1
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Gram IT, Antypas K, Wangberg SC, Løchen ML, Larbi D. Factors associated with predictors of smoking cessation from
a Norwegian internet-based smoking cessation intervention
study. Tob Prev Cessat 2022; 8:38. [PMID: 36382026 PMCID: PMC9620393 DOI: 10.18332/tpc/155287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION We examined if we could identify predictors for smoking cessation at six months post cessation, among smokers enrolled in a large Norwegian population-based intervention study. METHODS We followed 4333 (72.1% women) smokers who enrolled in an internet-based smoking cessation intervention during 2010–2012. The baseline questionnaire collected information on sociodemographic and lifestyle factors, including current snus use. The cessation outcome was self-reported no smoking past seven days, at six months. We used logistic regression to estimate odds ratios (ORs) with 95% confidence intervals, to identify predictors of smoking cessation, adjusting for potential confounders. RESULTS Women (OR=1.30; 95% CI: 1.01–1.69) compared with men, and those with medium (OR=1.31; 95% CI: 1.02–1.68) and longer (OR=1.42; 95% CI: 1.06–1.90) education compared with those with shorter education, were more likely to be successful quitters. Overall, being a student (OR=0.56; 95% CI: 0.37–0.85) compared with having full-time work, and a moderate to high Fagerström test for nicotine dependence (FTND) score (OR=0.69; 95% CI: 0.55–0.87) compared with a low score, were predictors for unsuccessful cessation. Current snus use was a predictor for unsuccessful cessation compared to no snus use for both men (OR=0.49; 95% CI: 0.28–0.88) and women (OR=0.49; 95% CI: 0.32–0.75). CONCLUSIONS Our study identifies female sex and longer education as predictors for successful smoking cessation, while a medium or high FTND score, being a student, and current snus use, were predictors for unsuccessful smoking cessation. Only current snus use was a predictor for unsuccessful cessation for both sexes. Our results indicate that smokers should be warned that snus use may prevent successful smoking cessation.
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Affiliation(s)
- Inger T. Gram
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Norwegian Centre for eHealth Research, University Hospital of North Norway, Tromsø, Norway
| | - Konstantinos Antypas
- Norwegian Centre for eHealth Research, University Hospital of North Norway, Tromsø, Norway
- SINTEF Digital, Oslo, Norway
| | - Silje C. Wangberg
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Dillys Larbi
- Norwegian Centre for eHealth Research, University Hospital of North Norway, Tromsø, Norway
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2
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BULUT H, YALNIZ E, ÇİMEN P. Is the diagnosis of lung cancer effective in decision of smoking cessation period? CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.980891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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3
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Olivieri M, Marchetti P, Murgia N, Nicolis M, Torroni L, Spiteri G, Ferrari M, Marcon A, Verlato G. Natural pollen exposure increases in a dose‐dependent way Fraction of exhaled Nitric Oxide (FeNO) levels in patients sensitized to one or more pollen species. Clin Transl Allergy 2022; 12:e12096. [PMID: 35145632 PMCID: PMC8818091 DOI: 10.1002/clt2.12096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 12/05/2021] [Accepted: 12/21/2021] [Indexed: 01/25/2023] Open
Affiliation(s)
- Mario Olivieri
- Unit of Occupational Medicine, Department of Diagnostics and Public HealthPoliclinico “G. Rossi”VeronaItaly
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public HealthUniversity of VeronaVeronaItaly
| | - Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and ToxicologyUniversity of PerugiaPerugiaItaly
| | - Morena Nicolis
- Unit of Hygiene and Preventive, Environmental and Occupational Medicine, Department of Diagnostics and Public HealthUniversity of VeronaVeronaItaly
| | - Lorena Torroni
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public HealthUniversity of VeronaVeronaItaly
| | - Gianluca Spiteri
- Unit of Occupational Medicine, Department of Diagnostics and Public HealthPoliclinico “G. Rossi”VeronaItaly
| | - Marcello Ferrari
- Department of Medicine, Section of Respiratory DiseasesUniversity of VeronaVeronaItaly
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public HealthUniversity of VeronaVeronaItaly
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public HealthUniversity of VeronaVeronaItaly
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4
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Moafa I, Hoving C, van den Borne B, Jafer M. Identifying Behavior Change Techniques Used in Tobacco Cessation Interventions by Oral Health Professionals and Their Relation to Intervention Effects-A Review of the Scientific Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147481. [PMID: 34299931 PMCID: PMC8305605 DOI: 10.3390/ijerph18147481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 11/22/2022]
Abstract
This review aimed to identify the behavioral change techniques (BCTs) used in behavioral interventions for tobacco cessation at dental practices in relation to their effect on tobacco use. Six scientific databases were searched for behavior change interventions for tobacco cessation and were coded using the BCT taxonomy of behavioral support for smoking cessation (BCTTsm). Fifteen interventions were identified, and data related to intervention characteristics were abstracted. Sixteen BCTs were identified, mainly related to increased motivation and teaching regulatory skills. Goal setting was the most commonly used BCT. Ten out of fifteen interventions effectively impacted tobacco cessation outcomes (OR = 2 to 5.25). Effective interventions more frequently included goal setting, written materials, readiness to quit and ability assessment, tobacco-use assessment, self-efficacy boost, listing reasons for quitting, action planning and environment restructuring. Other BCTs were not clearly associated with an increased effect. Among the behavioral interventions, certain techniques were associated with successful tobacco quitting. Tobacco cessation interventions in a dental setting appear to benefit from using BCTs that increase motivation and teach regulatory skills. The identified BCTs in this review could provide a source to better inform researchers and dentists about the active ingredients in behavior change interventions for tobacco cessation in a dental setting.
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Affiliation(s)
- Ibtisam Moafa
- Department of Preventive Dental Sciences, Jazan University, Jazan 45142, Saudi Arabia;
- Department of Health Promotion, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.H.); (B.v.d.B.)
- Correspondence:
| | - Ciska Hoving
- Department of Health Promotion, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.H.); (B.v.d.B.)
| | - Bart van den Borne
- Department of Health Promotion, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.H.); (B.v.d.B.)
| | - Mohammed Jafer
- Department of Preventive Dental Sciences, Jazan University, Jazan 45142, Saudi Arabia;
- Department of Health Promotion, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.H.); (B.v.d.B.)
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5
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Wang G, Hallberg J, Um Bergström P, Janson C, Pershagen G, Gruzieva O, van Hage M, Georgelis A, Bergström A, Kull I, Lindén A, Melén E. Assessment of chronic bronchitis and risk factors in young adults: results from BAMSE. Eur Respir J 2021; 57:13993003.02120-2020. [PMID: 33184115 PMCID: PMC7930470 DOI: 10.1183/13993003.02120-2020] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/11/2020] [Indexed: 02/05/2023]
Abstract
Background Chronic bronchitis is associated with substantial morbidity among elderly adults, but little is known about its prevalence and risk factors in young adults. Our aim was to assess the prevalence and early-life risk factors for chronic bronchitis in young adults. Methods Questionnaire data and clinical measures from the 24-year follow-up of the Swedish BAMSE (Child (Barn), Allergy, Milieu, Stockholm, Epidemiological) cohort were used. We assessed chronic bronchitis (CB) as the combination of cough and mucus production in the morning during winter. Environmental and clinical data from birth and onwards were used for analyses of risk factors. Results At the 24-year follow-up, 75% (n=3064) participants completed the questionnaire and 2030 performed spirometry. The overall prevalence of CB was 5.5% (n=158) with similar estimates in males and females. 49% of CB cases experienced more than three self-reported respiratory infections in the past year compared to 18% in non-CB subjects (p<0.001), and 37% of cases were current smokers (versus 19% of non-CB cases). Statistically significant lower post-bronchodilator forced expiratory volume in 1 s/forced vital capacity were observed in CB compared to non-CB subjects (mean z-score −0.06 versus 0.13, p=0.027). Daily smoking (adjusted (a)OR 3.85, p<0.001), air pollution exposure (black carbon at ages 1–4 years aOR 1.71 per 1 μg·m−3 increase, p=0.009) and exclusive breastfeeding for ≤4 months (aOR 0.66, p=0.044) were associated with CB. Conclusion Chronic bronchitis in young adults is associated with recurrent respiratory infections. Besides smoking, our results support the role of early-life exposures, such as air pollution and exclusive breastfeeding, for respiratory health later in life. Chronic bronchitis in young adults is strongly associated with recurrent respiratory infections. Besides smoking, our results support the role of early-life environmental exposures for respiratory health in this age group.https://bit.ly/2RNsv5z
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Affiliation(s)
- Gang Wang
- Dept of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Sichuan, China.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Jenny Hallberg
- Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Petra Um Bergström
- Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Christer Janson
- Dept of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Olena Gruzieva
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Marianne van Hage
- Division of Immunology and Allergy, Dept of Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Antonios Georgelis
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Inger Kull
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Anders Lindén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Dept of Respiratory Medicine and Allergy, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
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6
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Esen AD, Soylem Y, Arica S, Belgin G, Gonultas N. Factors affecting success and abstinence within a smoking cessation clinic: A one-year follow-up study in Turkey. Tob Prev Cessat 2020; 6:71. [PMID: 33409425 PMCID: PMC7762927 DOI: 10.18332/tpc/130471] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/11/2020] [Accepted: 11/14/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Successful smoking cessation requires personal, environmental and pharmacological support. In our clinic, pharmacological treatment lasts up to three months. In this study, we aimed to investigate smoking cessation rates, the effects of follow-up visits and pharmacological therapies on smoking cessation in our smoking cessation clinic for one year. METHODS Our study included 505 patient files that were randomly selected from the 5271 patients who were admitted to our outpatient clinic for smoking cessation in 2015–2016 and at least one year has passed from treatment initiation. Patients, who agreed to participate in this study, provided information on their smoking cessation status, treatment duration and drug side effects. Data were recorded on electronic media for statistical analysis. Significance was evaluated at p<0.05. RESULTS Our study was conducted on 505 patients that were randomly selected, 309 (61.2%) males and 196 (38.8%) females. The mean age was 38.9±10.3 years. There were 313 (61.9%) participants who stopped smoking after treatment and 229 (45.3%) were not smoking currently. The smoking cessation rate of males (57.9%) was significantly lower than that of females (68.4%) (p=0.019). The rate of relapse of males (12.9%) was significantly lower than that of females (20.9%) (p=0.017). Side effects occurred in 68 (13.5%) patients, 32 taking varenicline and 36 taking bupropion. CONCLUSIONS In our study, 45.3% of the patients had stopped smoking after one year. Smoking cessation rates were higher in the early stages of treatment than at late periods. Approximately half of the participants had never attended follow-up visits. Due to the low number of follow-up visits, both pharmacological treatment and motivational support were insufficient for effective smoking cessation therapy.
