1
|
Abeysekera I, De Silva R, Silva D, Piumika L, Jayathilaka R, Rajamanthri L. Examining the influence of global smoking prevalence on stroke mortality: insights from 27 countries across income strata. BMC Public Health 2024; 24:857. [PMID: 38504226 PMCID: PMC10953178 DOI: 10.1186/s12889-024-18250-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/01/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND This study investigates the influence of Global Smoking Prevalence (GSP) on Stroke Death Rates (SDR) across 27 countries categorized into High-Income Countries (HIC), Upper Middle-Income Countries (UMIC), Lower Middle-Income Countries (LMIC), and Low-Income Countries (LIC). METHODS Analysing data from two distinct periods (1990-1999 and 2010-2019), countries exhibiting an increased SDR were selected. The study uses a polynomial regression model, treating income groups as cross-sectional and years as time series data. RESULTS Results from the regression model reveal that 17 countries observed a significant impact of GSP on SDR, with only Turkey, Solomon Islands, and Timor-Leste resulting in negative values. However, the study emphasises that out of all 27 countries, the highest occurrence of the impact of GSP on SDR has been reported in the LMIC stratum for the period under review. CONCLUSION It is evident that GSP affects the risk of incidence of stroke death, specifically in the LMIC stratum. Furthermore, it has been identified that GSP is a major preventable risk factor affecting global mortality. To mitigate the risk of stroke death attributable to smoking prevalence, necessary preventive steps should be adopted to encourage smoking cessation, and essential policies should be implemented to reduce the burden of SDR.
Collapse
Affiliation(s)
- Isuri Abeysekera
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka
| | - Roshinie De Silva
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka
| | - Disuri Silva
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka
| | - Lakindu Piumika
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka
| | - Ruwan Jayathilaka
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka.
| | - Lochana Rajamanthri
- Department of Information Management, SLIIT Business School, Sri Lanka Institute of Information Technology, New Kandy Road, Malabe, Sri Lanka
| |
Collapse
|
2
|
Hasan M, Hossain MM, Abrarin S, Kormoker T, Billah MM, Bhuiyan MKA, Akbor MA, Salam SMA, Khan R, Naher K, Salam MA, Ali MM, Rahman MM, Emran TB, Mahmoud Z, Khandaker MU, Siddique MAB. Heavy metals in popularly sold branded cigarettes in Bangladesh and associated health hazards from inhalation exposure. Environ Sci Pollut Res Int 2023; 30:100828-100844. [PMID: 37644270 DOI: 10.1007/s11356-023-29491-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
Tobacco products are widely recognized as a major contributor to death. Cigarette smoke contains several toxic chemicals including heavy metals particulate causing high health risks. However, limited information has been available on the health risks associated with the heavy metals in cigarettes commonly sold in the Bangladeshi market. This study evaluated the concentrations and potential health risks posed by ten concerned heavy metals in ten widely consumed cigarette brands in Bangladesh using an atomic absorption spectrometer. The concentration (mg/kg) ranges of heavy metals Pb, Cd, Cr, As, Co, Ni, Mn, Fe, Cu, and Zn vary between 0.46-1.05, 0.55-1.03, 0.80-1.2, 0.22-0.40, 0.46-0.78, 2.59-3.03, 436.8-762.7, 115.8-184.4, 146.6-217.7, and 34.0-42.7, respectively. We assume that the heavy metals content among cigarette brands is varied due to the differences in the source of tobacco they use for cigarette preparation. The carcinogenic risks posed by heavy metals follow the order of Cr > Co > Cd > As > Ni > Pb, while the non-carcinogenic risks for Cu, Zn, Fe, and Mn were greater than unity (HQ > 1), except for Fe. The existence of toxic heavy metals in cigarette tobacco may thus introduce noticeable non-carcinogenic and carcinogenic health impacts accompanying inhalation exposure. This study provides the first comprehensive report so far on heavy metal concentration and associated health risks in branded cigarettes commonly sold in Bangladesh. Hence, this data and the information provided can serve as a baseline as well as a reference for future research and have potential implications for policy and legislation in Bangladesh.
Collapse
Affiliation(s)
- Mehedi Hasan
- Institute of National Analytical Research and Service (INARS), Bangladesh Council of Scientific and Industrial Research (BCSIR), Dhanmondi, Dhaka, 1205, Bangladesh
| | - Md Moazzem Hossain
- Department of Applied Chemistry and Chemical Engineering, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Shaifa Abrarin
- Institute of National Analytical Research and Service (INARS), Bangladesh Council of Scientific and Industrial Research (BCSIR), Dhanmondi, Dhaka, 1205, Bangladesh
| | - Tapos Kormoker
- Department of Science and Environmental Studies, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong
| | - Md Masum Billah
- Inter-Departmental Research Centre for Environmental Science - CIRSA, University of Bologna, Via S. Alberto 163, Ravenna Campus, Ravenna, 48123, Italy
| | - Md Khurshid Alam Bhuiyan
- Institute of Marine Research (INMAR), University of Cádiz, Research Institutes Building, Puerto Real Campus, Cádiz, 11510, Puerto Real, Spain
| | - Md Ahedul Akbor
- Institute of National Analytical Research and Service (INARS), Bangladesh Council of Scientific and Industrial Research (BCSIR), Dhanmondi, Dhaka, 1205, Bangladesh
| | - Sayed M A Salam
- Department of Applied Chemistry and Chemical Engineering, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Rahat Khan
- Institute of Nuclear Science and Technology, Bangladesh Atomic Energy Commission (BAEC), Savar, Dhaka, 1349, Bangladesh
| | - Kamrun Naher
- Institute of Nuclear Science and Technology, Bangladesh Atomic Energy Commission (BAEC), Savar, Dhaka, 1349, Bangladesh
| | - Mohammed Abdus Salam
- Department of Environmental Science and Disaster Management, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Mir Mohammad Ali
- Department of Aquaculture, Sher-e-Bangla Agricultural University, Dhaka, 1207, Bangladesh
| | - Md Mostafizur Rahman
- Laboratory of Environmental Health and Ecotoxicology, Department of Environmental Sciences, Jahangirnagar University, Dhaka, 1342, Bangladesh
| | - Talha Bin Emran
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School & Legorreta Cancer Center, Brown University, Providence, RI 02912, USA
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, 1207, Bangladesh
| | - Z Mahmoud
- Department of Physics, College of Sciences, King Khalid University, P.O. Box 9004, Abha, Saudi Arabia
| | - Mayeen Uddin Khandaker
- Centre for Applied Physics and Radiation Technologies, School of Engineering and Technology, Sunway University, 47500, Bandar Sunway, Malaysia
| | - Md Abu Bakar Siddique
- Institute of National Analytical Research and Service (INARS), Bangladesh Council of Scientific and Industrial Research (BCSIR), Dhanmondi, Dhaka, 1205, Bangladesh.
| |
Collapse
|
3
|
Moqaddas A, Reisi M, Mahmoodi M, Javadzade H. Predictive Factors of Stages of Change in Hookah Smoking Cessation Among Iranian Adults Based on the Transtheoretical Model. Addict Health 2023; 15:77-86. [PMID: 37560398 PMCID: PMC10408760 DOI: 10.34172/ahj.2023.1347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 06/29/2022] [Indexed: 08/11/2023]
Abstract
BACKGROUND Hookah, as a traditional method of smoking, is widely used in Iran, especially in Bushehr province. It is essential to identify the most important determinants of modifying hookah smoking behavior. This study aimed to investigate the predictors of the stages of change in quitting hookah smoking in 15-60-year-old individuals in Bushehr province, southern Iran, based on the transtheoretical model (TTM). METHODS This descriptive-analytical study was conducted on 1173 Hookah smokers in Bushehr province. The samples were selected by two-stage random sampling from 10 cities. Data were collected using a valid and reliable questionnaire consisting of 5 sections (demographic characteristics, stages of change, processes of change, decisional balance, and self-efficacy). Data were analyzed by R version.3.3.1 using analysis of variance and ordinal logistic regression at a significant level of 0.05. FINDINGS The data revealed 82% of the participants were in the preparatory phase (55.3% in pre-contemplation and 26.7% in contemplation stages). Marital status, family members smoking hookah, cigarette smoking, level of education, number of family members, number of quitting attempts, self-efficacy, self-reevaluation, counter-conditioning, reinforcement management, and stimulus control were predictors of quitting hookah smoking. CONCLUSION Given that most study participants were in the inactive stages of quitting hookah smoking, it seems necessary to design and implement behavioral interventions based on the predictive TTM constructs in this population.
Collapse
Affiliation(s)
- Adel Moqaddas
- Department of Health Education and Health Promotion, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mahnoush Reisi
- Department of Health Education and Health Promotion, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Marzieh Mahmoodi
- Department of Epidemiology and Biostatistics, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Homamodin Javadzade
- Department of Health Education and Health Promotion, Bushehr University of Medical Sciences, Bushehr, Iran
| |
Collapse
|
4
|
Cherif I, Khiari H, Mallekh R, Hsairi M. Mortality attributable to tobacco in Tunisian adults, 2016Mortalité attribuable au tabac dans la population tunisienne adulte en 2016. Rev Epidemiol Sante Publique 2022; 70:191-195. [PMID: 35469686 DOI: 10.1016/j.respe.2022.03.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 03/05/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE We aimed to estimate the mortality attributable to current cigarette smoking among Tunisian individuals aged 30 years and over in 2016. METHODS The number of deaths attributable to cigarette smoking was estimated using the population attributable fraction (PAF) method of calculation. Current cigarette smoking-related data and number of deaths by cause were obtained from a Tunisian national household survey conducted in 2016 (THES-2016) and the "Global Burden of Disease" study respectively. Relative risks for cause-specific mortality among current cigarette smokers compared to never-smokers were obtained mainly from the American cancer prevention study II (CPS II), including adjustments for a range of potential confounders. RESULTS In 2016, 6,039 deaths were attributed to current cigarette smoking (5,934 in men and 105 in women), accounting for 14.3 % of total deaths in persons aged 30 years and over (24.2 % in men and 0.6 % in women). Lung cancer, chronic obstructive pulmonary diseases and upper aerodigestive tract cancers represented the highest smoking-attributable risks (74.5 %, 49.1 % and 42.2 % respectively). CONCLUSIONS In the present study, high rates of smoking-attributable mortality were found, mainly among men. In addition to more rigorous application of existing laws, sensitization to the dangers of tobacco, educational anti-smoking campaigns and help in quitting are of prime importance.
Collapse
Affiliation(s)
- Ines Cherif
- Department of Epidemiology, Salah Azaiez Institute of Tunis, Boulevard du 9-Avril 1938, 1006, Tunis, Tunisia.
| | - Houyem Khiari
- Department of Epidemiology, Salah Azaiez Institute of Tunis, Boulevard du 9-Avril 1938, 1006, Tunis, Tunisia
| | - Rym Mallekh
- Department of Epidemiology, Salah Azaiez Institute of Tunis, Boulevard du 9-Avril 1938, 1006, Tunis, Tunisia
| | - Mohamed Hsairi
- Department of Epidemiology, Salah Azaiez Institute of Tunis, Boulevard du 9-Avril 1938, 1006, Tunis, Tunisia
| |
Collapse
|
5
|
Alavi SS, Joukar S, Rostamzadeh F, Najafipour H, Darvishzadeh-Mahani F, Mortezaeizade A. Exercise Training Attenuates Cardiac Vulnerability and Promotes Cardiac Resistance to Isoproterenol-Induced Injury Following Hookah Smoke Inhalation in Male Rats: Role of Klotho and Sirtuins. Cardiovasc Toxicol 2022; 22:501-514. [PMID: 35316495 DOI: 10.1007/s12012-022-09733-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/17/2022] [Indexed: 11/25/2022]
Abstract
Hookah smoking is on the rise around the world. Present study investigated the heart resistance to harmful stress following long-term waterpipe tobacco smoking (WTS) and moderate-intensity exercise training intervention in male Wistar rats. Animals were randomly divided into a non-ischemic heart control group and four ischemic heart groups including ISO (isoproterenol-treated), Ex + ISO (subjected to exercise plus ISO), S + ISO (exposed to hookah smoke plus ISO), and Ex + S + ISO (subjected to exercise along with hookah smoke plus ISO). After eight weeks of training and WTS, heart ischemia induced by isoproterenol injections. Then, cardiac functional indices and some biochemical and histopathological parameters were assessed. WTS + ISO reduced systolic pressure, ± dP/dt max, and contractility indices (P < 0.001 vs. ISO group) and increased end diastolic pressure and Tau index (P < 0.001 vs. ISO) of the left ventricle. Also, WTS + ISO was associated with an increase in Bax protein level and Bax/Bcl-2 ratio (P < 0.05 and P < 001, respectively, vs. ISO group) as apoptotic markers of heart tissue. Hookah smoke significantly decreased SIRT1 (P < 0.05 and P < 0.001, respectively, vs. ISO) and klotho (P < 0.01 and P < 0.001, respectively, vs. ISO) in serum and heart, and SIRT3 and pS9-GSK-3β (P < 001 and P < 0.05, respectively, vs. ISO) in heart tissue. Combination of exercise with WTS prevented the hookah smoke-induced alterations in apoptotic markers, cardiac functional indices, and SIRT1, SIRT3, klotho, and pS9-GSK-3β proteins. The findings demonstrated that hookah smoke inhalation intensifies ventricular dysfunction and decreases heart resistance to harmful stresses. Moderate-intensity exercise training attenuated these complications partly through recovering the klotho and sirtuins levels and apoptosis-survival balancing.
