Sociodemographic and Psychological Characteristics of Very Light Smoking Among Women in Emerging Adulthood, National Survey of Drug Use and Health, 2011

The Combined Roles of Race/Ethnicity and Substance Use in Predicting Likelihood of Kidney Transplantation

BACKGROUND

Racial/ethnic minorities face known disparities in likelihood of kidney transplantation. These disparities may be exacerbated when coupled with ongoing substance use, a factor also reducing likelihood of transplantation. We examined whether race/ethnicity in combination with ongoing substance use predicted incidence of transplantation.

METHODS

Patients were enrolled between March 2010 and October 2012 at the time of transplant evaluation. Substance use data were retrieved from transplant evaluations. Following descriptive analyses, the primary multivariable analyses evaluated whether, relative to the referent group (White patients with no substance use), racial/ethnic minority patients using any substances at the time of evaluation were less likely to receive transplants by the end of study follow-up (August 2020).

RESULTS

Among 1152 patients, 69% were non-Hispanic White, 23% non-Hispanic Black, and 8% Other racial/ethnic minorities. White, Black, and Other patients differed in percentages of current tobacco smoking (15%, 26%, and 18%, respectively; P = 0.002) and illicit substance use (3%, 8%, and 9%; P < 0.001) but not heavy alcohol consumption (2%, 4%, and 1%; P = 0.346). Black and Other minority patients using substances were each less likely to receive transplants than the referent group (hazard ratios ≤0.45, P ≤ 0.021). Neither White patients using substances nor racial/ethnic minority nonusers differed from the referent group in transplant rates. Additional analyses indicated that these effects reflected differences in waitlisting rates; once waitlisted, study groups did not differ in transplant rates.

CONCLUSIONS

The combination of minority race/ethnicity and substance use may lead to unique disparities in likelihood of transplantation. To facilitate equity, strategies should be considered to remove any barriers to referral for and receipt of substance use care in racial/ethnic minorities.

Estimating causal and time-varying effects of maternal smoking on youth smoking

INTRODUCTION

Maternal smoking is a well-known risk factor for youth smoking, yet whether this relationship is causal remains unresolved. This study utilizes propensity score methods for causal inference to robustly account for shared risk factors between maternal and offspring smoking.

METHODS

An 8-year longitudinal cohort of 900 adolescents in the Chicago area were followed starting from approximately age 15.6. The effects of maternal lifetime smoking (MLS) and prenatal tobacco exposure (PTE) (among participants reporting MLS) on offspring's past 30-day smoking, daily smoking status and smoking frequency were examined using logistic regression and Poisson regression after nearest-neighbor propensity matching. Age dependency of this relationship was then examined across the age range of 15-25 using time-varying effect modeling.

RESULTS

Propensity matching yielded 438 and 132 pairs for MLS and PTE study samples, respectively. MLS demonstrated significant associations with past 30-day smoking (RR 1.09; 95% CI 1.04-1.14), daily smoking (RR 1.08; 95% CI 1.05-1.12), and smoking frequency of offspring (RR 1.32; 95% CI 1.15-1.52), with stable effects across age. Among participants reporting MLS, having PTE showed significant additional effects on daily smoking (RR 1.09; 95% CI 1.02-1.17) and age-dependency that showed significance during young adulthood but not adolescence.

CONCLUSION

The relationship between maternal and offspring smoking was not fully accounted for by shared risk factors, suggesting possible causation with PTE having a delayed effect across age. Targeted prevention efforts should be made on maternal smoking-exposed adolescents to mitigate their risks of developing heavy smoking habits in adulthood.

National, regional, and global prevalence of cigarette smoking among women/females in the general population: a systematic review and meta-analysis

Background

This systematic and meta-analysis review aimed to provide an updated estimate of the prevalence of ever and current cigarette smoking in women, in geographic areas worldwide, and demonstrate a trend of the prevalence of smoking over time by using a cumulative meta-analysis.

Methods

Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of ever and current cigarette smoking in women. We searched PubMed, Web of Science (ISI), Scopus, and Ovid from January 2010 to April 2020. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence of ever and current cigarette smoking in women. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression.

Results

The pooled prevalence of ever and current cigarette smoking in women was 28% and 17%, respectively. The pooled prevalence of ever cigarette smoking in adolescent girls/students of the school, adult women, pregnant women, and women with the disease was 23%, 27%, 32%, and 38%, respectively. The pooled prevalence of ever cigarette smoking in the continents of Oceania, Asia, Europe, America, and Africa was 36%, 14%, 38%, 31%, and 32%, respectively.

Conclusions

The prevalence of cigarette smoking among women is very high, which is significant in all subgroups of adolescents, adults, and pregnant women. Therefore, it is necessary to design and implement appropriate educational programs for them, especially in schools, to reduce the side effects and prevalence of smoking among women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12199-020-00924-y.

Smoking Cessation Treatment for Parents Who Are Light or Very Light Smokers in the Pediatric Setting

BACKGROUND

The percentage of US smokers who smoke <10 cigarettes per day has increased, yet it is not known how often light parental smokers are offered and accept cessation assistance in pediatric offices.

