China ; Female ; Humans ; Male ; Population Surveillance ; Tobacco Use Cessation ; methods ; Tobacco Use Disorder ; epidemiology ; prevention & control ; World Health Organization

Risk Factors ; Tars ; toxicity ; Tobacco Products ; standards ; toxicity ; Tobacco Use Disorder ; etiology ; prevention & control

OBJECTIVETo explore the relationship between the strength of tobacco control and the effectiveness of creating smoke-free hospital, and summarize the main factors that affect the program of creating smoke-free hospitals.

METHODSA total of 210 hospitals from 7 provinces/municipalities directly under the central government were enrolled in this study using stratified random sampling method. Principle component analysis and regression analysis were conducted to analyze the strength of tobacco control and the effectiveness of creating smoke-free hospitals.

RESULTSTwo principal components were extracted in the strength of tobacco control index, which respectively reflected the tobacco control policies and efforts, and the willingness and leadership of hospital managers regarding tobacco control. The regression analysis indicated that only the first principal component was significantly correlated with the progression in creating smoke-free hospital (P<0.001), i.e. hospitals with higher scores on the first principal component had better achievements in smoke-free environment creation.

CONCLUSIONSTobacco control policies and efforts are critical in creating smoke-free hospitals. The principal component analysis provides a comprehensive and objective tool for evaluating the creation of smoke-free hospitals.

Health Facility Environment ; Hospital Administration ; Principal Component Analysis ; Smoke-Free Policy ; Tobacco Smoke Pollution ; prevention & control

Cadherins ; metabolism ; Gastric Mucosa ; metabolism ; Humans ; Integrin beta1 ; metabolism ; Kangai-1 Protein ; metabolism ; Lymphatic Metastasis ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasm Staging ; Stomach Neoplasms ; metabolism ; pathology

The objective of the current study is to discuss the problems related to how data is used to calculate Years Lost with Disability (YLD) with the method recommended by the World Bank. The study includes collecting useful data, estimating disease duration and average age of disease onset,adjusting incidence and prevalence data by means of a software programme, DISMOD ( Harvard University Incidence & Prevalence Model), and assessing the importance of YLD calculation for different diseases.Remission and fatality rates of 3 diseases were estimated by experts at 2 round consultations.Incidence rates, disease duration and average age of disease onset were calculated and adjusted by DISMOD. YLD due to schizophrenia is the highest among 4 diseases in two regions. YLD is18.88% in disability adjusted life year for 4 diseases in Xiacheng District, and 19.97% in Fuyang County.Available data can be used for the calculation of YLD after being adjusted. DISMOD is a useful instrument to test the internal consistency of incidence, prevalence, remission and fatality rate. The adjusted data are acceptable to experts and DISMOD. To get rational remission and fatality rates, we can use a cohort method through expert consultations. To reflect overall burden of disease, YLD calculation should be used.

Objective To study the findings of 256‐slice CT angiography in atherosclerosis of the intracranial carotid arteary . Methods 402 cases of atherosclerotic lesions in the neck and brain were collected from 2013 to 2014 in our hospital ,in which there were 274 cases of male and 128 cases female .All patients underwent 256‐slice CT angiography of the head and neck .The incidence of atherosclerosis involvement in the intracranial carotid artery was analysed .The characteristics of carotid plaque on different sexes , age(≤60 years and >60 years) and location (right and left ) were observed .The length and property of plaque ,and stenostic rate of the artery were measured respectively .Results There were 164 cases (40 .80% ) of intracranial carotid artery athrosclerosis in 402 cases of atherosclerotic lesions of the neck and brain ,in which the incident rate of male was 38 .32% and female 46 .09% (χ2 =2 .182 ,P=0 .140) .The incident rate of >60 years group was more than that of ≤60 years group (χ2 <31 .105 ,P<0 .001)for both sexes . There were no differences on lesion location (right or left)for different sexes or age groups (χ2 <0 .035 ,P>0 .088) .And there were also no differences on lesion length (≤10 mm ,11-20 mm ,>20 mm) for different sexes or age groups (χ2 <0 .027 ,P>0 .091) . Calcified plaques were seen the most (79 .81% ) ,mixed plaques were seen more (15 .46% ) ,and lipid plaques (1 .58% ) and fibrous plaques (3 .15% ) were seen less .The mixed plaques were more seen on >60 years group than that on ≤60 years group for male pa‐tients (χ2 =12 .204 ,P=0 .001) ,but no other difference was found for plaque property in other different sexes or age groups .Mild stenosis of the corated artery was found in 54 .57% lesions ,moderate stenosis in 39 .75% and severe stenosis in 5 .68% ,and there were no any difference in different sexes or age groups (χ2 <2 .062 ,P>0 .151) .Conclusion CT angiography of the head and neck is of important significance for diagnosis of atherosclerosis in the intracranial carotid artery .

