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1.
Afr J Prim Health Care Fam Med ; 13(1): e1-e3, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33764140

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world, with devastating effects of the virus as well as the repercussions of the resulting 'lockdowns'. South Africa went into a national lockdown in March 2020 to mitigate the impact of the virus. This included a ban on the sales of tobacco and electronic cigarette products. The ban has been a highly contentious issue in South Africa, discussed worldwide, which has drawn many criticisms. The prevalence rate of smoking in South Africa was around 21.5%, with the Western Cape province having a prevalence rate of 39%. We compared the number of chronic obstructive pulmonary disease (COPD) presentations at a large regional referral hospital in the Western Cape province from January to August 2019 with the same period in 2020. Electronic emergency centre data showed a reduction of 69.28% in COPD presentations. To control for some confounders for the same period, we also reviewed patients presenting with urinary tract infections, which showed only a 30.60% reduction. This notable reduction in COPD presentations reduced service pressure of emergency centre and most likely benefitted patients' health. Further research and policies are needed to ensure ongoing reduction in the prevalence of smoking.


Assuntos
Fumar Cigarros/efeitos adversos , Serviço Hospitalar de Emergência , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/terapia , Produtos do Tabaco/legislação & jurisprudência , /epidemiologia , /virologia , Fumar Cigarros/epidemiologia , Fumar Cigarros/legislação & jurisprudência , Fumar Cigarros/prevenção & controle , Comércio/legislação & jurisprudência , Controle de Doenças Transmissíveis/métodos , Humanos , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/epidemiologia , África do Sul/epidemiologia , Exacerbação dos Sintomas , Produtos do Tabaco/efeitos adversos , Produtos do Tabaco/economia
2.
Toxicol Lett ; 338: 97-104, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33309995

RESUMO

Cigarette smoking is a risk factor for developing chronic obstructive pulmonary disease and protein aggresome formation is considered to be a hallmark event for the disease. Since dysfunction of lysosome-mediated protein degradation leads to enhanced accumulation of misfolded proteins and subsequent aggresome formation, we examined the effect of cigarette smoke extract (CSE) on ESCRT-mediated sorting in S. cerevisiae as this process is necessary for the functioning of the vacuole, the lysosomal equivalent in yeast. An operational ESCRT pathway is essential for ion homeostasis and our observation that exposure to CSE caused increased sensitivity to LiCl indicated CSE-induced impairment of ESCRT function. To confirm the inhibition of ESCRT function, the targeting of carboxypeptidase S (CPS), which reaches the vacuole lumen via the ESCRT pathway, was examined. Treatment with CSE resulted in the mislocalization of GFP-tagged CPS to the vacuolar membrane, instead of the vacuolar lumen, confirming defective functioning of the ESCRT machinery in CSE-treated cells. Further analysis revealed that CSE-treatment inhibited the recruitment of the ESCRT-0 component, Vps27, to the endosome surface, which is a key event is for the functioning of the ESCRT pathway. This lack of endosomal recruitment of Vps27 most likely results from a depletion of the endosomally-enriched lipid, phosphatidylinositol 3-phosphate (PI3-P), which is the target of Vps27. This is supported by our observation that the presence of excess leucine, a known activator of the lipid kinase responsible for the generation of PI3-P, Vps34, in the medium can rescue the CSE-induced ESCRT misfunctioning. Thus, the current study provides an insight into CSE-induced aggresome formation as it documents that CSE treatment compromises vacuolar degradation due to an impairment of the ESCRT pathway, which likely stems from the inhibition of Vps34. It also indicates that leucine has the potential to attenuate the CSE-induced accumulation of misfolded proteins.


Assuntos
Complexos Endossomais de Distribuição Requeridos para Transporte/metabolismo , Dobramento de Proteína/efeitos dos fármacos , Saccharomyces cerevisiae/efeitos dos fármacos , Fumaça/efeitos adversos , Produtos do Tabaco/efeitos adversos , Vacúolos/efeitos dos fármacos , Carboxipeptidases/genética , Carboxipeptidases/metabolismo , Classe III de Fosfatidilinositol 3-Quinases/genética , Classe III de Fosfatidilinositol 3-Quinases/metabolismo , Complexos Endossomais de Distribuição Requeridos para Transporte/genética , Leucina/farmacologia , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/metabolismo , Proteínas de Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/metabolismo , Vacúolos/genética , Vacúolos/metabolismo
3.
Nicotine Tob Res ; 22(Suppl 1): S76-S84, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33320256

