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Zamani M, Alizadeh-Tabari S. Does Elderly-Onset Inflammatory Bowel Disease Increase Risk of Colorectal Cancer? A Systematic Review and Meta-Analysis. J Clin Med 2023; 13:148. [PMID: 38202155 PMCID: PMC10779516 DOI: 10.3390/jcm13010148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/07/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Although younger adults with inflammatory bowel disease (IBD) are known to have an increased risk of developing colorectal cancer (CRC), the impact of IBD on CRC risk in elderly patients is not yet fully understood. Therefore, we conducted this systematic review and meta-analysis to address this knowledge gap. METHODS We thoroughly searched Embase, PubMed, and Scopus, covering the literature from inception to 31 August 2023, in any language. We enrolled population-based cohort studies that appraised the risk of CRC development in elderly patients (≥60 years) with IBD as compared to the non-IBD population. Our meta-analysis provided pooled relative risk (RR) with 95% confidence intervals (CIs) using a random-effect model. RESULTS Out of 3904 citations, 3 eligible cohort studies were ultimately included, reporting 694 CRC events in 35,187 patients with IBD. According to analysis, the risk of developing CRC did not increase in patients with elderly-onset IBD (RR = 1.17 [95% CI: 0.86-1.47]; I2 = 62.6%). This lack of a significant association was observed in both patients with Crohn's disease (RR = 1.28 [95% CI: 0.88-1.69]) and ulcerative colitis (RR = 0.99 [95% CI: 0.90-1.09]) (p for interaction = 0.166). CONCLUSION Our findings revealed no significant increase in the risk of incident CRC in patients with elderly-onset IBD, suggesting that intense screening of these patients for CRC may not be necessary.
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Affiliation(s)
- Mohammad Zamani
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 1411713135, Iran
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Ariaratnam S, Kee CC, Krishnapillai AD, Sanaudi R, Tohit NM, Ho KB, Ghazali SS, Omar MA. Smoking status and its relationship with depression among the elderly population in Malaysia: Findings from the National Health and Morbidity Survey 2018. Tob Induc Dis 2023; 21:109. [PMID: 37654502 PMCID: PMC10467346 DOI: 10.18332/tid/169682] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 09/02/2023] Open
Abstract
INTRODUCTION Literature exploring smoking status and its association with depression among the elderly population using nationwide data in Malaysia is limited. Hence, a nationwide survey to determine the prevalence of smoking and depression among the elderly (aged ≥60 years) population was undertaken. METHODS This secondary dataset analysis used data from the National Health and Morbidity Survey (NHMS) 2018. Data from 3914 participants were collected on elderly health in the Malaysian population. Sociodemographic characteristics were recorded. Smoking status was grouped as current smokers, former smokers, and non-smokers. A validated Malay language version of the Geriatric Depression Scale (M-GDS-14) was used to screen for depression among the elderly. RESULTS There was a significant association between smoking status with location, gender, employment status, marital status, ethnicity, education level, income, and depression. Current smokers are significantly higher in rural than urban areas. Among depressed participants, 65.7%, 17.1% and 17.2% were non-smokers, former smokers and current smokers, respectively. Multiple logistic regression showed that single (unmarried/separated/ divorced/widowed) participants were more likely to be depressed compared to married participants (AOR=1.68; 95% CI: 1.16-2.43). Whilst unemployed participants were more likely to be depressed than those who were employed (AOR=1.72; 95% CI: 1.22-2.44). Other Bumiputras were more likely to have depression compared to Malay, Chinese and Indian participants. Participants without formal education were more likely to be depressed compared to those having tertiary education. These participants have a 2-fold increased risk of depression (AOR=2.13; 95% CI: 1.02-4.45). Participants whose monthly salaries were <2000 MYR (AOR=3.67; 95% CI: 1.84-7.31) and 1000-1999 MYR (AOR=2.71; 95% CI: 1.23-5.94) were more likely to have depression compared with those who had received ≥3000 MYR. Ever smokers were more likely to be depressed than non-smokers (AOR=1.68; 95% CI: 1.23-2.29). CONCLUSIONS Elderly Malaysians are indeed at risk of developing depression particularly if they had ever smoked. Public health awareness and campaigning are pertinent to disseminate these outcomes in order to spread the awareness associated with smoking-related depression.
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Affiliation(s)
- Suthahar Ariaratnam
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Malaysia
| | - Cheong C. Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Ambigga D. Krishnapillai
- Department of Family Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Ridwan Sanaudi
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Noorlaili Mohd Tohit
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Kiau B. Ho
- Bandar Botanic Health Clinic, Klang, Malaysia
| | - Sazlina Shariff Ghazali
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
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Soberano JID, Hernandez MA, Cacciata MC, Flores JLA, Leyva EWA, Tuazon JA, Evangelista LS. A Comparative Study on Health Risks, Lifestyle Behaviors, Health Perceptions, and Health Seeking Patterns between Older and Younger Filipinos in the Rural Areas. THE PHILIPPINE JOURNAL OF NURSING 2023; 93:3-12. [PMID: 38406642 PMCID: PMC10888510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Background Worldwide trends in health risks, lifestyle behaviors, health perceptions, and health-seeking patterns suggest alarming disparities among individuals from low- and middle-income countries. Such international comparisons are particularly troubling for older individuals (≥ 60 years). Objectives This study aims to compare health risks, lifestyle behaviors, health perceptions, and health-seeking patterns between younger (<60) and older (≥60) Filipinos from rural communities in the Philippines. Methods A comparative cross-sectional study was employed with 863 younger and 427 older Filipinos. Data were analyzed using frequencies, chi-squares, and T-tests. Results Older participants were more likely to be single/widowed, ≤ high school education and had higher rates of hypertension, high cholesterol, diabetes, and depression. They reported poorer health status and went to the village health center when sick. Furthermore, they were less likely to drink alcohol and see a physician. Conclusion There were significant differences in modifiable health risks and lifestyle behaviors and differences in health perceptions between younger and older cohorts of Filipinos living in rural areas in the Philippines. Our findings suggest the need to design separate health promotion interventions that target older and younger Filipinos' unique needs from rural communities.
