Publications by authors named "Nathan R Jones"

42 Publications

Adolescent Barriers to HIV Prevention Research: Are Parental Consent Requirements the Biggest Obstacle?

J Adolesc Health 2020 10 5;67(4):495-501. Epub 2020 Jul 5.

Department of Bioethics, NIH Clinical Center, Bethesda, Maryland.

Purpose: One third of people newly living with HIV/AIDS are adolescents. Research on adolescent HIV prevention is critical owing to differences between adolescents and adults. Parental permission requirements are often considered a barrier to adolescent enrollment in research, but whether adolescents view this barrier as the most important one is unclear.

Methods: Adolescents were approached in schools in KwaZulu-Natal, South Africa, and at a sexually transmitted infection clinic at the Children's Hospital of Aurora, Colorado. Surveys with a hypothetical vignette about participation in a pre-exposure prophylaxis trial were conducted on smartphones or tablets with 75 adolescents at each site. We calculated descriptive statistics for all variables, using 2-sample tests for equality of proportions with continuity correction. Statistical significance was calculated at p < 0.05. Multivariate analyses were also conducted.

Results: Most adolescents thought side effects (77%) and parental consent requirements (69%) were very important barriers to research participation. When asked to rank barriers, adolescents did not agree on a single barrier as most important, but the largest group of adolescents ranked parental consent requirements as most important (29.5%). Parental consent was seen as more of a barrier for adolescents in South Africa than in the United States. Concerns about being experimented on or researchers' mandatory reporting to authorities were ranked much lower. Finally, most (71%, n = 106) adolescents said they would want to extra support from another adult if parental permission was not required.

Conclusion: Adolescents consider both parental permission requirements and side effects important barriers to their enrollment in HIV prevention research. Legal reform and better communication strategies may help address these barriers.
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http://dx.doi.org/10.1016/j.jadohealth.2020.05.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508889PMC
October 2020

Core Elements of Shared Decision-making for Women Considering Breast Cancer Screening: Results of a Modified Delphi Survey.

J Gen Intern Med 2020 06 19;35(6):1668-1677. Epub 2020 Mar 19.

University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA.

Background: The United States Preventive Services Task Force recommends individualized breast cancer screening for average-risk women before age 50, advised by risk assessment and shared decision-making (SDM). However, the foundational principles of this recommendation that would inform decision support tools for patients and primary care physicians at the point of care have not been codified. Determining the core elements of SDM for breast cancer screening as valued by patients and primary care providers (PCPs) is necessary for implementing effective SDM tools. The aim of this study is to affirm core elements of SDM in the context of clinical interactions, through a Delphi consensus process.

Methods: A Delphi was conducted with 30 participants (10 women aged 40-49, 10 PCPs, and 10 healthcare decision scientists), to codify core elements of breast cancer screening SDM. The criterion for establishing consensus was a threshold of 80% agreement. The Delphi concluded with an 83% response rate.

Results: Of 48 items fielded, 44 met the threshold on the high-importance end of the response scale and were accepted as core elements. Core elements across three thematic categories-information delivery and patient education, interpersonal clinician-patient communication, and framework of the decision-received panelists' support in nearly equal measure. Panelists unanimously agreed that SDM should include provision of clearly understandable information, including that of personal breast cancer risk factors, and benefits and harms of mammography screening, and that PCPs should convey they are listening, knowledgeable, and demonstrate cultural sensitivity.

Discussion: This research codifies the core elements of SDM for mammography in women 40-49, augmenting the evidence to inform discussions between patients and physicians. These core elements of SDM have the potential to operationalize SDM for breast cancer screening in an effort to improve public health outcomes.
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http://dx.doi.org/10.1007/s11606-019-05298-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280383PMC
June 2020

Association Studies of HFE C282Y and H63D Variants with Oral Cancer Risk and Iron Homeostasis Among Whites and Blacks.

Cancers (Basel) 2015 Dec 9;7(4):2386-96. Epub 2015 Dec 9.

Department of Public Health Sciences, Penn State University College of Medicine, 500 University Drive, CH69, Hershey, PA 17033, USA.

Background: Polymorphisms in the hemochromatosis (HFE) gene are associated with excessive iron absorption from the diet, and pro-oxidant effects of iron accumulation are thought to be a risk factor for several types of cancer.

Methods: The C282Y (rs1800562) and H63D (rs1799945) polymorphisms were genotyped in 301 oral cancer cases and 437 controls and analyzed in relation to oral cancer risk, and serum iron biomarker levels from a subset of 130 subjects.

Results: Individuals with the C282Y allele had lower total iron binding capacity (TIBC) (321.2 ± 37.2 µg/dL vs. 397.7 ± 89.0 µg/dL, p = 0.007) and higher percent transferrin saturation (22.0 ± 8.7 vs. 35.6 ± 22.9, p = 0.023) than wild type individuals. Iron and ferritin levels approached significantly higher levels for the C282Y allele (p = 0.0632 and p = 0.0588, respectively).

Conclusions: Iron biomarker levels were elevated by the C282Y allele, but neither (rs1800562) nor (rs1799945) was associated with oral cancer risk in blacks and whites.
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http://dx.doi.org/10.3390/cancers7040898DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695898PMC
December 2015

Battling tobacco use at home: an analysis of smoke-free home rules among U.S. veterans from 2001 to 2011.

Am J Public Health 2014 Sep;104 Suppl 4:S572-9

Xiao Zhang and Ana P. Martinez-Donate are with the Department of Population Health Sciences, University of Wisconsin, Madison. Jessica Cook, Megan E. Piper, and Kristin Berg are with the University of Wisconsin Center for Tobacco Research and Intervention. Nathan R. Jones is with the University of Wisconsin Survey Center.

Objectives: We examined national trends in smoke-free home rules among U.S. veterans and nonveterans.

Methods: We used data from the 2001-2002 and 2010-2011 Tobacco Use Supplement to the Current Population Survey to estimate and compare the existence of smoke-free home rules among veterans and nonveterans for each survey period.

Results: The prevalence of a complete smoke-free home rule among veterans increased from 64.0% to 79.7% between 2001 and 2011 (P < .01) but was consistently lower than were rates estimated for nonveterans (67.6% and 84.4%, respectively). Disparities between the 2 groups increased significantly over time (P < .05).

