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Within-country differences in the prevalence of tobacco consumption may be expected in Mozambique, as determinants of tobacco use vary considerably countrywide. We compared the daily use of smoked and smokeless tobacco in 2005 and 2014/2015 across Mozambican regions. Two surveys were conducted in Mozambique, in 2005 and 2014/2015, with representative samples of the adult population, following the World Health Organization's STEPwise Approach to NCD Risk Factor Surveillance. Prevalence estimates were computed for daily use of different types of tobacco, stratified by regions. Data from the 2014/2015 survey were compared to those from the 2005 survey, after direct age-standardization. During the 10-year period, a significant reduction was observed in the prevalence of daily tobacco smoking among women in the Northern and men in the Southern provinces, due to the decrease in the consumption of hand-rolled cigarettes among Northern women (from 9.6% to 2.3%), and manufactured cigarettes among Southern men (from 23.7% to 11.8%). In Center and Northern regions, nonsignificant increases were observed in the consumption of manufactured cigarettes among men. The consumption of smokeless tobacco among Southern women decreased (from 3.1% to 1%). There was a decrease in the daily consumption of hand-rolled cigarettes among women in the North and of manufactured cigarettes among men in the South, as well as a potential trend towards residual smokeless tobacco consumption. However, the results suggest increases in the daily consumption of manufactured cigarettes among men in the Center and Northern regions.

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Background: Thyroid eye disease (TED) is the most prevalent extrathyroidal manifestation of Graves' disease (GD). Emerging evidence suggests a relationship between elevated total and low-density lipoprotein (LDL) cholesterol levels and TED. This study aimed to investigate this correlation in the Brazilian population by analyzing data from two tertiary care centers. Methods: Data were collected from GD patients treated with methimazole between 1999 and 2021, excluding those receiving other treatments. Laboratory results and information on smoking habits, statin use and medications affecting lipid profiles during the euthyroid state were analyzed. Results: Smoking and elevated LDL cholesterol levels were significantly associated with TED activity and severity. Logistic regression revealed correlations between higher LDL cholesterol, total cholesterol and increased clinical activity score (P < 0.01, OR: 1.012, 95% CI: 1.003-1.021; P < 0.01, OR: 1.010, 95% CI: 1.002-1.018). These were also associated with more severe disease forms as defined by EUGOGO (P < 0.01, OR: 1.015, 95% CI: 1.006-1.024; P < 0.005, OR: 1.011, 95% CI: 1.004-1.019). Multiple regression confirmed that TED activity was significantly correlated with LDL cholesterol (P < 0.01) and smoking status (P < 0.01). Disease severity was associated with reduced HDL cholesterol (P < 0.05, OR: 0.973, 95% CI: 0.948-0.999), elevated LDL cholesterol (P < 0.005, OR: 1.013, 95% CI: 1.004-1.023) and active smoking (P < 0.05, OR: 2.881, 95% CI: 1.190-6.971). Conclusion: Elevated LDL cholesterol may serve as a potential indicator of TED. Further research is needed to determine whether lipid-lowering interventions could reduce TED risk or improve its management.

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BACKGROUND: Tobacco smoking remains the leading preventable cause of death, whereas chronic pain is the leading cause of disability. Chronic pain and tobacco smoking are closely interrelated. We investigated whether pain predicts daily cigarette smoking and if daily cigarette smoking predicts the development of pain. METHODS: We analyzed eight years of longitudinal data from the Population Assessment of Tobacco and Health study. We examined whether baseline pain (scored ≥4 on a 0-10 scale) predicts transition to daily smoking among individuals who do not smoke, and whether baseline daily smoking predicts the development of pain among those with no/low pain (scored 0-3). The pain and smoking outcomes were only included in the survival analysis if they persisted consistently throughout all subsequent years after the initial onset. Our analysis incorporated survey population controlled for alternative tobacco product use, gender, age categories, and race/ethnicity. RESULTS: Among the 32,320 participants, 49.5 % were women, the largest age cohort was 18-24 (28.2 %). Racial and ethnic distribution was 73.9 % White, 15.6 % Black, and 17.2 % Hispanic. Survival analysis revealed that baseline pain (scored ≥4) significantly increased the risk of transitioning to daily smoking (HR=2.40, 95 % CI=1.62-3.55, p < 0.001, n = 5731). Further, daily smoking at baseline was associated with an increased risk of developing persistent pain (scored ≥4) over the study period (HR=2.00, 95 % CI=1.86-2.16, p < 0.001, n = 12,099). CONCLUSION: This study provides evidence for the existence of a bidirectional relationship between chronic pain and cigarette smoking. Treatment strategies should consider this relationship early, aiming to prevent development of persistent pain at its earliest stages.

