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Gunby SA, Ma W, Levy MJ, Giovannucci EL, Chan AT, Strate LL. Smoking and Alcohol Consumption and Risk of Incident Diverticulitis in Women. Clin Gastroenterol Hepatol 2024; 22:1108-1116. [PMID: 38122959 PMCID: PMC11045313 DOI: 10.1016/j.cgh.2023.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 11/16/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND & AIMS Much of what is known about the effects of alcohol and tobacco use on diverticular disease derives from studies of asymptomatic diverticulosis or complicated diverticulitis. We examined smoking and alcohol consumption and risk of incident diverticulitis in a large cohort of women. METHODS We conducted a prospective study of 84,232 women in the Nurses' Health Study II (NHS II) who were 39-52 years old and without known diverticulitis at baseline in 2003. Smoking was ascertained every 2 years and alcohol use every 4 years. We used Cox proportional hazards regression to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (CIs). RESULTS During 1,139,660 person-years of follow up, we identified 3018 incident cases of diverticulitis. After adjustment for other risk factors, current (HR, 1.20; 95% CI, 1.04-1.39) and past smoking (HR, 1.20; 95% CI, 1.11-1.30) were associated with increased risk of diverticulitis when compared with never smokers. Women who consumed ≥30 g/d of alcohol had a multivariate HR of 1.26 (95% CI, 1.05-1.50) when compared with women who did not drink. A joint analysis of smoking and alcohol found that individuals who ever smoked and consumed ≥15 g/d of alcohol were at highest risk of diverticulitis (multivariate HR, 1.60; 95% CI, 1.16-2.21), compared with participants who never smoked and reported no alcohol use. CONCLUSIONS In this large prospective study of women, smoking and alcohol consumption were associated with an increased risk of incident diverticulitis. These data highlight additional modifiable risk factors for diverticulitis that may aid in prevention.
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Affiliation(s)
- Sarah A Gunby
- University of Washington Department of Medicine, Seattle, Washington
| | - Wenjie Ma
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School Department of Medicine, Boston, Massachusetts
| | - Miriam J Levy
- University of Washington Department of Medicine, Seattle, Washington
| | | | - Andrew T Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School Department of Medicine, Boston, Massachusetts; Harvard University T H Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Lisa L Strate
- University of Washington Department of Medicine, Seattle, Washington.
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Yang L, Zhou Y, Jiang M, Wen W, Guo Y, Pakhale S, Wen SW. Why Female Smokers Have Poorer Long-Term Health Outcomes than Male Smokers: The Role of Cigarette Smoking During Pregnancy. Public Health Rev 2024; 45:1605579. [PMID: 38487619 PMCID: PMC10938403 DOI: 10.3389/phrs.2024.1605579] [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: 11/11/2022] [Accepted: 01/11/2024] [Indexed: 03/17/2024] Open
Abstract
Objectives: Women's health status is better than men but the opposite is true for female smokers who usually have poorer long-health outcomes than male smokers. The objectives of this study were to thoroughly reviewed and analyzed relevant literature and to propose a hypothesis that may explain this paradox phenomenon. Methods: We conducted a search of literature from three English databases (EMBASE, MEDLINE, and Google Scholar) from inception to 13 November 2023. A combination of key words and/or subject headings in English was applied, including relevant terms for cigarette smoking, sex/gender, pregnancy, and health indicators. We then performed analysis of the searched literature. Results: Based on this review/analysis of literature, we proposed a hypothesis that may explain this paradox phenomenon: female smokers have worse long-term health outcomes than male smokers because some of them smoke during pregnancy, and the adverse effects of cigarette smoking during pregnancy is much stronger than cigarette smoking during non-pregnancy periods. Conclusion: Approval of our pregnancy-amplification theory could provide additional evidence on the adverse effect on women's long-term health outcomes for cigarette smoking during pregnancy.
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Affiliation(s)
- Li Yang
- Respiratory Medicine Department of Xiangtan Central Hospital of Hunan Province, Xiangtan, Hunan, China
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Yunchun Zhou
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Pulmonary and Critical Care Medicine of Yuxi People’s Hospital of Yunnan Province, Yuxi, Yunnan, China
| | - Mingyan Jiang
- Respiratory Medicine Department of Xiangtan Central Hospital of Hunan Province, Xiangtan, Hunan, China
| | - Wendy Wen
- School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
| | - Yanfang Guo
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- BORN (Better Outcome Registry Network) Ontario, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Smita Pakhale
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
- Division of Respiratory, The Ottawa Hospital, Ottawa, ON, Canada
| | - Shi Wu Wen
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, ON, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
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3
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Hanewinkel R, Ulbricht S. [Intended and unintended effects of e-cigarettes in clinical studies: a plea for (more) transparency]. Pneumologie 2024. [PMID: 38266746 DOI: 10.1055/a-2243-9399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
E-cigarettes are used in clinical trials to facilitate smoking cessation. Due to the health risks associated with the use of e-cigarettes, the results of clinical trials should be fully reported, including continued exclusive use and dual use of tobacco and e-cigarettes. Nicotine cessation outcomes should be reported as the primary endpoint as well as the analysis of tobacco cessation alone. As there is currently no robust evidence that reducing cigarette consumption provides substantial health benefits, cigarette consumption reduction should not be used as a health outcome in clinical trials. Continued nicotine dependence should be included as an "adverse event" in the reporting of trial results.
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Affiliation(s)
- Reiner Hanewinkel
- IFT-Nord gGmbH, Institut für Therapie- und Gesundheitsforschung, Kiel, Deutschland
| | - Sabina Ulbricht
- Institut für Community Medcine, Abteilung Präventionsforschung und Sozialmedizin, Universitätsmedizin Greifswald, Greifswald, Deutschland
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Shi Y, Peng J, Liu L, Zhao Z, Xiong J, Wan X. Effect of a two-phase tobacco control regulation on incidence from ischemic stroke and hemorrhagic stroke, Shenzhen, China, 2007-2016. Tob Induc Dis 2023; 21:100. [PMID: 37533958 PMCID: PMC10392040 DOI: 10.18332/tid/168123] [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: 02/12/2023] [Revised: 03/16/2023] [Accepted: 06/11/2023] [Indexed: 08/04/2023] Open
Abstract
INTRODUCTION The Shenzhen government is widely considered to be most efficiently implementing smoke-free legislation in China. We evaluated and compared the impact of Shenzhen's two-phase smoke-free regulation on the incidence rates for ischemic and hemorrhagic stroke. METHODS An interrupted time series design was used to capture immediate and annual incidence changes from 2007 to 2016 for both ischemic and hemorrhagic stroke due to two-phase smoke-free regulation in Shenzhen, China, by using a generalized additive model. The first phase, implemented on 9 March 2010, required five main public places to be smoke-free. In the second phase, the comprehensive law was expanded to the whole city on 1 March 2014. RESULTS The regulation implementation during phase I was associated with a strong immediate decline in the incidence rate of ischemic stroke (-14.2%, 95% CI: -19.6 - -8.4) and hemorrhagic stroke (-10.1%, 95% CI: -18.2 - -1.2), but without showing the annual changes (p>0.05). Following the implementation of the comprehensive law, the gradual annual effect showed a significant change in ischemic stroke, with a 6.3% (95% CI: 8.9 - -3.6) reduction. Neither the immediate nor gradual decreases in hemorrhagic stroke incidences associated with the comprehensive regulation were statistically significant during phase II (p>0.05). Subgroup analyses indicate that a much larger health effect of the regulation during phase I was greater among those aged ≥65 years than among those aged 35-64 years. CONCLUSIONS Shenzhen's two-phase smoke-free regulation was well implemented. Even though the regulation did not extend to the whole city, the immediate health benefits on the incidence rates of ischemic stroke and hemorrhagic stroke could be seen. However, the health benefits brought by the implementation of comprehensive smoke-free legislation were attenuated by previous smoke-free regulations in five main public places, which were more evident in hemorrhagic stroke.
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Affiliation(s)
- Yulin Shi
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Ji Peng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Liqun Liu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Zhiguang Zhao
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Jingfan Xiong
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Xia Wan
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
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Tyrrell J, Ghosh A, Manzo ND, Randell SH, Tarran R. Evaluation of chronic cigarette smoke exposure in human bronchial epithelial cultures. J Appl Toxicol 2023; 43:862-873. [PMID: 36594405 DOI: 10.1002/jat.4430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/12/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023]
Abstract
Cigarette smoke (CS) exposure induces both cytotoxicity and inflammation, and often causes COPD, a growing cause of morbidity and mortality. CS also inhibits the CFTR Cl- channel, leading to airway surface liquid dehydration, which is predicated to impair clearance of inhaled pathogens and toxicants. Numerous in vitro studies have been performed that utilize acute (≤24 h) CS exposures. However, CS exposure is typically chronic. We evaluated the feasibility of using British-American Tobacco (BAT)-designed CS exposure chambers for chronically exposing human bronchial epithelial cultures (HBECs) to CS. HBECs are polarized and contain mucosal and serosal sides. In vivo, inhaled CS interacts with mucosal membranes, and BAT chambers are designed to direct CS to HBEC mucosal surfaces while keeping CS away from serosal surfaces via a perfusion system. We found that serosal perfusion was absolutely required to maintain HBEC viability over time following chronic CS exposure. Indeed, with this system, we found that CS increased inflammation and mucin levels, while decreasing CFTR function. Without this serosal perfusion, CS was extremely toxic within 24 h. We therefore propose that 5- and 10-day CS exposures with serosal perfusion are suitable for measuring chronic CS exposure and can be used for monitoring new and emerging tobacco products.
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Affiliation(s)
- Jean Tyrrell
- Marsico Lung Institute, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Arunava Ghosh
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Nicholas D Manzo
- Marsico Lung Institute, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Scott H Randell
- Marsico Lung Institute, University of North Carolina, Chapel Hill, North Carolina, USA.,Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Robert Tarran
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina, USA
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Kim YH, Her AY, Jeong MH, Kim BK, Hong SJ, Kim S, Ahn CM, Kim JS, Ko YG, Choi D, Hong MK, Jang Y. Sex difference after acute myocardial infarction patients with a history of current smoking and long-term clinical outcomes: Results of KAMIR Registry. Cardiol J 2022; 29:954-965. [PMID: 33438183 PMCID: PMC9788752 DOI: 10.5603/cj.a2020.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 12/01/2020] [Accepted: 12/06/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The contribution of sex as an independent risk factor for cardiovascular disease still remains controversial. The present study investigated the impact of sex on long-term clinical outcomes in Korean acute myocardial infarction (AMI) patients with a history of current smoking on admission after drug-eluting stents (DESs). METHODS A total of 12,565 AMI patients (male: n = 11,767 vs. female: n = 798) were enrolled. Major adverse cardiac events (MACEs) comprising all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization were the primary outcomes that were compared between the two groups. Probable or definite stent thrombosis (ST) was the secondary outcome. RESULTS After adjustment, the early (30 days) cumulative incidences of MACEs (adjusted hazard ratio [aHR]: 1.457; 95% confidence interval [CI]: 1.021-2.216; p = 0.035) and all-cause death (aHR: 1.699; 95% CI: 1.074-2.687; p = 0.023) were significantly higher in the female group than in the male group. At 2 years, the cumulative incidences of all-cause death (aHR: 1.561; 95% CI: 1.103-2.210; p = 0.012) and Re-MI (aHR: 1.800; 95% CI: 1.089-2.974; p = 0.022) were significantly higher in the female group than in the male group. However, the cumulative incidences of ST were similar between the two groups (aHR: 1.207; 95% CI: 0.583-2.497; p = 0.613). CONCLUSIONS The female group showed worse short-term and long-term clinical outcomes compared with the male group comprised of Korean AMI patients with a history of current smoking after successful DES implantation. However, further studies are required to confirm these results.
