Tapani Piha

Bio: Tapani Piha is an academic researcher. The author has contributed to research in topics: Tobacco control & Population. The author has an hindex of 1, co-authored 1 publications receiving 1117 citations.

A descriptive model of the cigarette epidemic in developed countries

Abstract: It has been estimated that cigarettes are the cause of the deaths of one in two of their persistent users, and that approxi mately half a billion people currently alive-8% of the world's population could eventually be killed by tobacco if current smoking patterns persist. De spite this pandemic, tobacco consump tion continues and is increasing in many countries, especially in Asia and in Southern and Eastern Europe. A major factor affecting public awareness of the substantial health hazards of tobacco use is the three- to four-decade lag between the peak in smoking prevalence and the subsequent peak in smoking-related mortality. Based on nearly 100 years of observations in countries with the longest history of widespread cigarette use, a four-stage model of cigarette consump tion and subsequent mortality among men and women is proposed. From the model it is clear that, during certain periods of evolution of this epidemic, it is to be expected that smoking-attributable mortality will rise at the same time that smoking prevalence might be decreasing. This is because current mortality is most closely related to previous, not current, levels of cigarette consumption. Broad geographic classifications of regions are given, according to the stage of the epidemic that they are currently ex periencing. Tobacco control policy im plications for countries at each of the four stages of the cigarette epidemic are also discussed.

Socioeconomic Inequalities in Health in 22 European Countries

Abstract: A b s t r ac t Background Comparisons among countries can help to identify opportunities for the reduction of inequalities in health. We compared the magnitude of inequalities in mortality and self-assessed health among 22 countries in all parts of Europe. Methods We obtained data on mortality according to education level and occupational class from census-based mortality studies. Deaths were classified according to cause, including common causes, such as cardiovascular disease and cancer; causes related to smoking; causes related to alcohol use; and causes amenable to medical intervention, such as tuberculosis and hypertension. Data on self-assessed health, smoking, and obesity according to education and income were obtained from health or multipurpose surveys. For each country, the association between socioeconomic status and health outcomes was measured with the use of regression-based inequality indexes. Results In almost all countries, the rates of death and poorer self-assessments of health were substantially higher in groups of lower socioeconomic status, but the magnitude of the inequalities between groups of higher and lower socioeconomic status was much larger in some countries than in others. Inequalities in mortality were small in some southern European countries and very large in most countries in the eastern and Baltic regions. These variations among countries appeared to be attributable in part to causes of death related to smoking or alcohol use or amenable to medical intervention. The magnitude of inequalities in self-assessed health also varied substantially among countries, but in a different pattern. Conclusions We observed variation across Europe in the magnitude of inequalities in health associated with socioeconomic status. These inequalities might be reduced by improving educational opportunities, income distribution, health-related behavior, or access to health care.

Lung Cancer Statistics.

Abstract: Lung cancer is the leading cause of cancer death among both men and women in the United States. It is also the leading cause of cancer death among men and the second leading cause of cancer death among women worldwide. Lung cancer rates and trends vary substantially by sex, age, race/ethnicity, socioeconomic status, and geography because of differences in historical smoking patterns. Lung cancer mortality rates in the United States are highest among males, blacks, people of lower socioeconomic status, and in the mid-South (e.g., Kentucky, Mississippi, Arkansas, and Tennessee). Globally, rates are highest in countries where smoking uptake began earliest, such as those in North America and Europe. Although rates are now decreasing in most of these countries (e.g., United States, United Kingdom, Australia), especially in men, they are increasing in countries where smoking uptake occurred later. Low- and middle-income countries now account for more than 50% of lung cancer deaths each year. This chapter reviews lung cancer incidence and mortality patterns in the United States and globally.

Smoking Prevalence and Cigarette Consumption in 187 Countries, 1980-2012

Abstract: Importance Tobacco is a leading global disease risk factor. Understanding national trends in prevalence and consumption is critical for prioritizing action and evaluating tobacco control progress. Objective To estimate the prevalence of daily smoking by age and sex and the number of cigarettes per smoker per day for 187 countries from 1980 to 2012. Design Nationally representative sources that measured tobacco use (n = 2102 country-years of data) were systematically identified. Survey data that did not report daily tobacco smoking were adjusted using the average relationship between different definitions. Age-sex-country-year observations (n = 38 315) were synthesized using spatial-temporal gaussian process regression to model prevalence estimates by age, sex, country, and year. Data on consumption of cigarettes were used to generate estimates of cigarettes per smoker per day. Main Outcomes and Measures Modeled age-standardized prevalence of daily tobacco smoking by age, sex, country, and year; cigarettes per smoker per day by country and year. Results Global modeled age-standardized prevalence of daily tobacco smoking in the population older than 15 years decreased from 41.2% (95% uncertainty interval [UI], 40.0%-42.6%) in 1980 to 31.1% (95% UI, 30.2%-32.0%; P P P = .003). Despite the decline in modeled prevalence, the number of daily smokers increased from 721 million (95% UI, 700 million–742 million) in 1980 to 967 million (95% UI, 944 million–989 million; P Conclusions and Relevance Since 1980, large reductions in the estimated prevalence of daily smoking were observed at the global level for both men and women, but because of population growth, the number of smokers increased significantly. As tobacco remains a threat to the health of the world’s population, intensified efforts to control its use are needed.