Smoking cessation

戒烟
  • 文章类型: Systematic Review
    全球范围内,大约有13亿香烟消费者,表明它是早期死亡和发病的第二高危险因素。同时,心理治疗提供基于其不同模式和技术的工具,这有助于戒烟。在这种情况下,这项研究收集了科学证据,以确定可用于减少香烟消费的心理治疗方法。对对照临床研究进行了系统评价,实施PRISMA方法。使用从MESH(医学主题词)和DECS(健康科学中的描述符)提取的术语进行搜索查询。随后,搜索在Medline/PubMed的科学数据库中进行了查询,科克伦,Scopus,科学直接,ProQuest,和PsycNet,随后使用乔安娜·布里格斯研究所的检查表验证方法学质量。选定的文件显示,认知行为疗法因其在七份出版物中的使用和有效性而盛行(25%)。正念疗法的认知方法见于4份出版物(14%),动机疗法的跨理论模型发表在4篇出版物中(14%),简短的心理治疗在3出版物(10%),其余10份文件(37%)与其他文件对应。干预研究认为认知行为疗法是减少香烟消费最常用的方法;在禁欲持续时间方面,科学证据显示短期减少的有益效果。
    Globally, there are around 1.3 billion cigarette consumers, indicating it to be the second highest risk factor for early death and morbidity. Meanwhile, psychological therapy offers tools based on its different models and techniques, which can contribute to smoking cessation. In this context, this study gathers scientific evidence to identify psychological therapies that can be used to reduce cigarette consumption. A systematic review of controlled clinical studies was conducted, implementing the PRISMA methodology. Search queries were performed with terms extracted from MESH (Medical Subject Headings) and DECS (Descriptors in Health Sciences). Subsequently, the search was queried in the scientific databases of Medline/PubMed, Cochrane, Scopus, Science Direct, ProQuest, and PsycNet, with subsequent verification of methodological quality using the Joanna Briggs Institute checklists. The selected documents revealed that cognitive behavioral therapy prevails due to its use and effectiveness in seven publications (25%). The cognitive approach with mindfulness therapy is found in 4 publications (14%), the transtheoretical model with motivational therapy in 4 publications (14%), brief psychological therapy in 3 publications (10%), and the remaining 10 documents (37%) correspond with others. Intervention studies refer to cognitive behavioral therapy as the most used in reducing cigarette consumption; in terms of the duration of abstinence, scientific evidence shows beneficial effects with short-term reduction.
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  • 文章类型: Journal Article
    背景:在最近的出版物中,患COPD(慢性阻塞性肺疾病)的吸烟者的百分比达到40-50%。
    结论:烟草烟雾仍然是COPD的主要病因,尽管与吸烟相关的流量限制是相当主观的。对于持续吸烟的患者来说,全科医生(GP)和肺科医师应该能够将戒烟计划作为COPD治疗的重要组成部分.这篇叙述性文章旨在提供科学依据,帮助医疗保健专业人员开发这种疗法;考虑到这一目标,作者分析了最新的文献。
    结论:只有3%的吸烟者在没有得到任何支持的情况下尝试戒烟。有效的戒烟方法是咨询和药物治疗,which,结合在一起,成功率为24%。尽管没有强有力的科学证据证明戒烟的治疗新颖性,然而,建议将文献更新为新设备和新的数字疗法。
    BACKGROUND: The percentage of smokers who develop COPD (Chronic Obstructive Pulmonary Disease) peaks at 40-50% in most recent publications.
    CONCLUSIONS: Tobacco smoke remains the main cause of COPD, though smoking-related limitation of the flow is rather subjective. For patients who keep on smoking, general practitioners (GPs) and pulmonologists should be able to offer smoking cessation programs as an important part of COPD treatment. This narrative article aims to provide the scientific basis to help healthcare professionals develop this therapy; with this aim in mind, the authors have analyzed the most recent literature.
    CONCLUSIONS: Only 3% of smokers who try to quit without availing themselves of any support succeed. Effective smoking cessation methods are counselling and pharmacotherapy, which, combined together, are credited with a 24% success rate. Although there are no therapeutic novelties with strong scientific evidence for smoking cessation, it is however advisable to keep the literature updated to new devices and new digital therapies.