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Affiliation(s)
- Yong Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Ae-Young Her
- Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Myung Ho Jeong
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Byeong-Keuk Kim
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung-Jin Hong
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seunghwan Kim
- Division of Cardiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Chul-Min Ahn
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung-Sun Kim
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Guk Ko
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Donghoon Choi
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myeong-Ki Hong
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yangsoo Jang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Koike S, Sato K, Sawa M, Inaba Y, Hattori K, Nakadate K, Ushiyama A, Ogasawara Y. Exposure to Heated Tobacco Products Aerosol Causes Acute Stress Responses in the Lung of Mouse. Antioxidants (Basel) 2022; 11:antiox11122329. [PMID: 36552537 PMCID: PMC9774187 DOI: 10.3390/antiox11122329] [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: 09/27/2022] [Revised: 11/14/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
In the present study, we evaluated the acute response of mice exposed to IQOS aerosol, a brand-name heated tobacco product (HTP), in the lung tissue. First, the thiobarbituric acid-reactive substances (TBA-RS) value was measured as an index to assess oxidative stress, and a significant increase was observed after exposure, followed by a significant increase in the total lung GSH concentration. The stress responses induced by IQOS aerosols was then analyzed by focusing on the changes in Nrf2 and ATF4, which are transcription factors that induce the expression of genes involved in GSH biosynthesis or metabolism. Although Nrf2 activation was not observed, significant accumulation of ATF4 in the nuclear fraction was noted three hours after exposure to IQOS aerosols. Upon an examination of changes in factors in the GSH biosynthetic system, a significant increase in cystine concentration in the lung tissue was measured, and an increase in xCT expression level was observed in the cell membrane fraction three-six hours after IQOS exposure. Furthermore, characteristic changes in HO-1, a stress-response protein regulated by ATF4, was discovered six hours after IQOS exposure. Moreover, analysis of the upstream ATF4 regulatory system revealed that phosphorylation of eIF2α was enhanced in the lung cytoplasmic fraction three hours after exposure to IQOS aerosols. These findings suggest that ER stress might be induced as an early response to IQOS aerosol exposure, accompanied by the activation of the eIF2α-ATF4 axis. These intracellular changes have also been reported after exposure to combustible cigarette smoke. Thus, the acute response found in the lungs of mice in the present study demonstrate that the inhalation of aerosols from IQOS elicits a biological response similar to that of combustible cigarette smoke. In conclusion, our results provide evidence that the biological effects of HTPs, such as IQOS, cannot be ignored in the lungs.
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Affiliation(s)
- Shin Koike
- Department of Analytical Biochemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
| | - Kohei Sato
- Department of Analytical Biochemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
| | - Marie Sawa
- Department of Environmental Science, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
| | - Yohei Inaba
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Saitama 351-0197, Japan
| | - Kenji Hattori
- Department of Environmental Science, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
| | - Kazuhiko Nakadate
- Department of Basic Science, Educational and Research Center for Pharmacy, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
| | - Akira Ushiyama
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Saitama 351-0197, Japan
| | - Yuki Ogasawara
- Department of Analytical Biochemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Tokyo 204-8588, Japan
- Correspondence:
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Thiravetyan B, Vathesatogkit P. Long-Term Effects of Cigarette Smoking on All-Cause Mortality and Cardiovascular Outcomes in Thai Population: Results From a 30-Year Cohort Study. Asia Pac J Public Health 2022; 34:761-769. [PMID: 35703388 DOI: 10.1177/10105395221106860] [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] [Indexed: 12/15/2022]
Abstract
Despite the overwhelming evidences on the health consequences of smoking, studies in Asian population in low-to-middle income countries are very limited. Baseline data of a prospective cohort study were collected in year 1985. Endpoints regarding all-cause mortality and major adverse cardiovascular events (MACE) were followed for 30 years. Cox proportional hazard models were used for analysis. Participants had an average age of 43 years, 23% were female, and 43% were current smokers. All-cause mortality was significantly higher in ex-smokers (hazard ratio [HR] 1.32) and current smokers (HR 1.70) when compared with never smokers. Participants with any history of smoking had significantly higher risk of developing MACE. Furthermore, all-cause death, cardiovascular death, and MACE increased with increasing pack years. Statistically significant dose-response relationships were established. Therefore, cigarette smoking increased the risk of all-cause mortality, cardiovascular mortality, and MACE in Thai population. Results emphasized the importance of tobacco control in Thailand.
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Affiliation(s)
- Ben Thiravetyan
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Prin Vathesatogkit
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Shi H, Leventhal AM, Wen Q, Ossip DJ, Li D. Sex Differences in the Association of E-cigarette and Cigarette Use and Dual Use With Self-Reported Hypertension Incidence in US Adults. Nicotine Tob Res 2022; 25:478-485. [PMID: 35863748 PMCID: PMC9910126 DOI: 10.1093/ntr/ntac170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/24/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND While there is some evidence and conceptual plausibility that tobacco product use is associated with hypertension incidence and that this association varies by sex, extant longitudinal research had been conducted prior to the emergence of e-cigarette and dual e-cigarette and cigarette use. AIMS AND METHODS Data were analyzed from the US Population Assessment of Tobacco and Health study for adults with no lifetime history of hypertension at wave 1 (2013-2014) who completed waves 2-4 follow-up surveys (2014-2018; n = 16 434). Sex-stratified weighted covariate-adjusted multivariable Cox regression models were used to examine the association between established current e-cigarette or cigarette exclusive or dual-use (as a time-varying and time-lagged regressor) and subsequent self-reported hypertension onset. RESULTS Weighted cumulative hypertension incidence by wave 4 varied by waves 1-3 e-cigarette, cigarette, and dual use status in females (nonuse [incidence: 9.9%], exclusive e-cigarette use [11.8%], exclusive cigarette use [14.8%], dual-use [12.4%]; p = .003 for omnibus differences among all groups) but not males (nonuse [12.6%], exclusive e-cigarette use [9.7%], exclusive cigarette use [13.7%], dual-use [9.3%]; p = .231). Among females, exclusive cigarette (vs. no) use (hazard ratio: 1.69, 95%CI 1.21 to 2.34; p = .002), but not exclusive e-cigarette or dual-use, was significantly associated with subsequent hypertension. Dose-response models were suggestive that consistent exclusive e-cigarette or dual-use versus nonuse across multiple may be associated with hypertension among females, but results were nonsignificant. CONCLUSIONS The association of e-cigarette, cigarette, and dual use with hypertension may differ by sex, whereby exclusive cigarette use could be a prospective risk factor for subsequent self-reported hypertension in US adult females. IMPLICATIONS This nationally representative cohort study provides the very first evidence of whether there are prospective associations of established e-cigarette and cigarette use and dual use with future hypertension onset among US adult females and males. We found that exclusive cigarette smoking was associated with an increased risk of incident hypertension among females, but not males. We observed a trend of a dose-response relationship between e-cigarette use and risk of incident hypertension among female exclusive e-cigarette users or dual e-cigarette and cigarette users. Our study will contribute to understanding the chronic health risks of vaping to prevent the potential long-term e-cigarette use-related health burden.
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Affiliation(s)
- Hangchuan Shi
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY, USA,Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Adam M Leventhal
- USC Institute for Addiction Science, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Qiang Wen
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Dongmei Li
- Corresponding Author: Dongmei Li, Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY 14642-0708, USA. Telephone: (585)2767285; Fax: (585)2761122; E-mail:
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10
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Kim S, Oh J, Yun B, Cho A, Sim J, Yoon JH. Secondhand Smoke in the Workplace Is Associated With Depression in Korean Workers. Front Public Health 2022; 10:802083. [PMID: 35558545 PMCID: PMC9087188 DOI: 10.3389/fpubh.2022.802083] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Smoking negatively affects health, and previous studies argue that secondhand smoke (SHS) has a significantly negative health effect. We investigated whether SHS in the workplace influences workers' depression. Methods Three years of data (2014, 2016, and 2018) from the Korean National Health and Nutrition Examination Survey were analyzed. Participants who were not current smokers were classified into the occupational SHS exposed and non-exposed groups. Multivariate logistic regression was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) by adjusting various covariates. Stratified analysis with variables, such as year, sex, occupational classification, average working hours, was additionally performed. Results The crude ORs of depression was 1.51 (95% CI: 1.27–1.80), and the fully adjusted OR with all the covariates was 1.57 (95% CI: 1.30–1.88). This indicated a significant relationship between occupational SHS and depression. The ORs increased every 2 years: 1.07 (95% CI: 0.79–1.44) in 2014, 1.88 (95% CI: 1.34–2.64) in 2016, and 2.07 (95% CI: 1.43–2.99) in year 2018. Stratification analysis also showed a significant association between SHS and depression among those in the prolonged work hours group and male employees, as well as blue- and white-collar workers. Conclusion SHS in the workplace was significantly associated with workers' depression. Our study provides insights into the impact of exposure to SHS for workers and provides a basis for further research and policy-making in this field.
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Affiliation(s)
- Seunghan Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Juyeon Oh
- Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea
| | - Byungyoon Yun
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Ara Cho
- Department of Occupational Health, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Juho Sim
- Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
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11
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Benowitz NL, Liakoni E. Tobacco use disorder and cardiovascular health. Addiction 2022; 117:1128-1138. [PMID: 34590373 DOI: 10.1111/add.15703] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/01/2021] [Indexed: 12/28/2022]
Abstract
This narrative review examines the impact of cigarette smoking and the use of other tobacco and nicotine products on cardiovascular disease. Smoking increases the incidence of both acute and chronic cardiovascular diseases, and the harmful effects are substantially and relatively quickly reversible after quitting. Recommended cessation treatment includes offering pharmacotherapy, counseling which should emphasize the rapid risk reduction that occurs after quitting and adequate follow-up contacts. Although most research on cardiovascular disease in relation to tobacco use has focused upon cigarette smoking, we also review available data related to other combustible tobacco products, smokeless tobacco, electronic nicotine delivery systems and second-hand smoke. We discuss the implications of smoking on clinical management of patients with heart disease and newer developments with potential relevance to treatment of such patients.
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Affiliation(s)
- Neal L Benowitz
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA
| | - Evangelia Liakoni
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Lu CH, Lai YR, Fang FM, Tan TY, Chiu WC, Hsieh DY, Huang CC, Lien CY, Cheng BC, Chien CY, Huang TL, Kung CT. Radiotherapy Is Associated with an Accelerated Risk of Carotid Atherosclerosis in Patients with Nasopharyngeal Carcinoma: A Nine-Year Prospective Follow-Up Study. Cancers (Basel) 2022; 14:cancers14051234. [PMID: 35267542 PMCID: PMC8909632 DOI: 10.3390/cancers14051234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 02/04/2023] Open
Abstract
Radiation-related extracranial vasculopathy is a common late effect after radiation in patients with nasopharyngeal carcinoma (NPC). We proposed the hypothesis that radiation-related extracranial vasculopathy is a progressive process that can begin immediately after radiotherapy and persist for a longer period, and inflammation and oxidative stress may play a pivotal role in this process. Thirty-six newly diagnosed NPC patients were assessed with B-mode ultrasound for the common carotid artery (CCA) intima media thickness (IMT) measurement as well as surrogate markers at three different stages (baseline, immediately after concurrent chemoradiation therapy (CCRT), and 9 years after enrollment). A healthy control group was also recruited for comparison. Surrogate markers including a lipid profile, HbA1c, inflammation, oxidative stress, and platelet activation markers were assessed. The mean CCA IMT in the NPC group were increased immediately after CCRT (p = 0.043). The mean CCA IMT value after a 9-year follow-up also showed a significant increase in NPC and control group, respectively (p < 0.0001 and p < 0.0001, paired t test). The annual increase mean CCA IMT (mm) was 0.053 ± 0.025 and 0.014 ± 0.013 in NPC and control group, respectively (p < 0.0001). The baseline high sensitivity CRP (hs-CRP), thiol, TBARS, and CD63 level were significantly higher in the NPC group (hs-CRP, p = 0.001, thiol, p < 0.0001, TBARS, p = 0.05, and CD63 level, p = 0.04). The thiol and TBARS levels were significantly lower in NPC patients immediately after CCRT (thiol, p < 0.0001, and TBARS, p = 0.043). The CD62P level was significantly higher while the thiol level was significantly lower in the NPC group after a 9-year follow-up (CD62P level, p = 0.007; and thiol level, p = 0.004). Radiation-related extracranial vasculopathy is a progressive process that begins immediately after radiotherapy with significantly increased carotid IMT compared to the control group during the 9-year follow-up. Chronic inflammation and oxidative stress might serve to drive the process and also contribute to increased platelet activation.
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Affiliation(s)
- Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung District, Kaohsiung City 83301, Taiwan or (Y.-R.L.); (D.-Y.H.); (C.-C.H.); (C.-Y.L.)
