Tobacco Induced Diseases最新文献

Introduction: Understanding who includes e-cigarettes and heated tobacco products (HTPs) in smoke-free home or car rules could inform public health interventions, particularly in countries with high smoking prevalence and recently implemented national smoke-free laws, like Armenia and Georgia.

Methods: In 2022, we conducted a cross-sectional survey among 1468 adults in 28 Armenian and Georgian communities (mean age=42.92 years; 51.4% female, 31.6% past-month smoking). Multilevel regression (accounting for clustering within communities; adjusted for sociodemographics and cigarette use) examined e-cigarette/HTP perceptions (risk, social acceptability) and use intentions in relation to: 1) including e-cigarettes/HTPs in home and car rules among participants with home and car rules, respectively (logistic regressions); and 2) intention to include e-cigarettes/HTPs in home rules (linear regression, 1 = 'not at all' to 7 = 'extremely') among those without home rules.

Results: Overall, 72.9% (n=1070) had home rules, 86.5% of whom included e-cigarettes/HTPs; 33.9% (n=498) had car rules, 81.3% of whom included e-cigarettes/HTPs. Greater perceived e-cigarette/HTP risk was associated with including e-cigarettes/HTPs in home rules (AOR=1.28; 95% CI: 1.08-1.50) and car rules (AOR=1.46; 95% CI: 1.14-1.87) and next-year intentions to include e-cigarettes/HTPs in home rules (β=0.38; 95% CI: 0.25-0.50). Lower e-cigarette/HTP use intentions were associated with including e-cigarettes/HTPs in home rules (AOR=0.75; 95% CI: 0.63-0.88). While perceived social acceptability was unassociated with the outcomes, other social influences were: having children and no other household smokers was associated with including e-cigarettes/HTPs in car rules, and having children was associated with intent to include e-cigarettes/HTPs in home rules.

Conclusions: Interventions to address gaps in home and car rules might target e-cigarette/HTP risk perceptions.

Introduction: The controversial relationship between smoking and prostate cancer (PCa) risk prompted us to conduct a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES) database and apply Mendelian randomization (MR) analyses in order to clarify the possible causal effect of smoking on PCa risk.

Methods: Using univariate and multivariate logistic regression methods, a secondary analysis of the pooled 2003-2018 NHANES dataset was performed to explore the association between smoking and PCa risk. Propensity-score matching was used to reduce selection bias. Then, we conducted subsequent MR analysis study to investigate the potential causal effect of smoking on PCa risk, with genetic variants of four exposure factors including the lifetime smoking index, light smoking, smoking initiation, and the amount of smoking per day obtained from genome-wide association studies, and PCa summary statistics obtained from three database populations. Inverse-variance weighting was the primary analytical method, and weighted median and MR-Egger regression were used for sensitivity analyses. The MR results for the three PCa databases were combined using meta-analysis.

Results: The study included 16073 NHANES subjects, comprising 554 with PCa and 15519 without PCa. Logistic regression before and after matching did not reveal any significant association. Meta-analysis of the MR results also did not support an association of PCa risk with lifetime smoking index (OR=0.95; 95% CI: 0.83-1.09), light smoking (OR=1.00; 95% CI: 0.95-1.06), smoking initiation (OR=0.99, 95% CI=0.99-1.00), or the amount of smoking per day (OR=1.00; 95% CI: 0.99-1.00) and PCa risk.

Conclusions: There was no evidence for an association between smoking and the risk of PCa. Further studies are needed to determine if there are any associations of other forms of smoking with the risk of PCa at different stages.

Introduction: Understanding smokers' purchasing patterns can aid in customizing tobacco control initiatives aimed at reducing the tobacco smoking prevalence. Therefore, this study identified cigarette purchase behavior among Vietnamese male smokers and associated demographic and consumption factors.

Methods: We analyzed a secondary dataset of male current tobacco smokers (n=3983) who participated in the Vietnam Global Adult Tobacco Survey in 2015. We applied the latent class analysis (LCA) to identify the classes of purchase behavior among cigarette smokers (n=1241). Multinomial logistic regression was performed to identify demographics (education level, ethnicity, partnership status, and household socioeconomic status) and cigarette consumption variables (smoking years and heavy smoking status) related to purchase behavior classes. The results are reported as an adjusted relative risk ratio (ARRR).

Results: The LCA identified four cigarette purchase behaviors classes: Class 1 (price-insensitive and purchased international brand: 44.4%), Class 2 (price-sensitive and purchased domestic brand: 27.6%), Class 3 (price-sensitive and purchased cigarettes in a street vendor: 18.6%), and Class 4: price-sensitive and purchased loose/carton cigarette: 9.4%). The poorer economic groups were more likely to belong to the three price-sensitive classes. Heavy smokers and those who had smoked for a longer period were more likely to belong to Class 3 (ARRR=2.33; 95% CI: 1.51-3.58 and ARRR=1.02; 95% CI: 1.001-1.05, respectively) and Class 4 (ARRR=2.94; 95% CI: 1.71-5.06 and ARRR=1.05; 95% CI: 1.02-1.08, respectively).

Conclusions: Varied purchasing behaviors among male cigarette smokers, influenced by divergent price sensitivities and economic backgrounds, underscore the need for comprehensive tobacco control. Future efforts should include targeted policy interventions, behavior modification, and reshaping social norms.

Introduction: Tobacco-related diseases have a substantial economic impact in terms of medical expenses, loss of productivity, and premature death. Tobacco use is estimated to be responsible for more than 90000 deaths each year in Italy. We aimed to evaluate the annual direct economic impact on the National Health System of hospitalizations attributable to tobacco smoking in Italy.

Methods: We analyzed data from all the hospitalizations of patients aged ≥30 years that occurred in Italy for 12 selected tobacco-related diseases, during 2018. These diseases included oropharyngeal cancer, esophageal cancer, gastric cancer, lung cancer, pancreatic cancer, bladder cancer, laryngeal cancer, ischemic heart disease, stroke, diseases of arteries, arterioles, and capillaries, pneumonia and influenza, and chronic obstructive pulmonary disease. We obtained information on 984322 hospital discharge records, including each hospitalization's direct costs. Using relative risk estimates from the scientific literature, we computed the population attributable fraction for various tobacco-related diseases to estimate the economic impact attributable to tobacco smoking.

Results: One-third of all hospitalizations occurred in 2018 in Italy among people aged ≥30 years for 12 tobacco-related diseases were found to be attributable to smoking, accounting for a total cost of €1.64 billion. Among the diseases considered, those with the highest expenditures attributable to tobacco smoking were ischemic heart disease, cerebrovascular disease, and lung cancer, accounting for €556 million, €290 million, and €229 million, respectively.

Conclusions: Tobacco has a substantial economic impact in Italy, accounting for around 6% of the total cost of hospitalizations in 2018. This figure is expected to be largely underestimated due to several conservative assumptions adopted in the statistical analyses. It is imperative to prioritize comprehensive tobacco control measures to counteract the huge healthcare costs due to tobacco smoking.

This work aims to summarize the current evidence on the toxicity and health impact of IQOS, taking into consideration the data source. On 1 June 2022, we searched PubMed, Web of Science, and Scopus databases using the terms: 'heated tobacco product', 'heat-not-burn', 'IQOS', and 'tobacco heating system'. The search was time-restricted to update a previous search conducted on 8 November 2021, on IQOS data from 2010-2021. The data source [independent, Philip Morris International (PMI), or other manufacturers] was retrieved from relevant sections of each publication. Publications were categorized into two general categories: 1) Toxicity assessments included in vitro, in vivo, and systems toxicology studies; and 2) The impact on human health included clinical studies assessing biomarkers of exposure and biomarkers of health effects. Generally, independent studies used classical in vitro and in vivo approaches, but PMI studies combined these with modeling of gene expression (i.e. systems toxicology). Toxicity assessment and health impact studies covered pulmonary, cardiovascular, and other systemic toxicity. PMI studies overall showed reduced toxicity and health risks of IQOS compared to cigarettes, but independent data did not always conform with this conclusion. This review highlights some discrepancies in IQOS risk assessment regarding methods, depth, and breadth of data collection, as well as conclusions based on the data source.

Introduction: Electronic cigarettes (e-cigarettes) have emerged as a new paradigm in nicotine delivery systems. Although they are marketed as safer alternatives to tobacco, public perceptions of their safety and utility vary widely. This study aims to understand the percentage of use, factors associated, perceptions, and attitudes about e-cigarettes among Ecuadorian adults.

Methods: A cross-sectional survey was conducted among the Ecuadorian population aged 18-65 years through a convenience sample, using a structured online questionnaire designed to collect responses from voluntary participants over three months, from February to April 2023. The questionnaire assessed the respondents' attitudes and perceptions towards e-cigarettes. Data were analyzed using descriptive statistics, chi-squared tests, and adjusted logistic regression analyses to identify factors associated with e-cigarette use.

Results: Out of a total of 3047 Ecuadorian adults, the percentage of e-cigarette ever use was 27.9% (n=850), with 19.4% being current users and 8.5% former users. A negative stance towards e-cigarettes was predominant, with 66.3% considering e-cigarette use a public health problem in Ecuador. A significant association was observed between e-cigarette use and perceived harmfulness (p<0.001). Among non-users, there was a predominant stance in favor of control measures and disapproval of e-cigarette use among minors (p<0.001). The factors associated with the use of electronic cigarettes included being health personnel (AOR=1.51; 95% CI: 1.26-1.80). Older age (aged >24 years) and a history of tobacco use were associated with lower e-cigarette use (current users, OR=0.31; 95% CI: 0.25-0.38; previous users, OR=0.23; 95% CI: 0.18-0.28).

Conclusions: The findings highlight a significant percentage of e-cigarette use among Ecuadorian adults, especially among younger groups. There is a need for comprehensive public health education about e-cigarettes in Ecuador. There is strong support from the public for control measures, suggesting the potential acceptability of regulations concerning e-cigarettes.

Introduction: In Thailand, school smoke-free policies initially targeted cigarette smoking but now extend to include electronic cigarettes (e-cigarettes). Yet, the impact of this expansion on curbing e-cigarette use in schools is uncertain. This study seeks to explore how e-cigarette control policies and educational initiatives in Thai secondary schools influence students' legal knowledge, perception of harm, current e-cigarette use, and susceptibility to future use.

Methods: This cross-sectional survey was conducted in four regions of Thailand between May and August 2023, involving 6147 students selected through multistage sampling. Data collection utilized a self-reported online questionnaire in Thai, developed using Google Forms. For continuous outcomes, multiple linear regression models assessed relationships between school e-cigarette policy perceptions, covariates, knowledge of e-cigarette laws, and harm perception. Multiple logistic regression models analyzed the association between policy perceptions, covariates, and categorical outcomes: current e-cigarette use and susceptibility.

Results: Adjusting for covariates, a positive association was found between students' perceptions of e-cigarette policies and teachings and their knowledge of e-cigarette control laws (B=0.083, p<0.001) and harm perceptions (B=0.491, p<0.001). Additionally, these perceptions were protective against current e-cigarette use (AOR=0.970; 95% CI: 0.95-0.99, p=0.002) and susceptibility among non-users (AOR=0.962; 95% CI: 0.95-0.97; p<0.001).

Conclusions: A heightened perception of e-cigarette policies and teachings in schools is associated with increased legal knowledge, heightened harm perception, and a lower likelihood of current or future e-cigarette use. This underscores the importance of enforcing the e-cigarette-free policy in schools to mitigate vaping susceptibility amid the ongoing youth e-cigarette epidemic.

Introduction: The aim of the study is the regulatory effect of MicroRNA-210 (MiR-210) on cigarette smoke extract (CSE)-induced mouse lung epithelial type II cells (MLE-12) apoptosis and determine whether the MiR-210 is involved in cigarette smoke extract-induced apoptosis of MLE-12 via Shh signaling pathway.

Methods: Expression of MiR-210 in CSE-induced MLE-12 was assessed by qRT-PCR. The emphysema mouse model and MiR-210 knockdown mice were each established by inhaling cigarette smoke or intratracheal lentiviral vector instillation. The Sonic hedgehog (Shh), Ptch1, Gli1, B-cell lymphoma-2 (Bcl-2), and Caspase 3 protein expressions were detected by Western blotting. mRNA expressions of MiR-210, Shh, Ptch1, and Gli1 were measured using quantitative real-time polymerase chain reaction (qRT-PCR). Apoptotic ratios in mice and CSE-induced HPVEC were assessed using TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assays and flow cytometry.

Results: Our results showed that MiR-210 mRNA levels were significantly down-regulated in the CSE-induced MLE 12. MLE 12 apoptosis with down-regulated Shh, Ptch1, Gli1, and Bcl-2 expression, increased Caspase 3 expression in the emphysema mouse model and CSE-induced MLE 12. Knockdown MiR-210 can facilitate cell apoptosis and emphysema via the Shh signaling pathway in mice. In vitro, MiR-210 can attenuate the apoptosis of CSE-exposed MLE 12. Moreover, MiR-210 regulated the Shh pathway and promoted its expression.

