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2.
World Neurosurg ; 133: e31-e61, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31415895

RESUMO

BACKGROUND: The association between matrix metalloproteinase 9 (MMP-9) gene -1562C/T (rs3918242) polymorphism and the susceptibility of ischemic stroke (IS) has been investigated. However, results were ambiguous and inconsistent. Therefore, we performed this study to better assess the potential relationship between rs3918242 polymorphism and susceptibility risk of IS. METHODS: We included case-control studies concerning the relationship between the rs3918242 polymorphism and IS, and odds ratios with corresponding 95% confidence intervals were used to describe the associations. Furthermore, meta-regression analyses, heterogeneity, cumulative analyses, sensitivity analyses, and publication bias were examined. RESULTS: A total of 19 studies were included for analysis. Significant associations with the risk of IS were detected for the rs3918242 polymorphism in overall population, Asians, and whites. When available data were stratified by gender, we found a significant correlation with the risk of IS in both males and females. Further subgroup analysis by the subtypes of IS showed that the rs3918242 polymorphism was significantly correlated with the risk of patients with large artery atherosclerosis. When stratified by age, we found that the rs3918242 polymorphism was significantly correlated with the risk of IS in patients both aged ≥65 years and >65 years. Both the diabetes and the nondiabetes subgroups reached significant results, and in an analysis stratified by smoking status, an increased risk of IS was associated with smoking. CONCLUSIONS: The rs3918242 polymorphism may be a susceptible predictor of susceptibility of IS. Further large-scale studies are needed to verify the results of our findings.


Assuntos
Isquemia Encefálica/genética , Metaloproteinase 9 da Matriz/genética , Polimorfismo de Nucleotídeo Único , Adulto , Distribuição por Idade , Idoso , Aterosclerose/epidemiologia , Isquemia Encefálica/enzimologia , Isquemia Encefálica/epidemiologia , Estudos de Casos e Controles , Fumar Cigarros/epidemiologia , Comorbidade , Intervalos de Confiança , Diabetes Mellitus/epidemiologia , Grupos Étnicos , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Embolia Intracraniana/epidemiologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Distribuição por Sexo
3.
PLoS Genet ; 15(10): e1008353, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31671092

RESUMO

Mendelian randomization (MR) is an established approach to evaluate the effect of an exposure on an outcome. The gene-by-environment (GxE) study design can be used to determine whether the genetic instrument affects the outcome through pathways other than via the exposure of interest (horizontal pleiotropy). MR phenome-wide association studies (MR-pheWAS) search for the effects of an exposure, and can be conducted in UK Biobank using the PHESANT package. In this proof-of-principle study, we introduce the novel GxE MR-pheWAS approach, that combines MR-pheWAS with the use of GxE interactions. This method aims to identify the presence of effects of an exposure while simultaneously investigating horizontal pleiotropy. We systematically test for the presence of causal effects of smoking heaviness-stratifying on smoking status (ever versus never)-as an exemplar. If a genetic variant is associated with smoking heaviness (but not smoking initiation), and this variant affects an outcome (at least partially) via tobacco intake, we would expect the effect of the variant on the outcome to differ in ever versus never smokers. We used PHESANT to test for the presence of effects of smoking heaviness, instrumented by genetic variant rs16969968, among never and ever smokers respectively, in UK Biobank. We ranked results by the strength of interaction between ever and never smokers. We replicated previously established effects of smoking heaviness, including detrimental effects on lung function. Novel results included a detrimental effect of heavier smoking on facial aging. We have demonstrated how GxE MR-pheWAS can be used to identify potential effects of an exposure, while simultaneously assessing whether results may be biased by horizontal pleiotropy.


