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Mortality in relation to smoking: 50 years' observations on male British doctors
... The percentage of smokers among lung cancer patients is approximately 80-90% [15][16][17]. It is believed that the risk of disease increases with the number of cigarettes smoked and the duration of smoking, expressed in so-called pack-years [18,19]. ...
... The risk of developing lung cancer depends primarily on the duration of the addiction and the number of cigarettes smoked. Smoking 1-4 cigarettes a day increases the risk of lung cancer 3-fold in men and 5-fold in women [11][12][13][14][16][17][18][24][25][26]32,33]. ...
... Furthermore, successful abstinence from smoking has important short-and long-term patient-centered effects by reducing symptoms and improving lung function [18,38]. ...
Introduction. Smoking is associated with respiratory diseases. Despite declining smoking rates, asthma and chronic bronchitis cases rose between 2014 and 2019. Quitting smoking is vital for managing asthma and reducing the risks of bronchitis and lung cancer. Aim. A correlational study of smoking prevalence and its association with asthma, bronchitis and lung cancer in people from Malta, Poland and the EU in 2008/2014/2019. Materials and methods. Integration and comparison of statistical data from EUROSTAT – (EHIS) 2008/2014/2019, ISAAC; ESPAD, 2014/2015, ECIS 2020. Results. Smoking habits exhibit notable gender disparities, with 24% of Polish men and 23% of Maltese men being regular smokers, compared to women (Poland – 15%, Malta – 16%). While male smoking rates have declined, especially in Poland, female rates persist. In 2019, asthma affected 5.6% of the EU adult population, with Poland at 4.1% and Malta at 6%. Chronic bronchitis is more prevalent in Poland (3%) than Malta (1%). In 2020, lung cancer rates among men varied slightly between Poland and Malta (120.0; 100.3 per 100.000). However, the incidence among women is twice as high in Poland (53.1; 23.9 per 100.000). Conclusions. Malta’s elevated asthma rate, despite comparable smoking rates, hints at additional risk factors like traffic. Poland’s increased bronchitis rate likely stems from higher historical smoking. The doubled lung cancer incidence in Polish women suggests a passive smoking connection. The burden of bronchitis intensifies due to high smoking rates in men over 50. Addressing smoking rates can potentially address respiratory disease rates, but other risk factors should also be identified and managed. Keywords: tobacco smoking, asthma, bronchitis, lung cancer.
... According to Cancer Research UK, 72% of lung cancers are caused by smoking (CRUK 2018). It has been reported that smokers who undergo lung cancer surgery have more severe pain (Action on Smoking and Health 2021), lower quality of life (Doll et al. 2004), longer hospital stays (Halpern et al. 1993), a higher risk of postoperative complications (Burnham 2023), and a higher death rate than nonsmokers (Khan 2022). Smoking cessation at any age or stage would significantly reduce the risk of lung cancer (Doll et al. 2004;Halpern et al. 1993), and nearly 60% of smokers wish to quit,however, 95% of unsupported quit attempts result in a relapse within a year (Burnham 2023). ...
... It has been reported that smokers who undergo lung cancer surgery have more severe pain (Action on Smoking and Health 2021), lower quality of life (Doll et al. 2004), longer hospital stays (Halpern et al. 1993), a higher risk of postoperative complications (Burnham 2023), and a higher death rate than nonsmokers (Khan 2022). Smoking cessation at any age or stage would significantly reduce the risk of lung cancer (Doll et al. 2004;Halpern et al. 1993), and nearly 60% of smokers wish to quit,however, 95% of unsupported quit attempts result in a relapse within a year (Burnham 2023). ...
Background
Smoking is the leading single cause of preventable death in England and also increases the risk of postoperative complications. The preoperative period is a potential opportunity to introduce smoking cessation interventions to smokers to reduce the risk of postoperative complications. A systematic search was conducted to find all studies that investigated the effectiveness of preoperative smoking cessation interventions. The primary outcome was smoking cessation at surgical time to the last follow-up, and the secondary outcome was postoperative complications that required treatment or ICU admission. A random-effects meta-analysis was used to synthesize the outcomes. Sixteen studies were included in the review (3505 participants), and 14 studies were included in the meta-analysis (2940 randomized participants). The quality of evidence was moderate due to the high risk of bias and heterogeneity. We found that patients who were provided with a smoking cessation intervention had significantly increased odds of quitting smoking by the time of surgery compared with usual care, with a reported relative risk (95% CI) 1.64 (1.30–2.07) and at the longest follow-ups with RR (95% CI) 1.38 (1.12–1.70). Moreover, there was no difference found in the rate of postoperative complications between intervention and control conditions with RR (95% CI) 0.81 (0.62–1.06). The use of standardized outcome measurements is recommended to reduce heterogeneity for future studies, and further investigation focusing on patient perspectives is needed.
Trial registration
PROSPERO CRD42023423202.
... Tobacco smoking is a leading cause of preventable deaths worldwide and increases the likelihood of developing cardiovascular disease, respiratory disease and certain cancers [1,2]. Although many smokers want to quit smoking, only 33% attempt to quit [2] and up to 80% relapse within the first 6 months [3,4]. ...
... Using data from a large, population-based cohort of United Kingdom (UK) adults, the aims of the present study were twofold: (1) to examine the associations of smoking with different eating and dietary behaviours; and (2) to explore whether these associations were moderated by age, sex and socio-economic status. Based on existing evidence, we hypothesised that smoking would be associated with a greater likelihood of eating and dietary behaviours related to lower food/energy intake and lower dietary quality. ...
Background and aims
Smokers typically have a lower body mass index (BMI) than non‐smokers, while smoking cessation is associated with weight gain. In pre‐clinical research, nicotine in tobacco smoking suppresses appetite and influences subsequent eating behaviour; however, this relationship is unclear in humans. This study measured the associations of smoking with different eating and dietary behaviours.
Design
A cross‐sectional analysis of data from health assessments conducted between 2004 and 2022.
Setting
An independent healthcare‐based charity within the United Kingdom.
Participants
A total of 80 296 men and women (mean ± standard deviation [SD]: age, 43.0 ± 10.4 years; BMI, 25.7 ± 4.2 kg/m ² ; 62.5% male) stratified into two groups based on their status as a smoker ( n = 6042; 7.5%) or non‐smoker ( n = 74 254; 92.5%).
Measurements
Smoking status (self‐report) was the main exposure, while the primary outcomes were selected eating and dietary behaviours. Age, sex and socioeconomic status (index of multiple deprivation [IMD]) were included as covariates and interaction terms, while moderate‐to‐vigorous exercise and sleep quality were included as covariates only.
Findings
Smokers had lower odds of snacking between meals and eating food as a reward or out of boredom versus non‐smokers (all odds ratio [OR] ≤ 0.82; P < 0.001). Furthermore, smokers had higher odds of skipping meals, going more than 3 h without food, adding salt and sugar to their food, overeating and finding it hard to leave something on their plate versus non‐smokers (all OR ≥ 1.06; P ≤ 0.030). Additionally, compared with non‐smokers, smoking was associated with eating fried food more times per week (rate ratio [RR] = 1.08; P < 0.001), eating fewer meals per day, eating sweet foods between meals and eating dessert on fewer days per week (all RR ≤ 0.93; P < 0.001). Several of these relationships were modified by age, sex and IMD.
Conclusions
Smoking appears to be associated with eating and dietary behaviours consistent with inhibited food intake, low diet quality and altered food preference. Several of these relationships are moderated by age, sex and socioeconomic status.
... Cigarette smoking is widely recognized as a major risk factor for ischemic heart disease (IHD) in Western countries (Kannel, WB., 1996;Doll, R., 2002). In Korean populations, low cholesterol levels were found not to provide a protective effect against smoking-related cardiovascular disease (CVD) and atherosclerotic cardiovascular disease (ASCVD) in women (Sun, H., 2006). ...
This study examined the differences in plasma levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TGs) among a sample of individuals free from cardiovascular disease. The aim was to determine the effects of smoking and physical activity, as well as the influence of these factors, on the incidence of ischemic heart disease and stroke. The research included a total of 902 participants, of whom 412 were current smokers and 490 engaged in aerobic exercise. Enzymatic colorimetric methods were used to analyze all studied parameters. The results showed that, for both sexes, smokers had higher levels of plasma total cholesterol, LDL-C, and TGs compared to non-smokers, while HDL-C levels were inversely correlated with smoking. Significant changes were observed in individuals who smoked more than nine cigarettes per day, while those who smoked fewer than ten cigarettes per day showed only minor effects. Regular physical activity was found to improve the plasma lipid profile (total cholesterol, LDL-C, and TGs), with reductions in these parameters depending on the frequency, intensity, and duration of exercise, as measured by the FIT (Frequency, Intensity, Time) scoring of physical activity. Notable reductions were seen only in those who regularly performed aerobic exercise, while HDL-C levels positively correlated with FIT scores and significantly increased only in those with an active lifestyle. Furthermore, no significant differences were found between males and females in any of the parameters tested, regardless of smoking or physical activity.
