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1.
Medicine (Baltimore) ; 98(40): e17375, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577741

RESUMO

Achieving abstinence in schizophrenic smokers using a combination of medications and cognitive behavioral therapy is feasible; however, abstinence rates are significantly lower compared to the general population and studies are scanty. Additionally, maintaining sustained abstinence and preventing relapse is a major limiting factor and represents key tasks in managing tobacco dependence in schizophrenic patients. Several theories have been postulated to explain the higher tendency of tobacco use among schizophrenic individuals. Schizophrenic patients may use nicotine as a "self-medication" strategy to improve negative symptoms of schizophrenia. However, studies suggest that although nicotine may act as an anxiolytic acutely, chronic use of nicotine may lead to increased anxiety with the possibility of increased catecholamines, which is confirmed with the prevalence of tachycardia and hypertension in smokers in general. On this basis, the main objective of our present study was to assess anxiety in schizophrenic smoking and nonsmoking patients by comparing the number of anxiety and agitation episodes and evaluating the amount of antianxiety/antiagitation medication used by each group. A separate objective was to document the unmet needs of smoking cessation programs in treating schizophrenic patients. Consequently, in the present retrospective cohort study, it was observed that schizophrenic smokers tend to have higher anxiety episodes and utilize as-needed medications at a higher frequency compared to nonsmokers for the relief of anxiety and agitation symptoms. Further research is warranted to examine these results on a larger scale.


Assuntos
Ansiedade/epidemiologia , Fumar Cigarros/epidemiologia , Esquizofrenia/epidemiologia , Ansiolíticos/uso terapêutico , Antipsicóticos/uso terapêutico , Ansiedade/tratamento farmacológico , Feminino , Humanos , Masculino , Estudos Retrospectivos , Esquizofrenia/tratamento farmacológico , Fumantes , Abandono do Hábito de Fumar/métodos
2.
Mymensingh Med J ; 28(4): 808-810, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599244

RESUMO

Cigarette smoking is a practice in which tobacco (leaf of Nicotina Tabacum) is burned and the smoke (heterogeneous aerosol) is tasted or inhaled. Smoking may be linked to insulin resistance that leads to impaired glucose and lipid metabolism. Aim of the study was to assess the levels of fasting serum glucose level in healthy male cigarette smokers in order to compare this parameter with healthy non smokers. This comparative study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2013 to June 2014. One hundred healthy male subjects (75 male were cigarette smokers as study group and 25 male were non smokers as control group) aged between 16 to 40 years were enrolled in this study. Fasting serum glucose was estimated by GOD-PAP Method. Data were expressed as mean±SD and statistical significance of difference among the group was calculated by unpaired students''t' test. The mean±SD fasting serum glucose (FSG) levels were higher in smoker group in comparison to the non smoker group. There were gradual increases in FSG levels in the smokers as the duration of smoking was increased and these were 4.75±0.88, 5.12±0.67, 5.29±0.47 and 5.58±2.05mmol/L in group I, IIA, IIB and IIC respectively. This study concludes cigarette smoking impair the carbohydrate metabolism and increase fasting serum glucose level in accordance with the duration of smoking.


Assuntos
Glicemia , Fumantes/estatística & dados numéricos , Fumar/sangue , Adolescente , Adulto , Bangladesh , Jejum , Glucose , Humanos , Masculino , Adulto Jovem
3.
Am Surg ; 85(10): 1159-1161, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31657315

RESUMO

There are conflicting views regarding techniques for repair of small umbilical hernias (UHs). Here, we compare the recurrence rate in primary repair with that reported for mesh repair by examining a single surgeon's practice at a large medical center with a comprehensive electronic medical record. A six-year retrospective review of primary UH repairs between January 2012 and December 2017 at Kaiser Permanente Los Angeles Medical Center was undertaken. Patients were identified through a database search of the electronic medical record. The primary endpoint of UH recurrence was examined; median follow-up was 3.4 years. Primary, elective UH repair was performed in 244 patients; 71 per cent of hernias were small (<2 cm). The total number of recurrences was seven (3%). The t test analysis showed significant differences in the average size of hernia defects between those with recurrences (2 cm) and those without (1.4 cm), P < 0.05. Primary repair affords low infection and recurrence rates, comparable to those reported for mesh repair. Our single-surgeon/large-volume study contributes to the evidence that primary UH repair is a safe and durable method, with low risk of recurrence. The use of absorbable monofilament suture, and selection for lower BMI and smaller hernia sizes proved to be effective.


