Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 836
Filtrar
1.
Am J Epidemiol ; 190(2): 295-304, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33524122

RESUMO

Socioeconomic status has been associated with cardiovascular disease risk factors. However, few studies have examined this relationship among populations in the US Gulf Coast region. We assessed neighborhood deprivation in relation to obesity and diabetes in 9,626 residents participating in the Gulf Long-Term Follow-Up Study (2011-present) who completed a home visit (2011-2013) with height, weight, waist, and hip measurements. Obesity was categorized as body mass index of at least 30, and diabetes was defined by doctor's diagnosis or prescription medication. Participant home addresses were linked to an established Area Deprivation Index and categorized into 4 levels (1 = least deprived). In adjusted, modified Poisson regression models, participants with greatest deprivation were more likely to have obesity compared with those with least deprivation (adjusted prevalence ratio (aPR) = 1.21, 95% confidence interval (CI): 1.08, 1.35), central obesity (aPR = 1.11, 95% CI: 1.04, 1.19), and diabetes (aPR = 1.49, 95% CI: 1.03, 2.14). Repeated analyses among a subgroup of participants (n = 3,016) whose hemoglobin A1C values were measured 3 years later indicated the association with diabetes (defined as diagnosis, medications, or hemoglobin A1C ≥ 6.5) was similar (aPR = 1.46, 95% CI: 1.14, 1.86). Results suggest neighborhood deprivation is associated with obesity and diabetes in a US region with high baseline prevalence.


Assuntos
Diabetes Mellitus/epidemiologia , Obesidade/epidemiologia , Características de Residência/estatística & dados numéricos , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Índice de Massa Corporal , Fumar Cigarros/epidemiologia , Feminino , Hemoglobina A Glicada , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Classe Social , Fatores Socioeconômicos , Sudeste dos Estados Unidos/epidemiologia , Texas/epidemiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-33466304

RESUMO

E-cigarette-only use and dual-use are emerging behaviours among adolescent nicotine product users which have not yet been sufficiently explored. This study examines the prevalence of, and the factors associated with, nicotine product use in adolescence. The study is a cross-sectional analysis of the 2018 Planet Youth survey completed by 15-16 year olds in the West of Ireland in 2018. The outcome of interest was current nicotine product use, defined as use at least once in the past 30 days. A main effects multinomial logistic regression model was used to examine the association between potential risk and protective factors and nicotine product use. Among 4422 adolescents 22.1% were current nicotine product users, consisting of 5.1% e-cigarette only users, 7.7% conventional cigarette only users, and 9.3% dual-users. For risk factors, the odds of association were weaker for e-cigarette only use compared to conventional cigarette and dual use. Participating in team sport four times/week or more significantly reduced the odds of conventional cigarette and dual use but had no association with e-cigarette only use (Cig: adjusted odds ratio (AOR) 0.63, 95% confidence interval (CI) 0.44-0.90; Dual-use: AOR 0.63, 95% CI 0.43-0.93). Similarly, having higher value for conventional social norms reduced the odds of conventional cigarette and dual use but not e-cigarette only use. This is the first study to show, among a generalisable sample, that dual-use is the most prevalent behaviour among adolescent nicotine product users in Ireland. Risk factor profiles differ across categories of use and prevention initiatives must be cognisant of this.


Assuntos
Fumar Cigarros/epidemiologia , Vaping/epidemiologia , Adolescente , Estudos Transversais , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Humanos , Irlanda/epidemiologia , Masculino
3.
Environ Health Prev Med ; 26(1): 5, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33419408

RESUMO

BACKGROUND: This systematic and meta-analysis review aimed to provide an updated estimate of the prevalence of ever and current cigarette smoking in women, in geographic areas worldwide, and demonstrate a trend of the prevalence of smoking over time by using a cumulative meta-analysis. METHODS: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of ever and current cigarette smoking in women. We searched PubMed, Web of Science (ISI), Scopus, and Ovid from January 2010 to April 2020. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence of ever and current cigarette smoking in women. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression. RESULTS: The pooled prevalence of ever and current cigarette smoking in women was 28% and 17%, respectively. The pooled prevalence of ever cigarette smoking in adolescent girls/students of the school, adult women, pregnant women, and women with the disease was 23%, 27%, 32%, and 38%, respectively. The pooled prevalence of ever cigarette smoking in the continents of Oceania, Asia, Europe, America, and Africa was 36%, 14%, 38%, 31%, and 32%, respectively. CONCLUSIONS: The prevalence of cigarette smoking among women is very high, which is significant in all subgroups of adolescents, adults, and pregnant women. Therefore, it is necessary to design and implement appropriate educational programs for them, especially in schools, to reduce the side effects and prevalence of smoking among women.


