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Bao K, Zheng K, Zhou X, Chen B, He Z, Zhu D. The effects of nicotine withdrawal on exercise-related physical ability and sports performance in nicotine addicts: a systematic review and meta-analysis. J Int Soc Sports Nutr 2024; 21:2302383. [PMID: 38213003 PMCID: PMC10791090 DOI: 10.1080/15502783.2024.2302383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/05/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Previous research has established that nicotine withdrawal can ameliorate cardiovascular and pulmonary function in smokers. Nevertheless, the impact on physical fitness and athletic performance remains under-investigated. OBJECTIVE To evaluating the impacts of nicotine withdrawal on both exercise performance and exercise-associated physical capabilities in nicotine-dependent individuals. STUDY DESIGN A comprehensive systematic review and meta-analysis. DATA SOURCES The data was compiled from databases such as PubMed, Scopus, Web of Science, Cochrane Central, and EBSCO. STUDY SELECTION The selection criteria required studies to elucidate the effects of nicotine withdrawal on exercise performance or exercise-related physical abilities. Moreover, the selected studies needed to provide discernible experimental results. DATA SYNTHESIS AND ANALYSIS The random effects model was employed in data analysis, utilizing the standardized mean difference (SMD) and the 95% confidence intervals (95% CIs) to estimate participants' exercise performance and physical abilities, referencing the Mean ±SD during baseline and withdrawal states. RESULTS Out of the selected studies, 10 trials were included, encompassing 13,538 participants aged 18 to 65 years. The findings suggest that nicotine withdrawal could potentially enhance sports performance (SMD = 0.45, 95% CI: 0.03 to 0.88; I^2 = 83%), particularly in terms of aerobic capacity. Short-term nicotine withdrawal (spanning 12 to 24 hours) might lead to a decline in participants' physical abilities in certain aspects like reaction time and sustained attention (SMD = -0.83, 95% CI: -1.91 to 0.25; I^2 = 79%), whereas long-term withdrawal (lasting 48 hours or more) demonstrated an opposing trend (SMD = 0.25, 95% CI: 0.12 to 0.39; I^2 = 81%). Overall, the results show that long-term nicotine withdrawal exhibited some positive impacts on sports performance and exercise-related physical ability, with the withdrawal duration being an indicator of subsequent physical performance. CONCLUSIONS Mid- to long-term (≥3 months) nicotine withdrawal significantly improved the exercisers' exercise-related physical ability and sports performance. Conversely, short-term (≤24 hours) nicotine withdrawal considerably hampered exercisers' performance and physical cognition. It is suggested that exercises avoid abrupt nicotine cessation prior to competitions, as long-term nicotine withdrawal has been shown to significantly enhance exercise-related physiological capacities and athletic performance. By referring to existing literatures we also found that athletes with existing nicotine addiction may could consume nicotine 15-30 minutes before competition to enhance athletic performance and physical function.PROSPERO registration number CRD42023411381.
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Affiliation(s)
- Kangzhe Bao
- Zhejiang Normal University, College of Physical Education and Health Sciences, Jinhua, China
| | - Kai Zheng
- Zhejiang Normal University, College of Physical Education and Health Sciences, Jinhua, China
| | - Xianxian Zhou
- Zhejiang Normal University, College of Physical Education and Health Sciences, Jinhua, China
| | - Baichao Chen
- Zhejiang Normal University, College of Physical Education and Health Sciences, Jinhua, China
| | - Zerui He
- Zhejiang Normal University, College of Physical Education and Health Sciences, Jinhua, China
| | - Danyang Zhu
- Zhejiang Normal University, College of Education, Jinhua, China
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Bartík P, Šagát P, Pyšná J, Pyšný L, Suchý J, Trubák Z, Petrů D. The Effect of High Nicotine Dose on Maximum Anaerobic Performance and Perceived Pain in Healthy Non-Smoking Athletes: Crossover Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1009. [PMID: 36673765 PMCID: PMC9859273 DOI: 10.3390/ijerph20021009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
Background: In recent years, there has been intensive discussion about the positive effect of nicotine usage on enhancing sports performance. It is frequently applied through a non-burned tobacco form before physical activity. Nicotine is under the World Anti-Doping Agency (WADA) 2021 monitoring program. Therefore, study results that reveal either positive or negative effects are expected. This is the pilot study that reports the effect of 8 mg dose of nicotine on performance and perceived pain. Material and Methods: This research aimed to explore the oral intake effect of a high-nicotine dose (8 mg) on the maximum anaerobic performance and other selected physical performance parameters in healthy, well-trained adult athletes (n = 15, age 30.7 ± 3.6, BMI 25.3 ± 1.7). The cross-sectional study protocol included the oral administration of either sublingual nicotine or placebo tablets before the anaerobic load assessed by a standardized 30 s Wingate test of the lower limbs. Afterward, the Borg subjective perception of pain (CR 10) and Borg rating of perceived exertion (RPE) were evaluated. Wilcoxon signed-rank test was used for the analysis of data with a 0.05 level of significance. Results: The results revealed that oral administration of an 8 mg nicotine dose does not significantly improve any of the physical performance parameters monitored. We only reported the statistically significant positive effect in RPE (p = 0.03). Conclusion: Lower perception of pain intensity that we reported after nicotine application might be an important factor that affects performance. However, we did not report any improvement in physical performance parameters.
