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Chau SL, Wang MP, Wu Y, Cheung DYT, Kong A, Lai V, Lam TH, Ho SY. Polytobacco product use among current cigarette smokers in Hong Kong, China: results from population surveys (2015-17). BMC Public Health 2021; 21:307. [PMID: 33549071 PMCID: PMC7866759 DOI: 10.1186/s12889-021-10341-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 01/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Polytobacco product use is increasingly popular, but little is known about the prevalence, trend, and factors of such use particularly in non-western countries. METHOD A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015-2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population. RESULTS Eighty-four point one percent (95% CI 81.4-86.6%) were exclusive cigarette smokers. Fifteen point nine percent (13.4-18.6%) were current polytobacco product users, 12.3% (10.2-14.8%) used one tobacco product and 2.52% (1.59-3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75-8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44-2.50%). The changes in overall prevalence of PTU by number of products use varied in 3 years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12-3.61), younger age (AORs range from 1.34-4.65, P for trend < .001) and less ready to quit (2.08, 1.09-3.97). CONCLUSIONS Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU.
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Affiliation(s)
- S L Chau
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - M P Wang
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Y Wu
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - D Y T Cheung
- School of Nursing, University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
| | - A Kong
- Hong Kong Council on Smoking and Health, 183 Queen's Road East, Wanchai, Hong Kong
| | - V Lai
- Hong Kong Council on Smoking and Health, 183 Queen's Road East, Wanchai, Hong Kong
| | - T H Lam
- School of Public Health, University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong
| | - S Y Ho
- School of Public Health, University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong
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Haghighi B, Choi S, Choi J, Hoffman EA, Comellas AP, Newell JD, Graham Barr R, Bleecker E, Cooper CB, Couper D, Han ML, Hansel NN, Kanner RE, Kazerooni EA, Kleerup EAC, Martinez FJ, O'Neal W, Rennard SI, Woodruff PG, Lin CL. Imaging-based clusters in current smokers of the COPD cohort associate with clinical characteristics: the SubPopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). Respir Res 2018; 19:178. [PMID: 30227877 PMCID: PMC6145340 DOI: 10.1186/s12931-018-0888-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/10/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Classification of COPD is usually based on the severity of airflow, which may not sensitively differentiate subpopulations. Using a multiscale imaging-based cluster analysis (MICA), we aim to identify subpopulations for current smokers with COPD. METHODS Among the SPIROMICS subjects, we analyzed computed tomography images at total lung capacity (TLC) and residual volume (RV) of 284 current smokers. Functional variables were derived from registration of TLC and RV images, e.g. functional small airways disease (fSAD%). Structural variables were assessed at TLC images, e.g. emphysema and airway wall thickness and diameter. We employed an unsupervised method for clustering. RESULTS Four clusters were identified. Cluster 1 had relatively normal airway structures; Cluster 2 had an increase of fSAD% and wall thickness; Cluster 3 exhibited a further increase of fSAD% but a decrease of wall thickness and airway diameter; Cluster 4 had a significant increase of fSAD% and emphysema. Clinically, Cluster 1 showed normal FEV1/FVC and low exacerbations. Cluster 4 showed relatively low FEV1/FVC and high exacerbations. While Cluster 2 and Cluster 3 showed similar exacerbations, Cluster 2 had the highest BMI among all clusters. CONCLUSIONS Association of imaging-based clusters with existing clinical metrics suggests the sensitivity of MICA in differentiating subpopulations.
