Search

Reducing racial and socioeconomic inequities in smoking has been declared a priority for tobacco control in the USA for several decades. Yet despite the rhetoric, these inequities persist and some have actually worsened over time. Although tobacco companies have targeted racially and ethnically diverse and lower-income tobacco users, which substantially contributes to these disparities, less attention has been given to the role of individuals and organisations within the tobacco control movement who have allowed progress in eliminating disparities to stagnate. We examine the failure of tobacco control professionals to ensure the widespread adoption of equity-focused tobacco control strategies. Review of major US tobacco control reports found that the focus on equity often stops after describing inequities in tobacco use. We suggest ways to advance equity in tobacco control in the USA. These recommendations fall across five categories: surveillance, interventions, funding, accountability and addressing root causes. Policy interventions that will have a pro-equity impact on smoking and related disease should be prioritised. Funding should be designated to tobacco control activities focused on eliminating racial and socioeconomic inequities in smoking, and tobacco control programmes should be held accountable for meeting equity-related goals.

To reduce youth access to tobacco products, the California Tobacco Prevention Program funded local tobacco prevention programs from July 2017 through December 2021 to address its Communities of Excellence Indicator 3.2.9: the number of jurisdictions with a policy eliminating or restricting the sale and/or distribution of any mentholated cigarettes and other flavored tobacco products, and paraphernalia. We examined the strategies by which community coalitions attempted to limit the number of stores selling flavored tobacco across California. Thirty-six final evaluation reports (FERs) were used for our analysis. We examined certain elements or factors as primary areas of interest because of their apparent link to successful outcomes in analyses of FERs in the past. Over half (19 of 36) of FERs reported successfully passing at least 1 policy to regulate the sale of flavored tobacco products. Urban communities passed more policies (16 of 18) compared with rural communities (3 of 18). Successful campaigns tended to involve youth, demonstrate illegal sales to minors and public support for a ban, and identify a champion. Barriers included the COVID-19 pandemic, California wildfires, staffing shortages, and conservative political climates. This evaluation offers insights into the successes and challenges faced by local coalitions seeking policy changes for tobacco use prevention, which can be different for urban and rural communities. The evaluation also indicates the necessity of adopting flexible tactical plans for overcoming environmental factors that affected intervention and evaluation activities.

Purpose: This study aims to examine the effect of online individual motivational interviewing based on the transtheoretical model on pregnant women's smoking cessation behaviour. Material and Method: Sixty‐two pregnant women who did not complete the 16th gestational week and who smoked were randomly assigned to intervention (n = 31) and control (n = 31) groups. While the intervention group was administered model‐based motivational individual counselling interventions, the control group was administered no interventions. Findings The results showed that 58.1% of the pregnant women in the intervention group and 22.6% of the pregnant women in the control group ceased smoking. Conclusion: Online motivational interviewing based on the transtheoretical model was found to be effective in pregnant women's smoking cessation. Summary statement: What is already known about this topic? Smoking is one of the two leading causes of death worldwide.Smoking during pregnancy is a serious risk factor affecting both maternal and infant health.Nurses could make important contributions to raising non‐smoking generations and protecting and improving public health through trainings to be given to pregnant women. What this paper adds? This paper reveals that online motivational interviewing based on the transtheoretical model was effective in pregnant women's smoking cessation. The implications of this paper: The online motivational interviewing smoking cessation programme based on transtheoretical model, which forms the basis of our study, can be implemented by midwives and nurses without time, place and distance restrictions. [ABSTRACT FROM AUTHOR]

Objective: To investigate attitudes and practices toward smoking among university students and to identify associated factors. Methods: A cross-sectional study was conducted among 1,299 students from five public universities in Thailand. Factor analysis and multiple regression were used for analysis. Results: A higher score of anti-smoking attitude was associated with female gender, majoring in science, living on campus, having a father with primary or secondary school, and those whose father was employed in the private sector. A more positive perceptions about smoking was associated with male gender, having a family income of 30,001–50,000 baht, and having a smoking friend. High positive preventive practice score was associated with those who came from rural areas, having a mother who was self-employed, and having a smoking family member. Conclusions: Although students showed strong anti-smoking attitudes, their preventive practices were poor. These findings should be taken into consideration when developing preventive smoking programs. [ABSTRACT FROM AUTHOR]

Purpose: To understand from the perspectives of school professionals, parents and young people the socio-ecological factors that may facilitate and prevent e-cigarette use among young people in Perth, Western Australia. Methods: Purposive sampling was used to recruit school professionals, parents and young people for one-on-one (n = 35) or joint (n = 3) interviews (in-person n = 11 or online n = 27). Data were analysed using thematic analysis and classified into four domains based on the socio-ecological model: i) individual, ii) interpersonal, iii) organizational/community and iv) societal/policy. Results: Factors that were found to support vaping among young people included sensation-seeking and risk-taking behaviour; a low-risk perception of vapes; attractive characteristics of vapes; ease of access; perception vaping is a social activity; and lack of knowledge about vaping among parents and school professionals. Vaping prevention messages originating from the familial, educational and community spheres are lacking but wanted by adults and young people. Conclusions: The pervasiveness of the e-cigarette trade and persistent challenges related to surveillance and enforcement need to be addressed to reduce exposure and access to e-cigarettes. A mixture of "hard" and "soft" public policy tools involving key stakeholders in a range of settings is needed to prevent e-cigarette access and uptake by young people. [ABSTRACT FROM AUTHOR]

In absence of national legislation, local governments may stimulate outdoor sports clubs to become smoke-free. However, it is unknown whether and to what extent such efforts are effective in encouraging sports clubs to adopt a smoke-free policy (SFP). The aim of this study was to assess the association between tobacco control policies of municipalities and the prevalence of SFPs among outdoor sports clubs. Retrospective, cross-sectional. Information on Dutch sports clubs (N = 3068) was linked to information on tobacco control policies of municipalities (i.e., "smoking prevention policies", "smoke-free environment policies", and "smoke-free sports policies") (N = 218). Multilevel logistic regression models examined the association between municipal tobacco control policies and the prevalence of SFPs among outdoor sports clubs, while controlling for sports clubs' characteristics. We found a positive, dose-response association between tobacco control policies of municipalities and the prevalence of SFPs among outdoor sports clubs. The odds of having an SFP in place was significantly higher for sports clubs in municipalities with moderate "smoking prevention policies" (OR = 1.85, 95%CI = 1.18–2.89), strong "smoke-free environment policies" (OR = 1.95, 95%CI = 1.19–3.20), and strong "smoke-free sports policies" (OR = 1.66, 95%CI = 1.02–2.24) compared to sports clubs in municipalities with no/weak policies. The results suggest that local tobacco control policies can increase the prevalence of SFPs among outdoor sports clubs. In order to create maximum effect, local policies need to be comprehensive and widely implemented. [ABSTRACT FROM AUTHOR]

