Pub Date : 2025-10-30DOI: 10.1016/j.ypmed.2025.108437
Mason Earl, Ruchi Bhandari
Objective
Cannabis use has increased among younger adults in the United States alongside rising rates of heart disease. This study examines the association between cannabis use frequency and heart disease among adults aged 18–49.
Methods
A cross-sectional analysis of 88,166 United States adults aged 18–49 was conducted using 2021–2023 National Survey on Drug Use and Health data. Cannabis use frequency was measured as days of cannabis use in the past year. A weighted logistic regression model estimated the adjusted odds ratio (aOR) for heart disease, controlling for demographics, smoking, and heavy drinking. Additionally, A dose-response analysis was performed to further assess the relationship.
Results
Cannabis users had significantly higher odds of heart disease compared to non-users. Each 90-day increase in cannabis use was associated with 9 % higher odds of heart disease (aOR: 1.09; 95 % Confidence Interval: 1.03, 1.15). Daily users had 40 % higher odds of heart disease compared to non-users (aOR = 1.40; 95 % Confidence Interval: 1.11, 1.76). A clear dose-response relationship was observed.
Conclusions
Cannabis use frequency is significantly associated with higher odds of heart disease among US adults under 50. Findings demonstrate a positive linear relationship and indicate cannabis use as a potential modifiable risk factor for early-onset heart disease.
{"title":"Assessing the association between cannabis use frequency and heart disease in adults aged under 50: National Survey on Drug Use and Health, 2021–2023","authors":"Mason Earl, Ruchi Bhandari","doi":"10.1016/j.ypmed.2025.108437","DOIUrl":"10.1016/j.ypmed.2025.108437","url":null,"abstract":"<div><h3>Objective</h3><div>Cannabis use has increased among younger adults in the United States alongside rising rates of heart disease. This study examines the association between cannabis use frequency and heart disease among adults aged 18–49.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis of 88,166 United States adults aged 18–49 was conducted using 2021–2023 National Survey on Drug Use and Health data. Cannabis use frequency was measured as days of cannabis use in the past year. A weighted logistic regression model estimated the adjusted odds ratio (aOR) for heart disease, controlling for demographics, smoking, and heavy drinking. Additionally, A dose-response analysis was performed to further assess the relationship.</div></div><div><h3>Results</h3><div>Cannabis users had significantly higher odds of heart disease compared to non-users. Each 90-day increase in cannabis use was associated with 9 % higher odds of heart disease (aOR: 1.09; 95 % Confidence Interval: 1.03, 1.15). Daily users had 40 % higher odds of heart disease compared to non-users (aOR = 1.40; 95 % Confidence Interval: 1.11, 1.76). A clear dose-response relationship was observed.</div></div><div><h3>Conclusions</h3><div>Cannabis use frequency is significantly associated with higher odds of heart disease among US adults under 50. Findings demonstrate a positive linear relationship and indicate cannabis use as a potential modifiable risk factor for early-onset heart disease.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108437"},"PeriodicalIF":3.2,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.ypmed.2025.108435
Kristina Sabou , Anna-Maria Frescura , Gilla K. Shapiro , Marwa Ebrahim , Julie A. Laroche
Objective
The purpose of this study is to identify factors associated with HPV non-vaccination among 14-year-olds in Canada.
Methods
This study employed data from the 2021 Childhood National Immunization Coverage Survey. Data were collected between January and June 2022 across Canada's 10 provinces and three territories. Multivariate logistic regression analysis was conducted, to identify factors linked to HPV non-vaccination among 14-year-olds.
Results
HPV non-vaccination was found to be independently and significantly associated with the child being born outside of Canada (aOR = 2.61, 95 % CI: 1.20,5.70) and having a history of parental refusal, reluctance, or delay of at least one routine childhood vaccine other than HPV vaccine for their child (aOR = 3.26, 95 % CI: 1.87,5.66). Socioeconomic status-related factors such as household income, parent/guardian education, and the child's visible minority status were not found to be associated with HPV non-vaccination.
Conclusions
Future research is needed to better understand the barriers to HPV vaccination among non-Canadian-born adolescents and to gain insight into the complex intersecting factors at the individual, interpersonal, organizational, and societal levels that contribute to HPV non-vaccination in this population.