RESUMO

INTRODUCTION: This study assessed the association of exclusive and concurrent use of cigarettes, electronic nicotine delivery systems (ENDS), and cigars with ever and past 12-month wheezing symptoms among a nationally representative sample of US adult current tobacco users. METHODS: Cross-sectional data from the Population Assessment of Tobacco and Health (PATH) Study Wave 3 (W3) were used. The weighted prevalence of self-reported ever and past 12-month wheezing symptoms for noncurrent users compared with users of cigarettes, ENDS, cigars, and any combination of these products (polytobacco use of these tobacco products) were presented for 28 082 adults. The cross-sectional association of tobacco use with self-reported wheezing symptoms was assessed using weighted multivariable and ordinal logistic regression with consideration of complex sampling design. RESULTS: Significantly higher odds of ever had wheezing or whistling in the chest at any time in the past were observed among current cigarette (adjusted odds ratio: 2.62, 95% confidence intervals [CI]: 2.35, 2.91), ENDS (1.49, 95% CI: 1.14, 1.95), and polytobacco users (2.67, 95% CI: 2.26, 3.16) compared with noncurrent users. No associations were seen for cigar use. Polytobacco use was associated with a higher odds of ever wheezing when compared with exclusive ENDS (1.61, 95% CI: 1.19, 2.17) and exclusive cigar use (2.87, 95% CI: 1.93, 4.26), but not exclusive use of cigarettes. CONCLUSIONS: Ever wheezing is associated with the use of cigarettes, ENDS, and polytobacco use of cigarettes, ENDS, and/or cigars, but not cigar use. The association of polytobacco use and wheezing appears to be driven by cigarette use. IMPLICATIONS: Cross-sectional associations with ever and past 12-month wheezing symptoms were found to be the strongest among cigarette users, exclusively or in combination. Future longitudinal research is needed to better understand how cigarette use interacts with other tobacco and nicotine products and contributes to respiratory symptoms.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Sons Respiratórios/fisiopatologia , Produtos do Tabaco/efeitos adversos , Tabagismo/epidemiologia , Uso de Tabaco/efeitos adversos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Prevalência , Sons Respiratórios/efeitos dos fármacos , Tabagismo/etiologia , Estados Unidos/epidemiologia , Adulto Jovem
4.
Nicotine Tob Res ; 22(12 Suppl 2): S93-S95, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33320258

RESUMO

IMPLICATIONS: This commentary addresses the state of the evidence on tobacco products, nicotine, and COVID-19. The evidence of the effects of smoking on respiratory infections and the immune system in general are examined and the current understanding of tobacco products and risk for SARS-CoV-2 infection and the course of COVID-19 is addressed.


Assuntos
/complicações , Produtos do Tabaco/efeitos adversos , Fumar Tabaco/efeitos adversos , Fumar Tabaco/epidemiologia , Humanos
7.
Artigo em Inglês | MEDLINE | ID: mdl-32756449

RESUMO

Heated tobacco products (HTPs) have been widely used in Korea since their introduction in 2017. In this study, we investigated the perceptions of their relative harmfulness and smoking cessation effects. We performed an online survey in 7000 Koreans in 2018 (2300 males and 4700 females aged 20-69 years) by matching their age, sex, and provincial distribution. To investigate the factors causing HTPs to be perceived as less harmful than combustible cigarettes (CCs) and helpful for smoking cessation, we used multivariable logistic regression analyses. HTPs were less harmful than CCs in 16.8% of participants, particularly among HTP-only users and dual and triple users of HTPs, electronic cigarettes (ECs), or CCs than among CC-only users, those who were aged ≤ 34 years, males, and those with higher incomes. HTPs were reportedly helpful for smoking cessation in 11.2% of participants. Similar perceptions were more likely among HTP-only users, as well as dual and triple users than among CC-only users and adults with higher education/incomes. Although Korean adults generally had negative perceptions of the harmfulness and smoking cessation effects of HTPs compared with CCs, dual and triple users were more likely to have positive perceptions. Monitoring the use of multiple tobacco products and HTPs is a new challenge for Korean policymakers.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Conhecimentos, Atitudes e Prática em Saúde , Abandono do Hábito de Fumar , Produtos do Tabaco , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Tabaco , Produtos do Tabaco/efeitos adversos , Adulto Jovem
11.
Eur Heart J ; 41(41): 4057-4070, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-32585699

