Knowledge, Attitude, and Practice of College Students Toward E-cigarettes: A Study From the Northern Part of Karnataka, India.

INTRODUCTION: E-cigarettes, also known as electronic cigarettes or vape pens, are battery-powered devices that deliver nicotine, flavorings, and other chemicals to users in the form of an aerosol. It revolutionized the landscape of nicotine consumption, marketed as a safer alternative to traditional cigarettes. Since then, e-cigarettes have become popular among young adults and adolescents. There has always been a conflict in the risks versus benefits of e-cigarettes over the decade, which has created a gap in knowledge in the population. This study aimed to attain the knowledge, attitude, and practice of students from a semi-urban background to understand the level of education needed among the young population of our country. METHODS: This online survey was conducted among 411 students of Shri BM Patil Medical College Hospital and Research Centre (BLDE) (DU), College, Vijayapura, Karnataka. The survey consisted of 21 MCQ questionnaires to assess students' knowledge, attitude, and practice toward e-cigarettes. Later, the data was analyzed using SPSS version 28. RESULTS: The study included a diverse group of 411 participants, with a majority being males (63%) and the rest females (37%). The age distribution highlighted a young demographic, with 93% of participants aged between 18 and 34. The study revealed a high level of awareness about e-cigarettes, with 90% of participants being familiar with them. Friends and social media emerged as the primary sources of information, accounting for 52% and 40%, respectively. While 48% of the participants believed e-cigarettes to be non-addictive, only 19% recognized their addictive potential, with the rest being unsure. A majority, 45%, did not see e-cigarette users as superior to traditional smokers, while 15.5% held the opposite view. While 58% of e-cigarette users found them to be stress-relieving, 33% did not, highlighting a subjective aspect of e-cigarette use. CONCLUSION: The study offers critical insights into the knowledge, attitudes, and practices regarding e-cigarettes among medical students in northern Karnataka. While awareness is high, there is a notable gap in accurate understanding of e-cigarettes' safety and addictive nature. The findings emphasize the need for enhanced education and awareness campaigns to correct misconceptions about e-cigarettes.

Current cigarette smoking and decreased serum levels of α-Klotho, an anti-aging hormone, among US adult participants.

BACKGROUND AND AIMS: Cigarette smoking is a well-established risk factor for cardiovascular disease and other aging-related disorders; yet the pathogenesis of these diseases induced by smoking remains relatively underexplored. This study was to assess the association between cigarette smoking and serum α-Klotho levels, an anti-aging protein, in US adults. METHODS AND RESULTS: Data on 4196 participants aged 40-79 years from the 2013-2016 National Health and Nutrition Examination Survey was analyzed for the association using multiple general linear models. Smoking was assessed using both questionnaire data and serum cotinine measurements. Both past and current smokers exhibited significantly lower levels of α-Klotho, with the light smokers exhibiting the lowest levels [geometric mean: 720.85 pg/mL; 95% CI: 662.53, 784.31], compared with non-smokers [806.75 (790.69, 823.13)]. A significantly inverse association between current smoking and α-Klotho levels was revealed. This relationship extended across smoking intensities, with even light smokers displaying the strongest association. After adjusting for potential confounders, light (smoked <5 pack-years), moderate (5-19 pack-years), and heavy smoking (≥20 pack-years) were associated with reductions of 10.81% (-16.91, -4.28), 6.43% (-10.24, -2.47), and 3.38% (-6.83, 0.19) of Klotho levels, respectively, when compared to non-smoking. Active smoking, defined as serum cotinine levels ≥10 ng/mL, was associated with a 4.59% decrease (-6.91, -2.23) in α-Klotho levels. CONCLUSION: The study demonstrates an inverse relationship between current smoking and serum α-Klotho levels among middle-aged and older adults. Our findings suggest that Klotho may play an important role in smoking-induced diseases. Further investigations are warranted to explore these interactions.

Irritable Bowel Syndrome (IBS) and Smoking: An Evaluation of IBS symptom severity and anxiety sensitivity among adults in the United States.