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  • 文章类型: Systematic Review
    背景:怀孕期间吸烟对母婴健康有害。Vaping用于戒烟,但有关怀孕期间健康影响的证据很少。我们对怀孕期间电子烟的健康结果进行了系统评价。
    方法:我们搜索了六个数据库,以了解母体/胎儿/婴儿结局和电子烟,包括定量,英语语言,怀孕期间电子烟的人体研究,到11月10日,2023年。我们使用混合方法评估工具评估研究质量。我们专注于将专有电子烟与不使用尼古丁和烟草产品以及吸烟进行比较。由于研究质量不足,无法进行荟萃分析,因此介绍是叙事。
    结果:我们纳入了26项研究,765,527名女性,一项随机对照试验(RCT)比较了电子烟和尼古丁替代疗法对戒烟的作用,23项队列研究和两项病例对照研究。虽然RCT符合4/5的质量标准,队列研究和病例对照研究的质量较差;没有一项能够充分评估吸烟和电子烟暴露情况.对于将独占vaping与“不使用”进行比较的研究,更多的报告没有增加vaping的风险(三项研究)比报告的增加产妇怀孕/产后结局的风险(一项研究)和胎儿和婴儿结局(20项研究没有增加风险,四个风险增加),除了出生体重和神经系统结局,两项研究均观察到风险增加,但没有增加。当RCT将非使用者与不吸烟但吸烟或使用NRT的使用者进行比较时,不管随机化,他们报告没有电子烟/NRT风险的证据。对于比较独家吸烟和独家吸烟的研究,大多数研究提供了不同结局具有可比性风险的证据.一项母体生物标志物研究显示,vaping的风险较低。对于小于胎龄/平均出生百分位数的研究,发现电子烟的风险低于吸烟,因为两组(每组两个)的风险相似。
    结论:虽然更多的研究发现,与不使用相比,没有证据表明专有电子烟的风险增加,并且有证据表明专有电子烟和专有吸烟的风险相当,证据的质量限制了结论。如果没有充分评估暴露于电子烟和吸烟,调查结果不能归因于行为,因为许多vape的人会吸烟,许多vape的人可能会在低水平吸烟。
    背景:https://osf.io/rfx4q/。
    BACKGROUND: Smoking during pregnancy is harmful to maternal and child health. Vaping is used for smoking cessation but evidence on health effects during pregnancy is scarce. We conducted a systematic review of health outcomes of vaping during pregnancy.
    METHODS: We searched six databases for maternal/fetal/infant outcomes and vaping, including quantitative, English language, human studies of vaping during pregnancy, to November 10th, 2023. We assessed study quality with the Mixed-Methods Appraisal Tool. We focused on comparisons of exclusive-vaping with non-use of nicotine and tobacco products and with smoking. Presentation is narrative as the studies were of insufficient quality to conduct meta-analysis.
    RESULTS: We included 26 studies, with 765,527 women, with one randomised controlled trial (RCT) comparing vaping and nicotine replacement therapy for smoking cessation, 23 cohort studies and two case-control studies. While the RCT met 4/5 quality criteria, the quality of the cohort studies and case-control studies was poor; none adequately assessed exposure to smoking and vaping. For studies comparing exclusive-vaping with \'non-use\', more reported no increased risk for vaping (three studies) than reported increased risk for maternal pregnancy/postpartum outcomes (one study) and for fetal and infant outcomes (20 studies no increased risk, four increased risk), except for birth-weight and neurological outcomes where two studies each observed increased and no increased risk. When the RCT compared non-users with those not smoking but vaping or using NRT, irrespective of randomisation, they reported no evidence of risk for vaping/NRT. For studies comparing exclusive-vaping and exclusive-smoking, most studies provided evidence for a comparable risk for different outcomes. One maternal biomarker study revealed a lower risk for vaping. For small-for-gestational-age/mean-birth-centile equal numbers of studies found lower risk for vaping than for smoking as found similar risk for the two groups (two each).
    CONCLUSIONS: While more studies found no evidence of increased risk of exclusive-vaping compared with non-use and evidence of comparable risk for exclusive-vaping and exclusive-smoking, the quality of the evidence limits conclusions. Without adequate assessment of exposure to vaping and smoking, findings cannot be attributed to behaviour as many who vape will have smoked and many who vape may do so at low levels.
