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1.
Int J Mol Sci ; 21(11)2020 May 30.
Artigo em Inglês | MEDLINE | ID: covidwho-437415

RESUMO

The recently discovered novel coronavirus, SARS-CoV-2 (COVID-19 virus), has brought the whole world to standstill with critical challenges, affecting both health and economic sectors worldwide. Although initially, this pandemic was associated with causing severe pulmonary and respiratory disorders, recent case studies reported the association of cerebrovascular-neurological dysfunction in COVID-19 patients, which is also life-threatening. Several SARS-CoV-2 positive case studies have been reported where there are mild or no symptoms of this virus. However, a selection of patients are suffering from large artery ischemic strokes. Although the pathophysiology of the SARS-CoV-2 virus affecting the cerebrovascular system has not been elucidated yet, researchers have identified several pathogenic mechanisms, including a role for the ACE2 receptor. Therefore, it is extremely crucial to identify the risk factors related to the progression and adverse outcome of cerebrovascular-neurological dysfunction in COVID-19 patients. Since many articles have reported the effect of smoking (tobacco and cannabis) and vaping in cerebrovascular and neurological systems, and considering that smokers are more prone to viral and bacterial infection compared to non-smokers, it is high time to explore the probable correlation of smoking in COVID-19 patients. Herein, we have reviewed the possible role of smoking and vaping on cerebrovascular and neurological dysfunction in COVID-19 patients, along with potential pathogenic mechanisms associated with it.


Assuntos
Transtornos Cerebrovasculares/epidemiologia , Infecções por Coronavirus/epidemiologia , Doenças do Sistema Nervoso/epidemiologia , Pneumonia Viral/epidemiologia , Fumar Tabaco/epidemiologia , Vaping/epidemiologia , Humanos , Pandemias
2.
PLoS One ; 15(6): e0234561, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555596

RESUMO

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) has been associated with an increased risk of tobacco smoking, and more difficulties with smoking cessation compared to non-ADHD individuals. Women with ADHD may therefore show elevated rates of smoking during pregnancy. AIMS: To examine the association between ADHD and smoking habits among pregnant women in Sweden and Norway. METHODS: Women pregnant for the first time were identified in Sweden (n = 622,037), and Norway (n = 293,383), of which 1.2% (n = 7,444), and 1.7% (n = 4,951) were defined as having ADHD, respectively. Data on smoking habits were collected early and late in pregnancy. RESULTS: In Sweden, ADHD was associated with an increased risk of smoking early in pregnancy, adjusted risk ratio (adjRR) 2.69 (95% confidence interval, 2.58-2.81), and late in pregnancy, adjRR 2.95 (2.80-3.10). Similar findings were observed in the Norwegian data, early in pregnancy, adjRR 2.31 (2.21-2.40), and late in pregnancy, adjRR 2.56 (2.42-2.70). Women with ADHD were more likely to continue smoking during pregnancy, compared to women without ADHD, both in Sweden adjRR 1.13 (1.10-1.17), and in Norway, adjRR 1.16 (1.12-1.20). Having a sibling diagnosed with ADHD was associated with an increased risk of smoking early and late in pregnancy, in both Sweden and Norway. CONCLUSIONS: Women with ADHD are considerably more likely to smoke early and late in (their first) pregnancy and are less likely to stop smoking between the two time points. Smoking, early and late in pregnancy, co-aggregates in families with ADHD. Smoking prevention and intervention programs should be targeted towards women with ADHD, specifically during their childbearing years, to ensure better mother and child outcomes.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Fumar Tabaco/epidemiologia , Estudos de Coortes , Feminino , Humanos , Noruega/epidemiologia , Gravidez , Primeiro Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Fatores de Risco , Irmãos , Abandono do Hábito de Fumar , Suécia/epidemiologia
3.
PLoS One ; 15(6): e0233861, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32520979