... [5][6][7][8][9] Studies have established a strong link between tobacco smoking and an elevated risk for esophageal cancer. [10][11][12] Specifically, the risk associated with smoking can increase from twofold to tenfold depending on the study design and sample size. The risk of esophageal cancer is modulated by both the intensity and the duration of smoking; however, empirical evidence suggests that the duration of exposure exerts a more significant influence than the intensity. ...
Esophageal cancer continues to pose a significant public health issue in areas with increased incidence rates such as China. Although involuntary smoking was defined as a group 1 carcinogen for lung cancer, few studies have explored the impact of environmental tobacco smoking (ETS) on esophageal cancer. In this paper, we examined the association between ETS and esophageal cancer in high‐risk groups in Jiangsu Province, China. Epidemiologic data were collected for 2969 newly diagnosed cases and 8019 population controls including exposure to active/passive smoking and risk factors. The unconditional logistic regression model and the semi‐Bayes (SB) method were applied to assess adjusted odds ratios (ORs) and confidence intervals (CIs). ETS exposure (ever vs. never) was positively associated with esophageal cancer with an SB‐adjusted OR (95% CI) of 1.44 (1.31–1.58) among overall population, and 1.56 (1.35–1.82) among non‐smokers (i.e., non‐active smokers), with corresponding population attributable fractions of 15.0% (95% CI: 10.3%–18.9%) and 12.1% (95% CI: 8.8%–19.8%), respectively. The association was more prominent in men at work and in women at home, with SB‐adjusted OR (95% CI) of 1.36 (1.17–1.58) and 1.61 (1.35–1.58), respectively. A dose–response relationship between ETS exposure and the disease was detected across the entire population as well as in non‐smokers. This is the largest population‐based case–control study of ETS and esophageal cancer and the first study to evaluate such association among non‐smokers in a Chinese population. We recommend strengthening the ongoing anti‐tobacco public health initiatives in China with a particular emphasis on creating a tobacco‐free work/home environment.
... Predictors of death due to COPD are period of smoking, packets per year and timely smoking status [13]. Active smoking in adulthood causes a early decrease in lung functions by age rate of decrease increases as the amount of cigarettes increases. ...
Objective: Chronic Obstructive Pulmonary Disease (COPD) is the fourth most common cause of death in the world according to the reports of the World Health Organisation (WHO). Exacerbations impair the quality of life, fastens the progression of the disease and, thus, plays an important role in the morbidity and mortality of the disease. In this study with, we aimed to investigate the factors effecting the characteristics of the patients admitted to our emergency department (ED) due to COPD exacerbation in term of management, dischargement, hospitalization and death. Method: This retrospective study was approved by the Local Ethic Comitee of Ankara Numune Education and Research Hospital. This study consists of 106 patients with diagnosis of COPD. Results: Into our study, 106 patients were included. Of these patients, 58 were male and 48 were female, and mean age was 67.62±11.67. 56 of our patients expressed that they were active smokers, 19 expressed that they gave up smoking and 56 expressed that they have never smoke. In the last year, mean number of exacerbations was 10.1±6.1. While 50 (47.2%) patients were discharged from the ED, others were hospitalized or transferred to other hospitals. 15 patients were transferred to the ICU. Mean age of these patients was 76.13±12.03 (p= 0.002). 8 patients admitted to the ICU were smokers and mean smoking period was 42.88 ± 7.58 years. Inpatients not transferred to the ICU, this period was 35.26±11.12 years (p= 0.035). In the ED and ICU 11 deaths (10.37%) occured. 9 patients did not know the drugs they use at home (p= 0.026). Exacerbation frequency in the past year was 14.45 ± 5.7 (p= 0.008). 1 patient who died had undergone NIMV followed by IMV and 10 patients had undergone IMV. None of the patients in our study were vaccinated. We determined that smoking is the most important ethiological factor. Conclusion: We also determined that main target to reduce the frequency of annual exacerbations is patient education and patient concordance. When compared to mono therapy, combined inhaler therapy reduced the frequency of exacerbations and increases the rate of discharge.
Цель: В соответствии с отчетом Всемирной Организации Здравоохранения (ВОЗ), хроническая обструктивная болезнь легких (ХОБЛ) является четвертой в структуре наиболее значимых причин смертей в мире. Обострения заболевания приводят к снижению качества жизни, быстрому прогрессированию и, соответственно, повышению показателей смертности от ХОБЛ. Целью настоящего исследования явилось изучение факторов, влияющих на ведение, госпитализацию, выписку и смерть пациентов, поступивших в отделение неотложной медицины (ED) в связи с обострением ХОБЛ. Методы: Исследование является ретроспективным анализом. Оно получило одобрение местного этического комитета Научно-исследовательского госпиталя больницы Нумуне, Анкара. В исследование было включено 106 пациентов с диагнозом ХОБЛ. Результаты: Из 106 пациентов, участвовавших в исследовании, было 58 мужчин и 48 женщин в среднем возрасте 67.62±11.67 лет. Активными курильщиками являлись 56 пациентов, 19 отказались от курения и 56 отрицали курение в прошлом. В течение предыдущего года среднее число обострений составило 10.1±6.1. Пятьдесят (47,2%) пациентов были выписаны из ED, остальные были госпитализированы или переведены в другие больницы. 15 больных в среднем возрасте 76.13±12.03 лет (p= 0.002) были переведены в отделение интенсивной терапии, из них 8 были курильщиками со средней продолжительностью курения 42.88 ± 7.58 лет. Для остальных пациентов этот период составил 35.26±11.12 лет (p=0.035). В отделении интенсивной терапии и ED отмечено 11 случаев смерти (10.37%). 9 пациентов не помнили, какими препаратами они лечатся амбулаторно (p=0.026). Средняя частота обострений за предыдущий год была 14.45 ± 5.7 лет (p=0.008). Десять больных получали неинвазивную механическую вентиляцию, из них один пациент умер. Ни один из участников исследования не прошел вакцинацию. Курение оказалось наиболее важным этиологическим фактором болезни. Заключение: Мы определили, что основным способом снижения частоты ежегодных обострений ХОБЛ является образование пациентов и взаимодействие с ними. Комбинированная ингаляционнаятерапия снижает частоту обострений и повышает показатели выписки пациентов в сравнении с монотерапией.
Мақсаты: Дүниежүзілік Денсаулық сақтау Ұйымының есебіне сәйкес, Өкпенің созылмалы обструктивті ауруының асқынуыдүниежүзіндегі өлім–жітімдердің ең барынша себептерінің құрылымнда төртінші болыптабылады. Аурулардың асқынуы өмір сапасының төмендеуіне әкеледі, және тиісінше өкпенің созылмалы обструктивті ауруының асқынуынан өлім–жітім көрсеткіштері артады. Біздің зертетудің мақсаты өкпенің созылмалы обструктивті ауруының асқынуына байланысты шұғыл медицина бөліміне (ED) түсетін пацтиенттерді жүргізуге, госпитализацияға, шығаруға және өлімге әсер ететін факторларды зерделеу болып табылады. Әдістері: Зерттеу ретроспективті талдау болып табылады. Ол Анкара, Нумуне Ғылыми–зерттеу госпиталі ауруханасының жергілікті этикалық комитетімен қолдау тапты. Зерттеуге өкпенің созылмалы обструктивті ауруының асқынуыөкпенің созылмалы обструктивті ауруының асқынуыдиагнозымен 106 пациент енгізілді. Нәтижелері: Зерттеуге қатысқан 106 пациенттің ішінде 58 ер адам және 48 әйел орташа жастары 67.62±11.67 жас. Белсенді шылым шегушілер 56 пациент,19 шылым шегуден бас тартқандар және 56 бұрын шылым шекпегендер. Алдыңғы жыл бойы асқынулардың орташа саны 10.1±6.1 құрады. Елу пациент (47,2%) ED шығарылды, қалғандары госпитализацияланды немес басқа ауруханаларға ауыстырылды. 15 науқастың орташа жасы 76.13±12.03 жас (p = 0.002) қарқынды терапия бөлімшесіне ауыстырылды, осыдан 8 шылым шегушілермен 42.88 ± 7.58 жас шылым шегу орташа ұзақтығымен болды. Қалған пациенттер үшін осы мерзім 35.26±11.12 жасты (p=0.035) құрады. Қарқынды терапия және ED бөлімшесінде 11 өлім–жітім жағдайлары (10.37%) анықталды. 9 пациент олар қандай препараттармен амбулаториялық емделгені есінде жоқ (p=0.026). Алдыңғы жылға асқынулардың орташа жиілігі 14.45 ± 5.7 жас (p=0.008) болды. Он науқас инвазиялық емес механикалық желдетпе алды, осылардың біреуі өлген. Зерттеуге қатысушылардың бірде біреуі вакцинация алмаған. Шылым шегу аурудың ең маңызды этиологиялық факторы болды. Қорытынды: өкпенің созылмалы обструктивті ауруының жыл сайынғы асқынуы жиілігін төмендетудің негізгі әдісін біз анықтадық, ол пациенттердің білімі мен олармен өзара әрекет етуі болып табылады. Құрама ингаляциялық терапия асқынулар жиілігі төмендейді және монотерапиямен салыстырғанда пациентетрді шығару көрсеткіштері артады.
