American journal of preventive medicine
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Nondaily smokers are a growing subpopulation of smokers. Current cessation guidelines were developed for daily smokers, and how clinicians might help nondaily smokers is not clear. ⋯ While daily smokers may seem a higher cessation priority, nondaily smokers may be more likely to quit with brief interventions. Cessation messages should address health risks of any smoking, ethnic differences, smoke-free messages, and situational triggers.
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This discussion examines the use of litigation as a strategy to protect the public health. The history of tobacco litigation provides a model to evaluate potential litigation strategies against other industries that pose a threat to public health, particularly the food industry. This paper demonstrates that although legislation would be a preferable solution, lessons from the tobacco wars suggest that effective national legislation is unlikely at the present time. ⋯ Likewise, state lawsuits under consumer protection acts may be a distinct type of litigation that permits cases to focus on deceptive advertisements while avoiding complicated causation issues. Such lawsuits have the potential to be a useful tool to fight obesity and enlist the efforts of the food industry in resisting the epidemic. Understanding the lessons of tobacco can save public health advocates much time and many resources and thus allow tobacco litigation to benefit public health in new ways.
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The role of aspirin in prevention of cardiovascular disease (CVD) and cardiovascular complications among people with diabetes has been examined. A Healthy People 2010 objective calls for increasing the proportion of people with diabetes aged>or=40 years who take aspirin>or=15 times per month. ⋯ Regular aspirin use increased over a 4-year period. Greater use of inexpensive and easily accessible interventions to prevent cardiovascular events is encouraging. Increased efforts to continue preventive uses of available treatment and reduction in risk by modifying other risk factors will help lower future disease burden.
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Lower extremity arterial disease (LEAD) is one of the most common manifestations of atherosclerosis. Its epidemiologic characteristics have not been well described, particularly in African Americans. Our purpose was to estimate the prevalence of LEAD and its associations with cardiovascular risk factors in a biracial population of men and women aged 45 to 64 years. ⋯ The prevalence of LEAD appears to be higher in African Americans than whites. Elevations in traditional cardiovascular risk factors are associated with a higher prevalence of LEAD across race/ethnic and gender groups.
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Training practitioners to use evidence-based approaches to the primary prevention of violence is challenging as a result of the dearth of well-evaluated intervention programs and the lack of familiarity of some practitioners in drawing critically on existing literature. An element of the National Training Initiative in Injury and Violence Prevention, the PREVENT (Preventing Violence Through Education, Networking, and Technical Assistance) program began in late 2003 to train practitioners to address multiple types of violence by encouraging more widespread use of evidence-based approaches to primary prevention. ⋯ Ultimately the program intends to stimulate and facilitate changes in individual, organizational, and cultural awareness and practices fostering primary prevention of violence. The project employs formative, process, and impact evaluation techniques aimed at improving delivery of the training as well as tracking changes in individual and organizations.