Tobacco Induced Diseases最新文献

Introduction: Cannabis is the third most used drug in the world with emerging legalization in the US and other countries. In a descriptive analysis, we report trends in cannabis use and types of products used in the VapeScan longitudinal study, a cohort study of young adults designed to investigate subclinical health effects of e-cigarette use.

Methods: The VapeScan study recruited 372 adults aged 18-50 years in the New York City area in 2021-2024, independently of cannabis use. At Visit 1, we asked about cannabis use, and at Visit 2, we implemented a more detailed questionnaire to characterize longitudinal trends and methods of cannabis use. We performed descriptive analyses to compare and report cannabis and tobacco use among participants groups of: 1) no substance use, 2) exclusive cannabis use, 3) exclusive e-cigarette use, and 4) dual substance use (e-cigarette and cannabis use).

Results: Participants had a median age of 26 years (IQR: 21-33), were 50.5% male, 48.1% female, and 1.3% non-binary. At Visit 1, 125 (33.6%) participants reported dual substance use, 15 (4%) reported exclusive cannabis use, 129 (34.7%) reported e-cigarette but no cannabis use, and 103 (27.7%) reported no substance use. At Visit 2, 128 of 217 (58.9%) participants reported cannabis use; 63 (29.0%) vape cannabis, 61 (28.1%) smoke cannabis, 111 (51.2%) edible cannabis, 69 (31.8%) CBD, and 8 (3.7%) topical cannabis. Frequency and intensity varied by method of use. Self-reported trends of vaped or smoked cannabis use varied between visits, with 28 (20.9%) becoming new users at Visit 2, while quitting only happened in 5 (6.3%) of those who vaped or smoked cannabis at Visit 1 (p=0.007).

Conclusions: Our findings support that cannabis use is diverse and complex and is growing in urban communities, requiring further investigation to better understand use patterns and potential exposure to cannabis-related contaminants and related health effects.

Introduction: Before granting marketing authorization for electronic nicotine delivery systems (ENDS), the US Food and Drug Administration (FDA) must consider population risks and benefits associated with ENDS use. This study describes characteristics and usage patterns of individuals who use Juul or Vuse Alto to assess differences in product use.

Methods: A national, cross-sectional, online survey with US adults who use ENDS was conducted in 2022-2023 as the baseline component of a longitudinal study. Data from 503 people who regularly used either Juul (n=224) or Alto (n=279) were analyzed, including sociodemographic characteristics, cigarette smoking and quitting behaviors, ENDS use patterns, reasons for use, and risk perceptions. Chi-squared tests, ANOVA, and binary, ordinal, and multinomial logistic regression compared people who use each product.

Results: Those using Juul were less likely to have formerly smoked cigarettes than those using Alto (OR=0.50; 95% CI: 0.25-0.99), and those using Alto and currently smoking reported greater readiness to quit smoking cigarettes compared to those using Juul. People who used Juul and smoked cigarettes more often used Juul in places where they could not smoke compared with people using Alto. Those using Juul regularly were less likely to be over the age of 29 years (OR=0.47; 95% CI: 0.31-0.70) and more likely to come from racial/ethnic minoritized groups (34.1% vs 21.8%). People using Alto regularly consumed more e-liquid (6.6 mL vs 3.7 mL ) and those using Juul regularly used pods with higher nicotine content (OR=1.98; 95% CI: 1.25-3.14) than did those using Alto.

Conclusions: We noted differences between people using Juul and Alto in sociodemographic characteristics and usage patterns of both cigarettes and ENDS. These data provide information about the potential impact of authorizing marketing of a new product on tobacco use behaviors.

Introduction: As global population aging intensifies, the burden of lip and oral cavity cancer (LOCC) among middle-aged and older adults continues to worsen. This research systematically analyzed global LOCC burden trends among adults aged ≥45 years, aiming to inform evidence-based policy and public health strategies.

Methods: Key metrics were obtained from the GBD 2021 database including age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR). Their correlations with the sociodemographic index (SDI) were explored. Joinpoint models assessed trends via annual percent change (APC) and average annual percent change (AAPC). Bayesian Age-Period-Cohort (BAPC) models projected future trends.

