Preventive medicine最新文献_第7页

Does loneliness impact intentional weight loss? The role of obesity-related disadvantages and comorbidities 孤独会影响有意减肥吗？肥胖相关的不利因素和合并症的作用。

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-10-11 DOI: 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).

目的：孤独越来越被认为是影响健康结果的重要因素，包括体重管理。然而，它在有意减肥中的作用仍未得到充分研究。芬兰为期12个月的数字健康体重指导（HWC）提供了一个真实世界的背景来研究这种关系。我们探讨了基线孤独感是否影响HWC期间的体重减轻，以及合并症或感知到的肥胖相关不利因素是否介导了这种关系。方法：数据来自2016年至2020年期间参加HWC的参与者。基线评估包括孤独感、合并症和感知到的与肥胖相关的不利因素。每周自我报告体重，体重指数在3、6、9和12 个月时根据体重计算。采用广义估计方程分析基线孤独感对体重变化的影响，采用普通最小二乘回归分析分析中介效应。结果：在基线时感到孤独、有些孤独或不孤独的参与者取得了相当的体重减轻。然而，更高的孤独感与更大的肥胖相关的不利因素、心理困扰、合并症的数量和更低的活力有关，间接导致更少的体重减轻。结论：孤独并不直接阻碍减肥，但与健康和社会心理挑战有关，可能间接降低成功，强调在体重管理中需要整体支持。试验注册：该试验在clinicaltrials.gov（临床试验标识符NCT04019249）上注册。

{"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}

引用次数: 0

Association between smoking cessation and risk for type 2 diabetes, stratified by post-cessation weight change: A systematic review and meta-analysis 戒烟与2型糖尿病风险之间的关系，通过戒烟后体重变化分层：一项系统综述和荟萃分析。

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-10-10 DOI: 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.

目的：虽然戒烟可以降低健康风险，但考虑到戒烟后体重增加，戒烟对2型糖尿病（T2DM）的影响仍然很复杂。本系统综述和荟萃分析通过体重变化和戒烟持续时间对戒烟和糖尿病风险之间的关系进行了分层。方法：检索截至2025年4月14日的7个数据库。观察性研究包括戒烟、体重变化和2型糖尿病。随机效应模型汇集了危险比（hr），比较了最近和长期戒烟者与连续/从不吸烟者，按体重增加分层。结果:11个队列研究中,戒烟者体重增加显示增加糖尿病风险和连续吸烟者(HR = 1.71,95 % CI: 1.12, 2.62),最近戒烟者有更大的风险(HR = 2.20,95 % CI: 1.27, 3.82),但长期戒烟显示风险降低(HR = 0.91,95 % CI: 0.87, 0.95)。没有体重增加的戒烟者没有增加风险（近期：HR = 0.99,95 % CI: 0.81, 1.02）和更低的风险（长期：HR = 0.84,95 % CI: 0.81, 0.87）。与从不吸烟者相比，无论体重状况如何，最近戒烟者的T2DM风险更高（增加：HR = 1.61,95 % CI: 1.03, 2.50；未增加：HR = 1.25,95 % CI: 1.05, 1.48），而长期戒烟者没有显着差异。结论：戒烟暂时增加2型糖尿病的风险，尤其是体重增加，但长期具有保护作用，强调体重管理。

{"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}

引用次数: 0

Physical activity and subjective cognitive decline among U.S. older adults: A population-based analysis of the 2023 behavioral risk factor surveillance system 美国老年人的身体活动和主观认知能力下降：2023年行为风险因素监测系统的人口分析

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-10-06 DOI: 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.

目的：本研究旨在评估65岁 及以上老年人体力活动与主观认知能力下降（SCD）之间的关系。方法：数据来自2023年行为风险因素监测系统，包括完成认知能力下降模块的老年人。采用多变量回归模型评估自我报告的体力活动水平与SCD之间的关系。我们进一步对11种主要体育活动进行了分层分析。结果：在73339名老年人中，33.1% %报告没有PA， 14.7 %报告身体活动不足，28.4 %仅满足一个指南，23.8 %满足两个指南。步行（39.7% %）、园艺或庭院劳动（8.6% %）和骑自行车（2.7 %）是最常见的主要体育活动。与没有体育活动的老年人相比，从事体育活动并符合指南的老年人报告SCD的可能性较小（只有一条指南，调整患病率[95 % CI] = 0.87[0.78,0.96]；两条指南，APR[95 % CI] = 0.81[0.73,0.90]）。参加某些主要活动类型，并至少满足一项体育活动指南，与较低的SCD发生率相关。结论：我们的研究结果强调了满足身体活动指南对于降低老年人SCD风险的重要性，并揭示了主要活动类型的不同效果。

{"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}

引用次数: 0

Adverse birth outcomes in alcohol-exposed pregnancies with or without tobacco and cannabis 酒精暴露妊娠（含或不含烟草和大麻）的不良出生结局

