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Psychological Experience of Smoking Addiction in Family and Friends of Schizophrenic Adults Who Smoke Daily: A Qualitative Study. Healthcare (Basel) 2023; 11:healthcare11050644. [PMID: 36900649 PMCID: PMC10000785 DOI: 10.3390/healthcare11050644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
The smoking addiction of patients with severe mental disorders has consequences not only for the patients but also for the people around them. This is qualitative research on family and friends of patients with Schizophrenia spectrum disorders to investigate their perception and vision of smoking, its impact on the patients' physical and mental health, and the possible attempts to combat addiction. The research also investigates the participants' views on electronic cigarettes as a means of replacing traditional cigarettes and helping the patient to quit smoking. The survey method used was a semi-structured interview. The answers were recorded, transcribed and analyzed with the technique of thematic analysis. The results of this study show that the view of most participants on smoking is negative (83.3%), although not all of them consider smoking cessation treatments for these patients of primary importance (33.3%). Nevertheless, a good number of them have tried to intervene spontaneously with their own resources and strategies (66.6%). Finally, low-risk products, and in particular electronic cigarettes, are considered by many participants as a useful alternative to traditional cigarettes in patients with schizophrenia spectrum disorders. About the meaning that cigarettes can assume for the patient, recurring themes emerge: they are considered as a way to manage nervousness and tension or as a means to contrast daily monotony and boredom or repeat usual gestures and habits.
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Xie Z, Ossip DJ, Rahman I, Li D. Use of Electronic Cigarettes and Self-Reported Chronic Obstructive Pulmonary Disease Diagnosis in Adults. Nicotine Tob Res 2020; 22:1155-1161. [PMID: 31830263 DOI: 10.1093/ntr/ntz234] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 12/10/2019] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Electronic cigarette (e-cigarette) use (vaping) has increased in recent years. Chronic obstructive pulmonary disease (COPD) is the third leading cause of death associated with smoking. AIMS AND METHODS Based on 2016 and 2017 Behavioral Risk Factor Surveillance System national survey data on 891 242 adult participants who indicated their smoking and vaping status, the cross-sectional association of vaping with self-reported COPD diagnosis was investigated, using univariable and multivariable weighted logistic regression models. RESULTS Compared to never users, while dual users showed the highest association with self-reported COPD diagnosis (adjusted odds ratio [aOR] = 4.39; 95% confidence interval [CI] = 3.98 to 4.85), current vapers who were either ex-smokers or never smoked showed significantly higher association with self-reported COPD diagnosis (aOR = 3.24; 95% CI = 2.78 to 3.78 and aOR = 1.47; 95% CI = 1.01 to 2.12, respectively). Current vapers who were ex-smokers showed higher association with self-reported COPD diagnosis than ex-smokers who do not vape (aOR = 1.27; 95% CI = 1.09 to 1.48). Dual users showed higher association with self-reported COPD diagnosis than current smokers who do not vape (aOR = 1.16; 95% CI = 1.05 to 1.27). Ex-smokers showed significantly less association with self-reported COPD diagnosis (aOR = 0.67; 95% CI = 0.64 to 0.71) than current smokers. Current vapers who were either ex-smokers or never smoked had less association with self-reported COPD diagnosis compared to current smokers, with aOR = 0.85 (95% CI = 0.73 to 0.99) and aOR = 0.39 (95% CI = 0.27 to 0.56). CONCLUSIONS Vaping is significantly associated with self-reported COPD diagnosis in adults, even among vapers who never smoked. Whether there is a benefit for COPD of switching from smoking to vaping requires study of the long-term effects of vaping. IMPLICATIONS With the increase of e-cigarette use in recent years, the health effects of e-cigarettes need to be investigated. While several studies have examined the association of vaping with respiratory symptoms among adolescents, little is known about the association of vaping with susceptibility to COPD among US adults. Using cross-sectional national survey data in adults, our study showed that vaping was significantly associated with self-reported COPD diagnosis. Although our data did not establish the causal relationship between vaping and self-reported COPD diagnosis, this study raises concerns about the observed association between vaping and self-reported COPD diagnosis.