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PURPOSE: This scoping review aimed to map research on factors associated with obstructive sleep apnoea (OSA) in children and adolescents undergoing overnight polysomnography (PSG) and questionnaire-based diagnostic assessments. METHODS: Searches were conducted in three electronic databases up to May 2023, including nine observational studies, including 3482 individuals. RESULTS: Among the included studies, nine reported on sex, six on obesity, five on tonsillar hypertrophy, three on mouth breathing, two on allergic rhinitis, and three on smoking exposure. The sample comprised 3482 children, with subsets analyzed for sex (n = 3482), obesity (n = 2752), and tonsillar hypertrophy (n = 794). Meta-analysis demonstrated a significantly higher prevalence of OSA in males compared to females [P < 0.0001; I2 = 49 %], with a pooled relative risk (RR) of 1.15 (95 % confidence interval [CI]: 1.07-1.23). Associations were found between obesity and OSA [RR: 1.42; 95 % CI: 1.20-1.68; P = 0.02; I2 = 61 %], and tonsillar size and OSA [RR: 1.61; 95 % CI: 1.35-1.92; P = 0.06; I2 = 60 %]. CONCLUSION: Considering the study's limitations, these findings underscore the importance of considering sex, obesity, and tonsillar size when evaluating OSA in children and adolescents.

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OBJECTIVES: To examine prevalence trends in the use of smoked tobacco products in 11 South American (SA) countries (i.e., Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Suriname, Uruguay, and Venezuela) and their association with country-specific socio-demographic index (SDI) over 30 years. DATA AND METHODS: The estimates of SDI and smoked tobacco prevalence stratified by age, sex, and country were extracted from the Global Burden of Disease Study (1990-2019) on individuals aged 15+. The annual percentage changes (APCs) of trends in country-specific prevalence of smoked tobacco were evaluated using Joinpoint regression. Correlation analysis was also used to explore the association between country-specific prevalence of smoked tobacco and their SDIs, a measure of developmental status considering income per capita, educational attainment, and total fertility rate. RESULTS: While all SA countries showed an overall decline in smoked tobacco use prevalence between 1990 and 2019 (APCs between -0.52%-and -4.73%; p < 0.05), Bolivia and Ecuador showed a significant increasing trend (APCs of 0.34% and 0.20%). Country-specific SDI was strongly and significantly correlated (rs = -0.99 to -0.85) with smoking prevalence in SA countries, except for Ecuador and Bolivia (rs = 0.16 and 0.36, respectively). CONCLUSION: In recent decades, most SA countries have experienced a significant reduction in the prevalence of smoked tobacco use, except Ecuador and Bolivia, where smoking rates have risen, showing a direct correlation with SDI. These findings can contribute to the design and implementation of strategies and policies for tobacco prevention and control in the SA region especially within the two affected countries - Ecuador and Bolivia.

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In this research we show that ambitious increases in tobacco tax rates can substantially reduce tobacco consumption, increase fiscal revenue, and provide net positive social benefits even in contexts of low consumption prevalence and intensity. Low nicotine intake still constitutes a grave disease risk factor, and the effectiveness of tax increases might be questioned if income effects are small. We adapt spatial variation of price methodologies to deal with low prevalence and intensity, censored data, and small samples using the Bolivian case as an illustration. We find an average price elasticity of demand of - 0.69 ${-}0.69$ to - 0.76 ${-}0.76$ . Using our estimates of elasticities, we develop a simulation to anticipate the effects of a 35% yearly increase of the Bolivian specific excise on tobacco starting in 2025. Our estimates show that by 2030, this reform could reduce the consumption of cigarettes by 52.6%, diminish the prevalence of smoking by 30.6%, and increase fiscal revenue by $123 million over six years. Moreover, we estimate that the abated direct medical costs of reduced consumption net of the deadweight loss associated with a tax increase would generate a net social gain of over $100 million in five years.

