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Ajnakina O, Steptoe A. The shared genetic architecture of smoking behaviours and psychiatric disorders: evidence from a population-based longitudinal study in England. BMC Genom Data 2023; 24:31. [PMID: 37254052 DOI: 10.1186/s12863-023-01131-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 05/18/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Considering the co-morbidity of major psychiatric disorders and intelligence with smoking, to increase our understanding of why some people take up smoking or continue to smoke, while others stop smoking without progressing to nicotine dependence, we investigated the genetic propensities to psychiatric disorders and intelligence as determinants of smoking initiation, heaviness of smoking and smoking cessation in older adults from the general population. RESULTS Having utilised data from the English Longitudinal Study of Ageing (ELSA), our results showed that one standard deviation increase in MDD-PGS was associated with increased odds of being a moderate-heavy smoker (odds ratio [OR] = 1.11, SE = 0.04, 95%CI = 1.00-1.24, p = 0.028). There were no other significant associations between SZ-PGS, BD-PGS, or IQ-PGS and smoking initiation, heaviness of smoking and smoking cessation in older adults from the general population in the UK. CONCLUSIONS Smoking is a behaviour that does not appear to share common genetic ground with schizophrenia, bipolar disorders, and intelligence in older adults, which may suggest that it is more likely to be modifiable by smoking cessation interventions. Once started to smoke, older adults with a higher polygenic predisposition to major depressive disorders are more likely to be moderate to heavy smokers, implying that these adults may require targeted smoking cessation services.
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Affiliation(s)
- Olesya Ajnakina
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 16 De Crespigny Park, London, SE5 8AF, UK.
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, University of London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 16 De Crespigny Park, London, SE5 8AF, UK
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Peiffer G, Underner M, Perriot J, Ruppert AM, Tiotiu A. [Smoking cessation and lung cancer screening]. Rev Mal Respir 2020; 37:722-734. [PMID: 33129612 DOI: 10.1016/j.rmr.2020.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/03/2020] [Indexed: 02/08/2023]
Abstract
Several studies have shown that lung cancer screening, using annual low-dose computed tomography (CT) scan in a targeted population of smokers and ex-smokers reduces overall and lung cancer specific mortality rates. This form of screening strategy is not currently established for use in France by the French High Authority for Health. Quitting smoking is the most important measure in reducing mortality from lung cancer. The maximum benefit in reducing mortality from lung cancer should be seen through an effective combination of smoking cessation intervention and chest CT screening to identify early, curable disease. However, current data to guide clinicians in the choice of smoking cessation interventions in this specific context are limited due to the small number of randomized studies that have been carried out. The optimal approach to smoking cessation during lung cancer screening needs to be clarified by new studies comparing different motivation strategies, establishing the ideal moment to propose stopping smoking and the most effective therapies to use.
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Affiliation(s)
- G Peiffer
- Service de pneumologie, CHR de Metz-Thionville, 1, allée du Château, 57085 Metz, France.
| | - M Underner
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 86021 Poitiers, France
| | - J Perriot
- CLAT 63, dispensaire Emile-Roux, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - A-M Ruppert
- Unité de tabacologie, service de pneumologie, hôpital Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75970 Paris cedex 20, France
| | - A Tiotiu
- Département de pneumologie, CHRU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
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Jia H, Lubetkin EI. Dose-response effect of smoking status on quality-adjusted life years among U.S. adults aged 65 years and older. J Public Health (Oxf) 2019; 39:e194-e201. [PMID: 27613764 DOI: 10.1093/pubmed/fdw096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 08/01/2016] [Indexed: 12/20/2022] Open
Abstract
Background To estimate the impact of smoking on quality-adjusted life years (QALY) for US adults aged 65 years and older. Methods Using the 2003-08 National Health and Nutrition Examination Survey Linked Mortality File, we estimated the mean QALY throughout the remaining lifetime by participants' smoking status as well as smoking intensity and time since cessation. Results Never, former and current smokers had a mean QALY of 16.1, 12.7 and 7.3 years, respectively. Among current smokers, those who started smoking before age 18 had fewer QALYs than those who started at or after age 18 (6.0 and 8.5 years, respectively) and those smoking ≥20 cigarettes per day had fewer QALYs than those smoking <20 cigarettes per day (6.6 and 8.1 years, respectively). QALYs also declined with a longer duration of smoking and a shorter time since cessation. The potential gains if a person quit smoking would be 5.4 QALYs, and the gains would increase with a longer time since quitting as well as quitting at a younger age. Conclusions This study demonstrated the dose-response effect of smoking status on QALY. The results indicate the health benefits of tobacco cessation at any age and sizeable losses for former or current smokers.
