Tobacco Induced Diseases最新文献

Introduction: Cigarette smoking is a significant risk factor for atherosclerotic cardiovascular diseases (ASCVDs). Mildly elevated total serum bilirubin (TSB) levels can exert anti-atherosclerotic effects and may regulate inflammation. We explore the relationship between TSB levels, smoking, and inflammation.

Methods: This cross-sectional study evaluated health screening participants with no history of ASCVD between 1 April 2019 and 31 March 2020. TSB was compared between non-smokers and smokers using the Kruskal-Wallis test, and the influencing factors of TSB levels were identified using multivariable logistic regression with TSB levels above the 75th percentile set as the dependent variable. Mediation analysis was performed to determine whether TSB levels mediated the association between smoking and inflammation.

Results: A total of 8337 participants (mean age: 46.6 ± 13.0 years; 58.9% men) were included. TSB levels were significantly lower in smokers (n=1353) than in non-smokers (n=6984) [median (IQR): 0.72 (0.56-0.92) vs 0.76 (0.60-0.97) mg/dL, p<0.0001]. Multivariable logistic regression analysis demonstrated that smoking was an independent determinant of lower TSB levels (adjusted odds ratio, AOR=0.81; 95% CI: 0.70-0.93, p=0.003). Leukocyte counts and C-reactive protein levels significantly decreased as TSB levels increased (p<0.0001). Moreover, the relationship between the duration of smoking cessation and TSB levels showed a positive correlation. Mediation analysis indicated that cigarette smoking had significant indirect effects on higher leukocyte counts and higher CRP levels (coefficient=0.014; 95% CI: 0.008-0.021; and coefficient=0.002; 95% CI: 0.001-0.003, respectively].

Conclusions: Lower TSB levels related to a smoking habit may be associated with higher inflammation, thereby increasing the ASCVD risk. TSB may regulate inflammation and exert antioxidant effects. Furthermore, smoking cessation may lead to higher TSB levels and lower inflammation.

Introduction: Trabecular bone score (TBS) is gaining attention as a novel approach for evaluating bone quality, as it provides insights into skeletal microarchitecture. We aimed to investigate the possible relationship between serum cotinine and TBS in the US population.

Methods: This cross-sectional study utilized data from the 2005-2008 National Health and Nutrition Examination Survey (NHANES). A total of 6961 adults aged ≥20 years with complete data on TBS and serum cotinine were included. Serum cotinine levels were measured using isotope-dilution high-performance liquid chromatography coupled with tandem mass spectrometry. TBS was derived from lumbar spine DXA images using the Med-Imap SA TBS Calculator. Weighted multivariable linear regression analyses were conducted, adjusting for age, sex, race, BMI, poverty income ratio (PIR), total spine bone mineral density (TSBMD), smoking status, C-reactive protein (CRP), total protein, blood urea nitrogen, serum creatinine, serum uric acid, serum calcium, alkaline phosphatase, and serum phosphorus. Subgroup analyses were stratified by sex, race, BMI, and PIR.

Results: A total of 6961 individuals were included in the analysis, with a mean (± SE) age of 45.20 ± 0.39 years, comprising 49.21% males and 50.79% females. The serum level of cotinine was negatively associated with TBS in the fully adjusted model. Specifically, for each unit increase in the log2-cotinine score, there was a corresponding 0.01 unit decrease in TBS (β= -0.01; 95% CI: -0.02 - -0.01, p=0.002). Participants in the highest tertile of serum cotinine had a significantly lower TBS compared to those in the lowest tertile (β= -0.01; 95% CI: -0.02 - -0.01, p=0.002). Subgroup analysis revealed a significant negative association between serum cotinine and TBS in females (β= -0.021; 95% CI: -0.03 - -0.01), but not in males. No significant associations were found when stratified by race, BMI, and PIR.

Conclusions: Serum cotinine was negatively associated with TBS in US adults. Further large-scale prospective studies are still needed to explore the associative relationship of cotinine in TBS.

Introduction: Evidence of different smoking cessation interventions varies and has been assessed in many Cochrane reviews. We conducted an overview of these Cochrane reviews to summarize the effects of current interventions for smoking cessation.