Health communication research applies communication science to develop generalizable knowledge capable of improving the health and well-being of individuals and communities. But to what extent does the knowledge generated by the health communication field actually achieve public health impact? To answer this question, we discuss the application of health communication science and research within a tobacco regulatory science framework. We describe three areas in which health communication research funded by the Food and Drug Administration (FDA) Center for Tobacco Products (CTP) contributed to 1) youth tobacco prevention campaigns, 2) cigarette health warnings, and 3) regulation of labeling, advertising, and marketing claims. These examples demonstrate how communication regulatory science achieves public health impact in the real world by informing national policies, regulatory actions, and public health practice. [ABSTRACT FROM AUTHOR]

Background and Aims: Pathways of transitioning from tobacco smoking to vaping after receiving an e‐cigarette‐based smoking cessation intervention have been minimally explored. Study aims: 1) identify pathways between intervention delivery and final follow‐up; 2) describe baseline and post‐intervention statistical data in relation to smoking/vaping behaviour of the different pathway groups; 3) explore qualitative participant perspectives contextualising pathway groups. Design: Embedded mixed‐methods analysis of data collected for the Cessation of Smoking Trial in the Emergency Department (COSTED) randomised controlled trial. Setting: Recruitment from 6 Emergency Departments (5 in England and 1 in Scotland) between January and August 2022. Participants: 366 adult smokers who were randomised to receive the COSTED intervention and provided data at 6‐month follow‐up. Qualitative subsample of 24 participants interviewed after follow‐up. Interventions: Brief smoking cessation advice, provision of an e‐cigarette starter kit and referral to the local Stop Smoking Service. Measurements: Descriptive statistical reporting of identified pathways and smoking/vaping behaviour at baseline and 6‐month follow‐up. Semi‐structured phone/video interviews analysed thematically. Findings 13.4% (n = 49) of participants quit smoking within 1 month of receiving the intervention, 19.1% (n = 70) quit between 1 and 6 months, 24.9% (n = 91) reduced cigarettes per day (CPD) by at least 50%, and 42.6% did not experience a significant smoking reduction. Approximately a third of participants who quit reported not vaping at follow‐up. Reporting dual use was associated with a reduction in CPD. Appoximately a third reported experimenting with a different device to the one provided as part of the intervention. Quitters reported themes of satisfaction with vaping, changes in environment facilitating quitting and motivation to quit. Conclusions: Dual use of cigarettes and e‐cigarettes can result in a reduction of smoking and may prelude quitting smoking. Sustained e‐cigarette use is not always necessary for quitting success. Success depends on personal context as well satisfaction with vaping. [ABSTRACT FROM AUTHOR]

Aims: To summarise systematic reviews on tobacco addiction published by the Cochrane Tobacco Addiction Group (CTAG) from 2021 to 2023. Methods: We identified all new and updated Cochrane Reviews published by CTAG between 2021 and 2023. We present key results from these reviews and discuss promising avenues for future research. Results: CTAG published five new reviews and one overview of reviews, and updated eight reviews. Review evidence showed that all main pharmacotherapies (varenicline, cytisine, bupropion and nicotine replacement therapy [NRT], especially when patches are combined with fast acting forms like gum) are effective for smoking cessation, as are nicotine e‐cigarettes. Evidence suggested similar magnitude of effects of varenicline, cytisine, and nicotine e‐cigarettes; these emerged as the most effective treatments. Evidence also supported behavioural counselling and financial incentives for smoking cessation. Secondary analyses of the Cochrane review of e‐cigarettes for smoking cessation showed over half of participants assigned to e‐cigarette conditions were still using them at six months or longer, that biomarkers of potential harm significantly reduced in people switching from smoking to vaping or to dual use, and that there was insufficient evidence to draw associations between e‐liquid flavours and smoking cessation. Findings on mindfulness‐based interventions, interventions delivered by dental and primary care professionals, interventions to prevent weight gain after smoking cessation, and interventions for waterpipe cessation were less certain. Reviews of observational evidence showed that smoking cessation reduced cardiovascular events and mortality in people living with cardiovascular disease, and improved mental health. Conclusions: Nicotine replacement therapy (especially patches combined with fast acting forms), varenicline, cytisine, bupropion, nicotine e‐cigarettes, behavioural counselling, and financial incentives are all effective ways to help people quit smoking. Quitting smoking improves mental health and reduces cardiovascular events and mortality in people living with cardiovascular disease. [ABSTRACT FROM AUTHOR]

Hookahs have been rising in popularity in the United States (U.S.) especially among the youth yet not much research has been carried out to understand the various predictors of hookah use among youth. We have thus conducted a cross-sectional study with a mixed-methods triangulation design to identify the hookah use determinants at different levels of the Social Ecological Model among youth. Participants between the ages of 18–24 years were sampled purposively, between April to November 2023, following a snowballing technique from various communities in Virginia and California, United States. Data were collected via a survey, one-on-one interviews, and focus groups. The study had a total sample size of 20. We found that participants smoked for a median of 5 times in the past 30 days. The main determinants of hookah smoking included the limited knowledge of health effects and addiction, positive attitude, family and peer influence, use as a means to socially connect with others, culture, social acceptability, lack of education at school and work place, access to hookah bars and smoke shops, and lack of strict enforcement of laws to ban smoking of youth. Educational interventions should be implemented by public health authorities to target the youth, their social and communities to provide education on hookah harm and addictiveness and to restrict access to- and the production, distribution, marketing and sales of hookahs. [ABSTRACT FROM AUTHOR]

Objective: To investigate the level of knowledge, and attitude of society toward substance use disorder (SUD). Method: In this cross-sectional study, a questionnaire form created by the researchers was completed by individuals over the age of 18 between June and July 2022. A total of 1365 individuals (684 women, 681 men) participated in the study. Results: The mean age of the participants was 36.22 ± 10.47 years (min:18, max:75). A total of 19.2% did not consider addiction a medical disease, 37.4% thought that addiction was a moral failing, and 37.4% believed that addiction was a voluntary decision. 28.3% thought that only people with weak willpower will become addicted, 42.1% thought that trying substances would not lead to addiction, and 38.4% thought that substances can be quit without medical treatment. A total of 52.7% reported that they were afraid of people with addictions, 22.9% stated that they would not employ SUD patients in their workplace even if they had been treated. Only 36.8% of the participants had received any addiction-related training in their lifetime. Conclusion: Our findings display that the level of knowledge about addiction in society in Turkey is low, and there is substantial stigmatization and negative views on people with addictions. [ABSTRACT FROM AUTHOR]

