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Dylan Flores
Dylan Flores

Girl Smoking Mp4

Significant discrepancies in the likelihood of protecting children from differenttobacco product exposures were noted. Dual users were less likely to have asmoke-free car policy and less likely to have vape-free policies for the home andcar than parents who only smoked cigarettes. Additionally, dual users were morelikely to report people had vaped inside the car when children were present comparedwith parents who exclusively smoked cigarettes. These results suggest clinicalinterventions, such as CEASE, should identify parents who are dual users and enhancecounseling about the importance of keeping living spaces completely free from bothsmoking and vaping.20,27

Girl Smoking mp4

Results suggest a perception may exist among many parents that e-cigarette aerosol issafe for their children because the majority of dual users had a strictly enforcedsmoke-free home policy (63.8%), whereas a statistically significant lower percentageof these parents had a strictly enforced vape-free home policy (26.3%). When weexamined this issue by combining dual users and e-cigarette users into a singlegroup of e-cigarette users, we found the majority had a strictly enforced smoke-freehome policy (66.7%), yet significantly fewer had a strictly enforced vape-free homepolicy (25.4%). A greater percentage of the combined dual users and e-cigaretteusers group had strictly enforced smoke-free car policies (35.3%) compared withstrictly enforced vape-free car policies (22.5%). Pediatric health care providersshould address these apparent misperceptions about e-cigarette aerosol with parents.E-cigarette use has been proposed by some advocates as a potential risk-reductionstrategy compared with smoking combusted tobacco. This study suggests that dualusers of both traditional cigarettes and e-cigarettes are less likely to protectchildren with smoke-free (22.2% vs 37.5%; P = .02) as well asvape-free (21.1% vs 60.5%; P

When a pregnant woman breathes in any tobacco smoke, her unborn baby is exposed to the chemicals in the smoke too. About 10% of Australian women smoke during pregnancy. Both smoking and passive smoking can seriously affect the developing baby.

Help is available if you want to stop smoking. To find out all your options, call QuitlineExternal Link Tel. 13 78 48 for advice and support, and talk to your doctor or pharmacist about how they can help you quit.

Conclusions: The high proportion of tumors with detectable HPV suggests that infection with HPV is a necessary cause of anal cancer, similar to that of cervical cancer. Increases in the prevalence of exposures, such as cigarette smoking, anal intercourse, HPV infection, and the number of lifetime sexual partners, may account for the increasing incidence of anal cancer in men and women.

A 100% smoke-free building is one where smoking and vaping anything (including tobacco and cannabis) is prohibited in individual apartments, as well as common indoor and outdoor areas. Some smoke-free buildings may allow smoking or vaping in a limited outdoor area.

Residential buildings with three or more residential units are required to create a policy on smoking and disclose it to tenants and prospective tenants. Tenants can ask their building owners to make their building smoke-free.

Smoking is a leading cause of preventable deaths and morbidity, linked to high burden of lung cancer, chronic obstructive pulmonary disease (COPD), ischemic heart diseases and stroke [1,2,3]. It accounts for more than 7 million deaths annually with about 10% of these resulting from second-hand smoke [2]. There are around 1.1 billion smokers worldwide and about 80% of these live in low- and middle-income countries (LMICs), where more than two-thirds of smoking-related deaths occur [2].

Though global current smoking rates among adults decreased from 23.5 to 20.7% between 2007 and 2015 [4], this reduction was largely due to the declining smoking rates in Northern and Western Europe, North America and the Western Pacific regions [3, 4], where considerable measures have been implemented to tackle tobacco smoking. Conversely, smoking rate appears to be increasing in the Middle East and Africa [4]. For example, in sub-Saharan Africa, the consumption of tobacco increased by 57% between 1990 and 2009 [5]. A recent analysis of the Demographic Health Survey data of 30 sub-Saharan African countries revealed higher smoking rates, with prevalence as high as 37.7% among men in Sierra Leone [6].

Nigeria is the most populous country in Africa and has one of the leading tobacco markets in Africa, with over 18 billion cigarettes sold annually costing Nigerians over US$ 931 million [7, 8]. Following the 2003 World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) [2], Nigeria ratified the convention agreement in 2005, and in 2015 signed into law the National Tobacco Control (NTC) Act that regulates all aspects of tobacco control including advertising, packaging, and smoke-free areas [2]. Despite these initiatives, some reports suggest the prevalence of smoking in the country is rising at about 4% per year [8].

The WHO estimated about 13 million smokers in Nigeria in 2012 [7], with over 16,000 deaths attributable to smoking [9]. Increased commerce by international tobacco companies and the relative role they play in economic growth may have contributed to a rise in smoking rates [8, 10]. Although, some national estimates of smoking prevalence have been reported [11, 12], the exact number of smokers remains debated, which possibly hinders health policy. Concerns over current estimates include varying case definitions, representativeness of study samples or data, and poor study designs. We therefore conducted a comprehensive systematic search of the literature and synthesized data based on standard case definitions to estimate national and sub-national prevalence of smoking in Nigeria.

We searched MEDLINE, EMBASE, Global Health and Africa Journals Online (AJOL) on 31 January 2019. We initially searched for epidemiological studies on smoking in Nigeria and sourced for unpublished reports (or studies) from Google searches and Google Scholar. We included studies that were (i) population-based, (ii) reporting on the prevalence of smoking (current or ever) in a Nigerian setting, and (iii) published on or after 01 January 1990. Search terms are presented in the Additional file 1.

We employed a random-effects meta-analysis, using the DerSimonian and Laird Method [25], to combine individual study estimates and generate national and sub-national pooled estimates of the prevalence of tobacco smoking in Nigeria. Assuming a binomial (or Poisson) distribution, we estimated standard errors from crude prevalence and sample. Heterogeneity was identified from subgroup analyses, and assessed using I-squared (I2) statistics. To show trends and changes in smoking prevalence in the country, a meta-regression model accounting for the study period, and age was developed. Age-adjusted prevalence estimates were generated from the model for years 1995 and 2015. These were employed to estimate the absolute number of current and ever smokers in Nigeria based on the United Nations population (five-year age groups) for Nigeria for the two years [26]. This model has been described in detail in previous studies [13,14,15,16]. All statistical analyses were conducted on Stata (Stata Corp V.14, Texas, USA).

The prevalence of smokers was notably higher in North-east Nigeria which may be expected given an ongoing armed conflict lasting more than a decade. Although the evidence of the association between smoking and conflict is limited and inconclusive [96], varying social situations among vulnerable populations are known to precipitate substance use [97]. With several persons displaced, children and adolescents out of school, and youths without jobs, substance use, including tobacco products, is likely to increase in these settings. Although Kale and colleagues [92] reported South-easterners as the highest consumers of tobacco products in the country, the deviance from our estimates suggests a need for more research to understand regional variations.

Although the NTC Act was signed into law in 2015 and the country has committed to the WHO FCTC since 2005 [18], Nigeria is not yet on track to achieve tobacco control targets [98]. For example, our estimates show that rural dwellers smoke almost at the same rate as urban dwellers, indicating that smoking, believed to be associated with urbanization, has gradually penetrated remote areas. Further, we estimated that current smokers consume an average of 10 cigarettes per person per day accounting for about 110 million cigarettes per day and over 40 billion cigarettes in 2015 alone. Vellios et al. [99] noted that the demand for cigarettes increased by 44% across many African countries between 1990 and 2012, with this leading to over 100% increase in cigarettes production over the same period in these countries. A thriving tobacco market raises serious public health concerns, particularly for a country with a relatively weak health system. Tobacco companies see these countries as emerging markets due to weak tobacco control regulations and several vulnerable populations [91, 94]. Careful incorporation of the WHO MPOWER package (targeted at reversing tobacco epidemic) [18] beyond the national level to state and local levels may complement successful measures like smoke-free legislation, taxes, health education and media campaigns [2, 7]. Besides, Nigeria needs to develop comprehensive surveillance systems to monitor the production, sales, and consumption of cigarettes to effectively achieve control targets [99].

Search terms on tobacco smoking in Nigeria. Table S2. Quality assessment of selected studies. Table S3. Quality appraisal guide. Table S4. All extracted data employed in analysis. Figure S1. Crude prevalence rate of current smokers in Nigeria, by geopolitical zones. Figure S2. Crude prevalence rate of ever smokers in Nigeria, by geopolitical zones. Figure S3. Pooled mean cigarettes consumed per person per day in Nigeria. Figure S4. Meta-regression modelling. 041b061a72


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