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1.
Monaldi Arch Chest Dis ; 90(4)2020 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-33238700

RESUMO

Dear Editor, the issues recently raised by Carratù et al. on the role of smoking/former smoking in patients hospitalized for COVID-19 all around the world as widely reported in many different published papers, are important for different reasons...


Assuntos
/complicações , Fumar/efeitos adversos , /epidemiologia , Humanos , Prevalência , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/etiologia , Índice de Gravidade de Doença , Fumar/epidemiologia , Fumar/psicologia
2.
Sci Rep ; 10(1): 16365, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004859

RESUMO

Smoking remains among the leading causes of mortality worldwide. Obtaining a comprehensive understanding of a population's smoking behaviour is essential for tobacco control. Here, we aim to characterize lifelong smoking patterns and explore underlying sociodemographic and lifestyle factors in a population-based birth cohort population followed up for 46 years. Our analysis is based on 5797 individuals from the Northern Finland Birth Cohort 1966 who self-reported their tobacco smoking behaviour at the ages of 14, 31 and 46. Data on sex, education, employment, body mass index, physical activity, alcohol consumption, and substance addiction were also collected at the follow-ups. We profile each individual's annual smoking history from the age of 5 to 47, and conduct a latent class trajectory analysis on the data. We then characterize the identified smoking trajectory classes in terms of the background variables, and compare the heaviest smokers with other classes in order to reveal specific predictors of non-smoking and discontinued smoking. Six smoking trajectories are identified in our sample: never-smokers (class size 41.0%), youth smokers (12.6%), young adult quitters (10.8%), late adult quitters (10.5%), late starters (4.3%), and lifetime smokers (20.7%). Smoking is generally associated with male sex, lower socioeconomic status and unhealthier lifestyle. Multivariable between-class comparisons identify unemployment (odds ratio [OR] 1.28-1.45) and physical inactivity (OR 1.20-1.52) as significant predictors of lifetime smoking relative to any other class. Female sex increases the odds of never-smoking and youth smoking (OR 1.29-1.33), and male sex increases the odds of adult quitting (OR 1.30-1.41), relative to lifetime smoking. We expect future initiatives to benefit from our data by exploiting the identified predictors as direct targets of intervention, or as a means of identifying individuals who may benefit from such interventions.


Assuntos
Estilo de Vida , Fumantes/psicologia , Fumar/psicologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Finlândia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
3.
Rev Mal Respir ; 37(9): 699-709, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33071062

RESUMO

BACKGROUND: There is no validated Arabic version of the French questionnaire of quality of life, the VQ11. This study aimed to test the applicability of the Arabic version of the VQ11 in Tunisian patients with chronic obstructive pulmonary disease (COPD). METHODS: It was a prospective and cross-sectional study, spread over seven months, that included 40 stable COPD male patients. The Arabic version of VQ11, translated by a bilingual expert, was used. The functional, psychological, relational and total scores were calculated. Patients were divided into two groups according to the GOLD classification: "A-B" (n=25) and "C-D" (n=15). A significant correlation-coefficient (r) of≥0.51, between the VQ11 total score and the ADO index (age, dyspnoea, obstruction), and higher quality of life scores in GOLD "C-D" when compared to GOLD "A-B" would be in favour of application of the Arabic version of the VQ11. RESULTS: The mean±standard deviation of age, post-bronchodilator FEV1/FVC, ADO index and VQ11 total score were 64±8 years, 0.55±0.08, 4.8±1.7 and 2±10, respectively. A significant "r" (0.56) was identified between the ADO index and the total score. Psychological, relational and total scores of GOLD "A-B" patients were significantly lower than those in GOLD "C-D" patients: 10±4 vs. 12±3, 11±4 vs. 13±3 and 30±11 vs. 36±7, respectively. CONCLUSION: The Arabic version of VQ11 is applicable in Tunisian COPD patients with reliable results.


Assuntos
Comparação Transcultural , Idioma , Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Inquéritos e Questionários , Idoso , Árabes/estatística & dados numéricos , Comorbidade , Jejum/fisiologia , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Religião e Medicina , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Fumar/epidemiologia , Fumar/psicologia , Inquéritos e Questionários/normas , Tradução , Tunísia/epidemiologia
4.
JAMA ; 324(14): 1406-1418, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33048154