Collapse
Affiliation(s)
- Samaneh Sadat Alavi
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences and Department of Physiology and Pharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, P.O. Box 7616914115, Kerman, Iran
| | - Siyavash Joukar
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences and Department of Physiology and Pharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, P.O. Box 7616914115, Kerman, Iran.
| | - Farzaneh Rostamzadeh
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Najafipour
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Darvishzadeh-Mahani
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Mortezaeizade
- Pathology and Stem Cell Research Center, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
6
|
Ahammed T, Ahmed NU, Uddin MJ. Changes in prevalence, and factors associated with tobacco use among Bangladeshi school students: evidence from two nationally representative surveys. BMC Public Health 2021; 21:579. [PMID: 33757487 PMCID: PMC7989242 DOI: 10.1186/s12889-021-10623-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Globally, tobacco kills more than nine million people per year. Annually in Bangladesh, smoking accounts for 1.2 million illnesses and over one hundred fifty thousand deaths. Worldwide, about one out of five school students smoke tobacco, and this problem is also growing significantly in Bangladesh. There is a need to address this problem. However, to the best of knowledge, no published study has been evaluated the changes in factors associated with tobacco use over time among Bangladeshi adolescent students using large, nationally representative comparable surveys. Our objective was to identify the factors associated with tobacco use among school going students, examine any changes in them over time, and explore policy options based on national surveys. Methods We analysed the data from the 2007 and the 2013 Global Youth Tobacco Survey (GYTS), a school-based survey targeting adolescents age 13–15 years (7th–9th grade), developed by the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC). The samples were selected based on a two-stage cluster sample design. The data were collected in school classes using a self-administered anonymous survey. We applied chi-square tests and survey logistic regression models for analysing the data. Results Overall tobacco usage significantly declined from 8.4 to 6.9% over six years. The prevalence of tobacco use decreased among females (5.22 to 2.84%), those who received anti-tobacco messages (8.93 to 7.24%) and because of age restriction could not buy tobacco products (18.86 to 15.78%). Compared with the female, the odds of overall tobacco smoking among male students was 1.97 (CI: 0.99–3.92) in the year 2007 and it increased (OR = 3.07; CI: 1.56–6.04) in the year 2013. Moreover, the odds of smoking among those exposed to tobacco smoke had increased (OR = 3.26; CI: 1.46–7.29 vs 5.43; CI: 1.63–18.07) from 2007 to 2013. Conclusion There was a decline in tobacco use, especially among female students. Male students were higher tobacco user. It appeared anti-smoking campaign and age restriction policies were working. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10623-0.
Collapse
Affiliation(s)
- Tanvir Ahammed
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh
| | - Nasar U Ahmed
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, 3114, Bangladesh.
| |
Collapse
|
7
|
Münzel T, Hahad O, Kuntic M, Keaney JF, Deanfield JE, Daiber A. Effects of tobacco cigarettes, e-cigarettes, and waterpipe smoking on endothelial function and clinical outcomes. Eur Heart J 2020; 41:4057-4070. [PMID: 32585699 PMCID: PMC7454514 DOI: 10.1093/eurheartj/ehaa460] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/24/2020] [Accepted: 05/14/2020] [Indexed: 12/13/2022] Open
Abstract
Tobacco smoking is a leading cause of non-communicable disease globally and is a major risk factor for cardiovascular disease (CVD) and lung disease. Importantly, recent data by the World Health Organizations (WHO) indicate that in the last two decades global tobacco use has significantly dropped, which was largely driven by decreased numbers of female smokers. Despite such advances, the use of e-cigarettes and waterpipes (shisha, hookah, narghile) is an emerging trend, especially among younger generations. There is growing body of evidence that e-cigarettes are not a harm-free alternative to tobacco cigarettes and there is considerable debate as to whether e-cigarettes are saving smokers or generating new addicts. Here, we provide an updated overview of the impact of tobacco/waterpipe (shisha) smoking and e-cigarette vaping on endothelial function, a biomarker for early, subclinical, atherosclerosis from human and animal studies. Also their emerging adverse effects on the proteome, transcriptome, epigenome, microbiome, and the circadian clock are summarized. We briefly discuss heat-not-burn tobacco products and their cardiovascular health effects. We discuss the impact of the toxic constituents of these products on endothelial function and subsequent CVD and we also provide an update on current recommendations, regulation and advertising with focus on the USA and Europe. As outlined by the WHO, tobacco cigarette, waterpipe, and e-cigarette smoking/vaping may contribute to an increased burden of symptoms due to coronavirus disease 2019 (COVID-19) and to severe health consequences.
Collapse
Affiliation(s)
- Thomas Münzel
- Center for Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Omar Hahad
- Center for Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Marin Kuntic
- Center for Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - John F Keaney
- Division of Cardiovascular Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - John E Deanfield
- Institute of Cardiovascular Science, University College London, 1 St Martin's le Grand, London EC1A 4NP, UK
| | - Andreas Daiber
- Center for Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Langenbeckstraße 1, 55131 Mainz, Germany
| |
Collapse
|
8
|
Nolan-Kenney R, Wu F, Hu J, Yang L, Kelly D, Li H, Jasmine F, Kibriya MG, Parvez F, Shaheen I, Sarwar G, Ahmed A, Eunus M, Islam T, Pei Z, Ahsan H, Chen Y. The Association Between Smoking and Gut Microbiome in Bangladesh. Nicotine Tob Res 2020; 22:1339-1346. [PMID: 31794002 PMCID: PMC7364824 DOI: 10.1093/ntr/ntz220] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/02/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Epidemiological studies that investigate alterations in the gut microbial composition associated with smoking are lacking. This study examined the composition of the gut microbiome in smokers compared with nonsmokers. AIMS AND METHODS Stool samples were collected in a cross-sectional study of 249 participants selected from the Health Effects of Arsenic Longitudinal Study in Bangladesh. Microbial DNA was extracted from the fecal samples and sequenced by 16S rRNA gene sequencing. The associations of smoking status and intensity of smoking with the relative abundance or the absence and presence of individual bacterial taxon from phylum to genus levels were examined. RESULTS The relative abundance of bacterial taxa along the Erysipelotrichi-to-Catenibacterium lineage was significantly higher in current smokers compared to never-smokers. The odds ratio comparing the mean relative abundance in current smokers with that in never-smokers was 1.91 (95% confidence interval = 1.36-2.69) for the genus Catenibacterium and 1.89 (95% confidence interval = 1.39-2.56) for the family Erysipelotrichaceae, the order Erysipelotrichale, and the class Erysipelotrichi (false discovery rate-adjusted p values = .0008-.01). A dose-response association was observed for each of these bacterial taxa. The presence of Alphaproteobacteria was significantly greater comparing current with never-smokers (odds ratio = 4.85, false discovery rate-adjusted p values = .04). CONCLUSIONS Our data in a Bangladeshi population are consistent with evidence of an association between smoking status and dosage with change in the gut bacterial composition. IMPLICATIONS This study for the first time examined the relationship between smoking and the gut microbiome composition. The data suggest that smoking status may play an important role in the composition of the gut microbiome, especially among individuals with higher levels of tobacco exposure.
Collapse
Affiliation(s)
- Rachel Nolan-Kenney
- Department of Population Health, New York University School of Medicine, New York, NY
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Fen Wu
- Department of Population Health, New York University School of Medicine, New York, NY
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Jiyuan Hu
- Department of Population Health, New York University School of Medicine, New York, NY
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Liying Yang
- Department of Pathology, New York University School of Medicine, New York, NY
- Department of Medicine, New York University School of Medicine, New York, NY
- The Department of Veterans Affairs New York Harbor Healthcare System, New York, NY
| | - Dervla Kelly
- Health Research Institute, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Huilin Li
- Department of Population Health, New York University School of Medicine, New York, NY
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Farzana Jasmine
- Department of Public Health Sciences, Institute for Population and Precision Health, The University of Chicago, Chicago, IL
| | - Muhammad G Kibriya
- Department of Public Health Sciences, Institute for Population and Precision Health, The University of Chicago, Chicago, IL
| | - Faruque Parvez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Ishrat Shaheen
- Department of Informatics, U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Golam Sarwar
- Department of Informatics, U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Alauddin Ahmed
- Department of Informatics, U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Mahbub Eunus
- Department of Informatics, U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Tariqul Islam
- Department of Health, Research & Training, U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Zhiheng Pei
- Department of Pathology, New York University School of Medicine, New York, NY
- Department of Medicine, New York University School of Medicine, New York, NY
- The Department of Veterans Affairs New York Harbor Healthcare System, New York, NY
| | - Habibul Ahsan
- Department of Public Health Sciences, Institute for Population and Precision Health, The University of Chicago, Chicago, IL
| | - Yu Chen
- Department of Population Health, New York University School of Medicine, New York, NY
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| |
Collapse
|
9
|
Bhatnagar A, Maziak W, Eissenberg T, Ward KD, Thurston G, King BA, Sutfin EL, Cobb CO, Griffiths M, Goldstein LB, Rezk-Hanna M. Water Pipe (Hookah) Smoking and Cardiovascular Disease Risk: A Scientific Statement From the American Heart Association. Circulation 2020; 139:e917-e936. [PMID: 30845826 DOI: 10.1161/cir.0000000000000671] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Tobacco smoking with a water pipe or hookah is increasing globally. There are millions of water pipe tobacco smokers worldwide, and in the United States, water pipe use is more common among youth and young adults than among adults. The spread of water pipe tobacco smoking has been abetted by the marketing of flavored tobacco, a social media environment that promotes water pipe smoking, and misperceptions about the addictive potential and potential adverse health effects of this form of tobacco use. There is growing evidence that water pipe tobacco smoking affects heart rate, blood pressure regulation, baroreflex sensitivity, tissue oxygenation, and vascular function over the short term. Long-term water pipe use is associated with increased risk of coronary artery disease. Several harmful or potentially harmful substances present in cigarette smoke are also present in water pipe smoke, often at levels exceeding those found in cigarette smoke. Water pipe tobacco smokers have a higher risk of initiation of cigarette smoking than never smokers. Future studies that focus on the long-term adverse health effects of intermittent water pipe tobacco use are critical to strengthen the evidence base and to inform the regulation of water pipe products and use. The objectives of this statement are to describe the design and operation of water pipes and their use patterns, to identify harmful and potentially harmful constituents in water pipe smoke, to document the cardiovascular risks of water pipe use, to review current approaches to water pipe smoking cessation, and to offer guidance to healthcare providers for the identification and treatment of individuals who smoke tobacco using water pipes.
Collapse
|
10
|
Badran M, Laher I. Waterpipe (shisha, hookah) smoking, oxidative stress and hidden disease potential. Redox Biol 2020; 34:101455. [PMID: 32086009 PMCID: PMC7327957 DOI: 10.1016/j.redox.2020.101455] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 01/27/2020] [Accepted: 02/06/2020] [Indexed: 02/08/2023] Open
Abstract
Due to the abundant research on the harmful effects of cigarette smoking and the strict regulations enacted by many health authorities, many smokers are seeking for safer and more acceptable tobacco forms. Waterpipe (also known as shisha or hookah) use has increased dramatically during the past decade, mostly due to its improved taste, lack of regulations and social acceptability as a safer option than cigarettes. However, recent clinical and experimental studies indicate that waterpipe use is as, or even more, harmful than cigarettes. Although they differ in the method of consumption, waterpipe tobacco has similar deleterious constituents found in cigarettes but are generated at greater amounts. These constituents are known to induce oxidative stress and inflammation, the major underlying mechanisms of a wide array of chronic pathological conditions. We review the relationship between waterpipe tobacco use and oxidative stress and the disease potential of waterpipe use. Waterpipe tobacco smoking is growing in popularity globally, since it is thought to be a safer alternative to cigarette smoking. The amount of harmful substances produced from one waterpipe smoking session are greater than found in a standard cigarette. Waterpipe smoking can cause oxidative stress and inflammation, which precede and exacerbate multiple pathological conditions.
