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1.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32989082

RESUMO

OBJECTIVES: We tested a Public Health Service 5As-based clinician-delivered smoking cessation counseling intervention with adolescent smokers in pediatric primary care practice. METHODS: We enrolled clinicians from 120 practices and recruited youth (age ≥14) from the American Academy of Pediatrics Pediatric Research in Office Settings practice-based research network. Practices were randomly assigned to training in smoking cessation (intervention) or social media counseling (attentional control). Youth recruited during clinical visits completed confidential screening forms. All self-reported smokers and a random sample of nonsmokers were offered enrollment and interviewed by phone at 4 to 6 weeks, 6 months, and 12 months after visits. Measures included adolescents' report of clinicians' delivery of screening and counseling, current tobacco use, and cessation behaviors and intentions. Analysis assessed receipt of screening and counseling, predictors of receiving 5As counseling, and effects of interventions on smoking behaviors and cessation at 6 and 12 months. RESULTS: Clinicians trained in the 5As intervention delivered more screening (ß = 1.0605, P < .0001) and counseling (ß = 0.4354, P < .0001). In both arms, clinicians more often screened smokers than nonsmokers. At 6 months, study arm was not significantly associated with successful cessation; however, smokers in the 5As group were more likely to have quit at 12 months. Addicted smokers more often were counseled, regardless of study arm, but were less likely to successfully quit smoking. CONCLUSIONS: Adolescent smokers whose clinicians were trained in 5As were more likely to receive smoking screening and counseling than controls, but the ability of this intervention to help adolescents quit smoking was limited.


Assuntos
Aconselhamento/educação , Motivação , Abandono do Hábito de Fumar/psicologia , Adolescente , Feminino , Humanos , Masculino , não Fumantes/estatística & dados numéricos , Profissionais de Enfermagem/educação , Pediatras/educação , Assistentes Médicos/educação , Fumantes/estatística & dados numéricos , Fumar
2.
PLoS One ; 15(8): e0236559, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817636

RESUMO

Chronic obstructive pulmonary disease (COPD) poses a significant but heterogeneous burden to individuals and healthcare systems. Policymakers develop targeted policies to minimize this burden but need personalized tools to evaluate novel interventions and target them to subpopulations most likely to benefit. We developed a platform to identify subgroups that are at increased risk of emergency department visits, hospitalizations and mortality and to provide stratified patient input in economic evaluations of COPD interventions. We relied on administrative and survey data from Ontario, Canada and applied a combination of microsimulation and multi-state modeling methods. We illustrated the functionality of the platform by quantifying outcomes across smoking status (current, former, never smokers) and by estimating the effect of smoking cessation on resource use and survival, by comparing outcomes of hypothetical cohorts of smokers who quit at diagnosis and smokers that continued to smoke post diagnosis. The cumulative incidence of all-cause mortality was 37.9% (95% CI: 34.9, 41.4) for never smokers, 34.7% (95% CI: 32.1, 36.9) for current smokers, and 46.4% (95% CI: 43.6, 49.0) for former smokers, at 14 years. Over 14 years, smokers who did not quit at diagnosis had 16.3% (95% CI: 9.6, 38.4%) more COPD-related emergency department visits than smokers who quit at diagnosis. In summary, we combined methods from clinical and economic modeling to create a novel tool that policymakers and health economists can use to inform future COPD policy decisions and quantify the effect of modifying COPD risk factors on resource utilization and morality.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Formulação de Políticas , Doença Pulmonar Obstrutiva Crônica/mortalidade , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar Tabaco/efeitos adversos , Idoso , Análise Custo-Benefício , Feminino , Recursos em Saúde/economia , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , não Fumantes/estatística & dados numéricos , Ontário , Estudos Retrospectivos , Fatores de Risco , Fumantes/estatística & dados numéricos
3.
PLoS One ; 15(7): e0235276, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32673331

RESUMO

Smoking cessation reduces the cardiovascular risk but increases body weight. We investigated the risk of subsequent myocardial infarction and ischemic stroke according to weight gain after smoking cessation, using a nationwide population based cohort. We enrolled 3,797,572 Korean adults aged over 40 years who participated in national health screenings between 2009 and 2010. Subjects who quit smoking were classified into three subgroups according to the weight change between baseline and 4 years prior. Myocardial infarctions and ischemic strokes were followed until the end of 2015. We compared the hazard ratios among smoking cessation subgroups, non-smokers, and current smokers. The mean changes in weight (1.5 ± 3.9 kg) of the smoking cessation group were higher than those of the other groups (p < 0.0001). A total of 31,277 and 46,811 subjects were newly diagnosed with myocardial infarction and ischemic stroke, respectively. Regardless of weight change, all subgroups of smoking cessation had significantly less risk than current smokers. The subgroup of smoking cessation with weight gain over 4kg showed the lowest risk for myocardial infarctions (hazard ratio 0.646, 95% confidence interval 0.583-0.714, p < 0.0001) and ischemic strokes (hazard ratio 0.648, 95% confidence interval 0.591-0.71, p < 0.0001) after multivariable adjustment. In conclusion, weight gain after smoking cessation did not adversely affect the cardiovascular protective effect.


