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200 papers
The Whole School Food Approach: A European framework and implementation to promote healthy and sustainable school food systems.
Vidal I, Beelen K, Smets A … +4 more , Rut M, Piirsalu E, Diez J, Franco M
Prev Med · 2026 Jan · PMID 41232613 · Publisher ↗
OBJECTIVE: We describe the development of the Whole School Food Approach framework and its implementation in 12 European countries participating in the European-funded project, SchoolFood4Change. METHODS: The framework w...
OBJECTIVE: We describe the development of the Whole School Food Approach framework and its implementation in 12 European countries participating in the European-funded project, SchoolFood4Change. METHODS: The framework was developed in 2022 by a multidisciplinary team following an evidence-based approach. Data on implementation criteria were collected through mixed-methods in schools between 2022 and 2025 in 17 cities. Surveys with national project coordinators assessed achievement of bronze-level criteria for each framework component. Implementation scores were calculated based on the number of bronze criteria achieved. Semi-structured interviews with city representatives explored perceptions, challenges, and enablers of implementation. RESULTS: The framework comprised four interrelated components and three scalable levels of progress: bronze, silver, and gold. To date, 549 schools have implemented it. Online surveys from participating cities and schools (n = 109) showed diverse levels of implementation across schools, with 21 achieving bronze-level. Semi-structured interviews (n = 16) identified cross-departmental collaboration, staff capacity, and time availability as main barriers. Political and institutional support was reported as the main facilitator for promoting school food policies. CONCLUSIONS: Findings showed a diverse implementation of the framework in participating European countries. Despite challenges, the Whole School Food Approach was perceived as a valuable tool for developing healthy and sustainable school food systems.
Induced abortion rates among women vaccinated against human papillomavirus: Registry-based follow-up of a community-randomized trial.
Taavela K, Koivisto T, Eriksson T … +3 more , Apter D, Lehtinen M, Louvanto K
Prev Med · 2026 Jan · PMID 41223949 · Publisher ↗
OBJECTIVE: Concerns have been raised that human papillomavirus (HPV)-vaccination programs may alter risk perceptions and increase risk-taking sexual behavior among adolescents. This study aimed to assess induced abortion...
OBJECTIVE: Concerns have been raised that human papillomavirus (HPV)-vaccination programs may alter risk perceptions and increase risk-taking sexual behavior among adolescents. This study aimed to assess induced abortion rates (as a potential indicator of such behavior) between vaccinated and unvaccinated individuals. METHODS: This longitudinal, cluster-randomized cohort study included 6200 HPV-vaccinated women born in 1992-1993 who participated in a 2007 launched HPV-vaccination trial in Finland, and 19,473 unvaccinated women born in 1990-1991 from the same communities. Registry data from a 12-year follow-up period (between 2007 and 2020, depending on the group) up to the age of 28 years was obtained from The Finnish Register on Induced Abortions. RESULTS: Incidence rate of induced abortions per 10,000 person-years was significantly lower among HPV-vaccinated (145.6(95 %CI 137.1,154.5)) compared to unvaccinated individuals (161.4(95 %CI 156.4,166.7)). HPV-vaccinated individuals induced abortions in earlier gestational weeks (p = 0.049). Up to four-years post sexual health education given at HPV vaccination visits, induced abortion rates were significantly lower among individuals aged 15-19 (33.7(95 %CI 29.8,38.2)) than age-aligned unvaccinated controls (42.4(95 %CI 38.9,44.1)). CONCLUSIONS: HPV-vaccinated had lower induced abortion rates than unvaccinated individuals. When further developing HPV-vaccination programs, simultaneous sexual health education should be considered to comprehensively improve the reproductive health of adolescents.
Tobacco use and eligibility for lung cancer screening among dental patients at an academic institution in Houston, Texas.
Neumann AS, Toumazis I, O'Brien JA … +4 more , Beneventi D, Annam SK, Joy-Thomas A, Volk RJ
Prev Med · 2026 Jan · PMID 41213458 · Full text
OBJECTIVE: Tobacco use negatively impacts oral and general health and influences dental treatment outcomes. To advance prevention, we surveyed dental patients at an academic institution to characterize their history of t...