Collapse
Affiliation(s)
- Mohammad Badran
- Department of Child Health and Child Health Research Institute, University of Missouri School of Medicine, Columbia, MO, USA
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada.
| |
Collapse
|
11
|
Saidi O, Hajjem S, Zoghlami N, Aounallah-Skhiri H, Ben Mansour N, Hsairi M, Romdhane HB, Critchley JA, Mallouche D, O'Flaherty M, Fakhfakh R. Premature mortality attributable to smoking among Tunisian men in 2009. Tob Induc Dis 2019; 17:77. [PMID: 31768169 PMCID: PMC6843183 DOI: 10.18332/tid/112666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 05/12/2019] [Accepted: 09/28/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Tobacco smoking is a significant public health threat in the world, a risk factor for many diseases, and has been increasing in prevalence in many developing countries. In this study, we aimed to estimate the burden of premature deaths attributable to smoking among Tunisian men aged 35–69 years in 2009. METHODS The number of deaths attributable to smoking was estimated using the population attributable risk fraction method. Smoking prevalence was obtained from a nationally representative survey. Causes of death were obtained from the registry of the National Public Health Institute. Relative risks were taken from the American Cancer Society Prevention Study (CPS-II). RESULTS Total estimated premature deaths attributable to smoking among men in Tunisia were 2601 (95% CI: 2268–2877), accounting for 25% (95% CI: 23.3–26.6) of total male adult mortality. Cancer, cardiovascular and respiratory diseases were the major causes of premature deaths attributable to smoking with 1272 (95% CI: 1188–1329), 966 (95% CI: 779–1133) and 364 (300–415) deaths, respectively. CONCLUSIONS Tobacco smoking is highly relevant and is related to substantial premature mortality in Tunisia, around double that estimated for the region as a whole. This also has not decreased over the past 20 years. Urgent actions are needed to reduce this pandemic.
Collapse
Affiliation(s)
- Olfa Saidi
- National Institute of Public Health, Ministry of Health, Tunis, Tunisia.,Research Laboratory of Epidemiology and Prevention of Cardiovascular Diseases, Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Said Hajjem
- National Institute of Public Health, Ministry of Health, Tunis, Tunisia
| | - Nada Zoghlami
- National Institute of Public Health, Ministry of Health, Tunis, Tunisia.,Research Laboratory of Epidemiology and Prevention of Cardiovascular Diseases, Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Hajer Aounallah-Skhiri
- National Health Institute, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El-Manar, Tunis, Tunisia.,The SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, National Institute of Nutrition and Food Technology, Tunis, Tunisia
| | - Nadia Ben Mansour
- National Institute of Public Health, Ministry of Health, Tunis, Tunisia.,Research Laboratory of Epidemiology and Prevention of Cardiovascular Diseases, Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | | | - Habiba Ben Romdhane
- Research Laboratory of Epidemiology and Prevention of Cardiovascular Diseases, Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia
| | - Julia A Critchley
- Division of Population Health Sciences and Education, St George's, University of London, London, United Kingdom
| | - Dhafer Mallouche
- National Institute of Statistics and Data Analysis, Tunis, Tunisia
| | - Martin O'Flaherty
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
| | - Radhouane Fakhfakh
- National Institute of Public Health, Ministry of Health, Tunis, Tunisia.,Unit of Research in Tobacco Epidemiology and Control, Tunis, Tunisia
| |
Collapse
|
12
|
Abstract
Introduction: Waterpipe (WP) smoking is an important public health problem that is rapidly evolving globally. Much of WP spread among youth is perpetuated by a misperception of reduced harms compared to cigarettes. Increasing awareness about WP smoking harms through health warning labels (HWLs) represents a promising policy and regulatory strategy to curb WP smoking. Areas covered: Peer-reviewed publications indexed in PubMed and CINAHL were searched in March 2019. This review focuses on the current knowledge of WP smoking characteristics, its spread and patterns of use globally, and some of the major WP-related health effects. This knowledge is utilized to advance a promising policy and regulatory avenue to curb WP smoking by increasing awareness of its potential harms through HWLs. It also addresses product configuration and unique features that influence the adaptation of HWLs for WP smoking. Expert opinion: HWLs are effective in communicating smoking-related risks to WP smokers in a way that affects their smoking behavior and experience as well as interest in quitting. Although based on limited data, the WP device appears to be a promising location for HWLs as it offers prolonged contact with smokers and those surrounding them.
Collapse
Affiliation(s)
- Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
- Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Taghrid Asfar
- Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
- Division of Epidemiology, Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
13
|
Qasim H, Alarabi AB, Alzoubi KH, Karim ZA, Alshbool FZ, Khasawneh FT. The effects of hookah/waterpipe smoking on general health and the cardiovascular system. Environ Health Prev Med 2019; 24:58. [PMID: 31521105 PMCID: PMC6745078 DOI: 10.1186/s12199-019-0811-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/22/2019] [Indexed: 12/13/2022] Open
Abstract
Hookah or waterpipe smoking or use is an emerging trend in the US population, especially among the youth. The misperception of hookah being less harmful than cigarettes and the availability of different but "appealing" flavors are considered among the main reasons for this trend. Hookah users however are exposed to many of the same toxic compounds/by-products as cigarette users, but at dramatically higher levels, which might lead to more severe negative health effects. In fact, hookah users are at risks of infections, cancers, lung disease, and other medical conditions. Moreover, because of the overlapping toxicant/chemical profile to conventional cigarettes, hookah smoke effects on the cardiovascular system are thought to be comparable to those of conventional cigarettes. A major source of tobacco addiction is nicotine, whose levels in hookah are extremely variable as they depend on the type of tobacco used. Taken together, in this review of literature, we will provide insights on the negative health effects of hookah in general, with a focus on what is known regarding its impact on the cardiovascular system.
Collapse
Affiliation(s)
- Hanan Qasim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Ahmed B Alarabi
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Zubair A Karim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Fatima Z Alshbool
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA.
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA.
| |
Collapse
|
14
|
Hesami Z, Sharifi H, Behzadnia N, Naghashzadeh F, Heydari GR, Sharif-kashani B, Abbasi P. The acute effects of Water-pipe smoking on Ankle Brachial Index: A cross-sectional Study. ijcp 2019. [DOI: 10.29252/ijcp-26695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
|
15
|
Asfar T, Schmidt M, Ebrahimi Kalan M, Wu W, Ward KD, Nakkash RT, Thrasher J, Eissenberg T, Ben Romdhane H, Maziak W. Delphi study among international expert panel to develop waterpipe-specific health warning labels. Tob Control 2019; 29:159-167. [PMID: 30696784 DOI: 10.1136/tobaccocontrol-2018-054718] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/20/2018] [Accepted: 12/20/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Waterpipe (WP) smoking is increasing globally. The rise of WP has been fuelled by widespread misperception of reduced-harm compared to cigarettes. Health warning labels (HWLs) are one strategy to communicate smoking-related risks and address reduced-harm misperceptions. Therefore, the development of WP-specific HWLs represents a priority for WP control. METHODS A panel of experts in WP science developed 28 WP-specific HWLs corresponding to five themes (health risks, addiction, harm to others, WP-specific harm, WP harm compared to cigarettes). Subsequently, a three-round Delphi study was conducted among international expert panel to reach consensus on a set of the most effective HWLs for each theme. Levels of agreement between participants were assessed using interquartile deviations, and the rank between the tied HWLs was based on the median. RESULTS Starting with 28 candidate HWLs stratified according to five WP-related themes, our international expert panel reached consensus on the 13 most important WP-specific HWLs. Labels with the highest agreement were related to oral and heart disease, WP's harmful effects on newborn children and the amount of smoke inhaled from WP compared to cigarettes. CONCLUSION This study is the first to systematically develop and evaluate potential WP-specific HWLs based on the scientific evidence about WP's harmful effects, scientific understanding of HWL for cigarettes and the opinions of experts in WP science, tobacco control and health communication. The final selected HWLs can be adapted based on the context and policy landscape of the target country and can be further fine-tuned based on feedback from WP smokers and non-smokers.
Collapse
Affiliation(s)
- Taghrid Asfar
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA.,Syrian Center for Tobacco Studies, Aleppo, Syria.,Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, US
| | - Michael Schmidt
- Department of Art, The University of Memphis, Memphis, Tennessee, USA
| | - Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, USA
| | - Wensong Wu
- Department of Mathematics and Statistics, Florida International University, Miami, Florida, USA
| | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Aleppo, Syria.,School of Public Health, The University of Memphis, Miami, Florida, USA
| | - Rima T Nakkash
- Health Behaviour and Education Department, American University of Beirut, Beirut, Lebanon
| | - James Thrasher
- Health Promotion, Education, and Behavior, School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syria.,USA Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Habiba Ben Romdhane
- Cardiovascular Epidemiology and Prevention Research Laboratory, Faculty of Medicine of Tunis-Tunisia, Tunis, Tunisia
| | - Wasim Maziak
- Syrian Center for Tobacco Studies, Aleppo, Syria.,Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, USA
| |
Collapse
|
16
|
Chami HA, Isma'eel H, Tamim H, Adawi M, Al Kuwari M, Al Mullah A. The Association of Water-Pipe Smoking and Coronary Artery Calcium in a Community-Based Sample. Chest 2019; 155:1217-1225. [PMID: 30684475 DOI: 10.1016/j.chest.2019.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 12/04/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Water-pipe smoking is increasing in popularity, driven partly by a perception of reduced harm compared with cigarette smoking. This study evaluates the association of water-pipe smoking with coronary artery calcium (CAC), a marker of coronary heart disease (CHD) risk, in a community-based sample. METHODS A total of 175 exclusive water-pipe smokers and 170 nonsmokers, ≥ 35 years of age, were recruited from the community in Lebanon and Qatar. Water-pipe smoking was assessed using a validated questionnaire. CAC score was assessed using multidetector CT scan. The association of water-pipe smoking with the presence and extent of CAC was evaluated using regression analyses adjusted for CHD risk factors. RESULTS CAC was present in 41% of water-pipe smokers vs 28% of nonsmokers (P = .01), with an average CAC score ± SD of 90.6 ± 400.3 Agatston units (AUs) in water-pipe smokers and 52.4 ± 218.6 AUs in nonsmokers. In adjusted analyses, water-pipe smokers had significantly higher adjusted odds of having CAC (OR = 2.20; 95% CI, 1.20-4.01; P = .01) and being in the high CHD risk category defined by CAC > 300 AUs (OR = 3.41; 95% CI, 1.08-10.77; P = .04) or CAC > 75% of age, sex, and race-predicted (OR = 3.11; 95% CI, 1.55-6.24; P = .001) than nonsmokers. CAC extent was significantly associated with water-pipe smoking extent measured by smoking duration (β = 0.17/year; 95% CI, 0.05-0.29; P = .004) or the product of smoking duration and the number of water pipes smoked daily (β = 0.04/water-pipe-year; 95% CI, 0.003-0.07; P = .03). CONCLUSIONS Exclusive water-pipe smoking was associated with the presence and extent of CAC, with twice the risk of having CAC and three times the risk of being in the high CHD risk category while accounting for other risk factors.
Collapse
Affiliation(s)
- Hassan A Chami
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Hussain Isma'eel
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hani Tamim
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Marwa Adawi
- Institute of Public Health, United Arab Emirates University, Al Ain, UAE
| | | | | |
Collapse
|
17
|
Hertz JT, Fu T, Vissoci JR, Rocha TAH, Carvalho E, Flanagan B, de Andrade L, Limkakeng AT, Staton CA. The distribution of cardiac diagnostic testing for acute coronary syndrome in the Brazilian healthcare system: A national geospatial evaluation of health access. PLoS One 2019; 14:e0210502. [PMID: 30629670 PMCID: PMC6328143 DOI: 10.1371/journal.pone.0210502] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/24/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Little is known about the utilization of cardiac diagnostic testing in Brazil and how such testing is related with local rates of acute coronary syndrome (ACS)-related mortality. METHODS AND RESULTS Using data from DATASUS, the public national healthcare database, absolute counts of diagnostic tests performed were calculated for each of the 5570 municipalities and mapped. Spatial error regression and geographic weighted regression models were used to describe the geographic variation in the association between ACS mortality, income, and access to diagnostic testing. From 2008 to 2014, a total of 4,653,884 cardiac diagnostic procedures were performed in Brazil, at a total cost of $271 million USD. The overall ACS mortality rate during this time period was 133.8 deaths per 100,000 inhabitants aged 20 to 79. The most commonly utilized test was the stress ECG (3,015,993), followed by catheterization (862,627), scintigraphy (669,969) and stress echocardiography (105,295). The majority of these procedures were conducted in large urban centers in more economically developed regions of the country. Increased access to testing and increased income were not uniformly associated with decreased ACS mortality, and tremendous geographic heterogeneity was observed in the relationship between these variables. CONCLUSIONS The majority of testing for ACS in Brazil is conducted at referral centers in developed urban settings. Stress ECG is the dominant testing modality in use. Increased access to diagnostic testing was not consistently associated with decreased ACS mortality across the country.