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan
- Department of Biological Science, National Sun Yat-sen University, Kaohsiung City 80424, Taiwan
- Department of Neurology, Xiamen Chang Gung Memorial Hospital, Xiamen 361126, China
- Correspondence: or (C.-H.L.); (T.-Y.T.); Tel.: +886-7-7317123 (ext. 2283) (C.-H.L.); Fax: +886-7-731-8762 (C.-H.L.)
| | - Yun-Ru Lai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung District, Kaohsiung City 83301, Taiwan or (Y.-R.L.); (D.-Y.H.); (C.-C.H.); (C.-Y.L.)
| | - Fu-Min Fang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan;
| | - Teng-Yeow Tan
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung District, Kaohsiung City 83301, Taiwan or (Y.-R.L.); (D.-Y.H.); (C.-C.H.); (C.-Y.L.)
- Correspondence: or (C.-H.L.); (T.-Y.T.); Tel.: +886-7-7317123 (ext. 2283) (C.-H.L.); Fax: +886-7-731-8762 (C.-H.L.)
| | - Wen-Chan Chiu
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (W.-C.C.); (B.-C.C.); (T.-L.H.)
| | - Dong-Yi Hsieh
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung District, Kaohsiung City 83301, Taiwan or (Y.-R.L.); (D.-Y.H.); (C.-C.H.); (C.-Y.L.)
| | - Chih-Cheng Huang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung District, Kaohsiung City 83301, Taiwan or (Y.-R.L.); (D.-Y.H.); (C.-C.H.); (C.-Y.L.)
| | - Chia-Yi Lien
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung District, Kaohsiung City 83301, Taiwan or (Y.-R.L.); (D.-Y.H.); (C.-C.H.); (C.-Y.L.)
| | - Ben-Chung Cheng
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (W.-C.C.); (B.-C.C.); (T.-L.H.)
| | - Chih-Yen Chien
- Department of Otorhinolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan;
| | - Tai-Lin Huang
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan; (W.-C.C.); (B.-C.C.); (T.-L.H.)
| | - Chia-Te Kung
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan;
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Nishimoto-Kusunose S, Sawa M, Inaba Y, Ushiyama A, Ishii K, Hattori K, Ogasawara Y. Exposure to aerosol extract from heated tobacco products causes a drastic decrease of glutathione and protein carbonylation in human lung epithelial cells. Biochem Biophys Res Commun 2022; 589:92-99. [PMID: 34896781 DOI: 10.1016/j.bbrc.2021.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/02/2021] [Indexed: 12/20/2022]
Abstract
Heated tobacco products (HTPs) are an emerging class of tobacco goods that claim to have lower health risks than those of smoking combustible tobacco products. In this study, we exposed human lung epithelial cell lines to extracts prepared from HTP aerosols and combustible cigarette smoke to compare cytotoxicity. We focused on the effects of aldehydes present in the aerosols of HTPs at levels close to those in combustible cigarette smoke. Significant toxicity was confirmed for the HTP extract, albeit to a lesser extent than that with the combustible cigarette extract. When redox balance was evaluated by the oxidative loss of low-molecular-weight thiols in the cells, we found that total glutathione (GSH) contents and low-molecular-weight thiol levels were significantly decreased after exposure to the aerosol extract of HTPs. These results indicated that GSH is rapidly consumed during the detoxification of xenobiotics, such as aldehydes from tobacco extracts. Accordingly, exposure to the aerosol extract of HTPs resulted in the enhanced carbonylation of many proteins. In a simple comparison, the results for HTPs were significantly different from those obtained with combustible cigarette smoke, suggesting reduced toxicity of HTPs. However, we found significant and harmful effects after exposing lung epithelial cells to the aerosol extract of HTPs. Thus, a further comprehensive study is needed to clarify the lung damage induced via the long-term inhalation of aerosols from HTPs.
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Affiliation(s)
- S Nishimoto-Kusunose
- Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda-shi, Chiba, Japan
| | - M Sawa
- Department of Environmental Science, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo, 204-8588, Japan
| | - Y Inaba
- Department of Environmental Health, National Institute of Public Health. Minami, Wako-shi, Saitama, 351-0197, Japan
| | - A Ushiyama
- Department of Environmental Health, National Institute of Public Health. Minami, Wako-shi, Saitama, 351-0197, Japan
| | - K Ishii
- Department of Environmental Science, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo, 204-8588, Japan
| | - K Hattori
- Department of Environmental Science, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo, 204-8588, Japan
| | - Y Ogasawara
- Department of Analytical Biochemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo, 204-8588, Japan.
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Kataoka H, Kaji S, Moai M. Risk Assessment of Passive Smoking Based on Analysis of Hair Nicotine and Cotinine as Exposure Biomarkers by In-Tube Solid-Phase Microextraction Coupled On-Line to LC-MS/MS. Molecules 2021; 26:molecules26237356. [PMID: 34885941 PMCID: PMC8659248 DOI: 10.3390/molecules26237356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022] Open
Abstract
Passive smoking due to environmental tobacco smoke is a serious public health concern because it increases the risk of lung cancer and cardiovascular disease. However, the current status and effect of passive smoking in various lifestyles are not fully understood. In this study, we measured hair nicotine and cotinine levels as exposure biomarkers in non-smokers and assessed the risk from the actual situation of passive smoking in different lifestyle environments. Nicotine and cotinine contents in hair samples of 110 non-smoker subjects were measured by in-tube solid-phase microextraction with on-line coupling to liquid chromatography-tandem mass spectrometry, and self-reported lifestyle questionnaires were completed by the subjects. Nicotine and cotinine were detected at concentrations of 1.38 ng mg−1 and 12.8 pg mg−1 respectively in the hair of non-smokers, with levels significantly higher in subjects who reported being sensitive to tobacco smoke exposure. These levels were also affected by type of food intake and cooking method. Nicotine and cotinine in hair are useful biomarkers for assessing the effects of passive smoking on long-term exposure to environmental tobacco smoke, and our analytical methods can measure these exposure levels in people who are unaware of passive smoking. The results of this study suggest that the environment and places of tobacco smoke exposure and the lifestyle behaviors therein are important for the health effects of passive smoking.
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Ardiana M, Utami E, Pikir B, Santoso A. Preventive effect of Nigella sativa on M1/M2 ratio, reducing risk of endothelial dysfunction in cigarette smoked Wistars. F1000Res 2021; 10:917. [PMID: 36071890 PMCID: PMC9403357 DOI: 10.12688/f1000research.53713.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Smoking is one of the top three causes of cardiovascular disease (CVD). Natural antioxidants including black cumin ( Nigella sativa) may inhibit the pathogenesis of initial process of atherosclerosis. The aim of this study was to determine the effect of black cumin (Nigella sativa) in preventing endothelial dysfunction mainly through macrophage M1/M2 inflammatory response in cigarette smoked male Wistars. Methods: In total, 50 Wistar rats were randomly allocated to five experimental groups: two control groups, namely no intervention (K-) and exposure to smoke of 40 cigarettes each day (K+); and three treatment groups: rats given a dose of 0.3 g (P1), 0.6 g (P2) or 1.2 g (P3) black cumin per kilograms bodyweight/ day, respectively, and exposed to smoke of 40 cigarettes each day. After 28 days of cigarette smoke exposure, macrophage M1/M2 ratio was evaluated by counting total M1 and M2 in ten microscope field of view. Data were analysed by Mann-Whitney test. Results: The M1 / M2 ratio on K (-) was 0.9 7 ± 0.9 8 (<1) which means M2 was dominant, while the M1 / M2 ratio on K (+) was of 4.97 ± 3.42 (> 1) which means M1 dominant. There was no significant difference in the number of M1 count in treatment groups P1, P2, P3 (p value = 0.996; 0.170; 0.884, respectively) when compared with K+. Additionally, P2 group has the lower M1 number with the highest significance value when compared to K+. The number of M1 counts on P1 did not differ significantly when compared to P2 with p = 0.121 and P3 with p = 0.936. Conclusions: In sum, ethanol extract of black cumin prevents endothelial dysfunction by inhibiting increase in macrophages M1 / M2 ratio in rats Wistar exposed to sub-chronic cigarette smoke.
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Affiliation(s)
- Meity Ardiana
- Faculty of Medicine, Airlangga University, Surabaya, East Java, Indonesia
- Cardiology and Vascular Medicine, Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Eka Utami
- Faculty of Medicine, Airlangga University, Surabaya, East Java, Indonesia
- Cardiology and Vascular Medicine, Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Budi Pikir
- Faculty of Medicine, Airlangga University, Surabaya, East Java, Indonesia
- Cardiology and Vascular Medicine, Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Anwar Santoso
- Cardiology and Vascular Medicine, Harapan Kita National Hospital, Jakarta, West Java, Indonesia
- Faculty of Medicine, University of Indonesia, Jakarta, West Java, Indonesia
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16
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The emotional heart: prospective associations of anger, depression, and anxiety as risk factors for myocardial infarction in a 22-year follow-up of a working cohort of middle-aged men. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01598-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Abstract
Aim
The study aim was to further clarify the relationship between psychological factors and myocardial infarction (MI) by simultaneously examining anger, depression, and anxiety as risk factors for incident MI in a healthy working sample.
Subject and method
Baseline measurements of psychological variables were assessed through a self-reported questionnaire in a healthy cohort of 968 middle-aged men working at the Volvo Corporation. Single-item questions assessed depression and anxiety. Anger was assessed by the Trait Anger subscale of the Spielberger State-Trait Anger Expression Inventory. The endpoint was incident MI verified by national registers or medical records with follow up after 22 years. The main outcome was computed through logistic regression, reported as odds ratios. Additional correlation analyses were performed between psychological variables and coronary risk factors.
Results
None of the psychological variables was significantly associated with the outcome; thus, the results failed to show an association between anger, depression, or anxiety and incident MI in this sample. There were some significant, but weak, correlations between psychological factors and negative health behaviors. Other components of traditional risk scoring instruments did not correlate with the psychological factors.
Conclusion
A cohort restricted to middle-age healthy men limits applicability. However, our failure to replicate earlier results of population samples suggests a need for further research on associations between psychological factors and MI in healthy samples.
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Kim J, Lee S, Kimm H, Lee JA, Lee CM, Cho HJ. Heated tobacco product use and its relationship to quitting combustible cigarettes in Korean adults. PLoS One 2021; 16:e0251243. [PMID: 33961641 PMCID: PMC8104442 DOI: 10.1371/journal.pone.0251243] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 04/22/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE We assessed the prevalence of, and factors associated with, heated tobacco product (HTP) use and analysed the association between HTP use and quitting combustible cigarettes (CCs) in Korean adults. METHODS We conducted an online survey with 7,000 adults (males, 2,300; females, 4,700; ages 20-69) out of 70,000 age-, sex- and provincial-distribution-matched individuals based on 2018 national population statistics. Females were oversampled because the prevalence of tobacco product use is very low among women in Korea. Chi-square tests were used for bivariate analyses, and odds ratios were assessed after adjusting for sociodemographic variables. RESULTS The prevalence of current CC, electronic cigarette (EC), and HTP use was 24.8% (males, 40.4%; females, 9.3%), 6.8% (males, 10.1%; females, 3.4%), and 10.2% (males, 16.2%; females, 4.3%), respectively. Among the 574 current HTP users, 77 (13.4%) were HTP-only users and >80% were either dual users of HTP and CC/EC, or triple users of HTP, EC, and CC. Among the current CC users, the odds of having attempted to quit CCs in the past year were greater among EC-only users (aOR 2.92; 95% CI 1.81-4.69) and dual users of HTPs and ECs (aOR 8.42; 95% CI 4.85-14.62) than among non-HTP and non-EC users. Among 2,121 ever CC smokers, the likelihood of being a former CC smoker was 0.19 (95% CI 0.15-0.24) for HTP users, 0.29 (95% CI 0.20-0.42) for EC users, and 0.03 (95% CI 0.01-0.06) for users of both HTPs and ECs compared with non-HTP and non-EC users. CONCLUSION EC-only use and dual use of HTPs and ECs were associated with increased attempts to quit CCs; however, HTP and EC use was associated with lower odds of CC smoking abstinence.
