-
Nature Communications Jan 2024This work aims to investigate how smoking exerts effect on the development of inflammatory bowel disease (IBD). A prospective cohort study and a Mendelian randomization...
This work aims to investigate how smoking exerts effect on the development of inflammatory bowel disease (IBD). A prospective cohort study and a Mendelian randomization study are first conducted to evaluate the association between smoking behaviors, smoking-related DNA methylation and the risks of Crohn's disease (CD) and ulcerative colitis (UC). We then perform both genome-wide methylation analysis and co-localization analysis to validate the observed associations. Compared to never smoking, current and previous smoking habits are associated with increased CD (P = 7.09 × 10) and UC (P < 2 × 10) risk, respectively. DNA methylation alteration at cg17742416 [DNMT3A] is linked to both CD (P = 7.30 × 10) and UC (P = 1.04 × 10) risk, while cg03599224 [LTA/TNF] is associated with CD risk (P = 1.91 × 10), and cg14647125 [AHRR] and cg23916896 [AHRR] are linked to UC risk (P = 0.001 and 0.002, respectively). Our study identifies biological mechanisms and pathways involved in the effects of smoking on the pathogenesis of IBD.
Topics: Humans; Smoking; DNA Methylation; Prospective Studies; Inflammatory Bowel Diseases; Crohn Disease; Colitis, Ulcerative; Repressor Proteins; Basic Helix-Loop-Helix Transcription Factors
PubMed: 38238335
DOI: 10.1038/s41467-024-44841-y -
Journal of Atherosclerosis and... Mar 2024The detrimental effects of cigarette smoking on cardiovascular health, particularly atherosclerosis and thrombosis, are well established, and more detailed mechanisms... (Review)
Review
The detrimental effects of cigarette smoking on cardiovascular health, particularly atherosclerosis and thrombosis, are well established, and more detailed mechanisms continue to emerge. As the fundamental pathophysiology of the adverse effects of smoking, endothelial dysfunction, inflammation, and thrombosis are considered to be particularly important. Cigarette smoke induces endothelial dysfunction, leading to impaired vascular dilation and hemostasis regulation. Factors contributing to endothelial dysfunction include reduced bioavailability of nitric oxide, increased levels of superoxide anion, and endothelin release. Chronic inflammation of the vascular wall is a central pathogenesis of smoking-induced atherosclerosis. Smoking systemically elevates inflammatory markers and induces the expression of adhesion molecules and cytokines in various tissues. Pattern recognition receptors and damage-associated molecular patterns play crucial roles in the mechanism underlying smoking-induced inflammation. Smoking-induced DNA damage and activation of innate immunity, such as the NLRP3 inflammasome, cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) pathway, and Toll-like receptor 9, are shown to amplify inflammatory cytokine expression. Cigarette smoke-induced oxidative stress and inflammation influence platelet adhesion, aggregation, and coagulation via adhesion molecule upregulation. Furthermore, it affects the coagulation cascade and fibrinolysis balance, causing thrombus formation. Matrix metalloproteinases contribute to plaque vulnerability and atherothrombotic events. The impact of smoking on inflammatory cells and adhesion molecules further intensifies the risk of atherothrombosis. Collectively, exposure to cigarette smoke exerts profound effects on endothelial function, inflammation, and thrombosis, contributing to the development and progression of atherosclerosis and atherothrombotic cardiovascular diseases. Understanding these intricate mechanisms highlights the urgent need for smoking cessation to protect cardiovascular health. This comprehensive review investigates the multifaceted mechanisms through which smoking contributes to these life-threatening conditions.
Topics: Humans; Cigarette Smoking; Cardiovascular Diseases; Smoking; Endothelium, Vascular; Atherosclerosis; Thrombosis; Inflammation
PubMed: 38220184
DOI: 10.5551/jat.RV22015 -
Global Health Action Dec 2023Offering cessation support to health professionals who smoke to ensure optimal implementation of cessation support for patients is a key recommendation of the WHO... (Review)
Review
BACKGROUND
Offering cessation support to health professionals who smoke to ensure optimal implementation of cessation support for patients is a key recommendation of the WHO Framework Convention on Tobacco Control Article 14 guidelines. However, direct efforts to support this population to quit are limited. Although numerous articles on the topic of tobacco use among health professionals have been published, the factors associated with their own cessation have not been systematically synthesised.
OBJECTIVE
We sought to synthesise existing literature on the predictors and processes informing attitudes and beliefs of smoking health professionals' own cessation.