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-10-06 DOI: 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}

引用次数: 0

Somatic disease burden in parents of children with cancer - a nationwide cohort study in Sweden. 癌症儿童父母的躯体疾病负担——瑞典的一项全国性队列研究。

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-10-01 Epub Date: 2025-08-06 DOI: 10.1016/j.ypmed.2025.108382

Yishan Liu, Filip Jansåker, Jan Sundquist, Kristina Sundquist, Jianguang Ji

Objective: A diagnosis of childhood cancer is profoundly devastating for families, with well-recognized effects on parental mental health. However, its impact on parental somatic health remains poorly understood, particularly regarding potential long-term cumulative burden. These persistent somatic diseases require frequent clinic visits for ongoing management and adversely affect parents' quality of life.

Methods: Using several Swedish national registers, we identified biological parents of children diagnosed with cancer before age 14 between January 1, 1987, and December 31, 2016, and matched them with up to five parents of children without cancer. Parental somatic health conditions, encompassing both the initial occurrence and any recurrent episodes, were identified through the end of 2018 across 14 major disease groups using the National Patient Register and primary health care data. The marginal means/rates model was employed to compare recurrent somatic health events.

Results: A total of 6859 fathers and 7098 mothers of children diagnosed with cancer in Sweden were identified and followed for up to 32 years. Parents of children with cancer experienced increased rates of recurrent somatic health conditions compared to those without (84.14 vs. 80.63 per 1000 person-months). The increases were observed across multiple disease categories, including neoplasms, diseases related to blood and immune mechanisms, circulatory diseases, and genital organ diseases. Stratified analyses further revealed variations in risk estimates across subgroups.

Conclusions: Our findings highlight the long-term somatic health consequences of having a child with cancer and the need for supportive interventions to mitigate stress and improve parental somatic well-being.

目的：儿童癌症的诊断对家庭来说是毁灭性的，对父母的心理健康有着众所周知的影响。然而，其对父母身体健康的影响仍然知之甚少，特别是关于潜在的长期累积负担。这些持续的躯体疾病需要频繁的门诊治疗，并对父母的生活质量产生不利影响。方法：使用几个瑞典国家登记册，我们确定了1987年1月1日至2016年12月31日期间14岁之前被诊断患有癌症的儿童的亲生父母，并将其与多达5名未患癌症儿童的父母进行匹配。截至2018年底，使用国家患者登记册和初级卫生保健数据，在14个主要疾病组中确定了父母的躯体健康状况，包括初始发生和任何复发性发作。采用边际均值/比率模型比较复发性躯体健康事件。结果：在瑞典，共有6859名父亲和7098名母亲的孩子被诊断患有癌症，并被随访了32 年。患有癌症儿童的父母与没有癌症儿童的父母相比，复发性躯体健康状况的发生率增加（每1000人月84.14对80.63）。在多种疾病类别中都观察到这种增加，包括肿瘤、与血液和免疫机制有关的疾病、循环系统疾病和生殖器官疾病。分层分析进一步揭示了亚组间风险估计的差异。结论：我们的研究结果强调了患有癌症的孩子对身体健康的长期影响，以及需要支持性干预来减轻压力和改善父母的身体健康。

{"title":"Somatic disease burden in parents of children with cancer - a nationwide cohort study in Sweden.","authors":"Yishan Liu, Filip Jansåker, Jan Sundquist, Kristina Sundquist, Jianguang Ji","doi":"10.1016/j.ypmed.2025.108382","DOIUrl":"10.1016/j.ypmed.2025.108382","url":null,"abstract":"<p><strong>Objective: </strong>A diagnosis of childhood cancer is profoundly devastating for families, with well-recognized effects on parental mental health. However, its impact on parental somatic health remains poorly understood, particularly regarding potential long-term cumulative burden. These persistent somatic diseases require frequent clinic visits for ongoing management and adversely affect parents' quality of life.</p><p><strong>Methods: </strong>Using several Swedish national registers, we identified biological parents of children diagnosed with cancer before age 14 between January 1, 1987, and December 31, 2016, and matched them with up to five parents of children without cancer. Parental somatic health conditions, encompassing both the initial occurrence and any recurrent episodes, were identified through the end of 2018 across 14 major disease groups using the National Patient Register and primary health care data. The marginal means/rates model was employed to compare recurrent somatic health events.</p><p><strong>Results: </strong>A total of 6859 fathers and 7098 mothers of children diagnosed with cancer in Sweden were identified and followed for up to 32 years. Parents of children with cancer experienced increased rates of recurrent somatic health conditions compared to those without (84.14 vs. 80.63 per 1000 person-months). The increases were observed across multiple disease categories, including neoplasms, diseases related to blood and immune mechanisms, circulatory diseases, and genital organ diseases. Stratified analyses further revealed variations in risk estimates across subgroups.</p><p><strong>Conclusions: </strong>Our findings highlight the long-term somatic health consequences of having a child with cancer and the need for supportive interventions to mitigate stress and improve parental somatic well-being.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108382"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795153","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}

