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The FRESHAIR4Life study: Can we reduce the risk of non-infectious disease in low-income countries?

A summary of research published in npj Primary Care Respiratory Medicine. 

A new paper published in npj Primary Care Respiratory Medicine aims to understand how we can target populations to reduce the rates of non-infectious disease.

Non-infectious, or non-communicable diseases (NCDs), are a leading cause of death globally and are prevalent in low-income countries.

Background


Non-communicable diseases (NCDs) are the leading cause of death worldwide. NCDs are non-infectious so cannot pass from one person to another. They include conditions such as asthma and lung cancer. 

Tobacco use and air pollution are major risk factors for NCDs and are linked with a third of cases. Low-income countries usually have higher rates of NCDs due to less access to education and more exposure to risk factors. Since NCDs can be prevented, it is important to educate these countries on how to reduce the risk. This can reduce the strain on health services and improve population health. 

What did the study look at?


The FRESHAIR4Life study is a 4-year project with the aim of reducing the strain of NCD risk factors on health. It targets low-income areas and has 8 stages. This paper summarised the methods of FRESHAIR4Life and results of the initial review. The study is set to continue and will inform evidence-based interventions in the FRESHAIR4Life package. 

A review was carried out to decide on risk factors and who to target. 5 countries were identified: Greece, the Kyrgyz Republic, Romania, Pakistan and Uganda. The initial review and ongoing study targets young people who may be more exposed to tobacco use and pollution. Methods to reduce the burden of these risk factors were tailored to each country. 

The cost-effectiveness of any methods will be regularly evaluated. Through knowing the dangers of pollution and tobacco, teenagers are supported to promote this and contribute to improving lung health for all by reducing exposure to NCD risk factors. 

What did the results show?


  • Tobacco use and air pollution are within the top 10 risk factors for death by NCDs in all 5 countries. Tobacco use leads to more deaths in Greece, Romania and the Kyrgyz Republic. Air pollution is linked to more deaths in Uganda and Pakistan. 
  • More teenagers from Greece and Romania use tobacco. Males use tobacco more often than females in all countries.  
  • In 4 out of the 5 countries (excluding the Kyrgyz Republic) tobacco use is linked to low-income areas. Other factors linked to tobacco use is having a friend or relative who smokes, poor mental health, or a lack of support to quit.  
  • Tobacco alternatives, such as e-cigarettes, are becoming more common for all teenagers. This is due to misinformation that these products are less dangerous to health. However, in Greece and Romania, more teenagers still use conventional cigarettes. 
  • All countries had levels of air pollution exceeding the WHO air quality guidelines. Most pollution in these countries is from vehicles and burning fossil fuels. 

Why is this important?


Tobacco is commonly used in low-income countries. Its use is linked to a third of deaths caused by NCDs, alongside air pollution. Tobacco use often begins in youth, making teenagers an ideal group to target. In addition, higher air pollution in low-income countries means that it is relevant to ensure greater education in these countries. 

By raising awareness of these risk factors, the study aims to reduce deaths caused by NCDs and improve population health.  

 

Read the full text here: The FRESHAIR4Life study: Global implementation research on non-communicable disease prevention targeting adolescents’ exposure to tobacco and air pollution in disadvantaged populations | npj Primary Care Respiratory Medicine (nature.com)