Collapse
Affiliation(s)
- Julian T. Hertz
- Department of Surgery, Division of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Tommy Fu
- Department of Surgery, Division of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Joao Ricardo Vissoci
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- Department of Medicine, Centro Universitario Inga, Maringa, Brazil
| | | | - Elias Carvalho
- Department of Computer Science, Pontifical University Catholic of Parana, Curitiba, Brazil
- Data Processing Department, State University of Maringa, Maringa, Brazil
| | - Brendan Flanagan
- Department of Surgery, Division of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | | | - Alex T. Limkakeng
- Department of Surgery, Division of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Catherine A. Staton
- Department of Surgery, Division of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
- * E-mail:
| |
Collapse
|
18
|
Pratiti R, Mukherjee D. Epidemiology and Adverse Consequences of Hookah/Waterpipe Use: A Systematic Review. Cardiovasc Hematol Agents Med Chem 2019; 17:82-93. [PMID: 31483237 DOI: 10.2174/1871525717666190904151856] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/15/2019] [Accepted: 08/15/2019] [Indexed: 06/10/2023]
Abstract
Hookah smoking is becoming a popular trend globally. Waterpipe smoking is the second most prevalent form of alternate tobacco products. The rapid increase in hookah use is because of the misconception prevalent in society that hookah smoking is less harmful than cigarette smoking. Smoking ban policies had given impetus of switching from cigarette smoking to alternate tobacco products like waterpipe. Hookah users regard hookah to be more socially acceptable, less stigmatizing with flavors and to alleviate cigarette craving symptoms. Newer basic science research on animal models and human cells has shown consistently mutagenic, oxidative, and inflammatory changes that could cause possible health effects of premalignant oral lesion and chronic diseases like atherosclerosis and chronic obstructive pulmonary disease. Studies on the chemistry of waterpipe smoke had shown alarming results with the smoke containing seven carcinogens, 39 central nervous system depressants, and 31 respiratory irritants. Enormous data exist showing waterpipe smoking causing various health effects. Hookah smoking effects on cardiovascular disease is additive with hookah containing a significant amount of nicotine, tar, and heavy metals causing both acute and chronic effects on the cardiovascular system. These effects include increased heart rate, blood pressure, prevalence of coronary heart disease, heart failure, ST-segment elevation myocardial ischemia, recurrent ischemia, and worse outcomes including mortality related to these diseases. The objectives of the review are to assess the factor associated with the increasing use of hookah, its health effects, options for hookah smoking cessation, and public health policy initiatives to mitigate waterpipe use.
Collapse
Affiliation(s)
- Rebecca Pratiti
- McLaren HealthCare, G-3245 Beecher Rd, Flint, MA 48532, United States
| | - Debabrata Mukherjee
- Texas Tech University Health Science Center, Department of Internal Medicine, El Paso, TX 79905, United States
| |
Collapse
|
19
|
Chat V, Wu F, Demmer RT, Parvez F, Ahmed A, Eunus M, Hasan R, Nahar J, Shaheen I, Sarwar G, Desvarieux M, Ahsan H, Chen Y. Association between number of children and carotid intima-media thickness in Bangladesh. PLoS One 2018; 13:e0208148. [PMID: 30481229 PMCID: PMC6258552 DOI: 10.1371/journal.pone.0208148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/11/2018] [Indexed: 12/19/2022] Open
Abstract
Previous studies on the association between number of children and carotid intima-media thickness (cIMT) were limited to Western populations. Pregnancy in women is associated with physiologic changes that may influence the risk of cardiovascular disease. Comparing the association between number of children and cIMT in men and women can provide insights on whether the association may be due to pregnancy. We investigated the association between number of children and cIMT among 718 female (mean age 37.5 years) and 417 male participants (mean age 41.3 years), randomly selected from the Health Effect of Arsenic Longitudinal Study (HEALS), a population-based cohort study in Bangladesh. Multivariate linear regression was used to assess the association and to control for education attainment, history of diabetes, age, smoking, betel use, BMI, systolic blood pressure, and diastolic blood pressure. The average number of children was 4.43 for women and 3.74 for men. There were no nulliparous women. We observed a positive association between number of children and cIMT in women. Mean cIMT increased by 4.5 μm (95% CI, 0.8–8.1) per increment of one birth (P = 0.02). Compared to women with two children, cIMT in women with 4 children and ≥5 children was 23.6μm (95%CI, 2.6–44.7; P = 0.03) and 25.1 μm (95%CI, 3.5–46.6; P = 0.02) greater, respectively. The association was not modified by BMI, SBP, betel use or age. Data in men showed no evidence of association (P = 0.4). The finding suggests a role of high parity in atherosclerosis in women of a low-income, high parity population.
Collapse
Affiliation(s)
- Vylyny Chat
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Fen Wu
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, New York, United States of America
| | - Ryan T. Demmer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Faruque Parvez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | | | - Mahbub Eunus
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Rabiul Hasan
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Jabun Nahar
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | | | - Golam Sarwar
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- INSERM UMR 1153, Centre de Recherche Epidemiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Core, Paris France
| | - Habibul Ahsan
- Department of Health Studies, Center for Cancer Epidemiology and Prevention, The University of Chicago, Chicago, Illinois, United States of America
| | - Yu Chen
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, New York, United States of America
- * E-mail:
| |
Collapse
|
20
|
Rehman H, Samad Z, Mishra SR, Merchant AT, Narula JP, Mishra S, Virani SS. Epidemiologic studies targeting primary cardiovascular disease prevention in South Asia. Indian Heart J 2018; 70:721-730. [PMID: 30392513 PMCID: PMC6204454 DOI: 10.1016/j.ihj.2018.01.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 12/12/2017] [Accepted: 01/16/2018] [Indexed: 01/02/2023] Open
Abstract
South Asia has experienced a 73% increase in healthy life years lost due to ischemic heart disease between 1990 and 2010. There is a lack of quality data relating to cardiovascular risk factors and disease from this region. Several observational and prospective cohorts in South Asia have been established in recent times to evaluate the burden of cardiovascular disease and their risk factors. The Prospective Rural Urban Epidemiology (PURE) study is the largest of these studies that has provided data on social, environmental, behavioral and biologic risk factors that influence heart disease and diabetes. Some studies have also borrowed data from large datasets to provide meaningful insights. These studies have allowed a better understanding of cardiovascular disease risk factors indigenous to the South Asian population along with conventional risk factors. Culturally sensitive interventions geared towards treating risk factors identified in these studies are needed to fully realize the true potential of these epidemiologic studies.
Collapse
Affiliation(s)
| | - Zainab Samad
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Shiva Raj Mishra
- Nepal Development Society, Bharatpur-10, Chitwan, Nepal; Center for Longitudinal and Lifecourse Research, Faculty of Medicine, University of Queensland, Herston, QLD 4006, Australia
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; WJB Dorn VA Medical Center, Columbia, SC, USA
| | - Jagat P Narula
- Marie-Josée and Henry R. Kravis Center for Cardiovascular Health Mount Sinai School of Medicine, USA
| | - Sundeep Mishra
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Salim S Virani
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
| |
Collapse
|
21
|
Hossain MT, Hassi U, Imamul Huq S. Assessment of concentration and toxicological (Cancer) risk of lead, cadmium and chromium in tobacco products commonly available in Bangladesh. Toxicol Rep 2018; 5:897-902. [PMID: 30191134 PMCID: PMC6125795 DOI: 10.1016/j.toxrep.2018.08.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 08/27/2018] [Accepted: 08/29/2018] [Indexed: 10/29/2022] Open
Abstract
This study aimed to assess the concentrations of heavy metal ('lead (Pb)''cadmium (Cd)', and 'chromium (Cr)') in various brands of four types of tobacco products (zarda, gul, cigarettes, and bidi) as well as calculate toxicological risk as a lifetime cancer risk for Pb, Cd, and Cr. In smokeless tobacco products, the metal concentration ranged from 0.99 to 10.02 μg/g for Pb, 1.05-3.53 μg/g for Cd, and 1.23-7.29 μg/g for Cr, respectively. Metal concentrations in the smoke-based tobacco products ranged from 0.98 to 3.07 μg/g for Pb, 0.91-3.46 μg/g for Cd, 1.08-6.75 μg/g for Cr, respectively. When assuming a 100% transfer of these metals, the calculated lifetime cancer risk was found 'unacceptable' in 33 out of 35 tobacco samples which exceeded the U.S. Environmental Protection Agency (USEPA) benchmark of an 'acceptable' cancer risk range of 10E-4 to 10E-6. Our study demonstrated higher levels of Pb, Cd, and Cr in various tobacco products of Bangladesh compared to GOTHIATEK standard. This study shows the need for the development of industry standards and regulation for tobacco products to reduce the levels of heavy metals.
Collapse
Affiliation(s)
- Md Tawhid Hossain
- Department of Soil, Water & Environment, Faculty of Biological Sciences, University of Dhaka, Dhaka 1000, Bangladesh
| | - Ummehani Hassi
- Department of Soil, Water & Environment, Faculty of Biological Sciences, University of Dhaka, Dhaka 1000, Bangladesh
| | | |
Collapse
|
22
|
Sultana P, Rahman MT, Roy DC, Akter S, Jung J, Rahman MM, Akter J. Tobacco control policies to promote awareness and smoke-free environments in residence and workplace to reduce passive tobacco smoking in Bangladesh and its correlates. PLoS One 2018; 13:e0198942. [PMID: 29920514 DOI: 10.1371/journal.pone.0198942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 05/29/2018] [Indexed: 11/19/2022] Open
Abstract
Background Bangladesh is one of the highest tobacco consuming countries in the world, with reported 21.2% of the population as daily smokers, 24.3% as smokeless tobacco users, and 36.3% as adult passive smoker. Given the high prevalence and established harmful effects of passive tobacco smoking, this study aimed to estimate of pattern of smoking policies in residential and work place, and to identify the associated socio-economic and demographic correlates in Bangladesh. Data and methods Secondary data of sample size 9629 collected by the Global Adult Tobacco Survey (GATS) 2010 has been used. Along with descriptive analysis, binary logistic regression model has been used to analyze the socio-demographic and economic correlates to tobacco smoking policy. Results The prevalence of male and female passive tobacco smokers was 74.3% and 25.8% respectively. Among the passive tobacco smokers, 22.2% reported that smoking was allowed at their home and 29.8% reported that there was no such smoking policy at their home. Alternatively, 26.0% passive tobacco smokers reported that smoking was allowed and 27.5% reported that there was no such smoking policy at their work place. Logistic regression analysis indicated that for tobacco smokers group, the odds of allowing smoking at home was 4.85 times higher than the non-smoker respondent (OR = 4.85, 95% CI = 4.13, 5.71), 1.18 times more likely to be allowed at home in rural areas than urban areas (OR = 1.18, 95% CI = 1.06,1.32) and less for college/university completed and (or) higher educated respondent than no formal schooling (OR = 0.35, 95% CI = 0.24, 0.52). On the other hand, smoking was 1.70 times more likely to be allowed at work place for tobacco smokers than their counter part respondent (OR = 1.70, 95% CI = 1.36, 2.14) and was less likely to be allowed for college/university completed and (or) higher educated respondent (OR = 0.26, 95% CI = 0.14, 0.45) than respondent with no formal schooling. Conclusion To reduce the passive smoking, lower educated people and people in urban areas should advocate more about the adverse effect of active and passive tobacco smoking. Also, smoking policy should reform introducing smoking zone at work places and residential buildings.
