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1.
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
2.
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
3.
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
5.
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
6.
BMC Public Health ; 19(1): 808, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234809

RESUMO

BACKGROUND: Sleep problems are common in the general population. Cigarette smoking is common in the general population of China. Examinations of the prevalence of poor sleep quality among Chinese smokers and nonsmokers are still lacking. This study was designed to examine sleep quality and sleep disturbances among cigarette smokers and nonsmokers in the general population in central China. METHODS: In this population-based sampling project, we used a multi-stage sampling method to recruit survey participants from September 2012 to October 2012 in rural and urban areas of Hunan province, China. A total of 27,300 subjects were sampled from the general population and 26,282 completed the self-report of cigarette smoking characteristics. Cigarette smoker was defined as having smoked ≥100 cigarette in a lifetime and smoked during the last 28 days. Cigarette smoking characteristics were obtained from smokers, including cigarettes per day, years of smoking, quit attempts, and smoking cravings. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess quality of sleep and sleep disturbances (PSQI score > 5). RESULTS: Significantly more smokers than nonsmokers demonstrated poor sleep quality and sleep disturbances. Among smokers, linear regression analyses showed that poor sleep was inversely associated with cigarettes per day, and positively associated with years of smoking, quit attempts, and smoking craving. Logistic regression analysis showed that quit attempts and smoking cravings were associated with higher odds of sleep disturbances. CONCLUSIONS: Sleep disturbances were more prevalent among cigarette smokers than nonsmokers. Smokers also varied in sleep problems on the basis of the characteristics of their smoking. Smokers should be informed about the link between cigarette smoking and poor sleep quality, and should be advised that one of several important health benefits from smoking cessation could be the improvement of sleep quality. Sleep therapy should be recommended as an adjunctive treatment for smoking cessation.


Assuntos
Fumar Cigarros/efeitos adversos , não Fumantes/estatística & dados numéricos , Transtornos do Sono-Vigília/epidemiologia , Fumantes/estatística & dados numéricos , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural/estatística & dados numéricos , Sono , Transtornos do Sono-Vigília/etiologia , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
7.
BMC Public Health ; 19(1): 753, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196049

RESUMO

BACKGROUND: Tobacco smoking is a recognized risk factor for many chronic diseases and previous study evidences have indicated that smokers receive smoking cessation service after the diagnosis of chronic diseases increases successful rate in quitting. But the prevalence of tobacco related chronic diseases (TCD) among smokers, as well as the role of TCD diagnosis in smoking cessation is still unclear in China. METHODS: From June 2016 to December 2017, we sampled 36, 698 residents aged over 18 years by a three stage sampling in Songjiang district, Shanghai. We conducted a cross-sectional study to understand the prevalence of TCD among smokers, and the role of TCD diagnosis in smoking cessation among ex-smokers as well as the smoking cessation attempt among current smokers. RESULTS: Over all, the prevalence of current smoking is 19.78% (48.36% for male and 0.22% for female). 15.93% of smokers have stopped smoking successfully (1, 376/8, 636). The prevalence of ten selected TCDs among smokers range from 0.63% (Chronic Obstructive Pulmonary Disease, COPD) to 36.31% (hypertension). All of 1, 376 ex-smokers had at least one kind of TCD, and 52.33% of them stop smoking after the diagnosis of TCD, the time interval between TCD diagnosis and smoking cessation ranges from 0 to 65 years, with a median of 9 years. Smokers with TCD had higher prevalence of quit smoking, and current smokers with TCD had higher smoking cessation attempt proportion. CONCLUSIONS: The prevalence of current smoking is still very high among male residents in rural area of Shanghai, and the occurrence of TCD even non-lethal one could provide an opportunity for doctors to assist the smoking cessation among smokers.


