{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T15:39:30Z","timestamp":1762875570750,"version":"3.37.3"},"reference-count":57,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,1,10]]},"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the relationship between the prevalence of smoking in the population and incidence of invasive meningococcal disease (IMD) among children under 5\u2005years of age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective, longitudinal, observational study. Poisson regression controlled for confounding factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Norway, Sweden, Denmark and the Netherlands between 1975 and 2009.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Total population of approximately 35 million people in these four countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data sources<\/jats:title><jats:p>Data were collected from the Ministries of Health, National Statistics Bureaus and other relevant national institutes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In Norway, there was a significant positive relationship between the annual prevalence of daily smokers among individuals aged 25\u201349\u2005years and the incidence of IMD in children under 5\u2005years of age, unadjusted (RR=1.04\u20131.06, 95% CI 1.02 to 1.07, p&lt;0.001) and after adjustment for time of year (quarter), incidence of influenza-like illness and household crowding (RR=1.05\u20131.07, 95% CI 1.03 to 1.09, p&lt;0.001). Depending on age group, the risk of IMD increased by 5.2\u20136.9% per 1% increase in smoking prevalence among individuals aged 25\u201349\u2005years in adjusted analyses. Using limited datasets from the three other countries, unadjusted analysis showed positive associations between IMD in children related to older smokers in Sweden and the Netherlands and negative associations related to younger smokers in Sweden. However, there were no demonstrable associations between incidence of IMD and prevalence of smoking, after adjustment for the same confounding variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The reduced incidence of IMD in Norway between 1975 and 2009 may partly be explained by the reduced prevalence of smoking during this period. High-quality surveillance data are required to confirm this in other countries. Strong efforts to reduce smoking in the whole population including targeted campaigns to reduce smoking among adults may have a role to play in the prevention of IMD in children.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2013-003312","type":"journal-article","created":{"date-parts":[[2014,2,11]],"date-time":"2014-02-11T03:30:00Z","timestamp":1392089400000},"page":"e003312","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Association between population prevalence of smoking and incidence of meningococcal disease in Norway, Sweden, Denmark and the Netherlands between 1975 and 2009: a population-based time series analysis"],"prefix":"10.1136","volume":"4","author":[{"given":"Gunnstein","family":"Norheim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish","family":"Sadarangani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Omar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0331-7364","authenticated-orcid":false,"given":"Ly-Mee","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K\u00e5re","family":"M\u00f8lbak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Howitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per","family":"Olc\u00e9n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaretha","family":"Haglund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arie","family":"van der Ende","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J","family":"Pollard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,2,10]]},"reference":[{"unstructured":"World Health Organization. Control of epidemic meningococcal disease. WHO practical guidelines. 2nd edn. Geneva, Switzerland: World Health Organization, 1998.","key":"2024051510592195000_4.2.e003312.1"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.2","DOI":"10.1136\/adc.85.5.386"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.3","DOI":"10.1136\/adc.85.5.382"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.4","DOI":"10.1056\/NEJMsb035678"},{"unstructured":"Ramsay M Fox A . EU-IBIS Network. Invasive Neisseria meningitidis in Europe 2006. London: Health Protection Agency, 2007.","key":"2024051510592195000_4.2.e003312.5"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.6","DOI":"10.1086\/649209"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.7","DOI":"10.1017\/S0950268800066449"},{"key":"2024051510592195000_4.2.e003312.8","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1128\/jcm.32.2.323-330.1994","article-title":"Asymptomatic carriage of Neisseria meningitidis in a randomly sampled population","volume":"32","author":"Caugant","year":"1994","journal-title":"J Clin Microbiol"},{"unstructured":"Cheever FS . The meningococci. In: Dubos RJ Hirsch JG , eds. Bacterial and mycotic infections of man. 4th edn. Philadelphia, PA: J. B. Lipincott Co., 1965:440\u201350.","key":"2024051510592195000_4.2.e003312.9"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.10","DOI":"10.1016\/S1286-4579(00)00356-7"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.11","DOI":"10.1017\/S0950268800059367"},{"key":"2024051510592195000_4.2.e003312.12","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1017\/S0950268800049943","article-title":"Factors affecting carriage of Neisseria meningitidis among Greek military recruits","volume":"108","author":"Blackwell","year":"1992","journal-title":"Epidemiol Infect"},{"key":"2024051510592195000_4.2.e003312.13","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1093\/oxfordjournals.aje.a115873","article-title":"Risk factors for carriage of meningococcus in the Los Angeles County men's jail system","volume":"133","author":"Thomas","year":"1991","journal-title":"Am J Epidemiol"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.14","DOI":"10.1136\/bmj.320.7238.846"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.15","DOI":"10.1017\/S0950268898001496"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.16","DOI":"10.1007\/s100960100478"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.17","DOI":"10.3201\/eid1206.051297"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.18","DOI":"10.1093\/ije\/dyi295"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.19","DOI":"10.1111\/j.1445-5994.2004.00564.x"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.20","DOI":"10.1136\/adc.83.2.117"},{"key":"2024051510592195000_4.2.e003312.21","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1097\/00006454-200010000-00009","article-title":"Household crowding a major risk factor for epidemic meningococcal disease in Auckland children","volume":"19","author":"Baker","year":"2000","journal-title":"Pediatr Infect Dis J"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.22","DOI":"10.1097\/00006454-199710000-00015"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.23","DOI":"10.1056\/NEJM199609193351201"},{"unstructured":"World Health Organization. WHO report on the global tobacco epidemic. Warnings about the dangers of tobacco. Geneva, Switzerland: World Health Organization. 