Summary 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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Background Workplace stress occurs in all professionals but, in particular, health-care professionals are highly prone to workplace stress. Health-care professionals comprise an important group that can be impacted by workplace stress because of their unique work environment. The study was done to determine the level of workplace stress and its associated factors among health-care professionals in Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. Methods An institutional-based cross-sectional study was conducted among randomly selected health-care professionals in Felege-Hiwot Referral Hospital. Data were collected using a self-administered structured questionnaire by trained data collectors and the supervisor. The collected data were entered into EPI-info version 7 and exported to SPSS version 20 for analysis. Logistic regression was employed to assess the associations between dependent and explanatory variables. Results This study revealed that prevalence of workplace stress was 68.2%. Health professionals who work 50 hours and more per week and in night shift on sometimes base were more likely to develop workplace stress. Conclusion The level of workplace stress among health professionals was found to be high. This was due to long working hours and working in night shift. Identifying the source of workplace stress among health professionals should be a great concern for health service managers and other stakeholders.

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ObjectiveThe aim of this study was to assess diabetes self-care practice and associated factors among diabetes patients attending Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia.ResultPrevalence of desirable self-care behaviors toward Diabetes Mellitus was 28.4% (95% CI 24.0–32.7%). There were significant association between the combined treatment modality of tablet with insulin (AOR: 2.72; 95% CI 1.01, 7.40), primary and secondary education level (AOR: 4.82; 95% CI 1.88, 12.35 and AOR: 3.08; 95% CI 1.26, 7.53, respectively). A considerable number of the patients had poor self-care practice, especially lack of social support and treatment modality, which have critical roles in controlling diabetes. Therefore, attention should be given to improve self-care practice.

BackgroundSuicidal ideation and attempts are more frequent in people with epilepsy than in general population and suicide attempt increases the chance of later completed suicide. The aim of this study was to assess the prevalence and associated factors of suicidal ideation and attempt among people with epilepsy in Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.MethodsInstitution-based cross-sectional study was conducted from May to June 2014 at Amanuel Mental Specialized Hospital among people with epilepsy. The pre-tested semi-structured questionnaire was used for interviewing the study participants. Logistic regression analysis was used to assess predictors of suicidal ideation and attempt.ResultsThe study indicated that the prevalence of suicidal ideation and attempt among people with epilepsy were 29.8 and 14.1%, respectively. Poor social support, drug treatment for mental illness, had co-morbid depression, no seizure free within 1 year and family history committed suicide were significantly associated with suicidal ideation and attempt.ConclusionThe prevalence of suicidal ideation and attempt in people with epilepsy found to be higher when compared to general population. Therefore, screening all epilepsy patients should be done for early diagnosis and treatment.

BackgroundDepression is the most frequently and highly occurring mental disorders in epilepsy patients. When depression is comorbid with epilepsy, it leads to low employment and poor quality of life. Thus, the aim of this study was to assess the prevalence and associated factors of depression among people living with epilepsy in Central Ethiopia.MethodsInstitution-based cross-sectional study was conducted from April to May 2015 at Amanuel Mental Specialized and TikurAnbesa Hospitals, Addis Ababa, Ethiopia. Samples of 422 epilepsy patients were selected, and data on depression were collected using validated questionnaire using face-to-face interview technique. Logistic regression analysis was performed to assess predictors of depression.ResultsThe study indicated that the prevalence of depression among people with epilepsy was 43.8%. Factors associated with depression were being female (AOR 2.48; 95% CI, 1.61.3.81), being single (AOR 2.23; 95% CI 1.38–3.60), perceived stigma (AOR 2.47; 95% CI 1.59–3.83), medication adherence (AOR 2.85; 95% CI 1.64–4.96), and current substance use (AOR 2.10; 95% CI 1.34–3.30).ConclusionThere is a high prevalence of depression among epilepsy patients. Early detection and prompt management of depressive symptoms are critically important in reducing depression burden among people living with epilepsy.

IntroductionKhat is a well-known natural stimulant and is widely used in Ethiopia, particularly in Bahir Dar city. Khat chewing is linked with risky sexual behaviors.ObjectiveThe study was aimed to determine the prevalence of chewing khat and its relation with risky sexual behaviors among residents of Bahir Dar City administration, Northwest Ethiopia.MethodsA community based cross-sectional study was conducted from January to February, 2016. The data were collected using an interviewer administered structured questionnaire. Logistic regression analysis was applied to assess association between dependent and explanatory variables.ResultsThe proportion of lifetime and current chewing khat among the study participants were 25.7 and 19.5%, respectively. Males (AOR 5.0; 95% CI 3.0–8.2) than females, merchants (AOR 4.9; 95% CI 2.6–9.3) than government employees, and those with average monthly income of ≥ 3001 Ethiopian birr (AOR 2.4; 95% CI 1.2–4.8) than ≤ 1000 had an increased current chewing khat prevalence. Having lifetime history of chewing khat was significantly associated with ever had sexual intercourse, having extra sexual partners, watching pornographic film and self-reported sexually transmitted infections.ConclusionChewing khat is associated with increment of having risky sexual behaviors and self-reported sexually transmitted infections. Harm reduction measures are needed to prevent the community from engaging in khat use and risky sexual behaviors.