Youth vaping is a concern and schools may use many approaches to discipline students caught vaping at school. This study identified the prevalence of school staff seeing vaping in schools and the measures used to discipline students. A state-wide sample of 7,938 staff from 255 middle and high schools reported whether they saw any students vaping at school in the last 30 days, whether they have caught any students vaping during class in the last semester, and what happened after catching a student vaping in class. Open-text responses were coded and themes were identified related to disciplinary approaches. 31.9% of staff reported seeing students vaping at school, and 11.9% of teachers reported catching a student vaping during class. Teachers described four categories of disciplinary approaches after catching students vaping in class: no consequences, punitive approaches, restorative approaches, and mixed approaches. Additional support is necessary to help schools address student vaping. [ABSTRACT FROM AUTHOR]

E-cigarettes gained popularity globally through the promotion of e-cigarettes as a risk-free way to stop traditional smoking. However, new evidence suggests that they may have a detrimental effect on the nervous system and ultimately adverse neurological manifestations. Seizures have been reported among both new and experienced e-cigarette users. In several cases, the seizure presented immediately after its use, while others reported continuous use for weeks before seizures occurred. This review presents a deeper insight into the clinical management, implications, and public health considerations of seizure susceptibility in e-cigarette users. Using recent case reports, epidemiological studies, and experimental research, we highlight the role of likely etiological mechanisms such as how nicotine's convulsive effects are linked to α7- nicotinic acetylcholine receptors (nAChRs), the varied clinical presentations, and the potential nicotine toxicity linked to seizures. Furthermore, we discuss the existing debates and controversies, diagnostic directions, and potential role in individual susceptibility to e-cigarette-associated seizures. Importantly, we address how seizures may be accompanied by both physical and psychological sequelae, which may impair the quality of life for individuals presenting for emergency care. We also address the limitations and challenges in the etiology of e-cigarette-associated seizures and the non-criteria for defining seizures caused by e-cigarettes. The review concludes with an insight into public health considerations and policy recommendations by highlighting the importance of mass awareness and clinical considerations that could guide patient management. [ABSTRACT FROM AUTHOR]

Background: Implementation strategies have predominantly been operationalized and studied in clinical settings. Implementation strategies are also needed to improve evidence-based intervention (EBI) integration in community settings, but there is a lack of systematic characterization of their use, which limits generalizability of findings. The goals of this study were to determine which implementation strategies are most used to deliver primary prevention EBIs in community settings, develop a compilation and pragmatic strategy selection process with accompanying guidance tools, and understand practitioners' preferences for dissemination. Methods: Purposive and snowball sampling was used to recruit community setting researchers and practitioners delivering primary prevention EBIs (nutrition, physical activity, tobacco prevention) in community settings: education, social services, city planning and transportation, workplaces, recreation/sport, faith-based, and other public health organizations. Semi-structured interviews were conducted using a guide based on the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework. Participants were asked to describe barriers experienced and strategies used to overcome them within each RE-AIM dimension. Practitioners were also asked about preferred dissemination strategies, prompted by Diffusion of Innovations theory concepts of sources (who provides information) and channels (how information is provided). A rapid deductive approach was used to analyze findings with a coding matrix aligned with the interview guide. Results: Researchers (n = 10) and practitioners (n = 8) across all targeted settings and intervention outcomes completed interviews. Interviewees shared unique implementation strategies (N = 40) which were used to overcome barriers related to multiple RE-AIM dimensions, most commonly implementation (n = 29) and adoption (n = 27). Most frequently mentioned implementation strategies were conduct pragmatic evaluation (n = 31), provide training (n = 26), change adaptable program components (n = 26), and leverage funding sources (n = 21). Webinars (n = 6) and listservs/newsletters (n = 5) were the most mentioned dissemination channels; national public health organizations (n = 13) were the most mentioned sources. Conclusions: Results reflect commonly used implementation strategies in community settings (e.g., training, technical assistance) and add novel strategies not reflected in current taxonomies. Dissemination preferences suggest the need to involve broad-reaching public health organizations. The resultant compilation (Implementation Strategies Applied in Communities) and strategy selection process provide resources to assist researchers and practitioners in applying strategies and improving EBI delivery in community settings. [ABSTRACT FROM AUTHOR]

Purpose: This study analyzed the prevalence of metabolic syndrome and influencing factors among adult workers aged 19 to 64. Methods: Data from the ninth Korea National Health and Nutrition Examination Survey conducted in 2022 were utilized. The sample comprised 685 individuals who had measurements of fasting glucose, triglycerides, high-density lipoprotein cholesterol, blood pressure, and waist circumference, which are necessary to diagnose metabolic syndrome. Data analysis was performed using SPSS 26.0, and complex sample logistic regression was conducted to identify factors influencing metabolic syndrome. Results: Among the participants, 34.3% were diagnosed with metabolic syndrome. Significant differences were observed in sex, age, region, marital status, regular worker, and physical activity between participants with and without metabolic syndrome (p < .05). Factors influencing the prevalence of metabolic syndrome included sex, age (with the 19~29 age group showing a significantly lower risk), physical activity, smoking, and perceived stress levels (p < .05). Conclusion: To prevent metabolic syndrome in adult workers, it is essential to promote physical activity, discourage smoking, and encourage effective stress management. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The Turkish Global Youth Tobacco Survey (GYTS) 2017 revealed that 17.9% of students aged 13-15 used tobacco products and 7.7% smoked cigarettes. Given the high prevalence of smoking, it is important to evaluate the factors associated with quit attempts among adolescents. This study aimed to identify the factors associated with Turkish adolescents' attempts to quit smoking using Structural Equation Model (SEM) analyses. MATERIAL AND METHODS: This study utilized the data from GYTS 2017, which is a cross-sectional, nationally representative, schoolbased study carried out below 18-year-olds. The study population (n = 18 985) consisted of students who had smoked cigarettes within the past year. After excluding inconsistent responses, 9735 students remained for the analysis. The outcome was an attempt to quit smoking within the past year. Structural Equation Model (SEM) was used for data analysis. The model had good fit (CFI = 0.917, TLI = 0.900, RMSEA = 0.032). RESULTS: Of the 9735 students, 66.4% were male. In the past 12 months, 56.3% (95%CI: 55.3%-57.3%) of smokers attempted to quit. Exposure to anti-tobacco policies (β = 0.114. P < .001) had positive direct effects, whereas sociodemographic factors (β = -0.086. P < .001), nicotine dependency (β = -0.037. P = .008) and exposure to second-hand smoke (β = -0.051. P < .001) had negative direct effects on quit attempts. CONCLUSION: More than half of the smokers attempted to quit, and nicotine dependence predicted quit attempts. Exposure to secondhand smoke decreased cessation attempts. Anti-tobacco policies such as sale restrictions and warnings of the dangers of tobacco products should be given high priority and enforced fully since they are the strongest predictors of quit attempts. [ABSTRACT FROM AUTHOR]

