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      Konsum von Tabakzigaretten, E-Zigaretten und Wasserpfeifen bei Kindern und Jugendlichen. Ergebnisse des Präventionsradars von 2016 bis 2023

      1 , 1
      Pneumologie
      Georg Thieme Verlag KG

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          Zusammenfassung

          Fragestellung Trends der Nutzung verschiedener Rauchprodukte im Kindes- und Jugendalter von 2016–2023 sollen abgebildet werden.

          Methode Datengrundlage bilden sieben Wellen des Präventionsradars, einer schulbasierten epidemiologischen Studie in den Klassenstufen 5–10. Primäre Endpunkte der Untersuchung waren die Lebenszeit- und die Monatsprävalenz des Konsums von Tabakzigaretten, E-Zigaretten, Wasserpfeifen sowie des Konsums von mindestens zwei dieser Rauchprodukte (kombinierter Konsum). Prävalenzschätzungen basieren auf logistischen Regressionsmodellen.

          Ergebnisse Der Auswertung liegen 94.127 Fragebögen zugrunde. Das Geschlechtsverhältnis war ausgewogen (49% weiblich), das mittlere Alter betrug 13 Jahre (SD=1,8). 2022/2023 betrug die Lebenszeitprävalenz des Rauchens von Tabakzigaretten 18,8% (95%-KI 18,1–19,5), von E-Zigaretten 23,5% (95%-KI 22,8–24,3), von Wasserpfeifen 14,0% (95%-KI 13,4–14,7) und des kombinierten Konsums 19,0% (95%-KI 18,3–19,7). Die Monatsprävalenz des Rauchens von Tabakzigaretten betrug 5,9% (95%-KI 5,5–6,4), von E-Zigaretten 7,0% (95%-KI 6,5–7,4), von Wasserpfeifen 3,2% (95%-KI 2,8–3,5) und des kombinierten Konsums 4,8% (95%-KI 4,4–5,2). Seit 2016 zeichnen sich folgende Trends im Hinblick auf die Lebenszeitprävalenz ab: Tabakzigaretten (–3,0 Prozentpunkte), E-Zigaretten (+1,8 Prozentpunkte), Wasserpfeifen (–9,2 Prozentpunkte), kombinierter Konsum (–2,7 Prozentpunkte). In den Jahren der COVID-19-Pandemie rauchten weniger Jugendliche. Post-COVID stiegen die Prävalenzen mit Ausnahme der Wasserpfeife wieder an.

          Diskussion Der Konsum von Rauchprodukten im Jugendalter tritt häufig auf. Über den Beobachtungszeitraum deutet sich eine Trendumkehr hin zur E-Zigarette als populärstem Produkt bei Kindern und Jugendlichen an. Zudem hat sich der kombinierte Konsum mehrerer Rauchprodukte als häufiges Konsummuster verfestigt. Konsequente verhältnis- und verhaltenspräventive Maßnahmen sind erforderlich, um das Ziel einer rauchfreien Gesellschaft im Jahr 2040 noch erreichen zu können.

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          Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

          Background Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings Globally in 2019, 1·14 billion (95% uncertainty interval 1·13–1·16) individuals were current smokers, who consumed 7·41 trillion (7·11–7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5–28·5] reduction) and females (37·7% [35·4–39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98–1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16–8·20) deaths and 200 million (185–214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3–21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Funding Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
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            Why children start smoking cigarettes: predictors of onset.

            We review findings from 27 prospective studies of the onset of cigarette smoking conducted since 1980. Almost 300 measures of predictors of smoking onset were examined, and 74% of them provided multivariate support for predictors of onset derived from theory and previous empirical findings. Expected relationships were strongly supported for (a) socioeconomic status, with students with compromised status being more likely to try smoking; (b) social bonding variables, particularly peer and school bonding, with less support for family bonding; (c) social learning variables, especially peer smoking and approval, prevalence estimates, and offers/availability, with less consistent support for parent smoking and approval; (d) refusal skills self efficacy; (e) knowledge, attitudes and intentions, with the expected stronger predictions from intentions than from attitudes than from knowledge; and (f) broad indicators of self-esteem. The few investigators who analyzed their data separately by age, gender, or ethnicity found many differences by these factors, though there were too few of them to detect any pattern with confidence. Though the 27 studies are far from perfect, we believe that they confirm the importance of many well-accepted predictors and raise some questions about others. In particular, family smoking, bonding and approval each received unexpectedly low support. It is not clear whether this lack of support reflects reality as it has always been, is due to a changing reality, reflects developmental changes, either in the age of subjects or the stage of onset, or is due to poor measurement and too few tests. Future prospective studies need to be theory-driven, use measures of known reliability and validity, report analyses of scale properties, and use statistical methods appropriate to the hypotheses or theories under study. Finally, we encourage more investigations of the potentially different predictors of transitions to experimental or regular cigarette smoking. This will require multi-wave studies and careful measurement of changes in smoking behavior.
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              Smoking and mortality--beyond established causes.

              Mortality among current smokers is 2 to 3 times as high as that among persons who never smoked. Most of this excess mortality is believed to be explained by 21 common diseases that have been formally established as caused by cigarette smoking and are included in official estimates of smoking-attributable mortality in the United States. However, if smoking causes additional diseases, these official estimates may significantly underestimate the number of deaths attributable to smoking. We pooled data from five contemporary U.S. cohort studies including 421,378 men and 532,651 women 55 years of age or older. Participants were followed from 2000 through 2011, and relative risks and 95% confidence intervals were estimated with the use of Cox proportional-hazards models adjusted for age, race, educational level, daily alcohol consumption, and cohort. During the follow-up period, there were 181,377 deaths, including 16,475 among current smokers. Overall, approximately 17% of the excess mortality among current smokers was due to associations with causes that are not currently established as attributable to smoking. These included associations between current smoking and deaths from renal failure (relative risk, 2.0; 95% confidence interval [CI], 1.7 to 2.3), intestinal ischemia (relative risk, 6.0; 95% CI, 4.5 to 8.1), hypertensive heart disease (relative risk, 2.4; 95% CI, 1.9 to 3.0), infections (relative risk, 2.3; 95% CI, 2.0 to 2.7), various respiratory diseases (relative risk, 2.0; 95% CI, 1.6 to 2.4), breast cancer (relative risk, 1.3; 95% CI, 1.2 to 1.5), and prostate cancer (relative risk, 1.4; 95% CI, 1.2 to 1.7). Among former smokers, the relative risk for each of these outcomes declined as the number of years since quitting increased. A substantial portion of the excess mortality among current smokers between 2000 and 2011 was due to associations with diseases that have not been formally established as caused by smoking. These associations should be investigated further and, when appropriate, taken into account when the mortality burden of smoking is investigated. (Funded by the American Cancer Society.).
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                Author and article information

                Contributors
                (View ORCID Profile)
                (View ORCID Profile)
                Journal
                Pneumologie
                Pneumologie
                Georg Thieme Verlag KG
                0934-8387
                1438-8790
                December 13 2023
                December 2023
                September 27 2023
                December 2023
                : 77
                : 12
                : 1001-1008
                Affiliations
                [1 ]IFT-Nord gGmbH, Institut für Therapie- und Gesundheitsforschung, Kiel, Deutschland
                Article
                10.1055/a-2146-7087
                4afc448b-5190-4002-a426-bfca62e176f2
                © 2023
                History

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