Conclusions: Despite the general increase in the adoption of smoke-free home rules, veterans lag behind the rest of the U.S. population. Interventions promoting the adoption of complete smoke-free home rules are necessary to protect veterans and their families and to reduce disparities.
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http://dx.doi.org/10.2105/AJPH.2014.301975DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151893PMC
September 2014

Use of Nanotechnology to Develop Multi-Drug Inhibitors For Cancer Therapy.

J Nanomed Nanotechnol 2013 Dec;4(6)

Department of Pharmacology, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA ; Department of Pathology, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA ; Department of Dermatology, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA ; Department of Surgery, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA ; Penn State Hershey Melanoma Center, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA ; Penn State Melanoma Therapeutics Program, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA ; The Foreman Foundation for Melanoma Research, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.

Therapeutic agents that inhibit a single target often cannot combat a multifactorial disease such as cancer. Thus, multi-target inhibitors (MTIs) are needed to circumvent complications such as the development of resistance. There are two predominant types of MTIs, (a) single drug inhibitor (SDIs) that affect multiple pathways simultaneously, and (b) combinatorial agents or multi-drug inhibitors (MDIs) that inhibit multiple pathways. Single agent multi-target kinase inhibitors are amongst the most prominent class of compounds belonging to the former, whereas the latter includes many different classes of combinatorial agents that have been used to achieve synergistic efficacy against cancer. Safe delivery and accumulation at the tumor site is of paramount importance for MTIs because inhibition of multiple key signaling pathways has the potential to lead to systemic toxicity. For this reason, the development of drug delivery mechanisms using nanotechnology is preferable in order to ensure that the MDIs accumulate in the tumor vasculature, thereby increasing efficacy and minimizing off-target and systemic side effects. This review will discuss how nanotechnology can be used for the development of MTIs for cancer therapy and also it concludes with a discussion of the future of nanoparticle-based MTIs as well as the continuing obstacles being faced during the development of these unique agents.'
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http://dx.doi.org/10.4172/2157-7439.1000184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085796PMC
December 2013

UGT2B gene expression analysis in multiple tobacco carcinogen-targeted tissues.

Drug Metab Dispos 2014 Apr 23;42(4):529-36. Epub 2014 Jan 23.

Department of Pharmacology, Pennsylvania State College of Medicine, Hershey, Pennsylvania (N.R.J.); and Department of Pharmaceutical Sciences, Washington State University College of Pharmacy, Spokane, Washington (P.L.).

The UDP-glucuronosyltransferase (UGT) 2B subfamily of enzymes plays an important role in the metabolism of numerous endogenous and exogenous compounds, including various carcinogens present in tobacco smoke. The goal of the present study was to examine the levels of expression of individual UGT2B genes in various tissues that are targets for tobacco carcinogenesis. Using MT-ATP6 as the experimentally validated housekeeping gene, the highest extrahepatic expression of UGT2B genes was observed in human tonsil, with UGT2B expression levels similar to that observed in human liver. UGT2B17 exhibited high relative expression in most tissues examined, including lung, most tissues of the aerodigestive tract, and pancreas. UGT2B7 expression was highest in pancreas but low or undetectable in most other tissues examined. UGT2B10 expression was high in both tonsil and tongue. There was wide variability between individuals in the magnitude of expression in each tissue site, and there were strong correlations between UGT2B expression levels in different individuals within many of the tissue sites, suggesting coordinated regulation of UGT2B gene expression in extrahepatic tissues. In the liver, UGTs 2B4, 2B7, 2B10, and 2B15 were significantly correlated with each other (all r(2) > 0.70, P < 0.0001). In all examined tissues of the aerodigestive tract, UGTs 2B10, 2B11, and 2B17 exhibited a strong correlation with each other (all r(2) > 0.75, P < 0.05). UGTs 2B7 and 2B10 exhibited a strong inverse correlation in the pancreas (r(2) = -0.95, P < 0.01). These data suggest that specific UGT2B enzymes important in tobacco carcinogen metabolism are expressed and coordinately regulated in various target sites for tobacco-related cancers.
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http://dx.doi.org/10.1124/dmd.113.054718DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3965906PMC
April 2014

Surveying clinicians by web: current issues in design and administration.

Eval Health Prof 2013 Sep;36(3):352-81

University of Wisconsin-Madison, WI 53706, USA.

The versatility, speed, and reduced costs with which web surveys can be conducted with clinicians are often offset by low response rates. Drawing on best practices and general recommendations in the literature, we provide an evidence-based overview of methods for conducting online surveys with providers. We highlight important advantages and disadvantages of conducting provider surveys online and include a review of differences in response rates between web and mail surveys of clinicians. When administered online, design-based features affect rates of survey participation and data quality. We examine features likely to have an impact including sample frames, incentives, contacts (type, timing, and content), mixed-mode approaches, and questionnaire length. We make several recommendations regarding optimal web-based designs, but more empirical research is needed, particularly with regard to identifying which combinations of incentive and contact approaches yield the highest response rates and are the most cost-effective.
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http://dx.doi.org/10.1177/0163278713496630DOI Listing
September 2013

Educational disparities in home smoking bans among households with underage children in the United States: can tobacco control policies help to narrow the gap?

Nicotine Tob Res 2013 Dec 31;15(12):1978-87. Epub 2013 Jul 31.

Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI;

Background: The prevalence of home smoking bans in the United States has increased overtime, but educational disparities have persisted. Little research has explored potential associations between tobacco control policies and disparities by socioeconomic status in home smoking bans. We examined educational disparities in home smoking bans in the United States from 1995 to 2007 and investigated the association between these disparities and statewide tobacco control policies, including cigarette taxes, smoke-free air laws, and media campaigns.

Methods: We used data from the 1995-1996, 1998-1999, 2001-2002, and 2006-2007 Current Population Survey's Tobacco Use Supplement surveys (TUS-CPS) and data on state-level tobacco control policies. Disparities by level of education were calculated, and logistic regressions were estimated to explore the association between statewide tobacco control policies and educational disparities in the adoption of complete home smoking bans.

Results: Between 1995 and 2007, average absolute educational disparities in complete home smoking bans between those with and without a college degree were 8.5 percentage points (pp) and 17.1 pp among nonsmoker and smoker households, respectively. The adjusted odds ratio for education increased among nonsmoker households over time (p < .01) but remained stable among households with smokers. Households with less than college were generally more responsive to antitobacco policies. Antitobacco media campaigns at the state level were associated with reduced disparities by education among households with smokers (p < .05).

