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1.
Epidemiol Health ; 43: e2021048, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34525776

RESUMO

OBJECTIVES: This study aimed to examine whether the regional density of tobacco outlets in Korea was associated with the likelihood of attempting to quit among smokers. METHODS: This study was designed as a secondary data analysis of a cross-sectional study. Data from the 2015 Korean Community Health Survey and tobacco outlet registrations in 17 metropolitan cities and provinces with 254 communities in Korea were used for the analysis. In total, 41,013 current smokers (≥19 years of age) were included. Multi-level logistic regression analysis was conducted to investigate regional differences associated with smokers' attempts to quit and to evaluate the effects of individual and regional characteristics on quit attempts. RESULTS: Higher tobacco outlet density was associated with lower odds of attempting to quit. Smokers who resided in districts with the highest tobacco outlet density were 18% less likely to attempt quitting (odds ratio, 0.82; 95% confidence interval, 0.70 to 0.98) than smokers who resided in the regions with the lowest tobacco outlet density (intraclass correlation coefficient, 0.030). CONCLUSIONS: This study showed that quit attempts were related to community-level factors, such as tobacco outlet density, as well as other individual factors. These findings support the implementation of national policies restricting the number of tobacco outlets within communities or zones and limiting tobacco marketing in tobacco outlets.


Assuntos
Comércio/estatística & dados numéricos , Fumantes/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Produtos do Tabaco/provisão & distribuição , Adulto , Idoso , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multinível , República da Coreia/epidemiologia , Fumantes/estatística & dados numéricos , Fumar/epidemiologia , Adulto Jovem
2.
Int J Mol Sci ; 22(14)2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34299215

RESUMO

Synchronous primary malignancies occur in a small proportion of head and neck squamous cell carcinoma (HNSCC) patients. Here, we analysed three synchronous primaries and a recurrence from one patient by comparing the genomic and transcriptomic profiles among the tumour samples and determining the recurrence origin. We found remarkable levels of heterogeneity among the primary tumours, and through the patterns of shared mutations, we traced the origin of the recurrence. Interestingly, the patient carried germline variants that might have predisposed him to carcinogenesis, together with a history of alcohol and tobacco consumption. The mutational signature analysis confirmed the impact of alcohol exposure, with Signature 16 present in all tumour samples. Characterisation of immune cell infiltration highlighted an immunosuppressive environment in all samples, which exceeded the potential activity of T cells. Studies such as the one described here have important clinical value and contribute to personalised treatment decisions for patients with synchronous primaries and matched recurrences.


Assuntos
Neoplasias de Cabeça e Pescoço/genética , Mutação , Recidiva Local de Neoplasia/genética , Neoplasias Primárias Múltiplas/genética , Idoso , Consumo de Bebidas Alcoólicas/genética , Evolução Fatal , Perfilação da Expressão Gênica , Genômica , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Masculino , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/terapia , Estadiamento de Neoplasias , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/terapia , Fumantes/estatística & dados numéricos
3.
BMC Infect Dis ; 21(1): 663, 2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34238232

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is associated with a high mortality rate, especially in patients with severe illness. We conducted a systematic review and meta-analysis to assess the potential predictors of mortality in patients with COVID-19. METHODS: PubMed, EMBASE, the Cochrane Library, and three electronic Chinese databases were searched from December 1, 2019 to April 29, 2020. Eligible studies reporting potential predictors of mortality in patients with COVID-19 were identified. Unadjusted prognostic effect estimates were pooled using the random-effects model if data from at least two studies were available. Adjusted prognostic effect estimates were presented by qualitative analysis. RESULTS: Thirty-six observational studies were identified, of which 27 were included in the meta-analysis. A total of 106 potential risk factors were tested, and the following important predictors were associated with mortality: advanced age, male sex, current smoking status, preexisting comorbidities (especially chronic kidney, respiratory, and cardio-cerebrovascular diseases), symptoms of dyspnea, complications during hospitalization, corticosteroid therapy and a severe condition. Additionally, a series of abnormal laboratory biomarkers of hematologic parameters, hepatorenal function, inflammation, coagulation, and cardiovascular injury were also associated with fatal outcome. CONCLUSION: We identified predictors of mortality in patients with COVID-19. These findings could help healthcare providers take appropriate measures and improve clinical outcomes in such patients.