Assuntos
Fumar Cigarros/epidemiologia , Fumar Cigarros/tendências , Feminino , Humanos , Prevalência
4.
Addict Behav ; 115: 106783, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33360444

RESUMO

We examined tobacco use changes in young adult college students in the context of the COVID-19 pandemic, focusing on smoking and vaping. First, we evaluated changes in tobacco use from pre to post campus closure focusing on smoking and electronic nicotine vaping frequency (days) and quantity (cigarettes/cartridges per day). Also, given the potential protective effects of pausing (temporarily or permanently discontinuing) smoking or vaping, we evaluated its predictors. We hypothesized that generalized anxiety and moving home would increase the odds of pausing. We also explored effects of COVID-related news exposure and seeking on tobacco use. We re-contacted young adults two years after they completed a study on alcohol and marijuana co-use. A subset (N = 83; 26.6% of the 312 respondents) were enrolled in college and reported use of cigarettes (n = 35) and/or e-cigarettes (n = 69) in the week prior to their campus closing (PC). Paired sample t-tests compared smoking and vaping frequency and quantity PC to past-week use since closing (SC). Multivariate logistic regression models were fit to examine predictors of pausing. Both smoking and vaping frequency decreased from PC to SC; however, decreased frequency did not correspond to reduced quantity. Twenty-four participants (28.9%) paused past-week use SC. Higher anxiety and moving home (versus living independently) were related to increased odds of pausing, whereas COVID-19 related news exposure and seeking were related to decreased odds of pausing. Characterizing COVID-19 related tobacco use change provides insights into how college students respond to novel health threats and informs potential interventions.


Assuntos
/psicologia , Fumar Cigarros/epidemiologia , Fumar Cigarros/psicologia , Vaping/epidemiologia , Vaping/psicologia , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pandemias , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-33327373

RESUMO

Depression is a risk factor for nicotine use and withdrawal. Population level epidemiologic studies that include users of either combustible or electronic cigarette (NICUSER) could inform interventions to reduce nicotine dependence in vulnerable populations. The current study examined the relationship between depression diagnosis (DEPDX), NICUSER, and lifetime rates of DSM-V nicotine withdrawal (NW) symptoms in a nationally representative sample of US adults (N = 979), who answered related questions in surveys administered through GfK's KnowledgePanel. Over 42% of the sample reported lifetime ever combustible cigarette use, 15.6% electronic-cigarette use, and 45.9% either (NICUSER). Weighted logistic regression analyses (controlling for age and gender) found that DEPDX was associated with 2.3 times increased odds (ratio (OR); 95% Confidence Interval (CI): 1.5-3.5) of being a NICUSER. Regarding risks of NW symptoms among NICUSER, models that additionally controlled for frequency of nicotine use found that DEPDX was significantly associated with increased odds of concentration problems (OR = 2.4; 95% CI: 1.3-4.5) and depressed mood (OR = 2.2; 95% CI: 1.1-4.1) when quitting or cutting down on nicotine use. Results highlight the consistent comorbidity between depression, nicotine use, and symptomatic nicotine withdrawal in a population-based sample of combustible and electronic cigarette users.


Assuntos
Fumar Cigarros , Depressão , Nicotina , Síndrome de Abstinência a Substâncias , Vaping , Adulto , Fumar Cigarros/efeitos adversos , Fumar Cigarros/epidemiologia , Estudos Transversais , Depressão/induzido quimicamente , Depressão/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nicotina/efeitos adversos , Síndrome de Abstinência a Substâncias/epidemiologia , Vaping/efeitos adversos
6.
MMWR Morb Mortal Wkly Rep ; 69(47): 1792-1796, 2020 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-33237898

RESUMO

Cigarette smoking remains the leading cause of preventable disease and death in the United States (1). Although the percentage of all U.S. adults who smoke cigarettes has declined substantially since the mid-1960s (1,2), marked disparities persist, and declines have not been consistent across population groups (1,2). Studies have shown that cigarette smoking is as common, and sometimes more so, among adults with a history of epilepsy compared with those without a history of epilepsy, but reasons for this are unclear (3-6). Compared with adults without epilepsy, adults with epilepsy report lower household income, more unemployment and disability, worse psychological health, and reduced health-related quality of life (3,4,6,7). Trends in cigarette smoking among U.S. adults with epilepsy have not been previously assessed. CDC analyzed National Health Interview Survey (NHIS) data among 121,497 U.S. adults from 2010, 2013, 2015, and 2017 to assess current cigarette smoking by epilepsy status. From 2010 through 2017, the age-standardized percentages of current smoking were 24.9% among adults with active epilepsy, 25.9% among adults with inactive epilepsy, and 16.6% among adults with no history of epilepsy. After accounting for differences in data collection intervals and patterns in smoking status among subgroups, CDC found that current cigarette smoking declined significantly from 2010 to 2017 among adults with no history of epilepsy (19.3% to 14.0% [p<0.001]) and inactive epilepsy (29.2% to 16.2% [p = 0.03]), but declines among adults with active epilepsy were not statistically significant (26.4% to 21.8% [p = 0.2]). Epilepsy health and social service providers should promote smoking cessation resources to adults with active epilepsy who smoke cigarettes to help them quit smoking and to reduce their risk of smoking-related disease and death.