Collapse
|
23
|
Waziry R, Jawad M, Ballout RA, Al Akel M, Akl EA. The effects of waterpipe tobacco smoking on health outcomes: an updated systematic review and meta-analysis. Int J Epidemiol 2018; 46:32-43. [PMID: 27075769 DOI: 10.1093/ije/dyw021] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2016] [Indexed: 12/25/2022] Open
Abstract
Background and aims A systematic review conducted in 2008 found significant associations between waterpipe tobacco smoking and lung cancer, respiratory disease, periodontal disease and low birthweight. Since then, a number of relevant studies have been published. The objective of this study was to update the systematic review on the effects of waterpipe tobacco smoking on health outcomes. Methods In May 2015 we electronically searched the following databases with no date restrictions: MEDLINE, EMBASE and the ISI Web of Science using a detailed search strategy with no language restrictions. We also screened the references' lists of the included studies. We included cohort, case-control and cross-sectional studies, and excluded case reports, conference abstracts, editorials and reviews. We excluded studies not conducted in humans, assessing physiological outcomes, not distinguishing waterpipe tobacco smoking from other forms of smoking or not reporting association measures. We assessed risk of bias for each included study and conducted meta-analyses for each of the outcomes of interest. Results We identified 50 eligible studies. We found that waterpipe tobacco smoking was significantly associated with: respiratory diseases [COPD; odds ratio (OR) = 3.18, 95% confidence interval CI = 1.25, 8.08; bronchitis OR = 2.37, 95% CI = 1.49, 3.77; passive waterpipe smoking and wheeze OR) = 1.97, 95% CI = 1.28, 3.04]; oral cancer OR = 4.17, 95% CI = 2.53, 6.89; lung cancer OR = 2.12, 95% CI = 1.32, 3.42; low birthweight (OR = 2.39, 95% CI = 1.32, 4.32); metabolic syndrome (OR 1.63-1.95, 95% CI = 1.25, 2.45); cardiovascular disease (OR = 1.67, 95% CI = 1.25, 2.24); and mental health (OR 1.30-2.4, 95% CI = 1.20, 2.80). Waterpipe tobacco smoking was not significantly associated with: oesophageal cancer (OR = 4.14, 95% CI = 0.93, 18.46); worse quality of life scores [standardized mean difference (SMD) = -0.16, 95% CI = -0.66, 0.34]; gastric carcinoma (OR = 2.16, 95% CI = 0.72, 6.47); bladder cancer (OR = 1.25, 95% CI = 0.99, 1.57); prostate cancer (OR = 7.00, 95% CI = 0.90, 56.90); hepatitis C infection (OR = 0.98, 95%0.80, 1.21); periodontal disease (OR = 3.00, 5.00); gastro-oesophageal reflux disease (OR = 1.25, 95% CI = 1.01, 1.56); nasopharyngeal carcinoma (OR = 0.49, 95% CI = 0.20, 1.23); bladder cancer (OR = 1.25, 95% CI = 0.99, 1.57); infertility (OR = 2.50, 95% CI = 1.00, 6.30); and mortality (OR = 1.15, 95% CI = 0.93, 1.43). Conclusions There is accumulating evidence about the association of waterpipe tobacco smoking with a growing number of health outcomes.
Collapse
Affiliation(s)
- Reem Waziry
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.,Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Mohammed Jawad
- Department of Primary Care and Public Health, Imperial College London, London, UK.,Academic Department of Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Rami A Ballout
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Mohammad Al Akel
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.,Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
24
|
Duong M, Rangarajan S, Zhang X, Killian K, Mony P, Swaminathan S, Bharathi AV, Nair S, Vijayakumar K, Mohan I, Gupta R, Mohan D, Rani S, Mohan V, Iqbal R, Kazmi K, Rahman O, Yusuf R, Pinnaka LVM, Kumar R, O'Byrne P, Yusuf S. Effects of bidi smoking on all-cause mortality and cardiorespiratory outcomes in men from south Asia: an observational community-based substudy of the Prospective Urban Rural Epidemiology Study (PURE). Lancet Glob Health 2017; 5:e168-e176. [PMID: 28104186 DOI: 10.1016/s2214-109x(17)30004-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 11/14/2016] [Accepted: 12/14/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Bidis are minimally regulated, inexpensive, hand-rolled tobacco products smoked in south Asia. We examined the effects of bidi smoking on baseline respiratory impairment, and prospectively collected data for all-cause mortality and cardiorespiratory events in men from this region. METHODS This substudy of the international, community-based Prospective Urban Rural Epidemiology (PURE) study was done in seven centres in India, Pakistan, and Bangladesh. Men aged 35-70 years completed spirometry testing and standardised questionnaires at baseline and were followed up yearly. We used multilevel regression to compare cross-sectional baseline cardiorespiratory symptoms, spirometry measurements, and follow-up events (all-cause mortality, cardiovascular events, respiratory events) adjusted for socioeconomic status and baseline risk factors between non-smokers, light smokers of bidis or cigarettes (≤10 pack-years), heavy smokers of cigarettes only (>10 pack-years), and heavy smokers of bidis (>10 pack-years). FINDINGS 14 919 men from 158 communities were included in this substudy (8438 non-smokers, 3321 light smokers, 959 heavy cigarette smokers, and 2201 heavy bidi smokers). Mean duration of follow-up was 5·6 years (range 1-13). The adjusted prevalence of self-reported chronic wheeze, cough or sputum, dyspnoea, and chest pain at baseline increased across the categories of non-smokers, light smokers, heavy cigarette smokers, and heavy bidi smokers (p<0·0001 for association). Adjusted cross-sectional age-related changes in forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) ratio were larger for heavy bidi smokers than for the other smoking categories. Hazard ratios (relative to non-smokers) showed increasing hazards for all-cause mortality (light smokers 1·28 [95% CI 1·02-1·62], heavy cigarette smokers 1·59 [1·13-2·24], heavy bidi smokers 1·56 [1·22-1·98]), cardiovascular events (1·45 [1·13-1·84], 1·47 [1·05-2·06], 1·55 [1·17-2·06], respectively) and respiratory events (1·30 [0·91-1·85], 1·21 [0·70-2·07], 1·73 [1·23-2·45], respectively) across the smoking categories. INTERPRETATION Bidi smoking is associated with severe baseline respiratory impairment, all-cause mortality, and cardiorespiratory outcomes. Stricter controls and regulation of bidis are needed to reduce the tobacco-related disease burden in south Asia. FUNDING Population Health Research Institute, Canadian Institutes of Health Research, and Heart and Stroke Foundation of Ontario.
Collapse
Affiliation(s)
- MyLinh Duong
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Xiaohe Zhang
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Kieran Killian
- Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Prem Mony
- Division of Epidemiology and Population Health, St John's Research Institute, Bengaluru, India
| | - Sumathi Swaminathan
- Division of Epidemiology and Population Health, St John's Research Institute, Bengaluru, India
| | | | - Sanjeev Nair
- Department of Pulmonary Medicine, Medical College, Thiruvananthapuram, Kerala, India; Health Action by People, Thiruvananthapuram, Kerala, India
| | - Krishnapillai Vijayakumar
- Health Action by People, Thiruvananthapuram, Kerala, India; Dr Somervell Memorial CSI Medical College, Karakonam, Thiruvananthapuram, Kerala, India
| | - Indu Mohan
- Fortis Escorts Hospitals, JLN Marg, Jaipur, India
| | - Rajeev Gupta
- Fortis Escorts Hospitals, JLN Marg, Jaipur, India
| | - Deepa Mohan
- Madras Diabetes Research Foundation, Chennai, India
| | - Shanthi Rani
- Madras Diabetes Research Foundation, Chennai, India
| | | | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan; Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Khawar Kazmi
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | | | - Rita Yusuf
- Independent University, Dhaka, Bangladesh
| | | | - Rajesh Kumar
- Post Graduate Institute of Medical Education and Research (PGIMER) School of Public Health, Chandigarh, India
| | - Paul O'Byrne
- Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| |
Collapse
|
25
|
Etemadi A, Khademi H, Kamangar F, Freedman ND, Abnet CC, Brennan P, Malekzadeh R, Poustchi H, Pourshams A, Khoshnia M, Gharavi S, Norouzi A, Merat S, Jafari E, Islami F, Semnani S, Pharoah PDP, Boffetta P, Dawsey SM. Hazards of cigarettes, smokeless tobacco and waterpipe in a Middle Eastern Population: a Cohort Study of 50 000 individuals from Iran. Tob Control 2017; 26:674-682. [PMID: 27872345 PMCID: PMC5767941 DOI: 10.1136/tobaccocontrol-2016-053245] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/05/2016] [Accepted: 10/25/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND There is limited information about the hazards of cigarettes, smokeless tobacco and waterpipe in the Middle East. The aim of this study was to determine the association between different types of tobacco use and earlier death in the Golestan Cohort Study. METHODS The Study includes 50 045 adults (aged 40-75 years) from north eastern Iran. The baseline questionnaire (2004-2008) assessed information about use of cigarettes, chewing tobacco (nass) and waterpipe. To assess the use of each type of tobacco compared with never tobacco users, we used Cox regression models adjusted for age, socioeconomic status, area of residence, education and other tobacco used, and stratified by sex, ethnicity and opium use. RESULTS 17% of participants reported a history of cigarette smoking, 7.5% chewing tobacco (nass) and 1.1% smoking waterpipe, and these figures declined in the later birth cohorts. During a median follow-up of 8 years, 4524 deaths occurred (mean age 64.8+9.9 years). Current (HR=1.44; 95% CI 1.28 to 1.61) and former (HR=1.35; 95% CI 1.16 to 1.56) cigarette smokers had higher overall mortality relative to never tobacco users. The highest cigarette-associated risk was for cancer death among current heavy smokers (HR=2.32; 95% CI 1.66 to 3.24). Current nass chewing was associated with overall mortality (HR=1.16; 95% CI 1.01 to 1.34), and there was a 61% higher risk of cancer death in people chewing nass more than five times a day. We observed an association between the cumulative lifetime waterpipe use (waterpipe-years≥28) and both overall (HR=1.66; 95% CI 1.11 to 2.47), and cancer mortality (HR=2.82; 95% CI 1.30 to 6.11). CONCLUSIONS Regular use of cigarettes, smokeless tobacco and waterpipe were associated with the risk of earlier death (particularly from cancer) in our cohort.
Collapse
Affiliation(s)
- Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD 20850
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooman Khademi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- International Agency for Research on Cancer, Lyon, France
| | - Farin Kamangar
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD 21251
| | - Neal D. Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD 20850
| | - Christian C. Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD 20850
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobilliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hossein Poustchi
- Liver and Pancreaticobilliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobilliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khoshnia
- Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran
| | - Samad Gharavi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Norouzi
- Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran
| | - Shahin Merat
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobilliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Jafari
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobilliary Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Islami
- Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA 30303
| | - Shahryar Semnani
- Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran
| | - Paul DP Pharoah
- Departments of Oncology and Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Paolo Boffetta
- The Tisch Cancer Institute and Institute for Translational Epidemiology, Ichan School of Medicine at Mount Sinai, New York, NY 10029
| | - Sanford M. Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD 20850
| |
Collapse
|
26
|
Platt DE, Hariri E, Salameh P, Helou M, Sabbah N, Merhi M, Chammas E, Ammar W, Abchee AB, Zalloua PA. Association of waterpipe smoking with myocardial infarction and determinants of metabolic syndrome among catheterized patients. Inhal Toxicol 2017; 29:429-434. [PMID: 29064301 DOI: 10.1080/08958378.2017.1384085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Daniel E. Platt
- Bioinformatics and Pattern Discovery, IBM T. J. Watson Research Centre, Yorktown Heights, NY, USA
| | - Essa Hariri
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Pascale Salameh
- School of Pharmacy, Lebanese American University, Byblos, Lebanon
| | - Mariana Helou
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Nada Sabbah
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Mahmoud Merhi
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Elie Chammas
- Department of Cardiology, Clemenceau Medical Center, Beirut, Lebanon
| | | | | | - Pierre A. Zalloua
- School of Medicine, Lebanese American University, Beirut, Lebanon
- Harvard School of Public Health, Boston, MA, USA
| |
Collapse
|
27
|
Khandker NN, Biswas T, Khan ANS, Hasib E, Rawal LB. Socio-demographic characteristics and tobacco use among the adults in urban slums of Dhaka, Bangladesh. Tob Induc Dis 2017; 15:26. [PMID: 28484362 PMCID: PMC5420145 DOI: 10.1186/s12971-017-0131-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 04/21/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Use of tobacco has become one of the major causes of premature deaths in most developing countries, including Bangladesh. The poorest and most disadvantaged populations, such as those living in slums, are considered to be extremely vulnerable to non-communicable diseases and their risk factors, especially tobacco use. The objective of this study was to assess the current status of tobacco consumption among slum dwellers and its association with socio-demographic factors. METHODS A cross-sectional study was conducted in three slums of Dhaka city. Information about tobacco use as well as socio-demographic characteristics was collected from adult slum dwellers via face to face interviews using WHO STEPS questionnaire. RESULT Overall proportion of smoking, smokeless tobacco consumption and dual use of tobacco was 35% [95% CI: 31.6-39.8], 40.6% [95% CI: 36.5-45.2] and 12% [95% CI: 9.3-15.0] respectively. Elderly people (55-64 years) were more likely to smoke (OR: 2.34, 95% CI: 1.21-4.49) than younger people (aged 25-34 years). On the other hand, those who had no schooling history (OR: 2.95, 95% CI: 1.66-5.25) were more likely to consume smokeless tobacco than those who had higher education (secondary or above). At the same time, manual workers were more likely to indulge in dual use of tobacco (OR: 5.17, 95% CI: 2.82-9.48) as compared to non-manual workers. CONCLUSION The urban slum population of Dhaka city has a high prevalence of tobacco use, which increases their likelihood of developing non-communicable diseases. Proper attention needs to be directed towards addressing the risk factors related to non-communicable diseases within this vulnerable population.
