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1.
Addict Behav ; 137: 107545, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36403489

RESUMO

BACKGROUND: The endocannabinoid system is implicated in psychiatric disorders and drug dependence. Within this system, fatty acid amide hydrolase (FAAH) metabolizes endocannabinoids. Individuals with A-group genotypes (C/A or A/A) of a common FAAH variant (rs324420; C > A; Pro129Thr) have slower enzymatic activity compared to C-group individuals (C/C genotype). Slow FAAH activity is differentially associated with alcohol and nicotine use. METHODS: Among European-ancestry participants in the NDIT study (n = 249-607), genotype associations with past-year binge drinking in young adults were estimated in logistic regression models. In adolescents, hazard ratios (HR) were estimated from Cox proportional hazards models to assess the FAAH genotype group association with time to drinking initiation and attaining drinking frequency outcomes. HR were also used to assess genotype effect on time to smoking initiation and attaining early smoking milestones (e.g., first inhalation, ICD-10 dependence). RESULTS: Compared to those in the C-group, those in the A-group had higher odds of binge drinking at ages 20 (Odds ratio (OR) = 2.16, 95 % CI 1.36-3.42) and 30 (OR = 1.61, 95 % CI 1.10-2.36). Time to initiation of drinking and daily drinking was faster in adolescents in the A-group (HR = 1.39, 95 % CI 1.09-1.77 and HR = 2.24, 95 % CI 1.05-4.76, respectively). Time to smoking initiation was faster in the A-group (HR = 1.20, 95 % CI 1.04-1.39); however, time to smoking milestones among adolescent smokers was not consistently different for the A- versus C-groups (HR = 0.43 to 1.13). CONCLUSIONS: Slow FAAH activity (A-group) was associated with greater risks for binge drinking, drinking initiation and escalation, and cigarette smoking initiation, but had little impact on the escalation in cigarette smoking behaviors.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas , Adolescente , Adulto Jovem , Humanos , Adulto , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/genética , Fumar/epidemiologia , Fumar/genética , Amidoidrolases/genética , Etanol , Variação Genética
2.
Addict Behav ; 137: 107524, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36279712

RESUMO

OBJECTIVE: The adolescent health consequences of the school-to-prison pipeline remain underexplored. We test whether initiating components of the school-to-prison pipeline-suspensions, expulsions, and school policing-are associated with higher school-average levels of student substance use, depressed feelings, and developmental risk in the following year. METHOD: We linked 2003-2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection from over 4,800 schools and 4,950,000 students. With lagged multi-level models, we estimated relationships between the school prevalence of total discipline, out-of-school discipline, and police-involved discipline, and standardized school-average levels of 6 substance use measures and 8 measures of developmental risk, respectively. RESULTS: The prevalence of school discipline predicted subsequent school-mean substance use and developmental risk. A one-unit higher prevalence of total discipline predicted higher school levels (in standard deviations) of binge drinking alcohol (0.14, 95% CI: 0.11, 0.17), drinking alcohol (0.15, 95% CI: 0.12, 0.18), smoking tobacco (0.09, 95% CI: 0.06, 0.12), using cannabis (0.16, 95% CI: 0.14, 0.19), using other drugs (0.17, 95% CI: 0.14, 0.21), and violence/harassment (0.16, 95% CI: 0.12, 0.2). Total discipline predicted lower levels of reported community support (-0.07, 95% CI: -0.1, -0.05), feeling safe in school (-0.12, 95% CI: -0.16, -0.09), and school support (-0.16, 95% CI: -0.19, -0.12). Associations were greater in magnitude for more severe out-of-school discipline. Findings were inconsistent for police-involved discipline. CONCLUSION: Exclusionary school discipline and school policing-core elements of the school-to-prison pipeline-are previously unidentified population predictors of adolescent substance use and developmental risk.


Assuntos
Prisões , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Humanos , Instituições Acadêmicas , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estudantes , Fumar/epidemiologia
3.
Tijdschr Psychiatr ; 64(9): 604-607, 2022.
Artigo em Holandês | MEDLINE | ID: mdl-36349857