INTRODUCTION: Irritable bowel syndrome (IBS) is a prevalent disorder of gut-brain function associated with psychological distress as well as work and quality of life impairment. Smoking has been linked to gastrointestinal dysfunction, however, research focused on the prevalence of IBS and smoking is limited. Previous research has shown that anxiety sensitivity is linked to increased risk of aversive bodily experiences and subsequent coping-oriented regulation efforts. Higher anxiety sensitivity has also been associated with processes linked to tobacco cigarette smoking lapse and relapse. There is a need to clarify the explanatory roles of anxiety sensitivity in the context of more severe IBS symptoms among persons with IBS who are current smokers. METHOD: The present investigation evaluated the main and interactive effects of IBS symptom severity and anxiety sensitivity in relation to processes related to the maintenance and relapse of tobacco smoking among adults with IBS. The sample consisted of 263 (52.1 % female; Mage = 44.13 years, SD = 12.71) adults who met criteria for IBS and smoke at least 5 cigarettes per day. RESULTS: Hierarchical regression results indicated that both anxiety sensitivity and IBS symptom severity independently predicted greater perceived barriers to smoking cessation, severity of problems experienced during quitting, and negative reinforcement smoking expectancies. A statistically significant interaction further indicated that IBS symptom severity was more strongly associated with negative reinforcement smoking expectancies among participants with higher, relative to lower, anxiety sensitivity. CONCLUSIONS: This study is the first to show that both IBS symptom severity and anxiety sensitivity are related to greater perceived barriers to smoking cessation, previous difficulty quitting, and negative reinforcement expectancies among adults with IBS. There is a continued need to further scientific understanding of interrelations between anxiety sensitivity, IBS symptom severity, and smoking cessation-related beliefs and processes to identify novel approaches that can best support quitting among this understudied population.

Comparative evaluation of cigarette smoke and a heated tobacco product on microglial toxicity, oxidative stress and inflammatory response.

BACKGROUND: Tobacco smoking is the leading cause of preventable death and disease worldwide, with over 8 million annual deaths attributed to cigarette smoking. This study investigates the impact of cigarette smoke and heated tobacco products (HTPs) on microglial function, focusing on toxicological profiles, inflammatory responses, and oxidative stress using ISO standard and clinically relevant conditions of exposure. METHODS: We assessed cell viability, reactive oxygen species (ROS) production, lipid peroxidation, mitochondrial function, unfolded protein response, and inflammation in human microglial cells (HMC3) exposed to cigarette smoke, HTP aerosol or nicotine. RESULTS: Our findings show that cigarette smoke significantly reduces microglial viability, increases ROS formation, induces lipid peroxidation, and reduces intracellular glutathione levels. Cigarette smoke also alters the expression of genes involved in mitochondrial dynamics and biogenesis, leading to mitochondrial dysfunction. Additionally, cigarette smoke impairs the unfolded protein response, activates the NF-κB pathway, and induces a pro-inflammatory state characterized by increased TNF and IL-18 expression. Furthermore, cigarette smoke causes DNA damage and decreases the expression of the aging marker Klotho ß. In contrast, HTP, exhibited a lesser degree of microglial toxicity, with reduced ROS production, lipid peroxidation, and mitochondrial dysfunction compared to conventional cigarettes. CONCLUSION: These results highlight the differential toxicological profile of cigarette smoke and HTP on microglial cells, suggesting a potential harm reduction strategy for neurodegenerative disease for smokers unwilling or unable to quit.

Awareness and Knowledge of Tobacco Use and Its Relation to Oral Cancer Among Patients Visiting Stomatology Teaching Hospital.

Background: Oral cancer (OC) is a major global health issue, with tobacco use being one of the most significant preventable risk factors. Despite its strong association with OC, public awareness about the harmful effects of tobacco remains limited. This study aims to evaluate the awareness and knowledge of tobacco use related to oral cancer among patients referred to the Stomatology Teaching Hospital. Methods: A cross-sectional survey was conducted at the Stomatology Teaching Hospital of Kabul University of Medical Sciences (KUMS) between January 1 and July 30, 2023. Using a convenience sampling method, the study included 435 patients aged 15 to 76 years. Logistic regression analysis was employed to determine factors associated with tobacco use, and the data were analyzed using SPSS version 26.0. Results: Participants were divided into two groups: tobacco users and non-tobacco users. Most of them were young (18 to 30 years old) with a significant difference in oral cancer knowledge between the two groups (p < 0.001). Cigarettes were the most common tobacco type among users (62.1%), which was also statistically significant (p < 0.001). Tobacco users were 3.04 times more likely to have knowledge about oral cancer (OR: 3.04, p < 0.001, 95% CI: 1.93-4.80), indicating a significant association. Conclusion: The study reveals a general lack of awareness about oral cancer in our study population, particularly regarding specific risk factors. To improve awareness, it is essential for both public awareness campaigns and dentists to play a more active role in educating the public about oral cancer.

Effect of the Heaviness of Smoking Index (HSI) and Duration of Smoking on Central Neural Processing Using Brainstem Auditory Evoked Responses (BAERs).