引用次数: 0

Effectiveness of multidisciplinary approaches including exercise to treat non-specific chronic low back pain: A systematic review and meta-analysis across multiple regions. 包括运动在内的多学科方法治疗非特异性慢性腰痛的有效性：一项跨多区域的系统综述和荟萃分析。

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-10-01 Epub Date: 2025-08-05 DOI: 10.1016/j.ypmed.2025.108381

Nerea Vega-Retuerta, Sandra Sánchez-Parente, Víctor Segura-Jiménez

Objective: To determine the effectiveness of multidisciplinary interventions including exercise in improving health outcomes for patients with non-specific chronic low back pain (NSCLBP) across different regions.

Methods: The search for studies was not restricted to a specific time period but was conducted based on the availability of existing literature within the selected databases. A comprehensive literature search was conducted in four databases: EBSCOhost (from 1995), PubMed (from 1996), Web of Science (from 1964), and Scopus (from 2004), up to November 3, 2021. After applying exclusion criteria, 31 studies published between 1998 and 2021 were selected for final inclusion. The methodological approach included both qualitative and quantitative analyses, ensuring a comprehensive evaluation of the available evidence.

Study selection criteria: Multidisciplinary interventions including exercise aimed at relieving symptoms of NSCLBP were included. Outcomes analyzed were disability, pain, fear avoidance, quality of life, perceived change, depression, anxiety and stress. The Comprehensive Meta-Analysis software was used for statistical analyses.

Results: Thirty-one studies were included in the qualitative analysis and 29 in the meta-analysis. The qualitative analysis showed improvements in favor of the intervention group (IG) in pain, fear avoidance, quality of life and perceived change. The meta-analysis reported significant pooled effect size (ES) in favor of the IGs in disability, pain, fear avoidance, quality of life, and perceived change among patients with NSCLBP.

Conclusion: Multidisciplinary approaches including exercise appear to be effective in reducing disability, pain, fear avoidance, quality of life and perceived change, but not depression, anxiety or stress in patients with NSCLBP. The findings should be interpreted cautiously in light of substantial heterogeneity and the limited quality of the available evidence.

目的：确定包括运动在内的多学科干预措施在改善不同地区非特异性慢性腰痛（NSCLBP）患者健康结局方面的有效性。方法：研究的检索不局限于特定的时间段，而是根据所选数据库中现有文献的可用性进行的。在EBSCOhost（自1995年）、PubMed（自1996年）、Web of Science（自1964年）和Scopus（自2004年）四个数据库中进行了全面的文献检索，截止到2021年11月3日。应用排除标准后，最终纳入了1998年至2021年间发表的31项研究。方法方法包括定性和定量分析，确保对现有证据进行全面评价。研究选择标准：纳入旨在缓解NSCLBP症状的运动等多学科干预措施，并分析残疾、疼痛、恐惧回避、生活质量、感知变化、抑郁、焦虑和压力。采用综合meta分析软件进行统计分析。结果：31项研究被纳入定性分析，29项研究被纳入meta分析。定性分析显示干预组（IG）在疼痛、恐惧回避、生活质量和感知变化方面有改善，荟萃分析报告IG组在NSCLBP患者的残疾、疼痛、恐惧回避、生活质量和感知变化方面有显著的综合效应大小（ES）。结论：包括运动在内的多学科方法似乎可以有效地减少NSCLBP患者的残疾、疼痛、恐惧回避、生活质量和感知变化，但不能减少抑郁、焦虑和压力。研究结果应谨慎解释，考虑到实质性的异质性和现有证据的有限质量。

{"title":"Effectiveness of multidisciplinary approaches including exercise to treat non-specific chronic low back pain: A systematic review and meta-analysis across multiple regions.","authors":"Nerea Vega-Retuerta, Sandra Sánchez-Parente, Víctor Segura-Jiménez","doi":"10.1016/j.ypmed.2025.108381","DOIUrl":"10.1016/j.ypmed.2025.108381","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effectiveness of multidisciplinary interventions including exercise in improving health outcomes for patients with non-specific chronic low back pain (NSCLBP) across different regions.</p><p><strong>Methods: </strong>The search for studies was not restricted to a specific time period but was conducted based on the availability of existing literature within the selected databases. A comprehensive literature search was conducted in four databases: EBSCOhost (from 1995), PubMed (from 1996), Web of Science (from 1964), and Scopus (from 2004), up to November 3, 2021. After applying exclusion criteria, 31 studies published between 1998 and 2021 were selected for final inclusion. The methodological approach included both qualitative and quantitative analyses, ensuring a comprehensive evaluation of the available evidence.</p><p><strong>Study selection criteria: </strong>Multidisciplinary interventions including exercise aimed at relieving symptoms of NSCLBP were included. Outcomes analyzed were disability, pain, fear avoidance, quality of life, perceived change, depression, anxiety and stress. The Comprehensive Meta-Analysis software was used for statistical analyses.</p><p><strong>Results: </strong>Thirty-one studies were included in the qualitative analysis and 29 in the meta-analysis. The qualitative analysis showed improvements in favor of the intervention group (IG) in pain, fear avoidance, quality of life and perceived change. The meta-analysis reported significant pooled effect size (ES) in favor of the IGs in disability, pain, fear avoidance, quality of life, and perceived change among patients with NSCLBP.</p><p><strong>Conclusion: </strong>Multidisciplinary approaches including exercise appear to be effective in reducing disability, pain, fear avoidance, quality of life and perceived change, but not depression, anxiety or stress in patients with NSCLBP. The findings should be interpreted cautiously in light of substantial heterogeneity and the limited quality of the available evidence.</p>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":" ","pages":"108381"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789761","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}

