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Xie Y, Sun P, Huang H, Wu J, Ba Y, Zhou G, Yu F, Zhang D, Zhang Y, Qie R, Hu Z, Zou K, Zhang Y. Network analysis of smoking-related sleep characteristics in Chinese adults. Ann Med 2024; 56:2332424. [PMID: 38527416 PMCID: PMC10964831 DOI: 10.1080/07853890.2024.2332424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 02/29/2024] [Indexed: 03/27/2024] Open
Abstract
The associations between multiple sleep characteristics and smoking behavior are inconsistent, and it is unclear which sleep characteristics are most crucial for tobacco prevention. This study aimed to explore the associations between smoking status/intensity and multiple sleep characteristics and to identify the potential core domain of smoking-related sleep using network analysis. Data were obtained from a survey of cancer-related risk factors among Chinese adults. Logistic regression models were used to quantify the associations between sleep characteristics and smoking status/intensity. Network analyses were employed to identify the core sleep characteristics. A total of 5,228 participants with a median age of 44 years old were included in the study. Current smoking was significantly positively associated with long nap time, difficulty falling asleep, late bedtime, getting up after 7 am, and waking up earlier than expected. There was significant positive association between current smoking and short sleep duration in young adults under 45 years old. Late bedtime and getting up after 7 am were only associated with current heavy smoking, but not current light smoking. Network analyses showed that multiple smoking-related sleep characteristics were interconnected, with difficulty falling asleep and late bedtime as central characteristics in the network. The study found that the associations between sleep characteristics and smoking varied by age and smoking intensity and highlights the potential benefits of sleep health promotion in smoking cessation, with a particular focus on difficulty falling asleep and late bedtime.
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Affiliation(s)
- Yuting Xie
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Peiyuan Sun
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huang Huang
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianjun Wu
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
| | - Yue Ba
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Guoyu Zhou
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Fangfang Yu
- Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Daming Zhang
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yaqun Zhang
- Department of Ecology and Environment of Gansu Province, Lanzhou, Gansu, China
| | - Ranran Qie
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhuolun Hu
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kaiyong Zou
- Office for Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yawei Zhang
- Department of Cancer Prevention and Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Horvath M, Pittman B, O’Malley SS, Grutman A, Khan N, Gueorguieva R, Brewer JA, Garrison KA. Smartband-based smoking detection and real-time brief mindfulness intervention: findings from a feasibility clinical trial. Ann Med 2024; 56:2352803. [PMID: 38823419 PMCID: PMC11146247 DOI: 10.1080/07853890.2024.2352803] [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: 09/28/2023] [Accepted: 02/29/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Smartbands can be used to detect cigarette smoking and deliver real time smoking interventions. Brief mindfulness interventions have been found to reduce smoking. OBJECTIVE This single arm feasibility trial used a smartband to detect smoking and deliver brief mindfulness exercises. METHODS Daily smokers who were motivated to reduce their smoking wore a smartband for 60 days. For 21 days, the smartband monitored, detected and notified the user of smoking in real time. After 21 days, a 'mindful smoking' exercise was triggered by detected smoking. After 28 days, a 'RAIN' (recognize, allow, investigate, nonidentify) exercise was delivered to predicted smoking. Participants received mindfulness exercises by text message and online mindfulness training. Feasibility measures included treatment fidelity, adherence and acceptability. RESULTS Participants (N=155) were 54% female, 76% white non-Hispanic, and treatment starters (n=115) were analyzed. Treatment fidelity cutoffs were met, including for detecting smoking and delivering mindfulness exercises. Adherence was mixed, including moderate smartband use and low completion of mindfulness exercises. Acceptability was mixed, including high helpfulness ratings and mixed user experiences data. Retention of treatment starters was high (81.9%). CONCLUSIONS Findings demonstrate the feasibility of using a smartband to track smoking and deliver quit smoking interventions contingent on smoking.
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Affiliation(s)
- Mark Horvath
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Aurora Grutman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Nashmia Khan
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Ralitza Gueorguieva
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Judson A. Brewer
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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Le H, Simons CCJM, van den Brandt PA. The association between height and risk of lung cancer subtypes in men and women in the Netherlands Cohort Study. Cancer Epidemiol 2024; 92:102613. [PMID: 39024861 DOI: 10.1016/j.canep.2024.102613] [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: 03/18/2024] [Revised: 06/26/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVES Previous studies found no or weak positive associations between height and lung cancer (LC) risk, with differences between sexes. Few studies stratified the association by smoking status and LC subtype. This prospective study investigated the association between height and risks of overall LC and LC subtypes (i.e., adenocarcinoma, squamous cell carcinoma, small cell carcinoma, large cell carcinoma) in Dutch men and women, with comprehensive adjustment for smoking, and stratified by smoking status. MATERIALS AND METHODS Data originate from 120,852 Dutch participants aged 55-69 in 1986 in the Netherlands Cohort Study. Self-reported height and potential confounders were collected at baseline. After 20.3 years of follow-up, 3318 LC cases (2765 men; 553 women) and 4314 subcohort members were included in the multivariable Cox regression analysis. RESULTS There were no significant associations between height and risks of overall LC and LC subtypes in men and women, except for an increased adenocarcinoma risk in taller women (HRquartile4 vs quartile1=1.62, 95% CI: 1.02-2.55, Ptrend=0.031). This positive association was borderline statistically significant in female current smokers only when stratifying on smoking status. No interaction by smoking status was shown in women for any LC risk. In men, smoking modified the association between height and risks of overall LC, large cell and squamous cell carcinoma, with the p-values for interaction of 0.037, 0.007 and 0.050, respectively. CONCLUSION Positive associations between height and LC subtypes were predominantly seen in smokers. Further studies should focus on LC subtypes and stratify the association by smoking status.
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Affiliation(s)
- Huyen Le
- Department of Epidemiology, GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Colinda C J M Simons
- Department of Epidemiology, GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Piet A van den Brandt
- Department of Epidemiology, GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Epidemiology, CAPHRI - School for Public Health and Primary Care, Maastricht University Medical Centre+, Maastricht, the Netherlands.
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Kunutsor SK, Dey RS, Touw DJ, Bakker SJL, Dullaart RPF. Urine cotinine versus self-reported smoking and the risk of chronic kidney disease. Nephrol Dial Transplant 2024; 39:1683-1691. [PMID: 38402463 DOI: 10.1093/ndt/gfae054] [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: 12/19/2023] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND AND HYPOTHESIS Evidence on the role of smoking in the development of chronic kidney disease (CKD) has mostly relied on self-reported smoking status. We aimed to compare the associations of smoking status as assessed by self-reports and urine cotinine with CKD risk. METHODS Using the PREVEND prospective study, smoking status was assessed at baseline using self-reports and urine cotinine in 4333 participants (mean age, 52 years) without a history of CKD at baseline. Participants were classified as never, former, light current, and heavy current smokers according to self-reports and comparable cutoffs for urine cotinine. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated for CKD. RESULTS The percentages of self-reported and cotinine-assessed current smokers were 27.5% and 24.0%, respectively. During a median follow-up of 7.0 years, 593 cases of CKD were recorded. In analyses adjusted for established risk factors, the HRs (95% CI) of CKD for self-reported former, light current, and heavy current smokers compared with never smokers were 1.17 (0.95-1.44), 1.48 (1.10-2.00), and 1.48 (1.14-1.93), respectively. On further adjustment for urinary albumin excretion (UAE), the HRs (95% CI) were 1.07 (0.87-1.32), 1.26 (0.93-1.70), and 1.20 (0.93-1.57), respectively. For urine cotinine-assessed smoking status, the corresponding HRs (95% CI) were 0.81 (0.52-1.25), 1.17 (0.92-1.49), and 1.32 (1.02-1.71), respectively, in analyses adjusted for established risk factors plus UAE. CONCLUSION Self-reported current smoking is associated with increased CKD risk, but dependent on UAE. The association between urine cotinine-assessed current smoking and increased CKD risk is independent of UAE. Urine cotinine-assessed smoking status may be a more reliable risk indicator for CKD incidence than self-reported smoking status.
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Affiliation(s)
- Setor K Kunutsor
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Richard S Dey
- Department of Medicine, University of Ghana Hospital, Legon, Ghana
| | - Daan J Touw
- Department of Pharmacy and Clinical Pharmacology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robin P F Dullaart
- Department of Internal Medicine, Division of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Marler JD, Fujii CA, Utley MT, Balbierz DJ, Galanko JA, Utley DS. Outcomes of a Comprehensive Mobile Vaping Cessation Program in Adults Who Vape Daily: Cohort Study. JMIR Form Res 2024. [PMID: 39331522 DOI: 10.2196/57376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2024] Open
Abstract
BACKGROUND In the United States, e-cigarettes, or vapes, are the second most-commonly used tobacco product. Despite abundant smartphone app-based cigarette cessation programs, there are few such programs for vaping and even less supporting data. OBJECTIVE This exploratory, prospective open-label, single-arm, remote, initial cohort study of the Pivot vaping cessation program assessed enrollment and questionnaire completion rates, participant engagement and retention, changes in attitudes toward quitting vaping, changes in vaping behavior, and participant feedback. The aim was to establish early data in each of these areas to inform program improvements and future study design. METHODS U.S. adults aged ≥ 21 years who vape daily, report ≥ 5 vape sessions per day, and plan to quit vaping in the next 6 months were recruited online. Participants completed an online screening form, screening call, electronic informed consent, registration, and onboarding before beginning Pivot. Data were self-reported via app and web-based questionnaires. Outcomes focused on engagement and retention (i.e., weeks in the program, number of Pivot app openings, number of messages sent to coach); vaping attitudes (i.e., success to quit, difficulty to stay quit); vaping behavior (i.e., quit attempts, Penn State Electronic Cigarette Dependence Index, 7- and 30-day point prevalence abstinence [PPA], continuous abstinence [defined as ≥ 7-day PPA at 12 weeks + 30-day PPA at 26 weeks + 0 vaping sessions since 12 weeks]); and participant feedback. RESULTS Seventy-three participants completed onboarding (intention-to-treat [ITT] sample); 68/73 (93%) completed the 12- and 26-week questionnaires (completer samples). On average, participants were active in Pivot for 13.8 (SD 7.3) weeks, had 87.3 (SD 99.9) app sessions, and sent 37.6 (SD 42.3) messages to their coach over 26 weeks. Success to quit and difficulty to stay quit (scale 1-10) improved from baseline to 12 weeks: 4.9 (SD 2.9) to 7.0 (SD 3.0) and 4.0 (SD 2.8) to 6.2 (SD 3.1), respectively; both P < .001. Most participants (64/73, 88%) made ≥ 1 quit attempt. At 26 weeks, ITT 7-day PPA, 30-day PPA and continuous abstinence rates were: 35/73 (48%), 33/73 (45%), and 22/73 (30%), respectively. Thirty-three participants did not achieve 7-day PPA at 26 weeks; their mean Penn State Electronic Cigarette Dependence Index score decreased from baseline (13.9, SD 3.1) to 26 weeks (10.8, SD 4.5) (mean change -3.2, SD 3.9, P < .001); almost half (16/33, 48%) had improvement in e-cigarette dependence category. At 2 weeks, 51/71 (72%) reported using Pivot increased their motivation to quit vaping; at 4 weeks, 55/70 (79%) reported using Pivot decreased the amount they vape per day. CONCLUSIONS In this first evaluation of Pivot in adult daily vapers, questionnaire completion rates were >90%, average program engagement duration was approximately 14 weeks and most participants reported increased motivation to quit vaping. These and early cessation outcomes herein suggest a role for Pivot in vaping cessation and will inform associated future study and program improvements. CLINICALTRIAL ClinicalTrials.gov NCT05642598; https://clinicaltrials.gov/study/NCT05642598.
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Affiliation(s)
- Jennifer D Marler
- Pivot Health Technologies, Inc., 1010 Commercial St.Suite C, San Carlos, US
| | - Craig A Fujii
- Pivot Health Technologies, Inc., 1010 Commercial St.Suite C, San Carlos, US
| | - MacKenzie T Utley
- Pivot Health Technologies, Inc., 1010 Commercial St.Suite C, San Carlos, US
| | - Daniel J Balbierz
- Pivot Health Technologies, Inc., 1010 Commercial St.Suite C, San Carlos, US
| | - Joseph A Galanko
- Department of Pediatrics, University of North Carolina, Chapel Hill, US
| | - David S Utley
- Pivot Health Technologies, Inc., 1010 Commercial St.Suite C, San Carlos, US
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Yee H, Adkins S. Cigarette Smoking and its Association with Primary Open Angle Glaucoma: A Systematic Review and Meta-Analysis. Ophthalmic Epidemiol 2024:1-13. [PMID: 39288318 DOI: 10.1080/09286586.2024.2391028] [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: 01/10/2024] [Revised: 08/01/2024] [Accepted: 08/05/2024] [Indexed: 09/19/2024]
Abstract
PURPOSE To systematically assess the association between cigarette smoking and development of Primary Open Angle Glaucoma (POAG) in the general adult population. Heterogeneity will be explored appropriately. METHODS Outcomes of glaucoma, OAG and POAG were explored in adults who were current, former, and never cigarette smokers. An additional category of 'smokers with "any" smoking status' was used where former smokers were not clearly distinguished from current and never smokers and in smokers whose form of smoking was not defined. All studies were observational and there was no limit to time period. Databases used were MEDLINE, Embase, Global Health and Web of Science. Study quality was assessed using the JBI critical appraisal tool. The DerSimonian-Laird random-effects model and weighting method was applied for meta-analysis with subgroup and sensitivity analyses along with meta-regression. RESULTS Four cohort, six cross-sectional and nine case-control studies were included. Only one cohort study attained a low risk of bias (RoB), two cohort studies were of medium RoB and the rest of the studies were of high RoB. There was no evidence for an association between smoking statuses: current smoking: OR 0.96, 95%CI (0.76,1.21), former smoking: OR 0.96, 95%CI (0.83,1.11), smoking (any): OR 1.48, 95%CI (0.96, 2.29) and glaucoma. Sensitivity analyses did not have a material impact on findings. Heterogeneity was not explained by smoking status, study quality, smoking exposure, and glaucoma outcome criteria. CONCLUSION This review suggests no evidence for an association between cigarette smoking and the development of POAG. There was no evidence that current, former, and general smoking increased the risk of glaucoma.
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Affiliation(s)
- Hiromi Yee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Suzanne Adkins
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Crane HM, Nance RM, Ruderman SA, Drumright LN, Mixson LS, Heckbert SR, Feinstein MJ, Budoff MJ, Bamford L, Cachay E, Napravnik S, Moore RD, Keruly J, Willig AL, Burkholder GA, Hahn A, Ma J, Fredericksen R, Saag MS, Chander G, Kitahata MM, Crothers K, Mayer KH, O'Cleirigh C, Cropsey K, Whitney BM, Delaney JAC. Smoking and Type 1 Versus Type 2 Myocardial Infarction Among People With HIV in the United States. J Assoc Nurses AIDS Care 2024:00001782-990000000-00123. [PMID: 39241219 DOI: 10.1097/jnc.0000000000000492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2024]
Abstract
ABSTRACT Smoking is a myocardial infarction (MI) risk factor among people with HIV (PWH). Questions persist regarding the role of smoking behaviors and measurements (e.g., intensity, duration) on MI risk. We used Cox proportional hazards regression to compare the association of smoking parameterization with incidents of type 1 and type 2 MI and whether smoking intensity or duration improves MI risk prediction among PWH. Among 11,637 PWH, 37% reported currently smoking, and there were 346 MIs. Current smoking was associated with type 1 (84% increased risk) but not type 2 MI in adjusted analyses. The type 1 MI model with pack years had the best goodness of fit compared with other smoking parameterizations. Ever or never parameterization and smoking diagnosis data had significantly poorer model fit. These results highlight the importance of differentiating MI types and performing patient-based smoking assessments to improve HIV care and research rather than relying on smoking status from diagnoses.