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Affiliation(s)
- Ayse D Esen
- Department of Family Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Yuksel Soylem
- Department of Family Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Secil Arica
- Department of Family Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Gulten Belgin
- Department of Family Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Nadire Gonultas
- Department of Family Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey
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7
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Zhu N, Lin S, Cao C, Xu N, Yu X, Chen X. Nomogram to predict successful smoking cessation in a Chinese outpatient population. Tob Induc Dis 2020; 18:86. [PMID: 33117113 PMCID: PMC7586925 DOI: 10.18332/tid/127736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/08/2020] [Accepted: 09/22/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The study aimed to establish and internally validate a nomogram to predict successful smoking cessation in a Chinese outpatient population. METHODS A total of 278 participants were included, and data were collected from March 2016 to December 2018. Predictors for successful smoking cessation were evaluated by 3-month sustained abstinence rates. Least absolute shrinkage and selection operator (LASSO) regression was used to select variables for the model to predict successful smoking cessation, and multivariable logistic regression analysis was performed to establish a novel predictive model. The discriminatory ability, calibration, and clinical usefulness of the nomogram were determined by the concordance index (C-index), calibration plot, and decision curve analysis, respectively. Internal validation with bootstrapping was performed. RESULTS The nomogram included living with a smoker or experiencing workplace smoking, number of outpatient department visits, reason for quitting tobacco, and varenicline use. The nomogram demonstrated valuable predictive performance, with a C-index of 0.816 and good calibration. A high C-index of 0.804 was reached with interval validation. Decision curve analysis revealed that the nomogram for predicting successful smoking cessation was clinically significant when intervention was conducted at a successful cessation of smoking possibility threshold of 19%. CONCLUSIONS This novel nomogram for successful smoking cessation can be conveniently used to predict successful cessation of smoking in outpatients.
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Affiliation(s)
- Ning Zhu
- Department of Respiratory and Critical Care Medicine, Ningbo First Hospital, Ningbo, China
| | - Shanhong Lin
- Department of Ultrasound, Ningbo First Hospital, Ningbo, China
| | - Chao Cao
- Department of Respiratory and Critical Care Medicine, Ningbo First Hospital, Ningbo, China
| | - Ning Xu
- Department of Respiratory and Critical Care Medicine, Ningbo First Hospital, Ningbo, China
| | - Xiaopin Yu
- Department of Prevention and Health Care, Ningbo First Hospital, Ningbo, China
| | - Xueqin Chen
- Department of Traditional Medicine, Ningbo First Hospital, Ningbo, China
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Ekbom E, Quint J, Schöler L, Malinovschi A, Franklin K, Holm M, Torén K, Lindberg E, Jarvis D, Janson C. Asthma and treatment with inhaled corticosteroids: associations with hospitalisations with pneumonia. BMC Pulm Med 2019; 19:254. [PMID: 31856764 PMCID: PMC6923948 DOI: 10.1186/s12890-019-1025-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 12/11/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Pneumonia is an important cause of morbidity and mortality. COPD patients using inhaled corticosteroids (ICS) have an increased risk of pneumonia, but less is known about whether ICS treatment in asthma also increases the risk of pneumonia. The aim of this analysis was to examine risk factors for hospitalisations with pneumonia in a general population sample with special emphasis on asthma and the use of ICS in asthmatics. METHODS In 1999 to 2000, 7340 subjects aged 28 to 54 years from three Swedish centres completed a brief health questionnaire. This was linked to information on hospitalisations with pneumonia from 2000 to 2010 and treatment with ICS from 2005 to 2010 held within the Swedish National Patient Register and the Swedish Prescribed Drug Register. RESULTS Participants with asthma (n = 587) were more likely to be hospitalised with pneumonia than participants without asthma (Hazard Ratio (HR 3.35 (1.97-5.02)). Other risk factors for pneumonia were smoking (HR 1.93 (1.22-3.06)), BMI < 20 kg/m2 (HR 2.74 (1.41-5.36)) or BMI > 30 kg/m2 (HR 2.54 (1.39-4.67)). Asthmatics (n = 586) taking continuous treatment with fluticasone propionate were at an increased risk of being hospitalized with pneumonia (incidence risk ratio (IRR) 7.92 (2.32-27.0) compared to asthmatics that had not used fluticasone propionate, whereas no significant association was found with the use of budesonide (IRR 1.23 (0.36-4.20)). CONCLUSION Having asthma is associated with a three times higher risk of being hospitalised for pneumonia. This analysis also indicates that there are intraclass differences between ICS compounds with respect to pneumonia risk, with an increased risk of pneumonia related to fluticasone propionate.
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Affiliation(s)
- Emil Ekbom
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Jennifer Quint
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College, London, UK
| | - Linus Schöler
- Department of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Karl Franklin
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Kjell Torén
- Department of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Deborah Jarvis
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College, London, UK
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden. .,Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College, London, UK.
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Olivieri M, Murgia N, Carsin AE, Heinrich J, Benke G, Bono R, Corsico AG, Demoly P, Forsberg B, Gislason T, Janson C, Jõgi R, Leynaert B, Martínez-Moratalla Rovira J, Norbäck D, Nowak D, Pascual S, Pin I, Probst-Hensch N, Raherison C, Sigsgaard T, Svanes C, Torén K, Urrutia I, Weyler J, Jarvis D, Zock JP, Verlato G. Effects of smoking bans on passive smoking exposure at work and at home. The European Community respiratory health survey. INDOOR AIR 2019; 29:670-679. [PMID: 30963644 DOI: 10.1111/ina.12556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 02/11/2019] [Accepted: 04/02/2019] [Indexed: 06/09/2023]
Abstract
This longitudinal study investigated whether smoking bans influence passive smoking at work and/or at home in the same subjects. Passive smoking at work and/or at home was investigated in random population samples (European Community Respiratory Health Survey) in 1990-1995, with follow-up interviews in 1998-2003 and 2010-2014. National smoking bans were classified as partial (restricted to public workplaces) or global (extended to private workplaces). Multivariable analysis was accomplished by three-level logistic regression models, where level-1, level-2, and level-3 units were, respectively, questionnaire responses, subjects, and centers. Passive smoking at work was reported by 31.9% in 1990-1995, 17.5% in 1998-2003, and 2.5% in 2010-2014. Concurrently, passive smoking at home decreased from 28.9% to 18.2% and 8.8%. When controlling for sex, age, education, smoking status, and ECHRS wave, the odds of passive smoking at work was markedly reduced after global smoking bans (OR = 0.45, 95% CI 0.25-0.81), particularly among non-smokers, while the protective effect of global smoking bans on passive smoking at home was only detected in non-smokers. Smoking bans both in public and private workplaces were effective in reducing passive smoking at work in Europe. However, given the inefficacy of smoking bans in current smokers' dwellings, better strategies are needed to avoid smoking indoors.
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Affiliation(s)
- Mario Olivieri
- Unit of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy
| | - Anne-Elie Carsin
- ISGlobal (Instituto de Salud Global de Barcelona), Campus MAR, Barcelona Biomedical Research Park (PRBB), Barcelona, Spain
| | - Joachim Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig Maximilians University Munich, Munich, Germany
| | - Geza Benke
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Angelo Guido Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Pascal Demoly
- Départment Pneumologie et Addictologie, University Hospital of Montpellier, Montpellier, France
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Thorarinn Gislason
- Faculty of Medicine and Department of Sleep, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
| | - Christer Janson
- Department of Medical Sciences/Respiratory, Allergy & Sleep Research, Akademiska sjukhuset, Uppsala University, Uppsala, Sweden
| | - Rain Jõgi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Bénédicte Leynaert
- Inserm UMR 1152-Equipe Epidémiologie, Université Paris Diderot, Paris, France
| | | | - Dan Norbäck
- Department of Medical Sciences/Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Dennis Nowak
- Institut und Poliklinik für Arbeits, Sozial- und Umweltmedizin, WHO Collaborating Centre for Occupational Health, Klinikum der Universität München, München, Germany
| | - Silvia Pascual
- Pulmonology Department, Galdakao Hospital, Biscay, Spain
| | - Isabelle Pin
- Department of Pédiatrie, CHU de Grenoble Alpes, Grenoble, France
| | - Nicole Probst-Hensch
- Department Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Chantal Raherison
- INSERM U897, Institute of Public Health and Epidemiology, Bordeaux University, Bordeaux, France
| | - Torben Sigsgaard
- Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway
| | - Kjell Torén
- Section of Occupational and environmental medicine, University of Gothenburg, Gothenburg, Sweden
| | - Isabel Urrutia
- Pulmonology Department, Galdakao Hospital, Biscay, Spain
| | - Joost Weyler
- Epidemiology and Social Medicine and the StatUA Statistics Centre, University of Antwerp, Antwerp, Belgium
| | - Deborah Jarvis
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, UK
| | - Jan-Paul Zock
- ISGlobal (Instituto de Salud Global de Barcelona), Campus MAR, Barcelona Biomedical Research Park (PRBB), Barcelona, Spain
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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10
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Ten-year experience of smoking cessation in a single center in Japan. Respir Investig 2019; 57:380-387. [PMID: 30795920 DOI: 10.1016/j.resinv.2019.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 01/16/2019] [Accepted: 01/29/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Long-term, real-world data, as opposed to academic or research data, on outcomes of smoking cessation clinics are scarce. We assessed patient outcomes over a 10-year period at a smoking cessation clinic in a community teaching hospital in Japan and explored predictors of successful smoking cessation. METHODS We used data from a prospective registry of cigarette smokers who participated in a 3-month smoking cessation program comprising combined pharmacological treatment and cognitive behavioral therapy and explored factors associated with program execution and successful smoking cessation. The primary outcome was smoking cessation, defined by quitting completely between the 8-week and 12-week sessions, with verification according to exhaled carbon monoxide (CO) level of ≤10 ppm. RESULTS Between August 2007 and December 2017, 813 patients with nicotine dependence participated in the program. The number of participants decreased after Japan׳s 2010 tobacco tax increase. Among participants, 433 (53.3%) completed the program. In multivariate analysis, the number of cigarettes smoked daily (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.96, 0.99), cardiovascular disease (OR 1.75, 95% CI 1.16, 2.68), chronic obstructive pulmonary disease (OR 1.74, 95% CI 1.10, 2.78), and gastric/duodenal ulcer (OR 1.77, 95% CI 1.04, 3.08) were significantly associated with program completion. Among program completers, 288 (66.5%) achieved smoking cessation. Exhaled CO level (OR 0.94, 95% CI 0.93, 0.97) and mental disorders (OR 0.53, 95% CI 0.33, 0.85) were negatively associated with successful smoking cessation. CONCLUSIONS Baseline exhaled CO level and mental disorders were significantly associated with either success or failure of smoking cessation.