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OBJECTIVE: Sublingual varicose veins are variations of normality that appear more prominent during aging. The systematic review aim to investigate sublingual varicose veins frequency in patients exposed to systemic and environmental exposed factors linked to cardiovascular diseases. METHODS: This systematic review was based on the PECO strategy, and the PubMed, Web of Science, Scopus, Embase and Grey Literature library were searched for publications examining the association between sublingual varicose veins and systemic and environmental exposed factors linked to cardiovascular diseases, such as hypertension, diabetes, smoking, and leg varices. A meta-analysis was conducted using random-effects models. This review included 11 studies with a total of 2,272 patients with sublingual varicosity and systemic exposed factors linked to cardiovascular diseases. The quality assessment was improved by Newcastle and Ottawa Scales (NOS). RESULTS: Consistent results were observed across all systemic and environmental exposed factors linked to cardiovascular diseases subgroups. We found association between sublingual varicose veins and hypertension [p = 0.0002; 95%IC2.90 [1.66-5.06]; I2 91%); diabetics (p = 0.009; 95%IC 3.19 [1.34 - 7.62]; I2 84%); tobacco abuse (p = 0.002; 95%IC 1.97 [1.29 - 3.01]; I2 82%) and leg varicosity (p = 0.03; 95%IC 2.63 [1.08 - 6.44]; I2 95%). Seven articles received score 7, indicating good quality and four articles received moderate quality. CONCLUSION: Patients exposed to exposed factors that affect blood vessels showed a higher prevalence of sublingual varicose veins. These findings emphasize the importance of recognizing oral signs underlying systemic diseases. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42023397166.

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INTRODUCTION: The objective was to analyze the prevalence of classic CVRFs in specialist doctors and establish if there are differences by sex, age and specialty. MATERIALS AND METHODS: Observational, cross-sectional study carried out through an anonymous selfadministered survey of specialist doctors throughout the country. Sociodemographic and CVRF data were collected by self-report. Excess weight was considered if the body mass index (BMI) was ≥ 25. Records without weight and/or height were excluded. RESULTS: A total of 2925 specialist doctors participated, 67.5% women and 84% between 40 and 60 years old. The prevalence of SBO was 75%. The most prevalent conventional risk factors were family history (AHF) 57%, excess weight (53%), sedentary lifestyle (44%), followed by dyslipidemia 21%, smoking 16.5%, hypertension 16% and diabetes 4%. Men had significantly more CVRF than women except for smoking and sedentary lifestyle, which were similar in both sexes. DISCUSSION: Specialist physicians have a high prevalence of modifiable CRFs, which are also associated with AHF, present in more than half of the physicians. The prevalence is higher in men, intensivists and those over 60 years of age.

Introducción: El objetivo de este análisis fue evaluar la prevalencia de los factores de riesgo cardiovascular (FRCV) clásicos en médicos especialistas y establecer si existen diferencias por sexo, edad y especialidad. Materiales y métodos: Estudio observacional, de corte transversal mediante una encuesta anónima autoadministrada realizada a médicos especialistas de todo el país. Se recabaron datos sociodemográficos y de síndrome de burnout (SBO) y FRCV por autorreporte. Se consideró exceso de peso si el índice de masa corporal (IMC) era ≥ a 25. Se excluyeron los registros sin peso y/o altura. Resultados: Participaron 2925 médicos especialistas, 67.5% mujeres y 84% tenía entre 40 y 60 años. La prevalencia de SBO fue del 75%. Los factores de riesgo convencionales más prevalentes fueron los antecedentes heredofamiliares (AHF) 57%, el exceso de peso (53%), el sedentarismo (44%), seguidos por dislipemia 21%, tabaquismo 16.5%, hipertensión 16% y diabetes 4%. Los varones tuvieron significativamente más FRCV que las mujeres a excepción del tabaquismo y el sedentarismo que fueron similares en ambos sexos. Discusión: Los médicos especialistas presentan una prevalencia importante de FRCV modificables, que se asocian también al AHF, presente en más de la mitad de los médicos. Estos factores afectan más a los varones, los intensivistas y a los mayores de 60 años.