Assuntos
Infarto Encefálico/epidemiologia , Infarto do Miocárdio/epidemiologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/efeitos adversos , Ganho de Peso , Adulto , Idoso , Infarto Encefálico/etiologia , Infarto Encefálico/prevenção & controle , Ex-Fumantes/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/prevenção & controle , não Fumantes/estatística & dados numéricos , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de Risco , Fumantes/estatística & dados numéricos
4.
DNA Cell Biol ; 39(9): 1657-1663, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32552051

RESUMO

Cell adhesion molecules (CAMs) play crucial roles in the genesis and progress of tumor. We investigated the effects of single nucleotide polymorphisms (SNPs) of CAMs, neuronal growth regulator 1 (NEGR1), and Otoancorin (OTOA) on lung cancer susceptibility in Chinese nonsmoking females. Logistic regression and Cox regression analyses were conducted to investigate the effects of SNPs and environmental factors. For rs3102911, genotype TT carriers decreased the risk of lung cancer with an odds ratio (OR) of 0.635. AA genotypes of rs741718 increased the risk of lung cancer with an OR of 3.527. In stratified analysis, genotype AA carriers of rs741718 had a high susceptibility to lung adenocarcinoma compared with GG and AG genotypes. Analyses of association between SNPs and clinical characteristics revealed that rs3102911 as a protective factor and rs741718 as a risk factor influenced the lung cancer occurrence and progression in nonsmoking females.


Assuntos
Adenocarcinoma/genética , Moléculas de Adesão Celular Neuronais/genética , Proteínas Ligadas por GPI/genética , Neoplasias Pulmonares/genética , Polimorfismo de Nucleotídeo Único , Adulto , Idoso , China , Feminino , Humanos , Pessoa de Meia-Idade , não Fumantes/estatística & dados numéricos
5.
Ann Epidemiol ; 45: 5-11, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32439149

RESUMO

PURPOSE: Lung cancer mortality among never-smokers is an often overlooked yet important cause of adult mortality. Moreover, indirect approaches for estimating smoking-attributable mortality use never-smoker lung cancer death rates to approximate smoking burden. To date, though, most studies using indirect approaches import rates from the Cancer Prevention Study II (CPS-II), which is not representative of the U.S. METHODS: We use the nationally representative 1985-2015 National Health Interview Survey-Linked Mortality Files (NHIS-LMF) to calculate lung cancer death rates among never-smokers aged 50 years or older. We then import rates from NHIS-LMF and CPS-II into the Preston-Glei-Wilmoth indirect method to determine whether smoking-attributable fractions differ. RESULTS: Never-smokers account for 16% of U.S. lung cancer deaths among women and 11% among men. Lung cancer death rates among never-smokers are higher in NHIS-LMF than CPS-II for several age groups. Smoking-attributable fractions of mortality are slightly lower with NHIS-LMF rates (19% of male deaths and 16% of female deaths) than with CPS-II rates (21% of male deaths and 17% of female deaths). CONCLUSIONS: Fractions based on nonrepresentative CPS-II data may modestly overestimate smoking-attributable mortality. Thus, indirect methods should use never-smoker lung cancer death rates from such nationally representative datasets as NHIS-LMF.


Assuntos
Neoplasias Pulmonares/mortalidade , não Fumantes/estatística & dados numéricos , Fumar/efeitos adversos , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Fumar/epidemiologia , Estados Unidos/epidemiologia
6.
Nat Commun ; 11(1): 2485, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32427931

RESUMO

Cigarette smoke first interacts with the lung through the cellularly diverse airway epithelium and goes on to drive development of most chronic lung diseases. Here, through single cell RNA-sequencing analysis of the tracheal epithelium from smokers and non-smokers, we generate a comprehensive atlas of epithelial cell types and states, connect these into lineages, and define cell-specific responses to smoking. Our analysis infers multi-state lineages that develop into surface mucus secretory and ciliated cells and then contrasts these to the unique specification of submucosal gland (SMG) cells. Accompanying knockout studies reveal that tuft-like cells are the likely progenitor of both pulmonary neuroendocrine cells and CFTR-rich ionocytes. Our smoking analysis finds that all cell types, including protected stem and SMG populations, are affected by smoking through both pan-epithelial smoking response networks and hundreds of cell-specific response genes, redefining the penetrance and cellular specificity of smoking effects on the human airway epithelium.


Assuntos
Células Epiteliais/metabolismo , Perfilação da Expressão Gênica/métodos , Pulmão/metabolismo , Mucosa Respiratória/metabolismo , Fumar/genética , Traqueia/metabolismo , Animais , Células Cultivadas , Técnicas de Inativação de Genes , Redes Reguladoras de Genes , Humanos , Pulmão/citologia , Camundongos , Células NIH 3T3 , não Fumantes/estatística & dados numéricos , Mucosa Respiratória/citologia , Análise de Sequência de RNA/métodos , Análise de Célula Única/métodos , Fumantes/estatística & dados numéricos , Traqueia/citologia
7.
Acta Cytol ; 64(5): 471-476, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32316006

