correlated (men P = 0.000, women P = 0.004), the stability indices (men 0.466, women 0.495) showed the non-recursive models were stable, and the proportion of variance explained was mid-range (men 0.553, women 0.579).

Conclusion: This study provided statistical evidence of a feedback loop between systolic BP and BG. BMI and WC were confirmed to be their primary explanatory factors. Saturated fat intake and physical activity were identified as possible targets of intervention for overweight and obesity, and indirectly for reducing systolic BP and BG. Harmful/hazardous alcohol intake was identified as a target of intervention for systolic BP.
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http://dx.doi.org/10.1007/s40292-020-00431-9DOI Listing
March 2021

Secondhand Tobacco Smoke Exposure in Indoor Workplaces in Viet Nam and Associated Factors: Findings from Two Rounds of Global Adult Tobacco Surveys (GATS) 2010 and 2015.

Asian Pac J Cancer Prev 2020 Jul 1;21(S1):33-38. Epub 2020 Jul 1.

World Health Organization, Country Office for Viet Nam, Hanoi, Viet Nam.

Objectives: This paper explores changes in the level of secondhand smoke (SHS) exposure at indoor workplaces between 2010 and 2015 in Viet Nam and the association between the exposure and various demographic factors, using data from Viet Nam's Global Adult Tobacco Surveys (GATS) 2010 and 2015.

Methods: Data was pooled from the two GATS surveys and analysed using descriptive and Poisson regression analyses.

Results: There was a highly statistically significant reduction in the level of SHS exposure at indoor workplaces from 55.9% to 42.6% (p.
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http://dx.doi.org/10.31557/APJCP.2020.21.S1.33DOI Listing
July 2020

Factors associated with the duration of hospitalisation among COVID-19 patients in Vietnam: A survival analysis.

Epidemiol Infect 2020 06 10;148:e114. Epub 2020 Jun 10.

Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.

Background: The median duration of hospital stays due to COVID-19 has been reported in several studies on China as 10-13 days. Global studies have indicated that the length of hospitalisation depends on different factors, such as the time elapsed from exposure to symptom onset, and from symptom onset to hospital admission, as well as specificities of the country under study. The goal of this paper is to identify factors associated with the median duration of hospital stays of COVID-19 patients during the second COVID-19 wave that hit Vietnam from 5 March to 8 April 2020.

Method: We used retrospective data on 133 hospitalised patients with COVID-19 recorded over at least two weeks during the study period. The Cox proportional-hazards regression model was applied to determine the potential risk factors associated with length of hospital stay.

Results: There were 65 (48.9%) females, 98 (73.7%) patients 48 years old or younger, 15 (11.3%) persons with comorbidities, 21 (16.0%) severely ill patients and 5 (3.8%) individuals with life-threatening conditions. Eighty-two (61.7%) patients were discharged after testing negative for the SARS-CoV-2 virus, 51 were still in the hospital at the end of the study period and none died. The median duration of stay in a hospital was 21 (IQR: 16-34) days. The multivariable Cox regression model showed that age, residence and sources of contamination were significantly associated with longer duration of hospitalisation.

Conclusion: A close look at how long COVID-19 patients stayed in the hospital could provide an overview of their treatment process in Vietnam, and support the country's National Steering Committee on COVID-19 Prevention and Control in the efficient allocation of resources over the next stages of the COVID-19 prevention period.
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http://dx.doi.org/10.1017/S0950268820001259DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306545PMC
June 2020

Palliative Care-Related Knowledge, Attitudes, and Self-Assessment Among Physicians in Vietnam.

J Pain Symptom Manage 2019 12 16;58(6):1015-1022.e10. Epub 2019 Aug 16.

Harvard Medical School, Boston, USA; Massachusetts General Hospital, Boston, USA; Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.

Context: Palliative care is rarely accessible in low- and middle-income countries, and lack of adequate training for health care providers is a key reason. In Vietnam, the Ministry of Health, major hospitals and medical universities, and foreign physician-educators have partnered to initiate palliative care training for physicians.