METHODS
A five-step methodological framework for scoping reviews was followed. We conducted a systematic search of EMBASE, PubMed, Web of Science, and PsycINFO databases, as well as Google Scholar for relevant articles. Titles, abstracts, and full texts were screened against predefined criteria: research published between 1990 and 2021, in English-language peer-reviewed journals; participants included doctors, nurses, medical, and student nurses who smoke.
RESULTS
The initial search yielded 120, 883 articles, with 27 selected for synthesis. Prevalence estimates and predictors of smoking behaviour have remained the primary focus of smoking health professional research. Few studies explicitly examined the relevant predictors of quit attempts and quit attempt success. There is evidence that age and work environment factors predict quit attempt success in some health professional groups. There is also some evidence of tobacco smoking stigma experiences among nurses and nursing students who smoke.
CONCLUSION
Although cessation support is desperately needed for health professionals who smoke, the evidence for factors predicting quit success remains limited. To better guide future research, first, more theoretical work is required to identify the relevant predictors. Second, these should be tested using prospective research designs that take a multi-focal perspective to clarify the targets for change.
Topics: Humans; Smoking Cessation; Prospective Studies; Health Personnel; Smoking; Physicians
PubMed: 37254873
DOI: 10.1080/16549716.2023.2216068 -
Cardiovascular Diabetology Sep 2023Peripheral artery disease (PAD) is a major health problem with increased cardiovascular mortality, morbidity and disabling critical limb threatening ischemia (CLTI) and... (Review)
Review
Peripheral artery disease (PAD) is a major health problem with increased cardiovascular mortality, morbidity and disabling critical limb threatening ischemia (CLTI) and amputation. Diabetes mellitus (DM) and cigarette smoke are the main risk factors for the development of PAD. Although diabetes related PAD shows an accelerated course with worse outcome regarding complications, mortality and amputations compared with non-diabetic patients, current medical treatment does not make this distinction and includes standard antiplatelet and lipid lowering drugs for all patients with PAD. In this review we discuss the pathophysiologic mechanisms of PAD, with focus on differences in thrombo-inflammatory processes between diabetes-related and smoking-related PAD, and hypothesize on possible mechanisms for the progressive course of PAD in DM. Furthermore, we comment on current medical treatment and speculate on alternative medical drug options for patients with PAD and DM.
Topics: Humans; Peripheral Arterial Disease; Diabetic Angiopathies; Diabetic Neuropathies; Inflammation; Smoking; Diabetes Mellitus
PubMed: 37735399
DOI: 10.1186/s12933-023-01990-6 -
International Journal of Epidemiology Dec 2023In pregnancy, women are encouraged to cease smoking and limit caffeine intake. We employed objective definitions of smoking and caffeine exposure to assess their...
BACKGROUND
In pregnancy, women are encouraged to cease smoking and limit caffeine intake. We employed objective definitions of smoking and caffeine exposure to assess their association with adverse outcomes.
METHODS
We conducted a case cohort study within the Pregnancy Outcome Prediction study to analyse maternal serum metabolomics in samples from 12, 20, 28 and 36 weeks of gestational age. Objective smoking status was defined based on detectable cotinine levels at each time point and objective caffeine exposure was based on tertiles of paraxanthine levels at each time point. We used logistic and linear regression to examine the association between cotinine, paraxanthine and the risk of pre-eclampsia, spontaneous pre-term birth (sPTB), fetal growth restriction (FGR), gestational diabetes mellitus and birthweight.
RESULTS
There were 914 and 915 women in the smoking and caffeine analyses, respectively. Compared with no exposure to smoking, consistent exposure to smoking was associated with an increased risk of sPTB [adjusted odds ratio (aOR) = 2.58, 95% CI: 1.14 to 5.85)] and FGR (aOR = 4.07, 95% CI: 2.14 to 7.74) and lower birthweight (β = -387 g, 95% CI: -622 g to -153 g). On univariate analysis, consistently high levels of paraxanthine were associated with an increased risk of FGR but that association attenuated when adjusting for maternal characteristics and objective-but not self-reported-smoking status.
CONCLUSIONS
Based on objective data, consistent exposure to smoking throughout pregnancy was strongly associated with sPTB and FGR. High levels of paraxanthine were not independently associated with any of the studied outcomes and were confounded by smoking.
Topics: Pregnancy; Female; Humans; Pregnancy Outcome; Caffeine; Cohort Studies; Birth Weight; Cotinine; Smoking; Fetal Growth Retardation
PubMed: 37759082
DOI: 10.1093/ije/dyad123 -
Nature Communications Dec 2023Smoking is the leading risk factor for chronic obstructive pulmonary disease (COPD) worldwide, yet many people who never smoke develop COPD. We perform a longitudinal...
