Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.886
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-33050574

RESUMO

SARS-CoV-2 is a new coronavirus that has caused a worldwide pandemic. It produces severe acute respiratory disease (COVID-19), which is fatal in many cases, characterised by the cytokine release syndrome (CRS). According to the World Health Organization, those who smoke are likely to be more vulnerable to infection. Here, in order to clarify the epidemiologic relationship between smoking and COVID-19, we present a systematic literature review until 28th April 2020 and a meta-analysis. We included 18 recent COVID-19 clinical and epidemiological studies based on smoking patient status from 720 initial studies in China, the USA, and Italy. The percentage of hospitalised current smokers was 7.7% (95% CI: 6.9-8.4) in China, 2.3% (95% CI: 1.7-2.9) in the USA and 7.6% (95% CI: 4.2-11.0) in Italy. These percentages were compared to the smoking prevalence of each country and statistically significant differences were found in them all (p < 0.0001). By means of the meta-analysis, we offer epidemiological evidence showing that smokers were statistically less likely to be hospitalised (OR = 0.18, 95% CI: 0.14-0.23, p < 0.01). In conclusion, the analysis of data from 18 studies shows a much lower percentage of hospitalised current smokers than expected. As more studies become available, this trend should be checked to obtain conclusive results and to explore, where appropriate, the underlying mechanism of the severe progression and adverse outcomes of COVID-19.


Assuntos
Infecções por Coronavirus/terapia , Hospitalização/estatística & dados numéricos , Pneumonia Viral/terapia , Fumantes/estatística & dados numéricos , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Itália/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Estados Unidos/epidemiologia
2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47863

RESUMO

Organização lançou programa para ajudar fumantes a largarem o tabaco durante a pandemia


Assuntos
Fumantes , Infecções por Coronavirus , Organização Mundial da Saúde
3.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47867

RESUMO

Segundo a coordenadora do programa, os fumantes são 14 vezes mais vulneráveis a contrair uma forma mais grave de coronavírus, além de 50 tipos de outras doenças crônicas


Assuntos
Tabagismo/prevenção & controle , Fumantes , Portais do Paciente
4.
J UOEH ; 42(3): 251-259, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32879189

RESUMO

Preventing cardiovascular disease (CVD) is an urgent public health challenge. Although brachial-ankle pulse wave velocity (baPWV) can indicate the risk of arterial stiffness and CVD, findings regarding whether baPWV is associated with smoking are inconsistent. This study considered the influence of smoking on arteriosclerosis, specifically focusing on secondhand smoke (SHS), and aimed to construct a strategy for preventing the worsening of arteriosclerosis. We recruited 295 male employees from five companies who had smoking habits such as being smokers, living with smokers, and exposure to SHS outside the home. We measured body composition and hemodynamics, including blood pressure and baPWV, and found that baPWV had significant positive correlations with age, smoking index, alcohol consumption, body-fat percentage, blood pressure, and heart rate, and significant negative correlations with height, fat-free mass, and lower-limb muscle mass. Moreover, baPWV showed a significant adverse effect on participants who had metabolic syndrome (MetS) risk factors such as hypertension, dyslipidemia, and diabetes. Multiple regression analysis showed that baPWV had significant positive relationships with age, height, MetS risk factors, cohabitation with smokers, blood pressure, and heart rate, and a significant negative relationship with lower-limb muscle mass. The same results were obtained when adjusting for current smoking status, smoking index, cohabitation with smokers at birth, and frequency of exposure to SHS outside the home. Exposure to tobacco smoke due to cohabitation with smokers increased baPWV regardless of the person's smoking habits. Thus, to prevent an increase in baPWV in housemates and smokers, it is necessary for smokers to quit smoking.


