PLOS global public health最新文献

{"title":"Preparing for future pandemics: A qualitative exploration of social media in light of the COVID-19 pandemic and vaccine hesitancy.","authors":"Emmanuel A Odame, Oluwabunmi Dada, Jordan Nelson, Ayorinde Ogunyiola, Jessica Haley","doi":"10.1371/journal.pgph.0004317","DOIUrl":"10.1371/journal.pgph.0004317","url":null,"abstract":"<p><p>Vaccine hesitancy remains a significant barrier to the success of global vaccination campaigns and vaccine programs. Understanding people's perceptions of vaccines on social media during disease outbreaks can aid in reducing socially induced vaccine hesitancy and improve program implementation. Social media is an increasingly valuable tool for assessing public perceptions on critical issues, including vaccine adoption. This study examines perceptions surrounding the COVID-19 vaccine among Twitter users in the United States, Brazil, and India within a few weeks post-vaccine release. These countries are associated with anti-vaccine movements and outbreaks of vaccine-preventable diseases. We identified and analyzed key themes related to vaccine perception in 2,858 Twitter posts. Using a qualitative interpretive approach to analyze tweets, we found that mistrust in vaccine science, politics of vaccination, and religious pushbacks were the main themes that emerged from the analysis. Perceptions harbored by individuals and communicated frequently via mass communication platforms may erode public trust and disarticulate avenues of communication between public health officials and communities. Thus, we suggest that harnessing vaccine hesitancy-related information on social media can enhance understanding of public perceptions about vaccines while providing opportunities for interventional communications to educate the public.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004317"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobials as cornerstones and quick fixes Zimbabwean in healthcare and society: Health practitioners´ critical reflections on two stories of antimicrobial use as part of antimicrobial resistance (AMR) education.","authors":"Martin Mickelsson, Tungamirirai Simbini","doi":"10.1371/journal.pgph.0004793","DOIUrl":"10.1371/journal.pgph.0004793","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Antimicrobials are often presented as key for the sustainability of healthcare as these pharmaceuticals are viewed as critical resources for much of modern medicine. Communicable diseases are a major contributing factor to morbidity and mortality in developing countries. The emergence of antimicrobial resistance (AMR) thus poses a significant challenge to global public health towards controlling these diseases and the SDG 3 Good health and well-being promoting calls for shared responsibility in preserving antimicrobials. This paper aims to explore health practitioners' understandings of the role of antimicrobials in healthcare and society and how this could inform antimicrobial resistance (AMR) education. Using a qualitative participatory research methodology, two participatory research workshops formed the empirical basis for the study and included 25 health practitioners from two major Zimbabwean central hospitals in the latter half of 2023. The focus of the workshops was on participants´ engagement with and discussions of two conceptual stories of antimicrobials in healthcare and society, as cornerstones which are key to the sustainability of healthcare and viability of modern medicine, and quick fixes that are used to mitigate but not resolve deeper and structural challenges as part of the Zimbabwean healthcare and society. During the workshops research data was collected through audio recordings supported in the analysis by contemporary field notes as well as written documentation created by the workshop participants. Three interconnected themes were identified as part of the results outlining how participants operationalised the two stories as part of AMR education. These included (i) preventing common infections, (ii) addressing risk factors, and (iii) engaging with societal inequalities. A key result was how the participating health practitioners highlighted the need to reduce reliance on antimicrobials which in turn necessitates a shift in focus towards preventive health actions such as improved hygiene, better water and sanitation as well as improved infection control. Such preventive efforts were furthermore linked in the participants´ discussions to structural challenges, including poor housing, limited access to clean water and inaccessible health care that was quoted as crucial to reduce infection risk and thus mitigate the need for antimicrobials in the first place. Bringing