... It can be achieved by reducing rates of initiation and increasing rates of cessation among people who smoke. Stopping smoking is associated with substantial improvements in health and life expectancy at any age [1][2][3][4][5]. In the context of an ageing population, it is particularly important to reduce tobacco smoking rates among older adults as they make up an increasing proportion of the population, and smoking exacerbates age-related illnesses [6,7]. ...
Background
This study aimed to characterise patterns of tobacco smoking and vaping among older adults (≥ 65 years) in England, to explore harm perceptions of e-cigarettes among those who smoke, and to estimate the real-world effectiveness of e-cigarettes for helping older adults to stop smoking.
Methods
Data were collected as part of a representative monthly cross-sectional household survey in England between April 2014 and April 2024 (n = 197,219). We analysed differences between older (≥ 65 years) and younger/middle-aged adults (18–64 years) in (a) time trends in tobacco smoking and vaping, (b) harm perceptions of e-cigarettes vs. cigarettes (adjusting for gender, socioeconomic position, and vaping status), and (c) the real-world effectiveness of e-cigarettes for smoking cessation (adjusting for gender, socioeconomic position, characteristics of the quit attempt, and use of other evidence-based cessation aids).
Results
Tobacco smoking prevalence remained relatively unchanged over time among older adults (at ~ 9%; 9.5% [8.5–10.6%] in April 2014 and 8.7% [7.7–9.8%] in April 2024) but vaping prevalence increased (from 2.1% [1.6–2.7%] to 3.7% [3.0–4.6%], respectively). These trends differed from those observed among younger/middle-aged adults, among whom there was a clear decline in smoking (from 21.8% [21.0–22.7%] to 18.2% [17.3–19.0%]) and a larger increase in vaping (from 5.6% [5.2–6.1%] to 16.2% [15.3–17.0%]). Older adults were consistently less likely than younger/middle-aged adults to use e-cigarettes to support attempts to quit smoking (26.8% [17.2–39.3%] vs. 43.7% [39.6–48.0%] in April 2024). Older smokers reported greater uncertainty about the harms of e-cigarettes compared with cigarettes (ORadj = 2.48 [2.28–2.69]). E-cigarettes appeared to be effective for helping older adults to stop smoking (ORadj = 1.50 [0.96–2.34]); whether effectiveness was lower than for younger/middle-aged adults was inconclusive.
Conclusions
Over the past decade, smoking prevalence has remained stable among older adults while decreasing among the rest of the adult population in England. Older adults are more unsure about the relative harms of e-cigarettes and less likely to use them to support attempts to quit smoking, despite evidence that they are effective for smoking cessation in this population.
... Quitting smoking is strongly associated with a decreased risk of death [8][9][10][11]. Accumulating evidence from the USA, UK and China has consistently reported the benefits of smoking cessation in reducing total and major cause mortality [12,13]. However, current studies on the association between smoking cessation and the risk of all-cause mortality have mainly focus on the general population [14], with less attention given to the elderly population. ...
Background
The association between smoking cessation and decreased mortality existed among former smokers has been well documented. However, evidence is limited for smokers with long-term exposure. This study aims to quantify the association between smoking cessation and mortality by years since quitting in older adults with long-term smoking history.
Methods
Data from Beijing Healthy Aging Cohort Study (BHACS), conducted among communities aged over 55 years old at recruitment, were collected via questionnaire between July 2009 and September 2015 and followed up for all-cause and cancer mortality until March 2021. Self-reported smoking status and years since quitting were collected at baseline. Cox proportional hazards models were used to examine the association between smoking cessation and all-cause and cancer mortality.
Results
A total of 11 235 participants (43.9% male) were included, with a mean age of 70.35 (SD 7.71) years. Former smokers comprised 31.7% of the cohort, with a median smoking duration of 43 (IQR: 34–50) years. During 71 573 person-years of follow-up, there were 1 617 deaths (14.4% of the total cohort), of which 872 (17.7%) occurred among male participants. Compared with never smokers, HR (95%CI) for participants who current smoked was 2.898 (2.092–4.013); quit smoking less than 10 years (medians [quartiles] 4 [1, 7] years) before recruitment was 2.738(1.972–3.802); 10 to 20 years (16 [13, 20] years), 1.807(1.286–2.540); and 20 years or more (30 [25, 37] years), 1.293(0.981–1.705). The risk of all-cause and cancer mortality decreased gradually over years since quitting. Quitting less than 10 years, 10 to 20 years and 20 years or more, former smokers avoided an estimated 8.4%, 57.5% and 84.6% of excess all-cause mortality associated with current smoking, respectively. The association between smoking cessation and decreased mortality was observed among former smokers regardless of smoking history.
Conclusions
In this study, current smoking was associated with nearly triple the mortality risk compared to never smoking. Smoking cessation, even after a long-term smoking history, was associated with significant decreases in the relative excess mortality linked to continuing smoking. The association were more pronounced in men.
... Therefore, our cross-sectional results should be interpreted with caution and should not be used as evidence to promote these behaviors among older adults. In fact, research indicates that even in advanced age, individuals can gain health bene ts from abstaining from or reducing alcohol consumption [56] and quitting smoking [57]. ...
Background
The aging population, including octogenarians (aged 80–89) and nonagenarians (aged 90–99), is rapidly increasing. Understanding their self-rated health in urban and rural settings is vital for public health policy development. This study examined factors associated with self-rated health among octogenarians and nonagenarians across urban and rural areas of South Korea.
Methods
We analyzed data of 21,896 older adults (aged 80–99) from the 2023 Korea Community Health Survey. Self-rated health was assessed on a 5-point scale and categorized as "good" or "poor." Variables included age, residence area (urban/rural), sociodemographic characteristics, health behaviors, healthcare utilization, morbidity, and social interactions. Descriptive statistics were used to examine variable distributions, and logistic regression models identified factors associated with self-rated health in each age group and residential area.
Results
Among octogenarians, 18.7% in urban areas reported good self-rated health, compared to 15.0% in rural areas. In contrast, a smaller proportion of nonagenarians reported good self-rated health in urban areas (13.6%) than in rural areas (14.7%). Octogenarians in both rural and urban areas with higher education (urban odds ratio [OR] = 1.15, 95% CI = 1.07–1.24; rural OR = 1.15, 95% CI = 1.10–1.22) and higher income (urban OR = 1.18, 95% CI = 1.07–1.31; rural OR = 1.09, 95% CI = 1.01–1.18) reported better self-rated health. However, this association was less pronounced among nonagenarians. Characteristics such as regular walking (OR range 1.41 [95% CI = 1.23–1.62] among rural octogenarians to 2.25 [95% CI = 1.89–2.69] among urban nonagenarians), good self-rated oral health (OR range 2.48 [95% CI = 1.98–4.00] among rural nonagenarians to 3.50 [95% CI = 3.01–4.07] among urban octogenarians), and participation in social activities (OR range 1.24 [95% CI = 1.09–1.41] among rural nonagenarians to 1.67 [95% CI = 1.29–2.16] among urban octogenarians) were consistently associated with good self-rated health across all age groups in both rural and urban areas.
Conclusions
Characteristics associated with self-rated health differed significantly between octogenarians and nonagenarians in rural and urban areas. Public health strategies must support health-promoting behaviors such as regular walking, enhance oral health services, improve healthcare accessibility, reduce environmental stressors, and strengthen social support networks to promote health among octogenarians and nonagenarians.
... Например, в метаанализе S. Lewington et al., 2002 [26] (61 исследование, около 1 млн человек, 12,7 млн человеко-лет наблюдения) степень уменьшения риска смертности ранжировалось от 60 до 40 % для МИ, от 50 до 30 % -для ИБС и от 60 до 30 % -для прочих ССЗ в возрастных декадах от 40-49 до 80-89 Т а б л и ц а 2 [32]. Вклад курения в риск смертности от всех причин многократно показан когортными ис-Т а б л и ц а 3 следованиями и метаанализами [25,[33][34][35][36][37]. В нашей когорте 45-69 лет риск смерти, связанный с курением, был даже выше по сравнению с наблюдением когорты MONICA 25-64 лет в Новосибирске (2,4 по сравнению с 2,0-2,1) [32]. ...
Cardiovascular diseases (CVD) occupy a leading position in the structure of all-cause mortality. Prospective and interventional studies have identified the major risk factors for CVD and shown their associations with the risk of cardiovascular outcomes and all-cause death. The impact on the individual risk of death may vary by age, sex, study design, and may be population-specific. We aimed to study the contribution of major CVD risk factors to the 15-year risk of all-cause death in the Russian (Siberian) population cohort aged 45–69 years.
