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Bohra, T, Benmarhnia T, McKinnon B, Kaufman JS.  In Press.  ecomposing educational inequalities in child mortality: a temporal trend analysis of access to Water and Sanitation in Peru. American Journal of Tropical Medicine and Hygiene.
Leas, EC, Pierce JP, Benmarhnia T, White MM, Noble ML, Trinidad DR, Strong DR.  2018.  Effectiveness of pharmaceutical smoking cessation aids in a nationally representative cohort of American smokers. Jnci-Journal of the National Cancer Institute. 110:581-587.   10.1093/jnci/djx240   AbstractWebsite

Background: Despite strong efficacy in randomized trials, the population effectiveness of pharmaceutical aids in long-term smoking cessation is lacking, possibly because of confounding (factors that are associated with both pharmaceutical aid use and difficulty quitting). Matching techniques in longitudinal studies can remove this confounding bias. Methods: Using the nationally representative Tobacco Use Supplement to the Current Population Survey (TUS-CPS), we assessed the effectiveness of medications to aid quitting among baseline adult smokers who attempted to quit prior to one year of follow-up in two longitudinal studies: 2002-2003 and 2010-2011. Pharmaceutical aid users and nonusers with complete data (n = 2129) were matched using propensity score models with 12 potential confounders (age, sex, race-ethnicity, education, smoking intensity, nicotine dependence, previous quit history, self-efficacy to quit, smoke-free homes, survey year, and cessation aid use). Using matched data sets, logistic regression models were fit to assess whether use of any individual pharmaceutical aid increased the proportion of patients who were abstinent for 30 days or more at follow-up. Results: Propensity score matching markedly improved balance on the potential confounders between the pharmaceutical aid use groups. Using matched samples to provide a balanced comparison, there was no evidence that use of varenicline (adjusted risk difference [aRD] = 0.01, 95% confidence interval (CI] = -0.07 to Oil), bupropion (aRD = 0.02, 95% CI = -0.04 to 0.09), or nicotine replacement (aRD = 0.01, 95% CI = -0.03 to 0.06) increased the probability of 30 days or more smoking abstinence at one-year follow-up. Conclusions: The lack of effectiveness of pharmaceutical aids in increasing long-term cessation in population samples is not an artifact caused by confounded analyses. A possible explanation is that counseling and support interventions provided in efficacy trials are rarely delivered in the general population.

Tresa, E, Benmarhnia T, Clemens T, Burazeri G, Czabanowska K.  2018.  Europeanization process impacts the patterns of alcohol consumption in the Western Balkans. European Journal of Public Health. 28:516-521.   10.1093/eurpub/ckx175   AbstractWebsite

Background: Western Balkan countries exhibit high levels of alcohol consumption, which constitutes a serious public health concern. We aimed to quantitatively assess the influence of the Europeanization process on levels of alcohol consumption in Western Balkans, an issue that has been under-researched. Methods: The process of Europeanization was defined as the penetration of European dimension, procedures, policy paradigms, beliefs and norms in national arenas of politics and policy development. Data about alcohol consumption in six Western Balkan countries from 1991 to 2011 were gathered from the World Bank and World Health Organization databases. Azerbaijan and Georgia were considered control countries. A difference-in-differences approach was used to assess the impact of Europeanization process on levels of alcohol consumption. Results: The Europeanization process impacts alcohol consumption in Western Balkan countries through the European Union directives and tax policies. After starting the Europeanization process, the spirits consumption in Croatia and The Former Yugoslav Republic of Macedonia decreased by 1.06 litter per capita (95% CI: from -1.63 to -0.49) and 1.02 litter per capita in Serbia (95% CI: from -1.9 to -0.1). Conclusion: Our analysis provides useful evidence about the possible influence of Europeanization process especially on spirits consumption levels in Western Balkans. These findings draw attention to the need to implement new policies in order to prevent alcohol health-related harm due to the possible increase of wine and beer consumption.

Benmarhnia, T, Zhao X, Wang J, Macdonald M, Chen H.  2019.  Evaluating the potential public health impacts of the Toronto cold weather program. Environment International. 127:381-386.   10.1016/j.envint.2019.03.042   AbstractWebsite

Background: Extreme cold weather alert programs have been implemented in some areas to address the significant health impacts of exposure to cold. One such program is the Toronto Cold Weather Program (TCWP) that was implemented in the City of Toronto since 1996 to protect the public from extreme weather conditions. In this paper, we aim to evaluate the effectiveness of the TCWP in reducing mortality and morbidity outcomes related to cold temperatures. Methods: We applied a quasi-experimental study design using the Difference-in-Differences method coupled with propensity-score-matching to determine the effect of the TCMP on daily hospitalizations and deaths due to cardiovascular disease (CVD), coronary heart disease (CHD) or cerebrovascular disease, using two complementary analytical approaches. Results: Overall, the analysis did not detect an impact on reduced mortality/morbidity in the City of Toronto from the TCMP. For example, we obtained a Risk Difference (RD) of -0.88 (per 1,000,000 people) (95% CI: -3.27 to 1.51) and a Risk Ratio (RR) of 0.98 (95% CI: 0.91 to 1.05) people for CVD hospitalizations. Conclusions: The TCWP was not found to be effective in reducing cold related mortality and morbidity which demonstrates the importance of improving existing policies related to cold in Canada and other countries.