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Allagbé I, Zeller M, Thomas D, Airagnes G, Limosin F, Boussadi A, Chagué F, Le Faou AL. Sex-specific predictive factors of smoking cessation in subjects at high cardiovascular risk. Arch Cardiovasc Dis 2024:S1875-2136(24)00221-3. [PMID: 39089897 DOI: 10.1016/j.acvd.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 08/04/2024]
Abstract
Smoking is a major risk factor for cardiovascular diseases (CVD), in particular in women, but smoking cessation (SC) reduces or even cancels the risk for both sexes. Using a nationwide SC services database, we aimed to determine the predictive factors of SC in men and women smokers with CV risk factors (CVRF) or CVD. A retrospective study from the French CDTnet database was conducted. Inclusion criteria were age ≥18years, and≥1 CVRF (Body Mass Index ≥25kg/m2, hypertension, diabetes, hypercholesterolemia) or CVD (myocardial infarction (MI) or angina pectoris, stroke, peripheral arterial disease [PAD]). Self-reported smoking abstinence (≥28 consecutive days) was confirmed by exhaled carbon monoxide<10ppm. Logistic regression analysis assessed the association between SC and sociodemographic, medical characteristics, and smoking profile. Among the 36,864 smokers at high CV risk, abstinence rate was slightly lower in women than in men, (52.6% [n=8,102] vs 55.0% [n=11,848], P<0.001). For both sexes, factors associated with the lowest abstinence rates were diabetes, respiratory and psychiatric diseases, anxiolytic/antidepressant use, and cannabis consumption. In women, the factors associated with smoking abstinence were suffering from MI or angina and taking contraceptive pill and the factors associated with persistent smoking were alcohol disorder and high cigarette consumption. In men, there was a positive relationship between overweight and abstinence while being dual users of cigarettes and electronic cigarettes at first visit, having tobacco-related diseases (cancer and PAD) and taking opioid substitution treatment were associated with persistent smoking. Finally, in both sexes, the factors associated with abstinence were: age≥65years, having a diploma, being employed, self-referred or encouraged by entourage, ≥1 previous quit attempt, ≤20 cigarettes per day consumption, benefiting from SC medication prescription and ≥4 follow-up visits. In conclusion, our results suggest the relevance of SC intensive management in smokers at high CV risk, based on sociodemographic, medical, and smoking behaviour characteristics, as well as a gender-specific SC approach.
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Affiliation(s)
- Ingrid Allagbé
- Physiopathology and Epidemiology Cerebro-Cardiovascular, PEC2, EA 7460 UFR Health Sciences, University of Burgundy and Franche Comté, Dijon, France; University Paris Cité, AP-HP.Center, Outpatient Addictology Center, Paris, France; Groupement d'Intérêt Scientifique du Réseau Français d'Excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France.
| | - Marianne Zeller
- Physiopathology and Epidemiology Cerebro-Cardiovascular, PEC2, EA 7460 UFR Health Sciences, University of Burgundy and Franche Comté, Dijon, France; Groupement d'Intérêt Scientifique du Réseau Français d'Excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; Cardiology Department, Dijon University Hospital, Dijon, France
| | - Daniel Thomas
- Groupement d'Intérêt Scientifique du Réseau Français d'Excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; Université Paris-Sorbonne, AP-HP, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Guillaume Airagnes
- University Paris Cité, AP-HP.Center, Outpatient Addictology Center, Paris, France; DMU Psychiatry and Addictology, AP-HP, Centre-University of Paris, Paris, France
| | - Frédéric Limosin
- DMU Psychiatry and Addictology, AP-HP, Centre-University of Paris, Paris, France
| | - Abdelali Boussadi
- Département de Santé Publique et Informatique Médicale, Hôpital Européen Georges Pompidou, AP-HP. Centre - Université de Paris, Paris, France
| | - Frédéric Chagué
- Groupement d'Intérêt Scientifique du Réseau Français d'Excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; Cardiology Department, Dijon University Hospital, Dijon, France
| | - Anne-Laurence Le Faou
- University Paris Cité, AP-HP.Center, Outpatient Addictology Center, Paris, France; Groupement d'Intérêt Scientifique du Réseau Français d'Excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; DMU Psychiatry and Addictology, AP-HP, Centre-University of Paris, Paris, France; Fédération Hospitalo-Universitaire Network of Research in Substance Use Disorder, Paris, France