Assuntos
COVID-19/diagnóstico , COVID-19/mortalidade , Corticosteroides/administração & dosagem , Distribuição por Idade , Doenças Cardiovasculares/epidemiologia , Comorbidade , Bases de Dados Factuais , Dispneia/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Inflamação/epidemiologia , Rim/fisiopatologia , Fígado/fisiopatologia , Masculino , Estudos Observacionais como Assunto , Prognóstico , Fatores de Risco , Distribuição por Sexo , Fumantes/estatística & dados numéricos
4.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48234

RESUMO

O número de fumantes diminuiu no Brasil e o grupo de ex-usuários de tabaco é cada vez maior. Os dados são da Pesquisa Nacional de Saúde (PNS 2019), realizada pelo Instituto Brasileiro de Geografia e Estatística (IBGE), com o apoio o Ministério da Saúde, e divulgada nesta segunda-feira (31), quando é celebrado o Dia Mundial sem Tabaco.


Assuntos
Tabaco , Brasil/etnologia , Fumantes/estatística & dados numéricos , Prevenção do Hábito de Fumar
5.
Medicine (Baltimore) ; 100(22): e25842, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087827

RESUMO

ABSTRACT: To investigate the relationship between urinary cotinine and colorectal neoplasm (CRN).The participants in the health screening cohort of the National Cancer Center who underwent screening colonoscopy between June 2007 and December 2009 were included. A total of 8121 subjects who underwent urinary cotinine measurement within 14 days from the index colonoscopy were included. Cotinine positivity was defined as having a urinary cotinine level ≥50 ng/mL. Follow-up colonoscopy data were collected by reviewing the patients' medical records.Patients were classified according to their urinary cotinine level and self-reported smoking status, and the number of patients with cotinine positivity was 1960 (24.1%). There was no significant difference in the cumulative CRN and advanced CRN (ACRN) risks according to the self-reported smoking status. However, cotinine positivity at the time of index colonoscopy was an independent risk factor for CRN (hazard ratio [HR]= 1.23, P = .006) in follow-up colonoscopy. Moreover, in never- and ex-smokers, cotinine positivity was an independent risk factor for CRN (HR = 1.95, P = .019; HR = 2.12, P = .003, respectively) and ACRN (HR = 8.89, P < .001; HR = 5.03, P = .003) during follow-up colonoscopy. The cumulative incidence of CRN and ACRN was higher in the cotinine-positive never- and ex-smokers than in the cotinine-negative never- and ex-smokers (P < .001 and P = .008, respectively).CRN or ACRN is more likely to occur at follow-up colonoscopy in the urinary cotinine-positive never- and ex-smokers than in the urinary cotinine-negative group. Therefore, urinary cotinine measurements may provide useful information on never- or ex-smokers undergoing screening colonoscopy.


Assuntos
Neoplasias Colorretais/epidemiologia , Cotinina/urina , Fumantes/estatística & dados numéricos , Fumar Tabaco/epidemiologia , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/epidemiologia , Pesos e Medidas Corporais , Colonoscopia/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais
6.
Eur J Vasc Endovasc Surg ; 62(2): 284-293, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34144885

RESUMO

OBJECTIVE: Smoking is a strong risk factor for the development of abdominal aortic aneurysm (AAA). It was hypothesised that a Mediterranean diet via its anti-oxidative properties would decrease the risk of AAA, particularly among smokers. METHODS: The study population included the Cohort of Swedish Men (45 072 men) and the Swedish Mammography Cohort (36 632 women), aged 45 - 83 years at baseline. A modified Mediterranean Diet (mMED) score, including eight food groups, was calculated based on a food frequency questionnaire. Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS: During 17.5 years of follow up (1 427 841 person-years), 1 781 AAA cases (1 496 in men, 285 in women; 1 497 non-ruptured, 284 ruptured) were ascertained via Swedish registers. The mMED score was inversely associated with AAA incidence in men (per each one point increment in mMED score HR 0.96, 95% CI 0.93 - 1.00) and in women (HR 0.83, 95% CI 0.77 - 0.90), for non-ruptured (HR 0.95, 95% CI 0.92 - 0.99; in men with infrarenal aortic diameter ≥ 30 mm HR 0.90, 95% CI 0.81 - 1.00) and for ruptured AAA (HR 0.81, 95% CI 0.70 - 0.93). In current and ex-smokers with low (< 20) and moderate (20 - 39.9) pack-years of smoking, a statistically significant inverse association was observed. HRs for each one point increment in the mMED score in current smokers were 0.83 (95% CI 0.75 - 0.91) and 0.90 (95% CI 0.84 - 0.97), respectively; in ex-smokers 0.89 (95% CI 0.81 - 0.97) and 0.93 (95% CI 0.85 - 1.01), respectively. No association was observed among current or ex-smokers with ≥ 40 pack-years; HRs 1.02 (95% CI 0.91 - 1.13) and 0.95 (95% CI 0.83 - 1.10), respectively. CONCLUSION: Adherence to the Mediterranean diet was associated with a reduced AAA risk in current and ex-smokers with low pack-years of smoking.