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Affiliation(s)
- Peter Bartík
- Health and Physical Education Department, Prince Sultan University, Riyadh 11586, Saudi Arabia
| | - Peter Šagát
- Health and Physical Education Department, Prince Sultan University, Riyadh 11586, Saudi Arabia
| | - Jana Pyšná
- Department of Physical Education and Sport, Faculty of Education, J. E. Purkyne University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
| | - Ladislav Pyšný
- Department of Physical Education and Sport, Faculty of Education, J. E. Purkyne University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
| | - Jiří Suchý
- Department of Physical Education, Faculty of Education, Charles University, 116 39 Prague, Czech Republic
| | - Zdeněk Trubák
- Department of Physical Education and Sport, Faculty of Education, J. E. Purkyne University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
| | - Dominika Petrů
- Department of Physical Education and Sport, Faculty of Education, J. E. Purkyne University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
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3
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Ishii H, Leung GNW, Yamashita S, Nagata SI, Kushiro A, Sakai S, Toju K, Okada J, Kawasaki K, Kusano K, Kijima-Suda I. Identification of potential biomarkers in urine and plasma after consumption of tobacco product in horses. Drug Test Anal 2022; 14:902-914. [PMID: 35195357 DOI: 10.1002/dta.3242] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/07/2022] [Accepted: 02/15/2022] [Indexed: 11/06/2022]
Abstract
The use of nicotine stimulants in horses is generally banned in horse racing and equestrian sports-accidental consumption of tobacco products is one of the possible causes of nicotine exposure in horses. The authors recently reported a comprehensive metabolic study of nicotine in equines, differentiating between nicotine exposure and sample contamination by means of a nicotine biomarker trans-3'-hydroxycotinine. To identify potential biomarkers for the differentiation of genuine nicotine administration and consumption of tobacco products, tobacco leaves (equivalent to 250 mg of nicotine) were nasoesophageally administered to three thoroughbred mares. Quantification methods of anatabine in plasma and urine were newly developed and validated and successfully applied to post-administration samples. Previously reported simultaneous quantification methods of eight target analytes including nicotine and its metabolites in plasma and urine were also applied to the samples. The results demonstrate that both trans-3'-hydroxycotinine and anatabine could be used as potential biomarkers in equine urine and plasma to indicate recent exposure to tobacco products in horses. As well, trans-3'-hydroxycotinine had the longest half-life as a detectable metabolite in urine and plasma. To our knowledge, this is the first report of a comprehensive study of tobacco product detection in horses.
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Affiliation(s)
- Hideaki Ishii
- Drug Analysis Department, Laboratory of Racing Chemistry, Tochigi, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Gary Ngai-Wa Leung
- Drug Analysis Department, Laboratory of Racing Chemistry, Tochigi, Japan
| | - Shozo Yamashita
- Drug Analysis Department, Laboratory of Racing Chemistry, Tochigi, Japan
| | - Shun-Ichi Nagata
- Genetic Analysis Department, Laboratory of Racing Chemistry, Tochigi, Japan
| | - Asuka Kushiro
- Equine Research Institute, Research Planning & Coordination Division, JRA, Tochigi, Japan
| | - Satoshi Sakai
- Race Horse Hospital, Miho Training Center, JRA, Ibaraki, Japan
| | - Kota Toju
- Race Horse Hospital, Miho Training Center, JRA, Ibaraki, Japan
| | - Jun Okada
- Veterinarian Section, Equine Department, JRA, Tokyo, Japan
| | | | - Kanichi Kusano
- Race Horse Hospital, Ritto Training Center, JRA, Ritto, Shiga, Japan
| | - Isao Kijima-Suda
- Drug Analysis Department, Laboratory of Racing Chemistry, Tochigi, Japan
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4
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Acute Effects of Nicotine on Physiological Responses and Sport Performance in Healthy Baseball Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010515. [PMID: 35010774 PMCID: PMC8745004 DOI: 10.3390/ijerph19010515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 12/04/2022]
Abstract
There is interest in whether nicotine could enhance attention in sporting performance, but evidence on the acute effect of nicotine on physical response and sports performance in baseball players remains scant. This was an observational study to examine whether nicotine gum chewed before exercise could provide acute effects on physiological responses and sport performance. Accordingly, heart rate variability (HRV), saliva cotinine concentration and α-amylase activity, cognitive function, muscle strength, and baseball-hitting performance were measured. Thirteen healthy male non-smoker baseball players were recruited. Conducting two sequences with 7-day intervals, they chewed nicotine gum (nicotine group) or flavor-matched placebo gum (placebo group) for 30 min. HRV and saliva analyses were conducted before gum consumption (S1), after gum consumption (S2), and after test completion (S3). Cognitive, muscle strength, and baseball-hitting performance tests were performed after nicotine or placebo gum chewing. The outcomes of all assessed variables were compared within and between the groups. Significant changes in HRV, α-amylase, testosterone, and cortisol were observed in the nicotine group at S2 and S3 (p < 0.05). Compared with the placebo group, the nicotine group exhibited enhanced motor reaction times, grooved pegboard test (GPT) results on cognitive function, and baseball-hitting performance, and small effect sizes were noted (d = 0.47, 0.46 and 0.41, respectively). Nicotine could induce changes in endocrine and sympathetic nerve activity and enhance cognitive function and baseball-hitting performance. However, no increase in muscle strength was observed after nicotine intake.