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Affiliation(s)
- Zidian Xie
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY
| | - Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY
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3
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Xie Z, Ossip DJ, Rahman I, O’Connor RJ, Li D. Electronic cigarette use and subjective cognitive complaints in adults. PLoS One 2020; 15:e0241599. [PMID: 33137145 PMCID: PMC7605645 DOI: 10.1371/journal.pone.0241599] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 10/17/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Electronic cigarette use (vaping) has become popular in recent years. The number of Americans with a variety of cognitive deficits has been increasing dramatically. This study aimed to examine the potential association of vaping with subjective cognitive complaints in US adults. METHODS A combined 2016 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) national survey dataset yielded 886,603 adults who indicated their smoking and vaping status, as well as whether they had subjective cognitive complaints. With this dataset, the cross-sectional association of electronic cigarette use with subjective cognitive complaints was examined using multivariable weighted logistic regression models. RESULTS Both dual users (adjusted Odds Ratio [aOR] = 2.07; 95% Confidence Interval [CI] = 1.66 to 2.60) and current vapers who were either ex-smokers (aOR = 1.94; 95% CI = 1.40 to 2.71) or never smoked (aOR = 1.96; 95% CI = 1.16 to 3.30) showed a significantly higher association with subjective cognitive complaints than never users. Current smokers (aOR = 1.49; 95% CI = 1.32 to 1.69) and ex-smokers (aOR = 1.25; 95% CI = 1.11 to 1.41) had a significantly higher association with subjective cognitive complaints compared to never users. Compared to current smokers, the ex-smokers showed a lower association with subjective cognitive complaints (aOR = 0.84; 95% CI = 0.73 to 0.96). Finally, the association of vaping with subjective cognitive complaints was not statistically significant in individual age group. CONCLUSION Similar to smoking, vaping is associated with subjective cognitive complaints in US adults. These results provide preliminary evidence for a cross-sectional association of vaping with potential cognitive health effects in adults.
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Affiliation(s)
- Zidian Xie
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Richard J. O’Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States of America
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, New York, United States of America
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4
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Ozga-Hess JE, Felicione NJ, Ferguson SG, Dino G, Elswick D, Whitworth C, Turiano N, Blank MD. Piloting a clinical laboratory method to evaluate the influence of potential modified risk tobacco products on smokers' quit-related motivation, choice, and behavior. Addict Behav 2019; 99:106105. [PMID: 31470240 DOI: 10.1016/j.addbeh.2019.106105] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/15/2019] [Accepted: 08/19/2019] [Indexed: 11/28/2022]
Abstract
Research methods are needed that can predict whether the availability of potential modified risk tobacco products (MRTPs) may influence smokers' quit-related motivation, choice, and behavior. This pilot study assessed the primary outcomes of feasibility and adherence to address this need using an electronic cigarette (ECIG) as a model MRTP. Cigarette smokers were randomly assigned to use only their own brand of cigarettes (OB-only) or a second-generation ECIG (18 ng/ml nicotine) plus their OB cigarettes (ECIG+OB) ad libitum for four weeks. Participants logged products using a mobile device, collected used cigarette filters, and provided saliva samples every day for analysis of cotinine. They returned to the lab once per week to provide a breath sample and accept or decline a choice to quit all tobacco products (i.e., cigarettes and/or ECIGs). They also returned for a one-month follow-up visit. Of those participants randomized (n = 60), 56.7% completed the 4-week intervention and 40.0% completed the follow-up visit. The primary reason for withdrawal was poor adherence with mobile device use. Comparable numbers of participants in each group chose to make a quit attempt, although more OB-only participants chose to quit during the first two weeks and more ECIG+OB participants during the last two weeks. With protocol modifications to reduce participation burden, the current method might ultimately be used by regulators to predict how smokers' quit-related motivation, choice, and behavior are influenced by current and future MRTPs.
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Affiliation(s)
- Jenny E Ozga-Hess
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | | | | | - Geri Dino
- WV Prevention Research Center, West Virginia University, Morgantown, WV, USA; Department of Social and Behavioral Sciences, West Virginia University, Morgantown, WV, USA
| | - Daniel Elswick
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, USA
| | - Catherine Whitworth
- WV Prevention Research Center, West Virginia University, Morgantown, WV, USA
| | - Nicholas Turiano
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, WV, USA.
