Alcohol and smoking

Alcohol and Nicotine Dependence and Time to Death in a General Adult Population: A Mortality Cohort Study

INTRODUCTION

Findings from general population studies are lacking in regard to the co-occurrence of alcohol and nicotine dependence in relation to later mortality. The aim of this study was to analyze potential interactions of risky alcohol drinking, tobacco smoking, alcohol and nicotine dependence, and time until the first cigarette is smoked in the morning after awakening in the prediction of mortality.

METHODS

This study analyzed a random sample of the general population in Northern Germany, which comprised adults aged 18-64 years. Risky alcohol drinking, tobacco smoking, alcohol and nicotine dependence, and the time until the first cigarette in the morning after awakening were assessed for the period of 1996-1997 by applying the Munich-Composite International Diagnostic Interview. Data about all-cause mortality were gathered for the period of 2017-2018 and analyzed using Cox proportional hazards models.

RESULTS

Risky alcohol drinking, tobacco smoking, alcohol and nicotine dependence, and the time until the first cigarette in the morning were associated with each other and predicted the time to death. Among participants with a former alcohol dependence, 29.59% had a current nicotine dependence. Participants who had ever been dependent on alcohol at some point in their life before and currently smoked their first cigarette in the morning within 30 min or less after awakening had a hazard ratio of 5.28 (95% confidence interval: 3.33-8.38) for early death compared to low-risk alcohol consumers who had never smoked.

CONCLUSION

Risky alcohol drinking, tobacco smoking, alcohol and nicotine dependence, and the time until the first cigarette in the morning may have a cumulative impact on time to death. The findings suggest that it could be beneficial to provide support for quitting both risky alcohol drinking and tobacco smoking among nondependent individuals in addition to supporting remission from dependence.

The relationship between unhealthy lifestyle patterns and depressive symptoms among residents in Beijing, China: A community-based cross-sectional study

Introduction

Depression is a prevalent mental disorder that has an irreversible impact on people's health status. Unhealthy lifestyles are modifiable and influence mental health significantly. The purpose of this study was to explore the impact of different unhealthy lifestyles and their patterns on depressive symptoms.

Methods

The data for this study were obtained from the 2017 Community Diagnostic survey in Daxing District, Beijing. It was a cross-sectional study that included 6,252 samples. The Patient Health Questionnaire version 9 was used to measure depressive symptoms, and the self-administered questionaires were used to investigate five unhealthy lifestyles, including sleep deprivation, the inadequate intake of fruits and vegetables, physical inactivity, smoking, and excessive alcohol consumption. Respondents were assigned 1 point for each of their unhealthy lifestyles, and their overall unhealthy lifestyle scores were calculated. The total scores of unhealthy lifestyles ranged from 0 to 5. Descriptive analyses and Firth's logistic regression model were used to analyze the relationship between unhealthy lifestyle and depression symptoms.

Results

It was found that 12.1% of the participants had depressive symptoms. The respondents whose unhealthy lifestyle scores were 2 (OR1.45, 95%CI:1.01 to 2.12), 3 (OR2.29, 95%CI:1.57 to 3.42), 4 (OR 3.04, 95%CI:1.96 to 4.76), or 5 (OR4.08, 95%CI:2.09 to 7.78) were more likely to experience depressive symptoms in comparison with those whose unhealthy lifestyle scores were 0, and the OR increased with the unhealthy lifestyle scores. When the participants had 3 or more unhealthy lifestyles at the same time, different combination patterns of unhealthy lifestyles showed a different effect on depression. The OR was 3.01 (95%CI:1.45 to 5.95) for the combination of sleep deprivation-insufficient intake of fruit and vegetables-excessive alcohol consumption, and was 2.89 (95%CI:1.52 to 5.25) for the combination of sleep deprivation-insufficient intake of fruit and vegetables-physical inactivity-excessive alcohol consumption.

Discussion

The co-existence of multiple unhealthy behavioral lifestyles are associated with depressive symptoms. Among the five unhealthy lifestyles, sleep deprivation and the inadequate intake of fruits and vegetables may have a greater impact on depression.

