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Stroke Apr 2023Cigarette smoking is a known risk factor for cardiovascular disease, including ischemic stroke. The literature regarding the rate of persistent smoking after acute... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Cigarette smoking is a known risk factor for cardiovascular disease, including ischemic stroke. The literature regarding the rate of persistent smoking after acute ischemic stroke and its effect on subsequent cardiovascular events is scarce. With this study, we aimed to report the rate of persistent smoking after ischemic stroke and the association between smoking status and major cardiovascular outcomes.
METHODS
This is a post-hoc analysis of the SPS3 trial (Secondary Prevention of Small Subcortical Strokes). Patients were divided into 4 groups based on smoking status at trial enrollment: (1) never smokers, (2) former smokers, (3) smokers who quit at 3 months, and (4) persistent smokers. The primary outcome is a major adverse cardiovascular events composite of stroke (ischemic and hemorrhagic), myocardial infarction, and mortality. Outcomes were adjudicated after month 3 of enrollment until an outcome event or the end of study follow-up.
RESULTS
A total of 2874 patients were included in the study. Of the total cohort, 570 patients (20%) were smokers at enrollment, of whom 408 (71.5%) patients continued to smoke and 162 (28.4%) quit smoking by 3 months. The major adverse cardiovascular events outcome occurred in 18.4%, 12.4%, 16.2%, and 14.4%, respectively, in persistent smokers, smokers who quit, prior smokers, and never smokers. In a model adjusted for age, sex, race, ethnicity, education, employment status, history of hypertension, diabetes, hyperlipidemia, myocardial infarction, and intensive blood pressure randomization arm, the risk of major adverse cardiovascular events, and death were higher in the persistent smokers compared with never smokers (HR for major adverse cardiovascular events: 1.56 [95% CI, 1.16-2.09]; HR for death: 2.0 [95% CI, 2.18-3.12]). The risk of stroke, and MI did not differ according to smoking status Conclusions: Compared with never smoking, persistent smoking after acute ischemic stroke was associated with an increased risk of cardiovascular events and death.
REGISTRATION
URL: https://www.
CLINICALTRIALS
gov; Unique identifier: NCT00059306.
Topics: Humans; Hemorrhage; Ischemic Stroke; Myocardial Infarction; Risk Factors; Smoking; Stroke; Treatment Outcome
PubMed: 36876480
DOI: 10.1161/STROKEAHA.121.038202 -
Journal of Primary Care & Community... 2023Smoking is associated with many diseases and is a target for primary preventive efforts in numerous morbidities. Studies show that smoking and depression may be...
INTRODUCTION
Smoking is associated with many diseases and is a target for primary preventive efforts in numerous morbidities. Studies show that smoking and depression may be associated. Never-smokers are at significantly lower risk than current and former smokers. Despite this observation, the effect of smoking on depression risk reduction has not been adequately explored. The purpose of this study was to explore the effect of smoking on depression risk reduction in adult patients seen in a primary care clinic at an academic medical center 6 months after they were identified as being at risk for depression. Findings may influence the direction and intensity of our smoking cessation endeavors in patients at risk of depression who smoke.
METHODS
We conducted an analytic cross-sectional study using electronic medical records of patients 18 years and older seen a primary care setting between January 1, 2019 and December 31, 2020. All participants included had an initial depression risk score (assessed by the 9-item Patient Health Questionnaire (PHQ-9)) of 5 or higher, information on smoking status and a PHQ-9 score at 6 months. We determined the percentage of patients with PHQ-9 score decrease of 5 or more at 6 months and used logistic regression to determine the association depression risk reduction (of 5 units or more) at 6 months and smoking, adjusting for demographic, clinical, and behavioral characteristics.
RESULTS
Number of patients included were 120, mean age was 55 (16), years, 88 (74%) were female, 68 (57%) were African American, and 31 (26%) were Caucasian. Fifty (44%) had a history of smoking and 31 (25.8%) had improvement (ie, a decrease of 5 units or more) in their PHQ-9 score at 6 months. Smoking was associated with decreased odds of improvement in depressive symptoms (Odds ratio = 0.32, 95% Confidence interval: 0.12-0.87).
CONCLUSION
Risk of depression was more likely to persist in smokers than non-smokers at 6 months. Addressing smoking behavior in those with risk of depression may be beneficial.