OBJECTIVE: Tobacco use negatively impacts oral and general health and influences dental treatment outcomes. To advance prevention, we surveyed dental patients at an academic institution to characterize their history of tobacco use and eligibility for lung cancer screening (LCS). METHODS: Anonymous surveys were administered to adult dental patients at the UTHealth Houston School of Dentistry between April 2022 and October 2022. Surveys collected information on smoking history, pack-year history, health literacy, personal and family history of lung cancer, and previous LCS. Demographic variables included age, gender, race/ethnicity, and education level. RESULTS: Among 432 patients (mean age: 46.4, range 18-88 years, 57.0 % female), 22.7 % were patients who currently smoked cigarettes, and 13.2 % were patients who formerly smoked. Smoking rates were highest among males (36.2 %) and patients younger than 50 (26.0 %). Among patients who currently smoked, 44.1 % met eligibility for LCS based on age and a 20+ pack-year smoking history; 43.2 % of patients who formerly smoked were eligible for LCS. CONCLUSIONS: A substantial proportion of patients are eligible for LCS; tailored cessation counseling and electronic-referral pathways could impact screening and cessation support for millions of high-risk adults who visit a dentist each year, closing a critical gap in cancer prevention.
Incidence and synergistic Association of Type 2 diabetes and apolipoprotein E epsilon 4 with dementia risk in the Kunshan aging research with E-health cohort study.
Dong W, Bai J, Wu B … +2 more , Zhou K, Jiang H
Prev Med · 2026 Jan · PMID 41202930 · Publisher ↗
OBJECTIVE: To investigate the independent and combined associations of type 2 diabetes (T2D) and APOE genotype on dementia risk. METHODS: We analyzed 104,911 participants aged ≥50 years from the Kunshan Aging Research wi...
OBJECTIVE: To investigate the independent and combined associations of type 2 diabetes (T2D) and APOE genotype on dementia risk. METHODS: We analyzed 104,911 participants aged ≥50 years from the Kunshan Aging Research with E-Health cohort (2018-2024). Incident dementia was identified using electronic medical records. Cox proportional hazards models and additive interaction analyses assessed associations and interactions. RESULTS: Over a median follow-up of 6.19 years, 8115 participants developed dementia. T2D was associated with higher risks of all-cause dementia (HR:2.06), Alzheimer's disease (HR:2.16), and vascular dementia (HR:1.62). APOE ε4 carriers had higher Alzheimer's risk (HR:1.35), while ε2 carriers had lower risk (HR:0.87). The combination of T2D and ε4 was associated with the highest Alzheimer's risk (HR:2.87) with a significant positive additive interaction. In men, T2D interacted with ε2 on a multiplicative scale, whereas in women, a positive additive interaction was observed between T2D and ε2 for Alzheimer's disease. CONCLUSIONS: T2D was associated with higher dementia risk. APOE ε4 was associated with higher and ε2 with lower Alzheimer's risk. A positive additive T2D-ε4 interaction and sex-specific ε2 associations underscore integrating diabetes management with genetic profiling to optimize dementia risk reduction strategies.
Correlates of antibiotic use in U.S. adults: An analysis of medical expenditure panel survey data, 2017-2022.
Abousamra E, Borrell LN
Prev Med · 2026 Jan · PMID 41187863 · Publisher ↗
OBJECTIVE: To identify sociodemographic and health-related correlates of antibiotic use in U.S. adults and determine whether racial/ethnic and regional disparities persisted throughout and after the COVID-19 pandemic. ME...
OBJECTIVE: To identify sociodemographic and health-related correlates of antibiotic use in U.S. adults and determine whether racial/ethnic and regional disparities persisted throughout and after the COVID-19 pandemic. METHODS: Using data from the Medical Expenditure Panel Survey (2017-2022) for 118,110 U.S. adults aged 18 years or older, Poisson regression was used to quantify the associations of interest via prevalence ratios (PR) and 95 % confidence intervals (CI). Effect modifications of race/ethnicity and region with pandemic periods were evaluated. RESULTS: The prevalence of antibiotic use was 14.3 %. In adjusted analyses, adults aged 65 or older (PR = 1.27, 95 %CI:1.20, 1.35), women (PR = 1.45, 95 %CI:1.40, 1.51), and privately insured individuals (PR = 1.67, 95 %CI:1.50,1.87) had higher antibiotic use than their counteraprts who were aged 18-34 years, men, and uninsured. Higher education was associated with a higher probability of antibiotic use. Hispanic (PR = 0.65, 95 %CI:0.60, 0.71), Black (PR = 0.61, 95 %CI: 0.57, 0.65), and Asian adults (PR = 0.54, 95 %CI:0.47, 0.62) use less antibiotics than White adults. Antibiotic used was greater in the South (PR = 1.18, 95 %CI:1.09, 1.28) and Midwest (PR = 1.12, 95 %CI:1.03, 1.22) than the Northeast. Chronic bronchitis showed the strongest association (PR = 1.34, 95 %CI:1.23, 1.46). No interactions of race/ethnicity and region with pandemic period were observed (p-values>0.12). CONCLUSIONS: Given the observed antibiotic use disparities, stewardship efforts require strategies targeting specific groups to address inequities.
Assessing the association between cannabis use frequency and heart disease in adults aged under 50: National Survey on Drug Use and Health, 2021-2023.
