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Saxena S, Singh PK, Singh L, Kashyap S, Singh S. Smokeless tobacco use and public health nutrition: a global systematic review. Public Health Nutr 2023; 26:46-55. [PMID: 35618706 PMCID: PMC11077452 DOI: 10.1017/s1368980022001331] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/26/2022] [Accepted: 05/04/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Tobacco consumption among low- and middle-income countries where food insecurity remains a challenge poses several concerns. This review examines the available global evidence linking smokeless tobacco (SLT) use with public health nutrition and its implications. DESIGN Systematic review of articles extracted from PubMed and Scopus from January 2000 to December 2020. SETTING Included studies that demonstrated the relationship between SLT and nutrition-related factors, that is, BMI, malnutrition, anaemia, poor birth outcomes and metabolic disorders. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines have been followed to conduct the systematic evidence review. PARTICIPANTS A total of thirty-four studies were finally used in the systematic review, which included cross-sectional (thirty-one) and cohort (three). RESULTS SLT use has a huge impact on body weight, alteration in taste, poor oral health, and consumption of fruits and vegetables leading to malnutrition. Maternal use of SLT not only leads to anaemia but also hampers birth outcomes. Increased risk of metabolic syndrome and gallstone disease among SLT users are also well documented in the studies. CONCLUSION The review highlights the linkages between SLT usage and poor nutritional outcomes. Tobacco control efforts should be convergent with public health nutrition to achieve overall health benefits. Attention is also required to explore suitable mechanisms for SLT cessation combined with enhancing food and nutrition security at the community level in sync with investments in public health nutrition intervention.
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Affiliation(s)
- Shikha Saxena
- Division of Preventive Oncology, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh201301, India
| | - Prashant Kumar Singh
- Division of Preventive Oncology, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh201301, India
| | - Lucky Singh
- ICMR National Institute of Medical Statistics, New Delhi, India
| | - Shekhar Kashyap
- Department of Cardiology, Army Research & Referral Hospital, New Delhi, India
| | - Shalini Singh
- Division of Preventive Oncology, National Institute of Cancer Prevention and Research, Indian Council of Medical Research, Noida, Uttar Pradesh201301, India
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Andong FA, Okwuonu ES, Melefa TD, Okoye CO, Nkemakolam AO, Hinmikaiye FF, Nwankpo EO, Ozue CC. The Consequence of Aqueous Extract of Tobacco Leaves ( Nicotiana tabacum. L) on Feed Intake, Body Mass, and Hematological Indices of Male Wistar Rats fed under Equal Environmental Conditions. J Am Coll Nutr 2021; 40:429-442. [PMID: 32729775 DOI: 10.1080/07315724.2020.1788471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE While the dangers of consuming tobacco by smoking has been of concern, the hazardous effect of other forms of tobacco consumption (in smokeless form) on health indices are less well explored. In this paper, we explored the effect of different doses of aqueous extract of tobacco leaves on feed intake, body mass, and hematological indices of male Wistar rats under equal environmental conditions. METHOD Using an oral route of administration, the rats (n = 24; w = 65-85 g; 2-3 weeks old) were administered at different doses of 100, 200, 400, 0 mg/kg body weight (b.w.) per day to group A, B, C, and D for 42 days, after phytochemical and acute toxicity testing of the tobacco leaves. RESULTS Compared to the negative control group (D), packed cell volume, hemoglobin concentration, red blood cells, and lymphocytes reduced dose-dependently in contrast to the white blood cells, neutrophils, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, and mean corpuscular volume. As body mass and feed intake in relation to the different doses of aqueous extract of tobacco leaves reduced significantly (p < 0.05), the reverse was observed for body mass and feed intake in relation to room temperature. CONCLUSIONS By influencing hematological indices, feed intake, and body mass, the extract of tobacco leaves can be hazardous to health. However, to assess safety and to come up with a conscious conclusion, future studies should explore the effect of the extract on organs histopathology, biochemical parameters, and lipid profile of the body.
