Tobacco Induced Diseases最新文献

Introduction: The contribution of cigarettes to disease initiation, manifestation and progression is well-established for complex disorders, such as inflammatory bowel disease. However, studying its impact on disease pathophysiology in a controlled setting is challenging in humans, resulting in the application of various model systems, amongst them tobacco smoke-exposed mice. While frequently employed, it is unclear to what extent this model reflects human responses to tobacco smoke.

Methods: Employing a mouse study of experimental nature, we assessed established parameters for monitoring responses to tobacco smoke, paralleled by 16S rRNA gene-based profiling of the murine gut microbiome in n=32 suitable animals. This was supplemented by a case-control study design, based on n=3 publicly available transcriptome datasets, from human oral mucosa, human large airway epithelium and murine lung tissues, where we assessed which components of the response to tobacco smoke observed in mice are functionally comparable to responses seen in humans.

Results: We observed several physiological responses in mice that paralleled human scenarios (weight loss, serum cotinine and Cyp1a1 mRNA expression), serving as a proof of principle. We identified shared microbiome-associated processes: stress related functions were enriched in mice and humans, while other processes, such as inflammatory functions, were discordant. The mouse microbiota showed significant changes in response to tobacco smoke, which mimicked patterns seen in human datasets, such as changes for Lachnospiraceae and Prevotellaceae. In contrast, some families that show significant responses to tobacco smoke in humans, such as Bacteroidaceae, could not be observed in mice.

Conclusions: Considering the high inter-individual variation in humans and the well-controlled conditions in mice, our results suggest that mice, despite the identified limitations, most likely represent a suitable model for studying specific processes, such as stress responses, in the context of tobacco smoke exposure and its impact on the microbiota.

Introduction: E-cigarette use among young adults represents a growing public health concern. This pilot randomized controlled trial evaluated the preliminary effects of Protection Motivation Theory (PMT)-based peer education on strengthening university students' cognition to refuse e-cigarette use in China, where tobacco control policies remain limited.

Methods: A total of 289 participants completed baseline assessment and were randomly assigned to an intervention group (n=144) and a control group (n=145). The intervention consisted of a 1-month peer education program in which trained peer educators delivered PMT-based messages through weekly one-on-one conversations via phone or messaging platforms. Intervention participants received messages addressing all seven PMT constructs, while control participants received only messages about health risks of two PMT constructs. Primary outcomes were four PMT-based cognitive appraisals measured at baseline, 1 month, and 3 months. Linear mixed-models examined group × time interactions, and effect sizes were calculated for all comparisons.

Results: No statistically significant between-group differences were observed for primary outcomes. Subgroup analysis revealed significant intervention effects at 3 months among participants with family or friends who used cigarettes/e-cigarettes: lower perceived rewards (mean difference= -0.55; 95% CI: -1.07 - -0.03, p=0.04) and greater perceived efficacy (mean difference=0.34; 95% CI: 0.06-0.62, p=0.02).

Conclusions: While overall effects were not statistically significant, observed effect sizes and significant subgroup findings suggest PMT-based peer education may influence cognitive precursors to e-cigarette use, particularly among students with social exposure to tobacco use. Larger trials with extended follow-up periods are warranted to confirm these preliminary findings.

Introduction: This study assessed the general perceptions of smokers in Saudi Arabia about the harms of smoking and identified the different methods used by them to quit smoking.

Methods: A descriptive cross-sectional study was designed using an online self-administered questionnaire to assess the smoker's perceptions on smoking and ways to quit smoking. A convenience sample of 1358 participants aged ≥18 years were enrolled from December 2022 to February 2023. Data analysis was carried out using the Statistical Package for Social Sciences (SPSS) software with p<0.05 indicating statistical significance.

Results: A total of 1358 participants completed the online survey. Most of the respondents were smokers (63.3%; n=860). Forty-six percent of the participants (n=396) started smoking when they were aged <18 years. Around 71% of the participants did not like the presence of any family member who smokes. More than half (52%) of the participants admitted that friends are the main reason for beginning smoking. Around 40% (n=229) of the 860 participants were enrolled in a smoking cessation program at some point.