    BACKGROUND: https://osf.io/rfx4q/ .
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  • 文章类型: Journal Article
    目标:工作场所是戒烟计划和激励措施的合适区域。进行这项研究是为了确定工作场所干预措施对工作个体戒烟的有效性。
    方法:在2013年至2022年之间以英文发表的所有研究都在PubMed进行了搜索,科学直接,Scopus,WebofScience,和CINAHL数据库。荟萃分析基于PRISMA2020。研究方案在PROSPERO注册。随机效应模型被应用于荟萃分析过程,和Hedges\'g用于计算效果大小。
    结果:在纳入的研究中,11项随机对照试验,8项为整群随机对照试验.在不同的工作部门,各种干预措施,如动机/个人访谈,团体咨询,电话辅导,基于网络的培训,正念冥想,并实施了金融干预措施。这些干预措施单独进行或与一种或多种其他干预措施组合进行。干预措施通常具有短期效果,财务激励或支持是积极激励干预措施的因素。在工作场所尝试戒烟的联合效应大小(Hedges\'g)为1.171。研究之间的异质性是显著的(Q=199.762,p=0.015,I2=80.477%)。未检测到发表偏倚。
    结论:我们确定在工作场所应用戒烟干预措施具有很大的效果。我们建议根据工作组的需要,考虑和规划这些干预措施提高有效性的长期影响。
    OBJECTIVE: Workplaces are suitable areas for smoking cessation programs and incentives. This study was carried out to determine the effectiveness of interventions in the workplace for smoking cessation in working individuals.
    METHODS: All studies published in English between 2013 and 2022 were searched in Pub Med, Science Direct, Scopus, Web of Science, and CINAHL databases. Meta-analysis was based on PRISMA 2020. The study protocol was registered with PROSPERO. A random effects model was applied to the meta-analysis processes, and Hedges\' g was used to calculate the effect size.
    RESULTS: Of the included studies, 11 were randomized controlled trials, and 8 were cluster randomized controlled trials. In different working sectors, various interventions such as motivational/individual interviews, group counseling, telephone coaching, web-based training, mindfulness meditation, and financial interventions were implemented. These interventions were carried out alone or in combination with one or more other interventions. The interventions generally have short-term effects, and financial incentives or supports were the factors that positively motivate the interventions. The joint effect size of attempts to quit smoking in the workplace (Hedges\' g) was 1.171. Heterogeneity between studies was significant (Q = 199.762, p = 0.015, I2 = 80.477%). No publication bias was detected.
    CONCLUSIONS: We determined that smoking cessation interventions applied in the workplace have a large effect. We recommend that the long-term effects of increasing effectiveness of these interventions be considered and planned in line with the needs of working groups.
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  • 文章类型: Journal Article
    这是更新的坎贝尔系统审查的协议。目的如下:评估行为干预对无家可归者戒烟的影响。
    This is the protocol for an updated Campbell systematic review. The objectives are as follows: To evaluate the effect of behavioral interventions on smoking cessation among homeless individuals.
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  • 文章类型: Journal Article
    目的:在手术环境中戒烟干预措施未得到充分利用。我们旨在系统地确定在手术环境中戒烟的障碍和促进因素。
    方法:遵循JoannaBriggsInstitute(JBI)范围审查框架,我们搜索了5个数据库(MEDLINE,Embase,科克伦中部,CINAHL,和PsycINFO),用于以英文发表的定量或定性研究(自2000年以来),评估围手术期戒烟干预措施的障碍和促进因素。使用主题分析对数据进行分析,并映射到理论领域框架(TDF)。
    结果:来自31项研究,我们确定了14个TDF域中11个的23个独特障碍和13个促进子.障碍在知识领域内(例如,23项(74.2%)研究中对戒烟干预措施的知识不足;环境背景和资源(例如,在19项(61.3%)研究中,缺乏提供戒烟干预措施的时间;关于能力的信念(例如,认为患者对手术/诊断感到紧张)在14项(45.2%)研究中;以及社会/专业角色和身份(例如,在8项(25.8%)研究中,外科医生不认为提供戒烟干预措施是他们的角色)。促进者主要在环境背景和资源领域(例如,在15项(48.4%)研究中,提供戒烟建议作为常规手术护理),钢筋(例如,手术本身作为启动退出尝试的动力)在8项(25.8%)研究中,和技能(例如,戒烟培训和指南意识)在5项(16.2%)研究中。
    结论:所确定的障碍和促进因素是未来研究的可操作目标,旨在将有证据的戒烟干预措施转化为围手术期的实践。需要更多的研究来评估针对这些障碍和促进因素将如何影响吸烟结果。
    OBJECTIVE: Smoking cessation interventions are underutilized in the surgical setting. We aimed to systematically identify the barriers and facilitators to smoking cessation in the surgical setting.