Earl M, Bhandari R
Prev Med · 2026 Jan · PMID 41175987 · Publisher ↗
OBJECTIVE: Cannabis use has increased among younger adults in the United States alongside rising rates of heart disease. This study examines the association between cannabis use frequency and heart disease among adults a...
OBJECTIVE: Cannabis use has increased among younger adults in the United States alongside rising rates of heart disease. This study examines the association between cannabis use frequency and heart disease among adults aged 18-49. METHODS: A cross-sectional analysis of 88,166 United States adults aged 18-49 was conducted using 2021-2023 National Survey on Drug Use and Health data. Cannabis use frequency was measured as days of cannabis use in the past year. A weighted logistic regression model estimated the adjusted odds ratio (aOR) for heart disease, controlling for demographics, smoking, and heavy drinking. Additionally, A dose-response analysis was performed to further assess the relationship. RESULTS: Cannabis users had significantly higher odds of heart disease compared to non-users. Each 90-day increase in cannabis use was associated with 9 % higher odds of heart disease (aOR: 1.09; 95 % Confidence Interval: 1.03, 1.15). Daily users had 40 % higher odds of heart disease compared to non-users (aOR = 1.40; 95 % Confidence Interval: 1.11, 1.76). A clear dose-response relationship was observed. CONCLUSIONS: Cannabis use frequency is significantly associated with higher odds of heart disease among US adults under 50. Findings demonstrate a positive linear relationship and indicate cannabis use as a potential modifiable risk factor for early-onset heart disease.
Determinants of successful completion and short-term benefits associated with temporary alcohol abstinence during Dry January in France: A prospective cohort study.
Lespine LF, François D, Haesebaert J … +5 more , Delile JM, Savy M, Naassila M, de Ternay J, Rolland B
Prev Med · 2026 Jan · PMID 41110619 · Publisher ↗
OBJECTIVE: Temporary alcohol abstinence campaigns (TAAC), such as Dry January, aim to encourage behavioural change in the general population. Despite its popularity, a comprehensive evaluation of the French version has n...
OBJECTIVE: Temporary alcohol abstinence campaigns (TAAC), such as Dry January, aim to encourage behavioural change in the general population. Despite its popularity, a comprehensive evaluation of the French version has not yet been conducted. This prospective study aimed to identify characteristics associated with successful completion of the challenge (i.e., remaining alcohol-free throughout January), and to assess improvements in drinking refusal self-efficacy, sleep quality, and mental and physical health. METHODS: A sample of 2123 French adults participating in Dry January 2024 completed both a baseline and a one-month follow-up questionnaire online. A broad range of variables were assessed, including demographic and contextual factors, alcohol use patterns and motives, drinking refusal self-efficacy, and health-related outcomes. RESULTS: Key factors positively associated with successful completion included previous participation, registration, and higher baseline self-efficacy in resisting alcohol in social situations. Among registrants, greater engagement with support emails significantly increased the likelihood of abstinence. In contrast, smoking and identifying one's drinking as excessive were linked to lower odds of completion. The campaign was associated with improvements in drinking refusal self-efficacy, mental well-being, sleep quality, and physical health - particularly among participants who completed the full month without alcohol. CONCLUSIONS: This study offers the first evaluation of the French version of Dry January, highlighting the factors influencing challenge completion and short-term benefits of participation. The findings add support to the value of TAAC as scalable and impactful public health tools and underscore the importance of tailored support strategies to maximize participant success and behavioural change.
Stagnating declines in cardiovascular disease mortality in the United States expanded the black-white life expectancy gap.
Abrams LR, Brower N
Prev Med · 2026 Jan · PMID 41101740 · Full text
OBJECTIVE: To assess how stagnation in cardiovascular disease (CVD) mortality declines since 2010 impacted racial disparities in life expectancy between Black and White Americans. METHODS: We analyzed U.S. vital statisti...
OBJECTIVE: To assess how stagnation in cardiovascular disease (CVD) mortality declines since 2010 impacted racial disparities in life expectancy between Black and White Americans. METHODS: We analyzed U.S. vital statistics from 2000 to 2022 to compare age-standardized CVD mortality trends in Black and White middle-aged and older adults. Using life tables, we then estimated racial differences in life expectancy under observed mortality conditions and under a counterfactual scenario in which CVD mortality had continued to decline in 2010-2022 at pre-2010 rates. RESULTS: In 2000-2009, CVD mortality was declining more quickly among Black Americans, and the Black-White life expectancy gap narrowed by 1.39 years for women and 1.44 years for men. Progress slowed after 2010. Had pre-2010 CVD mortality trends continued, Black women would have lived 2.04 years longer in 2019, narrowing the 1.88-year Black-White life expectancy gap by 0.43 years. If improvements had continued through 2022, Black women would have lived 2.83 years longer, translating to a 0.64-year reduction in the Black-White life expectancy gap. Men exhibited a similar pattern with a smaller effect. CONCLUSIONS: The post-2010 slowdown in CVD mortality declines disproportionately limited longevity gains for Black Americans, especially Black women.
