Experimentation with tobacco during adolescence as a factor influencing treatment of smoking in adulthood. A retrospective cohort

The first day of smoking abstinence is more challenging for women than men: A meta-analysis and meta-regression across 12 low- and middle-income countries

BACKGROUND

Maintained abstinence during the first 24 h of a quit attempt is a critical predictor of long-term smoking cessation. Little is known about sex differences in the very early abstinence period, particularly in the context of low- and middle-income countries (LMICs) with varying anti-smoking policies and female smoking prevalences. We examined female sex effects on one-day relapse in a cross-national sample from 12 LMICs.

METHODS

Data from the Global Adult Tobacco Survey (2008-2012) included nationally representative samples from 12 LMICs restricted to smokers with ≥ 1 quit attempt in the past 12 months (n = 16,576). We ran adjusted logistic regression models for female sex effects on one-day relapse, adjusting for nine individual-level demographics (e.g., age, education, age at smoking initiation) and smoking cessation variables (e.g., exposure to health warnings, receipt of counseling). We then conducted a meta-analysis adjusted for national-level and policy measures through meta-regression (e.g., cigarette consumption per capita, percent of cigarette box covered with warning labels).

RESULTS

One-day relapse prevalence varied across countries (2.7-13.6%). The odds of one-day relapse were significantly higher for women than for men in six countries (adjusted for nine individual-level sociodemographic variables), and there were no significant sex differences in the remaining six countries. Result remained significant after meta-regressions for national-level tobacco consumption and policy measures. Sensitivity analyses showed that the odds of one-day relapse for women remained significant when excluding countries with both higher and lower relative rates of female smoking. Larger warning labels on cigarette packs were associated with reduced odds of one-day relapse among women.

CONCLUSION

The first day of a quit attempt is more challenging for women than men in LMICs. Tailored interventions incorporating national policies, in addition to counseling and pharmacotherapy, could play an essential role in supporting women during the initial abstinence phase of smoking cessation in LMICs.

Patterns of six behaviors and psychosomatic symptoms in adolescents: A six-province study in China

BACKGROUND

Psychosomatic symptoms are often related with behaviors. However, the association between different behaviors and their latent patterns and psychosomatic health status is unclear. Current study aimed to identify the patterns of six behaviors and explore the association between different patterns and psychosomatic symptoms in a school-based sample of Chinese adolescents.

METHODS

From November 2015 to January 2016, the study enrolled 22,628 students from six cities in China (15.36 ± 1.79 years). Six behaviors [unintentional injury (UI), non-suicidal self-injury (NSSI), suicidal behaviors (SB), drinking, smoking, screen time (ST)] and psychosomatic symptoms (psychological and physical symptoms) were measured by self-report validated questionnaires.

RESULTS

Six behaviors were all related to psychosomatic symptoms, among which SB was the strongest. Four patterns of behaviors were be identified as follows: low-risk pattern (64.0%), substance use pattern (4.5%), injury pattern (28.8%) and high-risk pattern (2.7%). Logistic regression analysis of psychological symptoms indicated that compared with low-risk pattern, high-risk pattern had the highest risk, followed by injury pattern, substance use pattern showed the lowest risk. Compared with low-risk pattern, the results of physical symptoms suggested the degree of risk was high-risk pattern, injury pattern and substance use pattern, respectively.

LIMITATIONS

Cross-sectional data were used in the study that could not evaluate causal relationships between six behaviors and psychosomatic symptoms.

CONCLUSIONS

Six behaviors and their latent patterns are related to psychosomatic symptoms among Chinese adolescents differently, so different intervention and prevention protocol need to be taken for different patterns of adolescents.

Prospective association between use of electronic cigarettes and use of conventional cigarettes: a systematic review and meta-analysis

Objective

The aim of this systematic review and meta-analysis was to assess the association between e-cigarette use and subsequent initiation or recurrence of cigarette smoking.

Data sources

A systematic literature search was finalised on 11 November 2019 using PubMed (including MEDLINE), EMBASE, Cochrane Library, Scopus, PubMed Health, NICE Evidence Search, PROSPERO, CRD and PsycInfo.

Study selection

Studies were included if meeting the following criteria: reporting empirical results; longitudinal observational design with a minimum of 3 months of follow-up; including general population samples; allowing for the comparison between users and nonusers of e-cigarettes. Studies rated as having high risk of bias were excluded. Studies were independently assessed by at least two authors. The procedures described by PRISMA were followed, and the quality of evidence was rated using GRADE.

Data synthesis

30 longitudinal studies from 22 different cohorts assessing e-cigarette use among nonsmokers or never-smokers at baseline, and subsequent use of cigarette smoking at follow-up, were included in this review. A random-effects meta-analysis based on 89 076 participants showed a pooled unadjusted odds ratio (OR) of cigarette smoking among baseline nonsmoker e-cigarette users compared with nonusers of 4.68 (CI 3.64–6.02), while the adjusted OR was 3.37 (CI 2.68–4.24). These results were consistent irrespective of whether the outcome was measured as ever-smoking or as past 30-day smoking. The evidence was graded as moderate.

Conclusions

Use of e-cigarettes may predict the initiation or recurrence of cigarette smoking.

This meta-analysis shows that e-cigarette use increases the risk of future initiation or recurrence of cigarette smoking, even after adjusting for potential confounders, suggesting that e-cigarette use could be considered a predictor of subsequent smokinghttps://bit.ly/3buMccm

Effect of BMI on Prolonged Abstinence after Smoking Cessation Treatment: A Retrospective Cohort Study

BACKGROUND

 Despite the well-documented relationship between weight gain and poorer cessation outcomes among smokers, the role of the former (baseline) weight in smoking cessation is insufficiently investigated. We hypothesized that patients with higher baseline body mass index(BMI) have a worse prognosis in tobacco cessation.

OBJECTIVES

 This retrospective clinical cohort study aimed to investigate the role of the baseline BMI on abstinence over 12 months after participation in smoking cessation treatment conducted in a middle-income country (n = 664).

METHODS

 Data from a 6-week smoking cessation protocol performed in a Psychosocial Care Unit(CAPS) were used. The protocol included four medical consultations and six Cognitive-Behavioral Therapy(CBT) group sessions. Initially, 1,213 participants were evaluated for the study, but only the participants whose telephone contact was successful were included in the outcome analyses. The attrition rate was 45.3%. Continuous and categorical (normal, overweight, and obesity) BMI values were computed. Survival regression models were used to test the associations between BMI and the 12-month abstinence outcome. Self-report 4-week abstinence at the end of treatment was also investigated using logistic regression models.

RESULTS

 Baseline BMI had no significant effect on both short (4-week-point abstinence) and long (12-month prolonged abstinence) treatment outcomes.

CONCLUSION

 The possible influence of the baseline BMI on smoking cessation outcomes, especially considering prolonged abstinence, was not corroborated by our results. Regardless of our results, the detrimental health outcomes due to the combination of obesity/overweight and smoking justify that these subgroups of individuals be continuously targeted for adequate smoking prevention and treatment.