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Allagbé I, Nicolas R, Airagnes G, Frédéric L, Boussadi AA, Le Faou AL. Clinical factors associated with smoking cessation among smokers with Chronic Obstructive Pulmonary Disease by sex: Longitudinal analyses from French smoking cessation services. Heliyon 2024; 10:e30920. [PMID: 38770314 PMCID: PMC11103529 DOI: 10.1016/j.heliyon.2024.e30920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024] Open
Abstract
Background Smoking is responsible for 80 % of cases of Chronic Obstructive Pulmonary Disease (COPD), while the prognosis is improved by smoking cessation (SC). We examined clinical factors associated with SC among smokers with COPD comparing women and men. Methods The study comprised a cohort of 1470 smokers who visited a SC service and completed at least 28-day of follow-up visits. The outcome was smoking status at follow-up (abstinence, reduction, no change). Abstinence was defined as continuous abstinence for at least 28 days, validated by the measurement of expired Carbon Monoxide. Reduction was defined as a halving of the baseline tobacco consumption. Results The average age of the population was 53 (±11) years and 58.2 % were women. Men were 2 years younger than women and consulted more likely after a hospital contact, whereas women consulted on their own initiative. Women more often had a depression history, whereas men had medical comorbidities and co-addictions. There was no significant difference by sex regarding the abstinence rate (41.0 % in women vs 40.7 in men, p > 0.9). The factors significantly associated with higher abstinence rates in both sexes were: at least one previous quit attempt and number of follow-up visits ≥4. The factors negatively associated with quitting in women were diabetes, intake of mood stabilizers and consuming more than 10 cigarettes per day while having a chronic bronchitis, taking antidepressants and having consumed cannabis in the last 30 days hampered SC in men. Conclusions Concerning factors associated with SC, few differences were found between female and male smokers suffering from COPD. However, due to the different medical and smoking behavior characteristics according to sex, it might be important to take these differences into account in order to provide tailored SC management.
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Affiliation(s)
- Ingrid Allagbé
- Centre Ambulatoire d'Addictologie, Hôpital Européen Georges Pompidou, Département Médico-Universitaire de Psychiatrie et Addictologie, AP-HP. Centre - Université Paris Cité, Paris, France
- Groupement d’Intérêt Scientifique du Réseau Français d’Excellence de Recherche sur le tabac, la nicotine et les produits connexes (REFERtab), Paris, France
| | - Roche Nicolas
- Respiratory and Intensive Care Medicine, Hôpital Cochin, AP-HP. Centre - Université Paris Cité (EA2511), Paris, France
| | - Guillaume Airagnes
- Centre Ambulatoire d'Addictologie, Hôpital Européen Georges Pompidou, Département Médico-Universitaire de Psychiatrie et Addictologie, AP-HP. Centre - Université Paris Cité, Paris, France
- UMS 011, Population-based Epidemiological Cohorts, Inserm, Villejuif, France
| | - Limosin Frédéric
- Département de Psychiatrie, Hôpital Corentin-Celton, Centre Université Paris Cité, AP-HP, Issy-les-Moulineaux, France
- INSERM, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
- Faculté de Santé, UFR de Médecine, Université Paris Cité, Paris, France
| | - Abdel-Ali Boussadi
- Département de Santé Publique et Informatique Médicale, Hôpital Européen Georges Pompidou, AP-HP. Centre - Université Paris Cité, Paris, France
- INSERM UMR 1138, Equipe 22, Centre de Recherche des Cordeliers, Paris, France
| | - Anne-Laurence Le Faou
- Centre Ambulatoire d'Addictologie, Hôpital Européen Georges Pompidou, Département Médico-Universitaire de Psychiatrie et Addictologie, AP-HP. Centre - Université Paris Cité, Paris, France
- Respiratory and Intensive Care Medicine, Hôpital Cochin, AP-HP. Centre - Université Paris Cité (EA2511), Paris, France
- Groupement d’Intérêt Scientifique du Réseau Français d’Excellence de Recherche sur le tabac, la nicotine et les produits connexes (REFERtab), Paris, France
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Mazzitelli M, Scaglione V, Cozzolino C, Zuin M, Putaggio C, Bragato B, Vania E, Sasset L, Leoni D, Baldo V, Cattelan A. Achievement of Primary Prevention Cardiometabolic Targets in Women with HIV: An Urgent Call to Action to Pursue Cardiovascular Health. Viruses 2024; 16:578. [PMID: 38675920 PMCID: PMC11054919 DOI: 10.3390/v16040578] [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: 02/28/2024] [Revised: 04/01/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Cardiometabolic health has become crucial, especially for women with HIV (WWH). We assessed the achievement of targets for hypertension, dyslipidemia, and diabetes (H/Dy/DT) in primary prevention in a WWH cohort. METHODS Cross-sectional analysis including all WWH in our clinic, excluding those who had a myocardial infarction. H/Dy/DT achievement