Smoking & autonomy: the generational tobacco endgame.

New Zealand and Malaysia have abandoned plans to introduce a generational smoking ban because of concerns that such a policy is incompatible with liberal democracy as it undermines autonomy. This paper challenges this claim by showing that smoking is not an autonomous act. Autonomy requires a deliberation of preferences, wills and inclinations. This does not occur in smokers because of three related factors: nicotine addiction, cognitive biases and psychosocial development in addiction. Nicotine addiction results in strong physical and psychological desires to seek pleasure and to avoid withdrawal. This is further potentiated by conditioned behaviour. Cognitive biases explain why smokers act in ways that are detrimental to their health. Psychosocial development explains how the brains of smokers are unable to make rational decisions. This combination renders smokers unable to reflect on their actions and thus act autonomously. This stance is compatible with Mill's view that actions that devalue autonomy cannot be considered autonomous. Defenders of liberalism should not be quick to dismiss a smoking ban and can instead foster autonomy by supporting it.

The Punicalagin Compound Mitigates Bronchial Epithelial Cell Senescence Induced by Cigarette Smoke Extract through the PAR2/mTOR Pathway.

BACKGROUND: Tobacco smoke is an important inducer of airway epithelial cell aging. Punicalagin(PCG) is a natural anti-aging compound. The effect of PCG on tobacco smoke-induced airway epithelial cell senescence is unknown. OBJECTIVE: Our study investigated whether PCG can treat the human bronchial epithelial cell line (BEAS-2B) aging by inhibiting the protease-activated receptor 2 (PAR2)/m- TOR pathway. METHODS: Bioinformatics techniques were used to analyze the potential biological functions of PAR2. Molecular dynamics evaluated the binding ability of PCG and PAR2. The CCK8 assay was used to detect the cytotoxicity of CSE and PCG. The activity of the PAR2/mTOR pathway and the expression of the characteristic aging markers p16, p21, and SIRT1 are detected by qRT-PCR and Western blotting. Cell senescence was observed by Senescence-associated ß-galactosidase (SA-ß-gal) staining. The senescence-associated secretory phenotype (SASP): concentrations of interleukin IL-6, IL-8, and TNF- α were detected by ELISA. RESULTS: The GSE57148 bioinformatics analysis dataset showed that PAR2 regulates lung senescence through the mTOR signaling pathway. Molecular dynamics results found that PCG and PAR2 had a strong and stable binding force. CSE induces BEAS-2B cell senescence and activates the PAR2/mTOR pathway. Inhibition of PAR2 mitigated the senescence changes. In addition, PCG's pretreatment can significantly alleviate CSE-induced BEAS-2B cell senescence while inhibiting the PAR2/mTOR pathway. CONCLUSION: PCG has a therapeutic effect on the senescence of airway epithelial cells.

Effects of Message Frames and Sources in TikTok Videos for Youth Vaping Cessation: Emotions and Perceived Message Effectiveness as Mediating Mechanisms.

PURPOSE: The objective of this study was to evaluate the effect of message frames (gain vs. loss) and sources (formal expert: a health-care professional vs. informal expert: an individual who successfully quit vaping) on the persuasiveness of TikTok videos among youth who currently use e-cigarettes. Additionally, the study examined how emotional responses and perceived message effectiveness (PME) mediate the framing effect on youth intention to quit vaping. METHODS: A 2 (gain frame vs. loss frame) × 2 (formal expert vs. informal expert) factorial design experiment was conducted with 378 youth aged 13 to 18 who currently use e-cigarettes. The study measured participant's emotional responses, PME of the messages, and intention to quit vaping after the video exposure. RESULTS: Messages from a formal expert resulted in stronger intention to quit vaping compared to messages from an informal expert. Gain-framed messages were associated with higher PME when delivered by an informal expert, whereas loss-framed messages showed stronger effects on PME from a formal expert. Positive emotional responses and increased PME mediated the relationship between gain-framed messages and youth intention to quit vaping. DISCUSSION: TikTok could serve as an effective tool for formal experts to promote vaping cessation among youth who use e-cigarettes. Additionally, the findings suggest that gain frames may be more influential than loss frames in promoting vaping cessation among youth, by eliciting positive emotional responses from the audience. The differential impact of message frames depending on source type indicates a nuanced interaction between content and messenger.

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.

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.

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.

