Tobacco Induced Diseases最新文献

Introduction: Although global smoke-free policies have significantly reduced smoking rates, exposure to secondhand smoke (SHS) in homes and public places remains common. SHS continues to be a significant risk factor for lower respiratory infections (LRIs) in children. However, there is still a lack of systematic assessment of the spatiotemporal trends and future disease burden of LRIs attributable to SHS in children aged under 14 years.

Methods: This study is a secondary analysis of the Global Burden of Disease (GBD) 2021 data. We used joinpoint regression to analyze trends and calculate the average annual percentage change (AAPC) in the burden of LRIs attributable to SHS among children aged under 14 years, globally from 1990 to 2021. Age-standardized rates (ASRs) of mortality and DALYs were quantified at the global, regional, and national levels. Finally, a Bayesian age-period-cohort (BAPC) model was applied to forecast trends up to 2035, providing a basis for formulating targeted intervention strategies.

Results: In 2021, the number of deaths and disability-adjusted life years (DALYs) among children aged under 14 years worldwide due to LRIs caused by SHS decreased significantly. The ASR declined to 2.25 (95% UI: 0.73-3.86) for mortality and 199.84 (95% UI: 64.82-342.97) for DALYs per 100000 population. The forecast results indicated that by 2035, both the mortality and the DALY rates would continue to decline.

Conclusions: Although the global burden had declined significantly and was expected to continue decreasing through 2035, SHS remained a significant contributor to LRIs in children.

Introduction: Amid increasingly stringent e-cigarette regulations in China - including taxation, flavor bans, and advertising restrictions - coordinated communication has emerged as a key challenge in tobacco control. This study investigates a viral incident involving Blackpink's Jennie to explore how failures in strategic narrative coordination have undermined the legitimacy of regulatory efforts.

Methods: This study combined web scraping, large language models (LLMs) topic modeling, and critical discourse analysis (CDA) to collect and analyze an e-cigarette-related event on the Chinese social media platform Weibo from July to October 2024.

Results: Findings reveal that although e-cigarette-related content was widely circulated, public discourse largely lacked critical health framing. Instead, discussions often shifted toward moral judgments, cultural identity, and individual freedoms. This discursive vacuum weakened the normative foundation of tobacco control and enabled counter-narratives that questioned the state's regulatory intent.

Conclusions: The study introduces 'coordinated communication' as both an analytical framework and a practical imperative for effective tobacco governance. Our Research argues that legal regulation must be accompanied by proactive narrative leadership to sustain public health legitimacy. A multi-stakeholder governance mechanism involving health authorities, media institutions, and digital platforms is recommended to rebuild a coherent, health-centered public discourse in the digital.

Introduction: The aim of the study was to evaluate smoking habits and the factors influencing them among school students in rural areas of Romania.

Methods: The study sample included 748 school students aged 13-14 years from twenty-four schools from rural areas situated in two counties of Romania. The cross-sectional study was conducted in 2019 among participating students using confidential questionnaires to assess smoking-related behaviors and the factors that influence them.

Results: Our findings revealed that 15.9 % of the sample were current smokers (no statistically significant differences were noticed between boys and girls). Smoking prevalence was higher among students without household goods such as a phone or a computer, compared to those who owned them (28.4% vs 13.8%, p<0.001, and 25.2% vs 14%, p<0.01, respectively). Students with lower school results also had higher smoking rates than those with better results (21.1% vs 8.1%, p<0.001). Adolescents who consumed alcohol monthly had higher smoking prevalence compared to those who did not (41.2% vs 13.4%, p<0.001). Engaging in fights monthly (34.6% vs 15%, p<0.001), vandalism (44.1% vs 14.3%, p<0.001), and stealing monthly (50% vs 15.2%, p<0.01) were also linked to higher smoking prevalence compared to not having these behaviors. Spending most spare time in bars/discos was associated with higher smoking prevalence (60% vs 14.9%, p<0.001). Practicing sports was correlated with lower smoking prevalence than not practicing sports (12.7% vs 16.4%, p<0.05). Smokers were more likely to perceive the benefits of smoking, whereas non-smokers were significantly more convinced about several disadvantages of smoking. Additionally, the study found an increased perceived behavior and pressure to smoke from parents, siblings, friends, best friends, and peers in the same school year among smokers. Smokers had lower self-efficacy to refrain from smoking in different situations. Intention to smoke in the next year was higher among smokers.

Conclusions: The results have implications for the development of health promotion activities for smoking prevention among Romanian adolescents from rural areas.