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Flexeder C, Zock JP, Jarvis D, Verlato G, Olivieri M, Benke G, Abramson MJ, Sigsgaard T, Svanes C, Torén K, Nowak D, Jõgi R, Martinez-Moratalla J, Demoly P, Janson C, Gislason T, Bono R, Holm M, Franklin KA, Garcia-Aymerich J, Siroux V, Leynaert B, Dorado Arenas S, Corsico AG, Pereira-Vega A, Probst-Hensch N, Urrutia Landa I, Schulz H, Heinrich J. Second-hand smoke exposure in adulthood and lower respiratory health during 20 year follow up in the European Community Respiratory Health Survey. Respir Res 2019; 20:33. [PMID: 30764884 PMCID: PMC6376659 DOI: 10.1186/s12931-019-0996-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/04/2019] [Indexed: 11/11/2022] Open
Abstract
Background Early life exposure to tobacco smoke has been extensively studied but the role of second-hand smoke (SHS) for new-onset respiratory symptoms and lung function decline in adulthood has not been widely investigated in longitudinal studies. Our aim is to investigate the associations of exposure to SHS in adults with respiratory symptoms, respiratory conditions and lung function over 20 years. Methods We used information from 3011 adults from 26 centres in 12 countries who participated in the European Community Respiratory Health Surveys I-III and were never or former smokers at all three surveys. Associations of SHS exposure with respiratory health (asthma symptom score, asthma, chronic bronchitis, COPD) were analysed using generalised linear mixed-effects models adjusted for confounding factors (including sex, age, smoking status, socioeconomic status and allergic sensitisation). Linear mixed-effects models with additional adjustment for height were used to assess the relationships between SHS exposure and lung function levels and decline. Results Reported exposure to SHS decreased in all 26 study centres over time. The prevalence of SHS exposure was 38.7% at baseline (1990–1994) and 7.1% after the 20-year follow-up (2008–2011). On average 2.4% of the study participants were not exposed at the first, but were exposed at the third examination. An increase in SHS exposure over time was associated with doctor-diagnosed asthma (odds ratio (OR): 2.7; 95% confidence interval (95%-CI): 1.2–5.9), chronic bronchitis (OR: 4.8; 95%-CI: 1.6–15.0), asthma symptom score (count ratio (CR): 1.9; 95%-CI: 1.2–2.9) and dyspnoea (OR: 2.7; 95%-CI: 1.1–6.7) compared to never exposed to SHS. Associations between increase in SHS exposure and incidence of COPD (OR: 2.0; 95%-CI: 0.6–6.0) or lung function (β: − 49 ml; 95%-CI: -132, 35 for FEV1 and β: − 62 ml; 95%-CI: -165, 40 for FVC) were not apparent. Conclusion Exposure to second-hand smoke may lead to respiratory symptoms, but this is not accompanied by lung function changes. Electronic supplementary material The online version of this article (10.1186/s12931-019-0996-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Claudia Flexeder
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
| | - Jan-Paul Zock
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Deborah Jarvis
- MRC-PHE Centre for Environment and Health, Imperial College London, London, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Geza Benke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Kjell Torén
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Rain Jõgi
- Lung Clinic, Tartu University Clinics, Tartu, Estonia
| | - Jesús Martinez-Moratalla
- Servicio de Neumología del Complejo, Servicio de Salud de Castilla - La Mancha (SESCAM), Hospitalario Universitario de Albacete, Albacete, Spain.,Facultad de Medicina de Albacete, Universidad de Castilla - La Mancha, Albacete, Spain
| | - Pascal Demoly
- Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France.,Inserm, Sorbonne Université, Equipe EPAR - IPLESP, Paris, France
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Thorarinn Gislason
- Department of Sleep, Landspitali National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karl A Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umea University, Umea, Sweden
| | - Judith Garcia-Aymerich
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Valérie Siroux
- Institute for Advanced Biosciences, UGA-Inserm U1209-CNRS UMR 5309, Joint Research Center, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Site Santé - Allée des Alpes, 38700 La Tronche, Grenoble, France
| | - Bénédicte Leynaert
- Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France, UMR 1152, University Paris Diderot Paris, Paris, France
| | | | - Angelo Guido Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.,Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Antonio Pereira-Vega
- Respiratory and Allergy Clinical Unit, Universitary Hospitalary Complex, Huelva, Spain
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | | | - Holger Schulz
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Joachim Heinrich
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Munich, Germany.,Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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12
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Time and age trends in smoking cessation in Europe. PLoS One 2019; 14:e0211976. [PMID: 30730998 PMCID: PMC6366773 DOI: 10.1371/journal.pone.0211976] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/24/2019] [Indexed: 11/24/2022] Open
Abstract
Background Smoking is the main risk factor for most of the leading causes of death. Cessation is the single most important step that smokers can take to improve their health. With the aim of informing policy makers about decisions on future tobacco control strategies, we estimated time and age trends in smoking cessation in Europe between 1980 and 2010. Methods Data on the smoking history of 50,228 lifetime smokers from 17 European countries were obtained from six large population-based studies included in the Ageing Lungs in European Cohorts (ALEC) consortium. Smoking cessation rates were assessed retrospectively, and age trends were estimated for three decades (1980–1989, 1990–1999, 2000–2010). The analyses were stratified by sex and region (North, East, South, West Europe). Results Overall, 21,735 subjects (43.3%) quit smoking over a total time-at-risk of 803,031 years. Cessation rates increased between 1980 and 2010 in young adults (16–40 years), especially females, from all the regions, and in older adults (41–60 years) from North Europe, while they were stable in older adults from East, South and West Europe. In the 2000s, the cessation rates for men and women combined were highest in North Europe (49.9 per 1,000/year) compared to the other regions (range: 26.5–32.7 per 1,000/year). A sharp peak in rates was observed for women around the age of 30, possibly as a consequence of pregnancy-related smoking cessation. In most regions, subjects who started smoking before the age of 16 were less likely to quit than those who started later. Conclusions Our findings suggest an increasing awareness on the detrimental effects of smoking across Europe. However, East, South and West European countries are lagging behind North Europe, suggesting the need to intensify tobacco control strategies in these regions. Additional efforts should be made to keep young adolescents away from taking up smoking, as early initiation could make quitting more challenging during later life.
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Torén K, Andersson M, Olin AC, Blanc PD, Järvholm B. Airflow limitation classified with the fixed ratio or the lower limit of normal and cause-specific mortality - A prospective study. Respir Med 2018; 144:36-41. [PMID: 30366582 DOI: 10.1016/j.rmed.2018.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/29/2018] [Accepted: 10/01/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND There is controversy as to whether airflow limitation should be defined as forced expiratory volume in 1 s (FEV1)/vital capacity (VC) < 0.7 or as FEV1/VC< the lower limit of normal (LLN). The aim was to examine whether different definitions of airflow limitation differ in predicting mortality. METHODS Longitudinal prospective study of a national cohort of Swedish workers (199,408 men; 7988 women), aged 20-64 years with spirometry without bronchodilation at baseline followed from 1979 until death, or censorship at 2010. Airflow limitation (AL) by Global Obstructive Lung Disease criteria, ALGOLD, was defined as FEV1/VC < 0.7; ALLLN as FEV1/VC < LLN. All all-cause, COPD and cardiovascular disease mortality was analyzed among men and women in relation to ALGOLD and ALLLN, adjusted for age and smoking. RESULTS Among men, all-cause mortality risks were similar by airflow limitation criteria: ALGOLD RR = 1.32, 95% CI 1.26-1.38; ALLLN, RR = 1.37, 95% CI 1.31-1.44. The risk estimates were also similar by airflow limitation definition for cardiovascular mortality and for COPD mortality. Among women, all-cause mortality was also similar by airflow limitation criteria, but significantly higher as compared to men: ALGOLD RR = 2.10, 95% CI 1.66-2.66; ALLLN, RR = 2.09, 95% CI 1.66-2.62. Also cardiovascular and COPD mortality by airflow limitation criteria was significantly higher among women as compared to men. CONCLUSIONS Defined either as FEV1/VC < 0.7 or as FEV1/VC < LLN, airflow limitation predicted excess mortality risk of similar magnitude. Mortality in relation to airflow limitation was higher among women compared to men.