the identified themes and in-depth participant discussions together in the discussion, the paper presents a mirror model of antimicrobials in healthcare, highlighting how they are essential resources and cornerstones for healthcare while simultaneously and perpetuating systemic challenges in healthcare and society. The integration of this co-created knowledge as part of AMR education would contribute to a shift from the prevalent focus on preventing resistance to also consider the prevention of infections and the need for antimicrobials, including underst","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004793"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of COVID-19 vaccine uptake among persons with disabilities in three selected districts of Zambia.","authors":"Allan Mayaba Mwiinde, Isaac Fwemba, Joseph Mumba Zulu, Choolwe Jacobs, Patrick Kaonga","doi":"10.1371/journal.pgph.0003868","DOIUrl":"10.1371/journal.pgph.0003868","url":null,"abstract":"<p><p>COVID-19, is still a public health threat due to uncertainties around the potential evolution of the virus, changes in clinical characteristics, and the introduction of new prevention and therapeutic modalities. Persons with Disabilities (PWDs) were among the most highly affected groups by the COVID-19 pandemic due to their underlying conditions. This study aimed to establish the prevalence and identify the determinants of COVID-19 vaccine uptake among PWDs in three selected districts of Zambia. A cross-sectional study was conducted from June to August 2023 in Lusaka, Mazabuka, and Monze Districts. Structured questionnaires were developed and administered to PWDs aged 18 years and above. Log-binomial model was used to calculate the adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for assessing COVID-19 vaccine acceptance and its determinants. Out of the sample of 985, the proportion of COVID-19 vaccine uptake was 67.6% (95% CI: 65%, 71%). Vaccine uptake was higher among the married (aPR: 1.21; 95% CI:1.06, 1.39) participants from Mazabuka District (aPR: 1.61; 95% CI: 1.34, 1.93) living in rural areas (aPR:1.27; 95% CI: 1.09, 1.49) having extra income (aPR:1.27; 95% CI: 1.09,1.50) involved in routine health checkup (aPR:1.23; 95% CI: 1.11, 1.37) previously infected with COVID-19 (aPR:1.32; 95% CI, 1.04-1.68) previously vaccinated (aPR: 1.16; 95% CI: 1.00, 1.33) and understanding safety of the vaccine (aPR: 2.33; 95% CI: 1.55, 3.49). Conversely, low vaccine uptake was observed among participants earning less than k200 from social cash transfer (aPR: 0.79; 95% CI: 0.71, 0.87). More research is needed to identify determinants of vaccine uptake among PWDs that make them more vulnerable to infectious diseases such as COVID-19. There is need to improve vaccination coverage among PWDs. A more holistic and inclusive health promotion approach needs to be adopted to ensure that PWDs are not left behind in accessing vaccines.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0003868"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness and compliance with tobacco control policies among retailers near schools in Arghakhanchi, Nepal: A mixed- methods study.","authors":"Arjun Poudel, Hari Prasad Kaphle, Sunita Poudel, Sagar Parajuli, Kumud Bhurtel, Shalik Ram Dhital","doi":"10.1371/journal.pgph.0004780","DOIUrl":"10.1371/journal.pgph.0004780","url":null,"abstract":"<p><p>Tobacco consumption is the second leading cause of death among adults, and it is a major public health challenge worldwide including Nepal. This paper aims to assess awareness and compliance of tobacco legislation among retailers located nearby schools, and facilitators, and barriers to the implementation of legislation at the district level. A cross-sectional mixed-methods study design was carried out among randomly selected retailers (n = 203) located within 100 meters of schools from 51 sites, along with 8 Key Informant Interviews (KII) with purposefully selected implementation-level officials. Data were collected using an interview schedule, a checklist, and KII guideline. Awareness and compliance of retailers were measured for 14 provisions of the Tobacco Products (Control and Regulatory) Act (TPCRA), 2011 of Nepal. Bivariate and multivariate analyses were conducted to identify associations between dependent variables and independent predictors for policy compliance, and manual thematic analysis was performed for qualitative data. Only one third (33%) of retailers were found aware on provisions of TPCRA while majority (93.6%) of retailers were found violating policy provision by selling tobacco close to school. Only 14.7% of retailers were found in compliance with provision of not selling tobacco to minors and 5.8% retailers were found restricting sale of loose cigarettes. Retailers of rural settings were found two times (aOR 2.50, 95% CI, 0.99-6.27) more likely to comply with banning to tobacco sale to minors as compared to urban retailers. The enforcement of legislation, dedicated inspection mechanism and raised public awareness were found as key facilitators for policy implementation. Awareness and compliance among retailers were found to be inadequate despite the enforcement of the TPCRA since 2011. In order to strengthen policy implementation, it is essential to raise awareness, conduct regular and rigorous market inspection, and empower officials and elected representatives to take proactive measures.