Assuntos
Doença Crônica/epidemiologia , População Rural , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar Tabaco/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , População Rural/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar Tabaco/epidemiologia , Adulto Jovem
8.
BJOG ; 126(10): 1213-1222, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31188526

RESUMO

OBJECTIVE: Studies on pregnancy outcomes in psoriatic arthritis (PsA) are scarce and typically of small size. Available studies have reported conflicting results. The aim of this study was to describe maternal and infant pregnancy outcomes among women with PsA compared with women without PsA. DESIGN: Nationwide cohort study. SETTING: Nationwide Swedish registers. POPULATION: A total of 41 485 singleton pregnancies in 1997-2014, of which 541 pregnancies were identified with PsA exposure and 40 944 pregnancies were unexposed. METHODS: By linkage of national health and population register data, we obtained information on individual pregnancies and compared outcomes among pregnancies with PsA and non-PsA pregnancies. Relative risks were estimated by odds ratios (ORs) with 95% CIs using a generalised linear regression model with generalised estimating equations. Adjustments were made for maternal factors and calendar year of birth. MAIN OUTCOME MEASURES: Maternal and infant pregnancy outcomes. RESULTS: Pregnancies to women with PsA had increased risks of preterm birth (adjusted OR 1.63; 95% CI 1.17-2.28), elective and emergency caesarean deliveries (adjusted OR 1.47; 95% CI 1.10-1.97 and adjusted OR 1.43; 95% CI 1.08-1.88, respectively) compared with non-PsA pregnancies. No increased risks were observed for pre-eclampsia, stillbirth or other infant outcomes apart from preterm birth. CONCLUSION: The majority of women with PsA have uneventful pregnancies with respect to adverse outcomes. In the present study, we found increased risks of preterm birth and caesarean delivery compared with non-PsA pregnancies. TWEETABLE ABSTRACT: Women with psoriatic arthritis have uneventful pregnancies but are at increased risk of preterm birth and caesarean delivery.


Assuntos
Artrite Psoriásica/fisiopatologia , Cesárea/estatística & dados numéricos , Obesidade/epidemiologia , Sistema de Registros/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Adolescente , Adulto , Artrite Psoriásica/epidemiologia , Estudos de Coortes , Comorbidade , Feminino , Humanos , Recém-Nascido , Masculino , Obesidade/fisiopatologia , Razão de Chances , Paridade , Gravidez , Resultado da Gravidez , Suécia/epidemiologia , Adulto Jovem
9.
Environ Pollut ; 251: 970-974, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31234264

RESUMO

Data from National Health and Nutrition Examination Survey for 2013-2016 were used to compare observed levels of cadmium, lead, and total mercury in blood among US residents aged ≥12 years who were users of cigars, cigarettes, cigars and cigarettes, e-cigarettes and dual users of cigarettes and e-cigarettes. Total sample size available for analysis was 1139. Adjusted geometric means (AGM) among cigarette, cigar, e-cigarette, cigarette and cigar, and cigarette-e-cigarette users were comparable for blood cadmium lead, and total mercury. Cigar only users had lower AGM than cigar and cigarette users for total mercury (0.56 vs. 0.97 µg/L, p = 0.03). There is no evidence yet that can show concentrations of blood and urine cadmium, lead, and mercury among e-cigarette users are any different than among cigarette and/or dual users of cigarettes and e-cigarettes.


Assuntos
Cádmio/sangue , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Chumbo/sangue , Mercúrio/sangue , Fumantes/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos , Criança , Humanos , Masculino , Inquéritos Nutricionais
10.
BMC Public Health ; 19(Suppl 4): 579, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196055