Methods: Nine databases were searched from their inception to October 2024, with no restrictions on language. Two authors independently extracted data from the same studies simultaneously, double checking after extraction. A second round of examination was conducted on all the extracted contents by another author. We employed a measurement tool to assess systematic reviews (AMSTAR-2) to evaluate the methodological rigor of the included systematic reviews (SRs), synthesized the GRADE results as reported, and conducted a narrative synthesis. The research protocol was registered on PROSPERO (CRD42023388884).

Results: Seventy-one Cochrane reviews involving 3022 trials were included in this comprehensive analysis. The two predominant smoking cessation interventions were pharmacotherapy (24 SRs) and non-pharmacological therapy (31SRs). Overall, the methodological quality of all the reviews was good. Compared with placebo, the point effect size for each Cochrane review on relative risk (RR) regarding pharmacotherapies for prolonged abstinence rate ranged from 1.11 to 3.34, demonstrating high- or moderate-certainty evidence; whereas for non-pharmacological therapies, it varied from 0.79 to 25.38, but substantial heterogeneity was observed in most meta-analysis (I2>50%). Four studies investigating pharmacotherapies as interventions, adverse events were reported but no significant differences in outcomes were observed.

Conclusions: Pharmacotherapy demonstrated some efficacy in promoting prolonged abstinence rate, while the effectiveness of different non-pharmacological interventions for smoking cessation varied widely, highlighting the need for further research on the integration of pharmacotherapy and non-pharmacological therapies.

Introduction: Tobacco use remains a significant public health issue worldwide, causing over 7 million deaths annually. Polytobacco use has become a common phenomenon. This study aims to analyze reasons for cigarette and tobacco product use, dual use and poly use among university students by sex, in China and Cyprus, selected owing to their still high consumption rates.

Methods: An online survey was conducted among 589 university students (55% women) with a mean age of 24.2 years from Guangzhou, China, and the Republic of Cyprus. Participants reported their use of cigarettes, e-cigarettes, and waterpipes, as well as their reasons for using these products. Statistical analyses included chi-squared tests, and effect sizes were computed using the phi (φ) coefficient.

Results: The Chinese participants gave as reasons for using cigarettes: 'because of the taste', 'because it looks cool', 'to get high' and 'because friends and family use them'. These were less frequently given by the Cypriots who opted more for 'to relax and relieve tension'. Compared to the Cypriot participants, the more frequent reasons given for consuming e-cigarettes and waterpipes among Chinese students were: 'due to boredom', 'because it looks cool', 'to get high', 'because I am hooked', 'because friends or family members use them', 'because they are less harmful than regular cigarettes' and 'because friends of family members allow their use more'. Dual or poly users felt more addicted than those who practiced single use. Among e-cigarette users, dual users and poly users valued the taste of the product more than single users. In general, men found more reasons for tobacco use than women did.

Conclusions: This study shows substantial differences in the motivation for using these products according to the product type, number of tobacco/nicotine products used, country, and sex. Understanding the reasons for tobacco use can inform targeted interventions aimed at reducing tobacco consumption among young adults.

Introduction: The association between secondhand smoking (SHS) and the risk of Type 1 diabetes mellitus (DM) has garnered increasing interest. The aim of this study is to examine whether exposure to SHS is associated with an increased likelihood of Type 1 DM.

Methods: This study was designed as a case-control study. Children aged 4-14 years diagnosed with Type 1 DM who were followed in the Endocrine and Metabolic Diseases Outpatient Clinic were included as cases, and healthy children (without any chronic disease) in the same age range were included as the controls. A total of 248 children were included in the study, with two research arms. The structured questionnaire was applied face-to-face. Adjusted odds ratios (AOR) and 95% confidence intervals (CIs) of other risk factors were evaluated by multivariable regression analysis.

Results: No difference was found in the number of cigarettes mothers smoked daily and the duration of the smoking period during pregnancy and lactation, between the two groups. Among the cases, the daily number of cigarettes smoked by parents at home was 3.28 ± 4.90, higher than in the controls (p=0.039). Comparing the controls, children with Type 1 DM were more likely to be exposed to SHS at home by 1.08 (95% CI: 1.004-1.15, p=0.039) times in cases.

Conclusions: Children with Type 1 DM had higher odds of being exposed to SHS at home. These results suggest substantial health gains could be made by extending effective public health interventions to reduce exposure to SHS and prevent Type 1 DM in children.