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004780"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: Level of satisfaction and associated factors among patients attending outpatient departments of south Wollo health facilities, Ethiopia.","authors":"","doi":"10.1371/journal.pgph.0004902","DOIUrl":"10.1371/journal.pgph.0004902","url":null,"abstract":"","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004902"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and enablers in measles vaccination implementation in Ethiopia: Insights from a qualitative study.","authors":"Gulilat Gezahegn Wodajo, Tezera Moshago Berheto, Haimanot Kifle Telila, Yohannes Kebede Lemu","doi":"10.1371/journal.pgph.0004859","DOIUrl":"10.1371/journal.pgph.0004859","url":null,"abstract":"<p><p>Even though safe and free vaccines are available, measles vaccination coverage remains low in Ethiopia. There is a paucity of studies on measles vaccination implementation challenges and enablers. Hence, this study aimed to examine implementation challenges and enablers of measles vaccination, both from the perspectives of service providers and caregivers. A case study was conducted in the east Gurage zone of central Ethiopia from December 2023 to May 2024. Fifteen health workers and 16 mothers of children aged 12-23 months who missed the measles vaccination were interviewed. Fifteen service exit interviews and six focus group discussions were also conducted. We analyzed the data manually using an inductive thematic analysis approach and presented the themes and sub-themes with representative quotations. The four basic trustworthiness measures for qualitative research were taken into account. The major measles vaccination implementation challenges for caregivers were inaccessibility, unaware of the next vaccination schedule, unavailability of a daily immunization service, interrupted outreach vaccination sessions, long waiting times, adverse event following immunization, and health workers' impoliteness. Lack of funding, transportation, vaccine refrigerators, space, training, benefit packages, inadequate child screening practices, vaccine stockouts, and fear of vaccine wastage and contraindications were among the major challenges health workers faced when implementing the measles vaccination. Our results suggest that there is an urgent need to improve service availability and accessibility, vaccine and other supply management, basic and refresher training, health workers' benefit packages, and provider-client communications.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004859"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The global scope and components of family-centred care for preterm infants: An umbrella review.","authors":"Jacklyn Adella, Francesca Giulia Maraschin, Shobhana Nagraj","doi":"10.1371/journal.pgph.0004900","DOIUrl":"10.1371/journal.pgph.0004900","url":null,"abstract":"<p><p>Preterm birth is the leading cause of under-five mortality. Family-centred care (FCC) interventions may improve outcomes related to prematurity and may be used to address this issue to achieve the Sustainable Development Goals. We aimed to consolidate the scope of evidence and components of FCC interventions for preterm infants globally and see its relevance for low-resource settings. We conducted an umbrella review informed by the Joanna Briggs Institute (JBI) guidelines. Systematic literature reviews evaluating FCC in the preterm or high-risk infant population and their families were identified from six databases. Keywords included \"family-centred care\", \"premature infants\", \"neonatal intensive care unit\", and their relevant synonyms. Quality appraisal was conducted using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses and data extraction performed to an agreed table. Thematic analysis was carried out to categorise the components of FCC interventions. Forty-four reviews were included in the umbrella review. Outcomes were observed on the parents in 40 studies, the infant in 19, the health care provider in 