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Affiliation(s)
- Heidi M Crane
- Heidi M. Crane, MD, MPH, is a Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Robin M. Nance, PhD, is a Research Scientist, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Stephanie A. Ruderman, PhD, is a Research Scientist, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Lydia N. Drumright, PhD, is an Assistant Professor, Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA. L. Sarah Mixson, MPH, is a Research Scientist, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Susan R. Heckbert, MD, is a Professor of Epidemiology, Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA. Matthew J. Feinstein, MD, is an Associate Professor of Medicine, Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Matthew J. Budoff, MD, is a Professor of Medicine, Division of Cardiology, Department of Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, Los Angeles, California, USA. Laura Bamford, MD, is an Associate Clinical Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California, USA. Edward Cachay, MD, is a Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California, USA. Sonia Napravnik, PhD, is an Associate Professor of Epidemiology, Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA. Richard D. Moore, MD, is a Professor of Medicine, Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Massachusetts, USA. Jeanne Keruly, MS, CRNP, is an Assistant Professor of Medicine, Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. Amanda L. Willig, PhD, is an Associate Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama, USA. Greer A. Burkholder, MD, is an Associate Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama, USA. Andrew Hahn, MD, is a Clinical Assistant Professor, Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA. Jimmy Ma, MD, is an Acting Instructor, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Rob Fredericksen, PhD, is an Assistant Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Michael S. Saag, MD, is a Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama, USA. Geetanjali Chander, MD, is a Professor of Medicine, Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA. Mari M. Kitahata, MD, is a Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Kristina Crothers, MD, is a Professor of Medicine, Division of Pulmonology, Department of Medicine, University of Washington, Seattle, Washington, USA. Kenneth H. Mayer, MD, is a Professor of Medicine, Fenway Institute, Boston, Massachusetts, USA. Conall O'Cleirigh, PhD, is an Associate Professor in Psychology, Fenway Institute, Boston, Massachusetts, USA. Karen Cropsey, MD, is a Professor of Psychiatry, Department of Psychiatry, University of Alabama Birmingham, Birmingham, Alabama, USA. Bridget M. Whitney, PhD, is a Senior Research Scientist, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Joseph A.C. Delaney, PhD, is an Associate Professor of Medicine, Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA
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Kunutsor SK, Tetteh J, Dey RS, Touw DJ, Dullaart RPF, Bakker SJL. Self-reported smoking, urine cotinine, and risk of type 2 diabetes: Findings from the PREVEND prospective cohort study. Prim Care Diabetes 2024; 18:414-421. [PMID: 38734534 DOI: 10.1016/j.pcd.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/17/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Smoking is a major risk factor for type 2 diabetes (T2D), but the evidence has mostly relied on self-reports. We aimed to compare the associations of smoking exposure as assessed by self-reports and urine cotinine with T2D. METHODS Using the PREVEND prospective study, smoking status was assessed at baseline by self-reports and urine cotinine in 4708 participants (mean age, 53 years) without a history of diabetes. Participants were classified as never, former, light current and heavy current smokers according to self-reports and analogous cut-offs for urine cotinine. Hazard ratios (HRs) with 95% CIs were estimated for T2D. RESULTS During a median follow-up of 7.3 years, 259 participants developed T2D. Compared with self-reported never smokers, the multivariable adjusted HRs (95% CI) of T2D for former, light current, and heavy current smokers were 1.02 (0.75-1.4), 1.41 (0.89-2.22), and 1.30 (0.88-1.93), respectively. The corresponding adjusted HRs (95% CI) were 0.84 (0.43-1.67), 1.61 (1.12-2.31), and 1.58 (1.08-2.32), respectively, as assessed by urine cotinine. Urine cotinine-assessed but not self-reported smoking status improved T2D risk prediction beyond established risk factors. CONCLUSION Urine cotinine assessed smoking status may be a stronger risk indicator and predictor of T2D compared to self-reported smoking status.
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Affiliation(s)
- Setor K Kunutsor
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK.
| | - John Tetteh
- Department of Population Health Sciences, University of Leicester, Leicester, UK; Department of Community Health, University of Ghana Medical School, Accra, Ghana
| | - Richard S Dey
- Department of Medicine, University of Ghana Hospital, Legon, Ghana
| | - Daan J Touw
- Department of Pharmacy and Clinical Pharmacology, University of Groningen and University Medical Center Groningen, the Netherlands
| | - Robin P F Dullaart
- Department of Internal Medicine, Division of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Rasmussen JB, Rath SM, Wu C, Weile LKK, Schmal H, Olsen J, Bech BH, Nohr EA. Fractures in Childhood and Young Adulthood According to Maternal Smoking in Late Pregnancy. A Danish Cohort Study. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2024; 162:410-418. [PMID: 37463590 DOI: 10.1055/a-2103-6915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Fractures account for the most frequent cause of hospitalization during childhood and numbers have increased over time. Of all fractures in childhood and young adulthood, 66% are recurrent fractures, suggesting that some people are predestined for fractures. The aim of this study was to investigate the association between maternal smoking during late pregnancy and the risk of fractures in the children.The study included 11,082 mothers and their children from the cohort "Healthy Habits for Two" born between 1984 and 1987. Information about maternal smoking during pregnancy came from questionnaires filled out in pregnancy, while information about fractures was derived from the Danish National Patient Registry. Over a follow-up of 24 years (1994-2018), Cox regression with multiple failures was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for fractures in childhood and young adulthood according to maternal smoking in late pregnancy. Information about body mass index (BMI) and smoking status in young adulthood was included as time variant covariates.During an age span of 8-32 years, 6,420 fractures were observed. Of the mothers, 39.1% smoked during late pregnancy. Compared to children of mothers who did not smoke, children of mothers who smoked 1-9 cigarettes per day and 10+ cigarettes per day had an increased risk of fractures (HR 1.14 [CI: 1.06; 1.21] and HR 1.14 [CI: 1.07; 1.22], respectively). After adjusting for BMI and smoking status in young adulthood, the findings were slightly strengthened, showing an increased risk of fractures of 23 and 25% in children of mothers smoking 1-9 cigarettes per day and 10+ cigarettes per day, respectively.Maternal smoking during late pregnancy was associated with a higher risk of fractures in the child. This result indicates that exposure to cigarette smoke in utero may play a role in lifelong bone health.
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Affiliation(s)
| | - Sabine Marie Rath
- Research Unit of Obstetrics and Gynecology, University of Southern Denmark, Odense, Denmark
| | - Chunsen Wu
- Research Unit of Obstetrics and Gynecology, University of Southern Denmark, Odense, Denmark
| | | | - Hagen Schmal
- Clinic of Orthopaedic Surgery, University of Southern Denmark, Odense, Denmark
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus Universitet, Aarhus, Denmark
| | | | - Ellen Aagaard Nohr
- Research Unit of Obstetrics and Gynecology, University of Southern Denmark, Odense, Denmark
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Mauries S, Dufayet G, Lengereau A, Lejoyeux M, Geoffroy PA, Dupong I. Cognitive-behavioral therapies in the management of adolescents with cannabis use disorder (CUD): A systematic review. Drug Alcohol Depend 2024; 260:111321. [PMID: 38759505 DOI: 10.1016/j.drugalcdep.2024.111321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/19/2024]
Abstract
INTRODUCTION Cannabis currently stands as the most prevalent illicit substance used by adolescents in France. Its use is associated with an elevated risk of developing psychiatric disorder, affecting neuro-cognitive development, or leading to psycho-social challenges in the long run. Cognitive-behavioral therapies (CBT) have emerged as a preferred approach for treating cannabis use disorders (CUD) in adults. METHODS This review is grounded in a systematic search of the PubMed scientific database for randomized controlled trials focusing on CBT treatment for adolescents (12-18 years old) with CUD. RESULTS Nine studies met the inclusion criteria. Currently, several variants of CBT-based treatments are available for adolescents, differing in duration based on the intended objectives (ranging from 3 to 24 weeks). These CBT therapies are often complemented by motivational interviewing or family therapy. Only two studies draw comparisons between CBT and alternative therapeutic approaches. DISCUSSION The current scientific literature in this field is limited, and the study designs display heterogeneity. However, abbreviated treatment courses appear to have value, especially within the adolescent population. These courses offer treatment advantages and may enhance treatment adherence among these young patients, who may face challenges in maintaining consistent follow-up. Additionally, involving parents in psychotherapeutic care seems to have a positive impact. CONCLUSION CBT in adolescents with CUD appears to be a promising approach to assist with maintaining abstinence and managing emotions. However, given the diverse study designs found in the literature, conducting research with standardized treatments on larger patient cohorts would be valuable.
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Affiliation(s)
- Sibylle Mauries
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris F-75018, France; Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris F-75019, France.
| | - Geoffrey Dufayet
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris F-75018, France; Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, Paris 75014, France
| | - Ariane Lengereau
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris F-75018, France; Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, Paris 75014, France
| | - Michel Lejoyeux
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris F-75018, France; Inserm U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Bron, France; Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris F-75019, France; Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, Paris 75014, France
| | - Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris F-75018, France; Inserm U1028, CNRS UMR5292, Université Claude Bernard Lyon 1, Bron, France; Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris F-75019, France; Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, Paris 75014, France
| | - Irène Dupong
- AP-HP, Child and Adolescent Psychopathology unit, Robert Debré Hospital, Paris cite, Paris, France
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Kruk MD, Soliman MAR, Aguirre AO, Kuo CC, Ruggiero N, Quiceno E, Khan A, Ghannam MM, Smolar DE, Pollina J, Mullin JP. Pack Years of Tobacco Cigarette Smoking as a Predictor of Bony Fusion after Anterior Cervical Discectomy and Fusion. World Neurosurg 2024; 187:e174-e180. [PMID: 38636629 DOI: 10.1016/j.wneu.2024.04.060] [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: 10/20/2023] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE Smoking tobacco cigarettes negatively impacts bone healing after spinal fusion. Smoking history is often assessed based on current smoker and nonsmoker status. However, in current research, smoking history has not been quantified in terms of pack years to estimate lifetime exposure and assess its effects. Our goal was to investigate the influence of smoking history, quantified in pack years, on bony fusion after anterior cervical discectomy and fusion (ACDF). METHODS A retrospective chart review of consecutive patients who underwent ACDF for cervical disc degeneration between September 21, 2017 and October 17, 2018 was conducted. Patient demographics, procedural variables, and postoperative outcomes were analyzed. Multivariate logistic regression analysis was performed to identify predictive factors for bony fusion following ACDF. Receiver operating characteristic curve analysis was used to determine the optimal discrimination threshold for smoking history pack years in association with nonfusion. RESULTS Among 97 patients identified, 90 (93%) demonstrated bony fusion on postoperative imaging. Mean number of smoking history pack years was 6.1 ± 13 for the fusion group and 16 ± 21 for the nonfusion group. Multivariate logistic regression analysis suggested that increased pack years of tobacco cigarette smoking was a significant predictor of nonfusion (95% confidence interval, [1.0,1.1], P = 0.045). The receiver operating characteristic curve analysis revealed that 6.1 pack years best stratified the risk for nonfusion (area under the curve, 0.8). CONCLUSIONS Patients with a history of tobacco cigarette smoking ≥6.1 pack years may have an increased risk of nonfusion after ACDF.
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Affiliation(s)
- Marissa D Kruk
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
| | - Mohamed A R Soliman
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA; Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Alexander O Aguirre
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
| | - Cathleen C Kuo
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
| | - Nicco Ruggiero
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA
| | - Esteban Quiceno
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - Asham Khan
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - Moleca M Ghannam
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - David E Smolar
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - John Pollina
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - Jeffrey P Mullin
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA.
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12
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Ansari SM, Hession PS, David M, Blanc N, de La Bourdonnaye G, Pouly S, Haziza C. Impact of switching from cigarette smoking to tobacco heating system use on biomarkers of potential harm in a randomized trial. Biomarkers 2024; 29:298-314. [PMID: 38804903 DOI: 10.1080/1354750x.2024.2358318] [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: 02/21/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Smoking cessation reduces the risk of developing smoking-related diseases. Although smoking prevalence has declined, many continue smoking cigarettes. Switching completely to smoke-free alternatives like the Tobacco Heating System (THS) 2.2-a heated tobacco product for which there is evidence demonstrating significantly reduced formation and exposure to harmful chemicals compared to cigarettes-has the potential to reduce the harm caused by continuing to smoke cigarettes. METHODS We conducted a 6-month clinical study (NCT02396381) with a 6-month extension (NCT02649556), initially randomizing 984 adult smokers to continue smoking or switch to THS (non-mentholated), of which 672 continued into the extension study. Endpoints were evaluated at baseline and at 3, 6, and 12 months. We longitudinally assessed biomarkers of potential harm (BoPHs) known to be reversible upon smoking cessation as indicators of pathways involved in the pathogenesis of cardiovascular or respiratory diseases and carcinogenicity. The need to cough and safety profile were also assessed. Impact on eight key BoPHs was used as a proxy to evaluate harm reduction potential. RESULTS At 12 months, comparison of BoPH levels between the predominant THS use and cigarette smoking groups showed a positive effect in favor of switching, partially or in full, to THS. CONCLUSION These results provide additional evidence of the harm reduction potential of THS for smokers who would otherwise continue smoking, but they need to be verified in long-term confirmatory studies. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT0264955. Date of registration: January 7, 2016 https://clinicaltrials.gov/ct2/show/NCT02649556.
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Affiliation(s)
| | - Paul S Hession
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
| | - Morgane David
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
| | - Nicolas Blanc
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
| | | | - Sandrine Pouly
- PMI R&D, Philip Morris Products S.A, Neuchâtel, Switzerland
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Poliakova N, Shrier LA, Harris SK, Bélanger RE. Predicting Time to Return to Cannabis Use After a Cessation Attempt: Impact of Cumulated Exposure to Nicotine-Containing Products. Tob Use Insights 2024; 17:1179173X241259603. [PMID: 38846268 PMCID: PMC11155328 DOI: 10.1177/1179173x241259603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 05/09/2024] [Indexed: 06/09/2024] Open
Abstract
Objective: Cannabis is frequently co-used with tobacco/nicotine products, especially among young adults. Little is known about the effects of this co-use on cannabis cessation outcomes. Within a sample of young adults using cannabis frequently (current use of ≥5 days/week in the past 3 months), this study aimed to (a) document sources of exposure to tobacco/nicotine products, whether used simultaneously with cannabis or on different occasions, (b) examine if the level of cumulated exposure to tobacco/nicotine (self-reported or from biochemical testing) could predict time to cannabis lapse during a cannabis abstinence period, and (c) explore the relationship between nicotine/tobacco exposure and time to cannabis lapse according to tobacco cigarette smoking status. Method: Urine cotinine measures and self-reported data on use of different tobacco/nicotine products, collected from 32 participants (aged 19 to 23), were analyzed to predict time to lapse during a 2-week period of attempted abstinence from cannabis, controlling for cannabis dependence and sex. Results: Half of participants (56.3%) used at least one tobacco/nicotine product. Higher urine cotinine, representing higher cumulated tobacco/nicotine exposure, was related to a higher risk of lapsing (Hazard Ratio [HR] = 1.64; 95%CI [1.04, 2.58]). The risk of lapsing was even higher ([HR] = 3.46; 95%CI [1.17, 10.25]) among heavily tobacco/nicotine exposed (>600 ng/mL, urine cotinine) participants than among unexposed (<50 ng/mL) or lightly/moderately exposed (50-600 ng/mL) participants. Among those smoking cigarettes (solely or in combination with other products), there was no relation between cotinine level and time to lapse, likely due to a reduced variability in abstinence probability and a high likelihood of lapse observed for higher cotinine levels, mainly achieved by cigarette use. Conclusions: With a rapidly changing landscape of tobacco/nicotine use, our results underscore the need to consider all sources of tobacco/nicotine exposure to fully understand the specific and cumulative contributions of tobacco/nicotine to cannabis cessation outcomes.