RESUMO

Importance: Persistent smoking may cause adverse outcomes among patients with cancer. Many cancer centers have not fully implemented evidence-based tobacco treatment into routine care. Objective: To determine the effectiveness of sustained telephone counseling and medication (intensive treatment) compared with shorter-term telephone counseling and medication advice (standard treatment) to assist patients recently diagnosed with cancer to quit smoking. Design, Setting, and Participants: This unblinded randomized clinical trial was conducted at Massachusetts General Hospital/Dana-Farber/Harvard Cancer Center and Memorial Sloan Kettering Cancer Center. Adults who had smoked 1 cigarette or more within 30 days, spoke English or Spanish, and had recently diagnosed breast, gastrointestinal, genitourinary, gynecological, head and neck, lung, lymphoma, or melanoma cancers were eligible. Enrollment occurred between November 2013 and July 2017; assessments were completed by the end of February 2018. Interventions: Participants randomized to the intensive treatment (n = 153) and the standard treatment (n = 150) received 4 weekly telephone counseling sessions and medication advice. The intensive treatment group also received 4 biweekly and 3 monthly telephone counseling sessions and choice of Food and Drug Administration-approved cessation medication (nicotine replacement therapy, bupropion, or varenicline). Main Outcome and Measures: The primary outcome was biochemically confirmed 7-day point prevalence tobacco abstinence at 6-month follow-up. Secondary outcomes were treatment utilization rates. Results: Among 303 patients who were randomized (mean age, 58.3 years; 170 women [56.1%]), 221 (78.1%) completed the trial. Six-month biochemically confirmed quit rates were 34.5% (n = 51 in the intensive treatment group) vs 21.5% (n = 29 in the standard treatment group) (difference, 13.0% [95% CI, 3.0%-23.3%]; odds ratio, 1.92 [95% CI, 1.13-3.27]; P < .02). The median number of counseling sessions completed was 8 (interquartile range, 4-11) in the intensive treatment group. A total of 97 intensive treatment participants (77.0%) vs 68 standard treatment participants (59.1%) reported cessation medication use (difference, 17.9% [95% CI, 6.3%-29.5%]; odds ratio, 2.31 [95% CI, 1.32-4.04]; P = .003). The most common adverse events in the intensive treatment and standard treatment groups, respectively, were nausea (n = 13 and n = 6), rash (n = 4 and n = 1), hiccups (n = 4 and n = 1), mouth irritation (n = 4 and n = 0), difficulty sleeping (n = 3 and n = 2), and vivid dreams (n = 3 and n = 2). Conclusions and Relevance: Among smokers recently diagnosed with cancer in 2 National Cancer Institute-designated Comprehensive Cancer Centers, sustained counseling and provision of free cessation medication compared with 4-week counseling and medication advice resulted in higher 6-month biochemically confirmed quit rates. However, the generalizability of the study findings is uncertain and requires further research. Trial Registration: ClinicalTrials.gov Identifier: NCT01871506.


Assuntos
Aconselhamento/métodos , Neoplasias/diagnóstico , Abandono do Hábito de Fumar/psicologia , Temperança/psicologia , Dispositivos para o Abandono do Uso de Tabaco , Idoso , Bupropiona/efeitos adversos , Bupropiona/uso terapêutico , Cotinina/análise , Aconselhamento/estatística & dados numéricos , Técnicas de Apoio para a Decisão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Entrevista Motivacional , Satisfação do Paciente , Seleção de Pacientes , Saliva/química , Fumar/tratamento farmacológico , Fumar/epidemiologia , Fumar/psicologia , Agentes de Cessação do Hábito de Fumar/efeitos adversos , Agentes de Cessação do Hábito de Fumar/uso terapêutico , Telefone , Dispositivos para o Abandono do Uso de Tabaco/efeitos adversos , Vareniclina/efeitos adversos , Vareniclina/uso terapêutico
5.
Nat Commun ; 11(1): 5302, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33082346

RESUMO

Here we report a large genome-wide association study (GWAS) for longitudinal smoking phenotypes in 286,118 individuals from the Million Veteran Program (MVP) where we identified 18 loci for smoking trajectory of current versus never in European Americans, one locus in African Americans, and one in Hispanic Americans. Functional annotations prioritized several dozen genes where significant loci co-localized with either expression quantitative trait loci or chromatin interactions. The smoking trajectories were genetically correlated with 209 complex traits, for 33 of which smoking was either a causal or a consequential factor. We also performed European-ancestry meta-analyses for smoking status in the MVP and GWAS & Sequencing Consortium of Alcohol and Nicotine use (GSCAN) (Ntotal = 842,717) and identified 99 loci for smoking initiation and 13 loci for smoking cessation. Overall, this large GWAS of longitudinal smoking phenotype in multiple populations, combined with a meta-GWAS for smoking status, adds new insights into the genetic vulnerability for smoking behavior.


Assuntos
Estudo de Associação Genômica Ampla , Fumar/genética , Afro-Americanos/genética , Estudos de Coortes , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Hispano-Americanos/genética , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Locos de Características Quantitativas , Fumar/psicologia
6.
J Affect Disord ; 277: 893-900, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33065831