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Affiliation(s)
- Jinyoung Kim
- Southern Gyeonggi Regional Smoking Cessation Centre, Hallym University, Anyang, Republic of Korea
| | - Sungkyu Lee
- Korea Tobacco Control Research and Education Centre, Seoul, Republic of Korea
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Heejin Kimm
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Juna-Ah Lee
- Department of Family Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Cheol-min Lee
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hong-Jun Cho
- Department of Family Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Jalali Z, Khademalhosseini M, Soltani N, Esmaeili Nadimi A. Smoking, alcohol and opioids effect on coronary microcirculation: an update overview. BMC Cardiovasc Disord 2021; 21:185. [PMID: 33858347 PMCID: PMC8051045 DOI: 10.1186/s12872-021-01990-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 04/07/2021] [Indexed: 02/07/2023] Open
Abstract
Smoking, heavy alcohol drinking and drug abuse are detrimental lifestyle factors leading to loss of million years of healthy life annually. One of the major health complications caused by these substances is the development of cardiovascular diseases (CVD), which accounts for a significant proportion of substance-induced death. Smoking and excessive alcohol consumption are related to the higher risk of acute myocardial infarction. Similarly, opioid addiction, as one of the most commonly used substances worldwide, is associated with cardiac events such as ischemia and myocardial infarction (MI). As supported by many studies, coronary artery disease (CAD) is considered as a major cause for substance-induced cardiac events. Nonetheless, over the last three decades, a growing body of evidence indicates that a significant proportion of substance-induced cardiac ischemia or MI cases, do not manifest any signs of CAD. In the absence of CAD, the coronary microvascular dysfunction is believed to be the main underlying reason for CVD. To date, comprehensive literature reviews have been published on the clinicopathology of CAD caused by smoking and opioids, as well as macrovascular pathological features of the alcoholic cardiomyopathy. However, to the best of our knowledge there is no review article about the impact of these substances on the coronary microvascular network. Therefore, the present review will focus on the current understanding of the pathophysiological alterations in the coronary microcirculation triggered by smoking, alcohol and opioids.
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Affiliation(s)
- Zahra Jalali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Building Number 1, Emam Ali Boulevard, P.O. Box: 77175-835, 7719617996, Rafsanjan, Iran
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Morteza Khademalhosseini
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Building Number 1, Emam Ali Boulevard, P.O. Box: 77175-835, 7719617996, Rafsanjan, Iran
- Department of Pathology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Narjes Soltani
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Building Number 1, Emam Ali Boulevard, P.O. Box: 77175-835, 7719617996, Rafsanjan, Iran
| | - Ali Esmaeili Nadimi
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Building Number 1, Emam Ali Boulevard, P.O. Box: 77175-835, 7719617996, Rafsanjan, Iran.
- Department of Cardiology, School of Medicine, Rafsanjani University of Medical Sciences, Rafsanjan, Iran.
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Zheng Y, Wu Y, Wang M, Wang Z, Wang S, Wang J, Wu J, Wu T, Chang C, Hu Y. Impact of a comprehensive tobacco control policy package on acute myocardial infarction and stroke hospital admissions in Beijing, China: interrupted time series study. Tob Control 2020; 30:tobaccocontrol-2020-055663. [PMID: 32669389 PMCID: PMC8237181 DOI: 10.1136/tobaccocontrol-2020-055663] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/16/2020] [Accepted: 04/21/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To evaluate a comprehensive tobacco control policy package on hospital admissions for acute myocardial infarction (AMI) and stroke in a global city. DESIGN Interrupted time series study. SETTING Beijing, China. POPULATION 31 707 AMI and 128 116 stroke hospital admissions recorded by the Beijing Medical Claim Data for Employees in 17.7 million residents from January 2013 to June 2017. INTERVENTION The policy package including all components of MPOWER has been implemented since June 2015. MAIN OUTCOME MEASURES The immediate change of AMI and stroke hospital admissions and the annual change in the secular trend. RESULTS There was a secular increase trend for the crude hospital admission rates of AMI and stroke during the observational period. After implementation of the policy, immediate reductions were observed in the hospital admissions for both AMI (-5.4%, 95% CI -10.0% to -0.5%) and stroke (-5.6%, 95% CI -7.8% to -3.3%). In addition, the secular increase trend for stroke was slowed down by -15.3% (95% CI -16.7% to -13.9%) annually. Compared with the hypothetical scenario where the policy had not taken place, an estimated 18 137 (26.7%) stroke hospital admissions had been averted during the 25 months of postpolicy period. CONCLUSIONS The results indicated significant health benefits on cardiovascular morbidity after the Beijing tobacco control policy package, which highlighted the importance for a comprehensive tobacco control policy at the national level in China. Similar tobacco control policy which consists of all components of MPOWER is urgently needed in other areas, especially in settings with high tobacco consumption, to achieve greater public health gains.
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Affiliation(s)
- Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Zijing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Junhui Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
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Sadeghi M, Daneshpour MS, Khodakarim S, Momenan AA, Akbarzadeh M, Soori H. Impact of secondhand smoke exposure in former smokers on their subsequent risk of coronary heart disease: evidence from the population-based cohort of the Tehran Lipid and Glucose Study. Epidemiol Health 2020; 42:e2020009. [PMID: 32150674 PMCID: PMC7285426 DOI: 10.4178/epih.e2020009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 03/07/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Cigarette smoking is an established, strong, and modifiable risk factor for coronary heart disease (CHD). However, little research has investigated CHD risk in former smokers who continue to be exposed to others’ cigarette smoke (former & secondhand smokers). METHODS In the Tehran Lipid and Glucose Study, a prospective population-based cohort (n=20,069) was followed up for a median period of 14.6 years. A subset of 8,050 participants of 30 years of age and older was analyzed, with first CHD events as the study outcome. Participants were categorized as never, former, current, secondhand, and former & secondhand smokers. Data on smoking intensity (cigarette/d) were also collected. A Cox proportional hazards regression model was applied to estimate the risk of CHD, taking into account the main potential confounders. RESULTS The mean age of participants was 46.10 ±11.38 years, and they experienced 1,118 first CHD events (with most CHD cases in former smokers) during the follow-up period. The risk of CHD was highest in current smokers, followed in order by former & secondhand, former, and secondhand smokers (hazard ratio [HR], 1.99; 95% confidence interval [CI], 1.65 to 2.39; HR, 1.55; 95% CI, 1.15 to 2.08; HR, 1.39; 95% CI, 1.12 to 1.72; HR, 1.27; 95% CI, 1.07 to 1.51, respectively), compared to never smokers. The risk of CHD increased with smoking intensity, which has been proposed as a preferable measure of smoking, indicating a dose-response pattern. CONCLUSIONS The elevated risk of CHD in former & secondhand smokers was a noteworthy finding, with possible implications for health policy; however, further research is needed.
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Affiliation(s)
- Masoumeh Sadeghi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam S Daneshpour
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Khodakarim
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abbas Momenan
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Akbarzadeh
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Soori
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Stewart J, Addy K, Campbell S, Wilkinson P. Primary prevention of cardiovascular disease: Updated review of contemporary guidance and literature. JRSM Cardiovasc Dis 2020; 9:2048004020949326. [PMID: 32994926 PMCID: PMC7502686 DOI: 10.1177/2048004020949326] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/01/2020] [Accepted: 07/16/2020] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular disease remains a substantial concern in terms of global mortality and morbidity, while prevalence of cardiovascular disease is increasing as treatment modalities improve survival. With an ageing population and increasing costs of chronic medical care, primary prevention of cardiovascular disease is an important target for healthcare providers. Since the previous iteration of this paper, new international guidelines have been produced regarding hypertension and lipid lowering therapies, whilst there is a growing body of evidence and new therapies emerging in other areas of lifestyle and pharmacotherapeutic intervention. This review outlines emerging evidence in the field and compares and contrasts contemporary recommendations from European and American guidelines.
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Affiliation(s)
- Jack Stewart
- Department of Cardiology, St Thomas’ Hospital London,
Guy’s & St Thomas’ NHS Trust, London, UK
| | - Katherine Addy
- St Peter’s Hospital Chertsey, Ashford & St Peter’s
NHS Trust, Surrey, UK
| | - Sarah Campbell
- Department of Cardiology, Princess Royal University
Hospital, Kings College Hospital NHS Trust, Kent, UK
| | - Peter Wilkinson
- Department of Cardiology, Ashford & St Peter’s
Hospital NHS Trust, Chertsey, UK
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22
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Cho HJ. Comparison of the risks of combustible cigarettes, e-cigarettes, and heated tobacco products. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2020. [DOI: 10.5124/jkma.2020.63.2.96] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hong-Jun Cho
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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23
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Affiliation(s)
- Takahisa Kondo
- Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine
| | - Yoshihisa Nakano
- Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine
| | - Shiro Adachi
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine
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24
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25
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Minué-Lorenzo C, Olano-Espinosa E. Tabaquismo, el gran olvidado en el cálculo y abordaje del riesgo cardiovascular. Med Clin (Barc) 2019; 152:154-158. [DOI: 10.1016/j.medcli.2018.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 11/28/2022]
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26
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Lennon RP, Claussen KA, Kuersteiner KA. State of the Heart: An Overview of the Disease Burden of Cardiovascular Disease from an Epidemiologic Perspective. Prim Care 2018; 45:1-15. [PMID: 29406937 DOI: 10.1016/j.pop.2017.11.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cardiovascular diseases are prevalent worldwide and have significant impact on morbidity, mortality, and overall health care costs. Common risk factors include obesity, hypertension, hyperlipidemia, diabetes mellitus, chronic kidney disease, and smoking. Both modifiable and nonmodifiable risks should be accounted for when evaluating and managing patients with cardiovascular diseases. The complex nature of cardiovascular disease is not fully understood. Therefore, primary care physicians must balance what is known, what is suspected, and each patient's individual preferences to create an optimal treatment plan.
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27
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Mayne SL, Widome R, Carroll AJ, Schreiner PJ, Gordon-Larsen P, Jacobs DR, Kershaw KN. Longitudinal Associations of Smoke-Free Policies and Incident Cardiovascular Disease: CARDIA Study. Circulation 2018; 138:557-566. [PMID: 29735485 PMCID: PMC6202173 DOI: 10.1161/circulationaha.117.032302] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/21/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Smoke-free legislation has been associated with lower rates of cardiovascular disease hospital admissions in ecological studies. However, prior studies lacked detailed information on individual-level factors (eg, sociodemographic and clinical characteristics) that could potentially confound associations. Our objective was to estimate associations of smoke-free policies with incident cardiovascular disease in a longitudinal cohort after controlling for sociodemographics, cardiovascular disease risk factors, and policy covariates. METHODS Longitudinal data from 3783 black and white adults in the CARDIA study (Coronary Artery Risk Development in Young Adults; 1995-2015) were linked to state, county, and local 100% smoke-free policies in bars, restaurants, and nonhospitality workplaces by Census tract. Extended Cox regression estimated hazard ratios (HRs) of incident cardiovascular disease associated with time-dependent smoke-free policy exposures. Models were adjusted for sociodemographic characteristics, cardiovascular disease risk factors, state cigarette tax, participant-reported presence of a smoking ban at their workplace, field center, and metropolitan statistical area poverty. RESULTS During a median follow-up of 20 years (68 332 total person-years), 172 participants had an incident cardiovascular disease event (2.5 per 1000 person-years). Over the follow-up period, 80% of participants lived in areas with smoke-free policies in restaurants, 67% in bars, and 65% in nonhospitality workplaces. In fully adjusted models, participants living in an area with a restaurant, bar, or workplace smoke-free policy had a lower risk of incident cardiovascular disease compared with those in areas without smoke-free policies (HR, 0.75, 95% confidence interval, 0.49-1.15; HR, 0.76, 95% confidence interval, 0.47-1.24; HR, 0.54, 95% confidence interval, 0.34-0.86, respectively; HR, 0.58, 95% confidence interval, 0.33-1.00 for living in an area with all 3 types of policies compared with none). The estimated preventive fraction was 25% for restaurant policies, 24% for bar policies, and 46% for workplace policies. CONCLUSIONS Consistent with prior ecological studies, these individual-based data add to the evidence that 100% smoke-free policies are associated with lower risk of cardiovascular disease among middle-aged adults.
