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Abstract Introduction Physician-brief advice has been utilized in high-income countries to promote smoking cessation among cancer patients. Empirical evidence on its effectiveness among cancer patients in low and middle-income countries (LMICs) is lacking. The gap could be due to inadequate training, and competing healthcare priorities, leading to insufficient implementation of targeted smoking cessation interventions in oncology settings. We undertook this scoping review to determine if physician-brief advice is effective in promoting smoking cessation among cancer patients in LMICs. Methods We conducted a literature search of all relevant articles across five databases: Cochrane Central Register of Controlled Trials, Cochrane Library (Tobacco Addiction Group trials), World Conference on Lung Cancer proceedings, PubMed, and Google Scholar up to November 2023, using pre-defined inclusion criteria and keywords. The study population was cancer survivors in LMICs, the intervention was smoking cessation advice by a physician in a clinic or oncology center during a consultation, and the outcome was the effect of smoking cessation programs in discontinuing smoking among cancer survivors in LMICs. Results Overall, out of every 10 cancer patients in LMICs, about seven were smokers, and one-half had received physician-brief advice for smoking cessation. Physician-brief advice was more likely to be delivered to patients with smoking-related cancer (Cohen’s d = 0.396). This means that there is a noticeable difference between patients with smoking-related cancer compared to those with cancer unrelated to smoking. Smoking cessation failure was due to the inability to cope with the symptoms of withdrawal, missed smoking cessation clinic visits, mental health disorders, limited time and resources, and minimal patient-physician contact. Conclusion There is very little literature on the frequency of use or the efficacy of physician-brief advice on smoking cessation in LMICs. The literature suggests that cancer patients in LMICs have low self-efficacy to quit smoking, and smoking cessation is rarely part of cancer care in LMICs. Physicians in LMICs should be trained to use motivational messages and good counseling techniques to improve smoking cessation among cancer patients. Policymakers should allocate the resources to implement physician-brief advice and design training programs for physicians focusing on physician-brief advice tailored to cancer patients.

Introduction Examining gender differences in youth tobacco use is important as it aligns tobacco control within the context of broader human development goals seeking to eliminate gender inequalities. In this study, we examined gender differences in adolescent use of cigarettes, smokeless tobacco, shisha, and e-cigarettes in Africa. Methods This was a cross-sectional study using data from the Global Youth Tobacco Survey. Our analytical sample comprised 56442 adolescents aged 13–15 years from 20 African countries. Weighted, country-specific prevalence estimates were computed overall and by gender. Adjusted prevalence ratios (APRs) were calculated in a multivariable Poisson regression model to examine whether correlates of tobacco use differed between boys and girls. Results Ever cigarette smoking prevalence was significantly higher among boys than girls in 16 of the 20 countries, but a significantly higher percentage of girls reported earlier age of cigarette smoking initiation than boys within pooled analysis. Some of the largest gender differences in current cigarette smoking were seen in Algeria (12.2% vs 0.8%, boys and girls, respectively), Mauritius (21.2% vs 6.6%), and Madagascar (15.0% vs 4.1%). Current use of e-cigarettes, shisha, and smokeless tobacco was generally comparable between boys and girls where data existed. Among girls, higher levels of reported exposure to tobacco advertisement were positively associated with shisha smoking whereas perceived tobacco harm was inversely associated with current cigarette and shisha smoking. Among boys, perceived social acceptability of smoking at parties was associated with an increased likelihood of cigarette smoking (APR=2.27; 95% Cl: 1.20–4.30). Conclusions The prevalence of cigarette smoking among boys was higher than that of girls in many countries. However, girls who smoke tend to start at an earlier age than boys. Differential gender patterns of cigarette and non-cigarette tobacco product use among youth may have implications for future disease burden. As the tobacco control landscape evolves, tobacco prevention efforts should focus on all tobacco products, not just cigarettes.

Summary: Colonialism’s enduring impact on Brazil has had significant implications for health and oncology outcomes. This historical essay delves into the profound changes brought about by the transatlantic slave trade from Africa to the Americas, particularly in terms of its influence on the economy, sociocultural habits, and health outcomes. This essay explores the enduring connections between the colonial period’s operational dynamics in Brazil and the current epidemiological panorama of head and neck cancer (HNC). The examination provides original insights on the role of tobacco and alcohol production and consumption, alongside the investigation of structural racism, which contributes to disparities in access to diagnosis, treatment, and prognosis for patients with HNC. This article presents novel visions and an analysis of evidence-based strategies to disrupt the adverse impact of colonialism’s legacy on the epidemiology of HNC in Brazil.