Objectives: To measure the baseline palliative care-related knowledge, attitudes, and self-assessment of Vietnamese physicians as a basis for curriculum development and to enable evaluation of training courses.

Methods: Before palliative care training courses in Vietnam from 2007 to 2014, we collected data on the participating physicians' demographics, self-assessed competence in palliative care, and palliative care-related knowledge and attitudes. Scores were calculated in three outcome categories-knowledge, attitudes, and self-assessment-and in two subcategories related to physical and psychological symptoms. Associations between the demographic, education, and practice factors and these scores were assessed using linear regression.

Results: Among the 392 physicians surveyed, concern about untreated suffering was highly prevalent. 85% felt that most patients with cancer in Vietnam die in pain. On self-assessment, only 8% felt adequately trained in palliative care and the mean knowledge assessment score was 44%. Although 77% had prescribed an opioid in the past year and most had appropriate attitudes toward the use of morphine for pain, the majority reported explicit or implicit restrictions on prescribing morphine.

Conclusion: There is a great need among Vietnam's physicians for training in palliative care and especially in nonpain and psychological symptom control. Rational, balanced, and clear opioid-prescribing policies are needed to enable physicians to treat pain without fear of repercussions.
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http://dx.doi.org/10.1016/j.jpainsymman.2019.08.001DOI Listing
December 2019

The dental arch dimensions in Vietnamese children at 7 years of age, and their variation by gender and ethnicity.

J Oral Biol Craniofac Res 2019 Jul-Sep;9(3):236-240. Epub 2019 Jun 4.

Institute for Research and Development, Duy Tan University, 03 Quang Trung, Danang, Viet Nam.

Purpose: Dental arch dimensions are important not only in dentistry (e.g. orthodontists and prosthodontists, and forensic odontology), but also other medical fields, biology, biometrics, painting or sculpture. This study aimed to determine these dimensions in Vietnamese children and compare these measurements across four ethnic groups and genders.

Methods: A cross-sectional study was conducted on 3204 Vietnamese children at 7 years of age from four major ethnic groups in Vietnam (Kinh, Tay, Thai and Muong).

Results: The means variables in study subjects were 33.72 ± 2.16 mm for upper inter-canine width (UCW); 52.74 ± 2.55 mm for upper inter-molar width (UMW); 8.69 ± 1.79 mm for upper anterior length (UAL); 29.59 ± 1.97 mm for upper posterior length (UPL); 26.94 ± 2.49 mm for lower inter-canine width (LCW); 45.89 ± 2.59 mm for lower inter-molar width (LMW); 5.04 ± 1.53 mm for lower anterior length (LAL); and 26.22 ± 2.07 mm for lower posterior length (LPL). The UCM, UMW, and LMW of Muong were significantly wider in males, but narrower in females compared with other ethnic groups. The Kinh, Tay and Thai groups had no significant differences between genders in all dimensions, but these sizes were significantly larger in males than females of Muong group.

Conclusions: This study presents the means of dental arch dimensions in 7 year-old Vietnamese children, and there is no statistical differences in these dimensions between genders of almost studied groups, except Muong group. Ethnic differences are observed only in UCW, UMW and LMW of Muong vs other groups. Furthermore, Vietnamese children have dental arch width similar to the African and Caucasian.
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http://dx.doi.org/10.1016/j.jobcr.2019.06.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6558299PMC
June 2019

Salience and Impact of Health Warning Label on Cigarette Packs in Vietnam: Findings From the Global Adult Tobacco Survey 2015.

Behav Med 2019 Jan-Mar;45(1):30-39. Epub 2018 Apr 13.

a Hanoi University of Public Health , Hanoi , Vietnam.