Assuntos
Arteriosclerose/etiologia , Arteriosclerose/prevenção & controle , Saúde do Trabalhador , Características de Residência , Fumantes , Poluição por Fumaça de Tabaco/efeitos adversos , Rigidez Vascular , Local de Trabalho , Arteriosclerose/fisiopatologia , Progressão da Doença , Humanos , Masculino , Análise de Onda de Pulso , Fatores de Risco , Abandono do Hábito de Fumar
5.
Medicine (Baltimore) ; 99(38): e22104, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957330

RESUMO

INTRODUCTION: Smoking is well-known to increase cancer risk, particularly risk of lung cancer, and negatively affects efficacy of cancer treatment. However, recent evidence suggests that among cancer patients, paradoxically, smokers respond to treatment better than non-smokers. We propose to conduct a focused review and meta-analysis to compare response to drug treatment between smoking and non-smoking cancer patients. METHODS AND DESIGN: We will collect data from large clinical trials of therapies for cancer patients which have included smokers and non-smokers. We will search PubMed, PMC/ MEDLINE, SCOPUS, Embase, and the registries for clinical trials and four major clinical journals up to June 30, 2019. Search terms will be "Drug name" phase-3" or "Drug name" phase-III." Data collection will be focused on randomized clinical trials of cancer drugs that enrolled at least 100 participants and reporting treatment results from smoking and nonsmoking patients. Initial selection criteria will be clinical trial studies of drug treatment of 100 or more cancer patients, and reporting hazard ratios (HR) for smokers and non-smokers. Two persons will be searching such publications independently, or data will be provided, double checked, or confirmed by authors. Multiple sub-group analyses will be conducted by at least two persons to avoid bias or experimental errors. DISCUSSION: The results will clarify whether smoking and response to treatment of cancer are linked not. Our results may possibly identify drug/s that work better among cancer patients who are smokers. TRIAL REGISTRATION: PROSPERO registration number: CRD42019146402.


Assuntos
Neoplasias/tratamento farmacológico , Projetos de Pesquisa , Fumantes , Ensaios Clínicos como Assunto , Humanos , Metanálise como Assunto , Revisões Sistemáticas como Assunto
6.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32989082

RESUMO

OBJECTIVES: We tested a Public Health Service 5As-based clinician-delivered smoking cessation counseling intervention with adolescent smokers in pediatric primary care practice. METHODS: We enrolled clinicians from 120 practices and recruited youth (age ≥14) from the American Academy of Pediatrics Pediatric Research in Office Settings practice-based research network. Practices were randomly assigned to training in smoking cessation (intervention) or social media counseling (attentional control). Youth recruited during clinical visits completed confidential screening forms. All self-reported smokers and a random sample of nonsmokers were offered enrollment and interviewed by phone at 4 to 6 weeks, 6 months, and 12 months after visits. Measures included adolescents' report of clinicians' delivery of screening and counseling, current tobacco use, and cessation behaviors and intentions. Analysis assessed receipt of screening and counseling, predictors of receiving 5As counseling, and effects of interventions on smoking behaviors and cessation at 6 and 12 months. RESULTS: Clinicians trained in the 5As intervention delivered more screening (ß = 1.0605, P < .0001) and counseling (ß = 0.4354, P < .0001). In both arms, clinicians more often screened smokers than nonsmokers. At 6 months, study arm was not significantly associated with successful cessation; however, smokers in the 5As group were more likely to have quit at 12 months. Addicted smokers more often were counseled, regardless of study arm, but were less likely to successfully quit smoking. CONCLUSIONS: Adolescent smokers whose clinicians were trained in 5As were more likely to receive smoking screening and counseling than controls, but the ability of this intervention to help adolescents quit smoking was limited.


Assuntos
Aconselhamento/educação , Motivação , Abandono do Hábito de Fumar/psicologia , Adolescente , Feminino , Humanos , Masculino , não Fumantes/estatística & dados numéricos , Profissionais de Enfermagem/educação , Pediatras/educação , Assistentes Médicos/educação , Fumantes/estatística & dados numéricos , Fumar
7.
BMC Public Health ; 20(1): 1478, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993598