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Affiliation(s)
- Natalia Poliakova
- Research Centre of CHU de Québec-Université Laval, Quebec City, QC, Canada
| | - Lydia A. Shrier
- Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sion Kim Harris
- Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Richard E. Bélanger
- Research Centre of CHU de Québec-Université Laval, Quebec City, QC, Canada
- Faculty of Medicine, Université Laval, Quebec City, QC, Canada
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Bartholomew K, Aye PS, Aitken C, Chambers E, Neville C, Maxwell A, Sandiford P, Puloka A, Crengle S, Poppe K, Doughty RN, Hill A. Smoking data quality of primary care practices in comparison with smoking data from the New Zealand Māori and Pacific abdominal aortic aneurysm screening programme: an observational study. BMC Public Health 2024; 24:1513. [PMID: 38840063 PMCID: PMC11154981 DOI: 10.1186/s12889-024-19021-8] [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: 09/18/2023] [Accepted: 05/31/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Quality smoking data is crucial for assessing smoking-related health risk and eligibility for interventions related to that risk. Smoking information collected in primary care practices (PCPs) is a major data source; however, little is known about the PCP smoking data quality. This project compared PCP smoking data to that collected in the Māori and Pacific Abdominal Aortic Aneurysm (AAA) screening programme. METHODS A two stage review was conducted. In Stage 1, data quality was assessed by comparing the PCP smoking data recorded close to AAA screening episodes with the data collected from participants at the AAA screening session. Inter-rater reliability was analysed using Cohen's kappa scores. In Stage 2, an audit of longitudinal smoking status was conducted, of a subset of participants potentially misclassified in Stage 1. Data were compared in three groups: current smoker (smoke at least monthly), ex-smoker (stopped > 1 month ago) and never smoker (smoked < 100 cigarettes in lifetime). RESULTS Of the 1841 people who underwent AAA screening, 1716 (93%) had PCP smoking information. Stage 1 PCP smoking data showed 82% concordance with the AAA data (adjusted kappa 0.76). Fewer current or ex-smokers were recorded in PCP data. In the Stage 2 analysis of discordant and missing data (N = 313), 212 were enrolled in the 29 participating PCPs, and of these 13% were deceased and 41% had changed PCP. Of the 93 participants still enrolled in the participating PCPs, smoking status had been updated for 43%. Data on quantity, duration, or quit date of smoking were largely missing in PCP records. The AAA data of ex-smokers who were classified as never smokers in the Stage 2 PCP data (N = 27) showed a median smoking cessation duration of 32 years (range 0-50 years), with 85% (N = 23) having quit more than 15 years ago. CONCLUSIONS PCP smoking data quality compared with the AAA data is consistent with international findings. PCP data captured fewer current and ex-smokers, suggesting ongoing improvement is important. Intervention programmes based on smoking status should consider complementary mechanisms to ensure eligible individuals are not missed from programme invitation.
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Affiliation(s)
- Karen Bartholomew
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Phyu Sin Aye
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand.
- University of Auckland, Auckland, New Zealand.
| | - Charlotte Aitken
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Erin Chambers
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Cleo Neville
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Anna Maxwell
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Peter Sandiford
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | - Aivi Puloka
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
| | | | | | | | - Andrew Hill
- Service Improvement and Innovation, Health New Zealand Te Whatu Ora, Auckland, New Zealand
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15
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Nishimoto D, Ibusuki R, Shimoshikiryo I, Shibuya K, Tanoue S, Koriyama C, Takezaki T, Oze I, Ito H, Hishida A, Tamura T, Kato Y, Tamada Y, Nishida Y, Shimanoe C, Suzuki S, Nishiyama T, Ozaki E, Tomida S, Kuriki K, Miyagawa N, Kondo K, Arisawa K, Watanabe T, Ikezaki H, Otonari J, Wakai K, Matsuo K. Association Between Awareness of Limiting Food Intake and All-cause Mortality: A Cohort Study in Japan. J Epidemiol 2024; 34:286-294. [PMID: 37926519 PMCID: PMC11078597 DOI: 10.2188/jea.je20220354] [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: 11/07/2023] Open
Abstract
BACKGROUND Improving diets requires an awareness of the need to limit foods for which excessive consumption is a health problem. Since there are limited reports on the link between this awareness and mortality risk, we examined the association between awareness of limiting food intake (energy, fat, and sweets) and all-cause mortality in a Japanese cohort study. METHODS Participants comprised 58,772 residents (27,294 men; 31,478 women) aged 35-69 years who completed baseline surveys of the Japan Multi-Institutional Collaborative Cohort Study from 2004 to 2014. Hazard ratios (HRs) for all-cause mortality and 95% confidence intervals (CIs) were estimated by sex using a Cox proportional hazard model, with adjustment for related factors. Mediation analysis with fat intake as a mediator was also conducted. RESULTS The mean follow-up period was 11 years, and 2,516 people died. Estimated energy and fat intakes according to the Food Frequency Questionnaire were lower in those with awareness of limiting food intake than in those without this awareness. Women with awareness of limiting fat intake showed a significant decrease in mortality risk (HR 0.73; 95% CI, 0.55-0.94). Mediation analysis revealed that this association was due to the direct effect of the awareness of limiting fat intake and that the total effect was not mediated by actual fat intake. Awareness of limiting energy or sweets intake was not related to mortality risk reduction. CONCLUSION Awareness of limiting food intake had a limited effect on reducing all-cause mortality risk.
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Affiliation(s)
- Daisaku Nishimoto
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
- School of Health Sciences, Faculty of Medicine, Kagoshima University
| | - Rie Ibusuki
- Department of Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Ippei Shimoshikiryo
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
- Environmental Epidemiology Section, Health and Environmental Risk Division, National Institute for Environmental Studies
| | | | - Shiroh Tanoue
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Chihaya Koriyama
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Toshiro Takezaki
- Community Medicine Support Center, Kagoshima University Hospital
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center
| | - Hidemi Ito
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute
- Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Yasufumi Kato
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Yudai Tamada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Yuichiro Nishida
- Department of Preventive Medicine, Faculty of Medicine, Saga University
| | | | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine
| | - Satomi Tomida
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine
- Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine
| | - Kiyonori Kuriki
- Laboratory of Public Health, Division of Nutritional Sciences, School of Food and Nutritional Sciences, University of Shizuoka
| | - Naoko Miyagawa
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
- Department of Public Health, Shiga University of Medical Science
| | - Keiko Kondo
- NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Kokichi Arisawa
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Watanabe
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital
- Department of Comprehensive General Internal Medicine, Kyushu University Faculty of Medical Sciences
| | - Jun Otonari
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University Hospital
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine
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Chen M, Ding N, Grams ME, Matsushita K, Ishigami J. Cigarette Smoking and Risk of Hospitalization With Acute Kidney Injury: The Atherosclerosis Risk in Communities (ARIC) Study. Am J Kidney Dis 2024; 83:794-802.e1. [PMID: 38070588 PMCID: PMC11116070 DOI: 10.1053/j.ajkd.2023.10.008] [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: 03/30/2023] [Revised: 09/04/2023] [Accepted: 10/29/2023] [Indexed: 02/02/2024]
Abstract
RATIONALE & OBJECTIVE Smoking is a modifiable risk factor for various adverse events. However, little is known about the association of smoking with the incidence of acute kidney injury (AKI) in the general population. This study investigated the association of cigarette smoking with the risk of AKI. STUDY DESIGN Prospective observational study. SETTING & PARTICIPANTS 14,571 participants (mean age 55±6 years, 55% women, and 25% Black participants) from the ARIC study visit 1 (1987-1989) followed through December 31, 2019. EXPOSURE Smoking parameters (status, duration, pack-years, intensity, and years since cessation). OUTCOME Incident hospitalization with AKI, defined by a hospital discharge with a diagnostic code relevant to AKI. ANALYTICAL APPROACH Multivariable Cox regression models. RESULTS Over a median follow-up period of 26.3 years, 2,984 participants had an incident hospitalization with AKI. Current and former smokers had a significantly higher risk of AKI compared to never smokers after adjusting for potential confounders (HR, 2.22 [95% CI, 2.02-2.45] and 1.12 [1.02-1.23], respectively). A dose-response association was consistently seen for each of smoking duration, pack-years, and intensity with AKI (eg, HR, 1.19 [95% CI, 1.16-1.22] per 10 years of smoking). When years since cessation were considered as a time-varying exposure, the risk of AKI associated with smoking compared with current smokers began to decrease after 10 years, and became similar to never smokers at 30 years (HR for≥30 years, 1.07 [95% CI, 0.97-1.20] vs never smokers). LIMITATIONS Self-reported smoking measurements and missing outpatient AKI cases. CONCLUSIONS In a community-based cohort, all smoking parameters were robustly associated with the risk of AKI. Smoking cessation was associated with decreased risk of AKI, although the excess risk lasted up to 30 years. Our study supports the importance of preventing smoking initiation and promoting smoking cessation for the risk of AKI. PLAIN-LANGUAGE SUMMARY Smoking is a behavior that is associated with many negative health effects. It is not well understood how smoking relates to the occurrence of acute kidney injury (AKI) in the community. In this study, we looked at data from a group of 14,571 adults who were followed for 26 years to see how different aspects of smoking (such as whether someone smoked, how long they smoked for, how many cigarettes they smoked per day, and whether they quit smoking) were related to AKI. We found that smoking was strongly linked to an increased risk of AKI. This risk decreased after 5-10 years of quitting smoking, but the excess risk lasted up to 30 years. This study shows the importance of preventing people from starting smoking and to encourage smokers to quit to reduce their risk of AKI.
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Affiliation(s)
- Mengkun Chen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ning Ding
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Morgan E Grams
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Division of Precision of Medicine, Department of Medicine, Grossman School of Medicine, New York University, New York, New York
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Junichi Ishigami
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
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Dahne J, Wahlquist AE, McClure EA, Natale N, Carpenter MJ, Tomko RL. Remote Carbon Monoxide Capture via REDCap: Evaluation of an Integrated Mobile Application. Nicotine Tob Res 2024; 26:696-703. [PMID: 37983048 PMCID: PMC11109493 DOI: 10.1093/ntr/ntad230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/10/2023] [Accepted: 11/17/2023] [Indexed: 11/21/2023]
Abstract
INTRODUCTION To improve the feasibility of remote biochemical verification of smoking status, our team developed "COast," a mobile app integrated with REDCap that allows a research participant to complete self-report research assessments and provide a breath sample via the iCOQuit Smokerlyzer for the purposes of carbon monoxide (CO) testing. The aims of the present study were to examine (1) the validity of remote CO data capture using COast as compared to gold-standard approaches (salivary cotinine, stand-alone CO monitor) and (2) the feasibility of remote CO data capture using COast as applied to both daily and weekly CO collection schedules. METHODS Participants (N = 143, 59% Female), including recently quit (n = 36) and current (n = 107) smokers, completed a baseline video session to capture validity data, and then were randomized to daily or weekly CO monitoring for a period of 1 month. RESULTS Balancing both sensitivity and specificity, optimal cut-points for defining abstinence using the COast system were <4 parts per million (ppm) with salivary cotinine as the referent (Sensitivity = 100%, Specificity = 92.8%) and <8 ppm with the stand-alone CO monitor as the referent (Sensitivity = 100%, Specificity = 88.9%). Compliance across groups with CO monitoring was high with average compliance of 74% for the daily group and 84% for the weekly group. Self-reported feasibility and acceptability of using the system were strong. CONCLUSIONS Pairing the iCOQuit with REDCap via the COast app was both valid and feasible among a sample of adults who smoke cigarettes enrolled remotely. This integration may help to improve the rigor of decentralized smoking cessation trials. IMPLICATIONS With increasing prevalence of decentralized trial designs, innovative methods are needed to remotely capture biomarkers. Methods that leverage existing widely available research data capture platforms may be particularly useful for promoting adoption. The COast app, which integrates a Bluetooth-enabled CO monitor with REDCap, is a fitting, valid, and feasible solution to remotely biochemically verify smoking status.
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Affiliation(s)
- Jennifer Dahne
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
- Hollings Cancer Center, MUSC, Charleston, SC, USA
| | - Amy E Wahlquist
- Center for Rural Health Research, East Tennessee State University, Johnson City, TN, USA
| | - Erin A McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
- Hollings Cancer Center, MUSC, Charleston, SC, USA
| | - Noelle Natale
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
- Hollings Cancer Center, MUSC, Charleston, SC, USA
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
- Hollings Cancer Center, MUSC, Charleston, SC, USA
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
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Park SK, Oh CM, Kim E, Ryoo JH, Jung JY. The longitudinal analysis for the association between smoking and the risk of depressive symptoms. BMC Psychiatry 2024; 24:364. [PMID: 38750466 PMCID: PMC11094926 DOI: 10.1186/s12888-024-05828-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Despite high smoking rate in people with depressive symptoms, there is ongoing debate about relationship between smoking and depressive symptoms. METHODS Study participants were 57,441 Korean men. We collected their baseline data between 2011 and 2012, and conducted follow-up from 2013 to 2019. They were categorized by smoking status (never: < 100 cigarettes smoking in life time, former: currently quitting smoking, and current smoker: currently smoking), smoking amount (pack/day and pack-year) and urine cotinine excretion. The development of depressive symptoms was determined in CES-D score ≥ 16. Cox proportional hazards model was used to analyze the multivariable-adjusted hazard ratio (HR) and 95% confidence intervals (CI) for depressive symptoms in relation to smoking status, smoking amount, and urine cotinine excretion. RESULTS During 6.7 years of median follow-up, the risk of depressive symptoms increased in order of never (reference), former (HR = 1.08, 95% CI: 1.01-1.15) and current smoker (HR = 1.24, 95% CI: 1.16-1.32). Among current smoker, the risk of depressive symptoms increased proportionally to daily smoking amount (< 1 pack; HR = 1.21, 95% CI: 1.13-1.29, and ≥ 1 pack; HR = 1.34, 95% CI: 1.23 - 1.45). This pattern of relationship was consistently observed for pack-year in former smoker and current smoker. Additionally, urine cotinine excretion was proportionally associated with the risk of depressive symptoms. CONCLUSION Exposure to smoking was associated with the increased risk of depressive symptoms. Dose dependent relationship was observed between smoking amount and the risk of depressive symptoms.
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Affiliation(s)
- Sung Keun Park
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang-Mo Oh
- Departments of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Eugene Kim
- Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hong Ryoo
- Departments of Occupational and Environmental Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Ju Young Jung
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.
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Stattin K, Eriksson M, Frithiof R, Kawati R, Crockett D, Hultström M, Lipcsey M. Smoking is associated with higher risk of contracting bacterial infection and pneumonia, intensive care unit admission and death. PLoS One 2024; 19:e0302505. [PMID: 38722836 PMCID: PMC11081217 DOI: 10.1371/journal.pone.0302505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/05/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Smoking has been associated with a higher risk of contracting pneumonia, but contradictory results have shown that smoking may or may not decrease the risk of dying in pneumonia. The aim of this study is to investigate how smoking is associated with contracting any infection and pneumonia and death. METHOD AND FINDINGS Participants were drawn from the population-based Cohort of Swedish Men and the Swedish Mammography Cohort, which are representative of the Swedish population. Participants have answered detailed lifestyle questionnaires and have been followed in national registers, such as the Patient Register, Cause of Death register and Swedish Intensive Care Registry. The risks of contracting infection and pneumonia or dying in infection and pneumonia were assessed using Cox regression. Of 62,902 cohort participants, 25,297 contracted an infection of which 4,505 died; and 10,471 contracted pneumonia of which 2,851 died. Compared to never smokers, former smokers at baseline had hazard ratio (HR) 1.08 (95% confidence interval (CI) 1.05-1.12) of contracting and HR 1.19 (95% CI 1.11-1.28) of dying in infection and HR 1.17 (95% CI 1.12-1.23) of contracting and HR 1.16 (95% CI 1.06-1.27) of dying in pneumonia during follow-up. Compared to never smokers, current smokers at baseline had HR 1.17 (95% CI 1.13-1.21) of contracting infection and HR 1.64 (95% CI 1.52-1.77) dying in infection; HR 1.42 (95% CI 1.35-1.49) of contracting pneumonia and HR 1.70 (95% CI 1.55-1.87) of dying in pneumonia during follow-up. The risk of contracting and dying in infection and pneumonia increased in a dose-response manner with number of pack years smoked and decreased with years since smoking cessation. CONCLUSION Smoking is associated with contracting and dying in any infection and pneumonia and the risk increases with pack years smoked, highlighting the importance of both primary prevention and smoking cessation.