Topics: Adult; Female; Humans; Male; Middle Aged; Cross-Sectional Studies; Depression; Primary Health Care; Risk Reduction Behavior; Smoking
PubMed: 38041400
DOI: 10.1177/21501319231213748 -
Asian Pacific Journal of Cancer... Jun 2022Smoking is a growing public health problem throughout the world. However, the attitude of males and females toward smoking may differ. Therefore, this study examines...
BACKGROUND
Smoking is a growing public health problem throughout the world. However, the attitude of males and females toward smoking may differ. Therefore, this study examines gender differences in smoking behavior and attitude among Saudi medical students.
METHODS
From January 2020 to August 2020, a snowball cross-sectional online survey was conducted in five major regions of Saudi Arabia. Medical students (18 years or older) were invited to respond to the questionnaire.
RESULTS
Out of the 421 respondents, 255 (60.6%) were female, 243 (57.7%) were between 18 and-24-year-old, and 164 (39%) were from the Eastern Province. The overall prevalence of smoking was 25.4% and was higher among males than females [(44% and 13.3%, respectively), P < 0.001]. However, there was no significant difference in the mean score of the overall attitude towards smoking between males and females [(3.02±0.44 and 3.00±0.34), respectively, P=0.64]. However, more female students believed e-cigarettes were harmful to health than male students [(4.19±1.04 and 4.45±0.9), respectively, P=0.002].
CONCLUSION
The study showed that male students smoke more than female students, and there were no significant differences in the overall attitudes score towards smoking. Therefore, campaigns are needed to decrease smoking rate, especially among male students.
Topics: Adolescent; Adult; Cross-Sectional Studies; Electronic Nicotine Delivery Systems; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Saudi Arabia; Sex Factors; Smoking; Students, Medical; Young Adult
PubMed: 35763652
DOI: 10.31557/APJCP.2022.23.6.2089 -
International Journal of Environmental... Dec 2022Smoking is considered a major preventable cause of cardiovascular and lung diseases, as well as cancer. During the COVID-19 pandemic, there was extensive discussion...
Smoking Behavior and Smoking Cessation Because of and during the COVID-19 Pandemic: A Brief Online Survey 12 Months into the Pandemic and during the Second Wave in Europe.
Smoking is considered a major preventable cause of cardiovascular and lung diseases, as well as cancer. During the COVID-19 pandemic, there was extensive discussion about the influence of nicotine use; ultimately, smoking was considered a major risk factor for poor disease progression. Therefore, in April 2021, we conducted an anonymous cross-sectional online survey on smoking and vaping behavior, as well as smoking cessation, in four different countries in Europe (the United Kingdom, Germany, Spain, and Italy). A total of 3605 participants completed a questionnaire on their smoking and vaping behaviors and smoking cessation because of and during the COVID-19 pandemic. Fear of COVID-19 infection, a high percentage of quarantine stays (44.9% Italy and 52.1% Spain), and high infection (75.5% Italy and 52.4% Spain) and death (42% Italy) rates in respondents' personal circles were observed mostly in the surveyed populations of Italy and Spain. Smoking cessation attempts and success were mainly seen in the Italian population and were linked to psychological distress, while the same effects were shown for vaping in Spain. In summary, health anxiety was detected in all cohorts. Despite these findings, smoking as a risk factor for severe outcomes of COVID-19 infection did not lead to a higher rate of smoking cessation attempts.
Topics: Humans; COVID-19; Smoking Cessation; Pandemics; Cross-Sectional Studies; Smoking; Europe; Surveys and Questionnaires
PubMed: 36554420
DOI: 10.3390/ijerph192416540 -
Cancer Epidemiology, Biomarkers &... Nov 2020The smoking behavior of American Indians (AI) differs from that of non-Hispanic whites (NHW). Typically light smokers, cessation interventions in AIs are generally less...
BACKGROUND
The smoking behavior of American Indians (AI) differs from that of non-Hispanic whites (NHW). Typically light smokers, cessation interventions in AIs are generally less effective. To develop more effective cessation programs for AIs, clinicians, researchers, and public health workers need a better understanding of the genetic factors involved in their smoking behavior. Our aim was to assess whether SNPs associated with smoking behavior in NHWs are also associated with smoking in AIs.