RESUMO

OBJECTIVES: The primary objective of the present study was to compare the prevalence and patterns of second-hand smoke (SHS) exposure in the home, workplace, public places, and at all three places amongst the non-smoker respondents between the two rounds of Global Adult Tobacco Survey (GATS) in India. The secondary objectives were to assess the differences in various factors associated with SHS exposure among non-smokers. STUDY DESIGN: This secondary data analysis incorporated data generated from the previous two rounds of the cross-sectional, nationally representative GATS India, which covered 69,296 and 74,037 individuals aged 15 years and above. Exposure to the SHS at home, workplace, and public places amongst the non-smokers were the primary outcome variables. Standard definitions of the surveys were used. RESULTS: The overall weighted prevalence of exposure to SHS amongst the non-smokers inside the home and public places reduced. In contrast, the prevalence in the workplace increased marginally in round II compared to I. The proportion of adults who were exposed to SHS at all three places did not change much in two rounds of surveys. A decrease in the knowledge of the respondents exposed to SHS at home and public places was observed about the harmful effects of smoking in round II. Age, gender, occupation, place, and region of respondents were found to be significant determinants of SHS exposure at all the three places on multinomial logistic regression analysis. CONCLUSIONS: The study calls for focused interventions in India and stringent implementation of anti-tobacco legislation, especially in the workplaces for reducing the exposure to SHS amongst the non-smokers and to produce encouraging and motivating results by next round of the survey.


Assuntos
Exposição Ambiental/estatística & dados numéricos , não Fumantes , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Fumar Tabaco/epidemiologia , Adolescente , Adulto , Estudos Transversais , Análise de Dados , Exposição Ambiental/prevenção & controle , Feminino , Habitação , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Instalações Privadas , Logradouros Públicos , Inquéritos e Questionários , Poluição por Fumaça de Tabaco/prevenção & controle , Fumar Tabaco/prevenção & controle , Local de Trabalho , Adulto Jovem
4.
Int J Mol Sci ; 21(11)2020 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-32486196

RESUMO

The recently discovered novel coronavirus, SARS-CoV-2 (COVID-19 virus), has brought the whole world to standstill with critical challenges, affecting both health and economic sectors worldwide. Although initially, this pandemic was associated with causing severe pulmonary and respiratory disorders, recent case studies reported the association of cerebrovascular-neurological dysfunction in COVID-19 patients, which is also life-threatening. Several SARS-CoV-2 positive case studies have been reported where there are mild or no symptoms of this virus. However, a selection of patients are suffering from large artery ischemic strokes. Although the pathophysiology of the SARS-CoV-2 virus affecting the cerebrovascular system has not been elucidated yet, researchers have identified several pathogenic mechanisms, including a role for the ACE2 receptor. Therefore, it is extremely crucial to identify the risk factors related to the progression and adverse outcome of cerebrovascular-neurological dysfunction in COVID-19 patients. Since many articles have reported the effect of smoking (tobacco and cannabis) and vaping in cerebrovascular and neurological systems, and considering that smokers are more prone to viral and bacterial infection compared to non-smokers, it is high time to explore the probable correlation of smoking in COVID-19 patients. Herein, we have reviewed the possible role of smoking and vaping on cerebrovascular and neurological dysfunction in COVID-19 patients, along with potential pathogenic mechanisms associated with it.


Assuntos
Transtornos Cerebrovasculares/epidemiologia , Infecções por Coronavirus/epidemiologia , Doenças do Sistema Nervoso/epidemiologia , Pneumonia Viral/epidemiologia , Fumar Tabaco/epidemiologia , Vaping/epidemiologia , Humanos , Pandemias
5.
Dev Cell ; 53(5): 514-529.e3, 2020 06 08.
Artigo em Inglês | MEDLINE | ID: covidwho-276241

RESUMO

The factors mediating fatal SARS-CoV-2 infections are poorly understood. Here, we show that cigarette smoke causes a dose-dependent upregulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 receptor, in rodent and human lungs. Using single-cell sequencing data, we demonstrate that ACE2 is expressed in a subset of secretory cells in the respiratory tract. Chronic smoke exposure triggers the expansion of this cell population and a concomitant increase in ACE2 expression. In contrast, quitting smoking decreases the abundance of these secretory cells and reduces ACE2 levels. Finally, we demonstrate that ACE2 expression is responsive to inflammatory signaling and can be upregulated by viral infections or interferon treatment. Taken together, these results may partially explain why smokers are particularly susceptible to severe SARS-CoV-2 infections. Furthermore, our work identifies ACE2 as an interferon-stimulated gene in lung cells, suggesting that SARS-CoV-2 infections could create positive feedback loops that increase ACE2 levels and facilitate viral dissemination.


