Tobacco Induced Diseases最新文献

Introduction: Snus is currently the most used tobacco product in Norway. This study aims to identify the overall cessation interest among Norwegian snus users, the preferred quitting aids, and correlates of cessation interest.

Methods: Survey data were collected by the Norwegian Directorate of Health through a nationwide web panel, with respondents completing an online questionnaire. Three time points (two in 2018, one in 2019) were pooled, resulting in n=820 snus users. Descriptive statistics and adjusted multinomial logistic regression were applied to identify the extent of snus cessation behavior and factors associated with overall cessation interest.

Results: In all, 58.5% had attempted to quit snus, while 52.7% expressed current plans to quit. Of all snus users, 26.6% had never tried to quit and did not intend to quit in the future; 35.7% had either previously tried to quit but held no current quit plans, or they had never attempted to quit but were willing to try in the future. The remaining 37.7% had both tried to quit and intended to try again. Frequently preferred quitting aids were: quit on my own, mobile app, and nicotine-free snus. Higher interest in quitting was associated with younger age (AOR=0.94, p<0.001), living in western (AOR=2.27, p=0.019) or northern (AOR=2.60, p=0.022) Norway, perceiving snus use as hazardous to health (AOR=2.37, p<0.001), using snus daily (AOR=2.83, p<0.001), and non-smoking (AOR=0.53, p=0.033). Cessation behavior was not statistically associated with education level or income, after controlling for covariates.

Conclusions: The majority of snus users are interested in quitting, especially those who are young and worry about their own health. We found no evidence of a social gradient in cessation interest.

Introduction: Online education platforms offer promising solutions for tobacco control capacity building. This study evaluated an online tobacco control course's effectiveness on healthcare professionals' knowledge, attitudes, and behavioral intentions.

Methods: A cross-sectional survey was conducted among healthcare workers and medical students (n=719) in a Chinese city, January 2023. Participants were categorized as course participants (n=387) or non-participants (n=332). The validated survey instrument (Cronbach's α=0.963) assessed tobacco-related knowledge, attitudes, and behavioral intentions using 5-point Likert scales. Statistical analyses included t-tests, effect size, and multivariable regression.

Results: Course participants demonstrated significantly higher knowledge scores across multiple domains compared to non-participants. Regarding specific tobacco harms, participants showed greater awareness that smoking causes stroke (4.21 ± 0.90 vs 3.86 ± 1.04, p<0.001, Cohen's d=0.37), heart disease (4.27 ± 0.85 vs 3.93 ± 1.03, p<0.001, d=0.36), and erectile dysfunction (4.05 ± 0.97 vs 3.72 ± 1.12, p<0.001, d=0.32). For secondhand smoke, participants better recognized risks of adult cardiovascular disease (4.26 ± 0.81 vs 4.04 ± 0.90, p=0.001, d=0.26) and pediatric respiratory illness (4.37 ± 0.73 vs 4.15 ± 0.83, p<0.001, d=0.28). Participants also showed more positive attitudes toward tobacco control policies and greater behavioral intentions for tobacco control advocacy. In multivariable analysis adjusting for demographics and smoking status, course participation remained significantly associated with higher knowledge scores (β=0.28; 95% CI: 0.18-0.38, p<0.001), more positive attitudes (β=0.22; 95% CI: 0.12-0.32, p<0.001), and stronger behavioral intentions (β=0.31; 95% CI: 0.19-0.43, p<0.001).

Conclusions: The online tobacco control course significantly improved participants' knowledge of tobacco harms and strengthened their support for tobacco control measures. These findings suggest that digital health education platforms may be valuable tools for tobacco control capacity building, though further longitudinal studies are needed to establish causal relationships and assess long-term effectiveness.

Introduction: In recent years, alongside the Healthy China Initiative, extensive nationwide efforts have been undertaken to enhance the health literacy of the population. Health knowledge dissemination has emerged as a key approach within these efforts. This study focused on non-smokers aged 15-44 years in Jilin Province, China. It analyzed their patterns of secondhand smoke (SHS) exposure and their level of awareness regarding its risks.

Methods: The study selected non-smoking permanent residents aged 15-44 years from the 2020 Jilin Province Adult Tobacco Survey database as its subjects. Following the requirements of the China Adult Tobacco Survey Protocol, the project employed a multistage stratified cluster random sampling method. This involved: selecting 10 surveillance sites from all of the province's districts or counties; choosing 3 sub-districts/townships within each surveillance site; selecting 2 neighborhood or village committees within each sub-district or township; and randomly sampling 120 households from each neighborhood or village committee. This resulted in a total sample of 7200 households province-wide. One resident aged ≥15 years was randomly selected from each household for a face-to-face in-home interview. The present analysis utilized eligible questionnaires from individuals within the target age group 15-44 years.

Results: The prevalence of secondhand smoke (SHS) exposure among surveyed non-smoking residents in Jilin Province was 59.16% (95% CI: 52.87-65.17). Awareness rates of specific SHS health risks were as follows: 76.16% (95% CI: 59.77-87.30) knew SHS causes lung cancer in adults; 61.95% (95% CI: 52.26-70.77) knew SHS causes lung diseases in children; and 49.21% (95% CI: 34.99- 63.56) knew SHS causes heart disease in adults. However, only 42.26% (95% CI: 32.60-52.56) were aware that SHS causes all three conditions (heart disease in adults, lung diseases in children, and lung cancer in adults). SHS exposure rates varied significantly by location: restaurants had the highest exposure rate (50.85%) , homes (37.72%), and public transport (5.01%).

Conclusions: SHS exposure prevalence among residents aged 15-44 years in Jilin Province remained high, while comprehensive awareness of its associated health risks was relatively low. A discrepancy existed between possessing knowledge about SHS harms and translating that knowledge into protective behaviors or reduced exposure. Intervention efforts should focus on priority venues, intensify the dissemination of core knowledge on tobacco hazards, implement targeted health promotion activities for key populations, and foster supportive smoke-free environments.

Introduction: Globally, sexual and gender minorities (SGM) exhibit significantly higher tobacco use rates than their cisgender heterosexual counterparts, a persistent health disparity that has garnered increasing attention in public health research.

Methods: We conducted a bibliometric analysis of 704 SGM tobacco use-related publications from the Web of Science Core Collection. First, we examined publication trends, key contributors, and collaborative networks. Second, we performed co-citation network analysis to identify disciplinary characteristics and research hotspots. Finally, we applied keyword burst detection and clustering techniques to assess emerging trends and frontier areas.

Results: From 1984 to 2024, research on SGM tobacco use demonstrated consistent growth. The US accounted for the majority of publications (82.52%), with institutions such as the University of California System serving as key hubs for research collaboration. Research hotspots clustered around five key themes: 1) the effects of novel tobacco products, 2) subgroup differences in tobacco use, 3) tobacco-related health disparities, 4) smoking cessation research, and 5) social and psychological mechanisms.

Conclusions: Using data mining and visualization techniques, this study constructed a comprehensive knowledge map of research on SGM tobacco use. Our findings elucidate evolving patterns and emerging trends while offering valuable perspectives to guide future investigations.

Introduction: There is evidence that exposure to tobacco smoke is associated to a number of chronic diseases, but the evidence for an association with osteoarthritis (OA) is sparse and inconclusive. The aim of this study was to investigate whether exposure to tobacco smoke for an adult is associated with developing OA at a young age, and to assess dose-response patterns.

Methods: We conducted a pooled, cross-sectional analysis of secondary data from the National Health and Nutrition Examination Survey (NHANES) 1999-2020 among US adults aged 20-54 years (n=26145). Tobacco smoke exposure was quantified by serum cotinine. Multivariable logistic regression, restricted cubic splines, and threshold analyses were used to estimate the dose-response relationship between cotinine and self-reported physician-diagnosed early-onset OA.

Results: Overall, 1086 participants (4.2%) reported early-onset OA. After full adjusted odds ratio (AOR), serum cotinine ≥3 ng/mL was associated with a 52% increase in odds of early-onset OA (AOR=1.52; 95% CI: 1.30-1.79), compared with <0.05 ng/mL. A non-linear, positively saturated relationship was observed between the cotinine levels after the natural logarithm (LN) transformation and early-onset OA, with an inflection point at approximately 2.90 ng/mL (AOR=1.38; 95 % CI: 1.17-1.63, p=0.00). Subgroup analyses confirmed the robustness of this association across demographic and clinical strata.

Conclusions: This study, based on a nationally representative sample from the United States, suggests that high levels of tobacco smoke exposure significantly increase the likelihood of early-onset OA, highlighting the need for further research into factors associated with early-onset OA.

Introduction: Electronic cigarettes are battery-operated devices that allow users to 'vape' flavored solutions including nicotine. The prevalence of users of e-cigarettes with different flavors, is not known in the Medina region in Saudi Arabia. Thus, the study aimed to assess the prevalence and characteristics of e-cigarette smokers in Medina region. Additionally, this study aimed to determine the popular flavors and the most common reasons for smoking e-cigarettes among young adults.

Methods: This cross-sectional study was conducted between 1 February and 19 March 2024 using an online questionnaire via convenience sampling. The total number of participants was 388, including males and females aged ≥18 years.

Results: The study findings showed that 78.2 % of the e-cigarette smokers were young adults, while 58.4 % of the participants aged 18-29 years preferred fruit flavors. Additionally, the majority of young adults used e-cigarettes for reducing stress and enjoyment, corresponding to 40.6 % and 31.7 % of participants, respectively.

Conclusions: Our study is useful for identifying the preferences towards e-cigarette usage within a population and monitoring emerging trends, particularly among young adults. Researching regional preferences for e-cigarette flavors might help to direct future studies into the health effects of various flavorings.

Introduction: Electronic cigarettes (e-cigarettes) have gained increasing popularity among young adults worldwide, particularly among college students who represent a key target population for e-cigarette marketing. Understanding cognitive factors that influence e-cigarette use susceptibility is critical for developing effective prevention strategies. This study aimed to develop and validate a scale based on the Protection Motivation Theory (PMT) to assess cognitive factors related to e-cigarette use susceptibility among Chinese college students for prevention purposes.

Methods: A cross-sectional survey design was employed and data were collected among 303 students aged 18-24 years from universities in China during February 2023. A 21-item PMT scale was adapted from a previous study on Chinese youth tobacco use. Construct validity was assessed using confirmatory factor analysis (CFA). Internal consistency reliability was evaluated using Cronbach's α. Structural equation modeling was used to examine associations between PMT constructs and e-cigarette use susceptibility. Statistical significance was set at p<0.05, and all tests were 2-tailed. Power calculations indicated adequate sample size for the planned analyses. Concurrent validity was examined by correlating PMT constructs with e-cigarette use susceptibility.

Results: After removing one item, the final 20-item scale demonstrated good model fit in the CFA (GFI=0.917, CFI=0.933, RMSEA=0.055). Internal reliability was acceptable to good (Cronbach's α=0.52-0.83). The overall Cronbach's α coefficient was 0.831. All PMT constructs were significantly correlated with e-cigarette use susceptibility in the expected directions (p<0.05).

Conclusions: The PMT-based scale is a valid and reliable measure to investigate e-cigarette use related cognitions among Chinese college students, and can be used as a tool to guide prevention efforts. The study supports the utility of applying PMT to e-cigarette research in different socio-cultural contexts.

Introduction: China, the world's largest tobacco market, has raised concerns due to e-cigarettes' health risks and rising youth usage. Despite a decade of regulatory policies, their effectiveness remains uncertain. This study examines trends in e-cigarette discourse on Weibo (2016-2025), analyzing discussion volume shifts and the impact of various topics on public engagement.

Methods: This study employs a hybrid computational approach integrating topic modeling, LLM-assisted annotation, and quantitative analysis to examine the evolution of e-cigarette discussions on Weibo (2015-2025) and topic dissemination effects (n=129769). LDA modeling identify 10 topics, followed by DeepSeek-V3-assisted classification. Linear regression in SPSS analyzed relationships between topic categories and social media engagement metrics (reposts/comments/likes) at 95% confidence intervals.

Results: Findings reveal 2020 as a key year of change: pro-vaping posts declined while anti-vaping content increased. Despite reduced volume, pro-vaping material maintained significant digital influence. Pre-policy, marketing content (p<0.01), health effects (p<0.01) and regulation (p<0.01) drove engagement. Post-policy, marketing lost engagement impact, while 'user experience' posts gained traction, significantly correlating with all interactions (all p<0.05). This indicates regulations were less effective against user-generated content, with pro-vaping messaging shifting towards peer-driven channels. Crucially, influencers consistently triggered strong engagement throughout the period (p<0.01) despite lower post volume, remaining key discourse drivers.

Conclusions: Although China is strengthening its control over e-cigarettes, the results of our study indicate that this control remains limited. We advocate for more robust regulation of social media content, particularly concerning the management of celebrities and influencers, as well as the sharing of e-cigarette use experiences. However, the current regulatory framework enforced by the State Tobacco Monopoly Administration has proven inadequate for widespread and effective governance. We suggest that regulatory authority be shared with public health agencies in order to better integrate e-cigarette regulation with broader public health objectives.

Introduction: Smoking has been identified as a potential risk factor for adverse COVID-19 outcomes. This study aimed to investigate the association between long-term smoking cessation and COVID-19 outcomes.

Methods: In this nationwide, cross-sectional online survey conducted in China (January-February 2023), 22709 adults with COVID-19, confirmed by nucleic acid amplification test (NAAT) or SARS-CoV-2 antigen testing, were included. Smoking status was self-reported and classified as never smokers, long-term ex-smokers (≥10 years), ex-smokers (<10 years), and current smokers. COVID-19 outcomes, including pneumonia, hospitalization, and severe COVID-19, were compared across these groups. Logistic regression models were used to adjust for potential confounders. Sensitivity analyses included all self-reported cases irrespective of test confirmation.

Results: Among 22709 COVID-19-positive participants, current smokers and ex-smokers <10 years exhibited significantly higher proportion of pneumonia, hospitalization, and severe COVID-19 than never smokers. Current smokers (AOR=3.18; 95% CI: 2.90-3.48) and ex-smokers quit <10 years (AOR=3.48; 95% CI: 2.96-4.09) had increased odds of pneumonia, whereas long-term ex-smokers showed no elevated risk (AOR=1.12; 95% CI: 0.45-2.41). These associations were consistent in sensitivity analyses. Other factors significantly associated with pneumonia included sex, education level, residence, obesity, income, and chronic conditions.

Conclusions: Long-term smoking cessation was not associated with an elevated risk of COVID-19-related pneumonia compared to never smokers, whereas ex-smokers (<10 years) and current smokers remained high-risk groups. These findings support the potential benefits of sustained cessation, although further longitudinal studies are needed to confirm and extend these findings.