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Fakunle AG, Okekunle AP, Asowata OJ, Akpa O, Sarfo FS, Akpalu A, Wahab K, Obiako R, Komolafe M, Owolabi L, Osaigbovo GO, Adeoye AM, Tiwari HK, Uvere EO, Akinyemi J, Jenkins C, Arulogun O, Ibinaiye P, Appiah LT, Bello T, Singh A, Yaria J, Calys-Tagoe B, Ogbole G, Chukwuonye I, Melikam C, Adebayo P, Mensah Y, Adebayo O, Adeniyi S, Oguike W, Donna A, Akinyemi R, Ovbiagele B, Owolabi M. Non-cigarette Tobacco Use and Stroke Among West Africans: Evidence From the SIREN Study. Nicotine Tob Res 2024; 26:589-596. [PMID: 38015428 DOI: 10.1093/ntr/ntad239] [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: 07/14/2022] [Revised: 09/27/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Non-cigarette tobacco (NCT) represents a form of tobacco use with a misperceived significance in chronic disease events. Whether NCT use is sufficient to promote stroke events, especially among Africans, is yet to be understood. This study assessed the relationship between NCT use and stroke among indigenous Africans. METHODS A total of 7617 respondents (NCT users: 41 vs. non-NCT: 7576) from the Stroke Investigative Research and Educational Network (SIREN) study were included in the current analysis. NCT use was defined as self-reported use of smoked (cigars or piper) or smokeless (snuff or chewed) tobacco in the past year preceding stroke events. Stroke was defined based on clinical presentation and confirmed with a cranial computed tomography/magnetic resonance imaging. Multivariable-adjusted logistic regression was applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship of NCT with stroke at a two-sided p < .05. RESULTS Out of the 41 (0.54%) who reported NCT use, 27 (65.9%) reported using smokeless NCT. NCT users were older than non-NCT users (62.8 ± 15.7 vs. 57.7 ± 14.8 years). Overall, NCT use was associated with first-ever stroke (OR: 2.08; 95% CI: 1.02, 4.23) in the entire sample. Notably, smokeless NCT use was independently associated with higher odds of stroke (OR: 2.74; 95% CI: 1.15, 6.54), but smoked NCT use (OR: 0.16; 95% CI: 0.02, 1.63) presented a statistically insignificant association after adjusting for hypertension and other covariates. CONCLUSIONS NCT use was associated with higher odds of stroke, and public health interventions targeting NCT use might be promising in reducing the burden of stroke among indigenous Africans. IMPLICATIONS A detailed understanding of the relationship between NCT use and stroke will likely inform well-articulated policy guidance and evidence-based recommendations for public health prevention and management of stroke on the African continent.
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Affiliation(s)
- Adekunle Gregory Fakunle
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Public Health, Osun State University, Osogbo, Nigeria
| | - Akinkunmi Paul Okekunle
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Food and Nutrition, Seoul National University, Seoul, Korea
| | - Osahon Jeffery Asowata
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
| | - Onoja Akpa
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
- Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Fred S Sarfo
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Albert Akpalu
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | - Kolawole Wahab
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Reginald Obiako
- Department of Radiology, Ahmadu Bello University, Zaria, Nigeria
| | - Morenikeji Komolafe
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | - Lukman Owolabi
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Abiodun M Adeoye
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Hemant K Tiwari
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ezinne O Uvere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Joshua Akinyemi
- Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria
| | - Carolyn Jenkins
- Department of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Oyedunni Arulogun
- Department of Health Promotion and Education, University of Ibadan, Ibadan, Nigeria
| | - Philip Ibinaiye
- Department of Radiology, Ahmadu Bello University, Zaria, Nigeria
| | - Lambert T Appiah
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Temilade Bello
- Department of Public Health, Osun State University, Osogbo, Nigeria
| | - Arti Singh
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Yaria
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Benedict Calys-Tagoe
- Department of Community Health, University of Ghana Medical School, Accra, Ghana
| | - Godwin Ogbole
- Department of Radiology, University of Ibadan, Ibadan, Nigeria
| | | | - Chidinma Melikam
- Department of Radiology, Ahmadu Bello University, Zaria, Nigeria
| | - Philip Adebayo
- Department of Internal Medicine, Aga-Khan University, Dar es Salaam, Tanzania
| | - Yaw Mensah
- Department of Radiology, University of Ghana Medical School, Accra, Ghana
| | - Oladimeji Adebayo
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Sunday Adeniyi
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Wisdom Oguike
- Department of Radiology, Ahmadu Bello University, Zaria, Nigeria
| | - Arnett Donna
- College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Rufus Akinyemi
- Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Bruce Ovbiagele
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Mayowa Owolabi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Lebanese American University, Beirut, Lebanon
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Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH, Dixon DL, Fearon WF, Hess B, Johnson HM, Kazi DS, Kolte D, Kumbhani DJ, LoFaso J, Mahtta D, Mark DB, Minissian M, Navar AM, Patel AR, Piano MR, Rodriguez F, Talbot AW, Taqueti VR, Thomas RJ, van Diepen S, Wiggins B, Williams MS. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2023; 82:833-955. [PMID: 37480922 DOI: 10.1016/j.jacc.2023.04.003] [Citation(s) in RCA: 71] [Impact Index Per Article: 71.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
AIM The "2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease" provides an update to and consolidates new evidence since the "2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease" and the corresponding "2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease." METHODS A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. STRUCTURE This guideline provides an evidenced-based and patient-centered approach to management of patients with chronic coronary disease, considering social determinants of health and incorporating the principles of shared decision-making and team-based care. Relevant topics include general approaches to treatment decisions, guideline-directed management and therapy to reduce symptoms and future cardiovascular events, decision-making pertaining to revascularization in patients with chronic coronary disease, recommendations for management in special populations, patient follow-up and monitoring, evidence gaps, and areas in need of future research. Where applicable, and based on availability of cost-effectiveness data, cost-value recommendations are also provided for clinicians. Many recommendations from previously published guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.
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Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH, Dixon DL, Fearon WF, Hess B, Johnson HM, Kazi DS, Kolte D, Kumbhani DJ, LoFaso J, Mahtta D, Mark DB, Minissian M, Navar AM, Patel AR, Piano MR, Rodriguez F, Talbot AW, Taqueti VR, Thomas RJ, van Diepen S, Wiggins B, Williams MS. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation 2023; 148:e9-e119. [PMID: 37471501 DOI: 10.1161/cir.0000000000001168] [Citation(s) in RCA: 180] [Impact Index Per Article: 180.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
AIM The "2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease" provides an update to and consolidates new evidence since the "2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease" and the corresponding "2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease." METHODS A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. STRUCTURE This guideline provides an evidenced-based and patient-centered approach to management of patients with chronic coronary disease, considering social determinants of health and incorporating the principles of shared decision-making and team-based care. Relevant topics include general approaches to treatment decisions, guideline-directed management and therapy to reduce symptoms and future cardiovascular events, decision-making pertaining to revascularization in patients with chronic coronary disease, recommendations for management in special populations, patient follow-up and monitoring, evidence gaps, and areas in need of future research. Where applicable, and based on availability of cost-effectiveness data, cost-value recommendations are also provided for clinicians. Many recommendations from previously published guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.