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Affiliation(s)
- Babak Haghighi
- Department of Mechanical and Industrial Engineering, University of Iowa, 2406 Seamans Center for the Engineering Art and Science, Iowa City, Iowa, 52242, USA
- IIHR-Hydroscience & Engineering, University of Iowa, 2406 Seamans Center for the Engineering Art and Science, Iowa City, Iowa, 52242, USA
| | - Sanghun Choi
- Department of Mechanical Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Jiwoong Choi
- Department of Mechanical and Industrial Engineering, University of Iowa, 2406 Seamans Center for the Engineering Art and Science, Iowa City, Iowa, 52242, USA
- IIHR-Hydroscience & Engineering, University of Iowa, 2406 Seamans Center for the Engineering Art and Science, Iowa City, Iowa, 52242, USA
| | - Eric A Hoffman
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA
| | | | - John D Newell
- Department of Radiology, University of Iowa, Iowa City, Iowa, USA
| | - R Graham Barr
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical School, New York, NY, USA
| | - Eugene Bleecker
- Division of Genetics, Genomics and Precision Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | | | - David Couper
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA
| | - Mei Lan Han
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Ella A Kazerooni
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Wanda O'Neal
- School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Stephen I Rennard
- Department of Internal Medicine, University of Nebraska College of Medicine, NE, USA and Clinical Discovery Unit, AstraZeneca, Cambridge, UK
| | - Prescott G Woodruff
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Ching-Long Lin
- Department of Mechanical and Industrial Engineering, University of Iowa, 2406 Seamans Center for the Engineering Art and Science, Iowa City, Iowa, 52242, USA.
- IIHR-Hydroscience & Engineering, University of Iowa, 2406 Seamans Center for the Engineering Art and Science, Iowa City, Iowa, 52242, USA.
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Jain RB. Factors affecting the variability in the observed levels of cadmium in blood and urine among former and current smokers aged 20-64 and ≥ 65years. Environ Sci Pollut Res Int 2017; 24:8837-8851. [PMID: 28214937 DOI: 10.1007/s11356-017-8607-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/07/2017] [Indexed: 06/06/2023]
Abstract
Data from National Health and Nutrition Examination Survey for 1999-2012 were used to evaluate factors that affect observed levels of blood cadmium (BCd) and urine cadmium (UCd) among former and current smokers aged 20-64 and ≥65 years. Adjusted levels (AGM) for BCd and UCd were higher among females as compared to males. The order of AGM for BCd by race/ethnicity for 20-64 years old was non-Hispanic white (NHW) < non-Hispanic black (NHB) and NHW > NHB for ≥65 years old. The order of AGMs for UCd for 20-64-year-old current smokers was NHW > NHB and NHW > NHB for former smokers. For 20-64-year-old current smokers, exposure to environmental tobacco smoke at home was associated with higher levels of BCd. Levels of both UCd and BCd increased with age, but the rate of increase was as much as seven times higher among ≥65 years old than 20-64 years old. For current smokers, the number of cigarettes smoked inside home was positively associated with the levels of BCd. For current smokers aged 20-64 years, the number of cigarettes smoked inside home was positively associated with the levels of UCd (p < 0.01), and the number of cigarettes smoked every day on the days they were smoked was also positively associated with the levels of UCd (p < 0.01). Among former smokers, levels of both UCd and BCd were positively associated (p < 0.1) with the number of cigarettes smoked per day at the time of quitting smoking and negatively associated with the time since smoking was quitted (p < 0.01).
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Affiliation(s)
- Ram B Jain
- , 2959 Estate View Ct, Dacula, GA, 30019, USA.
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Saruya S, Yamashiro T, Matsuoka S, Matsushita S, Yagihashi K, Nakajima Y. Decrease in Small Pulmonary Vessels on Chest Computed Tomography in Light Smokers Without COPD: An Early Change, but Correlated with Smoking Index. Lung 2017; 195:179-184. [PMID: 28224233 DOI: 10.1007/s00408-017-9985-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 02/07/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE The aim of this study was to evaluate the relationship between the amount of smoking and the cross-sectional area (CSA) of small pulmonary vessels in light smokers without a diagnosis of chronic obstructive pulmonary disease (COPD). METHODS This retrospective study was approved by our institutional review board, which waived the need for informed consent from patients. The study included 34 current smokers without COPD, who were defined as light smokers based on their smoking history (≤25 pack years). The CSA of small pulmonary vessels (<5 mm2 [CSA<5]) was measured on computed tomography (CT) scans, and the percentage of total CSA of the lung (%CSA<5) was calculated. The extent of emphysema was also assessed as the percentage of low attenuation area (%LAA, <-950 Hounsfield units). The correlations of %CSA<5 and %LAA with pack years were determined using the Spearman rank correlation. RESULTS There was a significant negative correlation between %CSA<5 and pack years, whereas no significant correlation was found between %LAA and pack years. The correlations between pack years and percent predicted forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity were not significant. CONCLUSIONS The percentage of total CSA of the lung made up of small pulmonary vessels in light smokers without COPD significantly decreases with increasing amount of smoking, in contrast to emphysema measurements. This suggests that small pulmonary vessels might have been injured or might have degenerated because of smoking, and might represent an initial stage in the development of COPD.