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Affiliation(s)
- Haomiao Jia
- Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, New York, NY, USA
| | - Erica I Lubetkin
- Department of Community Health and Social Medicine, CUNY Medical School, New York, NY, USA
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Gonçalves IB, Lebrão ML, Duarte YADO, Wagner GA, Zanetta DMT. Nutrition status of elderly smokers and former smokers of São Paulo City, Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 21Suppl 02:e180013. [PMID: 30726358 DOI: 10.1590/1980-549720180013.supl.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 03/31/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The concomitance of smoking and poor dietary habits represents a worsened prognosis of health and quality of life for elderly. The aim of this study was to characterize the nutritional status of elderly who were smokers and former smokers and residents of São Paulo city. METHODS A cross-sectional study was conducted in 2010 with a representative sample of 1,345 individuals aged 60 years and over, who were part of the elderly cohort monitored at the SABE Study. Sociodemographic, health, and nutritional aspects of the elderly were described, according to their tobacco use in life. RESULTS The proportion of smokers and former smokers was 12.9 and 54.7%, 11.0 and 25.2%, and 11.8 and 37.2% for male, female, and total population, respectively. For both genders, increasing age decreased the proportion of smokers. The proportion of proper fruit intake was smaller for female smokers. Poorer nutritional status was observed in smokers, who had fewer meals per day and greater frequency of underweight compared with elderly nonsmokers. CONCLUSION Considering the impact of inappropriate eating habits and smoking on health, elderly smokers deserve special attention on their nutritional status.
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Affiliation(s)
- Isis Bonfitto Gonçalves
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Maria Lúcia Lebrão
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | | | - Gabriela Arantes Wagner
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo - São Paulo (SP), Brasil
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Fucito LM, Czabafy S, Hendricks PS, Kotsen C, Richardson D, Toll BA. Pairing smoking-cessation services with lung cancer screening: A clinical guideline from the Association for the Treatment of Tobacco Use and Dependence and the Society for Research on Nicotine and Tobacco. Cancer 2016; 122:1150-9. [PMID: 26916412 PMCID: PMC4828323 DOI: 10.1002/cncr.29926] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 01/12/2016] [Accepted: 01/21/2016] [Indexed: 12/17/2022]
Abstract
Smoking cessation is crucial for reducing cancer risk and premature mortality. The US Preventive Services Task Force (USPSTF) has recommended annual lung cancer screening with low-dose computed tomography (LDCT), and the Center for Medicare and Medicaid Services recently approved lung screening as a benefit for patients ages 55 to 77 years who have a 30 pack-year history. The Society for Research on Nicotine and Tobacco (SRNT) and the Association for the Treatment of Tobacco Use and Dependence (ATTUD) developed the guideline described in this commentary based on an illustrative literature review to present the evidence for smoking-cessation health benefits in this high-risk group and to provide clinical recommendations for integrating evidence-based smoking-cessation treatment with lung cancer screening. Unfortunately, extant data on lung cancer screening participants were scarce at the time this guideline was written. However, in this review, the authors summarize the sufficient evidence on the benefits of smoking cessation and the efficacy of smoking-cessation interventions for smokers ages 55 to 77 years to provide smoking-cessation interventions for smokers who seek lung cancer screening. It is concluded that smokers who present for lung cancer screening should be encouraged to quit smoking at each visit. Access to evidence-based smoking-cessation interventions should be provided to all smokers regardless of scan results, and motivation to quit should not be a necessary precondition for treatment. Follow-up contacts to support smoking-cessation efforts should be arranged for smokers. Evidence-based behavioral strategies should be used at each visit to motivate smokers who are unwilling to try quitting/reducing smoking or to try evidence-based treatments that may lead to eventual cessation.
