Trends in smoking initiation in Europe over 40 years: A retrospective cohort study
Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations. We pooled data from six m...
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| Published in: | PloS one Vol. 13; no. 8; p. e0201881 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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United States
Public Library of Science
22.08.2018
Public Library of Science (PLoS) |
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| ISSN: | 1932-6203, 1932-6203 |
| Online Access: | Get full text |
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| Abstract | Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations.
We pooled data from six multicentre studies involved in the Ageing Lungs in European Cohorts consortium, including overall 119,104 subjects from 17 countries (range of median ages across studies: 33-52 years). We estimated retrospectively trends in the rates of smoking initiation (uptake of regular smoking) by age group, and tested birth cohort effects using Age-Period-Cohort (APC) modelling. We stratified all analyses by sex and region (North, East, South, West Europe).
Smoking initiation during late adolescence (16-20 years) declined for both sexes and in all regions (except for South Europe, where decline levelled off after 1990). By the late 2000s, rates of initiation during late adolescence were still high (40-80 per 1000/year) in East, South, and West Europe compared to North Europe (20 per 1000/year). Smoking initiation rates during early adolescence (11-15 years) showed a marked increase after 1990 in all regions (except for North European males) but especially in West Europe, where they reached 40 per 1000/year around 2005. APC models supported birth cohort effects in the youngest cohorts.
Smoking initiation is still unacceptably high among European adolescents, and increasing rates among those aged 15 or less deserve attention. Reducing initiation in adolescents is fundamental, since youngsters are particularly vulnerable to nicotine addiction and tobacco adverse effects. |
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| AbstractList | Background Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations. We pooled data from six multicentre studies involved in the Ageing Lungs in European Cohorts consortium, including overall 119,104 subjects from 17 countries (range of median ages across studies: 33-52 years). We estimated retrospectively trends in the rates of smoking initiation (uptake of regular smoking) by age group, and tested birth cohort effects using Age-Period-Cohort (APC) modelling. We stratified all analyses by sex and region (North, East, South, West Europe). Smoking initiation during late adolescence (16-20 years) declined for both sexes and in all regions (except for South Europe, where decline levelled off after 1990). By the late 2000s, rates of initiation during late adolescence were still high (40-80 per 1000/year) in East, South, and West Europe compared to North Europe (20 per 1000/year). Smoking initiation rates during early adolescence (11-15 years) showed a marked increase after 1990 in all regions (except for North European males) but especially in West Europe, where they reached 40 per 1000/year around 2005. APC models supported birth cohort effects in the youngest cohorts. Smoking initiation is still unacceptably high among European adolescents, and increasing rates among those aged 15 or less deserve attention. Reducing initiation in adolescents is fundamental, since youngsters are particularly vulnerable to nicotine addiction and tobacco adverse effects. BackgroundTobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations.MethodsWe pooled data from six multicentre studies involved in the Ageing Lungs in European Cohorts consortium, including overall 119,104 subjects from 17 countries (range of median ages across studies: 33-52 years). We estimated retrospectively trends in the rates of smoking initiation (uptake of regular smoking) by age group, and tested birth cohort effects using Age-Period-Cohort (APC) modelling. We stratified all analyses by sex and region (North, East, South, West Europe).ResultsSmoking initiation during late adolescence (16-20 years) declined for both sexes and in all regions (except for South Europe, where decline levelled off after 1990). By the late 2000s, rates of initiation during late adolescence were still high (40-80 per 1000/year) in East, South, and West Europe compared to North Europe (20 per 1000/year). Smoking initiation rates during early adolescence (11-15 years) showed a marked increase after 1990 in all