Lancet Regional Health-Europe最新文献

{"title":"Rurality, travel distance, and effectiveness of remote patient management in patients with heart failure in the TIM-HF2 trial in Germany: a pre-specified analysis of an open-label, randomised controlled trial","authors":"Fabian Kerwagen , Stefan Störk , Kerstin Koehler , Eik Vettorazzi , Maximilian Bauser , Jasmin Zernikow , Gina Barzen , Meike Hiddemann , Jan Gröschel , Michael Gross , Christoph Melzer , Karl Stangl , Gerhard Hindricks , Friedrich Koehler , Sebastian Winkler , Sebastian Spethmann","doi":"10.1016/j.lanepe.2025.101321","DOIUrl":"10.1016/j.lanepe.2025.101321","url":null,"abstract":"<div><h3>Background</h3><div>Despite the higher burden of heart failure (HF) in rural areas, the accessibility of specialised HF care is limited when compared to urban areas. This study aimed to evaluate the impact of remote patient management (RPM) on clinical outcomes in heart failure patients, considering three different geospatial determinants.</div></div><div><h3>Methods</h3><div>This was a pre-specified analysis of the TIM-HF2 (Telemedical Interventional Management in Heart Failure II) open-label, randomised trial, which compared the effects of an RPM intervention with care as usual in patients with HF hospitalisation within the last 12 months before randomisation. Patients were randomised in a 1:1 ratio to RPM or usual care. Additionally, randomisation employed a 2:1 ratio between rural and urban areas of medical care based on the location of the cardiologist. The primary endpoint was percentage of days lost due to all-cause death or unplanned cardiovascular hospitalisation, the secondary endpoints were all-cause and cardiovascular mortality. The current investigation focused on three key factors hypothesised to influence the effectiveness of the RPM intervention: the location of the cardiologist (rural vs. urban), the patient's place of residence (rural vs. urban), and the travel distance between these two locations. The TIM-HF2 trial was registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT01878630</span><svg><path></path></svg></span>) and has been completed.</div></div><div><h3>Findings</h3><div>The TIM-HF2 trial was performed between August 13, 2013, and May 18, 2018. In the present analysis, all 1538 patients from the main trial were included; 915 (59%) of these were treated by a rural cardiologist, while 623 (41%) were treated by an urban cardiologist. The median travel distance was higher for patients living in rural than for those living in urban areas: 14.1 km (quartiles 4.3, 29.1) vs. 6.5 km (3.9, 13.8). The RPM intervention demonstrated a comparable reduction in the primary endpoint, irrespective of cardiologist location: rate ratio 0.82 (95% CI 0.62–1.08) for rural vs. 0.78 (0.55–1.09) for urban; or place of residence: 0.74 (0.55–0.99) for rural vs. 0.89 (0.65–1.22) for urban. The RPM intervention exhibited enhanced effectiveness at increasing travel distances, with a 13% risk reduction for each doubling of distance (2.2%–23.3%; p-interaction = 0.021). These distance-dependent effects were consistent for both secondary endpoints, i.e., all-cause (hazard ratio 0.75 [0.63–0.90]; p-interaction = 0.002) and cardiovascular mortality (0.77 [0.62–0.96]; p-interaction = 0.019).</div></div><div><h3>Interpretation</h3><div>RPM, as deployed in the TIM-HF2 trial, was equally effective irrespective of the cardiologist’s location. Patients living further from their cardiologist benefited the most from the RPM intervention. These findings suggest that greater emphasis should be placed on facilita","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"54 ","pages":"Article 101321"},"PeriodicalIF":13.