Assuntos
Fumar Cigarros/epidemiologia , Fumar Cigarros/tendências , Epilepsia/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estados Unidos/epidemiologia , Adulto Jovem
7.
Eur Addict Res ; 26(6): 309-315, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32961535

RESUMO

BACKGROUND: The outbreak of coronavirus disease 19 (COVID-19) has led to measures of social distancing and quarantine worldwide. This stressful period may lead to psychological problems, including increases in substance use. OBJECTIVE: To investigate changes in alcohol, tobacco, and cannabis consumption before and during COVID-19 lockdown and motives for these changes in substance use. METHOD: A web-based survey was filled out by an unselected population during the social distancing measures of the COVID-19 pandemic in Belgium that assessed changes in alcohol, tobacco, and cannabis consumption in the period before and during the COVID-19 lockdown and also asked about reasons for change. RESULTS: A total of 3,632 respondents (mean age 42.1 ± 14.6 years; 70% female) filled out the survey. Overall, respondents reported consuming more alcohol (d = 0.21) and smoking more cigarettes (d = 0.13) than before the COVID-19 pandemic (both p < 0.001), while no significant changes in the consumption of cannabis were noted. The odds of consuming more alcohol during the lockdown were associated with younger age (OR = 0.981, p < 0.001), more children at home (OR = 1.220, p < 0.001), non-healthcare workers (p < 0.001), and being technically unemployed related to COVID-19 (p = 0.037). The odds of smoking more cigarettes during the lockdown were associated with younger age (OR = 0.988, p = 0.027), current living situation (p < 0.001), lower education (p = 0.015), and working situation related to COVID-19 (p = 0.018). Boredom, lack of social contacts, loss of daily structure, reward after a hard-working day, loneliness, and conviviality were the main reasons for consuming more of the various substances. CONCLUSIONS: During the lockdown, individuals consumed slightly more alcohol and smoked marginally more cigarettes compared to the period before the lockdown. Further research focussing on follow-up of individuals at risk may be useful to provide appropriate care in post-COVID times.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Fumar Cigarros/epidemiologia , Infecções por Coronavirus , Uso da Maconha/epidemiologia , Pandemias , Pneumonia Viral , Quarentena/psicologia , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/psicologia , Bélgica/epidemiologia , Betacoronavirus , Tédio , Fumar Cigarros/psicologia , Escolaridade , Feminino , Humanos , Solidão , Masculino , Uso da Maconha/psicologia , Pessoa de Meia-Idade , Motivação , Características de Residência , Autorrelato , Fatores Sexuais , Comportamento Social , Inquéritos e Questionários , Adulto Jovem
8.
Medicine (Baltimore) ; 99(38): e22036, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957321

RESUMO

Studies about the effects of metabolically healthy obesity on cardiovascular disease (CVD) have yielded conflicting results. These heterogeneous results could be due to the limited usefulness of BMI in measuring general adiposity, as body mass index (BMI) does not accurately reflect body composition. This study aimed to evaluate the effect of body shape on CVD outcomes across different obesity phenotypes, and to provide an explanation for the heterogeneous effects of metabolically healthy obese (MHO) phenotype on CVD.We analyzed data from the Korean Genome and Epidemiology Study, a population-based cohort study conducted between 2001 and 2012. We divided the participants into 4 groups: metabolically healthy non-obese (MHNO), MHO, metabolically unhealthy non-obese (MUNO), and metabolically unhealthy obese (MUO). To assess body shape, we calculated the z-score of the log-transformed a body shape index (LBSIZ). We computed Pearson correlation coefficients to examine the association of LBSIZ with muscle mass index, percentage of total fat mass (%Total FM), and percentage of abdominal fat mass (%Abdominal FM). We also used Cox proportional hazards regression to evaluate the effect of LBSIZ on CVD events according to the obesity phenotypes.A total of 9460 participants were assessed in this study. The incidence of CVD was 8.53 cases per 1000 person-year. LBSIZ showed strong positive correlation with %Total FM and %Abdominal FM, but negative correlation with muscle mass index. In Cox regression, MHO individuals did not show increased risk of CVD compared with MHNO individuals (hazard ratio [HR], 1.29; 95% confidence interval [CI], 0.96-1.73). However, MHO individuals in the 3rd (HR, 2.40; 95% CI, 1.28-4.51) and 4th (HR, 3.67; 95% CI, 1.99-6.74) quarters of LBSIZ showed significantly higher risk of CVD compared with MHNO individuals in the 1st quarter of LBSIZ. Moreover, LBSIZ showed a linear relationship with CVD among MHO individuals.While the MHO individuals showed similar CVD risk to the MHNO individuals, CVD risk increases with LBSIZ among the MHO individuals. LBSIZ appears to be a useful measure for CVD risk assessment in clinical practice and epidemiologic studies, especially for MHO patients.