A quantitative proteomic approach to evaluate the efficacy of carnosine in a murine model of chronic obstructive pulmonary disease (COPD).

The aim of the work was to study a dose-dependent effect of inhaled carnosine (10, 50 or 100 mg/kg/day) in mice exposed to cigarette smoke as a model of chronic obstructive pulmonary disease (COPD). A dose-dependent loading of the dipeptide in lung tissue and bronchoalveolar lavage (BAL) was firstly demonstrated by LC-ESI-MS analysis. Cigarette smoke exposure induced a significant lung inflammation and oxidative stress in mice which was dose-dependently reduced by carnosine. Inflammation was firstly evaluated by measuring the cytokines content in the BAL. All the measured cytokines were found significantly higher in the smoke group in respect to control, although the data are affected by a significant variability. Carnosine was found effective only at the highest dose tested and significantly only for keratinocyte-derived cytokine (KC). Due to the high variability of cytokines, a quantitative proteomic approach to better understand the functional effect of carnosine and its molecular mechanisms was used. Proteomic data clearly indicate that smoke exposure had a great impact on lung tissue with 692 proteins differentially expressed above a threshold of 1.5-fold. Protein network analysis identified the activation of some pathways characteristic of COPD, including inflammatory response, fibrosis, induction of immune system by infiltration and migration of leukocyte pathways, altered pathway of calcium metabolism and oxidative stress. Carnosine at the tested dose of 100 mg/kg was found effective in reverting all the pathways evoked by smoke. Only a partial reverse of the dysregulated proteins was evident at low- and mid-tested doses, although, for some specific proteins, indicating an overall dose-dependent effect. Regarding the molecular mechanisms involved, we found that carnosine upregulated some key enzymes related to Nrf2 activation and in particular glutathione peroxidase, reductase, transferase, SOD, thioredoxins, and carbonyl reductase. Such mechanism would explain the antioxidant and anti-inflammatory effects of the dipeptide.

Patient-provider communication about cigarette and e-cigarette use during pregnancy: Adaptation and validation of frequency and quality of communication measures among a sample of pregnant patients.

INTRODUCTION: Quality of patient-provider communication regarding tobacco use may encourage cessation that could lead to improved health outcomes for mothers and children. However, currently there are no validated measures of frequency and quality of patient-provider communication about cigarettes and e-cigarettes. The objective of this study was to adapt and validate measures of frequency and quality of patient-provider communication about smoking and e-cigarette use among a sample of pregnant mothers who currently smoked. METHODS: An online sample of US pregnant women who reported past 30-day smoking were recruited to complete a cross-sectional, online survey (n=267). An exploratory factor analysis examined the factor structure of four measures of frequency and quality of patient-provider communication about cigarettes and e-cigarettes among those who reported prior communication with their provider about cigarettes and e-cigarettes (n=170). Relationships between measures were explored, and a logistic regression explored each measure's association with intention to switch from cigarettes to e-cigarettes. RESULTS: Items measuring the frequency of communication loaded onto one factor for both cigarettes and e-cigarettes (α=0.88). Quality of communication loaded onto two factors for both cigarettes and e-cigarettes, termed active communication and internalized perception. Internalized perceptions of communication quality about cigarettes (ß= -0.32, p<0.002), active communication (ß=0.46, p<0.02), and internalized perceptions of communication about e-cigarettes (ß= -0.36, p<0.001) were related to intention to switch, in separated models. CONCLUSIONS: Quality conversations between healthcare providers and pregnant patients is likely more important for behavioral decision-making than the frequency of communication.

The impact of electronic cigarette use on periodontitis and periodontal outcomes: a systematic review and meta-analysis.