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OBJECTIVE: To analyze the association of household composition with risk behaviors in Brazilian adolescents. METHODS: Cross-sectional study, with a nationally representative sample of Brazilian adolescents (n=159,245) aged 13 to 17, enrolled and regularly attending the 7th to 9th year of elementary school and the 1st to 3rd year of high school, participants in the National Survey of School Health in 2019. The risk behaviors were: insufficient physical activity, sedentary behavior, alcohol consumption, smoking, poorer diet quality, skipping breakfast and not having meals with parents/guardians. In the analyses, the sampling weights and study design were considered, stratified by the type of school (public or private) and estimated using Poisson regression models. RESULTS: Adolescents, from public and private schools, who lived in single-parent households or where parents were absent, had a higher prevalence of alcohol consumption, smoking, poorer diet quality, skipping breakfast and not eating meals with parents/guardians, compared to those who lived with both parents. Additionally, adolescents from public schools showed a higher prevalence of sedentary behavior than those from single-parent households. Adolescents from private schools had a higher prevalence of sedentary behavior among those who lived only with their mother and a higher prevalence of insufficient physical activity among those who lived without either parent. CONCLUSION: Brazilian adolescents, from public and private schools, who lived in single-parent households or without parents, showed higher prevalence of risk behaviors.

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OBJECTIVE: To estimate the prevalence and to evaluate trends and disparities in the occurrence of smoking among pregnant women living in the municipality of Rio Grande (RS), in the extreme south of Brazil, between 2007 and 2019. METHODS: All pregnant women living in this municipality who had a child in one of the local hospitals between January 1st and December 31st in the years 2007, 2010, 2013, 2016, and 2019 were included in the study. The interviews took place within 48 hours after childbirth. A pregnant woman was considered a smoker if she smoked at least one cigarette per day for 30 consecutive days in any of the pregnancy trimesters. The respective Pearson's χ2 test was used to estimate the proportions and the trend. RESULTS: The mean prevalence of smoking in the studied period was 17.7% (95%CI 17.0-18.3), dropping from 23.4 (95%CI 21.7-25.0) in 2007 to 12.4% (95%CI 11.1-13.9) in 2019. This decrease occurred in all categories of the studied variables (p>0.001). The greatest disparities in the decrease were observed between the extreme groups for income (75.0 versus 34.4%) and level of education (51.0 versus 32.1%) and living or not with a partner (50.7 versus 27.7%). CONCLUSION: There was a sharp and uneven drop in the prevalence of smoking over these 13 years. Pregnant women at higher risk of complications during pregnancy and childbirth were at a clear disadvantage compared to others. Reducing the prevalence of smoking depends on prioritizing interventions among pregnant women with greater social vulnerability.

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BACKGROUND: Diabesity is a condition characterized by the coexistence of type 02 diabetes and obesity. The causes are multifactorial, resulting from a complex interaction of genetic and behavioral factors. Among the behavioral factors, there are physical inactivity, inadequate eating habits and excessive consumption of alcohol and tobacco. OBJECTIVE: To investigate the clustering of physical inactivity and other risk factors and the association between risk factor combinations and the presence of diabesity in quilombola adults. METHODS: Cross-sectional study involving a sample of 332 middle-aged and older adults (≥ 50 years) selected among participants in the "Epidemiological Profile of Quilombolas in Bahia" study. Data were collected by interview and anthropometric assessment. Descriptive statistics, cluster analysis, and multinomial logistic regression procedures were used for data analysis. RESULTS: The highest prevalence of clustering was identified for the combinations of regular alcohol consumption in the absence of the other factors (O/E=14.2; 95%CI 0.87-1.15), followed by regular alcohol and tobacco consumption (O/E=10.3; 95%CI 0.64-0.95) and regular consumption of alcohol, tobacco and foods high in sugar and fat (O/E=6.8; 95%CI= 1.31-1.75). Unadjusted analysis revealed an association between physical inactivity in the absence of the other factors (OR=0.82; 95%CI 0.78-0.86) and diabesity. CONCLUSION: Alcohol consumption was the most prevalent factor among the largest combinations evaluated. Furthermore, the presence of physical inactivity without the other behaviors analyzed and the absence of all behaviors were associated with diabesity only in unadjusted analysis.

