Person: Rees, Vaughan
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Rees
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Vaughan
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Rees, Vaughan
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Publication The Association Between Alcohol Access and Alcohol‐attributable Emergency Department Visits in Ontario, Canada(Wiley, 2019-04-17) Myran, Daniel; Chen, Jarvis; Giesbrecht, Norman; Rees, VaughanBackground and aims: The availability of alcohol through retail outlets is associated with alcohol‐related harms, but few studies have demonstrated a causal relationship. We investigated the association between alcohol availability and alcohol‐attributable emergency department (ED) visits in the province of Ontario during a period of deregulation of controls on the number of alcohol outlets. Design: Cross‐sectional and pre–post design. Setting and participants: The study used data from two time‐periods: pre‐deregulation (2013–14) and post‐deregulation (2016–17), to compare rates of ED visits for 513 defined geographic regions in Ontario Canada, called Forward Sortation Areas (FSAs). Measurements: The primary outcome was the age‐standardized rates of alcohol‐attributable ED visits. We compiled a list of all alcohol retail outlets in Ontario during 2014 and 2017 and matched them to their corresponding FSA. We fitted mixed‐effects Poisson regression models to assess: (a) the cross‐sectional association between number of outlets and hours of operation and ED visits; and (b) the impact of deregulation on ED visits using a difference‐in‐difference approach. Findings: Alcohol‐attributed ED visits increased 17.8% over the study period: more than twice the rate of increase for all ED visits. Increased hours of operation and numbers of alcohol outlets within an FSA were positively associated with higher rates of alcohol‐attributable ED visits. The increase in ED visits attributable to alcohol was 6% (incident rate ratio = 1.06; 95% confidence interval = 1.04–1.08) greater in FSAs that introduced alcohol sales in grocery stores following deregulation compared with FSAs that did not. Conclusions: Deregulation of alcohol sales in Ontario, Canada in 2015 was associated with increased emergency department visits attributable to alcohol.Publication Children’s Exposure to Secondhand Smoke during Ramadan in Jakarta, Indonesia(MDPI, 2016) Luntungan, Nurul (Nadia) H.W.; Byron, M. Justin; Hovell, Melbourne F.; Rosen, Laura J.; Anggraeni, Annisa; Rees, VaughanSecondhand smoke exposure (SHS) causes a disproportionate health burden for children, yet existing smoke-free laws are often poorly enforced. We monitored air quality while observing children and adult nonsmokers present in public venues during Ramadan, a period of Muslim religious observance marked by family and social gatherings, in Jakarta, Indonesia. A repeated-measures design was used to assess indoor air quality during and after Ramadan in 43 restaurants and in five smoke-free control venues. Fine particulate matter of 2.5 microns or less (PM2.5) was sampled. The average number of children and active smokers present in each venue was also observed. PM2.5 levels were significantly higher during Ramadan (mean 86.5 µg/m3) compared with post-Ramadan (mean 63.2 µg/m3) in smoking venues (p = 0.015). During Ramadan, there were more active smokers (p = 0.012) and children (p = 0.051) observed in venues where smoking occurred, compared with the same venues post-Ramadan. Poor enforcement of the smoke-free law in Jakarta has failed to protect children from SHS exposure in public venues during Ramadan. Collaboration between the government, NGOs (such as the Indonesian Cancer Foundation (YKI) and the Smoking Control Foundation (LM3)), religious leaders, and venue owners and managers must be developed to ensure that the comprehensive smoking bans apply to all venues, and that smoke-free laws are enforced.Publication A cross-sectional study on tobacco use and dependence among women: Does menthol matter?(BioMed Central, 2012) Rosenbloom, Judith; Rees, Vaughan; Reid, Kathleen; Wong, Jeannie; Kinnunen, Taru HanneleBackground: The question of whether mentholation of cigarettes enhances tobacco dependence has generated conflicting findings. Potential mediating factors in a putative relationship between menthol use and tobacco dependence may include race and gender. While an association between menthol use and dependence is mixed, research on the role of race solely among women smokers is scarce. This study examined whether women menthol smokers have higher tobacco use and dependence than non-menthol smokers. Further, the study investigated differences between White and African American smokers. Methods: A cross-sectional study was conducted among 928 women seeking tobacco dependence treatment in Boston, Massachusetts. Measures obtained included preferred brand and menthol content, dependence markers (cigarettes per day (CPD); time to first cigarette in the morning; number of and longest previous quit attempts) and smoking history (age of initiation; years smoking; menthol or non-menthol cigarette preference). Analysis of variance (ANOVA) was used to detect interactions between menthol preference by race for continuous variables, and Pearson’s chi-squared test was used for analyses with dichotomous variables. Results: A greater proportion of menthol smokers smoked their first cigarette within five minutes of waking (p < 0.01) and were less likely to have a previous quit attempt longer than 90 days (p < 0.01). ANOVAs revealed no main effects for menthol preferences. However, African American smokers smoked fewer CPD (p<.001), started smoking later in life (p= .04), and had been smoking the same brand for longer (p= .04). Conclusions: Women menthol smokers showed signs of greater tobacco dependence than non-menthol smokers. African Americans smoked fewer CPD but nevertheless had evidence of greater dependence.Publication Indoor Secondhand Tobacco Smoke Emission Levels in Six Lebanese Cities(BMJ Group, 2010) Saade, Georges; Seidenberg, Andrew; Rees, Vaughan; Otrock, Zaher; Connolly, GregroryBackground: To date, Lebanon has failed to enact comprehensive clean indoor air laws despite ratification of the Framework Convention on Tobacco Control (FCTC), which calls for the protection of non-smokers from exposure to secondhand tobacco smoke (SHS). Complicating the problem of SHS exposure in Lebanon is the widespread use of the tobacco water-pipe. While most research on SHS has involved cigarette smoking as a source of emissions, other sources, including tobacco water-pipes, may be an important contributor. Methods: \(PM_{2.5}\) concentrations \((\mu g/m^3)\) were measured in a sample of 28 public venues located in six major Lebanese cities. Active smoker density (number of smokers\(/100 m^3\)) was calculated for both water-pipe and cigarette smokers. Venues were then categorised as having higher density of water-pipe smokers or higher density of cigarette smokers, and resultant emission levels were compared between the two groups. Results: Cigarette and water-pipe smoking was observed in 14 venues, while cigarette smoking only and water-pipe smoking only were found in 12 venues and one venue, respectively. Among all smoking-permitted venues, the mean \(PM_{2.5}\) concentration was \(342 \mu g/m^3\). Venues with a higher density of water-pipe smokers \((n =14)\) showed a similar median \(PM_{2.5}\) concentration \(349 \mu g/m^3\) compared with venues with a higher density of cigarette smokers \((n =13; 241 \mu g/m^3; p=0.159)\). The mean \(PM_{2.5}\) concentration in the single venue with a voluntary smoke-free policy was \(6 \mu g/m^3\). Conclusions: Despite ratification of the FCTC in 2005, both cigarette and water-pipe smoking are commonly practised in enclosed public places throughout Lebanon, leading to unsafe levels of indoor particulate pollution. Smoke-free policies are needed in Lebanon to protect the public's health, and should apply to all forms of tobacco smoking.