Assuntos
Hérnia Umbilical/cirurgia , Herniorrafia/estatística & dados numéricos , Telas Cirúrgicas/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , California , Feminino , Hérnia Umbilical/patologia , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Hospitais com Alto Volume de Atendimentos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Fumantes/estatística & dados numéricos , Telas Cirúrgicas/efeitos adversos , Suturas , Técnicas de Fechamento de Ferimentos
5.
BMC Public Health ; 19(1): 1083, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399047

RESUMO

BACKGROUND: The recent development of smoking cessation interventions for smokers with chronic diseases has focused heavily on brief interventions. However, these interventions are too brief to make an impact on these smokers, especially when most of them are without any intention to quit. Previous studies showed that smokers who did not want to quit might be interested in changing other health behaviours. Also, once people engage in a health behaviour, they are found more likely to change other unhealthy habits. Hence, a general health promotion approach could be a feasible approach to motivate smokers who do not want to quit to first engage in any desirable health behaviour, and later quit smoking when they intend to do so. This study aims to determine the potential efficacy and effect size of such intervention approach in promoting smoking cessation for smokers with chronic diseases. METHODS: This is a randomized controlled trial. A convenience sample of 60 smokers with chronic diseases will be randomly assigned into either experimental (n = 30) or control group (n = 30). Smokers in the experimental group will receive an individual face-to-face brief motivational interviewing (MI) with generic advice on selected health behaviour. More brief MI messages will be delivered to them via WhatsApp/WeChat for 6 months. For subject in the control group, they will be asked to indicate their desirable health-related practice. However, no MI and booster interventions will be given. All subjects will complete a questionnaire at 1, 3, 6 and 12 months. Subjects abstinent from cigarettes at 12 months will perform a biochemical validation. The primary outcome is biochemically validated smoking abstinence at 12 months. Effect size of the intervention will be estimated by the odd ratios using intention-to-treat. DISCUSSION: This is the first study to determine the potential efficacy for the use of a personalized general health promotion approach in promoting smoking cessation for smokers with chronic diseases. If our proposed intervention is effective, we will able to assist smokers with chronic disease to quit smoking and change their health behaviour simultaneously. TRIAL REGISTRATION: CinicalTrials.gov NCT03983330 (Prospectively registered), registered on June 12, 2019.


Assuntos
Doença Crônica/epidemiologia , Comunicação , Tecnologia da Informação , Aplicativos Móveis , Entrevista Motivacional/métodos , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Adulto , Feminino , Humanos , Masculino , Projetos de Pesquisa , Fumantes/estatística & dados numéricos
6.
Mymensingh Med J ; 28(3): 582-585, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31391430

RESUMO

Cigarette smoking is a practice in which tobacco (leaf of Nicotina Tabacum) is burned and the smoke (heterogeneous aerosol) is tasted or inhaled. The systolic and diastolic blood pressures were significantly elevated among smokers as compared with non smokers. This study was done to assess the blood pressure in healthy male cigarette smokers in order to compare this parameter with healthy male non smokers. This comparative study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh, from July 2013 to June 2014. One hundred healthy male subjects (75 male were cigarette smokers as study group and 25 male were non smokers as control group) aged between 16 to 40 years were enrolled in this study. Blood pressure of the individual was measured by an android sphygmomanometer with appropriate size of cuff and stethoscope. Data were expressed as mean±SD and statistical significance of difference among the groups was calculated by unpaired student's 't' test. The mean±SD of systolic and diastolic blood pressure were higher in smoker group in comparison to the non smoker group. There were gradual increases in systolic and diastolic blood pressure in the smokers as the duration of smoking was increased. This study concludes cigarette smoking increase systolic and diastolic blood pressure in accordance with the duration of smoking.


Assuntos
Pressão Sanguínea , Fumantes , Fumar , Adolescente , Adulto , Bangladesh , Humanos , Masculino , Fumar/efeitos adversos , Adulto Jovem
7.
JAMA ; 322(7): 642-650, 2019 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429895