The ongoing public health crisis of substance use among school adolescents and young adults (AYAs) in South Africa is not new in research parlance, amidst the national policy of drug abuse management in schools. In view of no tangible progress to reduce substance use in high schools in the country, we conducted a cross-sectional quantitative study aimed at investigating substance use among adolescents and young adults in the four public high schools selected through multi-stage sampling in rural Mpumalanga province, South Africa. Data on substance use, demographics, household socio-demographics, and related factors were collected via a validated self-administered questionnaire. Hierarchical logistic regression was performed using STATA 18. The study included 402 AYAs aged between 14 and 23 years (18 ± 1 years), and 45% reported substance use in the last twelve months. Alcohol was the most used substance (74%), followed by cigarettes (12%) and cannabis (11%). AYAs used substances out of social influence, curiosity, to find joy, and to eliminate stress, especially in social events, on the streets, and at home, and reported negative physical health outcomes, mainly hallucinations, sleeping disorders, body weakness, and dry mouths. Hierarchical logistic regression showed that the likelihood of substance use was three times in a particular high school (S4) (AOR = 3.93, 95%CI: 1.72–8.99), twice among the grade 12s (AOR = 2.73, 95%CI: 1.46–5.11), over twenty times in the communities with substance availability (AOR = 22.45, 95%CI: 2.75–183.56), almost ten times among AYAs participating in recreational/sports activities (AOR = 9.74, 95%CI: 4.21–22.52), and twice likely to happen in larger households (AOR = 2.96, 95%CI: 1.57–5.58). Prevention and intervention efforts should consider these specific health concerns to develop targeted strategies for mitigating substance use and its adverse consequences in this vulnerable population towards achieving the United Nations’ Sustainable Development Goal Target 3.5, which aims to strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and the harmful use of alcohol.

Background: Sexually transmitted infections (STIs) are a global public health concern and sub-Saharan Africa, has limited data on STIs in the men who have sex with men (MSM) population. Syndromic management has controversies for treating asymptomatic STIs (ASTIs). Aim: The aim of this study was to describe the risk factors for STIs among MSM. Setting: This study was conducted in Tshwane North, Gauteng Province in South Africa. Methods: A cross-sectional quantitative design was employed using structured questionnaires, rapid plasma reagent test, from December 2021 to May 2022. Bivariate and multivariate analyses were used for statistical analysis. Results: A total of 200 MSM with the mean age of 27.6, standard deviations: 6.8 participated, and STIs prevalence was 66%, with 37% concurrent infections. Ureaplasma urealyticum was (24%), Mycoplasma hominis (23%), Chlamydia trachomatis (20%), Treponema pallidum (20%) and Neisseria gonorrhoeae (9%). The risk factors for acquisition of STI include having a new partner in the last month (OR = 1.68; CI: 0.98–3.13). Conclusion: The prevalence of ASTIs is high. Serial and multiple sexual partners are the risk factors. Contribution: This study contributes to the body of knowledge of the burden of STIs among high-risk population.

Introduction The increasing use of roll-your own (RYO) cigarettes has been documented globally, but there are no recent data from South Africa, particularly among youths and low-income groups. We assessed changes in prevalence and correlates of RYO smoking among South African adults during 2010–2011 and 2017–2018, and explored expenditure differences between daily smokers of RYO and manufactured cigarettes. Methods Nationally representative data of South Africans aged ≥16 years used in this study were from the South African Social Attitudes Survey (SASAS) for 2010–2011 (n=6116), and 2017–2018 (n=5799). Current RYO cigarette use included daily and non-daily use. Annual expenditures were estimated based on typical usage patterns for daily users. Descriptive and multivariable analyses were performed using Stata Version 15 with the level of statistical significance set at p

Cervical cancer is largely preventable through early detection, but screening uptake remains low among black women in South Africa. The purpose of this study was to determine the prevalence and factors associated with cervical cancer screening in the past 10 years among black African women in primary health care (PHC) clinics, in Gauteng Province, South Africa. This was a cross-sectional study involving 672 consecutively recruited black women at cervical cancer screening programs in PHC clinics between 2017 and 2020. An interviewer-administered questionnaire covered socio-demographics, HIV status, sexual history, cervical cancer risk factors knowledge, and screening behaviours in the past 10 years. The mean age of participants was 38 years. More than half (63%) were aged 30-49 years. Most completed high school education (75%), were unemployed (61%), single (60%), and HIV positive (48%). Only 285 (42.4%) of participants reported screening for cervical cancer in the past 10 years. Of participants that reported receiving information on screening, 27.6% (n = 176) and 13.97% (n = 89) did so from healthcare facilities and community platforms respectively. Participants aged 30 years or more were more likely to report for cervical cancer screening as compared to other categories in the past 10 years. The study found low cervical cancer screening prevalence. This calls for health education campaigns and prevention strategies that would target individual patients' contexts and stages of behavioral change. Such strategies must also consider socio-demographic and clinical correlates of cervical cancer screening and promote better integration into PHC services in South Africa.