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Affiliation(s)
- Felix Atawal Andong
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
- A.P. Leventis Ornithological Research Institute, Department of Zoology, University of Jos, Jos, Plateau, Nigeria
| | - Elijah Sunday Okwuonu
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Temitope Dadewura Melefa
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Charles Obinwanne Okoye
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Augustine Okorie Nkemakolam
- Department of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Funmilayo Faith Hinmikaiye
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Emelda Obioma Nwankpo
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Chibike Chisom Ozue
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
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Kaboré S, Millogo T, Soubeiga JK, Lanou H, Bicaba B, Kouanda S. Prevalence and risk factors for overweight and obesity: a cross-sectional countrywide study in Burkina Faso. BMJ Open 2020; 10:e032953. [PMID: 33208322 PMCID: PMC7677366 DOI: 10.1136/bmjopen-2019-032953] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The objective of this study was to determine the prevalence and predictors of overweight and obesity in Burkina Faso using a population-based countrywide sample. We hypothesise that there is a significant burden related to overweight/obesity in Burkina Faso. DESIGN Secondary analysis of a population-based countrywide cross-sectional study. SETTING Burkina Faso, all the 13 regions including both rural and urban residential areas. PARTICIPANTS 4800 participants of both sexes, aged between 25 and 64 years. MAIN OUTCOMES Overweight and obesity using body mass index cut-off levels of the WHO. RESULTS The prevalence of overweight and obesity in Burkina Faso were 13.82% (95% CI: 12.25 to 15.55) and 4.84% (95% CI: 3.99 to 5.86), respectively. Among men, the proportional odds of overweight/obesity increase with urban residency (p<0.001), greater age (p<0.002), marital status different from single (p≤0.007) and decrease with current smoking (p=0.009). Among women, the proportional odds of overweight/obesity increase with urban residency (p<0.001), primary educational level (p=0.01), high total blood cholesterol level (p<0.001) and high fasting blood glucose level (p=0.02), and decrease with current smoking (p<0.001). CONCLUSION Our study showed that nearly one person out of five in the adult population of Burkina has an abnormal weight status with women being more affected than men. Urban residency is a consistent risk factor in both men and women. Alcohol consumption and education were associated with an increased odds in only women. Overnutrition needs to be recognised as an important public health issue in Burkina Faso and nutrition interventions need to be reshaped to account for it.
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Affiliation(s)
- Seydou Kaboré
- Epidemiology and Biostatistics, African Institute of Public Health, Ouagadougou, Centre, Burkina Faso
- National Tuberculosis Program, Ministry of Health, Ouagadougou, Burkina Faso
| | - Tieba Millogo
- Epidemiology and Biostatistics, African Institute of Public Health, Ouagadougou, Centre, Burkina Faso
- Biomedicine and Public Health, Institut de Recherche en Sciences de la Sante, Ouagadougou, Centre, Burkina Faso
| | - Joseph Kouesyandé Soubeiga
- Epidemiology and Biostatistics, African Institute of Public Health, Ouagadougou, Centre, Burkina Faso
- East Health Regional Directorate, Ministry of Health, Fada N'Gourma, Burkina Faso
| | - Hermann Lanou
- Epidemiology and Biostatistics, African Institute of Public Health, Ouagadougou, Centre, Burkina Faso
- Biomedicine and Public Health, Institut de Recherche en Sciences de la Sante, Ouagadougou, Centre, Burkina Faso
| | - Brice Bicaba
- Epidemiology and Biostatistics, African Institute of Public Health, Ouagadougou, Centre, Burkina Faso
- National Institute of Public Health, Ministry of Health Burkina Faso, Ouagadougou, Centre, Burkina Faso
| | - Seni Kouanda
- Epidemiology and Biostatistics, African Institute of Public Health, Ouagadougou, Centre, Burkina Faso
- Biomedicine and Public Health, Institut de Recherche en Sciences de la Sante, Ouagadougou, Centre, Burkina Faso