RESUMO

Importance: The time course of cardiovascular disease (CVD) risk after smoking cessation is unclear. Risk calculators consider former smokers to be at risk for only 5 years. Objective: To evaluate the association between years since quitting smoking and incident CVD. Design, Setting, and Participants: Retrospective analysis of prospectively collected data from Framingham Heart Study participants without baseline CVD (original cohort: attending their fourth examination in 1954-1958; offspring cohort: attending their first examination in 1971-1975) who were followed up through December 2015. Exposures: Time-updated self-reported smoking status, years since quitting, and cumulative pack-years. Main Outcomes and Measures: Incident CVD (myocardial infarction, stroke, heart failure, or cardiovascular death). Primary analyses included both cohorts (pooled) and were restricted to heavy ever smokers (≥20 pack-years). Results: The study population included 8770 individuals (original cohort: n = 3805; offspring cohort: n = 4965) with a mean age of 42.2 (SD, 11.8) years and 45% male. There were 5308 ever smokers with a median 17.2 (interquartile range, 7-30) baseline pack-years, including 2371 heavy ever smokers (406 [17%] former and 1965 [83%] current). Over 26.4 median follow-up years, 2435 first CVD events occurred (original cohort: n = 1612 [n = 665 among heavy smokers]; offspring cohort: n = 823 [n = 430 among heavy smokers]). In the pooled cohort, compared with current smoking, quitting within 5 years was associated with significantly lower rates of incident CVD (incidence rates per 1000 person-years: current smoking, 11.56 [95% CI, 10.30-12.98]; quitting within 5 years, 6.94 [95% CI, 5.61-8.59]; difference, -4.51 [95% CI, -5.90 to -2.77]) and lower risk of incident CVD (hazard ratio, 0.61; 95% CI, 0.49-0.76). Compared with never smoking, quitting smoking ceased to be significantly associated with greater CVD risk between 10 and 15 years after cessation in the pooled cohort (incidence rates per 1000 person-years: never smoking, 5.09 [95% CI, 4.52-5.74]; quitting within 10 to <15 years, 6.31 [95% CI, 4.93-8.09]; difference, 1.27 [95% CI, -0.10 to 3.05]; hazard ratio, 1.25 [95% CI, 0.98-1.60]). Conclusions and Relevance: Among heavy smokers, smoking cessation was associated with significantly lower risk of CVD within 5 years relative to current smokers. However, relative to never smokers, former smokers' CVD risk remained significantly elevated beyond 5 years after smoking cessation.


Assuntos
Doenças Cardiovasculares/epidemiologia , Fumantes , Abandono do Hábito de Fumar , Adulto , Doenças Cardiovasculares/prevenção & controle , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Risco , Fatores de Risco
8.
Clin Implant Dent Relat Res ; 21(4): 702-707, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31267668

RESUMO

BACKGROUND: Assessment of cotinine levels in the peri-implant sulcular fluid (PISF) may serve as a valuable biomarker of peri-implant diseases in nicotine-product users. PURPOSE: The aim of the present study was to compare cotinine levels in the PISF among cigarette smokers, waterpipe users, electronic-cigarette users, and nonsmokers. MATERIALS AND METHODS: Cigarette smokers, waterpipe smokers, electronic-cigarette users, and nonsmokers were included. A questionnaire was used to collect information about age, gender, duration of smoking and vaping, family history of smoking, duration of smoking/vaping, and daily frequency of smoking/vaping. Implant-related data including implant dimensions and duration of implants in function were also recorded. In all groups, peri-implant probing depth (PD), bleeding on probing (BoP), and plaque index (PI) were assessed. Using standard techniques, PISF was collected and levels of cotinine in the PISF were measured. Sample-size estimation was performed, and statistical comparisons were done using one-way analysis of variance and Bonferroni post hoc adjustment tests. P values below .05 were categorized as statistically significant. RESULTS: One hundred two male individuals (35 cigarette smokers, 33 waterpipe smokers, 34 electronic-cigarette users, and 35 nonsmokers) were included. Scores of peri-implant PI (P < .05) and PD (P < .05) were significantly higher among cigarette smokers, waterpipe smokers, and electronic-cigarette users compared with nonsmokers. Peri-implant BoP was more often manifested in nonsmokers compared with cigarette smokers (P < .05), waterpipe smokers (P < .05), and electronic-cigarette users (P < .05). The volume of collected PISF was significantly higher among cigarette (P < .05) and waterpipe smokers (P < .05) and electronic-cigarette users (P < .05) than nonsmokers. Cotinine levels were significantly higher in the PISF of cigarette (P < .05) and waterpipe smokers (P < .05) and electronic-cigarette users (P < .05) than nonsmokers. CONCLUSIONS: Habitual use of nicotinic products enhances the expression of cotinine in the PISF. Cotinine levels in the PISF of cigarette and waterpipe smokers and electronic-cigarette users are comparable.


