Women and tobacco dependence

Lifestyle factors, cardiovascular disease and all-cause mortality in middle-aged and elderly women: a systematic review and meta-analysis

Cardiovascular disease (CVD) risk factors, incidence and death increases from around the time of menopause comparing to women in reproductive age. A healthy lifestyle can prevent CVD, but it is unclear which lifestyle factors may help maintain and improve cardiovascular health for women after menopausal transition. We conducted a systematic review and meta-analysis of prospective cohort studies to evaluate the association between modifiable lifestyle factors (specifically smoking, physical activity, alcohol intake, and obesity), with CVD and mortality in middle-aged and elderly women. Pubmed, Embase, among other databases and reference lists were searched until February 29th, 2016. Study specific relative risks (RR) were meta-analyzed using random effect models. We included 59 studies involving 5,358,902 women. Comparing current versus never smokers, pooled RR were 3.12 (95% CI 2.15-4.52) for CHD incidence, 2.09 (95% CI 1.51-2.89) for stroke incidence, 2.76 (95% CI 1.62-4.71) for CVD mortality and 2.22 (95% CI 1.92-2.57) for all-cause mortality. Physical activity was associated with a decreased risk of 0.74 (95% CI 0.67-0.80) for overall CVD, 0.71 (95% CI 0.67-0.75) for CHD, 0.77 (95% CI 0.70-0.85) for stroke, 0.70 (95% CI 0.58-0.84) for CVD mortality and 0.71 (95% CI 0.65-0.78) for all-cause mortality. Comparing moderate drinkers versus non-drinkers, the RR was 0.72 (95% CI 0.56-0.91) for CHD, 0.63 (95% CI 0.57-0.71) for CVD mortality and 0.80 (95% CI 0.76-0.84) for all-cause mortality. For women with BMI 30-35 kg/m² the risk was 1.67 (95% CI 1.24-2.25) for CHD and 2.3 (95% CI 1.56-3.40) for CVD mortality, compared to normal weight. Each 5 kg/m² increase in BMI was associated with 24% (95% CI 16-33%) higher risk for all-cause mortality. This meta-analysis suggests that physical activity and moderate alcohol intake were associated with a reduced risk for CVD and mortality. Smoking and higher BMI were associated with an increased risk of these endpoints. Adherence to a healthy lifestyle may substantially lower the burden of CVD and reduce the risk of mortality among middle-aged and elderly women. However, this review highlights important gaps, as lack of standardized methods in assessing lifestyle factors and lack of accurate information on menopause status, which should be addressed by future studies in order to understand the role of menopause on the association between lifestyle factors and cardiovascular events.

Nasal mucociliary transportability of male and female smokers

Introduction

Female smoker's present increased susceptibility to several diseases when compared to the opposite gender. However, there are no studies showing differences in nasal mucociliary transport behavior between male and female smokers.

Objective

To compare the nasal mucociliary transportability in male and female smokers and non-smokers, taking into consideration age, anthropometric data, smoking load and pulmonary function.

Methods

The analysis included 139 individuals (33 men and 37 women smokers and 32 men and 37 women non-smokers). All participants answered an initial interview to obtain personal data and smoking load. Anthropometric data and carbon monoxide in the exhaled air were assessed. Individuals also performed pulmonary function test and Saccharin Transit Time test. To compare saccharin transit time values between men and women, smokers and non-smokers, stratification of all independent variables was performed (sociodemographic, smoking and respiratory variables) into two categories: below and above the median values.

Results

There was no difference between men and women, smokers and non-smokers, regarding nasal mucociliary transportability. Significant differences were only observed between non-smokers. Among those with less forced vital capacity values (<97.37% of predicted), women presented mucociliary transport faster than men. Moreover, it was observed influence of BMI and COex (women smokers), FCV and FEV1 (men non-smokers) and FEF_25–75% (women non-smokers) on saccharin transit time values.

Conclusion

Based on the findings of this study, nasal mucociliary transport in male and female adult smokers, apparently healthy, are similar.

Women and smoking: risks, impacts, and challenges

Smoking among women has drawn increasing attention because of the increase (or less pronounced decrease) in its prevalence when compared with that observed for men, as well as because of the specific effects that smoking has on women's health. For the 2010 "World No Tobacco Day", the World Health Organization chose the theme "Gender and tobacco with an emphasis on marketing to women", with the aim of encouraging policies to combat marketing strategies employed by the tobacco industry and to curb the epidemic of smoking among women. In this article, we discuss the characteristics of smoking among women, addressing factors such as smoking prevalence, nicotine dependence, the role of the tobacco industry, health risks, approaches to smoking cessation, treatment strategies, and prevention measures.