Purpose of study The goal of this research was to find the correlation of nicotine dependence and duration of smoking with the status of central neuronal processing in chronic smokers. Our primary objective was to record brainstem auditory evoked responses (BAERs) in chronic smokers and further find their correlation to the Heaviness of Smoking Index (HSI) scores and years of non-abstained smoking of the subjects. We postulated that smoking leads to myelination abnormalities which in turn causes decreased impulse conduction velocity. Methods After obtaining informed consent, we conducted BAER on 60 male smokers who were further classified into groups based on their HSI scores (low, moderate, and high nicotine dependency) and 20 age-matched, non-smoking males. The obtained data was examined using the two-way ANOVA test and the Kruskal-Wallis test. Pearson's coefficient of correlation and the median (as a measure of central tendency) were calculated. Results We observed a non-significant negative correlation between wave I BAER latency and the degree of nicotine dependence. Wave II showed minimal correlation, whereas a positive correlation was seen in waves III, IV, and V. Interpeak latencies (IPL) I-III and III-V showed a non-significant positive correlation with the HSI score, whereas IPL I-V showed a significant positive correlation with the same. When correlated with the duration of smoking (years), the latencies (msec) of BAER waves I-V showed a pattern of progressively decreasing negative correlation, out of which waves I, II, and III were significantly affected. The IPL (msec) of waves I-III was non-significantly, yet positively, correlated, while the IPL of waves I-V and III-V showed a significant positive correlation to the duration of smoking. Conclusions The degree of nicotine dependence and duration of tobacco smoking progressively affected the latencies of BAER waves at the pontomedullary level of the brainstem. This indicates slower central neuronal processing at this level and an increased central transmission time, the extent of which is directly dependent on the extent of tobacco smoking. This is attributed to the myelination defects caused by direct and indirect effects of the toxic metabolites of tobacco smoke, chronic hypoxia, hypercapnia, and respiratory acidosis.

Identifying Predictors of Smoking Switching Behaviours Among Adult Smokers in the United States: A Machine Learning Approach.

Completely abstaining from cigarette smoking or fully switching to e-cigarette (EC) use may be beneficial for reducing the global burden of smoking-related diseases. This study aimed to identify and compare the top 10 prospective predictors of smokers switching away from smoking in the United States. Data from adult exclusive cigarette smokers at Wave 4 of the Population Assessment of Tobacco and Health (PATH) study, who were followed up at Wave 6, were analysed. An Xgboost-based machine learning (ML) approach with a nested cross-validation scheme was utilised to develop a multiclass predictive model to classify smokers' behavioural changes from W4 to W6, including smoking cessation, full and partial switching to EC, and cigarette non-switching. The SHapley Additive exPlanations (SHAP) algorithm was deployed to interpret the top 10 predictors of each switching behaviour. A total of 396 variables were selected to generate the four-class prediction model, which demonstrated a micro- and macro-average area under the receiver operating characteristics curve (ROC-AUC) of 0.91 and 0.81, respectively. The top three predictors of smoking cessation were prior regular EC use, age, and household rules about non-combusted tobacco. For full switching to EC use, the leading predictors were age, type of living space, and frequency of social media visits. For partial switching to EC use, the key predictors were daily cigarette consumption, the time from waking up to smoking the first cigarette, and living with tobacco users. ML is a promising technique for providing comprehensive insights into predicting smokers' behavioural changes. Public health interventions aimed at helping adults switch away from smoking should consider the predictors identified in this study.

Lifetime exposure to smoking and substance abuse may be associated with late-onset multiple sclerosis: a population-based case-control study.