was assessed by both EACS guidelines and individual cardiovascular risk, CVR (measured by ESC calculator), using logistic regression to evaluate differences in H/Dy/DT achievement between migrant and Italian women. RESULTS We included 292 WWH, 55.5% Italian and 44.5% migrant women; the median age was 50 (IQR:42-58) years, 94.5% had undetectable HIV-RNA, 55.1% had a high level of education, 27.1% were smokers, and 19.2% did regularly physical exercise. Overall, 76%, 19%, and 5% of women presented a low, a high, and a very high CVR, respectively. Among Italians, 28.4% and 6.2% women presented a high and a very high CVR, respectively. Considering migrants, 7.7% and 3.8% women presented a high and a very high CVR, respectively. Overall, among migrant women, those with a high CVR were more likely to be not at target than those with a low risk (especially for LDL-c and blood pressure among people on treatment), despite the fact that we did not detect a statistically significant difference. By contrast, migrants were more likely to achieve glycemic targets than Italians (p = 0.032). CONCLUSIONS H/Dy/DT target achievement is suboptimal, especially in migrants. A more aggressive pharmacological treatment, also assessing adherence to medical prescriptions, and promotion of healthy lifestyle should be urgently implemented, possibly redrawing the current model of care.
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Affiliation(s)
- Maria Mazzitelli
- Infectious and Tropical Diseases Unit, Department of Molecular Medicine, Padua University Hospital, 38128 Padua, Italy; (B.B.); (L.S.); (A.C.)
| | - Vincenzo Scaglione
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, 35131 Padua, Italy (C.C.); (V.B.)
| | - Claudia Cozzolino
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, 35131 Padua, Italy (C.C.); (V.B.)
| | - Marco Zuin
- Department of Translational Medicine, University of Ferrara, 42121 Ferrara, Italy
| | - Cristina Putaggio
- Infectious and Tropical Diseases Unit, Belluno Hospital, 32100 Belluno, Italy;
| | - Beatrice Bragato
- Infectious and Tropical Diseases Unit, Department of Molecular Medicine, Padua University Hospital, 38128 Padua, Italy; (B.B.); (L.S.); (A.C.)
| | - Eleonora Vania
- Infectious and Tropical Diseases Unit, Department of Molecular Medicine, Padua University Hospital, 38128 Padua, Italy; (B.B.); (L.S.); (A.C.)
| | - Lolita Sasset
- Infectious and Tropical Diseases Unit, Department of Molecular Medicine, Padua University Hospital, 38128 Padua, Italy; (B.B.); (L.S.); (A.C.)
| | - Davide Leoni
- Infectious and Tropical Diseases Unit, Department of Molecular Medicine, Padua University Hospital, 38128 Padua, Italy; (B.B.); (L.S.); (A.C.)
| | - Vincenzo Baldo
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua, 35131 Padua, Italy (C.C.); (V.B.)
| | - Annamaria Cattelan
- Infectious and Tropical Diseases Unit, Department of Molecular Medicine, Padua University Hospital, 38128 Padua, Italy; (B.B.); (L.S.); (A.C.)
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Corrêa PCRP, de Sales RKB, Knorst MM, Pinto SRHL, Ragnini LFQ, Tourinho CAP, Storrer KM, Scuarcialupi MECDA, Castellano MVCDO, Albuquerque AAD, Ravara SB. The challenge of tobacco and nicotine use among women. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e2023S124. [PMID: 37556643 PMCID: PMC10411695 DOI: 10.1590/1806-9282.2023s124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Paulo César Rodrigues P. Corrêa
- Universidade Federal de Ouro Preto, Faculdade de Medicina – Ouro Preto (MG), Brazil
- Brazilian Thoracic Society, Tobacco Control Section – Brasília (DF), Brazil
| | - Roberta Karla B. de Sales
- Universidade de São Paulo, Faculdade de Medicinaa, Hospital das Clínicas, Instituto do Coração, Departamento de Pneumologia – São Paulo (SP), Brazil
| | - Marli Maria Knorst
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Pneumológicas, Faculdade de Medicina – Porto Alegre (RS), Brazil
| | | | | | | | | | | | - Maria Vera C. De O. Castellano
- Hospital do Servidor Público Estadual de São Paulo (Hospital do Servidor Público Estadual – Instituto de Assistência Médica ao Servidor Público Estadual) – São Paulo (SP), Brazil
| | | | - Sofia Belo Ravara
- Universidade da Beira Interior, Centro de Investigação em Ciências da Saúde – Covilhã, Portugal
- Centro Hospitalar Universitário da Cova da Beira – Covilhã, Portugal
- Universidade NOVA, Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública (CISP) – Lisboa, Portugal
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The Link Between Reproductive History, Cardiovascular Disease, and Peripheral Arterial Disease in Women: Implications for Practice. J Nurse Pract 2023. [DOI: 10.1016/j.nurpra.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Zhao+ K, Li + J, Zhou P, Xu L, Yang M. Is electronic cigarette use a risk factor for stroke?