RESUMO

Tobacco smoking is a leading cause of non-communicable disease globally and is a major risk factor for cardiovascular disease (CVD) and lung disease. Importantly, recent data by the World Health Organizations (WHO) indicate that in the last two decades global tobacco use has significantly dropped, which was largely driven by decreased numbers of female smokers. Despite such advances, the use of e-cigarettes and waterpipes (shisha, hookah, narghile) is an emerging trend, especially among younger generations. There is growing body of evidence that e-cigarettes are not a harm-free alternative to tobacco cigarettes and there is considerable debate as to whether e-cigarettes are saving smokers or generating new addicts. Here, we provide an updated overview of the impact of tobacco/waterpipe (shisha) smoking and e-cigarette vaping on endothelial function, a biomarker for early, subclinical, atherosclerosis from human and animal studies. Also their emerging adverse effects on the proteome, transcriptome, epigenome, microbiome, and the circadian clock are summarized. We briefly discuss heat-not-burn tobacco products and their cardiovascular health effects. We discuss the impact of the toxic constituents of these products on endothelial function and subsequent CVD and we also provide an update on current recommendations, regulation and advertising with focus on the USA and Europe. As outlined by the WHO, tobacco cigarette, waterpipe, and e-cigarette smoking/vaping may contribute to an increased burden of symptoms due to coronavirus disease 2019 (COVID-19) and to severe health consequences.


Assuntos
Doenças Cardiovasculares/etiologia , Sistemas Eletrônicos de Liberação de Nicotina , Endotélio Vascular/fisiopatologia , Produtos do Tabaco/efeitos adversos , Fumar Cachimbo de Água/efeitos adversos , Humanos
12.
Health Psychol ; 39(8): 721-730, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32496078

RESUMO

OBJECTIVE: Greater numeracy is associated with higher likelihood to quit smoking. We examined whether numeracy supports learning of numeric health-risk information and, in turn, greater risk perceptions and quit intentions. METHOD: Adult smokers (N = 696) viewed text warnings with numeric risk information four times each in one of three warning-label types (text-only, low-emotion pictorial [i.e., with image], high-emotion pictorial). They completed posttest measures immediately or 6 weeks later. Emotional reactions to warnings were reported the second time participants viewed the warnings. Numeracy, memory for risk probabilities and risk outcomes, risk perceptions, and quit intentions were assessed postexposures. RESULTS: Memory for risk probabilities and risk outcomes depended on warning-label type and posttest timing. Consistent with memory-consolidation theory, memory for high- versus low-emotion labels was lower immediately, but declined less for high-than low-emotion labels. Label memory was similar between conditions at 6 weeks. Numeracy predicted overall superior memory (especially for risk probabilities) controlling for health literacy and education. It also indirectly predicted greater risk perceptions and quit intentions via memory. In exploratory analyses, however, the superior recall of risk probabilities of smoking among those higher in numeracy was associated with lower risk perceptions. CONCLUSIONS: Numeracy is associated with superior risk memory, which relates to greater risk perceptions and quit intentions. More numerate and educated smokers may be better able to quit due to their superior learning of smoking's risks. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Rotulagem de Produtos/métodos , Prevenção do Hábito de Fumar/métodos , Fumar/psicologia , Produtos do Tabaco/efeitos adversos , Adulto , Feminino , Humanos , Masculino , Fatores de Risco
13.
Toxicol Appl Pharmacol ; 398: 115026, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32353386

RESUMO

The presence of flavors is one of the commonly cited reasons for use of e-cigarettes by youth; however, the potential harms from inhaling these chemicals and byproducts have not been extensively studied. One mechanism of interest is DNA adduct formation, which may lead to carcinogenesis. We identified two chemical classes of flavors found in tobacco products and byproducts, alkenylbenzenes and aldehydes, documented to form DNA adducts. Using in silico toxicology approaches, we identified structural analogs to these chemicals without DNA adduct information. We conducted a structural similarity analysis and also generated in silico model predictions of these chemicals for genotoxicity, mutagenicity, carcinogenicity, and skin sensitization. The empirical and in silico data were compared, and we identified strengths and limitations of these models. Good concordance (80-100%) was observed between DNA adduct formation and models predicting mammalian mutagenicity (mouse lymphoma sassy L5178Y) and skin sensitization for both chemical classes. On the other hand, different prediction profiles were observed for the two chemical classes for the modeled endpoints, unscheduled DNA synthesis and bacterial mutagenicity. These results are likely due to the different mode of action between the two chemical classes, as aldehydes are direct acting agents, while alkenylbenzenes require bioactivation to form electrophilic intermediates, which form DNA adducts. The results of this study suggest that an in silico prediction for the mouse lymphoma assay L5178Y, may serve as a surrogate endpoint to help predict DNA adduct formation for chemicals found in tobacco products such as flavors and byproducts.