Objective To examine the use of different cessation aids among current South African smokers who have ever tried to quit smoking.Design Cross-sectional design.Setting South Africa has progressively passed several policies over the past few decades to encourage smoking cessation. Data on cessation behaviours are needed to inform policymaking. We investigated utilisation of evidence-based cessation aids and e-cigarettes among current combustible smokers. Current tobacco use, past quit attempts and use of evidence-based cessation aids (counselling, nicotine replacement therapy or prescription medication) were self-reported. Data were weighted and analysed using descriptive and multivariable approaches (p

As disasters increase in frequency and magnitude with adverse effects on population health, governments will be forced to implement disaster risk management policies that may include forced relocation. Ineffective public consultation has been cited as one reason for failure of these policies. Using the deliberative polling method, this study assessed the capacity of rural communities to participate in flood risk management policy priority setting and the impact of providing accurate and balanced information on policies by comparing pre-and post -deliberation data. The study also assessed the level of trust on whether government and community would use the results of this study. Results indicated strong community support for policy options to reduce vulnerability in communities and strong resistance to relocation. As all the top five ranked policy options were concerned with population pressure, gender, and social service issues, which are all conceptually considered social determinants of a healthy community, this study concludes that public health considerations are central to flood risk policy development and implementation. The study revealed high levels of trust in government and the community relating to flood risk management, which policymakers in low-to-middle income countries can capitalise on for meaningful community consultation for effective disaster risk management.

Background South Africa's protracted battle with the dual epidemic of HIV and TB is well-documented. TB patients who smoke tobacco are often faced by low socio-economic status and alcohol dependence, with poor TB treatment outcomes. This paper reports on findings that inform the feasibility of scaling an intervention based on motivational interviewing and mhealth, delivered by lay health workers (LHWs), towards achieving tobacco and alcohol cessation and improving TB and HIV treatment adherence. Methods A theory-driven, qualitative feasibility study was conducted in the Free State, North-West and Gauteng provinces of South Africa. Thirteen semi-structured interviews were conducted with district, provincial and national TB managers, and nine focus group discussions were conducted with LHWs and TB patients at the study sites. Transcribed data was thematically analysed in NVivo 11 and guided by Normalisation Process Theory. Results The intervention package and its importance were generally understood among participants, though some had difficulty differentiating it from past and current government initiatives (Coherence). The intervention package does not require extensive re-alignment in terms of work roles, and participants were well-aligned to the introduction of LHWs in existing work spaces (Cognitive Participation). Little difficulties were foreseen in different stakeholders working together in adopting new practices, and the intervention was perceived to align well with government policies. It was noted that the LHWs would require extensive training and support (Collective Action). Measuring the effects post-intervention was perceived to possibly be hampered by fragmented health information systems (Reflexive Monitoring). Conclusions The intervention package was suggested to have a fairly high level of feasibility, being well-supported by stakeholders and aligning well with key health system elements. The findings also illustrate the precarious nature of the challenge under focus, and suggest the necessity of a fair amount of sustained support, dynamism and flexibility in different sites for intervention success.

Background Although smoke-free public places are an important population-wide intervention to protect non-smokers from the harm of smoking and to encourage smokers to quit, others suggest it may increase smoking in homes. This study therefore sought to determine exposure to secondhand smoke (SHS) at home and in public places before and after 2009 when an amendment to legislation that introduced significant increase in fines came into effect. The study also sought to explore the association between SHS exposure and smokers' intention to quit. Methods This cross-sectional study involved three nationally representative samples of South African adults aged ≥16 years who participated in the 2007 (n=2,907), 2010 (n=3,112), 2016 (=3,063) South African Social Attitude Survey. Information obtained using interviewer-administered questionnaire included socio-demographic characteristics and self-reported exposure to tobacco smoking at home and public places (work, bars/clubs, and restaurants). The three datasets were merged (Pooled N = 9,082). Data analysis included chi-square statistics and multiple logistic regression analysis. Results During 2007-2016, the proportion of South Africans who reported exposure to SHS at home on any one day increased from 31.9% in 2007 to 36.6% in 2016 (p=0.637), while exposure on any one day at any one of the various public places decreased significantly from 71.9% to 54.4% (p< 0.001), albeit significantly only between 2010 and 2016. Compared to smokers exposed to others' smoking, those not exposed were more likely to report planning to quit (OR=1.73; 95%CI=1.07-2.79). However, after controlling for the number of cigarettes smoked daily, exposure to others' smoking in public was no longer significant, thus suggesting that the decreasing number of cigarettes smoked daily was the mediator of the effect of restricting public smoking. Conclusions While our findings suggest that the most recent legislative amendment related to public smoking seem to have reduced SHS exposure, further restrictions, which may motivate quitting, are still needed.