RESUMO

BACKGROUND: In 2018 Jellinek became a smoke free institution. By implementing ‘Jellinek Smoke free’ in all locations (15), a policy has been implemented to facilitate smoking cessation in clients with a comorbid tobacco use disorder seeking treatment for substance use disorders at Jellinek. AIM: To investigate whether the implementation of the new policy impacted smoking behaviour of clients in treatment for substance use disorders at Jellinek. METHOD: Based on data from anonymized client files, changes in smoking behaviour (cessation or reduction) were analysed for clients with other addictions who started treatment in 2016 versus clients who started in 2019 - after the implementation of the new smoke free policy. Comparative analyses were conducted on the population as a whole, per type of treatment (outpatient care, residential care, Minnesota, outreaching care) as well as per type of smoker (light, moderate, heavy). RESULTS: In the client population as a whole, significantly more people stopped smoking in 2019 (22%) in comparison to 2016 (16%) and there was a trend toward statistical significance with regard to reduction. When a cessation period was part of treatment, significantly more clients stopped and decreased the number of cigarettes a day. Moreover, light and moderate smokers (≤ 20 cigarettes a day) stopped and reduced significantly more in 2019 (32%) than in 2016 (23%). In outpatient care, outreaching care and with heavy smokers (> 20 cigarettes a day), there was no significant difference in percentage of cessation and reduction between 2016 and 2019. CONCLUSION: After implementing Jellinek Smoke free, significant changes in smoking behaviour occurred in the client population as a whole with a comorbid tobacco use disorder, in treatments where a cessation period was part of treatment as well as with light and moderate smokers.


Assuntos
Política Antifumo , Abandono do Hábito de Fumar , Transtornos Relacionados ao Uso de Substâncias , Tabagismo , Humanos , Tabagismo/epidemiologia , Tabagismo/terapia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Fumar/epidemiologia , Fumar/terapia
4.
BMJ Open ; 12(11): e058097, 2022 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-36414285

RESUMO

OBJECTIVES: To identify clues for women's tobacco control, this study analyses the gender differences in social environmental changes associated with smoking and the interaction between the environment and individuals' social integration. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional design and secondary analysis were used among Chinese internal migrants. Data were from the 2012 Migrant Dynamics Monitoring Survey in China with participants aged 15-59 years old (75 416 women and 83 140 men) who resided in cities for more than 1 month. PRIMARY AND SECONDARY OUTCOME MEASURES: Social environmental changes were measured by differences in smoking prevalence and women's empowerment between the migrant-receiving province (MRP) and migrant-sending province (MSP). Social participation and duration of stay (DOS) were adopted as indicators of social integration. Stratified analysis and binary logistic regression models were used to determine the dependent variable (smoking status) and environmental changes after controlling for age, education, income and happiness. RESULTS: Differences in the smoking prevalence environment (lower in MRP, OR 0.70, 95% CI 0.60 to 0.83; higher rate in MRP, OR 1.79, 95% CI 1.35 to 2.37) and women's empowerment (lower rate in MRP, OR 0.80, 95% CI 0.68 to 0.97; higher rate in MRP, OR 1.15, 95% CI 1.00 to 1.33) between MRP and MSP were positively correlated with women's smoking. In men, however, migrating to an area with lower smoking prevalence could not reduce smoking risk, whereas moving to an area with higher women's empowerment could. A long DOS was an independent risk factor for smoking in women (ranged from 1.20 to 2.00 in various environmental changes scenarios) but a protective factor for men. An interaction between environmental changes and social integration could not be verified. CONCLUSIONS: Tobacco control strategies should consider gender differences, especially women who are experiencing social environmental changes.


Assuntos
Migrantes , Masculino , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Fatores Sexuais , Fatores Socioeconômicos , Fumar/epidemiologia , China/epidemiologia , Tabaco
5.
BMC Pregnancy Childbirth ; 22(1): 865, 2022 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-36419041

RESUMO

OBJECTIVES: Some pregnant women are not ready or do not want to quit smoking completely, and currently there is no support provided for these women in the UK. Offering help to reduce smoking could reduce the health risks associated with smoking and increase the limited reach of the NHS Stop Smoking Services (SSS) for pregnant women. This study aimed to design and evaluate a hypothetical intervention aimed at pregnant women who are not yet ready or do not want to quit smoking entirely. METHODS: A hypothetical intervention, the Reduced Smoking During Pregnancy (RSDP) intervention, was conceptualised based on the best available evidence. The intervention was evaluated, using a decision-analytic model developed for SDP interventions. Two different scenarios, a base-case and a cautious-case were developed, and a cost-utility analysis and return on investment analysis were conducted. The uncertainty around the estimates was assessed, using deterministic and probabilistic sensitivity analyses. RESULTS: The RSDP intervention could prevent the loss of 13 foetuses and generate 43 quitters 1 year after delivery per 1000 women. In the lifetime analysis, the intervention was cost-effective in both scenarios, with an incremental cost of £363 (95% CI £29 to £672) and 0.44 (95% CI 0.32 to 0.53) QALYs gained in the base-case. CONCLUSIONS: The study found that the hypothetical reduction intervention would produce significant health benefits, reduce smoking and be cost-effective. Offering pregnant smokers help to reduce smoking could reduce health inequalities, widen the reach of SSS and improve health. This economic evaluation of a novel, intensive intervention could inform the piloting of such interventions.