regions (except for North European males) but especially in West Europe, where they reached 40 per 1000/year around 2005. APC models supported birth cohort effects in the youngest cohorts.ConclusionSmoking initiation is still unacceptably high among European adolescents, and increasing rates among those aged 15 or less deserve attention. Reducing initiation in adolescents is fundamental, since youngsters are particularly vulnerable to nicotine addiction and tobacco adverse effects. Background Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations. Methods We pooled data from six multicentre studies involved in the Ageing Lungs in European Cohorts consortium, including overall 119,104 subjects from 17 countries (range of median ages across studies: 33–52 years). We estimated retrospectively trends in the rates of smoking initiation (uptake of regular smoking) by age group, and tested birth cohort effects using Age-Period-Cohort (APC) modelling. We stratified all analyses by sex and region (North, East, South, West Europe). Results Smoking initiation during late adolescence (16–20 years) declined for both sexes and in all regions (except for South Europe, where decline levelled off after 1990). By the late 2000s, rates of initiation during late adolescence were still high (40–80 per 1000/year) in East, South, and West Europe compared to North Europe (20 per 1000/year). Smoking initiation rates during early adolescence (11–15 years) showed a marked increase after 1990 in all regions (except for North European males) but especially in West Europe, where they reached 40 per 1000/year around 2005. APC models supported birth cohort effects in the youngest cohorts. Conclusion Smoking initiation is still unacceptably high among European adolescents, and increasing rates among those aged 15 or less deserve attention. Reducing initiation in adolescents is fundamental, since youngsters are particularly vulnerable to nicotine addiction and tobacco adverse effects. Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations. We pooled data from six multicentre studies involved in the Ageing Lungs in European Cohorts consortium, including overall 119,104 subjects from 17 countries (range of median ages across studies: 33-52 years). We estimated retrospectively trends in the rates of smoking initiation (uptake of regular smoking) by age group, and tested birth cohort effects using Age-Period-Cohort (APC) modelling. We stratified all analyses by sex and region (North, East, South, West Europe). Smoking initiation during late adolescence (16-20 years) declined for both sexes and in all regions (except for South Europe, where decline levelled off after 1990). By the late 2000s, rates of initiation during late adolescence were still high (40-80 per 1000/year) in East, South, and West Europe compared to North Europe (20 per 1000/year). Smoking initiation rates during early adolescence (11-15 years) showed a marked increase after 1990 in all regions (except for North European males) but especially in West Europe, where they reached 40 per 1000/year around 2005. APC models supported birth cohort effects in the youngest cohorts. Smoking initiation is still unacceptably high among European adolescents, and increasing rates among those aged 15 or less deserve attention. Reducing initiation in adolescents is fundamental, since youngsters are particularly vulnerable to nicotine addiction and tobacco adverse effects. Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations.BACKGROUNDTobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations.We pooled data from six multicentre studies involved in the Ageing Lungs in European Cohorts consortium, including overall 119,104 subjects from 17 countries (range of median ages across studies: 33-52 years). We estimated retrospectively trends in the rates of smoking initiation (uptake of regular smoking) by age group, and tested birth cohort effects using Age-Period-Cohort (APC) modelling. We stratified all analyses by sex and region (North, East, South, West Europe).METHODSWe pooled data from six multicentre studies involved in the Ageing Lungs in European Cohorts consortium, including overall 119,104 subjects from 17 countries (range of median ages across studies: 33-52 years). We estimated retrospectively trends in the rates of smoking initiation (uptake of regular smoking) by age group, and tested birth cohort effects using Age-Period-Cohort (APC) modelling. We stratified all analyses by sex and region (North, East, South, West Europe).Smoking initiation during late adolescence (16-20 years) declined for both sexes and in all regions (except for South Europe, where decline levelled