American journal of preventive medicine
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Review Meta Analysis
Tobacco Use at the Intersection of Sex and Sexual Identity in the U.S., 2007-2020: A Meta-Analysis.
A 2009 systematic review synthesized data between 1987 and 2007 and revealed a higher prevalence of smoking among sexual minority populations than among heterosexuals. Subsequently, growing attention to tobacco use among sexual minority populations has spurred more literature on this issue because higher tobacco use prevalence has been found in certain sexual minority subgroups relative to others. However, a population-level synthesis of tobacco use prevalence by sexual minority subgroup has not been done for the past decade. ⋯ Tobacco use prevalence among sexual minorities during 2007-2020 remained at similarly high levels as those during 1987-2007, and tobacco use disparity between sexual minorities and heterosexuals persisted in the past decade. Significant heterogeneity existed in tobacco use across sexual minority subgroups, with bisexual women having the highest prevalence. These findings are critical for increasing decision maker's awareness and action to address sexual minorities' persistent high prevalence of tobacco use, particularly among bisexual women.
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Given the dangers posed by tobacco use and tobacco smoke exposure, pediatricians should address tobacco use and exposure with patients and parents at every opportunity, but this is not consistently done in practice. One reason may be that many medical residents do not receive education on how to address tobacco use and tobacco smoke exposure with patients and their parents. In a 2012 survey of U. ⋯ Moreover, a minority of the residents assessed themselves as effective at counseling parents (19%) or adolescents (23%), and their perceived effectiveness was related to small group learning and active learning workshops, modalities that were infrequently implemented in training. Respondents also reported infrequent use of electronic health record prompts regarding tobacco and the absence of prompts about critical issues (e.g., addressing tobacco smoke exposure in vehicles or other settings or offering treatment or referrals to parents who smoke). This paper provides recommendations about augmenting pediatric resident training in simple ways.
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About 80% of the 1.1 billion people who smoke tobacco worldwide reside in low- and middle-income countries. Evidence-based approaches to promote cessation include brief advice from health professionals and referrals through quitlines. This study assesses cessation behaviors and the use of cessation services in the past 12 months among current tobacco smokers in 31 countries who attempted to quit. ⋯ In the assessed countries, the majority of those who currently smoked tobacco and made a quit attempt did so without assistance; very few reported using quitlines, partly because of the lack of quitlines in some countries. In resource-limited settings, quitlines can play a greater role in helping people quit smoking as part of a comprehensive approach.
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Although there is evidence of disparities in breast cancer screening for women with mental illness in the U.S., there is a dearth of studies examining this association in the United Kingdom, where health care is provided free at the point of access. This population-based study examines the influence of mental illness, as assessed by the uptake of psychotropic medications, on breast screening uptake in the United Kingdom. ⋯ These findings confirm the existence of significant disparities in breast screening uptake for women with mental illness. Targeted interventions are warranted to prevent avoidable breast cancer deaths in these individuals, especially given the increasing prevalence of mental illness.
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With norovirus vaccine candidates currently under development, now is the time to identify the vaccine characteristics and implementation thresholds at which vaccination becomes cost effective and cost saving in a community setting. ⋯ This study outlines thresholds at which a norovirus vaccine would be cost effective and cost saving in the community when vaccinating children aged <5 years and older adults. Establishing these thresholds can help provide decision makers with targets to consider when developing and implementing a norovirus vaccine.