Assuntos
Cotinina/metabolismo , Sistemas Eletrônicos de Liberação de Nicotina , Fumantes , Fumar Cachimbo de Água , Índice de Placa Dentária , Humanos , Masculino , não Fumantes
9.
J Stroke Cerebrovasc Dis ; 28(9): 2496-2505, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31279697

RESUMO

BACKGROUND: Nicotine may have neuroprotective effects on the injured brain through modulation of the cholinergic anti-inflammatory pathway. AIMS: This study aimed to evaluate the relationship between cigarette smoking and outcomes in patients with spontaneous intracerebral hemorrhage (ICH). METHODS: This was a retrospective review of consecutive ICH patients enrolled in the ICH Outcomes Project from 2009 to 2017. Patients with age ≥18 years and baseline modified Rankin Scale (mRS) score 0-2 were included. Smoking patterns were categorized as recent smoker (≤30 days prior to ICH) and not recent smoker (>30 days prior to ICH). Not recent smokers were further categorized into former smokers and nonsmokers. The primary outcome was good outcome (90-day mRS ≤ 2). Secondary outcomes were excellent outcome (90-day mRS 0-1), 90-day Barthel Index, and in-hospital and 90-day mortality. RESULTS: The study cohort comprised 545 patients, including 60 recent smokers and 485 not recent smokers. Recent smokers had higher rates of good (35% versus 23%; odds ratio [OR] = 1.787, P = .047) and excellent (25% versus 13%; OR = 2.220, P = .015) outcomes compared to not recent smokers. These differences were not significant after baseline adjustments. Recent smokers had higher rates of good (36% versus 24%; OR = 1.732, P = .063) and excellent (25% versus 13%; OR = 2.203, P = .018) outcomes compared to nonsmokers. These differences were not significant after baseline adjustments. A 90-day Barthel Index, in-hospital, and 90-day mortality were comparable between recent and not recent smokers, recent and nonsmokers, and former and nonsmokers. CONCLUSIONS: Despite potential neuroprotective effects of nicotine found in cigarettes, these may be outweighed by the detrimental effects of cigarette smoking on health outcomes.


Assuntos
Encéfalo/fisiopatologia , Hemorragia Cerebral/fisiopatologia , não Fumantes , Fumantes , Fumar/efeitos adversos , Adulto , Idoso , Encéfalo/efeitos dos fármacos , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/mortalidade , Bases de Dados Factuais , Avaliação da Deficiência , Feminino , Nível de Saúde , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Neuroprotetores/administração & dosagem , Fármacos Neuroprotetores/efeitos adversos , Nicotina/administração & dosagem , Nicotina/efeitos adversos , Agonistas Nicotínicos/administração & dosagem , Agonistas Nicotínicos/efeitos adversos , Valor Preditivo dos Testes , Prognóstico , Fatores de Proteção , Recuperação de Função Fisiológica , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fumar/mortalidade , Abandono do Hábito de Fumar , Fatores de Tempo
10.
BMC Public Health ; 19(1): 1000, 2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31345189

RESUMO

BACKGROUND: The dual-process theory is central to several models of addiction, implying the importance of automatic processes in the maintenance and development of addiction. Implicit beliefs are traces of previous experience which relate to the representation in cognition. Implicit behavioral tendencies are traces of previous experience which relate to the representation in behavioral tendencies. In this study, we aim to provide behavioral evidence for implicit beliefs and implicit behavioral tendencies towards smoking-related cues among Chinese male smokers and non-smokers. We also examine the relationships among implicit beliefs, implicit behavioral tendencies and smoking behaviors of smokers. METHODS: In order to achieve these goals, we used an implicit association test (IAT) to measure implicit beliefs and implicit behavioral tendencies simultaneously. Thirty-nine smokers and twenty-five non-smokers were tested, using smoking-related words and images, as well as neutral words and images as stimuli. RESULTS: Our analysis shows significant differences in smokers' and non-smokers' implicit beliefs and behavioral tendencies (t62 = 3.494, p < 0.001; t62 = 5.034, p < 0.001). In the group of smokers, implicit beliefs and implicit behavioral tendencies were positively correlated with each other (r = 0.460, p < 0.01). In addition, smokers' scores for implicit behavioral tendencies are negatively correlated with the number of cigarettes smoked per day (r = - 0.51, p < 0.001). CONCLUSIONS: This study suggests that implicit beliefs and behavioral tendencies toward smoking-related cues vary significantly between Chinese male smokers and non-smokers. In addition, there is a positive correlation between implicit beliefs and behavioral tendencies within smokers. It also shows for the first time that the implicit behavioral tendencies are related to smoking behaviors. Our results may be considered as references for smoking cessation interventions focused on changes at the implicit level, and they provide a new perspective for measuring different dimensions of implicit attitudes by an IAT. This finding might promote the development of the network theory of implicit attitudes.