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Affiliation(s)
- Karl Stattin
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Mikael Eriksson
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Robert Frithiof
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Rafael Kawati
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Douglas Crockett
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Michael Hultström
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
- Department of Medical Cell Biology, Integrative Physiology, Uppsala University, Uppsala, Sweden
| | - Miklos Lipcsey
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
- Hedenstierna Laboratory, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Song J, Wang P, Li H. Sex disparities in the association between serum cotinine and chronic kidney disease. Tob Induc Dis 2024; 22:TID-22-68. [PMID: 38686043 PMCID: PMC11056949 DOI: 10.18332/tid/185965] [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: 11/07/2023] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION Despite the existence of numerous studies highlighting the adverse effects of smoking on kidney function, the investigation of the correlation between serum cotinine and chronic kidney disease (CKD) remains inconclusive due to insufficient evidence. Consequently, the primary objective of this study was to ascertain the association between serum cotinine levels and CKD. METHODS This study analyzed data from 10900 Americans participating in the National Health and Nutrition Examination Survey between 2005 and 2016. The independent variable under investigation was log serum cotinine, while the dependent variable was the presence of CKD. To investigate the potential linear and non-linear correlations between serum cotinine and CKD, logistic regression models and generalized additive models (GAM) were employed. Furthermore, stratified analyses and interaction tests were conducted to evaluate potential disparities in the relationship between serum cotinine and CKD, based on sex. RESULTS The median age in the study participants was 49.28 ± 17.96 years, and the median log serum cotinine (ng/mL) was -0.54 ± 1.68. The prevalence of CKD was found to be 17.04%. Multifactorial regression analysis did not show a statistically significant association between log serum cotinine and CKD (OR=1.02; 95% CI: 0.98-1.06, p=0.4387). A statistically significant non-linear association between log serum cotinine and CKD was also not observed in the GAM analysis (p non-linear value=0.091). Subgroup analyses revealed sex differences in the association between log serum cotinine and CKD. Briefly, males had a positive association between log serum cotinine and incident CKD (OR=1.08; 95% CI: 1.02-1.15, p=0.0049). In females, there was a U-shaped association between log serum cotinine and CKD, with an optimal inflection point for log serum cotinine of -0.30 (serum cotinine=0.5 ng/mL). CONCLUSIONS Cross-sectional analyses of NHANES data showed gender differences in the association between serum cotinine and the development of CKD.
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Affiliation(s)
- Jianling Song
- Department of Nephrology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People's Republic of China
| | - Ping Wang
- Department of Gynecology and Obstetrics, Yongfeng People's Hospital, Jian, People's Republic of China
| | - Hong Li
- Department of Medical Records, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, People's Republic of China
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Campagna D, Farsalinos K, Costantino G, Carpinteri G, Caponnetto P, Cucuzza F, Polosa R. Tobacco Smoking or Nicotine Phenotype and Severity of Clinical Presentation at the Emergency Department (SMOPHED): Protocol for a Noninterventional Observational Study. JMIR Res Protoc 2024; 13:e54041. [PMID: 38657239 PMCID: PMC11079756 DOI: 10.2196/54041] [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: 10/27/2023] [Revised: 01/24/2024] [Accepted: 02/19/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND In the last few years, several nicotine products have become available as alternatives to smoking tobacco. While laboratory and limited clinical studies suggest that these devices are less toxic compared to classic tobacco cigarettes, very little is known about their epidemiological impact. Visiting the emergency department (ED) often represents the first or even the only contact of patients with the health care system. Therefore, a study conducted at the ED to assess the impact of these products on health can be reliable and reflect a real-life setting. OBJECTIVE The aim of this noninterventional observational study (SMOPHED study) is to analyze the association between the severity of clinical presentation observed during ED visits among patients using various nicotine products and the subsequent outcomes, specifically hospitalization and mortality. METHODS Outcomes (hospitalization and mortality in the ED) will be examined in relation to various patterns of nicotine products use. We plan to enroll approximately 2000 participants during triage at the ED. These individuals will be characterized based on their patterns of tobacco and nicotine consumption, identified through a specific questionnaire. This categorization will allow for a detailed analysis of how different usage patterns of nicotine products correlate with the clinical diagnosis made during the ED visits and the consequent outcomes. RESULTS Enrollment into the study started in March 2024. We enrolled a total of 901 participants in 1 month (approximately 300 potential participants did not provide the informed consent to participate). The data will be analyzed by a statistician as soon as the database is completed. Full data will be published by December 2024. CONCLUSIONS There is substantial debate about the harm reduction potential of alternative nicotine products in terms of their smoking-cessation and risk-reduction potential. This study represents an opportunity to document epidemiological data on the link between the use of different types of nicotine products and disease diagnosis and severity during an ED visit, and thus evaluate the harm reduction potential claims for these products. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54041.
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Affiliation(s)
- Davide Campagna
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction, University of Catania, Catania, Italy
- Emergency Department, Policlinico Teaching Hospital, Catania, Italy
| | - Konstantinos Farsalinos
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Giorgio Costantino
- Scientific Institute for Research, Hospitalization and Healthcare Ca' Granda Ospedale Maggiore Policlinico, Unità Operativa Complessa Pronto Soccorso e Medicina d'Urgenza, University of Milan, Milan, Italy
| | | | - Pasquale Caponnetto
- Department of Educational Sciences, Section of Psychology, University of Catania, Catania, Italy
| | | | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction, University of Catania, Catania, Italy
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22
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Fu H, Zhang D, Li Y. NHANES-based analysis of the correlation between leisure-time physical activity, serum cotinine levels and periodontitis risk. BMC Oral Health 2024; 24:466. [PMID: 38632582 PMCID: PMC11022427 DOI: 10.1186/s12903-024-04141-9] [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: 11/26/2023] [Accepted: 03/13/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To investigate the association of leisure-time physical activity and serum cotinine levels with the risk of periodontitis in the general population and to further analyze the interaction between leisure-time physical activity and serum cotinine levels on the risk of periodontitis. METHODS This was a cross-sectional study, extracting data from 9605 (56.19%) participants in the National Health and Nutrition Examination Survey (NHANES) database from 2009 to 2014, and analyzing the relationship and interaction effects of serum cotinine level, leisure time physical activity, and risk of periodontitis by weighted univariate logistic modeling; Effect sizes were determined using ratio of ratios (OR), 95% confidence intervals (95% CI). RESULTS 5,397 (56.19%) of 9,605 participants had periodontitis; an increased risk of periodontitis was found in those in the leisure time physical activity intensity < 750 MET × min/week group (OR = 1.44, 95% CI: 1.17-1.78). Serum cotinine levels ≥ 0.05 ng/ml were associated with an increased risk of periodontitis (OR = 1.99, 95% CI: 1.69-2.33). The group with low leisure physical activity and serum cotinine levels ≥ 0.05 ng/ml had an increased risk of periodontitis compared to the group with high leisure physical activity and serum cotinine levels < 0.05 ng/ml (OR = 2.48, 95% CI: 1.88-3.27). Interaction metrics RERI = 0.90 (95% CI: 0.44-1.36) and API = 0.36 (95% CI: 0.18-0.55); CI for SI = 2.55 (95% CI: 1.03-6.28). for API 0.36. CONCLUSION Leisure time physical activity intensity interacted with smoking exposure on periodontitis risk and may provide the general population with the opportunity to Increasing leisure-time physical activity and smoking cessation may provide recommendations for the general population.
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Affiliation(s)
- Hua Fu
- Shangyu people's Hospital, Shaoxing City, Zhejiang Province, 312300, China.
| | - Diya Zhang
- Run Run Shaw Hospital, Zhejiang University, Hangzhou City, Zhejiang Province, China
| | - Yining Li
- Zhejiang University Affiliated Stomatology Hospital, Hangzhou City, Zhejiang Province, China
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Knie LV, Leknes KN, Xue Y, Lie SA, Bunæs DF. Serum biomarker levels in smokers and non-smokers following periodontal therapy. A prospective cohort study. BMC Oral Health 2024; 24:463. [PMID: 38627806 PMCID: PMC11020793 DOI: 10.1186/s12903-024-04196-8] [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: 10/27/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND To compare presence and levels of serum cytokines in smokers and non-smokers with periodontitis following periodontal therapy. METHODS Thirty heavy smokers and 30 non-smokers with stage III or IV periodontitis were included in this prospective cohort study. Clinical data and blood serum were collected at baseline (T0), after step I-III (T1), and after 12 months step IV periodontal therapy (T2). Cytokine IL-1β, IL-6, IL-8, TNF-α, IL-10, and IP-10 levels were measured using multiplex kit Bio-Plex Human Pro™ Assay. Linear regression models with cluster robust variance estimates to adjust for repeated observations were used to test intra- and intergroup levels for each marker, IL-6 and IL-8 defined as primary outcomes. RESULTS Clinical outcomes improved in both groups following therapy (p < 0.05). IL-6 levels increased with 75.0% from T0-T2 among smokers (p = 0.004). No significant intra- or intergroup differences were observed for IL-8. Higher levels of TNF-α (44.1%) and IL-10 (50.6%) were detected in smokers compared with non-smokers at T1 (p = 0.007 and p = 0.037, respectively). From T1-T2, differences in mean change over time for levels of TNF-α and IL-10 were observed in smokers compared with non-smokers (p = 0.005 and p = 0.008, respectively). CONCLUSION Upregulated levels of serum cytokines in smokers indicate a systemic effect of smoking following periodontal therapy. Differences in cytokine levels between smokers and non-smokers demonstrate a smoking induced modulation of specific systemic immunological responses in patients with severe periodontitis.
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Affiliation(s)
- Lorenz V Knie
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadsveien 19, Bergen, N-5009, Norway
- Oral Health Centre of Expertise Rogaland, Stavanger, Norway
| | - Knut N Leknes
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadsveien 19, Bergen, N-5009, Norway
| | - Ying Xue
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadsveien 19, Bergen, N-5009, Norway
- Faculty of Health Sciences, Department of Clinical Dentistry, UiT The Arctic University of Norway, Tromsø, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadsveien 19, Bergen, N-5009, Norway
| | - Dagmar F Bunæs
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadsveien 19, Bergen, N-5009, Norway.
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Romero Villela PN, Evans LM, Palviainen T, Border R, Kaprio J, Palmer RHC, Keller MC, Ehringer MA. Loci on chromosome 20 interact with rs16969968 to influence cigarettes per day in European ancestry individuals. Drug Alcohol Depend 2024; 257:111126. [PMID: 38387257 PMCID: PMC11062023 DOI: 10.1016/j.drugalcdep.2024.111126] [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: 10/20/2023] [Revised: 01/12/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND The understanding of the molecular genetic contributions to smoking is largely limited to the additive effects of individual single nucleotide polymorphisms (SNPs), but the underlying genetic risk is likely to also include dominance, epistatic, and gene-environment interactions. METHODS To begin to address this complexity, we attempted to identify genetic interactions between rs16969968, the most replicated SNP associated with smoking quantity, and all SNPs and genes across the genome. RESULTS Using the UK Biobank European subsample, we found one SNP, rs1892967, and two genes, PCNA and TMEM230, that showed a significant genome-wide interaction with rs16969968 for log10 CPD and raw CPD, respectively, in a sample of 116 442 individuals who self-reported currently or previously smoking. We extended these analyses to individuals of South Asian descent and meta-analyzed the combined sample of 117 212 individuals of European and South Asian ancestry. We replicated the gene findings in a meta-analysis of five Finnish samples (N=40 140): FinHealth, FINRISK, Finnish Twin Cohort, GeneRISK, and Health-2000-2011. CONCLUSIONS To our knowledge, this represents the first reliable epistatic association between single nucleotide polymorphisms for smoking behaviors and provides a novel direction for possible future functional studies related to this interaction. Furthermore, this work demonstrates the feasibility of these analyses by pooling multiple datasets across various ancestries, which may be applied to other top SNPs for smoking and/or other phenotypes.
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Affiliation(s)
- Pamela N Romero Villela
- Institute for Behavioral Genetics, University of Colorado, Boulder, USA; Department of Psychology and Neuroscience, University of Colorado, Boulder, USA
| | - Luke M Evans
- Institute for Behavioral Genetics, University of Colorado, Boulder, USA; Department of Ecology and Evolutionary Biology, University of Colorado, Boulder, USA
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, USA
| | - Richard Border
- Departments of Neurology and Computer Science, University of California, Los Angeles, USA
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, USA
| | - Rohan H C Palmer
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
| | - Matthew C Keller
- Institute for Behavioral Genetics, University of Colorado, Boulder, USA; Department of Psychology and Neuroscience, University of Colorado, Boulder, USA
| | - Marissa A Ehringer
- Institute for Behavioral Genetics, University of Colorado, Boulder, USA; Departments of Neurology and Computer Science, University of California, Los Angeles, USA; Department of Integrative Physiology, University of Colorado, Boulder, USA.
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Christensen MO, Yüksel YT, Vittrup I, Nymand LK, Thein D, Nørreslet LB, Toft-Hansen JM, Janstrup AK, Zachariae C, Sommerlund M, Bregnhøj A, Egeberg A, Agner T, Thomsen SF, Thyssen JP. Demographics, characteristics and medical treatment among adults with hand eczema in Denmark. A cross-sectional validation and registry-based study. Contact Dermatitis 2024; 90:350-364. [PMID: 37990822 DOI: 10.1111/cod.14456] [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: 05/31/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND The international classification of diseases, 10th revision (ICD-10) includes several unvalidated diagnostic codes for hand eczema (HE). Knowledge is sparse on HE patient characteristics. OBJECTIVES To validate selected HE ICD-10 codes in the Danish National Patient Registry (DNPR) and describe disease characteristics, lifestyle factors and medication use in adult HE patients. METHODS Nineteen HE ICD-10 codes were selected and validated based on patient charts. Five cohorts were constructed based on the diagnostic code, DL30.8H (HE unspecified), in the DNPR: (i) patients with DL30.8H code (n = 8386), (ii) patients with DL30.8H code, but without atopic dermatitis (AD) (n = 7406), (iii) sex- and age-matched general population (n = 8386) without HE. Two additional cohorts nested in the DNPR included participants from the Danish Skin Cohort, (iv) patients with DL30.8H code but without AD (n = 1340) and (v) general population cohort (n = 9876). RESULTS ICD-10 codes revealed positive predictive values ≥90% except irritant contact dermatitis (unspecified) (79.7%) and hyperkeratotic hand and foot eczema (84.1%). HE patients were most often women, middle-aged or older, of Danish ethnicity, had an atopic medical history and were smokers. Topical corticosteroid prescriptions were almost doubled in HE cohorts compared to general populations. CONCLUSION We validated several HE ICD-10 codes and identified important HE patient characteristics.