Assuntos
Fumar Cigarros/epidemiologia , Biologia Computacional/métodos , Análise da Randomização Mendeliana/métodos , Envelhecimento da Pele/efeitos dos fármacos , Bancos de Espécimes Biológicos , Fumar Cigarros/efeitos adversos , Fumar Cigarros/genética , Interação Gene-Ambiente , Pleiotropia Genética , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Estudo de Prova de Conceito , Reino Unido/epidemiologia
4.
Medicine (Baltimore) ; 98(46): e17996, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725666

RESUMO

To investigate the difference of clinical characteristics between chronic obstructive pulmonary disease (COPD) patients with the frequent exacerbators with chronic bronchitis (FE-CB) phenotype and those with the asthma-COPD overlap syndrome (ACO) phenotype.We searched CNKI, Wan Fang, Chongqing VIP, China Biology Medicine disc, PubMed, Cochrane Library, and EMBASE databases for studies published as of April 30, 2019. All studies that investigated COPD patients with the FE-CB and ACO phenotypes and which qualified the inclusion criteria were included. Cross-sectional/prevalence study quality recommendations were used to measure methodological quality. RevMan5.3 software was used for meta-analysis.Ten studies (combined n = 4568) qualified the inclusion criteria. The FE-CB phenotype of COPD was associated with significantly lower forced vital capacity percent predicted (mean difference [MD] -9.05, 95% confidence interval [CI] [-12.00, -6.10], P < .001, I = 66%), forced expiratory volume in 1 second (FEV1) (MD -407.18, 95% CI [-438.63, -375.72], P < .001, I = 33%), forced expiratory volume in 1 second percent predicted (MD -9.71, 95% CI [-12.79, -6.63], P < .001, I = 87%), FEV1/forced vital capacity (MD -5.4, 95% CI [-6.49, -4.30], P < .001, I = 0%), and body mass index (BMI) (MD -0.81, 95% CI [-1.18, -0.45], P < .001, I = 44%) as compared to the ACO phenotype. However, FE-CB phenotype was associated with higher quantity of cigarettes smoked (pack-years) (MD 6.45, 95% CI [1.82, 11.09], P < .001, I = 73%), COPD assessment test score (CAT) (MD 4.04, 95% CI [3.46, 4.61], P < .001, I = 0%), mMRC score (MD 0.54, 95% CI [0.46, 0.62], P < .001, I = 34%), exacerbations in previous year (1.34, 95% CI [0.98, 1.71], P < .001, I = 68%), and BMI, obstruction, dyspnea, exacerbations (BODEx) (MD 1.59, 95% CI [1.00, 2.18], P < .001, I = 86%) as compared to the ACO phenotype.Compared with the ACO phenotype, COPD patients with the FE-CB phenotype had poorer pulmonary function, lower BMI, and higher CAT score, quantity of cigarettes smoked (pack-years), exacerbations in previous year, mMRC score, and BODEx.This study is an analysis of published literature, which belongs to the second study. Therefore, this study does not require the approval of the ethics committee. The findings will be disseminated through a peer-reviewed journal publication or conference presentation.


Assuntos
Pneumopatias Obstrutivas/epidemiologia , Pneumopatias Obstrutivas/fisiopatologia , Asma/epidemiologia , Asma/fisiopatologia , Índice de Massa Corporal , Bronquite Crônica/epidemiologia , Bronquite Crônica/fisiopatologia , Fumar Cigarros/epidemiologia , Progressão da Doença , Dispneia/epidemiologia , Humanos , Estudos Observacionais como Assunto , Fenótipo , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Qualidade de Vida , Testes de Função Respiratória
5.
Pan Afr Med J ; 34: 1, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762870

RESUMO

Introduction: Early sexual debut is common among young people and it has several sexual and reproductive health consequences. But, its burden and the associated factors leading to this behavior haven't received due attention. The main purpose of this study was to investigate the prevalence and associated factors of sexual debut in the preparatory and high school students of Aksum town. Methods: A school-based quantitative cross-sectional study design was used for this research work. A total of 519 preparatory and high school regular students participated in the survey. The sample population was obtained by using a simple random sampling technique from each schooling proportion with their number of students. Data, that were collected using self administered questionnaires, were entered into EpiData 3.02 and analyzed in SPSS 22.0. Results were presented using frequencies, tables and graphs. Statistical significance was declared at a P-value <0.05. Results: Of the total participants, 266 (51.3%) were males. The age of the participants ranged from 13 to 23 years with a mean age of 16.3 ± 1.47 years. Of the total participants, 137(26.2%) had sexual experience, among which 119 (87.5%) had an early sexual debut at an average age of 13.7 + 1.4 years. Factors that were found to be significantly associated with an early sexual debut were gender (AOR=3.41; 95% CI: 1.54, 6.99), residence (AOR=0.44; 95% CI: 0.27, 0.81), alcohol drinking (AOR=5.5; 95% CI: 2.2, 14.8), cigarette smoking (AOR=3.3; 95% CI: 2.3, 7.5), exposure to pornography, such as reading/seeing pornographic materials (AOR=7.4; 95% CI: 4.4, 11.78), living arrangement for educational purpose (AOR= 0.43; 95% CI: 0.13, 0.89), grade (AOR=0.38; 95% CI: 0.06, 0.68) and monthly living allowance (AOR=0.419; 95% CI: 0.2, 0.9). Conclusion: A significant number of students reported early sexual debut. Gender, place of residence, alcohol drinking, cigarette smoking, exposure to pornography, grade and living arrangement for educational purpose and monthly living allowance were significant predictors of an early sexual debut.