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Affiliation(s)
| | | | | | - Jo Leah A. Flores
- Veteran’s Affairs Long Beach Healthcare System, Long Beach, California
| | | | - Josefina A. Tuazon
- University of the Philippines Manila College of Nursing, Manila, Philippines
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Avila JC, Lee S, Osuoha E, Maglalang DD, Sokolovsky A, Ahluwalia JS. Socioeconomic status across the life course and smoking cessation among older adult smokers in the U.S. Addict Behav 2022; 135:107454. [PMID: 35964392 PMCID: PMC9639006 DOI: 10.1016/j.addbeh.2022.107454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Socioeconomic status (SES) at different stages of the life course impacts late-life health. However, whether SES across the life course impacts smoking cessation in late-life is not known. PURPOSE Assess how life course SES impacts smoking cessation among older smokers. METHODS We identified 5,124 smokers, 50 years and older, from the 1998 to 2018 waves of the Health and Retirement Study. The outcome was self-reported smoking cessation. The main exposure was life course SES, defined as: low child and low adult SES (persistent low); low child, high adult SES (upward mobility); high child, low adult SES (downward mobility); and high child, high adult SES (persistent high). A multilevel mixed-effect logistic model was used to examine how life course SES predicts smoking cessation at age 65 and over time, adjusted for covariates. RESULTS Compared to those with persistent high SES, those with persistent low SES, upward and downward SES were more likely to be Hispanic or non-Hispanic Black. The adjusted results showed that at age 65, compared to those with persistent high SES, those with persistent low SES (OR= 0.69, 95 % CI = [0.51-0.92]), upward SES (OR= 0.49, [0.32-0.75]), and downward SES (OR= 0.55, [0.40-0.76]) were less likely to quit. However, as age increased, only those with downward or persistent low SES were significantly less likely to quit compared to those with persistent high SES. DISCUSSION Social mobility of SES from childhood to adulthood significantly impacts smoking cessation. Both stages of the life course should be considered to understand smoking behaviors.
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Affiliation(s)
- Jaqueline C Avila
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, School of Public Health, Brown University, United States.
| | - Sangah Lee
- Department of Epidemiology, School of Public Health, Brown University, United States
| | - Ezinwa Osuoha
- Department if Science and Technology Studies, Cornell University, United States
| | - Dale Dagar Maglalang
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, School of Public Health, Brown University, United States
| | - Alexander Sokolovsky
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, School of Public Health, Brown University, United States
| | - Jasjit S Ahluwalia
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, School of Public Health, Brown University, United States; Department of Medicine, Alpert School of Medicine, Brown University, United States; Brown Cancer Center, Brown University, United States
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Jia H, Lubetkin E. Use of a microsimulation method for assessing dynamics of smoking status and gains in life expectancy after quitting in a longitudinal cohort of US older adults. BMJ Open 2022; 12:e062189. [PMID: 36332957 PMCID: PMC9639091 DOI: 10.1136/bmjopen-2022-062189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Previous studies were unable to estimate the dynamics of smoking status in the US elderly general population, and no study has assessed the benefit of quitting in terms of resultant gains in life expectancy. We proposed a novel method to estimate the per cent of quitting in remaining lifetime, successful quitting and relapse, as well as life expectancy by participants' baseline smoking status. DESIGN Longitudinal cohort. SETTING US community-dwelling population. PARTICIPANTS Respondents from the Medicare Health Outcome Survey Cohort 15 (baseline 2012, follow-up 2014). We included respondents who were aged ≥65 years and alive at the baseline and participated in the baseline survey (n=164 597).Primary and secondary outcome measuresAttempt quitting, successful quitting, relapse rates and life expectancy by smoking status at age 65-95 years. RESULTS Among daily smokers aged 65 years, 61% would attempt to quit during their remaining lifetime, and 31% would quit successfully. Among some days smokers aged 65 years, 69% would attempt to quit during their remaining lifetime, and 37% would quit successfully. Among recent ex-smokers aged 65 years, 53% would relapse. Life expectancy at age 65 years was 20.0 (SE=0.27), 17.2 (SE=0.30), 16.2 (SE=0.29) and 15.9 (SE=0.29) years for long time non-smokers, recent ex-smokers, some days smokers and daily smokers, respectively. Although recent ex-smokers had a higher 2-year mortality than current smokers, those who quit up to 77 years (77 years for men and 87 years for women) had a significantly longer (p<0.05) life expectancy. Sensitivity analysis demonstrated that the model assumptions had a relatively small impact on estimates with a maximum relative bias within ±7%. CONCLUSIONS This study provides detailed information regarding the dynamics of smoking status in an understudied and growing population and demonstrates the benefit of smoking cessation on life expectancy. Future research should focus on understanding specific predictors of smoking cessation.