13, and the health system in 7. Most studies focused on inpatient settings (79.6%) and were conducted primarily in high-income countries (92.3%). The components identified were general FCC, health system design, parent support, partnership in care, and information and communication. Overall, FCC interventions have a positive impact on parental, infant, and health system outcomes, with consistent reporting of FCC impact on parental well-being and satisfaction, infant length of stay, feeding and growth, and hospital readmission rates. FCC interventions have the potential to improve preterm infant health system outcomes. To maximise impact, FCC interventions need to be further explored in low-resource and post-discharge settings, where the burden of premature infant morbidity and mortality is highest. Evidence in both these settings is scarce. Future research efforts should aim to close these evidence gaps.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004900"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health crisis within a crisis: Effect of COVID-19 on STI services for young adults in Lusaka, Zambia.","authors":"Ganizani Mwale, Mpundu Makasa","doi":"10.1371/journal.pgph.0004891","DOIUrl":"10.1371/journal.pgph.0004891","url":null,"abstract":"<p><p>In Zambia, approximately 5% of women and 8% of men aged 15-49 reported having a Sexually Transmitted Infection (STI) 12 months prior to the 2018 Zambia Demographic Health Survey. Notably, 62% of women and 73% of men who had an STI sought treatment at a clinic, signifying the importance attached to health services by STI treatment seekers. Regrettably, during the COVID-19 pandemic, entry points for accessing STI health services were closed as a public health measure to control the spread of infection. This study assessed the pandemic's effect on accessibility, availability, and delivery of STI health services in Lusaka. An explanatory sequential mixed-methods approach, incorporating a retrospective record review over a period of two years and a hermeneutic phenomenological qualitative design, was used to explore the lived experiences of healthcare providers. We found that Out-Patient Department (OPD) attendance dropped by 23% and 31% during the first and second phases of the pandemic, respectively. There was a positive correlation (p = 0.002) between OPD attendance and reported STI cases. The lived experiences of health providers revealed challenges in availability of STI health services, stemming from a range of factors that included truncated service points, reduced working hours, and limited interactions, all of which affected STI diagnosis. Stay-at-home orders, fear, lockdowns, and logistical challenges impeded access to STI health services. We established an intricate nexus between COVID-19 and the accessibility, availability, and delivery of STI health services and products. We recommend addressing pandemic-induced barriers to individuals' access to STI health services through enhanced health communication, adopting flexible service delivery models, adapting healthcare infrastructure, addressing health provider challenges, and investing in research and preparedness to guide future pandemic responses.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004891"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholder perspectives on the barriers and facilitators to integrating cardiovascular disease and diabetes management at primary care in Kenya.","authors":"Elvis O A Wambiya, James Odhiambo Oguta, Robert Akparibo, Duncan Gillespie, Peter Otieno, Catherine Akoth, Jemima Kamano, Peter Kibe, Yvette Kisaka, Elizabeth Onyango, Gladwell Gathecha, Peter J Dodd","doi":"10.1371/journal.pgph.0004164","DOIUrl":"10.1371/journal.pgph.0004164","url":null,"abstract":"<p><p>Integrated care is increasingly recognised as a key strategy for the management of multimorbidity. However, evidence on the factors associated with the implementation of integrated care models in low- and middle-income countries remains limited. We explored how stakeholders perceived integrated care, existing challenges, and recommendations for integrating cardiovascular disease and diabetes management at primary health care (PHC) level in Kenya. We conducted a qualitative study using key informant interviews with 16 key stakeholders involved in healthcare delivery, research, and policy on non-communicable diseases (NCDs) in Kenya between February and March 2024. All interviews were audio recorded and transcribed; and the data analysed both inductively and deductively within NVivo software. The deductive analysis was guided by the Rainbow Model of Integrated Care (RMIC) framework, which combines key dimensions necessary for successful integrated