METHODS
We collected questionnaire data on smoking behaviors and analyzed blood and saliva samples from two Tribal populations with dramatically different cultures and smoking prevalence, one in the Northern Plains ( = 323) and the other in the Southwest ( = 176). A total of 384 SNPs were genotyped using an Illumina custom GoldenGate platform. Samples were also assessed for cotinine and 3-hydroxycotinine as markers of nicotine intake and nicotine metabolite ratio.
RESULTS
Among 499 participants, we identified, in the Northern Plains sample only, a variant of the gamma-aminobutyric acid receptor subunit alpha-2 () (rs2119767) on chromosome 4p that was associated with many of the intake biomarkers of smoking we examined, suggesting a role for this gene in modifying smoking behavior in this population. We also identified three SNPs, in the Southwest sample only, as significant correlates of only cigarettes per day: rs4274224, rs4245147 (both dopamine receptor D2 gene), and rs1386493 (tryptophan hydroxylase 2 gene).
CONCLUSIONS
The contribution of many genes known to underlie smoking behaviors in NHWs may differ in AIs.
IMPACT
Once validated, these variants could be useful in developing more effective cessation strategies.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Smoking; Surveys and Questionnaires; Young Adult; American Indian or Alaska Native
PubMed: 32855268
DOI: 10.1158/1055-9965.EPI-20-0026 -
Nicotine & Tobacco Research : Official... Apr 2017There has been rapid growth in research exploring gene-environment interaction (G×E) contributing to smoking behaviors. Yet, no systematic review exists to date. (Review)
Review
INTRODUCTION
There has been rapid growth in research exploring gene-environment interaction (G×E) contributing to smoking behaviors. Yet, no systematic review exists to date.
METHODS
This article aims to review evidence on the contribution of G×E to the risk of smoking. Through a search of electronic databases (ie, Google Scholar, PubMed, ScienceDirect, and Elsevier) up until May 2014, 16 studies of G×E focused on smoking behaviors were identified. These studies were compared in terms of: research design and sample studied, measure of smoking behavior and environments used, genes explored, and G×E in relation to these factors.
RESULTS
Thirteen of 16 studies (81.2%) found at least one significant G×E association. Wide variation in analytic methods was found across studies, especially with respect to the phenotypes of interest, environmental measures used, and tests conducted to estimate G×E. Heterogeneity across studies made it difficult to compare findings and evaluate the strength of evidence for G×E.
CONCLUSIONS
G×E research on smoking contains studies that are methodologically different, making it difficult to assess the current state of the evidence. To decrease heterogeneity, we offer recommendations related to: (1) choice of measurement for environmental variables, (2) testing and reporting of main and interaction effects, (3) treatment of covariates, (4) reporting gene-environment correlation, and (5) conducting sensitivity analyses and checking for scaling artifacts. Continued study is needed to identify mechanisms by which genes and environmental factors combine to influence smoking behaviors.
IMPLICATIONS
No comprehensive review of G×E studies of smoking behavior has previously been published. The present article seeks to fill this gap by providing a comprehensive review of: how G×E has been defined, how twin and molecular genetic methodologies have been used to test for G×E, and which genes and environmental factors are associated with smoking behaviors. Variations in methodological approaches make it difficult to interpret and summarize findings, so recommendations for future research are provided as a means to more easily compare and replicate findings across studies.
Topics: Environment; Gene-Environment Interaction; Genotype; Humans; Smoking
PubMed: 27613915
DOI: 10.1093/ntr/ntw153 -
JMIR MHealth and UHealth Feb 2022There are 1.1 billion smokers worldwide, and each year, more than 8 million die prematurely because of cigarette smoking. More than half of current smokers make a... (Observational Study)
Observational Study
BACKGROUND
There are 1.1 billion smokers worldwide, and each year, more than 8 million die prematurely because of cigarette smoking. More than half of current smokers make a serious quit every year. Nonetheless, 90% of unaided quitters relapse within the first 4 weeks of quitting due to the lack of limited access to cost-effective and efficient smoking cessation tools in their daily lives.