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Affiliation(s)
| | | | | | | | | | | | - Dave L Dixon
- Former Joint Committee on Clinical Practice Guideline member; current member during the writing effort
| | - William F Fearon
- Society for Cardiovascular Angiography and Interventions representative
| | | | | | | | - Dhaval Kolte
- AHA/ACC Joint Committee on Clinical Data Standards
| | | | | | | | - Daniel B Mark
- Former Joint Committee on Clinical Practice Guideline member; current member during the writing effort
| | | | | | | | - Mariann R Piano
- Former Joint Committee on Clinical Practice Guideline member; current member during the writing effort
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Loh SM, Moloantoa T, Yende N, Variava E, Niaura R, Golub JE, Martinson N, Elf JL. A cross-sectional study of attitudes and behaviors of snuff use and cessation among people with and without HIV in South Africa. Tob Use Insights 2023; 16:1179173X231193890. [PMID: 37577008 PMCID: PMC10422901 DOI: 10.1177/1179173x231193890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023] Open
Abstract
Background Despite a high (48%) prevalence of snuff use among women with HIV in South Africa, little is known of the attitudes and behaviors of use, strategies for cessation, and potential health risks. Methods In a cross-sectional study, a questionnaire was administered to adults (≥18 years) with (HIV+) and without HIV (HIV-) who self-reported current snuff use to collect information on demographics, snuff use and cessation attempts, preferred strategies for cessation, other substance use, history of respiratory illness, and mental health. Results 150 (74 HIV+, 76 HIV-) participants were enrolled; 115 (77%) were daily snuff users, 6 (4%) were current smokers, and 17 (11%) former smokers. Top reasons for current snuff use included improving health (n = 48, 32%), reducing stress (n = 26, 16%), and "being a habit" (n = 38, 25%). Participants believed snuff use to have mostly positive (n = 68, 46%) or no (n = 54, 36%) health impacts, and 57 (38%) participants believed snuff cures headaches. 103 (69%) participants reported a previous quit attempt, and 110 (73%) indicated high interest in quitting snuff. Although 105 (70%) participants indicated that advice from a healthcare provider would aid them in quitting snuff, only 30 (20%) reported ever receiving that advice. A majority of participants (n = 141, 94%) suffer from moderate to high levels of perceived stress, and overall few differences were seen by HIV status. Conclusions Education on negative impacts of snuff, advice to quit from healthcare providers, and nicotine replacement therapy should be considered in the development of a snuff cessation program.
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Affiliation(s)
- Samantha M. Loh
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | | | | | - Ebrahim Variava
- Department of Internal Medicine, Klerksdorp Tshepong Hospital Complex, Matlosana, South Africa
| | - Raymond Niaura
- Department of Epidemiology; Department of Social and Behavioral Sciences, New York University, New York, NY, USA
| | - Jonathan E. Golub
- Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Jessica L. Elf
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
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Castro Conde A, Marzal Martín D, Campuzano Ruiz R, Fernández Olmo MR, Morillas Ariño C, Gómez Doblas JJ, Gorriz Teruel JL, Mazón Ramos P, García-Moll Marimon X, Soler Romeo MJ, León Jiménez D, Arrarte Esteban V, Obaya Rebollar JC, Escobar Cervantes C, Gorgojo Martínez JJ. Comprehensive Cardiovascular and Renal Protection in Patients with Type 2 Diabetes. J Clin Med 2023; 12:3925. [PMID: 37373620 PMCID: PMC10299569 DOI: 10.3390/jcm12123925] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/19/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Type 2 diabetes (T2DM) is one of the main public health care problems worldwide. It is associated with a marked increased risk of developing atherosclerotic vascular disease, heart failure, chronic kidney disease and death. It is essential to act during the early phases of the disease, through the intensification of lifestyle changes and the prescription of those drugs that have been shown to reduce these complications, with the aim not only of achieving an adequate metabolic control, but also a comprehensive vascular risk control. In this consensus document, developed by the different specialists that treat these patients (endocrinologists, primary care physicians, internists, nephrologists and cardiologists), a more appropriate approach in the management of patients with T2DM or its complications is provided. A particular focus is given to the global control of cardiovascular risk factors, the inclusion of weight within the therapeutic objectives, the education of patients, the deprescription of those drugs without cardiovascular benefit, and the inclusion of GLP-1 receptor agonists and SGLT2 inhibitors as cardiovascular protective drugs, at the same level as statins, acetylsalicylic acid, or renin angiotensin system inhibitors.
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Affiliation(s)
| | | | | | | | | | | | | | - Pilar Mazón Ramos
- Cardiology Department, Complejo Hospitalario Universitario Santiago de Compostela, 15706 A Coruña, Spain;
| | | | | | - David León Jiménez
- Internal Medicine Department, University Hospital Virgen del Rocío, 41013 Sevilla, Spain;
| | | | | | | | - Juan J. Gorgojo Martínez
- Department of Endocrinology and Nutrition, University Hospital Fundación Alcorcón, 28922 Madrid, Spain;
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Sehgal A, Tayade M, Kunkulol R. Effectiveness of brief counseling (5As): Antenatal tobacco cessation support program among pregnant women availing antenatal care. J Family Med Prim Care 2023; 12:768-771. [PMID: 37312787 PMCID: PMC10259542 DOI: 10.4103/jfmpc.jfmpc_1650_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/18/2023] [Accepted: 01/27/2023] [Indexed: 06/15/2023] Open
Abstract
Introduction It is likely that a pregnant woman is more motivated and receptive to accepting healthy habits and practices if talked about the benefits to the fetus. When explained about the harmful effects of tobacco on the health of the baby, the mother can be encouraged to modify her tobacco consumption habits and work toward quitting tobacco. Aim Our aim was to study the effectiveness of brief counseling (5As)-Antenatal Tobacco Cessation Support Program among pregnant women availing antenatal care (ANC). Methodology A quasi-randomized study design was used to conduct the study. The participants were identified by screening during ANC visits, and women consuming tobacco were subjected to detailed history taking and very brief counseling with the help of 5A's framework. Results We found that Mishri was the commonest form of tobacco consumed by these women. Around 93.33% of the women consume Mishri, followed by 6.66% of women consuming chewing tobacco. The method of brief counseling made an impact in the cessation of tobacco consumption in 13.37% of the study subjects. Conclusion We conclude that the use of brief counseling and motivational interviewing is feasible in most settings without inhibiting the other important aspects of ANC or disrupting the patient flow.
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Affiliation(s)
- Akansha Sehgal
- TRCC Department, Intern Student, Dr. Balasaheb Vikhe Patil Rural Medical College, Pravara Institute of Medical Sciences (DU), Loni, Maharashtra, India
| | - Motilal Tayade
- Department of Physiology, Dr. Balasaheb Vikhe Patil Rural Medical College, Pravara Institute of Medical Sciences (DU), Loni, Maharashtra, India
| | - Rahul Kunkulol
- Department of Pharmacology, Dr. Balasaheb Vikhe Patil Rural Medical College, Pravara Institute of Medical Sciences (DU), Loni, Maharashtra, India
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de Paula KM, Gomes CC, Valente MIB, Pires FR, Batistela Rodrigues Thuller KA, Salles L, Armada L. Evaluation of Receptor Activator of Nuclear Factor Kappa B Ligand, Osteoprotegerin, Osteopontin, and Tumor Necrosis Factor Alpha on Chronic Apical Periodontitis in Smokers. J Endod 2023; 49:137-143. [PMID: 36414095 DOI: 10.1016/j.joen.2022.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Smoking can be considered a risk factor for chronic apical periodontitis (CAP). This study compared the immunoexpression of biomarkers receptor activator of nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), osteopontin (OPN), and tumor necrosis factor alpha (TNF-α) in CAP in smokers and nonsmokers. METHODS Twelve smokers and 12 nonsmokers diagnosed with CAP and indicated for tooth extraction were selected. Exclusion factors were teeth with a diagnosis of root fracture, previous endodontic treatment, or endoperiodontal injury, in addition to individuals with systemic diseases, under 18 years of age, users of anti-inflammatory and/or antibiotics in the last 3 months, and drug users. Specimens were processed for histopathologic and immunohistochemical analysis. RESULTS Qualitative analysis of RANKL expression showed 66.66% weak/moderate and 33.33% strong in smokers and 100% weak/moderate in nonsmokers. OPG and OPN expressions were 100% negative to focal in the smoker group and 50% negative to focal and 50% weak/moderate in the nonsmoker group. TNF-α was 25% negative to focal and 75% weak/moderate in the smoker group and 33.33% negative to focal and 66.66% weak/moderate in the nonsmoker group. Quantitative analysis of the data using the Mann-Whitney U test showed that there was a significant difference in the immunoexpression of RANKL (P < .05), OPG (P < .05), and OPN (P < .05), but there was no statistical difference in the immunoexpression of TNF-α (P > .05) between the 2 groups. CONCLUSIONS These findings suggest that smoking is capable of altering the inflammatory response, influencing the evolution of CAP.