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying diagnostic intervals and routes to diagnosis for children and young people with cancer in the UK (Childhood Cancer Diagnosis study, CCD): a population-based observational study","authors":"Dhurgshaarna Shanmugavadivel ,&nbsp;Jo-Fen Liu ,&nbsp;Timothy A. Ritzmann ,&nbsp;Ashley Ball-Gamble ,&nbsp;Angela Polanco ,&nbsp;Neil Ranasinghe ,&nbsp;Kavita Vedhara ,&nbsp;Shalini Ojha ,&nbsp;David Walker","doi":"10.1016/j.lanepe.2025.101329","DOIUrl":"10.1016/j.lanepe.2025.101329","url":null,"abstract":"<div><h3>Background</h3><div>Childhood cancer is a global disease burden, with early diagnosis a priority. We quantified diagnostic intervals and referral routes for children and young people (CYP 0–18 years) diagnosed with cancer in the UK.</div></div><div><h3>Methods</h3><div>All CYP diagnosed between September 2020–March 2023 were eligible. Demographic, referral, and symptom data were collected prospectively. Patient interval (PI), diagnostic interval (DI), and total diagnostic interval (TDI) were calculated.</div></div><div><h3>Findings</h3><div>1957 CYP (mean age 7.4 years, 55% male, 78% white) participated. Median PI, DI, and TDI were 1.1 (IQR 0.1–4.0; range 0–164), 1.7 (IQR 0.4–5.9; range 0–310), and 4.6 weeks (IQR 2.0–11.4; range 0–310), respectively. Intervals were unaffected by sex, ethnicity or deprivation index (IMD). Median TDI was longest in 15–18 years (8.7 weeks, IQR 3.0–17.4) and bone tumours (12.6 weeks, IQR 6.6–23.4) and shortest in under ones (3.7 weeks, IQR 1.0–8.1) and renal tumours (2.3 weeks, IQR 0.9–5.0). 74% (n = 1438) had 1–3 pre-diagnostic healthcare contacts; 67% (n = 1312) presented emergently, with a median of 4.0 (range 0–26) symptoms. CYP with Langerhans Cell Histiocytosis were most likely to have ≥4 visits when compared with leukaemia (adjusted OR 7.48, 95% CI 3.54–15.82), followed by central nervous system, bone, and soft tissue tumours.</div></div><div><h3>Interpretation</h3><div>This study highlights equal access to diagnosis for sex, ethnicity and IMD, but disparities for age and diagnostic groups. These data will inform professional and public health strategies and health policy to accelerate diagnosis for all.</div></div><div><h3>Funding</h3><div><span>National Institute for Health and Social Care Research</span> (NIHR) <span><span>DRF-2018-11-ST2-055</span></span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"54 ","pages":"Article 101329"},"PeriodicalIF":13.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of myopia in Europe: a systematic review and meta-analysis of data from 14 countries","authors":"André Moreira-Rosário ,&nbsp;Carla Lanca ,&nbsp;Andrzej Grzybowski","doi":"10.1016/j.lanepe.2025.101319","DOIUrl":"10.1016/j.lanepe.2025.101319","url":null,"abstract":"<div><h3>Background</h3><div>Although myopia prevalence increased in East Asian countries, the burden of myopia in Europe is less known. We performed a systematic review and meta-analysis to estimate the prevalence of myopia in Europe and at the country level.</div></div><div><h3>Methods</h3><div>We searched PubMed, Scopus and Web of Science to identify studies on myopia prevalence published until January 2024, regardless of language. We included European cross-sectional and cohort studies with defined sampling strategies and excluded clinical surveys, myopia registries, self-reported near-sightedness, and non-representative populations. Pooled prevalence was estimated using random-effects models. Heterogeneity was assessed using the Cochran's Q (χ² test) and the I² statistic. The study protocol was preregistered in PROSPERO (CRD42023471527).</div></div><div><h3>Findings</h3><div>We screened 2074 records and included 22 studies (from 14 European countries; n = 128,012) in the meta-analyses. The pooled prevalence of myopia was 23.5% (95% CI: 18.5–29.3; I² = 99.7%), ranging from 11.9% in Finland to 49.7% in Sweden. In cycloplegic studies, myopia prevalence was 18.9% (95% CI: 13.2–26.5%; I² = 99.7%) vs. 31.2% (95% CI: 24.9–38.3%; I² = 99.3%) in non-cycloplegic studies. Subgroup and meta-regression analyses exploring sources of heterogeneity showed a lower prevalence in children (6–11 years; 5.5%) compared with adolescents (12–17 years; 25.2%) and adults (18–39 years; 24.3%) in cycloplegic studies. No significant differences in prevalence were observed between sexes. Myopia prevalence increased significantly between 2000–2010 and 2011–2022 (p = 0.040), although age-specific trends remained stable.