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Affiliation(s)
- Kjell Torén
- Section of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414, SE-405 30, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Box 414, SE-405 30, Gothenburg, Sweden.
| | - Martin Andersson
- Department of Occupational and Environmental Medicine, Institute of Clinical Medicine and Public Health, University of Umeå, SE-901 87, Umeå, Sweden
| | - Anna-Carin Olin
- Section of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414, SE-405 30, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Box 414, SE-405 30, Gothenburg, Sweden
| | - Paul D Blanc
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California, PO 0924, San Francisco, CA, USA
| | - Bengt Järvholm
- Department of Occupational and Environmental Medicine, Institute of Clinical Medicine and Public Health, University of Umeå, SE-901 87, Umeå, Sweden
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Janson C, Johannessen A, Franklin K, Svanes C, Schiöler L, Malinovschi A, Gislason T, Benediktsdottir B, Schlünssen V, Jõgi R, Jarvis D, Lindberg E. Change in the prevalence asthma, rhinitis and respiratory symptom over a 20 year period: associations to year of birth, life style and sleep related symptoms. BMC Pulm Med 2018; 18:152. [PMID: 30208969 PMCID: PMC6136212 DOI: 10.1186/s12890-018-0690-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 07/16/2018] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this investigation was to study change in adults over a 20 year period in the prevalence of respiratory symptoms and disorders and its association to year of birth, life style and sleep related variables. Method Adults 20–44 years of age, 6085 women and 5184 men, were randomly selected from seven centres in Northern Europe and followed for 20 years. The number of participants in the first survey was 21,595 and 11,269 participated in all three surveys. The participants were divided into three birth cohorts: 1944–1955, 1956–1965 and 1966–1975. Results During the 20 year period the prevalence of wheeze decreased (− 2%) and the prevalence of asthma (+ 4%) and allergic rhinitis (+ 5%) increased, whereas the prevalence of nocturnal respiratory symptoms was relatively unchanged. The increase in allergic rhinitis was largest in those born 1966 to 1975 except in Estonia. There was large decrease in smoking (− 20%), increase in obesity (+ 7%) and snoring (+ 6%) during the study period. Smoking, obesity, snoring and nocturnal gastroesophageal reflux (nGER) were related to a higher risk of all symptoms. Obesity, snoring and nGER were also independently related to asthma. Conclusion We conclude that as our participants got older there was a decrease in wheeze, no change in nocturnal symptoms and an increase in reported asthma and allergic rhinitis. These changes in prevalence are probably related to a decrease in smoking being counteracted by an increase in allergy, obesity and sleep related disorders.
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Affiliation(s)
- Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Medicine, Uppsala University, Uppsala, Sweden.
| | - Ane Johannessen
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Karl Franklin
- Dept. of Surgical and Perioperative Sciences, Surgery, Umea University, Umea, Sweden
| | - Cecilie Svanes
- Institute of Clinical Science, University of Bergen, Bergen, Norway
| | - Linus Schiöler
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Thorarinn Gislason
- Department of Respiratory Medicine and Sleep, the National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Bryndis Benediktsdottir
- Department of Respiratory Medicine and Sleep, the National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Vivi Schlünssen
- Department of Public Health, Section for Environment, Occupation and Health, Aarhus University, Aarhus, Denmark.,National Research Center for the Working Environment, Copenhagen, Denmark
| | - Rain Jõgi
- Lung Clinic, Tartu University Clinics, Tartu, Estonia
| | - Deborah Jarvis
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, UK
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Medicine, Uppsala University, Uppsala, Sweden
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15
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solak I, Yıldırım Dİ, Gümüş F, Eren İ, Eryılmaz MA. Depresyon ve anksiyetenin sigara bırakma tedavisi üzerine etkisi. KONURALP TIP DERGISI 2018. [DOI: 10.18521/ktd.351519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Zairina E. Maternal passive smoking and the risk of developing wheeze in children: how should we deal with it? Eur Respir J 2018; 48:3-5. [PMID: 27365501 DOI: 10.1183/13993003.01046-2016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 05/26/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Elida Zairina
- Dept of Pharmacy Practice, Faculty of Pharmacy, Airlangga University, Surabaya, Indonesia
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17
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Predictors of smoking cessation: A longitudinal study in a large cohort of smokers. Respir Med 2017; 132:164-169. [PMID: 29229092 DOI: 10.1016/j.rmed.2017.10.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 10/13/2017] [Accepted: 10/16/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND There are few studies on predictors of smoking cessation in general populations. We studied the smoking cessation rate in relation to several potential predictors, with special focus on respiratory and cardiovascular disease. METHODS Smokers (n = 4636) from seven centres in Northern Europe, born between 1945 and 1973, who answered a questionnaire in 1999-2001 (the RHINE study) were followed up with a new questionnaire in 2010-2012. Altogether 2564 answered the questionnaire and provided complete data on smoking. Cox regression analyses were performed to calculate hazard ratios (HRs). RESULTS A total of 999 subjects (39%) stopped smoking during the study period. The smoking cessation rate was 44.9/1000 person-years. Smoking cessation was more common with increasing age, higher education and fewer years of smoking. Asthma, wheeze, hay fever, chronic bronchitis, diabetes and hypertension did not significantly predict smoking cessation, but smokers hospitalized for ischaemic heart disease during the study period were more prone to stopping smoking (HR 3.75 [2.62-5.37]). CONCLUSIONS Successful smoking cessation is common in middle-aged smokers, and is associated with few smoking years and higher education. A diagnosis of respiratory disease does not appear to motivate people to quit smoking, nor do known cardiovascular risk factors; however, an acute episode of ischaemic heart disease encouraged smoking cessation in our study population.
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18
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Jarvis D, Newson R, Janson C, Corsico A, Heinrich J, Anto JM, Abramson MJ, Kirsten AM, Zock JP, Bono R, Demoly P, Leynaert B, Raherison C, Pin I, Gislason T, Jogi R, Schlunssen V, Svanes C, Watkins J, Weyler J, Pereira-Vega A, Urrutia I, Gullón JA, Forsberg B, Probst-Hensch N, Boezen HM, Martinez-Moratalla Rovira J, Accordini S, de Marco R, Burney P. Prevalence of asthma-like symptoms with ageing. Thorax 2017; 73:37-48. [PMID: 28974648 PMCID: PMC5738606 DOI: 10.1136/thoraxjnl-2016-209596] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 06/15/2017] [Accepted: 06/19/2017] [Indexed: 11/24/2022]
Abstract
Background Change in the prevalence of asthma-like symptoms in populations of ageing adults is likely to be influenced by smoking, asthma treatment and atopy. Methods The European Community Respiratory Health Survey collected information on prevalent asthma-like symptoms from representative samples of adults aged 20–44 years (29 centres in 13 European countries and Australia) at baseline and 10 and 20 years later (n=7844). Net changes in symptom prevalence were determined using generalised estimating equations (accounting for non-response through inverse probability weighting), followed by meta-analysis of centre level estimates. Findings Over 20 years the prevalence of ‘wheeze’ and ‘wheeze in the absence of a cold’ decreased (−2.4%, 95% CI −3.5 to −1.3%; −1.5%, 95% CI −2.4 to −0.6%, respectively) but the prevalence of asthma attacks, use of asthma medication and hay fever/nasal allergies increased (0.6%, 95% CI 0.1 to 1.11; 3.6%, 95% CI 3.0 to 4.2; 2.7%, 95% CI 1.7 to 3.7). Changes were similar in the first 10 years compared with the second 10 years, except for hay fever/nasal allergies (increase seen in the first 10 years only). Decreases in these wheeze-related symptoms were largely seen in the group who gave up smoking, and were seen in those who reported hay fever/nasal allergies at baseline. Interpretation European adults born between 1946 and 1970 have, over the last 20 years, experienced less wheeze, although they were more likely to report asthma attacks, use of asthma medication and hay fever. Decrease in wheeze is largely attributable to smoking cessation, rather than improved treatment of asthma. It may also be influenced by reductions in atopy with ageing.
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Affiliation(s)
- Debbie Jarvis
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College, London, UK.,MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Roger Newson
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Joachim Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Center, Ludwig Maximilian University, Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Muenchen, Germany
| | - Josep M Anto
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anne-Marie Kirsten
- Pulmonary Research Institute at Lung Clinic Grosshansdorf, Grosshansdorf, Germany
| | - Jan Paul Zock
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Pascal Demoly
- University Hospital of Montpellier, Montpellier, France.,Sorbonne Universités, Paris, France
| | - Bénédicte Leynaert
- Inserm UMR 1152-Equipe Epidémiologie, Université Paris Diderot, Paris, France
| | - Chantal Raherison
- Inserm-U1219 Bordeaux Population Health Research Center, Bordeaux University, Bordeaux, France
| | - Isabelle Pin
- INSERM, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.,Department of Pédiatrie, CHU de Grenoble Alpes, Grenoble, France
| | - Thorarinn Gislason
- Department of Respiratory Medicine and Sleep, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Rain Jogi
- Tartu University Hospital, Lung Clinic, Estonia, Europe
| | - Vivi Schlunssen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - John Watkins
- Public Health Wales, Cardiff, Wales.,University of Cardiff, Cardiff, Wales
| | - Joost Weyler
- Department of Epidemiology and Social Medicine (ESOC), Faculty of Medicine and Health Sciences, StatUA Statistics Centre, University of Antwerp, Antwerp, Belgium
| | - Antonio Pereira-Vega
- Respiratory and Allergy Clinical Unit, Universitary Hospitalary Complex, Huelva, Spain
| | - Isabel Urrutia
- Department of Respiratory, Galdakao Hospital, Galdakao, Spain
| | - Jose A Gullón
- Servicio Neumología, Hospital Universitario San Agustín, Avilés, Spain
| | - Bertil Forsberg
- Public Health and Clinical Medicine, Occupational and Environmental Medicine, University of Umea, Umea, Sweden
| | - Nicole Probst-Hensch
- Department Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - H Marike Boezen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jesús Martinez-Moratalla Rovira
- Servicio de Neumología, Complejo Hospitalario Universitario, Albacete, Spain.,Facultad de Medicina Albacete, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Roberto de Marco
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Peter Burney
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College, London, UK.,MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
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19
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Hou LS, Du XD, Li JJ, Zhu P, Yan PJ, Zhan FY, Zhou MK, Zhu CR. Long-term trends and predictors of smoking behaviors among men following first-ever ischemic stroke. ACTA ACUST UNITED AC 2017; 37:446-452. [DOI: 10.1007/s11596-017-1755-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/10/2017] [Indexed: 11/29/2022]
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20
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Gudnadóttir AÝ, Ólafsdóttir IS, Middelveld R, Ekerljung L, Forsberg B, Franklin K, Lindberg E, Janson C. An investigation on the use of snus and its association with respiratory and sleep-related symptoms: a cross-sectional population study. BMJ Open 2017; 7:e015486. [PMID: 28554933 PMCID: PMC5730007 DOI: 10.1136/bmjopen-2016-015486] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Studies of the health effects of moist oral tobacco, snus, have produced inconsistent results. The main objective of this study is to examine the health effects of snus use on asthma, respiratory symptoms and sleep-related problems, a field that has not been investigated before. METHODS AND MATERIAL This cross-sectional study was based on a postal questionnaire completed by 26 697 (59.3%) participants aged 16 to 75 years and living in Sweden. The questionnaire included questions on tobacco use, asthma, respiratory symptoms and sleeping problems. The association of snus use with asthma, respiratory symptoms and sleep-related symptoms was mainly tested in never-smokers (n=16 082). RESULTS The current use of snus in never-smokers was associated with an increased risk of asthma (OR 1.51 (95% CI 1.28 to 1.77)), asthmatic symptoms, chronic bronchitis and chronic rhinosinusitis. This association was not present among ex-snus users. Snoring was independently related to both the former and current use of snus ((OR 1.37 (95% CI 1.12 to 1.68)) and (OR 1.59 (95% CI 1.34 to 1.89), respectively)). A higher risk of difficulty inducing sleep was seen among snus users. CONCLUSION Snus use was associated with a higher prevalence of asthma, respiratory symptoms and snoring. Healthcare professionals should be aware of these possible adverse effects of snus use.