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Affiliation(s)
- Karoline Magalhães de Paula
- Postgraduate Program in Dentistry, Dental Clinic Concentration Area, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Cinthya Cristina Gomes
- Postgraduate Program in Dentistry, Dental Clinic Concentration Area, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil.
| | - Maria Isabel Bastos Valente
- Postgraduate Program in Dentistry, Dental Clinic Concentration Area, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Fabio Ramoa Pires
- Postgraduate Program in Dentistry, Endodontics, Estácio de Sá University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Katherine Azevedo Batistela Rodrigues Thuller
- Postgraduate Program in Dentistry, Dental Clinic Concentration Area, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Letícia Salles
- Postgraduate Program in Dentistry, Dental Clinic Concentration Area, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Luciana Armada
- Postgraduate Program in Dentistry, Endodontics, Estácio de Sá University, Nova Friburgo, Rio de Janeiro, Brazil
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Singh PK, Jain R, Tyagi A, Yadav A, Singh S. Smokeless tobacco industry's brand stretching through FM radio: A study from Delhi National Capital Region, India. Front Public Health 2022; 10:999552. [PMID: 36311609 PMCID: PMC9616108 DOI: 10.3389/fpubh.2022.999552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/25/2022] [Indexed: 01/26/2023] Open
Abstract
Smokeless tobacco (SLT) consumption is associated with multiple adverse health effects and mortality, with the highest burden in India. The WHO FCTC has banned tobacco advertisement, promotion and sponsorship via Article 13. Indian laws also prohibit any kind of direct or indirect advertisements in all forms of audio, visual, and print media; brand promotion; and sponsorship of tobacco products. However, the tobacco industry continues to find aggressive marketing ways to advertise their products. This study aims to assess the extent of surrogate advertisement of smokeless tobacco products through frequency modulation (FM) radio stations in the city of Delhi (National Capital Territory of India). In this study, the advertisements broadcasted over FM radio across different channels (private and government owned) in total 162 h were analyzed. The time duration was spread evenly over morning peak hours, off hours, and evening peak hours. It was found that multiple brands including Vimal, Kamla Pasand, and Rajshree have used surrogate advertising to market their brands that are commonly associated with smokeless tobacco products. However, no such advertisement was found to be aired on government-owned FM channels. The total surrogate advertisements broadcasted were over 286 times, where no significant difference was found in distribution among peak and non-peak hours. The study indicated that the tobacco industry is making its way to sell the products through indirect advertisements. The need of the hour is to not only enforce tobacco advertising ban laws in all forms of advertising media but also to strictly regulate smokeless tobacco products.
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Affiliation(s)
- Prashant Kumar Singh
- Division of Preventive Oncology and Population Health, WHO FCTC Knowledge Hub on Smokeless Tobacco, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India,*Correspondence: Prashant Kumar Singh
| | - Rupal Jain
- Division of Preventive Oncology and Population Health, WHO FCTC Knowledge Hub on Smokeless Tobacco, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Akansha Tyagi
- Guru Jambheshwar University of Science and Technology, Hisar, India
| | - Amit Yadav
- The International Union Against Tuberculosis and Lung Disease (The Union) South East Asia Office, New Delhi, India
| | - Shalini Singh
- Division of Preventive Oncology and Population Health, WHO FCTC Knowledge Hub on Smokeless Tobacco, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
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Drapkina OM, Kontsevaya AV, Kalinina AM, Avdeev SM, Agaltsov MV, Alexandrova LM, Antsiferova AA, Aronov DM, Akhmedzhanov NM, Balanova YA, Balakhonova TV, Berns SA, Bochkarev MV, Bochkareva EV, Bubnova MV, Budnevsky AV, Gambaryan MG, Gorbunov VM, Gorny BE, Gorshkov AY, Gumanova NG, Dadaeva VA, Drozdova LY, Egorov VA, Eliashevich SO, Ershova AI, Ivanova ES, Imaeva AE, Ipatov PV, Kaprin AD, Karamnova NS, Kobalava ZD, Konradi AO, Kopylova OV, Korostovtseva LS, Kotova MB, Kulikova MS, Lavrenova EA, Lischenko OV, Lopatina MV, Lukina YV, Lukyanov MM, Mayev IV, Mamedov MN, Markelova SV, Martsevich SY, Metelskaya VA, Meshkov AN, Milushkina OY, Mukaneeva DK, Myrzamatova AO, Nebieridze DV, Orlov DO, Poddubskaya EA, Popovich MV, Popovkina OE, Potievskaya VI, Prozorova GG, Rakovskaya YS, Rotar OP, Rybakov IA, Sviryaev YV, Skripnikova IA, Skoblina NA, Smirnova MI, Starinsky VV, Tolpygina SN, Usova EV, Khailova ZV, Shalnova SA, Shepel RN, Shishkova VN, Yavelov IS. 2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3235] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Hajat C, Stein E, Ramstrom L, Shantikumar S, Polosa R. The health impact of smokeless tobacco products: a systematic review. Harm Reduct J 2021; 18:123. [PMID: 34863207 PMCID: PMC8643012 DOI: 10.1186/s12954-021-00557-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The objective was to systematically review studies on health outcomes from smokeless tobacco (SLT) products. METHODS We analysed published literature on the health outcomes from SLT use between 01/01/2015 to 01/02/2020, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol using PubMed, Embase, Scopus, and Google Scholar. RESULTS Of 53 studies included, six were global, 32 from Asia, Middle East and Africa (AMEA), nine from USA and six from Europe. 'Poor'-rated studies predominated (23;43%), in particular, for global (4;66%) and AMEA (16;50%). Health outcomes differed between SLT-products and regions; those in AMEA were associated with higher mortality (overall, cancer, Coronary heart disease (CHD), respiratory but not cardiovascular disease (CVD)), and morbidity (CVD, oral and head and neck cancers), with odds ratios up to 38.7. European studies showed no excess mortality (overall, CVD, from cancers) or morbidity (ischemic heart disease (IHD), stroke, oral, head and neck, pancreatic or colon cancers) from several meta-analyses; single studies reported elevated risk of rectal cancer and respiratory disorders. Pooled study data showed protection against developing Parkinson's disease. US studies showed mixed results for mortality (raised overall, CHD, cancer and smoking-related cancer mortality; no excess risk of respiratory or CVD mortality). Morbidity outcomes were also mixed, with some evidence of increased IHD, stroke and cancer risk (oral, head and neck). No studies reported on switching from cigarettes to SLT-products. CONCLUSION Our review demonstrates stark differences between different SLT-products in different regions, ranging from zero harm from European snus to greatly increased health risks in AMEA. The literature on the safety profile for SLT-products for harm reduction is incomplete and potentially misinforming policy and regulation.
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Affiliation(s)
- C Hajat
- Public Health Institute, UAE University, Abu Dhabi, 15551, UAE.
| | - E Stein
- Independent Researcher, New York, USA
| | - L Ramstrom
- Independent Researcher, Institute for Tobacco Studies, Stockholm, Sweden
| | - S Shantikumar
- Warwick Medical School, University of Warwick, Coventry, UK
| | - R Polosa
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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12
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Saranyutanon S, Acharya S, Deshmukh SK, Khan MA, Singh S, Singh AP. Nicotine causes alternative polarization of macrophages via Src-mediated STAT3 activation: Potential pathobiological implications. J Cell Physiol 2021; 237:1486-1497. [PMID: 34647621 DOI: 10.1002/jcp.30607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 12/13/2022]
Abstract
Nicotine is an addictive ingredient of tobacco products and other noncigarette substitutes, including those being used for smoking cessation to relieve withdrawal symptoms. Earlier research, however, has associated nicotine with the risk and poorer outcome of several diseases, including cancer. Macrophages are an important component of the innate immune system and can have both pro-and anti-inflammatory functions depending upon their polarization state. Here, we investigated the effect of nicotine on macrophage polarization, growth, and invasion to understand its role in human physiology. We observed that nicotine induced M2 polarization of RAW264.7 and THP-1-derived macrophages in a dose-dependent manner. Cytokine profiling suggested a mixed M2a/d phenotype of nicotine-polarized macrophages associated with tissue repair and pro-angiogenic functions. Moreover, nicotine treatment also enhanced the growth, motility, and invasion of macrophages. Mechanistic studies revealed increased phosphorylation of STAT3 in nicotine-treated macrophages that was mediated through Src activation. Importantly, pretreatment of macrophages with either Src or STAT3 inhibitor abrogated nicotine-induced macrophage polarization, growth, and motility, suggesting a functional role of the Src-STAT3 signaling axis. Together, our findings reveal a novel role of nicotine in immunosuppression via causing M2 polarization of macrophages that could be implicated in the pathogenesis of various diseases.