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Kumar G, Dash P, J A, S V, Jha K, Singh A. An insight into the world of sports dentistry. J Sports Med Phys Fitness 2021; 61:1555-1561. [PMID: 34713684 DOI: 10.23736/s0022-4707.20.11778-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dental trauma in the field of sports is the major linking channel between sports and dentistry. Sports dentistry is the branch of sports medicine that deals with the prevention of oral or facial athletic injuries, oral diseases and manifestations. Sports dentistry is also related to mild traumatic brain injuries during games and erosive lesions due to continuous intake of highly acidic sports and energy drinks. Stress among sportsperson has also been depicted to impact their athletic performance leading athletes to the intake of drugs. Smokeless tobacco consumption and sponsorship is also found among athletes. Therefore, it is emphasized the need for a "team dentist," initiating from high schools to professional teams. The sports or "team dentist" assists athletes in the effective prevention, treatment, and diagnosis of various types of oral injuries. Sport-related orofacial injuries can be prevented by wearing primary protective devices such as properly fitting helmets, face masks and/or mouth guards. They can also enlighten athletes about the benefits of practicing yoga, as it reduces stress and improves performance. Hence, the dentist can perform an imperative role in informing parents, athletes, coaches and patients about the importance of preventing orofacial injuries in sports.
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Affiliation(s)
- Gunjan Kumar
- Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, Bhubaneswar, India
| | - Payal Dash
- Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, Bhubaneswar, India -
| | - Avinash J
- Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, Bhubaneswar, India
| | - Vinay S
- Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, Bhubaneswar, India
| | - Kunal Jha
- Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, Bhubaneswar, India
| | - Arpita Singh
- MDS, Public Health Dentistry, Bhubaneswar, India
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Chagué F, Reboursière E, Israël J, Hager JP, Ngassa P, Geneste M, Guinoiseau JP, Garet G, Girardin J, Sarda J, Cottin Y, Zeller M. Smoking and Vaping in Amateur Rugby Players, Coaches and Referees: Findings from a Regional Survey Might Help to Define Prevention Targets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115720. [PMID: 34073509 PMCID: PMC8198015 DOI: 10.3390/ijerph18115720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 01/02/2023]
Abstract
A high prevalence of cigarette smoking has been documented in France, and new patterns of tobacco and nicotine consumption are emerging, especially in some sports. In the amateur rugby population, data are scarce on harmful consumption and on the awareness of the risk of smoking. We analyzed the consumption of tobacco and other nicotine products in French amateur players, coaches and referees. Amateur players (>12 years old), coaches and referees participating in the Burgundy amateur championship were invited to answer an electronic, anonymous questionnaire during the 2017–2018 sport season. Among the 683 subjects (gender ratio M/F = 0.9), 176 (25.8%) were current smokers, including 32.4% of the referees and 28.2% of the coaches. The prevalence of smokers was higher in females (37.5%) than in males (24.6%). Most (86.4%) smoked within 2 h before/after a rugby session. Only 28 subjects (4.1%) usually vaped; 21 of them (75%) vaped within 2 h before/after a rugby session. Other tobacco or nicotine products were infrequent. The awareness about the risks of smoking before/after sport was incomplete, including in coaches and referees. The prevalence of cigarette smoking is alarming across the whole spectrum of rugby amateur actors. Education programs are urgently needed to reduce tobacco consumption in this at-risk population.
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Affiliation(s)
- Frédéric Chagué
- Cardiology Department, University Hospital Center Dijon Bourgogne, 21000 Dijon, France;
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
- Correspondence: ; Tel.: +33-619-748-171
| | - Emmanuel Reboursière
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
- Sport Medicine Department, University Hospital Center, 14000 Caen, France
| | - Jean Israël
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
- Cardiology Department, General Hospital, 91640 Bligny, France
| | - Jean-Philippe Hager
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
- Sport Medicine Department, Centre Orthopédique Santy, 69008 Lyon, France
| | - Patrice Ngassa
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
- Sport Medicine Department, Polyclinique Saint-Laurent, 35700 Rennes, France
| | - Marc Geneste
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
| | - Jean-Pierre Guinoiseau
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
| | - Gilles Garet
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
| | - Jacques Girardin
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
| | - Jacques Sarda
- French Rugby Federation, 91460 Marcoussis, France; (E.R.); (J.I.); (J.-P.H.); (P.N.); (M.G.); (J.-P.G.); (G.G.); (J.G.); (J.S.)
| | - Yves Cottin
- Cardiology Department, University Hospital Center Dijon Bourgogne, 21000 Dijon, France;
| | - Marianne Zeller
- Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), EA 7460 UFR Sciences de Santé, University of Bourgogne Franche Comté, 21000 Dijon, France;
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7
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Hung BL, Chen LJ, Chen YY, Ou JB, Fang SH. Nicotine supplementation enhances simulated game performance of archery athletes. J Int Soc Sports Nutr 2021; 18:16. [PMID: 33602279 PMCID: PMC7890628 DOI: 10.1186/s12970-021-00413-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 02/09/2021] [Indexed: 12/27/2022] Open
Abstract
Background Nicotine is beneficial to mood, arousal and cognition in humans. Due to the importance of cognitive functioning for archery athletes, we investigated the effects of nicotine supplementation on the cognitive abilities, heart rate variability (HRV), and sport performance of professional archers. Methods Eleven college archers were recruited and given 2 mg of nicotine supplementation (NIC group) and placebo (PLA group) in a crossover design. Results The results showed that at 30 min after the intake of nicotine gum, the “correct rejection” time in the NIC group was significantly lower than that of the PLA group (7.29 ± 0.87 vs. 8.23 ± 0.98 msec, p < 0.05). In addition, the NIC group completed the grooved pegboard test in a shorter time than the PLA group (48.76 ± 3.18 vs. 53.41 ± 4.05 s, p < 0.05), whereas motor reaction times were not different between the two groups. Saliva α-amylase activity was significantly lower after nicotine supplementation (p < 0.01) but increased immediately after the archery test in the NIC group (p < 0.05). In addition, nicotine supplementation significantly decreased HRV and increased the archery score (290.58 ± 10.09 vs. 298.05 ± 8.56, p < 0.01). Conclusions Nicotine enhances the performance of archery athletes by increasing cognitive function and stimulating the sympathetic adrenergic system.