Assuntos
Composição Corporal/fisiologia , Doenças Cardiovasculares/epidemiologia , Obesidade Metabolicamente Benigna/epidemiologia , Obesidade Metabolicamente Benigna/patologia , Adiposidade , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Glicemia , Índice de Massa Corporal , Pesos e Medidas Corporais , Fumar Cigarros/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Nível de Saúde , Humanos , Incidência , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Fenótipo , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de Risco , Fatores Socioeconômicos
9.
Croat Med J ; 61(4): 309-318, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32881428

RESUMO

AIM: To investigate the effect of the coronavirus 2019 (COVID-19) lockdown on lifestyle behaviors and mood changes in the Croatian general population. METHODS: During ten days of the COVID-19 lockdown in Croatia, 3027 respondents (70.3% female) from the general population completed an online, self-report questionnaire. Demographic data and data on lifestyle habits and mood changes before and during the COVID-19 lockdown were collected. RESULTS: A total of 95.64% of respondents reported to follow most or all restrictions, with female sex (P<0.001) and higher education level (P<0.001) being associated with higher restriction compliance. Women smoked an increased number of cigarettes (P<0.001). The proportion of respondents of both sexes who did not drink or drank 7 drinks per week or more increased (P<0.001). Women also reported lower frequency (P=0.001) and duration of physical exercise (P<0.001). In total, 30.7% of respondents gained weight, with female sex (OR, 2.726) and higher BMI (OR, 1.116; both P<0.001) being associated with an increased likelihood of gaining weight. Both men and women felt more frequently afraid (P<0.001), discouraged (P<0.001), and sad (P<0.001). CONCLUSION: Public health authorities should promote the adoption of healthy lifestyles in order to reduce long-term negative effects of the lockdown.


Assuntos
Afeto , Consumo de Bebidas Alcoólicas/epidemiologia , Fumar Cigarros/epidemiologia , Infecções por Coronavirus/epidemiologia , Exercício Físico , Pneumonia Viral/epidemiologia , Quarentena/estatística & dados numéricos , Ganho de Peso , Adulto , Betacoronavirus , Índice de Massa Corporal , Coronavirus , Croácia/epidemiologia , Estudos Transversais , Medo , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pandemias , Admissão e Escalonamento de Pessoal , Quarentena/psicologia , Tristeza , Inquéritos e Questionários
10.
PLoS One ; 15(8): e0236021, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32745082

RESUMO

BACKGROUND: The National Lung Screening Trial (NLST) demonstrated that annual screening with low dose CT in high-risk population was associated with reduction in lung cancer mortality. Nonetheless, the leading cause of mortality in the study was from cardiovascular diseases. PURPOSE: To determine whether the used machine learning automatic algorithms assessing coronary calcium score (CCS), level of liver steatosis and emphysema percentage in the lungs are good predictors of cardiovascular disease (CVD) mortality and incidence when applied on low dose CT scans. MATERIALS AND METHODS: Three fully automated machine learning algorithms were used to assess CCS, level of liver steatosis and emphysema percentage in the lung. The algorithms were used on low-dose computed tomography scans acquired from 12,332 participants in NLST. RESULTS: In a multivariate analysis, association between the three algorithm scores and CVD mortality have shown an OR of 1.72 (p = 0.003), 2.62 (p < 0.0001) for CCS scores of 101-400 and above 400 respectively, and an OR of 1.12 (p = 0.044) for level of liver steatosis. Similar results were shown for the incidence of CVD, OR of 1.96 (p < 0.0001), 4.94 (p < 0.0001) for CCS scores of 101-400 and above 400 respectively. Also, emphysema percentage demonstrated an OR of 0.89 (p < 0.0001). Similar results are shown for univariate analyses of the algorithms. CONCLUSION: The three automated machine learning algorithms could help physicians to assess the incidence and risk of CVD mortality in this specific population. Application of these algorithms to existing LDCT scans can provide valuable health care information and assist in future research.


Assuntos
Doenças Cardiovasculares/mortalidade , Aprendizado de Máquina , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Fumar Cigarros/efeitos adversos , Fumar Cigarros/epidemiologia , Ensaios Clínicos Fase III como Assunto , Vasos Coronários/diagnóstico por imagem , Detecção Precoce de Câncer/métodos , Enfisema/diagnóstico , Enfisema/epidemiologia , Enfisema/etiologia , Fígado Gorduroso/diagnóstico , Fígado Gorduroso/epidemiologia , Feminino , Humanos , Fígado/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/mortalidade , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , National Cancer Institute (U.S.) , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Medição de Risco/métodos , Fatores de Risco , Estados Unidos/epidemiologia
11.
PLoS Med ; 17(8): e1003158, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32810187