Material and methods. A random population sample (men and women 45–69 years old, n = 9360) was examined at baseline in 2003–2005 (Novosibirsk, Russian branch of the HAPIEE project) and re-examined twice in 2006–2008 and 2015–2018. Current analysis included individuals without baseline CVD ( n = 8087), the average follow-up period – 15.6 (SD 0.69) years. The fatal events were registered based on death certificates from the Population Registration Bureau (ZAGS), and using the data received at serial examinations and postal interview. We analyzed the association between CVD risk factors and all-cause death using multivariate Cox regression.
Results . In a cohort aged 45–69, in the adjusted model, 15-year risk of all-cause death was positively associated with age (HR = 1.08; 95 % CI 1.07–1.09), male sex (HR = 1.46; 95 % CI 1.24–1.71), hypertension (HT) (HR = 1.39; 95 % CI 1.25–1.55), smoking (HR = 2.37; 95 % CI 2.08–2.70), high WHR (HR = 1.19; 95 % CI 1.06–1.33), and type 2 diabetes (T2DM) (HR = 1.52; 95 % CI 1.34–1.73), and it was negatively associated with elevated total cholesterol (TC) or LDL-C in blood. In age- and sex-adjusted model, the risk was additionally associated with high triglycerides (HTG), obesity and elevated fasting plasma glucose (FPG). In men, the risk of death was independently associated with age, HT, smoking, low HDL-C, high WHR, and T2DM. In women, the risk of death was independently associated with age, HT, T2DM smoking, and, in age-standardized models, obesity, high WHR, and hyperglycemia.
Conclusions . In a population cohort of 45 years and older, among CVD risk factors male sex, HT, smoking, central obesity, and T2DM independently contributed to the risk of all-cause death. Among lipid parameters, low HDL-C and high TG levels increased the risk of death in men. Associations between cardiovascular risk factors and the risk of all-cause death in older people have the patterns specific for older age; these features are important to take into account in a strategy to reduce mortality in the population.
... Our findings may have important public health implications. There is certainly a plausible causal link between the groups of factors studied (smoking, diet, exercise, alcohol consumption) and morbidity/mortality [27][28][29][30]. This implies that creating health policy interventions that focus on individual health behaviours could substantially reduce inequalities in health and improve the population's health. ...
Background
Applying survival analysis techniques to epidemiological inference within research into ageing offers opportunities to estimate the association between exposure and outcome in longitudinal data. This study used Cox regression to investigate how socioeconomic inequality in mortality can be explained by exposure to various factors including smoking, diet, alcohol and physical activity. This study seeks to complement and extend previous work which found that the contribution of the socioeconomic gradient to inequalities in health was underestimated by baseline analysis.
Methods
Data was obtained from Whitehall II, a British longitudinal cohort study, which investigated social determinants of health. Analysis is based on 11 waves of data collected over 32 years on 10,308 civil servants aged between 35 and 90. Socioeconomic position was defined by baseline employment grade (1-3). During the follow-up 2,427 participants died. Extensive experimental analysis was conducted using a vast number of health behaviours. Cox regression produced an age-and-sex-adjusted hazard ratio for the socioeconomic inequality in mortality. Health behaviours (smoking, physical activity, alcohol consumption, and diet) were then added as covariates to determine the extent to which they statistically explain this inequality, and how this differed from the last similar analysis from 2009. This was done at baseline and longitudinally. The health behaviours were then combined linearly, nonlinearly and new health behaviours were added.
Results
Adding the above health behaviours as covariates statistically explained the socioeconomic gradient in mortality at baseline from 42% to 2009, to 51% to 2021. Longitudinal consideration increased the explanatory power, when all health behaviours were added as time-varying covariates, from 51% to 87%. Adding more variables in the form of a more comprehensive diet score statistically explained the gradient further, to 91%. The nonlinear model of smoking and exercise most accurately predicted mortality and had a 13% higher explanatory power when explaining the gradient compared to the linear model in longitudinal data.
Conclusion
In the Whitehall II study, socioeconomic position and mortality showed an association. There is a gain in explanatory power of the set of health behaviours at baseline when follow-up is extended by 12 years, from 42% to 51%. When changes in behaviour over the 32 years of follow-up were also accounted for, this association was now significantly explained by over 90%, compared with 51% when considered at baseline. We suggest that reverse causation is partly responsible for the almost complete explanation of the social gradient in mortality by health behaviours. These results would therefore lead us to question why health behaviours are socially patterned in the way that has been observed, which would be significant for targeting health behaviours in lower socioeconomic statuses.
... Data for this cross-sectional study were sourced from the Taiwan National Physical Fitness Survey (TNPFS) conducted by the Sports Administration, Ministry of Education, Taiwan. The TNPFS's established protocol and tool have been detailed in previous publications [20,21]. A summarized overview of the survey methods is provided here. ...
Obesity and smoking are two major public health challenges, both contributing significantly to morbidity and mortality worldwide. This study investigates the association between smoking behaviors and obesity among men in Taiwan, focusing on body mass index (BMI) and waist circumference (WC) as indicators of general and abdominal obesity. The sample consisted of 27,908 men categorized into five groups based on their smoking status: never smoking (NS), former smoking (FS), light-intensity smoking (LIS), moderate-intensity smoking (MIS), and heavy-intensity smoking (HIS). Our findings reveal a significant association between smoking and increased obesity risk, particularly among light- and moderate-intensity smokers. Socioeconomic factors such as education and income levels were also found to influence these behaviors. These results underscore the importance of integrated public health strategies that address both smoking cessation and obesity prevention.
... However, of great concern is the dangerous effects of tobacco use on the developing brains of children and adolescents [3]. Furthermore, tobacco smokers may have an average life expectancy that is 10 years less than that of people who have never smoked [7,8]. ...
Introduction
Risky behaviours, including tobacco use, are highly prevalent among adolescents worldwide. Although these behaviours are largely influenced by various sociodemographic factors, including sex, there is a paucity of regionally representative literature on the sex-related inequalities in cigarette smoking among adolescents in Africa. This study examined the sex-based disparities in current cigarette smoking among adolescents aged 13–15 years in Africa.
Methods
The present study employed a secondary analysis of nationally representative data on 45 African countries obtained from the Global Youth Tobacco Survey, accessible through the World Health Organization (WHO) Global Health Observatory. We used the online version of the WHO Health Equity Assessment Toolkit (HEAT) to generate the results.
Results
The prevalence of current cigarette smoking among the adolescents surveyed ranged from 1.6% in Eritrea to 10.4% in Mali among the low-income countries, from 1.3% in Tanzania to 13.1% in Mauritania among the lower-middle-income countries, from 5.2% in Gabon to 15.3% in Mauritius among the upper-middle-income countries, and 14.7% in Seychelles, the only high-income country in the study. The absolute summary measure (D) showed diverse sex-related disparities in the burden of current cigarette smoking among adolescents across the sub-regions. In all countries surveyed, the prevalence of cigarette smoking was higher among male adolescents compared to females, except in Liberia and Mozambique, where female adolescents bore a more significant burden than their male counterparts. Furthermore, male adolescents were more burdened with high cigarette smoking prevalence than females in low-income countries such as Mali, Madagascar, Guinea, Burkina Faso, and The Gambia, where such disparities were most pronounced. Meanwhile, we found less disparity in the burden of cigarette smoking between male and female adolescents in most of the lower and upper-middle-income countries surveyed.
Conclusion
This study sheds light on the sex-based inequalities in the prevalence of current cigarette smoking among adolescents in Africa. In contrast to female adolescents, male adolescents bear a greater burden of current cigarette smoking. The burden of cigarette smoking is most pronounced in low-income countries such as Mali, Madagascar, Guinea, Burkina Faso, and The Gambia. Conversely, in most of the lower and upper-middle-income countries surveyed, the burdens of current cigarette smoking among male and female adolescents were found to be less disparate. Consequently, cigarette smoking prevention programmes and strategies must be implemented in all African nations. There is also the need to intensify interventions aimed at altering the smoking behaviour of male adolescents. Policymakers can develop and implement evidence-based interventions to address the burden of cigarette smoking among the adolescents. Finally, existing policies and programmes addressing adolescents' cigarette smoking should be re-assessed and strengthened to achieve their objectives.
... Darden (2017) finds that people more likely to smoke are also prone to die from causes unrelated to smoking. 38 This approach is commonly used in epidemiological research (see, e.g.,Doll, et al., 1994).39 The authors base a diagnosis of high systolic blood pressure on an average of three blood pressure readings.40 ...