Tobacco pictorial warnings could employ a variety of emotional appeals to enhance effectiveness; however, little research exists to guide the selection of discrete emotional appeals. Further, it remains unclear how contextual pro-smoking norms might influence the persuasive impacts of discrete emotional appeals within pictorial warnings, especially in China, where the overall smoking rate and social acceptance remain high. To fill these gaps, this study leveraged the largest set of pictorial warnings (K = 510) tested to date. Using a randomized large-K multiple-message design, we evaluated the impacts of disgust, fear, self-anger, contempt, shame, and hope appeals among Chinese adult male smokers (N = 2,306) on perceived message effectiveness (PME). Results showed that fear, self-anger, shame, and hope appeals significantly increased PME, while disgust and contempt appeals appeared less effective. Importantly, the PME of nearly all emotional appeals – except hope appeals – was weakened for Chinese adult male smokers with higher pro-smoking normative perceptions, highlighting the importance of considering local contextual influences when implementing pictorial warnings. [ABSTRACT FROM AUTHOR]

Background: Episodic future thinking (EFT), which refers to people simulating possible future life events, has been suggested as a promising intervention for substance use disorders. Objectives: To examine the effect of gain-oriented and loss-oriented EFT on smoking cessation and its underlying mechanisms. Results: Two online experiments were conducted (Total N = 362). The results suggested that engaging in EFT led to increased short-term quitting behavior among smokers by bolstering their intentions to quit smoking (indirect effect = 0.10, bootstrap = 5000, bias-corrected 95% CI [0.0008, 0.2353]). Furthermore, the influence of EFT on quitting intention was mediated by anticipated regret (indirect effect = 0.37, bootstrap = 5000, bias-corrected 95% CI [0.2062, 0.5321]). There were no significant differences observed between the effects of gain-oriented and loss-oriented EFT on quitting intention (F = 0.28, p =.60). Importance: Our findings contribute to a growing body of literature on the adaptive functioning of EFT and lend support to the regret regulation theory. Health practitioners may consider integrating EFT into clinical interventions to help smokers quit smoking. [ABSTRACT FROM AUTHOR]

Purpose: This paper describes the planning and implementation program of Remaja Berdaya Sehat Tanpa Rokok (JayaStar) or Empower Youth Healthy without Smoking (EYHWS). This is a pilot tobacco control program for smoking behavior with a community-based participatory research (CBPR) approach in a rural area of Indonesia. Design/methodology/approach: This research used the participatory rural appraisal (PRA) method. The paper would describe three stages of the JayaStar program that started from diagnosis, planning action and taking action. Participants in this research were all youths aged 17–25 years including as many as 33 people. The key informants were the village head, the hamlet head, the hamlet head's wife, the youth leader, health promotion officers at the Pleret Health Center and the Health Promotion Section of the Bantul Health Office. Findings: The determinants of the youth empowerment process are divided into (1) predisposing factors, (2) group structure and (3) group climate. It has an important role in the success of the youth empowerment process in smoking behavior control. The implementation of the JayaStar program consisted of (1) outbound, and training with the theme of increasing self-potential; (2) training on the impact of cigarettes/vapors on the health of youths; (3) discussion and practice of making health campaign videos; (4) parenting program with the theme of the important role of parents in creating a healthy and superior young generation; (5) declaration and inauguration of JayaStar volunteers. Originality/value: This research is an example of a successful community-based youth project that resulted in a demonstrable positive outcome. It demonstrates the importance of good relations between stakeholders. The JayaStar movement could be a potential model for youth empowerment projects to control smoking behavior among future generations in Indonesia. [ABSTRACT FROM AUTHOR]

Background: India bears the highest global burden of oral cancer, despite having an operational tobacco cessation framework. Occupational groups like solid waste management personnel face significant health challenges due to prevalent tobacco use, leading to oral potentially malignant lesions and oral cancer. Enhanced tobacco control strategies are essential for these groups. Methods: A pre-post interventional, community-based study enrolled 1200 municipal workers in Varanasi, India, from July 2022 to August 2023. 858 tobacco users underwent screening and were randomly assigned to one of three interventions: Very Brief Advice, Individual Behavioral Counseling, or Group Behavioral Therapy. Follow-up was conducted one year after the baseline interventions Effectiveness was measured by nicotine dependence reduction using the Fagerstrom Test for Nicotine Dependence (FTND) scores and cessation rates defined as at least 6-month abstinence. Appropriate statistical tests assessed the burden of tobacco use, oral potentially malignant lesions, and pre-post differences in FTND scores within and between groups. A p-value of < 0.05 was considered statistically significant. Results: Municipal workers exhibited a high prevalence (71.5%) of smokeless tobacco (SLT) use. One-third (32.9%) of the participants screened positive for oral potentially malignant lesions and oral cancer. Leukoplakia was the most common lesion. Screened positivity correlated with significant nicotine dependence. Among 494 follow-up participants, 47.1% reported a significant reduction in nicotine dependence across all intervention groups. Quade's ANCOVA indicated significant differences in post-test FTND scores, with individual behavioral counselling showing the greatest reduction. However, no cessation was achieved in any group despite the significant decline in dependence. Conclusion: Solid waste management personnel in Varanasi show heightened SLT use and associated oral potentially malignant lesions. The persistent tobacco use in these high-risk occupational populations undermines government tobacco control efforts and highlights the need for robust policy and implementation strategies. The study demonstrated a significant reduction in nicotine dependence following interventions, though tobacco cessation was not achieved. More frequent interventions and addressing quitting barriers—such as cultural norms, lack of awareness, easy accessibility, and adverse working conditions—are crucial. Developing a tailored workplace model to tackle tobacco use in occupational settings may facilitate cessation. Clinical trial registration number: Trial registration Clinical Trials Registry India CTRI/2020/07/026479. Date of registration 10/07/2020. [ABSTRACT FROM AUTHOR]