Assuntos
Literatura Erótica , Comportamento Sexual/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Fumar Cigarros/epidemiologia , Estudos Transversais , Etiópia , Feminino , Humanos , Masculino , Prevalência , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
6.
Medicine (Baltimore) ; 98(40): e17218, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577712

RESUMO

Health examination is an important method for early detection of people with different risk of stroke. This study estimates the risk of stroke and identify risk factors for people who underwent health examinations at the Health Examination Center at West China Hospital, Sichuan University from July 2014 to February 2018.A total of 31,464 people were recruited in this study and divided into 3 groups (low risk, moderate risk, and high risk) according to risk of stroke. We explored possible factors associated with the risk of stroke by using multivariable stepwise logistic regression analysis.Among the participants, 17,959 were at low risk, 11,825 were at moderate risk, and 1680 were at high risk. Age, smoking, alcohol consumption, body mass index, uric acid, diastolic pressure, systolic pressure, triglycerides, low-density lipoprotein cholesterol, glucose, and brachial-ankle pulse wave velocity (baPWV) were independent significant risk factors for stroke, whereas high-density lipoprotein cholesterol was an independent protective factor for stroke. Interestingly, with increasing age, the percentage of people at moderate or high risk of stroke was increased. The percentages of people at moderate and high risk of stroke were also increased with respect to the stages of baPWV.This study showed that >40% of the participants were at moderate or high risk of stroke, especially the older participants. Several factors were related to the risk of stroke, especially baPWV. Some preventive action may be adopted early, and more attention can be paid to the health examination population.


Assuntos
Exame Físico/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/epidemiologia , Índice Tornozelo-Braço , Pressão Sanguínea , Índice de Massa Corporal , China/epidemiologia , Fumar Cigarros/epidemiologia , Estudos Transversais , Feminino , Humanos , Estilo de Vida , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos
7.
Medicine (Baltimore) ; 98(40): e17238, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577715

RESUMO

INTRODUCTION: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis due to its higher patency and lower infection rate. However, its suboptimal maturation rate is a major weakness. Although substantial risk factors for AVF maturation failure have been disclosed, modifiable risk factors remain unknown. During the AVF maturation process, an elevated luminal pressure is required for outward remodeling; however, excessively high luminal pressure may also be detrimental to AVF maturation, which remains to be defined. We hypothesized that higher AVF luminal pressure is harmful to its maturation, and investigate its potential as a modifiable factor to improve AVF maturation. METHODS AND ANALYSIS: This prospective study includes patients undergoing surgical creation for a native AVF. The exclusion criteria were as follows: age <20 years, inability to sign an informed consent, and failure to create a native AVF due to technical difficulties. Demographic and laboratory profiles will be collected before AVF surgery. Vascular sonography will be performed within 1 week of AVF creation to measure the diameters, flow rates, and flow volumes of AVF and its branched veins. The pressure gradient within AVF will be estimated from the blood flow rates using the modified Bernoulli equation. The primary outcome is spontaneous AVF maturation defined as provision of sufficient blood flow for hemodialysis within 2 months of its creation without any interventional procedures. The secondary outcome is assisted AVF maturation, which is defined as AVF maturation within 2 months from its creation aided by any interventional procedure before the successful use of AVF. DISCUSSION: While contemporary theory for AVF maturation failure focuses on disturbed wall shear stress, complicate assumptions and measurement preclude its clinical applicability. AVF luminal pressure, which may be manipulated pharmaceutically and surgically, may be a target to improve the outcome of AVF maturation. TRIAL REGISTRATION: This study has been registered at the protocol registration and results system. The Protocol ID: NCT04017806.