FUNDAMENTO: A diabesidade é uma condição caracterizada pela coexistência de diabetes tipo 02 e obesidade. As causas são multifatoriais, resultantes de uma complexa interação de fatores genéticos e comportamentais. Entre os fatores comportamentais, destacam-se a inatividade física, os hábitos alimentares inadequados e o consumo excessivo de álcool e tabaco. OBJETIVO: Investigar o agrupamento (clustering) da inatividade física e outros fatores de risco e a associação entre as combinações de fatores de risco e a presença de diabesidade em adultos quilombolas. MÉTODOS: Trata-se de estudo transversal com amostra composta por 332 adultos de meia idade e idosos (idade ≥ 50 anos), selecionados entre os participantes do estudo "Perfil epidemiológico dos quilombolas baianos". Os dados foram obtidos por meio de entrevistas e avaliação antropométrica. Para a análise dos dados, foram utilizadas estatísticas descritivas, análise de cluster e procedimentos de regressão logística multinominal. RESULTADO: A maior prevalência de agrupamento foi identificada para as combinações de consumo regular de álcool sem a presença dos demais fatores (O/E=14,2; IC95%= 0,87-1,15), seguido de consumo regular de álcool e tabaco (O/E=10,3; IC95%= 0,64-0,95) e consumo regular de álcool, tabaco e alimentos ricos em açúcar e gorduras (O/E=6,8; IC95%= 1,31-1,75). Na análise bruta, foram observadas associações entre inatividade física sem a presença dos demais fatores (OR= 0,82 IC95%= 0,78-0,86) e diabesidade. CONCLUSÃO: O consumo de álcool foi o fator mais prevalente nas maiores combinações avaliadas. Além disso, inatividade física, sem os outros comportamentos analisados, e a ausência de todos os comportamentos associaram-se à diabesidade apenas na análise bruta.

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OBJECTIVES: To assess work history, occupational exposure, smoking, and biomass fuel use in a Mexican IgG4-related disease (IgG4-RD) cohort. METHODS: We conducted a cross-sectional study among patients with IgG4-RD. A standardised questionnaire was used to collect data on occupational, smoking, and biomass fuel exposure. The International Standard Classification of Occupations (ISCO88) categorised patients into white-collar (ISCO88 groups 0-5) and blue-collar (ISCO88 groups 6-9) work. RESULTS: We included 95 patients, with a mean age of 53.8±15.8 years, and 50.5% were male. Seventy-eight (82.1%) had paid work: 63 (66.3%) in white-collar and 15 (15.8%) in blue-collar occupations. Of those who had no paid work, 13 (13.7%) did household work and 4 (4.2%) were students. White-collar jobs were more common than blue-collar jobs, both including (66.3% vs. 29.5%) and excluding (66.3% vs. 15.8%) unpaid household work. Pancreatobiliary involvement was not more frequent among blue-collar workers. Occupational exposure was reported by 31.6% of patients. White-collar workers had more lung involvement (29% vs. 7.1%, p=0.02) and less biomass exposure (19% vs. 64.3%, p<0.001). Occupational exposures were associated with the proliferative phenotype (OR 3.5, 95% CI 1.08-11.36). History of smoking was linked to increased lung involvement (OR 3.2, 95% CI 1.1-9.4), while biomass exposure was associated with the Mikulicz/systemic phenotype (OR 2.6, 95% CI 1.03-6.9). CONCLUSIONS: This study shows that there are different patterns of occupational exposure among Mexican IgG4-RD patients, with fewer blue-collar jobs compared to other cohorts. Smoking and biomass fuel exposure may be more significant risk factors for IgG4-RD in this population, warranting further investigation.

