Do the Number of Cigarettes Smokes per Day Contribute to the Incident of Malignant Cancer?

Relieving or aggravating the burden: Non-communicable diseases of dual users of electronic and conventional cigarette in Indonesia

INTRODUCTION

Conventional (tobacco) and e-cigarette smoking prevalence is a growing concern in Indonesia. It has worsened as e-cigarettes complement conventional cigarettes, resulting in dual users, potentially causing an additional burden in terms of health.

METHODS

Our study is a secondary data analysis of the 2018 National Basic Health (Riskesdas) Survey. The sample is limited to respondents aged 15-64 years who either only used e-cigarettes (e-cigarette single users), only used conventional cigarettes (conventional cigarette single users) or used both e-cigarettes and conventional cigarettes (dual users) in the last month. The sample size of the data was 174917 individuals. Our analysis utilized the logit and negative binomial regression to test whether the type of smoking behavior was associated with reporting to have a non-communicable diseases (NCDs) and multimorbidity, respectively.

RESULTS

We found that: 1) dual users are positively associated to report having NCDs, such as liver failure (AOR=2.38; 95% CI: 2.32-2.44), diabetes (AOR=1.53; 95% CI: 1.50-1.57), hypertension (AOR=1.49; 95% CI: 1.48-1.51), and gum diseases (AOR=1.74; 95% CI: 1.73-1.74) compared to single users; and 2) e-cigarette single users are positively associated with reporting to have NCDs such as asthma (AOR=3.11; 95% CI: 3.01-3.22) and diabetes (AOR=16.01; 95% CI: 14.57-17.59), and dental problems such as broken teeth (AOR=1.04; 95% CI: 1.03-1.06), and they have disease multimorbidity compared to conventional cigarette single users.

CONCLUSIONS

Simultaneous control of the consumption of e-cigarettes and conventional cigarettes is essential. In addition, it is important to promote policies to increase the price of e-cigarettes and conventional cigarettes to reduce smoking prevalence and prevent dual users. Moreover, as there are negative health consequences for conventional and e-cigarette single users or dual users, the most effective alternative is to stop smoking, not switching products.

Smoking behavior and hypertension among health workers during the COVID-19 pandemic: a case study in Java and Bali-Indonesia

Background

Health workers who should be role models for the community not to smoke and live a healthy life are still consuming cigarettes. Java and Bali (especially Java) are the biggest contributors to health worker deaths due to COVID-19 in Indonesia. This study aims to determine the association of smoking behavior and hypertension among health workers in Java and Bali. The researchers conducted this study in 2021 and designed it with a cross-sectional design. Data was collected online using the Lime Survey as a data collection tool. The data analysis used was logistic regression to determine the association of smoking and hypertension.

Result

A number of 7.6% of health workers were still smoking and 10.4% were suffering from hypertension during the COVID-19 pandemic. This study shows that the proportion of health workers with hypertension is two times that of smokers (18.0%) compared to non-smokers (9.8%). Logistic regression showed that smoking has a 20% higher risk of developing hypertension (OR = 1.97; 95%CI = 1.01-1.41; p = 0.034).

Conclusion

Among health workers on the islands of Java and Bali, there are still many who smoke, and this puts them at a higher risk of experiencing hypertension.

Cigarette Smoke Exposure and Stunting Among Under-five Children in Rural and Poor Families in Indonesia

Cigarette smoke exposure in mothers and children is highly prevalent in Asia, especially among rural and poor families. Second-hand smoke exposure might affect the nutritional status of children. Despite the emerging double burden of malnutrition and the very high prevalence of smoking in Indonesia, few studies have examined the effects of parental smoking on children's nutritional status. This study aims to measure the relationship between family smoking behavior and the occurrence of stunting in children under 5 years. This cross-sectional study used a purposive sampling technique, with 221 households with children aged 0 to 59 months from poor areas in Indonesia. Exposure to cigarette smoke is assessed using The Secondhand Smoke Exposure Scale questionnaire. The outcome measured is child stunting (height-for-age Z-score). The prevalence of stunting was estimated at 145 (65.6%). Children living with smoking parents were counted for 157 (71%), and most smoking exposure comes from fathers 147 (67.4%). The predictors of stunting in children under 5 years were a smoker father with (AOR 1.8; 95% CI 1.281-4.641), both parents are smokers increasing the risk of stunting with (COR 3.591; 95% CI 1.67-3.77), being exposed of smoke for more than 3 hours a day increase the risk of stunted children (COR 2.05; 95% CI 1.214-3.629), and using traditional cigarette or kretek expand the risk of stunting (AOR 3.19; 95% CI 1.139-67.785). The findings demonstrate the negative impact of parental smoking on children's growth, reinforcing the importance of reducing smoking prevalence by imposing a smoke-free home policy in the stunting prevention strategy.