RESUMO

BACKGROUND: Most of the women who smoke before pregnancy continue smoking during pregnancy, and some start to quit smoking after being pregnant, although existing guidelines for pregnancy recommend that women who smoke should quit smoking before pregnancy. Findings about the timing and intensity of maternal smoking, especially low-intensity smoking (1-9 cigarettes per day), and preterm birth are still inconsistent and ambiguous. This study aimed to examine the association of the timing of smoking and doses of smoking before pregnancy and during the first or second trimester of pregnancy with preterm birth in a large-scale population-based retrospective cohort study. METHODS AND FINDINGS: We used nationwide birth certificate data from singleton mother-infant pairs in the United States National Vital Statistics System, 2011-2018. All adult women with live singleton births, without preexisting hypertension or diabetes, and with complete data on smoking and gestational age at delivery were included. Participants reported their smoking status (yes or no) and daily number of cigarettes consumed before and during each trimester of pregnancy. The outcome of interest was preterm birth, defined as a birth before 37 weeks of gestation. Logistic regression models were used to estimate the odds ratio (OR) with 95% confidence intervals (CIs) of preterm birth associated with smoking status and the number of cigarettes consumed, adjusting for maternal age, race/ethnicity, parity, education levels, prepregnancy BMI, previous history of preterm birth, marital status, infant sex, and initiation of prenatal care. This study included 25,623,479 women, with a mean age of 29 years (range 20-50 years); 13,742,486 (53.6%) participants were of non-Hispanic white ancestry, 5,971,598 (23.3%) of Hispanic ancestry, and 3,417,456 (13.34%) of non-Hispanic black ancestry. The prevalence of preterm birth was 9.3% (n = 2,378,398). We found that maternal smoking during pregnancy, even at a very low level of intensity, was associated with an increased risk of preterm delivery. The adjusted ORs (95% CI) of preterm birth for mothers who smoked 1-2, 3-5, 6-9, 10-19, and ≥20 cigarettes per day during the first trimester compared with mothers who did not smoke were 1.31 (1.29-1.33), 1.31 (1.30-1.32), 1.33 (1.31-1.35), 1.44 (1.43-1.45), and 1.53 (1.52-1.55), respectively (all P values < 0.001), whereas for those who smoked during the second trimester, the corresponding ORs were 1.37 (1.35-1.39), 1.36 (1.35-1.38), 1.36 (1.34-1.38), 1.48 (1.47-1.49), and 1.59 (1.58-1.61), respectively (all P values < 0.001). Furthermore, smokers who quit before pregnancy, regardless of smoking intensity, had a comparable risk of preterm birth with nonsmokers, although this was not the case when cessation occurred in the first or second trimester of pregnancy. The major limitation of this study is the self-reported information about smoking, which may be subject to information bias. In addition, we cannot rule out the possibility of residual confounding caused by unmeasured factors in an observational research design. CONCLUSIONS: In this study, we observed that low-intensity cigarette consumption during either the first or second trimester of pregnancy, even as low as 1-2 cigarettes per day, was associated with an increased risk of preterm birth. These findings suggest that there is no safe level or safe trimester for maternal smoking during pregnancy. Women of reproductive age who smoke should be strongly encouraged and supported to quit smoking before pregnancy.


Assuntos
Fumar Cigarros/efeitos adversos , Fumar Cigarros/epidemiologia , Comportamento Materno , Nascimento Prematuro/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Adulto , Fumar Cigarros/tendências , Relação Dose-Resposta a Droga , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Nascimento Prematuro/diagnóstico , Nascimento Prematuro/etiologia , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Efeitos Tardios da Exposição Pré-Natal/etiologia , Fatores de Risco , Autorrelato , Estados Unidos/epidemiologia , Adulto Jovem
12.
J Adolesc Health ; 67(4): 519-523, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32798097

RESUMO

PURPOSE: This study aimed to assess whether youth cigarette and electronic cigarette (e-cigarette) use are associated with coronavirus disease 2019 (COVID-19) symptoms, testing, and diagnosis. METHODS: An online national survey of adolescents and young adults (n = 4,351) aged 13-24 years was conducted in May 2020. Multivariable logistic regression assessed relationships among COVID-19-related symptoms, testing, and diagnosis and cigarettes only, e-cigarettes only and dual use, sociodemographic factors, obesity, and complying with shelter-in-place. RESULTS: COVID-19 diagnosis was five times more likely among ever-users of e-cigarettes only (95% confidence interval [CI]: 1.82-13.96), seven times more likely among ever-dual-users (95% CI: 1.98-24.55), and 6.8 times more likely among past 30-day dual-users (95% CI: 2.40-19.55). Testing was nine times more likely among past 30-day dual-users (95% CI: 5.43-15.47) and 2.6 times more likely among past 30-day e-cigarette only users (95% CI: 1.33-4.87). Symptoms were 4.7 times more likely among past 30-day dual-users (95% CI: 3.07-7.16). CONCLUSIONS: COVID-19 is associated with youth use of e-cigarettes only and dual use of e-cigarettes and cigarettes, suggesting the need for screening and education.