Assuntos
Derivação Arteriovenosa Cirúrgica/métodos , Diálise Renal/métodos , Grau de Desobstrução Vascular/fisiologia , Remodelação Vascular/fisiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Fumar Cigarros/epidemiologia , Comorbidade , Feminino , Hemodinâmica/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Insuficiência Renal/etiologia , Insuficiência Renal/terapia , Projetos de Pesquisa , Fatores de Risco , Fatores Sexuais , Taiwan , Fatores de Tempo , Adulto Jovem
8.
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
9.
Pan Afr Med J ; 33: 136, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565115

RESUMO

Introduction: Shisha consumption is a growing public health issue all over the globe and public health awareness about its deleterious health consequences is still not sufficiently raised. Methods: In this location-based study of nightclubs in Ibadan, Nigeria, 633 patrons of selected nightclubs were interviewed in order to obtain information on prevalence, correlates and predictors of shisha smoking. Results: The overall prevalence of shisha smoking was 7.1%. The age of initiation into shisha smoking was lower among women, p = 0.03, but men were significantly more likely to be more frequent users, daily or weekly users, p < 0.001 and also to be current cigarette smokers, p = 0.03. There was no significant gender variability in the stage of readiness to quit. Regression analysis showed that after adjusting for age, the predictors of shisha smoking were: cigarette smoking, OR = 4.83, 95% CI (1.49-15.70) and more than 12 years of education, OR = 7.55, 95% CI (1.88 - 30.37), while being a rural dweller was a protective factor, OR = 0.05, 95% CI (0.01-0.20). Conclusion: Shisha smoking has emerged as a prevalent public health issue in Nigeria. There is a need for an immediate response from policy providers towards shisha smoking intervention in Nigeria.


Assuntos
Fumar Cigarros/epidemiologia , Abandono do Hábito de Fumar/psicologia , Cachimbos de Água/estatística & dados numéricos , Fumar/epidemiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de Proteção , Análise de Regressão , Fatores de Risco , Fatores Sexuais
10.
BMC Public Health ; 19(1): 1249, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31510968

RESUMO

BACKGROUND: The consumption of tobacco products has evolved to include more complex combinations of different products. We investigated the tobacco habits of a representative population of young Finnish male conscripts in order to evaluate the prevalence of dual use of cigarettes and snus as well as the transition from one tobacco product to another. In addition, we evaluated the correlation between the level of education and the use of cigarettes and snus. METHODS: A questionnaire-based survey was carried out in three out of 17 garrisons among conscripts during their first week of service in 2014. A total of 1971 male conscripts were selected by simple random sampling of the 9013 males in the selected garrisons. Of them 1916 participated and filled in the questionnaire. The response rate was 97.2%. The questionnaire consisted of 25 questions including age, gender, basic education, use of tobacco products as well as questions assessing nicotine dependency. RESULTS: The amount of dual users of cigarettes and snus was 21%. There was a higher probability of dual use of cigarettes and snus among smokers compared to snus users (p < 0.001). One third (35%) of former smokers reported daily snus use and over 40% of the former snus users smoked daily. One third (34%) of the participants reported snus usage and 14% of the study subjects used snus daily. 40% of the study population were smokers and over 25% smoked daily. Of the participants with basic educational background 57% smoked daily (p < 0.001), however, no association between snus and level of education was found (p = 0.69). CONCLUSIONS: This study provides better understanding of the complex tobacco habits of young adult males. The simultaneous usage of multiple tobacco products as well as the high tendency to transition from one tobacco product to another should be taken into consideration when planning cessation interventions in health care settings and tobacco control policies at societal levels.