Introduction: The emerging non-combustible tobacco products have complicated the tobacco landscape in Korea. This study aimed to assess subgroup trends in conventional cigarette (CC), electronic cigarette (EC), heated tobacco product (HTP), and poly-tobacco use in South Korea from 2013 to 2023.

Methods: We analyzed secondary data from the 2013-2023 Korea National Health and Nutrition Examination Survey, a nationally-representative cross-sectional data of adults (aged ≥19 years) (n=62935). Joinpoint regressions were used to estimate average annual percent changes (AAPCs) in tobacco use, stratified by sociodemographic and health-related characteristics. All measures were based on self-reports.

Results: Among men, the prevalence of CC smoking declined from 42.1% in 2013 to 32.2% in 2023 (AAPC= -3.4; 95% CI: -4.6 - -2.3), with small declines among those with a lower income, less-educated, manual workers, and those with multiple risk behaviors, and severe mental illness. EC use increased modestly overall, with a significant rise among in men aged 25-39 years; HTP use showed a slight overall decline. Poly-tobacco use increased, particularly among young adults (aged 19-24 years) and middle-aged adults (aged 40-64 years) the lowest-income group, manual workers, and those with multiple risk behaviors. Among women, overall prevalence of CC, EC, and HTP use remained below 7%, but prevalence rose among young women aged 19-24 years (CC: 9.6% to 16.1%; EC: 0.7% to 5.6%; HTP: 3.1% to 5.8%), although the corresponding AAPCs were not statistically significant (CC: 4.6; 95% CI: -1.9-12.4; EC: 15.1; 95% CI: -0.1-39.7; HTP: 26.3; 95% CI: -21.4-125.0).

Conclusions: Korea's progress in reducing CC smoking has not extended to vulnerable populations, and rising EC and poly-tobacco use, particularly among young adults, present new challenges. These findings underscore the need for tailored cessation interventions for vulnerable populations and for ongoing efforts to tackle the emerging use of novel tobacco products.

Introduction: Approximately 5000 child deaths are attributed to secondhand smoke exposure (SHSe) annually, which is three times the number of childhood cancers combined. Infants, medically fragile infants, are highly vulnerable to the harmful effects of SHSe, including respiratory infections and sudden infant death syndrome. While having a home smoking ban may mitigate these risks, implementation remains a challenge for many families. Our primary aim was to explore the familial and sociocultural factors associated with smoking-ban initiation and maintenance in households with medically fragile infants.

Methods: Qualitative interviews were conducted with 20 mothers participating in a behavioral intervention from 2015 to 2016 aimed at reducing SHSe in infants discharged from a large urban, children's hospital in Houston, Texas. Interviews explored family structure, cultural influences, social networks, and smoking history. Thematic analysis was used to identify key themes.

Results: Three primary themes emerged: 1) Household structure and power dynamics - mothers in multigenerational homes often lacked authority to enforce smoking bans, especially when the primary authority figure was a smoker; 2) Sole responsibility - mothers felt burdened as the only advocates for SHSe reduction, often without support from other household members; and 3) Variable level of support for SHS bans - while emotional and logistical support was common during infants' hospital stays, this support rarely extended to smoking-related behavior change. Participants felt these factors significantly influenced smoking-ban initiation and sustainability.

Conclusions: Findings underscore the need to move beyond individual-level interventions and engage the broader household context. Intervention sessions should include all household members - particularly individuals who smoke - and incorporate collaborative care models that offer behavioral counseling, pharmacological aids (e.g. nicotine replacement therapy), and real-time feedback technologies. Tailoring interventions to reflect household power structures and support systems may enhance their effectiveness in reducing SHSe and protecting medically vulnerable infants.

Introduction: Tobacco exposure is a plausible accelerator of biological aging, yet population-level evidence and mechanisms remain insufficiently defined. We examined the association between serum cotinine and phenotypic age acceleration (PhenoAgeAccel), and assessed whether oxidative-stress biomarkers were related to the serum cotinine-PhenoAgeAccel association.

Methods: We conducted a cross-sectional, survey-weighted analysis of n=19744 adults from NHANES 2011-2018. PhenoAgeAccel was computed as the residual from regressing PhenoAge on chronological age. Multivariable linear regressions related serum cotinine to PhenoAgeAccel across hierarchical adjustment models. Restricted cubic splines assessed non-linearity. Mediation analysis was conducted to quantify the extent to which oxidative-stress biomarkers contribute to this association.

