Liping Pan

Background: While cigarettes remain the most common form of tobacco product used, the global tobacco landscape is changing with the introduction and marketing of newer products. Methods: We examined the latest two waves of Global Youth Tobacco Survey data from 13 countries that implemented the survey between 2013 and 2023 to assess changes in exclusive, dual and poly-tobacco product use over time among students aged 13–15 years. Current tobacco use, defined as using any form of tobacco in the past 30 days, was categorised into six mutually exclusive variables: exclusive smoked tobacco, exclusive smokeless tobacco, exclusive heated tobacco, exclusive electronic cigarettes (e-cigarettes), dual use and poly-tobacco use. Multivariable logistic regression models adjusted for survey year, sex and age were used to estimate adjusted prevalence differences (aPDs) between survey rounds, accounting for the complex sampling design. Results: Exclusive smoked tobacco declined significantly in six countries, with aPDs ranging from −8.8 percentage points (95% CI −11.1 to −6.6) in Latvia to −2.8 points (95% CI −4.1 to −1.4) in Paraguay. Exclusive e-cigarette use increased in nine countries, ranging from 1.2 points (95% CI 0.3 to 2.1) in Albania to 6.6 points (95% CI 4.4 to 8.8) in the Czech Republic. Dual and/or poly-tobacco use also increased in eight countries, from 0.5 points (95% CI 0.0 to 0.9) in Nicaragua to 6.6 points (95% CI 3.0 to 10.2) in San Marino. Conclusions: There has been a shift in tobacco use patterns, moving from smoked tobacco to e-cigarettes and poly-tobacco use. Comprehensive implementation of tobacco control strategies may contribute to addressing emerging trends in tobacco use.

Electronic cigarette use is growing in popularity and accessibility among youth in the Southeast Asia region. We analyzed data on 6670 students, aged 13–15 years, from the Philippines’ 2019 Global Youth Tobacco Survey. Prevalence estimates and 95% confidence intervals (CI) were estimated for current use (i.e., past 30 days), ever use, and awareness of e-cigarettes. Chi-square tests compared prevalence differences between groups. Multiple logistic regression models assessed factors associated with e-cigarette use while controlling for sociodemographic characteristics, current use of other tobacco products, and secondhand smoke exposure. Prevalence of current e-cigarette use was 14.1% (95% CI = 12.4%, 15.8%), ever use was 24.6% (95% CI = 22.4%, 26.9%), and awareness was 75.5% (95% CI = 73.0%, 78.0%). Current use of any other tobacco products and exposure to secondhand smoke at home, school, or other public places were positively associated with current and ever use of e-cigarettes. Boys and youth living in Luzon or Mindanao had higher odds of current e-cigarette use compared to girls and youth in Visayas. Findings indicated that one in four Philippine students aged 13–15 years ever used e-cigarettes and one in seven currently use e-cigarettes. This study highlights the importance of implementing evidence-based strategies, including relevant tobacco control policies.

The collection of infant body data such as height and weight is a useful mean of tracking its growth and wellness. The contact-based measurements using height and weight scales are manual and cumbersome, camera-based methods were proposed to obtain features from face or body for height and weight estimation. In this paper, we created a clinical dataset including 200 newborns collected at obstetrics, and benchmarked four convolutions neural networks for infant height estimation, where MobileNet, VGG16, GoogleNet, and AlexNet were chosen. Moreover, we investigated different MobileNet-based variants for infant weight estimation, including linear regression model, one-task model, and multi-task model. Several sets of experiments were carried out on the newborn dataset to validate the effectiveness of the proposed methods. The results show that the Mean Absolute Error (MAE) of different models are quite similar, with an average MAE < 1.1 cm and < 0.28 kg for height and weight estimation, respectively. Among them, the multi-task MobileNet has better temporal stability given its lower variance of measurement in a video.

The implementation of several tobacco control policies in the Philippines may have contributed to a decrease in secondhand smoke (SHS) exposure. We examined changes in SHS exposure at work and in public places between 2009 and 2015 among adults aged ≥15 years and interpreted these results within the tobacco policy landscape in the Philippines. We analyzed the Philippines Global Adult Tobacco Survey 2009 and 2015 data. We examined marginal effects in logistic regression to get the adjusted prevalence of SHS exposure at five work and public places, controlling for selected characteristics. We calculated adjusted prevalence ratios and adjusted prevalence differences between 2009 and 2015. Adjusted prevalence of SHS exposure decreased from 2009 to 2015 by 19% (5.7 percentage points) at work, 45% (11.2 percentage points) in government buildings, 48% (3.2 percentage points) in healthcare facilities, 29% (8.2 percentage points) in restaurants, and 33% (19.9 percentage points) on public transportation. Although the prevalence of SHS exposure at work and in public places decreased significantly between 2009 and 2015, a substantial proportion of adults remain exposed to SHS. This study highlights the importance of continued implementation, enforcement, monitoring, and evaluation of tobacco control and prevention measures in the Philippines.