Conclusions: More vigorous tobacco control policies at the state level may help promote the adoption of home smoking bans and reduce educational disparities in these protective behaviors.
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http://dx.doi.org/10.1093/ntr/ntt090DOI Listing
December 2013

Characterization of raloxifene glucuronidation: potential role of UGT1A8 genotype on raloxifene metabolism in vivo.

Cancer Prev Res (Phila) 2013 Jul 16;6(7):719-30. Epub 2013 May 16.

Department of Pharmacology, Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA.

Raloxifene is a second-generation selective estrogen receptor modulator used for the prevention and treatment of osteoporosis and the prevention of breast cancer in postmenopausal women. Raloxifene is extensively metabolized by glucuronidation to form raloxifene-6-glucuronide (ral-6-Gluc) and raloxifene-4'-glucuronide (ral-4'-Gluc). The goal of the present study was to determine whether functional polymorphisms in active UGTs could play a role in altered raloxifene glucuronidation in vivo. Using homogenates from HEK293 UGT-overexpressing cell lines, raloxifene was shown to be glucuronidated primarily by the hepatic UGTs 1A1 and 1A9 and the extra-hepatic UGTs 1A8 and 1A10; no detectable raloxifene glucuronidation activity was found for UGT2B enzymes. Functional UGT1A1 transcriptional promoter genotypes were significantly (Ptrend = 0.005) associated with ral-6-Gluc formation in human liver microsomes, and, consistent with the decreased raloxifene glucuronidation activities observed in vitro with cell lines overexpressing UGT1A8 variants, the UGT1A8*2 variant was significantly (P = 0.023) correlated with total raloxifene glucuronide formation in human jejunum homogenates. While ral-4'-Gluc exhibited 1:100th the anti-estrogenic activity of raloxifene itself as measured by binding to the estrogen receptor, raloxifene glucuronides comprised about 99% of the circulating raloxifene dose in raloxifene-treated subjects, with ral-4'-Gluc comprising ~70% of raloxifene glucuronides. Plasma ral-6-Gluc (Ptrend = 0.0025), ral-4'-Gluc (Ptrend = 0.001), and total raloxifene glucuronides (Ptrend = 0.001) were increased in raloxifene-treated subjects who were predicted slow metabolizers [UGT1A8 (*1/*3)] versus intermediate metabolizers [UGT1A8 (*1/*1) or UGT1A8 (*1/*2)] versus fast metabolizers [UGT1A8 (*2/*2). These data suggest that raloxifene metabolism may be dependent on UGT1A8 genotype and that UGT1A8 genotype may play an important role in overall response to raloxifene.
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http://dx.doi.org/10.1158/1940-6207.CAPR-12-0448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057281PMC
July 2013

Quantification of Hepatic UDP glucuronosyltransferase 1A splice variant expression and correlation of UDP glucuronosyltransferase 1A1 variant expression with glucuronidation activity.

J Pharmacol Exp Ther 2012 Sep 1;342(3):720-9. Epub 2012 Jun 1.

Department of Pharmacology, Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA.

The UDP glucuronosyltransferase (UGT) 1A gene cluster encodes nine UGT1A family members via splicing of individual first exons to common exons 2 through 5. Each of these nine UGT1As can also undergo alternative splicing at their 3' ends by using an alternate exon 5, resulting in 27 different UGT1A mRNA species with each UGT1A gene encoding three different combinations of 5A and 5B UGT1A exons. To examine the importance of UGT1A exon 5 splice variants on overall UGT1A activity, a nested quantitative polymerase chain reaction assay was developed to accurately assess the combined expression of exon 5 splice variants (termed v2/v3) versus the expression of wild-type (termed v1) for each specific UGT1A. v1 expression was 16-, 17-, 57- and 29-fold higher than that observed for the levels of v2/v3 for UGTs 1A1, 1A4, 1A6, and 1A9, respectively, in normal human liver specimens. In a series of 58 normal human liver specimens, the expression of both UGT1A1 v1 and v2/v3 mRNAs was positively correlated with raloxifene glucuronidation activity in corresponding microsomes prepared from the same specimens (p < 0.0001, r² = 0.720; p = 0.0002, r² = 0.241, respectively), with expression of both variants lower in individuals homozygous for the UGT1A1*28 allele (42% for v1, p = 0.041; 53% for v2/v3, p = 0.0075). The expression of UGT1A1 v2/v3 was 1.6-fold higher than v1 (p = 0.03) in HepG2 cells, and short interfering RNA knockdown of HepG2 v2/v3 increased raloxifene glucuronidation activity by 83%. Together, these data suggest that hepatic UGT1A v2/v3 mRNA species are minor form variants in human livers from most individuals.
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http://dx.doi.org/10.1124/jpet.112.192658DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422519PMC
September 2012

Effect of policy changes on cigarette sales: the case of Turkey.

Eur J Public Health 2012 Oct 31;22(5):712-6. Epub 2012 Mar 31.

Centers for Disease Control and Prevention, Atlanta GA 30341-3724, USA.

Background: In 1996, Turkey made tobacco control a health priority. The tobacco control effort was extended in July 2009 with the expansion of the smoke-free law to include all enclosed workplaces and public places and, in January 2010, with a 20% increase in the Special Consumption Tax on Tobacco.

Methods: Sales data were averaged, by month, for the period January 2005 through June 2009 to establish an 'expected' monthly sales pattern. This was the period when no new tobacco control measures were implemented. The overall monthly average was then calculated for the same period. The expected monthly sales pattern was then graphed against the overall monthly sales average to delineate a seasonal sales pattern that was used to evaluate the divergence of actual monthly sales from the 'expected' pattern.

Results: A distinct seasonal pattern was found with sales above average from May through August. Comparison of actual cigarette sales to the 'expected' monthly sales pattern following the implementation of the expanded smoke-free law in July resulted in a 5.2% decrease. Cigarettes sales decreased by 13.6% following the January 2010 Special Consumption Tax. Since the implementation of the expanded smoke-free law in July 2009 and the tax increase in January 2010, cigarette sales in Turkey decreased by 10.7%.