Assuntos
Células Epiteliais Alveolares/metabolismo , Infecções por Coronavirus/epidemiologia , Interferons/metabolismo , Peptidil Dipeptidase A/genética , Pneumonia Viral/epidemiologia , Mucosa Respiratória/metabolismo , Poluição por Fumaça de Tabaco/efeitos adversos , Fumar Tabaco/genética , Adulto , Idoso , Animais , Células CACO-2 , Células Cultivadas , Feminino , Células HCT116 , Humanos , Interferons/genética , Masculino , Camundongos , Pessoa de Meia-Idade , Pandemias , Peptidil Dipeptidase A/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , RNA-Seq , Ratos , Transdução de Sinais , Análise de Célula Única , Fumar Tabaco/epidemiologia , Fumar Tabaco/metabolismo , Regulação para Cima
6.
PLoS One ; 15(5): e0233656, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32442211

RESUMO

INTRODUCTION: Depression is a global burden that is exacerbated by smoking. The association between depression and chronic smoking is well-known; however, existing findings contain possible confounding between nicotine dependence (ND), a latent construct measuring addiction, and objective smoking behavior. The current study examines the possible unique role of ND in explaining depression, independently of smoking behavior. METHODS: A nationally-representative sample of current adult daily smokers was drawn by pooling three independent, cross-sectional, biennial waves (spanning 2011-16) of the National Health and Nutrition Examination Survey (NHANES). The association between ND (operationally defined as time to first cigarette (TTFC) after waking) and the amount of depression symptoms was examined after adjusting for both current and lifetime smoking behaviors (cigarettes per day and years of smoking duration) and sociodemographic factors (gender, age, race, education and income to poverty ratio). RESULTS: Earlier TTFC was associated with more depression symptoms, such that those smoking within 5 minutes of waking had an approximately 1.6-fold higher depression score (PRR = 1.576, 95% CI = 1.324-1.687) relative to those who smoke more than 1 hour after waking. This relationship remained significant after adjusting for current and lifetime smoking behavior as well as sociodemographic factors (PRR = 1.370, 95% CI = 1.113, 1.687). CONCLUSIONS: The latent construct of ND, as assessed by TTFC, may be associated with an additional risk for depression symptoms, beyond that conveyed by smoking behavior alone. This finding can be used for more refined risk prediction for depression among smokers.


Assuntos
Transtorno Depressivo Maior/epidemiologia , Fumar Tabaco/epidemiologia , Tabagismo/epidemiologia , Adulto , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fumantes/psicologia , Fatores Socioeconômicos , Estados Unidos
7.
Medicine (Baltimore) ; 99(19): e20119, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384489

RESUMO

BACKGROUND: A growing number of epidemiological studies have suggested a possible association between long-chain omega-3 polyunsaturated fatty acid (PUFA) intake and the risk of cancers, but the results have been inconsistent. We aimed to conduct a meta-analysis to assess the association of omega-3 PUFA consumption with digestive system cancers. METHODS: Relevant observational studies were identified through a comprehensive search of PubMed, Embase, and the Web of Science through December 2019 and by reviewing the references of the retrieved articles. The relative risks (RRs) of digestive system cancers associated with omega-3 PUFA intake were estimated using a random-effect model and were stratified by region, sex, study design, type of omega-3 PUFAs, smoking status, alcohol consumption, BMI, and physical activity. RESULTS: Twenty-five studies (8 case-control studies and 17 cohort studies) involving 1,247,271 participants and 23,173 patients with digestive system cancers were included in this analysis. The risk of digestive system cancers decreased by 17% in individuals who consumed omega-3 PUFAs (RR = 0.83, 95% confidence interval (CI), 0.76-0.91). The risk estimates of digestive system cancers varied by cancer sites, study location, study design, type of omega-3 PUFAs, and other confounders (smoking, alcohol consumption, body mass index, and physical activity). Visual inspection of funnel plots and the Begg's and Egger's tests revealed no evidence of publication bias. CONCLUSION: The findings show that omega-3 PUFAs should be as a healthy dietary component for the prevention of digestive system cancers. Cancer incidence decreases with increasing omega-3 PUFAs intake for most digestive system cancer sites. The relation between omega-3 PUFAs and digestive system cancers RR is similar among different populations.