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Affiliation(s)
- Bao-Lien Hung
- Department of Sports Medicine, China Medical University, Taichung, 40402, Taiwan
| | - Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung, 40404, Taiwan
| | - Yi-Ying Chen
- Institute of Athletics, National Taiwan University of Sport, No. 16, Section 1, Shuang-Shih Road, Taichung, 40404, Taiwan
| | - Jhih-Bang Ou
- Institute of Athletics, National Taiwan University of Sport, No. 16, Section 1, Shuang-Shih Road, Taichung, 40404, Taiwan
| | - Shih-Hua Fang
- Institute of Athletics, National Taiwan University of Sport, No. 16, Section 1, Shuang-Shih Road, Taichung, 40404, Taiwan.
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Kasper AM, Close GL. Practitioner observations of oral nicotine use in elite sport: You snus you lose. Eur J Sport Sci 2021; 21:1693-1698. [PMID: 33263462 DOI: 10.1080/17461391.2020.1859621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The elite sport environment is one where athletes strive to find a competitive edge, through improved recovery modalities, cognitive performance or physical capacity. Due to this, non-scientifically evidenced and/or pseudo-scientific alternative remedies are ever popular. Snus (an oral tobacco based product containing the highly addictive compound nicotine) is one alternative 'physical and psychological performance enhancer', purported to act as a 'mental and physical booster', 'relaxative' and even as an 'appetite suppressor'. Despite snus having serious adverse health effects, along with no proven benefit to physical or mental performance, observations by the authors working in professional sport, along with several reports in the mainstream media, would suggest that the use of snus in elite sport appears to be increasing. Perhaps most worrying, the use of snus has been reported to be prevalent within younger athletes. It is crucial that athletes are fully educated with regards to the health implications of snus and other oral tobacco-based products, whilst practitioners should be aware of its growing prevalence in sport with strategies in place to discourage its use.
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Affiliation(s)
- Andreas M Kasper
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Graeme L Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Chen YM, Huang CC, Sung HC, Lee MC, Hsiao CY. Electronic cigarette exposure reduces exercise performance and changes the biochemical profile of female mice. Biosci Biotechnol Biochem 2019; 83:2318-2326. [PMID: 31392935 DOI: 10.1080/09168451.2019.1651627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Electronic cigarette(s) (EC) becoming a preferred replacement for nicotine delivery among many smokers in recent years. However, the effect of EC on human health is inconclusive due to a lack of empirical research investigating EC-induced health hazard or benefit. In this study, we examine the effect of vapor produced by EC on exercise performance and health-related profiles in a mouse model. Female ICR mice were divided into five groups (n = 6 per group) and exposed for 14 days. Our results indicate that EC exposure leads to dose-dependent decrease in the grip strength and swimming time of the mice. The EC-treated groups also showed a dose-dependent decrease in liver and muscle glycogen storage. In addition, EC treatment had no negative effect on levels of biochemical indices. We also did not detect any adverse effect or gross abnormalities on the morphology of the major organs.