{"title":"Factors associated with human papillomavirus (HPV) non-vaccination among 14-year-old children in Canada","authors":"Kristina Sabou , Anna-Maria Frescura , Gilla K. Shapiro , Marwa Ebrahim , Julie A. Laroche","doi":"10.1016/j.ypmed.2025.108435","DOIUrl":"10.1016/j.ypmed.2025.108435","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study is to identify factors associated with HPV non-vaccination among 14-year-olds in Canada.</div></div><div><h3>Methods</h3><div>This study employed data from the 2021 Childhood National Immunization Coverage Survey. Data were collected between January and June 2022 across Canada's 10 provinces and three territories. Multivariate logistic regression analysis was conducted, to identify factors linked to HPV non-vaccination among 14-year-olds.</div></div><div><h3>Results</h3><div>HPV non-vaccination was found to be independently and significantly associated with the child being born outside of Canada (aOR = 2.61, 95 % CI: 1.20,5.70) and having a history of parental refusal, reluctance, or delay of at least one routine childhood vaccine other than HPV vaccine for their child (aOR = 3.26, 95 % CI: 1.87,5.66). Socioeconomic status-related factors such as household income, parent/guardian education, and the child's visible minority status were not found to be associated with HPV non-vaccination.</div></div><div><h3>Conclusions</h3><div>Future research is needed to better understand the barriers to HPV vaccination among non-Canadian-born adolescents and to gain insight into the complex intersecting factors at the individual, interpersonal, organizational, and societal levels that contribute to HPV non-vaccination in this population.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108435"},"PeriodicalIF":3.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.ypmed.2025.108433
Rita Peila , Xiaonan Xue , Michael J. La Monte , Linda G. Snetselaar , Bernhard Haring , Aladdin H. Shadyab , JoAnn E. Manson , Thomas E. Rohan
Objective
A healthy lifestyle—characterized by physical activity, non-smoking, healthy diet, no alcohol, adequate sleep, and normal body mass index—has been linked to reduced chronic and acute disease risk. However, its impact on hospitalizations and mortality in postmenopausal women remains unclear. This study evaluated the association between a composite Healthy Lifestyle Index (HLI) and risk of all-cause hospitalization and mortality.
Methods
We analyzed 111,000 postmenopausal women aged 50–79 years at enrollment in the Women's Health Initiative (1993–1998, United States), followed for up to 30 years. HLI scores (range 0–24; higher = healthier) were derived from baseline lifestyle and anthropometric measures. Outcomes included first hospitalization, recurrent hospitalizations, and mortality. Cox regression estimated hazard ratios (HRs) and 95 % confidence intervals (CIs), excluding events within two years.
Results
A total of 75,703 women were hospitalized and 35,530 died. During the first 10 years, each HLI-unit increase was associated with lower risk of first hospitalization (HR 0.95, 95 %CI 0.94, 0.95) and mortality (HR 0.93, 95 %CI 0.92, 0.93). Associations remained consistent beyond 10 years.
Conclusions
Healthier lifestyle patterns were associated with reduced hospitalization and mortality risk in postmenopausal women, which supports public health efforts to promote healthy behaviors in aging populations.
健康的生活方式——以体育锻炼、不吸烟、健康饮食、不饮酒、充足睡眠和正常体重指数为特征——与降低慢性和急性疾病风险有关。然而，它对绝经后妇女住院和死亡率的影响尚不清楚。本研究评估了综合健康生活方式指数（HLI）与全因住院和死亡风险之间的关系。方法：我们分析了111,000名50-79岁的绝经后妇女（1993-1998年，美国），随访长达30年。HLI评分（范围0-24；越高=越健康）来自基线生活方式和人体测量测量。结果包括首次住院、复发住院和死亡率。Cox回归估计风险比（hr）和95%置信区间（ci），排除两年内的事件。结果共有75,703名妇女住院，35,530人死亡。在前10年，每增加一个hli单位与首次住院风险降低（HR 0.95, 95% CI 0.94, 0.95）和死亡率降低（HR 0.93, 95% CI 0.92, 0.93）相关。协会在10年后保持一致。结论健康的生活方式与绝经后妇女住院和死亡风险降低相关，支持公共卫生在老年人群中促进健康行为的努力。
{"title":"The association of a healthy lifestyle index with risk of all-cause hospitalization and mortality in US postmenopausal women","authors":"Rita Peila , Xiaonan Xue , Michael J. La Monte , Linda G. Snetselaar , Bernhard Haring , Aladdin H. Shadyab , JoAnn E. Manson , Thomas E. Rohan","doi":"10.1016/j.ypmed.2025.108433","DOIUrl":"10.1016/j.ypmed.2025.108433","url":null,"abstract":"<div><h3>Objective</h3><div>A healthy lifestyle—characterized by physical activity, non-smoking, healthy diet, no alcohol, adequate sleep, and normal body mass index—has been linked to reduced chronic and acute disease risk. However, its impact on hospitalizations and mortality in postmenopausal women remains unclear. This study evaluated the association between a composite Healthy Lifestyle Index (HLI) and risk of all-cause hospitalization and mortality.