Tobacco Induced Diseases最新文献

Introduction: Limited data exist on how home smoking and e-cigarette use restrictions influence patterns of cigarette and e-cigarette use among individuals who use both products. This study examined the association between home restrictions and the use of cigarettes and e-cigarettes among dual users of these two products.

Methods: We conducted a secondary analysis of data from the Adult Consumers of Tobacco Study (ACTS), an online, nationwide survey administered during 2020-2021. A sub-sample of 250 dual users of cigarettes and e-cigarettes was included in this analysis. Outcome variables were concurrent use behaviors, categorized as predominant smokers (daily smoking, e-cigarette use some days), equivalent users (either daily or some days use of both products), and predominant e-cigarette users (daily e-cigarette use, smoking some days), as well as e-cigarette use frequency (daily vs some days). Primary explanatory variables were home smoking and e-cigarette use restrictions (both categorized as complete, partial, or no restrictions). Multivariable logistic regression was used to examine associations between restrictions and concurrent use behaviors.

Results: Nearly half (46.8%) of dual users reported having complete smoking restrictions in their homes, complete e-cigarette use restrictions (12.8%), and complete restrictions on both (11.2%). Dual users reported having complete home smoking restrictions (vs no restrictions) were more than two times more likely to be predominant e-cigarette users versus equivalent users or predominant smokers (AOR=2.60; 95% CI: 1.30-5.30), after controlling for home e-cigarette use restrictions and other covariates. Neither partial smoking restrictions nor partial e-cigarette use restrictions were associated with concurrent use behaviors.

Conclusions: Small proportions of dual users reported having complete smoking and e-cigarette use restrictions adopted in their homes, suggesting a need for promoting the adoption of such restrictions. Moreover, how and why home smoking and e-cigarette use restrictions differentially impact use behaviors warrant additional investigation.

Introduction: The high prevalence of tobacco use in China has led to a heavy social burden. There have been many studies on smoking behavior in China, but few have explored it from the perspective of behavioral economics. This study investigated the association between time-inconsistent preferences and smoking behavior.

Methods: We conducted a household-based cross-sectional survey in Sichuan Province, southwestern China, in 2022. Participants were selected using multistage stratified sampling. Data were collected through face-to-face, questionnaire-based household surveys, yielding 5446 valid responses. The smoking status of all participants was confirmed by cotinine test. Descriptive statistical analysis was performed on variables such as sociodemographic variables and time-inconsistent preference, and a binary logistic regression model was used to explore the relationship between time-inconsistent preference and smoking behavior.

Results: The smoking rate of the survey participants was 23.87%, among which that of drinkers was 45.90%, which was significantly higher than that of non-drinkers (15.10%); 712 participants (13.07%) both smoked and drank, and the average time-inconsistent preference (time-inconsistent preferences measured over 1-month and 12-month delay periods) of smokers (mean ± standard deviation: 0.91 ± 0.14) was significantly lower than that of non-smokers (0.95 ± 0.11, p<0.001). Thus, those with weaker time-inconsistent preferences were less likely to smoke (p<0.001, adjusted odds ratio, AOR=0.276; 95% CI: 0.140-0.544). This trend was significant in both drinkers and non-drinkers, with AOR of 0.253 (95% CI: 0.093-0.693) and 0.26 (95% CI: 0.102-0.661), respectively.

Conclusions: Weaker time-inconsistent preferences show a significant negative association with smoking behavior in this Chinese sample, independent of alcohol consumption. Commitment mechanisms targeting time-inconsistent preferences may hold promise for smoking cessation interventions, although efficacy requires validation through randomized trials.

Introduction: Smoking cessation is a significant challenge, and various factors influence the success rates. Understanding the factors affecting cessation outcomes can guide more effective intervention strategies. This study compares the efficacy of a general outpatient cessation program versus a free cessation program, with subgroup analyses based on medication type (bupropion vs varenicline), aiming to identify factors associated with successful smoking cessation in outpatient settings.