BACKGROUND: Periodontitis, a prevalent inflammatory disease affecting tooth-supporting structures, leads to significant oral health and systemic complications if untreated. While traditional smoking is a well-known risk factor for periodontitis, the impact of electronic cigarettes (e-cigarettes) on periodontal health remains unclear. This systematic review and meta-analysis aim to synthesize existing evidence on the effects of e-cigarette use on periodontitis and other periodontal outcomes. METHODS: A literature search was conducted across PubMed, EMBASE, and Web of Science from their inception up to June 15 2024. Eligible studies included those assessing the impact of e-cigarette use on periodontal outcomes such as bleeding on probing (BOP), plaque index, probing depth, clinical attachment loss, and marginal bone loss. Data were extracted and analyzed using random-effect models to calculate pooled mean differences. R statistical software was used to perform meta-analyses. RESULTS: Twelve studies were included in the meta-analysis. E-cigarette users showed a significantly lower mean BOP score compared to non-users (pooled mean difference: -14.233; 95% CI: -20.424 to -8.043; I² = 99%). For other periodontal outcomes, the findings were as follows: Plaque Index (MD: -0.160; 95% CI: -0.680 to 0.360; I² = 95%), Clinical Attachment Loss (MD: 0.120; 95% CI: -0.045 to 0.285; I² = 90%), Probing Depth (MD: 0.056; 95% CI: -0.070 to 0.182; I² = 85%), and Marginal Bone Loss (MD: -0.052; 95% CI: -0.168 to 0.064; I² = 88%). CONCLUSION: Present studies have not identified a significant link between e-cigarette use and adverse effects on periodontal health, but the available research is limited. Further longitudinal research is necessary to evaluate the long-term effects of e-cigarette use on periodontal health and to clarify any associated risks.

Social Epidemiology of Early Initiation of Electronic and Conventional Cigarette Use in Early to Middle Adolescents.

Background: Early initiation of tobacco use among adolescents is a significant public health concern. While there is extensive research on overall tobacco use, much of it focuses on initiation in late adolescence, uses cross-sectional designs, and lacks specific exploration of electronic versus conventional cigarette use. This study aims to investigate social determinants influencing the early initiation of electronic and conventional cigarette use among U.S. adolescents. Methods: We utilized data from the Adolescent Brain Cognitive Development (ABCD) study, which follows a cohort of tobacco-naïve children from age nine through age 16. The social determinants examined included household income, parental education, financial difficulties, racial/ethnic minority status, family structure, neighborhood income, and gender minority status. Structural equation models were employed to assess associations between these determinants and early initiation of electronic and conventional cigarette use. Results: Male gender was associated with a higher likelihood of conventional cigarette use, while the risk of early initiation of electronic cigarette use was similar across genders. White adolescents were at a higher risk of conventional cigarette use; however, the risk for electronic cigarette use was comparable across White and non-White groups. Financial difficulties were linked to an increased likelihood of early initiation of conventional cigarette use but not electronic cigarette use. Higher household income was associated with a reduced risk of initiating conventional cigarettes but did not significantly impact electronic cigarette use. Adolescents from married families were less likely to initiate electronic cigarette use. No significant effects were found for parental education or neighborhood income on the initiation of either type of cigarette use. Age did not significantly affect the initiation of either cigarette type, and gender minority status was marginally associated with early initiation of conventional cigarette use. Conclusions: The social patterning of electronic cigarette use differs from that of conventional cigarette use, suggesting that distinct tobacco products do not pose a uniform risk across all adolescents. This study underscores the importance of tailored prevention efforts that address the unique challenges associated with early initiation of electronic and conventional cigarette use among adolescents. The differential risk factors identified suggest targeted prevention strategies for conventional cigarette use, focusing on financial difficulties, household income, and gender-specific interventions. In contrast, prevention efforts for electronic cigarette use may require broader, more inclusive approaches that address all adolescents, regardless of their background. Comprehensive universal screening for electronic cigarette use and targeted screening for conventional cigarette use among adolescents are recommended.

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.

[The impact of maternal smoking during pregnancy on respiratory disease in children]. / Impact du tabagisme au cours de la grossesse sur les pathologies respiratoires de l'enfant.

Among the causes of abnormal fetal lung development, active and environmental maternal smoking represents a major potential target in preventive medicine. Prevalence of smoking among women, particularly during pregnancy, varies across the different regions of the world. We reviewed the literature on the repercussions of maternal smoking on the lungs of the fetus and the neonate. One of the main consequences is prematurity, leading to pulmonary bronchodysplasia followed by respiratory infections, which particularly affect young children. In the medium- and long-term, smoking in utero leads to asthma and allergies, and is suspected to be associated with impaired respiratory function in children and teenagers. We also report on the potential effects of e-cigarettes, which represent an emerging threat to children's respiratory health.

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.

Variation in Relative Risk Perceptions and Tobacco Use by Race and Socioeconomic Status among Older Adults who Smoke: Evidence from the Population Assessment of Tobacco and Health (PATH) Study.