Is perception reality? Associations among "light" cigarettes and number of cigarettes smoked per day

INTRODUCTION

Cigarette filter ventilation and light descriptors are associated with lowered perceptions of risk and smoking more cigarettes per day (CPD). This study examined the relationship between usual cigarette ventilation, perception, and CPD.

METHODS

A crowdsourced sample (N = 995) of individuals who smoke higher-ventilated (=>20% ventilation) or lower-ventilated (=<10% ventilation) cigarettes identified their usual cigarette as "light" or "full flavor", and reported their average CPD.

RESULTS

We found: 1) no association between ventilation status and perception of light versus full flavor (AUC=0.58), with the inaccurate perception being more prevalent in younger individuals (p = 0.041) and those who smoke L&M (73%, p < 0.001) and Camel (61%, p = 0.006) brands; and 2) perception, but not ventilation of usual cigarette, was significantly associated with CPD (p = 0.006), with individuals who perceived their cigarettes as light reporting an average of 13% more cigarettes per day (2.6 CPD), compared to those who perceived their cigarette as full flavor.

CONCLUSIONS

Perceptions of light versus full-flavor, but not ventilation status, predicted CPD. These findings may inform anti-smoking health communication strategies and smoking cessation interventions.

IMPLICATIONS

Tobacco control policies should eradicate the perception of cigarettes as light or full-flavored. Future research investigating the associations between cigarette filter ventilation and smoking behavior should consider the confounding effects that may lie in an individual's perceptions of their cigarettes.

Effects of chronic electronic cigarettes exposure in inducing respiratory function decline and pulmonary tissue injury - A direct comparison to combustible cigarettes

BACKGROUND

Electronic cigarette (e-cig) use is increasing worldwide, especially among young individuals. Spirometry measures airflow obstruction and is the primary tool for diagnosing/monitoring respiratory diseases in clinical settings. This study aims to assess the effects of chronic e-cig exposure on spirometric traits, and directly compare to conventional combustible-cigarette (c-cig).

METHODS

We employed an e- and c-cig aerosol generation system that resembled human smoking/vaping scenario. Fifty 6-week old C57BL/6 mice were equally divided into five groups and exposed to clean air (control), e-cig aerosol (low- and high-dose), and c-cig aerosol (low- and high-dose), respectively, for 10 weeks. Afterwards, growth trajectory, spirometry and pulmonary pathology were analyzed.

RESULTS

Both e- and c-cig exposure slowed down growth and weight gain. Low dose e-cig exposure (1 h exposure per day) resulted in minimal respiratory function damage. At high dose (2 h exposure per day), e-cig exposure deteriorated 7 spirometry traits but by a smaller magnitude than c-cig exposure. For example, comparing to clean air controls, high dose e- and c-cig exposure increased inspiratory resistance by 24.3% (p = 0.026) and 66.7% (p = 2.6e-5), respectively. Low-dose e-cig exposure increased alveolar macrophage count but did not lead to airway remodeling. In contrast, even low-dose c-cig caused alveoli break down and thickening of the small airway, hallmarks of airway obstructive disease.

CONCLUSIONS

We conducted well-controlled animal exposure experiments assessing chronic e-cig exposure's effects on spirometry traits. Further, mechanistic study characterized airway remodeling, alveolar tissue lesion and inflammation induced by e- and c-cig exposure. Our findings provided scientific and public health insights on e-cig's health consequences, especially in adolescent users.

Development of an infectious disease prevention behavior model for public health center workers in a rural area of Indonesia

The Infection Prevention Behavior (IPB) for health personnel at the Surade Public Health Center has not reached the target. The purpose of this study was to develop the IPB model for health personnel which is suitable to be applied in rural areas in Indonesia. The model was developed through a literature review from online journal database in the last 10 years. The model was tested using a cross-sectional design by the Structural Equation Model Partial Least Square (SEM-PLS). Six selected variables had direct and indirect influences on the IPB of health personnel. They were supervision (27.50%), facilities (9.87%), training (10.44%), compensation (16.97%), work climate (10.78%), and work motivation (8.15%). The model was valid and significant. The Q2 showed 95.7% which mean 95.7% of the components in the model could be applied to other Public Health Centers in the rural area. The development of IPB models for health personnel which wass measured from the direct and indirect effects of six variables proved valid and significant to help achievement Public Health Center reach the target of protecting health workers from infectious diseases.

Optical coherence tomography angiography to evaluate murine fetal brain vasculature changes caused by prenatal exposure to nicotine

Maternal smoking causes several defects ranging from intrauterine growth restriction to sudden infant death syndrome and spontaneous abortion. While several studies have documented the effects of prenatal nicotine exposure in development and behavior, acute vasculature changes in the fetal brain due to prenatal nicotine exposure have not been evaluated yet. This study uses correlation mapping optical coherence angiography to evaluate changes in fetal brain vasculature flow caused by maternal exposure to nicotine during the second trimester-equivalent of gestation in a mouse model. The effects of two different doses of nicotine were evaluated. Results showed a decrease in the vasculature for both doses of nicotine, which was not seen in the case of the sham group.