Assuntos
Comportamento do Adolescente , Fumar Cigarros/efeitos adversos , Infecções por Coronavirus/etiologia , Pneumonia Viral/etiologia , Vaping/efeitos adversos , Adolescente , Betacoronavirus , Fumar Cigarros/epidemiologia , Estudos Transversais , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Humanos , Masculino , Pandemias , Fatores de Risco , Inquéritos e Questionários , Vaping/epidemiologia , Adulto Jovem
13.
J Stud Alcohol Drugs ; 81(4): 497-504, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32800087

RESUMO

OBJECTIVE: We compared estimates of adolescents' nicotine product use and perceptions of harm from two national surveys: Monitoring the Future (MTF) and Population Assessment of Tobacco and Health (PATH). We explored one explanation for the different estimates for nicotine product use and adolescents' perceptions of harm. METHOD: We used data source triangulation examining 30-day e-cigarette use and cigarette smoking, beliefs about harm, and friends' use of these products in two samples of adolescents from the 2015-2016 MTF and PATH samples. RESULTS: Differences were found, with MTF reporting higher prevalence rates in both past-30-day e-cigarette use (12.4% vs. 6.7%) and cigarette smoking (8.6% vs. 5.1%) when compared with PATH. Differences were significant at the .001 alpha level. MTF respondents were less likely than PATH respondents to view both e-cigarettes (17.7% vs. 48.6%) and cigarettes (75.6% vs. 82.4%) as harmful. The unadjusted odds ratio (OR) shows that PATH respondents had significantly lower odds of indicating either e-cigarette (OR = 0.509, 95% confidence interval [CI] [0.400, 0.648]) or cigarette smoking (OR = 0.571, 95% CI [0.433, 0.753]) when compared with MTF respondents. However, these differences in e-cigarette use (adjusted odds ratio [AOR] = 0.849, 95% CI [0.630, 1.144]) and cigarette smoking (AOR = 0.829, 95% CI = [0.578, 1.189]) were mediated when additional predictors were included in the model (i.e., friends use, risk of harm). CONCLUSIONS: Substantial differences were found between national surveys estimating population rates of e-cigarette use and cigarette smoking. Data source triangulation allowed for new explanations for several of the disparate nicotine use estimates between MTF and PATH.


Assuntos
Fumar Cigarros/epidemiologia , Vaping/epidemiologia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Inquéritos e Questionários
14.
PLoS One ; 15(7): e0235772, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32663217

RESUMO

The increasing denormalization of smoking by tobacco control policies and a normative smoke-free climate may shift power towards adolescent non-smokers. It is unclear, however, how common stigmatization of smokers is among adolescents or how stigmatization relates to the denormalization of smoking in their school and social environment. This paper aims to measure (1) whether stigmatization among European adolescents varies according to smoking status and socioeconomic position (SES), and (2) whether stigmatization is greater in school environments in which smoking is denormalized (i.e. those with low smoking rates and strong school tobacco policies). Data on 12,991 adolescents were collected in 55 schools in seven European countries (SILNE R-survey, 2016/17). We applied Stuber's adapted scale of perceived stereotyping and discrimination towards smokers to smoking status and five variables indicating a power shift towards non-smokers: the school's tobacco control policy (STP) score, the percentage of adolescents in the school who smoke, parents' level of education, students' academic performance, and the percentage of their friends who smoke. Multilevel regressions were applied to the global score for perceived stigmatization. Discrimination against smokers and stereotyping of smokers were frequently reported. Smokers reported less 'perceived stigmatization of smoking' than non-smokers (Beta = -0.146, p < 0.001). High-SES students reported stereotyping and discrimination more frequently than lower-SES students. The perception of stigmatization was lower among students whose academic performance was poor (Beta = -0.070, p < 0.001) and among those who had friends who smoked (Beta = -0.141, p < 0.001). Stigmatization was lower in schools with greater exposure to smoking and was not associated with the school's STP score. Perceived stigmatization of smoking is common among European adolescents. Smokers themselves, however, perceive stigmatization less often than non-smokers. Strong school tobacco policies do not increase stigmatization, but a social environment that is permissive of smoking decreases perceived stigmatization.


Assuntos
Instituições Acadêmicas , Política Antifumo , Estereotipagem , Adolescente , Comportamento do Adolescente , Fumar Cigarros/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Meio Social , Estudantes
15.
BMC Public Health ; 20(1): 1055, 2020 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-32641026

RESUMO

BACKGROUND: The United States (US) Food and Drug Administration (FDA), under the 2009 Family Smoking Prevention and Tobacco Control Act, banned characterizing flavors in cigarettes; however, mentholated tobacco products were exempt. Since 2009, over 20 US jurisdictions and numerous countries around the world have extended this restriction to menthol. Currently, the FDA is reconsidering its position on a nation-wide menthol cigarette ban. However, the effects of such a ban remain unclear. We conducted a scoping review to explore the impact of a menthol cigarette ban on individual behaviors (initiation, cessation, and product switching), sales, and compliance. METHODS: We conducted a search of the international literature using PubMed, EBSCO, and Web of Science (to November 25, 2019). We retrieved articles relevant to the impacts of an implemented or hypothetical menthol ban. We also included studies of flavored tobacco product bans due to their potential relevance in gauging compliance and product substitutability. RESULTS: The search identified 493 articles, of which 24 were included. Studies examined the effects of implemented menthol bans (n = 6), hypothetical menthol bans (n = 12) and implemented flavor bans that exclude menthol (n = 6). Menthol bans were found to reduce sales and increase smoking cessation with only partial substitution for non-menthol cigarettes. US smokers' reactions to a hypothetical ban indicate that about 25-64% would attempt to quit smoking and 11-46% would consider switching to other tobacco products, including 15-30% to e-cigarettes. Flavor ban studies indicate reductions in initiation of 6%. Ban compliance was high, but studies indicate that the tobacco industry and retailers have attempted to circumvent their impact via packaging changes and online sales. CONCLUSION: Our review finds that extending the US cigarette flavor ban to menthol products would promote smoking cessation and reduce initiation. This evidence supports further action by the FDA towards mentholated tobacco products. However, few studies have been conducted in the vaping era.