Objective: Our study aims to map the trends in obesity prevalence over the past four years and to describe the health, behavior, and psychological factors of people living with obesity in Saudi. Method: This is a secondary data analysis using the Sharik Health Indicators Surveillance System (SHISS) from 2020 to 2023. The SHISS dataset comprises cross-sectional telephone interviews carried out quarterly across all administrative regions of Saudi Arabia. Recruitment of participants was restricted to Saudi resident adults only. Results: The study analyzed data from 92,137 participants, with a balanced region and gender distribution. The average age of participants was 36.83 ± 13.68 years. The prevalence of obesity showed minor fluctuations over four years, with the highest at 22.2% in 2020 and lowest at 21.4% in 2023. This study showed that a slight decline in daily smoking rates was observed from 2020 to 2023 across all categories. Participants living with obesity reported a higher consumption of fruits and vegetables compared to their not with obesity counterparts. In addition, participants living with obesity engaged less frequently in physical activities compared to those without obesity. Moreover, people living with obesity have higher incidence rates of depression and anxiety, as well as various of chronic diseases. Conclusions: This study highlights the complex factors affecting obesity prevalence in Saudi Arabia. Despite progress, ongoing health promotion and disease prevention are crucial to address the persistent challenges driven by behavioral and socio-economic factors. Continued surveillance and longitudinal studies are essential to track trends in obesity, smoking, and physical activity, ensuring that health initiatives align with population needs. [ABSTRACT FROM AUTHOR]

Background: Homeless-experienced adults smoke at rates 5 times that of the general adult population, and often have limited access to cessation treatments while homeless. Permanent Supportive Housing (PSH) can be a catalyst for cessation treatment utilization, yet little is known about use of these treatments following PSH entry, or how to tailor and implement cessation care that meets homeless-experienced adults' vulnerabilities. Methods: Using Department of Veterans Affairs (VA) administrative data, we assessed smoking status (ie, current, former, non/never) among a cohort of homeless-experienced Veterans (HEVs) housed in Los Angeles-based PSH. We compared cessation treatment use rates (ie, nicotine replacement therapies, cessation medications, psychosocial counseling) pre- and post-housing using Chi-square tests. Predisposing (ie, demographics), enabling (eg, primary care, benefits), and need characteristics (ie, health, mental health, substance use diagnoses) were examined as correlates of cessation treatment utilization pre- and post-housing in univariable and multivariable logistic regression models. Results: Across HEVs (N = 2933), 48.6% were identified as currently-smoking, 17.7% as formerly-smoking, and 14.0% as non/never smoking. Among currently- and formerly-smoking HEVs (n = 1944), rates of cessation treatment use post-housing were significantly lower, compared to pre-housing, across all treatment types. Health, mental health, and substance use was more prevalent among currently- and formerly-smoking HEVs compared to non/never-smoking HEVs, and most diagnoses were positively associated with utilization univariably. However, in multivariable models, cessation clinic referrals and primary care engagement were the only significant (P <.001) predictors of pre-housing and post-housing cessation treatment utilization. Conclusion: Among HEVs, we found high smoking rates and low cessation treatment utilization pre- and post-PSH entry. Efforts to educate providers about this population's desire to quit smoking, support primary care engagement, and increase cessation clinic referrals may bolster their utilization. For homeless-experienced adults, optimizing cessation treatment accessibility by embedding cessation services within PSH and homeless service settings may reduce utilization impediments. [ABSTRACT FROM AUTHOR]

Introduction: Unassisted smoking cessation (USC) is a method of quitting smoking driven by self-determination without the support of professional cessation assistance. This approach may contribute to a potential decrease in overall smoking prevalence within a population. However, the factors potentially influencing smokers' choice of USC and their success remain unclear. This study examined the associations between mental stress and USC choice and success. Methods: Between June and September 2016, a cross-sectional multistage sampling design was used to interview subjects from six selected cities in China. A standardized questionnaire was used to obtain information on sociodemographic characteristics, USC choice, and success. Mental stress was measured by the Chinese version of the Perceived Stress Scale (CPSS). Multivariate logistic regression models were used to examine the association between mental stress, USC choice, and success, with adjustments for relevant covariates. Results: Among 1647 smokers who had attempted or had quit, 91.6% (95% CI: 90.9–97.5) reported that they had done so without assistance, and 42.1% (95% CI: 32.4–61.3) of them achieved abstinence. While mental stress was not significantly associated with USC success (χ2=2.02, p=0.1547), smokers experiencing high levels of mental stress were 0.34 times less likely (95% CI: 0.23–0.50) to attempt USC compared to those with low levels of mental stress. Moreover, a significant negative linear association was observed between varying levels of mental stress and the prevalence of USC use (R2=0.910, p<0.001). Conclusions: The study findings should help to understand USC and its role in reducing smoking prevalence in the Chinese population. These findings can inform future tobacco control programs and policies in China. Government and social agencies should prioritize understanding smokers' preferences for USC and providing USC services to promote success within the population. [ABSTRACT FROM AUTHOR]

Cigarette smoking is associated with adverse physical and mental health among Latinx adults in the United States. The present investigation sought to explore the main and interactive effects of anxiety symptoms and anxiety sensitivity in relation to cigarette dependence, perceived barriers for smoking cessation, and severity of problems experienced when quitting among adult Latinx smokers. Participants included 338 Latinx adult daily cigarette smokers (Mage = 35.53 years; SD = 8.65; age range 18–61; 37.3% female). Results indicated that anxiety symptoms were associated with greater cigarette dependence, severity of problems when quitting, and perceived barriers for smoking cessation (effect size range: 2%−3% of variance), whereas anxiety sensitivity was related to severity of problems when quitting and perceived barriers for smoking cessation (effect size range: 2%−3% of variance). There was also a statistically significant interaction between anxiety sensitivity and anxiety symptoms for cigarette dependence; anxiety was related to cigarette dependence for Latinx smokers with higher levels of anxiety sensitivity, but not for those with lower levels of anxiety sensitivity. Overall, the present findings indicate that anxiety symptoms and anxiety sensitivity are relevant factors for better understanding cigarette dependence, problems experienced when trying to quit, and perceptions of barriers to quitting among adult Latinx smokers. [ABSTRACT FROM AUTHOR]