Does loneliness impact intentional weight loss? The role of obesity-related disadvantages and comorbidities.
Männistö SA, Joki A, Suojanen LU … +3 more , Venäläinen MS, Pietiläinen KH, Ahola AJ
Prev Med · 2026 Jan · PMID 41082943 · Publisher ↗
OBJECTIVE: Loneliness is increasingly recognized as a significant factor influencing health outcomes, including weight management. Nevertheless, its role in intentional weight loss remains underexplored. The 12-month dig...
OBJECTIVE: Loneliness is increasingly recognized as a significant factor influencing health outcomes, including weight management. Nevertheless, its role in intentional weight loss remains underexplored. The 12-month digital Healthy Weight Coaching (HWC), in Finland, offers a real-world context to investigate this relationship. We explored whether baseline loneliness affects weight loss during HWC and whether comorbidities or perceived obesity-related disadvantages mediate this relationship. METHODS: Data were included from participants enrolled in the HWC between 2016 and 2020. Baseline assessments included loneliness, comorbidities, and perceived obesity-related disadvantages. Weight was self-reported weekly, with body mass index calculated from interpolated weights at three, six, nine, and 12 months. Generalized estimating equations were used to analyze the impact of baseline loneliness on weight change, and ordinary least squares regression analyses were used to analyze mediation. RESULTS: Participants who felt lonely, somewhat lonely, or not lonely at baseline achieved comparable weight loss. However, higher loneliness was linked to greater perceived obesity-related disadvantages, psychological distress, number of comorbidities, and lower vitality, indirectly leading to lesser weight loss. CONCLUSIONS: Loneliness did not directly hinder weight loss but was linked to health and psychosocial challenges that may indirectly reduce success, highlighting the need for holistic support in weight management. TRIAL REGISTRATION: The trial is registered at clinicaltrials.gov (Clinical Trials Identifier NCT04019249).
Association between smoking cessation and risk for type 2 diabetes, stratified by post-cessation weight change: A systematic review and meta-analysis.
Yu Y, Li Y, Nguyen TT … +4 more , Yue D, Tchangalova N, Flouton CE, Liu H
Prev Med · 2026 Jan · PMID 41077255 · Publisher ↗
OBJECTIVE: While smoking cessation reduces health risks, its impact on type 2 diabetes mellitus (T2DM) remains complex when considering post-cessation weight gain. This systematic review and meta-analysis examined the as...
OBJECTIVE: While smoking cessation reduces health risks, its impact on type 2 diabetes mellitus (T2DM) remains complex when considering post-cessation weight gain. This systematic review and meta-analysis examined the association between smoking cessation and diabetes risk stratified by weight change and cessation duration. METHODS: We searched seven databases through April 14, 2025. Observational studies examining smoking cessation, weight changes, and T2DM were included. Random-effects models pooled hazard ratios (HRs) comparing recent and long-term quitters to continuous/never smokers, stratified by weight gain. RESULTS: Among eleven cohort studies, quitters with weight gain showed increased diabetes risk versus continuous smokers (HR = 1.71, 95 % CI: 1.12, 2.62), with recent quitters having greater risk (HR = 2.20, 95 % CI: 1.27, 3.82) but long-term quitters showing reduced risk (HR = 0.91, 95 % CI: 0.87, 0.95). Quitters without weight gain demonstrated no increased risk (recent: HR = 0.99, 95 % CI: 0.81, 1.02) and lower risk (long-term: HR = 0.84, 95 % CI: 0.81, 0.87). Compared to never-smokers, recent quitters had a higher T2DM risk regardless of weight status (with gain: HR = 1.61, 95 % CI: 1.03, 2.50; without gain: HR = 1.25, 95 % CI: 1.05, 1.48), while long-term quitters showed no significant difference. CONCLUSIONS: Smoking cessation temporarily increases T2DM risk, particularly with weight gain, but becomes protective long-term, emphasizing weight management.
Adverse birth outcomes in alcohol-exposed pregnancies with or without tobacco and cannabis.
Anunziata F, Frankeberger J, Baer RJ … +2 more , Chambers C, Bandoli G
Prev Med · 2026 Jan · PMID 41062033 · Publisher ↗
OBJECTIVE: To examine the risk of preterm birth (PTB) and small for gestational age (SGA) infants among pregnant persons with alcohol use diagnoses, alone or with comorbid cannabis or tobacco use diagnoses. METHODS: Data...