</div></div><div><h3>Methods</h3><div>We analyzed 111,000 postmenopausal women aged 50–79 years at enrollment in the Women's Health Initiative (1993–1998, United States), followed for up to 30 years. HLI scores (range 0–24; higher = healthier) were derived from baseline lifestyle and anthropometric measures. Outcomes included first hospitalization, recurrent hospitalizations, and mortality. Cox regression estimated hazard ratios (HRs) and 95 % confidence intervals (CIs), excluding events within two years.</div></div><div><h3>Results</h3><div>A total of 75,703 women were hospitalized and 35,530 died. During the first 10 years, each HLI-unit increase was associated with lower risk of first hospitalization (HR 0.95, 95 %CI 0.94, 0.95) and mortality (HR 0.93, 95 %CI 0.92, 0.93). Associations remained consistent beyond 10 years.</div></div><div><h3>Conclusions</h3><div>Healthier lifestyle patterns were associated with reduced hospitalization and mortality risk in postmenopausal women, which supports public health efforts to promote healthy behaviors in aging populations.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108433"},"PeriodicalIF":3.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.ypmed.2025.108432
Stephen T. Higgins
This Special Issue (SI) of Preventive Medicine is the 12th in an annual series on behavior change, health, and health disparities. The theme of this 2025 issue is Intersections of Tobacco Use with Other Addictions, Chronic Disease, and Health Disparities. Considerable attention is given to cigarette smoking as it remains the leading cause of preventable death in the U.S., causing approximately 450,000 deaths annually in the U.S. and more than 7 million globally. This SI includes thirteen peer-reviewed articles that were invited from speakers at the 2024 annual conference of the Vermont Center on Behavior and Health. These articles report results from epidemiological studies, clinical trials, and commentaries. Collectively, the articles advance knowledge across a wide range of topics regarding the disproportionate impact of smoking and other tobacco use in vulnerable populations, intersections with other addictions, chronic disease, and health disparities along with clinical and regulatory interventions to reduce use and associated adverse health effects.
{"title":"Behavior change, health, and health disparities 2025: Intersections of tobacco use with other addictions, chronic disease, and health disparities","authors":"Stephen T. Higgins","doi":"10.1016/j.ypmed.2025.108432","DOIUrl":"10.1016/j.ypmed.2025.108432","url":null,"abstract":"<div><div>This Special Issue (SI) of Preventive Medicine is the 12th in an annual series on behavior change, health, and health disparities. The theme of this 2025 issue is <em>Intersections of Tobacco Use with Other Addictions, Chronic Disease, and Health Disparities.</em> Considerable attention is given to cigarette smoking as it remains the leading cause of preventable death in the U.S., causing approximately 450,000 deaths annually in the U.S. and more than 7 million globally. This SI includes thirteen peer-reviewed articles that were invited from speakers at the 2024 annual conference of the Vermont Center on Behavior and Health. These articles report results from epidemiological studies, clinical trials, and commentaries. Collectively, the articles advance knowledge across a wide range of topics regarding the disproportionate impact of smoking and other tobacco use in vulnerable populations, intersections with other addictions, chronic disease, and health disparities along with clinical and regulatory interventions to reduce use and associated adverse health effects.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"201 ","pages":"Article 108432"},"PeriodicalIF":3.2,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145546761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-17DOI: 10.1016/j.ypmed.2025.108428
Louis-Ferdinand Lespine , Diane François , Julie Haesebaert , Jean-Michel Delile , Myriam Savy , Mickael Naassila , Julia de Ternay , Benjamin Rolland
Objective
Temporary alcohol abstinence campaigns (TAAC), such as Dry January, aim to encourage behavioural change in the general population. Despite its popularity, a comprehensive evaluation of the French version has not yet been conducted. This prospective study aimed to identify characteristics associated with successful completion of the challenge (i.e., remaining alcohol-free throughout January), and to assess improvements in drinking refusal self-efficacy, sleep quality, and mental and physical health.