RESUMO

BACKGROUND/AIM: Cytogenetic biomarkers such as micronuclei (MN) are used for the evaluation of exposure to carcinogens and genotoxic effects in oral epithelial cells. Tobacco is one of the strongest carcinogens responsible for the development of cancer in oral mucosa. The aim of this study was to compare the genotoxic effect of waterpipe smoking with that of cigarette smoking. METHODS: This case-control study was performed on 30 waterpipe smokers, 30 cigarette smokers, and 30 nonsmokers. Buccal exfoliated cells were prepared using cytobrushes and stained with the Papanicolaou technique. The cytologic slides were examined under a light microscope for counting the number of MN and the number of cells with MN per 1,000 epithelial cells. RESULTS: The mean number ± standard deviation (SD) of MN in waterpipe smokers, cigarette smokers, and nonsmokers was 7.55 ± 5.530, 4.95 ± 5.633, and 2.00 ± 2.406, respectively. The mean number ± SD of cells with MN in waterpipe smokers, cigarette smokers, and nonsmokers was 6.20 ± 4.830, 3.50 ± 3.832, and 1.45 ± 1.701, respectively. Numbers of cells with MN differed significantly between waterpipe smokers and cigarette smokers (p = 0.04) and between waterpipe smokers and nonsmokers (p < 0.001). Numbers of MN differed significantly between waterpipe smokers and nonsmokers (p < 0.001). Numbers of MN did not differ significantly between waterpipe smokers and cigarette smokers (p = 0.10). Numbers of MN and of cells with MN did not differ significantly between cigarette smokers and nonsmokers (p = 0.06 and p = 0.052, respectively). CONCLUSIONS: Waterpipe smoking is associated with a significantly higher frequency of MN, and it seems that waterpipe smoking has a greater genotoxic effect than cigarette smoking.


Assuntos
Fumar Cigarros/efeitos adversos , Dano ao DNA , Micronúcleos com Defeito Cromossômico/induzido quimicamente , Mucosa Bucal/patologia , não Fumantes/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Fumar Cachimbo de Água/efeitos adversos , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Mucosa Bucal/efeitos dos fármacos , Adulto Jovem
8.
Arch. bronconeumol. (Ed. impr.) ; 56(1): 9-17, ene. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-186460

RESUMO

Introducción: La disfunción de las pequeñas vías aéreas (DPV) inducida por el tabaco contribuye precozmente a la patogenia de la limitación al flujo aéreo (LFA), aunque resulta poco conocida su repercusión en la percepción de salud. Se pretende evaluar la frecuencia de DPV en fumadores activos sin LFA y comparar la calidad de vida relacionada con la salud (CVRS) de no fumadores, fumadores sin DPV, fumadores con DPV y fumadores con LFA. Métodos: En 53 fumadores activos sin LFA, 20 fumadores con LFA y 20 no fumadores, se utilizaron los cuestionarios SF-36 y EuroQoL y se realizó oscilometría de impulsos, espirometría y determinación de las densidades de atenuación del parénquima pulmonar en inspiración y espiración máximas. Se consideró que existía DPV cuando la resistencia a 5 Hz (R5), la diferencia R5-R20 y el área de reactancia (AX) excedían su límite superior de la normalidad. Resultados: El 35,8% de los fumadores sin LFA tenía DPV. No se detectaron diferencias en los parámetros espirométricos ni la atenuación pulmonar entre los fumadores con o sin DPV y los no fumadores. Sin embargo, los fumadores con DPV presentaban una peor puntuación en los cuestionarios de CVRS que los fumadores sin DPV o los no fumadores, e intermedia a los fumadores con LFA. R5 y X5 fueron identificados como determinantes independientes de la CVRS en los fumadores sin LFA. Conclusiones: La DPV es frecuente en fumadores sin LFA, afectando a un tercio de los mismos, y condicionando de forma independiente su percepción de salud


Introduction: Small airway dysfunction (SAD) caused by smoking contributes to the early onset of airflow limitation (AFL), although its impact on patients’ perception of health is largely unknown. We aimed to evaluate the frequency of SAD in active smokers without AFL, and to compare health-related quality of life (HRQoL) of non-smokers, smokers without SAD, smokers with SAD, and smokers with AFL. Methods: A total of 53 active smokers without AFL, 20 smokers with AFL, and 20 non-smokers completed the SF-36 and EuroQoL questionnaires and performed impulse oscillometry and spirometry. Pulmonary parenchymal attenuation was determined in inspiration and expiration. SAD was determined to exist when resistance at 5Hz (R5), the difference between R5 and R20, and reactance area (AX) exceeded the upper limit of normal. Results: In total, 35.8% of smokers without AFL had SAD. No differences were detected in spirometric parameters or pulmonary attenuation between smokers with or without AFL and non-smokers. However, smokers with SAD had worse scores on HRQoL questionnaires than smokers without SAD or non-smokers, and scores compared to smokers with AFL were intermediate. R5 and X5 were identified as independent determinants of HRQoL in smokers without AFL. Conclusions: SAD is common in smokers without AFL, affecting one third of this population, and independently affecting their perception of health


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Manuseio das Vias Aéreas/métodos , Qualidade de Vida , Fumantes/estatística & dados numéricos , Inquéritos e Questionários , Oscilação da Parede Torácica/métodos , Abandono do Hábito de Fumar , Pacientes/classificação , não Fumantes/estatística & dados numéricos , Antropometria , Oscilometria/métodos , Espirometria
9.
Support Care Cancer ; 28(1): 123-130, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30989430