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Affiliation(s)
- Haomiao Jia
- Department of Biostatistics, School of Public Health and School of Nursing, Columbia University, New York, New York, USA
| | - Erica Lubetkin
- Community Health and Social Medicine, The City College of New York, New York, New York, USA
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Avila JC, Berg CJ, Robinson JD, Ahluwalia JS. Short- and Long-Term Cigarette and Tobacco Abstinence Among Daily and Nondaily Older Smokers. Nicotine Tob Res 2022; 24:1773-1780. [PMID: 35511741 PMCID: PMC9597074 DOI: 10.1093/ntr/ntac116] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 04/05/2022] [Accepted: 04/27/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION There is mixed evidence regarding whether older (vs. younger) smokers are more or less likely to quit smoking. We examined how age is associated with cigarette and all tobacco product abstinence and the potential moderating effects of smoking frequency. AIMS AND METHODS Data from a 4-year cohort of the Population Assessment of Tobacco and Health (PATH) study were used, including 7512 smokers at Wave 1 who had smoking status data at Wave 4. Logistic regression models were used to examine the effects of age (18-24, 25-34, 35-44, 45-54, and ≥55 years) on Wave 4, 30-day and 12-month cigarette and all tobacco product abstinence, adjusting for covariates and the interaction between age and cigarette use frequency (nondaily, light daily, and heavy daily). RESULTS Older smokers (≥55 years) were more likely to be heavy daily smokers than younger smokers 18-24 and 25-34 years, but were less likely to have a past-year cigarette quit attempt. Younger smokers 45-54 years were less likely to report 12-month cigarette abstinence than older smokers (odds ratio = 0.72 [0.54-0.95]). Younger smokers 18-24 and 45-54 years were less likely to report 12-month tobacco product abstinence than older smokers (odds ratio = 0.65 [0.45-0.93]; odds ratio = 0.73 [0.55-0.96], respectively). Thirty-day cigarette abstinence significantly decreased as age increased for nondaily smokers, significantly increased for heavier daily smokers, but remained similar across age for light daily smokers. CONCLUSIONS Older smokers were more likely to report 12-month cigarette and tobacco abstinence than younger smokers 45-54 years old, and the effect of age on abstinence differed by smoking frequency/intensity. Smoking cessation interventions need to be age specific and consider smoking frequency. IMPLICATIONS This study shows that although older smokers are more likely to be heavy smokers and less likely to have a quit attempt at baseline, they are more likely to have 12-month cigarette and tobacco abstinence than younger smokers. Furthermore, 30-day cigarette abstinence significantly decreases as age increases for nondaily smokers and significantly increases for heavy daily smokers, suggesting that the effect of cigarette smoking frequency and intensity changes with age. Smoking cessation interventions need to be age specific as well as consider the smoking frequency/intensity of each age group. Younger smokers may need more targeted cessation interventions to successfully quit.
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Affiliation(s)
- Jaqueline C Avila
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Jason D Robinson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jasjit S Ahluwalia
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Department of Medicine, Brown University Alpert Medical School, Providence, RI, USA
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Green R, Lin J, Montoya AK, Bello MS, Grodin EN, Ryu H, Ho D, Leventhal AM, Ray LA. Characteristics associated with treatment seeking for smoking cessation among heavy-drinking research participants. Front Psychiatry 2022; 13:951364. [PMID: 36245856 PMCID: PMC9554538 DOI: 10.3389/fpsyt.2022.951364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/25/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Treatment seeking for smoking cessation has tremendous clinical implications with the potential to reduce tobacco-related morbidity and mortality. The present study seeks to elucidate clinical variables that distinguish treatment seeking versus non-treatment seeking status for smoking cessation in a large sample of heavy drinking smokers using data-driven methods. MATERIALS AND METHODS This secondary data analysis examines n = 911 (n = 267 female) individuals who were daily smokers and heavy drinkers (≥ 7 drinks per week for women, ≥ 14 for men) that were enrolled in either a treatment-seeking study (N = 450) or a non-treatment seeking study (N = 461) using identical pharmacotherapies. Participants completed measures of demographics, alcohol and cigarette use, alcohol craving, the Barratt Impulsiveness Scale (BIS-11), and the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68). These measures were used in a random forest model to identify predictors of treatment seeking status. RESULTS The top variables of importance in identifying treatment seeking status were: age, drinks per drinking day, cigarettes per smoking day, BIS-11 cognitive impulsivity, WISDM social environmental goads, WISDM loss of control, WISDM craving, and WISDM tolerance. Age and drinks per drinking day were two of the most robust predictors, followed by measures of nicotine craving and tolerance. CONCLUSION Individuals who are daily smokers and consume more drinks per drinking day are less likely to belong to the smoking cessationtreatment-seeking group. Targeting heavy drinking smokers, particularly younger individuals, may be necessary to engage this group in smoking cessation efforts and to reduce the burden of disease of nicotine dependence earlier in the lifespan.