RESUMO

BACKGROUND: This study focused on the associations between socioeconomic status (SES) and adolescent smoking among secondary school students (13 to 17 years) in the Federal Territory of Kuala Lumpur, Malaysia. Our objective was to evaluate the relationships between adolescent demographics, socioeconomic status and smoking status. METHODS: The survey data were based on baseline findings from a cross-sectional study (N = 422 adolescents). Chi-square test was used to assess the relationship between demographic characteristics, socioeconomic status (household monthly income and daily allowance) and adolescent smoking status. Exhaled carbon monoxide (CO) reading and the Hooked on Nicotine Checklist (HONC) were used to evaluate adolescent smoking status. A Multivariate Multinomial Logistic Regression (MMLR) was employed to test selected demographic and socioeconomic predictors of smoking status. RESULTS: Of the 422 adolescents (M age = 15.58, SD = 1.24), more than half of the participants initiated smoking between 13 to 17 years old (59.0%). A total of 308 (73.0%) were electronic cigarette users, with more than 50% comprising of single users. The mean CO reading was 2.14 ppm with 78.0% of adolescents scoring more than 0 on the Hooked on Nicotine Checklist (HONC). Males and participants aged 15 and 16 years were at increased risks of sole CC smoking. Meanwhile, males, those who are not hooked on smoking and with a non-smoker CO reading were at increased risks of sole EC smoking. Finally, Bumiputeras were at less risk of EC smoking. CONCLUSIONS: Demographic variables such as age, gender and ethnicity predicted smoking status predicted smoking risk, but not socioeconomic factors. The findings allow policy makers to target specific high-risk demographic groups when designing smoking cessation programs for adolescents.


Assuntos
Fumantes/estatística & dados numéricos , Fumar/epidemiologia , Adolescente , Estudos Transversais , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Malásia/epidemiologia , Masculino , Fumar/etnologia , Classe Social , Fatores Socioeconômicos , Inquéritos e Questionários
12.
BMJ ; 365: l2036, 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31076461

RESUMO

The studyHajek P, Phillips-Waller A, Przulj D, et al. A randomised trial of e-cigarettes versus nicotine-replacement therapy. N Engl J Med 2019;380:629-37.This trial was funded by the NIHR Health Technology Assessment Programme (12/167/135) and by Cancer Research UK.To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000757/e-cigarettes-helped-more-smokers-quit-than-nicotine-replacement-therapy.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Nicotina/uso terapêutico , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/métodos , Dispositivos para o Abandono do Uso de Tabaco/estatística & dados numéricos , Análise Custo-Benefício , Humanos , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Resultado do Tratamento
13.
BMC Public Health ; 19(1): 642, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31133009

RESUMO

BACKGROUND: Tobacco vaporizers heat tobacco without burning it, to produce an inhalable aerosol. Various models have recently appeared on the market, mostly manufactured by the tobacco industry, but few of the studies published on tobacco vaporizers are independent from the manufacturers. The goals of this study were to explore who uses tobacco vaporizers, how these products are used, reasons for utilization, perceived advantages and risks. METHODS: Online questionnaire collected from October 2016 to January 2018 in self-selected visitors aged > 18 to an anti-addiction website. RESULTS: We obtained 170 valid responses, of whom 104 were using tobacco vaporizers. For homogeneity, we included only the 102 users of the Brand 1 tobacco vaporizer in our analysis, as there were only two users of other vaporizers. Among these 102 vaporizer users, about half were current cigarette smokers (57%), the rest were former cigarette smokers. The median age was 41, and the median duration of utilization was 9 months. Most (88%) used the vaporizer daily, 8% were occasional users and 4% were past users. Among current smokers, 80% were currently trying to reduce their cigarette consumption and 29% were trying to quit. The vaporizer was used mainly to replace cigarettes (94%), because it was perceived to be less toxic than cigarettes (89%), to help stop smoking or to avoid starting smoking again (72%), or to reduce cigarette consumption (71%). Current smokers who were daily or occasional vaporizer users reported smoking a median of 8.0 cigarettes per day, compared with 20.0 per day before they started to use the vaporizer (p < .0001, Wilcoxon signed-rank test). CONCLUSIONS: In this online sample of early adopters, Brand 1 was by far the most frequently used tobacco vaporizer. It was used by current or former smokers only, mainly to replace cigarettes, and satisfaction ratings were good. Users considered the tobacco vaporizer to be less toxic than cigarette smoke and perceived it to be helpful for reducing or stopping smoking.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Nebulizadores e Vaporizadores/estatística & dados numéricos , Fumantes/psicologia , Tabaco , Adulto , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fumantes/estatística & dados numéricos , Inquéritos e Questionários
14.
Public Health ; 171: 123-130, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31128557