Objective To determine the accuracy of prevalence data sets on tobacco use so as to measure the risk of tobacco use and the impact of tobacco control in China.Methods Three published data sets on nation-wide survey were reviewed,and compared.Two principles were applied to determine the accuracy of the data on prevalence: ) The estimated consumption of cigarettes based on the currentprevalence rate on smokers should have been close to the actual cigarette consumption level; ii) change on the annual prevalence of male current smokers should be around 1% in China,since the international experience on the prevalence of current smokers tended to decrease at a rate of around 1% per year in the presence of comprehensive tobacco control strategies.Results The differences between the estimated cigarette consumption and the actual cigarette consumption for the three surveys were 51.07 billion through Behavior Risk Factor Surveillance System (BRFSS 2002),62.94 billion through the Chinese Citizen Nutrition & Health Survey (CCNHS 2002),and 217.11 billion through the China Health Service Survey (CHSS 2003).In comparison with the national tobacco use survey in 1996,the prevalence of male current smokers apparently dropped by 0.9% in BRFSS 2002,2.2% in CCNHS 2002 and 2.0% per year in CHSS 2003.Thus,the prevalence of current smokers in BRFSS (2002) was more reliable,comparing to the results from the other two surveys.Conclusion The prevalence of current smokers as determined by the BRFSS should be used to reflect the epidemic of tobacco use when implementing the FCTC in China.However,the reporting prevalence rates of tobacco use were different in the different surveys regarding tobacco use,suggesting that the capacity of surveillance on tobacco control should be strengthened,including the standardization of definitions on 'ever-smoker' and 'current smoker',as well as on standardized questionnaire,sampling strategy and the process of data analysis,quality of field work etc.Precise estimation of prevalence appears to be the key point for understanding how many current smokers so as to develop control policy,including setting up 'quit' clinics and evaluating the impact of tobacco control programs.There is an urgent need to establish a national standardized surveillance system to monitor the tobacco epidemics.

Cost of Illness ; Risk Assessment

Accidents, Traffic ; mortality ; Adult ; Aged ; Cause of Death ; China ; epidemiology ; Coronary Disease ; mortality ; Databases, Factual ; Female ; Humans ; Hypertension ; prevention & control ; Male ; Middle Aged ; Risk Factors ; Smoking ; adverse effects ; Stroke ; mortality

OBJECTIVETo determine the level of awareness of the hazards of tobacco smoking and secondhand smoke inhalation among adults in China.

METHODSHousehold surveys were conducted with a total of 13,354 respondents aged 15 years or over from 100 counties of 28 Chinese provinces using a stratified multi-stage geographically clustered sample design.

RESULTSThe findings revealed that 81.8% of the population was aware that smoking causes serious diseases, and 27.2% and 38.7% were aware that smoking causes stroke and heart attack, respectively. Only 64.3% of respondents were aware that secondhand smoke can cause serious diseases, and 27.5%, 51.0%, and 52.6% were aware that secondhand smoke causes heart disease in adults, lung disease in children and lung cancer in adults, respectively. Awareness regarding smoking-related hazards across all participants was significantly associated with several factors, including gender, smoking status, urban/rural residency, education level and exposure to tobacco control publicity in the last 30 days. Awareness regarding tobacco-related hazards in smokers was significantly associated with urban/rural residency, education level, exposure to tobacco control publicity in the last 30 days, and physician's advice. Awareness relating to the hazards of inhaling secondhand smoke was associated with smoking status, urban/rural residency, age, education level, and exposure to tobacco control publicity in the last 30 days. Medical professionals were found to know more about the health hazards of tobacco compared with people in other types of employment.

CONCLUSIONSOverall awareness of the health hazards of tobacco has improved in the last 15 years in China, but is still relatively poor. Improved means of communicating information and more effective warning labels on cigarette packaging are necessary for increasing public awareness of tobacco hazards, particularly among rural residents and people with less education.

Adolescent ; Adult ; Aged ; Child ; China ; epidemiology ; Health Knowledge, Attitudes, Practice ; Health Surveys ; Heart Diseases ; etiology ; Humans ; Lung Diseases ; Middle Aged ; Smoking ; adverse effects ; Tobacco Smoke Pollution ; adverse effects ; Tobacco Use Disorder ; epidemiology ; Young Adult