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Affiliation(s)
- ReJoyce Green
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Johnny Lin
- Institute for Digital Research and Education, University of California, Los Angeles, Los Angeles, CA, United States
| | - Amanda K Montoya
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Mariel S Bello
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
| | - Erica N Grodin
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Howon Ryu
- Institute for Digital Research and Education, University of California, Los Angeles, Los Angeles, CA, United States
| | - Diana Ho
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States.,Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
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Impact of Depression and Nicotine Dependence on Executive Functioning in Rural Older Adult Smokers: A Brief Report (NCT02510716). J Addict Nurs 2021; 32:249-254. [PMID: 34855323 DOI: 10.1097/jan.0000000000000436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Rural older adults are an underserved population with high rates of smoking and related morbidity and mortality. Age-related executive function deficits are common in older smokers; however, the association of depression and nicotine dependence on executive function has not been explored. This study addressed whether depression and nicotine dependence are related to executive dysfunction in rural older adult smokers. METHODS The sample included 40 rural older adults recruited from two primary care clinics in North Carolina. Executive function was evaluated with the Behavioral Regulation Index (BRI), Metacognition Index, and Global Executive Composite (GEC) T scores from the Behavior Rating Inventory of Executive Function-Adult. Nicotine dependence and depression symptoms were assessed using the Fagerstrom Test and Center for Epidemiologic Depression Scale-10, respectively. Analysis of variance was used to explore whether depression and/or nicotine dependence influences executive function. Nondirectional tests were performed with significance set at .10. RESULTS Smokers who screened positive for depression had significantly greater executive dysfunction than those who did not (BRI: p = .0003, Metacognition Index: p < .0001, GEC: p < .0001), and moderate/high dependence was associated with greater executive function deficits compared with those with mild dependence (BRI: p = .0942). Together, depression and nicotine dependence explained 50% of the variability of the GEC overall scores. CONCLUSIONS Executive dysfunction is common in rural older adult smokers and associated with depression and nicotine dependence severity. Futures studies should test the relationship of executive function and smoking cessation in the older adult population as it may have implications for cessation in this population.
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Abstract
Nicotine is one of the most abused substances worldwide. Just as in adolescence and adulthood, tobacco use is also problematic in the elderly. Older people are more vulnerable to smoking consequences because of the additive effects of smoke. Cardiovascular diseases are the most common health problems associated with smoking; however, other systems are also affected, including the respiratory, nervous, integumentary, and many other systems. Smoking cessation is a difficult task especially in the elderly; therefore, physicians should encourage older patients to quit with every patient-physician encounter by offering counseling and replacement therapy.
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Affiliation(s)
- Nazem K Bassil
- Geriatric Medicine, Palliative Care, Balamand University, Saint George Hospital University Medical Center, Beirut, Lebanon.
| | - Marie Lena K Ohanian
- Family Medicine, Balamand University, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Theodora G Bou Saba
- Family Medicine, Balamand University, Saint George Hospital University Medical Center, Beirut, Lebanon
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Jing Z, Li J, Wang Y, Yuan Y, Zhao D, Hao W, Yu C, Zhou C. Association of smoking status and health-related quality of life: difference among young, middle-aged, and older adults in Shandong, China. Qual Life Res 2020; 30:521-530. [PMID: 32989682 DOI: 10.1007/s11136-020-02645-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Few studies explored the relationship between smoking status and health-related quality of life (HRQOL) among adults in China. This study aims to explore the relationship between smoking status and HRQOL among adults (18 +) and examine whether there is a difference in this relationship among young, middle-aged, and older adults in China. METHODS A total of 23,021 respondents were included in this study. The HRQOL is measured by EQ-5D-3L. The smoking status is divided into never smokers, current smokers, and former smokers. Tobit regression and Logistic regression are employed to explore the association between smoking status and HRQOL. The interaction term is included to explore the difference among young, middle-aged, and older adults. RESULTS This study finds smoking status is significantly associated with HRQOL. An interaction analysis shows that the association between smoking status and HRQOL is significantly different among young, middle-aged, and older adults (P < 0.05). The smoking status is only significantly associated with HRQOL in middle-aged and older adults, but not for young adults. Compared with never smokers, former smokers report significantly lower EQ-5D-3L utility value in middle-aged adults (coefficient = - 0.089; 95%CI - 0.128 to - 0.050), current smokers report significantly higher EQ-5D-3L utility value in older adults (coefficient = 0.041; 95%CI 0.005 to 0.076). CONCLUSIONS This study demonstrates a significant association between smoking status and HRQOL among adults in China, and there is a difference in this relationship among young, middle-aged, and older adults. The government should take efforts to formulate a variety of measures to control tobacco use among adults.