Assuntos
Aneurisma da Aorta Abdominal/epidemiologia , Ruptura Aórtica/epidemiologia , Dieta Mediterrânea , Ex-Fumantes/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Fumar Cigarros/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Proteção , Sistema de Registros , Fatores de Risco , Suécia/epidemiologia
7.
Epidemiol Health ; 43: e2021043, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34126705

RESUMO

OBJECTIVES: This study aimed to identify relapse patterns in smokers who participated in an inpatient treatment program and to investigate factors related to relapse. METHODS: The participants comprised 463 smokers who participated in an inpatient treatment operated by the Daejeon Tobacco Control Center from 2015 to 2018. Participants received high-intensity smoking cessation intervention for 5 consecutive days, including pharmacotherapy and behavioral support, and continued with follow-up for 1 year to determine whether they maintained smoking cessation after discharge from inpatient treatment. Kaplan-Meier and Cox proportional hazard models were used in the analysis. RESULTS: Participants' relapse rate within 1 year was 72.8%, and 59.8% of participants smoked again within 6 months after participation. A higher number of counseling sessions was significantly associated with a lower risk of relapse (hazard ratio [HR], 0.23; 95% confidence interval [CI], 0.17 to 0.32 for ≥9 vs. ≤5 counseling sessions). Conversely, higher relapse rates were significantly associated with the use of nicotine replacement therapy (NRT) (HR, 1.91; 95% CI, 1.43 to 2.55 for use vs. no use), and higher levels of baseline expired carbon monoxide (CO) (HR, 1.58; 95% CI, 1.21 to 2.06 for expired CO concentrations of 10-19 ppm vs. expired CO concentrations <10 ppm). CONCLUSIONS: High-intensity smoking cessation interventions in hospital settings can be effective for smoking cessation in smokers with high nicotine dependence. In addition, the results suggest that for quitters to maintain long-term abstinence, they should receive regular follow-up counseling for 1 year after completing a high-intensity smoking cessation intervention.


Assuntos
Pacientes Internados/psicologia , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Fumar/epidemiologia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Recidiva , República da Coreia/epidemiologia , Fatores de Risco , Fumantes/estatística & dados numéricos
8.
Int J Cancer ; 149(6): 1290-1301, 2021 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-33963762

RESUMO

Lung cancer screening by computed tomography (CT) reduces mortality but exhibited high false-positive rates. We established a diagnostic classifier combining chest CT features with bronchial transcriptomics. Patients with CT-detected suspected lung cancer were enrolled. The sample collected by bronchial brushing was used for RNA sequencing. The e1071 and pROC packages in R software was applied to build the model. Eventually, a total of 283 patients, including 183 with lung cancer and 100 with benign lesions, were included into final analysis. When incorporating transcriptomic data with radiological characteristics, the advanced model yielded 0.903 AUC with 81.1% NPV. Moreover, the classifier performed well regardless of lesion size, location, stage, histologic type or smoking status. Pathway analysis showed enhanced epithelial differentiation, tumor metastasis, and impaired immunity were predominant in smokers with cancer, whereas tumorigenesis played a central role in nonsmokers with cancer. Apoptosis and oxidative stress contributed critically in metastatic lung cancer; by contrast, immune dysfunction was pivotal in locally advanced lung cancer. Collectively, we devised a minimal-to-noninvasive, efficient diagnostic classifier for smokers and nonsmokers with lung cancer, which provides evidence for different mechanisms of cancer development and metastasis associated with smoking. A negative classifier result will help the physician make conservative diagnostic decisions.


Assuntos
Perfilação da Expressão Gênica/métodos , Redes Reguladoras de Genes , Neoplasias Pulmonares/classificação , não Fumantes/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisão Clínica , Diagnóstico Diferencial , Detecção Precoce de Câncer , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/genética , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Análise de Sequência de RNA , Software , Máquina de Vetores de Suporte , Adulto Jovem
9.
Clin Transl Gastroenterol ; 12(3): e00317, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33646204

