Age at Smoking Initiation and Prevalence of Cigarette Use Among Youths in Sub-Saharan Africa, 2014-2017.
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ABSTRACT:
SUBMITTER: Chido-Amajuoyi OG
PROVIDER: S-EPMC8105748 | biostudies-literature | 2021 May
REPOSITORIES: biostudies-literature
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Age at Smoking Initiation and Prevalence of Cigarette Use Among Youths in Sub-Saharan Africa, 2014-2017.
Chido-Amajuoyi Onyema Greg OG Fueta Patrick P Mantey Dale D
JAMA network open 20210503 5
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Project description:HIV/AIDS is a leading cause of disease burden in sub-Saharan Africa. Existing evidence has demonstrated that there is substantial local variation in the prevalence of HIV; however, subnational variation has not been investigated at a high spatial resolution across the continent. Here we explore within-country variation at a 5 × 5-km resolution in sub-Saharan Africa by estimating the prevalence of HIV among adults (aged 15-49 years) and the corresponding number of people living with HIV from 2000 to 2017. Our analysis reveals substantial within-country variation in the prevalence of HIV throughout sub-Saharan Africa and local differences in both the direction and rate of change in HIV prevalence between 2000 and 2017, highlighting the degree to which important local differences are masked when examining trends at the country level. These fine-scale estimates of HIV prevalence across space and time provide an important tool for precisely targeting the interventions that are necessary to bringing HIV infections under control in sub-Saharan Africa.
| S-EPMC6601349 | biostudies-literature
Project description: Not available
| S-EPMC6440252 | biostudies-literature
Project description:ImportanceCigarettes are still a commonly used tobacco product among youth despite recent declines in cigarette use.ObjectiveThe aim of this study was to prospectively estimate the age of cigarette use initiation among youth (aged 12-17 years) overall, by sex, and by race/ethnicity.Design, setting, and participantsThis cohort study used data from waves 1 through 4 of the nationally representative Population Assessment of Tobacco and Health (PATH) study, conducted from September 12, 2013, to January 3, 2018. Two subpopulations of youth were assessed: (1) those nonsusceptible to cigarette use and (2) never users of cigarettes at their first wave of PATH participation. Weighted interval-censoring survival analyses were used to prospectively estimate the age of initiation of cigarette use outcomes. Weighted interval-censoring Cox proportional hazard models were used to estimate differences in the age of initiation by sex and by race/ethnicity. Statistical analyses were performed from October 7, 2019, to May 1, 2020.ExposuresDifferences in the age of initiation by sex and race/ethnicity.Main outcomes and measuresAge of initiation of susceptibility to cigarette use, ever use, past 30-day use, and fairly regular cigarette use overall, by sex, and by race/ethnicity.ResultsA total of 15 776 youth never users and, among them, 11 022 youth who were nonsusceptible to cigarette use, were included in this study (weighted mean [SE] age, 13.5 [0.01] years; 58.6% [SE, 0.46%] non-Hispanic White; and 51.0% [SE, 0.32%] boys) and 15 776 were never users of cigarettes at their first wave of PATH participation (weighted mean [SE] age, 13.7 [0.01] years; 55.0% [SE, 0.29%] non-Hispanic White; and 51.0% [SE, 0.15%] boys). By age 18 years, among those who were nonsusceptible, 46.2% (95% CI, 44.3%-48.2%) became susceptible to cigarette use. Among never users, 24.4% (95% CI, 22.9%-25.9%) initiated ever cigarette use, 16.4% (95% CI, 15.2%-17.6%) initiated past 30-day cigarette use, and 4.3% (95% CI, 3.9%-4.8%) initiated fairly regular cigarette use. Boys had a higher risk of initiating ever (hazard ratio [HR], 1.21; 95% CI, 1.08-1.36) and past 30-day cigarette use (HR, 1.27; 95% CI, 1.10-1.47) at earlier ages compared with girls. Non-Hispanic White youth had a higher risk of an earlier age of initiation of susceptibility to cigarette use (HR, 0.77; 95% CI, 0.68-0.88), ever use (HR, 0.59; 95% CI, 0.49-0.71), past 30-day use (HR, 0.64; 95% CI, 0.52-0.77), and fairly regular cigarette use (HR, 0.25; 95% CI, 0.14-0.43) compared with non-Hispanic Black youth.Conclusions and relevanceThe results of this cohort study suggest that, despite current interventions and existing laws, a large number of youth initiated cigarette use before the legal age to purchase tobacco products.