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Affiliation(s)
- Zhengyue Jing
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Jie Li
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Yi Wang
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Yemin Yuan
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Dan Zhao
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Wenting Hao
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Caiting Yu
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Chengchao Zhou
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China. .,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
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Lappan S, Thorne CB, Long D, Hendricks PS. Longitudinal and Reciprocal Relationships Between Psychological Well-Being and Smoking. Nicotine Tob Res 2020; 22:18-23. [PMID: 30219867 DOI: 10.1093/ntr/nty185] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 09/05/2018] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Smoking cessation treatments currently succeed at a rate of approximately 20%-30%, underscoring the importance of exploring factors that might increase intervention effectiveness. Although negative affect has been studied extensively in relation to smoking cessation, psychological well-being (PWB; eg, life satisfaction, optimism, positive affect, purpose in life) has received little attention. This study tested longitudinal and reciprocal relationships between PWB and smoking status in older adults. METHODS Panel data were obtained from the biennial, longitudinal Health and Retirement Study. Using structural equation modeling, we developed cross-lagged models to examine the relationships of PWB in 2006 with smoking status in 2010 and of smoking status in 2006 with PWB in 2010 while controlling for covariates (Ns = 2939-4230, 55% women, 89% white, mean age = 64 years, mean years of education = 13, 25% smokers in 2006 and 21% smokers in 2010). Separate cross-lagged models were developed for each of the PWB variables: life satisfaction, optimism, positive affect, and purpose in life. RESULTS Greater life satisfaction (standardized path coefficient = -0.04), optimism (standardized path coefficient = -0.07), and positive affect (standardized path coefficient = -0.08) in 2006 predicted a reduced likelihood of smoking in 2010. Being a smoker in 2006 predicted lower life satisfaction (standardized path coefficient = -0.25), optimism (standardized path coefficient = -0.10), positive affect (standardized path coefficient = -0.10), and purpose in life (standardized path coefficient = -0.13) in 2010. CONCLUSIONS Findings warrant further exploration of the relationships between PWB and smoking, and support the incorporation of PWB-boosting components into existing treatments. IMPLICATIONS Given the relatively low success rate of current smoking cessation treatments, the present results suggest that increasing PWB might promote abstinence and therefore warrant consideration as a focus of future cessation treatment research. Moreover, these results suggest that smoking might inhibit PWB, illuminating a negative consequence of smoking not previously identified. Helping smokers increase their PWB may benefit them beyond promoting cessation and contribute to a flourishing society. These results warrant further investigation of PWB and smoking, and support the continued evaluation of PWB-boosting components in smoking cessation treatments.
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Affiliation(s)
- Sara Lappan
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Christopher B Thorne
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Dustin Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Peter S Hendricks
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
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Kleykamp BA. Response to Serrano-Alarcón et al. (2019): Tobacco control policy and smokers aged 65 years and older. Addiction 2020; 115:585-586. [PMID: 31655006 DOI: 10.1111/add.14856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 10/02/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Bethea A Kleykamp
- Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine and Dentistry, NY, USA
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Goldberg RL, Dankiewicz C, Cataldo JK. Older Smokers' Beliefs About e-Cigarettes and Intent to Quit Conventional Cigarettes. J Gerontol Nurs 2018; 44:17-24. [PMID: 30484844 DOI: 10.3928/00989134-20181018-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 09/13/2018] [Indexed: 11/20/2022]
Abstract
To explore associations between older smokers' attitudes and beliefs about electronic cigarettes (e-cigarettes) and tobacco use behavior, descriptive and correlational analysis of a cross-sectional survey of a random national sample of current smokers (age ≥45 years [considered "older" herein]) was performed. Of 498 older smokers, 75% wanted to quit smoking cigarettes and 60% had tried e-cigarettes. The 108 current e-cigarette users believed e-cigarettes help quit cigarettes (p < 0.001), are safer than cigarettes (p = 0.002), and are acceptable to friends (p = 0.010) and family (p = 0.007). Smokers not considering cessation believed friends and family think it is okay to smoke cigarettes (p < 0.001). Among older smokers: (a) most want to quit cigarettes; (b) e-cigarette use is increasing; (c) most believe e-cigarettes are healthier than cigarettes and effective for cessation; and (d) perceived social acceptability modifies tobacco use behavior by influencing initiation and maintenance of conventional cigarette and e-cigarette use. [Journal of Gerontological Nursing, 44(12), 17-24.].
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Yu J, Tao Y, Dou J, Ye J, Yu Y, Jin L. The dose-response analysis between BMI and common chronic diseases in northeast China. Sci Rep 2018. [PMID: 29523859 PMCID: PMC5845012 DOI: 10.1038/s41598-018-22551-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
High body mass index (BMI) predisposes to several chronic diseases, but a large-scale systematic and detailed study of dose-response relationship between BMI and chronic diseases has not been reported previously. In this study, we aimed to investigate the relationship between BMI and 3 chronic diseases (hypertension, dyslipidemia and MetS) in northeast China. A sample of 16412 participants aged 18~79 years old were included in Jilin province in 2012. The lambda-mu-sigma (LMS) method was applied to examine the trend of BMI by age, and the restricted cubic splines were used to investigate the non-linear associations (dose-response curve) between BMI and chronic diseases. It was pointed out that BMI increased rapidly when young, then kept steady in middle age, and finally declined slowly in old age, and accordingly age was divided into 3 segments, which were different by gender. The odds ratios (ORs) of BMI for the chronic diseases increased relatively slowly when young, then increased dramatically in middle-age and old population, especially for men. Further, the ORs of BMI among non-smokers were lower than those among smokers, and the same trend was shown to be more apparent among drinkers and non-drinkers. The risk of BMI for common chronic diseases increased dramatically in middle-aged, especially for men with drinking and smoking habits.