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This study investigates the changing epidemiological profile of tongue squamous cell carcinoma (SCC) to young patients, highlighting its rising incidence among non-traditional risk groups. A retrospective descriptive study was conducted, covering data from medical records between 2000 and 2012. Patients were categorised into two age groups (≤ 40 years; 41-50 years). Sociodemographic and clinicopathological characteristics were evaluated. A total of 108 patients participated, mostly aged 41-50. Alcohol consumption (43.3%) surpassed smoking. Majority (56.7%) aged ≤ 40 never smoked. Lateral tongue border was most affected, with stages III and IV prevalent. Patients aged ≤ 40 were mostly eligible for surgery (44%). Survival tied to staging and surgery; age had no significant impact. Young squamous cell carcinoma patients often lacked traditional risk factors like smoking, underwent surgery, and typically had disease-free margins. The study underscores the importance of broad external policies for early diagnosis, beyond just traditional risk groups.

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OBJECTIVE: To analyze the prevalence and associated factors with chronic diseases among women of reproductive age in primary health care. METHOD: Cross-sectional study conducted with 397 women of reproductive age living in northern Paraná, Brazil. Data were collected from July 2019 to September 2020. The Women's Clinical Record was used to collect sociodemographic data, risk behaviors, diagnosis of chronic diseases and medication use. Chi-Square test was performed for association analysis, and Logistic Regression estimating Odds Ratio and 95% confidence intervals. RESULTS: The prevalence of chronic diseases among women of reproductive age was 38.53% and the associated factors were: age group from 31 to 40 years old (OR=3.67; p=0.001) and from 41 to 49 years (OR =9.7; p=0.001), incomplete high school education (OR= 2.7; p=0.001), obesity (OR= 2.25; p=0.001) and smoking (OR=2.23; p=0.001). CONCLUSION: Age at the end of the reproductive phase, obesity and smoking were associated with the presence of chronic diseases. Knowledge of these factors can assist in screening, monitoring and health education actions provided to women of childbearing age.

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UNASSIGNED: Background: Smoking remains a significant issue that increases the prevalence of multiple sclerosis (MS) and its progression to secondary progressive forms. Objectives: The goal is to identify the relationship between smoking and disease progression in MS patients who have undergone autologous hematopoietic stem cell transplantation (auto-HSCT) at the Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico. Methods: This retrospective study involved MS patients treated with auto-HSCT, followed for 12 months. The response to transplantation was measured using the difference in Expanded Disability Status Scale (EDSS) scores before and 12 months after the transplant. A difference of -0.5 or greater indicated a good response, while a difference below 0.5 indicated a poor response. Results: The study included 419 patients, with a median age of 47 years (IQR: 40-53). The majority were non-smokers (315) compared to smokers/ex-smokers (104). In patients with PMSS, EDSS stabilization at 12 months was observed in both smokers/ex-smokers (median 6, interquartile range (IQR) = 1 vs. 6, IQR = 1, p = 0.466) and non-smokers (median 6, IQR = 1 vs. 6, IQR = 1.5, p = 0.001), although non-smokers showed a statistically significant difference. Conclusion: Smoking may negatively impact MS progression, especially in its progressive forms. (Rev Invest Clin. 2024;76(5):223-9).

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There is scarcity of information on the determinants of periodontitis in Latin America and Caribbean countries. We conducted a comprehensive review of studies examining the association of smoking and diabetes with periodontitis outcomes in this region. We searched for population-based, cross-sectional and prospective cohort studies from Latin America and the Caribbean region that reported on the association between smoking or diabetes and periodontitis. Databases were searched up to October 2023 by two reviewers. Subsequently, two authors independently conducted a rigorous data extraction process, focusing on study characteristics, the definition of exposures, and periodontitis outcomes, including measures of association and main findings. The results revealed a significant association between smoking and periodontitis, with a stronger effect observed in heavy smokers. Conversely, while some studies observed a higher prevalence of periodontitis among diabetic individuals, the association between diabetes and periodontitis was not significant after adjusting for confounding factors. These findings underscore a significant research gap in population-based studies on the effect of smoking and diabetes on periodontitis within Latin American and Caribbean countries, particularly when it comes to cohort studies. Addressing these gaps is crucial for a deeper understanding of these associations, which could lead to more effective prevention and treatment strategies in the region.