INTRODUCTION: Older adults who smoke face significant risk of tobacco-related disease and hold misperceptions about health risks posed by nicotine product use. This study examined whether socioeconomic status and race are associated with variation in cigarette/e-cigarette relative risk perceptions, whether relative risk perceptions are associated with tobacco use behaviors, and whether socioeconomic status and race moderate associations between perceptions and use behaviors. METHODS: Five waves of PATH Study yielded data from 1,879 adults >55 who smoked within the past 30 days during Wave 1. Adjusted longitudinal logistic models estimated associations between higher vs. lower SES ("low-SES": less than high school diploma/GED. and annual household income<$25,000) and race (White vs. Black/African American; AA) and e-cigarette/cigarette relative risk perceptions, behavioral intentions, and e-cigarette use. RESULTS: Lower-SES adults were more likely to report e-cigarettes were very/extremely harmful to health (AOR: 1.74, p<0.01) and less likely to report e-cigarettes were less harmful than cigarettes (AOR: 0.65, p<0.01). Black/AA adults were less likely to report that e-cigarettes were less harmful than cigarettes. Participants rating e-cigarettes as equally/more harmful than cigarettes exhibited lower odds of intending to quit smoking or switch to e-cigarettes. Finally, Black/AA adults who also perceived e-cigarettes equally/more harmful than cigarettes exhibited greater odds of trying to reduce rather than quit smoking (AOR: 1.58, p=0.02). CONCLUSIONS: Many older adults who smoke perceive e-cigarettes as equally or more harmful than cigarettes, particularly low-SES and Black/AA older adults. Differences in relative risk perceptions among high priority populations could negatively influence cessation attempts and switching behaviors. IMPLICATIONS: This study found that Black/AA and low-SES older adults who smoke cigarettes were more likely to perceive e-cigarettes as harmful or more harmful than cigarettes. The absence of accurate, evidence-based information regarding the relative health risks associated with the long-term use of various tobacco products may impede policy efforts to reduce disparities in smoking-related disease through increased cessation and/or harm reduction.

Oridonin alleviates cigarette smoke-induced nasal polyp formation by promoting autophagy.

Previous studies have indicated that oridonin is a promising candidate for therapeutic intervention in a range of inflammatory diseases. The objective of this study was to investigate the protective mechanism of oridonin in chronic rhinosinusitis with nasal polyp (CRSwNP). In nasal polyp (NP) mice model, cigarette smoke (CS) induced polypoid changes compared to previous modeling methods. Compared with CS-treated mice, oridonin reduced polypoid changes, goblet cell count, and promoted the expression of tight junction proteins (ZO-1, occludin, claudin-1) and production of autophagosomes. Following treatment with oridonin, the levels of OVA-specific IgE, IL-6, IFN-γ, IL-5, IL-13 and IL-17A in serum were observed to decrease; the levels of TGF-ß1, matrix metalloproteinase 2 (MMP2), MMP7, MMP9 and MMP12 levels in nasal lavage fluid were reduced, while tissue inhibitor of metalloproteinase-1 (TIMP-1) levels were increased. Furthermore, the aforementioned alterations in the mouse model were reversed by 3-methyladenine (3-MA), an autophagy inhibitor. In vitro, cigarette smoke extract (CSE) was observed to decrease the expression of tight junction proteins, the production of autophagosomes, and to reduce the expression of LC3-II and Beclin-1, accompanied by an increase in P62 expression. In addition, oridonin was observed to reverse CSE-induced epithelial barrier damage, and was associated with autophagy and the PI3K/AKT/mTOR pathway. In conclusion, oridonin was demonstrated to improve the damage of the nasal epithelial barrier induced by CS through the promotion of autophagy, which may represent a novel therapeutic option for the treatment of CRSwNP.

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.

Single-cell RNA sequencing reveals heterogeneity of ALI model and epithelial cell alterations after exposure to electronic cigarette aerosol.