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Fahey MC, Little MA, Klesges RC, Talcott GW, Richey PA, Mehmet K, Krukowski RA. Use of Tobacco for Weight Control across Products among Young Adults in the U.S. Military. Subst Use Misuse 2020; 56:153-161. [PMID: 33183122 PMCID: PMC8058943 DOI: 10.1080/10826084.2020.1846196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Approximately 17% of young adults currently use tobacco, most commonly cigarettes and/or electronic cigarettes (e-cigarettes), followed by other products (i.e., cigarillos, pipe/hookah, smokeless tobacco). Cigarettes have been historically used to control weight. Little is known about use of non-cigarette products for weight control, particularly among non-college young adults. Tobacco use in the military is higher than civilians, and personnel have increased motivation for weight control due to military fitness standards. This population might be vulnerable to use tobacco for this purpose. Purpose: Exploring prevalence, as well as demographic and behavioral correlates, of using tobacco products for weight control, among a large, diverse sample of military young adults. Methods: U.S. Air Force recruits (N = 24,543) completed a questionnaire about tobacco use. Among users of tobacco products, recruits reported if they had ever used that product to maintain their weight. Results: Smokeless tobacco was most commonly used for weight control (12.2%), followed by cigarettes (7.3%), e-cigarettes (5.5%), cigarillos (3.3%), and hookah/pipe (3.2%). Using tobacco for weight control was associated with fewer harm beliefs and more regular use of that product. Among e-cigarette users, having a higher BMI and a lower educational background was associated with ever using this product for weight control. Conclusions: The belief that a tobacco product helps control one's weight might increase the prevalence, and frequency of use, of that product among military young adults. Tobacco cessation programs should assess for this motivation of use and provide education about tobacco harm and alternative strategies for weight maintenance.
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Affiliation(s)
- M C Fahey
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - M A Little
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - R C Klesges
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - G W Talcott
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - P A Richey
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - K Mehmet
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - R A Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Bunney PE, Hansen M, LeSage M. Effects of isolated tobacco alkaloids and tobacco products on deprivation-induced food intake and meal patterns in rats. Pharmacol Biochem Behav 2018; 165:45-55. [PMID: 29196096 PMCID: PMC5801111 DOI: 10.1016/j.pbb.2017.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/01/2017] [Accepted: 11/27/2017] [Indexed: 12/19/2022]
Abstract
The ability of smoking to reduce body weight serves as motivation for continued smoking. It is unclear to what extent non-nicotine constituents in cigarettes are contributing to the weight-reducing effect of smoking. The purpose of the current study was to examine the effects of nicotine and four minor tobacco alkaloids (nornicotine, cotinine, anatabine, and anabasine) on food intake, one of the key regulators of body weight. In addition, a smokeless tobacco extract (STE) and e-cigarette (EC) refill liquid were used to model the effects of actual tobacco product exposure on food intake. Male Holztman rats were trained to lever press for food pellets during daily 2h sessions in operant chambers. In Experiment 1, the effects of subcutaneous injections of saline, nicotine (0.25-1.00mg/kg), nornicotine (0.50-6.00mg/kg), cotinine (1.00-100.00mg/kg), anatabine (0.25-3.00mg/kg), and anabasine (0.50-4.00mg/kg) were assessed. In Experiment 2, rats from Experiment 1 were used to examine the effects of nicotine, STE, and EC liquid. All alkaloids, except cotinine, produced a dose-dependent reduction in overall food intake. The highest doses of all drugs significantly reduced latency and response rate to obtain the first pellet. At some doses, nicotine, anatabine, and nornicotine reduced food intake within the first 45min without compensatory increases in intake later in the session. STE and EC liquid produced dose dependent decreases in food intake similar to nicotine alone. These data suggest that minor tobacco alkaloids have appetite suppressant effects and warrant further investigation into their effects on body weight, energy intake, and energy expenditure under free-feeding conditions. However, findings with STE and EC liquid suggest that nicotine is the primary constituent in these products to affect food intake, whereas levels of minor alkaloids in these products may be too low to influence food intake.