| S-EPMC7910812 | biostudies-literature
Project description:AimsTo provide up-to-date estimates of how changes in the prevalence of electronic cigarette (e-cigarette) use in England have been associated with changes in smoking cessation activities and daily cigarette consumption among smokers in England.DesignTime-series analysis of population trends.SettingEngland.ParticipantsParticipants came from the Smoking Toolkit Study, which involves repeated, cross-sectional household surveys of individuals aged 16 years and older in England. Data were aggregated on approximately 1200 past-year smokers each quarter (total n = 50 498) between 2007 and 2017.MeasurementsPrevalence of e-cigarette use in current smokers was used to predict (a) prevalence of quit attempts among last-year smokers, (b) overall quit rates among last-year smokers and (c) mean cigarette consumption per day among current smokers. Prevalence of e-cigarette use during a quit attempt among last-year smokers was used to predict (a) quit success rate among last-year smokers and (b) overall quit rates among last-year smokers.FindingsOverall quit rates increased by 0.054% [95% confidence interval (CI) = 0.032-0.076, P < 0.001] and 0.050% (95% CI = 0.031-0.069, P < 0.001) respectively for every 1% increase in the prevalence of e-cigarette use by smokers and e-cigarette use during a quit attempt. Quit success rates increased by 0.060% (95% CI = 0.043-0.078, P < 0.001) for every 1% increase in the prevalence of e-cigarette use during a quit attempt. No clear evidence was found for an association between e-cigarette use and either prevalence of quit attempt (BAdj = 0.011, 95% CI = -0.046 to 0.069, P = 0.698) or cigarette consumption (BAdj = 0.019, 95% CI = -0.043 to 0.082, P = 0.542).ConclusionChanges in prevalence of e-cigarette use in England have been positively associated with the overall quit rates and quit success rates but not clearly associated with the prevalence of quit attempts and mean cigarette consumption.
| S-EPMC7187187 | biostudies-literature
Project description:BackgroundHuman immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15-59 years across SSA.MethodsWe analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units.ResultsWe found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group.ConclusionsAs the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA.
| S-EPMC9760541 | biostudies-literature
Project description:ImportanceThe use of electronic cigarettes (e-cigarettes) and other noncigarette tobacco products may increase the odds of cigarette initiation, even among low-risk youths.ObjectiveTo evaluate the associations of prior e-cigarette use and other tobacco product use with subsequent cigarette initiation within 2 years of follow-up.Design, setting, and participantsIn this prospective cohort study, data from waves 1 through 3 of the Population Assessment of Tobacco and Health Study (2013-2016) were used to assess youths aged 12 to 15 years who had never used cigarettes, e-cigarettes, or other tobacco products at wave 1. This was a nationally representative study of the US population. Data analysis was conducted in 2018.ExposuresFirst noncigarette tobacco product used (none, e-cigarette, or other tobacco product) between wave 1 and wave 3.Main outcomes and measuresEver cigarette use and current cigarette use at wave 3.ResultsIn the sample (N = 6123), respondents were 49.5% female; 54.1% non-Hispanic, white; and the mean (SD) age was 13.4 (1.2) years. Of these, 8.6% reported e-cigarettes as their first tobacco product, while 5.0% reported using another noncigarette product first; 3.3% reported using cigarettes first. Cigarette use at wave 3 was higher among prior e-cigarette users (20.5%) compared with youths with no prior tobacco use (3.8%). Prior e-cigarette use was associated with more than 4 times the odds of ever cigarette use (odds ratio, 4.09; 95% CI, 2.97-5.63) and nearly 3 times the odds of current cigarette use (odds ratio, 2.75; 95% CI, 1.60-4.73) compared with no prior tobacco use. Prior use of other tobacco products was similarly associated with subsequent ever cigarette use (OR, 3.84; 95% CI, 2.63-5.63) and current cigarette use (OR, 3.43; 95% CI, 1.88-6.26) compared with no prior tobacco use. The association of prior e-cigarette use with cigarette initiation was stronger among low-risk youths (OR, 8.57; 95% CI, 3.87-18.97), a pattern not seen for prior other product use. Over the 2 years between 2013 and 2014 and 2015 and 2016, 21.8% of new cigarette ever use (178 850 youths) and 15.3% of current cigarette use (43 446 youths) among US youths aged 12 to 15 years may be attributable to prior e-cigarette use.Conclusions and relevanceThis study's findings support the notion that e-cigarette use is associated with increased risk for cigarette initiation and use, particularly among low-risk youths. At the population level, the use of e-cigarettes may be a contributor to the initiation of cigarette smoking among youths.