Viet Nam is among the countries having highest rate of male smokers in the world. The country has joined the Global Tobacco Surveillance System since 2010. Under this system, two rounds of Global Adult Tobacco Survey (GATS) were conducted in 2010 and 2015. Those two surveys provide excellent comparable data on tobacco usage and its related aspects in Vietnam. This study using the data from GATS 2015 to examine the salience and impact of cigarette pack health warnings on quitting intention in Vietnam. The Vietnam GATS 2015 was a nationally representative survey in which 9,513 households were selected using two-stage random systematic sampling method. Results of multivariate analysis showed that the strongest predictor for quit intention because of health warnings was "ever made a quit attempt in the past 12 months" followed by "believes that tobacco smoking causes serious illness". Compared to GATS 2010, GATS 2015 observed the increase in salience of cigarette health warnings. However, the current pictorial health warnings are losing their impact on motivating intention to quit. The results highlight that it is time to start the rotation cycle to refresh the current health warning set. Actions to select a new and more impressive set of pictorial health warnings should be developed as soon as possible.
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http://dx.doi.org/10.1080/08964289.2018.1434117DOI Listing
August 2019

Developing an antimicrobial resistance reference laboratory and surveillance programme in Vietnam.

Lancet Glob Health 2017 12;5(12):e1186-e1187

Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Nuffield Department of Medicine, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK. Electronic address:

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http://dx.doi.org/10.1016/S2214-109X(17)30370-4DOI Listing
December 2017

Exposure to Tobacco Advertising, Promotion Among the Adult Population in Vietnam and Its Implications for Public Health.

Asia Pac J Public Health 2017 Oct 17;29(7):569-579. Epub 2017 Oct 17.

1 Hanoi University of Public Health, Hanoi, Vietnam.

Introduction: The Law on Tobacco Control and the Law on Advertisement prohibit the advertising of any tobacco product in Vietnam. Tobacco promotion and marketing are alsostrictly prohibited. However, the violation of tobacco adverting and promotion is still common in Vietnam.

Objectives: This article aims at describing the exposure to tobacco advertising and promotion among the population aged 15+ years in Vietnam based on the data from the Global Adult Tobacco Survey 2015 from the view of the community, identifying any possible associations between the exposure to tobacco advertising and promotion and other individual factors, and discussing its possible public health implications.

Method: A cross-sectional study with the nationwide scale. Secondary data from the Global Adult Tobacco Survey 2015 was explored and analyzed. Chi-square test and multivariate logistic regressions were applied in the data analysis.

Results: The most common type of adults' exposure to tobacco advertising and promotion was points of sale (8.6%); 9.8% adults exposure to one source of tobacco advertising and 4.0% of them exposed to one source of tobacco promotion. Around 13.3% of Vietnamese adults were exposed to tobacco advertisement, while 2.0% were exposed to tobacco promotion, 5.3% were exposed to both tobacco advertising and promotion, and 16.6% were exposed to tobacco advertising or promotion. Gender, educational level, age, occupation, marital status, socioeconomic status, location (urban, rural), and current smoking status were associated with the exposure to tobacco advertising, tobacco promotion, tobacco advertising and promotion, and tobacco advertising or promotion.

Conclusion And Recommendation: Although there are comprehensive bans on tobacco advertising and promotion in Vietnam, adults aged 15+ years still reported their exposure to tobacco advertising and promotion. There should be a strict enforcement of the ban on tobacco advertising and promotion in Vietnam.
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http://dx.doi.org/10.1177/1010539517735630DOI Listing
October 2017

Palliative Care in Vietnam: Long-Term Partnerships Yield Increasing Access.

J Pain Symptom Manage 2018 02 10;55(2S):S92-S95. Epub 2017 Aug 10.

Vietnam Administration of Medical Services, Ministry of Health, Hanoi, Vietnam.