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Affiliation(s)
- Shinji Saruya
- Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
| | - Tsuneo Yamashiro
- Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.,Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Shin Matsuoka
- Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Shoichiro Matsushita
- Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Kunihiro Yagihashi
- Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Yasuo Nakajima
- Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
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Higgins ST, Kurti AN, Redner R, White TJ, Keith DR, Gaalema DE, Sprague BL, Stanton CA, Roberts ME, Doogan NJ, Priest JS. Co-occurring risk factors for current cigarette smoking in a U.S. nationally representative sample. Prev Med 2016; 92:110-117. [PMID: 26902875 PMCID: PMC4992654 DOI: 10.1016/j.ypmed.2016.02.025] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 02/16/2016] [Accepted: 02/18/2016] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Relatively little has been reported characterizing cumulative risk associated with co-occurring risk factors for cigarette smoking. The purpose of the present study was to address that knowledge gap in a U.S. nationally representative sample. METHODS Data were obtained from 114,426 adults (≥18years) in the U.S. National Survey on Drug Use and Health (years 2011-13). Multiple logistic regression and classification and regression tree (CART) modeling were used to examine risk of current smoking associated with eight co-occurring risk factors (age, gender, race/ethnicity, educational attainment, poverty, drug abuse/dependence, alcohol abuse/dependence, mental illness). RESULTS Each of these eight risk factors was independently associated with significant increases in the odds of smoking when concurrently present in a multiple logistic regression model. Effects of risk-factor combinations were typically summative. Exceptions to that pattern were in the direction of less-than-summative effects when one of the combined risk factors was associated with generally high or low rates of smoking (e.g., drug abuse/dependence, age ≥65). CART modeling identified subpopulation risk profiles wherein smoking prevalence varied from a low of 11% to a high of 74% depending on particular risk factor combinations. Being a college graduate was the strongest independent predictor of smoking status, classifying 30% of the adult population. CONCLUSIONS These results offer strong evidence that the effects associated with common risk factors for cigarette smoking are independent, cumulative, and generally summative. The results also offer potentially useful insights into national population risk profiles around which U.S. tobacco policies can be developed or refined.
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Affiliation(s)
- Stephen T Higgins
- Vermont Center on Tobacco Regulatory Science, University of Vermont, United States.