RESUMO

BACKGROUND: The mental health status caused by major epidemics is serious and lasting. At present, there are few studies about the lasting mental health effects of COVID-19 outbreak. The purpose of this study was to investigate the mental health of the Chinese public during the long-term COVID-19 outbreak. METHODS: A total of 1172 online questionnaires were collected, covering demographical information and 8 common psychological states: depression, anxiety, somatization, stress, psychological resilience, suicidal ideation and behavior, insomnia, and stress disorder. In addition, the geographical and temporal distributions of different mental states were plotted. RESULTS: Overall, 30.1% of smokers increased smoking, while 11.3% of drinkers increased alcohol consumption. The prevalence rates of depression, anxiety, mental health problems, high risk of suicidal and behavior, clinical insomnia, clinical post-traumatic stress disorder symptoms, moderate-to-high levels of perceived stress were 18.8%, 13.3%, 7.6%, 2.8%, 7.2%, 7.0%, and 67.9%, respectively. Further, the geographical distribution showed that the mental status in some provinces/autonomous regions/municipalities was relatively more serious. The temporal distribution showed that the psychological state of the participants was relatively poorer on February 20, 24 to 26 and March 25, especially on March 25. LIMITATIONS: This cross-sectional design cannot make causal inferences. The snowball sampling was not representative enough. CONCLUSION: Our findings suggest that the prevalence rate of mental disorders in the Chinese public is relatively low in the second month of the COVID-19 pandemic. In addition, people's mental state is affected by the geographical and temporal distributions.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus , Depressão/epidemiologia , Pandemias , Pneumonia Viral , Transtornos Somatoformes/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Ideação Suicida , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Ansiedade/psicologia , Betacoronavirus , China/epidemiologia , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Prevalência , Resiliência Psicológica , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Fumar/epidemiologia , Fumar/psicologia , Transtornos Somatoformes/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto Jovem
7.
PLoS One ; 15(10): e0240968, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33095798

RESUMO

Smoking rates in the UK are at an all-time low but this masks considerable inequalities; prevalence amongst adults who are homeless remains four times higher than the national average. The objective of this trial was to assess the feasibility of supplying free e-cigarette starter kits to smokers accessing homeless centres and to estimate parameters to inform a possible future larger trial. In this feasibility cluster trial, four homeless centres in Great Britain were non-randomly allocated to either a Usual Care (UC) or E-Cigarette (EC) arm. Smokers attending the centres were recruited by staff. UC arm participants (N = 32) received advice to quit and signposting to the local Stop Smoking Service. EC arm participants (N = 48) received an EC starter kit and 4-weeks supply of e-liquid. Outcome measures were recruitment and retention rates, use of ECs, smoking cessation/reduction and completion of measures required for economic evaluation. Eighty (mean age 43 years; 65% male) of the 153 eligible participants who were invited to participate, were successfully recruited (52%) within a five-month period, and 47 (59%) of these were retained at 24 weeks. The EC intervention was well received with minimal negative effects and very few unintended consequences (e.g. lost, theft, adding illicit substances). In both study arm, depression and anxiety scores declined over the duration of the study. Substance dependence scores remained constant. Assuming those with missing follow up data were smoking, CO validated sustained abstinence at 24 weeks was 3/48 (6.25%) and 0/32 (0%) respectively for the EC and UC arms. Almost all participants present at follow-up visits completed data collection for healthcare service and health-related quality of life measures. Providing an e-cigarette starter kit to smokers experiencing homelessness was associated with reasonable recruitment and retention rates and promising evidence of effectiveness and cost-effectiveness.


Assuntos
Pessoas em Situação de Rua/psicologia , Abandono do Hábito de Fumar/métodos , Fumar/terapia , Adulto , Análise Custo-Benefício , Sistemas Eletrônicos de Liberação de Nicotina , Estudos de Viabilidade , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Prevalência , Retenção nos Cuidados/estatística & dados numéricos , Fumar/epidemiologia , Fumar/psicologia , Abandono do Hábito de Fumar/psicologia , Fatores Socioeconômicos , Reino Unido
8.
Sci Rep ; 10(1): 15584, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32973155

RESUMO

Tobacco is still a leading cause of premature death and morbidity. Particular attention has been given to pregnant women due to the scientific evidence on the importance of early life exposures for disease onset later in life. The purpose of this study was to assess smoking prevalence, smoking cessation rate and environmental tobacco smoke (ETS) exposure, and the role of socioeconomic position (SEP) on these behaviors among pregnant women. Cross-sectional data of 619 pregnant women, aged between 18 and 46 years, from Porto Metropolitan Area, Portugal, on current smoking, ETS exposure and SEP indicators was collected, face-to-face, using a questionnaire filled in during a personal interview at the postpartum hospital stay. The smoking prevalence, and ETS exposure among non-smokers before pregnancy was 27.6% and 57.4%, respectively. 4.1% of the participants reported to have stopped smoking before pregnancy, whereas about 41% quitted along pregnancy, resulting in a smoking prevalence at birth of 14.6%. Exposure to ETS also decreased throughout pregnancy to 49.8% at birth. Lower educational level was significantly associated with both higher smoking prevalence and exposure to ETS and lower smoking cessation. This study demonstrates that smoking and ETS exposure during pregnancy remains high, and that there are still significant socioeconomic inequalities in smoking; thus tobacco-focused preventive interventions need to be reinforced.