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Affiliation(s)
- Sirin Saranyutanon
- Department of Pathology, University of South Alabama, Mobile, Alabama, USA
- Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile, Alabama, USA
| | - Srijan Acharya
- Department of Pathology, University of South Alabama, Mobile, Alabama, USA
- Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile, Alabama, USA
| | - Sachin Kumar Deshmukh
- Department of Pathology, University of South Alabama, Mobile, Alabama, USA
- Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile, Alabama, USA
| | - Mohammad Aslam Khan
- Department of Pathology, University of South Alabama, Mobile, Alabama, USA
- Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile, Alabama, USA
| | - Seema Singh
- Department of Pathology, University of South Alabama, Mobile, Alabama, USA
- Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile, Alabama, USA
- Department of Biochemistry and Molecular Biology, College of Medicine, University of South Alabama, Mobile, Alabama, USA
| | - Ajay Pratap Singh
- Department of Pathology, University of South Alabama, Mobile, Alabama, USA
- Cancer Biology Program, Mitchell Cancer Institute, University of South Alabama, Mobile, Alabama, USA
- Department of Biochemistry and Molecular Biology, College of Medicine, University of South Alabama, Mobile, Alabama, USA
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13
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Singhavi HR, Singh A, Chaturvedi P. Smokeless Tobacco and Its Ill-Effects: Recent Literature Update. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1735598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AbstractAccording to the Global Adult Tobacco Survey part 2 (GATS-2), approximately 200 million adult Indians consume smokeless tobacco (SLT). Circumvention of SLT product ban has been observed. We conducted a review of the literature to summarize the ill effects of tobacco for the articles published from 2019 to 2020. A systematic search of the databases PubMed (2019 onward) and Web of Science (2019 onward), through February 2021 was done. Search yielded 1,061 articles and after excluding articles based on the inclusion criteria, 37 articles were taken in to consideration. The review shows that differential SLT product has specific odds of oral carcinogenesis. Review also indicates the emerging data of cardiovascular risk due to higher use of SLT products along with its known cause of oral cancer. It also cautions about the adverse consequences of pregnancy associated with SLT use.
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Affiliation(s)
- Hitesh R. Singhavi
- Department of Surgical Oncology, Fortis Hospital, Mulund, Mumbai, Maharashtra, India
| | - Arjun Singh
- Department of Head and Neck Services, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
- Department of Surgical Oncology, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Pankaj Chaturvedi
- Department of Head and Neck Services, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
- Department of Surgical Oncology, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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14
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Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, Benetos A, Biffi A, Boavida JM, Capodanno D, Cosyns B, Crawford C, Davos CH, Desormais I, Di Angelantonio E, Franco OH, Halvorsen S, Hobbs FDR, Hollander M, Jankowska EA, Michal M, Sacco S, Sattar N, Tokgozoglu L, Tonstad S, Tsioufis KP, van Dis I, van Gelder IC, Wanner C, Williams B. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur J Prev Cardiol 2021; 29:5-115. [PMID: 34558602 DOI: 10.1093/eurjpc/zwab154] [Citation(s) in RCA: 211] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Alessandro Biffi
- European Federation of Sports Medicine Association (EFSMA).,International Federation of Sport Medicine (FIMS)
| | | | | | | | | | | | | | | | | | | | - F D Richard Hobbs
- World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) - Europe
| | | | | | | | | | | | | | | | | | | | | | - Christoph Wanner
- European Renal Association - European Dialysis and Transplant Association (ERA-EDTA)
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15
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Danielsson M, Tanner T, Patinen P, Birkhed D, Anttonen V, Lammi A, Siitonen S, Ollgren J, Pylkkänen L, Vasankari T. Prevalence, duration of exposure and predicting factors for snus use among young Finnish men: a cross-sectional study. BMJ Open 2021; 11:e050502. [PMID: 34521671 PMCID: PMC8442068 DOI: 10.1136/bmjopen-2021-050502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The health hazards of tobacco products depend on the level of exposure, but little is known about the characteristics of snus use. The aim of this study was to investigate the duration of daily exposure to snus among occasional and daily users and its associated predictive factors among young Finnish men. DESIGN Cross-sectional questionnaire study. SETTING Three out of 16 Finnish Defence Forces units. PARTICIPANTS 1280 young Finnish male conscripts starting their military service in 2016 chosen by simple random sampling. PRIMARY AND SECONDARY MEASURES The prevalence, duration of use and the amount of daily usage of snus and cigarettes were investigated. The attitudes towards perceived harmfulness of snus and the predictive factors affecting the total time of snus consumption were examined. RESULTS Almost a fifth (19.5%) of the conscripts reported daily snus use, and a further 16% reported occasional use. Daily snus use was associated with an earlier starting age, longer duration of use and higher daily exposure time compared with occasional use. On average, daily snus users consumed 10 portions and occasional users three portions per day (p<0.001). The daily total exposure time for daily users was 372 min (95% CI 344 to 401) and for occasional users 139 min (95% CI 106 to 171). Respondents with an upper secondary education had significantly less daily total exposure than those with basic comprehensive education (p=0.036). Perceptions of snus as a harmful substance resulted in a significantly lower duration of exposure. CONCLUSION Snus use was very common among young Finnish men. High snus exposure duration was associated with an earlier starting age, a longer history of use and a careless attitude to its health hazards. A higher education level was a protective factor for total exposure time. Studies of the long-term health effects and dependency profile of snus use are needed.
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Affiliation(s)
- Maria Danielsson
- Center for Military Medicine, Finnish Defence Forces, Helsinki, Uusimaa, Finland
- Doctoral Programme in Population Health, University of Helsinki, Helsinki, Uusimaa, Finland
| | - Tarja Tanner
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, University Hospital and University of Oulu, Oulu, Finland
| | - Pertti Patinen
- Center for Military Medicine, Finnish Defence Forces, Helsinki, Uusimaa, Finland
| | - Dowen Birkhed
- Former: Department of Cariology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Vuokko Anttonen
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, University Hospital and University of Oulu, Oulu, Finland
| | - Anelma Lammi
- Finnish Lung Health Association, Helsinki, Uusimaa, Finland
| | - Simo Siitonen
- The Defence Command, Finnish Defence Forces, Helsinki, Uusimaa, Finland
| | - Jukka Ollgren
- Department of Infectious Disease Surveillance and Control, Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Liisa Pylkkänen
- Finnish Medicines Agency Fimea, Helsinki, Uusimaa, Finland
- Division of Medicine, Department of Oncology, University of Turku, Turku, Varsinais-Suomi, Finland
| | - Tuula Vasankari
- Finnish Lung Health Association, Helsinki, Uusimaa, Finland
- Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Varsinais-Suomi, Finland
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16
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Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, Benetos A, Biffi A, Boavida JM, Capodanno D, Cosyns B, Crawford C, Davos CH, Desormais I, Di Angelantonio E, Franco OH, Halvorsen S, Hobbs FDR, Hollander M, Jankowska EA, Michal M, Sacco S, Sattar N, Tokgozoglu L, Tonstad S, Tsioufis KP, van Dis I, van Gelder IC, Wanner C, Williams B. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2021; 42:3227-3337. [PMID: 34458905 DOI: 10.1093/eurheartj/ehab484] [Citation(s) in RCA: 2289] [Impact Index Per Article: 763.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Alessandro Biffi
- European Federation of Sports Medicine Association (EFSMA)
- International Federation of Sport Medicine (FIMS)
| | | | | | | | | | | | | | | | | | | | - F D Richard Hobbs
- World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) - Europe
| | | | | | | | | | | | | | | | | | | | | | - Christoph Wanner
- European Renal Association - European Dialysis and Transplant Association (ERA-EDTA)
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17
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James SA, Heller JG, Hartman CJ, Schaff AC, Mushtaq N, Beebe LA. Smokeless Tobacco Point of Sale Advertising, Placement and Promotion: Associations With Store and Neighborhood Characteristics. Front Public Health 2021; 9:668642. [PMID: 34055727 PMCID: PMC8155309 DOI: 10.3389/fpubh.2021.668642] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/16/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction: Objectives of this study were to determine retail and neighborhood characteristics associated with smokeless tobacco (ST) product promotion, price promotion, and storefront advertising among retailers in Oklahoma. Methods: In this statewide point-of-sale study, we collected data from 1,354 ST retailers. Using store characteristics and census tract information, we estimated summary statistics and adjusted prevalence ratios during 2019–2020. Results: Of ST retailers audited, 11.0% demonstrated ST youth promotion, 43.0% ST price promotions, and 19.6% ST storefront advertising. The adjusted prevalence ratio (aPR) for convenience stores was higher for all three ST strategies: youth promotion (aPR = 3.4, 95% CI 1.9, 6.2), price promotion (aPR = 3.8, 95% CI 2.9, 5.0), and storefront advertising (aPR=16.4, 95% CI 6.7, 40.3) compared to other store types. Metropolitan tobacco retailers had higher aPRs for youth promotion (aPR = 1.7, 95% CI 1.12 2.6) and storefront advertising (aPR = 1.5, 95% CI 1.2, 1.9). Conclusions: Findings of this study suggest there are currently ample opportunities for youth and adults at risk for tobacco initiation to be exposed to ST products in the retail environment. Convenience stores, more likely to be found and utilized in rural areas compared to metropolitan areas, are disproportionately more likely to engage in marketing strategies that could lure youth into trying smokeless tobacco.