BACKGROUND: Late-onset multiple sclerosis (LOMS), defined as the development of MS after the age of 50, has shown a substantial surge in incidence rates and is associated with more rapid progression of disability. Besides, studies have linked tobacco smoking to a higher chance of MS progression. However, the role of smoking on the risk of developing LOMS remains unclear. This study aims to evaluate the possible association between lifetime exposure to cigarette and waterpipe smoking, drug abuse, and alcohol consumption and the risk of LOMS. METHODS: This population-based case-control study involved LOMS cases and healthy sex and age-matched controls from the general population in Tehran, Iran. The primary data for confirmed LOMS cases were obtained from the nationwide MS registry of Iran (NMSRI), while supplementary data were collected through telephone and on-site interviews. Predesigned questionnaire for multinational case-control studies of MS environmental risk factors was used to evaluate the LOMS risk factors. The study employed Likelihood ratio chi-square test to compare qualitative variables between the two groups and utilized two independent sample t-test to compare quantitative data. Adjusted odds ratio (AOR) for age along with 95% confidence intervals (CI) were calculated using matched logistic regression analysis in SPSS 23. RESULTS: Totally, 83 LOMS cases and 207 controls were included in the analysis. The female to male ratio in the cases was 1.5: 1. The mean ± SD age of 83 cases and 207 controls was 61.14 ± 5.38) and 61.51 ± 7.67 years, respectively. The mean ± SD expanded disability status scale (EDSS) score was 3.68 ± 2.1. Although the results of waterpipe exposure had no significant effect on LOMS development (P-value: 0.066), ever cigarette-smoked participants had a significantly higher risk of developing LOMS than those who never smoked (AOR: 2.57, 95% CI: 1.44-4.60). Furthermore, people with a history of smoking for more than 20 years had 3.45 times the odds of developing MS than non-smokers. Drug and alcohol abuse were both associated with LOMS in our study; of which opioids (AOR: 5.67, 95% CI: 2.05-15.7), wine (AOR: 3.30, 95% CI: 1.41-7.71), and beer (AOR: 3.12, 95% CI: 1.45-6.69) were found to pose the greatest risk of LOMS, respectively. CONCLUSION: For the first time, we identified smoking, drug, and alcohol use as potential risk factors for LOMS development. According to the global increase in cigarette smoking and alcohol use, these findings highlight the importance of conducting interventional approaches for prevention.

Association between Use of Combustible Cigarettes and Noncombustible Nicotine or Tobacco Products and Health-Related Quality of Life in Korean Men: A Nationwide Population-Based Study.

Background: Although the association between smoking and health-related quality of life (HRQoL) has been established, the effects of tobacco products, including combustible cigarettes (CCs) and non-combustible nicotine or tobacco products (NNTPs), on HRQoL remain unclear. This study examined the association between tobacco use and HRQoL in Korean men. Methods: Data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2020 were analyzed. A total of 16,429 male participants aged ≥19 years completed the European Quality of Life-5 Dimensions (EQ-5D). Impaired HRQoL was defined as scoring in the lowest 20% of the EQ-5D index and having some or extreme problems in the following five domains of the EQ-5D: mobility, self-care, usual activities, pain/ discomfort, and anxiety/depression. Multiple logistic regression was conducted to evaluate the risk of impaired HRQoL in current tobacco users. Results: Current tobacco users exhibited a significantly higher risk of impaired HRQoL compared with never users (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.05-1.92). Compared to never users, current tobacco users reported more problems with mobility and pain/discomfort (all P<0.05). Moreover, compared with former tobacco users, current tobacco users had a higher risk of impaired HRQoL (OR, 1.60; 95% CI, 1.18-2.17). Compared to former tobacco users, current tobacco users reported more problems with mobility and pain/discomfort (all P<0.05). Conclusion: Use of CCs and NNTPs is associated with impaired HRQoL in Korean men. Therefore, further interventions for lifestyle modification and smoking cessation treatments are required to reduce the risk of impaired HRQoL among current tobacco users.

Sex-related inequalities in current cigarette smoking among adolescents in Africa.

INTRODUCTION: Risky behaviours, including tobacco use, are highly prevalent among adolescents worldwide. Although these behaviours are largely influenced by various sociodemographic factors, including sex, there is a paucity of regionally representative literature on the sex-related inequalities in cigarette smoking among adolescents in Africa. This study examined the sex-based disparities in current cigarette smoking among adolescents aged 13-15 years in Africa. METHODS: The present study employed a secondary analysis of nationally representative data on 45 African countries obtained from the Global Youth Tobacco Survey, accessible through the World Health Organization (WHO) Global Health Observatory. We used the online version of the WHO Health Equity Assessment Toolkit (HEAT) to generate the results. RESULTS: The prevalence of current cigarette smoking among the adolescents surveyed ranged from 1.6% in Eritrea to 10.4% in Mali among the low-income countries, from 1.3% in Tanzania to 13.1% in Mauritania among the lower-middle-income countries, from 5.2% in Gabon to 15.3% in Mauritius among the upper-middle-income countries, and 14.7% in Seychelles, the only high-income country in the study. The absolute summary measure (D) showed diverse sex-related disparities in the burden of current cigarette smoking among adolescents across the sub-regions. In all countries surveyed, the prevalence of cigarette smoking was higher among male adolescents compared to females, except in Liberia and Mozambique, where female adolescents bore a more significant burden than their male counterparts. Furthermore, male adolescents were more burdened with high cigarette smoking prevalence than females in low-income countries such as Mali, Madagascar, Guinea, Burkina Faso, and The Gambia, where such disparities were most pronounced. Meanwhile, we found less disparity in the burden of cigarette smoking between male and female adolescents in most of the lower and upper-middle-income countries surveyed. CONCLUSION: This study sheds light on the sex-based inequalities in the prevalence of current cigarette smoking among adolescents in Africa. In contrast to female adolescents, male adolescents bear a greater burden of current cigarette smoking. The burden of cigarette smoking is most pronounced in low-income countries such as Mali, Madagascar, Guinea, Burkina Faso, and The Gambia. Conversely, in most of the lower and upper-middle-income countries surveyed, the burdens of current cigarette smoking among male and female adolescents were found to be less disparate. Consequently, cigarette smoking prevention programmes and strategies must be implemented in all African nations. There is also the need to intensify interventions aimed at altering the smoking behaviour of male adolescents. Policymakers can develop and implement evidence-based interventions to address the burden of cigarette smoking among the adolescents. Finally, existing policies and programmes addressing adolescents' cigarette smoking should be re-assessed and strengthened to achieve their objectives.