Although the use of tobacco in the state of Punjab is below the national statistics of India, according to Global Adult Tobacco Survey (GATS) 2016 Report, its consumption has increased. Also, what sets it apart from rest of the nation is the cultural as well as the religious taboo associated with tobacco use. The case of Punjab is also peculiar because of the socio demographic profile of the region which has changed since Green Revolution. Having said that, use of tobacco is a social phenomenon and it becomes important to place tobacco use in a social and cultural context. The aim of the study is to explore the socio -cultural determinants of tobacco use within local and migrant groups in a district of Punjab. The tobacco users in the district were divided into groups of local and migrant labourers and focus group discussion was carried out with them. There were various social correlates of tobacco use in the district which saw variations within and across these groups. The socio demographic factors of age, gender, religion and place of residence were related to the use of tobacco and presented similarities and variations across the groups. The study concluded that tobacco prevention and control policies should include cultural interventions to change current traditional practices and social determinants which influence the use of tobacco. [ABSTRACT FROM AUTHOR]

Causal inference represents a rapidly expanding interdisciplinary subfield that involves various assumptions, study designs, and estimation strategies, allowing researchers to establish causal relationships from both clinical trials and observational data. In tobacco research, numerous studies address causal questions, including the contentious issue of whether vaping in nonsmoking youth leads to smoking initiation, known as the "gateway effect." Determining the effectiveness and safety of many health interventions will continue to rely on observational [mainly longitudinal] data because randomized trials are not always feasible, ethical, or timely. Therefore, review articles that are synthesizing evidence on the gateway effects of electronic nicotine delivery systems [ENDS] on subsequent cigarette smoking must also consider observational studies as first-rate evidence that can help bring together the polarized tobacco research community and help better understand the "gateway effect." In addition, this will help ongoing efforts to rigorously prevent ENDS use by youth while expanding the cessation potential of ENDS among adult established smokers who are unwilling to quit otherwise. In this commentary, we discuss causal inference tobacco research as one of the public health challenges and provide some recommendations/implications. [ABSTRACT FROM AUTHOR]

Introduction: Smoking is more common among people with mental disorders and is associated with adverse effects. Some compounds, including nicotine and cytisine, have been used in many individuals to increase success in smoking cessation. In this study, the effect of cytisine on the smoking status of patients hospitalized in the psychiatry department was investigated. Method: Forty-seven patients, hospitalized in the psychiatry ward, motivated to quit smoking, participated in this open-label randomized trial. Thirty patients used nicotine gums 2 mg (Nicolife®) for eight weeks, and the remaining took cytisine pills (Tabex®) according to the manufacturer's instructions for 25 days. All patients were followed up for six months. The primary outcome was smoking cessation, measured by the mood and physical symptoms scale (MPSS), the AUDIT alcohol consumption questions (AUDIT-C), confirmatory factor analyses, and reliability of the modified cigarette evaluation questionnaire at the end of the 1st week and at 1st, 2nd and 6th months after quit day. Findings: Only two out of 30 patients (6.66%) in the group taking Nicotine Replacement Therapy (NRT) could quit smoking entirely (no cigarettes after six months). In contrast, three out of 17 patients (17.64%) managed to do so in the cytisine group. The number of cigarettes smoked by the patients in both groups decreased, but the reduction was significant in the cytisine group. Conclusion: Cytisine is an effective and suitable agent for smoking cessation in patients with psychological problems, with fewer adverse effects and more success rate compared to NRT. [ABSTRACT FROM AUTHOR]

The effectiveness of mutual help groups (MHGs) in promoting addiction recovery has been widely acknowledged. However, the psychological mechanisms underlying the impact of MHGs remain somewhat uncertain. Drawing on a social identity perspective, this study investigated a sequential mediation model in which social support is posited as a driving factor that enhances abstinence maintenance through group identification, recovery identity, and self‐efficacy. A sample of 820 smokers, participating in a 6‐month collective smoking cessation programme which included access to an online help group, completed measures of social support, group identification, smoker/ex‐smoker identity, and self‐efficacy at the programme's outset. Smoking abstinence was assessed 6 and 9 months later. The findings supported the proposed model, indicating that social support was positively associated with MHG identification, which, in turn, was related to a stronger recovery identity. Subsequently, recovery identity was associated with increased self‐efficacy, and indirectly, with smoking abstinence at both measurement times. Additional analyses testing alternative mediation models further supported the validity of the proposed model. These findings suggest that social identity factors play significant roles in accounting for the effectiveness of MHGs for addiction recovery. [ABSTRACT FROM AUTHOR]

Background: Adolescent smoking is associated with significant health and social risks. Previous research has demonstrated the effectiveness of interventions based on behavior change theories in preventing adolescent smoking uptake. However, evidence from the theory-based perspective of evaluation is limited, especially for how such complex interventions work, and how they work when implemented in different contextual settings. Method: A comparative qualitative analysis was conducted to explore various influences on behavior change among participants taking part in two smoking prevention interventions in Northern Ireland and Bogotá. Twenty-seven focus groups were conducted in 12 schools (6 in Northern Ireland and 6 in Bogota, n = 195 pupils participated; aged 11–15 years). The Theoretical Domains Framework guided a content analysis of the data. Results: We found similarities across settings in terms of knowledge, skills, and beliefs related to smoking or vaping behavior change, as well as differences in contextual resources and social influence. Different environmental resources included availability to purchase tobacco products in the neighborhoods and previous information about tobacco risk. Participants in both interventions perceived behavioral change outcomes related to personal skills and intention to not smoke or vape. Conclusion: These findings have highlighted how both individual factors and contextual resources influence behavior change for smoking prevention in practice. Local contextual factors and social influences affecting pupils should be taken into account in the implementation and evaluation of health behavior change interventions. In particular, this study supports using social and contextual influence strategies in interventions to reduce the onset of adolescent smoking and vaping. [ABSTRACT FROM AUTHOR]