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Affiliation(s)
- Shirley A James
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - John G Heller
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Chantel J Hartman
- Center for Chronic Disease Prevention and Health Promotion, Oklahoma State Department of Health, Oklahoma City, OK, United States
| | - Andrew C Schaff
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Nasir Mushtaq
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Laura A Beebe
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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Barua L, Banik PC, Islam SMS, Faruque M. Application of country‐specific Globorisk score to estimate next 10 years risk of cardiovascular diseases and its associated predictors among postmenopausal rural women of Bangladesh: A cross‐sectional study in a primary care setting. LIFESTYLE MEDICINE 2021. [DOI: 10.1002/lim2.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Lingkan Barua
- Department of Noncommunicable Diseases Bangladesh University of Health Sciences Dhaka Bangladesh
| | - Palash Chandra Banik
- Department of Noncommunicable Diseases Bangladesh University of Health Sciences Dhaka Bangladesh
| | | | - Mithila Faruque
- Department of Noncommunicable Diseases Bangladesh University of Health Sciences Dhaka Bangladesh
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19
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da Silva Júnior FMR, Tavella RA, Fernandes CLF, Mortola AS, Peraza GG, Garcia EM. Response to letter to the editor "Genetic biomonitoring of professionals occupationally exposed to ionizing radiation: Theoretical concepts for scientific debate". Toxicol Ind Health 2020; 36:745-749. [PMID: 33241773 DOI: 10.1177/0748233720951092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Flavio Manoel Rodrigues da Silva Júnior
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, 67820Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil.,Programa de Pós-Graduação em Ciências da Saúde, 67820Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil
| | - Ronan Adler Tavella
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, 67820Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil.,Programa de Pós-Graduação em Ciências da Saúde, 67820Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil
| | - Caroline Lopes Feijo Fernandes
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, 67820Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil.,Programa de Pós-Graduação em Ciências da Saúde, 67820Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil
| | - Alexandra Silveira Mortola
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, 67820Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil
| | - Gianni Goulart Peraza
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, 67820Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil
| | - Edariane Menestrino Garcia
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, 67820Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil
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20
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Pinto KP, Ferreira CM, Maia LC, Sassone LM, Fidalgo TKS, Silva EJNL. Does tobacco smoking predispose to apical periodontitis and endodontic treatment need? A systematic review and meta-analysis. Int Endod J 2020; 53:1068-1083. [PMID: 32344459 DOI: 10.1111/iej.13316] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 04/24/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Controversial findings exist in the literature regarding the association between tobacco smoking and development of apical periodontitis or need for root canal treatment, with some studies reporting an increase in the prevalence of these outcomes in smokers, whilst others reporting no association. AIM To evaluate if there is scientific evidence to support an association between tobacco smoking and a greater prevalence of apical periodontitis and/or root canal treatments. DATA SOURCES A systematic search was performed using MeSH terms and free terms in the PubMed, Scopus, Virtual Health Library (VHL), Cochrane library and Open Gray databases. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS Observational studies that evaluated the association between smoking and the development or healing of periapical lesion and/or the prevalence of root canal treatment in humans were included. STUDY APPRAISAL AND SYNTHESIS METHODS A quality assessment of included studies was performed, and the relevant information and findings were evaluated. A meta-analysis using nine included studies was performed through RevMan software, and the certainty of evidence was evaluated through GRADE. RESULTS Fifteen studies were included, of which 10 were classified as low risk of bias, 4 were considered as moderate risk of bias and 1 as high risk of bias. Ten studies reported that smoking was associated with a greater prevalence of periapical periodontitis and/or root canal treatment. Five studies reported no association. Nine studies were included in the pooled meta-analysis, comprising two subgroups: apical periodontitis and root canal treatment. From these nine studies, eight studies were included in the apical periodontitis subgroup meta-analysis and demonstrated that this condition was significantly more prevalent in smokers when compared to the nonsmokers (odds ratio = 2.78[CI: 1.60, 4.85], P < 0.001; I2 = 79%; no adjusted odds ratio). Three studies were included in the root canal treatment subgroup meta-analysis and demonstrated an increased prevalence in smokers when compared to the nonsmokers (odds ratio = 2.73 [CI: 1.06, 2.83], P < 0.001; I2 = 72%; no adjusted odds ratio). The pooled meta-analysis demonstrated that smokers had twice the chance of having apical periodontitis and/or root canal treatment when compared to nonsmokers (odds ratio of 2.42 [CI: 1.59, 3.68], P < 0.01; I2 = 85%). The GRADE analysis demonstrated moderate certainty of evidence. LIMITATIONS Several confounding factors were identified such as misinformation regarding the period of time subjects had smoked, as well as the frequency of smoking and the number of cigarettes consumed. No adjustment in odds ratio data for confounding was performed. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS This systematic review and meta-analysis indicate that tobacco smokers have an increased prevalence of periapical periodontitis and root canal treatments with moderate certainty of evidence.
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Affiliation(s)
- K P Pinto
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - C M Ferreira
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - L C Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - L M Sassone
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - T K S Fidalgo
- Department of Community and Preventive Dentistry, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - E J N L Silva
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
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21
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Ilies BD, Moosakutty SP, Kharbatia NM, Sarathy SM. Identification of volatile constituents released from IQOS heat-not-burn tobacco HeatSticks using a direct sampling method. Tob Control 2020:tobaccocontrol-2019-055521. [PMID: 32457207 DOI: 10.1136/tobaccocontrol-2019-055521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/01/2020] [Accepted: 04/21/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To identify the chemicals released in I Quit Ordinary Smoking (IQOS) heat-not-burn tobacco aerosol and to assess their potential human health toxicity. METHODS The heating temperature window of the IQOS heat-not-burn device was determined using a thermographic camera over a period of 100 s. Qualitative studies were performed using a novel real-time gas chromatograph-mass spectrometer set-up. Aerosols from six tobacco-flavoured IQOS HeatSticks (Amber, Blue, Bronze, Sienna, Turquoise and Yellow) were collected in a 1 mL loop via a manual syringe attached to the sample-out port of the valve. The gas transport line was heated to 200°C in order to prevent the condensation of volatile species. Compound identification was performed using the NIST11 mass spectrometry database library (US National Institute of Standards and Technology), where only chemicals with a match of 70% and above were listed as identifiable. RESULTS The temperature profile of the IQOS device revealed a non-combustive process employed in generating the tobacco aerosol. Real-time qualitative analysis revealed 62 compounds encompassing a broad spectrum of chemicals such as carbonyls, furans and phthalates, which are highly toxic. DISCUSSION Our findings complement the qualitative studies previously performed by Philip Morris International and others via indirect sampling methods. By analysing the aerosols in real time, we have identified a total of 62 compounds, from which only 10 were in common with previous studies. Several identified species such as diacetyl, 2,3-pentanedione, hydroxymethylfurfural and diethylhexyl phthalate are classified as highly toxic, with the latter considered carcinogenic.
