ABSTRACT
Youth around the world take up smoking and use tobacco products at high rates. Young people may not grasp the long-term consequences of tobacco use, although tobacco consumption and exposure has been shown to have significant negative health effects. Youth use a variety of tobacco products that are smoked, chewed, or sniffed, including machine-manufactured cigarettes, cigars, bidis, kreteks, sticks, and snuff. Prevention efforts have focused on countering those aspects that are believed to contribute to smoking uptake, such as tobacco industry advertising and promotion, and access to tobacco. There are many aspects of tobacco promotion through the media that have been more difficult to control, however, such as product placement within popular cinema movies. Once a youth has taken up tobacco, he or she is more likely than an adult to become addicted and should be offered treatment for tobacco cessation. Although there is not yet sufficient evidence to prove efficacy, the same treatments are suggested for youth as are recommended for adults, including nicotine replacement products. Given the severity of the tobacco epidemic worldwide and the devastating health effects on an individual and population basis, there are currently many efforts to curtail the tobacco problem, including the World Health Organization (WHO) sponsored Framework Convention on Tobacco Control. It is through comprehensive and collaborative efforts such as this that the global hazard of tobacco is most likely to be overcome.
Subject(s)
Adolescent Behavior , Smoking , Adolescent , Advertising , Age Factors , Child , Child, Preschool , Female , Humans , Infant , Italy/epidemiology , Male , Risk Factors , Sex Factors , Smoking/adverse effects , Smoking/epidemiology , Smoking/mortality , Smoking/psychology , Smoking Cessation/methods , Smoking Prevention , Tobacco Industry , Tobacco Smoke Pollution/adverse effects , Tobacco Use Disorder/complications , Tobacco Use Disorder/prevention & control , United States/epidemiologyABSTRACT
Maternal serum alpha-fetoprotein (MSAFP), human chorionic gonadotropin (hCG), and unconjugated estriol (uE3) are routinely measured in the second trimester ("triple" test) and combined with maternal age to evaluate risk for fetal Down syndrome. Triple test results and clinical findings were retrospectively reviewed for 30 newborns with Down syndrome to determine whether analyte values or second trimester risks for Down syndrome were more extreme in affected pregnancies where cardiac or other severe congenital malformations were present compared to those cases where major anatomical abnormalities were absent. Mean MS-AFP, uE3, maternal age, and second trimester Down syndrome risk were all similar in the two groups of pregnancies. However, hCG concentrations did appear to be higher in the group of Down syndrome pregnancies with anatomical anomalies (mean 1.74 MoM versus 1.19 MoM) (P<0.05). Overall, there was no significant difference in the incidence of major anomalies in patients with screen-positive test results versus those cases that were not identified by the triple test. Prenatal counseling should therefore reflect the general expectations of the Down syndrome phenotype that have been established from live-born infants with this disorder.