Collapse
Affiliation(s)
| | - Tuhin Biswas
- Health Systems and Population Studies Division, icddr, b Level 5, 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Abdullah Nurus Salam Khan
- Health Systems and Population Studies Division, icddr, b Level 5, 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Enamul Hasib
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Lal B Rawal
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Health Systems and Population Studies Division, icddr, b Level 5, 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| |
Collapse
|
28
|
Ali M, Jawad M. Health Effects of Waterpipe Tobacco Use: Getting the Public Health Message Just Right. Tob Use Insights 2017; 10:1179173X17696055. [PMID: 28579844 PMCID: PMC5428225 DOI: 10.1177/1179173x17696055] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/06/2017] [Indexed: 12/22/2022] Open
Abstract
Many public health messages benchmark the harms of waterpipe tobacco against those of cigarettes, usually using numerical magnitudes of risk. This approach, although well intentioned, could be perceived as alarmist, damaging scientific credibility, and giving an unintended impression that one tobacco product is less harmful than the other. This commentary makes clear the harm waterpipe tobacco smoking poses to public health by describing its mechanism of use, consumption uptake, toxicologic profile, and documented health outcomes, as well as challenge existing thinking that toxicologic assessments are the most appropriate way to frame waterpipe tobacco health promotion messages. How can we describe the health effects of waterpipe tobacco without undermining its toxicity nor falling into the temptation of alarmist messaging? Several recommendations are provided.
Collapse
Affiliation(s)
| | - Mohammed Jawad
- Department of Primary Care and Public Health, Imperial College London, London, UK
| |
Collapse
|
29
|
Abstract
PURPOSE OF REVIEW Smoking tobacco using a water pipe is becoming more prevalent globally, particularly amongst younger populations. In addition to its growing popularity, more evidence is emerging regarding associated harm, and several misconceptions exist concerning the likely adverse health effects of waterpipe smoking (WPS). It is timely, therefore, to examine the body of evidence linking WPS to coronary artery disease (CAD). Here, we review the direct evidence linking WPS to CAD and examine additional, indirect evidence of associated harm. We discuss the clinical and public health implications of the current evidence and provide suggestions for further research. RECENT FINDINGS A multicentre case-control study in Lebanon has recently demonstrated an association between WPS and CAD. There are few prior studies making this direct link. However, a large body of evidence has emerged showing close similarities between WPS and cigarette smoking with regard to the toxicity of smoke and acute inflammatory and haemodynamic effects following exposure to it. SUMMARY There are consistent similarities between WPS and cigarette smoking in regard to association with CAD, the nature of the smoke produced, and the acute haemodynamic effects and inflammatory responses that follow exposure. These findings justify both public health and clinical interventions to reduce WPS. Further studies are warranted to confirm a causal association between WPS and CAD.
Collapse
Affiliation(s)
- Mohamad Musbah Almedawar
- aVascular Medicine Program, American University of Beirut Medical Centre, Beirut, Lebanon bDivision of Vascular Endothelium and Microcirculation, Department of Medicine III, TU Dresden, Dresden, Germany *Mohamad Musbah Almedawar and Jason Leo Walsh contributed equally to the writing of this article
| | | | | |
Collapse
|
30
|
Wu F, Chen Y, Demmer RT, Parvez F, Paul RR, Shaheen I, Sarwar G, Ahmed A, Eunus M, Ahsan N, Habibullah NM, Islam T, Rundek T, Ahsan H, Desvarieux M. Periodontal diseases and carotid intima-media thickness in Bangladesh. J Clin Periodontol 2016; 43:909-917. [PMID: 27394059 DOI: 10.1111/jcpe.12597] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2016] [Indexed: 12/17/2022]
Abstract
AIM To evaluate the relationship between periodontal diseases and subclinical atherosclerosis in a younger and lean South Asian population. METHODS We conducted a cross-sectional study in 917 subjects (mean age 46 years and mean body mass index 21.1 kg/m2 ) from the Health Effects of Arsenic Longitudinal Study in Bangladesh. Multivariate linear regression models were used to assess the associations between multiple clinical measures of periodontal diseases and carotid intima-media thickness (IMT). RESULTS Mean attachment loss (AL) and percentage of sites with AL ≥ 4 mm (% AL ≥ 4) were associated with increased IMT. The IMT was 20.0-μm (95% CI: 2.2, 37.8) and 26.5-μm (95% CI: 8.9, 44.1) higher in subjects in the top quartile of mean AL (>3.72 mm) and % AL ≥ 4 (>58.4%), respectively, compared to those in the bottom quartile. In a subset of 366 subjects, mean AL was positively associated with plasma levels of matrix metalloproteinase-9 (p < 0.05) and soluble intercellular adhesion molecule-1 (p < 0.01). CONCLUSIONS Attachment loss was associated with subclinical atherosclerosis in this young and lean Bangladeshi population. Future prospective studies are needed to confirm this association.
Collapse
Affiliation(s)
- Fen Wu
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Yu Chen
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, USA.
| | - Ryan T Demmer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Faruque Parvez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | | | - Golam Sarwar
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | | | - Mahbub Eunus
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Nafiz Ahsan
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | | | - Tariqul Islam
- U-Chicago Research Bangladesh, Ltd., Dhaka, Bangladesh
| | - Tatjana Rundek
- Departments of Neurology and Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Habibul Ahsan
- Department of Health Studies, Center for Cancer Epidemiology and Prevention, The University of Chicago, Chicago, IL, USA
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| |
Collapse
|
31
|
Mamtani R, Cheema S, Sheikh J, Al Mulla A, Lowenfels A, Maisonneuve P. Cancer risk in waterpipe smokers: a meta-analysis. Int J Public Health 2017; 62:73-83. [PMID: 27421466 DOI: 10.1007/s00038-016-0856-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 05/16/2016] [Accepted: 07/08/2016] [Indexed: 01/08/2023] Open
Abstract
Objectives To quantify by meta-analysis the relationship between waterpipe smoking and cancer, including cancer of the head and neck, esophagus, stomach, lung and bladder. Methods We performed a systematic literature search to identify relevant studies, scored their quality, used fixed and random-effect models to estimate summary relative risks (SRR), evaluated heterogeneity and publication bias. Results We retrieved information from 28 published reports. Considering only highquality studies, waterpipe smoking was associated with increased risk of head and neck cancer (SRR 2.97; 95 % CI 2.26–3.90), esophageal cancer (1.84; 1.42–2.38) and lung cancer (2.22; 1.24–3.97), with no evidence of heterogeneity or publication bias. Increased risk was also observed for stomach and bladder cancer but based mainly on poor-quality studies. For colorectum, liver and for all sites combined risk estimates were elevated, but there were insufficient reports to perform a meta-analysis. Conclusions Contrary to the perception of the relative safety of waterpipe smoking, this meta-analysis provides quantitative estimates of its association with cancers of the head and neck, esophagus and lung. The scarcity and limited quality of available reports point out the need for larger carefully designed studies in well-defined populations.
Collapse
|
32
|
Haddad L, Kelly DL, Weglicki LS, Barnett TE, Ferrell AV, Ghadban R. A Systematic Review of Effects of Waterpipe Smoking on Cardiovascular and Respiratory Health Outcomes. Tob Use Insights 2016; 9:13-28. [PMID: 27398028 PMCID: PMC4934173 DOI: 10.4137/tui.s39873] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Waterpipe smoking (WPS) is a social custom common in many Middle Eastern, North African, and Asian countries and has become increasingly popular in the US, especially among youth; however, WPS smoking may be increasing in the US adult population as well. There is a common belief among waterpipe (WP) smokers that WPS is less harmful than smoking cigarettes. Thus, this review aims to systematically explore the literature on the effects of WP tobacco smoking with a particular focus on cardiovascular and respiratory health outcomes as well as on oxidative stress, immunity, and cell cycle interference health outcomes. METHODOLOGY We conducted a systematic review, guided by the criteria of The Preferred Reporting Items for Systematic Reviews and Meta-Analyses, using the following online databases MEDLINE, CINAHL, ScienceDirect, PMC, and Cochrane Library. Results were summarized qualitatively. RESULTS Forty studies met the inclusion criteria established for this review. Based on the existing evidence, several cardiovascular and respiratory physiologic health indicators and conditions have been shown to be negatively affected by WPS. In addition to the effects of nicotine and chemical toxicant exposures, WPS was significantly associated with an increase in heart rate, blood pressure, and lower pulmonary function test results, as well as a number of health conditions such as lung cancer, alterations in oxidative stress, immunity, and cell cycle interference. CONCLUSION The current literature provides evidence that WPS is associated with a number of negative health indicators and outcomes. There is need for more research related to WPS and its effects on health so that appropriate campaigns and prevention interventions can be implemented to control the epidemic increase of WPS in the US.
Collapse
Affiliation(s)
- Linda Haddad
- Associate Dean for Academic Affairs, College of Nursing, University of Florida, Gainesville, FL, USA.,CORRESPONDENCE:
| | - Debra Lynch Kelly
- Assistant Professor, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Linda S. Weglicki
- Professor and Schmidt Family Foundation Distinguished Professor, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Tracey E. Barnett
- Associate Professor, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | | | - Roula Ghadban
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
33
|
Saha N, Rahman MS, Jolly YN, Rahman A, Sattar MA, Hai MA. Spatial distribution and contamination assessment of six heavy metals in soils and their transfer into mature tobacco plants in Kushtia District, Bangladesh. Environ Sci Pollut Res Int 2016; 23:3414-26. [PMID: 26490917 DOI: 10.1007/s11356-015-5575-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 10/07/2015] [Indexed: 05/24/2023]
Abstract
Although the tobacco production and consumption rate in Bangladesh is very high and a substantial portion of premature deaths is caused by tobacco smoking, the status of heavy metals in tobacco plants has not yet determined. This study, therefore, investigated the concentrations of Cu, Ni, Cd, Pb, Cr, and Zn in tobacco plants and their surrounding agricultural soils in Kushtia District, Bangladesh. The geochemical maps showed a similar spatial distribution pattern of the analyzed metals and identified Shempur, Kharara, Taragunia, and Shantidanga as metal hot spots. Geoanalytical indexes were applied to assess the extent of soil contamination, and the results depicted that the soils of Shempur, Kharara, Taragunia, and Shantidanga were moderately contaminated where Cd contributed the most to contamination degree (C d) in spite of its relative low content. However, other five areas in Kushtia District were suggested as uncontaminated according to both C d and pollution load index (PLI). The hazard quotient (HQ) and hazard index (HI) showed no possible indication of human health risks via ingestion of agricultural soils. This study also determined that human activities such as excess application of commercial fertilizers, animal manures, and metal-based pesticides were the sources of Cu, Ni, Cd, and Cr enrichment in soils and that the metals into tobacco plants were transported from the soils. The present study conclusively suggested that regulation of improper use of agrochemicals and continuous monitoring of heavy metals in tobacco plants are needed to reduce the tobacco-related detrimental health problems in Bangladesh.
Collapse
Affiliation(s)
- Narottam Saha
- Department of Applied Chemistry and Chemical Technology, University of Rajshahi, Rajshahi, 6205, Bangladesh.
- School of Earth Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
| | - M Safiur Rahman
- Environmental Analytical Chemistry Laboratory, NRCD, Institute of Nuclear Science and Technology, BAEC, GPO Box 3787, Dhaka, 1000, Bangladesh.