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Affiliation(s)
- Bogdan Dragos Ilies
- CCRC, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | | | - Najeh M Kharbatia
- Analytical Core Laboratoy, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - S Mani Sarathy
- CCRC, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
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22
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Diendéré J, Zeba AN, Nikièma L, Kaboré A, Savadogo PW, Tougma SJB, Tinto H, Ouédraogo A. Smokeless tobacco use: its prevalence and relationships with dental symptoms, nutritional status and blood pressure among rural women in Burkina Faso. BMC Public Health 2020; 20:579. [PMID: 32345279 PMCID: PMC7189451 DOI: 10.1186/s12889-020-08700-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sub-Saharan women use smokeless tobacco (SLT) more than smoked tobacco. Among Western African countries, the estimated weighted prevalence of SLT use in rural women was found to be the highest in Burkina Faso (after Sierra Leone). This study aimed to assess the prevalence of SLT use and its associated factors among rural women in Burkina Faso by using nationally representative data. METHODS We used data from the 2013 STEPwise approach to Surveillance (STEPS) study, which provided sociodemographic, clinical (anthropometric, systolic blood pressure [SBP], diastolic blood pressure [DBP] and dental symptoms), biological (total and high-density lipoprotein cholesterol and fasting blood sugar), and tobacco and alcohol consumption data. Data for 1730 rural women were used, and we performed Student's chi-squared and logistic regression analyses. RESULTS The prevalence of current SLT use was 13.8% (95% CI: 12.2-15.5). Significant risks for SLT use were the presence of dental symptoms (adjusted odds ratio [aOR] = 2.59; p < 0.001), undernourishment (aOR = 1.78; p < 0.01), decreased waist circumference (aOR = 0.98; p < 0.05), decreased DBP (aOR = 0.97; p < 0.01), increased SBP (aOR = 1.01; p < 0.05), and increased differential blood pressure (aOR = 1.01; p < 0.05). The co-use of alcohol was also a significant risk factor (aOR = 2.80; p < 0.001). CONCLUSION The prevalence of current SLT use was high among rural women in Burkina Faso, and significant concerns for users included alcohol co-use, the occurrence of dental symptoms, undernourishment, and an increase in differential blood pressure. National Public Health interventions are needed to reduce SLT use and its health-related concerns.
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Affiliation(s)
- Jeoffray Diendéré
- Public Health Department, Research Institute for Health Sciences, 399, Avenue de la Liberté, 01 BP 545, Bobo-Dioulasso, 01, Burkina Faso. .,Public Health Department, Centre Muraz, Bobo-Dioulasso, Burkina Faso.
| | - Augustin Nawidimbasba Zeba
- Public Health Department, Research Institute for Health Sciences, 399, Avenue de la Liberté, 01 BP 545, Bobo-Dioulasso, 01, Burkina Faso
| | - Léon Nikièma
- Joseph Ki-Zerbo University, BP 5705, Ouagadougou, 01, Burkina Faso
| | - Ahmed Kaboré
- Public Health Department, Centre Muraz, Bobo-Dioulasso, Burkina Faso.,Joseph Ki-Zerbo University, BP 5705, Ouagadougou, 01, Burkina Faso
| | - Paul Windinpsidi Savadogo
- Institute of Environment and Agricultural Research (INERA/CNRST), rue Guisga, 04 BP 8645, Ouagadougou, Burkina Faso
| | | | - Halidou Tinto
- Public Health Department, Centre Muraz, Bobo-Dioulasso, Burkina Faso.,Clinical Research Unit of Research Institute for Health Sciences Nanoro, 11 BP 218, Ouagadougou, Burkina Faso
| | - Arouna Ouédraogo
- Department of Psychiatry, Yalgado Ouédraogo University Hospital, Joseph Ki-Zerbo University, 01 BP 5705, Ouagadougou, Burkina Faso
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Tripathi P, Alshahrani S, Alhazmi HA, Tripathi R, Siddiqui AH, Ahsan W, Al Bratty M. In vivo assessment of genotoxic potential of brown shammah (smokeless tobacco) in bone marrow cells of mice. Saudi Pharm J 2020; 28:480-486. [PMID: 32273808 PMCID: PMC7132595 DOI: 10.1016/j.jsps.2020.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 02/26/2020] [Indexed: 12/31/2022] Open
Abstract
This study was aimed to assess the genotoxicity of brown shammah (BS), a local form of smokeless tobacco, popular in Middle East countries including Yemen, Saudi Arabia and Sudan. The genotoxicity was explored using in vivo chromosomal aberration (CA), micronucleus (MN) and sperm abnormality (SA) assays. In addition, oxidative stress was also determined using various hepatic markers. Swiss albino mice were selected for the study, which were divided in to 5 groups of six animals each. They include, negative control (NC, received only vehicle) as well as positive control group (PC, received vehicle for 2 weeks followed by administration of cyclophosphamide, CP). Depending upon their dose, three BS treated animal groups were BS-100, 300 and 900 mg/kg. Doses of BS were obtained by suspending BS in 0.5% CMC (carboxy methyl cellulose) and orally administered once a day for 2 weeks. Significant augmentation of the average percentage of aberrant metaphase (AM), CA per cells and suppressed mitotic activity was observed on post administration of BS. In addition, BS increased the occurrence of MNPCEs (micronucleated polychromatic erythrocytes) formation, induced cytotoxicity and increased percentage of abnormal sperms as compared to NC. Moreover, BS also induced oxidative stress as the activities of hepatic superoxide dismutase (SOD) and glutathione (GSH) were reduced and malondialdehyde (MDA) content were increased by BS. Cyclophosphamide was utilized as clastogen, showed anticipated positive results and confirmed the sensitivity of test system. Therefore, it may be deduced from the study that the BS possesses genotoxic effects on mice bone marrow and germ cells in vivo.
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Affiliation(s)
- Pankaj Tripathi
- Department of Pharmacology, College of Pharmacy, Jazan University, P. Box No. 114, Jazan, Saudi Arabia
| | - Saeed Alshahrani
- Department of Pharmacology, College of Pharmacy, Jazan University, P. Box No. 114, Jazan, Saudi Arabia
| | - Hassan A. Alhazmi
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jazan University, P. Box No. 114, Jazan, Saudi Arabia
- Substance Abuse and Toxicology Research Centre, Jazan University, Jazan, P. Box No. 114, Jazan, Saudi Arabia
| | - Rina Tripathi
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, P. Box No. 114, Jazan, Saudi Arabia
| | - Abdul Hakeem Siddiqui
- Department of Pharmacology, College of Pharmacy, Jazan University, P. Box No. 114, Jazan, Saudi Arabia
| | - Waquar Ahsan
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jazan University, P. Box No. 114, Jazan, Saudi Arabia
| | - Mohammed Al Bratty
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jazan University, P. Box No. 114, Jazan, Saudi Arabia
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Pericot-Valverde I, Elliott RJ, Priest JS, Barret T, Yoon JH, Miller CC, Okoli CTC, Haliwa I, Ades PA, Gaalema DE. Patterns of tobacco use among smokers prior to hospitalization for an acute cardiac event: Use of combusted and non-combusted products. Prev Med 2019; 128:105757. [PMID: 31254538 PMCID: PMC7248643 DOI: 10.1016/j.ypmed.2019.105757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/30/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
Use of tobacco products before or after a cardiac event increases risk of morbidity and mortality. Unlike cigarette smoking, which is generally screened in the healthcare system, identifying the use of other tobacco products remains virtually unexplored. This study aimed at characterizing the use of other non-combusted tobacco products in addition to combusted products among cardiac patients and identifying a profile of patients who are more likely to use non-combusted products. Patients (N = 168) hospitalized for a coronary event who reported being current cigarette smokers completed a survey querying sociodemographics, cardiac diagnoses, use of other tobacco products, and perceptions towards these products. Classification and regression tree (CART) analysis was used to identify which interrelationships of participants characteristics led to profiles of smoking cardiac patients more likely to also be using non-combusted tobacco products. Results showed that non-combusted tobacco product use ranged from 0% to 47% depending on patient characteristic combinations. Younger age and lower perception that cigarette smoking is responsible for their cardiac condition were the strongest predictive factors for use of non-combusted products. Tobacco product use among cardiac patients extends beyond combusted products (13.7% non-combusted product use), and consequently, screening in health care settings should be expanded to encompass other tobacco product use. This study also characterizes patients likely to be using non-combusted products in addition to combusted, a group at high-risk due to their multiple product use, but also a group that may be amenable to harm reduction approaches and evidence-based tobacco treatment strategies.