Assuntos
Adutos de DNA/efeitos dos fármacos , Aromatizantes/farmacologia , Produtos do Tabaco/efeitos adversos , Tabaco/efeitos adversos , Animais , Simulação por Computador , Sistemas Eletrônicos de Liberação de Nicotina , Camundongos , Mutagênese/efeitos dos fármacos , Mutagênicos/efeitos adversos
14.
Mo Med ; 117(2): 159-164, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32308243

RESUMO

As our nation turns away from smoking tobacco and toward legalization of marijuana, vaporization of both plants has increased in popularity. There are medical and cultural implications of this new trend which are just recently being reported and investigated. The purpose of this article is to review the scientific and sociological literature as it pertains to the vaporization of both marijuana and tobacco products and the potential medical and cultural implications of this new phenomenon.


Assuntos
Cannabis/efeitos adversos , Produtos do Tabaco/efeitos adversos , Vaping/efeitos adversos , Cultura , Humanos , Terminologia como Assunto
15.
Iran J Allergy Asthma Immunol ; 19(1): 45-55, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32245320

RESUMO

Cigarette smoking and opium use are risk factors for coronary artery disease (CAD). It has been known that scavenger receptors such as CD36 and CD68 play critical roles in the pathogenesis of CAD. CD9, as a member of the tetraspanin, has been shown to interact with scavenger receptors. The aim of this study was to investigate the effects of these risk factors on expression levels of CD9, CD36, and CD68 on the THP-1 cell line. The THP-1 cell line treated with cigarette smoke extract (CSE( and opium, both individually and combinatory, in 24 h incubation. The protein and mRNA levels of CD9, CD36, and CD68 were evaluated by flow cytometry and quantitative reverse transcription-Polymerase Chain Reaction (qRT-PCR) techniques, respectively. CD36 and CD68 mRNA and protein expression levels were significantly increased in the cells treated with cigarette smoke extract compared to the control (p<0.001 in mRNA expression levels and p=0.016 and p=0.012 in protein expression levels, respectively). The CSE increased the level of CD9 protein expression compared to the control group (p=0.041) on the human macrophage cell line THP-1. No significant differences were observed in the CD9, CD36, and CD68 gene expression and at the protein levels between opium-treated THP-1 cells and controls. In conclusion, cigarettes by increasing the levels of CD36, CD68, and CD9 can be a risk factor in the development of many inflammatory diseases, including cardiovascular diseases, chronic obstructive pulmonary disease (COPD) and lung carcinoma.


Assuntos
Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Ópio/toxicidade , Extratos Vegetais/toxicidade , Fumaça/efeitos adversos , Tabaco/toxicidade , Antígenos CD/biossíntese , Antígenos CD/efeitos dos fármacos , Antígenos de Diferenciação Mielomonocítica/biossíntese , Antígenos de Diferenciação Mielomonocítica/efeitos dos fármacos , Antígenos CD36/biossíntese , Antígenos CD36/efeitos dos fármacos , Humanos , Fumar/efeitos adversos , Células THP-1 , Tetraspanina 29/biossíntese , Tetraspanina 29/efeitos dos fármacos , Produtos do Tabaco/efeitos adversos
16.
PLoS One ; 15(4): e0230932, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32251484

RESUMO

RATIONALE: Chronic smoke exposure is associated with weight loss in patients with Chronic Obstructive Pulmonary Disease (COPD). However, the biological contribution of chronic smoking and sex on the cecal microbiome has not been previously investigated. METHODS: Adult male, female and ovariectomized mice were exposed to air (control group) or smoke for six months using a standard nose-only smoke exposure system. DNA was extracted from the cecal content using the QIAGEN QIAamp® DNA Mini Kit. Droplet digital PCR was used to generate total 16S bacterial counts, followed by Illumina MiSeq® analysis to determine microbial community composition. The sequencing data were resolved into Amplicon Sequence Variants and analyzed with the use of QIIME2®. Alpha diversity measures (Richness, Shannon Index, Evenness and Faith's Phylogenetic Diversity) and beta diversity (based on Bray-Curtis distances) were assessed and compared according to smoke exposure and sex. RESULTS: The microbial community was different between male and female mice, while ovariectomy made the cecal microbiome similar to that of male mice. Chronic smoke exposure led to significant changes in the cecal microbial community in both male and female mice. The organism, Alistipes, was the most consistent bacteria identified at the genus level in the cecal content that was reduced with chronic cigarette exposure and its expression was positively related to the whole-body weight of these mice. CONCLUSION: Chronic smoke exposure is associated with changes in the cecal content microbiome; these changes may play a role in the weight changes that are observed in cigarette smokers.