Conclusion: The effect of recent Turkish tobacco control policies could contribute to a reduction in the number of premature deaths related to tobacco use. Evidence has shown that periodic tax increases and strong enforcement of all tobacco control policies are essential to further decrease tobacco consumption.
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http://dx.doi.org/10.1093/eurpub/ckr157DOI Listing
October 2012

"How is smoking handled in your home?": agreement between parental reports on home smoking bans in the United States, 1995-2007.

Nicotine Tob Res 2012 Oct 29;14(10):1170-9. Epub 2012 Feb 29.

Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, 605 WARF, Madison, WI 53726-2397, USA.

Introduction: Home smoking bans significantly reduce secondhand smoke exposure among children, but parents may offer discordant reports on whether there is a home smoking ban. The purpose of this study was to examine national trends in (a) parental discordance/concordance in the reporting of home smoking bans and (b) correlates of discordant/concordant reports among two-parent households with underage children from 1995 to 2007.

Methods: Data from the 1995/1996, 1998/1999, 2001/2002, 2003, and 2006/2007 Tobacco Use Supplement of the U.S. Current Population Survey were used to estimate prevalence rates and multinomial logistic regression models of discordant/concordant parental smoking ban reports by survey period.

Results: Overall, the percentage of households in which the 2 parents gave discordant reports on a complete home smoking ban decreased significantly from 12.7% to 2.8% from 1995 to 2007 (p < .001). Compared with households where both parents reported a complete smoking ban, discordant reports were more likely to be obtained from households with current smokers (p < .01) across survey periods. Compared with households where both parents reported the lack of a complete home smoking ban, discordant reports were more likely among households with college graduates, no current smokers, and parents with Hispanic ethnicity (p < .05).

Conclusions: Parental concordance on the existence of a home smoking ban increased from 1995 to 2007. This suggests estimates of home smoking bans based on just one parent may be more reliable now than they were in the past. Interventions to improve the adoption and enforcement of home smoking bans should target households with current smoker parents.
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http://dx.doi.org/10.1093/ntr/nts005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3457709PMC
October 2012

Trends in home smoking bans in the U.S.A., 1995-2007: prevalence, discrepancies and disparities.

Tob Control 2012 May 3;21(3):330-6. Epub 2011 Aug 3.

Department of Population Health Sciences, Carbone Cancer Center, University of Wisconsin-Madison, 610 Walnut St., 605 WARF, Madison, WI 53726-2397, USA.

Background: Home smoking bans significantly reduce the likelihood of secondhand smoke exposure among children and non-smoking adults. The purpose of this study was to examine national trends in (1) the adoption of home smoking bans, (2) discrepancies in parental smoking ban reports and (3) household and parental correlates of home smoking bans among households with underage children from 1995 to 2007.

Methods: The authors used data from the 1995-1996, 1998-1999, 2001-2002, 2003 and 2006-2007 Tobacco Use Supplement of the US Current Population Survey to estimate prevalence rates and logistic regression models of parental smoking ban reports by survey period.

Results: Overall, the prevalence of a complete home smoking bans increased from 58.1% to 83.8% (p<0.01), while discrepancies in parental reports decreased from 12.5% to 4.6% (p<0.01) from 1995 to 2007. Households with single parent, low income, one or two current smokers, parents with less than a college education or without infants were consistently less likely to report a home smoking ban over this period (p<0.05).

Conclusions: Despite general improvements in the adoption of home smoking bans and a reduction on parental discrepancies, disparities in the level of protection from secondhand smoke have persisted over time. Children living in households with single parents, low income, current smoker parents, less educated parents or without infants are less likely to be protected by a home smoking ban. These groups are in need of interventions promoting the adoption of home smoking bans to reduce disparities in tobacco-related diseases.
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http://dx.doi.org/10.1136/tc.2011.043802DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633927PMC
May 2012

Tobacco use, exposure to secondhand smoke, and cessation counseling among medical students: cross-country data from the Global Health Professions Student Survey (GHPSS), 2005-2008.

BMC Public Health 2011 Feb 1;11:72. Epub 2011 Feb 1.

Office on Smoking and Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA.

Background: GHPSS is a school-based survey that collects self-administered data from students in regular classroom settings. GHPSS produces representative data at the national or city level in each country. This study aims to investigate the prevalence of tobacco use, exposure to secondhand smoke, and cessation counseling among medical students using the GHPSS data.

Methods: The Global Health Professions Student Survey (GHPSS) was conducted among 3rd year medical students in 47 countries and the Gaza Strip/West Bank from 2005-2008 to determine the prevalence of tobacco use and amount of formal training in cessation counseling.

Results: In 26 of the 48 sites, over 20% of the students currently smoked cigarettes, with males having higher rates than females in 37 sites. Over 70% of students reported having been exposed to secondhand smoke in public places in 29 of 48 sites. The majority of students recognized that they are role models in society (over 80% in 42 of 48 sites), believed they should receive training on counseling patients to quit using tobacco (over 80% in 41 of 48 sites), but few reported receiving formal training (less than 40% in 46 of 48 sites).

Conclusion: Tobacco control efforts must discourage tobacco use among health professionals, promote smoke free workplaces, and implement programs that train medical students in effective cessation-counseling techniques.
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http://dx.doi.org/10.1186/1471-2458-11-72DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042391PMC
February 2011

Cancer health disparities persist among African Americans in Wisconsin.

WMJ 2010 Oct;109(5):267-73

University of Wisconsin Carbone Cancer Center, University of Wisconsin - Madison, 610 Walnut St (WARF 370E), Madison WI 53705, USA.

Background: Cancer incidence and mortality rates have decreased over the last few decades, yet not all groups have benefited equally from these successes. This has resulted in increased disparities in cancer burden among various population groups.

Objective: This study examined trends in absolute and relative disparities in overall cancer incidence and mortality rates between African American and white residents of Wisconsin during the period 1995-2006.

Methods: Cancer incidence data were obtained from the Wisconsin Cancer Reporting System. Mortality data were accessed from the National Center for Health Statistics' public use mortality file. Trends in incidence and mortality rates during 1995-2006 for African Americans and whites were calculated and changes in relative disparity were measured using rate ratios.

Results: With few exceptions, African American incidence and mortality rates were higher than white rates in every year of the period 1995-2006. Although cancer mortality and incidence declined for both groups over the period, relative racial disparities in rates persisted over the period and account for about a third of African American cancer deaths.