Assuntos
Fumar Cigarros/epidemiologia , Comportamentos Relacionados com a Saúde , Abandono do Hábito de Fumar/estatística & dados numéricos , Tabagismo/epidemiologia , Tabaco sem Fumaça/estatística & dados numéricos , Adolescente , Finlândia/epidemiologia , Humanos , Masculino , Produtos do Tabaco/estatística & dados numéricos , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-31480564

RESUMO

Smoking cigarettes and e-cigarettes is widely popular among Chinese students. Considering that school personnel are considered role models in the student community, we investigated the prevalence and determinants of such behavior among high school personnel in China so as to provide references for future related intervention measures. We used a stratified cluster sampling design on a total number of 3311 school employees recruited from 33 representative schools. Complex sampling analysis and logistic regressions were used for univariate and multivariate analyses. Among 3194 participants that met the study criteria, 7.4% were cigarette users, and 3.6% e-cigarette consumers. For conventional cigarette smokers, certain characteristics, such as being older and male, attaining less education, and having been exposed to secondhand smoke, were associated with heavier smoking. Nevertheless, e-cigarette users were predominantly male and of younger age. Those who understood the hazards of conventional cigarette smoking had less inclination to smoke but were at a higher risk of e-cigarette use. Our analysis suggests that it is necessary to target different populations for monitoring and controlling conventional cigarette smoking and e-cigarette use respectively among school personnel. In addition, China is in need of more relevant and strict anti-smoking regulations.


Assuntos
Fumar Cigarros/epidemiologia , Pessoal de Educação/estatística & dados numéricos , Vaping/epidemiologia , Adulto , China , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Instituições Acadêmicas , Fumantes , Estudantes , Produtos do Tabaco , Poluição por Fumaça de Tabaco
12.
Acta Diabetol ; 56(12): 1315-1321, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31493030

RESUMO

AIM: To assess the association between alcohol consumption and/or cigarette smoking with other unhealthy behaviors and clinical cardiovascular risk factors in youth with type 1 diabetes. METHODS: Two hundred and twenty-eight youth with type 1 diabetes (age 13-19 years) were consecutively enrolled in three Regional Pediatric Diabetes Centers in Italy. Demographic, anthropometric, lifestyle (adherence to the Mediterranean diet pattern and sports participation) and laboratory parameters were compared among youth reporting isolated or combined alcohol consumption and/or cigarette smoking. RESULTS: Ten percent of the youth reported alcohol consumption, 10% cigarette smoking and 6% both alcohol and cigarette use; 74% did not report alcohol or cigarette use. Compared to non-drinker non-smoker youth, smokers showed significantly higher percentages of each of the behavioral and clinical cardiovascular risk factors. Drinkers showed a significantly higher proportion of abdominal adiposity, dyslipidemia and poor adherence to the Mediterranean diet. Alcohol consumption was independently associated with both dyslipidemia and high glycosylated hemoglobin. CONCLUSIONS: Our findings emphasize the need to increase the awareness of youth with T1D about the negative impact of alcohol drinking on cardiovascular risk, since the effects of alcohol might be underestimated with respect to the well-known detrimental effects of smoking. Clustering of unhealthy lifestyle should be discouraged in type 1 diabetes youth in order to promote cardiovascular protection.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Doenças Cardiovasculares/epidemiologia , Fumar Cigarros/epidemiologia , Diabetes Mellitus Tipo 1/epidemiologia , Angiopatias Diabéticas/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Doenças Cardiovasculares/etiologia , Fumar Cigarros/efeitos adversos , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/complicações , Angiopatias Diabéticas/etiologia , Feminino , Hemoglobina A Glicada/análise , Hemoglobina A Glicada/metabolismo , Humanos , Itália/epidemiologia , Estilo de Vida , Masculino , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Adulto Jovem
13.
Med Arch ; 73(2): 104-108, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31391697

