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Introduction Lung cancer is the most commonly diagnosed cancer worldwide and is the leading cause of cancer death. Smoking is a major contributor to the pathogenesis of lung cancer. Cytochrome P450 2A6 (CYP2A6) is responsible for the metabolic activation of most tobacco carcinogens. CYP2A6 genetic polymorphism can cause variations in the human metabolism of xenobiotics. We performed this meta-analysis to determine the association between whole-gene CYP2A6 deletion polymorphism (CYP2A6*4) and lung cancer risk. Methods The PubMed, SAGE, Science Direct, the Cochrane Library and Ovid databases were searched for observational studies before October 2018. Methodological quality was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Results Nine case-control studies involving 4385 lung cancer cases and 4142 controls were included in the analysis. The random-effects model was used to combine results from individual studies. The pooled odds ratio was 0.39 (95% CI 0.27-0.56). There was no heterogeneity across studies (χ2=2.49, p=0.96, I2=0%). Conclusions Current evidence from the case-control studies suggests that the CYP2A6 whole-gene deletion polymorphism decreases the risk of lung cancer. Further research is needed to identify any potential confounding factors that may impact this association.Introduction Province-specific initiatives are at the forefront of tobacco control but limited studies have provided province-specific assessment of smoking-attributable cancer burden in China. Methods We estimated the fraction of total and site-specific cancer mortality attributable to tobacco smoking in 31 provinces in mainland China. The population attributable fractions (PAFs) for cancer deaths due to smoking were calculated by Levin's formula using province-specific smoking prevalence data around 1998 (assuming a 15-year latency time) and relative risks from cohort studies and meta-analyses. The 95% confidence intervals (CIs) of PAFs were calculated by a Delta method. Cancer deaths were abstracted from cancer registry data of the 31 provinces in mainland China in 2013. Results Overall, smoking contributed to a total of 421566 cancer deaths in mainland China in 2013 (19.46% of all cancer deaths), with 400701 of these deaths occurring in men (29.34%) and 20865 (2.61%) in women. The population attributable fractions ranged from 15.56% (95% CI 9.12-21.82%) in Tibet to 35.09% (95% CI 25.68-45.83%) in Guizhou among men, and from 0.28% (95% CI 0.00-0.64%) in Hainan to 10.44% (95% CI 4.86-16.32%) in Jilin among women. Cancers of lung and liver were the two main smoking-attributable cancers for both men and women. Conclusions Tobacco smoking was responsible for nearly 20% of all cancer deaths in mainland China, but the proportion of cancer deaths attributable to smoking varied substantially across provinces. More effective programs and innovative new strategies for local tobacco control are warranted to reduce the future burden of smoking-related cancers in all provinces of mainland China.Introduction There is a growing literature on the 'crowding-out' effects of tobacco expenditure, particularly in Low-to-Middle Income Countries (LMICs). However, there is no published study investigating these effects in the context of Ghana, a country where tobacco consumption is expected to increase in the future. This study aims to investigate whether tobacco influences expenditure patterns within Ghanaian households. Methods We estimate a demand system of quadratic conditional Engel curves for a set of twelve groups of commodities using the 2012/2013 Ghana Living Standards Survey. Unlike previous studies we use the GMM 3SLS estimator, which provides more efficient parameter estimates due to heteroskedastic errors inherent in cross-sectional datasets of this nature. Results The results show that Ghanaian households that spend on tobacco are more likely to spend also on alcohol, recreation, transport and communications, but less on food, housing, and health needs. RK 24466 Conclusions Tobacco expenditure, through its 'crowding-in' effects on alcohol and 'crowding-out' effects on food and health expenditure worsens household welfare in Ghana.Introduction The Global Youth Tobacco Survey's findings have been used to support Ghana's tobacco control legislation, monitor tobacco use among the youth and also used in meeting various Articles of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). These Articles include Article 8 (Protection for exposure to tobacco smoke); Article 12 (Education, communication, training and public awareness); Article 13 (Tobacco advertising, promotion, and sponsorship); Article 14 (Demand reduction measures concerning tobacco dependence and cessation); and Article 16 (Sales to and by minors). Among the four waves of GYTS in Ghana, the 2017 GYTS was the first to assess waterpipe smoking, through optional questions included in the GYTS questionnaire. We assessed sex, age and regional differentials in waterpipe smoking among the youth in Ghana, and also explored the association between the use of other tobacco products and waterpipe use. Methods The GYTS employs a standardized methodology with to half (46.9%) of the current waterpipe users smoked at home. Conclusions Waterpipe use, particularly among the female student population, represents an emerging tobacco epidemic and hence deserves immediate attention from authorities. This study revealed that waterpipe is being used among Junior High students in Ghana. Education on the health implications of waterpipe use should be intensified among the youth, to help minimize its use and to prevent its associated health harms.The aim of this study was to identify macro-level determinants of early work exit and investigate whether the effects of these determinants differ across educational groups. We used data from the Survey on Health, Ageing and Retirement in Europe (SHARE) (2011-2013) and the English Longitudinal Study of Ageing (ELSA) (2010/2011-2012/2013) as well as macro-level data and included 10,584 participants in 14 European countries. We used logistic multilevel analyses to examine educational differences in macro-level determinants of early work exit. Macro-level determinants were minimum unemployment replacement rates, expenditure on active labour market policies (aimed to help the unemployed find work) and passive labour market policies (unemployment and early retirement benefits), employment protection legislation (costs involved in dismissing individuals), unemployment rates, statutory pension age and implicit tax on continued work. We found low-educated workers to be more at risk of early work exit than higher educated workers.
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