Assuntos
Gestantes , Abandono do Hábito de Fumar , Feminino , Gravidez , Humanos , Análise Custo-Benefício , Fumar/epidemiologia , Fumar Tabaco
6.
Sci Rep ; 12(1): 19925, 2022 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-36402865

RESUMO

Although the smoking rate of human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) infected people was much higher than that of the general population, smoking cessation interventions have long been ineffective. We aimed to examine the estimates of prevalence, time-trend, and association of smoking among people living with HIV, HBV, or HCV. This cohort was composed of 32,115 individuals from the NHANES database (1999-2018) and they were collected in the US. The time trend analysis of smoking and quitting rates was conducted using different years of survey follow-up and different infected groups. Multivariable logistic regression analysis was used to identify the risk factors related to smoking behavior of these infected people. Compared to non-infected smokers, infected smokers were more likely to be older (aged 30-39, OR = 9.92, CI 6.07-16.21; aged 40-49,OR = 3.51, CI 2.49-4.94), males (1.99, 1.54-2.55), lower education and economic level (1.78, 1.39-2.29; 2.05, 1.59-2.65), unemployed (1.63, 1.21-2.20), suffering depression (1.35, 1.05-1.72), and drug users (7.65, 5.04-11.59). Taken together, our study showed that these complex psychosocial characteristics and unhealthy behavioral factors might be major independent risk factors for increasing smoking rate and decreasing smoking cessation rate among these infected people.


Assuntos
Infecções por HIV , Hepatite C , Humanos , Adulto , Masculino , Hepacivirus , Vírus da Hepatite B , Prevalência , Inquéritos Nutricionais , Hepatite C/epidemiologia , Hepatite C/complicações , Fumar/epidemiologia , Fumar/psicologia , Infecções por HIV/complicações
7.
Pan Afr Med J ; 42: 283, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36405659

RESUMO

Introduction: lung cancer is the most common cancer and the leading cause of cancer death worldwide. This study aimed to provide an overview of the epidemiology of primary lung cancer in Morocco. The distribution of histological subtypes by sex and smoking status was also assessed. Methods: this was a retrospective and descriptive study using medical records of patients with primary lung cancer, diagnosed at two university hospitals in Morocco between 2014 and 2017. Results: a total of 606 patients (average age = 58.5 ± 10.64 years, men = 521) were included. Four hundred and forty-three men had a history of smoking against sex women. Most patients (85.68%) had respiratory symptoms at diagnosis. Over half of patients (53.03%) had a performance status <2 and 38.94% had at least another pulmonary disease at presentation. Chronic obstructive pulmonary disease (COPD) and tuberculosis were present in 23.43% and 18% of patients, respectively. The majority (72.27%) of men practiced an occupation associated with a significant risk of lung cancer. Adenocarcinoma was the main histological type in our series with 60.40%. Most (79.55%) patients were diagnosed at stage IV. Only 7.83% of patients benefited from surgery. The distribution of histological subtypes by sex and smoking habits showed that adenocarcinoma was more frequent in women (p=0.011), and squamous cell carcinoma in men (p=0.014). No differences between smokers and non-smokers were noted. Conclusion: our results showed a decrease in the age of diagnosis and a late stage of the disease. Adenocarcinoma was the most frequent histological type.


Assuntos
Adenocarcinoma , Neoplasias Pulmonares , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Estudos Retrospectivos , Marrocos/epidemiologia , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/patologia , Adenocarcinoma/epidemiologia , Adenocarcinoma/patologia , Fumar/efeitos adversos , Fumar/epidemiologia
8.
Front Public Health ; 10: 1059195, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36408054

RESUMO

To explore the causal relationship between maternal smoking around birth and childhood asthma using Mendelian randomization (MR). Using the data from large-scale genome-wide association studies, we selected independent genetic loci closely related to maternal smoking around birth and maternal diseases as instrumental variables and used MR methods. In this study, we considered the inverse variance weighted method (MR-IVW), weighted median method, and MR-Egger regression. We investigated the causal relationship between maternal smoking around birth and maternal diseases in childhood asthma using the odds ratio (OR) as an evaluation index. Multivariable MR (MVMR) included maternal history of Alzheimer's disease, illnesses of the mother: high blood pressure and illnesses of the mother: heart diseaseas covariates to address potential confounding. Sensitivity analyses were evaluated for weak instrument bias and pleiotropic effects. It was shown with the MR-IVW results that maternal smoking around birth increased the risk of childhood asthma by 1.5% (OR = 1.0150, 95% CI: 1.0018-1.0283). After the multivariable MR method was used to correct for relevant covariates, the association effect between maternal smoking around birth and childhood asthma was still statistically significant (P < 0.05). Maternal smoking around birth increases the risk of childhood asthma.