Youth Smoking Behavior and Policy Attitudes: A Study of High-School Students in the Maldives.

Background: Tobacco use significantly impacts health and economic sectors. In the Maldives, 4 out of 10 men smoke daily, despite anti-tobacco policies. The Maldives Global Youth Tobacco Survey (GYTS) shows fluctuating cigarette smoking prevalence among secondary school students: 6.9% (2004), 3.8% (2007), 4.3% (2011), and 4.7% (2019). No studies have investigated smoking prevalence and attitudes toward anti-smoking policies among higher-secondary students in Addu City. This study examines smoking habits, susceptibility, and attitudes toward anti-smoking regulations to support policy development. Methods: We conducted an observational cross-sectional study using a self-administered survey based on the GYTS and the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS), involving 335 high school students in Addu City. Variables included sociodemographic factors, ever-smokers, current smokers, age at first cigarette, smoking dependency, use of other tobacco products, smoking susceptibility, willingness to quit, and reasons to quit or not smoke. Results with p-values < 0.05 were statistically significant. Results: 22.8% of the students had tried smoking, with 4.74% currently smoking, predominantly males. Additionally, 32.2% had tried e-cigarettes. Smoking susceptibility was 44.2%. Seven students showed smoking dependency, with a significant gender difference (75.4% boys vs 33.3% girls, p < 0.05). Among smokers, 20% wanted to quit, and 70% cited cost as a deterrent. Only 20% of smokers supported a total ban on smoking in media compared to 49.8% of non-smokers (p = 0.03). Non-smokers significantly supported anti-smoking measures (73% vs 12.5% of smokers). Conclusion: Cigarette smoking among high school students in Addu is below the national average, but the high number of ever-smokers and interest in smoking and e-cigarettes suggest potential future increases. Policymakers should enact stronger legislation, enforce age restrictions, raise tobacco taxes, and implement comprehensive smoking cessation programs to address tobacco use effectively.

Cigarette Smoking and its Association with Primary Open Angle Glaucoma: A Systematic Review and Meta-Analysis.

PURPOSE: To systematically assess the association between cigarette smoking and development of Primary Open Angle Glaucoma (POAG) in the general adult population. Heterogeneity will be explored appropriately. METHODS: Outcomes of glaucoma, OAG and POAG were explored in adults who were current, former, and never cigarette smokers. An additional category of 'smokers with "any" smoking status' was used where former smokers were not clearly distinguished from current and never smokers and in smokers whose form of smoking was not defined. All studies were observational and there was no limit to time period. Databases used were MEDLINE, Embase, Global Health and Web of Science. Study quality was assessed using the JBI critical appraisal tool. The DerSimonian-Laird random-effects model and weighting method was applied for meta-analysis with subgroup and sensitivity analyses along with meta-regression. RESULTS: Four cohort, six cross-sectional and nine case-control studies were included. Only one cohort study attained a low risk of bias (RoB), two cohort studies were of medium RoB and the rest of the studies were of high RoB. There was no evidence for an association between smoking statuses: current smoking: OR 0.96, 95%CI (0.76,1.21), former smoking: OR 0.96, 95%CI (0.83,1.11), smoking (any): OR 1.48, 95%CI (0.96, 2.29) and glaucoma. Sensitivity analyses did not have a material impact on findings. Heterogeneity was not explained by smoking status, study quality, smoking exposure, and glaucoma outcome criteria. CONCLUSION: This review suggests no evidence for an association between cigarette smoking and the development of POAG. There was no evidence that current, former, and general smoking increased the risk of glaucoma.

Effect of Eruca sativa on Spermatogenesis in Rats Exposed to Cigarette Smoke.