Electronic cigarettes (e-cigarettes) have been advertised as a healthier alternative to traditional cigarettes; however, their exact effects on the bronchial epithelium are poorly understood. Air-liquid interface culture human bronchial epithelium (ALI-HBE) contains various cell types, including basal cell, ciliated cell and secretory cell, providing an in vitro model that simulates the biological characteristics of normal bronchial epithelium. Multiplex single-cell RNA sequencing of ALI-HBE was used to reveal previously unrecognized transcriptional heterogeneity within the human bronchial epithelium and cell type-specific responses to acute exposure to e-cigarette aerosol (e-aerosol) containing distinct components (nicotine and/or flavoring). The findings of our study show that nicotine-containing e-aerosol affected gene expression related to transformed basal cells into secretory cells after acute exposure; inhibition of secretory cell function by down-regulating genes related to epithelial cell differentiation, calcium ion binding, extracellular exosomes, and secreted proteins; and enhanced interaction between secretory cells and other cells. On the other hand, flavoring may alter the growth pattern of epithelial cells and make basal cells more susceptible to SARS-CoV infection. Besides, the data also indicate factors that may promote SARS-CoV-2 infection and suggest therapeutic targets for restoring normal bronchial epithelium function after e-cigarette use. In summary, the current study offered fresh perspectives on alterations in the cellular landscape and cell type-specific responses in human bronchial epithelium that are brought about by e-cigarette use.

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.

Innovative upcycling cigarette filters into high-performance cellulose nanofiber-epoxy composites.

This research introduces a novel upcycling method for transforming cigarette filters-an abundant and persistent environmental waste-into high-performance epoxy composites reinforced with cellulose nanofibers. The innovation lies in extracting cellulose acetate nanofibers from used cigarette butts via a multi-step purification and electrospinning process, followed by their conversion into regenerated cellulose nanofibers through alkaline hydrolysis. This dual-fiber approach allows us to fabricate four distinct epoxy composites, each reinforced by different nanofiber types: recycled cellulose acetate nanofibers, regenerated cellulose nanofibers from recycled cigarette filters, and their commercial counterparts. Notably, this is the first time regenerated nanofibers derived from waste cigarette filters have been utilized for epoxy composite reinforcement, demonstrating a sustainable, high-value use for a major pollutant. Comprehensive characterizations, including FTIR, XRD, SEM, and contact angle measurements, confirmed the successful regeneration of cellulose nanofibers, showing improved hydrophilicity, reduced crystallinity, and uniform nanofiber morphology with diameters between 200 and 300 nm. The innovation further extends to the mechanical performance of these composites: tensile tests revealed that those reinforced with regenerated cellulose nanofibers exhibited superior tensile strength (49.5-53.8 MPa), significantly outperforming both cellulose acetate nanofiber composites (40.1-42.6 MPa) and neat epoxy resin (31.4 MPa). This marked improvement is attributed to enhanced nanofiber dispersion and interfacial adhesion within the epoxy matrix, an essential advancement over traditional composites. In addition, thermal analysis showed that all composites maintained thermal stability in the 300-400 °C range, comparable to commercial alternatives. The regenerated nanofiber-reinforced composites also displayed enhanced optical transparency due to reduced light scattering, making them ideal candidates for applications requiring both mechanical strength and optical clarity. By pioneering the use of cigarette filter waste for fabricating advanced cellulose nanofiber composites, this study presents an eco-friendly approach to addressing environmental pollution while creating sustainable materials with superior mechanical, thermal, and optical properties.

Understanding adolescent consumption patterns and attitudes towards the "puff" on the path to a smoke-free generation: a 2022 French perspective.

Purpose: Tobacco use remains the leading preventable cause of death in France, with 75,000 deaths each year. France aims to reduce smoking and achieve a smoke-free generation by 2032. However, recent tobacco industry innovations which mainly target young people, could undermine this goal. The main objective of this study is to assess the knowledge and consumption patterns of the "puff" among French adolescents in 2022. Methods: A cross-sectional study using a structured online survey on a representative sample of 400 adolescents aged 13 to 16 years was conducted from July 4th to 20th, 2022. Results: Around 66% of adolescents reported having heard of the puff", and one in ten having tried it. Slightly fewer of them have tried cigarettes; 89.6% of experimenters reported that it allowed them to explore unique flavors, 81.9% found it fun to play with the puff-cloud, and 94.5% of regular consumers considered it a stylish or cool product. 76% of adolescents believe that the puff is dangerous to their health, 71.6% describe it as a polluting device, and 62.8% think it's a gadget. Conclusion: The "puff" is widely known by French adolescents and more commonly used than cigarettes, due, in part, to marketing specifically designed to target youth. That is why it could represent a threat to the smoke-free generation objectives. Public health policy could be informed by the ecological awareness of adolescents as a new lever of counter-influence to prevent this kind of consumption, as did ACT with the #stopcigarettespollution prevention campaign.