Conclusions: Elimination of cancer health disparities will require further research into the many contributing factors, as well as into effective interventions to address them. In Wisconsin, policymakers, health administrators, and health care professsionals need to balance resources carefully and set appropriate priorities to target racial inequities in cancer burden.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3061556PMC
October 2010

Association studies of excision repair cross-complementation group 1 (ERCC1) haplotypes with lung and head and neck cancer risk in a Caucasian population.

Cancer Epidemiol 2011 Apr 21;35(2):175-81. Epub 2010 Sep 21.

Molecular Epidemiology and Cancer Control Programs, Penn State Hershey Cancer Institute, Penn State College of Medicine, 500 University Drive, Hershey, PA, USA.

Background: The formation of bulky DNA adducts caused by diol epoxide derivatives of polycyclic aromatic hydrocarbons has been associated with tobacco-induced cancers, and inefficient repair of such adducts by the nucleotide excision repair (NER) system has been linked to increased risk of tobacco-induced lung and head and neck (H&N) cancers. The human excision repair cross-complementation group 1 (ERCC1) protein is essential for a functional NER system and genetic variation in ERCC1 may contribute to impaired DNA repair capacity and increased lung and H&N cancer risk.

Methods: In order to comprehensively capture common genetic variation in the ERCC1 gene, Caucasian data from the International HapMap project was used to assess linkage disequilibrium and choose four tagSNPs (rs1319052, rs3212955, rs3212948, and rs735482) in the ERCC1 gene to genotype 452 lung cancer cases, 175 H&N cancer cases, and 790 healthy controls. Haplotypes were estimated using expectation maximization (EM) algorithm, and haplotype association with cancer was investigated using Haplo.stats software adjusting for known covariates.

Results: The genotype and haplotype frequencies matched previous estimates from Caucasians. There was no significant difference in the prevalence of rs1319052, rs3212955, rs3212948, and rs735482 when comparing lung or H&N cancer cases with controls (p-values>0.05). Similarly, there was no association between ERCC1 haplotypes and lung or H&N cancer susceptibility in this Caucasian population (p-values>0.05). No associations were found when stratifying lung cancer cases by histology, sex, smoking status, or smoking intensity.

Conclusions: This study suggests that ERCC1 polymorphisms and haplotypes do not play a role in lung and H&N cancer susceptibility in Caucasians.
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http://dx.doi.org/10.1016/j.canep.2010.08.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081042PMC
April 2011

FOXO3 encodes a carcinogen-activated transcription factor frequently deleted in early-stage lung adenocarcinoma.

Cancer Res 2010 Aug 14;70(15):6205-15. Epub 2010 Jul 14.

Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, USA.

The FOXO family of transcription factors elicits cell cycle arrest, apoptosis, and resistance to various physiologic and pathologic stresses relevant to sporadic cancer, such as DNA damage and oxidative stress. Although implicated as tumor suppressors, FOXO genetic inactivation has not been observed in human cancer. In an investigation of the two major types of non-small cell lung cancer, here, we identify the FOXO3 gene as a novel target of deletion in human lung adenocarcinoma (LAC). Biallelic or homozygous deletion (HD) of FOXO3 was detected in 8 of 33 (24.2%) mostly early-stage LAC of smokers. Another 60.6% of these tumors had losses of FOXO3 not reaching the level of HD (hereafter referred to as sub-HD). In contrast, no HD of FOXO3 was observed in 19 lung squamous cell carcinoma. Consistent with the deletion of FOXO3 were corresponding decreases in its mRNA and protein levels in LAC. The potential role of FOXO3 loss in LAC was also investigated. The carcinogen (+)-anti-7,8-dihydroxy-9,10-epoxy-7,8,9,10-tetrahydrobenzo[a]pyrene (BPDE) is strongly implicated as a cause of human lung cancer. Here, we show that FOXO3a is functionally activated and augments the level of caspase-dependent apoptosis in cells exposed to this DNA-damaging carcinogen. These results implicate FOXO3 as a suppressor of LAC carcinogenesis, a role frequently lost through gene deletion.
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http://dx.doi.org/10.1158/0008-5472.CAN-09-4008DOI Listing
August 2010

Results of global youth tobacco surveys in public schools in Bogotá, Colombia.

J Sch Health 2010 Mar;80(3):141-5

National Cancer Institute, Calle 1 # 9-85, Bogotá, DC, Colombia.

Background: The purpose of this paper is to use data from the Global Youth Tobacco Survey (GYTS) conducted in Bogotá, Colombia, in 2001 and 2007 to examine changes in tobacco use among youth 13-15 years of age. The current tobacco control effort in Bogotá will be accessed relative to Colombia ratifying the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in 2008.

Methods: GYTS was implemented in public schools in Bogotá, Colombia, by the Colombian National Cancer Institute. Data were collected from students in classrooms using self-administered procedures.

Results: Between 2001 and 2007, ever having smoked cigarettes decreased along with exposure to secondhand smoke (SHS) at home, having an object with a tobacco logo on it, and having been offered free cigarettes by a tobacco company representative. Prevalence of current cigarette smoking did not change from 2001 to 2007 (32.9% and 29.9%). Exposure to pro-tobacco advertising increased, reaching 71.4%, and 73.4% respectively, in 2007. Having been taught about the harmful effects of tobacco use did not change over time.

Conclusions: The government of Colombia ratified the WHO FCTC in 2008. However, Colombia has one of the highest levels of cigarette smoking among 13-15 year olds in the Region of the Americas. The tobacco control effort in Colombia has much work to do, including recognition that the levels of smoking among adolescents are already as high as those of adults. Future declines in tobacco use among adolescents in Bogotá will likely depend on development of a comprehensive tobacco control program.
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http://dx.doi.org/10.1111/j.1746-1561.2009.00479.xDOI Listing
March 2010

Tobacco use, exposure to secondhand smoke, and training on cessation counseling among nursing students: cross-country data from the Global Health Professions Student Survey (GHPSS), 2005-2009.

Int J Environ Res Public Health 2009 10 28;6(10):2534-49. Epub 2009 Sep 28.

Office on Smoking and Health, US Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.