- Atmospheric and Environmental Chemistry Laboratory, Atomic Energy Center, BAEC, 4-Kazi Nazrul Islam Avenue, Dhaka, 1000, Bangladesh.
| | - Yeasmin Nahar Jolly
- Atmospheric and Environmental Chemistry Laboratory, Atomic Energy Center, BAEC, 4-Kazi Nazrul Islam Avenue, Dhaka, 1000, Bangladesh
| | - Atiqur Rahman
- Department of Applied Chemistry and Chemical Technology, Islamic University, Kushtia, 7003, Bangladesh
| | - M Abdus Sattar
- Department of Applied Chemistry and Chemical Technology, Islamic University, Kushtia, 7003, Bangladesh
| | - M Abdul Hai
- Department of Applied Chemistry and Chemical Technology, Islamic University, Kushtia, 7003, Bangladesh
| |
Collapse
|
34
|
Pesola GR, Argos M, Chinchilli VM, Chen Y, Parvez F, Islam T, Ahmed A, Hasan R, Rakibuz-Zaman M, Ahsan H. Dyspnoea as a predictor of cause-specific heart/lung disease mortality in Bangladesh: a prospective cohort study. J Epidemiol Community Health 2016; 70:689-95. [PMID: 26767408 DOI: 10.1136/jech-2015-206199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 12/17/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND The spectrum of mortality outcomes by cause in populations with/without dyspnoea has not been determined. The study aimed to evaluate whether dyspnoea, a symptom, predicts cause-specific mortality differences between groups. The hypothesis was that diseases that result in chronic dyspnoea, those originating from the heart and lungs, would preferentially result in heart and lung disease mortality in those with baseline dyspnoea (relative to no dyspnoea) when followed over time. METHODS A population-based sample of 11 533 Bangladeshis was recruited and followed for 11-12 years and cause-specific mortality evaluated in those with and without baseline dyspnoea. Dyspnoea was ascertained by trained physicians. The cause of death was determined by verbal autopsy. Kaplan-Meier survival curves, the Fine-Gray competing risk hazards model and logistic regression models were used to determine group differences in cause-specific mortality. RESULTS Compared to those not reporting dyspnoea at baseline, the adjusted HRs were 6.4 (3.8 to 10.7), 9.3 (3.9 to 22.3), 1.8 (1.2 to 2.8), 2.2 (1.0 to 5.1) and 2.8 (1.3 to 6.2) for greater risk of dying from chronic obstructive pulmonary disease (COPD), asthma, heart disease, tuberculosis and lung cancer, respectively. In contrast, there was a similar risk of dying from stroke, cancer (excluding lung), liver disease, accidents and other (miscellaneous causes) between the dyspnoeic and non-dyspnoeic groups. In addition, the HR was 2.1 (1.7 to 2.5) for greater all-cause mortality in those with baseline dyspnoea versus no dyspnoea. CONCLUSIONS Dyspnoea, ascertained by a single question with binary response, predicts heart and lung disease mortality. Individuals reporting dyspnoea were twofold to ninefold more likely to die of diseases that involve the heart and/or lungs relative to the non-dyspnoeic individuals. Therefore, in those with chronic dyspnoea, workup to look for the five common dyspnoeic diseases resulting in increased mortality (COPD, asthma, heart disease, tuberculosis and lung cancer), all treatable, should reduce mortality and improve the public health.
Collapse
Affiliation(s)
- Gene R Pesola
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA Section of Pulmonary/Critical Care, Department of Medicine, Harlem Hospital affiliated with Columbia University, New York, New York, USA
| | - Maria Argos
- Department of Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Vernon M Chinchilli
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Yu Chen
- Department of Environmental Sciences, NYU Langone Medical Center, New York, New York, USA
| | - Faruque Parvez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Tariqul Islam
- University of Chicago Research (URB), Ltd., Dhaka, Bangladesh
| | - Alauddin Ahmed
- University of Chicago Research (URB), Ltd., Dhaka, Bangladesh
| | - Rabiul Hasan
- University of Chicago Research (URB), Ltd., Dhaka, Bangladesh
| | | | - Habibul Ahsan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA Department of Health Sciences, University of Chicago, Chicago, Illinois, USA Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA University of Chicago Research (URB), Ltd., Dhaka, Bangladesh
| |
Collapse
|
35
|
Wu F, Parvez F, Islam T, Ahmed A, Rakibuz-Zaman M, Hasan R, Argos M, Levy D, Sarwar G, Ahsan H, Chen Y. Betel quid use and mortality in Bangladesh: a cohort study. Bull World Health Organ 2015; 93:684-692. [PMID: 26600610 PMCID: PMC4645429 DOI: 10.2471/blt.14.149484] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 05/24/2015] [Accepted: 05/29/2015] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To evaluate the potential effects of betel quid chewing on mortality. (A quid consists of betel nut, wrapped in betel leaves; tobacco is added to the quid by some users). METHODS Prospective data were available on 20 033 individuals aged 18-75 years, living in Araihazar, Bangladesh. Demographic and exposure data were collected at baseline using a standardized questionnaire. Cause of death was defined by verbal autopsy questionnaires administered to next of kin. We estimated hazard ratios (HR) and their 95% confidence intervals (CI) for associations between betel use and mortality from all causes and from specific causes, using Cox proportional hazards models. We adjusted for age, sex, body mass index, educational attainment and tobacco smoking history. FINDINGS There were 1072 deaths during an average of 10 years of follow-up. Participants who had ever used betel were significantly more likely to die from all causes (HR: 1.26; 95% CI: 1.09-1.44) and cancer (HR: 1.55; 95% CI: 1.09-2.22); but not cardiovascular disease (HR: 1.16; 95% CI: 0.93-1.43). These findings were robust to adjustment for potential confounders. There was a dose-response relationship between mortality from all causes and both the duration and the intensity of betel use. The population attributable fraction for betel use was 14.1% for deaths from all causes and 24.2% for cancer. CONCLUSION Betel quid use was associated with mortality from all causes and from cancer in this cohort.
Collapse
Affiliation(s)
- Fen Wu
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, NY 10016, United States of America (USA)
| | - Faruque Parvez
- Department of Environmental Health Sciences, Columbia University, New York, USA
| | - Tariqul Islam
- U-Chicago Research Bangladesh Ltd., Dhaka, Bangladesh
| | | | | | - Rabiul Hasan
- U-Chicago Research Bangladesh Ltd., Dhaka, Bangladesh
| | - Maria Argos
- Department of Health Studies, University of Chicago, Chicago, USA
| | - Diane Levy
- Department of Environmental Health Sciences, Columbia University, New York, USA
| | - Golam Sarwar
- U-Chicago Research Bangladesh Ltd., Dhaka, Bangladesh
| | - Habibul Ahsan
- Department of Health Studies, University of Chicago, Chicago, USA
| | - Yu Chen
- Department of Population Health, New York University School of Medicine, 650 First Avenue, New York, NY 10016, United States of America (USA)
| |
Collapse
|
36
|
Iqbal R, Jahan N, Hanif A. Epidemiology and Management Cost of Myocardial Infarction in North Punjab, Pakistan. Iran Red Crescent Med J 2015; 17:e13776. [PMID: 26421164 PMCID: PMC4583611 DOI: 10.5812/ircmj.13776v2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 01/20/2014] [Accepted: 02/22/2015] [Indexed: 12/26/2022]
Abstract
Background: Coronary heart disease (CHD) is an important cause of morbidity and mortality in Pakistan. The temporal trends in the risk factors for myocardial infarction (MI) and the impact of socioeconomic status on these risk factors remain ambiguous. Objectives: The objectives of the present analysis were to investigate the potential association between various risk factors and MI in North Punjab, Pakistan, and to assess the status of the control of the risk factors associated with MI in this population. Patients and Methods: The present study included 515 patients admitted to the coronary care units or equivalent cardiology wards of the participating hospitals between 2011 and 2012 in North Punjab, Pakistan. The analysis was focused on identifying the socioeconomic status, lifestyle, family history of MI, and risk factors (i.e. hypertension, diabetes, smoking, and hyperlipidemia). A structured questionnaire was designed to collect data. The lipid profile was recorded from the investigation chart of every patient. For statistical analysis, the Kruskal Wallis, Mann-Whitney U, Wilcoxon, and chi-square tests were used. Results: MI was common in the males at the age of 41 - 60 years as compared to the females (P = 0.015). Patients with a positive parental history of CHD experienced MI at a younger age (P = 0.0001) at a body mass index (BMI) ≤ 25 kg/m2. Sedentary lifestyle (70%) and smoking (60%) had a male predominance. Hypertension accounted for nearly 37%, hyperlipidemia 26%, and diabetes 19.4% of the rural and urban subjects (P < 0.01). High-density lipoprotein cholesterol decreased (up to 34 mg/dl), while low-density lipoprotein cholesterol and hypertension increased with age. The mean monthly cost of medicines and physicians’ fees per patient was 2381.132 Pakistani Rupees (24.24 USD). Conclusions: Higher BMI, positive family history, smoking, hypertension, hyperlipidemia, and diabetes were the strong predictors of MI in North Punjab, Pakistan. Preventive efforts are needed to start early in life and continue throughout the life course.
Collapse
Affiliation(s)
- Riffat Iqbal
- Department of Zoology, Government College University, Lahore, Pakistan
- Corresponding Author: Riffat Iqbal, Department of Zoology, Government College University, Lahore, Pakistan. Tel: +92-3327272842, E-mail:
| | - Nusrat Jahan
- Department of Zoology, Government College University, Lahore, Pakistan
| | - Atif Hanif
- Department of Botany and Microbiology, College of Sciences, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
37
|
McClintock TR, Parvez F, Wu F, Islam T, Ahmed A, Rani Paul R, Shaheen I, Sarwar G, Rundek T, Demmer RT, Desvarieux M, Ahsan H, Chen Y. Major dietary patterns and carotid intima-media thickness in Bangladesh. Public Health Nutr 2016; 19:218-29. [PMID: 25958860 DOI: 10.1017/S136898001500124X] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Carotid intima-media thickness (IMT) is a validated surrogate marker of preclinical atherosclerosis and is predictive of cardiovascular morbidity and mortality. Research on the association between IMT and diet, however, is lacking, especially in low-income countries or low-BMI populations. DESIGN Cross-sectional analysis. Dietary intakes were measured using a validated, thirty-nine-item FFQ at baseline cohort recruitment. IMT measurements were obtained from 2010-2011. SETTING Rural Bangladesh. SUBJECTS Participants (n 1149) randomly selected from the Health Effects of Arsenic Longitudinal Study, an ongoing, population-based, prospective cohort study established in 2000. Average age at IMT measurement was 45·5 years. RESULTS Principal component analysis of reported food items yielded a 'balanced' diet, an 'animal protein' diet and a 'gourd and root vegetable' diet. We observed a positive association between the gourd/root vegetable diet and IMT, as each 1 sd increase in pattern adherence was related to a difference of 7·74 (95 % CI 2·86, 12·62) μm in IMT (P<0·01), controlling for age, sex, total energy intake, smoking status, BMI, systolic blood pressure and diabetes mellitus diagnoses. The balanced pattern was associated with lower IMT (-4·95 (95 % CI -9·78, -0·11) μm for each 1sd increase of adherence; P=0·045). CONCLUSIONS A gourd/root vegetable diet in this Bangladeshi population positively correlated with carotid IMT, while a balanced diet was associated with decreased IMT.
Collapse
|
38
|
Dalinjong PA, Welaga P, Azongo DK, Chatio S, Anaseba D, Kondayire F, Akazili J, Debpuur C, Oduro AR. A retrospective analysis of the association between tobacco smoking and deaths from respiratory and cardiovascular diseases in the Kassena-Nankana districts of Northern Ghana. Tob Induc Dis 2015; 13:12. [PMID: 25937824 PMCID: PMC4416277 DOI: 10.1186/s12971-015-0037-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 04/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco use is a public health problem, responsible for approximately six million deaths annually worldwide. It is a risk factor for many diseases including cancers, respiratory and cardiovascular diseases. In low-and middle-income countries, respiratory and cardiovascular diseases are important causes of death. Tobacco use is prevalent in Ghana, but no study had examined the relationship between tobacco use and deaths from respiratory and cardiovascular diseases in the Upper East Region of Northern Ghana. Hence the paper assessed the association between tobacco use and deaths from respiratory and cardiovascular diseases in that region. METHODS The study used verbal autopsy data collected from the Kassena-Nankana East and West districts of the Upper East Region of Northern Ghana. Data from deceased individuals aged 15 to 59 years whose deaths occurred between January 1, 2004 and December 31, 2011 and with a known cause as well as smoking status were analyzed. Two binary outcome variables were generated from the cause of death data; whether an individual died from respiratory diseases or not, and from cardiovascular diseases or not. Multiple logistic regression models were used to assess the relationship between tobacco use and deaths from respiratory and cardiovascular diseases. RESULTS Out of 3,492 deaths with a known cause of death and smoking status, a third of them smoked. About 16.6% of smokers and 8.1% of non-smokers died from respiratory diseases. Approximately, 10.7% of smokers died from cardiovascular diseases compared to 10.6% of non-smokers. In multivariate analyses, individuals with a history of smoking had two-fold increased odds [OR=2.18, 95% CI (1.6-2.9)] of dying from respiratory diseases. Besides, the number of years of smoking as well as the frequency of smoking is significantly associated with deaths from respiratory diseases. No association existed between tobacco use and deaths from cardiovascular diseases. CONCLUSIONS Within our study we identified a strong relationship between tobacco use and deaths from respiratory diseases, but not an association with deaths from cardiovascular diseases. Our findings highlight the need to make appropriate health interventions to control tobacco use and thus help reduce premature deaths from respiratory and other tobacco linked diseases.