Assuntos
Asma , Análise da Randomização Mendeliana , Humanos , Análise da Randomização Mendeliana/métodos , Estudo de Associação Genômica Ampla , Fumar/efeitos adversos , Fumar/epidemiologia , Asma/epidemiologia , Asma/etiologia , Viés
9.
J Bras Pneumol ; 48(5): e20220146, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-36350952

RESUMO

OBJECTIVE: To describe the performance of a pulmonologist-led lung cancer screening program using low dose CT (LDCT) in a cohort of outpatients with stable respiratory diseases in the Brazilian public health care system. METHODS: This was a retrospective analysis of the first two rounds of lung cancer screening of patients enrolled in the program. Inclusion criteria were being between 55 and 80 years of age, being a current or former smoker (smoking cessation ≤ 15 years), and having a smoking history ≥ 30 pack-years. LDCT results were interpreted in accordance with the Lung CT Screening Reporting and Data System, and those with a score of 3 or 4 were considered positive screening. Incidental pleuropulmonary findings were sought in all reports. RESULTS: LDCTs were requested for 791 patients during the study period, and 712 patients (90%) met the screening criteria. The mean patient age was 63 years, and most participants were current smokers (56%) with emphysema (78.5%) and other pleuropulmonary findings on CT (64%). Screening was positive in 14.0% and 5.6% of the cases in the first and second screening rounds, respectively. Lung cancer was detected in 1.5% of the patients in both first and second rounds (positive predictive value: 11.0% and 26.6%, respectively). The rate of early-stage (TNM I or II) screen-detected non-small cell carcinoma was 64.3%. Of the patients with positive screening, 19% were lost to follow-up before investigation was complete. CONCLUSIONS: The results of this screening program suggest its adequate performance in a cohort of patients with significant respiratory morbidity. The loss to follow-up rate highlights the need for constant monitoring and interventions to ensure adherence.


Assuntos
Neoplasias Pulmonares , Humanos , Adolescente , Pessoa de Meia-Idade , Neoplasias Pulmonares/patologia , Detecção Precoce de Câncer/métodos , Brasil/epidemiologia , Estudos Retrospectivos , Fumar/efeitos adversos , Fumar/epidemiologia , Tomografia Computadorizada por Raios X/métodos , Programas de Rastreamento , Hospitais Públicos
10.
BMC Geriatr ; 22(1): 872, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36384458

RESUMO

BACKGROUND: Aging of the world population is one of the most significant demographic changes of our time. Populations older than 60 years are heterogeneous, and age is an independent cardiovascular risk factor aggravated by frailty, obesity, and diabetes, and influenced by several factors, including sex and socioeconomic status. The objective of this study was to calculate cardiovascular risk in workers of both sexes over 60 years of age and to assess whether there are difference s by sex, social class, smoking, and type of job. METHODS: A cross-sectional study was carried out in 15,057 elderly Spanish workers from different autonomous communities in Spain and with different labor occupations. Anthropometric, sociodemographic, clinical, and laboratory values were determined. People were classified according to age from 60 to 64 years inclusive and from 65 to 69 years, smokers and non-smokers, and both blue-collar and white-collar workers. Subsequently, a multivariate analysis was carried out. RESULTS: Men, blue-collar workers, smokers, and aging were factors that influenced cardiovascular risk: with an OR of 3.27 (95% CI: 2.64-4.05) in people 65 years of age or older versus the younger group, and an OR of 3.15 (95% CI: 2.69-3.69) in smokers versus non-smokers. A stronger independent association was found between smoking, age, and cardiovascular risk. The risk of developing non-alcoholic fatty liver and liver fibrosis was much higher in men than in women, with an OR of 4.06 (95% CI: 3.66-4.50) for the former and an OR of 2.10 (95% CI: 1.95-2.26) for the BARD index. CONCLUSIONS: The highest risk groups were observed in male subjects with a history of smoking and blue-collar workers and, as such, should be considered for cardiovascular risk screening programs.