Conclusions: Around 46% of the study participants started smoking when they were aged <18 years. About two-thirds of them tried to quit smoking. Although many centers around the country are dedicated to helping smokers quit smoking, many smokers noted that their outreach should be further enhanced.

Introduction: Research consistently shows that bereavement is associated with subsequent poor self-rated health. In a separate line of research, smoking is common among persons with a mental illness diagnosis. In a population-based survey, the following three hypotheses are tested: 1) Compared to non-smokers, smokers are not more likely to report bereavement; 2) Among the bereaved, demographic factors - gender, race, and age - do not influence the likelihood of being a current smoker; and 3) Smoking does not influence or mediate the effect of bereavement on poor self-rated health.

Methods: The sample consisted of 7354 respondents to the annual 2019 Georgia Behavioral Risk Factor Surveillance Survey (BRFSS). Multiple imputation, descriptive analysis, ordered logistic regression, and mediation models were used.

Results: With imputed datasets, we found that bereavement rates were higher among every day (52.2%) compared to former smokers (46.4%) and never smokers (43.3%). Bereaved persons who smoke are also more likely to report heavy drinking: females (OR=3.92; 95% CI: 2.96-5.18) and males (OR=3.64; 95% CI: 2.72-4.86). Bereavement rates are highest among males who report smoking some days (OR=52.7; 95% CI: 44.4-61.0) and among females who report smoking every day (OR=56.77; 95% CI: 50.9-62.7).

Conclusions: Among all current smokers, bereavement is highly prevalent. However, gender, smoking and grief have a complex association. Bereaved female smokers typically smoke every day while bereaved male smokers on some days. Any bereaved smoker may benefit from cessation treatment to reduce health decline after loss.

Introduction: The complex relationship between smoking, depression, and lung cancer remains inadequately understood, particularly regarding smoking's association with depression risk among lung cancer patients. This study examines these interactions in a nationally representative sample.

Methods: This secondary dataset analysis used cross-sectional data from 1539 US adults aged ≥20 years from the pooled 2005-2016 National Health and Nutrition Examination Survey (NHANES). We employed survey-weighted logistic regression analyses to assess associations, adjusting for sociodemographic factors and clinical comorbidities.

Results: Weighted prevalence estimates were 3.14% (95% CI: 2.78-3.55) for lung cancer, 29.4% for current smoking (95% CI: 28.0-30.9), and 11.18% (95% CI: 10.12-12.34) for clinically significant depression (PHQ-9 ≥10) Females had significantly higher depression prevalence than males (AOR=2.18; 95% CI: 1.63-2.91; p<0.01). Current smokers demonstrated 3.12-fold higher odds of depression compared to non-smokers (AOR=3.12, 95% CI: 2.18-4.47; p<0.001). Recent quitters (<1 year) also showed elevated depression risk (AOR=2.89; 95% CI 1.15-7.25; p=0.024). Among participants with lung cancer, current smokers had a significantly higher prevalence of depression compared to non-smokers (16.82% vs 4.12%; p=0.0008).

Conclusions: Smoking was strongly associated with depression in lung cancer patients, with recent cessation representing a high-risk period. Integrated smoking cessation and mental health interventions are needed, particularly for young females.

Introduction: The treatment of choice for posterior teeth is full-coverage crowns, but these materials should not be color-affected by external factors such as tobacco use. This laboratory study aimed to evaluate the mean color change (ΔE*) values of lithium aluminum disilicate (LAD) full anatomical ceramic crowns after staining in different adverse materials consumed in different countries worldwide.

Methods: Ninety full anatomical crowns in the form of molars were constructed from LAD (Cerec Tessera blocks) with the use of computer-aided design/computerassisted manufacturing system. They were divided equally into nine groups, with 10 crowns for each group. The crowns were immersed for 15 days in different adverse materials (khat, shamma, yerba mate, snuff, soft drinks used daily as a mixture of fruit juice, Coca-Cola, Saudi coffee, and Nescafe). Instructions from the International Commission on Illumination were followed for color parameter measurements. The CIELab color space L* lightness value coordinate, a* red- green coordinate, and b* yellow-blue coordinate, were calculated before and after staining for 2 weeks. ΔE* values were calculated by spectrophotometry. One-way ANOVA followed by post hoc tests were used to assess significance differences between groups. The significance level was set at p<0.05.