Methods
A sample of 2123 French adults participating in Dry January 2024 completed both a baseline and a one-month follow-up questionnaire online. A broad range of variables were assessed, including demographic and contextual factors, alcohol use patterns and motives, drinking refusal self-efficacy, and health-related outcomes.
Results
Key factors positively associated with successful completion included previous participation, registration, and higher baseline self-efficacy in resisting alcohol in social situations. Among registrants, greater engagement with support emails significantly increased the likelihood of abstinence. In contrast, smoking and identifying one's drinking as excessive were linked to lower odds of completion. The campaign was associated with improvements in drinking refusal self-efficacy, mental well-being, sleep quality, and physical health — particularly among participants who completed the full month without alcohol.
Conclusions
This study offers the first evaluation of the French version of Dry January, highlighting the factors influencing challenge completion and short-term benefits of participation. The findings add support to the value of TAAC as scalable and impactful public health tools and underscore the importance of tailored support strategies to maximize participant success and behavioural change.
{"title":"Determinants of successful completion and short-term benefits associated with temporary alcohol abstinence during Dry January in France: A prospective cohort study","authors":"Louis-Ferdinand Lespine , Diane François , Julie Haesebaert , Jean-Michel Delile , Myriam Savy , Mickael Naassila , Julia de Ternay , Benjamin Rolland","doi":"10.1016/j.ypmed.2025.108428","DOIUrl":"10.1016/j.ypmed.2025.108428","url":null,"abstract":"<div><h3>Objective</h3><div>Temporary alcohol abstinence campaigns (TAAC), such as Dry January, aim to encourage behavioural change in the general population. Despite its popularity, a comprehensive evaluation of the French version has not yet been conducted. This prospective study aimed to identify characteristics associated with successful completion of the challenge (i.e., remaining alcohol-free throughout January), and to assess improvements in drinking refusal self-efficacy, sleep quality, and mental and physical health.</div></div><div><h3>Methods</h3><div>A sample of 2123 French adults participating in Dry January 2024 completed both a baseline and a one-month follow-up questionnaire online. A broad range of variables were assessed, including demographic and contextual factors, alcohol use patterns and motives, drinking refusal self-efficacy, and health-related outcomes.</div></div><div><h3>Results</h3><div>Key factors positively associated with successful completion included previous participation, registration, and higher baseline self-efficacy in resisting alcohol in social situations. Among registrants, greater engagement with support emails significantly increased the likelihood of abstinence. In contrast, smoking and identifying one's drinking as excessive were linked to lower odds of completion. The campaign was associated with improvements in drinking refusal self-efficacy, mental well-being, sleep quality, and physical health — particularly among participants who completed the full month without alcohol.</div></div><div><h3>Conclusions</h3><div>This study offers the first evaluation of the French version of Dry January, highlighting the factors influencing challenge completion and short-term benefits of participation. The findings add support to the value of TAAC as scalable and impactful public health tools and underscore the importance of tailored support strategies to maximize participant success and behavioural change.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108428"},"PeriodicalIF":3.2,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-14DOI: 10.1016/j.ypmed.2025.108431
Leah R. Abrams, Nora Brower
Objective
To assess how stagnation in cardiovascular disease (CVD) mortality declines since 2010 impacted racial disparities in life expectancy between Black and White Americans.
Methods
We analyzed U.S. vital statistics from 2000 to 2022 to compare age-standardized CVD mortality trends in Black and White middle-aged and older adults. Using life tables, we then estimated racial differences in life expectancy under observed mortality conditions and under a counterfactual scenario in which CVD mortality had continued to decline in 2010–2022 at pre-2010 rates.
Results
In 2000–2009, CVD mortality was declining more quickly among Black Americans, and the Black-White life expectancy gap narrowed by 1.39 years for women and 1.44 years for men. Progress slowed after 2010. Had pre-2010 CVD mortality trends continued, Black women would have lived 2.04 years longer in 2019, narrowing the 1.88-year Black-White life expectancy gap by 0.43 years. If improvements had continued through 2022, Black women would have lived 2.83 years longer, translating to a 0.64-year reduction in the Black-White life expectancy gap. Men exhibited a similar pattern with a smaller effect.
Conclusions
The post-2010 slowdown in CVD mortality declines disproportionately limited longevity gains for Black Americans, especially Black women.