RESUMO

PURPOSE: Lung cancer in non-smoking women is a distinct entity, but few studies have examined these patients' healthcare-related experiences. METHODS: Women with lung cancer and with no smoking history underwent a face-to-face semi-structured, audio-recorded interview that was analyzed with a qualitative inductive approach. RESULTS: Twenty-three patients were interviewed, and three themes emerged. The first theme centered on a delay in cancer diagnosis. One patient described, "The whole initial diagnostic process just fills me with rage… I didn't actually get my Tarceva® until the last week in April." Second, the diagnosis of lung cancer seemed especially challenging in view of patients' non-smoking history and otherwise good health; these factors seem to have contributed to the diagnostic delay. One patient explained, "Well, I was just so adamant that I didn't like smoking… maybe if I had been a smoker, they [the healthcare providers] would've been more resourceful." Finally, the stigma of a smoking-induced malignancy was clearly articulated, "Yeah. Because it's a stigma, and I had read that, too -- people go, 'Well, it's your own damn fault because you were a smoker.'" CONCLUSIONS: Non-smoking women with lung cancer appear to endure a long trajectory from symptoms to cancer diagnosis to the initiation of cancer therapy. An awareness and acknowledgement of this long trajectory might help healthcare providers render more compassionate cancer care to these patients.


Assuntos
Neoplasias Pulmonares/terapia , não Fumantes , Satisfação do Paciente/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Diagnóstico Tardio/estatística & dados numéricos , Empatia , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/normas , Pessoal de Saúde/estatística & dados numéricos , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/psicologia , Masculino , Pessoa de Meia-Idade , não Fumantes/psicologia , não Fumantes/estatística & dados numéricos , Relações Médico-Paciente , Padrões de Prática Médica/normas , Pesquisa Qualitativa , Estigma Social , Inquéritos e Questionários , Tempo para o Tratamento/normas , Tempo para o Tratamento/estatística & dados numéricos
10.
Environ Sci Pollut Res Int ; 27(6): 6033-6041, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31865581

RESUMO

Secondhand smoke (SHS) accounts for 0.9 million deaths and 24 million disability adjusted life years (DALYs) annually. Nearly 30% of adults in India are exposed to SHS in India. To reduce SHS exposure, India enacted a smoke-free law in 2003 under which smoking in public places is banned. However, the compliance to this law has been variable in several assessments in the country. A better understanding of the nature and extent of SHS exposure can help inform better implementation of national smoke-free policies. The Global Adult Tobacco Survey (GATS) India 2016-17 collects information on the self-reported prevalence of SHS exposure in homes, workplaces, government buildings, restaurants, public transportation and health care facilities among adults (> 15 years of age).The present study utilized the GATS India 2016-17 dataset to provide estimates of SHS exposure among adults in India in homes, workplace and other public places, across gender and age groups and among the overall population and non-smokers. Weighted analysis was carried out. In the overall population, exposure to SHS in the home was 29.2%, more among young females. In workplaces, exposure to SHS was 29.2% overall, significantly higher among males (32.5%) compared to females (17.8%). In public buildings such as health care facilities and government offices, SHS exposure was less with 15.6% and 21.2% respectively. SHS exposure was high in restaurants with 39.3% overall, significantly higher among males (43.2%) compared to females (22.2%). Similar results were also seen among non-smokers. A large proportion of adults in India, both smokers and non-smokers are exposed to SHS in their homes, workplaces and other public places, especially restaurants, workplaces and public transportation. Females are more exposed to SHS at home, whereas males are more exposed in public places including workplaces. High SHS exposure among youths is also a concern. Stricter enforcement of legislation is required to ensure 100% smoke-free homes, public places and workplaces and reduce SHS exposure.


Assuntos
Exposição Ambiental/estatística & dados numéricos , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Índia , Masculino , não Fumantes/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Inquéritos e Questionários , Tabaco
11.
Cancer Lett ; 468: 82-87, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31600530

RESUMO

Lung cancer is a heterogeneous disease that is impacted by environmental exposures and by constitutional genetic or epigenetic susceptibilities to disease development and progression. The United States and China have distinct and diverse populations and geographic environmental exposures that contribute to unique patterns of lung cancer incidence and mortality. In this paper, the authors compare trends of incidence and mortality of lung cancer in the US and China, and the impact on lung cancer screening programs in the two countries. It is worth noting that the mortality of lung cancer in the US has decreased gradually while in China it is still increasing over recent years. While decreasing smoking prevalence and the impact of clean air legislation have helped to mitigate the trend in the US relative to China, the increasingly widespread implementation of lung cancer chest CT screening is expected to impact lung cancer incidence and mortality in both countries. Currently there are few studies to compare the environmental and genetic risk factors for US and Chinese populations with regards to lung cancer incidence and mortality. The authors discuss the impact of gender and exposure risks, mainly smoking and environmental pollutants. Of high importance is the incidence of lung cancer in never smokers that is significantly higher in China than in the United States; this is particularly notable in women. These data suggest inclusion of ambient air pollution exposure and gender into lung cancer risk prognostic models to better capture high-risk individuals, especially for non-smoking women.