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Affiliation(s)
- Maria Oberländer Christensen
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Yasemin Topal Yüksel
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ida Vittrup
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Lea Krog Nymand
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - David Thein
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Line Brok Nørreslet
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Maarbjerg Toft-Hansen
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anne Klose Janstrup
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mette Sommerlund
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Bregnhøj
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Tove Agner
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Simon Francis Thomsen
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Pontoppidan Thyssen
- Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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Laudanski K, Mahmoud MA, Ahmed AS, Susztak K, Mathew A, Chen J. Immunological Signatures in Blood and Urine in 80 Individuals Hospitalized during the Initial Phase of COVID-19 Pandemic with Quantified Nicotine Exposure. Int J Mol Sci 2024; 25:3714. [PMID: 38612525 PMCID: PMC11011256 DOI: 10.3390/ijms25073714] [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: 12/31/2023] [Revised: 02/27/2024] [Accepted: 03/02/2024] [Indexed: 04/14/2024] Open
Abstract
This research analyzes immunological response patterns to SARS-CoV-2 infection in blood and urine in individuals with serum cotinine-confirmed exposure to nicotine. Samples of blood and urine were obtained from a total of 80 patients admitted to hospital within 24 h of admission (tadm), 48 h later (t48h), and 7 days later (t7d) if patients remained hospitalized or at discharge. Serum cotinine above 3.75 ng/mL was deemed as biologically significant exposure to nicotine. Viral load was measured with serum SARS-CoV-2 S-spike protein. Titer of IgG, IgA, and IgM against S- and N-protein assessed specific antiviral responses. Cellular destruction was measured by high mobility group box protein-1 (HMGB-1) serum levels and heat shock protein 60 (Hsp-60). Serum interleukin 6 (IL-6), and ferritin gauged non-specific inflammation. The immunological profile was assessed with O-link. Serum titers of IgA were lower at tadm in smokers vs. nonsmokers (p = 0.0397). IgM at t48h was lower in cotinine-positive individuals (p = 0.0188). IgG did not differ between cotinine-positive and negative individuals. HMGB-1 at admission was elevated in cotinine positive individuals. Patients with positive cotinine did not exhibit increased markers of non-specific inflammation and tissue destruction. The blood immunological profile had distinctive differences at admission (MIC A/B↓), 48 h (CCL19↓, MCP-3↓, CD28↑, CD8↓, IFNγ↓, IL-12↓, GZNB↓, MIC A/B↓) or 7 days (CD28↓) in the cotinine-positive group. The urine immunological profile showed a profile with minimal overlap with blood as the following markers being affected at tadm (CCL20↑, CXCL5↑, CD8↑, IL-12↑, MIC A/B↑, GZNH↑, TNFRS14↑), t48h (CCL20↓, TRAIL↓) and t7d (EGF↑, ADA↑) in patients with a cotinine-positive test. Here, we showed a distinctive immunological profile in hospitalized COVID-19 patients with confirmed exposure to nicotine.
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Affiliation(s)
- Krzysztof Laudanski
- Department of Anesthesiology and Perioperative Care, Mayo Clinic, Rochester, MN 55902, USA;
| | - Mohamed A. Mahmoud
- Department of Pulmonary and Critical Care, Mayo Clinic, Rochester, MN 55902, USA; (M.A.M.); (A.S.A.)
| | - Ahmed Sayed Ahmed
- Department of Pulmonary and Critical Care, Mayo Clinic, Rochester, MN 55902, USA; (M.A.M.); (A.S.A.)
| | - Kaitlin Susztak
- Department of Nephrology, University of Pennsylvania, Philadelphia, PA 19146, USA;
| | - Amal Mathew
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104, USA;
| | - James Chen
- Department of Anesthesiology and Perioperative Care, Mayo Clinic, Rochester, MN 55902, USA;
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Song L, Zhou H, Yang Q, He N, Fu F, Li W, Duan G, Wu D, Hao S, Wang J, Liu J. Association between the oxidative balance score and thyroid function: Results from the NHANES 2007-2012 and Mendelian randomization study. PLoS One 2024; 19:e0298860. [PMID: 38498431 PMCID: PMC10947682 DOI: 10.1371/journal.pone.0298860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/01/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Oxidative stress is a significant contributor to the development of various diseases, and the oxidative balance score (OBS) is a valuable tool for assessing the impact of dietary and lifestyle factors on oxidative stress in humans. Nevertheless, the precise relationship between OBS and thyroid function in adults remains elusive. METHODS This cross-sectional study comprised 6222 adult participants drawn from the National Health and Nutrition Examination Survey (NHANES) conducted from 2007 to 2012. Employing weighted multivariable linear regression modeling, the study estimated the connection between OBS quartiles and thyroid functions. The causal relationship between OBS components and thyroid function was analyzed by Mendelian randomization (MR). RESULTS We found a significant negative correlation between OBS and free thyroxine (FT4) and total thyroxine (TT4). Univariate and multivariate MR Analyses showed a causal relationship between BMI and FT4. Copper, smoking, and riboflavin showed a causal relationship with FT4 after moderation. CONCLUSION We found that a lifestyle high in antioxidant exposure reduced FT4 and TT4 levels in the population. We suggest that BMI, Copper, and Riboflavin are important factors in the regulation of FT4 levels.
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Affiliation(s)
- Liying Song
- Department of Thyroid Surgery, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Haonan Zhou
- Department of Vascular Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences and Tongji Shanxi Hospital, Tongji Medical College of HUST, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Qian Yang
- First School of Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Ningyu He
- Department of Thyroid Surgery, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Feifan Fu
- First School of Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Weichao Li
- Department of Thyroid Surgery, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Guosheng Duan
- Radiotherapy Department, Shanxi Provincial Peoples Hospital: Fifth Hospital of Shanxi Medical University, Taiyuan, China
| | - Di Wu
- Fifth School of Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Shuai Hao
- School of Basic Medicine, Shanxi Medical University, Taiyuan, China
| | - Jiaxing Wang
- School of Management, Shanxi Medical University, Taiyuan, China
| | - Jing Liu
- Department of Thyroid Surgery, First Hospital of Shanxi Medical University, Taiyuan, China
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Maspero S, Delle S, Kraus L, Pogarell O, Hoch E, Bachner J, Lochbühler K. Short-term effectiveness of the national German quitline for smoking cessation: results of a randomized controlled trial. BMC Public Health 2024; 24:588. [PMID: 38395782 PMCID: PMC10893695 DOI: 10.1186/s12889-024-18104-w] [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: 12/04/2023] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The objective of the present study was to examine the short-term effectiveness of the national German quitline for smoking cessation. METHODS A parallel-group, two-arm, superiority, randomized controlled trial with data collection at baseline and post-intervention (three months from baseline) was conducted. Individuals were randomized to either the intervention group, receiving up to six telephone counselling calls, or the control group, receiving an active control intervention (self-help brochure). The primary outcome was the seven-day point prevalence abstinence at post-assessment. Secondary outcomes included changes in smoking-related cognitions and coping strategies from pre- to post-assessment, the perceived effectiveness of intervention components, and the satisfaction with the intervention. RESULTS A total of n = 905 adult daily smokers were assigned to either the intervention group (n = 477) or the control group (n = 428). Intention-to-treat analyses demonstrated that individuals allocated to the telephone counselling condition were more likely to achieve seven-day point prevalence abstinence at post-assessment compared to those allocated to the self-help brochure condition (41.1% vs. 23.1%; OR = 2.3, 95% CI [1.7, 3.1]). Participants who received the allocated intervention in both study groups displayed significant improvements in smoking-related cognitions and coping strategies with the intervention group showing greater enhancements than the control group. This pattern was also found regarding the perceived effectiveness of intervention components and the satisfaction with the intervention. CONCLUSION The present study provides first empirical evidence on the short-term effectiveness of the national German quitline for smoking cessation, highlighting its potential as an effective public health intervention to reduce the burden of disease associated with smoking. TRIAL REGISTRATION This study is registered in the German Clinical Trials Register (DRKS00025343). Date of registration: 2021/06/07.
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Affiliation(s)
- Simona Maspero
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
| | - Simone Delle
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
| | - Ludwig Kraus
- Department of Public Health Science, Centre for Social Research On Alcohol and Drugs, Stockholm University, Stockholm, Sweden
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Eva Hoch
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Joachim Bachner
- Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Kirsten Lochbühler
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany.
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany.
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Wang R, Hall JM, Salloum RG, Kates F, Cogle CR, Bruijnzeel AW, Hong YR, LeLaurin JH. Prevalence of Underreported Nicotine Exposure Among US Nonsmoking Adults: A Comparison of Self-Reported Exposure and Serum Cotinine Levels From NHANES 2013-2020. Nicotine Tob Res 2024; 26:298-306. [PMID: 37647621 DOI: 10.1093/ntr/ntad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Secondhand smoke (SHS) poses a significant health risk. However, individuals who do not smoke may be unaware of their exposure, thereby failing to take protective actions promptly. AIMS AND METHODS We assessed the prevalence of underreported nicotine exposure in a nationally representative sample of US nonsmoking adults using data from the US National Health and Examination Survey. Individuals with underreported nicotine exposure were defined as those who reported no exposure to all tobacco products (traditional tobacco, nicotine replacements, and e-cigarettes) or SHS, yet had detectable levels of serum cotinine (>0.015 ng/mL). We fitted logistic regression models to determine sociodemographic and chronic condition factors associated with underreported nicotine exposure. RESULTS Our analysis included 13 503 adults aged 18 years and older. Between 2013 and 2020, the prevalence of self-reported SHS exposure, serum cotinine-assessed nicotine exposure, and underreported nicotine exposure among US nonsmokers were 22.0%, 51.2%, and 34.6%, respectively. Remarkably, 67.6% with detectable serum cotinine reported no SHS exposure. Males, non-Hispanic blacks, individuals of other races (including Asian Americans, Native Americans, and Pacific Islanders), and those without cardiovascular diseases were more likely to underreport nicotine exposure than their counterparts. The median serum cotinine value was higher in respondents who reported SHS exposure (0.107 ng/mL) than in those who reported no exposure (0.035 ng/mL). We estimate that approximately 56 million US residents had underreported nicotine exposure. CONCLUSIONS Over a third of US nonsmokers underreport their nicotine exposure, underlining the urgent need for comprehensive public awareness campaigns and interventions. Further research into sociodemographic determinants influencing this underreporting is needed. IMPLICATIONS Understanding the extent of underreported nicotine exposure is crucial for developing effective public health strategies and interventions. It is imperative to bolster public consciousness about the risks associated with SHS. Additionally, surveillance tools should also incorporate measures of exposure to outdoor SHS and e-cigarette vapor to enhance the quality of data monitoring. Findings from this study can guide tobacco control initiatives and inform smoke-free air legislation.
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Affiliation(s)
- Ruixuan Wang
- Department of Health Services Research, Management & Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Jaclyn M Hall
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Frederick Kates
- Department of Health Services Research, Management & Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Christopher R Cogle
- Division of Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Adriaan W Bruijnzeel
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Young-Rock Hong
- Department of Health Services Research, Management & Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Jennifer H LeLaurin
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
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Hejjaji V, Ellerbeck EF, Jones PG, Pacheco CM, Malik AO, Chan PS, Spertus JA, Arnold SV. Association Between Cardiovascular Event Type and Smoking Cessation Rates Among Outpatients With Atherosclerotic Cardiovascular Disease: Insights From the NCDR PINNACLE Registry. Circ Cardiovasc Qual Outcomes 2024; 17:e009960. [PMID: 38318702 DOI: 10.1161/circoutcomes.122.009960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 11/07/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND It is unclear how the type of an atherosclerotic cardiovascular disease (ASCVD) event potentially influences patients' likelihood of smoking cessation. METHODS Using 2013 to 2018 data from the US based National Cardiovascular Data Registry Practice Innovation and Clinical Excellence outpatient cardiac registry, we identified patients who were current smokers at a clinic visit and followed them over time for a subsequent ASCVD event. Self-reported smoking status was assessed at each consecutive visit and used to determine smoking cessation after each interim ASCVD event (myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, stroke/transient ischemic attack, peripheral artery disease). We constructed separate multivariable Cox models with nonproportional hazards to examine the association of each interim ASCVD event with smoking cessation, compared with not having an interim ASCVD event. We estimated the relative association of ASCVD event type with smoking cessation using contrast tests. Analyses were stratified by presence versus absence of ASCVD at baseline. RESULTS Across 530 cardiology practices, we identified 1 933 283 current smokers (mean age 62±15, male 54%, ASCVD at baseline 50%). Among the 322 743 patients who had an interim ASCVD event and were still smoking, 41 336 (12.8%) quit smoking by their first subsequent clinic visit, which was higher among those with baseline ASCVD (13.4%) as compared with those without baseline ASCVD (11.5%). Each type of ASCVD event was associated with an increased likelihood of smoking. Patients who had an myocardial infarction, underwent coronary artery bypass graft (hazard ratio, 1.60 [95% CI, 1.55-1.65]), or had a stroke or transient ischemic attack were more likely to quit smoking as compared with those who underwent elective percutaneous coronary intervention or had a new diagnosis of peripheral artery disease (hazard ratio, 1.20 [95% CI, 1.17-1.22]). CONCLUSIONS Only 13% of patients reported smoking cessation after an ASCVD event, with the type of event being associated with the likelihood of smoking cessation, prompting the need for patient-centered interventions.
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Affiliation(s)
- Vittal Hejjaji
- Department of Cardiovascular Medicine, Saint Luke's Mid America Heart Institute, Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
- Department of Cardiovascular Medicine, University of Missouri-Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
| | - Edward F Ellerbeck
- Department of Population Health, University of Kansas School of Medicine, KS (E.F.E.)
| | - Philip G Jones
- Department of Cardiovascular Medicine, Saint Luke's Mid America Heart Institute, Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
- Department of Cardiovascular Medicine, University of Missouri-Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
| | - Christina M Pacheco
- Department of Population Health, University of Kansas Medical Center, KS (C.M.P.)
| | - Ali O Malik
- Department of Cardiovascular Medicine, Saint Luke's Mid America Heart Institute, Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
- Department of Cardiovascular Medicine, University of Missouri-Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
| | - Paul S Chan
- Department of Cardiovascular Medicine, Saint Luke's Mid America Heart Institute, Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
- Department of Cardiovascular Medicine, University of Missouri-Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
| | - John A Spertus
- Department of Cardiovascular Medicine, Saint Luke's Mid America Heart Institute, Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
- Department of Cardiovascular Medicine, University of Missouri-Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
| | - Suzanne V Arnold
- Department of Cardiovascular Medicine, Saint Luke's Mid America Heart Institute, Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
- Department of Cardiovascular Medicine, University of Missouri-Kansas City, MO (V.H., P.G.J., A.O.M., P.S.C., J.A.S., S.V.A.)
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Nordstoga AL, Adhikari S, Skarpsno ES. The joint association of insomnia disorder and lifestyle on the risk of activity-limiting spinal pain: the HUNT Study. Sleep Med 2024; 114:244-249. [PMID: 38241943 DOI: 10.1016/j.sleep.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Abstract
OBJECTIVES To investigate whether the combination of multiple healthy lifestyle factors modify the well-established association between insomnia disorder and risk of activity-limiting spinal pain. METHODS We conducted a prospective study of 10,228 individuals who participated in two surveys over ∼11 years and were free of chronic pain in the neck, upper back, and lower back at baseline. Adjusted risk ratios (RRs) were calculated for the risk of activity-limiting chronic spinal pain (i.e., pain that impairs daily activities at work or leisure time) at follow-up associated with the joint association of insomnia disorder and the combination of five lifestyle factors (body mass index, leisure time physical activity, alcohol consumption, diet, and smoking) at baseline. RESULTS Our data indicate an additive interaction between insomnia disorder and lifestyle on risk of activity-limiting spinal pain, i.e., compared with participants without insomnia disorder and the best lifestyle score, participants with insomnia disorder and the worst lifestyle score had a RR of activity-limiting spinal pain of 3.57 (95 % CI: 2.65-4.80); participants with insomnia disorder and the best lifestyle score had a RR of 1.56 (95 % CI: 0.97-2.50); and those without insomnia disorder and the worst lifestyle score had a RR of 1.32 (95 % CI: 1.12-1.55). CONCLUSIONS Poor lifestyle behaviour amplifies the adverse effect of insomnia disorder on the risk of activity-limiting chronic spinal pain.