Assuntos
Exposição Ambiental/efeitos adversos , Comportamentos Relacionados com a Saúde , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/epidemiologia , Fatores Socioeconômicos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Portugal/epidemiologia , Gravidez , Prevalência , Fumar/economia , Fumar/psicologia , Adulto Jovem
9.
Lancet Child Adolesc Health ; 4(11): 837-845, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32979939

RESUMO

BACKGROUND: Although cigarette smoking typically begins in adolescence, evidence for successful pharmacological smoking cessation interventions for this population is scarce. In adult smokers, varenicline is the most effective single pharmacotherapy. The aim of this study was to assess the efficacy and tolerability of varenicline for smoking cessation in adolescents. METHODS: We did a randomised, placebo-controlled trial with adolescent smokers aged 12-19 years who were seeking treatment to quit at 57 outpatient centres (in the USA, Russia, South Korea, Taiwan, Canada, and Georgia). Participants were randomly assigned (1:1:1) to receive 12 weeks of high-dose varenicline (1 mg twice daily; 0·5 mg twice daily if bodyweight ≤55 kg), low-dose varenicline (0·5 mg twice daily; 0·5 mg once daily if bodyweight ≤55 kg), or placebo, then followed up for 40 additional weeks. At all visits, participants received brief, developmentally tailored smoking cessation counselling (<10 min per session) delivered by a trained counsellor. The primary efficacy outcome was continuous abstinence from weeks 9 to 12, measured via a Nicotine Use Inventory and confirmed by urine cotinine testing. The primary tolerability outcome was frequency of treatment-emergent adverse events, including neuropsychiatric adverse events, occurring after the first dose and within 30 days of the last dose of study medication. This trial is registered with ClinicalTrials.gov, NCT01312909. FINDINGS: Between April 26, 2011, and Jan 18, 2018, 312 participants were enrolled and completed participation in the study: 109 in the high-dose varenicline group, 103 in the low-dose varenicline group, and 100 in the placebo group. The continuous abstinence rates from week 9 to 12 were 20% (22 of 109) in the high-dose varenicline group, 27% (28 of 103) in the low-dose varenicline group, and 18% (18 of 100) in the placebo group. Abstinence rates between high-dose varenicline and placebo groups (odds ratio [OR] 1·18 [95% CI 0·59-2·37]; p=0·63) and between low-dose varenicline and placebo groups (1·73 [0·88-3·39]; p=0·11) did not differ significantly. Treatment-emergent adverse events occurred in 65 (60%) of 108 participants in the high-dose group, 53 (53%) of 100 in the low-dose group, and 52 (53%) of 99 in the placebo group, and most were rated as mild. Neuropsychiatric treatment-emergent adverse events occurred in 18 (17%) of 108 participants in the high-dose group, 11 (11%) of 100 in the low-dose group, and 12 (12%) of 99 in the placebo group, and none was rated as severe. INTERPRETATION: This trial did not show an advantage in abstinence with varenicline compared with placebo among adolescent smokers. The rates of treatment-emergent adverse events were similar to those in previous trials of adult smokers, raising no new tolerability signals. These findings do not support the use of varenicline as a first-line pharmacotherapy for smoking cessation in adolescents. FUNDING: Pfizer.


Assuntos
Relação Dose-Resposta a Droga , Abandono do Hábito de Fumar/métodos , Vareniclina , Adolescente , Comportamento do Adolescente , Monitoramento de Medicamentos/métodos , Feminino , Humanos , Masculino , Fumar/psicologia , Agentes de Cessação do Hábito de Fumar/administração & dosagem , Agentes de Cessação do Hábito de Fumar/efeitos adversos , Resultado do Tratamento , Vareniclina/administração & dosagem , Vareniclina/efeitos adversos , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-32977630

RESUMO

BACKGROUND: Despite the sustained high prevalence of smoking among Indonesian adult men, little is known about possible protective factors in this group. This study examined the relationship between key characteristics of masculinity (e.g., fatherhood status, being the main breadwinner or sole provider for the family) and current smoking behaviours (smoking status and cigarettes smoked per day (CPD)) among Indonesian men aged 18-49 years. METHODS: In total, 2540 Indonesian men aged 18-49 participated in the United Nations Multi-Country Study on Men and Violence, 2012. Fatherhood status was categorised into three groups: nonfathers, new fathers and more experienced fathers. The association between fatherhood status and current smoking, as well as fatherhood status and cigarettes smoked per day (CPD), was estimated by employing logistic and zero-inflated negative binomial regressions, respectively. RESULTS: Socioeconomic factors were associated with smoking behaviour among Indonesian adult men. The odds of smoking among new fathers and more experienced fathers were 2.3 (95% CI: 1.09-4.79) and 1.5 times (95% CI: 1.08-2.17) higher compared with nonfathers, respectively. Men who had a shared income with their partner or received income from their parents smoked 13% (95% CI 0.79-0.95) and 11% fewer CPD (95% CI 0.79-0.99) compared with men who were the main breadwinner, respectively. CONCLUSIONS: In this study, fatherhood represents an aspect of traditionally masculine roles, offering a new perspective for looking at smoking problems in Indonesia. Other key aspects of traditional masculinity characteristics, the breadwinner role, occupation and sources of family income had significant associations with smoking status and CPD. Men smoked fewer CPD as fathers and when sharing the financial responsibility for their family equally with their spouse.