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Affiliation(s)
- Stephanie L Mayne
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.L.M., A.J.C., K.N.K.)
| | - Rachel Widome
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneap-olis (R.W., P.J.S., D.R.J.)
| | - Allison J Carroll
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.L.M., A.J.C., K.N.K.)
| | - Pamela J Schreiner
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneap-olis (R.W., P.J.S., D.R.J.)
| | - Penny Gordon-Larsen
- Department of Nutrition, University of North Carolina Gillings School of Public Health, Chapel Hill (P.G.-L.)
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneap-olis (R.W., P.J.S., D.R.J.)
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (S.L.M., A.J.C., K.N.K.)
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28
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Mladěnka P, Applová L, Patočka J, Costa VM, Remiao F, Pourová J, Mladěnka A, Karlíčková J, Jahodář L, Vopršalová M, Varner KJ, Štěrba M. Comprehensive review of cardiovascular toxicity of drugs and related agents. Med Res Rev 2018; 38:1332-1403. [PMID: 29315692 PMCID: PMC6033155 DOI: 10.1002/med.21476] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/20/2017] [Accepted: 11/16/2017] [Indexed: 12/12/2022]
Abstract
Cardiovascular diseases are a leading cause of morbidity and mortality in most developed countries of the world. Pharmaceuticals, illicit drugs, and toxins can significantly contribute to the overall cardiovascular burden and thus deserve attention. The present article is a systematic overview of drugs that may induce distinct cardiovascular toxicity. The compounds are classified into agents that have significant effects on the heart, blood vessels, or both. The mechanism(s) of toxic action are discussed and treatment modalities are briefly mentioned in relevant cases. Due to the large number of clinically relevant compounds discussed, this article could be of interest to a broad audience including pharmacologists and toxicologists, pharmacists, physicians, and medicinal chemists. Particular emphasis is given to clinically relevant topics including the cardiovascular toxicity of illicit sympathomimetic drugs (e.g., cocaine, amphetamines, cathinones), drugs that prolong the QT interval, antidysrhythmic drugs, digoxin and other cardioactive steroids, beta-blockers, calcium channel blockers, female hormones, nonsteroidal anti-inflammatory, and anticancer compounds encompassing anthracyclines and novel targeted therapy interfering with the HER2 or the vascular endothelial growth factor pathway.
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Affiliation(s)
- Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Lenka Applová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Jiří Patočka
- Department of Radiology and Toxicology, Faculty of Health and Social StudiesUniversity of South BohemiaČeské BudějoviceCzech Republic
- Biomedical Research CentreUniversity HospitalHradec KraloveCzech Republic
| | - Vera Marisa Costa
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of PharmacyUniversity of PortoPortoPortugal
| | - Fernando Remiao
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of PharmacyUniversity of PortoPortoPortugal
| | - Jana Pourová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Aleš Mladěnka
- Oncogynaecologic Center, Department of Gynecology and ObstetricsUniversity HospitalOstravaCzech Republic
| | - Jana Karlíčková
- Department of Pharmaceutical Botany and Ecology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Luděk Jahodář
- Department of Pharmaceutical Botany and Ecology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Marie Vopršalová
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
| | - Kurt J. Varner
- Department of PharmacologyLouisiana State University Health Sciences CenterNew OrleansLAUSA
| | - Martin Štěrba
- Department of Pharmacology, Faculty of Medicine in Hradec KrálovéCharles UniversityHradec KrálovéCzech Republic
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29
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Merianos AL, Jandarov RA, Khoury JC, Mahabee-Gittens EM. Tobacco Smoke Exposure Association With Lipid Profiles and Adiposity Among U.S. Adolescents. J Adolesc Health 2018; 62:463-470. [PMID: 29224987 PMCID: PMC5866739 DOI: 10.1016/j.jadohealth.2017.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 09/13/2017] [Accepted: 10/06/2017] [Indexed: 01/19/2023]
Abstract
PURPOSE We investigated the association between tobacco smoke exposure (TSE) as measured by serum cotinine and lipoprotein cholesterols and adiposity in adolescents. METHODS We performed a secondary analysis of 1999-2012 National Health and Nutrition Examination Survey data including participants 12-19 years old. We examined TSE: unexposed (<.05 ng/mL), passively exposed (.05-2.99 ng/mL), and actively exposed (≥3 ng/mL); lipid profiles: total cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, low-density lipoprotein cholesterol (LDL-C), and triglycerides; and adiposity: body mass index z-score (BMIZ), waist circumference (WC), and waist-to-height ratio (WHtR). Covariates were age, sex, race/ethnicity, income, diet, and physical activity. Multiple regression models were used to assess the association between TSE and lipid profile variables separately, and then TSE and adiposity measures separately, adjusting for covariates. We performed logistic regression to examine the association of TSE with body mass index and WHtR classifications. RESULTS Of the 11,550 participants, 41.7% were unexposed to tobacco smoke, 40.5% were passively exposed, and 17.8% were actively exposed. Compared with unexposed, participants with active TSE had lower total cholesterol, lower HDL-C, and higher triglycerides; higher BMIZ, higher WC, and higher WHtR; participants with passive TSE had lower HDL-C, higher total cholesterol, and higher LDL-C; higher BMIZ, higher WC, and higher WHtR. Participants actively exposed were at increased odds of being obese or WHtR ≥.65, and those passively exposed were at increased odds of being overweight, obese, or WHtR ≥.65. CONCLUSIONS Active TSE and passive TSE are differentially associated with factors within the lipid profile and adiposity, independent of covariates. TSE prevention efforts should start as early as childhood and continue throughout adolescence and adulthood.
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Affiliation(s)
- Ashley L Merianos
- School of Human Services, University of Cincinnati, Cincinnati, Ohio.
| | - Roman A Jandarov
- Division of Biostatistics and Bioinformatics, Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Jane C Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, Ohio
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30
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Zuo H, Nygård O, Vollset SE, Ueland PM, Ulvik A, Midttun Ø, Meyer K, Igland J, Sulo G, Tell GS. Smoking, plasma cotinine and risk of atrial fibrillation: the Hordaland Health Study. J Intern Med 2018; 283:73-82. [PMID: 28940460 DOI: 10.1111/joim.12689] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cigarette smoking has been identified as a major modifiable risk factor for coronary heart disease and mortality. However, findings on the relationship between smoking and atrial fibrillation (AF) have been inconsistent. Furthermore, findings from previous studies were based on self-reported smoking. OBJECTIVE To examine the associations of smoking status and plasma cotinine levels, a marker of nicotine exposure, with risk of incident AF in the Hordaland Health Study. METHODS We conducted a prospective analysis of 6682 adults aged 46-74 years without known AF at baseline. Participants were followed via linkage to the Cardiovascular Disease in Norway (CVDNOR) project and the Cause of Death Registry. Smoking status was assessed by both questionnaire and plasma cotinine levels. RESULTS A total of 538 participants developed AF over a median follow-up period of 11 years. Using questionnaire data, current smoking (HR: 1.41, 95% CI: 1.09-1.83), but not former smoking (HR: 1.03, 95% CI: 0.83-1.28), was associated with an increased risk of AF after adjustment for gender, age, body mass index, hypertension, physical activity and education. Using plasma cotinine only, the adjusted HR (95% CI) was 1.40 (1.12-1.75) for participants with cotinine ≥85 nmol L-1 compared to those with cotinine <85 nmol L-1 . However, the risk increased with elevated plasma cotinine levels until 1199 nmol L-1 (HR: 1.55, 95% CI: 1.16-2.05 at the third group vs. the reference group) and plateaued at higher levels. CONCLUSIONS Current, but not former smokers, had a higher risk of developing AF. Use of plasma cotinine measurement corroborated this finding.
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Affiliation(s)
- H Zuo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - O Nygård
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - S E Vollset
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,The Norwegian Institute of Public Health, Bergen, Norway
| | - P M Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | | | | | | | - J Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - G Sulo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - G S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Domain for Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway
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31
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Olfert IM, DeVallance E, Hoskinson H, Branyan KW, Clayton S, Pitzer CR, Sullivan DP, Breit MJ, Wu Z, Klinkhachorn P, Mandler WK, Erdreich BH, Ducatman BS, Bryner RW, Dasgupta P, Chantler PD. Chronic exposure to electronic cigarettes results in impaired cardiovascular function in mice. J Appl Physiol (1985) 2017; 124:573-582. [PMID: 29097631 DOI: 10.1152/japplphysiol.00713.2017] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Proponents for electronic cigarettes (E-cigs) claim that they are a safe alternative to tobacco-based cigarettes; however, little is known about the long-term effects of exposure to E-cig vapor on vascular function. The purpose of this study was to determine the cardiovascular consequences of chronic E-cig exposure. Female mice (C57BL/6 background strain) were randomly assigned to chronic daily exposure to E-cig vapor, standard (3R4F reference) cigarette smoke, or filtered air ( n = 15/group). Respective whole body exposures consisted of four 1-h-exposure time blocks, separated by 30-min intervals of fresh air breaks, resulting in intermittent daily exposure for a total of 4 h/day, 5 days/wk for 8 mo. Noninvasive ultrasonography was used to assess cardiac function and aortic arterial stiffness (AS), measured as pulse wave velocity, at three times points (before, during, and after chronic exposure). Upon completion of the 8-mo exposure, ex vivo wire tension myography and force transduction were used to measure changes in thoracic aortic tension in response to vasoactive-inducing compounds. AS increased 2.5- and 2.8-fold in E-cig- and 3R4F-exposed mice, respectively, compared with air-exposed control mice ( P < 0.05). The maximal aortic relaxation to methacholine was 24% and 33% lower in E-cig- and 3R4F-exposed mice, respectively, than in controls ( P < 0.05). No differences were noted in sodium nitroprusside dilation between the groups. 3R4F exposure altered cardiac function by reducing fractional shortening and ejection fraction after 8 mo ( P < 0.05). A similar, although not statistically significant, tendency was also observed with E-cig exposure ( P < 0.10). Histological and respiratory function data support emphysema-associated changes in 3R4F-exposed, but not E-cig-exposed, mice. Chronic exposure to E-cig vapor accelerates AS, significantly impairs aortic endothelial function, and may lead to impaired cardiac function. The clinical implication from this study is that chronic use of E-cigs, even at relatively low exposure levels, induces cardiovascular dysfunction. NEW & NOTEWORTHY Electronic cigarettes (E-cigs) are marketed as safe, but there has been insufficient long-term exposure to humans to justify these claims. This is the first study to report the long-term in vivo vascular consequences of 8 mo of exposure to E-cig vapor in mice (equivalent to ~25 yr of exposure in humans). We report that E-cig exposure increases arterial stiffness and impairs normal vascular reactivity responses, similar to other risk factors, including cigarette smoking, which contribute to the development of cardiovascular disease.
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Affiliation(s)
- I Mark Olfert
- Division of Exercise Physiology, School of Medicine, West Virginia University , Morgantown, West Virginia.,Department of Physiology, Pharmacology, and Neurosciences, School of Medicine, West Virginia University , Morgantown, West Virginia.,Robert C. Byrd Health Science Center, West Virginia Clinical and Translational Sciences Institute , Morgantown, West Virginia
| | - Evan DeVallance
- Division of Exercise Physiology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Hannah Hoskinson
- Division of Exercise Physiology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Kayla W Branyan
- Division of Exercise Physiology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Stuart Clayton
- Division of Exercise Physiology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Christopher R Pitzer
- Division of Exercise Physiology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - D Patrick Sullivan
- Division of Exercise Physiology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Matthew J Breit
- Division of Exercise Physiology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Zhongxin Wu
- Department of Anatomy and Neurobiology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Powsiri Klinkhachorn
- Lane Department of Computer Science and Electrical Engineering, School of Engineering, West Virginia University , Morgantown, West Virginia
| | - W Kyle Mandler
- Division of Exercise Physiology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Brett H Erdreich
- Department of Internal Medicine, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Barbara S Ducatman
- Department of Pathology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Randall W Bryner
- Division of Exercise Physiology, School of Medicine, West Virginia University , Morgantown, West Virginia
| | - Piyali Dasgupta
- Department of Pharmacology, Physiology, and Toxicology, School of Medicine, Marshall University, Huntington, West Virginia
| | - Paul D Chantler
- Division of Exercise Physiology, School of Medicine, West Virginia University , Morgantown, West Virginia.,Robert C. Byrd Health Science Center, West Virginia Clinical and Translational Sciences Institute , Morgantown, West Virginia
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32
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Chehab OM, Dakik HA. Interventions for smoking cessation in patients admitted with Acute Coronary Syndrome: a review. Postgrad Med J 2017; 94:116-120. [PMID: 28942430 DOI: 10.1136/postgradmedj-2017-135040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 08/20/2017] [Accepted: 09/09/2017] [Indexed: 11/03/2022]
Abstract
Tobacco smoking contributes to about six million deaths per year and is predicted to increase in the future. Several pharmacological interventions are used for smoking cessation. Trials using nicotine replacement therapy (NRT) in acute coronary syndrome (ACS) showed inconclusive results. Furthermore, three trials using bupropion in patients admitted with ACS failed to show improvement in smoking cessation compared with placebo. Interestingly, only one trial using varenicline was successful in achieving smoking abstinence in the acute setting. With regard to behavioural interventions, a meta-analysis found that telephone counselling was successful in both the acute and stable settings, with greater effect in the acute setting. The best results for smoking cessation were found in trials that used a combination of pharmacological and behavioural interventions. The objective of this report is to review the results of studies on interventions used for smoking cessation after an ACS.