Assuntos
Doenças Cardiovasculares , Uso de Tabaco , Humanos , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Estudos Transversais , Fumar/efeitos adversos , Fumar/epidemiologia , Ocupações , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia
11.
Sci Rep ; 12(1): 19678, 2022 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-36385622

RESUMO

Unlike conventional epidemiological studies that use observational data to estimate "associations" between risk factors and disease, the science of causal inference has identified situations where causal estimates can be made from observational data, using results such as the "backdoor criteria". Here these results are combined with established epidemiological methods, to calculate simple population attribution fractions that estimate the causal influence of risk factors on disease incidence, and can be estimated using conventional proportional hazards methods. A counterfactual argument gives an attribution fraction for individuals. Causally meaningful attribution fractions cannot be constructed for all risk factors or confounders, but they can for the important established risk factors of smoking and body mass index (BMI). Using the new results, the causal attribution of smoking and BMI to the incidence of 226 diseases in the UK Biobank are estimated, and summarised in terms of disease chapters from the International Classification of Diseases (ICD-10). The diseases most strongly attributed to smoking and BMI are identified, finding 11 with attribution fractions greater than 0.5, and a small number with protective associations. The results provide new tools to quantify the causal influence of risk factors such as smoking and BMI on disease, and survey the causal influence of smoking and BMI on the landscape of disease incidence in the UK Biobank population.


Assuntos
Bancos de Espécimes Biológicos , Análise da Randomização Mendeliana , Humanos , Índice de Massa Corporal , Incidência , Análise da Randomização Mendeliana/métodos , Obesidade/epidemiologia , Obesidade/complicações , Fumar/efeitos adversos , Fumar/epidemiologia , Reino Unido/epidemiologia
12.
Dtsch Med Wochenschr ; 147(22): 1481-1487, 2022 11.
Artigo em Alemão | MEDLINE | ID: mdl-36318912

RESUMO

After several years of declining tobacco consumption, the number of smokers in Germany is currently stagnating or rising again. The reasons seem to be manifold, e. g. stress caused by the pandemic with social isolation, rising cost of living and war in Europe.With tobacco use still widespread in the German population, evidence-based tobacco cessation is rarely implemented.According to recent studies, e-cigarettes are involved in the pathogenesis of lung disease, cardiac and vascular damage. In addition, their ingredients also have carcinogenic effects. However, clinical studies on long-term use are not yet available.E-cigarettes as a consumer product are not superior to nicotine replacement products and addiction-reducing medications recommended in guidelines. In the therapeutic setting, they are slightly more effective than nicotine replacement products. However, they are usually consumed continuously and thus perpetuate nicotine dependence. Their use increases the risk of relapse to tobacco smoking.Despite the various new approaches, such as Internet-based offerings, app, etc., talks and pharmacotherapy are the gold standard and more effective than any therapy on its own.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Abandono do Hábito de Fumar , Tabagismo , Humanos , Dispositivos para o Abandono do Uso de Tabaco , Fumar/epidemiologia , Tabagismo/terapia
13.
Lancet Public Health ; 7(11): e923-e931, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36334608

RESUMO

BACKGROUND: Although socioeconomic status is a major determinant of premature mortality in many populations, the impact of social inequalities on premature mortality in Cuba, a country with universal education and health care, remains unclear. We aimed to assess the association between educational level and premature adult mortality in Cuba. METHODS: The Cuba Prospective Study (a cohort study) enrolled 146 556 adults aged 30 years and older from the general population in five provinces from Jan 1, 1996, to Nov 24, 2002. Participants were followed up until Jan 1, 2017, for cause-specific mortality. Deaths were identified through linkage to the Cuban Public Health Ministry's national mortality records. Cox regression models yielded rate ratios (RRs) for the effect of educational level (a commonly used measure for social status) on mortality at ages 35-74 years, with assessment for the mediating effects of smoking, alcohol consumption, and BMI. FINDINGS: A total of 127 273 participants aged 35-74 years were included in the analyses. There was a strong inverse association between educational level and premature mortality. Compared with a university education, men who did not complete primary education had an approximately 60% higher risk of premature mortality (RR 1·55, 95% CI 1·40-1·72), while the risk was approximately doubled in women (1·96, 1·81-2·13). Overall, 28% of premature deaths could be attributed to lower education levels. Excess mortality in women was primarily due to vascular disease, while vascular disease and cancer were equally important in men. 31% of the association with education in men and 18% in women could be explained by common modifiable risk factors, with smoking having the largest effect. INTERPRETATION: This study highlights the value of understanding the determinants of health inequalities in different populations. Although many major determinants lie outside the health system in Cuba, this study has identified the diseases and risk factors that require targeted public health interventions, particularly smoking. FUNDING: UK Medical Research Council, British Heart Foundation, Cancer Research UK, CDC Foundation (with support from Amgen).