OBJECTIVE: To examine the risk of preterm birth (PTB) and small for gestational age (SGA) infants among pregnant persons with alcohol use diagnoses, alone or with comorbid cannabis or tobacco use diagnoses. METHODS: Data from California birth certificates (2007-2021) were linked to maternal/infant hospitalization records. Maternal ICD 9-10 codes indicated substance use diagnoses. We calculated the adjusted risk ratios (aRR) and 95 % confidence intervals (CIs) of extreme/very PTB (<32 weeks' gestation), late PTB (32-36 weeks), and SGA (<10th centile for birth weight) among those with alcohol alone versus alcohol with tobacco and/or cannabis use diagnoses. RESULTS: Compared to alcohol alone, co-occurring alcohol and tobacco were associated with higher risks of extreme/very PTB (aRR = 1.44, 95 % CI = 1.09, 1.89), late PTB (aRR = 1.25, 95 % CI = 1.12, 1.40), and SGA infants (aRR = 1.31, 95 % CI = 1.19, 1.44). Individuals with alcohol and cannabis were at increased risk of SGA infants (aRR = 1.21, 95 % CI = 1.05, 1.38). Those with indications of all three substances had higher risk of extreme/very PTB (aRR = 1.68, 95 % CI = 1.17, 2.40) and SGA infants (aRR = 1.29, 95 % CI = 1.13, 1.48). CONCLUSIONS: Among those with an alcohol diagnosis, prenatal co-exposure to tobacco with or without cannabis was associated with increased risk of PTB and SGA relative to alcohol alone. Screening for and addressing prenatal polysubstance use should be prioritized.
Physical activity and subjective cognitive decline among U.S. older adults: A population-based analysis of the 2023 behavioral risk factor surveillance system.
Hao G, Guenzel N, Michaud TL
Prev Med · 2026 Jan · PMID 41057088 · Publisher ↗
OBJECTIVES: This study sought to assess associations between physical activities and subjective cognitive decline (SCD) among older adults aged 65 years and above. METHODS: Data were drawn from the 2023 Behavioral Risk F...
OBJECTIVES: This study sought to assess associations between physical activities and subjective cognitive decline (SCD) among older adults aged 65 years and above. METHODS: Data were drawn from the 2023 Behavioral Risk Factor Surveillance System and included older adults who completed the cognitive decline module. Multivariable regression models were performed to assess the relationship between self-reported physical activity levels and SCD. We further conducted stratified analyses of 11 types of primary physical activity. RESULTS: Among 73,339 older adults, 33.1 % reported no physical activity, 14.7 % reported insufficient physical activity, 28.4 % met one guideline only, and 23.8 % met both guidelines. Walking (39.7 %), gardening or yard work (8.6 %), and bicycling (2.7 %) were the most commonly reported primary physical activities. As compared to those without physical activities, older adults who engaged in physical activity and met guidelines were less likely to report SCD (only one guideline, Adjusted Prevalence Ratio[95 % CI] = 0.87[0.78, 0.96]; both guidelines, APR[95 % CI] = 0.81[0.73, 0.90]). Participation in certain primary activity types, combined with meeting at least one physical activity guideline, was associated with lower odds of SCD. CONCLUSIONS: Our findings highlight the importance of meeting physical activity guidelines to mitigate the risk of SCD among older adults and reveal varying effects by primary activity types.
Cigarette smoking prevalence, nicotine dependence, and quit ratios among U.S. adult females by residence and military-veteran status: 2002-2023.
McDaniel JT, Redner R, Coleman SRM … +4 more , Klemperer EM, Chen FF, Bolívar HA, Higgins ST
Prev Med · 2025 Dec · PMID 41033470 · Full text
OBJECTIVE: Examine nationally representative U.S. data to determine trends in cigarette smoking, nicotine dependence, and quit ratios among females by rurality and veteran status between 2002 and 2023. METHODS: Data were...
OBJECTIVE: Examine nationally representative U.S. data to determine trends in cigarette smoking, nicotine dependence, and quit ratios among females by rurality and veteran status between 2002 and 2023. METHODS: Data were obtained from the 2002-2023 files (N = 454,981) of the National Survey on Drug Use and Health. Adult female respondents were categorized by rural/urban residence and veteran/nonveteran status to examine smoking outcomes across 3-year intervals. To adjust for non-response, selection probability, and post-stratification, analyses were conducted using survey weighted logistic regression models controlling for socio-demographic covariates. RESULTS: Smoking prevalence was higher among rural versus urban residents (aOR = 1.55, 95 %CI = 1.43, 1.67) and veterans versus nonveterans (aOR = 1.72, 95 %CI = 1.36, 2.17). Nicotine dependence was higher among rural versus urban residents (aOR = 1.84, 95 %CI = 1.66, 2.03) and veterans versus nonveterans (aOR = 1.49, 95 %CI = 1.08, 2.06). Quit ratios were lower in rural versus urban residents (aOR = 0.70, 95 %CI = 0.63, 0.78), but not among veterans (aOR = 0.83, 95 % CI = 0.62, 1.10). Rates of decline over time in smoking prevalence and nicotine dependence, as well as increases in quit ratios, were lower among rural residents (p's < 0.001) whereas changes by veteran status did not interact with time. CONCLUSIONS: Results across 21 years from a nationally representative US survey substantiate a growing rural-urban disparity in smoking that disproportionately impacts rural females. We also identified a disparity that disproportionately impacts veteran compared to nonveteran females. Thus, rural and veteran female populations need targeted treatment interventions.