OBJECTIVE
This study aims to enable quantified monitoring of ambulatory smoking behavior 24/7 in real life by using continuous and automatic measurement techniques and identifying and characterizing smoking patterns using longitudinal contextual signals. This work also intends to provide guidance and insights into the design and deployment of technology-enabled smoking cessation applications in naturalistic environments.
METHODS
A 4-week observational study consisting of 46 smokers was conducted in both working and personal life environments. An electric lighter and a smartphone with an experimental app were used to track smoking events and acquire concurrent contextual signals. In addition, the app was used to prompt smoking-contingent ecological momentary assessment (EMA) surveys. The smoking rate was assessed based on the timestamps of smoking and linked statistically to demographics, time, and EMA surveys. A Poisson mixed-effects model to predict smoking rate in 1-hour windows was developed to assess the contribution of each predictor.
RESULTS
In total, 8639 cigarettes and 1839 EMA surveys were tracked over 902 participant days. Most smokers were found to have an inaccurate and often biased estimate of their daily smoking rate compared with the measured smoking rate. Specifically, 74% (34/46) of the smokers made more than one (mean 4.7, SD 4.2 cigarettes per day) wrong estimate, and 70% (32/46) of the smokers overestimated it. On the basis of the timestamp of the tracked smoking events, smoking rates were visualized at different hours and were found to gradually increase and peak at 6 PM in the day. In addition, a 1- to 2-hour shift in smoking patterns was observed between weekdays and weekends. When moderate and heavy smokers were compared with light smokers, their ages (P<.05), Fagerström Test of Nicotine Dependence (P=.01), craving level (P<.001), enjoyment of cigarettes (P<.001), difficulty resisting smoking (P<.001), emotional valence (P<.001), and arousal (P<.001) were all found to be significantly different. In the Poisson mixed-effects model, the number of cigarettes smoked in a 1-hour time window was highly dependent on the smoking status of an individual (P<.001) and was explained by hour (P=.02) and age (P=.005).
CONCLUSIONS
This study reported the high potential and challenges of using an electronic lighter for smoking annotation and smoking-triggered EMAs in an ambulant environment. These results also validate the techniques for smoking behavior monitoring and pave the way for the design and deployment of technology-enabled smoking cessation applications.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-10.1136/bmjopen-2018-028284.
Topics: Humans; Smokers; Smoking; Smoking Cessation; Surveys and Questionnaires; Tobacco Use Disorder
PubMed: 35179512
DOI: 10.2196/28159 -
Preventive Medicine Sep 2019Cross-sectional data reveal that smoking cigarettes is highly prevalent among those who are food insecure. However, there is limited and conflicting evidence concerning... (Comparative Study)
Comparative Study
Cross-sectional data reveal that smoking cigarettes is highly prevalent among those who are food insecure. However, there is limited and conflicting evidence concerning whether causal factors may influence associations of food insecurity with smoking behavior. Additionally, temporality is a core feature of food insecurity that should be considered when examining linkages between food insecurity and health behaviors like smoking cessation. In 2019, data were extracted from waves 2012 and 2014 of the Health and Retirement Study-a representative sample of U.S. adults ≥50. Analyses were limited to those who smoked cigarettes in 2012 (n = 2197). Food insecurity was assessed in 2012 and 2014 to indicate food insecurity transitions: (1) initially food insecure (food insecure in 2012 only); (2) became food insecure (food insecure in 2014 only); (3) remained food insecure (food insecure in 2012 and 2014), and; (4) not food insecure (reference group). Multivariable logistic regression examined odds of smoking cessation in 2014 due to food insecurity transition. Becoming food insecure was associated with a 2.0 (95% confidence interval = 1.1-3.4) higher odds of smoking cessation. Employment loss or retirement (p < 0.020) and diagnosis of a new chronic condition (p = 0.026) were also associated with higher odds of smoking cessation. In older U.S. adults, smoking cessation was associated with decreased spending power and new health problems. Future studies should examine whether findings of this study may be similar among younger adults and; whether those who quit smoking due to food insecurity are more susceptible to relapse than those who quit due to other factors.
Topics: Aged; Cross-Sectional Studies; Female; Food Supply; Humans; Male; Middle Aged; Smoking; Smoking Cessation; Socioeconomic Factors; United States
PubMed: 31325523
DOI: 10.1016/j.ypmed.2019.105784 -
BMC Psychiatry Dec 2023Smoking is harmful, which has become a major public health burden. Physical activity may be related to smoking. Physical activity is one of the current methods for...