RESUMO

BACKGROUND: Four decades of population-based tobacco control strategies have contributed to substantial reduction in smoking prevalence in Australia. However, smoking prevalence is still double in socially disadvantaged groups compared to those that are not. But not all tobacco control strategies successfully used in the general population is effective in specific high-risk population groups. Hence, an effective way to reduce smoking in high risk population groups may include targeting them specifically to identify and support smokers to quit. In this backdrop, we examined whether tobacco control interventions at the population-level are more effective in increasing life expectancy among Australians compared to interventions targeting a high risk group or a combination of the two when smoking prevalence is reduced to 10 and 0% respectively. METHODS: Using the risk percentiles approach, analyses were performed separately for men and women using data from various sources such as the 2014-15 National Health Survey linked to death registry, simulated data for high risk groups, and the Australian population and deaths data from the census. Indigenous status was simulated by preferentially assigning those who are indigenous to lower SES quintiles. The age-sex distribution of mental disorder status was simulated using its distribution from 2016 National Drug Strategy Household Survey with 25.9% of mentally ill being assigned to current smoking category and the rest to non-smoking category. The age-sex distribution of prisoners was simulated based on 2014 ABS Prisoners Australia survey with 74% of prisoners being assigned to current smoker category and the rest to non-smoker category. Homelessness status was simulated according to age, sex and indigenous status for 2011 census with all homeless being allocated to the lowest SES category. The age-sex distribution of total cholesterol level was simulated based on 2011-13 Australian Health Survey. RESULTS: The results showed that the combined approach for reducing smoking is most effective for improving life expectancy of Australians particularly for the socially disadvantaged and mentally ill groups both of which have high fraction of smokers in the population. For those who were mentally ill the gain in ALE due to reduction of smoking to 10% was 0.53 years for males and 0.36 years for females which were around 51 and 42% respectively of the maximal gains in ALE that could be achieved through complete cessation. CONCLUSIONS: Targeting high-risk population groups having substantial fraction of smokers in the population can strongly complement the existing population-based smoking reduction strategies. As population and high risk approaches are both important, the national prevention policies should make judicious use of both to maximize health gain.


Assuntos
Promoção da Saúde/estatística & dados numéricos , Expectativa de Vida/tendências , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Austrália/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Pessoas em Situação de Rua/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Dinâmica Populacional , Prevalência , Fatores de Risco , Distribuição por Sexo , Prevenção do Hábito de Fumar
8.
Artigo em Inglês | MEDLINE | ID: mdl-32948084

RESUMO

Background: COVID-19 has caused health impacts and disruptions globally. Electronic cigarette (ECIG) users may face additional impacts. This study examined impacts of COVID-19 on ECIG users. Methods: Concept mapping, a mixed-methods approach, was used to identify COVID-19 impacts on adult ECIG users. ECIG users (n = 93) provided statements completing a prompt: "A specific way Coronavirus/COVID-19 has affected my vaping/e-cigarette use, my vaping/e-cigarette related purchasing, or other vaping/e-cigarette related behaviors or issues is…". Participants generated 85 unique statements, sorted statements into groups of similar content and rated each statement on how true they were. Multidimensional scaling and hierarchical cluster analysis identified thematic clusters. Mean cluster ratings were compared between sample subgroups. Results: Ten clusters were identified: Stocking up and Bulk Purchasing, Challenges in Obtaining ECIG Supplies, Alternative Purchasing Procedures, Increased ECIG use, Disruption of Routine and ECIG Use, Efforts to Decrease ECIG Use, Improving ECIG Skills, COVID-19 Health Concerns, Perceptions of ECIG Use and COVID-19, and COVID-19 Protection. More dependent ECIG users and dual users of ECIGs and cigarettes rated clusters higher than less dependent ECIG users and non-dual users. Conclusions: ECIG users may experience or perceive they face additional COVID-19 impacts, such as increased exposure, financial burdens, stress, and health risks.


Assuntos
Comportamento do Consumidor , Infecções por Coronavirus/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina/economia , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , Humanos , Pandemias , Fumantes , Vaping
9.
BMC Public Health ; 20(1): 1237, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795286