Smoking is among the significant adverse factors to reproductive health and accounts for damage to spermatogenesis and maturation of spermatozoa. The proposed research contributes to understanding the potential of Eruca sativa to prevent the cytotoxic effect of tobacco smoke on different aspects of male reproductive health, including sperm: sperm morphology, sperm count, testes' weight, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), testosterone, and lipid profile in passive smokers. The experiment on how Eruca sativa leaves affect sperm morphology and concentration is performed by grinding leaves to make the aqueous juice. The research participants were grouped into four groups: a control group, Eruca sativa-treated, cigarette-treated, and a group receiving both Eruca sativa and cigarette exposure. The rats were weighed and euthanized surgically, and the testes were harvested and weighed after four weeks of treatment. The sperm count was determined using epididymal sperm, and sperm morphology was determined using vas deferens sperm. The collected cardiac blood was used for lipid profile assessment and hormone-level determination. The findings of this study are significant. Tobacco exposure led to a notable increase in abnormal sperm and a decrease in sex hormone levels. In contrast, the Eruca sativa group showed a highly significant difference in sperm morphology and counts compared to the cigarette group, with a p< 0.001. Although there was a slight decrease in the lipid profile concentration, it was insignificant. Importantly, the co-administration of Eruca sativa and cigarette smoke resulted in a significant reduction in abnormal sperm count, increased sperm count, higher sex hormone concentration, and lipid profile. The Eruca sativa juice used in this study had a protective effect that could be used to reverse or prevent the effects mentioned above of passive smoking.

Key role of activated platelets in the enhanced adhesion of circulating leucocyte-platelet aggregates to the dysfunctional endothelium in early-stage COPD.

Background: Chronic obstructive pulmonary disease (COPD), usually caused by long-term tobacco smoking, is independently associated with systemic inflammation. However, little is known about the systemic inflammatory status of patients with early-stage COPD (classified as GOLD 1) and long-term smokers with normal lung function (LF). Here, we characterised the early changes in the associated inflammatory state in patients with GOLD 1 and in long-term smokers with normal LF. Methods: Fresh blood samples from 27 patients with GOLD 1, 27 long-term smokers and 14 non-smokers were analysed. Results: Ex vivo blood analysis revealed greater leucocyte-platelet adhesion to TNFα-stimulated pulmonary endothelium in patients with GOLD 1 than in smokers and non-smokers. In addition, platelet reactivity (platelet count and activation, and fibrinogen levels) and the frequency of leucocyte-platelet aggregates were higher in the GOLD 1 group than in the other groups. Some of these findings correlated with the severity of lung dysfunction, while platelet hyperactivity correlated positively with leucocyte-platelet adhesion. The GOLD 1 group also had a higher Th17/Treg ratio and higher circulating levels of IL-17C and C-reactive protein than the other groups. However, long-term smokers also had higher leucocyte counts and activation, and higher plasma levels of TNFα and IL-6 than non-smokers. Conclusion: Our data suggest that the altered inflammatory parameters in long-term smokers may represent early biomarkers of COPD. Accordingly, peripheral immune monitoring based on the above parameters may be useful to prevent disease progression in long-term smokers with normal LF and early COPD.

RB1 Mutations Induce Smoking-Related Bladder Cancer by Modulating the Cytochrome P450 Pathway.

Cigarette smoking causes multiple cancers by directly influencing mutation burden of driver mutations. However, the mechanism between somatic mutation caused by cigarette smoking and bladder tumorigenesis remains elusive. Smoking-related mutation profile of bladder cancer was characterized by The Cancer Genome Atlas cohort. Integraticve OncoGenomics database was utilized to detect the smoking-related driver genes, and its biological mechanism predictions were interpreted based on bulk transcriptome and single-cell transcriptome, as well as cell experiments. Cigarette smoking was associated with an increased tumor mutational burden under 65 years old (p = 0.031), and generated specific mutational signatures in smokers. RB1 was identified as a differentially mutated driver gene between smokers and nonsmokers, and the mutation rate of RB1 increased twofold after smoking (p = 0.008). RB1 mutations and the 4-aminobiphenyl interference could significantly decrease the RB1 expression level and thus promote the proliferation, invasion, and migration ability of bladder cancer cells. Enrichment analysis and real-time quantitative PCR (RT-qPCR) data showed that RB1 mutations inhibited cytochrome P450 pathway by reducing expression levels of UGT1A6 and AKR1C2. In addition, we also observed that the component of immunological cells was regulated by RB1 mutations through the stronger cell-to-cell interactions between epithelial scissor+ cells and immune cells in smokers. This study highlighted that RB1 mutations could drive smoking-related bladder tumorigenesis through inhibiting cytochrome P450 pathway and regulating tumor immune microenvironment.