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Affiliation(s)
- Lisa M. Fucito
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- Smilow Cancer Hospital at Yale-New Haven, New Haven, Connecticut
- Yale Cancer Center, New Haven, Connecticut
| | - Sharon Czabafy
- Wellspan Ephrata Community Hospital Wellness Center, Stevens, Pennsylvania
| | - Peter S. Hendricks
- Department of Human Behavior, School of Public Health, University of Alabama, Birmingham, Alabama
| | - Chris Kotsen
- Tobacco Quitcenter, Lung Cancer Institute, Steeplechase Cancer Center, Robert Wood Johnson University Hospital, Somerville, New Jersey
| | - Donna Richardson
- Tobacco Dependence Program, Cancer Institute of New Jersey, School of Public Health, Robert Wood Johnson Medical School at Rutgers, New Brunswick, New Jersey
| | - Benjamin A. Toll
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
- Hollings Cancer Center, Charleston, South Carolina
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Shadel WG, Elliott MN, Haas AC, Haviland AM, Orr N, Farmer MM, Ma S, Weech-Maldonado R, Farley DO, Cleary PD. Clinician advice to quit smoking among seniors. Prev Med 2015; 70:83-9. [PMID: 25482423 PMCID: PMC5428890 DOI: 10.1016/j.ypmed.2014.11.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 10/09/2014] [Accepted: 11/26/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Little smoking research in the past 20years includes persons 50 and older; herein we describe patterns of clinician cessation advice to US seniors, including variation by Medicare beneficiary characteristics. METHOD In 2012-4, we analyzed 2010 Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data from Medicare beneficiaries over age 64 (n=346,674). We estimated smoking rates and the proportion of smokers whose clinicians encouraged cessation. RESULTS 12% of male and 8% of female respondents aged 65 and older smoke. The rate decreases with age (14% of 65-69, 3% of 85+) and education (12-15% with no high school degree, 5-6% with BA+). Rates are highest among American Indian/Alaskan Native (16%), multiracial (14%), and African-American (13%) seniors, and in the Southeast (14%). Only 51% of smokers say they receive cessation advice "always" or "usually" at doctor visits, with advice more often given to the young, those in low-smoking regions, Asians, and women. For all results cited p<0.05. CONCLUSIONS Smoking cessation advice to seniors is variable. Providers may focus on groups or areas in which smoking is less common or when they are most comfortable giving advice. More consistent interventions are needed, including cessation advice from clinicians.
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Affiliation(s)
- William G Shadel
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
| | - Marc N Elliott
- RAND Corporation, 1776 Main St., PO Box 2138, Santa Monica, CA 90407-2138, USA.
| | - Ann C Haas
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
| | - Amelia M Haviland
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA; H. John Heinz III College, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213, USA.
| | - Nate Orr
- RAND Corporation, 1776 Main St., PO Box 2138, Santa Monica, CA 90407-2138, USA.
| | - Melissa M Farmer
- Veteran's Administration HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, 16111 Plummer Street (152), Sepulveda, CA 91343, USA.
| | - Sai Ma
- Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244, USA.
| | - Robert Weech-Maldonado
- Dept. of Health Services Administration, University of Alabama, Birmingham, 1720 2nd Avenue South, SHPB 558, Birmingham, AL 35294, USA.
| | - Donna O Farley
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
| | - Paul D Cleary
- Yale School of Public Health, 60 College Street, P.O. Box 208034, New Haven, CT 06520-8034, USA.
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Park S, Lee JY, Song TM, Cho SI. Age-associated changes in nicotine dependence. Public Health 2012; 126:482-9. [DOI: 10.1016/j.puhe.2012.02.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 11/02/2011] [Accepted: 02/10/2012] [Indexed: 11/16/2022]
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