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Affiliation(s)
- Yi-Ming Chen
- Health Technology College, Jilin Sport University, Changchun, Jilin, China
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Hsin-Ching Sung
- Department of Anatomy, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Aesthetic Medical Center, Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Mon-Chien Lee
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Chien-Yu Hsiao
- Aesthetic Medical Center, Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Nutrition and Health Sciences, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Research Center for Industry of Human Ecology and Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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Nguyen VT, Zafonte RD, Chen JT, Kponee-Shovein KZ, Paganoni S, Pascual-Leone A, Speizer FE, Baggish AL, Taylor HA, Nadler LM, Courtney TK, Connor A, Weisskopf MG. Mortality Among Professional American-Style Football Players and Professional American Baseball Players. JAMA Netw Open 2019; 2:e194223. [PMID: 31125098 PMCID: PMC6632140 DOI: 10.1001/jamanetworkopen.2019.4223] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/25/2019] [Indexed: 12/11/2022] Open
Abstract
Importance Studies of American-style football players have suggested lower overall mortality rates compared with general populations, but with possibly increased neurodegenerative mortality. However, comparisons with general populations can introduce bias. This study compared mortality between US National Football League (NFL) and US Major League Baseball (MLB) players, a more appropriate comparison group of professional athletes. Objective To compare all-cause and cause-specific mortality between NFL and MLB players. Design, Setting, and Participants In this retrospective cohort study, the setting was US mortality from January 1, 1979, through December 31, 2013. The dates of analysis were January 2016 to April 2019. Participants were 3419 NFL and 2708 MLB players with at least 5 playing seasons. Exposures Participation in the NFL compared with the MLB. Main Outcomes and Measures Vital status and causes of death from the National Death Index from 1979 through 2013 were obtained. Cox proportional hazards regression models using age as the timescale were used to calculate hazard ratios (HRs) and 95% CIs to examine all-cause and cause-specific mortality among NFL players compared with MLB players, adjusted for race and decade of birth. Results By the end of follow-up, there were 517 deaths (mean [SD] age, 59.6 [13.2] years) in the NFL cohort and 431 deaths (mean [SD] age, 66.7 [12.3] years) in the MLB cohort. Cardiovascular and neurodegenerative conditions, respectively, were noted as underlying or contributing causes in 498 and 39 deaths in the NFL and 225 and 16 deaths in the MLB. Compared with MLB players, NFL players had significantly elevated rates of all-cause (HR, 1.26; 95% CI, 1.10-1.44), cardiovascular disease (HR, 2.40; 95% CI, 2.03-2.84), and neurodegenerative disease (HR, 2.99; 95% CI, 1.64-5.45) mortality. Comparing hypothetical populations of 1000 NFL and 1000 MLB players followed up to age 75 years, there would be an excess 21 all-cause deaths among NFL players, as well as 77 and 11 more deaths with underlying or contributing causes that included cardiovascular and neurodegenerative conditions, respectively. Conclusions and Relevance This study found that NFL players had elevated all-cause, cardiovascular, and neurodegenerative mortality rates compared with MLB players, although the absolute number of excess neurodegenerative deaths was still small. Factors that vary across these sports (eg, body habitus and head trauma) as opposed to those common across sports (eg, physical activity) could underlie the differences.
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Affiliation(s)
- Vy T. Nguyen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ross D. Zafonte
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Jarvis T. Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kalé Z. Kponee-Shovein
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sabrina Paganoni
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Frank E. Speizer
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Aaron L. Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston
| | - Herman A. Taylor
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Cardiovascular Research Institute, School of Medicine, Morehouse University, Atlanta, Georgia
| | - Lee M. Nadler
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Theodore K. Courtney
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Ann Connor
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Marc G. Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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11
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Chagué F, Georges M, Gudjoncik A, Hermerel T, Garet G, Israël J, Hager JP, Aviat P, Laurent Y, Gremeaux V, Cottin Y, Zeller M. Cardiovascular prevention and at-risk behaviours in a large population of amateur rugby players. Eur J Prev Cardiol 2019; 26:1522-1530. [PMID: 30889980 DOI: 10.1177/2047487319837066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM We aimed to investigate cardiovascular risk factors and health behaviours prospectively in a large population of French amateur rugby players. METHODS An anonymous questionnaire was displayed to rugby players aged over 12 years enrolled in the 2014-2015 French amateur rugby championship from the Burgundy region (n = 5140). Questions addressed awareness on: (a) cardiovascular prevention; (b) tobacco, alcohol and highly caffeinated beverages consumption; and (c) adherence to prevention guidelines (ECG checks, training in basic life support, avoidance of sports practice during fever/infectious episodes). RESULTS Among the 640 participants who completed the questionnaires, most were male (90%) and were aged under 35 years (80%). Almost half had basic life support training (42%), but only a minority attended an ECG check-up before licensing (37%), and only a few were aware of the cardiovascular prevention information campaign (17%), similarly across the age groups. Surprisingly, playing rugby with fever was commonly reported (44%) and was even more frequent in young women (55%). A high number of respondents were current smokers (35%), of whom most reported consumption less than 2 hours before/after a rugby session. Alcohol drinkers were frequent (69%), of whom most (79%) drank alcohol less than 2 hours before/after a match. Highly caffeinated beverages consumption (34%) was high, particularly in younger players (39%). Half highly caffeinated beverages consumption was in the setting of a rugby session, even greater in women and mainly motivated by performance enhancement (34%). CONCLUSION Our findings from a representative regional cohort may help to identify targets for cardiovascular prevention through the development of educational programmes aiming to improve the knowledge and behaviour of amateur rugby players.
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Affiliation(s)
- Frédéric Chagué
- 1 French Rugby Federation, France.,2 Cardiology Department, Dijon University Hospital, France
| | | | | | | | - Gilles Garet
- 5 Medical Board, French Rugby Federation, France
| | | | | | | | - Yves Laurent
- 2 Cardiology Department, Dijon University Hospital, France
| | | | - Yves Cottin
- 2 Cardiology Department, Dijon University Hospital, France
| | - Marianne Zeller
- 6 PEC2, EA 7460 UFR Sciences de Santé, University of Burgundy and Franche Comté, France
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12
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Zandonai T, Tam E, Bruseghini P, Capelli C, Baraldo M, Chiamulera C. Exercise performance increase in smokeless tobacco-user athletes after overnight nicotine abstinence. Scand J Med Sci Sports 2018; 29:430-439. [PMID: 30387193 DOI: 10.1111/sms.13333] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 10/25/2018] [Indexed: 01/26/2023]
Abstract
The use of nicotine administered through smokeless tobacco (snus) has increased among athletes. The purpose of this study was to investigate the ergogenic effects of snus on aerobic performance during exercise until exhaustion in athletes after abstinence or satiety nicotine conditions. The study utilized a randomized, controlled, within-subject design experiment. Sixteen male snus-user athletes completed an exercise until exhaustion at a constant load of their 80% of V ˙ O 2 max (calculated by a maximal incremental test) in two separate sessions, corresponding to nicotine conditions: 12-hour overnight abstinence and satiety. A portion of 1 g of snus (~8 mg/g of nicotine) was administered 25 minutes before each experimental test. In each session, time to exhaustion (TTE), global rating of perceived exertion, cardiovascular and metabolic responses, and muscle and cerebral oxygenation were measured. Nicotine and cotinine analysis confirmed session conditions (abstinence or satiety). Snus induced a significant increase (+13.1%) of TTE following abstinence (24.1 ± 10.7 minutes) compared to satiety condition (20.9 ± 8.0 minutes; P = 0.0131). The baseline values revealed that abstinence of snus induced significant increase in the oxygenation of the muscular tissues (+4%), in metabolic values and in cardiovascular parameters, when compared to satiety condition. Our results indicate an increase of exercise performance (+13.1% TTE) due to snus administration in an abstinence condition. Considering that twelve hours of abstinence from snus-contained nicotine affected metabolic, cardiovascular and muscular tissue oxygenation, we suggest that snus administration at test time might relieve these withdrawal changes and yield an increase in time to exhaustion.