Tobacco use and khat chewing among adolescents in Yemen: a large-scale school-based cross-sectional study.

OBJECTIVE: The present study sought to assess the prevalence and determinants of tobacco use (cigarette smoking and shisha use) and khat chewing among Yemeni adolescents, and to evaluate their knowledge and attitudes toward these habits. METHODS: This school-based cross-sectional study was conducted among 13 to 19-year-old students attending middle/high schools (both private and public) across five main cities in Yemen. Data were collected using self-administered questionnaires comprising questions/items related to sociodemographic data, cigarette smoking, shisha use, khat chewing, and knowledge on and attitudes toward these habits. Bivariate and multivariate analyses were used to explore the most determinant factors. RESULTS: A total of 7505 students were recruited from 42 schools across five major cities in Yemen. The prevalence rates of khat chewing, cigarette smoking, and shisha use were 42.4%, 6.8%, and 19.3%, respectively. Compared to females, male subjects reported significantly higher prevalence of khat chewing (51.4% vs. 23.5%, p < 0.001), shisha use (20.3% vs. 17.2%, p < 0.01), and cigarette smoking (8.8% vs. 2.6%, p < 0.001). Male gender, older age, poor knowledge, khat chewing, parents' low education level, and parents' and peers' smoking habits were significant determinants of adolescents' cigarette smoking status. Private education, male gender, older age, poor knowledge, parents' low education level, and parents' and peers' khat chewing habits were significant determinants of adolescents' khat chewing status. The participant's knowledge of and attitudes toward tobacco use and khat chewing were inadequate. CONCLUSION: The prevalence of khat chewing, shisha use, and to lesser extent cigarette smoking among Yemeni adolescents is high that needs immediate intervention. The results highlight the urgent need to implement prevention strategies to tackle these habits among the youth in Yemen.

Associations of weight control related behaviors with current cigarette smoking among Chinese adolescents: Results from an ongoing school-based survey in Zhejiang province.

INTRODUCTION: Previous studies have suggested that adolescents may smoke cigarettes to control weight, but relevant research is scarce in Chinese youth. This study was conducted to examine the associations of weight control related behaviors with cigarette smoking in Chinese students. METHODS: This was a secondary analysis of data for 24835 middle and high school students drawn from the 2022 Zhejiang Youth Risk Behavior Survey of China which collected self-reported information of cigarette smoking, weight control strategies and other health-related behaviors. Multivariable logistic regression models were used to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) for the study associations. RESULTS: Overall, there were 998 (4.02%) current cigarette smokers in this wave of the Zhejiang YRBS (2022). Neither trying to control weight nor healthy weight control behavior of exercising was associated with current cigarette smoking (AOR=1.15; 95% CI: 0.97-1.37 and AOR=1.01; 95% CI: 0.85-1.20, respectively). Meanwhile, unhealthy weight control behaviors of taking laxatives (AOR=1.52; 95% CI: 1.03-2.26), taking diet pills (AOR=1.82; 95% CI: 1.26-2.62), dieting (AOR=1.24; 95% CI: 1.04-1.49), and fasting (AOR=1.81; 95% CI: 1.40-2.34) were significantly associated with increased odds of current cigarette smoking. CONCLUSIONS: Screening and developing interventions for unhealthy weight control behaviors should be considered as part of smoking prevention programs among adolescents.

Adverse Cardiovascular Effects of Nicotine Delivered by Chronic Electronic Cigarettes or Standard Cigarettes Captured by Cardiovascular Intrinsic Frequencies.

BACKGROUND: Electronic cigarettes have gained popularity as a nicotine delivery system, which has been recommended by some as an aid to help people quit traditional smoking. The potential long-term effects of vaping on the cardiovascular system, as well as how their effects compare with those from standard cigarettes, are not well understood. The intrinsic frequency (IF) method is a systems approach for analysis of left ventricle and arterial function. Recent clinical studies have demonstrated the diagnostic and prognostic value of IF. Here, we aim to determine whether the novel IF metrics derived from carotid pressure waveforms can detect effects of nicotine (delivered by chronic exposure to electronic cigarette vapor or traditional cigarette smoke) on the cardiovascular system. METHODS AND RESULTS: One hundred seventeen healthy adult male and female rats were exposed to purified air (control), electronic cigarette vapor without nicotine, electronic cigarette vapor with nicotine, and traditional nicotine-rich cigarette smoke, after which hemodynamics were comprehensively evaluated. IF metrics were computed from invasive carotid pressure waveforms. Standard cigarettes significantly increased the first IF (indicating left ventricle contractile dysfunction). Electronic cigarettes with nicotine significantly reduced the second IF (indicating adverse effects on vascular function). No significant difference was seen in the IF metrics between controls and electronic cigarettes without nicotine. Exposure to electronic cigarettes with nicotine significantly increased the total IF variation (suggesting adverse effects on left ventricle-arterial coupling and its optimal state), when compared with electronic cigarettes without nicotine. CONCLUSIONS: Our IF results suggest that nicotine-containing electronic cigarettes adversely affect vascular function and left ventricle-arterial coupling, whereas standard cigarettes have an adverse effect on left ventricle function.