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Affiliation(s)
- Patricia E Bunney
- Department of Medicine, Minneapolis Medical Research Foundation, 701 Park Ave., Minneapolis, MN 55415, United States; Department of Medicine, University of Minnesota School of Medicine, 420 Delaware St. SE, Minneapolis, MN 55455, United States.
| | - Mylissa Hansen
- Department of Medicine, Minneapolis Medical Research Foundation, 701 Park Ave., Minneapolis, MN 55415, United States
| | - Mark LeSage
- Department of Medicine, Minneapolis Medical Research Foundation, 701 Park Ave., Minneapolis, MN 55415, United States; Department of Medicine, University of Minnesota School of Medicine, 420 Delaware St. SE, Minneapolis, MN 55455, United States; Department of Psychology, University of Minnesota, N218 Elliot Hall, 75 E River Rd., Minneapolis, MN 55455, United States
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6
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Wilkinson AV, Koehly LM, Vandewater EA, Yu RK, Fisher-Hoch SP, Prokhorov AV, Kohl HW, Spitz MR, Shete S. Demographic, psychosocial, and genetic risk associated with smokeless tobacco use among Mexican heritage youth. BMC MEDICAL GENETICS 2015; 16:43. [PMID: 26111525 PMCID: PMC4636823 DOI: 10.1186/s12881-015-0188-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 06/11/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Despite well-established negative health consequences of smokeless tobacco use (STU), the number and variety of alternative non-combustible tobacco products on the market have increased tremendously over the last 10 years, as has the market share of these products relative to cigarettes. While STU among non-Hispanic white youth has decreased over the last 10 years, the prevalence has remained constant among Hispanic youth. Here we examine demographic, psychosocial, and genetic risk associated with STU among Mexican heritage youth. METHODS Participants (50.5 % girls) reported on psychosocial risk factors in 2008-09 (n = 1,087, mean age = 14.3 years), and smokeless tobacco use in 2010-11 (mean age = 16.7 years). Participants provided a saliva sample that was genotyped for genes in the dopamine, serotonin and opioid pathways. RESULTS Overall 62 (5.7 %) participants reported lifetime STU. We identified five single nucleotide polymorphisms that increased the risk for lifetime use. Specifically, rs2023902 on SERGEF (OR = 1.93; 95 % CI: 1.05-3.53), rs16941667 on ALDH2 (OR = 3.14; 95 % CI: 1.65-5.94), and rs17721739 on TPH1 (OR = 1.71; 95 % CI: 1.00-2.91) in the dopamine pathway, rs514912 on TRH-DE (OR = 1.84; 95 % CI: 1.25-2.71) in the serotonin pathway, and rs42451417 on the serotonin transporter gene, SLC6A4 (OR = 3.53; 95 % CI: 1.56-7.97). After controlling for genetic risk, being male (OR = 1.86; 95 % CI: 1.02-3.41), obesity status (OR = 2.22; 95 % CI: 1.21-4.09), and both higher levels of anxiety (OR = 1.04; 95 % CI: 1.01-1.08) and social disinhibition (OR = 1.26; 95 % CI: 1.07-1.48) were associated with increased use. High subjective social status (OR = 0.78; 95 % CI: 0.64-0.93) was protective against use, while higher parental education (OR = 2.01; 95 % CI: 1.03-3.93) was associated with increased use. CONCLUSIONS These data suggest that use of genetic risk, along with psychosocial, demographic, and behavioral risk factors may increase our ability to identify youth at increased risk for STU, which in turn may improve our ability to effectively target prevention messages to Mexican heritage youth.