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Affiliation(s)
- Arna Ýr Gudnadóttir
- Deparment of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Inga Sif Ólafsdóttir
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Roelinde Middelveld
- The Centre for Allergy Research and the Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Linda Ekerljung
- Department of Internal Medicine and Clinical Nutrition, Göteborgs Universitet, Goteborg, Sweden
| | - Bertil Forsberg
- Department of Public Health and ClinicalMedicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Karl Franklin
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Eva Lindberg
- Deparment of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Christer Janson
- Deparment of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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Al-Shamkhi N, Alving K, Dahlen SE, Hedlin G, Middelveld R, Bjerg A, Ekerljung L, Olin AC, Sommar J, Forsberg B, Janson C, Malinovschi A. Important non-disease-related determinants of exhaled nitric oxide levels in mild asthma - results from the Swedish GA(2) LEN study. Clin Exp Allergy 2016; 46:1185-93. [PMID: 27138350 DOI: 10.1111/cea.12749] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 04/17/2016] [Accepted: 04/23/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Fractional exhaled nitric oxide (FeNO) has a potential clinical role in asthma management. Constitutive factors such as age, height and gender, as well as individual characteristics, such as IgE sensitization and smoking, affect the levels of FeNO in population-based studies. However, their effect on FeNO in subjects with asthma has been scarcely studied. OBJECTIVE To study the effects on FeNO of these commonly regarded determinants, as demonstrated in healthy subjects, as well as menarche age and parental smoking, in a population of asthmatics. MATERIAL AND METHODS Fractional exhaled nitric oxide was measured in 557 subjects with asthma from the Swedish GA(2) LEN study. Allergic sensitization was assessed by skin prick tests to most common aeroallergens. Upper airway comorbidities, smoking habits, smoking exposure during childhood and hormonal status (for women) were questionnaire-assessed. RESULTS Male gender (P < 0.001), greater height (P < 0.001) and sensitization to both perennial allergens and pollen (P < 0.001) are related to higher FeNO levels. Current smoking (P < 0.001) and having both parents smoking during childhood, vs. having neither (P < 0.001) or only one parent smoking (P = 0.002), are related to lower FeNO. Women with menarche between 9 and 11 years of age had lower FeNO than those with menarche between 12 and 14 years of age (P = 0.03) or 15 and 17 years of age (P = 0.003). CONCLUSIONS AND CLINICAL RELEVANCE Interpreting FeNO levels in clinical practice is complex, and constitutional determinants, as well as smoking and IgE sensitisation, are of importance in asthmatic subjects and should be accounted for when interpreting FeNO levels. Furthermore, menarche age and parental smoking during childhood and their effects on lowering FeNO deserve further studies.
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Affiliation(s)
- N Al-Shamkhi
- Department of Medical Sciences: Lung- allergy- and sleep research, Uppsala University, Uppsala, Sweden
| | - K Alving
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - S E Dahlen
- Experimental Asthma and Allergy Research Unit, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - G Hedlin
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - R Middelveld
- Experimental Asthma and Allergy Research Unit, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - A Bjerg
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - L Ekerljung
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - A C Olin
- Section of Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - J Sommar
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, University of Umeå, Umeå, Sweden
| | - B Forsberg
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, University of Umeå, Umeå, Sweden
| | - C Janson
- Department of Medical Sciences: Lung- allergy- and sleep research, Uppsala University, Uppsala, Sweden
| | - A Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
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Prugger C, Wellmann J, Heidrich J, De Bacquer D, Perier MC, Empana JP, Reiner Ž, Fras Z, Jennings C, Kotseva K, Wood D, Keil U. Passive smoking and smoking cessation among patients with coronary heart disease across Europe: results from the EUROASPIRE III survey. Eur Heart J 2013; 35:590-8. [DOI: 10.1093/eurheartj/eht538] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christof Prugger
- Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, 56 rue Leblanc, 75015 Paris, France
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Jürgen Wellmann
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Jan Heidrich
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Dirk De Bacquer
- Department of Public Health, University of Ghent, Ghent, Belgium
| | - Marie-Cécile Perier
- Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, 56 rue Leblanc, 75015 Paris, France
| | - Jean-Philippe Empana
- Paris Cardiovascular Research Centre, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, 56 rue Leblanc, 75015 Paris, France
| | - Željko Reiner
- Department of Internal Medicine, University Hospital Centre, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zlatko Fras
- Department of Vascular Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Catriona Jennings
- Cardiovascular Medicine, Imperial College London, London, United Kingdom
| | - Kornelia Kotseva
- Cardiovascular Medicine, Imperial College London, London, United Kingdom
| | - David Wood
- Cardiovascular Medicine, Imperial College London, London, United Kingdom
| | - Ulrich Keil
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
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Accordini S, Janson C, Svanes C, Jarvis D. The role of smoking in allergy and asthma: lessons from the ECRHS. Curr Allergy Asthma Rep 2013; 12:185-91. [PMID: 22528471 DOI: 10.1007/s11882-012-0260-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The European Community Respiratory Health Survey is an international multicenter cohort study of asthma, allergy, and lung function that began in the early-1990s with recruitment of population-based samples of 20- to 44-year-old adults, mainly in Europe. The aims of the study are broad ranging but include assessment of the role of in utero exposure to tobacco smoke, exposure to environmental tobacco smoke, and active smoking on the incidence, prevalence, and prognosis of allergy and asthma. Cross-sectional and longitudinal analyses looking at these associations have been conducted, sometimes only using information collected in one country, and on other occasions using information collected in all the participating centers. This article summarizes the results from these various publications from this large epidemiologic study.
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Affiliation(s)
- Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Italy
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Abstract
To assess the efficacy of nationwide anti-smoking campaign, we compared the findings of a study on worker smoking performed in 2005 with our latest cross-sectional study completed in 2010. It included 753 randomly selected workers, of whom 126 office, 108 construction, 93 agricultural, 97 petroleum refinery, 114 textile, 117 food processing workers, and 98 cleaners. Information was collected with a self-administered questionnaire. The prevalence of current smokers among all workers was 35.4 %, ranging from 30.2 % in office workers to 43.5 % in construction workers. It did not significantly differ from the prevalence recorded in 2005 (35.4 % vs. 36.8 %, respectively; P=0.441). Mean pack-years smoked among all smokers was 12.4 ± 2.3, ranging from 10.9 in administrative workers to 13.7 in agricultural workers. We did not find any significant difference in the prevalence of current smokers between male and female workers and between workers aged less or more than 40 years, as well as between workers of higher and lower education. The prevalence of ex-smokers was 10.5 %, ranging from 8.4 % in construction workers to 12.1 % in administrative workers, whereas the prevalence of passive smokers was 29.1 %, ranging from 26.2 % in food processing workers to 32.9 % in agricultural workers. Our findings indicate that the prevalence of current and passive smokers has remained high regardless of the anti-smoking campaign and call for stricter implementation of anti-smoking regulations.
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25
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Cerveri I, Cazzoletti L, Corsico AG, Marcon A, Niniano R, Grosso A, Ronzoni V, Accordini S, Janson C, Pin I, Siroux V, de Marco R. The impact of cigarette smoking on asthma: a population-based international cohort study. Int Arch Allergy Immunol 2012; 158:175-83. [PMID: 22286571 DOI: 10.1159/000330900] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 07/11/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The prevalence rates of smoking in subjects with asthma have frequently been reported as similar to those in the general population; however, available data are not up-to-date. There is only limited and somewhat conflicting information on the long-term effects of smoking on health outcomes among population-based cohorts of subjects with asthma. We aimed to investigate changes in smoking habits and their effects on forced expiratory volume in 1 s (FEV(1)) in subjects with asthma in comparison with the rest of the population, focusing on the healthy smoker effect. METHODS We studied 9,092 subjects without asthma and 1,045 with asthma at baseline who participated in both the European Community Respiratory Health Survey I (20-44 years old in 1991-1993) and II (1999-2002). RESULTS At follow-up, smoking was significantly less frequent among subjects with asthma than in the rest of the population (26 vs. 31%; p < 0.001). Subjects with asthma who were already ex-smokers at the beginning of the follow-up in the 1990 s had the highest mean asthma score (number of reported asthma-like symptoms, range 0-5), probably as a result of the healthy smoker effect (2.80 vs. 2.44 in never smokers, 2.19 in quitters and 2.24 in smokers; p < 0.001). The influence of smoking on FEV(1) decline did not depend on asthma status. Smokers had the highest proportion of subjects with chronic cough/phlegm (p < 0.01). CONCLUSION One out of 4 subjects with asthma continues smoking and reports significantly more chronic cough and phlegm than never smokers and ex-smokers. This stresses the importance of smoking cessation in all patients with asthma, even in those with less severe asthma.