Epidemiology, determinants, and consequences of cigarette smoking in African American women: an integrative review

Tobacco smoking is a national public health problem that has been associated with numerous adverse health effects, including increased disease and cancer rates. Previous review articles on smoking in specific demographic populations have focused on smoking in women and on smoking in African Americans, but have not considered the dual roles of ethnicity and gender in smoking behavior. African American women (AAW) are an important subgroup to study because they are distinct from non-AAW and their male African American counterparts on biopsychosocial factors that are relevant to smoking behavior. The purpose of the present review paper is to integrate and summarize the current literature on the epidemiology, determinants, and consequences of cigarette smoking among AAW, by contrasting them to relevant comparison groups (non-AAW and African American men). Evidence suggests that AAW are generally more likely to be light smokers and initiate smoking later. The prevalence rates of AAW smokers have decreased over the past 25years, yet AAW are disproportionately affected by several smoking-related illnesses when compared to their ethnic and gender comparison groups. AAW smokers are distinct from relevant comparison groups in metabolic sensitivity to nicotine, aspects of smoking topography, and several psychosocial factors that influence smoking. Although a small literature on smoking in AAW is emerging, further empirical research of AAW smokers could inform the development of tailored interventions for AAW.

Estimated time for occurrence of smoking-related consequences among pregnant and non-pregnant women

OBJECTIVES

To study time estimates by women smokers for when smoking-related consequences will occur given continuing or quitting smoking. The relationship of these estimates to pregnancy and intent to quit smoking was also investigated.

METHODS

Over a two-week period, eighty women, selected to constitute four subgroups formed by pregnant vs. non-pregnant and trying vs. not trying to quit smoking, rated times at which they would expect smoking-related consequences to occur given continuing or quitting smoking.

RESULTS

Somatic health consequences were estimated to occur later than consequences related to mood and social relations. All consequences were estimated to occur later given quitting smoking. Pregnancy had an effect on the estimated time that consequences would occur, with pregnant women estimating earlier occurrence of consequences related to mood and social relations than non-pregnant women did.

CONCLUSION

Health messages should stress consequences for somatic health in quitting smoking, since outcomes later in time might have too low a value to exert a positive effect on decisions to quit smoking.

Diretrizes para cessação do tabagismo - 2008

Estas diretrizes constituem uma ferramenta atualizada e abrangente para auxiliar o profissional de saúde na abordagem do tabagista, recomendando atitudes baseadas em evidências clínicas como a melhor forma de conduzir cada caso. De forma reduzida e mais objetiva possível, o texto final foi agrupado em dois grandes itens: Avaliação e Tratamento. Os dois itens apresentam comentários e níveis de recomendação das referências utilizadas, bem como algumas propostas de abordagem, como por exemplo, redução de danos, em situações específicas ainda pouco exploradas, como recaídas, tabagismo passivo, tabagismo na categoria médica e uso de tabaco em ambientes específicos.

Sex differences in the incidence and severity of respiratory tract infections

Sex is a significant epidemiological factor for several diseases. However, the role of sex in the development and outcome of various infections has not been extensively studied with the notable exception of urinary tract infections. We searched in the PubMed database to identify articles that could provide relevant data regarding sex differences in the incidence and severity of respiratory tract infections (RTIs). We extracted data from 84 relevant studies that provided information regarding sex differences in the incidence and severity of RTIs. Females are more commonly affected with infections of the upper respiratory tract, specifically sinusitis, tonsillitis, and otitis externa. On the other hand, males are more commonly affected with otitis media, croup, and most important, lower RTIs. It is also evident from the reviewed evidence that the course of most RTIs is more severe in males than in females, leading to higher mortality in males, especially in community-acquired pneumonia. In conclusion, the available data suggest that males are more susceptible than females to most types of RTIs in all age groups (adults and children). Overall, it seems that males develop RTIs more frequently than females, except for sinusitis, otitis externa, and probably tonsillitis. Anatomic, lifestyle, behavioural, and socioeconomic differences between males and females may explain the observed findings. The role of sex hormones in the regulation of the immune system may also contribute to the reported sex differences in the incidence and severity of the various types of RTIs, especially in adolescents and adults.