Assuntos
Neoplasias do Sistema Digestório/epidemiologia , Ácidos Graxos Ômega-3/administração & dosagem , Consumo de Bebidas Alcoólicas/epidemiologia , Índice de Massa Corporal , Neoplasias do Sistema Digestório/prevenção & controle , Exercício Físico , Humanos , Incidência , Estudos Observacionais como Assunto , Estudos Prospectivos , Características de Residência , Fatores de Risco , Fatores Sexuais , Fumar Tabaco/epidemiologia
8.
Dev Cell ; 53(5): 514-529.e3, 2020 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-32425701

RESUMO

The factors mediating fatal SARS-CoV-2 infections are poorly understood. Here, we show that cigarette smoke causes a dose-dependent upregulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 receptor, in rodent and human lungs. Using single-cell sequencing data, we demonstrate that ACE2 is expressed in a subset of secretory cells in the respiratory tract. Chronic smoke exposure triggers the expansion of this cell population and a concomitant increase in ACE2 expression. In contrast, quitting smoking decreases the abundance of these secretory cells and reduces ACE2 levels. Finally, we demonstrate that ACE2 expression is responsive to inflammatory signaling and can be upregulated by viral infections or interferon treatment. Taken together, these results may partially explain why smokers are particularly susceptible to severe SARS-CoV-2 infections. Furthermore, our work identifies ACE2 as an interferon-stimulated gene in lung cells, suggesting that SARS-CoV-2 infections could create positive feedback loops that increase ACE2 levels and facilitate viral dissemination.


Assuntos
Células Epiteliais Alveolares/metabolismo , Infecções por Coronavirus/epidemiologia , Interferons/metabolismo , Peptidil Dipeptidase A/genética , Pneumonia Viral/epidemiologia , Mucosa Respiratória/metabolismo , Poluição por Fumaça de Tabaco/efeitos adversos , Fumar Tabaco/genética , Adulto , Idoso , Animais , Células CACO-2 , Células Cultivadas , Feminino , Células HCT116 , Humanos , Interferons/genética , Masculino , Camundongos , Pessoa de Meia-Idade , Pandemias , Peptidil Dipeptidase A/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , RNA-Seq , Ratos , Transdução de Sinais , Análise de Célula Única , Fumar Tabaco/epidemiologia , Fumar Tabaco/metabolismo , Regulação para Cima
10.
BMC Public Health ; 20(1): 516, 2020 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-32303215

RESUMO

BACKGROUND: Smoking and alcohol consumption are the most common social habits in patients with sialolithiasis. Moreover, obesity has been reported to have a significant association with poor oral hygiene, one of the causes of sialolithiasis. The purpose of this study was to evaluate the relationships among tobacco smoking, drinking alcohol, obesity and sialolithiasis in a Korean population. METHODS: The Korean National Health Insurance Service-Health Screening Cohort, which includes patients ≥40 years old, was assessed from 2002 to 2013. A total of 947 sialolithiasis participants were matched with 3788 control subjects at a ratio of 1:4 with respect to age group, sex, income group, region of residence, hypertension, diabetes, and dyslipidemia. We analyzed the participants' previous histories of smoking (current or past smokers compared to nonsmokers) and alcohol consumption (≥ 1 time per week compared to < 1 time per week) in the sialolithiasis and control groups. Obesity was measured using body mass index (BMI, kg/m2), which was categorized as < 18.5 (underweight), ≥ 18.5 and < 23 (normal), ≥ 23 and < 25 (overweight), ≥ 25 and < 30 (obese I), and ≥ 30 (obese II). Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression analyses. RESULTS: The rate of smoking was higher in the sialolithiasis group (32.4% [307/947]) than in the control group (29.1% [1103/3788], P = 0.047). The adjusted OR of smoking for the sialolithiasis group was 1.31 (95% CI = 1.08-1.59, P = 0.006). Alcohol consumption and obesity were not statistically significantly related to sialolithiasis. CONCLUSION: The odds of smoking were increased in sialolithiasis patients compared with control subjects in the population ≥ 40 years of age.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Obesidade/epidemiologia , Cálculos das Glândulas Salivares/epidemiologia , Fumar Tabaco/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos de Coortes , Diabetes Mellitus , Dislipidemias , Feminino , Humanos , Hipertensão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , República da Coreia/epidemiologia , Fatores de Risco
11.
BMC Public Health ; 20(1): 378, 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32293365

