1
|
Masoudkabir F, Nayebirad S, Yousefi M, Azizi B, Karimi Z, Shafiee A, Yadangi S, Jalali A, Vasheghani-Farahani A. Waterpipe smoking is associated with presence and severity of coronary artery disease: a propensity score-matched study. BMC Cardiovasc Disord 2024; 24:424. [PMID: 39138402 PMCID: PMC11321025 DOI: 10.1186/s12872-024-04059-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 07/17/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND The prevalence of waterpipe smoking (WPS) has been increasing worldwide. This trend is alarming as WPS can negatively impact cardiovascular health. In the present study, we explored the association between WPS and the presence and severity of CAD. METHODS This study was a retrospective analysis of patients who underwent diagnostic coronary angiography at Tehran Heart Center between April 2021 and May 2022. Patients with a previous history of percutaneous coronary intervention and coronary surgery were excluded. Waterpipe smokers were matched with non-smokers based on age, gender, and cigarette smoking using a 1:4 propensity score matching model. Stenosis ≥ 50% in any coronary artery was considered a CAD diagnosis. Gensini score was also calculated to measure the severity of the CAD. RESULTS We reviewed the medical records of 8699 patients, including 380 waterpipe smokers. After matching, 1520 non-smokers with similar propensity scores to the waterpipe smokers were selected. Waterpipe smokers were more likely to have CAD than non-smokers (OR: 1.29; 95% CI: 1.04-1.60, P = 0.021). In addition, WPS increased the natural logarithm of the Gensini score by 1.24 (95% CI: 1.04-1.48, P = 0.014) in patients with atherosclerotic coronary disease. CONCLUSION WPS may increase the risk of CAD independent of age, gender, and cigarette smoking. In addition, among patients with any degree of atherosclerosis in coronary arteries (GS > 0), WPS may lead to higher average GS, suggesting more severe atherosclerosis.
Collapse
Affiliation(s)
- Farzad Masoudkabir
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Cardiovascular Research, Tehran Heart Center, North Kargar Ave, Tehran, 1411713138, Iran.
| | - Sepehr Nayebirad
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Yousefi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bayan Azizi
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Karimi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Shafiee
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Yadangi
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Li W, Kalan ME, Kondracki AJ, Gautam P, Jebai R, Osibogun O. Longitudinal impact of perceived harm and addiction on e-cigarette initiation among tobacco-naïve youth: Population Assessment of Tobacco and Health study (Waves 1-5). Public Health 2024; 230:52-58. [PMID: 38507916 PMCID: PMC11025441 DOI: 10.1016/j.puhe.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/11/2024] [Accepted: 02/20/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES This study investigates the effect of e-cigarette-related harm and addiction perceptions on e-cigarette initiation among US tobacco-naïve adolescents. STUDY DESIGN This is a longitudinal study. METHODS Using data from five waves (2013-2019) of the Population Assessment of Tobacco and Health Study, we created a longitudinal data set for 2775 youth aged 12-17 years who had no prior use of tobacco products at Wave 1. E-cigarette initiation was defined as transitioning from non-use at Wave 1 to ever use in subsequent waves. Kaplan-Meier survival and Cox proportional hazard regression models were used to assess the impact of harm and addiction perceptions on e-cigarette initiation. RESULTS Our analytic sample comprised 63.1% of youth who had never used tobacco products at Wave 1 and consequently initiated e-cigarette use in subsequent waves. Over time, fewer individuals perceived e-cigarettes as harmless (14.1%-2.1%), whereas more perceived them as likely to cause addiction (53.7%-76.6%). Compared with perceiving e-cigarettes as a lot of harm, those perceiving some harm (adjusted hazard ratio [aHR] = 1.30, 95% confidence interval [CI]: 1.12-1.52), little harm (aHR = 1.42, 95% CI: 1.20-1.68), or no harm (aHR = 2.09, 95% CI: 1.64-2.65) were more likely to initiate e-cigarette use. Demographic factors for initiation included being Black or Hispanic ethnicity (vs White), younger age (12-14 vs15-17 years), and receiving over $20 per week (vs $0) in pocket money, with P-values <0.05. However, in adjusted results, addiction perceptions did not significantly impact e-cigarette initiation (P-values >0.05). CONCLUSIONS Among youth without prior tobacco/nicotine use, perceiving e-cigarettes as having low harm significantly predicted initiation over time. Effective prevention strategies, including targeted risk communication interventions, are essential for discouraging e-cigarette use among youth.
Collapse
Affiliation(s)
- W Li
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA.
| | - M E Kalan
- School of Health Professionals, Eastern Virginia Medical School, Norfolk, VA, USA
| | - A J Kondracki
- Department of Community Medicine, Mercer University School of Medicine, Savannah, GA, USA
| | - P Gautam
- Texas State Board of Pharmacy, Austin, TX, USA
| | - R Jebai
- Department of Health Law, Policy, and Management, School of Public Health, Boston University, MA, USA
| | - O Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| |
Collapse
|
3
|
Cornacchione Ross J, Zizzi AR, Suerken CK, Kimes C, Soule E, Sutfin EL. Compliance With US Federal Regulations on Waterpipe Tobacco Warnings on Packaging. JAMA Netw Open 2024; 7:e2354467. [PMID: 38306102 PMCID: PMC10837745 DOI: 10.1001/jamanetworkopen.2023.54467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
This cohort study reports the rate and degree of compliance with the Food and Drug Administration–mandated warning labels among waterpipe tobacco brands and products.