RESUMO

INTRODUCTION: Smoking and genetic predisposition are established risk factors for colorectal cancer (CRC). We aimed to assess and compare their individual and joint impact on CRC risk using the novel approach of genetic risk equivalent (GRE). METHODS: Data were extracted from the Darmkrebs: Chancen der Verhütung durch Screening study, a large population-based case-control study in Germany. A polygenic risk score (PRS) based on 140 CRC-related single nucleotide polymorphisms was derived to quantify genetic risk. Multiple logistic regression was used to estimate the individual and joint impact of smoking and PRS on CRC risk, and to quantify the smoking effect in terms of GRE, the corresponding effect conveyed by a defined difference in PRS percentiles. RESULTS: There were 5,086 patients with CRC and 4,120 controls included. Current smokers had a 48% higher risk of CRC than never smokers (adjusted odds ratio 1.48, 95% confidence interval 1.27-1.72). A PRS above the 90th percentile was significantly associated with a 3.6-, 4.3-, and 6.4-fold increased risk of CRC in never, former, and current smokers, respectively, when compared with a PRS below the 10th percentile in never smokers. The interaction between smoking and PRS on CRC risk did not reach statistical significance (P = 0.53). The effect of smoking was equivalent to the effect of having a 30 percentile higher level of PRS (GRE 30, 95% confidence interval 18-42). DISCUSSION: Both smoking and the PRS carry essentially independent CRC risk information, and their joint consideration provides powerful risk stratification. Abstinence from smoking can compensate for a substantial proportion of genetically determined CRC risk.


Assuntos
Biomarcadores Tumorais/genética , Neoplasias Colorretais/epidemiologia , Predisposição Genética para Doença , Fumar/epidemiologia , Idoso , Estudos de Casos e Controles , Neoplasias Colorretais/genética , Neoplasias Colorretais/prevenção & controle , Ex-Fumantes/estatística & dados numéricos , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , não Fumantes/estatística & dados numéricos , Polimorfismo de Nucleotídeo Único , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Fumantes/estatística & dados numéricos , Fumar/efeitos adversos , Abandono do Hábito de Fumar
10.
J Epidemiol ; 31(6): 378-386, 2021 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-33746148

RESUMO

BACKGROUND: In April 2020, the Japanese government declared a state of emergency due to the COVID-19 pandemic, and infection control measures, including requests to work from home and stay-at-home restrictions, were introduced. This study examined changes in smoking behavior during the COVID-19 state of emergency. METHODS: An online cross-sectional survey was conducted in Osaka, Japan. To assess differences in smoking behavior among 5,120 current smokers before and after the declaration of a state of emergency, prevalence ratios (PRs) for two outcomes, increased smoking and quitting smoking, were calculated using multivariable Poisson regression, adjusting for potential covariates. RESULTS: We found 32.1% increased the number of cigarettes smoked and 11.9% quit smoking. After adjustment for all variables, we found risk factors for COVID-19 (men and older age group) had both significantly higher PR for quitting smoking (men: PR 1.38; 95% confidence interval [CI], 1.17-1.62) and participants aged ≥65 years: PR 2.45; 95% CI, 1.92-3.12) and significantly lower PR of increased smoking (men: PR 0.85; 95% CI, 0.78-0.93 and participants ≥65 years: PR 0.38; 95% CI, 0.29-0.49). Additionally, respondents working from home or living alone had significantly higher PR for increased smoking (working from home: PR 1.29; 95% CI, 1.17-1.41 and living alone: PR 1.23; 95% CI, 1.10-1.38) and respondents who changed from cigarettes to heated tobacco products (HTPs) had significantly lower PR for quitting smoking (PR 0.150; 95% CI, 0.039-0.582). CONCLUSIONS: We suggest people who have high-risk factors for COVID-19 might change their smoking behavior for the better, while people who work from home or live alone might change their smoking behavior for the worse, during the COVID-19 state of emergency. Additionally, changing from smoking cigarettes to using HTPs makes smokers less likely to quit.


Assuntos
COVID-19/psicologia , Distanciamento Físico , Quarentena/estatística & dados numéricos , Fumantes/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/epidemiologia , Adulto , Idoso , COVID-19/epidemiologia , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Fumantes/estatística & dados numéricos , Fumar/psicologia , Adulto Jovem
11.
Transl Behav Med ; 11(3): 882-890, 2021 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-33710308