Assuntos
Sinais (Psicologia) , Conhecimentos, Atitudes e Prática em Saúde , não Fumantes/psicologia , Fumantes/psicologia , Fumar/psicologia , China , Estudos Transversais , Humanos , Masculino , não Fumantes/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Adulto Jovem
11.
BMC Public Health ; 19(1): 976, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331316

RESUMO

BACKGROUND: Data on electronic cigarette (e-cigarette) use among health professional students, who can play a central role in promoting healthy habits and smoking cessation, are sparse. Moreover, the association between e-cigarettes and smoking habits is still debated. The present study aimed to investigate the diffusion of e-cigarette use among nursing students in north-eastern Italy and explore its association with tobacco smoking. METHODS: In 2015, a questionnaire focused on e-cigarette use and tobacco smoking habits was anonymously administered to 2020 students attending nursing courses held by Verona University in 5 different centres. Of these students, 1463 (72.4%) answered the questionnaire. The influence of e-cigarette ever use on both tobacco smoking initiation in all subjects and smoking cessation among ever smokers was investigated by multivariable logistic models. RESULTS: Most responders were female (77.1%), and the mean (SD) age was 23.2 (4.2) years. Nearly all students (94.7%) had heard about e-cigarettes. Approximately one-third (30.3, 95% CI 27.9-32.7%) had ever used e-cigarettes, but only 2.1% (1.5-3.0%) had used e-cigarettes in the last month. Very few (2.1%) of those responders who had never used e-cigarettes were willing to try them. Prevalence values were much higher for tobacco smoking: 40.9% of responders reported being current tobacco smokers, and 10.1% reported being past smokers. Ever use and current use of e-cigarettes were reported by 57.2 and 4.4% of current tobacco smokers and by 12.0 and 0.6% of never or past smokers, respectively (p < 0.001). In multivariable analysis, students who ever used e-cigarettes had 13 times greater odds of being an ever tobacco smoker than never users, whereas they had three times lower odds of being a former smoker. Only 26 students were currently using both electronic and tobacco cigarettes, and most declared that they used e-cigarettes to stop or reduce tobacco smoking. Of note, only three students reported that they had completely stopped smoking thanks to e-cigarette use. CONCLUSION: Use of e-cigarettes seemed to be rather rare among Italian nursing students and was mainly restricted to current smokers. E-cigarette use was not associated with smoking cessation in nursing students.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Estudantes de Enfermagem/psicologia , Vaping/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Itália/epidemiologia , Masculino , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários , Fumar Tabaco/psicologia , Adulto Jovem
12.
Br J Nurs ; 28(14): 912-917, 2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31348713

RESUMO

Two landmark studies demonstrated survival benefit in chronic obstructive pulmonary disease (COPD) complicated by chronic hypoxaemia with the prescription of long-term oxygen therapy (LTOT). Best practice evidence therefore recommends that individuals with stable COPD and resting hypoxaemia (PaO2≤7.3 kPa) should be assessed for long-term oxygen therapy. However, it is estimated that up to one-quarter of COPD patients prescribed LTOT continue to smoke. Oxygen therapy consequently presents an obvious fire hazard in the case of such patients, who are therefore at greater risk of death or sustaining devastating head and neck burns. This article critically analyses, through the context of a care study, the professional, ethical and legal issues involved in making a safe prescribing decision for LTOT in an individual with COPD who is a current smoker. Home oxygen prescription is a growing trend in the COPD population, and it is important for nurse prescribers to be aware of the issues highlighted in the article to ensure safe prescribing practices.


Assuntos
Serviços de Assistência Domiciliar , Oxigenoterapia/enfermagem , Prescrições/enfermagem , Doença Pulmonar Obstrutiva Crônica/terapia , Humanos , Oxigenoterapia/efeitos adversos , Segurança do Paciente , Doença Pulmonar Obstrutiva Crônica/enfermagem , Fumantes
14.
BMC Cancer ; 19(1): 580, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31256763

RESUMO

BACKGROUND: Smoking cessation is a key step towards improving cancer care and outcomes. However, smoking cessation interventions are underprovided in oncology settings. Within Jordan's only comprehensive oncology center, we sought to evaluate receipt of care at a smoking cessation clinic and the effect of assisted abstinence through the smoking cessation clinic on short-term (two-year) survival after a cancer diagnosis. METHODS: We employed a retrospective cohort study design. Cancer registry and smoking cessation clinic data for adult Jordanian cancer patients diagnosed between 2009 and 2016, who also were cigarette smokers, and who received full treatment at King Hussein Cancer Center, were analyzed. Specifically, descriptive statistics of patients who visited the smoking cessation clinic were generated, and short-term (two-year) hazard of death of patients based on whether or not smoking cessation clinic-assisted abstinence occurred, were evaluated. RESULTS: There were 3403 patients who met our inclusion criteria. Approximately 21% of cancer patients were seen at the smoking cessation clinic, and significant demographic and clinical disparities in who was being seen [at the smoking cessation clinic] existed. In 2387 patients with available survival data, smokers who never went to the smoking cessation clinic (or were seen only once, or seen a year or more from diagnosis) had a hazard of death 2.8 times higher than smokers who had visited the smoking cessation clinic and who also confirmed they had not smoked on atleast two of their 3-, 6- or 12-month follow-up visits (95% confidence interval [CI] = 1.7-4.6). Non-abstainers at the smoking cessation clinic exhibited a similar disadvantage (HR 2.7, 95% CI 1.4-5.0). CONCLUSIONS: Although evidence-based smoking cessation interventions increase the likelihood of abstinence and can lower the short-term hazard of death during cancer treatment, there is a deprioritization of smoking cessation interventions during cancer care, as indicated by low proportions of patients seen at the smoking cessation clinic. Our findings emphasize the importance of promoting interventions to avail smoking cessation interventions in oncology settings within the cancer treatment phase.


Assuntos
Neoplasias/terapia , Abandono do Hábito de Fumar/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Humanos , Jordânia/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/mortalidade , Estudos Retrospectivos , Fumantes/estatística & dados numéricos , Análise de Sobrevida , Adulto Jovem
15.
J Urol ; 202(6): 1248-1254, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31290707

RESUMO

PURPOSE: We explored the association between tobacco use and genitourinary cancer specific survival in a contemporary, nationally representative sample of the United States civilian population. MATERIALS AND METHODS: A total of 493,282 participants in the National Longitudinal Mortality Study who provided detailed tobacco information from 1993 to 2005 were included in study. Our primary outcome was death from bladder, kidney or prostate cancer. Cause of death was determined from death certificates. Analyzed smoking parameters included smoking status at the time of the survey, age at the start of smoking and home smoking rules. Multivariable Cox regression models were used to assess associations of different smoking parameters with bladder, kidney and prostate cancer specific mortality. RESULTS: During a 5-year followup 5.6% of participants who had ever smoked died compared to 3.1% of those who had never smoked (p <0.0001). Of those who died of bladder, kidney and prostate cancer 62%, 58% and 62%, respectively, were ever smokers. On multivariable analysis ever smoking was associated with bladder and kidney cancer mortality (HR 1.92, 95% CI 1.25-2.97, and HR 1.54, 95% CI 1.01-2.34, respectively). Additionally, starting to smoke during teenage years and smoking at home were associated with bladder cancer specific mortality (HR 2.14, 95% CI 1.28-3.56 and HR 2.99, 95% CI 1.34-6.65) and kidney cancer specific mortality (HR 1.65, 95% CI 1.03-2.66 and HR 2.84, 95% CI 1.54-5.23, respectively). However, only everyday smoking was associated with an increased risk of prostate cancer mortality (HR 1.81, 95% CI 1.30-2.53). CONCLUSIONS: In a nationally representative study we confirmed the association between smoking intensity and mortality from genitourinary malignancies. Starting to smoke at a younger age and smoking at home conferred a significantly higher risk of death from bladder and kidney cancers.