Background and Aims: Cytisine (also known as cytisinicline) is a low‐cost partial agonist of nicotinic acetylcholine receptors used to assist tobacco cessation. We aimed to review the effectiveness of cytisine for tobacco cessation and the effects of dose and co‐use of behavioural or other pharmacological interventions on cessation outcomes. Methods: We searched seven databases, Google Scholar, and reference lists of included publications for randomised controlled trials investigating use of cytisine as a tobacco cessation aid. Studies were eligible if participants were ≥15 years old and used tobacco upon study enrolment. We conducted four random effects meta‐analyses and sensitivity analyses with fixed effects models. We used the Cochrane risk‐of‐bias tool for randomised trials version 2 to assess risk of bias in included studies, with adjustments recommended by the Cochrane Tobacco Addiction Group. Results: Participants using cytisine were significantly more likely to quit tobacco than participants who received placebo/no intervention/usual care (risk ratio [RR] = 2.65, 95% confidence interval [CI] = 1.50–4.67, 6 trials, 5194 participants) or nicotine replacement therapy (RR = 1.36, 95% CI = 1.06–1.73, p = 0.0152, 2 trials, 1511 participants). The difference in cessation rates among participants receiving cytisine versus varenicline was not statistically significant (RR = 0.96, 95% CI 0.63–1.45, P = 0.8464, 3 trials, 2508 participants). Two trials examined longer versus shorter treatment duration, finding higher abstinence rates with longer treatment (RR = 1.29, 95% CI = 1.02–1.63, 2 trials, 1009 participants). The differences in the number of adverse events reported by participants who received cytisine versus placebo (RR = 1.19, 95% CI = 0.99–1.41, P = 0.0624; 6 trials; 4578 participants) or cytisine versus varenicline (RR = 1.37, 95% CI = 0.57–3.33, P = 0.4835; 2 trials; 1345 participants) were not statistically significant. Most adverse events were mild (e.g. abnormal dreams, nausea, headaches). Conclusions: Cytisine is an effective aid for tobacco cessation and appears to be more effective for tobacco cessation than placebo, no intervention, usual care and nicotine replacement therapy. [ABSTRACT FROM AUTHOR]

Background: Australia introduced a prescription only policy for e‐cigarettes in 2011 to prevent uptake among youth while allowing smokers to access e‐cigarettes for cessation. This is one of the restrictive forms of regulation for e‐cigarettes recommended by the World Health Organisation. Aims: To assess whether the policy has prevented e‐cigarette youth uptake and facilitated smokers' access to e‐cigarettes for cessation; and to examine a proposed toughening of the policy. Methods: An analysis of survey and administrative data on e‐cigarette use and smoking and a critical analysis of the contents of submissions to parliamentary inquiries into the policy. Results: E‐cigarette use among youth and young adults has increased steeply since 2016 but very few of these products have been obtained through the prescription system, because medical authorities discourage their use. A policy change in 2021 to increase the prescription of e‐cigarettes has not reduced e‐cigarette use among youth and only marginally increased rates of prescribing. Australian policy makers have nonetheless tightened the prescription system by banning any use of e‐cigarettes unless prescribed by a doctor and dispensed by a pharmacist. Implications: Australia's tightened prescription policy for e‐cigarettes may reduce adolescent vaping but at the risk of reducing smokers' access to e‐cigarettes and increasing the size of the illicit market for combustible cigarettes and e‐cigarettes. A more effective policy would allow vapes to be sold as consumer products by licensed tobacconists under regulations that require prior product approval, plain packaging, bans on their promotion and enforced age restrictions on purchases. [ABSTRACT FROM AUTHOR]

Background: Vaping is popular among adolescents and emerging adults; however, little is known about regular vaping patterns in older adolescents and emerging adults. Objective: The current study explored whether gender and age are associated with nicotine-based vaping frequency to ascertain ascertaining which subgroups of youth are most at-risk for frequent use. Methods: In a cross-sectional survey, participants using nicotine-based vaping devices (N=535, age range 16-24) reported frequency measured as vaping days in a week, number of episodes during which participants vaped, and puff numbers for each episode. A two-way multivariate analysis of variance was used to test the effects and interactions of gender and age groups on the three frequency outcomes. Results: Emerging adults and males vaped more frequently than their older adolescent and female counterparts, respectively. Specifically, emerging adults vaped more days per week in comparison to older adolescents, whereas males vaped more days per week and had more vaping episodes per day relative to females. Further, emerging adult males had more vaping episodes in comparison to other subgroups, and adolescent females as well as emerging adult males took more puffs per episode in comparison to emerging adult females. Conclusion: Vaping differences among subgroups suggests the need for policies to reduce regular nicotine vaping targeted toward specific gender and age groups. [ABSTRACT FROM AUTHOR]

Objective: The current study examined group differences in college students' views on e-cigarettes in terms of safety, popularity, health risks, social acceptability, efficacy as a cessation aid, and promoting combustible cigarette use. Participants: 337 undergraduates (Mage = 20.84, SD = 3.79; 72.1% female; 68.5% White) divided into three groups: Never Users (n = 178), Ever Users (n = 108), and Current Users (n = 51). Methods: Participants completed questionnaires for course credit. Results: Compared to Ever and Never Users, Current Users believed e-cigarettes were safer, healthier, a useful tool to quit smoking, did not lead to combustible cigarette smoking, and that nicotine was less dangerous. Current Users also were less likely to endorse boosting social image as a motive for use. Conclusions: Public health campaigns could benefit from targeting current users' positive beliefs about e-cigarettes to reduce the prevalence of e-cigarette use among college students. [ABSTRACT FROM AUTHOR]

Objective: To develop an instrument to examine tobacco-free campus policy components. Participants: Missouri two- and four-year, specialized/technical, and religious colleges and universities (N = 76). Methods: The instrument was informed via literature review and expert interviews. Coder agreement was strong (κ =.80). Qualitative policy language examples were identified. Results: Model policy components including consideration for population, prohibited products, location restrictions, enforcement, consequences, promotions, communications, cessation, designated smoking areas and exemptions; comprehensive policies included all populations, for all tobacco products, and at all locations on the campus. Nineteen campuses had comprehensive tobacco-free policies, five had comprehensive smoke-free policies (cigarettes and e-cigarettes), and no policy included all model components. Fifty-two were non-comprehensive. Conclusions: This instrument can allow campuses to identify components for comprehensive and model tobacco-free campus policies and assist officials in improving policy language. Future research can use this instrument to examine the effectiveness of components and their impact on tobacco use outcomes. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Describe the participatory research procedures of developing Kick Vaping, a vaping cessation text messaging intervention for Latino young adults, available in English and Spanish. Methods: Using community-based recruitment strategies, we convened a Community Advisory Board (CAB) of eight Latino young adults (ages 18–25) with different vaping experiences (never users, ex-users, and current users of e-cigarettes). Members held a series of working meetings to adapt Decídetexto, a smoking cessation text messaging intervention, for vaping cessation. Members provided iterative feedback on the text messages until reaching a consensus on content. Messages were translated from English to Spanish following a committee approach. Readability assessments were used to evaluate the legibility of the text messages Results: At baseline, members' mean age was 22.6 years old (SD 3.1), 75% were female, and 50% used both English and Spanish equally. Three members (37.5%) were ex-users and one member (12.5%) was a current user of e-cigarettes. 18 meetings provided sufficient opportunities for iterative feedback on the text messages for developing the intervention. The Kick Vaping intervention consists of 208 text messages. Readability scores of the text messages in English were equivalent to fourth and fifth grade, and in Spanish were equivalent to easy and somewhat easy. Conclusion: It is feasible and practical to build participatory research among Latino young adults focused on vaping cessation. Members of the CAB added innovation and creativity to the development of the vaping cessation text messaging intervention. Future research is needed to evaluate the impact of the intervention on vaping cessation. [ABSTRACT FROM AUTHOR]