</div></div><div><h3>Interpretation</h3><div>Myopia prevalence in Europe is lower than in Asia, with a less pronounced increase that disappears after stratifying by cycloplegic refraction and age. These findings highlight the need for age-specific data and cycloplegic refraction in future studies to reduce heterogeneity. Uneven country representation may limit the generalisability of these results.</div></div><div><h3>Funding</h3><div>The present publication was funded by <span>Fundação Ciência e Tecnologia</span>, IP national support through UID/04923—Comprehensive Health Research Centre.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"54 ","pages":"Article 101319"},"PeriodicalIF":13.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A call for doubling the diagnostic rate of at-risk metabolic dysfunction-associated steatohepatitis","authors":"Jeffrey V. Lazarus ,&nbsp;Paul N. Brennan ,&nbsp;Henry E. Mark ,&nbsp;William Alazawi ,&nbsp;Alina M. Allen ,&nbsp;Christopher D. Byrne ,&nbsp;Laurent Castera ,&nbsp;Cyrielle Caussy ,&nbsp;Kenneth Cusi ,&nbsp;Martin M. Grajower ,&nbsp;Christopher J. Kopka ,&nbsp;Jo Massoels ,&nbsp;Michael Roden ,&nbsp;C Wendy Spearman ,&nbsp;Frank Tacke ,&nbsp;Vincent Wai-Sun Wong ,&nbsp;Mazen Noureddin","doi":"10.1016/j.lanepe.2025.101320","DOIUrl":"10.1016/j.lanepe.2025.101320","url":null,"abstract":"<div><div>Metabolic dysfunction-associated steatohepatitis (MASH) is an increasingly important contributor to morbidity and mortality. Little emphasis has been placed on its timely diagnosis and interventions to prevent adverse disease outcomes. The principal determinant of MASH outcomes is the liver fibrosis stage. The prevalence of MASH is higher among people living with obesity and/or type 2 diabetes, with MASH with moderate to advanced fibrosis affecting one in six adults. Delivering a paradigm shift in MASH diagnosis in the four countries studied will require an expansion of community-based diagnostic capability that will also foster prevention efforts and provide opportunities for treatment and care.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"54 ","pages":"Article 101320"},"PeriodicalIF":13.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European Medicines Agency approvals of new medicines in March and April 2025","authors":"Bruno Sepodes ,&nbsp;Juan Garcia Burgos ,&nbsp;Steffen Thirstrup","doi":"10.1016/j.lanepe.2025.101330","DOIUrl":"10.1016/j.lanepe.2025.101330","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"54 ","pages":"Article 101330"},"PeriodicalIF":13.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intergenerational trauma in Poland","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2025.101379","DOIUrl":"10.1016/j.lanepe.2025.101379","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"54 ","pages":"Article 101379"},"PeriodicalIF":13.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of longitudinal observational studies for hereditary neurodegenerative disorders","authors":"Joseph H. Friedman ,&nbsp;Zbigniew K. Wszolek","doi":"10.1016/j.lanepe.2025.101374","DOIUrl":"10.1016/j.lanepe.2025.101374","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101374"},"PeriodicalIF":13.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trial","authors":"Thomas Gaziano ,&nbsp;José María Castellano ,&nbsp;Amy Dymond ,&nbsp;Alissa Looby ,&nbsp;Stuart Mealing ,&nbsp;Ruth Owen ,&nbsp;Stuart Pocock ,&nbsp;José Ramón González-Juanatey ,&nbsp;Alberto Cordero ,&nbsp;Antonio Fernández-Ortiz ,&nbsp;Aleš Linhart ,&nbsp;François Schiele ,&nbsp;Wolfram Doehner ,&nbsp;Luisa Ojeda Fernández ,&nbsp;Valentín Fuster","doi":"10.1016/j.lanepe.2025.101348","DOIUrl":"10.1016/j.lanepe.2025.101348","url":null,"abstract":"<div><h3>Background</h3><div>The SECURE trial (<span><span>NCT02596126</span><svg><path></path></svg></span>) demonstrated the efficacy of the cardiovascular polypill (“CV-Polypill”–acetyl salicylic acid, atorvastatin and ramipril) in reducing the risk of recurrent major cardiovascular events compared with standard care when initiated within six months of a myocardial infarction. This analysis aimed to estimate the cost-effectiveness of the CV-Polypill from the Spanish healthcare perspective using SECURE trial data.