care with key elements of primary care. The RMIC framework dimensions include systems, clinical, organisational, professional, functional, and normative integration. Out of the six RMIC dimensions, stakeholders' description of integrated care included elements of clinical, systems, and professional integration. Key systems level challenges included disparity between policy and practice, inadequate resource allocation, donor-driven priorities, and limited stakeholder collaboration. Fragmented care delivery was a key organisational challenge. Limited resources for integrated care delivery and inadequate staff numbers and capacity were considered key challenges in the functional and professional dimensions of the RMIC framework. Additional challenges included 'siloed' mindset (normative) and limited evidence on effective or cost-effective integrated care models. To address the identified barriers, policy-makers should develop clear and adaptable how-to county-specific guidelines for implementation and evaluation of integrated care at PHC level. There is a need for advocacy and research on models of integrated care at PHC level to guide prioritization and resource allocation in Kenya.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0004164"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco smoking and biomarker profile among beverage industrial workers and their spouses in Rwanda: A cross-sectional study.","authors":"Charles Nsanzabera, Jean Claude Rukundo, Mustafe Yusuf Said, Leonard Ndayisenga","doi":"10.1371/journal.pgph.0003946","DOIUrl":"10.1371/journal.pgph.0003946","url":null,"abstract":"<p><p>Globally, smoking leads to over 7 million preventable deaths annually, with higher rates in men (16%) than women (7%). Although smoking rates have declined in high-income countries, tobacco use in Rwanda remains relatively low, with 14% of men and 3% of women affected. The focus on beverage industry workers and their spouses is justified by their higher income levels and potential exposure to stressful occupational factors that are commonly associated with smoking. The study aimed to assess tobacco smoking prevalence and the biomarker profiles of beverage industrial workers and their spouses in Rwanda. This research employed a cross-sectional study design conducted in a beverage manufacturing industry in Rwanda. The study targeted 822 individuals, including beverage industry employees and their spouses, aged 30-75 years. An initial sample size of 384 was calculated using the Cochrane formula, which was adjusted to 440 to account for non-responses. Data collection was conducted from May to December 2018. Data analysis was conducted using SPSS version 22, with chi-square and logistic regression tests to assess tobacco use and other associated factors with a significance cutoff of p < 0.05 at 95% CI. The study controlled for confounders by increasing the sample size and using stratified and simple random sampling to ensure representativeness. Additionally, the multicollinearity test with VIF and selection of variables for multivariate analysis were ensured. The analysis reveals 6.8% were smokers and several key predictors of smoking behavior. Participants with elevated cardiovascular disease (CVD) risk (≥10%) have significantly higher odds of smoking, with an adjusted odds ratio of 2.95 (95% CI: 1.10-7.88), suggesting that CVD risk is a crucial factor in smoking behavior due to overlapping lifestyle risks. Additionally, high serum uric acid (SUA) levels (≥7 mg/dl) are strongly associated with smoking, with an adjusted odds ratio of 4.28 (95% CI: 1.14-11.87), indicating that elevated SUA levels are over four times more likely to be linked to smoking. Age is another significant predictor, with participants aged 50 years or older being nearly three times more likely to smoke compared to younger individuals, as shown by an adjusted odds ratio of 2.77 (95% CI: 1.13-6.80). Participants with hypertension or those treated for hypertension have lower adjusted odds ratio of 0.38 (95% CI: 0.10-1.45). The study's findings could guide public health policymakers in designing workplace-based smoking cessation programs tailored to industry employees and their spouses. The study found that tobacco smoking is relatively low in this population, with elevated cardiovascular disease risk. Also, there are significant associations between tobacco smoking and elevated CVD risk, high SUA levels, and older age. Policymakers should implement targeted awareness campaigns and education programs addressing the specific risk factors identified.</p>","PeriodicalId":74466,"journal":{"name":"PLOS global public health","volume":"5 7","pages":"e0003946"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}