Assuntos
Comparação Transcultural , Detecção Precoce de Câncer/estatística & dados numéricos , Neoplasias Pulmonares/epidemiologia , Programas de Rastreamento/estatística & dados numéricos , Mortalidade/tendências , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Detecção Precoce de Câncer/normas , Exposição Ambiental/efeitos adversos , Ex-Fumantes/estatística & dados numéricos , Feminino , Predisposição Genética para Doença , Humanos , Incidência , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/genética , Masculino , Programas de Rastreamento/normas , Pessoa de Meia-Idade , não Fumantes/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Prevalência , Fatores de Risco , Fatores Sexuais , Fumantes/estatística & dados numéricos , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Tomografia Computadorizada por Raios X/normas , Estados Unidos/epidemiologia
12.
Dis Markers ; 2019: 5292787, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31885738

RESUMO

Background: Lung squamous cell carcinoma (LUSC) is a subtype of highly malignant lung cancer with poor prognosis, for which smoking is the main risk factor. However, the underlying genetic and molecular mechanisms of smoking-related LUSC remain largely unknown. Methods: We mined existing LUSC-related mRNA, miRNA, and lncRNA transcriptome data and corresponding clinical data from The Cancer Genome Atlas (TCGA) database and divided them into smoking and nonsmoking groups, followed by differential expression analysis. Functional enrichment analysis of the unique differentially expressed mRNAs of the two groups was performed using the DAVID database. Subsequently, the lncRNA-miRNA-mRNA competing endogenous RNA (ceRNA) network of LUSC in smoking and nonsmoking groups was constructed. Finally, survival analyses were performed to determine the effects of differentially expressed lncRNAs/mRNAs/miRNAs that were involved in the ceRNA network on overall survival and to discover the hub genes. Results: A total of 1696 lncRNAs, 125 miRNAs, and 3246 mRNAs and 1784 lncRNAs, 96 miRNAs, and 3229 mRNAs with differentially expressed profiles were identified in the smoking and nonsmoking groups, respectively. The ceRNA network and survival analysis revealed four lncRNAs (LINC00466, DLX6-AS1, LINC00261, and AGBL1), one miRNA (hsa-mir-210), and two mRNAs (CITED2 and ENPP4), with the potential as biomarkers for smoking-related LUSC diagnosis and prognosis. Conclusion: Taken together, our research has identified the differences in the ceRNA regulatory networks between smoking and nonsmoking LUSC, which could lay the foundation for future clinical research.


Assuntos
Carcinoma de Células Escamosas/genética , Redes Reguladoras de Genes , Neoplasias Pulmonares/genética , não Fumantes/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Regulação Neoplásica da Expressão Gênica , Humanos , MicroRNAs/genética , Prognóstico , RNA Longo não Codificante/genética , RNA Mensageiro/genética , Análise de Sobrevida
13.
BMC Pulm Med ; 19(1): 180, 2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619218

RESUMO

BACKGROUND: E-cigarette use prevalence has grown rapidly in the US. Despite the popularity of these products, few acute exposure toxicity studies exist, and studies on long-term pulmonary health effects are limited. E-cigarette users who are never combustible cigarette smokers (sole users) constitute a unique group of young adults that may be at increased risk of bronchial hyperreactivity and development of asthma. Given the public health concern about the potential pulmonary health effects of sole e-cigarette use, we aimed to examine the association between e-cigarette use and asthma among never combustible cigarette smokers. METHODS: We pooled 2016 and 2017 data of the Behavioral Risk Factor Surveillance System (BRFSS), a large, cross-sectional telephone survey of adults aged 18 years and older in the U.S. We included 402,822 participants without any history of combustible cigarette smoking (defined as lifetime smoking < 100 cigarettes) and with complete self-reported information on key variables. Current e-cigarette use, further classified as daily or occasional use, was the primary exposure. The main outcome, asthma, was defined as self-reported history of asthma. We assess the relationship of sole e-cigarette use with asthma using multivariable logistic regression adjusting for age, sex, race, income, level of education and body mass index. RESULTS: Of 402,822 never combustible cigarette smokers, there were 3103 (0.8%) current e-cigarette users and 34,074 (8.5%) with asthma. The median age group of current e-cigarette users was 18-24 years. Current e-cigarette use was associated with 39% higher odds of self-reported asthma compared to never e-cigarette users (Odds Ratio [OR], 1.39; 95% confidence interval: 1.15, 1.68). There was a graded increased odds of having asthma with increase of e-cigarette use intensity. The odds ratio of self-reported asthma increased from 1.31 (95% confidence interval: 1.05, 1.62) in occasional users to 1.73 (95% confidence interval: 1.21, 2.48) in daily e-cigarette users, compared to never e-cigarette users. CONCLUSION: Our findings from a large, nationally representative survey suggest increased odds of asthma among never combustible smoking e-cigarette users. This may have potential public health implications, providing a strong rationale to support future longitudinal studies of pulmonary health in young e-cigarette-using adults.