| S-EPMC6484602 | biostudies-literature
Project description:BackgroundLimited studies have assessed the recent proportion and trend in the age of cigarette smoking initiation among adolescent smoking experiencers globally. We aimed to assess the recent global proportion, associated factors and the long-term trend of the initiated age of cigarette smoking among adolescent smoking experiencers.MethodsWe used data from the most recent Global Youth Tobacco Survey on 99,728 adolescent smoking experiencers aged 13-15 years from 144 countries/territories (hereafter "countries") that had conducted at least one survey in 2010-20, to assess the recent proportion of the age of cigarette smoking initiation. Additionally, we used data from 148 countries that had conducted ≥2 surveys between 1999 and 2020, to assess the trend in the average age of cigarette smoking initiation.ResultsAmong 99,728 adolescent smoking experiencers aged 13-15 years, the proportions of initiating cigarette smoking when aged ≤ 9 years, 10-11 years, 12-13 years, and 14-15 years were 22.8% (95%CI 21.3-24.4), 18.8% (17.3-20.2), 36.8% (34.5-39.2), and 21.6% (19.9-23.2), respectively. The average age of cigarette smoking initiation decreased by 0.44 years per 5 calendar-years averagely in 17 (11.5%) of 148 countries, was unchanged in 95 (64.2%) countries, and increased by 0.38 years per 5 calendar-years averagely in 36 (24.3%) countries. Higher income category (reference group: low-income countries; lower-middle-income: OR = 0.44, 95%CI = 0.28-0.70; upper-middle-income: OR = 0.56, 95%CI = 0.38-0.83; high-income: OR = 0.35, 95%CI = 0.22-0.53) and Framework Convention on Tobacco Control ratification (OR = 0.51, 95%CI = 0.42-0.63) were inversely associated with early cigarette smoking initiation.ConclusionsA substantial proportion (~80%) of adolescent smoking experiencers aged 13-15 years initiated cigarette smoking before 13 years, and the average age of cigarette smoking initiation decreased or remained unchanged in nearly three quarters of the countries surveyed. These findings emphasize that national governments around the world need to strengthen intervention strategies and measures aimed at children and adolescents to prevent smoking up-take.
| S-EPMC9742527 | biostudies-literature
Project description:Background and aimsReports of youth e-cigarette use often do not disaggregate by underlying smoking status. This study compared annual 2014-19 youth estimates of past 30-day e-cigarette use prevalence and frequency by smoking status in the United States.DesignNationally representative, cross-sectional, school-based survey [National Youth Tobacco Surveys (NYTS)]. General linear models accounting for complex survey design compared e-cigarette use prevalence by smoking status by year, overall and stratified by frequency, separately for high school (HS) and middle school (MS) students. The 2019 survey was analyzed separately because of its change in survey methodology.SettingMSs and HSs in the United States.ParticipantsA total of 116 704 students from 1268 schools, ages 9-19.MeasurementsStudents self-reported (paper 2014-18, electronic 2019) ever and past 30-day (current) use of e-cigarettes and cigarettes, as well as frequent use (20-30 days of month).FindingsFrom 2014 to 2018, current e-cigarette use prevalence increased among never, current and former smokers in HS, but only among never and current smokers in MS (each P-value < 0.001). E-cigarette use increases for current HS smokers were primarily among frequent e-cigarette users. In 2018, the absolute number of HS frequent users who were never or former smokers (420 000 combined) surpassed current smokers (370 000). In 2019, current e-cigarette use prevalence for never, former and current smokers was 17.5% [95% confidence interval (CI) = 16.0-19.0], 53.6% (95% CI = 45.2-61.9) and 85.8% (95% CI = 81.6-89.9) for HS students, respectively, and 6.8% (95% CI = 5.9-7.7), 40.8% (95% CI = 34.7-47.0) and 78.0% (95% CI = 71.9-84.2) for MS students. That year, the number of HS never (420 000) and former smokers (570 000) using e-cigarettes frequently eclipsed that of current smokers (390 000).ConclusionsE-cigarette use prevalence and frequency among youth vary by smoking status, with highest levels of use among current smokers. However frequent e-cigarette use among never smokers and former smokers has increased.
