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BMC Public Health Jul 2016Estimated medical costs ("T") and QALYs ("Q") associated with smoking are frequently used in cost-utility analyses of tobacco control interventions. The goal of this... (Review)
Review
BACKGROUND
Estimated medical costs ("T") and QALYs ("Q") associated with smoking are frequently used in cost-utility analyses of tobacco control interventions. The goal of this study was to understand how researchers have addressed the methodological challenges involved in estimating these parameters.
METHODS
Data were collected as part of a systematic review of tobacco modeling studies. We searched five electronic databases on July 1, 2013 with no date restrictions and synthesized studies qualitatively. Studies were eligible for the current analysis if they were U.S.-based, provided an estimate for Q, and used a societal perspective and lifetime analytic horizon to estimate T. We identified common methods and frequently cited sources used to obtain these estimates.
RESULTS
Across all 18 studies included in this review, 50 % cited a 1992 source to estimate the medical costs associated with smoking and 56 % cited a 1996 study to derive the estimate for QALYs saved by quitting or preventing smoking. Approaches for estimating T varied dramatically among the studies included in this review. T was valued as a positive number, negative number and $0; five studies did not include estimates for T in their analyses. The most commonly cited source for Q based its estimate on the Health Utilities Index (HUI). Several papers also cited sources that based their estimates for Q on the Quality of Well-Being Scale and the EuroQol five dimensions questionnaire (EQ-5D).
CONCLUSIONS
Current estimates of the lifetime medical care costs and the QALYs associated with smoking are dated and do not reflect the latest evidence on the health effects of smoking, nor the current costs and benefits of smoking cessation and prevention. Given these limitations, we recommend that researchers conducting economic evaluations of tobacco control interventions perform extensive sensitivity analyses around these parameter estimates.
Topics: Adolescent; Adult; Female; Health Care Costs; Humans; Male; Middle Aged; Quality-Adjusted Life Years; Smoking; Smoking Cessation; Tobacco Products; Young Adult
PubMed: 27460828
DOI: 10.1186/s12889-016-3319-z -
JAMA Dec 2007Observational studies have suggested an association between active smoking and the incidence of type 2 diabetes. (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Observational studies have suggested an association between active smoking and the incidence of type 2 diabetes.
OBJECTIVE
To conduct a systematic review with meta-analysis of studies assessing the association between active smoking and incidence of type 2 diabetes.
DATA SOURCES
A search of MEDLINE (1966 to May 2007) and EMBASE (1980 to May 2007) databases was supplemented by manual searches of bibliographies of key retrieved articles, reviews of abstracts from scientific meetings, and contact with experts.
STUDY SELECTION
Studies were included if they reported risk of impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes in relationship to smoking status at baseline; had a cohort design; and excluded persons with diabetes at baseline.
DATA EXTRACTION AND DATA SYNTHESIS
Two authors independently extracted the data, including the presence or absence of active smoking at baseline, the risk of diabetes, methods used to detect diabetes, and key criteria of study quality. Relative risks (RRs) were pooled using a random-effects model. Associations were tested in subgroups representing different patient characteristics and study quality criteria.
RESULTS
The search yielded 25 prospective cohort studies (N = 1.2 million participants) that reported 45 844 incident cases of diabetes during a study follow-up period ranging from 5 to 30 years. Of the 25 studies, 24 reported adjusted RRs greater than 1 (range for all studies, 0.82-3.74). The pooled adjusted RR was 1.44 (95% confidence interval [CI], 1.31-1.58). Results were consistent and statistically significant in all subgroups. The risk of diabetes was greater for heavy smokers (> or =20 cigarettes/day; RR, 1.61; 95% CI, 1.43-1.80) than for lighter smokers (RR,1.29; 95% CI, 1.13-1.48) and lower for former smokers (RR, 1.23; 95% CI, 1.14-1.33) compared with active smokers, consistent with a dose-response phenomenon.
CONCLUSION
Active smoking is associated with an increased risk of type 2 diabetes. Future research should attempt to establish whether this association is causal and to clarify its mechanisms.
Topics: Diabetes Mellitus, Type 2; Humans; Risk Factors; Smoking
PubMed: 18073361
DOI: 10.1001/jama.298.22.2654 -
Cancer Causes & Control : CCC Sep 2008We conducted a systematic review of studies addressing the relation between cigarette smoking and gastric cancer to estimate the magnitude of the association for... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
We conducted a systematic review of studies addressing the relation between cigarette smoking and gastric cancer to estimate the magnitude of the association for different levels of exposure and cancer locations.