RESUMO

BACKGROUND: Tobacco control strategies have engendered overall declines in smoking; however, a large gap remains between people with and without mental health problems, causing substantial health inequalities. Population-level information on barriers and opportunities for improvements is scarce. We aimed to assess mental health status of cigarette smokers and recent ex-smokers ('past-year smokers') in England, and smoking and harm reduction behaviour and quit attempts by mental health status. METHODS: Data were collected from 5637 current and 434 recent ex-smokers in 2016/17 in household surveys of representative samples of adults. We calculated weighted prevalence of different indicators of mental health problem: a) ever diagnosis, b) none, moderate, serious past-month distress, c) past-year treatment. We compared weighted smoking status, cigarette type, dependence, motivation to stop smoking, cutting down, use of nicotine replacement therapy or e-cigarettes, short-term abstinence, and quit attempts according to mental health status. RESULTS: Among past-year smokers: 35.9% ever had a diagnosis; 24.3% had experienced moderate, an additional 9.7% serious, past-month distress; 21.9% had had past-year treatment. Those with an indication of a mental health problem were more highly dependent and more likely to smoke roll-your-own cigarettes but also more likely to be motivated to stop smoking, to cut down, use nicotine replacement therapy or e-cigarettes and to have attempted to quit in the past year. CONCLUSIONS: About a third of cigarette smokers in England have mental health problems. Interventions should address their increased dependence and leverage higher prevalence of harm reduction behaviours, motivation to stop and attempts to stop smoking.


Assuntos
Redução do Dano , Transtornos Mentais/epidemiologia , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar/epidemiologia , Adolescente , Adulto , Idoso , Inglaterra/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Fumantes/estatística & dados numéricos , Adulto Jovem
10.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1058-1062, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741170

RESUMO

Objective: To understand the awareness of smoking hazards and intention of smoking concession in residents aged 18-65 years in Beijing, and provide scientific evidence for the development and improvement of tobacco control policies and measures. Methods: Data were collected from the 2017 Beijing Non-communicable and Chronic Disease surveillance. A multi-stage stratified cluster sampling method was used to take samples from 165 communities in 16 districts of Beijing. Logistic regression was used to analyze the influencing factors. Results: Among 11 594 participants, 49.93% had no intention of smoking concession. The percentage of refusing smoking concession was higher in men (50.39%) than in women (43.01%), the difference was significant ( χ(2)=14.211, P=0.002), and higher in suburban residents (56.78%) than in urban residents (45.30%), the difference was significant ( χ(2)=51.977, P<0.001). For the smoking cessation motivation, "illness" was the reason for more former smokers (29.88%) compared with current smokers (11.50%), the difference was significant ( χ(2)=85.865, P<0.001). The awareness rates of smoking hazards was higher in women (34.97%) than in men (32.63%), the difference was significant (Z=5.612, P<0.001), higher in suburban residents (35.44%) than in urban residents (33.03%), the difference was significant (Z=-3.734, P<0.001), and higher in never smokers (35.15%) than in smokers (30.06%), the difference was significant ( χ(2)=62.277, P=0.005). Multiple logistic regression analysis results showed people with general awareness (OR=0.61, 95%CI: 0.39-0.94) and poor awareness (OR=0.67, 95%CI: 0.50-0.90) of smoking hazards were less likely to quit smoking and people with general awareness (OR=0.64, 95%CI: 0.53-0.76) and poor awareness (OR=0.87, 95%CI: 0.78-0.98) of smoking hazards were more likely to smoke. Conclusions: Smokers aged 18-65 in Beijing had low willingness for smoking cessation. Health problem was main consideration for smoking cessation. Never-smokers had better awareness of smoking hazards than smokers, and the awareness of smoking hazards was an influencing factor of smoking status.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Intenção , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar/psicologia , Adolescente , Adulto , Idoso , Pequim/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fumantes/estatística & dados numéricos , Fumar/efeitos adversos , Fumar/epidemiologia , Adulto Jovem
12.
PLoS One ; 15(8): e0237769, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817718

RESUMO

Concerns exist that the positive association of physical activity with better lung function, which has been suggested in previous longitudinal studies in smokers, is due to reverse causation. To investigate this, we applied structural equation modeling (SEM), an exploratory approach, and marginal structural modeling (MSM), an approach from the causal inference framework that corrects for reverse causation and time-dependent confounding and estimates causal effects, on data from participants in the European Community Respiratory Health Survey (ECRHS, a multicentre European cohort study initiated in 1991-1993 with ECRHS I, and with two follow-ups: ECRHS II in 1999-2003, and ECRHS III in 2010-2014). 753 subjects who reported current smoking at ECRHS II, with repeated data on lung function at ECRHS I, II and III, physical activity at ECRHS II and III, and potential confounders at ECRHS I and II, were included in the analyses. SEM showed positive associations between physical activity and lung function in both directions. MSM suggested a protective causal effect of physical activity on lung function (overall difference in mean ß (95% CI), comparing active versus non-active individuals: 58 mL (21-95) for forced expiratory volume in one second and 83 mL (36-130) for forced vital capacity). Our results suggest bi-directional causation and support a true protective effect of physical activity on lung function in smokers, after accounting for reverse causation and time-dependent confounding.