Psoriasis is a common skin disease. With an in-depth understanding of psoriasis, small-molecule drugs and biologics are developed and used in clinical practice, but some patients still cannot achieve a satisfactory therapeutic effect. Tobacco smoking and alcohol drinking are proven to be factors affecting psoriasis. Still, evidence of the impact of tobacco smoking and alcohol consumption on the efficacy of psoriasis treatment is limited. This study aims to understand the prevalence of tobacco smoking and alcohol drinking among patients with psoriasis in Shanghai and to examine the association between tobacco smoking as well as alcohol drinking and the therapeutic effect in patients with psoriasis. We conducted a longitudinal observational study and recruited at least 500 psoriasis patients at Shanghai Skin Disease Hospital. In this study, patients with clinically diagnosed psoriasis vulgaris, aged ≥18 years, both males and females, with informed consent were recruited. However, patients with pregnancy, serious underlying disease conditions, communication barriers, and violation of medication regulations were excluded. Patients with psoriasis in this study receive a physical examination and case record form interview. The primary outcome indicator is the proportion of patients with PASI₇₅ achievement at Week 8. In this study, we use SAS 9.2 software to analyze the data. This study has been reviewed and approved by the Institutional Ethics Review Committee of Shanghai Skin Disease Hospital in 2021 (NO. 2021-44). It has been registered in the Chinese Clinical Trial Registry (ChiCTR2200066403). Patient recruitment began in January 2021 and is proposed to be finished in December 2024. The findings in this study will provide evidence of how tobacco smoking and alcohol drinking impact the treatment efficacy among patients with psoriasis. Therefore, the implementation of tobacco control and alcohol abstinence benefit the improvement of treatment responses.

Introduction: Combustible cigarettes have been shown to increase hypertension risk. Nevertheless, data on the association between electronic cigarettes (e-cigarettes), as well as dual use of e-cigarettes and combustible cigarettes, and hypertension, are limited.

Methods: This study aims to examine the association of the use of e-cigarettes, combustible cigarettes or dual use with hypertension. Data from the 2015-2018 National Health and Nutrition Examination Survey were used. Weighted logistic regression models were employed to determine the relationship between cigarette use and hypertension. Weighted Cox proportional hazard regression models were developed to evaluate the association between electronic/combustible cigarettes or dual use and mortality in hypertensive individuals.

Results: A total of 7696 participants (median age 47 years; 51.76% females) were included. In the adjusted model, the groups of e-cigarette use, combustible cigarette use, and dual use were found to be significantly associated with the risk of hypertension with AOR and 95% CI of 1.56 (1.01-2.42), 1.29 (1.01-1.64) and 1.83 (1.03-3.27) respectively. Significant trends of the relationship between cigarette use and hypertension were observed. The median follow-up for mortality was 38 months. Current e-cigarette use showed a positive correlation with all-cause death and cardiovascular death compared to never e-cigarette use with HR and 95% CI of 1.30 (1.01-1.66) and 1.30 (1.01-1.67), respectively. The trend of association of e-cigarette use with mortality was significant.

Conclusions: This study shows that electronic/combustible cigarette use or dual use increased risk of hypertension. E-cigarettes were associated with a higher risk of all-cause mortality and cardiovascular mortality. Notably, the increased risk of mortality among e-cigarette users may be due to underlying, pre-existing comorbidities related to prior combustible cigarette use. Findings from the study provide evidence of the benefits of e-cigarette use control, especially among individuals with hypertension.

Introduction: According to the literature, quitting tobacco before the age of 30 years would mitigate almost all tobacco-related hazards. In this respect, understanding behavioral patterns associated with the process of individual change to a healthier behavior is likely to contribute to tobacco control and avoidance of the related health risks, as well as to promote healthier behaviors, especially during adolescence.

Methods: This study is a secondary dataset analysis utilizing the 2016 Global Youth Tobacco Survey (GYTS) data for Morocco. Initially, a descriptive analysis is conducted to outline smoking prevalence and related behaviors among Moroccan youth, with a focus on gender differences, employing chi-squared tests for comparison. This is followed by bivariate and multivariate logistic regression analyses, which were adjusted for potential confounders to identify the determinants of intended smoking cessation.