Assuntos
Asma , Fumar Cigarros , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , não Fumantes/estatística & dados numéricos , Asma/diagnóstico , Asma/epidemiologia , Sistema de Vigilância de Fator de Risco Comportamental , Fumar Cigarros/epidemiologia , Fumar Cigarros/fisiopatologia , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Autorrelato/estatística & dados numéricos , Adulto Jovem
14.
Radiol Oncol ; 53(3): 357-361, 2019 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-31553706

RESUMO

Background The outcomes of patients with both lung cancer and idiopathic pulmonary fibrosis (IPF) are unfavorable. Therapeutic interventions for lung cancer such as surgery can cause acute exacerbation of IPF (aeIPF). This study aimed to assess the frequency of IPF in a group of patients with early-stage non-small-cell lung cancer (NSCLC) and to report clinical characteristics and outcomes of this cohort of patients. Patients and methods This observational cohort retrospective study analyzed 641 pathological records of patients after surgical resection of early-stage non-small-cell lung cancer (NSCLC) at University Clinic Golnik from May 2010 to April 2017. Pathological records of NSCLC with coexisting IPF were reviewed. CT scans and biopsy specimens for this group of patients were analyzed by a thoracic radiologist and pathologist, independently. We searched radiological and pathological features of usual interstitial pneumonia (UIP) pattern in this group of patients. We report the clinical characteristics and outcome of this cohort of patients. Results Out of 641 patients with early-stage NSCLC, only 13 (2.0%) had histologically and radiologically proven coexisting UIP/IPF. Squamous cell carcinoma was the most common type of lung cancer (7/13 patients). The majority of tumors were small size (all being pT1 or pT2), stage I-II (11/13 patients), located in the lower lung lobes (11/13 patients). Almost all patients were current or ex-smokers (11/13 patients). There were two pathologically confirmed fatal cases (15.4%) due to aeIPF in the first two months after radical treatment, one after adjuvant radiotherapy and the other after surgery. Out of 13 patients, one patient had a lung cancer relapse. Conclusions Frequency of UIP/IPF in surgically treated early stage NSCLC is rather low. Our observational study shows that radical treatment of lung cancer can cause aeIPF with dismal outcome in this group of patients. The standard of care in these mostly elderly patients still remains unresolved.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/complicações , Fibrose Pulmonar Idiopática/complicações , Neoplasias Pulmonares/complicações , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Ex-Fumantes/estatística & dados numéricos , Feminino , Humanos , Fibrose Pulmonar Idiopática/diagnóstico por imagem , Fibrose Pulmonar Idiopática/epidemiologia , Fibrose Pulmonar Idiopática/patologia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , não Fumantes/estatística & dados numéricos , Estudos Retrospectivos , Eslovênia/epidemiologia , Fumantes/estatística & dados numéricos , Carga Tumoral
15.
Artigo em Japonês | MEDLINE | ID: mdl-31534066

RESUMO

OBJECTIVES: The purpose of this study was to confirm the association of the status of implementation of nonsmoking at eating and drinking establishments with the prevalence of persons with subjective symptoms, the prevalence of persons with diseases under treatment, medical expenses, and mortality rate using prefectural data. METHODS: The prefectural rate of eating and drinking establishments implementing nonsmoking (hereafter, nonsmoking rate) was calculated using the data from "Tabelog®". The variables of interest were the prevalence of persons with subjective symptoms, the prevalence of persons with diseases under treatment, medical expenses (total, hospitalization and nonhospitalization expenses), and the mortality rates of malignant neoplasms (lung cancer, stomach cancer, and colon cancer), heart disease, acute myocardial infarction, cerebrovascular disease, cerebral infarction, and pneumonia in each prefecture. The partial correlation coefficient was estimated between the nonsmoking rate and the variable of interest using the smoking rate by prefectural as the control variable. RESULTS: The nonsmoking rate showed a significantly negative correlation with the medical expenses. When eating and drinking establishments were divided into "restaurant", "café", and "bar", the nonsmoking rate also indicated a significantly negative correlation with the medical expenses in any category. It was negatively related to the mortality rates of cerebrovascular disease, cerebral infarction, and pneumonia. The negative correlation was stronger in females than in males. CONCLUSIONS: These results suggest that the implementation of nonsmoking at eating and drinking establishments may reduce the mortality rates of diseases, such as cerebrovascular disease, cerebral infarction, and pneumonia, and medical expenses. Thus, it is important to implement nonsmoking at eating and drinking establishments in line with the Revised Health Promotion Act.


Assuntos
Transtornos Cerebrovasculares/mortalidade , Gastos em Saúde/estatística & dados numéricos , Promoção da Saúde/estatística & dados numéricos , Cardiopatias/mortalidade , Neoplasias/mortalidade , não Fumantes/estatística & dados numéricos , Restaurantes/estatística & dados numéricos , Prevenção do Hábito de Fumar/estatística & dados numéricos , Humanos , Japão/epidemiologia , Infarto do Miocárdio/mortalidade , Pneumonia/mortalidade , Prevalência
16.
Glob Heart ; 14(3): 335-341, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31451242

