Public Health Perspectives of Smokeless Tobacco and Areca Nut Use in the COVID-19 Era.
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ABSTRACT:
SUBMITTER: Kaur J
PROVIDER: S-EPMC7239101 | biostudies-literature | 2020 Aug
REPOSITORIES: biostudies-literature
Publications
Public Health Perspectives of Smokeless Tobacco and Areca Nut Use in the COVID-19 Era.
Kaur Jagdish J Rinkoo Arvind Vashishta AV
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 20200801 9
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Project description:Background: Betel nut (areca) is the world's fourth most commonly used addictive substance. Arecoline, a muscarinic agonist in areca, is also a partial agonist for the addiction-related high-affinity brain nicotine receptors. In many countries, smokeless tobacco is commonly mixed with areca. Objective: We sought to evaluate the knowledge of self-harm, and addiction associated betel quid use in an unban population. Methods: We conducted a survey study of 200 betel quid users in Yangon, Myanmar, and a survey of betel quid vendors to determine the relative amounts of areca and tobacco in the available quids. Results: The data determined that a large majority of the survey subjects (84%) used tobacco with their areca. Users had a general awareness that betel chewing was "a bad habit" (85%) and 80% were aware of the cancer risks. Understanding areca addiction remains a challenge since, aside from the strong muscarinic activity of arecoline stimulating salivation, overt neurologic effects are difficult for even the users to identify. Fifty eight percent of the respondents indicated that chewing betel quid had effects like drinking coffee, and 55.5% indicated that it had effects like drinking alcohol. Data obtained from the quid vendors indicated that 75% added tobacco in equal amounts to areca. Conclusion: The concomitant use of nicotine and areca indicates that betel quid addiction includes a significant component of nicotine dependence. However, the additional activities of areca, including the muscarinic effects of arecoline, indicate that potential cessation therapies should optimally address other factors as well.
| S-EPMC7774082 | biostudies-literature
Project description:BackgroundThe Betel Nut Intervention Trial (BENIT) is the first known randomized controlled intervention trial designed to help minority Pacific Islanders in Guam and Saipan quit chewing the carcinogenic Areca catechu nut (AN). We report the BENIT's saliva bioverification results against the self-reported chewing status ("quitter" or "chewer") at day 22 follow-up.Material and methodsAN-specific (arecoline, arecaidine, guvacoline, and guvacine) and tobacco-specific (nicotine, cotinine, and hydroxycotinine) alkaloids were analyzed in saliva from 176 BENIT participants by an established and sensitive liquid chromatography mass spectrometry-based assay.ResultsThe combined four AN alkaloid levels decreased from baseline in quitters (n = 50) and chewers (n = 108) by 32% and 9%, respectively. In quitters, decreases were significant for arecoline (p = 0.044)-the most prominent AN alkaloid, along with arecaidine (p = 0.042) and nicotine (p = 0.011). In chewers, decreases were significant only for hydroxycotinine (p = 0.004). Similar results were obtained when quitters and chewers were stratified by treatment arm.DiscussionSalivary AN alkaloid levels generally agreed with self-reported chewing status, which suggests the former can be used to verify the latter.ConclusionOur results can help to objectively evaluate compliance and program effectiveness in AN cessation programs.
| S-EPMC9870849 | biostudies-literature
Project description:INTRODUCTION:Tobacco use usually starts in the adolescent age group and continues in adulthood. This study's aim was to identify knowledge regarding the adverse effects of tobacco and areca-nut use among high school children of Ahmedabad, India. METHODS:An anonymous self-administered close-ended questionnaire was designed for the study. Principals of 9 schools, 3 municipal and 6 government-aided, were approached and written informed consent was obtained. A total of 3055 students studying in grades 7-12 were included. Data were analyzed using Microsoft Excel and SPSS 16.0. Chi-squared test was applied to investigate any differences between the responses of consumers and non-consumers, while Cramer's V was applied to analyze the strength of association between the awareness of ill-effects and tobacco product consumption. RESULTS:Of the 3055 children, 3% felt that tobacco use was definitely not harmful to health while 84% felt that it was. In all, 65% of respondents were aware that tobacco use caused cancer, 7% answered that it caused breathing problems, 5% said it caused heart problems, 0.3% answered that it caused paralysis, 4.3% felt it caused no health problems, whereas 18% thought that it caused multiple issues. With regards to the role of media, 78% had seen many anti-smoking warnings in the media, 15% had seen a few, 5% had seen none. There was a statistically significant difference between the tobacco users and and non-users with regards to exposure to media (p<0.001), discussions in class (p<0.001) and general awareness (p<0.001), but a weak association between awareness and tobacco consumption was identified (p<0.05). CONCLUSIONS:Awareness about the harmful effects of tobacco is high among school children of Ahmedabad, though use may still be prevalent.
| S-EPMC7205154 | biostudies-literature
Project description: Not available
| S-BSST1495 | biostudies-other
Project description:Because COVID-19 is a respiratory and cardiovascular disease, understanding behaviors that impact cardiopulmonary health, such as tobacco use, is particularly important. While early studies suggested no change in prevalence of tobacco use as COVID-19 emerged, pandemic fatigue, shifting levels of COVID-19 transmission, and vaccine availability have all changed since the start of the pandemic. The current study examined whether time, COVID-19 surges, and/or vaccination status were associated with likelihood of daily and non-daily tobacco use over the first 24 months of the pandemic. Data were obtained from electronic health records of healthcare visits (n = 314,787) to four Southern California VA healthcare systems. Multinomial logistic regression analyses indicated that the likelihood of reporting both daily and non-daily tobacco use (versus non-use) increased over time. Daily and non-daily tobacco use were less common at visits that occurred during COVID-19 surges, as well as among veterans vaccinated against COVID-19. Our findings provide new insight into changes of tobacco use patterns and correlates across the first two years of this pandemic, and understanding these associations may facilitate understanding of health-related behaviors and inform clinical treatment of tobacco use disorder during the COVID-19 pandemic.
| S-EPMC9859008 | biostudies-literature
Project description:BackgroundAreca nut (AN) is a traditional Chinese herbal medicine used for centuries to treat gastrointestinal (GI) disorders. Charred AN (CAN) is a processed product of AN with similar therapeutic effects. This study aimed to investigate the therapeutic mechanisms of AN and CAN for constipation via metabolomics and gut microbiota analysis.MethodsIn this study, the rats were randomly divided into 5 groups (n = 6): control, constipation model, positive drug, AN treatment, and CAN treatment groups. Constipation was induced by intragastric administration of loperamide hydrochloride, followed by 14-day treatment with mosapride, AN, or CAN. The efficacy difference between AN and CAN was assessed by evaluating the weight gain, fecal water content, GI transit rate, colonic histopathology, serum levels of GI hormones, gut microbiota, and fecal metabolites.ResultsThe results demonstrated that both AN and CAN could alleviate loperamide-induced constipation. Furthermore, they significantly elevated the serum levels of motilin, vasoactive intestinal peptide, substance P, and acetylcholine. 16S rRNA analysis revealed that AN regulated the relative abundance of Bacillus, UCG-005, norank_f_Muribaculaceae, Candidatus_Saccharimonas, and Ruminococcus, whereas CAN modulate the relative abundance of Lactobacillus, Bacillus, norank_f_Muribaculaceae, Ruminococcus, unclassified_f_Oscillospiraceae, and unclassified_f_Prevotellaceae. Moreover, the metabolic profile of AN- and CAN-treated rats was also different, where AN treatment involved pathways of citrate cycle (TCA) and tyrosine, alanine, aspartate, and glutamate metabolisms. Whereas CAN treatment involved pathways of steroid and primary bile acid biosynthesis, as well as pyrimidine and purine metabolisms. Spearman correlation analysis indicated a close relationship between gut microbiota and fecal metabolites.ConclusionIn summary, this study revealed that AN may protect GI mucosa, enhance GI motility, and alleviate constipation symptoms by regulating the relative abundance of specific gut microbiota (Bacillus, UCG-005, norank_f_Muribaculaceae, Candidatus_Saccharimonas, Ruminococcus) as well as citrate cycle or tyrosine, alanine, aspartate, and glutamate metabolic pathways. Furthermore, CAN was observed to promote gastric emptying and intestinal propulsion, thereby alleviating constipation, by modulating the relative abundance of specific gut microbiota (Lactobacillus, Bacillus, norank_f_Muribaculaceae, Ruminococcus, unclassified_f_Oscillospiraceae, unclassified_f_Prevotellaceae) as well as steroid and primary bile acid biosynthesis, as well as pyrimidine and purine metabolic pathways.
| S-EPMC11427381 | biostudies-literature
Project description:ObjectiveAreca nut is one of the most widely consumed substances globally, after nicotine, ethanol and caffeine and classified as carcinogenic to humans. This study examines the disparity and determinants of areca nut consumption with and without tobacco in India.DesignNationally representative cross-sectional study.ParticipantsWe used the nationally representative Global Adult Tobacco Survey 2016-2017. The analytical sample size was 74 037 individual's aged 15 years and above with a response rate of 92.9%.MeasuresCurrent consumption of areca nut without tobacco and with tobacco.MethodWe examined determinants of areca nut consumption (without tobacco and with tobacco) using multinomial logistic regression, accounting for the survey design.ResultsAbout 23.9% (95% CI 23.1 to 24.8) of the adult population consume areca nut, that is, approximately 223.79 million people in India; majority of users (14.2%-95% CI 13.5 to 14.9) consumed areca nut with tobacco. When compared with women, men were more likely to consume areca nut (with tobacco relative risk (RR)=2.02; 95% CI 1.85 to 2.21 and without tobacco RR=1.13; 95% CI 1.07 to 1.20). Age, marital status, education, occupation, caste, religion and region were significantly associated with areca nut consumption. However, the direction and magnitude of association differ with respect to the areca nut consumption with and without tobacco.ConclusionThe ongoing tobacco control efforts would not address the majority of areca nut users until greater attention to areca nut consumption with and without tobacco is reflected in health policies in India.
| S-EPMC8208015 | biostudies-literature
Project description:ImportanceAs COVID-19 vaccine distribution continues, policy makers are struggling to decide which groups should be prioritized for vaccination.ObjectiveTo assess US adults' preferences regarding COVID-19 vaccine prioritization.Design, setting, and participantsThis survey study involved 2 independent, online surveys of US adults aged 18 years and older, 1 conducted by Gallup from September 14 to 27, 2020, and the other conducted by the COVID Collaborative from September 19 to 25, 2020. Samples were weighted to reflect sociodemographic characteristics of the US population.ExposuresRespondents were asked to prioritize groups for COVID-19 vaccine and to rank their prioritization considerations.Main outcomes and measuresThe study assessed prioritization preferences and agreement with the National Academies of Science, Engineering, and Medicine's Preliminary Framework for Equitable Allocation of COVID-19 Vaccine.ResultsA total of 4735 individuals participated, 2730 (1474 men [54.1%]; mean [SD] age, 59.2 [14.5] years) in the Gallup survey and 2005 (944 men [47.1%]; 203 participants [21.5%] aged 55-59 years) in the COVID Collaborative survey. In both the Gallup COVID-19 Panel and COVID Collaborative surveys, respondents listed health care workers (Gallup, 93.6% [95% CI, 91.2%-95.3%]; COVID Collaborative, 80.0% [95% CI, 78.0%-81.9%]) and adults of any age with serious comorbid conditions (Gallup, 78.6% [95% CI, 75.2%-81.7%]; COVID Collaborative, 72.9% [95% CI, 70.7%-74.9%]) among their 4 highest priority groups. Respondents of all political affiliations agreed with prioritizing Black, Hispanic, Native American, and other communities that have been disproportionately affected by COVID-19 (Gallup, 74.2% [95% CI, 70.6%-77.5%]; COVID Collaborative, 84.9% [95% CI, 83.1%-86.5%]), and COVID Collaborative respondents were willing to be preceded in line by teachers and childcare workers (92.5%; 95% CI, 91.2%-93.7%) and grocery workers (85.9%; 95% CI, 84.2%-87.5%). Older respondents in both surveys were significantly less likely than younger respondents to prioritize healthy adults aged 65 years and older among their 4 highest priority groups (Gallup, 23.7% vs 39.1% [χ2 = 2160.8; P < .001]; COVID Collaborative, 23.3% vs 28.8% [χ2 = 5.0198; P = .03]). COVID Collaborative respondents believed the 4 most important considerations for prioritization were preventing COVID-19 spread (78.4% [95% CI, 76.3%-80.3%]), preventing the most deaths (72.1% [95% CI, 69.9%-74.2%]), preventing long-term complications (68.9% [66.6%-71.9%]), and protecting frontline workers (63.8% [95% CI, 61.5%-66.1%]).Conclusions and relevanceUS adults broadly agreed with the National Academies of Science, Engineering, and Medicine's prioritization framework. Respondents endorsed prioritizing racial/ethnic communities that are disproportionately affected by COVID-19, and older respondents were significantly less likely than younger respondents to endorse prioritizing healthy people older than 65 years. This provides reason for caution about COVID-19 vaccine distribution plans that prioritize healthy adults older than a cutoff age without including those younger than that age with preexisting conditions, that aim solely to prevent the most deaths, or that give no priority to frontline workers or disproportionately affected communities.
| S-EPMC8035644 | biostudies-literature
Project description:IntroductionCigarettes and smokeless tobacco (snus and nicotine pouches) are prevalent among youth and young adults in Denmark. Here, we examined the extent of changes in the use of cigarettes and smokeless tobacco during the first COVID-19 lockdown in March and April 2020 in Denmark as well as reasons for changed behavior.MethodsThis study used data from a nationwide survey conducted among 15- to 29-year-olds from January to March 2021 including 13,530 respondents (response rate = 36.0%). Logistic regression analyses assessed the associations between sociodemographic characteristics and the odds of initiating or increasing as well as trying to stop or decreasing cigarette smoking and smokeless tobacco use.ResultsThe prevalence of cigarette smoking was 17.8% and 10.5% reported using smokeless tobacco. Around 40% of those currently smoking cigarettes reported smoke on par during the COVID-19 lockdown as before, 24.5% started to smoke or increased their smoking, and 27.4% tried to stop or smoked less. Approximately 37% used smokeless tobacco on the same level as before the COVID-19 lockdown, 38.8% initiated or used more, and 14.1% tried to stop or used less. Females were more prone to initiate smokeless tobacco use and increase their level of smoking during the lockdown, and younger participants smoked less. More females compared with males changed their smoking behaviors due to their mood, and more younger participants did so due to fewer social gatherings.ConclusionAlthough most youths and young adults' tobacco behaviors remained the same during the COVID-19 lockdown, many also increased or decreased their behaviors - especially females and younger participants.ImplicationsThis study enables the possibility of detecting new tendencies in smoking and the use of smokeless tobacco among subgroups of the population during the COVID-19 lockdown. This knowledge is crucial for identifying which groups of youths are vulnerable to increasing their tobacco use in other pandemic situations and which groups call for special attention after the lockdown period. Future efforts may focus on vulnerable groups affected by the COVID-19 pandemic, such as females, and there is a need to monitor closely whether youth tobacco use changes as society becomes more normalized.
| S-EPMC9452126 | biostudies-literature
Project description:IntroductionA previous Minnesota SimSmoke tobacco control policy model is extended to more recent years and to include smokeless tobacco use.MethodsUsing data from the 1993 Tobacco Use Supplement and information on state policies, the Minnesota SimSmoke model was updated and extended to incorporate smokeless tobacco (both exclusive and dual use) and smokeless tobacco-attributable deaths. The model was then validated against the 2002, 2006/2007, and 2014/2015 Tobacco Use Supplement and the 1999, 2007, 2014, and 2018 Minnesota Adult Tobacco Survey and used to estimate the impact of policies implemented between 1993 and 2018. Analysis was conducted in April 2019.ResultsThe model validated well for cigarette and earlier smokeless tobacco use, but it predicted smokeless tobacco use less well in recent years. The model projected that male (female) smoking prevalence was 35% (36%) lower in relative terms by 2018 and 43% (44%) lower by 2040 owing to policies, with lesser reductions projected for male smokeless tobacco use. Tobacco-attributable deaths were reduced by 7,800 by 2018 and 46,900 by 2040. Price increases, primarily through taxes, were projected to have had the greatest impact on cigarette use followed by smoke-free air laws, cessation treatment policies, tobacco control campaign expenditures, and youth access enforcement. Similar effects were projected for smokeless tobacco use, except that smoke-free air laws had smaller effects.ConclusionsAs cigarettes remain the dominant form of nicotine delivery product, cigarette-oriented policies may be an effective means of reducing the use of all nicotine delivery products. However, noncigarette-oriented policies may also play an important role.
| S-EPMC6756173 | biostudies-literature