Exposure to secondhand tobacco smoke (SHS) is a global health threat that causes diseases and kills more than 1.2 million people each year, including 65000 children1-4. The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) urges countries to establish comprehensive smoke-free environments5. Although European Union (EU) member states have implemented smoke-free laws, challenges persist with designated smoking rooms (e.g. in hospital venues and in airports) and neglect of emerging products, such as electronic cigarettes (e-cigarette) and heated tobacco products (HTP)6,7. This editorial provides concise recommendations on smoke- and aerosol-free environments (SAFE) in the EU, focusing on evidence-based strategies for SAFE. Promoting the expansion of SAFE throughout EU countries was a key objective of the JATC-2, a project co-funded by the European Commission. To address this objective, WP8 focused on the current framework and potential expansion of SAFE in Europe. As part of this effort, a consultation was conducted in 2022, engaging 110 experts from 27 EU member states, along with Norway, Serbia, and the United Kingdom. The sources to identify experts were the JATC-2 contact list of all authorities and stakeholders working with tobacco regulation (policymakers and regulators, researchers and tobacco inspectors) for countries of the EU; the Catalan Institute of Oncology/WHO Collaborating Center for Tobacco Control list of contacts, including speakers and attendees to five editions of ICO-WHO Symposia on tobacco control; and lists of contacts from Smoke-Free Partnership and the European Network for Smoking and Tobacco Prevention. The responses from these experts provided valuable information on the barriers, opportunities, and best practices associated with SAFE policies across different countries. This collective knowledge, combined with findings from a systematic literature review (covering articles published between January 2010 and August 2022) and dedicated discussions (including a symposium satellite of the 9th European Conference on Tobacco or Health), forms the basis for recommendations on effective strategies and interventions to safeguard individuals from SHS and secondhand aerosol (SHA). The expert consultations are summarized in the following recommendations. [ABSTRACT FROM AUTHOR]

This paper investigates the effects of cigarette tax changes at different ages on long-term smoking behaviors. Using survey data on six decades of birth cohorts and a generalized difference-in-differences study design, I show that an increase in the cigarette tax at any age diminishes the long-term probabilities of smoking initiation and participation and reduces smoking intensity among people who currently smoke. These findings suggest that cigarette taxes prevent adults from beginning to smoke and cause people who smoke to promptly smoke less and quit over time. My estimates suggest that an average state tax hike applied to the national population would have caused over 400,000 people to quit smoking and prevented 4,000 deaths from smoking-related causes. [ABSTRACT FROM AUTHOR]

Previous literature suggested that promoting childhood health could have intergenerational benefits. While several studies have pointed to the life-cycle benefits of mass vaccinations and disease elimination, fewer studies have explored their long-run intergenerational aspects. This paper joins the ongoing literature by exploring the intergenerational health benefits of mothers' childhood exposure to the measles vaccination for their infants' birth outcomes. Our identification strategy takes advantage of cross-cohort exposure to the introduction of the measles vaccine in 1963 and cross-state variations in pre-vaccine measles rates. Using the universe of birth records in the US over the years 1970–2004, we show that mothers who were exposed to the measles vaccine reveal improved birth outcomes. For mothers in states with an average pre-vaccine measles rate, full exposure to the vaccine during childhood is associated with roughly 5.4 and 5.7 percent reduction in the incidence of low-birth-weight and preterm-birth newborns. A series of event study analyses suggest that these findings are not driven by preexisting trends in outcomes. Further analyses suggest that improvements in educational outcomes, increases in prenatal care utilization, reductions in smoking, and increases in several measures of socioeconomic status are potential mechanisms. [ABSTRACT FROM AUTHOR]

Copyright of ESTUDAM Public Health Journal is the property of ESTUDAM Public Health Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The prevalence of prenatal tobacco exposure remains high in many countries, particularly in southern Europe. The aims of this study were to estimate the prevalence of smoking among pregnant women in a southern Spanish city (Seville) and to identify the associated sociodemographic and obstetric characteristics. In a descriptive, cross-sectional study, a random sample of pregnant women who were scheduled to undergo a morphology scan at their public referral hospital in their 20th week of gestation were interviewed in person. At the start of pregnancy, 38.2% of the pregnant women were smokers. In the twentieth week, 19.1% continued to smoke, and the same percentage had quit. The prevalence of smoking in pregnant women was higher among those with a low level of education (60% among pregnant women with no studies and 30.4% in those with primary education) and among those who had had abortions (38.5%). Pregnant smokers with obesity were the least likely to have given up smoking during pregnancy. Women with a lower educational level should be a prime target for cross-sectoral interventions aimed at preventing prenatal tobacco exposure. Implementation of support measures for providing effective clinical advice in preconception and prenatal care regarding healthy lifestyles is particularly needed. [ABSTRACT FROM AUTHOR]

Background: Smoking during pregnancy has many adverse effects for infant and mother. Despite this, many pregnant women continue smoking. Primary care is a suitable area to provide smoking cessation interventions. Aim: To investigate available literature regarding effectiveness of smoking cessation interventions for pregnant women in primary care, the factors contributing to this effectiveness, and to provide suggestions for future research. Design & setting: Systematic scoping literature review. Method: The methodology followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Five electronic databases were searched. Inclusion criteria included original research studies and studies published in English. Data were extracted using a modified Joanna Briggs Institute (JBI) data-charting tool. Results: The initial search yielded 878 articles. Following article screening, 12 studies were included. Five studies found a statistically significant increase in smoking cessation rates or reduction in tobacco consumed in the intervention group. The remaining studies showed no significant difference between the groups. However, 10 studies showed the control group received usual antenatal care involving smoking cessation promotion. An increase in smoking cessation rates was seen in intervention and control groups, demonstrating the effectiveness of these interventions. Interventions included education, counselling, self-help, and financial incentives. They were delivered by GPs, midwives, counsellors, and pregnancy advisers. Conclusion: Primary care is suitable to offer smoking cessation interventions to pregnant women, as it is often the first point of care and more easily accessible than secondary care. Future research is needed to determine the most effective types of interventions. [ABSTRACT FROM AUTHOR]