Results: From 1990 to 2021, globally, the ASPR (EAPC=0.77; 95% CI: 0.72-0.82) and ASIR (EAPC=0.35; 95% CI: 0.29-0.41) of LOCC among adults aged ≥45 rose significantly, while ASMR (EAPC= -0.15; 95% CI: -0.20 - -0.09) and ASDR (EAPC= -0.25; 95% CI: -0.31 - -0.20) rates declined. Regionally, all SDI quintiles experienced rising ASPR and ASIR, with middle SDI regions showing the fastest growth. Low-middle and low SDI areas saw increases in ASMR and ASDR. A notable correlation was identified between ASPR, ASIR and SDI. East Asia and Oceania had the most severe increases in ASPR/ASIR and ASMR/ASDR, respectively. Males bore a greater burden than females. Population growth and epidemiological shifts drove the rise in ASIR and ASPR, with alcohol and tobacco use as key mortality contributors. Projections estimate ASPR will reach 61.81 (95% UI: 37.31-86.30) and ASIR 17.09 (95% UI: 11.95-22.23) by 2050, with ASMR and ASDR expected to initially decline before rising again.

Conclusions: The study highlights the need for early prevention, especially in high-risk regions and among male adults aged ≥45 years, and emphasizes the importance of considering multiple factors in public health interventions for effective disease management.

Article 8 of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) obligates Parties to enact policies that create 100% smoke-free environments in enclosed workplaces, public places and public transport. This narrative literature review examines studies reporting economic impact of smoke-free policies on tourism industry sectors including hotels, casinos/gambling venues, and sporting venues. A literature search was conducted across academic and gray literature published between 1 January 2004 and 18 June 2024, using the Scopus, Embase, and JSTOR databases. Search terms included variations of 'smoke-free' and 'tourism', 'hospitality', 'casino', 'hotel', and other related terms. Studies were included if they reported direct or indirect economic impacts of smoke-free policies on the tourism sector. The screening process involved an initial review of titles and abstracts, followed by full-text assessment for eligibility. Database searching identified 692 articles, of which 37 met the inclusion criteria. Nearly all identified studies (95%) focused on economic impacts in high income countries. The majority (76%) reported neutral or positive economic impacts following the implementation of smoke-free policies. There is evidence that most hotels and other hospitality venues experienced stable or improved revenues, increased customer satisfaction, and enhanced employee health outcomes after going smoke-free. Some evidence indicates that certain casinos experienced short-term revenue declines. Comprehensive smoke-free policies were more consistently associated with economic benefits, while partial policies often produced mixed results, commonly attributed to enforcement challenges. This review supports the evidence that comprehensive smoke-free policies aligned with WHO FCTC Article 8 deliver both health and economic benefits without harming the tourism sector. Findings can help policymakers counter tobacco industry claims and build political support for stronger smoke-free policies, especially in tourism-dependent jurisdictions. The lack of studies from low- and middle-income countries highlights the need for further research in these contexts.

Introduction: Type 2 diabetes mellitus (T2DM) poses a global health crisis. Smoking, a key risk factor for T2DM, significantly impacts middle-aged and elderly populations. In China, with the world's largest elderly population and a high prevalence of smoking, the burden of smoking-related T2DM remains underrecognized.

Methods: Using GBD 2021 data, we applied joinpoint regression, age-period-cohort analysis, and the ARIMA model for prediction. This is a secondary dataset analysis. The study population included Chinese adults aged ≥55 years.

Results: From 1990 to 2021, deaths and DALYs attributable to smoking-associated T2DM showed a substantial increase, with males experiencing a significant rise in both number of death and DALYs rates, while females exhibited a decrease in death rate though total number of deaths rose. Joinpoint analysis revealed fluctuating trends in mortality and DALYs. The age-period-cohort analysis highlighted the age group of 70-75 years as a high-risk period. Predictive analysis suggested a slight upward trend in mortality for the overall population and males, while the DALYs rate was expected to remain stable but increase among males and decrease among females.

Conclusions: From 1990 to 2021, the impact of smoking on type 2 diabetes mellitus (T2DM) among middle-aged and elderly adults in China continued to rise, with notable gender differences. Strengthening tobacco control and diabetes management, particularly for males and high-risk age groups, is crucial for reducing this burden.

Introduction: Although the relationship between taxation and conventional cigarette use is well established, little is known about the association with electronic cigarette (e-cigarette) use and no study has accounted for the potential delayed effects of e-cigarette policies beyond the observation period. This study aimed to evaluate the impact of China's 2022 e-cigarette tax increase on e-cigarette use.

Methods: A prospective longitudinal observational design was utilized by collecting three-waves of online survey data in China. Participants were recruited through social media platforms. Baseline data were collected in October 2022, with follow-up survey conducted in March and August 2023. Participants were eligible if they were aged ≥18 years, reported using e-cigarettes in the past 30 days at baseline, and provided informed consent to be recontacted for follow-up. The Friedman test and the Cochran's Q test were used to assess differences across the waves. The Wilcoxon signed-rank test and the Tukey test were used to make pairwise comparisons between the groups.