{"title":"Stagnating declines in cardiovascular disease mortality in the United States expanded the black-white life expectancy gap","authors":"Leah R. Abrams, Nora Brower","doi":"10.1016/j.ypmed.2025.108431","DOIUrl":"10.1016/j.ypmed.2025.108431","url":null,"abstract":"<div><h3>Objective</h3><div>To assess how stagnation in cardiovascular disease (CVD) mortality declines since 2010 impacted racial disparities in life expectancy between Black and White Americans.</div></div><div><h3>Methods</h3><div>We analyzed U.S. vital statistics from 2000 to 2022 to compare age-standardized CVD mortality trends in Black and White middle-aged and older adults. Using life tables, we then estimated racial differences in life expectancy under observed mortality conditions and under a counterfactual scenario in which CVD mortality had continued to decline in 2010–2022 at pre-2010 rates.</div></div><div><h3>Results</h3><div>In 2000–2009, CVD mortality was declining more quickly among Black Americans, and the Black-White life expectancy gap narrowed by 1.39 years for women and 1.44 years for men. Progress slowed after 2010. Had pre-2010 CVD mortality trends continued, Black women would have lived 2.04 years longer in 2019, narrowing the 1.88-year Black-White life expectancy gap by 0.43 years. If improvements had continued through 2022, Black women would have lived 2.83 years longer, translating to a 0.64-year reduction in the Black-White life expectancy gap. Men exhibited a similar pattern with a smaller effect.</div></div><div><h3>Conclusions</h3><div>The post-2010 slowdown in CVD mortality declines disproportionately limited longevity gains for Black Americans, especially Black women.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108431"},"PeriodicalIF":3.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-11DOI: 10.1016/j.ypmed.2025.108430
Siniriikka A. Männistö , Anu Joki , Laura-Unnukka Suojanen , Mikko S. Venäläinen , Kirsi H. Pietiläinen , Aila J. Ahola
Objective
Loneliness is increasingly recognized as a significant factor influencing health outcomes, including weight management. Nevertheless, its role in intentional weight loss remains underexplored. The 12-month digital Healthy Weight Coaching (HWC), in Finland, offers a real-world context to investigate this relationship. We explored whether baseline loneliness affects weight loss during HWC and whether comorbidities or perceived obesity-related disadvantages mediate this relationship.
Methods
Data were included from participants enrolled in the HWC between 2016 and 2020. Baseline assessments included loneliness, comorbidities, and perceived obesity-related disadvantages. Weight was self-reported weekly, with body mass index calculated from interpolated weights at three, six, nine, and 12 months. Generalized estimating equations were used to analyze the impact of baseline loneliness on weight change, and ordinary least squares regression analyses were used to analyze mediation.
Results
Participants who felt lonely, somewhat lonely, or not lonely at baseline achieved comparable weight loss. However, higher loneliness was linked to greater perceived obesity-related disadvantages, psychological distress, number of comorbidities, and lower vitality, indirectly leading to lesser weight loss.
Conclusions
Loneliness did not directly hinder weight loss but was linked to health and psychosocial challenges that may indirectly reduce success, highlighting the need for holistic support in weight management.
Trial registration: The trial is registered at clinicaltrials.gov (Clinical Trials Identifier NCT04019249).
{"title":"Does loneliness impact intentional weight loss? The role of obesity-related disadvantages and comorbidities","authors":"Siniriikka A. Männistö , Anu Joki , Laura-Unnukka Suojanen , Mikko S. Venäläinen , Kirsi H. Pietiläinen , Aila J. Ahola","doi":"10.1016/j.ypmed.2025.108430","DOIUrl":"10.1016/j.ypmed.2025.108430","url":null,"abstract":"<div><h3>Objective</h3><div>Loneliness is increasingly recognized as a significant factor influencing health outcomes, including weight management. Nevertheless, its role in intentional weight loss remains underexplored. The 12-month digital Healthy Weight Coaching (HWC), in Finland, offers a real-world context to investigate this relationship. We explored whether baseline loneliness affects weight loss during HWC and whether comorbidities or perceived obesity-related disadvantages mediate this relationship.</div></div><div><h3>Methods</h3><div>Data were included from participants enrolled in the HWC between 2016 and 2020. Baseline assessments included loneliness, comorbidities, and perceived obesity-related disadvantages. Weight was self-reported weekly, with body mass index calculated from interpolated weights at three, six, nine, and 12 months. Generalized estimating equations were used to analyze the impact of baseline loneliness on weight change, and ordinary least squares regression analyses were used to analyze mediation.</div></div><div><h3>Results</h3><div>Participants who felt lonely, somewhat lonely, or not lonely at baseline achieved comparable weight loss. However, higher loneliness was linked to greater perceived obesity-related disadvantages, psychological distress, number of comorbidities, and lower vitality, indirectly leading to lesser weight loss.</div></div><div><h3>Conclusions</h3><div>Loneliness did not directly hinder weight loss but was linked to health and psychosocial challenges that may indirectly reduce success, highlighting the need for holistic support in weight management.</div><div><em>Trial registration:</em> The trial is registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> (Clinical Trials Identifier <span><span>NCT04019249</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108430"},"PeriodicalIF":3.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-10DOI: 10.1016/j.ypmed.2025.108429
Yifan Yu , Yan Li , Thu T. Nguyen , Dahai Yue , Nedelina Tchangalova , Caitlin E. Flouton , Hongjie Liu
Objective
While smoking cessation reduces health risks, its impact on type 2 diabetes mellitus (T2DM) remains complex when considering post-cessation weight gain. This systematic review and meta-analysis examined the association between smoking cessation and diabetes risk stratified by weight change and cessation duration.
Methods
We searched seven databases through April 14, 2025. Observational studies examining smoking cessation, weight changes, and T2DM were included. Random-effects models pooled hazard ratios (HRs) comparing recent and long-term quitters to continuous/never smokers, stratified by weight gain.
Results
Among eleven cohort studies, quitters with weight gain showed increased diabetes risk versus continuous smokers (HR = 1.71, 95 % CI: 1.12, 2.62), with recent quitters having greater risk (HR = 2.20, 95 % CI: 1.27, 3.82) but long-term quitters showing reduced risk (HR = 0.91, 95 % CI: 0.87, 0.95). Quitters without weight gain demonstrated no increased risk (recent: HR = 0.99, 95 % CI: 0.81, 1.02) and lower risk (long-term: HR = 0.84, 95 % CI: 0.81, 0.87). Compared to never-smokers, recent quitters had a higher T2DM risk regardless of weight status (with gain: HR = 1.61, 95 % CI: 1.03, 2.50; without gain: HR = 1.25, 95 % CI: 1.05, 1.48), while long-term quitters showed no significant difference.
Conclusions
Smoking cessation temporarily increases T2DM risk, particularly with weight gain, but becomes protective long-term, emphasizing weight management.
{"title":"Association between smoking cessation and risk for type 2 diabetes, stratified by post-cessation weight change: A systematic review and meta-analysis","authors":"Yifan Yu , Yan Li , Thu T. Nguyen , Dahai Yue , Nedelina Tchangalova , Caitlin E. Flouton , Hongjie Liu","doi":"10.1016/j.ypmed.2025.108429","DOIUrl":"10.1016/j.ypmed.2025.108429","url":null,"abstract":"<div><h3>Objective</h3><div>While smoking cessation reduces health risks, its impact on type 2 diabetes mellitus (T2DM) remains complex when considering post-cessation weight gain. This systematic review and meta-analysis examined the association between smoking cessation and diabetes risk stratified by weight change and cessation duration.</div></div><div><h3>Methods</h3><div>We searched seven databases through April 14, 2025. Observational studies examining smoking cessation, weight changes, and T2DM were included. Random-effects models pooled hazard ratios (HRs) comparing recent and long-term quitters to continuous/never smokers, stratified by weight gain.</div></div><div><h3>Results</h3><div>Among eleven cohort studies, quitters with weight gain showed increased diabetes risk versus continuous smokers (HR = 1.71, 95 % CI: 1.12, 2.62), with recent quitters having greater risk (HR = 2.20, 95 % CI: 1.27, 3.82) but long-term quitters showing reduced risk (HR = 0.91, 95 % CI: 0.87, 0.95). Quitters without weight gain demonstrated no increased risk (recent: HR = 0.99, 95 % CI: 0.81, 1.02) and lower risk (long-term: HR = 0.84, 95 % CI: 0.81, 0.87). Compared to never-smokers, recent quitters had a higher T2DM risk regardless of weight status (with gain: HR = 1.61, 95 % CI: 1.03, 2.50; without gain: HR = 1.25, 95 % CI: 1.05, 1.48), while long-term quitters showed no significant difference.</div></div><div><h3>Conclusions</h3><div>Smoking cessation temporarily increases T2DM risk, particularly with weight gain, but becomes protective long-term, emphasizing weight management.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108429"},"PeriodicalIF":3.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-06DOI: 10.1016/j.ypmed.2025.108424
Gary Hao , Nicolas Guenzel , Tzeyu L. Michaud
Objectives
This study sought to assess associations between physical activities and subjective cognitive decline (SCD) among older adults aged 65 years and above.
Methods
Data were drawn from the 2023 Behavioral Risk Factor Surveillance System and included older adults who completed the cognitive decline module. Multivariable regression models were performed to assess the relationship between self-reported physical activity levels and SCD. We further conducted stratified analyses of 11 types of primary physical activity.
Results
Among 73,339 older adults, 33.1 % reported no physical activity, 14.7 % reported insufficient physical activity, 28.4 % met one guideline only, and 23.8 % met both guidelines. Walking (39.7 %), gardening or yard work (8.6 %), and bicycling (2.7 %) were the most commonly reported primary physical activities. As compared to those without physical activities, older adults who engaged in physical activity and met guidelines were less likely to report SCD (only one guideline, Adjusted Prevalence Ratio[95 % CI] = 0.87[0.78, 0.96]; both guidelines, APR[95 % CI] = 0.81[0.73, 0.90]). Participation in certain primary activity types, combined with meeting at least one physical activity guideline, was associated with lower odds of SCD.
Conclusions
Our findings highlight the importance of meeting physical activity guidelines to mitigate the risk of SCD among older adults and reveal varying effects by primary activity types.
{"title":"Physical activity and subjective cognitive decline among U.S. older adults: A population-based analysis of the 2023 behavioral risk factor surveillance system","authors":"Gary Hao , Nicolas Guenzel , Tzeyu L. Michaud","doi":"10.1016/j.ypmed.2025.108424","DOIUrl":"10.1016/j.ypmed.2025.108424","url":null,"abstract":"<div><h3>Objectives</h3><div>This study sought to assess associations between physical activities and subjective cognitive decline (SCD) among older adults aged 65 years and above.</div></div><div><h3>Methods</h3><div>Data were drawn from the 2023 Behavioral Risk Factor Surveillance System and included older adults who completed the cognitive decline module. Multivariable regression models were performed to assess the relationship between self-reported physical activity levels and SCD. We further conducted stratified analyses of 11 types of primary physical activity.</div></div><div><h3>Results</h3><div>Among 73,339 older adults, 33.1 % reported no physical activity, 14.7 % reported insufficient physical activity, 28.4 % met one guideline only, and 23.8 % met both guidelines. Walking (39.7 %), gardening or yard work (8.6 %), and bicycling (2.7 %) were the most commonly reported primary physical activities. As compared to those without physical activities, older adults who engaged in physical activity and met guidelines were less likely to report SCD (only one guideline, Adjusted Prevalence Ratio[95 % CI] = 0.87[0.78, 0.96]; both guidelines, APR[95 % CI] = 0.81[0.73, 0.90]). Participation in certain primary activity types, combined with meeting at least one physical activity guideline, was associated with lower odds of SCD.</div></div><div><h3>Conclusions</h3><div>Our findings highlight the importance of meeting physical activity guidelines to mitigate the risk of SCD among older adults and reveal varying effects by primary activity types.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108424"},"PeriodicalIF":3.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-06DOI: 10.1016/j.ypmed.2025.108427
Florencia Anunziata , Jessica Frankeberger , Rebecca J. Baer , Christina Chambers , Gretchen Bandoli
Objective
To examine the risk of preterm birth (PTB) and small for gestational age (SGA) infants among pregnant persons with alcohol use diagnoses, alone or with comorbid cannabis or tobacco use diagnoses.
Methods
Data from California birth certificates (2007–2021) were linked to maternal/infant hospitalization records. Maternal ICD 9–10 codes indicated substance use diagnoses. We calculated the adjusted risk ratios (aRR) and 95 % confidence intervals (CIs) of extreme/very PTB (<32 weeks' gestation), late PTB (32–36 weeks), and SGA (<10th centile for birth weight) among those with alcohol alone versus alcohol with tobacco and/or cannabis use diagnoses.