| | - Allison N Kurti
- Vermont Center on Tobacco Regulatory Science, University of Vermont, United States
| | - Ryan Redner
- Vermont Center on Tobacco Regulatory Science, University of Vermont, United States
| | - Thomas J White
- Vermont Center on Tobacco Regulatory Science, University of Vermont, United States
| | - Diana R Keith
- Vermont Center on Tobacco Regulatory Science, University of Vermont, United States
| | - Diann E Gaalema
- Vermont Center on Tobacco Regulatory Science, University of Vermont, United States
| | - Brian L Sprague
- Vermont Center on Tobacco Regulatory Science, University of Vermont, United States
| | | | - Megan E Roberts
- Center of Excellence in Regulatory Tobacco Science, The Ohio State University, United States
| | - Nathan J Doogan
- Center of Excellence in Regulatory Tobacco Science, The Ohio State University, United States
| | - Jeff S Priest
- Vermont Center on Tobacco Regulatory Science, University of Vermont, United States
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Hu M, Yip R, Yankelevitz DY, Henschke CI. CT screening for lung cancer: Frequency of enlarged adrenal glands identified in baseline and annual repeat rounds. Eur Radiol 2016; 26:4475-4481. [PMID: 27108301 DOI: 10.1007/s00330-016-4331-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/17/2016] [Accepted: 03/11/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To determine the frequency of adrenal enlargement of participants in a CT-screening program for lung cancer and demonstrate the progression during follow-up, separately for baseline and annual repeat rounds. MATERIALS AND METHODS HIPAA-compliant informed consent was obtained in 4,776 participants. The adrenal gland was defined as enlarged if it measured ≥6 mm at its largest diameter. Logistic regression analyses were performed. RESULTS At baseline, 202 (4 %) of 4,776 participants had adrenal enlargement. Significant factors were age (OR = 1.4, 95 % CI: 1.2-1.7) and current smoker (OR = 1.8, 95 % CI: 1.3-2.4). Follow-up 7-18 months after baseline for 133 cases with adrenal enlargement <40 mm showed it decreased or was stable in 85 (64 %), and increased by <10 mm in 48 (36 %). Five (0.04 %) cases of adrenal enlargement were newly identified, none increased beyond 40 mm on follow-up. Adrenal enlargement was a significant predictor of a subsequent diagnosis of lung cancer (OR = 2.0, 95 % CI: 1.2-3.4). CONCLUSION Participants with adrenal enlargement <40 mm identified at baseline and on repeat screening could be reasonably assessed on subsequent annual screening. Adrenal enlargement increased with increasing pack-years of smoking. Adrenal enlargement was an independent predictor of a subsequent diagnosis of lung cancer. KEY POINTS • Adrenal enlargement was seen in 4 % of participants at baseline screening. • Age and currently smoking were significantly associated with adrenal enlargement. • 0.04 % of participants were newly identified with adrenal enlargement. • Annual follow-up for adrenal enlargement <40 mm was appropriate. • Adrenal enlargement was an independent predictor of a diagnosis of lung cancer.
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Affiliation(s)
- Minxia Hu
- Department of Radiology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA.,Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Rowena Yip
- Department of Radiology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - David Y Yankelevitz
- Department of Radiology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Claudia I Henschke
- Department of Radiology, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA.
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Kamal R, Srivastava AK, Kesavachandran CN. Meta-analysis approach to study the prevalence of chronic obstructive pulmonary disease among current, former and non-smokers. Toxicol Rep 2015; 2:1064-74. [PMID: 28962448 DOI: 10.1016/j.toxrep.2015.07.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 07/15/2015] [Accepted: 07/15/2015] [Indexed: 11/21/2022] Open
Abstract
Comparative risk assessment for Chronic Obstructive Pulmonary Disease (COPD) among current, former and non-smokers categories remains controversial and not studied in detail. We conducted a meta-analysis to summarize all the relevant published studies on this topic and to update the association between smoking and prevalence of COPD in current, former and non-smokers. Identification, screening, eligibility and inclusion of articles for the study were conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Quality assessment of included studies was undertaken using a scoring sheet. Meta-analysis after the final synthesis of the selected studies was performed using the STATA and Comprehensive Meta-Analysis (CMA) software. Estimates from forty two independent studies reporting 547,391 individuals were identified. Twenty two studies were conducted in Europe, nine in America and ten in Asia and one from New Zealand. The meta-analysis showed that the prevalence of COPD was significantly higher in current smokers compared with former and non-smokers. However, owing to large heterogeneity among the estimates obtained from the studies, stratification was done with respect to continent, diagnostic criteria of COPD and study design which also showed similar results. The stratified analysis also revealed similar trend of results with prevalence of COPD being higher in current smokers as compared to former and non-smokers. The present meta-analysis highlights the positive association between smoking and COPD prevalence. There is an urgent need to implement more effective policies towards the restriction of tobacco use, to reduce the burden of COPD.
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