Determinants of smoke-free homes adoption among Spanish adults who smoke: A prospective cohort study from the 2016-2021 International Tobacco Control (ITC) EUREST-PLUS Spain Surveys.
Tigova O, Castellano Y, Fu M … +5 more , Driezen P, Martínez C, Quah ACK, Fong GT, Fernández E
Prev Med · 2025 Nov · PMID 40976422 · Publisher ↗
OBJECTIVE: To assess the prevalence and associated factors of smoke-free homes (SFHs) among Spanish adults who smoke across three cohort waves, and to identify determinants of SFH adoption during follow-up (2016-2021). M...
OBJECTIVE: To assess the prevalence and associated factors of smoke-free homes (SFHs) among Spanish adults who smoke across three cohort waves, and to identify determinants of SFH adoption during follow-up (2016-2021). METHODS: The International Tobacco Control EUREST-PLUS Spain Survey is a nationally representative cohort of ∼1000 adults (≥18 years) who smoke surveyed in 2016, 2018, and 2021. First, we conducted repeated cross-sectional analysis to estimate the prevalence of SFHs at each wave. Second, we estimated incidence and risk ratios (RR) with 95 % confidence intervals (CI) for SFH adoption during the follow-up using adjusted generalised linear models. Independent variables included sociodemographics, smoking characteristics, and beliefs about second-hand smoke harms. RESULTS: SFH prevalence was 13.1 % in 2016, 19.0 % in 2018, and 31.5 % in 2021 (p trend <0.001). Quitting smoking (RR = 2.66; 95 % CI: 2.10, 3.36), remaining in any stage other than precontemplation (RR = 1.76; 1.13, 2.73) and progressing beyond precontemplation stage (RR = 2.59; 1.99, 3.37) were determinants of SFH adoption. Maintaining moderate or high nicotine dependence (RR = 0.46; 0.30, 0.69) was inversely associated with SFH adoption. CONCLUSIONS: SFH prevalence among Spanish adults who smoke increased in 2016-2021. Initiatives promoting SFHs should encourage progression through the stages of change towards cessation and provide tailored support for individuals with high nicotine dependence.
Physical activity in youth and cardiovascular disease risk in later-life: Mediation by mid-life factors in a large cohort of Swedish adults.
Söderström F, Ekblom-Bak E, Paulsson S … +1 more , Väisänen D
Prev Med · 2025 Nov · PMID 40976421 · Publisher ↗
OBJECTIVE: The aims were to investigate the association between youth physical activity and the risk of cardiovascular disease (CVD) later in life in men and women and whether mid-life lifestyle-associated factors, inclu...
OBJECTIVE: The aims were to investigate the association between youth physical activity and the risk of cardiovascular disease (CVD) later in life in men and women and whether mid-life lifestyle-associated factors, including exercise, smoking, Body Mass Index (BMI), and cardiorespiratory fitness (VOmax), mediate this association. METHODS: Data from 269,431 Swedish participants (52 % men) who participated in occupational health profile assessments between 1995 and 2023 were included. Youth physical activity was self-reported as overall participation in school-based physical education and physical activity outside school before age 20. CVD incidence was obtained from national registers. Mediation analyses assessed mid-life lifestyle-associated factors' influence on the association. RESULTS: Compared to those reporting no physical education participation, participation in only physical education was associated with a 18 % lower risk for CVD later in life (HR = 0.82, 95 % CI 0.70,0.95). Participating in additional physical activity outside school yielded varying risk estimates (HR = 0.78, 95 % CI 0.67,0.90 for one to two times/week; HR = 0.84, 95 % CI 0.73,0.97 for three to five times/week). VOmax, BMI, and smoking mediated 16 %-32 % of the association. In the single mediation model, cardiorespiratory fitness explicitly mediated the association in those who participated in physical education and at least one weekly sessions of physical activity outside school. CONCLUSION: Youth refraining from participating in physical education class could be considered a risk group for later-life CVD. Mediation analyses suggest that engaging in only physical education or with additional physical activity outside school in youth, may confer more healthy behaviour in mid-life, which explain the lower CVD risk.