This article reviews economic studies based on data from high income countries published from 2007 to early 2024 to address three questions: (1) How accurate are subjective beliefs, mainly measured by subjective probabilities, compared to their objective counterparts? Objective evidence comes from another source (e.g., life table, empirical study, expert opinion), or subsequent realizations of beliefs elicited at baseline. (2) How are subjective beliefs determined? (3) Do subjective beliefs affect health behaviors? Several domains are included: survival, and health behaviors—smoking, alcohol consumption and impaired driving, preventive care, diet, and COVID-19 precautions. Results on a single domain, (e.g., survival), do not generalize to, e.g., COVID-19 results. Subjective probabilities embody private information (e.g., self-assessed health, parent longevity). However, individuals seem insufficiently informed about population-level probabilities. There is no systematic overestimation or underestimation of objective probabilities. Several determinants of beliefs are identified (demographic characteristics, education, cognition, current self-assessed health, health histories), but evidence on underlying mechanisms is lacking, how determinants, (e.g., education), affect beliefs. Subjective beliefs, even with substantial noise, often affect health behaviors. Given prior evidence that beliefs are influenced by health shocks, this article reviews research on effects of health shocks on health behaviors. A major health shock to an individual—a new diagnosis (e.g., diabetes) or a serious adverse health event (e.g., heart attack), by changing subjective probabilities leads to some healthier behaviors, however, sometimes only temporarily. Behaviors may also be influenced by utility loss following a health shock, e.g., learning about pecuniary and non-pecuniary costs of hospitalization.
... Smoking is leading risk factor for lung cancer with 80% related to tobacco consumption. Excess risk among addicted smokers compared to never-smokers is in the order of 20-50fold [11]. To classify cancer stage, there are two types of cancer staging systems: TNM staging system and numerical staging system. ...
Technically, medical imaging modalities are quantitative, qualitative, and semi-quantitative. Such modalities can generate meaningful and valuable quantitative and qualitative data. Correlating predictive outcomes with quantitative and qualitative data is a difficult process. Thanks to modern computational hardware and advanced machine learning algorithms, it is not a demanding job to perform predictive analysis by cultivating quantitative and qualitative data. Radiomics is a popular topic that studies quantitative data from medical images in order to obtain biologically meaningful information for diagnosis, prognosis, theragnosis, and decision support. Handcrafted radiomics is a process including features based on shape, pixel, and texture-related knowledge from medical scans. In the pursuit of advancing the field of radiomics, we have developed a cutting-edge radiomics training simulator, powered by MATLAB. This tool has been designed for those familiar with MATLAB, making it easy for them to transition into the fascinating world of radiomics. MATLAB's user-friendly interface and strong support in the engineering community provide an ideal platform for this simulator, ensuring aspiring radiomics learners have access to the resources they need for success. Throughout the paper, purpose, design details and methodology of the simulator are described.
... Smoking cessation is the most cost-effective measure for reducing LC mortality 7,49 and is associated with better therapeutic responses and fewer complications from chemotherapy, radiotherapy, and surgery. 50 Around 40À60 % of individuals still smoke at enrolment, and many of them are highly nicotine-dependent, 51 while ex-smokers undergoing LCS face a high risk of relapse. ...
... Smoking is demonstrably detrimental to health, linked to numerous health risks, premature death, and severe morbidity [1][2][3][4]. Unfortunately, while developed countries see a consistent decline in smoking prevalence, it's on the rise in many developing nations, including Nepal [5]. ...
Background
Despite declining smoking prevalence globally, South Asia faces a rising burden. In Nepal, existing tobacco control laws haven’t curbed use, with 28.9% of young adults engaging in tobacco use. This study investigates tobacco use and associated factors among medical, dental, and nursing students at a Nepalese tertiary care center.
Objective
We aimed to assess tobacco use prevalence and identify factors associated with it among future healthcare professionals, considering their distinct roles in tobacco control. Medical students can contribute through clinical counseling and public health advocacy, dental students through oral health education, and nursing students through patient education and community outreach.
Methods
A cross-sectional study involving 427 medical, dental, and nursing students was conducted. Data was collected using online questionnaires distributed via email and social media. Descriptive statistics and Chi-square tests were used for analysis.
Results
The study found that 45% of participants were aged 22–25, with females comprising the majority (53.2%). Nearly half (49.2%) belonged to the medical faculty, and 24.4% were in their first year. Furthermore, among those who smoke, 53% reported smoking less than 5 cigarettes daily. The analysis revealed significant associations between smoking with age (p = 0.01), year of study (p = 0.001), parental smoking history (p = 0.001), and having friends who smoke (p = 0.001).
Conclusion
Our findings highlight the moderate prevalence of cigarette smoking among medical students, with family and friends emerging as major influences. Stress relief was a common reason, particularly among young females and first-year students. These results emphasize the urgent need for comprehensive tobacco control programs within medical institutions to equip future healthcare professionals to effectively address smoking issues.
... Quitting smoking at age 60 increases life expectancy by 3 years, quitting at 50 by 6 years, quitting at 40 by 9 years, and quitting at 30 by 10 years. 3 A global struggle is being waged and some precautions are being taken in order to prevent people from smoking. However, people continue to die due to the preventable diseases caused by smoking, the burden of diseases increases, and a huge financial burden arises both at the individual and family level and on a societal and global scale. ...
Smoking cessation efforts are made in many countries and the results of these efforts should be measured. Therefore, there is a need for a short, feasible and validated scale that can measure the intention to quit smoking. The purpose of this study is to investigate the psychometric properties of the “Intention to Quit Smoking Scale (IQSS)”. Validity and reliability properties of the scale were examined. A total of 497 people were included in the study. First, 20 candidate items were prepared based on literature review and expert opinions and the scale with candidate items were subjected to a pilot test. The dimensional structure was determined statistically using confirmatory factor analysis and confirmed by confirmatory factor analysis. Cronbach’s α coefficient, CR and AVE values were calculated to examine internal consistency, composite reliability and convergent validity. A scale with one factor consisting of eight items was obtained. The fit indices of the single factor structure were at an acceptable level (X2/df 1.77, GFI 0.94, AGFI 0.88, CFI 0.98, NFI 0.97, RMSEA 0.079). Cronbach's alpha for IQSS was 0.943. CR was 0.95 and AVE was 0.96. The test-retest consistency of the scale was high (r=0.856). Correlations with “Smoking Cessation Success Prediction Scale” and its sub-dimensions showed that the scale provided concurrent validity (r=0.669; 0.698; 0.721 respectively). The IQSS is a short, reliable and valid scale that can measure the intention to quit smoking at the time of measurement and it can be easily used in future studies.
... Quitting smoking can significantly reduce mortality and morbidity from smoking-related diseases and lead to substantial economic savings in healthcare costs (Doll et al., 2004). Additionally, it can improve mental health, reduce stress, and enhance overall quality of life and well-being (Bloom et al., 2017;Lasser et al., 2000;Parrott, 1995). ...
This is the protocol for an updated Campbell systematic review. The objectives are as follows: To evaluate the effect of behavioral interventions on smoking cessation among homeless individuals.
... From a public health perspective, it is prolonged smoking that is the main concern, because that has serious health risks. For example, one study reported that adults who quit smoking by age 35 avoided the vast majority of premature mortality attributed to cigarette smoking [55]. Much lower cutoffs are used for youth, since they have not yet had time to develop such extensive smoking history, and experimentation could lead to regular use. ...
Background
Electronic nicotine delivery systems (ENDS) offer a substantial harm reduction opportunity for adults who smoke and are unlikely to quit. However, a major concern about ENDS is their use by non-smoking youth, and particularly whether ENDS are acting as a “gateway” that leads youth to later start smoking cigarettes. However, evidence for the gateway hypothesis can be interpreted in alternative ways, e.g. that youth who have certain characteristics were already predisposed to use both ENDS and cigarettes (“common liability” explanation).
Aims
This commentary provides an evaluation of the gateway hypothesis that is accessible by a lay audience. This paper first reviews and evaluates the evidence interpreted as supporting the gateway hypothesis. Important alternative explanations (i.e., common liability) are discussed, as are different types of evidence (i.e., population-level trends) that can help differentiate between these competing explanations.
Overview
Evidence for the gateway hypothesis is based on the finding that youth who use ENDS are more likely to also smoke cigarettes. However, this evidence suffers from an important flaw: these studies fail to fully account for some youths’ pre-existing tendency to use products containing nicotine, and inappropriately interpret the results as ENDS use causing some youth to smoke. Common liability studies suggest that ENDS use does not, in and of itself, directly cause youth to later smoke cigarettes, beyond their pre-existing tendency to use products containing nicotine. Population-level trends show that youth cigarette smoking declined faster after ENDS use became common, which contradicts the central prediction of the gateway hypothesis (i.e. that youth smoking would be more common following ENDS uptake, than otherwise be expected).
Conclusion
Evidence offered in support of the gateway hypothesis does not establish that ENDS use causes youth to also smoke cigarettes. Instead, this evidence is better interpreted as resulting from a common liability to use both ENDS and cigarettes. Population-level trends are inconsistent with the gateway hypothesis, and instead are consistent with (but do not prove) ENDS displacing cigarettes. Policies based on misinterpreting a causal gateway effect may be ineffective at best, and risk the negative unintended consequence of increased cigarette smoking.
... Following primary studies in the UK 1,2 and the US Surgeon General's report 3 , an overwhelming amount of evidence has led to the classification of smoking as the leading preventable cause of morbidity and mortality worldwide [4][5][6] . Changes to tobacco policy, and increases in smoking intervention and cessation campaigns, have been introduced to improve national and global public health. ...