BACKGROUND
Smoking is harmful, which has become a major public health burden. Physical activity may be related to smoking. Physical activity is one of the current methods for smoking control and smoking cessation. Different types of physical activity may have different effect on smoking behavior.
OBJECTIVE
The purpose of this study was to identify the direction and extent of the impact of different types of physical activity above moderate intensity (including work physical activity, recreational physical activity, commuter physical activity and sedentary behavior) on smoking behavior.
MATERIALS AND METHODS
In this study, a total of 2,015 individuals (1,233 males and 782 females, mean age 54.02±17.31 years) was selected from the representative population aged 20 and above in the National Health and Nutrition Survey of the United States from 2017 to 2018. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) ; the tobacco use questionnaire (SMQ) was used to determine whether the sample had smoking behavior at this stage. Binary Logistic regression analysis was performed with various physical activities as independent variables and smoking behavior as dependent variables. All data were analyzed through Statistical Product and Service Solutions (SPSS) 26.0.
RESULTS
After adjusted for all confounding variables, physical activity at work was close to significantly associated with smoking behavior (P=0.053), odds ratio (OR) =1.135 (95%Cl: 0.999-1.289). Recreational physical activity was significantly associated with smoking behavior (P < 0.001), OR=0.729 (95%Cl: 0.639-0.832). Commuting physical activity was significantly associated with smoking behavior (P < 0.001), OR=1.214 (95%Cl:1.048-1.405). Sedentary behavior was significantly associated with smoking behavior (P < 0.001), OR=1.363 (95%Cl: 1.154-1.611).
CONCLUSIONS
Given that different types of physical activity have different associations with smoking behavior. Therefore, when physical activity is used as a tobacco control measurement, it is necessary to pay attention to the type and environment of physical activity. Recreational physical activities should be appropriately increased, sedentary behavior should be reduced, and smoking prohibit environment should be expanded as far as possible to achieve better clinical intervention effects.
Topics: Male; Female; Humans; United States; Adult; Middle Aged; Aged; Exercise; Surveys and Questionnaires; Smoking; Nutrition Surveys; Sedentary Behavior
PubMed: 38082223
DOI: 10.1186/s12888-023-05416-1 -
Addictive Behaviors Jul 2018China produces the majority of the world's electronic cigarettes (e-cigarettes) and e-cigarettes have become popular in the country, especially among young people.... (Comparative Study)
Comparative Study
OBJECTIVE
China produces the majority of the world's electronic cigarettes (e-cigarettes) and e-cigarettes have become popular in the country, especially among young people. However, little is known about the characteristics of e-cigarette use in China and how it is associated with smoking cessation behavior. This study focuses on the adolescent group in China and examines their perception and use of e-cigarettes and the association with smoking abstinence.
METHODS
We use a mobile app-based survey on smoking behavior conducted in November 2015 in China, and focus on a sample of 2042 adolescents aged between 12 and 18. Awareness, perception, use of e-cigarettes are examined as well as the behaviors of promoting e-cigarettes and of smoking cessation. A logistic regression is performed to test the association between e-cigarette use and smoking abstinence behavior.
RESULTS
In 2015, nearly 90% of the surveyed adolescents in China were aware of e-cigarettes, while over a quarter of the respondents were ever users. The odds ratio for ever users of e-cigarettes to have tried to quit smoking conventional cigarettes was 1.60 that of never users. For those who tried to quit smoking, 36.02% indicated that they used e-cigarettes to help quit. However, only 13.52% of those who had used e-cigarettes to help quit smoking were successful in quitting.
CONCLUSIONS
This study is one of the first empirical research on e-cigarette use among Chinese adolescents. E-cigarettes are widely known and quite popular among Chinese adolescents. As the association between e-cigarette use and smoking cessation behavior is less than clear, more empirical research is called for to help form evidence-based regulatory policy on e-cigarettes in China.
Topics: Adolescent; China; Correlation of Data; Cross-Cultural Comparison; Cross-Sectional Studies; Developing Countries; Female; Health Surveys; Humans; Male; Smoking Cessation; Vaping
PubMed: 29522934
DOI: 10.1016/j.addbeh.2018.02.029