    METHODS: Following the Joanna Briggs Institute (JBI) framework for scoping reviews, we searched 5 databases (MEDLINE, Embase, Cochrane CENTRAL, CINAHL, and PsycINFO) for quantitative or qualitative studies published in English (since 2000) evaluating barriers and facilitators to perioperative smoking cessation interventions. Data were analyzed using thematic analysis and mapped to the theoretical domains framework (TDF).
    RESULTS: From 31 studies, we identified 23 unique barriers and 13 facilitators mapped to 11 of the 14 TDF domains. The barriers were within the domains of knowledge (e.g., inadequate knowledge of smoking cessation interventions) in 23 (74.2%) studies; environmental context and resources (e.g., lack of time to deliver smoking cessation interventions) in 19 (61.3%) studies; beliefs about capabilities (e.g., belief that patients are nervous about surgery/diagnosis) in 14 (45.2%) studies; and social/professional role and identity (e.g., surgeons do not believe it is their role to provide smoking cessation interventions) in 8 (25.8%) studies. Facilitators were mainly within the domains of environmental context and resources (e.g., provision of quit smoking advice as routine surgical care) in 15 (48.4%) studies, reinforcement (e.g., surgery itself as a motivator to kickstart quit attempts) in 8 (25.8%) studies, and skills (e.g., smoking cessation training and awareness of guidelines) in 5 (16.2%) studies.
    CONCLUSIONS: The identified barriers and facilitators are actionable targets for future studies aimed at translating evidence informed smoking cessation interventions into practice in perioperative settings. More research is needed to evaluate how targeting these barriers and facilitators will impact smoking outcomes.
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  • 文章类型: Systematic Review
    几种药物干预措施,例如尼古丁替代疗法(NRT),伐尼克林,还有安非他酮,已被批准用于临床戒烟。电子烟(EC)在戒烟方面的潜力越来越多地被许多RCT所探索。此外,一些RCT正在尝试探索戒烟的新药,如金雀花碱。该网络荟萃分析(NMA)旨在研究这些药物和电子烟在疗效和可接受性方面的比较。
    本系统综述和NMA检索了2011年1月至2022年5月使用MEDLINE发表的所有关于使用药物单一疗法或电子烟戒烟的临床研究,COCHRANE图书馆,PsychINFO数据库。NRT按给药途径分为透皮(TDN)和口鼻尼古丁(ONN),因此,建立了7个网络节点进行直接和间接比较。两种不同的指标衡量了疗效:普遍禁烟和持续禁烟。脱落率衡量了可接受性。
    本研究中包括的最后40项临床研究包括77个研究队列和25,889名参与者。Varenicline是更有效的干预措施,在16-32周的随访期间协助戒烟,很可能会导致辍学。Cytisine在连续戒烟中显示出更高的有效性,但也可能导致戒烟。电子烟和口鼻尼古丁在鼓励普遍禁欲方面比没有治疗更有效,但最不可能促使辍学。最后,在持续禁欲的情况下,经皮尼古丁给药比不治疗更有效,对普遍禁欲和辍学率没有显著影响。
    本次审查建议并同意,Cytisine和透皮尼古丁给药,作为戒烟干预,有优点和缺点。然而,我们不得不对电子烟作为青少年戒烟的一种方式有所保留。
    UNASSIGNED: Several pharmacological interventions, such as nicotine replacement therapy (NRT), varenicline, and bupropion, have been approved for clinical use of smoking cessation. E-cigarettes (EC) are increasingly explored by many RCTs for their potentiality in smoking cessation. In addition, some RCTs are attempting to explore new drugs for smoking cessation, such as cytisine. This network meta-analysis (NMA) aims to investigate how these drugs and e-cigarettes compare regarding their efficacy and acceptability.