</div></div><div><h3>Methods</h3><div>A decision analytic Markov modelling approach was conducted to compare the CV-Polypill with standard care over a lifetime time horizon. Six parametric distributions were fitted to SECURE trial data on time to reinfarction, stroke or death (cardiovascular or non-cardiovascular). Cost and utility data were sourced from literature. Respective model outputs were discounted at 3%. The model captured direct medical costs associated with treatment acquisition and acute/ongoing cardiovascular events. Probabilistic sensitivity analyses (PSA) and scenario analyses were conducted.</div></div><div><h3>Findings</h3><div>The CV-Polypill is dominant (improves health outcomes and reduces costs) in 84·8% of PSA iterations (848/1000 iterations), and cost effective in 89·3% of PSA iterations (893/1000 iterations) at a €30,000 threshold. Secondary prevention with the CV-Polypill reduces the recurrence of cardiovascular events and costs over the time horizon, from the Spanish healthcare perspective. A range of scenario analyses were conducted, demonstrating the robustness of the results when different inputs and assumptions were varied.</div></div><div><h3>Interpretation</h3><div>The CV-Polypill is a dominant strategy in secondary cardiovascular prevention, compared with standard care, from the Spanish healthcare perspective. The CV-Polypill should be considered as a secondary prevention for Spanish patients, like those enrolled in SECURE, at hospital discharge.</div></div><div><h3>Funding</h3><div>By <span>Ferrer International</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101348"},"PeriodicalIF":13.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility, time to pregnancy, and pregnancy outcomes among women with recurrent miscarriages in the UK: a prospective observational longitudinal study","authors":"Constandina Koki ,&nbsp;Rebecca Shields ,&nbsp;Rebecca Sweetman ,&nbsp;James Boyle ,&nbsp;Omar Khan ,&nbsp;Sarah N. Lim Choi Keung ,&nbsp;Theodoros N. Arvanitis ,&nbsp;Adam J. Devall ,&nbsp;Nigel John Burroughs ,&nbsp;Siobhan Quenby","doi":"10.1016/j.lanepe.2025.101343","DOIUrl":"10.1016/j.lanepe.2025.101343","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Recurrent miscarriage is a debilitating disorder associated with considerable physical and psychological morbidity. An estimated 50% of first trimester miscarriages remain unexplained. The aim of this study was to provide a personalised framework to guide the expectations of women experiencing recurrent miscarriage, with the ultimate goal of transforming clinical practice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We used real-world data from a UK longitudinal study of 1201 couples attending National Health Service (NHS) miscarriage clinics, with a history of previous miscarriages, comprising medical and obstetric history, results of investigations and pregnancy and neonatal outcome. We developed, parametrised, and validated predictive models for the probability that the next pregnancy is viable and for the time to next pregnancy. Time to next pregnancy separates couples into two groups, a group with subfertility, &lt;em&gt;i.e.,&lt;/em&gt; delay in conception, and a group with no significant delay in conception. We used Bayesian inference for the latter model.