RESUMO

BACKGROUND: Smoking is a well-established cardiac risk factor there is dearth of Local data regarding clinical and angiographic characteristics of smoker patients. OBJECTIVES: This study was planned to assess the differences in the clinical characteristics, angiographic characteristics, and in-hospital outcomes of smokers and nonsmokers after primary percutaneous coronary intervention at a tertiary care hospital in Karachi, Pakistan. METHODS: We included patients between 40 and 80 years of age diagnosed with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention from July 1, 2017, to March 31, 2018. Clinical and angiographic characteristics and in-hospital outcomes were obtained from the cases submitted to the National Cardiovascular Data Registry's CathPCI (Catheterization-Percutaneous Coronary Intervention) Registry from our site. RESULTS: A total of 3,255 patients were included in this study. Smokers consist of 25.1% (817) of the total sample. A high majority of smokers were male, 98.8% (807), and smokers were relatively younger as compared to nonsmokers with a mean age of 52.89 ± 10.59 versus 55.98 ± 11.24 years; p < 0.001. Smokers had higher post-procedure TIMI (Thrombolysis In Myocardial Infarction) flow grade III: 97.8% (794) versus 95.53% (2,329); p = 0.037, and they had a relatively low mortality rate: 2.69% (22) versus 3.16% (77); p = 0.502. CONCLUSIONS: Smokers were predominantly male and around 3 years younger than nonsmokers. Diabetes mellitus and hypertension were less common among smokers and single-vessel disease was the more common angiographic finding for smokers as compared to 3-vessel disease for nonsmokers. No statistically significant differences in in-hospital outcomes were observed. ST-segment elevation myocardial infarction in smokers despite younger age and the low atherosclerotic risk profile, in our region, emphasize the need for nicotine addiction management and smoking cessation campaigns at large and for pre-discharge counseling.


Assuntos
não Fumantes/estatística & dados numéricos , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Fumantes/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Fumar Cigarros/efeitos adversos , Angiografia Coronária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Estudos Prospectivos , Estudos Retrospectivos , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Centros de Atenção Terciária/estatística & dados numéricos
17.
BMC Public Health ; 19(1): 1000, 2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31345189

RESUMO

BACKGROUND: The dual-process theory is central to several models of addiction, implying the importance of automatic processes in the maintenance and development of addiction. Implicit beliefs are traces of previous experience which relate to the representation in cognition. Implicit behavioral tendencies are traces of previous experience which relate to the representation in behavioral tendencies. In this study, we aim to provide behavioral evidence for implicit beliefs and implicit behavioral tendencies towards smoking-related cues among Chinese male smokers and non-smokers. We also examine the relationships among implicit beliefs, implicit behavioral tendencies and smoking behaviors of smokers. METHODS: In order to achieve these goals, we used an implicit association test (IAT) to measure implicit beliefs and implicit behavioral tendencies simultaneously. Thirty-nine smokers and twenty-five non-smokers were tested, using smoking-related words and images, as well as neutral words and images as stimuli. RESULTS: Our analysis shows significant differences in smokers' and non-smokers' implicit beliefs and behavioral tendencies (t62 = 3.494, p < 0.001; t62 = 5.034, p < 0.001). In the group of smokers, implicit beliefs and implicit behavioral tendencies were positively correlated with each other (r = 0.460, p < 0.01). In addition, smokers' scores for implicit behavioral tendencies are negatively correlated with the number of cigarettes smoked per day (r = - 0.51, p < 0.001). CONCLUSIONS: This study suggests that implicit beliefs and behavioral tendencies toward smoking-related cues vary significantly between Chinese male smokers and non-smokers. In addition, there is a positive correlation between implicit beliefs and behavioral tendencies within smokers. It also shows for the first time that the implicit behavioral tendencies are related to smoking behaviors. Our results may be considered as references for smoking cessation interventions focused on changes at the implicit level, and they provide a new perspective for measuring different dimensions of implicit attitudes by an IAT. This finding might promote the development of the network theory of implicit attitudes.


Assuntos
Sinais (Psicologia) , Conhecimentos, Atitudes e Prática em Saúde , não Fumantes/psicologia , Fumantes/psicologia , Fumar/psicologia , China , Estudos Transversais , Humanos , Masculino , não Fumantes/estatística & dados numéricos , Fumantes/estatística & dados numéricos , Adulto Jovem
18.
J Urol ; 202(6): 1248-1254, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31290707

RESUMO

PURPOSE: We explored the association between tobacco use and genitourinary cancer specific survival in a contemporary, nationally representative sample of the United States civilian population. MATERIALS AND METHODS: A total of 493,282 participants in the National Longitudinal Mortality Study who provided detailed tobacco information from 1993 to 2005 were included in study. Our primary outcome was death from bladder, kidney or prostate cancer. Cause of death was determined from death certificates. Analyzed smoking parameters included smoking status at the time of the survey, age at the start of smoking and home smoking rules. Multivariable Cox regression models were used to assess associations of different smoking parameters with bladder, kidney and prostate cancer specific mortality. RESULTS: During a 5-year followup 5.6% of participants who had ever smoked died compared to 3.1% of those who had never smoked (p <0.0001). Of those who died of bladder, kidney and prostate cancer 62%, 58% and 62%, respectively, were ever smokers. On multivariable analysis ever smoking was associated with bladder and kidney cancer mortality (HR 1.92, 95% CI 1.25-2.97, and HR 1.54, 95% CI 1.01-2.34, respectively). Additionally, starting to smoke during teenage years and smoking at home were associated with bladder cancer specific mortality (HR 2.14, 95% CI 1.28-3.56 and HR 2.99, 95% CI 1.34-6.65) and kidney cancer specific mortality (HR 1.65, 95% CI 1.03-2.66 and HR 2.84, 95% CI 1.54-5.23, respectively). However, only everyday smoking was associated with an increased risk of prostate cancer mortality (HR 1.81, 95% CI 1.30-2.53). CONCLUSIONS: In a nationally representative study we confirmed the association between smoking intensity and mortality from genitourinary malignancies. Starting to smoke at a younger age and smoking at home conferred a significantly higher risk of death from bladder and kidney cancers.