Methods: We analyzed data from 356 patients visiting our smoking cessation clinic between January 2018 and June 2022, with random allocation into two groups via computerized random number table upon enrollment: Group A (general outpatient intervention, n=188) and Group B (free cessation program, n=168). Both groups were further subdivided based on the use of bupropion (A1, B1) or varenicline (A2, B2). Factors such as demographic data, nicotine dependence, smoking cessation confidence, exhaled carbon monoxide, and smoking cessation success (7-day point prevalence abstinence rate [PPAR] and 3-month continuous quitting rate [CQR]) were analyzed. To ensure comprehensive results, we performed an intention-to-treat (ITT) analysis, including participants who dropped out or did not complete the study as failures in the smoking cessation outcome.

Results: There were no significant differences between groups A and B in demographics, smoking behavior, or medication, except for occupation and duration of cigarette smoking. Group B had lower nicotine dependence but comparable smoking cessation outcomes to Group A. Factors associated with successful cessation included being older, married, employed full-time, smoking ≤20 cigarettes/day, and using varenicline. The CQR of Group A2 was 9.36% higher than that of Group A1. The PPAR and CQR of Group B2 were 16.66% and 17.93% higher than those of Group B1, respectively. However, there were no significant differences in PPAR and CQR between Group A2 and Group B2.

Conclusions: Varenicline use, specific sociodemographic characteristics (aged >50 years, married, full-time employment), and less severe smoking behavior (≤20 cigarettes/day, ≤25 years duration, ≤600 pack-year) are key determinants of successful smoking cessation in outpatient settings. Varenicline use was associated with significantly higher cessation rates compared to bupropion within both intervention models. The free program incorporating varenicline (B2) demonstrated particularly high success rates.

Introduction: Smoking and secondhand smoke are major global health threats, significantly contributing to the burden of ischemic heart disease (IHD). Despite the implementation of tobacco control policies worldwide, limited evidence exists on the health impacts in Shanghai. This study evaluates the effects of Shanghai's 2017 smoke-free legislation on IHD hospitalization and mortality rates.

Methods: We conducted Interrupted Time Series (ITS) method to analyze monthly data on IHD hospitalizations and mortality among registered residents of Shanghai from July 2013 to December 2021. Age-standardized rate, Poisson and negative binomial regression models were performed to control for covariates.

Results: We included 898535 hospitalizations and 180658 deaths caused by IHD from July 2013 to December 2021 in Shanghai. Following policy implementation, there was a significant immediate increase (β=8.29; 95% CI: 2.45-14.13) and post-trend decline (β= -0.73; 95% CI: -0.93 - -0.54) in IHD hospitalization, which is estimated to have prevented approximately 890 hospitalizations per year. Subgroup analysis revealed that the long-term decrease was more pronounced in individuals aged ≥65 years (β= -1.72; 95% CI: -2.21 - -1.24), compared to those aged 35-64 years (β= -0.33; 95% CI: -0.42 - -0.25). However, mortality rates showed no statistically significant immediate (β= -0.90, 95% CI: -4.76-2.95) or long-term changes (β= -0.0075; 95% CI: -0.14-0.12).

Conclusions: Shanghai's comprehensive smoke-free legislation appears to be associated with a significant long-term reduction in hospitalization rates and a modest decrease in mortality rates from ischemic heart disease, particularly among older adults. These findings support the potential cardiovascular health benefits of smoke-free policies, which provide useful evidence for other cities considering the adoption or reinforcement of comprehensive public smoking bans to help reduce the burden of cardiovascular disease and improve population health.

Introduction: Gender-specific variations in hormonal profiles, adipose tissue distribution, and metabolic pathways may differentially modulate the health impacts of smoking and alcohol use. Current population-based studies on the impact of smoking and alcohol consumption on cardiometabolic diseases (CMD) and multimorbidity (CMM) often lack gender-stratified analyses, thereby limiting the evidence base for gender-tailored preventive strategies.

Methods: This population-based cross-sectional study used data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), and a total of 11447 participants were included in the analysis. Multinomial logistic regression was conducted to assess behavioral risk factors, with interaction terms evaluating effect modification by gender.

Results: The prevalence was 16.67% for CMD and 5.66% for CMM. Participants who smoked were more likely to report CMM than those who did not smoke (OR=2.70, p<0.05). Smoking was significantly associated with the prevalence of CMD in females (AOR=1.34, p<0.05), but not in males (p=0.556). Moreover, female smokers were more likely to report CMM compared to male smokers (AOR_females=3.53, AOR_males=2.02, p<0.05). No significant associations were found between alcohol consumption and the prevalence of CMD or CMM, nor were any gender-specific differences observed.

Conclusions: Smoking may have a potential gender-specific effect on the risk of CMD and CMM, with female smokers exhibiting a higher prevalence of CMM than males. This highlights the need to integrate gender considerations into chronic disease prevention frameworks.

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Introduction: Thirteen Southern and Midwestern states - termed 'Tobacco Nation' - have persistently higher smoking rates than other US states. Previous research indicates increased cigarette taxes and tobacco control expenditures (TCE) may mitigate this geographical cigarette smoking disparity. The current study simulates the impact of these policies on racial and socioeconomic tobacco-related disparities within Tobacco Nation.

Methods: Using ModelHealth^TM:Tobacco, we simulated 20-year changes in smoking and smoking-attributable (SA) outcomes by poverty status and race. We projected the impact of: 1) a 'tax-only scenario', increasing cigarette taxes by $1.50; and 2) a 'combined policy scenario', simultaneously increasing cigarette taxes by $1.50 and increasing state TCE to the Centers for Disease Control (CDC)-recommended level.

Results: Under the tax-only scenario, SA outcomes would be reduced for Tobacco Nation residents below 138% the federal poverty level (FPL) by about 4.3 the magnitude of those above 138% the FPL. Some SA outcomes would be reduced by about 10% more among Non-Hispanic (NH) Black residents than NH White residents. For all subgroups, the combined policy scenario would reduce SA outcomes by about eight times the magnitude of the tax-only scenario, even though the relative reduction in disparities by poverty status would be smaller (2.8 higher reductions for those below compared to above 138% the FPL).

Conclusions: The combined policy scenario, compared to the tax-only scenario, would reduce SA harms by a substantially larger magnitude. Both scenarios are projected to reduce socioeconomic disparities in tobacco harms but not all racial disparities in Tobacco Nation without greater prioritization of targeted policies.

Introduction: Using data from the National Health and Nutrition Examination Survey (NHANES), this study aimed to assess the association between smoking and hearing loss and explore its heterogeneity across gender and age groups.

Methods: This secondary dataset analysis used a cross-sectional design and included NHANES data from 2005-2012 and 2015-2018. The study population consisted of adults without hearing-related disorders. Hearing loss was assessed by pure tone audiometry (PTA) and included low-frequency (LFHL), speech-frequency (SFHL) and high-frequency hearing loss (HFHL), expressed as continuous and categorical variables, respectively. Linear and logistic regression models were used to analyze the association between hearing loss and the exposure variable smoking status.

Results: A total of 4217 adult subjects were included. It was found that smokers had a higher prevalence of LFHL, SFHL and HFHL than non-smokers (LFHL: 15.62% vs 8.51%, SFHL: 23.22% vs 12.98%, HFHL: 53.48% vs 36.95%). In males, in Models 1 (unadjusted), 2 and 3 (adjusted), there were statistically significant differences (p<0.05) in LFHL (β=4.24; 95% CI: 3.32-5.17; β=1.65; 95% CI: 0.80-2.49; β=1.52; 95% CI: 0.66-2.38) in SFHL (β=5.63; 95% CI: 4.56-6.70; β=1.95; 95% CI: 1.05-2.84; β=1.62; 95% CI: 0.72-2.52) and in HFHL (β=10.20; 95% CI: 8.21-12.19; β=2.85; 95% CI: 1.33-4.37; β=2.19; 95% CI: 0.69-3.70) between smokers and non-smokers, for continuous variables of hearing loss. In male hearing loss, categorical variables also showed statistically significant differences between smokers and non-smokers (p<0.05). In the middle-aged group, compared with non-smokers, logistic regression of smoking with all three types of hearing loss showed statistically significant differences (p<0.05) in Models 1, 2 and 3.

Conclusions: There was a significant association between smoking and hearing loss, with maybe more significant associations with all three types of hearing loss in male smokers and a significant relationship between smoking and hearing loss in the middle-aged group.

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.