RESUMO

Introduction: The dietary supplements are defined as vitamins and minerals or herbal products and are typically given in the form of a capsule or tablet. The nonsmokers are more attempted to use dietary supplements than individuals who smoke. Aim: In our investigation, we examined associations between vitamin B, folic acid, multivitamin or mineral intake among the student population and their correlation with smoking prevalence and drinking coffee. Materials and methods: We used a questionnaire to examine the general characteristics of the subjects, age, sex, their lifestyle, cigarette smoking, coffee intake and their use of dietary supplements. Data were collected from participants of the University of Sarajevo and a longitudinal study of 960 men and women aged 18-24 years from 2017 to 2018 was conducted. Results: The results showed that 32% of students took vitamin B supplements and 10% folic acid. In opposite, more than half of students took multivitamins (59.5%) and minerals (60.4%) less than one year. About a quarter or less took multivitamins (23.9%) and minerals (24.3%) for years. Less than 20% of students took multivitamins and minerals within a period of one year. In student population smoking prevalence was estimated at 21.2% and coffee intake in 71.2%. The smoking and use of vitamin B supplements were independent of each other, p = 0.201. The use of folic acid did not depend on smoking p = 0.501. There were no observed correlations between multivitamin and mineral supplement consumption compared to smoking status or drinking coffee. Conclusion: Deficient dietary intake of folic acid and B vitamins from food and supplemental sources appear to be one of the atherosclerosis incidences. Further studies should examine associations between dietary supplements intake and lifestyle of students, as well as smoking status and coffee intake.


Assuntos
Fumar Cigarros/epidemiologia , Café , Suplementos Nutricionais , Comportamento de Ingestão de Líquido , Estudantes/estatística & dados numéricos , Oligoelementos/uso terapêutico , Vitaminas/uso terapêutico , Bósnia e Herzegóvina/epidemiologia , Feminino , Ácido Fólico/uso terapêutico , Humanos , Masculino , Prevalência , Universidades , Complexo Vitamínico B/uso terapêutico , Adulto Jovem
14.
Afr J Prim Health Care Fam Med ; 11(1): e1-e6, 2019 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-31296013

RESUMO

BACKGROUND:  Tobacco use is an important public health issue. Morocco implemented a tobacco control programme, which has been ongoing among students at middle and secondary schools since 2010. AIM:  This study aims to compare the trend in smoking among the programme beneficiaries with the results of the initial study conducted prior to the implementation of the programme. SETTING:  This study was conducted in middle and secondary schools of the Gharb Region in Morocco between 2010 and 2015. METHODS:  Two cross-sectional studies were conducted in 2010 and 2015 in the middle and secondary schools of the Gharb Region. Multistage cluster sampling was used. The information was collected using a self-administered questionnaire. RESULTS:  In the first study in 2010, 5312 students participated, and in the second one in 2015, 4208 students participated. The level of information on smoking and its effects was higher in 2015 (94.0%) than in 2010 (92.5%). In 2010, parents, primary schools and television and radio were more involved in student information on smoking compared to 2015. The proportion of students claiming that tobacco was not a pleasure (86.3%) and that it does not calm nerves (76.5%) was significantly higher in 2015 than in 2010. The prevalence of smoking increased significantly in 2015 (2.9%) against 2010 (1.8%). CONCLUSION:  This study reports the general positive evolution in knowledge about smoking and its effects. Despite that the prevalence of smokers increased in 2015. The results suggest the need to address family influences on adolescent smoking and to investigate participation of schools in education and training students in tobacco dependence prevention.


Assuntos
Fumar Cigarros/epidemiologia , Fumar Cigarros/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Avaliação de Programas e Projetos de Saúde/métodos , Adolescente , Adulto , Criança , Análise por Conglomerados , Estudos Transversais , Feminino , Humanos , Masculino , Marrocos/epidemiologia , Inquéritos e Questionários , Adulto Jovem
15.
Int J Equity Health ; 18(1): 109, 2019 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-31315627