Assuntos
Ceco/microbiologia , Microbioma Gastrointestinal/efeitos dos fármacos , Fumaça/efeitos adversos , Fumar/efeitos adversos , Produtos do Tabaco/efeitos adversos , Tabaco/efeitos adversos , Animais , Bactérias/efeitos dos fármacos , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Filogenia , Doença Pulmonar Obstrutiva Crônica/microbiologia
18.
Anticancer Res ; 40(3): 1277-1284, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32132024

RESUMO

BACKGROUND/AIM: We evaluated the influence of smoking on head and neck squamous cell carcinomas (HNSCC), which are in their majority tobacco-driven. Tobacco smoke is expected to influence the expression of ABCG2-transporters involved in multidrug resistance. The aim of the study was to evaluate the effect of cigarette smoke condensate (CSC) on ABCG2 expression on HNSCC cells, to demonstrate the adverse effects of cigarette smoke during anticancer treatment in vitro and to assess the prevalence of ABCG2 expression in HNSCC. MATERIALS AND METHODS: HNSCC cell lines were treated with CSC and basal and induced ABCG2 expression was examined. The impact of CSC on cellular viability/proliferation during cytotoxic drug treatment was also evaluated. ABCG2 expression levels in HNSCC were correlated with the smoking history of patients. RESULTS: HNSCC cells showed low basal ABCG2 expression. CSC treatment resulted in a threefold increase in the expression of ABCG2 and in resistance to cisplatin. Tumor samples of never smokers showed significantly higher ABCG2 expression compared to ever smokers. ABCG2 expression correlated with pack years of cigarette consumption. CONCLUSION: Tobacco consumption is linked to an inducible and increased ABCG2 protein expression and has an impact on drug resistance.


Assuntos
Cisplatino/química , Cisplatino/uso terapêutico , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Produtos do Tabaco/efeitos adversos , Cisplatino/farmacologia , Neoplasias de Cabeça e Pescoço/patologia , Humanos
19.
Sci Rep ; 10(1): 3829, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-32123204

RESUMO

Exposure to cigarette smoke (CS) causes detrimental health effects, increasing the risk of cardiovascular, pulmonary diseases and carcinogenesis in exposed individuals. The impact of CS on Inflammatory Bowel Disease (IBD) has been established by a number of epidemiological and clinical studies. In fact, CS is associated with a higher risk of developing Crohn's disease (CD) while inversely correlates with the development, disease risks, and relapse rate of ulcerative colitis (UC). To investigate the effect of CS exposure on experimental colitis, we performed a comprehensive and integrated comparative analysis of colon transcriptome and microbiome in mice exposed to dextran sodium sulfate (DSS) and CS. Colon transcriptome analysis revealed that CS downregulated specific pathways in a concentration-dependent manner, affecting both the inflammatory state and composition of the gut microbiome. Metagenomics analysis demonstrated that CS can modulate DSS-induced dysbiosis of specific bacterial genera, contributing to resolve the inflammation or accelerate recovery. The risks of smoking far outweigh any possible benefit, thus smoking cessation must always be encouraged because of its significant health benefits. However, the inverse association between active smoking and the development of UC cannot be ignored and the present study lays the foundation for investigating potential molecular mechanisms responsible for the attenuation of colitis by certain compounds of tobacco when decoupled from combustion.


Assuntos
Colite/imunologia , Colite/microbiologia , Sulfato de Dextrana/farmacologia , Fumaça/efeitos adversos , Produtos do Tabaco/efeitos adversos , Animais , Colite/induzido quimicamente , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Microbiota/efeitos dos fármacos
20.
PLoS One ; 15(3): e0230364, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32187225

RESUMO

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


Assuntos
Comércio/economia , Prevenção do Hábito de Fumar/economia , Impostos/legislação & jurisprudência , Produtos do Tabaco/economia , Fumar Tabaco/prevenção & controle , Adolescente , Adulto , Criança , Comércio/história , Comércio/legislação & jurisprudência , Comércio/estatística & dados numéricos , Simulação por Computador , Feminino , Política Fiscal/história , Gastos em Saúde/história , Gastos em Saúde/estatística & dados numéricos , História do Século XX , História do Século XXI , Humanos , Masculino , Minnesota/epidemiologia , Modelos Biológicos , Modelos Econômicos , Mortalidade/história , Prevalência , Prevenção do Hábito de Fumar/história , Prevenção do Hábito de Fumar/métodos , Impostos/história , Produtos do Tabaco/efeitos adversos , Produtos do Tabaco/história , Produtos do Tabaco/legislação & jurisprudência , Fumar Tabaco/efeitos adversos , Fumar Tabaco/economia , Fumar Tabaco/epidemiologia , Adulto Jovem
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