引用次数: 0

Cigarette smoking prevalence, nicotine dependence, and quit ratios among U.S. adult females by residence and military-veteran status: 2002–2023 2002-2023年美国成年女性的吸烟率、尼古丁依赖和戒烟比率（按居住地和退伍军人身份划分）

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-09-29 DOI: 10.1016/j.ypmed.2025.108417

Justin T. McDaniel , Ryan Redner , Sulamunn R.M. Coleman , Elias M. Klemperer , Fang Fang Chen , Hypatia A. Bolívar , Stephen T. Higgins

Objective

Examine nationally representative U.S. data to determine trends in cigarette smoking, nicotine dependence, and quit ratios among females by rurality and veteran status between 2002 and 2023.

Methods

Data were obtained from the 2002–2023 files (N = 454,981) of the National Survey on Drug Use and Health. Adult female respondents were categorized by rural/urban residence and veteran/nonveteran status to examine smoking outcomes across 3-year intervals. To adjust for non-response, selection probability, and post-stratification, analyses were conducted using survey weighted logistic regression models controlling for socio-demographic covariates.

Results

Smoking prevalence was higher among rural versus urban residents (aOR = 1.55, 95 %CI = 1.43, 1.67) and veterans versus nonveterans (aOR = 1.72, 95 %CI = 1.36, 2.17). Nicotine dependence was higher among rural versus urban residents (aOR = 1.84, 95 %CI = 1.66, 2.03) and veterans versus nonveterans (aOR = 1.49, 95 %CI = 1.08, 2.06). Quit ratios were lower in rural versus urban residents (aOR = 0.70, 95 %CI = 0.63, 0.78), but not among veterans (aOR = 0.83, 95 % CI = 0.62, 1.10). Rates of decline over time in smoking prevalence and nicotine dependence, as well as increases in quit ratios, were lower among rural residents (p's < 0.001) whereas changes by veteran status did not interact with time.

Conclusions

Results across 21 years from a nationally representative US survey substantiate a growing rural-urban disparity in smoking that disproportionately impacts rural females. We also identified a disparity that disproportionately impacts veteran compared to nonveteran females. Thus, rural and veteran female populations need targeted treatment interventions.

目的：检查具有全国代表性的美国数据，以确定2002年至2023年间农村和退伍军人身份的女性吸烟、尼古丁依赖和戒烟比例的趋势。方法：数据来源于2002-2023年全国药物使用与健康调查档案（N = 454,981）。成年女性受访者按农村/城市居住地和退伍军人/非退伍军人身份进行分类，以检查每隔3年的吸烟结果。为了调整无反应、选择概率和后分层，使用调查加权逻辑回归模型进行分析，控制社会人口统计学协变量。结果:农村与城市居民吸烟率较高(aOR = 1.55,95 % CI = 1.43,1.67)和退伍军人和非退伍(aOR = 1.72,95 CI  % = 1.36,2.17)。尼古丁依赖较高的农村和城市居民(aOR = 1.84,95 % CI = 1.66,2.03)和退伍军人和非退伍(aOR = 1.49,95 CI  % = 1.08,2.06)。在农村和城市居民戒烟率较低(aOR = 0.70,95 % CI = 0.63,0.78),但不是在退伍军人(aOR = 0.83,95 CI  % = 0.62,1.10)。随着时间的推移，吸烟率和尼古丁依赖性的下降率以及戒烟率的增加率在农村居民中较低（p's ）。结论：一项具有全国代表性的美国调查的21 年的结果证实，农村和城市在吸烟方面的差距越来越大，对农村女性的影响尤为严重。我们还发现，与非退伍女性相比，退伍女性受到的影响不成比例。因此，农村和退伍妇女群体需要有针对性的治疗干预措施。