Results: The survey was based on a sample of 3883 adolescents, of whom 11.07% have already tried smoking cigarettes at least once during childhood and adolescence, and 1.39% are current smokers. As for those close to the surveyed subjects, 22.2% had at least one smoking parent, and 24.1% had friends who smoked. Self-efficacy (AOR=15.54; 95% CI: 3.05-79.03) and noticing health warnings on cigarette packages (AOR=5.41; 95% CI: 2.54-11.52) were found to be important determinants of the intent to quit tobacco.

Conclusions: This study is a focused analysis of self-efficacy and health warnings as predictors of smoking cessation intent among Moroccan adolescents. The study elucidates the role of self-efficacy and exposure to health warnings in shaping the intent to quit smoking among Moroccan adolescents. These findings provide evidence for developing targeted interventions that support self-efficacy and impactful health warnings to promote healthier choices and reduce tobacco use among young Moroccans.

Introduction: Ischemic stroke is a major global health issue, with active smoking identified as a key modifiable risk factor. This study examines the burden of ischemic stroke due to active smoking from 1990 to 2021, across different sociodemographic contexts.

Methods: Data from the Global Burden of Disease (GBD) 2021 database were used to extract information on mortality and disability-adjusted life years (DALYs) attributable to active smoking-related ischemic stroke. Countries and regions were categorized by the sociodemographic index (SDI) into five levels. Statistical analyses were conducted using R Studio, including the calculation of estimated annual percentage change (EAPC) and joinpoint regression models.

Results: In 2021, there were 342674 deaths globally due to ischemic stroke caused by active smoking, with an age-standardized mortality rate (ASMR) of 4.06 and a population-attributable fraction (PAF) of 9.54%. The number of deaths increased by 35.59% from 1990 to 2021, with males aged ≥70 years experiencing the largest increase. The global age-standardized DALY rate in 2021 was 98.29, with an overall increase in DALYs by 33.55% from 1990. Regional analysis revealed significant disparities, with the middle SDI region reporting the highest number of deaths and DALYs, while the high SDI region reported the lowest. Geographically, East Asia had the highest burden in 2021. Nationally, China had the highest number of deaths and DALYs due to smoking-related ischemic stroke.

Conclusions: This study highlights the significant global burden of ischemic stroke attributable to active smoking and the critical need for targeted smoking cessation programs and stroke prevention strategies. Despite overall declines in ASMR and age-standardized DALY rates, the burden varies significantly across different regions and sociodemographic groups. Effective public health interventions, particularly in low- to middle-SDI regions, are essential to mitigate the impact of smoking-related ischemic stroke and improve global health outcomes.

Introduction: This study aims to estimate the prevalence and factors associated with cigarette smoking among patients in treatment for substance use disorders (SUD) in France.

Methods: We analyze a nation-wide dataset retrieving information on patients entering treatment for alcohol, opioid and stimulant use disorders between 2010 and 2020. We conduct multilevel Poisson regressions to determine the main factors associated with daily cigarette smoking among all patients who entered treatment for alcohol (n=607122), opioid (n=283381) or stimulant (n=57189) use disorders, and zero-truncated negative-binomial regressions to predict the average number of cigarettes per day.

Results: Daily cigarette smoking remains a widespread behavior among patients with SUD (overall prevalence: 72.2%, 95% CI: 72.1-72.3), with lower prevalence of daily cigarette smoking among patients treated for alcohol use disorders (69.9%, 95% CI: 69.8-70.0), and higher for patients treated for opioid (78.8%, 95% CI: 78.6-79.0) or stimulant use disorders (75.8%, 95% CI: 75.4-76.2). There was an overall increase in daily cigarette smoking over time (69.9%, 95% CI: 69.8-70.0 in 2010 vs 76.8%, 95% CI: 76.5-76.9 in 2020); however, the average number of cigarettes per day decreased (17.8 per day, 95% CI: 17.7-17.9 in 2010 vs 16.3 per day, 95% CI: 16.2-16.4 in 2020). The higher the education level, the fewer number of cigarettes per day; conversely, the higher the occupational status, the higher the number of cigarettes.

Conclusions: The high prevalence of smoking among patients treated for SUD in France departs from the decreasing trend observed in the general population and remains a source of concern. It is necessary to implement tailored prevention strategies that target specific patient subgroups and increase staff awareness.