Collapse
Affiliation(s)
- Philip Ayizem Dalinjong
- Navrongo Health Research Center, Ghana Health Service, Post Office Box 114, Navrongo, Ghana Africa
| | - Paul Welaga
- Navrongo Health Research Center, Ghana Health Service, Post Office Box 114, Navrongo, Ghana Africa
| | - Daniel K Azongo
- Navrongo Health Research Center, Ghana Health Service, Post Office Box 114, Navrongo, Ghana Africa
| | - Samuel Chatio
- Navrongo Health Research Center, Ghana Health Service, Post Office Box 114, Navrongo, Ghana Africa
| | - Dominic Anaseba
- Navrongo Health Research Center, Ghana Health Service, Post Office Box 114, Navrongo, Ghana Africa
| | - Felix Kondayire
- Navrongo Health Research Center, Ghana Health Service, Post Office Box 114, Navrongo, Ghana Africa
| | - James Akazili
- Navrongo Health Research Center, Ghana Health Service, Post Office Box 114, Navrongo, Ghana Africa
| | - Cornelius Debpuur
- Navrongo Health Research Center, Ghana Health Service, Post Office Box 114, Navrongo, Ghana Africa
| | - Abraham Rexford Oduro
- Navrongo Health Research Center, Ghana Health Service, Post Office Box 114, Navrongo, Ghana Africa
| |
Collapse
|
39
|
Abstract
OBJECTIVE It is widely held that waterpipe smoking (WPS) is not associated with health hazards. However, several studies have documented the uptake of several toxicants and carcinogens during WPS that is strongly associated with harmful health effects. This paper reviews the literature on the health effects of WPS. DATA SOURCES Three databases-PubMed, MEDLINE and EMBASE-were searched until August 2014 for the acute and long-term health effects of WPS using the terms 'waterpipe' and its synonyms (hookah, shisha, goza, narghileh, arghileh and hubble-bubble) in various spellings. STUDY SELECTION We included original clinical studies, case reports and systematic reviews and focused on clinical human studies. ∼10% of the identified studies met the selection criteria. DATA EXTRACTION Data were abstracted by all three authors and summarised into tables. Abstracted data included study type, results and methodological limitations and were analysed jointly by all three authors. DATA SYNTHESIS WPS acutely leads to increased heart rate, blood pressure, impaired pulmonary function and carbon monoxide intoxication. Chronic bronchitis, emphysema and coronary artery disease are serious complications of long-term use. Lung, gastric and oesophageal cancer are associated with WPS as well as periodontal disease, obstetrical complications, osteoporosis and mental health problems. CONCLUSIONS Contrary to the widely held misconception, WPS is associated with a variety of adverse short-term and long-term health effects that should reinforce the need for stronger regulation. In addition, this review highlights the limitations of the published work, which is mostly cross-sectional or retrospective. Prospective studies should be undertaken to assess the full spectrum of health effects of WPS, particularly in view of its growing popularity and attractiveness to youth.
Collapse
Affiliation(s)
- Ziad M El-Zaatari
- Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon
| | - Hassan A Chami
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon Boston University School of Medicine, Boston, Massachusetts, USA
| | - Ghazi S Zaatari
- Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
40
|
Abstract
![]()
The
prevalence of noncigarette tobacco product use is on the rise
across the globe, especially for waterpipes (also known as hookah,
narghile, and shisha) and electronic cigarettes (e-cigarettes). The
scientific literature reveals that waterpipe tobacco smoking is associated
with exposure to a variety of toxicants that can cause short- and
long-term adverse health events. In contrast, there is far less evidence
of health harms related to e-cigarette use, although the variety of
products in this category makes it difficult to generalize. We searched
the PubMed database for all publications on waterpipes and e-cigarettes
from January 2000 to March 2014. The number of publications on waterpipes
rose in a slow, linear pattern during this time, while the number
of publications on e-cigarettes showed exponential growth. The different
trends suggest there may be more interest in studying a novel nicotine
product (the e-cigarette) over a traditional tobacco product (the
waterpipe). We posit that, although the specific research needs for
these products are different, public health would be served best by
a more equitable research approach. Scientists should continue to
devote attention to understanding the unknown long-term health effects
of e-cigarettes and their potential to serve as harm reduction or
smoking cessation tools while simultaneously investigating how to
reduce waterpipe smoking given that it exposes users to toxicants
known to cause harm to health. Recent regulatory action in the United
States, which proposes to include waterpipes and e-cigarettes under
some of the same regulations as tobacco cigarettes, makes such research
particularly timely.
Collapse
Affiliation(s)
- Jessica K Pepper
- Center for Regulatory Research on Tobacco Communication, Lineberger Comprehensive Cancer Center, University of North Carolina , 319D Rosenau Hall, CB #7400, Chapel Hill, North Carolina 27599, United States
| | | |
Collapse
|
41
|
Chen Y, Ge W, Parvez F, Bangalore S, Eunus M, Ahmed A, Islam T, Rakibuz-Zaman M, Hasan R, Argos M, Levy D, Sarwar G, Ahsan H. A prospective study of arm circumference and risk of death in Bangladesh. Int J Epidemiol 2014; 43:1187-96. [PMID: 24713183 DOI: 10.1093/ije/dyu082] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Epidemiological studies have observed protective effects of mid-upper arm circumference (MUAC) against all-cause mortality mostly in Western populations. However, evidence on cause-specific mortality is limited. METHODS The sample included 19 575 adults from a population-based cohort study in rural Bangladesh, who were followed up for an average of 7.9 years for mortality. Cox proportional hazards regression was used to evaluate the effect of MUAC, as well as the joint effect of body mass index (BMI) and MUAC, on the risk of death from any cause, cancer and cardiovascular disease (CVD). RESULTS During 154 664 person-years of follow-up, 744 deaths including 312 deaths due to CVD and 125 deaths due to cancer were observed. There was a linear inverse relationship of MUAC with total and CVD mortality. Each 1-cm increase in MUAC was associated a reduced risk of death from any cause [hazard ratio (HR) = 0.85; 95% confidence interval (C), 0.81-0.89) and CVD (HR = 0.87; 95% CI, 0.80-0.94), after controlling for potential confounders. No apparent relationship between MUAC and the risk of death from cancer was observed. Among individuals with a low BMI (<18.5 kg/m(2)), a MUAC less than 24 cm was associated with increased risk for all-cause (HR = 1.81; 95% CI, 1.52-2.17) and CVD mortality (HR = 1.45; 95% CI, 1.11-1.91). CONCLUSIONS MUAC may play a critical role on all-cause and CVD mortality in lean Asians.
Collapse
Affiliation(s)
- Yu Chen
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Wenzhen Ge
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Faruque Parvez
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Sripal Bangalore
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Mahbub Eunus
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Alauddin Ahmed
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Tariqul Islam
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Muhammad Rakibuz-Zaman
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Rabiul Hasan
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Maria Argos
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Diane Levy
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Golam Sarwar
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| | - Habibul Ahsan
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, USA, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, USA, Leon H Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, USA, Columbia University Arsenic Research Project, Dhaka, Bangladesh, Departments of Health Studies, Medicine and Human Genetics and Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA and Department of Biostatistics, Mailman School of Public Health, Columbia University, New York City, USA
| |
Collapse
|
42
|
Argos M, Tong L, Pierce BL, Rakibuz-Zaman M, Ahmed A, Islam T, Rahman M, Paul-Brutus R, Rahaman R, Roy S, Jasmine F, Kibriya MG, Ahsan H. Genome-wide association study of smoking behaviours among Bangladeshi adults. J Med Genet 2014; 51:327-33. [PMID: 24665060 DOI: 10.1136/jmedgenet-2013-102151] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The high prevalence of tobacco use in some developing nations, including Bangladesh, poses several public health challenges for these populations. Smoking behaviour is determined by genetic and environmental factors; however, the genetic determinants of smoking behaviour have not been previously examined in a Bangladeshi or South Asian population. We performed a genome-wide association study (GWAS) of tobacco smoking behaviour among a population-based sample of 5354 (2035 ever smokers and 3319 never smokers) men and women in Bangladesh. METHODS Genome-wide association analyses were conducted for smoking initiation (ever vs never smokers), smoking quantity (cigarettes per day), age of smoking initiation, and smoking cessation (former vs current smokers). Sex-stratified associations were performed for smoking initiation. RESULTS We observed associations for smoking initiation in the SLC39A11 region at 17q21.31 (rs2567519, p=1.33×10⁻⁷) among men and in the SLCO3A1 region at 15q26 (rs12912184, p=9.32×10⁻⁸) among women. CONCLUSIONS These findings suggest possible underlying mechanisms related to solute carrier transporter genes, which transport neurotransmitters, nutrients, heavy metals and other substrates into cells, for smoking initiation in a South Asian population in a sex-specific pattern. Genetic markers could have potential translational implications for the prevention or treatment of tobacco use and addiction in South Asian populations and warrant further exploration.
Collapse
Affiliation(s)
- Maria Argos
- Department of Health Studies, The University of Chicago, Chicago, Illinois, USA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Goon S, Bipasha MS. Prevalence and Pattern of Smoking among Bus Drivers of Dhaka, Bangladesh. Tob Use Insights 2014; 7:21-5. [PMID: 25741182 PMCID: PMC4335464 DOI: 10.4137/tui.s13966] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/13/2014] [Accepted: 02/14/2014] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Smoking is an increasingly prevalent habit in Bangladesh, particularly among men with low socioeconomic status. AIM The aim of this study was determining the prevalence and pattern of smoking among bus drivers of Dhaka city, Bangladesh. METHODS A cross-sectional study was carried out from 15 to 26 March 2013 among four hundred bus drivers of Dhaka city, Bangladesh aged between 18 and 50 determining the prevalence, pattern, and socioeconomic determinants of smoking. Data were input into a pre-designed access database with data management and analysis using standard statistical tools (SPSS-15) to assess significance through cross-tabulation. RESULTS The overall prevalence of smoking among bus drivers was 93%, and 20% of their daily income was spent on smoking. Though most (32.3%) of the drivers started smoking before involving in driving profession, but excessive smoking had been promoted by occupational and environmental stress experiencing hectic work schedule. Individuals with no education were three times (odds ratio (OR) 2.8; 95% CI 1.2-6.13) more likely to be smoker. Smoking was detected among 53.2% of smokers aged 26 or above (χ (2) = 8.30, P < 0.05), and they showed significantly high prevalence. The reasons behind smoking were almost exclusively habit (38.1%), peer influence (26.8%), and thinking of stress relief (25.3%). Smoking can also worsen poverty among users and their families because most of the drivers reported chest pain (34.4%), heart disease (25.8%), and other health complications caused by smoking depriving families of much-needed income and imposing additional costs of health care. CONCLUSION Interventions and preventions by policy makers, public health experts, and other stakeholders should be introduced considering high prevalence of smoking among Bangladeshi bus drivers with detrimental health sequel.
Collapse
Affiliation(s)
- Shatabdi Goon
- Department of Nutrition and Food Engineering, Faculty of Allied Health Science, Daffodil International University, Dhaka, Bangladesh
| | - Munmun S Bipasha
- Business Administration Department, Faculty of Business and Economics, Daffodil International University, Dhaka, Bangladesh
| |
Collapse
|
44
|
Abstract
The hookah is a snuff smoking device whose origin dates back to the fifteenth century, has been used extensively in the Middle East in recent decades has become popular in Western culture countries, particularly in Americas and Europe. It has been reported that like other forms smoking tobacco, their use can lead to addiction also is used for inhaling and other addictive substances. Has also been considered a risk factor for various isolated diseases, including chronic obstructive pulmonary disease (COPD), different types of cancer, hemodynamic alterations, vascular disease, infectious diseases, among others. In pregnant women has been reported that there use condition a diminution on fetal growth and different diseases in the newborn. It was also mentioned that hookah smoke contains several toxic substances that can affect both, the primary and the passive smoker, so we did this review to determine the complications associated with its use.
Collapse
Affiliation(s)
- Ruben Blachman-Braun
- Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Av. Universidad Anahuac No. 46, Col. Lomas Anáhuac, Huixquilucan, Edo. de México C.P. 52786, Mexico
| | - Raquel Lira Del Mazo-Rodríguez
- Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Av. Universidad Anahuac No. 46, Col. Lomas Anáhuac, Huixquilucan, Edo. de México C.P. 52786, Mexico
| | - Gustavo López-Sámano
- Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Av. Universidad Anahuac No. 46, Col. Lomas Anáhuac, Huixquilucan, Edo. de México C.P. 52786, Mexico
| | - Ivette Buendía-Roldán
- Instituto Nacional de Enfermedades Respiratorias, Calzada de Tlalpan 4502, sección XVI, Del. Tlalpan, CP14080 México, D.F., Mexico.
| |
Collapse
|