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Affiliation(s)
- Jianxing Yu
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China
| | - Yuchun Tao
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China
| | - Jing Dou
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China
| | - Junsen Ye
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China
| | - Yaqin Yu
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China
| | - Lina Jin
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
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15
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Quiñones AR, Nagel CL, Newsom JT, Huguet N, Sheridan P, Thielke SM. Racial and ethnic differences in smoking changes after chronic disease diagnosis among middle-aged and older adults in the United States. BMC Geriatr 2017; 17:48. [PMID: 28178927 PMCID: PMC5299693 DOI: 10.1186/s12877-017-0438-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 02/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Middle-aged and older Americans from underrepresented racial and ethnic backgrounds are at risk for greater chronic disease morbidity than their white counterparts. Cigarette smoking increases the severity of chronic illness, worsens physical functioning, and impairs the successful management of symptoms. As a result, it is important to understand whether smoking behaviors change after the onset of a chronic condition. We assessed the racial/ethnic differences in smoking behavior change after onset of chronic diseases among middle-aged and older adults in the US. METHODS We use longitudinal data from the Health and Retirement Study (HRS 1992-2010) to examine changes in smoking status and quantity of cigarettes smoked after a new heart disease, diabetes, cancer, stroke, or lung disease diagnosis among smokers. RESULTS The percentage of middle-aged and older smokers who quit after a new diagnosis varied by racial/ethnic group and disease: for white smokers, the percentage ranged from 14% after diabetes diagnosis to 32% after cancer diagnosis; for black smokers, the percentage ranged from 15% after lung disease diagnosis to 40% after heart disease diagnosis; the percentage of Latino smokers who quit was only statistically significant after stoke, where 38% quit. In logistic models, black (OR = 0.43, 95% CI: 0.19-0.99) and Latino (OR = 0.26, 95% CI: 0.11-0.65) older adults were less likely to continue smoking relative to white older adults after a stroke, and Latinos were more likely to continue smoking relative to black older adults after heart disease onset (OR = 2.69, 95% CI [1.05-6.95]). In models evaluating changes in the number of cigarettes smoked after a new diagnosis, black older adults smoked significantly fewer cigarettes than whites after a new diagnosis of diabetes, heart disease, stroke or cancer, and Latino older adults smoked significantly fewer cigarettes compared to white older adults after newly diagnosed diabetes and heart disease. Relative to black older adults, Latinos smoked significantly fewer cigarettes after newly diagnosed diabetes. CONCLUSIONS A large majority of middle-aged and older smokers continued to smoke after diagnosis with a major chronic disease. Black participants demonstrated the largest reductions in smoking behavior. These findings have important implications for tailoring secondary prevention efforts for older adults.
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Affiliation(s)
- Ana R Quiñones
- OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA. .,Portland VA Medical Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
| | - Corey L Nagel
- OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.,School of Nursing, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Jason T Newsom
- Department of Psychology, Portland State University, P.O. Box 751, Portland, OR, 97207, USA
| | - Nathalie Huguet
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Paige Sheridan
- OHSU-PSU School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Stephen M Thielke
- Geriatric Research, Education, and Clinical Center, Puget Sound VA Medical Center, 1660 South Columbian Way, Seattle, WA, 98108, USA.,Psychiatry and Behavioral Sciences, University of Washington, 1959 Pacific Avenue, Seattle, WA, 98195, USA
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16
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Cawkwell PB, Blaum C, Sherman SE. Pharmacological Smoking Cessation Therapies in Older Adults: A Review of the Evidence. Drugs Aging 2015; 32:443-51. [PMID: 26025119 DOI: 10.1007/s40266-015-0274-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Nearly 12% of adults 65 years and over in Europe and 9% in the USA are current cigarette smokers. Numerous studies have demonstrated tangible benefits of smoking cessation, regardless of advanced age. However, it is unclear which pharmacotherapy strategies are most effective in the elderly population. To that end, the literature on smoking cessation in older adults was reviewed with the aim of identifying the safest and most effective cessation pharmacotherapies. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for all articles pertaining to elderly smoking cessation strategies. Randomized controlled trials and cohort studies were included. Studies were included without regard to population or intervention, as long as results were analyzed with a group of smokers aged 60 years and above and at least one arm of the study involved a pharmacotherapy. Only 12 studies were identified that met our inclusion criteria. The limited existing literature does not allow for a definitive answer to the most effective pharmacotherapy for smoking cessation in older adult smokers. Nicotine replacement therapy (NRT) is the pharmacotherapy most studied in older adults, and the limited evidence that exists suggests that NRT is effective for smoking cessation among this population. Higher-quality studies that directly compare cessation strategies, including bupropion and varenicline, are needed in the older population in order to guide treatment decision making.
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Affiliation(s)
- Philip B Cawkwell
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, USA
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17
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Müezzinler A, Mons U, Gellert C, Schöttker B, Jansen E, Kee F, O'Doherty MG, Kuulasmaa K, Freedman ND, Abnet CC, Wolk A, Håkansson N, Orsini N, Wilsgaard T, Bueno-de-Mesquita B, van der Schouw YT, Peeters PHM, de Groot LCPGM, Peters A, Orfanos P, Linneberg A, Pisinger C, Tamosiunas A, Baceviciene M, Luksiene D, Bernotiene G, Jousilahti P, Petterson-Kymmer U, Jansson JH, Söderberg S, Eriksson S, Jankovic N, Sánchez MJ, Veronesi G, Sans S, Drygas W, Trichopoulou A, Boffetta P, Brenner H. Smoking and All-cause Mortality in Older Adults: Results From the CHANCES Consortium. Am J Prev Med 2015; 49:e53-e63. [PMID: 26188685 DOI: 10.1016/j.amepre.2015.04.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 03/16/2015] [Accepted: 04/14/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged ≥60 years. METHODS Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014. RESULTS A total of 489,056 participants aged ≥60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit <10, 10 to 19, and ≥20 years ago, respectively. CONCLUSIONS Smoking remains as a strong risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority.