&lt;/div&gt;&lt;div&gt;Trial registration number: The prospective data collections were pre-registered ISRCTN17732518; &lt;span&gt;&lt;span&gt;https://doi.org/10.1186/ISRCTN17732518&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Predictive models of the time to pregnancy, the probability of the couple being subfertility and the probability of having a viable pregnancy can be parametrised from longitudinal study data. We identified several predictors for such models. In the viable pregnancy model, increased maternal age, higher Body Mass Index (BMI), having Polycystic Ovaries Syndrome (PCOS) and the number of previous miscarriages were associated with reduced odds of viable pregnancy. In contrast, having had previous live births increased the odds of a viable pregnancy. Model validation against a second external dataset gave an Area Under Curve (AUC) of 0.65 (95% Confidence Interval (CI): 0.55, 0.76). Of the 942 women referred to our recurrent miscarriage clinics and followed up over a period of 3 years, 10.7% (101) did not conceive during this time, indicating a potential subfertility problem. In the time to pregnancy model, increased maternal age, higher BMI, and smoking were associated with reduced likelihood of conception. Conversely, taking folic acid supplements and having a history of previous conceptions were associated with increased fertility. In our cohort, 53.4% (577 out of 1080 women) reported a pregnancy within 12 months. Additionally, 22.8% (277 out of 996 women who were followed up over a 2-year period) experienced a first pregnancy event in the second year. The area under the curve (AUC) for predicting pregnancy within 12 months was 0.60 (95% CI: 0.50–0.70) in an external validation using a second dataset.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;The pregnancy journey can be predicted on a personalised basis by integrating the validated models. We provid","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101343"},"PeriodicalIF":13.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of nicotine product use in Ireland 2015–2023, and associations with quit intentions and attempts: an analysis of nationally representative repeated cross-sectional surveys","authors":"Margaret M. Brennan ,&nbsp;Andrea K. Bowe ,&nbsp;Aishling Sheridan ,&nbsp;Frank Doyle ,&nbsp;Fiona Boland ,&nbsp;Paul Kavanagh","doi":"10.1016/j.lanepe.2025.101352","DOIUrl":"10.1016/j.lanepe.2025.101352","url":null,"abstract":"<div><h3>Background</h3><div>Nicotine product use (NPU; including combustible tobacco products and/or e-cigarettes) is changing rapidly worldwide. Aiming to inform an agile policy response, this study examined NPU trends, and associations with intentions and attempts to quit tobacco.</div></div><div><h3>Methods</h3><div>Survey-weighted prevalences of NPU (tobacco and/or e-cigarette), tobacco, e-cigarette, and dual (tobacco and e-cigarette) use were estimated from 2015 to 2023 (excluding 2020 and 2021) using seven waves of the nationally representative Healthy Ireland survey (combined N = 52,167). Associations between sociodemographic factors and NPU, as well as between NPU and quit intentions and attempts, were examined using survey-weighted regression in the 2015 and 2023 waves.</div></div><div><h3>Findings</h3><div>Between 2015 and 2023, decreases in NPU were non-significant (24·6% (1846/7502) to 22·9% (1688/7356), p_trend = 0·120), while tobacco use decreased (22·8% (1713/7502) to 17·7% (1303/7356), p_trend = 0·012), e-cigarette use increased (3·1% (230/7502) to 8·4% (614/7356), p_trend = 0·001) and dual use increased (1·3% (97/7502) to 3·1% (230/7356), p_trend = 0·006). Among those aged 15–24, NPU increased from 19·6% (214/1095) in 2015 to 30·0% (345/1149) in 2023. In 2015, dual use was strongly associated with higher odds of quit intentions and attempts to quit tobacco, compared to tobacco-only, but this was no longer the case in 2023.</div></div><div><h3>Interpretation</h3><div>E-cigarette and dual use have more than doubled in Ireland, while tobacco declines have slowed. The most substantial changes occurred among 15–24-year-olds. Concurrently, the link between dual use and quit intentions and attempts attenuated. These findings underscore the need for stronger e-cigarette regulation and renewed policy efforts to achieve tobacco endgame in Ireland.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101352"},"PeriodicalIF":13.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}