RESUMO

BACKGROUND: Socio-economic and sexual orientation inequalities in cigarette smoking are well-documented; however, there is a lack of research examining the social processes driving these complex inequalities. Using an intersectional framework, the current study examines key processes contributing to inequalities in smoking between four intersectional groups by education and sexual orientation. METHODS: The sample (28,362 adults) was obtained from Wave 2 (2014-2015) of the Population Assessment of Tobacco and Health (PATH) Study. Four intersectional positions were created by education (high- and low-education) and sexual orientation (heterosexual or lesbian, gay, bisexual, or queer/questioning (LGBQ). The joint inequality, the referent socio-economic inequality, and the referent sexual orientation inequality in smoking were decomposed by demographic, material, tobacco marketing-related, and psychosocial factors using non-linear Oaxaca decomposition. RESULTS: Material conditions made the largest contribution to the joint inequality (9.8 percentage points (p.p.), 140.9%), referent socio-economic inequality (10.01 p.p., 128.4%), and referent sexual orientation inequality (4.91 p.p., 59.8%), driven by annual household income. Psychosocial factors made the second largest contributions to the joint inequality (2.12 p.p., 30.3%), referent socio-economic inequality (2.23 p.p., 28.9%), and referent sexual orientation inequality (1.68 p.p., 20.5%). Referent sexual orientation inequality was also explained by marital status (20.3%) and targeted tobacco marketing (11.3%). CONCLUSION: The study highlights the pervasive role of material conditions in inequalities in cigarette smoking across multiple dimensions of advantage and disadvantage. This points to the importance of addressing material disadvantage to reduce combined socioeconomic and sexual orientation inequalities in cigarette smoking.


Assuntos
Fumar Cigarros/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Fatores Socioeconômicos , Adulto , Bissexualidade/estatística & dados numéricos , Feminino , Heterossexualidade/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Minorias Sexuais e de Gênero/estatística & dados numéricos
16.
Eur J Pediatr ; 178(9): 1343-1351, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31292730

RESUMO

Although tobacco use has decreased in the general population in recent years, smoking remains high among subpopulations. This study examined whether sexual identity is associated with cigarette smoking and e-cigarette use among high school students. Data were drawn from the US Youth Risk Behavior Surveillance System (n = 28811). We grouped participants according to sexual identity status. Propensity score matching technique was used to address covariate imbalance among sexual identity groups. Subgroup analyses were performed for male and female students. Of the four sexual identity groups analyzed in this study, bisexual adolescents had significantly higher odds of cigarette smoking (cigarette smoking, OR, 1.61; 95% CI, 1.24-2.08; cigarette smoking for ≥ 10 days, OR, 1.79; 95% CI, 1.28-2.51; cigarette smoking for ≥ 20 days, OR, 2.04; 95% CI, 1.38-3.03). Further, in a sex-based subgroup analysis, results showed significant differences, with bisexual females more likely to smoke cigarettes and use e-cigarettes for ≥ 20 days compared with heterosexual female adolescents.Conclusions: Sexual identity status is strongly associated with cigarette smoking and e-cigarette use. Female bisexual adolescents have an increased risk of cigarette smoking and e-cigarette use for ≥ 20 days. While tobacco control policies have been effective in reducing cigarette use in the general population, targeting policy toward sexual minorities is an important consideration. What is Known: • Sexual minority groups face a disproportionate amount of stress and have a heightened risk of substance use. • Methodological concerns exist in the extant literature, including limited data at the national level. What is New: • Propensity score matching was used to account for imbalances in sexual identity subgroups, and findings show significant heterogeneity in cigarette and e-cigarette use among sexual minority high school students. • Sexual identity status is strongly associated with cigarette smoking and e-cigarette use, especially among bisexual identity female subgroup.


Assuntos
Fumar Cigarros/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina , Minorias Sexuais e de Gênero/psicologia , Vaping/epidemiologia , Adolescente , Fumar Cigarros/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pontuação de Propensão , Fatores Sexuais , Minorias Sexuais e de Gênero/estatística & dados numéricos , Estados Unidos/epidemiologia , Vaping/psicologia
17.
Public Health ; 173: 126-129, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31276890