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Affiliation(s)
- Isa Cerveri
- Division of Respiratory Diseases, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
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Holmberg T, Bech M, Curtis T, Juel K, Grønbæk M, Brixen K. Association between passive smoking in adulthood and phalangeal bone mineral density: results from the KRAM study--the Danish Health Examination Survey 2007-2008. Osteoporos Int 2011; 22:2989-99. [PMID: 21170642 DOI: 10.1007/s00198-010-1506-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Accepted: 11/22/2010] [Indexed: 11/30/2022]
Abstract
UNLABELLED The study investigates an association between phalangeal bone mineral density (BMD) and self-reported passive smoking using data on 15,038 persons (aged 18-95 years), who underwent a BMD scan in the Danish KRAM study. BMD was significantly lower in persons exposed to long-term passive smoking in their home during adulthood. INTRODUCTION Smoking is associated with decreased bone mineral density (BMD) and increased risk of osteoporotic fractures. This study aimed to investigate a possible association between BMD at the phalangeal bones and self-reported passive smoking. METHODS The study included a cohort of 15,544 men and women aged 18-95 years, who underwent a BMD scan in the Danish KRAM study. BMD scans of the middle phalanges of the second, third and fourth digits of the non-dominant hand were performed with a compact radiographic absorptiometry system (Alara MetriScan®). Also, height, weight and body fat percentage were measured and 96.7% (n = 15,038) of the participants answered a self-reported questionnaire with information on passive smoking, other lifestyle factors, education, etc. The association between passive smoking and BMD was examined using multiple linear regression analysis. RESULTS A total of 39.1% (n = 5,829) of the participants had been exposed to passive smoking in adulthood at home. BMD was significantly lower in subjects exposed to passive smoking, 0.343 vs. 0.331 g/cm(2); p < 0.01 (unadjusted) and 0.339 vs. 0.337 g/cm(2); p < 0.05 (adjusted for age, gender, height and weight, and smoking). Multiple linear regression analysis showed that exposure to passive smoking for more than 20 years in adulthood at home was significantly related to BMD when adjusted for potential confounders (men, β = -4.4 × 10(-3); r = -0.05; p < 0.01 and women, β = -2.3 × 10 (-3); r = -0.03; p < 0.05). This relationship was also seen in the group of never smokers (β = -3.3 × 10(-3); r = -0.03; p = 0.01). CONCLUSION Our study supports a potential negative effect of long-term passive smoking in adulthood at home on phalangeal BMD.
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Affiliation(s)
- T Holmberg
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2, 1353, Copenhagen K, Denmark.
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El Idrissi-Raja L, Draïss G, Bourrous M, Amine M, Bouskraoui M. [Survey on passive smoking in children in Agadir]. REVUE DE PNEUMOLOGIE CLINIQUE 2011; 67:289-297. [PMID: 22017948 DOI: 10.1016/j.pneumo.2010.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 10/20/2010] [Accepted: 11/01/2010] [Indexed: 05/31/2023]
Abstract
INTRODUCTION The aim of the study was to assess children's exposure to tobacco smoke at home, at school and in public places, to study its risks and to educate parents about the dangers of passive smoking. METHODS This is a survey conducted in October 2007 among children enrolled in pre-school and primary school in the city of Agadir, Morocco. The data was gathered by a written questionnaire completed by parents at home. RESULTS The survey covered 776 children. The response rate to the questionnaires was 88%. The father was a smoker in 28.9% of cases, against 0.7% for the mother. The prevalence of childhood exposure to tobacco was 34.1% at home, 36.4% in public places and 30.1% in schools. Concerning pregnant women, passive smoking and/or active was associated with a significantly increased risk of respiratory distress in newborn babies and hospitalisations in the neonatology department. In infant and child, involuntary inhalation of tobacco smoke involved an increased risk of sudden infant death syndrome and recurrent respiratory symptoms. However, its noxious effects were not found in the case of child asthma and tumour. CONCLUSION Passive smoking is a real public health problem and smoking is a dangerous but also a preventable source of pollution.
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Affiliation(s)
- L El Idrissi-Raja
- Service de pédiatrie A, hôpital Ar-Razi Mère-Enfant, CHU Mohammed VI, avenue Ibn-Sina Ammerchich, Marrakech, Morocco.
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Danielsson P, Ólafsdóttir IS, Benediktsdóttir B, Gíslason T, Janson C. The prevalence of chronic obstructive pulmonary disease in Uppsala, Sweden--the Burden of Obstructive Lung Disease (BOLD) study: cross-sectional population-based study. CLINICAL RESPIRATORY JOURNAL 2011; 6:120-7. [PMID: 21651748 DOI: 10.1111/j.1752-699x.2011.00257.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To estimate chronic obstructive pulmonary disease (COPD) prevalence in Uppsala and the impact of risk factors on disease prevalence using the standardised methods of the Burden of Obstructive Lung Disease (BOLD) study initiative. METHODS Randomly selected participants, aged 40 years or more (n = 548) responded to a questionnaire regarding smoking habits, respiratory symptoms, medical history, and exposure to airway irritants. Spirometry, with a post-bronchodilator test, was performed and COPD defined as post-bronchodilatory forced expiratory volume in 1 s (FEV(1))/forced vital capacity (FVC) < 0.70 or FEV(1)/FVC < lower limit of normality (LLN). Circulatory inflammatory markers were measured. RESULTS COPD prevalence was 16.2%, which was the fourth lowest prevalence of COPD, compared with 12 other BOLD centres. Main risk factors for COPD were increasing age [odds ratio (OR) = 2.08 per 10 years] and smoking (OR = 1.33 per 10 pack years). Higher education was protective (OR = 0.70 per 5 years). Previous tuberculosis was an almost significant risk factor for COPD (P = 0.08). Subjects with COPD reported more respiratory symptoms but only 29% had previous doctor diagnosed COPD, asthma, chronic bronchitis or emphysema. Participants with COPD had higher levels of C-reactive protein (P = 0.01), but no difference was observed in interleukin 6 (IL-6) levels. Using LLN instead of the fixed FEV(1) /FVC ratio reduced the prevalence of COPD to 10%. CONCLUSION COPD prevalence in Uppsala was similar to other BOLD centres in high-income countries. Apart from known COPD risk factors (age, smoking, lower educational level), a history of tuberculosis may be associated with COPD even in high-income countries. COPD remains under-diagnosed, as only 29% of subjects with COPD had a previously diagnosed lung disorder.
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Affiliation(s)
- Patrik Danielsson
- Department of Medical Sciences: Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden
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29
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Minov J, Karadzinska-Bislimovska J, Vasilevska K, Risteska-Kuc S, Stoleski S, Mijakoski D. Exercise-induced bronchoconstriction and exercise-induced respiratory symptoms in nurses. J Allergy (Cairo) 2011; 2011:267542. [PMID: 21747865 PMCID: PMC3124891 DOI: 10.1155/2011/267542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 02/28/2011] [Indexed: 11/17/2022] Open
Abstract
In order to assess prevalence and characteristics of exercise-induced respiratory symptoms (EIRSs) and exercise-induced bronchoconstriction (EIB) in health care workers, we performed a cross-sectional study including 48 female nurses from primary care settings and an equal number of female office workers studied as a control group. The evaluation of examined groups included completion of a questionnaire, skin prick tests to common inhalant allergens, spirometry, and exercise and histamine challenge. We found a similar prevalence of EIRSs and EIB in both groups. EIB was closely related to asthma, atopy, family history of asthma, and positive histamine challenge in either group, while the association between EIB and daily smoking in nurses was of borderline statistical significance. Bronchial reaction to exercise was significantly higher in nurses than in controls with EIB. With the exception of exercise induced wheezing, EIRSs were weakly associated with EIB in both groups with a large proportion of false positive results.
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Affiliation(s)
- Jordan Minov
- Department of Cardiorespiratory Functional Diagnostics, Institute for Occupational Health of R. Macedonia—WHO Collaborating Center and GA2LEN Collaborating Center, II Makedonska Brigada 43, 1000 Skopje, Macedonia
| | - Jovanka Karadzinska-Bislimovska
- Department of Cardiorespiratory Functional Diagnostics, Institute for Occupational Health of R. Macedonia—WHO Collaborating Center and GA2LEN Collaborating Center, II Makedonska Brigada 43, 1000 Skopje, Macedonia
| | | | - Snezana Risteska-Kuc
- Department of Cardiorespiratory Functional Diagnostics, Institute for Occupational Health of R. Macedonia—WHO Collaborating Center and GA2LEN Collaborating Center, II Makedonska Brigada 43, 1000 Skopje, Macedonia
| | - Saso Stoleski
- Department of Cardiorespiratory Functional Diagnostics, Institute for Occupational Health of R. Macedonia—WHO Collaborating Center and GA2LEN Collaborating Center, II Makedonska Brigada 43, 1000 Skopje, Macedonia
| | - Dragan Mijakoski
- Department of Cardiorespiratory Functional Diagnostics, Institute for Occupational Health of R. Macedonia—WHO Collaborating Center and GA2LEN Collaborating Center, II Makedonska Brigada 43, 1000 Skopje, Macedonia
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Jönsson UB, Håkansson LD, Jõgi R, Janson C, Venge P. Associations of ECP (eosinophil cationic protein)-gene polymorphisms to allergy, asthma, smoke habits and lung function in two Estonian and Swedish sub cohorts of the ECRHS II study. BMC Pulm Med 2010; 10:36. [PMID: 20534163 PMCID: PMC2890597 DOI: 10.1186/1471-2466-10-36] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Accepted: 06/09/2010] [Indexed: 11/16/2022] Open
Abstract
Background The Eosinophil Cationic Protein (ECP) is a potent multifunctional protein. Three common polymorphisms are present in the ECP gene, which determine the function and production of the protein. The aim was to study the relationship of these ECP gene polymorphisms to signs and symptoms of allergy and asthma in a community based cohort (The European Community Respiratory Health Survey (ECRHS)). Methods Swedish and Estonian subjects (n = 757) were selected from the larger cohort of the ECRHS II study cohort. The prevalence of the gene polymorphisms ECP434(G>C) (rs2073342), ECP562(G>C) (rs2233860) and ECP c.-38(A>C) (rs2233859) were analysed by DNA sequencing and/or real-time PCR and related to questionnaire-based information of allergy, asthma, smoking habits and to lung functions. Results Genotype prevalence showed both ethnic and gender differences. Close associations were found between the ECP434(G>C) and ECP562(G>C) genotypes and smoking habits, lung function and expression of allergic symptoms. Non-allergic asthma was associated with an increased prevalence of the ECP434GG genotype. The ECP c.-38(A>C) genotypes were independently associated to the subject being atopic. Conclusion Our results show associations of symptoms of allergy and asthma to ECP-genotypes, but also to smoking habits. ECP may be involved in impairment of lung functions in disease. Gender, ethnicity and smoking habits are major confounders in the evaluations of genetic associations to allergy and asthma.