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Affiliation(s)
- Aysel Müezzinler
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Ute Mons
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Carolin Gellert
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eugène Jansen
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Mark G O'Doherty
- UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Kari Kuulasmaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nicola Orsini
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tom Wilsgaard
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Epidemiology, Julius Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Yvonne T van der Schouw
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Petra H M Peeters
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | | | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
| | - Philippos Orfanos
- Hellenic Health Foundation, Athens, Greece; Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - Allan Linneberg
- Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark; Department of Clinical Experimental Research, Glostrup University Hospital, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotta Pisinger
- Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
| | - Abdonas Tamosiunas
- Laboratory of Population Studies, Institute of Cardiology of Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Migle Baceviciene
- Laboratory of Population Studies, Institute of Cardiology of Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dalia Luksiene
- Laboratory of Population Studies, Institute of Cardiology of Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gailute Bernotiene
- Laboratory of Population Studies, Institute of Cardiology of Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Ulrika Petterson-Kymmer
- Department of Public Health and Clinical Medicine, Medicine, Skellefteå Research Unit, Cardiology, Umeå University, Umeå, Sweden; Department of Pharmacology and Clinical Neurosciences, Umeå University, Umeå, Sweden
| | - Jan Håkan Jansson
- Department of Public Health and Clinical Medicine, Medicine, Skellefteå Research Unit, Cardiology, Umeå University, Umeå, Sweden
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Medicine, Skellefteå Research Unit, Cardiology, Umeå University, Umeå, Sweden
| | - Sture Eriksson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Nicole Jankovic
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - María-José Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Granada, Spain; CIBER de Epidemiología y Salud Pública, Barcelona, Spain
| | - Giovanni Veronesi
- Department of Clinical and Experimental Medicine, Research Center in Epidemiology and Preventive Medicine, University of Insubria, Varese, Italy
| | - Susana Sans
- Institute of Health Studies, Barcelona, Spain
| | - Wojciech Drygas
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece; Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - Paolo Boffetta
- Hellenic Health Foundation, Athens, Greece; Tisch Cancer Institute and Institute for Translational Epidemiology, Mount Sinai School of Medicine, New York, New York
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Salgado-García FI, Zuber JK, Graney MJ, Nichols LO, Martindale-Adams JL, Andrasik F. Smoking and Smoking Increase in Caregivers of Alzheimer's Patients. THE GERONTOLOGIST 2015; 55:780-92. [PMID: 24371214 PMCID: PMC4683364 DOI: 10.1093/geront/gnt149] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 10/28/2013] [Indexed: 11/14/2022] Open
Abstract
PURPOSE OF THE STUDY The relationship between stress and smoking has been established, but there is little research on the effects of stress and coping on smoking in caregivers of Alzheimer's disease patients. This study examines how caregiver stressors and coping resources explain smoking status and recent smoking increase. DESIGN AND METHODS Data were obtained from the Resources for Enhancing Alzheimer's Caregivers Health (REACH II) study. Analyses identified differences between caregiver smokers and nonsmokers and between caregiver smokers who reported a recent smoking increase and those who did not. Variables that were significantly different between the groups were examined in two logistic regression analyses to explain smoking status and smoking increase. RESULTS Of 642 caregivers, nearly 40% reported smoking and 25% of smokers reported recent increase in smoking. Younger caregivers were more likely to report smoking. Explanatory variables for smoking increase were being Caucasian or African-American, higher depression scores, and less caregiving skills. IMPLICATIONS This study demonstrates that smoking among caregivers is a valid public health concern. Further investigation of ways that explanatory variables affect smoking status and increase in caregivers, and incorporation of smoking cessation strategies that address depression and low caregiving skills, seem warranted in future caregiver interventions.
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Affiliation(s)
| | - Jeffrey K Zuber
- Department of Preventive Medicine, University of Tennessee Health Science Center, Veterans Affairs Medical Center, Memphis
| | - Marshall J Graney
- Department of Preventive Medicine, University of Tennessee Health Science Center, Veterans Affairs Medical Center, Memphis
| | - Linda O Nichols
- Department of Preventive Medicine, University of Tennessee Health Science Center, Veterans Affairs Medical Center, Memphis. Department of Internal Medicine, University of Tennessee Health Science Center, Veterans Affairs Medical Center, Memphis
| | - Jennifer L Martindale-Adams
- Department of Preventive Medicine, University of Tennessee Health Science Center, Veterans Affairs Medical Center, Memphis.
| | - Frank Andrasik
- Department of Psychology, University of Memphis, Memphis, Tennessee
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Age Differences in the Trends of Smoking Among California Adults: Results from the California Health Interview Survey 2001–2012. J Community Health 2015; 40:1091-8. [DOI: 10.1007/s10900-015-0034-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Cataldo JK, Hunter M, Petersen AB, Sheon N. Positive and instructive anti-smoking messages speak to older smokers: a focus group study. Tob Induc Dis 2015; 13:2. [PMID: 25653578 PMCID: PMC4316656 DOI: 10.1186/s12971-015-0027-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 01/05/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Smokers over the age of 45 are the only group with an increase in smoking prevalence, are the least likely to quit smoking, and bear most of the burden of tobacco-related disease. Research characterizing older adult perceptions of warning labels and anti-tobacco messages has not been reported in the literature. The purpose of this study was to describe whether older smokers perceived warning labels and anti-tobacco messages as effective for the promotion of smoking cessation. A secondary aim was to explore what types of messages and message delivery formats are most relevant to older adult smokers. METHODS This focus group study is part of a larger study to characterize older smokers' perceptions of the risks and benefits associated with conventional and emerging tobacco products and determine the extent to which these perceptions relate to exposure to pro- and anti-tobacco messages. From April 2013 to August 2014 we conducted eight focus groups with 51 current and former smokers a focus group study in urban and suburban California. A semi-structured format about current use of conventional and emerging tobacco products was used. Participants were asked to recall and comment on examples of warning labels and anti-tobacco messages. Data were transcribed and thematically coded. RESULTS Warning labels and anti-smoking messages were seen as ineffective for smoking cessation motivation among older California smokers. Positive framed anti-tobacco messages were identified as most effective. Text-only warnings were seen as ineffective due to desensitizing effects of repeated exposure. Negative messages were described as easy to ignore, and some trigger urges to smoke. Older adults are knowledgeable about the risks and health effects of smoking. However, they tend to be less knowledgeable about the benefits of cessation and may underestimate their ability to quit. CONCLUSION These findings suggest that messages with a positive frame that outline immediate and long-term benefits of cessation would be an effective approach for long-term smokers. Current anti-tobacco messaging was generally not seen as effective for smoking cessation among long-term smokers.