RESUMO

People with mobility impairments (MIs; use assistive devices to ambulate) have twice the smoking prevalence versus the general population. A Facebook intervention could improve reach to smokers with MIs, but use and patterns of use are unknown. The study examined: (a) Facebook use and relationship with Facebook-based social support and (b) whether Facebook use differs by motivation to quit smoking. Participants (N = 510; 56.3% female, mean age = 42.4 years) were recruited via a recruitment company to complete a one-time online survey assessing motivation to quit within 30 days, Facebook use (Facebook Activities Scale), reasons for use (Facebook Motives Scale), attitudes (Facebook Intensity Scale), and social support (Facebook Measure of Social Support). The vast majority said that Facebook is part of their daily routine (92.9%), 83% checked Facebook >once a day, and 69% spent >30 min/day on Facebook. Facebook was used to connect with similar others (68.4%), participate in groups (72.9%), decrease loneliness (69.2%), and obtain health information (62.5%); 88% said that they would join a Facebook program to help them quit smoking. A greater number of Facebook friends (rs = .18-.22, p < .001) and greater Facebook use (rs = .20 to rs = .59; p < .001) were correlated with greater perceived social and emotional support. Those motivated to quit posted more frequently (odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.10, 2.22) and were more likely to indicate that they would join a Facebook group for smoking cessation (OR = 4.15, 95% CI = 2.05, 8.38) than those not motivated. Facebook could circumvent disability and environmental barriers to accessing cessation among this health disparity population.


Assuntos
Limitação da Mobilidade , Fumantes/psicologia , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/psicologia , Mídias Sociais/estatística & dados numéricos , Apoio Social , Adulto , Feminino , Humanos , Masculino , Motivação , Fumar/psicologia , Prevenção do Hábito de Fumar
12.
Am J Addict ; 30(4): 382-388, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33772971

RESUMO

BACKGROUND AND OBJECTIVES: Persons with current or past major depressive disorder (MDD) vs those without have higher smoking rates. The nicotine metabolite ratio (NMR) represents variation in the rate of nicotine metabolism and has been associated with smoking behaviors and response to tobacco treatments. We compared NMR between smokers with current or past MDD (MDD+) vs smokers without MDD (MDD-). We also assessed correlates of NMR and compared withdrawal and craving between MDD+ and MDD- smokers. METHODS: Using baseline data from two clinical trials and propensity score weighting based on sex, race, body mass index, and smoking rate, we compared NMR between MDD+ (N = 279) and MDD- (N = 1575) smokers. We also compared groups on and nicotine withdrawal and craving. RESULTS: Mean NMR (ß = -.02, 95% confidence interval [CI]: -0.05 to 0.01, P = .13) and the distribution of smokers across NMR quartiles (odds ratio [OR] = 0.76, 95% CI: 0.50 to 1.16, P = .21) were similar between MDD+ and MDD- samples. This relationship was not affected by antidepressant medication. In the MDD+ sample, African Americans had significantly lower mean NMR, while older smokers and smokers with lower education had higher mean NMR (Ps < .05). MDD+ smokers had significantly higher withdrawal and craving than MDD- smokers (Ps < .05). DISCUSSION AND CONCLUSIONS: While variability in NMR may not explain differences in smoking rates between MDD+ and MDD- smokers, MDD+ smokers report increased withdrawal and craving. SCIENTIFIC SIGNIFICANCE: In this first study to assess NMR among MDD+ smokers, the findings underscore the need to address withdrawal and craving within smoking cessation treatments for those with MDD. (Am J Addict 2021;00:00-00).


Assuntos
Transtorno Depressivo Maior/epidemiologia , Nicotina/metabolismo , Fumantes/psicologia , Fumar/epidemiologia , Adulto , Fissura , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fumantes/estatística & dados numéricos , Fumar/psicologia , Síndrome de Abstinência a Substâncias/epidemiologia
13.
Drug Alcohol Depend ; 221: 108615, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33652378

RESUMO

BACKGROUND: Federally funded health centers (HCs) provide care to the most vulnerable populations in the U.S., including populations with disproportionately higher smoking prevalence such as those with lower incomes. METHODS: This study compared characteristics of adult HC patients, by cigarette smoking status, and assessed smoking cessation-related behaviors using 2014 Health Center Patient Survey data; analysis was restricted to adults with data on cigarette smoking status (n = 5583). Chi-square and logistic regression analyses were conducted. RESULTS: Overall, 28.1 % were current smokers and 19.2 % were former smokers. Current smokers were more likely to report fair/poor health (48.2 %) and a high burden of behavioral health conditions (e.g., severe psychological distress 23.9 %) versus former and never smokers. Most current smokers reported wanting to quit in the past 12 months (79.0 %) and receiving advice to quit from a healthcare professional (78.7 %). In a multivariable model, age <45, non-white race, COPD diagnosis, and past 3-month marijuana use were significantly associated with desire to quit. Few former smokers (15.2 %) reported using cessation treatment, though use was higher among those who quit within the previous year (30.6 %). CONCLUSIONS: Although most current smokers reported a desire to quit, low uptake of evidence-based treatment may reduce the number who attempt to quit and succeed. Given the burden of tobacco use, future efforts could focus on identifying and overcoming unique personal, healthcare professional, or health system barriers to connecting them with cessation treatments. Increasing access to cessation treatments within HCs could reduce smoking-related disparities and improve population health.