Assuntos
Pai/psicologia , Fumar/efeitos adversos , Fumar/psicologia , Adolescente , Adulto , Humanos , Indonésia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Fumar/epidemiologia , Adulto Jovem
11.
Public Health Nurs ; 37(6): 854-862, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32981125

RESUMO

OBJECTIVE: The recent COVID-19 pandemic may catalyze smoking behavior modification. The purpose of the study was to examine factors associated with reducing smoking exposure during the COVID-19 outbreak. DESIGN: Cross-sectional design using the Health Belief Model to develop an online survey distributed throughout Ohio early during the outbreak. SAMPLE: 810 adults in Ohio (77.9% non-smokers, 22.1% current smokers). MEASUREMENTS: Sociodemographic factors, smoking and behavior changes since the COVID-19 outbreak, and perceived risk of infection were collected. Logistic regression analyses were conducted to determine factors associated with indoor smoking bans and factors associated with desire to quit smoking since the outbreak. RESULTS: For the overall sample, the odds of indoor smoking bans were significantly associated with never smoked, college education, single-family residence, not living with smokers, and perceived importance of avoiding public places. For smokers, the desire to quit smoking since the COVID-19 outbreak was associated with diabetes and perceived risk of severe infection. CONCLUSIONS: Identified factors inform residential smoking exposure reduction through indoor smoking bans. Having an increased perceived risk of severe infection among smokers may motivate cessation. Public health nurses can provide accurate and accessible resources for smoking cessation during the COVID-19 pandemic to promote healthy lifestyle modification.


Assuntos
/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Pandemias , Fumar/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ohio/epidemiologia , Enfermagem em Saúde Pública , Medição de Risco , Fumar/epidemiologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1058-1062, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741170

RESUMO

Objective: To understand the awareness of smoking hazards and intention of smoking concession in residents aged 18-65 years in Beijing, and provide scientific evidence for the development and improvement of tobacco control policies and measures. Methods: Data were collected from the 2017 Beijing Non-communicable and Chronic Disease surveillance. A multi-stage stratified cluster sampling method was used to take samples from 165 communities in 16 districts of Beijing. Logistic regression was used to analyze the influencing factors. Results: Among 11 594 participants, 49.93% had no intention of smoking concession. The percentage of refusing smoking concession was higher in men (50.39%) than in women (43.01%), the difference was significant ( χ(2)=14.211, P=0.002), and higher in suburban residents (56.78%) than in urban residents (45.30%), the difference was significant ( χ(2)=51.977, P<0.001). For the smoking cessation motivation, "illness" was the reason for more former smokers (29.88%) compared with current smokers (11.50%), the difference was significant ( χ(2)=85.865, P<0.001). The awareness rates of smoking hazards was higher in women (34.97%) than in men (32.63%), the difference was significant (Z=5.612, P<0.001), higher in suburban residents (35.44%) than in urban residents (33.03%), the difference was significant (Z=-3.734, P<0.001), and higher in never smokers (35.15%) than in smokers (30.06%), the difference was significant ( χ(2)=62.277, P=0.005). Multiple logistic regression analysis results showed people with general awareness (OR=0.61, 95%CI: 0.39-0.94) and poor awareness (OR=0.67, 95%CI: 0.50-0.90) of smoking hazards were less likely to quit smoking and people with general awareness (OR=0.64, 95%CI: 0.53-0.76) and poor awareness (OR=0.87, 95%CI: 0.78-0.98) of smoking hazards were more likely to smoke. Conclusions: Smokers aged 18-65 in Beijing had low willingness for smoking cessation. Health problem was main consideration for smoking cessation. Never-smokers had better awareness of smoking hazards than smokers, and the awareness of smoking hazards was an influencing factor of smoking status.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Intenção , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar/psicologia , Adolescente , Adulto , Idoso , Pequim/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fumantes/estatística & dados numéricos , Fumar/efeitos adversos , Fumar/epidemiologia , Adulto Jovem
13.
Cerebrovasc Dis Extra ; 10(2): 94-104, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32854098