Cardiopulmonary effects of very low nicotine content cigarettes with and without access to e-cigarettes in vulnerable populations.
Menson KE, Gaalema DE, Katz BR … +5 more , Tidey JW, Lee DC, Plucinski S, DeSarno M, Higgins ST
Prev Med · 2025 Dec · PMID 40975670 · Full text
OBJECTIVE: Reducing nicotine levels in cigarettes decreases smoking, which is enhanced by access to preferred-flavor e-cigarettes. Smoking increases risk of cardiopulmonary disease, but effects of very-low-nicotine-conte...
OBJECTIVE: Reducing nicotine levels in cigarettes decreases smoking, which is enhanced by access to preferred-flavor e-cigarettes. Smoking increases risk of cardiopulmonary disease, but effects of very-low-nicotine-content cigarettes (VLNCs) in combination with e-cigarettes are unknown. Health effects of nicotine-reduction approaches must be examined. METHODS: Data were from three randomized controlled trials conducted at the University of Vermont, Brown University, and Johns Hopkins University (October 2020-November 2023). Effects, within vulnerable populations, of 16 weeks of normal nicotine content cigarettes (NNC), VLNCs only, VLNCs plus e-cigarettes in only tobacco flavor (VLNC+TF), or VLNCs in combination with the option to select from eight commonly preferred flavors (VLNC+PF) were tested. Cardiopulmonary measures included vital signs and subjective respiratory symptoms. Effect of experimental condition on outcomes were examined using multivariable linear mixed models controlling for baseline values, age, sex, study week, and vulnerable population (lower-educated women [n = 80], those with opioid use disorder [n = 74], or affective disorders [n = 172]). RESULTS: Most (243/326, 74.5 %) participants were high-risk for cardiopulmonary disease (i.e., hypertension). There were no significant effects of experimental condition on objective cardiac or pulmonary measures. Within respiratory symptoms there were significant effects of condition on subjective ratings of cough severity especially among patients with preexisting disease (F(3,48) = 4.02, p = 0.01, partial η = 0.08) with higher severity ratings in the NNC and VLNC+PF compared to VLNC alone or VLNC+TF conditions (Ps < 0.05). CONCLUSIONS: Combining VLNCs with e-cigarettes in preferred flavors appears to have no adverse effects on objective cardiopulmonary measures but may increase subjective ratings of cough severity in higher-risk pulmonary subpopulations.
Health inequalities: Is adolescent involvement in the legal system associated with reduced health care access and usage during adulthood?
Silver IA, Newsome J, Cohen T
Prev Med · 2025 Nov · PMID 40953738 · Publisher ↗
OBJECTIVE: This study examined the association between being involved in the criminal legal system prior to age 18 and access to medical coverage/care in adulthood. METHODS: Data from the National Longitudinal Survey of...
OBJECTIVE: This study examined the association between being involved in the criminal legal system prior to age 18 and access to medical coverage/care in adulthood. METHODS: Data from the National Longitudinal Survey of Youth-1997 (NLSY-97) birth cohort - a United States based sample collected from 1997 to 2021 - was analyzed to estimate differences in the probability of having health coverage or accessing medical care across four groups with varying involvement in the criminal legal system prior to age 18. RESULTS: Arrests before 18 was associated with a 8.9 % reduction in health insurance endorsement (2003-2021), a 3 % reduction in routine check-up endorsement (2003-2021), and a 4 % increase in visiting a doctor when sick (2003-2008). Incarceration in juvenile facilities was associated with a 29 % decrease, a 16 % decrease, and a 21 % decrease in the three dependent variables (respectively). Incarceration in adult facilities before 18 was associated with a 36 % decrease, a 15 % decrease, and a 7 % increase in the three dependent variables (respectively). CONCLUSIONS: Being arrested, incarcerated in a facility for juveniles, or incarcerated in an adult facility before 18 may be linked to reduced access to medical insurance and medical care during adulthood.
Longitudinal association of change in physical activity and cognitive performance in midlife women: Study of women's health across the nation.
Wente KR, Dugan SA, Powell LH … +3 more , Kravitz HM, Karavolos K, Janssen I
Prev Med · 2025 Nov · PMID 40946752 · Full text
OBJECTIVE: To determine if physical activity increase at midlife is associated with less cognitive decline over time. METHODS: The Study of Women's Health Across the Nation, an ongoing longitudinal study, started in 1996...