2011.","key":"2024051510592195000_4.2.e003312.24"},{"key":"2024051510592195000_4.2.e003312.25","first-page":"169","article-title":"Factors preceding the onset of meningococcal disease, with special emphasis on passive smoking, symptoms of ill health","volume":"6","author":"Haneberg","year":"1983","journal-title":"NIPH Ann"},{"key":"2024051510592195000_4.2.e003312.26","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1017\/S0950268800057733","article-title":"Smoking, the environment and meningococcal disease: a case control study","volume":"112","author":"Stanwell-Smith","year":"1994","journal-title":"Epidemiol Infect"},{"key":"2024051510592195000_4.2.e003312.27","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1093\/oxfordjournals.aje.a008792","article-title":"Outbreak of serogroup C meningococcal disease associated with campus bar patronage","volume":"143","author":"Imrey","year":"1996","journal-title":"Am J Epidemiol"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.28","DOI":"10.1001\/jama.286.6.688"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.29","DOI":"10.1136\/bmj.38725.728472.BE"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.30","DOI":"10.1016\/0140-6736(91)91961-S"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.31","DOI":"10.1371\/journal.pmed.0050074"},{"unstructured":"Forey B Hamling J Lee P . International smoking statistics. A collection of historical data from 30 economically developed countries. Oxford: Oxford University Press, 2002.","key":"2024051510592195000_4.2.e003312.32"},{"key":"2024051510592195000_4.2.e003312.33","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1017\/S0950268810000671","article-title":"Estimating influenza-related excess mortality and reproduction numbers for seasonal influenza in Norway, 1975\u20132004","volume":"138","author":"Gran","year":"2010","journal-title":"Epidemiol Infect"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.34","DOI":"10.1007\/s10552-006-0090-y"},{"key":"2024051510592195000_4.2.e003312.35","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1177\/1536867X0500500404","article-title":"Multiple imputation of missing values: update of ice","volume":"5","author":"Royston","year":"2005","journal-title":"Stata J"},{"doi-asserted-by":"crossref","unstructured":"Rubin D . Multiple imputation for nonresponse in surveys. New York: Wiley, 1987.","key":"2024051510592195000_4.2.e003312.36","DOI":"10.1002\/9780470316696"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.37","DOI":"10.1186\/1471-2458-12-1062"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.38","DOI":"10.1093\/ntr\/ntn010"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.39","DOI":"10.1086\/605435"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.40","DOI":"10.1023\/B:EJEP.0000017659.80903.5f"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.41","DOI":"10.1002\/sim.3440"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.42","DOI":"10.1017\/S0950268807000271"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.43","DOI":"10.1093\/biostatistics\/4.2.265"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.44","DOI":"10.1093\/clinids\/14.2.515"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.45","DOI":"10.1371\/journal.pone.0045349"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.46","DOI":"10.1371\/journal.pmed.1000374"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.47","DOI":"10.1186\/1742-7622-3-10"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.48","DOI":"10.1093\/aje\/kwn220"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.49","DOI":"10.1086\/499822"},{"key":"2024051510592195000_4.2.e003312.50","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1016\/S0140-6736(89)90781-2","article-title":"Effect of smoking on meningococcal carriage","volume":"2","author":"Stuart","year":"1989","journal-title":"Lancet"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.51","DOI":"10.1038\/nri803"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.52","DOI":"10.1136\/thx.49.8.825"},{"key":"2024051510592195000_4.2.e003312.53","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/S0272-5231(21)01035-2","article-title":"Cigarette smoking and respiratory tract infection","volume":"8","author":"Marcy","year":"1987","journal-title":"Clin Chest Med"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.54","DOI":"10.1016\/j.ijporl.2010.01.006"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.55","DOI":"10.1093\/ije\/dyh169"},{"doi-asserted-by":"crossref","unstructured":"Goldacre MJ Wotton CJ Maisonneuve JJ . Maternal and perinatal factors associated with subsequent meningococcal, Haemophilus or enteroviral meningitis in children: database study. Epidemiol Infect 2013:1\u20138.","key":"2024051510592195000_4.2.e003312.56","DOI":"10.1017\/S095026881300099X"},{"doi-asserted-by":"publisher","key":"2024051510592195000_4.2.e003312.57","DOI":"10.1136\/adc.2007.133553"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2013-003312","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T17:59:42Z","timestamp":1715795982000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2013-003312"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,2]]},"references-count":57,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2014,2,10]]},"published-print":{"date-parts":[[2014,2]]}},"alternative-id":["10.1136\/bmjopen-2013-003312"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2013-003312","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2014,2]]}}}