RESUMO

BACKGROUND AND PURPOSE: Rates of depression after ischemic stroke (IS) and myocardial infarction (MI) are significantly higher than in the general population and associated with morbidity and mortality. There is a lack of nationally representative data comparing depression and suicide attempt (SA) after these distinct ischemic vascular events. METHODS: The 2013 Nationwide Readmissions Database contains >14 million US admissions for all payers and the uninsured. Using International Classification of Disease, 9th Revision, Clinical Modification Codes, we identified index admission with IS (n = 434,495) or MI (n = 539,550) and readmission for depression or SA. We calculated weighted frequencies of readmission. We performed adjusted Cox regression to calculate hazard ratio (HR) for readmission for depression and SA up to 1 year following IS versus MI. Analyses were stratified by discharge home versus elsewhere. RESULTS: Weighted depression readmission rates were higher at 30, 60, and 90 days in patients with IS versus MI (0.04%, 0.09%, 0.12% vs. 0.03%, 0.05%, 0.07%, respectively). There was no significant difference in SA readmissions between groups. The adjusted HR for readmission due to depression was 1.49 for IS versus MI (95% CI 1.25-1.79, p < 0.0001). History of depression (HR 3.70 [3.07-4.46]), alcoholism (2.04 [1.34-3.09]), and smoking (1.38 [1.15-1.64]) were associated with increased risk of depression readmission. Age >70 years (0.46 [0.37-0.56]) and discharge home (0.69 [0.57-0.83]) were associated with reduced hazards of readmission due to depression. CONCLUSIONS: IS was associated with greater hazard of readmission due to depression compared to MI. Patients with a history of depression, smoking, and alcoholism were more likely to be readmitted with depression, while advanced age and discharge home were protective. It is unclear to what extent differences in type of ischemic tissue damage and disability contribute, and further investigation is warranted.


Assuntos
Afeto , Isquemia Encefálica/psicologia , Depressão/psicologia , Infarto do Miocárdio/psicologia , Readmissão do Paciente , Acidente Vascular Cerebral/psicologia , Tentativa de Suicídio , Fatores Etários , Idoso , Alcoolismo/epidemiologia , Alcoolismo/psicologia , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/epidemiologia , Bases de Dados Factuais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/terapia , Feminino , Humanos , Masculino , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/epidemiologia , Alta do Paciente , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Fumar/psicologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Fatores de Tempo , Estados Unidos/epidemiologia
14.
BMC Cardiovasc Disord ; 20(1): 384, 2020 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-32838741

RESUMO

BACKGROUND: Smoking cessation is one of the most effective secondary prevention measures after acute myocardial infarction (AMI). However, around 50% of smokers do not quit smoking after AMI. The aim of the present study is to estimate the proportion of patients quitting smoking and to identify determinants of persistent smoking after AMI in a region with increased cardiovascular mortality. We also assessed the time of smoking cessation after AMI. METHODS: We used follow-up data of patients registered with the Regional Myocardial Infarction Registry in Saxony-Anhalt (RHESA) in Germany. We assessed smoking status and determinants of persistent smoking six weeks after discharge from hospital after AMI. Information on smoking, sociodemographic characteristics, risk factors for AMI, experienced symptoms of AMI, and clinical care were gathered in a computer-assisted telephone interview and questionnaires filled out by study subjects and physicians or study nurses. RESULTS: Out of 372 smokers at the time of AMI, 191 (51.3%) reported that they quit smoking within six weeks after discharge from hospital after AMI. Strongest determinant of persistent smoking was a previous AMI before the current one (OR = 2.19, 95%CI 1.10-4.38) and strongest determinants of smoking cessation were experiencing complications in the hospital (0.37, 95%CI 0.12-1.12) and having a life partner (0.56, 95%CI 0.34-0.95). Most individuals who stopped smoking did so during the initial stay in the hospital, before the cardiac rehabilitation (CR). CONCLUSIONS: Persistent smoking after AMI and its determinants were similar in our region to previous studies. CR cannot be viewed as determinant of smoking cessation - more likely the same teachable moment induces behavioural change with regard to smoking and participation in CR.


Assuntos
Reabilitação Cardíaca/psicologia , Ex-Fumantes/psicologia , Infarto do Miocárdio/reabilitação , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar/psicologia , Idoso , Feminino , Alemanha , Conhecimentos, Atitudes e Prática em Saúde , Comportamentos de Risco à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/psicologia , Educação de Pacientes como Assunto , Recidiva , Sistema de Registros , Comportamento de Redução do Risco , Fumar/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
15.
JAMA Netw Open ; 3(7): e209504, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32633765