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Affiliation(s)
- Anne Lovise Nordstoga
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Shreesti Adhikari
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eivind Schjelderup Skarpsno
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
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Park MB. Comparison of secondhand smoking exposure between self-report and creatinine-corrected urine cotinine: Result from Korean NHANES 2009-2018. J Formos Med Assoc 2024; 123:218-227. [PMID: 37586974 DOI: 10.1016/j.jfma.2023.07.021] [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: 03/29/2021] [Revised: 03/29/2023] [Accepted: 07/31/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND/PURPOSE Second-hand smoking (SHS) is usually examined by self-report (SR). However, there is a possibility that SR may not accurately measure SHS exposure. This study aimed to identify yearly trends and gender differences in SHS by SR and cotinine. METHODS We used data from the 2009-2018 Korea National Health and Nutrition Examination Survey (KNHANES) and included adults aged 19 years and older. We analyzed data of 47,907 respondents on SHS exposures in the past week and of 23,572 respondents who had both urine cotinine and creatinine measurements. SHS exposure was defined as those who answered 'yes' to whether or not they were exposed to smoking by SR. We performed descriptive analysis, Average annual percentage change (AAPC), and multiple regression analysis. All analyses were weighted reflecting the multi-stratified cluster sampling. RESULTS Exposure to SHS indoors at the work place (WSHS) (2009: 44.8%, 2018: 12.3%), indoors at home (HSHS) (2009: 14.1%, 2018: 3.9%), and indoors at public places (PSHS) (2013: 55.6%, 2018: 15.4%) decreased steadily over the years. WSHS and PSHS exposure was higher for males but HSHS was higher for females. However, the concentration of cotinine-to-creatinine ratio (Co/Cr) was higher among females regardless of SHS exposure status and environment. Multiple regression analysis showed that among males, the association between Co/Cr education level and WSHS was the strongest, and among females, the association was the strongest with HSHS. In addition, home exposure to SHS intensified the differences in Co/Cr levels between males and females. CONCLUSION Our study confirmed that cotinine-induced SHS showed different results by year and gender compared to SR. In particular, Co/Cr level in females was higher than in males regardless of exposure by SR, suggesting that SR did not correctly evaluate SHS. To reflect reality more accurately, biomarkers should be monitored along with SR.
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Affiliation(s)
- Myung-Bae Park
- Department of Health and Welfare, Pai Chai University, Daejeon, Republic of Korea.
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Sreeramareddy CT, Acharya K, Manoharan A, Oo PS. Changes in E-cigarette Use, Cigarette Smoking, and Dual-Use Among the Youth (13-15 Years) in 10 Countries (2013-2019)-Analyses of Global Youth Tobacco Surveys. Nicotine Tob Res 2024; 26:142-150. [PMID: 37466212 DOI: 10.1093/ntr/ntad124] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/05/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION The increasing use of e-cigarettes among the youth is a public health problem that needs surveillance. We report changes in e-cigarette use, cigarette smoking, and "dual use" among youth in 10 countries. AIMS AND METHODS Global Youth Tobacco Survey (GYTS)s from Georgia, Iraq, Italy, Latvia, Montenegro, Paraguay, Peru, Qatar, Romania, and San Marino were analyzed. Changes in prevalence of "awareness of e-cigarettes," "ever use" (even tried a few puffs) and "current use" (during last 30 days) of e-cigarettes and cigarette smoking, and "dual use" (both e-cigarette and cigarette smoking) between baseline (2013 and 2014) and most recent (2017-2019) surveys were estimated. RESULTS "Awareness of e-cigarettes" and "ever e-cigarette use" significantly increased (p < .001). "Ever e-cigarette use" was highest in Italy, 93% (95% CI 90.9, 94.4). "Current e-cigarette use" significantly (p < .05) increased by > 50% in most countries. During the most recent surveys, "current e-cigarette" use was > 10% in five countries Italy (18.3%) and Latvia (18.5%) being the highest. Cigarette smoking significantly declined in Italy, Latvia, Peru, and San Marino (p < .05) but remains unchanged in other countries. "Dual use" (both electronic and conventional cigarettes) significantly increased in all countries (p < .001). During the most recent surveys "dual use" was highest in Italy (10%, 95% CI 8.1, 12.2) and Latvia (8.6%, 95% CI 7.2, 10.2). Youth aged 14 and ≥15 years the smokers, were more likely to be e-cigarette users. CONCLUSIONS Awareness and use of e-cigarettes and "dual use" among youth have increased. Closer monitoring of tobacco use among youths and comprehensive tobacco control policies inclusive of e-cigarettes are needed. IMPLICATIONS Secondary data analyses of serial GYTSs in 10 countries showed that both awareness of e-cigarette and e-cigarette use has increased among school-going youth aged 13-15 years. A concurrent increase in "dual use" of e-cigarettes and cigarette smoking during the last 30 days in all 10 countries indicates continued cigarette smoking in the absence of e-cigarettes because of the common risk construct of tobacco product use. Results call for continued surveillance of both e-cigarettes and cigarette smoking among school-going youth. Comprehensive tobacco control measures inclusive of e-cigarettes should be implemented to reduce tobacco use among the youth.
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Affiliation(s)
| | | | | | - Phyu Synn Oo
- Department of Pathology, International Medical University, Kuala Lumpur, Malaysia
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Vlasschaert C, Buttigieg M, Pershad Y, Lanktree M, Aldrich MC, Rauh MJ, Bick AG. Clonal hematopoiesis of indeterminate potential-associated non-small cell lung cancer risk is potentiated by small particulate matter air pollution among non-smokers: a novel somatic variant-environment interaction. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.17.24301439. [PMID: 38293139 PMCID: PMC10827270 DOI: 10.1101/2024.01.17.24301439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Small particulate matter air pollution (PM 2.5 ) is a recognized driver of non-small cell lung cancer (NSCLC) among non-smoking individuals. Inhaled PM 2.5 recruits pro-inflammatory macrophages to the air-lung interface, which promotes malignant lung epithelial cell growth and progression to overt cancer. We sought to determine whether clonal hematopoiesis of indeterminate potential (CHIP), a common age-related condition characterized by hyperinflammatory macrophages, exacerbates PM 2.5 -associated NSCLC in non-smokers using genetic, environmental, and phenotypic data from 413,901 individuals in the UK Biobank. Among non-smokers, PM 2.5 is not associated with NSCLC and not associated with prevalence of CHIP, but CHIP is associated with a doubling of NSCLC risk (hazard ratio (HR) 2.01, 95% confidence interval (CI): 1.34-3.00). Moreover, CHIP-associated NSCLC risk is exacerbated in the setting of above-median PM 2.5 levels (HR 2.70, 95% CI: 1.60-4.55). PM 2.5 × CHIP is also associated with significantly greater markers of systemic inflammation (CRP, IL-6, and IL-1β) than expected. Altogether, these results suggest CHIP and PM 2.5 form a novel gene × environment interaction promoting NSCLC tumorigenesis in non-smokers.
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Kokts-Porietis RL, Morielli AR, McNeil J, Benham JL, Courneya KS, Cook LS, Friedenreich CM. Prospective cohort of pre- and post-diagnosis alcohol consumption and cigarette smoking on survival outcomes: an Alberta Endometrial Cancer Cohort Study. Cancer Causes Control 2024; 35:121-132. [PMID: 37596424 DOI: 10.1007/s10552-023-01777-w] [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: 01/12/2023] [Accepted: 08/09/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE To examine the independent and joint relationships between cigarette smoking and alcohol consumption with survival outcomes after endometrial cancer diagnosis. METHODS Pre- and post-diagnosis smoking and drinking histories were obtained from endometrial cancer survivors diagnosed between 2002 and 2006 during in-person interviews at-diagnosis and at ~ 3 years post-diagnosis. Participants were followed until death or January 2022. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with Cox proportional hazards regression for associations with disease-free survival (DFS) and overall survival (OS). RESULTS During a median 16.9 years of follow-up (IQR = 15.5-18.1 years), 152 of the 540 participants had a DFS event (recurrence: n = 73; deaths: n = 79) and 134 died overall. Most participants in this cohort were current drinkers (pre = 61.3%; post = 64.7%) while few were current cigarette smokers (pre = 12.8%; post = 11.5%). Pre-diagnosis alcohol consumption was not associated with survival, yet post-diagnosis alcohol intake ≥ 2 drinks/week was associated with worse OS compared with lifetime abstention (HR = 2.36, 95%CI = 1.00-5.54) as well as light intake (HR = 3.87, 95% CI = 1.67-8.96). Increased/consistently high alcohol intake patterns were associated with worse OS (HR = 2.91, 95% CI = 1.15-7.37) compared with patterns of decreased/ceased intake patterns after diagnosis. A harmful dose-response relationship per each additional pre-diagnosis smoking pack-year with OS was noted among ever smokers. In this cohort, smoking and alcohol individually were not associated with DFS and combined pre-diagnosis smoking and alcohol intakes were not associated with either outcome. CONCLUSION Endometrial cancer survivors with higher alcohol intakes after diagnosis had poorer OS compared with women who had limited exposure. Larger studies powered to investigate the individual and joint impacts of cigarette smoking and alcohol use patterns are warranted to provide additional clarity on these modifiable prognostic factors.
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Affiliation(s)
- Renée L Kokts-Porietis
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Andria R Morielli
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Jessica McNeil
- Department of Kinesiology, Faculty of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Jamie L Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Linda S Cook
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Mauries S, Bertrand L, Frija-Masson J, Benzaquen H, Kalamarides S, Sauvage K, Lejoyeux M, d’Ortho MP, Geoffroy PA. Effects of smoking on sleep architecture and ventilatory parameters including apneas: Results of the Tab-OSA study. Sleep Med X 2023; 6:100085. [PMID: 37736106 PMCID: PMC10509708 DOI: 10.1016/j.sleepx.2023.100085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
Background The interaction between smoking and sleep seems appears to be bidirectional, but few studies evaluated the impact of smoking and its cessation on objective sleep parameters. In this context, this new study aimed to assess the impact of smoking and its cessation on sleep architecture and on ventilatory sleep parameters, particularly the presence of sleep apnea syndrome (apnea-hypopnea index (AHI)≥15). Methods: Patients hospitalized for polysomnographic sleep exploration were compared according to their smoking status: active smokers (AS), former smokers (FS), non-smokers (NoNi). Psychiatric and non-psychiatric co-morbidities and treatment or substance use were taken into account in the analyses. Results A total of 170 participants were included (N = 37 FS, 39 AS, 86 NoNi). A significant decrease in the mean nocturnal O2 saturation was observed for FS and AS compared to NoNi. No differences were found regarding AHI. Regarding sleep architecture, we observed a significant decrease in the slow wave sleep duration for AS compared to NoNi, and interestingly not between FS and NoNi. Conclusion This study suggests that current smokers suffer from alterations in both sleep architecture and ventilatory parameters, the later appears to persist even after smoking cessation.
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Affiliation(s)
- Sibylle Mauries
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Léa Bertrand
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Justine Frija-Masson
- Université de Paris, NeuroDiderot, Inserm, U1141, 48 boulevard Sérurier, 75019, Paris, France
- Explorations Fonctionnelles et Centre du Sommeil- Département de Physiologie Clinique, Assistance Publique des Hôpitaux de Paris, GHU Paris Nord, DMU DREAM, Hôpital Bichat, 46 rue Henri Huchard, 75018, Paris, France
| | - Hélène Benzaquen
- Explorations Fonctionnelles et Centre du Sommeil- Département de Physiologie Clinique, Assistance Publique des Hôpitaux de Paris, GHU Paris Nord, DMU DREAM, Hôpital Bichat, 46 rue Henri Huchard, 75018, Paris, France
| | - Sophie Kalamarides
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Beaujon, 100 boulevard Général Leclerc, 92110, Clichy, France
| | - Karine Sauvage
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Michel Lejoyeux
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
- GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
| | - Marie-Pia d’Ortho
- Université de Paris, NeuroDiderot, Inserm, U1141, 48 boulevard Sérurier, 75019, Paris, France
- Explorations Fonctionnelles et Centre du Sommeil- Département de Physiologie Clinique, Assistance Publique des Hôpitaux de Paris, GHU Paris Nord, DMU DREAM, Hôpital Bichat, 46 rue Henri Huchard, 75018, Paris, France
| | - Pierre A. Geoffroy
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
- GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
- Université de Paris, NeuroDiderot, Inserm, U1141, 48 boulevard Sérurier, 75019, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5 rue Blaise Pascal, 67000, Strasbourg, France
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Beaujon, 100 boulevard Général Leclerc, 92110, Clichy, France
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McCutchan G, Engela-Volker J, Anyanwu P, Brain K, Abel N, Eccles S. Assessing, updating and utilising primary care smoking records for lung cancer screening. BMC Pulm Med 2023; 23:445. [PMID: 37974137 PMCID: PMC10655268 DOI: 10.1186/s12890-023-02746-4] [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: 05/25/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Lung cancer screening with low-dose computed tomography for high-risk populations is being implemented in the UK. However, inclusive identification and invitation of the high-risk population is a major challenge for equitable lung screening implementation. Primary care electronic health records (EHRs) can be used to identify lung screening-eligible individuals based on age and smoking history, but the quality of EHR smoking data is limited. This study piloted a novel strategy for ascertaining smoking status in primary care and tested EHR search combinations to identify those potentially eligible for lung cancer screening. METHODS Seven primary care General Practices in South Wales, UK were included. Practice-level data on missing tobacco codes in EHRs were obtained. To update patient EHRs with no tobacco code, we developed and tested an algorithm that sent a text message request to patients via their GP practice to update their smoking status. The patient's response automatically updated their EHR with the relevant tobacco code. Four search strategies using different combinations of tobacco codes for the age range 55-74+ 364 were tested to estimate the likely impact on the potential lung screening-eligible population in Wales. Search strategies included: BROAD (wide range of ever smoking codes); VOLUME (wide range of ever-smoking codes excluding "trivial" former smoking); FOCUSED (cigarette-related tobacco codes only), and RECENT (current smoking within the last 20 years). RESULTS Tobacco codes were not recorded for 3.3% of patients (n = 724/21,956). Of those with no tobacco code and a validated mobile telephone number (n = 333), 55% (n = 183) responded via text message with their smoking status. Of the 183 patients who responded, 43.2% (n = 79) had a history of smoking and were potentially eligible for lung cancer screening. Applying the BROAD search strategy was projected to result in an additional 148,522 patients eligible to receive an invitation for lung cancer screening when compared to the RECENT strategy. CONCLUSION An automated text message system could be used to improve the completeness of primary care EHR smoking data in preparation for rolling out a national lung cancer screening programme. Varying the search strategy for tobacco codes may have profound implications for the size of the population eligible for lung-screening invitation.