RESUMO

BACKGROUND: The study aims at identifying long-term trends and patterns of current smoking by age, gender, and education in Russia, including the most recent period from 2008 during which tobacco control policies were implemented, and to estimate the impact on mortality of any reductions in prevalence. We present an in-depth analysis based on an unprecedentedly large array of survey data. METHODS: We examined pooled micro-data on smoking from 17 rounds of the Russian Longitudinal Monitoring Study of 1996-2016, 11 other surveys conducted in Russia in 1975-2017, and two comparator surveys from England and the USA. Standardization by age and education, regression and meta-analysis were used to estimate trends in the prevalence of current smoking by gender, age, and educational patterns. RESULTS: From the mid-1970s to the mid-2000s smoking prevalence among men was relatively stable at around 60%, after which time prevalence declined in every age and educational group. Among women, trends in smoking were more heterogeneous. Prevalence more than doubled above the age of 55 years from very low levels (< 5%). At younger ages, there were steep increases until the mid-2000s after which prevalence has declined. Trends differed by educational level, with women in the lowest educational category accounting for most of the long-term increase. We estimate that the decline in male smoking may have contributed 6.2% of the observed reduction in cardiovascular deaths among men in the period 2008-16. CONCLUSIONS: The implementation of an effective tobacco control strategy in Russia starting in 2008 coincided with a decline in smoking prevalence among men from what had been stable, high levels over many decades regardless of age and education. Among women, the declines have been more uneven, with young women showing recent downturns, while the smoking prevalence in middle age has increased, particularly among those with minimal education. Among men, these positive changes will have made a small contribution to the reduction in mortality seen in Russia since 2005.


Assuntos
Política Pública , Política Antifumo , Abandono do Hábito de Fumar , Fumar Tabaco/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Escolaridade , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Federação Russa/epidemiologia , Fatores Sexuais , Fumantes , Fumar , Inquéritos e Questionários , Tabaco , Produtos do Tabaco , Fumar Tabaco/tendências , Adulto Jovem
12.
PLoS One ; 15(4): e0231095, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32348306

RESUMO

INTRODUCTION: Varenicline tartrate is superior for smoking cessation to other tobacco cessation therapies by 52 weeks, in the outpatient setting. We aimed to evaluate the long-term (104 week) efficacy following a standard course of inpatient-initiated varenicline tartrate plus Quitline-counselling compared to Quitline-counselling alone. METHODS: Adult patients (n = 392, 20-75 years) admitted with a smoking-related illnesses to one of three hospitals, were randomised to receive either 12-weeks of varenicline tartrate (titrated from 0.5mg daily to 1mg twice-daily) plus Quitline-counselling, (n = 196) or Quitline-counselling alone, (n = 196), with continuous abstinence from smoking assessed at 104 weeks. RESULTS: A total of 1959 potential participants were screened for eligibility between August 2008 and December 2011. The proportion of participants who remained continuously abstinent (intention-to-treat) at 104 weeks were significantly greater in the varenicline tartrate plus counselling arm (29.2% n = 56) compared to counselling alone (18.8% n = 36; p = 0.02; odds ratio 1.78; 95%CI 1.10 to 2.86, p = 0.02). Twenty-two deaths occurred during the 104 week study (n = 10 for varenicline tartrate plus counselling and n = 12 for Quitline-counselling alone). All of these participants had known or developed underlying co-morbidities. CONCLUSIONS: This is the first study to examine the efficacy and safety of varenicline tartrate over 104 weeks within any setting. Varenicline tartrate plus Quitline-counselling was found to be an effective opportunistic treatment when initiated for inpatient smokers who had been admitted with tobacco-related disease.