Palliative care began in Vietnam in 2001, but steady growth in palliative care services and education commenced several years later when partnerships for ongoing training and technical assistance by committed experts were created with the Ministry of Health, major public hospitals, and medical universities. An empirical analysis of palliative care need by the Ministry of Health in 2006 was followed by national palliative care clinical guidelines, initiation of clinical training for physicians and nurses, and revision of opioid prescribing regulations. As advanced and specialist training programs in palliative care became available, graduates of these programs began helping to establish palliative care services in their hospitals. However, community-based palliative care is not covered by government health insurance and thus is almost completely unavailable. Work is underway to test the hypothesis that insurance coverage of palliative home care not only can improve patient outcomes but also provide financial risk protection for patients' families and reduce costs for the health care system by decreasing hospital admissions near the end of life. A national palliative care policy and strategic plan are needed to maintain progress toward universally accessible cost-effective palliative care services.
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http://dx.doi.org/10.1016/j.jpainsymman.2017.03.038DOI Listing
February 2018

Trends in socioeconomic inequalities among adult male hardcore smokers in Vietnam: 2010-2015.

Int J Equity Health 2017 07 14;16(1):126. Epub 2017 Jul 14.

Center for Population Health Sciences, Hanoi School of Public Health, Hanoi, Vietnam.

Background: Despite male smokers being dominant in Vietnam, scarce evidence on trends in socioeconomics inequalities among the hardcore male smokers is available in the country. In this study, we aimed at assessing the trends in socioeconomics inequalities among the hardcore smokers in adult male population in Vietnam over a five-year period from 2010 to 2015.

Methods: We used data from two rounds of the Vietnam Global Adult Tobacco Survey (GATS) conducted in 2010 and 2015. We included only men aged 25 years and above in the analysis. We measured socioeconomic inequalities among hardcore smokers by calculating the concentration index. We conducted multiple logistic regression analysis to identify factors associated with hardcore smoking among men aged 25 years and above.

Results: The results of this study showed that the prevalence of male hardcore smokers aged 25 years and above in Vietnam was 9.5% in 2010 which increased to 13.1% in 2015. The prevalence of male hardcore smokers declined in the richest group from the 2010 level whereas it increased in the middle, poor and poorest groups. All values of weighted concentration indices indicated that the prevalence of male hardcore smokers occurred more among the poor men in Vietnam in both 2010 and 2015. The socioeconomic inequalities in hardcore smokers increased during 2010 and 2015. Residence in urban areas was significantly associated with higher adult male hardcore smoking in our study. Belonging to the age groups between 40 and 59 years, attaining primary and lower education, being self-employed, belonging to the poorest household group, smoking being allowed at home and no rule for smoking at home were associated with higher risk of being hardcore smoker among adult males in Vietnam.

Conclusions: We found increased trends in socioeconomic inequalities in hardcore smoking among the study population. Our study results indicate that existing smoking secession and tobacco control policy and interventions need to be modified or new policies and interventions should be introduced with the perspective of addressing socioeconomic inequalities to have the desired impact. We recommend implementing specific targeted interventions for vulnerable population groups for better results.
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http://dx.doi.org/10.1186/s12939-017-0623-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513204PMC
July 2017

Prevalence of tobacco smoking in Vietnam: findings from the Global Adult Tobacco Survey 2015.

Int J Public Health 2017 Feb 22;62(Suppl 1):121-129. Epub 2017 Feb 22.

Vietnam Steering Committee on Smoking and Health (VINACOSH), Hanoi, Vietnam.

Objectives: We report the prevalence of tobacco smoking among adult populations in Vietnam, 2015.

Methods: The Vietnam GATS 2015 was a nationally representative survey. 9513 households were selected using two-stage random systematic sampling method. Handheld computers were used for capturing data. Data collection was carried-out by National Statistics Office of Vietnam in 2015. Weight was used in all estimates.

Results: The Vietnam GATS 2015 found that the prevalence of smoking in Vietnam was 22.5% overall, 45.3% among men, and 1.1% among women. The overall 2015-2010 reduction in prevalence of any tobacco product was 5.3%. However, the reduction was not statistically significant. The significant reduction in prevalence of tobacco smoking was found for any type of cigarette (-8.4%), and especially for hand-rolled cigarettes (-38.3%). The use of cigarettes significantly decreased in urban areas (-14.7%).