Assuntos
Fumar Cigarros/epidemiologia , Aromatizantes , Mentol , Produtos do Tabaco/legislação & jurisprudência , United States Food and Drug Administration/legislação & jurisprudência , Comércio , Humanos , Abandono do Hábito de Fumar/métodos , Paladar , Indústria do Tabaco , Estados Unidos/epidemiologia
16.
JAMA Netw Open ; 3(6): e204813, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32501492

RESUMO

Importance: Relapse to smoking among former smokers is a serious clinical concern, and use of electronic nicotine delivery systems (ENDS) has been proposed as a new risk factor for relapse. Understanding the specificity of this risk can help guide clinical practice and lead to improved health outcomes. Objective: To assess the associations of ENDS use with cigarette smoking relapse among adult former cigarette smokers. Design, Setting, and Participants: This cohort study examined data from the Population Assessment of Tobacco and Health Study, waves 1 to 4 (2013-2018). Cox proportional hazards models were developed. This is an ongoing, nationally representative, longitudinal cohort study in the US. Participants included adult (≥18 years) former cigarette smokers who reported no tobacco product use at wave 1 (unweighted n = 2273), separated into recent former cigarette smokers (last smoked ≤12 months previously) and long-term former smokers (last smoked >12 months previously). Data analysis was conducted from July to August 2019. Exposures: Self-reported use of cigarettes, ENDS, and other tobacco products (ie, cigars, pipe tobacco, hookah, snus tobacco, other smokeless tobacco, and dissolvable tobacco) was assessed. Main Outcomes and Measures: Self-reported current (every day or some days) use of cigarettes at follow-up interviews. Results: Of 2273 adult former cigarette smokers, 51.8% (95% CI, 49.7%-53.8%) were women, 65.0% (95% CI, 62.6%-67.4%) were older than 50 years, and 79.5% (95% CI, 77.8%-81.2%) were non-Hispanic white participants. Use of ENDS was associated with significant risk of cigarette smoking relapse among recent former smokers (adjusted hazard ratio [AHR], 1.63; 95% CI, 1.04-2.53; unweighted n = 304) and among long-term former smokers (AHR, 3.79; 95% CI, 1.75-8.20; unweighted n = 1554). Use of other tobacco products was also associated with significant risk for cigarette smoking relapse among recent former smokers (AHR, 1.97; 95% CI, 1.27-3.05) and among long-term former smokers (AHR, 3.82; 95% CI, 1.91-7.66). Conclusions and Relevance: In this study, use of ENDS and other tobacco products was associated with increased risk of cigarette smoking relapse among former cigarette smokers who did not use any tobacco product at wave 1 of the PATH Study. For clinicians treating former smokers who have successfully quit all nicotine products, the implications are that use of ENDS products should be discouraged, just as use of all other tobacco products is discouraged.


Assuntos
Fumar Cigarros/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Ex-Fumantes/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Estimativa de Kaplan-Meier , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Recidiva , Fatores de Risco , Autorrelato , Produtos do Tabaco/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem
17.
PLoS One ; 15(6): e0234015, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497122

RESUMO

Cigarette smoking is among the leading risk factors for mortality and morbidity. While men have a higher smoking prevalence, mechanistic experiments suggest that women are at higher risk for health problems due to smoking. Moreover, the comparison of smoking effects on multiple conditions and mortality for men and women has not yet been done in a population-based group with race/ethnic diversity. We used proportional hazards models and restricted mean survival time to assess differences in smoking effects by sex for multiple health outcomes using data from the U.S. Health and Retirement Study (HRS), a population-representative cohort of individuals aged 50+ (n = 22,708, 1992-2014). Men had experienced more smoking pack-years than women (22.0 vs 15.6 average pack-years). Age of death, onset of lung disorders, heart disease, stroke, and cancer showed dose-dependent effects of smoking for both sexes. Among heavy smokers (>28 pack-years) women had higher risk of earlier age of death (HR = 1.3, 95%CI:1.03-1.65) and stroke (HR = 1.37, 95%CI:1.02-1.83). Risk of cancer and heart disease did not differ by sex for smokers. Women had earlier age of onset for lung disorders (HR = 2.83, 95%CI:1.74-4.6), but men risk due to smoking were higher (Smoking-Sex interaction P<0.02) than women. Passive smoke exposure increased risk of earlier heart disease (HR = 1.33, 95%CI:1.07-1.65) and stroke (HR:1.54, 95%CI:1.07-2.22) for non-smokers, mainly in men. Smoking cessation after 15 years partially attenuated the deleterious smoking effects for all health outcomes. In sum, our results suggest that women are more vulnerable to ever smoking for earlier death and risk of stroke, but less vulnerable for lung disorders. From an epidemiological perspective, sex differences in smoking effects are important considerations that could underlie sex differences in health outcomes. These findings also encourage future mechanistic experiments to resolve potential mechanisms of sex-specific cigarette smoke toxicity.