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Affiliation(s)
- Grace McCutchan
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK.
| | - Jean Engela-Volker
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
- Academic GP Fellows Scheme, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Philip Anyanwu
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, England, UK
| | - Kate Brain
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Nicole Abel
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
- Academic GP Fellows Scheme, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Sinan Eccles
- Wales Cancer Network, NHS Wales Executive, Cardiff, UK
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Karlsson ML, Hertzberg-Nyquist K, Saevarsdottir S, Lundberg IE, Demmelmaier I, Pettersson S, Chatzidionysiou K. Evaluation of an individually tailored smoking-cessation intervention for patients with rheumatoid arthritis in an outpatient clinic. Scand J Rheumatol 2023; 52:591-600. [PMID: 36815567 DOI: 10.1080/03009742.2023.2172903] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/23/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate an individually tailored smoking-cessation intervention delivered in rheumatology care and compare the characteristics of patients who quit smoking with those who did not. METHOD This was an open single-group prospective intervention study over 24 months, with assessments at baseline and at 6, 12, 18, and 24 months. Current smokers with rheumatoid arthritis (RA) were invited to a smoking-cessation programme including behavioural change support, with or without pharmacotherapy. Data on disease activity, medical treatment, and patient-reported outcomes were retrieved from the Swedish Rheumatology Quality Register. The primary outcome was the proportion of patients at month 24 who reported having quit smoking with self-reported 7 day smoking abstinence. RESULTS In total, 99 patients participated in the study. Median age was 58 years (interquartile range 50-64); 69% were female and 88% rheumatoid factor and/or anti-cyclic citrullinated peptide positive. At 24 months, 21% of the patients had quit smoking. At 6, 12, and 18 months, 12%, 12%, and 14% of patients, respectively, had quit smoking. For patients still smoking at 24 months, the median number of cigarettes per day was significantly reduced from 12 to 6 (p ≤ 0.001). Among patients who had quit smoking at 24 months, a smaller proportion reported anxiety at baseline compared to those still smoking (28% vs 58%, p = 0.02). CONCLUSION A smoking-cessation intervention including behavioural change support with or without pharmacotherapy can be helpful for a substantial number of RA patients. Anxiety is associated with lower smoking-cessation success rates.
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Affiliation(s)
- M-L Karlsson
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
- Department of Gastroenterology, Dermatology, Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | | | - S Saevarsdottir
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - I E Lundberg
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
- Department of Gastroenterology, Dermatology, Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - I Demmelmaier
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - S Pettersson
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
- Department of Gastroenterology, Dermatology, Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - K Chatzidionysiou
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
- Department of Gastroenterology, Dermatology, Rheumatology, Karolinska University Hospital, Stockholm, Sweden
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Malevolti MC, Maci C, Lugo A, Possenti I, Gallus S, Gorini G, Carreras G. Second-hand smoke exposure and cervical cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol 2023; 149:14353-14363. [PMID: 37516982 DOI: 10.1007/s00432-023-04841-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/04/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE The association between second-hand smoke (SHS) exposure and cervical cancer (CC) risk is still unclear. The aim of this study is to provide an accurate and updated estimate of this association. METHODS Through an original methodology to identify original publications, we conducted a systematic review and meta-analysis of all epidemiological studies published up to October 2022 evaluating the association between SHS exposure and CC risk among female non-smokers. Meta-analytic estimates were obtained using random-effects models and dose-response relationships were derived using log-linear functions. RESULTS Out of 25 eligible studies, 21 were included in the meta-analysis, providing a pooled relative risk (RR) of cervical intraepithelial neoplasia (CIN) of grade 2 or higher of 1.52 (95% confidence interval, CI 1.30-1.78, 21 studies) for overall SHS exposure versus non-exposure. When restricting the analysis to invasive CC, the pooled RR was 1.42 (95% CI 1.17-1.71, 13 studies), whereas the pooled RR for CIN was 1.50 (95% CI 1.22-1.84, 6 studies). Analyzing RR by setting or source of SHS exposure resulted in significant associations with CC risk for SHS exposure at home (RR for CIN2+ 1.49, 95% CI 1.21-1.84, 14 studies), in non-specified settings (RR for CIN2+ 1.64, 95% CI 1.20-2.23, 8 studies) and from partner (RR for CIN2+ 1.55, 95% CI 1.25-1.94, 10 studies). The risk of CIN2+ significantly increased linearly with the intensity and pack-years of SHS exposure. CONCLUSION This comprehensive review and meta-analysis confirmed the association of SHS exposure with CC, further suggesting the need to raise concern about SHS exposure in the population.
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Affiliation(s)
- Maria Chiara Malevolti
- Oncologic Network, Prevention and Research Institute (ISPRO), Via Cosimo il Vecchio 2, 50139, Florence, Italy
| | - Caterina Maci
- Oncologic Network, Prevention and Research Institute (ISPRO), Via Cosimo il Vecchio 2, 50139, Florence, Italy
| | - Alessandra Lugo
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Irene Possenti
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Silvano Gallus
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Giuseppe Gorini
- Oncologic Network, Prevention and Research Institute (ISPRO), Via Cosimo il Vecchio 2, 50139, Florence, Italy
| | - Giulia Carreras
- Oncologic Network, Prevention and Research Institute (ISPRO), Via Cosimo il Vecchio 2, 50139, Florence, Italy.
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Fink DS, Malte C, Cerdá M, Mannes ZL, Livne O, Martins SS, Keyhani S, Olfson M, McDowell Y, Gradus JL, Wall MM, Sherman S, Maynard CC, Saxon AJ, Hasin DS. Trends in Cannabis-positive Urine Toxicology Test Results: US Veterans Health Administration Emergency Department Patients, 2008 to 2019. J Addict Med 2023; 17:646-653. [PMID: 37934524 PMCID: PMC10766071 DOI: 10.1097/adm.0000000000001197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
OBJECTIVES This study aimed to examine trends in cannabis-positive urine drug screens (UDSs) among emergency department (ED) patients from 2008 to 2019 using data from the Veterans Health Administration (VHA) health care system, and whether these trends differed by age group (18-34, 35-64, and 65-75 years), sex, and race, and ethnicity. METHOD VHA electronic health records from 2008 to 2019 were used to identify the percentage of unique VHA patients seen each year at an ED, received a UDS, and screened positive for cannabis. Trends in cannabis-positive UDS were examined by age, race and ethnicity, and sex within age groups. RESULTS Of the VHA ED patients with a UDS, the annual prevalence positive for cannabis increased from 16.42% in 2008 to 27.2% in 2019. The largest increases in cannabis-positive UDS were observed in the younger age groups. Male and female ED patients tested positive for cannabis at similar levels. Although the prevalence of cannabis-positive UDS was consistently highest among non-Hispanic Black patients, cannabis-positive UDS increased in all race and ethnicity groups. DISCUSSION The increasing prevalence of cannabis-positive UDS supports the validity of previously observed population-level increases in cannabis use and cannabis use disorder from survey and administrative records. Time trends via UDS results provide additional support that previously documented increases in self-reported cannabis use and disorder from surveys and claims data are not spuriously due to changes in patient willingness to report use as it becomes more legalized, or due to greater clinical attention over time.
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Affiliation(s)
- David S Fink
- From the New York State Psychiatric Institute, New York, NY (DSF, ZLM, OL, MMW, DSH); Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, WA (CM, CCM, AJS); Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System, Seattle, WA (CM, YM, AJS); New York University, New York, NY (MC, SS); Columbia University Mailman School of Public Health, New York, NY (SSM, DSH); San Francisco VA Health System, San Francisco, CA (SK); University of California at San Francisco, San Francisco, CA (SK); Columbia University Irving Medical Center, New York, NY (MO, MMW, DSH); Boston University School of Public Health, Boston, MA (JLG); VA Manhattan Harbor Healthcare, New York, NY (SS); University of Washington, Seattle, WA (CCM); and University of Washington School of Medicine, Seattle, WA (AJS)
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Luna-Castillo KP, López-Quintero A, Carrera-Quintanar L, Llamas-Covarrubias IM, Muñoz-Valle JF, Márquez-Sandoval F. The Influence of Lifestyle on High-Density Lipoprotein Concentration among Mexican Emerging Adults. Nutrients 2023; 15:4568. [PMID: 37960221 PMCID: PMC10649881 DOI: 10.3390/nu15214568] [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: 08/31/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Previous studies have highlighted the role of lifestyle on HDL-C concentrations in adults. To our knowledge, the health and nutritional status of emerging adults have been understudied. The present study aimed to explore the most important lifestyle factors, including micronutrient intake adequacy and the percentage of energy from food processing, according to HDL-C concentrations in emerging adults. In this context, a cross-sectional analysis was conducted on 261 Mexican emerging adults who were apparently healthy. Lifestyle factors were collected through a structured survey and the prevalence of micronutrient intake inadequacy was estimated using the estimated average requirement cut-point method. The percentage of energy from ultra-processed foods was assessed using the NOVA system. HDL-C was determined using the enzymatic colorimetric method. Statistical analyses were conducted in SPSS. The results revealed that lifestyle factors do not differ according to HDL-C status. The participants showed a poor nutritional diet that was energy-dense and micronutrient-inadequate. Nearly half of their energy came from processed and ultra-processed foods. Most participants did not meet the recommendations for key nutrients (ϖ3 fatty acids and phytosterols) that promote a healthy lipid status. In conclusion, regardless of their HDL-C levels, emerging adults exhibited lifestyle-related risk factors. The persistence of these findings over time could contribute to the development of metabolic disorders in the future. It is crucial to increase understanding and to develop effective nutritional interventions during this critical phase of life.
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Affiliation(s)
- Karla Paulina Luna-Castillo
- Doctorado en Ciencias de la Nutrición Traslacional (DCNT), Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (L.C.-Q.); (I.M.L.-C.); (J.F.M.-V.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional (INNUGET), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
| | - Andres López-Quintero
- Doctorado en Ciencias de la Nutrición Traslacional (DCNT), Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (L.C.-Q.); (I.M.L.-C.); (J.F.M.-V.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional (INNUGET), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
| | - Lucrecia Carrera-Quintanar
- Doctorado en Ciencias de la Nutrición Traslacional (DCNT), Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (L.C.-Q.); (I.M.L.-C.); (J.F.M.-V.)
- Instituto de Investigación en Cáncer en la Infancia y Adolescencia (INICIA), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
| | - Iris Monserrat Llamas-Covarrubias
- Doctorado en Ciencias de la Nutrición Traslacional (DCNT), Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (L.C.-Q.); (I.M.L.-C.); (J.F.M.-V.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional (INNUGET), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
| | - José Francisco Muñoz-Valle
- Doctorado en Ciencias de la Nutrición Traslacional (DCNT), Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (L.C.-Q.); (I.M.L.-C.); (J.F.M.-V.)
- Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico
| | - Fabiola Márquez-Sandoval
- Doctorado en Ciencias de la Nutrición Traslacional (DCNT), Departamento de Clínicas de la Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (L.C.-Q.); (I.M.L.-C.); (J.F.M.-V.)
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Prell C, Hébert-Losier A, Filion KB, Reynier P, Eisenberg MJ. Evaluating the impact of varying expired carbon monoxide thresholds on smoking relapse identification: insights from the E3 trial on e-cigarette efficacy for smoking cessation. BMJ Open 2023; 13:e071099. [PMID: 37832989 PMCID: PMC10583027 DOI: 10.1136/bmjopen-2022-071099] [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: 02/17/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVES Expired carbon monoxide (ECO) is often used in smoking cessation trials to biochemically validate self-reported smoking status. The optimal ECO threshold to distinguish individuals who smoke from those who do not is debated. DESIGN The data from the 'Evaluating the Efficacy of E-Cigarette use for Smoking Cessation (E3) Trial' were used; the E3 trial was a randomised controlled trial that examined e-cigarettes efficacy for smoking cessation. SETTINGS Participants were recruited from 17 Canadian sites across 4 provinces. PARTICIPANTS This substudy included data from participants who returned for at least one of the clinical visits at week 4 (291), 12 (257) or 24 (218) and provided both self-reported smoking status and ECO measures. Analyses were based on 766 paired measures (ie, self-reported smoking status with corresponding ECO). RESULTS The ability of ECO measurements to discriminate between adults who reported smoking and those who reported abstinence varied with the threshold used. ECO thresholds of 6, 7, 8 and 9 parts per million (ppm) yielded the greatest area under the receiver operating characteristic curve (0.84). These thresholds produced sensitivities of 84%, 82%, 78% and 76% and specificities of 84%, 87%, 90% and 91%, respectively. However, at a threshold of 6 ppm, intersecting sensitivity (84%) and specificity (84%) were maximised with respect to each other. Biochemical validation had the highest agreement with self-report at an ECO threshold of 6 ppm (κ=0.57; 95% CI, 0.51 to 0.64). CONCLUSION The classification of participants' smoking status depends on the ECO threshold used for biochemical validation. We recommend that future smoking cessation trial investigators analyse and report the impact that varying ECO thresholds has on trial results. TRIAL REGISTRATION NUMBER NCT02417467.
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Affiliation(s)
- Celine Prell
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill University, Montreal, QC, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Andréa Hébert-Losier
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill University, Montreal, QC, Canada
| | - Kristian B Filion
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill University, Montreal, QC, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Pauline Reynier
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill University, Montreal, QC, Canada
| | - Mark J Eisenberg
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital/McGill University, Montreal, QC, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Division of Cardiology, Jewish General Hospital/McGill University, Montreal, QC, Canada
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Wang R, LeLaurin J, Carrier A, Churba B, Karanth S, Yoon HS, Braithwaite D, Salloum RG, Hong YR. Trends and factors associated with secondhand smoke exposure among US cancer survivors, 2013-2020. Cancer 2023; 129:3053-3063. [PMID: 37254857 DOI: 10.1002/cncr.34891] [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: 02/22/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Secondhand smoke (SHS) poses a significant public health threat. Cancer survivors are at a greater risk of adverse health outcomes from SHS because of its association with poor prognosis and other downstream clinical events. METHODS A nationally representative sample of US adults aged 20 years and older was analyzed from the National Health and Nutrition Examination Survey between 2013 and 2020. Data on indoor SHS exposure were reported by 16,778 adults who were not currently smoking (1775 cancer survivors; 15,003 individuals without a cancer history). The weighted prevalence of SHS exposure was estimated and compared across sociodemographic and health-related characteristics. Multivariable logistic regression models were fitted to identify correlates of SHS exposure. RESULTS Of the 1775 nonsmoking cancer survivors (mean age, 64.9 years; 57.0% female; 84.4% non-Hispanic Whites), 15.8% reported SHS exposure. No significant change in trends of SHS exposure was observed during the study period. The prevalence of SHS exposure was higher in cancer survivors who were younger, racial minorities, and had a household income below 130% of the federal poverty level. After adjustment for multiple correlates, age below 40 years, low income, smoking history, and diagnosis within 2 years were associated with SHS exposure. Cancer survivors were most likely to report that SHS exposure occurred at home or in a car. CONCLUSIONS The prevalence of SHS exposure among cancer survivors remained steady in the past decade. However, disparities exist in SHS exposure among cancer survivors across sociodemographic characteristics and smoking status. Smoking cessation programs should be promoted among caregivers and families of cancer survivors.
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Affiliation(s)
- Ruixuan Wang
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Jennifer LeLaurin
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Allison Carrier
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Benjamin Churba
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Shama Karanth
- Department of Epidemiology and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Hyung-Suk Yoon
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Dejana Braithwaite
- Department of Epidemiology and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Young-Rock Hong
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
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Nwaobi SO, Richmond HL, Babatunde DA, Twum F, Mallhi AK, Wei Y, Zhang J. Crossover Trends in Current Cigarette Smoking Between Racial and Ethnic Groups of US Adolescents Aged 12-19 Years Old, 1999-2018. J Racial Ethn Health Disparities 2023; 10:2114-2123. [PMID: 36006586 PMCID: PMC9406249 DOI: 10.1007/s40615-022-01391-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the racial difference and trends in cigarette smoking among adolescents from 1999 to 2018. METHODS We analyzed the data of 10,760 adolescents aged 12-19 who participated in the National Health and Nutrition Examination Surveys (NHANES), 1999-2018. Current tobacco smoking (CTS) was defined as participants with serum cotinine ≥10 ng/mL. Adjusted biennial prevalence ratios (abiPR: the ratio associated with a two-year increase in time) were estimated. RESULTS Diverging trends in CTS prevalence were revealed in adolescents. The steepest decrease occurred in Hispanics aged 12-17, with 15% declining every two calendar years [abiPR = 0.85(0.77, 0.94)]. The sharpest increase occurred with Blacks aged 18-19 years [abiPR = 1.06(0.99, 1.14)]. A crossover of prevalence trend between Blacks and Whites occurred in adolescents aged 18-19 years old due to the diverging trends. The average CTS prevalence was significantly higher in Whites than in Blacks in the early [(1999-2008, 13.65% (11.85%, 15.46%) vs. 8.80% (7.55%, 10.04%)], but Blacks had a higher average in recent years [(2009-2018, 8.32% (6.53%, 10.12%) vs. 7.77% (5.86%, 9.68%)]. For adolescents aged 18-19 years, the survey cycles or calendar years linearly explained 71% of the variations in the prevalence for Hispanics, 60% for Whites, but only 1% for Blacks. CONCLUSIONS A crossover in the trend of current tobacco smoking occurred between 1999 and 2018 due to an increase in prevalence among Black adolescents and a significant decrease in prevalence among other racial groups.