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BACKGROUND: Individual and Joint Association between Cardiovascular Disease Risk Factors and Inadequate Lifestyle Behaviors in a Sample from Brazil. CVD: cardiovascular diseases. BACKGROUND: Cardiovascular diseases (CVD) are often influenced by modifiable factors, notably individuals' lifestyle choices, which play a crucial role in modulating cardiovascular risk. OBJECTIVE: To investigate the individual and simultaneous association between inadequate lifestyle behaviors and risk factors for CVD in adults and older adults. METHOD: A cross-sectional study with 1079 users of the Health Academy Program in Brazil. Information related to inadequate diet, excessive alcohol consumption, smoking, and physical inactivity were individually and collectively investigated (0, 1, or ≥ 2 factors) in association with CVD risk factors (hypertension, hypercholesterolemia, diabetes mellitus, and obesity), considering the following two outcomes: presence of CVD risk factors and number of CVD risk factors present in the same individual (0, 1, 2, or ≥ 3 risk factors). Logistic and multinomial logistic regression analyses were used. The statistical significance adopted was 5%. RESULTS: A higher number of inadequate lifestyle behavior was associated with greater odds of simultaneous presence of 1, 2, or ≥ 3 CVD risk factors. The simultaneous adoption of 1 and ≥ 2 inadequate lifestyle behaviors was associated with greater odds of hypercholesterolemia. Simultaneous adherence to ≥ 2 inadequate lifestyle behaviors was associated with lower odds of hypertension. CONCLUSION: A greater number of inadequate lifestyle behaviors was associated with higher odds of simultaneous presence of multiple CVD risk factors.

BACKGROUND: Associação Individual e Simultânea entre Fatores de Risco para Doença Cardiovascular e Hábitos Inadequados do Estilo de Vida em uma Amostra do Brasil. DCV: doenças cardiovasculares. FUNDAMENTO: As doenças cardiovasculares (DCV) são frequentemente influenciadas por fatores modificáveis, principalmente pelas escolhas de estilo de vida dos indivíduos, que desempenham um papel crucial na modulação do risco cardiovascular. OBJETIVO: Investigar a associação individual e simultânea entre comportamentos inadequados do estilo de vida e fatores de risco para DCV em adultos e idosos. MÉTODOS: Trata-se de um estudo transversal com 1.079 usuários do Programa Academia da Saúde no Brasil. Foram investigadas individual e coletivamente informações relacionadas a dieta inadequada, consumo excessivo de álcool, tabagismo e inatividade física (0, 1 ou ≥ 2 fatores) em associação com fatores de risco para DCV (hipertensão, hipercolesterolemia, diabetes mellitus e obesidade), considerando os dois desfechos seguintes: presença de fatores de risco para DCV e número de fatores de risco para DCV presentes no mesmo indivíduo (0, 1, 2 ou ≥ 3 fatores de risco). Foram utilizadas análises de regressão logística e multinomial. A significância estatística adotada foi de 5%. RESULTADOS: Um maior número de comportamentos do estilo de vida inadequados foi associado a maiores chances de presença simultânea de 1, 2 ou ≥ 3 fatores de risco de DCV. A adoção simultânea de 1 e ≥ 2 comportamentos de estilo de vida inadequados foi associada a maiores chances de hipercolesterolemia. A adesão simultânea a ≥ 2 comportamentos de estilo de vida inadequados foi associada a menores chances de hipertensão. CONCLUSÃO: Um maior número de comportamentos de estilo de vida inadequados foi associado a maiores chances de presença simultânea de múltiplos fatores de risco de DCV.

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BACKGROUND: Low- and middle-income countries have increasingly banned e-cigarettes, as in Mexico. In these countries, little is known about where adults obtain e-cigarettes or who uses e-cigarettes with nicotine. METHODS: Data were analyzed from eight online surveys of Mexican adults who both smoked and used e-cigarettes (November 2018-March 2021; n = 2,060). For the e-cigarette they used most often, participants reported how they acquired it (social sources=reference; online purchase; vape shop purchase; other retail purchase) and if it contained nicotine (no=reference group; yes; don't know). Multinomial models regressed each of these outcomes on smoking- and e-cigarette-related factors, as well as sociodemographics. RESULTS: Almost half the sample (45.9 %) reported obtaining their e-cigarettes from social sources, with online purchase being the second most common source (28.7 %). Being male, having recently attempted to quit smoking, and more frequent e-cigarette use were positively associated with purchasing e-cigarettes (vs social sources) across all venues. Most reported that their e-cigarettes contained nicotine (58.2 %), a third reported using e-cigarettes without nicotine (35.9 %), and some did not know (5.8 %). More frequent smoking and e-cigarette use, using closed e-cigarette devices and purchasing e-cigarettes online were positively associated with using e-cigarettes with nicotine. CONCLUSIONS: Despite Mexico's e-cigarette ban, adults who smoke access e-cigarettes through multiple sources, including online and vape shop purchases. Most participants reported using e-cigarettes with nicotine, though many did not or did not know.