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Affiliation(s)
- Janine K Cataldo
- />Department of Physiological Nursing, University of California San Francisco, Parnassus Avenue, San Francisco, CA USA
| | - Mary Hunter
- />Department of Physiological Nursing, University of California San Francisco, Parnassus Avenue, San Francisco, CA USA
| | - Anne Berit Petersen
- />Department of Physiological Nursing, University of California San Francisco, Parnassus Avenue, San Francisco, CA USA
| | - Nicolas Sheon
- />Department of Medicine, University of California San Francisco, 550 16th St, 3rd Floor, San Francisco, CA USA
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Vrana SR, Calhoun PS, McClernon FJ, Dennis MF, Lee ST, Beckham JC. Effects of smoking on the acoustic startle response and prepulse inhibition in smokers with and without posttraumatic stress disorder. Psychopharmacology (Berl) 2013; 230:477-85. [PMID: 23828156 PMCID: PMC3830656 DOI: 10.1007/s00213-013-3181-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 06/03/2013] [Indexed: 11/25/2022]
Abstract
RATIONALE Cigarette smokers smoke in part because nicotine helps regulate attention. Prepulse inhibition (PPI) of the startle reflex is a measure of early attentional gating that is reduced in abstinent smokers and in groups with attention regulation difficulties. Attention difficulties are found in people with posttraumatic stress disorder (PTSD). OBJECTIVES The aim of this study is to assess whether smoking and abstinence differentially affect the startle response and PPI in smokers with and without PTSD. METHODS Startle response and PPI (prepulses at 60, 120, or 240 ms) were measured in smokers with (N = 39) and without (N = 61) PTSD, while smoking and again while abstinent. RESULTS Participants with PTSD produced both larger magnitude and faster latency startle responses than controls. Across groups, PPI was greater when smoking than when abstinent. The PTSD and control group exhibited different patterns of PPI across prepulse intervals when smoking and when abstinent. Older age was associated with reduced PPI, but only when abstinent from smoking. CONCLUSIONS The effects of PTSD on startle magnitude and of smoking on PPI replicate earlier studies. The different pattern of PPI exhibited in PTSD and control groups across prepulse intervals, while smoking and abstinent suggests that previous research on smoking and PPI has been limited by not including longer prepulse intervals, and that nicotine may affect the time course as well as increasing the level of PPI. The reduced PPI among older participants during abstinence suggests that nicotine may play a role in maintaining attention in older smokers, which may motivate continued smoking in older individuals.
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Affiliation(s)
| | - Patrick S. Calhoun
- Durham Veterans Affairs Medical Center, 508 Fulton St. (116 B), Durham, NC 27705, USA. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA. Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA. Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC 27705, USA
| | - F. Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, 508 Fulton St. (116 B), Durham, NC 27705, USA. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA
| | - Sherman T. Lee
- Durham Veterans Affairs Medical Center, 508 Fulton St. (116 B), Durham, NC 27705, USA
| | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, 508 Fulton St. (116 B), Durham, NC 27705, USA. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA. Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
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Zbikowski SM, Magnusson B, Pockey JR, Tindle HA, Weaver KE. A review of smoking cessation interventions for smokers aged 50 and older. Maturitas 2011; 71:131-41. [PMID: 22209349 DOI: 10.1016/j.maturitas.2011.11.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 11/27/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Cigarette smoking poses substantial health risks at any age, but is particularly dangerous for older smokers, who are already at heightened risk for various health conditions. Studies suggest that older smokers are motivated to quit and succeed, but few of these have been randomized controlled trials. There is a need to systematically evaluate the research on effective interventions in older smokers. METHODS We followed PRISMA guidelines in the development of this systematic review, which included randomized controlled trials of cessation interventions with smokers aged 50 or older. RESULTS We found 740 unique titles matching specified search criteria; 13 met final eligibility criteria. Nearly all the cessation treatments combined counseling with other strategies. Eight studies provided smoking cessation medications. None of the studies used newer forms of technology such as web- or text-based interventions. Nine of the 13 studies reported a significant intervention effect at one or more time points, with three studies reporting sustained treatment effects at 12 mos or longer. In general, more intensive interventions and those with combined approaches including medications and follow-up counseling achieved the best outcomes. CONCLUSION The quit rates from these studies and the relative effectiveness of different intervention approaches are consistent with the general smoking cessation literature. However, in most studies, treatment effects were of short duration, and absolute quit rates were low, leaving the vast majority of older smokers at high risk for smoking-related health conditions. This systematic review suggests a need for additional research to design and test future interventions specifically tailored for older smokers.
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