The Nursing Global Health Professions Student Survey (GHPSS) has been conducted in schools in 39 countries and the Gaza Strip/West Bank (identified as "sites" for the remainder of this paper). In half the sites, over 20% of the students currently smoked cigarettes, with males having higher rates than females in 22 sites. Over 60% of students reported having been exposed to secondhand smoke in public places in 23 of 39 sites. The majority of students recognized that they are role models in society, believed they should receive training on counseling patients to quit using tobacco, but few reported receiving any formal training. Tobacco control efforts must discourage tobacco use among health professionals, promote smoke free workplaces, and implement programs that train health professionals in effective cessation-counseling techniques.
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http://dx.doi.org/10.3390/ijerph6102534DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790091PMC
October 2009

Tobacco use and cessation counseling among health professional students: Lebanon Global Health Professions Student Survey.

J Med Liban 2009 Oct-Dec;57(4):243-7

Lebanese University, Faculty of Public Health, Fanar Campus, Beirut, Lebanon.

Introduction: The number of deaths attributable to tobacco use is rising globally. Health professionals can help reduce tobacco use by providing advice to patients regarding smoking cessation. Very few studies have collected information on tobacco use and cessation counseling training among health professional students. The purpose of this paper is to examine these issues using data from the 2005 Lebanon Global Health Professions Student Survey (GHPSS).

Methods: The 2005 Lebanon GHPSS includes nationally representative estimates of third-year students in all dental, medical, nursing, and pharmacy schools in Lebanon.

Results: Current cigarette use ranged from 14.8% for pharmacy students to 26.9% for nursing students and 27.4% for medical students. Current waterpipe use ranged from 20.6% for medical students to 44.9% for nursing students. About 8 in 10 students in all four disciplines were exposed to second-hand smoke in public places. More than 8 in 10 students in medical, nursing, and pharmacy schools believed that health professionals have a role in giving advice or information on smoking cessation to patients. More than 9 in 10 students in all four disciplines believed that health professionals should receive training on smoking cessation techniques. However, those who received training ranged from 19.8% of pharmacy students to 43.7% of nursing students.

Conclusion: Tobacco use (cigarettes and water-pipe) is high among third-year health professional students in Lebanon. Students are willing to provide smoking-cessation counseling but lack training. The Ministry of Public Health, the Ministry of Education, and educational institutions in Lebanon should work together with other interested partners in developing, testing, and implementing successful patient cessation counseling training programs for health professionals.
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October 2010

Change in tobacco use among 13-15 year olds between 1999 and 2008: findings from the Global Youth Tobacco Survey.

Glob Health Promot 2009 Sep;16(2 Suppl):38-90

US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.

Tobacco use is the leading preventable cause of death and disease in the world; yet little is known about the levels or patterns of youth tobacco use on a global basis. The purpose of this paper is to focus on change in youth tobacco use using data from 100 sites that have conducted repeat Global Youth Tobacco Surveys (GYTS). The GYTS is a school-based survey that collects data from students aged 13-15 years using a standardized methodology for constructing the sample frame, selecting schools and classes, and processing data. GYTS is conducted in school classes using self-administered anonymous data collection. The GYTS sample produces representative, independent, cross-sectional estimates for each sampling frame. Of the 100 sites surveyed, 61 reported no change over time in prevalence of cigarette smoking, likewise in 50 of the 97 sites with data on use of other tobacco products there was no change. However, 34 sites reported an increase in other tobacco use. This appears to be attributed to waterpipe, an emerging trend in tobacco use. Evidence was found supporting the idea that tobacco use among adolescent girls is likely increasing. The global tobacco control effort continues to face many challenges in reversing the tobacco epidemic. Few countries have implemented comprehensive tobacco control legislation laid out by the World Health Organization. The few countries that have adopted some of these proven policies can serve as examples in achieving positive results in curbing the tobacco epidemic.
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http://dx.doi.org/10.1177/1757975909342192DOI Listing
September 2009

Prevalence of youth cigarette smoking and selected social factors in 25 European countries: findings from the Global Youth Tobacco Survey.

Int J Public Health 2009 ;54(6):439-45

Department of Epidemiology, Institute of Public Health, Jessenius Faculty of Medicine, Comenius University, Sklabinská 26, 037 53 Martin, Slovakia.

Objectives: To present Global Youth Tobacco Survey (GYTS) data on the prevalence of cigarette smoking and selected social factors among students aged 13-15 years in 25 European countries.

Methods: The GYTS is a school-based survey of students aged 13-15 years. The GYTS was conducted in 25 European countries (2002-2005) and produced representative data for each country.

Results: In 25 European countries studied, 22% of boys and 18% of girls smoked cigarettes. In 17 of 25 countries, current cigarette smoking did not differ between boys and girls. Exposure to secondhand smoke is very high throughout the 25 countries. Exposure to pro-tobacco indirect advertising (having tobacco company logos on promotional items and being given free cigarettes) is frequent throughout the countries.

Conclusions: Intensified efforts to lessen harm caused by tobacco use among youth in 25 European countries included in this study are urgently needed. These countries need to develop and implement comprehensive tobacco control programs including public education campaigns, cessation programs, enforcement of existing measures, and related policy efforts. The WHO FCTC provides a useful framework for implementing such a comprehensive approach.
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http://dx.doi.org/10.1007/s00038-009-0051-9DOI Listing
April 2010

Tobacco use among Palestine refugee students (UNRWA) aged 13-15.

Prev Med 2009 Aug-Sep;49(2-3):224-8. Epub 2009 Jun 9.

UNRWA Headquarters, Amman, Jordan.

Objective: The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) has made tobacco use prevention a primary health issue. UNRWA provides education, health, relief and social services in five fields of operation: Jordan, Lebanon, Syria, Gaza Strip and the West Bank. The purpose of this paper is to compare tobacco use among Palestine refugee students and students in the general population of the five fields of operation.

Methods: Global Youth Tobacco Survey (GYTS) data were collected from representative samples of students in UNRWA schools in each of the five fields of operation in 2008. For comparison, previous data are included from GYTS conducted in Gaza Strip, Lebanon, and the West Bank (2005) and in Jordan and Syria (2007). Data are presented for three groups of students: refugees attending schools within and outside the camps and non-refugee students in the general population.

Results: In each of the five fields of operation, there was no difference in current cigarette smoking, current use of shisha, or susceptibility to initiate smoking among the three groups of students. Cigarette smoking and susceptibility was lowest in the Gaza Strip and highest in the West Bank; shisha use was lowest in the Gaza Strip but over 30% in Lebanon, Syria, and the West Bank. Exposure to secondhand smoke in public places was greater than 60% in almost all sites. Exposure to indirect advertising was almost 10%.