Collapse
Affiliation(s)
- Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, North Carolina
- Now with Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts
| | - Alexandra R Zizzi
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, North Carolina
| | - Cynthia K Suerken
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston Salem, North Carolina
| | - Caroline Kimes
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, North Carolina
| | - Eric Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, North Carolina
| |
Collapse
|
4
|
Li W, Osibogun O, Gautam P, Li T, Cano MÁ, Maziak W. Effect of harm perception on ENDS initiation among US adolescents and young adults: Longitudinal findings from the population assessment of tobacco and health (PATH) study, 2013-2018. Drug Alcohol Depend 2023; 244:109784. [PMID: 36706674 DOI: 10.1016/j.drugalcdep.2023.109784] [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: 05/16/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND This study investigates how ENDS harm perception influences ENDS initiation over time among US young people. METHODS Data were from the sample of the Population Assessment of Tobacco and Health (PATH) Study conducted from 2013 to 2018. The Cox proportional hazards regression models were used to assess the relationship between absolute (the perception of harm from ENDS only) and relative harm perception (ENDS' harm relative to cigarettes) and ENDS initiation among adolescents (12-17 years) and young adults (18-24 years) separately. Harm perception was assessed at the wave before ENDS initiation in a subsequent wave. Weighted results were reported. RESULTS Of the 11,633 adolescents and 5089 young adults from baseline, 17.1% and 25.5% initiated ENDS use across four waves, respectively. Among adolescents (HR=2.31; 95%CI: 1.95-2.73) and young adults (HR=1.97; 95%CI: 1.69-2.30), perceiving lower relative harm of ENDS significantly predicted ENDS initiation in subsequent waves. Among adolescents, perceiving lower absolute harm of ENDS (HR=2.18; 95%CI: 1.83-2.60) predicted ENDS initiation in subsequent waves. Additionally, adolescents and young adults who ever used any other tobacco products or alcohol and lived with anyone who used tobacco were more likely to initiate ENDS use. CONCLUSIONS Among a representative longitudinal cohort of adolescents and young adults who had never used ENDS at baseline, perceiving ENDS as reduced or low-harm products significantly predicted ENDS initiation in subsequent waves. These findings underscore the importance of ENDS harm perception and the central role of risk communication strategies that need to target those young people at particular risk of unwarranted ENDS use.
Collapse
Affiliation(s)
- Wei Li
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Prem Gautam
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA; Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
| |
Collapse
|
5
|
Gautam P, Sharma E, Li T, Maziak W. Prevalence and predictors of waterpipe smoking cessation among young adults in the US: Findings from a population-based study. Addict Behav 2022; 135:107457. [PMID: 35986954 DOI: 10.1016/j.addbeh.2022.107457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/04/2022] [Accepted: 08/07/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND The prevalence of waterpipe tobacco (WPT) smoking is 9.2 % among young adults aged 18-24 years in the United State (US). Adequate understanding of the factors predicting WPT smoking cessation among the young population is essential to tobacco control efforts. This study assessed the prevalence and predictors of WPT smoking cessation among young adults. METHODS The population assessment of tobacco and health (PATH) study data (waves 1-5) was used for the study. A total sample of 561 young adults exclusively using WPT (past 30-days) was used for the analysis. The probability of WPT smoking cessation (no use in the past 12 months) was estimated using the Kaplan-Meier survival method, and the predictors were assessed using the Cox proportional hazards regression model. RESULTS During the five waves, 25.1 % of the young adult WPT smokers quit smoking. Among them, 58.2 % were females and the remaining 41.8 % were males. The Hispanics (40.2 %) had the highest rate of cessation among the ethnic groups. Regret smoking (adjusted hazard ratio (aHR) = 2.33, 95 % confidence interval (CI) = 1.24-4.36), smoking restriction at home (aHR = 2.86, 95 % CI = 1.41-5.88), and living in Midwest geographical region (aHR = 2.11, 95 % CI = 1.16-3.84) increased the likelihood whereas alcohol use (aHR = 0.62, 95 % CI = 0.41-0.93) decreased the likelihood of cessation among the young adult WPT smokers. CONCLUSIONS Communicating the health and economic consequences associated with WPT smoking (e.g., pictorial health warning labels), involving smoker's household members in WPT awareness campaigns, and closing regulatory loopholes related to WPT venues will increase the WPT smoking cessation rate among the young population in the US.
Collapse
Affiliation(s)
- Prem Gautam
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8thSt AHC5, 4thFloor, Miami, FL 33199, USA.
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD 20850, USA.
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St AHC5, 4th Floor, Miami, FL 33199, USA.
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8thSt AHC5, 4thFloor, Miami, FL 33199, USA; Syrian Center for Tobacco Studies, Tishreen Street, Sheehan, Aleppo, P.O. Box: 16542, Syria.
| |
Collapse
|