Smoking is the leading risk factor for chronic obstructive pulmonary disease (COPD) worldwide, yet many people who never smoke develop COPD. We perform a longitudinal analysis of COPD in the UK Biobank to derive and validate the Socioeconomic and Environmental Risk Score which captures additive and cumulative environmental, behavioral, and socioeconomic exposure risks beyond tobacco smoking. The Socioeconomic and Environmental Risk Score is more predictive of COPD than smoking status and pack-years. Individuals in the highest decile of the risk score have a greater risk for incident COPD compared to the remaining population. Never smokers in the highest decile of exposure risk are more likely to develop COPD than previous and current smokers in the lowest decile. In general, the prediction accuracy of the Social and Environmental Risk Score is lower in non-European populations. While smoking status is often considered in screening COPD, our finding highlights the importance of other non-smoking environmental and socioeconomic variables.
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Risk Factors; Smoking
PubMed: 38097585
DOI: 10.1038/s41467-023-44047-8 -
Gaceta Sanitaria 2023To investigate the causal relationship between poor lifestyle habits, such as smoking and drinking, and cutaneous malignant melanoma.
OBJECTIVE
To investigate the causal relationship between poor lifestyle habits, such as smoking and drinking, and cutaneous malignant melanoma.
METHOD
In the present study, alcohol consumption and smoking were used as exposure factors, and single nucleotide polymorphisms closely associated with alcohol consumption and smoking were used as instrumental variables, while cutaneous melanoma was set as an outcome variable. Two-sample Mendelian randomization analyses were run between alcohol consumption and melanoma and smoking and melanoma to investigate their causal associations, respectively.
RESULTS
We found a positive and statistically significant causal effect of alcohol intake on the risk of cutaneous malignant melanoma (OR: 2.23; 95%CI: 1.11-4.47; p=0.02). The present study showed no significant causal relationship between cigarettes per day and cutaneous melanoma (OR: 0.85; 95%CI: 0.54-1.35; p=0.50) or smoking initiation and cutaneous melanoma (OR: 1.02; 95%CI: 0.74-1.39; p=0.88).
CONCLUSIONS
This study provides Mendelian randomization evidence supporting alcohol consumption as a risk factor for cutaneous malignant melanoma. And the causal relationship between smoking and cutaneous malignant melanoma still needs to be further investigated.
Topics: Humans; Mendelian Randomization Analysis; Melanoma; Skin Neoplasms; Alcohol Drinking; Smoking; Risk Factors; Melanoma, Cutaneous Malignant
PubMed: 38052122
DOI: 10.1016/j.gaceta.2023.102351 -
Cardiovascular Diabetology Jul 2023We aimed to examine the association between smoking behavior change and risk of cardiovascular disease (CVD) incidence and mortality in patients with type 2 diabetes...
BACKGROUND
We aimed to examine the association between smoking behavior change and risk of cardiovascular disease (CVD) incidence and mortality in patients with type 2 diabetes mellitus (T2DM).
METHODS
This study used nationwide data from the Korean National Health Insurance System and included 349,137 T2DM patients who smoked. Smoking behavior changes were defined with five groups: quitters, reducers I (≥ 50% reduction), reducers II (20-50% reduction), sustainers (± 20%), and increasers (≥ 20% increase) from the number of cigarettes/day at the baseline.
RESULTS
During a median follow-up of 5.1 years, 6,514 cases of myocardial infarction (MI) (1.9%), 7,837 cases of ischemic stroke (IS) (2.2%), and 14,932 deaths (4.3%) were identified. Quitters had a significantly decreased risk of MI (adjusted hazard ratio [aHR] 0.80, 95% CI 0.75-0.86) and IS (aHR 0.80, 95% CI 0.75-0.85) compared to sustainers, whereas reducers did not have a significant association with the risk of MI (aHR 1.03, 95% CI 0.94-1.13) and IS (aHR 1.00, 95% CI 0.92-1.08) in reducer I. Quitters also had a lower all-cause and CVD mortality than sustainers.
CONCLUSIONS
Smoking cessation was associated with decreased CVD incidence, and all-cause and CVD mortality among T2DM patients. However, smoking reduction was not associated with decreased risks for these.
Topics: Humans; Incidence; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Smoking; Cardiovascular System; Myocardial Infarction; Ischemic Stroke
PubMed: 37516874
DOI: 10.1186/s12933-023-01930-4 -
JAMA Network Open Jan 2024Epidemiological studies have found that cannabis increases the risk of a motor vehicle collision. Cannabis use is increasing in older adults, but laboratory studies of...