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Affiliation(s)
- Thomas Zandonai
- Mind, Brain and Behaviour Research Center, Department of Experimental Psychology, Faculty of Psychology, University of Granada, Granada, Spain.,Neuropsychopharmacology Lab., Department of Diagnostic and Public Health, University of Verona, Italy
| | - Enrico Tam
- School of Exercise and Sport Science, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Paolo Bruseghini
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Carlo Capelli
- Department of Physical Performances, Norwegian School of Sport Sciences, Oslo, Norway
| | - Massimo Baraldo
- Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
| | - Cristiano Chiamulera
- Neuropsychopharmacology Lab., Department of Diagnostic and Public Health, University of Verona, Italy
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13
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Nicotine: Sporting Friend or Foe? A Review of Athlete Use, Performance Consequences and Other Considerations. Sports Med 2018; 47:2497-2506. [PMID: 28791650 PMCID: PMC5684328 DOI: 10.1007/s40279-017-0764-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Nicotine use amongst athletes is high and increasing, especially in team sports. This narrative review examines the rationale behind its use and evidence of its effect on physical performance, and considers important factors that should determine future research efforts. To date, ten studies have assessed muscular strength and power, sub- or maximal endurance and high-intensity exercise when nicotine (medication) or smokeless tobacco was used as an intervention. Two studies observed an ergogenic effect, one an ergolytic with the remaining seven reporting no change. These studies have notable limitations and confounding factors that include participant tolerance to nicotine, interindividual responses, the nicotine delivery system used and failure to adhere to rigorous experimental/scientific design. Further research is encouraged to address these limitations and determine the extent to which anti-doping and governing bodies should consider promoting, coordinating and monitoring any effort against nicotine and nicotine-containing substances in sports.
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14
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Zandonai T, Tam E, Bruseghini P, Pizzolato F, Franceschi L, Baraldo M, Capelli C, Cesari P, Chiamulera C. The effects of oral smokeless tobacco administration on endurance performance. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:465-472. [PMID: 30450256 PMCID: PMC6226421 DOI: 10.1016/j.jshs.2016.12.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/14/2016] [Accepted: 11/08/2016] [Indexed: 06/09/2023]
Abstract
BACKGROUND Smokeless tobacco is widely used by athletes to enhance performance. Nicotine is a central nervous system stimulant and acts on cardiocirculatory and metabolic systems, involving tissue blood flow and circulatory vasoreactivity. The aim of this study was to investigate the effects of the oral smokeless tobacco (Swedish snus (SS)) on the perception of fatigue and time to exhaustion (TTE) during moderate-intensity aerobic exercise. METHODS Fourteen healthy non-tobacco male users were recruited for a double-blind, controlled crossover design (SS vs. snus placebo (SP)). Subjects were tested for 3 sessions: experimental session 1 (Exp1) consisted of an incremental test to determine the maximal aerobic power output (Wmax), whereas Exp2 and Exp3 consisted of exercising at 65%Wmax until exhaustion in SS or SP conditions. During Exp2 and Exp3, muscle and cerebral oxygenation was assessed by means of near-infrared spectroscopy, and the rating of perceived exertion (RPE) was recorded. RESULTS Comparing SS with SP tests, significant differences (p < 0.05) were found in the values of cerebral (~3%) and muscular tissues oxygenation (~4%) in the first 30 min of exercise. The RPE values were not significantly different between the 2 conditions (SS vs. SP). No significant difference was found in TTE (SS: 54.25 ± 21.84 min; SP: 50.01 ± 17.03 min). CONCLUSION This study showed that muscular and cerebral oxygenation increased significantly with snus administration during an endurance exercise until exhaustion, but this did not affect fatigue perception and TTE. The results showed that snus could not be considered an ergogenic substance in non-tobacco users.