METHODS

A secondary analysis of parent interview data collected April to October 2017 at 10 pediatric practices participating in a cluster-randomized controlled trial of the Clinical Effort Against Secondhand Smoke Exposure (CEASE) intervention.

RESULTS

Forty percent of 725 usual care control (UCC) group smokers smoked lightly (<10 cigarettes per day); of these 58% smoked very lightly (<5 per day). Compared to heavier smokers in UCC practices, light and very light smokers in UCC practices were more likely to have made a recent quit attempt (P < .001), yet less likely to have used cessation medication (P = .001). In intervention practices, compared to heavier smokers, light (P = .04) and very light (P < .01) smokers were less likely to be asked if they smoke and very light smokers were less likely to be advised to quit (P = .02) and to receive a nicotine replacement therapy (NRT) prescription (P < .01). However, light smokers (P < .001), very light smokers (P < .001), and light smokers who use e-cigarettes (P = .01) were more likely to receive assistance (NRT or quitline enrollment) in intervention versus UCC practices.

CONCLUSIONS

The CEASE intervention increased assistance to light and very light smokers, yet heavier smokers received more assistance than light smokers. Improving cessation interventions for light and very light smokers is warranted.

Impact and Effectiveness of Legislative Smoking Bans and Anti-Tobacco Media Campaigns in Reducing Smoking among Women in the US: A Systematic Review and Meta-Analysis

Background: The purpose of this study is to systematically review the literature addressing the effectiveness of legislative smoking bans and anti-tobacco media campaigns in reducing smoking among women. Methods: MEDLINE, PubMed, CINAHL, and ABI/INFORM were searched for studies published from 2005 onwards. Meta-analysis was conducted using a random effects model and subgroup analysis on pre-selected characteristics. Results: In total, 652 articles were identified, and five studies satisfied the inclusion criteria. The studies varied from school-based to workplace settings and had a total of 800,573 women participants, aged 12 to 64 years old. Three studies used legislative bans, one study used anti-tobacco campaigns and another one used both as their intervention. The overall pooled effect of the five studies yielded an odds ratio (OR) = 1.137 (C.I. = 0.976–1.298 and I² = 85.6%). Subgroup analysis by intervention revealed a significant pooled estimate for studies using legislative smoking bans OR = 1.280 (C.I. = 1.172–1.389 and I² = 0%). Conclusion: Legislative smoking bans were found to be associated with a reduction in the smoking rates among women compared to anti-tobacco media campaigns. Further research in this area is needed.

Black Light Smokers: How Nicotine Intake and Carcinogen Exposure Differ Across Various Biobehavioral Factors

OBJECTIVE

The study objective was to identify biobehavioral variables associated with greater intake of nicotine and a tobacco carcinogen among Black light smokers who smoke 1 to 10 cigarettes per day (CPD).

METHODS

We analyzed baseline data collected from 426 Black light smokers enrolled in Kick It at Swope III (KIS III), a smoking cessation trial for Black smokers. We examined differences in concentrations of tobacco biomarkers, including urinary total nicotine equivalents (TNE) and total 4-(methylnitrosamino)-1-(3)pyridyl-1-butanonol (NNAL; a human carcinogen), across gender, age, plasma nicotine metabolite ratio (NMR), CPD, and measures of tobacco dependence, including time to first cigarette (TFC), using ANOVA.

RESULTS

Tobacco biomarker levels were significantly higher among those who smoked more CPD (6-10 vs 1-5 CPD) and those with greater reported physical dependence on tobacco. Concurrently, those who smoked 1-5 CPD smoked each cigarette more intensely than those who smoked 6-10 CPD. While we found no gender differences overall, among those who smoked 1-5 CPD, women had higher NNAL levels compared to men. The rate of nicotine metabolism, measured by the nicotine metabolite ratio, was not significantly related to TNE or NNAL levels.

CONCLUSION

Among Black Light smokers, higher cigarette consumption and greater physical dependence-but not rate of nicotine metabolism, menthol use, or socioeconomic status-were associated with greater toxicant exposure and thus a likely increased risk of tobacco-related diseases. The lack of data on light smokers, and specifically on Blacks, make this observation important given the disproportionate burden of lung cancer in this population.

Tobacco product use and smoking frequency among US adults with intellectual and developmental disabilities

BACKGROUND

People with intellectual and developmental disabilities (IDD) have been overlooked in tobacco use research although they are likely to experience tobacco-related health disparities. This study examined tobacco product use and smoking frequency and amount among a sample of US Special Olympics athletes with IDD.

METHODS

Multiple regression analysis was used to test whether age, gender, body mass index, blood pressure, bone density, eating fruits and vegetables and family member tobacco use were correlated with the number of cigarettes smoked per day.

RESULTS

The sample of people with IDD who used tobacco (n = 501) were aged 18-75 (M = 33.37) and 76.4% were male. About 73.6% reported cigarette use only, 10.6% reported dual or poly use of cigarettes and other tobacco products (cigars, pipe, and chewing tobacco) and 15.8% reported using only tobacco products other than cigarettes. Men were more likely than women to use tobacco products other than cigarettes. Of the cigarette smokers, 79.6% were daily smokers, and their mean cigarettes per day was 10.08 (SD = 9.50). Special Olympics athletes who did not have low bone density and those who consumed fruits and vegetables less than daily reported higher numbers of cigarettes per day.