A systematic review and meta-analysis. Tob Induc Dis 2022; 20:101. [DOI: 10.18332/tid/154364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/15/2022] [Accepted: 09/17/2022] [Indexed: 11/16/2022] Open
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Allagbé I, Zeller M, Thomas D, Airagnes G, Limosin F, Boussadi A, Chagué F, Le Faou AL. Cardiovascular Risk Among Patients Who Smoke: Risk Profiles and Differences by Sex. Am J Prev Med 2022; 63:800-808. [PMID: 35773102 DOI: 10.1016/j.amepre.2022.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Smoking is particularly harmful to the cardiovascular system, and smoking-cessation is a key target for cardiovascular prevention. From a large nationwide database on subjects who visited smoking-cessation services, this study assessed the profile and abstinence rate comparing female with male smokers at high cardiovascular risk. METHODS This was an observational study from the French smoking-cessation services cohort (French national cohort Consultations de Dépendance Tabagique) between 2001 and 2018. Inclusion criteria were being aged ≥18 years and having ≥1 cardiovascular risk factor. Abstinence was self-reported (stopping cigarettes or other tobacco products use ≥28 consecutive days) and confirmed by exhaled carbon monoxide <10 parts per million. Analysis was conducted in 2021. RESULTS Among 36,864 people who smoke, 15,407 (42%) were women. Women were 3 years younger (48 vs 51 years, p<0.001) and more educated (≥high school diploma: 54% vs 45%, p<0.001) than men. The burden of cardiovascular risk factors was slightly lower in women than in men and, for hypercholesterolemia, hypertension, diabetes, and cardiovascular diseases, were half as frequent in women as they were in men (16% vs 32%, p<0.001). However, women suffered more often from obesity, respiratory diseases, and anxiety‒depression symptoms (53% vs 39%, p<0.001). Finally, although women were less nicotine dependent, their abstinence rate was slightly lower (52.6% vs 55.2%, p<0.001). CONCLUSIONS Women who smoked had a high burden of risk factors, especially obesity and elevated rates of lung diseases, and a lower abstinence rate, with more common anxiety‒depression symptoms. Men who smoked had a higher prevalence of cardiovascular disease, higher nicotine dependence, and coaddictions. These findings highlight the need to strengthen cardiovascular prevention strategies through comprehensive sex-tailored smoking-cessation interventions.
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Affiliation(s)
- Ingrid Allagbé
- Physiopathology and Epidemiology Cerebro-cardiovascular (PEC2, EA 7460), Faculty of Health Science (UFR des Sciences de Santé), University Burgundy and Franche-Comté, Dijon, France; Outpatient Addictology Center, AP-HP Center, University of Paris, Paris, France; Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France.
| | - Marianne Zeller
- Physiopathology and Epidemiology Cerebro-cardiovascular (PEC2, EA 7460), Faculty of Health Science (UFR des Sciences de Santé), University Burgundy and Franche-Comté, Dijon, France; Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France
| | - Daniel Thomas
- Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; Institut de Cardiologie, Hôpital Pitié Salpêtrière, AP-HP, Université Paris-Sorbonne, Paris, France
| | - Guillaume Airagnes
- Outpatient Addictology Center, AP-HP Center, University of Paris, Paris, France
| | - Frédéric Limosin
- DMU Psychiatry and Addictology, AP-HP Centre-University of Paris, Paris, France
| | - Abdelali Boussadi
- Medical Informatics, Biostatistics and Public Health Department, Georges Pompidou University Hospital, Paris, France
| | - Frédéric Chagué
- Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; Cardiology Department, Dijon University Hospital, Dijon, France
| | - Anne-Laurence Le Faou
- Outpatient Addictology Center, AP-HP Center, University of Paris, Paris, France; Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; DMU Psychiatry and Addictology, AP-HP Centre-University of Paris, Paris, France; University Hospital Federation - Network of Research in Substance Use Disorder, Paris, France
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