Results: There were 116 participants recruited at baseline and 91 (78.5%) of them complete all three surveys. E-cigarette use (ECU) decreased by 33.0% (95% CI: 23.7-42.3) in wave 2 after the tax increase was implemented, and by an additional 35.2% (95% CI: 26.8-43.7) in wave 3. The overall quit rate was 68.2% (95% CI: 60.3-75.9). However, 74.2% (95% CI: 65.9-82.5) of e-cigarette users whose quit switched to conventional cigarettes, resulting in an absolute cessation prevalence of only 17.6% (95% CI: 7.8-25.4). While perceived risk for ECU (χ²=0.41, p>0.05), perceived severity for ECU (χ²=1.02, p>0.05), and behavioral beliefs (χ²=2.28, p>0.05) did not change following the e-cigarette tax increase. Friends' attitudes (χ²=8.74, p<0.05), coworkers' attitudes (χ²=4.71, p<0.05), and exposure to e-cigarette advertising (Q=9.76, p<0.01) showed significant decreases.

Conclusions: This study suggests a possible association between the China's 2022 e-cigarette tax increase and changes in e-cigarette use. However, its effectiveness was diminished due to the large number of e-cigarette users who switched to conventional cigarettes. China's 2022 e-cigarette tax increase also affected social norms regarding e-cigarette use and exposure to e-cigarette advertising. The findings may inform future policy considerations for a comprehensive strategy.

Introduction: Tobacco exposure is a leading modifiable risk factor for preventable deaths, harming the digestive system, and leading to a large number of deaths.

Methods: A secondary assessment of Global Burden of Disease (GBD) datasets was conducted. From 1990 to 2021, data on deaths from tobacco exposure on digestive diseases, including various genders and age groups, from the 2021 GBD Study were utilized. Trends across 204 countries/territories, 21 GBD, and 5 sociodemographic index (SDI) regions were analyzed. Additionally, a detailed analysis was conducted. Pearson correlation analysis, frontier analysis, age-period-cohort (APC) model, and the Bayesian APC (BAPC) model was utilized.

Results: From 1990 to 2021, the global number of deaths from tobacco-attributable digestive diseases decreased from 52789 (95% uncertainty interval (UI): 36999-68307) to 34061 (95% UI: 23821-46548). The age-standardized rate also decreased, from 1.34 (95% UI: 0.93-1.73) to 0.40 (95% UI: 0.28-0.55). Overall, SDI was negatively associated with disease burden, and the Quality of Care Index for digestive diseases increased with SDI. Results from the APC analysis showed that the mortality rate increased with age; more recently born cohorts had lower mortality rates at the same age; and the mortality rate across all age groups decreased over time. Predictions indicated that the death burden of tobacco-attributable digestive diseases will continue to decline for both males and females from 2022 to 2042.

Conclusions: Global tobacco-attributable digestive diseases mortality may have decreased due to tobacco control and medical advances. The disease burden in older adults, males, and regions with middle to high SDI deserves special attention. Countries with a relatively high disease burden should learn from those with a lower burden among nations at the same SDI level regarding tobacco control and healthcare management.

Introduction: Tobacco use remains a major preventable cause of morbidity and mortality worldwide. Despite economic development and growing health system capacity, countries in the Gulf Cooperation Council (GCC) region face rising tobacco use and a shifting burden of smoking-attributed diseases. This study systematically analyzes age-specific and age-standardized smoking-related mortality trends across six Gulf countries Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates over a 30-year period.

Methods: We extracted and analyzed smoking-attributed mortality data from the Global Burden of Disease 2021 dataset (1990-2019), including death rates per 100000 population for age groups 15-49, 50-69, and ≥70 years, and the age-standardized percentage of deaths due to smoking. We conducted descriptive trend analysis, heatmap visualization, correlation assessment, and linear projections to 2030.

Results: Bahrain and Kuwait exhibited the highest smoking-attributed mortality rates with 14.3% of all deaths in 2019, particularly among those aged ≥70 years, with death rates exceeding 1300 per 100000. In contrast, Saudi Arabia and Oman maintained relatively lower and stable rates. Strong correlations were observed between mid-life and elderly smoking mortality (r about 0.97), while slightly lower in the ≥70 years group (r about 0.85). Projections indicate a highest burden increase in Bahrain (about 13.5%) and slight increases in Qatar and UAE (about 9%, each) by 2030 without policy intensification.

Conclusions: Despite regional advances in tobacco control, the burden of smoking-related mortality remains high in parts of the Gulf, especially among older adults. Immediate, targeted interventions particularly for middle-aged smokers are necessary to prevent further escalation. These findings support prioritizing tobacco cessation and surveillance as part of GCC public health strategies.