Assuntos
Abandono do Hábito de Fumar/métodos , Fumar/tratamento farmacológico , Fumar Tabaco/tratamento farmacológico , Vareniclina/administração & dosagem , Adulto , Idoso , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Agonistas Nicotínicos/administração & dosagem , Pacientes Ambulatoriais , Fumar/epidemiologia , Fumar/psicologia , Tabaco/efeitos adversos , Fumar Tabaco/epidemiologia , Fumar Tabaco/psicologia , Resultado do Tratamento
15.
Am J Physiol Lung Cell Mol Physiol ; 318(5): L1004-L1007, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32233791
17.
PLoS One ; 15(3): e0230364, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32187225

RESUMO

INTRODUCTION: Tobacco control programs and policies reduce tobacco use and prevent health and economic harms. The majority of tobacco control programs and policies in the United States are implemented at local and state levels. Yet the literature on state-level initiatives reports a limited set of outcomes. To facilitate decision-making that is increasingly focused on costs, we provide estimates of a broader set of measures of the impact of tobacco control policy, including smoking prevalence, disease events, deaths, medical costs, productivity and tobacco tax revenues, using the experience of Minnesota as an example. METHODS: Using the HealthPartners Institute's ModelHealth™: Tobacco MN microsimulation, we assessed the impact of the stream of tobacco control expenditures and cigarette price increases from 1998 to 2017. We simulated 1.3 million individuals representative of the Minnesota population. RESULTS: The simulation estimated that increased expenditures on tobacco control above 1997 levels prevented 38,400 cancer, cardiovascular, diabetes and respiratory disease events and 4,100 deaths over 20 years. Increased prices prevented 14,600 additional events and 1,700 additional deaths. Both the net increase in tax revenues and the reduction in medical costs were greater than the additional investments in tobacco control. CONCLUSION: Combined, the policies address both short-term and long-term goals to reduce the harms of tobacco by helping adults who wish to quit smoking and deterring youth from starting to smoke. States can pay for initial investments in tobacco control through tax increases and recoup those investments through reduced expenditures on medical care.


Assuntos
Comércio/economia , Prevenção do Hábito de Fumar/economia , Impostos/legislação & jurisprudência , Produtos do Tabaco/economia , Fumar Tabaco/prevenção & controle , Adolescente , Adulto , Criança , Comércio/história , Comércio/legislação & jurisprudência , Comércio/estatística & dados numéricos , Simulação por Computador , Feminino , Política Fiscal/história , Gastos em Saúde/história , Gastos em Saúde/estatística & dados numéricos , História do Século XX , História do Século XXI , Humanos , Masculino , Minnesota/epidemiologia , Modelos Biológicos , Modelos Econômicos , Mortalidade/história , Prevalência , Prevenção do Hábito de Fumar/história , Prevenção do Hábito de Fumar/métodos , Impostos/história , Produtos do Tabaco/efeitos adversos , Produtos do Tabaco/história , Produtos do Tabaco/legislação & jurisprudência , Fumar Tabaco/efeitos adversos , Fumar Tabaco/economia , Fumar Tabaco/epidemiologia , Adulto Jovem
18.
N Z Med J ; 133(1509): 28-38, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32027636