Assuntos
Asma/terapia , Exercício Físico , Pulmão/fisiologia , Infecções Respiratórias/terapia , Adolescente , Adulto , Asma/etiologia , Asma/fisiopatologia , Peso Corporal/fisiologia , Dieta , Feminino , Volume Expiratório Forçado/fisiologia , Inquéritos Epidemiológicos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Fumantes , Fumar/efeitos adversos , Capacidade Vital/fisiologia , Adulto Jovem
13.
Med Hypotheses ; 143: 110153, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32763662

RESUMO

Reports from various countries suggest that tobacco smoking might protect from SARS-CoV-2 infection, since the prevalence of smoking in COVID-19 hospitalized patients is lower than in the respective general population. Apart from nicotine or other chemicals contained in tobacco smoke, we propose that a single-stranded RNA virus that infects tobacco leaves, tobacco mosaic virus (TMV), might be implicated in this effect. TMV, though non-pathogenic, is found in smokers' airways, and stimulates adaptive and innate immunity, with release of specific antibodies and interferons. The latter may have preventive and/or therapeutic effects against COVID-19. If confirmed by epidemiological and interventional studies, this might lead to the use of TMV as an immunological adjuvant against SARS-CoV-2 infection and COVID-19 disease.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Modelos Imunológicos , Pandemias , Pneumonia Viral/imunologia , Fumantes , Vírus do Mosaico do Tabaco/imunologia , Produtos do Tabaco/virologia , Fumar Tabaco , Animais , Anticorpos Antivirais/biossíntese , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Resistência à Doença , Humanos , Interferons/biossíntese , Camundongos , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Sistema Respiratório/imunologia , Sistema Respiratório/virologia , Vírus do Mosaico do Tabaco/isolamento & purificação , Fumar Tabaco/epidemiologia , Receptores Toll-Like/imunologia
14.
Artigo em Inglês | MEDLINE | ID: mdl-32748882

RESUMO

Chronic cigarette smokers (CCS) are known to have elevated levels of carboxyhemoglobin (COHb). However, it is not known whether increased levels of COHb are associated with endothelial dysfunction (ED), and therefore the development of peripheral arterial disease (PAD). The aim of the study was to investigate the association of blood COHb and plasma nitric oxide (NO) levels, and whether it is an independent risk factor in the development of PAD among CCS at Dr George Mukhari Academic Hospital (DGMAH). A sample of 120 CCS with PAD and a convenience sample of 100 CCS without PAD were recruited into the study. Blood COHb levels were measured using the ABL 90 FLEX CO-oximeter automated spectroscopy. Plasma nitric oxide (NO) levels were measure using ELISA. Logistic regression analysis was used to investigate the association of blood COHb and plasma NO with PAD. Blood COHb levels of CCS with PAD were significantly higher than those of CCS without PAD, and the NO levels of CCS with PAD were significantly lower than those of CCS without PAD. Although both the blood COHb and plasma NO in CCS were significantly associated with PAD in bivariate logistic analysis, only plasma NO was independently associated with PAD in multivariate logistic analysis. This finding is consistent with the hypothesis that COHb is a cause of arterial damage in PAD, leading to reduced NO, and therefore reduced arterial dilation.


Assuntos
Carboxihemoglobina/análise , Fumar Cigarros/sangue , Óxido Nítrico/sangue , Doença Arterial Periférica/sangue , Adulto , Idoso , Artérias , Carboxihemoglobina/metabolismo , Estudos de Casos e Controles , Fumar Cigarros/efeitos adversos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oximetria , Doença Arterial Periférica/patologia , Fumantes
15.
PLoS One ; 15(8): e0236559, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817636