Results: Higher serum cotinine was associated with accelerated biological aging: each doubling of serum cotinine corresponded to a 0.22-year increase in PhenoAgeAccel (β=0.22; 95% CI: 0.16-0.29). Mediation analyses indicated that γ-glutamyl transferase (GGT) and uric acid (UA) statistically accounted for 9.5% of the association between serum cotinine and PhenoAgeAccel (p<0.001). Interactions were observed for sex and PIR, with stronger associations among women and participants with lower socioeconomic status. There was no evidence of non-linearity in the relationships of the serum cotinine with GGT, PhenoAgeAccel, or UA.

Conclusions: In this nationally representative cross-sectional study of US adults, higher serum cotinine levels were associated with greater phenotypic age acceleration. Oxidative-stress biomarkers were related to the observed association, although causal inferences cannot be drawn.

Introduction: Existing evidence on the association between smoking and hypertension (HTN) remains conflicting, and the potential role of systemic inflammation in mediating smoking-related mortality among hypertensive patients is poorly understood. This study aimed to investigate the association between smoking status, smoking volume, and HTN risk in a large, nationally representative sample. Furthermore, we sought to determine whether systemic inflammation, measured by the systemic inflammation index (SII), mediates the association between smoking and all-cause mortality in hypertensive individuals.

Methods: This cross-sectional, pooled secondary data analysis study utilized data from 10 cycles of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Data on smoking, covariates, and hypertension status were collected through standardized interviews, questionnaires, and laboratory/physical examinations. A total of 28967 participants were included after excluding those with incomplete data. Propensity score matching (PSM) analysis was employed to adjust for confounding factors such as age, gender, BMI, race, and other sociodemographic variables. Logistic regression and restricted cubic spline regression were used to assess the dose-response relationship between smoking and HTN. Mediation analysis was performed to evaluate the role of systemic inflammation, as measured by the systemic inflammation index (SII), in the increased mortality risk among hypertensive smokers.

Results: Smoking significantly increased the likelihood of HTN after adjusting for confounders (adjusted odds ration, AOR=1.18; 95% CI: 1.10-1.27). A dose-response relationship was observed, with individuals smoking >30 cigarettes/day having the highest likelihood of HTN (AOR=1.37; 95% CI: 1.07-1.75). PSM analysis confirmed these findings, showing a significant increase in HTN prevalence among smokers (p=0.045). Smoking was also associated with increased overall mortality in hypertensive patients (HR=1.993; 95% CI: 1.766-2.249). Mediation analysis revealed that systemic inflammation, as measured by SII, accounted for 87.70% of the increased mortality in hypertensive smokers (ACME=0.068, p<0.001).

Conclusions: This study establishes a significant association between smoking, HTN and mortality. The findings underscore a potential dose-response trend between cigarette consumption and HTN, with systemic inflammation playing a key role in mediating the higher mortality observed in hypertensive smokers. Interventions targeting smoking cessation and systemic inflammation may significantly reduce the burden of HTN-related morbidity and mortality.

Introduction: Tobacco use among adolescents is a concern in the Upper East Region of Ghana. We estimated the prevalence and identified factors contributing to single and multiple use of tobacco products among junior high school students in Ghana.

Methods: We conducted a cross-sectional analysis of a baseline survey of a school-based tobacco control intervention among adolescents in the Upper East Region of Ghana in 2022. A multi-stage cluster sampling approach was employed to identify the study sample, and data were collected using self-administered questionnaires. Current use of single tobacco products (at least one: cigarette, e-cigarette, shisha, or smokeless tobacco products) and multiple products (≥2 products) in the past 30 days was assessed. Multinomial logistic regression was used to assess the association of sociodemographic characteristics, perceptions towards tobacco's health risks, and exposure to tobacco products with single and multiple product use. Adjusted relative risk ratios (ARRR) and their corresponding 95% confidence intervals (CI) were computed.

Results: We surveyed 1328 adolescents, comprising an equal proportion of males (49.8%) and females (50.4%). One in five (21.7%) reported using tobacco products, with 11.5% using single products and 13.0% using multiple products. Shisha (13.6%), cigarettes (10.6%), e-cigarettes (8.2%), and smokeless tobacco (6.0%) were used. A number of factors were identified to be associated with tobacco use among adolescents.

Conclusions: One in five junior high school students used at least one form of tobacco product. Adolescent tobacco use is impacted by demographic factors and risk perceptions. Further studies are needed to better understand these associations.