Conclusion: The reduction in the prevalence of tobacco smoking in Vietnam during the last 5 years (2010-2015) has not been as high as expected, especially in rural areas. Further efforts are needed to continue to reduce the harms caused by tobacco smoking.
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http://dx.doi.org/10.1007/s00038-017-0955-8DOI Listing
February 2017

Exposure to Tobacco Advertising and Promotion among School Children Aged 13-15 in Vietnam - an Overview from GYTS 2014.

Asian Pac J Cancer Prev 2016 ;17(S1):49-53

Hanoi School of Public Health, Hanoi, Viet Nam E-mail :

Evidence shows that tobacco advertising and promotion activities may increase tobacco consumption and usage, especially in youth. Despite the regulation on prohibiting advertisement of any tobacco product, tobacco advertisement and promotion activities are still common in Vietnam. This article presents current exposure to tobacco advertising and promotion (TAP) among school children aged 13 to 15 years in Vietnam in 2014 and potential influencing factors. Data from the Global Youth Tobacco Survey 2014 in Vietnam covering 3,430 school aged children were used. Both descriptive and analytical statistics were carried out with Stata 13 statistical software. Binary logistic regression was applied to explain the exposure to TAP among youth and examine relationships with individual factors. A significance level of p<0.05 and sampling weights were used in all of the computations. In the past 30 days, 48.6% of the students experienced exposure to at least 1 type of tobacco advertising or promotion. Wearing or otherwise using products related to tobacco was the most exposure TAP type reported by students (22.3%). The internet (22.1), points of sales (19.2) and social events (11.5) were three places that students aged 13-15 frequently were exposed to TAP. Binary logistic results showed that gender (female vs male) (OR = 0.61, 95%CI: 0.52 - 0.71), susceptibility to smoking (OR = 2.12, 95%CI: 1.53 - 2.92), closest friends' smoked (OR = 1.43, 95%CI: 1.2 - 1.7) and parents smoking status (OR = 2.83, 95%CI: 1.6 - 5.01) were significantly associated with TAP exposure among school-aged children. The research findings should contribute to effective implementation of measures for preventing and controlling tobacco use among students aged 13-15 in Viet Nam.
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http://dx.doi.org/10.7314/apjcp.2016.17.s1.49DOI Listing
August 2017

Trends in Second-Hand Tobacco Smoke Exposure Levels at Home among Viet Nam School Children Aged 13-15 and Associated Factors.

Asian Pac J Cancer Prev 2016 ;17(S1):43-7

World Health Organization Office in Viet Nam, Hanoi, Viet Nam E-mail :

Second-hand tobacco smoke (SHS) exposure at home, especially among children, is a serious issue in Viet Nam. During the past decade, much effort has been taken for tobacco control in the country, including various prgorammes aiming to reduce SHS exposure among adults and children. This article analysed trends and factors associated with SHS exposure at home among school children aged 13-15 in Viet Nam, using the Global Youth Tobacco Surveys conducted in 2007 and 2014. Descriptive and inferential statistical methods with logistic regression were applied. Overall, there was a significant reduction in the level of exposure, from 58.5% (95%CI: 57.6-59.3) in 2007 to 47.1% (95%CI: 45.4-48.8) in 2014. Of the associated factors, having one or both parents smoking was significantly associated with the highest odds of SHS exposure at home (OR=5.0; 95%CI: 4.2-6.1). Conversely, having a mother with a college or higher education level was found to be a protective factor (OR=0.5; 95%CI: 0.3-0.8).
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http://dx.doi.org/10.7314/apjcp.2016.17.s1.43DOI Listing
August 2017

Knowledge and Attitude Towards Tobacco Smoking among 13-15 Year-Old School Children in Viet Nam - Findings from GYTS 2014.