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5
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Polosa R, O'Leary R, Tashkin D, Emma R, Caruso M. The effect of e-cigarette aerosol emissions on respiratory health: a narrative review. Expert Rev Respir Med 2019; 13:899-915. [PMID: 31375047 DOI: 10.1080/17476348.2019.1649146] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction: Due to the uptake in the use of e-cigarettes (ECs), evidence on their health effects is needed to inform health care and policy. Some regulators and health professionals have raised concerns that the respirable aerosols generated by ECs contain several constituents of potential toxicological and biological relevance to respiratory health. Areas covered: We critically assess published research on the respiratory system investigating the effects of ECs in preclinical models, clinical studies of people who switched to ECs from tobacco cigarettes, and population surveys. We assess the studies for the quality of their methodology and accuracy of their interpretation. To adequately assess the impact of EC use on human health, addressing common mistakes and developing robust and realistic methodological recommendations is an urgent priority. The findings of this review indicate that ECs under normal conditions of use demonstrate far fewer respiratory risks than combustible tobacco cigarettes. EC users and smokers considering ECs have the right to be informed about the relative risks of EC use, and to be made aware that findings of studies published by the media are not always reliable. Expert opinion: Growing evidence supports the relative safety of EC emission aerosols for the respiratory tract compared to tobacco smoke.
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Affiliation(s)
- Riccardo Polosa
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", Università of Catania , Catania , Italy.,Center of Excellence for the acceleration of HArm Reduction (CoEHAR), University of Catania , Catania , Italy
| | - Renée O'Leary
- Canadian Institute for Substance Use Research , Victoria , Canada
| | - Donald Tashkin
- David Geffen School of Medicine at the University of California, Los Angeles (UCLA) , Los Angeles , CA , USA
| | - Rosalia Emma
- Dipartimento di Medicina Clinica e Sperimentale (MEDCLIN), University of Catania , Catania , Italy.,Dipartimento di Scienze biomediche e biotecnologiche (BIOMETEC), University of Catania , Catania , Italy
| | - Massimo Caruso
- Dipartimento di Medicina Clinica e Sperimentale (MEDCLIN), University of Catania , Catania , Italy.,Dipartimento di Scienze biomediche e biotecnologiche (BIOMETEC), University of Catania , Catania , Italy
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6
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Caruso M, Emma R, Fuochi V, Furneri PM, Polosa R. Electronic cigarette vapour enhances pneumococcal adherence to airway epithelial cells under abnormal conditions of exposure. Eur Respir J 2018; 52:52/3/1800915. [PMID: 30190260 DOI: 10.1183/13993003.00915-2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Massimo Caruso
- Dept of Clinical and Experimental Medicine (MEDCLIN), University of Catania, Catania, Italy
| | - Rosalia Emma
- Dept of Clinical and Experimental Medicine (MEDCLIN), University of Catania, Catania, Italy
| | - Virginia Fuochi
- Dept of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Pio M Furneri
- Dept of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.,Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Catania, Italy
| | - Riccardo Polosa
- Dept of Clinical and Experimental Medicine (MEDCLIN), University of Catania, Catania, Italy.,Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Catania, Italy
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7
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Polosa R, Morjaria JB, Prosperini U, Russo C, Pennisi A, Puleo R, Caruso M, Caponnetto P. Health effects in COPD smokers who switch to electronic cigarettes: a retrospective-prospective 3-year follow-up. Int J Chron Obstruct Pulmon Dis 2018; 13:2533-2542. [PMID: 30197510 PMCID: PMC6113943 DOI: 10.2147/copd.s161138] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Health effects of electronic cigarette (EC) use in patients with chronic obstructive pulmonary disease (COPD) are largely unexplored. Aim We present findings from a long-term prospective assessment of respiratory parameters in a cohort of COPD patients who ceased or substantially reduced conventional cigarette use with ECs. Methods We prospectively re-evaluated COPD exacerbations, spirometric indices, subjective assessments (using the COPD Assessment Tool [CAT] scores), physical activity (measured by the 6-minute walk distance [6MWD]), and conventional cigarette use in EC users with COPD who were retrospectively assessed previously. Baseline measurements prior to switching to EC use were compared to follow-up visits at 12, 24, and 36 months. Age- and sex-matched regularly smoking COPD patients who were not using ECs were included as reference (control) group. Results Complete data were available from 44 patients. Compared to baseline in the EC-user group, there was a marked decline in the use of conventional cigarettes. Although there was no change in lung function, significant improvements in COPD exacerbation rates, CAT scores, and 6MWD were observed consistently in the EC user group over the 3-year period (p<0.01). Similar findings were noted in COPD EC users who also smoked conventional cigarettes (“dual users”). Conclusion The present study suggests that EC use may ameliorate objective and subjective COPD outcomes and that the benefits gained may persist long-term. EC use may reverse some of the harm resulting from tobacco smoking in COPD patients.