Assuntos
Fumar Cigarros/psicologia , Hospitais Federais/estatística & dados numéricos , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Populações Vulneráveis/psicologia , Adolescente , Adulto , Distribuição de Qui-Quadrado , Fumar Cigarros/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Disparidades nos Níveis de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos/epidemiologia , Populações Vulneráveis/estatística & dados numéricos , Adulto Jovem
14.
Pain Res Manag ; 2021: 1541748, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33574973

RESUMO

Smoking is clinically associated with high postoperative pain scores and increased perioperative analgesic requirements. However, the association between the duration of smoking cessation and postoperative opioid requirements remains unclear. Therefore, this study aimed to evaluate the association between the duration of smoking cessation and postoperative opioid requirements. We retrospectively analyzed the data of 144 male patients who received intravenous patient-controlled analgesia (IV PCA) after laparoscopic distal gastrectomy with gastroduodenostomy. All patients were divided into three groups: G0, nonsmoker; G1, smoker who quit smoking within 1 month preoperatively; G2, smoker who quit smoking over 1 month preoperatively. Analgesic use, pain intensity, and IV PCA side effects were assessed up to postoperative day 2. As the duration of smoking cessation increased, the amount of postoperative opioid consumption decreased (ß = -0.08; 95% confidence interval (CI), -0.11 to -0.04; P < 0.001). The total postoperative opioid requirements in G1 were significantly higher than those in G0 and G2 (G0, 75.5 ± 15.9 mg; G1, 94.6 ± 20.5 mg; and G2, 79.9 ± 19.4 mg (P < 0.001)). A multivariate regression analysis revealed that G1 was independently associated with increased postoperative opioid requirements (ß = 12.80; 95% CI, 5.81-19.80; P < 0.001). Consequently, male patients who had ceased smoking within 1 month of undergoing a laparoscopic distal gastrectomy with gastroduodenostomy had higher postoperative opioid use than patients who had ceased smoking for more than 1 month and nonsmokers.


Assuntos
Analgésicos Opioides/uso terapêutico , Duodenostomia/métodos , Gastrectomia/métodos , Gastroenterostomia/métodos , Laparoscopia/métodos , Dor Pós-Operatória/tratamento farmacológico , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/métodos , Analgésicos Opioides/farmacologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
15.
Am J Public Health ; 111(4): 730-738, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33600255

RESUMO

Objectives. To analyze trends in cigarette smoking among Brazilian adults from 2006 to 2019.Methods. We performed a time-series analysis based on data from the Surveillance of Risk and Protective Factors for Chronic Diseases Telephone Survey (n = 730 309). We calculated the annual prevalence of current cigarette smokers, heavy smokers, and passive smokers in the workplace and investigated linear trends using Prais-Winsten regression, for the entire period and for the past 5 years. We performed the analyses for the total population and according to the sociodemographic characteristics.Results. The prevalence of cigarette smoking, heavy smoking, and passive smoking in the workplace declined, respectively, an average of 3.99% per year, 5.65% per year, and 6.55% per year from 2006 to 2019. We observed this reduction regardless of gender, age, educational level, and geographic region. The magnitude of reduction in the prevalence of current cigarette smoking decreased in the past 5 years, while the magnitude of the change in heavy smoking increased.Conclusions. The prevalence of cigarette smoking decreased in the time period studied. The smaller magnitude of reduction for current cigarette smoking in the most recent years might indicate a fatigue with the current policy scenario.


Assuntos
Fumar Cigarros , Fumantes/estatística & dados numéricos , Adulto , Distribuição por Idade , Brasil/epidemiologia , Fumar Cigarros/epidemiologia , Fumar Cigarros/tendências , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Fatores Sexuais , Abandono do Hábito de Fumar
16.
Aust N Z J Public Health ; 45(1): 34-38, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33522685