RESUMO

OBJECTIVE: Smokers who access free National Health Service (NHS) Stop Smoking Services (SSS) in the UK are four times more likely to stop smoking, yet uptake of the services has been in decline in recent years. Evidence was collated to explore the beliefs of smokers, ex-smokers and Stop Smoking Advisors (SSAs) about SSS and the barriers and facilitators to access. STUDY DESIGN: Mixed-methods design including i) a search of the literature; ii) a cross-sectional online questionnaire completed by 38 smokers and ex-smokers; and iii) semistructured interviews with 5 SSAs. METHODS: PubMed, Web of Science, Scopus, Prospero and the NIHR Portfolio were searched in October 2017 to identify relevant studies. Smokers and ex-smokers were recruited to the online questionnaire via Public Health websites and social media in Warwickshire. SSAs identified via Public Health Warwickshire were invited to take part in an interview conducted over the telephone. Findings were collated and analysed using the COM-B ('Capability', 'Opportunity', 'Motivation' and 'Behaviour') model framework. RESULTS: A range of practical and psychological or belief-based barriers and facilitators to accessing SSS were identified within all the components of the COM-B model, aside from physical capability, for example; 'Psychological capability', such as lack of understanding about what the service offers; 'Reflective motivation', such as lack of confidence in service efficacy; and 'Social opportunity', such as recommendations from healthcare professionals to attend. Suggestions and consideration on how future tobacco control intervention and public health messages can address these components are reported. CONCLUSIONS: Public health interventions and campaigns may benefit from focussing on addressing the well-known perceived barriers and facilitators smokers experience, in particular focussing on the components of the COM-B that have been identified as being important to increase the uptake of SSS.


Assuntos
Atitude Frente a Saúde , Conselheiros/psicologia , Ex-Fumantes/psicologia , Acesso aos Serviços de Saúde , Fumantes/psicologia , Prevenção do Hábito de Fumar , Medicina Estatal , Adolescente , Adulto , Idoso , Conselheiros/estatística & dados numéricos , Estudos Transversais , Ex-Fumantes/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fumantes/estatística & dados numéricos , Reino Unido , Adulto Jovem
15.
BMC Public Health ; 19(1): 635, 2019 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-31126265

RESUMO

BACKGROUND: Up to 80% of the adult homeless population use tobacco, and smoking cessation programs could offer an important opportunity to address preventable mortality and morbidity for this population. This population faces serious challenges to smoking cessation, including the impact of the social environment. METHODS: Forty participants (11 female; 29 male) from an ongoing smoking cessation randomized clinical trial conducted at 2 urban homeless shelters in the Upper Midwest were invited to take part in semi-structured interviews in 2016-2017. An interviewer used a semi-structured interview guide asking participants to describe their experience of how the social environment impacted their attempt to quit smoking. RESULTS: Participants described feeling pressure to smoke and drink in and around shelters, and that this pressure had led some to start smoking or resume smoking, along with making it very challenging to quit. Participants described being motivated to quit, and seeing smoking cessation as positively impacting the time and focus they felt they had for finding housing. However many felt more interested in reducing their smoking, rather than quitting. CONCLUSIONS: Addressing smoking cessation for people experiencing homelessness is both an important public health opportunity, and a challenge. There is a need to consider cessation in the context of the social and environmental factors impacting smokers who are experiencing homelessness. In particular, there is a need to address the collective value placed on smoking in social interactions. Despite these challenges, there are high levels of motivation and interest in addressing smoking. TRIAL REGISTRATION: NCT01932996 . Date of registration 30th August 2013. Prospectively registered.


