{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T03:37:37Z","timestamp":1752550657730,"version":"3.37.3"},"reference-count":62,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"SIREN","award":["U54HG007479"],"award-info":[{"award-number":["U54HG007479"]}]},{"name":"SIBS Genomics","award":["R01NS107900"],"award-info":[{"award-number":["R01NS107900"]}]},{"name":"African Neurobiobank for Precision Stroke Medicine ELSI project","award":["U01HG010273"],"award-info":[{"award-number":["U01HG010273"]}]},{"name":"SIBS Gen Gen","award":["R01NS107900-02S1"],"award-info":[{"award-number":["R01NS107900-02S1"]}]},{"name":"ARISES","award":["R01NS115944-01"],"award-info":[{"award-number":["R01NS115944-01"]}]},{"name":"H3Africa CVD Supplement","award":["3U24HG009780-03S5"],"award-info":[{"award-number":["3U24HG009780-03S5"]}]},{"name":"CaNVAS","award":["1R01NS114045-01"],"award-info":[{"award-number":["1R01NS114045-01"]}]},{"name":"sub-Saharan Africa Conference on Stroke Conference","award":["1R13NS115395-01A1"],"award-info":[{"award-number":["1R13NS115395-01A1"]}]},{"name":"Training Africans to Lead and Execute Neurological Trials & Studies","award":["D43TW012030"],"award-info":[{"award-number":["D43TW012030"]}]},{"name":"Growing Data-science Research in Africa to Stimulate Progress","award":["1UE5HL172183-01"],"award-info":[{"award-number":["1UE5HL172183-01"]}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2020H1D3A1A04081265"],"award-info":[{"award-number":["2020H1D3A1A04081265"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Non-cigarette tobacco (NCT) represents a form of tobacco use with a misperceived significance in chronic disease events. Whether NCT use is sufficient to promote stroke events, especially among Africans, is yet to be understood. This study assessed the relationship between NCT use and stroke among indigenous Africans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 7617 respondents (NCT users: 41 vs. non-NCT: 7576) from the Stroke Investigative Research and Educational Network (SIREN) study were included in the current analysis. NCT use was defined as self-reported use of smoked (cigars or piper) or smokeless (snuff or chewed) tobacco in the past year preceding stroke events. Stroke was defined based on clinical presentation and confirmed with a cranial computed tomography\/magnetic resonance imaging. Multivariable-adjusted logistic regression was applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship of NCT with stroke at a two-sided p &amp;lt; .05.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Out of the 41 (0.54%) who reported NCT use, 27 (65.9%) reported using smokeless NCT. NCT users were older than non-NCT users (62.8 \u00b1 15.7 vs. 57.7 \u00b1 14.8 years). Overall, NCT use was associated with first-ever stroke (OR: 2.08; 95% CI: 1.02, 4.23) in the entire sample. Notably, smokeless NCT use was independently associated with higher odds of stroke (OR: 2.74; 95% CI: 1.15, 6.54), but smoked NCT use (OR: 0.16; 95% CI: 0.02, 1.63) presented a statistically insignificant association after adjusting for hypertension and other covariates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>NCT use was associated with higher odds of stroke, and public health interventions targeting NCT use might be promising in reducing the burden of stroke among indigenous Africans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>A detailed understanding of the relationship between NCT use and stroke will likely inform well-articulated policy guidance and evidence-based recommendations for public health prevention and management of stroke on the African continent.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntad239","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T20:09:00Z","timestamp":1701202140000},"page":"589-596","source":"Crossref","is-referenced-by-count":1,"title":["Non-cigarette Tobacco Use and Stroke Among West Africans: Evidence From the SIREN Study"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8391-9394","authenticated-orcid":false,"given":"Adekunle Gregory","family":"Fakunle","sequence":"first","affiliation":[{"name":"Department of Medicine, College of Medicine, University of Ibadan , Ibadan ,","place":["Nigeria"]},{"name":"Department of Public Health, Osun State University , Osogbo ,","place":["Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4825-4934","authenticated-orcid":false,"given":"Akinkunmi Paul","family":"Okekunle","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine, University of Ibadan , Ibadan ,","place":["Nigeria"]},{"name":"Department of Food and Nutrition, Seoul National University , Seoul ,","place":["Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1823-1558","authenticated-orcid":false,"given":"Osahon Jeffery","family":"Asowata","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Medical Statistics, University of Ibadan , Ibadan ,","place":["Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5201-512X","authenticated-orcid":false,"given":"Onoja","family":"Akpa","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Medical Statistics, University of Ibadan , Ibadan ,","place":["Nigeria"]},{"name":"Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan , Ibadan ,","place":["Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fred S","family":"Sarfo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Kwame Nkrumah University of Science and Technology , Kumasi ,","place":["Ghana"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Akpalu","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ghana Medical School , Accra ,","place":["Ghana"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kolawole","family":"Wahab","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ilorin Teaching Hospital , Ilorin ,","place":["Nigeria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reginald","family":"Obiako","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ahmadu Bello University , Zaria 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