RESUMO

OBJECTIVE: To examine the supply of smoking cessation medicines to Aboriginal and Torres Strait Islander smokers compared to non-Indigenous smokers across Australia. METHODS: We analysed the total number of smoking cessation prescriptions dispensed over three years through the Pharmaceutical Benefits Scheme (PBS) compared to those supplied nationally through the Closing the Gap (CTG) measure and also in the Northern Territory through the Remote Area Aboriginal Health Service (RAAHS) program. RESULTS: Aboriginal and Torres Strait Islander smokers were supplied with fewer smoking cessation medicines per smoker under the CTG measure compared to non-Indigenous smokers under general PBS benefits. Supply of medicines though the RAAHS program complicated the use of CTG data where higher proportions of Aboriginal and Torres Strait Islander people live in remote areas and use of the CTG measure is lower. CONCLUSIONS: Fewer smoking cessation medicines are being prescribed and then dispensed to Aboriginal and Torres Strait Islander smokers than to non-Indigenous smokers. Implications for public health: CTG and RAAHS data may be useful to monitor and evaluate the effectiveness of interventions to improve the use of smoking cessation medicines by Aboriginal and Torres Strait Islander smokers. However, there are limitations and current obstacles to accessing RAAHS data would need to be removed.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde do Indígena/organização & administração , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/efeitos adversos , Adulto , Idoso , Austrália/epidemiologia , Pesquisa Participativa Baseada na Comunidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Northern Territory/epidemiologia , Grupo com Ancestrais Oceânicos , Estudos Prospectivos , Fumantes/psicologia , Fumar/epidemiologia , Fumar/etnologia , Abandono do Hábito de Fumar/etnologia
17.
Drug Alcohol Depend ; 221: 108590, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33631546

RESUMO

AIMS: To explore i) associations between vaping and self-reported diagnosed/suspected Covid-19; ii) changes in vaping since Covid-19 and factors associated with these changes; iii) whether Covid-19 motivated current or recent ex-vapers to quit. METHODS: Cross-sectional online survey of 2791 UK adults recruited 30/04/2020-14/06/2020. Participants self-reported data on sociodemographic characteristics, diagnosed/suspected Covid-19, vaping status, changes in vaping and motivation to quit vaping since Covid-19. RESULTS: There were no differences in diagnosed/suspected Covid-19 between never, current and ex-vapers. Bayes factors indicated there was sufficient evidence to rule out small negative (protective) associations between vaping status and diagnosed/suspected Covid-19. Among current vapers (n = 397), 9.7 % (95 % CI 6.8-12.6 %) self-reported vaping less than usual since Covid-19, 42.0 % (37.2-46.9 %) self-reported vaping more, and 48.3 % (43.4-53.2 %) self-reported no change. In adjusted analyses, vaping less was associated with being female (aOR = 3.40, 95 % CI 1.73-6.71), not living with children (aOR = 4.93, 1.15-21.08) and concurrent smoking (aOR = 8.77, 3.04-25.64), while vaping more was associated with being younger (aOR = 5.26, 1.37-20.0), living alone (aOR = 2.08, 1.14-3.85), and diagnosed/suspected Covid-19 (aOR = 4.72, 2.60-8.62). Of current vapers, 32.2 % (95 % CI 27.5-36.8 %) were motivated to quit vaping since Covid-19, partly motivated by Covid-19, and 21.0 %, (10.5-31.4 %) of recent ex-vapers quit vaping due to Covid-19. CONCLUSIONS: Among UK adults, self-reported diagnosed/suspected Covid-19 was not associated with vaping status. Half of current vapers changed their vaping consumption since Covid-19, with the majority reporting an increase, and a minority was motivated to quit due to Covid-19. REGISTRATION: The analysis plan was pre-registered, and it is available at https://osf.io/6j8z3/.


Assuntos
COVID-19/psicologia , Motivação , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Vaping/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Fumantes/estatística & dados numéricos , Reino Unido/epidemiologia , Vaping/epidemiologia , Adulto Jovem
18.
Nicotine Tob Res ; 23(8): 1398-1404, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-33420786