| S-EPMC8328922 | biostudies-literature
Project description:ImportanceSuccess in reducing the prevalence of adolescent smoking could reflect complete prevention of smoking initiation or a shift in the age of cigarette smoking initiation from adolescence into early adulthood.ObjectiveTo assess trends in early adult (ages 18-23 years) vs adolescent (age <18 years) cigarette smoking initiation and transition to daily cigarette smoking from 2002 to 2018.Design, setting, and participantsAges at initiation of smoking and the transition to daily smoking were ascertained from the National Survey on Drug Use and Health (2002-2018), an annual, population-based, repeated cross-sectional study representative of the US population. This cross-sectional analysis was restricted to young adults who completed the survey at ages 22 to 23 years during survey years 2002 to 2018 to limit potential age-related recall bias. Retrospectively collected age of cigarette smoking initiation was assessed among ever cigarette smokers; age of transition to daily smoking was assessed among ever daily cigarette smokers. Data analysis was performed from June 2019 to July 2020.ExposuresCalendar year of survey (2002 to 2018).Main outcomes and measuresThe main outcomes were population-weighted cigarette smoking prevalence and cigarette smoking initiation and transition to daily smoking in adolescence (age <18 years) vs early adulthood (ages 18-23 years).ResultsAmong 71 756 young adults aged 22 to 23 years (38 226 women [50.5%]), ever cigarette smoking prevalence decreased from a population-weighted estimate of 74.6% (95% CI, 73.1%-75.9%) in 2002 to 51.4% (95% CI, 49.3%-53.5%) in 2018 (P < .001). Daily smoking prevalence rates similarly decreased from 41.1% (95% CI, 39.1%-43.1%) in 2002 to 20.2% (95% CI, 18.6%-21.8%) in 2018 (P < .001). However, among 48 015 ever smokers, the proportion initiating smoking in early adulthood (ages 18-23 years) increased over this time, from 20.6% (95% CI, 18.5%-22.8%) in 2002 to 42.6% (95% CI, 39.6%-45.7%) in 2018 (P < .001). Similarly, among 24 490 daily cigarette smokers, the proportion who transitioned to daily smoking in early adulthood increased from 38.7% (95% CI, 35.9%-41.6%) in 2002 to 55.9% (95% CI, 52.0%-59.8%) in 2018 (P < .001).Conclusions and relevanceA substantial proportion of beginning smokers and most new daily smokers are now young adults, reflecting a shift from adolescence to early adulthood, a population segment once considered beyond the critical risk period for cigarette smoking onset. Expanding the long-standing emphasis on adolescent surveillance and prevention in adolescence to include the young adult population is warranted.
| S-EPMC7539122 | biostudies-literature
Project description:Background. Pneumonia and bronchiolitis are common childhood illnesses caused by the respiratory syncytial virus. A systematic analysis of published epidemiological data in sub-Saharan African children under the age of 5 was conducted. Methods. To retrieve literature, electronic databases, indexing services, and directories such as PubMed/MEDLINE, Scopus, EMBASE (Elsevier), Google Scholar, and Worldcat were utilized. Data from the included studies were extracted after screening and eligibility evaluation. Results. The pooled prevalence rate of respiratory syncytial virus was 21% (95% CI: 17, 25). Subgroup analysis based on participants' ages showed that, prevalence was highest in children <6 months (32%). High prevalence was also found in children who were hospitalized (27%), children co-infected with HIV (28%), and children co-infected with bacteria respiratory pathogens (22%). Conclusion. The prevalence of respiratory syncytial virus infection was high in children in sub-Saharan African countries. Therefore, it should be prioritized as a major health problem.
| S-EPMC11571251 | biostudies-literature