Introduction
Smoking contributes a huge burden on public health; thus, identifying risk factors for smoking remains an important area of research. This study adds to the wealth of existing literature by utilising repeated smoking measures collected in a UK sample of young adults to (a) examine differences between longitudinal smoking behaviours, (b) investigate their association with many risk factors, and c) consider how these associations may change over time.
Methods
This study uses longitudinal latent class analysis and 12 repeated measures to derive patterns of smoking in the Avon Longitudinal Study of Parents and Children. The association of these patterns with 402 risk factor measures collected from 0-28 years is then investigated. The selected risk factors include familial and peer factors, lifestyle and sociodemographic factors, mental health, parenthood, adverse childhood experiences and trauma.
Results
Five different latent classes of smoking were derived and referred to as non-smoking, short-term smoking, occasional smoking, early-onset smoking, and late-onset smoking. These showed differences in age of onset, frequency, and cessation. Other substance use, and parental and peer substance use, showed the strongest association with smoking patterns. More risk factors were associated with early-onset than late-onset smoking. Many risk factors of regular smoking did not show the same associations with occasional smoking. Fewer measures differentiated late-onset from short-term smoking. Some associations varied depending on the time of measurement or smoking pattern in question.
Conclusions
Findings from this study may be used to identify groups of people most vulnerable to more harmful smoking patterns despite being exposed to strong tobacco prevention efforts. This could also help better tailor smoking interventions and improve tobacco control policies.
... They were the subjects of the earliest cohorts that showed that smoking kills. (40) They galvanised reports (41,42) that led to the first government actions. They quit rapidly and in large numbers once they understood the evidence. ...
Current global approaches to tobacco control have failed to halt the devastating toll of tobacco-related deaths, with the World Health Organization (WHO) estimating 8.5 million annual tobacco-related deaths, projected to increase to 10 million before slowly declining.
This report addresses the pressing issue of tobacco control policies in four Low Middle-Income Countries (LMICs), Kazakhstan, Pakistan, South Africa, and Bangladesh where a total of 350 000 people die prematurely from tobacco use each year.
In these four countries there is a significant gender gap in smoking rates and related deaths, contributing to differences in life expectancy. In two of these countries, Pakistan and Bangladesh, toxic smokeless tobacco product use is common. In addition, tobacco-related causes, including heart disease, chronic obstructive pulmonary disease (COPD), stroke, lung cancer and tuberculosis (TB), are among the leading causes of death in all these nations.
The report aims to provide policymakers and public health experts with estimates of the potential benefit of tobacco harm reduction (THR), improved cessation, and better access to lung cancer diagnostics and treatment on reducing premature deaths.
The study considers the crucial role of time in addressing tobacco-related diseases, emphasizing that the benefits of cessation or harm reduction take decades to fully manifest.
All premature tobacco-related deaths by 2060 will occur in current adult smokers, underscoring the need to focus on middle-aged smokers and users of toxic smokeless tobacco products.
Recent modelling efforts have demonstrated the potential health gains from the adoption of THR products, including e-cigarettes, oral nicotine pouches, snus and heated tobacco products. This report builds upon their work.
The study's key findings indicate that significant lives can be saved in these countries through the widespread adoption of THR and related measures. For instance, Kazakhstan could prevent 165 000 premature deaths in the next four decades, while South Africa, Bangladesh and Pakistan could save 320 000, 920 000, and 1 200 000 lives, respectively.
This report demands several actions. Member States at COP10 need to activate the harm reduction provisions of the WHO Framework Convention on Tobacco Control (FCTC). WHO needs to be held accountable for supporting policy positions that undermine population health. Governments need to regulate nicotine products proportionate to the risk they pose to health. Physician leadership is needed to better support their patients and policymakers about the benefits of THR. THR users need to galvanise into a powerful movement that advocates pro-THR policies. Industry needs to step up THR activities in LMICS and consider developing products that meet medical licensing approval.
Alcohol consumption has been identified as a risk factor for various types of cancer. This meta-analysis aims to quantify the association between alcohol intake and cancer risk and to explore the underlying biological mechanisms. A comprehensive literature search was conducted for studies published between January 2000 to December 2023. Eligible studies included cohort and case-control studies that reported relative risks (RRs) or odds ratios (ORs) for cancer associated with alcohol consumption. Data were extracted and pooled using a random-effects model. Heterogeneity was assessed using the I² statistic. Subgroup analyses were performed based on cancer type and level of alcohol consumption. A total of 75 studies were included in the meta-analysis. Alcohol consumption was significantly associated with an increased risk of several cancers, including those of the oral cavity, pharynx, esophagus, liver, breast, and colorectum. The pooled RRs for high vs. low/no alcohol consumption were as follows: oral cavity and pharynx (RR=3.15, 95% CI: 2.44-4.05), esophagus (RR=2.89, 95% CI: 2.19-3.81), liver (RR=1.83, 95% CI: 1.39-2.40), breast (RR=1.25, 95% CI: 1.14-1.37), and colorectum (RR=1.21, 95% CI: 1.09-1.34). Heterogeneity was moderate to high across studies. This meta-analysis confirms the significant association between alcohol consumption and increased risk of multiple cancers. Public health strategies should emphasize reducing alcohol intake to lower cancer risk.
INTRODUCTION
According to the literature, quitting tobacco before the age of 30 years would mitigate almost all tobacco-related hazards. In this respect, understanding behavioral patterns associated with the process of individual change to a healthier behavior is likely to contribute to tobacco control and avoidance of the related health risks, as well as to promote healthier behaviors, especially during adolescence.
METHODS
This study is a secondary dataset analysis utilizing the 2016 Global Youth Tobacco Survey (GYTS) data for Morocco. Initially, a descriptive analysis is conducted to outline smoking prevalence and related behaviors among Moroccan youth, with a focus on gender differences, employing chi-squared tests for comparison. This is followed by bivariate and multivariate logistic regression analyses, which were adjusted for potential confounders to identify the determinants of intended smoking cessation.
RESULTS
The survey was based on a sample of 3883 adolescents, of whom 11.07% have already tried smoking cigarettes at least once during childhood and adolescence, and 1.39% are current smokers. As for those close to the surveyed subjects, 22.2% had at least one smoking parent, and 24.1% had friends who smoked. Self-efficacy (AOR=15.54; 95% CI: 3.05–79.03) and noticing health warnings on cigarette packages (AOR=5.41; 95% CI: 2.54–11.52) were found to be important determinants of the intent to quit tobacco.
CONCLUSIONS
This study is a focused analysis of self-efficacy and health warnings as predictors of smoking cessation intent among Moroccan adolescents. The study elucidates the role of self-efficacy and exposure to health warnings in shaping the intent to quit smoking among Moroccan adolescents. These findings provide evidence for developing targeted interventions that support self-efficacy and impactful health warnings to promote healthier choices and reduce tobacco use among young Moroccans.
Objective
In Sweden, the prevalence of daily smoking has decreased substantially over the past few decades. However, a socioeconomic divide is evident, contributing to health inequities. The current study focuses on the needs, facilitators, and barriers in relation to quitting smoking among individuals in disadvantaged areas and explores their perception of digital tools for smoking cessation.
Method
Semi-structured interviews were conducted with 30 participants in Stockholm County between 2022 and 2023. Participants were recruited through health care centres, dental clinics, and civil society actors. A thematic analysis was performed.
Results
Two cross-cutting main themes were identified; 1) Motivational factors and barriers in smoking cessation, including the subthemes “health, concern for loved ones and economic aspects” and “emotional, environmental, and cultural barriers” and 2) Benefits and limitations of a digital tool for smoking cessation, including the subthemes”important/relevant features in a digital app” and “limitations of digital support”.
Conclusions
The results reveal that most participants want to quit smoking but perceive it as difficult. The study highlights the importance of addressing social disparities in smoking and the need for accessible smoking cessation support. While mobile apps are viewed as promising for smoking cessation by some of the participants, scepticism exists among others. Moving forward, personalized approaches that integrate digital tools with traditional methods for smoking cessation can be important to reduce smoking prevalence. Ensuring accessibility of effective smoking cessation support for all is a key public health interest.
Background
Cigarette smoking is incredibly harmful, even for people who do not smoke every day. This study aimed to estimate trends in non-daily smoking in England between 2006 and 2024, how these differed across population subgroups, and to explore changes in the profile of non-daily smokers in terms of their sociodemographic and smoking characteristics and vaping and alcohol consumption.
Methods
Data were collected monthly between November 2006 and April 2024 as part of a nationally representative, repeat cross-sectional survey of adults (≥ 18 years; n = 353,711). We used logistic regression to estimate associations between survey wave and non-daily smoking and used descriptive statistics to characterise the profile of non-daily smokers across 3-year periods.