Assuntos
Neoplasias Renais/mortalidade , Neoplasias da Próstata/mortalidade , Fumar/epidemiologia , Neoplasias da Bexiga Urinária/mortalidade , Fatores Etários , Idoso , Feminino , Seguimentos , Humanos , Neoplasias Renais/etiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , não Fumantes/estatística & dados numéricos , Neoplasias da Próstata/etiologia , Fatores de Risco , Fatores Sexuais , Fumantes/estatística & dados numéricos , Fumar/efeitos adversos , Estados Unidos/epidemiologia , Neoplasias da Bexiga Urinária/etiologia
16.
Zhonghua Yi Xue Za Zhi ; 99(26): 2068-2072, 2019 Jul 09.
Artigo em Chinês | MEDLINE | ID: mdl-31315379

RESUMO

Objective: To estimate the effect of smoking cessation on the risk of hypertension. Methods: Literature search of PubMed, Embase, Vip and CNKI between 2001 and 2016 was performed to retrieve prospective cohort studies assessing the relative risks (RR) of smoking cessation and current smoking on hypertension. The pooled RR with 95% confidence intervals (CI) were calculated using random effects models, and subgroup analyses were employed based on participants and study characteristics. Results: A total of 8 eligible prospective cohort studies with 70 130 participants and 21 238 incident cases of hypertension were retrieved. The individuals aged 25-84 years, among them, 53.64% (37 618/70 130) were men and the follow-up period were 4-14.5 years. The pooled RR of hypertension was 1.08 (95%CI: 0.94-1.20) for comparing smoking cessation with current smoking and the pooled adjusted RR was 0.91 (95%CI: 0.33-2.50) (both P>0.05). Conclusions: Smoking cessation did not increased risks of hypertension. Therefore, effective strategies are needed to encourage smokers to quit.


Assuntos
Hipertensão , Abandono do Hábito de Fumar , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Hipertensão/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fumantes , Fumar
17.
Int J Occup Med Environ Health ; 32(4): 527-536, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31241624

RESUMO

OBJECTIVES: The aim of the current study was to assess the perceived treatment effectiveness and beliefs with respect to the best advisor who could conduct smoking cessation treatment or counseling among socially disadvantaged light and heavy smokers. This could be crucial for implementation of a successful smoking cessation intervention among this vulnerable population. MATERIAL AND METHODS: The current assessments were based on the data collected during the second wave of a cross-sectional study performed in the Piotrkowski District among 1668 adults aged 18-59, entitled to social aid from welfare institutions. Face-to-face interviews were conducted to collect the relevant data. RESULTS: The current daily smoking status was declared by 31% of the participants. About 23% of the study sample (74% of daily smokers) admitted to being heavy smokers with a meaningful difference between men and women (p < 0.05). About 29% of the daily smokers indicated that medications/pharmacotherapy could be a good method for giving up the habit. Fifteen percent of the participants shared the opinion that a smoking cessation specialist is the best advisor for counseling, and only about 7% would choose a general practitioner or pharmacist, and even fewer a nurse, as a person who could provide help to smokers. There were no statistically significant differences in any of the evaluated perceptions between the light and heavy smokers (p > 0.05). CONCLUSIONS: A high share of heavy smokers among socially disadvantaged people, and their perception that medications/pharmacotherapy would be a good solution to quit smoking, underline the need for stronger support for this method, including relevant financing resources and training. However, this method should be applied along with behavioral counseling. Int J Occup Med Environ Health. 2019;32(4):527-36.


Assuntos
Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Resultado do Tratamento , Adolescente , Adulto , Aconselhamento , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Agentes de Cessação do Hábito de Fumar , Populações Vulneráveis/psicologia
18.
BMC Cancer ; 19(1): 631, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31242899

RESUMO

BACKGROUND: Mammographic density is one of the strongest risk factors for breast cancer. In the general population, mammographic density can be modified by various exposures; whether this is true for women a strong family history is not known. Thus, we evaluated the association between reproductive, hormonal, and lifestyle risk factors and mammographic density among women with a strong family history of breast cancer but no BRCA1 or BRCA2 mutation. METHODS: We included 97 premenopausal and 59 postmenopausal women (age range: 27-68 years). Risk factor data was extracted from the research questionnaire closest in time to the mammogram performed nearest to enrollment. The Cumulus software was used to measure percent density, dense area, and non-dense area for each mammogram. Multivariate generalized linear models were used to evaluate the relationships between breast cancer risk factors and measures of mammographic density, adjusting for relevant covariates. RESULTS: Among premenopausal women, those who had two live births had a mean percent density of 28.8% vs. 41.6% among women who had one live birth (P=0.04). Women with a high body weight had a lower mean percent density compared to women with a low body weight among premenopausal (17.6% vs. 33.2%; P=0.0006) and postmenopausal women (8.7% vs. 14.7%; P=0.04). Among premenopausal women, those who smoked for 14 years or longer had a lower mean dense area compared to women who smoked for a shorter duration (25.3cm2 vs. 53.1cm2; P=0.002). Among postmenopausal women, former smokers had a higher mean percent density (19.5% vs. 10.8%; P=0.003) and dense area (26.9% vs. 16.4%; P=0.01) compared to never smokers. After applying the Bonferroni correction, the association between body weight and percent density among premenopausal women remained statistically significant. CONCLUSIONS: In this cohort of women with a strong family history of breast cancer, body weight was associated with mammographic density. These findings suggest that mammographic density may explain the underlying relationship between some of these risk factors and breast cancer risk, and lend support for the inclusion of mammographic density into risk prediction models.