Conclusions: MiRNA-210 is involved in cigarette smoke extract-induced apoptosis of MLE-12 via the Shh signaling pathway. The present study reveals that MiRNA-210 may be a key regulator of cellular apoptosis and could be explored as a potential therapeutic target in the future.

Introduction: Heated tobacco products (HTPs) are promoted as less harmful than cigarettes; nonetheless, whether HTPs help smokers quit is uncertain.

Methods: Data from 4067 Mexican adult smokers surveyed longitudinally every four months (November 2019-March 2021) were analyzed. Mixed-effects multinomial models regressed HTP use frequency (no use=reference; monthly; weekly; and daily use) on sociodemographics and tobacco/nicotine-related variables. Among participants who completed at least two surveys (n=2900) over four months, the duration of their longest smoking quit attempt (SQA) between surveys (SQAs: <30 days; ≥30 days; no SQA=reference) was regressed on HTP use frequency, and changes in the number of cigarettes smoked per day were regressed on HTP initiation between surveys, adjusting for covariates.

Results: Consistent predictors of all HTP use frequencies (monthly, weekly, or daily vs no use) were daily smoking >5 cigarettes (ARRR=1.69 [95% CI: 1.12-2.55], 1.88 [95% CI: 1.26-2.81] and 6.46 [95% CI: 3.33-12.52], respectively); e-cigarette use (ARRR =5.68 [95% CI: 3.38-9.53], 6.54 [95% CI: 4.06-10.55] and 2.59 [95% CI: 1.26-5.30]); lower HTP risk perceptions (ARRR=2.12 [95% CI: 1.50-30.00], 2.25 [95% CI: 1.63-3.10] and 2.00 [95% CI: 1.25-3.22]); exposure to HTP information inside (ARRR=2.13 [95% CI: 1.44-3.15], 2.13 [95% CI: 1.49-3.05] and 3.72 [95% CI: 2.28-6.09]) and outside stores (ARRR=2.36 [95% CI: 1.56-3.57], 2.32 [95% CI: 1.65-3.25] and 2.44 [95% CI: 1.41-4.24]) where tobacco is sold; having family (ARRR=2.46 [95% CI: 1.54-3.91], 2.90 [95% CI: 1.93-4.37] and 2.96 [95% CI: 1.52-5.77]) and friends (ARRR=5.78 [95% CI: 3.60-9.30], 4.98 [95% CI: 3.22-7.72] and 6.61 [95% CI: 2.91-15.01]) who use HTPs. HTP use frequency was not associated with quit attempts, except for monthly HTP use predicting SQAs lasting ≥30 days (ARRR=2.12 [95% CI: 1.17-3.85]). Initiation of HTP use was not associated with changes in smoking frequency. Limiting analysis to those who intend to quit smoking also yielded null results.

Conclusions: Among Mexican adult smokers, frequency of HTP use was mostly not associated with either cessation behaviors or changes in cigarette consumption, suggesting that HTPs have limited to no effectiveness for smoking cessation.

Introduction: In recent years, e-cigarettes as an emerging tobacco product have been favored by college students. Our study aims to explore the factors affecting the use of e-cigarettes among college students and to put forward feasible suggestions for effectively controlling the use of e-cigarettes among college students.

Methods: The participating students were from three undergraduate and three specialized colleges in Guangdong Province, surveyed from January to March 2022. The Fuzzy-set Qualitative Comparative Analysis (fsQCA) method was used to analyze the influence mechanism and path of five antecedents: self-efficacy, social environment, cognition, sales environment, and negative outcome expectation, on the use of e-cigarettes. The fsQCA used in this study is a novel research methodology that combines the strengths of qualitative and quantitative analyses, through which we can determine which conditions are essential to the outcomes that lead to e-cigarette use among college students, and which combinations of conditions are more important than others.

Results: The interaction of self-efficacy, social environment, cognition, sales environment, and negative outcome expectation, affected college students' use of e-cigarettes. Through the fsQCA method, it was found that self-efficacy alone constitutes a necessary condition for college students not to use e-cigarettes. There are four possible pathways for college students not to use e-cigarettes, with higher self-efficacy, correct cognition, and a healthy social environment influencing the most important combination of conditions for college students to use e-cigarettes.

Conclusions: The use of e-cigarettes by students in Guangdong Province is the result of the synergistic effect of multiple factors. Tobacco control action suggestions focus on improving students' self-efficacy and paying attention to the combination of different factors to achieve more effective tobacco control.