Results: The ΔE* changed after immersion in all solutions except for the control group. The highest average ΔE* values and standard deviation were observed with yerba mate 6.3 ± 2.0, followed by shammah 4.6 ± 0.9, whereas the lowest ΔE* was recorded for the mixture of fruit juice 3.2 ±1.3. One-way ANOVA test showed a significant difference between the group of yerba mate, with p<0.001. Pearson's correlation coefficient test was used to assess the statistical relationship of ΔE* among groups. A highly positive significant correlation was found between shammah and Nescafe (r=0.798). A medium correlation was found between khat with yerba mate (r=0.520) and snuff and control groups (r=0.474), without significant differences.

Conclusions: The overall recorded ΔE* values for LAD full anatomical ceramic crowns following 2 weeks of staining in different staining media were marginally higher than the clinically acceptable values except for the fruit-juice group.

Introduction: The impact of smoking behaviors on asthma incidence and all-cause mortality among middle-aged and older adults remains understudied. In particular, whether the potential effect of adolescent smoking initiation on late-onset asthma is independent of cumulative tobacco exposure is unclear.

Methods: Cox proportional hazards models assessed longitudinal impact of smoking behaviors on asthma incidence and mortality risks using 2011-2018 China Health and Retirement Longitudinal Study (CHARLS) data. Cross-sectional smoking-asthma associations were analyzed with logistic regression. Additionally, restricted cubic splines were used to assess the nonlinear relationships between smoking characteristics and asthma incidence.

Results: Smokers had a 65% higher risk of incident asthma compared to non-smokers in middle-aged and older adults (HR=1.65; 95% CI: 1.10-2.46, p=0.015). According to stratified analysis, individuals with smoking duration ≥40 years (HR=1.95; 95% CI: 1.2-3.15, p=0.007), cumulative pack-years under 15 pack-years (HR=1.76; 95% CI: 1.04-2.99, p=0.035), and smoking onset before the age of 18 years (HR=2.31; 95% CI: 1.35-3.96, p=0.002) were at significantly greater risk for asthma. After controlling for cumulative pack-years, early smoking initiation (<18 years) remained an independent and significant predictor of asthma onset in middle and older age (HR=2.56; 95% CI: 1.29-5.06, p=0.007). Subgroup analysis revealed that smoking-related asthma risk was especially elevated among those aged <65 years, females, overweight individuals, and those without baseline comorbidities. Moreover, there was no significant difference in all-cause mortality between the smoking and non-smoking groups in asthma patients.

Conclusions: The increased risk of asthma onset among middle-aged and older adults due to adolescent smoking initiation was independent of cumulative smoking pack-years, even though low pack-years and long-term smoking also contribute to increased risk. Targeted smoking cessation programs, especially adolescent prevention, are crucial to reduce asthma burden in this population.

Introduction: Tobacco smoking continues to pose a major global public health challenge. Medical students play a crucial role in shaping future smoking cessation practices. Nicotine pouches have recently emerged as a tobacco-free alternative with a potentially reduced harm profile. However, little is known about their use and perception among medical students in Saudi Arabia. This study aimed to assess medical students' knowledge and perceptions of nicotine pouches and to examine usage patterns among those who consume these products.

Methods: A cross-sectional study was conducted between April and July 2024 among 295 medical students from three universities in Saudi Arabia. Data were collected through a self-administered electronic questionnaire covering demographics, smoking history, knowledge, perceptions, and usage behaviors. Statistical analyses, including chi-squared tests and logistic regression, were used to identify factors associated with knowledge and usage.