Assuntos
Mortalidade Prematura , Doenças Vasculares , Adulto , Masculino , Humanos , Feminino , Estudos Prospectivos , Fumar/epidemiologia , Estudos de Coortes , Cuba/epidemiologia
14.
BMC Endocr Disord ; 22(1): 273, 2022 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-36348470

RESUMO

BACKGROUND: Depression is a risk factor for type 2 diabetes (T2D) and cardiovascular disease (CVD). The aims were to explore the prevalence of depression, anxiety, antidepressant use, obesity, Hemoglobin A1c > 64 mmol/mol, life-style factors, pre-existing CVD, in patients with newly diagnosed T2D; to explore associations with depression; and to compare with Swedish general population data. METHODS: Multicentre, cross-sectional study. INCLUSION CRITERIA: adults with serologically verified newly diagnosed T2D. Included variables: age, sex, current depression and anxiety (Hospital Anxiety and Depression Scale), previous depression, antidepressant use, obesity (BMI ≥ 30 and ≥ 40 kg/m2), Hemoglobin A1c, pre-existing CVD. Logistic regression analyses were performed. RESULTS: In 1027 T2D patients, aged 18-94 years, depression was associated with age (per year) (inversely) (odds ratio (OR) 0.97), anxiety (OR 12.2), previous depression (OR 7.1), antidepressant use (OR 4.2), BMI ≥ 30 kg/m2 (OR 1.7), BMI ≥ 40 kg/m2 (OR 2.3), smoking (OR 1.9), physical inactivity (OR 1.8), and women (OR 1.6) (all p ≤ 0.013). Younger women (n = 113), ≤ 59 years, compared to younger men (n = 217) had higher prevalence of current depression (31% vs 12%), previous depression (43 vs 19%), anxiety (42% vs 25%), antidepressant use (37% vs 12%), BMI ≥ 30 kg/m2 (73% vs 60%) and BMI ≥ 40 kg/m2) (18% vs 9%), and smoking (26% vs 16%) (all p ≤ 0.029). Older women (n = 297), ≥ 60 years, compared to older men (n = 400) had higher prevalence of previous depression (45% vs 12%), anxiety (18% vs 10%), antidepressant use (20% vs 8%), BMI ≥ 30 kg/m2 (55% vs 47%), BMI ≥ 40 kg/m2 (7% vs 3%) (all p ≤ 0.048), but not of current depression (both 9%). Compared to the Swedish general population (depression (women 11.2%, men 12.3%) and antidepressant use (women 9.8%, men 5.3%)), the younger women had higher prevalence of current depression, and all patients had higher prevalence of antidepressant use. CONCLUSIONS: In patients with newly diagnosed T2D, the younger women had the highest prevalence of depression, anxiety, and obesity. The prevalence of depression in young women and antidepressant use in all patients were higher than in the Swedish general population. Three risk factors for CVD, obesity, smoking, and physical inactivity, were associated with depression.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Adulto , Masculino , Humanos , Feminino , Idoso , Comportamento Sedentário , Estudos Transversais , Hemoglobina A Glicada , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Suécia/epidemiologia , Obesidade/epidemiologia , Fumar/epidemiologia , Antidepressivos/uso terapêutico , Prevalência , Fatores de Risco
15.
BMJ Open ; 12(11): e062189, 2022 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-36332957

RESUMO

OBJECTIVES: Previous studies were unable to estimate the dynamics of smoking status in the US elderly general population, and no study has assessed the benefit of quitting in terms of resultant gains in life expectancy. We proposed a novel method to estimate the per cent of quitting in remaining lifetime, successful quitting and relapse, as well as life expectancy by participants' baseline smoking status. DESIGN: Longitudinal cohort. SETTING: US community-dwelling population. PARTICIPANTS: Respondents from the Medicare Health Outcome Survey Cohort 15 (baseline 2012, follow-up 2014). We included respondents who were aged ≥65 years and alive at the baseline and participated in the baseline survey (n=164 597).Primary and secondary outcome measuresAttempt quitting, successful quitting, relapse rates and life expectancy by smoking status at age 65-95 years. RESULTS: Among daily smokers aged 65 years, 61% would attempt to quit during their remaining lifetime, and 31% would quit successfully. Among some days smokers aged 65 years, 69% would attempt to quit during their remaining lifetime, and 37% would quit successfully. Among recent ex-smokers aged 65 years, 53% would relapse. Life expectancy at age 65 years was 20.0 (SE=0.27), 17.2 (SE=0.30), 16.2 (SE=0.29) and 15.9 (SE=0.29) years for long time non-smokers, recent ex-smokers, some days smokers and daily smokers, respectively. Although recent ex-smokers had a higher 2-year mortality than current smokers, those who quit up to 77 years (77 years for men and 87 years for women) had a significantly longer (p<0.05) life expectancy. Sensitivity analysis demonstrated that the model assumptions had a relatively small impact on estimates with a maximum relative bias within ±7%. CONCLUSIONS: This study provides detailed information regarding the dynamics of smoking status in an understudied and growing population and demonstrates the benefit of smoking cessation on life expectancy. Future research should focus on understanding specific predictors of smoking cessation.