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Affiliation(s)
- Irene Pericot-Valverde
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States of America; Departments of Psychiatry, University of Vermont, Burlington, VT, United States of America; School of Health Research, Clemson University, Greenville, SC, United States of America.
| | - Rebecca J Elliott
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States of America; Departments of Psychiatry, University of Vermont, Burlington, VT, United States of America
| | - Jeff S Priest
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States of America; Biostatistical Unit, University of Vermont, Burlington, VT, United States of America
| | - Trace Barret
- Division of Cardiology, University of Vermont, Burlington, VT, United States of America
| | - Jin H Yoon
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science at Houston, Houston, TX, United States of America
| | - Charles C Miller
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science at Houston, Houston, TX, United States of America
| | - Chizimuzo T C Okoli
- College of Nursing, University of Kentucky, Lexington, KY, United States of America
| | - Ilana Haliwa
- Department of Behavioral Neuroscience, West Virginia University, Morgantown, WV, United States of America
| | - Philip A Ades
- Division of Cardiology, University of Vermont, Burlington, VT, United States of America
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States of America; Departments of Psychiatry, University of Vermont, Burlington, VT, United States of America
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25
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Kennedy CD, van Schalkwyk MCI, McKee M, Pisinger C. The cardiovascular effects of electronic cigarettes: A systematic review of experimental studies. Prev Med 2019; 127:105770. [PMID: 31344384 DOI: 10.1016/j.ypmed.2019.105770] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 06/18/2019] [Accepted: 07/12/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Smoking is responsible for substantial cardiovascular morbidity and mortality. Electronic cigarettes have been advocated as a means to reduce this disease burden; by reducing exposure to harmful substances in smokers who are unable to quit. Concerns have been raised however, about cardiovascular effects of their use, with inhalants containing carbonyls and fine particulate matter. We systematically reviewed experimental studies of in vitro, animal, and human cardiovascular effects associated with electronic cigarette use. METHODS A literature search was conducted using Ovid MEDLINE & Embase databases, identifying experimental studies investigating cardiovascular effects of electronic cigarette use. Subsequently, Cochrane Risk of Bias tools were used to assess study quality. Any differences in outcomes by conflict of interest and risk of bias status were sought. RESULTS 38 studies were included, investigating animals (n=6), humans (n=24) and human cardiovascular cells in vitro (n=8). 74.3% of studies found potentially harmful effects. Increased sympathetic nerve activity was observed in human studies, whilst platelet haemostatic processes, reactive oxygen species production and endothelial dysfunction were reported across all study types. Studies with conflicts of interest or median-high risk of bias were less likely to identify potentially harmful effects (p=0.0007, p=0.04 respectively). DISCUSSION Most studies suggest potential for cardiovascular harm from electronic cigarette use, through mechanisms that increase risk of thrombosis and atherosclerosis. Notably, studies with conflicts of interest are significantly less likely to identify concerning cardiovascular effects. Included studies examine healthy, adult participants, limiting generalisation to potential high-risk groups including individuals with established cardiovascular disease or young, non-smokers.
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Affiliation(s)
- Ciaran D Kennedy
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - May C I van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, Denmark; Danish Heart Foundation, Copenhagen, Denmark; University of Copenhagen, Faculty of Health and Medical Science, Denmark.
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26
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Mehrotra R, Yadav A, Sinha DN, Parascandola M, John RM, Ayo-Yusuf O, Nargis N, Hatsukami DK, Warnakulasuriya S, Straif K, Siddiqi K, Gupta PC. Smokeless tobacco control in 180 countries across the globe: call to action for full implementation of WHO FCTC measures. Lancet Oncol 2019; 20:e208-e217. [PMID: 30942182 DOI: 10.1016/s1470-2045(19)30084-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 01/20/2019] [Accepted: 02/05/2019] [Indexed: 12/11/2022]
Abstract
Smokeless tobacco is consumed by 356 million people globally and is a leading cause of head and neck cancers. However, global efforts to control smokeless tobacco use trail behind the progress made in curbing cigarette consumption. In this Policy Review, we describe the extent of the policy implementation gap in smokeless tobacco control, discuss key reasons on why it exists, and make recommendations on how to bridge this gap. Although 180 countries have agreed that the WHO Framework Convention on Tobacco Control is the best approach to control the demand and supply of smokeless tobacco, only 138 (77%) Parties define smokeless tobacco in their statutes. Only 34 (19%) Parties tax or report taxing smokeless tobacco products, six (3%) measure content and emissions of smokeless tobacco products, and 41 (23%) mandate pictorial health warnings on these products. Although awareness of the harms related to smokeless tobacco is growing in many parts of the world, few Parties collect or present data on smokeless tobacco use under global or national surveillance mechanisms (eg, Global Tobacco Surveillance System and WHO STEPwise). Only 16 (9%) Parties have implemented a comprehensive ban on smokeless tobacco advertisement, promotion, and sponsorships. Globally, a smaller proportion of smokeless tobacco users are advised to quit the use of smokeless tobacco products compared to tobacco users. Use of smokeless tobacco is becoming a global cause of concern, requiring a greater commitment on the full implementation of the WHO Framework Convention on Tobacco Control measures.
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Affiliation(s)
- Ravi Mehrotra
- Division of Preventive Oncology and WHO-FCTC Global Knowledge Hub on Smokeless Tobacco, Indian Council of Medical Research National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India.
| | - Amit Yadav
- Division of Preventive Oncology and WHO-FCTC Global Knowledge Hub on Smokeless Tobacco, Indian Council of Medical Research National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | | | | | - Rijo M John
- Centre for Public Policy Research, Kochi, Kerala, India
| | - Olalekan Ayo-Yusuf
- Sefako Makgatho Health Sciences University, Pretoria North, South Africa
| | | | | | - Saman Warnakulasuriya
- Department of Oral Medicine and Pathology and WHO Collaborating Centre for Oral Cancer, King's College London, London, UK
| | - Kurt Straif
- International Agency for Research on Cancer, Lyon, France
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
| | - Prakash C Gupta
- Healis-Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra, India
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27
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Sun H, Wu C. Acupuncture combined with Buyang Huanwu decoction in treatment of patients with ischemic stroke. J Int Med Res 2019; 47:1312-1318. [PMID: 30704331 PMCID: PMC6421375 DOI: 10.1177/0300060518822923] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 12/12/2018] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE This study was performed to investigate the effect of acupuncture combined with Buyang Huanwu decoction in patients with ischemic stroke. METHODS In total, 115 patients with ischemic stroke were recruited and divided into 3 groups. The control group received normal treatment, the acupuncture group received additional acupuncture treatment, and the combined group received additional acupuncture combined with Buyang Huanwu decoction treatment. The National Institutes of Health Stroke Scale (NIHSS) and Chinese Stroke Scale (CSS) were used to evaluate the stroke condition, and the Barthel index (BI) was used to measure life quality. Blood lipids and recurrence were also analyzed. RESULTS The CSS and NIHSS scores were significantly lower in the acupuncture group and combined group than in the control group; however, the BI score was significantly higher in the acupuncture group and combined group. Similarly, the levels of cholesterol, triglycerides, and low-density lipoprotein were all significantly increased, while the level of high-density lipoprotein showed no significant difference in all groups. The recurrence rate was significantly lower in the combined group than in the other two groups. CONCLUSION Acupuncture combined with Buyang Huanwu decoction could improve the clinical outcomes and reduce the recurrence rates in patients with ischemic stroke.
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Affiliation(s)
- Huili Sun
- School of Basic Medical Sciences, Nanjing University of
Traditional Chinese Medicine, Nanjing, Jiangsu, China
- TCM Physiotherapy, First People’s Hospital of Xuzhou, Xuzhou,
Jiangsu, China
| | - Chengyu Wu
- School of Basic Medical Sciences, Nanjing University of
Traditional Chinese Medicine, Nanjing, Jiangsu, China
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28
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Gulati HK, Kumar A, Dhama AS, Gupta R, Sharma AK, Singh H, Sinha DN, Mehrotra R. Setting research priorities in smokeless tobacco control: A retrospective review. Indian J Med Res 2018; 148:103-109. [PMID: 30264759 PMCID: PMC6172912 DOI: 10.4103/ijmr.ijmr_80_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background & objectives Smokeless tobacco (SLT) has become a global menace; India being one of the high-burden countries contributes about 67 per cent of its users. Although research is ongoing on various aspects of SLT use and its effects, there is a need to identify the still under-researched areas in this field. This study was aimed at delineating the quantum of research on various topics of SLT, with intent to delineate research gaps for guiding future research priorities. Methods Data about research in SLT were collected from PubMed database using 'smokeless tobacco' as a keyword and applying Medical Subject Headings (MeSH) terms filter. Data were extracted in XML (Extensible Markup Language) format and parsed into database to extract necessary fields such as PubMed IDs, authors' names, affiliations and MeSH terms. Quantum of research in various aspects of SLT was identified for individual MeSH terms and compared for global and Indian data. Results Data analysis of 2857 records revealed that maximum number of articles was devoted to adverse effects (35.6%) followed by epidemiology (32.4%). In comparison, India contributed only 11.7 per cent of records with maximum number of articles on the topics of epidemiology (26%) and adverse effects (45.8%). Higher proportion of research was published on epidemiology, aetiology and prevention and control at global level, while adverse effects of SLT were researched more in Indian studies as compared to global data. Interpretation & conclusions The present analysis highlighted the paucity of research studies on important topics such as economics and alternative strategies of SLT control, both on the global and regional levels.