Combined and interactive effects of alcohol drinking and cigarette smoking on the risk of severe illness and poor clinical outcomes in patients with COVID-19: A multicentre retrospective cohort study

Objectives

Cigarette smoking is an established risk factor for illness severity and adverse outcomes in patients with COVID-19. Alcohol drinking may also be a potential risk factor for disease severity. However, the combined and interactive effects of drinking and smoking on COVID-19 have not yet been reported. This study aimed to examine the combined and interactive effects of alcohol drinking and cigarette smoking on the risk of severe illness and poor outcomes in patients with COVID-19.

Study design

This was a multicentre retrospective cohort study.

Methods

This study retrospectively reviewed the data of 1399 consecutive hospitalised COVID-19 patients from 43 designated hospitals. Patients were grouped according to different combinations of drinking and smoking status. Multivariate mixed-effects logistic regression models were used to estimate the combined and interactive effects of drinking and smoking on the risk of severe COVID-19 and poor clinical outcomes.

Results

In the study population, 7.3% were drinkers/smokers, 4.3% were drinkers/non-smokers and 4.9% were non-drinkers/smokers. After controlling for potential confounders, smokers or drinkers alone did not show a significant increase in the risk of severe COVID-19 or poor clinical outcomes compared with non-drinkers/non-smokers. Moreover, this study did not observe any interactive effects of drinking and smoking on COVID-19. Drinkers/smokers had a 62% increased risk (odds ratio = 1.62, 95% confidence interval: 1.01-2.60) of severe COVID-19 but did not have a significant increase in the risk for poor clinical outcomes compared with non-drinkers/non-smokers.

Conclusions

Combined exposure to drinking and smoking increases the risk of severe COVID-19, but no direct effects of drinking or smoking, or interaction effects of drinking and smoking, were detected.

Transcranial direct current stimulation of the frontal-parietal-temporal area attenuates smoking behavior

Many brain regions are involved in smoking addiction (e.g. insula, ventral tegmental area, prefrontal cortex and hippocampus), and the manipulation of the activity of these brain regions can show a modification of smoking behavior. Low current transcranial direct current stimulation (tDCS) is a noninvasive way to manipulate cortical excitability, and thus brain function and associated behaviors. In this study, we examined the effects of inhibiting the frontal-parietal-temporal association area (FPT) on attention bias to smoking-related cues and smoking behavior in tobacco users. This inhibition is induced by cathodal tDCS stimulation. We tested three stimulation conditions: 1) bilateral cathodal over both sides of FPT; 2) cathodal over right FPT; and 3) sham-tDCS. Visual attention bias to smoking-related cues was evaluated using an eye tracking system. The measurement for smoking behavior was the number of daily cigarettes consumed before and after tDCS treatment. We found that, after bilateral cathodal stimulation of the FPT area, while the attention to smoking-related cues showed a decreased trend, the effects were not significantly different from sham stimulation. The daily cigarette consumption was reduced to a significant level. These effects were not seen under single cathodal tDCS or sham-tDCS. Our results show that low current tDCS of FPT area attenuates smoking cue-related attention and smoking behavior. This non-invasive brain stimulation technique, targeted at FPT areas, might be a promising method for treating smoking behavior.

Side-stream smoking reduces intestinal inflammation and increases expression of tight junction proteins

AIM: To investigate the effect of side-stream smoking on gut microflora composition, intestinal inflammation and expression of tight junction proteins.

METHODS: C57BL/6 mice were exposed to side-stream cigarette smoking for one hour daily over eight weeks. Cecal contents were collected for microbial composition analysis. Large intestine was collected for immunoblotting and quantitative reverse transcriptase polymerase chain reaction analyses of the inflammatory pathway and tight junction proteins.

RESULTS: Side-stream smoking induced significant changes in the gut microbiota with increased mouse intestinal bacteria, Clostridium but decreased Fermicutes (Lactoccoci and Ruminococcus), Enterobacteriaceae family and Segmented filamentous baceteria compared to the control mice. Meanwhile, side-stream smoking inhibited the nuclear factor-κB pathway with reduced phosphorylation of p65 and IκBα, accompanied with unchanged mRNA expression of tumor necrosis factor-α or interleukin-6. The contents of tight junction proteins, claudin3 and ZO2 were up-regulated in the large intestine of mice exposed side-stream smoking. In addition, side-stream smoking increased c-Jun N-terminal kinase and p38 MAPK kinase signaling, while inhibiting AMP-activated protein kinase in the large intestine.

CONCLUSION: Side-stream smoking altered gut microflora composition and reduced the inflammatory response, which was associated with increased expression of tight junction proteins.