RESUMO

INTRODUCTION: Preliminary reports indicated that smokers could be less susceptible to coronavirus SARS-CoV-2, which causes Covid-19. However, once infected an increased risk of severe disease is reported. We investigated the association between smoking and COVID-19 during an outbreak of the disease on a naval vessel. METHODS: We conducted a cross-sectional, observational study on the 1769 sailors of the same navy aircraft carrier at sea exposed at the same time to SARS-CoV2 to investigate the link between tobacco consumption and Covid-19. RESULTS: Among the 1688 crewmembers (87% men; median age = 28 [interquartile range 23-35]) included, 1279 (76%) developed Covid-19 (1038 [62%] reverse-transcriptase- polymerase chain reaction testing-positive and 241 [14%] with only clinical signs). One hundred and seven patients were hospitalized. The univariable analysis odds ratio (OR) for Covid-19 infection was 0.59 (95% confidence interval [CI], 0.45-0.78; p < .001) for current smokers versus former and nonsmokers; sex, body mass index or blood group had no significant impact. Crewmembers >50 years old had an increased risk of contracting Covid-19 (OR, 2.84 [95% CI, 1.30-7.5]; p = .01). Multivariable analysis retained the lower risk of current smokers becoming infected (OR, 0.64 [0.49-0.84]; p < .001) and age >50 years was significatively associated with Covid-19 (OR, 2.6 [1.17-6.9]; p = .03). CONCLUSIONS: Current smoking status was associated with a lower risk of developing Covid-19 but cannot be considered as efficient protection against infection. The mechanism of the lower susceptibility of smokers to SARS-CoV-2 requires further research. TRIAL REGISTRATION: IRB no.: 0011873-2020-09. IMPLICATIONS: (1) Recent epidemiologic data suggest a paradoxical link between smoking and COVID-19. (2) Among the 1688 crewmembers (with an attack rate of 76% and exposed at the same time in the same place to SARS-CoV2), we found a significantly lower risk for developing COVID-19 in current smokers (71%) versus former and nonsmokers (80%). This finding strongly supports the need for further research on nicotine physiological pathway and its impact on COVID-19 infection whilst emphasizing that tobacco smoking should not be considered as efficient protection against COVID-19.


Assuntos
COVID-19/epidemiologia , Suscetibilidade a Doenças , Fumantes/estatística & dados numéricos , Fumar Tabaco/epidemiologia , Adulto , COVID-19/virologia , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2/patogenicidade , Adulto Jovem
19.
Sci Rep ; 11(1): 398, 2021 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-33432008

RESUMO

The longitudinal relationship between smoking status and risk of developing visual impairment (VI) remains unclear. We examined the relationship of smoking status and urinary cotinine level, an objective measure of smoking, with incidence of VI. This cohort study included 279,069 individuals free of VI who were followed for up to 8.8 years (median 4.8 years). VI was defined as when bilateral visual acuity was worse than 0.5 (cutoffs of 0.3 Logarithm of the Minimum Angle of Resolution). During 1,324,429.8 person-years of follow-up, 7852 participants developed new-onset bilateral VI. Self-reported current smoking status was associated with increased risk of developing VI in both men and women, with a stronger association in women (P for interaction = 0.01). Multivariable adjusted hazard ratios (95% confidence intervals) for incident VI comparing current smokers to never-smokers were 1.14 (1.04-1.25) in men and 1.52 (1.28-1.80) in women. Urinary cotinine levels of ≥ 100 ng/ml were significantly associated with increased risk of incident VI, and these associations remained when introducing changes in urinary cotinine and other confounders during follow-up as time-varying covariates. Cigarette smoking assessed based on self-report and urinary cotinine level was associated with increased incidence of VI. Our findings identify smoking as an independent risk factor for VI.


Assuntos
Cotinina/urina , Fumar/epidemiologia , Transtornos da Visão/epidemiologia , Adulto , Fumar Cigarros/epidemiologia , Fumar Cigarros/urina , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Fatores de Risco , Fumantes/estatística & dados numéricos , Fumar/urina , Fumar Tabaco/epidemiologia , Fumar Tabaco/urina , Transtornos da Visão/urina
20.
Sci Rep ; 11(1): 1866, 2021 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-33479364

RESUMO

According to the 'hardening hypothesis', average nicotine dependence will increase as less dependent smokers quit relatively easily in response to effective public health interventions, so that sustained progress in reducing smoking prevalence will depend on shifting the emphasis of tobacco control programs towards intensive treatment of heavily dependent smokers (who comprise an increasing fraction of continuing smokers). We used a system dynamics model of smoking behaviour to explore the potential for hardening in a population of smokers exposed to effective tobacco control measures over an extended period. Policy-induced increases in the per capita cessation rate are shown to lead inevitably to a decline in the proportion of smokers who are heavily dependent, contrary to the hardening hypothesis. Changes in smoking behaviour in Australia over the period 2001‒2016 resulted in substantial decreases in current smoking prevalence (from 23.1% in 2001 to 14.6% in 2016) and the proportion of heavily dependent smokers in the smoking population (from 52.1% to 36.9%). Public health interventions that have proved particularly effective in reducing smoking prevalence (tobacco tax increases, smoke-free environment legislation, antismoking mass media campaigns) are expected to also contribute to a decline in population-level nicotine dependence.


Assuntos
Modelos Teóricos , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/métodos , Tabagismo/prevenção & controle , Adolescente , Adulto , Austrália/epidemiologia , Promoção da Saúde/métodos , Promoção da Saúde/estatística & dados numéricos , Humanos , Prevalência , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Uso de Tabaco/prevenção & controle , Tabagismo/epidemiologia , Adulto Jovem
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