{"title":"Cigarette smoking prevalence, nicotine dependence, and quit ratios among U.S. adult females by residence and military-veteran status: 2002–2023","authors":"Justin T. McDaniel , Ryan Redner , Sulamunn R.M. Coleman , Elias M. Klemperer , Fang Fang Chen , Hypatia A. Bolívar , Stephen T. Higgins","doi":"10.1016/j.ypmed.2025.108417","DOIUrl":"10.1016/j.ypmed.2025.108417","url":null,"abstract":"<div><h3>Objective</h3><div>Examine nationally representative U.S. data to determine trends in cigarette smoking, nicotine dependence, and quit ratios among females by rurality and veteran status between 2002 and 2023.</div></div><div><h3>Methods</h3><div>Data were obtained from the 2002–2023 files (<em>N</em> = 454,981) of the National Survey on Drug Use and Health. Adult female respondents were categorized by rural/urban residence and veteran/nonveteran status to examine smoking outcomes across 3-year intervals. To adjust for non-response, selection probability, and post-stratification, analyses were conducted using survey weighted logistic regression models controlling for socio-demographic covariates.</div></div><div><h3>Results</h3><div>Smoking prevalence was higher among rural versus urban residents (aOR = 1.55, 95 %CI = 1.43, 1.67) and veterans versus nonveterans (aOR = 1.72, 95 %CI = 1.36, 2.17). Nicotine dependence was higher among rural versus urban residents (aOR = 1.84, 95 %CI = 1.66, 2.03) and veterans versus nonveterans (aOR = 1.49, 95 %CI = 1.08, 2.06). Quit ratios were lower in rural versus urban residents (aOR = 0.70, 95 %CI = 0.63, 0.78), but not among veterans (aOR = 0.83, 95 % CI = 0.62, 1.10). Rates of decline over time in smoking prevalence and nicotine dependence, as well as increases in quit ratios, were lower among rural residents (p's < 0.001) whereas changes by veteran status did not interact with time.</div></div><div><h3>Conclusions</h3><div>Results across 21 years from a nationally representative US survey substantiate a growing rural-urban disparity in smoking that disproportionately impacts rural females. We also identified a disparity that disproportionately impacts veteran compared to nonveteran females. Thus, rural and veteran female populations need targeted treatment interventions.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"201 ","pages":"Article 108417"},"PeriodicalIF":3.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207303","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}

引用次数: 0

Cardiopulmonary effects of very low nicotine content cigarettes with and without access to e-cigarettes in vulnerable populations 极低尼古丁含量香烟对脆弱人群的心肺影响。

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-09-20 DOI: 10.1016/j.ypmed.2025.108414

Katherine E. Menson , Diann E. Gaalema , Brian R. Katz , Jennifer W. Tidey , Dustin C. Lee , Shirley Plucinski , Michael DeSarno , Stephen T. Higgins

Objective

Reducing nicotine levels in cigarettes decreases smoking, which is enhanced by access to preferred-flavor e-cigarettes. Smoking increases risk of cardiopulmonary disease, but effects of very-low-nicotine-content cigarettes (VLNCs) in combination with e-cigarettes are unknown. Health effects of nicotine-reduction approaches must be examined.

Methods

Data were from three randomized controlled trials conducted at the University of Vermont, Brown University, and Johns Hopkins University (October 2020–November 2023). Effects, within vulnerable populations, of 16 weeks of normal nicotine content cigarettes (NNC), VLNCs only, VLNCs plus e-cigarettes in only tobacco flavor (VLNC+TF), or VLNCs in combination with the option to select from eight commonly preferred flavors (VLNC+PF) were tested. Cardiopulmonary measures included vital signs and subjective respiratory symptoms. Effect of experimental condition on outcomes were examined using multivariable linear mixed models controlling for baseline values, age, sex, study week, and vulnerable population (lower-educated women [n = 80], those with opioid use disorder [n = 74], or affective disorders [n = 172]).

Results

Most (243/326, 74.5 %) participants were high-risk for cardiopulmonary disease (i.e., hypertension). There were no significant effects of experimental condition on objective cardiac or pulmonary measures. Within respiratory symptoms there were significant effects of condition on subjective ratings of cough severity especially among patients with preexisting disease (F(3,48) = 4.02, p = 0.01, partial η² = 0.08) with higher severity ratings in the NNC and VLNC+PF compared to VLNC alone or VLNC+TF conditions (Ps < 0.05).

Conclusions

Combining VLNCs with e-cigarettes in preferred flavors appears to have no adverse effects on objective cardiopulmonary measures but may increase subjective ratings of cough severity in higher-risk pulmonary subpopulations.