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Affiliation(s)
- Riccardo Polosa
- Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy.,Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico - V. Emanuele", University of Catania, Catania, Italy.,Institute of Internal and Emergency Medicine, Teaching Hospital "Policlinico - V. emanuele", University of Catania, Catania, Italy
| | - Jaymin Bhagwanji Morjaria
- Department of Respiratory Medicine, Royal Brompton & Harefield Hospital Foundation Trust, Harefield Hospital, Harefield, UK, .,Imperial College, Harefield, UK,
| | | | - Cristina Russo
- Emergency Department, Hospital "Arnas Garibaldi", Catania, Italy
| | - Alfio Pennisi
- Department of Respiratory Medicine, Private clinics "Musumeci-Gecas", Catania, Italy
| | - Rosario Puleo
- Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy.,Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico - V. Emanuele", University of Catania, Catania, Italy.,Institute of Internal and Emergency Medicine, Teaching Hospital "Policlinico - V. emanuele", University of Catania, Catania, Italy
| | - Massimo Caruso
- Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy.,Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico - V. Emanuele", University of Catania, Catania, Italy
| | - Pasquale Caponnetto
- Department of Clinical & Experimental Medicine, University of Catania, Catania, Italy.,Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico - V. Emanuele", University of Catania, Catania, Italy
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8
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Tsai MS, Yang YH, Liu CY, Lin MH, Chang GH, Tsai YT, Li HY, Tsai YH, Hsu CM. Unilateral Vocal Fold Paralysis and Risk of Pneumonia: A Nationwide Population-Based Cohort Study. Otolaryngol Head Neck Surg 2018; 158:896-903. [PMID: 29405850 DOI: 10.1177/0194599818756285] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To investigate pneumonia risk among patients with unilateral vocal fold paralysis (UVFP). Study Design Retrospective population-based cohort study. Setting This study used data from the National Health Insurance Research Database of Taiwan, a nationwide population-based database. Subjects and Methods A total of 419 patients newly diagnosed with UVFP between January 1, 1997, and December 31, 2013, were identified from the Longitudinal Health Insurance Database 2000, a nationally representative database of 1 million randomly selected patients. Moreover, 1676 patients without UVFP were matched to patients with UVFP at a 1:4 ratio based on age, sex, socioeconomic status, urbanization level, and site-specific cancers. Patients were followed up until death or the end of the study period (December 31, 2013). The primary outcome was the occurrence of pneumonia. Results The cumulative incidence of pneumonia was significantly higher for patients with UVFP than those without UFVP ( P < .001). The adjusted Cox proportional hazard model showed that UVFP was significantly associated with a higher incidence of pneumonia (hazard ratio, 1.97; 95% CI, 1.35-2.86; P < .001). Subgroup analyses demonstrated that UVFP was an independent risk factor of pneumonia for 4 subgroups: young (18-50 years), older (≥51 years), male, and cancer. Conclusion This is the first nationwide population-based cohort study to investigate the association between UVFP and pneumonia. The findings indicate that UVFP is an independent risk factor of pneumonia. Given the study results, physicians should be aware of the potential for pneumonia occurrence following UVFP.
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Affiliation(s)
- Ming-Shao Tsai
- 1 Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.,2 Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Hsu Yang
- 2 Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan.,3 Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan.,4 Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.,5 School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yen Liu
- 2 Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Meng-Hung Lin
- 2 Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Geng-He Chang
- 1 Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Te Tsai
- 1 Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Hsueh-Yu Li
- 6 Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,7 Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ying-Huang Tsai
- 8 Division of Pulmonary and Critical Care Medicine, Department of Respiratory Care, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.,9 Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Ming Hsu
- 1 Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.,5 School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,10 Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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9
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Miler JA, Hajek P. Resolution of recurrent tonsillitis in a non-smoker who became a vaper. A case study and new hypothesis. Med Hypotheses 2017; 109:17-18. [DOI: 10.1016/j.mehy.2017.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 07/31/2017] [Accepted: 09/07/2017] [Indexed: 11/29/2022]
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10
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Morjaria JB, Mondati E, Polosa R. E-cigarettes in patients with COPD: current perspectives. Int J Chron Obstruct Pulmon Dis 2017; 12:3203-3210. [PMID: 29138548 PMCID: PMC5677304 DOI: 10.2147/copd.s135323] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Conventional cigarette smoking is known to result in significant COPD morbidity and mortality. Strategies to reduce and/or stop smoking in this highly vulnerable patient group are key public health priorities to reduce COPD morbidity and mortality. Unfortunately, smoking cessation efforts in patients with COPD are poor and there is a compelling need for more efficient approaches to cessation for patients with COPD. Electronic cigarettes (ECs) are devices that use batteries to vaporize nicotine. They may facilitate quit attempts and cessation in many smokers. Although they are not risk free, ECs are much less harmful than tobacco smoking. Hence, the use of ECs in vulnerable groups and in patients with challenges to abstain or multiple relapses to this habit may be promising. To date, little is known about health consequences of EC use among COPD smokers and whether their regular use has any effects on subjective and objective COPD outcomes. In the current review, we discuss the current perspectives and literature on the role of ECs in abstaining from conventional smoking and the effects of ECs on the respiratory tract in patients with COPD.
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Affiliation(s)
- J B Morjaria
- Department of Respiratory Medicine, Royal Brompton and Harefield Hospital Foundation Trust, Harefield Hospital, Harefield.,Department of Respiratory Medicine, Imperial College, London, UK
| | - E Mondati
- Department of Clinical and Experimental Medicine.,Department of Internal and Emergency Medicine
| | - R Polosa
- Department of Clinical and Experimental Medicine.,Department of Internal and Emergency Medicine.,Centro per la Prevenzione e Cura del Tabagismo (CPCT), "Policlinico-V. Emanuele," University of Catania, Catania, Italy
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11
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Bian LQ, Bi Y, Zhou SW, Chen ZD, Wen J, Shi J, Mao L, Wang L. T cell responses in senior patients with community-acquired pneumonia related to disease severity. Exp Cell Res 2017; 361:56-62. [PMID: 28986067 DOI: 10.1016/j.yexcr.2017.09.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/27/2017] [Accepted: 09/30/2017] [Indexed: 12/19/2022]
Abstract
Senior individuals older than 65 years of age are at a disproportionally higher risk of developing pneumonia. Impaired capacity to defend against airway infections may be one of the reasons. It is generally believed that weaker regulatory T cell responses may be beneficial to host defense against pathogens. In senior patients with community-acquired bacterial pneumonia, we investigated the frequencies and functions of regulatory T cells. Interestingly, we found that compared to age- and sex-matched healthy controls, senior pneumonia patients presented lower frequencies of Foxp3-expressing and Helios-expressing CD4+ T cells. The quantity of Foxp3 and Helios being expressed, measured by their mRNA transcription levels, was also lower in CD4+ T cells from pneumonia patients. Furthermore, following TCR and TGF-β stimulation, pneumonia patients presented impaired capacity to upregulate Foxp3 and Helios. Functional analyses revealed that CD4+ T cells from pneumonia patients secreted lower amounts of IL-10 and TGF-β, two cytokines critical to regulatory T cell-mediated suppression. Also, the expression of granzyme B and perforin, which were cytolytic molecules potentially utilized by regulatory T cells to mediate the elimination of antigen-presenting cells and effector T cells, were reduced in CD4+CD25+ T cells from senior pneumonia patients. In addition, the CD4+CD25+ T cells from senior pneumonia patients presented reduced capacity to suppress effector CD4+ and CD8+ T cell proliferation. Moreover, the value of pneumonia severity index was inversely correlated with several parameters of regulatory T cell function. Together, our results demonstrated that senior pneumonia patients presented a counterintuitive impairment in regulatory T cell responses that was associated with worse prognosis.