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Affiliation(s)
- Samuel O Nwaobi
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Holly L Richmond
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Doyinsola A Babatunde
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Felix Twum
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
- School of Health Professions, Public Health Program, The University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Arshpreet Kaur Mallhi
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA
| | - Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, 31207, USA
| | - Jian Zhang
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30460, USA.
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Tonkin S, Kezbers KM, Noble B, Cropsey K, Kendzor DE, Oliver J, Businelle M. Comparison of the Bluetooth iCOquit, piCO, and Vitalograph for the assessment of breath carbon monoxide among adults initiating smoking cessation and standardized canisters. Drug Alcohol Depend 2023; 250:110902. [PMID: 37506541 PMCID: PMC10529684 DOI: 10.1016/j.drugalcdep.2023.110902] [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: 05/17/2023] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND The Bluetooth iCOquit enables remote biochemical verification of smoking status, but its validity among adults attempting to quit smoking is unclear. This study 1) compared the iCOquit, piCO, and Vitalograph sensors to identify device-specific bias, 2) assessed the diagnostic accuracy of the iCOquit for the overall sample and within specific subgroups (sex, race, smoking rate, menthol use), and 3) assessed the validity of iCOquit readings against standardized CO canisters. METHODS iCOquit devices were tested with human breath samples from individuals seeking treatment for combustible tobacco use (N = 93) attending an in-person clinic visit. Participants provided breath samples via the iCOquit, piCO, and Vitalograph (order randomized). iCOquit devices were also tested using 5 and 10 parts per million (ppm) canisters. RESULTS The iCOquit underestimated CO and categorized more participants as abstinent relative to the other CO sensors with human breath samples. The results suggested the iCOquit could not be used interchangeably with the other CO devices. Using a cut-off of < 6 ppm, the diagnostic accuracy of the iCOquit (specificity = 94%; sensitivity = 85%) did not vary across demographic/smoking subgroups. Canister tests with the iCOquit suggested good precision (< 1 ppm). CONCLUSIONS The iCOquit is an affordable option for the remote measurement of CO that provides a reasonably accurate assessment of smoking status of those attempting to quit smoking using abstinence cut-off criteria of < 6 ppm. However, compared to other CO monitors, the iCOquit may underestimate CO, thereby increasing error in assessing abstinence.
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Affiliation(s)
- Sarah Tonkin
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States.
| | - Krista M Kezbers
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Bishop Noble
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Karen Cropsey
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Darla E Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jason Oliver
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Michael Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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Carroll NM, Burnett-Hartman AN, Rendle KA, Neslund-Dudas CM, Greenlee RT, Honda SA, Vachani A, Ritzwoller DP. Smoking status and the association between patient-level factors and survival among lung cancer patients. J Natl Cancer Inst 2023; 115:937-948. [PMID: 37228018 PMCID: PMC10407692 DOI: 10.1093/jnci/djad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Declines in the prevalence of cigarette smoking, advances in targeted therapies, and implementation of lung cancer screening have changed the clinical landscape for lung cancer. The proportion of lung cancer deaths is increasing in those who have never smoked cigarettes. To better understand contemporary patterns in survival among patients with lung cancer, a comprehensive evaluation of factors associated with survival, including differential associations by smoking status, is needed. METHODS Patients diagnosed with lung cancer between January 1, 2010, and September 30, 2019, were identified. We estimated all-cause and lung cancer-specific median, 5-year, and multivariable restricted mean survival time (RMST) to identify demographic, socioeconomic, and clinical factors associated with survival, overall and stratified by smoking status (never, former, and current). RESULTS Analyses included 6813 patients with lung cancer: 13.9% never smoked, 54.2% formerly smoked, and 31.9% currently smoked. All-cause RMST through 5 years for those who never, formerly, and currently smoked was 32.1, 25.9, and 23.3 months, respectively. Lung cancer-specific RMST was 36.3 months, 30.3 months, and 26.0 months, respectively. Across most models, female sex, younger age, higher socioeconomic measures, first-course surgery, histology, and body mass index were positively associated, and higher stage was inversely associated with survival. Relative to White patients, Black patients had increased survival among those who formerly smoked. CONCLUSIONS We identify actionable factors associated with survival between those who never, formerly, and currently smoked cigarettes. These findings illuminate opportunities to address underlying mechanisms driving lung cancer progression, including use of first-course treatment, and enhanced implementation of tailored smoking cessation interventions for individuals diagnosed with cancer.
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Affiliation(s)
- Nikki M Carroll
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
| | - Andrea N Burnett-Hartman
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Katharine A Rendle
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Stacey A Honda
- Hawaii Permanente Medical Group, Center for Integrated Healthcare Research, Kaiser Permanente Hawaii, Honolulu, HI, USA
| | - Anil Vachani
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Debra P Ritzwoller
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
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47
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Sreeramareddy CT, Fernandez E, Feliu A. Hardening determinants among adult daily smokers in nine African countries: Data from the Global Adult Tobacco Survey. Prev Med Rep 2023; 34:102226. [PMID: 37228834 PMCID: PMC10203766 DOI: 10.1016/j.pmedr.2023.102226] [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: 12/08/2022] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/27/2023] Open
Abstract
Little has been reported about hardening nor softening indicators in Africa where smoking prevalence is low. We aimed to examine the determinants of hardening in nine African countries. We conducted two separate analyses using data from the most recent Global Adult Tobacco Survey in Botswana, Cameroon, Egypt, Ethiopia, Kenya, Nigeria, Senegal, Tanzania, and Uganda (total sample of 72,813 respondents): 1) multilevel logistic regression analysis to assess individual and country-level factors associated with hardcore, high dependence, and light smoking.; 2) a Spearman-rank correlation analysis to describe the association between daily smoking and hardcore, high dependence, and light smoking at an ecological level. Age-standardized daily smoking prevalence varied from 37.3% (95 %CI: 34.4, 40.3) (Egypt) to 6.1% (95 %CI: 3.5, 6.3) (Nigeria) among men; and 2.3% (95 %CI: 0.7, 3.9) (Botswana) to 0.3% (95 %CI: 0.2, 0.7) (Senegal) among women. The proportion of hardcore and high-dependence smokers was higher among men whereas for light smokers the proportion was higher among women. At the individual level, higher age and lower education groups had higher odds of being hardcore smokers and having high dependence. Smoke-free home policies showed decreased odds of both being hardcore and highly dependent smokers daily smoking correlated weakly and negatively with hardcore smoking (r = -0.243, 95 %CI: -0.781, 0.502) among men and negatively with high dependence (r = -0.546, 95 %CI: -0.888, 0.185) and positively with light smokers (r = 0.252, 95 %CI: -0.495, 0.785) among women. Hardening determinants varied between the countries in the African region. Wide sex differentials and social inequalities in heavy smoking do exist and should be tackled.
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Affiliation(s)
| | - Esteve Fernandez
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d’Oncologia-ICO, L’Hospitalet de Llobregat (Barcelona), Spain
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat (Barcelona), Spain
- CIBER en Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, Campus de Bellvitge,Universitat de Barcelona, L'Hospitalet del Llobregat (Barcelona), Spain
| | - Ariadna Feliu
- Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d’Oncologia-ICO, L’Hospitalet de Llobregat (Barcelona), Spain
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L’Hospitalet de Llobregat (Barcelona), Spain
- CIBER en Enfermedades Respiratorias (CIBERES), Madrid, Spain
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48
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He H, Shen Q, He MM, Qiu W, Wang H, Zhang S, Qin S, Lu Z, Zhu Y, Tian J, Chang J, Wang K, Zhang X, Miao X, Song M, Zhong R. In Utero and Childhood/Adolescence Exposure to Tobacco Smoke, Genetic Risk, and Cancer Incidence in Adulthood: A Prospective Cohort Study. Mayo Clin Proc 2023; 98:1164-1176. [PMID: 37422733 DOI: 10.1016/j.mayocp.2023.03.024] [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] [Received: 07/31/2022] [Revised: 03/11/2023] [Accepted: 03/28/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE To evaluate the association of early-life tobacco smoke exposure, especially interacting with cancer genetic variants, with adult cancer. PARTICIPANTS AND METHODS We examined the associations of in utero tobacco smoke exposure, age of smoking initiation, and their interaction with genetic risk levels with cancer incidence in 393,081 participants from the UK Biobank. Information on tobacco exposure was obtained by self-reported questionnaires. A cancer polygenic risk score was constructed by weighting and integrating 702 genome-wide association studies-identified risk variants. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for overall cancer and organ-specific cancer incidence. RESULTS During 11.8 years of follow-up, 23,450 (5.97%) and 23,413 (6.03%) incident cancers were included in the analyses of in utero exposure and age of smoking initiation, respectively. The HR (95% CI) for incident cancer in participants with in utero exposure to tobacco smoke was 1.04 (1.01-1.07) for overall cancer, 1.59 (1.44-1.75) for respiratory cancer, and 1.09 (1.03-1.17) for gastrointestinal cancer. The relative risk of incident cancer increased with earlier smoking initiation (Ptrend<.001), with the HR (95% CI) of 1.44 (1.36-1.51) for overall cancer, 13.28 (11.39-15.48) for respiratory cancer, and 1.72 (1.54-1.91) for gastrointestinal cancer in smokers with initiation in childhood compared with never smokers. Importantly, a positive additive interaction between age of smoking initiation and genetic risk was observed for overall cancer (Padditive=.04) and respiratory cancer (Padditive=.003) incidence. CONCLUSION In utero exposure and earlier smoking initiation are associated with overall and organ-specific cancer, and age of smoking initiation interaction with genetic risk is associated with respiratory cancer.
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Affiliation(s)
- Heng He
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Qian Shen
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming-Ming He
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Weihong Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Haoxue Wang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shanshan Zhang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shifan Qin
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zequn Lu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
| | - Jianbo Tian
- Department of Epidemiology and Biostatistics, School of Public Health, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
| | - Jiang Chang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Xiaoping Miao
- Department of Epidemiology and Biostatistics, School of Public Health, TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
| | - Mingyang Song
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Clinical and Translational Epidemiology Unit, Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Rong Zhong
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Zettergren A, Sompa S, Palmberg L, Ljungman P, Pershagen G, Andersson N, Lindh C, Georgelis A, Kull I, Melen E, Ekström S, Bergstrom A. Assessing tobacco use in Swedish young adults from self-report and urinary cotinine: a validation study using the BAMSE birth cohort. BMJ Open 2023; 13:e072582. [PMID: 37438074 PMCID: PMC10347476 DOI: 10.1136/bmjopen-2023-072582] [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: 02/09/2023] [Accepted: 06/26/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVES Studies on health effects of tobacco often rely on self-reported exposure data, which is subjective and can lead to misclassification. The aim of this study was to describe the prevalence of cigarette smoking, snus and e-cigarette use, as well as to validate self-reported tobacco use among young adults in Sweden. METHOD Participants of a population-based Swedish cohort (n=3052), aged 22-25 years, assessed their tobacco use in a web questionnaire. Urinary cotinine was analysed in a subsample of the study population (n=998). The agreement between self-reported tobacco use and urinary cotinine was assessed using Cohen's Kappa coefficient (κ) at a cut-off level of 50 ng/mL. RESULTS Patterns of tobacco use differed between men and women. Among men, 20.0% reported daily snus use, 5.8% daily cigarette smoking and 5.6% any e-cigarette use. In contrast, 3.2% of the women reported daily snus use, 9.0% daily cigarette smoking and 2.4% any e-cigarette use. Among the tobacco use categories, daily snus users had the highest levels of cotinine. Of reported non-tobacco users, 3.5% had cotinine levels above the cut-off, compared with 68.0% among both occasional cigarette smokers and snus users, 67.5% among all e-cigarette users and 94.7% and 97.8% among daily cigarette smokers and snus users, respectively. Agreement between self-reported tobacco use and urinary cotinine was classified as strong for daily use of cigarettes (κ=0.824) and snus (κ=0.861), while moderate to weak for occasional smoking (κ=0.618), occasional snus use (κ=0.573) and any e-cigarette use (κ=0.576). CONCLUSIONS We found high validity of self-reported tobacco use in our study population, particularly for daily tobacco use. Further, we found that daily snus users were exposed to high levels of cotinine. Together with previous findings, our results indicate good validity of self-reported tobacco use among young adults.
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Affiliation(s)
- Anna Zettergren
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Shanzina Sompa
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lena Palmberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Antonios Georgelis
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Inger Kull
- Sachs' Children and Youth Hospital, Södersjukhuset AB, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Erik Melen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset AB, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Anna Bergstrom
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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Delcroix MH, Delcroix-Gomez C, Marquet P, Gauthier T, Thomas D, Aubard Y. Active or passive maternal smoking increases the risk of low birth weight or preterm delivery: Benefits of cessation and tobacco control policies. Tob Induc Dis 2023; 21:72. [PMID: 37256119 PMCID: PMC10226447 DOI: 10.18332/tid/156854] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/07/2022] [Accepted: 11/23/2022] [Indexed: 06/01/2023] Open
Abstract
In France, maternal smoking, active or passive, remains one of the highest in Europe. At the same time, there is an increase in the number of low birth weight (<2500 g) and premature (<37 weeks of amenorrhea) newborns. The objective of this narrative review is to examine the impact of active or passive maternal smoking on birth weight or prematurity rates, and to consider the benefits of policies to stop or control smoking. This is a narrative review that analyzes and discusses the major articles published over the past 20 years regarding the role of active or passive maternal smoking on the risk of low birth weight or preterm delivery. Articles were selected using the following keywords: maternal smoking, low birth weight, preterm birth, smoking cessation, passive smoking, exhaled carbon monoxide, tobacco control policies. Active smoking is associated, in a dose-response relationship, with increased risks of low birth weight and preterm delivery. Passive smoking, mainly related to the presence of a smoking spouse, increases the risk of low birth weight and preterm birth. Our review confirmed also the benefits of smoking cessation, even in the third trimester, in reducing the risk of small for gestation age or fetal growth restriction and preterm birth. Several studies of tobacco control policies have been shown to be effective in significantly reducing maternal smoking. There is sufficient evidence to infer a causal link between active or passive maternal smoking and low birth weight or preterm delivery. This causal link is compelling and sufficient to justify intensifying efforts to promote rapid progress in tobacco control policies, with the vision of a tobacco-free generation, and smoking cessation with best practices during preconception or pregnancy.
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Affiliation(s)
- Michel-Henri Delcroix
- Établissement Public de Santé Mentale, Association Périnatalité Recherche Information - Maternité Sans Tabac, Bailleul, France
| | - Conchita Delcroix-Gomez
- Service de Gynécologie-Obstétrique, Pôle Femme-Enfant, Centre Hospitalier d’Arras, Arras, France
| | - Pierre Marquet
- Service de Pharmacologie, Toxicologie et de Pharmacovigilance, Centre Hospitalier Universitaire, Limoges, France
| | - Tristan Gauthier
- Service de Gynécologie-Obstétrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire, Limoges, France
| | - Daniel Thomas
- Institut de Cardiologie, Groupe Hospitalier Pitié Salpêtrière, Paris, France
| | - Yves Aubard
- Service de Gynécologie-Obstétrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire, Limoges, France
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