Suchergebnisse

Purpose: The study objective was to describe and compare changes in newly funded National Institutes of Health (NIH) tobacco-related awards between fiscal year (FY) 2006 and FY2016. Design: Secondary analysis of NIH data. Setting: National Institutes of Health Research Portfolio Online Reporting Tool database was used. Subjects: National Institutes of Health tobacco-related awards newly funded during FY2006 and FY2016. Measures: Search terms included tobacco, smoking, nicotine, secondhand smoke, and e-cigarettes. Grants and funding amounts were retrieved. Analysis: We calculated frequency distributions to determine the number and percentage of total NIH grants funded overall and by specific institute, and inflation-adjusted total and median funding amounts. We computed percentage differences in number of new grants, funding amounts, and percentage of funding allocated overall, and by institute. Results: There was a 187% increase in the percentage of total NIH funding allocated to new tobacco-related awards from 0.09% in FY2006 to 0.25% in FY2016. Total number of awards increased by 67% in FY2016 (n = 144; $56 015 931) compared to FY2006 (n = 86; $22 076 987), and there was a 154% increase in inflation-adjusted total funding for tobacco control. The top funding institutes were National Institute on Drug Abuse and National Cancer Institute; National Institute on Alcohol Abuse and Alcoholism was third in FY2006; and National, Heart, Lung and Blood Institute in FY2016. Research grants were the most frequently funded. Smoking cessation was a common topic area and increased by 64%. Conclusion: NIH funding is critical for advancing the science of nicotine and tobacco research.

Purpose: To investigate how mode of entry into a quitline influences program utilization and quit outcomes among clients seeking cessation services. Design: This is a retrospective analysis of clients receiving quitline services from January 2011 to June 2016. Setting: The study was conducted at the Arizona Smokers' Helpline. Participants: Enrolled clients completed a 7-month follow-up (N = 18 650). Measures: The independent variable was referral mode of entry (ie, proactive, passive, and self-referral). Outcome variables included tobacco cessation medication use, number of coaching sessions completed, and 30-day tobacco abstinence at 7 months. Analysis: Logistic regression was used to analyze tobacco abstinence after controlling for potential confounders. Results: Compared to self-referred clients, proactively referred clients were least likely (odds ratio [OR]: 0.88; 95% confidence interval [CI]: 0.81-0.97), whereas passively referred clients were most likely (OR: 1.14; 95% CI: 1.00-1.30) to report tobacco abstinence. Proactively referred (OR: 0.79; 95% CI: 0.70-0.88), but not passively referred, clients were 21% less likely to report tobacco cessation medication use than self-referred clients. Conclusion: Proactive referrals are associated with lower utilization of tobacco cessation medication and less successful quit outcomes; however, provider referrals are critical to reaching tobacco users who may have more significant health risks and barriers to quitting. Examining potential barriers among both providers and provider-referred clients is needed to inform improvements in training providers on brief interventions for tobacco cessation.

Purpose: The '5-2-1-0' guidelines recommend that children: eat ≥5 servings of fruits/vegetables ('5'), have ≤2 hours of screen-time ('2'), have ≥1 hour of activity ('1'), and drink 0 sugar-sweetened beverages ('0') daily. The pediatric emergency department (PED) treats children at risk for obesity and tobacco smoke exposure (TSE). We examined body mass index (BMI), overweight, obesity, TSE, and '5-2-1-0' rates in children with TSE in the PED. Design: Cross-sectional study of PED children. Setting: The PED of a children's hospital. Sample: Children with TSE >6 months-5 years old (N = 401). Measures: Sociodemographics, '5-2-1-0' behaviors, BMI, and cotinine-confirmed TSE. Analysis: Associations between '5-2-1-0' and sociodemographics were examined with logistic regression. Results: Mean (SD) age = 2.4 (1.6) years; 53.1% were Black; 65.8% had low-income; and 93.4% had TSE. Of 2-5-year-olds, mean (SD) BMI percentile was 66.2 (30.1), 16.1% were overweight and 20.6% were obese. In total, 10.5% attained '5', 72.6% attained '2', 57.8% of 2-5-year-olds attained '1', and 9.8% attained '0'. Compared to White children, "other" race children were more likely to meet '5' (aOR(95% CI):4.67(1.41, 5.45)); 2-5-years-olds (aOR(95%CI):0.60(0.38, 0.95)) and Black children (aOR(95%CI):0.36(0.21, 0.60)) were at decreased odds to meet '2' compared to younger or White children, respectively. Compared to younger children, 2-5-year-olds were at decreased odds to meet '0' (aOR(95%CI):0.08(0.02, 0.26)). Conclusion: Racially diverse, low-income children with TSE had low '5-2-1-0' attainment. Interventions are needed to improve lifestyle habits in this population.

Purpose: The study purpose was to examine changes in patterns of ever and current dual- and polyproduct use over time and to examine demographic and modifiable risk factors including tobacco smoke exposure (TSE). Design: A secondary analysis of the 2013 to 2015 National Youth Tobacco Survey data. Setting: Nationwide high schools were selected. Subjects: A total of 31 022 high school students. Measures: Ever and current (past 30 days) tobacco/nicotine product use, home tobacco/nicotine product use, TSE and e-cigarette vapor exposure, and demographic characteristics were measured. Analysis: Multivariable logistic regression and multinomial logistic regression models. Results: Of the students, 9.4% were ever dual users and 18.6% were ever poly users. Rates of ever/current use of e-cigarettes and hookah increased from 2013 to 2015 (all Ps < .001). In 2015, participants were 4.8 times (95% confidence interval [CI], 4.5-5.2) and 4.0 times (95% CI, 3.5-4.4) more likely to report ever/current e-cigarette use and 1.61 times (95% CI, 1.5-1.7) and 1.48 times (95% CI, 1.3-1.7) more likely to report ever/current hookah use. Participants reporting TSE were 15.4 times (95% CI, 11.5-21.0) more likely to report current poly use, and those with e-cigarette exposure were 10.4 times (95% CI, 7.8-13.8) more likely to report current poly use. Conclusion: From 2013 to 2015, rates of ever and current use of e-cigarettes and hookah increased. Tobacco smoke and e-cigarette exposure were associated with higher rates of dual and poly use. Prevention efforts targeting these products are needed.