Conclusions: The similarity in tobacco use among the three groups of students suggests that a coordinated plan between the UNRWA and the governmental authority could be most beneficial in reducing the burden of tobacco-related morbidity and mortality.
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http://dx.doi.org/10.1016/j.ypmed.2009.06.001DOI Listing
February 2010

Exposure to and attitudes regarding secondhand smoke among secondary students in Taiwan.

Asia Pac J Public Health 2009 Jul 14;21(3):259-67. Epub 2009 May 14.

Taipei Medical University; Taiwan Bureau of Health Promotion, Taipei, Taiwan.

The 2003 School Health Act of Taiwan stipulated that school campuses of senior high and below should be smoke free, but data from the Global Youth Tobacco Survey show that the majority of students are exposed to smoke in public and at home. More than 50% of nonsmokers indicated that they had been exposed to secondhand smoke (SHS) in public places, with the exposure rate as high as 90% among smokers. More than 40% of junior and senior high school students were exposed to SHS at home. Support for banning smoking in public places ranged from almost 60% to almost 80%. More than 60% of current smokers and almost 90% of never smokers think that smoke from others is harmful to them. With a clear body of evidence detailing the harmful effects, reduction and eventual elimination of exposure to SHS should be the goal of the tobacco control community.
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http://dx.doi.org/10.1177/1010539509335398DOI Listing
July 2009

Evaluation of the use of Global Youth Tobacco Survey (GYTS) data for developing evidence-based tobacco control policies in Turkey.

BMC Public Health 2008 Dec 15;8 Suppl 1:S4. Epub 2008 Dec 15.

World Health Organization Country Office, Birlik Mahallesi 2, Cadde No: 11, Cankaya, Ankara, Turkey.

Introduction: The tobacco control effort in Turkey has made significant progress in recent years. Turkey initiated its tobacco control effort with the passing of Law 4207 (The Prevention of Harmful Effects of Tobacco Products) in 1996 and ratified the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) in 2004. It is important to base policy decisions on valid and reliable evidence from population-based, representative studies that are periodically repeated to enable policy makers to monitor the results of their interventions and to appropriately tailor anti-tobacco activities towards future needs.

Methods: The Global Youth Tobacco Survey (GYTS) was developed to track tobacco use among young people and enhance the capacity of countries to design, implement, and evaluate tobacco control and prevention programs. Turkey conducted the GYTS in 2003 and data from this survey can be used as baseline measures for evaluation of the tobacco control programs implemented by the Ministry of Health (MOH) of the Turkish government.

Results: The GYTS was conducted in 2003 on a representative sample of students aged 13 to 15 years. It indicated that almost 3 in 10 students in Turkey had ever smoked cigarettes, with significantly higher rates among boys. Current cigarette smoking rates were lower, at 9% for boys and 4% for girls. The prevalence of current use of other tobacco products was about half these figures for each gender. About 80% were exposed to secondhand smoke. Exposure to pro-smoking media messages was not rare. Almost half of the smokers 'usually' bought their tobacco from a store, despite the law prohibiting this. Exposure to teaching against smoking in schools was not universal.

Conclusion: Findings from the GYTS, with periodic repeats of the survey, can be used to monitor the impact of enforcing various provisions of the present law (No: 4207), the progress made in achieving the goals of the WHO FCTC, and the effectiveness of various preventive interventions against smoking. Such data would inform and help in the development of public health strategy.
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http://dx.doi.org/10.1186/1471-2458-8-S1-S4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2604868PMC
December 2008

Prevalence of smoking and other smoking-related behaviors reported by the Global Youth Tobacco Survey (GYTS) in Thailand.

BMC Public Health 2008 Dec 15;8 Suppl 1:S3. Epub 2008 Dec 15.

Health Administration Department, Faculty of Public Health, Mahidol University, 420/1 Rajvithi Road, Rajthevi District, Bangkok, Thailand.

Introduction: Thailand ratified the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) on November 8, 2004. The WHO FCTC requires all parties to inform all persons of the health consequences of tobacco consumption and exposure to tobacco smoke. Each party has agreed to develop, implement and evaluate effective tobacco control programs to measure progress in reaching the goals of the WHO FCTC.

Methods: The Global Youth Tobacco Survey (GYTS) was developed to provide data on youth tobacco use to countries for their development of youth-based tobacco control programs. Data in this report can be used as baseline measures for future evaluation of the tobacco control programs implemented by the Ministry of Public Health.

Results: Overall, about 1 in 10 Thai students are current smokers, this number including 4 times more boys than girls (17% versus 3.9%). Almost 2 in 10 Thai students start smoking before the age of 10, and almost 7 in 10 students are reported to have been exposed to smoke from others in public places. About 4 in 10 students are reported to have an object with a cigarette brand logo on it.

Conclusion: The key for Thailand is to implement and enforce the provisions on indirect tobacco advertising, smoking in public places, selling tobacco to youths under 18 years of age, and to use the data from the GYTS to monitor progress toward achieving the goals of the WHO FCTC. When these goals are met, tobacco consumption and exposure in Thailand will have declined substantially.
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http://dx.doi.org/10.1186/1471-2458-8-S1-S3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2604867PMC
December 2008

Prevalence of smoking and other smoking related behaviors reported by the Global Youth Tobacco Survey (GYTS) in four Peruvian cities.

BMC Public Health 2008 Dec 15;8 Suppl 1:S2. Epub 2008 Dec 15.

Centro de información y educación para la prevención del abuso de drogas (Cedro), Av. Roca y Boloña 271, Lima, Peru.

Introduction: In 2004, Peru ratified the Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) and in 2006 passed Law 28705 for tobacco consumption and exposure reduction. The Global Youth Tobacco Survey (GYTS) provides data on youth tobacco use for development of tobacco control programs. Findings from the GYTS conducted in four main cities in Peru in 2000 and 2003 are reported in this paper and can be used to monitor provisions of the WHO FCTC.

Methods: The GYTS is a school-based survey that uses a standardized methodology for sampling, questionnaire construction, field procedures, and data management. In total, 5,332 and 7,824 students aged 13 to 15 years participated in the 2000 and 2003 surveys conducted in Huancayo, Lima, Tarapoto and Trujillo.