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Affiliation(s)
- Ulla-Britt Jönsson
- Department of Medical Sciences, Clinical Chemistry, University of Uppsala, Uppsala, Sweden
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31
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Heck JE, Stücker I, Allwright S, Gritz ER, Haglund M, Healton CG, Králíková E, Del Mazo SS, Tamang E, Dresler CM, Hashibe M. Home and workplace smoking bans in Italy, Ireland, Sweden, France and the Czech Republic. Eur Respir J 2010; 35:969-79. [PMID: 19926747 PMCID: PMC4629784 DOI: 10.1183/09031936.00066809] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The purpose of this study was to report predictors and prevalence of home and workplace smoking bans in five European countries. We conducted a population-based telephone survey of 4,977 females, ascertaining factors associated with smoking bans. Odds ratios and 95% confidence intervals were derived using unconditional logistic regression. A complete home smoking ban was reported by 59.5% of French, 63.5% of Irish, 61.3% of Italian, 74.4% of Czech and 87.0% of Swedish females. Home smoking bans were associated with younger age and being bothered by secondhand smoke, and among smokers, inversely associated with greater tobacco dependence. Among nonsmokers, bans were also related to believing smoking is harmful (OR 1.20, 95% CI 1.11-1.30) and having parents who smoke (OR 0.62, 95% CI 0.52-0.73). Workplace bans were reported by 92.6% of French, 96.5% of Irish, 77.9% of Italian, 79.1% of Czech and 88.1% of Swedish females. Workplace smoking bans were reported less often among those in technical positions (OR 0.64, 95% CI 0.50-0.82) and among skilled workers (OR 0.53, 95% CI 0.32-0.88) than among professional workers. Workplace smoking bans are in place for most workers in these countries. Having a home smoking ban was based on smoking behaviour, demographics, beliefs and personal preference.
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Affiliation(s)
- Julia E. Heck
- International Agency for Research on Cancer, Lyon, France
- School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, US
| | | | - Shane Allwright
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Ellen R. Gritz
- Department of Behavioral Science, The University of Texas M.D. Anderson Cancer Center, Houston, TX, US
| | | | - Cheryl G. Healton
- American Legacy Foundation, Washington DC, US
- Mailman School of Public Health, Columbia University, New York, NY, US
| | - Eva Králíková
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- 3 Medical Department - Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | | | - Elizabeth Tamang
- Regione del Veneto - Direzione Prevenzione, Servizio di Sanità Pubblica e Screening, Venezia, Italia
| | - Carolyn M. Dresler
- Tobacco Prevention and Cessation Program, Arkansas Department of Health, Little Rock, AR, US
| | - Mia Hashibe
- International Agency for Research on Cancer, Lyon, France
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Linden K, Jormanainen V, Linna M, Sintonen H, Wilson K, Kotomäki T. Cost effectiveness of varenicline versus bupropion and unaided cessation for smoking cessation in a cohort of Finnish adult smokers. Curr Med Res Opin 2010; 26:549-60. [PMID: 20050814 DOI: 10.1185/03007990903542666] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the cost effectiveness of varenicline compared with bupropion or unaided cessation for smoking cessation in Finnish adult smokers. RESEARCH DESIGN AND METHODS The BENESCO (BENEfits of Smoking Cessation on Outcomes) Markov model was used to follow a hypothetical cohort of smokers making a single quit attempt over a lifetime. Gender and age-specific data on the incidence and prevalence of five smoking-related diseases (chronic obstructive pulmonary disease [COPD], lung cancer, coronary heart disease [CHD], stroke and asthma exacerbations) were included in the model. Life-years (LYs), quality-adjusted life-years (QALYs), total treatment costs and the lifetime cumulative incidence of these parameters were the primary outcomes evaluated, and they were compared for varenicline versus bupropion and varenicline versus unaided cessation. The primary data were derived from Finnish publications and databases. Deterministic and probabilistic sensitivity analyses were performed to test the robustness of the base-case model. RESULTS The treatment cohort comprised 229 301 smokers making a quit attempt. In the lifetime simulation, use of varenicline prevented 1965 and 5057 additional cases of smoking-related disease, and 1184 and 3047 deaths attributable to smoking, when compared with bupropion and unaided cessation, respectively. Compared with bupropion and unaided cessation varenicline treatment yielded 4392 and 11 303 additional LYs (4851 and 12 485 QALYs), respectively. Varenicline resulted in cost savings of 15 million and 43 million euros (euro) compared with bupropion and unaided cessation, respectively. In the 20-year time horizon analysis, varenicline yielded an incremental cost-effectiveness ratio (ICER) of euro8791/QALY and euro7791/QALY gained in comparison to bupropion and unaided cessation, respectively. Sensitivity analyses supported the robustness of the base-case results for varenicline. CONCLUSION Varenicline dominated over its comparators, i.e. it was more effective and resulted in cost saving compared with bupropion and unaided cessation.
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Pamplona P, Mendes B. [Tobacco smoking treatment strategy in COPD]. REVISTA PORTUGUESA DE PNEUMOLOGIA 2009; 15:1121-56. [PMID: 19859630 DOI: 10.1016/s0873-2159(15)30196-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Smoking cessation is one of the most important ways of improving the prognosis of COPD patients. Based on currently available evidence professional health workers should take a proactive and continuous role with smokers, motivating them to stop smoking and providing treatment to aid smoking cessation. The treatment should include pharmacotherapy in addition to behavioural support and should be part of management of the patient's chronic respiratory condition, as the COPD National Prevention and Treatment Programme recommends. Respiratory physicians and other professional health workers should receive training to ensure they have the necessary knowledge, attitude and skills to undertake these initiatives or to refer the smokers to a suitable qualified specialist. In the near future specialised smoking units should provide specific support, promote training, improve research and awareness and establish tobacco control measures in hospitals and primary health care centres.
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Affiliation(s)
- Paula Pamplona
- Hospital de Pulido Valente, Alameda das Linhas Torres, 117 1769 -001 Lisboa.
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Nejjari C, Benjelloun MC, Berraho M, El Rhazi K, Tachfouti N, Elfakir S, Serhier Z, Slama K. Prevalence and demographic factors of smoking in Morocco. Int J Public Health 2009; 54:447-51. [PMID: 19851709 DOI: 10.1007/s00038-009-0082-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Revised: 05/15/2009] [Accepted: 09/02/2009] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To study the prevalence and determinants of cigarette smoking in Morocco. METHODS A sample of 9,195 individuals aged 15-90 years, were randomly selected, using a stratified cluster sampling technique. A cross-sectional, household, community-based survey was conducted using a tested questionnaire. The interview covered personal, social and educational characteristics of the respondents and their smoking status. The association between current smoking and sociodemographic variables was estimated. RESULTS The overall prevalence of current smoking was 31.5% for males and 3.1% for females. In men, smoking was associated with lower educational level. In women, it was associated with higher educational level and social class. CONCLUSION Cigarette smoking remains an important public health problem in Morocco. A comprehensive strategy for tobacco control is needed.
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Affiliation(s)
- Chakib Nejjari
- Department of Epidemiology, Clinical Research and Community Health, Fez University, Km 2.2, Route Sidi Harazem, Fez, Morocco.
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Gielkens-Sijstermans CM, Mommers MA, Hoogenveen RT, Feenstra TL, de Vreede J, Bovens FM, van Schayck OC. Reduction of smoking in Dutch adolescents over the past decade and its health gains: a repeated cross-sectional study. Eur J Public Health 2009; 20:146-50. [PMID: 19706696 DOI: 10.1093/eurpub/ckp115] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Smoking is the main preventable lifestyle-related risk factor threatening human health. In this study, time trends in smoking behaviour between 1996 and 2005 among adolescents enrolled in secondary school were assessed. METHODS In 1996, 2001 and 2005, a survey was conducted in the south-eastern region of the Netherlands. All students in second and fourth year of secondary education (1996: n = 20 000; 2001: n = 27 500; 2005: n = 24 000) were asked to complete a questionnaire about their smoking behaviour. A simulation model was used to estimate lifetime health gains related to the observed trends. RESULTS In 1996, 2001 and 2005, the number of questionnaires analysed were 13 554 (68%), 20 767 (76%) and 17 896 (75%), respectively. The results show a decrease in 'ever smoking' as well as 'current smoking' between 1996 and 2005. Among second year high school students, current smoking prevalence decreased from 22.2% in 1996 to 8.0% in 2005 (P(trend) < 0.001). Among fourth year students, current smoking declined from 37.5% in 1996 to 22.0% in 2005 (P(trend) < 0.001). Time trends were not influenced by gender or educational level. Model projections show that if these students not take up smoking later in life, 11 500 new cases of COPD, 3400 new cases of lung cancer and 1800 new cases of myocardial infarction could be prevented for the Dutch 13-year-olds. CONCLUSION This study found that, in the past decade, smoking prevalence among adolescents has declined by almost 50%, potentially resulting in a considerable reduction in new cases of COPD or lung cancer.
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Chronic airflow obstruction and markers of systemic inflammation: results from the BOLD study in Iceland. Respir Med 2009; 103:1548-53. [PMID: 19427181 DOI: 10.1016/j.rmed.2009.04.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Revised: 03/31/2009] [Accepted: 04/05/2009] [Indexed: 12/20/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is characterized by an irreversible chronic airflow obstruction and by an accelerated decline in lung function. Elevated circulating levels of C-reactive protein (CRP) and interleukin-6 (IL-6), both markers of systemic inflammation, have been found in COPD. Their possible associations with chronic airflow obstruction have mostly been evaluated in highly selected patient samples. Our objective was to evaluate the association between postbronchodilator lung function CRP and IL-6 in a randomly selected sample of the Icelandic population, 40 years and older, while adjusting for gender, age, smoking, and body weight. METHODS Serum CRP and IL-6 values were measured among participants in the Burden of Obstructive Lung Disease (BOLD) study. RESULTS Of the 938 subjects invited a total of 403 men and 355 women participated (response rate 81%) in the study. Their mean age (+/-SD) was 57.7 (+/-12.7) years. Both CRP and IL-6 were independently related to lower FEV1 and FVC values. Individuals in the highest quartiles of CRP and IL-6 had a 7.5% and 3.9%, respectively, lower FEV1% than predicted after adjustment for smoking, age, and body weight. High CRP levels were more strongly related to lower FEV1 levels in men (-11.4%) than in women (-0.4%). CONCLUSIONS In a random population-based sample both CRP and IL-6 were significantly related to lower spirometric values. The association with CRP was stronger in men than in women. This finding underscores the possible importance of systemic inflammation in irreversible airflow limitation.