Assuntos
Medicare , Abandono do Hábito de Fumar , Masculino , Humanos , Idoso , Feminino , Estados Unidos/epidemiologia , Idoso de 80 Anos ou mais , Recidiva Local de Neoplasia , Abandono do Hábito de Fumar/métodos , Expectativa de Vida , Fumar/epidemiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-36361246

RESUMO

BACKGROUND: Smoking is associated with poor health status. Increased prevalence of multiple diseases has been found in populations of smokers and ex-smokers. Physical activity (PA) could reduce the negative effects of smoking. AIMS: To analyze the relationships between smoking and self-perceived health and between PA level and self-perceived health, according to the relationship with smoking in the Spanish population. To calculate the risks of perceiving negative health in relation to smoking, according to the PA level of the population. HYPOTHESIS: A higher level of PA reduces the risk of perceiving negative health in the Spanish smoking population. DESIGN AND METHODOLOGY: Cross-sectional study with data from 17,708 participants, 15-69 years old, interviewed in the Spanish National Health Survey 2017. Intergroup differences were studied. Odds ratios (OR) and relative risks (RR) and their confidence intervals (95% CI) were calculated for negative self-perceived health. A Spearman's rho correlation study was performed between the variables of interest. RESULTS: Dependency relationships were found between self-perceived health and PA levels, in both genders and in different relationships with smoking (x2 < 0.001). Inactivity was related to higher prevalences of negative health perception (p < 0.05) in all groups analyzed. Inactive smokers (OR: 6.02. 95% CI: 3.99-9.07. RR: 5.24. 95% CI: 3.56-7.73) presented increased risks of negative health perception compared to people with low/medium PA levels, similarly found in other relationships with tobacco. CONCLUSIONS: Increasing the PA level of the smoking population could reduce the negative effects on their perceived health. Medium and high PA levels reduce the risk of negative health perception in the Spanish population, both in smokers, ex-smokers, and non-smokers.


Assuntos
Abandono do Hábito de Fumar , Fumar , Humanos , Feminino , Masculino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Fumar/epidemiologia , Estudos Transversais , Exercício Físico , Comportamento Sedentário
17.
Health Promot Chronic Dis Prev Can ; 42(11-12): 457-465, 2022 Nov.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-36383157

RESUMO

INTRODUCTION: Youth initiation may drive differences in smoking prevalence across Canadian provinces. Provincial differences in initiation relate to tobacco control strategies and public health funding, but have also been attributed to population characteristics. We test this hypothesis by examining the extent to which seven characteristics-immigration, language, family structure, education, income, home ownership and at-school status-explain differences in initiation across provinces. METHODS: We used data from 16 897 youth aged 12 to 17 years in the Canadian Community Health Survey collected from 2015 to 2018. To examine the proportion of provincial differences explained by population characteristics, we compared average marginal effects (AMEs) from partially and fully adjusted models regressing "having ever initiated" on province and other characteristics. We also tested interactions to examine differences in the association between population characteristics and initiation across provinces. RESULTS: Initiation varied from 4% in British Columbia to 10% in Quebec. Being born in Canada, speaking French, not living in a two-parent household, being in the lowest household income quintile, having parents without postsecondary education, living in rented accommodation and not being in school were each associated with initiation. Taking these results into consideration, the AME of residing in another province compared with Quebec was attenuated by between 3% and 9%. Family structure and household income were more strongly associated with initiation in the Atlantic region and Manitoba, but not in Quebec. CONCLUSION: Differences in initiation between Quebec and other provinces are unlikely to be substantially explained by their demographic or socioeconomic composition. Reprioritizing tobacco control and public health funding are likely key in attaining the "tobacco endgame" across provinces.