Assuntos
Pessoas em Situação de Rua/psicologia , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Meio Social , Estresse Psicológico/psicologia , Adulto , Idoso , Feminino , Pessoas em Situação de Rua/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Fumantes/estatística & dados numéricos , Fumar/epidemiologia , Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , População Urbana
16.
Artigo em Inglês | MEDLINE | ID: mdl-31010185

RESUMO

This study examines whether having health conditions or concerns related to smoking is associated with use of vaping products. Data came from the 2016 wave of the International Tobacco Control Four Country Smoking and Vaping Survey. Smokers and recent quitters (n = 11,344) were asked whether they had a medical diagnosis for nine health conditions (i.e., depression, anxiety, alcohol problems, severe obesity, chronic pain, diabetes, heart disease, cancer, and chronic lung disease) and concerns about past and future health effects of smoking, and their vaping activities. Respondents with depression and alcohol problems were more likely to be current vapers both daily (Adjusted odds ratio, AOR = 1.42, 95% confidence interval, CI 1.09-1.85, p < 0.05 for depression; and AOR = 1.52, 95% CI 1.02-2.27, p < 0.05 for alcohol) and monthly (AOR = 1.32, 95% CI 1.11-1.57 for depression, p < 0.01; and AOR = 1.43, 95% CI 1.06-1.90, p < 0.05 for alcohol). Vaping was more likely at monthly level for those with severe obesity (AOR = 1.77, 95% CI 1.29-2.43, p < 0.001), cancer (AOR = 5.19, 95% CI 2.20-12.24, p < 0.001), and concerns about future effects of smoking (AOR = 1.83, 95% CI 1.47-2.28, p < 0.001). Positive associations were also found between chronic pain and concerns about past health effects of smoking and daily vaping. Only having heart disease was, in this case negatively, associated with use of vaping products on their last quit attempt (AOR = 0.72, 95% CI 0.43-0.91, p < 0.05). Self-reported health condition or reduced health associated with smoking is not systematically leading to increased vaping or increased likelihood of using vaping as a quitting strategy.


Assuntos
Transtornos Mentais/epidemiologia , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Vaping/psicologia , Adolescente , Adulto , Depressão , Transtorno Depressivo , Etanol , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Saúde Mental , Pessoa de Meia-Idade , Razão de Chances , Autorrelato , Fumantes/estatística & dados numéricos , Fumar , Inquéritos e Questionários , Produtos do Tabaco , Fumar Tabaco , Adulto Jovem
17.
Pregnancy Hypertens ; 15: 123-129, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30825909

RESUMO

OBJECTIVES: The objective of this study was to examine whether the association between maternal smoking and gestational hypertension varies by the timing of exposure. STUDY DESIGN: Retrospective cohort study of women identified in 2015 US natality records for singleton births. MAIN OUTCOME MEASURES: Our outcome was whether a woman was diagnosed with gestational hypertension (GH) on the birth record, a category which includes preeclampsia. RESULTS: Women who smoked before and during pregnancy had a reduced risk for GH relative to non-smokers (adjusted RR 0.92, 95% CI 0.90-0.94). In contrast, women who apparently quit just before the start of pregnancy had higher risk than non-smokers (adjusted RR 1.02, 95% CI 1.00-1.05). When the trimester-specific effects were examined, only women who smoked before pregnancy and in all three trimesters had reduced risk for GH. Smoking mothers who quit just before the start of the 3rd trimester had an increased risk for GH compared to non-smokers (adjusted RR 1.08, 95% CI 1.02-1.16). CONCLUSION: In our analysis, women who smoked before pregnancy and in all three trimesters have reduced risk of GH compared to non-smokers, while smokers who reported quitting before pregnancy were at an increased risk. Our results offer new insights into the importance of timing of smoking in pregnancy on risk of GH, and challenge the notion that any smoking during pregnancy has a protective effect.