RESUMO

Chronic obstructive pulmonary disease (COPD) poses a significant but heterogeneous burden to individuals and healthcare systems. Policymakers develop targeted policies to minimize this burden but need personalized tools to evaluate novel interventions and target them to subpopulations most likely to benefit. We developed a platform to identify subgroups that are at increased risk of emergency department visits, hospitalizations and mortality and to provide stratified patient input in economic evaluations of COPD interventions. We relied on administrative and survey data from Ontario, Canada and applied a combination of microsimulation and multi-state modeling methods. We illustrated the functionality of the platform by quantifying outcomes across smoking status (current, former, never smokers) and by estimating the effect of smoking cessation on resource use and survival, by comparing outcomes of hypothetical cohorts of smokers who quit at diagnosis and smokers that continued to smoke post diagnosis. The cumulative incidence of all-cause mortality was 37.9% (95% CI: 34.9, 41.4) for never smokers, 34.7% (95% CI: 32.1, 36.9) for current smokers, and 46.4% (95% CI: 43.6, 49.0) for former smokers, at 14 years. Over 14 years, smokers who did not quit at diagnosis had 16.3% (95% CI: 9.6, 38.4%) more COPD-related emergency department visits than smokers who quit at diagnosis. In summary, we combined methods from clinical and economic modeling to create a novel tool that policymakers and health economists can use to inform future COPD policy decisions and quantify the effect of modifying COPD risk factors on resource utilization and morality.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Formulação de Políticas , Doença Pulmonar Obstrutiva Crônica/mortalidade , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar Tabaco/efeitos adversos , Idoso , Análise Custo-Benefício , Feminino , Recursos em Saúde/economia , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , não Fumantes/estatística & dados numéricos , Ontário , Estudos Retrospectivos , Fatores de Risco , Fumantes/estatística & dados numéricos
17.
Med Hypotheses ; 143: 110153, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: covidwho-688792

RESUMO

Reports from various countries suggest that tobacco smoking might protect from SARS-CoV-2 infection, since the prevalence of smoking in COVID-19 hospitalized patients is lower than in the respective general population. Apart from nicotine or other chemicals contained in tobacco smoke, we propose that a single-stranded RNA virus that infects tobacco leaves, tobacco mosaic virus (TMV), might be implicated in this effect. TMV, though non-pathogenic, is found in smokers' airways, and stimulates adaptive and innate immunity, with release of specific antibodies and interferons. The latter may have preventive and/or therapeutic effects against COVID-19. If confirmed by epidemiological and interventional studies, this might lead to the use of TMV as an immunological adjuvant against SARS-CoV-2 infection and COVID-19 disease.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Modelos Imunológicos , Pandemias , Pneumonia Viral/imunologia , Fumantes , Vírus do Mosaico do Tabaco/imunologia , Produtos do Tabaco/virologia , Fumar Tabaco , Animais , Anticorpos Antivirais/biossíntese , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Resistência à Doença , Humanos , Interferons/biossíntese , Camundongos , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Sistema Respiratório/imunologia , Sistema Respiratório/virologia , Vírus do Mosaico do Tabaco/isolamento & purificação , Fumar Tabaco/epidemiologia , Receptores Toll-Like/imunologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-32722469

RESUMO

Combustible tobacco users appear to be at greater risk for serious complications from COVID-19. This study examined cigar smokers' perceived risk of COVID-19, quit intentions, and behaviors during the current pandemic. We conducted an online study between 23 April 2020 to 7 May 2020, as part of an ongoing study examining perceptions of different health effects of cigars. All participants used cigars in the past 30 days (n = 777). Three-quarters of the sample (76.0%) perceived they had a higher risk of complications from COVID-19 compared to non-smokers. The majority of participants (70.8%) intended to quit in the next six months due to COVID-19, and almost half of the sample (46.5%) reported making a quit attempt since the start of the COVID-19 pandemic. Far more participants reported increasing their tobacco use since COVID-19 started (40.9%) vs. decreasing their tobacco use (17.8%). Black or African American participants, participants who reported using a quitline, and participants with higher COVID-19 risk perceptions had higher intentions to quit using tobacco due to COVID-19, and higher odds of making a quit attempt since COVID-19 started. More research is needed to understand how tobacco users are perceiving COVID-19 risks and changing their tobacco use behaviors.