RESUMO

OBJECTIVES: Cuba is a tobacco-producing country that has been economically isolated as a consequence of an embargo imposed by the USA. It has also experienced a severe economic depression in the 1990s after the withdrawal of support by the former Soviet Union. These characteristics provide a unique opportunity to study the relation between large changes in economic activity, cigarette price and demand for cigarettes in a relatively isolated socialist economy. STUDY DESIGN: This is an observational epidemiological study. METHODS: Data were obtained on the annual price of a packet of cigarettes and the mean number of cigarettes consumed per adult living in Cuba from 1980 to 2014. Descriptive and regression analysis were used to explore the relationship between cigarette consumption and price in Cuba. RESULTS: In 1980, the mean price of a packet of cigarettes was 1.53 Cuban peso (CUP) in 1997 prices and the mean annual per capita consumption was 2237 cigarettes. In 2014, the mean price had increased to 5.57 CUP (1997 prices) per packet of cigarettes, and consumption had fallen to 1527 cigarettes per capita. There were significant negative associations between annual cigarette consumption and both price and living through an economic depression. The elasticity was approximately -0.31 with price, and living through an economic depression was also associated with lower consumption of cigarettes (a reduction of 9%, 95% confidence intervals -0.18 to -0.001). CONCLUSIONS: Higher cigarette pricing, along with other public health interventions, are required to protect the national population from the adverse effects of tobacco smoke exposure.


Assuntos
Fumar Cigarros/economia , Comércio/estatística & dados numéricos , Recessão Econômica , Produtos do Tabaco/economia , Adulto , Fumar Cigarros/epidemiologia , Cuba/epidemiologia , Humanos
18.
Artigo em Inglês | MEDLINE | ID: mdl-31261697

RESUMO

Electronic cigarettes (e-cigarettes) are an alternative to traditional tobacco cigarette smoking. The aim of this study was to assess the prevalence of cigarette smoking and e-cigarette use among university students from Central and Eastern Europe and to investigate personal characteristics associated with cigarette and e-cigarette smoking. A questionnaire-based cross-sectional survey was performed between 2017-2018 among university students in five European countries: Belarus, Lithuania, Poland, Russia, and Slovakia. The questionnaire included 46 questions related to the frequency and habits of traditional cigarettes and e-cigarettes use. Completed questionnaires were obtained from 14,352 students (8800 medical; aged 20.9 ± 2.4 years) with an overall response rate of 72.2%. Two-thirds of the respondents had smoked a traditional tobacco cigarette and 43.7% had used an e-cigarette. Overall current smoking status included 12.3% traditional cigarette smokers, 1.1% e-cigarette users, and 1.8% were dual users with the remainder being non-smokers. Smoking status differed between the research centres (p < 0.001). Females were less likely to try either cigarettes (OR = 0.83) or e-cigarettes (OR = 0.62) and were less likely to be current cigarette (OR = 0.64), e-cigarette (OR = 0.34), or dual users (OR = 0.33) than males. Perception of e-cigarettes significantly differed between smokers and non-smokers (p < 0.001). Among university students, cigarettes are more popular than e-cigarettes.


Assuntos
Fumar Cigarros/epidemiologia , Estudantes/estatística & dados numéricos , Vaping/epidemiologia , Adolescente , Adulto , Estudos Transversais , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Europa Oriental/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Abandono do Hábito de Fumar/métodos , Inquéritos e Questionários , Adulto Jovem
19.
Pan Afr Med J ; 32: 156, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31308861

RESUMO

Introduction: Tobacco is one of the leading preventable cause of death worldwide. Tobacco consumption among teenagers is a major public health problem, especially in developing countries. Younger smokers are more liable to smoking complications. The objectives were to evaluate the prevalence of smoking among male secondary school students in the Northern Borders region, KSA. Methods: A cross-sectional study was conducted in Arar city. Four schools were chosen randomly from 21 secondary schools. A total of 240 students responded to the pre-designed questionnaire. The questionnaire included questions on demographic factors, smoking behavior and knowledge about smoking hazards. Results: Prevalence of current smoking among male secondary school students is 40.8%. Cigarette smoking was the most common type (67.3%) followed by Shish smoking (22.4%). Few students (2.1%) reported other forms of smoking, example (Hashish). Of the studied group, 39.8% smoke on a daily basis with 29.6% of them smoke more than five cigarettes per day. Conclusion: Smoking is a prevalent habit among teenagers. Special concern should be directed to smoking cessation campaigns with behavioral, legal and economic interventions.


Assuntos
Fumar Cigarros/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Fumar/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Estudos Transversais , Humanos , Masculino , Prevalência , Arábia Saudita/epidemiologia , Instituições Acadêmicas , Abandono do Hábito de Fumar/métodos , Inquéritos e Questionários
20.
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
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