Assuntos
Hipertensão Induzida pela Gravidez/epidemiologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/epidemiologia , Adulto , Intervalo entre Nascimentos/estatística & dados numéricos , Ex-Fumantes/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , National Center for Health Statistics (U.S.) , não Fumantes/estatística & dados numéricos , Vigilância da População , Gravidez , Estudos Retrospectivos , Fatores de Risco , Fumantes/estatística & dados numéricos , Fatores de Tempo , Estados Unidos/epidemiologia , Adulto Jovem
18.
BMC Public Health ; 19(1): 302, 2019 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-30866897

RESUMO

BACKGROUND: Knowledge about the health effects of e-cigarette use (or vaping) among past and current combustible cigarette users is limited. Several studies have assessed vaping-related adverse events (AEs) and beneficial health effects, however, most studies focused on AEs in general and examined only a few physiological changes that vapers experience. This study aims to explore self-reported AEs and perceived health changes due to e-cigarette use among Hungarian adult e-cigarette-only users (former smokers who switched completely to e-cigarette use) and dual users (smokers who use e-cigarettes and combustible tobacco cigarettes concomitantly). METHODS: A cross-sectional, web-based survey of 1042 adult Hungarian e-cigarette users was conducted in 2015. Participants reported AEs and changes in physiological functions since they switched from smoking to e-cigarette use or while dually using e-cigarettes and combustible cigarettes. Confirmatory factor analysis with covariates was applied to explain perceived health changes due to e-cigarette-only use and dual use. RESULTS: Dual users (17.6%) were significantly more likely to report AEs of vaping than e-cigarette-only users (26.2% vs. 11.8%, p < 0.001). Experiencing health improvements were significantly more likely among e-cigarette-only users than for dual users for all surveyed physiological functions. E-cigarette-only users reported larger effects of vaping on sensory, physical functioning, and mental health factors compared to dual users. Self-reported changes in sensory and physical functioning were significantly higher among individuals using e-cigarettes more than a year and people who were past heavy smokers (smoked ≥20 cigarettes per day). Gender was related to sensory improvement only; males reported greater improvement than females. CONCLUSIONS: The majority of e-cigarette-only users reported more perceived beneficial changes in physiological functions and fewer AEs than dual users. Perceived short-term benefits of e-cigarette use may reinforce users despite the uncertainty of long-term health consequences. Health professionals should provide balanced information regarding the possible short- and long-term positive and negative health effects of e-cigarette use during consultations with patients.


Assuntos
Autoavaliação Diagnóstica , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Fumantes/psicologia , Produtos do Tabaco/estatística & dados numéricos , Vaping/efeitos adversos , Adulto , Estudos Transversais , Feminino , Humanos , Hungria , Internet , Masculino , Pessoa de Meia-Idade , Fumantes/estatística & dados numéricos , Inquéritos e Questionários
19.
Health Qual Life Outcomes ; 17(1): 48, 2019 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-30876466