Assuntos
Neoplasias Renais/mortalidade , Neoplasias da Próstata/mortalidade , Fumar/epidemiologia , Neoplasias da Bexiga Urinária/mortalidade , Fatores Etários , Idoso , Feminino , Seguimentos , Humanos , Neoplasias Renais/etiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , não Fumantes/estatística & dados numéricos , Neoplasias da Próstata/etiologia , Fatores de Risco , Fatores Sexuais , Fumantes/estatística & dados numéricos , Fumar/efeitos adversos , Estados Unidos/epidemiologia , Neoplasias da Bexiga Urinária/etiologia
19.
BMC Public Health ; 19(1): 808, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234809

RESUMO

BACKGROUND: Sleep problems are common in the general population. Cigarette smoking is common in the general population of China. Examinations of the prevalence of poor sleep quality among Chinese smokers and nonsmokers are still lacking. This study was designed to examine sleep quality and sleep disturbances among cigarette smokers and nonsmokers in the general population in central China. METHODS: In this population-based sampling project, we used a multi-stage sampling method to recruit survey participants from September 2012 to October 2012 in rural and urban areas of Hunan province, China. A total of 27,300 subjects were sampled from the general population and 26,282 completed the self-report of cigarette smoking characteristics. Cigarette smoker was defined as having smoked ≥100 cigarette in a lifetime and smoked during the last 28 days. Cigarette smoking characteristics were obtained from smokers, including cigarettes per day, years of smoking, quit attempts, and smoking cravings. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess quality of sleep and sleep disturbances (PSQI score > 5). RESULTS: Significantly more smokers than nonsmokers demonstrated poor sleep quality and sleep disturbances. Among smokers, linear regression analyses showed that poor sleep was inversely associated with cigarettes per day, and positively associated with years of smoking, quit attempts, and smoking craving. Logistic regression analysis showed that quit attempts and smoking cravings were associated with higher odds of sleep disturbances. CONCLUSIONS: Sleep disturbances were more prevalent among cigarette smokers than nonsmokers. Smokers also varied in sleep problems on the basis of the characteristics of their smoking. Smokers should be informed about the link between cigarette smoking and poor sleep quality, and should be advised that one of several important health benefits from smoking cessation could be the improvement of sleep quality. Sleep therapy should be recommended as an adjunctive treatment for smoking cessation.


Assuntos
Fumar Cigarros/efeitos adversos , não Fumantes/estatística & dados numéricos , Transtornos do Sono-Vigília/epidemiologia , Fumantes/estatística & dados numéricos , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural/estatística & dados numéricos , Sono , Transtornos do Sono-Vigília/etiologia , Inquéritos e Questionários , População Urbana/estatística & dados numéricos
20.
Am Heart J ; 213: 112-122, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31132583

RESUMO

AIMS: To quantify the relation between smoking cessation after a first cardiovascular (CV) event and risk of recurrent CV events and mortality. METHODS: Data were available from 4,673 patients aged 61 ± 8.7 years, with a recent (≤1 year) first manifestation of arterial disease participating in the SMART-cohort. Cox models were used to quantify the relation between smoking status and risk of recurrent major atherosclerotic cardiovascular events (MACE including stroke, MI and vascular mortality) and mortality. In addition, survival according to smoking status was plotted, taking competing risk of non-vascular mortality into account. RESULTS: A third of the smokers stopped after their first CV event. During a median of 7.4 (3.7-10.8) years of follow-up, 794 patients died and 692 MACE occurred. Compared to patients who continued to smoke, patients who quit had a lower risk of recurrent MACE (adjusted HR 0.66, 95% CI 0.49-0.88) and all-cause mortality (adjusted HR 0.63, 95% CI 0.48-0.82). Patients who reported smoking cessation on average lived 5 life years longer and recurrent MACE occurred 10 years later. In patients with a first CV event >70 years, cessation of smoking had improved survival which on average was comparable to former or never smokers. CONCLUSIONS: Irrespective of age at first CV event, cessation of smoking after a first CV event is related to a substantial lower risk of recurrent vascular events and all-cause mortality. Since smoking cessation is more effective in reducing CV risk than any pharmaceutical treatment of major risk factors, it should be a key objective for patients with vascular disease.


Assuntos
Doenças Cardiovasculares/etiologia , Abandono do Hábito de Fumar , Fumar/efeitos adversos , Fatores Etários , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Causas de Morte , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Expectativa de Vida , Masculino , Pessoa de Meia-Idade , não Fumantes/estatística & dados numéricos , Modelos de Riscos Proporcionais , Estudos Prospectivos , Recidiva , Medição de Risco , Fatores de Risco , Fumantes/estatística & dados numéricos , Fumar/epidemiologia , Fumar/mortalidade , Abandono do Hábito de Fumar/estatística & dados numéricos
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