RESUMO

AIM: To determine the contribution of smoking-related deaths to the life expectancy gap in both Maori and Pacific people compared with non-Maori/non-Pacific people in New Zealand. METHODS: Death registration and population data between 2013 and 2015 were used to calculate life expectancy. To determine the contribution of smoking to the life expectancy gap, population attributable fractions for all causes of death where smoking is a casual risk factor were calculated using age- and ethnic-specific smoking data from the 2013 New Zealand Census and relative risk estimates from the American Cancer Society Cancer Prevention Study II. Population attributable fractions were applied to all deaths registered in New Zealand for the 2013-15 period to estimate the number of deaths attributable to tobacco smoking. The life expectancy gap was decomposed using the Arriaga method. The gap was decomposed both overall and by specific smoking attributable causes of death. RESULTS: Between 2013 and 2015 an estimated 12,421 (13.4% of all deaths) were attributable to smoking. Nearly one in four (22.6%) deaths among Maori were attributable to smoking (2,199 out of 9,717 deaths) and nearly one in seven (13.8%) among Pacific people (512 out of 3,720 deaths). Among non-Maori/non-Pacific people, one in eight (12.3%) deaths were attributable to smoking (9,710 out of 78,759 deaths). Higher rates of smoking attributable mortality were responsible for 2.1 years of the life expectancy gap in Maori men, 2.3 years in Maori women, 1.4 years in Pacific men and 0.3 years among Pacific women. Cancers of the trachea, bronchus and lung, chronic obstructive pulmonary disease (COPD) and ischaemic heart disease were the leading smoking attributable causes of death contributing to the gap. CONCLUSION: Smoking is an important preventable risk factor contributing to ethnic inequities in life expectancy for Maori men and women, and Pacific men. Dramatic declines in smoking-attributable deaths can be achieved by reducing smoking prevalence rates. Preventing smoking initiation and increasing cessation rates must remain a top priority for the Ministry of Health and District Health Boards. Smokefree initiatives should be reoriented to be Tiriti o Waitangi (Treaty of Waitangi) compliant and better meet the needs of Maori and Pacific people who smoke. Addressing the residual risk in ex-smokers through equitable early diagnosis and treatment of smoking-related conditions will further assist a more rapid closing of life expectancy gaps for Maori men and women and Pacific men. The next five years provide the opportunity to demonstrate commitment to achieving a smokefree Aotearoa for all: an aspiration, based on the current trajectory, which is most probably out of reach.


Assuntos
Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Expectativa de Vida/etnologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Fumar Tabaco/etnologia , Feminino , Humanos , Masculino , Nova Zelândia/epidemiologia , Fumar Tabaco/epidemiologia
19.
PLoS One ; 15(2): e0229090, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32059049

RESUMO

BACKGROUND: Smoking is widely recognized as one of the most prevalent and preventable causes of many cancer types. This study aimed to quantify the population attributable fraction (PAF) of the lung cancer burden for smoking in Mongolia. METHODS: Lung cancer incidence and lung cancer-related death data came from the population-based national registry covering the period 2007-2016. Smoking prevalence data came from the STEPwise approach (STEP) national survey. The lung cancer-related disease burden was calculated and expressed in Disability Adjusted Life Years (DALYs) lost by gender and by year. This was combined with current smoking and former smoking prevalence data, and relative risks (RR) of lung cancer-related deaths for current smokers and former smokers versus never smokers from region-specific cohort studies to estimate the PAF of lung cancer attributable to "ever-smoking" in Mongolia. RESULTS: Between 2007 and 2016, lung cancer accounted for the loss of over 63,000 DALYs in Mongolia. The PAF of lung cancer-related deaths attributable to current and former smoking combined was 58.1% (95% IR = 43.1%-72.2%) for men and 8.9% (95% IR = 4.1% -13.5%) for women. Smoking-attributable DALYs loss amounted to 2589 years (95% IR = 1907-3226) in 2016. CONCLUSIONS: A considerable health loss may be prevented with an effective anti-smoking policy. In Mongolia, more than one third of lung cancer-related DALY loss is attributable to active smoking, and thus is potentially preventable. Furthermore, a gender-specific tobacco control policy may be worthwhile because of the large gender difference in smoking exposure in Mongolia. Next to this, age specific policy, including a smoke-free generation policy for adolescents, with targeted education, and mass media campaigns is needed.


Assuntos
Efeitos Psicossociais da Doença , Pessoas com Deficiência/estatística & dados numéricos , Neoplasias Pulmonares/epidemiologia , Fumar Tabaco/efeitos adversos , Adolescente , Adulto , Idoso , Causas de Morte , Feminino , Seguimentos , Humanos , Incidência , Expectativa de Vida , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/prevenção & controle , Masculino , Pessoa de Meia-Idade , Mongólia/epidemiologia , Prevalência , Anos de Vida Ajustados por Qualidade de Vida , Sistema de Registros/estatística & dados numéricos , Medição de Risco , Fatores Sexuais , Fumar Tabaco/epidemiologia , Adulto Jovem
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