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Affiliation(s)
- Omar M Chehab
- Division of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.,National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Habib A Dakik
- Division of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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33
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Lubin JH, Albanes D, Hoppin JA, Chen H, Lerro CC, Weinstein SJ, Sandler DP, Beane Freeman LE. Greater Coronary Heart Disease Risk With Lower Intensity and Longer Duration Smoking Compared With Higher Intensity and Shorter Duration Smoking: Congruent Results Across Diverse Cohorts. Nicotine Tob Res 2017; 19:817-825. [PMID: 27941116 PMCID: PMC5896542 DOI: 10.1093/ntr/ntw290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/17/2016] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Relative risks (RRs) for coronary heart disease (CHD) by cigarettes/day exhibit a concave pattern, implying the RR increase with each additional cigarette/day consumed decreases with greater intensity. Interpreting this pattern faces limitations, since cigarettes/day alone does not fully characterize smoking-related exposure. A more complete understanding of smoking and CHD risk requires a more comprehensive representation of smoking. METHODS Using Poisson regression, we applied a RR model in pack-years and cigarettes/day to analyze two diverse cohorts, the US Agricultural Health Study, with 4396 CHD events and 1 425 976 person-years of follow-up, and the Finnish Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, with 5979 CHD events and 486 643 person-years. RESULTS In both cohorts, the concave RR pattern with cigarettes/day was consistent with cigarettes/day modifying a linear RR association for CHD by pack-years within categories of cigarettes/day, indicating that strength of the pack-years association depended on cigarettes/day (p < .01). For example, at 50 pack-years (365 000 total cigarettes), estimated RRs of CHD were 2.1 for accrual at 20 cigarettes/day and 1.5 for accrual at 50 cigarettes/day. CONCLUSIONS RRs for CHD increased with pack-years with smoking intensities affecting the strength of association. For equal pack-years, smoking fewer cigarettes/day for longer duration was more deleterious than smoking more cigarettes/day for shorter duration. We have now observed inverse smoking intensity effects in multiple cohorts with differing smoking patterns and other characteristics, suggesting a common underlying phenomenon. IMPLICATIONS Risk of CHD increases with pack-years of smoking, but accrual intensity strongly influences the strength of the association, such that smoking fewer cigarettes/day for longer duration is more deleterious than smoking more cigarettes/day for shorter duration. This observation offers clues to better understanding biological mechanisms, and reinforces the importance of cessation rather than smoking less to reduce CHD risk.
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Affiliation(s)
- Jay H Lubin
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, US National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Demetrius Albanes
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, US National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Jane A Hoppin
- Department of Biological Sciences and Center for Human Health and the Environment, North Carolina State University, Raleigh, NC
| | - Honglei Chen
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC
| | - Catherine C Lerro
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, US National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Stephanie J Weinstein
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, US National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC
| | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, US National Cancer Institute, National Institutes of Health, Bethesda, MD
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34
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Reed RM, Dransfield MT, Eberlein M, Miller M, Netzer G, Pavlovich M, Pollin TI, Scharf SM, Shuldiner AR, Sin D, Mitchell BD. Gender differences in first and secondhand smoke exposure, spirometric lung function and cardiometabolic health in the old order Amish: A novel population without female smoking. PLoS One 2017; 12:e0174354. [PMID: 28362870 PMCID: PMC5375129 DOI: 10.1371/journal.pone.0174354] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 03/07/2017] [Indexed: 01/04/2023] Open
Abstract
Due to their relatively homogeneous lifestyle and living environment, the Amish offer a novel opportunity to study the health associations of tobacco smoke exposure, particularly secondhand smoke. We hypothesized that secondhand smoke exposure is associated with worse pulmonary and cardiometabolic health. We examined cross-sectional data on 3568 Amish study participants, including tobacco use and secondhand smoke exposure from family members included in the study. Thirty-four percent of Amish men reported ever smoking. Of this proportion, 64% used cigars, 46% cigarettes, and 21% pipes. Less than 1% of women reported ever smoking. Smoking was associated with lower spirometric lung function, higher body mass index, lower HDL cholesterol, higher heart rate, lower ankle-brachial index, and larger aortic diameter in men. A greater number of sources of secondhand smoke exposure (defined from the total of spouses, parents, and siblings who smoke) was associated with higher body mass index (p = 0.03) and with higher fasting glucose in men (p = 0.01), but not in women (p = 0.007 for sex*secondhand smoke interaction). Secondhand smoke exposure was also associated with reduced HDL cholesterol only in women (p = 0.002) and a lower heart rate only in men (p = 0.006). Smoking habits among the Old Order Amish are notable for the absence of female participation and a high proportion of cigar and pipe use. Smoking is associated with decreased spirometric indices of lung function and increased cardiovascular risk in this population and secondhand smoke exposure is associated with a greater burden of risk factors for cardiovascular disease. Sex differences in correlations could reflect differences in exposure patterns, mechanisms, or susceptibilities.
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Affiliation(s)
- Robert M. Reed
- University of Maryland School of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, Maryland, United States of America
| | - Mark T. Dransfield
- University of Alabama School of Medicine, Division of Pulmonary and Critical Care Medicine, Birmingham, Alabama, United States of America
| | - Michael Eberlein
- University of Iowa School of Medicine, Division of Pulmonary and Critical Care Medicine, Iowa City, Iowa, United States of America
| | - Michael Miller
- University of Maryland School of Medicine, Division of Endocrinology, Diabetes, and Nutrition, Baltimore, Maryland, United States of America
- Department of Veterans Affairs and Veterans Affairs Medical Center Baltimore Geriatric Research Education and Clinical Center (GRECC), Baltimore, Maryland, United States of America
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, Maryland, United States of America
| | - Giora Netzer
- University of Maryland School of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, Maryland, United States of America
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, Maryland, United States of America
| | - Mary Pavlovich
- University of Maryland School of Medicine, Division of Endocrinology, Diabetes, and Nutrition, Baltimore, Maryland, United States of America
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, Maryland, United States of America
| | - Toni I. Pollin
- University of Maryland School of Medicine, Division of Endocrinology, Diabetes, and Nutrition, Baltimore, Maryland, United States of America
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, Maryland, United States of America
| | - Steven M. Scharf
- University of Maryland School of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, Maryland, United States of America
| | - Alan R. Shuldiner
- University of Maryland School of Medicine, Division of Endocrinology, Diabetes, and Nutrition, Baltimore, Maryland, United States of America
- Department of Veterans Affairs and Veterans Affairs Medical Center Baltimore Geriatric Research Education and Clinical Center (GRECC), Baltimore, Maryland, United States of America
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, Maryland, United States of America
| | - Don Sin
- University of British Columbia Respiratory Medicine; Vancouver, British Columbia, Canada
| | - Braxton D. Mitchell
- University of Maryland School of Medicine, Division of Endocrinology, Diabetes, and Nutrition, Baltimore, Maryland, United States of America
- Department of Veterans Affairs and Veterans Affairs Medical Center Baltimore Geriatric Research Education and Clinical Center (GRECC), Baltimore, Maryland, United States of America
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, Maryland, United States of America
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Risk of Cardiovascular Disease from Cumulative Cigarette Use and the Impact of Smoking Intensity. Epidemiology 2017; 27:395-404. [PMID: 26745609 DOI: 10.1097/ede.0000000000000437] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Relative risks (RRs) for cardiovascular disease (CVD) by smoking rate exhibit a concave pattern, with RRs in low rate smokers exceeding a linear extrapolation from higher rate smokers. However, cigarettes/day does not by itself fully characterize smoking-related risks. A reexamination of the concave pattern using a comprehensive representation of smoking may enhance insights. METHODS Data were from the Atherosclerosis Risk in Communities (ARIC) Study, a prospective cohort enrolled in four areas of the US in 1987-1989. Follow-up was through 2008. Analyses included 14,233 participants, 245,915 person-years, and 3,411 CVD events. RESULTS The concave RRs with cigarettes/day were consistent with cigarettes/day modifying a linear RR association of pack-years with CVD (i.e., strength of the pack-years association depended on cigarettes/day, indicating that the manner of pack-years accrual impacted risk). Smoking fewer cigarettes/day for longer duration was more deleterious than smoking more cigarettes/day for shorter duration (P < 0.01). For 50 pack-years (365,000 cigarettes), estimated RRs of CVD were 2.1 for accrual at 20 cigarettes/day and 1.6 for accrual at 50 cigarettes/day. Years since smoking cessation did not alter the diminishing strength of association with increasing cigarettes/day. Analyses that accounted for competing risks did not affect findings. CONCLUSION Pack-years remained the primary determinant of smoking-related CVD risk; however, accrual influenced RRs. For equal pack-years, smoking fewer cigarettes/day for longer duration was more deleterious than smoking more cigarettes/day for shorter duration. This observation provides clues to better understanding the biological mechanisms, and reinforces the importance of cessation rather than smoking less to reduce CVD risk.
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Stewart J, Manmathan G, Wilkinson P. Primary prevention of cardiovascular disease: A review of contemporary guidance and literature. JRSM Cardiovasc Dis 2017; 6:2048004016687211. [PMID: 28286646 PMCID: PMC5331469 DOI: 10.1177/2048004016687211] [Citation(s) in RCA: 177] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 11/22/2016] [Accepted: 12/02/2016] [Indexed: 12/25/2022] Open
Abstract
Cardiovascular disease is a significant and ever-growing problem in the United Kingdom, accounting for nearly one-third of all deaths and leading to significant morbidity. It is also of particular and pressing interest as developing countries experience a change in lifestyle which introduces novel risk factors for cardiovascular disease, leading to a boom in cardiovascular disease risk throughout the developing world. The burden of cardiovascular disease can be ameliorated by careful risk reduction and, as such, primary prevention is an important priority for all developers of health policy. Strong consensus exists between international guidelines regarding the necessity of smoking cessation, weight optimisation and the importance of exercise, whilst guidelines vary slightly in their approach to hypertension and considerably regarding their approach to optimal lipid profile which remains a contentious issue. Previously fashionable ideas such as the polypill appear devoid of in-vivo efficacy, but there remain areas of future interest such as the benefit of serum urate reduction and utility of reduction of homocysteine levels.
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Affiliation(s)
- Jack Stewart
- Department of Cardiology, Ashford & St Peter's NHS Foundation Trust, London, UK; Institute of Cardiovascular Research, Biological Sciences, University of London, Surrey, UK
| | | | - Peter Wilkinson
- Department of Cardiology, Ashford & St Peter's NHS Foundation Trust, London, UK
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Bouchard P, Carra MC, Boillot A, Mora F, Rangé H. Risk factors in periodontology: a conceptual framework. J Clin Periodontol 2016; 44:125-131. [PMID: 27862138 DOI: 10.1111/jcpe.12650] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2016] [Indexed: 12/17/2022]
Abstract
AIM The definition and assessment of risk factors, risk indicators and predisposing factors are of paramount importance in the understanding of the pathogenesis of periodontitis, as well as in its prevention and treatment. This article aims to emphasize the concepts of causal chains and the causal network of risk factors in periodontitis. MATERIALS AND METHODS This is a narrative review focusing on two main questions: (1) what is a risk in periodontology? and (2) how can a risk be assessed? RESULTS The probability of the occurrence of an adverse outcome following exposure is not sufficient to analyse the impact of a risk factor on the disease. A network model for the pathway of risk factors in the pathogenesis of periodontitis is described. This article emphasizes the concepts of causal chains and the causal network of risk factors in periodontitis. CONCLUSION Chronic periodontal diseases are among the most complex non-communicable diseases. A conceptual framework intended to clarify the relationship between risk and causality may improve the understanding of the underlying mechanisms of chronic diseases. The proposed causal network may provide a model to assess the role of risk factors in periodontitis.
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Affiliation(s)
- Philippe Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7-Denis Diderot University, U.F.R. of Odontology, Paris, France.,EA 2496, Paris 5-Descartes University, U.F.R. of Odontology, Paris, France
| | - Maria Clotilde Carra
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7-Denis Diderot University, U.F.R. of Odontology, Paris, France.,INSERM, U1018, Villejuif, France
| | - Adrien Boillot
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7-Denis Diderot University, U.F.R. of Odontology, Paris, France
| | - Francis Mora
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7-Denis Diderot University, U.F.R. of Odontology, Paris, France
| | - Hélène Rangé
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7-Denis Diderot University, U.F.R. of Odontology, Paris, France.,EA 2496, Paris 5-Descartes University, U.F.R. of Odontology, Paris, France
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Dias NR, Peechatka AL, Janes AC. Insula reactivity to negative stimuli is associated with daily cigarette use: A preliminary investigation using the Human Connectome Database. Drug Alcohol Depend 2016; 159:277-80. [PMID: 26748411 PMCID: PMC4724488 DOI: 10.1016/j.drugalcdep.2015.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 12/14/2015] [Accepted: 12/14/2015] [Indexed: 01/29/2023]
Abstract
BACKGROUND Individuals who smoke more cigarettes per day are at greater risk for developing smoking-related illness and have more difficulty quitting. Withdrawal-related negative mood is one factor thought to motivate drug use. However, heavy smokers are generally more sensitive to negative affect, not just negative emotion stemming from withdrawal. One possibility is that individual differences in how the brain processes negative stimuli may impact smoking use. Given the wealth of data implicating the insula in nicotine dependence and affective processing we hypothesize that the number of cigarettes an individual smokes per day will relate to insula reactivity to negative stimuli. METHODS A functional magnetic resonance imaging (fMRI) emotional processing task collected by the Human Connectome Project was assessed in 21 daily tobacco smokers who reported smoking between 5 and 20 cigarettes per day. The number of cigarettes smoked per day was correlated with right and left anterior insula reactivity to faces expressing a negative emotion relative to a control. This anterior insula region of interest has been associated with treatment outcome and smoking cue-reactivity in our prior work. RESULTS Those who smoked more daily cigarettes showed greater right insula reactivity to negative stimuli (r=0.564, p=0.008). Left insula reactivity was not associated with cigarettes smoked per day. CONCLUSION Smokers who use more cigarettes per day have greater insula reactivity to negative stimuli, furthering the field's understanding of the insula's involvement in nicotine use. This preliminary work also suggests a mechanism contributing to higher rates of daily smoking.
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Affiliation(s)
- NR Dias
- McLean Neuroimaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
| | - AL Peechatka
- McLean Neuroimaging Center, McLean Hospital, Belmont, MA, USA,Suffolk University, Boston, MA, USA
| | - AC Janes
- McLean Neuroimaging Center, McLean Hospital, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, Belmont, MA, USA,Corresponding author at: McLean Neuroimaging Center, McLean Hospital, 115 Mill St. Belmont, MA 02478.
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Sipilä JOT, Gunn JM, Kauko T, Rautava P, Kytö V. Association of restaurant smoking ban and the incidence of acute myocardial infarction in Finland. BMJ Open 2016; 6:e009320. [PMID: 26826146 PMCID: PMC4735218 DOI: 10.1136/bmjopen-2015-009320] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To describe the changes in nationwide acute myocardial infarction (AMI) incidence following the implementation of a law banning smoking indoors in restaurants on 1 June 2007. METHODS Retrospective registry study of all hospitalisations for AMI in Finland. All 34,887 hospitalisations for AMI between 1 June 2005 and 31 May 2009 were identified from the Care Register for Health Care (CRHC) and statistics for tobacco consumption were obtained from the National Institute for Health and Welfare. Comorbidities for individual hospitalisations were searched from the CRHC. RESULTS The incidence rate of AMI was reduced by 6.3% (95% CI 4.1% to 8.6%; p<0.0001) in the latter half of the study period following the smoking ban when adjusted for age, gender and overall population prevalence of smoking. Short-term incidence of AMI (6-month prior vs 6 months after the smoking ban) was also reduced (4.5%, 95% CI 0.2% to 9.0%; p=0.0399) and was largest in the working middle-aged group (40-50 years) but observed also in the oldest age group (>70 years). The incidence rates declined similarly for men and women. CONCLUSIONS Banning indoor tobacco smoking in restaurants was associated with a mild additional reduction in AMI incidence on a nationwide level in Finland.
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Affiliation(s)
- Jussi Olli Tapani Sipilä
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland Department of Neurology, University of Turku, Turku, Finland Neurology Clinic, North Karelia Central Hospital, Joensuu, Finland
| | - Jarmo Mikael Gunn
- Heart Center, Turku University Hospital, Turku, Finland Department of Surgery, Faculty of Medicine, University of Turku, Turku, Finland
| | - Tommi Kauko
- Department of Biostatistics, Faculty of Medicine, University of Turku, Turku, Finland
| | - Päivi Rautava
- Department of Public Health, Faculty of Medicine, University of Turku, Turku, Finland
| | - Ville Kytö
- Heart Center, Turku University Hospital, Turku, Finland Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Morris PB, Ference BA, Jahangir E, Feldman DN, Ryan JJ, Bahrami H, El-Chami MF, Bhakta S, Winchester DE, Al-Mallah MH, Sanchez Shields M, Deedwania P, Mehta LS, Phan BAP, Benowitz NL. Cardiovascular Effects of Exposure to Cigarette Smoke and Electronic Cigarettes: Clinical Perspectives From the Prevention of Cardiovascular Disease Section Leadership Council and Early Career Councils of the American College of Cardiology. J Am Coll Cardiol 2016; 66:1378-91. [PMID: 26383726 DOI: 10.1016/j.jacc.2015.07.037] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 07/12/2015] [Accepted: 07/14/2015] [Indexed: 02/07/2023]
Abstract
Cardiovascular morbidity and mortality as a result of inhaled tobacco products continues to be a global healthcare crisis, particularly in low- and middle-income nations lacking the infrastructure to develop and implement effective public health policies limiting tobacco use. Following initiation of public awareness campaigns 50 years ago in the United States, considerable success has been achieved in reducing the prevalence of cigarette smoking and exposure to secondhand smoke. However, there has been a slowing of cessation rates in the United States during recent years, possibly caused by high residual addiction or fatigue from cessation messaging. Furthermore, tobacco products have continued to evolve faster than the scientific understanding of their biological effects. This review considers selected updates on the genetics and epigenetics of smoking behavior and associated cardiovascular risk, mechanisms of atherogenesis and thrombosis, clinical effects of smoking and benefits of cessation, and potential impact of electronic cigarettes on cardiovascular health.
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Affiliation(s)
- Pamela B Morris
- Medical University of South Carolina, Charleston, South Carolina.
| | - Brian A Ference
- Wayne State University School of Medicine, Detroit, Michigan
| | - Eiman Jahangir
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana
| | | | - John J Ryan
- University of Utah Health Science Center, Salt Lake City, Utah
| | - Hossein Bahrami
- Stanford Cardiovascular Institute, Stanford University, Stanford, California
| | | | - Shyam Bhakta
- Northeast Ohio Medical University College of Medicine, Rootstown, Ohio
| | | | - Mouaz H Al-Mallah
- Wayne State University School of Medicine, Detroit, Michigan; King Abdul-Aziz Cardiac Center, Riyadh, Saudi Arabia
| | | | | | | | - Binh An P Phan
- University of California, San Francisco, San Francisco, California
| | - Neal L Benowitz
- University of California, San Francisco, San Francisco, California
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Fischer F, Kraemer A. Meta-analysis of the association between second-hand smoke exposure and ischaemic heart diseases, COPD and stroke. BMC Public Health 2015; 15:1202. [PMID: 26627181 PMCID: PMC4667413 DOI: 10.1186/s12889-015-2489-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/12/2015] [Indexed: 02/07/2023] Open
Abstract
Background Second-hand smoke (SHS) is the most important contaminant of indoor air in first world countries. The risks associated with SHS exposure are highly relevant, because many people are regularly, and usually involuntarily, exposed to SHS. This study aims to quantify the effects of SHS exposure. Therefore, its impact on ischaemic heart diseases (IHD), chronic obstructive pulmonary diseases (COPD) and stroke will be considered. Methods A systematic literature review was conducted to identify articles dealing with the association between SHS and the three outcomes IHD, COPD and stroke. Overall, 24 articles were included in a meta-analysis using a random effects model. Effect sizes stratified for sex and for both sexes combined were calculated. Results The synthesis of primary studies revealed significant effect sizes for the association between SHS exposure and all three outcomes. The highest RR for both sexes combined was found for COPD (RR = 1.66, 95 % CI: 1.38–2.00). The RR for both sexes combined was 1.35 (95 % CI: 1.22–1.50) for stroke and 1.27 (95 % CI: 1.10–1.48) for IHD. The risks were higher in women than in men for all three outcomes. Conclusions This is the first study to calculate effect sizes for the association between SHS exposure and the disease outcomes IHD, COPD, and stroke at once. Overall, the effect sizes are comparable with previous findings in meta-analyses and therefore assumed to be reliable. The results indicate the high relevance of public health campaigns and legislation to protect non-smokers from the adverse health effects attributable to SHS exposure. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2489-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Florian Fischer
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, P.O. Box 100 131, 33501, Bielefeld, Germany.
| | - Alexander Kraemer
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, P.O. Box 100 131, 33501, Bielefeld, Germany.
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Sivadasan Pillai H, Ganapathi S. Tobacco Cessation Approaches and Impact on CVD. Glob Heart 2015; 7:129-38. [PMID: 25691309 DOI: 10.1016/j.gheart.2012.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 06/06/2012] [Indexed: 12/30/2022] Open
Affiliation(s)
- Harikrishnan Sivadasan Pillai
- Department of Cardiology, Sree ChitraTirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala 695011, India; Correspondence: S. Harikrishnan
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Rutten LJF, Blake KD, Agunwamba AA, Grana RA, Wilson PM, Ebbert JO, Okamoto J, Leischow SJ. Use of E-Cigarettes Among Current Smokers: Associations Among Reasons for Use, Quit Intentions, and Current Tobacco Use. Nicotine Tob Res 2015; 17:1228-34. [PMID: 25589678 DOI: 10.1093/ntr/ntv003] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 12/29/2014] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Research has documented growing availability and use of e-cigarettes in the United States over the last decade. METHODS We conducted a national panel survey of current adult cigarette smokers to assess attitudes, beliefs, and behaviors relating to e-cigarette use in the United States (N = 2,254). RESULTS Among current cigarette smokers, 20.4% reported current use of e-cigarettes on some days and 3.7% reported daily use. Reported reasons for e-cigarette use included: quit smoking (58.4%), reduce smoking (57.9%), and reduce health risks (51.9%). No significant differences in sociodemographic characteristics between e-cigarette users and nonusers were observed. Prior quit attempts were reported more frequently among e-cigarette users (82.8%) than nonusers (74.0%). Intention to quit was reported more frequently among e-cigarette users (64.7%) than nonusers (46.8%). Smokers intending to quit were more likely to be e-cigarette users than those not intending to quit (odds ratio [OR] = 1.90, CI =1.36-2.65). Those who used e-cigarettes to try to quit smoking (OR = 2.25, CI = 1.25-4.05), reduce stress (OR = 3.66, CI = 1.11-12.09), or because they cost less (OR = 3.42, CI = 1.64-7.13) were more likely to report decreases in cigarette smoking than those who did not indicate these reasons. Smokers who reported using e-cigarettes to quit smoking (OR = 16.25, CI = 8.32-31.74) or reduce stress (OR = 4.30, CI = 1.32-14.09) were significantly more likely to report an intention to quit than those who did not indicate those reasons for using e-cigarettes. CONCLUSIONS Nearly a quarter of smokers in our study reported e-cigarettes use, primarily motivated by intentions to quit or reduce smoking. These findings identify a clinical and public health opportunity to re-engage smokers in cessation efforts.
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Affiliation(s)
- Lila J Finney Rutten
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN;
| | - Kelly D Blake
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Amenah A Agunwamba
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Rachel A Grana
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Patrick M Wilson
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Jon O Ebbert
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Janet Okamoto
- Health Sciences Research Mayo Clinic, Scottsdale, AZ
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Ebbert JO, Agunwamba AA, Rutten LJ. Counseling patients on the use of electronic cigarettes. Mayo Clin Proc 2015; 90:128-34. [PMID: 25572196 DOI: 10.1016/j.mayocp.2014.11.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 11/07/2014] [Accepted: 11/07/2014] [Indexed: 02/08/2023]
Abstract
Electronic cigarettes (e-cigarettes) have substantially increased in popularity. Clear evidence about the safety of e-cigarettes is lacking, and laboratory experiments and case reports suggest these products may be associated with potential adverse health consequences. The effectiveness of e-cigarettes for smoking cessation is modest and appears to be comparable to the nicotine patch combined with minimal behavioral support. Although a role for e-cigarettes in the treatment of tobacco dependence may emerge in the future, the potential risk of e-cigarettes outweighs their known benefit as a recommended tobacco treatment strategy by clinicians. Patients should be counseled on the known efficacy and potential risks of e-cigarettes.
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Affiliation(s)
- Jon O Ebbert
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN.
| | - Amenah A Agunwamba
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN
| | - Lila J Rutten
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN; Department of Health Sciences Research, Mayo Clinic, Rochester, MN
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Pujades-Rodriguez M, George J, Shah AD, Rapsomaniki E, Denaxas S, West R, Smeeth L, Timmis A, Hemingway H. Heterogeneous associations between smoking and a wide range of initial presentations of cardiovascular disease in 1937360 people in England: lifetime risks and implications for risk prediction. Int J Epidemiol 2014; 44:129-41. [PMID: 25416721 PMCID: PMC4339760 DOI: 10.1093/ije/dyu218] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background It is not known how smoking affects the initial presentation of a wide range of chronic and acute cardiovascular diseases (CVDs), nor the extent to which associations are heterogeneous. We estimated the lifetime cumulative incidence of 12 CVD presentations, and examined associations with smoking and smoking cessation. Methods Cohort study of 1.93 million people aged ≥30years, with no history of CVD, in 1997–2010. Individuals were drawn from linked electronic health records in England, covering primary care, hospitalizations, myocardial infarction (MI) registry and cause-specific mortality (the CALIBER programme). Results During 11.6 million person-years of follow-up, 114 859 people had an initial non-fatal or fatal CVD presentation. By age 90 years, current vs never smokers’ lifetime risks varied from 0.4% vs 0.2% for subarachnoid haemorrhage (SAH), to 8.9% vs 2.6% for peripheral arterial disease (PAD). Current smoking showed no association with cardiac arrest or sudden cardiac death [hazard ratio (HR) = 1.04, 95% confidence interval (CI) 0.91–1.19).The strength of association differed markedly according to disease type: stable angina (HR = 1.08, 95% CI 1.01–1.15),transient ischaemic attack (HR = 1.41, 95% CI 1.28-1.55), unstable angina (HR = 1.54, 95% CI 1.38–1.72), intracerebral haemorrhage (HR = 1.61, 95% CI 1.37–1.89), heart failure (HR = 1.62, 95% CI 1.47–1.79), ischaemic stroke (HR = 1.90, 95% CI 1.72–2.10), MI (HR = 2.32, 95% CI 2.20–2.45), SAH (HR = 2.70, 95% CI 2.27–3.21), PAD (HR = 5.16, 95% CI 4.80–5.54) and abdominal aortic aneurysm (AAA) (HR = 5.18, 95% CI 4.61–5.82). Population-attributable fractions were lower for women than men for unheralded coronary death, ischaemic stroke, PAD and AAA. Ten years after quitting smoking, the risks of PAD, AAA (in men) and unheralded coronary death remained increased (HR = 1.36, 1.47 and 2.74, respectively). Conclusions The heterogeneous associations of smoking with different CVD presentations suggests different underlying mechanisms and have important implications for research, clinical screening and risk prediction.
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Affiliation(s)
- Mar Pujades-Rodriguez
- Farr Institute of Health Informatics Research, University College London, London, UK, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK and National Institute for Health Research, Biomedical Research Unit, Barts Health NHS Trust, London, UK
| | - Julie George
- Farr Institute of Health Informatics Research, University College London, London, UK, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK and National Institute for Health Research, Biomedical Research Unit, Barts Health NHS Trust, London, UK
| | - Anoop Dinesh Shah
- Farr Institute of Health Informatics Research, University College London, London, UK, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK and National Institute for Health Research, Biomedical Research Unit, Barts Health NHS Trust, London, UK
| | - Eleni Rapsomaniki
- Farr Institute of Health Informatics Research, University College London, London, UK, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK and National Institute for Health Research, Biomedical Research Unit, Barts Health NHS Trust, London, UK
| | - Spiros Denaxas
- Farr Institute of Health Informatics Research, University College London, London, UK, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK and National Institute for Health Research, Biomedical Research Unit, Barts Health NHS Trust, London, UK
| | - Robert West
- Farr Institute of Health Informatics Research, University College London, London, UK, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK and National Institute for Health Research, Biomedical Research Unit, Barts Health NHS Trust, London, UK
| | - Liam Smeeth
- Farr Institute of Health Informatics Research, University College London, London, UK, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK and National Institute for Health Research, Biomedical Research Unit, Barts Health NHS Trust, London, UK
| | - Adam Timmis
- Farr Institute of Health Informatics Research, University College London, London, UK, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK and National Institute for Health Research, Biomedical Research Unit, Barts Health NHS Trust, London, UK
| | - Harry Hemingway
- Farr Institute of Health Informatics Research, University College London, London, UK, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK and National Institute for Health Research, Biomedical Research Unit, Barts Health NHS Trust, London, UK
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Association of inflammatory and oxidative stress biomarkers in subjects with cardiovascular risk. Am J Ther 2014; 20:422-31. [PMID: 23344094 DOI: 10.1097/mjt.0b013e318235f32f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cardiovascular disease is originated in the vascular endothelium, which controls the homeostasis and the filtration and diffusion of molecules from blood to the tissues. The classical cardiovascular risk factors (CRFs) act directly on the endothelium through an increase in the production of reactive oxygen species, promoting an endothelial activation mediated by the expression of adhesion and proinflammatory molecules, which lead to endothelial dysfunction, the progression of the atherosclerotic plaque, and the onset of cardiovascular disease. The objective of this study was to analyze the association of superoxide dismutase, catalase, gluthatione peroxidase, and lipoperoxidation with fibrinogen, interleukin (IL)-6, tumor necrosis factor-α, and vascular cell adhesion molecule (VCAM)-1 in subjects with cardiovascular risk (CVR) and CRF. This was a cross-sectional study of 114 individuals; oxidative stress (superoxide dismutase, catalase, gluthatione peroxidase, and lipoperoxidation) and inflammatory (fibrinogen, IL-6, tumor necrosis factor-α, and VCAM-1) biomarkers were measured; a CVR score (Framingham) and its CRF were taken into consideration to classify the participants. Twenty-nine subjects out of a total of 114 had high CVR. Smokers and subjects with diabetes (43 subjects) were excluded from the low CVR group. Significant decreases in lipoperoxidation, IL-6, and VCAM-1 and an increase in SOD were found in the high CVR group (P ≤ 0.05). Individual analysis of each CRF in the 114 subjects revealed a different pattern in the biomarkers' statistical differences. Concluding that the biomarkers show statistical differences in each CRF, especially IL-6, VCAM-1, and SOD; therefore, these are highly recommended to be used as biomarkers of the oxidative stress and inflammatory status in CVR.
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Bullen C. Impact of tobacco smoking and smoking cessation on cardiovascular risk and disease. Expert Rev Cardiovasc Ther 2014; 6:883-95. [DOI: 10.1586/14779072.6.6.883] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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48
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Prugger C, Wellmann J, Heidrich J, De Bacquer D, Perier MC, Empana JP, Reiner Ž, Fras Z, Jennings C, Kotseva K, Wood D, Keil U. Passive smoking and smoking cessation among patients with coronary heart disease across Europe: results from the EUROASPIRE III survey. Eur Heart J 2013; 35:590-8. [DOI: 10.1093/eurheartj/eht538] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christof Prugger
- Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, 56 rue Leblanc, 75015 Paris, France
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Jürgen Wellmann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Jan Heidrich
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Dirk De Bacquer
- Department of Public Health, University of Ghent, Ghent, Belgium
| | - Marie-Cécile Perier
- Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, 56 rue Leblanc, 75015 Paris, France
| | - Jean-Philippe Empana
- Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, 56 rue Leblanc, 75015 Paris, France
| | - Željko Reiner
- Department of Internal Medicine, University Hospital Centre, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zlatko Fras
- Department of Vascular Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Catriona Jennings
- Cardiovascular Medicine, Imperial College London, London, United Kingdom
| | - Kornelia Kotseva
- Cardiovascular Medicine, Imperial College London, London, United Kingdom
| | - David Wood
- Cardiovascular Medicine, Imperial College London, London, United Kingdom
| | - Ulrich Keil
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
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Vander Weg MW, Rosenthal GE, Vaughan Sarrazin M. Smoking bans linked to lower hospitalizations for heart attacks and lung disease among medicare beneficiaries. Health Aff (Millwood) 2013; 31:2699-707. [PMID: 23213154 DOI: 10.1377/hlthaff.2011.0385] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Policies limiting exposure to cigarette smoke have been associated with reduced hospitalizations for heart attacks, but little is known about the impact of smoking bans on other health conditions and whether findings from individual communities generalize to other areas. We investigated the association between smoking bans targeting workplaces, restaurants, and bars passed throughout the United States during 1991-2008 and hospital admissions for smoking-related illnesses-acute myocardial infarction and chronic obstructive pulmonary disease-among Medicare beneficiaries age sixty-five or older. Risk-adjusted hospital admission rates for acute myocardial infarction fell 20-21 percent thirty-six months following implementation of new restaurant, bar, and workplace smoking bans. Admission rates for chronic obstructive pulmonary disease fell 11 percent where workplace smoking bans were in place and 15 percent where bar smoking bans were present. By contrast, very little effect was found for hospitalization for gastrointestinal hemorrhage and hip fracture-two conditions largely unrelated to smoking and examined as points of comparison. These findings provide further support for the public health benefits of laws that limit exposure to tobacco smoke.
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Affiliation(s)
- Mark W Vander Weg
- University of Iowa Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
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50
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Barua RS, Ambrose JA. Mechanisms of Coronary Thrombosis in Cigarette Smoke Exposure. Arterioscler Thromb Vasc Biol 2013; 33:1460-7. [DOI: 10.1161/atvbaha.112.300154] [Citation(s) in RCA: 153] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Acute rupture or erosion of a coronary atheromatous plaque and subsequent coronary artery thrombosis cause the majority of sudden cardiac deaths and myocardial infarctions. Cigarette smoking is a major risk factor for acute coronary thrombosis. Indeed, a majority of sudden cardiac deaths attributable to acute thrombosis are in cigarette smokers. Both active and passive cigarette smoke exposure seem to increase the risk of coronary thrombosis and myocardial infarctions. Cigarette smoke exposure seems to alter the hemostatic process via multiple mechanisms, which include alteration of the function of endothelial cells, platelets, fibrinogen, and coagulation factors. This creates an imbalance of antithrombotic/prothrombotic factors and profibrinolytic/antifibrinolytic factors that support the initiation and propagation of thrombosis.
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Affiliation(s)
- Rajat S. Barua
- From the Department of Medicine, Division of Cardiology, University of Kansas School of Medicine, KS and Division of Cardiology, Kansas City Veterans Affairs Medical Center, MO (R.S.B.); and Department of Medicine, Division of Cardiology, University of California San Francisco, Fresno, CA (J.A.A.)
| | - John A. Ambrose
- From the Department of Medicine, Division of Cardiology, University of Kansas School of Medicine, KS and Division of Cardiology, Kansas City Veterans Affairs Medical Center, MO (R.S.B.); and Department of Medicine, Division of Cardiology, University of California San Francisco, Fresno, CA (J.A.A.)
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