IMPORTANCE
Epidemiological studies have found that cannabis increases the risk of a motor vehicle collision. Cannabis use is increasing in older adults, but laboratory studies of the association between cannabis and driving in people aged older than 65 years are lacking.
OBJECTIVE
To investigate the association between cannabis, simulated driving, and concurrent blood tetrahydrocannabinol (THC) levels in older adults.
DESIGN, SETTING, AND PARTICIPANTS
Using an ecologically valid counterbalanced design, in this cohort study, regular cannabis users operated a driving simulator before, 30 minutes after, and 180 minutes after smoking their preferred legal cannabis or after resting. This study was conducted in Toronto, Canada, between March and November 2022 with no follow-up period. Data were analyzed from December 2022 to February 2023.
EXPOSURES
Most participants chose THC-dominant cannabis with a mean (SD) content of 18.74% (6.12%) THC and 1.46% (3.37%) cannabidiol (CBD).
MAIN OUTCOMES AND MEASURES
The primary end point was SD of lateral position (SDLP, or weaving). Secondary outcomes were mean speed (MS), maximum speed, SD of speed, and reaction time. Driving was assessed under both single-task and dual-task (distracted) conditions. Blood THC and metabolites of THC and CBD were also measured at the time of the drives.
RESULTS
A total of 31 participants (21 male [68%]; 29 White [94%], 1 Latin American [3%], and 1 mixed race [3%]; mean [SD] age, 68.7 [3.5] years), completed all study procedures. SDLP was increased and MS was decreased at 30 but not 180 minutes after smoking cannabis compared with the control condition in both the single-task (SDLP effect size [ES], 0.30; b = 1.65; 95% CI, 0.37 to 2.93; MS ES, -0.58; b = -2.46; 95% CI, -3.56 to -1.36) and dual-task (SDLP ES, 0.27; b = 1.75; 95% CI, 0.21 to 3.28; MS ES, -0.47; b = -3.15; 95% CI, -5.05 to -1.24) conditions. Blood THC levels were significantly increased at 30 minutes but not 180 minutes. Blood THC was not correlated with SDLP or MS at 30 minutes, and SDLP was not correlated with MS. Subjective ratings remained elevated for 5 hours and participants reported that they were less willing to drive at 3 hours after smoking.
CONCLUSIONS AND RELEVANCE
In this cohort study, the findings suggested that older drivers should exercise caution after smoking cannabis.
Topics: Male; Humans; Aged; Cannabis; Cohort Studies; Hallucinogens; Marijuana Smoking; Cannabidiol; Cannabinoid Receptor Agonists
PubMed: 38236599
DOI: 10.1001/jamanetworkopen.2023.52233 -
United European Gastroenterology Journal Sep 2023Prior studies on the effect of smoking on the risk of colitis-associated colorectal neoplasia (CRN) have reported conflicting results. We aimed to further elucidate the...
BACKGROUND AND AIMS
Prior studies on the effect of smoking on the risk of colitis-associated colorectal neoplasia (CRN) have reported conflicting results. We aimed to further elucidate the association between smoking, including possible dose-effects, and the development of colorectal neoplasia in patients with inflammatory bowel disease (IBD).
METHODS
We performed a prospective multicenter cohort study including patients with colonic IBD enrolled in a surveillance program in four academic hospitals between 2011 and 2021. The effects of smoking status and pack-years at study entry on subsequent recurrent events of CRN (including indefinite, low- and high-grade dysplasia, and colorectal cancer [CRC]) were evaluated using uni- and multivariable Prentice, Williams, and Peterson total-time Cox proportional hazard models. Adjustment was performed for extensive disease, prior/index dysplasia, sex, age, first-degree relative with CRC, primary sclerosing cholangitis, and endoscopic inflammation.
RESULTS
In 501 of the enrolled 576 patients, at least one follow-up surveillance was performed after the study index (median follow-up 5 years). CRN occurred at least once in 105 patients. Ever smoking was not associated with recurrent CRN risk (adjusted hazard ratio [aHR] 1.04, 95% confidence interval [CI] 0.75-1.44), but an increasing number of pack-years was associated with an increased risk of recurrent CRN (aHR per 10 pack-years 1.17, 95% CI 1.03-1.32; p < 0.05). Separate analyses per IBD type did not reveal differences.
CONCLUSIONS
This study found that an increase in pack-years is associated with a higher risk of recurrent CRN in patients with IBD, independent of established CRN risk factors (NCT01464151).
Topics: Humans; Smoking; Colitis, Ulcerative; Cohort Studies; Prospective Studies; Neoplasm Recurrence, Local; Inflammatory Bowel Diseases; Colorectal Neoplasms
PubMed: 37505117
DOI: 10.1002/ueg2.12426