RESUMO

INTRODUCTION: The aim of this paper is to find out generic preference-based Short-Form 6 Dimensions (SF-6D) utility scores of smokers and ex-smokers with varying cigarette exposure, with and without respiratory symptoms. METHODS: Seven hundred thirty one people aged ≥30 with a history of smoking who attended 5 public primary care clinics completed a cross-sectional survey using SF-6D utility score, Breathlessness, Cough, and Sputum Scale (BCSS©) and office spirometry. RESULTS: Most of the subjects were men (92.5%) in an older age group (mean age 62.2 ± 11.7 years). About half of them (48.3%) were current smokers while the other half (51.7%) were ex-smokers. More than half of them (54.2%) reported mild respiratory symptoms (mean BCSS score 0.95 ± 1.12). The most common symptoms were sputum (45.1%), followed by cough (34.2%) and breathlessness (6.0%). The SF-6D overall utility score was 0.850 ± 0.106. The subjects reported significantly lower SF-6D scores when they had breathlessness (0.752 ± 0.138; p = < 0.001), cough (0.836 ± 0.107; p = 0.007), sputum (0.838 ± 0.115; p = 0.004) or any of the above symptom (0.837 ± 0.113; p < 0.001). In both groups of current smokers and ex-smokers, there was no statistically significant difference in the scores among light, moderate or heavy smokers. In the Tobit regression model of factors affecting SF-6D utility score, subjects who reported more respiratory symptoms (i.e. higher BCSS©) had lower SF-6D scores (B = - 0.018 ± 0.007, p < 0.001), while men had higher SF-6D scores than women (B = 0.037 ± 0.031, p = 0.019). Subjects who attended middle or high school had higher SF-6D score than those attended the University or above. The presence of airflow obstruction was not associated with the score. CONCLUSIONS: The study yielded SF-6D utility scores of smokers and ex-smokers with different reported cigarette exposure, which could be useful in future clinical studies and cost-effectiveness analysis.


Assuntos
Ex-Fumantes/estatística & dados numéricos , Qualidade de Vida , Fumantes/estatística & dados numéricos , Idoso , Análise Custo-Benefício , Tosse/complicações , Tosse/psicologia , Estudos Transversais , Dispneia/complicações , Dispneia/psicologia , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Inquéritos e Questionários
20.
Cent Eur J Public Health ; 27(1): 3-9, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30927390

RESUMO

OBJECTIVES: Alternative tobacco product (ATP) use is popular among adolescents in Western countries, however, little is known about factors influencing ATP experimentation in Europe. The aim of this study was to explore factors associated with ATP experimentation, and to identify patterns of ATP experimentation among Hungarian adolescents who had ever tried manufactured cigarette smoking. METHODS: Logistic regression analyses were applied to estimate the relationship between individual cigarette smoking experiences, social smoking influences, demographics, and ATP experimentation (roll-your-own (RYO) cigarettes, cigars/cigarillos, waterpipe, traditional pipe and flavoured cigarettes) in a cross-sectional sample of 8th and 11th grade students (N = 1,067, 56.0% of girls) who had ever tried manufactured cigarette smoking in six metropolitan cities of Hungary. Latent class analysis (LCA) was performed to identify patterns of different ATP use. RESULTS: Almost 90% of the sample had ever tried ATPs and significantly more commonly older (91.8%) versus younger (79.8%) students. Waterpipe was the most popular product to try followed by flavoured cigarettes, cigars/cigarillos, RYO cigarettes, and pipe. Boys were more likely to report ATP experimentation compared to girls. Younger age of cigarette smoking experimentation, greater frequency of past month cigarette smoking and history of ever daily smoking for 30 days showed strong association with ATP experimentation. Students with one or more smoking friends were more vulnerable to experiment with ATPs. Weekly allowance, school academic achievement and household smoking exposure showed no effect on the experimentation. LCA identified four subgroups of ATP experimenters comprising intense polytobacco experimenters (38.4%), mainly waterpipe experimenters (34.2%), moderate polytobacco experimenters (14.9%), and less interested experimenters (12.5%). CONCLUSION: Tobacco prevention programmes targeting adolescents should emphasize the risks of using ATPs in addition to manufactured cigarettes. Accessibility of ATPs should be better regulated and restrictions should be strongly enforced in order to prevent potential harmful consequences of adolescent polytobacco use.


Assuntos
Comportamento do Adolescente , Fumantes/psicologia , Fumar/epidemiologia , Produtos do Tabaco/estatística & dados numéricos , Tabaco , Adolescente , Estudos Transversais , Feminino , Humanos , Hungria/epidemiologia , Masculino , Fumantes/estatística & dados numéricos
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