Assessing the knowledge, attitudes and perceptions of tobacco-associated diseases and how it is influenced by tobacco products advertisement, promotion and sponsorship while enforcing a strong and comprehensive ban in Panama: a cross-sectional study

Abstract

ObjectivesAssessing the knowledge, attitudes and perceptions (KAP) of tobacco-associated diseases, and how it is influenced by tobacco products' advertisement, promotion and sponsorship (TAPS) while enforcing a strong and comprehensive ban.DesignThe Panamanian implementation of the Global Adult Tobacco Survey: an international standardised cross-sectional survey study.SettingNational Panamanian population aged between 15 years and 29 years old.ParticipantsThere were 4796 responding participants (n=905 830 in the expanded sample).Primary and secondary outcomesAn index was developed using factorial analysis using TAPS and KAP variables. The primary outcomes were: (1) The national median index value. (2) The index value stratified by sex, age, occupation, income quintile and geographical areas. (3) The first and second factor loadings (FFL and SFL, respectively) for variables included in the KAP index.ResultsFifteen out of the 16 variables comprising the index were variables related to KAP and one variable was related to TAPS. The top three variables according to their FFL were ‘KAP that cigarette is associated to …’: (1) ‘… bladder cancer’. (2) ‘… breast cancer’. (3) ‘… stomach cancer’. The top three variables according to the SFL were ‘KAP that cigarette is associated to …’: (1)‘… chronic bronchitis’. (2) ‘… myocardial infarction’. (3) ‘… lung cancer’. Illegal tobacco advertisement in posters was the only TAPS variable included in the index. The national KAP index value was 0.26. Our results show that current smokers, teens, men, people with the lowest income quintile, and those living in Guna Yala Indigenous Territory (health region with the highest smoking prevalence) had a lower median value than the national median.ConclusionsMen, young adults and deprived youth had the lowest median KAP index. Illegal TAPS had no influence on the KAP of tobacco-associated diseases when a strong and comprehensive ban is enforced.

Development and Validation of a Novel Recurrence Risk Stratification for Initial Non-Muscle Invasive Bladder Cancer in the Han Chinese Population

“…In the external validation group, we analyzed data from patients with NMIBC who underwent initial TURBT from the Zhongnan Hospital of Wuhan University between 2012 and 2014. The inclusion criteria for patients are: (1) Intraoperative pathology confirmed as NMIBC; (2) The patient who underwent initial TURBT; (3) The clinical stage is Ta or T 1 , and single or multiple NMIBC, and no clinical metastasis; (4) Patients undergoing standard intravesical instillation chemotherapy and regular cystoscopy; (5) Patients who completed follow-up after surgery; (6) Patient who has provided informed consent; (7) The general condition is good, no serious heart, lung, liver, kidney and other complications; (8) The patient was conscious and had no history of mental illness. Patients with any of the following were excluded: (1) Follow-up time is less than three months; (2) History of cancer; (3) History of radiotherapy and chemotherapy treatment; (4) History of BCG therapy; (5) Patients or their families are reluctant to participate in this study; (6) The patient's clinical pathology data is incomplete.…”

“…Bladder cancer has high morbidity and mortality worldwide, with nearly 549,393 newly diagnosed cases and approximately 199,922 patients dying each year [1]. In recent years, with the increase of tobacco consumption, and the development of industrialization, the incidence of bladder cancer has been increased year by year [2][3]. In China, the incidence and mortality of bladder cancer heads the list among urinary malignant tumors [4].…”

“…EORTC risk stratification divides NMIBC patients into low-risk, intermediate-risk, and high-risk recurrence groups, and then develops different treatment options through these groups [8]. However, there are certain restrictions on the EORTC, including the following aspects [10][11][12]: (1) The calculation steps of the EORTC are cumbersome; (2) No tumor heterogeneity was considered; (3) There is no evidence that EORTC can improve patient survival; (4) During the EORTC building process, TURBT did not receive intravesical instillation chemotherapy in 22% of patients, and only 6% of patients received postoperative intravesical Bacillus Calmette-Guerin (BCG) immunotherapy. Moreover, the effect of BCG instillation or intravesical instillation chemotherapy on recurrence was not considered; (5) Less than one-third of patients received immediate intravesical instillation after surgery, and fluorescent cystoscopy was not available at the time.…”