Results: In both years, Lima had the highest lifetime (54.6% and 59.6%) and current use of tobacco (18.6% and 19.2%) of the four cities. According to gender, boys smoked more than girls and less than 20% of students initiated smoking before the age of 10. Among smokers, more than 60% bought their cigarettes in a store with no restriction for their age, and approximately 12% had ever been offered "free cigarettes". Around 90% of students were in favor of banning smoking in public places. Changes between 2000 and 2003 included an increase in the percentage of smokers who wanted to have a cigarette first thing in the morning in Tarapoto (from 0% to 1.2%) and a decrease in exposure to tobacco at home in Huancayo (from 23.7% to 17.8%) and Trujillo (from 27.8% to 19.8%)

Conclusion: While few changes in tobacco use among youth have been observed in the GYTS in Peru, the data in this report can be used as baseline measures for future evaluation efforts. At this time, tobacco control efforts in Peru need to focus on enhancing Law 28705 to include enforcement of existing provisions and inclusion of new laws and regulations. Most of these provisions are required of all countries, such as Peru, that have ratified the WHO FCTC.
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http://dx.doi.org/10.1186/1471-2458-8-S1-S2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2604866PMC
December 2008

Prevalence of tobacco use among junior high and senior high school students in Taiwan.

J Sch Health 2008 Dec;78(12):649-54

Taipei Medical University, No. 250, Wu-Hsing St, Taipei 110, Taiwan.

Background: Tobacco use is a major preventable cause of death in the world. This article describes and compares tobacco use prevalence for students attending junior high schools and senior high schools in Taiwan.

Methods: This report uses data from the Global Youth Tobacco Survey (GYTS) completed among 4689 junior high school students and 4426 senior high school students in Taiwan in 2004-2005. The GYTS uses a 2-stage sampling design to produce nationally representative data for junior and senior high students in general and vocational schools.

Results: Higher smoking prevalence was observed among senior high (10.1% general schools and 15.9% vocational schools) than junior high (5.5%) school students. Smoking prevalence of girls in junior high (3.2%) and senior high schools (4.6% general and 11.1% vocational) was almost as high or higher than adult females' (4.3%) smoking rates. The pattern of smoking intensity across school years and type of school shows that the percentage of smokers who were experimenters (47.1%) was higher in junior high school and the percentage of smokers who were regular/established smokers (over 50%) was higher in senior high school.

Conclusions: Smoking prevalence described in this report shows that there are challenges facing the tobacco prevention and control program in Taiwan. The findings suggest that schools should increase their smoking initiation prevention efforts and make available cessation programs and counseling to help students quit smoking. If effective youth tobacco control programs are not developed and implemented in Taiwan, future morbidity and mortality attributed to tobacco will surely increase, especially among women.
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http://dx.doi.org/10.1111/j.1746-1561.2008.00361.xDOI Listing
December 2008

Linking Global Youth Tobacco Survey 2003 and 2006 data to tobacco control policy in India.

J Sch Health 2008 Jul;78(7):368-73

School of Preventive Oncology, A/27, Anandpuri, Boring Canal Rd, Patna 800001, Bihar, India.

Background: India made 2 important policy statements regarding tobacco control in the past decade. First, the India Tobacco Control Act (ITCA) was signed into law in 2003 with the goal to reduce tobacco consumption and protect citizens from exposure to secondhand smoke (SHS). Second, in 2005, India ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). During this same period, India conducted the Global Youth Tobacco Survey (GYTS) in 2003 and 2006 in an effort to track tobacco use among adolescents.

Methods: The GYTS is a school-based survey of students aged 13-15 years. Representative national estimates for India in 2003 and 2006 were used in this study.

Results: In 2006, 3.8% of students currently smoked cigarettes and 11.9% currently used other tobacco products. These rates were not significantly different than those observed in 2003. Over the same period, exposure to SHS at home and in public places significantly decreased, whereas exposure to pro-tobacco ads on billboards and the ability to purchase cigarettes in a store did not change significantly.

Conclusions: The ITCA and the WHO FCTC have had mixed impacts on the tobacco control effort for adolescents in India. The positive impacts have been the reduction in exposure to SHS, both at home and in public places. The negative impacts are seen with the lack of change in pro-tobacco advertising and ability to purchase cigarettes in stores. The Government of India needs to consider new and stronger provisions of the ITCA and include strong enforcement measures.
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http://dx.doi.org/10.1111/j.1746-1561.2008.00316.xDOI Listing
July 2008

Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control (FCTC): the case for Lebanon.

Prev Med 2008 Sep 12;47 Suppl 1:S15-9. Epub 2008 Jun 12.

Non-Communicable Disease Program World Health Organization, Beirut Office Glass Building 4th Floor, Museum Square Beirut Lebanon.

Objectives: The purpose of this paper is to use data collected in the 2001 and 2005 Lebanon Global Youth Tobacco Survey (GYTS) to monitor articles in the WHO Framework Convention on Tobacco Control (WHO FCTC). This information is necessary to enhance the capacity of the Ministry of Health and relevant organizations to design, implement, and evaluate tobacco control and prevention programs in Lebanon, especially among adolescents.

Methods: The GYTS is a school-based survey which uses a two-stage sample design to produce representative, independent, cross-sectional estimates. The GYTS was conducted in 2001 and 2005 in Lebanon to produce representative national estimates. Data in this report are limited to students aged 13-15 years. In total, 5035 students from 50 schools participated in 2001; and 3341 students from 50 schools participated in 2005.

Results: The data in this report show that, in 2005, 8.6% of the students currently smoked cigarettes, but 33.9% currently smoked narguileh. Half of current smokers wanted to stop smoking and 6 in 10 have tried to stop during the past year but have failed. In 2005, exposure to SHS at home (78.4%) and in public places (74.4%) was very high; while 85.2% thought smoking should be banned in public places. Nearly 9 in 10 students who usually buy their cigarettes in stores were not refused purchase because of their age. Overall, only half of the students in Lebanon reported that during the past school year they had been taught about the dangers of smoking.

Conclusions: Data in this report can be used as baseline measures for future evaluation of the tobacco control programs implemented by the Ministry of Health with particular attention to youth. The key for the Lebanese parliament is to develop, endorse, implement and enforce these new tobacco control laws and use the data from GYTS to monitor progress toward achieving the goals of the WHO FCTC. One key component of tobacco control needs to be the monitoring of Narguileh use among youth, a new emergency.
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http://dx.doi.org/10.1016/j.ypmed.2008.06.003DOI Listing
September 2008
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