    UNASSIGNED: This systematic review and NMA searched all clinical studies on smoking cessation using pharmacological monotherapies or e-cigarettes published from January 2011 to May 2022 using MEDLINE, COCHRANE Library, and PsychINFO databases. NRTs were divided into transdermal (TDN) and oronasal nicotine (ONN) by administrative routes, thus 7 network nodes were set up for direct and indirect comparison. Two different indicators measured the efficacy: prevalent and continuous smoking abstinence. The drop-out rates measured the acceptability.
    UNASSIGNED: The final 40 clinical studies included in this study comprised 77 study cohorts and 25,889 participants. Varenicline is more effective intervention to assist in smoking cessation during 16-32 weeks follow-up, and is very likely to prompt dropout. Cytisine shows more effectiveness in continuous smoking cessation but may also lead to dropout. E-cigarettes and oronasal nicotine are more effective than no treatment in encouraging prevalent abstinence, but least likely to prompt dropout. Finally, transdermal nicotine delivery is more effective than no treatment in continuous abstinence, with neither significant effect on prevalent abstinence nor dropout rate.
    UNASSIGNED: This review suggested and agreed that Varenicline, Cytisine and transdermal nicotine delivery, as smoking cessation intervention, have advantages and disadvantages. However, we had to have reservations about e-cigarettes as a way to quit smoking in adolescents.
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  • 文章类型: Journal Article
    背景:糖尿病患者吸烟会显著增加其发生并发症的风险,并增加心血管死亡的可能性。这篇综述首次专门提供了关于戒烟对2型糖尿病患者糖尿病相关并发症影响的循证分析。
    方法:本综述是根据系统评价和Meta分析(PRISMA)扩展范围的首选报告项目进行的。包括所有评估戒烟对糖尿病相关并发症影响的人类临床研究。PubMed和Embase进行筛选,直到2024年1月。手动筛选了该领域主要研究和主要同行评审科学期刊的参考文献。
    结果:我们共确定了1023项研究。只有26人符合资格标准。一般来说,戒烟与心肌梗死和缺血性中风的风险降低有关。关于微血管并发症,在糖尿病肾病中观察到戒烟有益效果的最有力证据。然而,戒烟和视网膜病变之间的关系,神经病,糖尿病足并发症和糖尿病相关勃起功能障碍,调查不力。
    结论:戒烟在治疗糖尿病相关并发症方面具有显著优势,显著降低心肌梗塞的风险,缺血性卒中,和糖尿病肾病。这强调了停止的重要性。提供有关戒烟对吸烟的2型糖尿病患者的益处的循证信息,可以在糖尿病管理的背景下加强戒烟努力。
    Smoking in people with diabetes markedly elevates their risk of developing complications and increases the likelihood of cardiovascular mortality. This review is the first to specifically provide evidence-based analysis about the influence of quitting smoking on diabetes-related complications in people with type 2 diabetes.
    The present review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. All human clinical studies assessing the effects of stopping smoking cessation on diabetes-related complications were included. PubMed and Embase were screened until January 2024. References of primary studies and principal peer-reviewed scientific journals in the field were manually screened.
    We identified a total of 1023 studies. Only 26 met the criteria for eligibility. In general quitting smoking is associated with decreased risks of myocardial infarction and ischemic stroke. Regarding microvascular complications, the strongest evidence for the beneficial effects of smoking cessation is observed in diabetic nephropathy. However, the relationship between smoking cessation and retinopathy, neuropathy, diabetic foot complications and diabetic-related erectile dysfunction, is poorly investigated.
    Quitting smoking offers significant advantages in managing diabetes-related complications, significantly lowering the risks of myocardial infarction, ischemic stroke, and diabetic nephropathy. This underscores the importance of cessation. Providing evidence-based information on the benefits of stopping smoking for people with type 2 diabetes who smoke, can bolster smoking cessation efforts in the context of diabetes management.