Assuntos
Saúde Pública , Fumar , Adolescente , Humanos , Canadá/epidemiologia , Fumar/epidemiologia , Renda , Emigração e Imigração , Colúmbia Britânica
18.
Front Public Health ; 10: 904971, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36438262

RESUMO

Tobacco is both toxic and addictive. Mounting evidence shows that tobacco use has a detrimental impact on almost every aspect of human health, causing or worsening deadly public health crises from the cancer epidemic to the COVID-19 pandemic. However, while tobacco use is a threat to both personal and public health, it continues to surge across the world, especially in China and other low- and middle-income countries. To this end, this article argues in favor of using a ban on the sale of all tobacco products as a practical solution to the global tobacco use epidemic. It is our hope that insights provided by our work will inspire swift policy actions in countries such as China and beyond to curb the tide of rising tobacco consumption, so that populations around the world could be better shielded from the pervasive and long-lasting damage that tobacco products cause or compound.


Assuntos
COVID-19 , Produtos do Tabaco , Humanos , Pandemias , Fumar/epidemiologia , COVID-19/epidemiologia , Comércio
19.
Artigo em Inglês | MEDLINE | ID: mdl-36429485

RESUMO

BACKGROUND: Previous studies have shown that socializing with other smokers is an essential trigger for social smoking among smokers with a low nicotine dependence. This study further explored the mediating effects of the belief of smoking rationalization and smoker identity on the relationship between socializing with smokers and social smoking behavior. METHODS: A cross-sectional design was conducted. A total of 696 low-nicotine-dependent smokers in China completed questionnaires that assessed socializing with smokers, social smoking behavior, smoker identity, and the belief of smoking rationalization. The mediating roles of the belief of smoking rationalization and smoker identity on the relationship between socializing with smokers and social smoking behavior were assessed by using SPSS 23 and AMOS 23. RESULTS: The belief of smoking rationalization, smoker identity, socializing with smokers, and social smoking behavior were significantly and positively correlated with each other. In addition, this study found an independently mediated role for smoker identity in the relationship with smoker socialization and social smoking behavior, and a sequentially mediated role for smoking rationalization and smoker identity in this relationship. CONCLUSION: Reducing the belief of smoking rationalization and smoker identity may be conducive to reducing social smoking behavior for low-nicotine-dependent smokers when socializing with other smokers.


Assuntos
Abandono do Hábito de Fumar , Tabagismo , Masculino , Humanos , Fumantes , Racionalização , Estudos Transversais , Nicotina , Fumar/epidemiologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-36429968

RESUMO

INTRODUCTION: Little filtered cigars and cigarillos (LCCs) are consumed infrequently, co-administered with marijuana, and concurrently used with other tobacco products. Reliance on the past 30-day use estimate, a marker of tobacco user status, may underestimate the dynamic nature of intermittent LCC and other tobacco product use. We developed a framework to capture the intermittent nature of exclusive LCC use and dual/poly use with cigarettes and large cigars using broader timing of last product use categories and product use modality (e.g., with marijuana). METHODS: Data come from the baseline C'RILLOS study, a U.S. nationally representative sample of young adults aged 18-34 (n = 1063) collected in October 2019. We developed a consumption taxonomy framework that accounted for respondents' modality of LCC use (i.e., use with tobacco, LCC-T, or use with marijuana as blunts, LCC-B), the exclusive use of LCCs and other tobacco products (i.e., cigarettes, and large cigars) or their co-use and the timing of last product use (i.e., ever and past 30 days, past 3 months, past 6 months, greater than 6 months). RESULTS: Seventy-five percent of our sample reported ever use of any combustible tobacco product, including LCCs. The most common ever use pattern was poly use of LCC-T + LCC-B + cigarettes (16%). Our consumption taxonomy framework demonstrated the fluid nature of combustible tobacco product use among LCC users. For instance, among past 30-day cigarette users, 48% reported using LCC-T, 39% reported using LCC-B, and 32% reported using large cigars in the past 3 months or more. DISCUSSION: The tobacco use field currently classifies 'tobacco users' based on the product they smoked in the past 30 days. Any tobacco product use beyond the past 30-day period is considered 'discontinued use' and not the focus of intervention or tobacco regulatory science decisions. We documented the substantial proportion of young adult LCC, cigarette, and large cigar users who either exclusively or dual/poly used these combustible products in recent (e.g., past 3 months) periods. To prevent underestimation of use, surveillance measures should assess the use modality, timing of last product use, and exclusive/multiple product use to more accurately identify the smoking status of young adult LCC users.


Assuntos
Cannabis , Produtos do Tabaco , Tabagismo , Adulto Jovem , Humanos , Tabaco , Fumar/epidemiologia , Uso de Tabaco/epidemiologia
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