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Affiliation(s)
- Thomas Zandonai
- Neuropsychopharmacology Laboratory, Department of Diagnostic and Public Health, University of Verona, Verona 37134, Italy
- Mind, Brain and Behavior Research Center CIMCYC, Department of Experimental Psychology, University of Granada, Granada 18071, Spain
| | - Enrico Tam
- Department of Neurosciences, Biomedicine and Movement Sciences, School of Exercise and Sport Science, University of Verona, Verona 37131, Italy
| | - Paolo Bruseghini
- Department of Neurosciences, Biomedicine and Movement Sciences, School of Exercise and Sport Science, University of Verona, Verona 37131, Italy
| | - Fabio Pizzolato
- Department of Neurosciences, Biomedicine and Movement Sciences, School of Exercise and Sport Science, University of Verona, Verona 37131, Italy
| | - Loretta Franceschi
- Department of Experimental and Clinical Medical Sciences, University of Udine, Udine 33100, Italy
| | - Massimo Baraldo
- Department of Experimental and Clinical Medical Sciences, University of Udine, Udine 33100, Italy
| | - Carlo Capelli
- Department of Neurosciences, Biomedicine and Movement Sciences, School of Exercise and Sport Science, University of Verona, Verona 37131, Italy
- Department of Physical Performances, Norwegian School of Sport Sciences, Oslo N-0806, Norway
| | - Paola Cesari
- Department of Neurosciences, Biomedicine and Movement Sciences, School of Exercise and Sport Science, University of Verona, Verona 37131, Italy
| | - Cristiano Chiamulera
- Neuropsychopharmacology Laboratory, Department of Diagnostic and Public Health, University of Verona, Verona 37134, Italy
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15
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Li L, Zhou X, Wang Y. Smokeless tobacco extract inhibits proliferation and promotes apoptosis in oral mucous fibroblasts. Oncol Lett 2018; 16:5066-5074. [PMID: 30250574 PMCID: PMC6144942 DOI: 10.3892/ol.2018.9252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 04/23/2018] [Indexed: 01/01/2023] Open
Abstract
The consumption of smokeless tobacco extract (STE) is growing rapidly, and it has been implicated in several human diseases including diabetes, inflammation and a number of types of cancer. The toxicity of STE requires evaluation, as it is known to induce numerous public health issues. To investigate whether STE serves a role in cultured human oral mucosa fibroblasts (hOMFs), the present study examined HOMF morphology with inverted microscopy and immunofluorescence staining. The cell viability was measured with MTT assays, which detected the cell apoptosis rate via flow cytometry. The activities of reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) were measured via flow cytometry and commercial kits, subsequent to exposing the cells to various concentrations of STE. Reverse transcription quantitative polymerase chain reaction and western blot analyses were used to demonstrate that the mRNA and the protein expression levels of cell cycle-associated genes (cyclin-dependent kinase inhibitor 1 and cyclin D1), apoptosis-associated genes [B cell lymphoma 2 (Bcl-2) and Bcl-2-associatied X protein], tumor protein (p53), nuclear factor kappa light chain enhancer of activated B cells (NF-κB)-transcription factor (p65) signaling pathways, NF-E2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1) and NAD(P)H: quinoneoxidoreductase1 (NQO1). The results indicated that the hOMF cells were positive for cytokeratin staining. STE induced G1-S cell cycle progression and cell apoptosis by regulating the cell cycle or apoptosis-associated proteins. STE treatment increased the concentrations of ROS and MDA, and decreased the concentrations of SOD and CAT. STE unregulated phosphorylated-p53, NF-κB p65, Nrf2, HO-1, and NQO1 expression levels in the hOMF cells. The present study demonstrated that STE appears to promote oral disease.
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Affiliation(s)
- Lei Li
- Department of Stomatology, Jining No. 1 People's Hospital, Jining, Shandong 272011, P.R. China
| | - Xiaoqing Zhou
- Department of Oral and Maxillofacial Surgery, Jining No. 1 People's Hospital, Jining, Shandong 272011, P.R. China
| | - Yanran Wang
- Department of Stomatology, Jining No. 1 People's Hospital, Jining, Shandong 272011, P.R. China
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16
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Johnston R, Doma K, Crowe M. Nicotine effects on exercise performance and physiological responses in nicotine-naïve individuals: a systematic review. Clin Physiol Funct Imaging 2017; 38:527-538. [PMID: 28574230 DOI: 10.1111/cpf.12443] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 05/09/2017] [Indexed: 02/06/2023]
Abstract
The purpose of this systematic review was to evaluate the effects of smokeless forms of nicotine on physiological responses and exercise performance. Methodology and reporting were based on the PRISMA statement. The intervention was defined as any product containing nicotine that did not require smoking. Searches were conducted across two electronic databases with supplementary approaches utilized. Studies were selected following set inclusion and exclusion criteria and checked by two independent authors. A modified PEDro scale was utilized to rate study quality with studies averaging 9·3/13. Six studies assessed exercise performance with endurance-based parameters reported as significantly improved with nicotine in one study, while anaerobic parameters were unaffected or decreased compared to placebo except in one study which reported enhanced leg extensor torque but no effect on countermovement jump or Wingate anaerobic capacity. Sixteen of 28 studies investigating physiological responses reported that nicotine significantly increased heart rate compared to placebo or control. Blood pressure and blood flow were also reported as significantly increased in multiple studies. While there is strong evidence of nicotine-induced changes in physiological function that would benefit physical performance, beneficial effects have only been reported on leg extensor torque and endurance performance by one study each. Subsequently, there is need for more research with strong methodological quality to definitively evaluate nicotine's potential as an ergogenic aid.