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Affiliation(s)
- Anna V Wilkinson
- Michael & Susan Dell Center for Healthy Living & The University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin, TX, 78701, USA.
| | - Laura M Koehly
- Social and Behavioral Division, National Human Genome Research Institute, Bethesda, MD, USA.
| | - Elizabeth A Vandewater
- Michael & Susan Dell Center for Healthy Living & The University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin, TX, 78701, USA.
| | - Robert K Yu
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Susan P Fisher-Hoch
- The University of Texas School of Public Health Brownsville Regional Campus, Brownsville, TX, USA.
| | - Alexander V Prokhorov
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Harold W Kohl
- Michael & Susan Dell Center for Healthy Living & The University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin, TX, 78701, USA.
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA.
| | | | - Sanjay Shete
- Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Abstract
Workers in blue collar occupations have been shown to have higher rates of smokeless tobacco (ST) use compared to other occupational groups. Guided by the Health Promotion Model, the purpose of this study was to understand various factors that predict ST use in Operating Engineers. A cross-sectional design was used to determine variables related to ST use among Operating Engineers. Engineers (N = 498) were recruited during their 3-day apprentice certification course to participate in the study. Logistic regression was used to assess the associations between personal, psychological and behavioral characteristics associated with ST use. Past month ST use was reported among 13% of operating engineers surveyed. Multivariate analysis showed that younger age and lower rates of past month cigarette use were significantly associated with ST use, while higher rates of problem drinking were marginally associated with ST use. Operating Engineers are at high risk for using ST products with rates in this sample well over the national average. Work site interventions, which have shown promise in other studies, may be useful in decreasing ST use among this population.
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Affiliation(s)
- Devon Noonan
- Health Promotion/Risk Reduction Interventions with Vulnerable Populations, University of Michigan School of Nursing, 400 North Ingalls, Ann Arbor, MI, 48109-5482, , Phone: 617-543-5759, FAX: 734-647-9325
| | - Sonia A. Duffy
- University of Michigan, Nursing, Otolaryngology, Psychiatry Ann Arbor VA Health Care System, 400 North Ingalls Building Ann Arbor, MI 48109-0482 Telephone: (734) 395-0613
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Sundbeck M, Grahn M, Lönngren V, Månsson NO, Råstam L, Lindblad U. Snuff use associated with abdominal obesity in former smokers. Scand J Public Health 2009; 37:487-93. [DOI: 10.1177/1403494809105546] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Aim: To describe the consumption of snuff in a rural male population and to explore associations between snuff use and obesity. Participants and Methods: Tobacco use was explored in 834 men aged 30—75 years old who participated in a cross-sectional population survey in the municipality of Vara (participation rate was 81%). Self-reported questionnaires assessed the habits of smoking and snuff use. Anthropometric measures were obtained during a health examination. Results: Of these men 21% (n = 179) were snuff users, 13% (n = 109) current smokers, and 65% (n = 546) were non-users. Of all snuff users 65% (n = 116) were former smokers, and 35% (n = 63) were exclusive snuff users (current users who never smoked). Among non-users 65% (n = 357) were never users and 35% (n = 189) had quit smoking without nicotine substitution. These men were characterized by abdominal obesity; OR 1.84 (1.08—3.12) (p = 0.002) (WHR 41.0) and OR 1.71 (1.08—2.72) (p = 0.022) (waist circumference 4102 cm). One can/week use of snuff among ex-smokers was associated with a 1.21 cm wider (0.05—2.36) (p = 0.041) waist circumference and 0.01 (0.00—0.02) units higher (p = 0.021) WHR. There were statistically significant associations between former smoking without current nicotine substitute and both general and abdominal obesity. No similar association with abdominal obesity was seen among exclusive snuff users. Conclusions: Abdominal obesity in current snuff users is limited to former smokers. The remaining effect of previous smoking has to be considered in future studies on obesity and related disorders in snuff users. Counselling among people who substitute snuff for smoking should include measures to prevent weight gain.