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Andreas S, Hering T, Mühlig S, Nowak D, Raupach T, Worth H. Smoking cessation in chronic obstructive pulmonary disease: an effective medical intervention. DEUTSCHES ARZTEBLATT INTERNATIONAL 2009; 106:276-82. [PMID: 19547629 DOI: 10.3238/arztebl.2009.0276] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Accepted: 02/18/2009] [Indexed: 11/27/2022]
Abstract
BACKGROUND As many as 50% of older smokers develop chronic obstructive pulmonary disease (COPD), and more than 80% of COPD-associated morbidity is caused by tobacco smoking. Despite the severe symptoms from which COPD patients suffer, they are often unable to quit smoking on their own. METHODS Experts from 9 medical societies, under the aegis of the German Society of Pulmonology and Respiratory Medicine (Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin), have developed an S3 guideline on smoking cessation in COPD. They took previously published guidelines into account, as well as more than 2000 initially surveyed publications, and created the new guideline in two consensus conferences followed by a Delphi process. RESULTS The following strongly evidence-based statements can be made: A smoking cessation strategy based on a combination of medication and psychosocial support has been found to be effective in COPD patients. Smoking cessation improves pulmonary function, alleviates dyspnea and cough, reduces the frequency of COPD exacerbations, and lowers mortality. Mere smoking reduction does not improve pulmonary function or alleviate symptoms. Smoking cessation is the most effective and least expensive single means of lowering the risk of developing COPD and of arresting its progression. Smoking cessation should therefore be strongly promoted at all levels of health care delivery. CONCLUSIONS There is no question that smoking cessation ranks among the most effective medical interventions, yet the German health care system still does not assign it an adequate priority.
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Affiliation(s)
- Stefan Andreas
- Lungenfachklinik Immenhausen/Kreis Kassel Pneumologische Lehrklinik der Universität Göttingen Robert Koch Str. 3 34376 Immenhausen, Germany.
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Body mass index, weight gain, and other determinants of lung function decline in adult asthma. J Allergy Clin Immunol 2009; 123:1069-74, 1074.e1-4. [PMID: 19321196 DOI: 10.1016/j.jaci.2009.01.040] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 01/07/2009] [Accepted: 01/12/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND Little is known about factors associated with lung function decline in asthma. OBJECTIVE To identify the determinants of FEV(1) decline in adults with asthma with and without airflow obstruction at baseline. METHODS An international cohort of 638 subjects with asthma (20-44 years old) was identified in the European Community Respiratory Health Survey (1991-1993) and followed up from 1998 to 2002. Spirometry was performed on both occasions. FEV(1) decline was related to potential determinants evaluated at baseline and during the follow-up by random intercept linear regression models. The analyses were stratified by the presence of airflow obstruction (FEV(1)/forced vital capacity < 0.70) at baseline. RESULTS In the group of individuals without airflow obstruction (n = 544), a faster FEV(1) decline was observed for subjects with intermediate body mass index (BMI) than for lean and obese subjects. FEV(1) decline was associated with weight gain independently of baseline BMI, and this association was stronger in men (20; 95% CI, 10-30, mL/y/kg gained) than in women (6; 95% CI, 1-11, mL/y). In the group of individuals with airflow obstruction (n = 94), the absence of allergen sensitization and a low BMI at baseline were associated with a faster FEV(1) decline, whereas weight gain was not associated with decline. CONCLUSIONS The detrimental effect of weight gain on FEV(1) decline is particularly relevant in subjects with asthma who still do not have an established airflow obstruction. Our findings support the importance of weight management in asthma and recommend weight loss in overweight or obese individuals with asthma.
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Second-hand smoke exposure in Canada: prevalence, risk factors, and association with respiratory and cardiovascular diseases. Can Respir J 2008; 15:263-9. [PMID: 18716689 DOI: 10.1155/2008/912354] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES The aims of the present study were to estimate the prevalence of second-hand smoke exposure in Canada, to identify sociodemographic risk factors for second-hand smoke exposure, and to examine the relationship between second-hand smoke exposure and respiratory and cardiovascular diseases. METHODS Data from the 2000/2001 Statistics Canada Canadian Community Health Survey (n=130,880, aged 12 years or older) were analyzed. Second-hand smoke exposure was based on self-report within the past month. The presence of chronic health conditions was also based on self-report. Because ex-smokers would be expected a priori to have poorer health than never-smokers, the analysis was stratified by previous smoking status. RESULTS Approximately 25% of never-smokers and 30% of ex-smokers self-reported recent second-hand smoke exposure. The following factors were identified as risk factors for second-hand smoke exposure: men; residences in Quebec, Atlantic Canada and the Territories; younger ages; nonimmigrant status; low education and income levels; social assistance receipt; and households without children younger than 12 years of age. After controlling for potential confounders, both never- and ex-smokers exposed to second-hand smoke had significantly higher odds of self-reporting asthma (20% to 30%) and chronic bronchitis (50%) than those not exposed to second-hand smoke. Among ex-smokers, those exposed to second-hand smoke also had significantly higher odds of self-reporting hypertension (20%) than those not exposed to second-hand smoke. No associations were observed between second-hand smoke exposure and emphysema or heart disease. CONCLUSIONS Self-reported recent second-hand smoke exposure in Canada in 2000/2001 was high, and was associated with asthma, chronic bronchitis and hypertension in never- and ex-smokers. Potential causal associations and public health implications warrant additional research.
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Montgomery SM, Bahmanyar S, Hillert J, Ekbom A, Olsson T. Maternal smoking during pregnancy and multiple sclerosis amongst offspring. Eur J Neurol 2008; 15:1395-9. [DOI: 10.1111/j.1468-1331.2008.02331.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bahmanyar S, Montgomery SM, Weiss RJ, Ekbom A. Maternal smoking during pregnancy, other prenatal and perinatal factors, and the risk of Legg-Calvé-Perthes disease. Pediatrics 2008; 122:e459-64. [PMID: 18625663 DOI: 10.1542/peds.2008-0307] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The causes of Legg-Calvé-Perthes disease are largely unknown, but this pediatric disease seems to result from interruption of the blood supply to the proximal femur and is considered a vascular disease. Because maternal smoking during pregnancy influences fetal development and is associated with cardiovascular diseases in offspring, we hypothesized that this exposure is a risk for Legg-Calvé-Perthes disease and also investigated other markers of impaired fetal development and early-life exposures. MATERIALS AND METHODS The Swedish Inpatient Register identified 852 individuals with a diagnosis of Legg-Calvé-Perthes disease from 1983 to 2005, individually matched by year of birth, age, sex, and region of residence with 4432 randomly selected control subjects. Linkage with the Swedish Medical Birth Register provided information on prenatal factors, including maternal smoking. Conditional logistic regression examined associations of maternal smoking during pregnancy and the other measures with the risk of Legg-Calvé-Perthes disease in offspring, adjusted for socioeconomic index and other potential confounding factors. RESULTS Maternal smoking during pregnancy was associated with an increased Legg-Calvé-Perthes disease risk, and heavy smoking was associated with a risk increase of almost 100%. Very low birth weight and cesarean section were independently associated with approximately 240% and 36% increases in the risk of Legg-Calvé-Perthes disease, respectively. CONCLUSION Maternal smoking during pregnancy and other factors indicated by impaired fetal development may be associated with an increased risk of Legg-Calvé-Perthes disease.
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Affiliation(s)
- Shahram Bahmanyar
- Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden.
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Exposure to Environmental Tobacco Smoke in the Workplace in Macedonia: Where Are We Now? Arh Hig Rada Toksikol 2008; 59:103-9. [DOI: 10.2478/10004-1254-59-2008-1870] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Exposure to Environmental Tobacco Smoke in the Workplace in Macedonia: Where Are We Now?To assess the prevalence and the level of exposure to environmental tobacco smoke (ETS) in the workplace after the enactment of the law restricting indoor smoking in Macedonia, we performed a cross-sectional, self-administered questionnaire study including 372 never-smoking workers recruited from six workplaces. We found a high prevalence of workers exposed to ETS in the workplace (27.4 %) with no significant difference between particular occupation groups. We found no significant difference in the prevalence of passive smokers in the workplace between this study and our study conducted before the law was enacted (31.5 %vs.27.4 %, P=0.324). The prevalence of workers exposed to ETS for less than three hours a day was significantly lower than of passive smokers with longer exposure (28.4 %vs.71.6 %, P=0.038). The prevalence of workers exposed to ETS from less than 10 cigarettes smoked by coworkers per day was lower than the prevalence of workers with higher exposure, but statistical significance was not reached (37.9 %vs.62.1 %, P=0.087). Our findings indicate a high prevalence and a high level of exposure to ETS in the workplace, which calls for stricter adherence to smoking-free legislation or even the total ban of smoking in the workplace.
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Thomson NC. The role of environmental tobacco smoke in the origins and progression of asthma. Curr Allergy Asthma Rep 2007; 7:303-9. [PMID: 17547853 DOI: 10.1007/s11882-007-0045-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Exposure to environmental tobacco smoke (ETS) is a major source of indoor air pollution and causes adverse effects on the respiratory health of individuals with asthma. At least one third of children and adults with asthma are exposed to ETS on a regular basis. There is convincing evidence for a causal relationship between exposure to ETS and development of asthma in children and in nonsmoking adults. Exposure to ETS also worsens asthma control in children and nonsmoking adults who have established asthma. The mechanism by which ETS causes these harmful effects is not established but may involve genetic predisposition, impairment of lung development, and altered lung inflammatory responses. Workplace smoking restrictions and reduced smoking in the home may lower the prevalence of asthma, improve asthma control, and reduce the use of medical services in both children and adults who are exposed to ETS.
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Affiliation(s)
- Neil C Thomson
- Department of Respiratory Medicine, Division of Immunology, Infection and Inflammation, Western Infirmary and University of Glasgow, Glasgow G11 6NT, UK.
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Bellamy D. Clinical consensus on chronic obstructive pulmonary disease. Expert Rev Respir Med 2007; 1:35-7. [PMID: 20477263 DOI: 10.1586/17476348.1.1.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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