Results
The proportion who smoked non-daily was relatively stable between November 2006 and November 2013, at an average of 10.5% [10.1–10.9%] of cigarette smokers, then increased to 27.2% [26.0–28.4%] of cigarette smokers (4.0% [3.7–4.2%] of adults) by April 2024. This increase was particularly pronounced among younger adults (e.g. reaching 52.8%, 20.4%, and 14.4% of 18-, 45-, and 65-year-old cigarette smokers by April 2024) and those who vape (reaching 34.2% among vapers vs. 23.1% among non-vapers). Over time, there were reductions in non-daily smokers’ mean weekly cigarette consumption (from 34.3 in 2006–2009 to 21.1 in 2021–2024), urges to smoke (e.g. the proportion reporting no urges increased from 29.2 to 38.0%), and motivation to stop smoking (e.g. the proportion highly motivated to quit within the next 3 months decreased from 30.8 to 21.0%).
Conclusions
An increasing proportion of adults in England who smoke cigarettes do not smoke every day, particularly younger adults. Although non-daily smokers report smoking fewer cigarettes and weaker urges to smoke than they used to, which may make it easier for them to stop smoking, they appear to be decreasingly motivated to quit.
Our understanding of the ways in which smoking damages the lung has evolved significantly over the last 100 years, and a large body of scientific literature on this topic has accumulated. It has become clear that smoking causes not only lung cancer but also emphysema, interstitial fibrosis, Langerhans cell proliferation, accumulation of pigmented macrophages and cystic change in various permutations. Some patients with these abnormalities are symptomatic while in others they remain subclinical. The aim of this review is to trace the history of our understanding of the role of smoking in the causation of lung disease using landmark papers that have significantly advanced our understanding of the link between smoking and diseases of the lung. These papers were identified using a combination of careful perusal of published historical reviews, cross-referencing and a review of the smoking-related literature on PubMed. Emphasis was placed on studies/papers that made key original observations and advanced the field. This review includes well-known diseases such as emphysema, lung cancer, pulmonary Langerhans cell histiocytosis, combined pulmonary fibrosis and emphysema and smoking-related interstitial lung disease, but we also highlight new developments in the field in the 21 st century, including the recognition of smoking-related interstitial fibrosis, the high prevalence of interstitial changes on high-resolution chest tomograms in adult smokers, smoking-related diffuse cystic lung disease and thoracic SMARCA4-deficient undifferentiated tumour.
Objectives
The effects of nicotine metabolism on the kidneys of healthy individuals have not been determined. The nicotine metabolite ratio (NMR) indicates the rate of nicotine metabolism and is linked to smoking behaviors and responses to tobacco treatments. We conducted this study in order to investigated the relationship between nicotine metabolite ratio (NMR) and kidney function.
Methods
An analysis of cross-sectional data of adults was conducted using a population survey dataset (National Health and Nutrition Examination Survey Data 2013/2018 of the United States). A weighted multivariate regression analysis was conducted to estimate the correlation between NMR and kidney function. Furthermore, we apply fitting smooth curves to make the relationship between NMR and estimated glomerular filtration rate (eGFR) more visualized.
Results
The research included a total of 16153 participants. Weighted multivariate regression analyses adjusted for possible variables showed a negative relationship between NMR and estimated glomerular filtration rate (eGFR).The β (95%CI) of the regression equation between NMR and eGFR was -2.24 (-2.92, -1.55), the trend testing showed consistent results. NMR is positively correlated with urinary albumin creatinine ratio (uACR), but it is not statistically significant. A stratified analysis found a negative correlation between NMR and eGFR in all age, gender and diabetes subgroups, the results were not statistically significant among Mexican Americans and other races. Notably, each unit rise in NMR corresponded to a 4.54 ml/min·1.73m² lower eGFR in diabetic participants and a 6.04 ml/min·1.73m² lower eGFR in those aged 60 and above.
Conclusions
Our study shows that nicotine metabolite ratio is negatively associated with kidney function among most adults. It will be necessary to conduct more well-designed prospective clinical trials in order to determine the exact causal interactions between NMR and kidney function. Specific mechanisms also need to be further explored in basic experiments.
Objective: Smoking, with a prevalence of about 25%–30% in Switzerland, is
proven to cause major systemic, avoidable diseases including lung cancer,
increasing societies morbidity and mortality. Diverse strong quitting smoking
recommendations have been made available providing advice facilitating
smoking cessation globally. In other European countries like Germany, clinical
practice guidelines for smoking cessation services have been implemented.
However, in Switzerland, there is still no national consensus on a
comprehensive smoking cessation program for lung cancer patients nor on
the adequate provider. Our primary aim was to assess the current status of
smoking cessation practice among specialists, mainly involved in lung cancer
care, in Switzerland in order to uncover potential shortcomings.
Material and methods: A self-designed 14-items questionnaire, which was
reviewed and approved by our working group consisting of pneumologists and
thoracic surgeons, on demographics of the participants, the status of smoking
cessation in Switzerland and specialists’ opinion on smoking cessation was
sent to thoracic surgeons and pneumologists between January 2024 and
March 2024 via the commercially available platform www.surveymonkey.com.
Data was collected and analysed with descriptive statistics.
Results: Survey response rate was 22.25%. Smoking cessation was felt to
positively affect long term survival and perioperative outcome in lung cancer
surgery. While 33 (37.08%) physicians were offering smoking cessation
themselves usually and always (35.96%), only 12 (13.48%) were always referring
their patients for smoking cessation. Patient willingness was clearly identified
as main factor for failure of cessation programs by 63 respondents (70.79%).
Pneumologists were deemed to be the most adequate specialist to offer
smoking cessation (49.44%) in a combination of specialist counselling
combined with pharmaceutic support (80.90%).
Conclusion: The development of Swiss national guidelines for smoking
cessation and the implementation of cessation counselling in standardized
lung cancer care pathways is warranted in Switzerland to improve long-term
survival and perioperative outcome of lung cancer patients.
Objective
This study aimed to find out whether phenotypic age could mediate the protective effects of healthy lifestyles on mortality.
Methods
We included adult participants with available data for individual PhenoAge and LE8 scores from the National Health and Nutrition Examination Survey 2005–2010 (3 cycles) and linked mortality records utill Dec 31, 2019. Adjusted hazard ratios (HR) were estimated to evaluating the associations of PhenoAge and LE8 scores with all-cause and cardiovascular mortality risk. Mediation analyses were performed to estimate the proportional contribution of PhenoAge to the effect of LE8 on mortality risks.
Results
One-year increment in PhenoAge was associated with a higher risk of all-cause (HR = 1.04 [95% CI, 1.04–1.05]) and cardiovascular (HR = 1.04 [95% CI, 1.04–1.05]) mortality, independent of chronological age, demographic characteristics and disease histories. High level of LE8 (score: 80–100) was associated with a 3.30-year younger PhenoAge. PhenoAge was estimated to mediate 36% and 22% of the effect of LE8 on all-cause and cardiovascular mortality, respectively (all P < 0.001). As for single-metric scores of LE8, PhenoAge mediated 30%, 11%, 9%, and 7% of the effects of the healthy diet, smoking status, blood pressure and physical activity on all-cause mortality risk, respectively (all P < 0.05).
Conclusion
Adherence to LE8 recommendations slows phenotypic aging. PhenoAge could mediate the effect of LE8 on mortality risk.
Background
Most smokers attempting to quit will quickly relapse to tobacco use even when treated with the most efficacious smoking cessation agents currently available. This highlights the need to develop effective new smoking cessation medications. Evidence suggests that positive allosteric modulators (PAM) and other enhancers of nicotinic acetylcholine receptor (nAChR) signaling could have therapeutic utility as smoking cessation agents.
Methods
3-[3-(3-pyridyl)-1,2,4-oxadiazol-5-yl]benzonitrile (NS9283) was used as a starting point for medical chemistry efforts to develop novel small molecule enhancers of α4β2* nAChR stoichiometries containing a low-affinity agonist binding site at the interface of α4/α4 and α4/α5 subunits.
Results
The NS9283 derivative SR9883 enhanced the effect of nicotine on α4β2* nAChR stoichiometries containing low-affinity agonist binding sites, with EC 50 values from 0.2–0.4 μM. SR9883 had no effect on α3β2* or α3β4* nAChRs. SR9883 was bioavailable after intravenous (1 mg kg ⁻¹ ) and oral (10–20 mg kg ⁻¹ ) administration and penetrated into the brain. When administered alone, SR9883 (5–10 mg kg ⁻¹ ) had no effect on locomotor activity or intracranial self-stimulation (ICSS) thresholds in mice. When co-administered with nicotine, SR9883 enhanced locomotor suppression and elevations of ICSS thresholds induced by nicotine. SR9883 (5 and 10 mg kg ⁻¹ ) decreased responding for intravenous nicotine infusions (0.03 mg kg ⁻¹ per infusion) but had no effect on responding for food rewards in rats.
Conclusions
These data suggest that SR9883 is useful for investigating behavioral processes regulated by certain α4β2* nAChR stoichiometries. SR9883 and related compounds with favorable drug-like physiochemical and pharmacological properties hold promise as novel treatments of tobacco use disorder.