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Affiliation(s)
| | - Mathias Grahn
- Department of Social and Preventive Medicine, Malmö University Hospital, Malmö, Sweden
| | | | | | - Lennart Råstam
- Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Ulf Lindblad
- Department of Clinical Sciences, Malmö, Lund University, Sweden, , Skaraborg Institute, Skövde, Sweden, Department of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy at Göteborg University, Sweden
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Caria MP, Bellocco R, Zambon A, Horton NJ, Galanti MR. Overweight and perception of overweight as predictors of smokeless tobacco use and of cigarette smoking in a cohort of Swedish adolescents. Addiction 2009; 104:661-8. [PMID: 19215597 DOI: 10.1111/j.1360-0443.2009.02506.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To study the association between measured or perceived overweight in adolescence and subsequent uptake of cigarette smoking and of the Swedish smokeless tobacco 'snus' (oral moist snuff). DESIGN Population-based prospective cohort study with 7 years' follow-up. SETTING Self-administered questionnaires and school nurses' visits. PARTICIPANTS A total of 2922 children of both sexes and mean age 11.6 years at recruitment, resident in the Stockholm region, Sweden. MEASUREMENTS Tobacco use was self-reported at baseline and on six subsequent surveys. Subjects' height and weight were measured by school nurses during the first 4 years, self-reported thereafter. Overweight perception was self-reported at the age of 15 years. FINDINGS Overweight and perception of overweight were not associated with subsequent uptake of either smoking or snus among males. Among females, overweight at baseline was associated with uptake of smoking [adjusted hazard ratio (HR) 1.34, 95% confidence interval (CI) 1.09-1.63], but not of snus. A similar pattern was found with overweight status during follow-up. Among girls with low-educated parents, overweight at baseline predicted the uptake of both snus and smoking. Among 15-year-old females who never used tobacco perceived overweight was associated with subsequent uptake of smoking (adjusted HR 1.71, 95% CI 1.20-2.46), but not of snus. CONCLUSIONS In Sweden, adolescent girls with actual or perceived overweight are at increased risk to start smoking, while indications that this increased risk applies to smokeless tobacco (snus) are limited to girls of low socio-economic status.
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Affiliation(s)
- Maria Paola Caria
- Department of Statistics, University of Milano-Bicocca, Milan, Italy
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Chatkin R, Chatkin JM. [Smoking and changes in body weight: can physiopathology and genetics explain this association?]. J Bras Pneumol 2008; 33:712-9. [PMID: 18200373 DOI: 10.1590/s1806-37132007000600016] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2007] [Accepted: 08/13/2007] [Indexed: 11/21/2022] Open
Abstract
Tobacco use is the leading preventable cause of death in most countries, including Brazil. Smoking cessation is an important strategy for reducing the morbidity and mortality associated with tobacco-related diseases. An inverse relationship between nicotine use and body weight has been reported, in which body weight tends to be lower among smokers than among nonsmokers. Smoking abstinence results in an increase in body weight for both males and females. On average, sustained quitters gain from 5 to 6 kg, although approximately 10% gain more than 10 kg. Pharmacological treatment for smoking cessation attenuates weight gain. The importance of smoking cessation as a contributing cause of the current obesity epidemic has been little studied. In the USA, the rate of obesity attributable to smoking cessation has been estimated at approximately 6.0 and 3.2% for males and females, respectively. Although the mechanisms are unclear, there is evidence that dopamine and serotonin are appetite suppressants. The administration of nicotine, regardless of the delivery system, acutely raises the levels of these neurotransmitters in the brain, reducing the need for energy intake and consequently suppressing appetite. In addition, nicotine has a direct effect on adipose tissue metabolism, influencing the rate of weight gain following smoking cessation. Leptin, ghrelin and neuropeptide Y are substances that might constitute factors involved in the inverse relationship between nicotine and body mass index, although their roles as determinants or consequences of this relationship have yet to be determined.
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Affiliation(s)
- Raquel Chatkin
- Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
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