Asian Pac J Cancer Prev 2016 ;17(S1):37-42

Hanoi School of Public Health, Hanoi, Vietnam E-mail :

Studies have shown that smoking is a learnt behavior, often initiated during adolescence. This paper aims to describe tobacco-related knowledge, attitude and associations among school adolescents aged 13-15 with exposure to anti-smoking information. Using data from the Global Youth Tobacco Survey (GYTS) in Viet Nam, 2014, knowledge was measured through 4 questions about tobacco use, and attitude was assessed through 3 questions on personal, social and environmental aspects. Students giving most anti-tobacco responses to all questions were considered as having correct knowledge or appropriate attitude or both. Access to anti-smoking information was determined by exposure to any media messages on tobacco control during the past 30 days and teaching in school about the danger of tobacco use during the past 12 months. A substantial percentage of students thought that being near others who smoke might be harmful to them and smoking is harmful to health (89.4% and 89.6% respectively). However, only 46.4% reported that it is definitely difficult to quit smoking and 66.9% thought that smoking for only 1 or 2 years, once stopped, is harmful to health. Slightly more than half of the respondents reported appropriate attitude that young smokers have fewer friends than others and smoking makes them less attractive and less comfortable at social events. Noticing anti-smoking messages in the media together with having lessons in school about the dangers of tobacco substantially increased the likelihood of having correct knowledge, appropriate attitude and both. Despite relatively high awareness about smoking harms, effective educational communication is still highly needed to improve the level of comprehensive knowledge and an appropriate attitude regarding tobacco use.
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http://dx.doi.org/10.7314/apjcp.2016.17.s1.37DOI Listing
August 2017

Access to Anti-smoking Information among School Children and its Potential Impact on Preventing Smoking Initiation: Results from the Global Youth Tobacco Use Survey (GYTS) 2014 in Viet Nam.

Asian Pac J Cancer Prev 2016 ;17(S1):31-6

Hanoi School of Public Health, Hanoi, Vietnam E-mail :

Scientific evidence on all aspects of smoking amongst youth is very important for designing appropriate interventions to reduce smoking among this vulnerable population. This paper describes current access to antismoking information among school children aged 13 to 15 years in Vietnam in 2014 and examines its potential impact on preventing smoking initiation. The data used in this paper were obtained from the 2014 Global Youth Tobacco Survey (GYTS) in Vietnam. Students were asked questions about their level of awareness of anti-smoking information from various sources in the past 30 days and about lessons in school regarding the dangers of tobacco use during the last 12 months. Those who have never smoked were asked "whether or not they thought about avoiding cigarettes because of health warnings on cigarette packages" and answers were analyzed in combination with data on access to anti-smoking information from other sources. The prevalence of exposure to antismoking campaigns was high among school children in Viet Nam: 55.3% of current smokers reported thoughts of smoking cessation because of health warnings on cigarette packages; 60.5% of never smokers avoided initiating smoking because of the same health warnings. The potential impact of graphic health warnings to prevent school-aged children from smoking initiation would be stronger if there was concurrent access to anti-smoking programs on the dangers of tobacco use in schools. However, school education for tobacco prevention and control has not been as strong as expected. A more comprehensive school curriculum on tobacco prevention and control is recommended to reinforce antismoking messages among school children.
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http://dx.doi.org/10.7314/apjcp.2016.17.s1.31DOI Listing
August 2017

Tobacco Access and Availability for Vietnamese School Children (aged 13-15): Results from the Global Youth Tobacco Use Survey (GYTS) 2014 in Viet Nam.

Asian Pac J Cancer Prev 2016 ;17(S1):25-9

Hanoi School of Public Health, Hanoi, Vietnam E-mail :