Assuntos
Fumar Cigarros/efeitos adversos , Fatores Etários , Idoso , Envelhecimento , Fumar Cigarros/epidemiologia , Feminino , Cardiopatias/etiologia , Humanos , Pneumopatias/etiologia , Pessoa de Meia-Idade , Neoplasias/etiologia , Fatores de Risco , Fatores Sexuais , Acidente Vascular Cerebral/etiologia
18.
BMC Public Health ; 20(1): 815, 2020 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-32473627

RESUMO

BACKGROUND: Few data were available on smoking and smokeless tobacco use in South Asian migrants in the United Arab Emirates (UAE). This study aimed to identify the prevalence and correlates of cigarette smoking and smokeless tobacco use in male South Asian migrants in the UAE. METHODS: We used a cross-sectional study to recruit a random representative sample of male South Asian migrants, including Indian (n = 433), Pakistani (n = 383) and Bangladeshi (n = 559) nationalities. We used multivariable logistic regression analysis to identify significant correlates of cigarettes smoking and smokeless tobacco use. RESULTS: 1375 South Asian migrant adult males participated in the study (response rate 76%) with a mean age of 34 years (SD ± 10). The overall prevalence of cigarette smoking was 28% (95%CI 25-30%) and smokeless tobacco use was 11% (95%CI 10-13%). The prevalence of current cigarette smoking was 21, 23, and 37% among participants from India, Pakistan and Bangladesh, respectively. The prevalence of current smokeless tobacco use was 6, 12, and 16% for Indian, Pakistani, and Bangladeshi participants, respectively. Among study participants, Bangladeshi nationality, hypertension, and alcohol use were significant correlates of current cigarette smoking. Significant correlates of smokeless tobacco use included increased age, less than college level education, alcohol use, and Pakistani or Bangladeshi nationality. CONCLUSIONS: Current smoking and smokeless tobacco use in South Asian migrants represent a significant public health burden in the UAE. Effective public health measures are needed to reduce tobacco use in this migrant population.


Assuntos
Fumar Cigarros/etnologia , Fumar Cigarros/psicologia , Fumantes/psicologia , Uso de Tabaco/etnologia , Uso de Tabaco/psicologia , Tabaco sem Fumaça/estatística & dados numéricos , Migrantes/psicologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/psicologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Bangladesh , Fumar Cigarros/epidemiologia , Estudos Transversais , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Paquistão , Prevalência , Fumantes/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Migrantes/estatística & dados numéricos , Emirados Árabes Unidos/epidemiologia , Emirados Árabes Unidos/etnologia , Adulto Jovem
20.
Medicine (Baltimore) ; 99(26): e20839, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590777

RESUMO

Although the inverse correlation between smoking and degenerative arthritis is controversial, quantitative analysis of the correlation between lifetime cigarette smoking amount and degenerative arthritis has not been performed. We investigated the correlation between knee radiographic osteoarthritis (ROA) and lifetime cigarette smoking amount in the general population.This cross-sectional study used the Fifth and Sixth Korean National Health and Nutrition Examination Survey (2010-2013) data. Subjects included 11,638 community-dwelling adults aged ≥50 years. Knee ROA was defined as a Kellgren/Lawrence grade ≥2 on plain radiography. Lifetime cigarette smoking amount was calculated in terms of pack-year and further divided into quartile groups. Independent correlation between smoking and knee ROA was determined using odds ratios (OR) adjusted for age, sex, obesity, physical activity, and household income on multivariate logistic regression analysis.Knee ROA prevalence was 37.3%; prevalence of lifetime cigarette smokers was 26.0%. Subjects with knee ROA had higher mean age, female sex ratio, and body mass index but lower physical activity level. The adjusted logistic regression model revealed that female sex (OR, 2.110; 95% confidence interval [CI], 1.895-2.349) was significantly associated with knee ROA. Older age, obesity, and lower household income were positively correlated with knee ROA. Second-and fourth-quartile groups of smokers had the lower ROA prevalence than never-smokers (OR, 0.800; 95% CI, 0.643-0.99; OR, 0.812; 95% CI, 0.684-0.965, respectively).An inverse correlation with knee ROA was confirmed in mid-light to heavy smokers. Prospective studies are needed to reveal whether knee ROA involves smoking.


Assuntos
Fumar Cigarros/efeitos adversos , Osteoartrite do Joelho/diagnóstico , Prevalência , Idoso , Índice de Massa Corporal , Fumar Cigarros/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Osteoartrite do Joelho/classificação , Osteoartrite do Joelho/epidemiologia , Radiografia/métodos , Radiografia/estatística & dados numéricos , República da Coreia/epidemiologia , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA