RESUMO
OBJECTIVE: In this study, we assessed differences in type, number, and perceptions of ENDS flavors used at initiation and currently among 4 smoking and ENDS use profiles of US adults with a history of smoking and ENDS use. METHODS: Our nationally representative survey sample included 1814 participants. We estimated Rao-Scott χ2 and adjusted odds ratios. Use profiles included: (1) Dual Users (current smokers/current ENDS users), (2) ENDS Rejecters (current smokers/former ENDS users), (3) Switchers (former smokers/current ENDS users), and (4) Quitters (former smokers/former ENDS users). RESULTS: Multiple flavor use at initiation was associated with higher odds of being a Dual User or Switcher. Those who used mint/wintergreen/menthol flavored ENDS at initiation had lower odds of being an ENDS Rejecter (vs Dual User). Current use of tobacco/unflavored or menthol/mint/wintergreen flavor was associated with higher odds of being a Dual User (vs Switcher). Switchers were more likely to perceive flavors as safe in ENDS and rate flavors as important to their ENDS use. CONCLUSIONS: Multiple flavor use at initiation, perceiving flavors as safe, and use of specific flavors (mint/wintergreen/menthol) at initiation may discourage rejecting ENDS. However, current use of traditional cigarette flavors (ie, tobacco, menthol) may promote sustained smoking.
RESUMO
AIM: To determine which cardiometabolic risk factors and clusters of cardiometabolic risk factors that are mostly associated with elevated HbA1c in non-Hispanic White (NHW), non-Hispanic Black (NHB) and Mexican-American (MA) adults who have type 2 diabetes. METHODS: Data (n=2910) from the United States National Health and Nutritional Examination Surveys were used in this study. Elevated HbA1c was defined as having HbA1c value was 7% or greater. Race/ethnicity-specific associations of individual and clustered (2-5 factors) cardiometabolic risk factors with elevated HbA1c were determined using prevalence odds ratio from multivariate logistic regression analyses. Statistical adjustments were made for sex, age, education, income and marital status. RESULTS: Joint occurrence of abdominal obesity, high blood pressure, and elevated triglycerides and joint occurrence of high blood pressure, elevated triglycerides and low HDL were more highly associated with elevated odds of HbA1c compared to other cardiometabolic risk factors joint occurrences. Joint occurrences of abdominal obesity, high blood pressure, and elevated triglycerides was associated with 2.3 (95% CI: 1.2-3.3), 9.1 (95% CI: 2.9-28.7) and 4.8 (95% CI: 2.0-11.5) increased odds of elevated HbA1c in NHW, NHB and MA, respectively. The corresponding values for the joint occurrence of high blood pressure, elevated triglycerides and low HDL was associated with 2.4 (95% CI: 1.2-3.7), 3.5 (95% CI: 1.1-5.5) and 2.6 (95% CI: 1.5-4.7) increased odds of elevated HbA1c in NHW, NHB and MA, respectively. CONCLUSION: This finding calls for consideration of cardiovascular risk factor clustering in deciding medical therapies to optimize glycemic control in individuals with type 2 diabetes. Interventions designed to achieve glycemic control coupled with modification of cardiometabolic risk factors may be crucial in alleviating sequelae resulting from type 2 diabetes.
Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/sangue , Hemoglobinas Glicadas/metabolismo , Adulto , Negro ou Afro-Americano , Estudos Transversais , Diabetes Mellitus Tipo 2/etnologia , Feminino , Humanos , Hipertensão/epidemiologia , Hipoalfalipoproteinemias/epidemiologia , Modelos Logísticos , Masculino , Americanos Mexicanos , Análise Multivariada , Inquéritos Nutricionais , Obesidade Abdominal/epidemiologia , Razão de Chances , Prevalência , Fatores de Risco , Triglicerídeos/sangue , Estados Unidos , População BrancaRESUMO
The Global Youth Tobacco Survey (GYTS) project was developed by the World Health Organization and the US Centers for Disease Control and Prevention to track tobacco use among youth in countries across the world, using a common methodology and core questionnaire. The GYTS is school based and employs a two stage sample design to produce representative data on smoking among students aged 13-15 years. The first stage consists of a probabilistic selection of schools. All students in the selected classes are eligible for the survey. In 1999, the GYTS was conducted in 13 countries and is currently in progress in over 30 countries. This report describes data from 12 countries: Barbados, China, Costa Rica, Fiji, Jordan, Poland and the Russian Federation (Moscow), South Africa, Sri Lanka, Ukraine (Kiev), Venezuela and Zimbabwe. The findings show that tobacco use in the surveyed age group ranged from a high of 33 percent to a low of 10 percent. While the majority of current smokers wanted to stop smoking, very few were able to attend a cessation programme. In most countries the majority of young people reported seeing advertisements for cigarettes in media outlets, but anti-tobacco advertising was rare. The majority of young people being taught in school about the dangers of smoking. Environmental tobacco smoke exposure was very high in all countries. These results show that the GYTS surveillance system is enhancing the capacity of countries to design, implement, and evaluate tobacco prevention and control programmes. (AU)