Efforts to reduce tobacco use among school children need to be based on understanding of access to cigarettes by these subjects because previous studies indicated that enforcement of laws for controlling tobacco sales seems to not affect teen/school children because they can obtain cigarettes from different sources. This paper aims to describe access to and availability of cigarettes among school students (aged 13-15 years old) according to the data from GYTS Vietnam 2014. In GYTS, a national school-based survey of students of grades 8-10, our findings showed that about 15% school children are current smokers who smoke at home, and that they could easily buy cigarettes from stores (63.2%), or someone else (27.8%), or street vendors (9%). Notably, over 85% of school children answered that they were not refused because of their age. This high percentage was nearly the same in the North (85.7%), the Centre (92.5%), and the South (89.7%) of Viet Nam. These findings show that it is quite easy for school children to obtain cigarettes and this is a crucial challenge for policy makers aiming to reduce tobacco use among youth in general and school-age students in particular.
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http://dx.doi.org/10.7314/apjcp.2016.17.s1.25DOI Listing
August 2017

Cigarette Smoking among Adolescents aged 13-15 in Viet Nam and Correlates of Current Cigarette Smoking: Results from GYTS 2014 Data.

Asian Pac J Cancer Prev 2016 ;17(S1):17-23

Institute of Preventive Medicine and Public Health, Hanoi Medical University, Viet Nam E-mail :

The aim of this paper is to report the rate of current and ever cigarette smoking and explore correlates of current cigarette smoking among adolescents aged 13-15 in Viet Nam. This analysis was derived from GYTS survey, which comprised of 3,430 adolescents aged 13-15, conducted in 2014 in 13 cities and provinces of Viet Nam. We calculated the weighted rates of current and ever cigarette smoking and reported patterns of smoking behavior. We also performed logistic regression to explore correlates of current cigarette smoking behavior. The weighted rate of ever cigarette smoking was 9.5% (95% confidence interval (CI): 8.5 %-10.5%), in which the weighted rate among males (15.4%; 95% CI: 13.6%-17.0%) was higher than that among females (4.2%; 95% CI: 3.3%-5.1%). The weighted rate of current cigarette smoking was relatively low at 2.5% (95%CI: 2.0%- 3.0%) with higher weighted rate among males (4.9%; 95% CI: 3.8%-5.9%) compared to the corresponding figure among females (0.2%; 95% CI: 0.0 %-0.5%). Current cigarette smoking was significantly higher among males than females, in students aged 15 versus 13 years old, and in students who had several or all close friends smoking and students with daily observation of smoking at school. For greater smoking reduction outcomes, we recommend that tobacco interventions for adolescents should consider targeting more male students at older ages, establish stricter adherence to school-based banning of cigarette smoking, engage both smoking and nonsmoking adolescents and empower adolescents to resist peer smoking influence as well as changing their norms or beliefs towards smoking benefits.
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http://dx.doi.org/10.7314/apjcp.2016.17.s1.17DOI Listing
August 2017

Methodology for the Global Youth Tobacco Use Survey (GYST), Vietnam, 2014.

Asian Pac J Cancer Prev 2016 ;17(S1):11-5

Hanoi Medical University, Viet Nam E-mail :

Viet Nam is a country with the highest rate of adult male smokers in the world. In 2010, the percentage of adult male smokers was 47.4%. Each year in Viet Nam, there are 40,000 lives lost from tobacco-related diseases. The Global Tobacco Youth Survey is an international standardized survey that has been conducted in more than 140 countries. To provide evidence for tobacco control, Viet Nam already conducted two rounds of GYTS in 2003 and 2007. The GYTS in 2014 is the survey's third iteration. This paper aims to document key methodological details and socio-demographic characteristics of the respondents included in the 2014 GYTS in Viet Nam. This survey followed international protocol and was conducted in 13 provinces representative of 6 geographical regions. A total of 3,430 school children, aged 13 to 15 years used a standardized answer sheet to answer 76 questions about seven tobacco-related topics, including prevalence of tobacco use, environmental tobacco smoke, access and availability, media and advertisement, cessation, knowledge and attitudes, tobaccorelated school curriculum. This GYTS provides valid and reliable data for monitoring tobacco use among youth in Vietnam and is recommended to be regularly repeated.
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http://dx.doi.org/10.7314/apjcp.2016.17.s1.11DOI Listing
August 2017

Toward safe accessibility of opioid pain medicines in Vietnam and other developing countries: a balanced policy method.