RESUMO

Importance: In 2006, a US district court judge ordered tobacco companies to sponsor nationwide antismoking advertising campaigns. This landmark ruling and its subsequent execution represent an unprecedented tobacco control event; however, the association of this campaign with intentions and/or attempts to quit smoking is unknown. Objectives: To assess the reach of the expanded court-ordered tobacco industry antismoking advertisements (via television, newspapers, tobacco company websites, and/or cigarette packages), to examine associations between exposure to industry antismoking advertisements and intentions and/or attempts to quit smoking among cigarette smokers, and to calculate the numbers of US smokers who would have quit intentions associated with exposure to multiple advertisements. Design, Setting, and Participants: Data for this study were obtained from 5309 US adults, including 610 smokers, who responded to the Health Information National Trends Survey, a nationally representative cross-sectional survey conducted from January 22 to April 30, 2019. Respondents were representatives of households selected by equal-probability sampling of a database of US residential addresses. Exposure: Reported exposure to antismoking messages. Main Outcomes and Measures: Cigarette smoking cessation attempt in the past 12 months and intentions to quit cigarette smoking in the next 6 months. Covariates were age, sex, household annual income, race/ethnicity, educational level, and geographical residence. Data were weighted to be nationally representative after applying survey weights specified for the survey cycle. Results: The overall sample of 5309 respondents were a mean (SD) age of 55.6 (19.1) years and included 3073 women (51.2%), 3037 non-Hispanic white respondents (59.1%), 4645 respondents who lived in urban US areas (84.7%), and 610 current smokers (12.5%). Findings indicate that 2464 US adults (45.8%; 95% CI, 43.2%-48.5%) and 410 current smokers (66.8%; 95% CI, 61.1%-72.4%) were exposed to antismoking advertisements. Exposure to multiple antismoking messages was associated with 2.19 (95% CI, 1.10-4.34) greater odds of having intentions to quit cigarette smoking but was not associated with attempts to quit (adjusted odds ratio, 1.31; 95% CI, 0.69-2.52). Furthermore, an examination of the association of cumulative exposure to antismoking messages with cessation intentions revealed that, with each additional exposure to an antismoking message, the odds of smoking cessation intentions increased by 1.21 (95% CI, 1.02-1.44). If all smokers were to be exposed to multiple antitobacco messages, there could be an estimated 3.98 million (95% CI, 492 480-7 223 040) current smokers in the United States with intentions to quit. Conclusions and Relevance: Although the reach of court-ordered industry advertisements increased among smokers, the reach of these advertisements within the general population remains suboptimal. The finding that industry advertisements helped smokers consider quitting highlights their potential to aid smoking cessation. However, the lack of association with actual attempts to quit suggests that the industry antismoking advertisement campaigns were inadequate. The design and content of industry antismoking advertisement campaigns should be enhanced to help smokers quit.


Assuntos
Promoção da Saúde/métodos , Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar/métodos , Fumar , Adulto , Feminino , Humanos , Intenção , Masculino , Determinação de Necessidades de Cuidados de Saúde , Avaliação de Programas e Projetos de Saúde , Fumar/epidemiologia , Fumar/psicologia , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Indústria do Tabaco/métodos , Estados Unidos/epidemiologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-32635510

RESUMO

E-cigarettes may have a role in supporting pregnant women who would otherwise smoke to stop smoking. The study aimed to understand pregnant women's vaping experiences, in particular how vaping to stop smoking is facilitated and how barriers to this are overcome. We conducted semi structured telephone interviews (n = 15) with pregnant or postpartum women who vaped during pregnancy, either exclusively (n = 10) or dual-used (n = 5) (smoked and vaped). Thematic analysis was used to analyse the interviews. Two themes emerged. First, 'facilitating beliefs': inherent beliefs that helped women overcome barriers to vaping. These included understanding the relative safety of vaping and economic gains compared with smoking and pregnancy being a motivator to stop smoking. Second, 'becoming a confident vaper': accumulating sufficient skill and confidence to comfortably vape. This included experimentation with e-cigarettes to ensure nicotine dependence and sensory needs were met. Seeking social support and employing strategies to address social stigma were also important. Positive beliefs about vaping and becoming proficient at vaping were viewed as ways to overcome barriers to vaping. The theoretical domain framework informed intervention recommendations to assist pregnant smokers who have tried but cannot stop smoking to switch to vaping.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Gestantes/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar/efeitos adversos , Vaping/efeitos adversos , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Gravidez , Pesquisa Qualitativa , Fumantes , Fumar/psicologia , Telefone
17.
J Adolesc Health ; 67(3): 362-368, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32674964

RESUMO

PURPOSE: COVID-19 morbidity and mortality reports in the U.S. have not included findings specific to young adults. The Centers for Disease Control and Prevention provides a list of conditions and associated behaviors, including smoking, conferring vulnerability to severe COVID-19 illness regardless of age. This study examines young adults' medical vulnerability to severe COVID-19 illness, focusing on smoking-related behavior. METHODS: A young adult subsample (aged 18-25 years) was developed from the National Health Interview Survey, a nationally representative data set, pooling years 2016-2018. The medical vulnerability measure (yes vs. no) was developed, guided by the Centers for Disease Control and Prevention medical indicators. The estimates of medical vulnerability were developed for the full sample, the nonsmoking sample, and the individual risk indicators. Logistic regressions were conducted to examine differences by sex, race/ethnicity, income, and insurance. RESULTS: Medical vulnerability was 32% for the full sample and half that (16%) for the nonsmoking sample. Patterns and significance of some subgroup differences differed between the full and the nonsmoking sample. Male vulnerability was (33%) higher than female (30%; 95% CI: .7-.9) in the full sample, but lower in nonsmokers: male (14%) versus female (19%; 95% CI: 1.2-1.7). The white subgroup had higher vulnerability than Hispanic and Asian subgroups in both samples-full sample: white (31%) versus Hispanic (24%; 95% CI: .6-.9) and Asian (18%; 95% CI: .4-.5); nonsmokers: white (17%) versus Hispanic (13%; 95% CI: .06-.9) and Asian (10%; 95% CI: .3-.8). CONCLUSIONS: Notably, lower young adult medical vulnerability within nonsmokers versus the full sample underscores the importance of smoking prevention and mitigation.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Fumar/epidemiologia , Fumar/psicologia , Populações Vulneráveis , Adolescente , Adulto , Infecções por Coronavirus/etnologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pandemias , Pneumonia Viral/etnologia , Índice de Gravidade de Doença , Fumar/etnologia , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
18.
PLoS One ; 15(6): e0235496, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32598379