off after 1990). By the late 2000s, rates of initiation during late adolescence were still high (40-80 per 1000/year) in East, South, and West Europe compared to North Europe (20 per 1000/year). Smoking initiation rates during early adolescence (11-15 years) showed a marked increase after 1990 in all regions (except for North European males) but especially in West Europe, where they reached 40 per 1000/year around 2005. APC models supported birth cohort effects in the youngest cohorts.RESULTSSmoking initiation during late adolescence (16-20 years) declined for both sexes and in all regions (except for South Europe, where decline levelled off after 1990). By the late 2000s, rates of initiation during late adolescence were still high (40-80 per 1000/year) in East, South, and West Europe compared to North Europe (20 per 1000/year). Smoking initiation rates during early adolescence (11-15 years) showed a marked increase after 1990 in all regions (except for North European males) but especially in West Europe, where they reached 40 per 1000/year around 2005. APC models supported birth cohort effects in the youngest cohorts.Smoking initiation is still unacceptably high among European adolescents, and increasing rates among those aged 15 or less deserve attention. Reducing initiation in adolescents is fundamental, since youngsters are particularly vulnerable to nicotine addiction and tobacco adverse effects.CONCLUSIONSmoking initiation is still unacceptably high among European adolescents, and increasing rates among those aged 15 or less deserve attention. Reducing initiation in adolescents is fundamental, since youngsters are particularly vulnerable to nicotine addiction and tobacco adverse effects. Background Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations. Methods We pooled data from six multicentre studies involved in the Ageing Lungs in European Cohorts consortium, including overall 119,104 subjects from 17 countries (range of median ages across studies: 33–52 years). We estimated retrospectively trends in the rates of smoking initiation (uptake of regular smoking) by age group, and tested birth cohort effects using Age-Period-Cohort (APC) modelling. We stratified all analyses by sex and region (North, East, South, West Europe). Results Smoking initiation during late adolescence (16–20 years) declined for both sexes and in all regions (except for South Europe, where decline levelled off after 1990). By the late 2000s, rates of initiation during late adolescence were still high (40–80 per 1000/year) in East, South, and West Europe compared to North Europe (20 per 1000/year). Smoking initiation rates during early adolescence (11–15 years) showed a marked increase after 1990 in all regions (except for North European males) but especially in West Europe, where they reached 40 per 1000/year around 2005. APC models supported birth cohort effects in the youngest cohorts. Conclusion Smoking initiation is still unacceptably high among European adolescents, and increasing rates among those aged 15 or less deserve attention. Reducing initiation in adolescents is fundamental, since youngsters are particularly vulnerable to nicotine addiction and tobacco adverse effects. Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations. We pooled data from six multicentre studies involved in the Ageing Lungs in European Cohorts consortium, including overall 119,104 subjects from 17 countries (range of median ages across studies: 33-52 years). We estimated retrospectively trends in the rates of smoking initiation (uptake of regular smoking) by age group, and tested birth cohort effects using Age-Period-Cohort (APC) modelling. We stratified all analyses by sex and region (North, East, South, West Europe). Smoking initiation during late adolescence (16-20 years) declined for both sexes and in all regions (except for South Europe, where decline levelled off after 1990). By the late 2000s, rates of initiation during late adolescence were still high (40-80 per 1000/year) in East, South, and West Europe compared to North Europe (20 per 1000/year). Smoking initiation rates during early adolescence (11-15 years) showed a marked increase after 1990 in all regions (except for North European males) but especially in West Europe, where they reached 40 per 1000/year around 2005. APC models supported birth cohort effects in the youngest cohorts. Smoking initiation is still unacceptably high among European adolescents, and increasing rates among those aged 15 or less deserve attention. Reducing initiation in adolescents is fundamental, since youngsters are particularly vulnerable to nicotine addiction and tobacco adverse