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Affiliation(s)
- Robert Johnston
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Kenji Doma
- Sport & Exercise Science, James Cook University, Townsville, Queensland, Australia
| | - Melissa Crowe
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
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17
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Electronic cigarettes and sports: Dangerous liaisons? Int J Cardiol 2016; 215:400-1. [DOI: 10.1016/j.ijcard.2016.04.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 04/10/2016] [Indexed: 01/24/2023]
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18
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Tretzel L, Thomas A, Piper T, Hedeland M, Geyer H, Schänzer W, Thevis M. Fully automated determination of nicotine and its major metabolites in whole blood by means of a DBS online-SPE LC-HR-MS/MS approach for sports drug testing. J Pharm Biomed Anal 2016; 123:132-40. [DOI: 10.1016/j.jpba.2016.02.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 02/05/2016] [Accepted: 02/08/2016] [Indexed: 01/06/2023]
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19
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Efird JT, Griffin WF, Gudimella P, O'Neal WT, Davies SW, Crane PB, Anderson EJ, Kindell LC, Landrine H, O'Neal JB, Alwair H, Kypson AP, Nifong WL, Chitwood WR. Conditional long-term survival following minimally invasive robotic mitral valve repair: a health services perspective. Ann Cardiothorac Surg 2015; 4:433-42. [PMID: 26539348 DOI: 10.3978/j.issn.2225-319x.2015.08.08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Conditional survival is defined as the probability of surviving an additional number of years beyond that already survived. The aim of this study was to compute conditional survival in patients who received a robotically assisted, minimally invasive mitral valve repair procedure (RMVP). METHODS Patients who received RMVP with annuloplasty band from May 2000 through April 2011 were included. A 5- and 10-year conditional survival model was computed using a multivariable product-limit method. RESULTS Non-smoking men (≤65 years) who presented in sinus rhythm had a 96% probability of surviving at least 10 years if they survived their first year following surgery. In contrast, recent female smokers (>65 years) with preoperative atrial fibrillation only had an 11% probability of surviving beyond 10 years if alive after one year post-surgery. CONCLUSIONS In the context of an increasingly managed healthcare environment, conditional survival provides useful information for patients needing to make important treatment decisions, physicians seeking to select patients most likely to benefit long-term following RMVP, and hospital administrators needing to comparatively assess the life-course economic value of high-tech surgical procedures.
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Affiliation(s)
- Jimmy T Efird
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - William F Griffin
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Preeti Gudimella
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Wesley T O'Neal
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Stephen W Davies
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Patricia B Crane
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ethan J Anderson
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Linda C Kindell
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Hope Landrine
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jason B O'Neal
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Hazaim Alwair
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alan P Kypson
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Wiley L Nifong
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - W Randolph Chitwood
- 1 East Carolina Heart Institute, Department of Cardiovascular Sciences, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 2 Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 3 Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA ; 4 Department of Pharmacology and Toxicology, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; 5 Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA ; 6 Department of General Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA ; 7 The College of Nursing at East Carolina University, Greenville, NC, USA ; 8 Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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20
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Pacifici R, Pichini S, Palmi I, de la Torre X, Botrè F. Smoking habits of italian athletes undergoing anti-doping control. Drug Test Anal 2015; 8:133-5. [PMID: 26290451 DOI: 10.1002/dta.1837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/09/2015] [Accepted: 06/10/2015] [Indexed: 11/12/2022]
Affiliation(s)
- Roberta Pacifici
- Drug Abuse and Doping Unit, Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Roma, Italy
| | - Simona Pichini
- Drug Abuse and Doping Unit, Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Roma, Italy
| | - Ilaria Palmi
- Drug Abuse and Doping Unit, Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Roma, Italy
| | - Xavier de la Torre
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Roma, Italy
| | - Francesco Botrè
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Roma, Italy
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Kvaavik E, Lund I, Nygård M, Hansen BT. Lifestyle Correlates of Female Snus Use and Smoking: A Large Population-Based Survey of Women in Norway. Nicotine Tob Res 2015; 18:431-6. [PMID: 26069033 DOI: 10.1093/ntr/ntv126] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/01/2015] [Indexed: 02/05/2023]
Abstract
INTRODUCTION While smoking in Norway has become less prevalent, snus use has increased, including among women. The aims of this study were to describe female snus use and its correlates, and to contrast patterns of snus use and smoking. METHODS In 2011-2012, data on tobacco use, age, education, alcohol consumption, sexual behaviors, and physical activity were collected from a population based sample of 13 756 Norwegian women aged 18-45 years, using a self-administered questionnaire. RESULTS Ever-use prevalence of snus ranged from 29.6% to 4.5% among those aged 18-19 years and 40-45 years, respectively. In contrast, the corresponding figures for smoking were 24.1% and 44.1%. Among snus users, 54.1% and 22.8% of 18-19 and 40 to 45-year-olds had never smoked, respectively. Debut age for snus use increased markedly with age, and was higher than debut age for smoking. Female snus use was positively associated with intermediate education, alcohol consumption, number of sexual partners, and hard physical activity. Smoking was also positively associated with alcohol consumption and number of sexual partners, but negatively associated with physical activity and education. CONCLUSION While most snus users among older women were former or current smokers, this was not the case among younger women. Low snus debut age and extensive snus use among younger women suggest that measures to reduce snus use should be targeted at young adolescents. The correlates of female snus use and smoking were not identical, and were similar to those previously documented for men.
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Affiliation(s)
- Elisabeth Kvaavik
- Department of Tobacco, Norwegian Institute for Alcohol and Drug Research, Oslo, Norway;
| | - Ingeborg Lund
- Department of Tobacco, Norwegian Institute for Alcohol and Drug Research, Oslo, Norway
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
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