Results
Compared to alcohol alone, co-occurring alcohol and tobacco were associated with higher risks of extreme/very PTB (aRR = 1.44, 95 % CI = 1.09, 1.89), late PTB (aRR = 1.25, 95 % CI = 1.12, 1.40), and SGA infants (aRR = 1.31, 95 % CI = 1.19, 1.44). Individuals with alcohol and cannabis were at increased risk of SGA infants (aRR = 1.21, 95 % CI = 1.05, 1.38). Those with indications of all three substances had higher risk of extreme/very PTB (aRR = 1.68, 95 % CI = 1.17, 2.40) and SGA infants (aRR = 1.29, 95 % CI = 1.13, 1.48).
Conclusions
Among those with an alcohol diagnosis, prenatal co-exposure to tobacco with or without cannabis was associated with increased risk of PTB and SGA relative to alcohol alone. Screening for and addressing prenatal polysubstance use should be prioritized.
目的探讨诊断为酒精使用、单独使用或合并大麻或烟草使用的孕妇早产（PTB）和小胎龄儿（SGA）的风险。方法将加州出生证明（2007-2021年）的数据与母婴住院记录相关联。产妇ICD 9-10代码显示药物使用诊断。我们计算了在单独饮酒与酒精合并烟草和/或大麻的诊断中，极端/非常PTB（妊娠32周）、晚期PTB（32 - 36周）和SGA（出生体重第10百分位）的调整风险比（aRR）和95%置信区间（CIs）。结果与单独饮酒相比，同时发生的酒精和烟草与极端/非常PTB （aRR = 1.44, 95% CI = 1.09, 1.89）、晚期PTB （aRR = 1.25, 95% CI = 1.12, 1.40）和SGA婴儿（aRR = 1.31, 95% CI = 1.19, 1.44）的风险相关。有酒精和大麻的个体发生SGA婴儿的风险增加（aRR = 1.21, 95% CI = 1.05, 1.38）。有这三种药物适应症的婴儿患极端/非常PTB （aRR = 1.68, 95% CI = 1.17, 2.40）和SGA婴儿（aRR = 1.29, 95% CI = 1.13, 1.48）的风险更高。结论：在有酒精诊断的人群中，与单独饮酒相比，产前同时接触烟草或不接触大麻与PTB和SGA的风险增加有关。筛查和解决产前多物质使用应优先考虑。
{"title":"Adverse birth outcomes in alcohol-exposed pregnancies with or without tobacco and cannabis","authors":"Florencia Anunziata , Jessica Frankeberger , Rebecca J. Baer , Christina Chambers , Gretchen Bandoli","doi":"10.1016/j.ypmed.2025.108427","DOIUrl":"10.1016/j.ypmed.2025.108427","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the risk of preterm birth (PTB) and small for gestational age (SGA) infants among pregnant persons with alcohol use diagnoses, alone or with comorbid cannabis or tobacco use diagnoses.</div></div><div><h3>Methods</h3><div>Data from California birth certificates (2007–2021) were linked to maternal/infant hospitalization records. Maternal ICD 9–10 codes indicated substance use diagnoses. We calculated the adjusted risk ratios (aRR) and 95 % confidence intervals (CIs) of extreme/very PTB (<32 weeks' gestation), late PTB (32–36 weeks), and SGA (<10th centile for birth weight) among those with alcohol alone versus alcohol with tobacco and/or cannabis use diagnoses.</div></div><div><h3>Results</h3><div>Compared to alcohol alone, co-occurring alcohol and tobacco were associated with higher risks of extreme/very PTB (aRR = 1.44, 95 % CI = 1.09, 1.89), late PTB (aRR = 1.25, 95 % CI = 1.12, 1.40), and SGA infants (aRR = 1.31, 95 % CI = 1.19, 1.44). Individuals with alcohol and cannabis were at increased risk of SGA infants (aRR = 1.21, 95 % CI = 1.05, 1.38). Those with indications of all three substances had higher risk of extreme/very PTB (aRR = 1.68, 95 % CI = 1.17, 2.40) and SGA infants (aRR = 1.29, 95 % CI = 1.13, 1.48).</div></div><div><h3>Conclusions</h3><div>Among those with an alcohol diagnosis, prenatal co-exposure to tobacco with or without cannabis was associated with increased risk of PTB and SGA relative to alcohol alone. Screening for and addressing prenatal polysubstance use should be prioritized.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"202 ","pages":"Article 108427"},"PeriodicalIF":3.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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