effects. Background: Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health policies. We evaluated trends in smoking initiation between 1970 and 2009 in random samples of European populations. Methods: We pooled data from six multicentre studies involved in the Ageing Lungs in European Cohorts consortium, including overall 119,104 subjects from 17 countries (range of median ages across studies: 33-52 years). We estimated retrospectively trends in the rates of smoking initiation (uptake of regular smoking) by age group, and tested birth cohort effects using Age-Period-Cohort (APC) modelling. We stratified all analyses by sex and region (North, East, South, West Europe). Results: Smoking initiation during late adolescence (16-20 years) declined for both sexes and in all regions (except for South Europe, where decline levelled off after 1990). By the late 2000s, rates of initiation during late adolescence were still high (40-80 per 1000/year) in East, South, and West Europe compared to North Europe (20 per 1000/year). Smoking initiation rates during early adolescence (11-15 years) showed a marked increase after 1990 in all regions (except for North European males) but especially in West Europe, where they reached 40 per 1000/year around 2005. APC models supported birth cohort effects in the youngest cohorts. Conclusion: Smoking initiation is still unacceptably high among European adolescents, and increasing rates among those aged 15 or less deserve attention. Reducing initiation in adolescents is fundamental, since youngsters are particularly vulnerable to nicotine addiction and tobacco adverse effects. |
| Audience | Academic |
| Author | Marcon, Alessandro Zuberbier, Torsten Leynaert, Bénédicte Garcia-Aymerich, Judith Jarvis, Deborah Villani, Simona Gislasson, Thorarinn Janson, Christer Bellisario, Valeria Heinrich, Joachim Dharmage, Shyamali C. Holm, Mathias Pirina, Pietro Accordini, Simone Svanes, Cecilie Minelli, Cosetta Pesce, Giancarlo Calciano, Lucia Matheson, Melanie C. |
| AuthorAffiliation | 3 Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia 11 Department of Medical Sciences: Respiratory, Allergy and Sleep research, Uppsala University, Uppsala, Sweden 4 ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain 8 University of Iceland, Faculty of Medicine, Reykjavik, Iceland 14 Inserm UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France Legacy, Schroeder Institute for Tobacco Research and Policy Studies, UNITED STATES 6 CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain 5 Universitat Pompeu Fabra (UPF), Barcelona, Spain 10 Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden 13 MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom 9 Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Center, Ludwig Maximilians Uni |
| AuthorAffiliation_xml | – name: 20 Allergy Centre Charité, Department of Dermatology & Allergy, Charité—Universitätsmedizin Berlin, Berlin, Germany – name: 7 Department of Respiratory Medicine and Sleep, Landspitali University Hospital (E7), Reykjavik, Iceland – name: 2 Department of Public Health and Pediatrics, University of Turin, Turin, Italy – name: 8 University of Iceland, Faculty of Medicine, Reykjavik, Iceland – name: 3 Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia – name: 12 Population Health & Occupational Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom – name: 9 Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Center, Ludwig Maximilians University, Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Muenchen, Germany – name: Legacy, Schroeder Institute for Tobacco Research and Policy Studies, UNITED STATES – name: 16 Institute of Respiratory Diseases, University of Sassari, Sassari, Italy – name: 11 Department of Medical Sciences: Respiratory, Allergy and Sleep research, Uppsala University, Uppsala, Sweden – name: 13 MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom – name: 5 Universitat Pompeu Fabra (UPF), Barcelona, Spain – name: 1 Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy – name: 4 ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain – name: 10 Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden – name: 17 Centre for International Health, University of Bergen, Bergen, Norway – name: 18 Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway – name: 6 CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain – name: 14 Inserm UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France – name: 19 Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy – name: 15 University Paris Diderot Paris 7, UMR 1152, Paris, France |