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  • 文章类型: Systematic Review
    (1)背景:健康的生活方式对哮喘和慢性阻塞性肺疾病(COPD)的发病和管理具有保护作用。因此,综合生活方式干预(CLIs)是一种潜在的有价值的预防方法。这篇综述旨在概述现有的用于预防和管理哮喘或COPD的CLIs。(2)方法:使用PubMed进行系统的文献检索,EMBASE,和PsycInfo。如果CLI针对至少两个生活方式因素,则纳入研究。(3)结果:在纳入的56项研究中,9人解决哮喘问题,47人解决COPD管理问题,没有专注于预防的研究。对于这两种情况,最普遍的生活方式目标组合是饮食和体力活动(PA),常与COPD患者的戒烟相结合。研究的CI导致生活质量的改善,呼吸道症状,体重指数/体重,和锻炼能力。行为变化仅在有限数量的研究中进行了测量,主要显示饮食摄入量和PA水平的改善。(4)结论:CLIs在哮喘和COPD管理中是有效的。除了优化CI的内容和实现之外,这些积极的结果需要对这些慢性呼吸系统疾病风险增加的人群给予更多的关注.
    (1) Background: A healthy lifestyle has a protective role against the onset and management of asthma and chronic obstructive pulmonary disease (COPD). Therefore, combined lifestyle interventions (CLIs) are a potentially valuable prevention approach. This review aims to provide an overview of existing CLIs for the prevention and management of asthma or COPD. (2) Methods: A systematic literature search was conducted using PubMed, EMBASE, and PsycInfo. Studies were included if CLIs targeted at least two lifestyle factors. (3) Results: Among the 56 included studies, 9 addressed asthma and 47 addressed COPD management, with no studies focusing on prevention. For both conditions, the most prevalent combination of lifestyle targets was diet and physical activity (PA), often combined with smoking cessation in COPD. The studied CLIs led to improvements in quality of life, respiratory symptoms, body mass index/weight, and exercise capacity. Behavioural changes were only measured in a limited number of studies and mainly showed improvements in dietary intake and PA level. (4) Conclusions: CLIs are effective within asthma and COPD management. Next to optimising the content and implementation of CLIs, these positive results warrant paying more attention to CLIs for persons with an increased risk profile for these chronic respiratory diseases.
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  • 文章类型: Journal Article
    各国都设定了烟草残局目标,以在某一年前消除烟草使用。通常认为,在烟草控制措施先进且吸烟率为15%或更低的国家中,烟草残杀更为可行。我们对563篇来自新闻的文章进行了范围审查,学术文献,和灰色文献来考察全球烟草残局的进展,并根据烟草政策执行得分和吸烟流行率将153个国家分组,以系统地确定哪些国家可能处于成功烟草残局的有利地位。欧盟,太平洋岛屿,其他18个国家设定了烟草残局目标,另有七个国家被描述为处于最后阶段。这些国家大多是高收入国家,吸烟率较高。我们确定了28个具有先进烟草政策和低吸烟率的终局准备国家。其中,只有五个是烟草残局运动的一部分;其余23个都是非洲的低收入或中等收入国家,拉丁美洲,或亚洲。因此,全球烟草终局运动应更多关注低吸烟率和先进烟草政策的低收入和中等收入国家,尤其是在非洲,拉丁美洲,和亚洲。
    Various countries have set tobacco endgame targets to eliminate tobacco use by a certain year. Tobacco endgames are generally considered more feasible in countries with advanced tobacco control measures and a smoking prevalence of 15% or less. We conducted a scoping review of 563 articles sourced from news, academic literature, and grey literature to examine global tobacco endgame progress, and grouped 153 countries into clusters based on their tobacco policy implementation score and smoking prevalence to systematically identify countries that might be well positioned to succeed in a tobacco endgame. The EU, Pacific Islands, and 18 other individual countries have set tobacco endgame targets, with another seven countries described as well positioned for an endgame. These were mostly high-income countries with higher smoking prevalence. We identified 28 endgame-ready countries with advanced tobacco policies and a low smoking prevalence. Of these, only five were part of tobacco endgame movements; the remaining 23 were all low-income or middle-income countries in Africa, Latin America, or Asia. Therefore, the global tobacco endgame movement should focus more on low-income and middle-income countries with low smoking rates and advanced tobacco policies, particularly in Africa, Latin America, and Asia.
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