目的：降低香烟中的尼古丁水平可以减少吸烟，而使用偏好口味的电子烟可以增强吸烟的效果。吸烟会增加患心肺疾病的风险，但尼古丁含量极低的香烟（VLNCs）与电子烟结合使用的影响尚不清楚。必须检查减少尼古丁的方法对健康的影响。方法：数据来自佛蒙特大学、布朗大学和约翰霍普金斯大学的3项随机对照试验（2020年10月- 2023年11月）。在弱势人群中，测试了16周尼古丁含量正常的香烟（NNC）、纯VLNCs、纯VLNCs加烟草香料的电子烟（VLNC+TF），或VLNCs与8种常用香料（VLNC+PF）中选择的组合的效果。心肺测量包括生命体征和主观呼吸症状。采用多变量线性混合模型检验实验条件对结果的影响，控制基线值、年龄、性别、学习周数和弱势群体（受教育程度较低的女性[n = 80]、阿片类药物使用障碍患者[n = 74]或情感性障碍患者[n = 172]）。结果：大多数（243/326,74.5%）参与者是心肺疾病（即高血压）的高危人群。实验条件对客观心肺指标无显著影响。在呼吸系统症状中，病情对咳嗽严重程度的主观评分有显著影响，特别是在已有疾病的患者中（F(3,48) = 4.02, p = 0.01，部分η2 = 0.08）， NNC和VLNC+PF的严重程度评分高于单独的VLNC或VLNC+TF （Ps）。将VLNCs与首选口味的电子烟结合使用似乎对客观心肺测量没有不良影响，但可能会增加高风险肺亚人群咳嗽严重程度的主观评分。

{"title":"Cardiopulmonary effects of very low nicotine content cigarettes with and without access to e-cigarettes in vulnerable populations","authors":"Katherine E. Menson , Diann E. Gaalema , Brian R. Katz , Jennifer W. Tidey , Dustin C. Lee , Shirley Plucinski , Michael DeSarno , Stephen T. Higgins","doi":"10.1016/j.ypmed.2025.108414","DOIUrl":"10.1016/j.ypmed.2025.108414","url":null,"abstract":"<div><h3>Objective</h3><div>Reducing nicotine levels in cigarettes decreases smoking, which is enhanced by access to preferred-flavor e-cigarettes. Smoking increases risk of cardiopulmonary disease, but effects of very-low-nicotine-content cigarettes (VLNCs) in combination with e-cigarettes are unknown. Health effects of nicotine-reduction approaches must be examined.</div></div><div><h3>Methods</h3><div>Data were from three randomized controlled trials conducted at the University of Vermont, Brown University, and Johns Hopkins University (October 2020–November 2023). Effects, within vulnerable populations, of 16 weeks of normal nicotine content cigarettes (NNC), VLNCs only, VLNCs plus e-cigarettes in only tobacco flavor (VLNC+TF), or VLNCs in combination with the option to select from eight commonly preferred flavors (VLNC+PF) were tested. Cardiopulmonary measures included vital signs and subjective respiratory symptoms. Effect of experimental condition on outcomes were examined using multivariable linear mixed models controlling for baseline values, age, sex, study week, and vulnerable population (lower-educated women [<em>n</em> = 80], those with opioid use disorder [<em>n</em> = 74], or affective disorders [<em>n</em> = 172]).</div></div><div><h3>Results</h3><div>Most (243/326, 74.5 %) participants were high-risk for cardiopulmonary disease (i.e., hypertension). There were no significant effects of experimental condition on objective cardiac or pulmonary measures. Within respiratory symptoms there were significant effects of condition on subjective ratings of cough severity especially among patients with preexisting disease (F(3,48) = 4.02, <em>p</em> = 0.01, partial η<sup>2</sup> = 0.08) with higher severity ratings in the NNC and VLNC+PF compared to VLNC alone or VLNC+TF conditions (Ps < 0.05).</div></div><div><h3>Conclusions</h3><div>Combining VLNCs with e-cigarettes in preferred flavors appears to have no adverse effects on objective cardiopulmonary measures but may increase subjective ratings of cough severity in higher-risk pulmonary subpopulations.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"201 ","pages":"Article 108414"},"PeriodicalIF":3.2,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102886","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}

引用次数: 0

Determinants of smoke-free homes adoption among Spanish adults who smoke: A prospective cohort study from the 2016–2021 International Tobacco Control (ITC) EUREST-PLUS Spain Surveys 西班牙吸烟成年人采用无烟家庭的决定因素：2016-2021年国际烟草控制（ITC） EUREST-PLUS西班牙调查的前瞻性队列研究。

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-09-19 DOI: 10.1016/j.ypmed.2025.108415

Olena Tigova , Yolanda Castellano , Marcela Fu , Pete Driezen , Cristina Martínez , Anne C.K. Quah , Geoffrey T. Fong , Esteve Fernández

Objective

To assess the prevalence and associated factors of smoke-free homes (SFHs) among Spanish adults who smoke across three cohort waves, and to identify determinants of SFH adoption during follow-up (2016–2021).

Methods

The International Tobacco Control EUREST-PLUS Spain Survey is a nationally representative cohort of ∼1000 adults (≥18 years) who smoke surveyed in 2016, 2018, and 2021. First, we conducted repeated cross-sectional analysis to estimate the prevalence of SFHs at each wave. Second, we estimated incidence and risk ratios (RR) with 95 % confidence intervals (CI) for SFH adoption during the follow-up using adjusted generalised linear models. Independent variables included sociodemographics, smoking characteristics, and beliefs about second-hand smoke harms.

Results

SFH prevalence was 13.1 % in 2016, 19.0 % in 2018, and 31.5 % in 2021 (p trend <0.001). Quitting smoking (RR = 2.66; 95 % CI: 2.10, 3.36), remaining in any stage other than precontemplation (RR = 1.76; 1.13, 2.73) and progressing beyond precontemplation stage (RR = 2.59; 1.99, 3.37) were determinants of SFH adoption. Maintaining moderate or high nicotine dependence (RR = 0.46; 0.30, 0.69) was inversely associated with SFH adoption.

Conclusions

SFH prevalence among Spanish adults who smoke increased in 2016–2021. Initiatives promoting SFHs should encourage progression through the stages of change towards cessation and provide tailored support for individuals with high nicotine dependence.

目的：评估三个队列波中吸烟的西班牙成年人中无烟家庭（SFHs）的患病率及其相关因素，并在随访（2016-2021）期间确定无烟家庭采用的决定因素。方法：国际烟草控制EUREST-PLUS西班牙调查是在2016年、2018年和2021年对吸烟的约1000名成年人（≥18 岁）进行的全国代表性队列调查。首先，我们进行了反复的横断面分析，以估计每一波SFHs的患病率。其次，我们使用调整后的广义线性模型估计随访期间采用SFH的发生率和风险比（RR）为95 %置信区间（CI）。独立变量包括社会人口统计学、吸烟特征和对二手烟危害的看法。结果：2016年SFH患病率为13.1 %，2018年为19.0 %，2021年为31.5 % （p趋势）。结论：2016-2021年西班牙成年吸烟者中SFH患病率上升。促进SFHs的举措应鼓励戒烟阶段的进展，并为高度尼古丁依赖的个人提供量身定制的支持。

{"title":"Determinants of smoke-free homes adoption among Spanish adults who smoke: A prospective cohort study from the 2016–2021 International Tobacco Control (ITC) EUREST-PLUS Spain Surveys","authors":"Olena Tigova , Yolanda Castellano , Marcela Fu , Pete Driezen , Cristina Martínez , Anne C.K. Quah , Geoffrey T. Fong , Esteve Fernández","doi":"10.1016/j.ypmed.2025.108415","DOIUrl":"10.1016/j.ypmed.2025.108415","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the prevalence and associated factors of smoke-free homes (SFHs) among Spanish adults who smoke across three cohort waves, and to identify determinants of SFH adoption during follow-up (2016–2021).</div></div><div><h3>Methods</h3><div>The International Tobacco Control EUREST-PLUS Spain Survey is a nationally representative cohort of ∼1000 adults (≥18 years) who smoke surveyed in 2016, 2018, and 2021. First, we conducted repeated cross-sectional analysis to estimate the prevalence of SFHs at each wave. Second, we estimated incidence and risk ratios (RR) with 95 % confidence intervals (CI) for SFH adoption during the follow-up using adjusted generalised linear models. Independent variables included sociodemographics, smoking characteristics, and beliefs about second-hand smoke harms.</div></div><div><h3>Results</h3><div>SFH prevalence was 13.1 % in 2016, 19.0 % in 2018, and 31.5 % in 2021 (p trend <0.001). Quitting smoking (RR = 2.66; 95 % CI: 2.10, 3.36), remaining in any stage other than precontemplation (RR = 1.76; 1.13, 2.73) and progressing beyond precontemplation stage (RR = 2.59; 1.99, 3.37) were determinants of SFH adoption. Maintaining moderate or high nicotine dependence (RR = 0.46; 0.30, 0.69) was inversely associated with SFH adoption.</div></div><div><h3>Conclusions</h3><div>SFH prevalence among Spanish adults who smoke increased in 2016–2021. Initiatives promoting SFHs should encourage progression through the stages of change towards cessation and provide tailored support for individuals with high nicotine dependence.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"200 ","pages":"Article 108415"},"PeriodicalIF":3.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113964","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}

引用次数: 0

Physical activity in youth and cardiovascular disease risk in later-life: Mediation by mid-life factors in a large cohort of Swedish adults 青年体育活动与晚年心血管疾病风险：在一大群瑞典成年人中中年因素的中介作用

IF 3.2 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Preventive medicine

Pub Date : 2025-09-19 DOI: 10.1016/j.ypmed.2025.108416

Frida Söderström , Elin Ekblom-Bak , Sofia Paulsson , Daniel Väisänen

Objective

The aims were to investigate the association between youth physical activity and the risk of cardiovascular disease (CVD) later in life in men and women and whether mid-life lifestyle-associated factors, including exercise, smoking, Body Mass Index (BMI), and cardiorespiratory fitness (VO₂max), mediate this association.

Methods

Data from 269,431 Swedish participants (52 % men) who participated in occupational health profile assessments between 1995 and 2023 were included. Youth physical activity was self-reported as overall participation in school-based physical education and physical activity outside school before age 20. CVD incidence was obtained from national registers. Mediation analyses assessed mid-life lifestyle-associated factors' influence on the association.

Results

Compared to those reporting no physical education participation, participation in only physical education was associated with a 18 % lower risk for CVD later in life (HR = 0.82, 95 % CI 0.70,0.95). Participating in additional physical activity outside school yielded varying risk estimates (HR = 0.78, 95 % CI 0.67,0.90 for one to two times/week; HR = 0.84, 95 % CI 0.73,0.97 for three to five times/week). VO₂max, BMI, and smoking mediated 16 %–32 % of the association. In the single mediation model, cardiorespiratory fitness explicitly mediated the association in those who participated in physical education and at least one weekly sessions of physical activity outside school.

Conclusion

Youth refraining from participating in physical education class could be considered a risk group for later-life CVD. Mediation analyses suggest that engaging in only physical education or with additional physical activity outside school in youth, may confer more healthy behaviour in mid-life, which explain the lower CVD risk.

目的探讨青年体育活动与成年后心血管疾病（CVD）风险之间的关系，以及中年生活方式相关因素（包括运动、吸烟、体重指数（BMI）和心肺功能（VO2max））是否介导了这种关系。方法纳入1995年至2023年间参加职业健康概况评估的269,431名瑞典参与者（52%为男性）的数据。青少年体育活动自我报告为20岁前参加校本体育教育和校外体育活动的总体情况。心血管疾病发病率来自国家登记册。中介分析评估了中年生活方式相关因素对该关联的影响。结果与没有参加体育锻炼的人相比，只参加体育锻炼的人晚年患心血管疾病的风险降低18% （HR = 0.82, 95% CI 0.70,0.95）。参加校外额外的体育活动产生了不同的风险估计（HR = 0.78, 95% CI 0.67,0.90, 1 - 2次/周；HR = 0.84, 95% CI 0.73,0.97, 3 - 5次/周）。最大摄氧量（VO2max）、体重指数（BMI）和吸烟介导了16% - 32%的相关性。在单一中介模型中，心肺健康在参加体育教育和每周至少一次校外体育活动的人群中显着介导了这种关联。结论不参加体育课的青少年是晚年心血管疾病的高危人群。中介分析表明，在青年时期只参加体育教育或在校外进行额外的体育活动，可能会给中年带来更健康的行为，这解释了较低的心血管疾病风险。

{"title":"Physical activity in youth and cardiovascular disease risk in later-life: Mediation by mid-life factors in a large cohort of Swedish adults","authors":"Frida Söderström , Elin Ekblom-Bak , Sofia Paulsson , Daniel Väisänen","doi":"10.1016/j.ypmed.2025.108416","DOIUrl":"10.1016/j.ypmed.2025.108416","url":null,"abstract":"<div><h3>Objective</h3><div>The aims were to investigate the association between youth physical activity and the risk of cardiovascular disease (CVD) later in life in men and women and whether mid-life lifestyle-associated factors, including exercise, smoking, Body Mass Index (BMI), and cardiorespiratory fitness (VO<sub>2</sub>max), mediate this association.</div></div><div><h3>Methods</h3><div>Data from 269,431 Swedish participants (52 % men) who participated in occupational health profile assessments between 1995 and 2023 were included. Youth physical activity was self-reported as overall participation in school-based physical education and physical activity outside school before age 20. CVD incidence was obtained from national registers. Mediation analyses assessed mid-life lifestyle-associated factors' influence on the association.</div></div><div><h3>Results</h3><div>Compared to those reporting no physical education participation, participation in only physical education was associated with a 18 % lower risk for CVD later in life (HR = 0.82, 95 % CI 0.70,0.95). Participating in additional physical activity outside school yielded varying risk estimates (HR = 0.78, 95 % CI 0.67,0.90 for one to two times/week; HR = 0.84, 95 % CI 0.73,0.97 for three to five times/week). VO<sub>2</sub>max, BMI, and smoking mediated 16 %–32 % of the association. In the single mediation model, cardiorespiratory fitness explicitly mediated the association in those who participated in physical education and at least one weekly sessions of physical activity outside school.</div></div><div><h3>Conclusion</h3><div>Youth refraining from participating in physical education class could be considered a risk group for later-life CVD. Mediation analyses suggest that engaging in only physical education or with additional physical activity outside school in youth, may confer more healthy behaviour in mid-life, which explain the lower CVD risk.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"200 ","pages":"Article 108416"},"PeriodicalIF":3.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109022","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}

引用次数: 0