METHODS
Published cohort, case-cohort, and nested case-control studies were identified through PubMed, Scopus, and Web of Science searches, from inception to July 2007. Relative risk (RR) estimates referring to the comparison of two categories of exposure (e.g., current smokers vs. never smokers) were combined using a random effects model. Generalized least squares regression was used for trend estimation. Heterogeneity was quantified using the I (2) statistic.
RESULTS
Forty-two articles were considered for the systematic review. Comparing current smokers with never smokers: the summary RR estimates were 1.62 in males (95% CI: 1.50-1.75; I (2) = 46.0%; 18 studies) and 1.20 in females (95% CI: 1.01-1.43; I (2) = 49.8%; nine studies); the RR increased from 1.3 for the lowest consumptions to 1.7 for the smoking of approximately 30 cigarettes per day in the trend estimation analysis; smoking was significantly associated with both cardia (RR = 1.87; 95% CI: 1.31-2.67; I (2) = 73.2%; nine studies) and non-cardia (RR = 1.60; 95% CI: 1.41-1.80; I (2) = 18.9%; nine studies) cancers.
CONCLUSION
Our study provides solid evidence to classify smoking as the most important behavioral risk factor for gastric cancer.
Topics: Cohort Studies; Confidence Intervals; Female; Humans; Logistic Models; Male; Risk Factors; Sensitivity and Specificity; Smoking; Stomach Neoplasms
PubMed: 18293090
DOI: 10.1007/s10552-008-9132-y -
BMC Medicine Oct 2012Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability... (Review)
Review
BACKGROUND
Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective), the population assessed (random sample versus clinical population) and diagnostic instrument utilized.
METHODS
We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD)) for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders.
RESULTS
In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder), although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified.
CONCLUSIONS
Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as increasing the risk of panic disorder and generalized anxiety disorder. The literature assessing anxiety disorders increasing smoking and nicotine dependence is inconsistent. Potential issues with the current literature are discussed and directions for future research are suggested.
Topics: Anxiety Disorders; Epidemiologic Studies; Humans; Smoking; Tobacco Use Disorder
PubMed: 23083451
DOI: 10.1186/1741-7015-10-123 -
Critical Care (London, England) Apr 2024The relationship between smoking and the risk of acute respiratory distress syndrome (ARDS) has been recognized, but the conclusions have been inconsistent. This... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The relationship between smoking and the risk of acute respiratory distress syndrome (ARDS) has been recognized, but the conclusions have been inconsistent. This systematic review and meta-analysis investigated the association between smoking and ARDS risk in adults.
METHODS
The PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched for eligible studies published from January 1, 2000, to December 31, 2023. We enrolled adult patients exhibiting clinical risk factors for ARDS and smoking condition. Outcomes were quantified using odds ratios (ORs) for binary variables and mean differences (MDs) for continuous variables, with a standard 95% confidence interval (CI).
RESULTS
A total of 26 observational studies involving 36,995 patients were included. The meta-analysis revealed a significant association between smoking and an increased risk of ARDS (OR 1.67; 95% CI 1.33-2.08; P < 0.001). Further analysis revealed that the associations between patient-reported smoking history and ARDS occurrence were generally similar to the results of all the studies (OR 1.78; 95% CI 1.38-2.28; P < 0.001). In contrast, patients identified through the detection of tobacco metabolites (cotinine, a metabolite of nicotine, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a metabolite of tobacco products) showed no significant difference in ARDS risk (OR 1.19; 95% CI 0.69-2.05; P = 0.53). The smoking group was younger than the control group (MD - 7.15; 95% CI - 11.58 to - 2.72; P = 0.002). Subgroup analysis revealed that smoking notably elevated the incidence of ARDS with extrapulmonary etiologies (OR 1.85; 95% CI 1.43-2.38; P < 0.001). Publication bias did not affect the integrity of our conclusions. Sensitivity analysis further reinforced the reliability of our aggregated outcomes.
CONCLUSIONS
There is a strong association between smoking and elevated ARDS risk. This emphasizes the need for thorough assessment of patients' smoking status, urging healthcare providers to vigilantly monitor individuals with a history of smoking, especially those with additional extrapulmonary risk factors for ARDS.
Topics: Adult; Humans; Reproducibility of Results; Smoking; Risk Factors; 1-Butanol; Respiratory Distress Syndrome
PubMed: 38616271
DOI: 10.1186/s13054-024-04902-6 -
Journal of Public Health Management and...Worldwide, the number of cigarette smokers is increasing. All tobacco products come in packs. Packaging and branding are important elements of advertising and promotion....
CONTEXT
Worldwide, the number of cigarette smokers is increasing. All tobacco products come in packs. Packaging and branding are important elements of advertising and promotion. The plain packaging concept introduced by the World Health Organization, where marketing elements such as branding appeal are removed from the cigarette pack, is said to be effective for reducing smoking habits. The objective of this systematic review was to determine the influence of plain packaging on smoking behavior.
METHOD
This systematic review was conducted using 2 databases (Scopus and Web of Science). We did not search for unpublished reports. The search was performed from September 2020 to December 2020 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The inclusion criteria were original article that used a qualitative or quantitative method, English-language article, published in 2016-2020, and availability of full-text article.
RESULTS
A total of 15 studies were included. All of the studies had adequate methodological quality. Most of the studies reported the effectiveness of plain packaging in preventing smoking initiation among nonsmokers. However, more studies reported no effect of plain packaging on smoking behavior among smokers. Furthermore, there was a greater impact of plain packaging on smoking behavior among female smokers and those who had recently started smoking.
CONCLUSIONS
Plain packaging is more effective for evoking negative smoking behavior among nonsmokers than among smokers. As many of the included studies did not stratify the results based on age group and gender, future research should address these issues.
Topics: Female; Humans; Marketing; Product Packaging; Smoking; Smoking Prevention; Tobacco Products
PubMed: 35452436
DOI: 10.1097/PHH.0000000000001517 -
BMC Geriatrics Dec 2008Nicotine may aid reaction time, learning and memory, but smoking increases cardiovascular risk. Cardiovascular risk factors have been linked to increased risk of... (Review)
Review
BACKGROUND
Nicotine may aid reaction time, learning and memory, but smoking increases cardiovascular risk. Cardiovascular risk factors have been linked to increased risk of dementia. A previous meta-analysis found that current smokers were at higher risk of subsequent dementia, Alzheimer's disease, vascular dementia and cognitive decline.
METHODS
In order to update and examine this further a systematic review and meta-analysis was carried out using different search and inclusion criteria, database selection and more recent publications. Both reviews were restricted to those aged 65 and over.
RESULTS
The review reported here found a significantly increased risk of Alzheimer's disease with current smoking and a likely but not significantly increased risk of vascular dementia, dementia unspecified and cognitive decline. Neither review found clear relationships with former smoking.
CONCLUSION
Current smoking increases risk of Alzheimer's disease and may increase risk of other dementias. This reinforces need for smoking cessation, particularly aged 65 and over. Nicotine alone needs further investigation.
Topics: Aged; Aging; Cognition Disorders; Dementia; Humans; Risk Factors; Smoking
PubMed: 19105840
DOI: 10.1186/1471-2318-8-36 -
BMJ Open Jun 2022Although the global COVID-19 pandemic has increased interest in research involving high-risk smokers, studies examining changed smoking behaviours, cessation intentions...
OBJECTIVES
Although the global COVID-19 pandemic has increased interest in research involving high-risk smokers, studies examining changed smoking behaviours, cessation intentions and associated psychological states among smokers are still scarce. This study aimed to systematically review the literature related to this subject.
DESIGN
A systematic review of published articles on cigarettes and -related topics DATA SOURCES: Our search was conducted in January 2021. We used the keywords COVID-19, cigarettes, electronic cigarettes (e-cigarettes) and psychological factors in PubMed and ScienceDirect and found papers published between January and December 2020.
DATA SELECTION
We included articles in full text, written in English, and that surveyed adults. The topics included smoking behaviour, smoking cessation, psychological state of smokers and COVID-19-related topics.
DATA EXTRACTION AND SYNTHESIS
Papers of low quality, based on quality assessment, were excluded. Thirteen papers were related to smoking behaviour, nine papers were related to smoking cessation and four papers were related to psychological states of smokers.
RESULTS
Owing to the COVID-19 lockdown, cigarette users were habituated to purchasing large quantities of cigarettes in advance. Additionally, cigarette-only users increased their attempts and willingness to quit smoking, compared with e-cigarette-only users.
CONCLUSIONS
Owing to the COVID-19 outbreak, the intention to quit smoking was different among smokers, according to cigarette type (cigarette-only users, e-cigarette-only users and dual users). With the ongoing COVID-19 pandemic, policies and campaigns to increase smoking cessation intentions and attempts to quit smoking among smokers at high risk of COVID-19 should be implemented. Additionally, e-cigarette-only users with poor health-seeking behaviour require interventions to increase the intention to quit smoking.
Topics: Adult; COVID-19; Communicable Disease Control; Electronic Nicotine Delivery Systems; Humans; Pandemics; Smokers; Smoking; Smoking Cessation; Tobacco Products
PubMed: 35701057
DOI: 10.1136/bmjopen-2021-055179 -
Critical Reviews in Oncology/hematology Apr 2024Smoking history is a heterogeneous situation for different populations, and numerous studies suggest that smoking cessation is conducive to reduce the mortality of lung... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Smoking history is a heterogeneous situation for different populations, and numerous studies suggest that smoking cessation is conducive to reduce the mortality of lung cancer. However, no quantitative meta-analysis regarding smoking cessation duration based on different populations has demonstrated it clearly.
METHODS
We systematically searched four electronic databases (PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Scoups) till February 2023. Eligible studies reported the association between lung cancer survival and duration of smoking cessation. Additionally, we stratified the study population according to whether they had lung cancer at the time they quit smoking. Studies were pooled with the random-effects model.
RESULTS
Out of the 11,361 potential studies initially identified, we included 24 studies involving 969,560 individuals in our analysis. Lung cancer mortality varied across two groups: general quitters and peri-diagnosis quitters. For general quitters, those who had quit smoking for less than 10 years exhibited an RR of 0.64 (95% CI [0.55-0.76]), while those who quit for 10-20 years had an RR of 0.33 (0.25-0.43), over 20 years had an RR of 0.16 (0.11-0.24), and never-smokers had an RR at 0.11 (0.07-0.15). Among peri-diagnosis quitters, the 1-year Overall Survival (OS) showed an RR of 0.80 (0.67-0.96), the 2-year OS had an RR of 0.89 (0.80-0.98), the 3-year OS had an RR of 0.93 (0.84-1.03), and the 5-year OS had an RR of 0.85 (0.76-0.96).
CONCLUSIONS
Earlier and longer smoking cessation is associated with reduced lung cancer mortality, no matter in which cessation stage for two different populations.
Topics: Humans; Smoking Cessation; Lung Neoplasms; Smoking; Tobacco Smoking
PubMed: 38462148
DOI: 10.1016/j.critrevonc.2024.104323 -
Journal of Glaucoma 2008To evaluate the epidemiologic evidence for a causal association between tobacco smoking and primary open angle glaucoma (POAG). (Review)
Review
PURPOSE
To evaluate the epidemiologic evidence for a causal association between tobacco smoking and primary open angle glaucoma (POAG).
METHODS
Systematic review, including quality assessment, of published analytical epidemiologic studies and evaluation of the evidence using established causality criteria (strength, consistency, temporality, dose response, reversibility, and biologic plausibility).
RESULTS
Eleven papers describing 9 case-control studies, 1 prospective cohort study, and a paper describing a pooled analysis based on 2 prospective cohort studies were included in the review. The methodologic quality of most included studies was poor. The strongest studies methodologically were the cohort studies on which the pooled analysis was based. Neither the prospective cohort study (rate ratio not reported) nor the pooled analysis of 2 prospective cohort studies (adjusted rate ratio 0.9) found an association between smoking and POAG. There was a significant positive association between smoking and POAG in only 2 of the case-control studies (adjusted odds ratio 2.9 and 10.8). There was no evidence of a dose-response relationship with smoking or of reversibility of effect in the studies where this was assessed.
CONCLUSIONS
This systematic review provided little evidence for a causal association between smoking and development of POAG. Given the limited evidence from high quality studies, and the possibility that flaws in many of the studies reviewed biased the results toward the null, further high quality research to confirm our conclusions is needed. However, it remains important to warn ophthalmic patients of the dangers of smoking and provide cessation support owing to the clear evidence of links between smoking and other ocular and systemic diseases.
Topics: Chronic Disease; Epidemiologic Studies; Glaucoma, Open-Angle; Humans; Smoking
PubMed: 18854733
DOI: 10.1097/IJG.0b013e31815f530c