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Affiliation(s)
- Harleen Kaur Gulati
- WHO FCTC Global Knowledge Hub for Smokeless Tobacco, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | - Amit Kumar
- Data Management Laboratory, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | - Ajay Singh Dhama
- Division of Informatics, Systems Research and Management, Indian Council of Medical Research, New Delhi, India
| | - Ruchika Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | - Amitesh Kumar Sharma
- Division of Informatics, Systems Research and Management, Indian Council of Medical Research, New Delhi, India
| | - Harpreet Singh
- Division of Informatics, Systems Research and Management, Indian Council of Medical Research, New Delhi, India
| | | | - Ravi Mehrotra
- WHO FCTC Global Knowledge Hub for Smokeless Tobacco, ICMR-National Institute of Cancer Prevention & Research, Noida, India
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29
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Hussain A, Zaheer S, Shafique K. School-based behavioral intervention to reduce the habit of smokeless tobacco and betel quid use in high-risk youth in Karachi: A randomized controlled trial. PLoS One 2018; 13:e0206919. [PMID: 30388182 PMCID: PMC6214566 DOI: 10.1371/journal.pone.0206919] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 10/19/2018] [Indexed: 11/18/2022] Open
Abstract
There have been recent surges in the use of smokeless tobacco (SLT) and betel quid (BQ) chew among adolescents in South East Asian countries, with an increase, on average, of 7% to 15% between 2004 and 2013, necessitating interventional investigations to modify this behavior. The current intervention was aimed towards changing adolescents' perceptions regarding the harmful effects of SLT and BQ use and encouraging them to quit. This randomized control trial involved 2140 adolescents from 26 private and public-sector schools in Karachi, Pakistan. After randomization, 1185 individuals were placed in the intervention group and administered a behavior changing intervention (BCI), while 955 individuals constituted the control group. A generalized estimating equation was employed to measure differences in repeated measures for both groups. The beta coefficients were reported after adjusting the covariates with the 95% confidence interval, and the p-value was considered significant at <0.050. Cohen's d was employed to report the effect size of the intervention. The BCI resulted in a 0.176-unit (95% CI 0.078-0.274, p-value <0.001) increase in knowledge scores regarding the health hazards of SLT and BQ, a 0.141-unit (95% CI 0.090-0.192, p-value <0.001) increase in use perception scores, and a 0.067-unit (95% CI 0.006-0.129, p-value 0.031) increase in quit perception scores in the intervention group compared with those in the control group. A knowledge related module (p-value 0.024) and quit preparation module (p-value 0.005) were found to be helpful by adolescents in either changing their perceptions regarding SLT and/or BQ chew use or in quitting. The role of BCI is promising in improving adolescents' knowledge and changing their perceptions in a positive manner regarding their harmful SLT and BQ use. Convincing results may be achieved if interventions are tailored, with an emphasis on the identification of the products that are used by adolescents in addition to highlighting their ill effects and how students may manage to quit them. If included in the schools' curricula, this BCI method may help in developing schools that are free of SLT and BQ use. Trial registration: ClinicalTrials.gov NCT03488095.
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Affiliation(s)
- Azmina Hussain
- Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Gulzar e Hijri, Karachi, Pakistan
| | - Sidra Zaheer
- School of Public Health, Dow University of Health Sciences, Gulzar e Hijri, Karachi, Pakistan
| | - Kashif Shafique
- School of Public Health, Dow University of Health Sciences, Gulzar e Hijri, Karachi, Pakistan
- Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, United Kingdom
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30
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Rostron BL, Chang JT, Anic GM, Tanwar M, Chang CM, Corey CG. Smokeless tobacco use and circulatory disease risk: a systematic review and meta-analysis. Open Heart 2018; 5:e000846. [PMID: 30364426 PMCID: PMC6196954 DOI: 10.1136/openhrt-2018-000846] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/24/2018] [Accepted: 08/22/2018] [Indexed: 02/07/2023] Open
Abstract
Objective Smokeless tobacco use is a public health issue throughout the world, but reviews and analyses of circulatory disease risks associated with smokeless tobacco use may be outdated or incomplete. This study provides a thorough and comprehensive review and meta-analysis of circulatory disease risks in high-income countries, including recently published study estimates. Methods We conducted a systematic review of studies of circulatory disease risks associated with smokeless tobacco use in Europe and North America that were identified from electronic databases and reference lists. Study estimates were extracted by region, smokeless tobacco use status, cigarette smoking status, and circulatory condition and combined in meta-analysis using a random-effects model. We used the Newcastle-Ottawa scale to assess study quality and risk of bias. Results We identified 17 relevant cohort studies, two pooled analyses, five case-control studies and one cross-sectional analysis. We found increased risk of heart disease (relative risk (RR) 1.17, 95% CI 1.09 to 1.27) and stroke (RR 1.28, 95% CI 1.01 to 1.62) among US smokeless tobacco users compared with non-users. Increased circulatory disease risk was not observed among Swedish smokeless tobacco users. Conclusion US smokeless tobacco users were found to have increased risk of heart disease and stroke.
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Affiliation(s)
- Brian L Rostron
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Joanne T Chang
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Gabriella M Anic
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Manju Tanwar
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Cindy M Chang
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Catherine G Corey
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
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31
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Gupta R, Gupta S, Sharma S, Sinha DN, Mehrotra R. A systematic review on association between smokeless tobacco & cardiovascular diseases. Indian J Med Res 2018; 148:77-89. [PMID: 30264756 PMCID: PMC6172910 DOI: 10.4103/ijmr.ijmr_2020_17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND & OBJECTIVES The association of smokeless tobacco (SLT) with cardiovascular diseases has remained controversial due to conflicting reports from various countries. Earlier meta-analyses have shown significantly higher risk of fatal myocardial infarction and stroke in SLT users. However, the risk of hypertension (HTN) with SLT products has not been reviewed earlier. This systematic review was undertaken to summarize the evidence available from global literature on the association of SLT with cardiovascular outcomes - heart disease, stroke and HTN. METHODS A systematic literature search was performed in PubMed and Google Scholar since their inception till October 2017 using pre-decided search terms and inclusion/exclusion criteria. Data were extracted from studies included independently by two authors and reviewed. RESULTS The review included 50 studies - 23 on heart disease, 14 on stroke and 14 on HTN. Majority of the studies evaluating heart disease or stroke were conducted in the European Region and most of these did not find a significant association between SLT use and either of these outcomes. On the other hand, 70 per cent of the studies on HTN were reported from South-East Asian Region and about half of the studies found a higher risk of HTN in SLT users. INTERPRETATION & CONCLUSIONS Current available evidence is insufficient to conclusively support the association of cardiovascular diseases with SLT use due to variability in results and methodological constraints in most of the studies. Region and product-specific well-designed studies are required to provide this evidence to the policymakers. However, advice on cessation of SLT products should be offered to patients presenting with cardiovascular diseases.
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Affiliation(s)
- Ruchika Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | - Sanjay Gupta
- Division of Cytopathology, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | - Shashi Sharma
- Division of Epidemiology & Biostatistics, ICMR-National Institute of Cancer Prevention & Research, Noida, India
| | | | - Ravi Mehrotra
- WHO FCTC Global Knowledge Hub for Smokeless Tobacco, ICMR-National Institute of Cancer Prevention & Research, Noida, India
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