Exploring the causal links between cigarette smoking, alcohol consumption, and aneurysmal subarachnoid hemorrhage: a two-sample Mendelian randomization analysis.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) represents a critical health concern characterized by elevated mortality and morbidity rates. Although both genetic predisposition and lifestyle choices influence aSAH susceptibility, understanding the causative associations between cigarette smoking, alcohol consumption, and aSAH risk remains imperative. Mendelian randomization (MR) offers a robust methodological framework for dissecting these associations, leveraging genetic variants as instrumental variables. Objective: In this study, a two-sample Mendelian randomization (TSMR) approach was employed to elucidate the causal connections between genetically determined cigarette smoking, alcohol consumption, and aSAH risk. Methods: Genetic instruments associated with cigarette smoking and alcohol consumption were sourced from the genome-wide association study (GWAS) and Sequencing Consortium of Alcohol and Nicotine use (GSCAN). Using a genome-wide association study (GWAS) dataset that encompassed aSAH cases and controls of European ancestry, TSMR, which utilized the inverse variance weighting (IVW) method, was employed to estimate the causal effects. Rigorous criteria were applied for selecting instrumental variables to ensure a robust Mendelian randomization analysis. Results: A significant causal association was found between genetically determined cigarette smoking and an increased risk of aSAH, with a 1-standard deviation (SD) increase in cigarette use genetically linked to a 96% relative risk elevation [OR-IVW = 1.96, 95% confidence interval (CI) = 1.28-3.01, p = 0.0021]. However, genetically determined alcohol consumption did not exhibit a statistically significant association with aSAH risk (OR-IVW = 1.22, 95% CI = 0.61-2.45, p = 0.578). Conclusion: The Mendelian randomization analysis revealed a causal nexus between cigarette smoking and an increased risk of aSAH, advocating for targeted smoking cessation interventions within genetically predisposed cohorts. The results regarding the relationship between alcohol consumption and aSAH were affected by insufficient statistical power. A prudent interpretation of the findings highlights the limitations of Mendelian randomization in elucidating intricate genetic epidemiological relationships. Ongoing research involving larger cohort sizes and advanced methodological approaches is essential for comprehending the genetic underpinnings of aSAH.

Therapeutic potential of 18-ß-glycyrrhetinic acid-loaded poly (lactic-co-glycolic acid) nanoparticles on cigarette smoke-induced in-vitro model of COPD.

Chronic obstructive pulmonary disease (COPD) is strongly linked to cigarette smoke, which contains toxins that induce oxidative stress and airway inflammation, ultimately leading to premature airway epithelial cell senescence and exacerbating COPD progression. Current treatments for COPD are symptomatic and hampered by limited efficacy and severe side effects. This highlights the need to search for an optimal therapeutic candidate to address the root causes of these conditions. This study investigates the possible potential of poly (lactic-co-glycolic acid) (PLGA)-based nanoparticles encapsulating the plant-based bioactive compound 18-ß-glycyrrhetinic acid (18ßGA) as a strategy to intervene in cigarette smoke extract (CSE)-induced oxidative stress, inflammation, and senescence, in vitro. We prepared 18ßGA-PLGA nanoparticles, and assessed their effects on cell viability, reactive oxygen species (ROS) production, anti-senescence properties (expression of senescence-associated ß galactosidase and p21 mRNA), and expression of pro-inflammatory genes (CXCL-1, IL-6, TNF-α) and inflammation-related proteins (IL-8, IL-15, RANTES, MIF). The highest non-toxic concentration of 18ßGA-PLGA nanoparticles to healthy human broncho epithelial cell line BCiNS1.1 was identified as 5 µM. These nanoparticles effectively mitigated cigarette smoke-induced inflammation, reduced ROS production, protected against cellular aging, and counteracted the effects of CSE on the expression of the inflammation-related genes and proteins. This study underscores the potential of 18ßGA encapsulated in PLGA nanoparticles as a promising therapeutic approach to alleviate cigarette smoke-induced oxidative stress, inflammation, and senescence. Further research is needed to explore the translational potential of these findings in clinical and in vivo settings.