Results: Smoking prevalence among participants was 16.3%, with significantly higher rates among males. Overall, 58.6% of students demonstrated good knowledge of nicotine pouches. Higher knowledge scores were associated with male gender, senior academic year, and higher grade point average (GPA). Among users, 62.9% reported quitting smoking, and more than half noted health improvements. The 10 mg nicotine strength was the most commonly used. Social influence, particularly peer pressure, was the primary reason for use. Despite noting harm reduction potential, students expressed concern about nicotine dependence and the need for stronger regulation.

Conclusions: Saudi medical students show moderate knowledge of nicotine pouches, influenced by academic and demographic factors. However, concerns about dependence and regulation highlight the need for targeted education and policy development. Integrating this topic into medical curricula may better prepare future physicians to address nicotine use in clinical practice.

Introduction: The association between electronic cigarettes (e-cigarettes) and the risk of cardiovascular disease (CVD) remains inconclusive. This study aims to compare CVD risk from the use of e-cigarettes, cigarettes, combined cigarette and e-cigarette use, and non-use.

Methods: This study is a systematic review and network meta-analysis (NMA). MEDLINE and Scopus databases (through February 2024) were used to identify eligible studies. Observational studies that investigated the effect of e-cigarettes on the risk of composite CVD, myocardial infarction (MI), or stroke, compared to cigarette, dual use, or non-use, were included. NMA was applied to estimate relative effects (i.e. adjusted odds ratio, AOR) of e-cigarette, cigarette, and dual use, on composite CVD, MI, and stroke outcomes. Risk of bias was assessed using the Joanna Briggs Institute tool for surveys and the Newcastle-Ottawa scale for cohort studies.

Results: Eleven adult population studies were eligible for review. E-cigarette, cigarette, and dual use were significantly associated with composite CVD outcomes. Pooled AORs (95% CI) were 1.31 (1.05-1.62) for e-cigarette, 1.57 (1.30-1.88) for cigarette, and 1.67 (1.37-2.03) for dual use. Additionally, former cigarette and former dual use significantly increased the risk of composite CVD outcomes, compared to non-use. The pooled AORs (95% CI) were 1.29 (1.05-1.59) for former cigarette, and 1.46 (1.03-2.08) for former dual use, while former e-cigarette use was not significantly associated with composite CVD endpoints. For MI and stroke outcomes, only cigarette and dual use were significantly associated with these events.

Conclusions: Current e-cigarette, cigarette, and dual use were significantly associated with increased risk of composite CVD outcomes, while only cigarette and dual use significantly increased the risk of MI and stroke, compared to non-use. However, these findings were primarily based on cross-sectional data limiting the temporality of effect; additional prospective cohort studies are needed to confirm our findings.

Introduction: Smoking after a cancer diagnosis is associated with poor outcomes whereas smoking cessation improves survival and other outcomes. Although professional societies and practice guidelines call for equitable tobacco treatment delivery in healthcare, disparities in tobacco-related disease burden persist.

Methods: In the context of an outpatient US cancer center's population-based tobacco treatment program, this study examines associations between cancer survivors' rural and Appalachian residence status and: 1) current tobacco use status, 2) decision to decline tobacco treatment, and 3) reason for declining assistance. A cross-sectional, retrospective analysis was conducted using electronic health record data from 16839 adults: 64.04% female, 88.49% non-Hispanic White, mean age 59.19 ± 14.52 years, 35.97% rural residence, 53.14% Appalachian residence, who sought cancer care in 2019. Descriptive statistics and logistic regression models were applied.

Results: The portion of patients that reported current tobacco use was 21.75%. Rural patients had higher odds of tobacco use than urban (OR=1.22; 95% CI: 1.12- 1.34), as did Appalachian patients compared to non-Appalachian (OR=1.41; 95% CI: 1.28-1.54). Neither rural nor Appalachian residence status was significantly associated with responses to tobacco treatment offers (76.65% declined the offer) or reason for declining (65.19% declined because they were 'not ready to quit').

Conclusions: Findings highlight continued need for population-level tobacco use screening and proactive tobacco treatment offers, given elevated tobacco use in some minority groups and overall low rates of tobacco treatment acceptance. This large study helps shed light on the association between geographical residence and tobacco-related outcomes among patients with cancer, and underscores room for improvement in tobacco treatment uptake in cancer care.