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This study systematically reviews the evidence on the association between sense of coherence (SOC) and substance use during adulthood. Two researchers conducted independent literature searches on the PubMed, LILACS, PsycINFO and Web of Science databases. Original articles assessing SOC and substance use in adults (age > 19 years) were included. Two reviewers independently assessed studies in two phases - initially by reading the title/abstract, then the full text. Discrepancies were resolved by a third reviewer. Estimates were pooled using random-effects models. Bibliographic search identified 21 studies on the association between SOC and substance use in adults. Studies (n = 11) that assessed the association with tobacco smoking found a 0.92 (95%CI: 0.82; 1.01, very low degree of certainty) odds of smoking among those with a high SOC; the association was not modified by age. Individuals with a strong SOC had lower odds of using alcohol (pooled effect: OR = 0.70, 95%CI: 0.50; 0.90, very low degree of certainty); adjustment for confounding variables decreased the magnitude of the association (pooled OR = 0.89, 95%CI: 0.80; 0.98). This systematic review and meta-analysis suggests that a strong SOC protects against substance use among adults regardless of age, with practical implications for preventive interventions and tailored strategies aimed at high-risk individuals. Longitudinal studies are needed to understand the impact of SOC on substance use. Examining interactions with socioeconomic factors and including diverse populations would enhance generalizability.

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BACKGROUND: The prevalence of tobacco and alcohol use among adolescents is alarming, and these substances are among the leading risk factors for current and future health among adolescents. Physical activity has the potential to help prevent substance use among adolescents. The objective of this study was to evaluate the association between physical activity, modes of transportation to or from school, and sitting time with tobacco and alcohol use among 222,495 adolescents. METHODS: This cross-sectional study used data from national surveys conducted in 66 countries, obtained through the Global School-based Student Health Survey, and included adolescents aged 11 to 17 years. Information on physical activity, transportation to or from school, sitting time, and tobacco and alcohol use was collected through self-report questionnaires. Generalized linear models were employed to estimate the associations between these variables. RESULTS: The analysis, adjusted for sex, age, and region, revealed that being physically active was associated with lower odds of smoking (OR: 0.86, 95%CI: 0.83-0.89), alcohol use (OR: 0.74, 95%CI: 0.72-0.76), binge drinking (OR: 0.66, 95%CI: 0.62-0.69), and drunkenness (OR: 0.85, 95%CI: 0.83-0.88) compared to inactivity. Insufficiently active participants also had lower odds of tobacco use (OR: 0.83, 95%CI: 0.80-0.85), alcohol use (OR: 0.77, 95%CI: 0.75-0.79), binge drinking (OR: 0.91, 95%CI: 0.87-0.96), and drunkenness (OR: 0.88, 95%CI: 0.85-0.90) compared to inactive participants. Additionally, active transportation to or from school was associated with lower odds of tobacco use (OR: 0.97, 95%CI: 0.95-0.99), alcohol use (OR: 0.94, 95%CI: 0.92-0.96), and binge drinking (OR: 0.78, 95%CI: 0.75-0.81) compared to those using passive transportation. Participants with acceptable sitting time, however, were more likely to use tobacco (OR: 1.48, 95%CI: 1.45-1.52), use alcohol (OR: 1.68, 95%CI: 1.64-1.72), binge drink (OR: 1.68, 95%CI: 1.62-1.75), and experience drunkenness (OR: 1.66, 95%CI: 1.62-1.69) compared to those with excessive sitting time. CONCLUSION: Being physically active, even at insufficient levels, may have beneficial effects on tobacco and alcohol use in adolescents. Acceptable sedentary time, on the other hand, was positively associated with tobacco and alcohol use.