Understanding daily life experiences of women who smoke: The role of smoking-related weight control expectancies

Tobacco smoking and the risk of eating behaviors and depression among Palestinian female university students

BACKGROUND

Tobacco smoking and eating disorders are often connected to concerns about body image and can be indicative of underlying mental health conditions, such as depression. In Palestinian society, females have a cultural belief that smoking can aid in weight loss. Societal pressure on body image may drive females to such risky behaviors. However, few studies have examined the link between smoking and eating disorder behaviors. We researched the prevalence of tobacco smoking among Palestinian female university students and its association with binge/purge behaviors and depression.

METHOD

A cross-sectional research study was carried out at An-Najah National University. Female students [N = 642] completed anonymous surveys, sharing information about tobacco smoking and other substance use habits, answering questions from the Eating Attitude Test-26, the Sick (EAT-26), Control, One, Fat, and Food (SCOF) screening tests, and the Beck Depression Inventory.

RESULTS

The study reported a high prevalence of waterpipe smoking (24.4%) among Palestinian university female students, which exceeded the prevalence of cigarette smoking (4%). For the SCOF scale, 36.3% scored ≥ 2 points, indicating a screened positive for anorexia or bulimia nervosa; 40% struggled with binge-eating behavior, while only 7.8% had sought treatment for eating disorders. Additionally, 34.7% of the students experienced depression. The adjusted binary logistic regression model of risk factors for cigarette smoking has shown that cigarette smoking is significantly associated with self-induced vomiting (aOR = 6.075, p-value = 0.027), history for eating disorder treatment (aOR = 3.438, p-value = 0.047), e-cigarettes (aOR = 10.070, p-value = 0.001), waterpipe (aOR = 3.299, p-value = 0.022), energy drinks (aOR = 5.163, p-value = 0.003), moderate depression (aOR = 11.499, p-value = 0.010), and mild depression (aOR = 12.963, p-value = 0.003).

CONCLUSION

The study revealed concerning results of tobacco smoking linked to depression, binge/purge behaviors, obesity, and various weight-control methods. These findings highlight the urgent need for targeted interventions through awareness campaigns, culturally tailored health education, implementation of mental health support for students, and provide accessible medical and psychological assistance to at-risk Palestinian female students.

Global trends in the burden of ischemic heart disease attributable to smoking from 1990 to 2021: A systematic analysis of the Global Burden of Disease Study 2021

INTRODUCTION

Ischemic heart disease (IHD) remains a leading cause of death and disability worldwide. This study evaluates the trends in IHD burden attributable to smoking, utilizing Global Burden of Disease Study 2021 (GBD 2021) data, across 204 countries and territories from 1990 to 2021. By examining age-standardized death rates (ASDR) and disability-adjusted life years (ASRDALYs), the study provides insights into the spatiotemporal variations associated with smokingattributable IHD in different sociodemographic regions.

METHODS

Data on smoking-attributable IHD mortality and DALYs were obtained from the GBD 2021 database. This secondary analysis examined ASDR and ASRDALYs for IHD as primary outcomes, with active smoking as the primary exposure. Temporal trends were analyzed using estimated annual percentage changes (EAPCs). The burden was stratified by age, sex, and sociodemographic index (SDI) to identify disparities across regions.

RESULTS

Over the last three decades, global ASDR and ASRDALYs for smokingrelated IHD have generally declined. High-SDI regions had the largest reductions, with EAPCs of -4.31 (95% CI: -5.73 - -2.87) and -4.02 (95% CI: -5.40 - -2.62), respectively. In contrast, low-SDI regions experienced slower declines, with EAPCs of -0.54 (95% CI: -1.41-0.33) and -0.80 (95% CI: -1.52 - -0.08), respectively. Older age groups and males consistently had a higher burden across all regions. Global death rates for populations aged 15-49, 50-74, and ≥75 years were 4.31, 46.57, and 142.52 per 100000, respectively. The global ASDR for males (30.24) was 8.54 times higher than that for females (3.54). Regional disparities were most pronounced in low- and middle-income areas, particularly in Eastern Europe and Central Asia, where smoking related IHD burden remains high.

CONCLUSIONS

While global reductions in smoking-related IHD burden are encouraging, sustained disparities remain, particularly in low-SDI regions. Males and older populations continue to have a disproportionately higher burden, emphasizing the need for targeted interventions and sustained efforts to address these inequities.

An adaptation and exploratory factor analysis of the smoking-related weight and eating episodes test (SWEET) for electronic cigarette users

INTRODUCTION

Smoking for weight control is a well-documented behavior. There is emerging evidence to suggest electronic cigarettes (e-cigarettes) may be used for similar motivations yet measure development for the use of e-cigarettes for weight control has received less attention. The objective of the current study was to adapt and explore the psychometric properties of The Smoking-Related Weight and Eating Episodes Test (SWEET) for e-cigarette users.

METHODS

Young adult (N=1875) current cigarette, e-cigarette, and dual users completed the original SWEET (SWEET-C) and/or adapted SWEET for e-cigarette use (SWEET-EC) based on current tobacco product use. Demographics, associated e-cigarette characteristics, nicotine dependence, outcome expectancies, and eating disorder behaviors were also assessed. Participants were recruited online and measures were completed via self-report.

RESULTS

Four exploratory factor analyses using principal components extraction and direct oblimin rotation methods were run to explore the SWEET-C and SWEET-EC. A one-factor solution explaining 66 % of the variance was retained for the SWEET-C, and a one-factor solution explaining 73 % of the variance was retained for the SWEET-EC. Both measures exhibited excellent internal consistency. Higher SWEET-EC scores were observed among dual users, and were associated with daily e-cigarette use, JUUL use, self-reported vaping for weight control, older age, higher body mass index, and problematic eating behaviors.

CONCLUSION

Our findings support the adaptation of the SWEET-EC to measure e-cigarette use for weight control. The SWEET-EC will help to better understand how individuals use e-cigarettes to curb eating behavior and for weight control.

Trends of ischemic heart disease mortality attributable to smoking in the five countries with the highest number of smokers during 1990-2019: an age-period-cohort analysis

Introduction

Smoking increases the risk of various cardiovascular diseases, including ischemic heart disease (IHD). This study aimed to assess the impact of age, period, and cohort on long-term trends in IHD mortality in China, India, Indonesia, the United States, and Russia, the five countries with the highest number of smokers, from 1990 to 2019.

Material and methods

The data were obtained from the Global Burden of Disease (GBD) Study 2019, and the age-standardized mortality rate (ASMR) was calculated. Joinpoint regression analysis was used to assess the magnitude and direction of trends in smoking-attributable mortality from IHD. Age-period-cohort (APC) studies were used to estimate net drift (estimated annual percentage change (EAPC)s), local drift (age-specific EAPCs), and independent trends in age, period, and cohort effects.

Results

The analysis revealed a significant downward trend in ASMRs attributable to IHD as a result of smoking in the United States, India, and Russia. Indonesia and China showed an upward trend. Age effects were increasing for both country and sex, with China showing the most significant increase in the older age group; period effects were decreasing in all countries except Indonesia, and cohort effects were increasing only in Indonesia and China.

Conclusions

From 1990 to 2019, mortality from IHD caused by smoking showed a downward trend in these five countries. However, the pattern of increased mortality from IHD in women caused by smoking warrants further study.