OBJECTIVE: To determine if physical activity increase at midlife is associated with less cognitive decline over time. METHODS: The Study of Women's Health Across the Nation, an ongoing longitudinal study, started in 1996 with a diverse cohort of midlife women, and. Included cognitive and physical activity tests. Analytic baseline for physical activity was the average of visits zero through six, prior to cognitive testing. Women missing educational levels or baseline stroke, or fewer than two baseline physical activity or three cognitive assessments, were excluded. Change in physical activity was calculated as difference between metabolic equivalent of task (MET) hours at analytic baseline and visits nine, 12, 13, and 15 (2017). Cognitive baseline was defined at visit nine to reduce practice effects. Longitudinal association between physical activity change and cognition for processing speed [Symbol Digit Modalities Test (SDMT)], working memory [Digit Span Backwards (DSB)], and verbal episodic memory [East Boston Memory Test- delayed recall (EBMT-d)] were analyzed using mixed linear and Poisson regression models. RESULTS: Our sample consisted of 2020 women. Baseline MET hours/week was Mean (SD) 6.8 (2.4). Increases in MET hours/week from physical activity baseline was positively associated with higher SDMT scores over time, adjusting for sociodemographic, medical, and emotional-behavioral factors [β = 0.02 (0, 0.04)]. No significant associations were observed for the other two measures. CONCLUSION: Physical activity increase was associated with higher processing speed over time but not with working or verbal episodic memory. Increased physical activity in midlife women may delay cognitive decline.
Digital health strategies for sudden infant death syndrome prevention: A scoping review.
Ejezie CL, Sacca L, Burgoa S … +4 more , Zerrouki Y, Oladoyin OO, Anunobi PC, Messiah SE
Prev Med · 2025 Nov · PMID 40934978 · Publisher ↗
OBJECTIVE: Sudden infant death syndrome (SIDS) has been widely studied, leading to the development of various preventive interventions. However, the application of digital health strategies for SIDS prevention remains la...
OBJECTIVE: Sudden infant death syndrome (SIDS) has been widely studied, leading to the development of various preventive interventions. However, the application of digital health strategies for SIDS prevention remains largely unexplored. This study was conducted to identify and characterize the digital health strategies that have been utilized to address SIDS. METHODS: The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews and the Arksey and O'Malley methodological framework were used to guide this review. PubMed, CINAHL, and Ovid MEDLINE were searched for relevant peer-reviewed manuscripts published from database inception to April 2024. Peer-reviewed studies in English that utilized digital health strategies were included. Articles that did not explicitly indicate the use of digital health interventions for SIDS prevention were excluded. RESULTS: Eighteen peer-reviewed manuscripts were included in this review. The type of digital health technology and/or strategies used included video, livestream, digital document, online/web-based program, telephone, blog posts, Instagram post, home monitor, email, and text message. SIDS prevention efforts employed included education, sleep guidelines, sleep instructions, sleep recommendations, modeling, skills training, and safe sleep policy. CONCLUSIONS: Overall, the application of digital health strategies for SIDS prevention remains limited. More research is needed to examine how digital health technologies can be better employed to address SIDS.
Persistent sex differences in diabetes management (1997-2022): 25 years of national evidence from the Swiss Health Survey.
Yi S, Marques-Vidal P
Prev Med · 2025 Nov · PMID 40915368 · Publisher ↗
OBJECTIVE: To evaluate sex-specific trends in diabetes management in Switzerland over a 25-year period using nationally representative data, and to determine whether menopausal status modifies these differences. METHODS:...
OBJECTIVE: To evaluate sex-specific trends in diabetes management in Switzerland over a 25-year period using nationally representative data, and to determine whether menopausal status modifies these differences. METHODS: We analyzed six Swiss Health Surveys (1997-2022) to assess sex differences in diabetes screening, diagnosis, treatment, and control. Multivariable logistic regressions were adjusted for demographic, socioeconomic, and lifestyle covariates. Age-stratified analyses explored life-stage-specific patterns, using age > 50 as a proxy for menopausal status. RESULTS: A total of 80,133 participants (54.5 % female) were included. After multivariable adjustment, females showed a higher likelihood of recent diabetes screening than males across all survey years (e.g., OR 1.20, 95 % CI 1.12-1.28 in 2022), with no evidence of narrowing over time. Conversely, females had a consistently lower likelihood of being diagnosed with diabetes (e.g., OR 0.71, 95 % CI 0.63-0.81 in 2022) and of being treated once diagnosed (e.g., OR 0.56, 95 % CI 0.40-0.80 in 2022), with no temporal improvement. No significant sex differences in diabetes control were observed among those treated. Age-stratified analyses revealed that sex disparities varied by age, potentially reflecting that life-stage-related factors may contribute to the observed disparities. CONCLUSIONS: This study highlights persistent, age-modulated sex differences in diabetes management over two decades in Switzerland. While diabetes control was similar between sexes once treatment was initiated, inequities in screening, diagnosis, and treatment remain.
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