Seventy to ninety percent of HIV-infected individuals have oral lesions that affect their quality-of-life. Caregivers play an important role in complementing the healthcare team. It is essential that the caregivers have optimal knowledge, beliefs and practices toward the management of care regarding oral-lesions in HIV-infected patients in caregiving institutions in Johannesburg, South Africa. To measure the knowledge, beliefs and practices relating to oral lesions in HIV infection amongst caregivers in caregiving institutions in Johannesburg. This cross-sectional pilot study conducted during 2005 and 2006 involved caregivers in palliative care institutions in Region 8, Johannesburg Metropolitan area (n = 52). Using a questionnaire, information obtained included demographics, knowledge, beliefs and practices with regard to oral care for HIV-positive patients. Principal component analysis was used to extract questionnaire items of the knowledge domain. The knowledge domain displayed excellent internal consistency (Cronbach α-score of > 0.91). Of the caregivers, 65.4% had received training in oral care. Compared to caregivers not trained in oral care (NTOC), those caregivers trained in oral care (TOC) were more likely to be older (31 yrs vs. 44 yrs; p= 0.001), female (72% vs. 94%; p = 0.03) and were less likely to be employed on a full-time basis (94% vs. 68%; p = 0.03). Compared with NTOCs, TOCs had more knowledge regarding HIV-specific lesions and ‘routine’ oral-care for the patients (p < 0.005). Similarly, TOC caregivers had more positive beliefs about oral care for those living with HIV (p < 0.05). Offering training in oral healthcare to caregivers improves their knowledge of oral lesions and their beliefs about oral care. Sewentig tot negentig persent van MIV-geïnfekteerde individue mondelinge letsels wat hul kwaliteit van lewe. Versorgers speel ‘n belangrike rol in die aanvulling van die gesondheidsorg span. Dit is noodsaaklik dat die versorgers het ‘n beter kennis, oortuigings en praktyke na die bestuur van sorg met betrekking tot mondelinge letsels in MIV-geïnfekteerde pasiënte in die versorgingstaak van instellings in Johannesburg, Suid-Afrika. Om die kennis, oortuigings en praktyke met betrekking tot mondelinge letsels in MIV-infeksie onder versorgers in die versorgingstaak van instellings in Johannesburg te meet. Hierdie deursnee-loodsstudie uitgevoer gedurende 2005 en 2006 betrokke versorgers in palliatiewe sorg instellings in Streek 8, Johannesburg Metropolitaanse gebied (n = 52). Met behulp van ‘n vraelys, inligting ingesluit demografie, kennis, oortuigings en praktyke met betrekking tot mondelinge sorg vir MIV-positiewe pasiënte. Principal component analise is gebruik om vraelys items te onttrek van die kennis domein. Die kennis domein vertoon uitstekende interne konsekwentheid (Cronbach α-telling van > 0,91). Van die versorgers, het 65.4% ontvang opleiding in mondelinge sorg. Vergeleke met versorgers wat nie opgelei in mondelinge sorg (NTOC), die versorgers opgelei in mondelinge sorg (TOC), was meer geneig om ouer (31 jaar teen 44 jaar; p = 0.001), vroue (72% teen 94%; p = 0.03) en is minder geneig om te word op ‘n voltydse basis (94% teen 68%, p = 0.03) in diens geneem. Vergeleke met NTOCs, TOCs versorgers het meer kennis aangaande MIV-spesifieke letsels en roetine ‘mondelinge sorg vir die pasiënte (p < 0,005). TOC versorgers het meer positiewe oortuigings oor mondelinge sorg vir diegene wat met MIV (p < 0.05). Aanbod opleiding in mondelinge gesondheidsorg te versorgers verbeter hul kennis van mondelinge letsels en hulle oortuigings oor mondelinge sorg.