| Author_xml | – sequence: 1 givenname: Alessandro orcidid: 0000-0002-2778-658X surname: Marcon fullname: Marcon, Alessandro – sequence: 2 givenname: Giancarlo surname: Pesce fullname: Pesce, Giancarlo – sequence: 3 givenname: Lucia surname: Calciano fullname: Calciano, Lucia – sequence: 4 givenname: Valeria surname: Bellisario fullname: Bellisario, Valeria – sequence: 5 givenname: Shyamali C. surname: Dharmage fullname: Dharmage, Shyamali C. – sequence: 6 givenname: Judith surname: Garcia-Aymerich fullname: Garcia-Aymerich, Judith – sequence: 7 givenname: Thorarinn surname: Gislasson fullname: Gislasson, Thorarinn – sequence: 8 givenname: Joachim surname: Heinrich fullname: Heinrich, Joachim – sequence: 9 givenname: Mathias surname: Holm fullname: Holm, Mathias – sequence: 10 givenname: Christer surname: Janson fullname: Janson, Christer – sequence: 11 givenname: Deborah surname: Jarvis fullname: Jarvis, Deborah – sequence: 12 givenname: Bénédicte surname: Leynaert fullname: Leynaert, Bénédicte – sequence: 13 givenname: Melanie C. surname: Matheson fullname: Matheson, Melanie C. – sequence: 14 givenname: Pietro surname: Pirina fullname: Pirina, Pietro – sequence: 15 givenname: Cecilie surname: Svanes fullname: Svanes, Cecilie – sequence: 16 givenname: Simona surname: Villani fullname: Villani, Simona – sequence: 17 givenname: Torsten surname: Zuberbier fullname: Zuberbier, Torsten – sequence: 18 givenname: Cosetta surname: Minelli fullname: Minelli, Cosetta – sequence: 19 givenname: Simone surname: Accordini fullname: Accordini, Simone |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30133533$$D View this record in MEDLINE/PubMed https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-365827$$DView record from Swedish Publication Index (Uppsala universitet) https://gup.ub.gu.se/publication/271534$$DView record from Swedish Publication Index (Göteborgs universitet) |
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| Cites_doi | 10.1093/ije/dyy031 |
| ContentType | Journal Article |
| Copyright | COPYRIGHT 2018 Public Library of Science 2018 Marcon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2018 Marcon et al 2018 Marcon et al |
| Copyright_xml | – notice: COPYRIGHT 2018 Public Library of Science – notice: 2018 Marcon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2018 Marcon et al 2018 Marcon et al |
| CorporateAuthor | on behalf of the Ageing Lungs In European Cohorts study Ageing Lungs In European Cohorts study |
| CorporateAuthor_xml | – name: on behalf of the Ageing Lungs In European Cohorts study – name: Ageing Lungs In European Cohorts study |
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| DOI | 10.1371/journal.pone.0201881 |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: TZ has received industry consulting, research grants and/or honoraria from: AstraZeneca, AbbVie, ALK, Almirall, Astellas, Bayer Health Care, Bencard, Berlin Chemie, FAES, HAL, Henkel, Kryolan, Leti, L'Oreal, Meda, Menarini, Merck, MSD, Novartis, Pfizer, Sanofi, Stallergenes, Takeda, Teva, UCB; TZ reports the following organizational affiliations: Committee member, WHO-Initiative “Allergic Rhinitis and its Impact on Asthma” (ARIA); Member of the Board, German Society for Allergy and Clinical Immunology (DGAKI); Head, European Centre for Allergy Research Foundation (ECARF); Secretary General, Global Allergy and Asthma European Network (GA2LEN); Member, Committee on Allergy Diagnosis and Molecular Allergology, World Allergy Organisation (WAO). All the other authors report no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, and no other relationships or activities that could appear to have influenced the submitted work. These competing interests do not alter the authors' adherence to PLOS ONE policies on sharing data and materials. There are no restrictions to the sharing of data from this study. Principal Investigators and Partners of the Ageing Lungs In European Cohorts study are provided in the Acknowledgments and the study website https://www.alecstudy.org/. |
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| Snippet | Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to implementing health... Background Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to... Background: Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to... BackgroundTobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to... Background Tobacco consumption is the largest avoidable health risk. Understanding changes of smoking over time and across populations is crucial to... |
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| Title | Trends in smoking initiation in Europe over 40 years: A retrospective cohort study |
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