CONCLUSIONS

Although people with IDD are less likely to use tobacco than the general population, study results suggest that people with IDD who smoke cigarettes are just as likely as smokers in the general US population to smoke daily. Improving overall health behaviours may be important in helping smokers with IDD to reduce their tobacco use. Research is needed to understand longitudinal patterns of tobacco use and how to prevent tobacco use among people with IDD.

Very light smoking and alternative tobacco use among college students

INTRODUCTION

Concurrent use of cigarettes with alternative tobacco products (ATPs), even among very light smokers, may be harmful. This study examined current use of e-cigarettes, cigars, and hookah, and susceptibility to future use of these products in a sample of college student cigarette smokers.

METHODS

Participants were 1161 18-29 year old (M age = 21.15; SD = 2.72; 52.7% female; 41.2% non-Hispanic white) current, or past 30-day cigarette smokers, drawn from a larger study. Current smokers were categorized as very light smokers [≤5 cigarettes per day (cpd)] and heavier smokers (>5 cpd).

RESULTS

88.6% of all participating college student smokers were very light smokers and 67.7% used at least one ATP concurrently. The prevalence of current use in this sample was 42.9% for e-cigarettes, 36.4% for hookah, and 25.9% for cigars. Compared to heavier smokers, very light smokers were more likely to be younger, racial/ethnic minorities, and four-year versus two-year college students. Multilevel logistic regression models showed that after controlling for socio-demographic characteristics and substance use, being a very light smoker, compared with a heavier smoker, was negatively associated with concurrent e-cigarette use, but positively associated with concurrent cigar use, and not associated with concurrent hookah use. Moreover, compared to heavier smokers, very light smokers reported being more susceptible to future cigar and hookah use, but not e-cigarette use.

CONCLUSIONS

Concurrent use of cigarettes with ATPs is popular among all college student smokers, but very light smokers are more likely than heavier smokers to use combustible ATPs. Smoking intervention programs and campus policies should caution smokers, especially very light smokers, against ATP use.

Genomic and Bioinformatics Approaches for Analysis of Genes Associated With Cancer Risks Following Exposure to Tobacco Smoking

Cancer is a significant health problem in the Middle East and global population. It is well established that there is a direct link between tobacco smoking and cancer, which will continue to pose a significant threat to human health. The impact of long-term exposure to tobacco smoke on the risk of cancer encouraged the study of biomarkers for vulnerable individuals to tobacco smoking, especially children, who are more susceptible than adults to the action of environmental carcinogens. The carcinogens in tobacco smoke condensate induce DNA damage and play a significant role in determining the health and well-being of smokers, non-smoker, and primarily children. Cancer is a result of genomic and epigenomic malfunctions that lead to an initial premalignant condition. Although premalignancy genetic cascade is a much-delayed process, it will end with adverse health consequences. In addition to the DNA damage and mutations, tobacco smoke can cause changes in the DNA methylation and gene expression associated with cancer. The genetic events hint on the possible use of genomic–epigenomic changes in genes related to cancer, in predicting cancer risks associated with exposure to tobacco smoking. Bioinformatics provides indispensable tools to identify the cascade of expressed genes in active smokers and non-smokers and could assist the development of a framework to manage this cascade of events linked with the evolvement of disease including cancer. The aim of this mini review is to cognize the essential genomic processes and health risks associated with tobacco smoking and the implications of bioinformatics in cancer prediction, prevention, and intervention.

Adolescent Light Cigarette Smoking Patterns and Adult Cigarette Smoking

PURPOSE

Light cigarette smoking has had limited research. The purpose of this study was to examine the relationship between light smoking in adolescence with smoking in adulthood.

METHODS

National Longitudinal Study of Adolescent Health data, Waves I and IV, were analyzed. Previous month adolescent smoking of 1-5 cigarettes/day (cpd) (light smoking); 6-16 cpd (average smoking); 17 or more cpd (heavy smoking); and nonsmoking were compared with the outcome of adult smoking.

RESULTS

At baseline, 15.9% of adolescents were light smokers, 6.8% were average smokers, and 3.6% were heavy smokers. The smoking patterns were significantly related to adult smoking. In logistic regression analyses, adolescent light smokers had an adjusted odds ratio (AOR) of 2.45 (95% CI: 2.00, 3.00) of adult smoking; adolescent average or heavy smokers had AOR of 5.57 (95% CI: 4.17, 7.43) and 5.23 (95% CI: 3.29, 8.31), respectively.

CONCLUSION

Individuals who initiate light cigarette smoking during adolescence are more likely to smoke as young adults.

PRACTICAL IMPLICATIONS

When screening for tobacco use by adolescents, there is a need to verify that the adolescents understand that light smoking constitutes smoking. There is a need for healthcare providers to initiate interventions for adolescent light smoking.