J Pain Symptom Manage 2015 May 15;49(5):916-22. Epub 2014 Dec 15.

Pain & Policy Studies Group, Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin, USA; World Health Organization Collaborating Center for Pain Policy in Palliative Care, Madison, Wisconsin, USA.

Moderate or severe pain is common among people with advanced cancer and other life-threatening illnesses. Yet despite agreement that pain relief is a human right, the poorest 80% of the world's population rarely have access to strong opioid analgesics. Excessively restrictive opioid policies, especially in developing countries, both stem from and propagate misguided fears about opioids, so-called opiophobia. Because opiophobia, like any norm, is historically, socially, and culturally situated, efforts to change opiophobic policies will be most effective if guided by awareness of their historical, social, and cultural determinants. We describe some of these determinants in Vietnam and report on results of an ongoing project there to allay opiophobia and improve safe access to opioids for medical uses. We used a method that entails working with committed local partners, including a high-level official from the Ministry of Health, to review all Vietnamese policies governing opioid accessibility to identify the barriers; devising an action plan to safely reduce or circumnavigate the barriers; obtaining buy-in for the plan from all stakeholders, including drug regulators and the police; and assisting the Ministry of Health to implement the plan. Since the start of the project, morphine consumption has increased each year and as of 2010 was ninefold greater than in 2003, and the number of hospitals offering palliative care has increased from three to 15. We conclude that this balanced policy method appears to be helping to reduce barriers to opioid access in Vietnam and should be used in other developing countries.
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http://dx.doi.org/10.1016/j.jpainsymman.2014.10.012DOI Listing
May 2015

Vietnam's palliative care initiative: successes and challenges in the first five years.

J Pain Symptom Manage 2010 Jul;40(1):27-30

Center for Palliative Care and Department of Medicine, Harvard Medical School, and Palliative Care Service, Massachusetts General Hospital, Boston, Massachusetts 02115, USA.

In 2005, Vietnam's Ministry of Health (MoH) launched a palliative care initiative that uses the World Health Organization (WHO) public health strategy for national palliative care program development. With international financial and technical support, the initiative has made significant early progress. A rapid situation analysis in 2005 led to national Guidelines on Palliative Care in 2006, radically improved opioid prescribing regulations in 2008, the training of more than 400 physicians in palliative care by early 2010 using three curricula written especially for Vietnam, and the initiation of palliative care services in some hospitals and in the community. Yet, access to palliative care services remains very limited. Many challenges must be overcome to reach the goal of access for all to essential palliative care services that are integrated into the systems of cancer care, HIV/AIDS care, and primary care. Going forward, crucial aspects of the initiative will be continued commitment to palliative care by the MoH, careful planning and targeted funding that address each part of the WHO public health strategy, ongoing expert technical support, and collaboration among international technical and financial supporters.
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http://dx.doi.org/10.1016/j.jpainsymman.2010.04.009DOI Listing
July 2010

Vietnam: integrating palliative care into HIV/AIDS and cancer care.

J Pain Symptom Manage 2007 May;33(5):578-83

Harvard Medical School Center for Palliative Care and Vietnam-CDC-Harvard Medical School AIDS Partnership, Boston, MA 02115, USA.

Vietnam is struggling to meet the growing need for both disease-modifying and palliative care for people with life-threatening chronic diseases such as HIV/AIDS and cancer. Recently, Vietnam initiated rapid development of a national palliative care program for HIV/AIDS and cancer patients that builds on existing palliative care programs and experience and integrates palliative care into standard HIV/AIDS and cancer care. National palliative care guidelines have been issued by the Ministry of Health based on a rapid situation analysis. Plans now call for review and revision of opioid laws and regulations to increase availability of opioids for medical use, training in palliative care for clinicians throughout the country, and development of palliative care programs both in the community and in inpatient referral centers.
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http://dx.doi.org/10.1016/j.jpainsymman.2007.02.004DOI Listing
May 2007