background Smoke-free legislation is an effective way to protect the population from the harms of secondhand smoke and has been implemented in many countries. On 31 May 2012, Tianjin became one of the few cities in China to implement smoke-free legislation. We investigated the impact of smoke-free legislation on mortality due to acute myocardial infarction (AMI) and stroke in Tianjin. Methods An interrupted time series design adjusting for underlying secular trends, seasonal patterns, population size changes and meteorological factors was conducted to analyse the impact of the smoke-free law on the weekly mortality due to AMI and stroke. The study period was from 1 January 2007 to 31 December 2015, with a 3.5-year postlegislation follow-up. Results Following the implementation of the smokefree law, there was a decline in the annual trends of AMI and stroke mortality. An incremental 16% (rate ratio (RR): 0.84; 95% CI: 0.83 to 0.85) decrease per year in AMI mortality and a 2% (RR: 0.98; 95% CI: 0.97 to 0.99) annual decrease in stroke mortality among the population aged ≥35 years in Tianjin was observed. Immediate postlegislation reductions in mortality were not statistically significant. An estimated 10 000 (22%) AMI deaths were prevented within 3.5 years of the implementation of the law. Conclusion The smoke-free law in Tianjin was associated with reductions in AMI mortality. This study reinforces the need for large-scale, effective and comprehensive smoke-free laws at the national level in China.

Objective To identify the predictive ability of the three‐dimensional psychological pain scale (TDPPS) on suicide risk among MDD patients as compared to impulsivity, depression, hopelessness, psychache and acquired capability for suicide, and to determine the cut‐off point of TDPPS in the identification of those at risk for suicide. Method The sample comprised 137 depressed outpatients who were divided into subjects with a history of suicidal attempt (SA, N = 31) and those without such history (NSA, N = 106). All participants completed the questionnaires to evaluate interested variables. Broad sociodemographic and clinical variables were analyzed by using hierarchical and logistic regression analysis and Receiver Operating Characteristic curve analysis. Results TDPPS, especially pain avoidance subscale displayed superior performance in accurately identifying suicide attempt compared with other measurements. The appropriate cut‐off point was 58 for the TDPPS. Conclusions TDPPS may be an effective screening scale for detecting depressed patients at high suicidal risk.

Background The aim of this study was to examine the trends in the mortality rate and years of life lost (YLL) rate of lung cancer in Tianjin, China, during the period from 1999 to 2016. Methods Lung cancer death data were obtained from Tianjin residents' all‐cause death monitoring system, which covers the whole population of Tianjin. Crude mortality rate, age‐standardized mortality rate, truncated rate (35–64 years), YLL and age‐standardized YLL rate data were calculated and trends examined. Results From 1999 to 2016, a total of 93 358 lung cancer deaths were reported in Tianjin, which accounted for 38.0% of all cancer deaths (93 358/245744). The crude mortality rate of lung cancer had increased 58.5% from 1999 (40.15/100000) to 2016 (63.64/100000), average annual percent change (AACP) = 2.9%, P < 0.01. However, the age‐standard YLL rate had decreased to 13.3% in 2016 than in 1999, AACP = –0.8%, P < 0.01, with a stable trend in males (AACP = –0.2%), and noticeable decreasing trend in females (AACP = –1.4%). The lung cancer mortality rate (ASRW) in urban areas was higher than that in rural areas in 1999, with a ratio of 1.99:1. However, it was lower in 2016, with the ratio of 0.98:1. For the truncated rate (35–64 years), it had decreased in urban areas compared with rural areas since the year 2013. Conclusion Lung cancer remains the most fatal cancer in Tianjin. However, the age‐standard YLL rate of lung cancer has decreased considerably accompanied by a decline in smoking rate years ago, especially in women and people living in urban areas. Considerable attention is therefore needed in the rural areas where cases of lung cancer are still rapidly increasing.

No abstract

Objective Compare the urban-rural disparity in cancer mortality and changing trend during the past 18 years in Tianjin, China. Methods Cancer death data were obtained from Tianjin All Cause of Death Registration System (CDRS), which covers the whole population of Tianjin. We calculated and compared the constituent ratio of cancer deaths, age-standardized mortality rate(ASR)and changing trends between urban and rural areas. Results From 1999 to 2016, a total of 245,744 cancer deaths were reported, accounting 21.7% of all deaths in Tianjin. The ASR of total cancer mortality was higher in urban areas than in rural areas. A total of 33,739 persons were avoided dying of cancers in rural area compared to the urban death level from 1999 to 2016, which was 40.1% compare to the current level of rural areas. But the gap between urban and rural areas became narrowed gradually. The urban-rural ratios (urban/rural) of total cancer mortality changed from 1.76 (125.7/71.5)[95%CI,1.67,1.84] in 1999 to 1.11 (99.6/90.0)[95%CI,1.06,1.15] in 2016. The ASR of lung, liver and esophagus cancer became higher in rural areas than in urban areas in 2016. Conclusion Cancer transition was obviously occurred in Tianjin and showed different speeds and big gap between urban and rural areas. Much more attention was needed to pay in rural areas which still have increasing trends in most cancers mortality recently.