Assuntos
Peso Corporal , Densidade da Mama/genética , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/genética , Saúde da Família , Mamografia , Adulto , Idoso , Estudos Transversais , Ex-Fumantes/estatística & dados numéricos , Feminino , Genes BRCA1 , Genes BRCA2 , Humanos , Estilo de Vida , Modelos Lineares , Pessoa de Meia-Idade , Paridade , Pós-Menopausa , Pré-Menopausa , Saúde Reprodutiva , Fatores de Risco , Fumantes/estatística & dados numéricos
19.
Public Health ; 172: 40-42, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31158567

RESUMO

OBJECTIVES: Nationally representative studies suggest 1-2% of Indonesian women (2.3 million) smoke various tobacco products daily; however, in recent years, there has been concern that the tobacco industry has successfully increased female smoking. Our objective was to describe current cigarette smoking behaviors, past quit attempts, and intention to quit of female daily smokers in Surabaya, Indonesia. STUDY DESIGN: Survey. METHODS: Female daily smokers (n = 112) in Surabaya, Indonesia, the country's second largest city, were recruited to participate in a survey during 2018. Convenience sampling was utilized in two malls. Potential participants were intercepted in or near designated smoking areas and invited to the nearby data collection site. Survey items from Global Adult Tobacco Survey and the International Tobacco Control Policy Evaluation Project were utilized. RESULTS: Participants self-reported smoking 13.8 cigarettes per day (7.3 white machine-rolled cigarettes per day, 4.2 kreteks per day, and 2.4 roll-your-own cigarettes per day). Over 75% smoked their first cigarette within 30 min of waking. Over 53% had a heaviness of smoking index score suggesting moderate or high addiction. Approximately half (51%) did not attempt to quit smoking in the previous 12 months, and 55% planned to quit beyond 6 months or not at all. CONCLUSIONS: Our sample smoked five to six more cigarettes per day than female daily smokers in previous national surveys. Relative to previous studies, our data suggest an unexpected preference for white machine-rolled cigarettes and that there could be, at a minimum, pockets of increased smoking and addiction among female daily smokers in Indonesia.


Assuntos
Fumar Cigarros/psicologia , Intenção , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Adolescente , Adulto , Fumar Cigarros/epidemiologia , Feminino , Humanos , Indonésia/epidemiologia , Fumantes/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
20.
Int J Biometeorol ; 63(9): 1209-1216, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31227888

RESUMO

Sulphurous thermal water inhalations have been traditionally used in the treatment of airway diseases. In vivo and in vitro studies reported that they ameliorate mucus rheology, mucociliary clearance and reduce inflammation. Cigarette smoking induces an inflammatory damage, with consequent remodeling of respiratory airways, which in turn affect pulmonary functions. Despite the anti-inflammatory effects of H2S are clinically documented in several airway inflammatory diseases, data on the effects of sulphurous thermal water treatment on pulmonary function and biomarkers of airways inflammation in smokers are still scant. Therefore, we investigated whether a conventional cycle of sulphurous thermal water inhalation produced changes in markers of respiratory inflammation and function. A cohort of 504 heavy current and former smokers underwent 10-day cycles of sulphurous thermal water inhalation. Pulmonary function and metabolic analyses on exhaled breath condensate were then performed at day 0 and after the 10-day treatment. Spirometric data did not change after spa therapy, while exhaled breath condensate analysis revealed that a single 10-day cycle of sulphurous water inhalation was sufficient to induce a statistically significant increase of citrulline levels along with a decrease in ornithine levels, thus shifting arginine metabolism towards a reduced nitric oxide production, i.e. an anti-inflammatory profile. Overall, sulphurous thermal water inhalation impacts on arginine catatabolic intermediates of airways cells, shifting their metabolic balance towards a reduction of the inflammatory activity, with potential benefits for smokers.


Assuntos
Testes Respiratórios , Fumantes , Administração por Inalação , Humanos , Óxido Nítrico , Enxofre
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