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Will 5.6 million current American youth eventually die from smoking? The anatomy of a commonly accepted tobacco control measure

2020 ◽  
pp. tobaccocontrol-2020-055672 ◽  
Author(s):  
Kenneth E Warner

BackgroundAccording to the 2014 Surgeon General’s Report (SGR), ‘5.6 million (American) youth currently aged 0–17 years of age will die prematurely of a smoking-related illness.’ Advocates cite this number as evidence that smoking will exact an enormous toll for decades to come. This paper examines whether the projected toll accurately portrays smoking’s likely future burden.MethodsThe SGR estimate, using 2012 state-specific data, can be closely approximated using national data by multiplying the population ages 0–17 by 2012 smoking prevalence among adults ages 18–30, and multiplying that by 32%, the 1996 estimate by the Centers for Disease Control and Prevention of the probability of future smoking-attributable mortality among young adult smokers. Repeating this process using 2018 data estimates the number of future deaths of youth ages 0–17 in 2018. A hypothetical estimate for 2024 assumes continuation of the 2012–2018 smoking prevalence decrease.FindingsBased on 2012 data, the estimated number of youth alive in 2012 who will die prematurely from smoking is 5.31 million. With lower young adult smoking prevalence in 2018, the future smoking-related mortality estimate is 3.66 million. For 2024, the estimate is 2.54 million.ConclusionsThe SGR estimate depended on assumptions that no longer held a few years later. Yet advocates for youth smoking prevention cite it frequently today. Considerations such as this paper’s calculations, decreasing smoking initiation rates, increasing cessation, better screening for and treatment of smoking-related diseases, and smoking’s increasing social unacceptability suggest that smoking’s death toll for today’s youth will be far lower than contemporary estimates. How much lower is virtually impossible to estimate.

Author(s):  
Barry Knishkowy ◽  
Gina Verbov ◽  
Yona Amitai ◽  
Chen Stein-Zamir ◽  
Laura Rosen

Abstract Background: Ultra-orthodox, Jewish adolescent boys are considered to have relatively high smoking rates, but are generally not targeted by Israel’s smoking prevention programs. Objective: The objective of this trial was to test the effectiveness of a religion-based tobacco control intervention in reducing smoking prevalence among these youth. Methods: The study population participants were 340 boys from 63 religious boys’ schools in Jerusalem. The intervention consisted of a mailing that included a pamphlet describing the health effects of and rabbinical prohibitions on smoking. A cluster randomized trial was conducted between March and May, 2005. The primary endpoint was current smoking status. Secondary endpoints were future intent to smoke and attitudes towards smoking. Generalized estimating equations and mixed models of analysis of variance were used to perform the analyses. Results: The intervention did not significantly affect current smoking, intent to smoke or attitudes towards smoking. Prevalence of smoking and future intent to smoke were higher in schools without enforced smoking regulations [odds ratio (OR) 2.74, p=0.026, OR 3.38, p=0.018]. Increased smoking prevalence was associated with a high prevalence of smoking among friends (p=0.031) and not finding smoking repulsive (p=0.024). Conclusions: This study adds to the public health literature linking smoke-free schools and peer influences to adolescent smoking. Pamphlets containing rabbinic prohibitions on smoking initiation did not affect smoking behavior or intent to smoke.


2020 ◽  
Vol 18 (S1) ◽  
Author(s):  
Deborah Carvalho Malta ◽  
Luisa Sorio Flor ◽  
Ísis Eloah Machado ◽  
Mariana Santos Felisbino-Mendes ◽  
Luisa Campos Caldeira Brant ◽  
...  

Abstract Background The present study sought to analyze smoking prevalence and smoking-attributable mortality estimates produced by the 2017 Global Burden of Disease Study for Brazil, 26 states, and the Federal District. Methods Prevalence of current smokers from 1990 to 2017 by sex and age was estimated using spatiotemporal Gaussian process regression. Population-attributable fractions were calculated for different risk-outcome pairs to generate estimates of smoking-attributable mortality. A cohort analysis of smoking prevalence by birth-year cohort was performed to better understand temporal age patterns in smoking. Smoking-attributable mortality rates were described and analyzed by development at state levels, using the Socio-Demographic Index (SDI). Finally, a decomposition analysis was conducted to evaluate the contribution of different factors to the changes in the number of deaths attributable to smoking between 1990 and 2017. Results Between 1990 and 2017, prevalence of smoking in the population (≥ 20 years old) decreased from 35.3 to 11.3% in Brazil. This downward trend was seen for both sexes and in all states, with a marked reduction in exposure to this risk factor in younger cohorts. Smoking-attributable mortality rates decreased by 57.8% (95% UI − 61.2, − 54.1) between 1990 and 2017. Overall, larger reductions were observed in states with higher SDI (Pearson correlation 0.637; p < 0.01). In Brazil, smoking remains responsible for a considerable amount of deaths, especially due to cardiovascular diseases and neoplasms. Conclusions Brazil has adopted a set of regulatory measures and implemented anti-tobacco policies that, along with improvements in socioeconomic conditions, have contributed to the results presented in the present study. Other regulatory measures need to be implemented to boost a reduction in smoking in order to reach the goals established in the scope of the 2030 United Nations Agenda for Sustainable Development.


The essential requirement for human life to exist is water. After to the air, the other It has in various sources such as canals, ponds, rivers, lake, streams, reservoirs and etc. human settlers on the banks of major river systems at the earliest and has need water for drinking, bathing, cooking, laundering, and many more. But with the advancement of civilization the demand of water supply grately increased and now has such a stage to come that without well organized public water supply scheme, it is not possible to move the present human life and the develop the towns. Earlier has importance on quantity. And now today importance of quality comes to be recognized gradually in the later days. In this present study, numbers of water samples were collected various water supply schemes from 20 villages of bhimavaram region, West Godavari district, Andhra Pradesh. The drinking water samples are analyze its biological quality and it was found that some of the samples in the study area are exceeds or above the standard limit or permissible limit. On over all based on biological quality few drinking water sources located in and around different areas of Bhimavaram was seriously polluted by harmful bacteria and must need few treatment methods. So that need of attention not to use of supplied water and need to give suggestions and remedial measures to concerned local authorities of various disinfection treatment technologies or control measure to make supplied water free from pathogenic Bactria. Quality Assessment of drinking water from various sources (S Malhotra, S.K., Sndhu (2015), especially bacteriological quality should be periodically planned regularly to avoid and control waterborne diseases


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Douglas Levy ◽  
Sydney L Goldberg ◽  
Emily P Hyle ◽  
Krishna P Reddy

Background: The AHA’s 2030 Impact Goals seek to increase population health-adjusted life expectancy (LE) by 2y. Tobacco is a top contributor to all-cause mortality and cardiovascular disease (CVD). We estimated the potential contribution of improved tobacco control to achieve the 2030 Impact Goals in the US. Methods: We used the validated STOP microsimulation model with NHIS estimates of age- and sex-stratified mortality and CVD incidence to project changes in LE, as well as 10y, 20y, and lifetime CVD cumulative incidence, if cigarette smoking declined among the current US population. We assessed the impact of preventing initiation (current v never smokers) or increasing cessation (current v former smokers) at different ages. To examine the maximum impact of population-wide cessation, we projected changes in population LE and CVD incidence if smoking prevalence among those ≥20yo went immediately to 0%. Results: Preventing smoking initiation increases LE by 10.2y (men [M]) and 9.1y (women [W]) and reduces lifetime CVD incidence by 16.8% (M) and 26.2% (W) compared to lifetime smoking. Even cessation at age 60 extends LE by 3.7y (M) and 2.5y (W) and reduces 10y CVD incidence by 39.1% (M) and 59.4% (W) (Table). Total elimination of cigarette smoking in the 2020 US population aged ≥20y (e.g. by outlawing cigarettes) would increase the cohort LE by 0.4 (M) and 0.2 (W) years and reduce 20y CVD incidence by 6.0% (M) and 7.0% (W). Conclusion: Preventing smoking initiation offers the greatest benefit, but cessation at any age substantially improves LE and reduces CVD risk. The modest potential contribution of tobacco elimination to achieving the 2030 Impact Goals is due to already low smoking prevalence: <14% (projected) in 2020.


Author(s):  
Rebekah Sheldon

In the conclusion of The Child to Come, the book asks, ‘What happens when the life figured by the child--innocent, self-similar human life at home on a homely Earth--no longer has the strength to hold back the vitality that animates it?’ This chapter looks at two kinds of texts that consider this question: Anthropocene cinema and Young Adult Fiction. By focusing on the role of human action, the Anthropocene obscures a far more threatening reality: the collapse of the regulative. In relation, both children’s literature and young adult literature grow out of and as disciplinary apparatuses trained on that fraught transit between the presumptive difference of those still in their minority and the socially necessary sameness that is inscribed into fully attained adulthood.


Author(s):  
Brian L. Rostron ◽  
Catherine G. Corey ◽  
Enver Holder-Hayes ◽  
Bridget K. Ambrose

Flavored cigar use is common among cigar smokers, particularly those at younger ages. Several US localities have implemented policies restricting the sale of flavored tobacco products, including cigars. We estimated the population health benefits of removal of flavored cigars throughout the US in terms of reductions in cigar smoking-attributable mortality due to increased cessation and reductions in cigar smoking prevalence due to decreased initiation and continuing use. Monte Carlo simulation was used to estimate possible ranges for these values. We used published estimates of cigar use and attributable mortality in the US, as well as prior study conclusions on the effect of local and national flavor restriction policies. We estimated that removal of flavored cigars would result in approximately 800 (90% prediction interval = 400–1200) fewer cigar smoking-attributable deaths in the US each year and 112,000 fewer cigar smokers (90% prediction interval = 76,000–139,000) in each cohort of 18 year olds. The removal of characterizing flavors in cigars sold in the US is thus projected to have substantial public health benefits over time.


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