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Affiliation(s)
- Lu-Qin Bian
- Department of Special Procurement Ward, The First Affiliated Hospital of Soochow University, Suzhou 215006 China; Department of Pneumoconiosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433 China
| | - Ying Bi
- Department of Pneumoconiosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433 China
| | - Shao-Wei Zhou
- Department of Pneumoconiosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433 China
| | - Zi-Dan Chen
- Department of Pneumoconiosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433 China
| | - Jun Wen
- Department of Pneumoconiosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433 China
| | - Jin Shi
- Department of Pneumoconiosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433 China
| | - Ling Mao
- Department of Pneumoconiosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai 200433 China.
| | - Ling Wang
- Department of Special Procurement Ward, The First Affiliated Hospital of Soochow University, Suzhou 215006 China.
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12
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Polosa R, Morjaria JB, Caponnetto P, Prosperini U, Russo C, Pennisi A, Bruno CM. Evidence for harm reduction in COPD smokers who switch to electronic cigarettes. Respir Res 2016; 17:166. [PMID: 27986085 PMCID: PMC5162097 DOI: 10.1186/s12931-016-0481-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 12/01/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Electronic cigarettes (ECs) are battery-operated devices designed to vaporise nicotine, which may help smokers quitting or reducing their tobacco consumption. There is a lack of data on the health effects of EC use among smokers with COPD and whether regular use results in improvement in subjective and objective COPD outcomes. We investigated long-term changes in objective and subjective respiratory outcomes in smokers with a diagnosis of COPD who quit or reduced substantially their tobacco consumption by supplementing with or converting only to ECs use. METHODS We conducted a retrospective chart review of patients with COPD to identify those reporting regular daily use of ECs on at least two follow-up visits at 12- (F/up1) and 24-months (F/up2). Regularly smoking COPD patients were included as a reference group. RESULTS A marked reduction in cigarette consumption was observed in ECs users. A significant reduction in COPD exacerbations was reported in the COPD EC user group, their mean (±SD) decreasing from 2.3 (±1) at baseline to 1.8 (±1; p = 0.002) and 1.4 (±0.9; p < 0.001) at F/up1 and F/up2 respectively. A significant reduction in COPD exacerbations was also observed in ECs users who also smoked conventional cigarettes (i.e. 'dual users'). COPD symptoms and ability to perform physical activities improved statistically in the EC group at both visits, with no change in the control group. CONCLUSIONS These findings suggest that ECs use may aid smokers with COPD reduce their cigarette consumption or remain abstinent, which results in marked improvements in annual exacerbation rate as well as subjective and objective COPD outcomes.
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Affiliation(s)
- Riccardo Polosa
- Dipartimento di Medicina Clinica e Sperimentale, University of Catania, Catania, Italy
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), "Policlinico - V. Emanuele", University of Catania, Catania, Italy
- Internal and Emergency Medicine, "Policlinico - V. Emanuele", University of Catania, Catania, Italy
| | - Jaymin Bhagwanji Morjaria
- Department of Respiratory Medicine, Royal Brompton & Harefield Hospital Foundation Trust, Harefield Hospital, Hill End Road, Harefield, UB9 6JH, UK.
| | - Pasquale Caponnetto
- Dipartimento di Medicina Clinica e Sperimentale, University of Catania, Catania, Italy
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), "Policlinico - V. Emanuele", University of Catania, Catania, Italy
| | | | | | - Alfio Pennisi
- U.F. Malattie Apparato Respiratorio, Casa di Cura Musumeci-Gecas, Gravina di Catania, Italy
| | - Cosimo Marcello Bruno
- Dipartimento di Medicina Clinica e Sperimentale, University of Catania, Catania, Italy
- Internal and Emergency Medicine, "Policlinico - V. Emanuele", University of Catania, Catania, Italy
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