Background: Infants and young children with high weight-for-length are at increased risk for obesity in later life. This study describes prevalence of high weight-for-length and examines changes during 2010–2018 among 11,366,755 infants and young children 3–23 months of age in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods: Children's weights and lengths were measured. High weight-for-length was defined as ≥2 standard deviations above sex and age-specific median on World Health Organization growth charts. Adjusted prevalence differences (APDs) between years were calculated as 100 times marginal effects from logistic regression models. APD was statistically significant if 95% confidence interval did not include 0. Results: Adjusted prevalence of high weight-for-length decreased from 2010 to 2014, and leveled off through 2018 overall, in boys and girls, those 6–11 and 18–23 months of age, and non-Hispanic whites, non-Hispanic blacks, Hispanics, and Asians/Pacific Islanders. For 12–17 months old and American Indian/Alaska Native infants and young children, adjusted prevalence decreased from 2010 to 2014, and then increased slightly through 2018. Among 56 WIC state or territorial agencies, 33 had significant decreases between 2010 and 2018, whereas 8 had significant increases. Between 2014 and 2018, prevalence decreased significantly in 12 agencies and increased significantly in 23. Conclusions: The results indicate overall declines in prevalence of high weight-for-length from 2010 to 2018, with a prevalence stabilization since 2014. Continued surveillance is needed. Obesity prevention strategies in WIC and multiple settings are important for ensuring healthy child growth.

In 2010, the overall upward trend in obesity prevalence turned downward among children aged 2–4 years enrolled in WIC, the Special Supplemental Nutrition Program for Women, Infants, and Children.

Prevalence of childhood obesity is high in the United States, especially among children from lower-income families.¹ Among children aged 2 through 4 years enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), obesity prevalence increased between 2000 and 2010 but declined through 2014.² The decline was statistically significant among all racial/ethnic groups and in 34 of 56 state WIC agencies. The present study examines trends in overweight and obesity by age, sex, and race/ethnicity using WIC data from 2010 to 2016.

Childhood obesity remains a public health concern. Data from the National Health and Nutrition Examination Survey (NHANES) indicated that obesity prevalence increased from 7.2% in 1988 to 1994 to 13.9% in 2003-2004 and then decreased to 9.4% in 2013 to 2014 among children aged 2 to 5 years.¹ Despite the recent declines, the prevalence of childhood obesity remains high, especially among children living in low-income families because obesity disproportionally affects this vulnerable group.^2,3 According to a previous Centers for Disease Control and Prevention (CDC) study, the prevalence of obesity was 14.5% among young children who were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in 2014.³ Obesity and severe obesity in childhood have been associated with other cardiovascular risk factors, impaired glucose tolerance, respiratory problems, increased health care costs, and premature death.^4-7 Those who have obesity or severe obesity during early childhood are also likely to have obesity during middle or late childhood, and obesity often persists into adulthood.^8,9 Adults who have obesity and severe obesity are at increased risk for stroke, coronary heart disease, diabetes, and many other common and costly chronic diseases.¹⁰

Childhood obesity is associated with negative health consequences in childhood (1) that continue into adulthood (2), putting adults at risk for type 2 diabetes, cardiovascular disease, and certain cancers (1). Obesity disproportionately affects children from low-income families (3). Through a collaboration with the United States Department of Agriculture (USDA), CDC has begun to use data from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Participants and Program Characteristics (WIC PC) to replace the Pediatric Nutrition Surveillance System (PedNSS) (4,5) for obesity surveillance among young children from low-income families. CDC examined trends in obesity prevalence during 2000-2014 among WIC participants aged 2-4 years using WIC PC data. Overall obesity prevalence increased from 14.0% in 2000 to 15.5% in 2004 and 15.9% in 2010, and then decreased to 14.5% in 2014. During 2010-2014, the prevalence of obesity decreased significantly overall, among non-Hispanic whites, non-Hispanic blacks, Hispanics, American Indian/Alaska Natives and Asians/Pacific Islanders, and among 34 (61%) of the 56 WIC state agencies in states, the District of Columbia, and U.S. territories. Despite these declines, the obesity prevalence among children aged 2-4 years in WIC remains high compared with the national prevalence of 8.9% among children aged 2-5 years in 2011-2014. Continued initiatives to work with parents and other stakeholders to promote healthy pregnancies, breastfeeding, quality nutrition, and physical activity for young children in multiple settings are needed to ensure healthy child development.