Introduction
New-generation tobacco products (NGPs) hold promises as modified-risk alternatives to conventional cigarettes (CCs), given their comparable characteristics. This study investigated the nicotine pharmacokinetics (PK) of NGPs, encompassing closed pod systems, refillable e-cigarettes (ECs), and heated tobacco products (HTPs), in comparison to CCs through systematic review and meta-analysis.
Aims and Methods
A comprehensive search was conducted on PubMed, Embase, and Web of Science for articles published between January 2013 and July 2023. Maximum nicotine concentration (Cmax), time to peak concentration (Tmax), and total nicotine exposure (area under the concentration-time curve, AUC) were extracted to evaluate nicotine delivery PK. Random effects meta-analyses were performed to determine pooled standardized mean differences, facilitating a comparison of PK profiles between NGPs and CCs. Subgroup analyses exploring flavors and nicotine concentrations across NGPs, and CCs were also conducted.
Results
The meta-analysis incorporated 30 articles with 2728 participants. Cmax and AUC were significantly lower for NGPs, while Tmax demonstrated statistical similarity compared to CCs. Among three NGPs, Cmax, and AUC were lower for closed pod systems and refillable ECs. In HTPs, Cmax was statistically similar while AUC was lower compared to CCs. Tmax was statistically similar in closed pod systems and HTPs compared to that of CCs. No significant difference was observed in the comparisons of PK between each type of NGPs versus CCs.
Conclusions
NGPs delivered less nicotine than CCs but reached Cmax over a similar timeframe, indicating that NGPs may serve as modified-risk alternatives with lower nicotine delivery to CCs for craving relief and smoking cessation.
Implications
This study suggested that NGPs, such as the closed pod systems, the refillable ECs, and the HTPs, delivered either lower or comparable nicotine levels and achieved peak nicotine concentration at a similar rate as CCs. Our findings carry implications that NGPs can serve as modified-risk nicotine alternatives to CCs in helping smokers manage cravings and potentially quit smoking, thereby highlighting their value in the field of tobacco harm reduction.
Simple Summary
Given its huge impact on global health, lung cancer remains a major diagnostic and therapeutic challenge. However, much has been achieved, and this review reports on recent advances, from the genetic understanding of lung cancer to personalized treatments and targeted therapies based on genetic landscape.
Abstract
Lung cancer, including both non-small cell lung cancer and small cell lung cancer, remains the leading cause of cancer-related mortality worldwide, representing 18% of the total cancer deaths in 2020. Many patients are identified already at an advanced stage with metastatic disease and have a worsening prognosis. Recent advances in the genetic understanding of lung cancer have opened new avenues for personalized treatments and targeted therapies. This review examines the latest discoveries in the genetics of lung cancer, discusses key biomarkers, and analyzes current clinical therapies based on this genetic information. It will conclude with a discussion of future prospects and potential research directions.
The study examined the utilization of the Students’ Information System (SIS) within public Senior High Schools in the Cape Coast Metropolis. Adopting a mixed method convergent parallel research design, the study sampled 306 teachers and 22 ICT coordinators through proportionate stratified and purposive sampling techniques respectively. Findings indicate that the SIS facilitates teachers in efficiently inputting students’ scores and providing feedback through their portals. While teachers perceive the system as aiding in accurately interpreting students’ scores, they encounter challenges when attempting to upload scores from Microsoft Excel onto the SIS. Despite its benefits, teachers disagree that the SIS is entirely error-free. The study concludes that though the SIS streamlines various tasks for teachers, such as score entry and feedback provision, issues persist with uploading scores from Excel, possibly due to inadequate training. Thus, the study recommends organizing training sessions or workshops to enhance teachers’ proficiency in utilizing the SIS, particularly concerning the upload process from Excel.
Objectives: This study used repeated cross-sectional data from three national surveys in Vietnam to determine tobacco smoking prevalence from 2010 to 2020 and disparities among demographic and socioeconomic groups.
Methods: Tobacco smoking temporal trends were estimated for individuals aged 15 and over and stratified by demographic and socioeconomic status (SES). Prevalence estimates used survey weights and 95% confidence intervals. Logistic regression models adjusted for survey sample characteristics across time were used to examine trends.
Results: Tobacco smoking prevalence dropped from 23.8% in 2010 to 22.5% in 2015 and 20.8% in 2020. The adjusted OR for 2015 compared to 2010 was 0.87, and for 2020 compared to 2010 was 0.69. Smoking decreased less for employed individuals than unemployed individuals in 2020 compared to 2010. Smoking was higher in the lower SES group in all 3 years. Higher-SES households have seen a decade-long drop in tobacco use.
Conclusion: This prevalence remained constant in lower SES households. This highlights the need for targeted interventions to address the specific challenges faced by lower-SES smokers and emphasizes the importance of further research to inform effective policies.
Smoking is a major global health issue that contributes to various chronic diseases, while hypertension and obesity are considered significant health concerns due to their associated complications, such as cardiovascular diseases and metabolic disorders. In this study, we investigated the associations between current smoking status, hypertension, and obesity among the Korean population, excluding individuals with high blood pressure (systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 100 mmHg) and those taking antihypertensive medications. Data from the 2015 Korea National Fitness Assessment, encompassing 3457 individuals, were analyzed. Logistic regression analysis was used to examine the effects of current smoking and other variables on hypertension and obesity. The results showed that, among the population that excludes specific hypertension criteria, current smoking status was not significantly associated with hypertension or obesity. However, sex and body mass index were significantly associated with hypertension, and age, sex, and blood pressure were significantly associated with obesity. Future research should utilize larger sample sizes and longitudinal designs to confirm these findings and include a broader range of hypertensive participants to better control for potential confounding variables.
Background
Nicotine dependence, also known as tobacco dependence, is a common chronic disease and a major risk factor for chronic respiratory diseases. The present study was designed to determine the prevalence of nicotine dependence and its changes among smokers aged 40 years and older in China, to analyze the characteristics of nicotine dependence among smokers, and to provide a reference for smoking cessation interventions.
Methods
The data were sourced from nationally representative large-sample surveys conducted during 2014–2015 and 2019–2020 in the Chinese population, covering 125 counties (districts) in 31 provinces, autonomous regions and municipalities. Variables related to smoking and nicotine dependence among residents ≥40 years old were collected in face-to-face interviews. A total of 20,062 and 18,975 daily smokers were included in the 2014–2015 and 2019–2020 surveys, respectively. The severity of nicotine dependence was evaluated according to the Fagerström Test for Nicotine Dependence and Heaviness of Smoking Index. The level and change in nicotine dependence among daily smokers aged ≥40 years were estimated using a complex weighted sampling design, and their influencing factors were analyzed.
Results
Levels of nicotine dependence among daily smokers aged ≥40 years in China could be divided into very low, low, medium, high, and very high, accounting for 31.1%, 27.9%, 13.4%, 20.5%, and 7.1% of the total, respectively. The average Fagerström Test for Nicotine Dependence score was 3.9 (95% confidence interval [CI]: 3.8–4.0), with the prevalence of medium–high nicotine dependence being 41.0% (95% CI: 39.0–42.9%) and that of high and very high nicotine dependence being 27.6% (95% CI: 26.0–29.3%), both of which were significantly higher in men than in women (both P < 0.001). Among daily smokers, those with a low education level, age at smoking initiation <18 years, and with smoking duration of ≥20 years had a higher degree of nicotine dependence. In terms of geographic region, the level of medium–high nicotine dependence in South China was higher than in other areas, and the decline in the prevalence of high nicotine dependence was the greatest in Northwest China (P < 0.001). The prevalence of medium–high and high and very high nicotine dependence was significantly higher in men with chronic respiratory symptoms, chronic obstructive pulmonary disease (COPD), and/or chronic respiratory diseases than in men without these conditions (all P < 0.05). The prevalence of high and very high nicotine dependence in women with chronic respiratory symptoms and chronic respiratory diseases was significantly higher than that in women without these conditions (both P < 0.05). Compared with that during 2014–2015, the prevalence of high nicotine dependence among daily smokers decreased during 2019–2020 by 4.5 percentage points in the total population (P < 0.001) and by 4.8 percentage points in men (P < 0.001), with no significant change seen in women (P > 0.05). Additionally, the prevalence of high nicotine dependence in men with chronic respiratory symptoms and COPD decreased by 6.7 and 4.7 percentage points, respectively (P < 0.05), but showed no significant change in women with these conditions (P > 0.05). Multivariate logistic regression analysis showed that the risk of medium-high nicotine dependence was higher among daily smokers who were male; 50–59 years old; unmarried/divorced/widowed/separated; engaged in agriculture, forestry, husbandry, fishery and water conservancy; had a low education level; started smoking before the age of 18 years; and smoked for more than 20 years.
Conclusions
The past few years have seen a slight decline in the prevalence of high (severe) nicotine dependence among smokers aged ≥40 years in China. However, 41.0% of daily smokers had medium-high nicotine dependence, and 27.6% had high or very high nicotine dependence, with notable differences in population and geographic distributions. Development of tailored interventions, optimization of smoking cessation service systems, and integration of smoking cessation into the management of chronic diseases will effectively reduce the burden of nicotine dependence in China.
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