The study aimed to investigate the relationship between mobile phone use and cognitive impairment using the data of the Prevention and Intervention on Neurodegenerative Disease for Elderly in China (PINDEC) survey. A total of 21,732 participants aged 60 years and above in China were recruited using a stratified, multi-stage cluster sampling method, providing information on demographics, lifestyle and health-related characteristics, mobile phone use, and cognitive impairment through face-to-face interviews by trained staff according to a standard protocol. All estimates of rates were weighted by sex, age, and living area (rural or urban) in the elderly Chinese population. The rate of mobile phone usage was 65.5% (14.3% for smartphone use). The prevalence of cognitive impairment in non-users of mobile phone, dumbphone users, and smartphone users were 17.8%, 5.0%, and 1.4%, respectively. The odds of having cognitive impairment in users of dumbphone and smartphone were lower than non-users after adjusting for demographics, lifestyle, and health-related factors (adjusted odds ratio (AOR), 0.39, 95% CI 0.35 to 0.45; p < 0.001; AOR, 0.16, 95% CI 0.11 to 0.25; p < 0.001, respectively). Smartphone use in Chinese elderly people was quite low. A strong correlation was found between mobile phone use and better cognitive function; yet longitudinal studies are warranted to explore the causal relationship. Future design of mobile phone-based interventions should consider the feasibility among those in need.

Background Independent studies on exhaled carbon monoxide (CO) and saliva cotinine levels in regular heated tobacco product (HTP) users, and how they compare with conventional cigarette (CC) smokers, are lacking. Methods A total of 3294 current users of CCs, HTPs or electronic cigarettes (ECs) from a household survey and a smoking hotspot survey were classified into seven groups: exclusive users of CCs, HTPs, ECs; dual users of CCs and HTPs, CCs and ECs, HTPs and ECs; and triple users. We measured exhaled CO level using the piCo Smokerlyzer (n=780) and saliva cotinine using NicAlert cotinine test strips (n=620). Among the seven groups, the differences in (1) CO and cotinine levels were examined using Kruskal-Wallis test, and (2) the average daily tobacco consumption in the past 30 days was examined using multivariable linear regression. Results Both exclusive and dual users of CCs had a higher CO level than exclusive HTP or EC users (p<0.05). Exhaled CO levels were similar between HTP and EC users, as were saliva cotinine levels among the seven groups. Compared with exclusive CC users, those who also used HTPs or ECs smoked fewer CCs (CCs+HTPs: adjusted coefficient −2.79, 95% CI −3.90 to –1.69; CCs+ECs: −1.34, 95% CI −2.34 to –0.34), but consumed more tobacco sticks equivalent in total (2.79 (95% CI 1.61 to 3.96); 1.95 (95% CI 0.79 to 3.12)). Conclusions HTP or EC use showed lower exhaled CO but similar saliva cotinine levels compared with CC use. Dual users of CCs and HTPs/ECs smoked fewer CCs than exclusive CC users, but consumed more tobacco in total.

This study was to observe smoking behaviours and infection control behaviours in smokers at outdoor smoking hotspots during the COVID-19 pandemic in Hong Kong. We conducted unobtrusive observations at nine hotspots during 1 July 2019–31 January 2020 (pre-outbreak, 39 observations), 1 February–30 April 2020 (outbreak, eight observations), and 1 May–11 June 2020 (since-outbreak, 20 observations). Sex, age group, type of tobacco products used, duration of stay, group smoking behaviours, face mask wearing and infection control behaviours of smokers, and mask wearing of non-smoking pedestrians were observed. Compared with pre-outbreak, lower volumes of smokers were observed during outbreak and since-outbreak. Smokers gathered more in a group (24.5% and 25.8% vs. 13.4%, respectively) and stayed longer (91.5% and 83.6% vs. 80.6% stayed ≥1 min) during outbreak and since-outbreak than pre-outbreak. Ninety-six percent smokers possessed a face mask. While smoking, 81.6% of smokers put the mask under the chin and 13.8% carried it in the hand, 32.4% did not wear a mask immediately after smoking, 98.0% did not sanitize hands, and 74.3% did not keep a distance of at least one metre. During the COVID-19 pandemic, smokers gathered closely and stayed longer at the hotspots, and few practised hand hygiene, all of which may increase the risk of infection.

Introduction: Changes in tobacco use since the COVID-19 outbreak differed by countries and little is known about changes in the use of specific tobacco products. Methods: We analyzed data from four cross-sectional telephone/online surveys from April to June 2020 to investigate such changes...

Objective: To design a smartphone app and evaluate its effect on promoting mental well-being and awareness of anxious symptoms in adolescents. Materials and Methods: A pilot cluster randomized controlled trial was conducted with two secondary schools (390 students, mean age 13.1 years) randomized to the intervention and control groups. An app was designed to encourage “Sharing, Mind, and Enjoyment (SME)” between students and their parents (e.g., express gratitude), including interaction and game elements. The app was used daily over 1 month. The waitlist control group was offered the app after completing all assessments. The primary outcomes were changes in SME behaviors measured at 1 month and 3 months. Secondary outcomes included subjective happiness, well-being, personal health and happiness, family health, happiness and harmony, self-perceived knowledge, and understanding of anxious symptoms. Two focus groups of students and three individual in-depth interviews of community partners were conducted. Results: Seventeen of 152 students (11.2%) in the intervention group used the app together with parents (adherent subgroup) and 69 (45.4%) used it without involving parents. The intervention group did not show significant difference in the change of SME behaviors at 1- or 3-month follow-up compared with the control group. However, the intervention group reported greater increase in the awareness of anxious symptoms at follow-ups than the control group (d = 0.52 at 1 month and d = 0.43 at 3 month, both P < 0.001). Post hoc analysis showed a significantly greater increase in SME-related behaviors in the adherent subgroup than the control group at 3 months (d = 0.46, P = 0.04). The interviews found favorable changes in app users, but motivation to use the app was low in general. Both students and community partners suggested primary school students would be more receptive users. Conclusions: The app did not show effectiveness in increasing SME behaviors of students, but increased awareness of anxious symptoms. Further improvements and tests are warranted. Trial Registration: ClinicalTrials.gov NCT03361475

We conducted a cluster randomised controlled trial of parents in 56 primary schools and community service centres (clusters) to evaluate the effectiveness of a single-session workshop on promoting more fruit and vegetable (FV) intake. A total of 803 parents were randomised to the FV intervention arm (16 clusters, n = 197), the more appreciation control arm (19 clusters, n = 270), or the less criticism control arm (21 clusters, n = 336). The FV intake of the FV arm was compared with that of the combined more appreciation or less criticism (MALC) arm. Both arms received a 2 h workshop: (i) the FV arm on increasing FV consumption and related food literacy; (ii) the MALC arm on increasing appreciation or reducing criticism of children. Primary outcomes were FV consumption per day in the past week assessed at baseline, 2-weeks, and 6-weeks. Secondary outcomes were behavioural determinants proposed by the Health Action Process Approach (HAPA), including outcome expectancies, self-efficacy, intention, and planning behaviour. The FV arm had a greater increase in FV consumption than the MALC arm, with large effect sizes (d: 0.97–1.08) and improvements in behavioural determinants with small effect sizes at all time points (d: 0.19–0.43). Our study was the first population-based randomised controlled trial to show that a brief, single 2 h HAPA-based workshop was effective in promoting fruit and vegetable intake in parents.