RESUMO

INTRODUCTION: Over 120 US jurisdictions have implemented policies mandating minimum cigar pack quantities, yet little empirical research exists on the relationship between pack quantity and use. We examined whether cigar use was associated with purchasing cigars by the box/pack or as singles, purchase quantity, and price paid per cigar. METHODS: Data are from Waves 1-3 (2013-2016) of the Population Assessment of Tobacco and Health (PATH) Study, analyzed in 2019. The sample included adults who reported current use of any type of cigars (cigarillos [N = 3,051], traditional cigars [N = 2,586], and filtered cigars [N = 1,295], including with marijuana) at Wave 1. For each cigar type, a generalized estimating equation model was used to examine the population-averaged effects of purchasing behavior on cigar use. RESULTS: Cigar users of each type who purchased by the box or pack smoked more per day than users who purchased singles (cigarillos: ß = 1.02, p<0.0001; traditional cigars: ß = 1.40, p<0.0001; filtered cigars: ß = 2.55, p<0.01). Cigar users who purchased larger quantities smoked more per day (cigarillos: ß = 0.16, p<0.0001; traditional cigars: ß = 0.04, p<0.0001; filtered cigars: ß = 0.24, p<0.0001). Higher price per cigar was significantly associated with smoking fewer traditional cigars (ß = -0.12, p<0.01) and filtered cigars (ß = -0.86, p = 0.02), but not cigarillos (ß = 0.08, p = 0.62). CONCLUSIONS: Smaller pack quantities and higher price per cigar were associated with smoking fewer cigars per day. Given the authority of the Food and Drug Administration and local jurisdictions over cigar pack quantity, this study provides data pertinent to potential minimum and maximum package quantity regulations and policies.


Assuntos
Comportamento do Consumidor/economia , Vigilância da População , Fumar/epidemiologia , Fumar/psicologia , Produtos do Tabaco/economia , Adolescente , Adulto , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fumar/economia , Produtos do Tabaco/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem
19.
Chest ; 158(4): 1770-1776, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32561438

RESUMO

Smoking is associated with one of five deaths in the United States. Multimodality tobacco treatment increases rates of successful cessation by at least 20%. The coronavirus disease 2019 pandemic has put a halt to many inpatient and outpatient medical visits that have been deemed nonessential, including tobacco treatment. The transition to telehealth has been wrought with challenges. Although data on the association between coronavirus disease 2019 and tobacco products are mixed, the overall health consequences of tobacco point towards increased risk of morbidity and death that is associated with the virus. This leaves smoking as one of the few readily modifiable risk factors in an environment understandably not set up to prioritize cessation. A military health facility on Fort Eustis in Virginia runs a successful tobacco treatment program and adapted it to pandemic times. This article describes the process and lessons learned from this initiative. The model is applicable and scalable to government and civilian health centers as health care adapts to a new normal.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar/organização & administração , Fumar/psicologia , Tabagismo/prevenção & controle , Humanos , Pandemias
20.
Rev Lat Am Enfermagem ; 28: e3296, 2020.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-32578752

RESUMO

OBJECTIVE: to assess risk related to drug use in men admitted to a psychiatric hospital and to identify associations with sociodemographic, socioeconomic variables, and risk conditions. METHOD: a cross-sectional study with the application of a screening test in 209 participants hospitalized for mental and behavioral disorders due to the use of psychoactive substances. Statistical analysis was performed using descriptive statistics and adjustment of a binary logistic regression model for moderate or high risk of drug use. The odds ratio measured the strength of association. RESULTS: high use in life was observed, with alcohol and tobacco experimentation in adolescence. A high prevalence of related risk was observed for alcohol, tobacco, smoked and inhaled cocaine, and marijuana. Moderate and elevated risks were found for tobacco (22.5% and 62.5%, respectively), alcohol (13.5% and 73%), marijuana (16% and 32.5%), smoked cocaine (3% and 41%) and inhaled cocaine (9% and 19.5%). CONCLUSION: the results showed high use in life, with an age of early experimentation. Tobacco and alcohol are the main drugs used by hospitalized men.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Hospitais Psiquiátricos/estatística & dados numéricos , Fumar/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fumar/epidemiologia , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
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