Assuntos
Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Fumantes/psicologia , Abandono do Uso de Tabaco/psicologia , Adulto , Afro-Americanos , Betacoronavirus , Fumar Charutos , Infecções por Coronavirus/etnologia , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/etnologia , Tabaco , Produtos do Tabaco , Uso de Tabaco , Abandono do Uso de Tabaco/etnologia , Estados Unidos
19.
PLoS One ; 15(7): e0235709, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32650339

RESUMO

BACKGROUND: Since 2005, the Smoking Treatment for Ontario Patients (STOP) program has provided smoking cessation treatment of varying form and intensity to smokers through 11 distinct treatment models, either in-person at partnering healthcare organizations or remotely via web or telephone. We aimed to characterize the patient populations reached by different treatment models. METHODS: We linked self-report data to health administrative databases to describe sociodemographics, physical and mental health comorbidity, healthcare utilization and costs. Our sample consisted of 107,302 patients who enrolled between 18Oct2005 and 31Mar2016, across 11 models operational during different time periods. RESULTS: Patient populations varied on sociodemographics, comorbidity burden, and healthcare usage. Enrollees in the Web-based model were youngest (median age: 39; IQR: 29-49), and enrollees in primary care-based Family Health Teams were oldest (median: 51; IQR: 40-60). Chronic Obstructive Pulmonary Disease and hypertension were the most common physical health comorbidities, twice as prevalent in Family Health Teams (32.3% and 30.8%) than in the direct-to-smoker (Web and Telephone) and Pharmacy models (13.5%-16.7% and 14.7%-17.7%). Depression, the most prevalent mental health diagnosis, was twice as prevalent in the Addiction Agency (52.1%) versus the Telephone model (25.3%). Median healthcare costs in the two years up to enrollment ranged from $1,787 in the Telephone model to $9,393 in the Addiction Agency model. DISCUSSION: While practitioner-mediated models in specialized and primary care settings reached smokers with more complex healthcare needs, alternative settings appear better suited to reach younger smokers before such comorbidities develop. Although Web and Telephone models were expected to have fewer barriers to access, they reached a lower proportion of patients in rural areas and of lower socioeconomic status. Findings suggest that in addition to population-based strategies, embedding smoking cessation treatment into existing healthcare settings that reach patient populations with varying disparities may enhance equitable access to treatment.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Fumantes/psicologia , Adulto , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Depressão/patologia , Feminino , Custos de Cuidados de Saúde , Humanos , Hipertensão/epidemiologia , Hipertensão/patologia , Internet , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/patologia , Abandono do Hábito de Fumar , Inquéritos e Questionários , Telefone
20.
PLoS One ; 15(7): e0235276, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32673331

RESUMO

Smoking cessation reduces the cardiovascular risk but increases body weight. We investigated the risk of subsequent myocardial infarction and ischemic stroke according to weight gain after smoking cessation, using a nationwide population based cohort. We enrolled 3,797,572 Korean adults aged over 40 years who participated in national health screenings between 2009 and 2010. Subjects who quit smoking were classified into three subgroups according to the weight change between baseline and 4 years prior. Myocardial infarctions and ischemic strokes were followed until the end of 2015. We compared the hazard ratios among smoking cessation subgroups, non-smokers, and current smokers. The mean changes in weight (1.5 ± 3.9 kg) of the smoking cessation group were higher than those of the other groups (p < 0.0001). A total of 31,277 and 46,811 subjects were newly diagnosed with myocardial infarction and ischemic stroke, respectively. Regardless of weight change, all subgroups of smoking cessation had significantly less risk than current smokers. The subgroup of smoking cessation with weight gain over 4kg showed the lowest risk for myocardial infarctions (hazard ratio 0.646, 95% confidence interval 0.583-0.714, p < 0.0001) and ischemic strokes (hazard ratio 0.648, 95% confidence interval 0.591-0.71, p < 0.0001) after multivariable adjustment. In conclusion, weight gain after smoking cessation did not adversely affect the cardiovascular protective effect.


Assuntos
Infarto Encefálico/epidemiologia , Infarto do Miocárdio/epidemiologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/efeitos adversos , Ganho de Peso , Adulto , Idoso , Infarto Encefálico/etiologia , Infarto Encefálico/prevenção & controle , Ex-Fumantes/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/prevenção & controle , não Fumantes/estatística & dados numéricos , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de Risco , Fumantes/estatística & dados numéricos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA